Supportive interventions for enhancing dietary intake in malnourished or nutritionally at‐risk adults

Christine Baldwin; Katherine L Kimber; Michelle Gibbs; Christine Elizabeth Weekes

doi:10.1002/14651858.CD009840.pub2

Unterstützende Interventionen zur Verbesserung der Nahrungsaufnahme von mangelernährten oder Mangelernährungs‐gefährdeten Erwachsenen

Appendices

Appendix 1. Search strategies (inception to March 2013)

Cochrane Library

#1 food* OR meal* OR snack* OR drink* OR feed*: ti,ab
#2 nutri* OR diet*: ti,ab
#3 dining*: ti,ab
#4 screening OR monitoring: ti,ab
#5 documentation OR communication: ti,ab
#6 time* OR timing OR pattern OR style OR arrangement* OR environment*: ti,ab
#7 staff* OR train*: ti,ab
#8 nurs*: ti,ab
#9 healthcare OR health care: ti,ab
#10 cater*: ti,ab
#11 flavo?r* OR taste: ti,ab
#12 content OR composition OR density: ti,ab
#13 appear* OR presentation:ti,ab
#14 size OR portion OR amount: ti,ab
#15 protected meal*: ti,ab
#16 red tray*: ti,ab
#17 fortif*:ti,ab
#18 supplement*: ti,ab
#19 ((supportive OR nutrition* OR diet*) NEAR/3 intervention):ti,ab
#20 (assist* OR help* OR support*):ti,ab
#21 (add* OR extra):ti,ab
#22 (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*):ti,ab
#23 (food* OR meal* OR snack* OR drink* OR feed*) NEAR/3 ((time* OR timing OR pattern OR style OR arrangement* OR environment*) OR (flavour* OR flavor* OR taste) OR (content OR composition OR density) OR (appear* OR presentation) OR (size OR portion OR amount) OR (fortif*) OR (supplement*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)):ti,ab
#24 (nutri* OR diet*) NEAR/4 ((content OR composition OR density) OR (fortif*) OR (supplement*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)):ti,ab
#25 dining* NEAR/4 ((time* OR timing OR pattern OR style OR arrangement* OR environment*) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)):ti,ab
#26 (screening OR monitoring) NEAR/4 ((nutri* OR diet*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)):ti,ab
#27 (documentation OR communication) NEAR/4 (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*):ti,ab
#28 (staff* OR train*) NEAR/4 ((nurs*) OR (healthcare OR health care) OR (cater*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)):ti,ab
#29 supplement* NEAR/5 (add* OR extra):ti,ab
#30 (assist* OR help* OR support*) NEAR/4 ((nurs*) OR (healthcare OR health care) OR (cater*)):ti,ab
#31 (#15 OR #16 OR #19)
#32 (#23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31)
#33 (low BMI OR low body mass index):ti,ab
#34 (low weight OR underweight OR under‐weight):ti,ab
#35 (maln*):ti,ab
#36 (nutritional risk OR (risk NEAR/4 maln*)):ti,ab
#37 (poor nutr* OR undernourish* OR under‐nourish*):ti,ab
#38 ((poor OR inadequate OR suboptimal) NEAR/5 intake*):ti,ab
#39 (institutionali?ed):ti,ab
#40 (elderly):ti,ab
#41 (homebound OR home‐bound OR housebound OR house‐bound):ti,ab
#42 ((extended OR longterm OR long‐term OR community) NEAR/1 care):ti,ab
#43 ((nursing OR care OR residential) NEAR/1 home):ti,ab
#44 (inpatient* OR hospitali?* OR hospital patient*):ti,ab
#45 exp Nutritional Status/
#46 exp Nutrition Disorders/
#47 exp Nutrition Assessment/
#48 exp Nutritional Support/
#49 exp Nutrition Policy/
#50 exp Malnutrition/
#51 diet/
#52 dietetics/
#53 hospital food service/
#54 energy intake/
#55 fortified food/
#56 #33 OR #34 OR #35 OR #36 OR #37 OR #38 OR #39 OR #40 OR #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48 OR #49 OR #50 OR #51 OR #52 OR #53 OR #54 OR #55
#57 32 AND 56
#58 exp Pregnancy/
#59 pregnan*:kw,ti
#60 #58 OR #59
#61 #57 NOT #60
#62 (child* OR infant OR paediatric OR pediatric):kw,ti
#63 #61 NOT #62
#64 (animal OR rat OR mouse OR guinea pig OR primate OR monkey OR cat OR dog):kw,ti
#65 #63 NOT #64

MEDLINE + OLDMEDLINE

#1 (food* OR meal* OR snack* OR drink* OR feed*).ab,ti.
#2 (nutri* OR diet*).ab,ti.
#3 "dining*".ab,ti.
#4 (screening OR monitoring).ab,ti.
#5 (documentation OR communication).ab,ti.
#6 (time* OR timing OR pattern OR style OR arrangement* OR environment).ab,ti.
#7 (staff* OR train*).ab,ti.
#8 "nurs*".ab,ti.
#9 (healthcare OR health care).ab,ti.
#10 "cater*".ab,ti.
#11 (flavo?r* OR taste).ab,ti.
#12 (content OR composition OR density).ab,ti.
#13 (appear* OR presentation).ab,ti.
#14 (size OR portion OR amount).ab,ti.
#15 "protected meal*".ab,ti.
#16 "red tray*".ab,ti.
#17 "fortif*".ab,ti.
#18 "supplement*".ab,ti.
#19 ((supportive OR nutrition* OR diet*) ADJ3 intervention).ab,ti.
#20 (assist* OR help* OR support*).ab,ti.
#21 (add* OR extra).ab,ti.
#22 (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*).ab,ti.
#23 1 ADJ3 (6 OR 11 OR 12 OR 13 OR 14 OR 17 OR 18 OR 20 OR 21 OR 22)
#24 2 ADJ4 (12 OR 17 OR 18 OR 21 OR 22)
#25 3 ADJ4 (6 OR 22)
#26 4 ADJ4 (2 OR 21 OR 22)
#27  5 ADJ4 22
#28 7 ADJ4 (8 OR 9 OR 10 OR 20 OR 21 OR 22)
#29 18 ADJ5 21
#30 20 ADJ4 (8 OR 9 OR 10)
#31 15 OR 16 OR 19
#32 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31
#33 (low bmi OR low body mass index).ab,ti.
#34 (low weight OR underweight OR under‐weight).ab,ti.
#35  "maln*".ab,ti.
#36 (nutritional risk OR (risk ADJ4 maln*)).ab,ti.
#37 (poor nutr* OR undernourish* OR under‐nourish*).ab,ti.
#38 ((poor OR inadequate OR suboptimal) adj5 intake*).ab,ti.
#39 institutionali?ed.ab,ti.
#40 elderly.ab,ti.
#41 (homebound OR home‐bound OR housebound OR house‐bound).ab,ti.
#42 ((extended OR longterm OR long‐term OR community) ADJ1 care).ab,ti.
#43 ((nursing OR care OR residential) ADJ1 home).ab,ti.
#44  (inpatient* OR hospitali?* OR hospital patient*).ab,ti.
#45 exp Nutritional Status/
#46 exp Nutrition Disorders/dh, th [Diet Therapy, Therapy]
#47 nutrition assessment.sh.
#48 nutritional support.sh.
#49 nutrition policy.sh.
#50 exp Malnutrition/dh, th [Diet Therapy, Therapy]
#51 *diet/
#52 *dietetics/
#53 *food service, hospital/
#54 *energy intake/
#55 *food, fortified/
#56 33 OR 34 OR 35 OR 36 OR 37 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 44 OR 45 OR 46 OR 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55
#57 32 AND 56
#58 randomized controlled trial.pt.
#59 controlled clinical trial.pt.
#60 randomi?ed.ab.
#61 placebo.ab.
#62 clinical trials as topic.sh.
#63 randomly.ab.
#64 trial.ti.
#65 58 OR 59 OR 60 OR 61 OR 62 OR 63 OR 64
#66 meta‐analysis.pt
#67 exp technology assessment, biomedical/
#68 exp meta‐analysis/
#69 exp meta‐analysis as topic/
#70 hta.tw, ot.
#71 (health technology ADJ6 assessment$).tw,ot.
#72 (meta analy$ OR metaanaly$ or meta?analy$).tw,ot.
#73 ((review$ OR search$) ADJ10 (literature$ OR medical database$ OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR current content$ OR systemat$)).tw,ot.
#74 66 OR 67 OR 68 OR 69 OR 70 OR 71 OR 72 OR 73
#75 65 OR 74
#76 (comment OR editorial OR historical‐article).pt.
#77 75 NOT 76
#78 57 AND 77
#79 (animals NOT (animals AND humans)).sh.
#80 78 NOT 79
#81 exp Pregnancy/
#82 pregnan*.tw,ot.
#83 81 OR 82
#84 80 NOT 83
#85 limit 84 to "all adult (19 plus years)"

MEDLINE in‐process & other non‐indexed citations

#1 (food* OR meal* OR snack* OR drink* OR feed*).ab,ti.
#2 (nutri* OR diet*).ab,ti.
#3 "dining*".ab,ti.
#4 (screening OR monitoring).ab,ti.
#5 (documentation OR communication).ab,ti.
#6 (time* OR timing OR pattern OR style OR arrangement* OR environment).ab,ti.
#7 (staff* OR train*).ab,ti.
#8 "nurs*".ab,ti.
#9 (healthcare OR health care).ab,ti.
#10 "cater*".ab,ti.
#11 (flavo?r* OR taste).ab,ti.
#12 (content OR composition OR density).ab,ti.
#13 (appear* OR presentation).ab,ti.
#14 (size OR portion OR amount).ab,ti.
#15 "protected meal*".ab,ti.
#16 "red tray*".ab,ti.
#17 "fortif*".ab,ti.
#18 "supplement*".ab,ti.
#19 ((supportive OR nutrition* OR diet*) ADJ3 intervention).ab,ti.
#20 (assist* OR help* OR support*).ab,ti.
#21 (add* OR extra).ab,ti.
#22 (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*).ab,ti.
#23 1 ADJ3 (6 OR 11 OR 12 OR 13 OR 14 OR 17 OR 18 OR 20 OR 21 OR 22)
#24 2 ADJ4 (12 OR 17 OR 18 OR 21 OR 22)
#25 3 ADJ4 (6 OR 22)
#26 4 ADJ4 (2 OR 21 OR 22)
#27 5 ADJ4 22
#28 7 ADJ4 (8 OR 9 OR 10 OR 20 OR 21 OR 22)
#29 18 ADJ5 21
#30 20 ADJ4 (8 OR 9 OR 10)
#31 15 OR 16 OR 19
#32 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31
#33 (low bmi OR low body mass index).ab,ti.
#34 (low weight OR underweight OR under‐weight).ab,ti.
#35 "maln*".ab,ti.
#36 (nutritional risk OR (risk ADJ4 maln*)).ab,ti.
#37 (poor nutr* OR undernourish* OR under‐nourish*).ab,ti.
#38 ((poor OR inadequate OR suboptimal) adj5 intake*).ab,ti.
#39 institutionali?ed.ab,ti.
#40 elderly.ab,ti.
#41 (homebound OR home‐bound OR housebound OR house‐bound).ab,ti.
#42 ((extended OR longterm OR long‐term OR community) ADJ1 care).ab,ti.
#43 ((nursing OR care OR residential) ADJ1 home).ab,ti.
#44 (inpatient* OR hospitali?* OR hospital patient*).ab,ti.
#45 33 OR 34 OR 35 OR 36 OR 37 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 44
#46  32 AND 45
#47 (random* OR rct*).tw,ot.
#48 “single blind*”.tw, ot.
#49 “double blind*”.tw, ot.
#50 ((triple OR treble) AND blind*).tw,ot.
#51 ((control* AND trial*) OR (clinical ADJ4 trial*) OR trial*).tw,ot.
#52 (systematic* review*).tw,ot.
#53 hta.tw, ot.
#54  (health technology ADJ6 assessment$).tw,ot.
#55 (meta analy$ OR metaanaly$ or meta?analy$).tw,ot.
#56 ((review$ OR search$) ADJ10 (literature$ OR medical database$ OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR current content$ OR systemat$)).tw,ot.
#57 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55 OR 56
#58 (comment OR editorial OR historical‐article).pt.
#59 57 NOT 58
#60  46 AND 59
#61 pregnan*.tw,ot.
#62 60 NOT 61

Embase + Embase classic

#1 (food* OR meal* OR snack* OR drink* OR feed*).ab,ti.
#2 (nutri* OR diet*).ab,ti.
#3   "dining*".ab,ti.
#4 (screening OR monitoring).ab,ti.
#5 (documentation OR communication).ab,ti.
#6 (time* OR timing OR pattern OR style OR arrangement* OR environment).ab,ti.
#7 (staff* OR train*).ab,ti.
#8 "nurs*".ab,ti.
#9 (healthcare OR health care).ab,ti.
#10  "cater*".ab,ti.
#11 (flavo?r* OR taste).ab,ti.
#12 (content OR composition OR density).ab,ti.
#13 (appear* OR presentation).ab,ti.
#14 (size OR portion OR amount).ab,ti.
#15 "protected meal*".ab,ti.
#16 "red tray*".ab,ti.
#17 "fortif*".ab,ti.
#18  "supplement*".ab,ti.
#19 ((supportive OR nutrition* OR diet*) ADJ3 intervention).ab,ti.
#20 (assist* OR help* OR support*).ab,ti.
#21 (add* OR extra).ab,ti.
#22  (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*).ab,ti.
#23 1 ADJ3 (6 OR 11 OR 12 OR 13 OR 14 OR 17 OR 18 OR 20 OR 21 OR 22)
#24 2 ADJ4 (12 OR 17 OR 18 OR 21 OR 22)
#25 3 ADJ4 (6 OR 22)
#26 4 ADJ4 (2 OR 21 OR 22)
#27  5 ADJ4 22
#28  7 ADJ4 (8 OR 9 OR 10 OR 20 OR 21 OR 22)
#29 18 ADJ5 21
#30 20 ADJ4 (8 OR 9 OR 10)
#31 15 OR 16 OR 19
#32 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31
#33  (low bmi OR low body mass index).ab,ti.
#34 (low weight OR underweight OR under‐weight).ab,ti.
#35  "maln*".ab,ti.
#36 (nutritional risk OR (risk ADJ4 maln*)).ab,ti.
#37 (poor nutr* OR undernourish* OR under‐nourish*).ab,ti.
#38 ((poor OR inadequate OR suboptimal) adj5 intake*).ab,ti.
#39 institutionali?ed.ab,ti.
#40 elderly.ab,ti.
#41 (homebound OR home‐bound OR housebound OR house‐bound).ab,ti.
#42 ((extended OR longterm OR long‐term OR community) ADJ1 care).ab,ti.
#43 ((nursing OR care OR residential) ADJ1 home).ab,ti.
#44 (inpatient* OR hospitali?* OR hospital patient*).ab,ti.
#45  exp Nutritional Status/
#46 exp Nutritional Disorder/dh, th [Therapy]
#47 nutrition assessment.sh.
#48 nutritional support.sh.
#49 health care policy.sh.
#50 exp Malnutrition/dh, th [Therapy]
#51 *diet/
#52 *dietetics/
#53 *food service, hospital/
#54 *energy intake/
#55 *food, fortified/
#56   33 OR 34 OR 35 OR 36 OR 37 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 44 OR 45 OR 46 OR 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55
#57 32 AND 56
#58 (random* OR rct*).tw,ot.
#59 “single blind*”.tw, ot.
#60 “double blind*”.tw, ot.
#61 ((triple OR treble) AND blind*).tw,ot.
#62 ((control* AND trial*) OR (clinical ADJ4 trial*) OR trial*).tw,ot.
#63 (systematic* review*).tw,ot.
#64 hta.tw, ot.
#65 (health technology ADJ6 assessment$).tw,ot.
#66 (meta analy$ OR metaanaly$ or meta?analy$).tw,ot.
#67 ((review$ OR search$) ADJ10 (literature$ OR medical database$ OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR current content$ OR systemat$)).tw,ot.
#68 58 OR 59 OR 60 OR 61 OR 62 OR 63 OR 64 OR 65 OR 66 OR 67
#69 (comment OR editorial OR historical‐article).pt.
#70 68 NOT 69
#71 57 AND 70
#72 exp Pregnancy/
#73 pregnan*.tw,ot.
#74 72 OR 73
#75 71 NOT 74
#76 limit 75 to (human and (adult <18 to 64 years> or aged <65+ years>))

AMED

#1 (food* OR meal* OR snack* OR drink* OR feed*).ti,ab
#2 (nutri* OR diet*).ti,ab
#3   "dining*".ti,ab
#4   screening OR monitoring).ti,ab
#5   documentation OR communication).ti,ab
#6   time* OR timing OR pattern OR style OR arrangement* OR environment).ti,ab
#7   staff* OR train*).ti,ab
#8   nurs*".ti,ab
#9   healthcare OR “health care”).ti,ab
#10 cater*".ti,ab
#11 flavo?r* OR taste).ti,ab
#12 content OR composition OR density).ti,ab
#13 appear* OR presentation).ti,ab
#14 size OR portion OR amount).ti,ab
#15 protected meal*".ti,ab
#16 red tray*".ti,ab
#17 fortif*".ti,ab
#18 "supplement*".ti,ab
#19 ((supportive OR nutrition* OR diet*) ADJ3 intervention).ti,ab
#20 (assist* OR help* OR support*).ti,ab
#21 (add* OR extra).ti,ab
#22  alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*).ti,ab
#23  1 DJ3 (6 OR 11 OR 12 OR 13 OR 14 OR 17 OR 18 OR 20 OR 21 OR 22)
#24  2 ADJ4 (12 OR 17 OR 18 OR 21 OR 22)
#25 3 ADJ4 (6 OR 22)
#26 4 ADJ4 (2 OR 21 OR 22)
#27 5 ADJ4 22
#28 7 ADJ4 (8 OR 9 OR 10 OR 20 OR 21 OR 22)
#29 18 ADJ5 21
#30  20 ADJ4 (8 OR 9 OR 10)
#31 15 OR 16 OR 19
#32 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31
#33 (“low bmi” OR “low body mass index”).ti,ab
#34 (“low weight” OR underweight OR under‐weight).ti,ab
#35 "maln*".ti,ab
#36 (“nutritional risk” OR (risk ADJ4 maln*)).ti,ab
#37 (“poor nutr*” OR undernourish* OR under‐nourish*).ti,ab
#38 ((poor OR inadequate OR suboptimal) ADJ5 intake*).ti,ab
#39 institutionali?ed.ti,ab
#40 elderly.ti,ab
#41 (homebound OR home‐bound OR housebound OR house‐bound).ti,ab
#42 ((extended OR longterm OR long‐term OR community) ADJ1 care).ti,ab
#43 ((nursing OR care OR residential) ADJ1 home).ti,ab
#44 (inpatient* OR hospitali?* OR hospital patient*).ti,ab
#45 33 OR 34 OR 35 OR 36 OR 37 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 44
#46 2 AND 45
#47 (random* OR rct*).ti,ab
#48 “single blind*”.ti,ab
#49 “double blind*”.ti,ab
#50 ((triple OR treble) AND blind*).ti,ab
#51 ((control* AND trial*) OR (clinical ADJ4 trial*) OR trial*).ti,ab
#52 (systematic* review*).ti,ab
#53 (“health technology” ADJ6 assessment$).ti,ab
#54 hta.ti,ab
#55 (“meta analy$” OR metaanaly$ or meta?analy$).ti,ab
#56 47 OR 48 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55
#57 46 AND 56
#58 (comment OR editorial OR historical‐article).pt.
#59 57 NOT 58
#60 (animal OR rat OR mouse OR guinea pig OR primate OR monkey OR cat OR dog).ti,ab
#61  9 NOT 60
#62 regnan*.ti,ab
#63 61 NOT 62
#64 (child* OR infant OR paediatric OR pediatric).ti,ab
#65 63 NOT 64

