RESEARCH ARTICLE
Nutritional assessment of communitydwelling older adults in rural Nepal Saruna Ghimire1*, Binaya Kumar Baral2, Karen Callahan1 1 Department of Environmental and Occupational Health, School of Community Health Sciences, University of Nevada, Las Vegas, Nevada, United States of America, 2 Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal * [email protected]
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OPEN ACCESS Citation: Ghimire S, Baral BK, Callahan K (2017) Nutritional assessment of community-dwelling older adults in rural Nepal. PLoS ONE 12(2): e0172052. doi:10.1371/journal.pone.0172052 Editor: Mathias Toft, Oslo Universitetssykehus, NORWAY Received: June 30, 2016 Accepted: January 30, 2017 Published: February 14, 2017 Copyright: © 2017 Ghimire et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist.
Background Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal’s health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool.
Methods A cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated.
Results 111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p0.9 [45]. Youden index J criteria [45, 46] were used to define sensitivity and specificity cutoff points. To assess nutritional status, prevalence of the three nutritional categories—malnourished, at risk of malnourishment, and normal nutritional status—were calculated. The Shapiro-Wilks test was used to test the normality of variable distributions. Comparisons of means between the nutritional status groups were done by ANOVA, and frequency distributions were evaluated by Pearson’s chi square (χ2) test or the Fisher-Freeman-Halton Exact test, as indicated by variable distribution. For all statistical tests, two-tailed p-values
Nutritional assessment of communitydwelling older adults in rural Nepal Saruna Ghimire1*, Binaya Kumar Baral2, Karen Callahan1 1 Department of Environmental and Occupational Health, School of Community Health Sciences, University of Nevada, Las Vegas, Nevada, United States of America, 2 Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal * [email protected]
Abstract a1111111111 a1111111111 a1111111111 a1111111111 a1111111111
OPEN ACCESS Citation: Ghimire S, Baral BK, Callahan K (2017) Nutritional assessment of community-dwelling older adults in rural Nepal. PLoS ONE 12(2): e0172052. doi:10.1371/journal.pone.0172052 Editor: Mathias Toft, Oslo Universitetssykehus, NORWAY Received: June 30, 2016 Accepted: January 30, 2017 Published: February 14, 2017 Copyright: © 2017 Ghimire et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist.
Background Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal’s health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool.
Methods A cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated.
Results 111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p0.9 [45]. Youden index J criteria [45, 46] were used to define sensitivity and specificity cutoff points. To assess nutritional status, prevalence of the three nutritional categories—malnourished, at risk of malnourishment, and normal nutritional status—were calculated. The Shapiro-Wilks test was used to test the normality of variable distributions. Comparisons of means between the nutritional status groups were done by ANOVA, and frequency distributions were evaluated by Pearson’s chi square (χ2) test or the Fisher-Freeman-Halton Exact test, as indicated by variable distribution. For all statistical tests, two-tailed p-values
