Internet-based personalized dietary guidance is accepted and feasible in older adults

Rationale: To foster healthy ageing is one key priority of the European Union. Optimized nutrition and increased physical activity are main strategies to support healthy ageing. The aim of this pilot test was to evaluate if a new internet-based dietary intervention program (RISTOMED®) is accepted and feasible in older adults.

Methods: In total, 41 subjectively healthy volunteers aged 65 to 85 (23 women, 18 men, 72±4 years, BMI 25.5±3.2kg/m²) were recruited from the normal population of Berlin. Health was defined as absence of known disease and normal serum values of routine haematological, inflammatory, metabolic, hepatic and renal parameters. The participants were trained by a dietician to use their individualized password-protected e-dietary web-site to daily follow the personalized e-diet plan, and to fill in study requests (e.g. weight, online questionnaires).

Results: The majority of participants were between 65 and 75 years of age (78%). All participants had their own PC and used the internet daily (66%), preferably for e-mails and online searches (95% each). Impulses to buy a PC mainly came from previous profession (36.6%), friends and family (26.6%) and a PC course offered in a previous study (22%). Men had a significantly longer PC experience than women (13±7 vs. 5±5 years, p<0.001), but both felt equally well able to cope with the e-dietary platform after four weeks of use (very well or well: men 100% vs. women 95%, ns). Only 2 participants needed help from either friends, family or neighbours. Two participants (5%) expected an improvement of their nutrition through participation in the project before using the e-dietary platform. After using the e-dietary platform for four weeks, 13 participants (36%) declared a marked subjective improvement in their nutrition and further 25% subjectively improved their nutrition at least to some extent. At the end of the project, 81% of participants thought that RISTOMED® could be a future form of nutritional management in the elderly.

Conclusion: Currently 30% of the German population aged 65 to 75 years has internet skills, with similar numbers reported in most West-European countries. Based on our results and the steadily growing number of older people with internet skills in Europe, personalized e-dietary approaches could be relevant and feasible future strategies to optimize nutrition in the elderly. The efficacy of such approaches on diet modification and health effects will have to be tested in detail.