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Lipid Lowering from Isoflavone Extract and Soy Protein Powder
SUNDAY, OCTOBER 23
POSTER SESSION: NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY TITLE: THE KNOWLEDGE, ATTITUDES, PERSONAL HEALTH CARE AND PATIENT CARE PRACTICES OF THE UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY FACULTY MEMBERS REGARDING WEIGHT MANAGEMENT AUTHOR(S): D. Castellano, MS, RD, R. Touger-Decker, PhD, RD, FADA, University of Medicine and Dentistry of NJ; P. Matheson, PhD, L. ByhamGray, PhD, RD, University of Medicine and Dentistry of NJ; J. O’Sullivan Maillet, PhD, RD, FADA; University of Medicine and Dentistry of NJ LEARNING OUTCOME: To understand how knowledge, attitudes and personal health care practices affect health care professionals’ (HCPs’) patient care practices regarding weight management. TEXT: A mail survey was sent to a stratified random sample of full time faculty appointments of the University of Medicine and Dentistry of New Jersey during the academic year 2004, for the purposes of assessing their knowledge, attitudes, personal health care and patient care practices regarding weight management. Three-hundred and eighty nine of the 778 surveys were returned (50% response rate). Descriptive statistics were used to summarize data for all variables. Significance was set at alpha ⫽.05. Pearson product moment correlation coefficient was used to compare relationships among variables; one-way ANOVA was conducted to compare mean scores among various professions. More than 75% of faculty couldn’t identify the clinical definition of obesity based on BMI, and 25 % didn’t know the association between high waist circumference and increased disease risk. Reasons for not providing weight management care were related to it being “not their responsibility” or “outside of their specialty.” Significant correlations were found among faculty members’ knowledge (pⱕ.01), attitudes (p⫽.03) personal health care (p⬍.01) and patient care practices. No significant differences were found in mean scores for knowledge (p⫽.12), attitudes (p⫽.19), or personal health care practices (p⫽.93) among the various professions. Dentists had significantly lower patient care practice scores compared with physicians (p⫽.02) and nursing professionals (p⫽.03). Higher knowledge, positive attitudes and better personal health care practices were associated with better adherence to evidenced-based patient care practices for weight management. Education to improve HCPs’ use of screening techniques and need to take individual responsibility for weight management is paramount.
TITLE: PREVENTION AND TREATMENT OF ARTHRITIS: THE SOUTH CAROLINA PLAN FOR NUTRITION AND COMPLEMENTARY CARE AUTHOR(S): P.G. Wolman, J.D. Smith, L.B. Phillian, J.S. Lewis, A.C. Turner; Department of Human Nutrition, Winthrop University, Rock Hill, SC 29733 LEARNING OUTCOME: To identify safe and effective preventive and treatment strategies for rheumatoid arthritis and osteoarthritis for use in nutrition and complementary care settings. TEXT: Arthritis sufferers need help in finding safe and effective strategies to cope with their disease. Food supplements, special diets, and complementary and alternative treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) are touted in the popular press and available overthe-counter in pharmacies and grocery stores. The mainstay of nutrition therapy for OA remains weight management and exercise; however, supplementation with glucosamine and chondroitin may decrease pain and reduce swelling. S-adenosylmethionine (SAMe); ginger (Zingiber officinale); gamma-linolenic acid (evening primrose oil, borage seed oil, black current oil); devil’s claw root (Harpagophytum procumbens); as well as vitamins A; riboflavin; pyridoxine; C and E; and selenium show promise for OA treatment, as well. In rheumatoid arthritis food allergies, especially to animal products, have been associated with joint pain and swelling in conjunction with such allergic disorders as hay fever, asthma, and rhinitis. Whole food vegan diets may result in decreased inflammatory response in allergic clients. The Mediterranean diet; increased omega-3 fatty acid fish or capsules; olive oil; cruciferous vegetables; and B-crytoxanthin; as well as supplementation with pyridoxine and zinc have been shown to improve composite disease index scores and/or physical function. In laboratory animals polyphenolic compounds in green tea have been effective in reducing the incidence and severity of arthritis. Fasting for 7–10 days has been used as a prelude to an elimination diet; short term fasting results in relief of symptoms for RA clients. Safe nutritional and complementary practices for relief of inflammation and symptoms in RA and OA are reviewed and assessed. FUNDING DISCLOSURE: None
