PEN eNews 11(2) February 2021

Heart Failure and Dietary Patterns - What is the Latest?

A systematic review that examined the effectiveness of dietary patterns on outcomes in individuals with HF identified limited clinical trials and observational studies: 

• DASH Diet (two RCTs and five observational studies): suggested the DASH diet compared to usual diet improved functional capacity (three studies) and QoL (one study). A positive association was seen with adherence to the DASH diet and reductions in diastolic and systolic BP (two studies) and mortality (one study).

• Mediterranean Diet (four observational studies): suggested there was a positive association between adherence to a Mediterranean diet and systolic function, left ventricular ejection fraction and left atrial ejection fraction (one study) and QOL (one study) and a negative correlation with diastolic function (one study). No benefits were found in mortality risk. 

• Low Carbohydrate: one unpublished RCT (n=123) found inconsistent results when comparing low carbohydrate intake with a ‘conventional’ diet in six-minute walk test and in BP.

• High Protein: one RCT (feasibility study, n=14) found that six-minute walk test and maximum VO2 improved in individuals receiving a high protein diet compared to low protein and 'usual' diet. A significant improvement in the physical quality of life index was found but not in the general or emotional index in the high protein group compared to the other two groups. 

 A prospective cohort study published after the review showed no association between adherence to a Mediterranean diet and mortality in individuals with HF. However, greater adherence to the Mediterranean diet was associated with lower hospitalization rate compared to non-adherent individuals (HR, 0.74).  

To see the full practice question, including the Remarks, Comments, Evidence Statements and References, click here.

Want to know what else is new and updated? Bookmark these pages:
New Knowledge Pathway Content
 (Knowledge Pathways, Practice Questions, Summary of Recommendations and Evidence, Practice Guidance Toolkits, Backgrounds)
Tools and Resources.

• Do soy products or supplements (e.g. isoflavones, aglycone, genistein, daidzein, glycitein, equol) alleviate or reduce menopausal symptoms?

• Do flaxseed supplements alleviate or reduce menopausal symptoms?

• What is the impact of menopause on body weight and body composition?

• Does hormone replacement therapy (HRT) cause weight gain in perimenopausal and postmenopausal woman?

• What is the best strategy to manage weight in menopausal women?

• What strategies are effective in preventing cardiovascular disease (CVD) in perimenopausal and postmenopausal women?

• 10 Knowledge Pathways
• 114 Practice Questions
• 106 Handouts

We Need Your Expertise: PEN^® Reviewers Needed 

We are currently looking for reviewers for these topics:

• Infant Nutrition - Breastfeeding
• Infant Nutrition - Lactation

We need reviewers within the next few months for:

• Celiac Disease
• Diabetes - Subcutaneous Insulin Infusion
• Infant Nutrition - Infant Formula
• Multivitamin/mineral Supplements and Chronic Disease
• Postoperative Feeding
• Probiotics - Pediatric Gastroesophageal Reflux Disease
• Probiotics - Diarrhea and Constipation
• Research Methods
• Quality Improvement
• Weight/Obesity
• Weight Inclusive

There are currently more than 400 PEN Reviewers. We would love for you to join this group and share your expertise and energy. For more information, contact http://www.pennutrition.com/BecomeAuthor.aspx.

Open Access to COVID-19 Content Continues

• COVID-19
  • COVID-19 and Nutrition Background
  • COVID-19 Related Tools and Resources
• Trending Topics
• PEN eNews.

• Twitter
• Facebook
• Instagram
• LinkedIn

Earlier this month I was hungry and busy and I rushed to grab a quick bite to eat. It felt like each step I took, I created two more steps in its place. As I finished adding the jam to the top of the peanut butter on the bottom slice of bread on my P&J sandwich, I dropped it on the floor. Of course, it landed on the side that had the P&J on it! This culinary event reminded me of a 1976 book my father gave me called the "Butter Side Up! The Delights of Science" by Magnus Pike (1). It was a recommended read about the amazing and fun world of science; especially fitting for a young, budding food scientist. 

The delights of science have not been lost. As my slice of bread was falling, I was quickly trying to calculate the timing and number of flips to figure out which side was going to land on the floor. Based on Pike’s description (pages 2-3), 60% of the time the heavier side will win, although this is dependent on what is on the bread and in what quantity. 

