Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 38
Filter
1.
J Am Coll Health ; : 1-40, 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38870038

ABSTRACT

OBJECTIVE: This scoping review explores the broad body of peer-reviewed research measuring food insecurity in post-secondary students in the U.S. to identify trends and gaps to inform future research. METHODS: Three search engines (PubMed, Web of Science, and CINHAL Full Text) were systematically searched for articles reporting on food security status in U.S. college students. RESULTS: One-hundred and sixty studies met inclusion criteria. Emerging high-risk student characteristics include gender non-conforming (GNC) and non-binary, financial independence in college, and pregnant and parenting students. Emerging correlates include lack of transportation, anxiety, and eating disorders. CONCLUSIONS: Prevalence data can be used by colleges to advocate for services and programs. Additional multi-institutional cohort, longitudinal and qualitative studies are needed to identify timely interventions and effective solutions. A new "rights-based" approach to food security solutions that includes nutrition and food literacy for all students is needed.

3.
Geroscience ; 45(5): 2819-2834, 2023 10.
Article in English | MEDLINE | ID: mdl-37213047

ABSTRACT

The prevalence of age-related cognitive disorders/dementia is increasing, and effective prevention and treatment interventions are lacking due to an incomplete understanding of aging neuropathophysiology. Emerging evidence suggests that abnormalities in gut microbiome are linked with age-related cognitive decline and getting acceptance as one of the pillars of the Geroscience hypothesis. However, the potential clinical importance of gut microbiome abnormalities in predicting the risk of cognitive decline in older adults is unclear. Till now the majority of clinical studies were done using 16S rRNA sequencing which only accounts for analyzing bacterial abundance, while lacking an understanding of other crucial microbial kingdoms, such as viruses, fungi, archaea, and the functional profiling of the microbiome community. Utilizing data and samples of older adults with mild cognitive impairment (MCI; n = 23) and cognitively healthy controls (n = 25). Our whole-genome metagenomic sequencing revealed that the gut of older adults with MCI harbors a less diverse microbiome with a specific increase in total viruses and a decrease in bacterial abundance compared with controls. The virome, bacteriome, and microbial metabolic signatures were significantly distinct in subjects with MCI versus controls. Selected bacteriome signatures show high predictive potential of cognitive dysfunction than virome signatures while combining virome and metabolic signatures with bacteriome boosts the prediction power. Altogether, the results from our pilot study indicate that trans-kingdom microbiome signatures are significantly distinct in MCI gut compared with controls and may have utility for predicting the risk of developing cognitive decline and dementia- debilitating public health problems in older adults.


Subject(s)
Cognitive Dysfunction , Dementia , Microbiota , Humans , Aged , RNA, Ribosomal, 16S/genetics , Pilot Projects , Microbiota/genetics , Bacteria/genetics
4.
Nutr Health ; : 2601060231170248, 2023 Apr 26.
Article in English | MEDLINE | ID: mdl-37101378

ABSTRACT

BACKGROUND: Multidimensional determinants influence negative nutrition coping strategies and tradeoffs in households accessing food relief. AIMS: This study examined coping strategies and tradeoffs at different levels of food insecurity from individuals accessing food relief and how these behaviors relate to experience-based food insecurity dimensions and subpopulations at risk. METHODS: A secondary analysis of cross-sectional data from the Sunshine State Hunger Survey (SSHS) was conducted. The SSHS was a paper-based, 48-question survey, including questions about coping strategies and tradeoffs, use of food assistance programs, and food security. RESULTS: Out of 616 respondents who completed the survey, 73.9% identified as food insecure while 19.1%, as food secure. The average age of participants was 59.6 years and 62.6% were female. One-way analysis of variance indicated increases in negative nutrition coping strategies and tradeoffs with increasing levels of food insecurity status. The most common coping strategy reported by those with very low food security was "Eating less so children or others have enough food," while the most common tradeoff was "Trading off medicine or medical care for food." Two-step cluster analysis identified homogeneous subgroups by behavior and demographic characteristics: (1) late adult worriers, (2) middle adult traders, and (3) middle/late adult copers. CONCLUSION: Identifying coping strategies and tradeoffs used by participants accessing food relief is a multidimensional approach to addressing determinants of food insecurity. Future research on conceptual pathways is warranted to see if experience-based food insecurity variables help to understand relationships across a continuum, including barriers and influencers.

