4ward Nutrition

🌟 HEN Dietitians 🌟 The latest ESPEN guideline on Home Enteral Nutrition.

https://www.ncbi.nlm.nih.gov/pubmed/31255350

What are your thoughts on Recommendations 48 and 49?

48 - 'as home-made blenderized admixtures are less effective than EN formula or commercially produced 'whole food' solutions, they should not be utilized in patients on HEN'.

49 - ' as home-made blenderized admixtures are less safe than EN formula or commercially produced 'whole food' solutions, they should not be used in patients on HEN'.

It should be noted that agreement to these recommendations were 63% and 76% respectively.

I think as dietitians we have to support patient choice and I am sure this is an area that will see further research undertaken over the coming years.

https://www.ncbi.nlm.nih.gov/pubmed/29338077

Montreal naturopath found guilty of manslaughter as Quebec Court of Appeal overturns acquittal | CBC News The Quebec Court of Appeal found Mitra Javanmardi guilty Thursday of involuntary manslaughter in the 2008 death of a patient, 84-year-old Roger Matern. Javanmardi will be retried on a negligence charge.

another fascinating summary of Shaw et al study into the use of gelatin as a way to help prevent and treat injury by Asker Jeukendreup. particularly with regard to its timing
http://www.mysportscience.com/single-post/2017/03/15/Using-gelatin-to-improve-performance-prevent-injury-and-accelerate-return-to-play

Using gelatin to improve performance and prevent injury | Jeukendrup - Trusted sports nutrition advice & exercise science news New research suggests that we may be able to use gelatin to prevent injury. Here is the how and what by one of the worlds leading experts.

Fiber-fermenting bacteria improve health of type 2 diabetes patients: Dietary fibers promote gut bacteria that benefit blood glucose control The fight against type 2 diabetes may soon improve thanks to a pioneering high-fiber diet study.

Interesting and informative read

Recent Perspectives Regarding the Role of Dietary Protein for the Promotion of Muscle Hypertrophy with Resistance Exercise Training Skeletal muscle supports locomotion and serves as the largest site of postprandial glucose disposal; thus it is a critical organ for physical and metabolic health. Skeletal muscle mass is regulated by the processes of muscle protein synthesis (MPS) and muscle protein breakdown (MPB), both of which a...

IMPORTANT! Veganism did NOT cure his cancer, radiotherapy and chemotherapy did. He has however, embraced veganism to help remain in remission. Read the excellent summary by Clinical Dietetics for more info.

Father-of-two was CURED of cancer after going vegan Rob Mooberry, now 43, was 38 when he was diagnosed with stage 4 colorectal cancer in Las Vegas, where he is a bartender. He switched to a vegan diet after chemo, and the cancer shrunk.

Something I advise in clinic every week. A very good summary of the why’s and how’s by Fight the Fads ☀️

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Love it or hate it, there appears to be a scientific reason :-)

A fab visual showing the protein content of different milks

Many of you liked this picture that was recently posted on our PEN page. It is part of the new PEN Evidence Clip posted today on plant-based beverages and children: http://ow.ly/dBkw30f4vO4

after completing Spartan Super yesterday, a 10 mile obstacle course this is a very useful article for everyone from novices to elites. I firmly fall into the novice :-)
Thank you to the Australian Sports dietitian for good advice on this new type of sport.
https://www.sportsdietitians.com.au/factsheets/food-for-your-sport/obstacle-racing/

Obstacle Racing - Sports Dietitians Australia (SDA) Obstacle course racing was traditionally used as a means of physical and mental military training where participants complete gruelling feats such as wading through mud, sandbag carries, high ropes courses, and ice water swimming. Obstacle course events now incorporate social or 'weekend warrior' ch...

NGT feeding can be a blessing but the risks are there. You can never be too thorough in checking correct placement..

Nasogastric tube misplacement: continuing risk of death and severe harm This alert has been issued to support providers of NHS-funded care to prevent the risk of severe harm or death caused by the misplacement of nasogastric tube...

An area of dietetics I am passionate about, although this research is in adults it may lead to something in paediatrics - particularly interesting about removing ngt and appetite stimulation - great work Danielle

6 Danielle Bear Description

It's Nutrition and Hydration week and vitamin D is key to good health! Vitamin D mostly comes from sunshine. A deficiency could lead to bone pain & muscle weakness.
At risk groups should consider taking a vitamin D supplement https://www.bda.uk.com/foodfacts/VitaminD.pdf

interesting preliminary research into the spread of cancer and the influence of fat and sugar.
http://www.nature.com/nature/journal/vaop/ncurrent/full/nature20791.html

Targeting metastasis-initiating cells through the fatty acid receptor CD36 : Nature : Nature Research

is a marketing term, not a scientific one.

here is a fact sheet produced by the Association of UK Dietitians (formerly The British Dietetic Association) on the importance of Vit Dhttps://www.bda.uk.com/foodfacts/VitaminD.pdf

www.bda.uk.com

Further recommendations from Public Health England on Vitamin D supplementation. If you are exposed to regular reasonable amounts of sunshine during March-September you are unlikely to require supplementation during this time. However the most recent advice is that everyone (other than formula fed infants taking > 500mls/day) have a supplement of 10micrograms per day during the winter months.

