Nutrition in clinical care : an official publication of Tufts University最新文献_第8页

Stages of change in clinical nutrition practice. 临床营养实践的变化阶段。

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/j.1523-5408.2002.05507.x

Elaine Fontenot Molaison

{"title":"Stages of change in clinical nutrition practice.","authors":"Elaine Fontenot Molaison","doi":"10.1046/j.1523-5408.2002.05507.x","DOIUrl":"https://doi.org/10.1046/j.1523-5408.2002.05507.x","url":null,"abstract":"For years, nutritionists have developed education materials that attempted to change dietary behaviors. However, most of these programs were effective only in increasing knowledge and did not produce long-term behavior change. Research indicates that nutrition interventions will be more effective if based on a theoretical model. The stages of change theory attempts to explain behavior change as a series of levels of readiness to changes. The stages range from precontemplation, where an individual does not recognize the need for change, to the maintenance of long-term behavior change. Use of this theory in nutrition education has been found to be most effective if education methods are stage specific and address the individual needs of clients. Unfortunately, little research has been done using this theory in traditional clinical nutrition practice, but implementation may be easy for the nutritionist and may help to increase compliance with dietary recommendations in individuals with chronic disease. The first step in using the stages of change theory is to determine the behavior that is going to be changed. With this information, the clinician can then determine the patient's stage of readiness to change a variety of dietary habits. Through the identification of an individual's stage, education methods can be tailored to meet the needs of the patient, helping to promote life-long dietary change.","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"5 5","pages":"251-7"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1523-5408.2002.05507.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22131228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 28

Evaluation and treatment of iron deficiency in patients with kidney disease. 肾病患者缺铁的评价与治疗。

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/j.1523-5408.2002.05504.x

Andrea K Bickford

{"title":"Evaluation and treatment of iron deficiency in patients with kidney disease.","authors":"Andrea K Bickford","doi":"10.1046/j.1523-5408.2002.05504.x","DOIUrl":"https://doi.org/10.1046/j.1523-5408.2002.05504.x","url":null,"abstract":"Iron deficiency is common in patients with kidney disease and is one of the primary causes for decreased response to recombinant human erthropoietin (rHuEPO) therapy. Serum ferritin and percent tranferrin saturation are regarded as the preferred indirect measurements of iron status. The National Kidney Foundation-Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines recommend levels of > 100 ng/ml and > 20%, respectively. These tests, however, have practical limitations and lack sensitivity and specificity to identify \"functional\" iron deficiency, which can occur in the presence of normal or even increased iron stores. Newer methods of assessing iron status are becoming available, with reticulocyte hemoglobin content (CHr) showing the most promise at this time. K/DOQ1 guidelines recommend that adequacy of iron should be based on the amount of iron needed to sufficiently achieve target hemoglobin and hematocrit levels of 11-12 g/dL, or 33-36%. Studies have demonstrated for a majority of hemodialysis and some predialysis and peritoneal dialysis patients that intravenous iron therapy is necessary to improve response, thus reducing the amount of rHuEPO needed to achieve these goals. Though intravenous iron is generally regarded as safe and effective, caution should be taken in regard to acceptable amounts of supplementation and long-term effects with the potential risk of iron overload.","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"5 5","pages":"225-30"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1523-5408.2002.05504.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22131232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Evaluation and treatment of iron deficiency in adults. 成人缺铁的评价与治疗。

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/j.1523-5408.2002.05503.x

Elizabeth M Ross

引用次数: 35

The effect of calcium consumption on iron absorption and iron status. 钙消耗对铁吸收和铁状态的影响。

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/j.1523-5408.2002.05505.x

Susan S Harris

{"title":"The effect of calcium consumption on iron absorption and iron status.","authors":"Susan S Harris","doi":"10.1046/j.1523-5408.2002.05505.x","DOIUrl":"https://doi.org/10.1046/j.1523-5408.2002.05505.x","url":null,"abstract":"Recent increases in recommended calcium intakes recognize the important role of calcium in skeletal health, but many Americans, especially women, consume far less than recommended amounts. A potential drawback to encouraging increased calcium intake is suggested by the extensive literature showing an adverse effect of high calcium intake on dietary iron absorption, at least in short, highly controlled, experimental studies. However, the applicability of short-term studies involving test meals to long-term iron absorption and iron status is limited given the variety of foods and food combinations in self-selected diets and the ability of individuals to adapt to reduced iron intake. In general, studies of whole diets and studies conducted over several weeks tend to show no effect of increased calcium intake on iron absorption. In addition, experimental studies of calcium and iron status measures such as serum ferritin show no long-term effect of calcium supplementation on iron status. Prevention and treatment of iron deficiency should emphasize adequate consumption of iron-rich foods and, when indicated, the use of iron supplements. Recommended calcium intakes are important for skeletal health and do not appear to increase the risk for iron deficiency in healthy people.","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"5 5","pages":"231-5"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1523-5408.2002.05505.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22131312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Algorithm for Identification and Treatment of Iron Deficiency in Primary Care 初级保健中铁缺乏的识别和治疗算法

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/J.1523-5408.2002.T01-1-00055.X

E. Ross

引用次数: 0

Iron: tolerable upper intake levels. 铁:可容忍的最高摄入量。

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01

{"title":"Iron: tolerable upper intake levels.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"Gastrointestinal side effects were selected as the critical adverse effects on which to base the UL for iron. Although gastrointestinal distress is not a serious side effect when compared with the possible risk for vascular disease and cancer, the other side effects considered (impaired zinc absorption, increased risk for vascular disease and cancer, and systemic iron overload) did not permit the determination of a UL. Gastrointestinal distress is primarily observed in individuals who have consumed high levels of supplemental iron on an empty stomach. Large doses of iron supplements may inhibit zinc absorption when both are consumed in the fasting state, but zinc absorption is not impaired when supplementary iron is taken with meals. The relationship between iron intake and both vascular disease and cancer is unclear at the present time. With the possible exception of individuals living in Southern Africa who suffer from sub-Saharan iron overload, iron overload has not been shown to result solely from a high dietary iron intake. Moreover, no differences were found in the serum ferritin concentrations between individuals who fell in the lower and upper quartiles for total dietary iron intake in the Third National Health and Nutrition Examination Survey (NHANES 111) (Appendix Table H-5). Heterozygous carriers of the C282Y mutation most commonly associated with hereditary hemochromatosis could be at increased risk for accumulating harmful amounts of iron, but there are no direct observations to confirm this suspicion. Homozygotes and individuals with other iron-loading disorders may not be protected by the UL and are addressed under \"Special Considerations\".","PeriodicalId":83835,"journal":{"name":"Nutrition in clinical care : an official publication of Tufts University","volume":"5 5","pages":"236-50"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22131224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Iron Deficiency Prescription 缺铁处方

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/j.1523-5408.2002.00551.x

H. Rasmussen

引用次数: 0

Iron Resources on the Web 网络上的铁资源

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-09-01 DOI: 10.1046/J.1523-5408.2002.05508.X

Lisa M. Neff

引用次数: 0

El Programa de Cupones Para Alimentos 食品券计划

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-08-01 DOI: 10.1046/J.1523-5408.2002.00101.X

Isabel Jimenez Canez

引用次数: 0

The role of clinicians in helping patients achieve food security. 临床医生在帮助患者实现粮食安全方面的作用。

Nutrition in clinical care : an official publication of Tufts University Pub Date : 2002-07-01 DOI: 10.1046/j.1523-5408.2002.00202.x

Lynn Parker

引用次数: 9