Need For Nutritional Counseling Research Articles

Assessing nutrition literacy and nutrition counseling proficiency following an interdisciplinary culinary medicine elective.

Culinary medicine (CM) is a growing field of education that aims to bridge the gap between the clinical need for nutritional counseling and the lack of education on the topic. Healthcare professionals can aid in nutrition-related noncommunicable disease (NCD) prevention by improving a patient's dietary behavior. However, the presence of nutrition education in healthcare curricula is lacking. Early evidence indicates that CM could address this gap. The objectives of this study are to determine ifthe provision of an interdisciplinary CM elective will improve student knowledge and confidence with counseling on nutrition and culinary principles, and to improve personal dietary habits of students. This was a one-group pretest-posttest quasi-experimental design. First- and second-year osteopathic medical students (OMS) and nurse practitioner students were recruited to participate in a CM elective via email. Participants were excluded if they were not in good academic standing at their respective institutions. Twelve individuals (n=8 medical; n=4 nursing) were enrolled in the course. Participants completed pre- and postcourse surveys to determine changes in nutrition literacy (Nutrition Literacy Assessment Instrument [NLit42]), nutrition counseling proficiency (Nutrition Survey for Family Practitioners), and dietary quality (Automated Self-Administered 24-h dietary assessment tool; ASA24®). A two-sided, paired t test was conducted to determine changes in outcome variables. All 12 participants completed the precourse assessments, and 8 participants completed the postcourse assessments. Culinary activity attendance was 94.5 %. Participants exhibited a statistically significant increase in their overall nutrition literacy scores after completing the CM elective (p=0.006). Literacy subcategories indicated that the improvement came from the participant's ability to understand household measurements (p=0.005) better. Increases in self-reported proficiency were observed for participants' confidence to counsel on nutrition and prevention/wellness (p=0.02) and macronutrients in health and food safety (p=0.01). No statistically significant changes in the personal dietary pattern or quality were observed. The interdisciplinary CM elective improved nutrition literacy and some aspects of counseling proficiency. Although small shifts in dietary variables were observed, the elective did not statistically improve participants' dietary pattern. However, some changes that were observed may lead to clinically relevant outcomes if maintained long-term. These findings are encouraging. Implementing CM as an educational tool could improve healthcare practitioners' ability to understand and counsel patients on nutrition to prevent the nutrition-related NCDs.

Nutritional counseling needs of patients with mental disorders in psychiatric care: A cross-sectional survey.

The exploration of diet and nutrition as they relate to mental health and psychiatric disorders is a developing field. Anxiety, depression, and pharmacological treatments used to treat these disorders are likely to have side effects that induce decreases in activity and irregular eating habits, resulting in persistent nutritional imbalance. Unhealthy dietary patterns are associated with an increased risk of developing physical and mental health conditions. Despite this, nutritional support to patients in psychiatric care is not adequate. This study aimed to determine the factors underlying the need for nutritional counseling among patients with a mental disorder in psychiatry. The factors explored are eating-related symptoms, eating behavior, interest in food, seeking nutritional counseling, and impact on quality of life (QOL). We utilized a cross-sectional study design. Eligible patients were asked to complete a questionnaire regarding physical measurements and nutritional counseling. In addition, patients' diagnoses and blood test data were referenced from their medical records. The analysis focused on two groups: those who desired to consult a nutritionist and those who did not. Ninety-three patients completed the study. The nutritional status and need for nutritional counseling in psychiatry patients indicates that patients with dietary problems requested nutritional counseling (p < .001). Patients who were more likely to need nutritional counseling had lower QOL in daily life (p = .011), pain/discomfort (p = .024), and anxiety/depression (p = .010) on the EuroQol 5-Dimension 5-level (EQ-5D-5L). Patients with mental disorders who need nutritional counseling tend to have food-related problems and low QOL. It is necessary to establish an interdisciplinary system for nutritional counseling.

Consumption of ultra-processed foods and associated factors in children from Barbacena (MG), Brazil.

