Dietary Counseling Research Articles

Assessing perceptions of nursing knowledge, attitudes, and practices in diabetes management within Chinese healthcare settings.

Effective management of diabetes mellitus (DM) involves comprehensive knowledge, attitudes, and practices (KAP) by nurses, which is essential for optimal patient care and aiding patients in their self-management of the condition. This survey evaluates nurses' self-assessed knowledge, attitudes, and practices (KAP) related to diabetes management, focusing on their perceptions of personnel expertise and care approaches. Using a stratified sampling method, the survey was disseminated across various online platforms from January 2023 to February 2024 within China, including WeChat and Sina Weibo. We employed binary logistic regression and Chi-square tests to explore the statistical correlates of KAP related to DM. A total of 4,011 nurses participated, revealing significant perceived knowledge deficiencies in specialized DM management areas, with only 34% (n = 1,360) proficient in current pharmacological treatments. Attitudinal assessments showed that 54% (n = 2,155) recognized the importance of cultural competence in dietary counseling. Practices were strong in routine glucose monitoring (96%, n = 3,851) but weaker in psychological support (68%, n = 2,736). Regression analysis indicated significant effects of experience on KAP, where nurses with 1-5 years of experience were more likely to show better knowledge (OR = 1.09; p = 0.08), and those with advanced degrees demonstrated higher competence (OR = 1.52; p = 0.028). Marital status influenced attitudes, with single nurses more likely to exhibit positive attitudes (OR = 0.49; p < 0.001), and work environment impacted knowledge, with hospital-based nurses more knowledgeable (OR = 1.15; p = 0.14). Additionally, gender differences emerged, with male nurses showing greater knowledge (OR = 1.65; p = 0.03) and better practices in diabetes care (OR = 1.47; p = 0.04). The study underscores the critical need for targeted educational programs and policy interventions to enhance nursing competencies in DM management. While the study provides valuable insights into nurses' perceptions of their competencies, future research should incorporate objective knowledge assessments to ensure a comprehensive understanding of their actual capabilities. Interestingly, the data also suggests a substantial opportunity to leverage technology and inter-professional collaboration to further enhance DM management efficacy among nurses, fostering an integrated care approach.

Reviewing the recurrence rates in stage I-III HR or ER positive breast cancer in obese patients given multi-modal weight loss plan post-treatment with aromatase inhibitors.

15 Background: Aromatase inhibitors (AIs) in the treatment of endocrine recepter positive breast cancer stages I-III, poses significant challenges in the management of obesity. Obesity is not only associated with an increased risk of breast cancer incidence but also with higher rates of cancer recurrence and poorer treatment outcomes. Moreover, the use of AIs, while effective in reducing estrogen levels and preventing ER or HR positive breast cancer recurrence, may exacerbate weight gain and metabolic disturbances in obese individuals. Weight management strategies have experienced increased attention in breast cancer survivors in recent years, especially overweight or obese individuals. Novel data makes it possible to infer that obesity management activities and multimodal programs that incorporate dietary counseling and physical activity can reduce recurrence rates. Methods: Participants in this study were individuals with Stage I-III endocrine receptor positive breast cancer who had completed adjuvant therapy and had a BMI in the 40s or 50s, increasing risk of recurrence. Eligible patients were identified based on the start date for endocrine therapy. High-risk patients were then assigned to either the intervention or control group. Those in the intervention group received access to a dietician, along with informational pamphlets on physiology and weight loss strategies. Additionally, they were offered discounts to certain gyms or provided free access to fitness facilities. Both intervention and control groups were briefed about the study, with those in the intervention group encouraged to utilize the provided resources for weight management. Results: The evidence from our study will underscore the potential benefits of multimodal weight loss interventions in overweight or obese breast cancer survivors, particularly in improving anthropometric outcomes and enhancing overall quality of life. Conclusions: While the studies included in our analysis demonstrated reductions in body weight, BMI, and waist circumference, as well as improvements in quality of life measures, there remains a notable gap in understanding the impact of these interventions on breast cancer recurrence rates, especially in the context of endocrine-positive breast cancer treated with Aromatase Inhibitors (AIs).

