Dietary Challenges Among Older Men Caregivers: Implications for Health Interventions

In Japan, the declining birthrate, aging population, and the growing prevalence of nuclear families present major challenges for informal caregiving. These factors have led to an increase in caregiving among older adults, a phenomenon commonly referred to as “RouRou-kaigo” in Japanese. As of 2022, older adults account for 63.5% of informal care households in Japan [1]. Older informal caregivers frequently face a range of health issues, including depression, sleep disorders, and deteriorating dietary habits [2, 3]. The dietary habits of caregivers are critical as they influence both their own health and the well-being of care recipients [4, 5]. However, research on the dietary habits of older caregivers and their older care recipients is limited [6, 7]. This study aimed to identify factors associated with poor dietary variety and meal skipping among older caregivers and their care recipients, providing insights to improve their nutritional well-being. We conducted a web-based survey via Cross Marketing Inc., which has 10.5 million registered monitors nationwide as of 2024 [8]. The inclusion criteria were: (1) individuals aged ≥ 65 years, (2) those without dementia or other psychiatric disorders, and (3) primary informal caregivers for older family members requiring long-term care or support. The survey was administered from June 18 to 24, 2024. The survey was distributed online to 830 eligible individuals, and 525 responded. A total of 395 respondents, all of whom routinely prepare meals for both themselves and their care recipients, were included in the final analysis. Dependent variables assessed were caregivers' and care recipients' dietary variety and meal skipping. Caregivers' dietary variety was evaluated using the Dietary Variety Score [9], categorized as “at risk” (≤ 3) and “not at risk” (≥ 4). Care recipients' dietary variety was assessed by asking caregivers if they think the care recipient is eating a balanced diet. Meal skipping was assessed by asking if participants and care recipients ate three meals daily. Independent variables include caregivers' gender (women/men), economic status (satisfied/unsatisfied), support of caregiving (none/yes), and burden of care (low/high). Binomial logistic regression analysis was used to examine factors related to dietary habits among caregivers and care recipients. Statistical significance was set at p < 0.05. SPSS version 29.0 (IBM Corporation) was used for all analyses. All participants provided informed consent, and this study was approved by the Institutional Review Board at Sendai Center for Dementia Care Research and Practices (24U01). Twenty-seven percent of individuals recognized that their care recipients do not eat a balanced diet. There were 33.4% with poor dietary variety scores among older informal caregivers. Regarding meal skipping, 13.7% of care recipients and 19.2% of caregivers were observed. Table 1 presents the factors associated with poor dietary habits among caregivers and care recipients. Men caregivers were significantly more likely than women caregivers to perceive their care recipients as having poor dietary variety. A significant association was also observed between men caregivers and their poor dietary variety. Care recipients' meal skipping was influenced by caregivers' lower economic status and lack of caregiving support. Caregivers' poor economic status was also significantly related to increased meal skipping. Our findings highlight significant challenges in dietary management among older informal caregivers and their care recipients, particularly among men caregivers. Traditional gender roles may limit their cooking skills and confidence, contributing to poor dietary outcomes for both caregivers and care recipients [10]. Additionally, the impact of economic status on meal skipping emphasizes the need for financial and caregiving support. Caregivers with limited resources may struggle to provide consistent, nutritious meals, leading to both their own and their care recipients' poor dietary habits. Interventions targeting nutrition education and financial support for caregivers, especially men, could mitigate these challenges and improve dietary outcomes for both caregivers and care recipients. This study underscores the need for targeted interventions to improve dietary habits among older informal caregivers and their care recipients, particularly focusing on male caregivers and those with low economic status. Addressing these challenges could enhance caregivers' and care recipients' nutritional well-being. Morishita-Suzuki, Kumi: conceptualization, data curation, formal analysis, investigation, methodology, project administration, writing – original draft. The author has nothing to report. This study was approved by the Institutional Review Board at Sendai Center for Dementia Care Research and Practices (24U01). All participants provided informed consent. The author declares no conflicts of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request.