Assessing the readiness of small cities in Ghana to tackle overweight and obesity

The rapid rise in the prevalence of overweight and obesity, and the associated health problems, is an emerging challenge in Ghana, and for women in particular. This study contributes to the understanding of this emerging phenomenon in Ghana by analyzing it from a community perspective, applying the Community Readiness Model in two small cities in Ghana. A series of Key Informant Interviews were undertaken and analyzed, using the model’s scoring structure and supplementary textual analysis. We find that communities are aware of overweight and obesity as a health issue, but that it is not prioritized or championed. Furthermore, the diet counseling and keep-fit programs put the responsibility on individuals to address, rather than considering the upstream and structural causes and solutions.

Low Salt Diet Counseling as an Effort to Increase Knowledge of Hypertension Patients

The prevalence of hypertension has increased throughout the year. Hypertension spreads widely because of the lack of knowledge and a healthy lifestyle. People's lifestyle which is more practical has an impact on the implementation of inappropriate hypertension diets and triggers various diseases. Based on this phenomenon, it is necessary to increase public knowledge about hypertension diets. The purpose of this activity was to provide counseling about a low-salt diet as an effort to increase knowledge of hypertension patients. The method was done by giving counseling about low salt diet through lectures to 30 hypertension patients who were routinely monitored at the Panti Rahayu Clinic. The pre test showed that almost all of the hypertension patients (80%) were in the poor category of knowledge. The post test showed that after being given counseling the knowledge of hypertension patients increased almost half (46%) were in the good category. Knowledge of hypertension patients increased after getting information through counseling activities about a low salt diet. Suggestions for clinics are expected to hold regular and periodic health education or promotion programs to provide information so as to increase the knowledge of hypertension patients.

GAMBARAN KEPATUHAN DIET PADA ANGGOTA PROLANIS SELAMA PANDEMI COVID-19 DI WILAYAH KERJA PUSKESMAS BOJONG 2

Non-communicable diseases (NCDs) are the leading causes of death and are responsible for the highest mortality rates in the world and in Indonesia. One of the programs for controlling NCDs especially hypertension and Diabetes at the Public Health Center (PHC) is Prolanis. One of the Prolanis programs is the monitoring of dietary adherence among Prolanis members. A descriptive research design was used as research method. The samples of this study were 34 Prolanis members in Sumurjomblang Bogo Village, the working area of Puskesmas Bojong 2. The results showed that the majority of Prolanis members in Sumurjomblang Bogo did not compliant the right schedule of diet (80%), the right type of diet (60%), and the right number of diet (60 %) for diabetes mellitus and hypertension. This may be due to lack of monitoring from health workers. Therefore, the results of this study are expected for an online diet counseling and monitoring program involving families of prolanis members during covid-19 pandemic.

Abstract P719: Diet Counseling in Post-Stroke Patients in the United States

Introduction: Research demonstrates dietary modifications in post-stroke patients facilitated by nutrition consultations improve post stroke recovery and reduce risk of recurrent stroke. Racial/ethnic differences in post-stroke nutrition practices demonstrate that focused dietary counseling of minority groups may be needed. It is unknown to what extent clinicians are providing dietary counseling in ambulatory office visits. Methods: We used data from the 2011 to 2016 National Ambulatory Medical Care Surveys to assess trends in post-stroke diet consultations during routine office visits across all races and ethnicities. We use multivariate logistic regression models to assess variation in the provision of dietary counseling by patient and provider characteristics. Results: There were 4,960 patients with a history of stroke among a total of 249,282 in the study period. The proportion of patients with stroke over the age of 60 who received diet counseling increased from 6% in 2012 (95% Confidence Interval (CI)=4%, 9%) to 14% in 2016 (95% CI= 7%, 21%). Adjusted models showed that other, non-Hispanic patients had a higher likelihood of receiving diet counseling, compared with whites (Odds Ratio (OR)=1.80, 95% CI=0.85, 3.82). Patients in the South were more likely to receive diet counseling than patients from the West (OR=1.47, 95% CI=0.81, 2.67). Patients in metropolitan areas had (OR=1.84, 95% CI=1.09, 3.09) a higher likelihood of counseling compared to patients in rural areas (OR=1.84, 95% CI=1.09, 3.09). Neurologists were less likely to provide counseling when compared to family medicine physicians (OR=0.14, 95% CI=0.07, 0.28). Conclusion: Major gaps in post-stroke dietary counseling exist; though the proportion of Americans over 60 receiving dietary counseling in ambulatory visits has been increasing in the past half-decade. Future interventions should focus on addressing gaps in counseling.

