Nutrition Counseling Sessions Research Articles

Feasibility trial of STRONG: A digital intervention to improve nutritional management for individuals with esophageal and gastroesophageal junction cancer.

Individuals with esophageal and gastroesophageal junction (GEJ) cancers are at especially high risk of malnutrition. However, most patients with malnutrition do not receive adequate nutritional support. We conducted a single-arm trial to test the implementation of Support Through Remote Observation and Nutrition Guidance (STRONG), a multilevel digital intervention to improve nutritional outcomes for patients with locally advanced esophageal and gastroesophageal junction cancer. Participants received five nutritional counseling sessions with a dietitian, logged daily food intake through the Fitbit app, and completed five study assessments related to patient malnutrition, nutrition-related symptoms, and quality-of-life outcomes. We assessed the feasibility, acceptability, and usability of STRONG against a priori benchmarks. Participants (N=17) had a median age of 68 years, and 71% were male. Feasibility benchmarks were met for participants completing the baseline assessment (94%), completing four out of five assessments (82%), and participant retention (85%). Among participants who only received an oral diet during the study period, adherence to dietetic appointments (89%) and food intake tracking (78%) were high. Participant recruitment rate (47%) was slightly below the benchmark (50%). All participants found the intervention to be acceptable. Usability of the intervention was high, with 69% and 92% of participants reporting high satisfaction with tracking food intake through the Fitbit and the dietitian-led nutrition counseling sessions, respectively. Our study demonstrated that STRONG could be implemented with high feasibility, acceptability, and usability for esophageal and GEJ cancer patients. Findings from this study can guide a future efficacy study to assess the impact of STRONG on patient outcomes. The Support Through Remote Observation and Nutrition Guidance Program for Gastroesophageal Cancer Patients (STRONG-GEC) study was registered on clinicaltrials.gov (NCT05438940) in June 2022 prior to participant enrollment.

Family-based nutritional intervention to improve overweight in schoolchildren: a pragmatic clinical trial

Objective: To evaluate the effectiveness of behavior therapy and family-based dietary intervention for overweight schoolchildren. Methods: This is a pragmatic clinical trial. The intervention was carried out in a secondary care center with parent-child dyads attending the selected school. The children were overweight and aged between 5 and 12 years. They participated in 12 nutritional counseling sessions. One arm received non-directive nutritional counseling (NDC) and the other arm received directive nutritional counseling (DC) with a dietary intervention. The main outcomes evaluated were body mass index (BMI)/age, food intake, and eating behaviors. Comparisons between groups were made at baseline and at the end of the interventions using the Mann-Whitney U test. Intragroup differences were analyzed using the Wilcoxon test and Fisher's exact test or McNemar test analysis. Results: The DC arm showed a reduction in the eating behaviors of "desire to drink" and "emotional undereating" after the interventions. In addition, the frequency of fruit consumption by the caregiver was reduced. Conclusions: It was possible to provide nutritional care based on changes in eating behavior and dietary guidance using a menu. There is a need for specific training for nutritionists. In DC, there were changes in eating behaviors in favor of a reduction in food intake. There was no significant difference in the outcomes of BMI changes.

Examining Empathy During an Initial Nutrition Counseling Session Through Video-cued Narrative Reflection

Examining Empathy During an Initial Nutrition Counseling Session Through Video-cued Narrative Reflection

Effect of a lifestyle intervention among pregnant women with overweight on neonatal adiposity: A randomized controlled clinical trial

BackgroundThe excess neonatal adiposity is considered a risk factor for the development of childhood obesity and the birth weight is a marker of health throughout life. AimsTo evaluate the effect of a lifestyle intervention conducted among pregnant women with overweight on neonatal adiposity and birth weight. MethodsA total of 350 pregnant women were recruited and randomly allocated into the control (CG) and intervention (IG) groups. Pregnant women in the IG were invited to participate in three nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed foods, following the NOVA food classification system, which categorizes foods according to the extent and purpose of industrial processing, and the regular practice of physical activity. Neonatal adiposity was estimated using a previously validated anthropometric model. Adjusted linear regression models were used to measure the effect. ResultsAdopting the modified intention-to-treat principle, data from 256 neonates were analyzed for birth weight, and data from 163 for body composition estimation. The treatment had no effect on the proportion of fat mass [β 0.52 (95 % CI −1.03, 2.06); p = .51], fat-free mass [β −0.50 (95 % CI −2.45, 1.45); p = .61] or birth weight [β 53.23 (95 % CI −87.19, 193.64); p = .46]. ConclusionsIn the present study, the lifestyle counselling used had no effect on neonatal adiposity or birth weight. Future studies should investigate the effect of more intensive interventions.

