Showing posts with label nutrition. Show all posts
Showing posts with label nutrition. Show all posts

Saturday, August 7, 2021

A three-step nutrition intervention model associated with better health outcomes and reduced costs

Improving health outcomes while reducing costs, regardless of the setting of care, includes an often overlooked and rarely discussed element that has the potential to prohibit success on both fronts: nutrition health. Understanding and addressing patients' nutrition status is often a key component of reducing the length of hospital stays, decreasing the use of medical resources and lowering the total cost of care.



The Burden of Malnutrition


According to the World Health Organization, malnutrition is defined as an imbalance, deficiency, or sub-optimal intake of nutrients.1 Whether undernourished or overnourished, the effects of malnutrition can be harmful to achieving good health, and costly for patients and the larger healthcare system alike. In the United States, the cost of disease-associated malnutrition stemming mainly from conditions such as cancer or cardiovascular disease has been estimated at more than $147 billion per year, with $15.5 billion attributed directly to treatment costs.2,3 But health systems aren’t the only ones bearing the burden—people who are hospitalized and found to be malnourished may incur hospital costs nearly twice as high as those who are adequately nourished.4

Comprehensive nutrition care that delivers the nutrients patients need can support care across the continuum, including in hospitals, outpatient clinics, and community care settings. Furthermore, intentional effort to ensure patients are receiving proper nutrition improves overall patient health and reduces the use of healthcare resources and costs.




One Model to Address Malnutrition Across Care Settings Equals Better Outcomes for All


Healthcare providers often have only a few minutes to connect with their patients to evaluate their condition and address their concerns, which means that many may feel they don’t have enough time to discuss important topics with their patients like diet and nutrition. By implementing simple but comprehensive nutrition programs, healthcare providers can screen for undernutrition or overnutrition to assess risk and quickly determine if further intervention is needed. This screening includes a three-step approach:


1. Screen Patients to Determine Malnutrition Risk


Screen patients for undernutrition or overnutrition risk with a few simple questions such as: Has food intake reduced recently? Have they lost weight without trying? Have they experienced a recent illness or injury that suggests they may be undernourished? Have they noticed weight gain within the past 3-6 months? Have they noticed a change in fitting of clothing recently?


2. Communicate a Personalized Nutrition Care Plan


Create a customized plan for patients at risk for malnutrition and recommend an appropriate nutritional drink such as Ensure or Glucerna to help patients get the nutrients they need.


3. Deliver Nutrition Education


Educate patients and their caregivers on the importance of nutrition and nutritional drinks compliance.

When introduced as part of a comprehensive nutrition program, these three steps provide a model that has been successful in acute care settings, like hospitals where results from a study by Advocate Health Care and healthcare company Abbott included cost savings of nearly $4,000 per patient, shortened length of hospital stays, and reduced readmission rates.5,6 Another study by Advocate Health Care and Abbott which implemented a similar nutrition program using these three steps for patients at risk for malnutrition in transitional care touchpoints like home healthcare settings has also shown to have significantly reduced hospitalization rates and healthcare costs by an estimated $1,500 per patient treated.7




Quality of Care is Everyone's Priority


Stakeholders across the continuum of care benefit when people are properly nourished. And, when these benefits are realized, there is the ability to drive that value in communities by improving the health of the members within it. The three clinics that participated in the study and implemented a nutrition program saw a significant decrease in the percentage of patients using healthcare resources over 90 days, allowing healthcare providers to better manage their patients while reducing costs. The quality of care also improved, with 81.8% of patients reporting high levels of satisfaction with their nutrition care.8,9

While managing costs is important to leaders in healthcare practices and systems responsible for managing healthcare expenditure, healthcare professionals and administrators are generally more concerned about delivering quality care to their patients and enabling healthy outcomes for long-term success.

When nutrition is considered as a component of the overall treatment plan, patients can feel better about the holistic regimen of care they are receiving to actively treat symptoms and successfully manage conditions. To bring the value of nutrition to healthcare, healthcare authorities have an opportunity to develop effective practices, policies, and comprehensive malnutrition strategies for implementation across the continuum of care at hospitals, post-acute or primary care settings, and at home, making our communities healthier for all.


