Association Between Dietary Intake, Meal Patterns, and Malnutrition Risk Among Community-Dwelling Elderly in Northern Thailand: A Cross-Sectional Study

<b>Background:</b> Malnutrition is prevalent among older adults in low- and middle-income countries (LMIC), but the roles of dietary intake and meal patterns are less understood in community settings. <b>Objective:</b> To investigate the associations between dietary intake, meal patterns, and malnutrition risk among community-dwelling older adults. <b>Methods:</b> We conducted a cross-sectional study including 200 adults aged ≥60 years in San Pa Tong District, Chiang Mai and used standardized questionnaires to collect sociodemographic, health, and dietary data. Nutritional status was assessed using the Mini Nutritional Assessment-Full Form (MNA-FF), with scores <24 indicated malnutrition risk. Meal patterns included overnight fasting duration, meal skipping, and eating frequency. Associations were examined using multivariable logistic regression with adjustment for confounding. <b>Results:</b> Overall, 23% of participants were at risk of malnutrition. Micronutrient inadequacy was widespread, and 92.5% exceeded the sodium upper limit. In multivariable models, higher vitamin E intake was independently associated with a lower likelihood of malnutrition (OR = 0.07, 95% CI: 0.01-0.45), whereas longer overnight fasting increased risk (OR = 1.94, 95% CI: 1.30-2.89) and having more eating episodes was protective (OR = 0.19, 95% CI: 0.06-0.57). <b>Conclusions:</b> Adequate vitamin E intake and regular meal patterns were associated with reduced malnutrition risk. Public health interventions should prioritize micronutrient adequacy, sodium reduction, and the promotion of regular eating patterns.