CFDR Research Showcase Presentations
Perceptions of Body Image and Food Choices among Rural and Urban Baby Boomer Women
Dr. Christina Lengyel
Nutrition Labelling: Comprehension and Use of Nutrition Facts Tables among Young People in Canada
presented information on her research project, funded under CFDR's Nutrition Research in Focus
program at CFDR's Research Showcase in Toronto on November 27, 2014. Just beginning her project, Christina talked about her project's objectives and methodology. View the presentation slides here
Erin Hobin, PhD, Public Health Ontario
Foods specially fortified with vitamin D preserve winter-time status and BMD in elderly men
,explored how young people engage with, understand, and use serving size and percent daily value (%DV) information on Nutrition Facts tables when comparing and choosing foods. Erin shared the results of her study, funded under CFDR’s Nutrition Research in Focus program at the Research Showcase in May 2014. Read a short summary of Erin’s presentation in the Spring issue of Keeping in Touch
here link to http://www.cfdr.ca/Publications/newsletters.aspx
and see the presentation slides here.
Isabelle Germain PhD(c) MSc RD, Ste-Anne’s Hospital
Multi-Sectoral Perspectives on Regional Food Policy, Planning and Access to Food
evaluated the impact of vitamin D supplementation in senior men, as well as the men’s acceptance of foods fortified with vitamin D. See a summary of Isabelle’s presentation of her CFDR project in CFDR’s Spring 2014 newsletter here link to http://www.cfdr.ca/Publications/newsletters.aspx
and see the presentation slides here.
Jessica Wegener, PhD, RD, Ryerson University
Decreasing insulin resistance with dairy
received funding from CFDR for her project and reported the results at CFDR’s Research Showcase in May 2014. She and her research team investigated how regional planning policies and practices help to create ‘healthier’ communities by facilitating greater access to healthy, local food outlets in the Region of Waterloo. See a summary of Jessica’s presentation in the Spring issue of Keeping in Touch
here link to http://www.cfdr.ca/Publications/newsletters.aspx
and see the presentation slides here
Kim Wagner Jones, MSc, RD,
Tracking Nutrition Trends 2013
University of Calgary and and her research team examined overweight and obese adults to determine whether a high-dairy diet can decrease insulin resistance. She shared the results of her research at the 2013 CFDR Research Showcase. Read a short summary of her presentation in CFDR’s newsletter here
, and see the slides from Kim's presentation here
Laura Pasut, MSc, MBA, RD,
Providing person-centred mealtime care for long term care residents with dementia
of Nutridata Consulting Service manages the program to produce CFDR’s first version of Tracking Nutrition Trends, a survey which examines the self-reported knowledge, attitudes and behaviours of adult Canadians with respect to food and nutrition. Work on this project began in Spring 2013 and Laura provided an update of progress on the survey with a forward look at results dissemination at the 2013 CFDR Research Showcase. A short summary of the presentation appeared in the Summer issue of “Keeping in Touch
. Laura’s presentation slides are available here
Holly Reimer, RD, PhD,
Researching functional food consumption in older adults and creation of a toolkit for knowledge translation
University of Guelph. Holly's research project was designed to answer the question, “What can help long term care home staff implement person-centred care practices at mealtimes for residents with dementia?” Holly shared the research team’s findings at the 2013 CFDR Research Showcase. Read about the project in CFDR’s summer newsletter here
and see the full presentation slides posted here
Alison Duncan, RD, PhD
, University of Guelph, completed her research project which started in Fall 2010, looking at attitudes, understanding and behaviours related to functional foods. She and her team developed a helpful toolkit for dietitians. For a short summary of the presentation read CFDR’s Fall 2012 newsletter here
. See the complete slides here
Nutrition labelling: comprehension and use of Nutrition Facts tables among young people in Canada
Alison will present a free webinar, Functional Foods for Healthy Aging: A Toolkit
on January 16, 2013, 1:00 – 2:00 pm ET. To register, click here
Erin Hobin, PhD,
University of Waterloo and Public Health Ontario, began her research project on nutrition labelling in September 2012. She shared the objectives of the study, methods, and the anticipated impact of the study results at the November 2012 Research Showcase. Read a short summary of her presentation in CFDR’s Fall newsletter here
Predictors of vitamin D deficiency among recently immigrated pre-school children: A TARGet Kids! study
This research project is funded under CFDR’s Nutrition Research in Focus program. See the complete slides here
University of Toronto, was a recipient of the first partnered award between CFDR and CIHR. The Master’s Award was offered through SHOPP (Small Health Organizations Partnership Program). For a short summary of the presentation read CFDR’s Fall 2012 newsletter here
. See the complete slides here
Researching functional food consumption in older adults: exploration of a toolkit as a knowledge translation strategy
Alison Duncan, PhD, RD, Associate Professor , Department of Human Health and Nutritional Sciences, University of Guelph, was a keynote speaker at CFDR’s AGM and Research Breakfast on November 24, 2011. Alison spoke about the research project she is working on with co-investigator Judy Sheeshka, PhD, RD, on functional foods, funded through CFDR’s Nutrition Research in Focus program.
