01/05/09

American Dietetic Association Publishes Evidence-Based Nutrition Practice Guidelines for Registered Dietitians on Chronic Obstructive Pulmonary Disease and Heart Failure

Media contact:  Jennifer Starkey 
800/877-1600, ext. 4802
media@eatright.org

CHICAGO – The American Dietetic Association has published evidence-based nutrition practice guidelines for registered dietitians on treatment of heart failure and chronic obstructive pulmonary disease.

Both guidelines are available on ADA’s Evidence Analysis Library, www.adaevidencelibrary.com, which analyzes and summarizes the results of the best available research and offers recommendations for RDs to follow in their treatment of clients and patients.

ADA earlier published evidence-based nutrition practice guidelines for registered dietitians on disorders of lipid metabolism, adult weight management, critical illness, oncology, pediatric weight management, diabetes and hypertension. ADA members, including an expert workgroup and trained analysts, extensively examined the research to develop a series of recommendations and treatment algorithms which accurately summarize this body of evidence. The intent of ADA’s guidelines is to support the integration of evidence-based dietetics practice and improve the quality of care.

All ADA evidence-based nutrition practice guidelines have been reviewed by multidisciplinary teams consisting of RDs, physicians, respiratory therapists, pharmacists, registered nurses and faculty from institutions including Harvard Medical School, University of Pittsburgh School of Medicine, University of Texas, University of Tennessee and Oregon Health and Science University. For details on republishing information contained in ADA’s guidelines, visit www.adaevidencelibrary.com/content.cfm?content_code=help:faq.

Recommendations in ADA’s guidelines, as well as grades assigned to the strength of the scientific evidence used in supporting the recommendations, should not be interpreted as endorsements by the American Dietetic Association of any brand-name product or service. Consumers who want to know more about nutrition and health are encouraged to consult with a registered dietitian in their area.

Chronic Obstructive Pulmonary Disease Guideline
Evidence-based recommendations for RDs to follow in providing nutrition treatment for people with chronic obstructive pulmonary disease include:

  • Provide medical nutrition therapy focusing on prevention and treatment of weight loss and related conditions.
  • Assess quality of life of people with COPD, especially as it relates to their ability to obtain, prepare and consume food to meet nutritional needs. Research indicates that people with COPD may have more impairment with activities of daily living.
  • Use body mass index and weight change to assess weight status, body composition and calorie needs in people with COPD.
  • Advise patients and clients with COPD that selecting medical food supplements should be influenced more by the patient’s preference than nutritional factors such as percentage of fat or carbohydrates, as there is limited evidence to support consumption of a particular macronutrient composition of medical food supplementation.
  • Encourage people with COPD to consume a diet that meets Recommended Dietary Allowances for antioxidant vitamins A, C and E and the Adequate Intake for omega-3 fatty acids.

For an executive summary of ADA’s Chronic Obstructive Pulmonary Disease Evidence-Based Nutrition Practice Guideline for adults, visit http://www.adaevidencelibrary.com/topic.cfm?cat=3708.

Heart Failure Guideline
Evidence-based recommendations for RDs to follow in providing nutrition treatment for people with heart failure include:

  • Referral to a registered dietitian for medical nutrition therapy whenever a person has heart failure, because a planned initial visit and at least one to three planned follow-up visits can lead to improved dietary pattern and quality of life, decreases in edema and fatigue and with optimal pharmacological management, may reduce hospitalizations.
  • Appropriate daily intake of protein for clinically stable patients. Research indicates heart failure patients have significantly higher protein needs than those without heart failure.
  • Fluid intake between 48 ounces and 64 ounces per day, depending on clinical symptoms such as fatigue or shortness of breath.
  • Sodium intake less than 2,000 milligrams per day; sodium restriction will improve clinical symptoms and quality of life.
  • Patients with heart failure should consume folate through food and/or a combination of B6, B12 and folate supplementation. Folate supplementation given with other vitamins and minerals has been shown to have beneficial clinical outcomes. A multivitamin or mineral containing B12 or a combination of B6, B12 and folate could be recommended.

For an executive summary of ADA’s Heart Failure Evidence-Based Nutrition Practice Guideline, visit http://www.adaevidencelibrary.com/topic.cfm?cat=3249.

The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy. Visit the American Dietetic Association at www.eatright.org.