To evaluate the prevalence of ultra-processed food consumption and associated factors among children enrolled in the public school system of the city of Barbacena, Minas Gerais, Brazil. This is a cross-sectional study conducted with schoolchildren aged 7-9 years, of both sexes, enrolled in state public schools. Food intake was assessed using the Previous Day Food Questionnaire and the level of physical activity by the Previous Day Physical Activity Questionnaire. The listed foods were classified according to the extent and purpose of industrial processing, using the NOVA classification. Pearson's χ2 test, Fisher's exact test, χ2 with Yates correction, and Poisson regression were used in the statistical analysis, estimating the crude and adjusted prevalence ratio, with 95% confidence intervals. The prevalence of daily ultra-processed food consumption was 69.6%. After adjusted analyses, the consumption of ultra-processed food was associated with the omission of breakfast, mid-afternoon snack, supper, low physical activity, and consumption of risk foods. On the other hand, consumption of in natura or minimally processed foods was associated with older age, the consumption of lunch, mid-afternoon snack, dinner, and protective foods. There is a high prevalence of ultra-processed foods consumption, associated with unhealthy dietary habits among schoolchildren. This highlights the need for nutritional counseling and educational actions, favoring healthy eating in childhood.

Nurse practitioner experiences providing nutrition counseling to adult patients in primary care.

Poor nutrition is one of the leading risk factors for preventable chronic diseases in the United States. Nutrition counseling has been shown to improve clinical outcomes in the adult primary care setting. Nurse practitioners (NPs) can help fill the critical need for nutrition counseling, yet little is known about their role providing nutrition counseling. To describe the primary care NP's experience in providing nutrition counseling to adult patients in primary care practice. Qualitative descriptive study design. Data were collected through virtual semi-structured interviews with 18 board-certified primary care NPs. Interviews were audio-recorded, de-identified, transcribed verbatim, and analyzed. Data collection and analysis took place concurrently and continued until data saturation was achieved. Five themes emerged from NPs' descriptions of their experiences in providing nutrition counseling to adult patients in primary care practice: (1) role of nutrition counseling in NP primary care practice; (2) developing NP self-efficacy in nutrition counseling; (3) nutrition counseling is more than the provision of information; (4) emotional aspect of nutrition; and (5) barriers to behavior change. Findings suggest that although NPs understand the importance of nutrition counseling in primary care practice and provide it in some capacity, its continuance is limited by multiple barriers. Future research should evaluate ways to enhance NPs' preparedness to provide nutrition counseling, assess specific resources and tools to aid in nutrition counseling, and determine best practices for communication when delivering nutrition counseling. Future interventions have the potential to positively affect patients' dietary practices and improve clinical outcomes.

The Impact of Preconception Gastric Bypass Surgery on Maternal Micronutrient Status before and during Pregnancy: A Retrospective Cohort Study in the Netherlands between 2009 and 2019

Post-bariatric weight loss can cause iatrogenic malnutrition and micronutrient depletion. In this study, we evaluated the impact of gastric bypass surgery (GB) and multivitamin supplement use on maternal micronutrient status before and across pregnancy. A retrospective medical chart review of 197 singleton pregnancies after GB with a due date between 2009 and 2019 was performed at a bariatric expertise center in the Netherlands. Hemoglobin, calcium, iron status, folate, vitamin D, vitamin B12 and ferritin levels were determined before and after GB during standard follow-up and at all gestational trimesters and analyzed using linear mixed models. Patients were prescribed standard multivitamin supplements or multivitamins specifically developed for post-bariatric patients (FitForMe WLS Forte (FFM)). Overall, hemoglobin and calcium levels decreased after surgery and during pregnancy, whereas folate, vitamin D, and vitamin B12 levels increased, and iron levels remained stable. FFM use was associated with higher hemoglobin, folate, vitamin D, and ferritin levels. In conclusion, through adequate supplementation and follow-up, GB does not have to result in impaired micronutrient status. Supplements developed specifically for post-bariatric patients generally result in higher micronutrient values than regular multivitamins before and during pregnancy. These data emphasize the urgent need for nutritional counseling including dietary and multivitamin supplement advise for post-bariatric women contemplating and during pregnancy.