Functional foods, which Alison described as foods that may provide health benefits beyond basic nutrition, have attracted much attention lately from industry, government, health professionals and consumers. The researchers focused their project on understanding functional foods in health and disease among older adults.
At this point, Alison reported, the research team has completed much of the data collection and the researchers are looking forward to the next steps: data and statistical analysis, results interpretation, manuscript preparation and, finally, knowledge translation. For the latter, the researchers have been working on creating a toolkit that is designed to provide guidance and materials to assist Registered Dietitians in communicating with older adults about functional foods for healthy aging.
To read more about the project and the toolkit see the presentation slides here
The Canadian Council of Food and Nutrition (CCFN) was a multi-sectoral organization that worked to advance nutritional health and well-being of Canadians. It was decided that it was no longer feasible to continue and to wind down operations as of July 31, 2011. The President and Board of Trustees looked for an organization with synergistic beliefs and programs to receive its assets and chose CFDR as a natural fit.
One of these assets was CCFN’s cornerstone research program, called Tracking Nutrition Trends (TNT). With an impressive 20 year history TNT is the only Canadian consumer research of its kind. Its purpose is to provide policy makers, health professionals, academics and the food industry with insight into Canadians’ perspectives on the importance of nutrition and their self-reported knowledge and behaviours.
Michi Furuya Chang, a member of CFDR’s Board of Directors and Scientific Review Committee, and a former Trustee of CCFN, presented highlights about TNT, and shared some results from the 2010 Ethnographic Study. See the complete presentation slides here
CFDR Research: Highlights from the First 20 Years
At CFDR’s 20th Anniversary Research Breakfast and AGM, held on November 24, 2011, Rhona Hanning, RD, PhD, FDC, spoke about the impact CFDR-funded research projects made in two decades. Since 1993, when the first two CFDR grants were awarded, CFDR has funded more than 150 research projects, with well over a million dollars. Their impact can be illustrated in many ways; Dr. Hanning polled researchers who had received CFDR funding in the past and learned that CFDR research:
· supports an evidence base for practice
· raises the profile of dietitians and their practice
· raises the profile of Canadian dietetic research internationally
· supports research areas not funded by other organizations
· answers questions unique to food and human health
· acts as a catalyst for further research
· makes a difference in the care of patients
· acts as a catalyst for a career in dietetic research
· supports research trainees
To read more about CFDR research impact click here
Food Security Policy at the Federal Level: Why are we stuck, and how can we move forward together?
Researchers Dr. Patricia Williams, PDt and Dr. Ellen Vogel, RD, FDC presented the results of their CFDR-funded research project on food security at the Foundation's May 5th, 2011 Research Breakfast in Toronto. They entitled their presentation, "Food Security Policy at the Federal Level: Why are we stuck, and how can we move forward together?"
Over the past two decades, explained the researchers, our relationship with food has changed significantly. In 2007, at least 8% of Canadians experienced moderate or severe income-related food insecurity. Soaring food prices, child obesity rates, food waste and food safety concerns, together with the impact of climate change on the sustainability of our food systems, "buy-local" campaigns and private sector interest in working together for nourishing food and healthy farming and fishing communities, all suggest that food will be the defining issue of the next century. But, compared with other health and social issues, where is the political leadership? What would a strategic response to short- and long-term food challenges look like at the federal level?
Dr. Vogel and Dr. Williams outlined a preliminary roadmap for change, leading to a federal food policy. They encouraged CFDR and Dietitians of Canada to play a leadership role in initiating and supporting policy forums to inform the development of a national food strategy. They challenged the audience to champion food security as a key determinant of nutritional health through innovative partnerships and knowledge dissemination.
