Journal of Human Nutrition and Dietetics最新文献

{"title":"The use of ketogenic diets in children living with drug-resistant epilepsy, glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency: A scoping review","authors":"Tracy Cameron,&nbsp;Karen Allan,&nbsp; Kay Cooper","doi":"10.1111/jhn.13324","DOIUrl":"10.1111/jhn.13324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The ketogenic diet (KD) is a high fat, moderate protein and very low carbohydrate diet. It can be used as a medical treatment for drug-resistant epilepsy (DRE), glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency. The aim of this scoping review was to map the KD literature, with a focus on epilepsy and associated metabolic conditions, to summarise the current evidence-base and identify any gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review was conducted using JBI scoping review methodological guidance and the PRISMA extension for scoping reviews reporting guidance. A comprehensive literature search was conducted in September 2021 and updated in February 2024 using MEDLINE, CINAHL, AMED, EmBASE, CAB Abstracts, Scopus and Food Science Source databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The initial search yielded 2721 studies and ultimately, data were extracted from 320 studies that fulfilled inclusion criteria for the review. There were five qualitative studies, and the remainder were quantitative, including 23 randomised controlled trials (RCTs) and seven quasi-experimental studies. The USA published the highest number of KD studies followed by China, South Korea and the UK. Most studies focused on the classical KD and DRE. The studies key findings suggest that the KD is efficacious, safe and tolerable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are opportunities available to expand the scope of future KD research, particularly to conduct high-quality RCTs and further qualitative research focused on the child's needs and family support to improve the effectiveness of KDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"827-846"},"PeriodicalIF":2.9,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential therapeutic effect of a ketogenic diet for the treatment of lymphoedema: Results of an exploratory study","authors":"Inge Lodewijckx,&nbsp;Christophe Matthys,&nbsp;Joke Verheijen,&nbsp;Raf Verscuren,&nbsp;Nele Devoogdt,&nbsp;Bart Van der Schueren,&nbsp;Karolien Goffin,&nbsp;Inge Fourneau,&nbsp;Sarah Thomis","doi":"10.1111/jhn.13330","DOIUrl":"10.1111/jhn.13330","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lymphoedema is a chronic and progressive disease characterised by excessive accumulation of lymph in the interstitial compartment, leading to tissue swelling and fibroadipose deposition. Lymphangiogenesis is partly regulated by ketone body oxidation, and a ketogenic diet (KD) has shown therapeutic efficacy in a preclinical mouse tail lymphoedema model. Therefore, we aimed to investigate the potential therapeutic effect of a KD in patients with secondary lymphoedema.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine patients with unilateral stage 2 lymphoedema secondary to lymphadenectomy were included in this quasi-experimental exploratory study consisting of a short run-in phase to gradually induce ketosis, followed by a classic KD (CKD) and modified Atkins diet (MAD) phase during which patients consumed a CKD and MAD, respectively. Lymphatic function and oedema volume, the primary outcomes, were assessed at baseline and at the end of both the CKD and MAD phase. Secondary outcomes included health-related and lymphedema-specific quality of life (QoL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven out of nine patients completed the study protocol. Lymphatic function was improved upon consumption of both a CKD (dermal backflow score [mean ± SD]: 7.29 ± 2.98 vs. 10.86 ± 2.19 at baseline; <i>p</i> = 0.03) and MAD (6.71 ± 2.06; <i>p</i> = 0.02), whereas oedema volume did not decrease during the course of the study (excess limb volume [mean ± SD]: 20.13 ± 10.25% at end of CKD and 24.07 ± 17.77% at end of MAD vs. 20.79 ± 12.96% at baseline; <i>p</i> &gt; 0.99 and <i>p</i> &gt; 0.30, respectively). No changes were observed in health-related, nor lymphoedema-specific QoL at the end of CKD and MAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The consumption of a KD improved lymphatic function and was associated with a clinically meaningful reduction in oedema volume in some patients (3/7 at end of CKD, 2/7 at end of MAD) with unilateral stage 2 secondary lymphoedema. These results highlight the potential of a KD to improve lymphatic function in patients with lymphoedema. However, further studies are required to substantiate our findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"885-891"},"PeriodicalIF":2.9,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of