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Panduro A, Roman S, Mariscal-Martinez IM, Jose-Abrego A, Gonzalez-Aldaco K, Ojeda-Granados C, Ramos-Lopez O, Torres-Reyes LA. Personalized medicine and nutrition in hepatology for preventing chronic liver disease in Mexico. Front Nutr 2024; 11:1379364. [PMID: 38784134 PMCID: PMC11113077 DOI: 10.3389/fnut.2024.1379364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/01/2024] [Indexed: 05/25/2024] Open
Abstract
Chronic liver disease is a global health issue. Patients with chronic liver disease require a fresh approach that focuses on the genetic and environmental factors that contribute to disease initiation and progression. Emerging knowledge in the fields of Genomic Medicine and Genomic Nutrition demonstrates differences between countries in terms of genetics and lifestyle risk factors such as diet, physical activity, and mental health in chronic liver disease, which serves as the foundation for the implementation of Personalized Medicine and Nutrition (PerMed-Nut) strategies. Most of the world's populations have descended from various ethnic groupings. Mexico's population has a tripartite ancestral background, consisting of Amerindian, European, and African lineages, which is common across Latin America's regional countries. The purpose of this review is to discuss the genetic and environmental components that could be incorporated into a PerMed-Nut model for metabolic-associated liver disease, viral hepatitis B and C, and hepatocellular carcinoma in Mexico. Additionally, the implementation of the PerMed-Nut approach will require updated medicine and nutrition education curricula. Training and equipping future health professionals and researchers with new clinical and investigative abilities focused on preventing liver illnesses in the field of genomic hepatology globally is a vision that clinicians and nutritionists should be concerned about.
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Affiliation(s)
- Arturo Panduro
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Irene M. Mariscal-Martinez
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Alexis Jose-Abrego
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Karina Gonzalez-Aldaco
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
| | - Claudia Ojeda-Granados
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, Italy
| | - Omar Ramos-Lopez
- Medicine and Psychology School, Autonomous University of Baja California, Tijuana, Baja California, Mexico
| | - Luis A. Torres-Reyes
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico
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2
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Cuerda C, Muscaritoli M, Chourdakis M, Krznaric Z, Archodoulakis A, Gürbüz S, Berk K, Aapro M, Farrand C, Patja K, Schneider S, Barazzoni R. Nutrition education in medical schools (NEMS) project: Promoting clinical nutrition in medical schools - Perspectives from different actors. Clin Nutr 2023; 42:54-59. [PMID: 36473759 DOI: 10.1016/j.clnu.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND & AIMS Nutrition education is not adequately represented in the medical curriculum, and this prompted the European Society for Clinical Nutrition and Metabolism (ESPEN) to launch the Nutrition Education in Medical Schools (NEMS) Project in 2017. The aim of this original paper was to describe the perspectives of different actors in the promotion of nutrition education in medical schools. METHODS On 11 November 2021, an online meeting was held on this topic, where nine representatives from different backgrounds participated in the scientific programme. More than 640 participants registered to this webinar. RESULTS The different models of Nutrition Education in Medical Schools were introduced by Prof. Cristina Cuerda (Spain) and Prof. Maurizio Muscaritoli (Italy). The students' perspective was given by Ms. Alexandra Archodoulakis (Germany) and Ms. Sila Gürbüz (Turkey), representing the European Medical Students' Association. The dietitian's perspective was given by Dr. Kirsten Berk (The Netherlands), whereas Dr. Matti Aapro (Switzerland) gave the medical doctor (oncology)'s perspective. Ms. Clare Farrand (Australia) gave the WHO perspective and Dr. Kristiina Patja (Finland) explained the healthy lifestyle teaching to medical students. Lastly, Prof. Michael Chourdakis (Greece) and Prof. Zeljko Krznaric (Croatia) hosted the round-table discussion. CONCLUSIONS There was strong agreement among the representatives from different settings joining this ESPEN initiative that increasing nutritional knowledge and skills of young doctors is now possible and will launch a virtuous cycle that will proactively involve all the other healthcare professionals working in the nutritional field.
