Food security among community-living older persons in Malta : consumption, provisioning, and challenges

Abstract

Food insecurity is characterized by insufficient access to diverse, nutritious, and safe food and often intensifies in old age. This study was conducted among community-living older persons in Malta to determine their food security based on multiple factors. The specific objectives involved exploring dietary intake, food acquisition methods, perceptions of dietary sufficiency and healthy eating, nutrition information sources, and related challenges. A sequential mixed-methodology strategy was adopted comprising a questionnaire-based survey and focus group discussions. Data from the 264 survey respondents were analyzed for frequencies of different practices, perceptions, knowledge, and concerns regarding food security. Data from the twenty-five focus group participants were analyzed manually in an iterative manner, initially guided by the interview questions; then eventually identifying subthemes emerging from the data itself. The majority of the survey participants were fairly food secure. They consumed varied meals daily and were proficient in food accessibility, with 66% stating that it was easy/very easy to obtain food, 74% purchasing food themselves from near their home, and 50% reporting they were assisted by family members. The majority of the respondents found food affordable (86%) and indicated that they were comfortable with the type and amount of food available at home (96%). Dietary restrictions, living alone, a lack of motivation to cook, impaired physical functionality, and a lack of knowledge to maintain a healthy diet presented obstacles to preferred and nutritious food choices. There was a desire for more education, especially to help manage multiple health conditions. These findings will assist in developing nutrition policies and education interventions to enhance food security among communityliving older adults. A key recommendation is to conduct further research to determine nutritional adequacy, solutions to challenges, and nutrition and culinary education needs of non-surveyed persons, especially the very old still living independently, or those experiencing cognitive or financial decline.