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Elderly Health

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Adding a breakfast portion to home-delivered meals can improve the lives of frail, homebound older adults

Traditionally, home-delivered meal programs provide a hot, nutrient-dense lunch 5 days per week for frail, homebound older adults. Adding a breakfast portion to the home-delivered meal program could further improve the lives of these vulnerable individuals, according to a study supported in part by the Agency for Healthcare Research and Quality (HS10787). Elizabeth A. Gollub, Ph.D., M.P.H., R.D., formerly with Florida International University and currently an independent contractor, and Dian O. Weddle, Ph.D., R.D., F.A.D.A., of Florida International University, compared two groups of individuals who were recruited from five elderly nutrition programs involved in the Morning Meals on Wheels breakfast service demonstration project.

The breakfast group (167 men and women) received a home-delivered breakfast and lunch 5 days a week. The comparison group (214 participants) received a home-delivered lunch 5 days per week. The investigators obtained participants' 24-hour food recall, demographics, malnutrition risk, functional status, and perceptions of quality of life (health, loneliness, food enjoyment, food security, and depression). The geographically and racially/ethnically diverse participants were aged 60 to 100 years, functionally limited, and at high nutritional risk. Most individuals were low income, lived alone, and had difficulty grocery shopping and preparing food.

The breakfast group had greater energy/nutrient intakes; less worry about whether they would be able to get food, run out of food, or be able to eat a good meal; and fewer depressive symptoms than the comparison group. Members of the breakfast group consumed about 300 kcal, 14 g protein, 36 g carbohydrate, 12 g fat, and 4 g fiber more than the comparison group, all significant differences. They also consumed significantly greater amounts of potassium, folate, calcium, iron, magnesium, and zinc and tended to consume more of vitamins A, B-6, B-12, and D. In addition, those in the breakfast group were significantly less bothered than those in the comparison group by dietary restrictions, money problems, or problems with cooking, and they tended to maintain their sense of taste. They also were happier, more hopeful, and less bored.

For more details, see "Improvements in nutritional intake and quality of life among frail homebound older adults receiving home-delivered breakfast and lunch," by Drs. Gollub and Weddle, in the August 2004 Journal of the American Dietetic Association 104, pp. 1227-1235.

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