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Laura D Byham-Gray, PHD

Department : Clinical and Preventive Nutritional Sciences
Program/Division : Clinical Nutrition
Academic Title: Professor
Administrative Title(s): Vice Chair


Office Address:
65 Bergen Street 
Stanley S. Bergen Building, Rm 157
Newark, NJ 07107
Phone: (973) 972-1605

Email: byhamgld@rutgers.edu

Education
Degree Degree Source Year Awarded
MS University of Delaware 1991
PHD New York University 2004
Certification
Reg Certificate Type Reg Certificate Number
R 706858
Publications
Title Authors Where and When
Patient-centered model for protein-energy wasting: Stakeholder deliberative panels Byham-Gray, LD, Peters, EN, Rothpletz-Puglia, P J Ren Nutr. 2019, https://doi.org/10.1053/j.jrn.2019.06.001
Use and barriers to use of laboratory data by clinical dietitians Vickery, C.E., Cotugna, N., and Byham-Gray, L.D Hospital Topics. 2001;11:5-9
Characteristics and Drivers of the Registered Dietitian Nutritionist’s Sustained Involvement in Clinical Research Activities: A Mixed Methods Study Boyd M, Gall SB, Rothpletz-Puglia P, Parrott JS, King C, Byham-Gray L J Acad Nutr Diet. 2019, doi.org/10.1016/j.jand.2019.03.018
The Effectiveness of Nutrition Specialists on Pediatric Weight Management Outcomes in Multicomponent Pediatric Weight Management Interventions: A Systematic Review and Exploratory Meta-Analysis Thompson KL, Chung M, Handu H, Gutschall M, Jewell ST, Byham-Gray L, Parrott JS J Acad Nutr Diet. 2019;119(5): 799-816
Tooth Loss, the Eating Experience and Eating Related Quality of Life: Perceptions of Older Adults Zelig R, Jones VM, Touger-Decker R, Hoskin ER, Singer SR, Byham-Gray L, Rigassio Radler D, Rothpletz-Puglia P Journal of Dental Research: Clinical and Translational Research (JDR CTR). 2019;4(3);217-228
Volume-Based vs Rate-Based Enteral Nutrition in the Intensive Care Unit: Impact on Nutrition Delivery and Glycemic Control Roberts S, Brody R, Rawal S, Byham-Gray L J Parenter Enteral Nutr. 2018 Sep 19. doi: 10.1002/jpen.1428
The Relationships Between Physical Activity and Cardiometabolic Risk Factors Among Women Participating in a University-Based Worksite Wellness Program Gottesman K, Rawal S, Parrott JS, Byham-Gray LD, Touger-Decker R, Radler DR J Occup Environ Med. 2018 Dec;60(12):1098-1107. doi: 10.1097/JOM.0000000000001439. PMID:30188493
Comparison of a handheld indirect calorimetry device and predictive energy equations among individuals on maintenance hemodialysis Morrow, EA, Marcus, A, Byham-Gray, LD J Renal Nutr. 2018;27(6): 402-411
Is Nutrition Specific Quality of Life associated with nutritional status? Feasel-Aklilu, S, Marcus, A, Parrott, JS, Peters, E, Byham-Gray, LD J Renal Nutr. 2018; 28(4):283–291
Dentition and Malnutrition Risk in Community-Dwelling Older Adults Zelig R, Byham-Gray L, Singer SR, Hoskin ER, Fleisch Marcus A, Verdino G, Rigassio Radler D, Touger-Decker R Journal of Aging, Research and Clinical Practice, (JARCP), 1/18/2018
Modeling a predictive energy equation specific for maintenance hemodialysis Byham-Gray, LD, Parrott, JS, Peters, EN, Gould-Fogerite, SG, Hand, RK, Ahrens, S, Marcus, AF, Fiutem, JJ JPEN, J Parenter Enteral Nutr. ePub DOI: 10.1177/0148607117696942
Testing of a Tool to Measure Practice-Based Research Involvement for Registered Dietitian Nutritionists in Clinical Practice Plant MK, Marcus AF, Ziegler J, Byham-Gray L Topics in Clinical Nutrition, 2017;32(1):47-59
Predictors of preoperative weight loss achievement in adult bariatric surgery candidates while following a low-calorie diet for 4 weeks Hutcheon DA, Byham-Gray LD, Marcus AF, Scott JD, Miller M Surgery for Obesity and Related Diseases, 2017;13(6):1041-1051
Comparison of Subjective Global Assessment and Protein Energy Wasting Score to Nutrition Evaluations conducted by Registered Dietitian Nutritionists in identifying risk of Protein Energy Wasting in Maintenance Hemodialysis Patients Sum SS, Marcus AF, Blair D, Olejnik LA, Cao J, Parrott JS, Peters EN, Byham-Gray LD Journal of Renal Nutrition, doi: 10.1053/j.jrn.2017.04.006
Abbreviated steady state intervals for measuring resting energy expenditure in patients on maintenance hemodialysis Olejnik LA, Peters EN, Parrott JS, Marcus AF, Brody RA, Hand RK, Fiutem JJ, Byham-Gray LD JPEN J Parenter Enteral Nutr. Published online before print July 27, 2016, doi: 10.1177/0148607116660981
Associations between tooth loss, with or without dental prostheses, and malnutrition risk in older adults: a systematic review Zelig R, Touger-Decker R, Chung M, Byham-Gray L Top Clin Nutr. 2016;31(3):232-247
Nutritional Status Based on Body Mass Index Is Associated With Morbidity and Mortality in Mechanically Ventilated Critically Ill Children in the PICU Bechard LJ, Duggan C, Touger-Decker R, Parrott JS, Rothpletz-Puglia P, Byham-Gray, LD, Heyland, D., Mehta, NM Critical Care Medicine. 2016;44(8):1530-1537
