Food behavior change in late-life widowhood: A two-stage process

Changes in food habits during the transition to retirement: the Whitehall II cohort study

BACKGROUND

The transition to retirement is a significant turning point in life, which may lead to changes in food habits.

OBJECTIVE

To examine changes in red meat, fish, vegetables and fruit consumption during the retirement transition and whether these changes vary between sociodemographic groups.

METHODS

The data were from the Whitehall II study, a cohort of 10 308 British civil servants aged 35-55 years at study induction (1985-1988). Data collection has taken place every 2-3 years. Food consumption (n=2484-2491) was assessed with the Food Frequency Questionnaire in the periods before (max. 16 years) and after retirement (max. 16 years). Changes in preretirement and postretirement consumption were compared in the total cohort and subgroups by sex, marital status, preretirement occupation status and financial hardship using linear regression analyses with generalised estimating equations.

RESULTS

Weekly red meat consumption was stable before retirement but increased after retirement (p=0.02), especially among women, single and lower occupational status participants. Fish consumption increased during the follow-up and the increase was steeper before retirement than postretirement period (p=0.02). Vegetable and fruit consumption also increased during the entire follow-up, but more strongly during preretirement than postretirement period (p<0.001 for both).

CONCLUSION

The transition to retirement is accompanied by favourable (increase in fruit, vegetable and fish) and unfavourable (increase in red meat) dietary changes, varied to some extent by sex, marital status and preretirement occupational status. Our findings suggest that attention should be paid to this transitional phase to promote eating habits in accordance with the recommendations for retirement.

"Think positive and don't die alone" - Foreign-born, South Asian older adults' perceptions on healthy aging

South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults' ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens.

Perceptions and experiences of eating alone among community-living retired Swedes: Loss, routine and independence

The practice of eating together, commensality, is often considered as something positive in later life, particularly regarding peoples' nutritional status and psychosocial well-being. Eating alone, in contrast, is treated as a risk factor, although literature indicates that it is not necessarily something negative. Still, analyses that specifically target older peoples' varied experiences and notions of eating alone are scarce. This study has explored perceptions and experiences of eating alone among older people in Sweden, a country considered highly individualistic, yet with relatively low levels of loneliness in the older population. Semi-structured interviews were conducted with 20 community-living and retired Swedes, 70-90 years of age. A thematic analysis identified three themes: i) 'Eating alone as a manifestation of loss'; ii) 'Eating alone as an everyday routine'; and iii) 'Eating alone as independence and contentment'. General perceptions of eating alone were often related to the current living situation (e.g., cohabiting or single-living). One key finding was an identified tension between the idea of eating alone as something problematic among those living and eating with a partner and the practical experience of an uncomplicated routine among those living and eating alone. Eating together is discussed as a possible social need for many, but perhaps not for all. Some can feel content with eating alone or even enjoy it. Future studies should approach potential disadvantages of eating alone among older people as an open empirical question that is likely to depend on both the individual and the cultural context.

Post-Disaster Mental Health and Dietary Patterns among Older Survivors of an Earthquake and Tsunami

OBJECTIVES

Research suggests that cardiometabolic disease risks are elevated among survivors of natural disasters, possibly mediated by changes in diet. Using the Brief Dietary History Questionnaire, we examined (1) dietary patterns among older survivors of the 2011 Great East Japan Earthquake and Tsunami, and (2) the contribution of posttraumatic stress symptoms (PTSS)/depressive symptoms, as well as relocation to temporary housing on dietary patterns and (3) gender differences in the associations.

DESIGN, SETTING AND PARTICIPANTS

Data came from a prospective cohort study of 1,375 survivors aged 65-89 years (44.6% male).

MEASUREMENTS

PTSS/depression onset was evaluated in 2013, 2.5 years after the disaster. Dietary data was collected with a self-administered brief-type diet history questionnaire in 2020. A principal component analysis identified three posterior dietary patterns.

RESULTS

Diet 1 consisted of high intake of vegetables, soy products, and fruits; Diet 2 consisted of carbohydrate-rich foods and snacks/sweets; Diet 3 consisted of high intake of alcoholic beverages, meat, and seafood. Least-squares linear regression revealed that individuals with PTSS/depression were less likely to exhibit Diet 1, while individuals with PTSS were more likely to exhibit Diet 2 and 3. Especially, males who had depression showed an unhealthy dietary pattern. Those who have lived in a trailer-style temporary housing reported less consumption of Diet 3.

