Preventing the risk of undernutrition by fostering meal FORTIfication and PHYsical activity in older adult
For the older people, eating well is a key factor in preserving their health and preventing the onset of diseases linked to aging. “Eating well” means having a diet adapted in terms of quality and quantity, allowing the older adult to fulfil their nutritional needs. But it is also means promoting eating pleasure in order to sustain the desire to eat. However, aging may be accompanied by a decline in appetite, which predisposes the older individual to the onset of undernutrition. Recently, Sulmont-Rossé and Van Wymelbeke (CND, 2019) observed that about 4 older individuals over 5 who receive help for their meals do not meet their caloric and/or protein requirements. In addition, the results showed that 90% of the participants who were at risk of undernutrition did not fulfil the recommended daily allowance and could be qualified as ‘small eaters’ (Moye & Bohmer, 2002, J Nutr Health Aging)
The project FORTIPHY will address the nutritional and physical activity needs of older small eaters (≥ 70 years old) living at home. Specifically, FORTIPHY will develop new solutions allowing older people to fortify their regular meals, namely increasing caloric and protein intake without increasing the volume to be ingested (Morilla-Herrera et al, 2016, J Nutr health Ageing). In addition, given that several studies have highlighted the importance of physical activity to sustain muscle mass and functional capacity (Shad et al, 2016, Am J Physiol Endocrinol Metab). FORTIPHY will develop a physical activity program easy to implement by frail older people living at home. To achieve these ambitious goals, the FORTIPHY project has gathered scientists covering different disciplines (food science & technology, nutrition, sensory science, consumer behavior). In addition, end users (older people, caregivers) will be involved very early in the innovation process, in order to ensure the feasibility and the relevance of newly developed solutions (co-creation of solutions).
- Design and develop new recipes to fortify regular meals with high-calorie and high-protein ingredients. These recipes will be validated in terms of bioavailability and acceptability.
- Design and develop new physical activity programs tailored to the capacities and the environment of the targeted older population.
- Assess the efficiency of fortified dishes and the added value of physical activity to prevent undernutrition.
- Develop cookbooks and MOOC (Massive open on-line courses) combining recipes and physical exercises in synergy to support the health of the aging population.
- Offer a summer school to empower professionals in creating novel business solutions aimed at enabling older people to fortify their regular meals to prevent undernutrition
|University of Reading
|Vrije Universiteit Brussel
- In France, around 1,7 million people aged over 65 with a Body Mass Index over 25 are undernourished or at risk of undernutrition. Specifically, 18% of overweight and 29% of obese older people were at risk of undernutrition (Sulmont-Rossé et al., 2022, Frontiers in Nutrition).
- A systematic literature review and a meta-analysis showed that, compared to a standard diet, food-based fortification significantly increases energy and protein intake in older adults, as well as decreases the risk of undernutrition in this population (Geny et al., submitted, Clinical Nutrition ESPEN).
- One-hundred-thirty-five different protein extracts were identified on the European market. Of these, 38% are of animal origin and 50% of plant protein. The protein content of these products varies from 9 to 98% .
- Culinary ingredients such as eggs and dairy were considered acceptable fortificants. Older adults did not consume animal-derived or plant-based protein extracts, and were less accepting of an unfamiliar protein source. Opportunities to replace other powders (such as flour) with protein extracts, for example in thickening stews and baking cakes, moderated these attitudes (Smith et al., 2022, EuroSense).
- Older adults were generally unaware of their protein needs and reported a much lower intake than recommended, especially for dinner. The acceptance of health innovation in food requires that older people clearly perceive the health benefits of the innovation in order to change their attitudes towards health innovation (Geny et al., 2022, EuroSense).
- Eight fortified recipes were developped, each providing an additional load of 8-12 g of protein and 250-300 Kcal per serving. Fortificiation is achieved by adding high-protein culinary ingredients and protein extracts to the standard recipe. Recipes can be made in different variants (various flavours; cooking from scratch or from ready-to-heat ingredients).
Author: Sulmont-Rossé C*, Van Wymelbeke-Delannoy V*, Maître I*