Nov. 27, 2001

America's bounty of food will not guarantee healthy holiday table for elderly who are poor or immobile, Cornell studies show

This holiday season many elderly Americans will not get enough to eat simply because they lack the mobility to prepare their own meals. Others will lack the funds to purchase nutritionally adequate meals.

As a result of such problems, the health and nutritional status of many older Americans is being significantly impaired, according to several new studies from Cornell University.

In three published studies, Edward Frongillo, associate professor of public nutrition at Cornell, and Jung Sun Lee, a postdoctoral fellow at the University of Pittsburgh who is finishing up her Cornell Ph.D., explored elderly Americans' problems in getting enough to eat and the assistance provided by food programs. Unlike most research on so-called food insecurity (defined as not getting enough to eat, occasionally or often), which mainly has looked at families with young children, Frongillo and Lee studied the vulnerable elderly population.

Using national and state data on more than 6,600 adults, ages 60 and older, from the Third National Health and Nutrition Examination Survey (1988-94) and the Nutrition Survey of the Elderly in New York State (1994), the researchers found that factors such as poverty, low education and social isolation are related to inadequate purchasing power for a nutritious diet. The researchers also report in the Journal of Gerontology (2001, 56B:2, pp. S94-S99) that functional impairments, such as serious disease or disability, greatly increase the risk of not always having enough to eat.

"The findings suggest that elderly persons with a functional impairment, even when they have plenty of food in the house and social support available, are at a much higher risk for food insecurity than those without impairments," says Frongillo. The second study, which used data from the same samples and is published in the Journal of Nutrition (2001, 131, pp. 1503-1509, available at http://www.nutrition.org/cgi/content/full/131/5/1503 ), found that older people, whether or not they have adequate resources, tend to consume less than the recommended dietary allowance (RDA) for calories and seven nutrients. The elderly who don't always having enough to eat tend to consume fewer calories and less of 18 nutrients, particularly protein, iron, magnesium and zinc, vitamins B-6 and B-12, riboflavin and niacin, compared with those who do have sufficient food. About one-third of the food insecure studied were homebound, half were considered poor and two-thirds functionally impaired.

"Older Americans need more attention because food insecurity is an undesirable phenomenon, not only because of its negative impact on health and nutritional status, but also because it is ethically unacceptable," Frongillo says.

The third study, published in the Journal of Nutrition (2001, 131, pp. 765-773) and available at http://www.nutrition.org/cgi/content/full/131/3/765 ), looks at how participation in food programs, such as the U.S. Department of Agriculture's (USDA) Food Stamp Program, is related to the nutritional and health status of the elderly. Using the same data sets as in the other two studies, as well as data on 7,527 adults, ages 70 and older, from the Longitudinal Study of Aging (1984-1990), the researchers conclude that analysis shows no statistical benefit from food-assistance programs. But, Frongillo explains, that is probably due to the limitations in the available data: It is unethical to keep a group of elderly people unassisted, even though they are clearly not getting enough to eat, and compare their welfare with those participating in programs.

"This is a common problem and must be addressed by improving study designs as well as by making food assistance programs as effective and beneficial as possible for our vulnerable elderly population," concludes Frongillo. However, he says, anecdotal evidence consistently reports benefits of the assistance programs to the elderly.

The studies were supported, in part, by the USDA.