Individualized Nutrition Therapy Research Articles

Compensation for metabolic dietitians practicing in the United States: 2023 genetic metabolic dietitians international professional status survey

BackgroundGenetic Metabolic Dietitians International (GMDI) conducted a professional status survey of metabolic dietitians working in the United States to describe job satisfaction and establish salary and compensation benchmarks specific to metabolic dietitians. MethodsThe survey was anonymously administered in a web-based format via REDCap between October and November 2023. Registered dietitians working with inborn errors of metabolism (IEM) were eligible to participate. ResultsA total of 178 surveys were received and 147 were included in the final analysis. Most respondents were female (96 %), worked in a clinical setting (83 %), and held a graduate degree (75 %), while 30 % had one or more board certifications and 8 % were faculty. Respondents specialized in genetic metabolic nutrition for a median of 6 years (IQR 2–15). Overall satisfaction with one's professional focus in IEM was high among respondents (87 %), though 40 % reported dissatisfaction with earnings potential in their current position.The median annual, full-time salary for US-based metabolic dietitians in all work settings was $80,400 (IQR $67,100-96,000). After excluding dietitians working in the pharmaceutical and/or nutrition industry (n = 14), the median annual salary decreased to $76,200 (IQR $66,700-91,000). Increased years' experience, responsibility (e.g., supervisor), expertise (i.e., board certification), and categorization as a Level II dietitian or higher were associated with higher annual salary. ConclusionThe results of the 2023 GMDI Professional Status Survey provide insight into the current compensation and benefits of metabolic dietitians practicing in the US. These data can be used to support individual efforts to secure equitable compensation for the metabolic dietitian's critical role in the medical nutrition therapy for individuals with IEM.

Gastrointestinal symptoms and dietary intake of patients with irritable bowel syndrome following a low FODMAP diet

High FODMAP (fermentable oligo-, di, monosaccharides and polyols) foods have been linked with worsening symptoms of IBS patients. The aim was to compare gastrointestinal symptoms and dietary intake of patients with irritable bowel syndrome following a low FODMAP diet, with or without individual nutrition therapy. A total of 54 patients that met Rome IV criteria for IBS were randomized into two groups, guided group (individual nutrition therapy, n=28) and self-management group (learned about low FODMAP diet online, n=26). Both groups followed low FODMAP diet for 4 weeks. Four-day food records were used to assess dietary intake. Symptoms were assessed by the IBS-severity scoring system (ISB-SSS). The number of subjects who did not complete the study was 13, thereof five in the nutrition therapy and eight in the self-management group, leaving 23 and 18 subjects available for analysis, respectively. Symptoms declined from baseline to endpoint in both groups, by 183±101 points on average in the group receiving nutrition therapy (p< 0.001) and 132±110 points in the self-management group (p< 0.001), with no difference between groups. At baseline, about 80% of meals in both groups contained food high in FODMAP's. The corresponding proportion was 9% and 36% in week 3 in the nutrition therapy and self-management group, respectively (p< 0.001). Both groups experienced relieve of symptoms, but compliance to the low FODMAP diet was better in the group receiving individual nutrition therapy compared with the group who only received instructions on how to learn about low FODMAP diet online.

Effectiveness of the Therapeutic Lifestyle Change Diet Intervention to Improve Biochemical Markers of Cardiovascular Diseases in HIV-Infected Patients with Dyslipidemia

Introduction: This randomized controlled trial study aimed to investigate the effectiveness of therapeutic lifestyle change (TLC) diet intervention by the registered dietitians. Methods: Eighty-two people living with HIV (PLHIV) with dyslipidemia were randomly allocated to the intervention group as well as another 82 PLHIV with dyslipidemia to the control group. Participants in the intervention group were instructed to meet the registered dietitians every 2 weeks at weeks 0, 2, 4, 6, and 12 (a totally of 12 weeks) to receive individual medical nutrition therapy according to the TLC diet principles, while the participants in the control group only received routine health care service. Results: Triglycerides, total cholesterol, and LDL cholesterol of the intervention group were significantly lower than those of the control group at the endpoint (p < 0.05). In addition, these biomarkers and C-reactive protein of the intervention group were significantly lower when compared with their baseline (p < 0.05). The overall dietary habits of participants in the intervention group were significantly improved at the end of the study (p < 0.05). Conclusion: The medical nutrition therapy intervention based on the TLC diet is effective in improving blood lipid profiles among PLHIV with dyslipidemia.

