# Diet, Food Intake, and Exercise Mixed Interventions (DEMI) in the Enhancement of Wellbeing among Community-Dwelling Older Adults in Japan: Systematic Review and Meta-Analysis of Randomized Controlled Trials

## TL;DR

A review of mixed diet and exercise interventions in older Japanese adults shows some improvements in health and mobility, but evidence is moderate.

## Contribution

This study systematically evaluates the effectiveness of combined diet and exercise interventions for older adults in Japan.

## Key findings

- DEMI interventions improved usual gait speed, diet scores, and reduced frailty in some studies.
- Meta-analysis showed positive outcomes for specific variables, but evidence levels were moderate.
- Interventions included home-based activities, lectures, and group exercises with mixed additional components.

## Abstract

This systematic review and meta-analysis discusses the available data on the efficacy of diet, food intake, and exercise mixed interventions (DEMI) for community-dwelling older adults in Japan and assesses the evidence level. We searched the literature regarding the research questions using electronic and hand-searching methods. To ensure the reliability and quality of the evidence, we used the Cochrane risk of bias tool and GRADE system. All studies included DEMI; other interventions included group activities, health education, and community participation. All interventions were categorized into three classifications, namely “Diet and food intake”, “Exercise”, and “Other”. Programs included lectures, practical exercises, group activities, consulting, and programs that could be implemented at home. By comparing groups and measuring outcomes at various time points, most studies reported positive results regarding the impact of the interventions. Specifically, usual gait speed, Food Frequency Questionnaire Score, and Diet Variety Score demonstrated significant improvement. Additionally, three studies demonstrated improvement in frailty. This review suggests that DEMI resulted in improvements in some outcome variables. However, the efficacy of all variables was not fully examined. The results of the meta-analysis revealed positive outcomes for some variables, although the evidence level for these outcomes was considered moderate.