Low Nutrient Intake and Frailty Among Overweight and Obese Migrant Women From Ethnically Diverse Backgrounds Ages 60 Years and Older: A Mixed-Methods Study

Abstract Objective To examine associations between energy/nutrient intakes and frailty in older migrant women, and to explore perceptions of body weight, dietary intake, and physical function. Design Cross-sectional, mixed-methods study. Setting Birmingham, United Kingdom. Participants Seventy-six first-generation migrant women ≥ 60 years of age. Main Outcome Measures Energy/nutrient intakes (assessed by 24-hour dietary recall), frailty (using the frailty phenotype), and links between perceptions of body weight, dietary intake, and physical function (via semi-structured interviews). Analysis Bivariate and logistic regression analyses examined associations between frailty and low energy/nutrient intakes. Interviews were analyzed using inductive thematic analysis. Results Seventy-six women completed a 24-hour dietary recall; 46 participated in a semi-structured interview. Low energy intake was associated with frailty (odds ratio [OR], 11.71; 95% confidence interval [CI], 2.36–57.97). After adjusting for energy and other confounders, a low intake of > 3 nutrients was associated with frailty (OR, 6.58; 95% CI, 1.01–43.08). Qualitative data suggest that dietary intake was influenced by concerns about body weight and perceptions that unhealthy foods reduce mobility. Conclusions and Implications Among older migrant women with high prevalence of overweight/obesity, an inadequate dietary intake may be a stronger predictor of frailty than weight loss. Dietary interventions should focus on healthy weight maintenance and optimization of nutritional adequacy and physical function.