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Evaluation and standardisation of different matrices used for double-blind placebo-controlled food challenges to fish.

BACKGROUND: Fish allergens represent one of the most common causes of adverse reactions to food worldwide. Double-blind placebo-controlled food challenges (DBPCFC) are the gold standard for food allergy diagnosis. However, no standardised recipes are available for common food allergens such as fish, and a well trained dietitian is essential for creating and standardising them. The present study aimed to create and standardise recipes for use in DBPCFCs to fish. METHODS: Three recipes were prepared. Employing a standardised procedure, a total of 35 panelists evaluated the different matrices us

An investigation to determine the nutritional adequacy and individuals experience of a very low fat diet used to treat type V hypertriglyceridaemia.

BACKGROUND: The management of Type V hypertriglyceridaemia at some centres involves the use of a very low fat diet (15% energy as fat). There is no published research examining compliance with, or nutritional adequacy, of this treatment. This study assesses the nutritional adequacy of the diet and examines barriers and enablers to adherence. METHODS: Fifty-four eligible patients were invited to take part. Eight males and one female agreed to participate. One male later withdrew. The mean age of participants was 49.4 years (SD 12.9 years), their mean BMI was 30.4 kg m(-2) (SD 3.4 kg m(-2)) and

The effect of substituting alternative grains in the diet on the nutritional profile of the gluten-free diet.

BACKGROUND: The only treatment for coeliac disease is lifelong adherence to a gluten-free diet. Several studies have reported nutritional deficiencies in individuals on a gluten-free diet. The present study aimed to determine whether the nutritional profile of gluten-free diet could be improved through the use of alternative grains. METHODS: A retrospective review of diet history records by a celiac specialist dietitian were used to establish a 'standard' gluten-free dietary pattern. An 'alternative' gluten-free dietary pattern was developed that substituted naturally gluten-free grains or gl

Appetite stimulants in cystic fibrosis: a systematic review.

BACKGROUND: The use of appetite stimulants in cystic fibrosis (CF) is controversial because of doubts concerning efficacy and side-effects. The aim of the review was to establish whether appetite stimulants should be recommended in CF. MATERIALS AND METHODS: Medline, AMED, British Nursing Index, Cinahl, Embase, The Cochrane Library, National Research Register and Google were searched. Unpublished studies, case reports and conference abstracts were sought from experts, including authors of identified published articles, and suppliers of appetite stimulants. RESULTS: Fifty-four articles were l

Sharing life with a gluten-intolerant person--the perspective of close relatives.

BACKGROUND: Several studies indicate the importance of social support in the case of chronic disease. AIM: The aim was to explore dilemmas experienced by close relatives living with a person suffering from coeliac disease, and to describe the strategies they used to deal with these dilemmas. METHODS: Twenty-three informants were interviewed. A systematic inductive qualitative method, the critical incident technique was used. RESULTS: Disease-related worries included having bad conscience about not being affected by the disease, experiencing anxiety and witnessing the vulnerability of the af

Comparison of open and double-blind placebo-controlled food challenges in diagnosis of food hypersensitivity amongst children.

BACKGROUND: Correct diagnosis of food hypersensitivity (FHS) is important to ensure appropriate patient care and to accurately establish the population prevalence and incidence. Food challenges play a very important role in the diagnosis of FHS, but it is unclear when open food challenges (OFCs) opposed to double-blind placebo-controlled food challenges (DBPCFCs) should be used. This study investigated the use of OFCs and DBPCFCs when diagnosing FHS. METHODS: Children with a reported history of FHS or with sensitization to a food without known previous consumption were invited to undergo food

Nutritional status of patients who have fallen in an acute care setting.

BACKGROUND: Falls may result in injury, loss of independence and higher healthcare costs. The aim of this study was to examine the nutritional status of patients who had fallen in an acute care setting. METHODS: Forty-nine patients who had experienced a fall while admitted at an Australian private hospital participated in the study (age: 71.2 (SD 14.1) years; 21 male: 28 female). Nutritional status was assessed using subjective global assessment. Protein and energy intake was determined by dietary history and analysed using Australian computerised food composition data. RESULTS: According to

Early versus late enteral nutritional support in adults with burn injury: a systematic review.

BACKGROUND: Burn injury increases the body's metabolic demands, and therefore nutritional requirements. Provision of an adequate supply of nutrients is believed to lower the incidence of metabolic abnormalities, thus reducing septic morbidity, and improving survival rates. Enteral nutrition support is the best feeding method in a patient who is unable to achieve an adequate oral intake, but optimal timing of its introduction after burn injury (i.e. early versus late) needs to be established. The purpose of this review is to examine evidence for the effectiveness and safety of early versus late

Do health visitors advise mothers about vitamin supplementation for their infants in line with government recommendations to help prevent rickets?

BACKGROUND: Increasing numbers of children are presenting with nutritional rickets. Rickets affects mainly dark-skinned infants being breastfed for prolonged periods without vitamin supplementation. The main aim of this study was to assess health visitors' (HV) knowledge of the government guidelines for vitamin supplementation for infants and children and the advice given to mothers. METHODS: Questionnaires were sent to all HV in Brent, Harrow and Westminster Primary Care Trusts (PCT). Information received was collated and used to assess HV knowledge. RESULTS: A total of 98 (69%) questionnai

Home enteral feeding audit 1 year post-initiation.

