Do You Want to Apply Your Nutrition Practice Knowledge to PEN Content?

Do You Want to Apply Your Nutrition Practice Knowledge to PEN Chronic Disease Content?

We need dietitians to review the latest evidence on dietitians' critical role in preventing, treating and managing chronic diseases.

We are looking for individuals to contribute approximately two hours to reviewing content on the effectiveness of dietary counselling and nutrition interventions for chronic disease. 

Reviewers will be acknowledged in the published content and can download a Letter of Contribution summarizing their contributions for their professional portfolio.

Are you interested? Email coordinator@pennutrition.com by January 26th, 2024.

Learn more about getting involved as a PEN reviewer here.

Knowledge Pathway Alert: Pregnancy - Hypertension

The Pregnancy - Hypertension KP is updated! The update includes these practice questions:

• What dietary interventions can prevent the development of gestational hypertension and preeclampsia in pregnancy?
• What are nutrition recommendations for individuals who are pregnant with pre-existing moderate or severe hypertension? Is sodium restriction advisable?
• What dietary interventions are effective for the treatment of preeclampsia in pregnancy?

For a concise summary of these practice questions, see the Pregnancy - Hypertension Summary of Recommendations and Evidence.

Looking for more pregnancy content? See these knowledge pathways:

• Pregnancy
• Pregnancy - Multi-fetal
• Pregnancy - Nausea and Vomiting/Hyperemesis Gravidarum
• Gestational Diabetes
• Nutrition and Fertility.

Wound Care and Pressure Injuries: Are You Up to Date?

Do you know the answers to these questions?

What are the nutritional requirements (energy, protein, fluid) of individuals with existing pressure injuries?

Can nutrition intervention prevent the development of pressure injuries in at-risk individuals?

Does nutrition supplementation improve the healing of pressure injuries?

Does oral supplementation of specific nutrients or mixed nutritional supplements improve wound healing in adults with chronic injuries caused by diabetes or non-diabetic vascular disease?

Does immunonutrient supplementation improve outcomes in surgical patients?

To find out, click on each practice question above or for a condensed version, see the Wound Care and Pressure Injuries Summary of Recommendations and Evidence.

Age-related Eye Diseases and Dietary Patterns

What dietary patterns reduce the risk or slow the progression of age-related eye diseases (e.g. macular degeneration, glaucoma, diabetic retinopathy, cataracts)?

Mediterranean Dietary Pattern

A Mediterranean diet may reduce the risk and progression of age-related macular degeneration (AMD) and may protect against diabetic retinopathy. It may not have any effect on the risk for glaucoma or cataracts, although there is a general lack of evidence for these eye diseases. Evidence for dry eye syndrome is inconsistent.

Asian Dietary Pattern

An Asian dietary pattern may reduce the risk and progression of AMD.

Other Dietary Patterns

Dietary patterns that are high in grains, fish, poultry, vegetables and nuts and low in red meat may slow the progression of AMD.

A 2023 systematic review of 18 studies (three RCTs, 15 observational) found that a Mediterranean diet reduced the risk of the development and progression of AMD and protected against diabetic retinopathy. The authors found no effect on glaucoma or cataracts (although they noted an overall lack of research) and inconsistent results for dry eye syndrome. Results may be limited by the exclusion of studies published in a language other than English and by the heterogeneity of study designs, measurement of adherence to a Mediterranean diet, and criteria used to diagnose each of the age-related eye diseases.

Results from a 2019 systematic review of two observational studies suggested that an Asian dietary pattern and dietary patterns low in red meat and high in grains, fish, poultry, vegetables and nuts reduced the risk of the development and progression of AMD while a Western dietary pattern increased the risk. Results may be limited by the low number of studies conducted on this topic and by recall bias associated with the use of food frequency questionnaires to assess dietary intake.

Grade of Evidence C

The Remarks

In the included studies, a Mediterranean dietary pattern encouraged high intakes of vegetables, nuts, cereal grains, fruit, beans and olive oil; a moderate intake of dairy products, poultry, fish and red wine; and a low intake of red meat and sugary foods. An Asian dietary pattern was high in fruit, vegetables (including tomatoes), legumes, whole grains and seafood. A Western dietary pattern was high in red and processed meat, eggs, high-fat dairy products, fried potatoes and refined grains.

Mediterranean and Asian dietary patterns may promote eye health because they emphasize foods that are high in antioxidants (e.g. vegetables, fruit, whole grains, nuts, seafood) and limit pro-inflammatory foods (e.g. red meat, sugary foods), thereby reducing the inflammation that can contribute to several age-related eye diseases.

To see the full practice question, including the Evidence Statements, Comments and References, click here.

Practice guidance toolkits make access to essential information on nutrition assessment, diagnosis, intervention, monitoring, associated tools and education materials based on nutrition-related conditions/diseases more 'up-front' and easier to retrieve. The toolkits present information in a format consistent with Nutrition Care Process Terminology (NCPT) with direct access to succinct information that dietitians use in their practice. The toolkits are a stand-alone tool used primarily for clinical knowledge pathways and also include the associated Summary of Recommendations and Evidence.  

To find toolkits on the PEN home page, click on the Toolkits icon, which leads to all of the available toolkits.

They can also be found on the Knowledge Pathways Table of Contents page. Click on any of the icons under the Practice Guidance Toolkit column. Alternatively, within a knowledge pathway, click on the “Toolkit “ tab on the right-hand side of the page. The Toolkit tab will only display as an option if the knowledge pathway has a toolkit.

Helpful Features in the Toolkits  

• Click on any of the items on the Table of Contents on the right-hand side of a toolkit to get quick, direct access to any section within the toolkit.  
• Flags! Where information is specific to a particular country, you can see only your country’s information or view other’s information as well. Simply click the box at the top of the page for the country information that you would like to view, and it will be displayed (or alternatively unclick the box to hide it).

Below is a list of toolkits that have recently been added or updated: 

• Wound Care and Pressure Injuries Practice Guidance Toolkit
  
• Gastrointestinal System - Pancreatitis
  
• Hematology/Haematology - Anemia/Anaemia: Iron Deficiency Toolkit
  
• Spinal Cord Injury Practice Guidance Toolkit