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Are Wound Care Protocols Evidence Based?
SUNDAY, OCTOBER 26
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: THE FACTORS ASSOCIATED WITH DIETARY SUPPLEMENT USE IN COLLEGE STUDENTS Author(s): M. E. Geraghty, J. Bates-Wall, C. A. Taylor; Medical Dietetics, The Ohio State University, Columbus, OH Learning Outcome: To describe the dietary supplement use in college students in terms of type, indication for use, perceived side effects and source of supplement information and recommendation. Text: Dietary supplement use has increased substantially over the past decade in college students. Many have received formal health education concerning effects of alcohol consumption or drug use, but few have studied the efficacy and safety of dietary supplements. To assess the supplement intake patterns of college students at a major, Midwestern university, an online survey was available for students in a business and an allied medical professions survey course. An email was sent from the instructors inviting students to participate, providing a study description, participation criteria, and an embedded link to the survey. Questions were modified from a previous survey to identify the proportion of students using dietary supplements, the specific supplements taken, indications, and side effects. Of the 336 students completing the survey, approximately 40% reported current or previous use of dietary supplements. The most common supplement types were dietary/ herbal supplementswithout vitamins/minerals( 35%); dietary/herbal supplement with vitamins/minerals, (26%); and vitamin supplements alone (21%). The most frequently cited reasons for taking dietary supplements were to: increase energy; lose weight; ensure adequate nutritional status; prevent illness; and enhance athletic performance. Side effects reported included nausea, light-headedness and jitteriness and tachycardia. Family members were the most common source of information/recommendation regarding dietary supplements, with twice the influence than friends or health food stores. The prevalence of the use of dietary supplements warrants the availability of Student Health Center RD consultations as well as the development and strategic marketing of evidence-based dietary supplement curricular offerings.
Title: PATTERNS OF NONVITAMIN AND NONMINERAL SUPPLEMENT USE ARE SIMILAR AMONG ADULTS FROM DIFFERENT INCOME AND ETHNICITY GROUPS Author(s): L. Kinsella,1 B. Henry2; 1Nutrition Services, Advocate Trinity Hospital, Chicago, IL, 2Family Consumer Nutrition Sciences, Northern Illinois University, DeKalb, IL Learning Outcome: Increase awareness of nonvitamin nonmineral supplement use among patients of diverse backgrounds to identify communication strategies and messages for health care. Text: Objective: Determine usage patterns of nonvitamin nonmineral (NVNM) supplements among adults of different income and ethnic groups. Methods/ Subjects/ Design: Descriptive study utilized survey design with adult patients attending a Midwestern Family Medicine Clinic over a three-day period, with each patient having an equal chance of participation. One-on-one personal interviews, based on a 10-item structured questionnaire were conducted with 100 volunteers of 150 adults approached. Analysis/ Results: Participants were economically and ethnically diverse, though the majority was female; 48 met criteria of NVNM supplement use. Data analyzed by Fisher’s exact test revealed no difference in usage patterns of NVNM supplements between income or ethnic groups. Thirty participants (63%) described use as everyday. Most NVNM supplement users (94%) expected health benefits from use, though not more likely to alert a health care professional, and 85% obtained supplement information from sources other than healthcare professionals. Thirteen participants (27%) identified as ‘at risk’ for adverse interactions were not more likely to inform a health care professional regarding NVNM supplement use. Of 22 participants (46%) who reported NVNM supplement use to a health care professional, four were asked. Conclusions/implications: NVNM supplement use cannot be estimated by income or ethnicity. Communication strategies about NVNM supplements are needed to inform patients about possible benefits and adverse interactions. Positive messages for health care professionals should aim for greater understanding of patients’ concerns and beliefs about management of their health. Consistently changing trends, new products, and new regulations require ongoing research by dietitians regarding NVNM supplements.
Funding Disclosure: None
Funding Disclosure: None
Title: HALF OF THE HOMEBOUND ELDERLY LIVING IN A LARGE MIDWESTERN CITY RELY ON THEIR PHYSICIANS FOR ADVICE REGARDING TAKING OR NOT TAKING VITAMIN OR MINERAL SUPPLEMENTS
Title: ARE WOUND CARE PROTOCOLS EVIDENCE BASED?
