Bayram 2009.

Methods	Randomized (2:1 randomization) controlled open‐label study. Duration: 3 months (follow up of a subset of participants for a further 3 months). Parallel design. Single centre. Location: Turkey. No intention‐to‐treat analysis.
Participants	52 children (31 boys, 21 girls) with paediatric malignant disease receiving intensive chemotherapy. Mean (SD) age 7.5 (3.0) years. Treatment group n = 33: 18 children were diagnosed with leukaemia (12 acute lymphoblastic leukaemia, 6 acute myeloid leukaemia) and 15 had a solid tumour (4 non‐Hodgkin lymphoma, 3 neuroblastoma, 2 Wilm’s tumour, 2 brain tumour, 2 malignant bone tumour, 1 soft tissue tumour, and 1 hepatoblastoma). Control group n = 19: 11 children were diagnosed with leukaemia (7 acute lymphoblastic leukaemia, 4 acute myeloid leukaemia) and 8 had a solid tumour (3 neuroblastoma, 2 soft tissue tumour, 1 brain tumour, 1 malignant bone tumour, and 1 retinoblastoma).
Interventions	Treatment: usual dietary intake plus 2x daily (morning and evening) oral supplement (ProSure™) containing protein and energy dense EPA (banana and vanilla flavoured); each 240 ml container contained 300 kcal, 16 g protein, 1.09 g EPA (derived from deodorized sardine oil). Children supervised by a nurse specialized in nutrition who monitored compliance with supplement. Control: usual dietary care.
Outcomes	Body weight, BMI, weight percentiles, status of primary disease, attacks of febrile neutropenia and clinical status. Measured monthly for 3 months. Subgroup of 23 children followed for further 3 months (6 months total).
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Children were randomized, using a 2:1 randomization scheme. No further details given.
Allocation concealment (selection bias)	High risk	Open‐label design and therefore did not maintain concealment of allocation.
Blinding (performance bias and detection bias) All outcomes	Low risk	Not blinded. Outcomes were not affected by blinding due to the fact that they were objective measures.
Incomplete outcome data (attrition bias) All outcomes	Low risk	There was no loss to follow up.
Selective reporting (reporting bias)	Low risk	Outcomes all reported in the Results as outlined in the Methods.