Living alone but eating together: Exploring lunch clubs as a dining out experience

What helps or hinders intervention success in primary care? Qualitative findings with older adults and primary care practitioners during a feasibility study to address malnutrition risk

BACKGROUND

In the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those identified as 'at risk' may help reduce malnutrition risk and associated healthcare use, and improve quality of life. The aim of this study is to explore how primary care practitioners (PCPs) and older adults perceive, use and respond to an intervention to support those identified as 'at risk'.

METHODS

We developed and optimised an intervention (screen and treat protocol, online tools and printed materials) to support primary care practitioners to identify malnutrition risk among older adults, and intervene where necessary. We recruited older adults (described as 'patients' here) taking part in a feasibility study, and carried out semi-structured interviews to assess PCPs' and patients' engagement with the intervention, and identify any contextual issues that supported or undermined their engagement.

RESULTS

Four themes were developed, encompassing patients' and PCPs' perceptions of undernutrition, study measures and appointments, constraints on PCPs' enthusiasm to make a difference, and patients' expectations of nutritional appointments. Key findings included patients commonly not accepting advice for undernutrition/malnutrition but welcoming support for their nutritional needs; checklists potentially distracting patients from recalling discussions about their nutritional needs; a tension between PCPs' desire to recruit less-well patients and logistical difficulties in doing so; and patients compromising their nutritional needs to suit others.

CONCLUSIONS

Diverse factors influence whether an intervention succeeds in primary care. PCPs learn about an intervention/study in different ways, vary in how they understand and accept its aims, and desire to make a difference to their patients. Patients bring perceptions and expectations about the study's aims, coloured by their habits and preferences, prior experience of research and healthcare, and pressure from social expectations. Each aspect must be considered when developing a successful primary care intervention that is viewed as relevant and meaningful, and presented using language that aligns with participants' values and goals. Our findings suggest that references to 'malnutrition risk' should be avoided in any patient-facing materials/interactions as participants do not accept or identify with this label.

Association between Number of Teeth and Eating out of Home: A 2019 Statistical Survey of the Japanese Representative Population

Eating out of home (EOH), with its diverse food options, can benefit those with difficulty preparing their meals, especially older adults. Oral health status may be a determinant of EOH, as food accessibility is influenced by oral health, but this association remains unclear. This cross-sectional study used merged data from two national statistical surveys conducted in 2019. Participants were individuals aged ≥ 65 years who responded to both surveys. The frequency of EOH ( Collapse

Key Words

• eating out
• older population
• oral health

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MESH Headings

• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Cross-Sectional Studies
• East Asian People
• Feeding Behavior
• Japan/epidemiology
• Meals
• Oral Health/statistics & numerical data
• Prevalence
• Surveys and Questionnaires
• Tooth Loss/epidemiology

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Grants

• 202209053A Ministry of Health, Labour and Welfare
• JPMJSP2114 Japan Science and Technology Agency

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Affiliation(s)

Anna Kinugawa Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan; (A.K.); (T.K.); (K.T.); (K.O.)
Takafumi Yamamoto Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan; (A.K.); (T.K.); (K.T.); (K.O.) Preventive Dentistry, Hokkaido University Hospital, Kita 13 jo Nishi 7 Chome, Kita-ku, Sapporo 060-8586, Hokkaido, Japan Department of Health Promotion, National Institute of Public Health, 2-Chome-3-6 Minami, Wako 351-0104, Saitama, Japan
Taro Kusama Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan; (A.K.); (T.K.); (K.T.); (K.O.) Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan
Kenji Takeuchi Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan; (A.K.); (T.K.); (K.T.); (K.O.) Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan
Ken Osaka Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, 4-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Miyagi, Japan; (A.K.); (T.K.); (K.T.); (K.O.)

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Interaction as the foundation for eating practices in shared mealtimes

Mealtimes shared with other people define how, what, how much, and with whom we eat. On such occasions, whether in private or public spaces, and as formal or informal events, our eating practices are inseparable from our interactions with other people. In this Editorial for the Special Issue on Interactional approaches to eating together and shared mealtimes, we provide an overview of the interdisciplinary field of research on eating together and shared mealtimes to illustrate the breadth and depth of work that has been developed in this area to date. The overview is divided into three broad clusters of research that focus primarily on (1) cultural or societal aspects, (2) individual outcomes, or (3) interactional practices. Commonalities across these clusters are discussed, the need for more research across a greater global and cultural diversity of eating practices is highlighted, and the potential for interdisciplinary collaboration on research on eating together and shared mealtimes across diverse scientific disciplines is explored. The papers in this Special Issue showcase a sample of contemporary work from within the cluster of research on interactional practices, and a brief overview of these papers is discussed. Finally, it is argued that as a common area of interest, social interaction as the foundation of eating practices within shared mealtimes poses considerable potential for interdisciplinary collaboration across scientific disciplines, and between scientists, professionals, and participants from the study populations.

