[Family Physicians and Nutritionists in Health Centers, Commentary on "Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study"]

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Dietary Habits of Newly Diagnosed Patients with Breast Cancer in Korea

Background

In patients with breast cancer, a healthy diet can help reduce breast cancer-specific recurrence, mortality, and comorbid chronic disease rates. There have been few studies on dietary habits immediately after breast cancer diagnosis, especially those involving the Asian population. Therefore, this study aimed to compare the nutritional habits of newly diagnosed patients with breast cancer and the general population without cancer in Korea using propensity score (PS) matching.

Methods

We conducted a case-controlled study of 157 patients with breast cancer and 2,363 cancer-free control participants from the Korea National Health and Nutrition Examination Survey. The PS values for the predicted probability of patients with breast cancer and the general population were estimated using logistic regression analysis, including age and body mass index. The dietary patterns were assessed using a 24-hour recall of 1 day and the Food Frequency Questionnaire.

Results

PS matching showed that patients with breast cancer consumed fewer calories and carbohydrates; however, they consumed more protein and fat compared to the general population. Compared to the general population, patients with breast cancer consumed more healthy foods such as fish, seaweed, vegetables, fruit, mixed-grain rice, and nuts; however, they also consumed more soup, stew, and red meat.

Conclusion

Newly diagnosed patients with breast cancer have some healthy dietary habits compared to the general population. However, there is considerable room for improvement in their diet quality. Our results support the need to develop tailored dietary recommendations for patients with breast cancer during the diagnostic and posttreatment periods to improve their diet quality.

[Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study]

INTRODUCTION

Nutrition is a cornerstone of diabetes mellitus prevention and management; therefore, it is essential to enable patients to adopt healthy eating habits. Previous studies have not yet documented the main errors in the eating habits of Portuguese people with type 2 diabetes mellitus. This study aims to identify the main errors in the eating habits of people living with type 2 diabetes mellitus in Portugal and to evaluate its associations with sociodemographic variables.

METHODS

Cross-sectional multicentric study in a convenience sample of people with type 2 diabetes mellitus in Primary Health Care Units. The UK Diabetes and Diet Questionnaire (UKDDQ) - translated and adapted, was applied from July to October 2022. Descriptive and inferential statistical analyses were conducted.

RESULTS

Of the 550 participants, 52.2% were female, 68.3% were 65 years or over, 55.8 % had an education level up to the fourth grade, 24.7% had economic deprivation, and the mean time since diagnosis was 10.60 ± 8.13 years. Only 36.2% of the sample had a healthy UKDDQ score. Less than 50% of the sample had healthy scores for the items "high-fiber rice or pasta", "high-fiber bread", "butter, margarine and vegetable oils" and "vegetables and pulses". Only 8.9% of the sample had a healthy consumption of fiber. About 70.4% reported healthy scores for the consumption of "high-added-sugar foods" and 54.7% for "high-saturated fat". A statistically significant weak positive correlation was found between the UKDDQ score and age (ρ = 0.201, p < 0.001) with a more frequent choice of healthy foods with increasing age. Female respondents reported healthier habits, particularly in the consumption of "high-saturated fat" and "high-fiber foods".

CONCLUSION

The majority of our sample did not take advantage of the potential benefits of healthy eating habits. The main food groups whose consumption should be emphasized or discouraged were individualized, particularly the need to encourage the consumption of high-fiber foods. Targeted educational actions must focus especially on younger and/or male patients.

Assessment of eating habits, lifestyle and physical activity among medical and dental students of Faisalabad Medical University

Objective

To assess the eating habits, lifestyle and physical activity and their impact on health of students of Faisalabad Medical University (FMU) Faisalabad Pakistan.

Methods

A descriptive cross-sectional study was prepared on 328 medical and dental students at Faisalabad Medical University from June, 2022 to October, 2022. Three Factor Eating Questionnaire Revised 21 (TFEQ-R21) was used to assess the eating habits among medical students and physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short version. A self-constructed questionnaire was used to assess lifestyle patterns.

