Healthy Eating for Successful Living in Older Adults Program (HE) Study (HES)

The Healthy Eating for Successful Living in Older Adults™ (HESL) is a six-week community nutrition and lifestyle education program designed specifically for the elderly (>60 years), to promote dietary and behavioral changes towards a healthy lifestyle. The intervention was evaluated using a randomized-controlled trial.

The elderly are at a higher risk of various chronic diseases. The burden of various chronic diseases such as heart disease and osteoporosis can be reduced with change in dietary and other lifestyle behaviors. The Healthy Eating for Successful Living in Older Adults™ (HESL) provides elderly with needed knowledge on healthy food choices and lifestyle behaviors, and tools that support behavioral changes. The investigators aimed to evaluate this intervention program by determining, among others, the impact of the intervention on factors such as dietary intake of fiber, and other nutrients, as well as healthy behaviors and food choices, and quality of life at 6 months post-intervention, using a randomized-controlled trial. The intervention group was compared to the control group receiving no intervention to evaluate the effects of the six-week HESL intervention on our outcome measures of interest.

The control group did not receive any intervention, but met at three timepoints to complete study questionnaires and provide anthropometric measurements,

Intervention group participants met once a week, for 2.5 hours, over a period of six weeks for the HES workshops. The HES workshops followed a scripted curriculum that incorporated information from the USDA's MyPlateTM, and the USDA 2015-2020 dietary guidelines. Participants were also taught goal-setting, problem-solving through brainstorming, group support, self-assessment and management of dietary and physical activity patterns.

Change from baseline dietary saturated fat intake (mean intake in g/day) at 6 months using the Willett FFQ

Change from baseline dietary polyunsaturated fat intake (mean intake in g/day) at 6 months using the Willett FFQ

Change from baseline dietary monounsaturated fat intake (mean intake in g/day) at 6 months using the Willett FFQ.

Change from baseline dietary trans fat intake (mean intake in g/day) at 6 months using the Willett FFQ

Change from baseline dietary cholesterol intake (mean intake in mg/day) at 6 months using the Willett FFQ

Change from baseline dietary omega-3 fat intake (mean intake in g/day) at 6 months using the Willett FFQ

Change from baseline dietary omega-6 fat intake (mean intake in g/day) at 6 months using the Willett FFQ

Change from baseline dietary calcium intake (mean intake in mg/day) at 6 months using the Willett FFQ

Change from baseline dietary vitamin D intake (mean intake in IU/day) at 6 months using the Willett FFQ

Change from baseline physical activity (metabolic equivalent task (MET)-hours per week ) at 6 months using the Harvard Physical Activity Questionnaire.

Change from baseline Body mass index (calculated from: weight in kilograms, and height in meters; weight and height will be combined to report BMI, Kg/m2) at 6 months

Change from baseline quality of life measure at 6 months using the Euro-QoL-5D-5L questionnaire; Participants were asked to provide a rating of their own health on a scale of 0-100, where 0 means "death" and 100 means "the best health.

Change in response to the question: "do you make food choices that are healthy for your bones?" from baseline at 6 months

Change in response (in percentage points) to the above question at 6 months; questions were originally in a Likert scale from always to never with five categories. We converted responses into dummy variables (with 1=always, most of the time, or sometimes; and 0 =rarely and never).

Change in response to the question: "do you make food choices that are healthy for your heart?" from baseline at 6 months

Change in response (in percentage points) to the above question at 6 months; questions were originally in a Likert scale from always to never with five categories. We converted responses into dummy variables (with 1=always, most of the time, or sometimes; and 0 =rarely and never).

Change in response to the question: "do you read nutrition labels when shopping or planning for meals?" from baseline at 6 months

Change in response (in percentage points) to the above question at 6 months; questions were originally in a Likert scale from always to never with five categories. We converted responses into dummy variables (with 1=always, most of the time, or sometimes; and 0 =rarely and never).

Change in response to the question:"do you use MyPlateTM tools to help make food choices?" from baseline at 6 months

Change in response (in percentage points) to the above question at 6 months; questions were originally in a Likert scale from always to never with five categories. We converted responses into dummy variables (with 1=always, most of the time, or sometimes; and 0 =rarely and never).

Change in response to the question: "How confident are you that you can manage most of your health problems?" from baseline at 6 months

Change in response (in percentage points) to the above question at 6 months; questions were originally on a scale of 0-10, with 10 being most confident. These ratings were coded as 1 if they were 6 and above, and 0 if 5 or below.

Change in response to the question: "How understandable and useful is the information that your doctor or nurses have given you about your health problems or concerns?" from baseline at 6 months

Change in response (in percentage points) to the above question at 6 months; questions were originally on a scale of 0-10, with 10 being most understandable/useful. These ratings were coded as 1 if they were 6 and above, and 0 if 5 or below.

Change in response (in percentage points) to the above question at 6 months; questions were originally on a scale of 0-10, with 10 being most active. These ratings were coded as 1 if they were 6 and above, and 0 if 5 or below.

Inclusion Criteria: willingness to participate and complete all study activities following randomization into the intervention or control group. English-speaking. interested and able to participate. Exclusion Criteria: None

Barnett JB, Zeng W. Healthy Eating for Successful Living in Older Adults community education program-evaluation of lifestyle behaviors: A randomized controlled trial. Front Aging. 2022 Sep 6;3:960986. doi: 10.3389/fragi.2022.960986. eCollection 2022.