Exploring within-meal variety to promote appeal of home-cooked meals in older adults

Undernutrition is highly prevalent in older adults and poses a major threat to physical and mental wellbeing. To foster healthy eating (and healthy aging), strategies are needed to improve dietary quality of older adults. In this study, the feasibility of increasing food variety in home-cooked meals is explored as strategy to promote meat and vegetable consumption in community dwelling older adults. Adults aged 50 years or older (N = 253) evaluated pictures of traditional Dutch dinner meals with more or less variety in the vegetable or meat component in an online questionnaire. Specifically, four different variety 'levels' were presented: (1) no variety, (2) meat variety, (3) vegetable variety, and (4) variety in both meat and vegetables (mixed). Participants indicated for each meal picture how much they would like the meal, whether it represented an ideal portion size, and whether they would be able and willing to prepare the meal. We expected that with increasing variety, liking and ideal portion size would increase, while ability and willingness to prepare the meals would decrease. Results showed that the meals with meat variety and mixed variety were liked less than meals with vegetable variety or no variety. Participants were all highly willing to prepare the meals, but they were less willing to prepare the meals with meat variety and mixed variety compared to the meals with vegetable variety and no variety. All meals were evaluated as being too large, but the meals with vegetable variety and mixed variety were evaluated as more oversized than the meals without variety and with meat variety. These results suggest that encouraging older adults to include variety in home-cooked meals might be more challenging than anticipated.

Factors affecting public acceptance of healthy lifestyle nudges

In two online vignette studies, we investigated the effects of healthy lifestyle nudging and pricing interventions in two different contexts: a supermarket (Study 1) and a train station (Study 2). In Study 1 (N = 318) participants were randomly assigned to evaluate one of eight interventions described in a vignette and designed to either encourage healthier food choices or discourage unhealthy food choices in a supermarket setting. Two interventions comprised a small financial incentive to either encourage a healthy food choice or discourage an unhealthy food choice, but the other six interventions were nudges conceived to specifically impact agency, self-constitution or freedom of choice (three different aspects of autonomy). Relative to these nudges, the financial incentive interventions were not found to be less acceptable or more patronising. Overall, the encouragement of healthy food choices was rated as more acceptable and less patronising. The same pattern of results was found in Study 2 (N = 314). We conclude that interventions threatening specific aspects of one's autonomy do not necessarily affect its acceptance. However, the behavioural focus does affect intervention acceptance, that is, interventions focused on encouraging healthy choices are considered more acceptable than interventions that discourage the unhealthy option.

The impact of changes in taste, smell, and eating behavior in children with cancer undergoing chemotherapy: A qualitative study

Background and aims

Taste changes are the third most common bothersome symptom during treatment in children with cancer. However, it is still unclear what the essence of these taste changes are, to what degree concomitant changes in sense of smell qualify this bothersome treatment symptom and how much of an impact these changes have on the life of children with cancer. The aim of this study was to explore characteristics of both taste and smell changes and to gain insight into the impact of these changes in children with cancer receiving chemotherapy.

Methods

Semi-structured interviews were performed until data saturation was achieved in each age group (6–12, 13–17 years). This resulted in an in-depth description of taste and smell changes, including its impact on the life of 27 children with various cancer types receiving chemotherapy. Thematic analysis of interview data was performed.

Results

Interview data could be grouped into three main themes, namely changes in (1) taste, (2) smell, and (3) eating behavior. As expected, most children reported experiencing taste and smell changes just after start of treatment, but changes varied greatly between children; that is, some reported changes in intensity (increased or decreased), whereas others reported different perceptions or preferences (from sweet to savory). Taste and smell changes (regardless of direction) negatively impacted quality of life, with these changes commonly described as “disappointing” or “frustrating.” Interestingly, particular chemotherapeutic agents were frequently mentioned regarding taste and smell changes, prompting sensory-specific coping strategies. Children's eating behavior changed in terms of alterations in food liking and appetite, sometimes due to chemosensory changes, but children also mentioned specific medication or hospital food being responsible for their altered eating behavior.

Conclusions

Both taste and smell changes are common in children with cancer. The essence of these changes varies widely, but taste and smell changes are generally considered bothersome treatment symptoms. Ways to cope with taste or smell changes specifically were described by the children warranting further research and offering the opportunity for enhancing patient-centered care.