Medical Nutrition Therapy, In-Person, or Telephone Group Lifestyle Intervention for Type 2 Diabetes? A Qualitative Study of Patient Perceptions and Treatment Preferences.

The purpose of the study was to explore the thoughts, feelings, motivations, and assignment preferences of community health center patients with type 2 diabetes considering participation in a 2-year lifestyle intervention trial aimed at weight loss and increased physical activity. The reasons for patients' delivery mode preferences were also explored to aid in the design of future interventions for controlled trials. Using structured telephone interview guides, 57 patients with type 2 diabetes receiving primary care at 3 community health centers affiliated with an academic medical center were interviewed regarding the perceived pros and cons of each of the 3 possible treatment assignments: telephone conference group, in-person group, or individual medical nutrition therapy. The interview data were organized using NVIVO and analyzed using content analysis. Findings on whether preferences varied by age, gender, or diabetes duration were also examined. Six categories related to patient treatment preferences were identified: (1) perception of time, (2) learning style, (3) comfort, (4) prior experience with weight loss programs and conference calls, (5) desire for support/idea exchange, and (6) accountability. Preferences did not seem to vary by age, gender, or diabetes duration. Key factors influencing preference of treatment assignment included schedule demands, belief about learning style, and past experiences. These findings demonstrate the importance of having a variety of nutrition and lifestyle treatment options available to meet the needs of people with type 2 diabetes.

Effect of Individualized Nutritional Therapy Combined with Low-intensity Continuous Exercise on Pregnancy Outcomes in Patients with Gestational Diabetes

Objective: To study the effect of individualized nutrition therapy combined with low intensity continuous exercise on gestational diabetes mellitus (GDM) control and pregnancy outcome. Methods: A total of 72 GDM patients diagnosed and treated in our hospital from October 2022 to October 2023 were randomly divided into an observation group and a control group. Individualized nutritional therapy combined with low-intensity continuous exercise therapy and conventional therapy were given, respectively. The blood glucose level, biochemical indexes, depression score, anxiety score and pregnancy outcome of the patients were observed and compared. Results: After individualized nutrition therapy combined with low-intensity continuous exercise, compared with the control group, the levels of fasting blood glucose, 2h postprandional blood glucose, glycated protein, albumin, total cholesterol, and triacylglycerol of the patients in the observation group were significantly reduced, and the depression and anxiety of the patients in the observation group were significantly alleviated, and the pregnancy complications were significantly reduced. Conclusion: Individualized nutrition therapy combined with low-intensity continuous exercise can effectively control gestational diabetes and improve pregnancy outcomes.

Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China

The Chinese Society of Critical Care Medicine (CSCCM) has developed the clinical practice guidelines of nutrition assessment and monitoring for patients in adult intensive care unit (ICU) of China. This guideline focuses on nutrition assessment and metabolic monitoring to achieve the optimal and individualized nutrition therapy for critical ill patients. This guideline was made by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough system review and summary of relevant trials or studies published from 2000 to July 2023. A total of 18 recommendations were formed and consensus was reached through discussions and review by expert groups in critical care medicine, parenteral and enteral nutrition, and surgery. The recommendations are based on the currently available evidence and cover several key fields, including nutrition risk screening and assessment, evaluation and assessment of enteral feeding intolerance, metabolic and nutritional measurement and monitoring during nutrition therapy, and organ function evaluation related to nutrition supply. Each question was analyzed according to the PICO principle. In addition, interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research value. The plan is to update this nutrition assessment and monitoring guideline using the international guideline update method within 3 to 5 years.

Functional performance recovery after individualized nutrition therapy combined with a patient-tailored physical rehabilitation program versus standard physiotherapy in patients with long COVID: a pilot study

BackgroundLong COVID is suggested to be present in 14 to 43% of COVID 19-survivors. Literature on this new condition states a need for a multidisciplinary approach including physical exercise and nutrition. The aim of the current pilot study is to investigate the feasibility of the proposed protocol to prepare for a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment compared to standard physiotherapy.MethodsThis is a protocol of the UNLOCK (Nutrition and LOComotoric rehabilitation in long COVID) study, a pragmatic, single center, randomized controlled pilot trial with two groups. Patients with persisting symptoms related to a SARS-CoV-2 infection will receive either standard physiotherapy or a personalized multimodal treatment for a period of 12 weeks, consisting of individualized physical exercise program combined with individualized nutritional therapy. They will be followed-up at 6, 12, and 18 weeks after randomization.DiscussionA multidisciplinary approach for dealing with long COVID is needed. Because of the lack of clear data and the fact that this is a very heterogenic group, we aim to prepare and optimize a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment.Trial registrationClinicalTrials.gov Identifier: NCT05254301 (since February 24, 2022).