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Affiliation(s)
- C Cuerda
- Department of Medicine, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - M Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - M Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Z Krznaric
- Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb, University of Zagreb, Croatia
| | | | - S Gürbüz
- Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - K Berk
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - M Aapro
- Oncology Department, Genolier Cancer Center, Clinique de Genolier, Genolier, Switzerland
| | - C Farrand
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office), Copenhagen, Denmark
| | - K Patja
- Department of Public Health, Medical Faculty, University of Helsinki, Finland
| | - S Schneider
- Gastroenterology and Nutrition, Centre Hospitalier Universitaire de Nice, Universite Cote d'Azur, Nice, France
| | - R Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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3
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Ganguli SC, Russell LA, Tsoi KS. Implementation of a Whole Food Plant Based Diet in a Food as Prevention Program in a Resource Constrained Environment. J Lifestyle Med 2022; 12:148-152. [PMID: 36628184 PMCID: PMC9798881 DOI: 10.15280/jlm.2022.12.3.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background The efficacy of a Whole Food Plant-based (WFPB) diet has been shown in randomized controlled trials in diabetes, cardiovascular disease and obesity. However, it's effectiveness in routine clinical settings is less well documented. This study describes the implementation and outcomes of a "Food as Prevention" program run by a single clinician. Methods Participants were referred to a "Food as Prevention" program run by a single gastroenterologist at an academic teaching center. The program included 5 physician-led discussion and small group educational sessions. Data collected included demographics, weight and biochemical measurements before and after completion of the program. Statistical analysis included paired t-test and Pearson correlation coefficients were used to assess differences before and after WFPB implementation. Results A total of 17 participants (age 59 years; 59% female) with an average weight of 90.0 kg attended a median of 3 group sessions. Majority of patients had hyperlipidemia (71%) followed by hypertension (47%) and coronary artery disease (35%), fatty liver disease (35%) and diabetes mellitus (29%). Adoption of a WFPB diet led to significant decreases in weight (4.3 kg; p < 0.01), total cholesterol (0.72 mmol/L; p = 0.046), and triglycerides (0.53 mmol/L; p = 0.005) with an increase in high-density lipoprotein (HDL) (0.10 mmol/L; p = 0.01).Conclusions Implementation of the WFPB diet in this novel pilot program led to weight loss and improvement in biochemical markers of disease. Future studies are needed to implement this model on a larger scale.
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Affiliation(s)
- Subhas C. Ganguli
- Department of Gastroenterology, McMaster University, Hamilton, Canada,Corresponding author: Subhas C. Ganguli, Department of Gastroenterology, McMaster University, St. Joseph’s Hospital, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, CanadaTel: 1-905-1155 ext 35109, Fax: 1-905-526-0540, E-mail:
| | - Lindsey A. Russell
- Department of Gastroenterology, McMaster University, Hamilton, Canada,Farncombe Family Digestive Health Research Institute, Hamilton, Canada
| | - Keith S. Tsoi
- Department of Gastroenterology, McMaster University, Hamilton, Canada
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4
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Pujia A, Montalcini T, Donini LM, Frittitta L, Galvano F, Natali A, Pironi L, Porrini M, Riso P, Rivellese AA, Russo D, Scapagnini G, Serafini M, Tagliabue A, De Lorenzo A. Roles and competencies in the nutritional domain for the management of the metabolic diseases and in the hospital setting: A position paper of the Italian College of Academic Nutritionists, MED-49 (ICAN-49). Nutr Metab Cardiovasc Dis 2021; 31:2993-3003. [PMID: 34518088 DOI: 10.1016/j.numecd.2021.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/19/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
Epidemiological evidence has confirmed the potential causal relationship between specific dietary factors and non-communicable diseases. However, currently nutrition was shown to be insufficiently integrated into medical education, regardless of the country. Without an adequate nutrition education, it is reasonable to assume that future physicians, as well as other health care professionals, will be not able to provide the highest quality care to patients in preventing and treating non-communicable diseases. Furthermore, the insufficient availability of physicians with specializations in nutrition has posed the basis for the development of non-medical careers in the field of nutrition. The present document was drafting by the Italian College of Academic Nutritionists, MED-49 (ICAN-49), with the aim to provide an overview on the nutritional competency standards covered by several health care professionals (Physicians Clinical Nutrition Specialists, Clinical Dietitians, Professional Clinical Nutrition Specialists, etc) for the prevention of diseases and/or support of pharmacological therapies. The aim of the ICAN 49 is to suggest a major shift in practice opportunities and roles for many nutritionists, especially for the management of the metabolic diseases, and promote a paradigm change: a clinical and educational leadership role for Physician Clinical Nutrition Specialists in the hospital setting.
