Diet and health outcomes in vulnerable populations.

Good nutritional health is essential to physical and cognitive function, prevention or management of chronic health conditions, and prevention of disability. Poor nutritional health describes dietary intakes of inadequate amounts of energy, protein, and individual or multiple micronutrients. Homebound older adults are considered the most vulnerable for poor nutritional health; many are poor and experience persistent food insufficiency. This chapter discusses the importance of dietary intakes, especially for homebound older adults, and presents resource-related factors that influence food choice and food acquisition. These factors include limited household income, food insufficiency, and utilization of community nutrition assistance programs. Of importance is that low dietary intakes influence balance, gait speed, leg strength, and overall lower extremity physical performance (LEP). This is crucial since decreased LEP is associated with increased disability over time. It is time to review policies and programs that influence dietary intake of homebound older adults.