Journal of Human Nutrition and Dietetics最新文献_第6页

Dietary counselling to increase soluble fibre in patients with gynaecological cancers undergoing pelvic radiotherapy: A feasibility study 对接受盆腔放疗的妇科癌症患者进行饮食指导，以增加可溶性纤维：可行性研究。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-25 DOI: 10.1111/jhn.13402

Emilie Croisier, Teresa Brown, Alice Grigg, Philip Chan, Judy Bauer

Background

This study aimed to determine the feasibility of increasing soluble fibre intake via dietary counselling to improve gastrointestinal toxicity and quality of life in patients with gynaecological cancers undergoing pelvic radiotherapy without adverse consequences on radiation treatment (RT) delivery accuracy.

Methods

A single-arm, single-centre intervention feasibility trial included patients with gynaecological cancers undergoing pelvic RT ± chemotherapy at a tertiary hospital. Participants were provided weekly dietary counselling over the duration of their RT (5–6 weeks) to increase soluble fibre intake incrementally each week. Stakeholder surveys were also completed.

Results

In total, 9 of 14 eligible patients participated (55 years old [SD 13.2], diagnosis: cervical [n = 3], endometrial/uterine [n = 5] and vaginal [n = 1]), with the majority categorised as low fibre consumers at baseline (n = 6). On average, soluble fibre intake increased by 150% throughout treatment. There were no adverse events or major adjustments required for RT delivery. There were improving trends in the functional subset identified. Results may be confounded by the sample size resulting from limited eligibility (n = 14) and a high attrition rate (n = 4).

Conclusions

Most participants successfully increased their soluble fibre intake throughout treatment, without significant adverse events noted for RT delivery accuracy. These results provide preliminary data to calculate the sample size required to produce meaningful effect sizes. However, this study highlighted challenges in participant recruitment and retention, with limited organisational support and perceived compatibility.

研究背景本研究旨在确定通过饮食咨询增加可溶性纤维摄入量的可行性，以改善接受盆腔放疗的妇科癌症患者的胃肠道毒性和生活质量，同时不对放射治疗（RT）的准确性造成不利影响：这是一项单臂、单中心干预可行性试验，参与者包括在一家三级医院接受盆腔 RT± 化疗的妇科癌症患者。参与者在接受 RT 治疗期间（5-6 周）每周接受一次饮食咨询，每周逐步增加可溶性纤维的摄入量。同时还完成了利益相关者调查：14 名符合条件的患者中共有 9 人参与（55 岁 [SD 13.2]，诊断：宫颈癌 [n = 3]、子宫内膜/子宫颈癌 [n = 5] 和阴道癌 [n = 1]），其中大多数人在基线时被归类为低纤维摄入者（n = 6）。在整个治疗过程中，可溶性纤维摄入量平均增加了 150%。RT 给药过程中未出现不良反应或重大调整。已确定的功能性子集有改善趋势。结果可能会受到样本量的影响，因为合格人数有限（14 人），且自然减员率较高（4 人）：大多数参与者在整个治疗过程中成功增加了可溶性纤维的摄入量，在 RT 输送准确性方面没有发现明显的不良事件。这些结果为计算产生有意义的效应大小所需的样本量提供了初步数据。不过，这项研究也凸显了在招募和留住参与者方面存在的挑战，即组织支持有限和兼容性问题。

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引用次数: 0

Dietitians' perspectives on key components relevant for successful dietetic treatment of adults with obesity in primary health care: a qualitative study in the Netherlands 营养师对在初级医疗保健中成功为成人肥胖症患者提供营养治疗的关键要素的看法：荷兰的一项定性研究。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-25 DOI: 10.1111/jhn.13387

Annemieke van de Riet, Rebecca S. Otte, Harriët Jager-Wittenaar, Marian A. E. de van der Schueren, Elke Naumann, the Dietetics Building the Future consortium

Background

Dietetic treatment of adults with obesity can result in effective weight loss with health improvements. However, it remains unclear which components of dietetic consultation are key for successful treatment of individual patients. Therefore, the aim of this study is to explore dietitians' perceptions of key components relevant for successful dietetic treatment of adults with obesity in primary health care in the Netherlands.

