Rural adults' perceptions of nutrition recommendations for cancer prevention: Contradictory and conflicting messages

Despite robust evidence linking alcohol, processed meat, and red meat to colorectal cancer (CRC), public awareness of nutrition recommendations for CRC prevention is low. Marginalized populations, including those in rural areas, experience high CRC burden and may benefit from culturally tailored health information technologies. This study explored perceptions of web-based health messages iteratively in focus groups and interviews with 48 adults as part of a CRC prevention intervention. We analyzed transcripts for message perceptions and identified three main themes with subthemes: (1) Contradictory recommendations, between the intervention's nutrition risk messages and recommendations for other health conditions, from other sources, or based on cultural or personal diets; (2) reactions to nutrition risk messages, ranging from aversion (e.g., "avoid alcohol" considered "preachy") to appreciation, with suggestions for improving messages; and (3) information gaps. We discuss these themes, translational impact, and considerations for future research and communication strategies for delivering web-based cancer prevention messages.

Hospital Malnutrition, Nutritional Risk Factors, and Elements of Nutritional Care in Europe: Comparison of Polish Results with All European Countries Participating in the nDay Survey

NutritionDay (nDay) is a project established by the Medical University of Vienna and the European Society for Clinical Nutrition and Metabolism (ESPEN) to audit the nutritional status of hospitalized patients and nursing home residents. This study aimed to evaluate nDay data describing the prevalence of hospital malnutrition, nutritional risk factors, and elements of the nutritional care process implemented in hospital wards in 25 European countries and to compare the data derived from Poland with the data collected in all the European countries participating in the study. In total, 10,863 patients (European reference group: 10,863 participants including Poland: 498 participants) were involved in the study. The prevalence of malnutrition was identified on the basis of the ESPEN diagnostic criteria established in 2015, while the prevalence of nutritional risk factors was assessed by analyzing the following parameters: body mass index (BMI), score of Malnutrition Screening Tool (MST), recent weight loss, insufficient food intake, decreased appetite, increased number of drugs intake, reduced mobility, and poor self-reported health status. Malnutrition prevalence was 12.9% in patients from the European reference group and 9.4% in patients from Polish hospital wards (p < 0.05). However, the prevalence of some nutritional risk factors, i.e., recent weight loss, history of decreased food intake, and low actual food intake, were approximately four times more prevalent than diagnosed malnutrition (referring to approximately 40-50% of all participants). In comparison to the European reference group, the significant differences observed in Polish hospital wards concerned mainly dietitian's involvement in the process of treating malnutrition (16% vs. 57.2%; p < 0.001); supply of special diets (8% vs. 16.1%; p < 0.0001); provision of oral nutritional support (ONS) (3.8% vs. 12.2%; p < 0.0001); prescription of enteral/parenteral nutrition therapy to hospitalized patients (8.2% vs. 11.7%; p < 0.001); as well as recording patient weight performed at hospital admission (100% vs. 72.9%; p < 0.0001), weekly (20% vs. 41.4%; p < 0.05), and occasionally (0% vs. 9.2%). These results indicate that the prevalence of malnutrition and malnutrition risk factors in hospitalized patients in Poland was slightly lower than in the European reference group. However, some elements of the nutritional care process in Polish hospitals were found insufficient and demand more attention.

Age, race and season predict vitamin D status in African American and white octogenarians and centenarians

OBJECTIVE

Poor vitamin D status has been associated with osteoporosis, falls, cardiovascular diseases, cancer, autoimmune diseases, pain, nursing home placement, and other age-related conditions, but little is known about the prevalence and predictors of vitamin D status in those aged 80 and older. Thus, this study tested the hypothesis that vitamin D status would be 1) poorer in a population-based multi-ethnic sample of centenarians as compared with octogenarians and 2) predicted by specific dietary, demographic or environmental factors.

DESIGN

Cross-sectional population-based analyses.

SETTING

Northern Georgia in the United States.

PARTICIPANTS

Men and women aged 80 to 89 (octogenarians, n=80) and 98 and older (centenarians, n=237).

MEASUREMENTS

Regression analyses were used to examine the associations of serum 25-hydroxyvitamin D [25(OH)D] with age, gender, race, living arrangements, dairy food intake, supplement intake, and season.

RESULTS

The prevalence of vitamin D insufficiency [25(OH)D<50 nmol/L] was higher in centenarians than in octogenarians (p<0.02). In logistic regression analyses, the risk of being vitamin D insufficient was significantly increased by being a centenarian vs. octogenarian (p<0.005) and by being African American vs. white (p<0.001) and decreased by taking a supplement with vitamin D (p<0.001) or by having vitamin D status measured in the summer or fall (each p<0.05), compared with spring.

CONCLUSIONS

Centenarians and octogenarians are at high risk for vitamin D insufficiency for many of the same reasons identified in younger populations. Given the numerous potential adverse consequences of poor vitamin D status, efforts are needed to ensure vitamin D adequacy in these older adults.