Quantifying Dietary Diversity by Using Food Group Scores among Schoolchildren of Jaipur: A Seasonal Longitudinal Study.

Need of the studyMost dentists are concerned that their patients are consuming a record number of sugar-filled sodas, sweetened fruit drinks, and other stuff that affect their oral environment. Children are invariably the victims of these foodstuffs. These items generally have very little nutritional value, albeit their commercial value. Thus, dietary habits and the choice of food among children and teens are important factors that determine how quickly they may develop oral diseases. Thus, to design good intervention programs and preventive strategies, information on food habits and dietary intake of the target population is very important.Aim and objectiveTo determine dietary diversity using food group score (FGS) among 12–15 years schoolchildren of urban and rural areas of Jaipur.Materials and methodsJaipur district is divided into 13 Tehsils. Based on a simple random number table, Bhanpur (Rural) and Central Jaipur (Urban) were selected for the present study. Food group scores were calculated from the 5-day diet diary of the study subjects.ResultsScores were found to be higher in winters as compared to the summer season and this difference is observed to be highly statistically significant. Scores were found to be higher in urban schoolchildren as compared to rural and the difference was highly statistically significant among urban schoolchildren in winters. Scores were found to be higher among private schoolchildren as compared to government and this difference was highly statistically significant among schoolchildren belonging to urban areas.ConclusionThere is a need for nutritional counseling and basic oral health care in the study area irrespective of the season. The dietary diversity of children is determined by social, psychological, and economic factors. Thus, counseling should be given accordingly in conjunction with a team of health professionals including physicians, dieticians, and dentists under the supervision of parents, guardians, and schoolteachers and management.How to cite this articleGaur A, Sharma M, Sharma R. Quantifying Dietary Diversity by Using Food Group Scores among Schoolchildren of Jaipur: A Seasonal Longitudinal Study. Int J Clin Pediatr Dent 2021;14(3):376–382.

Association Between Chemosensory Dysfunction and Diet Quality in United States Adults.

Evidence suggests chemosensory dysfunction (CSD) patients have altered diet, but population-level evidence assessing diet quality in CSD patients is lacking. We examined the association between CSD and diet quality in a representative sample of United States adults. This cross-sectional study included 2831 adults aged greater than 40 years from the 2013-2014 National Health and Nutrition Examination Survey who completed the taste/smell questionnaire and examination. Mean nutrient intake in subjects with self-reported olfactory/gustatory dysfunction (sOD/sGD) and measured olfactory/gustatory dysfunction (mOD/mGD) were compared to those without CSD using univariate Wilcoxon rank-sum tests. The Healthy Eating Index (HEI), a validated measure of diet quality, was calculated. The proportion of subjects with CSD with bottom-quartile HEI was compared to those without CSD using multivariate logistic regression, adjusting for demographic and socioeconomic covariates. The population-weighted prevalence of sOD, sGD, mOD, and mGD was 20.1%, 14.4%, 15.9% and 25.6%, respectively. Subjects with mOD had lower mean intake of total calories, total fat, protein, sodium, and potassium compared to normal subjects (1873.4 ± 49.6 vs 2010.2 ± 24.2 kcal, 72.3 ± 2.7 vs 78.6 ± 1.0 gm, 74.0 ± 2.5 vs 80.4 ± 0.6 gm, 3122 ± 97.2 vs 3353.2 ± 37.0 mg, 2509.8 ± 69.8 vs 2684.7 ± 26.1 mg, P < 0.05 respectively). When controlling for sociodemographic factors and comorbidities, subjects with sOD were more likely to have bottom-quartile HEI compared to normal subjects (OR 1.33, 95% CI 1.04-1.70). This population-level study suggests an association between poor diet quality and variation in dietary intake in patients with CSD, which warrants further investigation and suggests the possible need for nutritional counseling for CSD patients.