CONCLUSION

Survivors of disaster with symptoms of mental illness tended to exhibit less healthy dietary patterns after 9 years. Diet varied by type of post-disaster mental illness, gender, and current social circumstances. We lacked pre-disaster BDHQ data, which is a limitation.

Implication of knowledge, lifestyle and self-efficacy in the prevention of cardiovascular diseases' risk factors among the urban elderly

Background: Cardiovascular disease (CVD) is preventable by effectively managing its risk factors. Such risk factors (smoking, unhealthy eating habits, sedentary lifestyles, etc.) are judged to reflect an individual's self-efficacy, lifestyle modification, and CVD knowledge. Objectives: To evaluate the relationship between lifestyle practices, self-efficacy, and knowledge of CVDs risk factors among the elderly. Methods: A descriptive cross-sectional study was conducted on 424 randomly individuals whose age is ≥60 years. A questionnaire-based survey was administered on the self-efficacy rate, lifestyle practices, and respondents' knowledge of CVDs risk factors. Respondents with a score of ≤50%, 51%-74.99%, and ≥75% were classified as having low, medium, or high self-efficacy. Similarly, the same score was used to classify poor, fair, or good lifestyle; and low, average, or high knowledge. Data were analysed using Statistical Package for Social Sciences, while association among variables was determined using chi-square. Results: Few respondents were involved in physical exercise (1.7%), cigarette smoking (4.5%), regular soft drinks (18.2%), and alcohol consumption (13.2%). Many respondents used excess salt during cooking (92.7%) or ate outside their homes (64.6%). 58.5%, 30.0%, and 11.6% of the respondents had fair, good, and poor lifestyle practices. 11.3%, 58.7%, and 30.0% had low, medium, and high self-efficacy scores. A total of 45.3%, 35.4%, and 19.3% had low, average, and high knowledge. Knowledge and self-efficacy scores were significantly different (P  =  0.001). Conclusion: High self-efficacy and its significant relationship with knowledge could mean that CVD risk factors can be checked if the elderly have a proper lifestyle, positive attitudes, and nutrition education.

The partner in the plate: the association between changes in partnership status and protein consumption among older people in Europe

Experiencing a change in partnership status at older ages might have detrimental effects on an individual's habits, including eating behaviours. Prior studies presented evidence that widowhood is related to altered diets with a decrease in the amount of protein consumed, which is considered to be an important risk factor of frailty among older people. Using data from Waves 4–8 of the Survey of Health, Ageing and Retirement in Europe (N = 134,313), we investigate the association between stability and changes in partnership status and changes in the frequency of protein consumption at older ages. We also explore the potential moderating role played by changes in economic resources. Having never been married, being divorced and being widowed were significantly associated with a lower frequency of protein consumption among both men and women. The transition to widowhood was significantly associated with a reduction in the frequency of protein consumption, while this same association was not found in the transition to divorce. Subjective evaluation of economic resources did not moderate the relationship between changes in partnership status and frequency of protein consumption. In short, changes in eating behaviours after having experienced the loss of a partner due to widowhood might contribute to accounting for health differentials between those ageing alone and those with a partner.

Psychosocial factors influencing the eating behaviours of older adults: A systematic review

Our understanding of how eating behaviours change in later life have been dominated by the studies of physiological and biological influences on malnutrition. Insights from these studies were consequently used to develop interventions, which are predominantly aimed at rectifying nutritional deficiencies, as opposed to interventions that may enable older adults to eat well and enjoy their food-related life well into older age. The objective of the present review is to summarise the existing knowledge base on psychosocial influences on eating behaviours in later life. Following comprehensive searches, review, and appraisal, 53 articles were included (22 qualitative and 31 quantitative) to provide a greater understanding of the mechanisms underpinning the psychosocial factors influencing eating behaviours. Our analysis identified eight underpinning psychosocial factors that influences eating behaviours in later life; (1) health awareness & attitudes, (2) food decision making, (3) perceived dietary control, (4) mental health & mood, (5) food emotions & enjoyment, (6) eating arrangements, (7) social facilitation, and (8) social support. The importance and lasting influence of early food experiences were also identified as contributing to eating behaviours in later life. The review concludes with the call for further investigation into specific psychosocial factors that influence eating behaviour, calls for improvements in methodologies, and a summary of psychosocial barriers and enablers to eating well in later life.