Determinants for Effective Nutritional Counselling on Prognosis of Moderate Acute Malnutrition in Paediatric HIV/AIDS Positive Patients Conducted at Hoima Regional Referral Hospital, Uganda

This study evaluated the determinants of effective nutritional counselling on the prognosis of moderate acute malnutrition in Paediatric HIV/AIDS patients at Hoima Regional Referral Hospital. This study used pre- and post-study design, which measured the occurrence of an outcome of interest using specific values in a group of participants before and after the intervention; it was conducted among 157 paediatric HIV/AIDS patients at Hoima RRH, western Uganda. Data were obtained from all the participants using a questionnaire, and focus group discussion was analysed using Stata 17. The findings reveal that of the 157 paediatric HIV/AIDS patients studied, 67.5% improved after nutritional counselling. Paediatric HIV/AIDS patients aged ≥ 60 months (p = 0.009), caretakers whose occupations other than peasantry (p = 0.021), and attendance to ≥ 3 nutritional counselling sessions (p = 0.004) were associated with a higher likelihood of improvement after nutritional counselling with a significant increase in Body Mass Index of (p = 0.007). Thus, the majority of Paediatric HIV/AIDS patients indicated a significant improvement in prognosis after nutritional counselling and being aged ≥ 60 months, having an attendance of ≥ 3 sessions and having a caretaker’s occupation other than peasantry determined the effectiveness of nutritional counselling. The study concludes that there is a need to routinely refer Paediatric HIV/AIDS patients with moderate acute malnutrition for nutritional counselling

Exploring feasibility and acceptability of an integrated urban gardens and peer nutritional counselling intervention for people with HIV in the Dominican Republic.

Food security interventions with people living with HIV (PLHIV) are needed to improve HIV outcomes. This process evaluation of a pilot intervention involving urban gardening and peer nutritional counselling with PLHIV assesses feasibility, acceptability and implementation challenges to inform scale-up. Mixed methods were used, including quantitative data on intervention participation and feasibility and acceptability among participants (n 45) and qualitative data from a purposive sample of participants (n 21). Audio-recorded interviews were transcribed and coded using a codebook developed iteratively. An HIV clinic in the northwest-central part of the Dominican Republic. The intervention was feasible for most participants: 84 % attended a garden workshop and 71 % established an urban garden; 91 % received all three core nutritional counselling sessions; and 73 % attended the cooking workshop. The intervention was also highly acceptable: nearly, all participants (93-96 %) rated the gardening as 'helpful' or 'very helpful' for taking HIV medications, their mental/emotional well-being and staying healthy; similarly, high percentages (89-97 %) rated the nutrition counselling 'helpful' or 'very helpful' for following a healthy diet, reducing unhealthy foods and increasing fruit/vegetable intake. Garden barriers included lack of space and animals/pests. Transportation barriers impeded nutritional counselling. Harvested veggies were consumed by participants' households, shared with neighbours and family, and sold in the community. Many emphasised that comradery with other PLHIV helped them cope with HIV-related marginalisation. An urban gardens and peer nutritional counselling intervention with PLHIV was feasible and acceptable; however, addressing issues of transportation, pests and space is necessary for equitable participation and benefit.

A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes.

(1) Background: Prior research in individuals with overweight/obesity and prediabetes or type 2 diabetes has shown that the ingestion of protein-rich food and non-starchy vegetables before concentrated carbohydrates (a carbohydrate-last food order) led to lower postprandial glucose excursions over 180 min, compared to eating the same foods in the reverse order. To expand upon this research, we sought to examine the feasibility and impact of carbohydrate-last food order behavioral intervention on glucose tolerance (GT), HbA1c, weight, and nutrient intake in adults with prediabetes in the real world over a 16-week span. (2) Methods: A total of 45 adults with overweight/obesity and prediabetes were randomized to receive 4-monthly standard nutritional counseling (C) or standard nutritional counseling plus carbohydrate-last food order counseling (FO) sessions (NCT# NCT03896360). (3) Results: The FO group decreased in body weight (-3.6 ± 5.7 lbs, p = 0.017), and trended toward lower HbA1c (-0.1 ± 0.2, p = 0.054). The C group weight trended lower (-2.6 ± 6.8 lbs, p = 0.102) without altering HbA1c (-0.03 ± 0.3, p = 0.605). GT was unchanged in both groups after 16 weeks. Changes in weight, HbA1c, and GT were similar between groups. Sensitivity analysis of pre-COVID participants showed significant weight loss in the FO group (-5.9 ± 5.3 lbs, p = 0.003) but not in C group (-1.0 ± 6.8 lbs, p = 0.608). After 16 weeks, the C group significantly reduced its daily intake of calories, fat, protein, and grains whereas the FO group increased its daily intake of vegetables and protein. There were 17 (94%) FO participants that reported high intervention adherence and 13 (72%) reported it was easy to eat protein/vegetables before carbohydrates. (4) Conclusions: A carbohydrate-last food order is a feasible behavioral strategy in individuals with prediabetes that improves diet quality, notably increasing protein and vegetable intake.

