• Title/Summary/Keyword: medical nutrition therapy

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Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis

  • Shahein, Abdul R.;Quiros, J. Antonio;Arbizu, Ricardo A.;Jump, Candi;Lauzon, Steven D.;Baker, Susan S.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.4
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    • pp.356-365
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    • 2020
  • Purpose: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP. Methods: We conducted a retrospective chart review of patients between ages of 0-18 years, who were admitted with AP at 2 institutions between 2013-2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS. Results: Ninety-two patients were included in the study. The mean age was 12 years (range, 7.6-17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49). Conclusion: Elevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS.

A Comparative Study on Acquiring and Using Patterns of Information about Food and Nutrition between Medical Personnel and Non-Medical Personnel (의료인과 비의료인의 인터넷을 통한 식품영양정보 습득 및 활용에 관한 비교 연구)

  • 김우경;한상진;서은영
    • Journal of the East Asian Society of Dietary Life
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    • v.14 no.3
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    • pp.302-308
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    • 2004
  • This study was conducted to compare the acquiring and using patterns of information about food and nutrition between medical professional group (MP) and non-medical professionals group (NP). Questionnaire survey were done by total 310 subjects, 149 doctors/nurses (MP) working in Dankook University Hospital and 161 general laborers (NP) in Cheonan area. Personal characteristics, interests in food and nutrition information, and application of information about food and nutrition were asked in questionnaire. Age of MP and NP ranged from 20 to 50. In education level, 59.8% of MP and 46.6% of NP had college degree. The source of information favored the most was the internet website, 53.0% in MP and 51.6% in NP. The most interested information subjects in MP were ‘the diet therapy related to diseases’, and ‘cooking recipes’ in NP. The information was applied to their real life in 55.7% of MP and 58.4% of NP. The percentiles who would like to take part in the education about food and nutrition through internet system were 44.3% of MP and 34.8% of NP. From the results of this study, we concluded that many of MP and NP wanted and needed the education on food and nutrition through internet system. For being the better and more efficient source for the information about food and nutrition, internet websites should provide accurate informations and easier method to find the needed information to the users.

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Nutrition Counseling and Tailored Dietary Intervention for Patients with Obesity (비만 환자에서의 맞춤형 영양 상담과 식사 치료)

  • Seo Young Kang
    • Archives of Obesity and Metabolism
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    • v.2 no.1
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    • pp.11-16
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    • 2023
  • Nutrition counseling and dietary intervention are essential to obesity management because weight reduction is the consequence of negative energy balance. The first step of the nutrition counseling in patients with obesity is thorough evaluation of the nutritional status. During the nutritional evaluation, amount of energy consumption, dietary habits, and medical and socioeconomic factors influencing diets should be evaluated. Diet interventions including low calorie diet, low fat diet, low carbohydrate diet, and high protein diet are all effective in weight reduction as long as decrease in energy consumption is accompanied. Amount of energy restriction and choice of diet interventions should be individualized based the medical condition and characteristics of each patient.

Review of Application of Medicinal Porridges by King-Injo of the Joseon Dynasty - Based on the Records from The Daily Records of the Royal Secretariat of Joseon Dynasty - (조선 인조(仁祖)의 질병관리 중 약죽(藥粥)의 적용과 의미에 관한 고찰 - 승정원일기 기록을 중심으로 -)

