Nutrition Program for Difficulty Walking

Overseen By Elizabeth A Dennis, PhD RD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Uncontrolled diabetes, Chronic kidney disease, Dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 12 weeks

180 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you have a physician-prescribed diet, you may not be eligible to participate.

What data supports the effectiveness of the treatment Virtual Nutrition and Teaching Kitchen Intervention for difficulty walking?

Research shows that improving nutrition in older adults can enhance muscle function and physical performance, which may help with walking difficulties. Studies have found that better nutritional status is linked to improved physical abilities, like walking speed, in older people. ^{1 2 3 4 5}

Is the Nutrition Program for Difficulty Walking safe for humans?

Research on similar nutrition programs, like those involving trained volunteers, suggests they are generally safe and can improve patient satisfaction and experience. ^{6 7 8 9 10}

How is the Virtual Nutrition and Teaching Kitchen Intervention treatment different from other treatments for difficulty walking?

The Virtual Nutrition and Teaching Kitchen Intervention is unique because it combines virtual nutrition education with practical cooking skills, potentially offering a more engaging and accessible way for individuals with difficulty walking to improve their nutrition compared to traditional in-person programs. ^{11 12 13 14 15}

What is the purpose of this trial?

Compared to non-Veterans, Veterans demonstrate an increased risk for obesity and multimorbidity. Thus, interventions to improve overall health are warranted in this population. Healthy diets that include fruits and vegetables are linked to a reduced risk of chronic disease including mobility disability, and are associated with higher muscle mass, strength and physical performance potentially slowing further disability progression later in life. The investigators will determine if a three-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, health-related quality of life and muscle strength.

Research Team

Elizabeth A Dennis, PhD RD

Principal Investigator

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

Eligibility Criteria

This trial is for older veterans who have trouble walking, likely due to impaired mobility. Participants should be interested in improving their diet and health-related quality of life. The study aims to help them by providing a virtual nutrition program with cooking demonstrations and delivering fresh produce.

Inclusion Criteria

I am a veteran over 65, walk slowly or need help walking, and want to eat healthier.

Exclusion Criteria

I am not on a doctor-prescribed diet that restricts my eating plan.

Dementia (on medical record review or a mini-mental status exam score <24)

Behavior that prevents group interaction

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a 3-month virtual group nutrition intervention with produce delivery and virtual teaching kitchen cooking demonstrations

12 weeks

Weekly virtual live group sessions, twice weekly for 1 hour each

Follow-up

Participants are monitored for sustained effects on dietary quality and other outcomes

3 months

Treatment Details

Interventions

• Virtual Nutrition and Teaching Kitchen Intervention

Trial Overview The intervention being tested is a three-month virtual group nutrition program tailored for older veterans with mobility issues. It includes produce delivery and online teaching kitchen sessions designed to encourage healthier eating habits, potentially increasing muscle mass, strength, and physical performance.

Participant Groups

Group I: Nutrition Intervention Experimental Treatment 1 Intervention

Weekly virtual live group sessions led by a trained study team member will be held twice weekly for 1 hour/week over 12 weeks using a HIPAA compliant online platform. The first class of each week will include the teaching kitchen cooking demonstration (\~30 min) and the remainder of the class will focus on dietary education. The second class each week will provide an opportunity for group discussion to have Veterans share to their peers about how they used the weekly produce

Group II: Contact Control Active Control 1 Intervention

Weekly virtual live group health education sessions led by staff will be held for two hours/week over 12 weeks. We will enroll up to 15 participants into each virtual class cohort and run multiple different group sessions for a total sample size of 90 participants. The content follows the LIFE study structured successful aging health education curriculum80,81 which was designed to increase self-efficacy and empower older Veterans to take control of their own healthcare. Topics focus on a broad range of healthy aging, such as importance of sleep, safe travel, goal setting, self-care, and common comorbidities

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

A 3-week hospital-based cooking and gardening program for children aged 8-15 in Seattle showed promising results, with 100% of participants cooking at home and 78% gardening at home one year later.

This program demonstrates the feasibility of using integrated cooking and gardening interventions as effective strategies for promoting healthy eating habits among children and their families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Joy of gardening: a hospital-based cooking and gardening program. Kim, G., Thompson, K.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Should oral nutritional supplementation be given to undernourished older people upon hospital discharge? A controlled trial. [2010]

2. Sweden pubmed.ncbi.nlm.nih.gov

Malnutrition is associated with poor rehabilitation outcome in elderly inpatients with hospital-associated deconditioning a prospective cohort study. [2018]

3. France pubmed.ncbi.nlm.nih.gov

Effect on Body Weight, Quality of Life and Appetite Following Individualized, Nutritional Counselling to Home-Living Elderly after Rehabilitation - An Open Randomized Trial. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Nutritional rehabilitation after acute illness among older patients: A systematic review and meta-analysis. [2023]

5. Germany pubmed.ncbi.nlm.nih.gov

Malnutrition and physical performance in nursing home residents: results from the INCUR study. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

The effects of aerobic training and nutrition education on functional performance in low socioeconomic older adults. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Determinants of Incident Malnutrition in Community-Dwelling Older Adults: A MaNuEL Multicohort Meta-Analysis. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Group-based nutrition interventions to promote healthy eating and mobility in community-dwelling older adults: a systematic review. [2023]

9. England pubmed.ncbi.nlm.nih.gov

The effectiveness of trained volunteer delivered interventions in adults at risk of malnutrition: A systematic review and meta-analysis. [2021]

10. Japan pubmed.ncbi.nlm.nih.gov

[Nutritional risk in community-dwelling elderly long-term care insurance recipients]. [2019]

11. England pubmed.ncbi.nlm.nih.gov

Pedi-R-MAPP | the development, testing, validation, and refinement of a digital nutrition awareness tool. [2023]

12. Switzerland pubmed.ncbi.nlm.nih.gov

Joy of gardening: a hospital-based cooking and gardening program. [2021]

13. England pubmed.ncbi.nlm.nih.gov

Long-term effects of a computer-based nutritional training program for inpatient hospital care. [2018]

14. Spain pubmed.ncbi.nlm.nih.gov

[Nutritional Support Groups in a hospital setting. The Cuban experience]. [2019]

15. England pubmed.ncbi.nlm.nih.gov

A team approach to health promotion of community elders: the microwave project. [2013]