Medical Nutrition Research Articles

Exploring the intersections of frailty, sarcopenia, and cachexia with malnutrition.

This review examines our current understanding of consensus definitions for frailty, sarcopenia, and cachexia and their perceived overlap with malnutrition. Patients with these syndromes will often meet the criteria for malnutrition. It is common for these overlap syndromes to be misapplied by practitioners, and confusion has been further exacerbated by the lack of a common malnutrition language. To address the latter concern, we recommend using either the standalone Global Leadership Initiative in Malnutrition (GLIM) framework or the GLIM consensus criteria integrated with other accepted approaches as dictated by preference and available resources. Established care standards should guide the recognition and treatment of malnutrition to promote optimal clinical outcomes and quality of life. The effectiveness of nutrition interventions may be reduced in settings of severe acute inflammation and in end-stage disease that is associated with cachexia. However, such interventions may still assist patients to tolerate treatments that target the underlying etiology for an overlap syndrome, and they may help to improve select clinical outcomes and quality of life. Recent, large, well-designed randomized controlled trials have demonstrated the compelling positive clinical effects of medical nutrition therapy. The application of concurrent malnutrition risk screening and assessment is therefore a high priority. The necessity to deliver specific interventions that target the underlying mechanisms of these overlap syndromes and also diagnose and address malnutrition is paramount. It must be highlighted that securing beneficial outcomes for frailty, sarcopenia, and cachexia will also require nonnutrition interventions, like comprehensive care plans, pharmacologic agents, and prescribed exercise.

Abstract 4144549: Proof of Concept of a Novel Culinary Medicine Service Line to Address Diet-Related Cardiovascular Disease Risk Factors

Background: Poor diet has emerged as a top contributor to cardiovascular disease (CVD) in the United States. Evidence-based dietary strategies have been shown to decrease CVD risk by addressing comorbid conditions such as hypertension and diabetes, and there is a growing demand for practical nutrition guidance from health providers. However, implementation of nutrition support in healthcare settings remains limited due to lack of time, expertise, and reimbursement, necessitating creative interprofessional collaboration. Culinary Medicine (CM) combines medical nutrition education with culinary literacy and holds promise to address these challenges. Our study reports on the cascade implementation of a 3-prong CM service line which includes a CM eConsult, 1:1 CM specialty clinic, and shared medical appointment (group visit) in a teaching kitchen at a large, academic medical center from 2021 to 2024. Methods: A CM-specific eConsult was designed and launched on August 1 st 2021 utilizing existing eConsult workflows in the electronic health record. Next, an in-person, interprofessional CM specialty clinic launched at a community-based satellite clinic December 4 th 2022 open to referrals from physicians and patients. In April 2024, established patients in the CM clinic were invited to participate in six, biweekly cooking classes billed as shared medical appointments. A Microsoft PowerBI dashboard was developed to track patient demographics, referrals and participation, associated diagnoses, and billing data for the service line for continuous quality improvement. Results: In the first year of eConsults, 25 eConsults were completed with 19 (76%) reimbursed by insurance. In the first year from launch of the CM specialty clinic, 96 patients completed initial visits with a 100% insurance collections rate. In the recent launch of shared medical appointments, the initial cohort included 17 unique patients with 58% completing at least 4 of 6 classes. Referrals to the CM clinic included hypertension, hyperlipidemia, coronary artery disease, and type 2 diabetes as the top 4 associated diagnoses. Conclusions: We demonstrated proof-of-concept of a novel CM service line as an interprofessional, financially sustainable preventive strategy to target patients with diet-sensitive CVD risk factors such as diabetes, hypertension, and obesity. Future study will investigate the impact on biomarkers of CVD health for patients served by the CM service line.

Incretin-Based Therapies and Lifestyle Interventions: The Evolving Role of Registered Dietitian Nutritionists in Obesity Care

