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Kirby AN, DeBellis J, Wolter K, Mount G, Wang CH, Bishop J, Barkhouse J, Wirth K, Nguyen N, Cacciatore C, Kraus K. Assessing nutrition literacy and nutrition counseling proficiency following an interdisciplinary culinary medicine elective. J Osteopath Med 2024; 0:jom-2023-0094. [PMID: 38676937 DOI: 10.1515/jom-2023-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 03/12/2024] [Indexed: 04/29/2024]
Abstract
CONTEXT Culinary medicine (CM) is a growing field of education that aims to bridge the gap between the clinical need for nutritional counseling and the lack of education on the topic. Healthcare professionals can aid in nutrition-related noncommunicable disease (NCD) prevention by improving a patient's dietary behavior. However, the presence of nutrition education in healthcare curricula is lacking. Early evidence indicates that CM could address this gap. OBJECTIVES The objectives of this study are to determine if the provision of an interdisciplinary CM elective will improve student knowledge and confidence with counseling on nutrition and culinary principles, and to improve personal dietary habits of students. METHODS This was a one-group pretest-posttest quasi-experimental design. First- and second-year osteopathic medical students (OMS) and nurse practitioner students were recruited to participate in a CM elective via email. Participants were excluded if they were not in good academic standing at their respective institutions. Twelve individuals (n=8 medical; n=4 nursing) were enrolled in the course. Participants completed pre- and postcourse surveys to determine changes in nutrition literacy (Nutrition Literacy Assessment Instrument [NLit42]), nutrition counseling proficiency (Nutrition Survey for Family Practitioners), and dietary quality (Automated Self-Administered 24-h dietary assessment tool; ASA24®). A two-sided, paired t test was conducted to determine changes in outcome variables. RESULTS All 12 participants completed the precourse assessments, and 8 participants completed the postcourse assessments. Culinary activity attendance was 94.5 %. Participants exhibited a statistically significant increase in their overall nutrition literacy scores after completing the CM elective (p=0.006). Literacy subcategories indicated that the improvement came from the participant's ability to understand household measurements (p=0.005) better. Increases in self-reported proficiency were observed for participants' confidence to counsel on nutrition and prevention/wellness (p=0.02) and macronutrients in health and food safety (p=0.01). No statistically significant changes in the personal dietary pattern or quality were observed. CONCLUSIONS The interdisciplinary CM elective improved nutrition literacy and some aspects of counseling proficiency. Although small shifts in dietary variables were observed, the elective did not statistically improve participants' dietary pattern. However, some changes that were observed may lead to clinically relevant outcomes if maintained long-term. These findings are encouraging. Implementing CM as an educational tool could improve healthcare practitioners' ability to understand and counsel patients on nutrition to prevent the nutrition-related NCDs.
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Affiliation(s)
- Anna N Kirby
- Department of Cell Biology and Physiology and Preventative Medicine and Public Health, Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Joy DeBellis
- 1383 College of Nursing at Auburn University , Auburn, AL, USA
| | - Katie Wolter
- Department of Clinical Affairs in the Discipline for Pediatrics, Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Gary Mount
- Department of Pharmacology, Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Chih-Hsuan Wang
- College of Education, 1383 Auburn University , Auburn, AL, USA
| | | | | | - Kathryn Wirth
- Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | - Nancy Nguyen
- Edward Via College of Osteopathic Medicine, Auburn, AL, USA
| | | | - Kristyn Kraus
- Edward Via College of Osteopathic Medicine, Auburn, AL, USA
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Hand RK, Schofield MK. Expanding time covered for Medical Nutrition Therapy: A Need for Clear Reporting on the Intensity of Nutrition Interventions. J Acad Nutr Diet 2024:S2212-2672(24)00038-8. [PMID: 38286250 DOI: 10.1016/j.jand.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Rosa K Hand
- Associate Professor, Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106.
| | - Marsha K Schofield
- Owner, Marsha Schofield & Associates LLC, 4186 Cheval Circle, Stow, OH 44224.
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Rajbhandari-Thapa J, Chung SR, Hu H, Hall DB, Tiwari BB. Utilization of Counseling Services by Pediatric Patients With Obesity Using MarketScan Data (2017-2019). Child Obes 2023; 19:570-574. [PMID: 36413350 DOI: 10.1089/chi.2022.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The United States has implemented policy efforts for public and private insurance to cover counseling services related to the treatment of obesity. However, no research has yet studied counseling service utilization among pediatric patients with obesity. We used 3 years (2017-2019) of IBM MarketScan Commercial Claims and Encounters Database and IBM MarketScan Multi-State Medicaid Data to examine such utilization patterns. We found the proportion of patients receiving any counseling services to be low among both privately insured (7.06%-7.97%) and Medicaid patients (9.51%-11.61%) within 6 months from diagnosis of obesity. This underutilization is concerning as many pediatric patients go undiagnosed, as evidenced in this research. Among the utilized services, nutrition counseling and face-to-face counseling were utilized the most by privately and Medicaid-insured patients over 6- and 12-month follow-ups. Our study underscores the need for implementing policies and programs to promote the utilization of counseling services among pediatric patients.
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Affiliation(s)
| | - Sae Rom Chung
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
| | - Huimin Hu
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
| | - Daniel B Hall
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
| | - Biplav Babu Tiwari
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
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Su L, Lin QJ, Ma SQ, Song XR, Ye JR, Ni MS, Hong JS. The effect of early oral nutritional supplements on improving nutritional outcomes and radiation-induced oral mucositis for nasopharyngeal carcinoma patients undergoing concurrent chemoradiotherapy. Head Neck 2023; 45:2798-2808. [PMID: 37642216 DOI: 10.1002/hed.27503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND To explore the value of early oral nutritional supplements (ONS) in patients with nasopharyngeal carcinoma (NPC) treated with concurrent chemoradiotherapy (CCRT). METHODS Patients with newly diagnosed II-IVA stage NPC were analyzed and divided into Early and Routine ONS groups according to whether they received early ONS at the beginning of CCRT. Changes in nutritional indicators, incidence of treatment-related toxicity, radiation interruption, and completion of CCRT were compared. RESULTS In total, 161 patients with NPC were analyzed, including 72 in the Early ONS group and 89 in the Routine ONS group. Multivariate analysis showed that early ONS was an independent protective factor for concurrent chemotherapy ≥2 cycles, and a protective factor against ≥grade 3 radiation-induced oral mucositis (RIOM) and weight loss >5%. In stage III-IVA patients, early ONS was beneficial in decreasing the risk of severe malnutrition. CONCLUSIONS Early ONS can improve nutritional outcomes, reduce RIOM, and enhance treatment adherence.
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Affiliation(s)
- Li Su
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Qiao-Jing Lin
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Qing Ma
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiu-Rong Song
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jin-Ru Ye
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Meng-Shan Ni
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jin-Sheng Hong
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Radiotherapy, Cancer Center, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Tan X, Xie H, Wang D. Nutrition and Physical Activity Counseling by General Practitioners in China. Risk Manag Healthc Policy 2023; 16:2151-2162. [PMID: 37868022 PMCID: PMC10588712 DOI: 10.2147/rmhp.s427481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction To reduce unhealthy lifestyles in China, it is critical to implement effective strategies. Counseling provided by physicians is important for assisting patients in improving their lifestyles, and general practitioners (GPs) are the main providers of lifestyle counseling to patients. However, few studies have focused on the lifestyle counseling practices by GPs in China, particularly in regard to nutrition and physical activity. Objective The aims of this study are: (i) to examine the current practice of Chinese GPs in counseling patients regarding nutrition and physical activity; (ii) to understand the common barriers to such counseling by Chinese GPs; and (iii) to study the association between GPs' personal lifestyle choices and their practices in lifestyle counseling. Methods A cross-sectional, self-reported online questionnaire was conducted among GPs in Hunan province, China. A total of 198 GPs completed the questionnaire. Results The majority of GPs provide nutrition and physical activity counseling to less than 40% of their patients, spending less than three minutes per counseling session. The main reported barriers to counseling on nutrition and physical activity are inadequate time and a lack of knowledge or experience. GPs primarily acquire knowledge through medical books and journals, followed by science popularization. Furthermore, GPs who maintain healthier lifestyle habits, possess a better understanding of lifestyle guidelines, conduct longer office visits, and exhibit higher self-efficacy are more likely to provide counseling to patients. Conclusion This study highlights the need for improvement in nutrition and physical activity counseling among Chinese GPs. GPs' personal nutrition and physical activity habits may measurably influence their counseling practice. We recommend that GPs themselves adopt healthier lifestyle habits to potentially improve their counseling practice. Moreover, proactive measures should be taken to assist GPs in overcoming barriers encountered with lifestyle counseling.
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Affiliation(s)
- Xian Tan
- Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
- Institute for Future Sciences, University of South China, Changsha, Hunan, People's Republic of China
| | - Hebin Xie
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People's Republic of China
| | - Danling Wang
- Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
- Institute for Future Sciences, University of South China, Changsha, Hunan, People's Republic of China
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People's Republic of China
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Brennan BR, Beals KA, Burns RD, Chow CJ, Locke AB, Petzold MP, Dvorak TE. Impact of Culinary Medicine Course on Confidence and Competence in Diet and Lifestyle Counseling, Interprofessional Communication, and Health Behaviors and Advocacy. Nutrients 2023; 15:4157. [PMID: 37836442 PMCID: PMC10574678 DOI: 10.3390/nu15194157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Most physicians report inadequate training to provide diet and lifestyle counseling to patients despite its importance to chronic disease prevention and management. To fill the nutrition training gap, elective Culinary Medicine (CM) courses have emerged as an alternative to curriculum reform. We evaluated the impact of an interprofessional CM course for medical and health professional students who experienced the hands-on cooking component in person or a in mixed-mode format (in-person and via Zoom) at the University of Utah from 2019-2023 (n = 84). A factorial ANOVA assessed differences between educational environment and changes between pre- and post-course survey responses related to diet and lifestyle counseling, interprofessional communication, and health behaviors and advocacy. Qualitative comments from post-course surveys were analyzed on a thematic level. Students rated themselves as having greater confidence and competence in diet and lifestyle counseling (p < 0.05) and increased ability to prepare eight healthy meals (p < 0.05). Additionally, a Mann-Whitney two-sample rank-sum test was used to compare data from exit survey responses from medical students who took the CM course (n = 48) and did not take the CM course (n = 297). Medical students who took CM were significantly more likely to agree that they could counsel patients about nutrition (p < 0.05) and physical activity (p < 0.05). CM courses may improve students' confidence to provide diet and lifestyle counseling.
