ABSTRACT

Introduction: Vietnam is facing a rapidly aging population, leading to many health issues,
especially malnutrition among the elderly. Malnutrition and its consequences increase economic
burdens. One of the most popular causes of undernutrition is inadequate food intake. Assessing
dietary intake is an effective method to improve the nutritional status of the elderly. However,
the dietary intake research among the elderly in Hue City is still limited. It is necessary to
evaluate dietary intake and related factors to propose interventional solutions to improve the
nutritional status of the elderly.

Objectives:

1. To evaluate the 24-hour diet among the elderly in Hue City.

2. To identify related factors that affect the diet among the elderly

Methods: This cross-sectional descriptive study was conducted on 845 elderly people living in
Hue City, Vietnam. Baseline demographic information, anthropometry, and nutritional indicators
were measured. The nutritional status of the elderly was determined based on their body mass
index (BMI), which was calculated using height and body weight (kg/m2). The 24-hour recall
method was used to record participants’ diets in the 24 hours preceding the date of the survey.
The diet was then analyzed using a designated software (Eiyokun, National Institute of Nutrition,
Vietnam) based on the Vietnamese food composition table to calculate the total energy and
macronutrient intake. The recommended dietary intake is calculated based on the body weight
index of the study subjects. This intake is then compared with the total energy intake surveyed
over a 24-hour period. Similarly, the requirements for protein, carbohydrate, and lipid are
determined according to the recommended ratios for the elderly in Vietnam. The actual energy
intake from these nutrients is then compared to the recommended requirements. This approach
allows for an assessment of whether the study subjects meet the recommended dietary intake. An
individual was finally dichotomized as either meeting or not meeting the recommended
nutritional needs for Vietnamese people. A multivariate logistic model was applied to find the
related factors of 24-hour dietary intake (p<0.05).

Results: The mean age was 69.8 ± 8.4 years; 54.5% were male. 22.0% of the elderly were
undernourished. The average daily energy intake was 1661.38 ± 464.05 kcal/day. The intake of
protein, lipid, and carbohydrate was 65.97 ± 28.64 g/day, 41.87 ± 23.64 g/day, and 232.88 ±
109.82 g/day, respectively. The proportions meeting the recommended intake for energy, protein,
and lipid were high, while the proportion meeting the recommended carbohydrate intake was the
lowest at 29.8%. Factors associated with meeting the 24-hour dietary energy requirement
included a reduced appetite (OR = 2.134; 95% CI: 1.578–2.887) and not meeting the lipid
requirement within 24 hours (OR = 1.438; 95% CI: 1.280–1.683). Factors related to meeting the
24-hour protein requirement included not preparing meals oneself (OR = 1.831; 95% CI: 1.079–
3.1424) and not meeting the lipid requirement within 24 hours (OR = 34.15; 95% CI: 19.99–
58.34). Factors associated with meeting the 24-hour carbohydrate requirement included
education level (OR=1.873; 95% CI: 1.046-3.351), alcohol consumption (OR=2.122; 95% CI:
1.332-3.380), not preparing meals oneself (OR=1.755; 95% CI: 1.133-2.658), limited food
accessibility (OR=1.555; 95% CI: 1.005-2.406), and not meeting the lipid requirement within 24
hours (OR=15.78; 95% CI: 5.985-41.64). Factors related to meeting the 24-hour lipid
requirement included not meeting the 24-hour dietary energy requirement (OR = 2.309; 95% CI:
1.471–3.625), not meeting the 24-hour protein requirement (OR = 35.03; 95% CI: 20.05–59.86),
and not meeting the 24-hour carbohydrate requirement (OR = 14.95; 95% CI: 5.836-38.43).

Conclusion: The prevalence of elderly individuals with adequate dietary intake remains low,
making it crucial to encourage a healthy lifestyle among this population. To address this, both
the elderly and their family members need to enhance their efforts to seek nutritional counseling
and establish a balanced diet. Raising awareness through educational programs and involving
healthcare professionals, such as dietitians and nutritionists, can provide tailored dietary advice.
Family members play a vital role in preparing nutritious and appealing meals, understanding
portion sizes, and recognizing the nutritional value of foods. This collaborative approach can
significantly improve the dietary habits and overall health of the elderly.

Keywords: 24-hour dietary intake, nutritional status, meeting needs, elderly