hypertriglyceridemic waist phenotype with metabolic syndrome traits and its diagnostic potential to predict metabolic syndrome in adults with excess body weight: A community-based cross-sectional study","authors":"Keddagoda Gamage Piyumi Wasana,&nbsp;Nayomi Deshani De Silva,&nbsp;Anoja Priyadarshani Attanayake,&nbsp;Thilak Priyantha Weerarathna","doi":"10.1111/jhn.13332","DOIUrl":"10.1111/jhn.13332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The hypertriglyceridemic waist (HTGW) phenotype is a simple measure to identify individuals at increased risk of metabolic syndrome (MetS) traits. The present study aimed to describe the HTGW prevalence, and its associations with MetS traits, and also determine the diagnostic potential of the mirror indices of HTGW phenotype to predict MetS and its components in community-dwelling adults with overweight or obesity in Southern, Sri Lanka.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a cross-sectional study, 300 adults with excess body weight (body mass index &gt;23 kg/m²) were enrolled and examined for the HTGW phenotype (fasting plasma triglyceride concentration ≥1.695 mmol/L and waist circumference &gt;90 and &gt;85 cm in males and females, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One in five adults with excess body weight had the HTGW phenotype. Phenotype-positive adults had significantly higher fasting plasma glucose (FPG) (<i>p</i> = 0.010), low-density lipoprotein cholesterol (HDL-C) (<i>p</i> &lt; 0.001), total cholesterol (<i>p</i> &lt; 0.001), atherogenic index (<i>p</i> &lt; 0.001), coronary risk index (<i>p</i> = 0.001), triglyceride glucose index (<i>p</i> = 0.040), bioimpedance visceral fat (<i>p</i> = 0.041) and significantly lower HDL-C (<i>p</i> = 0.001) and cardioprotective index (<i>p</i> = 0.009) than those without the HTGW phenotype. Adults with excess body weight and the HTGW phenotype had an increased risk of FPG (odds ratio [OR] = 1.294; 95% confidence interval [CI] 1.051–1.594), atherogenic index (OR = 3.138; 95% CI = 1.559–6.317) and triglyceride glucose index (OR = 3.027; 95% CI = 1.111–8.249). The HTGW phenotype was strongly associated with MetS traits (OR = 16.584; 95% CI = 6.230–44.147). The cut-off values for the product of waist circumference × triglyceride, to identify the risk of having MetS and dyslipidemia among adults with excess body weight were 158.66 and 160.15 cm × mmol/L, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The readily available and inexpensive measures of the HTGW phenotype could serve as a clinically useful marker to identify MetS traits in adults with excess body weight.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1130-1140"},"PeriodicalIF":2.9,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary habits and self-reported health outcomes in a cross-sectional survey of health-conscious adults eating a plant-based diet","authors":"Isabelle Sadler,&nbsp;Alexander Bauer,&nbsp;Shireen Kassam","doi":"10.1111/jhn.13321","DOIUrl":"10.1111/jhn.13321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the growing popularity of plant-based diets, this study investigated the dietary habits and self-reported health outcomes of health-conscious adults consuming plant-based diets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey (<i>n</i> = 315) was distributed to members of Plant-Based Health Professionals UK, a community interest company. Dietary intake was assessed through a food frequency questionnaire. Data were summarised descriptively. Dietary habits among respondents following a whole food plant-based (WFPB) and vegan diet were compared using hypothesis tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Respondents reported following a WFPB (61%), vegan (28%) and semi plant-based (11%) diet. Median time on current dietary pattern was 5 years. Daily or more frequent consumption was reported for the following foods: fruits 77%, berries 51%, green vegetables 48%, cruciferous vegetables 45%, other vegetables 64%, beans/legumes 41%, whole grains 62%, nuts and all seeds 63%. Consumption of ultra-processed foods and plant-based meat alternatives was low. About 93% of those on a WFPB or vegan diet supplemented with vitamin B₁₂ and 61% with vitamin D. The median body mass index was 22.4 kg/m². Fifty per cent of participants reported weight loss after adopting a plant-based diet, with a median loss of 6.4 kg. Thirty-five per cent reported reversing or improving an underlying health condition, and 15% were able to stop or reduce prescribed medication use as a result of dietary changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that a well-planned plant-based diet is achievable and sustainable in a community setting and can be associated with health benefits. How to best encourage such sustainable diets among the broad population requires further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1061-1074"},"PeriodicalIF":2.