24. Supplementary feeding versus no supplementary feeding (control, placebo, standard care, dietary advice), outcome, nutritional status of adults, weight.
| Review | Target group | Intervention | Outcome | Corresponding risk with intervention (95% CI) | Number of participants (studies) | Certainty of evidence (GRADE)a |
| Grobler 2013 | Adults with HIV | Balancedb | Body weight (6–12 weeks' follow‐up) | MD –0.17 (–1.10 to 0.75) | 233 (4) | Moderate |
| Balancedc | Body weight at baseline (ART arm) | MD –0.58 (–1.47 to 0.31) | 617 (1) | NR | ||
| Body weight at baseline (pre‐ART arm) | MD 0.60 (–0.60 to 1.80) | 429 (1) | NR | |||
| Body weight at 1 month (ART arm) | MD 0.58 (–0.62 to 1.78) | 366 (1) | NR | |||
| Body weight at 1 month (pre‐ART arm) | MD 1.09 (–0.59 to 2.77) | 261 (1) | NR | |||
| Body weight at 3 months (ART arm) | MD 0.41 (–0.99 to 1.81) | 322 (1) | NR | |||
| Body weight at 3 months (pre‐ART arm) | MD 2.82 (1.02 to 4.62)d | 211 (1) | NR | |||
| Body weight at 6 months (ART arm) | MD 0.17 (–1.50 to 1.84) | 237 (1) | NR | |||
| Body weight at 6 months (pre‐ART arm) | MD 3.67 (1.50 to 5.84)d | 157 (1) | NR | |||
| Body weight at 12 months (ART arm) | MD –1.00 (–3.19 to 1.19) | 180 (1) | NR | |||
| Body weight at 12 months (pre‐ART arm) | MD 2.25 (–0.41 to 4.91) | 118 (1) | NR | |||
| Change in body weight at 1 month (ART arm) (kg) | MD 0.90 (0.40 to 1.41)e | 366 (1) | NR | |||
| Change in body weight at 1 month (pre‐ART arm) (kg) | MD 0.82 (0.28 to 1.36)f | 261 (1) | NR | |||
| Change in body weight at 3 months (ART arm) (kg) | MD 1.12 (0.29 to 1.95)e | 322 (1) | NR | |||
| Change in body weight at 3 months (pre‐ART arm) (kg) | MD 1.22 (0.31 to 2.12)f | 211 (1) | NR | |||
| Change in body weight at 6 months (ART arm) (kg) | MD 0.89 (–0.30 to 2.08) | 237 (1) | NR | |||
| Change in body weight at 6 months (pre‐ART arm) (kg) | MD 2.06 (0.82 to 3.30)f | 157 (1) | NR | |||
| Change in body weight at 12 months (ART arm) (kg) | MD –0.03 (–1.78 to 1.71) | 180 (1) | NR | |||
| Change in body weight at 12 months (pre‐ART arm) (kg) | MD 0.83 (–0.79 to 2.45) | 118 (1) | NR | |||
| Specific (AA mixture)g | Mean change in body weight (baseline to 8 weeks) (kg) | MD 2.63 (0.72 to 4.54)h | 43 (1) | NR | ||
| Specific (OKG)i | Mean weight at study endpoint (kg) | MD –5.00 (–11.68 to 1.68) | 46 (1) | NR | ||
| Specific (GLN)j | Mean weight at study endpoint (kg) | MD –1.30 (–10.18 to 7.58) | 21 (1) | NR | ||
| Grobler 2016 | Adults with TB | Balanced and high energy | Mean weight gain (after 6 weeks) (kg) | MD 1.73 (0.81 to 2.65)k | 34 (1) | NR |
| Mean weight gain (after 8 weeks) (kg) | MD 0.78 (–0.05 to 1.60) | 689 (3) | NR | |||
| Mean weight gain (after 12 weeks) (kg) | MD 2.60 (1.74 to 3.46)k | 100 (1) | NR | |||
| Mean weight gain (after 20 weeks) (kg) | MD –0.20 (–1.34 to 0.94) | 306 (1) | NR | |||
| Mean weight gain (after 24 weeks) (kg) | MD 1.78 (–0.25 to 3.81) | 26 (1) | NR | |||
| Mean weight gain (after 32 weeks) (kg) | MD 2.60 (0.52 to 4.68)k | 265 (1) | NR | |||
| Mean weight gain (at 8 weeks) (kg)l | Not pooled | 731 (4) | Moderate | |||
| Ota 2015 | Pregnant women | Balanced | Weekly gestational weight gain (g/week) | MD 18.63 (–1.81 to 39.07) | 2391 (9) | NR |
| Maternal weight 4 weeks' postpartum (kg) | MD –0.90 (–1.92 to 0.12) | 354 (1) | NR | |||
| High protein | Weekly gestational weight gain (g/week) | MD 4.50 (–33.55 to 42.55) | 486 (1) | NR | ||
| Isocaloric balanced protein | Weekly gestational weight gain (g/week) | MD 110.45 (–82.87 to 303.76) | 184 (2) | Very low | ||
| AA: amino acid; ART: antiretroviral therapy; CI: confidence intervals; GLN: L‐glutamine; MD: mean difference; NR: not reported; OKG: ornithine alpha‐ketoglutarate; TB: tuberculosis. | ||||||
aAs reported in 'Summary of findings' tables. bAll commercial balanced macronutrient formulas + nutrition counselling versus nutrition counselling in participants with weight loss. cFortified blended food + nutrition counselling versus nutrition counselling in malnourished adults on ART and pre‐ART. dAmong participants not receiving antiretroviral therapy (ART), the supplement group had a significantly greater mean body weight than the non‐supplement group at both three months (P = 0.0022) and at six months (P = 0.001). eAmong participants receiving ART, the supplement group appeared to gain weight more rapidly than the non‐supplement group in the first three months of the trial, as they had a significantly greater change in body weight gain compared to the non‐supplement group at these time points. After this time point, the change in body weight was not significantly different between the groups. fAmong participants not receiving ART, the supplement group gained significantly more body weight compared with the non‐supplement group in the first three months of the trial and at the six‐month time point. After this time point, the change in body weight was not significantly different between the groups. gAmino acid mixture (arginine, glutamine, β‐hydroxy‐β‐methylbutyrate versus placebo). hAfter eight weeks, the arginine‐rich group gained significantly more body weight than the control group. iOrnithine alpha‐ketoglutarate versus placebo. jL‐glutamine versus placebo. kSupplementation did seem to improve weight gain at specific time points during treatment, although one large trial exclusively in people coinfected with HIV found no difference at any time point (PrayGod 2011). lSupplementation probably increases weight gain during treatment. Four studies reported measures of weight gain but at different time points, which prevented meta‐analysis.