The present study demonstrated a significant decrease in the daily consumption of cereals after the intervention program. This might be explained by the attempts to avoid weight gain, considering cereals mainly as sugars although the program stressed the importance of cereal fiber consumption late in life as it is associated with lower risk of incidence of cardiovascular diseases, in addition to their benefits for avoidance of constipation, and positive effect on plasma LDL-cholesterol and the present study intervention did not lead to sig-nificant increase in the daily intake of animal proteins. This could be linked to dental health and mastication problems arising due to missing teeth, denture wearing and decreased biting forces. It could also be attributed to the high cost of this type of food. The finding is in agreement with Shin-Jivan [iii who found that the elderly Taiwan-ese consumed less poultry and meat than their younger counterparts.
Nevertheless, our study intervention led to improvement in the consumption of dietary fruits and vegetables although they still need more im-provement. The findings are in congruence with previous studies that demonstrated the effectiveness of dietary interventions in increasing the intake of these food items [12-141. Meanwhile, the program developed by Park et al. [15] indicated that stage-tailored nutrition education produced positive shift in several indicators and mediators of vegetables but not for fruits intake, which is near to our findings where the improvement was more marked in the vegetables compared to fruits. The improve-ment in the mean daily dairy products consumption at the post-intervention phase is in congruence with previous studies [16,17] which reported increas-es in the intake of calcium, vitamin D, and a number of other nutrients in the intervention group between the baseline and the end of the intervention. Thus, the dairy products may be the easiest to change given the availability, cost, and readiness to con-sume with no preparation, as compared with pro-teins. Hence, while there were gains in knowledge and changes in attitudes, not all of these resulted in corresponding improvements in behavior as lmowledge and attitude can be changed faster than behavior, and also behavior need resources so that it could be improved.
Conclusion and recommendations: The coun-seling intervention was effective in improving their lmowledge and changing their attitudes to be more positive, which led to improvements in elderly dietary practices. The study recommends more efforts in the provision of nutritional counseling to the elderly through similar interventions, with more community service programs. The family medicine department should organize of training courses for family physicians in comprehensive geriatric assessment and management, with shared training courses for nurses and family physicians to improve their knowledge and skills in the pro-vision of nutritional counseling, and establish a specialized clinic in the Family Practice Centers to provide all-inclusive Care for the Elderly.
The present study demonstrated a significant decrease in the daily consumption of cereals after the intervention program. This might be explained by the attempts to avoid weight gain, considering cereals mainly as sugars although the program stressed the importance of cereal fiber consumption late in life as it is associated with lower risk of incidence of cardiovascular diseases, in addition to their benefits for avoidance of constipation, and positive effect on plasma LDL-cholesterol and the present study intervention did not lead to sig-nificant increase in the daily intake of animal proteins. This could be linked to dental health and mastication problems arising due to missing teeth, denture wearing and decreased biting forces. It could also be attributed to the high cost of this type of food. The finding is in agreement with Shin-Jivan [iii who found that the elderly Taiwan-ese consumed less poultry and meat than their younger counterparts.Nevertheless, our study intervention led to improvement in the consumption of dietary fruits and vegetables although they still need more im-provement. The findings are in congruence with previous studies that demonstrated the effectiveness of dietary interventions in increasing the intake of these food items [12-141. Meanwhile, the program developed by Park et al. [15] indicated that stage-tailored nutrition education produced positive shift in several indicators and mediators of vegetables but not for fruits intake, which is near to our findings where the improvement was more marked in the vegetables compared to fruits. The improve-ment in the mean daily dairy products consumption at the post-intervention phase is in congruence with previous studies [16,17] which reported increas-es in the intake of calcium, vitamin D, and a number of other nutrients in the intervention group between the baseline and the end of the intervention. Thus, the dairy products may be the easiest to change given the availability, cost, and readiness to con-sume with no preparation, as compared with pro-teins. Hence, while there were gains in knowledge and changes in attitudes, not all of these resulted in corresponding improvements in behavior as lmowledge and attitude can be changed faster than behavior, and also behavior need resources so that it could be improved.Conclusion and recommendations: The coun-seling intervention was effective in improving their lmowledge and changing their attitudes to be more positive, which led to improvements in elderly dietary practices. The study recommends more efforts in the provision of nutritional counseling to the elderly through similar interventions, with more community service programs. The family medicine department should organize of training courses for family physicians in comprehensive geriatric assessment and management, with shared training courses for nurses and family physicians to improve their knowledge and skills in the pro-vision of nutritional counseling, and establish a specialized clinic in the Family Practice Centers to provide all-inclusive Care for the Elderly.
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