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Affiliation(s)
- Britta Retzlaff Brennan
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Katherine A. Beals
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Ryan D. Burns
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Candace J. Chow
- Department of Internal Medicine, University of Utah, Salt Lake City, UT 84112, USA;
| | - Amy B. Locke
- Department of Family and Preventative Medicine, University of Utah, Salt Lake City, UT 84112, USA; (A.B.L.); (M.P.P.)
| | - Margaret P. Petzold
- Department of Family and Preventative Medicine, University of Utah, Salt Lake City, UT 84112, USA; (A.B.L.); (M.P.P.)
| | - Theresa E. Dvorak
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA;
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Griffin A, Conway H, Chawke J, Keane M, Douglas P, Kelly D. An exploration of self-perceived competence in providing nutrition care among physiotherapists in Ireland: a cross-sectional study. Physiother Theory Pract 2023:1-10. [PMID: 37540212 DOI: 10.1080/09593985.2023.2243624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Integrating nutrition care into physiotherapy can address modifiable risk factors contributing to chronic diseases, providing comprehensive and effective patient care, and supporting a wellness-oriented approach to healthcare. OBJECTIVE To investigate physiotherapists' self-perceived confidence in their competence in nutrition care in Ireland. METHODS Cross-sectional study using data from a validated online survey tool. Four constructs of competence in nutrition care were assessed: knowledge, skill, communication and counseling, and attitude. Open-ended responses were collected to gather opinions on nutrition knowledge requirements. Participants were chartered physiotherapists representing public and private workplaces across geographical settings in Ireland. RESULTS 447 physiotherapists completed the survey. Most were female (n = 364, 81%), in private practice (n = 136, 31%), and located in a city (n = 215, 48%) with a mean 17 years post-qualification experience. Participants' self-perceived confidence in nutrition care competence was positive (mean score of 107.2/175). However, knowledge (mean score of 18.5/35) and skills (mean score of 27.2/55) related to nutrition care received lower ratings. Age and years of practice were positively associated with higher confidence in providing nutrition care. Most participants (n = 314, 71%) agreed that additional nutrition education is needed. Three overarching themes were identified regarding nutrition knowledge requirements: importance of providing nutrition advice, stated knowledge needs for nutrition education and training, and feasibility of nutrition care within physiotherapy practice. CONCLUSIONS Physiotherapists in Ireland have confidence in provision of nutrition care but rated their knowledge and skills in nutrition as relatively low. Nutrition knowledge and skill are essential for physiotherapist practice as they can significantly impact patients' outcomes.
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Affiliation(s)
- Anne Griffin
- Human Nutrition and Dietetics, School of Allied Health, Health Sciences Building, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Helen Conway
- Human Nutrition and Dietetics, School of Allied Health, Health Sciences Building, University of Limerick, Limerick, Ireland
- Clinical Nutrition and Dietetics Department, St James's Hospital, Dublin, Ireland
| | - Jacqueline Chawke
- Human Nutrition and Dietetics, School of Allied Health, Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Megan Keane
- Human Nutrition and Dietetics, School of Allied Health, Health Sciences Building, University of Limerick, Limerick, Ireland
| | - Pauline Douglas
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Dervla Kelly
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
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Mambrini SP, Soranna D, Averna E, Di Guglielmo G, Lucchetti E, Tinozzi T, Vinci C, Barbieri V, Zambon A, Bertoli S, Scacchi M. Development of a questionnaire on nutritional knowledge for the obese hospitalized patient: the NUTRIKOB questionnaire. Front Nutr 2023; 10:1232424. [PMID: 37545574 PMCID: PMC10400352 DOI: 10.3389/fnut.2023.1232424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/29/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Different approaches, involving different areas and figures, are useful for the rehabilitation of obese subjects through a multidisciplinary hospital path. A focal point of rehabilitation is represented by education on healthy eating by increasing the dietary knowledge patients. Few tools investigating food knowledge are available in Italy: therefore, the need has emerged to develop easy-to-use tools for clinical practice that allow to detect food knowledge to set up a more targeted food re-education. The following work aimed at building and validating a questionnaire capable of investigating the dietary knowledge of the population affected by obesity. Methods A pool of experts carried out a review of the literature, gathering all the information necessary to select and construct the best set of questions and the format of the final project of the questionnaire. During statistical analysis the validity, reproducibility and stability of the questionnaire were investigate in a sample of 450 subjects with obesity. Results Early analysis disclosed that 5 questions of the original questionnaire had no discriminating power. The successive validation phases were successful, confirming good content validity, stability and reproducibility over time. Discussion The questionnaire has all the characteristics to be considered a valid tool for investigating dietary knowledge in the obese population. The psychometric tests confirmed a good internal consistency of the structure, a validity of the content, a good reproducibility and stability over time.
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Affiliation(s)
- Sara Paola Mambrini
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Laboratory of Metabolic Research, S. Giuseppe Hospital, Istituto Auxologico Italiano, IRCCS, Piancavallo, Italy
| | - Davide Soranna
- Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Eva Averna
- Servizio di dietetica e nutrizione clinica -Ospedale San Giuseppe-Oggebbio- VB- Istituto Auxologico Italiano IRCCS, Oggebbio, Italy
| | - Giulia Di Guglielmo
- Servizio di dietetica e nutrizione clinica -Ospedale San Giuseppe-Oggebbio- VB- Istituto Auxologico Italiano IRCCS, Oggebbio, Italy
| | - Elisa Lucchetti
- Servizio di dietetica e nutrizione clinica -Ospedale San Giuseppe-Oggebbio- VB- Istituto Auxologico Italiano IRCCS, Oggebbio, Italy
| | - Tiziana Tinozzi
- Servizio di dietetica e nutrizione clinica -Ospedale San Giuseppe-Oggebbio- VB- Istituto Auxologico Italiano IRCCS, Oggebbio, Italy
| | - Calogero Vinci
- Servizio di dietetica e nutrizione clinica -Ospedale San Giuseppe-Oggebbio- VB- Istituto Auxologico Italiano IRCCS, Oggebbio, Italy
| | - Valerio Barbieri
- Servizio di dietetica e nutrizione clinica -Ospedale San Giuseppe-Oggebbio- VB- Istituto Auxologico Italiano IRCCS, Oggebbio, Italy
| | - Antonella Zambon
- Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Lab of Nutrition and Obesity Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Massimo Scacchi
- Laboratory of Metabolic Research, S. Giuseppe Hospital, Istituto Auxologico Italiano, IRCCS, Piancavallo, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Kim SS, Ashok S, Avula R, Mahapatra T, Gokhale P, Walton S, Heidkamp RA, Munos MK. Moderate Accuracy of Survey Responses about Infant and Young Child Feeding Counseling Reported by Mothers with Children Less than 1 Year of Age in India. J Nutr 2023; 153:1220-1230. [PMID: 36796483 DOI: 10.1016/j.tjnut.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Counseling on infant and young child feeding (IYCF) to support optimal breastfeeding and complementary feeding practices is an essential intervention, and accurate coverage data is needed to identify gaps and monitor progress. However, coverage information captured during household surveys has not yet been validated. OBJECTIVES We examined the validity of maternal reports of IYCF counseling received during community-based contacts and factors associated with reporting accuracy. METHODS Direct observations of home visits conducted by community workers in 40 villages in Bihar, India served as the "gold standard" to maternal reports of IYCF counseling received during 2-wk follow-up surveys (n = 444 mothers with children less than 1 y of age, interviews matched to direct observations). Individual-level validity was assessed by calculating sensitivity, specificity, and AUC. Population-level bias was measured using the inflation factor (IF). Multivariable regression models were used to examine factors associated with response accuracy. RESULTS Prevalence of IYCF counseling during home visits was very high (90.1%). Maternal report of any IYCF counseling received in the past 2 wk was moderate (AUC: 0.60; 95% CI: 0.52, 0.67), and population bias was low (IF = 0.90). However, the recall of specific counseling messages varied. Maternal report of any breastfeeding, exclusive breastfeeding, and dietary diversity messages had moderate validity (AUC > 0.60), but other child feeding messages had low individual validity. Child age, maternal age, maternal education, mental stress, and social desirability were associated with reporting accuracy of multiple indicators. CONCLUSIONS Validity of IYCF counseling coverage was moderate for several key indicators. IYCF counseling is an information-based intervention that may be received from various sources, and it may be challenging to achieve higher reporting accuracy over a longer recall period. We consider the modest validity results as positive and suggest that these coverage indicators may be useful for measuring coverage and tracking progress over time.
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Affiliation(s)
- Sunny S Kim
- Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA.
| | | | | | | | - Priya Gokhale
- CARE India Solutions for Sustainable Development, Bihar, India
| | - Shelley Walton
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca A Heidkamp
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Melinda K Munos
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Sykes KJ, Gibbs H, Farrokhian N, Arthur A, Flynn J, Shnayder Y, Kakarala K, Nallani R, Smith JB, Penn J, Fassas S, Cummings E, Arambula Z, Karadaghy O, Bur AM. Pilot randomized, controlled, preoperative intervention for nutrition trial in head and neck cancer. Head Neck 2023; 45:156-166. [PMID: 36250283 DOI: 10.1002/hed.27220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/20/2022] [Accepted: 10/04/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several prospective studies report improved outcomes with pretreatment nutrition interventions prior to radiation therapy for head and neck cancer (HNC), but none have assessed similar interventions before surgery for HNC. METHODS POINT, a pilot randomized controlled trial, was conducted to evaluate a multimodal nutrition intervention. Patients undergoing primary surgery with free flap reconstruction for HNC were randomly assigned to the control arm or a preoperative multimodal nutrition intervention. RESULTS POINT included 49 patients. Nutrition risk scores did not change significantly for either the intervention or control group. Control patients had a significant decrease in body weight in the preoperative period (p < 0.001). Conversely, weight among intervention patients did not significantly decrease (p = 0.680). The intervention mitigated weight loss in patients with dysphagia (p = 0.001). CONCLUSIONS Preoperative nutrition optimization shows potential to reduce weight loss normally experienced by patients with head and neck cancer prior to surgical extirpation, especially among those with subjective dysphagia.