Methods

In this phenomenological study, semistructured interviews were conducted with 18 dietitians who have experience in treating adults with obesity in primary care. Validation of interview data was performed through two focus group discussions with 14 dietitians. Thematic analysis was used to analyse the data.

Results

Four main themes were identified: (i) building a good relationship; (ii) identifying patient needs; (iii) supporting behaviour change and (iv) providing advice. Dietitians highlighted the relevance of building a good relationship with their patients and emphasised adopting a counselling role alongside their role of educator. They also recommended the use of educational materials, counselling techniques and behaviour change strategies (e.g. goal setting, self-monitoring, addressing barriers) to address specific patient needs, such as health literacy, self-efficacy and motivation.

Conclusions

This study demonstrates that dietitians perceive the ability to build a trusted relationship, in which patient needs are properly explored and addressed, as the key to successful dietetic treatment of adults with obesity. Our findings emphasise the importance of the dietitian's approach in this process and show that patient factors influence the choice of appropriate treatment approaches.

背景：对成人肥胖症患者进行饮食治疗可有效减轻体重，改善健康状况。然而，目前仍不清楚营养咨询的哪些内容是成功治疗个别患者的关键。因此，本研究旨在探讨营养师对荷兰初级卫生保健中成功对肥胖症成人进行营养治疗的关键要素的看法：在这项现象学研究中，我们对 18 名在初级保健中具有肥胖症成人治疗经验的营养师进行了半结构式访谈。通过与 14 名营养师进行两次焦点小组讨论，对访谈数据进行了验证。采用主题分析法对数据进行分析：结果：确定了四大主题：结果：确定了四大主题：(i) 建立良好关系；(ii) 确定患者需求；(iii) 支持行为改变；(iv) 提供建议。营养师强调了与患者建立良好关系的重要性，并强调在扮演教育者角色的同时，还应扮演咨询者的角色。他们还建议使用教育材料、咨询技巧和行为改变策略（如设定目标、自我监控、解决障碍）来满足患者的特定需求，如健康知识、自我效能和动机：这项研究表明，营养师认为，能否建立一种相互信任的关系，并在这种关系中适当探讨和满足患者的需求，是成功为成人肥胖症患者提供营养治疗的关键。我们的研究结果强调了营养师的方法在这一过程中的重要性，并表明患者因素会影响适当治疗方法的选择。

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引用次数: 0

Accuracy of reported energy in food and beverages supplied to hospital patients 为医院病人提供的食品和饮料中能量报告的准确性。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-25 DOI: 10.1111/jhn.13394

Claire E. Chapman, Christopher Irwin, Zane Hopper, Ben Desbrow

Background

Underprovision of food energy within the hospital environment can negatively affect clinical outcomes. Hence, the supply of hospital foods/beverages and the ability to assess their calorie provision is critical. The aim of this study was to directly measure the energy density of foods/beverages supplied to patients by Gold Coast University Hospital (GCUH) foodservice and compare these to caloric values established from nutrition information panels (NIPs) on product packaging.

Methods

Bomb calorimetry was used to determine the gross energy density of 58 food/beverage items (~47% of total menu) using standardised procedures. Food items included those from the general menu, in addition to therapeutic menu items. Equivalence between directly measured values and those derived from NIPs was determined by comparing the measured mean and ±90% confidence interval (CI) against two pre-defined equivalence bounds (i.e., ±10% NIP value [consensus criteria] and ±20% NIP value [United States Food and Drug Administration (US FDA) criteria]). Caloric values from NIPs were considered equivalent to measured values when the 90% CI of the measured values fell within these thresholds.

Results

Overall, 34 (59%) and 19 (33%) items had measured energy density values not equivalent to those from product NIPs according to the consensus and US FDA thresholds, respectively. When employing the US FDA criteria, 12 (21%) items contained a higher calorie density than that established from the label, while seven (12%) items were lower. While non-equivalent items were identified across all therapeutic menus, food labels from items exclusively prepared for the smooth-pureed menu were particularly inaccurate (~60% non-equivalency).

