EC Nutrition

Research Article Volume 19 Issue 7 - 2024

Informal and Formal Caregivers’ Nutritional Status, Food Insecurity and Caregiver Burden

Filipa Correia1, Beatriz Teixeira1,2,3*, Rui Poínhos1, José Manuel Silva4 and Cláudia Afonso1,2,3

1Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto [Faculty of Nutrition and Food Sciences, University of Porto], Porto, Portugal

2EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal

3Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal

4Escola Superior de Saúde de Santa Maria, Porto, Portugal

*Corresponding Author: Beatriz Teixeira, Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.
Received: May 08, 2024; Published: July 01, 2024



Introduction: Caregiving has an association with poorer health outcomes, physical stress and emotional stress, due to caregivers’ predisposition to leave their own basic needs unfulfilled in favor of those of the care recipient. Furthermore, there is an association between caregiving and financial constraints, thus, informal caregivers are more vulnerable to food insecurity. Lastly, it is reasonable to deem that caregivers’ food insecurity, which is often accompanied by a higher emotional burden, might negatively influence their nutritional status and, indirectly, decrease the quality of the care provided.

Objectives: This study aims to characterize informal and formal caregivers’ nutritional status, food insecurity level and caregiver burden, and to study the associations between those three conditions.

Methodology: In this cross-sectional study, data collection was performed through two questionnaires developed by the investigation team, applied on-site and online. Nutritional status was assessed through body mass index (BMI) and the adherence to a healthy diet lifestyle (using the “Brief and initial evaluation of dietary habits” scale). Food insecurity was screened by the scale from the “INFOFAMILIA” project. Caregiver burden was assessed through the four-point Zarit Burden Interview developed to be used in Portugal.

Results: Informal caregivers’ BMI, compared to formal caregivers, was significatively higher (mean = 27.5 kg/m2, SD = 6.7 vs. mean = 24.8, SD 4.3, p = 0.018); nevertheless, this study didn’t find significatively differences concerning their level of adherence to healthy diet patterns (1.4% vs. 0.0% low adherence, p = 0.952). Food insecurity had a higher prevalence among informal caregivers (44.7% vs. 27.1%, p = 0.040) and was predicted by not practicing physical exercise, a higher BMI, the presence of caregiver burden and having intermediate (7 to 9 years) of education. Caregiver burden was more prevalent among informal caregivers (61.7% vs. 20.1%, p < 0.001), and it had two protector factors: literacy level (middle school level) and type of caregiver (formal caregiver). Finally, it wasn’t found a significant relation between caregivers’ weight status and food insecurity (OR = 1.12, 95%CI: 0.52; 2.41) nor between caregivers’ weight status and caregiver burden (OR = 1.40, 95%CI: 0.64; 2.96). However, a higher level of food insecurity was associated to higher caregiver burden score (mean = 6.0, SD = 3.5 vs. mean = 4.5, SD = 3.1, p = 0.007).

Conclusion: Caregivers, in particular the informal ones, exhibited an inadequate nutritional status (concerning their BMI values). Besides, food insecurity and caregiver burden were prevalent among this population. Lastly, caregivers’ weight status, food (in)security and caregiver burden were not related to each other. The present study seems to suggest that people who provide any type of care are a risk group for higher BMI, food insecurity and caregiver burden; nonetheless this is even more noticeable in informal caregivers.

 Keywords: Informal Caregivers; Formal Caregivers; Nutritional Status; Food Insecurity; Caregiver Burden

