NUTR 4346 – Research in Nutrition Group 9 Project Dietary Patterns to Prevent He

NUTR 4346 – Research in Nutrition Group 9 Project
Dietary Patterns to Prevent Heart Disease
You are the nutrition manager for a major hospital in the Texas Medical Center. You manage a team of 10 dietitians and administrative staff members. Your patient population primarily consists of older adults from a mix of SES, race, and ethnic groups. The hospital administrator wants to begin offering more prevention services to patients in addition to the standard treatment approaches for those with pre-existing conditions. As part of this effort she has asked you to develop a nutrition education webinar series on dietary patterns to prevent heart disease. As a licensed and registered dietitian you have an ethical and professional obligation to be sure the information you present is evidence based. A friendly inpatient nurse recommends you use the webinar series to promote the ketogenic diet as an overall healthy diet. She swears she has seen really positive results in her patients that practice it. You are aware that there is research to show the keto diet reduces seizure activity in children and it may be helpful for reducing blood glucose levels among those with type II diabetes, but you are not sure whether it has been shown to prevent heart disease. You will make this decision based on a review of the literature, which will answer the below two questions.
1. What types of diets have been shown to reduce heart disease risk? Answer this by finding published guidelines on dietary patterns for the prevention of heart disease.(Published Clinical Guideline Summary Assignment) Example of clinical guideline from public health website (CF Foundation): https://www.cff.org/nutrition-children-and-adults-clinical-care-guidelines
2. If you recommend your currently healthy employees follow a ketogenic diet, will fewer of them have heart disease in the long term future than those who don’t follow keto diet? To determine this, review relevant research from peer reviewed original research studies.(Group Recommendation Report)
Published Clinical Guideline Summary
One assignment will be turned in per group (i.e., group assignment).
For each case study, the first question requires you to find clinical guidelines pertaining to the specific case your group chose. There are several health and medical organizations that publish clinical guidelines. Some of these organizations include the Academy of Nutrition and Dietetics (Evidence Analysis Library), American Academy of Pediatrics, American College of Obstetrics and Gynecology, American Heart Association, American Cancer Society, USDA and CDC, American Diabetes Association, National Heart Lung and Blood Institute, etc. To answer the first question of your case study you should find at least two sets of guidelines published by a major health organization, and then write a 2-page (no minimum page limit; points will be deducted for going even one line over the 2nd page) paper briefly 1) summarizing the similarities and differences between them, 2) discussing the process each organization used to develop the guidelines (i.e., how were the guidelines derived), and 3) discussing the implications of these guidelines for your case study. Include full text copies of the clinical recommendations you review for this assignment.
Group Recommendations
Groups will turn in one report (group assignment)
Each case study has a 2nd question requiring a review of the research literature to answer it.
First you will need to find peer reviewed articles of original research studies (DO NOT use review articles). To do this you will conduct a search of the available peer reviewed research studies related to your case study question. Use the resources available on BB or arrange a virtual (or live) consult with a UH librarian to construct a thorough search strategy, apply the search strategy to conduct a PubMed or PsychInfo search. Narrow your search to those articles that will help you answer your question. Hint: The studies to retain should conduct an original research study testing a research question that is very similar to the case study question you have. Remember – you should not select review articles for this assignment. Let’s say you were trying to determine whether the DASH dietary pattern is a valid dietary pattern for promoting bone density. You would look for original research studies that tested (in various ways) whether the DASH diet was related to or led to increased bone density. Very important note (READ THIS): You should select research studies that test the research question you are interested in regardless of what they find NOT research studies that only confirm your hypothesis. You are an unbiased professional – not someone who has subjectively answered the research question in your head and is looking for research to justify your current opinion. Also note: You should make sure that the target population of the research studies matches the target population of your research question. Also make sure the outcome (dependent variables) in the study match the variables in your research question. For example, if you want to know if the DASH diet prevents bone density loss, you should not review articles that show the DASH diet prevents heart disease because they don’t answer your question. Articles that test intuitive eating on mental health or that test the keto diet on children with epilepsy are not going to address your case study questions.
Next you will take the most recent articles found and assess the quality of the research studies reported in the articles you have collected. You should identify the qualities that strengthen their internal and external validity and the qualities that weaken their internal and external validity. You may want to categorize each study as “high,” “moderate,” or “low” or you may give each article a grade of A, B, C, or D or you may rank the studies from best to worst. Very important note (READ THIS): The quality of a study has NOTHING to do with what they found, or what the results are. If my research question is, “Does the DASH diet prevent bone loss?” and I found a very large multi-site double blind RCT that tested this very question and found the DASH diet did not affect bone density, I would still put it as one of the strong articles based on the quality of the research design.
Next you will summarize the findings of the articles you critiqued (step 2). What are the conclusions of each study alone and what is the overall conclusion across all the studies in light of the quality of each study as they relate to your case study.