Results

According to the study, 191(58.2%) students out of 328 practiced unrestricted eating. While 229(69.8%) students demonstrated cognitive restraint and 128(39%) students indulged in emotional eating. Less than half of the students, 52(15.9%) lead unhealthy lifestyles compared to 276(84.1%) who had healthy habits. Out of 328 students, 104 (31.7%) engaged in low, 137(41.8%) in moderate, and 87(26.5%) in high levels of physical activity. Whereas a higher proportion of female students engaged in low to moderate physical activity (61.5% and 52.6%, respectively), while a higher proportion of male students (63.2%) were involved in intense physical activity.

Conclusions

A large proportion of medical students exhibited poor dietary habits with low physical activity. Obesity and other metabolic diseases are more likely to strike medical students who engage in these unhealthy eating habits. As future health providers, health interventions must be implemented to avert future harm.

[Diet and body weight at the beginning of the COVID-19 pandemic in Mexico]

Background

Weight changes in adults have strong repercussions on people's health status. During the COVID-19 pandemic, these changes could be more evident due to the mandatory confinement, as well as eating habits and lifestyle. In this study, changes in diet and body weight in Mexican population at the beginning of COVID-19 lockdown period (weeks 4-7) were evaluated using an online survey.

Objective

To identify the characteristics of the diet and the perceived change in body weight at the beginning of the COVID-19 pandemic in Mexico.

Material and methods

Descriptive, cross-sectional study of 1281 people over 18 years of age, electronic survey in weeks 4-7 of confinement with sociodemographic data, food consumption and perception of body weight.

Results

The change in food consumption was 53.9%, finding differences according to gender in beverages (carbonated, juices, alcoholic), coffee/tea, fruits, legumes (p < 0.05). The perception of body weight increases by 3.4 (increased) and 2.1 (lowered) times more than the risk of change in diet.

Conclusions

The dietary differences refer to a tendency to the type of food consumed, mainly sugary drinks, with the perception of changes in positive body weight in women.

Caregiver burden related to feeding process in Alzheimer's disease

Difficulties in the feeding process, such as aversive feeding behaviors and dysphagia, are common in patients with Alzheimer's disease (AD) and can often overload their caregivers. Although dysphagia is already established as a factor contributing to caregiver burden, the impact of aversive behaviors is less studied.

Objectives

Evaluate the relationship between the feeding process in individuals with AD and their caregiver's burden.

Methods

Dyads of individuals with AD and their caregivers were recruited for a cross-sectional study. The Edinburgh Feeding Evaluation in Dementia (EdFED) scale, the Zarit Burden Interview (ZBI), the mini-mental state examination (MMSE), the Functional Activities Questionnaire (FAQ), and the Functional Oral Intake scale (FOIS) were performed.

Results

We included 60 AD individuals-caregivers dyads. The median (IQR) age of caregivers was 57 (19-81) years, and the most were females (70%). The individuals with AD had a median MMSE of 12 (6-15), and the disease duration was 4 (2-6) years. The mean (SD) Zarit score was 20.95 (6.51). In the multivariate linear regression, the EdFED score (95% CI 0.368-1.465) and time as a caregiver (95% CI 0.133-1.355) were associated with the caregiver's burden.

Conclusions

Aversive behaviors were associated with the caregiver burden of individuals with AD, even with a short duration of the disease. These findings show the importance of education for caregivers regarding the feeding process, as these measures have great potential to minimize the caregiver's burden.

Eating Habits During Pregnancy of Women Giving Birth Very Prematurely: An Exploratory Analysis

INTRODUCTION

Preterm birth is increasing worldwide, representing a major cause of death and long-term loss of human potential among survivors. Some morbidities during pregnancy are well-known risk factors for preterm labor, but it is not yet known whether deviations from adequate dietary patterns are associated with preterm delivery. Diet may be an important modulator of chronic inflammation, and pro-inflammatory diets during pregnancy were reported to be associated with preterm birth. The aim of this study was to assess the food consumption during pregnancy of Portuguese women giving birth very prematurely and the association between the food consumption and the major maternal morbidities during pregnancy related with preterm delivery.

