Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial

Tenna Christoffersen; Anne Marie Beck; Anja Weirsøe Dynesen; Janne Kunchel Lorenzen; Anders Reenberg Andersen; Margit Dall Aaslyng; Inge Tetens

doi:10.1016/j.nut.2025.112876

Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial

Tenna Christoffersen^*
, Anne Marie Beck
, Anja Weirsøe Dynesen
, Janne Kunchel Lorenzen
, Anders Reenberg Andersen
, Margit Dall Aaslyng
, Inge Tetens

^*Corresponding author for this work

Steno Diabetes Centre Zealand

Research output: Contribution to journal › Article › Research › peer-review

Abstract

BACKGROUND: Overnutrition, defined as overweight and obesity, is a growing concern among older adults, increasing the risk of comorbidity, disabilities, and mortality. However, the optimal management of overnutrition in this population remains unclear.

PURPOSE: The aim is to develop and assess the effectiveness of a nutritional and physical activity intervention on muscle function and quality of life (QoL) among older adults with overnutrition in nursing homes (NHs).

METHODS: A 12-mo cluster randomized participatory trial was conducted in six Danish NHs. The NHs were assigned following a 1:1 allocation ratio for control and intervention. Using the Plan-Do-Study-Act model, intervention components were participatorily developed over the first 6 mo and implemented over the remaining 6 mo. Muscle strength was measured via hand grip strength and a 30-second chair stand test. The Adult Social Care Outcomes Toolkit assessed the care-related QoL. Mixed-effects models analyses were used to evaluate the intervention effects.

RESULTS: Ninety-three residents participated; 59% were overnourished. The intervention included daily/weekly physical and social activities, protein-rich bread, "Snack-on-Wheels," systematic weighing, nutritional tasks for trained staff, and communication standards. Hand grip strength improved among men across weight statuses in the intervention group compared to the control group (P = 0.039). QoL was maintained in the overweight group, whereas it improved in the normal weight group (P = 0.019), with significant gains in social participation for both subgroups (P = 0.026).

CONCLUSIONS: Participatorily developed nutrition and physical activity interventions can improve all NH residents' physical function and well-being.

Original language	English
Article number	112876
Number of pages	12
Journal	Nutrition
Volume	139
Early online date	13 Jun 2025
DOIs	https://doi.org/10.1016/j.nut.2025.112876
Publication status	Published - Nov 2025

Funding

The study received funding from the Innovation Fund Denmark under Grant (1155-00001B) , Diabetes Center Zealand Denmark under Grant (2022-03) , and University College Absalon. The fund-ing sources were not involved in the study design, data collection, analysis, interpretation of data, or the decision to submit the article.

Funders	Funder number
Danish Council for Strategic Research	1155-00001B
Steno Diabetes Center Sjaelland	2022-03
University College Absalon

Keywords

Community-based
Intervention
Long-term care facilities
Multi-component
Obesity
Overweight
Nursing Homes
Humans
Muscle Strength/physiology
Male
Homes for the Aged
Exercise
Quality of Life
Aged, 80 and over
Denmark
Female
Aged
Overnutrition/therapy
Hand Strength

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Christoffersen, T., Marie Beck, A., Dynesen, A. W., Lorenzen, J. K., Andersen, A. R., Aaslyng, M. D., & Tetens, I. (2025). Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial. Nutrition, 139, Article 112876. https://doi.org/10.1016/j.nut.2025.112876

@article{4c94af08cafe463fb5e74edc30dd7056,

title = "Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial",

abstract = "BACKGROUND: Overnutrition, defined as overweight and obesity, is a growing concern among older adults, increasing the risk of comorbidity, disabilities, and mortality. However, the optimal management of overnutrition in this population remains unclear.PURPOSE: The aim is to develop and assess the effectiveness of a nutritional and physical activity intervention on muscle function and quality of life (QoL) among older adults with overnutrition in nursing homes (NHs).METHODS: A 12-mo cluster randomized participatory trial was conducted in six Danish NHs. The NHs were assigned following a 1:1 allocation ratio for control and intervention. Using the Plan-Do-Study-Act model, intervention components were participatorily developed over the first 6 mo and implemented over the remaining 6 mo. Muscle strength was measured via hand grip strength and a 30-second chair stand test. The Adult Social Care Outcomes Toolkit assessed the care-related QoL. Mixed-effects models analyses were used to evaluate the intervention effects.RESULTS: Ninety-three residents participated; 59\% were overnourished. The intervention included daily/weekly physical and social activities, protein-rich bread, {"}Snack-on-Wheels,{"} systematic weighing, nutritional tasks for trained staff, and communication standards. Hand grip strength improved among men across weight statuses in the intervention group compared to the control group (P = 0.039). QoL was maintained in the overweight group, whereas it improved in the normal weight group (P = 0.019), with significant gains in social participation for both subgroups (P = 0.026).CONCLUSIONS: Participatorily developed nutrition and physical activity interventions can improve all NH residents' physical function and well-being.",

keywords = "Community-based, Intervention, Long-term care facilities, Multi-component, Obesity, Overweight, Nursing Homes, Humans, Muscle Strength/physiology, Male, Homes for the Aged, Exercise, Quality of Life, Aged, 80 and over, Denmark, Female, Aged, Overnutrition/therapy, Hand Strength",

author = "Tenna Christoffersen and \{Marie Beck\}, Anne and Dynesen, \{Anja Weirs{\o}e\} and Lorenzen, \{Janne Kunchel\} and Andersen, \{Anders Reenberg\} and Aaslyng, \{Margit Dall\} and Inge Tetens",

year = "2025",

month = nov,

doi = "10.1016/j.nut.2025.112876",

language = "English",

volume = "139",

journal = "Nutrition",

issn = "0899-9007",

publisher = "Elsevier",

}

Christoffersen, T, Marie Beck, A, Dynesen, AW, Lorenzen, JK, Andersen, AR, Aaslyng, MD & Tetens, I 2025, 'Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial', Nutrition, vol. 139, 112876. https://doi.org/10.1016/j.nut.2025.112876

Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial. / Christoffersen, Tenna; Marie Beck, Anne; Dynesen, Anja Weirsøe et al.
In: Nutrition, Vol. 139, 112876, 11.2025.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial

AU - Christoffersen, Tenna

AU - Marie Beck, Anne

AU - Dynesen, Anja Weirsøe

AU - Lorenzen, Janne Kunchel

AU - Andersen, Anders Reenberg

AU - Aaslyng, Margit Dall

AU - Tetens, Inge

PY - 2025/11

Y1 - 2025/11

N2 - BACKGROUND: Overnutrition, defined as overweight and obesity, is a growing concern among older adults, increasing the risk of comorbidity, disabilities, and mortality. However, the optimal management of overnutrition in this population remains unclear.PURPOSE: The aim is to develop and assess the effectiveness of a nutritional and physical activity intervention on muscle function and quality of life (QoL) among older adults with overnutrition in nursing homes (NHs).METHODS: A 12-mo cluster randomized participatory trial was conducted in six Danish NHs. The NHs were assigned following a 1:1 allocation ratio for control and intervention. Using the Plan-Do-Study-Act model, intervention components were participatorily developed over the first 6 mo and implemented over the remaining 6 mo. Muscle strength was measured via hand grip strength and a 30-second chair stand test. The Adult Social Care Outcomes Toolkit assessed the care-related QoL. Mixed-effects models analyses were used to evaluate the intervention effects.RESULTS: Ninety-three residents participated; 59% were overnourished. The intervention included daily/weekly physical and social activities, protein-rich bread, "Snack-on-Wheels," systematic weighing, nutritional tasks for trained staff, and communication standards. Hand grip strength improved among men across weight statuses in the intervention group compared to the control group (P = 0.039). QoL was maintained in the overweight group, whereas it improved in the normal weight group (P = 0.019), with significant gains in social participation for both subgroups (P = 0.026).CONCLUSIONS: Participatorily developed nutrition and physical activity interventions can improve all NH residents' physical function and well-being.

AB - BACKGROUND: Overnutrition, defined as overweight and obesity, is a growing concern among older adults, increasing the risk of comorbidity, disabilities, and mortality. However, the optimal management of overnutrition in this population remains unclear.PURPOSE: The aim is to develop and assess the effectiveness of a nutritional and physical activity intervention on muscle function and quality of life (QoL) among older adults with overnutrition in nursing homes (NHs).METHODS: A 12-mo cluster randomized participatory trial was conducted in six Danish NHs. The NHs were assigned following a 1:1 allocation ratio for control and intervention. Using the Plan-Do-Study-Act model, intervention components were participatorily developed over the first 6 mo and implemented over the remaining 6 mo. Muscle strength was measured via hand grip strength and a 30-second chair stand test. The Adult Social Care Outcomes Toolkit assessed the care-related QoL. Mixed-effects models analyses were used to evaluate the intervention effects.RESULTS: Ninety-three residents participated; 59% were overnourished. The intervention included daily/weekly physical and social activities, protein-rich bread, "Snack-on-Wheels," systematic weighing, nutritional tasks for trained staff, and communication standards. Hand grip strength improved among men across weight statuses in the intervention group compared to the control group (P = 0.039). QoL was maintained in the overweight group, whereas it improved in the normal weight group (P = 0.019), with significant gains in social participation for both subgroups (P = 0.026).CONCLUSIONS: Participatorily developed nutrition and physical activity interventions can improve all NH residents' physical function and well-being.

KW - Community-based

KW - Intervention

KW - Long-term care facilities

KW - Multi-component

KW - Obesity

KW - Overweight

KW - Nursing Homes

KW - Humans

KW - Muscle Strength/physiology

KW - Male

KW - Homes for the Aged

KW - Exercise

KW - Quality of Life

KW - Aged, 80 and over

KW - Denmark

KW - Female

KW - Aged

KW - Overnutrition/therapy

KW - Hand Strength

U2 - 10.1016/j.nut.2025.112876

DO - 10.1016/j.nut.2025.112876

M3 - Article

C2 - 40651183

SN - 0899-9007

VL - 139

JO - Nutrition

JF - Nutrition

M1 - 112876

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Christoffersen T, Marie Beck A, Dynesen AW, Lorenzen JK, Andersen AR, Aaslyng MD et al. Developing and assessing the effectiveness of a participatory, nutritional, and physical activity intervention on muscle function and quality of life among older adults with overnutrition in nursing homes-The IFEBO cluster randomized control trial. Nutrition. 2025 Nov;139:112876. Epub 2025 Jun 13. doi: 10.1016/j.nut.2025.112876