Research interest and research involvement among US registered dietitian nutritionists Boyd M, Byham-Gray L, Touger-Decker R, Marcus AF, King C Topics in Clinical Nutrition, 2016;31(3):267-277
Physical activity level is associated with maintaining anthropometric improvements among participants in a worksite wellness program Wanik J, Marcus AF, Radler DR, Byham-Gray L, Touger-Decker R American Journal of Lifestyle Medicine. Published online before print January 3, 2016, doi: 10.1177/1559827615624420
Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: A systematic review and meta-analysis. Willcutts KF, Chung MC, Erenberg MLS, Finn KL, Schirmer BD, Byham-Gray LD Ann Surg. 2016;264(1):54-63
Research interest and research involvement among US registered dietitian nutritionists Boyd M, Byham-Gray L, Touger-Decker R, Marcus AF, King C Top Clin Nutr. 2016;31(3):267-277
Increased physical activity leads to improved health-related quality of life among employees enrolled in a 12-week worksite wellness program Macaluso S, Marcus AF, Rigassio-Radler D, Byham-Gray L, Touger-Decker R J Occup Environ Med. 2015;57(11):1214-21
A review of dietary intake studies in maintenance hemodialysis patients Therrien, M, Byham-Gray, LD, Beto, J J Renal Nutr, 2015; 25(4): 329–338
Support Care Cancer Ganzer H, Rothpletz-Puglia P, Byham-Gray L, Murphy B, Touger-Decker R Support Care Cancer 2015;23(11): 3257-3268.
Comparison of Standardized Patients and Real Patients as an Experiential Teaching Strategy Schwartz V, Rothpletz-Puglia P, Denmark R, Byham-Gray L Patient Education and Counseling Nov. 2014
Applying social cognitive career theory to Registered Dietitian research involvement, a randomized controlled trial King C, Byham-Gray L, Parrott JS, O’Sullivan Maillet J, Roberts MM, Splett P J Allied Health. 2014;43(4):201-211
Online education improves Canadian dietitians attitudes and knowledge regarding recommending and ordering multivitamin/mineral supplements daSilva L, Brody RA, Byham-Gray L, Parrott J Canadian Journal of Dietetic Practice and Research 2014; 75(3): 111-117
The effect of medical nutrition therapy by a registered dietitian nutritionist in patients with prediabetes participating in a randomized controlled clinical research trial Parker, AR, Byham-Gray, L, Denmark, R, Winkle, PJ J Acad Nutr Diet. 2014;114(111): 1739-1748
Improving enteral delivery through the adoption of the “feed early enteral diet adequately for maximum effect (FEED ME)” protocol in a surgical trauma ICU: A quality improvement review Taylor B, Brody R, Denmark R, Southard R, Byham-Gray L Nutr Clin Pract. 2014;29(5):639-48
Dietitians and research: Facilitating involvement. History of dietitian involvement in dietetics research in the US King C, Byham-Gray L, O’Sullivan-Maillet J, Parrott JS, Splett P, Roberts MM Topics in Clinical Nutrition. 2014;29(3):227-238
Impact of providing a combination lipid emulsion compared with a standard soybean oil lipid emulsion in children receiving parenteral nutrition: A systematic review and meta-analysis Finn, KF, Chung, MC, Rothpletz-Puglia, P, Byham-Gray, LD Journal of Parenteral and Enteral Nutrition. 2015;39(6):656-67
Academy of Nutrition and Dietetics and National Kidney Foundation: Revised 2014 standards of practice and standards of professional performance for Registered Dietitian Nutritionists (competent, proficient, and expert) in nephrology nutrition Kent PS, McCarthy MP, Burrowes JD, McCann L, Pavlinac J, Goeddeke-Merickel CM, Wiesen K, Kruger S, Byham-Gray L, Pace RC, Hannahs V, Benner D Journal of Renal Nutrition. 2014;24(5):275-285
Academy of Nutrition and Dietetics and National Kidney Foundation: Revised 2014 standards of practice and standards of professional performance for Registered Dietitian Nutritionists (competent, proficient, and expert) in nephrology nutrition Kent PS, McCarthy MP, Burrowes JD, McCann L, Pavlinac J, Goeddeke-Merickel CM, Wiesen K, Kruger S, Byham-Gray L, Pace RC, Hannahs V, Benner D J Acad Nutr Diet. 2014;114:1448-1457
The impact of standardized feeding guidelines on enteral nutrition administration, growth outcomes, metabolic bone disease and cholestasis in a neonatal intensive care unit Loomis, T, Byham-Gray, L, Ziegler, J, Parrott, JS Journal of Pediatric Gastroenterology and Nutrition. 2014;59: 93–98
Comparison of dietary intake among women on maintenance dialysis to a Women's Health Initiative cohort: Results from the NKF-CRN Second National Research Question Collaborative Study Therrien, M, Byham-Gray, LD, Denmark, R, Beto, JA Journal of Renal Nutrition, 2014;24:72-80
Development of predictive energy equation-A pilot study Byham-Gray, L, Parrot, JS, Ho, WY, Sundell, MA, Ikizler, TA Journal of Renal Nutrition. 2014;24: 32-41
Perceptions, attitudes, knowledge, and clinical use of evidence-based practice among US registered dietitians: A prospective descriptive pilot study Vogt, A., Byham-Gray, L., Touger-Decker, R Topics in Clinical Nutrition. 2013;28(3):283-294
The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines Moore, LM, Byham-Gray LD, Parrott JS, Rigassio Radler D, Mandayam S, Jones SL, Mitch WE, Gaber AO Kidney International. 2013; doi:10.1038/ki.2012.420
