Complementary and alternative medicine: Competencies for dietetics professionals

Effect of westernization on oral health among college students of Udaipur City, India

BACKGROUND

There is overwhelming evidence that periodontal disease and dental caries affect the majority of populations and that western culture and lifestyle may have a profound influence on oral health, especially in adults. The present study was performed to determine the effect of westernization on the oral health of college students of Udaipur City, Rajasthan.

METHODS

A descriptive cross-sectional study was conducted among students attending various professional and non-professional bachelor's degree colleges of Udaipur City, Rajasthan, India, from March 2013 to May 2013. Eight hundred students were selected based on a two-stage random sampling procedure. Westernization was assessed by a self-administered structured questionnaire. Periodontal status, dental caries status and malocclusion were assessed according to World Health Organization (WHO) criteria (1997). Statistical analysis was performed using chi-square and Multivariate logistic regression. The confidence level and level of significance were set at 95 and 5 %, respectively.

RESULTS

The present study suggested that adverse habits, listening to English music and preferring English food had a significant association with dental caries and periodontal diseases. Malocclusion also showed a significant relationship with consuming English food for snacks and desserts. Multivariate analysis revealed a significantly greater odds ratio (OR) for periodontal disease and dental caries among those who preferred English food for lunch.

CONCLUSION

Based on the results of the present study, there is an association between westernization and oral health.

Polymorphisms in sweet taste genes (TAS1R2 and GLUT2), sweet liking, and dental caries prevalence in an adult Italian population

The aim of the study was to assess the relationship between sweet taste genes and dental caries prevalence in a large sample of adults. In addition, the association between sweet liking and sugar intake with dental caries was investigated. Caries was measured by the decayed, missing, filled teeth (DMFT) index in 647 Caucasian subjects (285 males and 362 females, aged 18-65 years), coming from six villages in northeastern Italy. Sweet liking was assessed using a 9-point scale, and the mean of the liking given by each individual to specific sweet food and beverages was used to create a sweet liking score. Simple sugar consumption was estimated by a dietary history interview, considering both added sugars and sugar present naturally in foods. Our study confirmed that polymorphisms in TAS1R2 and GLUT2 genes are related to DMFT index. In particular, GG homozygous individuals for rs3935570 in TAS1R2 gene (p value = 0.0117) and GG homozygous individuals for rs1499821 in GLUT2 gene (p value = 0.0273) showed higher DMFT levels compared to both heterozygous and homozygous for the alternative allele. Furthermore, while the relationship sugar intake-DMFT did not achieve statistical significance (p value = 0.075), a significant association was identified between sweet liking and DMFT (p value = 0.004), independent of other variables. Our study showed that sweet taste genetic factors contribute to caries prevalence and highlighted the role of sweet liking as a predictor of caries risk. Therefore, these results may open new perspectives for individual risk identification and implementation of target preventive strategies, such as identifying high-risk patients before caries development.

Online Education Improves Canadian Dietitians' Attitudes and Knowledge Regarding Recommending and Ordering Multivitamin/Mineral Supplements

PURPOSE

To determine the attitudes and knowledge of Fraser Health registered dietitians (RDs) regarding recommending and ordering multivitamin/mineral supplements prior to and following an online education module.

METHODS

The educational intervention consisted of narrated slides with electronic resources. After undergoing external review for face and content validity, 6 attitude questions and a 15-item knowledge test were administered pre- and postintervention. The attitude questionnaire utilized a 5-point Likert scale and had a maximum summative score of 30 points. The knowledge test was worth a maximum of 15 points.

RESULTS

Of the eligible RDs (n = 123), 57 (46.3%) completed the study and 55 participants were included in the final analyses. Summative attitude scores were higher on the post-intervention questionnaire compared with the preintervention questionnaire (t = 92.5, P < 0.001). The proportion of correctly answered knowledge questions pre- (78.0% ± 10.0%) to postintervention (mean = 87.4% ± 6.0%) increased significantly (t = 7.16, P < 0.001).

CONCLUSIONS

Postintervention, RD attitudes and knowledge improved confirming that the education strategy was effective. Future work should focus on optimizing the module and knowledge questions.

