Co jedzą dzieci i młodzież?

Artykuł z numeru 4/2013 internetowego czasopisma edukacyjnego ORE "Trendy

Leczenie żywieniowe w neurologii — stanowisko interdyscyplinarnej grupy ekspertów

U pacjentów hospitalizowanych z powodu chorób neurologicznych oraz w okresie usprawniania i opieki często stwierdza się zaburze­nia o charakterze dysfagii oraz inne zaburzenia i stany kliniczne ograniczające przyjmowanie odpowiedniej ilości składników odżywczych. Może się to przyczynić do utrudnienia leczenia oraz do pogorszenia jego wyniku. Stanowisko interdyscyplinarnej grupy ekspertów wskazuje na znaczenie badań przesiewowych i diagnostyki dysfagii oraz zawiera wytyczne prawidłowej terapii żywieniowej w celu profilaktyki zachłystowego zapalenia płuc, niedożywienia i odwodnienia

Effectiveness of Personalized Low Salicylate Diet in the Management of Salicylates Hypersensitive Patients: Interventional Study

Salicylic acid and its derivatives (including acetylsalicylic acid/aspirin) are popular in medicine. They also occur naturally in many food products. The aim of the study was to investigate the effect of the personalized low salicylate diet (PLSD) on the reduction of asthma, rhinosinusitis and urticaria symptoms in patients with hypersensitivity to aspirin (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs). To achieve the research goal, a prospective, nonrandomized, baseline-controlled intervention study was conducted. Thirty patients diagnosed with NSAIDs hypersensitivity, who despite pharmacotherapy had symptoms of hypersensitivity, were included in the study. The PLSD was recommended for all participants for a period of two to four weeks. The intensity of subjectively declared symptoms of asthma, rhinosinusitis and urticaria were measured before and after dietary intervention, using, respectively, the asthma control test (ACT), the sino-nasal outcome test (SNOT-22) and the four-item itch questionnaire (FIIQ). Diet adherence and salicylate intake were measured by a 3-day food record. The severity of symptoms improved significantly after the intervention. The median of the ACT score was 24 scores before and 25 after the dietary intervention (p < 0.002), the median of the SNOT-22 score was 25 before and 13 after a dietary intervention (p < 0.0002) and the median of the FIIQ score was 5 before and 0 after a dietary intervention (p < 0.0002). The intake of salicylates decreased from 0.79 mg/day (before intervention) to 0.15 mg/day (p < 0.001) (during intervention). Although the usefulness of a low salicylate diet in the treatment of salicylate hypersensitivity is controversial, the results of our study indicate that the PLSD may have a positive effect in reducing symptoms of salicylate hypersensitivity and could be an additional tool supporting the therapy of these patients

Dietary Intervention Effectiveness, Clinical Outcomes and Nutrient and Salicylate Intakes in Older Adults Living in Long-Term Care Homes: The Results from the Senior’s Plate Project

Optimal nutrition is an important part of the therapeutic process offered to patients in long-term care, as it can significantly influence their nutritional and health status. The aim of this study was to assess the impacts of a dietary intervention on the nutritional status, clinical outcomes and selected nutrient and salicylate intakes among older adults living in a long-term care nursing home. To achieve the research goal, a prospective, non-randomized, baseline-controlled intervention study was conducted. The study was conducted within the framework of the “Senior’s Plate Project”, a project established in 2018 by the Polish Society of Dietetics. Methods: A 3 month dietary intervention, which included one serving of supplementary food, served as a second breakfast (Nestle Sinlac). Energy, nutrients and salicylates intakes were estimated on the basis of the menus. Food and beverage intakes among residents were verified by health care personnel. Anthropometric measurements and clinical examinations were conducted according to standard procedures at baseline and after intervention. Results: Of the 38 residents qualified for the study, 29 completed the program. Residents’ body mass index (BMI) values ranged from 13.3 kg/m2 to 34 kg/m2. A BMI < 22 kg/m2, indicating underweight, was found in 19 subjects. The dietary intervention resulted in increased body weight (57.8 ± 12.3 vs. 59.4 ± 12.6 kg), BMI (22.4 ± 4.0 vs. 23.0 ± 4.1 kg/m2) and body fat (19.2 ± 8.7 vs. 20.6 ± 8.9 kg). Significant changes in the levels of biochemical parameters, including serum calcium (8.7 vs. 9.5 mg/dL), potassium (4.1 ± 0.6 vs. 4.5 ± 0.5 mmol/L) and zinc (74.1 ± 10.9 vs. 109.0 ± 20.4 µg/dL), were observed. Energy, protein, fat and carbohydrate intakes were significantly higher in the third month of the intervention as compared to the baseline. The estimated medial daily intake of salicylates was low and ranged from 0.34 mg to 0.39 mg. Conclusions: The dietary intervention resulted in beneficial and significant changes in the nutritional status, biochemical parameters and nutrition of residents of the long-term care home. These results suggest that practical and individualized approaches are required to improve the nutritional status and clinical outcomes of nursing homes residents

Dietary strategies for the management of obesity - is there an optimal diet?

