-
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 -
Nutrition & Dietetics: the Journal of... Jul 2020Dietitian-led implementation of evidence-based nutrition support practices improves nutrient intakes, clinical outcomes and growth, decreases length of stay and related...
AIM
Dietitian-led implementation of evidence-based nutrition support practices improves nutrient intakes, clinical outcomes and growth, decreases length of stay and related costs, and reduces intravenous nutrition costs and prescription errors. We aimed to investigate current neonatal dietitian resourcing and roles in New Zealand and Australian neonatal units, and to compare this with dietitian workforce recommendations and previously reported survey data.
METHODS
A two-part electronic survey was emailed to 50 Australasian Neonatal Dietitians Network members and other dietitians working in neonatal intensive care or special care baby units in New Zealand and Australia. The survey ran from July to October 2018. Descriptive statistics were used to examine the distribution of responses. Responses were compared with other similar surveys and British Dietetic Association workforce recommendations.
RESULTS
There was an 88% response rate for Part 1. Forty-eight percent of respondents had worked in neonatology for more than 5 years. Ward rounds were attended weekly or more often by 43% of respondents. One-third regularly attended neonatal conferences or grand rounds. The majority spent less than 25% of their neonatal service allocation on teaching, developing policy or research. All respondents reported their unit had written enteral feeding guidelines. The neonatal dietitian workforce is at 23% of recommended levels.
CONCLUSIONS
Australasian neonatal dietitians have great potential to add value in neonatal units which has not yet been fully realised. Funding reallocation, upskilling and on-going professional development are needed to ensure the neonatal dietitian workforce is at the recommended level to be safe, sustainable and effective.
Topics: Adult; Aged; Australia; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Intensive Care, Neonatal; Middle Aged; New Zealand; Nutritionists; Patient Care Team; Practice Guidelines as Topic; Surveys and Questionnaires
PubMed: 31762224
DOI: 10.1111/1747-0080.12592 -
Journal of the Academy of Nutrition and... Jan 2022
A Profession That Leads Together Makes a Difference Together: A definitive description of leadership in nutrition and dietetics is impossible, because examples and resulting actions are diverse, spanning and impacting all practice areas. Below, in response to questions I asked of some RDN leaders,...
Topics: Academies and Institutes; Dietetics; Humans; Leadership; Nutritionists
PubMed: 34924147
DOI: 10.1016/j.jand.2021.10.028 -
Nutrition & Dietetics: the Journal of... Apr 2020
Topics: Dietetics; Humans; Nutritionists; Research; Science
PubMed: 32239635
DOI: 10.1111/1747-0080.12614 -
Journal of Human Nutrition and... Feb 2022There is an increased demand in primary healthcare but general practitioner (GP) numbers are declining, creating significant challenges. Dietitians are ideal...
BACKGROUND
There is an increased demand in primary healthcare but general practitioner (GP) numbers are declining, creating significant challenges. Dietitians are ideal professionals to lead the treatment of patients with conditions that are amenable to dietary manipulation, including the management of malnutrition and frailty. The present study evaluated the benefits of a model of care in which a dietitian, working as a first contact practitioner within a general practice, provided care to patients at risk of malnutrition and frailty, aiming to reduce GP workload, improve patient care and make cost savings.
METHODS
A service evaluation with a dietitian employed 6 h per week for 6 months. The practice database was screened for patients aged ≥65 years and electronic Frailty index 0.26-0.36 or body mass index <19 kg m . These patients were triaged by the dietitian and those at risk of malnutrition offered consultations. Patients prescribed oral nutritional supplements (ONS) and not under dietetic management were also seen.
RESULTS
Approximately 1200 patients met the screening criteria; 189 (16%) patients were triaged by the dietitian. Most (75%) were at risk of malnutrition and 63 of these were seen. Improvements in strength, frailty and nutrition status were observed, and changes to ONS prescriptions in 27 patients equated to annual cost savings of £15,379. Patient satisfaction was high.
CONCLUSIONS
Dietitians, acting as first contact practitioners, can deliver significant improvements in care for older people at risk of malnutrition and frailty as part of the practice multi-disciplinary team. Cost savings for ONS were made and other potential cost saving were evident.
Topics: Aged; Frail Elderly; General Practice; Humans; Malnutrition; Nutritional Status; Nutritionists
PubMed: 34482578
DOI: 10.1111/jhn.12942 -
Nutrition in Clinical Practice :... Dec 2019Registered dietitian nutritionists (RDNs), like other healthcare professionals, are often searching for ways to improve their skills and advance their practice. One way... (Review)
Review
Registered dietitian nutritionists (RDNs), like other healthcare professionals, are often searching for ways to improve their skills and advance their practice. One way RDNs have expanded their skills is by learning to place small bowel feeding tubes (SBFTs). However, it is also important that staffing RDNs to place SBFTs makes sense for their institution and their patient population. Although it is unknown how many RDNs place SBFTs, feeding tube placements by RDNs have been in practice for almost 2 decades, and it is within the RDN scope of practice. This article is a review of the literature, including indications for SBFT, possible benefits of RDNs placing SBFTs, development and maintenance of an RDN-led SBFT program, and assessment of clinical and institutional outcomes for this procedure.
