British Dietetic Association (BDA)’s Post

JHND August: a systematic review of dietary modifications to improve the pain scores of osteoarthritis. Weight loss plus dietary increase in plant polyphenols and omega 3 fatty acids all lowered pain scores. Diets higher in saturates, omega 6 fatty acids and refined carbohydrates associated with greater pain scores #dietitian #nutritionist #osteoarthritis

The Correlation Between Diet and Knee Arthritis How Your Diet Could Be Impacting Your Knee Arthritis Did you know that what you eat might be affecting the health of your knees? Knee arthritis, particularly osteoarthritis, is often linked to factors like aging, genetics, and physical activity levels, but emerging research suggests that diet could also play a significant role. **The Science Behind It:** Several studies have explored the relationship between diet and knee arthritis: 1. **Inflammatory Foods:** Diets high in sugar, processed foods, and unhealthy fats can increase inflammation in the body, which may exacerbate symptoms of knee arthritis. A study published in *Arthritis Care & Research* found that people who consumed more sugary beverages were more likely to develop knee osteoarthritis. 2. **Antioxidant-Rich Foods:** On the flip side, a diet rich in fruits and vegetables, particularly those high in antioxidants like vitamin C and E, has been shown to help reduce inflammation and slow the progression of knee osteoarthritis. The *American Journal of Clinical Nutrition* highlighted that a higher intake of these nutrients could be associated with a reduced risk of cartilage loss in the knee. 3. **Omega-3 Fatty Acids:** Omega-3s, commonly found in fish and flaxseeds, have anti-inflammatory properties. Research from *The Journal of Nutrition* indicated that higher omega-3 intake might be linked to lower levels of knee pain and reduced symptoms in people with osteoarthritis. 4. **Weight Management:** Being overweight is a significant risk factor for knee osteoarthritis. Excess weight puts additional strain on the knee joints, which can accelerate the wear and tear process. Studies consistently show that weight loss can alleviate symptoms and reduce the progression of knee arthritis. **Takeaway:** While no specific diet can cure knee arthritis, adopting an anti-inflammatory diet rich in fruits, vegetables, lean proteins, and healthy fats, along with maintaining a healthy weight, can help manage symptoms and improve your overall joint health. At Victory, we believe in a Whole-istic approach to knee health, which is a huge part of our trademarked “Knee Repair, NOT Knee Replacement, TM” brand, philosophy and individualized, personalized programs. This includes not only advanced regenerative treatments but also genetic based 🧬 nutritional guidance. By taking care of your body from the inside out, you can take significant steps towards healthier, pain-free knees. #KneeHealth #ArthritisDiet #HolisticHealing #KneeRepairNOTKneeReplacement #VictoryInMotion #DrMarcPietropaoli **References:** - Zeng, C., et al. (2017). Sugary beverages and knee osteoarthritis. *Arthritis Care & Research*. - McAlindon, T.E., et al. (1996). Antioxidants and cartilage loss in knee osteoarthritis. *The American Journal of Clinical Nutrition*. - Alviar, M.J., et al. (2014). Omega-3 fatty acids and osteoarthritis. *The Journal of Nutrition*.