5.
Front Nutr ; 10: 1011958, 2023.
Article in English | MEDLINE | ID: mdl-36969819

ABSTRACT

Objectives: To describe nutrition care documentation patterns and investigate predictors of nutrition diagnosis resolution. Methods: This is a secondary data analysis of a 2-year pragmatic, quasi-experimental study conducted in outpatient clinics where nutrition care was provided to adults with diabetes Type 1 or 2 from May 2017 to June 2019 (n = 564 patients). The main outcome measures were frequency of standardized Nutrition Care Process (NCP) terms, NCP links, nutrition diagnosis resolution and predictors of nutrition diagnosis resolution. Predictors of diagnosis resolution were identified using a multivariable logistic regression model. Results: The most prevalent resolved diagnoses were excessive carbohydrate intake (32%), undesirable food choices (21%) and excessive energy intake (13%). The top etiology was food and nutrition related knowledge deficit (57%) and interventions were drawn mainly from the Nutrition Education domain (64%). One hundred forty-six patient cases (26%) had at least one follow-up visit and 26% of those with a follow-up (n = 38) had a resolved diagnosis. The presence of the evidence-diagnosis NCP link in documentation predicted diagnosis resolution (OR = 2.80, 95% CI 1.30-6.02; p = 0.008). Conclusion: Most diagnoses were caused by patients' lack of knowledge and respective interventions focused on nutrition education. Odds of diagnosis resolution improved when the signs and symptoms of the diagnosis were documented during assessment (evidence-diagnosis NCP link). Training dietitians on NCP links may be important to resolve nutrition diagnoses. Presented findings are hypothesis generating.

6.
Nutr Health ; : 2601060231151263, 2023 Jan 17.
Article in English | MEDLINE | ID: mdl-36650916

ABSTRACT

Background: Important changes in lifestyle habits, especially diet, typically occur during the transitional period between high school and college and some of these changes may increase the risk of inflammation. Aim: The purpose of this study was to investigate the relationship between lifestyle factors and inflammation in college students. Methods: Students enrolled in a southeastern university participated in this cross-sectional study. Participants completed online questionnaires for assessment of demographics, supplement and dietary intake, sleep quality, and perceived stress. Body composition was measured during a clinic visit via air displacement plethysmography and blood and urine were collected for measurement of C-reactive protein (CRP) and cortisol, respectively. Analysis of variance was used to examine associations between tertiles of CRP levels and lifestyle variables and a linear regression model was fit to investigate whether there were any significant predictors of CRP levels. Results: Analysis included data for 83 participants for whom serum CRP levels and diet intake were available. Approximately 68% of the participants were female; mean age and body mass index (BMI) were 24 years and 23.4 kg/m2, respectively. Alcohol intake was significantly associated with increasing CRP levels (P = 0.017). No other dietary variables or lifestyle characteristics such as sleep quality, perceived stress, or BMI were associated with tertiles of CRP. The best model to predict CRP levels included urinary cortisol, aerobic exercise duration, alcohol, and vitamin E intake (adjusted R2=0.27). Conclusion: Alcohol and vitamin E intake were found to be associated with increased CRP levels.

