Factors influencing independent older adults (un)healthy food choices: A systematic review and research agenda

Population aging, the epidemiological transition, and associated lifestyle changes are among the major drivers of the increased incidence and prevalence of non-communicable diseases. Preparing for change is essential to ensure progress towards achieving the goals outlined in the 2030 Agenda for Sustainable Development. The first step for health care providers is to build specific programs or interventions that guide healthy long-term food choices during old age. Thus, identifying and understanding the specific factors that influence the food choices of elderly adults and how these factors limit or encourage food consumption is imperative. The current review aimed to identify how personal, social, cultural, psychological, situational and intrinsic/extrinsic aspects of food guide or hinder the dietary choices of independent elderly individuals (aged 65 years and older) towards both healthy and unhealthy food choices. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Thirty-seven papers satisfied the screening. Results are schematized through the Mojet model by framing all potential drivers that guide the independent elderly respectively to make healthy and less healthy choices in their diet. Findings revealed that food choices of independent older adults are shaped by a multitude of factors and sub-factors that may serve to promote or limit the desire and ability to consume a healthy food. Situational, socio-demographic, and psychological factors were the most investigated in the analysed literature, albeit with different aspects and dimensions. Future studies should extend the analysis including multiple factors and evaluate possible interactions between different dimensions. A research agenda provided insights for scholars and policymakers interested in further investigating the factors that influence food choices of this target group.