Riva Touger-Decker

Rutgers, The State University of New Jersey | Rutgers · Clinical and Preventive Nutrition Sciences, School of Health Professions & Diagnostic Sciences School of Dental Medicine

Objectives: To explore associations between periodontal disease (PD) severity and cardiometabolic risk factors, including body mass index (BMI), age, Type 2 Diabetes Mellitus (T2DM) risk, sex, and hypertension (HTN) in patients at an urban dental school clinic. Methods and materials: A cross-sectional study design was used to analyze electronic...

Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition, oral, and systemic diseases that contribute to multi-morbidity. Diet and nutrient-related risk factors for oral diseases include high intakes of free sugars, lo...

Background/Objective Tooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults. Materials and Methods This was a cross‐sectional study of data from a convenience sample of older adults (65–89 years) treated at an u...

Research in aging has significantly advanced; scientists are now able to identify interventions that slow the biologic aging processes (i.e., the “hallmarks of aging”), thus delaying the onset and progression of multiple diseases, including oral conditions. Presentations given during the 3-part session “Geroscience: Aging and Oral Health Research,”...

Background: Tooth loss is associated with suboptimal nutrient intake and greater risk of malnutrition. Objective: To develop and field-test a stakeholder-informed diet education tool that addresses the unique needs of older adults with tooth loss who do not wear dentures. Methods: An iterative user-centered approach was used. Initial content w...

Objective: To explore the feasibility of screening for type 2 diabetes (T2DM) and the prevalence of adult patients seen in a dental clinic at risk for T2DM based on American Diabetes Association (ADA) diabetes risk test (DRT) scores and Point of Care (POC) Hemoglobin A1C (A1C) values. Methodology: A cross-sectional analysis of data from adults 1...

Temporomandibular joint disorder (TMD) is a chronic disorder that significantly affects oral function. It can affect appetite and the mechanical components involved with eating, including mandibular opening, biting, chewing, and even swallowing. Thus, dietary intake and, subsequently, nutrition status are affected. The functional challenges present...

Adults with acute respiratory distress syndrome (ARDS) may experience enteral nutrition (EN) intolerance. They often require mechanical ventilation and other specialized management including prone positioning. There is a controversy as to whether patients fed in prone position experience more EN intolerance than when they are in supine position. Th...

Objectives Food insecurity (FI) affects between 11% and 51% of health sciences graduate students attending universities across the United States. This study aimed to describe the food security status of health sciences graduate students during the COVID-19 pandemic and to determine the educational, social, and economic characteristics associated wi...

Objectives To determine the prevalence of patient-reported diet and nutrition risk factors related to oral health of adults who attended an undergraduate dental school clinic. Associations between risk factors were also explored. Methods This was a cross-sectional study of data from adult patients 18–89 years of age (N = 1071) who received care at...

Objectives The prevalence of food insecurity and high stress rose among college students during the COVID-19 pandemic, however, there is limited research on the prevalence among health professions students. This study investigated the association between self-reported impacts of the COVID-19 pandemic on stress and food security among health profess...

PurposeApplying the Social Cognitive Transition (SCT) Model of Adjustment as an interpretive framework, this mixed-methods case series explored how head and neck cancer (HNC) survivors participate in the dimensions of the eating experience (described as physiological, psychological, social, cultural).Methods This was a sub-study of a primary study,...

Diet, nutrition, and oral health screening to detect factors influencing the ability to eat and drink and the risk for micronutrient deficiencies and malnutrition can help identify older adults needing intervention early and help prevent or mitigate the severity of problems. This chapter addresses nutrition risk factors and screening of older adult...

Background/Objective Older adults are at higher risk of malnutrition. The aim of this study was to explore associations between nutritional status and dentition status among older adults seeking care in a dental clinic. Methods This was a cross-sectional study of data from older adults (65–89 y) who received care at a northeastern US urban dental...

This pilot study explored nutrition-focused physical examination (NFPE) knowledge and practice changes in clinical dietitians and dietetics educators who completed a hybrid training program in Malaysia. Integration of NFPE into dietetics curricula was also assessed. Mean knowledge scores increased significantly from baseline to posttests immediatel...

