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Mediterranean diet and exercise helps liver patients

Thursday 06 August 2020

For medical researchers to bring their work to fruition sometimes they need to reach out to multiple sources before their work can be translated into a clinical setting, and ultimately help thousands of patients.

For PA Hospital (PAH) dietitian Dr Ingrid Hickman and her colleague Dr Graeme Macdonald, their LIFE study research into the benefits of a Mediterranean diet and exercise, for liver transplant patients, was completed thanks to support from the PA Research Foundation to finalise the evaluation of the study, which has now meant they can progress to a larger trial.

Dietitian Dr Ingrid Hickman and Dr Graeme Macdonald

"PA Foundation funding allowed us to evaluate patient feedback and gather stories from the patients about their experiences with the program," Ingrid said.

"Without that PA Foundation's support, we wouldn't have got that really rich patient feedback data, which was so important to open our eyes to a lot of the things, we would never have thought about if we hadn't really engaged with the patients.

"We are really interested in the physiology and the science behind what's the mechanism for why diet improves metabolism. We love that hard science aspect of it, but we also recognize that we have to intertwine patient engagement in everything that we do. Otherwise, it won't have an impact on the actual people that we are hoping to have benefit from the research.

"That's important for people who donate money to hospital research foundations. People want to donate to medical research that's going to have an impact. They don't want to just donate to make some scientist smarter, they want to know that in the future, someone lying in a hospital bed in this hospital is going to benefit from their funds."

After recognising a service gap and delivered through telehealth, the LIFE study aimed to monitor the effects of a Mediterranean diet on PAH liver transplant patients who were back living at home. The team were interested to see if the diet, which encourages social interaction and exercise as well as changes in eating habits, would help liver transplant patients with their overall health and improve their quality of life post-transplant.

"Historically we didn't see patients after a liver transplant, after they'd been discharged from hospital, they went back into the community and then if they got sick again, of course they come back and they'd see a specialist dietitian, but that general health promotion about preventing chronic disease wasn't a focus," Ingrid said.

"Australian transplant centres care for patients from vast geographical distances. When people go home, they could be thousands of kilometres away from the centre, they're not going to come back to PA to see a dietitian. As a result, we were interested in not only how we develop a service for metabolic health, but how do we integrate telehealth as part of that."

The choice of the Mediterranean diet as opposed to other diets came about as a result of translating existing data from other patient groups and testing the effects with liver transplant recipients.

"There was really no data specifically in this transplant population, but the Mediterranean diet is one of the most studied diets in the world, there was clear evidence that in other patient groups who have similar risk factors to transplant recipients, it's very effective in dampening down the cardiovascular risk and reducing the risk of having a heart attack," Ingrid said.

"Though the patient populations where the Mediterranean diet had been beneficial and effective are not transplant patients, they have a similar metabolic profile to transplant patients. It's been tested in people with diabetes, it's been tested in people with cardiovascular disease, and it shows general benefit at addressing those key cardiovascular risk factors."

With the LIFE study now completed, the patient feedback collected thanks to PARF support is now being used to drive a much larger trial that looks to benefit a much greater cohort of patients than just those who have had a liver transplant.

The U-Decide Study will investigate the effect of integrating technology into the telehealth delivery of health services in people with complex chronic diseases. It will incorporate patient choice into how services are delivered for people at the PA Hospital with chronic kidney disease, chronic liver disease as well as kidney and liver transplant patients.

Support the work of PA Research Foundation in funding unique medical research like the work of Dr Ingrid Hickman and Dr Graeme Macdonald by donating here.

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