Do you really want me to reinfuse a gastric residual volume (GRV) of 490 mL? The answer is a firm YES! It is known that GRVs do not correlate with incidences of pneumonia, regurgitation, or aspiration. Thus, recommendations include not to not use gastric residual volumes as part of routine care to monitor ICU patients receiving EN. In "those ICUs where GRVs are still utilized, holding EN for GRVs <500 mL in the absence of other signs of intolerance should be avoided." Despite these well documented recommendations, as published in 2016 by the Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), I still find discrepancies between recommendations and clinical practices at the bedside for those still adopting routine measurements of gastric residual volume. A nurse might be reluctant to reinfuse a gastric residual of 490 mL, deciding to reinfuse only 50 mL and discarding the rest. This causes unnecessary loss of calories, protein, fat, vitamins, minerals, fiber, water, electrolytes, and enzymes. The gastroenterology team might decide to interrupt the enteral nutrition infusion, sometimes even going as far as to diagnose gastroparesis, based on a single finding of a residual of 490 mL (true story). So I feel it is important to review a few facts about the stomach and it's contents under normal conditions: The stomach lining has wrinkles and folds (rugae) when it is empty. These folds disappear as the stomach expands with the ingestion of solids or liquids. An empty stomach has a volume of about 25–50 mL vs 1–1.5 L after an average meal. This volume can increase up to 4 L when full by unfolding and stretching. The gastric mucosa also secretes about 1.2 to 1.5 litres of gastric juice per day. When we are fasting the gastric volume ranges between 13 mL and 72 mL, while during the fed state, the gastric volume could be between 534 and 839 mL. So let us keep in mind what normally happens when we do not measure gastric residual volume, as is the case of those patients that are being fed orally. Then, a gastric residual volume of 490 mL in the absence of any signs of intolerance might not concern us as much. At the risk of dating myself, I was one of those practitioners that wrote recommendations to hold enteral nutrition infusion if the gastric residual volume meaured double the amount of the hourly infusion rate. That would have allowed a nurse to stop an enteral nutrition infusing at 60 mL/hr, solely based on a single finding of a gastric residual volume of 120 mL. As illogical as that sounds, it was me the one adopting that school of thought in the early 1990s. The focus on medicine today challenges us to make decisions based on evidence. Clinical "judgment" is also valid, as long as we do not use that as an excuse to impose any unsupported health beliefs or our hesitancy to do the right thing based on our own knowledge deficits. #evidencebasedpractice #nutritionsupport

🌟 Review of the Article: Nonalcoholic Fatty Liver Disease and Omega-3 Fatty Acids: Mechanisms and Clinical Use 🌟 As an M.Sc. (Human Nutrition and Dietetics) student, I recently explored a fascinating review article, that is published by Annual Reviews.This article delves into the connection between nonalcoholic fatty liver disease (NAFLD) and omega-3 polyunsaturated fatty acids (PUFAs). With NAFLD being a prevalent chronic liver condition globally, this article highlights the potential role of omega-3 PUFAs, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), in reducing the severity of the disease. 🔑 Following are some key takeaways: 🔖 NAFLD is strongly linked to obesity and metabolic disorders such as type 2 diabetes. 🔖The article explains how omega-3 PUFAs regulate various cellular functions, helping to reduce liver fat, inflammation, and fibrosis. 🔖Current therapeutic strategies, such as dietary supplementation of omega-3 PUFAs, show promise in mitigating NAFLD progression. This review resonates with my current studies, emphasizing the importance of diet and nutrition in managing chronic diseases. It serves as a reminder of the significance of ongoing research in clinical nutrition, encouraging me to integrate scientific findings into practice.

As obesity rates continue to rise in adults across the nation, RDNs are encouraged to collaborate with their clients to create treatment plans that align with their desires, lifestyle and values to help them meet their health goals, according to a new paper published by the Academy of Nutrition and Dietetics. Read more in our latest press release. 👇 #eatrightPRO #dietetics #dietitian #nutrition #RDN #NDTR #rdchat