The emergence of incretin-based therapies, specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucose-dependent insulinotropic polypeptide (GIP), as a new class of obesity medications, is dramatically changing obesity care. Use of these medications, known categorically as anti-obesity medications, as part of comprehensive obesity management is associated with significantly greater weight loss and health benefits than found with earlier generation obesity medications. The outcomes reported from medication trials were often achieved in conjunction with lifestyle counseling sessions by a registered dietitian nutritionist (RDN) or other qualified health care professional. Research demonstrates that evidence-based obesity care should incorporate lifestyle interventions. Counseling by a RDN, paired with incretin-based therapies, can play a critical role in supporting adherence to the medication regimen, preventing and managing side effects, adequate nutrient intake, and establishment of lifestyle behaviors for long-term weight and health management. To date, minimal research has been reported on the impact of incretin-based therapies on food and nutrient intake. Until that research is conducted, RDNs and other health professionals can apply knowledge and experience from clients who have undergone other intensive treatments. This article provides considerations for lifestyle interventions, with a focus on medical nutrition therapy (MNT) provided by RDNs, for adults prescribed incretin-based therapies. RDNs have the education and training to provide MNT for people with overweight or obesity, as well as lifestyle counseling on physical activity, stress management, sleep hygiene, goal setting, and other behaviors associated with positive health outcomes. RDNs have a critical role in the integration of incretin-based therapies into obesity management.

The effect of the keto diet on lipid profile with type two diabetic patients

Introduction. In the developed world, among the main causes of disease and death is type 2 diabetes. It is a significant public health issue with rising prevalence, with more than 380 million patients estimated to be affected by 2025.Aim. To evaluate the effect of ketogenic diets on glycemic control in patients with type II DM in Kirkuk and Mosul provinces.Materials and methods. Patients with T2DM in both Mosul and Kirkuk cities were enrolled in this study to evaluate the effect of keto diet on HbA1c level and Lipid profile variations between 1/9/2022 to 1/4/2023.Results and discussion. This study shows that the distributions of patients according to age and gender there was about 43.3 % female and 56.7 % male and the age variations, female with age above 56 years old was 30 % while male 60.7 %. A significant p value was shown in HbA1C variations before and after keto diet (0.0001), also in lipid profile of a significant p value before and after keto diet (0.001) regarding total Glyceride a significant p value highly was (0.002). Due to the large particle size of LDL-C, it has been hypothesized that this elevation in LDL-C would not likely cause cardiovascular problems. For individuals with type 2 diabetes, the low-calorie-ketogenic VLCK diet (<50 g of carbohydrates per day) is a safe, well-tolerated, and recognized medical nutritional therapy option when used in conjunction with an interventional weight loss program that offers support for lifestyle and behavioral modification over a 4-month period.Conclusion. Diabetic and ketogenic diet there is a good clear relationship regarding the HbA1c and lipid profile. Further studies are required for larger numbers of patients and longer duration follow up.

Guideline for medical nutritional treatment of adult patients with gastrointestinal dysfunction (2025 edition)

Gastrointestinal dysfunction is a common clinical disease. Due to abnormal gastrointestinal digestive and absorption functions, nutrients, water, and electrolytes cannot be absorbed properly, and therefore, scientific and reasonable nutritional intervention is needed. In order to further standardize medical nutrition treatment of patients with gastrointestinal dysfunction, the Chinese Society of Parenteral and Enteral Nutrition (CSPEN) organized experts and scholars in related fields in China to elaborate on the following topics based on current evidence-based medical evidence: the standard process of medical nutrition treatment for patients with gastrointestinal dysfunction, the time and mode of enteral and parenteral nutrition application, and the nutritional intervention mode for patients with gastrointestinal dysfunction in special disease state. Finally, 29 questions and 58 recommendations were formed to provide reference for the standardized application of medical nutrition therapy for patients with gastrointestinal dysfunction.

In vitro validation of colon delivery of vitamin B2 through a food grade multi-unit particle system.

Colon target delivery of active ingredients is frequently applied in pharmaceutical products. However, in functional food and beverage applications, dietary supplements, and medical nutrition, formats targeting colonic delivery to improve human health are rare. Nevertheless, there is emerging evidence for beneficial effects of colonic delivered nutrients on gut microbiota and host health which increases the demand for sustainable food grade materials that are regulatory approved for application. In this paper, we describe a double layer coated multi-unit particle system (MUPS) with a diameter of approximately 730 microns consisting of food grade materials: shellac as outer layer, alginate as inner layer, cellulose as a core and riboflavin as active ingredient. The suitability of the MUPS for colonic delivery was tested in three well-established in vitro digestion and fermentation models: the USP Apparatus 3 and the TNO Intestinal Models 1 and 2 (TIM-1 and TIM-2). All systems confirmed the integrity of the MUPS under simulated upper gastrointestinal tract conditions with approximately 90% of the active ingredient being released under simulated ileal-colonic conditions. The TIM-2 model also showed the effects of riboflavin loaded MUPS on the microbiome composition with an increase in the production of short-chain fatty acids, acetate and butyrate. The results of these experiments provide a reliable basis for validation of this vitamin-loaded food grade MUPS in future human clinical trials. In addition, following the recent announcement of the European Commission to restrict intentionally added microplastics to products, the materials used in the described formulation offer an environmentally friendly alternative to often applied methyl acrylate based coatings.