7.
J Hum Nutr Diet ; 36(1): 323-335, 2023 02.
Article in English | MEDLINE | ID: mdl-35485216

ABSTRACT

BACKGROUND: There is a lack of a valid and reliable instrument that measures objective and subjective knowledge of evidence-based dietetic practices (EBDP) among registered dietitian nutritionists (RDNs). The present study aimed to develop and assess the validity and reliability of an EBDP Questionnaire (EBDPQ) with objective knowledge items (i.e., quiz items) among RDNs in the USA. METHODS: Subscales from four existing evidence-based practice (EBP) instruments were combined and modified for dietetics. Content and face validity and internal consistency were used to assess the full survey. Survey responsiveness and test-retest reliability were evaluated within the objective knowledge subscale. Content experts (n = 11) and nutrition professionals (n = 16) completed validation reviews. Doctoral students enrolled in a research course (n = 12) were used to analyse survey responsiveness. Internal and test-retest relability analyses utilised RDN participants (time point 1, n = 482; time point 2, n = 335). RESULTS: Content validation resulted in a 38-item questionnaire. Average percent agreement among face validity reviewers was 95.1%. Only the pre-validation version of the objective knowledge subscale resulted in significantly higher post-course scores (Mdn = 11.50) compared to the pre-course (Mdn = 9.75, p = 0.05). The validated instrument had excellent internal consistency (Cronbach's α = 0.91); however, the objective knowledge subscale was low (Cronbach's α = 0.41). A good degree of reliability was found between the two time points (intraclass correlation coefficient = 0.71). CONCLUSIONS: The EBDPQ demonstrated adequate validity and reliability among RDNs. Future research should assess construct validity, with the responsiveness and objective knowledge subscale requiring additional evaluation through an EBDP course.


Subject(s)
Dietetics , Nutritionists , Humans , Reproducibility of Results , Students , Surveys and Questionnaires , Psychometrics
8.
J Diet Suppl ; 20(6): 870-884, 2023.
Article in English | MEDLINE | ID: mdl-36255153

ABSTRACT

The relationship between intake of dietary supplements and biomarkers such as insulin and insulin-like growth factor has not been well explored. The primary aim of this cross-sectional study was to investigate the associations between supplement intake and biological and lifestyle factors. We hypothesized that dietary supplement intake was associated with healthier lifestyle behaviors. College students attending a Southeast university were recruited between January 2018 and April 2019. Blood samples were collected to measure insulin, insulin-like growth factor 1 (IGF-1) and alanine aminotransferase (ALT). Statistical tests employed were linear regression and analysis of variance. Ninety-eight participants completed the study and 91% reported taking at least one supplement, while 5.1% reported taking 9+ supplements once per week. There were no differences in levels of insulin, IGF-1 and ALT by levels of dietary supplement intake. Although there were no differences in HEI-2015 score among the groups, those who consumed five or more supplements met a higher percentage of the recommended intake for fruits, performed aerobic exercise for longer duration, and had lower body fat percentage compared to participants who consumed two or less supplements at least once per week. These findings are consistent with previous studies and suggest that dietary supplement intake is highly prevalent in college students, and it may be related to healthy lifestyle behaviors. Future studies should employ mixed methodology to examine reasons by which college students consume dietary supplements and to assess perceived and direct health benefits associated with consumption.


Subject(s)
Dietary Supplements , Health Behavior , Healthy Lifestyle , Students , Humans , Cross-Sectional Studies , Insulin/blood , Insulin-Like Growth Factor I/metabolism , Life Style , Students/psychology , Universities , Alanine Transaminase/blood
9.
Nutr Diet ; 80(3): 262-272, 2023 06.
Article in English | MEDLINE | ID: mdl-36193686