Use of the subjective global assessment to predict health-related quality of life in chronic kidney disease stage 5 patients on maintenance hemodialysis Vero LM, Byham-Gray L, Parrott JS, Steiber AL Journal of Renal Nutrition. 2013;23(2):141-147
Effect of a dietitian-managed bone algorithm on serum phosphorus level in maintenance hemodialysis patients Blair D, Byham-Gray LD, Sweet SJ, Denmark R, Parrott JS, Lewis E, McCaffrey S, Thomson S Journal of Renal Nutrition. 2013;23(2):98-105
Impact of two pulmonary enteral formulations on nutritional indices and outcomes Cohen DA, Byham-Gray L, Denmark RM Journal of Human Nutrition and Dietetics. 2013;26, 286–293
Identifying components of advanced-level clinical nutrition practice: a Delphi study Brody RA, Byham Gray L, Touger-Decker R, Passannante MR, O’Sullivan Maillet J Journal of the Academy of Nutrition and Dietetics. 2012;112(6):859-869
Workplace weight loss program: Impact on quality of life Bruno M, Touger-Decker R, Byham-Gray L, Denmark R Journal of Occupational and Environmental Medicine. 2011: 53 (12):1396–1403
Impact for continuing education: Applying the nutrition care process and model and the international dietetics and nutrition terminology for dietitians in long term care Zelig R, Byham-Gray L, Parrott J, Rigassio-Radler D, and Touger-Decker R Topics in Clinical Nutrition. 2011; 26(3): 268-280
The perceived benefits of master’s degrees in two samples of Registered Dietitians Rigby-Koutz J, Touger-Decker R, Brody R, Rigassio-Radler D, Khan H, Byham-Gray L, O’Sullivan Maillet J Topics in Clinical Nutrition; 25(3):202-212, July/September 2010
Resting energy expenditure in overweight and obese adults Ziegler J, Rothpletz-Puglia P, Touger-Decker R, Byham-Gray L, O’Sullivan-Maillet J, Denmark RM Topics in Clinical Nutrition. 2010;25(2):180-7
Standards of Practice and Standards of Professional Performance for Registered Dietitians (Generalist, Specialty, and Advanced) in Nephrology Care. The Joint Standards Task Force of the American Dietetic Association Renal Dietitians Dietetic Practice Group and the National Kidney Foundation Council on Renal Nutrition: Brommage, D., Karalis, M, Martin, C., McCarthy, M, Benner, D., Goeddeke-Merickel, CM, Wiesen, K., Byham-Gray, LD, House, JL, Pavlinac, J., McCann, L Journal of the American Dietetic Association. 2009. 109(9): 1617-1625.e3
Survey of Current Job Functions of Renal Dietitians Thelen, B, Byham-Gray, LD, Touger-Decker, R, Maillet, JO, Khan, H Journal of Renal Nutrition. 2009; 19 (6): 450-461
Effect of aggressive osteodystrophy management on clinical outcomes in Stage 5 Chronic Kidney Disease Byham-Gray, L.D., Drasher, T., Deckman, K., Graham, D., Liftman, C., Roberto, L., Peiffer, P., Denmark, R Journal of Renal Nutrition. 2009; 19: 321-333
Effect of an oral health assessment education program on murses’ knowledge and patient care practices in skilled nursing facilities Munoz, N., Touger-Decker R, Byham Gray L, O’Sullivan Maillet J Special Care Dentistry. 2009; 29:179-185
A review of characteristics of graduates in the allied health and nursing professions. Entry level and advanced practice Brody RA, Byham-Gray L, Touger-Decker R Topics in Clinical Nutrition. 2009; 24: 181-192
Vitamin D and metabolic syndrome Johnson, T., Avery, G., Byham-Gray L Topics in Clinical Nutrition. 2009; 24: 47-54
Perceived needs for graduate level clinical nutrition education for registered dietitians Tatum C, Touger-Decker R, Brody R, Byham-Gray L, O’Sullivan-Maillet J Topics in Clinical Nutrition. 2008; 23: 320-332
Wellness in the workplace: A 12week wellness program in an academic health sciences university Touger-Decker, R., Maillet, J.O., Byham-Gray, L.D., Stoler, F.D Topics in Clinical Nutrition. 2008; 23: 244-251
Prevalence of vitamin D [25(OH)D] deficiency and effects of supplementation with ergocalciferol (Vitamin D2) in Stage 5 Chronic Kidney Disease patients Topics in Clinical Nutrition. 2008; 23: 244-251 Journal of Renal Nutrition. 2008; 18:375-382
An overview of nutrition and diabetes management Journal of Renal Nutrition. 2008; 18:375-382 Topics in Clinical Nutrition. 2006; 21: 328-340
Predictors for research involvement among registered dietitians Byham-Gray, L.D., Gilbride, J.A., Dixon, L.B., Stage, F.K Journal of the American Dietetic Association. 2006;106:2008-2015
2005 American Society of Parenteral and Enteral Nutrition (A.S.P.E.N.) Standards and Guidelines Survey Seres, D., Compher, C., Seidner, D., Byham-Gray, L.D., Gervasio, J. McClave, S. and the A.S.P.E.N. Standards and Guidelines Committees Nutrition in Clinical Practice. 2006;21:529-532
Scope of practice in renal nutrition Byham-Gray, L.D., Wiesen, K., Goode, J Journal of Renal Nutrition. 2006;16:160-7
Weighing the evidence: Energy determinations across the spectrum of kidney disease Byham-Gray, L.D Journal of Renal Nutrition, 2006;16:17-26