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.

The experiences of older adult members of a combined lunch club and assisted shopping group and the perceived value in their occupational lives: A qualitative study

Background and Aims

Health and social care policies are increasingly focusing on community interventions for older adults with service providers diversifying services to widen their reach. As a result, new concepts are under-researched, and it can be challenging to draw parallels with existing interventions. Evidence of the value of community interventions is often limited and conflicting and few researchers have considered the service-user perspective. This qualitative research explores the experiences of members of a combined lunch club and assisted shopping group based in North-East England to understand the perceived value in their lives from an occupational perspective.

Methods

Six older adult members were recruited through convenience sampling to participate in individual semistructured interviews January-March 2020. Interview data was subject to thematic analysis using an inductive approach and three key themes were constructed to represent the data.

Results

Themes identified were: "Togetherness: promoting social belonging"; "Meaningful engagement for older adults" and "Independence and staying active in later life." Findings indicated largely positive experiences with themes depicting influences that motivate engagement and perceived benefits.

Conclusion

Participants particularly valued the opportunity for social engagement, as well as independence through supporting continued engagement with shopping in later life. In conclusion, successful community interventions for older adults need to be meaningful and purposeful.

The Health and Well-being Impacts of Community Shared Meal Programs for Older Populations: A Scoping Review

Background and Objectives

There are social and economic benefits to supporting individuals to live independently for as long as possible. Structured shared meal programs provide opportunities for older individuals to connect in their communities and likely impact their health and well-being. Research in this area has not been summarized in recent years. This scoping review was undertaken to explore the impact shared meal programs may have for older community-dwelling adults.

Research Design and Methods

Nine databases were systematically searched in 2020, and 5,996 unique studies were identified. Two independent reviewers screened titles, abstracts, and full text for inclusion. Reference lists of included papers were hand searched, and the search was updated in 2021. Eighteen studies were included in the final review.

Results

Studies were published between 1980 and 2021 and most were published in the United States. Most studies were cross-sectional, two adopted a qualitative design, one a cohort design. Significant associations were reported between shared meal programs and improved dietary intake; however, minimal improvements were reported for physical health measures. The programs had a positive impact on attendees' social networks and perceived well-being.

Discussion and Implications

Structured shared meal programs show promise in supporting the health and well-being of older adults in the community. They provide additional nutrition, opportunities for social connection, and are perceived to contribute to perceived well-being. More investigation is required to understand how these programs work to facilitate health and well-being, and how they can best be used to improve health outcomes for older populations.

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.

Solo Dining at Home in the Company of ICT Devices

The consumption of a solo meal is often subject to negative associations. Studies indicate that solo diners use information and communication technology (ICT) devices such as smartphones, to mitigate negative experiences such as boredom and loneliness, especially when dining in a public context. However, we know less about the motivation to use such devices and consequent meal experiences in a private context. For this exploratory qualitative study, we asked participants to fill out a cultural probe kit to capture their dining experience and use of ICT devices over a period of seven days. Once completed, the content was discussed with participants during a semi-structured interview. Data was analyzed using thematic analysis in a deductive and inductive form leading to four themes: (1) The experience of eating with others; (2) The use of electronic devices while eating; (3) The meaning of food; and (4) Relaxing features and influences. Participants indicated that eating alone can be a pleasurable experience that people enjoy and perceive as relaxing. ICT devices were named to play an essential part in the dining experience. The entertainment that devices provide can mitigate feelings of loneliness and uncomfortable silence when eating by oneself. We reflect on the findings and point out potential design avenues for future studies.

The lack of opportunity to eat together is associated with an increased risk of weight loss among independent older adults: a prospective cohort study based on the JAGES

OBJECTIVE

the present study aimed to investigate the relationship between the frequency of eating together and the risk of weight loss in older adults.

