Abstract
BackgroundDietary diversity score (DDS) is an indicator for assessing nutritional adequacy. Food security is another important measure in nutrition field which can be associated with several cardiovascular risk factors. Considering the importance of nutrition in heart failure (HF) patients, this study was designed to evaluate the DDS and food security of patients with HF.MethodsA total of 200 HF patients were enrolled. DDS was evaluated using valid and reliable food frequency questionnaire and was calculated by scoring food intakes as 5 main groups. Household food insecurity access scale was applied to assess food security status. Data were analyzed using descriptive statistics, Chi-square and Kruskal-Wallis tests and multiple logistic regression models.ResultsThe mean age of patients was 65 (standard deviation: 12) years and 59% of patients were male. Median of DDS was 1.96 (range: 0.29 to 6.12). Adjusted odds of greater DDS (> = median of 2) was 2.58 times higher for patients without hypertension than for patients with hypertension (95%CI: 1.31–5.08, P = 0.006). Also, odds of greater DDS were more in ex-smokers’ patients when compared to non-smokers (adjusted odds ratio (AOR): 2.70, 95%CI: 1.27–5.75, P = 0.010), patients with supplement use (AOR: 2.42, 95%CI: 1.16–5.05, P = 0.019), patients with lower total cholesterol level (AOR: 1.01, 95%CI: 1.00–1.02, P = 0.051), and patients with higher ejection fraction (AOR: 1.03, 95%CI: 1.00–1.05, with borderline.P = 0.073). About 57% of patients had experienced degrees of food insecurity as mild (26%), moderate (16%) and severe (15%). On the other hand, women (AOR: 1.90, 95%CI: 0.90–3.71, with borderline P = 0.061) and patients with middle (AOR: 3.48, 95%CI: 1.79–6.76, P < 0.001) or high (AOR: 20.32, 95%CI: 2.56–161.19, P = 0.004) socio-economic status were more likely to be food secure or mild insecure. Also, no relation between DDS and food security was found (r = − 0.08, P = 0.262).ConclusionThis study found that HF patients had a low DDS and more than half of the patients were food insecure to some extents.
Highlights
Dietary diversity score (DDS) is an indicator for assessing nutritional adequacy
Prevalence of heart failure (HF) is increasing and it is estimated that about 26 million people worldwide are influenced by the disease [2].This is due to increased prevalence of its known risk factors such as: diabetes, hypertension, hyperlipidemia, ischemic heart disease, obesity and overweight [1]
Energy protein malnutrition is often common in patients with HF because of increased energy needs for heart and lung function as well as decreased desire to eat food due to weakness and early satiety, besides, Risk of electrolyte imbalance and nutrients deficiency as a result of drug use such as diuretics in patients with HF indicate the necessity of paying attention to diet and adequate nutrition [10, 11]
Summary
Dietary diversity score (DDS) is an indicator for assessing nutritional adequacy. Food security is another important measure in nutrition field which can be associated with several cardiovascular risk factors. Considering the importance of nutrition in heart failure (HF) patients, this study was designed to evaluate the DDS and food security of patients with HF. Energy protein malnutrition is often common in patients with HF because of increased energy needs for heart and lung function as well as decreased desire to eat food due to weakness and early satiety, besides, Risk of electrolyte imbalance and nutrients deficiency as a result of drug use such as diuretics in patients with HF indicate the necessity of paying attention to diet and adequate nutrition [10, 11]
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