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Accepted for/Published in: JMIR Aging

Date Submitted: Nov 7, 2025
Open Peer Review Period: Nov 26, 2025 - Jan 21, 2026
Date Accepted: Jul 16, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Assessing a Digital Platform (KOKU-Nut) to Improve Nutrition in Older Adults: Mixed Methods Feasibility Randomized Controlled Trial

French C, Burden S, Gangannagaripalli J, Stanmore E

Assessing a Digital Platform (KOKU-Nut) to Improve Nutrition in Older Adults: Mixed Methods Feasibility Randomized Controlled Trial

JMIR Aging 2026;9:e87351

DOI: 10.2196/87351

Assessing a digital platform (KOKU-Nut) to improve nutrition in older adults: a mixed-methods feasibility randomised controlled trial

  • Chloe French; 
  • Sorrel Burden; 
  • Jaheeda Gangannagaripalli; 
  • Emma Stanmore

ABSTRACT

Background:

Keep-on-Keep-up Nutrition (KOKU-Nut) is a free, tablet-based digital platform that focuses on increasing physical activity and improving the dietary intake of older adults.

Objective:

The aim of this study is to assess the feasibility of using KOKU-Nut among community-dwelling older adults. Feasibility was assessed by considering recruitment and retention rates, and acceptability of the intervention and study design.

Methods:

Participants (community-dwelling adults ≥65 years) were randomised 1:1 to either the intervention or control group. The intervention group were asked to engage with KOKU-Nut three times a week for 12 weeks. Participants in the control group received a leaflet promoting a healthy lifestyle. All participants completed questionnaires at baseline and 12 weeks. A sample of participants were asked to complete an optional interview. The study collected data on anthropometry (height, weight), dietary intake (24-hour food diary), physical function (grip strength, 5 times sit-to-stand), usability of the intervention (system usability scale) and safety (adverse events).

Results:

Of 51 participants assessed for eligibility, 31 were randomised and 28 completed the 12-week follow-up. Ten of the participants in the intervention group (71.4%) reported engagement with KOKU-Nut three or more times a week. There was no difference in physical function or dietary intake at 12-weeks between participants in the intervention and control group after adjusting for age and baseline values.

Conclusions:

This feasibility RCT demonstrates the study design was appropriate and acceptable to older adults as demonstrated by the recruitment and retention rates. This is promising and demonstrates the potential for conducting a future powered RCT to assess the effectiveness of KOKU-Nut. Clinical Trial: The trial was registered prior to recruitment (NCT05943366).


 Citation

Please cite as:

French C, Burden S, Gangannagaripalli J, Stanmore E

Assessing a Digital Platform (KOKU-Nut) to Improve Nutrition in Older Adults: Mixed Methods Feasibility Randomized Controlled Trial

JMIR Aging 2026;9:e87351

DOI: 10.2196/87351

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