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Li X, Bai Y, Weng L, Bai Y, Gong W. COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study. Hum Vaccin Immunother 2024; 20:2315663. [PMID: 38439589 PMCID: PMC10936594 DOI: 10.1080/21645515.2024.2315663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.
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Affiliation(s)
- Xiaoyu Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yanping Bai
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lijun Weng
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yunshan Bai
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
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2
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Znyk M, Kaleta D. Healthy lifestyle counseling, and barriers perceived by general practitioners in Poland. Front Public Health 2023; 11:1256505. [PMID: 37829088 PMCID: PMC10565007 DOI: 10.3389/fpubh.2023.1256505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction The aim of the study was to determine the influence of the personal factors, such as body mass index (BMI), of general practitioners (GPs), and their counseling on weight management, healthy lifestyle, and their perceived barriers. Materials and methods The cross-sectional study was conducted from January 2020 to December 2021 among 161 GPs in the city of Lodz. Results Only 3.7% of physicians always advised their patients on diet and physical activity (p < 0.05). Most of the GPs (54%) provide counseling occasionally. GPs gave general advice more often to patients with chronic diseases than to patients who did not. The study showed that the chance of providing advice on eating habits or physical activity was significantly higher for the GPs who practiced physical activity (OR = 2.64; 95%Cl: 1.01-6.91, p < 0.05) and measured patient weight, height, and BMI (OR = 4.86; 95%Cl: 1.86-12.67, p < 0.001). GPs who were overweight (OR = 3.55; 95%Cl: 1.49-8.41, p < 0.01) and measured patient weight, height, and BMI (OR = 3.61; 95%Cl: 1.58-8.25, p < 0.01) were more likely to advise on nutrition or physical activity to "healthy" patients. Doctors who measured patient weight, height, and BMI advised patients with chronic diseases (OR = 6.45; 95%Cl: 2.54-16.34, p < 0.001). Over 40% of GPs believe that they are not effective in counseling. Lack of time turned out to be the main barrier to counseling for 73.3% of GPs, which was associated with heavy workload (>100 visits per week). Conclusion As many GPs doubt their effectiveness, it is recommended that GPs attend more training activities regarding counseling. In addition, organizational changes are needed to reduce patient numbers, and financial incentives are needed to improve counseling and patient measurement.
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Affiliation(s)
- Małgorzata Znyk
- Department of Hygiene and Epidemiology, Medical University of Lodz, Lodz, Poland
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Vrkatić A, Grujičić M, Jovičić-Bata J, Novaković B. Nutritional Knowledge, Confidence, Attitudes towards Nutritional Care and Nutrition Counselling Practice among General Practitioners. Healthcare (Basel) 2022; 10:2222. [PMID: 36360563 PMCID: PMC9691229 DOI: 10.3390/healthcare10112222] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 08/04/2023] Open
Abstract
Nutritional care represents any practice provided by a health professional, aimed to improve the patient's health outcomes by influencing patient's dietary habits. Clearly, dietitians are the ones supposed to provide top-quality nutrition care, but their services are often inaccessible to many for various reasons. This obliges general practitioners (GPs) in primary health care to provide nutritional counselling to their patients to a certain extent. Preconditions to successful nutritional counselling are GPs with adequate nutritional knowledge, positive attitudes towards nutrition and nutritional care, self-confident and competent in nutritional counselling. Therefore, the aim of this review is to summarise currently available information on nutritional knowledge, confidence and attitudes towards nutritional care and nutrition counselling practice of GPs, as well as barriers towards provision of nutritional counselling. GPs do not consistently obtain satisfying results in nutrition knowledge assessments and their self-confidence in nutrition counselling skills varies. Studies suggest that nutritional counselling practice still has not met its full potential, and GPs frequently report various barriers that impair nutritional counselling practice. Thus, health policies that help overcome barriers and create stimulating environment for GPs to implement nutrition counselling strategies efficiently are the key to improving quality and quantity of nutritional counselling.
