ESPEN guideline on hospital nutrition

Probably not a substantial claim: may not pass S3 (load-bearing).

A Cochrane Review of eight RCTs (N=3518) concluded that there is insufficient power to confirm clinically important effects of dietary advice and salt substitution on cardiovascular mortality in normotensive or hypertensive populations.

“Review of eight RCTs (N=3518) concluded that there is insufficient power to confirm clinically”

• cites [152] Garofalo, 2018, Dietary salt restriction in chronic kidney disease: a meta-analysis of randomized clinical trials, Nutrients sourceDisputed

  Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The effects of snacks were not analyzed separately, so no specific conclusions were possible.

“However, the effects of snacks were not 430 analyzed separately and thus no specific conclusions were possible in this regard.”

• cites [16] Volkert, 2019, ESPEN guideline on clinical nutrition and hydration in geriatrics, Clin Nutr sourceSupported

Classified as probably not a substantial claim.

Simple dietary interventions based on food-based fortification or densification with protein or energy of the standard diet could be considered in patients at risk of malnutrition because of their effect on total energy and protein intakes.

“simple 434 dietary interventions based on the food-based fortification or densification with protein or 435 energy of the standard diet could be considered in patients at risk of malnutrition because its 436 effect on the total amount of energy and protein intakes.”

• cites [25] Morilla-Herrera, 2016, Effectiveness of food-based fortification in older people. A systematic review and meta-analysis, JNHA sourceSupported

May combine two claims.

In cancer patients who are malnourished or at risk of malnutrition, nutritional therapy has been shown to improve body weight and energy intake but not survival.

“In cancer patients who are malnourished or at risk of malnutrition, nutritional therapy has been 462 shown to improve body weight and energy intake but not survival.”

• cites [12] Arends, 2017, ESPEN guidelines on nutrition in cancer patients, Clin Nutr sourceCould not verify

  The retrieved passages contain publication metadata rather than the guideline’s findings. Searches for survival, body weight, energy intake, and nutritional therapy found no passage in our copy addressing the claimed effects, so the claim cannot be verified from it. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Eight studies investigate the effect of dietary enrichment.

“Eight studies investigate the effect of dietary enrichment [25-32].”

• cites [25] Morilla-Herrera, 2016, Effectiveness of food-based fortification in older people. A systematic review and meta-analysis, JNHA sourceSupported
• cites [26] Kiss, 2014, The effect of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review, Nutr Cancer sourceNot checked — no full text of the source
• cites [27] Munk, 2014, Positive effect of protein-supplemented hospital food on protein intake in patients at nutritional risk: a randomised controlled trial, J Hum Nutr Diet sourceNot checked — no full text of the source
• cites [28] Stelten, 2015, Protein-enriched 'regular products' and their effect on protein intake in acute hospitalized older adults; a randomized controlled trial, Clin Nutr sourceSupported
• cites [29] Ziylan, 2017, Protein-enriched bread and readymade meals increase community-dwelling older adults' protein intake in a double-blind randomized controlled trial, J Am Med Dir Assoc sourceSupported
• cites [30] Leslie, 2013, Improving the dietary intake of under nourished older people in residential care homes using an energy-enriching food approach: a cluster randomised controlled study, J Hum Nutr Diet sourceNot checked — no full text of the source
• cites [31] Leedo, 2017, The effect of a home delivery meal service of energy- and protein-rich meals on quality of life in malnourished outpatients suffering from lung cancer: a randomized controlled trial, Nutr Cancer sourceNot checked — no full text of the source
• cites [32] Cano-Torres, 2017, Impact of nutritional intervention on length of hospital stay and mortality among hospitalized patients with malnutrition: a clinical randomized controlled trial, J Am Coll Nutr sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

There is very low-quality evidence regarding adverse effects of nutritional interventions.

“There is very low-quality evidence regarding adverse effects; therefore whilst 491 some of these interventions are advocated at a national level, clinicians should recognize the 492 lack of clear evidence to support their role.”

• cites [35] Baldwin, 2016, Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults, Cochrane Database Syst Rev sourceSupported

May combine two claims.

Nutritional support improves intake and weight, and some aspects of quality of life under radiotherapy.

“There is good evidence that 463 nutritional support improves intake and weight, and some aspects of quality of life under 464 radiotherapy [12].”

• cites [12] Arends, 2017, ESPEN guidelines on nutrition in cancer patients, Clin Nutr sourceCould not verify

  The available indexed passages identify the guideline but contain bibliographic metadata rather than its recommendations or evidence review. Searches for radiotherapy, nutritional support, intake, weight, and quality of life found no passage addressing the claimed effects, so the claim cannot be verified from our copy. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

May combine two claims.

Older people consider that dietary interventions are less valuable than medical treatment, and therefore did not perceive eating poorly as a problem.

“Particular attention must be taken into account for the older people, 602 because they consider that dietary interventions are less valuable than medical treatment, and 603 therefore did not perceive eating poorly as a problem [46].”

• cites [46] Engelheart, 2015, Dietary intake of energy, nutrients and water in elderly people living at home or in nursing home, J Nutr Health Aging sourceCould not verify

  The Introduction discusses possible reasons for inadequate dietary intake, including reduced appetite and difficulties preparing meals. The Discussion addresses nutritional assessment and clinical evaluation. Neither section reports older people's views on dietary interventions versus medical treatment or whether they perceive poor eating as a problem; searches for those attitudes found no supporting passage. Page numbers were unavailable in our copy. (LLM, conf=0.75)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim.

The respect of religious freedom has long been considered a basic civil right.

“The respect of religious freedom has long been considered a basic civil right [63].”

• cites [63] Padela, 2012, Religious values and healthcare accommodations: voices from the American muslim community, J Gen Intern Med sourceCould not verify

  The Cultural Competence and Priorities for Healthcare Accommodation sections discuss respect for Muslim patients’ beliefs and requests for religious accommodations. Neither those passages nor searches for religious freedom and civil rights address whether religious freedom has long been considered a basic civil right. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

May combine two claims.

