Effectiveness of individual nutrition counselling for the prevention of undernutrition among elderly people living in depopulated areas: secondary analysis of a model project in Tsu city

Keiko Okumura; Shuhei Ichikawa; Hideki Wakabayashi; Young Jae Hong; Yuko Tokudome; Yousuke Takemura

doi:10.1136/bmjnph-2022-000576

Effectiveness of individual nutrition counselling for the prevention of undernutrition among elderly people living in depopulated areas: secondary analysis of a model project in Tsu city

BMJ Nutr Prev Health. 2023 Jul 20;6(2):127-138. doi: 10.1136/bmjnph-2022-000576. eCollection 2023.

Authors

Keiko Okumura¹, Shuhei Ichikawa², Hideki Wakabayashi³, Young Jae Hong⁴, Yuko Tokudome⁵, Yousuke Takemura⁶

Affiliations

¹ Faculty of Health and Human, The University of Nagano, Nagano, Japan.
² Faculty of General Medicine, Department of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu, Japan.
³ Department of Community Medicine, Mie University School of Medicine, Tsu, Japan.
⁴ Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁵ Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan.
⁶ Department of General Medicine, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Abstract

Objectives: To examine the effectiveness of nutrition counselling (NC) in preventing undernutrition in elderly people living in depopulated areas.

Design: Participants were elderly people aged at least 65 years living in a depopulated area. Participants completed self-administered questionnaires evaluating nutritional status, frailty and body composition at the start of the study, after a non-NC period (3-month control) and after an NC period (3-month intervention). During the NC period, participants attended monthly 1-hour NC sessions over 3 months. Sessions were conducted in three areas (A, B and C), and the schedule was staggered so that the NC period in one area was conducted simultaneously with the non-NC period of the next. All sessions within an area were attended by the same registered dietitian. Outcomes were assessed three times: before the non-NC period, after the non-NC period and after the NC period. The effects of NC were assessed by comparing the results between the non-NC and NC periods of all participants, using the Cochran-Mantel-Haenszel stratified test.

Outcome measures: The primary outcome was undernutrition, as determined by the Mini Nutritional Assessment-Short Form. Secondary outcomes were Dietary Diversity Score (DVS), body weight and frailty. Body composition was also assessed.

Results: Of 106 individuals who joined the project, 61 completed the project and were analysed. The NC in this study had no effect on the primary outcome. DVS in area A was significantly higher after the NC period than after the non-NC period (p=0.012). Frailty in area C was significantly lower after the NC period than after the non-NC period (p=0.025). NC had no significant effects on the other outcomes.

Conclusions: NC improved food variety but did not improve nutritional status, frailty or body composition.

Keywords: dietary patterns; nutrition assessment; preventive counselling.