Perbedaan Asupan Energi, Zat Gizi Makro dan Serat Berdasarkan Kadar Kolesterol Total pada Dewasa Muda Vegetarian di Indonesia Vegetarian Society Jakarta

Background: Vegetarians are people who live from consuming plant-based (or plant-based) products with or without milk and eggs, but over all avoid eating meat, poultry and marine animals.. According to Household Health Survey (SKRT) cited Budiarti, in 2004 prevalence of hypercholesterolemia in Indonesia in the age range 25-65 years of 11.2%. One way to prevent elevated levels of cholesterol in the blood is to change the diet to become a vegetarian. Objective: To purpose the difference between energy intake, macro nutrients (protein, fat, and carbohydrates), fiber, based on total cholesterol levels in young vegetarian adults in Indonesia Vegetarian Society Jakarta. Methods: Cross sectional study design, independent Bed T-Test test if normal distribution data and Mann Whitney if the data is not normally distributed. Determination of the sample was done by means of different test of two mean and obtained sample of 70 people. Results: The results of the statistical test obtained p-value for energy intake, protein intake, fat intake, carbohydrate intake based on total cholesterol level with normal and abnormal category showed significant difference (p-value ≤ 0,05), and mean fiber intake showed no significant difference (p-value &gt; 0,05). Conclusions: There are differences in energy, protein, fat, carbohydrate intake based on normal and abnormal total cholesterol levels, and fiber intake are expressed as no difference. There is a need for nutritional counseling and routine monitoring of total cholesterol in young vegetarian adults in IVS Jakarta.

Cocaine Use and Inflammation Is Associated with Diet Quality in People Living with HIV (PLWH) from the MASH Cohort

Abstract Objectives Cocaine use is one of the most widely used illicit drugs in Miami, FL and especially among PLWH. Cocaine use is associated with greater systemic inflammation and poor dietary intake. Lifestyle factors such as diet may influence inflammation and further exacerbate the effects of substance use and HIV infection on systemic inflammation. This study examined the relationships of cocaine use, inflammation and diet quality in PLWH from the Miami Adult Studies on HIV (MASH) cohort. Methods After obtaining informed consent, data on demographics, socioeconomic status, substance use and parameters of HIV disease progression (CD4 cell count and HIV viral load) were collected from 50 participants enrolled in the MASH cohort in Miami, FL. A total of 4 to 5 24-hour recalls were collected for each participant. Diet quality was assessed using the USDA Healthy Eating Index (HEI)-2015. Interleukin 6 (IL-6) was measured using the Quantikine ELISA kit (R&amp;D Systems, Minneapolis, MN). Statistical analyses used descriptive statistics, Spearman's correlations, Mann-Whitney U and logistic regression. Results The participants’ mean age was 55 ± 6.81, 58% were male, and 68% were African Americans. Overall the diet quality was low with a total median HEI-2015 score of 44.5 (IQR = 38.8–53.8), lower than the general US population score of 59 (P &amp;lt; 0.001) and it was not significantly correlated with IL-6 scores (r = −0.212, P = 139). Cocaine users had significantly lower total median HEI scores [41 (IQR = 35–48) vs.45 (IQR = 41–57.50), P = 0.048] than cocaine non-users. Component HEI scores of whole fruit (r = −0.280, P = 0.049) and saturated fat (r = −0.341, P = 0.015) were correlated with IL-6. Moreover, lower saturated fat intake reduced odds of having IL-6 above the median (OR = 0.710, 95% CI: 0.544–0.928, P = 0.012), after controlling for age, sex, income, education, and cocaine use. Conclusions Diet quality was low for all the participants and significantly lower for those who used cocaine compared to non-users. Higher inflammation was associated with lower fruit and higher saturated fat intakes. Larger studies are needed to elucidate these relationships in order to develop appropriate interventions for PLWH. These results highlight the need for nutritional counseling for PLWH, especially if the condition is associated with cocaine use. Funding Sources NIDA and NIMHD.

Assessment of Risk Factors for Iron Deficiency Anemia in Infants and Young Children: A Case-Control Study.