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Affiliation(s)
- Kevin J Sykes
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Heather Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Nathan Farrokhian
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anna Arthur
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - John Flynn
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Yelizaveta Shnayder
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kiran Kakarala
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Rohit Nallani
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Joshua B Smith
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Joseph Penn
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Scott Fassas
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Emily Cummings
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Zack Arambula
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Omar Karadaghy
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andrés M Bur
- Department of Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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11
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Dai W, Wang SA, Wang K, Chen C, Wang J, Chen X, Yan J. Impact of Nutrition Counseling in Head and Neck Cancer Sufferers Undergoing Antineoplastic Therapy: A Randomized Controlled Pilot Study. Curr Oncol 2022; 29:6947-6955. [PMID: 36290823 PMCID: PMC9600229 DOI: 10.3390/curroncol29100546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 01/13/2023] Open
Abstract
Head and neck cancer (HNC) sufferers usually encounter arduous nutritional problems when they are receiving antineoplastic therapy. Consequently, the presence of anxiety and depression is commonly observed in this population. This study aimed to explore the physical and psychological influence of nutritional counseling in patients with HNC. Patients receiving concurrent chemo-radiotherapy were randomly assigned to the nutritional counseling group (n = 32, 52.45%) and the control group (n = 29, 47.54%) according to their treatment patterns. In the nutritional counseling group, registered dietitians provided face-to-face counseling during the antineoplastic treatment course at least every two weeks. Nutrient intake amount, relevant nutritional indexes, quality of life, and the degree of anxiety and depression were compared between the two groups. We observed a decrease in the calorie and protein intake amount in both groups, while the decrease in the control group is even worse. The weight loss is more obvious in the control group. The HADS scores in the intervention group were significantly lower than that in the control group (p < 0.05). The Karnofsky Performance Status (KPS) scores in the intervention group were significantly higher than that in the control group (p < 0.05). The level of serum total protein, serum albumin, transferrin, and the thickness of the triceps skin fold decreased less in the intervention group (p < 0.05). Our findings suggest that nutrition counseling is essential for the maintenance of calorie and protein intake in HNC suffers, which contributes to an improvement in the physical and psychological states. The impacts observed in this pilot study warrant further exploration in a larger prospective trial.
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Affiliation(s)
- Wangshu Dai
- Department of Geriatric Medcine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Shu-An Wang
- Department of Clinic Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Kongcheng Wang
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing 210008, China
| | - Chen Chen
- Department of Clinic Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Juan Wang
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing 210008, China
| | - Xiaotian Chen
- Department of Clinic Nutrition, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
- Correspondence: (X.C.); (J.Y.)
| | - Jing Yan
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing 210008, China
- Correspondence: (X.C.); (J.Y.)
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12
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Garite TJ, Manuck TA. Should case management be considered a component of obstetrical interventions for pregnancies at risk of preterm birth? Am J Obstet Gynecol 2022; 228:430-437. [PMID: 36130634 PMCID: PMC10024643 DOI: 10.1016/j.ajog.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022]
Abstract
Preterm birth remains the leading cause of morbidity and mortality among nonanomalous neonates in the United States. Unfortunately, preterm birth rates remain high despite current medical interventions such as progestogen supplementation and cerclage placement. Case management, which encompasses coordinated care aimed at providing a more comprehensive and supportive environment, is a key component in improving health and reducing costs in other areas of medicine. However, it has not made its way into the general lexicon and practice of obstetrical care. Case management intended for decreasing prematurity or ameliorating its consequences may include specialty clinics, social services, coordination of specialty services such as nutrition counseling, home visits or frequent phone calls by specially trained personnel, and other elements described herein. It is not currently included in nor is it advocated for as a recommended prematurity prevention approach in the American College of Obstetricians and Gynecologists or Society for Maternal-Fetal Medicine guidelines for medically indicated or spontaneous preterm birth prevention. Our review of existing evidence finds consistent reductions or trends toward reductions in preterm birth with case management, particularly among individuals with high a priori risk of preterm birth across systematic reviews, metaanalyses, and randomized controlled studies. These findings suggest that case management has substantial potential to improve the environmental, behavioral, social, and psychological factors with patients at risk of preterm birth.
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Affiliation(s)
- Thomas J Garite
- Sera Prognostics, Salt Lake City, UT; University of California Irvine, Irvine, CA.
| | - Tracy A Manuck
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Institute for Environmental Health Solutions, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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13
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Mackeen AD, Young AJ, Lutcher S, Hetherington V, Mowery JW, Savage JS, Symons Downs D, Bailey‐Davis L. Encouraging appropriate gestational weight gain in high-risk gravida: A randomized controlled trial. Obes Sci Pract 2022; 8:261-271. [PMID: 35664244 PMCID: PMC9159567 DOI: 10.1002/osp4.565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/30/2021] [Accepted: 08/28/2021] [Indexed: 12/04/2022] Open
Abstract
Trial Design Excessive gestational weight gain (GWG) can increase pregnancy morbidity and is particularly problematic for women with pregestational obesity. A lifestyle modification intervention was introduced to gravida with obesity to decrease excessive GWG as compared to usual care (UC). Methods A randomized controlled trial was conducted to improve healthy lifestyle behaviors to manage appropriate GWG. Consenting participants with prepregnancy obesity and singletons ≤17 weeks were randomized to (1) Usual Care (UC): usual written educational materials and counseling by obstetric provider or (2) Enhanced Care (EC): UC plus (a) personalized letter from physician detailing appropriate GWG; (b) access to individualized GWG chart; (c) ongoing counseling with registered dietitian/nutritionist (RDN). The primary outcome was proportion with GWG ≤9.1 kg, as this is upper limit recommended by Institute of Medicine (IOM). Total GWG and GWG as less than/within/greater than IOM recommendations (in aggregate and stratified by obesity class), and pregnancy/neonatal outcomes were evaluated as secondary outcomes. Results Analyses included 105 participants in EC and 109 in UC arms. The groups had similar demographics: 46% with class I obesity, 26% class II, and 28% class III. There were no group differences for any GWG, pregnancy, or neonatal outcomes when analyzed in aggregate. As compared to those randomized to the EC arm, participants in UC arm with class I obesity gained 1.4 kg less and those with class II obesity were significantly more likely to gain within IOM guidelines (14.8% vs. 40.0%, adjusted p = 0.04). Participants with class III obesity randomized to EC arm were more likely to gain within IOM guidelines as compared to participants randomized to UC arm (29.0% vs. 6.7%, adjusted p = 0.02). Conclusion There were no differences in GWG observed between groups when analyzing participants in aggregate. However, a physician's letter detailing appropriate GWG, patient portal access to a personalized GWG chart, and RDN consultation were helpful for encouraging GWG within IOM guidelines for women with prepregnancy class III obesity. Women with class I or II obesity had better GWG outcomes without these additional interventions.
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Affiliation(s)
| | - Amanda J. Young
- Department of Population Health SciencesGeisingerDanvillePennsylvaniaUSA
- Biostatistics CoreGeisingerDanvillePennsylvaniaUSA
| | | | | | | | - Jennifer S. Savage
- Department of Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Danielle Symons Downs
- Department of KinesiologyThe Pennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Lisa Bailey‐Davis
- Department of Population Health SciencesGeisingerDanvillePennsylvaniaUSA
- Obesity InstituteGeisingerDanvillePennsylvaniaUSA
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14
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Elfert P, Berndt J, Dierkes L, Eichelberg M, Rösch N, Hein A, Diekmann R. A Novel Digital Nutrition Diary for Geriatric Patients at High Risk of Frailty Syndrome. Nutrients 2022; 14:nu14030400. [PMID: 35276760 PMCID: PMC8838007 DOI: 10.3390/nu14030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 02/01/2023] Open
Abstract
Due to the physical, psychological, or socioeconomic changes that accompany aging, many people will be affected by geriatric frailty syndrome, which can lead to multimorbidity and premature death. Nutrition counseling is often used to prevent and intervene in frailty syndrome, especially in geriatric rehabilitation. To this end, the consumption behavior of geriatric patients is recorded using paper-based, as well as retrospective memory logs in face-to-face interviews between patients and nutritionists. To simplify this procedure, a digital nutrition diary was developed that is specially adapted to the needs of geriatric patients (>=70 years), enabling them to record their consumption behavior themselves. In an initial study (Study 1), conducted in a geriatric rehabilitation division with twelve subjects (ten male, two female, mean age 79.2 ±5.9 years), feedback about the usability of the digital nutrition diary, and how to improve it, was surveyed. In addition, the usability of an activity tracker and a body composition scale was surveyed to determine whether geriatric patients are generally able to use these devices. In a second study (Study 2), also conducted in the geriatric rehabilitation division, this time with sixteen subjects (ten male, six female, mean age 79.3 ±3.9 years), the usability of the digital nutrition diary was surveyed again to evaluate its modifications based on the feedback from Study 1. In Study 1, the usability rating of the system (0−100) was 82.5 for the activity tracker, 29.71 for the body composition scale, and 51.66 initially for the digital nutrition diary, which increased to 76.41 in Study 2.
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Affiliation(s)
- Patrick Elfert
- R&D Division Health, OFFIS Institute for Information Technology, 26121 Oldenburg, Germany;
- Correspondence:
| | - Julia Berndt
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
| | - Louisa Dierkes
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
| | - Marco Eichelberg
- R&D Division Health, OFFIS Institute for Information Technology, 26121 Oldenburg, Germany;
| | - Norbert Rösch
- Department of Computer Sciences and Microsystems Technology, University of Applied Sciences Kaiserslautern, 66482 Zweibrücken, Germany;
| | - Andreas Hein
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
| | - Rebecca Diekmann
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany; (J.B.); (L.D.); (A.H.); (R.D.)
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15
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Sahathevan S, Karupaiah T, Khor BH, Sadu Singh BK, Mat Daud ZA, Fiaccadori E, Sabatino A, Chinna K, Abdul Gafor AH, Bavanandan S, Visvanathan R, Yahya R, Wahab Z, Goh BL, Morad Z, Bee BC, Wong HS. Muscle Status Response to Oral Nutritional Supplementation in Hemodialysis Patients With Protein Energy Wasting: A Multi-Center Randomized, Open Label-Controlled Trial. Front Nutr 2022; 8:743324. [PMID: 34977109 PMCID: PMC8717812 DOI: 10.3389/fnut.2021.743324] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Muscle wasting, observed in patients with end-stage kidney disease and protein energy wasting (PEW), is associated with increased mortality for those on hemodialysis (HD). Oral nutritional supplementation (ONS) and nutrition counseling (NC) are treatment options for PEW but research targeting muscle status, as an outcome metric, is limited. Aim: We compared the effects of combined treatment (ONS + NC) vs. NC alone on muscle status and nutritional parameters in HD patients with PEW. Methods: This multi-center randomized, open label-controlled trial, registered under ClinicalTrials.gov (Identifier no. NCT04789031), recruited 56 HD patients identified with PEW using the International Society of Renal Nutrition and Metabolism criteria. Patients were randomly allocated to intervention (ONS + NC, n = 29) and control (NC, n = 27) groups. The ONS + NC received commercial renal-specific ONS providing 475 kcal and 21.7 g of protein daily for 6 months. Both groups also received standard NC during the study period. Differences in quadriceps muscle status assessed using ultrasound (US) imaging, arm muscle area and circumference, bio-impedance spectroscopy (BIS), and handgrip strength (HGS) methods were analyzed using the generalized linear model for repeated measures. Results: Muscle indices as per US metrics indicated significance (p < 0.001) for group × time interaction only in the ONS + NC group, with increases by 8.3 and 7.7% for quadriceps muscle thickness and 4.5% for cross-sectional area (all p < 0.05). This effect was not observed for arm muscle area and circumference, BIS metrics and HGS in both the groups. ONS + NC compared to NC demonstrated increased dry weight (p = 0.039), mid-thigh girth (p = 0.004), serum prealbumin (p = 0.005), normalized protein catabolic rate (p = 0.025), and dietary intakes (p < 0.001), along with lower malnutrition–inflammation score (MIS) (p = 0.041). At the end of the study, lesser patients in the ONS + NC group were diagnosed with PEW (24.1%, p = 0.008) as they had achieved dietary adequacy with ONS provision. Conclusion: Combination of ONS with NC was effective in treating PEW and contributed to a gain in the muscle status as assessed by the US, suggesting that the treatment for PEW requires nutritional optimization via ONS.