Objectives There is limited research on the integration of Nutrition Focused Physical Examination (NFPE) into dietetic educators’ curricula practices globally. The primary objectives of this study were to assess changes in dietetic educators’ NFPE knowledge and curricula practices over 12-months after completing a hybrid training program in NFPE....

Objectives Nutrition-focused physical examination (NFPE) is a component of nutrition assessment performed by dietitians. There is limited research globally on NFPE practices of dietitians. This study explored changes in NFPE knowledge and practices over 1-year among clinical dietitians in Malaysia who completed a hybrid NFPE training program. Meth...

Objectives Older adults in the United States are at greater risk for tooth loss and malnutrition than those younger than 65 years. Prior research regarding associations between dentition status and nutritional status in older adults is heterogeneous. The primary aim of this study was to explore associations between dentition status and nutritional...

Background: Preoperative malnutrition adversely impacts perioperative outcomes among patients with gastrointestinal (GI) cancer. The attributable risk (AR) that nutrition status contributes towards negative outcomes is poorly understood. Design: Adults undergoing GI cancer surgeries were identified within the ACS-NSQIP database (2005-2017). Emer...

Background/Objective Older adults are at risk for tooth loss and compromised nutritional status. Our objective was to conduct a systematic review and meta-analysis to answer the following question: Among adults aged ≥60 y living in developed countries, what are the associations between tooth loss and nutritional status as assessed by a validated nu...

Objective: To determine the prevalence of food insecurity and the factors associated with it among health sciences graduate students. Methods: A cross-sectional web-based survey conducted in 2019 on an urban health sciences campus of a large, public northeastern university among health sciences graduate students. Food security status was assesse...

Introduction: Taste and olfactory changes begin within days of initiating chemotherapy and radiation therapy for head and neck cancers (HNC) and may persist 12 months or longer post-treatment, affecting 50 to 75% of adults with HNC. In this study, we assess taste function and diet in addition to food product evaluation among patients with HNC. Meth...

Background Malnutrition is common among patients with gastrointestinal (GI) cancer and contributes to their morbidity and mortality. Nutrition interventions provided by a registered dietitian (RD) or dietitian may improve nutrition status and patient outcomes; however, there are few studies that attempt to define the contribution of the dietitian t...

Objectives Replacement of natural dentition with dentures can impact the ability to consume foods and ultimately impact nutrition status. The objective of this study was to explore associations between patient-reported removal of dentures for eating and risk of malnutrition, using Self Mini Nutritional Assessment (Self-MNA) total and select compone...

Objectives To determine the prevalence of food insecurity and its associated factors among health sciences students at a large Northeastern University. Methods A cross-sectional web-based survey was emailed to students in the 2019 spring semester. Food insecurity was assessed using the United States Department of Agriculture validated 6-item short...

Objectives Increased physical activity and decreased sedentary time are associated with reduced risk of cardiometabolic disease. The aim of this study was to examine the associations between changes in weight, and walking and sitting time of female employees with overweight or obesity enrolled in a university-based worksite wellness program (WWP)....

Objectives: To assess and compare dietpractices, body mass index (BMI), and oral health-related quality of life (OHRQoL) in adults with and without periodontitis. Methods: Demographics, health-related behaviors, BMI, dental and periodontal parameters, diet practices, and Oral Health Impact Profile-14 (OHIP-14) were collected from 62periodontitis...

A potential risk of long‐term parenteral nutrition (PN) is intestinal failure–associated liver disease (IFALD). One recommendation for mitigating risk is limiting the fat dose to reduce the harmful effects of the ω‐6 fatty acids, which are the main ingredient in traditional fats. SMOFlipid (SMOF) (Kabi‐Fresenius, Bad Homburg, Germany) is a combinat...

Objectives: This study explored associations between dental occlusion and nutritional status in community dwelling older adults. Methods: This cross-sectional study utilized data from electronic health records (EHR) of new patients (>65 years), who presented for care at the Rutgers School of Dental Medicine between June 1, 2015 and June 30, 2018...

Objective: To explore the eating experience and eating-related quality of life (ERQOL) of community-dwelling older adults with tooth loss. Method: Nineteen older adults from the clinics of a northeast US dental school who met inclusion criteria (>65 y old, <20 teeth, and no dentures) composed the sample. For this mixed methods study, demographic...

