An anti-inflammatory diet intervention for knee osteoarthritis: a feasibility study

Background Knee osteoarthritis has an inflammatory component that is linked to pain and joint pathology, yet common non-surgical and non-pharmacological interventions (e.g., exercise, calorie restricting diets) do not typically target inflammation. We aimed to evaluate the feasibility of a telehealth delivered anti-inflammatory diet intervention for knee osteoarthritis. Methods This 9-week single-arm feasibility study recruited participants aged 40–85 years with symptomatic knee osteoarthritis (inclusion criteria: average pain ≥4/10 or maximal pain ≥5/10 during past week). All participants received a telehealth-delivered anti-inflammatory dietary education intervention involving 1:1 consultations at baseline, 3- and 6-week follow-up. The diet emphasised nutrient-dense wholefoods and minimally processed anti-inflammatory foods and discouraged processed foods considered to be pro-inflammatory. The primary outcome of feasibility was assessed via: i) eligibility, recruitment and retention rates; ii) self-reported dietary adherence; iii) adverse events; and iv) treatment satisfaction. Post-intervention interviews evaluated the acceptability of the dietary intervention delivered via telehealth. Secondary outcomes included changes in self-reported body mass, Knee injury and Osteoarthritis Outcome Score (KOOS), health-related quality of life (EuroQoL-5D), analgesic use and global rating of change. Worthwhile effects were determined by the minimal detectable change (MDC) for all five KOOS-subscales (pain, symptoms, activities of daily living, sport/recreation, quality of life) being contained within the 95% confidence interval. Results Forty-eight of seventy-three (66%) individuals screened were eligible and 28 enrolled over 2 months (82% female, mean age 66 ± 8 years, body mass index 30.7 ± 4.8 kg.m−2). Six participants withdrew prior to final follow-up (21% drop-out). Of those with final follow-up data, attendance at scheduled telehealth consultations was 99%. Self-reported adherence to diet during the 9-week intervention period: everyday = 27%, most of time = 68% and some of time = 5%. Two minor adverse events were reported. Change scores contained the MDC within the 95% confidence interval for all five KOOS subscales. Suggestions to improve study design and limit drop-out included an initial face-to-face consultation and more comprehensive habitual dietary intake data collection. Conclusion This study supports the feasibility of a full-scale randomised controlled trial to determine the efficacy of a primarily telehealth-delivered anti-inflammatory dietary education intervention in adults with symptomatic knee osteoarthritis. Trial registration ACTRN12620000229976 prospectively on 25/2/2020.

Dietary Adherence and Associated Factors among Hypertensive Patients in Bahir Dar City Administration, Ethiopia, 2020

Introduction: Hypertension is considered one of the most challenging public health problems worldwide. Adherence to the recommended diet has a key role to reduce uncontrolled hypertension and hypertension-related complications. A study on dietary adherence among hypertensive patients and associated factors are limited in Ethiopia. So,this study aimed to assess dietary adherence and associated factors among hypertensive patients in Bahir Dar city governmental hospitals, Bahir Dar, Ethiopia. Method: A cross-sectional study was conducted at Bahir Dar city governmental hospitals from February- March 2020. Proportional allocation and systematic random sampling techniques were used to select 386 individuals with hypertension. The logistic regression model was used to assess the association between predictors and dietary adherence. The association was interpreted using the odds ratio and 95% confidence interval. Result: In this the proportion of dietary adherence was 32.8% (CI: 28.0, 37.6). Educational level college and above (AOR=3.0, CI=1.26, 7.08), received nutritional education (AOR=1.9, CI=1.05, 3.62), knowledgeable about hypertension (AOR=2.5, CI=1.36, 4.58), who had no co-morbidities (AOR=2.8, CI=1.49, 5.20), who lived two to four years with hypertension (AOR=2.4, CI=1.17, 5.07), and who had strong social support (AOR=7.1, CI=2.85, 17.46) had significantly association with dietary adherence. Conclusion and recommendations: This study demonstrated that low proportion of hypertensive individuals were adhered to recommended diet. Therefore, availed a social network of family and friends; providing dietary education to address the participants’ knowledge of hypertension, promote survival skill to new diagnosed and considered co-morbidities are an integral part of overall health in people with hypertension.

The Effects of Dietary Education Interventions on Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis

As the incidence and prevalence of diabetes increases, intervention through dietary education is becoming more important for diabetes control. This systematic review examines the evidence for the efficacy of dietary education interventions on diabetes control. The study subjects were patients with type 2 diabetes, and the main outcome variable was glycosylated hemoglobin level (HbA1c). The target studies were randomized controlled trials. Thirty-six studies were included in the analysis, of which 33 were included in the meta-analysis. The effect size between dietary education and general interventions was −0.42 (n = 5639, MD = −0.42; 95% CI −0.53 to −0.31) and was significantly different (Z = 7.73, p < 0.001). When subgroup analyses were performed following the application periods, intervention methods, and intervention contents, the mean differences in 4–6-month application, individual education, and diet-exercise-psychosocial intervention were −0.51, (n = 2742, 95% CI −0.71 to −0.32), −0.63 (n = 627, 95% CI −1.00 to −0.26), and −0.51 (n = 3244, 95% CI −0.71 to −0.32), respectively. Dietary education interventions provided for at least 3 months were highly effective in controlling HbA1c levels. Regarding the education method, individualized education was more effective, and contact or non-contact education may be applied for this. Combining diet, exercise, and psychosocial intervention is more effective than diet education alone.