Hiesmayr performed a large one-day cross-sectional survey on food intake in hospitalized patients (N=16,290), which showed that eating 1⁄4 meal gave an adjusted hazard ratio of 2.10 of dying; eating nothing has a HR of 3.20.

“Hiesmayr performed a large one-day cross-sectional survey on food 557 intake in hospitalized patients (N=16,290), which showed that eating ¼ meal gave an adjusted 558 hazard ratio of 2.10 of dying [39]. Eating nothing has a HR of 3.20.”

• cites [39] Hiesmayr, 2009, Decreased food intake is a risk factor for mortality in hospitalised patients: the NutritionDay survey 2006, Clin Nutr sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

Levels of 1.2-1.5 g/kg BW/day have been suggested for older persons with acute or chronic illness, and up to 2.0 g/kg BW/day in case of severe illness, injury, or malnutrition.

“Levels of 1.2-1.5 g/kg BW/day have been suggested for older 511 persons with acute or chronic illness [37, 38] and up to 2.0 g/kg BW/day in case of severe 512 illness, injury, or malnutrition [37].”

• cites [37] Bauer, 2013, Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group, J Am Med Dir Assoc sourceSupported
• cites [38] Deutz, 2014, Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group, Clin Nutr sourcePartly supported

  The Abstract recommends 1.2–1.5 g/kg body weight/day for older people who are malnourished or at risk of malnutrition because of acute or chronic illness. It recommends even higher intake for severe illness or injury, but does not specify 2.0 g/kg/day or extend that higher recommendation to malnutrition alone. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

The risk of frailty and sarcopenia is higher in people with diabetes, and this risk is increased in acute or chronic illnesses associated with diabetes.

“of frailty and sarcopenia is higher in people with diabetes”

• cites [176] The Emerging Risk Factors, 2010, Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies, Lancet sourceCould not verify

  The Discussion and Findings report increased risks of vascular disease in people with diabetes, not frailty or sarcopenia. Searches for frailty, sarcopenia, and acute or chronic illness found no passage addressing the attributed claim. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims. The quote only partly states this claim.

In real-life practice in France, unnecessary measures (potassium supplementation, peptic ulcer prevention, low-sodium diet) were frequently associated with long-term systemic glucocorticoid therapy, while consensual measures (osteoporosis prevention, vaccinations) were prescribed to less than half of patients.

“unnecessary measures in most patients (potassium supplementation, prevention of”

• cites [168] Liu, 2013, A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy, Allergy Asthma Clin Immunol sourcePartly supported

  Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

Salt reduction in people with chronic kidney disease reduced blood pressure considerably and consistently reduced proteinuria.

“kidney disease, however, reduced blood pressure considerably and consistently reduced”

• cites [154] Moore, 2003, The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club, Hepatology sourceCould not verify

  The Sodium and Water Restriction and Trials on Sodium Restriction sections discuss salt restriction for ascites in cirrhosis, not blood pressure or proteinuria in people with chronic kidney disease. Searches for those outcomes and that population found no passage addressing the claim. (LLM, conf=0.75)

  Experimental — accuracy not yet measured

May combine two claims. The quote only partly states this claim.

In patients with heart failure, assignment to a low-sodium diet and fluid restriction is associated with worse neurohormonal profiles; in those with heart failure and reduced ejection fraction, it is associated with increased heart failure admissions.

“assigned to a low-sodium diet and fluid restriction showed worse neurohormonal profiles”

• cites [151] Hummel, 2016, Dietary sodium restriction in heart failure: a recommendation worth its salt? ∗, JACC (J Am Coll Cardiol): Heart Fail sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

Randomized controlled trials in adults with type 1 diabetes have shown that carbohydrate counting can improve glycemic control, quality of life, and general well-being without increases in severe hypoglycemic events, body weight, or blood lipids.

“carbohydrate counting can improve glycemic control, quality of life, and general well-being”

• cites [170] Bell, 2014, Efficacy of carbohydrate counting in type 1 diabetes: a systematic review and meta-analysis, The Lancet Diabetes & Endocrinology sourceNot checked — no full text of the source
• cites [171] Schmidt, 2014, Effects of advanced carbohydrate counting in patients with Type 1 diabetes: a systematic review, Diabet Med sourceNot checked — no full text of the source
• cites [172] Souto, 2014, Impact of advanced and basic carbohydrate counting methods on metabolic control in patients with type 1 diabetes, Nutrition sourceNot checked — no full text of the source
• cites [173] Bataille, 2017, Haemodialysis patients with diabetes eat less than those without: a plea for a permissive diet, Nephrology sourceCould not verify

  Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

In the same trial, both the standard diet and the low glycemic diet were equally tolerable and did not cause flares in disease activity.

“Both diets were equally tolerable and did not cause flares in disease”

• cites [162] Fardet, 2007, Corticosteroid-induced lipodystrophy is associated with features of the metabolic syndrome, Rheumatology sourceCould not verify

  The Participants and Study design and data collection sections describe follow-up of patients receiving corticosteroids, not a comparison of standard and low-glycemic diets. Searches for the diets, tolerability, and disease flares found no passage in our copy addressing the claim. Page numbers were not available for these passages. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

May combine two claims.

Reduced dietary sodium and the DASH diet are associated with significantly lower systolic blood pressure, with the DASH diet having a greater effect on blood pressure reduction.

“reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet are”

• cites [157] Graudal, 2017, Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride, Cochrane Database Syst Rev sourcePartly supported

  The Discussion (Summary of main results; page unavailable) reports lower systolic blood pressure with sodium reduction, particularly in hypertensive study populations. The paper mentions DASH 2001 but does not report that the DASH diet lowers blood pressure more than sodium reduction; it instead questions that study’s control diet. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Individuals with type 1 and type 2 diabetes have about a twofold increased risk of developing a range of cardiovascular diseases compared with those without diabetes.

“Individuals with type 1 and type 2 diabetes have about a twofold increased risk of developing”

• cites [177] Camilleri, 2013, Clinical guideline: management of gastroparesis, Am J Gastroenterol sourceCould not verify

  The guideline’s section on identifying the cause of gastroparesis reports its incidence in people with type 1 and type 2 diabetes versus controls, not cardiovascular disease risk. Searches for a twofold cardiovascular risk and for cardiovascular disease, myocardial infarction, and stroke found no passage in our copy addressing the claimed comparison. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

In a prospective Swedish cohort study of individuals with non-gallstone-related acute pancreatitis, there was no clear association between overall diet quality and risk of recurrent and progressive pancreatitis.

