The below list represents only planned manuscripts. Some of these
manuscripts have not been received by the Editorial Office yet. Papers
submitted to MDPI journals are subject to peer-review.
Type of Paper: Article
Title: Telehealth Coaching to Promote Bone Health and Nutrition in Deployed Soldiers
Authors: Mary S. McCarthy
Affiliation: Center for Nursing Science & Clinical Inquiry, Madigan Army Medical Center, Tacoma, WA 98388, USA; E-Mail: firstname.lastname@example.org
Abstract: The purpose of this study was to determine if telehealth coaching is superior to one-time nutrition and fitness education regarding: a) dietary contributions to bone health, and b) exercise contributions to bone health, assessed before and after deployment. Young service men and women are returning from war with significant physical injuries, as well as “wear and tear” from long work hours, heavy body armor, and alterations in diet and exercise behaviors. This is the second in a series of studies examining the impact of deployment specifically on bone health and nutrition. Previous findings have demonstrated that inadequate consumption of calcium and vitamin D and a decrease in exercise while deployed can be detrimental to bone health. This prospective, longitudinal, cluster-randomized, controlled trial enrolled 234 Soldiers at baseline; 155 returned from deployment with 85 in the telehealth group and 70 in the control group, yielding a 34% attrition rate. All Soldiers received a nutrition and bone health class prior to deployment; Soldiers randomized to the telehealth intervention group received on-demand health-related messages via electronic mail platforms. Baseline 25(OH) vitamin D revealed a high rate of insufficiency (61%, level < 30 ng/mL) and moderate level of deficiency (17%, level < 20 ng/mL) in both groups. Soldier participants significantly improved their vitamin D levels post-deployment with the control group achieving a “sufficient” level; M=34.9 ng/mL. Post-deployment bone turnover measured by osteocalcin was significantly higher in the telehealth group (22.0 + 0.99 vs 28.3 + 1.1 ng/mL; p = 0.01) and change in sport index was positive for this group but negative for the control group (-0.17 + .09 vs 0.29 + 0.11; p = .01). Improving vitamin D status and remaining active while deployed appears to sustain healthy bone density in young Soldiers. Bone density remained stable with no significant difference between groups. Early and aggressive educational outreach efforts can prevent chronic musculoskeletal conditions and disabling osteoporosis.
Type of Paper: Article
Title: Fat Intake and Mental Health in Mid Aged Australian Women
Authors: Lesley MacDonald-Wicks, Lee Ting, Amanda Patterson; David Sibritt
Affiliations: Nutrition and Dietetics, School Health Sciences, Faculty Health and Medicine, The University of Newcastle (UoN), University Drive, Callaghan NSW 2308, Australia; E-Mail: email@example.com
Abstract: Emerging evidence relates dietary intake of unsaturated fats to mental well-being. However, the relationship between dietary intake of unsaturated fats and depression or anxiety remains poorly understood. The aim of this paper was to undertake a cross-sectional analysis of the dietary intake of unsaturated fats in a mid-aged cohort of Australian women from the Australian Longitudinal Study of Women’s Health (n= 9530; 50 – 55yo in 2001) and their relationship with markers of mental well-being (CESD-10 and SF36 Mental Health subscale). The study found that for every one unit increase in oleic acid (OA), the odds of diagnosed depression declines by 1% (Odd Ratio (OR)=0.99; p=0.03). Moreover, positive associations between total omega-9 monounsaturated fatty acids (n-9 MUFAs) and OA and Short Form-36 (SF-36) Mental Health subscale scores were found. Therefore, in a nationally representative sample of Australian mid-aged women, higher OA intake was inversely associated with the risk of depression, and both higher OA and total n-9 MUFAs intakes were associated with better mental health outcomes. Further prospective observational studies and trials with regular follow-up are required to confirm the association.
Type of Paper: Review
Title: Exploiting Food Resources: Risks and Benefits, Challenges and Opportunities of Sorghum
Authors: Proietti I., Frazzoli C. and Mantovani A.
