-
Cancer Causes & Control : CCC Aug 2023Updated evidence for the treatment of obesity in cancer survivors includes behavioural lifestyle interventions underpinning at least one theoretical framework. The aim... (Review)
Review
Identifying the effective behaviour change techniques in nutrition and physical activity interventions for the treatment of overweight/obesity in post-treatment breast cancer survivors: a systematic review.
PURPOSE
Updated evidence for the treatment of obesity in cancer survivors includes behavioural lifestyle interventions underpinning at least one theoretical framework. The aim of this systematic review was to assess the effectiveness of theory-based lifestyle interventions for the treatment of overweight/obesity in breast cancer survivors and to report effective behavioural change techniques (BCTs) and components used in these interventions.
METHODS
Four databases were searched for RCTs published between database inception and July 2022. The search strategy included MeSH terms and text words, using the PICO-framework to guide the eligibility criteria. The PRISMA guidelines were followed. Risk-of-bias, TIDier Checklist for interventions' content, and the extent of behaviour change theories and techniques application were assessed. To evaluate the effectiveness of interventions, trials were categorised as "very," "quite," or "non" promising according to their potential to reduce body weight, and BCTs promise ratios were calculated to assess the potential of BCTs within interventions to decrease body weight.
RESULTS
Eleven RCTs met the inclusion criteria. Seven trials were classified as "very", three as "quite" and one study was "non" promising. Studies' size, design, and intervention strategies varied greatly, but the weight-loss goal in all studies was ≥ 5% of the initial body weight through a 500-1000 kcal/day energy deficit and a gradually increased exercise goal of ≥ 30 min/day. Social Cognitive Theory was the most commonly used theory (n = 10). BCTs ranged from 10 to 23 in the interventions, but all trials included behaviour goal setting, self-monitoring, instructions on the behaviour, and credible source. The risk-of-bias was "moderate" in eight studies and "high" in three.
CONCLUSION
The present systematic review identified the components of theory-based nutrition and physical activity behaviour change interventions that may be beneficial for the treatment of overweight/obesity in breast cancer survivors. The strategies mentioned, in addition to reported behavioural models and BCTs, should be considered when developing weight-loss interventions for breast cancer survivors.
Topics: Humans; Female; Overweight; Breast Neoplasms; Cancer Survivors; Obesity; Exercise; Behavior Therapy; Body Weight
PubMed: 37149509
DOI: 10.1007/s10552-023-01707-w -
BMC Public Health Jun 2024COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition. (Review)
Review
BACKGROUND
COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition.
METHODS
This review aims to summarize the current literature on the association between dietary intake and serum levels of micronutrients, malnutrition, and dietary patterns and respiratory infections, including flu, pneumonia, and acute respiratory syndrome, with a focus on COVID-19. We searched for relevant articles in various databases and selected those that met our inclusion criteria.
RESULTS
Some studies suggest that dietary patterns, malnutrition, and certain nutrients such as vitamins D, E, A, iron, zinc, selenium, magnesium, omega-3 fatty acids, and fiber may have a significant role in preventing respiratory diseases, alleviating symptoms, and lowering mortality rates. However, the evidence is not consistent and conclusive, and more research is needed to clarify the mechanisms and the optimal doses of these dietary components. The impact of omega-3 and fiber on respiratory diseases has been mainly studied in children and adults, respectively, and few studies have examined the effect of dietary components on COVID-19 prevention, with a greater focus on vitamin D.
CONCLUSION
This review highlights the potential of nutrition as a modifiable factor in the prevention and management of respiratory infections and suggests some directions for future research. However, it also acknowledges the limitations of the existing literature, such as the heterogeneity of the study designs, populations, interventions, and outcomes, and the difficulty of isolating the effects of single nutrients from the complex interactions of the whole diet.
Topics: Humans; COVID-19; Micronutrients; Respiratory Tract Infections; Diet; SARS-CoV-2; Dietary Patterns
PubMed: 38907196
DOI: 10.1186/s12889-024-18760-y -
Frontiers in Nutrition 2023
PubMed: 37575328
DOI: 10.3389/fnut.2023.1223975 -
Cancers Oct 2023Cancer cases are continuously increasing, while the prevalence rates of physical inactivity are also continuously increasing. Physical inactivity is a causative factor... (Review)
Review
BACKGROUND
Cancer cases are continuously increasing, while the prevalence rates of physical inactivity are also continuously increasing. Physical inactivity is a causative factor in non-communicable diseases, including cancer. However, the potential beneficial effects of exercise on cancer treatment have not received much attention so far. The aim of this study was to highlight the relationship between cancer and exercise on a molecular basis.
METHODS
Comprehensive and in-depth research was conducted in the most accurate scientific databases by using relevant and effective keywords.
RESULTS
The mechanisms by which exercise may reduce cancer risk and/or progression may include the metabolic profile of hormones, systemic inflammation reduction, insulin sensitivity increase, antioxidant capacity augmentation, the boost to the immune system, and the direct effect on the tumor. There is currently substantial evidence that the effect of exercise may predict a stronger association with cancer and could supplementarily be embedded in cancer clinical practice to improve disease progression and prognosis.