Last you will summarize the clinical recommendations you would make based on your articles and the case study question you have to answer. Based on the qualities outlined in the Evidence Analysis Table, describe the strength of the recommendations you are able to provide. Important notes: Remember that this is a report to administrators not patient education materials. You are not writing ALL recommendations you would make to a patient in your clinic. You are answering a very specific question about a specific type of diet and its impact on a very specific health outcome. DO NOT put recommendations about exercise or other dietary components or drinking water or any other generic health practices into this report. Remember the case study and your role. Also remember you are grading the recommendations you write, not the articles. And, there are several qualities in the EAL to grade your recommendations on.
Your group will turn in a 4 page report (3-page if you have 3 group members) that includes the following components representing each of the 4 steps above:
1. A descriiption of the search strategy you used (1/2-1pg). This should be like a recipe or set of instructions. I should be able to follow the search strategy you outline and find the articles you review for this paper.
a. What is your research question (e.g., What is the relationship between the DASH diet and bone density? Does breastfeeding prevent postpartum weight retention? Is breakfast consumption associated with blood glucose control?)?
b. What were your keywords and filters? (e.g., We searched for diet, osteoporosis, nutrition, bone density. We restricted the search to humans, peer reviewed articles, and those studies published in English).
c. What are your inclusion and exclusion criteria? (e.g., We included studies conducted on women of childbearing age, studies in which breastfeeding was compared to no breastfeeding, studies in which the dependent variable was postpartum weight).
d. What databases did you search? (e.g., Pubmed, PsychInfo)
2. A 1 page critique of 2 articles you retained from your literature review (step 1). Refer to each article with Author (year) or (Author, year). (E.g., The purpose of the Ledoux (2022) study was to determine whether eating breakfast improved blood sugar control among adults with pre-diabetes who were not accustomed to eating breakfast. The internal validity of this study (Ledoux, 2022) was strengthened by the RCT design.). The most important elements to include here are the overall purpose of the study and the strengths and weaknesses for establishing internal and external validity of the study. Include the articles described in this critique in the appendix of the paper. (IF YOUR GROUP ONLY HAS 3 MEMBERS, DO NOT DO THIS SECTION).
3. A 1 page summary of all the articles you reviewed for this assignment (i.e., all the articles you retained from your search strategy). You should summarize the purposes, research designs, major and minor findings, target populations, and common strengths/weaknesses. This is very high level. It is totally fine to say things like, “Of the 10 articles we reviewed, most of them were RCTs, but there were a few cross-sectional, cohort, and quasi experimental studies. Five of the 10 articles recruited healthy adult samples, but 3 included clinical samples with diabetes, and 2 were focused on older adults. Most of the studies found a positive association between consumption of vegan diets and various cardiometabolic protective factors. However, the strongest quality study we had failed to show any significant association between vegan diets and cardiometabolic health.”
4. A 1-page summary of the clinical recommendations you have for your case study. Of course, these clinical recommendations should be based on the articles you reviewed in steps 2 and 3 (i.e., the articles that arose from your search strategy conducted in step 1). Use the Evidence Analysis Library grading table on BB to evaluate and grade the strength of each recommendation. Describe your rationale for the strength provided for each recommendation.
5. Reference Page including a listing of all articles reviewed for part 3 of this report.
6. Appendix: Full text of articles from part 2 of this report.
Note: Each student in the group will have equal responsibility for the final products turned in as indicated by their name on the cover page. Papers should follow APA format (no abstract is needed), be double spaced, have 12 pt font and 1” margins, and use proper spelling and grammar. Include all group member names, a title, and your group number on the title page. It would be unfair if some groups used more pages or lines to explain their points than other groups, so stick to the page limit. No exceptions to page limits – points will be deducted for going even 1 line over the page limit.
Questions:
Further explain discussing the implications of the guidelines for our case study?
Professor’s Announcements:
Why do I want you to answer the 2nd question about how the guidelines were developed? For question 2, you should tell me all the steps and methods that went into the organization developing the guidelines. Understanding the origins of these types of sources will help you know how to use them in the future. Explain to me things like who the authors are, how were they selected, how were the articles selected, how were they rated for quality, and how did the authors work with the organization to write the conclusions and publish the guidelines
Clinical guidelines are NOT patient education materials, systematic reviews, reports of individual research studies. They are summaries of the available research in a particular area and endorsed by a major public health or professional organization.
I have gotten a few questions about what types of sources are appropriate for obtaining published clinical guidelines. You should find the primary source. There may be articles, websites, and newspapers that describe the guidelines, but they would not be considered the primary source. They did not develop the guidelines themselves. The publication written by the organization who developed the guidelines would be the primary source.
Primary Sources:
AHA Guideline:
Dietary Guidelines for americans 2020-2025 (General):
https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf
Full-text: American Heart Association:
2019 Guideline:
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000678
https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2019/03/07/16/00/2019-acc-aha-guideline-on-primary-prevention-gl-prevention
2021 Guideline:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001031#:~:text=In%20general%2C%20heart%2Dhealthy%20dietary,desired%2C%20lean%20cuts%20and%20unprocessed
Full-Text: Australia https://www.proquest.com/docview/2056771902?parentSessionId=rZxckFgNsAt0qhtDMTYcbyoWqAH5FJiX%2FlxUfjKviNM%3D&accountid=7107