Evidence - Based Practice Skills Nutrition

1 Interventions to Improve Nutritional Status 2 Introduction and Key Points Improving the overall diet of patients can be as simple as making small changes, but other times the big changes can discourage people from even attempting the changes. As many as 42.4% of adults in the United States are obese, which is a 26% increase from 2008 (Warren, Beck, and Delgado, 2020). This brings up the topic of, what type of interventions can improve adherence to recommendations on nutritional intake? Interventions for adherence to dietary changes including education, restriction, enablement, and outcomes are some that are listed; as well as “measures of diet adherence, dietary advice, nature of the chronic diseases and duration of interventions and follow-up” (Desroches, et al., 2013). Because this article reviewed so many different studies, there were not pooled results but a qualitative analysis. Article Search When beginning the search for a related article, I started with Google Scholar to try to find a direction for my thoughts to go. Using the question provided as my search brought up a ton of articles, close to 60,000. To filter the results further, I made sure that the articles being shown were written within the last five years, had to be peer-reviewed and scholarly articles. Once I had a better understanding of key terms, I should use to find an article, I used PubMed with the following key terms: dietary adherence, weight loss, diets, and meal planning, to identify the article written in 2017, written by Alice Gibson and Amanda Sainsbury titled, Strategies to Improve Adherence to Dietary Weight Loss Interventions in Research and RealWorld Settings. A larger reason as to why weight loss attempts end up unsuccessful is an increased drive to eat, so this is a large focus on improving adherence. 3 Article Findings This study emphasized the importance of adherence being the key to successfully losing weight, and keeping it off. There are a variety of techniques that can influence an individual's ability to adhere to dietary intervention, and doctors will most likely need to use a combination of dietary and behavioral treatments. Increased dietary fiber intake, for example, may aid in controlling the desire to eat. One way that has shown to have great success in sticking to a diet, even after reaching the goal weight, was meal planning/prepping. Having all the meals planned out makes eating unhealthy foods a little less appealing. Another strategy studied to decrease cravings and binge eating is the ketosis diet and ketogenic low carb diet. These diets include eating little to no carbohydrates and increasing healthy fats and protein; following this diet, can force the body into ketosis. Ketosis is when there is an increase of ketones circulating throughout the body, which can help to suppress the need to eat. This is considered a very low energy diet (VLED), that can then lead to rapid weight loss, greater fullness, and less hunger. More research needs to be done to evaluate the minimal level of ketosis that needs to be achieved to suppress the appetite to promote long-term adherence. This article was chosen because it uses the base of many studies to find the best strategies to improve adherence to dietary changes. It looks at three main methods for improving dietary weight loss intervention adherence: designing diets to assist in minimizing the desire to eat, customizing the diet to match dietary references, and encouraging self-monitoring of eating habits and nutrition. Evidence for Practice The evidence showed that weight loss success in the short and long term is highly linked 4 to adherence to a dietary weight loss plan. Customizable dietary interventions that can be modified to a person's specific dietary preferences may result in higher compliance to a dietary plan. Having a diet that is tailored around someone means they are eating foods that they like, rather than having to give up their favorite foods. Dietary weight reduction strategies should take into consideration an individual's nutritional requirements and be nutritionally balanced, in addition to individualization based on an individual's regular diet and dietary interests. Many people will not even try a diet because all they see or hear about it is how they “can’t have…,” for those that are picky eaters, their options are extremely limited. Sharing of Evidence For this information to reach the largest number of people, I would share this information with any patients that are overweight, obese, or showing signs of poor eating habits that could lead to them being overweight. I would also try and start to share this information with parents and young children. If we could teach parents that making small changes in their child’s diet could then prevent them from becoming overweight, that could prevent any chronic illnesses, there could be a large impact on the amount of the population that is overweight or obese. Ideally, the best method to share this information would be a pamphlet or brochure stating all the facts in simple terms, while also providing recommendations to start improving the reader's diet now. Simple tips can be the best way to get a person started on their health journey, showing them how small changes can be of big impact will help encourage them to keep making healthy changes. It would be extremely valuable to begin sharing this type of evidence in the nursing profession because many health conditions and chronic diseases are related to weight, like heart disease and diabetes to name two big ones Conclusion 5 In conclusion, diets should be designed to assist and lessen the weight loss-induced desire to eat by adapting them to dietary preferences while still satisfying nutritional needs and encouraging self-monitoring of food consumption. By listing the facts without bias, without people having to give up their favorite foods, and providing easy tips to start with, adherence to nutritional intake can be improved and maintained over a long period of time.