A Systematic Review of the Impact of Multi-Strategy Nutrition Education Programs on Health and Nutrition of Adolescents

Nutritional Intervention Improves the Dietary Intake of Essential Micronutrients in Patients with Diabetic Foot Ulcers

207P - Significant changes in dietary intake and physical activity after breast cancer diagnosis in a Chinese breast cancer cohort study

The diagnosis of cancer can motivate survivors to alter their lifestyle habits. Healthcare providers need to be aware of what changes patients are likely to make in order to derive more pertinent recommendations; however, few studies have reported pre- and post-diagnostic lifestyle behaviours. Semi-quantitative food frequency questionnaires (FFQs) completed approximately 1 year after diagnosis were used to evaluate dietary intake and supplement use before and after diagnosis in a cohort of 1,560 breast cancer patients participating in the UK, prospective DietCompLyf study. Intake of fruit and vegetables, wholegrains and lean sources of protein increased significantly post-diagnosis (P < 0.05, each). Conversely, after diagnosis consumption of high-fat, high-sugar products, red meat, coffee, some alcoholic drinks and refined grains significantly decreased (P < 0.05, each). Post-diagnostic changes in diet were accompanied by changes in the intake of macronutrients and a number of vitamins and minerals. Supplement use was highly prevalent (56.1%) pre-diagnosis, increasing to 62.8% after diagnosis (P = 0.001). Fish oils, multivitamin and minerals, and evening primrose oil were most often used and the proportion of users significantly increased (P < 0.05, each) after diagnosis. The percentage of women using oestrogenic botanical supplements (OBSs) was small but more than doubled to 8.4% after diagnosis (P < 0.05). British women participating in the DietCompLyf study reported significant changes in dietary intake and supplement use after their breast cancer diagnosis. These findings contribute to our understanding of female cancer survivors' dietary behaviours which is crucial for developing and implementing recommendations.

Background People with inflammatory bowel disease (IBD) are at higher risk of metabolic diseases that may respond to changes in diet and physical activity. Whether these lifestyle changes are possible and effective in IBD is unclear. This study aims to investigate the effectiveness of personalised diet and physical activity advice on metabolic disease risk factors in adults with inactive IBD. Methods A randomised controlled trial was conducted at three hospitals in New Zealand (NZ) from May 23 to August 24. Eligible participants (aged &amp;gt;18 years, body mass index (BMI) ≥ 25 kg/m2, low fibre intake (&amp;lt;25g/day), stable medical therapy, and could exercise) were randomised to one of two 6-month interventions: dietitian-delivered generic or personalised physical activity and heart-healthy diet advice. The primary outcome was body fat change and secondary outcomes included disease activity, faecal calprotectin, self-reported physical activity, and dietary intake (3-day food diaries). Multivariable regression models investigated between group differences adjusted for age, sex, and baseline values (significance p&amp;lt;0.05). Dietary intake and physical activity were adjusted for seasonality and disease activity. The study was approved by the NZ Health and Disability Ethics Committee (ref 2022 EXP 13602). Results A total of 64 participants were randomised and 51 (80%) completed the 6-month intervention and had complete datasets. Participants were median age 47 (LQ, UQ 37, 55), 59% female, 91% NZ European ethnicity, 61% had Crohn’s disease, 75% had faecal calprotectin &amp;lt; 100µg/g, 80% were non-smokers, and 81% on maintenance medical therapy including 44% on biologics. The intervention group had a non-significant decrease in fat mass (-188g; 95%CI: -1606, 1230) compared to the control group and statistically significant changes in dietary intake: increased fruit (0.5 serves/day; 95%CI: 0.1, 1.0) and dietary fibre (3.1 g/1000kcal/day; 95%CI: 1.1, 5.1), and reduced discretionary food and drink (-1.7 serves/day; 95%CI: -3.0, -0.3) and sodium (-911 mg/day; 95%CI: -1783, -40). Physical activity increased non-significantly by 188 total MET-mins/week (95%CI: -3336, 3711). Disease activity indices and faecal calprotectin did not significantly alter. Conclusion Dietitian-delivered personalised compared to generic advice, led to significant changes in dietary intake associated with reduced metabolic disease risk in patients with inactive IBD. However, the lack of significant changes in fat mass between groups is likely due to the absence of increased physical activity or reduced energy intake. Nonetheless, this study shows that adults with inactive IBD can make lifestyle changes without worsening disease activity.