Targeting maternal gut microbiome to improve mental health outcomes-a pilot feasibility trial.

Perinatal depression and anxiety (PDA) is prevalent in new and expectant mothers, affecting millions of women worldwide. Those with a history of mood and anxiety disorders are at the greatest risk of experiencing PDA in a subsequent pregnancy. Current safety concerns with pharmacological treatments have led to a greater need for adjunctive treatment options for PDA. Changes in the composition of the microbiome have been associated with various diseases during pregnancy, and these changes are thought to play some role in perinatal mood disorders. While the relationship between PDA and the microbiome has not been explored, evidence suggests that nutritional interventions with fiber, fish oils, and probiotics may play a favorable role in neuropsychiatric outcomes during and after pregnancy. The primary objective of the present study is to assess the feasibility and acceptability of a combination of nonpharmacological interventions to maintain stability in pregnant women who have a history of depression and/or anxiety. This study will also aim to understand ease of recruitment and protocol adherence in this cohort. This is a single-centered, partially randomized, placebo-controlled, double-blind feasibility trial. One hundred pregnant women with a history of depression and/or anxiety/PDA will be recruited and randomized into one of four arms, which could include the following: receiving a daily dose of both investigational products and dietary counseling on increasing dietary fiber, receiving a daily dose of both investigational drugs only, receiving fish oil investigational product and placebo, and a control arm with no intervention. The study involves six study visits, all of which can be conducted virtually every 3 months from the time of enrollment. At all study visits, information on diet, mental health, physical activity, and sleep quality will be collected. Additionally, all participants will provide a stool sample at each visit. It is anticipated that pregnant women with a history of depression and anxiety will be particularly interested in partaking in this trial, resulting in favorable recruitment rates. Given the positive findings of omega-3 fatty acids (O3FAs) and probiotic supplements on mental health symptoms in nonpregnant adults, we expect a similar trend in PDA symptoms, with a low likelihood of adverse events. This study will build the foundation for larger powered studies to further contribute evidence for the efficacy of this potential preventative treatment option. This trial was registered at ClinicalTrials/gov on October 6, 2023; NCT06074250. Trial Sponsor: The Canadian College of Naturopathic Medicine, 1255 Sheppard Ave E, Toronto, ON M2K 1E2, 416-498-1255.

Impact of Dietary Counseling on Nutritional requirements and Mitigating Noncompliance behavior in Hemodialysis Patients: A Pilot Study

Abstract Introduction Hemodialysis is the most sought-after treatment modality in patients with end-stage renal disease. The success of hemodialysis depends on the patient's adherence to diet and fluid restrictions to a great extent. Nutritional health is a critical consideration, especially for hemodialysis patients. Nutritional education and counseling for renal disease patients significantly preserve renal function and overall well-being. Methods Quantitative research approach with a quasi-experimental crossover design to determine the effectiveness of dietary counseling on the nutritional requirement and noncompliance behavior of patients undergoing hemodialysis conducted at Mangala Kidney Hospital, Mangalore, Karnataka, India. Results The mean age among the participants was 46.07 + 9.67 years. Nearly half of the subjects, 11 (39.29%), had undergone dialysis for 1 to 5 years. Twenty-six (96.3%) had noncompliance behavior toward diet and fluid. Based on biochemical parameters, 20 (74.07%) were classified as low-risk noncompliance and 7 (25.92%) high-risk noncompliance behavior. A paired t-test showed that there is a significant difference in knowledge of nutritional requirements, t (26) = 6.30, p ≤ 0.001 at 5% level of significance, and noncompliance among the participants before and after the dietary counseling program as t (26) = –5.41, p ≤ 0.001 at 5% level of significance. Conclusion Implementing nurse-led counseling for hemodialysis patients can improve biochemical parameters and enhance understanding of dietary and fluid restrictions, positively impacting laboratory indicators.

