THE DISABILITY EXPERIENCE CONFERENCE:
THEORETICAL AND EXPERIENTIAL
PERSPECTIVES ON NUTRITION IN THE
DISABILITY EXPERIENCE
LAURA MAYDAK
JULIANA MUSMANNO
ERIN LONG
AMANDA BRIGHT
BACKGROUND
• The effect of disability and nutrition on one another is often overlooked
• Socioeconomic, mental, physical, and emotional disabilities affect one’s
nutritional status and needs
• Relevant experiences of students in University of Pittsburgh's
Coordinated Master in Nutrition & Dietetics (CMD) will be highlighted
• The critical role of a Registered Dietitian (RD) in aiding persons with
disabilities will be addressed
INVESTIGATING NUTRITION & THE DISABILITY
EXPERIENCE
•
Involvement in community-based nutrition events has revealed many populations in need
of nutrition-related guidance
•
Socioeconomic, mental, physical, and emotional disabilities must all be addressed when
considering nutrition and the disability experience
•
A preliminary analysis of select studies was conducted to evaluate the nutritional aspect
of the disability experience1-2
•
The examination revealed the need for dietetic intervention in the care of individuals with
a variety of disabilities
THE MOVE FROM A LONG-STAY LEARNING
DISABILITIES HOSPITAL TO COMMUNITY HOMES: A
COMPARISON OF CLIENT’S NUTRITIONAL STATUS
•
Methods:
• Nutritional risk screenings were given pre-departure and one year post-departure from
a long-stay learning hospital
•
Results:
• Comparison between screenings revealed an increase in overall risk relating to food
groups, unintentional weight gain and loss, and overall risk relating to weight
•
Conclusion:
• This population is at risk for nutrition-related problems when living independently
• Nutritional intervention provided by an RD would produce more favorable outcomes
relating to health status and overall quality of life
1
PREVALENCE AND SEVERITY OF FEEDING AND
NUTRITIONAL PROBLEMS IN CHILDREN WITH
NEUROLOGICAL IMPAIRMENT: OXFORD FEEDING STUDY
•
Method:
• Validated questionnaire was sent to parents children with oromotor dysfunction
•
Results
• Respondents included a wide range of disabilities
• Gastrointestinal and feeding problems were common
• The feeding process was described as stressful and unenjoyably
•
Conclusion:
• Concern regarding nutritional status was revealed
• 64% of children had never had a feeding- or nutrition-related assessment
2
MAINSTAY LIFE SERVICES
•
Independent study (University of Pittsburgh Coordinated Masters in Nutrition & Dietetics)
•
Pilot project for development and implementation of healthy cooking classes for
caretakers and disabled individuals at Mainstay Life Services, an assisted living facility
•
•
Nonprofit organization that provides residential services to individuals with developmental
disabilities
 24-hour full care homes
 Semi-independent living
 Supported living (less than 30 hours/week of assistance)
165 individuals in 59 homes throughout Allegheny County
MAINSTAY LIFE SERVICES
• Taught healthy cooking classes to disabled individuals and staff members
 Understand and accommodate specific needs of this population
 Tailor teaching methods for this group
 Comfort in familiarity and fear what is unknown
 Not open to trying new things no matter what the health benefit
 Easy recipes that they can make for themselves on their own
 Nothing too complicated or with a lot of ingredients
MAINSTAY LIFE SERVICES
• How can a Registered Dietitian (RD) help?
 Include nutritious ingredients in common recipes
 Recipe substitutions (Greek yogurt example)
 Effectively work with this population to incorporate nutrition and understand
the basic essentials to a healthy lifestyle
INDEPENDENT LIVING AND CHRONIC CONDITIONS:
ARTHRITIS
• Chronic health conditions can impair the functionality of free-living individuals
• Disabling chronic conditions are areas of opportunity for quality of life
improvement
• Serving the unique nutritional needs of a population can have a positive impact
on quality of life
• Rheumatoid Arthritis
• Osteoarthritis
• Applicable research questions posed by members of the arthritic community as
well as professionals working in health care
INDEPENDENT LIVING AND CHRONIC CONDITIONS:
RESEARCH RESULTS
•
Review of the available nutrition-based literature
•
Results from the evidence-based literature review showed potential for dietary
interventions in treating symptoms of arthritis3,4,6-9
•
Necessity for further research will help to strengthen the findings and allow for
subsequent clinical trials to be conducted
•
Role of the RD in research
• Conducting research trials as practicing health care professionals
• Holding knowledge of both chronic health conditions and nutrient metabolism
• Increasing accessibility to diverse populations through outpatient and
community education
CONCLUSION
• Each disability has a unique influence upon the affected individual
• Registered Dietitians are the credentialed experts able to:
• Understand the underlying science and its application in determining the
nutritional needs of an individual
• Navigate complex motivations (behavioral, genetic, environmental, etc.)
behind what, why, and how an individual chooses to eat
• Implement evidence-based practices to optimize health and the overall
quality of life
• The addition of an RD to the medical team is essential to provide individuals
with disabilities the best possible healthcare outcomes
REFERENCES
1
Bryan F, Allan T, Russell L. The move from a long-stay learning disabilities hospital to community homes: a comparison of client’s
nutritional status. J Hum Nutr Dietet. 2000;13:265-270.
2
Sullivan P, Lambert B, Rose M, Ford-Adams M, Johnson A, Griffiths P. Prevalence and severity of feeding and nutritional problems in
children with neurological impairment: Oxford Feeding Study. Dev Med & Child Neuro. 2000;42:674-680.
3
Scoditti E, Calabriso N, Massaro M, et al. Mediterranean diet polyphenols reduce inflammatory angiogenesis through MMP-9 and COX-2
inhibition in human vascular endothelial cells: A potentially protective mechanism in atherosclerotic vascular disease and cancer.
Archives of Biochemistry and Biophysics. 2012;527:81-89.
4Elkan
A, Sjoberg B, Kolsrud B, et al. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective
natural antibodies phosphorlycholine in patients with rheumatoid arthritis: a randomized study. Arthritis Research & Therapy.
2008;10:R34
5Your
guide to lowering your blood pressure with DASH. U.S. Department of Health and Human Services: National Institute of Health.
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
6Nakasone
Y, Watabe K, Watanabe K, et al. Effect of a glucosamine-based combination supplement containing chondroitin sulfate and
antioxidant micronutrients in subjects with symptomatic knee osteoarthritis: A pilot study. Experimental and Therapeutic Medicine.
2011;2:893-899.
7Sawitzke
AD, Shi H, Finco MF, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis.
Arthritis & Rheumatism. 2008;10:3183-3191.
8Caughley GE,
James MJ, Proudman SM, et al. Fish oil supplementation increases the cyclooxygenase inhibitory activity of paracetamol in
rheumatoid arthritis patients. Complementary Theories in Medicine. 2010;18:171-174.
9Bahadori
B, Uitz E, Thonhofer R, et al. Omega-3 Fatty Acids Infusions as Adjuvant Therapy in Rheumatoid Arthritis. J Parenter Enteral
Nutr. 2010;34:151-155.
10Arthritis
Foundation. www.arthritistoday.org