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Milk fat globule membranes for psychological and physical health: qualitative results from the Employing Milk Phospholipids to Observe Well-being and Emotional Resilience (EMPOWER) randomised trial","authors":"Rebecca Slykerman,&nbsp;Naomi Davies,&nbsp;Maher Fuad,&nbsp;James Dekker","doi":"10.1111/jhn.13326","DOIUrl":"10.1111/jhn.13326","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Milk fat globule membranes (MFGM) present a nutritional intervention with the potential to improve psychological well-being and mitigate the negative effects of stress on health. The present study aimed to investigate participant's experience of different aspects of health during a trial of MFGM supplementation and determine the effect of MFGM on qualitative measures of psychological and physical well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-three adults in New Zealand who were enrolled in a clinical trial to test MFGM supplementation for improvement of psychological well-being took part in a post-intervention interview. Participants and researchers remained blinded to intervention group allocation. Interviews were conducted over the video conferencing platform Zoom and transcribed. A mixed methods analytical approach included thematic analysis to identify emerging themes and χ² regression models to examine frequency of improvements in different aspects of well-being between the MFGM and placebo groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant demographic or psychological differences between interviewees and non-interviewed study participants. Four central themes emerged from the data for all participants: improved well-being, increased ability to cope with stress and improvements in mood, improvement in physical energy or activity, and improved sleep. The frequency of improved ability to cope with stress and improved sleep quality was significantly higher in participants who received MFGM supplementation compared to those receiving the placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Qualitative data may capture aspects of improved sleep or psychological well-being not measured by rating scales. The results suggest that MFGM supplementation may improve the ability to cope with stress and improve sleep quality in healthy adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1091-1099"},"PeriodicalIF":2.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of employer perceptions of Irish nutrition graduate competencies","authors":"Sarah O'Donovan,&nbsp;Shannon Owens,&nbsp;Elaine Hubble,&nbsp;Lisa Ryan","doi":"10.1111/jhn.13323","DOIUrl":"10.1111/jhn.13323","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Undergraduate nutrition programmes prepare students and graduates for a wide range of employment opportunities. However, little is known about how employers perceive current nutrition education practices in Ireland and how well graduates are prepared for the realities of today's workforce. The present study aimed to explore employers' perspectives of nutrition placement students and graduates' competencies for the workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Interviews were conducted with 12 nutrition employers across Ireland and the UK who currently or have recently employed Irish nutrition graduates or supervised placement students. Interviews were transcribed verbatim and thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three themes were identified including: “adapting to modern workforce needs”, “professional competency expectations” and “valuing competency-based educational and professional systems”. Employers reported an overall positive experience with Irish nutrition placement students and graduates. They are perceived as adaptable, willing to learn and professional. Many felt nutrition students and graduates had received quality education with knowledge, skills and attitudes meeting expectations of nutrition education being provided but felt that students and graduates often lacked confidence in their abilities. Employers remarked that graduates who had undergone placements were better prepared for the professional work environment. However, gaps were identified because employers felt nutrition curricula lack training on business skills and digital competencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Employers had a positive experience with Irish nutrition graduates and students and felt they were competent for the workforce. Addressing the gaps identified by employers to adapt curricula to modern workforce needs would further enhance graduate employability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1075-1090"},"PeriodicalIF":2.