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On our radar: Nutrition

Eating at restaurants linked to higher calories, poorer nutrition

For adults, eating at both fast-food and full-service restaurants is associated with significant increases in the intake of calories, sugar, saturated fat and sodium, according to a new study.

The study, which appeared online in Public Health Nutrition, found on days when adults ate at restaurants they consumed about 200 additional total daily calories — whether they ate at fast-food restaurants or at full-service restaurants, according to a news release about the study on the American Cancer Society website.

Previous studies looking at restaurant food consumption have found adults who reported eating fast food consumed more calories, fat and sodium, as well as fewer fruits, vegetables and vitamins compared with those who did not report eating fast food.

Previous studies also have linked meals consumed at both fast-food and full-service restaurants with higher caloric intake.

Binh T. Nguyen, PhD, of the American Cancer Society and Lisa M. Powell, PhD, of the University of Illinois at Chicago used more recent data from more than 12,000 respondents between the ages of 20 and 64 taking part in the National Health and Nutrition Examination Survey 2003-2010 for the study.

Participants in the study were asked by researchers about visits to fast-food and full-service restaurants on two successive days.

The study found on days when eating at a fast-food restaurant, there was a net increase of total energy intake (194.49 kcal), saturated fat (3.48 g), sugar (3.95 g) and sodium (296.38 mg). Eating at a full-service restaurant also was associated with an energy intake (205.21 kcal), and with higher intake of saturated fat (2.52 g) and sodium (451.06 mg), according to the release.

The study found individual characteristics moderated the impact of restaurant food consumption, with adverse impacts on net energy intake being larger for black adults compared with their white and Hispanic counterparts and greater for middle-income than high-income adults, according to the release.

“The United States is one of the most obese nations in the world, with more than one in three adult men and women defined as obese,” Nguyen said in the release. “Just as obesity rates rise, there’s been a marked increase in total energy consumption consumed away from home, with about one in four calories coming from fast-food or full-service restaurants in 2007–2008. Our study confirms that adults’ fast-food and full-service restaurant consumption was associated with higher daily total energy intake and poorer dietary indicators.”

The researchers say efforts to improve diet and reduce energy intake from restaurant sources could help reduce racial and socioeconomic disparities in U.S. diets, according to the release.

New hospital screening tool helps find children at nutritional risk easier, study finds

A new screening tool developed in Australia to better detect nutritional issues in pediatric inpatients would allow providers to develop intervention and treatment plans to improve health outcomes, according to a new study.

Pediatric inpatients with poor nutrition are at greater risk for problems with their immune systems, physical and cognitive development and clinical outcomes, according to a news release about the study, which was published online in the Journal of Parenteral and Enteral Nutrition, the research journal of the American Society for Parenteral and Enteral Nutrition.

A four-question survey was found to be very effective at finding nutrition issues in pediatric patients, according to the release. The Pediatric Nutrition Screening Tool, tested in three hospitals in Australia, was found to be more effective than the existing pediatric Subjective Global Nutrition Assessment. The PNST identified 37.6% of patients as being at nutritional risk, whereas the pediatric SGNA identified 34.2%. The PNSA also was effective at finding patients with low body mass index, according to the release.

However, neither screening tool was highly effective at detecting patients whose growth was stunted due to malnutrition or patients who were overweight.

The PNST has the further advantage of being easier to administer than the SGNA or other screening tools. With only four questions and no requirements for further personnel training, the PNST can be administered quickly and simply upon patient admission, according to the release.

While the PNST showed promise in the study, the researchers suggest further study is needed to independently validate it and refine it for more effective use.

Soy-rich diet might improve heart health in postmenopausal women

A diet rich in soy may help reduce heart health risk in postmenopausal women, according to a new study published online in Menopause, the journal of the North American Menopause Society.

Researchers at Wake Forest University School of Medicine in Winston-Salem, N.C., reached those conclusions based on their feeding study of cynomolgus monkeys before and after surgical menopause, according to a news release. They fed premenopausal monkeys a diet with protein derived mainly from animal sources or a diet with protein from high-isoflavone soybeans. After having their ovaries removed, mimicking human menopause, one group of monkeys continued to eat a soy diet, another switched from animal protein to soy, a third group stuck with animal protein, and a fourth switched from animal protein to soy, according to the release.

After 34 months, cholesterol levels were good in the monkeys who ate soy before and after menopause, and for those that switched to a soy protein diet after menopause, cholesterol levels improved significantly (with lower total LDL, and VLDL and higher HDL), according to the release.

As far as the total amount of atherosclerosis was concerned, monkeys eating a lifelong soy diet showed a much lower proportion of complicated plaque in the arteries than the other monkeys. For those that had small plaques in the arteries at the time of menopause, the switch to soy after menopause markedly reduced the progression of plaque in the arteries, according to the release.

