ZoekresultatenZoekresultaten
Volg ons op
Volg ons op
Types
0Instelling
26Bestandstype
9Taal
5Publicatiejaar
12Thema's
14Producttype
14Publicaties met bestand / URL
2Projectstatus
3OBJECTIVES: To compare the dietary intakes of Dutch nutrition and dietetics students with the Dutch RDA and the Dutch National Food Consumption Survey (DNFCS), and to assess whether dietary intake changes during education.DESIGN: Cross-sectional and longitudinal research (2004-2010).SETTING: Data collection by 7 d dietary record and questionnaire.SUBJECTS: Dutch nutrition and dietetics students.RESULTS: Three hundred and fifty-two first-year and 216 fourth-year students were included. One hundred and thirty-three students in three cohorts were assessed twice. Of first-year students, >80 % met the RDA for all macronutrients. Of these students only 37 % met the RDA for fibre and in 43 % intake of saturated fat was too high. Fourth-year students more often met the RDA for fruits (55 %) and vegetables (74 %) compared with first-year students (32 % and 40 %, respectively). Intake of fruits and vegetables of both first- and fourth-year students was much higher than that of DNFCS participants (where 2 % and 7 %, respectively, met the corresponding RDA). Only <25 % of fourth-year students met the RDA for Fe, Se and vitamin D. In the cohorts, dietary intake for all macronutrients stabilised from the first to the fourth year (>80 %). Intakes of dietary fibre, Ca, Mg, Se, riboflavin, niacin, fruits, vegetables and fish improved significantly during education.CONCLUSIONS: Dietary intake of nutrition and dietetics students is much better than that of DNFCS participants and improved during education. However, there is still a gap between actual dietary intake and the RDA, especially for Fe, Se and vitamin D.
LINK
BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.
METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.
RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.
CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.
DOCUMENT
Aims
To report the changes in nutritional status, nutrition-related complaints and risk of sarcopenia in individuals attending a primary care dietitian in the Netherlands after a COVID-19 infection.
Methods
The study was registered on the clinicaltrials.gov registry (NCT04735744). Nutritional status and nutrition-related complaints were assessed with the Patient-Generated Subjective Global Assessment Short Form and body composition measurements when possible. Risk of sarcopenia was assessed with the Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls questionnaire. Dietitians reported on treatment goals, content and volume of dietetic treatment. Descriptive statistics were used to describe the study population and outcomes at baseline and end of treatment. For continuous variables, paired samples t-tests were used to compare scores at the start and the end of dietetic treatment. For dichotomous variables. McNemar tests and Wilcoxon signed-rank tests were used to determine differences between the start and end of treatment.
Results
A total of 222 participants were included [mean age 50 (SD 13), 58% female, 34% overweight, 40% obese]. Malnutrition risk decreased from 44% (medium risk) and 20% (high risk) to 29% and 12% by the end of treatment (p < 0.001). The risk of sarcopenia decreased from 31% to 22% (p < 0.001). There was an imbalance between fat-free mass and fat mass in about half of the participants. The most commonly reported nutrition-related complaints were fatigue, no appetite, the feeling of being full and changed or loss of taste. Median treatment duration was 21 weeks [interquartile range (IQR) 13–26] and 5 consultations (IQR 4–7). Most participants (46%) aimed to maintain weight, with others aiming to lose (14%) or gain (14%) weight. At the end of treatment, 57% had achieved the goals.
Conclusions
Significant improvements in nutritional status and risk of sarcopenia were observed after dietetic treatment in primary care, and most participants achieved the treatment goals. Nevertheless, nutrition-related complaints and the risk of malnutrition or sarcopenia remained prevalent.
