Dietary Outcomes Improvement Older Adults

Q1. What type of interventions improve adherence to recommendations on nutritional intake?
Making dietary changes is a struggle for all, but for older individuals it is particularly difficult, given that they have a lifetime of habits to unlearn. Yet it is often all the more critical for elderly individuals with chronic ailments to make proactive changes in a radical manner to improve their health. The systematic review conducted by Desroches (et al., 2013) of various dietary interventions designed to improve adherence found that the interventions which enhanced following suggested nutritional guidelines included: telephone or video follow-up and feedback offered by providers, self-monitoring nutritional tools, and multiple complex interventions. The review noted that of 123 dietary studies, 32 supported the proposed intervention, only 4 supported the control (no intervention) and 62 showed no statistically significant difference. The majority of the studies were of short duration and judged to be of low quality. Group versus individual sessions, behavioral approaches, restriction of foods, and other types of reminders that were not face-to-face counseling showed no difference.
The studies did not address some notable problems which may occur regarding adherence among the elderly to dietary guidelines, such as low income levels, lack of access to shopping facilities, and difficulties in meal preparation. Depression and a lack of social connections may also inhibit adherence. This is one of the principles of Meals on Wheels, a service which provides prepared meals to the elderly and infirm, and offers a source of personal support and a connection with the outside world. If the elderly individual is not eating or has other health needs that inhibit nutritional adherence, the volunteer can alert someone before the condition becomes life-threatening. In a systematic review of 80 articles of the service by Campbell (et al., 2015), the studies were found to be of low levels of rigor and focused on patient’s self-reported dietary intake. Studies focused primarily on ensuring regular access to food, rather than improving nutritional quality to remedy chronic illnesses. More research is again needed on Meals on Wheels regarding specific interventions to promote dietary improvement.
References
Campbell, A. D., Godfryd, A., Buys, D. R., & Locher, J. L. (2015). Does participation in home- delivered meals programs improve outcomes for older adults? Results of a systematic
review. Journal of Nutrition in Gerontology and Geriatrics, 34(2), 124-67. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480596/
Desroches, S., Lapointe, A., Ratté, S., Gravel, K., Légaré, F., Turcotte, S. (2013). Interventions
to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Review, 2. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23450587