The Duration of Hemodialysis Treatment and the Adherence of Chronic Kidney Disease Patients in Fluid Intake Limitation: a Relationship

Hemodialysis is a routine medical intervention for a patient with chronic kidney disease. The duration of hemodialysis treatment makes the patient's behavior change to be not adherence to the recommended diet, including restrictions on fluid intake. The objective of this research is to determine the Relationship duration of hemodialysis treatment with Adherence to fluid restriction of Chronic Kidney Disease Patients. This cross-sectional study involving 44 respondents, taken by consecutive sampling techniques. Research has been conducted in the hemodialysis room at the Reksodiwiryo hospital in Padang from May-June 2019. Data collection was carried out by looking at medical records and questionnaires regarding fluid intake compliance in patients with chronic kidney disease. The data obtained were analyzed univariate with frequency distribution and bivariate with the Kendall Tau test. The results showed that there were 26 (59.1%) non-adherence patients, and 18 (40.9%) patients were adherence to limiting fluid intake. Old patients were 17 people (38.6%) and new patients were 27 (61.4%). The Kendall Tau bivariate test showed that the length of hemodialysis has a significant correlation with adherence fluid restriction (p = 0.014), with a negative correlation (r -0.375), it's meaning that the longer the hemodialysis, the lower the fluid restriction compliance. It is expected that hemodialysis nurses regularly evaluate the compliance of hemodialysis patients and routinely carry out educational and motivational programs as well as fluid diet counseling at each hemodialysis session. Keywords: compliance, fluid, hemodialysis, restriction

AB1207 EFFECT ON DIET MODIFICATION ON GOUT AND METABOLIC SYNDROME RISK FACTORS

Background:Gout is the most prevalent inflammatory arthritis globally. Despite treatment advances, the prevalence of gout has continued to increase over the last several decades. There has also been increasing evidence that gout has a strong association with the metabolic syndrome. This indicates that gout is likely both an inflammatory and a metabolic disease that has a significant effect on quality of life and healthcare costs. Although current recommendations support aggressive medical therapy for gout treatment, dietary counseling is less emphasized. We hypothesize that emphasis on this nonpharmacological therapy will likely improve management and the metabolic syndrome in gout patients.Objectives:To analyze the effectiveness of dietary counseling on gout management and risk factors for metabolic syndrome in gout patients at the Veteran’s Affairs Medical Center in Long Beach, CA (VALB).Methods:A retrospective cohort study was created from 2009-2016 involving Long Beach Veterans Affairs Hospital gout patients (n= 119) based on International Classification of Disease version 9 or 10. Patients were then stratified into two cohorts: received diet counseling (n=90) and no diet counseling (n=29). Data was reviewed for 24 months following initial gout diagnosis or intervention. Management was evaluated based on frequency of flares and related ED visits, change in creatinine clearance, serum uric acid levels (sUA), and changes to risk factors for metabolic syndrome including blood pressure, body mass index (BMI), cholesterol panel and hemoglobin A1c levels at six-month intervals.Results:Although patients in both cohorts were noted to have decreased number of gout attacks, patients who received diet counseling had a significant decrease in number of gout attacks by month 12 (0=0.004). In addition, after 6 months, patients who received diet counseling were more likely to have sUA at goal (sUA<6 for nontophaeous gout and sUA<5 for tophaceous gout) (p=0.003). These patients were also noted to have improved creatinine clearance (p=0.08) and increased HDL (p =0.08). In addition, patients with improved HDL and LDL values more likely to have improved sUA levels and decreased ED visits (R2=0.4, slope 0.14 and R2=0.4, slope 0.05, respectively) by month 6. Patients with improved hemoglobin A1c levels were also noted to have a significant outcome in lowering serum uric acid level at month 18 (R2=0.9, slope 2.6).Conclusion:Gout patients who receive diet counseling had lower rate of future attacks and better control of sUA. In addition, these gout patients were also noted to have improvement in some risk factors associated with the metabolic syndrome. Notably, patients who had better control of their hemoglobin A1c levels were able to have lower serum uric acid levels. This may imply that controlling diabetes in patients may also help improve gout management. Given the serious complications and increased cardiovascular risks that can be associated with metabolic syndrome, optimization of gout through a nonpharmacologic intervention such as diet counseling can enhance clinical outcomes and optimize healthcare resources.References:[1]Rai SK et al. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017;357:j1794.[2]Álvarez-lario B, et al. Hyperuricemia and gout; the role of diet. Nutr Hosp. 2014;29(4):760-70.Disclosure of Interests:None declared