  • Lim, Hyunjung;Cha, Wung-Seok
    • Journal of the Korean Society of Food Culture
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    • v.28 no.5
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    • pp.438-449
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    • 2013
  • During the Joseon Dynasty, medicinal foods derived from herbs were often more effective than traditional medicines. In addition, the royal family of the Joseon Dynasty believed that foods could be used as various disease treatments. Grain-based foods, especially medicinal porridges (藥粥), were most frequently used for diet therapy. We investigated various types of diet-related diseases suffered by King Injo (仁祖) as well as how the diseases were treated using medicinal porridges based on information in the SeungjeongwonIlgi (承政院日記), which is the daily record of the Royal Secretariat of the Joseon Dynasty. This study examined the SeungjeongwonIlgi of King Injo from his1st year (1623) to 27th year (1649) on a website database maintained by the National Institute of Korean History. According to the records, King Injo suffered from severe diarrhea several times due mainly to febrile disease (煩熱症) as well as abdominal dropsy (脹滿) throughout his entire life. Major diseases affecting King Injo were due to his unhealthy eating habits and psychological factors. For treatment, royal doctors prescribed around 15 medicinal porridges, including nelumbo (seed) porridge (Yeonja-juk), milk porridge (Tarak-juk), Chinese dioscorea porridge (Sanyak-juk), mungbean porridge (Nokdu-juk), perilla seed porridge (Imja-juk), adzuki-bean porridge (Pat-juk), soybean porridge (Kong-juk), Korean-leek porridge (Buchu-juk), and so on, in addition to other medical treatments. Diet therapy using medicinal porridges has been used throughout history since the Joseon Dynasty period. However, knowledge of traditional diet therapy and medicinal porridges used by monarchs in the Joseon Dynasty is insufficient. Therefore, in-depth study is needed to understand the theory of traditional medicinal foods as well as explore their application to patients in the context of modern medicine.

Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: a randomized, double-blinded, placebo-controlled clinical trial

  • Yazdchi, Roya;Gargari, Bahram Pourghassem;Asghari-Jafarabadi, Mohammad;Sahhaf, Farnaz
    • Nutrition Research and Practice
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    • v.10 no.3
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    • pp.328-335
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    • 2016
  • BACKGROUND/OBJECTIVES: Vitamin D plays an important role in the etiology of gestational diabetes mellitus (GDM). This study evaluated the effect of vitamin D supplementation on metabolic indices and hs-C-reactive protein (CRP) levels in GDM patients. SUBJECTS/METHODS: The study was a randomized, placebo-controlled, double-blinded clinical trial. Seventy-six pregnant women with GDM and gestational age between 24-28 weeks were assigned to receive four oral treatments consisting of 50,000 IU of vitamin $D_3$ (n = 38) or placebo (n = 38) once every 2 weeks for 2 months. Fasting blood glucose (FG), insulin, HbA1c, 25-hydroxyvitamin D, lipid profile, hs-CRP, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured before and after treatment. Independent and paired t-tests were used to determine intra- and intergroup differences, respectively. ANCOVA was used to assess the effects of vitamin D supplementation on biochemical parameters. RESULTS: Compared with the placebo group, in the vitamin D group, the serum level of 25-hydroxyvitamin D increased (19.15 vs. -0.40 ng/ml; P < 0.01) and that of FG (-4.72 vs. 5.27 mg/dl; P = 0.01) as well as HbA1c (-0.18% vs. 0.17%; P = 0.02) decreased. Improvements in the lipid profiles were observed in the vitamin D group, but without statistical significance. Significant increases in concentrations of hs-CRP, FG, HbA1c, total cholesterol, and LDL cholesterol were observed in the placebo group. No significant change in fasting insulin and HOMA-IR was observed in either group. CONCLUSIONS: In GDM patients, vitamin D supplementation improved FG and HbA1c but had no significant effects on lipid profile or hs-CRP.

How to Improve Eating Behaviour during Early Childhood

  • Green, Robin John;Samy, Gamal;Miqdady, Mohamad Saleh;Salah, Mohamed;Sleiman, Rola;Abdelrahman, Hatim Mohamed Ahmed;Al Haddad, Fatima;Reda, Mona M.;Lewis, Humphrey;Ekanem, Emmanuel E.;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.1-9
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    • 2015
  • Eating behaviour disorder during early childhood is a common pediatric problem. Many terminologies have been used interchangeably to describe this condition, hindering implementation of therapy and confusing a common problem. The definition suggests an eating behaviour which has consequences for family harmony and growth. The recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition does not cover the entire spectrum seen by pediatricians. Publications are substantive but level of evidence is most of the time low. This purpose of this review is to clarify terminology of eating behaviour problems during early childhood; including benign picky eating, limited diets, sensory food aversion, selective eating, food avoidance emotional disorder, pervasive refusal syndrome, tactile defensiveness, functional dysphagia, neophobia and toddler anorexia. This tool is proposed only to ease the clinical management for child care providers. Diagnostic criteria are set and management tools are suggested. The role of dietary counselling and, where necessary, behavioural therapy is clarified. It is hoped that the condition will make its way into mainstream pediatrics to allow these children, and their families, to receive the help they deserve.