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Affiliation(s)
- Arturo Pujia
- Department of Medical and Surgical Science, University of Catanzaro Magna Grecia, Viale Europa, Catanzaro, 88100, Italy.
| | - Tiziana Montalcini
- Department of Clinical and Experiment Medicine, University of Catanzaro Magna Grecia, Viale Europa, Catanzaro, 88100, Italy.
| | - Lorenzo M Donini
- Department of Experimental Medicine, University of La Sapienza, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - Lucia Frittitta
- Department of Clinical and Experiment Medicine, University of Catania, Via Santa Sofia, 86-95123, Catania, Italy.
| | - Fabio Galvano
- Department of Biomedical and Biotechnology Science, University of Catania, Via Santa Sofia, 86-95123, Catania, Italy.
| | - Andrea Natali
- Department of Clinical and Experiment Medicine, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126, Pisa, Italy.
| | - Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria, 2, 20133, Milano, Italy.
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences, University of Milan, Via Celoria, 2, 20133, Milano, Italy.
| | - Angela Albarosa Rivellese
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Corso Umberto I, 40, 80138, Napoli, Italy.
| | - Diego Russo
- Department of Health Science, University of Catanzaro Magna Grecia, Viale Europa, 88100, Catanzaro, Italy.
| | - Giovanni Scapagnini
- Department of Medicine and Health Science, University of Molise, Via F. De Sanctis, 86100, Campobasso, Italy.
| | - Mauro Serafini
- Faculty of Biosciences and Technologies for Agriculture, Food and Environment, University of Teramo, Via Renato Balzarini, 1, 64100, Teramo, Italy.
| | - Anna Tagliabue
- Department of Public Health, University of Pavia, Via Agostino Bassi, 21, 27100, Pavia, Italy.
| | - Antonino De Lorenzo
- Biomedicine and Prevention, University of Tor Vergata, Via Montpellier, 1, 00133, Roma, Italy.
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5
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Abu Farha RJ, Zein MH, Al Kawas S. Introducing integrated case-based learning to clinical nutrition training and evaluating students' learning performance. J Taibah Univ Med Sci 2021; 16:558-564. [PMID: 34408613 PMCID: PMC8348321 DOI: 10.1016/j.jtumed.2021.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
Objectives Clinical nutrition training is an essential course for clinical nutrition and dietetics (CN&D) students. The training combines theoretical knowledge with practical skills. The goal is to prepare competent graduates for future practice. Case-based learning is an active learning method based on cases from the clinical setting. This study aimed to introduce an integrated case-based learning (ICBL) method to the clinical training of a cohort of CN&D students and to evaluate its impact on the students’ knowledge of nutrition care process. Methods This action research project employed an ICBL-method of teaching in the clinical training of senior students in the CN&D course at the University of Sharjah, United Arab Emirates. Ten integrated case-based learning sessions were conducted with 29 students. The record of the nutrition care process was used to evaluate the learners' performance through a pretest-posttest mechanism. Furthermore, a focus group interview was conducted to determine the impact of the ICBL-based training on the students' learning experience. Results All of the students (100%) showed improvement in their learning. There was a 55% improvement in their grades. There was also self-perceived improvement of their life-long learning skills after the ICBL sessions. Conclusion Integraed case-based learning positively influenced learning among CN&D students. Consequently, the students were able to describe appropriate and individualized nutritional care plans. The students were satisfied with the training and considered ICBL to be an effective method of clinical training.