Effects of Oral Nutritional Supplement with β-Hydroxy-β-methylbutyrate (HMB) on Biochemical and Hematological Indices in Community-Dwelling Older Adults at Risk of Malnutrition: Findings from the SHIELD Study.

Malnutrition may result in abnormal biochemical and hematological indices. This planned prespecified analysis investigated the effects of a specialized oral nutritional supplement (ONS) on biochemical and hematological indices in community-dwelling older adults at risk of malnutrition. In the Strengthening Health in ELDerly through nutrition (SHIELD) study, 811 older adults aged 65 years and above took part in this randomized, double-blind, placebo-controlled, multi-center study. Participants were randomly allocated to either a complete and balanced specialized ONS (each serving provides 262 kcal, 10.5 g protein, 7.75 µg vitamin D3, and 0.74 g calcium β-hydroxy-β-methylbutyrate) and dietary counselling (intervention group) or a placebo and dietary counselling (placebo group). Both groups consumed study products twice a day for 180 days. Data were collected at baseline, day 90, and day 180. Blood analysis results at follow-up visits were analyzed using repeated measures analysis of covariance with adjustments for confounders. Overall, when compared with the placebo group, the intervention group showed significantly greater urea (6.0 mmol/L vs. 5.4 mmol/L, p < 0.001), urea to creatinine ratio (4.39 vs. 4.26, p < 0.001), prealbumin (24.9 mg/dL vs. 24.0 mg/dL, p < 0.001), vitamin B12 (480.0 pmol/L vs. 420.1 pmol/L, p < 0.001), and globulin levels (26.8 g/L vs. 26.5 g/L, p = 0.032). The intervention group also had a significantly higher absolute reticulocyte count (62.0 × 103/µL vs. 58.2 × 103/µL, overall p < 0.001) and mean platelet volume (10.0 fL vs. 9.9 fL, overall p = 0.003). Furthermore, significant improvements were seen in total protein at day 90 (71.7 g/L vs. 71.1 g/L, p = 0.017) and in absolute monocyte count at day 90 (0.50 × 103/µL vs. 0.47 × 103/µL, p = 0.009) in the intervention group. In conclusion, daily consumption of a specialized ONS for six months led to significant improvements in biochemical and hematological indices in community-dwelling older adults at risk of malnutrition.

Micronutrient deficiency, dietary diversity, and sociodemographic and lifestyle determinants of dietary diversity among pregnant slum-dwelling women in Pune, India

BackgroundIncreasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India.MethodsThis study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study. Sociodemographic and lifestyle data were collected at baseline (< 12 weeks gestation). Dietary data (24-h dietary recall) were collected in mid-pregnancy (23 ± 2 weeks). Nutrient intakes were compared with the Estimated Average Requirements (EAR) for pregnant Indian women. Dietary diversity score (DDS, range 0–10) and unhealthy food (sweet snacks, sweet beverages, fried and salty food) group score (range 0–3) were calculated as per FAO guidelines. Multivariate logistic regression was conducted to examine determinants of adequate dietary diversity (DDS ≥ 5).ResultsThe average age of women was 25 (4.5) years. The median (Q1, Q3) total energy and protein intakes were 1771 (1456, 2185) kcal/d and 44.7 (34.7, 55.0) g/d, respectively. Total energy and protein were consumed as per EAR by 37% and 54% of women, respectively. Forty percent of women exceeded the recommended energy intake from carbohydrates. Diets of slum-dwelling women were lacking in multiple micronutrients (especially iron, zinc, riboflavin, thiamine, folate). The mean DDS was 4.2 ± 1.2 and 36.5% of the women had DDS ≥ 5. All women consumed mainly cereal-based starchy staples; 80% consumed pulses and legumes, and 60% consumed other vegetables. Fifty-nine percent of women consumed ≥ 2 unhealthy food groups. Higher educational and occupational status of the primary earning members of the family and lower parity were determinants of adequate dietary diversity.ConclusionThe diets of pregnant slum-dwelling women were lacking in numerous micronutrients. Dietary counselling programs need to be tailored to the socioeconomic backgrounds of pregnant slum-dwelling women and involve their family members to improve reach and effectiveness.