Prevention and management of obesity has become a priority action for many institutions in the whole world and also one of the biggest challenges in the 21st century. Dietary pattern as well as physical activity has deteriorated, particular among Western populations. The consumption of industrially processed foods with high content of sugar and fat as well as the intake of beverages sweetened with sucrose or fructose has increased, but the consumption of fruit and vegetables has declined. Strategies for the management of obesity that leads to weight loss include three basic elements: increase in physical activity, consumption of a balanced diet as well as behavioral therapy. Low-calorie, balanced diets with adequate amount of vitamins and minerals are used in the management of obesity. Energy deficit can be induced via modification of the proportion of macronutrients (protein, fat and carbohydrates). Therefore, it is possible to have different modifications that can yield several proportions of these macronutrients. In any case, diet has to be planned individually. Weight loss can be achieved by the use of high-carbohydrate diet (rich in dietary fiber), high-fat diet or high-protein diet, but with energy deficit. Low-calorie diets should be planned individually in such a way that long-term adherence to them would be easy to achieve

Analysis of nutritional value and costs of gluten-free diet compared to standard food ration

Wprowadzenie. Dieta bezglutenowa jest podstawową metodą postępowania terapeutycznego w celiakii. Pacjent, stojąc przed koniecznością wyeliminowania glutenu z diety, teoretycznie może wybierać pomiędzy produktami naturalnie bezglutenowymi lub produktami bezglutenowymi specjalnego przeznaczenia żywieniowego. Pomimo dobrej dostępności produktów bezglutenowych wciąż istnieją problemy związane ze zbilansowaniem takiej diety, jak również jej kosztem. Cel. Celem pracy była ocena zawartości wybranych składników pokarmowych oraz oszacowanie kosztów diety bezglutenowej z wykorzystaniem dostępnych na polskim rynku produktów naturalnie bezglutenowych oraz bezglutenowych środków spożywczych specjalnego przeznaczenia żywieniowego w odniesieniu do diety zwyczajowej. Materiał i metody. Do analizy wybrano całodzienną modelową rację pokarmową na poziomie 2000 kcal, którą następnie zmodyfikowano pod kątem zamiany produktów zbożowych na produkty naturalnie bezglutenowe oraz bezglutenowe środki spożywcze zgodnie z założeniami diety bezglutenowej. Oceniono zawartość wybranych składników pokarmowych dostarczanych przez produkty zbożowe tradycyjne oraz ich bezglutenowe zamienniki. Analizy kosztów racji pokarmowych dokonano w oparciu o cenniki firm oferujących produkty bezglutenowe oraz uśrednione ceny produktów spożywczych z warszawskich supermarketów. Wyniki. Wykazano, że koszt bezglutenowej racji pokarmowej przy założeniu wyłącznie zamiany tradycyjnych produktów zbożowych wzrasta o prawie 30%. Przy podobnej ilości energii oraz węglowodanów ogółem, bezglutenowe zamienniki produktów zbożowych wnoszą do racji pokarmowej zdecydowanie mniejszą wartość odżywczą w odniesieniu do białka, żelaza, cynku, magnezu, tiaminy oraz błonnika pokarmowego przy jednoczesnej wyższej zawartości tłuszczu. Wnioski. Dostępne w handlu produkty bezglutenowe są znacznie droższe od odpowiadających im glutenowych produktów tradycyjnych. Zamiana produktów tradycyjnych na ich bezglutenowe odpowiedniki powoduje istotne obniżenie wartości odżywczej diety.Introduction. A gluten-free diet is the only method of therapeutic treatment of celiac disease. A patient in need of eliminating gluten from the diet can theoretically choose between the naturally gluten-free products, or gluten-free products for particular nutritional purpose. Despite good access to gluten-free products, there are still problems with balancing the diet, as well as its cost. Aim. The aim of this study was to evaluate the nutritional value and the costs of a gluten-free diet with naturally gluten-free products, and products for particular nutritional purposes available on the Polish market in relation to the standard diet. Materials and methods. The standard daily food ration (SDFR) of 2,000 calories and its modification (conversion of cereal products to gluten-free products in SDFR) were analyzed. Contents of selected nutrients provided by traditional cereals and their gluten-free alternatives were compared. Cost analysis of food rations were based on the price lists of companies offering gluten-free products, and the average prices of food in supermarkets in Warsaw. Results: The cost of a gluten-free food ration, assuming only the conversion of traditional cereal products, increased by almost 30%. With a similar amount of energy and total carbohydrates, gluten-free cereal substitutes contributed a much smaller nutritional value in relation to protein, iron, zinc, magnesium, thiamine and fibre, and with a higher fat content. Conclusions. Commercially available gluten-free products are much more expensive than the equivalent traditional gluten products. Replacement of traditional products for their gluten-free counterparts significantly reduces the nutritional value of the diet