British Nursing Index

#1 (food* OR meal* OR snack* OR drink* OR feed*).ab,ti.
#2 (nutri* OR diet*).ab,ti.
#3 "dining*".ab,ti.
#4  (screening OR monitoring).ab,ti.
#5  (documentation OR communication).ab,ti.
#6  (time* OR timing OR pattern OR style OR arrangement* OR environment).ab,ti.
#7  (staff* OR train*).ab,ti.
#8 "nurs*".ab,ti.
#9 (healthcare OR health care).ab,ti.
#10 "cater*".ab,ti.
#11 (flavo?r* OR taste).ab,ti.
#12 (content OR composition OR density).ab,ti.
#13 (appear* OR presentation).ab,ti.
#14 (size OR portion OR amount).ab,ti.
#15 "protected meal*".ab,ti.
#16 "red tray*".ab,ti.
#17 "fortif*".ab,ti.
#18 "supplement*".ab,ti.
#19 ((supportive OR nutrition* OR diet*) ADJ3 intervention).ab,ti.
#20 (assist* OR help* OR support*).ab,ti.
#21 (add* OR extra).ab,ti.
#22 (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*).ab,ti.
#23 1 ADJ3 (6 OR 11 OR 12 OR 13 OR 14 OR 17 OR 18 OR 20 OR 21 OR 22)
#24 2 ADJ4 (12 OR 17 OR 18 OR 21 OR 22)
#25 3 ADJ4 (6 OR 22)
#26 4 ADJ4 (2 OR 21 OR 22)
#27 5 ADJ4 22
#28 7 ADJ4 (8 OR 9 OR 10 OR 20 OR 21 OR 22)
#29 18 ADJ5 21
#30 20 ADJ4 (8 OR 9 OR 10)
#31 15 OR 16 OR 19
#32 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31
#33 (low bmi OR low body mass index).ab,ti.
#34 (low weight OR underweight OR under‐weight).ab,ti.
#35 "maln*".ab,ti.
#36 (nutritional risk OR (risk ADJ4 maln*)).ab,ti.
#37 (poor nutr* OR undernourish* OR under‐nourish*).ab,ti.
#38 ((poor OR inadequate OR suboptimal) adj5 intake*).ab,ti.
#39 institutionali?ed.ab,ti.
#40 elderly.ab,ti.
#41 homebound OR home‐bound OR housebound OR house‐bound).ab,ti.
#42 ((extended OR longterm OR long‐term OR community) ADJ1 care).ab,ti.
#43 ((nursing OR care OR residential) ADJ1 home).ab,ti.
#44 (inpatient* OR hospitali?* OR hospital patient*).ab,ti.
#45 33 OR 34 OR 35 OR 36 OR 37 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 44
#46 32 AND 45
#47 (random* OR rct*).tw,ot.
#48 “single blind*”.tw, ot.
#49 “double blind*”.tw, ot.
#50 ((triple OR treble) AND blind*).tw,ot.
#51 ((control* AND trial*) OR (clinical ADJ4 trial*) OR trial*).tw,ot.
#52 (systematic* review*).tw,ot.
#53 hta.tw, ot.
#54 (health technology ADJ6 assessment$).tw,ot.
#55 (meta analy$ OR metaanaly$ or meta?analy$).tw,ot.
#56 (review$ OR search$) ADJ10 (literature$ OR medical database$ OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR current content$ OR systemat$)).tw,ot.
#57 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55 OR 56
#58 (comment or editorial or historical‐article).pt.
#59 57 NOT 58
#60 46 AND 59
#61 pregnan*.tw,ot.
#62 60 NOT 61

CINAHL

#1 (TI (food* OR meal* OR snack* OR drink* OR feed*)) OR (AB (food* OR meal* OR snack* OR drink* OR feed*))
#2 (TI (nutri* OR diet*)) OR (AB (nutri* OR diet*))
#3  (TI dining*) OR (AB dining*)
#4 (TI (screening OR monitoring)) OR (AB (screening OR monitoring))
#5  (TI (documentation OR communication)) OR (AB (documentation OR communication))
#6 (TI (time* OR timing OR pattern OR style OR arrangement* OR environment*)) OR (AB (time* OR timing OR pattern OR style OR arrangement* OR environment*))
#7  (TI (staff* OR train*)) OR (AB (staff* OR train*))
#8 (TI nurs*) OR (AB nurs*)
#9 (TI (healthcare OR health care)) OR (AB (healthcare OR health care))
#10 (TI cater*) OR (AB cater*)
#11 (TI (flavo?r* OR taste)) OR (AB (flavo?r* OR taste))
#12 (TI (content OR composition OR density)) OR (AB (content OR composition OR density))
#13 (TI (appear* OR presentation)) OR (AB (appear* OR presentation))
#14 (TI (size OR portion OR amount)) OR (AB (size OR portion OR amount))
#15 (TI (protected meal*)) OR (AB (protected meal*))
#16 (TI (red tray*)) OR (AB (protected meal*))
#17 (TI fortif*) OR (AB fortif*)
#18 (TI supplement*) OR (AB supplement*)
#19 (TI ((supportive OR nutrition* OR diet*) N3 intervention)) OR (AB ((supportive OR nutrition* OR diet*) N3 intervention))
#20 (TI (assist* OR help* OR support*)) OR (AB (assist* OR help* OR support*))
#21 (TI (add* OR extra)) OR (AB (add* OR extra))
#22 (TI (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)) OR (AB (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))
#23 (TI (food* OR meal* OR snack* OR drink* OR feed*) N3 ((time* OR timing OR pattern OR style OR arrangement* OR environment*) OR (flavour* OR flavor* OR taste) OR (content OR composition OR density) OR (appear* OR presentation) OR (size OR portion OR amount) OR (fortif*) OR (supplement*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))) OR (AB (food* OR meal* OR snack* OR drink* OR feed*) N3 ((time* OR timing OR pattern OR style OR arrangement* OR environment*) OR (flavour* OR flavor* OR taste) OR (content OR composition OR density) OR (appear* OR presentation) OR (size OR portion OR amount) OR (fortif*) OR (supplement*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)))
#24 (TI (nutri* OR diet*) N4 ((content OR composition OR density) OR (fortif*) OR (supplement*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))) OR (AB (nutri* OR diet*) N4 ((content OR composition OR density) OR (fortif*) OR (supplement*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)))
#25 (TI dining* N4 ((time* OR timing OR pattern OR style OR arrangement* OR environment*) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))) OR (AB dining* N4 ((time* OR timing OR pattern OR style OR arrangement* OR environment*) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)))
#26 (TI (screening OR monitoring) N4 ((nutri* OR diet*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))) OR (AB (screening OR monitoring) N4 ((nutri* OR diet*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)))
#27 (TI (documentation OR communication) N4 ((alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))) OR (AB (documentation OR communication) N4 ((alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)))
#28 (TI (staff* OR train*) N4 ((nurs*) OR (healthcare OR health care) OR (cater*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))) OR (AB (staff* OR train*) N4 ((nurs*) OR (healthcare OR health care) OR (cater*) OR (assist* OR help* OR support*) OR (add* OR extra) OR (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*)))
#29 (TI (supplement* N5 (add* OR extra))) OR (AB (supplement* N5 (add* OR extra)))
#30 (TI (assist* OR help* OR support*) N4 ((nurs*) OR (healthcare OR health care) OR (cater*))) OR (AB (assist* OR help* OR support*) N4 ((nurs*) OR (healthcare OR health care) OR (cater*)))
#31 (S15 OR S16 OR S19)
#32 S23 OR S24 OR S25 OR S26 OR S27 OR S28 OR S29 OR S30 OR S31
#33 (TI (low BMI OR low body mass index)) OR (AB (low BMI OR low body mass index))
#34 (TI (low weight OR underweight OR under‐weight)) OR (AB (low weight OR underweight OR under‐weight))
#35 (TI maln*) OR (AB maln*)
#36 (TI (nutritional risk OR (risk N4 maln*))) OR (AB (nutritional risk OR (risk N4 maln*)))
#37 (TI (poor nutr* OR undernourish* OR under‐nourish*)) OR (AB (poor nutr* OR undernourish* OR under‐nourish*))
#38 TI (poor OR inadequate OR suboptimal) N5 intake*) OR (AB (poor OR inadequate OR suboptimal) N5 intake*)
#39 (TI (institutionali?ed)) OR (AB (institutionali?ed))
#40 (TI elderly) OR (AB elderly)
#41 (TI (homebound OR home‐bound OR housebound OR house‐bound)) OR (AB (homebound OR home‐bound OR housebound OR house‐bound))
#42 (TI ((extended OR longterm OR long‐term OR community) N1 care)) OR (AB ((extended OR longterm OR long‐term OR community) N1 care))
#43 (TI ((nursing OR care OR residential) N1 home)) OR (AB ((nursing OR care OR residential) N1 home))
#44 (TI (inpatient* OR hospitali?* OR hospital patient*)) OR (AB (inpatient* OR hospitali?* OR hospital patient*))
#45 SU Nutritional Status
#46 SU Nutrition Disorders
#47 SU Nutritional Assessment
#48 SU Nutritional Support
#49 SU Nutrition Policy
#50 SU Malnutrition
#51 SU Diet
#52 SU Dietetics
#53 SU Hospital Food Service
#54 SU Energy Intake
#55 SU Fortified Food
#56 S33 OR S34 OR S35 OR S36 OR S37 OR S38 OR S39 OR S40 OR S41 OR S42 OR S43 OR S44 OR S45 OR S46 OR S47 OR S48 OR S49 OR S50 OR S51 OR S52 OR S53 OR S54 OR S55
#57 S32 AND S56
#58 (TI (random* OR rct*)) OR (TX (random* OR rct*))
#59 (TI single blind*) OR (TX single blind*)
#60 (TI double blind*) OR (TX double blind*)
#61 (TI ((triple OR treble) AND blind*)) OR (TX ((triple OR treble) AND blind*))
#62 (TI ((control* AND trial*) OR (clinical N4 trial*) OR trial*)) OR (TX ((control* AND trial*) OR (clinical N4 trial*) OR trial*))
#63 (TI systematic* review*) OR (TX systematic* review*)
#64 (TI hta) OR (TX hta)
#65 (TI (health technology N6 assessment*)) OR (TX (health technology N6 assessment*))
#66 (TI (meta analy* OR metaanaly* or meta?analy*)) OR (TX (meta analy* OR metaanaly* or meta?analy*))
#67 (TI ((review* OR search*) N10 (literature* OR medical database* OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR current content* OR systemat*))) OR (TX ((review* OR search*) N10 (literature* OR medical database* OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR current content* OR systemat*)))
#68 S58 OR S59 OR S60 OR S61 OR S62 OR S63 OR S64 OR S65 OR S66 OR S67
#69 PT (comment OR editorial OR historical‐article)
#70 S68 NOT S69
#71 SU Pregnancy
#72 (TI pregnan*) OR (TX pregnan*)
#73 S71 OR S72
#74 S70 NOT S73
#75 S57 AND S74
Limiters ‐ Human; Age Groups: Adult: 19‐44 years, Aged: 65+ years

SCOPUS

#1
((TITLE‐ABS‐KEY((food* W/3 time*) OR (food* W/3 timing) OR (food* W/3 pattern) OR (food* W/3 style) OR (food* W/3 arrangement*)OR (food*W/3 environment) OR (food* W/3 flavour) OR (food* W/3 taste) OR (food* W/3 content) OR (food* W/3 composition) OR (food* W/3 density) OR (food* W/3 appear*) OR (food* W/3 presentation) OR (food* W/3 size) OR (food* W/3 portion) OR (food* W/3 amount) OR (food* W/3 fortifi*) OR (food* W/3 supplement*) OR (food* W/3 assist*) OR (food* W/3 help*) OR (food* W/3 support*) OR (food* W/3 add*) OR (food* W/3 extra) OR (food* W/3 alter*) OR (food* W/3 chang*) OR (food* W/3 new) OR (food* W/3 enhance*) OR (food* W/3 modif*) OR (food* W/3 increas*) OR (food W/3 decreas*) OR (food* W/3 improv*) OR (food* W/3 reduc*) OR (food* W/3 target*))) OR (TITLE‐ABS‐KEY((meal* W/3 time*) OR (meal* W/3 timing) OR (meal* W/3 pattern) OR (meal* W/3 style) OR (meal* W/3 arrangement*)OR (meal*W/3 environment) OR (meal* W/3 flavour) OR (meal* W/3 taste) OR (meal* W/3 content) OR (meal* W/3 composition) OR (meal* W/3 density) OR (meal* W/3 appear*) OR (meal* W/3 presentation) OR (meal* W/3 size) OR (meal* W/3 portion) OR (meal* W/3 amount) OR (meal* W/3 fortifi*) OR (meal* W/3 supplement*) OR (meal* W/3 assist*) OR (meal* W/3 help*) OR (meal* W/3 support*) OR (meal* W/3 add*) OR (meal* W/3 extra) OR (meal* W/3 alter*) OR (meal* W/3 chang*) OR (meal* W/3 new) OR (meal* W/3 enhance*) OR (meal* W/3 modif*) OR (meal* W/3 increas*) OR (food W/3 decreas*) OR (meal* W/3 improv*) OR (meal* W/3 reduc*) OR (meal* W/3 target*))) OR (TITLE‐ABS‐KEY((snack* W/3 time*) OR (snack* W/3 timing) OR (snack* W/3 pattern) OR (snack* W/3 style) OR (snack* W/3 arrangement*)OR (snack*W/3 environment) OR (snack* W/3 flavour) OR (snack* W/3 taste) OR (snack* W/3 content) OR (snack* W/3 composition) OR (snack* W/3 density) OR (snack* W/3 appear*) OR (snack* W/3 presentation) OR (snack* W/3 size) OR (snack* W/3 portion) OR (snack* W/3 amount) OR (snack* W/3 fortifi*) OR (snack* W/3 supplement*) OR (snack* W/3 assist*) OR (snack* W/3 help*) OR (snack* W/3 support*) OR (snack* W/3 add*) OR (snack* W/3 extra) OR (snack* W/3 alter*) OR (snack* W/3 chang*) OR (snack* W/3 new) OR (snack* W/3 enhance*) OR (snack* W/3 modif*) OR (snack* W/3 increas*) OR (food W/3 decreas*) OR (snack* W/3 improv*) OR (snack* W/3 reduc*) OR (snack* W/3 target*))) OR (TITLE‐ABS‐KEY((drink* W/3 time*) OR (drink* W/3 timing) OR (drink* W/3 pattern) OR (drink* W/3 style) OR (drink* W/3 arrangement*)OR (drink*W/3 environment) OR (drink* W/3 flavour) OR (drink* W/3 taste) OR (drink* W/3 content) OR (drink* W/3 composition) OR (drink* W/3 density) OR (drink* W/3 appear*) OR (drink* W/3 presentation) OR (drink* W/3 size) OR (drink* W/3 portion) OR (drink* W/3 amount) OR (drink* W/3 fortifi*) OR (drink* W/3 supplement*) OR (drink* W/3 assist*) OR (drink* W/3 help*) OR (drink* W/3 support*) OR (drink* W/3 add*) OR (drink* W/3 extra) OR (drink* W/3 alter*) OR (drink* W/3 chang*) OR (drink* W/3 new) OR (drink* W/3 enhance*) OR (drink* W/3 modif*) OR (drink* W/3 increas*) OR (food W/3 decreas*) OR (drink* W/3 improv*) OR (drink* W/3 reduc*) OR (drink* W/3 target*))) OR (TITLE‐ABS‐KEY((feed* W/3 time*) OR (feed* W/3 timing) OR (feed* W/3 pattern) OR (feed* W/3 style) OR (feed* W/3 arrangement*) OR (feed* W/3 environment) OR (feed* W/3 flavour) OR (feed* W/3 taste) OR (feed* W/3 content) OR (feed* W/3 composition) OR (feed* W/3 density) OR (feed* W/3 appear*) OR (feed* W/3 presentation) OR (feed* W/3 size) OR(feed* W/3 portion) OR(feed* W/3 amount) OR(feed* W/3 fortifi*) OR (feed* W/3 supplement*) OR (feed* W/3 assist*) OR(feed* W/3 help*) OR (feed* W/3 support*) OR (feed* W/3 add*) OR (feed* W/3 extra) OR (feed* W/3 alter*) OR(feed* W/3 chang*) OR (feed* W/3 new) OR (feed* W/3 enhance*) OR (feed* W/3 modif*) OR (feed* W/3 increas*) OR (food W/3 decreas*) OR (feed* W/3 improv*) OR (feed* W/3 reduc*) OR (feed* W/3 target*))))
#2
OR ((TITLE‐ABS‐KEY((nutri* W/3 content) OR (nutri* W/3 composition)OR (nutri* W/3 density))) OR (TITLE‐ABS‐KEY((diet* W/3 content) OR (diet* W/3 composition)OR (diet* W/3 density))) OR (TITLE‐ABS‐KEY(nutri* W/3 fortifi*)) OR (TITLE‐ABS‐KEY(diet* W/3 fortifi*)) OR (TITLE‐ABS‐KEY(nutri* W/3 supplement*)) OR (TITLE‐ABS‐KEY(diet* W/3 supplement*)) OR (TITLE‐ABS‐KEY(nutri* W/3 add*) OR (nutri* W/3 extra)) OR (TITLE‐ABS‐KEY((diet* W/3 add*) OR (diet* W/3 extra))))
#3
OR ((TITLE‐ABS‐KEY((dining* W/3 time*) OR (dining* W/3 timing) OR (dining* W/3 pattern) OR (dining* W/3 style) OR (dining* W/3 arrangement*)OR (dining* W/3 environment))) OR (TITLE‐ABS‐KEY((dining* W/3 alter*) OR (dining* W/3 chang*) OR (dining* W/3 new) OR (dining* W/3 enhance*) OR (dining* W/3 modif*) OR (dining*W/3 increas*) OR (food W/3 decreas*) OR (dining* W/3 improv*) OR (dining* W/3 reduc*) OR (dining* W/3 target*))))
#4
OR ((TITLE‐ABS‐KEY((screening W/3 nutri*) OR (screening W/3 diet*))) OR (TITLE‐ABS‐KEY((monitoring W/3 nutri*) OR (monitoring W/3 diet*))) OR (TITLE‐ABS‐KEY((screening W/3 add*) OR (screening W/3 extra))) OR (TITLE‐ABS‐KEY((monitoring W/3 add*) OR (monitoring W/3 extra))) OR (TITLE‐ABS‐KEY((screeningW/3 alter*) OR (screening W/3 chang*) OR (screening W/3 new) OR (screening W/3 enhance*) OR (screeningW/3 modif*) OR (screening W/3 increas*) OR (food W/3 decreas*) OR (screening W/3 improv*) OR (screening W/3 reduc*) OR (screening W/3 target*))) OR (TITLE‐ABS‐KEY((monitoring W/3 alter*)OR (monitoringW/3 chang*)OR (monitoringW/3 new)OR (monitoringW/3 enhance*)OR (monitoringW/3 modif*)OR (monitoringW/3 increas*)OR (foodW/3 decreas*)OR (monitoringW/3 improv*)OR (monitoringW/3 reduc*)OR (monitoringW/3 target*))))
#5
OR ((TITLE‐ABS‐KEY((documentation W/3 alter*) OR (documentation W/3 chang*) OR (documentation W/3 new) OR (documentation W/3 enhance*) OR (documentation W/3 modif*) OR (documentation W/3 increas*) OR (food W/3 decreas*) OR (documentation W/3 improv*)OR (documentation W/3 reduc*)OR (documentation W/3 target*))) OR (TITLE‐ABS‐KEY((communication W/3 alter*)OR (communicationW/3 chang*) OR (communication W/3 new) OR (communication W/3 enhance*) OR (communication W/3 modif*) OR (communication W/3 increas*) OR (food W/3 decreas*) OR (communication W/3 improv*) OR (communication W/3 reduc*) OR (communication W/3 target*))))
#6
OR ((TITLE‐ABS‐KEY((staff* W/3 nurs*)OR (train* W/3 nurs*))) OR (TITLE‐ABS‐KEY((staff* W/3 healthcare)OR (train*W/3 healthcare)OR (staff* W/3 health care) OR (train* W/3 healthcare))) OR (TITLE‐ABS‐KEY(staff* W/3 cater*)) OR (TITLE‐ABS‐KEY((staff* W/3 assist*) OR (train* W/3 assist) OR (staff* W/3 help*) OR (train* W/3 help*) OR (staff* W/3 support*) OR (train*W/3 support*) OR (staff* W/3 add*) OR (train* W/3 add*) OR (staff* W/3 extra) OR (train* W/3 extra))) OR (TITLE‐ABS‐KEY((staff* W/3 alter*) OR (staff* W/3 chang*) OR (staff* W/3 new) OR (staff* W/3 enhance*)OR (staff* W/3 modif*)OR (staff* W/3 increas*)OR (food W/3 decreas*)OR (staff* W/3 improv*)OR (staff* W/3 reduc*)OR (staff* W/3 target*))) OR (TITLE‐ABS‐KEY((train* W/3 alter*) OR (train* W/3 chang*) OR (train* W/3 new) OR (train* W/3 enhance*)OR (train* W/3 modif*)OR (train* W/3 increas*)OR (food W/3 decreas*)OR (train* W/3 improv*)OR (train* W/3 reduc*)OR (train* W/3 target*))))
#7
OR (TITLE‐ABS‐KEY((supplement* W/3 add*) OR (supplement* W/3 extra)))))
#8
(((((((TITLE‐ABS‐KEY((assist* W/3 nurs*) OR (assist* W/3 healthcare) OR (assist* W/3 healthcare) OR(assist* W/3 cater*))) OR (TITLE‐ABS‐KEY((help* W/3 nurs*) OR (help* W/3 healthcare)OR (help* W/3 health care) OR (help* W/3 cater*))) OR (TITLE‐ABS‐KEY((support* W/3 nurs*) OR (support* W/3 healthcare) OR (support* W/3 health care) OR (support* W/3 cater*))))
#9
OR (TITLE‐ABS‐KEY(("protected meal" OR "red tray")) OR ((supportive W/3 intervention) OR (nutrition* W/3intervention) OR (diet* W/3intervention)))
#10
#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9
#11
OR (TITLE‐ABS‐KEY("low BMI" OR "low body mass index"))
#12
OR (TITLE‐ABS‐KEY("low weight" OR underweightOR "under‐weight"))
#13
OR (TITLE‐ABS‐KEY(maln*))
#14
OR (TITLE‐ABS‐KEY(("nutritional risk") OR (risk W/3 maln*)))
#15
OR (TITLE‐ABS‐KEY("poor nutr*"OR undernourish* OR "under‐nourish*"))
#16
OR (TITLE‐ABS‐KEY((poor W/3 intake*) OR (inadequateW/3 intake*) OR (suboptimal W/3 intake*)))
#17
OR (TITLE‐ABS‐KEY(institutionali?ed OR elderly))
#18
OR (TITLE‐ABS‐KEY(homebound OR "home bound" OR housebound OR "house bound"))
#19
OR (ABS((extended W/1care) OR(longterm W/1care) OR("long term" W/1 care) OR (community W/1 care)))
#20
OR (ABS((nursing W/1 home)OR (care W/3 home) OR (residential W/3 home)))
#21
OR (ABS(inpatient* OR hospitali?* OR "hospital patient*"))
#22
OR (ABS("nutritional status" OR "nutrition disorder*" OR "nutrition assessment*" OR "nutritional support*" OR "nutrition policy"))
#23
OR (ABS(diet* OR "food service" OR "energy intake" OR "fortified food"))
#24
#11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17
#25
#18 OR #19 OR #20 OR #21 OR #22 OR #23
#26
#24 OR #25
#27
#10 AND #26
#28
((ABS("controlled trial*" OR "controlled clinical trial*" OR "clinical trial*")) OR (ABS(random* ORplacebo)) OR (ABS("meta‐analys*" OR metaanalys* OR hta OR "health technology assessment")) OR (ABS(literature* OR "medical database*" OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR "current content*" OR "systematic review*")))
#29
#27 AND #28
#30
(ABS(adult*))
#31
#29 AND #30
#32
(ABS(pregnan*))
#33
#31 AND NOT #32
#34
(ABS(animal*))
#35
#33 AND NOT #34