MATERIAL AND METHODS

A single-center cross-sectional observational study including consecutive Portuguese women giving birth before 33 weeks of gestation was conducted. Recall of eating habits during pregnancy was obtained within the first week after delivery, using a semi quantitative food frequency questionnaire validated for Portuguese pregnant women.

RESULTS

Sixty women with a median age of 36.0 years were included. Of these, 35% were obese or overweight at the beginning of pregnancy, 41.7% and 25.0% gained excessive or insufficient weight during pregnancy, respectively. Pregnancy-induced hypertension was present in 21.7% of cases, gestational diabetes in 18.3%, chronic hypertension in 6.7%, and type 2 diabetes mellitus in 5.0%. Pregnancy-induced hypertension was significantly associated with increased daily consumption of pastry products (31.2 vs 10.0 g, p = 0.022), fast food (39.6 vs 29.7 g, p = 0.028), bread (90.0 vs 50.0 g, p = 0.005), pasta, rice and potatoes (225.7 vs 154.3 g, p = 0.012). In a multivariate analysis, only bread consumption maintained a significant, albeit weak, association (OR = 1.021; 1.003 - 1.038, p = 0.022).

CONCLUSION

Pregnancy-induced hypertension was associated with increased consumption of pastry products, fast food, bread, pasta, rice, and potatoes, although only bread consumption had a weak but statistically significant association with pregnancy-induced hypertension in a multivariate analysis.

Blood Level of 2-arachidonoyl glycerol (2-AG), Neuropeptide Y and Omentin and Their Correlation with Food Habits in Obese Women

Background:

Despite growing concern about the increasing global burden of obesity, there are still many uncertainties in understanding the pathogenesis of this disease. This study aimed to investigate the serum levels of 2-arachidonoylglycerol (2-AG), neuropeptide Y (NPY), and omentin, concerning dietary patterns in obese women.

Materials and Methods:

This case-control study was carried on an equal number of obese (case group) and normal-weight women (n=45 each). Dietary intake was determined based on the food frequency questionnaire. Serum levels of 2-AG, NPY, and omentin were determined using ELISA.

Results:

The obese group showed significantly higher 2-AG and NPY levels than the controls(P<0.001). There were significant positive correlations between the serum level of 2-AG and calorie intake (r=0.219, P=0.038), carbohydrates (r=0.238, P=0.024), fat (r=0.227, P=0.032), saturated fatty acids (r=0.272, P=0.009), and monounsaturated fatty acids (r=0.265, P=0.012).

Conclusion:

Our study revealed that dietary patterns, in particular, the type of fatty acids used may influence levels of 2-AG, NPY, and omentin, which all are involved in pathways resulting in obesity.

A Relationship Between Mortality and Eating Breakfast and Fiber

BACKGROUND

Recent studies suggest that intermittent fasting or skipping breakfast may be good strategies for weight loss and better health. The objective of this study was to determine whether regular breakfast is associated with overall or cardiovascular mortality.

METHODS

Cohort study with follow-up mortality data from the NHANES 1999-2002. National weighted sample. Outcomes were overall and cardiovascular mortality; secondary was fiber intake.

RESULTS

Out of 5761 participants, there were 4778 (82.9%) identified as breakfast eaters and 2027 deaths (35.2%); 469 (23.1%) deaths were due to cardiovascular diseases. The average daily intake of calories was 2015, and fiber was 16.3 g/day. A total of 17.7%, 66.0%, and 11.4% of participants had diabetes, hypertension, and cardiovascular diseases, respectively. Analysis showed breakfast eaters were older, had lower body mass index, and ate more calories and fiber daily than non-breakfast eaters. Cox proportional hazard regression analyses showed that compared to non-breakfast eaters, the breakfast eaters were less likely to experience mortality after multivariable adjustments (overall mortality: hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.57-0.84 and cardiovascular mortality: HR, 0.45; 95% CI, 0.32-0.63). For the breakfast eaters, fiber intake >25 g/day was associated with 21% (HR, 0.79; 95% CI, 0.66-0.96) reduction in all-cause mortality after multivariable adjustments.

