Journal of Human Nutrition and Dietetics最新文献_第5页

Life Challenges and Quality of Life of People Living With Coeliac Disease: Time of Diagnosis Matters 乳糜泻患者的生活挑战和生活质量：诊断时间问题

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-24 DOI: 10.1111/jhn.13413

Nanette Stroebele-Benschop, Christine J. Rau, Anastasia Dieze, Andreas Bschaden

Background

Previous studies have examined the quality of life of patients with coeliac disease. There is a lack of understanding about potential changes in emotional responses and life challenges after diagnosis. This exploratory study aimed to evaluate the emotional impact, life challenges and quality of life in people living with coeliac disease in Germany.

Methods

An online survey was conducted among patients with coeliac disease to assess difficulties in implementing a gluten-free diet in daily life activities, including food shopping and preparation, and eating away from home, as well as additional costs of time and money. Furthermore, the questionnaire assessed the time of diagnosis, emotions felt after diagnosis and today, compliance regarding the gluten-free diet and sociodemographic data. Participants were recruited in 2022 via social media, newsletters and websites. Out of 1286 participants who had taken part in the survey, 766 met the inclusion criteria and were included in the data analysis.

Results

The majority of the respondents (aged 18–83 years) were female (93%) and almost 50% were diagnosed more than 5 years ago. Negative emotion ratings related to the disease were associated with age at the time of diagnosis and years passed since diagnosis. While compliance was high with 89% of respondents strictly adhering to the gluten-free diet, patients with coeliac disease reported mainly life challenges in social situations involving food such as out-of-home consumption in restaurants, at work and while travelling. These challenges appear to persist over time.

Conclusions

Negative emotions and difficulties in implementing a gluten-free diet are negatively impacting individuals with coeliac disease, particularly in the first months after diagnosis. Particularly adolescents and young adults appear to be negatively impacted. The study emphasises the need to improve the quality of life in all impacted areas through better guidance and improved training of health professionals as well as food providers outside of home and through psychological counselling in the first year of diagnosis to better help individuals improve their quality of life.

背景：以前的研究已经检查了乳糜泻患者的生活质量。人们对诊断后情绪反应和生活挑战的潜在变化缺乏了解。本探索性研究旨在评估德国乳糜泻患者的情绪影响、生活挑战和生活质量。方法：在乳糜泻患者中进行一项在线调查，以评估在日常生活活动中实施无麸质饮食的困难，包括食品采购和准备，离家吃饭，以及额外的时间和金钱成本。此外，问卷还评估了诊断时间、诊断后和今天的情绪、对无麸质饮食的依从性和社会人口数据。参与者是在2022年通过社交媒体、时事通讯和网站招募的。在参与调查的1286名参与者中，有766人符合纳入标准，并被纳入数据分析。结果：大多数受访者（18-83岁）为女性（93%），近50%的人在5年前确诊。与疾病相关的负面情绪评分与诊断时的年龄和诊断后的年数有关。虽然依从性很高，89%的受访者严格遵守无麸质饮食，但乳糜泻患者报告的主要生活挑战是在涉及食物的社交场合，如在餐馆、工作场所和旅行时的户外消费。这些挑战似乎会持续一段时间。结论：负面情绪和实施无麸质饮食的困难对乳糜泻患者产生负面影响，特别是在诊断后的头几个月。尤其是青少年和年轻人似乎受到了负面影响。该研究强调，需要通过更好的指导和改进对保健专业人员以及家庭以外的食品提供者的培训，以及通过在诊断的第一年提供心理咨询，更好地帮助个人提高生活质量，从而改善所有受影响地区的生活质量。

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引用次数: 0

Tea Consumption and Long-Term Mortality in Very Elderly Individuals With or Without Cardiovascular and Cerebrovascular Disease: Findings From a Sample of 19664 Chinese 饮茶与有或无心脑血管疾病的高龄人群的长期死亡率：来自19664名中国人的调查结果

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-24 DOI: 10.1111/jhn.70001

Guang-zhi Liao, Man-qing Luo, Xue-mei Zhao, Bo-ping Huang, Yu-hui Zhang, Jian Zhang

Background

The association between tea consumption and mortality among very elderly individuals, with or without cardiovascular and cerebrovascular diseases (CCD), including stroke, remains unclear. This study hypothesised that a significant association exists.

Methods

We analysed data from two waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), spanning 1998/2000 to 2018, with a maximum follow-up of 20 years. Cox proportional hazards models, adjusted for potential confounders, were used to examine the association between tea consumption and all-cause mortality among the oldest old ( ≥ 80 years) with or without CCD. Participants were categorised based on the frequency of tea consumption (rare, occasional or regular) at the time of the survey and around the age of 60.