ISI Web of Science

#1 TS=((food* OR meal* OR snack* OR drink* OR feed*) NEAR/3 (time* OR timing OR pattern OR style OR arrangement* OR environment OR flavor OR taste OR content OR composition OR density OR appear* OR presentation OR size OR portion OR amount OR fortifi* OR supplement* OR assist* OR help* OR support* OR add* OR extra OR alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))
# 2 TS=((nutri* OR diet*) NEAR/3 (content OR composition OR density OR fortfi* OR supplement* OR add* OR extra OR alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target))
# 3 TS=((dining*) NEAR/3 (time* OR timing OR pattern OR style OR arrangement* OR environment OR alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))
# 4 TS=((screening OR monitoring) NEAR/3 (nutri* OR diet* OR add* OR extra OR alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))
# 5 TS=((documentation OR communication) NEAR/3 (alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))
# 6 TS=((staff* OR train*) NEAR/3 (nurs* OR healthcare OR "health care" OR cater* OR assist* OR help* OR support* OR add* OR extra OR alter* OR chang* OR new OR enhance* OR modif* OR increas* OR decreas* OR improv* OR reduc* OR target*))
# 7 TS=((supplement*) NEAR/6 (add* OR extra))
# 8 TS=((assist* OR help* OR support*) NEAR/3 (nurs* OR healthcare OR "health care" OR cater*))
# 9 TS=(("protected meal" OR "red tray") OR ((supportive OR nutrition* OR diet*) NEAR/3 intervention*))
# 10 #9 OR #8 OR #7 OR #6 OR #5 OR #4 OR #3 OR #2 OR #1
# 11 TS=(("low bmi" OR "low body mass index"))
# 12 TS=(("low weight" OR underweight OR "under‐weight"))
# 13 TS=(maln*)
# 14 TS=("nutritional risk" OR (risk NEAR/3 maln*))
# 15 TS=(("poor nutr*" OR undernourish* OR "under nourish*"))
# 16 TS=((poor OR inadequate OR suboptimal) NEAR/6 intake*)
# 17 TS=((institutionali?ed OR elderly))
# 18 TS=((homebound OR "home bound" OR housebound OR "house bound"))
# 19 TS=((extended OR longterm OR "long term" OR community) NEAR/1 care)
# 20 TS=((nursing OR care OR residential) NEAR/1 home)
# 21 TS=((inpatient* OR hospitali?* OR "hospital patient*"))
# 22 TS=(nutritional status)
# 23 TS=(nutrition disorder*)
# 24 TS=(("nutrition assessment*" OR "nutritional support*"OR "nutrition policy"))
# 25 TS=((diet* OR "food service" OR "energy intake" OR "fortified food"))
# 26 #25 OR #24 OR #23 OR #22 OR #21 OR #20 OR #19 OR #18 OR #17 OR #16 OR #15 OR #14 OR #13 OR #12 OR #11
# 27 #26 AND #10
# 28 TS=("controlled trial*" OR "controlled clinical trial*" OR "clinical trial*")
# 29 TS=(random* OR placebo)
# 30 TS=("meta‐analys*" OR metaanalys* OR hta OR "health technology assessment")
# 31 TS=((literature* OR "medical database*" OR medline OR pubmed OR embase OR cochrane OR cinahl OR psycinfo OR psyclit OR healthstar OR biosis OR "current content*" OR "systematic review*"))
# 32 #31 OR #30 OR #29 OR #28
# 33 #32 AND #27
# 34 TS=(adult*)
# 35 #34 AND #33
# 36 TS=(pregnan*)
# 37 #35 NOT #36
# 38 TS=(animal*)
# 39 #37 NOT #38

Appendix 2. Search strategies (January 2013 to September 2016)

Cochrane Library (Wiley)

I: Population

1. [mh ^Stroke] or stroke:ti,ab

2. [mh ^"Alzheimer Disease"] or alzheimer:ti,ab

3. [mh ^Dementia] or dement*:ti,ab

4. [mh ^"Mild Cognitive Impairment"] or "cognitive impairment":ti,ab

5. [mh "Hip Fractures"] or ("hip fracture*" or "femoral neck fracture*"):ti,ab

6. [mh ^"Nursing Homes"] or [mh ^"Homes for the Aged"] or ("nursing home*"):ti,ab

7. (residents or residential):ti,ab

8. [mh ^"Aged"] or [mh ^"Aging"] or aged:ti,ab

9. [mh ^"Frail Elderly"] or (elder or elders or elderly):ti,ab

10. (older or geriatric):ti,ab

11. [mh ^"Inpatients"] or inpatients:ti,ab

12. [mh ^"Outpatients"] or outpatients:ti,ab

13. [mh ^"Institutionalization"] or institutionali*:ti,ab

14. [mh ^"Hospitalization"] or (hospitali?ed or hospitali?ation):ti,ab

15. {or #1‐#14}

II: Condition

16. [mh ^"Malnutrition"] or [mh ^"Protein‐Energy Malnutrition"]

17. (malnourish* or malnutrition):ti,ab

18. [mh ^"Nutrition Assessment"]

19. [mh ^"Nutritional Status"] or "nutritional status":ti,ab

20. [mh ^"Nutritional Requirements"]

21. [mh ^"Nutrition Disorders"]

22. [mh ^"Nutritional Support"]

23. ((nutritional or nutrition or nutritionally) near/2 risk):ti,ab

24. ((unintentional or risk) near/2 "weight loss"):ti,ab

25. (undernutrition or undernourished or hyponutrition):ti,ab

26. [mh ^"Elder Nutritional Physiological Phenomena"]

27. [mh ^"Energy Intake"]

28. [mh ^"Feeding Behavior"] or [mh ^"Feeding Methods"]

29. ("Mini Nutritional Assessment" or "Eating Behaviour Scale" or "Edinburgh Feeding Evaluation" or "Malnutrition Universal Screening Tool"):ti,ab

30. ((improve* or increase* or inadequate) near/3 ("nutrient intake" or "energy intake" or "dietary intake" or "food intake")):ti,ab

31. {or #16‐#30}

32. #15 and #31

33. #32 not (child* or infant* or pregnan*):ti,ab,kw

34. Publication Year from 2013 to 2016

MEDLINE (Ovid SP)

I: Population

1. Stroke/ or stroke.tw.

2. Alzheimer Disease/ or alzheimer.tw.

3. Dementia/ or dement*.tw.

4. Mild Cognitive Impairment/ or cognitive impairment.tw.

5. exp Hip Fractures/ or (hip fracture? or femoral neck fracture?).tw.

6. Nursing Homes/ or Homes for the Aged/ or (nursing home?).tw.

7. (residents or residential).tw.

8. Aged/ or Aging/ or aged.tw.

9. Frail Elderly/ or (elder or elders or elderly).tw.

10. (older or geriatric).tw.

11. Inpatients/ or inpatients.tw.

12. Outpatients/ or outpatients.tw.

13. Institutionalization/ or institutionali*.tw.

14. Hospitalization/ or (hospitali?ed or hospitali?ation).tw.

15. or/1‐14

II: Condition

16. Malnutrition/ or Protein‐Energy Malnutrition/

17. (malnourish* or malnutrition).tw.

18. Nutrition Assessment/

19. Nutritional Status/ or nutritional status.tw.

20. Nutritional Requirements/

21. Nutrition Disorders/

22. Nutritional Support/

23. ((nutritional or nutrition or nutritionally) adj2 risk).tw.

24. ((unintentional or risk) adj2 weight loss).tw.

25. (undernutrition or undernourished or hyponutrition).tw.

26. Elder Nutritional Physiological Phenomena/

27. Energy Intake/

28. Feeding Behavior/ or Feeding Methods/

29. (Mini Nutritional Assessment or Eating Behaviour Scale or Edinburgh Feeding Evaluation or Malnutrition Universal Screening Tool).tw.

30. ((improve* or increase? or inadequate) adj3 (nutrient intake or energy intake or dietary intake or food intake)).tw.

31. or/16‐30

32. 15 and 31

III. [Cochrane Handbook 2008 RCT filter ‐ sensitivity and precision max. version]

33. randomized controlled trial.pt.

34. controlled clinical trial.pt.

35. randomi?ed.ab.

36. placebo.ab.

37. clinical trials as topic/

38. randomly.ab.

39. trial.ti.

40. or/33‐39

41. exp animals/ not humans/

42. 40 not 41

43. 32 and 42

44. 43 not (child* or infant* or pregnan*).tw.

45. limit 44 to yr="2013‐Current"

ClinicalTrials.gov (Advanced search)

Search Terms: malnourished OR malnutrition OR undernourished OR undernutrition OR "under nutrition" OR "poor nutritional status" OR "nutritional risk" OR "inadequate nutrient intake"

Study Type: Interventional Studies

Age Group: Adult (18–65), Senior (66+)

WHO ICTRP (Standard search)

malnourished AND elder* OR

malnutrition AND elder* OR

undernourished AND elder* OR

undernutrition AND elder* OR

malnourished AND aged OR

malnutrition AND aged OR

undernourished AND aged OR

undernutrition AND aged OR

malnourished AND geriatric OR

malnutrition AND geriatric OR

undernourished AND geriatric OR

undernutrition AND geriatric

Appendix 3. Description of interventions

	Intervention(s)	Type of intervention(s)^a	Comparator(s)
Barton 2000	I1: portion size decreased by 20% but fortified to achieve overall daily energy provision increased by 200 kcal (randomised)	Modification of meal profile or pattern	Normal hospital menu (randomised group)
Barton 2000	I2: normal hospital menu plus cooked breakfast (not randomised group)	Modification of meal profile or pattern	Normal hospital menu (randomised group)
Beck 2002	I1: homemade oral supplement (group A, not randomised)	Additional supplementation of meals	Usual diet
Beck 2002	I2: homemade oral supplement (group B)	Additional supplementation of meals	Usual diet
Bouillanne 2013	'Pulse diet': 78% of daily protein requirements provided at lunch (no change to energy and protein)	Modification of meal profile or pattern	'Spread diet': usual diet (daily protein requirements distributed between meals)
Bourdel‐Marchasson 2000	Oral supplementation in addition to standard diet	Additional supplementation of meals	Standard diet
Brouillette 1991	Osmotherapy (use of aromas to stimulate appetite) + activities	Changes to the feeding environment	Activities only
Castellanos 2009	I1: two breakfast and two lunch foods fortified to improve energy and protein content (hot cereal and juice breakfast, soup and side dish at lunch)	Modification of meal profile or pattern	Routine care, no meals enhanced
Castellanos 2009	I2: two lunch foods only fortified versus normal menu	Modification of meal profile or pattern	Routine care, no meals enhanced
Chang 2005	Training in feeding skills (feeding skills training programme for nursing assistants)	Changes to the organisation of nutritional care	No training
Dennis 2005	Normal hospital diet plus oral nutritional supplements	Additional supplementation of meals	Normal hospital diet
Duncan 2006	Additional personal attention of a dietetic assistant e.g. checking personal food preferences, assisting with food choice, provision of appropriate feeding aids, feeding assistance and collecting information to aid nutritional assessment	Changes to the organisation of nutritional care	Routine care
Essed 2007	Food sprinkled with 1 g (+ 0.2 g) of intervention + maltodextrin carrier I1: monosodium glutamate	Modification of meal profile or pattern	Maltodextrin (placebo)
	I2: flavour
	I3: monosodium glutamate + flavour
Essed 2009	Three foods (previously identified as preferred), i.e. mashed potato (0.2 g NaCl/100 g + 0.5% monosodium glutamate), mince meat (0.37 g NaCl/100 g + 2% monosodium glutamate and spinach (0.25 g NaCl/100 g + 2% monosodium glutamate)	Modification of meal profile or pattern	Usual hot meal
Faxen‐Irving 2011	A daily dose of 3 x 30 mL fat emulsion distributed at the same time as pharmaceutical prescriptions	Additional supplementation of meals	Standard care
Gaskill 2009	Nutrition education programme	Changes to the organisation of nutritional care	Usual care
Germain 2006	Re‐formed foods, thickened beverages and dietary supplements as necessary	Modification of meal profile or pattern	Traditional modified texture diet
Hankey 1993	Supplements in addition to their normal hospital diet	Additional supplementation of meals	Standard hospital food
Hickson 2004	Additional nutritional care from a trained health care assistant	Changes to the organisation of nutritional care	Usual care
Holyday 2012	Malnutrition care plan; screening, assessment and intervention tailored to individuals requirements (including texture modification, fortification, oral nutritional supplements, snacks, assistance)	Changes to the organisation of nutritional care	Usual care
Johansen 2004	Nutrition team (dietitian + nurse)	Changes to the organisation of nutritional care	Usual care
Kraft 2012	Oral nutritional supplements + monitoring using telemedicine	Changes to the organisation of nutritional care	Usual care
Kretser 2003	Modified meals on wheels system (21 meals + 14 snacks) and daily phone call	Congregate and home meal delivery systems	Traditional meals on wheels (one hot meal delivered five days a week at lunch)
Larsson 1990	Oral nutritional supplements plus normal hospital diet	Additional supplementation of meals	Normal hospital diet
Leslie 2012	Energy enriched usual meals	Modification of meal profile or pattern	Usual care
Lin 2010	I1: spaced‐retrieval ‐ a method to enhance learning, retention and recall of information	Changes to the organisation of nutritional care	Usual care
Lin 2010	I2: Montessori intervention ‐ a method capable of stopping or reducing residents problem behaviours	Changes to the organisation of nutritional care	Usual care
Lin 2011	Montessori intervention ‐ designed to manage eating difficulties	Changes to the organisation of nutritional care	Usual care
Mathey 2001a	Improved meal ambiance comprising improvements to physical environment, meal service and organisation of assistance	Changes to the feeding environment	Usual care
Mathey 2001b	Creating a better ambience during food consumption	Changes to the feeding environment	Usual care
Munk 2014	Energy and protein enriched foods provided in addition to the hospital food via an a la carte menu	Modification of meal profile or pattern	Usual care
Nijs 2006	Family‐style meals comprising table dressing, food service, staff protocols, residents protocol and a meal‐time protocol, meal choice at the time of meal	Changes to the feeding environment	Individual pre‐plated meal service, meal chosen 2 weeks in advance.
Olofsson 2007	Multi‐component intervention (including nutrition)	Changes to the organisation of nutritional care	Usual care
Pivi 2011	I1: nutrition education for caregivers and participants	Changes to the organisation of nutritional care	Usual care
Pivi 2011	I2: oral nutritional supplements (two cartons daily for six months)	Changes to the organisation of nutritional care	Usual care
Potter 2001	Oral nutritional supplement + normal hospital diet	Additional supplementation of meals	Normal hospital diet
Remsburg 2001	Buffet style dining programme for supper only	Changes to the feeding environment	Usual care, tray‐style meal served by nursing home staff
Salva 2011	Teaching and training intervention to improve nutrition care	Changes to the organisation of nutritional care	Usual care
Silver 2008	Home‐delivered fortified lunch once weekly for 7 months	Modification of meal profile or pattern	Home delivered usual lunch once weekly for 7 months
Simmons 2008	Mealtime feeding assistance and/or between meal snacks	Additional supplementation of meals	Usual care
Simmons 2010	I1: snacks between meal snacks	Additional supplementation of meals	Usual care
Smolliner 2008	I2: oral nutritional supplements	Additional supplementation of meals	Usual care
Smolliner 2008	Protein and energy‐enriched soups and sauces and two additional snacks high in protein and energy	Modification of meal profile or pattern	Usual diet
Splett 2003	Medical nutrition therapy (protocol‐driven nutritional assessment and intervention activities carried by dietitians)	Changes to the organisation of nutritional care	Usual care by dietitians
Taylor 2006	5‐meal menu pattern with energy content similar to existing 3‐meal menu	Modification of meal profile or pattern	3‐meal menu (usual care)
Van den Berg 2015	I1: offered 125 mL ONS twice daily with medication rounds	Additional supplementation of meals	Usual care (125 mL ONS offered in between meals)
Van den Berg 2015	I2: offered 62 mL ONS four times daily with medication rounds	Additional supplementation of meals	Usual care (125 mL ONS offered in between meals)
Van Ort 1995	I2: offered 62 mL ONS daily with medication rounds	Changes to the feeding environment	Usual care
^aNumbers refer to intervention sub‐categories: (1) changes to the organisation of nutritional care, (2) changes to the feeding environment, (3) modification of meal profile or pattern, (4) additional supplementation of meals, (5) congregate and home meal delivery systems ‐ see Table 1 C: comparator; I: intervention; ONS: oral nutritional supplement