ABSTRACT

AIMS: There is a lack of research assessing perceived and actual evidence-based dietetics practice knowledge among registered dietitian nutritionists. This cross-sectional research examined the association between determinant factors (i.e., education attainment) and objective knowledge (i.e., quiz items) of evidence-based dietetics practices. Other determinant factors associated with perceived knowledge and skill, attitudes, behaviours and outcomes related to evidence-based dietetics practice were also assessed. Perceived knowledge items were compared to objective knowledge items to evaluate the accuracy of self-assessed evidence-based dietetics practice knowledge among dietitians in the United States. METHODS: A modified and adapted evidence-based practice survey was emailed to registered dietitian nutritionists in the United States via the Commission on Dietetic Registration database between November and December 2020. Analysis of variance assessed the relationship between highest degree held and actual knowledge of evidence-based dietetics practices. Multiple linear regression and ordinal logistic regression determined participant-level characteristics associated with survey subscales and survey items, respectively. Pearson's correlation coefficient evaluated the relationship between subjective and objective items. RESULTS: Four hundred and eighty-two dietitians completed the survey. Each increase in degree type was associated with an increase in objective knowledge score (all comparisons p < 0.001). Other determinants included recency of degree completion and peer-reviewed publications. Moderate positive associations (r = 0.35, p < 0.001) were found between subjective and objective measures. CONCLUSION: Graduate-level education, recency of degree completion and peer-reviewed publications were supportive of evidence-based dietetics practice-related outcomes. Future research should evaluate the efficacy of training, particularly among those further from their highest completed degree.


Subject(s)
Dietetics , Nutritionists , Humans , Dietetics/education , Nutritionists/education , Cross-Sectional Studies , Clinical Competence , Surveys and Questionnaires
10.
PLoS One ; 17(10): e0275275, 2022.
Article in English | MEDLINE | ID: mdl-36201455

ABSTRACT

The primary objective of this pilot study was to investigate the feasibility of regular consumption of fermented vegetables for six weeks on markers of inflammation and the composition of the gut microflora in women (clinical trials ID: NTC03407794). Thirty-one women were randomized into one of three groups: 100 g/day of fermented vegetables (group A), 100 g/day pickled vegetables (group B), or no vegetables (group C) for six weeks. Dietary intake was assessed by a food frequency questionnaire and blood and stool samples were provided before and after the intervention for measurement of C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), and lipopolysaccharide binding protein (LBP). Next-generation sequencing of the V4 region of the 16S rRNA gene was performed on the Illumina MiSeq platform. Participants' ages ranged between 18 and 69 years. Both groups A and B had a mean daily consumption of 91g of vegetables for 32 and 36 days, respectively. Serum CRP ranged between 0.9 and 265 ng/mL (SD = 92.4) at baseline, while TNF-α and LBP concentrations ranged between 0 and 9 pg/mL (SD = 2.3), and 7 and 29 µg/mL (SD = 4.4), respectively. There were no significant changes in levels of inflammatory markers among groups. At timepoint 2, group A showed an increase in Faecalibacterium prausnitzii (P = 0.022), a decrease in Ruminococcus torques (P<0.05), and a trend towards greater alpha diversity measured by the Shannon index (P = 0.074). The findings indicate that consumption of ~100 g/day of fermented vegetables for six weeks is feasible and may result in beneficial changes in the composition of the gut microbiota. Future trials should determine whether consumption of fermented vegetables is an effective strategy against gut dysbiosis.


Subject(s)
Gastrointestinal Microbiome , Vegetables , Adolescent , Adult , Aged , Biomarkers , C-Reactive Protein , Feasibility Studies , Female , Fruit , Humans , Lipopolysaccharides , Middle Aged , Pilot Projects , RNA, Ribosomal, 16S , Tumor Necrosis Factor-alpha , Young Adult
11.
Gerontologist ; 2022 Oct 28.
Article in English | MEDLINE | ID: mdl-36306201

ABSTRACT

BACKGROUND AND OBJECTIVES: Food insecurity is considered an increasing public health problem worldwide with adverse effects, especially among older adults. Although the literature related to food insecurity among older adults in low- and middle-income countries (LMIC) is expanding, little is known about existing patterns and knowledge gaps in these settings. This scoping review aims to provide a comprehensive overview of the current research related to food insecurity among older adults in LMIC. RESEARCH DESIGN AND METHODS: A systematic search was conducted in November 2021 and revised in July 2022 on six databases using terms related to food insecurity and older adults. Data were extracted and the emerging themes from the main findings were summarized using a Social-Ecological Model (SEM). RESULTS: Forty-one studies met the inclusion criteria. Almost half (48.8%) were published in the last two years and utilized a quantitative approach (n=38). Only one study was conducted in a low-income country. Using the SEM, most studies included in this review focused on addressing the relationship between food insecurity with intrapersonal factors. DISCUSSION AND IMPLICATIONS: Several gaps in the current literature were identified. There is a lack of longitudinal and qualitative studies available on this topic. Also, only fifteen LMIC were represented in the literature. A critical point in this review is that only a few studies addressed the relationship between food insecurity and the policy/social structure, institutional, community and interpersonal levels. These identified gaps can serve as a guide for future research on this topic.