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Affiliation(s)
- Rand J Abu Farha
- Master's in Leadership in Health Professions Education, College of Medicine, University of Sharjah, United Arab Emirates
| | - Mona H Zein
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, United Arab Emirates
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6
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Caccialanza R, De Lorenzo F, Lobascio F, Gnagnarella P, Iannelli E, Traclò F, Delrio P, Tancredi R, Pedrazzoli P. Nutritional care in cancer patients: Initiatives and perspectives of the Italian Intersociety Working Group for Nutritional Support in Cancer Patients. Nutrition 2021; 91-92:111358. [PMID: 34303958 DOI: 10.1016/j.nut.2021.111358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/07/2021] [Accepted: 05/18/2021] [Indexed: 01/07/2023]
Abstract
Malnutrition is a frequent comorbidity in people with cancer, associated with poor tolerance of anticancer treatments, prognosis, and quality of life. Despite the abundance of scientific literature supporting this evidence and the availability of international guidelines for managing nutritional care in people with cancer, attitudes about this issue still vary considerably among oncologists, to the point that many patients who are malnourished do not receive adequate nutritional support. In view of this, the Italian Association of Medical Oncology, the Italian Society of Artificial Nutrition and Metabolism, and the Italian Federation of Volunteer-based Cancer Organizations implemented in 2016 a collaborative working group and initiated a structured project called Integrating Nutritional Therapy in Oncology, with the aim of increasing oncologists' awareness of nutritional issues and consequently improving the nutritional care of cancer patients in Italy. In 2019, the Italian Society of Oncological Surgery and the Technical Scientific Association of Food, Nutrition and Dietetics joined the working group. In this article, we present the updated initiatives and the perspectives of this intersociety project.
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Affiliation(s)
- Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | | | - Federica Lobascio
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCSS, Milan, Italy
| | | | - Francesca Traclò
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
| | - Paolo Delrio
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Giovanni Pascale IRCCS, Naples, Italy
| | - Richard Tancredi
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine, University of Pavia, Pavia, Italy
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7
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Cardenas D, Díaz G, Fuchs-Tarlovsky V, Cristina Gonzalez M, Carrasco F, Cano AMP, Bermúdez C, Maza C, Ferraresi E, Lipovestky F, Villafana H, Arenas-Márquez H, Calvo I, Cordova LRA, Canicoba M, Sánchez P, Santana S, Tihista S, Adrianza de Baptista GM, Garcia Y, Correia MITD. Nutrition competencies for undergraduate medical education: Results of an international interdisciplinary consensus. JPEN J Parenter Enteral Nutr 2021; 46:635-645. [PMID: 34117790 DOI: 10.1002/jpen.2203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The gap between the nutrition education provided to medical students and the nutrition competencies and attitudes needed for physicians to provide adequate nutrition care is a global concern. There is no universally accepted benchmark on nutrition competencies for doctors. The objective of this study was to establish, by expert consensus, the objectives of undergraduate nutrition medial education, the nutrition core competencies, and strategies for curriculum development in medical nutrition education. METHODS We administered a Delphi survey to systematically gather the opinion of a panel of Latin American experts in nutrition. The survey questionnaire was constructed considering scientific literature by using a 5-point Likert scale. Consensus was defined as >70% agreement on the importance of an item (Likert scale 4 and 5). RESULTS A four-round Delphi survey was conducted for this research. In the second, third, and fourth rounds, we validated a total of 130 competencies by consensus, which were distributed into four different thematic areas: (1) basic nutrition concepts, (2) public nutrition and nutrition prevention throughout the life cycle, (3) nutrition status and disease, and (4) nutrition care process. CONCLUSION The curricula for general physician education in medical school must include health promotion, prevention, and treatment of diseases related to nutrition. This goal can be reached by integrating ≤130 competencies into four different fundamental areas.