Appendix 4. Baseline characteristics (I)

	Intervention(s) and comparator(s)	Participants (N)	Description of participants (trial design)	Country	Setting	Sex N (female %)	Age mean years (SD)/range)
Barton 2000	I1: reduced portion fortified menu	13	Elderly hospitalised individuals (cross‐over RCT)	UK	Elderly rehab ward	6 (46)	77 (8)
	I2: normal menu plus cooked breakfast	8 (non‐randomised)				5 (63) (non‐randomised)	78 (9) (non‐randomised)
	C: normal hospital menu	14				11 (79)	75 (11)
Beck 2002	I1: homemade oral supplement	36	Nursing home residents > 65 years (parallel RCT)	Denmark	Residential care home	22 (61)	81 (76‐86)
	I2: homemade oral supplement (B)
	C: usual diet
Bouillanne 2013	I: pulse diet (78% protein at lunch)	66	Hospitalised elderly individuals (parallel RCT)	France	Intermediate care unit	46 (70)	84.1 (6)
	C: usual diet (protein distributed between meals)						85.7 (6.3)
Bourdel‐Marchasson 2000	I: oral supplementation + standard diet	295	Critically ill elderly participants (cluster‐RCT)	France	Hospital wards & geriatric units	199 (67.5)	83.6 (7.3)
	C: standard diet	377				238 (63.1)	83.0 (7.1)
Brouillette 1991	I: osmotherapy + activities	10	Nursing home residents (parallel RCT)	USA	Residential care home	14 (88) of those that completed the trial	80 (6.4)
	C: activities only	10					87 (6.8)
Castellanos 2009	I1: fortified breakfast and lunch menu	39	Nursing home residents (cross‐over RCT)	USA	Residential care home	23/33 finishing (70)	87.3 (8.6)
	I2: fortified lunch menu	39
	C: usual menu	39
Chang 2005	I: training in feeding skills	20	Nursing assistants and nursing home residents with dementia (cluster RCT)	Taiwan	Residential care home	‐	‐
	C: no training	16
Dennis 2005	I: nutritional supplement + normal hospital diet	2016	Participants with recent stroke (parallel RCT)	15 different countries	Hospital	945 (47)	71 (12)
	C: normal hospital diet	2007				929 (46)	71 (13)
Duncan 2006	I. dietetic assistant	153	Women > 65 years admitted with acute hip fracture (parallel RCT)	UK	Acute trauma ward	318 (100)	83.6
	C: usual care	165					83.5
Essed 2007	I1: monosodium glutamate	19	Residents of nursing home ≥ 65 years (factorial RCT)	Netherlands	Residential care home	58 (70)	84.9 (5.7)
	I2: flavour	19					85.4 (6.7)
	I3: monosodium glutamate + flavour	22					84.9 (6.2)
	C: maltodextrin	23					85.6 (8.5)
Essed 2009	I: monosodium glutamate + NaCl	53	Nursing home residents > 65 years (cross‐over RCT)	Netherlands	Residential care home	40 (76)	85.8 (6.2)
	C: usual hot meal	53
Faxen‐Irving 2011	I: 3 x 30 mL of fat emulsion daily	34	Recently admitted geriatric persons > 65 years (parallel RCT)	Sweden	Geriatric acute ward	(61)	82.7 (7.5) ‐ data from those who completed the trial only (N = 24)
	C: usual care	37				(49)	85.1 (6.7) ‐ data from those who completed the trial only (N = 27)
Gaskill 2009	I: nutrition education programme	352	Nursing home residents (cluster‐RCT)	Australia	Residential care home	245 (70)	84.2 (8.7)
	C: usual care
Germain 2006	I: re‐formed foods	8	Frail institutionalised elderly people with dysphagia (parallel RCT)	Canada	Residential care home	5 (63)	82.5 (4.4)
	C: usual diet	9				5 (56)	84.6 (3.8)
Hankey 1993	I: oral nutritional supplement	7	Frail elderly persons in continuing care (parallel RCT)	UK	Hospital	11 (79)	81 (1.6)
	C: standard hospital diet	7
Hickson 2004	I: feeding assistance	292	Acutely ill elderly inpatients (parallel RCT)	UK	Elderly medicine ward	200 (69)	82 (76 ‐ 86)
	C: usual care	300				173 (58)	82 (77 ‐ 87)
Holyday 2012	I: malnutrition care plan	71	Acutely ill elderly inpatients (parallel RCT)	Australia	Acute geriatric medicine ward	43 (61)	83.7 (6.7)
	C: usual care	72				39 (54)	83.4 (7.6)
Johanssen 2004	I: nutrition team	108	Nutritional risk score 2000 > 3 on admission to hospital (parallel RCT)	Denmark	Hospital, three different levels	54 (50)	62 (1.6)
	C: usual care	104				56 (54)	62.4 (1.7)
Kraft 2012	I: ONS + telemedicine monitoring	13	Malnourished geriatric home‐dwelling persons (parallel RCT)	Germany	Hospital discharge and tele‐medicine monitoring	7 (54)	80.7 (5.6)
	C: usual care	13				9 (69)	78.8 (8.8)
Kretser 2003	I: modified meals on wheels	102	Homebound older adults at nutritional risk (parallel RCT)	USA	Home care	70 (69)	(60‐90)
	C: traditional meals on wheels	101				74 (73)
Larsson 1990	I: ONS plus normal hospital diet	435	Older people admitted to a long‐term medical care clinic (parallel RCT)	Sweden	Hospital	Unclear ‐ varies between papers, authors to be contacted	80.1 (8.5)
	C: normal hospital diet
Leslie 2012	I: energy enriched meals	22	People living in residential care homes (cluster‐RCT)	UK	Residential care home	36 (88%)	90.9 (77‐105)
	C; usual care	19					90.3 (70‐100)
Lin 2010	I1: spaced‐retrieval	32	Residents with dementia (cluster‐RCT)	Taiwan	Residential care home	18 (56)	76.7 (6.1)
	I2: Montessori	29				12 (41)	82.9 (6.0)
	C: usual care	24				15 (63)	81.1 (7.0)
Lin 2011	I: Montessori	29	Residents with dementia (cluster RCT & cross‐over RCT)	Taiwan	Residential care home	12 (41)	82.9 (6.0)
	C: usual care
Mathey 2001a	I: improved meal ambiance	21	Nursing home residents > 65 years (cluster‐RCT)	Netherlands	Residential care home	25 (66)	82.2 (7.9)
	C: usual care	17
Mathey 2001b	I: flavour enhancement	36	Nursing home residents > 65 years (parallel RCT)	Netherlands	Residential care home	29 (74)	84.6 (6.1)
	C: usual care	31				25 (81)	83.0 (5.5)
Munk 2014	I: energy and protein enriched foods provided via a la carte menu in addition to hospital food	41 (number completing the trial)	New admissions to hospital ward (oncology, orthopaedics or urology) (parallel RCT)	Denmark	Hospital	25 (61)	75 (10
	C: usual care	40				22 (55)	74 (11)
Nijs 2006	I: family‐style meals	94	Nursing home residents (cluster‐RCT)	Netherlands	Residential care home	70 (74)	78 (11.1)
	C: usual care	84				55 (65)	75 (9.9)
Olofsson 2007	I: multi‐component intervention (including nutrition)	102	People > 70 years with femoral neck fracture (parallel RCT)	Sweden	Geriatric orthopaedic ward	62 (75)	82.1 (6.8)
	C: usual care	97				57 (77)	82.2 (5.6)
Pivi 2011	I1: nutrition education	25	Individuals > 65 years old with Alzheimer's disease (parallel RCT)	Brazil	Neurology outpatients	53 (68)	75.2
	I2: oral nutritional supplements	26
	C: usual care	27
Potter 2001	I: oral nutritional supplement + normal hospital diet	186	Unwell elderly people (parallel RCT)	Scotland, UK	Medicine for the elderly unit	140 (75)	Median 83 (61‐79)
	C: normal hospital diet	195				139 (71)
Remsburg 2001	I: buffet‐style meals	20	Nursing home residents > 65 years (parallel RCT)	USA	Residential care home	19 (95)	80 (6)
	C: usual care	20				13 (65)	80 (8)
Salva 2011	I: teaching and training	448	People with dementia (cluster RCT)	Spain	Home care	300 (67)	79.4 (7)
	C: usual care	498				344 (69)	78.6 (7.5)
Silver 2008	I: fortified home delivered lunch	‐	Adults > 60 years receiving home‐delivered lunch meals (cross‐over RCT)	USA	Home care	31(69) of those who completed the trial (N = 45)	84.4 (1) of those who completed the trial (N = 45)
	C: usual home delivered lunch
Simmons 2008	I: feeding assistance and/or snacks	35	Nursing home residents (cluster‐RCT & cross‐over RCT)	USA	Residential care home	Reported for the total group, and not the subgroup to be used in this review	Reported for the total group, and not the subgroup to be used in this review
	C: usual diet	34
Simmons 2010	I1: snacks	25	Nursing home residents (parallel RCT)	USA	Residential care home	39 (62)	86.9 (11.3)
	I2: supplements	18
	C: usual care	20
Smolliner 2008	I: fortified meals and snacks		Elderly nursing home residents (cluster RCT)	Germany	Residential care home	17 (77)	82.2 (9.5)
	C: usual diet					21 (70)	84.7 (9.5)
Splett 2003	I: medical nutrition therapy	223	Frail elderly nursing home residents (cluster‐RCT)	USA	Residential care home	143 (67)	Male 79.2 (9.7); Female 82.8 (8.7)
	C: usual care	171				125 (73)
Taylor 2006	I: 5‐meal menu	31	Elderly nursing home residents with dysphagia (cross‐over RCT)	Canada	Residential care home	26 (84)	85 (6.4)
	C: usual (3‐meal menu)
Van den Berg 2015	I1: 125 mL ONS twice daily with medication round		Patients newly admitted to medical and surgical wards (parallel RCT)	The Netherlands	Hospital	34 (52)	70.5 (15)
	I2: 62 mL ONS four times daily with medication round					37 (46)	72.6 (10)
	C: usual care (125 mL ONS offered in between meals)					34 (39)	70.4 (13)
Van Ort 1995	I: contextual and behavioural intervention	4	Nursing home residents requiring feeding assistance (parallel RCT)	USA	Residential care home	6 (75)	(65‐93)
	C: usual care	4
‐ denotes not reported C: comparator; I: intervention; ONS: oral nutritional supplement; RCT: randomised controlled trial

Appendix 5. Baseline characteristics (II)

