Our research aim is to improve health, function, and well-being in individual patients before, during and after medical treatment through optimal nutritional status and life style. The Nutrition Alliance Gelderse Vallei offers opportunities to perform studies in patients from Hospital Gelderse Vallei and use expertise from medical specialists, paramedical staff, and dieticians.
This group within the Division of Human Nutrition addresses nutritional challenges caused by acute and chronic diseases. We focus on deficiencies and requirements of patients with gastrointestinal disease, heart failure and COPD patients, and those undergoing major therapies including surgery, chemotherapy, and radiation therapy. Outcome measures are nutritional status including body composition and energy expenditure, quality of life, and health care efficiency. Research methods include randomized controlled trials but also historical control studies, observational studies, non-inferiority studies, and before-after studies in groups of patients for which no control or placebo group is available. Study results are used to define evidence-based dietary strategies that can be used in practice.
Clinical nutrition research topics:
Our focus is on intestinal barrier function and integrity in relation to various diseases. Permeability tests with multiple sugars, absorption markers, and markers such as zonulin are performed. We closely collaborate with the Food and Pharma group. Dietary interventions include probiotics and elimination diets.
Pre-operative dietary interventions using both carbohydrates and branched chain amino acids seem to be an attractive therapeutic strategy to optimise postoperative conditions. We already investigated the gastric emptying of a glucose/protein beverage in patients with normal or delayed gastric emptying for solid foods. The gastric emptying time was measured using a 13C-acetate-breath test. In both groups the beverage passed the stomach within 2 hours demonstrating its safety in regard to aspiration. Now, we want to continue our research with an intervention study in patients undergoing elective surgery. Since surgery is comparable in intensity and physiology to an intensive sport events we work in collaboration with prof. Maria Hopman and dr. Marco Mensink.
Evidence-based dietary guidelines and nutrition carepaths
Our researchers contribute to the development of evidence-based guidelines and nutrition carepaths by describing patient groups and their nutritional problems, reviewing the literature on clinical nutrition studies, and studying the effects of dietary interventions in patient groups. Guidelines have been developed and evaluated for patients with COPD, heart failure, IBD, and IBS. Screening instruments on malnutrition and dietary interventions by dieticians have been evaluated in these patient groups.
For patients with kidney diseases, the use of several vitamins to minimize comorbidities has been studied and discussed (vit D and blood pressure, vit K deficiency, niacin for phosphate lowering). Undernutrition, especially as a result of inadequate protein intake, is studied in elderly hospital patients.