“there was no clear association between overall diet quality”

• cites [204] Lodewijkx, 2016, Nutrition in acute pancreatitis: a critical review, Expet Rev Gastroenterol Hepatol sourceCould not verify

  The section on timing and type of oral nutrition (page unavailable) discusses diets used during treatment of acute pancreatitis, not overall diet quality as a predictor of later pancreatitis. Searches for a Swedish cohort, non-gallstone pancreatitis, and recurrent or progressive disease found no passage addressing the claimed association. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims. The quote only partly states this claim.

In an RCT with 72 patients, there was no difference in feeding tolerance comparing an immediately full caloric diet versus a stepwise increase approach; refeeding after the presence of bowel sounds with an immediate full caloric diet was safe and well-tolerated.

“there was no difference in feeding tolerance comparing immediately full”

• cites [202] Meng, 2011, Three initial diets for management of mild acute pancreatitis: a meta-analysis, World J Gastroenterol sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

In patients with mild acute pancreatitis, early oral feeding with the subjective feeling of hunger is safe, feasible, and reduces length of hospital stay.

“early oral feeding, with the subjective feeling of hunger, is safe,”

• cites [193] Zhang, 2019, Early enteral nutrition versus delayed enteral nutrition in patients with gastrointestinal bleeding: a PRISMA-compliant meta-analysis, Medicine sourcePartly supported

  The Discussion (page not provided) reports that early enteral nutrition shortened hospital stay in patients with severe acute pancreatitis. It does not establish that hunger-guided early oral feeding is safe or feasible in patients with mild acute pancreatitis. (LLM, conf=0.83)

  Experimental — accuracy not yet measured

May combine two claims. The quote only partly states this claim.

A meta-analysis of three RCTs with 362 patients showed that a non-liquid soft or solid diet did not increase pain recurrence after refeeding compared with a clear liquid diet, and reduced hospitalization with a pooled mean difference of -1.05 days.

“the non-liquid soft or solid diet did not”

• cites [203] Oskarsson, 2017, Overall diet quality and risk of recurrence and progression of non-gallstone-related acute pancreatitis: a prospective cohort study, Eur J Nutr sourceCould not verify

  Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims. The quote only partly states this claim.

In IBD patients with intestinal strictures or stenosis in combination with obstructive symptoms, a diet with adapted texture, or distal (post-stenosis) enteral nutrition, can be recommended; there is no robust data and this is a logical practical approach.

“a diet with adapted texture, or distal (post-stenosis)”

• cites [190] Barbon, 2015, Efficacy of thickened liquids for eliminating aspiration in head and neck cancer: a systematic review, Otolaryngol Head Neck Surg sourcePartly supported

  Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim.

Many guidelines and studies recommend that in initial stages of dysphagia, adequate nutrition intake may be achieved through dietary modification to include soft, semisolid, or semi-liquid consistencies, partnered with appropriate swallowing techniques.

“In initial stages of dysphagia, adequate”

• cites [15] Burgos, 2018, ESPEN guideline clinical nutrition in neurology, Clin Nutr sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured
• cites [189] Forbes, 2017, ESPEN guideline: clinical nutrition in inflammatory bowel disease, Clin Nutr sourceCould not verify

  The guideline’s commentary on Crohn’s disease strictures recommends soft foods or nutritious fluids for intestinal obstruction, not for dysphagia. Its nutrition-route commentary says enteral feeding should be considered when a patient cannot swallow safely. Neither passage addresses whether modified food consistencies and swallowing techniques maintain adequate intake in early dysphagia (searched: dysphagia, soft or semi-liquid consistencies, swallowing techniques). (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Xanthan gum seems to be better than starch as a thickening agent.

“xanthan gum seems to be better than starch”

• cites [80] Kim, 2017, Obesity, metabolic syndrome, and cardiovascular risk in gluten-free followers without celiac disease in the United States: results from the national health and nutrition examination survey 2009-2014, Dig Dis Sci sourceNot checked — no full text of the source
• cites [191] Newman, 2016, Effect of bolus viscosity on the safety and efficacy of swallowing and the kinematics of the swallow response in patients with oropharyngeal dysphagia: white paper by the European society for swallowing disorders (ESSD), Dysphagia sourcePartly supported

  The Results sections on palatability and rheology report that patients preferred gum-based drinks and that xanthan gum maintains viscosity more consistently than modified starch. But the Results section on swallowing assessment says the two agents showed no major or significant difference in swallowing safety, so the paper does not establish that xanthan gum is better overall. Page numbers were not supplied in our copy. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

After severe acute pancreatitis, an early oral diet is recommended at least by soft food; solid food is not contraindicated but should be built up to a normal diet within days, judging by abdominal pain and postprandial pain.

“an early oral diet is”

• cites [206] Han-Geurts, 2007, Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery, Br J Surg sourcePartly supported

  The Abstract reports that patients recovering from elective colorectal or abdominal vascular surgery could resume oral intake as tolerated and reached a normal diet in a median of two days in the free-diet group. The Discussion also reports earlier tolerance of solid food. The paper does not study severe acute pancreatitis or recommend soft food or using abdominal and postprandial pain to guide diet advancement. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

In that RCT, early recovery of intestinal function and improvement of quality of life were the main advantages.

“Early 1603 recovery of intestinal function and an improvement of quality of life were the main advantages 1604 [215].”

• cites [215] Wang, 2014, Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for patients with head and neck cancer: a systematic review, J Radiat Res sourcePartly supported

  The Results section (page unavailable) reports better global quality of life for some patients receiving percutaneous gastrostomy than for those receiving nasogastric feeding. Our copy does not report early recovery of intestinal function as an advantage, and the cited paper is a systematic review, not itself an RCT. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

The quote only partly states this claim.

That RCT showed early feeding provides better nutrition compared to delayed feeding.

