Effective elements of home delivered meal services to improve energy and protein intake: a systematic review.

Abstract Objective Home delivered meal services are an example of a nutritional intervention in the home setting developed to enhance dietary intake and contribute to the independence of especially older adults. There is a lack of evidence on the contribution of specific elements of any home delivered meal service on the improved outcomes. Therefore, a systematic review was performed to evaluate which elements of home delivered meal services are effective to improve energy and protein intake, nutritional status, functional outcomes and satisfaction in adults. Research Methods & Procedures Pubmed, Embase and Web of Science databases were searched for studies assessing energy and protein intake, nutritional or functional status or satisfaction for home delivered meal services. The quality of the studies was assessed using the Quality Criteria Checklist for Primary Research. Results Out of 138 studies meeting the search criteria, 19 were included, none of which met the criteria to be rated as high quality. These studies show that various elements of home delivered meal services such as, Meals on Wheels, providing protein-enriched bread or snacks in addition to meals or providing meals and snacks for whole days can improve outcomes such as energy and protein intake and satisfaction. A distinction can be made between services focusing on supporting homebound, essentially healthy, older adults and services aiming at the optimal, nutritional, transmural care for patients at risk of malnutrition. Conclusion This review shows that various elements of home delivered meal services can improve key outcomes. Following the rising interest and importance of these interventions, there is an urgent need to optimize such services in order to improve nutritional care at home regarding the increasingly limited time frame of admission in hospitals.