FUNDING DISCLOSURE: None
TITLE: LIPID LOWERING FROM ISOFLAVONE EXTRACT AND SOY PROTEIN POWDER AUTHOR(S): M.Z.Vitolins, DrPH, RD; H. Chen, PhD; G.L. Burke, MD, MSc; Wake Forest University School of Medicine, Winston-Salem, NC LEARNING OUTCOME: To understand the effect that soy protein and isoflavone (soy) pills have on blood isoflavone levels and lipids of moderately hypercholesterolemic adults. TEXT: The Food and Drug Administration approved a cardiovascular disease health claim for foods containing soy protein. Little data exists regarding the effect of isoflavone pills on lipids. We evaluated the efficacy of isoflavone pills compared to soy protein for improving lipids in 51 moderately hypercholesterolemic participants. This was a randomized double-blind placebo controlled trial employing a 10-week cross-over design. The isocaloric treatments groups were: 1) Control (casein powder) plus placebo pills; 2) Casein powder plus 100 mg isoflavone pills; 3) Soy powder containing 100 mg isoflavones plus placebo pills. Thirty-six Caucasian females, 4 African American females, and 11 Caucasian males participated; median age was 56. Linear mixed effect models were used to assess differences between treatment groups in isoflavone and lipid levels. Pairwise comparisons were used to assess the differences in blood lipids and isoflavones among treatment conditions. The mean mg/dl total cholesterol for the control, soy powder, soy pill treatments were 225.76⫾5.03, 237.38⫾5.03, and 226.92⫾4.87, respectively (P ⫽ 0.21). Serum isoflavone levels during soy powder treatment were significantly higher than during soy pill and control treatments (P⬍0.0001). Our findings illustrate that neither treatment improved lipids; however, serum isoflavone levels were higher after soy powder treatment. Isoflavone pills are purchased for their cardiovascular disease prevention attributes despite the lack of studies supporting their efficacy. To increase serum isoflavone levels, based on our study data, consumers should purchase soy foods as they contain beneficial nutrients such as protein, calcium and fiber in addition to the isoflavones. FUNDING DISCLOSURE: Funded Association of Teachers of Preventive Medicine and the Centers for Disease Prevention and Control (GTS 10423) and the General Clinical Research Center (M01-RR07122). Protein supplements and pills provided by CentralSoya and Cognis Nutrition & Health.
A-32 / August 2005 Suppl 2—Abstracts Volume 105 Number 8
TITLE: STANDARDIZED PROTOCOL FOR USING INTRADIALYTIC PARENTERAL NUTRITION (IDPN) AS AN ADJUNCT THERAPY IN SEVERELY MALNOURISHED HEMODIALYSIS PATIENTS AUTHOR(S): D.S. Baker, RD; J.L. Weinstein, MS, MBA, RD; D.K. Murray, MD; J.E. Parker, MD; K.J. Kerr, PharmD; P.J. Petnicki, MS, RD, FADA; United States Air Force, David Grant Medical Center, Nutritional Medicine, Travis AFB, CA LEARNING OUTCOME: To develop and utilize a protocol for the initiation, monitoring, and termination of Intradialytic Parenteral Nutrition in maintenance hemodialysis patients. TEXT: Patients receiving maintenance hemodialysis (MHD) often become malnourished as a result of inadequate dietary intake, loss of nutrients into the dialysate, abnormal metabolism, and co-morbid conditions, which may contribute to an increase in morbidity and morality. Protein energy malnutrition has been identified in up to 50% of patients receiving hemodialysis. Intradialytic Parenteral Nutrition (IDPN) has been used in our facility, a medium-sized military medical treatment center, as a supportive therapy in MHD patients unable to meet total nutrition requirements orally. Several protocols on the use of IDPN have been suggested, but none have yet been widely accepted/implemented. After reviewing available literature on IDPN, the hospital Nutrition Support Team developed a protocol with input from pharmacy, nephrology, endocrinology, general surgery, and nutritional medicine, to serve as a guideline for initiating, monitoring, and terminating IDPN. Key aspects of the protocol include: a defined treatment period (3– 6 months in length), monitored nutrition outcomes, and trend analysis of complications and comorbid conditions. Preliminary data suggest the protocol is easy to use, has standardized the IDPN ordering process among providers, and provides an easy to use patient outcomes tracking tool. Our aim is to standardize the use of IDPN among all providers within this facility in order to improve efficacy and enable better outcomes monitoring. IDPN shows much promise as a clinically effective therapy for improving the nutritional status of malnourished patients receiving MHD. It is imperative that a standardized protocol is used to ensure maximum patient safety and treatment effectiveness. FUNDING DISCLOSURE: None
