| 1. |
- Al-Adili, Lina, et al.
(författare)
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Discrepancy in the evaluation of explicit and implicit nutrition care outcomes for patients at risk of malnutrition : A qualitative study
- 2022
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Ingår i: Journal of human nutrition and dietetics. - : John Wiley & Sons. - 0952-3871 .- 1365-277X. ; 35:3, s. 494-503
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Nutrition care plays a significant role in the prevention and treatment of malnutrition, although the challenge to establish the precise impact of a nutrition intervention on patient outcomes remains. Malnutrition can be associated with diverse underlying diseases and an increased risk of complications, which increases the difficulty of monitoring and evaluating the nutrition intervention. The aim is to gain an understanding of dietitians' reflections concerning nutrition care outcomes of interventions in patients at risk of malnutrition.METHODS: Six semi-structured audio-recorded focus group discussions with registered dietitians from primary healthcare and hospitals (n = 29) in Sweden were held at the dietitians' place of work or at the University. Focus group transcripts were analysed thematically to reveal patterns in the data and identify themes and subthemes.RESULTS: The dietitians described an approach to nutrition monitoring and evaluation of patients at risk of malnutrition that was categorised into three themes: (i) quantitative explicit outcomes, based on objective measures and described as rigorous; (ii) quantitative estimated outcomes, based on estimates and described as less rigorous and (iii) qualitative implicit outcomes, based on patients' subjective perceptions and experiences of their health and described as difficult to measure.CONCLUSIONS: Findings indicate the need for new strategies to promote systematic and comprehensive nutrition monitoring and evaluation.
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| 2. |
- Al-Adili, Lina, et al.
(författare)
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Nutrition intervention goals from the perspectives of patients at risk of malnutrition : A qualitative study
- 2024
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Ingår i: Journal of human nutrition and dietetics. - : John Wiley & Sons. - 0952-3871 .- 1365-277X. ; 37:1, s. 217-226
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Nutrition counselling is characterized by a collaborative approach whereby the patient and the dietitian establish goals that promote health and self-management. Little is known about goal-setting in nutrition interventions of patients at risk of malnutrition. This study describes the perspectives and needs of patients at risk of malnutrition regarding goals of nutrition interventions.Methods: Semi-structured interviews were conducted with 15 patients from three primary care centres and one hospital in mid-Sweden. Interview transcripts were analysed using reflexive thematic analysis to identify themes and patterns in the data. Results: Findings highlight that the participants rarely reflected on their personal goals of the nutrition intervention. Instead, they strived to maintain strength and energy, with the nutrition counselling being seen as supportive in managing nutrition impact symptoms. They described discrepancies between their perspectives and the dietitian’s regarding weight goals and the diet prescribed to gain weight.Conclusion: Elucidating patients’ goals is key to counteracting the discrepancies between the dietitians’ clinically oriented goals and patients’ perspectives. New strategies and tools that support collaborative goal-setting in nutrition interventions are needed to provide person-centred nutrition care.
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| 3. |
- Ali, MA, et al.
(författare)
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Lower polyamine levels in breast milk of obese mothers compared to mothers with normal body weight
- 2013
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Ingår i: Journal of human nutrition and dietetics (Print). - Hoboken, USA : Wiley. - 0952-3871 .- 1365-277X. ; 26 Suppl 1, s. 164-170
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Obesity is associated with risks for mother and infant, and the mothers' dietary habits influence breast milk composition. Polyamines are secreted in breast milk and are essential for the regulation of intestinal and immune function in newborns and infants. The present study aimed to investigate the level of polyamines in human milk obtained from obese and normal weight mothers at different times of lactation.METHODS:Breast milk from 50 mothers was obtained at day 3, and at 1 and 2 months after delivery. The mothers had normal body weight [body mass index (BMI) < 25 kg m(-2) ] or were obese (BMI > 30 kg/m(2) ). A subgroup of obese mothers participated in a weight reduction programme during pregnancy. Polyamines were analysed using high-performance liquid chromatography.RESULTS:The total polyamine content was significantly lower at all times in breast milk from obese mothers compared to milk from controls. Spermine levels did not differ between groups at any time in contrast to the levels of putrescine and spermidine. Putrescine concentrations were highest on day 3 and spermidine and spermine were highest at 1 month of lactation. The obese mothers, who received dietary advice during pregnancy based on the Nordic Nutrition Recommendations, had higher concentrations of putrescine and spermidine in their milk than the obese mothers without any intervention.CONCLUSIONS:Polyamine concentrations were lower in breast milk from obese mothers compared to mothers with a normal weight. General dietary intervention in obese mothers increased the polyamine levels, suggesting that the low levels in obesity were at least partly associated with food habits. However, the consistency of spermine suggests a special metabolic function of this polyamine.
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| 4. |
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| 5. |
- Atiya Ali, M., et al.
(författare)
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Polyamine levels in breast milk are associated with mothers' dietary intake and are higher in preterm than full-term human milk and formulas
- 2014
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Ingår i: Journal of human nutrition and dietetics (Print). - : Wiley. - 0952-3871 .- 1365-277X. ; 27:5, s. 459-467
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Polyamine intake from milk is considered essential for post-natal maturation of the immune system and small intestine. The present study aimed to determine polyamine content in human milk after preterm delivery and the association with mothers' dietary intake. In comparison, the polyamine levels were compared with those in term breast milk and some corresponding formulas.METHODS: Transitional breast milk was collected from 40 mothers delivering after 24-36 weeks of gestation, and from 12 mothers delivering after full term. Food intake was assessed in mothers delivering preterm babies using a 3-day diary. Polyamines were analysed by high-performance liquid chromatography.RESULTS: The dietary intake of polyamines was significantly associated with breast milk content but weaker for spermine than for spermidine and putrescine. Total polyamine level was higher in preterm than term milk and lower in the corresponding formulas. Putrescine, spermidine and spermine contents [mean (SEM)] in preterm milk were 165.6 (25), 615.5 (80) and 167.7 (16) nmol dL(-1) , respectively, with the levels of putrescine and spermidine being 50% and 25% higher than in term milk. The content of spermine did not differ.CONCLUSIONS: Dietary intake of polyamines has an impact on the content in breast milk. The difference between human milk after preterm and term delivery might be considered when using donor human milk for preterm infants. The corresponding formulas had lower contents. Further studies are important for determining the relationship between tissue growth and maturation and optimal intake.