Evidence-based practice: What are dietitians’ perceptions, attitudes, and knowledge? Byham-Gray, L.D., Gilbride, J.A., Dixon, L.B., Stage, F.K Journal of the American Dietetic Association, 2005;105:1574-1581
Functions performed by level of practice of registered dietitian members of the Diabetes Care and Education Dietetic Practice Group Green, D.M., Maillet, J.O., Touger-Decker, R., Byham-Gray, L., Matheson, P Journal of the American Dietetic Association. 2005; 105:1280-128
Research: A review of the “body” and the “backbone” for the dietetics profession Byham-Gray, L.D Topics in Clinical Nutrition. 2005;20(1):1-13
Outcomes research in nutrition and chronic kidney disease: Perspectives, issues in practice, and processes for improvement Byham-Gray, LD Advances in Chronic Kidney Disease. 2005;12(1):96-106
Comparison of dysphagia screening by a registered dietitian in acute stroke patients to speech language pathologist’s evaluation Huhmann, M., Touger-Decker, R., Byham-Gray, L.D., Maillet, J.O., VonHagen, S Topics in Clinical Nutrition. 2004;19(3):239-249
Conference Summary: Nutrition management of cancer: Past, present, and future trends Szebalskie, M. and Byham-Gray, L.D Topics in Clinical Nutrition. 2003;18(3):150-153
Use and barriers to use of laboratory data by clinical dietitians Vickery, C.E., Cotugna, N., and Byham-Gray, L.D Hospital Topics. 2001;11:5-
Commentary: Prospective analysis of patterns of weight change in stage IV human immunodeficiency virus infection Byham-Gray, L.D Nutrition in Clinical Practice. 1994; 9(3):116-117
Commentary: Standards of Practice for Nutrition Support Dietitian: Importance and value to practitioners Byham-Gray, L.D Nutrition in Clinical Practice. 1994;9(4):156-157
Commentary: Nutrition screening and assessment: Current practices and dietitians’ leadership roles Byham-Gray, L.D Nutrition in Clinical Practice. 1994;9(5):200-201
Commentary: Nutrition screening for malnutrition: Potential economic impact at a community hospital Byham-Gray, L.D Nutrition in Clinical Practice. 1994;9(5): 201
Intraperitoneal nutrition Byham, L.D. and Cieri, E Contemporary Dialysis and Nephrology. 1991;10:12-14
Nursing the patient on intradialytic parenteral nutrition Cieri, E., Teti, S., and Byham, L.D Contemporary Dialysis and Nephrology. 1991;12(4):49-50
Dietary fat and natural killer cell function Byham, L.D Nutrition Today. 1991;26(1): 31-36
Compliance and health promotion Byham, L.D. and Vickery, C.E Health Values. 1988;12(4):5-11
Awards
Award Year
Presidential Citation for Outstanding Achievement University of Delaware, College of Health Sciences 11/2010
Excellence in Teaching Award RBHS (formerly UMDNJ)-SHRP 5/2010
Joel D. Kopple Award National Kidney Foundation-Council on Renal Nutrition 4/2010
Susan C. Knapp Excellence in Education Award National Kidney Foundation-Council on Renal Nutrition 4/2009
Outstanding Service Award Academy of Nutrition and Dietetics (AND)-Renal Dietitians Dietetic Practice Group (RPG) 10/2007
Dean’s Excellence in Research Award RBHS (formerly UMDNJ)-SHRP 5/2006
Outstanding Service Award AND-RPG 10/2000
Manager Profile for Leadership Excellence Shore Memorial Hospital, Department of Nutrition Services 4/1998
Outstanding Renal Dietitian National Kidney Foundation-Council on Renal Nutrition Network 4 10/1997
Recognized Young Dietitian for the Year New Jersey Dietetic Association-Southern District 5/1996
Nutrition Graduate Student Award Williams & Wilkens, Incorporated 6/1990
Amy Rextrew Outstanding Graduate Student Award University of Delaware, Department of Nutrition and Dietetics 5/1990
Weight Watcher’s Fort Worth Corporate Donor Award The AND (formerly American Dietetic Association) Foundation 5/1990
Marion Steele Symposium Winner University of Delaware, Department of Nutrition and Dietetics 3/1990
President’s Associate Achievement Award Mercyhurst University (formerly Mercyhurst College), Department of Human Ecology 5/1986
Egan Honor Society Scholar Mercyhurst University (formerly Mercyhurst College) 9/1982-5/1986
Research
Research Interests
evidence-based practice, research activities, research involvement, chronic kidney disease, nutrition, clinical nutrition, diet, dietetics, dietetics education, aging and geriatrics
Research Grants
Title Sponsor Effective Dates Role
Image-based DiEtary Assessment in Chronic Kidney Disease (IDEA-CKD) Rutgers-Busch Biomedical Grant Current Principal Investigator
Bone Outcomes: Nutrition, body composition, and Energy expenditure (BONE) Study. National Kidney Foundation-Council on Renal Nutrition/Keryx Grant Current Principal Investigator
Linking Symptoms to Protein-Energy Wasting in Hemodialysis: KNOW SIGNS SHP Dean’s Bridge Grant Current Principal Investigator
Exploring Daily Activity and Total Energy Expenditure in the Adult Hemodialysis Population: A pilot study SHP Dean’s Bridge Grant July 1, 2016-June 30, 2017 Principal Investigator
Patient-Centered Approach to Exploring Protein-Energy Wasting in Dialysis Agency for Healthcare Research and Quality (AHRQ) September 1, 2015-August 31, 2017 Principal Investigator