💉Wegovy, Ozempic, Zepboud…these boutique brands of GLP-1 agonists have quickly become household names. These GLP-1 agonists, such as semaglutide, are making waves for their impressive results in weight loss and diabetes control, with more benefits being discovered regularly. ⠀ However, there's a flip side we need to discuss - potential (serious) gastrointestinal side effects. ⠀ 🤢Recent research, including a systematic review and meta-analysis from 2023, has shown that #semaglutide can increase the risk of nausea, vomiting, dyspepsia, decreased appetite, constipation, and diarrhea by 54% compared to placebo! [1]  ⠀ 🚑Plus, individuals taking GLP-1 agonists were NINE TIMES more likely to experience pancreatitis. This is a serious (and painful!) condition requiring immediate medical care. [2] ⠀ 🥴GLP-1’s effect on slowing gut motility is also well documented. [3] This slowing can make individuals FOUR TIMES more likely to experience gastroparesis and bowel obstruction compared to those taking bupropion-naltrexone. [2] ⠀ ⚖️These side effects are serious and should be carefully considered for each patient. ⠀ The potential benefits of #GLP1agonists are significant, and the BeWell team is excited to see how the research continues to unfold. ⠀ ✅But it’s important to remember that for true, sustainable weight loss, an integrative nutrition and lifestyle program is always best. ⠀ This means combining medications like semaglutide with a functional food and supplements strategy to support a weight loss journey focused not just on the scale, but on creating a healthier, happier you! ⠀ Sources: [1] Bandyopadhyay S, Das S, Samajdar SS, Joshi SR. Role of semaglutide in the treatment of nonalcoholic fatty liver disease or non-alcoholic steatohepatitis: A systematic review and meta-analysis. Diabetes Metab Syndr. 2023 Oct;17(10):102849. doi: 10.1016/j.dsx.2023.102849. Epub 2023 Sep 13. PMID: 37717295. [2] Sodhi M, Rezaeianzadeh R, Kezouh A, Etminan M. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA. 2023;330(18):1795–1797. doi:10.1001/jama.2023.19574 [3] Marathe CS, Rayner CK, Jones KL, Horowitz M. Effects of GLP-1 and incretin-based therapies on gastrointestinal motor function. Exp Diabetes Res. 2011;2011:279530. doi: 10.1155/2011/279530. Epub 2011 Jun 22. PMID: 21747825; PMCID: PMC3124003. ⠀  #SummerRecipes #HealthyLiving #BeWellAssociates #happyvalley #functionalnutrition 

Read All About It: Compassion, Collaboration Key in Treating Patients with Overweight, Obesity: Updated Position Paper of Academy of Nutrition and Dietetics Compassion and collaboration are such important components of providing the very best care to our patients and clients - no matter what area of nutrition you practice in. Using shared decision making, finding out what they really want and need, and then helping them achieve THEIR idea of their best health is transformative. The skills of the registered dietitian nutritionist as part of an interdisciplinary care team is essential for providing this kind of care with the best outcomes. I really like this quote pulled from the position paper: "It is the position of the Academy of Nutrition and Dietetics that medical nutrition therapy (MNT) behavioral interventions for adults (18 years and older) with overweight or obesity should be a treatment option, when appropriate and desired by the client, to improve cardiometabolic, quality of life, and anthropometric outcomes. Registered dietitian nutritionists or international equivalents (dietitians) providing MNT recognize the complex contributors to overweight and obesity, and thus individualize interventions, based upon a shared decision-making process, and deliver interventions in an inclusive, compassionate, and client-centered manner. Interventions should include collaboration with an interprofessional team when needed. Dietitians strive to increase health equity and reduce health disparities by advocating and providing opportunities for increased access to effective nutrition care services." https://lnkd.in/enzgbXmY

'This review synthesized existing literature on the efficacy of personalized or precision nutrition (PPN) interventions, including medical nutrition therapy (MNT), for improving health outcomes in adults with prediabetes or metabolic syndrome. A systematic search of six databases identified seven randomized controlled trials (RCTs) involving 873 participants, examining outcomes like glycaemic control, anthropometry, blood lipids, blood pressure, and dietary intake. The review found consistent and significant improvements in HbA1c, post-prandial glucose, and waist circumference with PPN and MNT interventions, though results for other measures were inconsistent. Longer and more frequent interventions showed greater benefits, particularly for HbA1c and waist circumference. The review highlighted the need for more research with larger sample sizes and standardized PPN definitions, and suggested future studies should explore integrating MNT with contemporary PPN factors such as genetic, epigenetic, metabolomic and metagenomic data.'