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Tolín Hernani MDM, Miranda Cid MDC, Guerrero Cuevas M, Álvarez Calatayud G, Sánchez C. Perception of Paediatricians and Families about Nutritional Supplements: Acceptance, Tolerability and Satisfaction in Malnourished Children (PerceptiONS Jr Study). Nutrients 2024; 16:2475. [PMID: 39125355 PMCID: PMC11313921 DOI: 10.3390/nu16152475] [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: 06/17/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Malnutrition is a common situation in the Spanish paediatric population. Malnourished children may benefit from different strategies, including dietary modifications or nutritional supplements (NS). It is important to know the different factors that can influence treatment tolerance and adherence, and their impact on nutrition monitoring. OBJECTIVES To explore the perception of doctors who prescribe nutritional supplements (NS) in children and to investigate different factors involved in tolerance and adherence. MATERIAL AND METHODS A cross-sectional, descriptive observational study based on an ad hoc electronic survey designed to study doctors' perceptions of at least five of their children with NS and their families, subjected to outpatient follow up. Variables included were the socio-demographic variables of the doctors and children, nutritional status of the patients, amount and characteristics of NS (hyper-caloric oral with fibre (HOFF), oral peptide (OPF) and hyper-caloric infant (HIF)), route of administration, perceived benefits, satisfaction, palatability, adherence, and acceptance. RESULTS 815 patients aged 0-16 years (mean 10.6 years; SD 7.8) were included. A proportion of 64% received HOFF, 16% FOP, and 20% HIF. A proportion of 84% received exclusive oral NS. Total daily calorie intake prescribed with NS ranged from 30-75% in 48.2% of cases, though it was significantly higher in children under 6 months of age. Improvement in overall condition, nutritional status and quality of life was observed in 82%, 79.5%, and 80% of subjects. Improvement in tolerance and digestive symptoms was reported in 83.5% and 72% of subjects. The degree of satisfaction and acceptance of NS was very good in 80% of cases, with taste being the most influential factor (82.3%). Adherence was adequate in more than 60%, and smell was the most significant feature in lack of adherence (55%). The flavour of the best-accepted supplement was chocolate (44%). A total of 97% of prescribing doctors would recommend the same formula again. CONCLUSIONS In our study, prescribing doctors and families perceived an excellent benefit from the use of the prescribed formulas, improved quality of life, high satisfaction, acceptance, and adherence. The positive factors for adequate adherence were sufficient information about the formulations and their benefits, and continuity of care during follow-up. Prescribing doctors would recommend supplement use again given the perceived benefits and satisfaction.
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Affiliation(s)
- María del Mar Tolín Hernani
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| | - María del Carmen Miranda Cid
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| | | | - Guillermo Álvarez Calatayud
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
| | | | - César Sánchez
- Digestive, Hepatology and Paediatric Nutrition Unit, Infant Maternal Hospital, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (M.d.M.T.H.); (M.d.C.M.C.); (G.Á.C.)
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Umentum B, Kim HJ, Adkins A, Feuling MB, Hilbrands J, Martin N, Goday PS, Smith A. Are dietitian recommendations followed? A descriptive study of paediatric hospitalised and ambulatory patients. J Hum Nutr Diet 2024; 37:655-662. [PMID: 38420835 DOI: 10.1111/jhn.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The primary objective of this cross-sectional retrospective study was to describe the implementation of dietitian prescribed nutrition recommendations in malnourished paediatric patients in the hospital and ambulatory settings. We also aimed to investigate other characteristics that could be associated with differences in implementation. METHODS Data were collected from 186 hospitalised and 565 ambulatory patients between February 2020 and January 2021. Data included age, hospital or ambulatory specialty departments, primary diagnosis, malnutrition status, hospital length of stay (LOS), and medical nutrition therapy recommendations. Implementation by the medical team in the hospital setting and adherence by the family in the outpatient setting were categorised as "Full", "Partial" or "None". "Partial" and "None" were combined for analysis. RESULTS Dietitian prescribed recommendations were implemented in 79.6% of hospitalised patients. In the ambulatory population, 46.4% of patients were adherent with nutrition recommendations. Within the hospital, there was a significant difference in implementation of nutrition recommendations based on age (p = 0.047), hospital department (p = 0.002) and LOS (p = 0.04), whereas, in the ambulatory population, there were no significant differences in the rate of adherence among any of the studied characteristics. CONCLUSIONS Dietitian recommendations are frequently implemented in the hospital, whereas adherence to such recommendations is poor in the outpatient population. Interventions to improve adherence to nutrition recommendations in the ambulatory setting are needed.