CONCLUSION
The field of this study requires interconnecting the overall knowledge of exercise physiology with cancer biology and cancer clinical oncology to provide the basis for personalized targeting strategies that can be merged with training as a component of a holistic co-treatment approach to optimize cancer healthcare.
PubMed: 37958310
DOI: 10.3390/cancers15215135 -
Journal of the Academy of Nutrition and... Dec 2023Communication skills are a cornerstone of practice for dietitians. The field of dietetics is evolving and there is a need to synthesize the available literature on...
BACKGROUND
Communication skills are a cornerstone of practice for dietitians. The field of dietetics is evolving and there is a need to synthesize the available literature on communication skills to improve the effectiveness of patient consultations and inform practitioner development.
OBJECTIVE
This scoping review aimed to identify the research literature relating to communication skills used in dietetics practice and perceptions and experiences of dietetics students, dietitians, and patients regarding communication skills.
METHODS
This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews and best practice guidance. Five databases (Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and PsycInfo), two theses databases, and conference proceedings for 8 dietetics and health professions education associations were systematically searched for research on dietitians' communication skills. This included skills used in dietitian-patient communication, in communication interactions in different employment contexts, and diverse forms of communication (verbal, written, technological) and the views of dietetics students, dietitians, and patients, regarding communication skills. The search had no geographical or time limits. Studies were independently screened by two authors.
RESULTS
The 70 included studies spanned 45 years and were organized into four thematic categories: importance of communication skills in dietetics practice, development of communication skills, communication skills for dietitian-patient communication, and communication skills for wider dietetics practice. Sixty-five (92.9%) of the studies specifically explored the communication skills used for dietitian-patient consultations, including rapport building, questioning, listening, paraphrasing, and clarifying, whereas skills such as intercultural communication were less researched.
CONCLUSIONS
There is consensus between patients and dietitians regarding the skills that contribute to effective dietitian-patient communication. Areas less explored in the literature include the skills needed for intercultural communication and those needed for science communication. Greater understanding of the communication skills needed for contemporary nutrition and dietetics practice will guide education strategies for the development of dietitians.
PubMed: 38142740
DOI: 10.1016/j.jand.2023.12.008 -
Nutrients Jul 2023Although global food consumption costs more in terms of impact on human life than money is spent on it, health costs have not been consistently quantified or included in...
Although global food consumption costs more in terms of impact on human life than money is spent on it, health costs have not been consistently quantified or included in food prices to date. In this paper, a method to determine the external health costs of nutrition and dietetics is developed by employing the cost-of-illness (COI) and true cost accounting (TCA) approaches. This is done exemplarily for the reference country Germany. The results show that 601.50 € per capita and 50.38 billion € in total external health costs are incurred annually due to nutrition. Overall, most costs are accrued through excessive meat consumption (32.56% of costs), deficient whole grain intake (15.42% of costs), and insufficient uptake of legumes (10.19% of costs). Comparing the external health costs with the external environmental costs in Germany, it can be seen that of the total annual costs of around 153.86 billion €, 67.26% originate from environmental impacts and 32.74% from impacts on human life. In order to achieve the 17 Sustainable Development Goals and to increase family as well as public health, there is a need to internalise these external costs into actual food prices.
Topics: Humans; Health Care Costs; Germany; Cost of Illness; Meat
PubMed: 37571323
DOI: 10.3390/nu15153386 -
Clinical Nutrition (Edinburgh, Scotland) May 2024The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index,...
BACKGROUND & AIMS
The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation in support of the etiologic criterion for inflammation.
METHODS
A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified-Delphi review. A multi-round review and revision process served to develop seven guidance statements.
RESULTS
The final round of review was highly favorable with 99 % overall "agree" or "strongly agree" responses. The presence of acute or chronic disease, infection or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (mg/dL or mg/L) for the clinical laboratory that is being used.
CONCLUSION
Confirmation of inflammation should be guided by clinical judgement based upon underlying diagnosis or condition, clinical signs, or CRP.
Topics: Humans; Inflammation; Malnutrition; Delphi Technique; C-Reactive Protein; Consensus; Nutrition Assessment; Body Mass Index; Biomarkers; Weight Loss
PubMed: 38238189
DOI: 10.1016/j.clnu.2023.11.026 -
Cureus Nov 2023Background Poor nutrition and lifestyle choices are major contributors to the development and progression of various chronic diseases. Enhancing patients' awareness of...