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Affiliation(s)
- Sharmela Sahathevan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Perak, Malaysia
| | - Tilakavati Karupaiah
- School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University Lakeside, Selangor, Malaysia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Birinder Kaur Sadu Singh
- Department of Pharmacy, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Enrico Fiaccadori
- Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Alice Sabatino
- Nephrology Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University Lakeside, Selangor, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sunita Bavanandan
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | - Rosnawati Yahya
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Zaimi Wahab
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Bak-Leong Goh
- Department of Nephrology, Serdang Hospital, Selangor, Malaysia
| | - Zaki Morad
- National Kidney Foundation, Selangor, Malaysia
| | - Boon Cheak Bee
- Department of Nephrology, Selayang Hospital, Selangor, Malaysia
| | - Hin Seng Wong
- Department of Nephrology, Selayang Hospital, Selangor, Malaysia
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16
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Roba AA, Tola A, Dugassa D, Tefera M, Gure T, Worku T, Ayele AT, Dasa TT, Workie HM, Asfaw MM, Asfaw A, Mesfin F, Regassa LD, Dessie Y, Abera F, Yeshitila M, Girma M, Gezahagn M, Tezera F, Assefa N, Roba KT. Antenatal care utilization and nutrition counseling are strongly associated with infant and young child feeding knowledge among rural/semi-urban women in Harari region, Eastern Ethiopia. Front Pediatr 2022; 10:1013051. [PMID: 36245728 PMCID: PMC9557120 DOI: 10.3389/fped.2022.1013051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/12/2022] [Indexed: 11/15/2022] Open
Abstract
There is a gap in evidence linking antenatal care (ANC) utilization, nutrition counseling, and knowledge of pregnant women about infant and young child feeding (IYCF), particularly in low-income settings. Therefore, this study aimed to identify the association between ANC follow-up and nutrition counseling with IYCF knowledge. A cross-sectional study was conducted among 390 pregnant women in the rural kebeles of the Harari region from January to June 2019. Data were collected using face-to-face interviews on tablet computers. Bivariate and multivariate logistic regression were employed. An adjusted odds ratio (with 95% CI) was used to determine the strength of association between IYCF knowledge with ANC follow-up and nutrition counseling by adjusting for educational status, occupation, gravida, and distance to the nearest health center. Overall, 54.4% [95% CI 49.2, 59.2] of currently pregnant women were knowledgeable about IYCF of which only 20% started ANC follow-up and 24.4% received nutrition counseling. Out of 288 multigravida women, only 51.4% had ANC follow-up during their last pregnancy. In the adjusted model, ANC follow-up during the current pregnancy (AOR 1.85, 95% CI 1.07-3.22), those who received nutrition counseling (AOR 1.92, 95% CI 1.09-3.38), literate in education (AOR 1.71, 95% CI 1.07-2.73), multigravida (AOR 1.96, 95% CI 1.12-3.43), and far from the nearest health center (AOR 0.95, 95% CI 0.93-0.97) were significantly associated with the mothers IYCF knowledge. Thus, health care providers should encourage mothers to attend ANC during pregnancy and provide nutrition counseling about the IYCF.
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Affiliation(s)
- Aklilu Abrham Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Assefa Tola
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Desta Dugassa
- Haramaya Institute of Technology, Haramaya University, Dire Dawa, Ethiopia
| | - Maleda Tefera
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tadese Gure
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Teshager Worku
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | | | | | | | | | - Abiyot Asfaw
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Firehiwot Mesfin
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | | | - Yadeta Dessie
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Fitsum Abera
- College of Agriculture, Haramaya University, Dire Dawa, Ethiopia
| | - Meron Yeshitila
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Meskerem Girma
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Gezahagn
- College of Agriculture, Haramaya University, Dire Dawa, Ethiopia
| | - Feven Tezera
- College of Agriculture, Haramaya University, Dire Dawa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
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17
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Schrauben SJ, Inamdar A, Yule C, Kwiecien S, Krekel C, Collins C, Anderson C, Bailey-Davis L, Chang AR. Effects of Dietary App-Supported Tele-Counseling on Sodium Intake, Diet Quality, and Blood Pressure in Patients With Diabetes and Kidney Disease. J Ren Nutr 2022; 32:39-50. [PMID: 34649784 PMCID: PMC8727497 DOI: 10.1053/j.jrn.2021.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/15/2021] [Accepted: 08/10/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The aim of this study is to examine the effect of a telehealth intervention that used a dietary app, educational website, and weekly dietitian tele-counseling on sodium intake, diet quality, blood pressure, and albuminuria among individuals with diabetes and early-stage chronic kidney disease. DESIGN AND METHODS We examined the effects of a dietary app-supported tele-counseling intervention in a single center, single arm study of 44 participants with type 2 diabetes and stage 1-3a chronic kidney disease. Participants recorded and shared dietary data via MyFitnessPal with registered dietitians, who used motivational interviewing to provide telephone counseling weekly for 8 weeks. After the 8-week intensive intervention, participants were followed at 6 and 12 months. Outcomes included 24-hour urine sodium (2 collections per timepoint), Healthy Eating Index 2015 score (three 24-hour dietary recalls per timepoint), 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP), and 24-hour urine albumin excretion. RESULTS Out of 44 consented participants (mean age 60.3 ± 11.9 years, 43% female, 89% white, median estimated glomerular filtration rate was 78.5 mL/min/1.73 m2, median urine albumin excretion 52.9 mg/day, 84% hypertension), 32 (73%) completed 8-week follow-up, 27 (61%) completed 6-month follow-up, and 25 (57%) completed 12-month follow-up. Among participants who completed 12-month follow-up, reported sodium intake decreased by 638 mg/day from baseline of 2,919 mg/day (P < .001). The 24-hour mean urine sodium and albumin excretion did not decline over the study period. Healthy Eating Index 2015 score improved by 7.76 points at 12 months from a mean baseline of 54.6 (P < .001). Both 24-hour SBP and DBP declined at 12 months from baseline (SBP -5.7 mm Hg, 95% confidence interval -10.5 to -1.0, P = .02; DBP -4.1 mm Hg, 95% confidence interval -7.2 to -1.1, P = .01). CONCLUSIONS Overall, this study demonstrates that a short, intensive, remotely delivered dietary intervention for adults with type 2 diabetes and early chronic kidney disease at high risk for disease progression and cardiovascular complications led to improvement in blood pressure and self-reported sodium intake and diet quality, but no improvement in albuminuria. Future research studies are needed to examine whether remotely delivered dietary interventions can ultimately improve kidney health over time.
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Affiliation(s)
- Sarah J. Schrauben
- Renal, Electrolyte-Hypertension Division; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | | | - Cheryl Anderson
- Department of Family Medicine and Public Health, University of California San Diego
| | - Lisa Bailey-Davis
- Obesity Institute, Geisinger Health,Department of Population Health Sciences, Geisinger Health
| | - Alex R. Chang
- Kidney Health Research Institute, Geisinger Health,Department of Population Health Sciences, Geisinger Health
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18
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Mizukami T, Miyaji T, Narita Y, Matsushima T, Ogura T, Miyagaki H, Kawabata R, Horie Y, Kawaguchi T, Muro K, Hara H, Yamaguchi T, E Nakajima T. An observational study on nutrition status in gastric cancer patients receiving ramucirumab plus taxane: BALAST study. Future Oncol 2021; 17:2431-2438. [PMID: 33764163 DOI: 10.2217/fon-2021-0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Limited data are available regarding the efficacy of nutrition support in advanced gastric cancer (AGC) patients receiving a standard second-line combination chemotherapy. The BALAST study is conducted as a prospective, multicenter observational study to evaluate the efficacy of nutrition support for patients with AGC treated with ramucirumab plus taxane as second-line treatment. As part of the routine care, patients who are malnourished or at risk of malnutrition will receive nutrition support from dietitians. We will enroll a total of 26 patients to estimate weight control rate at 12 weeks as primary end point. This study will generate valuable data reinforcing the role of nutrition support therapy for AGC patients receiving second-line chemotherapy.
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Affiliation(s)
- Takuro Mizukami
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Yukiya Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Tomohiro Matsushima
- Department of Gastroenterology, Saitama Cancer Center, Saitama, 362-0806, Japan
| | - Takashi Ogura
- Department of Clinical Oncology, Kawasaki Municipal Tama Hospital, Kawasaki, 214-8525, Japan
| | | | - Ryohei Kawabata
- Department of Surgery, Osaka Rosai Hospital, Sakai, 591-8025, Japan
| | - Yoshiki Horie
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy & Life Sciences, Hachioji, 192-0392, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama, 362-0806, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Takako E Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
- Kyoto Innovation Center for Next-Generation Clinical Trials & iPS Cell Therapy, Kyoto University Hospital, Kyoto, 606-8507, Japan
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19
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Cho J, Marishak-Simon S, Smith DR, Stevens AB. The impact of a nutrition counseling program on the use of hospital services for Meals on Wheels clients. J Prev Interv Community 2021:1-13. [PMID: 34096479 DOI: 10.1080/10852352.2021.1930818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Home-delivered meals have shown considerable promise in overcoming nutritional challenges among homebound older adults facing food insecurity and the risk of diabetes, while nutrition counseling provides knowledge and skills for diabetes management. The purpose of this study was to identify the impact of a program combining nutrition counseling with home-delivered meals by examining the use of hospital services 6 months before and after participating in the program. This study included 1009 clients who are at risk for diabetes and who received home-delivered meals and nutrition counseling via Meals on Wheels in Fort Worth, Texas. Hospital service data were extracted from a regional claims database. Generalized linear models were performed to examine changes in use of hospital services 6 months before and after program participation. The mean number of emergency department visits and hospitalizations decreased from 0.69 to 0.50 (p < .001) and from 0.35 to 0.22 (p < .001), respectively. The findings of this study indicate that combining structured nutritional counseling with home-delivered meals may contribute to reducing healthcare use among older adults facing the challenges of diabetes and food insecurity.
