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Dietary diversity is a key indicator of nutritional status in older adults. Rural areas of Ecuador have a high prevalence of malnutrition in this population, although the associated dietary factors have been poorly documented. To evaluate the association between dietary diversity and nutritional status in older adults in rural areas of Ecuador. A community-based cross-sectional study was conducted among 316 adults aged 65 years and older in the rural parishes of Sinincay, Ricaurte, and El Valle (Cuenca canton). A Dietary Diversity Score (DDS) ranging from 0 to 7 points was calculated based on items from the Mini Nutritional Assessment (MNA) regarding food groups and consumption frequencies. Overall nutritional status was determined using the complete MNA. Chi-square tests and adjusted binary logistic regression were performed. The mean DDS was 5.65 ± 1.70. 50.3% of participants had inadequate dietary diversity (DDS < 5.65). 43.4% were at risk of malnutrition, and 14.6% had established malnutrition. A statistically significant association was found between adequate PDD and better nutritional status (p<0.001). Logistic regression showed that adequate PDD was a protective factor against malnutrition/risk (OR=0.26; 95% CI: 0.15–0.45; p<0.001). Neuropsychological problems (OR=8.00; 95% CI: 3.94–16.22; p<0.001) and difficulty swallowing (OR=3.70; 95% CI: 1.58–8.64; p=0.002) were the main associated risk factors. Inadequate dietary diversity is significantly associated with an increased risk of malnutrition among rural older adults in Ecuador. Nutritional interventions should prioritize dietary variety, with an emphasis on groups with lower education levels, lower socioeconomic status, and the presence of neuropsychological problems.
References
Aiello, A., Calabrò, A., Zarcone, R., Caruso, C., Candore, G., & Accardi, G. (2025). Refining nutritional assessment methods for older adults: A pilot study on Sicilian long-living individuals. Nutrients, 17(11). https://doi.org/10.3390/nu17111873
Arencibia Moreno, R., Hernández Gallardo, D., Linares Girela, D., & Linares Manrique, M. (2022). Nutritional status, dietary habits, and physical activity in older adults from Manta, Manabí. Foods, 11(23). https://doi.org/10.3390/foods11233901
Arimond, M., Wiesmann, D., Frongillo, E. A., Ballard, T., Carriquiry, A., Daniels, M. C., Deitchler, M., Fanou-Fogny, N., Joseph, G., Kennedy, G., Mamiro, P., Mitsiwilou, A. M., Moursi, M., Ntandou-Bouzitou, G., & Ruel, M. T. (2010). Dietary diversity as a measure of the micronutrient adequacy of women’s diets in resource-poor areas: Summary of results from a multicountry verification project. The Journal of Nutrition, 140(11), 2059–2069. https://doi.org/10.3945/jn.110.123448
Bagi, J. K. S., Kour, H., & Dhere, R. A. (2026). Nutritional status and food diversity among elderly people in an urban area of Belagavi, India: A cross-sectional study. Journal of Clinical and Diagnostic Research, 20(4), 12–18. https://doi.org/10.7860/JCDR/2026/80788.22189
Bakhtiari, A., Pourali, M., & Omidvar, S. (2020). Nutrition assessment and geriatric associated conditions among community-dwelling Iranian elderly people. BMC Geriatrics, 20. https://doi.org/10.1186/s12877-020-01668-8
Bylinowska, J., Wierzbicka, E., Bia?ecka-D?bek, A., Mossakowska, M., Szybalska, A., & Pietruszka, B. (2024). Association between dietary variety and anthropometric parameters in community-dwelling older adults: Results of a population-based PolSenior study. Annals of Agricultural and Environmental Medicine, 31(3), 460–471. https://doi.org/10.26444/aaem/190388
Cereda, E. (2012). Mini nutritional assessment. Current Opinion in Clinical Nutrition and Metabolic Care, 15(1), 29–41. https://doi.org/10.1097/MCO.0b013e32834d7647
Chalermsri, C., Rahman, S. M., Ekström, E. C., Ziaei, S., Aekplakorn, W., & Satheannopakao, W. (2023). Dietary diversity predicts the mortality among older people: Data from the fifth Thai national health examination survey. Archives of Gerontology and Geriatrics, 110. https://doi.org/10.1016/j.archger.2023.104986
Corona, L. P., Silva, G. M., & Freiria, C. N. (2024). Factors associated with dietary diversity in community-dwelling Brazilian older adults. Foods, 13(21). https://doi.org/10.3390/foods13213449
Fávaro-Moreira, N. C., Krausch-Hofmann, S., Matthys, C., Vereecken, C., Vanhauwaert, E., Declercq, A., Bekkering, G. E., & Duyck, J. (2016). Risk factors for malnutrition in older adults: A systematic review of the literature based on longitudinal data. Advances in Nutrition, 7(3), 507–522. https://doi.org/10.3945/an.115.011254
Gupta, K., Dutta, S., Mandal, M., Chakrabarti, S., & Bysack, R. K. (2025). Nutritional status and dietary diversity: A community-based assessment among elderly residents of Budge Budge II Block, West Bengal. International Journal of Applied & Basic Medical Research, 15(2), 109–115. https://doi.org/10.4103/ijabmr.ijabmr_533_24
Instituto Nacional de Estadística y Censos. (2020). Proyecciones de población 2010–2060.
Jana, S., & Midya, D. K. (2025). Nutritional status and covariates among the functionally dependent older people of the indigenous communities in India. Journal of Nutrition in Gerontology and Geriatrics, 44(3), 151–164. https://doi.org/10.1080/21551197.2025.2535300
Lin, S., Huang, M., Yang, L., Chen, S., Huang, X., Zheng, J., Yuan, Y., Li, N., Huang, F., & Zhu, P. (2023). Dietary diversity and overweight are associated with high intrinsic capacity among Chinese urban older adults (2020–2021). Experimental Gerontology, 177. https://doi.org/10.1016/j.exger.2023.112194
Maila, G., Audain, K., & Marinda, P. A. (2021). Association between dietary diversity, health and nutritional status of older persons in rural Zambia. South African Journal of Clinical Nutrition, 34(1), 34–39. https://doi.org/10.1080/16070658.2019.1641271
Milte, C. M., Ball, K., Crawford, D., et al. (2019). Diet quality and cognitive function in mid-aged and older men and women. BMC Geriatrics, 19. https://doi.org/10.1186/s12877-019-1326-5
Toniolo, J., Ngoungou, E. B., Preux, P. M., & Beloni, P. (2024). Role and knowledge of nurses in the management of non-communicable diseases in Africa: A scoping review. PLOS ONE, 19(4). https://doi.org/10.1371/journal.pone.0297165
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