Impact of Comprehensive Dietary Counseling on Dietary Quality, Mental Health, and Quality of Life in Older Adults

As a person ages, an incidence of mental distress such as depression and anxiety increases while the quality of life decreases. Singapore's population is aging rapidly and older adults may suffer from mental distress and deteriorated quality of life. Recent evidence suggests that good nutrition is essential for mental health and quality of life in older adults.

Previous research reported that provision of nutrition education and cooking workshops to people with mental illness for 3 months achieved healthy dietary change and improved mental health. This proposed study aims to further assess the effect of comprehensive dietary counselling on dietary quality, cardio-metabolic, mental health, sleep quality, and quality of life through a 24-wk parallel intervention study in Singapore older adults.

The investigators hypothesised that older adults who receive comprehensive dietary counselling will improve dietary quality, cardio-metabolic health, mental health, sleep quality, and quality of life when compared to older adults who do not receive comprehensive dietary counselling.

Study Overview

• Status: Recruiting
• Conditions: Aging; Age Problem; Age-related Cognitive Decline; Age-Related Atrophy
• Intervention / Treatment: Behavioral: Dietary Counselling

Detailed Description

Fifty female Chinese older adults (aged 60+y) will be recruited with the expectation that ≥ 40 subjects will complete the study. This is a 24-wk parallel, single-bind, prospective study design with subjects randomly assigned to either receiving comprehensive dietary counselling (intervention group) or not receiving comprehensive dietary counselling (control group). Subjects in the intervention group will only receive comprehensive dietary counselling for first 12-wk and then they will be followed for another 12-wk without comprehensive dietary counselling. Subjects in the control group will be followed for 24-wk without any intervention. Dietary quality, mental health, sleep quality, daily physical activity and quality of life will be assessed and blood lipid-lipoproteins, glucose and insulin concentrations will be measured from the collected blood samples.

• Study Type: Interventional
• Enrollment (Anticipated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jung Eun Kim, PhD, RD; Phone Number: 65 65161136; Email: fstkje@nus.edu.sg
• Study Contact Backup: Name: Jasmine Low, BSc (Hons); Phone Number: 65 94510860; Email: jasmine.low@u.nus.edu

Study Locations

• Singapore
  • Singapore, Singapore, 117546
    • Active, not recruiting
    • National University of Singapaore
  • Singapore, Singapore, 590021
    • Recruiting
    • Hannah Senior Activity Centre
    • Contact: Jasmine Low, BSc (Hons); Phone Number: +6594510860; Email: jasmine.low@u.nus.edu
    • Principal Investigator: Jung Eun Kim, PhD, RD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

1. Able to give an informed consent
2. Age ≥60 years
3. No weight change >3kg in the past 3 months
4. Not exercising vigorously over the past 3 months
5. Does not have any intestinal disorders, including lactose intolerance
6. No acute illness
7. Non-smoker
8. Non-vegetarian
9. Not drinking more than 2 alcoholic drinks/day
10. Not taking any lipid-lowering and blood pressure controlling medications less than 3 years

Exclusion Criteria:

1. Unable to give an informed consent
2. Age < 60 years
3. Weight change >3kg in the past 3 months
4. Exercises vigorously over the past 3 months
5. Have intestinal disorders, including lactose intolerence
6. Having acute illness
7. Smoking
8. Vegetarian
9. Drinking more than 2 alcoholic drinks/day
10. Taking lipid-lowering and blood pressure controlling medications less than 3 years