CONCLUSIONS

Regular daily intake of breakfast appears to be associated with lower overall and cardiovascular mortality, particularly when consuming fiber >25 g/day. Further studies examining specific breakfast foods and the timing of foods would be helpful.

Association of Eating Alone with Depressive Symptoms and Suicidal Ideation among Korean Adults

BACKGROUND

In recent years, eating dinner alone has become a rising social issue in Korea. Depression is one of the primary health problems that can lead to numerous negative consequences. However, few studies have focused on people who eat alone and the effect of eating alone on depression. We investigated the association between eating dinner alone and depression.

METHODS

Our cross-sectional study included data from 14,093 Korean adults aged above 19 years old; data were sourced from the Korea National Health and Nutrition Examination Survey in 2014, 2016, and 2018, when the Patient Health Questionnaire (PHQ-9) was used. We classified participants based on their dinner habits: eating alone or social eating. Depression and suicidal ideation among participants were measured using the PHQ-9. Multivariate logistic regression analysis was used to investigate whether eating alone was related to depression or suicidal ideation after adjusting for age, sex, household income, education, alcohol, smoking, exercise, frequency of eating out, and living arrangement.

RESULTS

Individuals who ate dinner alone (22.9%) had higher depression and suicidal ideation rates than those who ate with others. Those who ate alone had greater odds ratios (ORs) of depressive symptoms (depression: OR, 1.42; 95% confidence interval [CI], 1.27-1.58; suicidal ideation: OR, 1.49; 95% CI, 1.25-1.78) after adjustment for covariates. The subgroup analysis shows that the odds of suicidal ideation among individuals who eat alone were nonexistent among those who performed regular aerobic exercise.

CONCLUSION

Eating dinner alone is closely associated with depressive symptoms, particularly suicidal ideation. Therefore, providing opportunities to eat with others may be effective for maintaining the mental health of adults.

Non-suicidal self-injury in patients with eating disorders: nuclear aspects

Background:

Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing.

Objective:

This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article.

Methods:

The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared.

Results:

Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm.

Conclusions:

These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

[Effects of Program to Promote Obesity Prevention Behaviors on Pre-Schoolers: Focused on Kindergartener in Korea]

PURPOSE

This study aimed to develop a program to promote obesity prevention behaviors for pre-schoolers and to confirm the effectiveness of the program in Korea.

METHODS

The program comprised 8 sessions for 4 weeks including combined classroom lectures and physical activities. A non-equivalent control group pre-post test study design was used, and seventy two children, aged 5 to 6 years (experimental group: 33, control group: 39) and their parents participated in the study. To examine the effectiveness of the program, children's knowledge, intake of sugar-added beverages and fruits & vegetables, time of outdoor play and screen time, and parental self-efficacy were measured. Data were analyzed with SPSS/WIN ver. 22.0 and R 4.0.2, using descriptive analysis, chi-square test, Fisher's exact test, the independent t-test, and Analysis of covariance (ANCOVA).

RESULTS

The results showed that the experimental group reported significantly increased knowledge (p < .001) and longer time of outdoor play on weekends (p = .033). However, there were no significant differences in the intake of sugar-added beverages and fruits & vegetables, screen time, and parental self-efficacy in the two groups.

CONCLUSION

This study confirms the applicability of an obesity prevention intervention at kindergartens in Korea. The results can be used as basic data for the study of childhood obesity prevention in Korea.

