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Abstract

Food insecurity and obesity often coexist in older adults, leading to complex health issues. Standard obesity measures, such as Body Mass Index (BMI), do not adequately capture central adiposity, which is a more accurate predictor of metabolic risk. Newer anthropometric indices, such as the A Body Shape Index (ABSI) and the Body Roundness Index (BRI), offer improved precision in measuring central adiposity but are not commonly used in geriatric nursing assessments. To examine the associations between food insecurity and advanced anthropometric indices (BMI, ABSI, and BRI) in older adults, and explore implications for clinical nursing practice. A cross-sectional study was conducted with 152 older adults aged ≥65 from outpatient clinics at Assiut University Hospital, Egypt. Data were collected using the United States Department of Agriculture Food Security Survey and structured anthropometric measurements. BMI, ABSI, and BRI were calculated. Pearson correlations and multivariable regression identified predictors of food security status. Food insecurity was reported by 35.5% of participants. We found significant negative correlations between food security scores and BMI (r = −0.192, p = .018), BRI (r = −0.191, p = .019), and ABSI (r = −0.021, p = .023). This indicates that higher levels of adiposity and central obesity are associated with poorer food security. Regression analysis showed that gender, marital status, education, income, BMI, ABSI, and BRI were significant predictors of food security (p < .05 for all). Our findings demonstrate a significant association between central obesity, particularly as measured by ABSI and BRI, and food insecurity in older adults. We recommend that geriatric nurses integrate these advanced anthropometric indices into routine assessments to more accurately screen for food insecurity. This approach would allow for more effective and targeted nursing interventions for this vulnerable population.

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Keywords

food insecurity obesity A Body Shape Index (ABSI)Body Roundness Index (BRI)geriatric nursing older adults anthropometric indices

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References

Alao

Nur

Fivian

Shankar

Kadiyala

Harris-Fry

(2021). Economic inequality in malnutrition: A global systematic review and meta-analysis. BMJ Global Health, 6(12), e006906. https://doi.org/10.1136/bmjgh-2021-006906

Bianchettin

Lavie

Lopez-Jimenez

(2023). Challenges in cardiovascular evaluation and management of obese patients: JACC state-of-the-art review. Journal of the American College of Cardiology, 81(5), 490–504. https://doi.org/10.1016/j.jacc.2022.11.031

Brenner

Forner-Cordero

Faerber

Rapprich

Cornely

(2023). Body mass index vs. waist-to-height ratio in patients with lipohyperplasia dolorosa (lipedema). JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 21, 1179–1185. https://doi.org/10.1111/ddg.15182

Calcaterra

Rossi

Magenes

V. C.

Baldassarre

Grazi

Loiodice

Fabiano

Zuccotti

(2024). Dietary habits, depression and obesity: An intricate relationship to explore in pediatric preventive strategies. Frontiers in Pediatrics, 12, Article 1368283. https://doi.org/10.3389/fped.2024.1368283

Carvajal-Aldaz

Cucalón

Ordoñez

(2022). Food insecurity as a risk factor for obesity: A review. Frontiers in Nutrition, 9, Article 1012734. https://doi.org/10.3389/fnut.2022.1012734

Dhurandhar

E. J.

(2016). The food-insecurity obesity paradox: A resource scarcity hypothesis. Physiology & Behavior, 162, 88–92. https://doi.org/10.1016/j.physbeh.2016.04.025

Faham

Hojati

Farhangi

M. A.

(2024). Body shape index (ABSI), body roundness index (BRI) and risk factors of metabolic syndrome among overweight and obese adults: A cross-sectional study. BMC Endocrine Disorders, 24, Article 230. https://doi.org/10.1186/s12902-024-01763-6

Fidecki

Ślusarz

Sienkiewicz

Kuszplak

Wysokiński

(2025). Comprehensive geriatric assessment in clinical nursing practice. Annals of Agricultural and Environmental Medicine, 32(2), 302–307. https://doi.org/10.26444/aaem/204161

Fitzpatrick

Greenhalgh-Stanley

Ploeg

M. V.

(2016). The impact of food deserts on food insufficiency and SNAP participation among the elderly. American Journal of Agricultural Economics, 98(1), 19–40. https://doi.org/10.1093/ajae/aav044

10.