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dietary Counselling; Each subject will receive a comprehensive dietary counselling for the first 12-weeks of the study, which will be followed by another 12-weeks without dietary counselling.	Behavioral: Dietary Counselling; Intervention group will be given a comprehensive dietary guidance on how to choose healthier options when eating out, as well as how to personally prepare a healthy meals.
No Intervention: No Dietary Counselling; Subjects in the control group will be followed for 24-weeks without any dietary counselling.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in diet	Dietary assessment, 3-day food record (participant)	Every 2 week for the first 12 weeks and every 4 weeks for the last 12 weeks (Week 0, week 2, week 4, week 6, week 8, week 10, week 12, week 16, week 20, week 24)
Change in mental health status	Mental Health Questionnaire - Consisting of basic health screen recording anthropometric measurements, visual functioning questionnaire scale (1; Good, 2; Acceptable, 3; Poor), Lifestyle (0; Never, 1; 1-3 times/month, 2; 1-3 times/week, 3; 4-6 times/week, 4; daily), depression scale (Yes or no questionnaire)	Every 4 weeks (Week 0, week 4, week 8, week 12, week 16, week 20 and week 24)
Change in quality of life	Quality of Life Questionnaire; Subjective scale rating (1; very dissatisfied, 2; dissatisfied, 3; neither satisfied not dissatisfied, 4; satisfied, 5; very satisfied) assessing quality of life, health and other areas of life.	Every 4 weeks (Week 0, week 4, week 8, week 12, week 16, week 20 and week 24)
Change in sleep quality	Pittsburgh Sleep Quality Assessment (PSQI) - Recall based questionnaire assessing sleep habits for the past one month only which includes sleeping timing habits and quality of sleep (Very good, Fairly good, Fairly bad and very bad)	Every 4 weeks (Week 0, week 4, week 8, week 12, week 16, week 20 and week 24)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in diet	Dietary Assessment, 3-day food record (Participant's family member)	Every 12 weeks (Week 0, week 12 and week 24)
Change in weight	Weight (kg)	Every 4 weeks (Week 0, week 4, week 8, week 12, week 16, week 20 and week 24)
Change in waist circumference	Waist Circumference (cm)	Every 4 weeks (Week 0, week 4, week 8, week 12, week 16, week 20 and week 24)
Change in blood pressure	Systolic and diastolic blood pressure (mmHg) after a 10 hour overnight fast	Every 4 weeks (Week 0, week 4, week 8, week 12, week 16, week 20 and week 24)
Change in total cholesterol	Total cholesterol (mmol/l)	Every 12 weeks (Week 0, week 12, and week 24)
Change in high-density lipoprotein cholesterol	High-density lipoprotein cholesterol (mmol/l)	Every 12 weeks (Week 0, week 12, and week 24)
Change in low-density lipoprotein cholesterol	Low-density lipoprotein cholesterol (mmol/l)	Every 12 weeks (Week 0, week 12, and week 24)
Change in total triglyceride	Total triglyceride (mmol/l)	Every 12 weeks (Week 0, week 12, and week 24)
Change in blood glucose concentration	Blood glucose concentration	Every 12 weeks (Week 0, week 12, and week 24)
Change in blood insulin concentration	Blood insulin concentration	Every 12 weeks (Week 0, week 12, and week 24)
Change in daily physical activity	Tracked with an electronic activity tracker	Daily (Week 0 to week 24)

Collaborators and Investigators

• Sponsor: National University of Singapore
• Investigators: Principal Investigator: Jung Eun Kim, PhD, RD, National University of Singapore

Publications and helpful links

General Publications

• Parletta N, Zarnowiecki D, Cho J, Wilson A, Bogomolova S, Villani A, Itsiopoulos C, Niyonsenga T, Blunden S, Meyer B, Segal L, Baune BT, O'Dea K. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutr Neurosci. 2019 Jul;22(7):474-487. doi: 10.1080/1028415X.2017.1411320. Epub 2017 Dec 7.
• Bogomolova S, Zarnowiecki D, Wilson A, Fielder A, Procter N, Itsiopoulos C, O'Dea K, Strachan J, Ballestrin M, Champion A, Parletta N. Dietary intervention for people with mental illness in South Australia. Health Promot Int. 2018 Feb 1;33(1):71-83. doi: 10.1093/heapro/daw055.

Study record dates

Study Major Dates

• Study Start (Actual): November 13, 2018
• Primary Completion (Anticipated): September 1, 2021
• Study Completion (Anticipated): November 1, 2021

Study Registration Dates

• First Submitted: October 5, 2018
• First Submitted That Met QC Criteria: October 9, 2018
• First Posted (Actual): October 11, 2018

Study Record Updates

• Last Update Posted (Actual): September 2, 2021
• Last Update Submitted That Met QC Criteria: September 1, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: Mental health; Older adults; Sleep quality; Dietary quality; Dietary consultation; Cardio-metabolic health
• Additional Relevant MeSH Terms: Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Cognitive Dysfunction
• Other Study ID Numbers: S3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No