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Affiliation(s)
| | | | - Ashley Adkins
- Milwaukee Hospital-Children's Wisconsin, Milwaukee, WI, USA
| | | | | | - Nicole Martin
- Milwaukee Hospital-Children's Wisconsin, Milwaukee, WI, USA
| | | | - Amber Smith
- University of California San Francisco Health, San Francisco, CA, USA
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Palomo-Llinares R, Sánchez-Tormo J, Wanden-Berghe C, Sanz-Valero J. Occupational Health Applied Infodemiological Studies of Nutritional Diseases and Disorders: Scoping Review with Meta-Analysis. Nutrients 2023; 15:3575. [PMID: 37630765 PMCID: PMC10457772 DOI: 10.3390/nu15163575] [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: 07/13/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Objective: to identify and review existing infodemiological studies on nutritional disorders applied to occupational health and to analyse the effect of the intervention on body mass index (BMI) or alternatively body weight (BW); (2) Methods: This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American, and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Nutrition Disorders, "Occupational Health" and "Infodemiology", applying the filters "Humans" and "Adult: 19+ years". The search was conducted on 29 May 2021; (3) Results: a total of 357 references were identified from the bibliographic database searches; after applying the inclusion and exclusion criteria, a total of 11 valid studies were obtained for the review. Interventions could be categorised into (1) interventions related to lifestyle, physical activity, and dietary changes through education programmes, (2) interventions associated with lifestyle, physical activity, and dietary changes through the use of telemonitoring systems or self-help applications, (3) interventions tied to lifestyle, physical activity, and dietary changes through control and/or social network support groups, and (4) interventions linked to changes in the work environment, including behavioural change training and work environment training tasks. The meta-analysis demonstrated that the heterogeneity present when analysing the results for BMI was 72% (p < 0.01), which decreased to 0% (p = 0.57) when analysing the outcomes for weight, in which case the null hypothesis of homogeneity could be accepted. In all instances, the final summary of the effect was on the decreasing side for both BMI and BW; (4) Conclusions: Despite the high heterogeneity of the results reported, the trend shown in all cases indicates that the intervention methodologies implemented by empowering individuals through Web 2.0 technologies are positive in terms of the problem of overweight. Further implementation of novel strategies to support individuals is needed to overcome obesity, and, at least in the early studies, these strategies seem to be making the necessary change.
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Affiliation(s)
- Ruben Palomo-Llinares
- Department of Public Health and History of Science, School of Medicine, Miguel Hernandez University, 03550 Sant Joan d’Alacant, Spain;
| | - Julia Sánchez-Tormo
- Health and Biomedical Research Institute of Alicante (ISABIAL), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 30010 Alicante, Spain; (J.S.-T.); (C.W.-B.)
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante (ISABIAL), Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 30010 Alicante, Spain; (J.S.-T.); (C.W.-B.)
| | - Javier Sanz-Valero
- Department of Public Health and History of Science, School of Medicine, Miguel Hernandez University, 03550 Sant Joan d’Alacant, Spain;
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain
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Physicians' Perception of Oral Nutritional Supplement Acceptance and Tolerability in Malnourished Outpatients: PerceptiONS Study. Nutrients 2023; 15:nu15051219. [PMID: 36904218 PMCID: PMC10005370 DOI: 10.3390/nu15051219] [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: 02/01/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
Malnutrition is a common condition associated with various pathologies such as infections, neoplasms and digestive system disorders. Patients can be managed using different strategies, which include dietary modifications or oral nutritional supplements (ONS). It is important to promote good ONS adherence in order to attain clinical efficacy and cost-effectiveness. Several factors (amount, type, duration and tolerability) may have an impact on ONS adherence. PerceptiONS is a descriptive, cross-sectional observational study based on an ad hoc electronic survey designed to explore physicians' perception of malnourished outpatients prescribed ONS. The survey considered adherence, acceptance/satisfaction, tolerability and benefits within the context of Spain's healthcare system. The perceptions of 548 physicians regarding the experience of 2516 patients were analyzed. From the physicians' perspective, 57.11% of patients adhered to over 75% of the prescribed ONS. The organoleptic properties of ONS represented the aspect with the most positive impact on adherence, with smell (43.72%) ranking as the top characteristic. In general, patients were satisfied (90.10%) with the ONS, with their related benefits (88.51%) and their organoleptic properties (90.42%), and accepted ONS in their daily diet (88.63%). ONS improved patients' general condition (87.04%), quality of life (QoL) (81.96%) and vitality/energy (81.28%). Physicians would prescribe the same ONS again in 96.4% of the cases.
