An organizational model to translate nutritional recommendations into routine clinical practice in secondary prevention of coronary artery disease

BACKGROUND

We hypothesized that nutritional risk factors can be reduced routinely in all patients with coronary artery disease (CAD) by modifying general hospital catering into "antiatherogenic catering" and providing patients with an education program.

METHODS

General nutritional rules were applied to transform the standard alimentary regimen of our catering service (lipids 30% energy) into antiatherogenic catering (lipids 20% energy). The educational program (EP) consisted of a nutritional manual and 4 h/week of lessons. Eighty male patients (pts) with CAD (54 +/- 13 years), 10 +/- 4 days after an acute coronary event, were randomly allocated by cardiologists to a lipids 30% energy (control group = 40 pts) or to a lipids 20% energy diet (previously deposited in our catering service) + EP (treatment group = 40 pts). Serum total cholesterol (T-Chol), HDL- (HDL-Chol), LDL- (LDL-Chol), triglycerides (Trig), and body mass index (BMI) were determined before and after the 21-day treatment.

RESULTS

Lipids 20% energy reduced T-Chol (P < 0.001), LDL-Chol (P < 0.001), and Trig (P < 0.05), while lipids 30% worsened T-Chol and LDL-Chol. The changes in the lipid parameters resulted in significant differences between the two groups.

CONCLUSIONS

Simple reorganization of hospital catering and an educational program may routinely reduce nutritional risk factors in CAD patients, without individual counseling by the nutrition team.

Food hygiene training in the UK: time for a radical re-think?

Training food handlers in the hospitality industry has been recommended by various organisations as a means of improving food handling practices and thus the safety of food for consumers. It is nearly 20 years since the first examinations for basic level food hygiene certificates were made available to food handlers in the UK. Since then little has changed in the syllabuses and in the way the questions are worded. However, the range of languages spoken by food handlers working in the UK has increased substantially since more employers are recruiting those who speak English as a second language. Training can be an unwelcome expense for managers where there is a high turnover of employees, especially amongst those for whom English is not a first language. To improve practical implementation of food hygiene theory it is time to develop a radical strategy concerning the way training is targeted and delivered in the UK, and perhaps Europe.

Hospital finds nutrition care pays off on all counts, cutting costs, complications, mortality

Identifying and treating malnutrition early reduces hospital stays, complications, and mortality. St. Francis Healthcare Services in Wilmington, DE, reports a two-year cost avoidance of $2.4 million from the reduced length of stay attributed to its malnutrition program. The program includes a screen to identify patients at high-risk of developing malnutrition and an algorithm for aggressive restorative care.