Subsidized Community Dining as Social Welfare Infrastructure for Healthy Aging: A Randomized Crossover Field Study of Postmeal Walking and Glycemic Profiles in Older Adults
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 15
- 试验地点
- 1
- 主要终点
- Meal-Level 0- to 90-Minute Postprandial Glucose Incremental Area Under the Curve
研究概览
简要总结
This study will examine whether eating lunch and dinner at a subsidized community dining site affects postmeal walking and blood glucose patterns in older adults. Participants will be community-dwelling adults aged 60 to 79 years who are eligible for a local elderly meal subsidy and have prediabetes or elevated blood glucose risk.
Each participant will complete two 6-day meal conditions in random order. In one condition, participants will eat lunch and dinner at home. In the other condition, participants will eat lunch and dinner at a subsidized community dining site. Participants will wear a continuous glucose monitor and an activity tracker so the study team can measure postmeal glucose levels, daily glucose patterns, and steps after meals.
The study will compare community dining with home eating to determine whether community dining increases postmeal walking, improves postmeal glucose responses, and affects loneliness and meal experience.
详细描述
Subsidized community dining programs are designed to improve access to affordable meals for older adults, but they may also influence daily movement, social interaction, and metabolic health. Eating at a community dining site may encourage older adults to leave home, walk before or after meals, and interact with others in a shared meal environment.
This study will evaluate subsidized community dining as a real-world meal setting rather than as a prescribed exercise or dietary treatment. Participants will complete both study conditions: home eating and community dining. During the community dining condition, participants will eat lunch and dinner at a subsidized community dining site. During the home-eating condition, participants will eat lunch and dinner at home using meals designed to approximate the energy and macronutrient composition of the community dining meals.
The study will use continuous glucose monitoring and wearable activity tracking to measure postmeal glucose responses, daily glucose profiles, and postmeal steps under free-living conditions. No walking target will be prescribed. After each lunch and dinner, participants will be free to walk, sit, rest, remain at the dining site, or return home according to their usual preference.
The study will also assess loneliness and meal-condition experience to explore whether the dining setting affects social and experiential aspects of eating. Findings may help determine whether subsidized community dining can function not only as food assistance, but also as community-based infrastructure that supports healthy aging.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- None
盲法说明
This is an open-label study because participants and study staff cannot be masked to whether meals are consumed at home or at the community dining site. Glucose and activity data will be processed using coded condition labels when feasible.
入排标准
- 年龄范围
- 60 Years 至 79 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Community-dwelling adults aged 60 to 79 years
- •Eligible for the local elderly meal subsidy
- •Prediabetes or elevated glycemic risk, defined as HbA1c 5.7% to 6.4% or fasting plasma glucose 100 to 125 mg/dL
- •Able to consume meals orally
- •Able to walk independently without a walking aid
- •Able to attend the community dining site safely
- •Able and willing to wear a continuous glucose monitor and activity tracker
- •Able and willing to follow the home-meal plan and study procedures
- •Able to provide written informed consent
排除标准
- •HbA1c ≥6.5% or fasting plasma glucose ≥126 mg/dL
- •Diagnosed diabetes
- •Use of insulin or glucose-lowering medication
- •Severe cognitive impairment
- •Acute illness or recent hospitalization
- •Severe gastrointestinal disease affecting usual food intake or gastric emptying
- •Severe renal, hepatic, cardiovascular, or neurologic disease that would make participation unsafe
- •Skin conditions preventing continuous glucose monitor use
- •Food allergy or dietary restrictions incompatible with the standardized meal plan
研究组 & 干预措施
Home Eating Followed by Community Dining
Participants will complete 6 days of eating lunch and dinner at home, followed by 6 days of eating lunch and dinner at a subsidized community dining site.
干预措施: Subsidized Community Dining (Behavioral)
Home Eating Followed by Community Dining
Participants will complete 6 days of eating lunch and dinner at home, followed by 6 days of eating lunch and dinner at a subsidized community dining site.
干预措施: Home Eating (Behavioral)
Community Dining Followed by Home Eating
Participants will complete 6 days of eating lunch and dinner at a subsidized community dining site, followed by 6 days of eating lunch and dinner at home.
干预措施: Subsidized Community Dining (Behavioral)
Community Dining Followed by Home Eating
Participants will complete 6 days of eating lunch and dinner at a subsidized community dining site, followed by 6 days of eating lunch and dinner at home.
干预措施: Home Eating (Behavioral)
结局指标
主要结局
Meal-Level 0- to 90-Minute Postprandial Glucose Incremental Area Under the Curve
时间窗: Study Days 2-13; fixed premeal baseline window through 90 minutes after completion of each lunch and dinner during the 12-day randomized meal-condition period.
Postprandial glucose incremental area under the curve (iAUC) will be calculated for each lunch and dinner from exported timestamped continuous glucose monitoring data using the trapezoidal rule. Baseline glucose will be defined as the mean continuous glucose monitoring value during the fixed 30-minute premeal baseline window. The postprandial calculation window will extend from meal completion through 90 minutes after meal completion.
次要结局
- Meal-Level 0- to 90-Minute Postmeal Step Count(Study Days 2-13; from meal completion through 90 minutes after completion of each lunch and dinner during the 12-day randomized meal-condition period.)
- Meal-Level Peak Postprandial Glucose(Study Days 2-13; from meal completion through 90 minutes after completion of each lunch and dinner during the 12-day randomized meal-condition period.)
- Meal-Level Time to Peak Postprandial Glucose(Study Days 2-13; from meal completion through 90 minutes after completion of each lunch and dinner during the 12-day randomized meal-condition period.)
- Daily 24-Hour Mean Glucose(Study Days 2-13; over each 24-hour analytic day during the 12-day randomized meal-condition period.)
- Daily Time Above Range(Study Days 2-13; over each 24-hour analytic day during the 12-day randomized meal-condition period.)
- Daily Combined Postmeal Steps(Study Days 2-13; summed across the lunch and dinner 90-minute postmeal windows on each 24-hour analytic day during the 12-day randomized meal-condition period.)
- Total Daily Steps(Study Days 2-13; over each 24-hour analytic day during the 12-day randomized meal-condition period.)
- End-of-Condition Loneliness Score(Baseline and end of each 6-day meal condition during the 12-day randomized meal-condition period.)
- End-of-Condition Meal-Condition Experience and Satisfaction Score(End of each 6-day meal condition during the 12-day randomized meal-condition period.)
研究者
Yang Zhang
Independent researcher
Hunan Normal University