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Having a food secure home is influenced by economic, physical and social resources that elders may or may not have. Food insecurity has an important impact in the management of diseases of older people. Older adult's food insecurity situation demands a holistic approach beyond the access to food problem.

Introduction: Nutritional disorders in older adults are of much concern, especially underweight and obesity among older adults. This study aimed to evaluate prevalence of underweight and obesity and to identify factors associated with nutritional status in communitydwelling Portuguese elders. Methods: Cross-sectional study involving 337 elders attending day care centers in Lisbon. The data collected included self-perception of health state, chronic diseases, social support and relations as well as sociodemographic variables. Nutritional status was evaluated by Body Mass Index (BMI) classifying participants as underweight (BMI<24 Kg/m 2), normal weight (BMI=24 to<29kg/m 2) and obese (BMI≥29 kg/m 2). Data were compared using chi-square test and multinomial regressions were performed to identify determinants of underweight and obesity, being the normal weight the reference category. Results: Participants were mainly women (210; 62.3%), aged 66 to 99 years old. Overall prevalence of underweight and obesity was 21.7% and 38.3%, respectively. Of the 210 females, 24.3% presented underweight and 44.3% were obese. Of the 127 male participants, 17.3% were underweight and obesity affected 28.3%. Low BMI and obesity were associated with sociodemographic, health, psychosocial and institution attendance variables. Multinomial regressions revealed significant determinants for BMI status. Underweight was positively associated with age, gender and inability to cook and inversely with hypertension and diabetes. Obesity was positively associated with gender, hypertension and alcohol consumption. Conclusion Taking into account that health and nutrition are inherently connected, this research highlights the importance of considering all dimensions of health while managing weight and nutritional status of older adults. Health practitioners should set the focus on the underlying factors of the nutritional condition of this vulnerable population.