Effect of Smart Goal Setting and Nutritional Assessment on Treatment Compliance in Primary Care Dietetic Treatment

Van 5-8 september wordt in Lissabon het ESPEN congres gehouden. Lees hier het abstract wat vanuit het DIEET-project gepresenteerd zal worden. Uit de eerste analyses blijkt dat cliënten vaker terugkomen na een eerste consult wanneer er metingen worden verricht en SMART doelen worden gesteld. Benieuwd naar de abstract? Download dan de bijlage in het linkermenu

Smart goal setting in current dietetic practice in primary care in the Netrherlands: preliminary observations of the dieet study

RATIONALE: Current developments drive dieticians in the primary care setting to demonstrate their effectiveness to both patients and stakeholders. Working with SMART (Specific, Measurable, Attainable, Realistic, Time-bound) goal setting may increase effectiveness. This study describes the current dietetic practice in the primary care setting in The Netherlands with regard to goal setting

How to establish increased protein intake in a blended lifestyle intervention in community-dwelling older adults?: subgroup-analysis of the VITAMIN RCT

Rationale: The dietary protein counselling of the VITAMIN trial showed to be effective in increasing the protein intake in community-dwelling older adults up to 1.41 g/kg/day after 6-months intervention and sustaining this intake up to 1.24 g/kg/day at 12-months. In this sub-analysis we determine how the increased protein intake was established. Methods: The VITAMIN (VITal AMsterdam older adults IN the city) RCT randomised older adults into: control, exercise, or exercise plus dietary counselling (protein) group. The dietary counselling intervention was blended, by use of face-to-face contacts and videoconferencing during a 6-month intervention, followed by a 6-month follow-up. Dietary intake was measured by a 3d dietary record at 0, 6 and 12 months (m). Sub-group analysis included characterisation of protein sources, product groups, resulting amino acid intake, and intake per meal moment. Linear Mixed Models were performed with SPSSv25; whereas time and time*group interaction were defined as fixed factors, and the protein group as reference. Results: In total 212 subjects were eligible for analysis (72.2 ± 6.3y), with an average protein intake at baseline of 77.8 (20) g/day and 1.08 (0.3) g/kg/day. Animal protein (g) accounted as major source (6m +25.6 (2.7) p<0.001 | 12m +15.6 (2.8) p<0.001), with the main increase in dairy products (g) (6m +14.2 (1.5) p<0.001 | 12m +10.0 (1.5) p<0.001), followed by fish and meat. This resulted in significant changes in amino acid intake: e.g. leucine (g) 6m +2.3 (0.3) p<0.001 | 12m +1.1 (0.3) p<0.001. Significant increased intake for the protein group was seen at all 6 meal moments, and particularly at breakfast (g) 6m +6.2 (1.0) p<0.001 | 12m +6.5 (1.1) p<0.001) and lunch (g) 6m +7.2 (1.3) p<0.001 | 12m +4.0 (1.3) p=0.003. Conclusion: Blended dietary counselling was effective in increasing protein intake in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch. Grant / Research Support from: FrieslandCampin

Energy intake and expenditure in obese older adults with and without type 2 diabetes

Rationale: Obesity is a risk factor for type 2 diabetes (DM2), however not all obese people develop DM2. We explored differences in energy intake and expenditure between obese older adults with and without DM2. Methods: Baseline data from 2 lifestyle interventions with a total of 202 obese older adults were included in the analyses. Obesity was defined as BMI > 30.0, or >27.0 with waist circumference >88 (women) or >102 cm (men). DM2 was confirmed by use of diabetes medication. Subjects were between 55 and 85 years old and 45% was female. Energy intake (EI) was measured by 3-day food diary and physical activity level (PAL) by 3-day movement diary. Resting energy expenditure (REE) was measured using indirect calorimetry and total energy expenditure (TEE) was calculated as REE x PAL. Between group differences were analysed with independent samples T-tests. Results: The obese group with DM2 (n = 117) had more males (67.5% vs 37.6% p < 0.001) and similar BMI (33.3 vs 33.0 kg/m2) compared to the group without DM2 (n = 85). Analyses of males and females separately showed lower PAL in males with DM2 (vs without DM2; 1.37 vs 1.45, p = 0.015), without differences in EI (2055 vs 1953 kcal/d), REE (1970 vs 1929 kcal/d), and TEE (2699 vs 2830 kcal/d). In females with DM2, both PAL (1.38 vs 1.47, p = 0.014) and EI (1543 vs 1839 kcal/d, p = 0.008) were significantly lower, whereas REE (1592 vs 1598 kcal/d) and TEE (2220 vs 2318 kcal/d) did not differ significantly from obese females without DM2. Conclusion: In both males and females, obese older adults with type 2 diabetes showed similar resting and total energy expenditure but lower physical activity level compared to those without DM2. Females with DM2 showed lower energy intake. On average, subjects seem to have a negative energy balance, which is probably due to a combination of underreporting of intake and over-reporting of activity

Increased species richness in the oral microbiome by a 13-week protein and combined lifestyle intervention in older adults with obesity and type 2 diabetes

Rationale: While combined lifestyle interventions have multiple health benefits, their impact on the oral microbiome is not known. We explored the effects of a lifestyle intervention including protein drink on the oral microbiome in older adults with obesity and type 2 diabetes (T2D). Methods: In a post-hoc analysis of the PROBE study, 87 subjects (66.5±6.1 years, 33% female) with tongue dorsum samples at baseline and week 13 were included. All subjects participated in a 13-week lifestyle intervention with exercise (3x/week) and hypocaloric diet (-600 kcal/day), and had been randomized to receive a test product (21g whey protein enriched with leucine and vitamin D) or isocaloric control (0g protein) 10x/week. T2D was subtyped as muscle insulin resistance (MIR, n=34) or no-MIR (n=36) based on available muscle insulin sensitivity index. Microbiome was analysed by V4 16s rDNA sequencing. Diversity, measured as species richness and Shannon diversity index, was statistically analysed with paired (within group) and independent (between groups) samples t-test. Results: displayed below. Conclusion: Consuming a whey protein drink enriched with leucine and vitamin D during a combined lifestyle intervention increased species richness of the oral microbiome in obese T2D subjects with muscle insulin resistance