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The British Journal of Nutrition Apr 2016There is growing awareness of the role of diet in both health and disease management. Much data are available on the cardioprotective diet in the primary and secondary... (Review)
Review
There is growing awareness of the role of diet in both health and disease management. Much data are available on the cardioprotective diet in the primary and secondary prevention of CVD. However, there is limited information on the role of diet in the management of heart failure (HF). Animal models of HF have provided interesting insight and potential mechanisms by which dietary manipulation may improve cardiac performance and delay the progression of the disease, and small-scale human studies have highlighted beneficial diet patterns. The aim of this review is to summarise the current data available on the role of diet in the management of human HF and to demonstrate that dietary manipulation needs to progress further than the simple recommendation of salt and fluid restriction.
Topics: Adenosine Triphosphate; Diet, Carbohydrate-Restricted; Diet, Mediterranean; Diet, Sodium-Restricted; Dietary Proteins; Fatty Acids; Fatty Acids, Omega-3; Heart; Heart Failure; Humans; Hypertrophy, Left Ventricular; Lipids; Nutritionists; Obesity; Oxidation-Reduction; Patient Education as Topic; Triglycerides; Weight Loss
PubMed: 26857032
DOI: 10.1017/S000711451500553X -
Clinical Nutrition ESPEN Dec 2023Eating disorder diagnoses and disordered eating behaviours are more prevalent in people living with Type 1 Diabetes Mellitus, in particular in adolescents. The role of... (Review)
Review
A scoping review exploring the role of the dietitian in the identification and management of eating disorders and disordered eating in adolescents and adults with type 1 diabetes mellitus.
BACKGROUND
Eating disorder diagnoses and disordered eating behaviours are more prevalent in people living with Type 1 Diabetes Mellitus, in particular in adolescents. The role of the dietitian in this setting is not clearly outlined in the literature.
AIM
This scoping review aims to outline the available information for the role of the dietitian in identifying and managing eating disorders in adolescents and adults with co-occurring Type 1 Diabetes Mellitus (T1DM) in a clinical setting.
METHODS
The Johanna Briggs Institute was utilised to guide this scoping review and to develop a search strategy for relevant databases. Relevant organisations and societies websites and professional magazines were reviewed as part of the grey literature search.
RESULTS
38 peer reviewed journal articles, 5 professional articles, 5 book chapters and 11 clinical guidelines were included in this scoping review. Roles for the dietitian in identification, prevention and screening for eating disorders in Type 1 Diabetes Mellitus were identified and outlined in a visual workflow. The role of the dietitian in the management of eating disorder in both the outpatient/community and inpatient setting and as core member of the multidisciplinary team was detailed in the literature.
CONCLUSION
This scoping review mapped the available information in the current literature on the role of the dietitian in the identification and management of eating disorders and disordered eating in adolescents and adults with a dual diagnosis of T1DM. The reviewed literature suggests there is a strong reliance on expert opinion and practice to inform the role of the dietitian. Further research is required in order to ensure more robust evidence-based practice in this area.
Topics: Adult; Humans; Adolescent; Diabetes Mellitus, Type 1; Nutritionists; Feeding and Eating Disorders; Outpatients
PubMed: 38057030
DOI: 10.1016/j.clnesp.2023.10.038 -
Nutrients Feb 2022Delegation of malnutrition care to dietitian assistants can positively influence patient, healthcare, and workforce outcomes. However, nutrition care for hospital...
Delegation of malnutrition care to dietitian assistants can positively influence patient, healthcare, and workforce outcomes. However, nutrition care for hospital inpatients with or at risk of malnutrition remains primarily individually delivered by dietitians-an approach that is not considered sustainable. This study aimed to identify barriers and enablers to delegating malnutrition care activities to dietitian assistants. This qualitative descriptive study was nested within a broader quality assurance activity to scale and spread systematised and interdisciplinary malnutrition models of care. Twenty-three individual semi-structured interviews were completed with nutrition and dietetic team members across seven hospitals. Inductive thematic analysis was undertaken, and barriers and enablers to delegation of malnutrition care to dietitian assistants were grouped into four themes: working with the human factors; balancing value and risk of delegation; creating competence, capability, and capacity; and recognizing contextual factors. This study highlights novel insights into barriers and enablers to delegating malnutrition care to dietitian assistants. Successful delegation to dietitian assistants requires the unique perspectives of humans as individuals and in their collective healthcare roles, moving from words to actions that value delegation; engaging in processes to improve competency, capability, and capacity of all; and being responsive to climate and contextual factors.