Affiliation: Food and Veterinary Toxicology Unit, Dept. Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
Abstract: Food security challenges, including climate changes and population growth, call for attention towards currently neglected food resources, like sorghum. Sorghum (Sorghum bicolor (L.) Moench) is a drought-resistant crop important in terms of nutritional, economic and social value, especially in semi-arid environments; it is a gluten-free staple food also valuable for people with celiac disease and gluten intolerance. Sorghum weaknesses include susceptibility to mycotoxins contamination, amino acid imbalance and endogenous anti- nutrients that partly impair its nutritional potential. This paper reviews and discusses pros and cons of sorghum as food source and investigate approaches for improving its risk-benefit balance, such as landraces selection and characterization of local food processing methods.
Title: Dietary Restriction of Sodium and Fluid in Patients with Pulmonary Hypertension: An Often Underutilized Intervention
Authors: Zeiger T, Cueva Cobo G, Dillingham C, Lee A, Burger C.
Affiliations: Mayo Clinic, 4500 San Pablo Road S, Jacksonville, FL 32224, USA
E-Mails: firstname.lastname@example.org; Cueva.email@example.com; Dillingham.firstname.lastname@example.org; email@example.com; firstname.lastname@example.org
Abstract: Introduction. Right heart failure and fluid retention are common manifestations of pulmonary hypertension (PH). A straightforward intervention for improved control is dietary restriction of sodium and fluid; however, such a strategy may be underutilized in clinical practice.
Experimental Section. The study was approved by the Mayo Clinic Institutional Review Board. The design was retrospective review of prospectively collected data. A specific data information sheet was completed by consecutive patients seen in the PH Clinic. In addition to visit type, demographics, diagnosis, PH severity measures such as functional class, information was collected on prior and currently provided counseling for dietary restriction of sodium and fluid, as well as specific daily amounts advised. The data was reviewed for prevalence and specificity of such advice.
Results and Discussion. To be determined as data on approximately 100 patients is under review.
Keywords: Sodium Restriction, Fluid Restriction, Pulmonary Hypertension
Title: Designing and developing a smartphone application for women with gestational diabetes mellitus followed-up at diabetes outpatient clinics in Norway
Authors: Lisa Garnweidner-Holme, Iñaki Garitano, Iren Borgen, Mirjam Lukasse
Affiliations: Oslo and Akershus University College of Applied Sciences, University Graduate Center Unik, Kjeller, Oslo. E-Mails: email@example.com
Abstract: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. Controlling blood sugar levels, accompanied by a healthy diet and physical activity, is fundamental to the treatment of GDM. Currently, patients register their blood sugar levels in a leaflet and receive verbal or written health information at the clinics. A mobile smartphone application may provide patients tailored and easily available advice to register and control their blood sugar levels. The aim of this paper is to document the process of designing and developing a smartphone application (the Gravid+ app) to easily register blood sugar levels and to provide tailored information about healthy eating and physical activity. This formative research included expert group discussions among health professionals, software development professionals and researchers in nutrition, physical activity, obstetrics and midwifery. Individual interviews with patients were conducted to discuss different prototypes of the app. Results indicate that involving both expert groups and patients is important when designing a mobile health care device. Behaviour change techniques such as self-monitoring, perceived severity and benefits, as well as cues of action will be included before testing the app in a randomized controlled trial at the outpatient clinics.
Keywords: Gestational diabetes mellitus; mHealth; user-centered design
Title: Clinical Potential of Hyperbaric Pressure Treated Whey Protein
Authors: Larry C. Lands
Affiliations: McGill University
Abstract: Whey protein in cow’s milk is comprised of a mixture of several globular proteins, which provide a rich source of essential and branched chain amino acids. Bovine whey protein has been demonstrated to support muscle accretion, antioxidant activity, and immune modulation; however, certain whey proteins are not readily digestible due to their tight conformational structure. Treatment of whey with hyperbaric pressure results in protein unfolding. This enhances protein digestion, and results in an altered spectrum of released peptides, and greater release of essential and branched chain amino acids. Pressurized whey, through a series of animal model and clinical studies, has been demonstrated to enhance muscle accretion, reduce inflammation, improve immunity, and decrease fatigue.