Results

Due to violations of the proportional hazards assumption, Cox model results were reliable only for the first 8 years of follow-up. Among 19,664 elderly participants, frequent tea consumption was associated with a lower mortality risk during the initial 8 years (adjusted HR 0.93, 95% CI 0.89–0.97) compared to never or rare tea consumption. However, this association diminished over the full 20-year follow-up. The significant association was observed only in participants who also reported frequent tea consumption around the age of 60 (adjusted HR 0.91, 95% CI 0.85–0.95). No significant interaction was found between pre-existing CCD and the 8-year effect of tea consumption (P for interaction > 0.05).

Conclusion

Among very elderly Chinese individuals, frequent tea consumption was associated with reduced mortality over the short term, particularly in those who maintained this habit throughout life. No significant interaction effect was observed between pre-existing CCD and the mortality benefits of tea consumption.

背景：在患有或不患有心脑血管疾病（CCD）（包括中风）的老年人中，饮茶与死亡率之间的关系尚不清楚。这项研究假设存在显著的关联。方法：我们分析了中国纵向健康寿命调查（CLHLS）的两波数据，时间跨度为1998/2000至2018年，最长随访时间为20年。采用Cox比例风险模型，对潜在混杂因素进行校正，以检验有或无CCD的老年人（≥80岁）饮茶与全因死亡率之间的关系。参与者根据调查时的饮茶频率（罕见、偶尔或经常）和60岁左右的年龄进行分类。结果：由于违反比例风险假设，Cox模型结果仅在随访的前8年是可靠的。在19664名老年参与者中，与从不或很少喝茶相比，在最初的8年里，经常喝茶与较低的死亡风险相关（调整后HR 0.93, 95% CI 0.89-0.97）。然而，在整个20年的随访中，这种关联逐渐减弱。只有在60岁左右经常喝茶的参与者中才观察到显著的关联（调整后危险度0.91,95%可信区间0.85-0.95）。预先存在的CCD与喝茶的8年效应之间没有显著的交互作用（P为交互作用0.05）。结论：在中国的老年人中，经常喝茶与短期内降低死亡率有关，特别是那些终生保持这种习惯的人。未观察到预先存在的CCD与饮茶的死亡率效益之间的显著交互作用。

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引用次数: 0

Co-Designing Recipe Resources to Support Healthy Eating in African-Caribbeans in the United Kingdom: An Academic and Community Partnership Approach 联合设计食谱资源以支持联合王国非洲-加勒比人的健康饮食：一种学术和社区伙伴关系方法。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-19 DOI: 10.1111/jhn.13412

Tanefa A. Apekey, Sally G. Moore, Maria J. Maynard

Introduction

The wealth of free food-based resources available to UK consumers on healthy eating and nutrition provides very limited illustrations of ethnic foods including African-Caribbean cuisines. This inequality in available resources limits the ability of African-Caribbean communities to effectively manage their health and reduces the cultural competence of health professionals.

Objective

The aim was to co-design healthier versions of several traditional African-Caribbean recipe resources by working in partnership with academics, a community-based Third Sector organisation, and their service-users.

Methods

Nutritional analysis software was used to theoretically modify the nutritional composition of popular traditional African-Caribbean recipes using recently produced analytical food composition data. Twelve recipes were theoretically modified to reduce the content of key nutrients and ingredients of concern (i.e., salt/sodium, free sugars), or increase those nutrients known to be at risk of lower than adequate intakes (i.e., iron, folate) within the UK African-Caribbean communities. Recipes were then prepared by community service-users (n = 12) of African-Caribbean ethnicity living in Leeds (UK) in the community service setting. The feasibility and acceptability of the recipes were evaluated by obtaining verbal feedback from service-users, following which recipes were further refined as appropriate.

Results

Modification resulted in a reduction in the overall energy (in the range of 23–188 kcal), fat (in the range of 0.1–13.7 g), saturated fatty acid (in the range of 0.1–2.9 g) and sugar (in the range of 0.2–8.3 g), provided by 100 g of the standard recipes. Similarly, modification resulted in the reduction in salt from about 63 to 0.01 g per 100 g edible portion of the standard recipe.

Conclusion

It is feasible to modify African-Caribbean recipes to be healthier and acceptable to consumers. Combined with improving access to food environments that make available healthy foods, the recipes are intended to support healthier eating with African-Caribbean foods.