Background Poor nutrition and lifestyle choices are major contributors to the development and progression of various chronic diseases. Enhancing patients' awareness of healthy nutrition and lifestyle habits by interprofessional healthcare teams can play a significant role in tackling many chronic diseases, particularly in underserved communities with inequitable access to healthcare and educational opportunities. However, healthcare professionals are not adequately prepared to provide effective, culturally competent nutrition and lifestyle coaching due to a lack of emphasis on these topics in the curricula of many healthcare professional programs. Objective This study introduces a virtual, interprofessional, team-based elective course to address the curricular gap in nutrition education among healthcare professional programs. Methods Quantitative and qualitative pre-/post-surveys were utilized to evaluate course impact on student's knowledge, confidence in coaching families, and interprofessional competencies. Quantitative pre-/post-training scores were analyzed by a two-tailed, Mann-Whitney test, where P < 0.05 indicated a significant difference. Additionally, student learning outcomes were assessed using readiness assurance tests and application exercises, along with end-of-course presentations and mock interviews. Results Pre-/post-course assessments (n = 16) demonstrated significant improvement in students' confidence in coaching families (20%; P = 0.01) and knowledge of coaching curriculum (87%; P < 0.001). Improvement in different interprofessional competencies ranged between 15% (P = 0.002) and 46% (P < 0.001). Course material/activities, facilitation, impact on learning new knowledge/skills/mindset, and application in future practice were applauded by 81-94% of students. Conclusion Positive outcomes of this course encourage future offerings and systematic incorporation of similar training in healthcare professional programs to prepare clinicians capable of transforming lives through interprofessional, patient-centered nutrition and lifestyle coaching.
PubMed: 38058349
DOI: 10.7759/cureus.48302 -
Current Nutrition Reports Mar 2024The first stages of human life, which include the fetal period, infancy, and early childhood, are the most critical for human growth and development. This is the most... (Review)
Review
PURPOSE OF REVIEW
The first stages of human life, which include the fetal period, infancy, and early childhood, are the most critical for human growth and development. This is the most vulnerable phase to health challenges due to the immature immune system and rapid development. Mycotoxins such as aflatoxins, ochratoxin A, patulin, fumonisins, zearalenone, and deoxynivalenol are secondary metabolites secreted by various fungal species, primarily Aspergillus, Fusarium, Penicillium, and Alternaria. Aflatoxins are one of the major mycotoxins produced in cereals and cereal-based foods by several species of Aspergillus, mainly Aspergillus flavus. In this context, this review provides a brief overview of the occurrence, exposure, legal regulations, and health effects of aflatoxins (B1, B2, G1, G2, and M1) in cereal-based baby foods and breast milk.
RECENT FINDINGS
Human aflatoxin exposure in utero and through breast milk, infant formulas, cereals, and cereal-based foods has been linked to various health consequences, including adverse birth outcomes, impaired growth and development, immune system suppression, and hepatic dysfunction. Recent evidence suggests that especially infants and children are more susceptible to aflatoxins due to their lower body weight, lowered capacity to detoxify harmful substances, more restrictive diet, immature metabolism and elimination, and faster rates of growth and development. It is essential for both food safety and infant and child health that aflatoxins in cereal and cereal-based products are precisely detected, detoxified, and managed.
Topics: Child, Preschool; Infant; Child; Humans; Aflatoxins; Edible Grain; Mycotoxins; Zearalenone; Infant Food
PubMed: 38282161
DOI: 10.1007/s13668-024-00519-x -
BMJ Open Jul 2023Improving the diversity of the diets in young children 6-23 months is a policy priority in Nigeria and globally. Studying the relationship between maternal and child...
OBJECTIVES
Improving the diversity of the diets in young children 6-23 months is a policy priority in Nigeria and globally. Studying the relationship between maternal and child food group intake can provide valuable insights for stakeholders designing nutrition programmes in low-income and middle-income countries.
DESIGN
We examined the relationship between maternal and child dietary diversity among 8975 mother-child pairs using the Nigeria 2018 Demographic and Health Survey (DHS). We assessed concordance and discordance between maternal and child food group intake using the McNemar's χ test, and the determinants of child minimum dietary diversity (MDD-C) including women MDD (MDD-W) using hierarchical multivariable probit regression modelling.
SETTING
Nigeria.
PARTICIPANTS
8975 mother-child pairs from the Nigeria DHS.
PRIMARY AND SECONDARY OUTCOME MEASURES
MDD-C, MDD-W, concordance and discordance in the food groups consumed by mothers and their children.
RESULTS
MDD increased with age for both children and mothers. Grains, roots and tubers had high concordance in mother-child dyads (90%); discordance was highest for legumes and nuts (36%), flesh foods (26%), and fruits and vegetables (39% for vitamin-A rich and 57% for other). Consumption of animal source food (dairy, flesh foods, eggs) was higher for dyads with older mothers, educated mothers and more wealthy mothers. Maternal MDD-W was the strongest predictor of MDD-C in multivariable analyses (coef 0.27; 95% CI 0.25 to 0.29, p<0.000); socioeconomic indicators including wealth (p<0.000), mother's education (p<0.000) were also statistically significant in multivariable analyses and rural residence (p<0.000) was statistically significant in bivariate analysis.
CONCLUSION
Programming to address child nutrition should be aimed at the mother-child dyad as their food consumption patterns are related and some food groups appear to be withheld from children. Stakeholders including governments, development partners, non-governmental organizations, donors and civil society can act on these findings in their efforts to address undernutrition in the global child population.
Topics: Female; Animals; Humans; Mothers; Nigeria; Diet; Vegetables; Nutritional Status
PubMed: 37433728
DOI: 10.1136/bmjopen-2022-070876