"Health literacy, health behavior, and demographic determinants of BMI status among pre-older adults: a cross-sectional study".

BACKGROUND

Nutritional status significantly influences health outcomes during middle and older adulthood. This cross-sectional study aimed to identify determinants of BMI status among pre-older adults (50–59 years) in Phitsanulok Province, Thailand.

METHODS

Multi-stage random sampling was conducted among 532 participants aged 50–59 years. Data were collected using a validated, self-administered questionnaire assessing demographics, health literacy (HL), health behaviors, and nutritional status (Body Mass Index, based on WHO Asian-Pacific criteria). Questionnaire quality was confirmed through content validity, confirmatory factor analysis, and reliability testing. Analysis included descriptive statistics, chi-square tests, and multinomial logistic regression, presenting factors as adjusted relative risk ratios (aRRR) and 95% confidence intervals (95% CI).

RESULTS

Overweight/obesity (BMI ≥ 25 kg/m2) was prevalent, affecting 47.4% of participants, with higher rates in women (51.4%). Most participants had moderate HL (62.8%) and fair health behaviors (57.5%). Adults living alone showed significantly higher risk of both underweight (aRRR 13.02, 95% CI 4.03–42.08) and overweight/obesity (aRRR 4.57, 95% CI 2.30–9.10). Other strong risk factors for overweight/obesity included: having ≥ 20 natural teeth (aRRR 8.17, 95% CI 4.88–13.69), poor health behaviors (aRRR 5.17, 95% CI 2.14–12.51), female gender, and low to moderate HL.

CONCLUSION

The associations between oral health status, health behaviors, HL, and nutritional status emphasize the need for multifaceted public health interventions. Healthcare providers should develop targeted programs addressing modifiable risk factors, with a focus on individuals living alone, those with poor health behaviors, and women. Policy initiatives should integrate oral health with nutritional counseling while strengthening HL to promote healthier aging in this age group.