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Wang QC, Yuan H, Chen ZM, Wang J, Xue H, Zhang XY. Barriers and Facilitators of Adherence to Oral Nutritional Supplements Among People Living With Cancer: A Systematic Review. Clin Nurs Res 2023; 32:209-220. [PMID: 35707872 DOI: 10.1177/10547738221104216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aims to synthesize the barriers and facilitators of oral nutritional supplement adherence in people with cancer and assess levels of adherence. Databases including Embase, PubMed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journal Database, were used to search articles before January 4, 2021. Eighteen studies with 1,267 participants met the inclusion criteria. All studies reported rates of adherence, ranging from 6.0% to 96.9%. Gastrointestinal intolerances and disliked tastes were considered common barriers to cancer patients' adherence, whereas the ONS management strategy was considered the most crucial facilitator of adherence. Health professionals can improve adherence through regular monitoring and guidance and incentive strategies, and paying attention to the management and prevention of adverse reactions when prescribing nutritional products.
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Affiliation(s)
| | - Hua Yuan
- Jilin University, Changchun, P.R. China
| | | | - Jia Wang
- Jilin University, Changchun, P.R. China
| | - Hui Xue
- Jilin University, Changchun, P.R. China
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Nutritional management of cancer patients in clinical practice in Spain: patients' and multidisciplinary health care professionals' perceptions. Eur J Clin Nutr 2022; 77:454-459. [PMID: 36550218 DOI: 10.1038/s41430-022-01251-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND/OBJECTIVES Malnutrition is a prevalent problem in patients with cancer and is associated with poor prognosis. The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends the provision of nutritional support and evaluation. This study aims to describe the nutritional management of patients with cancer, including assessment of adherence, from the perspective of both patients and healthcare professionals (HCPs). SUBJECTS/METHODS A cross-sectional descriptive observational study was carried out through two surveys addressed to patients and HCPs. RESULTS A total of 230 cancer patients and 461 HCPs completed the questionnaire. The survey found 55.0% of patients experienced eating problems during treatment and 64.0% reported sequelae affecting nourishment. However, 60.1% of patients and 42.6% of HCPs indicated that nutritional status is not generally assessed. While 86.6% of HCPs stated that nutritional information is provided to patients, only 33.5% of patients reported having received it. Regarding nutritional adherence, 87.4% of HCPs stated that it is assessed whereas only 49.2% of patients receiving nutritional supplements confirmed this. General discomfort or gastrointestinal problems were the main issues hampering correct adherence perceived by both patients (41.8%) and HCPs (95.4%). CONCLUSIONS Our study demonstrate that different perceptions exist between patients and HCPs about nutritional management in cancer and suggests that in Spain nutritional approach is suboptimal in terms of screening/assessment of malnutrition, nutritional information provided to the patient, nutritional intervention and assessment of adherence to nutritional support. Therefore, measure should be taken to foster the adoption of ESPEN recommendations in clinical practice and to promote nutritional education of HCPs.