简介：丰富的免费食物为基础的资源提供给英国消费者健康饮食和营养提供了非常有限的插图民族食品，包括非洲-加勒比美食。现有资源的这种不平等限制了非洲-加勒比社区有效管理其健康的能力，并降低了保健专业人员的文化能力。目标：目的是通过与学术界、以社区为基础的第三部门组织及其服务用户合作，共同设计几种传统非洲-加勒比食谱资源的更健康版本。方法：采用营养分析软件，利用最近制作的分析食品成分数据，对流行的非洲-加勒比传统食谱的营养成分进行理论修正。从理论上修改了12种食谱，以减少关键营养素和关注成分（即盐/钠，游离糖）的含量，或增加英国非洲-加勒比社区中已知存在低于摄入量风险的营养素（即铁，叶酸）。然后由居住在利兹（英国）社区服务环境中的非裔加勒比族裔社区服务使用者（n = 12）准备食谱。通过获得服务用户的口头反馈，评估了配方的可行性和可接受性，然后酌情进一步完善配方。结果：经修改后，100克标准食谱所提供的总能量（23-188千卡）、脂肪（0.1-13.7克）、饱和脂肪酸（0.1-2.9克）和糖（0.2-8.3克）均有所减少。同样，经过修改后，标准配方中每100克可食用部分的含盐量从63克减少到0.01克。结论：对非洲-加勒比配方进行改良，使其更加健康，为消费者所接受是可行的。这些食谱与改善提供健康食品的食品环境相结合，旨在支持非洲-加勒比地区食品的健康饮食。

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引用次数: 0

Nutrition Interventions in the Treatment of Endometriosis: A Scoping Review 营养干预治疗子宫内膜异位症：范围综述。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-18 DOI: 10.1111/jhn.13411

Samantha C. De Araugo, Jane E. Varney, Amelia J. McGuinness, Colette Naude, Subhadra Evans, Antonina Mikocka-Walus, Heidi M. Staudacher

Background

Pain, poor quality of life (QOL) and gastrointestinal (GI) symptoms are commonly experienced by individuals with endometriosis. Although diet and nutrition supplements are frequently used to manage endometriosis-related symptoms, there is limited understanding of the breadth and quality of research in this field. Our aim was to undertake a scoping review of diet and nutrition supplement intervention studies in people with endometriosis, diagnosed by ultrasound or surgery.

Methods

MEDLINE Complete, Embase, CINAHL and PsycINFO databases were searched for articles published in English from database inception to November 2024. Quality was assessed by two reviewers independently using the Joanna Briggs Institute appraisal tools. In total, 5130 publications were screened and 13 were included.

Results

Among these, five evaluated the effect of diet intervention, one evaluated the effect of a combined diet–supplement intervention and seven evaluated the effect of a nutrition supplement in endometriosis. Overall, there were seven randomised controlled trials (RCTs) (n = 1 diet intervention, n = 6 nutrition supplement), two nonrandomised controlled studies (n = 1 diet intervention, n = 1 combined diet–supplement) and four uncontrolled studies (n = 3 diet intervention, n = 1 nutrition supplement). On the basis of evidence from the RCTs, the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet improved QOL and GI symptoms, whereas garlic supplements and combination trace element supplements may be beneficial for improving reduced pain symptoms related to endometriosis. The quality of most included studies was poor. Adherence to the interventions was only measured in five studies and only one diet study measured baseline diet.

Conclusions

High-quality RCTs of diet and nutrition supplement interventions are needed to progress the understanding of whether they should be integrated into the clinical management of endometriosis.

背景：疼痛、生活质量差和胃肠道症状是子宫内膜异位症患者常见的症状。虽然饮食和营养补充剂经常用于治疗子宫内膜异位症相关症状，但对该领域研究的广度和质量的了解有限。我们的目的是对通过超声或手术诊断的子宫内膜异位症患者的饮食和营养补充干预研究进行范围审查。方法：检索MEDLINE Complete、Embase、CINAHL和PsycINFO数据库自建库至2024年11月发表的英文文章。质量由两位评论者使用乔安娜布里格斯研究所的评估工具独立评估。共筛选了5130份出版物，其中13份列入。结果：其中5项评估饮食干预的效果，1项评估联合饮食补充剂干预的效果，7项评估营养补充剂对子宫内膜异位症的影响。总体而言，共有7项随机对照试验（rct）（n = 1项饮食干预，n = 6项营养补充剂），2项非随机对照研究（n = 1项饮食干预，n = 1项联合饮食-补充剂）和4项非对照研究（n = 3项饮食干预，n = 1项营养补充剂）。根据随机对照试验的证据，低发酵低聚糖、双糖、单糖和多元醇（FODMAP）饮食可改善生活质量和胃肠道症状，而大蒜补充剂和联合微量元素补充剂可能有助于改善与子宫内膜异位症相关的疼痛症状。大多数纳入的研究质量较差。只有五项研究测量了干预措施的依从性，只有一项饮食研究测量了基线饮食。结论：需要高质量的饮食和营养补充干预的随机对照试验，以进一步了解是否应将其纳入子宫内膜异位症的临床治疗。

