The energy and protein provided by texture-modified diets decreases dramatically as the stage increases. To prevent malnutrition in individuals on texture-modified diets, nutrition management detailing the amount of energy and protein required and consumed is needed; however, this has not yet progressed.
Aim:
To consider the factors responsible for the lack of progress in nutrition management.
Methods:
We reviewed the work content of the registered dietitian in Japan.
Results:
It takes over an hour a day to make calculations for the amount of energy and protein consumed for all of these patients, but it turned out that this time cannot be extracted considering the daily work of the registered dietitian.
Conclusion:
To prevent malnutrition, it is necessary to increase the number of registered dietitians.
Research article
Restricted accessResearch articleFirst published December, 2019pp. 245-252
Food insecurity is known to be a major public health issue. There is limited data on food insecurity and chronic disease in the general population.
Aim:
We aimed to assess effect of food insecurity on mortality of individuals with chronic disease like cardiorenal syndrome (CRS).
Methods:
The study was conducted on participants aged 20 years or older in the United States living below the 130% Federal Poverty Level. We assessed food insecurity utilizing the Household Food Security Survey Module in NHANES survey for the years 1999 to 2010 with mortality follow-up. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of food insecurity and CRS.
Results:
Prevalence of food insecurity among the low-income population was 16.1% among males and 21.7% among females. The mean follow-up was 6.5 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of food insecurity to no food insecurity was 1.28 (95% confidence interval [CI], 1.18–1.37, p < 0.001). Adjusted HR was elevated, 2.81 (CI 1.57–5.05, p < 0.001), among participants who were CRS-positive and food insecure but closer to 1.0 (2.48 CI 1.73–3.55, p < 0.001) among those who were CRS-positive and food secure, after controlling for medical and demographic risk factors.
Conclusions:
Food insecurity is associated with higher mortality than food security. Food insecurity also may modify the effect of CRS on all-cause mortality in a representative general population. Social policy, when addressing food insecurity, should be inclusive among those with specific chronic diseases.
Research article
Restricted accessResearch articleFirst published December, 2019pp. 253-264
The need for short and validated questionnaires to evaluate dietary patterns (DPs) and mental distress in clinical and research settings is increasing.
Aim:
The purpose of this study was to develop and validate a Food–Mood Questionnaire (FMQ) to assess DPs in relation to mental distress.
Method:
A standard validation protocol that included item development, pilot–testing, test–retesting, and a series of statistical validation analyses was used. Content, face, internal, construct and external validity as well as reliability were confirmed. Content and face validity were evaluated qualitatively.
Results:
Principal component analysis (PCA) for construct validity generated five sub-scales which reflected internal consistency (Cronbach’s α > 0.70) and internal reliability (intraclass correlation coefficient ranged between 0.619 and 0.884; p < 0.01; confidence interval 95%). External validity was also confirmed. A total of 563 participants from four different continents completed the survey online. PCA generated five different subscales. Mental distress was associated with regular consumption of fast-food, a DP known to induce anxiety and depression.
Conclusion:
The FMQ is a validated and a reliable tool with many potential applications that could be used with prophylactic and therapeutic approaches.
Research article
Restricted accessResearch articleFirst published December, 2019pp. 265-274
Trevor SimperORCID, Molly Gilmartin, Daniel Allwood , [...]
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Abstract
Background:
Concentrated cherry juice reportedly contains melatonin which, in turn, has been highlighted as an important regulator in initiating sleep.
Aim:
The present investigation aims to clarify whether Night Time Recharge (NTR), a marketed sleep aid containing cherry extract, improves key sleep parameters in young, active adults with mildly poor sleep.
Methods:
A double-blind, randomized, placebo-controlled, cross-over study design was employed. Twenty participants (nine female) consumed either NTR or a placebo for seven days. Accelerometers were used to assess sleep quality and physical activity levels. Urinary levels of 6-sulphatoxymelatonin (6-SMT), a marker of melatonin synthesis, was assessed via enzyme-linked immunosorbent assay.
Results:
6-SMT levels increased following NTR treatment (28.95 ng/ml) compared with placebo (4.0 ng/ml) (p < 0.001). There was also a significant difference (p = 0.047) in dietary tryptophan consumption during the NTR treatment (1236 mg) versus placebo (1149 mg). No trace of melatonin was detected from our analysis of the supplement. NTR had no significant effect on any sleep parameters with the exception of sleep latency (p = 0.001).
Conclusions:
As chemical analysis of NTR by liquid-chromatography mass-spectrometry identified no detectable melatonin, the tryptophan content of the supplement is a likely reason for improvement in sleep latency. These results are in contrast to previous studies which have found a positive effect on sleep following cherry supplementation. Future work should focus on sleep latency and investigating whether cherry juice is effective in participants with problems in initiating sleep.
Research article
Restricted accessResearch articleFirst published December, 2019pp. 275-279
Michele L Nicolo, Patricia A Shewokis, Joseph Boullata , [...]
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Abstract
Background:
Sedentary behavior activities have been associated with an increased risk of type 2 diabetes. Aim: Our aim was to determine whether sedentary behavior time (SBT) is predictive of hemoglobin A1c (HbA1c) ≥ 6.5% (48 mmol/mol).