The legacy of marriage: Using food to challenge traditional gender norms in widowhood

Studies on aging tend to apply a traditional approach to gender roles. This is especially evident in studies of widowhood, as responses to this life transition tend to be shaped by gender. Studies on food and widowhood in old age suggest that men and women differ when it comes to food related life after the loss of a spouse. As the traditionalist story goes, men face practical challenges because they lack cooking skills whereas women face emotional challenges because they are no longer the food provider. However, this research often overlooks that married couples may have had non-traditional ways of dividing domestic household tasks, and that this division of labor is likely to have affected the way in which widows and widowers experience and handle food related challenges. Applying a life course perspective to 31 qualitative interviews, I show that the way older men and women adjust to food activities in widowhood is shaped by the way these activities were shared in their marriage rather than by gender per se.

Biological mechanisms underlying widowhood's health consequences: Does diet play a role?

The loss of a spouse is a highly stressful event that puts older adults at increased risk for morbidity and mortality. The risk is highest in the first year to 18 months post-loss; nevertheless, widow(er)s, in general, are at heightened risk of cardiovascular disease (CVD) related morbidity and mortality, and to a lesser extent, non-CVD related morbidity and mortality. The primary goal of this article is to argue for a perspective that considers diet and emotion-induced autonomic, neuroendocrine, and immune dysregulation, in unison, to understand the mechanisms underlying morbidity and mortality in early widowhood. Toward this end, we first summarize our previously published work, as well as work from other investigatory teams, showing that compared with those who were not bereaved, widow(er)s have higher levels of pro-inflammatory cytokine production and more dysregulated autonomic and neuroendocrine activity than non-widow(er)s, independent of health behaviors such as diet. We highlight that a major gap in our current understanding of the biobehavioral mechanisms that underlie the widowhood effect is the role of diet and hypothesize that the adverse health impact of grief and associated negative emotions and diet may be more than additive. Therefore, we propose that diet may be a pathway by which widow(er)s are at higher CVD risk requiring further investigation.

Dietary habits and medical examination findings in Japanese adults middle-aged or older who live alone

OBJECTIVE

The influence of living alone on multiple food and nutrition behaviors across a range of ages and genders has not been sufficiently investigated. Moreover, to our knowledge, no studies have described both dietary status and medical examination findings in persons living alone. Among individuals who attended a health checkup in a rural town in Japan, we investigated dietary habits and medical examination findings in persons living alone and those living with one or more other persons.

METHODS

The participants in this investigation were 501 community-dwelling individuals aged 40 to 91 y (mean, 63.8 ± 9.9 y). Thirty-four (16.4%) of the 207 men and 45 (15.3%) of the 294 women lived alone. Dietary intake frequency of 28 types of foods and drinks, including various vegetables, fruits, meat, seafood, and dairy products, was investigated based on responses to a self-completed questionnaire. During the physical examination, body weight, body mass index, body fat percentage, and blood pressure (systolic and diastolic) were measured. Blood examination included red blood cell count, white blood cell count, platelet count, hemoglobin, hematocrit, total protein, albumin/globulin ratio, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, creatinine, blood urea nitrogen, uric acid, and serum calcium.

RESULTS

Multivariate analysis revealed that living alone independently was associated with a reduced intake frequency of various vegetables and seafood, especially in men. Diastolic blood pressure and triglyceride levels were significantly higher in men living alone than in men living with other persons. The albumin/globulin ratio in women living alone was significantly lower than in women living with other persons.

CONCLUSIONS

It was found that living alone was associated not only with a reduced quality of dietary intake but also with an unfavorable trend in some of the medical examination findings.

‘I'm old, but I'm not old-fashioned’: mealtimes and cooking practices among Danish widows and widowers

Existing research on how older adults handle challenges associated with domestic housework, and in particular food work, almost invariably assumes that older adults are traditionalist, and that this affects the way they adjust to widowhood. This assumption is problematic, as decades of research have emphasised increasing gender equality in food work. In this paper, I explore how older adult men and women adjust to food preparation after the loss of a spouse. Interviews with 31 Danish widows and widowers aged between 67 and 86 years old suggest that the men have made culinary progress. However, I also show that the narratives around domestic food work among the older generations remain gendered: both men and women identify widowed men's domestic food work as something meriting acknowledgement, and men and women draw on traditional masculine and feminine ways of approaching domestic food work.