BackgroundDietary modification is an important component to any public health strategy aimed at combatting obesity. Nutrition education is used for dietary modification as subjects obtain more knowledge about food and its nutritional content. Several nutrition education programs have led to healthier food choices. The purpose of this study was to assess the impact of enrolling in an introductory nutrition course at Whittier College on food choices.MethodsProspective three‐month study with 23 students from Whittier College (males = 8, females = 15) who were enrolled in an introductory nutrition course. A validated food frequency questionnaire from the University of Arizona was administered at baseline and at the three month follow‐up to assess any significant changes in dietary intake. The results from the frequency questionnaires were sent to the University of Arizona Diet, Behavior, and Quality of Life Assessment Lab to analyze macronutrient and micronutrient intake. Paired t‐tests were used to calculate mean differences (meand) and non‐parametric alternatives were used to calculate median differences (medd) between baseline and 3 month follow‐up on dietary intake and physical activity.ResultsThere was a significant reduction in caloric intake (meand=−22.31%, p=0.04), alcohol intake (meand=−3.4%, p=0.01), total fatty acid intake (meand=−24.69%, 0.03), saturated fatty intake (meand=−22.44%, p=0.03), and Trans fatty acid intake (meand=−23.5%, p=0.06). Total body weight and BMI were not significantly altered (medd @ 0, p=0.2471; medd @ 0, p=0.1311), respectively.ConclusionWhittier College students enrolled in a nutrition course showed significant decreases in their total fatty acid intake, but notably, their saturated fatty acid and Trans fatty acid intake were reduced. These reported changes may relate to the improvement of healthier food choices as a result of the students’ enrollment in a nutrition course that improved their self‐care

Appropriate dietary intake has been found to positively impact athletes’ performance, body composition and recovery from exercise. Strategies to optimise dietary intake often involve targeting one or more of the many factors that are known to influence dietary intake. This review aims to investigate the types and effectiveness of interventions used to impact modifiable factors of dietary intake in athletes. MEDLINE, CINAHL, SPORTDiscus and Web of Science were searched from inception to May 2022 for intervention studies that measured dietary intake with a quantitative tool and explored at least one factor thought to influence the dietary intake of adult athletes. Study quality was assessed using the ADA Quality Criteria Checklist: Primary Research. Twenty-four studies were included. The most common interventions focused on nutrition education (n 10), macronutrient adjustment (n 7) and physical activity (n 5). The three most common factors thought to influence dietary intake addressed were nutrition knowledge (n 12), hunger and appetite (n 8), and body composition (n 4). Significant changes in dietary intake were found in sixteen studies, with nutrition education interventions returning significant results in the largest proportion of studies (n 8). Study quality within this review was mostly average (n 4 < 50 %, n 19 50–80 %, n 1 > 80 %). As studies included were published between 1992 and 2021, interventions and factors explored in older studies may require up-to-date research to investigate possible differences in results due to time-related confounders.

Protein-energy wasting is a frequent and debilitating condition in maintenance dialysis. We randomly tested if an energy-dense, phosphate-restricted, renal-specific oral supplement could maintain adequate nutritional intake and prevent malnutrition in maintenance haemodialysis patients with insufficient intake. Eighty-six patients were assigned to a standard care (CTRL) group or were prescribed two 125-ml packs of Renilon 7.5(R) daily for 3 months (SUPP). Dietary intake, serum (S) albumin, prealbumin, protein nitrogen appearance (nPNA), C-reactive protein, subjective global assessment (SGA) and quality of life (QOL) were recorded at baseline and after 3 months. While intention to treat analysis (ITT) did not reveal strong statistically significant changes in dietary intake between groups, per protocol (PP) analysis showed that the SUPP group increased protein (P < 0.01) and energy (P < 0.01) intakes. In contrast, protein and energy intakes further deteriorated in the CTRL group (PP). Although there was no difference in serum albumin and prealbumin changes between groups, in the total population serum albumin and prealbumin changes were positively associated with the increment in protein intake (r = 0.29, P = 0.01 and r = 0.27, P = 0.02, respectively). The SUPP group did not increase phosphate intake, phosphataemia remained unaffected, and the use of phosphate binders remained stable or decreased. The SUPP group exhibited improved SGA and QOL (P < 0.05). This study shows that providing maintenance haemodialysis patients with insufficient intake with a renal-specific oral supplement may prevent deterioration in nutritional indices and QOL without increasing the need for phosphate binders.