Iron deficiency anemia (IDA) is common in children aged 0-35 months in Lithuania. Nevertheless, there are no studies investigating IDA in this age group. We aimed to identify the major risk factors for disease development focusing on medical history and dietary habits. A prospective case-control study was conducted in a university hospital. The enrolled cohort was divided into three groups: IDA infants (IDA-In; n = 36, aged 3-11 months), IDA children (IDA-Ch; n = 23, aged 12-32 months), and healthy controls (HCs; n = 32, aged 6-34 months). There was a higher number of premature, low birth weight (LBW), and faster gaining weight infants in the IDA-In group. Their diet diversity was lower than IDA-Ch and HC. In contrast, the IDA-Ch group had no signs of impaired iron stores at birth or higher iron need for fast growth; their diet diversity was similar to that of HC, but meat was introduced later as compared with those in the IDA-In and HC groups. Consumption of cow's milk was rather low among all study participants, but consumption of sugar-added products was found to be a new emerging problem. Exclusive breastfeeding did not differ in duration and prevalence; the age for introduction of complementary foods was similar in all groups. Low compliance with World Health Organization (WHO) recommendations on breastfeeding and complementary feeding suggests an urgent need for nutritional counseling in early childhood, especially in premature, LBW, and fast gaining weight infants.

Young patients and gastrointestinal (GI) tract malignancies - are we addressing the unmet needs?

BackgroundRecent epidemiological studies indicate the rate of gastrointestinal (GI) malignancies among younger patients is increasing, mainly due to colorectal cancer. There is a paucity of data regarding the magnitude of treatment-related symptoms, psychosocial issues and potential unmet needs in this population. We aimed to characterize the needs of this population to evaluate whether unmet needs could be targeted by potential intervention.MethodsFemale and male patients diagnosed with cancer of the gastrointestinal tract <40y retrospectively completed a questionnaire to evaluate symptoms, daily function and unmet needs at pre-treatment, during and post-treatment. Comparisons were made by gender, disease stage and treatment modality. Multiple linear regression models evaluated effects of demographics, symptoms and needs on multiple domains of health-related-quality-of-life (using Short-Form Health Survey-12 and CARES).ResultsFifty patients were enrolled (52 % female) to a pilot study. Median age at diagnosis was 35.5y (range, 21-40y). The symptoms that significantly increased from baseline to during and post-treatment were: diarrhea (37 %), sleeping disorder (32 %) and sexual dysfunction (40 %). Patients also reported significant deterioration in occupational activities and coping with children compared with baseline. Female patients reported significant unmet need for nutritional counseling and psychosocial support compared to male patients (p < 0.05). Patients treated with multimodality-treatment presented higher rates of unmet needs (p = 0.03).ConclusionsYoung patients with GI cancers represent a group with unique characteristics and needs compared with published evidence on other young-onset malignancies. The distinctive symptoms and areas of treatment-related functional impairments indicate there are unmet needs, especially in the area of psychosocial support and nutritional counseling.

Implicaciones nutricionales de las dietas de eliminación

BackgroundThe backbone of food allergy treatment is the restriction of causative foods. These interventions have shown that children who restrict the consumption of basic foods have a higher risk of malnutrition.The aim of the study was to identify the nutritional status of patients with elimination diet, characterizing their anthropometric indexes and identifying the percentage of patients in the group with true food allergies. MethodsA cross-sectional study was carried out from January to October 2014 at the Hospital Infantil de Mexico Federico Gomez. Patients 1 to 11 years of age with a history of elimination of at least one of five foods (eggs, milk, wheat, corn, soybeans) for a minimum of 6 months were included. Full nutritional assessment was performed by comparing the anthropometric indexes to z score for age. Data analysis used descriptive statistics. Kruskal-Wallis and Spearman correlation were performed. ResultsThe most frequent eliminated foods were milk, soy, eggs, corn, and wheat. Comparing the number of foods eliminated with different anthropometric indexes, with a greater amount of eliminated food, the z-score of weight/age (W/A), height/age (H/A) and weight/height (W/H) were lower and the most affected index was fat reserve. Only in 5% of children was food allergy confirmed. ConclusionsThe study confirms the need for nutrition counseling for patients who have elimination diets and overdiagnosis of food allergy.

