Nutritional status and functional ability of older people in rural Malawi.

A cross-sectional study was undertaken in Lilongwe, Malawi to ascertain the levels of malnutrition and functional impairment among older people, examine the relationship between nutritional status and function ability and identify risk factors for poor nutritional status. Selected anthropometric measurements were taken and nutritional indices were derived using standard equations. Functional ability was assessed by questionnaire (activities of daily living [ADLs]) and tests which assess manual dexterity, handgrip strength and psychomotor function. Respondents were interviewed using a pre-tested questionnaire and a basic clinical examination was conducted. A total of 296 respondents (97 males, 199 females) aged from 55 to 94 years were studied. Men were significantly heavier and taller than women but had smaller mid-upper arm circumferences and triceps skinfolds than women. Prevalence of undernutrition defined as body mass index (BMI) <18.5 kg/m2, was 33.7% among males and 27.7% among females. Over 90% of all respondents were independent in ADLs and men were generally stronger and faster than women in performing functional tests except for psychomotor function. Functional ability declined significantly with age in both sexes except for manual dexterity among women. Handgrip strength emerged as the most important predictor of BMI, contributing to 15.8% and 11.6% of the variation in BMI of males and females, respectively. Low BMI was associated with poor handgrip strength, a history of smoking, fear of dependence and disability, poverty and living alone among males and among females, it was associated with poor handgrip strength, reduced food intake during the pre-harvest season and a history of anaemia. The study has demonstrated for the first time that undernutrition is a significant problem among older people in Malawi. It also confirms that poor nutritional status is associated with poor functional ability (as assessed by handgrip strength), and that it is possible to identify risk factors of nutritional vulnerability in this population. The study highlights the need to incorporate older people into existing and future nutrition and health programmes

Hand Grip Strength: age and gender stratified normative data in a population-based study

Extent: 5p.Background: The North West Adelaide Health Study is a representative longitudinal cohort study of people originally aged 18 years and over. The aim of this study was to describe normative data for hand grip strength in a community-based Australian population. Secondary aims were to investigate the relationship between body mass index (BMI) and hand grip strength, and to compare Australian data with international hand grip strength norms. Methods: The sample was randomly selected and recruited by telephone interview. Overall, 3 206 (81% of those recruited) participants returned to the clinic during the second stage (2004-2006) which specifically focused on the collection of information relating to musculoskeletal conditions. Results: Following the exclusion of 435 participants who had hand pain and/or arthritis, 1366 men and 1312 women participants provided hand grip strength measurement. The study population was relatively young, with 41.5% under 40 years; and their mean BMI was 28.1 kg/m2 (SD 5.5). Higher hand grip strength was weakly related to higher BMI in adults under the age of 30 and over the age of 70, but inversely related to higher BMI between these ages. Australian norms from this sample had amongst the lowest of the hand grip strength of the internationally published norms, except those from underweight populations. Conclusions: This population demonstrated higher BMI and lower grip strength in younger participants than much of the international published, population data. A complete exploration of the relationship between BMI and hand grip strength was not fully explored as there were very few participants with BMI in the underweight range. The age and gender grip strength values are lower in younger adults than those reported in international literature.Nicola M Massy-Westropp, Tiffany K Gill, Anne W Taylor, Richard W Bohannon and Catherine L Hil

Food security and nutritional outcomes among urban poor orphans in Nairobi, Kenya

The study aims to inform policies and practice targeted at improving the welfare of orphans living in urban poor communities. The relationship between orphanhood and nutritional status remains unclear, suggesting further context specific studies. The study was conducted between January and June 2007 among orphans and non-orphans aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements: weight and height were taken using standard procedures and z-scores generated using the National Center for Health Statistics (NCHS)/WHO reference. Data on food security was collected through interviews with children and their caregivers separately. A composite food security measure was derived from the caregiver and child responses. Comparisons with regard to food security and nutritional outcomes were made between orphans and non-orphans and among orphan types. Multiple regression analysis was done to determine factors related to vulnerability with regards to food security and nutritional outcomes. Orphans were more vulnerable than non-orphans to issues of food security, but not nutritional status, with paternal orphans being the most vulnerable orphan group. Other factors associated with vulnerability were age, sex and ethnicity of the child; relationship of child to the household head; age, sex and education level of the household head; household socio-economic status; number of dependants; and location of residence and household head’s education. The differential effects of these factors suggest targeted interventions