FORTIPHY

Preventing the risk of undernutrition by fostering meal FORTIfication and PHYsical activity in older adult

Abstract

Image

For the older people, eating well is a key factor in preserving their health and preventing the onset of diseases linked to aging. “Eating well” means having a diet adapted in terms of quality and quantity, allowing the older adult to fulfil their nutritional needs. But it is also means promoting eating pleasure in order to sustain the desire to eat. However, aging may be accompanied by a decline in appetite, which predisposes the older individual to the onset of undernutrition. Recently, Sulmont-Rossé and Van Wymelbeke (CND, 2019) observed that about 4 older individuals over 5 who receive help for their meals do not meet their caloric and/or protein requirements. In addition, the results showed that 90% of the participants who were at risk of undernutrition did not fulfil the recommended daily allowance and could be qualified as ‘small eaters’ (Moye & Bohmer, 2002, J Nutr Health Aging)

Objective:

The project FORTIPHY will address the nutritional and physical activity needs of older small eaters (≥ 70 years old) living at home. Specifically, FORTIPHY will develop new solutions allowing older people to fortify their regular meals, namely increasing caloric and protein intake without increasing the volume to be ingested (Morilla-Herrera et al, 2016, J Nutr health Ageing). In addition, given that several studies have highlighted the importance of physical activity to sustain muscle mass and functional capacity (Shad et al, 2016, Am J Physiol Endocrinol Metab). FORTIPHY will develop a physical activity program easy to implement by frail older people living at home. To achieve these ambitious goals, the FORTIPHY project has gathered scientists covering different disciplines (food science & technology, nutrition, sensory science, consumer behavior). In addition, end users (older people, caregivers) will be involved very early in the innovation process, in order to ensure the feasibility and the relevance of newly developed solutions (co-creation of solutions).

Expected impact:

  • Design and develop new recipes to fortify regular meals with high-calorie and high-protein ingredients. These recipes will be validated in terms of bioavailability and acceptability.
  • Design and develop new physical activity programs tailored to the capacities and the environment of the targeted older population.
  • Assess the efficiency of fortified dishes and the added value of physical activity to prevent undernutrition.
  • Develop cookbooks and MOOC (Massive open on-line courses) combining recipes and physical exercises in synergy to support the health of the aging population.
  • Offer a summer school to empower professionals in creating novel business solutions aimed at enabling older people to fortify their regular meals to prevent undernutrition

 

Consortium

Partner Organization Partner Country
CHU Dijon France
NOFIMA AS Norway
University of Reading United Kingdom
Vrije Universiteit Brussel Belgium

 

Highlights

  • In France, around 1,7 million people aged over 65 with a Body Mass Index over 25 are undernourished or at risk of undernutrition. Specifically, 18% of overweight and 29% of obese older people were at risk of undernutrition (Sulmont-Rossé et al., 2022, Frontiers in Nutrition).
  • A systematic literature review and a meta-analysis showed that, compared to a standard diet, food-based fortification significantly increases energy and protein intake in older adults, as well as decreases the risk of undernutrition in this population (Geny et al., submitted, Clinical Nutrition ESPEN). 
  • One-hundred-thirty-five different protein extracts were identified on the European market. Of these, 38% are of animal origin and 50% of plant protein. The protein content of these products varies from 9 to 98% .
  • Culinary ingredients such as eggs and dairy were considered acceptable fortificants. Older adults did not consume animal-derived or plant-based protein extracts, and were less accepting of an unfamiliar protein source. Opportunities to replace other powders (such as flour) with protein extracts, for example in thickening stews and baking cakes, moderated these attitudes (Smith et al., 2022, EuroSense).
  • Older adults were generally unaware of their protein needs and reported a much lower intake than recommended, especially for dinner. The acceptance of health innovation in food requires that older people clearly perceive the health benefits of the innovation in order to change their attitudes towards health innovation (Geny et al., 2022, EuroSense).
  • Eight fortified recipes were developped, each providing an additional load of 8-12 g of protein and 250-300 Kcal per serving. Fortificiation is achieved by adding high-protein culinary ingredients and protein extracts to the standard recipe. Recipes can be made in different variants (various flavours; cooking from scratch or from ready-to-heat ingredients).

