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

Different liking but similar healthiness perceptions of rye bread among younger and older consumers in Sweden

Rye breads, especially those with a chewy texture and sour flavor, have shown several health benefits but their consumption is lower among younger consumers than older. This study explores liking of commercial rye bread in younger and older consumers in relation to socio-demographics, childhood bread-eating habits and food choice motives. Further, sensory attributes are explored in relation to the consumers’ concepts of a rye bread and healthiness in bread. Nine commercial rye breads, previously profiled by descriptive sensory analysis were tasted by 225 younger (18–44 years) and 173 older (45–80 years) consumers. Internal preference mappings by principal component regression for each age group showed low liking for rye bread with a chewy texture and sour flavor in the younger consumer group. Based on the preference mappings, the age groups were separately clustered. Associations between clusters and background variables were studied using discriminant partial least squares regression. Liking of rye bread with a chewy texture and sour flavor in the younger consumer group was associated with e.g., more education, females, childhood bread consumption and the food choice motive health. In the older consumer group, it was related to e.g., more education and childhood bread consumption. Partial least squares regression 1 showed that the combination of sensory attributes such as a light color and soft texture led to the perception of bread being less healthy and not a rye bread, and a dark brown color, chewy texture, sour and bitter flavor to the perception of a healthier bread and rye bread.submittedVersio

Attitudes towards fruit and vegetable consumption measured by a web-based or a paper-and-pen questionnaire

The aim was to investigate the attitudes towards fruit and vegetables (F&V) and assess their association with consumption. A nation-wide random-sample of Swedish inhabitants (18-84y) was contacted in three stages to cover the seasonal variation. They could choose a web-based or a paper-and-pen questionnaire. F&V consumption was measured with a validated 13-item precoded 24-h recall. The items regarding attitudes towards consumption of F&V had pre-drafted answer categories. Explanations for experienced barriers in F&V consumption were asked with open-ended items. Significance level was P<0.01 (2-sided). Totally, 1 304 (51%) questionnaires were returned. The web-based questionnaire (n=313) was more popular among younger (41y vs. 54y, P<0.001) and high-educated (P<0.001). As many as 93% believe F&V have some health effects. However, 58% think 1-2 F&V portions/day would be enough to be healthy and only 7% thought ≥5 F&V portions are needed. Almost all like the taste of F&V. However, 11% of the respondents find daily F&V consumption difficult, and 23% have problems with using F&V in cooking. Preparing vegetables is more often thought to take too long time than preparing fruit (21% vs. 9%). F&V consumption is higher among health interested (P<0.001), or those who try to eat healthily (P<0.001). Several explanations for consumption difficulties were given: not having F&V as a habit, being too lazy, or lack of time, to mention a few. Although using a web-based questionnaire can be a good option for some consumer subgroups, the traditional paper-and-pen version is still preferred by most respondents. Taste preferences cannot explain F&V consumption differences in this population. Preparation of vegetables was found to be more difficult than preparation of fruit which often are consumed as they are. The participants' beliefs on the needed F&V amounts are lower than the recommended ≥5 portions / day. Health interest was positively correlated with the F&V intake. Individual habits and responsibility for one's own F&V consumption were emphasized in the open responses.Posterpresentation: 7th International Conference on Diet and Activity Methods. Diet and Physical Activity Assessment: From the Individual to the Environment. June 5-7, 2009. Washington, DC, US

‘Between foods and medicines’: A qualitative interview study of patient experiences of the meaning and usage of oral nutritional supplements

