Amanda Björnwall: Eating alone or eating in loneliness: Food routines, health, and social relations in later life

Abstract

The overall aim of this thesis was to study eating alone or together with others among community-living older adults, focusing on how eating alone is experienced and how it is associated with aspects related to food routines, health, and social relations in Sweden. In Paper I, a scoping review was used to map and summarize existing scientific articles, while Paper II explored experiences and perceptions of eating alone through qualitative interviews. Papers III and IV are based on a national cross-sectional survey of 70- to 75-year-old adults, examining both the objective frequency and subjective experience of eating alone, and their associations with food-related outcomes, loneliness, and self-rated health. 

Research across various research fields has examined eating alone as a potential risk factor for different food- and health-related outcomes, often using cross-sectional designs to assess the frequency, but not the subjective experience, of eating alone or with others (Paper I). Perceptions of eating alone ranged from being a symbol of loss to an unproblematic routine or a sign of independence (Paper II). One-quarter of the 695 survey participants were categorised as eating alone, while three-quarters were eating together with someone daily. Eating alone seemed to be related to the organisation of food routines (e.g., lower number of main meals per day, and more frequent consumption of ready-made meals) but not to the healthiness of food intake (food index scores) or BMI (Paper III). A small share reported being bothered when eating alone; however, one-third of those eating alone reported not having the opportunity to eat together with someone if desired. Both eating alone and lower engagement in social activities were associated with loneliness. Lower engagement in social activities was also associated with lower self-rated health, though eating alone was not (Paper IV). 

In conclusion, eating alone, in the early phase of retirement age, is experienced in various ways and appears to be more closely related to food routines and social relations than to aspects of health. This thesis provides valuable insights for the development of future health policies and research on the implications of eating alone among older adults.