Topics: Clinical Competence; Enteral Nutrition; Health Care Costs; Health Facilities; Humans; Intestine, Small; Intubation, Gastrointestinal; Nutritionists; Outcome Assessment, Health Care; Practice Guidelines as Topic
PubMed: 31549444
DOI: 10.1002/ncp.10411 -
Nutrition & Dietetics: the Journal of... Sep 2019
Topics: Adolescent; Adult; Attitude of Health Personnel; Australia; Dietetics; Health Workforce; Humans; Nutritionists; Technology; Young Adult
PubMed: 31499595
DOI: 10.1111/1747-0080.12582 -
Journal of the Academy of Nutrition and... Mar 2023
Topics: Humans; Dietetics; Nutritionists
PubMed: 36801068
DOI: 10.1016/j.jand.2022.12.011 -
Nutrition & Dietetics: the Journal of... Apr 2023Globally, sustainability and planetary health are emerging as areas of critical importance. In 2015, the 2030 Agenda for Sustainable Development was adopted by the... (Review)
Review
AIM
Globally, sustainability and planetary health are emerging as areas of critical importance. In 2015, the 2030 Agenda for Sustainable Development was adopted by the United Nations member states. Since then, the United Nations Educational, Scientific and Cultural Organization and the Commonwealth Secretariat have published guidelines for educators to embed sustainability content into curricula. This scoping review aims to identify how student dietitians learn about sustainability, how learning opportunities are evaluated, their outcomes, and whether these guidelines have translated into teaching activities contained in dietetic degrees.
METHODS
A scoping review was used to address the aims. Eight electronic databases and Google Scholar were searched from inception to March 2022 for articles describing dietetics students' participation in learning activities focused on sustainability. Data that addressed the research aims were charted independently by two researchers, then narratively synthesised.
RESULTS
Twelve articles met the inclusion criteria. A range of teaching approaches and evaluation methods were used, from passive learning in lectures to experiential learning activities. A change in knowledge or behaviour was found for experiential learning activities (n = 5). For articles published after 2015 (n = 9), two mentioned the Sustainable Development Goals and no articles referenced the published guidelines.
CONCLUSIONS
A paucity of evidence exists describing how dietetics students learn about sustainability and their learning outcomes. Of the 12 articles published, varied teaching approaches and evaluation methods have resulted in inconsistencies in the reporting of outcomes. The minimal reference to the Sustainable Development Goals and published guidelines suggests a slow translation of knowledge to practice.
Topics: Humans; Dietetics; Students; Learning; Problem-Based Learning; Nutritionists
PubMed: 36710069
DOI: 10.1111/1747-0080.12795 -
Nutrition & Dietetics: the Journal of... Apr 2021Nutrition-based applications ("apps") offer enormous research potential, however evidence of their use and acceptability among older adults is limited. We compared... (Comparative Study)
Comparative Study
AIM
Nutrition-based applications ("apps") offer enormous research potential, however evidence of their use and acceptability among older adults is limited. We compared self-reported and dietitian-adjusted dietary intake records among adults aged 55 to 75 years using the Research Food Diary (RFD) app.
METHODS
Participants were recruited from the 45 and Up Study and completed a 3-day food record using the RFD. A follow-up dietetic telephone interview was performed to confirm the electronic dietary data. Independent of these interviews, a set of adjustments based on dietetic skills, nutritional database knowledge, food composition and dietary assessment was established to resolve probable reporting errors. The "adjusted" and "dietitian-assisted" records were compared to self-reported records for nutrient intakes and serves of The Five Food Groups using one-way repeated measures analysis of variance.
RESULTS
Sixty-two participants were recruited, with 48 using the RFD app which included eight records without any identified errors. Reporting errors contained in the raw self-reported records included: food items with missing/implausible quantities or insufficient descriptions to allow automatic coding. After removal of unusable records, 44 records were analysed. Differences were found between the self-reported and adjusted records for protein, calcium, vitamin B , zinc and dairy food serves (all P < .001; differences up to 8%). No significant differences were found between the adjusted and dietitian-assisted measures.
CONCLUSIONS
Similarities between adjusted and dietitian-assisted records suggest carefully applied dietetic assumptions are likely to improve accuracy of self-reported intake data where dietitian interviews are not possible. We provide four key recommendations to guide this process.
Topics: Aged; Electronics; Humans; Middle Aged; Mobile Applications; Nutrition Assessment; Nutritionists; Self Report
PubMed: 32037628
DOI: 10.1111/1747-0080.12606