[Empowering Patients with Adequate Eating Habits in the Context of Bariatric Surgery]

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Impact of asthma on children´s gustatory sensitivity, masticatory and feeding behaviors

Asthma is a chronic inflammatory disease, in which disturbances in breathing, masticatory and swallowing functions may impact the eating behavior. The aim of the study was to evaluate the impact of asthma on taste sensitivity, masticatory behavior and feeding problems in children. The sample consisted of 91 children (6-7y) divided into two groups: asthma (n=46) and control group (n=45). Interviews were held with parents/guardians and clinical examinations were performed to gather information on medical, dental and feeding aspects. The gustatory sensitivity for sucrose and urea (sweet and bitter, respectively) were measured by staircase method designed for this age-range. The respiratory and masticatory functions were evaluated using the Orofacial Myofunctional Evaluation with Scores-expanded (OMES-e) protocol. Feeding problems were assessed using the Montreal Children's Hospital Feeding Scale, exploring oral motor, sensory, appetite, maternal concerns, child's behavior, and strategy aspects after transcultural adaptation to Brazilian Portuguese. The two groups were homogeneous relative to sociodemographic characteristics and nutritional status. Although the total OMES-e scores did not differ between groups, the frequency of changes in food incision and escape were different (p=0.007 and p=0.0011, respectively). The Asthma group required more time and higher number of masticatory cycles to eat the test-food (p<0.05). The gustatory thresholds for sweet and bitter were different, with asthmatic children requiring significantly higher concentrations to perceive the taste (p<0.001). The frequency of children classified by their parents according to feeding difficulties also differed between groups (p=0.001; Fisher's exact test). Asthmatic children showed remarkable changes in taste, chewing and eating behaviors, thereby pointing out the eating problems they may experience, which should be considered when designing and implementing therapeutic interventions.

Clinical trial on stimulation of suction in preterm cases using neuromotor reactions

INTRODUCCIÓN

La succión nutritiva es un hito importante para la correcta alimentación del neonato. Los prematuros no tienen desarrollada esta habilidad, por lo que se han diseñado diferentes maneras de estimular su aparición.

OBJETIVO

Comprobar si la estimulación de los reflejos orales innatos, a través de reacciones neuromotrices, disminuye el tiempo para adquirir la destreza de succión nutritiva.

MATERIAL Y MÉTODOS

Se estudiaron neonatos nacidos antes de la semana 34 de gestación y alimentados mediante sonda por succión ineficaz. El grupo control estuvo constituido por los recién nacidos con las mismas características nacidos durante el año 2016. El grupo experimental fue estimulado mediante reacciones neuromotrices hasta el retiro de la sonda. Las variables observadas fueron el tiempo de transición a la alimentación oral completa, el peso, la talla y el perímetro craneal al alta, la saturación periférica de oxígeno y la frecuencia cardiaca antes y después de la intervención, así como la calidad de la succión mediante la escala ECLES.

RESULTADOS

Completaron el estudio 23 niños en el grupo de intervención y 25 en el grupo de control histórico. Los niños del grupo intervenido mostraron transición acelerada a la alimentación oral independiente y valores más elevados de altura (p = 0.01), peso (p < 0.001) y perímetro craneal (p = 0.04) en el momento del alta hospitalaria. La edad gestacional al alta y la duración total de la hospitalización no mostraron diferencias entre grupos (p > 0.05).

CONCLUSIONES

La estimulación mediante reacciones neuromotrices disminuye el tiempo necesario para alcanzar la succión nutritiva en los neonatos pretérmino.

BACKGROUND

Nutritive suction is an important milestone for correct newborn feeding. Premature infants do not develop this ability therefore, several proposals for their appearance have being designed.

OBJECTIVE

Assess whether the stimulation of the innate oral reflexes using neuromotor reactions reduces the time to acquire sucking behavior.

MATERIAL AND METHODS

Newborns before 34 weeks of gestation, fed by tube feeding due to an ineffective suction, were studied. Control group consisted of newborns with the same characteristics born during 2016. Experimental group was stimulated by neuromotor reactions until the tube feeding was retired. Observed variables included transition time to complete oral feeding, weight, height and cranial perimeter at discharge, peripheral oxygen saturation and heart rate before and after intervention, as well as quality of suction behavior using ECLES scale.

RESULTS

A total of 23 babies from intervention group completed the study, and 25 from historical control group. Children of intervention group showed an accelerated transition to independent oral feeding and higher values of height (p = 0.01), weight (p < 0.001) and cranial perimeter (p = 0.04), at the time of hospital discharge. Gestational age at discharge and total duration of hospitalization did not show differences between groups (p > 0.05).