View the complete presentation slides (pdf) here
Evaluation of the Adherence to Nutraceutical, Functional Food and Whole Food Strategies to Increase Omega-3 Fatty Acid Intakes in Men and Women at Risk for Cardiovascular Disease
Rhona Hanning PhD, RD, and Ashley Patterson, PhD (Cand), University of Waterloo spoke at CFDR's Research Breakfast in May 2010. They explained that an increased consumption of Omega-3 fatty acids has been shown to have numerous health benefits including the prevention of cardiovascular disease. However, most Canadians do not consume enough Omega-3 fatty acids for optimum health. This research project examined which strategy resulted in greatest adherence and greatest fatty acid intakes: nutraceuticals (capsules), whole foods (fish) or functional food (Omega-3 enriched foods). Throughout the project, study participants received dietary counselling and had their levels of EPA and DHA monitored.
After following the study participants for a year, the research term determined the following:
- Nutraceuticals, functional foods and seafood can be useful to increase EPA+DHA intakes to recommended levels in healthy middle aged adults.
- Long-term adherence to dietary advice to increase EPA+DHA intake is greatest for strategies involving the least dietary change (ie: Nutraceuticals).
View the complete presentation slides (pdf) here
Attitudes of Canadian Dietitians about Nutraceuticals and Functional Foods
Judy Sheeshka, RD, PhD, shared details of her CFDR-funded research at the May 2010 Research Breakfast. Judy's research project examined the following questions: How do Canadian dietitians (RDs) feel about nutraceuticals & functional foods? Should these products carry health claims? What roles do RDs play in recommending these products? Are there concerns about these products? Do RDs recommend them to clients? Through their survey of 151 dietitians from across Canada, the research term learned that 60% felt that health claims should be permitted with adequate scientific evidence and government regulation and that 81% felt that dietitians are the best professionals to recommend functional foods. However, dietitians were less clear about nutraceuticals, suggesting that pharmacists may be in a better position to recommend nutraceuticals. The team further learned that dietitians are cautiously optimistic about the potential benefits of functional foods and nutraceuticals, both for specific clinical groups and for the general public.
The study also showed that dietitians need to work in partnerships with government, industry and other health professionals to ensure that consumers get consistent messaging about functional foods and neutraceuticals. This recommendation was acted on in April 2010 when 60 people (dietitians, industry professionals, pharmacists and academics) attended a forum at the University of Waterloo entitled Functional Foods & Nutraceuticals: A Collaborative Forum Linking Practitioners & Researchers. Presentations by family health teams were particularly forward-thinking; 2 pairs of dietitians and pharmacists spoke about their experiences working as a team and providing advice on functional foods and nutraceuticals.
View the complete presentation slides (pdf) here
Ecologic view of perceptions and motivations to sodium reduction: State of the knowledge
Anna Farmer, PhD, MPH, RD, University of Alberta began work on her project in January 2009. The project on sodium intake was funded by CFDR in collaboration with the British Columbia Ministry of Healthy Living and Sport.
In May 2009 Dr. Farmer was a keynote speaker at CFDR's Partners' Breakfast and presented some background information that led to the development of her research project. She highlighted some of the known health risks associated with high sodium intake, specifically high blood pressure and its relationship to cardiovascular disease. It is estimated that a 50% reduction in salt may reduce hypertension and coronary heart disease and could save 150,000 lives annually.
In looking at current education programs Dr. Farmer found that current information is not very effective in reducing Canadians’ sodium intake. After reviewing the literature available, she and her colleagues determined that more research is needed to elucidate consumer understanding.
All of this background information led to the development of the research project which is designed to provide an understanding of the perceptions and motivations to reduce dietary sodium across different contexts through an ecological lens. The research team believes that there are a variety of influences on individuals and their behaviours:
- Social environment – family, friends and peers
- Physical environment – home, worksites, school, restaurants, etc.
- Macro-level influence – societal norms and values, the food and beverage industry, food marketing and the media, government policies, and more.
- Individual behaviours – attitudes, knowledge, preference; skills; lifestyle, outcome expectations, and others.
The research project will include a literature review, a quantitative study, and a qualitative study. Participants in the study will include consumers, health care practitioners, food producers and researchers, and policy makers.