	Intervention(s) and comparator(s)	Ethnic groups	Baseline nutritional status (N (%))	BMI (mean kg/m² (SD), range)	Duration of intervention (duration of follow‐up)	Comedications/cointerventions	Comorbidities (N or %)
Barton 2000	I1: reduced portion fortified menu	‐	‐	‐	Maximum of 56 d	‐	‐
	I2: normal menu plus cooked breakfast
	C: normal hospital menu
Beck 2002	I1: homemade oral supplement (A)	‐	Mini Nutritional Assessment score 17‐23.5 (increased risk of malnutrition)	22.8 (21.3 ‐ 26.1)	2 mo (2 mo)	‐	‐
	I2: homemade oral supplement (B)
	C: usual diet
Bouillanne 2013	I: pulse diet (78% protein at lunch)	‐	Albumin 25‐35 g/L; BMI < 22 kg/m² and/or weight loss > 10% in 6 months and/or MNA < 23.5	Median 20.7 (95% CI 20‐23.2)	6 wk (6 wk)	‐	‐
	C: usual diet (protein distributed between meals)	‐		Median 20.9 (95% CI 20‐25)
Bourdel‐Marchasson 2000	I: oral supplementation + standard diet	‐	‐	‐	15 d or until discharge (15 d or until discharge)	‐	‐
	C: standard diet
Brouillette 1991	I: osmotherapy + activities	‐	‐	‐	3 wk (4 wk)	‐	‐
	C: activities only
Castellanos 2009	I1: fortified breakfast and lunch menu	‐		‐	2 d (‐)	‐	‐
	I2: fortified lunch menu
	C: usual menu
Chang 2005	I: training in feeding skills	‐	‐	‐	Intervention: 3 hours "in‐service" within 2 days + 1 h "hands‐on" instruction (‐)	‐	‐
	C: no training
Dennis 2005	I: nutritional supplement + normal hospital diet	‐	‐	‐	Duration of hospital stay (6 mo)	‐	‐
	C: normal hospital diet
Duncan 2006	I. dietetic assistant	‐	‐	‐	Duration of hospital stay (4 mo)	‐	‐
	C: usual care
Essed 2007	I1: monosodium glutamate	‐	22 (27) at increased risk of malnutrition by MNA	‐	16 wk (16 wk)	‐	‐
	I2: flavour
	I3: monosodium glutamate + flavour
	C: maltodextrin
Essed 2009	I: monosodium glutamate + NaCl	‐	8 (15) at increased risk of malnutrition by MNA	26.5 (4.2)	4 wk (4 wk)	‐	‐
	C: usual hot meal
Faxen‐Irving 2011	I: 3 x 30 mL of fat emulsion daily	‐	‐	20.4 (3.5)	Median 8 d (median 8 d)	‐	Comorbidities related to anorexia were cancer (N = 6), liver disease (N = 1) and renal failure (N = 1) ‐ in both groups
	C: usual care			22.2 (3.7)
Gaskill 2009	I: nutrition education programme	‐	171 (49) moderately or severely malnourished by SGA	‐	6 mo (6 mo)	‐	‐
	C: usual care
Germain 2006	I: re‐formed foods	‐	17 (100) unintentional weight loss > 7.5% in previous 3 mo or BMI < 24 kg/m²	22.4 (3.9)	12 wk (12 wk)	‐	‐
	C: usual diet			21.2 (2.3)
Hankey 1993	I: ONS	‐	‐	‐	8 wk (8 wk)	‐	‐
	C: standard hospital diet
Hickson 2004	I: feeding assistance	282 (96.6) white ethnic group		21.7 (18.6‐25.3)	Duration of hospital stay (duration of hospital stay)	‐	‐
	C: usual care	286 (95.3) white ethnic group		21.8 (19.1‐25.7)
Holyday 2012	I: malnutrition care plan	‐	119 (83) malnourished or at risk of malnutrition by MNA score	23.8 (5.9)	Duration of hospital stay (duration of hospital stay)	‐	‐
	C: usual care			23.3 (5.9)
Johansen 2004	I: nutrition team	‐	212 (100) ESPEN 2002 NRS (score > 3 nutritionally at risk)	21.2 (0.5)	Duration of hospital stay (duration of hospital stay)	‐	‐
	C: usual care	‐		21.8 (0.5)
Kraft 2012	I: ONS + telemedicine monitoring	‐	26 (100) weight loss > 10% in 6 months, BMI < 21 kg/m², albumin < 35 g/L	23.4 (3.7)	6 mo (6 mo)	Number of medications: 7.5 (SD 4.2)	‐
	C: usual care			23.4 (4.5)		Number of medications: 8.2 (SD 3.4)
Kretser 2003	I: modified meals on wheels	45 (44) white	97 (96) at risk or malnourished according to MNA	14 (14%) BMI < 18.5	26 wk (26 wk)	‐	A variety of self‐reported health problems reported
	C: traditional meals on wheels	38 (58) white	95 (95) at risk or malnourished	9 (9%) BMI < 18.5
Larsson 1990	I: ONS plus normal hospital diet	‐	(28.5) malnourished	‐	26 wk (26 wk)	‐	‐
	C: normal hospital diet
Leslie 2012	I: energy enriched meals	‐	100% malnourished (BMI < 18.5 kg/m²	17.1 (1.5)	12 wk (12 wk)	‐	6 participants with dementia
	C; usual care			17.3 (1.4)
Lin 2010	I1: spaced‐retrieval	‐	‐	24.7 (4.3)	8 wk (8 wk)	‐	‐
	I2: Montessori			21.2 (3.4)
	C: usual care			23.1 (2.7)
Lin 2011	I: Montessori	‐	‐	21.4 (3.5)	8 wk (8 wk)	‐	‐
	C: usual care
Mathey 2001a	I: improved meal ambiance	‐	‐	‐	12 mo (12 mo)	‐	‐
	C: usual care
Mathey 2001b	I: flavour enhancement	‐	‐	28.4 (7.1)	16 wk (16 wk)	Number of medicines/day 2.1 (1.8)	‐
	C: usual care			28.1 (7.0)		Number of medicines/day 2.1 (1.6)
Munk 2014	I: energy and protein enriched foods provided via a la carte menu in addition to hospital food	‐	NRS score 0 = 1, 1 = 10, 2 = 18, 3 = 12	21(4)	Duration of hospital stay (duration of hospital stay)	‐	Disease severity score: 0 = 2; 1 = 30; 2 = 8; 3 = 1
	C: usual care		NRS score 0 = 0, 1 = 15, 2 = 17, 3 = 8	22(4)			Disease severity score: 0 = 3; 1 = 34; 2 = 3; 3 = 0
Nijs 2006	I: family‐style meals	‐	17 (18) MNA score < 17	28.7 (6.8)	6 mo (6 mo)	‐	CVA: 57%
	C: usual care		13 (13) MNA score < 17	28.4 (5.8)			CVA: 50%
Olofsson 2007	I: multi‐component intervention (including nutrition)	‐	48 (58 ) malnourished or at risk by MNA score	25.1 (4.1)	Duration of hospital stay (4 mo)	Staff education; team work, individual care planning; prevention and treatment of delirium and complications; nutrition; rehabilitation; secondary prevention of falls and fractures; osteoporosis prophylaxis	‐
	C: usual care		47 (57 ) malnourished or at risk by MNA score	23.3 (4.0)		‐
Pivi 2011	I1: nutrition education	‐	‐	‐	6 mo (6 mo)	‐	‐
	I2: ONS
	C: usual care
Potter 2001	I: ONS + normal hospital diet	‐	Adequately nourished: 62/186 (33); moderately malnourished: 90/186 (48); severely malnourished: 34/186 (18)	‐	Duration of hospital stay (duration of hospital stay)	‐	‐
	C: normal hospital diet		Adequately nourished: 68/195 (35); moderately malnourished: 87/195 (45); severely malnourished: 40/195 (21)
Remsburg 2001	I: buffet‐style meals	17 (85) white ethnic group	‐	24.4 (6.1)	3 mo (3 mo)	‐	CVA: 6 (30%) CVD: 13 (65%)
	C: usual care	15 (75) white ethnic group		24.3 (5.8)			CVA: 10 (50%) CVD: 12 (60%)
Salva 2011	I: teaching and training	‐	(7.8) malnourished (51.5) or at risk by MNA	26.6 (4.4)	12 mo (12 mo)	Number of comorbidities 4.6 (SD 2.2)	‐
	C: usual care		(2.8) malnourished (34.5) or at risk by MNA	27.3 (4.6)		Number of comorbidities 4.2 (SD 2.6)
Silver 2008	I: fortified home‐delivered lunch	‐	‐	24.2 (7)	7 mo (7 mo)	‐	‐
	C: usual home‐delivered lunch
Simmons 2008	I: feeding assistance and/or snacks	‐	‐	‐	2 x/d for 5 days/week and 24 wk (24 wk)	‐	‐
	C: usual diet
Simmons 2010	I1: snacks	‐	‐	‐	6 wk (6 wk)	‐	‐
	I2: supplements
	C: usual care
Smolliner 2008	I: fortified meals and snacks	‐	22 (100) by MNA score indicating at risk or malnourished	21.6 (3.6)	12 wk (12 wk)	Number of prescriptions median 4 (IQR 2‐6.5)	GDS: 6.7 (SD 2.9)
	C: usual diet		30 (100) by Mini Nutritional Assessment score indicating at risk or malnourished	22.5 (3.4)		Number of prescriptions median 6 (IQR 3.8‐7)	GDS: 7.5 (SD 3)
Splett 2003	I: medical nutrition therapy	‐	‐	‐	19‐180 d (19‐180 d)	‐	Dementia: 24% congestive heart failure: 25% depression: 19% Alzheimer’s disease: 14% bone/hip fracture: 15% chronic obstructive: 10% pulmonary disease cancer: 5% pneumonia: 4% dehydration: 1%
	C: usual care						Dementia: 34% congestive heart failure: 26% depression: 32% Alzheimer’s disease: 21% bone/hip fracture: 19% chronic obstructive: 17% pulmonary disease cancer: 12% pneumonia: 6% dehydration: 4%
Taylor 2006	I: 5‐meal menu	‐	31 (100) mean MNA score 16.3	20.4 (3.4)	2 x 4 d, separated by 4 wk) (2 x 4 d, separated by 4 wk)	‐	‐
	C: usual (3‐meal menu)
Van den Berg 2015	I1: 125 mL ONS twice daily with medication round	‐	SNAQ score 1 or 2 = 6, 3 = 13, 4 or 5= 6, 6 or 7 = 41	25 (4.3)	median 5 (range 1‐17)	‐	‐
	I2: 62 mL ONS four times‐ daily with medication round		SNAQ score 1 or 2 = 6, 3 = 13, 4 or 5= 12, 6 or 7 = 49	23.8 (3.9)	median 5 (range 1‐15)	‐	‐
	C: usual care (125 mL ONS offered in between meals)		SNAQ score 1 or 2 = 5, 3 = 13, 4 or 5 = 18, 6 or 7 = 52	24.3 (4.7)	median 6 (range 1‐30)	‐	‐
Van Ort 1995	I: contextual and behavioural intervention	‐	‐	‐	2 wk (6 wk, 1 mo after intervention)	‐	‐
	C: usual care
'‐' denotes not reported BMI: body mass index; C: comparator; CI: confidence interval; CVA: cerebrovascular accident; CVD: cardiovascular diagnosis; d: days; GDS: geriatric depression scale; I: intervention; IQR: interquartile range; mo: month(s); MNA: mini nutritional assessment; NRS: nutritional risk score; ONS: oral nutritional supplement; SD: standard deviation; SGA: subjective global assessment; SNAQ: Simplified Nutritional Appetite Questionnaire; wk: week(s)

Appendix 6. Matrix of study endpoints (publications and trial documents)

	Endpoints quoted in trial document(s) (ClinicalTrials.gov, FDA/EMA document, manufacturer's website, published design paper)^a	Trial results/ publications available in trials register	Endpoints quoted in publication(s)^b,c	Endpoints quoted in abstract of publication(s)^b,c
Bouillanne 2013	Source:NCT00135590 Primary outcome measure(s): lean mass (dual energy X‐ray absorptiometry (dexa) and bioelectrical‐impedance analysis (bia)) ‐ time frame: 42 days	No/Yes (last verified: November 2004)	Primary outcome measure(s): lean mass (total lean soft‐tissue mass (LM) index, appendicular muscle mass (ASMM) index or body cell mass (BCM) index, which is the metabolically active compartment))	Primary outcome measure(s): body composition ((lean mass (LM), appendicular skeletal muscle mass (ASMM), and body cell mass (BCM) indices, measured by X‐ray absorptiometry combined with bioelectrical impedance analysis)
	Secondary outcome measure(s): immune functions ‐ time frame: 42 days hand‐grip strength ‐ time frame: 42 days biological nutritional parameters ‐ time frame: 42 days mortality and morbidity (infections and bedsores) ‐ time frame: 42 days ADL ‐ time frame: 42 days plasmatic amino acid levels ‐ time frame: 42 days		Secondary outcome measure(s): hand grip strength ADL score	Secondary outcome measure(s): hand grip strength ADL score
	Other outcome measure(s): ‐		Other outcome measure(s): albumin transthyretin C‐reactive protein prognostic inflammatory and nutritional index (PINI)	Other outcome measure(s): ‐
	History of changes: 6 documented changes
Faxen‐Irving 2011	Source:NCT01042340 Primary outcome measure(s): to detect a significant difference in energy intake of 48 kj/200 kcal between the groups at 5% significance level and with 80% power ‐ time frame: 5 days to 3 weeks intervention	No/Yes (last verified: December 2009)	Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
	Secondary outcome measure(s): effects on serum lipids and appetite ‐ time frame: 5 days to 3 weeks treatment		Secondary outcome measure(s): acceptance and compliance of the concept by the participants at the ward	Secondary outcome measure(s): ‐
	Other outcome measure(s): ‐		Other outcome measure(s): sample size calculation was performed: to detect a significant difference in energy intake of 200 kcal between the groups at 5% significance level and with 80% power, 27 participants in each group were needed. To allow for dropouts this was increased to 35 participants in each group nutritional assessment, by the Nutritional Risk Screening (NRS‐2002) form: evaluation of BMI, weight loss, reduced dietary intake, age 70 and presence of severe illness and a sum score (0‐7 points) was calculated biochemical indicators of nutritional status serum levels of albumin, transthyretin and insulin‐like growth factor‐1 (IGF‐1) C‐reactive protein (CRP) total cholesterol, high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL) cholesterol, fasting serum triglyceride concentrations fatty acid (FA) profiles were measured in serum phospholipids function as determined by ADL according to the Katz ADL index	Other outcome measure(s): food intake and self‐rated appetite Nutritional risk screening (NRS) 2000 serum lipids and fatty acid profiles
	History of changes: 1 documented change
Holyday 2012	Source:NCT01179321 Primary outcome measure(s): length of stay	No/No (last verified: March 2006)	Primary outcome measure(s): ‐	Primary outcome measure(s): ‐
	Secondary outcome measure(s): ‐		Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
	Other outcome measure(s): ‐		Other outcome measure(s): pre‐study power analysis based on the average length of stay (LOS) of the trial population (11 d) with 0.80 power using a test with significance of 0.05, would require at least 50 participants in each group to detect a reduction in LOS of 20% the number of participants seen by a clinical dietitian, number of consults per participant and total consultation time per participant was captured from the hospital’s computerised dietitians’ statistics system timeliness of intervention was counted as days between date of admission to the ward and the date seen by the clinical dietitian weight change over the course of admission was calculated from the weight on admission and the weight at discharge deaths during admission number of presentations to emergency and number of hospital readmissions cost of hospital admission, additional costs of a screening and nutritional intervention programme	Other outcome measure(s): length of stay LOS) weight change frequency of readmission to hospital
	History of changes: 0 documented changes
Munk 2014	Source:NCT01415635 Primary outcome measure(s): Percentage of participants reaching > 75% of their calculated energy and protein requirements	No/No (last verified: December 2012)	Primary outcome measure(s): Percentage of participants reaching > 75% of their calculated energy and protein requirements	Primary outcome measure(s): Percentage of participants reaching > 75% of their calculated energy and protein requirements
	Secondary outcome measure(s): handgrip strength daily energy and protein intake use of tube feeding use of parenteral nutrition length of stay		Secondary outcome measure(s): Mean daily energy and protein intake body weight handgrip strength Length of stay number of participants receiving enteral or parenteral feeding	Secondary outcome measure(s): Mean daily energy and protein intake body weight handgrip strength Length of stay
	Other outcome measure(s): none provided		Other outcome measure(s): number of participants receiving ONS	Other outcome measure(s): ‐
	History of changes: 1 documented change
Nijs 2006	Source:NCT00114582 Primary outcome measure: nutritional status, quality of life, physical performance	No/Yes (last verified: February 2009)	Primary outcome measure(s): quality of life	Primary outcome measure(s): ‐
	Secondary outcome measure(s): ‐		Secondary outcome measure(s): ‐	Secondary outcome measure(s): ‐
	Other outcome measure(s): ‐		Other outcome measure(s): physical performance body weight energy intake	Other outcome measure(s): quality of life (perceived safety; autonomy; and sensory, physical, and psychosocial functioning) gross and fine motor function body weight
	History of changes: 4 documented changes
Salva 2011	Source:NCT00479843 Primary outcome measure(s): evaluation of the effectiveness of the intervention ‐ the main evaluation criteria which would allow the effectiveness of this intervention to be evaluated were the reduction in the loss of autonomy measured by the ADL/iADL scale ‐ time frame: baseline, 6 months, 12 months	No/Yes (last verified: January 2014)	Primary outcome measure(s): ‐	Primary outcome measure(s): main outcome measure was the reduction in the loss of autonomy ((ADL/IADL) scales) assessed at 6 and 12 months
	Secondary outcome measure(s): improvement in the participant's state of nutrition ‐ reducing the burden on carers with the Zarit scale evaluation of the use of healthcare and social resources with the RUD scale improvement of medical practice regarding nutrition (time frame: baseline, 6 months, 12 months)		Secondary outcome measure(s): improvement in nutritional state of the participant evaluated by their change in weight, BMI and MNA reduction in burden on caregiver (ZARIT scale) reduction in the use of healthcare and social resources (RUD scale)	Secondary outcome measure(s): improvement in nutritional status (Mini Nutritional Assessment (MNA), BMI, and weight changes) caregiver burden (Zarit scale)
	Other outcome measure(s): ‐		Other outcome measure(s): our primary hypothesis was that participants in the intervention group would achieve a lower level of dependency compared with participants in the usual care‐control group at 12 months. We considered a significant benefit in the intervention group to be a reduction of 30% in the proportion of participants who lost more than 0.5 points according to the ADL score (loss of autonomy) over one year	Other outcome measure(s)‐
	History of changes: 2 documented changes
Van den Berg 2015	Source:NTR2535 Primary outcome measure(s): proportion of participants who received their treatment goal. The treatment goal was to receive at least 75% of the prescribed volume of ONS during admission	No (last verified 19 Nov 2010)	Primary outcome measure(s):the percentage of participants who reached the treatment objective of at least 75% of the prescribed volume of ONS during admission	Primary outcome measure(s): The percentage of participants who consumed at least 75% of the prescribed volume of ONS
	Secondary outcome measure(s): intake (mL of ONS) (nurses and food assistants read the amount of ONS left in the bottle)		Secondary outcome measure(s): Mean intake of ONS per day in mL and energy and protein	Not stated
	Other outcome measure(s):‐		Other outcome measure(s): length of hospital stay, hospital readmissions, time to intervention, duration of intervention, mortality	Median time of taking ONS
	History of changes: No documented changes
'‐' denotes not reported ^aTrial document(s) refers to all available information from published design papers and sources other than regular publications (e.g. FDA/EMA documents, manufacturer's websites, trials registers) ^bPublication(s) refers to trial information published in scientific journals (primary reference, duplicate publications, companion documents or multiple reports of a primary trial) ^cOther outcome measures refer to all outcomes not specified as primary or secondary outcome measures ADL: activities of daily living; BMI: body mass index; EMA: European Medicines Agency; FDA: Food and Drug Administration (US); mo: month(s); N/A: not applicable; N/T: no trial document available; yr: year(s); wk: week(s); ONS oral nutritional supplement

Appendix 7. High risk of outcome reporting bias according to ORBIT classification

	Outcome	High risk of bias (category A)^a	High risk of bias (category D)^b	High risk of bias (category E)^c	High risk of bias (category G)^d
Barton 2000	Energy intake	Yes
	Food wastage	Yes
	Protein intake	Yes
Beck 2002	N/D
Bouillanne 2013	N/D
Bourdel‐Marchasson 2000	Energy intake	Yes
	Incidence of death	Yes
	Pressure ulcer developments			Yes (40% in intervention group, 48% in control; no further analysis)
Castellanos 2009	3 meal energy intake		Yes
Castellanos 2009	3 meal protein intake		Yes
Chang 2005	N/D
Dennis 2005	Death or poor outcome	Yes
	Death	Yes
	Complications: pneumonia, UTI, pressure sores	Yes
	Length of stay	Yes
	Discharge destination	Yes
	EUROQoL	Yes
Duncan 2006	N/D
Essed 2007	Pleasantness	Yes
	Olfactory sensitivity		Yes (analysed but reported as correlation with energy intake)
	Appetite, hunger and sensory perception	Yes
	GDS		Yes
Essed 2009	N/D
FaYesen‐Irving 2011	Energy intake	Yes
	Body mass index	Yes
	Activities of Daily Living	Yes
	Length of stay	Yes
	Appetite
	Fatty acid profiles (myristic acid, margarinic acid, stearic acid, oleic acid, alpha‐linoleic acid, eicosapentaenoic acid)	Yes
	Pentadecanoic acid			Yes
Gaskill 2009	Subjective global assessment		Yes
Germain 2006	N/D
Hankey 1993	Anthropometry: TSF, MAC weight	Yes
	Serum albumin	Yes
	Fiber intake	Yes
Hickson 2004	Serum albumin	Yes
	Barthel score	Yes
	Cognition and depression score (BASDEC)			Yes
	Pressure sore incidence				Yes
	Laxative use				Yes
	Artificial nutrition use				Yes
	Economic analysis				Yes
	Dietary intake
	In‐hospital mortality
	Grip strength
Holyday 2012	N/D
Johansen 2004	N/D
Kraft 2012	N/D
Kretser 2003	Satisfaction with programme			Yes
Larsson 1990	Nutritional assessment (TSF, MAC)	Yes
	Serum protein analysis	Yes
	Acute phase reactants (antitrypsin, orosomucoid)	Yes
	Length of stay		Yes
Leslie 2012	N/D
Lin 2010	Eating time		Yes
Lin 2011	N/D
Mathey 2001a	Health‐related quality of life	Yes (P < 0.05 stated for intervention but no P value for control)
Mathey 2001a	Philadelphia Geriatric Center Morale Scale		Yes (no P values reported)
Mathey 2001b	N/D
Munk 2014	N/D
Nijs 2006	N/D
Olofsson 2007	N/D
Pivi 2011	N/D
Potter 2001	Anthropometry: TSF, BMI		Yes
	Arm muscle circumference	Yes
	Mortality	Yes (significant result when severely undernourished analysed in isolation)
	Functional recovery (Barthel ADL index)	Yes (significant result when severely undernourished analysed in isolation)
	Discharge placement	Yes
	Length of hospital stay	Yes
Remsburg 2001	N/D
Salva 2012	Health and social care costs (Resource Utilisation in Dementia (RUD) scale)		Yes
Silver 2008	Confounding effect of age, sex and BMI on meal treatment order, total energy, energy density and macronutrients	Yes
Simmons 2008	N/D
Simmons 2010	Weight	Yes
Smolliner 2008	N/D
Splett 2003	N/D
Taylor 2006	N/D
Van den Berg 2015	N/D
Van Ort 1995	Nutritional status (weight change)			Yes
	Feeding related interpersonal contact between residents and feeder			Yes
	Functional ability of subject, and level of assistance offered by feeder			Yes
^aClear that outcome was measured and analysed; trial report states that outcome was analysed but only reports that result was not significant (Classification 'A', table 2, Kirkham 2010) ^bClear that outcome was measured and analysed; trial report states that outcome was analysed but no results reported (Classification 'D', table 2, Kirkham 2010) ^cClear that outcome was measured; clear that outcome was measured but not necessarily analysed; judgement says likely to have been analysed but not reported because of non‐significant results (Classification 'E', table 2, Kirkham 2010) ^dUnclear whether the outcome was measured; not mentioned but clinical judgement says likely to have been measured and analysed but not reported on the basis of non‐significant results (Classification 'G', table 2, Kirkham 2010) ADL: activities of daily living; BMI: body mass index; EuroQol: European Quality of Life Scale; GDS: geriatric depression scale; mo: months; N/D: none detected; ORBIT: Outcome Reporting Bias In Trials; TSF: triceps skinfold thickness

Appendix 8. Definition of endpoint measurement (I)