{"title":"Nutrition Interventions in the Treatment of Endometriosis: A Scoping Review","authors":"Samantha C. De Araugo, Jane E. Varney, Amelia J. McGuinness, Colette Naude, Subhadra Evans, Antonina Mikocka-Walus, Heidi M. Staudacher","doi":"10.1111/jhn.13411","DOIUrl":"10.1111/jhn.13411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pain, poor quality of life (QOL) and gastrointestinal (GI) symptoms are commonly experienced by individuals with endometriosis. Although diet and nutrition supplements are frequently used to manage endometriosis-related symptoms, there is limited understanding of the breadth and quality of research in this field. Our aim was to undertake a scoping review of diet and nutrition supplement intervention studies in people with endometriosis, diagnosed by ultrasound or surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE Complete, Embase, CINAHL and PsycINFO databases were searched for articles published in English from database inception to November 2024. Quality was assessed by two reviewers independently using the Joanna Briggs Institute appraisal tools. In total, 5130 publications were screened and 13 were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among these, five evaluated the effect of diet intervention, one evaluated the effect of a combined diet–supplement intervention and seven evaluated the effect of a nutrition supplement in endometriosis. Overall, there were seven randomised controlled trials (RCTs) (<i>n</i> = 1 diet intervention, <i>n</i> = 6 nutrition supplement), two nonrandomised controlled studies (<i>n</i> = 1 diet intervention, <i>n</i> = 1 combined diet–supplement) and four uncontrolled studies (<i>n</i> = 3 diet intervention, <i>n</i> = 1 nutrition supplement). On the basis of evidence from the RCTs, the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet improved QOL and GI symptoms, whereas garlic supplements and combination trace element supplements may be beneficial for improving reduced pain symptoms related to endometriosis. The quality of most included studies was poor. Adherence to the interventions was only measured in five studies and only one diet study measured baseline diet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High-quality RCTs of diet and nutrition supplement interventions are needed to progress the understanding of whether they should be integrated into the clinical management of endometriosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hand Grip Strength Index, a Novel Tool in Risk-Assessing Multi-Ethnic End-Stage Kidney Disease Patients Treated by Haemodialysis 握力指数：一种评估多民族终末期肾病血液透析患者风险的新工具

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-17 DOI: 10.1111/jhn.13414

Mai Nguyen, Andrew Davenport

Introduction

Increasing numbers of elderly co-morbid patients with end-stage kidney disease (ESKD) are now offered haemodialysis. Simple, rapid screening tools are required to risk-assess patients, highlighting those requiring nutritional or other support and advising on prognosis. As such, we assessed a newly introduced tool, the hand grip strength index (HGS index), a comparison of measured to predicted HGS.

Methods

We reviewed ESKD dialysis patients dialysing under the care of an inner-city tertiary dialysis centre who had contemporaneous HGS measurements, and body composition measured by multifrequency bioelectrical impedance analysis, followed for ≤ 9 years, censoring for transplantation.

Results

Results from 1023 patients, 63.2% male, 48.2% White and 46.5% diabetic, with a dialysis vintage of 21.2 (7.2–61.0) months, were analysed. Mortality was significantly greater for those in the lowest HGS index quartile using Kaplan–Meier analysis (p < 0.001). On multivariable step-backward Cox regression analysis, mortality was independently significantly associated (p < 0.001) with increasing age (hazard ratio [HR] 1.04 95% confidence interval (CI) [1.029–1.045]), higher co-morbidity score (HR 1.24 [1.142–1.347]) and post-dialysis extracellular water/total body water ratio (HR 1.15 [1.089–1.219]) and lower HGS index (HR −0.76 [0.991–0.998]), whereas sarcopenia and frailty were not retained in the model.

Conclusion

Increasing numbers of elderly co-morbid patients are being treated with dialysis, so simple screening tools are required to advise on prognosis and highlight patients who may need additional support, including nutrition. We found the HGS index to have prognostic value, along with the traditional risk factors of patient age and co-morbidity.

