OBJECTIVES: Weight loss is common in people with motor neurodegenerative diseases (MNDDs) and is associated with reduced quality of life, functional ability and survival. This systematic review aims to identify any interventions and intervention components (i.e. behaviour change techniques [BCTs] and modes of delivery [MoDs]) that are associated with increased effectiveness in promoting nutritional behaviours that help people with MNDDs to achieve a high-calorie diet.

METHODS: Eight electronic databases including MEDLINE and CINAHL were searched from inception to May 2018. All interventions were mapped to relevant BCTs and MoDs. Methodological quality of studies was assessed using the Cochrane risk of bias tool.

RESULTS: Fourteen studies were included. Of these, eight studies provided details on interventions used to assist with swallowing difficulties and six studies on interventions targeting dietary content. Beneficial effects in managing swallowing difficulties were observed with video assisted swallowing therapy, lung volume recruitment and swallowing management clinics with outpatient support. In contrast, effectiveness of chin down posture, use of thickened liquids and respiratory muscle training were inconclusive. Positive effects in interventions targeting dietary content included the use of food pyramid tool, high fat, high carbohydrate and milk whey protein supplements, individualised nutritional advice with nutritional interventions, electronic health applications and in-person dietary counseling. Individualised nutritional advice with weekly phone contact did not appear to be effective. Most frequently coded BCTs were ‘instructions on how to perform the behaviour’, ‘self-monitoring’ and ‘behavioural practice/rehearsal’. Most commonly identified MoDs were ‘human’, ‘face-to-face’ and ‘somatic therapy’. However, the robustness of these findings are low due to small number of studies, small sample sizes and large between-study variability.

CONCLUSIONS: Despite the limited evidence, these findings may help inform more effective structured intervention treatment strategies to achieve high-calorie diets in people with MNDDs. However, further research is needed to demonstrate which interventions, or intervention components, yield most benefit.