As the Canadian population continues to age, the government’s healthy aging strategy recognises the importance of social engagement, the extent to which people are connected to and participate in their communities, for maintaining and promoting health. At Advancing Health, Dr. Annalijn Conklin’s program of research is adding an important layer to this picture, illustrating the complex interplay between gender, social engagement, nutrition and health.
By 2036, Canadians who are 65+ will comprise around 25 per cent of the total population. As more Canadians approach that threshold, systems of care must keep up with the needs of an aging population. Understanding the social determinants of health, like social engagement in relation to nutrition, is the first step to supporting healthy aging.
Social engagement is essential for our survival and is hard-wired in our bodies and brains. Conversely, social isolation can have serious negative health effects and reduce the quality of life for older adults.
Proper nutrition and healthy eating are key to aging well and can help seniors maintain independence, prevent chronic conditions, and improve overall quality of life. Data from 2008 show that 34 per cent of Canadians aged 65 or older were at nutritional risk, with a gender breakdown of the data indicating that women were at higher risk than men (38 per cent vs 29 per cent). Importantly, social isolation is strongly linked to nutritional risk.
The social environment can influence the type, variety and quantity of food intake and the quality of a diet. Physiological studies demonstrate the theory of social facilitation of food intake, and research on older adults shows that older adults with fewer social contacts or who live alone consume fewer calories, have less varied diets and eat fewer servings of fruits and vegetables.
The social determinants of nutrition and healthy aging, with a focus on gender differences, remain understudied, which prompted Dr. Conklin to fill the research gaps.
Building on what we know about nutrition, social isolation, and aging
According to a 2023 study, one in five Canadians aged 65+ reported feeling lonely. This is primarily influenced by the variance in a person’s social activities that involve social interaction.
As people age into later life, social activities and connections often decline over time, putting older adults at an increased vulnerability to persistent social isolation. However, little nutrition research looks at how social relationships change over time and or considers how the dietary effects may differ between older women and older men.
The implications of the social dynamics of aging for nutritional risk led to Dr. Conklin’s study using longitudinal data from a Canadian aging cohort (aged 45–85) to understand losses or persistent lack of different social ties as causal risk factors of unhealthy eating habits among older women and men.
The research team, which included researchers from UBC and the University of Waterloo, published two papers this year: one found that loss and persistent lack of close social ties (because of living arrangement and partnership changes) resulted in less healthy eating among aging Canadian adults; the other showed that persistent social isolation precipitated a decline in daily fruit and vegetable consumption in women only.
The impact of social isolation varies by gender
According to Dr. Conklin’s research from 2024, not only does the diversity in social engagement decrease over time among middle-aged and older adults, but social isolation also increases, with the risk being highest among women and especially those from vulnerable groups, such as those aged 75+ and lower socio-economic status. The newest 2025 study further revealed that losses, gains, and persistent lack of social connections influence the development of poor diet quality, with effects differing between women and men.
More specifically, the study found that older women who remained socially isolated (participating in one or no activities per month) experienced a decline in diet quality over time compared to those participating in two or more activities monthly. Similarly, women who reduced the diversity of their social activities also faced a decline in diet quality. Additionally, both older women and men with a small, stable number of social activities were at increased risk of poorer diet quality.
In combination, the findings from these papers reinforce the need to address health and nutrition equity by understanding the social determinants from a sex and gender perspective. Women and men differ in the type and size of their social connections and also show differences in their dietary behaviours. Thus, public health strategies to support healthy aging will need to acknowledge and address the differences between the two groups to maximize their effectiveness.
The limitations of homogeneous data
The evidence gathered from their ongoing research is informative, but is limited by the lack of diversity of the cohort used for this study, according to Dr. Conklin. There are many strengths of the Canadian Longitudinal Study on Aging, which is one of a kind in Canada; however, results can only be interpreted in terms of white, cisgender, and heteronormative adults aged 45 years and older.
“My focus was on the structural dimension of social connections, which allow for and facilitate opportunities for social support,” said Dr. Conklin. “But our ability to study all factors related to this topic, particularly ethnic or country of origin differences, is limited because the available data doesn’t account for the full diversity present in Canada.”
To address this limitation, Dr. Conklin says, “We need longitudinal research from other populations or more diverse cohorts that allow us to capture changes in individuals’ social lives as they age, including both losses and gains of different types of social connections. We generally need more research on chronic disease prevention in women with multiple social identities to better understand how social experiences influence health outcomes.”
Implications of the findings
With increasing focus on more research into healthy aging, Dr. Conklin’s study establishes a foundation for future investigations into the connections between aging, social determinants of health, and nutrition.
They stated, “These studies will fill gaps in the current literature on nutrition and social factors that have so far been cross-sectional, meaning they lack change assessments, used composite scores of variable relationships, and have only considered transitions in marital status that inadvertently ignore change in other aspects of social integration. Additionally, we’ve included separate analyses for men and women within the same population, which helps to inform tailored interventions.”
Furthermore, this research could enhance public awareness of the social influences on health, improve clinical practices by screening for changes in social ties to better individualise care, and draw policy and research focus toward addressing the gender-specific social needs of both aging women and men.
Yet, there is still much work to be done before we have enough evidence to inform policy decisions and public health programs. “We need multiple studies that replicate and validate these findings across various settings and diverse populations and that comprehensively measure diet for overall quality,” said Dr. Conklin.
As a next step, Dr. Conklin is expanding this research to examine the role of healthy eating as a mediator between changes in social relationship status and physiological determinants of aging, such as obesity and hypertension, as well as chronic disease outcomes such as cardiovascular disease, diabetes, and depression. Future research will also include other indicators of healthy eating beyond fruits and vegetables, as well as diet quality overall.
Unravelling these social determinants of diet could be crucial for tackling health inequities and prompting policy shifts in social intervention models for this growing demographic.