The findings were similar to those from the Women’s Isoflavone Soy Health clinical trial on atherosclerosis in women after menopause. The animal study modeled the effects a soy diet or soy supplements may have on women’s diets and heart health before menopause or very early after menopause, when artery plaques still may be small, according to the release.

“This study underscores how important it is for women to get into the best cardiovascular shape they can before menopause,” Margery Gass, MD, executive director of the North American Menopause Society, said in the release. “The healthy habits they start then will carry them through the years to come.”

Malnutrition can put patients at risk, review finds

Varying practices and frequent lapses in nutrition delivery can put critically ill patients at greater risk for malnutrition and associated complications, according to an article in the August issue of Critical Care Nurse.

“Interruptions in Enteral Nutrition Delivery in Critically Ill Patients and Recommendations for Clinical Practice,” by Melissa L. Stewart, RN, DNP, MSN, CCNS, CCRN, a staff nurse in the medical ICU at the University of Kentucky Chandler Medical Center in Lexington, offers strategies to address underfeeding and decrease the time patients spend without nutrition, according to a news release.

“Critical care nurses spend more time at the bedside than other healthcare providers and are well positioned to monitor nutrition delivery,” Stewart said in the release. “Malnutrition is common in critically ill patients and the use of a nutrition support protocol can help improve patients’ outcomes.”

Stewart reviewed the latest research related to enteral nutrition, also known as tube feeding, which is the feeding method of choice for critically ill adult patients. Enteral nutrition often is interrupted because of positioning during procedures, technical issues with feeding accesses and gastrointestinal intolerance issues, which may lead to underfeeding.

Deteriorating nutritional status while hospitalized is strongly associated with prolonged length of stay, increased cost of hospitalization and higher mortality, according to the release. The article encourages the development and use of nutrition support protocols to offer guidance to bedside nurses when addressing common issues related to enteral nutrition such as the initiation of feedings and feeding intolerance as well as advancement and discontinuation of enteral nutrition.

Protocols are effective in increasing the amount of nutrients provided to critically ill patients and decreasing the amount of time necessary to reach target nutrition goals, according to the release.

The article encourages nurses to work with other members of the multidisciplinary team to develop and implement interventions to prevent and treat malnutrition including efforts to limit the amount of time nutrition delivery is interrupted because of procedures, according to the release.

Study: Eating 5 portions of fruits, vegetables may reduce early mortality risk

Eating five portions of fruits and vegetables daily may be enough to lower the risk of early death, particularly from cardiovascular disease, according to a new study.

The study, published in the British Medical Journal July 29, examined the potential relationship between fruit and vegetable consumption and risk of death from all causes, including cardiovascular disease and cancer.

Researchers from China and the U.S. analyzed the results of 16 different studies involving 833,234 participants and 56,423 deaths from cancer, cardiovascular deaths and other causes.

The study found each additional daily serving of fruits and vegetables decreased the risk of death from all causes by 5%.

“Our study also showed that higher consumption of fruit and vegetables was associated with lower risk of mortality from cardiovascular disease, but not cancer,” the researchers wrote.

In terms of total mortality reduction, the study also found a threshold of about five servings a day of vegetables and fruits after which the risk of death did not reduce further.

Those findings seemed to conflict with another recent study published in BMJ’s Journal of Epidemiology and Public Health, which suggested seven or more daily servings of fruits and vegetables were linked to lower risk of death.

Volume-based tube feeding may improve nutrition in ICU patients

Changing to a volume-based system of tube feeding can improve nutrition and reduce the risk of underfeeding for ICU patients, according to a new study. While enteral nutrition, or feeding patients through a tube, is common among ICU units, underfeeding still can be a problem.

Common practice is for patients to receive a certain amount of feeding per hour, but feeding often can be interrupted by tests, procedures or emergencies. Researchers from Barnes-Jewish Hospital in St. Louis, Rutgers University in Newark, N.J., and Washington University School of Medicine in St. Louis studied whether a system of volume-based feeding, which calls for patients to receive a certain nutritional volume per day, had an effect on the adequacy of enteral nutrition delivery and the amount of calories and protein in ICU patients.

Findings in the study were published in the journal Nutrition in Clinical Practice. Mechanically ventiliated patients in a St. Louis-based surgical trauma ICU hospital unit were studied using the standard EN feeding practice and a volume-based system called the FEED ME (Feed Early Enteral Diet adequately for Maximum Effect) protocol, and results of both patient pools were compared.

Researchers found the FEED ME protocol significantly increased the proportion of EN volume and calories delivered to patients, and also resulted in increased protein and body weight.

“A change in standard of practice to an EN volume-based feeding approach in a STICU led to a significant improvement in adequacy of calories and protein delivered, with only a slight increase in diarrhea,” the authors wrote.

Nutrition counseling can reduce diabetes risk

Nutrition counseling provided by a registered dietitian nutritionist can reduce the risk of diabetes and its related health problems through lifestyle and dietary changes, according to the Academy of Nutrition and Dietetics.

