Effects of a combined diet and physical activity intervention (the ALAPAGE program) on dietary diversity and lower-limb muscle strength in community-dwelling older people: a pragmatic randomized controlled trial.
8 affiliations
- 1Observatoire Régional de la Santé - PACA, Marseille, France.
- 2Université de Bordeaux - Campus Carreire, Bordeaux, France.
- 3Université de Lorraine, Inserm, INSPIIRE, Nancy, F-54000, France.
- 4Trophis, Marseille, France.
- 5Avignon Université, CER STAPS , Avignon, France.
- 6Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRBA), IRD 190, Inserm, Marseille, 1207, France.
- 7Univ Montpellier, Cirad, Ciheam-Iamm, Inrae, Institut agro, Ird, Inrae - Centre Occitanie-Montpellier, Moisa, Montpellier, France.
- 8Avignon Université, LAPEC, Avignon, UPR4278, France. [email protected].
Abstract
Background
Diet and physical activity are key components of healthy aging. We aimed to evaluate the effectiveness of a combined diet and physical activity intervention (the ALAPAGE program) in improving dietary diversity (proxy for the nutritional quality of individual diets) and lower-limb muscle strength (LLMS, a predictor of the ability to perform activities of daily living) among community-dwelling adults aged ≥ 60 years in France.Methods
The ALAPAGE program comprised a 7-week intervention period with weekly collective sessions supervised by a dietician and/or a qualified physical activity professional, followed by 12 weeks of unsupervised activity. Its effectiveness was assessed through a cluster-randomized controlled trial conducted in 2022-2024. Clusters of groups of approximately 10 participants were allocated to either an intervention arm or a control arm (2:1 ratio). Primary outcomes were (1) dietary diversity assessed with the ORCHID score (each assessment based on two 24-hour dietary recalls and a simplified food frequency questionnaire), and (2) LLMS, assessed by the 30-second chair stand test. Assessments were conducted at baseline (T0), 7 weeks (T1, dietary diversity only), and 3 months (T2). A difference-in-difference (D-I-D) analysis, adjusted for covariables, was used to evaluate the specific impact of the intervention over time, compared to the control arm.Results
The analysis included 376 participants: 254 (26 clusters) in the intervention arm and 122 (12 clusters) in the control arm. At baseline, the ORCHID score and LLMS did not differ significantly between the two arms. The ORCHID score improved significantly with time in both arms (intervention: +10% and + 16% increase at T1 and T2 respectively, control: +4% and + 11%) with no significant difference between the arms. LLMS improved between T0 and T2 in both arms (intervention: +15%; control: +5%), with a statistically significantly greater increase of 1.3 chair stands over 30 s in the intervention vs. the control arm (P = 0.005).Conclusion
While dietary diversity improved similarly in both arms, the intervention-specific improvement in LLMS - a parameter associated with functional capacity - suggests the ALAPAGE program has potential as a preventive public health approach for contributing to healthy aging in community-dwelling older adults.Trial registration
ClinicalTrials.gov Identifier: NCT05140330, November 4, 2021.
Related
- mHealth-based lifestyle intervention for hypertension in community-dwelling adults: a cluster-randomized controlled trial with exploratory multi-omics analyses
- Pilot Feasibility Study of a Community Health Worker-delivered Tobacco Cessation Intervention During Pregnancy: The Smoke-Free HOPE Randomized Controlled Trial
- Low cost app-based intervention DIALOG+ for anxiety and depression in outpatient psychiatric settings: a pragmatic multisite cluster randomized controlled trial
- Standardised procalcitonin monitoring and antibiotic duration in community-acquired sepsis: a pragmatic randomised controlled trial
- Effect of the CP@clinic program (Community Paramedicine at Clinic program) on health care utilization from administrative data during and after the intervention: a cluster-randomized controlled trial
BibTeX
@article{jacquemot2026effects,
title = {{Effects of a combined diet and physical activity intervention (the ALAPAGE program) on dietary diversity and lower-limb muscle strength in community-dwelling older people: a pragmatic randomized controlled trial.}},
author = {Anne-Fleur Jacquemot and Chloé Cogordan and Lisa Fressard and Gwenaelle Maradan and Cheraz Riabi and Aurélie Bocquier and Hélène Tréhard and Victor Hervieu and Christophe Dubois and Sarah Danthony and Pierre Verger and Nicole Darmon and Agnès Vinet},
journal = {BMC geriatrics},
year = {2026},
month = jul,
doi = {10.1186/s12877-026-07999-2},
url = {https://europepmc.org/article/MED/42907749},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Effects of a combined diet and physical activity intervention (the ALAPAGE program) on dietary diversity and lower-limb muscle strength in community-dwelling older people: a pragmatic randomized controlled trial.
AU - Anne-Fleur Jacquemot
AU - Chloé Cogordan
AU - Lisa Fressard
AU - Gwenaelle Maradan
AU - Cheraz Riabi
AU - Aurélie Bocquier
AU - Hélène Tréhard
AU - Victor Hervieu
AU - Christophe Dubois
AU - Sarah Danthony
AU - Pierre Verger
AU - Nicole Darmon
AU - Agnès Vinet
PY - 2026
DA - 2026/07/01
JO - BMC geriatrics
DO - 10.1186/s12877-026-07999-2
UR - https://europepmc.org/article/MED/42907749
AB - Background Diet and physical activity are key components of healthy aging. We aimed to evaluate the effectiveness of a combined diet and physical activity intervention (the ALAPAGE program) in improving dietary diversity (proxy for the nutritional quality of individual diets) and lower-limb muscle strength (LLMS, a predictor of the ability to perform activities of daily living) among community-dwelling adults aged ≥ 60 years in France.Methods The ALAPAGE program comprised a 7-week intervention period with weekly collective sessions supervised by a dietician and/or a qualified physical activity professional, followed by 12 weeks of unsupervised activity. Its effectiveness was assessed through a cluster-randomized controlled trial conducted in 2022-2024. Clusters of groups of approximately 10 participants were allocated to either an intervention arm or a control arm (2:1 ratio). Primary outcomes were (1) dietary diversity assessed with the ORCHID score (each assessment based on two 24-hour dietary recalls and a simplified food frequency questionnaire), and (2) LLMS, assessed by the 30-second chair stand test. Assessments were conducted at baseline (T0), 7 weeks (T1, dietary diversity only), and 3 months (T2). A difference-in-difference (D-I-D) analysis, adjusted for covariables, was used to evaluate the specific impact of the intervention over time, compared to the control arm.Results The analysis included 376 participants: 254 (26 clusters) in the intervention arm and 122 (12 clusters) in the control arm. At baseline, the ORCHID score and LLMS did not differ significantly between the two arms. The ORCHID score improved significantly with time in both arms (intervention: +10% and + 16% increase at T1 and T2 respectively, control: +4% and + 11%) with no significant difference between the arms. LLMS improved between T0 and T2 in both arms (intervention: +15%; control: +5%), with a statistically significantly greater increase of 1.3 chair stands over 30 s in the intervention vs. the control arm (P = 0.005).Conclusion While dietary diversity improved similarly in both arms, the intervention-specific improvement in LLMS - a parameter associated with functional capacity - suggests the ALAPAGE program has potential as a preventive public health approach for contributing to healthy aging in community-dwelling older adults.Trial registration ClinicalTrials.gov Identifier: NCT05140330, November 4, 2021.
SN - 1471-2318
ER -