Accumulating awareness on the clinical significance and relevance of frailty in cirrhosis: Time to dig deeper into mechanistic basis!

Frailty corresponds to an emerging construct in the hepatology which is originally introduced as a validated geriatric syndrome regarding increased vulnerability to pathophysiological stressors. As for patients with cirrhosis, the presence of frailty is indicative of debilitating conditions that subjects are prone to deleterious acute insults and have difficulties to restore even if the underlying liver function partially returned to normal levels. Since this conceptual development, a variety of tools assessing frailty have been proposed and evaluated in the context of cirrhosis. A recent performance-based metric for frailty, designated as Liver Frailty Index, has broadly been applied in patients with cirrhosis and exhibited acceptable predictive ability in relation to disease progression, mortality and hospitalization. However, those functional tests measuring frailty may be impossible to perform in circumstance that patients are critically ill or undergoing detrimental events. An interesting modality indicates the use of alternative tests to evaluate frailty, which may be more adaptable and of choice for specific subgroups. The interrelation between frailty and various cirrhosis-associated pathological entities is of clinical importance and implication. Noticeably, it is imperative to clarify these complex linkages to highlight novel therapeutic targets or interventional endpoints. The efficient and effective management of frailty is still challenging, but many attempts have been made to overcome barriers of affordability and availability. Some clinical trials on small scale revealed that home-based exercise and individualized nutrition therapy show benefits in patients with cirrhosis, and high adherence to the treatment regimen may direct better efficacy and performance.

Mangelernährung in der Inneren Medizin

Disease-related malnutrition has a strong influence on the further course of the disease and mortality, especially in chronically ill patients. In recent years it could be shown in large randomized studies that an individual nutrition therapy could significantly and relevantly improve the clinical outcome of patients in internal medicine with arisk of malnutrition, both in hospital and in aftercare. Therefore, due to the increasing proportion of multimorbid patients the significance of malnutrition and its treatment is becoming increasingly more important in the practice and in research. Nutritional medicine should nowadays be considered as an effective and integral component of aholistic treatment in internal medicine; however, further research is necessary in order to investigate new nutritional biomarkers and for abetter integration of an evidence-based personalized nutritional medicine into routine clinical practice.

Medical nutrition therapy in patients receiving ECMO: Evidence-based guidance for clinical practice.

Patients receiving extracorporeal membrane oxygenation (ECMO) inherit substantial disease-associated metabolic, endocrinologic, and immunologic modifications. Along with the technical components of ECMO, the aforementioned alterations may affect patients' needs and feasibility of adequate macronutrient and micronutrient supply and intake. Thus, patients receiving ECMO are at increased risk for iatrogenic malnutrition and require targeted individual medical nutrition therapy (MNT). However, specific recommendations for MNT in patients receiving ECMO are limited and, with some exceptions, based on an evidence base encompassing general patients who are critically ill. Consequently, clinician decision-making for MNT in patients receiving ECMO is unguided, which may further increase nutrition risk, culminating in iatrogenic malnutrition and ultimately affecting patient outcomes. The purpose of this article is to provide educational background and highlight specific points for MNT in adult patients receiving ECMO, which might serve as evidence-based guidance to develop institutional standard operating procedures and nutrition protocols for daily clinical practice.

HOMEFOOD randomized trial—beneficial effects of 6-month nutrition therapy on body weight and physical function in older adults at risk for malnutrition after hospital discharge

Background/objectivesMalnutrition is common among older adults. Dietary intervention studies in older adults aiming to improve anthropometrics measures and physical function have been inconsistent. We aimed to investigate the effects of nutrition therapy in combination with home delivered meals and oral nutritional supplements (ONS) in community-dwelling older adults discharged from hospital.MethodsA total of 106 participants (>65 years) were randomized into the intervention group (n = 53) and into the control group (n = 53). The intervention group received individual nutrition therapy (five in person visits and three phone calls) and freely delivered energy- and protein- rich foods, while the control group received standard care. Dietary intake, anthropometrics, and short physical performance battery (SPPB) were assessed at baseline and at endpoint.ResultsEnergy intake at baseline was similar in both groups (~1500 kcal at the hospital) but there was a significant increase in energy intake and body weight in the intervention group (+919 kcal/day and 1.7 kg, P < 0.001 in both cases) during the study period, compared to a significant decrease in both measures among controls (−815 kcal/day and −3.5 kg, P < 0.001 in both cases). SPPB score increased significantly in the intervention group while no changes were observed among controls.ConclusionsMost Icelandic older adults experience substantial weight loss after hospital discharge when receiving current standard care. However, a 6-month multi-component nutrition therapy, provided by a clinical nutritionist in combination with freely delivered supplemental energy- and protein-dense foods has beneficial effects on body weight, physical function, and nutritional status.Study registrationThis study was registered at ClinicalTrials.gov (NCT03995303).