“provides better nutrition”

• cites [225] 2002, Non-variceal upper gastrointestinal haemorrhage: guidelines, Gut sourcePartly supported

  Section 4.0 (Management Following Endoscopy; page unavailable) recommends allowing haemodynamically stable patients to drink and start a light diet 4–6 hours after endoscopy. But this source is a guideline, not the RCT described in the claim, and the passage reports neither a comparison with delayed feeding nor a nutritional benefit. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The Cochrane review cautioned interpretation due to substantial heterogeneity and low-quality evidence.

“cautious interpretation must be taken due to substantial heterogeneity and low-1599 quality evidence [214].”

• cites [214] Sun, 2018, Early oral feeding following McKeown minimally invasive esophagectomy: an open-label, randomized, controlled, noninferiority trial, Ann Surg sourceCould not verify

  The Study Design section identifies this paper as a single-center randomized trial, while the Discussion’s Limitations section discusses restrictions of that trial. Searches for a Cochrane review, substantial heterogeneity, and low-quality evidence found no passage in our copy addressing the attributed caution; no page numbers were available. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

The quote only partly states this claim.

An RCT showed that early feeding with a regular solid diet in patients after successful variceal ligation for esophageal varices is safe compared to delayed feeding.

“An RCT showed that early feeding with a regular solid diet in patients after successful variceal 1656 ligation for esophageal varices is safe”

• cites [225] 2002, Non-variceal upper gastrointestinal haemorrhage: guidelines, Gut sourcePartly supported

  Section 4.0 (page unavailable) recommends a light diet for patients who are haemodynamically stable 4–6 hours after endoscopy and says prolonged fasting is unnecessary. It does not report an RCT comparing early regular solid food with delayed feeding after variceal ligation; section 3.4.1 says variceal banding is described elsewhere. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

May combine two claims.

At the hospital, malnutrition is associated with increased mortality, morbidity, length of stay, and costs.

“At the hospital, 1715 malnutrition is associated with increased mortality, morbidity, length of stay, and costs [112].”

• cites [112] Friedli, 2018, Management and prevention of refeeding syndrome in medical inpatients: an evidence-based and consensus-supported algorithm, Nutrition sourceCould not verify

  The Conclusion (page unavailable) links high morbidity and mortality to refeeding syndrome in malnourished patients, not to hospital malnutrition generally. Searches for malnutrition-related mortality, morbidity, length of stay, and costs found no passage in our copy establishing the claimed associations; the matching references alone do not establish them. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

Reduced food intake is defined as food intake equal to or less than 50% of energy requirements over one week, or any reduction in food intake for more than two weeks.

“reduced 1745 food intake is defined as food intake equal to or less than 50% of energy requirements over one 1746 week, or any reduction in food intake for more than two weeks.”

• cites [8] Cederholm, 2019, GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community, Clin Nutr sourcePartly supported

  Section 3.6 identifies reduced food intake as a GLIM etiologic criterion and says the group sought practical thresholds. The passages available from our copy do not state the claimed ≤50% threshold or the one- and two-week durations; searches for those terms did not recover them. (LLM, conf=0.78)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

To assess food intake, the GLIM advocated the use of semi-quantitative methods.

“To assess food intake, the GLIM advocated the use of semi-quantitative methods [8]”

• cites [8] Cederholm, 2019, GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community, Clin Nutr sourcePartly supported

  Section 3.6 treats reduced food intake as a GLIM criterion and discusses thresholds for assessing its impairment. It does not advocate semi-quantitative methods for assessing intake; a search for that term found no such recommendation in our copy. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The assessment of food energy intake has long been considered a key part of the nutritional assessment.

“The assessment of food energy intake has long been considered a key part of the nutritional 1720 assessment [8, 106, 235].”

• cites [8] Cederholm, 2019, GLIM criteria for the diagnosis of malnutrition - a consensus report from the global clinical nutrition community, Clin Nutr sourceSupported
• cites [106] Porter, 2017, Protected Mealtimes in hospitals and nutritional intake: systematic review and meta-analyses, Int J Nurs Stud sourceNot checked — no full text of the source
• cites [235] Schindler, 2016, To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006–2014 in 56 countries worldwide: a descriptive analysis, Am J Clin Nutr sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

During the second voting, all recommendations except for eleven of them received an agreement higher than 90%.

“During the second voting, all recommendations except 132 for eleven of them received an agreement higher than 90%.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Of the recommendations below 90% agreement in the second voting, ten received an agreement >75% and one an agreement >50%.

“Of those below 90%, ten received 133 an agreement >75%, one an agreement > 50%.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The final guideline comprises 56 recommendations.

“The final guideline comprises 56 134 recommendations.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Twenty-nine recommendations reached an agreement >90%, 22 recommendations reached an agreement of >75-90%, and six recommendations an agreement ≤75%.

“Twenty-nine 123 recommendations reached an agreement >90%, 22 recommendations reached an agreement of 124 >75–90%, and six recommendations an agreement ≤75%.”

May combine two claims.

Qualitative studies took account of patients' perception of meals or motivation to eat.

“Qualitative studies took 676 account of patients' perception of meals [57, 58] or motivation to eat [59].”

• cites [57] Johns, 2010, Improving the provision of meals in hospital. The patients' viewpoint, Appetite sourceNot checked — no full text of the source
• cites [58] Sorensen, 2012, Food for patients at nutritional risk: a model of food sensory quality to promote intake, Clin Nutr sourceNot checked — no full text of the source
• cites [59] Stroebele, 2004, Effect of ambience on food intake and food choice, Nutrition sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

No RCTs are investigating the optimal dietary management of patients with lower gastrointestinal bleeding.

“No RCTs are investigating the optimal 1634 dietary management of patients with lower gastrointestinal bleeding.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The grading system of the Scottish Intercollegiate Guidelines Network (SIGN) was used to grade the literature.

“The grading system of the 99 Scottish Intercollegiate Guidelines Network (SIGN) was used to grade the literature [6].”

• cites [6] 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

The literature search was performed separately for each PICO question in May 2019 by using the Pubmed and Cochrane databases.