Diabetes mellitus and oral health

The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen oral infections and vice versa. In the literature, periodontitis and diabetes in the young to middle-aged adults have been the most widely researched area. Understanding the patho-physiology, clinical manifestations and management of different types of orofacial diseases in diabetic patients are important to the diabetologist and the dentist for the optimal care of patients with these diseases. This review explores the inter-link between diabetes and oral health.

Oral health issues in the nutrition of institutionalized elders

Oral health is critical to systemic health and quality of life for the elderly, especially the institutionalized elderly, who are at high risk for oral and nutritional problems. Oral health is an integral component of overall nutritional health, just as nutrition plays a vital role in overall oral health. This article reviews the critical factors in the relationship among oral, nutritional, and systemic health and urges ongoing collaboration of providers of health care to reduce the rate of morbidity and mortality in institutionalized elders.

What should students learn about complementary and alternative medicine?

With thousands of complementary and alternative medicine (CAM) treatments currently being used in the United States today, it is challenging to design a concise body of CAM content which will fit into already overly full curricula for health care students. The purpose of this article is to outline key principles which 15 National Center for Complementary and Alternative Medicine-funded education programs found useful when developing CAM course-work and selecting CAM content. Three key guiding principles are discussed: teach foundational CAM competencies to give students a framework for learning about CAM; choose specific content on the basis of evidence, demographics and condition (what conditions are most appropriate for CAM therapies?); and finally, provide students with skills for future learning, including where to find reliable information about CAM and how to search the scientific literature and assess the results of CAM research. Most of the programs developed evidence-based guides to help students find reliable CAM resources. The cumulative experiences of the 15 programs have been compiled, and an annotated table outlining the most highly recommended resources about CAM is presented.

Complementary and alternative medicine education in dietetics programs: existent but not consistent

This descriptive survey was undertaken to determine the inclusion of complementary and alternative medicine topics into undergraduate didactic dietetics education. The response rate was 34% (n=92) of all directors (N=273) of didactic and coordinated dietetics programs. Almost all programs (n=81; 88%) include complementary and alternative medicine instruction in some form in their curricula; the majority of content is integrated into already existing nutrition courses. The nutrition courses most often containing complementary and alternative medicine were medical nutrition therapy, advance nutrition, and community nutrition. Topics addressed were varied and included herbal supplements, functional foods, Native-American healing, and quackery in medicine. Most directors indicated that complementary and alternative medicine is an important component of dietetics education, yet many indicated that students are not being adequately prepared in this area. The mean familiarity of program directors with complementary and alternative medicine competencies for dietetics practice was 6 on a scale, with 10 being the most knowledgeable. Respondents also identified whether complementary and alternative medicine and dietary supplement competencies were being addressed at all in their curricula. Lack of time seemed to be the limiting factor to incorporation of complementary and alternative medicine topics into the curricula. Evidence from this study indicates that current curricula are providing some complementary and alternative medicine content, but a core of knowledge is lacking. The complementary and alternative medicine competencies for entry-level dietetics practice anticipated by 2006 will be useful in helping educators adequately meet the needs of future professionals in the area of complementary and alternative medicine.

Perceived Knowledge, Attitudes, and Practices of California Registered Dietitians Regarding Dietary Supplements

A convenience sample of California registered dietitians (RDs) (n=253) completed a survey investigating the perceived knowledge, attitudes, and practices of RDs who had or had not received formal training in use of dietary supplements. We also examined whether differences existed between RDs registered before or after 1997, when the American Dietetic Association began requiring that dietetics curricula include basic knowledge of dietary supplements. Statistical analysis included analysis of variance and chi2 analysis. Among this sample of RDs from California, those registered before 1997 (n=194) were more likely (P<0.05) to agree that they are knowledgeable regarding supplement use, safety, interactions, and contraindications than those registered after 1997 (n=46), and were more likely (P<0.05) to assess client use. Among this sample of RDs from California, those reporting that they had received formal training in dietary supplements (n=145) were more likely (P<0.05) than those who had no formal training in supplement use (n=105) to agree that they are comfortable discussing supplements with the public; are knowledgeable regarding uses, safety, interactions, and contraindications of supplements; and assess client use. Providing RDs professional education opportunities on supplements continues to be warranted.