{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:01:14Z","timestamp":1787029274119,"version":"build-2736575974"},"reference-count":44,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Thammasat University Bualuang ASEAN Chair Professorship Grant"},{"name":"U.S. Fulbright Foundation\/Fulbright Thailand"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The older adult population in Thailand has been steadily increasing in recent years, and urbanization has resulted in many older adults living independently, leaving many at nutritional risk. The purpose of this research is to explore food security among Thai older adults using a simple screening tool, the DETERMINE tool, as well as from three surveys which reflect seniors\u2019 health and ultimately food security including the mini-mental state examination (MMSE), the self-efficacy for physical activity scale (SEPAS), and the health literacy questionnaire. The DETERMINE tool was used in Thailand for the first time in this study. The findings revealed a moderate risk of food insecurity amongst participants, as most of them claimed to have underlying diseases, eat alone, eat a few nutrient-rich foods, and take medication. The MMSE, SEPAS, and health literacy questionnaire results suggested that food security was found to be negatively correlated with higher cognitive ability, higher physical activity, self-efficacy, and higher health literacy. In conclusion, there appears to be a high risk for malnutrition among older adults in Thailand, particularly in those with low income and underlying diseases.<\/jats:p>","DOI":"10.3390\/nu16162703","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T10:28:41Z","timestamp":1723631321000},"page":"2703","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Nutritional Health Risk (Food Security) in Thai Older Adults and Related Factors"],"prefix":"10.3390","volume":"16","author":[{"given":"Teeranut","family":"Harnirattisai","sequence":"first","affiliation":[{"name":"Faculty of Nursing, Thammasat University, Khlong Nueng 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sararud","family":"Vuthiarpa","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Rattana Bundit University, Khlong Nueng 12160, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9239-9682","authenticated-orcid":false,"given":"Lisa Renee","family":"Pawloski","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, Thammasat University, Khlong Nueng 12120, Thailand"},{"name":"Department of Anthropology, University of Alabama, Tuscaloosa, AL 35401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-7845","authenticated-orcid":false,"given":"Kevin Michael","family":"Curtin","sequence":"additional","affiliation":[{"name":"Department of Geography and the Environment, University of Alabama, Tuscaloosa, AL 35401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2413-7187","authenticated-orcid":false,"given":"Eden","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Department of Anthropology, University of Alabama, Tuscaloosa, AL 35401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5459-9495","authenticated-orcid":false,"given":"Jenny","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Alabama, Tuscaloosa, AL 35401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5572-3540","authenticated-orcid":false,"given":"Sophia Madeleine","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Alabama, Tuscaloosa, AL 35401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"ref_1","unstructured":"(2024, February 12). Food Security & Nutrition: Essential Ingredients to Build Back Better. Available online: https:\/\/www.who.int\/news-room\/events\/detail\/2022\/10\/18\/default-calendar\/food-security-nutrition-essential-ingredients-to-build-back-better."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Phulkerd, S., Gray, R.S., Chamratrithirong, A., Pattaravanich, U., and Thapsuwan, S. (2023). Financial satisfaction, food security, and shared meals are foundations of happiness among older persons in Thailand. BMC Geriatr., 23.","DOI":"10.1186\/s12877-023-04411-1"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"457","DOI":"10.3390\/adolescents3030032","article-title":"Gender-Based Determinants of Obesity among Thai Adolescent Boys and Girls","volume":"3","author":"Pawloski","year":"2023","journal-title":"Adolescents"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.gerinurse.2021.06.005","article-title":"Factors associated with nutrition risk among community-dwelling older adults in Thailand","volume":"42","author":"Nawai","year":"2021","journal-title":"Geriatr. Nur."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Vapattanawong, P., Aekplakorn, W., Rakchanyaban, U., Prasartkul, P., and Porapakkham, Y. (2010). Obesity and mortality among older Thais: A four year follow up study. BMC Public Health, 10.","DOI":"10.1186\/1471-2458-10-604"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"em458","DOI":"10.29333\/ejgm\/12855","article-title":"Association of abdominal obesity and systolic blood pressure indices with cardiovascular disease risk prediction among community-dwelling older adults","volume":"20","author":"Duangjai","year":"2023","journal-title":"Electron. J. Gen. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"861","DOI":"10.35755\/jmedassocthai.2022.09.13596","article-title":"Prevalence and Risk Factors of Overweight and Obesity and Physical Activity Patterns among Elderly Individuals in Southern Thailand: A Community Cross-Sectional Study","volume":"105","author":"Sukchan","year":"2022","journal-title":"J. Med. Assoc. Thail. Chotmaihet Thangphaet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1605755","DOI":"10.3389\/ijph.2023.1605755","article-title":"Financial Hardship on Food Security in Ageing Populations","volume":"68","author":"Phulkerd","year":"2023","journal-title":"Int. J. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1353\/hpu.2010.0569","article-title":"Assessing Health Status in the Elderly: The Nutrition Screening Initiative","volume":"7","author":"Barrocas","year":"1996","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1017\/S0007114599000112","article-title":"The \u2018Mini Nutritional Assessment\u2019 (MNA) and the \u2018Determine Your Nutritional Health\u2019 Checklist (NSI Checklist) as predictors of morbidity and mortality in an elderly Danish population","volume":"81","author":"Beck","year":"1999","journal-title":"Br. J. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1046\/j.1523-5408.1999.00109.x","article-title":"Usefulness of Nutrition Screening of the Elderly","volume":"2","author":"Sahyoun","year":"1999","journal-title":"Nutr. Clin. Care"},{"key":"ref_12","first-page":"110640","article-title":"Malnutrition in older adults: Correlations with social, diet-related, and neuropsychological factors","volume":"71","author":"Katsas","year":"2020","journal-title":"Nutr. Burbank Los Angel. Cty. Calif"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1038\/sj.ejcn.1600658","article-title":"Evaluating the DETERMINE Your Nutritional Health Checklist and the Mini Nutritional Assessment as tools to identify nutritional problems in elderly Europeans","volume":"52","author":"Beck","year":"1998","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1038\/ejcn.2013.175","article-title":"Nutritional risk of European elderly","volume":"67","author":"Oliveira","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Wang, X., Shen, W., Wang, C., Zhang, X., Xiao, Y., He, F., Zhai, Y., Li, F., Shang, X., and Lin, J. (2016). Association between eating alone and depressive symptom in elders: A cross-sectional study. BMC Geriatr., 16.","DOI":"10.1186\/s12877-016-0197-2"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2834","DOI":"10.1017\/S1368980013002413","article-title":"Malnutrition in older adults on financial assistance in an urban Asian country: A mixed methods study","volume":"17","author":"Koo","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_17","first-page":"911","article-title":"Nutrition screening among community-dwelling older adults in Singapore","volume":"48","author":"Yap","year":"2007","journal-title":"Singapore Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Mikami, Y., Motokawa, K., Shirobe, M., Edahiro, A., Ohara, Y., Iwasaki, M., Hayakawa, M., Watanabe, Y., Inagaki, H., and Kim, H. (2022). Relationship between Eating Alone and Poor Appetite Using the Simplified Nutritional Appetite Questionnaire. Nutrients, 14.","DOI":"10.3390\/nu14020337"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Sugiura, Y., Tanimoto, Y., Imbe, A., Inaba, Y., Sakai, S., Shishikura, K., Tanimoto, K., and Hanafusa, T. (2016). Association between Functional Capacity Decline and Nutritional Status Based on the Nutrition Screening Initiative Checklist: A 2-Year Cohort Study of Japanese Community-Dwelling Elderly. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0166037"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"972","DOI":"10.2105\/AJPH.83.7.972","article-title":"Nutrition and health risks in the elderly: The nutrition screening initiative","volume":"83","author":"Posner","year":"1993","journal-title":"Am. J. Public Health"},{"key":"ref_21","unstructured":"Thailand Ministry of Public Health, Department of Medical Services, Institute of Geriatric Medicine (2008). Medical Technology Assessment: A Comparison of Mini-Mental State Examination-Thai (MMSEThai) 2002 and Thai Mini-Mental State Examination (TMSE) for Screening Older Persons with Dementia Nonthaburi: Institute of Geriatric Medicine, Thai Institute for Geriatric Medicine."},{"key":"ref_22","first-page":"8","article-title":"The Mini-Mental State Examination (MMSE)","volume":"25","author":"Kurlowicz","year":"1999","journal-title":"J. Gerontol. Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1097\/00006199-200005000-00007","article-title":"Testing the reliability and validity of the Self-Efficacy for Exercise scale","volume":"49","author":"Resnick","year":"2000","journal-title":"Nurs. Res."},{"key":"ref_24","first-page":"309","article-title":"Selection of an instrument to measure the physical activity of elderly people in rural areas","volume":"23","author":"Allison","year":"1998","journal-title":"Rehabil. Nurs. Off. J. Assoc. Rehabil. Nurses"},{"key":"ref_25","first-page":"340","article-title":"Health knowledge in taking care of oneself to be healthy of people. Elderly in Bangkok Development and quality checking of tests","volume":"20","author":"Srisaeng","year":"2019","journal-title":"J. R. Thai Army Nurses"},{"key":"ref_26","first-page":"74","article-title":"Knowledge of health in self-care for good health among the elderly in Bangkok: A case study of enhancement of health knowledge in the elderly","volume":"63","author":"Deechum","year":"2019","journal-title":"Urban Med."