导言：目前，越来越多患有终末期肾病（ESKD）的老年并发症患者接受血液透析治疗。我们需要简单、快速的筛查工具来对患者进行风险评估，突出那些需要营养或其他支持的患者，并对预后提出建议。因此，我们评估了一种新推出的工具--手部握力指数（HGS 指数），这是一种将测量的 HGS 与预测的 HGS 进行比较的工具：我们对在市内一家三级透析中心接受透析治疗的 ESKD 患者进行了回顾性研究，这些患者接受了同期 HGS 测量，并通过多频生物电阻抗分析测量了身体成分，随访时间不超过 9 年，并对移植进行了普查：分析了 1023 名患者的结果，其中 63.2% 为男性，48.2% 为白人，46.5% 为糖尿病患者，透析时间为 21.2（7.2-61.0）个月。通过 Kaplan-Meier 分析，死亡率最低的 HGS 指数四分位数患者的死亡率明显更高（p 结论：透析时间越长，死亡率越高：越来越多的合并疾病的老年患者正在接受透析治疗，因此需要简单的筛查工具来提供预后建议，并突出可能需要额外支持（包括营养）的患者。我们发现，HGS 指数与患者年龄和合并疾病等传统风险因素一样，都具有预后价值。

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引用次数: 0

Prevalence of Emotional and Binge Eating Among Patients With Obesity Attending a Specialist Weight Management Service for Bariatric Surgery in the United Kingdom 在英国接受减肥手术的肥胖症患者中，情绪性进食和暴饮暴食的流行率。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-17 DOI: 10.1111/jhn.13415

Yousef Alhindi, Guy Holt, Katy A. Jones, Najat Khalifa, Waleed Al-Khyatt, Iskandar Idris

Background

Emotional eating (EE) is a tendency to consume food in response to positive or negative emotions, leading to obesity and an increased Body Mass Index (BMI). Evidence supports the positive association between EE and binge eating disorder (BED), but little is known about its prevalence among patients referred for bariatric surgery and the psychological characteristics of this patient population. We aim to examine (i) the prevalence of binge eating and EE, (ii) its association with the prevalence of anxiety, depression, diabetes and hypertension and (iii) the correlation between anxiety and depression with emotional and binge eating behaviours among patients attending a regional bariatric service in the UK.

Method

A cross-sectional case file design involving 285 participants (mean age = 43.88 ± 11.5, female (80.7%) and male (19.3%)) was used. Outcome measures included body weight, BMI, the Weight Loss Readiness (WLR) Questionnaire, Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorders Identification Test- Consumption (AUDIT-C).

Results

Within this patient group, the prevalence of binge eating and EE were 28.8% and 22.1% respectively. Among these, 19.3% had diabetes mellitus, 24.8% hypertension, 21% harmful alcohol use, 65% had high anxiety score and 77% high depression scores. Most correlations between body weight and variables like AUDIT-C, GAD-7, PHQ-9 scores and WLR scores for hunger, binge eating and EE were not significant. A positive association was observed between depression and anxiety with binge eating, and EE behaviours.

Conclusion

Patients awaiting bariatric surgery have a wide range of mental and physical health comorbidities, with evidence of positive associations between higher depression and anxiety levels with abnormal eating behaviours. These findings highlight the need for screening for comorbidities in this patient population to optimise patient outcomes postbariatric surgery.

背景：情绪性进食（情绪性进食）是一种为了应对积极或消极情绪而进食的倾向，会导致肥胖和体重指数（BMI）的增加。有证据支持情感表达与暴食症（BED）之间的正相关，但对其在接受减肥手术的患者中的患病率以及这一患者群体的心理特征知之甚少。我们的目的是研究(i)暴饮暴食和情感表达的流行，（ii）它与焦虑、抑郁、糖尿病和高血压的流行的关联，以及（iii）在英国参加地区减肥服务的患者中，焦虑和抑郁与情绪和暴饮暴食行为之间的相关性。方法：采用横断面病例档案设计，共纳入285例患者（平均年龄43.88±11.5岁，女性占80.7%，男性占19.3%）。结果测量包括体重、BMI、减肥准备（WLR）问卷、广泛性焦虑症-7 （GAD-7）、患者健康问卷（PHQ-9）和酒精使用障碍识别测试-消费（AUDIT-C）。结果：该患者组暴食和情感表达的患病率分别为28.8%和22.1%。其中，19.3%患有糖尿病，24.8%患有高血压，21%有害饮酒，65%有高焦虑评分，77%有高抑郁评分。体重与饥饿、暴饮暴食和情感表达的AUDIT-C、GAD-7、PHQ-9评分和WLR评分等变量之间的相关性不显著。研究发现，抑郁和焦虑与暴饮暴食和情感表达行为之间存在正相关。结论：等待减肥手术的患者有广泛的精神和身体健康合并症，有证据表明，抑郁和焦虑水平较高与异常饮食行为呈正相关。这些发现强调了在这一患者群体中筛查合并症以优化减肥手术后患者预后的必要性。