Comparison of Dietary Inflammatory Index Scores with Inflammatory and Anthropometric Metrics in Individuals Receiving Maintenance Hemodialysis

ObjectivesThe modified dietary inflammatory index (DII) is a scoring tool that reflects inflammatory influence of diet components and has been studied as a predictor of inflammatory markers. This study explored correlations between modified DII scores, C-reactive protein (CRP), and conicity index (Ci) in patients receiving maintenance hemodialysis (MHD). MethodsThis study was a secondary analysis of 142 participants in the Rutgers Nutrition and Kidney Disease database. Food intake data were collected using the NHANES multi-pass method and were reflective of a dialysis treatment day. The modified DII scores were divided into tertiles; tertile 1 had the least inflammatory (negative) and tertile 3 had the most inflammatory (positive) scores. Correlations between DII scores, CRP, and Ci were measured using Spearman’s and Pearson’s Coefficients. Between tertile differences were compared using Kruskal-Wallis and ANOVA. ResultsThe median age was 55.3 years and 59.2% were male. The majority were African American (83.8%) and non-Hispanic (77.5%). The range of modified DII scores was –9.7 to 536.0, and the median score was 203.2, indicating a pro-inflammatory diet. The median scores for tertille 3 (338.1) were significantly higher than tertiles 1 or 2 (114.6 and 201.5, p-value < 0.001). Tertile 3 consumed more omega-3 fats, fiber, calories, total fat, and saturated fat. The median CRP and Ci were 5.6 mg/L and 1.33 ± 0.1, and did not differ significantly by tertile. A non-significant, small, positive correlation was observed between DII scores and CRP (r = 0.161, p = 0.071), but not for Ci (r = 0.046, p = 0.586). ConclusionsThis sample consumed a mostly pro-inflammatory diet. Food selections may be the result of consuming convenience foods on dialysis days, which are generally pro-inflammatory. Regardless, in our sample the pro-inflammatory dietary intakes did not correlate with markers of inflammation, likely due to homogeneity across the tertiles. While exploratory, this tool may assist clinicians in assessing patients on MHD who may benefit from individualized nutrition therapy to reduce their risks for chronic inflammation. Funding SourcesResearch reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (awards 1R15DK090593-01A1,6R15DK090593-02, and 3R15DK090593-02S1).

Nutritional support in the acute phase of critical illness—how to break the dilemma

Overfeeding caused by the inaccurate estimation of energy might be one of the most important reasons leading to unsatisfactory outcomes of nutritional support, especially for Parental Nutrition (PN). The current method of determining calorie needs by energy expenditure (EE), either measured by indirect calorimetry (IC) or equations, might not accurately represent the actual energy requirements of critically ill patients, especially in the acute phase. Nutrition protocols based on the measurement of time might not be effective. Research on the real-time metabolic status and the actual energy requirements of the patients, as well as more individualized nutrition therapy, is required. Central regulation, especially those involving hypothalamic pathways, is an effective solution for the current dilemma.

Effect of Individual Nutrition Therapy and Exercise Regime on Gait Speed, Physical Function, Strength and Balance, Body Composition, Energy and Protein, in Injured, Vulnerable Elderly: A Multisite Randomized Controlled Trial (INTERACTIVE).

It is imperative that the surgical treatment of hip fractures is followed up with rehabilitation to enhance recovery and quality of life. This randomized controlled trial aimed to determine if an individualised, combined exercise–nutrition intervention significantly improved health outcomes in older adults, after proximal femoral fracture. We commenced the community extended therapy while in hospital, within two weeks post-surgery. The primary outcome was gait speed and secondary outcomes included physical function, strength and balance, body composition, energy and protein intake. Eighty-six and 89 participants were randomized into six months individualised exercise and nutrition intervention and attention-control groups, respectively. There were no statistically significant differences in gait speed between the groups at six and 12 months. There were no major differences between groups with respect to the secondary outcomes, except estimated energy and protein intake. This may be explained by the sample size achieved. Participants in the intervention group had greater increment in energy (235 kcal; 95% CI, 95 to 375; p = 0.01) and protein intake (9.1 g; 95% CI, 1.5 to 16.8; p = 0.02), compared with those in the control group at six months but not significant at 12 months. This study has demonstrated that providing early, combined exercise and nutrition therapy can improve dietary energy and protein intake in older adults with hip fractures.

