1.
Impact of Dietetic Intervention on Skin Autofluorescence and Nutritional Status in Persons Receiving Dialysis: A Proof of Principle Study.
Viramontes Hörner, D, Willingham, FC, Selby, NM, Taal, MW
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. 2020;(6):540-547
Abstract
OBJECTIVE Advanced glycation end-products (AGEs) are uremic toxins that result from oxidative stress and food consumption. It has been reported that markers of malnutrition are more important determinants of increased skin autofluorescence (SAF), a measure of AGE accumulation and risk factor for mortality, than high dietary AGE intake in a hemodialysis (HD) population, suggesting that correcting malnutrition may decrease SAF. DESIGN AND METHODS We investigated this hypothesis in a single-center, nonrandomized proof-of-principle study. We enrolled 27 patients on HD and one on peritoneal dialysis with malnutrition who received individualized nutritional advice and support over 6 months. SAF was measured at baseline, 3 months, and 6 months. Dietary intake and nutritional status were assessed at baseline and 6 months. Results were compared with a control group of malnourished patients on dialysis (n = 41 HD and 8 peritoneal dialysis) from a previous observational study. RESULTS The intervention group showed a significant increase in dietary intake, including AGEs, Subjective Global Assessment score, and serum albumin, while SAF levels remained stable for over 6 months (3.8 ± 0.7 arbitrary units [AU] vs. 3.7 ± 0.7 AU; P = .3). Conversely, in the control group, SAF increased significantly during the observation period (3.5 ± 0.9 AU vs. 3.8 ± 1.2 AU; P = .03) during which there was no improvement in nutritional intake and other markers of nutrition, although dietary AGE intake and Subjective Global Assessment score did increase. CONCLUSION Dietetic support was associated with stable SAF levels in this proof-of-principal study despite an increase in dietary AGE intake, suggesting that interventions to improve nutrition may be important in preventing the rise in SAF observed in malnourished dialysis populations. Further long-term studies are needed to test this hypothesis and evaluate the impact on survival.
2.
Prevalence of Exercise Addiction Symptomology and Disordered Eating in Australian Students Studying Nutrition and Dietetics.
Rocks, T, Pelly, F, Slater, G, Martin, LA
Journal of the Academy of Nutrition and Dietetics. 2017;(10):1628-1636
Abstract
BACKGROUND Previous research has reported the existence of disordered eating in students studying nutrition and dietetics. However, the occurrence of exercise addiction, previously linked to disordered eating, is poorly understood in this group. OBJECTIVE The main objective of this study was to explore the prevalence of self-reported symptoms of exercise addiction and the association with disordered eating in a sample of students studying nutrition and dietetics. A secondary objective was to compare the prevalence of exercise addiction to students enrolled in another health-related degree. DESIGN We conducted a cross-sectional study in 165 undergraduate students. PARTICIPANTS/SETTING Participants were students of both sexes enrolled in nutrition and dietetics and occupational therapy degree programs at an Australian university in August 2013. MAIN OUTCOME MEASURES Participants completed four validated questionnaires for assessment of exercise- and eating-related attitudes and behaviors measuring scores for exercise addiction, weekly volume of physical activity (PA), eating disorder symptoms, and cognitive restraint. Stretch stature and body mass were measured and body composition was assessed using dual energy x-ray absorptiometry. STATISTICAL ANALYSES PERFORMED Independent t test, Mann-Whitney U test, and χ2 test were completed to compare groups of students based on sex, degree, or eating attitudes. Spearman's correlation was performed to explore associations between continuous variables (exercise addiction scores, PA volume, and scores for eating attitudes and cognitive restraint). RESULTS Approximately 23% of nutrition and dietetics students were found to be at risk of exercise addiction (20% females and 35% males; P=0.205), while the majority demonstrated some symptoms of exercise addiction. A similar proportion of at risk individuals was found in the female occupational therapy group (19%; P=1.000). In females (nutrition and dietetics and occupational therapy combined), the exercise addiction scores were associated with three other outcome measures: PA volume (rs=0.41; P<0.001), eating attitudes scores (rs=0.24; P=0.008), and cognitive restraint (rs=0.32; P<0.001). Comparative analysis indicated that female students with high cognitive restraint had greater exercise addiction scores than those with low cognitive restraint (20.3 [4.8] compared to 17.8 [4.2]; P=0.003). CONCLUSIONS Results suggest high prevalence of exercise addiction in this sample of undergraduate health-related degree students and its link to amount of PA and disordered eating in females. Future research should include larger samples of both sexes to build the existing understanding on these maladaptive behaviors.
3.
Attendance, weight and waist circumference outcomes of patients with type 2 diabetes receiving Medicare-subsidised dietetic services.
Spencer, L, O'Shea, MC, Ball, L, Desbrow, B, Leveritt, M
Australian journal of primary health. 2014;(3):291-7
Abstract
The aim of the present study was to investigate the participation and weight and waist circumference outcomes of patients with type 2 diabetes (T2D) receiving Medicare-subsidised dietetic services. A prospective observational study was conducted between January and September 2011 involving three private practice dietitians who provided services at 11 medical centres in south-east Queensland. All patients with T2D who were referred by their general practitioner (GP) to one of the dietitians as part of their team care arrangements were asked to participate. Participants' attendance at consultations was recorded for the study duration. The dietitian collected weight and waist circumference measures at each consultation. In all, 129 participants (mean age 58.9 ± 15.7 years; mean body mass index 32.2 ± 5.6 kgm⁻²) were included in the study. The most frequent number of consultations allocated to a dietitian was two. Small, but significant reductions in bodyweight (1.9 ± 2.9 kg; P ≤ 0.05) and waist circumference (2.0 ± 4.8 cm; P ≤ 0.05) were observed from the initial to final consultation. Participants who attended more than two consultations lost significantly more weight than those who attended two consultations only (3.7 ± 4.2 vs 1.1 ± 1.6 kg, respectively; P ≤ 0.05). Almost one-third of participants (n=38; 29%) did not complete the allocated number of consultations available through their referral. Modest weight and waist circumference reductions are achievable for patients with T2D receiving Medicare-subsidised dietetic services. The clinical significance of these reductions requires further investigation. Patients who attend more consultations with a dietitian may experience further improvements in weight and waist circumference outcomes. However, many patients do not complete the number of consultations allocated. Further research is required to explore the determinants of attendance at consultations in order to maximise potential improvements in health outcomes for patients receiving Medicare-subsidised dietetic services.