Kent State Interns

Martindale R, Warren M. Should enteral nutrition be started in the first week of critical illness? Curr Opin Clin Nutr Metab Care . 2015;18(2):202-206.               This study looks at the early initiation of enteral nutrition for patients who are critically ill. Authors admit that there is a lack of trials that contain a large number of participants and are randomized. A majority of the supporting studies on this topic were done on animal models and not human patients.             Results from this study show that the initiation of enteral nutrition within the first week of being in the intensive care unit promotes gut-mediated immunity, lowers metabolic response to stress, maintains microbial diversity, and improves clinical outcomes versus standard of care or parenteral nutrition.             This is important because of the time frame and what’s going on. This is a very stressful time for the patient and family and feeding of any kind can often be associated with e

Kang K, Shu X, Zhang Y, Liu X, Zhao J. Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumors: A meta-analysis of randomized controlled trials. Chin Med J. 2015;128(2):245-251               This study a meta-analysis that looks at the addition of glutamine supplementation in patients with severe traumatic stress or tumor bearing states. The meta-analysis showed that glutamine enriched nutrition support improved immune function, reduced incidence of infectious complications postoperatively, and shortened the length of hospital stays.             A number of the trials were conducted on patients with post-operative GI cancer patients, but the results seem to be applicable to any severe traumatic stress situation.             All studies were randomized, but not all studies were blind. For specific dosing of glutamine an investigation of individual studies would have to be done.             Some of the mechanisms associated with these

Shaw C, Fleuret C, Pickard J, Mohammed K, Black G, Wedlake, L. Comparison of a novel, simple nutrition screening tool for adult oncology inpatients and the Malnutrition Screening Tool(MST) against the Patient-Generated Subjective Global Assessment(PG-SGA). Support Care CancerI. 2015;23(1):47-54.                         This article evaluates the specificity and sensitivity of different methods of assessing nutrition status. What is different is that this article is looking to find a the best one for a specific disease.             While some screening tools are better than others overall for identifying malnutrition in patients, no one tool is the best for everyone. More than the contents of this study  the idea itself is what is important. Instead of a tool or method that is used throughout dietetics or through a hospital  using one that has been proven to me the most effective at identifying malnutrition within a specific disease state is the most appropriate course of a

Daley BJ, Cherry-Bukowiec J, Van Way III CW, et al. Current status of nutrition training in graduate medical education from a survery of residency program directors: A formal nutrition education course is necessary. J parenter Enteral Nut. 2015;XX(X):1-5.               Among dietitians it is sometimes a sore subject as to whether or not they are allowed to prescribe diet orders. It changes from state to state and from hospital to hospital. The questions arise as to who is more knowledgeable in regard to diets and if doctors are prescribing diet orders then what is the point of clinical dietetics? Well, this article surveyed graduate medical education facilities to determine what level of nutrition education was being giving. Of the 72 residencies programs that responded only 19(26.4%) had a formal course in nutrition, and of these 19 institutions only 16 required that the courses be taken. The statistics go on to show that not only are nutrition classes not being given, when

I previously wrote an article about how sugar-sweetened beverages may decrease the body's stress response. Now, there is another study out suggesting that drinking sugar-sweetened beverages may increase the risk of heart disease. It is important to keep in mind that how the studies were conducted and if there is other research out there to back it up. It is also important to remember moderation is key when it comes to what we eat and drink. This study is the first to show a direct dose-dependent relationship between the amount of added sugar consumed in sugar-sweetened beverages and increases in specific risk factors for cardiovascular disease. There are other studies that show an increase in sugar-sweetened beverages correlates with an increase in cardiovascular disease. There were 85 participants both men and women between the ages of 18-40 years old who were divided into four different groups. The study followed these participants for 15 days while they consumed sugar-sweetene

New research may suggest that compounds in apples and green tea may help to protect our health. Other dietary studies have shown that consuming diets high in fruits and vegetables reduces the chance of developing chronic diseases like heart disease, diabetes, and cancer. There could be multiple reasons for this. One reason may be the fact that fruits and vegetables contain polyphenols, which may help to protect our health.  In this study it was shown that polyphenols that are in green tea and apples block a signaling molecule called VEGF, which can trigger atherosclerosis in the body and anti-cancer drugs. In the body VEGF drives blood cell formation by a process called angiogenesis. Angiogenesis is a major contributor to cancer progression and the formation of plaque and plaque rupture, which can cause a heart attack or stroke. Using cells that were from human blood vessels, the researchers found that low levels of EGCG the polyphenol in green tea and procyanidin from apples stoppe

There is no standard diet to prevent kidney stones because there are various types of kidney stones and risk factors associated with each one of them. In order to provide individualized nutrition therapy, dietitians need to look at the medical history, current/past dietary pattern, type of stone, 24-hour urine parameters, and medications. The followings are some types of kidney stones: ·       Calcium oxalate stones (which is caused by: high urinary calcium excretion, high urinary oxalate excretion, low urinary citrate/magnesium excretion or low urine volume. ·       Calcium phosphate stone (which is caused by: high urinary calcium excretion, low urinary citrate excretion, high urine pH, or low urine volume) ·       Uric acid stones (which is caused by: genetic problem, or some diseases such as leukemia, lymphoma, multiple myeloma, and sickle cell disease. These might result in high urinary uric acid excretion, low (acid) urine pH, or low urine volume) ·       Cystine

