Group virtual nutrition and teaching kitchen intervention versus time/attention-matched health education curriculum control to improve dietary quality and social engagement among older Veterans with impaired mobility: a randomized controlled trial

Older Veterans with impaired mobility often face barriers to food shopping, meal preparation, and cooking that can contribute to poor diet quality and declining health. This randomized controlled trial will test whether a 12-week virtual nutrition and teaching kitchen program improves diet quality (Healthy Eating Index [HEI]), compared with time- and attention-matched contact-control group. We plan to enroll 180 Veterans ≥ 65 years of age with mobility limitations who will be randomized to an intervention or control group. Participants in the intervention group will attend one live, one-hour virtual session each week for 12 weeks, including cooking demonstrations, and tailored nutrition education, with adaptive equipment and occupational therapy guidance provided as needed. Control participants will attend matched group health education sessions focused on healthy aging. Outcome assessments occur at baseline, 3 months, and 6 months. The primary outcome is change in HEI score from baseline to 3 months. Secondary outcomes include change in HEI from 3 to 6 months, and changes in social isolation, loneliness, and health-related quality of life, physical function, body composition, and fear of falling from baseline to 3 months. Sample size calculations indicate that 73 participants per group will provide 80% power to detect a 5.5-point between-group difference in HEI, allowing for 20% attrition. This trial aims to provide evidence on effectiveness of a virtual nutrition and cooking program designed to improve diet quality and social connection in older adults with mobility impairments. We anticipate that this protocol will show that virtual nutrition education and cooking demonstrations is an efficacious strategy to improve diet that also has potential for scalability through implementation into existing health promotion programs. This trial was registered at ClinicalTrials.gov: NCT06726083 on 12/05/2024 (https://clinicaltrials.gov/study/NCT06726083). Two-arm RCT (N = 180; ≥65 years with mobility limitations) testing a 12-week virtual nutrition + teaching kitchen program (with produce delivery) vs. time/attention-matched health education curriculum control. Primary outcome is change in Healthy Eating Index (HEI) with assessments at baseline, after the 3-month intervention, and at 3 months post-intervention. Secondary outcomes include food literacy, health literacy, food insecurity, social isolation, health-related quality of life, frailty, body composition, and physical function. 6-month follow-up focus groups will assess sustained effects of the intervention.