Rural-urban differences in the association between senior-center meal use and micronutrient inadequacy among older Korean adults: KNHANES 2016-2023.

OBJECTIVES: Community-based meal programs, including senior-center meals, are provided to help meet the nutritional needs of older adults in Korea. However, evidence on how these meals contribute to daily nutrient intake and micronutrient adequacy remains limited, particularly across residential settings. METHODS: Using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2016-2023, we analyzed adults aged ≥65 years with a 24-hour dietary recall (n=6,438). Participants were classified as senior-center meal users (SCMU, n=162) or home-only meal users (HOMU, n=6,276), after excluding those who could not be classified into either group. Survey-weighted regression models compared nutrient intake patterns and assessed nutrient inadequacy based on Estimated Energy Requirement (EER), Estimated Average Requirement (EAR), and Adequate Intake (AI) criteria. Survey-weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for nutrient inadequacy according to senior-center meal use and examined effect modification by residential area. RESULTS: SCMU were older and more socioeconomically disadvantaged than HOMU. Although total nutrient intakes were similar, SCMU had higher lunch energy and nutrient intake, reflecting meal redistribution. Overall nutrient inadequacy did not differ. However, SCMU were associated with lower odds of vitamin A inadequacy (OR 0.33, 95% CI 0.14-0.75) and riboflavin inadequacy (OR 0.45, 95% CI 0.22-0.91) among rural, but not urban, residents (both Pinteraction < 0.05). CONCLUSION: Senior-center meals shifted a greater proportion of daily nutrient intake to lunch without substantially increasing total daily intake. SCMU had lower odds of vitamin A and riboflavin inadequacy among rural older adults.