Posts

Showing posts from April, 2014

New Trends in nutritional status assessment in cancer patients

This study is from the European review for Medical and Pharmacological Sciences. Cancer is currently the most frequent cause of morbidity and mortality in Europe. Often in cancer patients weight loss and nutritional status are a large concern for those on the team that takes care of a patient. The definition of malnutrition is stated as, " a subacute or chronic state of nutrition in which varying degrees of over or undernutrition and inflammation activity have lead to a change in the body composition and function." In cancer patients if there is severe malnutrition there are associated complications to treatment that are often seen. Cancer patients have also been noted to suffer from cachexia, " a complex metabolic syndrome associated with underlying illness and characterized by muscle loss with or without loss of fat." These two forms of malnutrition in general are the same thing with very similar effects on the patient. If the patient is suffering from a poor nutr

Statins Users have Increased the Amount of Calories and Fat in 10 years

Researchers have found that Americans that are taking statin have increased the amount of calories and fat during the 2009-2010 year than in the past ten years. Statins are cholesterol lowering drugs that inhibits the HMG-CoA reductase enzyme, which plays a role in producing cholesterol in the liver. Researchers found that the increase of fat and calories were only among those that are taking satins. According to National Center for Global Health and Medicine in Japan, "We may need to re-emphasize the importance of dietary modification for those who are taking these medications, now that obesity and diabetes are important problems in society". Patients are usually put on statins when obesity and high cholesterol are already an issue for the patient. Does the use of statins entitle patients not to change their lifestyle and behavior modifications since the drug will work to lower the amount of cholesterol even though they are receiving large amounts through diet? http://

New Hospital Malnutrition Standardized Guidelines

Hospital Malnutrition Standardized Guidelines Malnutrition remains a serious problem in hospitals today. It is estimated that one in three patients enter the hospital malnourished and if left untreated will experience significant decline in their condition. It is also estimated that one in three patients becomes malnourished during their hospital stay which severely compromises their short and long term outcomes. Malnutrition contributes to pressure ulcers, poor wound healing, infection, longer hospital stays, and readmissions which all create higher health care costs. These serious consequences of malnutrition have led dietitians to improve nutritional assessments and allot more time to spend monitoring malnourished or at-risk patients. With current policy changes in our healthcare system promoting affordable care, there is a need to emphasize the role that nutrition therapy plays in patient care. Five organizations have launched a partnership to improve patie

New Cholesterol Guidelines Released

New Cholesterol Guidelines Released The American Heart Association released new clinical practice guidelines for managing cholesterol. The focus for lowering LDL cholesterol has moved away from focusing on achieving target numbers and instead has moved toward assessing risk and implementing cholesterol-lowering statin medications as appropriate.             This new recommendation is based on recent research that found that lifestyle changes as combined with a statin have shown the most significant improvements in cholesterol levels. They establish risk categories to determine the need for statin use. “High risk” include those who have already suffered a heart attack or stroke or suffer from cardiovascular disease, or who have abnormally high LDL levels. It is recommended that these patients use statins. For others, the American Heart Association has created a risk calculator to determine if statin use is appropriate. According to the guidelines, anyone with a

Diabetes and Heart Disease

Diabetes and Heart Disease             According to the American Heart Association, at least 68% of people 65 and older die from heart disease and 16% die of stroke. Heart disease rates are two to four times higher in adults with diabetes than among adults without diabetes. What is the link between heart disease and diabetes? How should dietitians counsel patients who are at risk? It is estimated that about 97% of people with diabetes have dyslipidemia. Dyslipidemia causes disturbances in endothelial function which promotes atherosclerosis is these individuals. Some changes that result include increased constriction of the   coronary artery, increased thrombosis, and increased local inflammatory response. There is a strong relationship between hyperglycemia, hypertension, dyslipidemia, and heart disease. It has been shown that managing proper blood glucose levels can reduce heart disease risk. Keeping blood pressure in a healthy range can reduce overall cardiov

Vitamin D and Fall Risk in Seniors

Vitamin D and Fall Risk Along with the majority of people in the north during the winter months, many seniors in retirement centers are also vitamin D deficient. Many older individuals experience a loss of muscle mass and muscle strength that is directly related to loss of bone. Elderly with low intake of vitamin D may have decreased renal production of calcitrol and may be more at risk for falls due to resulting proximal myopathy. Some studies have suggested that supplemental vitamin D may decrease seniors’ fall risk. This may be due to the decreased psychomotor functioning and increased sway that occurs with vitamin D deficiency that increases fall risk.             Such studies that have proven that vitamin D supplements are beneficial for improving fall risk include meta-analysis was conducted by Bischoff-Ferrari, Dawson-Hughes, and Staehelin et al. This study reviewed eight randomized control trials of supplemental vitamin D. This review found that vitam

Is Animal Protein Intake Linked to Diabetes Risk?