Title: Dietary Advice and Collaborative Working: Do Pharmacists and Allied Health Professionals Other Than Dietitians Have a Role?
Authors: Jane McClinchy1, Julia Williams2, Lynne Gordon2, Mindy Cairns2 and Gail Fairey3.
Affiliations: 1 School of Life and Medical Sciences University of Hertfordshire, College Lane, Hatfield, Herts, United Kingdom AL10 9AB
2 School of Health and Social Work, University of Hertfordshire, College Lane, Hatfield, Herts, United Kingdom AL10 9AB
3 Stoke Mandeville Hospital, Mandeville Road, Aylesbury, Herts United Kingdom HP21 8AL E-Mails: firstname.lastname@example.org
Abstract: Long term health conditions either wholly or partly diet-related continue to increase. Although health care professionals (HCPs) have a role in the management of patients with long term conditions, there is limited research exploring whether those other than dietitians have a role in the delivery of dietary advice. This research aimed to explore Pharmacists and Allied Health Professionals (AHPs) other than dietitians views regarding the provision of dietary advice to patients. The research involved a qualitative methodology utilising five uniprofessional focus groups with 23 participants. All groups considered the provision of dietary advice in the context of their own professional roles, discussed issues regarding referral to the dietitian for specialist advice and most discussed the need for written information. General conclusions are made about the value of collaborative working, the importance of communication between health professionals and access to written evidence based information to ensure patients receive timely dietary advice.
Keywords: Communication; education, patient; focus groups; health care professionals; health care, interprofessional; nutrition / malnutrition
Title: Of What Value is a 1:1 Multidisciplinary Weight Management Clinic?
Authors: Desley Turner and Nadim Haboubi
Affiliations: Aneurin Bevan Health Board Multi-disciplinary Weight Management Centre E-Mails: email@example.com
Abstract: Background. Obesity management in Wales includes provision of a 1:1 Multidisciplinary Weight Management Clinic (MDWMC). Strategic management of obesity in Wales is guided by The All Wales Obesity Pathway and recommends MDWMCs for people with obesity who have one or more co-morbidities and who have tried several interventions without success, or who have complex emotional relationships with food.1 No known previous studies have included a qualitative evaluation of a MDWMC. Objectives. To conduct a service evaluation of a 1:1 Multi-disciplinary Weight Management Clinic to evaluate associated physiological benefits and qualitative data about the service. Methods. Semi-structured interviews were conducted with 180 patients attending the MDWMC at Aneurin Bevan Hospital, Ebbw Vale, Wales. Results. The MDWMC supports weight loss with 95% of patients reporting loss. For those whom baseline data was available 73% lost at least 5% of initial body weight. 88% of patients prefer individual appointments and over 90% of patients who see each team member find consultations useful. 69% of patients report improved health mainly due to a decrease in obesity-related symptoms, and of patients taking obesity-related medication 48% report a reduction in dose of medication for asthma, 42% report a reduction in dose of antidepressants and 36% report a reduction in dose for medication for diabetes. Of employed patients 30% report a reduction of days taken off work due to sickness. 96% of patients would recommend the clinic to others. Conclusions. A 1:1 Multi-disciplinary Weight Management Clinic provides value in reducing obesity and symptoms of obesity-related diseases. It also is a treatment choice favoured by patients.
