Nutrients · 6 authors, 6 centres
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This cross-sectional study of 1200 Jordanian adults aged 60+ found that 52.8% had poor nutrition knowledge, 52.7% had negative attitudes, and 72.6% had poor practices, with significant regional variation. Low educational level was strongly associated with worse KAP scores. These findings highlight the urgent need for targeted nutrition education and public health interventions for Jordan's elderly population.
**Background:** The elderly population in Jordan is growing rapidly, increasing from 405,101 in 2016 to 588,075 in 2021. Non-communicable diseases (NCDs) cause 78% of all deaths in Jordan, with cardiovascular disease alone accounting for approximately 45% of deaths. Malnutrition—both undernutrition and overnutrition—is a critical health concern in older adults. Nutrition knowledge, attitudes, and practices (KAPs) are essential for preventing malnutrition and ensuring good health, yet no prior studies had assessed KAPs among Jordanian elderly. This study aimed to evaluate nutritional KAPs in Jordanian adults aged 60 years and over.
**Methods:** A cross-sectional survey was conducted from December 2021 to March 2022 across three discrete regions (north, central, south) covering all Jordanian governorates. A total of 1200 participants aged ≥60 years were recruited (33.2% central, 33.4% north, 33.4% south). Inclusion criteria were: age ≥60 years, Jordanian nationality, ability to understand and respond to questions, and willingness to provide informed consent. A structured questionnaire was developed from literature review, translated to Arabic, and validated by a panel of academic nutrition experts. Reliability was assessed via a pilot study (n=42) with Cronbach's alpha values of 0.701 (knowledge), 0.943 (attitude), and 0.805 (practice). Knowledge was assessed with 9 closed-ended questions (yes/no), attitude with 19 multiple-choice questions using a five-point Likert scale, and practice with 9 closed-ended questions (yes/no). Knowledge and practice scores were classified as poor (0–50%), moderate (51–74%), or good (≥75%). Attitude scores were classified as negative (<71.70%), neutral (71.70–84.92%), or positive (>84.92%). Statistical analyses included chi-square tests, independent samples T-tests, and one-way ANOVA, with p<0.05 considered significant.
**Key Results:** Among the 1200 participants, 50.2% were women, 70.8% lived in cities, 92.2% were aged 60–79 years, 73.3% were married, 87.6% lived with spouse/family, 42.3% had low education (no formal education), 80.4% were unemployed, 61.0% had income <JD 500, and 57.6% depended on retirement salary. BMI data showed 38.7% overweight, 34.6% obese, 25.6% normal weight, and 1.1% underweight. Chronic illnesses were reported by 74.6% of participants. Overall, 52.8% had poor knowledge, 52.7% had negative attitude scores, and 72.6% had poor practices. No significant differences were found between men and women in overall KAP scores. Significant regional differences existed (p<0.001): the northern region had the highest prevalence of poor knowledge (65.6%) compared to central (52.5%) and southern (40.4%) regions; the southern region had the highest prevalence of good knowledge (59.6%). For attitude, the central region had the highest prevalence of positive attitudes (55.4%), while the north (65.6%) and south (54.4%) had higher negative attitudes. All regions reported high rates of poor practices, with the north highest (80.5%), followed by central (72.8%) and south (64.4%) (p<0.001). In the southern region, women had significantly higher negative attitudes (58.2%) than men (p<0.001), and women had significantly higher poor practices (68.4%) than men (58.8%). Educational level was strongly associated with KAP: participants with low education (no education, high school, college diploma) had significantly higher prevalence of poor knowledge (55.0%, 56.3%, 53.5% respectively), negative attitudes (57.9%, 53.7%, 53.0%), and poor practices (76.5%, 69.7%, 74.8%) compared to those with bachelor's degree or higher, who had significantly higher good knowledge (53.6% and 75.0%), positive attitudes (59.1% and 70.3%), and better practices (69.4% and 51.3% good/moderate).
**Clinical Implications:** This study reveals alarmingly high rates of poor nutrition knowledge, negative attitudes, and poor practices among Jordanian elderly, with significant regional and educational disparities. The high prevalence of overweight/obesity (73.3%) and chronic diseases (74.6%) underscores the urgent need for targeted nutrition interventions. The strong association between low educational level and poor KAP scores suggests that educational interventions could be effective. Regional differences indicate that public health strategies must be tailored to local contexts, with the northern region requiring the most intensive support. These findings provide a baseline for developing national nutrition strategies and educational programs to improve the nutritional status and quality of life of Jordan's growing elderly population.