Yupa Chanwikrai - Graduate School of Human Life Sciences, Jumonji University, Saitama, Japan
Jukkrit Wungrath - Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
Sunard Taechangam - Thai Dietetic Association, Bangkok, Thailand
Chanida Pachotikarn - Thai Dietetic Association, Bangkok, Thailand
Shigeru Yamamoto - Asian Nutrition and Food Culture Research Center, Jumonji University, Saitama, Japan

Background: Inadequate dietary intake and malnutrition are commonly found in older adults. They tendto have early satiety that limits intake from main meals. Some reports indicated that small frequent mealsmay promote higher intake. From that point of view, snacks may be useful. Therefore, this study aimed todetermine the effects of frequent snacks on energy intakes and nutritional status in older adults at risk ofmalnutrition.Methods: A randomized controlled study was conducted among older adults at risk of malnutrition in asuburban community from November ۲۰۲۰ to March ۲۰۲۱ in Chiang Mai, Thailand. Two villages wererandomly assigned to either a control group (n = ۱۷) or an intervention group (n = ۱۷), and they werematched pairs by age and gender. An intervention snack consisted of ۲ desserts and a box of milk (total۵۴۸ kcal) was used. For the first ۳ weeks, an intervention snack was provided every day although it was tooheavy for some participants. Therefore, after that, the intervention snack was provided every other day for۴ weeks. A nutrition survey by the ۲۴-hour recall method for ۳ days, body weight, mid-arm circumference(MAC), triceps skinfold (TSF), and grip strength were assessed at weeks ۳ and ۷ as baseline.Results: Thirty-one participants completed the study (۹۱%). The average age was ۷۱.۸ ± ۴.۸ years, andbody mass index (BMI) was ۱۹.۰ ± ۲.۱ kg/m۲. In the intervention snack group, there was an increased dailyenergy intake by ۳۱۶ kcal and ۲۱۴ kcal at weeks ۳ and ۷, respectively, (P < ۰.۰۰۱, effect size: ۰.۸۸۴), witha body weight of ۰.۸ kg (P < ۰.۰۰۱, effect size: ۰.۳۱۴), BMI of ۲% (P = ۰.۰۰۹, effect size: ۰.۳۱۴), and MACof ۴% (P < ۰.۰۰۱, effect size: ۰.۲۶۵) compared with baseline, but such energy intake was not observed inthe control group.Conclusion: Providing frequent snacks was an effective way to improve energy intake and nutritional statusin community-dwelling older adults at risk of malnutrition.

Age, Nutritional intake, Energy intake, Snack food