Effectiveness and cost-effectiveness of a 1-year dietary and physical activity intervention of childhood obesity—study protocol for a randomized controlled clinical trial

BackgroundWe investigate and try to find out the optimal duration and intensity for the treatment and content useful for clinical work. The aim of our study is to evaluate the effects of lifestyle intervention on the management of childhood overweight and to explore the factors that contribute to the outcome, as well as the costs for the health care system. The hypotheses of the study are that lifestyle intervention is efficient in reducing BMI-SDS and thus effective in preventing overweight from progressing to obesity, and it is also cost-effective.Methods and analysesWe aim to recruit 80 children and they randomize either to an intervention group or a control group with standard care. The intervention group receives intensive, family-based diet, and physical activity counseling, delivered by a multidisciplinary team of a pediatrician, a nurse, and a clinical nutritionist. The control group does not receive any lifestyle intervention during the study. The inclusion criteria are age of 6–12 years, weight-for-height ≥ + 40% or ≥ + 30%, and increasing curve. All participants fill out the study questionnaires and plasma samples are taken at baseline and at 12 months. Outcome variables will be compared between intervention and control groups.DiscussionIf the effects of this lifestyle intervention are positive and it is also cost-effective, the implication of our study will be of great importance to the treatment of childhood obesity and to improve the health care system.Trial registrationClinicalTrials.gov NCT06126679. Registered on 25 October 2028 in Finland.ORCID: 0009-0009-6659-5290.

Nutritional status, food security and other correlates among adult tuberculosis patients in a block of Murshidabad district, West Bengal.

Tuberculosis (TB) and malnutrition are epidemiologically interrelated two major public health problems in India. Food security also influences nutritional status. This aspect needs evaluation in diverse geographical areas. This study aimed to assess the level of food security, nutritional status and correlates among adult TB patients in a block of Murshidabad, West Bengal. This cross-sectional study was undertaken in the Nabagram block of Murshidabad district during April-July 2023. All adult (≥18 years) patients registered under the Tuberculosis Unit of the block during a reference period of 6 months (October 2022-March 2023) were considered study subjects. Eighty such eligible participants recruited randomly were interviewed with a pre-designed schedule for socio-demographic and programmatic characteristics. Household food security was measured using a validated U.S. Household Food Security Survey Module. Anthropometric measurements were taken, and nutritional status was determined based on body mass index. Statistical Package for the Social Sciences (SPSS) version 26 was used for analysis. Among 80 TB patients, 51% were underweight and 20% were severely underweight. The majority (90%) of them had high or marginal food security, and 10% had low or very low food security. On multivariable logistic regression, Hindu religion (adjusted odds ratio (AOR): 6.74, 95% confidence interval (CI): 2.12-29.39), presence of any chronic morbidity (AOR: 11.61, 95%CI: 2.71-49.78) and receipt of dietary counselling by a health worker (AOR: 7.25, 95%CI: 1.22-43.13) appeared as predictors of underweight. Underweight among TB patients is quite prevalent in the area, and few programmatic interventions are influencing factors. This underscores the importance of nutritional counselling services and the universal provision of Poshan benefits.

Importance of an Ongoing Nutritional Counselling Intervention on Eating Habits of Newly Diagnosed Children with Celiac Disease.

