Effectiveness of individual nutrition counselling for the prevention of undernutrition among elderly people living in depopulated areas: secondary analysis of a model project in Tsu city.

OBJECTIVES

To examine the effectiveness of nutrition counselling (NC) in preventing undernutrition in elderly people living in depopulated areas.

DESIGN

Participants were elderly people aged at least 65 years living in a depopulated area. Participants completed self-administered questionnaires evaluating nutritional status, frailty and body composition at the start of the study, after a non-NC period (3-month control) and after an NC period (3-month intervention). During the NC period, participants attended monthly 1-hour NC sessions over 3 months. Sessions were conducted in three areas (A, B and C), and the schedule was staggered so that the NC period in one area was conducted simultaneously with the non-NC period of the next. All sessions within an area were attended by the same registered dietitian. Outcomes were assessed three times: before the non-NC period, after the non-NC period and after the NC period. The effects of NC were assessed by comparing the results between the non-NC and NC periods of all participants, using the Cochran-Mantel-Haenszel stratified test.

OUTCOME MEASURES

The primary outcome was undernutrition, as determined by the Mini Nutritional Assessment-Short Form. Secondary outcomes were Dietary Diversity Score (DVS), body weight and frailty. Body composition was also assessed.

RESULTS

Of 106 individuals who joined the project, 61 completed the project and were analysed. The NC in this study had no effect on the primary outcome. DVS in area A was significantly higher after the NC period than after the non-NC period (p=0.012). Frailty in area C was significantly lower after the NC period than after the non-NC period (p=0.025). NC had no significant effects on the other outcomes.

CONCLUSIONS

NC improved food variety but did not improve nutritional status, frailty or body composition.