Author(s): J. A. Driskell, S. A. Minor; Nutrition and Health Sciences, University of Nebraska, Lincoln, NE Learning Outcome: To gain insight into the reasons given by the homebound elderly for taking or not taking vitamin or mineral supplements and where these individuals got dietary supplement information. Text: The prevalence of vitamin and mineral supplement usage by a homebound elderly population in a large Midwestern city was evaluated by sex and ethnic groups. Their motivation for supplement use or nonuse was also evaluated. A descriptive vitamin mineral supplement usage questionnaire was completed by a group (23 males, 38 females) of homebound elderly (60 years and above) individuals. Forty-one subjects were white and 20, non-white. Forty-seven percent reported taking vitamin or mineral supplements. About half of the supplement users reported taking supplements because they were prescribed or recommended, with the next two predominant reasons being general health and to prevent disease. Significantly larger (p⬍0.05) percentages of non-whites than whites took a multivitamin to improve their general health and to feel better. The most frequently used individual vitamin or mineral supplements were calcium, vitamin D, vitamin E, and vitamin C. The predominant reason subjects gave for not using supplements was that supplements had not been prescribed or recommended, followed by their being unsure which supplements to take. A significantly larger (p⬍0.01) percentage of non-whites than whites indicated not taking supplements because they were unsure which ones to take. Most subjects received their information regarding supplements from a health care professional, most often a physician, with four subjects reporting getting information from registered dietitians. This study indicates that the homebound elderly generally get advice regarding the usage of vitamin or mineral supplements from physicians. Dietitians working with the homebound elderly should be giving advice regarding dietary supplement usage.
Author(s): J. Hill, P. Landers, J. Butcher, H. Solnok; Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK Learning Outcome: The participant will be able to determine which macronutrients and micronutrients to include in a wound healing protocol for optimum results. Text: For several years, wound care protocols in health care settings have included arginine, vitamin C, zinc, and protein, either together or alone as treatment(s) for various types of wounds. Is this treatment evidenced based or is it expert opinion? Using established search methods, this investigation sought to locate and evaluate controlled trials focusing on arginine, vitamin C, zinc, and protein and their use in wound healing. The clinical outcome desired was wound healing as evidenced by reduced wound surface area, reduced wound depth, reduced exudate volume, and/or increase in hydroxyproline deposition. The search restrictions included subjects aged 18 years and older and English language. There were no restrictions on setting or date. Four of 11 potentially relevant articles were included for analysis. Exclusionary criteria ranged from a study with fewer than 10 subjects per group to a study on risk behaviors. This review and analysis failed to demonstrate that supplementation with vitamin C and/or zinc was beneficial to reduce the time it took for wounds to heal. Arginine improved collagen deposition in surgically placed catheters. Protein had a positive effect on wound healing. The implication for clinicians is that protein supplementation and in some instances, arginine, may be beneficial for the patient with wound healing needs. Supplementation with vitamin C and/or zinc has not been shown to be effective in studies of any size. Funding Disclosure: None
Funding Disclosure: USDA W-1002 Regional Research Funds
Journal of the AMERICAN DIETETIC ASSOCIATION / A-29
POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY Title: THE FACTORS ASSOCIATED WITH DIETARY SUPPLEMENT USE IN COLLEGE STUDENTS Author(s): M. E. Geraghty, J. Bates-Wall, C. A. Taylor; Medical Dietetics, The Ohio State University, Columbus, OH Learning Outcome: To describe the dietary supplement use in college students in terms of type, indication for use, perceived side effects and source of supplement information and recommendation. Text: Dietary supplement use has increased substantially over the past decade in college students. Many have received formal health education concerning effects of alcohol consumption or drug use, but few have studied the efficacy and safety of dietary supplements. To assess the supplement intake patterns of college students at a major, Midwestern university, an online survey was available for students in a business and an allied medical professions survey course. An email was sent from the instructors inviting students to participate, providing a study description, participation criteria, and an embedded link to the survey. Questions were modified from a previous survey to identify the proportion of students using dietary supplements, the specific supplements taken, indications, and side effects. Of the 336 students completing the survey, approximately 40% reported current or previous use of dietary supplements. The most common supplement types were dietary/ herbal supplementswithout vitamins/minerals( 35%); dietary/herbal supplement with vitamins/minerals, (26%); and vitamin supplements alone (21%). The most frequently cited reasons for taking dietary supplements were to: increase energy; lose weight; ensure adequate nutritional status; prevent illness; and enhance athletic performance. Side effects reported included nausea, light-headedness and jitteriness and tachycardia. Family members were the most common source of information/recommendation regarding dietary supplements, with twice the influence than friends or health food stores. The prevalence of the use of dietary supplements warrants the availability of Student Health Center RD consultations as well as the development and strategic marketing of evidence-based dietary supplement curricular offerings.