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| 6. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Attitudes and barriers to dietary advice aimed at reducing risk of type 2 diabetes in first-degree relatives of patients with type 2 diabetes.
- 2004
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Ingår i: Journal of Human Nutrition and Dietetics. - 0952-3871. ; 17:6, s. 513-21
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the attitudes to and adoption of dietary advice in nondiabetic first-degree relatives of patients with type 2 diabetes and to examine barriers to adherence. DESIGN: One-year controlled intervention study, where treatment group (n=73) received lifestyle education. Attitudes towards dietary advice, change in dietary habits and importance of potential barriers to adherence were evaluated by questionnaires. Nondiabetic relatives (25-55 years; males and females) of individuals with type 2 diabetes were recruited. Education was based on current nutrition recommendations and aimed at improving dietary fat quality, increasing intake of fruit and vegetables, with additional advice to reduce dietary glycaemic index (GI). MAIN OUTCOME MEASURES: Attitudes and importance of barriers were classified by the intervened subjects into four categories ranging from 'No problem' to 'Yes, definitely a problem'. Dietary adherence was monitored by food frequency questionnaire at baseline and after 1 year. RESULTS: Participants were generally in favour of advice aimed at improving dietary fat quality. Attitudes towards advice to reduce GI varied widely. Food selection changed in accordance with predefined dietary goals. 'Forgetfulness', 'low availability in lunch restaurant' and 'lack of ideas for cooking' were barriers to adherence. CONCLUSIONS: Dietary advice aimed at reducing risk of type 2 diabetes was generally positively received and adopted in subjects with heredity for the disease. The most prevalent barriers reported are potentially modifiable.
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| 9. |
- Duncanson, K., et al.
(författare)
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Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity : a systematic review with meta-analysis
- 2021
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Ingår i: Journal of human nutrition and dietetics. - : Wiley. - 0952-3871 .- 1365-277X. ; 34:1, s. 147-177
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The impact of obesity interventions on dietary intake in children and adolescents with overweight or obesity is unclear. This systematic review aimed to investigate the impact of the dietary component of weight management interventions on the change in diet in children and adolescents with overweight or obesity.METHODS: Eligible randomised controlled trials (RCTs) published between 1975 and 2020 were identified by a systematic search following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Meta-analyses of eligible study outcomes were performed using statistical software. A multilevel random effects model was used with three significant random effects fitted using restricted maximum likelihood estimation.RESULTS: This review identified 109 RCTs, including 95 that reported at least one statistically significant dietary outcome change and 14 reporting no significant dietary change. Results from the meta-analyses (n = 29 studies) indicated that, compared to control groups, intervention groups achieved significantly greater reductions in mean total energy intake at ≤6 months (-194 kcal day-1 , 95% confidence interval = -275.80 to -112.90 kcal day-1 , P < 0.001) and up to 12 months (-112 kcal day-1 95% confidence interval = -218.92 to -5.83 kcal day-1 ) P = 0.038), increases in fruit and/or vegetable intakes over 2-12 months (n = 34, range +0.6 to +1.5 servings day-1 ) and reductions in consumption of sugar-sweetened beverages (n = 28, range -0.25 to -1.5 servings day-1 ) at 4-24 months follow-up.CONCLUSIONS: Obesity interventions with a dietary component have a modest but sustained impact on reducing total energy intake and improving intakes of specific food groups in children and adolescents with overweight or obesity. High quality RCTs that are powered to detect change in diet as a primary outcome are warranted.
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| 10. |
- Frid, Hanna, et al.
(författare)
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Agreement between different methods of measuring height in elderly patients
- 2013
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Ingår i: Journal of human nutrition and dietetics. - : Wiley. - 0952-3871 .- 1365-277X. ; 26:5, s. 504-511
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe present study aimed to examine the agreement between measurements of standing height and self-reported height, height measured with a sliding caliper, and height estimated from either demispan or knee height in elderly patients.MethodsFifty-five patients (mean age 79 years) at a Swedish hospital were included in this observational study. The participants' heights were evaluated as the standing height, self-reported height, height measured in a recumbent position with a sliding caliper, and height estimated from the demispan or knee height.ResultsThe measurements made with a sliding caliper in the recumbent position agreed most closely with the standing height. Ninety-five percent of the individuals' differences from standing height were within an interval of +1.1 to −4.8 cm (limits of agreement). Self-reported height and height estimated from knee height differed relatively strongly from standing height. The limits of agreement were +5.2 to −9.8 cm and +9.4 to −6.2 cm, respectively. The widest distribution of differences was found in the height estimated from the demispan, with limits of agreements from +11.2 to −9.3 cm.ConclusionsWhen measuring the height of patients who find it difficult to stand upright, a sliding caliper should be the method of choice, and the second choice should be self-reported height or the height estimated from knee height. Estimating height from the demispan should be the method of last resort.
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