Efficiency of nutrition management in real clinical practice: more questions than answers

Background. Nutrition regimen and dietary preferences, along with adequate drug therapy, are one of the most important factors in successful treatment of patients with chronic somatic pathology. Even greater importance is given in diet control and food pattern in the treatment of patients with chronic, diet-dependent diseases, when food restrictions are most significant, and deviations from them can lead to serious consequences. Objective: To evaluate the eating behavior and the effectiveness of nutrition management, including readiness for its modification, of respondents receiving or potentially needing of vitamin K-reductase inhibitors, compared to healthy volunteers and taking into account the geographic specificity of food rations. Methods. Dietary preferences and adherence to treatment were evaluated in 196 respondents (88 men, 108 women) in the cohort study by the method of questionnaire survey using authors’ questionnaires. Results. The absence of statistically significant differences in the food rations increasing (37.0±19.5 against 37.3±17.98 points, Wald-Wolfowitz (Z), р=0.16) and decreasing activity of vitamin-K-reductase inhibitors (62.2±26.3 vs. 63.4±23.8 points, Wald-Wolfowitz (Z), р=0.95) was revealed. The absence of differences also remained after assessment taking into account the regional features of nutrition (104.9±45.6 vs. 100.7±43.9 points, Wald-Wolfowitz (Z), р=0.78). It was shown that the medical recommendations aimed at correcting the eating behavior of vitamin-K-reductase inhibitor users are not effective. This can serve as an independent risk factor for complications of both the therapy using these drugs and the underlying disease. Conclusion. Further evaluation of the patients’ readiness for forced eating behavior in conditions of real clinical practice is necessary. It is recommended to use the analysis of diets controlled in local studies with a similar methodological basis for the formation of a single database with its subsequent use in comparative studies evaluating the effectiveness of interventions for nutrition correction. It is proposed to expand the studies devoted to the evaluation of the effectiveness of nutrition management in patients with functional dyspepsia, non-alcoholic fatty liver disease, ulcerative colitis, Crohn's disease, and other diseases.

diet, eating behavior, readiness for modification, adherence