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Sarrió-Sanz P, Martinez-Cayuelas L, Lumbreras B, Sánchez-Caballero L, Palazón-Bru A, Gil-Guillén VF, Gómez-Pérez L. Mortality prediction models after radical cystectomy for bladder tumour: A systematic review and critical appraisal. Eur J Clin Invest 2022; 52:e13822. [PMID: 35642331 DOI: 10.1111/eci.13822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To identify risk-predictive models for bladder-specific cancer mortality in patients undergoing radical cystectomy and assess their clinical utility and risk of bias. METHODS Systematic review (CRD42021224626:PROSPERO) in Medline and EMBASE (from their creation until 31/10/2021) was screened to include articles focused on the development and internal validation of a predictive model of specific cancer mortality in patients undergoing radical cystectomy. CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) and Prediction model Risk Of Bias ASsessment Tool (PROBAST) were applied. RESULTS Nineteen observational studies were included. The main predictors were sociodemographic variables, such as age (18 studies, 94.7%) and sex (17, 89.5% studies), tumour characteristics (TNM stage (18 studies, 94.7%), histological subtype/grade (15 studies, 78.9%), lymphovascular invasion (10 studies, 52.6%) and treatment with chemotherapy (13 studies, 68.4%). C-index values were presented in 14 studies. The overall risk of bias assessed using PROBAST led to 100% of studies being classified as high risk (the analysis domain was rated to be at high risk of bias in all the studies), and 52.6% showed low applicability. Only 5 studies (26.3%) included an external validation and 2 (10.5%) included a prospective study design. CONCLUSIONS Using clinical predictors to assess the risk of bladder-specific cancer mortality is a feasibility alternative. However, the studies showed a high risk of bias and their applicability is uncertain. Studies should improve the conducting and reporting, and subsequent external validation studies should be developed.
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Affiliation(s)
- Pau Sarrió-Sanz
- Urology Services, University Hospital of San Juan de Alicante, Alicante, Spain
| | | | - Blanca Lumbreras
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University, and CIBER en Epidemiología y Salud Pública, Alicante, Spain
| | | | - Antonio Palazón-Bru
- Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain
| | | | - Luis Gómez-Pérez
- Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain
- Urology Services, University General Hospital of Elx, Alicante, Spain
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He FJ, Wang MJ, Yang K, Chen XL, Jin T, Zhu LL, Zhuang W. Effects of Preoperative Oral Nutritional Supplements on Improving Postoperative Early Enteral Feeding Intolerance and Short-Term Prognosis for Gastric Cancer: A Prospective, Single-Center, Single-Blind, Randomized Controlled Trial. Nutrients 2022; 14:nu14071472. [PMID: 35406085 PMCID: PMC9002901 DOI: 10.3390/nu14071472] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Early enteral nutrition (EN) after abdominal surgery can improve the prognosis of patients. However, the high feeding intolerance (FI) rate is the primary factor impeding postoperative EN. METHODS Sixty-seven patients who underwent radical subtotal or total gastrectomy for gastric cancer (GC) were randomly allocated to the preoperative oral nutritional supplement group (ONS group) or dietary advice alone (DA group). Both groups were fed via nasojejunal tubes (NJs) from the first day after surgery to the fifth day. The primary endpoint is the FI rate. RESULTS Of the patients, 66 completed the trial (31 in the ONS group, 35 in the DA group). The FI rate in the ONS group was lower than that in the DA group (25.8% vs. 31.4%, p = 0.249). The postoperative five-day 50% energy compliance rate in the ONS group was higher than that in the DA group (54.8% vs. 48.6%, p = 0.465). The main gastrointestinal intolerance symptoms were distension (ONS vs. DA: 45.2% vs. 62.9, p = 0.150) and abdominal pain (ONS vs. DA: 29.0% vs. 45.7%, p = 0.226). Postoperative nausea/vomiting rate and heartburn/reflux rate were similar between the two groups. We noted no difference in perioperative serum indices, short-term prognosis or postoperative complication rates between the two groups. CONCLUSIONS The study shows that short-term preoperative ONS cannot significantly improve FI and the energy compliance rate in the early stage after radical gastrectomy.
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Affiliation(s)
- Feng-Jun He
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610044, China; (F.-J.H.); (T.J.); (L.-L.Z.)
| | - Mo-Jin Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610044, China; (M.-J.W.); (K.Y.); (X.-L.C.)
| | - Kun Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610044, China; (M.-J.W.); (K.Y.); (X.-L.C.)
| | - Xiao-Long Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610044, China; (M.-J.W.); (K.Y.); (X.-L.C.)
| | - Tao Jin
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610044, China; (F.-J.H.); (T.J.); (L.-L.Z.)
| | - Li-Li Zhu
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610044, China; (F.-J.H.); (T.J.); (L.-L.Z.)
| | - Wen Zhuang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610044, China; (M.-J.W.); (K.Y.); (X.-L.C.)