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Affiliation(s)
- Jinmyoung Cho
- Baylor Scott & White Health, Temple, Texas, USA.,Texas A&M School of Public Health, College Station, Texas, USA
| | | | - Donald R Smith
- Area Agency on Aging, United Way of Tarrant County, Fort Worth, Texas, USA
| | - Alan B Stevens
- Baylor Scott & White Health, Temple, Texas, USA.,Texas A&M College of Medicine, Temple, Texas, USA
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Doxey RS, Krug MF, Tivis R. The Lunch Conference Diet: Fostering Resident Engagement in Culinary Medicine Through a Curriculum Centered on Changes to Provided Conference Food. Am J Lifestyle Med 2021; 15:249-255. [PMID: 34025315 DOI: 10.1177/1559827621994499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite the burden of chronic disease attributable to lifestyle, most internal medicine residents do not receive adequate training in nutrition and nutrition counseling. METHODS We held a culinary medicine workshop in September 2018, followed by didactic sessions throughout the academic year. Changes were made to lunch conference food to more closely follow the Mediterranean diet and to encourage healthy eating. With a modified NUTCOMP (Nutrition Competence Questionnaire) instrument, we assesses residents' perceived competence with nutrition counseling before and after the curriculum. RESULTS Twenty-six of 30 residents completed the pre-curriculum and post-curriculum surveys (not the same 26). The mean NUTCOMP score increased from 3.5 to 4.0 (P < .0001), indicating an increased perceived competence with nutritional counseling. Residents felt that nutritional counseling was important before and after the curriculum (4.2 to 4.3, P = .48). Conference food was more nutritious at the end of the intervention (Mediterranean diet score range 1-4 to 4-7) and residents enjoyed the food more. CONCLUSIONS An innovative, multimodal nutrition curriculum centered on changes to catered lunch conference food improved resident's confidence with nutritional counseling. This could feasibly be integrated into other residency programs with supportive leadership and adequate training.
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Affiliation(s)
- Richmond S Doxey
- University of Washington-Boise VA Internal Medicine Residency, Boise, Idaho
| | - Michael F Krug
- University of Washington-Boise VA Internal Medicine Residency, Boise, Idaho
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Lelijveld N, Godbout C, Krietemeyer D, Los A, Wegner D, Hendrixson DT, Bandsma R, Koroma A, Manary M. Treating high-risk moderate acute malnutrition using therapeutic food compared with nutrition counseling (Hi-MAM Study): a cluster-randomized controlled trial. Am J Clin Nutr 2021; 114:955-964. [PMID: 33963734 PMCID: PMC8921644 DOI: 10.1093/ajcn/nqab137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/01/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is a lack of consensus on what is the most appropriate treatment of moderate acute malnutrition (MAM). OBJECTIVES We aimed to determine if provision of ready-to-use-therapeutic food (RUTF) and antibiotics to "high-risk" MAM (HR-MAM) children in addition to nutritional counseling would result in higher recovery and less deterioration than nutrition counseling alone. METHODS At the 11 intervention clinics, HR-MAM children were given RUTF and amoxicillin along with standard nutrition counseling, for 2-12 wk. All others received 6 wk of nutrition counseling alone. HR-MAM was defined as midupper arm circumference (MUAC) <11.9 cm, weight-for-age z score (WAZ) <-3.5, mother not the main caregiver, or a child <2 y old not being breastfed. Outcomes were compared using intention-to-treat analysis. RESULTS Analysis included 573 children at the intervention sites and 714 children at the control sites. Of the intervention group, 317 (55%) were classified as HR-MAM. Short-term recovery was greater at the intervention sites [48% compared with 39% at week 12; risk difference (rd): 0.08; 95% CI: 0.03, 0.13]. The intervention group had lower risk of deteriorating to severe acute malnutrition (SAM) (18% compared with 24%; rd: -0.07; 95% CI: -0.11, -0.04), lower risk of dying (1.8% compared with 3.1%; rd: -0.02; 95% CI: -0.03, -0.00), and greater gains in MUAC and weight than did children at the control sites. However, by 24 wk, the risk of SAM was similar between the 2 arms (31% compared with 34%; rd: -0.03; 95% CI: -0.09, 0.02). Control group data identified recent illness, MUAC <12.0 cm, WAZ <-3, dropping anthropometry, age <12 mo, being a twin, and a history of previous SAM as risk factors for deterioration. CONCLUSIONS Provision of RUTF and antibiotics to HR-MAM children improved short-term recovery and reduced short-term risk of deterioration. However, recovery rates were still suboptimal and differences were not sustained by 6 mo post enrollment.This trial was registered at clinicaltrials.gov as NCT03647150.
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Affiliation(s)
| | - Claire Godbout
- Project Peanut Butter, Freetown, Sierra
Leone,Washington University School of Medicine, St. Louis, MO,
USA
| | - Destiny Krietemeyer
- Project Peanut Butter, Freetown, Sierra
Leone,Washington University School of Medicine, St. Louis, MO,
USA
| | - Alyssa Los
- Project Peanut Butter, Freetown, Sierra
Leone,Washington University School of Medicine, St. Louis, MO,
USA
| | - Donna Wegner
- Washington University School of Medicine, St. Louis, MO,
USA
| | | | - Robert Bandsma
- Centre for Global Child Health, Hospital for Sick Kids,
Toronto, Ontario, Canada
| | | | - Mark Manary
- Project Peanut Butter, Freetown, Sierra
Leone,Washington University School of Medicine, St. Louis, MO,
USA
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Woo J, Ho EY, Jih J. Heart-Healthy Integrative Nutritional Counseling Group Education Sessions Among Chinese Americans With Cardiovascular Risk Factors or Disease: A Primary Care Quality Improvement Pilot. J Patient Cent Res Rev 2021; 8:127-133. [PMID: 33898645 PMCID: PMC8060041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
PURPOSE Current biomedical cardiovascular disease nutrition counseling does not incorporate Chinese medicine principles. METHODS A heart-healthy integrative nutritional counseling (H2INC) curriculum consistent with Chinese medicine principles and biomedical nutrition guidelines was taught to Chinese Americans in group education sessions. Chinese-speaking patients with cardiovascular disease or risk factors from an urban general medicine practice were recruited to attend a 90-minute group session. Participants completed pre-post surveys to assess the impact of H2INC on their perceived heart-healthy nutrition knowledge and empowerment, as well as the cultural relevance of H2INC. RESULTS A total of 47 participants (mean age: 74 years; 63.8% female) attended a session. In response to the statement "I am able to choose heart-healthy Chinese foods to eat," on a 5-point Likert scale for which "strongly disagree" = 1 and "strongly agree" = 5, the presession survey mean response was 3.87 ± 0.69 and the postsession survey mean response was 4.13 ± 0.58 (P=0.05). Postsession, 87% of participants agreed or strongly agreed that they felt confident using what they learned and 94% agreed or strongly agreed that H2INC fit their culture. CONCLUSIONS H2INC had a positive impact on perceived heart-healthy nutrition knowledge and empowerment and rated high in cultural relevance. Culturally relevant education sessions like H2INC could be a promising primary care health education intervention.
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Affiliation(s)
- Jasmin Woo
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
- School of Nursing, University of California, San Francisco, San Francisco, CA
| | - Evelyn Y. Ho
- Department of Communication Studies, University of San Francisco, San Francisco, CA
- Asian American Research Center on Health, San Francisco, CA
| | - Jane Jih
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
- Asian American Research Center on Health, San Francisco, CA
- Multiethnic Health Equity Research Center, University of California, San Francisco, San Francisco, CA
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Matsuzaki K, Fukushima N, Saito Y, Matsumoto N, Nagaoka M, Katsuda Y, Miura SI. The Effects of Long-Term Nutrition Counseling According to the Behavioral Modification Stages in Patients with Cardiovascular Disease. Nutrients 2021; 13:nu13020414. [PMID: 33525463 PMCID: PMC7911793 DOI: 10.3390/nu13020414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: the behavioral modification stages (BMS) are widely used; however, there are no reports on long-term nutrition counseling for cardiovascular disease (CVD) according to BMS. Aim: to study the effects of long-term nutrition counseling based on the BMS in patients with CVD. Methods: fifteen patients with CVD who participated in nutrition counseling were enrolled between June 2012 and December 2016. We provided BMS and dietary questionnaires to estimate the stage score (SS), salt intake, and drinking habits (non-drinking group (n = 7)/drinking group (n = 8)), and measured the blood pressure (BP), body mass index (BMI), and biochemical markers before and after hospitalization at 6 months, 1 year, and 1.5 years after leaving the outpatient department (OPD). Results: a significant decreased salt intake and increase in SS were found at 1.5 years. It significantly decreased the BP and salt intake in the non-drinking group at 1.5 years. Conclusions: long-term nutrition counseling according to BMS improved salt intake and BP in the non-drinking group. However, in the drinking group, increased salt intake might weaken the BP improvement. Temperance and low-sodium intake are essential factors that control BP, especially in drinkers.
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Affiliation(s)
- Keiko Matsuzaki
- Department of Nutrition, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan
- Correspondence: ; Tel.: +81-92-831-1211
| | - Nobuko Fukushima
- Fukuoka Women’s Junior College Health and Nutrition, Fukuoka 818-0193, Japan;
| | - Yutaka Saito
- Department of Cardiovascular Medicine, Public Yame General Hospital, Fukuoka 834-0034, Japan;
| | - Naoya Matsumoto
- Department of Rehabilitation, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan;
| | - Mayu Nagaoka
- Department of Pharmacy, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan;
| | - Yousuke Katsuda
- Department of Cardiovascular Medicine, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan; (Y.K.); (S.-i.M.)
| | - Shin-ichiro Miura
- Department of Cardiovascular Medicine, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan; (Y.K.); (S.-i.M.)
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Richards J, Arensberg MB, Thomas S, Kerr KW, Hegazi R, Bastasch M. Impact of Early Incorporation of Nutrition Interventions as a Component of Cancer Therapy in Adults: A Review. Nutrients 2020; 12:nu12113403. [PMID: 33167544 PMCID: PMC7694504 DOI: 10.3390/nu12113403] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022] Open
Abstract
Malnutrition is prevalent among oncology patients and can adversely affect clinical outcomes, prognosis, quality of life, and survival. This review evaluates current trends in the literature and reported evidence around the timing and impact of specific nutrition interventions in oncology patients undergoing active cancer treatment. Previous research studies (published 1 January 2010–1 April 2020) were identified and selected using predefined search strategy and selection criteria. In total, 15 articles met inclusion criteria and 12/15 articles provided an early nutrition intervention. Identified studies examined the impacts of nutrition interventions (nutrition counseling, oral nutrition supplements, or combination of both) on a variety of cancer diagnoses. Nutrition interventions were found to improve body weight and body mass index, nutrition status, protein and energy intake, quality of life, and response to cancer treatments. However, the impacts of nutrition interventions on body composition, functional status, complications, unplanned hospital readmissions, and mortality and survival were inconclusive, mainly due to the limited number of studies evaluating these outcomes. Early nutrition interventions were found to improve health and nutrition outcomes in oncology patients. Future research is needed to further evaluate the impacts of early nutrition interventions on patients’ outcomes and explore the optimal duration and timing of nutrition interventions.