	Nutritional intake	Health‐related quality of life/patient satisfaction	Mortality	Morbidity/complications	Nutritional status
Barton 2000	Energy intake (kcal), protein intake (g), food wastage (%)	‐	‐	‐	‐
Beck 2002	Energy intake (MJ)	‐	‐	‐	Weight (kg)
Bouillanne 2013	‐	‐	Yes	Infections	Body composition
Bourdel‐Marchasson 2000	Energy intake (kcal), protein intake (g)	‐	Yes	‐	‐
Brouillette 1991	Energy intake (kcal), % food consumed	‐	Yes	‐	‐
Castellanos 2009	Energy intake (kcal), protein intake (g)	‐		‐	‐
Chang 2005	% meal eaten	‐	‐	‐	‐
Dennis 2005	‐	Quality of life (EUROQoL)	Yes	Incidence of pneumonia, UTI and pressure sores	‐
Duncan 2006	Dietary intake records on day 3‐6	‐	‐	Records of medical and surgical complications	Weight, MAMC, TSF, HGS
Essed 2007	Energy intake (kJ), protein, fat and CHO (g)	‐	‐	‐	Weight (kg), BMI, body composition
Essed 2009	Energy intake (kJ)	‐	‐	‐	‐
Faxen‐Irving 2011	Energy intake (kcal/kg body weight/day)	‐	Yes	‐	Weight, appetite, BMI
Gaskill 2009	SGA	‐	‐	‐	‐
Germain 2006	Dietary intake, energy (kcal), other nutrients (g/mg)	‐	Yes	‐	Weight, BMI
Hankey 1993	Energy intake (kj/24hours), protein intake (g/24hours)	‐	‐	‐	Weight, TSF, MAC, AMC, serum albumin
Hickson 2004	Energy intake (J), protein (g)	EQ‐5D	Yes	Antibiotics prescribed (N), days on antibiotics	Weight, BMI, MAC, TSF, MAMC,
Holyday 2012	‐	‐	Yes	‐	Weight
Johansen 2004	Energy intake (kJ/kg and % requirements), protein intake (g/kg and % requirements)	SF‐36	Yes	Infectious and other complications graded into major and minor (using Buzby et al 1988 and CDC definitions)	Weight change (kg)
Kraft 2012	_	‐	‐	‐	Weight change (kg)
Kretser 2003	‐	‐	Yes	‐	Weight, weight change (lb)
Larsson 1990	Encompassed in the Modified Norton Scale	‐	Yes	‐	Weight index, TSF, MAC, AMC
Leslie 2012	Dietary intake, 3 day weighed records	‐	Yes	‐	Weight change, change in BMI & MUAC
Lin 2010	Eating amount (unit unclear)	‐	No	‐	MNA and BMI
Lin 2011	‐	‐	No	‐	MNA and BMI
Mathey 2001a	Macro‐ and micronutrient intakes	SIP, PGCMS	Yes	No	Weight
Mathey 2001b	Energy intake	_	No	no	Weight
Munk 2014	Percent of participants meeting > 75% of their energy and protein requirements. Mean daily energy and protein intake	‐	Yes	‐	Weight
Nijs 2006	Energy intake (kcal), macronutrient (g)	Dutch QOL nursing home residents questionnaire	Yes	‐	Weight (kg, calf circumference (cm), MAC (cm), MNA score
Olofsson 2007	‐	‐	Yes	Infectious and non‐infectious complications during hospital stay	Weight, BMI, MNA
Pivi 2011	‐	‐	Yes	‐	Weight, BMI, MAC, MAMC, TSF
Potter 2001	Total energy intake (kcal)	‐	Yes	‐	Weight, AMC, TSF, BMI
Remsburg 2001	‐	‐	Yes	‐	Weight (kg)
Salva 2011	‐	‐	Yes	‐	Weight (kg), BMI, MNA
Silver 2008	Total energy (kcal), energy density (kcal/g), macronutrient's (g), micronutrients	‐	‐	‐	‐
Simmons 2008	Total energy (kcal)	‐	‐	‐	Weight (lb), BMI
Simmons 2010	Energy intake (kcal)	‐	Yes	‐	Weight (lb)
Smolliner 2008	Energy (kcal and kcal/kg body weight), protein (g and g/kg body weight)	‐	Yes	‐	Weight, BMI, MNA score, fat‐free mass
Splett 2003	‐	‐	Yes	‐	Weight
Taylor 2006	Energy intake (kcal/day), fluid intake (mL/day)	‐	‐	‐	‐
Van den Berg 2015	Energy intake from ONS (kcal/day)	‐	Yes
Van Ort	‐	‐	‐	‐	Weight
ADL: activities of daily living; AMC: arm muscle circumference; BMI: body mass index; CDC: Centre for Disease Control; CDR: clinical dementia rating scale; CHO: carbohydrate; d: day; EQ‐5D/EuroQol: European Quality of Life Scale; HGS: handgrip strength; iADL: instrumental Activities of Daily Living; MAC: mid‐arm circumference; MAMC: mid‐arm muscle circumference; MJ: mega joules; MMSE: Mini Mental State Examination; MNA: Mini Nutritional Assessment; NPIQ: Neuropyschiatric Inventory Question; PGCMS: Philadelphia Geriatric Centre Morale Scale; QOL: quality of life; RUD: reduction in use of health and social care scale; SF‐36: Short Form ‐ 36; SGA: subjective global assessment; SIP: sickness impact profile; TSF: triceps skinfold thickness

Appendix 9. Definition of endpoint measurement (II)

	Functional status	Clinical function	Hospitalisation/ institutionalisation	Severe/serious adverse events	Economic costs
Barton 2000	‐	‐	‐	‐	‐
Beck 2002	‐	‐	‐	‐	‐
Bouillanne 2013	Handgrip strength, ADL score	Biochemical data	‐	‐	‐
Bourdel‐Marchasson 2000	‐	Pressure ulcer development	‐	‐	‐
Brouillette 1991	‐	‐	‐	‐	‐
Castellanos 2009		‐	‐	‐	‐
Chang 2005	‐	‐	‐	‐	‐
Dennis 2005	‐	‐	Discharge destination	‐	‐
Duncan 2006	‐	‐	Length of stay in acute unit and in hospital (days)	‐	‐
Essed 2007	‐	‐	‐	‐	‐
Essed 2009	‐	‐	‐	‐	‐
Faxen‐Irving 2011	‐	Serum/plasma proteins, serum lipids, fatty acid profiles, ADLs	Length of stay	‐	‐
Gaskill 2009	‐	‐	‐	‐	‐
Germain 2006	‐	‐	‐	‐	‐
Hankey 1993	‐	‐	‐	‐	‐
Hickson 2004	Grip strength	‐	Length of stay (d), volume of fluids given	‐	‐
Holyday 2012	‐	‐	Length of stay, readmissions	Estimated
Johansen 2004	‐	‐	Length of stay (LOS₂₈) = LOS from admission to inclusion + LOS from inclusion to discharge (maximum 28 days) LOS _NDI = LOS 28 ‐ number of final days with NDI = 3) NDI = index of mobility, infections and complications	‐	‐
Kraft 2012	‐	‐	‐	‐	‐
Kretser 2003	iADL, ADL, dependence	‐	‐	‐	‐
Larsson 1990	Encompassed in the Modified Norton Scale	‐	‐	‐	‐
Leslie 2012	‐	‐	Yes	‐	‐
Lin 2010	Eating function (need for verbal and/or physical assistance or feeding + eating time)	‐	‐	‐	‐
Lin 2011	Eating function (need for verbal and/or physical assistance or feeding + eating time)	‐	‐	‐	‐
Mathey 2001a	‐	Biochemical data	_	_	_
Mathey 2001b	Hunger, appetite and sensory perception	‐	‐	‐	‐
Munk 2014	Handgrip strength		Length of hospital stay	‐	‐
Nijs 2006	Motor function (nursing home physical performance test)	‐	‐	‐	‐
Olofsson 2007	‐	‐	Length of hospital stay	‐	‐
Pivi 2011	‐	Biochemical data	‐	‐	‐
Potter 2001	Functional recovery (20‐point Barthel ADL index)	‐	Length of hospital stay, discharge placement	‐	‐
Remsburg 2001	‐	Biochemical status	‐	‐	‐
Salva 2011	ADL, iADL scores	MMSE, CDR, NPIQ	‐	‐	RUD score
Silver 2008	‐	‐	‐	‐	‐
Simmons 2008	‐	‐	‐	‐	‐
Simmons 2010	‐	‐	‐	‐	Cost‐effectiveness
Smolliner 2008	Handgrip strength, peak flow, Barthel score, SF‐36 (physical function only)	‐	‐	‐	‐
Splett 2003	‐	‐	Hospital admissions	‐	‐
Taylor 2006	‐	‐	‐	‐	‐
Van den Berg 2015			Length of stay	Stated as none but not defined	‐
Van Ort	Functional ability of participant	‐	‐	‐	‐
ADL: activities of daily living; AMC: arm muscle circumference; BMI: body mass index; CDC: Centre for Disease Control; CDR: clinical dementia rating scale; CHO: carbohydrate; d: day; EQ‐5D/EuroQol: European Quality of Life Scale; HGS: handgrip strength; iADL: instrumental Activities of Daily Living; MAC: mid‐arm circumference; MAMC: mid‐arm muscle circumference; MJ: mega joules; MMSE: Mini Mental State Examination; MNA: Mini Nutritional Assessment; NPIQ: Neuropyschiatric Inventory Question; PGCMS: Philadelphia Geriatric Centre Morale Scale; QOL: quality of life; RUD: reduction in use of health and social care scale; SF‐36: Short Form ‐ 36; SGA: subjective global assessment; SIP: sickness impact profile; TSF: triceps skinfold thickness

Appendix 10. Adverse events

	Intervention(s) and comparator(s)	Deaths (N/N (%))	Participants with adverse events (N/N (%))	Participants with severe/serious adverse events (N/N (%))	Participants discontinuing trial due to adverse event (N/N (%))
Barton 2000	I1: reduced portion fortified menu	‐	‐	‐	‐
	I2: normal menu plus cooked breakfast	‐	‐	‐
	C: normal hospital menu	‐	‐	‐	‐
Beck 2002	I1: homemade oral supplement (A)	‐	‐	‐	‐
	I2: homemade oral supplement (B)
	C: usual diet	‐	‐	‐	‐
Bouillanne 2013	I: pulse diet (78% protein at lunch)	1/30 (3.3)	‐	‐	‐
Bouillanne 2013	C: usual diet (protein distributed between meals)	1/36 (2.8)	‐	‐	‐
Bourdel‐Marchasson 2000	I: oral supplementation + standard diet	25/295 (8.5)	‐	‐	‐
Bourdel‐Marchasson 2000	C: standard diet	22/377 (5.8)	‐	‐	‐
Brouillette 1991	I: osmotherapy + activities	1/10 (10)	‐	‐	‐
Brouillette 1991	C: activities only	0/10 (0)	‐	‐	‐
Castellanos 2009	I1: fortified breakfast and lunch menu	‐	‐	‐	‐
	I2: fortified lunch menu	‐	‐	‐	‐
	C: usual menu	‐	‐		‐
Chang 2005	I: training in feeding skills	‐	‐	‐	‐
Chang 2005	C: no training	‐	‐	‐	‐
Dennis 2005	I: nutritional supplement + normal hospital diet	241/2016 (12)	138/4023 (3.4)	‐	‐
Dennis 2005	C: normal hospital diet	253/2007 (12.6)	138/4023 (3.4)	‐	‐
Duncan 2006	I. dietetic assistant	19/145 (13.1)	‐	‐	‐
Duncan 2006	C: usual care	36/157 (22.9)	‐	‐	‐
Essed 2007	I1: monosodium glutamate	‐	‐	‐	‐
	I2: flavour	‐	‐	‐	‐
	I3: monosodium glutamate + flavour	‐	‐	‐	‐
	C: maltodextrin	‐	‐	‐	‐
Essed 2009	I: monosodium glutamate + NaCl	‐	‐	‐	‐
Essed 2009	C: usual hot meal	‐	‐	‐	‐
Faxen‐Irving 2011	I: 3 x 30 mL of fat emulsion daily	‐	5/34 (14.7)	‐	5/34 (14.7)
Faxen‐Irving 2011	C: usual care	2/37 (5.4)	‐	‐	‐
Gaskill 2009	I: nutrition education programme	‐	‐	‐	‐
Gaskill 2009	C: usual care	‐	‐	‐	‐
Germain 2006	I: re‐formed foods	‐	‐	‐	‐
Germain 2006	C: usual diet	‐	‐	‐	‐
Hankey 1993	I: oral nutritional supplement	‐	3/10 (30)	‐	‐
Hankey 1993	C: standard hospital diet	‐	3/10 (30)	‐	‐
Hickson 2004	I: feeding assistance	31/292 (10.6)	‐	‐
Hickson 2004	C: usual care	35/300 (11.7)	‐	‐	‐
Holyday 2012	I: malnutrition care plan	1/72 (1.4)	‐	‐	‐
Holyday 2012	C: usual care	4/72 (5.6)	‐	‐	‐
Johansen 2004	I: nutrition team	‐	‐	‐	‐
Johansen 2004	C: usual care	‐	‐	‐	‐
Kraft 2012	I: oral nutritional supplement + telemedicine monitoring	‐	‐	‐	2/13 (15.4)
Kraft 2012	C: usual care	‐	‐	‐	‐
Kretser 2003	I: modified meals on wheels	3/102 (2.9)	‐	‐	‐
Kretser 2003	C: traditional meals on wheels	9/101 (8.9)	‐	‐	‐
Larsson 1990	I: oral nutritional supplement plus normal hospital diet	29/197 (14.7)	‐	‐	‐
Larsson 1990	C: normal hospital diet	56/238 (23.5)	‐	‐	‐
Leslie 2012	I: energy enriched meals	2/19 (10.5)	‐	‐
Leslie 2012	C: usual care	5/22 (22.7)	‐	‐	‐
Lin 2010	I1: spaced‐retrieval	‐	‐	‐	‐
	I2: Montessori	‐	‐	‐	‐
	C: usual care	‐	‐	‐	‐
Lin 2011	I: Montessori	‐	‐	‐	‐
Lin 2011	C: usual care	‐	‐	‐	‐
Mathey 2001a	I: improved meal ambiance	7/21 (33.3)	‐	‐	‐
Mathey 2001a	C: usual care	5/17 (29.4)	‐	‐	‐
Mathey 2001b	I: flavour enhancement	‐	‐	‐	‐
Mathey 2001b	C: usual care	‐	‐	‐	‐
Munk 2014	I: energy and protein enriched foods provided via a la carte menu in addition to hospital food	1/44 (2.2)	‐
Munk 2014	C: usual care	1/40 (2.5)	‐
Nijs 2006	I: family‐style meals	18/112 (16.1)		‐	‐
Nijs 2006	C: usual care	16/133 (12.0)	‐	‐	‐
Olofsson 2007	I: multi‐component intervention (including nutrition)	9/102 (8.8)	‐	‐	‐
Olofsson 2007	C: usual care	13/97 (13.4)	‐	‐	‐
Pivi 2011	I1: nutrition education	‐	‐	‐	‐
	I2: oral nutritional supplements	‐	‐	‐	‐
	C: usual care	‐	‐	‐	‐
Potter 2001	I: oral nutritional supplement + normal hospital diet	21/186 (11.3)	Reported "no serious adverse events"	‐	‐
Potter 2001	C: normal hospital diet	33/195 (16.9)	Reported "no serious adverse events"	‐	‐
Remsburg 2001	I: buffet‐style meals	‐	‐	‐	‐
Remsburg 2001	C: usual care	‐	‐	‐	‐
Salva 2011	I: teaching and training	43/448 (9.6)	‐	‐	‐
Salva 2011	C: usual care	29/498 (5.8)	‐	‐	‐
Silver 2008	I: fortified home‐delivered lunch	‐	‐	‐	‐
Silver 2008	C: usual home‐delivered lunch	‐		‐	‐
Simmons 2008	I: feeding assistance and/or snacks	‐	‐	‐	‐
Simmons 2008	C: usual diet	‐	‐	‐	‐
Simmons 2010	I1: snacks	‐	‐	‐	‐
	I2: supplements	‐	‐	‐	‐
	C: usual care	‐	‐	‐	‐
Smolliner 2008	I: fortified meals and snacks	2/31 (6.5)	‐	‐	‐
Smolliner 2008	C: usual diet	1/34 (2.9)	‐	‐	‐
Splett 2003	I: medical nutrition therapy	‐	‐	‐	‐
Splett 2003	C: usual care	‐	‐	‐	‐
Taylor 2006	I: 5‐meal menu	‐	‐	‐	‐
Taylor 2006	C: usual (3‐meal menu)	‐	‐	‐	‐
V an den Berg 2015	I1: 125 mL ONS twice daily with medication round	1/66 (1.5)	Reported "no serious adverse events"		11/88 (12.5) (refused further ONS)
	I2: 62 mL ONS four times daily with medication round	2/80 (2.5)	Reported "no serious adverse events"		9/66 (13.6) (refused further ONS)
	C: usual care (125 mL ONS offered in between meals)	4/88 (4.5)			11/80 (13.8) (refused further ONS)
Van Ort 1995	I: contextual and behavioural intervention	‐	‐	‐	‐
Van Ort 1995	C: usual care	‐	‐	‐	‐
C: comparator, I: intervention; ONS: oral nutritional supplement

Appendix 11. Survey of authors' providing information on trials

	Trial author contacted	Trial author replied	Trial author provided data	Comments
Barton 2000	Yes	Yes	Yes	Additional data not used
Beck 2002	Yes	Yes	Yes	Additional data not used
Bourdel‐Marchasson 2000	Yes	Yes	Yes	Not used, and unable to provide data requested on weight
Bouillanne 2013	Yes	Yes	Yes	Data received on weight and energy intake
Brouillette 1991	No	N/A	N/A
Castellanos 2009	Yes	No	N/A
Chang 2005	Yes	No	N/A
Dennis 2005	Yes	Yes	Yes	Information used on complication rates
Duncan 2006	Yes	Yes	Yes	Awaiting data on length of stay
Essed 2007	Yes	No	N/A
Essed 2009	Yes	No	N/A
Faxen‐Irving 2011	Yes	Yes	Yes	Data on energy intake, length of stay, BMI and ADLs provided. No data available on infections
Gaskill 2009	Yes	Yes	No	Assume unable to provide data
Germain 2006	Yes	Yes	Yes	Data provided for BMI mean and SD of change
Hankey 1993	Yes	No	N/A
Hickson 2004	Yes	Yes	Yes	Author unable to provide this data on energy intake and hospital readmission as it was not measured, therefore not usable. Data provided on complications as requested
Holyday 2012	Yes	Yes	Yes	Data obtained and used for hospital readmission rates
Johansen 2004	Yes	No	N/A	Data not used
Kraft 2012	Yes	No	N/A
Kretser 2003	No	N/A	N/A	Unable to find contact for author
Larsson 1990	Yes	No	N/A	Data not used
Lin 2010	Yes	No	N/A
Lin 2011	No	N/A	N/A
Mathey 2001a	Yes	No	N/A
Mathey 2001b	Yes	No	N/A
Nijs 2006	No	N/A	N/A
Olofsson 2007	Yes	Yes	Yes	Data used for BMI, weight and complications
Pivi 2011	Yes	No	N/A
Potter 2001	Yes	No	N/A
Remsburg 2001	No	N/A	N/A
Salva 2011	Yes	No	N/A
Silver 2008	No	N/A	N/A
Simmons 2008	Yes	Yes	No	Data not available
Simmons 2010	Yes	Yes	No	Data not available
Smolliner 2008	Yes	Yes	Yes	Data provided for mean and SD of change for weight, BMI, handgrip, and QoL
Splett 2003	Yes	No	N/A
Taylor 2006	No	N/A	N/A
Van Ort 1995	Yes	No	N/A
Leslie 2012	No	N/A	N/A
Munk 2014	No	N/A	N/A
V an den Berg 2015	Yes	Yes	Yes	The clinical trial register number did not allow the trial to be identified within the register. The authors provided a link to the trial protocol via the WHO International Clinical Trials Registry Platform.
ADL: activities of daily living; BMI: body mass index; N/A: not applicable; QoL: (health‐related) quality of life; SD: standard deviation: WHO World Health Organisation

