Low Nutrient Intake and Frailty Among Overweight and Obese Migrant Women From Ethnically Diverse Backgrounds Ages 60 Years and Older: A Mixed-Methods Study

Abstract

Objective: To examine associations between energy/nutrient intakes and frailty in older migrant women, and to explore perceptions of body weight, dietary intake, and physical function.

Design: Cross-sectional, mixed-methods study.

Setting: Birmingham, United Kingdom.

Participants: Seventy-six first-generation migrant women ≥ 60 years of age.

Main outcome measures: Energy/nutrient intakes (assessed by 24-hour dietary recall), frailty (using the frailty phenotype), and links between perceptions of body weight, dietary intake, and physical function (via semi-structured interviews).

Analysis: Bivariate and logistic regression analyses examined associations between frailty and low energy/nutrient intakes. Interviews were analyzed using inductive thematic analysis.

Results: Seventy-six women completed a 24-hour dietary recall; 46 participated in a semi-structured interview. Low energy intake was associated with frailty (odds ratio [OR], 11.71; 95% confidence interval [CI], 2.36-57.97). After adjusting for energy and other confounders, a low intake of > 3 nutrients was associated with frailty (OR, 6.58; 95% CI, 1.01-43.08). Qualitative data suggest that dietary intake was influenced by concerns about body weight and perceptions that unhealthy foods reduce mobility.

Conclusions and implications: Among older migrant women with high prevalence of overweight/obesity, an inadequate dietary intake may be a stronger predictor of frailty than weight loss. Dietary interventions should focus on healthy weight maintenance and optimization of nutritional adequacy and physical function.

Keywords: body image; ethnically diverse; frailty; nutrient inadequacy; older women; overweight/obesity; physical function.