Title: PATTERNS OF NONVITAMIN AND NONMINERAL SUPPLEMENT USE ARE SIMILAR AMONG ADULTS FROM DIFFERENT INCOME AND ETHNICITY GROUPS Author(s): L. Kinsella,1 B. Henry2; 1Nutrition Services, Advocate Trinity Hospital, Chicago, IL, 2Family Consumer Nutrition Sciences, Northern Illinois University, DeKalb, IL Learning Outcome: Increase awareness of nonvitamin nonmineral supplement use among patients of diverse backgrounds to identify communication strategies and messages for health care. Text: Objective: Determine usage patterns of nonvitamin nonmineral (NVNM) supplements among adults of different income and ethnic groups. Methods/ Subjects/ Design: Descriptive study utilized survey design with adult patients attending a Midwestern Family Medicine Clinic over a three-day period, with each patient having an equal chance of participation. One-on-one personal interviews, based on a 10-item structured questionnaire were conducted with 100 volunteers of 150 adults approached. Analysis/ Results: Participants were economically and ethnically diverse, though the majority was female; 48 met criteria of NVNM supplement use. Data analyzed by Fisher’s exact test revealed no difference in usage patterns of NVNM supplements between income or ethnic groups. Thirty participants (63%) described use as everyday. Most NVNM supplement users (94%) expected health benefits from use, though not more likely to alert a health care professional, and 85% obtained supplement information from sources other than healthcare professionals. Thirteen participants (27%) identified as ‘at risk’ for adverse interactions were not more likely to inform a health care professional regarding NVNM supplement use. Of 22 participants (46%) who reported NVNM supplement use to a health care professional, four were asked. Conclusions/implications: NVNM supplement use cannot be estimated by income or ethnicity. Communication strategies about NVNM supplements are needed to inform patients about possible benefits and adverse interactions. Positive messages for health care professionals should aim for greater understanding of patients’ concerns and beliefs about management of their health. Consistently changing trends, new products, and new regulations require ongoing research by dietitians regarding NVNM supplements.
Funding Disclosure: None
Funding Disclosure: None
Title: HALF OF THE HOMEBOUND ELDERLY LIVING IN A LARGE MIDWESTERN CITY RELY ON THEIR PHYSICIANS FOR ADVICE REGARDING TAKING OR NOT TAKING VITAMIN OR MINERAL SUPPLEMENTS
Title: ARE WOUND CARE PROTOCOLS EVIDENCE BASED?
Author(s): J. A. Driskell, S. A. Minor; Nutrition and Health Sciences, University of Nebraska, Lincoln, NE Learning Outcome: To gain insight into the reasons given by the homebound elderly for taking or not taking vitamin or mineral supplements and where these individuals got dietary supplement information. Text: The prevalence of vitamin and mineral supplement usage by a homebound elderly population in a large Midwestern city was evaluated by sex and ethnic groups. Their motivation for supplement use or nonuse was also evaluated. A descriptive vitamin mineral supplement usage questionnaire was completed by a group (23 males, 38 females) of homebound elderly (60 years and above) individuals. Forty-one subjects were white and 20, non-white. Forty-seven percent reported taking vitamin or mineral supplements. About half of the supplement users reported taking supplements because they were prescribed or recommended, with the next two predominant reasons being general health and to prevent disease. Significantly larger (p⬍0.05) percentages of non-whites than whites took a multivitamin to improve their general health and to feel better. The most frequently used individual vitamin or mineral supplements were calcium, vitamin D, vitamin E, and vitamin C. The predominant reason subjects gave for not using supplements was that supplements had not been prescribed or recommended, followed by their being unsure which supplements to take. A significantly larger (p⬍0.01) percentage of non-whites than whites indicated not taking supplements because they were unsure which ones to take. Most subjects received their information regarding supplements from a health care professional, most often a physician, with four subjects reporting getting information from registered dietitians. This study indicates that the homebound elderly generally get advice regarding the usage of vitamin or mineral supplements from physicians. Dietitians working with the homebound elderly should be giving advice regarding dietary supplement usage.
Author(s): J. Hill, P. Landers, J. Butcher, H. Solnok; Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK Learning Outcome: The participant will be able to determine which macronutrients and micronutrients to include in a wound healing protocol for optimum results. Text: For several years, wound care protocols in health care settings have included arginine, vitamin C, zinc, and protein, either together or alone as treatment(s) for various types of wounds. Is this treatment evidenced based or is it expert opinion? Using established search methods, this investigation sought to locate and evaluate controlled trials focusing on arginine, vitamin C, zinc, and protein and their use in wound healing. The clinical outcome desired was wound healing as evidenced by reduced wound surface area, reduced wound depth, reduced exudate volume, and/or increase in hydroxyproline deposition. The search restrictions included subjects aged 18 years and older and English language. There were no restrictions on setting or date. Four of 11 potentially relevant articles were included for analysis. Exclusionary criteria ranged from a study with fewer than 10 subjects per group to a study on risk behaviors. This review and analysis failed to demonstrate that supplementation with vitamin C and/or zinc was beneficial to reduce the time it took for wounds to heal. Arginine improved collagen deposition in surgically placed catheters. Protein had a positive effect on wound healing. The implication for clinicians is that protein supplementation and in some instances, arginine, may be beneficial for the patient with wound healing needs. Supplementation with vitamin C and/or zinc has not been shown to be effective in studies of any size. Funding Disclosure: None
Funding Disclosure: USDA W-1002 Regional Research Funds
Journal of the AMERICAN DIETETIC ASSOCIATION / A-29