Do patients with lymphoedema cholestasis syndrome 1/Aagenaes syndrome need dietary counselling outside cholestatic episodes?

Do patients with lymphoedema cholestasis syndrome 1/Aagenaes syndrome need dietary counselling outside cholestatic episodes?

Aug 2010

Drivdal M, Løken EB, Hagve TA, Bergstad I, Aagenaes Ø.

Source

Regional Department of Eating Disorders, Division of Psychiatry, Building 37A, Oslo University Hospital, Ullevaal, N-0407 Oslo, Norway. ildr@uus.no

Abstract

Keywords:  Intrahepatic cholestasis, Lymphoedema, Nutrition assessment, Nutrient intake, Syndrome

BACKGROUND & AIMS: Patients with lymphoedema cholestasis syndrome 1/Aagenaes Syndrome need a fat reduced diet when cholestatic. We wanted to assess the need for dietary counselling outside cholestatic episodes, and hypothetized that no counselling was needed.

METHODS:

Fifteen patients above 10 years of age without symptoms of cholestasis were compared with a sex and age matched control group. Diet from a four-day weighed record and blood samples were compared between the two groups and with general Norwegian recommendations.

RESULTS:

The patients had a similar diet to the healthy controls, except for statistically significant lower intake of energy from total fat (p=0.04) and saturated fat (0.02), and fish (0.05). The patients met the dietary recommendations for macronutrients, except for saturated fat, monounsaturated fat, refined sugar and fibre. Supplements were needed to meet the micronutrient recommendations. Patients had a significantly lower serum level of alpha-tocopherol (0.01) compared with the control group, and the serum 25-OH D level was below reference ranges.

CONCLUSIONS:

The patients would benefit from counselling on fat quality, carbohydrates including fibre intake, and individual needs for vitamins D and E. To secure serum 25-OH D and alpha-tocopherol levels within reference ranges, regular examinations to determine the need for supplementary vitamins D and E are recommended.

Elsevier

Nutrient Intake, Peripheral Edema, and Weight Change in Elderly Recuperative Care Patients.

Nov 2012

Sullivan DH, Johnson LE, Dennis RA, Roberson PK, Garner KK, Padala PR, Padala KP, Bopp MM.

Source

Geriatric Research Education and Clinical Center (Building 170, 3J/NLR), Central Arkansas Veterans Healthcare System, 4300W 7 Street, Little Rock, AR 72205. SullivanDennisH@uams.edu.

Abstract

BACKGROUND:

It is unclear whether serial measures of body weight are valid indicators of nutritional status in older patients recovering from illness.

OBJECTIVES: Investigate the relative influence of nutrient intake and changes in peripheral edema on weight change.

METHODS:

A prospective cohort study of 404 older men (mean age = 78.7±7.5 years) admitted to a transitional care unit of a Department of Veterans Affairs nursing home. Body weight and several indicators of lower extremity edema were measured at both unit admission and discharge. Complete nutrient intake assessments were performed daily.

RESULTS:

Over a median length of stay of 23 days (interquartile range: 15-41 days), 216 (53%) participants gained or lost more than or equal to 2.5% of their body weight. Two hundred eighty-two (70%) participants had recognizable lower extremity pitting edema at admission and/or discharge. The amount of weight change was strongly and positively correlated with multiple indicators of both nutrient intake and the change in the amount of peripheral edema. By multivariable analysis, the strongest predictor of weight change was maximal calf circumference change (partial R(2) = .35, followed by average daily energy intake (partial R(2) = .14, , and the interaction of energy intake by time (partial R(2) = .02. 

CONCLUSIONS:

Many older patients either gain or lose a significant amount of weight after admission to a transitional care unit. Because of the apparent high prevalence of co-occurring changes in total body water, the weight changes do not necessarily represent changes in nutritional status. Although repeat calf circumference measurements may provide some indication as to how much of the weight change is due to changes in body water, there is currently no viable alternative to monitoring the nutrient intake of older recuperative care patients in order to ensure that their nutrient needs are being met.

Oxford Journals

Do patients with lymphoedema cholestasis syndrome 1/Aagenaes syndrome need dietary counselling outside cholestatic episodes?

Aug 2010

Drivdal M, Løken EB, Hagve TA, Bergstad I, Aagenaes Ø.

Source

Regional Department of Eating Disorders, Division of Psychiatry, Building 37A, Oslo University Hospital, Ullevaal, N-0407 Oslo, Norway. ildr@uus.no

Abstract

BACKGROUND & AIMS:

Patients with lymphoedema cholestasis syndrome 1/Aagenaes Syndrome need a fat reduced diet when cholestatic. We wanted to assess the need for dietary counselling outside cholestatic episodes, and hypothetized that no counselling was needed.

METHODS:

Fifteen patients above 10 years of age without symptoms of cholestasis were compared with a sex and age matched control group. Diet from a four-day weighed record and blood samples were compared between the two groups and with general Norwegian recommendations.

RESULTS:

The patients had a similar diet to the healthy controls, except for statistically significant lower intake of energy from total fat (p=0.04) and saturated fat (0.02), and fish (0.05). The patients met the dietary recommendations for macronutrients, except for saturated fat, monounsaturated fat, refined sugar and fibre. Supplements were needed to meet the micronutrient recommendations. Patients had a significantly lower serum level of alpha-tocopherol (0.01) compared with the control group, and the serum 25-OH D level was below reference ranges.

CONCLUSIONS:

The patients would benefit from counselling on fat quality, carbohydrates including fibre intake, and individual needs for vitamins D and E. To secure serum 25-OH D and alpha-tocopherol levels within reference ranges, regular examinations to determine the need for supplementary vitamins D and E are recommended.

Elsevier/Clinical Nutrition