Dr. Farmer’s research project is expected to add to the gaps in the literature for understanding the relationships among different factors that may influence perceptions and motivations regarding sodium intake; and to help to inform and shape various strategies aimed at reducing sodium intakes of Canadians, dietary guidance messages and product communications.
The project is expected to be completed by June 2010.
The slides from Dr. Farmer’s presentation, which include references for the statistics presented in this summary, are available here.
Developing Evidence-based Client-Centred Nutrition Education Practice Points
We have all heard the cacophony of messages about what, how much and how often we should eat. We've read articles, seen ads and heard announcements about special diets for health conditions, weight loss, or general health. But how can dietetic educators cut through this dietary cacophony to share the nutrition information that Canadians need and prefer?
Catherine Morley, PhD, RD, FDC and her research team spent the past two years looking at how to help dietitians develop approaches to nutrition education with the view to optimizing client outcomes. Their study, funded by the Canadian Foundation for Dietetic Research (CFDR) is entitled “Developing Evidence-based Client-Centred Nutrition Education Practice Points.”
Catherine shared information on the research project during CFDR’s Annual General Meeting and Research Breakfast at the end of November. Standing before a wallhanging illustrating some of the cacophony that consumers encounter through magazine and book covers, advertisements, news articles, cookbooks for people living with various medical conditions or for specific diet restrictions (e.g., low carb diets; the obesity epidemic; cooking for diabetes), she told the audience that the public is bombarded daily with messages about eating. “How does a nutrition educator break through all this “noise” to help clients figure out what actions they will take?” she asked.
The purpose of the research project was three-fold: to develop practice guidelines to inform nutrition education practice and training; to connect these guidelines to health status; and to build capacity for dietetic research. The research team recognized that preparation for nutrition education and counselling is neither standard nor defined; rather it is based on the instructors’ views, theories or a combination of both. They wanted to develop standardized, evidence-based, client centred nutrition education practice points that dietetics educators could use in planning their curricula and course content, and that preceptors could use in framing their training efforts with dietetic students.
The main research “product” is what the researchers refer to as the Collaborative Client-Centred Nutrition Education (3CNE) framework. The framework is depicted as four concentric circles, with the client/dietitian at the centre and determining his/her course of action through consideration of factors in the other rings. The 3CNE represents the ‘swirl of ideas and information processing’ that goes on in the mind of a nutrition educator while engaged in conversation with clients. It offers a foundational document for dietetics education that has national and international application, as well as a conceptual framework for further research.
Cathy Morley's presentation slides (pdf) are available here or view her research abstract on CINDAR.
Vitamin and Mineral Supplementation in Canada
||Some much-anticipated preliminary research results were presented on Thursday, May 8 at the Canadian Foundation for Dietetic Research's annual Partners' Breakfast. Susan Whiting, PhD, University of Saskatchewan, spoke about her project on vitamin and mineral supplementation in Canada. The research project is a collaborative project between CFDR and Dietitians of Canada. At the time of the presentation, Dr. Whiting's research was nearing completion and some data were still being collected. She was, however, able to share some preliminary information.
Responding to recent news stories about supplementation being hazardous, Dr. Whiting explained that there are accepted recommendations for supplementation in some instances: "In Canada's Food Guide there are specific recommendations for supplement use—vitamin D and folic acid, for example. The Food Guide says 'a health care professional can help you find the multivitamin that's right for you.' I think that what you'll find from my research is that we really need to act on this sentence."
Recent stories in the media point out the hazards of too much of any one nutrient—taking too much of one type of supplement could lead to cardiovascular disease, cancer or others. Dr. Whiting's response is that those risks appear in extremely high supplement use. She points out that studies where over-supplementation caused problems used 20 - 30 times the recommended upper level of nutrients.
Dr. Whiting gave an overview of the vitamins of most concern to Canadians. Data from the 2004 Canadian Community Health Survey show that the main nutrient concerns for Canadians—where 10% or more Canadians have an inadequate intake—re calcium and vitamin D. Other nutrients of concern are vitamin C and vitamin A (suggesting diets low in vegetables and fruits); B6, folate, B12, iron and zinc (possibly reflective of low intakes of protein foods, specifically from meat); and magnesium (reflecting an overall poor diet.)