A strict lifelong gluten-free diet (GFD) is the current treatment for the management of celiac disease (CD). Several studies have demonstrated that without proper dietary assessment, this diet leads to nutritional deficiencies and/or imbalances. The present study aimed to improve the dietary habits of newly diagnosed children with CD through ongoing and face-to-face dietary counseling. Forty-three participants were followed during the first year after CD diagnosis. Dietary data were collected at diagnosis (Vt0), after 3 months on a GFD (Vt3), and after 1 year following a GFD (Vt12). Participants completed a 3-day 24-h food recall, a food frequency questionnaire, and the KIDMED index. After each data collection, participants received dietary assessment and nutritional education. Participants consumed more plant-origin foods after the intervention, with most of them reaching the daily recommendations. Fresh food intake increased and that of ultra-processed foods decreased. Compliance with the Mediterranean diet also improved. Personalized dietary assessment and ongoing follow-up improved the dietary patterns of children recently diagnosed with CD, highlighting the importance of dietitian involvement in the management of CD.

Are first-trimester pregnant women consuming adequate and diverse diet? A hospital-based cross-sectional study in Karachi, Pakistan

BackgroundMaintaining a healthy and diverse diet during pregnancy is crucial for maternal well-being and fetal development. The first trimester marks the beginning of vital developmental processes influenced by maternal nutritional status. Therefore, we aimed to determine dietary adequacy and diversity among first-trimester pregnant women.MethodsIn this cross-sectional study, we recruited 306 first-trimester pregnant women from the antenatal clinics of Aga Khan University Hospital, Karachi (January 2020 to September 2021). Eligible women possessed smartphones (for the mHealth intervention trial) and reported no major comorbidities or medication use. Data about socio-demographic, obstetric, and dietary history were collected through interviews using a structured questionnaire. Booking weight, height, blood pressure, and haemoglobin levels were extracted from medical records. An aggregate dietary risk score (DRS) was calculated separately for quantity and quality by summing the DRS for each of the six major food groups. A score of 0 was assigned to adequate, 1.5 to intermediate, and 3 to inadequate quantity or quality categories. Data were analysed using STATA 14.0.ResultsThe mean ± SD for DRS quantity and quality were 10.6 ± 2.4 and 7.5 ± 2.5, respectively. Adequate dietary quantity and quality per week for starch-based food were reported by 14.4% and 21.2%, for vegetables by 0.3% and 49%, for fruits by 41.2% and 88.6%, for animal and plant protein by 19% and 0%, for milk and milk products by 1% and 37.6% and for oils and fats by 90.5% and 8.8%, respectively. Sweet and savoury snacks were eaten by 74.8% and 53.9%, respectively. Ready-made meals, carbonated beverages, packaged juices, and additional salt were consumed by 55.2%, 46.4%, 34.3%, and 7.5%, respectively. The median (IQR) water intake was 6 (4–8) glasses/day.ConclusionsDuring the early stages of pregnancy, women enrolled for antenatal care at an urban private tertiary care hospital report inadequate dietary intake for various food groups, except for the quantity of oils/fats and the quality of fruit consumption. Poor dietary practices underscore the need for focused and impactful dietary counselling during the initial stages of pregnancy.

Characterization of the nutritional profile of three plant-based drinks

This study aimed to analyze the nutrient composition of plant-based drinks (oat, almond, soy) available on the German market, focusing on 36 samples, representing non-fortified and unsweetened products. Due to the absence of standardized legal specifications, macronutrient variations within each category were observed. Besides this, distinct differences especially in macronutrients were identified among oat, almond, and soy drinks. This can be observed in the varying fat contents from 1.01 (oat) to 2.16 g/ 100 g (almond). Soy drinks exhibited the highest levels of minerals (e.g. potassium: 131.99 mg/100 g), trace elements (e.g. copper: 116.51 µg/100 g), vitamins (e.g. thiamine: 44.02 µg/100 g; folate: 9.7 µg/100 g), and protein (3.23 g/100 g).The presence of phytates found in all plant-based drinks, particularly the high concentrations in soy drinks (up to 81.5 mg/100 g) could negatively affect the bioavailability of essential elements like zinc, iron, and calcium. The study noted generally low concentrations of water-soluble (e.g. 8.25 µg/100 g riboflavin in oat) and fat-soluble vitamins (e.g. 0.35 mg/100 g vitamin E in soy) in the drinks. The insights gained from this research are expected to contribute to the enhancement of the German nutrient database Bundeslebensmittelschlüssel (BLS), facilitating better evaluation of dietary intake studies and dietary counseling.