CONCLUSION

Oral stimuli intervention by means of neuromotor reactions reduced the time necessary to reach suction behavior in preterm babies.

[Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status]

PURPOSE

This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities.

METHODS

This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data.

RESULTS

The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and 23.16 kg/m², respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (β=.72, p<.001), a lower Model for End-stage Liver Disease (MELD) score (β=-.18, p<.001), and being male (β=-.10, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020).

CONCLUSION

LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients' post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

Nutri-Score: A Public Health Tool to Improve Eating Habits in Portugal

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The effects of age and gender (bull vs steer) on the feeding behavior of young beef cattle fed grass silage

Objective

The objective of this study was to determine the effects of age and gender (bull vs steer) on feeding behavior parameters in young beef cattle fed grass silage.

Methods

The study was conducted on 180 young beef cattle at 7 to 18 mo of age. The experimental materials comprised 90 bulls produced by commercial crossing of Polish Holstein-Friesian cows with Charolais, Limousin and Hereford bulls (30 animals of each breed) and 90 steers of the same genotypes. The animals had ad libitum access to grass silage; the concentrate was fed separately, in feed stations. They received 28 g dry matter of concentrate per kg of metabolic body weight per day. Bunk visit data and silage intake for all experimental animals were recorded individually using the Roughage Intake Control system (5 feed bunks per 15 animals).

Results

Age and gender (bull vs steer) exerted significant effects on the feeding behavior of young beef cattle. The frequency of bunk visits and meal frequency decreased, whereas the feeding rate of silage, and the average duration and size of a single meal increased with age (p<0.01). Bunk attendance and meal frequency were higher (p<0.01) in steers than in bulls (49.1 vs 37.4 visits/d, and 8.63 vs 7.99 meals/d, respectively). Daily feeding time was longer in steers than in bulls (102.3 vs 100.3 min/d, respectively), but the feeding rate of silage was lower in steers, and their meals were smaller in size and shorter in duration (p<0.01). Daily silage dry matter intake was higher (p<0.01) in bulls than in steers (4.62 vs 4.47 kg/d, respectively).

Conclusion

The results of this study indicate that age and gender (bull vs steer) exerted significant effects on the feeding behavior of young beef cattle.

[Problematic Eating Behaviors after Bariatric Surgery: A National Study with a Portuguese Sample]

INTRODUCTION

Bariatric surgery is the most effective method for the treatment of morbid obesity. However, the development of eating psychopathology and the emergence of problematic eating behaviours have been reported in the literature. The aim of this crosssectional study was to characterize the post-bariatric population in terms of the frequency of problematic eating behaviours over time and to understand the related psychological features.

MATERIAL AND METHODS

This sample was composed of 155 bariatric patients that responded to several self-reported instruments assessing eating psychopathology, problematic eating behaviours, anxiety, depression and stress and impulsive behaviour.

RESULTS

Results showed that grazing, binge eating, concerns about body weight and shape, and negative urgency are significantly more frequent at 24 months after bariatric surgery (when compared to earlier postoperative assessments). Correlational analyses showed that eating psychopathology and problematic eating behaviours were significantly and positively associated with levels of anxiety, depression, stress and negative urgency. This study also reinforces the mediating role of negative urgency in the relationship between time elapsed since surgery and psychological distress, and problematic eating behaviours, accounting for a total of 32.3% and 27.2% of its variance, respectively.

DISCUSSION

The results suggest a growing trend of problematic eating behaviours and levels of impulsivity being reported by bariatric patients over time.

CONCLUSION

Given the established evidence that supports its impact on weight variability, early identification of problematic eating behaviours and of patients with a tendency to act impulsively in situations of negative emotionality should be a central concern in the follow-up of the bariatric population.

Backgrounding steers on temperate grasses mixed with vetch and/or using energy supplementation

OBJECTIVE

The aim was to evaluate backgrounding beef steers on oat + ryegrass pastures mixed with vetch and/or using energy supplementation.