The research team conducted focus groups with lower income individuals to determine why they might not use supplements. Five themes regarding barriers to supplement use emerged:
- Preferences: people were unhappy taking pills but didn't know that liquid supplements were available
- Knowledge: people were unsure if they needed supplements
- Income: cost of the supplements
- Accessibility: forgetting to take them
- Health: Some people reported side effects.
So what does make people decide to take a supplement? Dr. Whiting says, "The bottom line is that people have to know why the supplement is needed, and they have to know that it will work. So, there has to be a relationship built with a client, there must be education, and there must be some kind of personal contact."
At the end of her presentation, Dr. Whiting expressed the need for a reference book on vitamins and minerals that offers simple answers to the questions that Canadian consumers and health care providers have about vitamin and mineral supplementation. Hopefully, the work of Dr. Whiting and her research team will begin to answer some of those questions.
Susan Whiting's presentation slides (pdf) are available here or view her research abstract on CINDAR.
Glycemic Index: From Research to Practice
||Maria Kalergis, PhD, Rd, CDE, from the McGill Nutrition and Food Science Centre in Montreal, QC, received a grant from CFDR in 2002 for her research on Canadian dietitians' use and perceptions of glycemic index in diabetes management. She described her research project, Glycemic Index: From Research to Practice, at the Partners' Breakfast on May 3, 2007.
"The glycemic index is a scale that ranks carbohydrate-containing foods by how much they raise blood glucose levels compared to a standard food (glucose or white bread)," explained Dr. Kalergis. "There is a growing evidence base that GI can be used in the prevention and management of diabetes, obesity, cardiovascular disease and other conditions."
Many health organizations around the world, including the World Health Organization and the Canadian Diabetes Association advocate the use of the glycemic index in clinical practice. However, the clinical use and applications of the GI remain controversial. Dr. Kalergis' project looked at whether dietitians were using the GI and, if not, what were the barriers to its use. Through a postal survey of more than 1,000 dietitians who counseled clients with diabetes, the researchers learned that 61% of those who responded did not use the GI, citing lack of teaching tools and lack of knowledge on how to teach the concept as major barriers.
The research team concluded that further education of dietitians on the use of GI in their practice is needed, and that educational tools need to be developed. Since completing the research project, Dr. Kalergis has done much to move the research into practice, including preparing a Current Issues backgrounder on GI for Dietitians of Canada (targeting dietitians), and writing an article for Canadian Diabetes (targeting physicians). Dr. Kalergis is now developing content for PEN (Practice-Based Evidence in Nutrition), Dietitians of Canada's on-line resource for practitioners.
"GI can be easily applied into practice and may be effective in the management and prevention of diabetes, cardiovascular disease and obesity," says Dr. Kalergis. "Tools like the PEN pathway will help to provide practitioners with the information they need to use GI in their practice."
Download Maria Kalergis' presentation slides (pdf) or view her research abstract on CINDAR
Nutrition and Genes: More Questions than Answers
||On November 29, 2007 Ellen Vogel, PhD, RD, FDC (left) and Milly Ryan-Harshman, PhD, RD were the keynote speaker's at CFDR's Annual General Meeting and Research Breakfast. Ellen and Milly have completed their project on nutritional genomics, funded by CFDR with matching funds provided by The Centrum Foundation.
The presentation focused on preliminary research findings regarding the current opportunities, challenges and strategies for moving forward in the emerging science of nutritional genomics—which is best understood as establishing individual dietary recommendations based on nutrient requirements, nutritional status and each person's unique genetic makeup to reduce disease risk. Ellen and Milly's project involved a national study which identified gaps in capacities for dietetic practice, education and research, while increasing awareness and understandings of new roles for registered dietitians in diet-gene interactions. Data were collected through key informant interviews (n=12) conducted with national and international experts. Further, semi-structured focus group interviews (n=6) were held with dietitians employed in diverse practice settings.
The researchers found through their study that people are already attempting to collect and act on genetic information in identifying their nutritional needs—the future is here now. Overall, the researchers found that dietitians in the focus groups were "cautiously optimistic" about how this emerging science relates to their work. They articulated some benefits, like being able to enhance the scientific foundation on which their clinical practice is based, improving clinical outcomes and enhancing their practice. They stressed that more and objective information would help dietitians to define specific types of interventions for clients that would ultimately lead to improvements.
