Associations among social engagement, meal-related behaviour, satisfaction with food-related life and wellbeing in Danish older adults living alone.

The present study aimed at exploring associations among meal-related behaviour, social engagement factors, satisfaction with food-related life (SWFL) to assess food-related wellbeing and subjective wellbeing in Danish older adults living alone. Three hundred and eighty-eight older adults aged 65-75 years from six Danish municipalities completed an online or article-based survey addressing home cooking, commensality, loneliness, SWFL and subjective wellbeing. Home cooking frequency and self-perceived cooking skills were positively associated with SWFL but not with subjective wellbeing. Commensality was positively associated with SWFL but was not associated with subjective wellbeing. The level of loneliness was negatively associated with SWFL and with subjective wellbeing. Satisfaction with food-related life and subjective health status were positively associated with subjective wellbeing. Male and female respondents did not differ in meal-related behaviour, social engagement factors, SWFL and wellbeing. While the cross-sectional nature of this study does not allow for the direction of causality to be determined, these results suggest that older adults living alone could benefit from a higher frequency of home-cooked meals, a higher level of self-perceived cooking skills and commensality to support SWFL. A higher level of SWFL could, in turn, lead to a higher level of wellbeing.

A contextual identification of home-living older adults' positive mealtime practices: A honeycomb model as a framework for joyful aging and the importance of social factors.

In this study, we outlined contextual identifications within positive mealtime practices among home-living older adults in Denmark. We aimed to understand and facilitate optimal dietary intake and to promote well-being for older adults who live at home. We used data from 22 participants, who wrote diary entries and took photos of their meal experiences over a 6-day period. We followed this with in-depth interviews, using the photos as mediators within a photo-elicitation framework. The results revealed that social factors play a major role in positive mealtime practices and that the types of commensal eating vary based on the contextual setting. Furthermore, we found that, in the new generation of older adults, some men have extremely good cooking skills and are interested in contextual food matters. Meeting older adults' needs for adequate nutrition requires in-depth knowledge, including a complex understanding of individual preferences and contextual everyday practices.

A Systematic Review of Behavioural Interventions Promoting Healthy Eating among Older People.

Because eating habits are inseparably linked with people's physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases-PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies' duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people's dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.

Terminal costs, improved life expectancy and future public health expenditure.

This paper presents an empirical analysis of public health expenditure on individuals in Denmark. The analysis separates out the individual effects of age and proximity to death (reflecting terminal costs of dying) and employs unique micro data from the period 2000 to 2009, covering a random sample of 10% of the Danish population. Health expenditure includes treatment in hospitals, subsidies to prescribed medication and health care provided by general practitioners and specialists and covers about 80% of public health care expenditure on individuals. The results confirm findings from previous studies showing that proximity to death has a significant impact on health care expenditure. However, it is also found that cohort effects (the baby boom generation) as well as improvements in life expectancy have a substantial effect on future health care expenditure even when proximity to death is controlled for. These results are obtained by combining the empirical estimates with a long term population forecast. When life expectancy increases, terminal costs are postponed but the increases in health expenditure that follow from longer life expectancy are not as large as the increase in the number of elderly persons would suggest (due to "healthy ageing"). Based on the empirical estimates, healthy ageing is expected to reduce the impact of increased life expectancy on real health expenditure by 50% compared to a situation without healthy ageing.