*6.1. Clinical Perspective*

Given the high proportion of older people with HF and at risk of malnutrition [9,44], we anticipate that patient-specific nutritional interventions can lead to substantial reductions in healthcare costs in addition to well-recognized health and mortality benefits. The evaluation of other patient-centered outcomes, such as quality of life, should also be explored in future studies.

#### *6.2. Translational Outlook*

The significant reduction in hospital complications and the associated costs in the subgroup of HF patients with established malnutrition may be particularly relevant for policymakers. We anticipate that such findings will be confirmed and extended by randomized controlled trials that specifically enroll hospitalized patients with CHF.

**Author Contributions:** P.S.: conceptualization, investigation, funding acquisition, original draft preparation; S.S. and C.B.: conceptualization, writing—review and editing; S.W. and S.K.: formal analysis, writing—review and editing; Z.S., F.G. and B.M.: conceptualization, investigation, writing review and editing. All authors have read and agreed to the published version of the manuscript.

**Funding:** The initial trial was funded by the Swiss National Science Foundation (SNSF) (PP00P3\_ 150531) and the Research Council of the Kantonsspital Aarau (1410.000.058 and 1410.000.044). Abbott provided a grant (HA34) to cover expenses associated with the economic analysis.

**Institutional Review Board Statement:** The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of Northwestern part of Switzerland (EKNZ) (protocol code 2014\_001 and 15.1.2014).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study. Not applicable for economic analysis.

**Data Availability Statement:** The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical reasons.

**Acknowledgments:** We would like to thank all participating patients and hospital staff for their support of our trial. We thank Cecilia Hofmann for her assistance with manuscript review and editing.

**Conflicts of Interest:** The initial study was investigator-initiated and supported by a grant from the Swiss National Science Foundation to P. Schuetz (SNSF Professorship, PP00P3\_150531) and the Forschungsrat of the Kantonsspital Aarau (1410.000.058 and 1410.000.044). The institution of P. Schuetz previously received unrestricted grant money unrelated to this project from Nestlé Health Science and Abbott Nutrition. The institution of Z. Stanga received speaking honoraria and research support from Nestlé Health Science, Abbott Nutrition, and Fresenius Kabi. S. Sulo and C. Brunton are employees and stockholders of Abbott. S. Walzer and S. Krenberger received funding for the model development by Abbott. S. Walzer has also received funding from Nestlé and Fresenius Kabi for health economic support. All other authors report no conflicts of interest.

**Trial registration:** ClinicalTrials.gov number NCT02517476.