Effectiveness of Nutrition Intervention : Systematic Review & Meta-Analysis (임상영양서비스의 효과성 평가 : 체계적 검토와 메타분석을 통하여)

  • 이해영;김현아;양일선;남정모;박은철
    • Korean Journal of Community Nutrition
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    • v.9 no.1
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    • pp.81-89
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    • 2004
  • A systematic review and meta-analysis of the literatures was conducted to evaluate the effectiveness of nutrition intervention by dietitian. The 31 studies that were all randomized controlled trials, were identified from computerized search of published researches on MEDLINE, Embase database until January, 2003 and review of reference lists. The main search terms were the combination “dietitian”, “dietary intervention”, “nutrition intervention” or “nutritional intervention” and “effectiveness”. The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention (nutritional counseling and education/nutrilion counseling and education + diet modification), method of intervention (individual/group/individual + group) and follow-up period. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The meta-analysis of 31 studies based on the random effect model showed that the medical nutrition therapy was significantly effective in treating the diseases (effect size 0.1715 : 95% confidence interval 0.0938-0.2491). This study showed the clear evidence of the effectiveness of nutrition intervention through the meta-analysis. So the nutrition intervention by dietitian should be recommended and recognized as the effective therapy of treating the diseases. Also the nutrition intervention should be conducted regularly to maintain the effectiveness of the nutrition intervention. The nutrition intervention was significantly effective in treating the diseases on the random effect model (effect size 0.1715 : 95% confidence interval 0.0938-0.2491).

Effect of Supplementation of Fermented Milk Containing Active Peptides(IPP, VPP) in Accordance with Medical Nutrition Therapy in Pre- and Hypertension Subjects (고혈압 전단계 및 고혈압 환자에서 의학영양치료와 병행한 생리활성 펩티드 함유 유산균 발효유 섭취가 혈압에 미치는 영향)

  • Kim, Ji-Young;Kim, Yun-Young;Kim, Hye-Rang;Yun, Sung-Seob;Kim, Wan-Sik;Yea, Hyun-Soo;Chung, Jin-Young;Lee, In-Hoe;Choue, Ryo-Won
    • Journal of the East Asian Society of Dietary Life
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    • v.18 no.6
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    • pp.918-926
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    • 2008
  • It is well known non-drug therapy for hypertension patients can reduce blood pressure. These types of therapy include maintaining ones ideal body weight, quitting smoking, consuming large amounts of fruits and vegetables consuming low levels of saturated fat and salt and regular exercise. Fermented milk protein derived biologically active peptides such as isoleucine-proline-proline_(IPP) or valine-proline-proline_(VPP) have been shown to lower blood pressure in hypertensive subjects. This study was conducted to investigate the antihypertensive effects of medical nutritional therapy _(MNT) in accordance with the consumption of fermented milk enriched with IPP and VPP. To accomplish this, we conducted a randomized case-controlled study of 43 subjects who had blood pressure levels greater than 120/80 mmHg. The subjects in the study group were randomly allocated into two groups, an MNT + fermented milk (100mL/day) group (n=21) and an MNT+L. helveticus fermented milk with tripeptides (IPP=2.2mg, VPP=2.6mg/100mL) group (n=22). The MNT included weight management, reduction of sodium, total fat and saturated fat intake, increased intake of fruits and vegetables, and increased intake of low fat dairy products. The treatments were administered for 12 weeks during which time no drug interventions were conducted. The daily intakes of total calories, fats, cholesterol and Na decreased significantly after 12 weeks of MNT in the control and the experimental groups. In addition, the systolic blood pressure de creased significantly in the control and experimental groups; however, the diastolic blood pressure only decreased significantly in the experimental group. Overall, the results of this study indicate that the intake of fermented milk containing IPP and VPP in conjunction with MNT exerted positive effects on the blood pressure of pre- and hypertensive subjects.

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Beyond the clinical walls: registered dietitian nutritionists providing medical nutrition therapy in the home setting

  • Hicks-Roof, Kristen;Xu, Jing;Fults, Amanda K.;Latortue, Krista Yoder
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.789-797
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    • 2021
  • BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m2. Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.