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引用次数: 0

Development of a perceived nutrition care competencies scale for Japanese dietetic students: A cross-sectional survey 日本学生营养护理能力量表的发展：一项横断面调查。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-16 DOI: 10.1111/jhn.13409

Sayaka Yamamoto, Yuko S. Yoshimoto, Kengo Yoshii, Ryo Shimizu, Ritsuko Ohnishi, Hiroko Takahashi, Takayo Kawakami

Background

There are currently few appropriate instruments for assessing nutrition care competencies in clinical practice. This study aimed to develop a perceived nutrition care competencies (PNCC) scale for dietetic students and test its validity. Factors that influence PNCC scores were examined through a cross-sectional study.

Methodology

This cross-sectional survey involved 501 dietetic students (mean age of 21.4 years, 428 females) and employed a web-based questionnaire between September 2022 and February 2023. A scale derived from previous research was used to assess nutrition management practices and basic dietetic competencies. Questionnaire data were analysed using exploratory factor analysis.

Results

Exploratory factor analysis identified five factors: nutritional status assessment and preparation for intervention, communication skills for nutritional support, nutritional diagnosis and recording, supplementation suggestions and coordination and dietitian orientation and attitude. Multivariate logistic regression analysis showed that field practice increased the ‘nutrition diagnosis and recording’ scores, and the subconcepts ‘nutrition diagnosis and recording’ and ‘suggestion and coordination of nutritional supplementation’ showed odds ratios (ORs) <1 for the ‘online role-play among students’ experience. In addition, experience with face-to-face simulated patients increased the total scores (OR 2.46, 95% confidence interval 1.43–4.22, p = 0.001).

Conclusions

The PNCC scale demonstrated reliability and validity, offering a valuable measure of dietetics students' perceptions of their nutrition care practice competence. The findings highlight the need to increase the willingness of the students to work as dietitians and to incorporate realistic, safe learning experiences beyond on-site practice to enhance nutrition management practice competency.

背景：目前，用于评估临床实践中营养护理能力的适当工具很少。本研究旨在为营养学专业学生开发一个营养护理能力感知量表（PNCC），并测试其有效性。通过横断面研究对影响 PNCC 分数的因素进行了分析：这项横断面调查涉及 501 名营养学专业学生（平均年龄 21.4 岁，女性 428 人），在 2022 年 9 月至 2023 年 2 月期间采用网络问卷调查。调查采用了先前研究的量表来评估营养管理实践和营养学基本能力。问卷数据采用探索性因素分析法进行分析：探索性因子分析确定了五个因子：营养状况评估和干预准备、营养支持的沟通技巧、营养诊断和记录、补充建议和协调以及营养师的定位和态度。多变量逻辑回归分析表明，现场实践提高了 "营养诊断和记录 "的得分，"营养诊断和记录 "和 "营养补充建议和协调 "这两个子概念显示出了几率比（ORs）：PNCC 量表显示了其可靠性和有效性，为测量营养学学生对其营养护理实践能力的看法提供了一个有价值的方法。研究结果突出表明，有必要增强学生作为营养师工作的意愿，并在现场实践之外融入现实、安全的学习体验，以提高营养管理实践能力。

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引用次数: 0

Supporting those experiencing food insecurity: A scoping review of the role of a dietitian 支持那些经历粮食不安全的人：对营养师作用的范围审查。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-15 DOI: 10.1111/jhn.13407

Aashna Kundra, Hiba Batool, Sally G. Moore, Avril Aslett-Bentley, Sharon Noonan-Gunning, Isabel Rice, Jo Smith, Luise V. Marino

Background

Increasing levels of food insecurity in the United Kingdom (UK) suggest an imperative to consider the role of dietitians in supporting people who may have insufficient access to safe and nutritious food.

Objective

To explore the available evidence on the (i) role of a dietitian, (ii) impact of support and (iii) training needs of dietitians to support those with inadequate access to food.

Methods and Design

Scoping review methodology was used to identify qualitative, quantitative and grey literature on the role of dietitians in supporting those with/or at risk of food insecurity. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to report the evidence reviewed for this study. Methods included multiple literature searches, charting of data extracted, and content analysis. The data of interest included the country of study, study methodology, the population of interest, the role of a dietitian, the measures, tools or guidance used and a summary of key findings.