Baby-led weaning and the family diet. A pilot study

To investigate the use of community-supported agriculture (CSA) as an employer-based health promotion intervention. Quasi-experimental study using a convenience sample of employees at three employers. Participants and controls from three Minnesota employers completed baseline and follow-up health assessments and surveys about their experiences with CSA. A total of 324 participants purchased a CSA share and were eligible for study inclusion. Study participants were matched by age, sex, employer and occupation to a non-randomized control group of individuals who did not purchase a CSA share but completed health assessments during the same time frame as the study participants. The majority of participants were female, white, middle-aged and highly educated. The most common reason for purchasing a CSA share was a desire for fresh food, and the majority of participants were satisfied with their experience. Participants reported a significant increase in the number of vegetables present in the household and the frequency of family meals. The frequency of eating out decreased significantly, especially at fast-food restaurants. Participants also reported an increase in the amount and variety of produce consumed. However, health assessment data did not show significant changes in dietary intake, health status or BMI. CSA participation was associated with improvement in some aspects of the household environment and dietary behaviours. Further research is needed to determine whether employer-based CSA interventions may also lead to improvements in dietary intake and health.

The effects of 6 mo of supplementation with probiotics and synbiotics on gut microbiota in the adults with prediabetes: A double blind randomized clinical trial.

Participation in mindfulness-based stress reduction is not associated with reductions in emotional eating or uncontrolled eating

Relationships between adipose tissue and cytokine responses to a randomized controlled exercise training intervention

We do not know how racial composition of a group influences behavior change for African Americans (AAs) in group-based weight loss programs. We tested the hypothesis that AA who participate in all AA weight loss intervention groups will lose more weight than AA who participate in mixed race groups. This observational study was ancillary to Phase 1 of the Weight Loss Maintenance Study, a multi-center trial of strategies to maintain weight loss after a 20-week behavior modification program. Three of four centers recruited several all-AA intervention groups. Remaining groups were combinations of AA and non-AA participants. All participants received the same weight loss intervention. Change in weight was the primary outcome, comparing participants of all-AA groups with AA participants of mixed race groups conducted by the same AA interventionists. Secondary outcomes included measures of intervention adherence and behavior change. Participants of all-AA groups (n = 271) were comparable to other AA participants (n = 106). The mean proportion of AA in mixed race groups was 56%. All-AA group participants had similar weight loss as those in mixed groups (-4.2 vs. -4.2 kg, P = 0.97). There were no differences between the groups in mean number of sessions attended or changes in dietary intake. Significant weight loss was observed in both groups, with no effect of group composition on adherence or weight loss outcomes. Special logistics to accommodate all-AA groups may not be necessary. Despite varying instructional environments, AA appeared to respond positively to intervention messages with significant changes in dietary intake, physical activity (PA), and weight.

The Role of Self-efficacy in Improving Dietary Behaviors for Reduction of Nutrition-related Cancers

Weight gain is a common problem amongst women receiving adjuvant chemotherapy for early breast cancer. We undertook a study to determine the causes of this weight gain. Prospective measurements of body mass and composition (skinfolds, bioelectrical impedance, total body potassium), energy balance (resting energy expenditure dietary intake, and physical activity), were determined in 17 women during and in the 6 months after commencing adjuvant chemotherapy. Women gained significant amounts of weight (5.0 +/- 3.8; p < 0.01) and body fat (7.1 kg +/- 4.5; p < 0.01) over the year. Waist circumference (5.1 +/- 4.5 cm; p < 0.01) and abdominal skinfold (16.2 +/- 10 mm; p < 0.01) were also increased but there was a decline in fat free mass (FFM); 1.7 +/- 2.5 kg. Women due to receive adjuvant chemotherapy had a greater resting energy expenditure (REE) compared with healthy subjects (n = 21); 100.5 +/- 8.0% Harris Benedict compared to 94.5 +/- 8.4% Harris Benedict (p = 0.05). REE declined by 3% during adjuvant chemotherapy (p < 0.05), and remained depressed until at least 3 months posttreatment. There were no significant changes in dietary intake or physical activity over the year. Failure of women to reduce their energy intake to compensate for the decreased energy requirement may account for some of the weight gain. Treatment of adjuvant chemotherapy causes gain of body fat because of reduced energy expenditure, and the failure of women to reduce their energy intake to compensate for the decline in energy requirement during and in the 6 months posttreatment. Since weight gain impacts on survival, patients should be counselled to reduce energy intake and exercise during and after adjuvant treatment.