“The literature search was performed separately for each PICO question in May 2019 by using 144 the Pubmed and Cochrane databases with the search terms presented in Table 4.”

May combine two claims.

In frail older people living in residential care homes, energy enriched food was shown to increase energy intake and slow chronic weight loss.

“energy enriched food was shown to increase energy 446 intake and slow chronic weight loss.”

• cites [30] Leslie, 2013, Improving the dietary intake of under nourished older people in residential care homes using an energy-enriching food approach: a cluster randomised controlled study, J Hum Nutr Diet sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Promoting six-meal services (three main meals plus three snacks, or six small protein-rich meals per day) as the standard hospital food service could improve protein and energy delivery and reach nutritional targets in hospitalized patients.

“One means to improve protein and energy delivery and to 447 reach the nutritional targets to hospitalized patients could be to promote six-meal services (three 448 main meals + three snacks; or six small protein-rich meals per day) as the standard hospital 449 food service.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The present guideline was developed according to the standard operating procedure for ESPEN guidelines.

“The present guideline was developed according to the standard operating procedure for 90 ESPEN guidelines [4].”

• cites [4] Bischoff, 2015, Standard operating procedures for ESPEN guidelines and consensus papers, Clin Nutr sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

A literature search was performed to identify suitable meta-analyses, systematic reviews, and primary studies.

“a literature search was performed to identify suitable meta-96 analyses, systematic reviews, and primary studies”

Probably not a substantial claim: may not pass S3 (load-bearing).

The guideline was developed by an expert group of seven physicians and four dietitians.

“The guideline was developed by an expert group of seven physicians 91 and four dietitians.”

May combine two claims.

Dietary counseling improves energy and protein intake during chemotherapy in lung cancer patients, but has no benefit to other outcomes during chemotherapy.

“dietary counseling improves energy and protein intake during chemotherapy, but has no 439 benefit to other outcomes during chemotherapy.”

• cites [26] Kiss, 2014, The effect of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review, Nutr Cancer sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Existing guidelines were also considered in the literature search.

“Existing 145 guidelines were also considered.”

Classified as probably not a substantial claim. May combine two claims.

The ESPEN guideline office created evidence tables of relevant meta-analyses, systematic reviews, and (randomized) controlled trials to support the recommendations and assigned grades.

“To support the recommendations and the assigned grades of 135 recommendation, the ESPEN guideline office created evidence tables of relevant meta-136 analyses, systematic reviews, and (randomized) controlled trials.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The good practice points (GPP) are based on experts' opinions due to the lack of studies.

“The good practice points (GPP) are based on experts' opinions due to the lack 116 of studies, for which the choice of wording was not restricted.”

Classified as probably not a substantial claim.

Therapeutic diets increase the risk for malnutrition.

“therapeutic diets should only be used if medically indicated, since they 395 increase the risk for malnutrition.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Units who adopt meals on wheels distribution have to be aware of the nutritional risk due to possible smaller portions served.

“units who adopt these meals on wheels distribution have to be aware of the 664 nutritional risk due to possible smaller portions served [53, 54].”

• cites [53] Ofei, 2015, Effect of meal portion size choice on plate waste generation among patients with different nutritional status. An investigation using Dietary Intake Monitoring System (DIMS), Appetite sourceNot checked — no full text of the source
• cites [54] 2017Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Rattray et al. performed an observational study in 110 patients, and showed that patients are provided 75% of estimated needs, and consume less than required (~50%).

“Rattray et al performed an observational study in 110 566 patients, and showed that patients are provided 75% of estimated needs, and consume less than 567 required (~50%) [43].”

• cites [43] Rattray, 2017, Comparing nutritional requirements, provision and intakes among patients prescribed therapeutic diets in hospital: an observational study, Nutrition sourceNot checked — no full text of the source

May combine two claims.

Engelheart et al. showed that the length of fasting of the elderly was significantly shorter in the self-managing elderly than in a nursing home with frail, emphasizing the impact of staff organizations on overnight fasting.

“Engelheart et al. showed that 609 the length of fasting of the elderly was significantly shorter in the self-managing elderly than 610 in a nursing home with frail, emphasizing the impact of staff organizations on overnight fasting 611 [47].”

• cites [47] Correa-Arruda, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Health institutions strive 'as much as possible' to find alternatives to food that is rejected by a fraction of the patients.

“Health institutions strive”

• cites [65] Draper, 2019, Front cover: vegan and animal meal composition and timing influence glucose and lipid related postprandial metabolic profiles, Mol Nutr Food Res sourceNot checked — no full text of the source

May combine two claims.

Oral nutritional interventions are effective at increasing nutritional intake and improving some aspects of quality of life in patients with cancer who are malnourished or at nutritional risk but do not appear to improve mortality.

“oral nutritional interventions are effective at increasing 469 nutritional intake and improving some aspects of quality of life in patients with cancer who are 470 malnourished or are at nutritional risk but do not appear to improve mortality [31].”

• cites [31] Leedo, 2017, The effect of a home delivery meal service of energy- and protein-rich meals on quality of life in malnourished outpatients suffering from lung cancer: a randomized controlled trial, Nutr Cancer sourceNot checked — no full text of the source

May combine two claims.

Dietary requirements related to religions are heterogeneous, and further variability is due to variations in a single religion depending upon the country of origin.

“Dietary requirements related to religions are heterogeneous, 711 and further variability is due to variations in a single religion depending upon the country of 712 origin [62].”

• cites [62] Hodge, 2015, Respecting religious freedoms and protecting the public's health, Publ Health Rep sourceNot checked — no full text of the source

The quote only partly states this claim.

In malnourished and at-risk hospitalized elderly patients, pulse feeding (72% of dietary protein consumed in one meal) had a clinically relevant effect on lean mass compared to spreading dietary protein over four daily meals.

“Pulse 483 feeding had a clinically relevant effect on lean mass in malnourished and at-risk hospitalized 484 elderly patients.”

• cites [36] Bouillanne, 2013, Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: a randomized controlled trial, Clin Nutr sourceNot checked — no full text of the source

May combine two claims. The quote only partly states this claim.

