Kent State Interns

Fish and omega 3 fatty acid intake has been an area of interest for the potential protection effect against cardiovascular disease. Metabolic syndrome is one risk factor for Coronary Heart Disease (CHD) and has also been associated with increased CHD mortality and morbidity. Because fish/omega 3 intake may protect from CHD, this study had the objective of determining the effect of intake on metabolic disease prevalence. This study used 3,504 male and female Koreans aged 40-69 from a previous study. Each participant completed a food frequency questionnaire to identify omega 3 intake. Metabolic syndrome incidence was identified by health examinations during a follow up period. The data revealed that fish intake was significantly associated with more acceptable triglyceride and HDL levels. Daily fish intake in males (but not females) also demonstrated a significant decrease in occurrence in metabolic syndrome. The study concludes with the thoughts that a diet high in omega 3 fatty acids ...

In any form of acquired brain injury, your first concerns are stabilizing the patient and preventing further neuronal injury/limiting secondary brain damage. In patients with traumatic brain injury (TBI) many metabolic alterations can occur such as hypermetabolism, hypercatabolism, and glucose intolerance (Wang et al., 2013). The management of such alterations hinges on nutritional support. Nutritional support is recognized as an “important adjunctive therapy" (Wang et al., 2013) for targeting primary, secondary and long-term effects of TBI. Various prevention strategies have been identified which may reduce mortality, improve outcomes and decrease infectious (i.e., pneumonia/other respiratory tract infections; CNS infection; bloodstream infection/sepsis; urinary tract infection) and feeding-related   complications (i.e., feeding intolerance; aspiration; diarrhea; vomiting; constipation; abdominal distention) (Wang et al., 2013). These include the use of enteral nutrition (E...

AND Works to Expand Medicare Coverage of MNT The Centers of Medicare and Medicaid Services (CMS) is working to improve outcomes in regards to patient care and lower costs of medical services.   In conjunction with a committee from the Academy of Nutrition and Dietetics, the CMS coverage team hopes to change coverage for medical nutrition therapy for adults over the age of 65.   It is their goal to expand coverage to a broader group of disease states and conditions.   The Academy is supportive of this expansion of Medicare Part B, however as part of this change the AND wants to provide evidence to show the importance of a registered dietitian’s role in primary care practices.   Web based resources, toolkits, and downloadable brochures are just some of the ways RDs can utilize evidence based practice and take advantage of opportunities under the Affordable Health Care Act that can further provide a case to insurance companies and employers for RD nutrition service...

Racial disparity exists for receiving diabetes education referral http://www.healio.com/endocrinology/diabetes-education/news/online/%7Bc28aa91c-1a8f-42c9-922d-c537c4377b8a%7D/racial-disparity-exists-for-receiving-diabetes-education-referral               According to research published in The Diabetes Educator , black patients with pre-diabetes and diabetes are more likely to be given an education referral than white patients (14.8% vs. 10%; P < .0001).   A retrospective cross-sectional study was conducted on almost 4,000 patients ages 14-89 from 2008 to 2013 to determine diabetes education referrals based upon race. Black patients had higher rates of diabetes than pre-diabetes (75.8% and 24.2%), while white patients had higher rates of pre-diabetes than diabetes (62.3% and 37.7%). Overall, patients with diabetes were more likely to receive referrals than those with pre-diabetes.    ...

Evidence from clinical trials, observational studies and in vitro studies suggest that the active carotenoid component in tomatoes - lycopene - may exert anti-atherogenic activity. Concerning possible implications for the human heart, it has been suggested that the anti-atherogenic activity of lycopene may play a role in vascular function and, in addition, the primary and secondary prevention of cardiovascular diseases. In a recent double-blind, randomized, two-arm, prospective controlled study, the potential anti-atherogenic activity of lycopene was evaluated in vivo by monitoring forearm blood flow (FBF), arterial stiffness, blood pressure, heart rate and cardiac biomarkers. The study screened ninety participants who had presented at the Clinical Pharmacology Unit: University of Cambridge, United Kingdom. Gajendragadkar et al. (2014) sought to 1. Investigate to which extent oral lycopene supplementation predicts vasculature in patients with (or without evidence of) CVD and 2. To d...

