Food Tasting as Nutrition Education For Older Adults

Group-based nutrition interventions to promote healthy eating and mobility in community-dwelling older adults: a systematic review

OBJECTIVE

To identify the efficacy of group-based nutrition interventions to increase healthy eating, reduce nutrition risk, improve nutritional status and improve physical mobility among community-dwelling older adults.

DESIGN

Systematic review. Electronic databases MEDLINE, CINAHL, EMBASE, PsycINFO and Sociological Abstracts were searched on July 15, 2020 for studies published in English since January 2010. Study selection, critical appraisal (using the Joanna Briggs Institute's tools) and data extraction were performed in duplicate by two independent reviewers.

SETTING

Nutrition interventions delivered to groups in community-based settings were eligible. Studies delivered in acute or long-term care settings were excluded.

PARTICIPANTS

Community-dwelling older adults aged 55+ years. Studies targeting specific disease populations or promoting weight loss were excluded.

RESULTS

Thirty-one experimental and quasi-experimental studies with generally unclear to high risk of bias were included. Interventions included nutrition education with behaviour change techniques (BCT) (e.g. goal setting, interactive cooking demonstrations) (n 21), didactic nutrition education (n 4), interactive nutrition education (n 2), food access (n 2) and nutrition education with BCT and food access (n 2). Group-based nutrition education with BCT demonstrated the most promise in improving food and fluid intake, nutritional status and healthy eating knowledge compared with baseline or control. The impact on mobility outcomes was unclear.

CONCLUSIONS

Group-based nutrition education with BCT demonstrated the most promise for improving healthy eating among community-dwelling older adults. Our findings should be interpreted with caution related to generally low certainty, unclear to high risk of bias and high heterogeneity across interventions and outcomes. Higher quality research in group-based nutrition education for older adults is needed.

The food environment and diet quality of urban-dwelling older women and men: Assessing the moderating role of diet knowledge

OBJECTIVES

The relationships between local food environments and dietary patterns are important for older adults and could be different in men and women. We examined associations between exposure to neighbourhood food sources and food consumption and the moderating role of diet knowledge separately among older women and men living in Montreal in 2003-2005 (n = 722).

METHODS

The proportion of fast-food outlets relative to all restaurants (%FFO) and the proportion of healthy food stores relative to all stores (%HFS) were estimated for 500 m buffers around participants' homes. Two dietary patterns, designated "Western" and "prudent", reflecting lower- and higher-quality diets respectively, were identified from food frequency questionnaire data. The unique and interactive effects of diet knowledge and food-source exposure on diet scores were tested with separate linear regression models for women and men.

RESULTS

For men, greater %FFO exposure was related to lower prudent diet scores (β = -0.18, p = 0.02), but no effect of %HFS exposure was observed and no interactions were statistically significant. For women, an inverse relationship between %FFO and prudent diet scores was strongest among those with low diet knowledge (β = -0.22, p < 0.01). No other associations were statistically significant.

CONCLUSION

Older men's diet patterns may reflect unhealthy cues associated with fast-food outlets. Among women, diet knowledge potentiated both negative and positive relationships with the food environment. In the absence of consistent main effects of the food environment on diet scores, subgroup analysis is a promising avenue for research.

Menu engineering: A strategy for seniors to select healthier meals

Aims: The specific objective of this ongoing investigation is to assess various menu manipulations and nutrition labelling to determine if they can effectively guide the older adult consumer to select healthier food items from a menu offering meals with differing nutritional attributes.

Methods: One of three randomly assigned menus and a questionnaire were distributed to 150 senior adults (> 60 years of age) living in three assisted living residences, three congregate senior day programmes, and one senior church group in New Jersey, USA. A generic control menu, a treatment menu that used various merchandizing tools to promote the healthier menu items and the same treatment menu with nutritional labels added were designed. Participants selected their top five choices and then answered a short questionnaire, which surveyed demographics and menu selection background information.

Results: The researchers found that certain menu merchandizing tools were effective, while nutrition labelling did not have a substantial effect for this population.

Conclusions: Nutrition labels did not encourage healthier choices for the seniors surveyed in this study. Therefore, subliminal menu treatments may be more effective than nutrition labelling of menu items for elderly populations. Menu design has the potential to encourage healthier decisions through hidden persuaders, without infringing on the rights of elderly consumers to choose more indulgent menu options. However, menus are not effective tools for seniors who cannot cognitively and independently understand the menu. In certain circumstances, a non-select meal offering might be the best option. The menu strategies used in this study are most effective for those who are able to make independent menu choices.