Conclusion

This study found a discrepancy between energy density that was directly measured and that derived from manufacturers' NIPs for many foods and beverages supplied via a hospital foodservice. Given the importance of accurate energy provision for hospitalised patients, this level of inaccuracy is concerning and may warrant a revision of food labelling procedures for items supplied in hospital settings.

背景：医院环境中食物能量供应不足会对临床效果产生负面影响。因此，医院食品/饮料的供应以及评估其热量供应的能力至关重要。本研究的目的是直接测量黄金海岸大学医院（GCUH）餐饮服务部门向患者提供的食品/饮料的能量密度，并将其与产品包装上的营养信息面板（NIP）所确定的热量值进行比较：方法：采用标准化程序，使用炸弹热量计测定 58 种食品/饮料（约占菜单总量的 47%）的总能量密度。食品包括普通菜单上的食品和食疗菜单上的食品。直接测量值和从国家营养指标中得出的值之间的等效性是通过比较测量平均值和±90%置信区间(CI)与两个预先确定的等效界限（即±10%国家营养指标值[共识标准]和±20%国家营养指标值[美国食品和药物管理局(US FDA)标准]）来确定的。当测量值的 90% CI 在这些阈值范围内时，来自 NIP 的热量值被认为等同于测量值：结果：总体而言，根据共识和美国食品及药物管理局的阈值，分别有 34 个（59%）和 19 个（33%）项目的能量密度测量值不等同于产品国家实施计划的测量值。如果采用美国食品及药物管理局的标准，有 12 种（21%）产品的卡路里密度高于标签上的数值，有 7 种（12%）产品的卡路里密度低于标签上的数值。虽然在所有食疗菜单中都发现了不相等的食品，但专门为顺滑纯净菜单准备的食品标签尤其不准确（约 60% 不相等）：本研究发现，对于医院餐饮服务供应的许多食品和饮料，直接测量的能量密度与根据制造商的 NIP 得出的能量密度之间存在差异。鉴于为住院病人提供准确能量的重要性，这种不准确程度令人担忧，可能需要对医院供应食品的标签程序进行修订。

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引用次数: 0

The pivot to online teaching: an opportunity to create effective problem-based learning environments for dietetic education 转向在线教学：为营养学教育创造有效的基于问题的学习环境的机会。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-07 DOI: 10.1111/jhn.13378

Anne Griffin

Background

Dietetics, as an autonomous profession guided by evidence-based practice, requires a dynamic and adaptable workforce to meet evolving challenges in healthcare, public health nutrition and epidemiological research. This study aimed to explore the opportunities presented by the transition to online education of preparing dietetic students for professional demands, particularly, through the lens of problem-based learning (PBL) within the Community of Inquiry (CoI) framework.

Methods

This paper examines the shift from traditional classroom and practice placement education to online and blended learning accelerated by the COVID-19 pandemic. It focuses on the application of PBL, rooted in constructivist theories and the CoI framework, which includes social, cognitive and teaching presences.

Results

PBL encourages active and collaborative learning, aligning with the multifaceted roles of dietetic professionals. The CoI framework guides the development of effective online learning environments, emphasising the importance of social, cognitive and teaching presence.

Conclusion

The transition to online education presents significant opportunities for dietetic education. Careful instructional design and effective teaching strategies are crucial for creating successful online learning environments, as demonstrated through an illustrative case study.