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Wednesday, March 3, 2021

Three strategies for discussing plant-based nutrition with pediatric patients

Growing concerns around animal fats, processed foods, and ecology are leading millions of Americans to choose meal options that center on fruits, vegetables, beans, nuts, seeds, whole grains, and legumes. These diets are also gaining traction within the healthcare space as more medical professionals recommend plant-based foods for patients struggling with weight maintenance or chronic illnesses, such as diabetes, inflammatory bowel disease, cancer, and ALS.


While health benefits are reported for adult patients incorporating more plant-based foods into their diet—such as decreased inflammation, improved gut health, and cardiovascular disease prevention—many parents are concerned about the safety of such diets for their children and teens. According to the American Academy of Pediatrics, children following vegetarian diets can meet their nutritional needs without compromising growth and benefit from diets that incorporate more whole plant-based foods.

Recent studies have found plant-based enteral formulas have been clinically proven to demonstrate improved health outcomes in pediatric patients. Research presented at the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NAPSGHAN) annual meeting demonstrated pediatric patients experienced improved tolerance, weight gain and adherence when prescribed pea protein plant-based enteral formula (PP PBEF) is used, whether used orally or through a feeding tube.

How can physicians help pediatric patients transition to a healthier diet using more plant-based foods? Here are three strategies for discussing plant-based foods and diets with patients and their families to help them find a nutrition plan that fits their lifestyle.


Help them understand the health-related benefits


As medical professionals, we have a unique opportunity to educate patients and families on the benefits of plant-based foods and their role in providing healthy nutrition. Many will adopt these lessons to benefit their entire family’s lifestyle, increasing the likelihood of everyone adhering to their physicians’ recommendations.

Plant-based foods contain vitamins, minerals, fiber and phytonutrients that are often missing according to the CDC and National Health and Nutrition Examination Study (NHANES) data. Moreover, replacing animal-based foods with plant-based options also eliminates or significantly decreases patients’ intake of saturated fats and cholesterol—ingredients that can lead to obesity and heart disease.

As I often tell my patients, just as we brush our teeth with toothpaste to prevent cavities and keep teeth healthy, we need to “brush” our intestines with fruits and vegetables to enhance their intestinal microbiome and lessen health concerns. While kids may not enjoy brushing their teeth or their intestines, it’s important for their health and will improve their overall quality of life. They often understand the visual picture, when I ask what would happen if they only brushed their teeth once a week.


Address any barriers to plant-based nutrition


When discussing diets with pediatric patients and their families, it’s important to meet them where they are with their current lifestyle and address any obstacles that may prevent them from adopting a more plant-based style of eating. For some, these obstacles could be cost concerns or the perception that plant-based foods are inconvenient and unappealing.

If patients or their families view a plant-based lifestyle as expensive or difficult, especially compared to fast food restaurants or processed foods, physicians can provide tips and resources for making whole foods more accessible. For example, physicians can encourage parents to replace less healthy, and sometimes expensive, processed foods at the grocery store with affordable, nutritious options that fit within their budget (frozen fruits and vegetables are usually good options, but sugary juices aren’t). Also, kids look to their parents, who can lead by example with the food choices they offer and eat. Additionally, fruit and vegetable prescription programs are growing nationwide, meaning that health care providers may be able to provide patient vouchers to purchase fresh fruits and vegetables from participating local farmers’ markets.


Find a solution that works for them


While physicians play a critical role in helping patients select options that support their individual health needs, there isn’t a one-size-fits-all solution. For instance, patients facing difficulty gaining or maintaining weight do not need to become strictly vegetarian to benefit from plant-based nutrients.

Improving patients’ nutrition literacy and helping them overcome barriers to healthy nutrition are two vital approaches for discussing plant-based options with pediatric patients and their families. While physicians can provide evidence-based information and counseling on plant-based diets for children and teens, it’s also important to promote parents as positive role models of healthy, mindful eating.

Encouraging the whole family to experience the benefits of plant-based foods is similar in many ways to advocating an active lifestyle, since both can improve their potential for a longer, healthier lifetime.


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