ABSTRACT
Introduction
The management of malnutrition in home-dwelling older adults is challenging since they often must adjust long-standing food habits developed throughout a lifetime. Dietitians aim to support these adjustments by applying patient-centered care (PCC). Whether and how PCC-based dietary advice fits patients’ everyday handling of food remains, however, relatively unexplored. Specifically, it is unclear to what extent everyday dimensions of food, such as health, social, and cultural dimensions emerge during consultations, and who tends to raise them. This study aims to analyse and compare which food dimensions are raised by dietitians and patients during consultations and how these dimensions are embedded in patients’ everyday lives.
Methods
From November 2022 to March 2023, observations were conducted of 31 home visit consultations with home-dwelling older adults by 8 dietitians in the Netherlands and 31 informal interviews with dietitians to provide further context about the visit. The participants included dietitians visiting malnourished, home-dwelling older adults, the malnourished older adults themselves, and, if applicable, their informal caregivers. Bourdieu’s sociological concept of habitus, a set of ingrained social structures that shape everyday thinking and acting, was applied to categorize food dimensions and to analyse how they are embedded in patients’ everyday lives.
Results
While dietitians customize their advice for each patient, they emphasize different dimensions of food. Dietitians primarily focus on ‘measuring and knowing’ and the ‘effect of diet therapy’, reflecting a rational and functional approach to food and malnutrition treatment. Patients emphasize social, emotional and temporal dimensions, bringing in a broader and personal approach to food and malnutrition.
Conclusion
Dietitians emphasize rational and functional dimensions of food, while patients foreground social, emotional, and temporal dimensions. From a Bourdieusian perspective, dietitians’ advice often reflects pragmatic and individualistic orientations. Recognizing these orientations can help dietitians further integrate the historical and social embeddedness of food, allowing their advice to better resonate with patients’ habitus and thus with their everyday food-related practices, attitudes, and behaviors.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 3, June 2026. Read More