Validation of a Handheld Indirect Calorimeter in Patients Diagnosed with Stage 5 Chronic Kidney Disease on Maintenance Hemodialysis Academy of Nutrition and Dietetics - Renal Dietitians Dietetic Practice Group July 1, 2014-June 30, 2015 Principal Investigator
National Diabetes, Digestive and Kidney Diseases, Development and Validation of a Predictive Energy Equation in Patients Diagnosed Stage 5 Chronic Kidney Disease on Maintenance Hemodialysis National Institutes of Health (1R15DK090593-01A1; 6R15DK090593-02; 3R15DK090593-02S1) September 25, 2012-August 31, 2015 Principal Investigator
Arbor Research Collaborative for Health, Relationship of Nutritional Status Indicators and Health-Related Quality of Life Among an International Sample of Maintenance Hemodialysis Patients: A Cross-Sectional Analysis Statistical support for data analyses acquired from Arbor Research June 1, 2010-November 2010 Principal Investigator
Effect of Medical Nutrition Therapy on Clinical and Patient-Oriented Outcomes Among Overweight/Obese Older Adults Treated by the New Jersey Institute for Successful Aging (NJISA) Foundation of the Rutgers University (formerly UMDNJ) July 1, 2007-January 31, 2009 Principal Investigator
Effect of Aggressive Osteodystrophy Management on Clinical Outcomes in Stage 5 Chronic Kidney Disease National Kidney Foundation-Council on Renal Nutrition July 2006-April 2009 Principal Investigator
Web-based Course Modules for Evidence-Based Practice RBHS (formerly UMDNJ) July 2004-August 2005 Principal Investigator
Defining and Validating Advanced-Level Practice in Clinical Nutrition Among Registered Dietitians The Foundation of Rutgers University (formerly UMDNJ) May 31, 2012-December 31, 2013, Co-Investigator
Clinical Outcomes Research Project The Foundation of Rutgers University (formerly UMDNJ) January 2004-December 2007 Co-Investigator
Development of a Graduate Geriatric Certificate Program for Dietitians and Physical Therapists Health Resources and Services Administration Grant, Allied Health Grant Program July 1, 2004-December 31, 2006 Co-Investigator
BioSketch
Title Details
Laura Byham-Gray Biosketch  3/20/2020 Mercyhurst University B.S. 1986 Nutrition and Dietetics University of Delaware M.S. 1991 Food Science & Nutrition New York University Ph.D. 2004 Nutrition A. Personal Statement I have devoted my professional career to working with patients diagnosed with chronic kidney disease (CKD); trying to solve the clinical dilemmas that often plague this extremely vulnerable group. While advancing medicine and technology have improved aspects of treatment, the mortality rates remain unacceptable. As a registered dietitian/nutritionist with over 15 years of clinical experience in patients with CKD, I have witnessed firsthand the deleterious effects of this disease and its treatment on patient outcomes. As described in the research proposal, self-management of disease is critical to improved health but given the complexity of CKD and limited resources and tools to assist patients, positive changes in health behavior are difficult to achieve. I am committed to improving the outcomes for these patients. This grant opportunity will allow us to create a mobile platform that will integrate the multiple facets of treatment and guide the patients in satisfying their health goals, thereby making a meaningful difference in the millions of persons diagnosed with CKD. Positions and Honors Positions and Employment 1986-1989 Renal Dietitian, Shore Memorial Hospital, Somers Point, NJ 1988-1989 Outpatient Nutrition Consultant, Shore Memorial Hospital, Somers Point, NJ 1991 Coordinator, Nutrition Support Services, PenTech Infusions, Media, PA 1991-1999 Assistant Director, Department of Nutrition Services, Shore Memorial Hospital, Somers Point, NJ 1999-2000 Renal Nutrition Specialist, Gambro Healthcare-Patient Services-Old Bridge, NJ 1999-2001 College Health Nutritionist, New York University Health Center-New York, NY 2002-2007 Assistant Professor, Department of Primary Care, Rutgers University (formerly UMDNJ) Stratford, NJ 2007-2014 Associate Professor, Department of Nutritional Sciences, Rutgers University (formerly UMDNJ) Stratford, NJ 2008-2015 Director, MS in Clinical Nutrition Program, Department of Nutritional Sciences, Rutgers University (formerly UMDNJ) Stratford, NJ 2014- Professor, Department of Nutritional Sciences, Rutgers University-School of Health Related Professions, Newark, NJ 2015- Director of Research, Department of Nutritional Sciences, Rutgers University-School of Health-Related Professions, Newark, NJ Other Experience and Professional Memberships 1986- Member, Academy of Nutrition and Dietetics (formerly The American Dietetic Association) 1991- Member, National Kidney Foundation-Council on Renal Nutrition (NKF-CRN) 1996-1999 Chair-Elect/Chair/Past-Chair, Renal Dietitians Dietetic Practice Group-ADA 2004-2012 Member, Board of Editors, Journal