Abstract
Objective: Older adults face many chronic health issues including heart disease and osteoporosis, which are preventable through changes in lifestyle behaviors. The Healthy Eating for Successful Living in Older Adults (TM) (HESL) is a 6-week community education program designed specifically for persons aged >= 60 years, to promote behavioral changes toward a healthy lifestyle. Our objective is to evaluate the HESL. This is the first official evaluation of the HESL since its initiation in 2005.Study Design: A cluster randomized controlled trial.Method: Program implementation and evaluation took place between July 2018 and January 2020. Twenty-nine sites, with 292 participants aged >= 60 years from across five states (mostly from Massachusetts), were randomized into the intervention group (IG) (16 sites; n = 150 participants) and control group (CG) (13 sites; n = 142 participants). The HESL workshops followed a scripted curriculum including information from the USDA's MyPlate (TM) and the USDA 2015-2020 dietary guidelines. Intervention elements included goal setting, self-assessment, group support, and problem solving through brainstorming. The CG received no intervention. Outcome measures were collected in both groups at baseline, 2 weeks postintervention (week 8), and 6 months postintervention. These included self-reported lifestyle behaviors, a composite healthy behavior index (HBI), body mass index [weight (kg)/height (m2)], and waist-to-hip circumference ratio (WHR). Mixed-effects regression models were used to examine the impact of the intervention.Results: The IG showed significantly improved responses to most healthy lifestyle behavior questions at week 8 compared to the CG. However, not all improved responses were sustained at month 6. Significant improvements detected at month 6 included responses to the question on making food choices that are healthy for the heart, using MyPlate (TM) tools for food choices, reading nutrition labels when shopping/planning meals, and confidence in managing own health (p < 0.001 in most cases). HBI was significantly improved at week 8 and month 6 (p < 0.001). WHR decreased significantly (p < 0.05) at month 6.Conclusion: Positive changes in lifestyle behaviors and WHR were observed in older adults due to the HESL intervention.