Using Motivational Interviewing to Increase Confidence in Nutritional Counseling Among Dental Hygienists: A Pilot Study

Purpose: Dental hygienists have the unique opportunity to educate patients on connections between nutrition and oral health. Dental hygiene students are introduced to these concepts but struggle to gain confidence to share this knowledge with patients. This pilot study looked at an educational module on motivational interviewing (MI) and an assessment and counseling tool to build student confidence with nutritional counseling. Methods: Dental hygiene students participated in an educational module to review MI and introduce a nutritional risk assessment and counseling tool. Prior to the module, participants completed a pretest about confidence levels regarding MI and nutritional counseling. After three weeks of clinical practice, participants completed a posttest. Data was compared for quantitative changes and qualitative themes from responses. Results: Twenty-two senior dental hygiene students (n = 22) participated in both the pretest and posttest. There were statistically significant changes in participants’ confidence (p = 0.007) and comfort (p = 0.020) discussing nutrition with patients. Participants struggled to become more confident in MI as demonstrated by no significant change in their feelings surrounding MI (p = 0.150). Students reporting increased nutritional counseling sessions showed improvement in their confidence. Conclusion: Introducing MI with an assessment and counseling tool to aid students can improve confidence with nutritional counseling. This type of education may translate into more chairside discussions about nutrition, improving overall patient care.

Impact of nutrition counseling on anthropometry and dietary intake of multiple sclerosis patients at Kasr Alainy Multiple Sclerosis Unit, Cairo, Egypt 2019–2020: randomized controlled clinical trial

BackgroundFaulty dietary habits and overnutrition are prevalent among Egyptian patients with multiple sclerosis (MS) who do not receive nutrition care as part of treatment. Thus, this study was conducted to identify the effect of nutrition counseling on the nutritional status of patients with MS. This endeavor might provide evidence for the value of counseling in such a setting and advance the integration of nutrition counseling into the routine management of patients with MS.MethodsA single-blinded, parallel-randomized controlled clinical trial was conducted at Kasr Alainy MS Unit on 120 eligible patients with MS from September 2019 to February 2020. Patients were randomly allocated to either the nutrition counseling intervention group (IG) or the control group (CG). Allocation concealment was performed by using sequentially numbered opaque sealed envelopes. All patients were assessed initially and complied with the Kasr Alainy MS Unit standard management protocol for the study period. Only patients in the IG underwent initial nutrition counseling sessions followed by a monthly evaluation. All patients were assessed at the end of the 3-month follow-up period. Sociodemographic data were gathered through a structured interview. Nutritional status was assessed anthropometrically and via 24-h recall. The 2 groups were compared initially and at the end of the follow-up. Both intention-to-treat and per-protocol analyses were conducted.ResultsAt baseline assessment, the prevalence of overweight and obesity was 31.7% and 32.5%, respectively, and the mean body mass index was 27.7 ± 5.7 kg/m2. Mean waist circumference was 93.5 ± 11.9 and 99.2 ± 13.1 cm for males and females, respectively. Approximately 27.3% of males and 83.9% of females showed abdominal obesity. After 3 months of counseling, weight, body mass index, waist circumference, nutrient intake and adequacy significantly improved in the IG (p < 0.05).ConclusionNutrition counseling significantly improved anthropometric measurements, dietary habits, nutrient intake and adequacy.Trial registrationThe study was registered on ClinicalTrial.gov and was given a code (NCT04217564).