In hospitalized patients with malnutrition, an individualized nutrition plan according to energy and protein (1.0-1.5 g/kg) intake requirements plus dietary advice suggests dietary advice decreases hospital stay but not mortality.

“Results suggest dietary advice decreases hospital stay 481 but not mortality.”

Classified as probably not a substantial claim.

Kosher, Halal, vegetarian, or other diets should be provided by hospitals, even if these diets have nowadays no medical rationale.

“Kosher, Halal, vegetarian, or other diets should be provided by 714 hospitals, even if these diets have nowadays no medical rationale [64].”

• cites [64] Laïcité, 2016, Un guide pour la gestion du fait religieux dans les hôpitaux, Histoire, monde et cultures religieusesNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

The prevention of malnutrition or its worsening implies the coverage of at least 80% of estimated energy and protein needs.

“The prevention of malnutrition or its worsening implies the coverage of at least 80% of 591 estimated energy and protein needs.”

May combine two claims.

The enrichment of the diet or counseling aiming to increase energy and protein intake positively affects energy intake and body weight, but effects on hard outcomes such as reduced morbidity and mortality and increased functional capacity are rare.

“the enrichment of the diet or counseling aiming to increase energy and 488 protein intake positively affects energy intake and body weight, but effects on hard outcomes 489 as reduced morbidity and mortality and increased functional capacity are rare.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Some units experienced the trolley meal system as a strategy to adapt the meal with the patient's desires and to minimize food waste.

“Some units experienced the trolley meal 662 system as a strategy to adapt the meal with the patient's desires [52] and to minimize food 663 waste.”

• cites [52] Ofei, 2014, How practice contributes to trolley food waste. A qualitative study among staff involved in serving meals to hospital patients, Appetite sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

There is no evidence that every hospitalized patient should receive more micronutrients; this is the same for salt intake and fatty acid composition.

“There is no evidence that every hospitalized patient should receive more 572 micronutrients. This is the same for salt intake and fatty acid composition.”

May combine two claims.

Munk et al. showed that protein enriched meals gave a significantly higher protein intake (not energy intake) (the relative risk was 2.20).

“Munk et al showed that protein enriched meals gave a significantly higher 568 protein intake (not energy intake) (the relative risk was 2.20 [44]).”

• cites [44] Söderström, 2013, Mealtime habits and meal provision are associated with malnutrition among elderly patients admitted to hospital, Clin Nutr sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Snack consumption could enhance patient satisfaction and thus contribute to an overall increase in the consumption of food.

“Snack consumption could enhance patient 594 satisfaction and thus contribute to an overall increase in the consumption of food.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Every patient should be able to follow the precepts of his religion (meditation, presence of a minister of his religion, food, freedom of action and expression, etc.).

“Every patient should be 715 able to follow the precepts of his religion (meditation, presence of a minister of his religion, 716 food, freedom of action and expression, etc.) [65].”

• cites [65] Draper, 2019, Front cover: vegan and animal meal composition and timing influence glucose and lipid related postprandial metabolic profiles, Mol Nutr Food Res sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In the study by Munk, the range is extended to 2.0 g/kg BW during illness.

“In the study by Munk, the range is extended to 2.0 g/kg BW during 515 illness [27].”

• cites [27] Munk, 2014, Positive effect of protein-supplemented hospital food on protein intake in patients at nutritional risk: a randomised controlled trial, J Hum Nutr Diet sourceNot checked — no full text of the source

May combine two claims.

A Cochrane systematic review of 185 RCTs (N=12210) showed that sodium reduction from an average high usual intake (201 mmol/day, 11.5 g sodium chloride/day) to 66 mmol/day (3.8 g sodium chloride/day) decreased systolic/diastolic blood pressure in white, Asian and black normotensive participants and decreased it even more in hypertensive participants.

“sodium reduction from an average high”

• cites [158] Paterna, 2009, Medium term effects of different dosage of diuretic, sodium, and fluid administration on neurohormonal and clinical outcome in patients with recently compensated heart failure, Am J Cardiol sourceNot checked — no full text of the source

The quote only partly states this claim.

An RCT showed that a normal-sodium diet with high diuretic doses and fluid intake restriction, compared with other combinations, leads to reductions in readmissions, neurohormonal activation, and renal dysfunction.

“the combination of a normal-sodium diet with high”

• cites [160] Fardet, 2009, Effet à court terme des apports sodés sur la pression artérielle des patients recevant une corticothérapie systémique : étude prospective, randomisée, croisée, Rev Med Interne sourceNot checked — no full text of the source

The quote only partly states this claim.

A small qualitative study of 16 adults on long-term corticosteroids highlighted difficulties and psychological distress in comprehending and implementing diet recommendations.

“highlighted the difficulties and the”

• cites [166] Miggiano, 2004, [Diet and chronic corticosteroid therapy], Clin TerNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Patients in rehabilitation units would benefit from eating together with conviviality and caregivers could pay more attention to patients with assisted meals if needed.

“Patients would benefit from eating together with conviviality and caregivers could pay more 668 attention to patients with assisted meals if needed (following recommendations of the French 669 National Food Council [55] and of the National Nutrition Council and Finnish Institute for 670 Health and Welfare [56], autonomous patients should stop keeping in their rooms for”

• cites [55] 2020, Meal situation from the client's perspective. In: Nutrition Council and Finnish Institute for health and WelfareNot checked yet

  Not checked in the free run.

• cites [56] Stanga, 2003, Hospital food: a survey of patients' perceptions, Clin Nutr sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The hospital staff is facing a complex situation to satisfy the patients' expectations.

“The hospital staff is facing a complex situation to 710 satisfy the patients' expectations.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). The quote only partly states this claim.

Increasing ambulatory hospitalization may accelerate the shift towards a new organization where patients can eat at every moment of the day in dedicated places.

“Increasing ambulatory hospitalization may accelerate the shift towards this 675 new organization.”

The quote only partly states this claim.

In an RCT of 410 compensated chronic heart failure patients, the group consuming a normal-sodium diet (120 mmol sodium) showed significant reductions in readmissions, brain natriuretic peptide, aldosterone, and plasma renin activity compared with groups consuming lower sodium dosages.