Gastroparesis is a complex, difficult-to-manage condition of delayed gastric emptying that can result in a debilitating set of symptoms. Diagnosis involves objective measurement of gastric emptying delay. Treatment success is typically based on subjective improvement in patient-reported symptoms. Medical nutrition therapy is recommended as a primar...

Objective: Associations between changes in physical activity (PA) and cardiometabolic risk factors among women with overweight/obesity enrolled in a university-based worksite wellness program (WWP) were examined. Methods: Data from 173 women who completed a 26-week WWP were analyzed retrospectively. Participants completed diet and PA assessments...

This review explored research on e-learning (EL), blended learning (BL), and face-to-face learning (F2FL) as teaching strategies for physical examination (PE) in regard to skill, attitude, and knowledge outcomes of students and trainees in the health professions. A search was performed of CINAHL, PubMed, and ProQuest databases; 9 studies were revie...

This study explored nutrition-focused physical examination (NFPE) practices of registered dietitian nutritionists (RDNs) who completed an in-person NFPE course. Relationships between NFPE conduct and professional characteristics of respondents were also investigated using a mixed-mode survey. Ninety-six respondents met the inclusion criteria. Exami...

Background and Objective: Older adults are at risk for both impaired oral health and suboptimal nutritional status. The objective of this study was to explore the relationships between malnutrition risk and missing teeth in community-dwelling older adults. Design: This was a retrospective cross-sectional analysis of data obtained from the electroni...

Background. Physical activity (PA) can facilitate weight loss, help avoid weight regain, and improve body composition. This study examined the relationships between PA level and changes in anthropometric measures among university employees in a worksite wellness program. Methods. A registered dietitian provided individualized assessments at baselin...

Purpose: To explore knowledge and skill acquisition outcomes related to learning physical examination (PE) through computer-assisted instruction (CAI) compared with a face-to-face (F2F) approach. Method: A systematic literature review and meta-analysis published between January 2001 and December 2016 was conducted. Databases searched included Me...

The purpose of this study was to assess changes in knowledge scores of dietetic students enrolled in a computer-assisted instruction (CAI) module about nutrition focused physical examination (NFPE). The module included live virtual classroom sessions, multi-media presentations, online discussion forums, and case studies. Students completed multiple...

A systematic review was conducted to investigate the associations between missing teeth, teeth replaced with dental prostheses, and malnutrition risk, as determined by the Mini Nutritional Assessment (MNA), among community-dwelling older adults. A comprehensive search strategy was designed to identify studies published between 2000 and 2014 that me...

Research is important for advancing the profession of dietetics. This secondary analysis explored relationships between US registered dietitian nutritionists' professional characteristics and research interest and involvement. Respondents (n = 580) had mean scores on the Interest in Research Questionnaire (IRQ) and the Dietitian Research Involvemen...

Background and overview: Patients with painful temporomandibular disorders (TMD) commonly report problems eating, owing to limited mandibular opening and pain and discomfort with biting and chewing. Consequently, painful TMD may affect dietary intake and nutritional status. Conclusions: Treatment of painful TMD is multifaceted and involves pharm...

Implementation of evidence-based practice in clinical practice is essential for safety, quality, cost, and reimbursement of dietetics services. This prospective randomized controlled trial aimed to measure changes in knowledge and practice behaviors of evidence-based practice after an educational intervention. The ability to interpret statistical r...

Objective To describe an interprofessional model to train students in the dental school clinic setting on exploration of drug‐diet/nutrient interactions. Methods Students and residents from the Rutgers’ Department of Nutritional Sciences, School of Health Related Professions and the School of Dental Medicine engage in interprofessional patient car...

Objective: To determine the influence of admission anthropometry on clinical outcomes in mechanically ventilated children in the PICU. Design: Data from two multicenter cohort studies were compiled to examine the unique contribution of nutritional status, defined by body mass index z score, to 60-day mortality, hospital-acquired infections, leng...