12.
J Nutr Gerontol Geriatr ; 41(2): 175-189, 2022.
Article in English | MEDLINE | ID: mdl-35179450

ABSTRACT

Food insecurity is a growing problem among seniors. A novel program was established to help mitigate the problem of food insecurity among seniors who are homebound. Volunteers recover unused prepared food donated by area hospitals, repack it into healthy meals which are delivered to program participants. To evaluate the impact of our intervention, seniors' nutritional health and social well-being were measured at enrollment and after three to five months using the following: Mini Nutritional Assessment Short Form (MNA-SF), 24-hour recall, USDA 6-Item Food Security Survey, WHO-5 Well-Being Index, and the 3-Item Loneliness Scale. Statistical analysis indicated a significant improvement in nutritional health, well-being, and loneliness; participants also increased their consumption of protein and calories. Semi-structured interviews were conducted to investigate the self-perceived impact of the program. Thematic analysis of the interviews revealed that meal recipients perceive that food recovery-meal delivery programs may improve their nutrition health, food security, and well-being.


Subject(s)
Food Services , Homebound Persons , Aged , Food Security , Humans , Meals , Nutritional Status
13.
Nutr Cancer ; 74(3): 816-819, 2022.
Article in English | MEDLINE | ID: mdl-34615429

ABSTRACT

Chronically elevated levels of inflammatory biomarkers may contribute to the development of cancer and diet may be an important factor in the interplay between inflammation and cancer. We examined associations between glycemic load (GL), glycemic index (GI), and adapted dietary inflammatory index (ADII) and markers of inflammation and adipokines in 135 premenopausal women at high genetic risk for breast cancer (NCT00892515). We assessed body mass index (BMI), 3-day food records, and blood biomarkers TNF-α, IL-12, CCL2, IL-10, leptin, and adiponectin. Regression models assessed associations between dietary variables and biomarkers, adjusted for caloric intake and BMI. Participants were on average 34.2 years old with mean BMI of 26.8 kg/m2. Significantly higher levels of IL-10 and leptin were observed in participants with higher GI. Leptin and adiponectin were significantly associated with ADII. Leptin remained associated with ADII after adjustment for caloric intake and BMI. There were no associations between inflammatory biomarkers of interest and GL, GI, and ADII, after adjusting for caloric intake and BMI. Elevated leptin levels were observed with higher ADII independent of caloric intake and BMI. The relationship between carbohydrate quality and inflammatory potential of the diet and markers of inflammation may be modulated by leptin.


Subject(s)
Breast Neoplasms , Leptin , Adiponectin , Adult , Biomarkers , Body Mass Index , Breast Neoplasms/genetics , Diet/adverse effects , Female , Glycemic Index , Humans , Inflammation , Interleukin-10/genetics
14.
J Menopausal Med ; 27(2): 79-86, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34463071

