A contextual identification of home-living older adults' positive mealtime practices: A honeycomb model as a framework for joyful aging and the importance of social factors

Risk of Social Isolation as a Contributing Factor to Diet Quality in Community-Dwelling Older Persons Living in the Australian Capital Territory-A Pilot Study

OBJECTIVES

Social isolation is recognised as a risk factor in the inflammatory process. This study explored the association between social isolation and the Dietary Inflammatory Index (DII) in community-dwelling older persons.

METHODS

This cross-sectional pilot study recruited 107 community-dwelling people aged over 55 years living in the Australian Capital Territory. Participants completed an extensive food frequency questionnaire and provided anthropometric and sociodemographic data. Social isolation was evaluated using the Lubben Social Network Scale (LSNS). Diet quality was assessed using DII.

RESULTS

Average age was 70.1 (±8.61) years and 62.8% were female. The average DII score was -1.10 (±1.21), indicating an anti-inflammatory diet. Higher LSNS was associated with lower DII (b (95% CI) = -0.041 (-0.066, -0.17); p < 0.01) and was positively influenced by the number of people in household (b (95% CI) = 5.731 (2.336, 9.127); p = 0.001).

CONCLUSION

Increased risk of social isolation was associated with an increased tendency towards a more inflammatory diet. Reducing social isolation may decrease the inflammatory component of dietary intake for older persons living independently in the community.

Opportunities and barriers for food intake in older age - a Norwegian perspective

Background

The ageing processes occur slowly over time and are often not detectable by the individual. Thus, preparing for dietary needs in later years should start at an earlier age than most people realise.

Objective

This study aims at better understanding what characterises food-related practices in active, home-living older adults, in order to identify food-related factors that act as barriers and those that promote healthy ageing.

Design

Three experiments were conducted: First, a web-based quantitative survey to collect information about home-living older adults' food-related behaviours (67+ years, N = 1,005). Second, two focus groups with respondents 67-74 years (N = 7) and 75-84 years (N = 6) to elicit aspects not adequately covered in the survey. Third, 10 individual interviews to provide in-depth insights.

Results

Two distinct groups were identified in the survey; 67-79 years and 80+ years. The older age group experienced more barriers and restrictions in food intake and food-related behaviours compared to the younger group. Good taste, routines and social settings were important for appetite and food intake.

Discussion

Using a mixed-methods approach proved valuable for extracting information and a better understanding of what impacts on food-related aspects amongst older adults. Strategies for upholding a healthy food intake involve establishing daily routines and meeting arenas where older adults can socialise and eat food together.

Conclusion

This study confirmed that knowledge of older adults' physical needs, barriers and abilities must be a part in preparation for a healthy diet.

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.

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.

An Umbrella Review of Systematic Reviews on Food Choice and Nutrition Published between 2017 and-2019

The objective of this umbrella review was to provide an update on the latest knowledge in the field of food choice and nutrition. Databases Scopus and ISI-Web of Science were searched for "food choice" AND nutrition. Papers were included if they were systematic reviews published between January 2017 and August 2019 on any subpopulation group. In total, 26 systematic reviews were kept. Data were extracted with a predetermined grid including first author, publication year, country, population group, explanatory constructs (intervention focus) and reported outcomes. Common indicators for outcome measures on food choice and nutrition studies are nutrition knowledge, healthy food choices, food purchases and food and nutrient intake. The most common strategy implemented to alter food choice with a nutritional aim is nutrition education, followed by provision of information through labels. Among children, parent modelling is key to achieving healthy food choices. In general, combining strategies seems to be the most effective way to achieve healthier food consumption and to maintain good nutrition in all age groups.

"I Go Upstairs and Eat in Front of the Television:" the Cooking and Eating Behaviors of Mexican Older Women Living Alone

The increasing tendency of older people living alone may pose a number of challenges including factors related to food insecurity, such as functional impairment, social isolation, and financial vulnerability. The purpose of this study was to explain the cooking and eating behaviors of Mexican older women living alone using a life course perspective. A qualitative research methodology was chosen and deductive thematic analysis was used to examine accounts given by 14 older women through one-on-one interviews. Findings showed that age-related transitions, role changes, and the social context in which older women are embedded have changed their cooking and eating behaviors. Participants mentioned the need to accept and adapt to changes in later life; however, the loss of commensality, cooking for one, economic constraints, a decline in health, and the disruption of family roles and rituals were identified as the negative aspects affecting the cooking and eating behaviors of older women.