Individuals with Hematological Malignancies Before Undergoing Chemotherapy Present Oxidative Stress Parameters and Acute Phase Proteins Correlated with Nutritional Status

Hematological malignancies present abnormal blood cells that may have altered functions. This study aimed to evaluate nutritional status, acute phase proteins, parameters of cell's functionality, and oxidative stress of patients with hematological malignancies, providing a representation of these variables at diagnosis, comparisons between leukemias and lymphomas and establishing correlations. Nutritional status, C-reactive protein (CRP), albumin, phagocytic capacity and superoxide anion production of mononuclear cells, lipid peroxidation and catalase activity in plasma were evaluated in 16 untreated subjects. Main diagnosis was acute leukemia (n = 9) and median body mass index (BMI) indicated overweight (25.6 kg/m2). Median albumin was below (3.2 g/dL) and CRP above (37.45 mg/L) the reference values. Albumin was inversely correlated with BMI (r = −0.53). Most patients were overweight before the beginning of treatment and had a high CRP/albumin ratio, which may indicate a nutrition inflammatory risk. BMI values correlated positively with lipid peroxidation and catalase activity. A strong correlation between catalase activity and lipid peroxidation was found (r = 0.75). Besides the elevated BMI, these patients also have elevated CRP values and unexpected relations between nutritional status and albumin, reinforcing the need for nutritional counseling during the course of chemotherapy, especially considering the correlations between oxidative stress parameters and nutritional status evidenced here.

Nutritional status in stage V dialyzed patient versus CKD patient on conservative therapy across different economic status

Background: This aim of this multi-centric cross-sectional study was to assess the nutritional status in Indian chronic kidney disease (CKD) patients and to compare the nutritional indicators between stage 5 dialyzed (CKD-D) patients below the poverty line (BPL), and stage 3–4 non-dialyzed (CKD-ND) patients above (APL) and below the poverty line. Methods: Patients were selected from a government medical college hospital, a charity-based outpatient dialysis unit, and a non-profit tertiary care center. The study groups included BPL CKD-ND (n = 100), BPL CKD-D (n = 98), and APL CKD-ND (n = 92) patients, based on a cut-off of per capita income US $1.25 a day. Patients were enquired by a qualified renal dietitian about their pattern of diet, and daily energy and protein intake by 24 h recall method. Anthropometric measurements and biochemical investigations were made and compared. Results: Nutritional indicators were low in all three groups compared to those prescribed by European Best Practice Guidelines (EBPG). BPL CKD-D patients had low serum albumin levels (32.44444 ± 6.279961 g/L; p = 0.017) and 41.83% of them were underweight. The APL CKD-ND group registered the lowest mean daily energy (22.576 ± 6.289 kcal/kg/day) and protein intake (0.71 ± 0.06 g/kg/day), due to dietary restrictions imposed on them by themselves and unqualified renal dietitians. The APL group had better indicators of nutritional status in terms of mid-upper arm circumference (p = 0.001), triceps skin fold thickness (p < 0.001), and serum hemoglobin (p < 0.001). Conclusion: Several nutritional parameters were below the recommended international guidelines for all the three groups, though the high income group had better parameters from several indicators. There is an urgent need for nutritional counseling for CKD-D and CKD-ND patients.

