Age-related changes in physiological function as well as the physical, social and economic environment can impact an older person’s nutritional intake and overall health. It is well-established that social isolation and loneliness can contribute to decreased food intake in older adults. However, prior to this systematic review, the impact of eating alone on quantifiable nutritional outcomes in community-dwelling older adults (≥65 years), a growing proportion of the population, had not been explored.

A systematic literature search was conducted in Medline, CINAHL, Scopus and PsycINFO in October 2023. Following PRISMA guidelines, 3531 articles were identified, from which 21 fulfilled the inclusion criteria (10 conducted in Japan; sample size=54 to 83364 participants). Findings offer insights into the negative impact of eating alone on multiple nutritional and physical outcomes. Eating alone was significantly associated with poorer diet quality and food diversity, lower fruit, vegetable and meat consumption, and increased risk of weight loss and frailty.

Social connection in older peoples’ lives is important, particularly during mealtimes. Whilst the importance of the dining experience is considered in aged care, Fresh Thinking is needed to target social isolation during mealtimes for those living independently in the community, to reduce the negative impact of eating alone. Implications for dietetic practice, primary and preventative healthcare include screening of mealtime habits to determine nutritional risk and interprofessional collaboration to support older adults to maintain their nutritional, physical and psychosocial health.