of Renal Nutrition 2006-2009; 2013- Member, Standards of Practice/Professional Performance-Nephrology Care- Academy of Nutrition and Dietetics (AND) and NKF 2007- Member, Chronic Kidney Disease-Evidence Analysis Library 2008-2009 Member, Nutrition Care Process-Standardized Language Committee-AND 2008-2009 Member, Research Committee-AND 2008-2012 Member, NKF-CRN Research Steering Committee 2010-2011 Member, Advanced Practice Nutrition Residency Taskforce Commission on Accreditation for Dietetic Education 2011- Member, Dialysis Outcomes and Practice Patterns Study Advisory Taskforce, Arbor Research Collaborative for Health 2011-2014 Member, Patient Education Taskforce, American Society of Nephrology 2012- Associate Editor, Journal of Renal Nutrition 2012-2013 Early Career Reviewer for the Center for Scientific Review of the NIH 2013- Patient-Centered Outcomes Research Institute (PCORI) Merit Reviewer 2014- Joanna Briggs Institute-Certified in Comprehensive Systematic Review Awards and Honors 2000 Outstanding Service Award, AND-RPG 2006 Dean’s Excellence in Research Award, Rutgers University (formerly UMDNJ)-School of Health Related Professions 2007 Outstanding Service Award, AND-RPG 2009 Susan C. Knapp, Excellence in Education Award, NKF-CRN 2010 Joel D. Kopple Award, NKF-CRN 2010 Presidential Citation for Outstanding Achievement, University of Delaware 2010 Excellence in Teaching, School of Health Related Professions C. Contribution to Science 1. One significant component theorized to contribute to the risk for protein-energy wasting (PEW) is the metabolic rate or energy expenditure (EE) among patients diagnosed with chronic kidney disease (CKD) on maintenance hemodialysis (MHD). My hypothesis is that as kidney disease progresses to end-stage failure there are substantive alterations in the EE coupled with a simultaneous decline in dietary intake thereby engendering an energy imbalance; placing these vulnerable patients at high mortality risk. Although measuring EE using IC is the preferred method for determining energy requirements in CKD, it is not routinely done in this practice setting because the methods required are cumbersome and the equipment used is cost-prohibitive. Typically, EE is estimated from a predictive formula or equation that has been validated in other disease states or patient populations, and then extrapolated or retrofitted to CKD, with serious limitations and consequences. Over 200 predictive energy equations are currently published but none are specific to CKD, and thus a “best practice” formula does not exist. Using EE measured by IC in a convenience sample of patients diagnosed with stage 5 CKD on maintenance hemodialysis (MHD), we were able to develop a preliminary predictive energy equation that more accurately estimates energy needs in this unique patient population. In comparison to other PEEs, including a disease-specific one, our model demonstrated the least bias. While we were able to achieve a stronger ability to predict estimated energy needs, there were still a substantial amount of persons in the tails of the distribution for whom the equation estimated inaccurate energy needs leading to either over- or under-estimation. These data support the hypothesis that there are disease-specific determinants of EE in CKD but also that a more sophisticated approach to statistical modeling is warranted. a. Byham-Gray, LD, Parrott, JS, Peters, EN, Gould-Fogerite, SG, Hand, RK, Ahrens, S, Marcus, AF, Fiutem, JJ. Modeling a predictive energy equation specific for maintenance hemodialysis. J Parenter Enteral Nutr. ePub DOI: 10.1177/0148607117696942. b. Olejnik LA, Peters EN, Parrott JS, Marcus AF, Brody RA, Hand RK, Fiutem JJ, Byham-Gray LD. Abbreviated steady state intervals for measuring resting energy expenditure in patients on maintenance hemodialysis. J Parenter Enteral Nutr. Published online before print July 27, 2016, doi: 10.1177/0148607116660981 c. Byham-Gray LD, Parrott JS, Ho WY, Sundell MA, and Ikizler, TA. Development of predictive energy equation-A pilot study. J Renal Nutr. 2014;24:32-41 d. Byham-Gray LD. Weighing the evidence: Energy determinations across the spectrum of kidney disease. J Renal Nutr. 2006;16:17-26. 2. Another research contribution relates to studying the effect of nutrition interventions on clinical and patient-centered outcomes, particularly among the CKD population. Based on the seminal report by the Institute of Medicine (2001) titled “Crossing the Quality Chasm: A New Health Care System in the 21st Century,” a major goal of the health care industry (inclusive of institutions, practitioners, payors, and legislators) is to provide patient-centered care that is aimed at improving outcomes as well as being cost-effective. As such, nutrition interventions are a critical component for both preventive care and treatment of a myriad of diseases and conditions. Thus, my research interests have focused on investigating the effectiveness of nutrition therapy