The impact of a nutrition and cooking programme on energy and nutrient intake to prevent frailty in pre-frail communitydwelling older adults: A Randomised Controlled Trial

Abstract

Background: Frailty is a debilitating condition faced by the growing geriatric community world-wide that limits the potential for many to live their last years to the fullest functional capacity. Current research sees the importance of targeting the nutrition status of communitydwelling older adults to prevent its incidence from rising. Few trials have demonstrated an effective impact of nutrition interventions on frailty. Fewer studies have examined cooking programmes in their ability to improve nutrition for the elderly. Little is known about nutrition interventions in pre-frail older adults in New Zealand. Objectives: This thesis aims to bridge this gap in the literature by evaluating the effectiveness of a nutrition education and cooking programme (Senior Chef) on improving energy and nutrient intake in pre-frail older adults living in the community. Design: This was a randomised controlled trial where participants were randomly assigned to participate in Senior Chef classes (SC, n=157) or non-Senior Chef activities (NSC, n=146) for 8 weeks. Setting: Multiple cities across New Zealand with classes conducted at local churches or community centres. Participants: 303 community-dwelling pre-frail elderly men and women aged 75 years old and over (60+ for Māori and Pasifika). Measurements: Energy and nutrient intake were derived from home-based interviews using the 24 hour-multiple pass recall method through an online tool called ‘INTAKE24’. Two dietary assessments were completed at baseline and post-intervention. Results: At the end of 8-weeks, significant reduction in intakes of energy, protein, fat, saturated fat, omega-6, omega-6:3 ratio, vitamin E and A were seen in the SC group but effects were not strong enough to be significant compared to NSC. Upon adjusting for gender, the omega-6:3 ratio was significantly reduced in SC men (p=0.011) compared to their counterparts, and likewise, vitamin B12 for women (p=0.036). Conclusion: An 8-week cooking programme improves polyunsaturated fatty acid profiles in men but may have unwanted effects for women, namely a drop in vitamin B12 intake. This suggests that cooking and nutrition programmes might benefit from gender-specific advice to achieve beneficial changes in dietary intake for both genders.