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Insegurança alimentar em idosos a viver na comunidade em Portugal
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RESUMO: Introdução: A insegurança alimentar é um problema de saúde pública, especialmente nas populações mais idosas. O objetivo deste trabalho é caracterizar a situação de insegurança alimentar numa amostra representativa da população idosa (65 ou mais anos) a viver na comunidade em Portugal.
Material e Métodos: Este trabalho foi baseado numa amostra de carater nacional recolhida no âmbito do projeto EpiDoC 3 - Promoting Food Security (2015 – 2016), o qual constitui a terceira avaliação do Estudo epidemiológico de coorte de Doenças Crónicas EpiDoC. A insegurança alimentar foi avaliada pela aplicação de uma escala psicométrica, adaptada da Escala de Insegurança Alimentar Brasileira. As variáveis sociodemográficas, comportamentos alimentares, doenças crónicas, gestão de doenças crónicas e o peso e altura, foram autorreportados. A qualidade de vida relacionada com a saúde foi avaliada segundo o Questionário Europeu de Qualidade de Vida, (versão validada para a população portuguesa). Foram aplicados modelos de regressão logística para determinar os odds ratios brutos e ajustadaos (idade, sexo, educação e região NUT II), sendo a variável dependente o nível de segurança alimentar.
Resultados: A prevalência de insegurança alimentar encontrada nos agregados familiares dos idosos foi de 23%. Idosos que pertenciam ao grupo etário entre os 70-74 anos (OR = 1,405;95% IC: 1,392-1,417), ao sexo feminino (OR = 1,545; 95% IC: 1,534-1,556), com menor nível de educação (0 anos vs 5-9 anos: OR = 3,355; 95% IC: 3,306-3,404), com rendimentos ≤ 500€ (OR = 4,150; 95% IC: 4,091-4,210), reportaram ser muito difícil viver com o atual rendimento (OR = 16,665; 95% IC: 16,482-16,851), que faziam menos refeições (2 vs 5 refeições/dia: OR =2,304; 95% IC: 2,260-2,350), que davem menos importância a ter uma alimentação saudável (“Nem importante, nem sem importância” OR = 3,463 95% IC: (3,279-3,657), evitavam a compra de alimentos caros (OR = 6,737 95% IC: 6,684-6,790); tinham doenças crónicas como diabetes mellitus (OR = 1.832; 95% IC 1.818-1.846), doença pulmonar (OR = 1.628; 95% IC 1.606-1.651), doença cardíaca (OR = 1.329; 95% IC 1.319-1.340), obesidade (OR = 2.609; 95% IC 2.477-2.748); que reduziram as visitas médicas (OR = 4.381; 95% IC 4.334-4.428) e a toma de medicação (OR = 5.477; 95% IC 5.422-5.532) devido a dificuldade económicas, e que apresentaram menor qualidade de vida (OR = 0.212; 95% IC 0.210-0.214) tiveram uma maior possibilidade de pertencer a agregados familiares em insegurança alimentar.
Discussão de Resultados: Os resultados do presente trabalho evidenciam que a insegurança alimentar está significativamente associada a fatores socioeconómicos, ao menor consumo de alimentos essenciais, ao evitar da aquisição de alimentos, a uma maior prevalência de doenças crónicas, a maiores dificuldades na gestão de doenças crónicas e a uma menor qualidade de vida nos idosos.