All around me, I see individuals being intrigued by the wonder of science. Whether it is being interested in new information, combating myths and misinformation,  sharing learning and fun facts with others or just wanting to make sense of things, curiosity abounds! I also witness the curiosity related to food, nutrition and science within dietetic students, especially around this time of the year when many are applying for dietetic practicums and/or graduate school. I see it in my fellow dietitians as well.

The PEN^® System provides answers to practice-based questions for students as well as dietitians already in practice. The PEN System, based on rigorous review of the scientific literature, helps users to know and understand the science behind food and nutrition and to use that knowledge within their practice. 

Do you have a question that isn’t already in PEN? Practice question suggestions are always welcome: https://www.pennutrition.com/SubmitAQuestion.aspx . Share your curiosity!

Reference

1. Pike M. Butter side up! The delights of science. Great Britian: John Murray (Publishers) Ltd.; 1976.

The PEN^® Team has years of experience working home-based, as that is our norm. Here are some tips we hope you will find helpful.

Routine

• Have a set schedule/routine and stick to it as best as you can. 
• Have a structured work time for your day. If you are full-time, start and end around the same time each day. If you are part-time, set a certain time of the day/week when you work.
• Discipline is needed for working from home. It can be easy to get distracted by domestic things (chores and people!). With a schedule/routine, it makes it easier to stay on track.
• A task list can help keep structure. Prepare your list for the next day before finishing work every night so that you start every day with a clear plan. 
• Schedule breaks using a timer - otherwise it's too easy to say "I need a break!" and then look at your phone for 1/2 hour without realizing it. Here is a favourite: https://tomato-timer.com/ 
• Changing out of pyjamas into regular day clothes in the morning is important. It is okay to wear yoga pants and leggings but try to avoid pyjamas unless you are still at the desk past 8 pm! 
• Dress in clothes so that you are ready to be on a video call - you just never know who it might be! For those who don't want to get dressed in 'business casual' every day, hang a blazer or nice sweater on the back of your office door or chair that you can throw on at a moment's notice! 
• For parents with young kids, waking up an hour or half hour before them to get ready and plan the day can be helpful.
• Without a routine, it can also be easy to get distracted by work and the domestic things don’t get done. It can depend on what you don’t like to do. Work can more fun than cleaning sometimes!
• Family and friends may make more contact with you during your work hours when you are in a home setting. Unless it is urgent, don't respond to personal calls or texts during your work hours, which keeps you focused and gives them the message that you are not available when working.

• Have a designated workspace if possible. A separate room with a door is ideal.
• Whether your home office is for a few weeks, a few months or longer, having an organized, ergonomic workspace that is personalized and inviting (i.e. decorated with favourite books, memorabilia, degrees/diploma, greenery!) is more comfortable.
• Invest in some house plants so that you have something to talk to, feed and water.
• If possible, don't use your office space for anything personal. It helps to separate home and personal worlds.
  
  

• Engage with colleagues through phone or video chat meetings.
• Sometimes scheduling meetings/conference calls is difficult to do with others as they have their own schedules/routines. Try to find a common time that is mutually agreeable. Be creative and flexible.
• Schedule regular virtual meetings with teams and start them with a check-in to see how everyone is doing before discussing business. It nice getting to know colleagues on a different level.

Physical Activity, Healthy Eating and Mental Health

• In your schedule/routine, include time for fitness/physical movement/fresh air breaks.
• Set a timer to go off every hour to make sure you remember to move.
• Set exercise breaks throughout the day and drink lots of water. 
• A midday exercise break is a great way to clear your head.
• Walk while you are talking on the phone or stand while you are listening to a podcast, webinar or in a virtual meeting.
• Get up and have breakfast at a regular time.
• Plan meals and try to keep them at typical times spread throughout the day. It is easy to snack too much!
• Invest in some high quality teas, coffee, espressos and good quality equipment and good water to prepare them, so that you have a source of joy and comfort.
• It is important to connect with others after work, particularly if you live alone. Schedule a time to email, call, video chat, etc. with a friend or family member every day.
• And finally, be kind to yourself. These are challenging times. Those of us who normally work home-based have had years of finding the best ways for doing so. It takes time for most of us to figure it out.