Exploring Meditron-7b performance on a small-scale purpose made dataset in human nutrition queries

Abstract The interest in Large Languages Models (LLMs) has been rapidly evolving over the last years, boosting concerns about their potential to improve the efficiency and effectiveness of clinical, educational and research work in medicine. In this study, we aimed to test the performance of MEDITRON, a recently released suite of open-source LLMs with 7B parameters adapted to the medical domain, on a small sample of human nutrition queries. To facilitate our assessment, we curated a specialized dataset comprising a diverse range of human nutrition-related queries, which have been manually collected from various medical databases and nutrition exams. The dataset was adapted for the scope of our analysis to encompass variations in language complexity, query types, and semantic nuances commonly encountered in real-world settings. Additionally, to ensure a standardized and clinically relevant context for our evaluations, we engineered a specialized prompt designed to mimic interactions with a highly esteemed physician specializing in nutrition, food science, and diet-related disorders. The prompt guided the generation of nutrition-related queries in a structured format, enabling MEDITRON to provide responses consistent with the latest advancements in medical research. Our preliminary findings revealed promising capabilities of MEDITRON in understanding medical language, providing contextually appropriate responses to several human nutrition related questions. Through this study, we add valuable insights to the ongoing discussion around the deployment of LLMs in public health, highlighting their potential to improve access to essential human nutrition literacy. Key messages • Design of LLMs tools holds the potential to improve healthcare in clinical, research and education applications. • Further evidence is needed to foster their actual integration in real world settings.

Effects of an Exercise and Lifestyle Education Program in Brazilians living with prediabetes or diabetes: study protocol for a multicenter randomized controlled trial.

Patient education is a crucial strategy for promoting prevention and diabetes self-management since glycemic control achievement involves taking medications, medical nutrition therapy, physical exercise, and behavior changes. However, patient education programs are still barely implemented in low- and middle-income countries. This trial aims to investigate whether a lifestyle education intervention added to physical exercising is superior to sole physical exercising regarding functional capacity, disease-related knowledge, health behaviors, cardiometabolic health parameters, quality of life, depression, and diet quality in individuals with prediabetes or diabetes. Multicenter double-blinded randomized controlled trial with two parallel arms involving 12-week intervention and 6-month follow-up. The eligible individuals (≥ 18years, living with prediabetes or diabetes, literate, no clinical decompensation and/or physical and/or mental limitations that contraindicate physical exercising, written physician permission for exercise, no cognitive impairment, no vision limitations for reading, no confirmed diagnosis of unstable coronary disease or heart failure, no pacemaker and/or implantable cardioverter-defibrillator, no complex ventricular arrhythmias, no intermittent claudication, no recent cardiovascular event or cardiac surgery, and no currently enrolled in a structured exercise program) were recruited from two Brazilian cities and randomized to either (1) an Exercise and Lifestyle Education Program (ExLE) or (2) an Exercise Program (Ex), which can be delivered on-site or remotely based on the participants' internet access and technology literacy. The primary outcomes will be changes in functional capacity and disease-related knowledge. The secondary outcomes will involve changes in health behaviors (health literacy, physical activity level, exercise self-efficacy, and medication adherence) and cardiometabolic health parameters (glycemic control, anthropometric measures, and cardiac autonomic control). Program adherence, satisfaction with the program, diabetes-related morbidity, and changes in quality of life, depression, and diet quality will be the tertiary outcomes. Assessments will occur at baseline, post-intervention, and after 6-month follow-up. If superior effectiveness of ExLE compared to Ex program to improve the outcomes measures is found, this program could be delivered broadly in the Brazilian health system, especially in the primary care facilities where most individuals living with prediabetes and diabetes in our country are assisted. ClinicalTrials.gov, NCT03914924 . Registered on April 16, 2019.