New MIND Diet Could Significantly Reduce Alzheimer’s Disease Nutritional epidemiologist Dr. Martha Claire Morris at Rush University Medical Center in Chicago, Illinois developed the Mediterranean-DASH Intervention Neurodegenerative Delay diet, known as the MIND diet for individuals who are at a higher risk of developing Alzheimer’s.   The diet includes aspects of both the DASH and Mediterranean diets that have been found to be beneficial for cardiovascular disease, stroke and high blood pressure.   The MIND diet consists of ten “brain-healthy food groups” and five unhealthy food groups.   Green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine are considered healthy food groups, whereas red meat, butter, cheese, pastries, sweets and fried foods should all be limited.   The MIND diet also places extra emphasis on berries such as blueberries and strawberries because they have been found to be beneficial for b...

In Today’s Dietitian , registered dietitian Mandy Corrigan highlights the importance of an RD during a patient’s stay in a hospital.   She first approaches the subject by highlighting the 1974 article “Skeleton in the Hospital Closet,” which discusses the incidence of malnutrition in the nations hospitals.    Fast forward 40 years, and we are still dealing with the serious issue today. It has been found that 1/3 patients enter the hospital malnourished, and if the issue is not addressed within their stay, 2/3 will experience further nutritional decline.   The Academy of Nutrition and Dietetics (AND) and The American Society of Parental and Enteral Nutrition (ASPEN) have addressed and are helping the initiative of preventing and treating malnutrition.   AND and ASPEN have developed a standardized protocol for diagnosing adult malnutrition and use an etiology-based definition that utilizes the relationship between malnutrition and disease...

The Crossing the Quality Chasm: A New Health System for the 21 st Century identifies the need to re-invent healthcare by incorporating patient centered medical homes (PCMH). A PCMH is defined as, “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.”   The concept of PCMH focuses primarily on the patient and delivers comprehensive, team-based, coordinated and accessible care.   The good news for us future dietitians is that the data reveals that RDNs need to be integrated and valued among PCMH!   The December 2014 Journal of the Academy of Nutrition and Dietetics highlights the wide variety of roles that dietitians will play in PCMH and include the following: MNT, patient self-management support, providing comprehensive and coordinated care to patient, community outreach, ect.   Jortberg, B.T., & Fleming, M.O. (2014)....

As future healthcare professionals, we are aware of the benefits of probiotics from whole foods such as yogurt, kefir, miso, or kimchee.   However, those who cannot consume enough of these foods to meet their needs or need a certain dosage for a certain medical diagnosis, supplementation may be the way to go.   The following six probiotic supplements may be used for specific conditions: 1.      Align- used to reduce symptoms of bloating, cramping, and stool frequency in those with IBS 2.      Bio-K+- reduces incidence of antibiotic associated diarrhea 3.      Culturelle- has been shown to reduce severity and duration of acute infectious diarrhea and antibiotic associated diarrhea 4.      Florastor- prevents “traveler’s” diarrhea and antibiotic associated diarrhea 5.      Mutaflor- has been found to be as potent as mesalazine (anti-inflammatory drug) in remissi...

Because Type 2 Diabetes Mellitus (T2DM) is one of the top ten leading causes of death in the US and it directly and indirectly causes approximately 174 billion dollars a year in the US, prevention has become a highly researched area. There have studies in the past correlating lifestyle changes in the prevention or delayed onset of T2DM in at risk populations. This specific study had the objective of determining if medical nutrition therapy (MNT) has a different effect on prevention than the usual care. 76 partiipants were used for this study, all of which had impaired fasting blood glucose or a glycated hemoglobin (HbA1C) of 5.7-6.4%. The participants were split up into two groups; one was a control group that received the usual care and the second underwent a 12 week intervention period. Data was collected pre-test and post-test to measure differences. Quantitative data collected during the study included fasting blood glucose, serum lipid levels, and a Diabetes risk score. The resul...

Rethinking the Restriction on Nutrition During Hemodialysis             Patients on hemodialysis have a 20% higher rate of mortality in the United States compared to other industrialized countries.   This difference could be attributed to being allowed to eat during treatment, this is known as intradialytic feeding.   Intradialytic feeding is not generally allowed during treatment in the U.S. because it is thought that eating during dialysis will make the treatment less effective, cause a greater fluctuation in blood pressure and gastrointestinal issues.    More recent studies have shown that these side effects are rare and the patients are at a greater risk of poor protein status and inflammation caused by hemodialysis.   Research has shown that up to 75% of patients on hemodialysis suffer from protein energy wasting, which lowers their quality of life and increases their mortality risk.   The Kid...