Products

Title: Prevalence of undernutrition and risk of undernutrition in overweight and obese older people
Author: Sulmont-Rossé C*, Van Wymelbeke-Delannoy V*, Maître I*
Magazine: Frontiers in Nutrition
Start- and endpage: 2022, 9
Link: https://doi.org/10.3389/fnut.2022.892675
Title: Review of protein intake and suitability of foods for protein- fortification in older adults in the UK
Author: Smith R, Clegg M, Methven L
Magazine: Critical Reviews in Food Science and Nutrition
Start- and endpage: 2022, 22, 1-18
Link: https://doi.org/10.1080/10408398.2022.2137777
Title: Impact of food fortification on nutritional outcomes and acceptability in older people: systematic literature review and meta-analysis.
Author: Geny A, Petitjean M, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: Frontiers in Nutrition
Start- and endpage: 2023, 27
Link: https://doi.org/10.3389/fnut.2023.1232502
Title: Older adults' acceptability of and preferences for food-based protein fortification in the UK, France and Norway.
Author: Smith R, Methven L, Clegg ME, Geny A, Ueland Ø, Synnøve Grini I, Helgesdotter Rognså G, Maitre I, Brasse C, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: Appetite
Start- and endpage: 2024, 1, 197:107319
Link: https://doi.org/10.1016/j.appet.2024.107319
Title: Acceptability of protein-fortified recipes in older adults in France
Author: Geny A, Brasse C, Helgesdotter Rognså G, Filin L Nouri L, Feyen V, Szleper E, Ueland Ø, Smith R, Methven L, Maître I, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: Food Quality and Preference
Start- and endpage: 2024, 118, 105205
Link: https://doi.org/10.1016/j.foodqual.2024.105205
Title: Design and assessment of protein-fortified recipes for community-dwelling older adults to prevent the onset of undernutrition
Author: Geny A, Koga S, Smith R, Helgesdotter Rognså G, Brasse C, Synnøve Grini I, Maître I, Feron G, Clegg M, Methven L, Ueland Ø, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: Food Research International
Start- and endpage: 2025, 202
Link: https://doi.org/10.1016/j.foodres.2024.115558
Title: Developing meat-based recipes suited to the chewing and salivary capacities of older adults: A participatory approach from the ALIMADENT project
Author: Sulmont-Rossé C, Septier C, Feron G
Magazine: Cahiers de Nutrition et de Diététique
Start- and endpage: 2026
Link: https://doi.org/10.1016/j.cnd.2025.12.002
Title: Co-creation of food solutions to sustain health and autonomy in older adults [Oral presentation]
Author: Methven L & Sulmont-Rossé C
Magazine: IFST SSG / 10th E3S Annual symposium, Reading, 2022 May 13, Unit-Kingdom
Title: DIY protein fortification: what foods are suitable for UK older adults to fortify at home? [Oral presentation]
Author: Smith R, Methven L, Clegg M, Geny A, Ueland O, Helgesdotter Rognså G, Synnøve Grini I, Sulmont-Rossé C
Magazine: EuroSense, 2022 September 13-16, Turku, Finland
Title: Geny A, Van Wymelbeke-Delannoy V, Smith R, Methven L, Ueland O, Sulmont-Rossé C [Oral presentation]
Author: Acceptance of health innovation in their food in French older consumers.
Magazine: EuroSense, 2022 September 13-16, Turku, Finland
Title: FortiPhy: Preventing the risk of undernutrition by fostering meal FORTIfication and PHYsical activity in older adults [Oral presentation]
Author: Clegg M
Magazine: Nutritional Resilience for Healthy Ageing’ Conference, 2023 June 6-7, Belfast, Ireland
Title: Dietary strategies for improving healthy life expectancy: a focus on protein [Oral presentation]
Author: Clegg M
Magazine: Ageing of the Mind and Senses Conference, 2023 April 4, Sussex, UK
Title: Development of innovative food-based fortification solutions to sustain health in older people using a co-creation approach [Oral presentation]
Author: Sulmont-Rossé C
Magazine: Société Française d’Analyse Sensorielle, 2023 May 24, online
Title: The FORTIPHY project: development of innovative food-based fortification solutions to sustain health in older people using a co-creation approach [Oral presentation]
Author: Sulmont-Rossé C
Magazine: 14th European Nutrition Conference FENS, 2023 November 14-17, Belgrade, Serbie
Title: Leef vitaal en blijf actief: ontdek de geheimen van actief ouder worden! [Oral presentation]
Author: Beckwee D & De Keyser E
Magazine: Spectrum, 2023 October 5
Title: Regards de chercheurs – Résultats de l’étude Fortiphy [Oral presentation]
Author: Vanwymelbeke-Delannoy V
Magazine: 2ème Journée Annuelle Antichute Bourgogne-Franche-Comté PGI, 2024 January 16, Dijon, France
Title: Comprendre le comportement alimentaire pour personnaliser l’offre [Oral presentation]
Author: Vanwymelbeke-Delannoy V
Magazine: Journée de l’Institut Universitaire de Gérontologie Yves Mémin : bien manger pour bien vieillir. 2024 April 13, Paris, France
Title: Augmenter la masse musculaire de la personne âgée par enrichissement alimentaire : essai Fortiphy [Oral presentation]
Author: Geny A, Van Wymelbeke V, Sulmont-Rossé C, Graglia E, Antoci S, Barben J, Jouanny P
Magazine: 45èmes journées annuelles de la Société Française de Gériatrie et Gérontologie, 2025 November 24-26, Paris, France
Title: Le projet FORTIPHY [Oral presentation]
Author: Delannoy V
Magazine: Vitagora Connect, 2025 April 8, Dijon, France