Methods:
We used cross-sectional data, adults 40 to 59 years of age, from the National Health and Nutrition Examination Survey (NHANES) for 2003 to 2004 and 2013 to 2014. Responses to questions on the Physical Activity Questionnaire regarding time watching television/videos, and time spent sitting in front of a computer per day were compiled into tertiles. Binary logistic regression analysis was used to determine whether SBT was a predictor of a HbA1c ≥ 6.5% adjusting for age, sex, race and ethnicity, and body mass index.
Results:
In a univariate model, adults reporting ≥ 8 hours of SBT in NHANES 2003–2004 had 2.02 increased odds of a HbA1c ≥ 6.5% (OR = 2.02, 95% CI: 1.31, 3.13, p < 0.0001) compared to adults reporting ≤ 3 hours. After adjusting the regression model for age, sex, race and ethnicity, and body mass index, adults reporting ≥ 8 hours of SBT in NHANES 2003 to 2004 had 1.72 increased odds of HbA1c ≥ 6.5% (OR = 2.02, 95% CI: 1.10, 2.68, p < 0.0001) compared to adults reporting ≤ 3 hours of SBT. Reported SBT was not a predictor of HbA1c ≥ 6.5% for NHANES 2013 to 2014.
Conclusion:
Reported SBT was a predictor of HbA1c ≥ 6.5% among adults, 40 to 59 years of age, in NHANES 2003 to 2004, but was not a predictor in 2013 to 2014.
Review article
Restricted accessReview articleFirst published December, 2019pp. 281-290
Lifestyle interventions, including dietary modifications, play a key role in the treatment of type 2 diabetes. By the second half of the last century, dietary oatmeal interventions had frequently been used in patients with diabetes; however, with the widespread introduction of insulin, this practice gradually fell into disuse. Within the last decades, the original oatmeal intervention, first described in 1903, has been modified towards a hypocaloric, low-fat, and plant-based intervention.
Aim:
The aim of this review was to investigate the current role of these adapted short-term dietary oatmeal interventions in the treatment of patients suffering from poorly-controlled type 2 diabetes. A special focus was put on opportunities for and barriers to its clinical implementation and its potential mechanisms of action.
Methods:
The electronic databases of PubMed and Google Scholar were searched using the keywords “oat,” “oats,” “oatmeal,” and “diabetes.”
Results:
While there are a limited number of clinical studies including hypocaloric short-term dietary oatmeal interventions, there is evidence that these interventions may lead to a significant decrease in mean blood glucose levels and a significant reduction of insulin dosage in patients suffering from poorly-controlled type 2 diabetes.
Conclusion:
Modified short-term dietary oatmeal interventions are an effective and economical tool in the treatment of patients suffering from poorly-controlled type 2 diabetes.
Research article
Open accessResearch articleFirst published December, 2019pp. 291-301
Polytrauma patients are at risk of considerable harm from malnutrition due to the metabolic response to trauma. However, there is little knowledge of (the risk of) malnutrition and its consequences in these patients. Recognition of sub-optimally nourished polytrauma patients and their nutritional needs is crucial to prevent complications and optimize their clinical outcomes.
Aim:
The primary objective is to investigate whether polytrauma patients admitted to the Intensive Care Unit (ICU) who have or develop malnutrition have a higher complication rate than patients who are and remain well nourished. Secondary objectives are to determine the prevalence of pre-existent and in-hospital acquired malnutrition in these patients, to assess the association between malnutrition and long-term outcomes, and to determine the association between serum biomarkers (albumin and pre-albumin) and malnutrition.
Methods:
This international observational prospective cohort study will be performed at three Level-1 trauma centers in the United States and two Level-1 centers in the Netherlands. Adult polytrauma patients (Injury Severity Score ≥16) admitted to the ICU of one of the participating centers directly from the Emergency Department are eligible for inclusion. Nutritional status and risk of malnutrition will be assessed using the Subjective Global Assessment (SGA) scale and Nutritional Risk in Critically Ill (NUTRIC) score, respectively. Nutritional intake, biomarkers and complications will be collected daily. Patients will be followed up to one year after discharge for long-term outcomes.
Conclusions:
This international prospective cohort study aims to gain more insight into the effect and consequences of malnutrition in polytrauma patients admitted to the ICU.
Case report
Restricted accessCase reportFirst published December, 2019pp. 303-305
Tirin Babu, George Mathew PanachiyilORCID, Juny Sebastian , [...]
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Abstract
Background:
Blueberry is a North American native fruit increasingly popular as a source of health-promoting bioactive compounds. However, there is evidence in the literature stating that blueberries should be avoided in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Case Presentation:
We report the first case of a G6PD deficient child who developed haemolysis approximately after half a day following the intake of fresh blueberry. He presented with the complaints of the passage of orange coloured urine and hurried breathing. The child had haemoglobin of 7.9 g/dl on admission day and the laboratory results were indicative of haemolytic process.
Outcomes and Implications:
During the stay in the hospital, the child was managed conventionally, and he improved both clinically and symptomatically. The child was discharged after four days of treatment and diet counselling was provided to his parents.
Recommendations:
Our report should encourage further research on this fruit regarding the mechanism behind the development of haemolytic anaemia. Also, it is important in the case of G6PD deficient patients to take lifelong precautions to avoid the foods that can trigger haemolysis.