“Health professionals are in agreement that nutrition services are one of the first treatments individuals should receive to improve conditions such as diabetes and its related complications,” registered dietitian nutritionist and academy spokeswoman Angela Ginn said in a news release on the academy’s website.

The academy cited the findings of a study by researchers from the Centers for Disease Control and Prevention and published in the Aug. 13 issue of The Lancet Diabetes & Endocrinology, which found about 40% of Americans will develop type 2 diabetes in their lifetime.

“Research has shown that weight loss through moderate diet changes and physical activity plays a significant role in reducing a person’s risk of diabetes and its complications such as heart disease, stroke, kidney disease, blindness, nerve damage and other health problems,” Ginn, who is also a certified diabetes educator, said in the release. “For those who have been diagnosed with diabetes, an RDN can create an eating plan tailored just for you, taking into account your weight, medicines, lifestyle and other health problems you might have. The expert advice of an RDN can help you manage your diabetes while ensuring you get the nutrients your body needs.”

RDNs often work as part of a medical team in many practice settings, such as hospitals, physician offices, private practice and other healthcare facilities. Medical nutrition therapy provided by an RDN is covered by insurance plans including Medicare Part B, according to the release.

Genetics might affect obesity risk from eating fried foods

People with a genetic predisposition to obesity are at a higher risk for weight gain and obesity-related chronic diseases from eating fried foods than those with a lower genetic risk, according to a recent study from researchers from Harvard School of Public Health, Brigham and Women’s Hospital and Harvard Medical School, all in Boston.

Published online in the British Medical Journal, the study is the first of its kind to show the adverse effects of fried foods may vary depending on the genetic makeup of the individual, according to a news release.

“Our study shows that a higher genetic risk of obesity may amplify the adverse effects of fried food consumption on body weight, and high intakes of fried food also may exacerbate the deleterious genetic effects,” Lu Qi, PhD, MD, lead author and assistant professor in the department of nutrition at HSPH and Brigham and Women’s Hospital and Harvard Medical School, said in the release.

Researchers analyzed data from 9,623 women in the Nurses’ Health Study, 6,379 men in the Health Professionals Follow-up Study, and 21,426 women in the Women’s Genome Health Study. Participants filled out food frequency questionnaires that asked how often they ate fried foods both at home and away from home.

Body mass index and lifestyle factors, such as physical activity, were assessed and genetic risk scores were calculated based on genetic variants associated with BMI, according to the release.

The results showed that regular consumption of fried foods was associated with higher BMI, after taking into account other dietary and lifestyle factors. The study also showed the association between overconsumption of fried foods and obesity was particularly pronounced among people with a greater genetic predisposition to obesity. However, the genetic effect on BMI among those who ate fried foods more than four times a week was about twice as large compared with those who ate them less than once a week.

“Our findings indicate that genetic risk of obesity could be mitigated by simply changing an eating habit,” Frank Hu, PhD, MPH, MD, co-author and professor of nutrition and epidemiology at HSPH, said in the release. “From a public health point of view, everyone should be encouraged to adopt healthy eating habits, not just those who are genetically susceptible.”

Study: High-salt diets double risk of CVD for people with diabetes

People with Type 2 diabetes who eat a diet high in salt face twice the risk of developing cardiovascular disease as those who consume less sodium, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

An estimated 29.1 million Americans have some form of diabetes, according to the U.S. Centers for Disease Control and Prevention.

Between 2003 and 2006, cardiovascular disease death rates were about 1.7 times higher among adults diagnosed with diabetes than those who were not, according to the CDC’s 2014 National Diabetes Statistics Report.

“The study’s findings provide clear scientific evidence supporting low-sodium diets to reduce the rate of heart disease among people with diabetes,” the study’s first author, Chika Horikawa, MSc, RD, CDE, of the University of Niigata Prefecture in Niigata, Japan, said in a news release.

The nationwide cohort study surveyed participants in the Japan Diabetes Complications Study who were between 40 and 70 and had been diagnosed with diabetes. Participants were identified at 59 outpatient centers and universities across Japan. In all, 1,588 people responded to a survey about their diets, including sodium intake. •

The researchers reviewed data on cardiovascular complications participants experienced over the course of eight years, according to the release.

Researchers divided the participants into four groups based on their sodium intake. The analysis found people who ate an average of 5.9 grams of sodium daily had double the risk of developing cardiovascular disease than those who ate 2.8 grams of sodium daily on average. The effects of a high-sodium diet were exacerbated by poor blood sugar control.

“To reduce the risk of developing cardiovascular disease, it is important for people who have Type 2 diabetes to improve their blood sugar control as well as watch their diet,” Horikawa said in the release. “Our findings demonstrate that restricting salt in the diet could help prevent dangerous complications from diabetes.”

By | 2014-09-29T00:00:00-04:00 September 29th, 2014|Categories: National|0 Comments

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