Medical nutrition therapy in patients with severe malnutrition, unresectable gastric cancer and percutaneous endoscopic gastrostomy (PEG)

Medical nutrition therapy in patients with severe malnutrition, unresectable gastric cancer and percutaneous endoscopic gastrostomy (PEG)

Shaping the future: perspectives on the Integration of Artificial Intelligence in health profession education: a multi-country survey

BackgroundArtificial intelligence (AI) is transforming health profession education (HPE) through personalized learning technologies. HPE students must also learn about AI to understand its impact on healthcare delivery. We examined HPE students’ AI-related knowledge and attitudes, and perceived challenges in integrating AI in HPE.MethodsThis cross-sectional included medical, nursing, physiotherapy, and clinical nutrition students from four public universities in Jordan, the Kingdom of Saudi Arabia (KSA), the United Arab Emirates (UAE), and Egypt. Data were collected between February and October 2023 via an online survey that covered five main domains: benefits of AI in healthcare, negative impact on patient trust, negative impact on the future of healthcare professionals, inclusion of AI in HPE curricula, and challenges hindering integration of AI in HPE.ResultsOf 642 participants, 66.4% reported low AI knowledge levels. The UAE had the largest proportion of students with low knowledge (72.7%). The majority (54.4%) of participants had learned about AI outside their curriculum, mainly through social media (66%). Overall, 51.2% expressed positive attitudes toward AI, with Egypt showing the largest proportion of positive attitudes (59.1%). Although most participants viewed AI in healthcare positively (91%), significant variations were observed in other domains. The majority (77.6%) supported integrating AI in HPE, especially in Egypt (82.3%). A perceived negative impact of AI on patient trust was expressed by 43.5% of participants, particularly in Egypt (54.7%). Only 18.1% of participants were concerned about the impact of AI on future healthcare professionals, with the largest proportion from Egypt (33.0%). Some participants (34.4%) perceived AI integration as challenging, notably in the UAE (47.6%). Common barriers included lack of expert training (53%), awareness (50%), and interest in AI (41%).ConclusionThis study clarified key considerations when integrating AI in HPE. Enhancing students’ awareness and fostering innovation in an AI-driven medical landscape are crucial for effectively incorporating AI in HPE curricula.

The Influence of Prone Positioning on Energy and Protein Delivery in COVID-19 Patients Requiring ECMO Support

Background: Gastrointestinal dysfunction is a common complication of medical nutrition therapy in critically ill patients. Whether prone positioning leads to a deterioration in gastrointestinal function has not been fully clarified. Thus, we aimed to analyze the influence of prone positioning on the tolerance of medical nutrition therapy. Methods: We conducted a retrospective analysis of 102 SARS-CoV-2 infected patients with venovenous extracorporeal membrane oxygenation support (VV ECMO). Gastric residual volume (GRV) was used to assess the tolerance of enteral nutrition. Results: Nutritional data were collected for 2344 days. Undernutrition was observed in 40.8%, with a significantly higher incidence on days in prone position (48.4% versus 38.6%, p < 0.001). On days in supine position, significantly more calories were administered enterally than on days in prone position (p < 0.001). The mean GRV/24 h was 111.1 mL on days in supine position and 187.3 mL on days in prone position (p < 0.001). Prone positioning was associated with higher rates of GRV of ≥500 mL/24 h independent of age, disease severity at ECMO start, ECMO runtime and ICU length of stay (adjusted hazard ratio: 4.06; 95%CI: 3.0–5.5; p < 0.001). Conclusions: Prone position was associated with lower tolerance of enteral nutrition, as indicated by an increased GRV. As a result, reduced enteral nutritional support was administered.

The transition from blenderized tube feeding to medical nutrition therapy in the adult patient with spastic dystonia

The transition from blenderized tube feeding to medical nutrition therapy in the adult patient with spastic dystonia

Navigating Chronic Kidney Disease: Through Culturally Sensitive Medical Nutrition Therapy

Navigating Chronic Kidney Disease: Through Culturally Sensitive Medical Nutrition Therapy

Protein supplementation preserves muscle mass in persons against sleeve gastrectomy.

