Demographic and Physical Determinants of Unhealthy Food Consumption in Polish Long-Term Care Facilities

Background: Unhealthy food consumption in long-term care facilities (LTCFs) contributes to poor health outcomes among residents. This study aimed to assess its prevalence, identify demographic and physical risk factors, and propose targeted interventions. Methods: A mixed-methods study (2017-2021) analyzed data from 1000 Polish LTCF residents (aged 35-105 years). Anthropometric measurements, bioimpedance analyses, dietary assessments, and physical activity records were collected. Food items were classified as "healthy" or "unhealthy" using an AI-based Large Language Model (LLM), applying WHO guidelines and the NOVA classification system. Logistic regression and chi-square tests assessed associations between unhealthy food consumption and marital status, education level, mobility aid use, and portion control. Results: Unhealthy food consumption prevalence was 15.6%. Married residents had significantly higher rates than unmarried individuals (22.6% vs. 14.3%, p < 0.01). Lower educational attainment correlated with increased risk (partial primary education: 34.7% vs. tertiary education: 8.1%). Mobility aid users exhibited elevated consumption (cane: 34.6%; walker: 22.6%). Poor portion control showed the strongest association (OR = 3.2, 95% CI: 1.8-5.7). Conclusions: Marital status, educational disparities, mobility limitations, and portion control were key modifiable risk factors. Findings suggest the need for targeted nutrition programs, caregiver education, and policy reforms to improve dietary literacy and meal portioning. Future research should validate AI-based food classification methods, assess long-term intervention outcomes, and expand studies to diverse LTCF settings. These findings align with Poland's National Health Programme and provide actionable insights for global LTCF populations.