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Affiliation(s)
- Diana Cardenas
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | - Gustavo Díaz
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | | | | | | | | | - Charles Bermúdez
- Surgery department, Clinica la Colina, Clinica del Country, Bogotá, Colombia
| | - Claudia Maza
- Clinical Nutrition Section, Centro Médico Militar, Universidad del Valle de Guatemala, Guatemala
| | - Eduardo Ferraresi
- Hospital Interzonal General de Agudos Profesor Dr Rodolfo Rossi, La Plata, Buenos Aires, Argentina
| | | | - Haydee Villafana
- Faculty of Pharmacy and Biochemistry, Universidad Nacional de Trujillo, Perú
| | | | - Isabel Calvo
- Nutrition service, Hospital General de Tijuana, México
| | | | - Marisa Canicoba
- Hospital National Alejandro Posadas, Universidad de Buenos Aires, Argentina
| | - Paola Sánchez
- Faculty of Medicine, Universidad Hispanoamericana, San José, Costa Rica.,Faculty of Medicina Universidad de Ciencias Médicas, San José, Costa Rica.,Faculty of Medicine Universidad Latina, San José, Costa Rica
| | - Sergio Santana
- Hospital Pediátrico Juan Manuel Márquez, Marianao, Ciudad de la Habana, Cuba
| | | | | | - Yawelida Garcia
- Faculty of Nutrition, Universidad O&M, Santo Domingo, Dominican Republic
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8
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Cuerda C, Muscaritoli M, Krznaric Z, Pirlich M, Van Gossum A, Schneider S, Ellegard L, Fukushima R, Chourdakis M, Della Rocca C, Milovanovic D, Lember M, Arias-Diaz J, Stylianidis E, Anastasiadis K, Alunni V, Mars T, Hellerman MI, Kujundžić-Tiljak M, Irtun O, Abbasoglu O, Barazzoni R. Nutrition education in medical schools (NEMS) project: Joining ESPEN and university point of view. Clin Nutr 2021; 40:2754-2761. [PMID: 33933741 DOI: 10.1016/j.clnu.2021.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/07/2021] [Accepted: 03/08/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Nutrition education is not well represented in the medical curriculum. The aim of this original paper was to describe the Nutrition Education in Medical Schools (NEMS) Project of the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS On 19 January 2020, a meeting was held on this topic that was attended by 51 delegates (27 council members) from 34 countries, and 13 European University representatives. RESULTS This article includes the contents of the meeting that concluded with the signing of the Manifesto for the Implementation of Nutrition Education in the Undergraduate Medical Curriculum. CONCLUSION The meeting represented a significant step forward, moved towards implementation of nutrition education in medical education in general and in clinical practice in particular, in compliance with the aims of the ESPEN Nutrition Education Study Group (NESG).
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Affiliation(s)
- C Cuerda
- Nutrition Unit. Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - M Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Z Krznaric
- Department of Gastroenterology, Hepatology and Nutrition, University Hospital Centre Zagreb, University of Zagreb, Croatia
| | - M Pirlich
- Imperial Oak Outpatient Clinic, Endocrinology, Gastroenterology & Clinical Nutrition, Berlin, Germany
| | - A Van Gossum
- Department of Gastroenterology and Nutritional Support, Hopital Erasme and Institut Bordet, Free University of Brussels, Brussels, Belgium
| | - S Schneider
- Department of Gastroenterology and Nutrition, CHU de Nice, Université Côte D'Azur, Nice, France
| | - L Ellegard
- Sahlgrenska Academy at the University of Gothenborg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - R Fukushima
- Department of Surgery, Teikyo University School of Medicine, Japan
| | - M Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - C Della Rocca
- Dean of the Faculty of Pharmacy and Medicine, Sapienza University of Rome, Italy
| | - D Milovanovic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences University of Kragujevac, Kragujevac, Serbia
| | - M Lember
- Dean of the Faculty of Medicine, University of Tartu, Estonia
| | - J Arias-Diaz
- Dean of the Faculty of Medicine, Complutense University, Madrid, Spain
| | - E Stylianidis
- Vice Rector for Research and Lifelong Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Anastasiadis
- Dean of the School of Medicine, Aristotle University of Thessaloniki, Greece
| | - V Alunni
- Vice Dean of the Faculty of Medicine for Education, Université Côte D'Azur, Nice, France
| | - T Mars
- Vice Dean Erasmus LLP Coordinator, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - M I Hellerman
