Digestive diseases can have debilitating impacts on the people who live with them. From constant discomfort and pain, to an urgent need to relieve themselves – when you are constantly worried about where and when you may need to access a washroom, it can quickly take over your life.

But what if nutrition therapy could be used to manage symptoms and make life a little easier for people with digestive diseases? Today, there are major gaps in the practice of clinical nutrition relevant to digestive health and diseases, and there are very few specialists trained to deliver specialized nutrition care to these patients.

This gap is what Alberta’s Collaboration of Excellence for Nutrition in Digestive Diseases (AsCEND) is trying to fill.

AsCEND is led by Dr. Maitreyi Raman (Director), Dr. Leah Gramlich (Co-Director), and Dr. Puneeta Tandon (Co-Director). Through a collaborative approach, built on partnerships with academic institutions, government, industry partners and research organizations, AsCEND hopes to advance ground-breaking nutrition research as it relates to digestive diseases, and the translation and application of that research into real world clinical settings. Their goal is to enhance treatments for digestive diseases in Alberta and beyond and improve the lives of those affected.

Ascend has received funding from the Takeda Alberta Health Collaboration Fund, a pan-provincial collaboration focused on improving the long term health outcomes, quality of life, and economic prosperity for Albertans suffering with digestive diseases. The University Hospital Foundation, Ministry of Jobs, Economy and Innovation, and Takeda Canada through the Calgary Health Trust, jointly invested $1.7 million into the partnership.

Out of this strategic partnership funding came four projects:

• Examining the effectiveness of nutrition therapy in patients with active Crohn’s Disease
• Developing the Lyfe MD Digital Health Solution: an Evidence-based, Physician Recommended Digital Health Mobile Application that provide a lifestyle and wellness solution for Inflammatory Bowel Disease (IBD) patients
• Examining the impact of evidence-based nutrition and physical activity care in patients with cirrhosis and;
• Analysing and describing the inputs and outputs of specialized nutrition care Intestinal Failure patients in hospital, in malnutrition clinics, and at home

Dr. Puneeta Tandon (MD, MSc Epidemiology) is a gastroenterologist, hepatologist, and faculty member at the University of Alberta. She is the founder and co-director of the internationally recognized Cirrhosis Care Clinic and is the Edmonton co-lead for AsCEND. Dr. Tandon is currently leading two Cirrhosis Projects at AsCEND. The first is examining the baseline knowledge, attitudes and practices of healthcare professionals around nutrition and activity in hospitalized patients with cirrhosis and how these change after an electronic medical record based intervention. The second will evaluate the team’s CIHR funded Heal-Me (Healthy Eating, Active Living, Mindful Energy) mobile app for the delivery of an evidence-based nutrition and exercise intervention in outpatients with cirrhosis.

Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases and conditions. Symptoms include tiredness, fluid accumulation, muscle weakness, and confusion due to toxin accumulation in the blood.

“Most people with cirrhosis lose muscle mass and strength. This has a tremendous impact not only on their ability to function and their quality of life but also is a major predictor of how long they live. There is no doubt that nutrition and exercise improve muscle mass and strength,” said Dr. Tandon. “But our patients need more than just information. The aim of our research is to harness the power of digital technology to provide healthcare practitioners and patients engaging tools to shift this knowledge into action for the care of every patient with cirrhosis.”

Phase 1 of AsCEND’s projects have seen great success with gathering data, identifying gaps in care, and gaining additional support. Now heading into Phase 2 they will continue to address the gaps identified by developing a curriculum and formalized training program for physicians, offering structured clinical training experiences, sharing knowledge and promoting healthy nutrition with patients, and extending research to other geographic locations across the nation, putting Canada on the international map of nutrition and wellness excellence. Overall AsCEND will continue to enhance treatments and increase the quality of life for those affected by IBD, celiac disease, non-alcoholic fatty liver disease (NAFLD), irritable bowel syndrome (IBS), cirrhosis and intestinal failure.

The LyfeMD mobile application, a project led by Dr. Raman, was a great success for home health monitoring of patients with IBD and using nutrition, exercise, and mindfulness to manage symptoms. The application was easily accessible, and empowered patients to take wellness into their own hands. In the future, as content is added to support other common digestive diseases, the impact it can have on patient health outcomes and the wider community will increase.

The team at AsCEND is well on its way to reaching their goals of enhancing treatments and improving the quality of life and health outcomes for individuals suffering from digestive diseases. And the University Hospital Foundation is proud to continue to support their efforts.

Dr. Puneeta Tandon (MD, MSc Epidemiology) is a gastroenterologist, hepatologist, and faculty member at the University of Alberta. She is the founder and co-director of the internationally recognized Cirrhosis Care Clinic and is the Edmonton co-lead for AsCEND. Dr. Tandon is currently leading two Cirrhosis Projects at AsCEND. The first is examining the baseline knowledge, attitudes and practices of healthcare professionals around nutrition and activity in hospitalized patients with cirrhosis and how these change after an electronic medical record based intervention. The second will evaluate the team’s CIHR funded Heal-Me (Healthy Eating, Active Living, Mindful Energy) mobile app for the delivery of an evidence-based nutrition and exercise intervention in outpatients with cirrhosis.

Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases and conditions. Symptoms include tiredness, fluid accumulation, muscle weakness, and confusion due to toxin accumulation in the blood.

“Most people with cirrhosis lose muscle mass and strength. This has a tremendous impact not only on their ability to function and their quality of life but also is a major predictor of how long they live. There is no doubt that nutrition and exercise improve muscle mass and strength,” said Dr. Tandon. “But our patients need more than just information. The aim of our research is to harness the power of digital technology to provide healthcare practitioners and patients engaging tools to shift this knowledge into action for the care of every patient with cirrhosis.”

Phase 1 of AsCEND’s projects have seen great success with gathering data, identifying gaps in care, and gaining additional support. Now heading into Phase 2 they will continue to address the gaps identified by developing a curriculum and formalized training program for physicians, offering structured clinical training experiences, sharing knowledge and promoting healthy nutrition with patients, and extending research to other geographic locations across the nation, putting Canada on the international map of nutrition and wellness excellence. Overall AsCEND will continue to enhance treatments and increase the quality of life for those affected by IBD, celiac disease, non-alcoholic fatty liver disease (NAFLD), irritable bowel syndrome (IBS), cirrhosis and intestinal failure.

The LyfeMD mobile application, a project led by Dr. Raman, was a great success for home health monitoring of patients with IBD and using nutrition, exercise, and mindfulness to manage symptoms. The application was easily accessible, and empowered patients to take wellness into their own hands. In the future, as content is added to support other common digestive diseases, the impact it can have on patient health outcomes and the wider community will increase.

The team at AsCEND is well on its way to reaching their goals of enhancing treatments and improving the quality of life and health outcomes for individuals suffering from digestive diseases. And the University Hospital Foundation is proud to continue to support their efforts.