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 healthrelated 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, <30% of UK councils provide meal delivery services. This study aimed to determine the impact of longer term (12-weeks) daily provision of nutrient-dense meals (>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 follow-up 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<0.001; 0.24 g.kg-1 Cohen’s D=0.52 (95% CI 0.19 to 0.81), p<0.001, respectively), MNA score (mean effect 2.6 points Cohen’s D=1.14 (95% CI 0.78 to 1.50), p<0.001), and handgrip strength (mean effect 1.5kg Cohen’s D=0.36 (95% CI 0.06 to 0.66), p=0.02), but did not change levels of depression or self-esteem. Energy and protein intake decreased by 85% and 94% respectively upon return to habitual diet for the 12-week follow up. Sixty-eight percent of the favourable effect of the meal intervention on MNA score remained after the 12-week follow-up period, whilst handgrip strength reverted to baseline. 
Provision of nutrient-dense meals to community-dwelling elderly adults for 12-weeks improved nutritional status and handgrip strength, indicative of reduced frailty risk. Benefits were not retained on withdrawal of the intervention, suggesting a need for sustained interventions in this cohort to meet nutritional needs. Future research is needed to identify optimal meal delivery service designs to support expansion of home-delivered meals to all eligible older adults to improve health-related outcomes and consequently reduce HRU.

OC203 - Provision of a daily high protein and high energy meal: effects on the physical and psychological wellbeing of community-dwelling, malnourished elderly adults

Unique to the new Congress (previously the Summer Conference) is that you will have greater opportunity to engage with more nutrition science than ever before. In 2024 the core programme will be delivered by the Irish Section of The Nutrition Society, supported by the Science Committee. The theme of these symposia will be ‘new data – focused approaches and challenges’. Outside of the core programme you will have the chance to hear the latest research from the Society’s partner organisations, universities, the private sector and more, on a diverse range of research.