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      Health and Nutritional Beliefs and Practices among Rural Elderly Population: An Ethnographic Study in Western Spain

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          Abstract

          Background: Demographic transition is causing an increasingly aged society, which has a significant impact on public health strategies. Increases in the size of the elderly cohort create a wider stratification and pose specific challenges. Nutrition and diet are one key issue. This study aims to describe food-related practices, beliefs, and representations of non-institutionalized older adults in rural communities in Extremadura (Western Spain). Method: The ethnographic-based fieldwork was conducted from January to July 2019. Empirical material was collected through different research relationships (semi-structured interviews and informal conversations) and direct observation in various locations in Extremadura―involving a variety of agents associated with different aspects of the nutritional process. Results: Data analysis revealed four major themes: (1) Limitations on choice and quality of food available; (2) food preferences and cooking methods; (3) the role of nostalgia in the construction of taste preferences; and (4) perceptions of what “healthy” food is and how respondents relate to the advice provided by health professionals. Conclusions: Nutritional choices among the group studied presented significant differences from medical advice―which was seen as a series of “bans” that did not carry enough authority to alter the symbolic value attached to their traditions.

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          Most cited references 52

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          Health consequences of obesity in the elderly: a review of four unresolved questions.

          Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.
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            Old and alone: barriers to healthy eating in older men living on their own.

            Ageing is associated with reduced energy intake and loss of appetite. Older men tend to have poorer dietary intakes including consumption of fewer fruits and vegetables in comparison to older women. Living and eating alone further diminishes food consumption and dietary quality. The aim of the present study was to explore food choice and energy intake in older men living alone using both quantitative and qualitative methods. 39 older men were interviewed and completed questionnaires on health, food choice, dietary patterns and appetite. Few men managed to consume recommended levels of energy, essential trace elements or vitamins A and D. Age and BMI failed to predict patterns of intake, but men with good cooking skills reported better physical health and higher intake of vegetables. However, cooking skills were negatively correlated with energy intake. Men who managed to consume at least 4 portions of fruits and vegetables each day had significantly higher vitamin C levels, a greater percentage of energy as protein and generally more adequate diets. Interviews revealed that poor cooking skills and low motivation to change eating habits may constitute barriers to improving energy intake, healthy eating and appetite in older men (193).
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              Malnutrition and frailty in community dwelling older adults living in a rural setting.

              Malnutrition and frailty are frequent and serious conditions within the geriatric population. Both are of multifactorial origin and linked to adverse outcomes. The purpose of this study was to analyze the relationships between these two concepts in a representative sample of rural elderly Lebanese with a high prevalence of malnutrition.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                14 August 2020
                August 2020
                : 17
                : 16
                Affiliations
                [1 ]Department of Computer and Telematic Systems Engineering, Polytechnic School, University of Extremadura, 10003 Cáceres, Spain
                [2 ]Department of Nursign, School of Nursing and Occupational Therapy, University of Extremadura, 10003 Cáceres, Spain; dcondecab@ 123456unex.es (D.C.-C.); lorenmariano@ 123456unex.es (L.M.-J.)
                Author notes
                [* ]Correspondence: brivero@ 123456unex.es ; Tel.: +34-927-257-064
                Article
                ijerph-17-05923
                10.3390/ijerph17165923
                7459967
                32824078
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                Categories
                Article

                Public health

                extremadura (spain), anthropology, aging, nutrition, ideologies, health, rural areas

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