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Biomedical subjects

Irene Strychar

Publications and source records attributed to Irene Strychar.

6 recordsLinked to original sources
PubMed2006

Diet in the management of weight loss.

Obesity is an established risk factor for numerous chronic diseases, and successful treatment will have an important impact on medical resources utilization, health care costs, and patient quality of life. With over 60% of our population being overweight, physicians face a major challenge in assisting patients in the process of weight loss and weight-loss maintenance. Low-calorie diets can lower total body weight by an average of 8% in the short term. These diets are well-tolerated and characterize successful strategies in maintaining significant weight loss over a 5-year period. Very-low-calorie diets produce a more rapid weight loss but should only be used for fewer than 16 weeks because of clinical adverse effects. Diets that are severely restricted in carbohydrates (3%-10% of total energy intake) and do not emphasize a reduction of energy intake may be effective in reducing weight in the short term, but there is no evidence that they are sustainable or innocuous in the long term because their high saturated-fat content may be atherogenic. Fat restriction in a weight-loss regimen is beneficial, but the optimal percentage has yet to be determined. Longitudinal trials are needed to resolve these issues. In this article I discuss the evidence for and pitfalls of various types of weight-loss diets and identify issues that physicians need to address in weight loss and weight-loss maintenance.

Diet, Reducing↗
PubMed2006

Canadian dietitians' use and perceptions of glycemic index in diabetes management.

PURPOSE: Several health organizations, including the Canadian Diabetes Association, advocate use of the glycemic index (GI) in the nutritional management of diabetes. However, the clinical utility and applications of the GI remain controversial. Our goal was to determine, via a postal survey, whether dietitians were using the GI and barriers to its use if they were not. METHODS: This cross-sectional study was conducted in 2003. Members of Dietitians of Canada and the Ordre professionnel des diététistes du Québec (n=6,060) were first contacted by mail to identify those working with individuals with diabetes. Among respondents (n=2,857), 1,805 worked with individuals with diabetes and were sent a questionnaire. Using Chi-square analyses, users and nonusers were compared for their professional characteristics, perceived benefits, barriers, general knowledge about the concept, and confidence in teaching the GI. RESULTS: Among questionnaire respondents (n=1,057), 39% (n=415) used the GI and 61% (n=642) did not. Overall, users were more likely to have a greater diabetes patient caseload, perceived greater benefits and had greater confidence in teaching the concept. Nonusers cited lack of teaching tools and lack of knowledge on how to teach the concept as major barriers. CONCLUSIONS: Further research is required to identify the clinical reasoning that triggers dietitians to apply the concept in their practice.

Clinical Competence↗
PubMed2005

Learning opportunity and preparedness for practice: perceptions from dietetics programs in Canada.

PURPOSE: This study determined dietetics trainees' and program coordinators' perceptions about trainees' preparedness to practice, based on Dietitians of Canada's 145 competency statements. Depth and breadth of learning opportunity were also determined with definitions of these two concepts based on Elliott's view of professional education and practice. METHODS: Research questions were: 1. How prepared were trainees for practice? 2. What were the depth and breadth of learning opportunity in assessment, planning, implementation and evaluation? 3. How many learning opportunities were there in professional practice and communication? 4. Did responses vary between integrated programs and internships or between trainees and program coordinators? RESULTS: Of 313 trainees, 168 (54%) responded and 23 (72%) of 32 coordinators responded. Preparedness was rated as "well prepared" or better for 25 (56%) of the 45 main competencies. For every competency, preparedness ratings were higher in integrated programs than in internships. Learning opportunities were rated as sufficient in depth and breadth or number for 88 (61%) of the 145 competency statements. Low ratings for preparedness were accompanied by low ratings for depth and/or breadth or number of learning opportunities. CONCLUSIONS: The notion of depth and breadth is useful as a framework to assess learning opportunities for developing entry-level competence.

Canada↗
PubMed2003

Impact of a high-monounsaturated-fat diet on lipid profile in subjects with type 1 diabetes.

OBJECTIVE: Controversy persists regarding the use of a high-monounsaturated-fat diet in people with type 1 diabetes. The purpose of this study was to compare the effects of a high-monounsaturated-fat diet containing 43% to 46% carbohydrates and 37% to 40% fat (17% to 20% monounsaturated fat) with those of a high-carbohydrate diet containing 54% to 57% carbohydrates and 27% to 30% fat (10% to 13% monounsaturated fat) on the quantitative and qualitative lipoprotein profile in type 1 diabetes. DESIGN: A randomized crossover study was conducted. Two months before the dietary trial, subjects were monitored on their intensive insulin regimen to normalize glycemic and lipid levels. SUBJECTS: Twenty-six individuals followed each diet for 2 months. Eight subjects lost or gained >2 kg, and three had the same dietary intakes during the two diets. For the remaining 15, seven adhered to the two diet prescriptions and eight followed one of the two diets. STATISTICAL ANALYSIS: Analysis of variance for crossover design (intent-to-treat group of 26) and Wilcoxon signed rank test (group of seven) were used to assess differences between the two diets. RESULTS: For the intent-to-treat group (n=26), low-density lipoprotein cholesterol, although within normal range, was lower by 7% (P=.034) at the end of the high-monounsaturated-fat diet. The other 17 lipid parameters tested were not statistically significant. For those who adhered to the two diets (n= 7), lower plasma total triglycerides by 18% (P=.027), lower very low-density lipoprotein triglycerides by 26% (P=.043), lower very low-density lipoprotein cholesterol by 48% (P=.043), higher apolipoprotein A1 by 7% (P=.018), smaller low-density lipoprotein particle size by 1% (P=.043), and longer low-density lipoprotein oxidation lag time by 25% (P=.043) were found after the high-monounsaturated-fat diet. APPLICATIONS/CONCLUSIONS: A high-monounsaturated-fat diet seemed to have a favorable effect on fasting lipoprotein profile in people with type 1 diabetes. Further research is needed with a larger sample to recommend a high-monounsaturated-fat diet as an alternative diet therapy in type 1 diabetes.

Adult↗