Title: Comprendre le comportement alimentaire pour mieux répondre aux besoins des personnes âgées [Oral presentation]
Author: Delannoy V
Magazine: Journée gérontologie ANFH, October 14, Montpellier, France
Title: Les différents regards sur l’alimentation en Ehpad [Oral presentation]
Author: Delannoy V
Magazine: Journée Gérontologie ANFH, L’alimentation au sein des EHPAD, 2025 November 4, Toulouse, France
Title: Impact d’une intervention ciblant les apports protéiques et caloriques combinée ou non à des séances de renforcement musculaire sur le statut nutritionnel de personnes âgées vivant à domicile : étude contrôlée randomisée [Oral presentation]
Author: Geny A, Sulmont-Rosse C, Clarys P, Beckwee D, Dujourdy L, Quiroz Marnef A, Belbaghdadi F, Guyot C, Feyen V, Szleper E, Van Wymelbeke-Delannoy V
Magazine: Journées Francophones de Nutrition, 2025 December 10-12, Lyon, France
Title: Fortifier l’alimentation des personnes âgées : encore trop peu de stratégies efficaces pour lutter contre la dénutrition [Poster]
Author: Geny A, Petitjean M, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: Journées Francophones de Nutrition, 2021 November 10-12, Lilles, France
Title: Co-creation of food solutions to improve nutritional status in older adults [Poster]
Author: Smith R, Clegg M, Methven L
Magazine: BFDG, 2022 April 13-14, On line
Title: Development of innovative food-based fortification solutions to sustain health in older people using a co-creation approach [Poster]
Author: Sulmont-Rossé C, Feron G, Synnøve Grini I, Geny A, Smith R, Koga S, Helgesdotter Rognså G, Maître I, Brasse C, Clarys P, Clegg M, Van Wymelbeke-Delannoy V, Methven L, Ueland O
Magazine: EuroSense, 2022 September 13-16, Turku, Finland
Title: DIY protein fortification: what foods are suitable for UK older adults to fortify at home? [Poster]
Author: Smith R, Methven L, Clegg M, Geny A, Ueland O, Helgesdotter Rognså G, Synnøve Grini I, Sulmont-Rossé C
Magazine: EffoST, 2022 November 7-9, Dublin, Ireland
Title: Identification of foods commonly used by older adults in England, France and Norway for protein enrichment to prevent undernutrition [Poster]
Author: Ueland Ø, Clegg M, Geny A, Methven L, Helgesdotter Rognså G, Smith R, Sulmont-Rossé C, Van Wymelbeke-Delannoy V, Synnøve Grini I
Magazine: ISBNPA: 22th meeting of the International Society of Behavioral Nutrition and Physical Activity, 2023 June 14-17, Uppsala, Sweden
Title: Identification of foods commonly used by older adults in England, France and Norway for protein enrichment to prevent undernutrition [Poster]
Author: Smith R, Methven L, Clegg M, Geny A, Ueland Ø, Helgesdotter Rognså G, Synnøve Grini I, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: ISBNPA: 22th meeting of the International Society of Behavioral Nutrition and Physical Activity, 2023 June 14-17, Uppsala, Sweden
Title: European older adults' acceptability of and preferences for protein fortification [Poster]
Author: Smith R, Methven L, Clegg M, Geny A, Ueland Ø, Helgesdotter Rognsåc G, Synnøve Grini I, Maitre I, Sulmont-Rossé C
Magazine: Pangborn, 2023 August 20-24, Nantes, France
Title: Acceptability of newly protein-fortified recipes [Poster]
Author: Geny A, Helgesdotter Rognså G, Ueland Ø, Smith R, Methven L, Brasse C, Filin L, Nouri L, Feyen V, Szleper E, Maître I, Van Wymelbeke-Delannoy V, Sulmont-Rossé C
Magazine: Pangborn, 2023 August 20-24, Nantes, France
Title: Do-it-yourself protein fortified foods developed for and validated by older adults living at home [Poster]
Author: Geny A, Smith R, Brasse C, Synnøve Grini I, Maître I, Clegg M, Methven L, Ueland Ø, Van Wymelbeke V, Sulmont-Rossé C
Magazine: Nordic Nutrition Conference, 2024 June 17-19, Bergen, Norway
Title: Food fortification – a road to better health for Norwegian older adults? [Poster]
Author: Ueland Ø, Synnøve Grini I, Clegg M, Geny A, Maître I, Methven L, Smith R, Sulmont-Rossé C
Magazine: Nordic Nutrition Conference, 2024 June 17-19, Bergen, Norway
Title: Developing and assessing fortified foods to enable older people to fulfil their nutritional needs while maintaining pleasure to eat
Author: Geny A
Start- and endpage: 2024
Link: https://theses.hal.science/tel-04984909
Title: Nutritional status according to weight status in French older adults
Author: Sulmont-Rossé C
Start- and endpage: 2022
Link: https://doi.org/10.15454/MJTRXM
Title: Impact of food fortification on nutritional outcome: meta-analysis data
Author: Sulmont-Rossé C
Start- and endpage: 2023
Link: https://doi.org/10.57745/FBMURG
Title: Developing meat-based recipes suited to the oral capacities of older adults: a participatory approach from the ALIMADENT project
Author: Sulmont-Rossé C, Septier C, Feron G
Start- and endpage: 2025
Link: https://doi.org/10.57745/QA4YKS
Title: Acceptability of protein-fortified recipes in older adults in France: central location test
Author: Sulmont-Rossé C, Geny A, Brasse C, Maître I, Delannoy V
Start- and endpage: 2026
Link: https://doi.org/10.57745/7V58R8
Title: Acceptability of protein-fortified recipes in older adults in France, UK and Norway: home-use test
Author: Sulmont-Rossé C, Geny A, Smith R, Methven L, Brasse C, Maître I, Synnøve Grini I, Ueland Ø, Delannoy V
Start- and endpage: 2026
Link: https://doi.org/10.57745/WODOJW