Oral nutritional supplementation with dietary counseling improves linear catch-up growth and health outcomes in children with or at risk of undernutrition: a randomized controlled trial.

Childhood undernutrition is associated with increased morbidity, mortality and a high socio-economic burden. Supporting Pediatric GRowth and Health OUTcomes (SPROUT) is a randomized, controlled trial evaluating the effects of an oral nutritional supplement (ONS) with dietary counseling (DC; n = 164) compared to a DC-only group who continued consuming their habitual milk (n = 166; NCT05239208). Children aged 24-60 months who were at risk or with undernutrition, as defined by weight-for-age [WAZ] < -1 and height-for-age [HAZ] < -1 according to the WHO Growth Standards, and who also met the criterion of weight-for-height [WHZ] < 0, were enrolled in Vietnam. ONS + DC had a larger WAZ increase at day 120 (primary endpoint) vs. DC (least squares mean, LSM (SE): 0.30 (0.02) vs. 0.13 (0.02); p < 0.001), and larger improvements in all weight, BMI and weight-for-height indices at day 30 and 120 (all p < 0.01). Height gain was larger in ONS + DC in all indices, including height-for-age difference [HAD; cm: 0.56 (0.07) vs. 0.10 (0.07); p < 0.001], at day 120. ONS + DC had larger arm muscle but not arm fat indices, higher parent-rated appetite, physical activity and energy levels, longer night sleep, fewer and shorter awakenings, and better sleep quality than DC. Adding ONS to DC, compared to DC-alone, improves growth in weight and height, linear catch-up growth, and health outcomes in children with or at risk of undernutrition.

The effects of dietary compliance counseling on calorie consumption in type 2 diabetes mellitus

The effects of dietary compliance counseling on calorie consumption in type 2 diabetes mellitus

Nurse-led virtual clinic for liver cirrhosis: impact on quality of life and health outcomes – a mixed methods research proposal

Liver cirrhosis causes high mortality and morbidity, affecting patients' quality of life (QoL) and health outcomes. Given the significant burden of liver cirrhosis, restructuring healthcare services is crucial. Nurses' involvement in secondary prevention for other chronic diseases has shown benefits, including improved symptom control, reduced hospitalisations and enhanced HRQoL. However, the nursing role in liver disease management remains understudied. This mixed-methods study proposal with an embedded sequential design will assess the effectiveness of a nurse-led virtual liver cirrhosis clinic (NLVLCC) on QoL, self-efficacy, and health outcomes in 90 patients with alcohol-related cirrhosis (60 intervention, 30 control). Health outcomes include medication adherence, performance status, dietary adherence, alcohol intake, depression, anxiety, stress and 30-day readmission. Phase one will involve a randomised controlled trial, followed by narrative analysis in phase two. Data collection will utilize standardized and structured tools, including the Chronic Liver Disease Questionnaire, Self-Efficacy for Managing Chronic Disease 6-item Scale, MARS, Karnofsky Performance Scale, 24-hour dietary recall, AUDIT, DASS, and adherence logs. NLVLCC components include patient education, dietary counseling, brief alcohol de-addiction intervention, psychological support, medication adherence, physical activity guidance and regular virtual follow-ups.