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Affiliation(s)
- Julie Richards
- Abbott Nutrition, Bob Evans Farms, Columbus, OH 43212, USA
- Correspondence: ; Tel.: +1-740-497-7708
| | - Mary Beth Arensberg
- Abbott Nutrition Division of Abbott, Columbus, OH 43219, USA; (M.B.A.); (S.T.); (K.W.K.); (R.H.)
| | - Sara Thomas
- Abbott Nutrition Division of Abbott, Columbus, OH 43219, USA; (M.B.A.); (S.T.); (K.W.K.); (R.H.)
| | - Kirk W. Kerr
- Abbott Nutrition Division of Abbott, Columbus, OH 43219, USA; (M.B.A.); (S.T.); (K.W.K.); (R.H.)
| | - Refaat Hegazi
- Abbott Nutrition Division of Abbott, Columbus, OH 43219, USA; (M.B.A.); (S.T.); (K.W.K.); (R.H.)
| | - Michael Bastasch
- Department of Medicine and Division of Radiation Oncology, University of Texas East Health, Athens, TX 75751, USA;
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Mattei J, Alfonso C. Strategies for Healthy Eating Promotion and Behavioral Change Perceived as Effective by Nutrition Professionals: A Mixed-Methods Study. Front Nutr 2020; 7:114. [PMID: 32923451 PMCID: PMC7457058 DOI: 10.3389/fnut.2020.00114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/18/2020] [Indexed: 01/16/2023] Open
Abstract
Nutrition professionals may recognize ways to improve diet among their clients/patients. This study aimed to survey strategies and foods that nutrition professionals in Puerto Rico perceive as most effective for healthy eating promotion and behavioral change. The study was a cross-sectional online mixed-methods survey conducted among registered members of the College of Nutritionists and Dietitians of Puerto Rico. Using close-ended questions, nutrition professionals identified foods that they considered as easy to include or difficult to control in the diet of their clients/patients, and strategies that may work best for healthy eating. Frequencies of responses were analyzed. Open-ended questions were qualitatively analyzed in NVivo v11. The response rate was 33.2% (n = 414). The foods deemed as easy to include in the diet were root vegetables (66%), fruit (66%), legumes (57%), water (38%), and yogurt/dairy (37%). The foods deemed as more difficult to control were sugary beverages (63%), sweets and desserts (57%), fats and fried foods (56%), salt (50%), and white rice (44%). The strategies for healthy eating deemed effective were personalized orientation (79%), setting short-term goals (61%), making gradual dietary changes (53%), and setting health-oriented (41%), and personal (37%) goals. Emerging themes from qualitative analysis included the intuited key role of nutrition professionals, the need for policy changes, emphasizing prevention, cultural sensitivity, and practical issues. Respondents suggested potential strategies across levels of the socioecological model. In conclusion, healthy eating strategies and foods perceived by nutrition professionals as effective may shape optimal nutritional counseling and population-wide approaches to improve healthy eating in Puerto Rico.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Charmaine Alfonso
- College of Nutritionists and Dietitians of Puerto Rico, San Juan, PR, United States
- School of Health Sciences, Ana G. Méndez University, Gurabo Campus, Gurabo, PR, United States
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Sorić T, Mavar M, Rumbak I. The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Syndrome in Hospitalized Schizophrenic Patients: A Randomized Controlled Trial. Nutrients. 2019;11. [PMID: 31817080 DOI: 10.3390/nu11122950] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023] Open
Abstract
The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and metabolic syndrome (MetS) in people with schizophrenia is unknown and remains to be investigated. Therefore, we have conducted a three-month parallel-group randomized controlled trial. Sixty-seven hospitalized schizophrenic patients with MetS [n = 33 in the intervention group (IG) and n = 34 in the control group (CG)] completed the intervention. The IG followed the DASH diet with the caloric restriction of approximately 1673.6 kJ/day (400 kcal/day) when compared to the standard hospital diet followed by the CG. Simultaneously, both groups participated in a nutrition counseling program. Anthropometric and biochemical parameters and blood pressure were measured at the baseline and after three months, while nutrient intakes during the intervention were assessed using three non-consecutive 24-hour dietary recalls. The analyses were carried out based on the per-protocol approach. At three months, the MetS prevalence significantly decreased in both the IG and the CG (75.8%, p = 0.002, and 67.7%, p = 0.0003, respectively; odds ratio = 0.9; 95% confidence interval = 0.43–1.87). No significant differences in the prevalence of MetS and its features were found between the groups.
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Limon-Miro AT, Lopez-Teros V, Astiazaran-Garcia H. Dynamic Macronutrient Meal-Equivalent Menu Method: Towards Individual Nutrition Intervention Programs. Methods Protoc 2019; 2:E78. [PMID: 31491882 DOI: 10.3390/mps2030078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/24/2019] [Accepted: 09/03/2019] [Indexed: 11/23/2022] Open
Abstract
Nutrition interventions should reflect the state of the art in science and dietetics to meet each patient’s requirements. Incorporating new knowledge into individualized food-based nutrition interventions is a major challenge, and health care professionals constantly search for novel approaches through specific and standardized methods. The dynamic macronutrient meal-equivalent menu method involves individuals making informed food choices that match their requirements, schedule, and food availability and affinity, helping them maintain a sense of control and motivation to adhere to a nutrition intervention program. This protocol includes the steps required to prepare a nutrition plan containing equivalent meal options consistent with the patient’s needs and preferences. Standard food servings are planned according to population specific dietary guidelines and individual characteristics. Servings are distributed at required mealtimes, and are all equivalent in energy and macronutrient content, providing every patient with interchangeable choices within each mealtime. This empowers individuals to select foods in a guided format whilst adhering to a dietary plan. Acceptable variations for calculated energy and macronutrient content are as follows: protein ±1 g/day, fat ±1 g/day, carbohydrate ±2 g/day, and energy ±15 kcal/day. Following this method, health care professionals can develop individualized nutrition intervention programs that may improve patients’ adherence, nutritional status, and health.
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Watowicz RP, Wexler RK, Weiss R, Anderson SE, Darragh AR, Taylor CA. Nutrition Counseling for Hypertension Within a Grocery Store: An Example of the Patient-Centered Medical Neighborhood Model. J Nutr Educ Behav 2019; 51:129-137.e1. [PMID: 30738561 DOI: 10.1016/j.jneb.2018.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of nutrition counseling for patients with hypertension, provided in a grocery store setting. DESIGN Single-arm pretest-posttest design implementing a 12-week dietary intervention. SETTING Grocery store. PARTICIPANTS Thirty adults with hypertension recruited from a primary care practice. INTERVENTION Registered dietitian nutritionists provided counseling based on the Dietary Approaches to Stop Hypertension diet. MAIN OUTCOME MEASURES Dietary intake patterns and Healthy Eating Index-2010 (HEI-2010) scores measured via food-frequency questionnaire. Change in systolic blood pressure (SBP) was a secondary outcome. ANALYSIS Paired t tests were used to test for differences between HEI-2010 scores, intake of key food pattern components, and SBP at baseline compared with follow-up. Statistical significance was established at P ≤ .05. RESULTS Eight HEI-2010 component scores increased significantly from baseline to follow-up (a change toward a more desirable eating pattern): total fruit, whole fruit, greens and beans, whole grains, fatty acids, refined grains, and empty calories. Sodium (P < .001), saturated fat (P < .001), discretionary solid fat (P < .001), added sugars (P = .01), and total fat (P < .001) all decreased significantly. The change in SBP was not significant. CONCLUSIONS AND IMPLICATIONS Grocery store-based counseling for patients with hypertension may be an effective strategy to provide lifestyle counseling that is not typically available within primary care.
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Affiliation(s)
- Rosanna P Watowicz
- Department of Nutrition, Case Western Reserve University, Cleveland, OH.
| | - Randell K Wexler
- Department of Family Medicine, The Ohio State University, Columbus, OH
| | | | - Sarah E Anderson
- College of Public Health, The Ohio State University, Columbus, OH
| | - Amy R Darragh
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
| | - Christopher A Taylor
- Department of Family Medicine, The Ohio State University, Columbus, OH; School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
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Menasria L, Blaney S, Main B, Vong L, Hun V, Raminashvili D, Chhea C, Chiasson L, Leblanc CP. Mitigated Impact of Provision of Local Foods Combined with Nutrition Education and Counseling on Young Child Nutritional Status in Cambodia. Nutrients 2018; 10:nu10101450. [PMID: 30301233 PMCID: PMC6212877 DOI: 10.3390/nu10101450] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/25/2018] [Accepted: 09/30/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In Cambodia, stunting and wasting affect, respectively, 32% and 10% of children 0⁻59 months while 55% are anemic. Our research aims to assess the efficiency of two local foods combined with nutritional education and counseling (CEN) activities as compared to CEN alone on improving child nutritional status and dietary intake. METHODS A cluster-randomized controlled trial was conducted in Soth Nikum area over a six-month period among children 6⁻23 months (n = 360) assigned to receive either moringa +CEN, cricket +CEN or CEN alone. Anthropometric measurements were performed and hemoglobin and ferritin levels assessed. RESULTS Overall, no significant increase in the mean length/height-for-age z-score was observed, although a small increase of the weight-for-length/height was noted in intervention groups. Hemoglobin and ferritin mean values increased in all groups. The degree of satisfaction of energy, proteins, iron, and zinc requirements improved in all groups, but to a greater extent in the intervention groups and more children were healthy. CONCLUSION Our research shows no significant impact of the provision of two local foods combined with CEN on the improvement of child nutritional status as compared to CEN alone. However, children consuming them better fulfilled their energy, iron, and zinc requirements and were healthier.
