Liberal Democrat MP Norman Lamb recently suggested that encouraging people to take their elderly neighbours out for the day could improve their health and their dependency on care services. Attempts to tackle social isolation led by organisations such as the Campaign to End Loneliness don’t tend to get as big headlines in the health pages as the importance of getting your five a day, but the two are closely linked, particularly where the elderly are concerned.
In the next two decades there will be a 45% increase in the number of over-65s and an over seven-fold increase in the number of people over 100. Whilst life expectancy is rising, the time spent in chronic illness is increasing. Nutrition plays a key role in healthy ageing. In the UK, it is estimated that around 70,000 avoidable deaths are caused by diets that do not match current guidelines.
The EPIC-Norfolk study is following a population of over 25,000 people in Norfolk since 1993 to study diet and other factors in relation to chronic diseases. Previous research drawing on the study found that individuals who consumed three additional vegetable items per week had a 13% lower risk of developing type 2 diabetes.
What people eat can change, though, and people’s ability to engage in healthy eating is influenced by the social environment. This includes factors such as marriage, cohabitation, friendship and general social interaction.
Around half of those over 75 now live alone, and social isolation can affect their health, including whether they eat well. Research shows people over 50 who are single, widowed or divorced eat less healthily than those with partners. Men, people who live alone and those who are socially isolated are most likely to eat a diet with little variety.
This suggests strongly that improving people’s social ties could have a positive impact on health. As part of a Centre for Diet and Activity Research study, we have been analysing the EPIC-Norfolk data to look at the combined influences of multiple social ties in relation to the daily variety of fruits and vegetables eaten, regardless of quantity.
The research adds new evidence about how unique combinations of older people’s social lives can affect their diet. Our results confirmed, for instance, that marital status is an important social relationship influencing diet quality in older people. Compared to older adults in a partnership, single over-50s ate 2.3 fewer different vegetable products per day. Those who were widowed ate 1.1 fewer different vegetable products daily. Furthermore, widows and widowers living alone consumed 1.3 fewer different vegetable products daily than married lone-dwellers. By contrast, widows and widowers living with someone else ate the same number of different vegetable products each day as over-50s who are in a partnership and live with someone.
This shows that it is not solely widowhood but rather the combination of both widowhood and living alone that puts older people at risk of a lower quality diet.
The research suggests interventions which increase the availability of various social relationships are important for supporting a healthy diet. This could range from organising social activities to considering how the design of accommodation for older people might support interaction. The study also suggests that intervention needs to be tailored to include other social factors beyond marital status and to take into account that over 50s are more likely than other groups in the population to experience changes in their social relationships. These moments of change are important to target in assessment and intervention. For example, around the time of widowhood, assessment of risk to healthy eating needs to consider gender, living arrangement and friend contact.
The Campaign to End Loneliness says loneliness is a bigger problem than simply an emotional experience and cites research showing that it has an equivalent impact on our health to smoking 15 cigarettes a day and is worse for us than well-known risk factors such as obesity and physical inactivity. A considered approach to tackle it could have significant health benefits.
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