Backgrounds: Food security is one of the most important factors affecting food access and diet diversity. Older age is a period when adequate and diverse dietary intake is a challenge and there is a high risk for malnutrition. This study aimed to investigate the association between food security, dietary diversity and socioeconomic factors among the free-living elderly in the city of Tehran. Methods In this cross-sectional study, 583 elderlies (279 men and 304 women) aged 60–80 years were selected through clustered systematic multi-stage sampling method from 10 districts of Tehran city. Food security status of the subjects was determined using locally validated version of the United States Household Food Security Survey Module )US-HFSSM( questionnaire. Socio-economic status was assessed by a questionnaire. Dietary intake of the subjects was evaluated using two 24-hour recalls (one weekday and one week-end) through face-to-face interviews. Dietary Diversity Score (DDS) was calculated using the FAO 2010 guideline. Multinomial logistic regression was applied for the analysis. Results The average age of participants was 67.87 ± 5.86 years. Based on US-HFSSM, 56.9% of the elderly were food secure; while 25.7%, 14.2% and 3.2% suffered from food insecurity (FI) without hunger, with moderate hunger, and with severe hunger, respectively. There was no association between FI and DDS, even after controlling for confounders. Multinomial logistic regression models suggested that after adjusting for age and gender, being illiterate increased the possibility of different levels of food insecurity [(OR = 3.107, 95% CI = 1.672–5.775), (OR = 2.736, 95% CI = 1.261–5.935) and (OR = 6.193, 95% CI = 1.368–28.039)], respectively. Also, FI with mild hunger was associated with total household income (OR = 2.744, 95% CI = 1.100-6.846), while FI with severe hunger was significantly associated with Fars ethnicity (OR = 0.146, 95% CI = 0.051–0.424). Conclusions Overall, socio-economic status and demographic characteristics were the predictors of FI among the elderly, while DDS was not associated with FI.
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