Abstract
Background: Setting up a home-delivered meal service often allows older people suffering from physical and/or cognitive disabilities to stay at home. However, older people who delegate their food activities (food purchasing, cooking…) have been reported to have a worse nutritional status than people who take care of their food activities. In this context, we will conduct a systematic review of all studies related to the nutritional issue in home-delivered meal older recipients.Methods: In June 2020, we searched 3 databases (Pubmed, Web of Science, EMBASE) to identify studies from all years on older adults at home and receiving home-delivered meal services (population). The following outcomes were considered: nutritional status (Body Mass Index, weight, undernutrition) and nutritional intake. Any nutritional intervention, comparator, and study design were relevant for inclusion.Results: Forty-eight original studies met the inclusion criteria, most of them being published after the year 2000 (n = 34) and undertaken in the USA (n = 32). The selection includes 30 cross-sectional and 18 longitudinal studies. The main findings of this review are the following: (1) home-delivery meal older recipients are at high risk of undernutrition; (2) providing home-delivery meals may improve the nutritional status and nutrient intake; (3) this improvement is even higher when the home-delivery meal service is improved, for instance by providing dietetic counseling or adding supplementary snacks/meals or enriched food. However, even an improved service does not allow all the older recipients meeting their recommended nutritional allowance.Conclusion: This review reveals a need to further develop strategies allowing home-delivery meal older recipients to fulfill their nutritional needs. From a methodological point of view, there is a need to describe in more detail the home-delivered services provided to studies' participants to better consider meal frequency and meal content in the results.
Highlights
Home-delivered meal (HDM) services for older adults and/or disabled people were introduced in the United Kingdom during the Second World War, providing meals for people who could no longer prepare food for themselves
After title and abstract screening, 334 records were kept for full-text retrieval and 52 articles were included at full-text review−48 original studies (Figure 1) and four Systematic Literature Reviews [13,14,15,16]
It should be noted that seven papers including older people with HDM in a broad sample were not included in the synthesis as separated data analyses were not conducted for HDM participants—analyses were done on a broader sample including participants without and with HDM [17,18,19,20,21,22,23]
Summary
Home-delivered meal (HDM) services for older adults and/or disabled people were introduced in the United Kingdom during the Second World War, providing meals for people who could no longer prepare food for themselves. This type of service spread first to the United States, Ireland, Australia, and more generally to the other industrialized countries [1, 2]. The number of 80 and over is expected to increase from 126 million in 2015 to 202 million in 2030 and 426 million in 2050 [5] These “very old” people are the ones who present the poorest health and accumulate the severest disabilities. We will conduct a systematic review of all studies related to the nutritional issue in home-delivered meal older recipients
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