Impact of the COVID-19 Pandemic on Dietary Counseling Session Attendance and Self-Monitoring Adherence Dur034 a Behavioral Weight Loss Intervention

ObjectivesTo assess the impact of the COVID-19 pandemic on participants’ intervention counseling session attendance and dietary self-monitoring adherence during the Personal Diet Study, a remote behavioral weight loss intervention for individuals with overweight and obesity with pre-diabetes and moderately controlled type 2 diabetes. MethodsParticipants (n = 200) were instructed to complete four in-person measurement visits, enter their meals daily in a smartphone application, and attend 14 virtual group nutrition counseling sessions over a 6-month intervention period. Due to COVID-19, the assessments were modified to be conducted remotely. We stratified participants into 3 categories: a) all study measures and intervention occurred before the start of the COVID-19 pandemic (BEFORE, n = 106) b) a portion of the intervention or follow-up measures occurred after the start of the pandemic (MIXED, n = 54), and 3) all study measures and intervention took place after the start of the pandemic (AFTER, n = 40). Attendance was defined as percentage of counseling intervention sessions attended. Dietary self-monitoring adherence was measured as percentage of days participants entered at least 50% of their daily caloric goal in a smart phone application. Between-group differences were assessed using linear regression models. ResultsMean [SD] counseling session attendance for the MIXED (72.6%, [28.9%]) and AFTER (73.8% [28.1%]) groups did not differ from the BEFORE group (64.5% [31.8%]), p = 0.26 and 0.22 respectively. Adherence to dietary self-monitoring was lower for the MIXED group (25.5% [30.55]) compared to BEFORE group (36.0% [34.8%], p = 0.03), but did not differ between the AFTER (44.5% [35.8%]) and BEFORE groups (p = 0.288). ConclusionsIntervention counseling attendance did not change substantially due to the COVID-19 pandemic. The MIXED group had lower self-monitoring adherence rates than the BEFORE grouip, which may be due to disruptions in daily life and habits that occurred in the early months of the COVID-19 pandemic. Virtual weight loss counseling methods are a practical way of circumventing program disruptions without compromising protocol adherence. Funding SourcesThis research was supported by the American Heart Association.

Nutrition guidelines compliance in cardiovascular disease patients attending a long-term exercise-based cardiac rehabilitation program during COVID-19 era

Funding AcknowledgementsType of funding sources: None.IntroductionDietary habits influence cardiovascular disease (CVD) risk, mainly through risk factors such as lipids, blood pressure, body weight and diabetes. Therefore, a healthy diet is recommended as a cornerstone of CVD prevention in all individuals and in reducing risk of recurrent disease, yet few studies have examined diet quality in cardiac-rehabilitation patients on a long-term basis.PurposeTo evaluate the compliance with dietary guidelines in patients who attend a long-term cardiac rehabilitation program (phase III) during COVID-19 era.MethodsThe study was developed between October 2020 and October 2021 in a phase III centre-based cardiac rehabilitation program. To evaluate dietary intake a 24hour recall questionnaire was used. Diet composition was analysed using ESHA’s Food Processor® software. Cunningham equation was used to evaluate resting energy expenditure and physical activity expenditure measured by accelerometery was added to calculate daily energetic requirements. The nutrients and cut-offs considered for the analysis were saturated fat (<10%), sodium (<2g), potassium (≥3.5g), fibre (≥30g), and alcohol (<100g/week), considering the 2021 ESC Guidelines on CVD Prevention in Clinical Practice or the World Health Organization guidelines for a healthy diet. To evaluate weight and height a digital scale SECA 799 and a stadiometer SECA 220 were used, respectively.ResultsA total of 57 patients (78.9% men) with a mean age of 63.8±8.5 were evaluated. Mean body mass index (BMI) was 28.4±3.8kg/m2, being most patients overweight or obese (61.7%). A higher caloric consumption, compared to the individual energy requirements, was found in 26.3% of patients. No statistical differences were found between mean saturated fat intake (10.1±3.6%) and the recommended intake (p=0.85). Mean sodium consumption was 3.42±1.46 grams and mean potassium intake was 3.0±1.0 grams. Sodium intake was significantly higher (p<0.001), and potassium intake significantly lower (p<0.001) than the recommendation. Fibre intake was also significantly lower than the recommendation (median intake was 21.1±12.2 grams, p<0.001). Among patients who drank alcoholic beverages (n=28), the median alcohol intake per day was 17.4±26.3 grams which was significantly higher than the limit recommended (p=0.043).ConclusionOur findings showed that these patients deviated from the recommendations in some key nutrients. The intake of sodium and alcohol was higher than the recommendations, and the intake of potassium and fibre were lower than the recommendations. Moreover, most patients were overweight or obese. This study highlights the need for individual nutritional counselling sessions as a reinforcement of a standard educational program, to effectively promote an adequate diet, which may reduce the risk of recurrent disease. Further research about nutritional intervention in patients undergoing on a long-term basis cardiac rehabilitation is warranted.