Communication & Dissemination Activities

Target groupAuthorsMeans of communication
Scientist, healthcare professional, industryGeny A*, Petitjean M*, Van Wymelbeke-Delannoy V*, Sulmont-Rossé C*. Fortifier l’alimentation des personnes âgées : encore trop peu de stratégies efficaces pour lutter contre la dénutrition. Journées Francophones de Nutrition, Lilles, 2021.Poster
Scientist, IndustrySmith R*, Clegg M*, Methven L*. Co-creation of food solutions to improve nutritional status in older adults. BFDG, Onl line, 2022Poster
ScientistMethven L* & Sulmont-Rossé C*. Co-creation of food solutions to sustain health and autonomy in older adults. IFST SSG / 10th E3S Annual symposium, Reading, 2022Oral
Scientist, industrySmith R*, Methven L*, Clegg M*, Geny A*, Ueland O*, Helgesdotter Rognså G*, Synnøve Grini I*, Sulmont-Rossé C*. DIY protein fortification: what foods are suitable for UK older adults to fortify at home? The recipe for success. EUROSENSE, Turku, 2022Oral and poster
Scientist, industryGeny A*, Van Wymelbeke-Delannoy V*, Smith R*, Methven L*, Ueland O*, Sulmont-Rossé C*. Acceptance of health innovation in their food in French older consumers. EUROSENSE, Turku, 2022.Oral and poster
Scientist, industrySulmont-Rossé C*, Feron G*, Synnøve Grini I*, Geny A*, Smith R*, Koga S*, Helgesdotter Rognså G*, Maître I*, Brasse C*, Clarys P*, Clegg M*, Van Wymelbeke-Delannoy V*, Methven L*, Ueland O*. Development of innovative food-based fortification solutions to sustain health in older people using a co-creation approach. EUROSENSE, Turku, 2022Poster

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Features

Project number:
FORTIPHY
Duration: 100%
Duration: 100 %
2021
2025
Related funding round:
Project lead and secretary:
Claire Sulmont-Rossé
Responsible organisation:
INRAE, France