背景：作为以循证实践为指导的自主职业，营养学需要一支充满活力、适应性强的人才队伍，以应对医疗保健、公共卫生营养和流行病学研究领域不断变化的挑战。本研究旨在探讨向在线教育过渡所带来的机遇，特别是通过探究社区（CoI）框架内的基于问题的学习（PBL），帮助营养学学生为专业需求做好准备：本文探讨了因 COVID-19 大流行而加速的从传统课堂和实习教育向在线和混合式学习的转变。方法：本文研究了因 COVID-19 大流行而加速的从传统课堂和实习教育向在线和混合式学习的转变，重点关注 PBL 的应用，它植根于建构主义理论和 CoI 框架，包括社会、认知和教学等方面：结果：PBL 鼓励积极主动的协作学习，符合营养学专业人员的多方面角色。CoI框架为开发有效的在线学习环境提供了指导，强调了社会、认知和教学存在的重要性：向在线教育的过渡为营养学教育带来了重大机遇。精心的教学设计和有效的教学策略对于创建成功的在线学习环境至关重要，这一点可以通过一个案例研究来说明。

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引用次数: 0

Interventions to improve vitamin and mineral inadequacies among children in India: a scoping review 改善印度儿童维生素和矿物质不足的干预措施：范围审查。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-05 DOI: 10.1111/jhn.13384

Edlin Glane Mathias, Kurvatteppa Halemani, Ameeka Shereen Lobo, Latha Thimappa Bhat

Introduction

Vitamin and mineral deficiencies are commonly seen in children, and they affect the physical, mental and cognitive development of a child.

Objective

This study aimed to map interventions to improve vitamin and mineral inadequacies among children in India.

Methods

A review was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) 2018 checklist. Based on the PICO framework, further steps were followed in conducting the review. Studies conducted on children and adolescents (ranging in age from 6 months to 19 years) in India were considered. A search was carried out in PubMed, CINAHL, ProQuest, Cochrane Library, Scopus and Web of Science. Interventions that focused on improving vitamin and mineral inadequacies were collated. Studies published in the English language between 1 January 2012, and 30 September 2023, were included. The data from the included studies were reported narratively.

Results

The search yielded 1566 records through the databases. Finally, 18 studies were found to be eligible to be considered in this review. For improving vitamin and mineral deficiencies, different types of supplements like iron, vitamins A, C and D in different amounts; nutritional supplements like zinc-rich foods, whole-wheat recipes, milk, lipid-based vitamin B12 supplements, ragi, porridge and iron-fortified whole-wheat drinks; or nutritional counselling worked better in children.

Conclusion

Vitamin and mineral supplementation for children reduces anaemia among children. Policymakers need to develop a strategy to increase awareness among parents, AWWs, caregivers and schoolteachers to reduce further complications.

简介儿童普遍缺乏维生素和矿物质，这会影响儿童的身体、智力和认知发展：本研究旨在绘制改善印度儿童维生素和矿物质不足的干预措施图：采用 PRISMA 扩展范围综述（PRISMA-ScR）2018 核对表进行综述。根据 PICO 框架，在进行综述时遵循了进一步的步骤。考虑了针对印度儿童和青少年（年龄在 6 个月至 19 岁之间）的研究。在 PubMed、CINAHL、ProQuest、Cochrane Library、Scopus 和 Web of Science 中进行了检索。整理了以改善维生素和矿物质不足为重点的干预措施。纳入了 2012 年 1 月 1 日至 2023 年 9 月 30 日期间以英语发表的研究。对纳入研究的数据进行了叙述性报告：结果：在数据库中搜索到 1566 条记录。结果：在数据库中搜索到 1566 条记录，最后发现有 18 项研究符合本综述的审议条件。为改善维生素和矿物质缺乏症，不同类型的补充剂，如不同含量的铁、维生素A、C和D；营养补充剂，如富含锌的食物、全麦食谱、牛奶、基于脂质的维生素B12补充剂、拉格米、粥和铁强化全麦饮料；或营养咨询对儿童的效果更好：结论：为儿童补充维生素和矿物质可减少儿童贫血。政策制定者需要制定一项战略，以提高家长、助产士、护理人员和学校教师的认识，从而减少进一步的并发症。

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引用次数: 0

Management of inoperable malignant bowel obstruction using the 4-step BOUNCED diet 使用 BOUNCED 四步饮食法治疗无法手术的恶性肠梗阻。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-05 DOI: 10.1111/jhn.13388

Lindsey Allan, Naomi Hatchett, Simon S. Skene, Kate Bennett Eastley, Agnieszka Michael

Background

Malignant bowel obstruction (MBO) presents with multiple symptoms. The 4-step BOUNCED diet educates patients to self-manage oral intake according to symptoms. It includes clear fluids, thin liquids, purée and soft, sloppy foods, which are low in fibre.

