Simon Karyne June D, Elopre Wilmar Jun O
Department of Nutrition and Dietetics, College of Human Ecology, Central Mindanao University.
Acta Med Philipp. 2025 Jan 15;59(1):7-17. doi: 10.47895/amp.vi0.8167. eCollection 2025.
This study aimed to evaluate the nutritional adequacy and compliance with cardiovascular disease (CVD) guidelines in therapeutic diets implemented in four hospitals in General Santos City, Philippines.
The study employed a cross-sectional study and analyzed the one-day therapeutic menus of four hospitals using the Philippine Food Composition Table and the United States Department of Agriculture nutrient database. The nutrient contents calculated in this study were compared among hospitals and benchmarked against the Philippine Dietary Reference Intakes (PDRI) and CVD-specific guidelines, the Dietary Approaches to Stop Hypertension (DASH), and Therapeutic Lifestyle Changes (TLC). The nutrient adequacy ratios (NARs) and the corresponding mean (SD) values were used to interpret the data.
Based on the PDRI, the mean (SD) NARs for proteins, simple sugars, vitamin B6, folate, and vitamin B12 were 116% (11%), 72% (16%), 139% (34%), 115% (7%), and 324% (156%), respectively, which were all interpreted as adequate. However, the mean (SD) NARs for energy, 88% (7%), and dietary fiber, 53% (33%), indicate non-compliance with the requirements for these components. As for the DASH guidelines, the hospitals failed to meet the recommendations for calcium, magnesium, and potassium, with mean (SD) NARs of 45% (14%), 49% (10%), and 51% (7%), respectively. The levels of saturated fatty acids, 195% (53%), and dietary cholesterol, 363% (177%), exceeded the limits set by the guidelines. For the TLC guidelines, the mean (SD) NARs of 70% (24%) and 40% (10%) for monounsaturated fatty acids and polyunsaturated fatty acids, respectively, were interpreted as suboptimal. Conclusive interpretations cannot be drawn for sodium, total carbohydrates, total fats due to large variations in their compositions among the hospitals.
At the menu analysis level, while the therapeutic diets adhered to the recommendations for proteins, simple sugars, and the vitamins, they fell short in their provision for energy, unsaturated fats, dietary fiber, and most minerals. They also exceeded the limits for most dietary lipid parameters set by DASH and TLC. The findings of this study highlight the need for improvements in nutritional adequacy and adherence to CVD guidelines in hospital therapeutic diets. Due to the limited number of observations, future research should aim to confirm and clarify these findings.
本研究旨在评估菲律宾桑托斯将军城四家医院实施的治疗性饮食中营养充足性以及对心血管疾病（CVD）指南的遵循情况。
本研究采用横断面研究方法，使用菲律宾食物成分表和美国农业部营养数据库对四家医院的一日治疗性菜单进行分析。将本研究计算得出的营养成分含量在各医院之间进行比较，并与菲律宾膳食参考摄入量（PDRI）以及特定于心血管疾病的指南、停止高血压膳食方法（DASH）和治疗性生活方式改变（TLC）进行对比。营养充足率（NARs）及相应的均值（标准差）用于解释数据。
基于PDRI，蛋白质、单糖、维生素B6、叶酸和维生素B12的平均（标准差）NARs分别为116%（11%）、72%（16%）、139%（34%）、115%（7%）和324%（156%），均被判定为充足。然而，能量的平均（标准差）NARs为88%（7%），膳食纤维为53%（33%），表明未达到这些成分的要求。至于DASH指南，各医院未达到钙、镁和钾的推荐量，平均（标准差）NARs分别为45%（14%）、49%（10%）和51%（7%）。饱和脂肪酸水平为195%（53%），膳食胆固醇为363%（177%），超过了指南设定的限值。对于TLC指南，单不饱和脂肪酸和多不饱和脂肪酸的平均（标准差）NARs分别为70%（24%）和40%（10%），被判定为次优。由于各医院之间钠、总碳水化合物、总脂肪的组成差异较大，无法得出确定性解释。
在菜单分析层面，虽然治疗性饮食遵循了蛋白质、单糖和维生素的推荐量，但在能量、不饱和脂肪、膳食纤维和大多数矿物质的供应方面存在不足。它们还超过了DASH和TLC设定的大多数膳食脂质参数限值。本研究结果凸显了改善医院治疗性饮食中营养充足性以及遵循心血管疾病指南的必要性。由于观察数量有限，未来研究应旨在证实和阐明这些发现。