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do people with type 2 diabetes find continuous and intermittent low-energy diets for weight loss and diabetes remission acceptable?","authors":"Joanna Brooks,&nbsp;Helen Ruane,&nbsp;Sarah McDiarmid,&nbsp;Avni Vyas,&nbsp;Basil Issa,&nbsp;Michelle Harvie","doi":"10.1111/jhn.13313","DOIUrl":"10.1111/jhn.13313","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Manchester Intermittent versus Daily Diet App Study (MIDDAS) tested the feasibility and potential efficacy of two remotely delivered low-energy diet (LED) programmes (800 kcal/day) to support weight loss and remission of type 2 diabetes: continuous [CLED] (8 weeks of daily LED) and intermittent [ILED] (2 days of LED/week for 28 weeks). Understanding participant experiences can help us to understand the acceptability of LED programmes to people with type 2 diabetes, informing future programme development and implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty participants (10 CLED; 10 ILED) took part in interviews conducted at the end of the active weight loss phase (CLED week 12, ILED week 28). Interviews were transcribed and analysed thematically using the template analysis approach, with an a priori focus on acceptability. Four themes are presented: prospective acceptability, intervention coherence and perceived effectiveness, opportunity costs and self-efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both remotely supported CLED and ILED interventions appeared acceptable to participants. CLED participants found the rapid initial weight loss phase comparatively easy and highly motivating but expressed more concerns around weight maintenance. ILED participants found the more gradual weight loss initially frustrating but expressed greater confidence in their longer-term adherence. The importance of continued individualised support from healthcare professionals was emphasised, and evidence of weight loss and improvement in other medical markers through monitoring via the mobile phone app was useful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Different approaches to remotely delivered LEDs appear acceptable; therefore asking patients which approach may be more acceptable to them may be a useful way to offer individualised and tailored support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"995-1006"},"PeriodicalIF":2.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploration of the experiences and attitudes of healthcare professionals towards enteral tube feeding for adults living in the community following stroke","authors":"Konstantinos Eleftheriadis,&nbsp;Angela M. Madden","doi":"10.1111/jhn.13320","DOIUrl":"10.1111/jhn.13320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Guidelines recommend enteral feeding via gastrostomy should be considered for adult survivors of stroke with dysphagia who cannot eat or drink sufficiently for &gt;4 weeks. Many people continue long-term tube-feeding via this route in the community where healthcare professionals contribute to their care and nutritional management, although little is known about their experiences of or attitudes towards enteral feeding in this situation. The present study aimed to explore the experiences and attitudes of healthcare professionals working with this patient group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Healthcare professionals were invited to complete a questionnaire devised for the study which comprised closed and open questions about tube-feeding including their patients' participation in feeding processes and mealtimes and how these might be improved. Responses to closed questions were analysed descriptively and free-text responses analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-seven participants met the inclusion criteria. They identified patients' quality of life (77% of respondents) and nutritional support (75%) as the most important aspects of tube-feeding. Good communication and training with healthcare teams and carers were considered important. Their patients' participation in tube-feed administration and mealtime involvement were described as variable and potentially beneficial, but both were related to patients' choice and health impairment. Blended tube-feeding was considered an option by 89% provided practical and safety conditions were met.