Gianfredi

Palmisano

Vetrano

D. L.

(2025). Food insecurity and its impact on older adults: A systematic review and meta-analysis. Journal of Gerontology, 69, 964–971.

11.

Hales

C. M.

Carroll

M. D.

Fryar

C. D.

Ogden

C. L.

(2020). Prevalence of obesity and severe obesity among adults: United States, 2017–2018 (NCHS data brief 360, pp. 1–8). https://www.cdc.gov/nchs/products/databriefs/db360.htm

12.

Hernandez

D. C.

Reesor

L. M.

Murillo

(2017). Food insecurity and adult overweight/obesity: Gender and race/ethnic disparities. Appetite, 117, 373–378. https://doi.org/10.1016/j.appet.2017.07.010

13.

Koenen

Hill

M. A.

Cohen

Sowers

J. R.

(2021). Obesity, adipose tissue, and vascular dysfunction. Circulation Research, 128(7), 951–968. https://doi.org/10.1161/CIRCRESAHA.121.318093

14.

Rosenthal

S. R.

(2021). Food insecurity and obesity among US young adults: The moderating role of biological sex and the mediating role of diet healthfulness. Public Health Nutrition, 24(15), 5058–5065. https://doi.org/10.1017/S1368980020004577

15.

Morales

M. E.

Berkowitz

S. A.

(2016). The relationship between food insecurity, dietary patterns, and obesity. Current Nutrition Reports, 5(1), 54–60. https://doi.org/10.1007/s13668-016-0153-y

16.

Mozaffarian

Agarwal Aggarwal

, & Collaborators from Major Nutrition/Obesity Organizations. (2025). Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory. American Journal of Lifestyle Medicine. Advance online publication. https://doi.org/10.1177/15598276251344827

17.

Neeland

I. J.

Ross

Després

J. P.

Matsuzawa

Bray

G. A.

Bergman

R. N.

Seidell

J. C.

Aronne

L. J.

Shulman

G. I.

Kligman

L. B.

Sam

(2019). Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: A position statement. The Lancet Diabetes & Endocrinology, 7(9), 715–725. https://doi.org/10.1016/S2213-8587(19)30084-1

18.

Pourebrahim

Sadeghi

Hosseini

Eshratkhah

(2024). Food insecurity, body composition, and sarcopenia in older adults in Tehran, Iran: A cross-sectional study. Nutrition & Food Science, 54(1), 32–45.

19.

Rezaei

Eshratkhah

Sadeghi

(2024). Association between dietary diversity, body mass index, and a body shape index in older adults. Journal of Nutritional Science, 13, e54.

20.

Schrock

J. M.

McClure

H. H.

Snodgrass

J. J.

, & SAGE collaborators. (2017). Food insecurity partially mediates associations between social disadvantage and body composition among older adults in India. American Journal of Human Biology, 29(6), e23033. https://doi.org/10.1002/ajhb.23033

21.

Stefanescu

Revilla

Lopez

Villena

Viteri

Sanchez

(2020). Using A Body Shape Index (ABSI) and Body Roundness Index (BRI) to predict risk of metabolic syndrome in Peruvian adults. Journal of International Medical Research, 48(1), Article 030006051984885. https://doi.org/10.1177/030006051984885

22.

United Nations Food and Agriculture Organization. (2002). The state of food security in the world. http://www.fao.org/docrep/003/y1500e/y1500e06.htm

23.

United States Department of Agriculture (USDA). (2023). Food security in the U.S. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/

24.

Zhou

Liu

Huang

Feng

(2022). A nonlinear association between body roundness index and all-cause and cardiovascular mortality in the general population. Public Health Nutrition, 25(11), 3008–3015. https://doi.org/10.1017/S1368980022001768

Food Insecurity,Advanced Anthropometric Indices,and Central Obesity in Older Adults: Implications for Geriatric Nursing Assessments

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