A groundbreaking tool leverages science and user insights to tackle protein deficiencies in older adults embracing plant-based diets, ensuring healthier and sustainable aging.
Study: Developing a Digital Tool to Calculate Protein Quality in Plant-Based Meals of Older Adults: User Engagement Design Approach With End Users. Image Credit: marilyn barbone / Shutterstock
In a recent study published in the Journal of Participatory Medicine, researchers explored the creation of a digital tool to ensure sufficient protein quality in plant-based diets for older adults. The study design involved dietitians and identified the needs and barriers to practicing a plant-based diet. The aim was to address the nutritional challenges posed by aging and plant-based transitions through user-centered, scientifically driven solutions.
Background
The global shift towards plant-based diets is being driven by concepts of environmental sustainability and health benefits. These diets are also believed to reduce risks of cardiovascular diseases and certain cancers. However, these diets pose challenges for older adults, a growing European demographic group.
Plant-based foods often lack sufficient essential amino acids compared to animal-based proteins, making older adults vulnerable to protein deficiencies that could lead to reduced muscle mass, bone health, and cognitive decline. Furthermore, this age group already faces issues such as appetite reduction and limited outdoor activity, which can further exacerbate the nutritional risks.
While increasing dietary protein could theoretically address these gaps, it conflicts with the environmental goals of sustainable eating. Meal planning with complementary protein sources offers a promising solution but is complex due to limited consumer access to detailed amino acid data. The researchers also noted that older adults often lack familiarity with such nutritional complexities, requiring targeted education for successful dietary changes.
About the Study
The present study utilized a user-centered design to develop a digital tool to optimize protein quality in plant-based diets for older adults. The researchers conducted three focus group interviews in Denmark and the Netherlands, involving dietitians and older adults. The participants were selected through purposive sampling to ensure a diverse yet relevant study population. The study was structured in three phases to understand the needs, conceptualize solutions, and test the usability of the solutions.
Screenshot 2: add new client, 3A: add food intake, 4A: new consultation session, and 5: alternatives; all used in the cognitive walkthrough. Screenshot 2 shows how to add a new client with client details; screenshot 3A shows how to add a new product separated by meal moments; screenshot 4A shows the feedback that is given on the original and alternative food intake on sustainability, protein intake, and protein quality; screenshot 5 is the screenshot where alternatives (green) can be chosen for the original products (blue).
In the first phase, a user-task-environment analysis was performed to gather input on tool functionalities, user preferences, and ideal usage scenarios. This process identified features valued by both dietitians and older adults, such as dietary customization, feedback on protein quality, and user-friendly interfaces.
The second phase used creative methods to generate and refine ideas for the tool. Based on elements such as personalized feedback mechanisms and flexible input options, the solutions were scored for feasibility and relevance. Notably, brainstorming methods like brainwriting helped generate innovative ideas for addressing database gaps and keeping users engaged with the tool.
The final phase involved a cognitive walkthrough of tool prototypes, during which the participants provided feedback on usability. Challenges such as understanding interface elements (e.g., unclear icons and navigation difficulties) were identified and addressed.
Parallel to these qualitative efforts, the researchers also built databases integrating amino acid composition, digestibility scores, and sustainability metrics. The study used algorithms designed to calculate personalized Meal Protein Quality Scores (MPQS) and suggest dietary adjustments. These algorithms considered factors such as taste preferences, food availability, and environmental impact.
Major Findings
The results showed that a user-centered approach effectively addressed nutritional challenges in older adults who were transitioning to plant-based diets. Given their expertise and the complexity of protein quality evaluation, it identified dietitians as the primary target audience for the prototype tool. The study also highlighted a significant need for a resource to aid meal planning to optimize essential amino acid intake.
The user-task-environment analysis revealed shared preferences among dietitians and older adults, including the desire for clear visual feedback, ease of use, and features such as personalized recommendations and preprogrammed meal options. However, the dietitians prioritized precise, science-backed data, while the older adults emphasized the need for accessibility and simplicity.
Additionally, focus group analysis identified practical solutions for incorporating incomplete database entries, engaging users with interactive elements, and providing relevant nutritional insights. The cognitive walkthrough identified critical usability issues, which led the researchers to refine the interface design and functionality. Examples include the older adults' difficulty understanding navigation and the need for a simplified interface, and dietitians' preference for customizable reports.
The database and algorithms used in the tool also helped develop an innovative framework for evaluating MPQS. These scores helped obtain precise feedback on the adequacy of essential amino acid profiles. They proposed dietary adjustments through three tailored algorithms: gram-by-gram substitution, proportional adjustments, and adding missing components.
While the prototype effectively addressed the needs of the dieticians, the older adults expressed some reservations, especially regarding digital literacy and understanding complex nutritional data. This feedback underscored the importance of providing foundational education on protein quality before broader adoption among non-experts.
Conclusions
The study demonstrated that a user-centered approach can be used to develop tools for enhancing protein quality in plant-based diets, especially for dietitians managing older clients. Although promising, the findings also indicated that the prototype's application among older adults requires foundational education on protein quality.
The researchers stated that future iterations should integrate usability refinements, validate the MPQS framework, and expand databases for global relevance. Further usability testing, including real-life scenarios and cultural adaptation, is essential to ensure the tool's effectiveness. Continued collaboration with end users, such as older adults, remains crucial for effective implementation.
Journal reference:
- Dam, van, Christensen, S. H., Tetens, I., III, R., Timmer, M., Jr, S., Marin, I., Groot, D., & Grootswagers, P. (2024). Developing a digital tool to calculate protein quality in plant-based meals of older adults: User engagement design approach with end users. Journal of Participatory Medicine, 16, e48323. DOI:10.2196/48323, https://jopm.jmir.org/2024/1/e48323/