How eating alone shapes meal routines in elderly Swedes

From a recent study published in BMC Public Health, researchers investigate the subjective experience and eating habits of older Swedish individuals who mainly eat their meals alone.

Study: The impact of eating alone on food intake and daily eating routines: a cross-sectional study among community-dwelling 70- to 75-year-olds in Sweden. Image credits: Rawpixel.com / Shutterstock.com

The health benefits of commensality

Food is essential for human survival, health and social organization. Previous research has identified several benefits of communal eating, prompting public health policymakers in many countries to advise their citizens to share meals when possible. This advice comes from studies on a concept called “commensality,” which has been observed to improve both physiological and psychosocial outcomes, especially in individuals aged 60 or older.

Unfortunately, most of this research operationalizes the abstract concept of commensality objectively, introducing many theoretical and empirical issues. An important limitation is that it does not take into account individual differences in the subjective perception or feeling of eating alone. While some people may feel lonely or lose interest in cooking and eating, others remain unaffected.

Most published literature does not examine the subjective aspects of commensality and instead focuses solely on its measurable outcomes, such as physical and mental health. The Swedish population represents an ideal study cohort to address these knowledge gaps, as approximately 30% of older Swedish adults live alone. Furthermore, Swedish residents report the lowest incidence of subjective loneliness among European countries.

About the study

The researchers used a self-reported, survey-based cross-sectional study design to examine the associations between eating alone and food-related outcomes. The study focused on community-dwelling Swedish citizens between the ages of 70 and 75, who were randomly selected from the Swedish state’s personal address register.

The current study was conducted between November 2021 and January 2022, with 1,500 individuals invited to participate. Respondents living in a long-term care facility or with clinically diagnosed dementia were excluded from the study.

Data of interest included objective and subjective measures of eating alone, food-related outcomes, demographic data such as year of birth, gender, living situation and marital status, as well as medical history including general health, chronic diseases, height, weight and body weight index (BMI).

Statistical analysis included linear regression models to compare participants who ate alone with those who practiced commensality. Models were adjusted for demographic variables and independently for subjective responses to eating alone.

Findings of the study

Of the 1,500 participants invited to participate, 695 responded, met inclusion criteria, and were included in the final analysis. Evaluations of the included participants showed that the distribution of gender and age was almost equal.

Approximately 75% of the study cohort lived together, while 25% reported living alone. This coincided with eating alone or together, as most people living together ate together, while most people living alone also ate alone. Individuals who reported eating alone did not report negative subjective feelings about their eating habits; However, a small proportion indicated that they suffered from eating alone.

About 72% of respondents regularly participated in commensality at least once a day. Of the 28% of study participants who ate alone, most were women.

Evaluations of the food index results revealed virtually no differences between the two cohorts. The only statistically significant differences were observed among respondents who ate alone and who reported fewer vegetables, snacks, sweet drinks and sugary foods than participants from the commensality cohort.

In contrast, the frequency of daily food intake was strongly cohort dependent. About 59% of the commensality cohort reported eating at least three main meals daily, while 56% of the alone cohort reported eating two or fewer meals per day. The cohort eating alone reported a higher proportion of ready-to-eat ‘convenience’ foods than the commensality cohort.

Conclusions

The current study contrasts with previous research in that it failed to identify the health or subjective benefits of commensality compared to eating alone. The lack of association observed in this study may be due to the high fitness, independence and low loneliness potential of older Swedish citizens compared to those residing in other European countries.

The study highlights the link between eating alone and both lower daily main meal intake and higher consumption of convenience foods. These findings indicate that eating alone had a greater impact on the organization of daily meal routines than on the quality or nutritional health of the food consumed.