A Randomised Control Trial Exploring the Effect of Food Textures on Food Intake and Eating Rate in Care Home Dwelling Older Adults.

The hypothesis of this study is that consumption of all-meals of a study day with food textures that require reduced oral processing versus food textures that require increased oral processing, would lead to increased total daily food and energy intake in care home older adults. The null hypothesis is that the two study days will no differ in food intake and the alternative hypothesis is that the study day with food textures that require increased oral processing will lead to increased food and energy intake..

Study design: This study includes two study days with a one week washout in between them. In one study day all meals of the day will be provided in "more difficult" to eat textures (a diet with food textures that require increased oral processing). In the other study day all meals of the day will be provided in "easier" to eat textures (a diet with food textures that require reduced oral processing). All meals will be prepared and provided by Apetitio Limited, a food company that specialises in designing and delivering foods for older adults. Some options will be provided by the research team following retail purchase (i.e., biscuits, cakes, bread etc.) All meals, recipes, snacks will be to kept consistent across care homes. The time each participant is starting each meal and the time finishing each meal will be recorded, to calculate total eating time. The weight of the food provided and the weight of the food when finished the meal will also be recorded to calculate food intake, and then using the eating time the eating rate of the meal will be calculated. With residents that are able to using rating scales, short questions on appetite, hunger and liking of the meal will be asked before and after each main meal (breakfast, lunch, evening meal). Same snacks and fluid types will be provided in both study days and the snack and fluid intake will be recorded. No other changes in the daily life of the participant will happen. Baseline information from each participant will be collected before the start of the study from the care homes' records.

The above study design and methodology was influenced by previous research that measured eating rate and food intake in similar ways. At the same time, the methods we will use in this study have been selected carefully to be feasible in care homes and minimise effort needed from the participants and carers.

Food/plate waste measurement (in an audit form): To the residents that are not part of the trial, the meals will also be offered as one of the options on each daily menu. From these meals, and in a fully anonymised way, the researchers will collect the total amount of meals leaving the kitchen and the total leftovers/food waste are being thrown away in order to collect the total amount of these meals consumed and the number of the meals. Data will not be identifiable to the individual. These extra data will be collected to support power and study findings, but will not require consent as no individual is participating in the study, this is purely an "audit" of food served and wasted.

The timetable for the stages of the research is as follows: The researchers aim to run the research around spring-summer 2025. Results will be analysed on completion of the study across care homes. Anonymised results will be then published as a scientific paper and will be presented in international conferences (November 2025- May 2026). Results of this study will also be part of the PhD thesis of the student which will be submitted on or before April 2026.