in the management of bone and mineral disorders in CKD and in pre-diabetes. I have also studied the impact of nutrition support therapies and interventions in critical illness and trauma. My research has shown that nutrition interventions make a significant impact on clinical and patient-centered outcomes. a. Sum SS, Marcus AF, Blair D, Olejnik LA, Cao J, Parrott JS, Peters EN, Byham-Gray LD. Comparison of Subjective Global Assessment and Protein Energy Wasting Score to Nutrition Evaluations conducted by Registered Dietitian Nutritionists in identifying risk of Protein Energy Wasting in Maintenance Hemodialysis Patients. Journal of Renal Nutrition, doi: 10.1053/j.jrn.2017.04.006. b. Parker AR, Byham-Gray L, Denmark R, and Winkle PJ. The effect of medical nutrition therapy by a registered dietitian nutritionist in patients with prediabetes participating in a randomized controlled clinical research trial. J Acad Nutr Diet. 2014;114(111):1739-1748. c. Moore LM, Byham-Gray LD, Parrott JS, Rigassio Radler D, Mandayam S, Jones SL, Mitch WE, and Gaber AO. The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines. Kidney Int. 2013; 83(4):724-32 d. Byham-Gray L, Drasher T, Deckman K, Graham D, Liftman C, Roberto L, Peiffer P, and Denmark R. Effect of aggressive renal osteodystrophy management on clinical outcomes stage 5 chronic kidney disease. J Renal Nutr. 2009;19:321-333. 3. The third area of science where I have made a significant contribution is related to dietetics education and practice. Most importantly, I have written or co-authored a few seminal papers for the profession that assist registered dietitian nutritionists being engaged in research and adding to the body of literature related to clinical dilemmas. a. Boyd, M, Gall, SB, Rothpletz-Puglia, P, Parrott, JS, King, C, Byham-Gray, LD. Characteristics and drivers of the registered dietitian nutritionist’s sustained involvement in clinical research activities: A mixed methods study. J Acad Nutr Diet. 119(12): 2099-2108. b. Brody RA, Byham-Gray L, Touger-Decker R, Passannante MR, Rothpletz Puglia P, O'Sullivan Maillet J. What clinical activities do advanced-practice registered dietitian nutritionists perform? Results of a Delphi study. J Acad Nutr Diet. 2014 May;114(5):718-33. doi: 10.1016/j.jand.2014.01.013. Epub 2014 Mar 13. PubMed PMID: 24630681. c. Byham-Gray LD, Gilbride JA, Dixon LB, Stage FK. Predictors for research involvement among registered dietitians. J Am Diet Assoc. 2006 Dec;106(12):2008-15. PubMed PMID: 17126632. Complete List of Published Work in MyBibliography: https://www.ncbi.nlm.nih.gov/myncbi/laura.byham-gray.1/bibliography/public/ D. Research Support Ongoing Rutgers Busch Biomedical Grant Byham-Gray (Co-PI) 9/1/19-8/31/21 Image-based DiEtary Assessment in Chronic Kidney Disease (IDEA-CKD) Description: Protein-energy malnutrition and wasting (PEW) is an independent risk factor for the poor health outcomes and premature death experienced in patients diagnosed with chronic kidney disease (CKD). Hypermetabolism is theorized as one of the key determinants for PEW. Achieving energy balance, and therefore optimal nutritional status, requires that daily dietary energy intake (DEI) equate to total energy expenditure (TEE). Concordant with other chronic diseases as well as the healthy population, our research team has demonstrated how current methods for DEI are inadequate for CKD. In addition, the NIDDK has a specific program announcement (PA-18-856: Diet and Physical Assessment Methodology) that requests applications addressing the current limitations of dietary assessment methods, inclusive of DEI in this patient population. Thus, the objective of this proposal is two-fold: to develop and validate computational machine learning algorithms for the recognition of food and related quantity using multimodal measurements from joint image and depth sensors. We anticipate that the proposed algorithms will more precisely measure dietary intake than traditional methods, while overcoming many of the barriers for their utilization. Designing this innovative approach of dietary assessment will enable us to further test it in a sample of patients diagnosed with CKD in a larger grant application with the goal of eventually making the algorithms available for public use. National Kidney Foundation Byham-Gray (PI) 10/1/18-9/30/20 Bone Outcomes, Nutrition, and Energy Expenditure Study in Chronic Kidney Disease (BONES-CKD) Description: While survival is improving among U.S. patients diagnosed with chronic kidney disease, they are still at considerable risk for poor outcomes. One factor explaining the high mortality rate is the presence of malnutrition and muscle wasting which may be associated with compensatory changes in bone and energy metabolism. This proposed study seeks to explore the relationship of alterations in bone health measures secondary to chronic kidney disease on body composition and energy expenditure. Accessing our expansive patient network, we