DOCUMENT
Background: In patients with chronic intestinal failure, the content and type of parenteral nutrition are individually determined based on various factors, including body composition. In clinical practice, bioelectrical impedance analysis is used to assess body composition using standardized protocols. However, these protocols lack specific recommendations for patients receiving parenteral nutrition. Therefore, this study described the effect of parenteral nutrition infusion on fat-free mass as evaluated by single-frequency bioelectrical impedance analysis. Methods: We performed a descriptive cohort study using bioelectrical impedance analysis to assess adult patients with chronic intestinal failure receiving parenteral nutrition. Measurements were performed at baseline (before parenteral nutrition infusion) and 0, 1, 2, and 4 h after (usually) 18-h parenteral nutrition infusion using hand-to-foot single-frequency bioelectrical impedance analysis (Bodystat 500). The primary outcome of fat-free mass was calculated using the Kyle equation. A linear mixed model was used to compare baseline values with other time points. A difference of >1 kg in fat-free mass compared with baseline was considered clinically relevant. Results: Twenty patients (70% female) with a mean age of 58 (SD, 14) years and a median body mass index of 22.3 (IQR, 21.2–24.8) kg/m2 were included in the analysis. No significant change in fat-free mass after parenteral nutrition infusion was observed, and 90% (69/77 measurements) of all fat-free mass outcomes after parenteral nutrition infusion remained within the ≤1-kg clinically relevant range. Conclusion: This study found that parenteral nutrition infusion does not affect fat-free mass estimation as assessed by hand-to-foot single-frequency bioelectrical impedance analysis.
DOCUMENT
Muscle health, encompassing muscle mass, composition, strength, physical performance and patient-reported outcomes, is a key determinant of clinical outcomes across the life course and a wide range of disease states. Despite growing recognition of its importance, muscle health remains insufficiently integrated into routine clinical nutrition practice, and nutritional recommendations often rely on population averages rather than individual muscle status, disease phase or metabolic context.This narrative review, developed by an international multidisciplinary expert group, synthesises current evidence on muscle health and clinical nutrition across major clinical domains, including ageing, cancer, metabolic disease, obesity, weight loss interventions and acute illness. We critically appraise methods for assessing muscle mass, function, and patient-reported outcomes, highlighting their strengths, limitations, and feasibility for clinical practice and research. In doing so, we highlight marked heterogeneity in metabolic and functional responses to nutrition and exercise interventions, underscoring the need for phenotyping, endotyping and precision nutrition to individualise protein and energy requirements.Beyond biological mechanisms, we address key implementation challenges limiting translation into practice, including inequities in access to dietetic and other rehabilitation services, variability in health system organisation and underuse of functional and patient-centred outcomes in trials and routine care. Finally, we propose a translational research agenda to harmonise outcome measures, improve trial design and support integration of muscle health assessment and personalised nutritional strategies into clinical care pathways.By positioning muscle health as a central and actionable outcome of clinical nutrition, this review supports a shift from uniform recommendations towards more personalised and effective nutrition care.
DOCUMENT
Malnutrition is an alarming and ongoing healthcare problem globally. Malnutrition has a negative impact on the individual patient, leading to poorer clinical outcomes and increased mortality, but also poses an economic burden on society. Proper identification and diagnostics are prerequisites for initiation of treatment. In 2019, the Global Leadership Initiative on Malnutrition, a consensus-based global framework to uniformly diagnose malnutrition across populations, healthcare settings, and countries was published. Identifying and treating malnutrition is an interdisciplinary team effort. Nonetheless, the nutrition and dietetics profession is specifically trained for diagnosing and treating nutrition(-related) conditions, and therefore has a key role in the interdisciplinary team in implementing the GLIM framework in clinical practice. For the nutrition and dietetics profession, GLIM offers a great opportunity for moving both the scientific and clinical knowledge of malnutrition management forward. While the GLIM framework has been extensively studied since its launch, various knowledge gaps still remain. For the nutrition and dietetics profession, these knowledge gaps mainly relate to the GLIM implementation process, to the role of GLIM in relation to the nutrition care process, and to treatment strategies for various nutrition-related conditions. In this opinion paper, we aimed to describe the rationale for implementing the GLIM framework in clinical dietetic practice, and propose a research agenda based on knowledge gaps regarding GLIM in relation to nutrition care from a dietetic point of view.
DOCUMENT
BACKGROUND & AIMS: Although up-to-date definitions for nutrition assessment integrate behavioural components, it is not clear what behavioural components are to be assessed. Since behavioural modification is linked to effective therapeutic dietetic interventions, assessing behaviour and factors influencing behaviour might be beneficial to improve personalized dietetic outcome. The aim of the following report is to emphasize the role of behavioural components and factors affecting behaviour at baseline nutrition assessment in personalized dietetic intervention.