The researchers suggest that in order to move forward with nutritional genomics, an interdisciplinary and cross sectoral collaboration is needed. Dietitians in the focus groups felt it was unwise to restrict nutritional genomic information to dietitians only. They suggested that health care providers, physicians, pharmacists and others need to be educated in the science of nutritional genomics before it is made available to the public, so that the public is protected and can use this information in a supported, educated way.
View their presentation slides (pdf) or view the research abstract on CINDAR.
Nutrient Composition of Hindmilk Produced by Mothers of Very Low Birthweight Infants
||Pauline Darling, MSc, PhD, RD, from St. Michael's Hospital, made a well-received presentation on two CFDR-funded research projects at the annual Research Breakfast held just before the AGM on November 30, 2006. Dr. Darling's two projects demonstrate the diversity of projects in nutrition that CFDR funds and underscores the breadth of the Foundation's research program.
Nutrient Composition of Hindmilk Produced by Mothers of Very Low Birthweight Infants In 2002, Dr. Darling and her research team (Rosine Bishara RD MSc, Susan Merko RD and Michael Dunn MD) received CFDR funding for a project looking at the nutrient composition of hindmilk produced by mothers of very low birthweight infants. Typically, these infants fed fortified human milk exhibit growth failure. One approach to enhancing the nutritional intake is to introduce hindmilk—milk produced after the first three minutes of milk flow. Hindmilk has a higher fat and energy concentration than foremilk, but there is not enough known about the vitamin content of hindmilk produced by mothers who have given birth to low birthweight infants. Researchers found that compared to foremilk, hindmilk had significantly higher concentrations of retinol, tocopherol, fat and energy; and that the composition of normalized fatty acids was slightly and significantly altered in hindmilk vs. foremilk. These findings have implications in assessing the fat-soluble vitamin content of human milk fortifiers for feeding very low birthweight infants.
View Pauline Darling's presentation slides (pdf) or view the research abstract on CINDAR.
Prevalence of Hyperhomocysteinemia in Patients with Predialysis Chronic Kidney Disease after Food Folic Acid Food Fortification of the Canadian Food Supply
Dr. Darling's 2006 project is looking at whether people with pre-dialysis kidney disease would benefit from additional folic acid and other B-vitamins. Her team consists of Jane Paterson RD, MSc candidate, Deborah O'Conner PhD RD, Carol Huang RD, and Vanita Jassal MD. An estimated 1.5 million Canadians have pre-dialysis kidney disease, and this number is expected to rise as a result of the global pandemic of type 2 diabetes. Low blood levels of folic acid and related B-vitamins have been linked to a high blood level of homocysteine, a risk factor for heart disease. Since the recent change in Canada's food fortification regulations to require the mandatory addition of folic acid to flours and most cereal grain products, blood homocysteine levels have decreased in the general population. What is unknown is whether the fortification regulation has led to a reduction in plasma homocysteine concentration in people with predialysis kidney disease. This will be the first study to describe the prevalence of high blood homocysteine levels and the adequacy of dietary folic acid intakes in the pre-dialysis kidney disease population in the era of Folic Acid Fortification. This information may provide evidence to guide dietetic practice regarding whether or not dietitians should be prescribing vitamin supplements to people with pre-dialysis kidney disease.
View Dr. Darling's presentation slides (pdf) or view the research abstract on CINDAR.
Prevalence of Thiamin Deficiency in Hospitalized Patients with Congestive Heart Failure
||At the Partners Breakfast on May 4, 2006, CFDR supporters had the opportunity to listen to Dr. Mary Keith describe her CFDR-funded research, which has received international attention.
More than 350,000 Canadians are afflicted with congestive heart failure (CHF), and mortality rates one year after diagnosis range from 25% to 40%. Research to identify new treatment and management options is crucial given the predicted future impact of CHF as our population ages. Nutrition has long been a cornerstone of treatment. Dr. Keith described her team's research, the largest study of thiamin deficiency among hospitalized patients with CHF. The team includes Stacy Douglas-Hanninen, RD, MSc, who conducted the research for her Masters of Science thesis, and Pauline Darling, PhD, RD, both of St. Michael's Hospital and University of Toronto; Dr. Michael Sole, MD, FRCPC, FACC, Cardiologist at the University Health Network and Professor at the University of Toronto; and Aiala Barr, PhD, University of Toronto.