ABSTRACT

OBJECTIVES: The purpose of this cross-sectional study was to examine whether single nucleotide polymorphisms (SNPs) in enzymes that metabolize sex steroid hormones were associated with the blood levels of these hormones in postmenopausal women and if the use of menopausal hormone therapy (MHT) could modify this association. METHODS: Baseline data were collected from 932 postmenopausal women enrolled in the Minnesota Green Tea Trial. Participants filled out a questionnaire about their demographics, lifestyle factors, and medical and reproductive history. Free, bioavailable, and total serum levels of reproductive hormones were measured through liquid chromatography/tandem mass spectrometry. For genotyping of UGT1A1 (rs10928303), UGT1A4 (rs10929301, rs11673726), UGT1A6 (rs1105879, rs2070959, rs6759892), UGT1A8 (rs10167119), UGT2B7 (rs7439366), and SULT1A1 (rs9282861, rs1968752), mass spectrometry based on multiplex methods and TaqMan assays were performed. Adjusted linear models were fit to assess the associations between SNPs and blood hormones using age, body mass index (BMI), and MHT as covariates. RESULTS: The mean age was 59.8 years, and the mean BMI was 25.1 kg/m². Past or recent use of MHT was reported by 41.2% of the participants. SNPs in SULT1A1 (rs1968752 and rs9282861) and UGT1A4 (rs11673726) genes were significantly associated with estrone levels, whereas SNPs in UGT1A6 (rs6759892) and UGT1A8 (rs10167119) genes were significantly associated with bioavailable estradiol levels. CONCLUSIONS: There was no evidence that MHT use modified the association between SNPs and sex-steroid hormone levels; however, further studies are needed to establish the potential clinical significance of UGT1A4 (rs11673726), UGT1A6 (rs6759892), and UGT1A8 (rs10167119) SNPs and the modulation of hormone levels in postmenopausal women.

15.
Nutrients ; 13(6)2021 Jun 06.
Article in English | MEDLINE | ID: mdl-34204023

ABSTRACT

The purpose of this cross-sectional study was to examine the relationship between diet and anthropometric measures in postmenopausal women. Data collected from 937 women enrolled in the Minnesota Green Tea Trial (NTC00917735) were used for this analysis. Dietary intake and health-related data were collected via questionnaires. Body weight, height, and waist circumference (WC) were measured by the study staff. The mean age of participants was 59.8 years and mean WC was 83 cm. Approximately 30% of the participants had WC greater than 88 cm. Healthy Eating Index-2015 score was 72.6 and the Dietary Inflammatory Index score was 0. Intakes of whole grains, dairy, protein, sodium, and saturated fat did not meet the dietary guidelines. Only 12.5% consumed the recommended daily amount of calcium (mean intake = 765 mg/day). When calcium supplements were considered, only 35.2% of the participants had adequate intakes, even though 68.9% reported taking a calcium supplement. We found that age and number of medications taken were significantly associated with waist circumference (p = 0.005). Women who reported taking two or more medications had greater WC (85 cm) compared to women who reported not taking any medications (82.2 cm), p = 0.002. Our findings suggest that achieving adequate calcium and vitamin D intake may be challenging to postmenopausal women.


Subject(s)
Anthropometry , Diet, Healthy/statistics & numerical data , Guideline Adherence/statistics & numerical data , Postmenopause , White People/statistics & numerical data , Aged , Calcium, Dietary/analysis , Cross-Sectional Studies , Double-Blind Method , Female , Humans , Middle Aged , Nutrition Policy , Randomized Controlled Trials as Topic , Vitamin D/analysis , Waist Circumference
16.
J Acad Nutr Diet ; 121(7): 1231-1241, 2021 07.
Article in English | MEDLINE | ID: mdl-33158800