Methods

This mixed methods single-arm feasibility study aimed to establish if the diet could reduce MBO symptoms in patients with inoperable colorectal and gynaecological malignancies. The secondary objectives were to investigate if it was easily followed, improved quality of life (QOL) and reduced hospital admissions. Patients able to tolerate an oral diet with one or more symptoms (pain, bloating, early satiety, nausea and vomiting) were eligible. Following informed consent, an oncology dietitian took a diet history and determined which step of the diet they needed to follow using a detailed patient information leaflet. Patients remained on the trial for 28 days. Symptom and QOL data were collected on Days 1 and 28 using the Memorial Symptom Assessment Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) questionnaires.

Results

Thirty patients (24 female, 6 male) aged 18–85 years consented from March 2021 to November 2022. Twenty-six participants completed the trial and 25 found the diet very easy or easy to understand. There was a significant reduction in pain from 96% on Day 1 to 63% on Day 28 (p = 0.004). The mean increase of EORTC global health status/QOL was 23.5 points, 95% CI (12.4–32.5) (p ≤ 0.001). There was a significant difference between number of admissions (p = 0.018) and bed days (p = 0.004) in the 28 days prior to consent compared to the trial period.

Conclusions

A modified consistency low-fibre diet is easily followed, may reduce symptoms of MBO, admissions to hospital and improve QOL.

背景：恶性肠梗阻 (MBO) 表现出多种症状。四步 BOUNCED 饮食法教育患者根据症状自我管理口腔摄入量。它包括清流质、稀流质、泥浆和软烂的低纤维食物：这项混合方法的单臂可行性研究旨在确定该饮食能否减轻无法手术的结直肠癌和妇科恶性肿瘤患者的 MBO 症状。次要目标是调查该饮食是否易于遵循、是否能改善生活质量（QOL）以及是否能减少入院次数。能够耐受口服饮食但有一种或多种症状（疼痛、腹胀、早饱、恶心和呕吐）的患者符合条件。在获得知情同意后，肿瘤营养师会询问患者的饮食史，并通过详细的患者信息宣传单确定患者需要遵循的饮食步骤。患者的试验期为 28 天。第1天和第28天使用纪念症状评估量表和欧洲癌症研究和治疗组织生活质量问卷（EORTC-QQLQ-C30）收集症状和生活质量数据：2021年3月至2022年11月，30名年龄在18-85岁之间的患者（24名女性，6名男性）同意接受治疗。26 名参与者完成了试验，25 名参与者认为饮食非常简单或容易理解。疼痛明显减轻，从第 1 天的 96% 降至第 28 天的 63%（p = 0.004）。EORTC 全球健康状况/QOL 的平均值增加了 23.5 分，95% CI (12.4-32.5) (p ≤ 0.001)。与试验期间相比，同意试验前28天的入院人数（p = 0.018）和住院天数（p = 0.004）有明显差异：结论：改良的低纤维膳食容易坚持，可减轻 MBO 症状、减少入院次数并改善 QOL。

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引用次数: 0

Dietary assessments in individuals living with coeliac disease: key considerations 乳糜泻患者的饮食评估：关键注意事项。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-05 DOI: 10.1111/jhn.13380

Anne R. Lee, Melinda Dennis, Jessica Lebovits, Lori Welstead, Ritu Verma, Amelie Therrien, Benjamin Lebwohl

Background

Coeliac disease (CeD) is a type of enteropathy characterised by an immune-mediated reaction to ingested gluten, resulting in impaired absorption of nutrients and symptoms such as bloating, abdominal cramping and diarrhoea. Currently, the only treatment for CeD is adherence to a gluten-free diet (GFD). The latest draft guidance from the US Food and Drug Administration recommends that dietitians experienced in CeD management evaluate patients during the screening and treatment period of CeD clinical trials to assess adherence to a GFD. However, there are currently no standardised guidelines on dietary assessment of patients with CeD on a GFD and there is a lack of widespread availability of expertise in this field.