The lifetime prevalence of a woman developing an eating disorder is about 6%, and a man developing an eating disorder is about 3%. Yet, it was found that 98% of those with eating disorders experienced gastrointestinal issues as a complication of the disease and 50% were diagnosed with irritable bowel syndrome. The most common gastrointestinal issues were seen to be heartburn, bloating, constipation, dysphagia, and anorectal pain. These are all facts that you could find just about anywhere. What was so interesting about this article is that it really talks about the connection into all the causes of GI distress stemming from eating disorders. For example, although the actual eating disorder can be the primary cause of a gastrointestinal disease such as irritable bowel syndrome, this article explains that the primary cause is frequently anxiety and obsessive compulsive tendencies that put stress on the body that eventually leads to GI issues. This article explains that it is the dietit

Intellectual and developmental disability (IDD) affects about 1-3% of adults and children in the United States. Intellectual function and adaptive behavior will be limited which affects many aspects of daily life such as self-care, mobility, self-direction, and learning and language skills. Children and youth with special health care needs (CYSHCN) require special health service as a result of increase risk of emotional, behavioral, physical or developmental conditions. It was estimated that during the year of 2009-2010, there was 11.2 million children under this category. Prevention and early treatment is essential in reducing the high cost of health care services that results from several chronic conditions that IDD and CYSHCN individuals may develop over their life span such as obesity, diabetes mellitus and hypertension. Many of these conditions are nutrition-related, therefore, the role of the RDN and the NDTR as part of the comprehensive care process is considered vital.  

There was a recent study that looked at the relationship between sugar sweetened beverages and non-sugar sweetened beverages and how the body responds in respect to stress. This double-masked diet intervention studied the effects of consuming sugar and aspartame-sweetened beverages. This study was conducted on 19 women between the ages of 18-40. Eight women were assigned to consume the aspartame-sweetened beverages, while eleven women were assigned to consume sugar-sweetened beverages for twelve days. Over the twelve day period the women were to consume one of the assigned beverages at breakfast, lunch, and dinner. The participants were instructed not to consume any other sugar-sweetened beverages including fruit juice.  For three and a half days before and after the study the women consumed a low fat diet and stayed at the UC Davis Clinical and Translational Science Center's Clinical Research Center. Before and after the twelve day intervention the women would take a math tes

Over production of free radicals may result in damage of DNA and bodily lipids and proteins. Excessive oxidative stress is also associated with infertility, impaired follicular growth, endometriosis, spontaneous abortion, increased risk for low-birth weight children, and several chronic diseases. Fruits and vegetables (F/V) contain several anti-oxidant compounds that assist in alleviating oxidative stress, thus making them an essential component of a healthy diet. This study had the goal of determining if consuming five servings of F/V per day has an effect on oxidative damage and anti-oxidant defense biomarkers. The participants of the study included 258 premenopausal women. Dietary intake of the participants was determined by food frequency questionnaires and 24 hour diet recalls. Lab values measured in this study included plasma concentrations of F2-isoprostane, 9-hydroxyoctadecadieneoic acid, 13-hydroxyoctadecadieneoic acid, erythrocyte activity of superoxide dismutase, glutathion

This study, by the department of medicine and division of gastroenterology at Beth Israel Deaconess Medical Center in Boston, is examining the effect of gluten-free diet (GFD) on the BMI of biopsy diagnosed coeliac disease (CD) patients. CD is an autoimmune disorder that causes the affected individuals to be sensitive to gluten. CD patients may experience many gastrointestinal symptoms such as: nausea, vomiting, diarrhea, and weight loss. In this study, most diagnosed CD patients were found to have underweight or normal weight, when compared with the population in the same area (data for these population were obtained from NHIS 2007). The effect of GFD on the BMI was examined by measuring the initial BMI (when they were initially diagnosed with CD), and after 39 months (where they were strictly following GFD). The major finding of the 679 tested patients, 65% of the underweight patients had significant increase in their BMI after adhering to the GFD and they become in the normal B

Increased Visits by Registered Dietitians Linked to Improved BMI Outcomes in Children with Obesity             A study done at Cincinnati Children’s Hospital monitored 92 children participating in comprehensive weight management programs to evaluate two different dietary management approaches.   The first dietary management approach used education on portion control by a registered dietitian following a medical visit.   The second approach educated participants on a glycemic load diet during a medical visit.   Participants in the first weight management program had monthly visits with a registered dietitian and were found to have greater success in improving BMI.   The researchers found participants improved by 28% with each additional visit with an RD.   Those who had one or more visits with an RD per month had a 78% success rate in improving BMI.   It was concluded that when organizing a weight management program it is beneficial to have a multi-disciplinary team and at least on