Food insecurity and nutritional status relating to chronic disease of elderly caregivers within the rural households of Mpharane in Lesotho

Abstract

Rational and Objectives The objective of this study was to determine socio-demographic, socio-economic, health status, dietary diversity, nutrition adequacy, food consumption patterns, coping strategies, and agricultural practices in relation to food insecurity and nutritional status of elderly population in Mpharane.

Methodology The sample size was n=260 participants with 75 men and 185 women. A variety of variables were used to measure the objectives and different types of questionnaires were used as measuring instruments for all the variables of the study. Socio-demographic questionnaires determined household indicators like age, employment status, and number of dependents, living conditions and assets. Anthropometrics measurements that were conducted included height, weight and blood pressure. Health status questionnaires included indictors such as consumption of alcohol, smoking, food allergies and affected parts of the body. Food frequency score, dietary intake and nutrition adequacy were established. Coping strategies in the household were determined for the period of food insecurity. Agricultural practices questionnaires were to determined household indictors like land, types of crops and livestock. The completed Socio-demographic Questionnaires, Health Questionnaires, Food Frequency Questionnaires, Anthropometric Measurements Forms, Coping Strategies Questionnaires and the Agricultural Practices Questionnaire were captured on a Microsoft Excel® Spreadsheet by the researcher and analyzed using the Statistical Package for the Social Sciences (SPSS), version 21.0, with the assistance of a statistician.

Results Results indicated that all participants resided with grandchildren. Majority of grandmothers headed the households. All participants were unemployed and 61.20% often had shortage of money to buy food. Nutrient analysis from 24-Hour Food Recall indicated deficient intake in energy, calcium and vitamin A. There were high levels of food insecurity among the participants since all the participants used all 15 coping strategies. The Body Mass Index (BMI) results indicated 65.50% of participants were overweight, 60.70% obese and 13.60% were underweight. Majority of participants had access to land for plantation. All Participants suffered from various health aliments. The history of health associated with diseases indicating that 24.60% (n=64) of the participants had reported skin diseases, 71.20% (n=185) of the participants suffered from diseases of skeleton or joints and 81.90% (n=213) of the participants indicated affected eyes, ears, nose and teeth. Diseases of the chest or respiratory system were experienced by 50.80% (n=132) of the participants. The total fat intake of all the groups was slightly below the recommended goal by the World Health Organization WHO (15-30%), with men obtaining 13.33% and women 12.55% of energy from fat. Carbohydrates contributed 75.12% for men and 75.41% for women of the daily energy needs in the groups, slightly above the levels recommended by the WHO (55-75%). The contribution of protein to total daily energy intake for all the groups was within the recommendation of 10-15%, men (11.56%) and women (12.07%). As a result this proves that the average participant consumed a balanced diet in terms of the macronutrient intake. Carbohydrates were the main source of food consumption. The highest number of individual foods consumed by the majority of the participants was between 6-10 individual foods (53.46%, n=139) followed by 11-15 individual foods (39.23%, n=102). The mean Food Variety Score (FVS) (±SD) for all the foods consumed from the food groups during seven days was 10.06 (±6.726), which indicated a low food variety score. The food group with the most variety was the cereal group. Seven different cereals were consumed by (1.53%, n=4) participants, a large number of the participants (31.15%, n=81) only consumed 3 different cereals within seven day period and (23.46%, n=61) of the participants consumed 4 different cereals.

Conclusion The grandparents were the principle providers for the grandchildren and the demographic pressures, unemployment and old age increased the financial strains which contributed to high levels of poverty resulting in food and nutrition insecurity and poor nutritional status of the elderly people.