ABSTRACT

BACKGROUND: There are few published studies addressing food insecurity and eating disorders in lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) individuals. OBJECTIVE: The primary objective of this study was to describe the proportion of food insecurity and eating disorder behaviors in a volunteer sample of LGBTQ+ individuals aged 18 to 35 years. DESIGN: This study was a cross-sectional analysis of questionnaire data collected from 253 participants between March 2018 and March 2019. PARTICIPANTS AND SETTING: To be included in the study, participants had to be aged 18 to 35 years and identify as being LGBTQ+. MAIN OUTCOME MEASURES: Food security score, Eating Attitudes Test score, Eating Disorder Examination Self-Report Questionnaire score, anxiety score (Beck), and depressive symptoms score. STATISTICAL ANALYSES PERFORMED: The χ2 test was used to analyze the categorical outcomes. One-way analysis of variance was used to compare continuous variables across gender identity groups. All P values < 0.05 were taken as statistically significant. RESULTS: The proportion of participants identifying as a woman, trans male, gender nonconforming, and a man were 39%, 24%, 24%, and 13%, respectively. Food insecurity was reported by 54.4% of respondents with trans males reporting the highest proportions (64.8%). High levels of depressive symptoms were reported by 68.2% of men, 89.8% of women, 91.4% of trans males, and 95.5% of gender-nonconforming respondents (P = 0.009). High anxiety was reported by 20.5%. Eating Disorder Examination Self-Report Questionnaire scores were significantly higher (P < 0.001) compared with a community-based sample. The eating disorder behavior most frequently reported by respondents was binge eating. Only 4.3% reported having sought treatment for an eating disorder. CONCLUSIONS: Members of the LGBTQ+ community are at greater risk for food insecurity, eating disorders, and depression, particularly those who identify as trans males. These findings denote the need to focus future research efforts on effective prevention and treatment strategies that are specific to sexual and gender identity groups within the LGBTQ+ community.


Subject(s)
Depression/epidemiology , Feeding and Eating Disorders/epidemiology , Food Insecurity , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical data , Adolescent , Adult , Depression/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/psychology , Female , Humans , Male , Surveys and Questionnaires , Young Adult
17.
J Acad Nutr Diet ; 121(9): 1831-1840, 2021 09.
Article in English | MEDLINE | ID: mdl-32732152

ABSTRACT

In this article, we evaluate relationships between Nutrition Care Process (NCP) chain links and improvement or resolution of the nutrition diagnosis. We conducted a retrospective record review for 12 months in a single Veterans Health Administration health care system using the Veterans Health Administration-specific monitoring and evaluation terms, NCP terminology, and its etiology categories to evaluate outcomes. Logistic regression analysis revealed that the strongest predictor for diagnosis improvement was the etiology-intervention link. The odds of improving the nutrition diagnosis were 51.43 times higher when the etiology-intervention link was present. The odds of improving the nutrition diagnosis were 19.74 times higher when the evidence-diagnosis link was present and 9.46 times higher when the intervention-goal link was present. For every added nutrition visit by the registered dietitian nutritionist, the odds of improving the nutrition diagnosis increased by 32.5%. For every increased point on the NCP audit score, the odds of resolving or improving the nutrition diagnosis increased by 37.7%. When applying the NCP, the presence of the etiology-intervention link significantly improves the odds of resolving the nutrition diagnosis in a Veterans Health Administration population. For the first time, we show evidence that the NCP works as designed. Also, we demonstrate that the quality of NCP documentation impacts resolution of the diagnosis, and we describe the methodology for how to evaluate NCP outcomes. Registered dietitian nutritionists are encouraged to critically evaluate links of the NCP chain, assess NCP documentation for quality, and pursue follow-up visits to improve resolution of nutrition problems.


Subject(s)
Dietetics/statistics & numerical data , Nutrition Disorders/therapy , Nutrition Therapy/statistics & numerical data , Outcome and Process Assessment, Health Care , Veterans/statistics & numerical data , Aged , Documentation/statistics & numerical data , Female , Hospitals, Veterans , Humans , Logistic Models , Male , Middle Aged , Nutrition Disorders/etiology , Retrospective Studies , United States , United States Department of Veterans Affairs
18.
Metabolites ; 9(5)2019 May 11.
Article in English | MEDLINE | ID: mdl-31083533