Keywords: obesity; weight management; BMI
Title: Comparison of a vegan diet plan with a traditional and modified Daniel Fast on anthropometric and biochemical markers of health
Authors: Richard J. Bloomer*, Trint A. Gunnels, JohnHenry M. Schriefer
Affiliation: Cardiorespiratory/Metabolic Laboratory, The University of Memphis, Memphis, TN 38152, USA; Email: firstname.lastname@example.org
Abstract :Background: We have previously noted beneficial health outcomes when individuals follow a dietary restriction model known as a Daniel Fast (DF). This is true whether individuals eliminate all animal products or include small amounts of meat and dairy in their plan. The present study sought to compare anthropometric and biochemical measures of health in individuals following a traditional (vegan-based) or modified DF (inclusive of ad libitum meat and skim milk consumption), with those following a standard vegan diet. Methods: 35 subjects (6 men; 29 women; 33±2 yrs; range: 18-67 yrs) completed a 21-day period of modified food intake in accordance with guidelines provided by investigators. Subjects reported to the lab for their pre- (day 1) and post-intervention testing (day 22) in a 10 hr fasted state. Blood was collected for determination of complete blood count, metabolic panel, lipid panel, insulin, HOMA-IR, C-reactive protein, and oxidative stress biomarkers (malondialdehyde, advanced oxidation protein products, and nitrate/nitrite). Heart rate and blood pressure were measured and body composition was determined via dual energy x-ray absorptiometry. Subjects’ self-reported compliance, mental and physical health, and satiety in relation to the dietary modification was recorded. Results: No interaction effects were noted for our outcome measures (p>0.05). However, subjects in the traditional DF group reported an approximate 10% increase in perceived mental and physical health, with a 25% reduction in malondialdehyde and a 33% reduction in blood insulin. Systolic BP was reduced approximately 7 mmHg in subjects assigned to the traditional DF, with an approximate 5 mmHg reduction in subjects assigned to the modified DF and the vegan plan. A small (2 mmHg) reduction in diastolic BP was noted for subjects in both DF groups; a slight increase in diastolic BP was noted for subjects assigned to the vegan group. An approximate 20% reduction was noted in total and LDL cholesterol for subjects in the traditional DF group, with an approximate 10% decrease for subjects in the modified DF group. No decrease in total or LDL cholesterol was noted for subjects in the vegan group. Conclusion: These data indicate that both a traditional or modified DF may improve blood pressure and blood lipids in a clinically meaningful manner. A traditional DF also results in a significant reduction in blood insulin and oxidative stress. Although a standard vegan diet may improve systolic blood pressure, it does not appear to favorably impact other markers of health measured in the present study.
Keywords: Dietary modification, nutrient intake, lipid panel, veganism, oxidative stress
Title: Identifying malnutrition in an elderly ambulatory population: agreement between validated screening tools
Authors: Alison Yaxley1, Maria Crotty2 and Michelle Miller1
Affiliations: 1 Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University
2 Rehabilitation, Aged and Extended Care, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University
Abstract: Malnutrition is common in the elderly and often goes unrecognised and untreated. Effective treatment of malnutrition relies on accurate diagnosis. Australian evidence based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen have been validated for use in the rehabilitation setting. However, other screening tools exist including the Simplified Nutritional Appetite Questionnaire (SNAQ) which has been validated in all other adult settings, therefore the aim of this secondary analysis was to assess the validity and reliability of two of these tools within a rehabilitation population. 225 ambulatory rehabilitation patients (48% male; mean age 71.6 years) completed the Council on Nutrition Appetite Questionnaire (CNAQ) and the SNAQ, and these screening tools were evaluated in comparison to the Mini Nutritional Assessment (MNA) as a reference technique. For identification of malnutrition the CNAQ had sensitivity 50.7%, specificity 80.7%, positive predictive value 82% and negative predictive value 49%, compared to 25.7%, 92%, 86% and 42.5%, respectively, using SNAQ. Assessment of reliability indicated significant slight agreements between MNA with CNAQ (κ = .278, p<0.001) and SNAQ (κ = .149, p=0.001). Results indicate that neither the CNAQ nor the SNAQ have a high level of validity or reliability in this frail elderly population. The authors recommend the use of MNA-SF and Rapid Screen in the rehabilitation setting as recommended by the Australian evidence based guidelines in preference to either of the screening tools evaluated in this study.
