‘Focus on diet quality’: a qualitative study of clinicians’ perspectives of use of the Mediterranean dietary pattern for non-alcoholic fatty liver disease

Mayr, Hannah L; Kelly, Jaimon T; Macdonald, Graeme A.; Hickman, Ingrid

doi:10.1017/s0007114521001100

Cited by 12 publications

(21 citation statements)

References 39 publications

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“…Doctors and nurses were not recruited into this study but we appreciate that they have a very important role in the delivery of nutrition care as indicated in the literature. 37 Nonetheless, the shift to virtual nutrition care due to COVID-19 was an opportunity to examine nutrition service delivery more specifically from health professionals who are delivering nutrition care or allied health professionals who face similar enablers and barriers to using virtual care in a tertiary setting. Another limitation of the study is that results reflect the experience within a large Australian public health service and therefore, may not reflect other countries and in the private sector.…”

Section: Discussionmentioning

confidence: 99%

Technology-supported models of nutrition care: Perspectives of health service providers

et al. 2022

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Objective To determine the perspectives to the adoption, scale-up, sustainability, and spread of technology-supported models of nutrition care, in hospital and ambulatory care settings. Methods Thirty-one health service providers participated in individual semi-structured interviews from a tertiary health service in Queensland, Australia. The Non-adoption, Abandonment, and challenges to the Scale up, Spread and Sustainability (NASSS) framework, designed to evaluate technology-supported models’ success, informed the qualitative design. Results Key findings were that technology-supported models of care could benefit many chronic condition patient groups; dietitians are well suited to adopting this technology: and the value proposition in creating efficiency gains in the health service. However, challenges of transitioning and sustainability were identified. Perceived enablers for technology supported models of care included: previous intentions for technology supported models of care prior to the 2019 novel coronavirus pandemic; opportunity for clinicians to complete higher valued tasks; and integration of technology systems and assisted staff roles. Perceived barriers included: suitability for patients is dependent on experience and ability to use technology, varied confidence by clinicians when conducting clinical assessments; high investment required for set up and ongoing maintenance; and patients desire for adopting face-to-face care over technology. Health service providers perceived that embedding and adapting such models requires maintenance of high-quality service and continued research. Conclusions Health service providers recognize adopting, scaling, and sustaining technology-supported models of nutrition care benefits patients, clinicians, and health services in general. Robust clinical trials and health service evaluations of technology-supported models of care, across practice settings are now needed.

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Section: Discussionmentioning

confidence: 99%

Technology-supported models of nutrition care: Perspectives of health service providers

et al. 2022

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“…This study shows that one session might not be enough to guarantee the amount of weight loss necessary to improve liver steatosis/fibrosis. This reinforces the need to maintain/create adequate multidisciplinary groups to guarantee an adequate care and management of these patients, since often clinicians do not have either time or resources to support behavior change [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

NAFLD Nutritional Management: Results from a Multidisciplinary Approach

Policarpo

Machado

Barreira

et al. 2021

GE Port J Gastroenterol

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Introduction: Lifestyle changes are the mainstay treatment of nonalcoholic fatty liver disease (NAFLD). We aimed to assess the magnitude of weight loss in a group of NAFLD patients followed on a combined lifestyle intervention by a multidisciplinary team. Methods: Patients were assessed before and after a 12-month dietary intervention (Mediterranean diet aiming at weight loss). Patients who received a structured dietary plan along with general lifestyle recommendations were designated as the multidisciplinary treatment (MdT) group. Patients who declined follow-up still received general lifestyle recommendations and were designated as the conventional treatment group, being used as a control group. Results: From the 77 patients with documented NAFLD, 31.2% of patients were overweight and 55.8% obese; 66 patients constituted the MdT group and 11 the conventional treatment group. After 3 months, 89% of patients lost weight; at 6 months, 75.4% maintained the weight lost. At 12 months, 65% of patients still decreased their weight, with 92.2% of patients in the MdT group still maintaining a lower weight than baseline versus just 50% in the conventional group (p = 0.008). Only patients in the MdT group presented a weight loss higher than 10% (9.6%; n = 6). At 12 months patients in the MdT group presented an average reduction of 4.2 kg versus a reduction of just 0.6 kg in the conventional treatment group (p = 0.016). The MdT group, but not the conventional group, presented significant differences in liver enzymes at 12 months compared to baseline. Conclusion: Adherence to a multidisciplinary approach, compared to management solely by a hepatologist, in NAFLD patients, is effective with greater weight loss after a 12-month follow-up and a lower rate of weight gain recurrence.

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“…Several barriers were noted including cultural and socioeconomic backgrounds but also time and resourcing to support behaviour change. Further, innovations to service delivery could better support and empower patients to change dietary behaviour long-term (22) .…”

Section: A Mdp Inflammation and Other Chronic Conditionsmentioning

confidence: 99%

“…Emerging evidence is focussing on the relationship between consumption of a MDP and many other chronic diseases (21) , including non-alcoholic fatty liver disease (NAFLD) (22) , cancers and colorectal cancer (23) , multiple sclerosis (19) , as well as positive roles in athletic performance (24) and weight management in pregnancy (25) .…”

Section: A Mdp Inflammation and Other Chronic Conditionsmentioning

confidence: 99%

“…This edition has provided insights into the additive/ synergistic effects of a MDP with PA (3,20,35) and also the association between various lifestyle/behaviour factors and MDP adherence particularly in adolescents (29)(30)(31) . Knowledge of such interdependence is hugely important for the design and delivery of future public health (36) and clinic practice (22) guidelines.…”

Section: Mdp Adoption Approachesmentioning

confidence: 99%

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The health benefits and practical considerations for the adoption of a Mediterranean-style dietary pattern

Minihane

Murphy

2022

Br J Nutr

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The term Mediterranean diet first appeared in the late 1940s (1) . It is described by UNESCO as 'a set of skills, knowledge, practices and traditions ranging from the landscape to the table, including the crops, harvesting, fishing, conservation, processing, preparation and, particularly, consumption of food'. A Mediterranean dietary pattern (MDP) varies in composition between the 21 countries which make up the Mediterranean region but is typically characterised by high intakes of minimally processed plant-based foods such as fruits, vegetables, nuts, seeds, legumes and wholegrains. Extra virgin olive oil is the main culinary fat, with a moderate intake of dairy products, and a variety of herbs and spices used as condiments, rather than salt. Fish/seafood is typically consumed two-three times per week.Red and processed meat, and discretionary foods including sugar or honey sweetened food and drink are consumed in low amounts. Wine, and in particular red wine, is consumed in moderation and with meals. Although in many ways analogous to other global healthy plantbased dietary patterns, it is the high intakes of olive oil, nuts and red wine, which makes the MDP unique. The MDP has been used as a benchmark for comparison with other dietary

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‘Focus on diet quality’: a qualitative study of clinicians’ perspectives of use of the Mediterranean dietary pattern for non-alcoholic fatty liver disease

Cited by 12 publications

References 39 publications

Technology-supported models of nutrition care: Perspectives of health service providers

Technology-supported models of nutrition care: Perspectives of health service providers

NAFLD Nutritional Management: Results from a Multidisciplinary Approach

The health benefits and practical considerations for the adoption of a Mediterranean-style dietary pattern

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