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Affiliation(s)
- Aleksandra Vrkatić
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
| | - Maja Grujičić
- Department of General Education Subjects, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
| | - Jelena Jovičić-Bata
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
| | - Budimka Novaković
- Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
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Williams AR, Hines AL, Dow AW, Sabo RT, Thomson MD. Are primary care providers' nutrition care and food insecurity screening practices associated with their perceptions of team-based care? Fam Pract 2022; 39:860-867. [PMID: 35325099 DOI: 10.1093/fampra/cmac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Screening for food insecurity (FI) and providing nutrition care are important management strategies for chronic diseases, but rates are low. Aspects of team-based care and providers' nutrition competence may help inform interventions to improve these services. The objectives of this study were to describe US primary care providers' FI screening and nutrition care practices (counselling, referrals, and time spent counselling) and test for associations with scored measures of their perceptions of team-based care (care continuity, patient-centredness, coordination with external providers and resources) and nutrition competence (confidence counselling and attitudes towards nutrition). METHODS Cross-sectional online survey data of primary care providers were described and analysed for associations using Wilcoxon rank sum tests. RESULTS Of provider respondents (N = 92), 35% (n = 32) worked in clinics that screen for FI and had higher team perceptions (P = 0.006) versus those who do not. Those who reported counselling >30% patients about nutrition (57%, n = 52) and referring >10% patients to nutrition professionals (24%, n = 22) had significantly better attitudes towards nutrition (P = 0.013 and P = 0.04, respectively) compared with those with lower counselling and referral rates. Half (n = 46) of the providers reported spending >3-min counselling each patient about nutrition and had higher patient-centred care (P = 0.004) and nutrition competence (P < 0.001) compared with those who spent less time counselling. CONCLUSION Providers in clinics that screen for FI had higher overall perceptions of team-based care, but their nutrition competence was not significantly different. Meanwhile, reported more time counselling was associated with a culture of patient-centredness. Promoting team-based care may be a mechanism for improving FI screening and nutrition care.
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Affiliation(s)
- April R Williams
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Anika L Hines
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan W Dow
- School of Medicine, IPE Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Roy T Sabo
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.,C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA
| | - Maria D Thomson
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
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5
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Reuzé A, Méjean C, Carrère M, Sirieix L, Druesne-Pecollo N, Péneau S, Touvier M, Hercberg S, Kesse-Guyot E, Allès B. Rebalancing meat and legume consumption: change-inducing food choice motives and associated individual characteristics in non-vegetarian adults. Int J Behav Nutr Phys Act 2022; 19:112. [PMID: 36050684 PMCID: PMC9438278 DOI: 10.1186/s12966-022-01317-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
Background A shift toward more plant-based foods in diets is required to improve health and to reduce environmental impact. Little is known about food choice motives and associated characteristics of those individuals who have actually reduced their consumption of animal-based foods. The aim of this cross-sectional study was to identify change-inducing motives related to meat and legume consumptions among non-vegetarians. The association between change-inducing motives and individual characteristics was also studied. Methods This study included 25,393 non-vegetarian participants in the French NutriNet-Santé cohort (77.4% women, mean age 55.4 ± 13.9 y.). The motives related to the declared change in meat and legume consumptions (e.g., taste, environment, social pressure) were assessed by an online questionnaire in 2018. For each motive, respondents could be classified into three groups: no motive; motive, not change-inducing; change-inducing motive. Associations between change-inducing motives and individual characteristics were evaluated using multivariable polytomic logistic regressions. Characteristics of participants who rebalanced their meat and legume consumptions were also compared to those who reduced their meat but did not increase their legume consumption. Results Motives most strongly declared as having induced a change in meat or legume consumptions were health and nutrition (respectively 90.7 and 81.0% declared these motives as change-inducing for the meat reduction), physical environment (82.0% for meat reduction only) and taste preferences (77.7% for legume increase only). Other motives related to social influences, meat avoidance and meat dislike were reported by fewer individuals, but were declared as having induced changes in food consumption. Most motives that induced a meat reduction and a legume increase were more likely to be associated with specific individual characteristics, for example being a woman or highly educated for health motives. Conclusions Besides the motives reported as important, some motives less frequently felt important were declared as having induced changes in meat or legume consumptions. Change-inducing motives were reported by specific subpopulations. Public campaigns on health and sustainability could usefully develop new tools to reach populations less willing to change. Trial registrations The study was registered at ClinicalTrials.gov (NCT03335644). Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01317-w.
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Affiliation(s)
- Anouk Reuzé
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France. .,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France.