Appendix 12. Checklist to aid consistency and reproducibility of GRADE assessments

		(1) All‐cause mortality	(2) Morbidity/complications: number of participants with complications (any/pressure ulcers/needing oral antibiotics)	(3) Health‐related quality of life and patient satisfaction	(4) Hospitalisation and institutionalisation	(5) Adverse events	(6) Nutritional status (weight change)	(7) Economic costs
Trial limitations (risk of bias)^a	Was random sequence generation used (i.e. no potential for selection bias)?	Unclear	Unclear	Unclear	Yes	Unclear	Unclear	Unclear
	Was allocation concealment used (i.e. no potential for selection bias)?	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear
	Was there blinding of participants and personnel (i.e. no potential for performance bias) or outcome not likely to be influenced by lack of blinding?	Unclear	Unclear	Unclear	No (↓)	Unclear	Unclear	No (↓)
	Was there blinding of outcome assessment (i.e. no potential for detection bias) or was outcome measurement not likely to be influenced by lack of blinding?	Unclear	Unclear	No (↓)	Unclear	No (↓)	Unclear	No (↓)
	Was an objective outcome used?	Yes	No (↓)	No (↓)	Yes	No (↓)	Yes	Yes
	Were more than 80% of participants enrolled in trials included in the analysis (i.e. no potential reporting bias)?^e	Yes	Yes	Yes	Yes	Yes	Yes	Yes
	Were data reported consistently for the outcome of interest (i.e. no potential selective reporting)?	Yes	Yes	Yes	Yes	Unclear	Yes	Yes
	No other biases reported (i.e. no potential of other bias)?	Yes	Yes	No (↓)	Yes	Yes	Yes	No (↓)
	Did the trials end up as scheduled (i.e. not stopped early)?	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Inconsistency^b	Point estimates did not vary widely?	Yes	No (↓)	N/A	Yes	N/A	Yes	N/A
	To what extent did confidence intervals overlap (substantial: all confidence intervals overlap at least one of the included studies point estimate; some: confidence intervals overlapped but not all overlapped at least 1 point estimate; no: at least 1 outlier: where the confidence interval of some of the studies did not overlap with those of most included studies)?	Substantial	Some	N/A	Substantial	N/A	Substantial	N/A
	Was the direction of effect consistent?	Yes	No (↓)	N/A	Yes	N/A	Yes	N/A
	What was the magnitude of statistical heterogeneity (as measured by I²) ‐ low (I² < 40%), moderate (I² 40%‐60%), high I² > 60%)?	Low	High (↓)	N/A	Moderate	N/A	Moderate	N/A
	Was the test for heterogeneity statistically significant (P < 0.1)?	Not statistically significant	Statistically significant (↓)	N/A	Not statistically significant	N/A	Statistically significant (↓)	N/A
Indirectness^a	Were the populations in included studies applicable to the decision context?	Highly applicable	Highly applicable	Highly applicable	Highly applicable	Highly applicable	Highly applicable	Highly applicable
	Were the interventions in the included studies applicable to the decision context?	Highly applicable	Highly applicable	Highly applicable	Highly applicable	Highly applicable	Highly applicable	Highly applicable
	Was the included outcome not a surrogate outcome?	Yes	Yes	Yes and unclear	Yes	Yes	Yes	Yes
	Was the outcome timeframe sufficient?	Sufficient	Sufficient	Sufficient	Sufficient	Sufficient	Sufficient	Sufficient
	Were the conclusions based on direct comparisons?	Yes	Yes	N/A	Yes	Yes	Yes	Yes
Imprecision^c	Was the confidence interval for the pooled estimate not consistent with benefit and harm?	Yes	No (↓)	N/A	No (↓)	N/A	Yes	N/A
	What is the magnitude of the median sample size (high: 300 participants, intermediate: 100‐300 participants, low: < 100 participants)?^e	Intermediate to high	Intermediate	Intermediate	Intermediate	Intermediate	Low	Intermediate
	What was the magnitude of the number of included studies (large: > 10 studies, moderate: 5‐10 studies, small: < 5 studies)?^e	Large	Moderate	Moderate	Moderate	Small (↓)	Large	Small (↓)
	Was the outcome a common event (e.g. occurs more than 1/100)?	Yes	Yes	N/A	N/A	Yes	N/A	N/A
Publication bias^d	Was a comprehensive search conducted?	Yes	Yes	Yes	Yes	Yes	Yes	Yes
	Was grey literature searched?	Yes	Yes	Yes	Yes	Yes	Yes	Yes
	Were no restrictions applied to study selection on the basis of language?	Yes	Yes	Yes	Yes	Yes	Yes	Yes
	There was no industry influence on studies included in the review?	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear
	There was no evidence of funnel plot asymmetry?	Unclear	Unclear	N/A	Unclear	Unclear	Unclear	N/A
	There was no discrepancy in findings between published and unpublished trials?	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear
^aQuestions on risk of bias are answered in relation to the majority of the aggregated evidence in the meta‐analysis rather than to individual trials ^bQuestions on inconsistency are primarily based on visual assessment of forest plots and the statistical quantification of heterogeneity based on I² ^cWhen judging the width of the confidence interval it is recommended to use a clinical decision threshold to assess whether the imprecision is clinically meaningful ^dQuestions address comprehensiveness of the search strategy, industry influence, funnel plot asymmetry and discrepancies between published and unpublished trials ^eDepends on the context of the systematic review area (↓): key item for possible downgrading the quality of the evidence (GRADE) as shown in the footnotes of the 'Summary of finding' table(s); GRADE: Grading of Recommendations Assessment, Development and Evaluation; N/A: not applicable

Figure 1

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Figure 2

Study flow diagram

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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included trial.

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Figure 4

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included trials.

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Figure 5

Forest plot of comparison: 1 Supportive interventions for enhancing dietary intake versus comparators, outcome: 1.2 Nutritional status (weight change) (kg)

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Figure 6

Forest plot of comparison: 1 Supportive interventions for enhancing dietary intake versus comparators, outcome: 1.4 All‐cause mortality

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Analysis 1.1

Comparison 1 Supportive interventions for enhancing dietary intake versus comparators, Outcome 1 No. of participants with complications.

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Analysis 1.2

Comparison 1 Supportive interventions for enhancing dietary intake versus comparators, Outcome 2 Nutritional status (weight change).

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Analysis 1.3

Comparison 1 Supportive interventions for enhancing dietary intake versus comparators, Outcome 3 Hospitalisation.

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Analysis 1.4

Comparison 1 Supportive interventions for enhancing dietary intake versus comparators, Outcome 4 All‐cause mortality.

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Summary of findings for the main comparison. Supportive interventions for enhancing dietary intake versus comparators in malnourished or nutritionally at‐risk adults

Supportive interventions compared with usual care for malnourished or nutritionally at‐risk adults
Population: malnourished or nutritionally at‐risk adults Settings: residential care (21 trials), hospital (15 trials), outpatients (5 trials) Intervention: supportive interventions for enhancing dietary intake (changes to the organisation of nutritional care, changes to the feeding environment, modification of meal profile or pattern, additional supplementation of meals, congregate and home meal delivery systems) Comparison: usual care
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of participants (trials)	Quality of the evidence (GRADE)	Comments
Outcomes	Usual care	Supportive interventions	Relative effect (95% CI)	No of participants (trials)	Quality of the evidence (GRADE)	Comments
All‐cause mortality Follow‐up: duration of hospital stay to 12 months	133 per 1000	107 per 1000 (92 to 124)	RR 0.78 (0.66 to 0.92)	6683 (12)	⊕⊕⊕⊝ moderate^a	‐
Morbidity/complications (number of participants with any medical complication) Follow‐up: duration of hospital stay to 6 months	See comment	See comment	See comment	4015 (5)	⊕⊝⊝⊝ very low^b	No summary effect size calculated because of high inconsistency; RR ranged from 0.59 in favour of supportive interventions to 1.42 in favour of usual care
Health‐related quality of life and patient satisfaction Follow‐up: duration of hospital stay to 12 months	See comment	See comment	See comment	4451 (5)	⊕⊕⊝⊝ low^c	5/41 trials investigated health‐related quality of life using different instruments in participants from a wide range of different clinical backgrounds; overall we noted no substantial differences between intervention and comparator groups 2/41 trials investigated patient satisfaction by means of an unvalidated questionnaire
Hospitalisation and institutionalisation (days) Follow‐up: 8 days to 4 months	The mean hospitalisation ranged across control groups from 10 days to 40 days	The mean hospitalisation in the intervention groups was 0.5 days shorter (2.6 days shorter to 1.6 days longer)	‐	667 (5)	⊕⊝⊝⊝ very low^d	3/5 trials with data on hospitalisation were in the group of trials of 'Changes to the organisation of nutritional care'
Adverse events Follow‐up: 8 days to 6 months	See comment	See comment	See comment	4108 (3)	⊕⊝⊝⊝ very low^e	Only 3/41 trials reported on adverse events (all evaluating the impact of supplementation of meals with oral nutritional supplements); 1 trial reported intolerance to the supplement (diarrhoea, vomiting) in 3/34 (15%) of participants. In another large trial 565/2017 (28%) of stroke patients stopped taking the oral nutritional supplements because of refusal or dislike of taste
Nutritional status (weight change in kg) Follow‐up: 8 days to 12 months	The mean weight change ranged across control groups from ‐3.0 kg to +0.3 kg	The mean weight change in the intervention groups was +0.6 kg higher (0.2 kg to 1.0 kg higher)	‐	2024 (17)	⊕⊕⊕⊝ moderate^f	‐
Economic costs Follow‐up: duration of hospital stay to 12 months	See comment	See comment	See comment	1152 (3)	⊕⊝⊝⊝ very low^g	3/41 trials evaluated and 2/41 trials reported some data on economic costs; none of the trials used accepted health economic methods and the reported data on both costs and effectiveness were generally poor
The basis for the assumed risk* (e.g. the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
^*aAssumed risk was derived from the event rates in the comparator groups (usual care) ^aDowngraded by one level because of risk of bias in several risk of bias domains ^bDowngraded by three levels because of risk of bias in several risk of bias domains, serious inconsistency and imprecision ^cDowngraded by two levels because of risk of bias in several risk of bias domains, indirectness and few trials investigating health‐related quality of life in substantially diverse trial populations ^dDowngraded by three levels because of risk of performance bias and serious imprecision ^eDowngraded by three levels because of risk of bias in several risk of bias domains, imprecision and general substandard reporting of adverse events in included trials ^fDowngraded by one level because of imprecision ^gDowngraded by three levels because of risk of bias in several risk of bias domains, imprecision and few trials investigating economic costs with poor reporting, not using accepted health economic methods

Summary of findings for the main comparison. Supportive interventions for enhancing dietary intake versus comparators in malnourished or nutritionally at‐risk adults

Supportive nutritional care intervention Broad intervention category	Examples
1. Changes to the organisation of nutritional care	Use of dietetic or healthcare assistants Targeted staff training in nutritional care Monitoring and documentation of nutritional care Implementation of nutritional care pathways/protocols Identification of nutritionally at‐risk individuals (e.g. red trays, mandatory nutrition screening)
2. Changes to the feeding environment	Changes to dining arrangements/style/setting Protected meal times Feeding assistance
3. Modification of meal profile or pattern	Changes to meal pattern (e.g. 5 small meals/day) Manipulating energy/nutrient density of foods (e.g. food fortification Changes to the taste, flavour, appearance of foods, or a combination
4. Additional supplementation of meals	Between‐meal snacks, drinks or both Supplementation with oral nutritional supplements (e.g. routinely provided to entire ward, not individually prescribed)
5. Congregate and home meal delivery systems	Home meal delivery systems Community lunch clubs

	Intervention(s) and comparator(s)	Screened/eligible (N)	Randomised (N)	ITT (N)	Finishing trial (N)	Randomised finishing trial (%)	Follow‐up
Barton 2000^a2 (modification of meal profile or pattern)	I1: reduced portion size, fortified menu	‐	13	‐	^b	70^c	56 days
	I2: cooked breakfast		(8 not randomised)
	C: normal hospital diet with usual portion size		14
	total:		27^a		‐	‐
Beck 2002^a1 (additional supplementation of meals)	I1: homemade oral supplement (A)	‐	‐	‐	‐	‐	2 months
	I2: homemade oral supplement (B)
	C: usual diet
	total:		36		‐	‐
Bouillane 2013^a1 (modification of meal profile or pattern)	I: 78% protein at lunch	‐	30	‐	30	88	6 weeks
	C: usual diet (protein distributed between meals)		36		23	79
	total:		66		63	96
Bourdel‐Marchasson 2000^a3 (additional supplementation of meals)	I: 2 oral nutritional supplements		295	‐	‐	‐	15 days or until hospital discharge
	C: usual care		377
	total:		672		‐	‐
Brouillette1991^a1 (changes to the feeding environment)	I: osmotherapy + activities	‐	10	‐	9	90	4 weeks
	C: activities only		10		7	70
	total:		20		16	80
Castellanos 2009^a2 (modification of meal profile or pattern)	I1: fortified breakfast and lunch menu		39		^d	^e	2 days of the study
	I2: fortified lunch menu		39
	C: usual menu		39
	total:		39^a		33	85
Chang 2005^a3 (changes to the organisation of nutritional care)	I: training in feeding skills	‐	31	‐	12	60	Quote: "Data collection was from February 2004 to May 2004" Comment: implies 4 months of data collection, following training but not clearly stated
	C: no training		36		8	50
	total:		67		20^f	56
Dennis 2005^a1 (additional supplementation of meals)	I: oral nutritional supplement + normal diet		2016	‐	‐	‐	6 months
	C: normal hospital diet		2007
	total:		4023		‐	‐
Duncan 2006^a1 (changes to the organisation of nutritional care)	I: dietetic assistant	363	153	‐	145	95	4 months
	C: usual care		165		157	95
	total:		318		302	95
Essed 2007^a4 (modification of meal profile or pattern)	I1: monosodium glutamate	‐	‐	‐	19	N/A	16 weeks
	I2: flavour				19
	I3: monosodium glutamate + flavour				22
	C: maltodextrin (placebo)				23
	total:		97		83	86
Essed 2009^a2 (modification of meal profile or pattern)	I: monosodium glutamate + NaCl	‐	59	‐	53	90	4 weeks
	C: usual hot meal		59		53	90
	total:		59^a		53	90
Faxen‐Irving 2011^a1 (additional supplementation of meals)	I: 30 mL of fat emulsion 3 x per day	107	34	‐	24	71	Median 8 days
	C: usual care		37		27	73
	total:		71		51	72
Gaskill 2009^a3 (changes to the organisation of nutritional care)	I: nutrition education programme	377	‐	‐	‐	‐	6 months
	C: usual care
	total:		352		‐	‐
Germain 2006^a1 (modification of meal profile or pattern)	I: re‐formed foods	93	8	‐	7	88	12 weeks
	C: usual diet		9		8	89
	total:		17		15	88
Hankey 1993^a1 (additional supplementation of meals)	I: supplemented with nutritionally complete drink in addition to normal hospital diet	‐	10	‐	7	70	8 weeks
	C: standard hospital food		10		7	70
	total:		20		14	70
Hickson 2004^a1 (changes to the organisation of nutritional care)	I: feeding assistance	1776	292	292	250	86	Duration of hospital stay
	C: usual care		300	300	259	86
	total:		592	592	509	86
Holyday 2012^a1 (changes to the organisation of nutritional care)	I: malnutrition care plan	‐	71	71	71	100	Duration of hospital stay
	C: usual care		72	72	72	100
	total:		143	143	143	100
Johansen 2004^a1 (changes to the organisation of nutritional care)	I: nutrition team	7468	‐	‐	108	N/A	Duration of hospital stay
	C: usual care				104
	total:		215		212	99
Kraft 2012^a1 (changes to the organisation of nutritional care)	I: oral nutritional supplement + telemedicine monitoring	87/50	13	5	1	8	6 months
	C: usual care		13	9	4	31
	total:		26	14	5	19
Kretser 2003^a1 (congregate and home meal delivery systems)	I: modified meals on wheels	324	102	‐	‐	‐	26 weeks
	C: traditional meals on wheels		101
	total:		203		60	30
Larsson 1990^a1 (additional supplementation of meals)	I: oral nutritional supplement + normal hospital diet	‐	197	‐	‐	‐	26 weeks
	C: normal hospital diet		238
	total:		435		‐	‐
Leslie 2012^a3 (modification of meal profile or pattern)	I: energy enriched usual meals	445	22		16	73	12 weeks
	C: usual care		19		16	84
	total:		41
Lin 2010^a3 (changes to the organisation of nutritional care)	I1: spaced‐retrieval^g	‐	32	‐	‐	‐	8 weeks
	I2: Montessori^h		29
	C: usual care		24
	total:		85		82	97
Lin 2011^{a2, a3} (changes to the organisation of nutritional care)	I: Montessori		‐	‐	‐	‐	8 weeks
	C: usual care
	total:		29^a		29	100
Mathey 2001a^a3 (changes to the feeding environment)	I: improved meal ambiance	60	21	‐	12	57	12 months
	C: usual care		17		10	59
	total:		38		22	58
Mathey 2001b^a1 (changes to the feeding environment)	I: flavour enhancement	‐	‐	‐	31	N/A	16 weeks
	C: usual care				36
	total:		71		67	94
Munk 2014^a1 (modification of meal profile or pattern)	I: energy and protein enriched foods provided via a la carte menu in addition to hospital food		44		41	96	Duration of hospital stay
	C: usual care		40		40
	total:		84
Nijs 2006^a3 (changes to the feeding environment)	I: family‐style meals	282	133	‐	95	71	6 months
	C: usual care		112		83	74
	total:		245		178	73
Olofsson 2007^a1 (changes to the organisation of nutritional care)	I: multi‐component intervention (including nutrition)	353	102	‐	83	81	4 months
	C: usual care		97		74	76
	total:		199		157	79
Pivi 2011^a1 (changes to the organisation of nutritional care)	I1: nutrition education	‐	‐	‐	25	N/A	6 months
	I2: oral nutritional supplements				26
	C: usual care				27
	total:		90		78	87
Potter 2001^a1 (additional supplementation of meals)	I: oral nutritional supplement + normal hospital diet	618	186	‐	186	100	Duration of hospital stay
	C: normal hospital diet		195		195	100
	total:		381		381	100
Remsburg 2001^a1 (changes to the feeding environment)	I: buffet‐style meals	62	20	‐	20	100	3 months
	C: usual care		20		19	95
	total:		40		39	98
Salva 2011^a3 (changes to the organisation of nutritional care)	I: teaching and training	‐	448	448	300	67	12 months
	C: usual care		498	498	368	74
	total:		946	946	668	71
Silver 2008^a2 (modification of meal profile or pattern)	I: fortified home‐delivered lunch	‐	‐	‐	‐	‐	7 months
	C: usual home‐delivered lunch
	total:		52		45	87
Simmons 2008^{a2, a3} (additional supplementation of meals)	I: feeding assistance and/or snacks	173	30	‐	28	88	24 weeks
	C: usual diet		34		32	94
	total:		64^a	‐	60	94
Simmons 2010^a1 (additional supplementation of meals)	I1: snacks	280	‐	‐	25	N/A	6 weeks
	I2: additional supplementation of meals				18
	C: usual care				20
	total:		86		63	73
Smolliner 2008^a3 (modification of meal profile or pattern)	I: fortified meals and snacks	295/92	‐	‐	22	N/A	12 weeks
	C: usual diet				30
	total:		65		52	80
Splett 2003^a3 (changes to the organisation of nutritional care)	I: medical nutrition therapy	394	223	‐	200	90	19‐180 days
	C: usual care		171		164	96
	total:		394		364	92
Taylor 2006^a2 (modification of meal profile or pattern)	I: 5‐meal menu	66	‐	‐	‐	‐	2 periods of 4 days
	C: usual (3‐meal menu)
	total:		31^a		31	100
Van den Berg 2015^a1 (additional supplementation of meals	I1: offered 125 mL ONS daily with medication rounds	885	88		75	85	Maximum period 30 days
	I2: offered 62 mL ONS daily with medication rounds		66		51	77
	C: offered 125 mL ONS twice daily in between meals		80		66	83
	total:		234
Van Ort 1995^a1 (changes to the feeding environment)	I: contextual and behavioural intervention	8	‐	‐	‐	‐	1 month to 6 weeks
	C: usual care
	total:		8		7	88
*Grand total*	All interventions^j
	All controls^j
	*All interventions and controls*		*10,681*
^a1Parallel RCT; ^a2cross‐over RCT; ^a3cluster RCT; ^a4 factorial RCT ^bData presented on 19 participants who had at least 3 days on each menu ^cOf those randomised to normal or fortified menu, not stated for those receiving cooked breakfast ^dData analysed for 26 participants with complete data ^eData were reported on 67% of those who consented ^fData on knowledge and attitude of staff to nutrition available on all 67 staff. Data on actual practice at mealtimes from observation available on 20 staff ^gMethod to enhance learning, retention and recall of information ^hMethod capable of stopping or reducing residents' problem behaviours ⁱAssmumed 30 per group, two groups included in this review ^jNo details because of substantial number of trials not providing data C: comparator; I: intervention; ITT: intention‐to‐treat