UNLABELLED: OBJECTIVE To determine the practical problems that families of children on home enteral tube feeds (HETF) experience in the first year post-hospital discharge. METHODS Thirty parents/carers of children (0-16 years) completed a multiple choice/short answer questionnaire by interview 12 months after discharge from hospital. Issues addressed included: home delivery of feed and equipment; pump usage; tube changes; and overnight feeding. RESULTS: The main problems identified were: sleep disturbance (75%); frequent tube dislodgement (46%); tube blockages (41%); inability of some home de

Home delivery of dietary products in inherited metabolic disorders reduces prescription and dispensing errors.

UNLABELLED: In the UK, for patients with inherited metabolic disorders (IMD) the traditional system for acquiring essential dietary products [patient prompted prescriptions generated by a medical general practitioner (GP) and dispensed by a chemist] is problematic. OBJECTIVE: To investigate the efficacy of a home delivery service (HDS) for essential dietary products (EDP) (i.e. protein substitutes, milk replacements, energy and vitamin and mineral supplements) for subjects with IMD, particularly examining any prescription and dispensing errors, metabolic control and consumer satisfaction. ME

Food provision and the meal situation in elderly care - outcomes in different social contexts.

BACKGROUND: Nutritional problems concerning older people in care can be affected both by their illness and by the standard procedures surrounding food provision, for example rigid routines of food supply and ritualized mealtime situations. METHOD: The aim was to study how organizational structure and staff members' routines and actions influence activities related to food and meals in different caring context in Sweden. The qualitative methodology chosen for this study was participant observation. RESULT: Care recipients were given different opportunities concerning what, how, when and with

Food habits and appetite of elderly women at the time of a femoral neck fracture and after nutritional and anabolic support.

OBJECTIVE: To study appetite and food choices in lean elderly women at the time of a femoral neck fracture and after 6 months of nutritional and anabolic intervention. SUBJECTS AND METHODS: Forty-five nondemented women >70 years of age (mean +/- SD: 83 +/- 5 years) with a recent hip fracture and body mass index <24 kg/m2 (mean: 20.5 +/- 2.3) were interviewed about their appetite and dietary habits prior to fracture. The patients were randomized to treatment with a protein-rich liquid supplement (PR; 200 kcal and 20 g protein day(-1)) alone or in combination with nandrolone decanoate injection

An elemental diet for bowel obstruction in pregnancy: a case study.

Bowel obstruction is a recognised complication in pregnancy, especially in those with adhesions from previous surgery. We report a case where the use of an elemental diet was successful in avoiding surgery in a pregnant patient with recurrent conservatively managed small bowel obstruction.

What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials.

BACKGROUND: Evidence is needed for the best long-term diet for weight loss, and improvement in cardiac risk and disease in obese adults. METHODS: We systematically reviewed randomized controlled trials (RCTs) in any language. We searched 13 databases and handsearched journals. Trials lasted 1 year or more. One investigator extracted the data and a second checked data extraction. Trial quality was assessed. RESULTS: Low fat diets (LFDs) produced significant weight losses up to 36 months (-3.55 kg; 95% CI, -4.54 to -2.55 kg). Blood pressure, lipids and fasting plasma glucose improved with thes

Is dietary counselling effective in increasing dietary calcium, protein and energy intake in patients with osteoporotic fractures? A randomized controlled clinical trial.

To determine the feasibility of increasing the calcium, protein and calorie intake of osteoporotic fracture patients by repeated dietary counselling delivered by a dietitian, a randomized controlled trial was conducted. Among 189 patients presenting with osteoporotic fractures to an Orthopaedics and Traumatology Department of a large regional hospital, 98 patients were randomized to the intervention group and 91 were randomized to the control group (with usual care). Intervention group received three sessions of dietary counselling with tailored made recommendations over a period of 4 months,

Caffeine ingestion and fluid balance: a review.

BACKGROUND: Caffeine and related methylxanthine compounds are recognized as having a diuretic action, and consumers are often advised to avoid beverages containing these compounds in situations where fluid balance may be compromised. The aim of this review is to evaluate the available literature concerning the effect of caffeine ingestion on fluid balance and to formulate targeted and evidence-based advice on caffeinated beverages in the context of optimum hydration. METHOD: A literature search was performed using the Medline database of articles published in the medical and scientific litera

A prospective study of the workload of a newly formed PEG advice team.

BACKGROUND: A multidisciplinary advice team may be the optimal way of providing the long-term nutritional and percutaneous endoscopic gastrostomy (PEG)-related care for patients dependent on PEG feeding but the workload involved is unknown. AIM: To study prospectively the workload of a proactive, multidisciplinary PEG advice team over a 2-year period. METHODS: Separate documentation from main case notes of each episode of the team's contact with PEG or potential PEG patients, including assessment, advice and therapy given, from the time of its establishment, for four consecutive 6-monthly pe

Benefit of Reducing Body Weight Loss with A Nutritional Support Pathway in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation.

BackgroundThis retrospective, historically controlled investigative study examined the benefit of a nutritional support pathway that included nutritional education before the start of conditioning and emphasized oral nutrition in response to nutrition-related adverse events in patients undergoing hematopoietic stem cell transplantation (HSCT).Material and methodsParticipants were patients undergoing allogeneic HSCT; 46 were in the control group (i.e., did not follow our nutritional pathway) and 36 were in the group that underwent nutritional intervention (enhanced nutrition group). We compared

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… Source of support: This research project was sponsored by The Foundation for Promotion of Cancer Research and The Japan Dietetic Association under 2015 and 2016 Grants for Nutritional Guidance-related Research References 1 Deeg HJ Seidel K Bruemmer B Impact of patient weight on non-relapse mortality … Board of Directors Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition) JPEN J Parenter Enteral Nutr 2012 36 275 83 22535923 10.1177 …