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RESEARCH PRODUCT

Home delivery meal : issue and impact of this service on the nutritional status of older people living at home

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Introduction. In old age, the onset of disabilities (physical, cognitive) can lead older adults to have difficulty doing certain tasks of daily life, particularly those related to alimentation (shopping, meal preparation). To alleviate these difficulties, more and more elderly people are using home delivery meal services. The objective of this thesis is to question the place and role of such services in preventing undernutrition in the elderly population. Undernutrition is common in this population and results from an imbalance between nutritional intake and needs. Materials and methods. In this thesis, several approaches were combined. A systematic literature review documented the undernutrition issue in home delivery meal services beneficiaries. Two studies contributed to characterize this population. A qualitative study described the dynamics underlying the installation of home delivery meal services. A quantitative study characterized beneficiaries food intake. Finally, two interventional studies evaluated the impact of personalized dietary support on elderly nutritional status who received a home meal delivery service. Results and discussion. The results highlighted the nutritional frailty of older adults receiving meal-on-wheels services, with a prevalence of undernutrition ranging from 17 to 20% depending on the study. In addition, 70 to 80% of the beneficiaries had insufficient food consumption to meet their nutritional needs. Considering this situation, this thesis showed a positive impact of the implementation of a home delivery service on the nutritional status of the elderly, especially when this service is associated with personalized nutritional interventions (e.g. dietician counseling, addition of energy/protein-rich foods). Nevertheless, home delivery meal structures must continue their efforts to find innovative solutions to improve the quality of the delivered meals and contribute more effectively to the prevention of undernutrition among the elderly population living at home.