| | - Caroline Méjean
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Myriam Carrère
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Lucie Sirieix
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, IRD, Institut Agro, Montpellier, France
| | - Nathalie Druesne-Pecollo
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Sandrine Péneau
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Mathilde Touvier
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Serge Hercberg
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France.,Department of Public Health, AP-HP Hôpital Avicenne, 93017, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
| | - Benjamin Allès
- Université Paris Cité, CRESS, INSERM, INRAE, CNAM, Bobigny, F-93017, France.,Équipe de Recherche en Épidémiologie Nutritionnelle (EREN) - Centre de Recherche en Épidémiologie et StatistiqueS (CRESS), Université Sorbonne Paris Nord, Inserm U1153, Inrae U1125, Cnam FR SMBH, 74, rue Marcel Cachin, F-93017, Bobigny, France
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Louzada MLDC, Tramontt CR, de Jesus JGL, Rauber F, Hochberg JRB, Santos TSS, Jaime PC. Developing a protocol based on the Brazilian Dietary Guidelines for individual dietary advice in the primary healthcare: theoretical and methodological bases. Fam Med Community Health 2022; 10:fmch-2021-001276. [PMID: 35140130 PMCID: PMC8830223 DOI: 10.1136/fmch-2021-001276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To describe the methodology of development of a protocol for application of the Brazilian Dietary Guidelines by primary healthcare professionals in individual dietary advice. A five-step approach was followed: (1) format definition; (2) definition of the instrument for assessment of individuals’ food consumption; (3) Dietary Guidelines’ content extraction; (4) protocol content development; (5) content and face validity. An example from Brazil was displayed with the development of a protocol to guide healthcare professional decision-making when providing nutrition advice based on the Brazilian Dietary Guidelines. The instrument of the Brazilian Nutrition Surveillance System (SISVAN) was chosen to the food consumption assessment, which contains questions about the consumption of seven healthy or unhealthy food groups and one question about eating modes. The Guidelines’ content extraction process led to the identification of recommendations related to the food consumption markers assessed by the SISVAN questionnaire. Then, a protocol was developed in a flowchart format, in which the professional’s conduct is guided by the answer given to each question of the SISVAN instrument. For each ‘non-compliant’ answer (unhealthy eating practice), the professional is instructed how to provide recommendations and identify obstacles. Lastly, experts and healthcare professionals highlighted pertinence, clarity and usability of the protocol. This study provides the blueprint for the phase-wise development of protocols of application of the Dietary Guidelines and may contribute to promote healthier eating and ending malnutrition in all its forms.
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Affiliation(s)
- Maria Laura da Costa Louzada
- Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil .,Center for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | - Cláudia Raulino Tramontt
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | - Juliana Giaj Levra de Jesus
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Rauber
- Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | | | - Thanise Sabrina Souza Santos
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Constante Jaime
- Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
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Alqahtani NM, Alqahtani AMM, Alqahtani HMS, Jathmi AYJ, Alqahtani BMS, Alshehri AA, Alqahtani AMA. Physicians’ Knowledge and practice of Nutrition Education in Health Care Centers of Saudi Arabia: Systematic Review. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/nhisq9dmhy] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Al-Gassimi O, Shah HBU, Sendi R, Ezmeirlly HA, Ball L, Bakarman MA. Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study. BMJ Open 2020; 10:e033443. [PMID: 31911521 PMCID: PMC6955539 DOI: 10.1136/bmjopen-2019-033443] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Primary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease. DESIGN A cross-sectional study. SETTING Chronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA. PARTICIPANTS 90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure was nutrition competence of primary care physicians measured via the validated NUTCOMP (nutrition competence) questionnaire. RESULTS Primary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians' confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008). CONCLUSIONS Primary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.
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Affiliation(s)
| | | | - Rawan Sendi
- King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Lauren Ball
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
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Nutrition care by primary-care physicians: advancing our understanding using the COM-B framework. Public Health Nutr 2019; 23:41-52. [PMID: 31736453 DOI: 10.1017/s1368980019003148] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the nutrition education provided by primary-care physicians (PCP). DESIGN An integrative review was used to examine literature on nutrition care provided by PCP from 2012 to 2018. A literature search was conducted in MEDLINE, PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Scopus using key search terms. SETTING USA, Netherlands, Germany, Denmark, UK, Lebanon, Australia and New Zealand. PARTICIPANTS Primary-care physicians. RESULTS Sixteen qualitative and quantitative studies were analysed thematically using meta-synthesis informed by the COM-B model of behaviour (capability, motivation and opportunity), to understand the influences on PCP behaviours to provide nutrition care. PCP perceive that they lack nutrition capability. While PCP motivation to provide nutrition care differs based on patient characteristics and those of their own, opportunity is influenced by medical educators, mentors and policy generated by professional and governmental organisations. CONCLUSIONS The development of PCP capability, motivation and opportunity to provide nutrition care should begin in undergraduate medical training, and continue into PCP training, to create synergy between these behaviours for PCP to become confident providing nutrition care as an integral component of disease prevention and management in contemporary medical practice.