METHODS

this was a three-year follow-up prospective cohort study based on a self-reported questionnaire. We used data from the Japan Gerontological Evaluation Study (JAGES) conducted in 2016 and 2019. The participants were independent older adults aged ≥65 years in Japan. We used >5% weight loss during follow-up as the outcome variable and frequency of eating together as the explanatory variable. The relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated based on the Poisson regression model with a Huber-White sandwich estimator for standard errors, including possible confounders.

RESULTS

among 56,919 participants, the mean age was 73.0 years (1SD = 5.5) at baseline, and 47.9% were male. About 15.1% (n = 8,596) of the participants experienced >5% weight loss during follow-up. The proportion of each category of the eating together frequency was 36.6% for 'every day', 10.3% for 'several times a week', 26.8% for 'several times a month', 20.5% for 'several times a year' and 5.8% for 'seldom'. Compared to 'every day', only 'several times a year (RR = 1.07, 95% CI = 1.01-1.13)' and 'seldom (RR = 1.17, 95% CI = 1.08-1.27)' were significantly associated with the increased risk of >5% weight loss.

CONCLUSION

there is a temporal association between less frequent opportunities to eat together and the increased risk of weight loss among independent older adults.

Living and eating alone on depressive symptoms by physical frailty status: A cross-sectional study based on the Korean Frailty and Aging Cohort Study

BACKGROUND

General health conditions in older adults, including their mental health, differ greatly based on their physical health conditions rather than age. Thus, we evaluated how lifestyle factors, which included eating and living, affected depressive symptoms in older adults based on their physical frailty status.

METHODS

We included older adults aged 70-84 years from the Korean Frailty and Aging Cohort Study (KFACS). Based on their eating and living patterns, we classified them into four groups: "lived and ate with others," "lived alone yet ate with others," "lived with others yet ate alone," and "lived and ate alone." Depressive symptoms and physical frailty were measured using the Korean version of the Geriatric Depression Scale and modified version of the Cardiovascular Health Study (CHS) Frailty Index, respectively.

RESULTS

A total of 2,702 participants, 11.4% lived with others yet ate alone, and 19.7% lived and ate alone. For robust older adults, after adjusting for variables, the "ate alone" group was significantly related with depressive symptoms, and the "lived and ate alone" group showed a higher risk of depressive symptoms. In the prefrail to frail participants, the "lived and ate alone" group was at a higher risk of depressive symptoms.

CONCLUSION

Eating and living alone are key risk factors for depressive symptoms in community-dwelling older adults regardless of their physical frailty status. Therefore, social interventions are needed for both physically frail and healthy older adults to support their eating patterns and increase opportunities for social interaction.

Health Star Ratings and Beverage Purchase Intentions: A Study of Australian and New Zealand Hospitality Consumers

This study examines the effects of a health star rating system on the attitudes of consumers and their purchase intentions towards beverage products sold in hospitality venues. Previous studies linking health ratings to the food and beverages of consumers mainly focus on fast-moving consumer goods and retail purchasing. However, purchasing patterns in hospitality and foodservice environments are distinct as consumers may be less concerned about health and more interested in the dining experience. Thus, this research focuses on: (1) whether the presence of health star ratings on beverage products influences the willingness of consumers to purchase in the context of the hospitality industry, and (2) identifying the demographic and psychographic factors influencing these behavioural intentions. Using Ordinary Least Squares regression to analyse data from an e-survey of 1021 consumers in Australia and New Zealand, the study found that health star ratings do have an impact on the willingness of consumers to purchase healthy beverages. Specifically, psychographic segmentation around ‘health goals’ is far more pertinent to understanding purchase behaviour in a hospitality setting than age, gender, income, or country. The findings present new insights into the importance of health star labelling on beverages and the purchase intentions of consumers.

Understanding the Key Factors of Older Adults' Continuance Intention in Congregate Meal Halls

Eating congregate/community meals with friends promotes a balanced and healthy diet among older adults. It is helpful for postponing aging, preventing chronic diseases, and improving their quality of life. However, little research has examined the continuance intention for older adults with the congregate meal program in Taiwan. This study established a model for key factors of older adults' continuance intention dining at senior meal halls, and hypotheses to explain them, and subsequently designed questionnaires and scales. By analyzing the longitudinal data collected from 416 individuals using survey questionnaires, we found that the perceived service quality is the main factor that affects the perceived satisfaction, and the perceived satisfaction of the older adults plays an important role in this survey. It showed that if the older adults are satisfied with the service quality provided by the senior meal halls, which will accordingly affect the post-use trust, they will show a positive continuance intention to participate in the senior meal halls. We also found that the older adults have positive views on the planning and service contents of the existing senior meal halls. Together, these results illustrate the process and provide comprehensive insights and evidence to create a better user experience and improve the satisfaction of the congregate meal for older adults.