“The group consuming the normal-sodium diet (120 mmol sodium) showed the best results, with”

• cites [159] Aliti, 2013, Aggressive fluid and sodium restriction in acute decompensated heart failure, JAMA Internal Medicine sourceNot checked — no full text of the source

May combine two claims.

In patients after elective colorectal surgery, a low residue diet on postoperative day one, compared with a clear liquid diet, is associated with less nausea, faster return of bowel function, and shorter hospital stay without increased postoperative morbidity.

“provision of a low residue diet rather than a clear liquid diet after colorectal surgery”

• cites [148] McMurray, 2012, Eur Heart J sourceNot checked — no full text of the source

May combine two claims.

Sodium restriction below 2500 mg/day is associated with a significantly higher risk for the combined primary endpoint of death or heart failure hospitalization, driven primarily by increased heart failure hospitalization.

“sodium restriction <2500 mg/day had a”

Probably not a substantial claim: may not pass S3 (load-bearing).

The refeeding regimen may also be gradually progressed from a clear liquid diet to a low-fat solid diet.

“The refeeding regimen may also be gradually progressed from a clear liquid diet”

• cites [201] Lariño-Noia, 2014, Early and/or immediately full caloric diet versus standard refeeding in mild acute pancreatitis: a randomized open-label trial, Pancreatology sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Mediterranean and DASH-style dietary patterns are recommended to reduce cardiovascular disease risk factors and cardiovascular disease events in people with diabetes.

“specifically the Mediterranean and dietary approaches to stop hypertension (DASH)‐style diets,”

• cites [175] Morley, 2014, Frailty, sarcopenia and diabetes, J Am Med Dir Assoc sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

For persons with diabetic nephropathy, national and international guidelines recommend dietary advice tailored to the stage of kidney disease concerning potassium, phosphate, salt, and energy intake, ensuring malnutrition is prevented.

“appropriate dietary advice tailored to the stage of kidney disease should be given concerning”

• cites [180] Beck, 2018, Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia - an updated clinical guideline, Clin Nutr sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Texture-modified food might look unappealing.

“texture-modified food might look”

• cites [182] Leder, 2009, An epidemiologic study on aging and dysphagia in the acute care hospitalized population: 2000-2007, Gerontology sourceNot checked — no full text of the source

May combine two claims.

The swallowing muscles are different from somatic muscles as they receive continuous stimulation from the respiratory center, but are inevitably affected by malnutrition and disuse; accumulating evidence exists regarding the negative influence on swallowing.

“muscles are different from somatic muscles as they receive continuous stimulation from the”

• cites [184] Carrión, 2015, Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital, Clin Nutr sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In people with diabetes, studies recommend up to 40% of energy from fat, mostly unsaturated fat.

“recommending up to 40% of energy from fat - mostly unsaturated fat.”

• cites [175] Morley, 2014, Frailty, sarcopenia and diabetes, J Am Med Dir Assoc sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

In mild diabetic gastroparesis, dietary recommendations rely on measures that optimize gastric emptying: low-fat, low-fiber meals, small frequent meals, complex carbohydrates, and energy-dense liquids in small volumes.

“dietary recommendations rely on measures that optimize gastric emptying. These are low-fat,”

• cites [178] Fontana, 1996, Jejunostomy tube placement in refractory diabetic gastroparesis: a retrospective review, Am J GastroenterolNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The exact proportion of energy that should be derived from total fat intake does not appear to be critical.

“the exact proportion of energy that should be derived”

• cites [175] Morley, 2014, Frailty, sarcopenia and diabetes, J Am Med Dir Assoc sourceNot checked — no full text of the source

May combine two claims.

In patients with moderate to severe acute pancreatitis, enteral nutrition is beneficial and early oral feeding with hospital food is not recommended if there is hemodynamic instability.

“EN is beneficial and early oral feeding with hospital food is not recommended”

• cites [205] Tenner, 2013, American College of gastroenterology guideline: management of acute pancreatitis, Am J Gastroenterol sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The overall incidence of dysphagia in traumatic and non-traumatic cervical spinal cord injury patients varies from 16% to 80%.

“the overall incidence of dysphagia in traumatic and non-traumatic cervical”

• cites [187] Smithard, 1996, Complications and outcome after acute stroke, Stroke sourceNot checked — no full text of the source

May combine two claims.

An RCT including 151 patients showed that oral refeeding with a soft diet in patients with mild acute pancreatitis is safe and results in a shorter length of hospital stay.

“oral refeeding with a soft diet in patients with mild”

• cites [198] Jacobson, 2007, A prospective, randomized trial of clear liquids versus low-fat solid diet as the initial meal in mild acute pancreatitis, Clin Gastroenterol Hepatol sourceNot checked — no full text of the source

May combine two claims.

Pureed diets usually have a low energy density, indicating that a greater quantity of food needs to be consumed to meet nutrient needs, which may impose a physiological burden on older adults.

“pureed diets usually have a low energy density, indicating that a greater”

• cites [182] Leder, 2009, An epidemiologic study on aging and dysphagia in the acute care hospitalized population: 2000-2007, Gerontology sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

There is no convincing evidence for a recommended ideal amount of carbohydrate for maintaining long-term glycemic control for people with type 1 diabetes.

“There is no convincing evidence for”

• cites [175] Morley, 2014, Frailty, sarcopenia and diabetes, J Am Med Dir Assoc sourceNot checked — no full text of the source

May combine two claims.

For a person with severe gastroparesis who is unable to maintain nutrition with oral intake, a feeding jejunostomy tube that bypasses the affected stomach can improve symptoms and reduce hospitalization.

“a feeding jejunostomy tube, which bypasses the affected stomach,”

• cites [179] National Clinical Guideline, 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

That review found no difference in risk of anastomotic leak, pneumonia, readmission rate, and mortality.

“and there was no 1610 difference in risk of anastomotic leak, pneumonia, readmission rate, and mortality [217].”

• cites [217] Tweed, 2019, Safety and efficacy of early oral feeding for enhanced recovery following gastrectomy for gastric cancer: a systematic review, Surg Oncol sourceNot checked — no full text of the source

May combine two claims.

