Older populations are in high risk of nutritional inadequacy and monotonous diet, and the assessment of dietary diversity can be a practical measure to indicate groups at nutritional risk. Our aim was to explore the dietary diversity of older adults enrolled in primary care services in Brazil, and to evaluate their associated factors. In this cross-sectional study, we evaluated the dietary diversity score (DDS) of 581 participants (≥ 60 years) registered in primary care services. All foods mentioned in a 24h-Food Recall were classified into 10 groups, and factors associated with the DDS were analyzed using hierarchical linear regression models in 2 blocks: 1) sociodemographic; 2) health conditions and lifestyle. The mean DDS was 5.07 (± 1.34) and 67.5% of the sample reached the minimum dietary diversity (≥ 5 groups). In the final model, income, previous diagnosis of cancer and sporadic intake of alcohol were positively associated with DDS, while cognitive decline, sedentary lifestyle and anorexia of aging were negatively associated with DDS. These findings show that entire structural, economic, and social system needs to facilitate access to quality food, adequate places and conditions for the practice of physical activity, and policies regarding tobacco and alcohol abuse, in addition to nutritional guidance.

The decrease in consumption of fresh or minimally processed foods and the increase in ultra-processed foods are being observed in the diet of older adults and these changes may lead to worsening health status and cognition. We aimed to evaluate the association between cognitive status and food consumption according to the level of processing in Brazilian older adults. Cross-sectional study, with a sample of 585 older adults (≥60 years). Cognition was evaluated using the Cognitive Skills Screening Instrument (CASI-S), considering cognitive deficit when scores < 23 in participants aged 60–69 and < 20 in those aged ≥70 years. Foods reported in 24-hour food recall were classified according to their processing level into four groups of NOVA proposal: 1) unprocessed/minimally processed foods, 2) culinary ingredients, 3) processed foods (products made only from groups 1 and 2); and 4) ultra-processed foods. We estimated the means of total CASI-S score and its four domains according to the quartiles of intake of each food group, and evaluated the association between cognitive decline and each food group intake using logistic models adjusted for gender, age, schooling. Individuals in the highest quartile of unprocessed/minimally processed foods intake had higher scores in temporal orientation (p=0.034), verbal fluency (p=0.002), and total CASI-S score (p=0.004). The scores did differ according to the intake of the other food groups. The ultra-processed was the only group associated with cognitive deficit (OR:1.02; p=0.002). Results suggest nutritional counselling for older adults should focus in reducing ultra-processed and increasing unprocessed foods to help preventing cognitive deficit.

Food security can be defined as when the individual has access to food consumption in adequate quality and quantity, respecting aspects such as age, physiological condition and cultural habits. While international studies showed the association of Food Insecurity (FI) and many negative health outcomes, like depressive symptoms, less is known about food insecurity among older people in Brazil, especially about its association with health. The aim of this study is to analyze the relationship between FI and Depressive Symptoms (DS) among community older Brazilian adults. Were included in this study 493 community older people with 60+. Geriatric Depression Scale were used to measure DS and for assessment of FI was used the short version of the Brazilian Food Insecurity Scale, added with one question involving functional limitations to buy food. Logistic regression was used to estimate the odds ratio (OR) adjusted for covariates (e.g., sex, education, age and familiar income). The prevalence of FI were 42.4% and the prevalence of DS were 71.5% of population. The prevalence of DS was higher in the group with FI than among those without F (78.9% vs 65.8% respectively; p=0.001). In the adjusted regression analysis, the chance of presenting positive symptomatology for depression was 1.87 times higher among the older people with FI (CI 1.18 –2.91; p=0.007). The findings demonstrate high prevalence of FI and DS indicating the importance of FI screening among community-based older people in order to avoid possible negative health outcomes in this population, such as the development of depressive symptoms.

The adequate nutrition has an important role in the prevent and treatment of frailty, however, there are only few studies showing the relationship between macronutrients intake and this geriatric syndrome, especially in Latin countries. The aim of this study was to analyze the association between macronutrients intake and frailty among older adults in Brazil. This study included 521 community-dwelling individuals aged 60 years old or older. Frailty was assessed using a self-reported instrument and individuals were categorized in two groups: frail and non-frail (robust + pre frail). Food consumption was evaluated using the 24-hour recall and the software NDSR®. Differences between groups was assessed using the Mann Whitney test. The prevalence of frailty was 42.0%. Older adults considered frails presented lower intake of calories (1510.9 kcal vs 1639.3 kcal; p = 0.016), carbohydrates (196.8 g vs 213.3 g; p = 0.011), proteins (60.7 g vs 68.5 g; p = 0.016) and fiber (15.1 g vs 17.5 g; p= 0.002). They also had lower intake of protein per kilograms of weight (0.88 g/kg vs 0.99 g/kg; p= 0.010). The findings demonstrate high prevalence of frail in our sample, and that intake of most macronutrients was significantly lower among older adults with frail, indicating the importance of the screening of frail as well the evaluation of macronutrients intake among community-based older adults, to prevent malnutrition, sarcopenia and frailty in this population.