Methods

Based on the findings of a literature review conducted between April and September 2023, this article provides an overview of key points to consider in the nutritional and dietary assessment of patients with CeD who are following a GFD, with particular focus on the clinical trial setting.

Results

Based on a consensus from dietitians and gastroenterologists experienced in treating patients with CeD, we present specific recommendations for registered dietitians who manage patients with CeD. We also describe the development of a simplified tool for assessment of adherence to a GFD, the Gluten-Free Adherence Survey, based on these recommendations.

Conclusions

These guidelines cover nutritional and dietary assessment of patients with CeD, physical assessments, intake of oats, environmental considerations and the disease burden.

背景：乳糜泻（Celiac disease，CeD）是一种肠道疾病，其特点是对摄入的麸质产生免疫介导反应，导致营养吸收受损，并出现腹胀、腹部绞痛和腹泻等症状。目前，治疗 CeD 的唯一方法是坚持无麸质饮食 (GFD)。美国食品和药物管理局（US Food and Drug Administration）的最新指南草案建议，在 CeD 临床试验的筛查和治疗期间，由有 CeD 管理经验的营养师对患者进行评估，以评估患者对无麸质饮食的依从性。然而，目前还没有关于CeD患者使用全食物营养素进行饮食评估的标准化指南，而且这一领域的专业知识也不普及：本文基于 2023 年 4 月至 9 月期间进行的文献综述结果，概述了对采用 GFD 的 CeD 患者进行营养和饮食评估时应考虑的要点，尤其侧重于临床试验环境：根据营养师和在治疗 CeD 患者方面经验丰富的肠胃病专家达成的共识，我们为管理 CeD 患者的注册营养师提出了具体建议。我们还介绍了在这些建议的基础上开发的用于评估无麸质饮食依从性的简化工具--无麸质饮食依从性调查：这些指南涵盖了 CeD 患者的营养和饮食评估、身体评估、燕麦摄入量、环境因素和疾病负担。

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引用次数: 0

A service evaluation of FODMAP restriction, FODMAP reintroduction and long-term follow-up in the dietary management of irritable bowel syndrome 对肠易激综合征饮食管理中限制 FODMAP、重新引入 FODMAP 和长期随访的服务评估。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-05 DOI: 10.1111/jhn.13393

Rosie Foulkes, Paru Shah, Alice Twomey, Lara Dami, Danielle Jones, Miranda C. E. Lomer

Background

The dietary restriction of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), called the low-FODMAP diet (LFD), is frequently used to manage irritable bowel syndrome (IBS). This service evaluation aimed to assess the long-term effectiveness of the LFD in managing IBS symptoms and whether symptom response and dietary adherence to the LFD were associated.

Methods

This observational service evaluation collected data via questionnaires during clinical dietetic appointments for IBS management. Symptom severity was reported at baseline, short term (following FODMAP restriction) and long term (following FODMAP reintroduction). Additional data that captured experiences following the LFD were collected at long-term follow-up.

Results

Of 184 patients, 14% reported satisfactory relief from global symptoms at baseline, which increased to 69% at short-term follow-up and 57% at long-term follow-up (p < 0.001). The most notable improvements in individual symptoms between baseline and long-term follow-up were abdominal bloating (72% baseline, 48% long term, p < 0.001), abdominal pain (61% baseline, 30% long term, p < 0.001) and flatulence (71% baseline, 40% long term, p < 0.001). High adherence with the LFD at short-term follow-up was not associated with long-term symptom improvement, but there was an association between long-term adherence and global symptom severity (p = 0.032). Completion of FODMAP reintroduction as per protocol was associated with long-term symptom improvement (p = 0.049).

