Community Dining, Walking, and Glucose in Older Adults

This study will examine whether eating lunch and dinner at a subsidized community dining site affects postmeal walking and blood glucose patterns in older adults. Participants will be community-dwelling adults aged 60 to 79 years who are eligible for a local elderly meal subsidy and have prediabetes or elevated blood glucose risk. Each participant will complete two 6-day meal conditions in random order. In one condition, participants will eat lunch and dinner at home. In the other condition, participants will eat lunch and dinner at a subsidized community dining site. Participants will wear a continuous glucose monitor and an activity tracker so the study team can measure postmeal glucose levels, daily glucose patterns, and steps after meals. The study will compare community dining with home eating to determine whether community dining increases postmeal walking, improves postmeal glucose responses, and affects loneliness and meal experience.

Inclusion Criteria: * Community-dwelling adults aged 60 to 79 years * Eligible for the local elderly meal subsidy * Prediabetes or elevated glycemic risk, defined as HbA1c 5.7% to 6.4% or fasting plasma glucose 100 to 125 mg/dL * Able to consume meals orally * Able to walk independently without a walking aid * Able to attend the community dining site safely * Able and willing to wear a continuous glucose monitor and activity tracker * Able and willing to follow the home-meal plan and study procedures * Able to provide written informed consent Exclusion Criteria: * HbA1c ≥6.5% or fasting plasma glucose ≥126 mg/dL * Diagnosed diabetes * Use of insulin or glucose-lowering medication * Severe cognitive impairment * Acute illness or recent hospitalization * Severe gastrointestinal disease affecting usual food intake or gastric emptying * Severe renal, hepatic, cardiovascular, or neurologic disease that would make participation unsafe * Skin conditions preventing continuous glucose monitor use * Food allergy or dietary restrictions incompatible with the standardized meal plan