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Affiliation(s)
- Lylia Menasria
- École des sciences des aliments, de nutrition et d'étude familiale, Université de Moncton, Moncton, NB E1A 3E9, Canada.
| | - Sonia Blaney
- École des sciences des aliments, de nutrition et d'étude familiale, Université de Moncton, Moncton, NB E1A 3E9, Canada.
| | - Barbara Main
- International Programs, World Vision Canada, 1 World Drive, Mississauga, ON L5T 2Y4, Canada.
| | - Lenin Vong
- Independent consultant, Phnom Penh 12203, Cambodia.
| | - Vannary Hun
- World Vision Cambodia, Phnom Penh 12203, Cambodia.
| | | | - Chhorvann Chhea
- National Institute of Public Health (NIPH), Ministry of Health, Phnom Penh 12203, Cambodia.
| | - Lucie Chiasson
- Direction du mieux-être, Ministère du développement social, Miramichi, NB E1N 1B6, Canada.
| | - Caroline P Leblanc
- École des sciences des aliments, de nutrition et d'étude familiale, Université de Moncton, Moncton, NB E1A 3E9, Canada.
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Abstract
INTRODUCTION Nutritional interventions improve patient outcomes and reduce mortality in patients with cirrhosis by reducing infection risk, ascites, length of stay in hospital and intensive care unit, and mortality. Follow-up phone calls have been found to be useful in improving patient adherence to therapy. PROBLEM The purpose of this quality improvement project was to determine whether supplemental nutrition education would improve nutrition and outcomes among patients with cirrhosis who are undergoing a liver transplant evaluation. In addition, we sought to measure patient adherence with nutritional recommendations and whether patients perceived this additional education improved their nutrition status. METHODS The Plan-Do-Study-Ask methodology was used. PROCESSES Addressed 8 patients were enrolled to participate in the supplemental nutrition education, after which they received 3 follow-up phone calls. A retrospective review of data from 10 patients meeting project inclusion criteria were identified by the nutrition specialist and were used as a comparison group. Data were analyzed using descriptive statistics; comparing data from before and after implementation of the supplemental nutrition education was done. OUTCOMES At the end of the 8-week project period, 4 (66.7%) patients reported weight loss since the time of enrollment (nutrition education class), and the median patient-generated subjective global assessment score increased by 4 points, rather than decreasing as expected. However, all patients reported they believed the phone calls improved their nutrition status. IMPLICATIONS With a multidisciplinary approach, this additional patient education may improve patient care and outcomes.
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Affiliation(s)
- Amanda J Chaney
- 1 Department of Transplant Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Michael G Heckman
- 2 Division of Biomedical Statistics and Informatics. Mayo Clinic, Jacksonville, FL, USA
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Bauer K, Bai Y. Using a Model to Design Activity-Based Educational Experiences to Improve Cultural Competency among Graduate Students. Pharmacy (Basel) 2018; 6:E48. [PMID: 29857579 PMCID: PMC6025602 DOI: 10.3390/pharmacy6020048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/02/2018] [Accepted: 05/21/2018] [Indexed: 11/22/2022] Open
Abstract
To improve the cultural competency of 34 students participating in graduate nutrition counseling classes, the Campinha-Bacote Model of Cultural Competence in the Delivery of Health Care Services was used to design, implement, and evaluate counseling classes. Each assignment and activity addressed one or more of the five constructs of the model, i.e., knowledge, skill, desire, encounters, and awareness. A repeated measure ANOVA evaluated pre- and post-test cultural competence scores (Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals). The overall cultural competence score significantly improved (p < 0.001) from "culturally aware" (68.7 at pre-test) to "culturally competent" (78.7 at post-test). Students significantly improved (p < 0.001) in four constructs of the model including awareness, knowledge, skill, and encounter. Factor analysis indicated that course activities accounted for 83.2% and course assignments accounted for 74.6% of the total variance of cultural competence. An activity-based counseling course encouraging self-evaluation and reflection and addressing Model constructs significantly improved the cultural competence of students. As class activities and assignments aligned well with the Campinha-Bacote Model constructs, the findings of this study can help guide health educators to design effective cultural competence training and education programs.
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Affiliation(s)
- Kathleen Bauer
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA.
| | - Yeon Bai
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA.
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Park EA, Chae IS, Jo MN. Importance-Performance Analysis (IPA) of Foodservice Operation, Dietary Life Education, and Nutrition Counseling Tasks of Nutrition Teachers and Dietitians in Jeju, Korea. Nutrients 2017; 9:E1157. [PMID: 29065495 DOI: 10.3390/nu9101157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/13/2017] [Accepted: 10/18/2017] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to analyze foodservice operation, dietary life education, and nutrition counseling tasks of nutrition teachers and dietitians in elementary, middle, and high schools in Jeju, Korea, and to provide effective ways to implement dietary life education and nutrition counseling in schools. This study surveyed 94 nutrition teachers and 46 dietitians working at elementary, middle, and high schools in Jeju during 7-14 May 2015. The importance and performance of 16 tasks of nutrition teachers and dietitians were measured using questionnaires. The data was analyzed by using the SPSS software and Importance-Performance Analysis (IPA). Importance was ranked in the order of foodservice operation (4.72), dietary life education (4.37), and nutrition counseling (4.24); and performance was ranked in the order of foodservice operation (4.48), dietary life education (3.70), and nutrition counseling (3.22). The importance-performance matrix showed that in Quadrant 4, the "Concentrate Here" item was "nutrition and dietary life education for students", while in Quadrant 2, the "Possible Overkill" item was "cost control and office management". These findings suggest that it is important to reduce unnecessary administrative and office management tasks in order for nutrition teachers and dietitians to implement effective nutrition education, dietary life education, and nutrition counseling programs.
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Harshman SG, Finnan EG, Barger KJ, Bailey RL, Haytowitz DB, Gilhooly CH, Booth SL. Vegetables and Mixed Dishes Are Top Contributors to Phylloquinone Intake in US Adults: Data from the 2011-2012 NHANES. J Nutr 2017; 147:1308-1313. [PMID: 28566528 DOI: 10.3945/jn.117.248179] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/22/2017] [Accepted: 04/20/2017] [Indexed: 01/30/2023] Open
Abstract
Background: Phylloquinone is the most abundant form of vitamin K in US diets. Green vegetables are considered the predominant dietary source of phylloquinone. As our food supply diversifies and expands, the food groups that contribute to phylloquinone intake are also changing, which may change absolute intakes. Thus, it is important to identify the contributors to dietary vitamin K estimates to guide recommendations on intakes and food sources.Objective: The purpose of this study was to estimate 1) the amount of phylloquinone consumed in the diet of US adults, 2) to estimate the contribution of different food groups to phylloquinone intake in individuals with a high or low vegetable intake (≥2 or <2 cups vegetables/d), and 3) to characterize the contribution of different mixed dishes to phylloquinone intake.Methods: Usual phylloquinone intake was determined from NHANES 2011-2012 (≥20 y old; 2092 men and 2214 women) and the National Cancer Institute Method by utilizing a complex, stratified, multistage probability-cluster sampling design.Results: On average, 43.0% of men and 62.5% of women met the adequate intake (120 and 90 μg/d, respectively) for phylloquinone, with the lowest self-reported intakes noted among men, especially in the older age groups (51-70 and ≥71 y). Vegetables were the highest contributor to phylloquinone intake, contributing 60.0% in the high-vegetable-intake group and 36.1% in the low-vegetable-intake group. Mixed dishes were the second-highest contributor to phylloquinone intake, contributing 16.0% in the high-vegetable-intake group and 28.0% in the low-vegetable-intake group.Conclusion: Self-reported phylloquinone intakes from updated food composition data applied to NHANES 2011-2012 reveal that fewer men than women are meeting the current adequate intake. Application of current food composition data confirms that vegetables continue to be the primary dietary source of phylloquinone in the US diet. However, mixed dishes and convenience foods have emerged as previously unrecognized but important contributors to phylloquinone intake in the United States, which challenges the assumption that phylloquinone intake is a marker of a healthy diet. These findings emphasize the need for the expansion of food composition databases that consider how mixed dishes are compiled and defined.
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Affiliation(s)
- Stephanie G Harshman
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Emily G Finnan
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Kathryn J Barger
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Regan L Bailey
- College of Health and Human Sciences, Purdue University, West Lafayette, IN; and
| | - David B Haytowitz
- Beltsville Human Nutrition Research Center, Baltimore, Beltsville, MD
| | - Cheryl H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Sarah L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA;
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Johnson DL, Gurenlian JR, Freudenthal JJ. A Study of Nutrition in Entry-Level Dental Hygiene Education Programs. J Dent Educ 2016; 80:73-82. [PMID: 26729687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aims of this study were to document the extent of nutritional content in U.S. dental hygiene program curricula; identify program directors' opinions, perceptions, and barriers to expanding nutritional content; and evaluate if a proposed nutrition curriculum model would be beneficial. This mixed methods study involved quantitative and qualitative aspects. An invitation letter was sent to all 335 directors of entry-level U.S. dental hygiene programs. In response, 55 directors submitted nutrition course syllabi from their programs (16.4% of the total) for the quantitative analysis. In addition, 14 nutrition instructors and ten program directors were interviewed regarding their perceptions and opinions of nutrition education for dental hygiene students. All aspects of the content analysis results revealed that nutrition content in entry-level dental hygiene programs is diverse. Some programs did not include nutrition content, while others provided oral and systemic nutrition intervention subject matter. Some programs offered multiple clinical nutrition applications and patient contact opportunities while most required none. The interview results disclosed a variety of opinions and perceptions of dental hygienists' role in nutrition. Several interviewees viewed dental hygienists' role in nutrition to be an integral part of patient care, while others indicated no role or providing caries prevention counseling only. Although dental hygienists are expected to provide nutrition assessments and interventions, no standards or standardized competencies exist for nutrition in dental hygiene education. A standardized nutrition model could be beneficial for entry-level programs to ensure dental hygienists possess basic knowledge to perform nutrition assessments and intervention to address Healthy People 2020's intervention initiatives.