Impact of physical activity and diet counseling on the management of Type-2 Diabetic patients undergoing vitamin D supplementation: A Follow-up Study

Impact of physical activity and diet counseling on the management of Type-2 Diabetic patients undergoing vitamin D supplementation: A Follow-up Study

Exploring Dietitians’ Perspectives Toward Current Practices and Services in Relation to Irritable Bowel Syndrome Management in Clinical Settings Across the United Kingdom: A Qualitative Study

BackgroundIrritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition that negatively impacts quality of life. Dietary triggers are common and dietary management is central to the IBS treatment pathway, and dietitians are the main education providers for patients. ObjectiveThe aim of this study was to explore dietitians’ perspectives on current practices and services in relation to IBS management in clinical settings across the United Kingdom. DesignQualitative semi-structured interviews were undertaken from May to October 2021 via videoconferencing software. Eligible participants were dietitians specializing in gastroenterology and working in National Health Service (NHS) Trusts in the United Kingdom. Interviews were audio recorded and transcribed following intelligent transcription. Template analysis guided by naïve realism and its underlying epistemological assumptions was used. Participants/settingDietitians (N = 13) working in various NHS Trusts across the United Kingdom with at least 1 year of clinical experience in IBS management were included. Qualitative data analysisTemplate analysis, a form of thematic analysis with hierarchical coding, was used to explore dietitians’ perspectives of IBS practices. ResultsParticipating dietitians were mostly female (92.3%), of White race (84.6%), working in various NHS Trusts across the United Kingdom, and had more than 5 years of clinical experience (69.2%). The following 3 main themes emerged: 1) dietetics services as part of IBS referral pathways; 2) practices in relation to dietetics services; and 3) patients’ expectations and feelings. Each main theme had subthemes to facilitate the description and interpretation of data. The increasing number of IBS referrals to dietitians and the need for accurate and timely IBS diagnosis and specialist dietitians were reported, along with the use of digital innovation to facilitate practice and access to dietetic care. The use of internet as a source of (mis)information by patients and the limited time available for educating patients were identified as potential barriers to dietetic practice. Dietitians follow a patient-centered approach to dietary counseling and recognize the negative implications of perceived IBS-related stigma by patients on their feelings and treatment expectations. ConclusionsThe study identified areas and practices that can facilitate access to dietetic services and patient-centered care in IBS management, as outlined in UK-based guidelines.

Association of Serum Trimethylamine-N-Oxide Concentration from Childhood to Early Adulthood with Age and Sex.

Primary prevention is the cornerstone of cardiometabolic health. In the randomized, controlled Special Turku Coronary Risk Factor Intervention Project (STRIP), dietary counseling intervention was given to children from infancy to 20 years of age and a follow-up was completed at age 26 years. We investigated the associations of age, sex, gut microbiome, and dietary intervention with the gut metabolite and the cardiac biomarker trimethylamine-N-oxide (TMAO). Overall, 592 healthy participants (females 46%) from STRIP were investigated. Compared to the control group, the intervention group had received dietary counseling between ages 7 months and 20 years focused on low intakes of saturated fat and cholesterol and the promotion of fruit, vegetable, and whole-grain consumption. TMAO serum concentrations were measured by a liquid chromatography-tandem mass spectrometry method at ages 11, 13, 15, 17, 19, and 26 years. Microbiome composition was assessed using 16S rRNA gene sequencing at 26 years of age. TMAO concentrations increased from age 11 to 26 years in both sexes. At all measurement time points, males showed significantly higher serum TMAO concentrations compared to females, but concentrations were similar between the intervention and control groups. A direct association between TMAO concentrations and reported fiber intake was found in females. Gut microbiome analysis did not reveal associations with TMAO. TMAO concentration increased from childhood to early adulthood but was not affected by the given dietary intervention. In females, TMAO concentrations could be directly associated with higher fiber intake suggesting sex-specific differences in TMAO metabolism.

