Effectiveness Of Medical Nutrition Therapy Research Articles

Effect of Medical Nutrition Therapy on Outcomes of Pre-Diabetes Patients in a Rural Nebraska Family Practice Clinic

Methods: This 2010 retrospective study examined electronic health records of newly diagnosed pre-diabetes patients who received MNT (n 20, mean age 61, 85% female) or did not receive MNT (NMNT) (n 22, mean age 63, 82% female). Weight, blood glucose, lipid profile, and medications data were collected at baseline and repeat measurements were recordedwhen available in the health record for up to one year post diagnosis. Data were analyzed using the Mixed Procedure and Chi Square.

Effects of Medical Nutrition Therapy on Body Fat and Metabolic Syndrome Components in Premenopausal Overweight Women

Background/Aims: To evaluate the effects of medical nutrition therapy (MNT) on body composition and metabolic syndrome (MetS) components in premenopausal Korean women with a body mass index ≥23. Methods: Participants (n = 160) were classified into MetS (n = 44) or non-MetS (n = 116) groups based on the criteria proposed by the revised National Cholesterol Education Program-Adult Treatment Panel III and the International Diabetes Federation classification. Anthropometric and dietary assessments and blood analyses were performed for all participants prior to and following 12 weeks of MNT. Results: Following MNT, body fat decreased in both groups by roughly 11% (p < 0.001), and the number of participants meeting the criteria for MetS thus decreased from 44 to 19 (56.8%). Mean waist circumference (WC), blood pressure (BP), plasma triglyceride (TG) and blood glucose levels decreased in the MetS group (p < 0.001). Body fat reduction in the MetS group was correlated with changes in WC (r = 0.584), systolic BP (r = 0.451), diastolic BP (r = 0.429) and plasma TG (r = 0.488) levels after adjusting for covariates (p < 0.05). Conclusions: Body fat reduction and MetS component improvement was achieved by MNT in overweight women. Changes in MetS components appear to be related to body fat reduction. MNT should focus on body fat reduction when used as a primary prevention for MetS.

What Is the Appropriate Distribution of Macronutrients for a Patient with Diabetes?

W HILE THE EFFECTIVENESS of medical nutrition therapy (MNT) in themanagement of diabetes has been well established, the ideal macronutrient distribution to improve glycemic control has been in question for many years. The American Diabetes Association established guidelines in 2001 stating that there was not one specific mix of macronutrients for all people with diabetes. A recent article published in Diabetes Care (1) reviewed the scientific literature from 2001 to 2010 regarding this question. The researchers reviewed almost 100 studies that discussed the kind and amount of carbohydrates, fat, protein, and specific foods and overall eating patterns that would have a possible impact on gylcemic control. The authors noted howdifficult it was to get a true picture of the effects of the macronutrients on glycemic control sincemany factors can influence the results. Variability in study methodology, includingmeasurement of dietary intake, retention rates, and confounding by weight loss, limits comparisons as to how macronutrient distribution independent of weight loss affects outcomes of interest. In the article, the authors defined the terms “conventional” or “traditional” macronutrient distribution as 55% to 65% carbohydrate, less than or equal to 30% fat, and 10% to 20% protein (1). It is interesting to note that research studies have shown people with diabetes typically consume only 45% of total calories from carbohydrates (1). Although in many instances there were not statistically significant differences between dietary approaches, im-

Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010.

The effectiveness of medical nutrition therapy (MNT) in the management of diabetes has been well established (1). Previous reviews have provided comprehensive recommendations for MNT in the management of diabetes (2,3). The goals of MNT are to 1 ) attain and maintain optimal blood glucose levels, a lipid and lipoprotein profile that reduces the risk of macrovascular disease, and blood pressure levels that reduce the risk for vascular disease; 2 ) prevent and treat the chronic complications of diabetes by modifying nutrient intake and lifestyle; 3 ) address individual nutrition needs, taking into account personal and cultural preferences and willingness to change; and 4 ) maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence (4). The literature on nutrition as it relates to diabetes management is vast. We undertook the specific topic of the role of macronutrients, eating patterns, and individual foods in response to continued controversy over independent contributions of specific foods and macronutrients, independent of weight loss, in the management of diabetes. The position of the American Diabetes Association (ADA) on MNT is that each person with diabetes should receive an individualized eating plan (4). ADA has received numerous criticisms because it does not recommend one specific mix of macronutrients for everyone with diabetes. The previous literature review conducted by ADA in 2001 supported the idea that there was not one ideal macronutrient distribution for all people with diabetes. This review focuses on literature that has been published since that 2001 date (5). This systematic review will be one source of information considered when updating the current ADA Nutrition Position Statement (4). Other systematic reviews and key research studies that may not be included in this review will also be considered. When attempting to tease out the role of macronutrients from other dietary …

