Frequent Snacks Improved Energy Intake and Nutritional Status in Community-Dwelling Older Adults at Risk of Malnutrition, Chiang Mai, Thailand

Background: Inadequate dietary intake and malnutrition are commonly found in older adults. They tend to have early satiety that limits intake from main meals. Some reports indicated that small frequent meals may promote higher intake. From that point of view, snacks may be useful. Therefore, this study aimed to determine the effects of frequent snacks on energy intakes and nutritional status in older adults at risk of malnutrition. Methods: A randomized controlled study was conducted among older adults at risk of malnutrition in a suburban community from November 2020 to March 2021 in Chiang Mai, Thailand. Two villages were randomly assigned to either a control group (n=17) or an intervention group (n=17), and they were matched pairs by age and gender. An intervention snack consisted of 2 desserts and a box of milk (total 548 kcal) was used. For the first 3 weeks, an intervention snack was provided every day although it was too heavy for some participants. Therefore, after that, the intervention snack was provided every other day for 4 weeks. A nutrition survey by the 24-hour recall method for 3 days, body weight, mid-arm circumference (MAC), triceps skinfold (TSF), and grip strength were assessed at weeks 3 and 7 as baseline. Results: Thirty-one participants completed the study (91%). The average age was 71.8±4.8 years, and body mass index (BMI) was 19.0±2.1 kg/m2 . In the intervention snack group, there was an increased daily energy intake by 316 kcal and 214 kcal at weeks 3 and 7, respectively, (P<0.001, effect size: 0.884), with a body weight of 0.8 kg (P<0.001, effect size: 0.314), BMI of 2% (P=0.009, effect size: 0.314), and MAC of 4% (P<0.001, effect size: 0.265) compared with baseline, but such energy intake was not observed in the control group. Conclusion: Providing frequent snacks was an effective way to improve energy intake and nutritional status in community-dwelling older adults at risk of malnutrition.