The use of ICT devices as part of the solo eating experience

An increasing number of people tend to eat alone due to social changes and an altered attitude towards cooking and eating practices. Anecdotal reports indicate that solo diners tend to use information and communication technology devices, for example, the smartphone, as part of the eating experience. While lab studies suggest that the devices contribute to an increased high-calorie food intake and decreased feeling of satiety, these studies disregard the everyday experience and motivation of solo diners. We conducted an exploratory study to investigate how solo diners use digital devices as part of their daily eating experience. Semi-structured interviews with solo diners (N = 12) were analyzed using thematic analysis in an inductive approach leading to six themes. The themes focus on (1) the perception of a meal; (2) the experience of a solo diner; (3) the purpose of using an information and communication technology device; (4) the perceived influence of the devices; (5) factors decreasing and increasing the use; (6) and the potential to promote healthier food consumption. Our results indicate that the use of digital devices while eating alone can lead to distraction, being unaware of the food texture and the amount that is eaten. The devices can also induce a positive influence by providing entertainment and mitigating negative emotions like loneliness and boredom. The devices have the potential to contribute to healthy eating practices by providing education and by influencing the speed of eating through elements of sound. Although the use of devices might negatively affect eating behavior, their ubiquitous presence also offers the opportunity to reach specific, vulnerable populations.

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.

Eating Alone or Together among Community-Living Older People-A Scoping Review

Research on healthy aging commonly concerns problems related to loneliness and food intake. These are not independent aspects of health since eating, beyond its biological necessity, is a central part of social life. This scoping review aimed to map scientific articles on eating alone or together among community-living older people, and to identify relevant research gaps. Four databases were searched, 989 articles were identified and 98 fulfilled the inclusion criteria. In the first theme, eating alone or together are treated as central topics of interest, isolated from adjoining, broader concepts such as social participation. In the second, eating alone or together are one aspect of the findings, e.g., one of several risk factors for malnutrition. Findings confirm the significance of commensality in older peoples' life. We recommend future research designs allowing identification of causal relationships, using refined ways of measuring meals alone or together, and qualitative methods adding complexity.

A Proposed Theoretical Model for Sustainable and Safe Commensality among Older Adults

Eating together at the same table, i.e., commensality, is an old phenomenon among humans. Today, there is a relatively high number of people living in single households eating most meals on their own. Among adults aged 65+ years, both malnutrition and non-communicable diseases are common. These circumstances, as well as foodborne illnesses, cause health problems for the individual, as well as high societal costs. In older adults, several external factors might impact on commensality, such as living arrangements, health status, and cooking competence. Improved knowledge regarding healthy eating and food handling may improve attitudes and behaviors in relation to food safety and dietary intake. Further, commensality has been shown to influence dietary intake in multiple ways. Community-organized activities, e.g., Food Classes for Older Adults (FCOA), may lead to sustainable commensality. Participating in health-promoting activities can contribute to improved health outcomes and improved social interaction among older adults. The objective of this study was to propose a theoretical model to inspire and create networks for sustainable commensality among older adults. The model could serve as a conceptual framework when implementing FCOA in communities and research. Outcomes could be measured by investigating the frequency of commensality, health effects, and well-being.

Aging and the (Chemical) Senses: Implications for Food Behaviour Amongst Elderly Consumers

The growing aging population are increasingly suffering from the negative health consequences of the age-related decline in their senses, especially their chemical senses. Unfortunately, however, unlike for the higher senses of vision and hearing, there is currently nothing that can be done to bring back the chemical senses once they are lost (or have started their inevitable decline). The evidence suggests that such chemosensory changes can result in a range of maladaptive food behaviours, including the addition of more salt and sugar to food and drink in order to experience the same taste intensity while, at the same time, reducing their overall consumption because food has lost its savour. Here, though, it is also important to stress the importance of the more social aspects of eating and drinking, given the evidence suggesting that a growing number of older individuals are consuming more of their meals alone than ever before. Various solutions have been put forward in order to try to enhance the food experience amongst the elderly, including everything from optimising the product-intrinsic food inputs provided to the remaining functional senses through to a variety of digital interventions. Ultimately, however, the aim has to be to encourage healthier patterns of food consumption amongst this rapidly-growing section of the population by optimising the sensory, nutritional, social, and emotional aspects of eating and drinking. An experimental dinner with the residents of one such home where nostalgic-flavoured healthy ice-creams were served is described.

