Dietary change for macular health of older people: Eating for Eye Health, a pilot community kitchens intervention

Abstract

BackgroundDry age-related macular degeneration (AMD) is a leading cause of untreatable, progressive central vision loss, social isolation, and disability in older people. Evidence suggests that diet (eg, the Mediterranean dietary pattern or increased oral carotenoid intake) might protect against dry AMD progression. The aim of this pilot study was to test the feasibility of a participant-informed community kitchens intervention (Eating for Eye Health project) to implement dietary behaviour change, to benefit macular health of older adults. MethodsAdults (≥50 years) with documented visual impairment due to dry AMD were invited, with a partner, carer, or friend for support, via a National Institute of Health Research mailing list, to participate in a focus group and pilot intervention in London, UK. The intervention was an ice-breaker session and a cookery activity with integrated health promotion information; it was participant codesigned to increase capability and opportunity for implementing dietary change for macular health. For the cookery activity, participants were divided into small groups, with different groups preparing different courses of a three-course meal containing carotenoid-rich foods, which they ate together. The primary outcome was participants' self-reported capability in cooking skills for eye health, evaluated before and after the intervention, using a ten-point confidence score (10=most confident). Secondary outcomes were participant-rated taste acceptability of the food, evaluated by a two-point (a physical thumbs-up or thumbs-down motion) scale for each course, and subjective experience of the intervention (thematic analysis of written qualitative feedback consisting of unstructured feedback using post-it notes immediately after the event and a standardised email questionnaire 1 week later). Findings12 adults (ten with dry AMD and two partners or friends) participated. All participants reported increased confidence scores, with improvement in scores ranging from 2 to 6 points, with all giving a score of 7 points or higher after the intervention, and rated food as acceptable in taste. Thematic analysis of qualitative written feedback, immediately and 1 week after the intervention, identified positive subjective experiences of “social participation” and “peer support”. InterpretationThis pilot study provides evidence to support the feasibility of National Health Service social prescribing of community cookery programmes for older people with dry AMD to increase their capability and social opportunity to implement dietary behaviour change for eye health. FundingUniversity College London Beacon Bursary (for RG to support Eating for Eye Health public engagement work).