- Department of General Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva 49100, Israel
| | - M Kujundžić-Tiljak
- Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Croatia
| | - O Irtun
- Gastrosurgical Research Group, Department of Clinical Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - O Abbasoglu
- Department of Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - R Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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9
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How Healthy Are Health-Related Behaviors in University Students: The HOLISTic Study. Nutrients 2021; 13:nu13020675. [PMID: 33669884 PMCID: PMC7926492 DOI: 10.3390/nu13020675] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this cross-sectional study was to assess the health-related behaviors among university students, with emphasis on health sciences students from Croatia, Italy, Lebanon, Poland, Romania, Spain and Turkey. We included 6222 students in Medicine, Dentistry, Nursing, Pharmacy, Nutrition and Dietetics, Sports Sciences, Veterinary, and Economics enrolled between April 2018 and March 2020. We assessed dietary patterns, sleeping habits, physical activity and perceived stress among students by means of validated questionnaires. The median age ranged between 19 and 24 years, smoking prevalence between 12.0% and 35.4%, and body mass index (BMI) ranged between 21.1 and 23.2 kg/m2. Breakfast was less often and more often consumed daily in Turkey (36.7%), and Italy (75.7%), respectively. The highest Mediterranean diet score was recorded in Spain and Italy, and the lowest in Turkey, followed by students from Croatia, Lebanon, Poland and Romania. Sleep duration, physical activity and stress perception also differed between countries. Multivariable regression analysis revealed a small, but positive association between BMI and several characteristics, including age, female gender, smoking, physical activity, mobile phone use, and perceived stress. A negative association was found between BMI and sleep duration on non-working days. Self-rated health perception was positively associated with female gender, breakfast, physical activity, and time spent studying, and negatively with BMI, smoking and stress. Our results demonstrated diverse habits in students from different countries, some of which were less healthy than anticipated, given their educational background. Greater emphasis needs to be placed on improving the lifestyle of these adolescents and young adults, who will be tomorrow’s healthcare workers.
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10
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Bassaganya-Riera J, Berry EM, Blaak EE, Burlingame B, le Coutre J, van Eden W, El-Sohemy A, German JB, Knorr D, Lacroix C, Muscaritoli M, Nieman DC, Rychlik M, Scholey A, Serafini M. Goals in Nutrition Science 2020-2025. Front Nutr 2021; 7:606378. [PMID: 33665201 PMCID: PMC7923694 DOI: 10.3389/fnut.2020.606378] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022] Open
Abstract
Five years ago, with the editorial board of Frontiers in Nutrition, we took a leap of faith to outline the Goals for Nutrition Science - the way we see it (1). Now, in 2020, we can put ourselves to the test and take a look back. Without a doubt we got it right with several of the key directions. To name a few, Sustainable Development Goals (SDGs) for Food and Nutrition are part of the global public agenda, and the SDGs contribute to the structuring of international science and research. Nutritional Science has become a critical element in strengthening work on the SDGs, and the development of appropriate methodologies is built on the groundwork of acquiring and analyzing big datasets. Investigation of the Human Microbiome is providing novel insight on the interrelationship between nutrition, the immune system and disease. Finally, with an advanced definition of the gut-brain-axis we are getting a glimpse into the potential for Nutrition and Brain Health. Various milestones have been achieved, and any look into the future will have to consider the lessons learned from Covid-19 and the sobering awareness about the frailty of our food systems in ensuring global food security. With a view into the coming 5 years from 2020 to 2025, the editorial board has taken a slightly different approach as compared to the previous Goals article. A mind map has been created to outline the key topics in nutrition science. Not surprisingly, when looking ahead, the majority of scientific investigation required will be in the areas of health and sustainability. Johannes le Coutre, Field Chief Editor, Frontiers in Nutrition.