Conclusions

The LFD is an effective treatment for managing IBS symptoms in the long term, particularly, when the diet is adhered to and reintroduction is completed as per dietetic education. Further randomised-controlled trials are required to explore the cause-and-effect relationship between LFD and IBS symptom management.

背景：饮食中限制可发酵低聚糖、双糖、单糖和多元醇（FODMAPs），即低FODMAP饮食（LFD），常用于控制肠易激综合征（IBS）。这项服务评估旨在评估低FODMAP饮食在控制肠易激综合征症状方面的长期有效性，以及症状反应与坚持低FODMAP饮食是否相关：方法：这项观察性服务评估通过问卷调查的形式收集了肠易激综合征临床饮食治疗预约期间的数据。报告了基线、短期（限制 FODMAP 后）和长期（重新引入 FODMAP 后）的症状严重程度。在长期随访中还收集了其他数据，这些数据反映了患者在接受低脂饮食治疗后的体验：结果：在 184 名患者中，14% 的患者在基线时报告总体症状得到了满意的缓解，而在短期随访和长期随访时，这一比例分别上升到 69% 和 57% （p 结论：LFD 是一种有效的治疗方法：长期来看，低脂低糖饮食是控制肠易激综合征症状的有效治疗方法，尤其是在坚持饮食并按照营养学教育完成再摄入的情况下。需要进一步开展随机对照试验，探讨低脂低糖饮食与肠易激综合征症状控制之间的因果关系。

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引用次数: 0

A cross-sectional survey exploring knowledge, beliefs and barriers to whole food plant-based diets amongst registered dietitians in the United Kingdom and Ireland 一项横断面调查，探讨英国和爱尔兰注册营养师对全食物植物性饮食的认识、信念和障碍。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-11-03 DOI: 10.1111/jhn.13386

Michael Metoudi, Alexander Bauer, Tanya Haffner, Shireen Kassam

Background

Plant-based diets (PBDs) have gained popularity in recent years due to their co-benefits for human and planetary health. Although clinical guidelines now recommend well-balanced PBDs, it remains unclear how dietitians in the United Kingdom (UK) and Republic of Ireland (ROI) view such diets and their implementation in practice. This study aimed to evaluate the perspectives of registered dietitians (RDs) on the role of a whole food plant-based diet (WFPBD) in clinical practice.

Methods

A cross-sectional online survey was conducted amongst RDs in the UK and ROI between September and November 2023.

Results

A total of 335 RDs participated in the survey. Most RDs (76%) agree that a well-planned WFPBD is suitable for all stages of life, with some (48%) expressing concerns over the risk of malnutrition and micronutrient deficiencies. Three-quarters of RDs (75%) incorrectly thought that plant protein is incomplete, necessitating protein combining. A WFPBD was on average ranked fourth out of 14 dietary strategies for managing some of the leading non-communicable diseases. Excluding dairy and eggs was the primary reason preventing RDs from personally adopting a WFPBD, whereas meal preparation and cost were the main barriers for their clients. The majority of RDs (79%) feel they did not receive sufficient education on WFPBDs, with 58% agreeing there are insufficient evidence-based resources available in their field. Only 33% feel supported when advocating for a WFPBD in their workplace.

Conclusions

Although many RDs view WFPBDs as viable and clinically relevant, significant barriers to their implementation exist, underscoring the need for enhanced education and support.

背景：植物性膳食（PBDs）因其对人类和地球健康的共同益处而在近几年大受欢迎。尽管目前临床指南推荐均衡的植物性膳食，但仍不清楚英国和爱尔兰共和国的营养师如何看待植物性膳食及其在实践中的实施。本研究旨在评估注册营养师（RDs）对全食物植物性饮食（WFPBD）在临床实践中的作用的看法：方法：2023 年 9 月至 11 月期间，对英国和爱尔兰共和国的注册营养师进行了一次横断面在线调查：共有 335 名研究与发展人员参与了调查。大多数营养师（76%）都认为计划周密的WFPBD适合生命的各个阶段，但也有一些营养师（48%）对营养不良和微量营养素缺乏的风险表示担忧。四分之三的营养学家（75%）错误地认为植物蛋白是不完全的，因此需要搭配蛋白质。在管理一些主要非传染性疾病的 14 种膳食策略中，WFPBD 平均排名第四。排除乳制品和蛋类是阻碍营养师个人采用 WFPBD 的主要原因，而膳食准备和成本则是客户的主要障碍。大多数营养师（79%）认为他们没有接受过足够的全食物营养促进生物发展的教育，58%的营养师认为在他们的领域没有足够的循证资源。只有 33% 的人认为他们在工作场所倡导世界家庭护理方案时得到了支持：结论：尽管许多研发人员认为全食物链促进生物多样性是可行的，而且与临床相关，但在实施过程中仍存在重大障碍，因此需要加强教育和支持。

