Co-Production of Behavior Change Intervention Promoting an Anti-Inflammatory Diet for Frailty Prevention in...

Background/Objectives: Chronic inflammation is a fundamental biological process underlying aging and frailty. We recently demonstrated that an anti-inflammatory diet, assessed using the Dietary Inflammatory Index (DII), was associated with serum high-sensitivity C-reactive protein levels and frailty incidence among community-dwelling older adults. The present study aimed to co-produce behavior change intervention promoting an anti-inflammatory diet by participatory action research with older adults. Particularly, increasing intake of dietary fiber was targeted as it represents a nutrient with the highest anti-inflammatory potential within the DII framework. Methods: Participants were community-dwelling older adults engaged in frailty checkup activity. Six co-production workshops were conducted between May 2022 and February 2023, integrating semi-structured group work and scientific evidence. Participant satisfaction was assessed after each session. Changes in dietary behavior were evaluated using DII score and dietary intake assessed by the Brief Self-Administered Diet History Questionnaire (BDHQ). Results: A cumulative total of 66 participants was involved (mean age, 73.7 ± 4.8 years; 80.0% women). When compared before and after co-production workshops, total DII scores and DII scores calculated by anti-inflammatory nutrients significantly decreased (p = 0.031 and p = 0.020, respectively). Dietary fiber intake also significantly increased following the workshop (p = 0.044). Among dietary fiber-rich food groups, mushroom consumption showed a particularly significant increase (p = 0.048). Conclusions: Co-production workshops integrating group work and scientific evidence were effective in promoting behavioral changes toward an anti-inflammatory diet among community-dwelling older adults. This developed intervention may represent a feasible and practical dietary strategy for frailty prevention in community settings.