The Academy of Nutrition and Dietetics posted a link to an article about a recent study that found that high animal protein consumption may increase ones risk for type 2 diabetes. According to their diet records those with diabetes tended to consume most of their protein from red meat and processed meats. They found those with a normal protein intake or getting higher protein from plant sources had a lower risk. Although this specific study focused only on the protein, it is important to also look at the overall big picture. Those consuming large quantities of meat were also consuming high saturated fat levels and lower fiber than those consuming lower amounts.   This can be beneficial in clinical dietetics when counseling those with a family history of diabetes, If their 24 hour recall shows that they are getting a majority of their protein from animal sources, it may be beneficial to educate them on plant sources of protein as well. Having recipes and ways for them to learn ho

Early Signs of Kidney Disease Often Ignored

Most common way of diagnosing kidney disease is testing the urine for proteins. Proteinuria is a condition where high amounts of protein found in the urine, this could mean kidney disease and lead to heart disease. High levels of protein could be the use of over the counter medicines such as non-steroidal inflammatory drugs (NAIDs), pain relievers. 300 patients that were admitted to a hospital in New York and Chicago were tested for proteinuria. 40% of them had it and only 37% of the 40 were treated for it. Most of the ones that had proteinuria reported that they have been using NAIDs. It is known that several medications can slow the progression of kidney disease and treat proteinuria such as angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). Researchers are finding that above 60% of patients that have proteinuria are not taking these drugs so that it can slow the progression of kidney disease in patients that are already prone to having it. A scre

East Meets West at the Cleveland Clinic

On Monday, the Wall Street Journal published a fascinating read on the Cleveland Clinic's new Chinese herbal therapy center. Despite the current lack of sufficient evidence that speaks to their effectiveness, more and more Americans are willing to try herbal remedies. The Cleveland Clinic hopes that this new venture will be a way to unite Eastern and Western medicines. According to Melissa Young, an integrative medicine physician at the Cleveland Clinic, "Western medicine does acute care phenomenally... But we're still struggling a bit with our chronic-care patients and this fills in that gap and can be used concurrently." Patients who seek care at the herbal therapy center will need to be referred by a doctor and will be monitored to ensure that there are no drug-herbal interactions or other complications. So far, referrals have come from neurology, oncology, gastroenterology and rheumatology departments, among others. Like many alternative forms of medicine, tr

New Saturated Fat Findings

A recent class discussion along with a hot topic all over the news reading "Saturated Fats wont raise heart disease risk". Due to a recent release of a new study on saturated fats researchers looked at 72 different studies and over 600,000 people from all over the world. The study found some interesting evidence that the recommendations that the American Heart Association give for recommended fat intake may be somewhat incorrect. The limiting of saturated fats that are consumed in a diet should be closely monitored to help decrease chances of heart disease. But this new study found that fats from dairy and specifically margaric acid showed a reduction in heart disease risks. The study also did not find any support that the "good fats" such as omega 3 and omgea 6 fatty acids actually lowered cholesterol levels in the blood. For many people seeing this on the news or hearing from a friend should beware. The high consumption of any one type of food may have poor health

Reasons for Racial Obesity Disparities

The University of Alabama at Birmingham has conducted research study about the root cause of obesity among minority populations such as African Americans. It has always been known that the cause of obesity was socioeconomic status of those that are effected but that might not be the main cause anymore. "Non-Hispanic blacks in the United States have the highest age adjusted rates of obesity at 47.8%, while the rate of non-Hispanic whites is at 32.6%" (Centers for Disease Control and Prevention). Researchers used behavior data for whites and blacks from Alabama and Mississippi taken from the National Behavioral Risk Factor Surveillance System and applied economic strategies to look at different factors in health disparities. They concluded that African Americans have a higher body mass than whites and as a group have lower income and education levels, consume less fruits and vegetables and workout less. This was true to African American men but when it came to women, they had m