Maria Papamichael is a registered dietician who has dedicated her life in educating people the importance of good nutrition and exercise in the prevention and management of disease as well as in improving health and well-being. Being an asthma sufferer since childhood, has motivated her to undertake a PhD research project at La Trobe University to investigate the prophylactic potential of a Mediterranean diet enriched with fatty fish in the management of asthma in children.
Background and Aims: Globally, asthma has rapidly become the most frequent allergic disease in children. It causes significant burden and is the most common reason for hospitalisation, absence from school and work for sufferers and their parents/carers, respectively. There is no cure for asthma, it can only be controlled by medication. Emerging evidence from observational studies indicate that diet and lifestyle play a role in the aetiology and management, with potential for a protective effect of a Mediterranean diet. However, randomized controlled trials are lacking. We aim to investigate whether fatty fish consumption as part of a Mediterranean dietary pattern improves pulmonary function and reduces asthma symptoms in children. rnMethods: A parallel Randomized Controlled Trial of 6 months duration is being conducted in asthmatic children, aged 5-12 years attending a paediatric respiratory clinic in Athens, Greece. The intervention includes two fatty fish meals (150g cooked) per week as part of the Greek Mediterranean diet. The control group will consume their usual diet. Assessments at baseline and 6 month follow-up include pulmonary function using spirometry (FEV1) and exhaled nitric oxide, asthma symptoms using the Asthma Control Questionnaire (ACQ), quality of life by the Paediatric Asthma Quality of life Questionnaire (PAQLQ), medication use and days hospitalized. A Food Frequency Questionnaire will be used to assess dietary intake and adherence to the Mediterranean dietary pattern will be assessed using the KIDMED index. rnApplications: This study is important in establishing the effect of a Mediterranean diet enriched with fatty fish in the management of asthma in children. Findings will inform the development of dietary guidelines for asthma management in children.
Nutrition screening is essential in clinical care to identify patients at nutrition risk for timely implementation of appropriate nutrition intervention. Routine screening of paediatric inpatients at malnutrition risk is not common in Hong Kong. Different paediatric nutritional screening tools(1-4) have been developed but no consensus has been reached for use in clinical practice. The key considerations for choice of a screening tool include skill level, time to undertake which affected by number of questions, measurements and equipment required. The aim of this pilot study is to find a simple, easy to use screening tool to identify paediatric patients at nutrition risk on admission at Prince of Wales Hospital, Hong Kong.\r\n\r\nThe Paediatric Nutrition Screening Tool (PNST) developed and validated by Melinda White (5) et al in 2016 was chosen for this pilot. The PNST consists of 4 simple questions (Table 1) that required a “yes” or “no” answer. Two positive answers indicate nutrition risk. Care plan relevant to the risk categories was developed via consultations with paediatrician and nursing staff.\r\n\r\nAll patients admitted to the paediatric wards including general, surgical and oncology between 13th Feb and 24 Feb 2017 were screened using PNST. A total of 239 patients were screened. 229 patients (95.8%) were classified as low risk and 10 patients (4.2%) as high risk. A user satisfaction survey was also conducted to collect feedback on using PNST. In the survey, users were asked to rate the tool’s easiness to use from scale 1 to 5 (1=most difficult, 5=most easy). Out of 40 feedback forms collected, 68% rated the tool for scale > 4.\r\n\r\nThis study is the first “Paediatric Nutrition Screening Tool” pilot study in Hong Kong. The results can be used to evaluate the feasibility of applying PNST and approaches to implement nutrition screening in paediatric patients in Hong Kong. \r\n