Effect of structured diet with exercise education on anthropometry and lifestyle modification in patients with type 2 diabetes: A 12-month randomized clinical trial

AimsLifestyle modification involving active engagement of specialised dietitian with diet and exercise education, can be effective as first-line treatment for diabetes. Methods192 patients were enrolled with diabetes in a randomised controlled trial and followed up for one year. Ninety-four patients in the intervention group participated in a comprehensive structured diet and exercise education conducted by a specialised dietitian at ambulatory centre in the United Arab Emirates. ResultsThe mean difference in the change in body mass index between study groups at study exit and baseline was statistically significant (BMI difference = -1.86, 95 % CI −2.68 – −1.04, P < 0.01). The intervention group reported significant decrease in total carbohydrate and daily energy intake compared to baseline (173.7 g vs 221.1 g and 1828.5 kcal vs 2177.9 kcal, respectively). Moreover, the mean metabolic equivalents (METs) in the intervention group increased significantly at study exit from baseline compared to control group METs, with mean difference between all between-group differences after baseline of 0.63 (95 % 0.29 – 0.97, P < 0.01). ConclusionsStructured diet and exercise counselling by specialised dietitian in ambulatory settings significantly reduced carbohydrate and daily energy intake, with improved anthropometric measurements and physical activity.

Course of growth and nutritional status in Swiss children with food allergies

Summary Purpose Studies suggest that children with immunoglobulin E (IgE)-mediated food allergies (FA) are at risk of impaired growth, especially those with cow’s milk or multiple FA. However, there is limited long-term data available on this topic. This analysis presents the growth of Swiss children for the first year after FA diagnosis. Methods This is a secondary analysis of data from a multicentered study following food allergic children (0–10 years) over 1 year post diagnosis, comparing those who received dietary counselling with those who did not. Growth z‑scores were calculated based on World Health Organization (WHO) standards, using data reported by caregivers. To analyze data, linear mixed models with between-subject factors related to dietary counselling, number of FA, and cow’s milk allergy were fitted to the data. Results In the 48 children (median age 16 months) studied, we observed an increasing prevalence of wasting (weight-for-length/height z‑score &lt; 2; 2–10%) and a lower prevalence of stunting (length/height-for-age &lt; 2; 0–2%) over the 1‑year period. Twelve months after diagnosis, all median z‑scores showed an increase. Linear mixed model analysis did not find any significant within-subject and between-subject effects on growth. Conclusion Children with IgE-mediated FA can have normal growth if children with cow’s milk allergy or multiple food allergies receive dietary counselling. Routine length/height and weight measurements should be taken to identify individual malnutrition and to initiate tailored nutritional interventions. Larger studies with longer duration are needed to assess further growth development in children with IgE-mediated food allergies.

Survey on patients’ attitude towards the nutritional counselling in the dental setting

AimA healthy diet could help to prevent both oral and systemic diseases, with dentists and nutritionists supplementing their skills. The dental setting, where patients periodically refer to seeking oral health care, represents a powerful opportunity for nutritional counselling. To the best of our knowledge, no study is available on patients’ attitudes towards dietary counselling in the dental setting. This cross-sectional study investigates patients’ attitude towards receiving nutritional support within the dental setting and it elucidates whether a transdisciplinary approach would be well accepted.Materials and MethodsA questionnaire was administered to patients attending three different clinics: a private clinic, a hospital dental clinic of the national healthcare system and the private dental practice within the same hospital.ResultsThree hundred thirteen questionnaires were collected. Most dental patients acknowledged receiving nutritional advice from both dentists and nutritionists. The nutritionist within the dental setting was positively perceived, providing useful advice to prevent oral and systemic diseases and also drawing up a diet with periodic follow-ups.Discussion and conclusionThese findings support the positive attitude of patients towards receiving nutritional counselling within the dental setting. The dental clinics can be pivotal in oral and systemic disease screening and prevention and a multidisciplinary approach is highly encouraged.