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Affiliation(s)
- Josep Bassaganya-Riera
- Nutritional Immunology and Molecular Medicine Laboratory (NIMML) Institute, Blacksburg, VA, United States
| | - Elliot M Berry
- Braun School of Public Health, Hebrew University - Hadassah Medical School, Jerusalem, Israel
| | - Ellen E Blaak
- Department of Human Biology, Maastricht University, Maastricht, Netherlands
| | | | - Johannes le Coutre
- School of Chemical Engineering, University of New South Wales, Sydney, NSW, Australia
| | - Willem van Eden
- Department of Infectious Diseases and Immunology, Utrecht University, Utrecht, Netherlands
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - J Bruce German
- Department of Food Science and Technology, University of California, Davis, Davis, CA, United States
| | - Dietrich Knorr
- Institute of Food Technology and Chemistry, Technische Universität Berlin, Berlin, Germany
| | - Christophe Lacroix
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - David C Nieman
- Human Performance Laboratory, Department of Biology, Appalachian State University, Kannapolis, NC, United States
| | - Michael Rychlik
- Technical University of Munich, Analytical Food Chemistry, Freising, Germany
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC, Australia
| | - Mauro Serafini
- Functional Food and Metabolic Stress Prevention Laboratory, Faculty of Biosciences and Technologies for Agriculture, Food and Environment, University of Teramo, Teramo, Italy
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11
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Moullet C, Schmutz E, Laure Depeyre J, Perez MH, Cotting J, Jotterand Chaparro C. Physicians' perceptions about managing enteral nutrition and the implementation of tools to assist in nutritional decision-making in a paediatric intensive care unit. Aust Crit Care 2020; 33:219-227. [PMID: 32414683 DOI: 10.1016/j.aucc.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/08/2020] [Accepted: 03/14/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND For critically ill children hospitalised in paediatric intensive care units, adequate nutrition reduces their risk of morbidity and mortality. Barriers may impede optimal nutritional support in this population. Moreover, physicians are usually responsible for prescribing nutrition, although they are not experts. Therefore, tools may be used to assist in nutritional decision-making, such as nutrition protocols. OBJECTIVES The objective of this two-stage qualitative study was to explore the perceptions of physicians about their management of enteral nutrition in a paediatric intensive care unit and the implementation of a nutrition protocol and computerised system. METHODS This study involved semistructured interviews with physicians at the Paediatric Intensive Care Unit of Lausanne University Hospital, Switzerland. Research dietitians conducted interviews before (stage one) and after (stage two) the implementation of a nutrition protocol and computerised system. During stage one, six junior physicians and five fellows were interviewed. At stage two, 12 junior physicians, 12 fellows, and five senior physicians were interviewed. Interviews were recorded, with data transcribed verbatim before a thematic analysis using a framework method. RESULTS Three themes emerged from thematic analysis: "nutritional knowledge", "nutritional practices", and "resources to manage nutrition". During stage one, physicians, especially junior physicians, reported a lack of nutritional knowledge for critically ill children and stated that nutritional issues primarily depended on senior physicians, who themselves had various practices. All physicians were in favour of a nutrition protocol and computerised system. At stage two, interviewees stated that they used both tools regularly. They reported improved nutritional knowledge, more systematic and consistent nutritional practices, and increased attention to nutrition. CONCLUSIONS The implementation of a nutrition protocol and computerised system by a multiprofessional team helped physicians in the paediatric intensive care unit to manage nutritional support and increase their attention to nutrition.
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Affiliation(s)
- Clémence Moullet
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Rue des Caroubiers 25, 1227 Carouge, Geneva, Switzerland.
| | - Elodie Schmutz
- HES-SO Master, University of Applied Sciences and Arts Western Switzerland, Avenue de Provence 6, 1007 Lausanne, University of Lausanne, Switzerland.
| | - Jocelyne Laure Depeyre
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Rue des Caroubiers 25, 1227 Carouge, Geneva, Switzerland.
| | - Marie-Hélène Perez
- Pediatric Intensive Care Unit, Lausanne University Hospital (CHUV/UNIL), Rue Du Bugnon 46, 1011 Lausanne, Switzerland.
| | - Jacques Cotting
- Pediatric Intensive Care Unit, Lausanne University Hospital (CHUV/UNIL), Rue Du Bugnon 46, 1011 Lausanne, Switzerland.
| | - Corinne Jotterand Chaparro
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Rue des Caroubiers 25, 1227 Carouge, Geneva, Switzerland.