Keywords: Malnutrition, Older adult, Screening, Rehabilitation
Title: Becoming Food Aware in Hospital: A narrative review of best practices for a multi-level approach to improve the culture of nutrition in hospitals
Authors: Celia Laur1, James McCullough1, Dr. Heather Keller1,2
Affiliations: 1University of Waterloo, Waterloo, Ontario, Canada 2Schlegel-University of Waterloo, Research Institute for Aging
Abstract: The Nutrition Care in Canadian Hospitals (2010-13) study identified the prevalence of malnutrition on admission to medical and surgical wards as 45%, with older patients more likely to be malnourished. Nutrition practices in these hospitals, including diagnosis, treatment and monitoring of malnourished patients were ad hoc. This lack of a systematic approach has demonstrated the need for knowledge translation of best practice. A multi-level approach is proposed to address this complex issue. Care practices discussed are based on grey literature and evidence to date, which encompasses training and methods of action for hospital staff including hospital management. Patients and their families also need to be included in this multi-level approach as being aware of the importance of nutrition can make a patient more involved in their recovery. This approach encompasses but goes beyond the UK Age Concern Seven Steps to End Malnutrition and the Australian Eight-Step Interdisciplinary Framework on the Prevention of Undernutrition. Improvements to organizational practices include use of screening tools, protected mealtimes and additional nursing or nutritional assistants during mealtimes. Everyone in the hospital should be aware of the importance of nutrition and their role in the optimization of nutrition care. Overall, this proposed multi-level approach aims to improve the culture of nutrition in hospitals.
Keywords: malnutrition; best practice; hospital; older adults; education; training;
Funder: Technology Evaluation in the Elderly Network (TVN) Catalyst Grant Program
Title: Vitamin D as an immunomodulator: risks with deficiencies and benefits of supplementation
Authors: Goldsmith, Rachel B1; Goldsmith, Jason R2
Affiliations: 1 MPI Research, Inc., Mattawan, MI, USA; 2 Department of Medicine, University of Michigan, Ann Arbor MI, USA
Abstract: Vitamin D refers to a class of fat-soluble secosteroids often associated with their role in absorption and metabolism of minerals such as calcium and phosphate. In recent years, our understanding of Vitamin D has expanded to include its role in modulating the immune system. Of particular focus are the effects of Vitamin D deficiency and supplementation on patients suffering from disorders due to dysregulation of the immune system. In patients with multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease, deficiencies in Vitamin D have been associated with an increased risk of disease activity. In this review, we will look at the current state of research in regards to the relationship between Vitamin D and immune-dysregulation. We will focus on both the risks associated with Vitamin D deficiency as well as the benefits of Vitamin D supplementation.
