Using social network theory to examine nutrition risk in community-dwelling midlife and older adults

Abstract

Background: Nutrition throughout the lifespan influences health and well-being. However, as people age, social changes can lead to changes in dietary habits. When these changes lead to inadequate intake, nutrition risk can develop. Nutrition risk is the risk of poor nutrition status or nutritional depletion that occurs when food and/or nutrient intake do not meet needs. Nutrition risk can lead to negative outcomes, including decreased quality of life, frailty, hospitalization, institutionalization, and mortality. Social networks also change as people age. Social networks can be defined as the web of social relationships that surround an individual and the characteristics of those relationships. Social networks have been shown to influence many health outcomes, both physical and psychological. Objective: The aim of the dissertation is to understand the social network factors associated with nutrition risk in community-dwelling Canadians aged 45 and older. Social network theory provided the theoretical framework. Methods: Four studies sought to contribute to the aim. The first sought to determine if social network type was associated with nutrition risk. The second examined the factors associated with nutrition risk scores at two time points. The third examined the factors associated with the development of high nutrition risk in individuals originally not at risk, and the fourth examined the factors associated with changes in nutrition risk scores. Results: Many social network factors were associated with nutrition risk. More restricted network types were associated with high nutrition risk and more diverse networks associated with less risk. Individuals with higher social participation, higher self-rated social standing, and higher levels of social support had higher nutrition risk scores at both time points, whereas lower levels of social support, and lower social participation were predictors of the development of high nutrition risk at follow-up. Finally, higher levels of social participation were associated with increases in nutrition risk scores (and therefore improved nutritional status). Conclusion: Programs and policies aimed at encouraging social participation and helping individuals expand their social networks may help to reduce the prevalence of nutrition risk. Individuals with restricted social networks and low levels of social participation should be screened proactively for nutrition risk.