Field Notes

Lifestyle Change Can Quickly Lower Blood Pressure

Researchers have demonstrated that a program aimed at helping people modify lifestyle factors such as diet and exercise is as effective as medication at reducing blood pressure. Participants in the study saw their blood pressure drop 19 points, on average, after taking part in the Weimer Institute Newstart Lifestyle program for just 14 days. Other studies have shown that a blood pressure reduction of this magnitude can cut a person’s risk of heart disease or stroke in half.

“By adapting selected lifestyle health principles, half of the people in our study achieved normal blood pressure within two weeks while avoiding the side effects and costs associated with blood pressure medications,” says research team leader M. Alfredo Mejia, DrPH, MS, RD, an associate professor at Andrews University in Michigan. “The Newstart Lifestyle program works quickly, is inexpensive, and uses a palatable diet that allows for moderate amounts of salt and healthy fats from nuts, olives, avocado, and certain vegetable oils.”

Mejia presented results from this study at the American Society for Nutrition annual meeting, Nutrition 2018, which was recently held in Boston.

The reduction in blood pressure accomplished by the program was equivalent to what can be achieved using three half-dose standard medications for blood pressure. In addition, 93% of the participants were able to either reduce the dose (24%) or eliminate their blood pressure medications (69%).

People participating in the Newstart Lifestyle program follow a vegan diet, walk outside daily, drink substantial quantities of water, get adequate daily sleep, and participate in optional spiritual activities. The program’s vegan diet consists of foods such as legumes, whole grains, vegetables, fruits, nuts, seeds, olives, avocados, soymilk, almond milk, and whole grain breads.

For the study, the researchers evaluated data from 117 people with high blood pressure who had participated in the Newstart Lifestyle program at the Weimer Institute for 14 days. At the end of the program, one-half of the participants achieved a systolic blood pressure below the recommended 120 mm Hg. The program was effective at lowering blood pressure in varying types of individuals, including otherwise healthy men and women and people with diabetes or who were obese and those with high cholesterol levels.

Next, the researchers plan to test the program in more people over a longer time period to better understand its long-term effects and biological basis. They also want to determine whether the program can be used to improve other health problems, such as diabetes, CVD, and obesity.

— Source: American Society for Nutrition


Optimizing Nutrition Support in the ICU

A new nutrition bundle strives to ensure that critically ill patients receive adequate nutrition while hospitalized and seeks to reduce adverse outcomes related to malnutrition.

More than one-half of patients admitted to critical care units are malnourished, which increases their risk of serious complications and contributes to longer hospital stays and higher health care costs. Yet many of those eligible to receive enteral feedings don’t receive adequate nutrition while hospitalized.

The American Society for Parenteral and Enteral Nutrition (ASPEN), in conjunction with the Society of Critical Care Medicine, created the nutrition bundle to ensure that patients’ nutrition status is optimized during acute care stays. The bundle is part of ASPEN’s updated guidelines for the assessment and implementation of nutrition support for critically ill patients.

“New Nutrition Guidelines: Promoting Enteral Nutrition via a Nutrition Bundle,” published in the June 2018 issue of Critical Care Nurse, addresses all components of nutrition, including assessment and interventions.

“Malnutrition in hospitals is often overlooked, underdiagnosed, and untreated,” says Ashleigh VanBlarcom, DNP, RN, AGACNP-BC, an acute care nurse practitioner in the thoracic-cardiovascular ICU at the University of Virginia Health System in Charlottesville. “The ASPEN nutrition bundle offers bedside nurses, registered dietitians, providers, and other members of the interprofessional team a comprehensive, step-by-step approach to early nutrition.”

The six main components of the nutrition bundle are as follows:

  • Assess patients’ nutrition status to identify those at risk of malnutrition.
  • Initiate and maintain enteral nutrition.
  • Reduce risks of aspiration.
  • Implement enteral feeding protocols.
  • Avoid the use of gastric residual volumes as an assessment of enteral feeding tolerance.
  • Consider parenteral nutrition early, when enteral feedings can’t be initiated.

Together, the components address the distinct aspects of nutrition assessment and related interventions for critically ill patients. As a result, patients can receive adequate nutrition earlier in their hospital stay, which may reduce their risk of adverse outcomes.

— Source: American Association of Critical-Care Nurses