Environmentally Sustainable Nutrition for Older Adults (55+) With Obesity (2EAT)

Environmentally Sustainable Nutrition for Older Adults (55+) With Obesity: a Pilot Study

The objective of the pilot study (feasibility study) is to assess the acceptability and feasibility of the developed 2EAT dietary treatment in obese older adults (55+).

For ecological reasons, the goal of the dietary treatment plan is to achieve an intake of 60% plant-based proteins in older adults (55+) in a healthy and nutritionally adequate way during a period of weight loss. The investigators developed the new dietary treatment plan for 6 months (RCT). To further optimize the new treatment plan the 2EAT study includes this feasibility study with a duration of 8 weeks.

In the feasibility study, the effect of a more plant-based hypocaloric diet on the protein intake of older adults (55+) with obesity is evaluated. To assess the feasibility of the treatment plan, 20 obese older adults will follow the newly developed dietary treatment for 8 weeks. The participants will be guided by experienced dieticians that are part of the study consortium, in their dietetic practice. All dieticians will be trained to execute the 2EAT dietary treatment plan.

The desired effect of the treatment is that participants change their protein intake and achieve an intake of 1.2 g/kg/d of which 60% is from plant-based sources. Additionally, the experience of both the older adults as well as the experience of the dieticians will be monitored during the 8 weeks of intervention. During 8 weeks there will be continuous monitoring of the implementation of the treatment plan by keeping logbooks (dieticians), and measurement of the food intake of the participants. When participants deviate from the diet, the dietician must make timely adjustments with available behavioral techniques. The primary outcome of the feasibility phase is the protein intake: source (plant-based vs. animal-based), amount (g/kg/day) and protein quality per meal (amino acid score). Secondary outcomes are the body weight and BMI of participants and qualitative information about the experience of participants and dieticians with the use of the new treatment plan. Dieticians are professionals in working with older clients with obesity during a weight loss program, and are competent to execute the treatment plan and additionally monitor and make adjustments to coach the participant towards the desired diet and goal. Findings and experiences from the 8-week feasibility study will be used to further improve the 2EAT dietary treatment. The optimized dietary plan will eventually be used in the RCT study.

Study Overview

• Status: Not yet recruiting
• Conditions: Obesity; Aging
• Intervention / Treatment: Behavioral: A more plant-based diet during weight loss

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Susanne Wildemast; Phone Number: +31623492734; Email: s.wildemast@hva.nl

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Aged 55 or older
• Are obese: have a BMI of >30 kg/m2 or BMI >27 kg/m2 and waist circumference >88 cm (women) or >102 cm (men)
• Living independently (not in a health facility)
• The willingness that the general practitioner will be notified of study participation
• Written informed consent
• Willingness to comply with the protocol
• Consent of the study physician

Exclusion Criteria:

• Inability to understand the Dutch language
• Cognitive impairment (MMSE <15)
• Use of total or partial parenteral nutrition (TPN)
• Alcohol or drug abuse in the opinion of the investigator
• Current enrolment in a fixed rehabilitation program or other intervention studies
• Palliative treatment or a life expectancy of ≤ 3 months
• Following a vegan (100% plant-based) diet
• Active medical treatment interfering with this intervention (e.g. cancer patients receiving systemic and immune therapy)
• Physical disabled: unable to meet the general daily exercise guideline for adults
• Planned a holiday during the intervention period and is unable to attend group- or individual sessions for > 1 week

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: More plant-based diet; Participants receive the dietary counselling focused on a more plant-based diet during weight loss	Behavioral: A more plant-based diet during weight loss; Participants receive dietary counseling on a more plant-based diet during weight loss. They will be counseled by a dietician to increase their plant-based protein intake up to 60%, focusing on 1.2 grams of protein per kg body weight.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assess the feasibility	The objective of the feasibility study is to assess the feasibility of the developed 2EAT dietary treatment in obese older adults (55+). The feasibility focusses on the ratio plant-based and animal-based protein, where it is aimed to reach 60% plant-based proteins at endline (week 9). This will be investigated via 3-day dietary records (measured at baseline and endline).	Baseline (week 0) and endline (week 9)
Assess the acceptability	The objective of the feasibility study is to assess the acceptability of the developed 2EAT dietary treatment in obese older adults (55+). This will be investigated via focus groups. Focus groups will be organized for participants and dieticians separately at endline (week 9).	Endline (week 9)

Collaborators and Investigators

• Sponsor: Amsterdam University of Applied Sciences
• Investigators: Principal Investigator: Peter Weijs, Amsterdam University of Applied Sciences

Study record dates

Study Major Dates

• Study Start (Estimated): February 1, 2024
• Primary Completion (Estimated): May 1, 2024
• Study Completion (Estimated): May 1, 2024

Study Registration Dates

• First Submitted: December 12, 2023
• First Submitted That Met QC Criteria: December 21, 2023
• First Posted (Actual): January 5, 2024

Study Record Updates

• Last Update Posted (Actual): January 5, 2024
• Last Update Submitted That Met QC Criteria: December 21, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: Obesity; Older adults; Sustainability; Plant-based diet; Dietary counseling; Sustainable diets; Healthy ageing; Plant-based protein
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity
• Other Study ID Numbers: RAAK.PRO04.033

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