Sleeve gastrectomy surgery can lead to deficiencies in both macro and micronutrients, with protein being particularly crucial due to its role in muscle mass, physiological, and metabolic functions. Inadequate protein intake due to physiological, psychological, or financial reasons may prevent achieving the recommended intake levels. The significance of this issue is often underappreciated. This study evaluates the impact of protein supplementation on muscle mass in individuals undergoing sleeve gastrectomy and emphasizes the need for more comprehensive dietary training by expert dietitians. Data were collected from 60 participants (15 male, 45 female, aged 20-54) who visited the surgery clinic. Participants were divided into two groups: those receiving the recommended protein supplement (15 g/day) with post-bariatric surgery diet training (BSD + PS), and those receiving only the post-bariatric surgery diet (BSD). A pre-surgery questionnaire gathered health and general information. Daily energy and nutrient intakes were recorded using 24-h food consumption logs on the day before surgery and at 7 days, 1 month, and 3 months postoperatively. Anthropometric measurements, including muscle and fat mass, and International Physical Activity Questionnaire (IPAQ) data were also collected. The characteristics of participants in both groups were similar, although there were more females in the BSD + PS group (86.7%) compared to the BSD group (63.3%). Despite an increase in energy and nutrient intake over time, levels remained below the recommended amounts in both groups. A significant difference was found in protein supplement consumption between the groups (p = 0.000). Repeated measures showed significant differences in body muscle mass percentage over time (F = 202.784; p = 0.000). In individuals who underwent sleeve gastrectomy surgery, deficiencies in macro and micronutrient intake were observed below reference levels. For this reason, the first approach in the treatment of obesity should always be medical nutrition therapy accompanied by a dietician. When designing post-bariatric surgery nutrition programs, it should be taken into consideration that nutrition protocols and trainings should be followed more closely and given in more detail under the supervision of a specialist before supplements are considered.

8469 Endocrinologists Underutilize Virtual Care Services Resulting in Suboptimal Clinical and Financial Outcomes

Abstract Disclosure: D. Terry: Employee; Self; Valendo Health. Less than 150,000 Medicare patients with diabetes (PWD) receive billable telehealth and remote monitoring services, even though over 12 million PWDs are eligible for these services. This is a missed quality opportunity, as studies show that PWDs who receive these services experience reductions in A1C levels and improvements in TIR. It is also a missed financial opportunity for Endocrinologists, who are among the lowest paid specialists in the US. The economics of Endocrinology are important, because inadequate compensation is leading to access constraints when the diabetes population is growing, and care complexity is increasing. We analyzed billed virtual health claims for every Medicare PWD in 2022. The types of services we examined included: Chronic Care Management (CCM & PCM), Continuous Glucose Monitoring (CGM & RPM), Medical Nutrition Therapy (MNT), and Diabetes Self-Management Training (DSMT). When we looked by Endocrinologist by virtual care service type, we found the following levels of service delivery for Endocrinologists at the median levels of utilization:4.8% of eligible PWDs received remote Continuous Glucose Monitoring support.4.2% received virtual Chronic Care Management services.6.2% received virtual Diabetes Self-Management Support.<1% received Medical Nutrition Therapy This is clearly a missed clinical quality opportunity as a study published in JAMA in October 2023, Comprehensive Telehealth Model to Support Diabetes Self-Management, reported the following improvements for PWDs who received virtual care for 6 months:Mean change in A1C levels: Type 1: -0.6%; Type 2: -1.0%Mean TIR Improvement: Type 1: 16%; Type 2: 18% It is also a missed financial opportunity for Endocrinology practices. Each patient with diabetes is potentially eligible for $100 or more of virtual care services per month. We’ve looked at every Endocrinology practice in the US and many are missing out on over a million dollars of annual revenue opportunity. This is important as Endocrinology organizations everywhere, independent and hospital based, are struggling to retain the doctors & staff necessary to provide adequate access to care - leading to months of wait time to see an Endocrinologist. The prevalence of diabetes is growing significantly, while Endocrinologist capacity is shrinking. Value added and billable virtual care services create new opportunities for Endocrinologist to generate the revenue necessary to increase clinical capacity and improve access by creating diverse clinical teams led by Endocrinologists and supported by Diabetes Educators, Dietitians, and others with expertise in diabetes who can care for many more PWDs. Creating virtual care capabilities is also an early step in moving Endocrinology into Value-Based Care arrangements that reward providers for improving care and reducing costs rather than for generating more visits. Presentation: 6/1/2024