Adding Flavours: Use of and Attitudes towards Sauces and Seasonings in a Sample of Community-Dwelling UK Older Adults

Adding flavours can encourage food intake in older adults for health benefits. The use and attitudes of 22 community-dwelling UK older adults (15 females, aged 65–83 years) towards foods and products that add flavour, e.g., sauces and seasonings, were investigated. Participants used foods/products to add flavour when cooking and eating from 0 to 17 times/day. Taste and flavour were important, and foods/products could add flavour, make foods more pleasant and did not cause discomfort. There were concerns, however, over the healthiness of some foods/products, while consuming a healthy diet and one’s health were important. Reasons for adding flavours largely centred around ‘meal enhancement’, reasons for not adding flavours focused on ‘the product itself’ and ‘characteristics of the meal’, but there was ‘variation’ and many ‘individual differences’. Our findings highlight the benefits of adding flavours for food intakes, particularly the use of naturally flavoursome foods, such as herbs, spices, onion and garlic.

The Psychology of Nutrition with Advancing Age: Focus on Food Neophobia

Many factors impact on eating behaviour and nutritional status in older adults. Strategies can be suggested to combat the impact of these factors, including the development of novel food products, but food neophobia ("the reluctance to eat and/or avoidance of novel foods") may be a barrier to the acceptance of these foods/products. This work aimed to investigate associations between food neophobia, physical disadvantage, and demographic characteristics in adults over 55 years old. Cross-sectional data from 377 older adults was analysed for relationships between food neophobia scores and physical disadvantage (denture wearing, help with food shopping and/or preparing, and risk of sarcopenia), controlling for age group, gender, living status, education, and employment level. Initial analyses demonstrated higher food neophobia scores in association with denture wearing (Beta = 0.186, p = 0.001). However, when demographic characteristics were also considered, food neophobia scores were no longer related to denture wearing (Beta = 0.069, p = 0.226) but instead were related to a higher age, living alone, and a shorter education (smallest Beta = -0.104, p = 0.048). Food neophobia may thus act as a barrier to the consumption of novel foods/products in those who are of higher age, are living alone, and have a shorter education.

Could Eggs Help Increase Dietary Protein Intake in Older Adults? - Exploring Reasons for the Consumption and Non-Consumption of Eggs in People over 55 years old

Compared to other protein-rich foods, eggs are of soft texture, easy to cook, and low cost, and may be useful in increasing protein intakes in older adults. Focus groups and interviews were used to explore all reasons for consuming and not consuming eggs in older adults. Forty-two individuals (20 males, 22 females, aged 56-96 years) took part in one of eight focus groups or two individual interviews. Thematic analyses revealed 69 different reasons for eating or not eating eggs in this population. Reasons were related to: hedonics, properties of the food, preparation style, convenience, physical environment, variety, physical health/abilities, nutrition and health knowledge, food safety, social environment, morality, emotion, and habit. Some of these reasons are likely to be specific to egg consumption in older adults, e.g. properties of the food and convenience combined with physical health/abilities. Some reasons are also likely to be more relevant to older than younger individuals, e.g. medical factors. Investigation of the reasons most related to intake on a population-wide scale would aid the development of interventions.

Human protein status modulates brain reward responses to food cues

BACKGROUND

Protein is indispensable in the human diet, and its intake appears tightly regulated. The role of sensory attributes of foods in protein intake regulation is far from clear.

OBJECTIVE

We investigated the effect of human protein status on neural responses to different food cues with the use of functional magnetic resonance imaging (fMRI). The food cues varied by taste category (sweet compared with savory) and protein content (low compared with high). In addition, food preferences and intakes were measured.

DESIGN

We used a randomized crossover design whereby 23 healthy women [mean ± SD age: 22 ± 2 y; mean ± SD body mass index (in kg/m(2)): 22.5 ± 1.8] followed two 16-d fully controlled dietary interventions involving consumption of either a low-protein diet (0.6 g protein · kg body weight(-1) · d(-1), ~7% of energy derived from protein, approximately half the normal protein intake) or a high-protein diet (2.2 g protein · kg body weight(-1) · d(-1), ~25% of energy, approximately twice the normal intake). On the last day of the interventions, blood oxygen level-dependent (BOLD) responses to odor and visual food cues were measured by using fMRI. The 2 interventions were followed by a 1-d ad libitum phase, during which a large array of food items was available and preference and intake were measured.

RESULTS

When exposed to food cues (relative to the control condition), the BOLD response was higher in reward-related areas (orbitofrontal cortex, striatum) in a low-protein state than in a high-protein state. Specifically, BOLD was higher in the inferior orbitofrontal cortex in response to savory food cues. In contrast, the protein content of the food cues did not modulate the BOLD response. A low protein state also increased preferences for savory food cues and increased protein intake in the ad libitum phase as compared with a high-protein state.

CONCLUSIONS

Protein status modulates brain responses in reward regions to savory food cues. These novel findings suggest that dietary protein status affects taste category preferences, which could play an important role in the regulation of protein intake in humans. This trial was registered at www.trialregister.nl/trialreg/admin/rctview.asp?TC=3288 as NTR3288.