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10
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Kenđel Jovanović G, Pavičić Žeželj S, Klobučar Majanović S, Mrakovcic-Sutic I, Šutić I. Metabolic syndrome and its association with the Dietary Inflammatory Index (DII) ® in a Croatian working population. J Hum Nutr Diet 2019; 33:128-137. [PMID: 31602707 DOI: 10.1111/jhn.12695] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a global public health concern, although its association with the inflammatory potential of the diet is still indefinite. The main objective of the present study was to investigate the association of MetS and its components with the inflammatory potential of the diet in a Croatian working population with sedentary occupations. METHODS In a cross-sectional study, Croatian workers (n = 366) self-administrated questionnaires for sociodemographic and health-related data. Their anthropometric measurements and fasting blood samples were collected for evaluation of MetS. The inflammatory potential of the diet was assessed with a Dietary Inflammatory Index (DII)® , scored using dietary data collected from a food frequency questionnaire. Multivariable logistic regression analysis, adjusted for sex, age, body mass index, education, smoking, physical activity and energy intake, was used to establish the association between DII and MetS. RESULTS MetS prevalence was 25% and was significantly associated with a pro-inflammatory diet [mean (SD) 3.28 (1.45); P < 0.01]. The pro-inflammatory diet was statistically associated with women, university degree, moderate physical activity, snacking between meals, central obesity, hypertriglyceridaemia, hypertension, low high-density lipoprotein-cholesterol, MetS prevalence and lower adherence to a Mediterranean diet. Multivariable logistic regression analysis showed a statistically positive association for a one-unit increase in the DII and MetS prevalence (odds ratio = 2.31; 95% confidence interval = 1.61-3.31; P < 0.01) and hypertension (odds ratio = 1.28; 95% confidence interval = 1.01-1.64; P = 0.04). CONCLUSIONS Further longitudinal studies in different parts of Croatia, including inflammation biomarkers, are needed to enable a more defined view of the inflammatory potential of a diet and its association with various inflammatory-based health conditions. The results obtained in the present study indicate the need for the development of anti-inflammatory dietary interventions for population health protection.
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Affiliation(s)
- G Kenđel Jovanović
- Department of Health Ecology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia
| | - S Pavičić Žeželj
- Department of Health Ecology, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia
| | - S Klobučar Majanović
- Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - I Mrakovcic-Sutic
- Department of Physiology, Immunology and Pathophysiology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - I Šutić
- Department of Family Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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Dumic A, Miskulin M, Pavlovic N, Orkic Z, Bilic-Kirin V, Miskulin I. The Nutrition Knowledge of Croatian General Practitioners. J Clin Med 2018; 7:jcm7070178. [PMID: 30029463 PMCID: PMC6068600 DOI: 10.3390/jcm7070178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 01/02/2023] Open
Abstract
Nutrition care delivered in primary health care setting is an effective and necessary preventive health care measure. General practitioners (GPs) nutrition knowledge is related to their nutrition care practice. The aim of this study was to explore the nutrition knowledge of Croatian GPs, and to investigate its connection with the implementation of nutrition care in GPs’ offices. A cross-sectional study was conducted among 17.0% of randomly selected GPs, from May to July 2013, via an anonymous questionnaire. The study showed that only 35.8% of the Croatian GPs had an adequate level of nutrition knowledge (five or more correct answers to nutrition questions). The study further revealed that females, GPs with additional education in nutrition and GPs who had not suffered from chronic diseases with poor nutrition posing as a risk factor had better nutrition knowledge (p = 0.029, p < 0.001 and p = 0.041, respectively). The Spearman rank correlation between GPs’ nutrition knowledge and the implementation of nutrition care in their offices during daily work with patients was rs = −0.190 (p < 0.001). To provide nutrition care in GPs’ offices in Croatia, strategies for improving GPs’ nutrition knowledge are needed.
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Affiliation(s)
- Albina Dumic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
| | - Maja Miskulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
| | - Nika Pavlovic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
| | - Zelimir Orkic
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
| | - Vesna Bilic-Kirin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
| | - Ivan Miskulin
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia.
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Dumic A, Miskulin I, Pavlovic N, Cacic Kenjeric D, Orkic Z, Miskulin M. Attitudes toward Nutrition Care among General Practitioners in Croatia. J Clin Med 2018; 7:jcm7040060. [PMID: 29561751 PMCID: PMC5920434 DOI: 10.3390/jcm7040060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 11/16/2022] Open
Abstract
Nutrition care should be an integral part of general practitioners' (GPs') daily work with patients. The aim of this study was to assess the attitudes of Croatian GPs toward nutrition and nutrition care, and to evaluate the interconnection between their attitudes and implementation of nutrition care in GPs offices. A cross-sectional study was conducted among 17.0% of randomly selected GPs, from May to July of 2013, via a specially designed anonymous questionnaire. The study showed that 36.0% of the Croatian GPs had satisfactory number of positive attitudes (5 or more) toward nutrition and nutrition care. There was statistically significant difference in the median number of positive attitudes based on the additional education of GPs in nutrition and their ailment from chronic diseases (p < 0.001 and p = 0.022, respectively). The Spearman rank correlation between GPs' attitudes toward nutrition and nutrition care and their practice, i.e., the implementation of nutrition care in GPs' everyday work with patients was rs = -0.235 (p < 0.001). In order to provide nutrition care in GPs' offices in Croatia, strategies for changing GPs' attitudes toward nutrition and nutrition care are needed.
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Affiliation(s)
- Albina Dumic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Ivan Miskulin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Nika Pavlovic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Daniela Cacic Kenjeric
- Faculty of Food Technology, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Zelimir Orkic
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
| | - Maja Miskulin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia.
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