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引用次数: 0

Knowledge, practices and perceptions of energy labelling of nut products among Australian consumers and stakeholders: an online survey 澳大利亚消费者和利益相关者对坚果产品能源标签的了解、做法和看法：在线调查。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-10-29 DOI: 10.1111/jhn.13379

Cassandra J. Nikodijevic, Yasmine C. Probst, Sze-Yen Tan, Elizabeth P. Neale

Background

Nut consumption in Australia is low, perhaps due to concerns with weight gain. However, nut consumption is not associated with increased weight, in part because of their lower metabolisable energy. Current energy labelling for nuts use Atwater factors, which over-represent the available energy from nuts. Therefore, this research aimed to examine stakeholders' knowledge, practices and perceptions of displaying true metabolisable energy on nutrition labels and its perceived impact on nut consumption.

Methods

An anonymous and voluntary survey was conducted online. Eligible respondents lived in Australia, were aged 18 years or older and had either no formal nutrition education (consumer group) or had formal training and were working as a stakeholder (stakeholder group; working in nutrition/dietetics, public health, food industry, food regulation or nut growing). Convenience sampling and snowballing were used to recruit respondents primarily via online advertisement.

Results

Three hundred and forty-eight respondents (63.2% female; 71.0% aged 18–39 years; 69.0% Bachelor's degree or higher) were included in the analyses. A larger proportion of stakeholders agreed that nut consumption assists with weight management (67.9%) compared with consumers (47.6%). Theoretical food packaging showing both Atwater and metabolisable energy in the nutrition information panel was favoured among consumers and stakeholders, though 62.3% of consumers reported that a lower metabolisable energy of nuts would not impact their consumption.

Conclusions

This study indicates a need to further investigate the impact of metabolisable energy labelling on nut intake. Further education about the relationship between nuts and body weight is required for consumers and stakeholders.

背景：在澳大利亚，坚果的消费量很低，这可能是因为人们担心体重增加。然而，坚果消费与体重增加并无关联，部分原因是坚果的可代谢能量较低。目前坚果的能量标签使用的是阿特沃特系数，该系数过高地反映了坚果的可用能量。因此，本研究旨在考察利益相关者对营养标签上显示真实可代谢能量的了解、做法和看法，以及其对坚果消费的影响：方法：在网上进行匿名自愿调查。符合条件的受访者居住在澳大利亚，年龄在 18 岁或以上，没有接受过正规营养教育（消费者群体），或接受过正规培训并作为利益相关者工作（利益相关者群体；从事营养学/饮食学、公共卫生、食品工业、食品监管或坚果种植工作）。主要通过网络广告采用便利抽样和滚雪球的方式招募受访者：348 名受访者（63.2% 为女性；71.0% 年龄在 18-39 岁之间；69.0% 具有学士或以上学位）参与了分析。与消费者（47.6%）相比，更多的利益相关者（67.9%）同意食用坚果有助于体重管理。尽管 62.3% 的消费者表示坚果的代谢能较低不会影响他们的消费，但消费者和利益相关者都倾向于在营养信息面板上显示 Atwater 和代谢能的理论食品包装：这项研究表明，有必要进一步调查可代谢能量标签对坚果摄入量的影响。需要对消费者和利益相关者开展有关坚果与体重之间关系的进一步教育。

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引用次数: 0