- Correspondence: ; Tel.: +86-189-8060-1497; Fax: +86-28-8542-2708
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Mou J, Sun J, Zhang R, Yang Y, Yang W, Zhao X. Experiences and needs of home caregivers for enteral nutrition: A systematic review of qualitative research. Nurs Open 2022; 9:11-21. [PMID: 34273248 PMCID: PMC8685892 DOI: 10.1002/nop2.990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/28/2021] [Accepted: 06/14/2021] [Indexed: 11/11/2022] Open
Abstract
AIMS To systematically identify, evaluate and synthesize the qualitative evidence on enteral nutrition of home caregivers. DESIGN A qualitative evidence synthesis using the Sandelowski and Barroso methodology. DATA SOURCES We reviewed articles from eight databases: CINAHL, Embase, PubMed, Web of Science, Cochrane, CNKI, Wanfang Data and CSTJ. Qualitative, peer-reviewed, original studies published in English or Chinese before April 2020 on home caregivers' experience and needs for enteral nutrition were included. The studies were selected by screening titles, abstracts and full texts, and the quality of each study was assessed by two researchers independently. REVIEW METHODS Two researchers independently used qualitative assessment and review tools for quality assessment and thematic synthesis for data analysis. RESULTS This review included 10 articles. The themes identified included balance the enteral nutrition, the experiences and feelings in practice and the recommendations to meet challenge. CONCLUSION Home caregivers reported that they played an important role and faced greater pressure. Future studies should establish a systematic and standardized follow-up schedule to improve home caregivers' physical and mental health. IMPACT The findings established that home caregivers experienced not only changes in their roles and concerns but also spiritual changes. Home caregivers develop different coping strategies to adapt to enteral nutrition without standardized training and support. Although home caregivers make much account of enteral nutrition and feeding issues, they lack of information and support services. Understanding existing problems from a caregiver's perspective can allow interventions to be more clearly developed and well-established training standards established in the future.
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Affiliation(s)
- Jingjing Mou
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Jianan Sun
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Rui Zhang
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Yang Yang
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Wenwen Yang
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
| | - Xiaosu Zhao
- The First Hospital of Jilin UniversityChangchunJilin ProvinceChina
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Melián-Fleitas L, Franco-Pérez Á, Caballero P, Sanz-Lorente M, Wanden-Berghe C, Sanz-Valero J. Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression. Nutrients 2021; 13:3945. [PMID: 34836200 PMCID: PMC8622081 DOI: 10.3390/nu13113945] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health. METHOD This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021. RESULTS A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise. CONCLUSIONS Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).
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Affiliation(s)
- Liliana Melián-Fleitas
- Nutrition Department, University of Granada, 18012 Granada, Spain;
- Geriatric Service, Insular Hospital, Health Services Management of the Health Area of Lanzarote, 35500 Arrecife, Spain
| | - Álvaro Franco-Pérez
- Playa Blanca Health Center, Health Services Management of the Health Area of Lanzarote, 35580 Playa Blanca, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- Center of Public Health, Consellería of Universal Health and Public Health, 46940 Manises, Spain
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante, University General Hospital, 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain
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Mitrev N, Huang H, Hannah B, Kariyawasam VC. Review of exclusive enteral therapy in adult Crohn's disease. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000745. [PMID: 34580154 PMCID: PMC8477235 DOI: 10.1136/bmjgast-2021-000745] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/07/2021] [Indexed: 12/14/2022] Open
Abstract
Background Exclusive enteral nutrition (EEN) is a potentially effective but underused therapy for Crohn’s disease (CD) in adults. It is first-line induction treatment for paediatric patients but remains a second-line or third-line therapy in adults. Objective To analyse the evidence for EEN in adult patients with CD, and summarise this in a narrative review. Methods In April/May 2020 and July 2021, a literature search was performed using the Medical Subject Headings (MeSH) terms: ‘Crohn’s disease’, ‘CD’, ‘inflammatory bowel disease’, ‘IBD’, ‘exclusive enteral nutrition’, ‘enteral nutrition’, ‘EEN’, in PubMed, Scopus, Cochrane. Additional studies were obtained from references of search result articles as well as general reading. Studies with adult patients with CD treated with EEN were selected. 79 articles of relevance were found. Where data in adults were lacking, data from paediatric studies as extrapolated with care. Results EEN in adult patients been shown to improve clinical, biomarker, endoscopic and radiologic measures of disease activity. EEN avoids the potential adverse effects of recurrent corticosteroids for induction such as metabolic derangements and opportunistic infections. EEN has also demonstrated benefits among adult patients with fistulising and stricturing CD. It may avoid surgery in such patients. Preoperative EEN has also been shown to reduce postoperative complications and recurrence. There appears to be benefits in combing EEN with antitumour necrosis factor agents, however, benefits of combination therapy with other biologics are less clear. A major drawback of EEN therapy in adults has been poor compliance. More palatable polymeric formulations improved patient education and dietitian support may overcome this. Evidence in adults is limited to small studies, often with suboptimal control arms and lack of blinding. Larger scale studies with improved study design are needed to confirm these beneficial effects. Conclusion Despite limitations in evidence EEN should be considered in treating adults with CD.