ABSTRACT

The bioactivities and potential health benefits of green tea polyphenols (GTP) have been extensively investigated, but the metabolic impact of chronic GTP intake on humans is not well defined. In this study, fecal and urine samples from postmenopausal female subjects taking a GTP supplement or placebo for 12 months were compared by liquid chromatography-mass spectrometry-based metabolomic analysis. The GTP-derived and GTP-responsive metabolites were identified and characterized by structural elucidation and quantitative analysis of the metabolites contributing to the separation of control and treatment samples in the multivariate models. Major GTP and their direct sulfate and glucuronide metabolites were absent in feces and urine. In contrast, GTP-derived phenyl-γ-valerlactone and phenylvaleric acid metabolites were identified as the most abundant GTP-derived metabolites in feces and urine, suggesting extensive microbial biotransformation of GTP in humans. Interestingly, GTP decreased the levels of microbial metabolites of aromatic amino acids (AAA), including indoxyl sulfate, phenylacetylglutamine, and hippuric acid, in urine. However, it did not affect the levels of AAA, as well as other microbial metabolites, including short-chain fatty acids and secondary bile acids, in feces. 16S rRNA gene sequencing indicated that the fecal microbiome was not significantly affected by chronic consumption of GTP. Overall, microbial metabolism is responsible for the formation of GTP metabolites while GTP metabolism may inhibit the formation of AAA metabolites from microbial metabolism. Because these GTP-derived and GTP-responsive metabolites have diverse bioactivities, microbial metabolism of GTP and AAA may play important roles in the beneficial health effects of green tea consumption in humans.

19.
Diabetes Res Clin Pract ; 148: 130-136, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30500547

ABSTRACT

AIMS: The primary aim of this research was to investigate the association between food insecurity and prediabetes and to identify specific subgroups for early clinical intervention. METHODS: Cross-sectional data from 25,814 participants were analyzed from the National Health and Nutrition Examination Survey for years 2005-2014. Multivariable logistic regression was used to explore the association between food security status and laboratory-confirmed prediabetes. All models were adjusted for age, sex, race, and body mass index. RESULTS: When compared to participants with full and marginal food security, participants with low/very food security were 1.35 (95% CI: 1.17-1.55) times more likely to have prediabetes. Younger individuals with low/very low food security had a greater likelihood of prediabetes, 1.50 (95% CI: 1.19-1.81), when compared with their food secure counterparts. CONCLUSIONS: Food insecurity at any level, whether low or very low, is positively associated with prediabetes in the U.S. general adult population. Food insecure young adults, particularly those aged 20-34 years, should be targeted for early clinical intervention.


Subject(s)
Food Supply/statistics & numerical data , Poverty/statistics & numerical data , Prediabetic State/epidemiology , Adult , Aged , Aged, 80 and over , Body Mass Index , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nutrition Surveys , Risk Factors , United States/epidemiology , Young Adult
20.
Environ Res ; 166: 588-594, 2018 10.
Article in English | MEDLINE | ID: mdl-29982146

ABSTRACT

OBJECTIVE: To explore the association between polycyclic aromatic hydrocarbons (PAHs) and diabetes and to determine whether effects are heterogeneous when examined by body mass index (BMI). METHODS: Cross-sectional data from 8664 participants were analyzed from the National Health and Nutrition Examination Survey for years 2005-2014. Multivariable logistic regression was used to explore the association between urinary biomarkers of PAHs and diabetes. All models were adjusted for age, sex, race, poverty-income ratio, and serum cotinine. RESULTS: When compared with the lowest quintiles of exposure, the highest quintiles of exposure to 2-hydroxynaphthalene, 2-hydroxyfluorene, 9-hydroxyfluorene, 2-hydroxyphenanthrene, and a summed variable of all low molecular weight PAHs (aOR = 1.73; 95% CI: 1.17-2.55) showed a positive association with diabetes. Stratified analyses by BMI indicated that the positive association between PAHs and diabetes was found among both normal weight and obese participants. CONCLUSIONS: High levels of exposure to PAHs are positively associated with diabetes in the U.S. general population and these effects are modified by BMI. These findings suggest the importance of strong environmental regulation of PAHs to protect population health.


Subject(s)
Diabetes Mellitus/epidemiology , Polycyclic Aromatic Hydrocarbons/urine , Adult , Cross-Sectional Studies , Diabetes Mellitus/urine , Humans , Logistic Models , Nutrition Surveys , United States/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL