Provision of a daily high protein and high energy meal: effects on the physical and psychological wellbeing of community-dwelling, malnourished elderly adults

Community-dwelling older adults experience a high prevalence of malnutrition(1), leading to frailty, loss of independence and poorer health including increased mortality and healthcare resource use (HRU)(2). Consumption of a high-quality diet is associated with better health-related outcomes(3). We previously found significantly improved mini nutritional assessment (MNA) and depression scores following 3-weeks of daily meal provisions to healthy community-dwelling elderly participants(4). However, 40% daily energy requirements and >50% recommended daily protein intake) to under-nourished, independently living, community-dwelling elderly adults on physical and psychological outcomes. We hypothesised the meal intervention would significantly improve nutritional outcomes, physical wellbeing and function, and psychological wellbeing. Participants (n = 56) were randomised (stratified for baseline MNA score and cohabiting or living alone) to receive 12-weeks of meal provisions followed by 12-weeks control (meals first group, n = 28) or, a 12-week control followed by 12-weeks of meal provisions (meals second group, n = 28). Forty-nine participants completed the study (16 males, 33 females; 81.8 ± 7.4 years). MNA, body composition, physical function, self-esteem, and depression were evaluated before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by testing pre-post meal intervention change in both groups via paired t-test. Group effects were combined via meta-analysis (STATA ver17). The retention of the meal provision effect was tested in the meals first group, by testing the change from the end of meal provision versus 12-weeks followup control via paired t-test. Meal provisions significantly improved energy and protein intakes (mean effect 311kcal Cohen’s D = 0.52 (95% CI 0.22 to 0.82), p