학교급식 영양사의 영양상담 실태 및 활성화 방안

ABSTRACT This study was conducted to develop expanding strategies of nutrition counseling in school foodservices. The study participants were 102 school dietitians in Gyeonggi province, and information on the current status, dietitians’ necessity awareness, and practical activation needs for nutrition counseling were investigated. While 78.8% of dietitians were aware that nutrition counseling was in need, it was only 31.3% who understood the necessity of nutrition counseling. The implementation rate of students’ nutrition counseling was 26.2%, and 74.0% of counseling dietitians reported that they conducted nutrition counseling because it was on the inspection list by the Office of Education. Overall, dietitians did not have high consciousness of the need for nutrition counseling. The implementation rate of students’ nutrition counseling was remarkably low due to the reason of excessive work and insufficient participants, and it was interpreted that dietitians had a low intrinsic motivation for nutrition counseling. So, we suggested several strategies to activate school nutrition counseling as follows. First of all, dietitians needed to increase the students’ participation rate by promoting the importance of nutrition counseling to students and by assigning their available work hours for nutrition counseling. Second, in academic communities, standardized counseling manuals and media covering the important nutrition and health issues should be developed and disseminated, and education programs needed to build up dietitians’ self-esteem and knowledge on nutrition counseling. Lastly, the Office of Education should have the initiative in activating nutrition counseling in school foodservices by supporting a budget and counseling dietitians who exclusively responsible part-time counseling at schools.Key words: nutrition counseling, school foodservices dietitian, part-time counseling dietitians

Nutritional Status and Quality of Life of Women with HIV/AIDS

Problem statement: HIV infection is a multisystem disorder which causes chronic infections that lead to profound immune- suppression. Women have always been a vulnerable section of the society. They are doubly vulnerable due to the HIV and malnutrition vicious cycle, which may affect their Quality Of Life (QOL). There are different literature reviews which suggest under-nutrition, wasting due to HIV but it is important to know whether this under-nutrition affects their Quality Of Life (QOL) of these vulnerable women. Approach: This cross sectional study recruited female patients on antiretroviral therapy. Weight, height, grip strength, Tricep Skin Fold (TSF) and Mid Upper Arm Circumference (MUAC) were measured. Nutrient intake was calculated by 24 h recall and food frequency questionnaire. WHO QOL-HIV BREF was used to assess QOL. Results: Among 55 patients, 32 (58.2%), 23 (41.8%) were asymptomatic and symptomatic respectively. The mean adequacies of energy and protein for all the subjects were 57.56 ± 21.89, 61.27 ± 28.50 percent respectively. The Body Mass Index (BMI) of the symptomatic were significantly (p = 0.009) lower than the asymptomatic subjects, the mean being 19.84 ± 3.6 (kg/m2), with 27.3% having BMI < 18.5 (kg/m2). The mean TSF, MUAC, grip strength and hemoglobin level were 10.66 ± 4.36 mm, 23.72 ± 3.43 cm, 16.12 ± 5.03 kg force and 10.8 ± 1.3g/dl respectively. The scores of QOL were correlated positively with all the parameters of nutritional status. Grip strength and hemoglobin level were significantly correlated (p = 0.01) with the scores of four and five domains of QOL respectively. Conclusion: Dietary intake was inadequate, which affected the nutritional status. Conservation of muscle mass and maintenance of hemoglobin levels may improve QOL in HIV infected women. Thus there is a need for nutritional counseling and other nutritional intervention.

Avaliação do consumo alimentar em pacientes HIV positivos com lipodistrofia

Objective: To identify the dietary intake profile of HIV positive patients with lipodystrophy. Materials and Methods: This is a cross-sectional, descriptive study, conducted in 2010 with HIV-infected patients with lipodystrophy using antiretroviral therapy. Patients were recruited in a reference Hospital of Northern Brazil, in Belem-Para. We have collected socio-demographic and food intake related data. To evaluate the food consumption, we have used a 24 hour recordatory method, applied in two week days and one day in the weekend. Results: We have evaluated 39 patients. Diet composition analysis in relation to macronutrients showed an adequate intake of calories and fat, but with high levels of protein (> 15%) and insufficient carbohydrate ( 52 mg). The dietary cholesterol was excessive (>200 mg) in both genders. Conclusion: The diet consumed by lipodystrophy patients presented inadequate profile in relation to macronutrients and micronutrients, indicating the need for nutritional counseling.

