title: Impact of home-delivered meal programs on diet and nutrition among older adults: a review.
abstract: BACKGROUND
  Poor diet quality and insufficient nutrient intake is of particular concern among older adults. The Older Americans Act of 1965 authorizes home-delivered meal services to homebound individuals aged 60 years and older.
  
  
  OBJECTIVE
  The purpose of this study was to review scientific evidence on the impact of home-delivered meal services on diet and nutrition among recipients.
  
  
  METHODS
  Keyword and reference searches were conducted in Cochrane Library, Google Scholar, PubMed and Web of Science. Inclusion criteria included: study design (randomized controlled trials, cohort studies, pre-post studies, or cross-sectional studies); main outcome (food and nutrient intakes); population (home-delivered meal program participants); country (US); language (articles written in English); and article type (peer-reviewed publications or theses).
  
  
  RESULTS
  Eight studies met the inclusion criteria, including two randomized controlled trial studies (from the same intervention), one cohort study, two pre-post studies, and three cross-sectional studies. All but two studies found home-delivered meal programs to significantly improve diet quality, increase nutrient intakes, and reduce food insecurity and nutritional risk among participants. Other beneficial outcomes include increased socialization opportunities, improvement in dietary adherence, and higher quality of life.
  
  
  CONCLUSIONS
  Home-delivered meal programs improve diet quality and increase nutrient intakes among participants. These programs are also aligned with the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services by helping older adults maintain independence and remain in their homes and communities as their health and functioning decline.
authors.affiliation: Department of Statistics, University of Illinois at Urbana-Champaign, USA.
authors.forename: Huichen
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA ran5@illinois.edu.
authors.forename: Ruopeng
authors.initials: R
authors.lastname: An
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004032:Diet; D002149:Energy Intake; D005522:Food Services; D018577:Homebound Persons; D006801:Humans; D008134:Long-Term Care; D008875:Middle Aged; D009751:Nutritional Requirements; D009752:Nutritional Status; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
keywords: Home-delivered meal; diet; meals on wheels; nutrition; systematic review