For every year that an adult aged 65 or older experiences food insecurity, they become more likely to undergo unhealthy weight changes associated with earlier death, according to a new study by researchers in the Penn State College of Health and Human Development.
The research team examined the associations between food insecurity, changes in body weight and composition, and participation in Supplemental Nutrition Assistance Program (SNAP) using 10 years of data from older adults in the United States.
Results of the study, published in The American Journal of Clinical Nutrition, added to the body of evidence that food insecurity — limited or unstable access to the food needed for daily life — causes health problems beyond potential nutritional deficits.
“Many studies on the effects of food insecurity have — for good reason — focused on pregnant women and children,” said Muzi Na, associate professor of nutritional sciences and lead author of the study. “We wanted to examine how food insecurity affected older adults over time because they are also vulnerable. Results from this study revealed more reasons that preventing food insecurity is critical for the health and survival of older adults.”
The research team analyzed data collected between 2012 and 2021 from 3,897 participants in the National Health and Aging Trends Study (NHATS). NHATS was designed to capture information from a nationally representative sample of adults 65 years or older enrolled in Medicare.
In this study, the researchers compared the associations among a person’s experience with food insecurity on an annual basis; their SNAP status at the start of data collection; and body measurements over time, including weight, waist circumference and body mass index.
The researchers observed four weight patterns among participants across the study: stability, loss, gain and fluctuations of more than 5% of body weight. Prior studies — as detailed in this meta-analysis by a team of Australian scientists — demonstrated that all these patterns except stability are associated with earlier death.
“Stable weight is important to older adults’ health and survival,” Na said. “Weight change is associated with cardiovascular disease, diabetes, Alzheimer’s disease and other common causes of death for older adults. Unfortunately, our study demonstrated that every year an older person experiences food insecurity, they have higher odds of losing, gaining or fluctuating weight, putting them at higher risk for premature death.”
Many studies define food insecurity as people not having enough money to buy food, Na said, but that can ignore the social and physical factors that may contribute to food insecurity even among older adults who have enough money. During NHATS data collection, participants were asked five questions related to different aspects of food insecurity: Did people go without groceries; did they have access to hot meals; did they have enough money to purchase food; did they have the social support needed to acquire food; and did they have physical constraints like age-related disabilities that prevented them from acquiring food? For this study, Na and her collaborators counted any participant who reported at least one of these experiences as food insecure.
While there isn’t a one-size-fits-all solution, Na suggested that meal delivery services might help address physical and social-support issues that contribute to food insecurity among older adults. More broadly, Na said, policymakers need to understand the implications of these results.
“This study shows that food insecurity among older adults is not being adequately addressed,” Na said. "As a society, we need to provide older adults with support to prevent unhealthy weight changes. This would save the nation untold millions of dollars in health care costs while improving quality of life for millions of people.”
Martin Sliwinski, professor of human development and family studies and director of the Penn State Center for Healthy Aging, and Penny Kris Etherton, retired Evan Pugh University Professor of Nutritional Sciences at Penn State, contributed to this research.