Outcome measure	No. of studies reporting outcome	No. of participants	Studies potentially with data for meta‐analysis
Energy intake	5	666	1
Health‐related quality of life	1	220	0
Patient satisfaction	2	1105	0
Complications	4	1263	3
Nutritional status: weight	10	2184	9
BMI	7	1537	6
TSF	3	536	3
MAC	3	568	3
Length of stay	5	1256	3
Hospital admission	1	143	1
Mortality	5	2182	5
Costs	2	1089	0
BMI: body mass index; MAC: mid‐arm circumference; TSF: triceps skinfold thickness

Outcome measure	No. of studies reporting outcome	No. of participants (treatment/control)	Studies with data for meta‐analysis
Energy intake	3	216	3
Health‐related quality of life	2	200	0
Nutritional status: weight	3	239	3
MAC	1	178	1
Clinical function	3	1664	2
Mortality	3	236	3
MAC: mid‐arm circumference

	Outcome	Reason the data were not usable	Contact with author	Outcome of contact with author	Action taken
1. Organisational change
Chang 2005	Energy intake	Data reported as amount eaten in ¼, ½, ¾	Yes	No response	Data reported in structured narrative summary
Duncan 2006	Complications	Reported as a median and IQR	Yes	Data provided	Data used
Duncan 2006	Length of stay	Reported as median and IQR	Yes	Confirmed data skewed	Data reported in structured narrative summary
Gaskill 2009	Measured prevalence of malnutrition with SGA	Not an outcome of interest for this review	Yes, to request weight data (a component of SGA)	Unable to provide data	Data not reported
Hickson 2004	Energy intake	Not measured at baseline, only at follow‐up	Yes, to confirm interpretation of data	Data not measured at baseline	Data reported in structured narrative summary
	Complications (antibiotic prescription)	Reported as median and IQR	Yes, to request complications according to group allocation	No. complications according to group allocation was provided	Data reported in structured narrative summary
	Hospital admission	States in protocol these are collected, but not reported	Yes, to request data	Author unable to recall what happened with data	Data not reported
Holyday 2012	Costs	An estimate based on local prices, not a complete cost analysis	No, judged unlikely to be available	N/A	Data not reported
Holyday 2012	Hospital admission	Presented as a frequency	Yes, to request total number of readmissions	Data provided	Data reported in structured narrative summary
Johansen 2004	Energy intake	Reported as kJ/kg/day	Yes, for mean change	No response	Data not reported
Kraft 2012	BMI	Presented as mean and SD at baseline and follow‐up, but no mean change	Yes	No response	Data not reported
Lin 2010	Energy intake	'Amount of each meal consumed' was reported as % eaten	Yes	No response	Data reported in structured narrative summary
	Weight	Reported as mean and SD pre and post intervention/control	Yes, to request mean change	No response	Calculated mean change, and imputed the SD of change from Salva 2011
	BMI	Reported as mean and SD pre and post intervention/control	Yes, to request mean change	No response	Calculated mean change, and imputed the SD of change from Salva 2011
Olofsson 2007	Weight	Reported as mean and SD pre and post intervention/control	Yes, to request mean change and SD	Data provided	Data reported in structured narrative summary
	BMI	Reported as mean and SD pre and post intervention/control	Yes, to request mean change and SD	Data provided	Data reported in structured narrative summary
	Complications	Reported as no. falls in men and women	Yes, to request total complications per group	Data provided	Data reported in structured narrative summary
Pivi 2011	Weight	Reported as mean and SD pre and post intervention/control	Yes, to request mean change	No response	Calculated mean change, and imputed the SD of change using the P value
	BMI	Reported as mean and SD pre and post intervention/control	Yes, to request mean change	No response	Calculated mean change, and imputed the SD of change from Salva 2011
	TSF	Reported as mean and SD pre and post intervention/control	Yes, to request mean change	No response	Calculated mean change, and imputed the SD of change from Salva 2011
	MAC	Reported as mean and SD pre and post intervention/control	Yes, to request mean change	No response	Calculated mean change, and imputed the SD of change
Salva 2011	MAC	Methodology reported this was an outcome measured, but not reported in results	Yes	No response	Data not used
Salva 2011	Costs	Described as data to be collected, but reported that analysis was not undertaken	No		Not reported
Splett 2003	Intake	Food intake is documented as a nutrition assessment activity	Yes, to request mean energy intake per group	Unable to provide data	Not reported
Splett 2003	Weight	Methodology reports this was an outcome measured, but reported in a format not usable	Yes	Unable to provide data	Not reported
2. Feeding environment
Brouilette 1991	Energy	Reported pre and post intervention data, but no SD of change	No, as no author contact details and study published in 1991	N/A	Imputed the SD from Nijs 2006
Van Ort 1995	Weight change	No figures reported	Yes, to request data on mean and SD of change for each group	Waiting response	Not used
Van Ort 1995	Intervention group clarification	Were the behavioural and contextual intervention received at the same time	Yes, to request this detail	Waiting response	Assumed the two interventions were given at the same time
3. Meal modification
Bouillanne 2013	Weight	Did not report weight, but assumed they had the data as Full Body Composition was used	Yes, to request data	Data provided	Data reported
	Energy intake	Reported as kcal/kg/day	Yes, to request data	Data provided	Data reported
	Hand grip strength	Reported data as mean/median and 95% CI of the median	Yes, to request data	Provided mean and SD of change	Data reported
	ADL	Reported data as mean/median and 95% CI of the median	Yes, to request data	Data provided	Data reported
Castellanos 2009	Energy intake	Results were not analysed according to groups randomised, but regrouped subjects into small eaters and large eaters	Yes, to ask for data on mean and SD of change for each group	No response	Data reported
Germain 2006	BMI	They reported the mean BMI rather than mean change	Yes, for mean and SD of change	Data provided	Data reported
Smolliner 2008	Weight change	Reported mean and SD at baseline and end of intervention	Yes, for mean change and SD	Data provided	Data reported
	BMI	Reported mean and SD at baseline and end of intervention	Yes, for mean change and SD	Data provided	Data reported
	Handgrip strength	Reported mean and SD at baseline and end of intervention	Yes, for mean change and SD	Data provided	Data reported
	health‐related quality of life	Reported mean and SD at baseline and end of intervention	Yes, for mean change and SD	Data provided	Data reported
4. Supplementation of meals
Beck 2002	Weight	Reported as median change with 95% CI	Yes, for mean change and SD	Response received but data not available	Data reported in structured narrative summary
Beck 2002	Energy intake	Reported as median change with 95% CI	Yes, for mean change and SD	Response received but data not available	Data reported in structured narrative summary
Bourdel‐ Marchasson 2000	Pressure ulcers	Data given as percentage per group	Yes, for number per group	Data provided	Data reported in structured narrative summary
Bourdel‐ Marchasson 2000	Weight	Data given for baseline only	Yes, for change in weight from baseline to follow‐up	Yes, author stated she did not find the analysis of discharge weight, probably due to the low quality of this data (too many missing data)	Data not reported
Dennis 2005	Complications	Data given as percentages	Yes for data on total complications per group	Data provided	Data reported in structured narrative summary
Dennis 2005	Health‐related quality of life score	Differences between means provided	Yes, to request mean and SD of changes	Unable to provide data, as EuroQol was only measured at follow‐up	Data reported in structured narrative summary
Faxen‐Irving 2011	Energy intake	Data given in a graph, no numbers available	Yes, for mean and SD of change in energy intake, between the control and intervention groups from baseline to the 2nd registration	Data provided	Data reported in structured narrative summary
	Length of stay	Data provided at baseline, not follow‐up	Yes, for mean and SD	Data provided	Data reported in structured narrative summary
	Infection	Data provided at baseline, not follow‐up	Yes, for mean and SD	Unable to provide data	Data not reported
	BMI	Data provided at baseline, not follow‐up	Yes, for mean and SD	Data provided	Not reported in the summary because few studies measured this outcome
	ADL	Data provided at baseline, not follow‐up	Yes, for mean and SD	Data provided	Not reported in the summary because few studies measured this outcome
Hankey 1993	Weight	Presented in graphs, no numbers given	Yes, for mean and SD	Unable to provide data but suggested using data from the review by Milne 2009 which included these data	Data obtained from systematic review by Milne 2009
	MAC	Presented in graphs, no numbers given	Yes, for mean and SD	Unable to provide data but suggested using data from the review by Milne 2009 which included these data	Data obtained from systematic review by Milne 2009 but not reported as few studies measured this outcome
	TSF	Presented in graphs, no numbers given	Yes, for mean and SD	Unable to provide data but suggested using data from the review by Milne 2009 which included these data	Not reported in the summary because few studies measured this outcome
	Energy and protein intake	Presented in graphs, no numbers given	Yes, for mean and SD	Unable to provide data	Data not reported
Larsson 1990	Energy intake	Data included in Modified Norton Scale	Yes, data for change in energy intake between groups (mean and SD)	No response	Data not reported
	Weight	Data provided as ‘weight index’	Yes, for change in weight between groups (mean and SD)	No response	Data not reported
	TSF	Data provided as differences between men and women, and non‐PEM and PEM groups	Yes, for change between groups (mean and SD)	No response	Data not reported
	MAC	Data provided as differences between men and women, and non‐PEM and PEM groups	Yes, for change between groups (mean and SD)	No response	Data not reported
	Length of stay	Not given	Yes, for mean and SD between groups	No response	Data not reported
	Total number of eligible participants	Unclear across all 4 duplicates of this study	Yes, for a clear number of randomised participants, no finishing study, and deaths	No response	Data not reported
Potter 2001	Length of stay	Provided as median with a range	Yes, for mean and SD between groups	No response	Data reported in structured narrative summary
	ADL	Stated as an outcome measure in methodology, then not reported in results	Yes, for mean and SD between groups	No response	Not reported in the summary because few studies measured this outcome
	BMI	Stated as an outcome measure in methodology, then not reported in results	Yes, for mean and SD between groups	No response	Not reported in the summary because few studies measured this outcome
	TSF	Stated as an outcome measure in methodology, then not reported in results	Yes, for mean and SD between groups	No response	Not reported in the summary because few studies measured this outcome
Simmons 2008	Weight	Data presented as phase 1 and 2 cross‐over combined. The data from phase 1 was needed for this review	Yes, for the phase 1 data	Yes, responded but unable to provide data	Data reported in structured narrative summary
	BMI	Data presented as phase 1 and 2 cross‐over combined. The data from phase 1 was needed for this review	Yes, for the phase 1 data	Yes, responded but unable to provide data	Not reported in the summary because few studies measured this outcome
	Energy intake	Presented as pre‐ and post intervention	Yes, for mean and SD of change	Yes, responded but unable to provide data	Imputed SD from Nijs 2006
Simmons 2010	Energy	Reported as mean difference without the SD	Yes, requested SD for mean change	Yes, responded but unable to provide data	Imputed SD from Nijs 2006
5. Home meal delivery systems
Kretser 2003	Weight	Reported separately for participants at risk of malnutrition, and those malnourished	No, failed to find contact information for the author	N/A	Combined the mean change data using the formulae for combining groups
ADL: activities of daily living; BMI: body mass index; CI: confidence interval; EuroQol: European Quality of Life Scale; IQR: interquartile range; MAC: midarm muscle circumference; N/A: not applicable; PEM: protein‐energy malnutrition; SD: standard deviation; SGA: subjective global assessment; TSF: triceps skinfold thickness

Setting	No. participants [N/N (%)]	No. studies
Hospital	7591/10,681 (71.1)	15
Residential care home	1731/10,681 (16.2)	21
Free‐living/outpatient setting	1305/10,681 (12.2)	5

	Outcome	(N)	Results		P Value
	Outcome	(N)	Intervention	Control
Dietetic assistants (Hospital)
Duncan 2006	Mean (SD) energy intake (kcal/day)	275 (total N = 302)	1105 (361)	756 (399)	< 0.001
Hickson 2004	Between‐group difference (kcal)	37 (total N = 592)	89		0.538
Specialist training (residential care settings)
Chang 2005	% (SD) meals consumed	67	Pre: 90 % (22) Post: 85 (25)	Pre: 78 % (34) Post: 94 % (18)	0.49
Lin 2010	% (SD) meals consumed	85	Spaced retrieval (SR) Pre: 85 % (11) Post: 91 % (9) Montessori (MON) Pre: 75 % (23) Post 78 % (10)	Pre: 79 % (19) Post: 88 % (18)	SR vs control = NS MON vs control < 0.05
Multi‐disciplinary team (hospital)
Johansen 2004	kcal/kg body weight per day (SE)	202 (total N = 212)	30 (SE 1)	25 (SE 1)	< 0.005
kcal: kilocalorie; SD: standard deviation; SE: standard error

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 No. of participants with complications Show forest plot	5	4702	Risk Ratio (M‐H, Random, 95% CI)	1.11 [0.86, 1.42]

1.1 Changes to the organisation of nutritional care	3	624	Risk Ratio (M‐H, Random, 95% CI)	1.12 [0.76, 1.67]
1.2 Modification of meal profile or pattern	1	63	Risk Ratio (M‐H, Random, 95% CI)	0.59 [0.06, 6.14]
1.3 Additional supplementation of meals	1	4015	Risk Ratio (M‐H, Random, 95% CI)	1.14 [1.02, 1.28]
2 Nutritional status (weight change) Show forest plot	17	2024	Mean Difference (IV, Random, 95% CI)	0.62 [0.21, 1.02]

2.1 Changes to the organisation of nutritional care	6	1140	Mean Difference (IV, Random, 95% CI)	0.09 [‐0.26, 0.45]
2.2 Changes to the feeding environment	1	39	Mean Difference (IV, Random, 95% CI)	‐0.43 [‐2.11, 1.25]
2.3 Modification of meal profile or pattern	5	253	Mean Difference (IV, Random, 95% CI)	1.16 [0.41, 1.92]
2.4 Additional supplementation of meals	4	475	Mean Difference (IV, Random, 95% CI)	0.90 [0.41, 1.38]
2.5 Congregate and home meal delivery systems	1	117	Mean Difference (IV, Random, 95% CI)	2.90 [1.00, 4.80]
3 Hospitalisation Show forest plot	5	667	Mean Difference (IV, Random, 95% CI)	‐0.48 [‐2.56, 1.59]

3.1 Changes to the organisation of nutritional care	3	515	Mean Difference (IV, Random, 95% CI)	‐2.08 [‐6.75, 2.58]
3.2 Modification of meal profile or pattern	1	81	Mean Difference (IV, Random, 95% CI)	0.0 [‐3.48, 3.48]
3.3 Additional supplementation of meals	1	71	Mean Difference (IV, Random, 95% CI)	0.20 [‐2.26, 2.66]
4 All‐cause mortality Show forest plot	12	6683	Risk Ratio (M‐H, Random, 95% CI)	0.78 [0.66, 0.92]

4.1 Changes to the organisation of nutritional care	4	1237	Risk Ratio (M‐H, Random, 95% CI)	0.71 [0.52, 0.97]
4.2 Changes to the feeding environment	1	20	Risk Ratio (M‐H, Random, 95% CI)	3.00 [0.14, 65.90]
4.3 Modification of meal profile or pattern	2	150	Risk Ratio (M‐H, Random, 95% CI)	1.04 [0.15, 7.22]
4.4 Additional supplementation of meals	4	5073	Risk Ratio (M‐H, Random, 95% CI)	0.77 [0.58, 1.02]
4.5 Congregate and home meal delivery systems	1	203	Risk Ratio (M‐H, Random, 95% CI)	0.33 [0.09, 1.18]

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Appendices

Appendix 1. Search strategies (inception to March 2013)

Appendix 2. Search strategies (January 2013 to September 2016)

Appendix 3. Description of interventions

Appendix 4. Baseline characteristics (I)

Appendix 5. Baseline characteristics (II)

Appendix 6. Matrix of study endpoints (publications and trial documents)

Appendix 7. High risk of outcome reporting bias according to ORBIT classification

Appendix 8. Definition of endpoint measurement (I)

Appendix 9. Definition of endpoint measurement (II)

Appendix 10. Adverse events

Appendix 11. Survey of authors' providing information on trials

Appendix 12. Checklist to aid consistency and reproducibility of GRADE assessments

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