Shatha Abu-Alnadi

Background: Celiac disease (CD) is a type of systemic autoimmune condition triggered by gluten consumption among genetically predisposed individuals. Aim: To assess the knowledge, awareness, and practices pertaining to CD and associated conditions among dietitians in Jordan. Method: A cross-sectional web-based survey was carried out between April and October 2023. The survey was an internet-based questionnaire with closed-ended questions. Results: The majority of dietitians answered correctly that CD is caused due to an immunological reaction to gluten, gliadin, and protamine (91.7%); it is an autoimmune disease (71.2%); and the risk of developing an autoimmune disease is higher among CD patients (78.8). The majority of respondents (93.6%) correctly identified that a strict gluten-free diet is the treatment approach for CD patients. However, only (18.9%) of dietitians correctly identified the FDA guidelines for “Gluten Free” food labeling. Approximately 53.4% of respondents identified immunoglobulin (IgA) antibody testing as the most reliable way to diagnose patients with CD. Conclusions: The dietitians have a good understanding of CD topics. The development of credentials in CD would ensure that dietitians practicing in CD are skilled.

Objectives The primary aim of this study is to evaluate protein–energy wasting in haemodialysis patients and assess their adherence to renal-specific guidelines. Design An observational cross-sectional study. Setting Patients were recruited from four major governmental hospitals in Amman, Jordan; The University of Jordan Hospital; Al-Hussain Medical Center, Al-Basheer Hospital; and Prince Hamzah Hospital. Data were collected during the period between January 2022 and January 2023. Participants The sample consisted of 344 adult patients who were above the age of 18 years with end-stage renal disease and undergoing haemodialysis. Outcome measures Anthropodermic measurements were performed, and biochemical and dietary data were collected during dialysis sessions. Results The occurrence of protein–energy wasting, as indicated by a low albumin level (<40 g/L), was 59.6%. The intakes of most of the nutrients were significantly lower than the recommended corresponding values except for fat, where average consumption was significantly higher than the recommended dietary intakes (33.8%, p value=0.000). Mean protein and calorie intakes were associated with serum albumin levels (p value=0.003 and 0.044, respectively). 70% of the study participants revealed that they have rarely or never been spoken to regarding the importance of a renal-specific diet by their healthcare provider. Among study participants, 24% faced a great level of difficulty in following dietary recommendations, and approximately 15% indicated their inability to follow any recommendations. Conclusion Dietary intake was not adequate according to the dietary guidelines for haemodialysis patients, which could contribute to their low albumin levels and augment the risk of protein–energy wasting. Haemodialysis patients may experience defective nutritional care and a reduced level of commitment to dietary recommendations.