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Affiliation(s)
- Deborah L Johnson
- Ms. Johnson is a part-time faculty member, Central Oregon Community College and Eastern Washington University; Dr. Gurenlian is Professor and Graduate Program Director, Department of Dental Hygiene, Idaho State University; and Prof. Freudenthal is Associate Professor, Department of Dental Hygiene, Idaho State University
| | - JoAnn R Gurenlian
- Ms. Johnson is a part-time faculty member, Central Oregon Community College and Eastern Washington University; Dr. Gurenlian is Professor and Graduate Program Director, Department of Dental Hygiene, Idaho State University; and Prof. Freudenthal is Associate Professor, Department of Dental Hygiene, Idaho State University.
| | - Jacqueline J Freudenthal
- Ms. Johnson is a part-time faculty member, Central Oregon Community College and Eastern Washington University; Dr. Gurenlian is Professor and Graduate Program Director, Department of Dental Hygiene, Idaho State University; and Prof. Freudenthal is Associate Professor, Department of Dental Hygiene, Idaho State University
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Santos IS, Matijasevich A, Assunção MCF, Valle NC, Horta BL, Gonçalves HD, Gigante DP, Martines JC, Pelto G, Victora CG. Promotion of Weight Gain in Early Childhood Does Not Increase Metabolic Risk in Adolescents: A 15-Year Follow-Up of a Cluster-Randomized Controlled Trial. J Nutr 2015; 145:2749-55. [PMID: 26491122 DOI: 10.3945/jn.115.212134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 10/01/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A rapid gain in weight for length may put children at a higher risk of noncommunicable diseases later in life. OBJECTIVE The objective of this study was to assess the long-term effects of nutrition counseling delivered in the first 2 y of life in Pelotas, a city in Southern Brazil. METHODS The original cluster-randomized controlled trial was conducted in 1998. Nutrition counseling (breastfeeding promotion and increased intake of micronutrient-rich and energy-dense foods) was delivered to mothers of children aged 0-17.9 mo attending primary care. Six months later, weight gain was higher in the intervention group than in the control group for children ≥12 mo of age at enrollment. In 2013 (mean age 15 y), assessments included anthropometric measurements, body composition (air-displacement plethysmography), body shape (3-dimensional photonic scan), and plasma total, LDL, and HDL cholesterol, triglycerides, C-reactive protein, and glucose. RESULTS A total of 363 of the 424 original participants were assessed. An a priori decision was made to prioritize analyses of subjects aged 12-17.9 mo at enrollment (51 from the intervention group and 45 from the control group). In this subgroup, boys in the intervention group were [mean (95% CI)] 3.4 (0.8, 6.0) cm taller than those in the control group. Systolic blood pressure tended to be 5.2 (-0.8, 11.1) mm Hg higher in male subjects from the intervention group than in those in the control group. Lipid profiles tended to be healthier in the intervention group. The plasma total cholesterol concentration was -17.8 (-29.8, -5.7) mg/dL lower in boys in the intervention group than in those in the control group. The total-to-HDL cholesterol ratio and triglyceride concentration in the girls in the intervention group were -0.4 (-0.6, -0.1) and -26.3 (-46.3, -6.3) mg/dL, respectively, lower than in the control group. There was no difference between the groups in terms of body composition. CONCLUSIONS Promotion of weight gain in children between 12.0-17.9 mo of age was not associated with higher metabolic risk 15 y later. On the contrary, there was some evidence of reduced metabolic risk in the intervention group.
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Affiliation(s)
- Iná S Santos
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil;
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Preventive Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria Cecília F Assunção
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Neiva Cj Valle
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Helen D Gonçalves
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Denise P Gigante
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - José C Martines
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway; and
| | - Gretel Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Cesar G Victora
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil
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Everett ST, Wolf R, Contento I, Haiduc V, Richey M, Erkan D. Short-term patient-centered nutrition counseling impacts weight and nutrient intake in patients with systemic lupus erythematosus. Lupus 2015; 24:1321-6. [PMID: 25931150 DOI: 10.1177/0961203315582284] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 03/23/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients with systemic lupus erythematosus (SLE) are at a high risk for cardiovascular disease (CVD) due to increased prevalence of traditional and nontraditional CVD risks factors. OBJECTIVE To evaluate the effect of patient-centered nutrition counseling methods on changes in select nutrient, anthropometric, and clinical outcomes in SLE patients enrolled in a CVD prevention counseling program (CVD PCP). METHODS From March 2009 to June 2011 a subgroup of SLE patients enrolled in our CVD PCP were referred to a registered dietitian for individualized nutrition counseling. Outcomes of interest were assessed at baseline and six months. A primary analysis evaluated the six-month changes in nutrient intake, weight, body mass index (BMI), waist circumference, and lipid levels. A secondary analysis compared the same measurements between the nutrition counseling patients and the group that was referred but did not attend. RESULTS Of 71 referrals, 41 (58%) attended nutrition counseling (female: 89%, African American/Hispanic: 72%, mean age of 39.7 ± 12.82 years, and a mean disease duration of 11.49 ± 8.02 years). Over a six-month period, patients attending nutritional counseling: (a) reduced their intake of sodium (p = 0.006), total calories (p = 0.07), and percent calories from fat (p = 0.011) and saturated fat (p = 0.068); (b) had decreased weight (-1.64 kg, p = 0.025); and (c) were more likely to report increases in eating a diet rich in fruits and vegetables (p < 0.001), a high fiber diet (p = 0.011), ≥two servings of fish/week (p = 0.002), and a low cholesterol diet (p = 0.034). There were no significant changes observed over the six months in BMI and clinical outcomes among nutrition counseling patients. When comparing nutrition counseling patients to those who were referred but did not attend, we found at six months a higher percentage of nutrition counseling patients reportedly followed a high-fiber diet (p = 0.03), consumed two or more servings of fish per week (p = 0.01), followed a low-cholesterol diet (p = 0.03), and achieved a greater weight loss (p = 0.04) compared to the group that did not attend. CONCLUSION At six months we found that nutrition counseling using patient-centered methods appears to be an effective method for promoting changes in nutrient intake, diet habits, and, possibly, anthropometric measures in SLE patients. However, the counseling did not show a significant improvement in lipid levels, possibly due to short follow-up and/or SLE related factors.
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Affiliation(s)
- S T Everett
- Hospital for Special Surgery, New York, USA Teachers College, Columbia University, New York, USA
| | - R Wolf
- Teachers College, Columbia University, New York, USA
| | - I Contento
- Teachers College, Columbia University, New York, USA
| | - V Haiduc
- Hospital for Special Surgery, New York, USA
| | - M Richey
- Hospital for Special Surgery, New York, USA
| | - D Erkan
- Hospital for Special Surgery, New York, USA
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Abstract
OBJECTIVE To document the prevalence of junk foods seen at clinic visits. DESIGN A cross-sectional 23-item survey of observed food items were completed by medical staff using a convenience sample of families from June 2, 2011 to March 2, 2012. SETTING The study was conducted in pediatric clinics affiliated with the University of Texas Medical School at Houston. PARTICIPANTS A convenience sample consisting of 738 families with children from 4 months to 16 years old presenting for visits were included in the study. Children exclusively breast and formula fed was excluded. RESULTS Junk food was observed 20.9% at the clinic visits. CONCLUSIONS AND RELEVANCE Junk food was often seen at clinic visits. There was a trend toward higher body mass index in patients whose families had junk food at the visit.
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Bleich SN, Gudzune KA, Bennett WL, Cooper LA. Do physician beliefs about causes of obesity translate into actionable issues on which physicians counsel their patients? Prev Med 2013; 56:326-8. [PMID: 23399006 PMCID: PMC3745015 DOI: 10.1016/j.ypmed.2013.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 01/14/2013] [Accepted: 01/20/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the relationship between primary care physicians' (PCPs') beliefs about the causes of obesity with the frequency of nutritional counseling. METHODS We analyzed a national cross-sectional internet-based survey of 500 US PCPs collected between February and March 2011. RESULTS PCPs that identified overconsumption of food as a very important cause of obesity had significantly greater odds of counseling patients to reduce portion sizes (OR 3.40; 95%CI: 1.73-6.68) and to avoid high calorie ingredients when cooking (OR 2.16; 95%CI: 1.07-4.33). Physicians who believed that restaurant/fast food eating was a very important cause of obesity had significantly greater odds of counseling patients to avoid high calorie menu items outside the home (OR 1.93; 95%CI: 1.20-3.11). Physicians who reported that sugar-sweetened beverages were a very important cause of obesity had significantly greater odds of counseling their obese patients to reduce consumption (OR 5.99; 95%CI: 3.53-10.17). CONCLUSIONS PCP beliefs about the diet-related causes of obesity may translate into actionable nutritional counseling topics for physicians to use with their patients.
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Affiliation(s)
- Sara N Bleich
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Tziraki C, Graubard BI, Manley M, Kosary C, Moler JE, Edwards BK. Effect of training on adoption of cancer prevention nutrition-related activities by primary care practices: results of a randomized, controlled study. J Gen Intern Med 2000; 15:155-62. [PMID: 10718895 PMCID: PMC1495352 DOI: 10.1046/j.1525-1497.2000.03409.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The National Cancer Institute (NCI) developed a manual to guide primary care practices in structuring their office environment and routine visits so as to enhance nutrition screening, advice/referral, and follow-up for cancer prevention. The adoption of the manual's recommendations by primary care practices was evaluated by examining two strategies: physician training on how to implement the manual's recommendations versus simple mailing of the manual. This article reports on the results of a randomized controlled trial to evaluate the effectiveness of these two strategies. DESIGN A three-arm, randomized, controlled study. SETTING Free-standing primary care physician practices in Pennsylvania and New Jersey. INTERVENTION Each study practice was randomly assigned to one of three groups. The training group practices were invited to send one member from their practice of their choosing to a 3-hour "train-a-trainer" workshop, the manual-only-group practices were mailed the nutrition manual, and the control group practices received no intervention. For training group practices, training was provided in the four major components of the nutrition manual: how to organize the office environment to support cancer prevention nutrition-related activities; how to screen patient adherence to the NCI dietary guidelines; how to provide dietary advice/referral; and how to implement a patient follow-up system to support patients in making changes in their nutrition-related behaviors. MEASUREMENTS The primary outcomes of the study were derived from two evaluation instruments. The observation instrument documented the tools and procedures recommended by the nutrition manual and adopted in patient charts and the office environment. The in-person structured interview evaluated the physician and staff's self-reported nutrition-related activities reflecting the nutrition manual's recommendations. Data from these two instruments were used to construct four adherence scores corresponding to the areas: office organization, nutrition screening, nutrition advice/referral, and patient follow-up. MAIN RESULTS The adoption of the manual's recommendations was highest among the practices in the training group as reflected by their higher adherence scores. They organized their office ( P =.005) and screened their patients regarding their eating habits ( P =.046) significantly more closely to the recommendations of the nutrition manual than practices in the manual-only group. However, despite being the highest in compliance, the training group practices were only 54.9% adherent to the manual's recommendations regarding nutrition advice/referral, and 28.5% adherent to its recommendations on office organization, 23.5% adherent to its recommendations on nutrition screening, and 14.6% adherent to its patient follow-up recommendations. CONCLUSIONS Primary care practices exposed to the nutrition manual in a training session adopted more of the manual's recommendations. Specifically, practices invited to training were more likely to perform nutrition screening and to structure their office environment to be conducive to providing nutrition-related services for cancer prevention. The impact of the training was moderate and not statistically significant for nutrition advice/referral or patient follow-up, which are important in achieving long-term dietary changes in patients. The overall low adherence scores to nutrition-related activities demonstrates that there is plenty of room for improvement among the practices in the training group.
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Affiliation(s)
- C Tziraki
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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