Strategy for prevention of undernutrition in the elderly: Meal delivery service and eating together in the community for health care and promotion

Abstract

In Japan, super aging is developing at an unprecedented speed in the world. There is a significant increase in the number of single-person households of elderly people and elderly households. The average life expectancy is the top class in the world, but the number of elderly people who receive support and/or nursing care under the long-term care insurance system is increasing. Conditions requiring support and/or nursing care caused by elderly factors such as dementia, bone fracture, falling, and frailty account for more than 50%, and are more frequent than factors arising from lifestyle-related diseases such as cerebrovascular disease, heart disease, and diabetes. Insufficient food intake and undernutrition are strongly related to frailty in the preliminary stage. Therefore, in considering the health of the elderly, effective approaches to reduce undernutrition are urgent issues.

According to the results of the latest National Health and Nutrition Survey conducted by the Ministry of Health, Labor and Welfare (MHLW), 13.4% of males and 22.4% of females were with a low malnutrition tendency of BMI 20 kg/m² or less", which is an indicator of Health Japan 21 (second phase) for the elderly. This percentage is a significant increase among females. Those with BMI less than 20 kg/m² had lower intake of energy, protein, vitamin B, etc. and were concerned about undernutrition. Also, elderly people living alone had lower score of the Food Diversity Index.

Factors related to food diversity among elderly people who live alone include access to grocery stores, instrumental social support, preparations for meals, etc. Therefore, as a strategy for the prevention of undernutrition among elderly people, it is important to develop a food environment that can ensure their intake of the appropriate amount and quality of foods. Specifically, this implies the enhancement of the meal delivery industry and the increase in opportunities for eating together in the community. Regarding the former, in March 2007, the MHLW developed guidelines on nutrition management of the meal delivery service for the health promotion of the elderly people dwelling in the community. For the latter, it is important to make room to prepare and eat together for different generations gathered from children to elderly as a place of Shokuiku (food and nutrition education) for the succession of food culture.