Dietary diversity and food security status among heart failure patients in the north of Iran

Abstract

Background Dietary diversity score (DDS) is an indicator for assessing nutritional adequacy. Food security is another important measure in nutrition field which can be associated with several cardiovascular risk factors. Considering the importance of nutrition in heart failure (HF) patients, this study was designed to evaluate the DDS and food security of patients with HF. Methods A total of 200 HF patients were enrolled. DDS was evaluated using valid and reliable food frequency questionnaire and was calculated by scoring food intakes as 5 main groups. Household food insecurity access scale was applied to assess food security status. Data were analyzed using descriptive statistics, Chi-square and Kruskal-Wallis tests and multiple logistic regression models. Results The mean age of patients was 65 (standard deviation: 12) years and 59% of patients were male. Median of DDS was 1.96 (range: 0.29 to 6.12). Adjusted odds of greater DDS (> = median of 2) was 2.58 times higher for patients without hypertension than for patients with hypertension (95%CI: 1.31–5.08, P = 0.006). Also, odds of greater DDS were more in ex-smokers’ patients when compared to non-smokers (adjusted odds ratio (AOR): 2.70, 95%CI: 1.27–5.75, P = 0.010), patients with supplement use (AOR: 2.42, 95%CI: 1.16–5.05, P = 0.019), patients with lower total cholesterol level (AOR: 1.01, 95%CI: 1.00–1.02, P = 0.051), and patients with higher ejection fraction (AOR: 1.03, 95%CI: 1.00–1.05, with borderline. P = 0.073). About 57% of patients had experienced degrees of food insecurity as mild (26%), moderate (16%) and severe (15%). On the other hand, women (AOR: 1.90, 95%CI: 0.90–3.71, with borderline P = 0.061) and patients with middle (AOR: 3.48, 95%CI: 1.79–6.76, P < 0.001) or high (AOR: 20.32, 95%CI: 2.56–161.19, P = 0.004) socio-economic status were more likely to be food secure or mild insecure. Also, no relation between DDS and food security was found (r = − 0.08, P = 0.262). Conclusion This study found that HF patients had a low DDS and more than half of the patients were food insecure to some extents.

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“…Heart failure is a common chronic condition which globally, the number of heart failure cases has nearly doubled to more than 64 million from 1990 to 2017, and this number is expected to continue to increase over the next few decades [ 1 ]. In Iran, the prevalence of heart failure is estimated to be about 8% [ 2 ], and the one-year mortality rate for these patients is remarkably high at 32% [ 3 ]. This condition poses various challenges such as high rehospitalization and in-hospital mortality rates [ 4 ].…”

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“…HF is estimated to have affected more than 64 million people worldwide 2. In Iran, the prevalence of this disease is estimated to be about 8% of the general population, which is higher than many other countries 3. Moreover, the number of patients with HF continues to rise as a result of population growth and ageing, making it an increasingly serious public health concern 4.…”

“… 2 In Iran, the prevalence of this disease is estimated to be about 8% of the general population, which is higher than many other countries. 3 Moreover, the number of patients with HF continues to rise as a result of population growth and ageing, making it an increasingly serious public health concern. 4 The overwhelmingly growing prevalence of HF directly culminates in increasingly economic costs and treatment burdens on healthcare systems.…”

“…2 In Iran, the prevalence of this disease is estimated to be about 8% of the general population, which is higher than many other countries. 3 Moreover, the number of patients…”