POSTER SESSION: NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY TITLE: THE KNOWLEDGE, ATTITUDES, PERSONAL HEALTH CARE AND PATIENT CARE PRACTICES OF THE UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY FACULTY MEMBERS REGARDING WEIGHT MANAGEMENT AUTHOR(S): D. Castellano, MS, RD, R. Touger-Decker, PhD, RD, FADA, University of Medicine and Dentistry of NJ; P. Matheson, PhD, L. ByhamGray, PhD, RD, University of Medicine and Dentistry of NJ; J. O’Sullivan Maillet, PhD, RD, FADA; University of Medicine and Dentistry of NJ LEARNING OUTCOME: To understand how knowledge, attitudes and personal health care practices affect health care professionals’ (HCPs’) patient care practices regarding weight management. TEXT: A mail survey was sent to a stratified random sample of full time faculty appointments of the University of Medicine and Dentistry of New Jersey during the academic year 2004, for the purposes of assessing their knowledge, attitudes, personal health care and patient care practices regarding weight management. Three-hundred and eighty nine of the 778 surveys were returned (50% response rate). Descriptive statistics were used to summarize data for all variables. Significance was set at alpha ⫽.05. Pearson product moment correlation coefficient was used to compare relationships among variables; one-way ANOVA was conducted to compare mean scores among various professions. More than 75% of faculty couldn’t identify the clinical definition of obesity based on BMI, and 25 % didn’t know the association between high waist circumference and increased disease risk. Reasons for not providing weight management care were related to it being “not their responsibility” or “outside of their specialty.” Significant correlations were found among faculty members’ knowledge (pⱕ.01), attitudes (p⫽.03) personal health care (p⬍.01) and patient care practices. No significant differences were found in mean scores for knowledge (p⫽.12), attitudes (p⫽.19), or personal health care practices (p⫽.93) among the various professions. Dentists had significantly lower patient care practice scores compared with physicians (p⫽.02) and nursing professionals (p⫽.03). Higher knowledge, positive attitudes and better personal health care practices were associated with better adherence to evidenced-based patient care practices for weight management. Education to improve HCPs’ use of screening techniques and need to take individual responsibility for weight management is paramount.
TITLE: PREVENTION AND TREATMENT OF ARTHRITIS: THE SOUTH CAROLINA PLAN FOR NUTRITION AND COMPLEMENTARY CARE AUTHOR(S): P.G. Wolman, J.D. Smith, L.B. Phillian, J.S. Lewis, A.C. Turner; Department of Human Nutrition, Winthrop University, Rock Hill, SC 29733 LEARNING OUTCOME: To identify safe and effective preventive and treatment strategies for rheumatoid arthritis and osteoarthritis for use in nutrition and complementary care settings. TEXT: Arthritis sufferers need help in finding safe and effective strategies to cope with their disease. Food supplements, special diets, and complementary and alternative treatments for rheumatoid arthritis (RA) and osteoarthritis (OA) are touted in the popular press and available overthe-counter in pharmacies and grocery stores. The mainstay of nutrition therapy for OA remains weight management and exercise; however, supplementation with glucosamine and chondroitin may decrease pain and reduce swelling. S-adenosylmethionine (SAMe); ginger (Zingiber officinale); gamma-linolenic acid (evening primrose oil, borage seed oil, black current oil); devil’s claw root (Harpagophytum procumbens); as well as vitamins A; riboflavin; pyridoxine; C and E; and selenium show promise for OA treatment, as well. In rheumatoid arthritis food allergies, especially to animal products, have been associated with joint pain and swelling in conjunction with such allergic disorders as hay fever, asthma, and rhinitis. Whole food vegan diets may result in decreased inflammatory response in allergic clients. The Mediterranean diet; increased omega-3 fatty acid fish or capsules; olive oil; cruciferous vegetables; and B-crytoxanthin; as well as supplementation with pyridoxine and zinc have been shown to improve composite disease index scores and/or physical function. In laboratory animals polyphenolic compounds in green tea have been effective in reducing the incidence and severity of arthritis. Fasting for 7–10 days has been used as a prelude to an elimination diet; short term fasting results in relief of symptoms for RA clients. Safe nutritional and complementary practices for relief of inflammation and symptoms in RA and OA are reviewed and assessed. FUNDING DISCLOSURE: None