8077 Use of Lovaza for Management of Hypertriglyceridemia in Pregnancy

Abstract Disclosure: J. Segarra-Villafane: None. L.R. Sepulveda-Garcia: None. L. El Musa Penna: None. I.C. Arroyo: None. Z. Maisonet -Feliciano: None. W. Medina-Torres: None. M. Alvarado: None. M. Ramirez: None. L.A. Gonzalez-Rodriguez: None. Severe hypertriglyceridemia in pregnancy increases the risk of health complications to both mother and fetus, including preeclampsia, hyperviscosity syndrome and life-threatening pancreatitis. Several case reports include management of hypertriglyceridemia in pregnancy with medical nutrition therapy, omega fatty acids and gemfibrozil but is controversial. There are no formal clinical guidelines for management of severe hypertriglyceridemia in pregnancy which presents a challenge for physicians. Lovaza is a combination of ethyl esters of omega 3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) indicated as an adjunct to diet to reduce triglycerides (TG) levels in adult patients with severe hypertriglyceridemia. Lovaza is Category C (risk cannot be ruled out) and should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Case of a 40 years old female G3P1A1 with IUP 25 WGA with history of hypothyroidism, dyslipidemia and episode of acute pancreatitis in 2016 due to hypertriglyceridemia, who was referred to clinics due to uncontrolled lipids and thyroid disease. Laboratories included fasting serum triglycerides (TG) 4357mg/dL (40-150mg/dL), total cholesterol 525mg/dL (120-200), HDL 56mg/dL, LDL invalid due to elevated TG. Thyroid function test revealed TSH of 161uIU/mL (0.43-2.91) and FT4 of 0.24ng/dL (0.8-1.8). HbA1c, lipase and amylase within range. Vital signs were normal. Patient was asymptomatic, no abdominal complaints or hypothyroidism-related symptoms, but hospital admission was recommended due to high risk of pancreatitis and uncontrolled hypothyroidism. She was started on Synthroid 220 mcg IV daily for hypothyroidism and was placed NPO until nutritionist evaluation. Triglycerides levels improved with conservative interventions and low-fat diet. However, TG persisted above 2000mg/dL and, after discussing risks and benefits with patient, pharmacological therapy with Lovaza was started to reach goal of TG less than 1000 mg/dL and reduce potential risk of pancreatitis. Patient agreed to start Lovaza 2gm AM and 2gm PM. After initiation of Lovaza, in addition to dietary modifications and hypothyroidism management, laboratories showed significant improvement in TG levels from 3569 down to 1778 mg/dL. Patient was discharged on Lovaza 2gm oral BID and Synthroid 200mcg oral daily. One month later, TG had decreased to 557mg/dL (0-150) and thyroid tests showed TSH at 0.305mIU/mL and FT4 at 1.71ng/dL. Patient tolerated medications well without side effects and had an uncomplicated pregnancy and delivery. This case demonstrates that severe hypertriglyceridemia during pregnancy can be managed effectively and, more importantly, in a safe manner with Lovaza, in addition to dietary fat restriction. However, additional research is needed if its use is to be included in future pregnancy management guidelines. Presentation: 6/2/2024

Medical Nutrition Therapy: Coding, Coverage, and Payment.

Medical Nutrition Therapy: Coding, Coverage, and Payment.

Enhancing Cancer Supportive Care: Integrating Psychosocial Support, Nutrition, and Physical Activity Using Telehealth Solutions.

This review explores current guidelines for integrating psychosocial support, nutrition, and physical activity into cancer care and examines the resources available to deliver comprehensive care effectively and equitably, with a focus on telehealth solutions. A review of current guidelines related to psychosocial support, nutrition, and exercise in oncology published between the years 2020 and 2024 was conducted. Additionally, relevant articles from the authors' personal archives were included. Current guidelines emphasize routine psychosocial distress screening, nutritional assessment, and tailored physical activity interventions for patients with cancer. The National Comprehensive Cancer Network and ASCO highlight the need for regular psychosocial evaluations and the management of common psychiatric disorders. The American Cancer Society and the Academy of Nutrition and Dietetics recommend nutritional screening, personalized counseling, and exercise to improve treatment tolerance and overall quality of life. Despite these recommendations, challenges such as resource limitations, time constraints, and financial barriers hinder their implementation. Integrating psychosocial support, medical nutrition therapy, and physical activity into cancer care is essential to enhancing patients' quality of life. Telehealth offers a viable solution to overcome barriers by providing remote access to supportive services, facilitating comprehensive care, and promoting patient engagement. The effectiveness of telehealth in delivering psychosocial, nutritional, and physical activity support highlights its potential to improve patient outcomes and overcome barriers to care. Telehealth technologies hold high potential to optimize cancer care delivery, ensuring personalized support for patients throughout their cancer journey.

Suitability of plant proteins in medical nutrition

Suitability of plant proteins in medical nutrition

Back to Basics: Student Perceptions of Study-skill Focused Supplemental Learning Sessions in Medical Nutrition Therapy Curriculum

Back to Basics: Student Perceptions of Study-skill Focused Supplemental Learning Sessions in Medical Nutrition Therapy Curriculum