  1. Serviço Nacional de Saúde. Cuidador Informal (2019).
  2. Zavagli V., et al. “Care for carers: an investigation on family caregivers' needs, tasks, and experiences”. Translational Medicine @ UniSa 19 (2019): 54-59.
  3. Decreto-Lei n.º 129/2017. Diário da República n.º 194/2017. Série I de 2017-10-09.
  4. Mooney-Doyle K and Lindley LC. “Family and child characteristics associated with caregiver challenges for medically complex children”. Family and Community Health 1 (2020): 74-81.
  5. Yiengprugsawan V., et al. “Physical and mental health among caregivers: findings from a cross-sectional study of Open University students in Thailand”. BMC Public Health1 (2012): 1111.
  6. Lacey RE., et al. “Informal caregiving and markers of adiposity in the UK household longitudinal study”. PLoS One 7 (2018): e0200777.
  7. Kalanlar B and Kuru Alici N. “The effect of care burden on formal caregiver's quality of work life: a mixed-methods study”. Scandinavian Journal of Caring Sciences 4 (2020): 1001-1009.
  8. Gregório MJ., et al. “Proposta Metodológica para a Avaliação da Insegurança Alimentar em Portugal”. Nutrícias 21 (2014): 4-11.
  9. Horner-Johnson W., et al. “Food insecurity, hunger, and obesity among informal caregivers”. Preventing Chronic Disease 12 (2015): E170.
  10. World Medical Association. “World medical association declaration of Helsinki: ethical principles for medical research involving human subjects”. Journal of the American Medical Association20 (2013): 2191-2194.
  11. Decreto-Lei n.º 104/98. Diário da República n.º 93/1998, Série I-A de 1998-04-21.
  12. Regulamento n.º 587/2016. Diário da República n.º 112/2016, Série II de 2016-06-14.
  13. Lei n.º 58/2019. Diário da República n.º 151/2019, Série I de 2019-08-08.
  14. Lopes C., et al. “Inquérito Alimentar Nacional e de Atividade Física IAN-AF 2015-2016”. Relatório de resultados. Porto: Universidade do Porto (2017).
  15. Gregório MJ., et al. “Aconselhamento Breve Para A Alimentação Saudável Nos Cuidados De Saúde Primários”. Lisboa: Direção-Geral da Saúde (2020).
  16. Perez-Escamilla R., et al. “Dietary energy density and body weight in adults and children: a systematic review”. Journal of the Academy of Nutrition and Dietetics 5 (2012): 671-684.
  17. Berteus Forslund H., et al. “Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population”. International Journal of Obesity (London) 6 (2005): 711-719.
  18. WHO Expert Committee on Physical Status: the Use and Interpretation of Anthropometry (1993: Geneva, Switzerland) & World Health Organization. Physical status: the use of and interpretation of anthropometry, report of a WHO expert committee. World Health Organization (1995).
  19. Bédard M., et al. “The Zarit burden interview: a new short version and screening version”. The Gerontologist5 (2001): 652-657.
  20. Alves S., et al. “Screening for caregiver burden in the community: validation of the European Portuguese screening version of the Zarit burden interview (ZBI-4)”. Clinical Gerontologist 3 (2020): 525-537.
  21. Diniz MAA., et al. “Comparative study between formal and informal caregivers of older adults. Estudo comparativo entre cuidadores formais e informais de idosos”. Ciência & Saúde Coletiva 11 (2018): 3789-3798.
  22. Movimento Cuidar dos Cuidadores Informais. O que é ser cuidador informal em Portugal? (2021).
  23. Carpenter CA., et al. “Weight status and sedentary behavior of alzheimer's disease caregivers”. American Journal of Health Behavior1 (2020): 3-12.
  24. Geiker NRW., et al. “Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa?”. Obesity Reviews 1 (2018): 81-97.
  25. Beesley VL., et al. “Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer”. Supportive Care in Cancer 12 (2011): 1949-1956.
  26. Tombini M., et al. “Nutritional status of patients with alzheimer's disease and their caregivers”. Journal of Alzheimer's Disease 4 (2016): 1619-1627.
  27. Li XS., et al. “Weight status, diet quality, perceived stress, and functional health of caregivers of children with autism spectrum disorder”. Journal for Specialists in Pediatric Nursing 1 (2018).
  28. Acton GJ. “Health-promoting self-care in family caregivers”. Western Journal of Nursing Research 1 (2002): 73-86.
  29. Lopes C., et al. “National food, nutrition, and physical activity survey of the Portuguese general population, IAN-AF 2015-2016: Summary of results” (2018).
  30. Álvares L and Amaral TF. “Food insecurity and associated factors in the Portuguese population”. Food and Nutrition Bulletin 4 (2014): 395-402.
  31. Adelman RD., et al. “Caregiver burden: a clinical review”. Journal of the American Medical Association10 (2014): 1052-1060.
  32. Wardle J., et al. “Stress and adiposity: a meta-analysis of longitudinal studies [published correction appears in Obesity (Silver Spring). 2011 Jun 19(6): 1315]”. Obesity (Silver Spring)4 (2011): 771-778.

Beatriz Teixeira., et al. “Informal and Formal Caregivers’ Nutritional Status, Food Insecurity and Caregiver Burden”. EC Nutrition  19.7 (2024): 01-12.

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