The impact of nutrition counselling via online application on nutrient intake among Thai older adults during COVID-19: pilot study of randomised controlled trial

Abstract

Background: During COVID-19, Thai older adults were restricted to travel due to fragile and easy to infect. Dental services and other healthcare also provided a limited scope for all. This study aimed to investigate the impact of online nutrition counselling on nutrient intake and nutritional status in older adults and the feasibility of online nutrition counselling among Thai older adults. Methods: A pilot randomised controlled trial was conducted among 30 older adults (aged ≥ 60 years) at Mahidol Dental Hospital, Bangkok, Thailand. Eligible participants were Thai nationals who had recently received dental services, were able to use a mobile phone with the LINE Official Account application, and could send food-related photos or messages. Participants were randomly assigned (1:1) via computer-generated randomisation to either an intervention group (n = 15) or a control group (n = 15). The intervention group received tailored dietary advice based on a three-day food diary, followed up monthly for three months. The control group received general health advice, which was also provided to the intervention group. Outcome assessors were blinded to group allocation. Primary outcomes included changes in nutrient intake, body measurements (weight, height, waist and hip circumference), and nutritional status assessed by the Mini Nutritional Assessment-Short Form (MNA-SF). Nutrient analysis was performed using INMUCAL-nutrient V4.0 software. Within- and between-group differences were assessed using the Wilcoxon signed-rank test. Results: All participants completed the study (100% retention). Both groups showed a significant decline in daily energy and nutrient intakes after three months (p < 0.05), but no significant between-group differences were observed for nutrient intake or body measurements. A trend toward reduced waist circumference was noted in the intervention group, whereas no such change was observed in the control group. Conclusions: This study showed that online nutritional counselling impacted food consumption and nutrients intake among Thai older adults during COVID-19. The combination of online tailored diet advice and dental treatment was feasible, highly acceptable and practical to participants to improve healthy diet consumption. Trial registration: MU-IRB DTPY 2021/DT100 (COA:2021/082.2209): 22 /09/2021; Retrospectively registered on Thai Clinical Trial Registry (TCTR20231101003): 01/11/2023.