Results

In total, 466 studies were identified, following the removal of duplicate records, 243 records were screened for inclusion; the full text of 95 articles was reviewed for eligibility, and 19 were included in the review. Articles were summarised descriptively using tables and synthesised to identify emerging themes. Overarching themes of dietitians' role included, (i) identification and screening of food insecurity, (ii) facilitating community interventions and (iii) policy development.

Conclusions

Dietitians hold a range of roles to support people at risk of or experiencing food insecurity. However, there are considerable gaps in current training programmes, and a paucity of evidence describing the impact dietitians have on improving nutrition outcomes for those individuals at risk of or experiencing food insecurity.

背景：英国日益严重的食品不安全问题表明，必须考虑营养师在为无法充分获得安全和营养食品的人群提供支持方面的作用：目的：探讨有关以下方面的现有证据：(i) 营养师的作用；(ii) 支持的影响；(iii) 营养师在支持无法获得充足食物者方面的培训需求：方法与设计：采用范围综述法来确定有关营养师在支持食物无保障者和/或面临食物无保障风险者方面的作用的定性、定量和灰色文献。本研究采用了 "系统综述和元分析首选报告项目扩展范围综述"（PRISMA-ScR）来报告所综述的证据。方法包括多种文献检索、数据提取图表和内容分析。相关数据包括研究国家、研究方法、相关人群、营养师的角色、使用的措施、工具或指导以及主要发现的摘要：在删除重复记录后，共确定了 466 项研究，筛选出 243 项可纳入研究；对 95 篇文章的全文进行了资格审查，其中 19 篇被纳入审查范围。我们使用表格对文章进行了描述性总结，并进行了综合，以确定新出现的主题。营养师角色的首要主题包括：(i) 识别和筛查食物不安全；(ii) 促进社区干预；(iii) 政策制定：营养师扮演着一系列角色，为面临粮食不安全风险或正在经历粮食不安全的人们提供支持。然而，目前的培训计划还存在相当大的差距，而且描述营养师对改善面临粮食不安全风险或正在经历粮食不安全的个人的营养结果的影响的证据也很少。

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引用次数: 0

Drivers of consumption of plant-based meat alternatives and their nutritional contributions: A mixed methods approach 植物性肉类替代品消费的驱动因素及其营养贡献：混合方法方法。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-11 DOI: 10.1111/jhn.13403

Deborah Cooper, Joel C. Craddock, Eleanor J. Beck

Background

Plant-based meat alternatives (PBMA) are considered an alternative to animal products. We aimed to understand the patterns and drivers of consumption of PBMA and their nutritional contributions using dietary modelling, whilst also considering the relevance of processing.

Methods

This study used a mixed methods exploratory sequential approach. Semistructured online interviews (n = 19) with consumers and nonconsumers of PBMA were conducted. Thematic analysis of interviews considered drivers of PBMA consumption, with content used to develop personas to represent key concepts driving incorporation (or lack of intake) into dietary patterns. Diets were modelled for personas, based on recommended and typical population intake and with variations in processed foods based on the Nova food classification system, including PBMA. Diets were analysed against nutrient reference values.

Results

The main drivers of PBMA consumption were animal welfare, health improvement and environmental concerns. Convenience, cost, taste, processing and thoughts that the nutritional value of PBMA was lesser than meats were all described. Six personas were identified from the interview content. The three most disparate personas (age, dietary pattern and nutrient requirements) were used for dietary modelling. Nutrient analyses showed diets predominantly meeting reference values, with deficiencies more likely when modelled on food choices typical of population intake and diets excluding processed foods.

Conclusions

This study found that PBMA may have beneficial nutritional qualities such as lower saturated fat and higher dietary fibre when compared to their meat equivalents. PBMA may have a place in a healthy diet, whilst alleviating animal welfare and environmental concerns which were identified as key drivers of consumption.

