Nutritional trials using high protein strategies and long duration of support show strongest clinical effects on mortality.

Malnutrition in Hospitalized Old Patients: Screening and Diagnosis, Clinical Outcomes, and Management

“…A recent meta-analysis, based on 29 randomized controlled trials, confirmed the positive effect of oral and enteral nutritional support, with a 30% of mortality reduction [124]. High protein strategies and long-term nutritional intervention were described as the most important predictors for the nutritional effect [124]. After discharge, nutritional intervention shows improvement in quality of life and physical function, lower LOS but no effect on readmission at six months [125].…”

“…Moreover, preserved muscle strength and architecture and reduced circulating markers of oxidative stress were observed in hospitalized old patients supplemented with oral amino acids [123]. A recent meta-analysis, based on 29 randomized controlled trials, confirmed the positive effect of oral and enteral nutritional support, with a 30% of mortality reduction [124]. High protein strategies and long-term nutritional intervention were described as the most important predictors for the nutritional effect [124].…”

Admission serum albumin concentrations and response to nutritional therapy in hospitalised patients at malnutrition risk: Secondary analysis of a randomised clinical trial

“… 4 , 5 , 6 , 7 In the last few years, several trials and meta-analyses of such trials, have provided evidence that nutritional support reduces risks associated with malnutrition. 8 , 9 The largest trial, the Effect of early nutritional therapy on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT), included 2028 medical inpatients at nutritional risk and reported significant reductions in severe complications and mortality for patients receiving nutritional support as compared with patients in the control group receiving usual care hospital nutrition. 10 While the overall population of medical inpatients did show benefit from nutritional support in this trial, it is possible that some patients experienced more or less benefit from this intervention allowing a more individualised approach to the patient at risk for malnutrition.…”

Effectiveness of dietary counseling with or without nutrition supplementation in hospitalized patients who are malnourished or at risk of malnutrition: A systematic review and meta‐analysis

“…For example, the inclusion of studies in the critical care settings and studies that only provided instructions on consuming ONS may have affected the outcomes and may not be an accurate representation of the provision of dietary advice or counseling. Similarly, for Kaegi‐Braun et al, 43 we disagree with their classification of the studies using multifactorial dietitian‐based interventions, as some were not considered a dietitian‐based intervention 48,49 ; and a protein‐supplemented meal service was included as an ONS‐only intervention 50 …”

“…We are unable to determine the effects of ONS when used in tandem with dietary counseling, as the use and adherence to ONS were not clearly reported in most studies. Recently, Kaegi‐Braun et al 43 did not find any conclusive benefits of the use of ONS‐only intervention. Although ONS may be a part of a nutrition care plan, the presence of a dietitian providing individualized dietary advice may address the various causes of malnutrition more effectively.…”