"You've Got to Be Old to Go There": Psychosocial Barriers and Facilitators to Social Eating in Older Adults

BACKGROUND AND OBJECTIVES

Social eating is associated with a range of physical and mental health benefits for older adults. Previous research has identified some of the practical barriers that may limit social eating, such as cost and access to public transport. However, little is known about the psychosocial issues that can affect older adults' engagement with social eating. This study examines psychosocial barriers and facilitators to attending community-based social eating opportunities for older adults.

DESIGN AND METHODS

Forty-two older people aged between 59 and 89 years living in Manchester, UK, participated in semi-structured interviews or focus groups about their experiences and perceptions of social eating opportunities. Interview transcripts were analyzed using inductive thematic analyses. As there are known gender differences in relation to attitudes and behaviors relating to food and social activities, a framework analysis was applied to explore how these themes were differentially expressed by gender.

RESULTS

Four themes were identified that related to the importance of (a) offering more than food; (b) participants' social identity; (c) taking the first step; and (d) embarrassment and self-consciousness about physical health. Gender differences related to perceptions of the relevance and attractiveness of social eating, and the role of social support.

DISCUSSION AND IMPLICATIONS

This study improves our understanding of older adults' social eating experiences and highlights clear strategies by which social eating opportunities could be made more attractive, accessible, and acceptable to older adults.

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.

New roads to commensality in widowhood

With the loss of a spouse everyday commensal routines can be disrupted or discontinued. This may challenge both the rhythm and organization of daily life, and it can be the first step of many impacting negatively on the widow's, or widower's, health status. Entering new commensal circles could offer a remedy here, helping widow(er)s to forge new social relationships through the sharing of meals. In this paper, we explore how old widows and widowers deal with the disruption of their commensal routines, and how they perceive community-based social meal arrangements for older adults. Qualitative interviews with 31 widow(er)s with different educational backgrounds confirm that many widow(er)s see eating alone as problematic, yet the majority prefer not to attend community-based meals. Reasons given for this often mention the other attendees. Widow(er)s describe the "segment" of people they take to be attending community-based meals as "old" in purely negative and stereotypical ways. We found, however, that when the community-based meal was based on a theme - a "shared third" - it was perceived more positively: the widow(er)s were then able to distance themselves from the negative stereotypes of old age and create a positive self-identity in which they were living up to societal norms of successful, active aging.

Disparities in dietary quantity and quality between the two different types of Korean family of older adults living with spouses and living alone: using data from the 6th Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES

This study was conducted to examine disparities in food and nutrient intakes based on family types identified among 1,856 participants who were the Korean elderly people in the 6th Korea National Health and Nutrition Examination Survey (KNHNES) excluding those who were currently practicing the diet therapy.

SUBJECTS/METHODS

We separated the subjects into two groups: living alone (LA, n = 638) and living with a spouse (LS, n = 1,218). We also examined the disparities of dietary quantity and quality of those two groups using complex sampling design general linear regression analyses (CS GLM).

RESULTS

In the LA group, there was a higher percentage of females and average age in LA group was higher than the participants in the LS group. Household income and education level were significantly lower in LA compared to those of LS. The frequencies of skipping meals were higher in LA. LA's food and nutrient intakes showed lower consumption of vegetables, fruits, seaweeds, and of most nutrients. Even after adjusting for the confounding factors, the consumption of vegetables, seaweeds, carbohydrates, potassium, riboflavin, and vitamin C showed lower in LA than LS. Moreover, LA's nutrient intake ratios compared to the KDRIs were lower which turned out to be similar to their nutrient intakes.

CONCLUSIONS

These results show that dietary behavior and food intake of the elderly are associated with family types. Frequently skipping meals and less dietary variety are more common with elderly persons who were living alone. Therefore, it is necessary to integrate the supplementary food programs and nutrition education programs for the elderly living alone.

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.