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants' experiences of and attitudes towards tube feeding in adults living with stroke in the community in the sample in the present study are varied and focussed on individual patients' needs, safety and professional standards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1050-1060"},"PeriodicalIF":2.9,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume-based enteral feeding for ward patients with acute neurological conditions: a pilot prospective cohort study","authors":"Jessie A. Varghese,&nbsp;Simone Keegan,&nbsp;Christine Nicholson,&nbsp;Katharine J. Drummond,&nbsp;Neha Kaul,&nbsp;Kate Fetterplace","doi":"10.1111/jhn.13319","DOIUrl":"10.1111/jhn.13319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients requiring enteral nutrition (EN) after neurological insults experience feeding interruptions, contributing to inadequate nutrition delivery. This prospective cohort study investigated if volume-based enteral feeding (VBF) improved the delivery of prescribed EN volume in ward patients with acute neurological conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Over two sequential periods, the usual care group received standard continuous rate-based feeding, and the intervention group received VBF with bi-daily EN rate adjustments to achieve target daily volume. The primary outcome was percentage of prescribed daily EN formula volume delivered. Differences in energy and protein provision, weight, malnutrition and safety were explored. An evaluation survey captured nurse acceptability of the protocol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intervention group (<i>n</i> = 32) achieved greater median interquartile range (IQR) EN adequacy of prescribed volume at 92% (88–97) compared to 67% (54–78) for usual care (<i>n</i> = 35) (<i>p</i> &lt; 0.001). VBF compared to rate-based feeding resulted in patients receiving more kilojoules (131 [121–138] kJ/kg vs. 84 [64–99] kJ/kg; <i>p</i> &lt; 0.001) and protein (1.3 [1.2–1.5] g/kg vs. 0.9 [0.6–1.1] g/kg; <i>p</i> &lt; 0.001). There were no differences in gastrointestinal intolerance between groups. Compliance to the VBF protocol was 90%, and 78% of staff reported high confidence using the protocol. The intervention group had less median weight loss at discharge (−1.4 [0.1 to −4.3] kg) than usual care (−3.6 [−1.3 to 8.4] kg; <i>p</i> &lt; 0.011), but no differences in malnutrition status were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A VBF protocol delivered greater EN volume, energy and protein following neurological injury. The VBF protocol was feasible with high acceptability from nursing staff.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1040-1049"},"PeriodicalIF":2.9,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US neonatal intensive care unit registered dietitian nutritionists salary description and correlates: results of a survey","authors":"Rosa K. Hand,&nbsp;Stephanie Merlino Barr,&nbsp;Tanis R. Fenton,&nbsp;Sharon Groh-Wargo","doi":"10.1111/jhn.13318","DOIUrl":"10.1111/jhn.13318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This survey described the compensation of neonatal intensive care unit (NICU) registered dietitian nutritionists (RDNs) in the United States and examined correlates of higher salaries within this group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was completed in 2021 by 143 NICU RDNs from 127 US hospitals who reported hourly wage in US dollars (USD). We used initial bivariate analyses to assess the relationship of selected institution-level and individual-level variables to hourly wage; the rank-sum test for binary variables; bivariate regression and Pearson correlation coefficients for continuous variables; the Kruskal–Wallis test for categorical variables. Variables with a compelling relationship to the hourly wage outcome were considered in model creation. Final model selection was based on comparisons of model fit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median hourly compensation was USD 33.24 (interquartile range [IQR] 29.81, 38.49). Seven variables had a compelling bivariate relationship with hourly wage: cost of living, employer facility with a paediatric residency, employer facility with a neonatal fellowship, NICU bed: full-time equivalents (FTE) RDN ratio, years in neonatal nutrition, having a certification and order writing privileges. In the final adjusted model (<i>R</i>² = 0.42), three variables remained associated with increased hourly wage: higher cost of living, longer length of career in neonatal nutrition and fewer NICU beds per NICU RDN FTE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>US NICU RDNs earn similar or slightly higher wages than other US paediatric RDNs; they earn substantially less than other NICU healthcare team members. Employers need to improve compensation for NICU RDNs to incentivise their retention and recognise their additional non-clinical responsibilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"37 4","pages":"1032-1039"},"PeriodicalIF":2.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.13318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}