With the European population growing older, the challenge is to keep an increasing number of seniors across all European countries healthy and active. In Europe, between 13.5 % and 29.7 % of older adults living at home are malnourished or at risk of protein energy malnutrition. PROMISS aims to better understand and ultimately prevent protein energy malnutrition in seniors. Thereby, PROMISS will contribute to improve active and healthy ageing.

Project information

Nutrition for healthy ageing


16th September 2019

Oral health determinants of incident malnutrition in community-dwelling older adults

Eva Kiesswetter, Linda M. Hengeveld, Bart JF Keijser, Dorothee Volkert, Marjolein Visser.

Journal of Dentistry, Volume 85, June 2019, Pages 73-80  doi.org/10.1016/j.jdent.2019.05.017


Malnutrition is a state of energy or protein deficiency, which causes measurable changes in body functions. Among older people malnutrition is widespread and is associated with frailty, functional decline and poor quality of life. Malnutrition can be caused by multiple different factors such as disease-related, functional, psychological, and socio-economic aspects. Moreover, it is assumed that the oral health status plays a role in the development of malnutrition, as mastication and insalivation are important steps in eating and digesting. Therefore, the aim of our study was to investigate the association of different oral health characteristics and the development of malnutrition during 9-years in community-dwelling older adults.

The data used were from the Longitudinal Aging Study Amsterdam (LASA). We included participants aged 55-80 years without malnutrition at the beginning of the investigation. To describe oral health status, aspects relating to teeth, dentures, oral hygiene and oral problems (e.g. bleeding gums) as well as the self-rated oral health were assessed.

Of the 19 investigated oral health characteristics, toothache while chewing was identified to increase the risk of devolving malnutrition. In addition, for a poor self-rated oral health and the feeling of a dry mouth in combination with having no teeth we found indications that they might play a role in the long-term development of malnutrition. Regarding strategies to prevent malnutrition in older people these three aspects are of specific interest as they are modifiable and can be easily assessed by self-reports.


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3rd September 2019

The association of olfactory function with BMI, appetite, and prospective weight change in dutch community-dwelling older adults

K.S. Fluitman, H.J. Nadar, D.S. Roos, H.W. Berendse, B.J.F. Keijser, M. Nieuwdorp, R.G.Ijzerman, M. Visser

J Nutr Health Aging (2019). https://doi.org/10.1007/s12603-019-1241-7


A common phenomenon amongst older adults is a decline in appetite, which is thought to contribute to the occurrence of undernutrition. This decline in appetite is called: “Anorexia of Aging”. Many factors are thought to contribute to anorexia of aging, including a decrease in smell function as we become older. A deteriorating sense of smell is believed to diminish eating pleasure and change people’s food-related choices. This would then lead to lower food intake and ultimately undernutrition.
In this study, we evaluated whether sense of smell was associated with appetite, weight change and BMI. In other words: do people with poorer sense of smell also report poorer appetite, suffer more weight loss and have a lower BMI? In 2012-2013, we used a commercially available smell test (the 40-item UPSIT test) to assess sense of smell in 824 Dutch older adults, aged 55-65 years old. All these older adults were also enrolled in the larger LASA-study which studies the consequences of aging in the Netherlands. In addition to the results of the smell test, we made use of the self-reported appetite, weight, and BMI, as well as many other variables measured by LASA.
Ultimately, 673 participant had correctly filled out the UPSIT-test and were included in this study. No association between sense of smell and appetite or weight change could be found. However, there was an association between poorer sense of smell and lower BMI in older adults who smoke, but not in older adults who do not smoke.
This means that poor sense of smell in older adults who also smoke might be a vulnerable group when it comes to undernutrition.


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16th August 2019

Older Consumers’ Readiness to Accept Alternative, More Sustainable Protein Sources in the European Union

Alessandra C. Grasso, Yung Hung, Margreet R. Olthof, Wim Verbeke and Ingeborg A. Brouwer

Nutrients 2019, 11, 1904; doi:10.3390/nu11081904doi.org/10.1111/jgs.16011


Considering today’s environmental challenges such as climate change and biodiversity loss, sustainable dietary strategies are needed to meet the high protein requirement of a growing aging population. This study investigated the readiness of older adults to accept the consumption of the following alternative, more sustainable protein sources: plant-based protein, insects, single-cell protein, and in vitro meat. We used data from a survey that was conducted among 1825 older adults aged 65 years or above living in the United Kingdom, the Netherlands, Poland, Spain, and Finland.

Dairy-based protein was the most accepted protein source among older adults, with 75% of the respondents reporting dairy to be acceptable or very acceptable. When it came to alternative, more sustainable protein sources, 58% of the respondents reported to accept plant-based protein, 20% reported to accept single-cell protein, 9% reported to accept insect-based protein, and 6% reported to accept in vitro meat-based protein. We found that fussy eaters were less likely to accept eating alternative, more sustainable protein sources. Older adults who were more active in sustainable food consumption (e.g. purchases organic food) and who were highly educated were more likely to accept eating alternative, more sustainable sources. Valuing health, sensory appeal, and price when making food choices, as well as gender and country of residence were found to influence acceptance, although not consistently across all the protein sources.

This paper concludes that a relatively high acceptance of plant-based protein sources provides an opportunity to increase protein intake in an environmentally sustainable way in EU older adults. More research is needed to determine ways to increase acceptance of more innovative, technology-driven protein sources such as single-cell protein and in vitro meat among older adults.

You can also read the scientific article here.

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Today we celebrate #WorldFoodDay! Learn more about good and #sustainable sources of #protein which are essential for a healthy diet. bit.ly/32lvQvV pic.twitter.com/dus8plaBTm

About 3 days ago from PROMISS Project's Twitter via TweetDeck

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