Food Habits of Older Australians Living Alone in the Australian Capital Territory

The link between adequate nutrition and quality of life for older persons is well established. With the proportion of older adults increasing, policy regarding support and care for the ageing has shifted emphasis to keeping older adults in their homes for as long as possible. Risk of malnutrition is an issue of importance for this population and, while this risk is well researched within the hospital setting, it is still relatively under-researched within the community-dwelling elderly, particularly with respect to the lived experience. This qualitative study (underpinned by interpretative phenomenology philosophy) explores how the lived experiences of community-dwelling older people living in one-person households in the Australian Capital Territory (ACT) influences dietary patterns, food choices and perceptions about food availability. Using purposeful and snowballing sampling, older people (65 years and over) living alone in the community participated in focus group discussions triangulated with their family/carers. Data were thematically analysed using a previously established approach. Participants (n = 22) were interviewed in three focus groups. Three themes were identified: active and meaningful community connectedness; eating well and behaviours to promote dietary resilience. Of these, community connectedness was pivotal in driving food patterns and choices and was a central component influencing behaviours to eating well and maintaining dietary resilience.

Beliefs about inevitable decline among home-living older adults at risk of malnutrition: a qualitative study

BACKGROUND

Approximately 14% of free-living adults aged ≥65 years are at risk of malnutrition. Malnutrition screen and treat interventions in primary care are few, show mixed results, and the advice given is not always accepted and followed. We need to better understand the experiences and contexts of older adults when aiming to develop interventions that are engaging, optimally persuasive and relevant.

METHODS

Using the Person-based Approach, we carried out 23 semi-structured interviews with purposively selected adults ≥65 years with chronic health or social conditions associated with malnutrition risk. Thematic analysis informed the development of key principles to guide planned intervention development.

RESULTS

We found that individuals' beliefs about an inevitable decline in appetite and eating in older age compound the many and varied physical and physiological barriers that they experience. Also, we found that expectations of decline in appetite and physical ability may encourage resignation, reduce self-efficacy to overcome barriers, and reduce motivation to address weight loss and/or recognise it as an issue that needs to be addressed. Fear of loss of independence may also reduce the likelihood of asking general practitioners for advice.

CONCLUSIONS

The key findings identified include a sense of resignation, multiple different barriers to eating and a need for independence, each underpinned by the expectation of a decline in older adulthood. Interventions need to address misperceptions about the inevitability of decline, highlight how and why diet recommendations are somewhat different from recommendations for the general population, and suggest easy ways to increase food intake that address common barriers.

Effects of lunch club attendance on the dietary intake of older adults in the UK: A pilot cross-sectional study

Background:

Lunch clubs are community-based projects where meals are offered with opportunities for social interaction, and a unique dining experience of dual commercial and communal nature.

Aim:

The aim of the present cross-sectional study was to assess differences in the dietary intake between lunch club and non-lunch club days among community-dwelling elderly, living in Dorset, UK.

Methods:

A total of 39 elderly individuals attending local lunch clubs were recruited. Socioeconomic factors were recorded, anthropometric measurements were taken and the dietary intake was assessed in lunch club and non-lunch club days via 24 hour dietary recalls.

Results:

For the majority of participants, having a hot meal (74.4%), meeting with friends (92.3%), dining outside home (76.9%), having a home-styled cooked meal (71.8%) and skipping cooking (43.6%) were considered as important factors for lunch club dining. Absolute energy intake, protein, fat, carbohydrate, saturated fatty acids, fibre, potassium, calcium, iron, vitamins A, C and folate and water from drinks were significantly greater on lunch club days. When intake was expressed as a percentage of the dietary reference values, all examined nutrients were consumed in greater adequacy during lunch club days, except potassium and vitamin D.

Conclusions:

Lunch clubs appear to be an effective means for ameliorating nutrient intake among older adults, while in parallel, offer the opportunity for socializing and sharing a hot meal with peers.