METHODS

A randomized block design with three treatments and three replications was used. The treatments were: grass + supplement (oat + ryegrass + supplementation), legume + supplement (oat + ryegrass + vetch + supplementation) and grass + legume (oat + ryegrass + vetch). A continuous grazing system with a variable stocking rate was used. Twenty-seven intact crossbred steers (1/4 Marchigiana, 1/4 Aberdeen Angus and 2/4 Nellore) aged 7 months old and average weight of 190 kg were used. Steers were supplemented at 1% of the body weight of ground corn. The experiment lasted 84 days, between May and August 2014. Behavioral assessments were performed two times per experimental period, for 24 hours.

RESULTS

The forage mass was different between treatments, being greater for steers fed without legume. The accumulation rate, forage allowance, and stocking rate did not differ between treatments due to the adequate adjustment of forage allowance. The final weight of animals, as well as the dry matter intake (kg/d), did not differ between treatments. However, forage intake was higher for non-supplemented animals in relation to supplemented steers. Supplement intake did not alter the total digestible nutrient intake due to pasture quality. Animals fed grass + supplement had higher live weight gain per area than those fed grass + legume. Animals without supplementation spent more time in grazing.

CONCLUSION

Feeding behavior was not altered by mixing with vetch or supplementation. Non-supplemented animals started the grazing peak earlier and spent more time in grazing than those supplemented; however, the average daily gain was similar between treatments. The live weight gain per hectare was 47% higher in pastures in which the animals received supplementation compared with those mixed with vetch, a consequence of the substitutive effect.

Feeding Behavioral Assessment in Children with Cleft Lip and/or Palate and Parental Responses to Behavior Problems

BACKGROUND

Children with cleft lip and/or palate frequently experience feeding difficulties that may place them at risk of malnutrition. Parents' negative response to these problems is associated with development of problematic behaviors in the child. This study aimed to investigate feeding behavior in children with cleft lip and/or palate and parental responses to these problems.

MATERIALS AND METHODS

A total of 120 parents of children (aged 6 months to 6 years) with cleft lip and/or palate were recruited from the Cleft Lip and Palate Clinic in Isfahan University of Medical Sciences, Isfahan, Iran, who gave consent and completed a two-part questionnaire through interviews. Part A of the questionnaire consisted of 25 items that evaluate children's feeding behavior during mealtimes and part B consists of 18 items that assess parental response (strategies, feelings, and anxiety) to these problems.

RESULTS

Independent t-test showed a significant difference in the mean score of feeding behavior in mothers (P = 0.020) and parental responses in fathers (P = 0.030). The Pearson correlation coefficient showed an inverse correlation between behavioral feeding score and children's interval (P = 0.008, r = -0.381) and direct correlation between parental response and feeding behavioral difficulties (P = 0.003, r = 0.428).

CONCLUSIONS

With regards to the results representing appropriate feeding behaviors in children with cleft lip and/or palate, it is suggested that feeding be avioral assessment is an essential nursing and nonmedical intervention for all children.

Feasibility and Acceptability of Adapting the Eating in the Absence of Hunger Assessment for Preschoolers in the Classroom Setting

Eating in the Absence of Hunger (EAH) represents a failure to self-regulate intake leading to overconsumption. Existing research on EAH has come from the clinical setting, limiting our understanding of this behavior. The purpose of this study was to describe the adaptation of the clinical EAH paradigm for preschoolers to the classroom setting and evaluate the feasibility and acceptability of measuring EAH in the classroom. The adapted protocol was implemented in childcare centers in Houston, Texas (N=4) and Phoenix, Arizona (N=2). The protocol was feasible, economical, and time efficient, eliminating previously identified barriers to administering the EAH assessment such as limited resources and the time constraint of delivering the assessment to participants individually. Implementation challenges included difficulty in choosing palatable test snacks that were in compliance with childcare center food regulations and the limited control over the meal that was administered prior to the assessment. The adapted protocol will allow for broader use of the EAH assessment and encourage researchers to incorporate the assessment into longitudinal studies in order to further our understanding of the causes and emergence of EAH.