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12
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Bozzetti F, Isenring L. Historical perspective on parenteral and enteral nutrition in oncology. Nutrition 2019; 67-68:110545. [PMID: 31561204 DOI: 10.1016/j.nut.2019.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Federico Bozzetti
- Faculty of Medicine, Oncology, University of Milan, Lombardia, Italy
| | - Liz Isenring
- Nutrition and Dietetics Research Group, Bond University, Robina, Australia
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13
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Cuerda C, Muscaritoli M, Donini LM, Baqué P, Barazzoni R, Gaudio E, Jezek D, Krznaric Z, Pirlich M, Schetgen M, Schneider S, Vargas JA, Van Gossum A. Nutrition education in medical schools (NEMS). An ESPEN position paper. Clin Nutr 2019; 38:969-974. [DOI: 10.1016/j.clnu.2019.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 01/25/2023]
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14
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Grammatikopoulou MG, Katsouda A, Lekka K, Tsantekidis K, Bouras E, Kasapidou E, Poulia KA, Chourdakis M. Is continuing medical education sufficient? Assessing the clinical nutrition knowledge of medical doctors. Nutrition 2018; 57:69-73. [PMID: 30153582 DOI: 10.1016/j.nut.2018.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/24/2018] [Accepted: 05/13/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Provision of nutritional support (NS) can improve disease outcome and shorten hospital length of stay. NS, often prescribed by medical doctors, requires adequate clinical nutrition (CN) expertise. The aim of this study was to investigate self-perceived and actual CN knowledge among medical doctors in Greece. METHODS Internal medicine physicians and surgical specialties (residents and specialized) were asked to self-evaluate their CN expertise, via a seven-item questionnaire and to complete a 20-question multiple-choice test on CN topics, with the aim of evaluating their actual CN knowledge. Participants were discouraged from accessing literature/information during the completion of either questionnaire. RESULTS Of 182 invited medical doctors, 115 (50.4% surgical specialties) participated in the study (63.2% response rate). The majority of participants (65.2%) demonstrated inadequate CN knowledge, with 30.4% of those scoring low having a high self-perception of their CN expertise. Comparison of perceived and actual CN knowledge revealed that only 56.5% of the participants estimated their knowledge correctly. Those who had participated in CN continuous medical education courses demonstrated increased related expertise (P = 0.002). CONCLUSIONS Medical doctors in Greece demonstrate low knowledge of fundamental CN principles, jeopardizing the provision of high-quality and efficient NS. Most importantly, the majority of participants overestimated their CN knowledge and prescribe artificial nutrition or participate in related decision making. Physicians' CN knowledge should be enhanced accordingly, either by attending CN modules during their studies, by participating in basic and advanced courses or CN-specific continuous medical education, or both.
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Affiliation(s)
- Maria G Grammatikopoulou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Katsouda
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kyriaki Lekka
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Tsantekidis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Bouras
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Kasapidou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Michael Chourdakis
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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15
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16
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Blumberg JB, Cena H, Barr SI, Biesalski HK, Dagach RU, Delaney B, Frei B, Moreno González MI, Hwalla N, Lategan-Potgieter R, McNulty H, van der Pols JC, Winichagoon P, Li D. The Use of Multivitamin/Multimineral Supplements: A Modified Delphi Consensus Panel Report. Clin Ther 2018; 40:640-657. [DOI: 10.1016/j.clinthera.2018.02.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/19/2018] [Accepted: 02/23/2018] [Indexed: 12/13/2022]
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17
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Cuerda C, Schneider SM, Van Gossum A. Clinical nutrition education in medical schools: Results of an ESPEN survey. Clin Nutr 2017; 36:915-916. [PMID: 28511999 DOI: 10.1016/j.clnu.2017.05.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/02/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Cristina Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Stéphane M Schneider
- Department of Gastroenterology and Clinical Nutrition, Archet Hospital, University of Nice Sophia Antipolis, Nice, France
| | - André Van Gossum
- Department of Gastroenterology, Clinic of Intestinal Diseases and Nutritional Support, Hopital Erasme, Free University of Brussels, Brussels, Belgium
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