FUNDING DISCLOSURE: None
TITLE: LIPID LOWERING FROM ISOFLAVONE EXTRACT AND SOY PROTEIN POWDER AUTHOR(S): M.Z.Vitolins, DrPH, RD; H. Chen, PhD; G.L. Burke, MD, MSc; Wake Forest University School of Medicine, Winston-Salem, NC LEARNING OUTCOME: To understand the effect that soy protein and isoflavone (soy) pills have on blood isoflavone levels and lipids of moderately hypercholesterolemic adults. TEXT: The Food and Drug Administration approved a cardiovascular disease health claim for foods containing soy protein. Little data exists regarding the effect of isoflavone pills on lipids. We evaluated the efficacy of isoflavone pills compared to soy protein for improving lipids in 51 moderately hypercholesterolemic participants. This was a randomized double-blind placebo controlled trial employing a 10-week cross-over design. The isocaloric treatments groups were: 1) Control (casein powder) plus placebo pills; 2) Casein powder plus 100 mg isoflavone pills; 3) Soy powder containing 100 mg isoflavones plus placebo pills. Thirty-six Caucasian females, 4 African American females, and 11 Caucasian males participated; median age was 56. Linear mixed effect models were used to assess differences between treatment groups in isoflavone and lipid levels. Pairwise comparisons were used to assess the differences in blood lipids and isoflavones among treatment conditions. The mean mg/dl total cholesterol for the control, soy powder, soy pill treatments were 225.76⫾5.03, 237.38⫾5.03, and 226.92⫾4.87, respectively (P ⫽ 0.21). Serum isoflavone levels during soy powder treatment were significantly higher than during soy pill and control treatments (P⬍0.0001). Our findings illustrate that neither treatment improved lipids; however, serum isoflavone levels were higher after soy powder treatment. Isoflavone pills are purchased for their cardiovascular disease prevention attributes despite the lack of studies supporting their efficacy. To increase serum isoflavone levels, based on our study data, consumers should purchase soy foods as they contain beneficial nutrients such as protein, calcium and fiber in addition to the isoflavones. FUNDING DISCLOSURE: Funded Association of Teachers of Preventive Medicine and the Centers for Disease Prevention and Control (GTS 10423) and the General Clinical Research Center (M01-RR07122). Protein supplements and pills provided by CentralSoya and Cognis Nutrition & Health.
A-32 / August 2005 Suppl 2—Abstracts Volume 105 Number 8
TITLE: STANDARDIZED PROTOCOL FOR USING INTRADIALYTIC PARENTERAL NUTRITION (IDPN) AS AN ADJUNCT THERAPY IN SEVERELY MALNOURISHED HEMODIALYSIS PATIENTS AUTHOR(S): D.S. Baker, RD; J.L. Weinstein, MS, MBA, RD; D.K. Murray, MD; J.E. Parker, MD; K.J. Kerr, PharmD; P.J. Petnicki, MS, RD, FADA; United States Air Force, David Grant Medical Center, Nutritional Medicine, Travis AFB, CA LEARNING OUTCOME: To develop and utilize a protocol for the initiation, monitoring, and termination of Intradialytic Parenteral Nutrition in maintenance hemodialysis patients. TEXT: Patients receiving maintenance hemodialysis (MHD) often become malnourished as a result of inadequate dietary intake, loss of nutrients into the dialysate, abnormal metabolism, and co-morbid conditions, which may contribute to an increase in morbidity and morality. Protein energy malnutrition has been identified in up to 50% of patients receiving hemodialysis. Intradialytic Parenteral Nutrition (IDPN) has been used in our facility, a medium-sized military medical treatment center, as a supportive therapy in MHD patients unable to meet total nutrition requirements orally. Several protocols on the use of IDPN have been suggested, but none have yet been widely accepted/implemented. After reviewing available literature on IDPN, the hospital Nutrition Support Team developed a protocol with input from pharmacy, nephrology, endocrinology, general surgery, and nutritional medicine, to serve as a guideline for initiating, monitoring, and terminating IDPN. Key aspects of the protocol include: a defined treatment period (3– 6 months in length), monitored nutrition outcomes, and trend analysis of complications and comorbid conditions. Preliminary data suggest the protocol is easy to use, has standardized the IDPN ordering process among providers, and provides an easy to use patient outcomes tracking tool. Our aim is to standardize the use of IDPN among all providers within this facility in order to improve efficacy and enable better outcomes monitoring. IDPN shows much promise as a clinically effective therapy for improving the nutritional status of malnourished patients receiving MHD. It is imperative that a standardized protocol is used to ensure maximum patient safety and treatment effectiveness. FUNDING DISCLOSURE: None