Topics: Dietetics; Humans; Malnutrition; Nutritional Status; Nutritionists; Qualitative Research
PubMed: 35268008
DOI: 10.3390/nu14051037 -
Nutrients Jan 2022Cachexia is one of the most common, related factors of malnutrition in cancer patients. Cancer cachexia is a multifactorial syndrome characterized by persistent loss of... (Review)
Review
Cachexia is one of the most common, related factors of malnutrition in cancer patients. Cancer cachexia is a multifactorial syndrome characterized by persistent loss of skeletal muscle mass and fat mass, resulting in irreversible and progressive functional impairment. The skeletal muscle loss cannot be reversed by conventional nutritional support, and a combination of anti-inflammatory agents and other nutrients is recommended. In this review, we reviewed the effects of nutrients that are expected to combat muscle loss caused by cancer cachexia (eicosapentaenoic acid, β-hydroxy-β-methylbutyrate, creatine, and carnitine) to propose nutritional approaches that can be taken at present. Current evidence is based on the intake of nutrients as supplements; however, the long-term and continuous intake of nutrients as food has the potential to be useful for the body. Therefore, in addition to conventional nutritional support, we believe that it is important for the dietitian to work with the clinical team to first fully assess the patient's condition and then to safely incorporate nutrients that are expected to have specific functions for cancer cachexia from foods and supplements.
Topics: Cachexia; Dietary Supplements; Functional Food; Humans; Neoplasms; Nutritional Support; Nutritionists
PubMed: 35057531
DOI: 10.3390/nu14020345 -
Clinical Nutrition ESPEN Feb 2022Explore the benefits and feasibility of a dual training program for dietetics and nursing to increase nutrition in clinical practice. (Review)
Review
PURPOSE
Explore the benefits and feasibility of a dual training program for dietetics and nursing to increase nutrition in clinical practice.
METHODS
A professional interest survey on the perceived value of a dual program with 222 registered nurses (RN) and registered dietitian nutritionists (RDN) and an in-depth literature review were completed.
RESULTS
A majority of RNs indicated the addition of the RDN would be beneficial for supporting patients with diet-related chronic diseases and performing nutritional assessments and interventions. The RDN respondents indicated a dual program approach would also improve the ability to serve a small community or place of employment that is limited in having both a full-time RDN and RN, and rated benefits for performing more medical and laboratory procedures. The RDNs also indicated the dual program could help increase their income potential. Both dual Master's and dual Bachelor's programs were rated as valuable. Of the 18 (8%) of respondents who had both RDN and RN credentials, half indicated personal growth and interest was the incentive for pursuing the dual training; whereas half indicated professional incentives (e.g., no RDN in the area, improving specialty care, job security, lack of opportunities), The literature review indicated no studies on the efficacy of a dual RDN-RN program on health outcomes; however, studies have shown that individualized counseling from RDNs is more beneficial than general nutritional counselling from other health care providers not specifically trained in dietary assessments. Noted barriers to pursuing dual training included time and cost, and some respondents in both specialties were not interested in a dual program.
DISCUSSION
These results support providing students with dual program options, although further exploration of the specific approach is warranted, particularly decreasing time-to-degree while not affecting efficacy.
Topics: Dietetics; Humans; Nurses; Nutrition Therapy; Nutritional Status; Nutritionists
PubMed: 35063216
DOI: 10.1016/j.clnesp.2021.11.030 -
Heliyon Aug 2023The dietitian service at a metropolitan health service in Queensland, Australia has a non-engagement rate for high-risk antenatal women of 50%.
PROBLEM
The dietitian service at a metropolitan health service in Queensland, Australia has a non-engagement rate for high-risk antenatal women of 50%.
AIM
Determine which attributes are related to non-attendance at dietitian appointments, and women's perceptions and attitudes towards dietitian appointments during pregnancy.
METHODS
An explanatory mixed-methods design was utilised, with first phase including 103 antenatal women referred to a dietitian in 2021 and compared the attributes of those who attended with those who did not engage. Queensland Health electronic databases were used to collect attribute data, which were then analysed with Jamovi (version 1.6) for descriptive, correlational, multivariate analyses of variance MANOVA. Second phase included seven semi-structured interviews with women attending a dietitian appointment, and subsequently analysed through thematic analysis.
RESULTS
Distance from clinic was not related to clinic attendance, and women reported they would attend regardless of distance or work status. Non-attendance was related to higher gravidity, parity, and if referred for obesity, but not previous gastric sleeve or underweight referral. Six themes were identified from the interview data: "Women want to be treated like an individual," "It's all about expectations," "Midwives hold the key," "Preferences in receiving dietary information," "Weight has been a long-term problem and is a sensitive topic," and "Barriers to attendance."
CONCLUSION
Antenatal services can adjust service delivery to improve engagement in weight management services during pregnancy. Telehealth appointments may reduce non-engagement due to distance from clinic. Demystifying the dietitian appointment, ensuring non-judgemental referral processes and collaboration between midwives and dietitians will ensure that women value the service.
PubMed: 37636384
DOI: 10.1016/j.heliyon.2023.e18106 -
Ciencia & Saude Coletiva Aug 2022COVID-19 has challenged health professionals in widely divergent areas, including innovation of practice, communication, multidisciplinary activities, broader use of...