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Affiliation(s)
- Nikola Mitrev
- Department of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia.,Western Sydney University Blacktown Mount Druitt Medical School, Blacktown, New South Wales, Australia
| | - Hin Huang
- Western Sydney University Blacktown Mount Druitt Medical School, Blacktown, New South Wales, Australia
| | - Barbara Hannah
- Department of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia
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Li S, Li P, Sun H, Hu W, Hu S, Chen Y, Lv M. Medication Belief is Associated with Improved Adherence to Exclusive Enteral Nutrition in Patients with Crohn's Disease. Patient Prefer Adherence 2021; 15:2327-2334. [PMID: 34703215 PMCID: PMC8528542 DOI: 10.2147/ppa.s330842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/04/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The prevalence of Crohn's disease (CD) has been increasing rapidly in China, and the role of exclusive enteral nutrition (EEN) in the management of adult patients with active CD is evolving. Adherence is a key factor in the effective treatment of many chronic diseases. AIM The aim of this study was to assess adherence to EEN of CD patients and to evaluate the relationship between medication belief and EEN adherence. METHODS A cross-sectional study was conducted, and demographic information, adherence to EEN, and beliefs about EEN were investigated. Medication belief was measured using the Beliefs about Medicines Questionnaire (BMQ)-Specific. RESULTS In all, 131 CD patients completed the questionnaire and were enrolled in this study. The high adherence rate was 73.3% (96 of 131 patients), and we found that medication belief, residency, medical insurance, and history of enteral nutrition therapy were factors affecting EEN adherence. More patients with a high BMQ score had high adherence to EEN (n = 54, 56.2%) compared to those with a low BMQ (n = 42, 43.8%). Moreover, price, taste, storage method, portability, and purchase convenience of EEN were not associated with adherence. CONCLUSION The adherence to EEN among patients with CD is relatively high and is related to medication belief, residency and history of enteral nutrition. The type of enteral nutrition, taste, storage, and convenience of purchase were not associated with EEN adherence. Future study is warranted to explore the possible role of improving patients' beliefs in increasing adherence.
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Affiliation(s)
- Shuyan Li
- Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China
| | - Peiwei Li
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China
| | - Hongling Sun
- Department of Nursing, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China
| | - Wen Hu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People’s Republic of China
| | - Shurong Hu
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China
| | - Yan Chen
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China
| | - Minfang Lv
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of China
- Correspondence: Minfang Lv; Yan Chen Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, People’s Republic of ChinaTel/Fax +86-571-87783540; +86-571-87783936 Email ;
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de Oliveira Faria S, Alvim Moravia R, Howell D, Eluf Neto J. Adherence to nutritional interventions in head and neck cancer patients: a systematic scoping review of the literature. J Hum Nutr Diet 2020; 34:562-571. [PMID: 33314352 DOI: 10.1111/jhn.12848] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Dietary counselling provided by a dietitian, with or without oral nutritional supplements, can impact on nutritional and clinical outcomes in head and neck cancer (HNC) patients undergoing radiotherapy. However, little is known about the role of adherence to oral nutritional interventions in this population. This review aimed to map the literature for evidence of adherence to oral nutritional interventions in HNC patients undergoing radiotherapy and to identify gaps in knowledge in this field. METHODS A scoping review methodology was used to identify studies, extract data, and collate and summarise results. We searched Medline, Embase, Cochrane Central and CINAHL, from the earliest available time up to 8 January 2020. RESULTS In total, 2315 unique articles were identified, 163 studies were assessed in full and niner were included in the scoping review. The use of different measures to assess adherence and variability in the timing of the assessments was noted across studies. Despite identifying studies that have measured adherence to oral nutritional interventions, very few studies monitored its influence on clinical and nutritional outcomes in HNC patients or reported factors related to adherence. CONCLUSIONS A robust evidence base is lacking for adherence to oral nutritional intervention in HNC patients. Overall, further studies evaluating the impact of oral nutritional interventions in HNC patients undergoing radiotherapy should measure adherence to the intervention. Early recognition of non-adherence and the contributing factors could ensure intensification of nutritional support and better health outcomes.