Deficiency of thiamin (vitamin B1) manifests as symptoms of heart failure and therefore may present as worsening CHF. It is thus critical to determine if hospitalized patients are at risk for thiamin deficiency, as well as the factors contributing to that deficiency. Mary Keith's team measured thiamin status among 100 heart failure patients admitted to St. Michael's Hospital in Toronto, compared with 50 matched healthy subjects. Based on red blood cell levels of thiamin, 33% of these CHF patients had thiamin deficiency, a statistically significant difference from the 12% of those without the disease.
Dr. Keith and her team also investigated factors that may contribute to the development of thiamin deficiency (diuretic type and dosage, urinary thiamin excretion, disease severity, thiamin intake, nutrition status, hospitalization, age and gender). Having low urinary thiamin losses, not using thiamin-containing supplements, and having good kidney function were significantly related to thiamin deficiency. In contrast to some previous studies, they did not find a relationship between the development of thiamin deficiency and the amount or duration of diuretic use, or urinary thiamin excretion. In fact, increased urinary loss of thiamin was found to be the only significant predictor of improved thiamin status. Their findings confirm that the development of deficiency is complex, not simply related to the dose or duration of diuretic use. Building on the CFDR-funded research, Dr. Keith also described an adjunct study in which her team investigated the status of riboflavin and vitamin B6 in the same CHF patients. They found that riboflavin deficiency was significantly related to thiamin deficiency, along with a high overall prevalence of B vitamin deficiency in these CHF patients (71%).
The team noted that heart failure may increase the body's need for certain nutrients, so that even individuals with healthful diets may still come up short on thiamin. Their findings raise questions about the need for B vitamin supplementation in this population. Dr. Keith indicated that routine supplementation of thiamin appears safe and justifiable; however, supplementation with B6 requires additional investigation to determine the impact of both deficiency status and the dose. Further research is needed to substantiate risk factors for thiamin deficiency, to assess whether thiamin supplementation improves thiamin status and disease severity in CHF patients, and to determine the impact of specific disease states on nutritional requirements in CHF patients.
View Mary Keith's presentation slides (pdf) or view the research abstract on CINDAR.
Finding Common Ground: Dietitians' Best Practices for Treating High Blood Cholesterol
||Dr. Paula Brauer described her 2-year CFDR-funded study, which has helped to identify how dietitians can best apply their skills and knowledge in the fight against a major risk factor for heart disease. She outlined how her team developed a consensus-based diet care map to define recommended practices for dealing with high blood cholesterol.
Although the overall goals of nutrition management had been well defined, specific diet treatment strategies were needed. The recommendations are based on the judgement of 39 dietitians, physicians and researchers from a range of practice settings across Canada who participated in a rigorous process to build consensus on appropriate, feasible and relevant dietetic practice in the Canadian health care system, which would be effective in the majority of clients. The care map is intended to be adapted to meet each client's unique needs.
Dr. Brauer's study is extremely relevant to the Foundation, as health system uptake has been identified as a key issue. The results can be used in current practice and in developing studies to measure effectiveness of intervention.
View Paula Brauer's presentation slides (pdf) or view the research abstract on CINDAR.
Putting Science into Practice: Dietitians & Nutritional Genomics
||Dr. Milly Ryan-Harshman described the impetus behind a cutting-edge research project for which she and lead researcher Dr. Ellen Vogel have recently received CFDR funding.
The scientific understanding of "nutritional genomics"-interactions between nutrition and genes- is evolving rapidly; at the same time, surveys forecast that one third of consumers will be collecting and acting on nutritional genomic information by 2010. Dietitians will need to be able to provide nutrition advice that is more and more individualized according to factors such as a person's genetic makeup.
This research will increase awareness and understanding of new roles for registered dietitians related to nutritional genomics. It will identify opportunities and gaps in knowledge, skills and resources, including needed updates to public health policy, for enhancing dietetic practice, education and research. The findings will provide insight into ethical issues and practice-based issues.
The team will conduct interviews with key informants having national and international expertise in nutritional genomics, ethics, public policy, education and professional practice. They will also conduct focus group interviews with dietitians across Canada. The research is ongoing and the final report is eagerly anticipated in the summer of 2007.
View Milly Ryan-Harshman's presentation summary (pdf) or view the research abstract on CINDAR.