will conduct this study among individuals diagnosed with stages 3-5 chronic kidney disease. By examining several bone disease markers, we will be able to determine a) whether mineral and bone disorders influence energy metabolism and b) if these influences are mediated by body composition. This knowledge will allow for earlier and more appropriate intervention and therefore prevent or treat abnormalities in mineral and bone disorders and improve patient outcomes Completed Dean’s Intramural Bridge Grant Byham-Gray (PI) 7/1/17-12/31/19 Linking Symptoms to Protein-Energy Wasting in Hemodialysis: KNOW SIGNS Description: Patients with stage 5 chronic kidney disease treated by maintenance hemodialysis experience a suboptimal functional status marked by low physical activity levels, prolonged sitting time, sarcopenia, frailty, and a diminished health-related quality of life (HR-QoL). Exercise interventions have shown improvement in functional abilities within this population, but the contribution of nutritional status and/or PEW on these outcomes remains unelucidated. In our AHRQ K18 grant, “Patient-Centered Approach to Protein-Energy Wasting in Hemodialysis, we have conducted deliberative panels of patients who rated maintaining functional status and improving HR-QoL as essential health outcomes. These findings verified that “the ability to do more” is what matters most to patients, and provides context for our proposed application. Our study will take a comprehensive, multi-faceted approach by documenting functional status through several quantitative measures. Additionally, we will integrate the patient voice in order to capture a more thorough analysis of the barriers for improving functional status and outline strategies for overcoming them using a mixed-methods design. Patient engagement is a unique methodological approach that will lay the groundwork for future studies in patient-centered outcomes research. 1K18HS023434-01A1 Byham-Gray (PI) 9/1/15-8/31/18 Patient-Centered Approach to Exploring Protein-Energy Wasting in Hemodialysis Description: The goals of our funded study are to 1) quantitatively assess which of the most meaningful etiological factors identified by patients/ stakeholders are the strongest determinants for PEW among incident dialysis patients in the Comprehensive Dialysis Study (CDS) data set, 2) examine whether a diagnosis of PEW predicts patient-centered outcomes (PCOs) among incident dialysis patients in the CDS dataset, and 3) critically evaluate, with patients/stakeholders, recently developed algorithms/guidelines in light of findings from goals 1 and 2 to determine their clinical relevance in reversing and/or preventing PEW and improving PCOs. Dean’s Intramural Bridge Grant Byham-Gray (PI) 7/1/16-12/31/17 Exploring Daily Activity and Total Energy Expenditure in the Adult Hemodialysis Population: A pilot study. Description: We have investigated one of the largest components of metabolic rate (e.g., calorie needs at rest), but this only explains part of the total energy requirements. We have not yet examined the calories expended during routine physical activity, and thus, determine its contribution to total energy expenditure (TEE). An accurate estimation of TEE in dialysis patients will lead to a significant reduction in the inappropriate administration of medical and nutritional therapies. The objective for this proposal is to investigate the TEE in a sample of patients maintained on hemodialysis and compare them to healthy individuals using the latest technologies. Our central hypothesis is that the amount of energy expended during physical activity is significantly different in hemodialysis patients than in the healthy subjects. The findings of this novel project will help in establishing more appropriate treatment regimens by providing more effective medical and nutritional care, and therefore, improving patient outcomes. 1R15DK090593-01A1; 6R15DK090593-02; 3R15DK090593-02S1 Byham-Gray (PI) 9/25/12-8/31/15 Development and Validation of a Predictive Energy Equation in Hemodialysis Description: The goals of this study were 1) to determine what clinical factors predict EE in patients diagnosed with stage 5 CKD on MHD; 2) to develop and validate a predictive energy equation that incorporates all of the influencing clinical factors measured in stage 5 CKD patients on MHD; and 3) to further test the clinical utility and application of this equation. Academy of Nutrition & Dietetics Byham-Gray (PI) 7/1/14-6/30/16 Validation of a Handheld Indirect Calorimeter in Patients Diagnosed with Stage 5 Chronic Kidney Disease on Maintenance Hemodialysis Description: The primary goal of this study is to validate a low-cost handheld IC device (MedGem®) in a pilot sample of patients diagnosed with stage 5 CKD on maintenance hemodialysis (MHD); thereby determining the reliability for use as an alternative to measuring REE in this unique population.


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