Effect of Medical Nutrition Therapy on the Clinical Outcomes of Dyslipidemia

The participant will be able describe the potential clinical benefits of implementing MNT protocols for dyslipidemic patients within a Primary Care setting.

The Effect of Medical Nutrition Therapy in Patients with Pre-Diabetes Participating in a Randomized Controlled Clinical Research Trial

The Effect of Medical Nutrition Therapy in Patients with Pre-Diabetes Participating in a Randomized Controlled Clinical Research Trial

The effect of medical nutrition therapy on changes in dietary knowledge and DASH diet adherence in older adults with cardiovascular disease.

To examine the effect of MNT on dietary knowledge of older adults at baseline, 6 months and 12 months and to assess the effect of dietary knowledge on change in DASH diet adherence from baseline to 12 months. Data for the analysis come from a controlled, randomized prospective design conducted from 2003-2005 with the outcome measures taken pre-, mid-, and post-intervention. Data were collected from participants in their homes in an urban community in North Carolina. Participants (N=147) were adults aged 60+ with a diagnosis of hypertension and/or hyperlipidemia. Intervention recipients received three sessions of MNT throughout the 1 year study period. The control group received nutrition information at enrollment. Participants completed a dietary knowledge questionnaire and a 24 dietary recall at baseline, 6 months, and 12 months. Instrumental variables models with participant fixed effects were used to determine the impact of MNT on dietary knowledge and dietary knowledge on DASH diet adherence. Among those who received MNT, dietary knowledge increased from baseline to twelve months (p<.01). Changes in dietary knowledge were not associated with changes in DASH adherence from baseline to 12 months (p=0.44). The MNT administered was effective at improving dietary knowledge, but not at improving DASH adherence. Three MNT sessions may be insufficient to change behavior. Integrating behavioral change theory and cultural sensitivity to MNT may improve diet adherence among diverse older adults.

The Effect of Medical Nutrition Therapy on Behavior Change and Clinical Outcomes for Clients Participating in a Cardiac Rehabilitation Program

The Effect of Medical Nutrition Therapy on Behavior Change and Clinical Outcomes for Clients Participating in a Cardiac Rehabilitation Program

Effect of Medical Nutrition Therapy on Health-Related Quality of Life among Overweight/Obese Older Adults: A Pilot Study

Effect of Medical Nutrition Therapy on Health-Related Quality of Life among Overweight/Obese Older Adults: A Pilot Study

The Effectiveness of Medical Nutrition Therapy Delivered by Registered Dietitians for Disorders of Lipid Metabolism: A Call for Further Research

Cardiovascular disease is the leading cause of death in the United States. Approximately 80% of patients with coronary heart disease have at least one of the four major risk factors—hypertension, dyslipidemia, diabetes, and smoking—that can be modified through lifestyle changes (1,2). Trained in biological and food science as well as nutrition counseling and behavioral skills management, registered dietitians (RDs) are uniquely qualified to tailor help for these patients to effectively modify their diets and reduce their risk for cardiovascular disease.