背景：植物性肉类替代品（PBMA）被认为是动物产品的替代品。我们的目的是利用饮食模型了解PBMA消费的模式和驱动因素及其营养贡献，同时也考虑到加工的相关性。方法：本研究采用混合方法、探索性序贯法。对PBMA的消费者和非消费者进行了半结构化在线访谈（n = 19）。访谈的主题分析被认为是PBMA消费的驱动因素，其内容用于发展人物角色，以代表驱动将（或缺乏摄入）纳入饮食模式的关键概念。根据推荐和典型人群的摄入量，以及根据Nova食品分类系统（包括PBMA）加工食品的变化，对人物饮食进行建模。根据营养参考值对饮食进行分析。结果：PBMA消费的主要驱动因素是动物福利、健康改善和环境问题。便利性，成本，味道，加工以及PBMA的营养价值低于肉类的想法都进行了描述。从访谈内容中确定了六个人物角色。三个最不同的角色（年龄、饮食模式和营养需求）被用于饮食模型。营养分析显示，饮食主要符合参考值，如果以人口摄入的典型食物选择和不包括加工食品的饮食为模型，则更有可能出现不足。结论：本研究发现，与肉类相比，PBMA可能具有有益的营养品质，如较低的饱和脂肪和较高的膳食纤维。PBMA可能在健康饮食中占有一席之地，同时减轻动物福利和环境问题，这些问题被确定为消费的主要驱动因素。

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引用次数: 0

Exclusive or partial breastfeeding and estimated protein intake in infancy: Associations with childhood growth and body composition at 7 years of age in the Odense Child Cohort 婴儿期纯或部分母乳喂养和估计蛋白质摄入量：与欧登塞儿童队列中7岁时儿童生长和身体组成的关系

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-12-05 DOI: 10.1111/jhn.13408

Karina Dyrvig Honoré, Signe Bruun, Kim F. Michaelsen, Sören Möller, Steffen Husby, Lotte Neergaard Jacobsen, Henrik Thybo Christesen, Marianne Skovsager Andersen, Gitte Zachariassen

Background

Protein intake in infancy influences infant growth, body composition, and possibly metabolic programming later in life. Our objectives were to investigate whether macronutrient content in mother's own milk (MOM) differed between exclusive (EBF) or partial breastfeeding (PBF), including an estimation of protein intake (ePI) during the first 6 months of life. Second, to investigate associations of feeding type and ePI with childhood growth and body composition at 7 years.

Methods

In a subset of 150 participants from the Odense Child Cohort, MOM was analysed for macronutrient content using midinfrared transmission spectroscopy. Information on breastfeeding duration was collected through weekly SMS questionnaires and used to calculate ePI. Outcomes were weight-for-age z-scores (WAZ) and height-for-age z-scores (HAZ) from birth to 7 years, and body composition in terms of dual X-ray absorptiometry fat mass, fat-free mass and calculated indexes at 7 years.

Results

The macronutrient content in MOM did not differ between EBF and PBF, but ePI was significantly higher in PBF infants than in EBF infants at 6 months. We found no difference in WAZ or HAZ until 7 years of age according to feeding type, but within the PBF group, ePI was positively associated with 7-year WAZ (β = 0.001; 95% CI 0.000–0.003; p = 0.03) and HAZ (β = 0.002; 0.001–0.003;p = 0.007). ePI was not associated with body composition at 7 years.

Conclusion

Milk macronutrient content and childhood growth did not differ between EBF and PBF during infancy. Estimated protein intake in partially breastfed infants was positively associated with childhood growth, but not body composition, at 7 years of age.

背景：婴儿期的蛋白质摄入影响婴儿的生长、身体组成，并可能影响以后的代谢程序。我们的目的是调查纯母乳喂养（EBF）或部分母乳喂养（PBF）中母乳（MOM）中的常量营养素含量是否存在差异，包括对生命最初6个月蛋白质摄入量（ePI）的估计。其次，研究喂养方式和ePI与儿童生长和7岁时体成分的关系。方法：在来自欧登塞儿童队列的150名参与者中，使用中红外透射光谱分析MOM的宏量营养素含量。通过每周短信问卷收集母乳喂养持续时间信息，并用于计算ePI。结果为出生至7岁的体重年龄z分数（WAZ）和身高年龄z分数（HAZ），以及7岁时双x线吸收测量脂肪质量、无脂质量和计算指数的身体成分。结果：在6个月时，妈妈的常量营养素含量在EBF和PBF之间没有差异，但PBF婴儿的ePI明显高于EBF婴儿。我们发现在7岁之前，不同喂养方式的WAZ和HAZ没有差异，但在PBF组，ePI与7岁WAZ呈正相关(β = 0.001；95% ci 0.000-0.003；p = 0.03)和HAZ (β = 0.002；0.001-0.003;p = 0.007)。7岁时ePI与体成分无关。结论：EBF和PBF在婴儿期的牛奶宏量营养素含量和儿童生长没有差异。部分母乳喂养婴儿的蛋白质摄入量与7岁时的儿童生长呈正相关，但与身体成分无关。

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引用次数: 0