The Significance of the FTO Gene for Weight and Body Composition in Swedish Women With Severe Anorexia Nervosa During Intensive Nutrition Therapy

Objective: The aim of this prospective study was to investigate the potential influence of the fat mass and obesity-associated gene (FTO), SNP rs9939609, on body mass index (BMI) and body composition in women with anorexia nervosa (AN) undergoing intensive nutrition therapy. Method: Twenty-five female patients with AN (20.1 ± 2.3 years; BMI, 15.5 ± 0.9 kg/m2) were included for 12 weeks of treatment with a high-energy diet. FTO was genotyped and body composition parameters were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography at baseline and after 12 weeks. Results: The distribution of the different FTO genotypes were as follows: AA, 24%; TA, 48%; and TT, 28%. Patients gained a median of 9.8 kg (range, 5.5–17.0 kg) and BMI increased to 19.0 ± 0.9 kg/m2. The increase in BMI, fat mass, and the quotient fat/muscle area was significant for the TT and TA genotype groups. Total lean mass was stable in all genotype groups. We could not demonstrate any difference among the 3 FTO genotypes related to the increases in BMI during nutrition therapy when the additive, dominant, and recessive models of inheritance were applied. Conclusions: Irrespective of the FTO genotype, there was no difference in weight response during nutrition therapy. Hence, in this small study there was limited support for individualized nutrition therapy for AN based on FTO genotype.

Effect of an intensified individual nutrition therapy on serum metabolites in critically ill patients - A targeted metabolomics analysis of the ONCA study.

The effect of medical nutrition on serum metabolomics has been poorly explored. The aim of the study was to investigate the relation between energy supply and metabolic profiles in critically ill patients. Twenty mechanically ventilated patients on enteral nutrition (EN) or enteral/parenteral nutrition (EN/PN) were randomized into two groups. One group received an individual energy supply based on indirect calorimetry (IC group, n=9), the other group received a standard energy supply based on a formula, the standard care group (SC group, n=11). Targeted metabolomics was performed in early-, late- and post-acute metabolic phase. Individual versus standard care energy supply resulted in a metabolite class separation between the IC and the SC group (P<0.001). In the SC group concentrations of four glucogenic amino acids and three biogenic amines increased between the early- and late-acute metabolic phase (P<0.05). The metabolomics pattern differed between the routes of nutrition administration (P<0.01). The amount of energy supply by EN or PN, besides other factors, seems to modulate serum metabolites. Nutrition therapy based on individualized energy supply is associated with a reduction of metabolites reflecting catabolism. Therefore, metabolomics could be a new tool to determine metabolic phases in critically ill patients.

1536-P: Trends in Eating Patterns among U.S. Adults with Diagnosed Diabetes

In 2019, the American Diabetes Association published a consensus report on nutrition therapy for individuals with diabetes (DM), which included a section on five recommended eating patterns: Mediterranean-style, Dietary Approaches to Stop Hypertension, low-fat, low-carbohydrate, and vegetarian. Using data from 4,718 non-pregnant adults aged ≥20 years with self-reported diagnosed DM and complete dietary data (i.e., one day of 24-hour recall) in the National Health and Nutrition Examination Surveys 2001-2016, we examined the proportion who followed each of the recommended eating patterns (including achieving different components/levels of the eating patterns), and whether this has changed over time. We used age-standardized descriptive statistics to calculate the proportion of individuals following each eating pattern across four 4-year time periods, and calculated p-values for trend across the time periods. Overall, the proportion of individuals following the recommended eating patterns was low and did not change significantly over time, although the decline in following the Mediterranean-style diet from the 2001-2004 to the 2013-2016 time period was significant (p=0.04 and p=0.046 for the highest and lowest categories, respectively) (Table). These results suggest more efforts may be considered for improving eating patterns among adults with DM in the United States. Disclosure K.R. Siegel: None. K.M. Bullard: None. S. Saydah: None. C. Mercado: None. M.K. Ali: Research Support; Self; Merck &amp; Co., Inc. A.L. Albright: None. G. Imperatore: None.