Weight Gain and Gestational Diabetes Mellitus Is a Sensitive Issue

Normal pregnancy is associated with reduced insulin sensitivity, compensatory increase in insulin secretion, and small changes in circulating nutrients. Gestational diabetes mellitus (GDM) occurs when insulin secretion is insufficient to compensate for the insulin resistance of pregnancy. During late pregnancy, women with GDM tend to be more insulin resistant than obesity-matched women with normal glucose tolerance (1). Little is known about the effects of weight gain in the third trimester versus no weight gain or weight loss as treatments for GDM. The objective of our study was to determine the effect of medical nutrition therapy (MNT) on insulin sensitivity ( S …

Measuring Effectiveness of Medical Nutrition Therapy in a High Risk Population

Measuring Effectiveness of Medical Nutrition Therapy in a High Risk Population

An example of social activities by registered dietitians: development of recipes for cook-chilled meals to be delivered to kidney disease patients in the conservative treatment and maintenance dialysis stages

Many studies have indicated the effectiveness of medical nutrition therapy for kidney diseases in various stages. However, compliance with dietary therapy over a long period is not easy for patients living alone, elderly patients, and disabled patients, and the concern of registered dietitians working at medical facilities has become increased. Our activities started in the form of social services, developing recipes for cook-chilled foods, collaborating with a firm that had been providing a meal-delivery service, for patients with kidney diseases. Our subjects were outpatients with renal failure at the conservative treatment stage, patients at the dialysis stage, and those with diabetic nephropathy. To develop recipes, the nutritional amounts of energy, protein, potassium, phosphorus, salt, and water content in the diet were determined on the basis of the guidelines of the Japanese Society of Nephrology. In 2000, a survey was conducted of 140 regular users of the cook-chilled and delivered foods. The items surveyed were: age, sex, duration of the use of the service, degree of satisfaction with the meals, palatability of menu items, opinions and requests, and reasons for the use of the service. Between February 1996 and August 2000, recipes for cook-chilled foods for patients with kidney diseases at the conservative-treatment stage, those at the dialysis stage, and those with diabetic nephropathy were gradually developed. As of July 2003, the total number of recipes was 946. Of the 140 users surveyed, we obtained valid responses from 91 (65.0%). Regarding duration of usage of the service (n = 91): it was 1 year or more in 38.6%, 6-12 months in 15.7%, 3-6 months in 22.9%. 1-3 months in 12.3%, and 1 month or less in 10.8%. Regarding degree of satisfaction with the meals (n = 91), it was very good or good in 58%, fair in 30%, and no good in 12% of respondents. As the results of the survey indicated, the home-delivered, cook-chilled foods were generally, favorably accepted by users (rate of satisfaction, 58% [very good and good], duration of usage, 54.3% [6 months or longer]), for them to continue their dietary therapy at their homes. It is suggested that the service of delivering cook-chilled meals can be used as one of the choices enabling continued dietary therapy for patients with chronic renal failure who have difficulty in self-management of the diet at home for diverse reasons.

Effectiveness of medical nutrition therapy: Importance of documenting and monitoring nutrition outcomes

Effectiveness of medical nutrition therapy: Importance of documenting and monitoring nutrition outcomes

How effective is medical nutrition therapy in diabetes care?

Historically, there has been a lack of evidence-based outcomes research to document clinical effectiveness. Today, evidence is available for the effectiveness of medical nutrition therapy (MNT) in diabetes management. Evidence exists from randomized controlled trials, observational studies, and meta-analyses that MNT improves metabolic outcomes such as blood glucose and hemoglobin A1C (A1C) in people with diabetes (Table 1)(1).

New diabetes nutrition resources.

Advances in diabetes management and the variety of nutrition care services available to individuals with diabetes make this an exciting time for dietetics professionals to be working in the field of diabetes. Evidence supporting the effectiveness of medical nutrition therapy (MNT) for diabetes management continues to grow, with documented decreases in A1C of ~2% in cases of newly diagnosed type 2 diabetes, and of ~1% in cases of type 2 diabetes with an average duration of 4 years and in newly diagnosed people with type 1 diabetes (1).