COVID-19 has challenged health professionals in widely divergent areas, including innovation of practice, communication, multidisciplinary activities, broader use of technology, and adaptability. The role of the dietitian and other health professionals in dealing with the evolving crisis might be considered essential in treating patients. Given the limited access to various food options, nutrition screening and assessment deserves a high priority to complete a comprehensive nutrition evaluation, identify nutrition risks, prioritize care, and provide early nutrition intervention and support to all patients with or who have had, COVID-19 and are experiencing ongoing symptoms. Such an intervention would benefit the patients and the health system by reducing the length of hospital stay, ameliorating further complications, limiting hospital readmission, enhancing recovery, and assisting in the management of comorbidities and their metabolic alterations. This brief overview outlines the essential role of nutrition intervention and support as part of an integrated, multidisciplinary treatment program for the care of COVID-19 patients during the pandemic. Restrictive movements have changed consultative approaches, and the importance of Telenutrition for the effective communication of health status and recommendations.
Topics: COVID-19; Health Personnel; Humans; Nutrition Assessment; Nutritionists; Pandemics
PubMed: 35894318
DOI: 10.1590/1413-81232022278.04082021 -
Nutrients Jan 2022Drugs and food interact mutually: drugs may affect the nutritional status of the body, acting on senses, appetite, resting energy expenditure, and food intake;... (Review)
Review
Drugs and food interact mutually: drugs may affect the nutritional status of the body, acting on senses, appetite, resting energy expenditure, and food intake; conversely, food or one of its components may affect bioavailability and half-life, circulating plasma concentrations of drugs resulting in an increased risk of toxicity and its adverse effects, or therapeutic failure. Therefore, the knowledge of these possible interactions is fundamental for the implementation of a nutritional treatment in the presence of a pharmacological therapy. This is the case of chronic kidney disease (CKD), for which the medication burden could be a problem, and nutritional therapy plays an important role in the patient's treatment. The aim of this paper was to review the interactions that take place between drugs and foods that can potentially be used in renal patients, and the changes in nutritional status induced by drugs. A proper definition of the amount of food/nutrient intake, an adequate definition of the timing of meal consumption, and a proper adjustment of the drug dosing schedule may avoid these interactions, safeguarding the quality of life of the patients and guaranteeing the effectiveness of drug therapy. Hence, a close collaboration between the nephrologist, the renal dietitian, and the patient is crucial. Dietitians should consider that food may interact with drugs and that drugs may affect nutritional status, in order to provide the patient with proper dietary suggestions, and to allow the maximum effectiveness and safety of drug therapy, while preserving/correcting the nutritional status.
Topics: Appetite; Biological Availability; Diet; Energy Metabolism; Food; Food-Drug Interactions; Humans; Kidney Diseases; Nutrition Therapy; Nutritional Status; Nutritionists; Pharmacokinetics; Quality of Life
PubMed: 35011087
DOI: 10.3390/nu14010212 -
Journal of Neurogastroenterology and... Jul 2022The 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on... (Review)
Review
BACKGROUND/AIMS
The 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on dietitian delivered education. However, access to dietitians can be limited, and challenges exist when applying the diet to a wide range of cultures, such as limited FODMAP analysis of local foods. This review aims to discuss ways to optimally use the FODMAP diet in practice in a wide range of cultures, directed at gastroenterologists from a dietitian's perspective.
METHODS
Recent literature was analysed via search databases including Medline, CINAHL, PubMed and Scopus.
RESULTS
The dietetic process involves detailed assessment and follow-up through the 3 stages of the FODMAP diet (restriction, re-introduction, and long-term maintenance). Emerging evidence suggests the diet can be delivered by other health professionals such as the gastroenterologist or nurse, but training on how to do so successfully would be needed. Self-guided approaches through use of technology or specialised food delivery services may be an alternative when dietitians are not available, but efficacy data is limited. Regardless of delivery mode, nutritional and psychological risks of the diet must be mitigated. Additionally, culturally appropriate education must be provided, with accommodations necessary when the FODMAP content of local foods are unknown.
CONCLUSION
While the diet has shown improved irritable bowel syndrome outcomes across studies, it is important to acknowledge the essential role of dietitians in implementing, tailoring, and managing the diet to achieve the best outcome for each individual.
PubMed: 35799231
DOI: 10.5056/jnm22035 -
Nutrition & Dietetics: the Journal of... Sep 2020It is the position of Dietitians Australia that clients can receive high-quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via...
It is the position of Dietitians Australia that clients can receive high-quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via telehealth. Outcomes of telehealth-delivered dietetic consultations are comparable to those delivered in-person, without requiring higher levels of additional training nor compromising quality of service provision. Dietitians Australia recommends that policy makers and healthcare funders broaden the recognition for telehealth-delivered dietetic consultations as a responsive and cost-effective alternative or complement to traditional in-person delivery of dietetic services. The successful implementation of telehealth can help to address health and service inequalities, improve access to effective nutrition services, and support people with chronic disease to optimise their diet-related health and well-being, regardless of their location, income or literacy level, thereby addressing current inequities.
Topics: Australia; Dietary Services; Dietetics; Humans; Nutritionists; Telemedicine
PubMed: 32596950
DOI: 10.1111/1747-0080.12619