The impact of home-delivered meal services on the nutritional intake of community living older adults: a systematic literature review

BACKGROUND

There is a global increase in populations aged over 65 years. Physiological changes that occur during ageing may increase the nutritional risk for older adults. To avoid malnutrition and address some of the barriers to obtain an adequate food supply, home-delivered meals services provide meals in the home or in congregate settings for older adults who require nutritional support.

METHODS

This systematic literature review explored whether nutritional intake is improved in community-living older adults when receiving meal services compared to when meal services are not received. Four electronic databases were searched up to 31 January 2019. In total, 13 original studies were included in this analysis with the components: intervention of home-delivered meal or congregate meal services to older adults; comparison with groups not receiving meal services or days not receiving the meal service; and nutritional intake as an outcome measured by food history, dietary recall and/or food frequency questionnaire.

RESULTS

The results supported a beneficial effect of home-delivered meals on dietary intake of energy, protein and/or certain micronutrients in older adults.

CONCLUSIONS

The increased total energy intake is a positive influence on malnutrition risk in frail older adults and the increased protein intake supports good health, promotes recovery from illness and assists in maintaining functionality in older adults. Additionally, there was a particular increase in calcium intake, which is relevant in ageing, especially for bone health.

Mental health viewed as an ideal

The concepts of health and disease have always challenged the human mind. They continue to be frequently discussed with reference to both the body and the mind, but conclusions seem elusive or at best heuristic. With respect to the mind, especially, the challenge seems awesome: When the investigator and what is being investigated are one and the same, impartiality, objectivity, and the other virtues of scientific inquiry appear difficult to assess, much less attain. And yet, not surprisingly, the subject continues to attract investigators (e.g., Kaplan, 1967; Sabshin, 1967; Shakow, 1967; Offer, 1973; Sedgwick, 1973; Bruhn, 1974; Margolis, 1976). Philosophers and physicians alike respond to the subject's appeal--its theoretical interest, the conceptual problem it presents, and its implications for our understanding of ourselves. And those of us who are clincians cannot deny the practical importance of our concepts of mental health and illness: We each daily base decisions on our understanding of these concepts, and even if we cannot provide solid basis for such an understanding, we perhaps owe it to our patients to make explicit what this understanding, our philosophy, is.