METHODS: The present work is part of the EU-funded project IMPECD ("Improvement of Education and Competences in Dietetics", www.impecd.eu). The project aims to improve the clarity and consistency of national dietetic process models to unify education and training of future dietitians. Experts from five European Universities of Applied Sciences (UAS) in Antwerp (BE), Fulda (DE), Groningen (NL), Neubrandenburg (DE) and St. Pölten (AT) developed a Massive Open Online Course (MOOC) consisting of several clinical cases. It warranted a detailed evaluation of all dietetic care process steps, starting with nutrition assessment.
RESULTS: Results for motivation assessed during nutrition assessment are not consistently positively associated with outcome and the added value of assessing them at baseline is still unclear. However, depressive symptoms, emotional distress, and anxiety negatively affect eating and physical activity and therefore limit the efficacy of the dietetic intervention. Assessing behavioural components including nutrition literacy is an important precondition for influence on behavioural modification.
CONCLUSION: Indisputably, baseline assessment of behavioural components and factors influencing behaviour are important to increase the therapeutic efficacy of personalized dietetic interventions.
DOCUMENT
The purpose of the study was to describe the food intake of Dutch Nutrition and Dietetic (ND) students compared to the Dutch Recommended Dietary Allowances (RDA) and the National Food Consumption Survey (NFCS).
DOCUMENT
Purpose: To develop and evaluate an interdisciplinary group intervention for patients with myotonic dystrophy regarding healthy nutrition, meal preparation, and consumption, called Meet and Eat. Materials and methods: A design-based approach was used, exploring experiences and needs of patients with myotonic dystrophy and their next of kin. This resulted in a 4-week interdisciplinary outpatient group intervention to increase awareness and change behavior. In a mixed-method feasibility study this intervention was evaluated with participants and facilitators. Results: Participants reported on social impact of difficulties with eating and drinking (speaking, swallowing, and social embarrassment) and a variety of complaints affecting meal preparation and consumption. Patients and family members expressed the wish to learn from others. After delivery of the intervention, self-reported outcome measures demonstrated improvement on eating and drinking issues in daily life. The qualitative evaluation showed increased awareness and appreciation of the following design principles: peer support, multidisciplinary approach, active involvement of patient with myotonic dystrophy and their next of kin by using personal goals and motivational interviewing. Conclusion: Participation in Meet and Eat seemed to increase insight in patients' condition and ways of management. However, a longer self-management life style program is recommended to change behavior.
DOCUMENT
Background Obesity is defined as a chronic, relapsing disease, characterised by its persistence and the frequent recurrence of weight gain following weight loss. It is linked to chronic diseases and reduced quality of life. Sustainable weight loss requires long-term dietary and behavioural changes. Dietetic treatment outcomes vary per patient, leading to differing success rates and effectiveness. Although understanding patient experiences is crucial for designing effective, patient-centered strategies, little is known about their lived experiences. This study aimed to obtain a better understanding of the perspectives and experiences of patients with obesity receiving dietetic treatment in primary health care in the Netherlands. Methods This qualitative interpretive study included 26 patients with obesity who were consulting or had consulted a dietitian. We performed purposeful sampling to ensure a sample diverse in socio-cultural background, region, age and health literacy. Semi-structured interviews were conducted using a predefined topic guide, with room for flexibility to explore emerging topics. We analysed the interview data using reflexive thematic analysis as described by Braun and Clarke. Results Four interconnected themes were constructed from what patients named to be important in dietetic treatment: (1) personalised treatment as a foundation for success, including feeling heard and receiving responsive and adaptive treatment (2) the personal impact of the dietitian on treatment, through the dietitian's attitude, professionalism, and background; (3) a personalised and holistic approach for lasting change, including clarity about the dietitian's ways of working, motivational and emotional support, attention to life context and guidance in developing sustainable habits; and (4) tailored and accessible advice, focusing on practical tools, understandable information, and consistency of advice. Conclusion This study highlights that successful dietetic treatment for adults with obesity depends on personalised support, a strong patient–dietitian relationship, and holistic attention to psychological and behavioural factors. Clear communication, involvement from the start, and practical, tailored advice help patients comply with treatment and apply recommendations in daily life. Findings emphasise the importance of aligning dietetic treatment with individual patient needs and expectations. **Summary** - A strong personal connection, in which patients feel heard and seen, forms the foundation for effective dietetic treatment. - The dietitian's attitude and communication style strongly shape how treatment is experienced. - Tailored advice, clear materials, and consistent communication enhance patients' ability to apply dietary guidance in daily life.
DOCUMENT