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Affiliation(s)
- S de Oliveira Faria
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Princess Margaret Cancer Centre Research Institute, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - R Alvim Moravia
- Departamento de Nutrição, Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - D Howell
- Princess Margaret Cancer Centre Research Institute, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - J Eluf Neto
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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Pelvic floor: vaginal or caesarean delivery? A review of systematic reviews. Int Urogynecol J 2020; 32:1663-1673. [PMID: 33068134 DOI: 10.1007/s00192-020-04550-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/27/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS In recent years the number of caesarean sections has increased worldwide for different reasons. to review the scientific evidence relating to the impact of the type of delivery on pelvic floor disorders (PFDs) such as urinary and faecal incontinence and pelvic organ prolapse. METHODS A review of systematic reviews and meta-analysis, drawn from the following databases: MEDLINE (via PubMed), Scopus, Web of Science, The Cochrane Library and LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud/Latin American and Caribbean Health Sciences Literature) prior to January 2019. The directives of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in assessing article quality. RESULTS Eleven systematic reviews were evaluated, 6 of which found a significantly decreased risk of urinary incontinence associated with caesarean section and 3 meta-analyses showed a significant reduction in POP for caesarean section, compared with vaginal delivery. Of 5 reviews that examined delivery type and faecal incontinence, only one indicated a lower incidence of faecal incontinence associated with caesarean delivery. However, most of the studies included in these reviews were not adjusted for important confounding factors and the risk of PFDs was not analysed by category of caesarean delivery (elective or urgent). CONCLUSION When compared with vaginal delivery, caesarean is associated with a reduced risk of urinary incontinence and pelvic organ prolapse. These results should be interpreted with caution and do not help to address the question of whether elective caesareans are protective of the maternal pelvic floor.
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Wall CL, McCombie A, Mulder R, Day AS, Gearry RB. Adherence to exclusive enteral nutrition by adults with active Crohn's disease is associated with conscientiousness personality trait: a sub-study. J Hum Nutr Diet 2020; 33:752-757. [PMID: 32627898 DOI: 10.1111/jhn.12787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND It is probable that psychosocial factors predict adherence to exclusive enteral nutrition (EEN). Conscientiousness is an intrapersonal factor associated with greater medication adherence and healthy eating behaviours. This sub-study aimed to determine whether adherence to EEN was associated with conscientiousness. METHODS Two groups of adults aged 16-40 years, were recruited to use EEN. Adults with active Crohn's disease used either EEN for 8 weeks or 2 weeks of EEN followed by 6 weeks of partial enteral nutrition (PEN). A control group of healthy adults used EEN for 2 weeks. Participants who reported eating food during EEN, ate more than one meal per day during PEN, or could not initiate or tolerate the oral nutritional supplements were defined as non-adherent. Conscientiousness was measured using the conscientiousness subset of the Big Five Inventory. RESULTS Thirty-eight patients with active Crohn's disease (mean age 24.8 years) and 21 healthy adults (mean age 27.3 years) completed the conscientiousness questionnaire. In the Crohn's disease group, 23 (59%) completed and adhered to the treatments compared to 17 (81%) healthy adults; their conscientiousness scores were similar. Adherence and completion by the Crohn's disease group were associated with a greater mean conscientiousness score 35.57 (95% confidence interval = 32.88-38.25) compared to 30.13 (95% confidence interval = 26.53-33.73) in the non-adherent Crohn's disease group (P = 0.014). CONCLUSIONS Conscientiousness was associated with treatment adherence. EEN can be a cognitively and emotionally demanding treatment for active adults with Crohn's disease; thus, considering personality traits may help determine suitable candidates.
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Affiliation(s)
- C L Wall
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - A McCombie
- Department of Surgery, Canterbury District Health Board, Christchurch, New Zealand
| | - R Mulder
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - A S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand.,Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - R B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.,Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
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