"Take good care of yourself" An integrative review of older widows' self-care for health and well-being

Take good care of yourself is a regard often said to older bereaved women. However, what does it mean? Though self-care is a well-known phenomenon within health, it is not well understood in the context of late life spousal bereavement and widowhood. We undertook an integrative review to synthesize knowledge of older women's self-care challenges, resources and activities when bereaved and in a healthy transition to widowhood. Good care refers to health-promoting self-care and can be explained as the older widows' ability to access and mobilize resources and activities that are significant for a healthy transition to widowhood.

“A mesa que encolheu”: a perspectiva alimentar das mães que perderam filhos

Resumo Este artigo descreve a relação de mães enlutadas com a alimentação, com base na fenomenologia existencial, considerando que o espaço familiar alimentar, protagonizado pela matriarca, pode ser perturbado com a perda de um filho. Foram realizadas entrevistas com quinze mães frequentadoras de Organizações Não Governamentais de apoio ao luto, com idade entre 40 e 61 anos. Da análise emergiram quatro eixos temáticos que indicam como a mãe enlutada se comporta no contexto da alimentação: a ausência de fome e do prazer em se alimentar; o ato de compartilhar refeições versus o luto materno; o confronto com a “cadeira vazia”; reações e sentimentos diante da culinária que simboliza a memória do filho. A influência que o luto exerce na relação das mães com a alimentação foi evidenciada de diversas maneiras, seja na ausência de fome, na alteração do peso e na falta do(a) filho(a) nas interações sociais durante as refeições compartilhadas, representando os desafios da mãe perante uma “mesa que encolheu”, exigindo das mesmas novas significações frente à alimentação. Compreende-se que a relação da enlutada com a alimentação é permeada de conflitos que a expõe a risco de desvios nutricionais e demanda apoio com profissionais sensíveis e esclarecidos sobre essa condição.

Health behaviors and illness according to marital status in middle-aged Koreans

Background

Marital status influences health and this association might differ by time and/or country. Divorce rates have increased abruptly in Korea. We investigated relationships between marital status and health behaviors and illness among middle-aged Koreans.

Methods

Data from the fifth Korean National Health and Nutrition Examination Survey 2010-12 was used. Participants were middle-aged (40-65 years) Koreans (3015 male and 4498 female) who had been married. Health behaviors and physical and mental health status were evaluated separately for each gender according to marital status (currently married versus separated, divorced or widowed) using logistic regression analyses adjusted for age, income level and region.

Results

About 5.4% of men and 13.0% of women lived without their spouses. Odd ratios (ORs) for smoking, binge drinking, inadequate sleep, hypertriglyceridemia and depression were significantly higher in participants not living with their spouses. ORs for non-participation in regular health examinations and cancer screenings, anemia, elevated alanine aminotransferase and suicidal ideation were significantly higher in men not living with their spouses.

Conclusions

Health behaviors and illness were significantly worse in middle-aged Koreans not living with their spouses. Men were more susceptible to poor health screening, nutritional deficiencies and mental illness. Preventive services are necessary to improve their health status.

Exploring the Views and Dietary Practices of Older People at Risk of Malnutrition and Their Carers: A Qualitative Study

BACKGROUND

While malnutrition is an important cause of morbidity and mortality in older people, it is commonly under-recognised. We know little on the views of community-dwelling older people and their carers regarding the management of malnutrition. The aim of the study was: (a) to explore views and dietary practices of older people at risk of malnutrition and their carers; (b) to identify gaps in knowledge, barriers and facilitators to healthy eating in later life; (c) to explore potential interventions for malnutrition in primary care.

METHODS

A qualitative study was performed using semi-structured interviews with participants recruited from four general practices and a carers' focus group in London. Community-dwelling people aged ≥75, identified as malnourished or at risk of malnutrition (n = 24), and informal carers of older people (n = 9) were interviewed. Data were analysed using thematic analysis.

RESULTS

Older people at risk of malnutrition rarely recognise appetite or weight loss as a problem. Commonly held perceptions include that being thin is healthy and 'snacking' is unhealthy. Changes in household composition, physical or mental health conditions and cognitive impairment can lead to inadequate food intake. Most carers demonstrate an awareness of malnutrition, but also a lack of knowledge of what constitutes a nutritious diet. Although older people rarely seek any help, most would value advice from their GP/practice nurse, a dietitian or another trained professional.

CONCLUSION

Older people at risk of malnutrition and their carers lack knowledge on nutritional requirements in later life but are receptive to intervention. Training for health professionals in delivering tailored dietary advice should be considered.