Systematic Review of the Effects of a Dietary Education Intervention on Individuals with Type 2 Diabetes

As the incidence and prevalence of diabetes increases, intervention through dietary education is becoming more important for diabetes control. This systematic review aimed to confirm the ef-fect of dietary intervention education on diabetes control. The study subjects were type 2 diabet-ic patients, and the main outcome variable was glycosylated hemoglobin level (HbA1c). The target studies were randomized controlled trials. Thirty-six studies were included in the analysis, of which 33 were included in the meta-analysis. The effect size between the dietary education and general intervention, was -0.42 (n=5,639, MD=-0.42; 95% CI -0.53 to -0.31) and was signifi-cantly different (Z=7.73, P&lt;.001). When subgroup analyses were performed following the appli-cation periods, intervention methods, and intervention contents, the mean differences in 4–6-month application, individual education, diet-exercise-psychosocial intervention were -0.51, (n=2,742, 95% CI -0.71 to -0.32), -0.63 (n=627, 95% CI -1.00 to -0.26), and -0.51 (n=3.244, 95% CI -0.71 to -0.32), respectively. Dietary education interventions provided for at least 3 months were highly effective in controlling blood sugar levels. Regarding the education method, individual-ized education was more effective, and for this, contact or non-contact education may be applied. Combining diet, exercise, and psychosocial intervention is more effective than diet education alone.

Effect of Dietary Education Program on Health Status of Heart Failure Patients

The article’s abstract is not available.

Effectiveness of a physiotherapy and nutrition program in patients with coronary artery disease: randomized controlled trial

Funding Acknowledgements Type of funding sources: None. Introduction. Dietary and exercise interventions are effective strategies for improving physical and nutritional status of patients with coronary artery disease (CAD). However, few studies have applied a combined exercise protocol based on high intensity interval training (HIIT) and dietary education in patients with CAD with percutaneous coronary intervention (PCI). Purpose This study researches the effectiveness of a multidisciplinary program based in HIIT with dietary education (DEHIIT) in comparison with only HIIT, on adherence to Mediterranean diet in CAD patients with PCI. Methods. A prospective, assessor-blinded, parallel group, randomized trial was developed. The study was developed at a University research lab. Forty-four adults diagnosed with CAD (between 40 and 72 years), were randomized to receive either combined dietary intervention and HIIT (DEHIIT, n = 22) or only HIIT (HIIT, n = 22). The adherence to the Mediterranean diet was assessed with a 14-item tool of adherence to the Mediterranean diet (MEDAS-14) at baseline and after the intervention. DEHIIT performed a 3-month dietary intervention program combined with 24 HIIT sessions at 85-95% of peak heart rate, whilst HIIT performed a 3-month HIIT sessions at 85-95% of peak heart rate. This study did not receive any funding. No conflict of interest is declared. Results. After three months, regarding to MEDAS-14, DEHIIT increased the fish/seafood consumption significantly (p = 0.001) and decreased the fruit consumption (p = 0.032) and dry fruits (p = 0.006). And, when comparing between groups, DEHIIT obtained significantly more MEDAS-14 score (p = 0.01) and more adherence to dieta mediterránea (p = 0.001). No adverse events were reported. Conclusions. A combined protocol including dietary intervention and HIIT can bring benefits for CAD patients with PCI on adherence to Mediterranean diet in comparison to only HIIT. Consequently, our combined program could be used as a treatment option in the therapeutic approach for these patients.

Multidisciplinary program based in physiotherapy and nutrition in coronary artery disease patients: randomized controlled trial

Funding Acknowledgements Type of funding sources: None. Introduction. The interventions on eating habits and exercise in physiotherapy programs are usually recommended in coronary artery disease (CAD), since they are beneficial to improve physical and nutritional status of patient. Despite this, scarce studies are focused on combined protocols based on high intensity interval training (HIIT) and dietary education in CAD patients with percutaneous coronary intervention (PCI). Purpose The main goal of this study was to compare the effectiveness of a multidisciplinary program based in HIIT, with a program based in dietary education and HIIT (DEHIIT), on eating habits in CAD patients with PCI. Methods. A prospective, randomized controlled trial with blinded outcome assessment was developed. The study was developed at a University research laboratory. 44 participants diagnosed with CAD, aged between 40 and 72 years, were randomly allocated to two treatment groups: HIIT group (HIITG, n = 22) and dietary intervention and HIIT group (DEHIITG, n = 22). The assessment consisted of applying a Food Frequency Questionnaires (FFQ) at baseline and post-intervention. DEHIITG performed a 3-month dietary intervention program combined with 24 HIIT sessions at 85-95% of peak heart rate, whilst HIITG performed a 3-month HIIT sessions at 85-95% of peak heart rate. This study did not receive any funding. No conflict of interest is declared. Results. At the end of the program, when comparing between groups, statistically significant changes were noted. DEHIITG consumed more olive oil (p = 0.021), chicken or turkey (p = 0.039), stir-fried with vegetables (p = 0.033), vegetables (p = 0.003), fish and seafood (p = 0.039), and quantity of commercial juices (p = 0.042), sweets and snacks (p = 0.033). HIITG showed more improvements than DEHIITG in soups and creams consumption (p = 0.042). No adverse events were reported. Conclusions. A dietary intervention with HIIT protocol yields better benefits than only HIIT on eating habits in CAD patients with PCI. Thus, our combined program could be considered a suitable treatment option among these patients.