},{"key":"ref_27","unstructured":"(2023, November 09). Statistical Yearbook Thailand 2020|SEADELT. Available online: https:\/\/seadelt.net\/Documents\/?ID=519."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1111\/j.1470-6431.2009.00795.x","article-title":"Cultural Resistance to Fast-Food Consumption? A Study of Youth in North Eastern Thailand","volume":"33","author":"Seubsman","year":"2009","journal-title":"Int. J. Consum. Stud."},{"key":"ref_29","first-page":"145","article-title":"Thai Food: A Gateway to Cultural Understanding","volume":"IV","author":"Watanasin","year":"2012","journal-title":"J. R. Inst. Thail."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1080\/07256860020007494","article-title":"Not \u2018From Scratch\u2019: Thai food systems and \u2018public eating\u2019","volume":"21","author":"Yasmeen","year":"2000","journal-title":"J. Intercult. Stud."},{"key":"ref_31","first-page":"110","article-title":"The Future of Family Support for Thai Elderly: Views of the Populace","volume":"21","author":"Knodel","year":"2013","journal-title":"J. Popul. Soc. Stud."},{"key":"ref_32","unstructured":"Knodel, J., and Teerawichitchainan, B.P. (2017). Family Support for Older Persons in Thailand: Challenges and Opportunities, Singapore Management University. Research Collection School of Social Sciences."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Chalermsri, C., Rahman, S.M., Ekstr\u00f6m, E.-C., Muangpaisan, W., Aekplakorn, W., Satheannopakao, W., and Ziaei, S. (2022). Socio-demographic characteristics associated with the dietary diversity of Thai community-dwelling older people: Results from the national health examination survey. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-12793-x"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Kaewkamnerdpong, I., Harirugsakul, P., Prasertsom, P., Vejvithee, W., Niyomsilp, K., and Gururatana, O. (2023). Oral status is associated with chewing difficulty in Thai older adults: Data from a National Oral Health Survey. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-02742-4"},{"key":"ref_35","unstructured":"Samnieng, P. (2012). Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dent. Health, 117\u2013123."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bandaogo, M., and Van Doorn, R. (2021). Labor Markets and Social Policy in a Rapidly Transforming and Aging Thailand: The Macroeconomic and Fiscal Impact of Aging in Thailand, World Bank.","DOI":"10.1596\/37234"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Chalermsri, C., Herzig van Wees, S., Ziaei, S., Ekstr\u00f6m, E.-C., Muangpaisan, W., and Rahman, S.M. (2020). Exploring the Experience and Determinants of the Food Choices and Eating Practices of Elderly Thai People: A Qualitative Study. Nutrients, 12.","DOI":"10.20944\/preprints202010.0040.v1"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"270","DOI":"10.5539\/gjhs.v7n4p270","article-title":"Health, happiness and eating together: What can a large Thai cohort study tell us?","volume":"7","author":"Yiengprugsawan","year":"2015","journal-title":"Glob. J. Health Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1093\/alcalc\/agq018","article-title":"Patterns of Alcohol Consumption in the Thai Population: Results of the National Household Survey of 2007","volume":"45","author":"Assanangkornchai","year":"2010","journal-title":"Alcohol Alcohol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Wakabayashi, M., McKetin, R., Banwell, C., Yiengprugsawan, V., Kelly, M., Seubsman, S., Iso, H., and Sleigh, A. (2015). Thai Cohort Study Team Alcohol consumption patterns in Thailand and their relationship with non-communicable disease. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-2662-9"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s10823-021-09438-8","article-title":"Smoking and Drinking Behaviors among Older Adults: A Comparative Analysis of Three Southeast Asian Countries","volume":"36","author":"Knodel","year":"2021","journal-title":"J. Cross-Cult. Gerontol."},{"key":"ref_42","unstructured":"Teerawattananon, Y., and Luz, A. (2017). Obesity in Thailand and Its Economic Cost Estimation, Asian Development Bank."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1017\/S1368980021004250","article-title":"Development of a protein energy malnutrition screening tool for older Thais in public residential homes","volume":"25","author":"Phodhichai","year":"2022","journal-title":"Public Health Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/10810730.2014.934933","article-title":"The association of health literacy with physical activity and nutritional behavior in older adults, and its social cognitive mediators","volume":"19","author":"Geboers","year":"2014","journal-title":"J. Health Commun."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/16\/2703\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:36:40Z","timestamp":1760110600000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/16\/2703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,14]]},"references-count":44,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["nu16162703"],"URL":"https:\/\/doi.org\/10.3390\/nu16162703","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,14]]}}}