Determining the relationship between dietary iodine intake, urinary iodine excretion and thyroid functions in people with type 2 diabetes mellitus.

Objective Type 2 diabetes mellitus (T2DM) is a worldwide health problem, and medical nutrition therapy is essential for improving the quality of life of patients with type 2 diabetes. Salt restriction may lead to iodine deficiency in these patients. Moreover, type 2 diabetes can be an indirect reason for thyroid disorders. This study was conducted to determine the relationship between dietary iodine intake, urinary iodine excretion and thyroid functions in people with T2DM. Materials and methods Iodine nutritional status was determined by a one day 24-h dietary recall and food-frequency questionnaire. Iodine status was detemined by urinary iodine excretion with morning urine sample. Results Iodine intake according to one day 24-h dietary recall was lower in T2DM patients [94.8 (76.0-112.0) μg] than people in control group [137.1 (123.1-165.4) μg] (p < 0.05). Iodine intake determined by food-frequency questionnaire rich in iodine was lower in T2DM patients [93.1 (84.4-113.9) μg] than people in control group [140.2 (125.1-166.1) μg] (p < 0.05). Mild iodine deficiency was found in %38.8 of diabetic and %55.1 of healthy individuals (p < 0.05). No significant relationship was found between urinary iodine excretion and thyroid function tests in groups (p > 0.05). However, the relationship between dietary iodine excretion and urinary iodine intake in the diabetic group was lower than in the control group (p < 0.05). Conclusion With this respect, the results showed that while planning medical nutrition therapy for diabetic individuals, the risk of iodine deficiency should be considered.

Virtually Better Diabetes Care?

Despite growing awareness of the problem, the diabetes epidemic shows no signs of abating and continues to pose a public health problem of grave concern (1). Nonpharmacologic interventions focused on lifestyle modifications, including diet and exercise, remain a major component of therapy. Individualized nutrition therapy has been shown to be effective for improvement of the metabolic profile and weight loss. However, most studies of popular diets are usually of short duration and have high attrition rates (15–50% within 1 year) (2). Adherence to any prescribed diet is a real challenge, especially when we are surrounded by easily accessible, processed food of high caloric and low nutritional value. It is therefore not surprising that lifestyle modification often fails, and as health care providers (HCPs), we find ourselves compelled to add more and more pharmacotherapies and often recommend metabolic surgery to achieve therapeutic goals. Indeed, despite significant advances in pharmacotherapy, there has been no significant change in the percentage of people who achieve therapeutic goals (3). A key question that needs to be addressed is how HCPs can help patients adhere to a treatment plan that will enable them to achieve and sustain improvements in metabolic control. One of the most essential components of diabetes care is access to an HCP. There is a significant shortage of primary care providers and endocrinologists in the United States, with the rising number of patients with diabetes outstripping the number of HCPs (4). Endocrinologists are asked to see more patients in less time, and new patients may have to wait for months to be seen. The problem is even worse for patients in remote areas, who must travel long distances to be seen. It is also commonly observed that patients …

Traditional v. modern dietary patterns among a population in western Austria: associations with body composition and nutrient profile.

The present study aimed to identify dietary patterns, compare dietary patterns regarding nutrient profile and investigate the association between dietary patterns and body composition in a population in western Austria. In a cross-sectional study, eating habits, anthropometric measurements and body composition were assessed. Food intake was collected by two non-consecutive 24 h recalls. Factor analysis (principal component analysis) with complementary cluster analysis was applied to identify dietary patterns. Associations of dietary patterns with body composition and nutrient profile were examined by the t test, one-way ANOVA and ANCOVA with Bonferroni's correction. The χ 2 test was used for categorical variables. Tyrol, western Austria, 2014-2015.ParticipantsAdults (n 463) aged 18-64 years. Three dietary patterns were derived, labelled as the 'health-conscious', the 'western' and the 'traditional' dietary pattern. After adjustment for confounding variables, individuals following the traditional and western patterns were more likely to be overweight/obese (P &lt;0·001) and to have a higher body fat percentage (P &lt;0·05). Individuals following the traditional dietary pattern consumed significantly more SFA and less PUFA and dietary fibre (P &lt;0·001) than those in the other groups. Individuals who mostly eat in a traditional way should be encouraged to increase their consumption of vegetables, fruits, whole grains and healthy fats. It is important to know local eating habits not only for planning individual nutritional therapy, but also for well-directed public health actions.