Keywords: Calcitriol; vitamin D; cholecalciferol; ergocalciferol; immunomodulator; inflammatory bowel disease; multiple sclerosis; rheumatoid arthritis
Title: How Research, International Law and Business Impact Infant and Young Child Nutrition, Child Survival and Lifetime Health
Authors: Veronika Scherbaum and Elizabeth Hormann
Affiliations: Universität Hohenheim
Abstract: In an historical perspective reaching back into the last century, with particular focus on the last four decades, this article explores scientific developments on the role of nutrition in early childhood and lifetime health of children and their mothers and examines the many multi-sectoral programs developed to implement this knowledge, not only through nutritional and health promotion, but also by anchoring it in binding international agreements and legislation. In the 75 years since Dr. Cicely William’s famous address to the Singapore Rotary Club on the devastating effects on infant health and survival of promotion and widespread use of breast-milk substitutes, abundant research has underpinned these concerns, raised awareness among health professionals, families and legislators world-wide and given impetus to a broad array of resolutions, initiatives and legislation [International Code of Marketing of Breast-Milk Substitutes (1981), The Convention on the Rights of the Child (CRC 1989), The Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding and The Baby Friendly Hospital Initiative (1991), A World Fit for Children (2002), Global Strategy for Infant and Young Child Feeding (2003), Global Strategy for Women’s and Children’s Health (2010) and the UN General Comment on Children’s Rights and Business (2013)]. There have been improvements over the last few decades, but still the problems of wasting, underweight, stunting and too high rates of infant and young child morbidity and mortality persist, especially, but not only, in developing countries. Alongside of this, are the more recently recognized problems of obesity (which often also involves micronutrient deficiencies) and its long term consequences including, diabetes, cardiac problems, metabolic disorders and psycho-social stress. The UN Millennium Development Goals set for 2015 will certainly not all be met on time and it is increasingly clear that an additional component to ensure that implementing the “right to the highest achievable level of health” (2000) can only happen if health and nutrition promoting programs are complemented by strong, enforceable legislation and the recognition by business leaders that healthy children and mothers – as well as healthy populations in general – are also in their best interests. The Global Strategy for Women’s and Children’s Health (2010) is one instrument to help put into practice the growing awareness that child health, maternal health and nutritional status are closely linked and should be addressed together and protected by adequate legislation. The post-2015 Sustainable Development Goals will be critically reviewed to assess their potential in strengthening the Right of Children to Health and Appropriate Nutrition.
Title: An Interactive Session on Nutritional Pathologies for Health Professional Students
Authors: Joshua DeSipio1 and Sangita Phadtare2*
Affiliations: 1Department of Medicine, gastroenterology/liver diseases division, Cooper Medical School of Rowan University; 2Department of Biomedical Sciences, Cooper Medical School of Rowan University (*Correponding author)
Abstract: Various studies have emphasized the need for improving the nutrition training of health professionals which will help them in providing optimal patient care. Nutrition-based interactive sessions may serve as an efficient approach to instigate an interest in nutrition among the students. Here we report the reception and effectiveness of a nutrition-pathology based interactive activity that we designed and implemented in the gastroenterology course given to the second year students at our medical school. The activity involved team work, individual accountability and peer-teaching. Nutrition pathology case stems (Kwashiorkor, vitamin B-12 deficiency, zinc deficiency or zinc-induced copper deficiency) were posted on the course website for the students to read before the session. At the start of the session, all the four-membered groups took pre-quiz. Each student was then given an information sheet describing one case. Each group discussed the four cases with students acting as the ‘teacher’ for the case assigned to them. Post quiz was administered to the groups to assess acquisition of knowledge as well as in-depth thinking about the nutrition aspects discussed. The efficacy of the session measured by pre and post-quizzes and the overwhelmingly positive student feedback indicated that the session was highly effective.
Keywords: nutrition, nutrition pathology, interactive session, peer teaching
Title: Supplementation of Coenzyme Q10 among Patients with Type 2 Diabetes Mellitus
Authors: Qiuhua Shen, Janet D. Pierce
Affiliations: School of Nursing, University of Kansas, Kansas City, KS 66160, USA
Abstract: Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality with ever increasing prevalence in the United States and worldwide. There is growing body of evidence suggesting that mitochondrial dysfunction secondary to oxidative stress plays a critical role in the pathogenesis of T2DM. Coenzyme Q10 is an important micronutrient acting on the electron transport chain of the mitochondria with two major functions: 1) synthesis of adenosine triphosphate (ATP) and 2) a potent antioxidant. Research has shown that deficiency in coenzyme Q10 is often seen in patients with T2DM. Whether restoration of coenzyme Q10 will help alleviate oxidative stress, preserve mitochondrial function, and thus improve glycemic control in T2DM is unclear. This article reviews the relationships among oxidative stress, mitochondrial dysfunction, and T2DM and examines the evidence for potential use of coenzyme Q10 as a supplement for the treatment of T2DM.
Keywords: type 2 diabetes mellitus; coenzyme Q10; mitochondrial dysfunction; oxidative stress; antioxidant; adenosine triphosphate