Body Composition, Playing Position and VO2max in a Professional Mexican Soccer Team During Preseason

Much of the preparatory conditioning for a sports season occurs in the preseason period. Body composition and aerobic conditioning are key factors that influence the physical make-up of professional soccer players. PURPOSE: The aim of this study was to determine the relationship between body composition, playing position and maximal work performance as measured through treadmill ergometry in a second division professional mexican soccer team during preseason. METHODS: Twenty-six male soccer players aged between 20 and 34 years of age were studied. Body composition was assessed using dual-energy X-ray absorptiometry. Body height, weight and circumferences were measured as well. Maximal oxygen uptake, (VO2max), was estimated from treadmill running using the Bruce protocol. RESULTS: The results indicated a median VO2max of 54.6 ml/kg/min (SD 2.3). In general, body fat percent averaged 16.8 (SD 1.67). As for playing position, goalkeepers presented higher body fat percent (19.2+1.1) in comparison to outfield players (16+2.7). In addition, no high significant correlation was found between body fat percent and VO2max. CONCLUSIONS: This study found a significantly high body fat percentage for all playing positions and, most importantly, this study found lack in homogeneity in the team's aerobic physical condition as measured through VO2max during pre-season, with an average value lower than expected for professional soccer players (60 ml/kg/min). This information suggests that the amount of time avaliable to improve the team's physical condition during pre-season does not suffice to reach desired international standards. Based on these results, it can be concluded that there is a need for nutrition counseling and health education in mexican professional players and that players should be encouraged to maintain a physical conditionning program during off-season periods to attain desired season standards.

Nutritional status of cancer patients in chemotherapy; dietary intake, nitrogen balance and screening

Objective: To evaluate a short screening sheet (SSM) for malnutrition and to investigate the nutritional status of patients receiving chemotherapy for cancer of the lungs, colon or breast at an outpatient clinic.Design: Full nutritional assessment was conducted to define malnutrition and validate the SSM. Additionally, weight change from earlier healthy weight was evaluated, and calculations for intake of energy-giving nutrients (three-day-weighed food records) and protein balance were performed. After the evaluation study, the SSM was tested in clinical routine and data collected about patients’ need for nutritional counseling.Subjects: Patients at the outpatient clinic of the Department of Oncology at Landspitali-University Hospital (n=30 with lung-, colon- or breast cancer in the study population, n=93 with all cancer type in clinical routine screening).Results: Malnutrition was defined by full nutritional assessment in 20% of the participating patients and SSM had high sensitivity and specificity. Declining nutritional status of the patients was seen as a negative nitrogen balance and unintentional weight loss from healthy weight, but not as total energy intake, recent weight loss or underweight. The test of SSM in clinical routine showed that 40% were malnourished. According to the patients, 80% needed nutritional counseling but only 17% had such counseling.Conclusion: Screening (SSM) for malnutrition in cancer patients is a valid simple approach to define cancer patients for nutritional care. More patients regard themselves in need for nutritional counseling than the number of patients really achieving any.

THE EFFECTIVENESS OF A MEDICAL NUTRITION THERAPY PROTOCOL IN PATIENTS WITH CROHN'S DISEASE

TEXT: This was a randomized, prospective 6-month study conducted at the General Clinical Research Center. Nineteen patients with Crohn's Disease were randomized to either a control or an intervention group. Control group subjects received printed nutrition instructions outlining energy, protein, fluid and other nutrient needs for patients with Crohn's. Intervention subjects received the same information individually tailored to their needs and met frequently with a dietitian. Outcome measures included evaluation of disease severity, nutritional status, and quality of life (QOL). Eleven (11) subjects (7 females and 4 males) completed the study. Despite randomization, intervention group subjects were less medically stable in terms of their Crohn's disease throughout the study when compared to the control group. A significant difference was found between the two groups for nutritional status as determined by Subjective Global Assessment with the intervention group scoring lower than the control group. Nutrient intakes between the two groups were similar. No significant differences were found between the two groups for eating habits and body composition. The intervention group did show an improvement in QOL throughout the duration of the study and appeared to benefit from the one-on-one nutrition intervention. The intervention group made positive improvements to the quality of their diet and maintained these improvements and their nutritional status during active disease flares. As the nutrition information provided was similar for both groups, this study demonstrates a need for nutrition counseling and information for patients with Crohn's disease.