PREVNUT - FORTIPHY, Preventing the risk of undernutrition by fostering meal fortification and physical activity in older adults

The results from the home testing of eight recipes enriched with protein have been processed during the period. The participants' feedback has provided valuable knowledge for processing the recipes for further use in the project. All the recipes were well liked by the Norwegian consumers. Good advice on further development was that some recipes should be simplified, more use of semi-finished products where available, and that consumers would prefer to enrich with natural ingredients. It was also pointed out that the addition of protein powder was most suitable for the oldest adults, and possibly nursing home residents who have their food prepared by others. The recipes were then simplified for use in an intervention study to be carried out in Great Britain, and there are draft handouts for these recipes in English. MOOC on nutrition and physical activity intended for the older adults and relatives has been developed in the project for launch in the UK. In addition, a consumer survey has been carried out in France where some of the recipes developed in the project have been tested for liking. The conclusion of this investigation is that the addition of protein powder creates a problem related to the texture of the dish, and that further development of products enriched with protein powder should be adapted to the texture of the non-enriched product so that the enriched product appears as similar to the original as possible.

Poor appetite is a major determinant of protein-energy undernutrition while contrary to common beliefs, nutritional needs decrease little with age and even sometimes increase. Fortification, which consists in adding high-energy/high-protein ingredients to regular drinks or foods is acknowledged to be a flexible and relevant approach for older people with reduced appetite. In parallel, several studies have demonstrated better effect of interventions combining nutritional approaches with physical activity over nutritional or physical activity interventions alone. Given this context, FORTIPHY will develop new solutions allowing older people (= 70 years old living at home) to fortify their regular meals, and will assess the added value of physical activity to meal fortification. In order to ensure high adoption and compliance levels for FORTIPHY solutions, end-users (older people, caregivers) will be associated in the project through co-creation and participatory research. A first work package will be dedicated to the rational design of fortified recipes through (i) an unbiased review of available high-protein ingredients and (ii) the identification of technological and consumer usage constraints. Based on these inputs, a second work package will develop fortified recipes considering the preferences of older people (home-used tests). The bioavailability of the amino acids in fortified dishes and potential impact of these dishes on satiety and biological markers of appetite will be measured. A third work package will assess the efficiency of meal fortification and the added value of physical activity to prevent the onset of the risk of undernutrition in older small eaters living at home (randomized controlled field trial). A fourth work package will disseminate the results in a massive open on-line course (MOOC) and a Summer School, contributing to raise the awareness of stakeholders regarding the issue and the solutions to prevent undernutrition.