An Internet-based survey was conducted to identify knowledge and performance of dysphagia risk screening among registered dietitian nutritionists in clinical practice. From a randomized sample of 3669 US registered dietitian nutritionists, 8.4% completed the survey and met inclusion criteria. Those who performed or used information about select dys...

Objective: To determine the relationship between physical activity (PA) and health-related quality of life among university employees who enrolled in a worksite wellness program (WWP). Methods: The study was an interim analysis of data collected in a WWP. The sample consisted of 64 participants who completed 12- and 26-week follow-up appointment...

Background. Physical activity (PA) can facilitate weight loss, help avoid weight regain, and improve body composition. This study examined the relationships between PA level and changes in anthropometric measures among university employees in a worksite wellness program. Methods. A registered dietitian provided individualized assessments at baselin...

Research has identified significant challenges that patients experience following treatment for head and neck cancer (HNC). These include the physical and emotional impacts of the diagnosis and treatment, which compound weight loss and negatively impact eating ability. There is limited research about the lived experience and the changed meaning of...

This study explored the eating experience in long-term survivors of head and neck cancer (HNC) ≥3 years post concurrent chemoradiation. Quality of life (QOL) and the meanings and perceptions survivors had as it related to the eating experience were explored. Purposive sampling was utilized; 10 long-term survivors of HNC participated in the study. A...

Methods Participants enrolled in a university‐based WWP between January 2013 and May 2014, received individual counseling with a Registered Dietitian (RD) and 12 weeks of group lifestyle education sessions. At both baseline and follow‐up, participants completed the CDC's “Healthy Days Measure” and had their WC measured. The Healthy Days core module...

The DSQ is a self‐administered on‐line 26‐item assessment of dietary intake over the past month. Participants who enrolled in the WWP between October 2013 and August 2014 completed the DSQ at baseline and after one‐on‐one counseling and a 12‐week education intervention. Comparison analyses were completed among those participants who provided suffic...

Use of a prophylactic feeding tube before concurrent chemotherapy and radiotherapy (CRT) for patients with head and neck cancer is often debated. A retrospective, exploratory study of 109 veterans with stage III/IV head and neck cancer who completed standard CRT was conducted. Relationships among 3 feeding tube status groups: prophylactic feeding t...

Background: Given the prevalence of vitamin and mineral supplement use among consumers and the potential for vitamin- and mineral-drug interactions, as well as oral and systemic adverse effects of excess consumption, oral health care providers (OHCPs) should ask all patients about their use. The challenges for OHCPs are how to recognize oral and s...

Objective: To determine immediate changes in weight and cardiometabolic risk of participants in a university worksite wellness program (WWP). It was hypothesized that there would be significant improvements in weight and waist circumference after 12 weeks. Method: Employees volunteered for enrollment in a 12-week WWP that provided educational se...

Oro-facial pain (OFP) is known to exert profound impacts on quality of life including functionally and psychosocially mediated changes in dietary intake and thereby nutrition. This commentary explores the evidence base available on chronic oro-facial pain, diet and nutrition and discusses current dietary guidance for individuals with chronic OFP; p...

Activities performed by advanced-practice registered dietitian nutritionists (RDNs) have yet to be clearly elucidated. The study aimed to gain consensus on the practice activities of advanced-practice RDNs who provide direct clinical nutrition care. A three-round Delphi study was conducted. Purposive sampling identified 117 RDN experts working as c...

Mechanically ventilated children in pediatric intensive care units (PICUs) are at risk for hospital‐acquired infections (HAI) and prolonged hospitalizations. We performed a multicenter, international cohort study to determine the unique contribution of nutritional status to clinical outcomes in mechanically ventilated children in PICUs (N=1622). Nu...

Critically ill children requiring mechanical ventilation in pediatric intensive care units (PICUs) are at high risk for mortality. Prior research regarding the impact of nutritional status on morbidity and mortality in PICU patients has been limited to single centers, small populations, or narrowly defined disease groups. We performed a multicenter...

Chronic orofacial pain may be musculoskeletal, neuropathic, or neurovascular in origin and can impact diet intake and nutrition status Treatment of chronic orofacial pain requires diagnosis of the underlying cause and individualized treatment for each pain diagnosis Primary aims of treatment focus on decreasing pain, restoring function, and maint...