Diet and nutrient intake of people receiving opioid agonist treatment (OAT): implications for recovery

Abstract

Purpose – The purpose of this paper is to provide new insights into the diet and nutrient intake of people receiving opioid agonist treatment (OAT) in the UK, offering implications for recovery-oriented treatment and care. Design/methodology/approach – Diet and nutrient intake were assessed using quantitative methods. The research tools used were: a socio-demographic and drug use questionnaire, 24-hour dietary recall interview and anthropometry measures. A four-month follow-up was conducted using the same methods. Findings – Mean (SD) body mass index for males (n=15) and females (n=10) exceeded the normal range (25.2 (5.9) kg/m2 and 33.3 (8.6) kg/m2, respectively) at baseline. Males decreased to the normal range at follow-up (mean (SD)=24.1 (±6.2) kg/m2]. Females increased to obesity Class II at follow-up (mean (SD)=35.1 (±8.0) kg/m2). Non-starch polysaccharide intakes were significantly lower than the reference nutrient intake (RNI). Iron intakes for females were significantly below the RNI. Saturated fat intake and sodium intake exceeded the RNI. In total, 11 (44 per cent) participants had multiple health conditions. Participants regularly consumed meals and reported frequent snacking events. Research limitations/implications – There is a need for better understanding of nutrition-related issues and dietary deficiencies amongst people receiving OAT, including larger studies that explore differences between males and females, other sub-groups and changes over time. Practical implications – Nutritional recommendations or guidelines and increased attention to nutrition and diet within treatment programmes are needed to help people receiving OAT. Originality/value – This paper demonstrates how diet and nutrient intake are essential to recovery processes and outcomes.

Examination of the nutritional intake of patients undergoing opioid replacement therapy: A systematic review

“…Of these studies, two were conducted in the United States 26,28 and one study was conducted in each of Poland, the United Kingdom, Australia, Portugal and Iran. 9,[23][24][25]27 Each of the studies investigated an aspect of nutritional intake in opioid replacement therapy patients. Both Shrestha et al and Tomedi et al specifically investigated pregnant women.…”

“…26 Patients receiving opioid replacement therapy treatment through various institutions were examined in the included ) of the included studies utilised a 24-h food recall to assess nutritional intake of patients. [23][24][25] The food recall assessment by Kolarzyk et al was completed once at baseline and again following 4 years of opioid replacement therapy. 23 Ii et al repeated the food recall assessment after a 4-month period.…”

“…23 Ii et al repeated the food recall assessment after a 4-month period. 24 Tomedi et al, Alves et al, Shrestha et al and Kheradmand and Kheradmand utilised food frequency questionnaires as a method of assessing intake with Tomedi et al also utilising biomarkers to assess micronutrient and essential fatty acid levels. 9,[26][27][28] The majority of included papers included an assessment of both macro and micronutrient and resulting energy intake as determined by food consumption.…”

“…9,[26][27][28] The majority of included papers included an assessment of both macro and micronutrient and resulting energy intake as determined by food consumption. [23][24][25][26]28 Kheradmand and Kheramand did not provide an analysis of nutrient levels. 27 Shrestha et al and Waddington et al also assessed reported nutritional supplement intake in their included patient groups.…”

“…25 The results from Ii et al also showed that intake differed between male and female patients however both sexes were observed to have potentially deficient intake of selenium, potassium, and fibre. 24 In addition, Waddington et al found that women reported potential insufficient intake of several vitamins including vitamin A, vitamin E and thiamin. Conversely, male intake of vitamins appeared to be more in line with Australian Government dietary guidelines.…”