In this issue of Topics in Clinical Nutrition, we explore a variety of clinically relevant topics touching upon cardiovascular disease (CVD) and metabolic disease risk, disordered eating attitudes and behaviors, xerostomia, the Advanced Practice credential, as well as zinc and inflammatory bowel disease (IBD), and review articles highlighting vitamin D status and omega-3 fatty acid supplementation in neurological injuries.
Pasdar et al from Kermanshah University of Medical Sciences in Iran studied the relationship of relative handgrip strength (RHGS) with anthropometrics, lipid profiles, and CVD through a cross-sectional study of 883 individuals both with and without CVD. They identified an inverse relationship between RHGS and body fat percentage, body fat mass, waist circumference, hip circumference, and waist-to-hip ratio in both groups but found no association between RHGS and total cholesterol, triglycerides, and low-density and high-density lipoprotein levels. Their results highlight that increased RHGS may be associated with improved body composition but not with improved lipid profiles.
Hamedi-Shahraki et al from Zabol University of Medical Sciences in Iran explored the relationship between dietary diversity and metabolic syndrome through a cross-sectional study of 410 adults using a validated food frequency questionnaire to assess dietary diversity. They found that the likelihood of having metabolic syndrome including abdominal adiposity, high blood pressure, and hypertriglyceridemia decreased with increasing dietary diversity, suggesting that more diverse diets may be useful in preventing metabolic syndrome and its associated features.
Stevens et al from Rutgers University examined the impact of the Advanced Practice Certification in Clinical Nutrition (RD-AP) credential through a qualitative study of 12 credentialed dietitians. The results of semistructured interviews revealed that attainment of the RD-AP credential was associated with increased confidence, validation, personal satisfaction, and enhanced quality of patient care. Barriers such as lack of recognition, unsupportive work environments, and limited advancement opportunities were also identified. Further education and marketing of the credential may help address these barriers both within and outside of the profession.
Novotny et al from Missouri State University studied the eating attitudes and behaviors of 317 undergraduate health students using the EAT-26 tool, a self-reported measure of disordered eating. They found that approximately 5% of students had scores suggestive of an eating disorder, with lower scores found in dietetics students who had completed more nutrition courses. An additional finding of the study included reports of disordered eating behaviors as well as identifying past and/or current disordered eating behaviors as a reason for choosing to study dietetics. These findings highlight the importance of addressing eating disorders in this population to minimize health impacts and implications to practice.
Dadgari et al from Shahroud University of Medical Sciences in Iran conducted a quasi-clinical trial in 77 elderly nursing home residents with xerostomia on the impact of sorbet intake before lunch and dinner for 8 weeks on oral diet and weight gain. They identified that individuals who consumed the preprandial sorbet needed less water while eating and demonstrated greater food intake. A statistically significant weight change was found in seniors with a BMI less than 25 kg/m2. Their findings suggest that management of xerostomia may improve oral intake and weight in this population.
Zhang et al from the First People's Hospital of Nanning in China conducted a systematic review and meta-analysis evaluating the relationship between serum zinc levels and IBD. Data extraction and analysis from 16 studies revealed a significant association between low serum zinc levels and Crohn disease but not ulcerative colitis. Clinicians may consider monitoring zinc levels and possibly supplementing zinc in this high-risk population.
Two groups conducted reviews to explore the relationship between nutrition and outcomes in patients with neurological disorders, including traumatic brain injury (TBI). Hahn et al from Rutgers University conducted a literature review examining the relationship of vitamin D status to cognitive and functional outcomes in patients with TBI in a rehabilitation setting. One challenge of the review was the lack of standardization of the definitions of vitamin D sufficiency, inadequacy, and deficiency. The findings from 3 observation studies revealed that while vitamin D deficiency was prevalent, there were no consistent findings in cognitive and functional outcomes in this population.
Adams and Hewlings from Central Michigan University conducted a systematic review to evaluate omega-3 fatty acid supplementation in health outcomes in patients with neurological injury. The review of 5 studies identified 2 trials that found improvements in postoperative bleeding and cerebral vasospasm associated with omega-3 fatty acid supplementation. Although the treatment type and dosage varied, no detrimental side effects of the supplementation were noted. Their findings suggest that omega-3 fatty acid supplementation may be beneficial to this population, although further study is needed.
Thank you for your contributions to Topics in Clinical Nutrition. We are currently encouraging submissions of clinical case studies to provide practice-oriented, problem-based learning opportunities in an effort to meet the needs of our readership. Thank you for your ongoing support.
-Kelly Kane, MS, RD, CNSC
Editor