Background: Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. Aims: The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). Methods: By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian–Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). Results: 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74–87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. Conclusions: The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.

Background: Few areas of health have been as insidiously influenced by misinformation as cancer. Thus, interventions that can help people impacted by cancer reduce the extent to which they are victims of misinformation are necessary. The Informed Health Choices (IHC) initiative has developed Key Concepts that can be used in the development of interventions for evaluating the trustworthiness of claims about the effects of health treatments. We are developing an online education programme called Informed Health Choices-Cancer (IHC-C) based on the IHC Key Concepts. We will provide those impacted by cancer with the knowledge and skills necessary to think critically about the reliability of health information and claims and make informed choices. Methods: We will establish a steering group (SG) of 12 key stakeholders, including oncology specialists and academics. In addition, we will establish a patient and public involvement (PPI) panel of 20 people impacted by cancer. After training the members on the Key Concepts and the prioritisation process, we will conduct a two-round prioritisation process. In the first round, 12 SG members and four PPI panel members will prioritise Key Concepts for inclusion. In the second round, the remaining 16 PPI members will undertake the prioritisation based on the prioritised Key Concepts from the first round. Participants in both rounds will use a structured judgement form to rate the importance of the Key Concepts for inclusion in the online IHC-C programme. A consensus meeting will be held, where members will reach a consensus on the Key Concepts to be included and rank the order in which the prioritised Key Concepts will be addressed in the IHC-C programme. Conclusions: At the end of this process, we will identify which Key Concepts should be included and the order in which they should be addressed in the IHC-C programme.

Background: More than one-third of cancer-related health information is unreliable or misleading. With increasing health information seeking, the risks of misinformation exposure are growing. Educational approaches that are delivered clearly and in accessible formats are a promising way to strengthen critical thinking and decision-making skills, thereby helping to reduce the exposure of those impacted by cancer to misleading cancer information. Methods: This pilot randomised trial will assess the feasibility and acceptability of conducting a larger definitive trial evaluating the Informed Health Choices-Cancer (IHC-C) programme. The IHC-C is an online evidence-based education programme co-designed by stakeholders, including public and patient partners. It aims to equip people impacted by cancer (i.e., current patients, survivors, caregivers, and loved ones) with the skills and knowledge necessary to think critically about the reliability of health information and claims and make informed health choices. Participants will be randomised to either the IHC-C intervention group or a waitlist control group. The primary outcome of this pilot trial are feasibility (recruitment and retention rates, etc.) and acceptability (participant satisfaction and perceived usefulness, etc.). Demographic and cancer-related data will be collected to characterise the sample and inform recruitment strategies for a future definitive trial. Preliminary measures of critical thinking and decision-making skills will also be gathered to support the selection of key outcomes for the future trial. Discussion: This pilot trial will inform the design and conduct of a future definitive randomised trial. Insights gained will inform sample size estimations, refine recruitment strategies, optimise programme delivery, and improve data collection processes, ensuring a robust and scalable approach for the definitive trial.

Background: People impacted by cancer may be confronted with conflicting and misleading cancer‐related information that is everywhere in daily life. The Informed Health Choices‐Cancer (IHC‐C) programme was developed to equip participants with the skills and knowledge necessary to think critically and make well‐informed health choices. Aims: To assess the feasibility, acceptability, and preliminary outcomes of the IHC‐C programme. Methods: We conducted an online pilot randomised trial to compare the IHC‐C programme with a waitlist control within a prespecified recruitment window. Adults impacted by cancer (current patients, survivors, informal caregivers and loved ones) were recruited and randomised 1:1. The intervention was a 4‐week, nine‐unit online learning programme. Primary outcomes assessed feasibility (recruitment, retention, adherence, technical feasibility, and data‐collection processes) and acceptability (participation rates, participation burden, and overall acceptability). Secondary outcomes included eHealth literacy, critical thinking and decision‐making skills, which were assessed post‐intervention. Results: Forty‐three participants were randomised (22 intervention; 21 waitlist control), achieving 72% of the recruitment target. In the intervention group, 91% accessed the platform and 64% completed all nine units. Outcome assessment completion was 64% (14/22) in the intervention group and 81% (17/21) in the control group. Acceptability was high among intervention completers, as indicated by both quantitative and qualitative measures. eHealth literacy scores were high in both groups, with ceiling effects and no between‐group difference (Hodges‐Lehmann median difference −1.0, 95% CI –5.0 to 1.0). Critical thinking and decision‐making quiz scores were higher in the intervention group in exploratory analyses (median difference: 1.0, 95% CI: 1.0–2.0), although the distributions clustered near the upper range. Conclusions: The IHC‐C programme was feasible to deliver and acceptable to participants within a defined recruitment period. These findings support progression to a fully powered trial, with refinements to engagement strategies and outcome measurement. Trial registration: This trial was registered on ISRCTN registry with ID ISRCTN17391470