Improving dietary quality and social engagement through a virtual nutrition and teaching kitchen intervention among older Veterans with impaired mobility

About This Grant

There are >8 million older Veterans (>65 years) in the United States, and nearly half of them self-report having a disability such as impaired mobility that impacts their ability to perform self-care. Among older Veterans with mobility disability, common self-care tasks like food shopping, meal preparation, and cooking are barriers to consuming a healthy diet, resulting in poor dietary intake. Poor dietary intake contributes to chronic disease risk and loss of muscle mass and strength, consequently limiting function and increasing immobility. Teaching older Veterans with impaired mobility how to overcome barriers limiting these diet-related self-care tasks provides an opportunity to significantly impact this group’s dietary intake. Lack of social support has also been associated with negative health outcomes and poor nutritional intake; thus, effective, age-friendly intervention strategies to improve dietary quality as a strategy to delay further progression of disability and maintain functional independence among this population are needed. In this randomized controlled trial, we will determine if a 3-month virtual group nutrition intervention paired with produce delivery and virtual teaching kitchen cooking demonstrations tailored for older Veterans with impaired mobility will improve diet and functional mobility. The intervention group will be compared to a contact control group. Our overarching hypothesis is that virtual group nutrition education classes and cooking demos, personalized to include considerations of this population’s physical limitations, age-related taste changes and technological barriers, will result in favorable improvements in dietary quality and functional mobility while promoting social interaction. In Specific Aim 1, we will determine the impact of our virtual intervention paired with produce delivery and virtual cooking demonstrations on objective measures of diet quality compared to contact control among a diverse sample of older Veterans with impaired mobility. Additionally, we will assess the sustained effects of the program on dietary quality at a 6-month follow-up, 3-months after the virtual intervention ends. If no treatment effects are observed at the end of the 3-month intervention, we will explore reasons why the intervention was ineffective. In Specific Aim 2, we will determine the impact of the 3-month virtual nutrition intervention on measures of social isolation, health-related quality of life and mental health using validated questionnaires. Specific Aim 3 will determine associations with changes in dietary quality and frailty-related physical function outcomes and body composition among those who benefit from a virtual nutrition education and cooking program. Through this randomized controlled trial, we will learn how to improve dietary intake among older Veterans with impaired mobility, and how to provide Veterans with skills that will allow them to connect virtually with their social networks. Identifying strategies that improve dietary quality of older Veterans and maintain social engagement likely will be beneficial not only for chronic disease management; but may also reduce the risk of further functional decline and promote functional independence in the growing aging population.