See the statement below: published by Public Health England in August this year

***Vitamin D: The Department of Health recommends that breastfed babies from birth to one year of age should be given a daily supplement containing 8.5 to 10μg of vitamin D, to make sure they get enough. Babies fed infant formula should not be given a vitamin D supplement until they are receiving less than 500ml (about a pint) of infant formula a day, because infant formula is fortified with vitamin D. Children aged 1 to 4 years old should be given a daily supplement containing 10μg of vitamin D.
As vitamin D is found only in a small number of foods, it might be difficult to get enough from foods that naturally contain vitamin D and/or fortified foods alone. So everyone, including pregnant and breastfeeding women, should consider taking a daily supplement containing 10μg of vitamin D. Between late March/April to the end of September, the majority of people aged five years and above will probably obtain sufficient vitamin D from sunlight when they are outdoors. So they may choose not to take a vitamin D supplement during these months. However, some groups of people will not get enough vitamin D from sunlight because they have very little or no sunshine exposure. So the Department of Health recommends
that people should take a daily supplement containing 10μg of vitamin D throughout the year if they are not often outdoors, such as those who are frail or housebound; are in an institution such as a care home; usually wear clothes that cover up most of their skin when outdoors. People from minority ethnic groups with dark skin, such as those of
African, African-Caribbean or South Asian origin, might not get enough vitamin D from sunlight – so they should consider taking a daily supplement containing 10μg of vitamin D throughout the year.

An article on research into the recommendation of Vitamin D supplements in the UK. The advice now is to have 10 micrograms per day, this is the first time an amount has been definitely advised. Due to the rubbish weather in UK the most effective way of getting regular Vit D is via supplementation. However, be cautious, if you take a multi vitamin routinely, check the Vit D content before considering adding an additional supplement. Vit D is a fat soluble vitamin so is stored in the body and you can overdose.
http://www.bbc.co.uk/news/health-36846894

Vitamin D supplements 'advised for everyone' - BBC News Everyone should consider taking vitamin D supplements in autumn and winter, public health advice in England and Wales says.

As summer is here....(allegedly) the whole detox saga will be rearing its head again. I thought i should have a bit of a refresh on whether this really is a useful exercise. Having just read a very well written article published in the Journal of Human Nutrition and Dietetics, my opinion remains that, our body is an incredible vessel and will do the job for us. We are responsible for what goes in it and if you want a healthy body, treat it with respect.

The reference for the article is;
Journal of Human Nutrition and Dietetics
Volume 28, Issue 6
December 2015
Pages 675–686

Detox diets for toxin elimination and weight management: a critical review of the evidence
Authors
A. V. Klein,
H. Kiat

The review confirms there is no robust evidence that detox diets work. Many of the studies have been conducted in fish and mice. There are some flawed methodologies, i.e. no controls.
It does state there can be weight loss, but this would go hand in hand with eliminating whole food groups from the diet....which in turn could lead to malnutrition. Extra supplementation of other nutrients has also been reported to cause death, as in some instances the product dose doesn't match what it claims on the packaging (Sanchez et al, 2012).

In conclusion, there is no evidence to suggest that detox diets work for either weight loss or toxin elimination. (Cohen 2007, Ernst, 2012).

The BBC has published an interesting article on 'superfoods' - well worth a read and written by an established and highly regarded dietitian

http://www.bbc.co.uk/guides/zt6yk7h

Are you fooled by superfoods? Are superfoods all they're cracked up to be? Would we better off just eating a varied diet that includes plenty of fruit and vegetables?

Should I eat more carbs? Thinking about a diet? Chances are you’ll be told to think about cutting back on “carbs”. But what if eating less carbohydrate is not as healthy as we think?

TPN is a lifeline, not a beauty treatment: intravenous vitamin therapy explained For celebrities, it’s the latest must-have treatment. But for others, it’s a matter of life and death. Here the parent of a child who needs daily TPN to stay alive explains why its use as a beauty fad is inappropriate, if not downright dangerous

Finally!! A dietitian has written and the media has published. They have sorted the wheat from the chaff (oh yes, i do like a pun!) A fantastic tell it how it is article. Particularly pay attention to Myth 8 - if you want dietary advice which is evidence based, i.e. NOT n=1 therefore it works - please contact a registered dietitian who will advise accordingly. Go to https://www.bda.uk.com where you can find a list of freelance dietitians or even better go to your GP who will refer you on :-)

in the meantime happy reading
http://www.dailymail.co.uk/health/article-3437400/Gluten-free-ISN-T-healthier-energy-bars-NOT-good-healthy-food-ISN-T-expensive-Dietitian-busts-8-common-diet-myths.html

Dietitian busts 8 common diet myths... Texas A&M Health Science Center dietitian explains gluten-free desserts can lead to weigh gain, not all carbs make you fat and advises eating seasonal fruit and veg to save money.

So Christmas is long gone and we are hurtling through the new year. With temperatures finally dropping, its time to ensure optimum nutrition! A quick and easy homemade soup is always a good start and packed full of nutrients - Spinach and coconut soup takes 15minutes to make.
Essential info -each 250mls serving will provide 315kcals, 10.7g CHO, 28g fat, 3.5g protein. The micronutrients provided are fab! 27.5% potassium, 12.5% calcium, 20% iron, 15% magnesium average daily requirements. Also a good fibre provider :-)

an interesting article on green tea and how if taken in excessive quantities could possibly have negative effects on health. The study was done on fruit flies so would need further investigation with humans. However, with a lot of nutritional supplements more is not always better and in some cases can be harmful. Always stick to the recommended doses as these have been proven to be safe :-)
http://www.medicalnewstoday.com/articles/304011.php?utm_source=Email+Campaign&utm_medium=email&utm_campaign=10491-351034-NH-eNews+15%2F12%2F15+-+Hospital+food+standards

Could too much green tea be harmful to health? Fruit flies exposed to large amounts of green tea showed impaired reproductive function and development in a new study, raising concerns about excessive consumption in humans.

t.co