Early resumption of oral intake does not diminish the duration of postoperative ileus or lead to a significantly increased rate of nasogastric tube reinsertion.

“Early resumption of oral intake”

• cites [207] Lassen, 2008, Allowing normal food at will after major upper gastrointestinal surgery does not increase morbidity, Ann Surg sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Usually, a liquid diet is initiated immediately, and subsequently, a soft diet is given.

“Usually, a liquid diet is 1652 initiated immediately, and subsequently, a soft diet is given [194].”

• cites [194] Rajkumar, 2012, Clear liquid diet vs soft diet as the initial meal in patients with mild acute pancreatitis, Nutr Clin Pract sourceNot checked — no full text of the source

The quote only partly states this claim.

In an RCT including 100 patients, early feeding starting on day one shortened the hospital stay compared to nil by mouth until day three.

“In an RCT including 100 patients early feeding starting 1647 on day one shortened the hospital stay”

• cites [224] Sidhu, 2019, Early feeding after esophageal variceal band ligation in cirrhotics is safe: randomized controlled trial, Dig Endosc sourceNot checked — no full text of the source

May combine two claims.

In a recent RCT in colorectal cancer surgery patients, early oral feeding was safe and effective, with a shortened hospital stay as the primary benefit.

“In a recent RCT in 1592 colorectal cancer surgery patients, early oral feeding was demonstrated to be safe and effective, 1593 with a shortened hospital stay as the primary benefit [212].”

• cites [212] Lucha, 2005, The economic impact of early enteral feeding in gastrointestinal surgery: a prospective survey of 51 consecutive patients, Am Surg sourceNot checked — no full text of the source

The quote only partly states this claim.

That meta-analysis showed early oral feeding decreases hospital length of stay.

“but decreases hospital length of stay [194].”

• cites [194] Rajkumar, 2012, Clear liquid diet vs soft diet as the initial meal in patients with mild acute pancreatitis, Nutr Clin Pract sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

In the absence of demonstrated benefits, there is no need of starving or restricted diet after an uncomplicated procedure.

“In the absence of demonstrated benefits, there is no need of starving or restricted diet after an 1672 uncomplicated procedure.”

May combine two claims.

It appears that early EN (within 24-48 h after surgery) has a positive effect on length of stay and no negative effect on complications.

“It appears that early EN (within 24-48 h after 1590 surgery) has a positive effect on length of stay and no negative effect on complications.”

May combine two claims.

An early normal hospital diet is feasible and safe after colorectal surgery.

“An early normal hospital diet is feasible and safe after colorectal surgery.”

Classified as probably not a substantial claim. May combine two claims.

Patients with clean-based ulcers or nonbleeding Mallory-Weiss tears may be refed early with the regular hospital diet and discharged home immediately after stabilization.

“Patients with clean-1643 based ulcers or nonbleeding Mallory-Weiss tears may be refed early with the regular hospital 1644 diet and discharged home immediately after stabilization [222].”

• cites [222] de Lédinghen, 1998, [When should patients with bleeding peptic ulcer resume oral intake? A randomized controlled study], Gastroenterol Clin BiolNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The French-Speaking Society for Clinical Nutrition and Metabolism (SFNCM) recommended the use of a 10-point analog visual scale for malnutrition screening in oncology patients.

“Nowadays, the French-Speaking Society for Clinical Nutrition and Metabolism 1763 (SFNCM) recommended the use of a 10-point analog visual scale for malnutrition screening in 1764 oncology patients [242].”

• cites [242]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Another semi-quantitative way of assessing food intake could be the use of a 10-point analog visual scale for food intake.

“Another semi-quantitative way of assessing food intake could be the use of a 10-point analog 1755 visual scale for food intake [239].”

• cites [239] Buzby, 1988, A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design, Am J Clin Nutr sourceNot checked — no full text of the source

May combine two claims.

The 10-point visual analog scale for food intake could help to identify hospitalized patients at risk of malnutrition, with 81% of those with a score <7 being at high nutritional risk according to the Nutritional Risk Index.

“Moreover, the 10-point visual analog scale 1760 for food intake could help to identify hospitalized patients at risk of malnutrition with 81% of 1761 those with a score <7 were at high nutritional risk [239] according to the Nutritional Risk Index 1762 (NRI) [241].”

• cites [239] Buzby, 1988, A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design, Am J Clin Nutr sourceNot checked — no full text of the source
• cites [241] Thibault, 2012, Comment évaluer l'état et le risque nutritionnels? Quelle stratégie d'intervention?Not checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Malnutrition affects 30-50% of adult patients admitted to hospitals.

“Malnutrition affects 30–50% of adult patients admitted to hospitals [233, 234].”

• cites [233] Baker, 1982, Nutritional assessment: a comparison of clinical judgement and objective measurements, N Engl J Med sourceNot checked — no full text of the source
• cites [234] Kuppinger, 2012, Nutritional screening for risk prediction in patients scheduled for abdominal operations, Br J Surg sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In 2009, the use of 10-point analog scales was proposed to assess food intake in both in- and out-patients.

“In 2009, the use of 10-point analog scales was proposed to 1756 assess food intake in both in- and out-patients”

• cites [239] Buzby, 1988, A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design, Am J Clin Nutr sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

These methods could be helpful to timely identify the patients who need the effort to be focussed on the best optimized nutritional care, without any delay in nutritional care decision.

“These methods could be helpful to timely identify the patients who need the effort to 1775 be focussed on the best optimized nutritional care, without any delay in nutritional care 1776 decision.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The Simple Evaluation of Food Intake (SEFI®) is approved by SFNCM to assess food intake.

“The Simple Evaluation of Food Intake (SEFI®) (www.sefi-1765 nutrition.com, Knoë, le Kremlin Bicêtre, France) (ex-EPA) is approved by SFNCM to assess 1766 food intake [243].”

• cites [243]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The 10-point analog scale is feasible, easy to use, and extremely well correlated with daily energy intake assessed by the 3-day dietary record, especially in malnourished patients.

“as it is feasible, easy to use, and extremely well 1757 correlated with daily energy intake assessed by the 3-day dietary record, especially in 1758 malnourished patients [239].”