On Your Own: Older Adults' Food Choice and Dietary Habits

The United Kingdom, in common with many countries, has an ageing demographic. Changes accompanying ageing can influence food choice and dietary habits. This study explored older adults’ perceptions and practices related to dietary behaviour and the factors influencing their food choice in later life. Semi-structured focus-group discussions were conducted with 30 individuals (aged 63–90 years) in a UK city. An inductive thematic approach was adopted for data analysis, and 4 themes and 12 sub-themes emerged: age-related changes (lower appetite, food changes, declining physical function); food access (food cost, support with food, maintaining independence); on your own (cooking for one, eating alone, shopping for one); and relationship with food (food variety, eating what you want, dieting). These influenced participants’ food acquisition, food preparation and cooking, as well as eating habits. Living alone and its substantial influence, as well as associated social isolation and loneliness, were highlighted in many of the discussions. Given the possible implications for nutritional intake, further work is recommended in this area. Likewise, steps should be taken to improve food access, increase opportunities for commensal eating and, fundamentally, address social isolation and loneliness in the older population.

Sodium and potassium urinary excretion and their ratio in the elderly: results from the Nutrition UP 65 study

BACKGROUND

We aimed to describe urinary sodium and potassium excretion and their ratio in a representative sample of Portuguese elderly population, according to sociodemographic characteristics and weight status.

METHODS

A cluster sampling approach was used, representing older Portuguese adults (≥65 years) according to age, sex, education level, and regional area within the Nutrition UP 65 study. This cross-sectional evaluation was conducted in 2015 and 2016. From a sample size of 1,500 participants, 1,318 were eligible for the present analysis, 57.3% were women, and 23.5% were aged ≥80 years. Sodium and potassium consumption was evaluated through one 24 h urinary excretion. Inadequate sodium intake was defined as ≥2,000 mg/day, inadequate potassium intake was considered as <3,510 mg/day, and inadequate sodium-to-potassium ratio was defined as >1, according to the World Health Organization cutoffs.

RESULTS

The proportion of the participants with an inadequate intake was 80.0% in women and 91.5% in men (sodium), 96.2% of women and 79.4% of men (potassium), and 98.4% of women and 99.1% of men (sodium-to-potassium ratio). Higher sodium adequacy was observed among the older elderly, unmarried, with lower household income, and underweight/normal weight. Higher potassium adequacy was observed in the younger elderly, married, and with higher income.

CONCLUSION

The majority of the Portuguese elderly population was classified as having inadequate sodium, potassium, and sodium-to-potassium ratio urinary excretion. Therefore, strategies for reducing sodium and increasing potassium intake are priorities in the Portuguese elderly population.

What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK

OBJECTIVE

To explore influences on diet in a group of community-dwelling older adults in the UK.

DESIGN

Data were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.

SETTING

Hertfordshire, UK.

SUBJECTS

Participants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998-2001 and 2011.

RESULTS

Ninety-two adults participated (47 % women; 74-83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about 'keeping going', being motivated to 'not give up', not wanting to be perceived as 'old', as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.

CONCLUSIONS

Interventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.

Alone at the Table: Food Behavior and the Loss of Commensality in Widowhood

OBJECTIVES

Eating alone is a known risk factor for nutritional vulnerability in later life. Widowhood often entails loss of commensality (shared meals). This article explores this experience among older widowed women in relation to food behavior.

METHOD

Qualitative methods based on constructivist grounded theory were used. Interviews were conducted with 15 women living alone in the community, aged 71 to 86 years, and widowed 6 months to 15 years.

RESULTS

Widowhood meant having significantly fewer opportunities for commensality. Participants attributed changes to their food behaviors to the loss of commensality, including food choice, fewer regular meals, and reduced work of meal preparation. These changes were attributed to the experienced difference between shared meals and meals eaten alone, no longer having the commitment of commensality, and having less interest in meal preparation in the absence of obligation or reward of commensality.

DISCUSSION

Eating alone symbolized loss and was less enjoyable, yet the pleasure experienced with food was intact. Focusing on the pleasure of eating may help support women when they lose regular commensality late in life. Free from the commitment of commensality, some shifted away from regular meals and simplified their meal preparation strategies. This has implications for clinical and research endeavors.