The aim of this study was to deepen the understanding of what oral nutritional supplements mean to patients and how this meaning connects to supplement usage, by exploring patient experiences of such supplements. Qualitative interviews were conducted in June 2019–March 2020 with ten patients with malnutrition or at nutritional risk, prescribed oral nutritional supplements by dietitians. Data were thematically analysed using systematic text condensation. Two final categories were identified: ‘Oral nutritional supplements are a one-dimensional remedy’ and ‘Everyday oral nutritional supplement usage is regulated autonomously’. The patients described the meaning of oral nutritional supplements as nutrition. While the supplements could compensate for nutrients not eaten or be part of a helpful compensation strategy, they could not lessen the burden of altered eating. Supplement usage was described as dependent on the acceptance of taste and the priority given to nutrition in everyday life. Usage was greater when nutrients were perceived as needed, such as when striving for higher bodyweight or disease recovery. Usage was lower when a patient's own goals were not increased nutrient intake or bodyweight or when other activities were perceived as more important. Patient experiences indicated that oral nutritional supplements could serve as a remedy for malnutrition, but not for a situation of altered eating. Supplement usage was described as being regulated autonomously based on patient views on the importance of nutrition. Those views were diverse, highlighting the importance of supplement prescribers discussing treatment goals with each patient. A deeper understanding of the meaning of oral nutritional supplements and reasons for their usage from a patient perspective is crucial in order for healthcare to provide appropriate, effective nutrition therapy for malnutrition

A qualitative exploration of dietitians' experiences of prescribing oral nutritional supplements to patients with malnutrition : A focus on shared tailoring and behaviour change support

Background: Oral nutritional supplements (ONS) are commonly prescribed to patients with malnutrition. Dietitians have been suggested as preferred prescribers butgenerally lack ONS prescribing rights. How dietitians with prescribing rights experience their professional practice of prescribing ONS remains understudied. Thus, byexploring dietitians’ experiences of prescribing ONS, the present study aimed to obtain a deeper understanding of specific aspects that are of importance for dietitianswhen providing a nutrition therapy including ONS. Methods: Qualitative individual interviews were conducted with 13 dietitians prescribing ONS to free-living adult outpatients with malnutrition or at nutritional riskin the hospital or primary care setting. Systematic text condensation was used fordata analysis. Results: Two main categories signifying important aspects were identified and labelled: ‘Shared tailoring of the ONS prescription’ and ‘Supporting and facilitatingONS use’. First, the dietitians described tailoring the ONS prescription together withthe patient, having their acceptance as a prerequisite, and being flexible regardingproducts and amounts prescribed. Second, they described performing different communication strategies and organising of practical issues (e.g., ONS delivery and support from others) to support and facilitate patients’ ONS usage. Conclusions: The present study identifies patient involvement and the role of dietitians as behaviour change facilitators as two important aspects when dietitiansprescribe ONS. These findings allow for dietitians’ ideals and strategies on how toprescribe ONS to be made more visible, which can inform both clinical practice andclinical trials for future improvements in nutrition therapy to address malnutrition

Comparison between optical readable and open-ended weighed food records

BACKGROUND: A simplified optically readable food record (ORFR) was developed and compared with an open-ended weighed record (WR). OBJECTIVE: To compare intake of nutrients and foods using a seven-day ORFR with intake estimated using a seven-day WR. The results from each method were validated against 24-h urinary nitrogen excretion and energy intake (EI)/estimated basal metabolic rate (BMR) cut-off values. DESIGN: The study comprised 73 free-living, healthy 70-year-old Swedish men. Dietary data were collected during seven consecutive days, starting either with WR or ORFR. RESULTS: Average intakes of energy and several nutrients were significantly lower when estimated using ORFR than when using WR. However, when adjusted for nutrient density, only a few nutrients were still lower with ORFR. Spearman correlation coefficients between the two methods regarding intakes of energy and energy-yielding nutrients were moderate to high, i.e. 0.4-0.6, while figures for most micro-nutrients were in the range 0.3-0.5. A large proportion of subjects under-reported their EIs, a higher proportion doing so when using ORFR. Protein intake obtained using ORFR was 31% lower than the values calculated from the 24-h urine nitrogen excretion, and 22% lower than those obtained from WR. Average intakes of milk, cheese and other milk products as well as coffee, tea and alcohol were significantly higher when estimated using ORFR than when using WR, while intakes of vegetables, meat and meat products, fish, bread and cereal products as well as number of sweet foods were significantly lower with ORFR. CONCLUSIONS: Based on these results, adjustments of some portion sizes in ORFR are suggested. In view of the advantages of ORFR with respect to lower response burden and rapid processing of data, such adjustments would make ORFR a suitable dietary assessment tool for use in dietary surveys, including larger resource-demanding epidemiological investigations