ABSTACT: Introduction: Food insecurity is a public health issue, especially in older populations. The aim of this study is to characterize the food insecurity situation in representative sample of the elderly population (65 or over) living in the community in Portugal. Methods: Data were collected from the EpiDoC3 cohort - Promoting Food Security Study (2015–2016), the third evaluation wave of the Epidemiology of Chronic Diseases Cohort Study, representative of the Portuguese adult population. Food insecurity was assessed with a psychometric scale adapted from the Brazilian Food Insecurity Scale. Data on sociodemographic variables, eating behaviors, chronic diseases, management of chronic diseases, weight and height, were self-reported. Health related quality of life was assessed using the European quality of life questionnaire (validated version for Portuguese population). Logistic regression models were conducted to determine crude and adjusted odds ratios (for age group, gender, region and education) being the dependent variable the perceived level of food security. Results: Among older adults, 23% were living in a food insecurity household. The odds of living in food insecurity households was higher for individuals among 70-74 years (OR = 1.405; 95% CI 1.392-1.417), females (OR = 1.545; 95% CI 1.534-1.556), those with lower education (OR = 3.355; 95% CI 3.306-3.404), low income (OR = 4,150; 95% CI 4.091-4.210) reporting very difficult living with the current income (OR = 16.665; 95% CI 16.482-16.851), who ate less meals (2 meals / day vs 5 meals / day: OR = 2.304; 95% CI: 2.260-2.350), less importance were given to healthy eating ("Neither important nor unimportant" OR = 3.463 95% CI: (3,279-3,657), avoided the purchase of expensive foods (OR = 6.737 95% CI: 6.684-6.790); who had chronic diseases such as diabetes mellitus (OR=1.832; 95% CI 1.818-1.846), pulmonary diseases (OR=1.628; 95% CI 1.606-1.651), dardiac disease (OR=1.329; 95% CI 1.319-1.340), obesity (OR=2.609; 95% CI 2.477-2.748); those which reduced medical visits (OR = 4.381; 95% IC 4.334-4.428), those who stop taking medication due to economic difficulties (OR =5.477; 95% IC 5.422-5.532) and those who had a lower health related quality of life (OR = 0.212; 95% IC 0.210-0.214). Discussion of results: The results of the present study show that food insecurity is significantly associated with socioeconomic factors, a lower consumption of essential foods, avoidance of food purchases, a higher prevalence of chronic diseases, a poorer management of chronic diseases and lower quality of life in the elderly.
ABSTACT: Introduction: Food insecurity is a public health issue, especially in older populations. The aim of this study is to characterize the food insecurity situation in representative sample of the elderly population (65 or over) living in the community in Portugal. Methods: Data were collected from the EpiDoC3 cohort - Promoting Food Security Study (2015–2016), the third evaluation wave of the Epidemiology of Chronic Diseases Cohort Study, representative of the Portuguese adult population. Food insecurity was assessed with a psychometric scale adapted from the Brazilian Food Insecurity Scale. Data on sociodemographic variables, eating behaviors, chronic diseases, management of chronic diseases, weight and height, were self-reported. Health related quality of life was assessed using the European quality of life questionnaire (validated version for Portuguese population). Logistic regression models were conducted to determine crude and adjusted odds ratios (for age group, gender, region and education) being the dependent variable the perceived level of food security. Results: Among older adults, 23% were living in a food insecurity household. The odds of living in food insecurity households was higher for individuals among 70-74 years (OR = 1.405; 95% CI 1.392-1.417), females (OR = 1.545; 95% CI 1.534-1.556), those with lower education (OR = 3.355; 95% CI 3.306-3.404), low income (OR = 4,150; 95% CI 4.091-4.210) reporting very difficult living with the current income (OR = 16.665; 95% CI 16.482-16.851), who ate less meals (2 meals / day vs 5 meals / day: OR = 2.304; 95% CI: 2.260-2.350), less importance were given to healthy eating ("Neither important nor unimportant" OR = 3.463 95% CI: (3,279-3,657), avoided the purchase of expensive foods (OR = 6.737 95% CI: 6.684-6.790); who had chronic diseases such as diabetes mellitus (OR=1.832; 95% CI 1.818-1.846), pulmonary diseases (OR=1.628; 95% CI 1.606-1.651), dardiac disease (OR=1.329; 95% CI 1.319-1.340), obesity (OR=2.609; 95% CI 2.477-2.748); those which reduced medical visits (OR = 4.381; 95% IC 4.334-4.428), those who stop taking medication due to economic difficulties (OR =5.477; 95% IC 5.422-5.532) and those who had a lower health related quality of life (OR = 0.212; 95% IC 0.210-0.214). Discussion of results: The results of the present study show that food insecurity is significantly associated with socioeconomic factors, a lower consumption of essential foods, avoidance of food purchases, a higher prevalence of chronic diseases, a poorer management of chronic diseases and lower quality of life in the elderly.
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Insegurança Alimentar Idosos Fatores Socioeconómicos Comportamentos Alimentares Doenças Crónicas Qualidade de Vida Food insecurity Older Adults Socioeconomic Factors Eating Behaviors Chronic Diseases Quality of Life