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Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common intervention with demonstrated effectiveness. "Food first" approaches have also been developed and evaluated. This scoping review identified and summarized 35 studies (41 citations) that described and/or evaluated dietary, foodservice, or mealtime interventions with a food first focus. There were few randomized control trials. Individualized dietary treatment leads to improved food intake and other positive outcomes. Foodservices that promote point-of-care food selection are promising, but further research with food intake and nutritional outcomes is needed. Protected mealtimes have had insufficient implementation, leading to mixed results, while mealtime assistance, particularly provided by volunteers or dietary staff, appears to promote food intake. A few innovative strategies were identified but further research to develop and evaluate food first approaches is needed.

Mealtime satisfaction is an important component of quality of life (QOL) in residential care, yet there currently is no self-administered tool described in the literature. The purpose of this study is to investigate internal and test-retest reliability, and construct validity of a mealtime satisfaction questionnaire (MSQ) designed for residential care, more specifically retirement homes. A 15-item MSQ was developed and eligible participants from four retirement homes (n = 749) were invited to participate. The participation rate was 24% and the median age was 88 years for respondents. The internal consistency of the MSQ was high (Cronbach Alpha = 0.83) and the test-retest reliability was also high (Intraclass coefficient = 0.91, P < 0.01). The MSQ was associated with a valid and reliable QOL instrument for older adults (Mann Whitney Test = 1595.5, P < 0.01). The MSQ is reliable and is content and construct valid. QOL can be enriched by improving mealtime satisfaction in retirement homes.

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