4P-0942 Effects of medical nutrition therapy on the blood lipid levels in hyperlipidemic patients according to genetic polymorphism of Apo E

We studied the amino acid and lipid dynamics during embryogenesis of Homarus gammarus. Major essential amino acids (EAA) in the last stage of embryonic development were arginine, lysine and leucine; major nonessential amino acids (NEAA) were glutamic acid, aspartic acid, valine and glycine. The highest percent of utilization occurred in respect to EAA (27.8%), mainly due to a significant decrease (p<0.05) of methionine (38.3%) and threonine (36.0%). NEAA also decreased significantly (p<0.05, 11.4%), namely serine (38.1%), tyrosine (26.4%) and glutamic acid (25.7%). In contrast, the free amino acid content increased significantly (p<0.05) during embryonic development, especially the free nonessential amino acids (FNEAA). In the last stage, the most abundant FNEAA were glycine, proline, alanine and taurine, and the major free essential amino acids (FEAA) were arginine, lysine and leucine. Lipid content decreased significantly (p<0.05) during embryonic development. A substantial decrease in all neutral lipid classes was observed (>80% of utilization). Major fatty acids were 16:0, 18:0, 18:1n-9, 18:2n-6, 18:3n-3, 20:5n-3 and 22:6n-3. Unsaturated (UFA) and saturated fatty acids (SFA) were used up at similar rates (76.5% and 76.3%, respectively). Within UFA, monounsaturates (MUFA) were consumed more than polyunsaturates (PUFA) (82.9% and 67.5%, respectively).

The evidence for the effectiveness of medical nutrition therapy in diabetes management.

Numerous advances in diabetes management and medical nutrition therapy (MNT) for individuals with diabetes make this an exciting time. Historically, a challenge to proving the benefit of MNT has been the lack of clinical and behavioral research. In recent years, however, evidence-based outcomes research that documents the clinical effectiveness of MNT in diabetes has been reported. The term “medical nutrition therapy” was introduced in 1994 by the American Dietetic Association to better articulate the nutrition therapy process. It is defined as the use of specific nutrition services to treat an illness, injury, or condition and involves two phases: 1 ) assessment of the nutritional status of the client and 2 ) treatment, which includes nutrition therapy, counseling, and the use of specialized nutrition supplements (1). MNT for diabetes incorporates a process that, when implemented correctly, includes: 1 ) an assessment of the patient’s nutrition and diabetes self-management knowledge and skills; 2 ) identification and negotiation of individually designed nutrition goals ; 3 ) nutrition intervention involving a careful match of both a meal-planning approach and educational materials to the patient’s needs, with flexibility in mind to have the plan be implemented by the patient; and 4) evaluation of outcomes and ongoing monitoring. These four steps are necessary to assist patients in acquiring and maintaining the knowledge, skills, attitudes, behaviors, and commitment to successfully meet the challenges of daily diabetes self-management (2). The primary purpose of this article is to review the evidence for the effectiveness of MNT in diabetes, both as an independent variable and in combination with other components of diabetes self-management training (DSMT). In addition, the recent studies that have demonstrated the effectiveness of lifestyle intervention, which included MNT, in preventing type 2 diabetes will be highlighted. Evidence from several studies that supports the cost-effectiveness of MNT in diabetes will also be …

Effectiveness of medical nutrition therapy for hyperlipidemia in a state-wide study

Effectiveness of medical nutrition therapy for hyperlipidemia in a state-wide study

Effectiveness of Medical Nutrition Therapy and Self Management Training in Lowering Hemoglobin Ale Values

Objectives: The main objective of this study was to determine the effectiveness of medical nutrition therapy (MNT) and self management training (SMT) provided specifically by a R.D. in lowering hemoglobin Ale (HbAlc) values. Additionally, correlations were calculated between patients* perceived diabetes control versus actual control as assessed by HbAlc.Methods: Subjects consisted of 15 Type I and 87 Type 2 diabetics diagnosed for at least six months. Patients who were pregnant or had end-stage renal disease were excluded. Medical records were reviewed before and after nutrition education sessions with the R.D. Data on patient level of understanding, demographics, anthropometries and goals were collected. Results: Mean pre-education HbAlc of 9.32% decreased significantly to 7.74% (p<.001) HbAlc values for Type 1 patients decreased from 9.24% to 7.97% (p<.995). HbAlc values for Type 2 patients decreased from 9.35% to 7.70%. Change in HbAlc did not differ based on gender, age, or level of education. Subjects' perceived level of understanding improved significantly after education (p<.001). There was no correlation between perceived control (assessed by subjects rating themselves on goal accomplishment) and actual control.Conclusion: MNT and SMT provided by an R.D. is effective in improving diabetes control in all subjects. Improved control results in decreased complications and thus significant cost savings.