Attitude of Nutrition Experts Toward Psychotherapy and Virtual Reality as Part of Obesity Treatment—An Online Survey

BackgroundThe management of obesity requires lifestyle-based interventions covering nutrition, physical activity, and behavior. As part of cognitive behavioral therapy (CBT), body image therapy approaches can be used not only by psychotherapists. One tool to conduct behavioral therapy is virtual reality (VR). It is unknown, whether nutrition experts conduct behavioral therapy, and whether they would like to use VR technology as a tool to conduct body image therapy as part of obesity management.ObjectiveThis survey aimed to collect data from nutrition experts treating people with obesity about the status quo regarding behavioral and body image therapy as part of obesity management, and regarding their attitude toward VR in obesity therapy.MethodsThe survey was conducted online in autumn 2020. Participants were recruited digitally through expert and professional associations. The standardized questionnaire included items concerning sociodemographic, professional status, behavioral therapy, body image, and VR. The descriptive analysis was performed with Excel, the subgroup analyses with R.ResultsData from 158 nutrition experts was analyzed. Participants were mostly female (98/102, 96.1%) and had a mean age of 45.6 ± 11.3 years (n = 101). Most of the survey participants (93/124, 75.0%) stated to use behavioral treatment methods in case of weight reduction as the primary target. More than half of the participants stated to address body image (99/150, 66.0%). Almost all (111/112, 99.1%) nutrition experts have never used VR-glasses. The suitability and importance of VR technology as part of obesity therapy was estimated as neutral by around 50%. Overall, no statistically significant difference could be shown between age groups regarding attitudes toward VR in obesity treatment.ConclusionThe results of this non-representative survey indicate that nutrition experts do not use VR technology in nutrition counseling sessions to treat obesity. In addition, survey participants have a positive attitude to VR technology, whereas they are not familiar with this technology. In future, VR technology might support nutrition experts of every age using elements of body image therapy.Survey RegistrationThe German Register of Clinical Studies (Registration Number: DRKS00022853).

Impact of nutrition counseling on Knowledge, Attitude and Practices (KAP) toward obesity risk factors among college-going students

Risk perception is a primary motive to change a behavior, and the greater the perceived threat, the more likely an individual will change his/her behavior. Physicians and metabolic experts need to understand the Knowledge, Attitude, and Practices (KAP) of obese and pre-obese individuals so that the factors that support an obesogenic environment can be addressed adequately. Non-Experimental Descriptive Design was taken for this Cross-sectional study. Random Sampling of 45 college-going students in the age group of 19 to 26 years old was done. Pretested and standardized questionnaires were used to collect data from the respondent, which was administered before and after the nutrition counseling session; thereafter the responses were collected and compared for differences. The study resulted in a significant change post nutrition counseling especially in terms of Knowledge and Attitude. It was concluded that more and more nutrition counseling sessions must be held among young people to deter the risk of development of NCD like Obesity.

36-Month Evaluation of a Weight Management Programme in Chinese Overweight and Obese Adults.

Background: Few comprehensive lifestyle intervention programmes have been investigated on overweight and obese adults in China. This study was to evaluate the effect of a 36-month weight management programme on weight loss and its maintenance among overweight and obese patients in Ningbo, China.Methods: Adults with BMI ≥24kg/m2 enrolled in this programme, including nutritional, physical activity, psychological and endocrinological counselling sessions, from July 2015 to January 2020. Adults participated in face-to-face counselling sessions and group-based education. Then, participants joined 21-day intensive programme using Bohe health APP and WeChat group to get personal advice of nutrition and lifestyle. In the end, participants were requested to join 33-month follow-ups including face-to-face counselling and personal advice on WeChat group. The main outcome was to evaluate the changes in weight at each followup from baseline weight.Results: In total, 692 adults participated in this entire weight management programme. During follow-ups, 579, 475, 299, 219, and 135 adults participated at 3, 6, 12, 24, and 36 months, respectively. All participants had a significant initial weight loss at 3 months, then maintained the weight loss during 33-month follow-ups. At 36 months, 11.0%, 6.4%, and 3.5% of all participants achieved 5%, 10%, and 15% weight loss from the baseline weight, respectively. Adjusted weight at 36 months was significantly reduced from the baseline weight in both sex (−7.2 kg).Conclusion: This weight management programme is suggested to benefit to reduce initial body weight and maintain long-term weight loss among overweight and obese adults.

A study protocol of a randomized trial evaluating the effect of using defined menu plans within an intensive personal nutritional counseling program on cardiovascular risk factors: The MoKaRi (modulation of cardiovascular risk factors) trial

ImportanceChanges in dietary habits and lifestyle can reduce the risk of cardiovascular disease which is the leading cause of death worldwide. Objectives of the MoKaRi study The MoKaRi (modulation of cardiovascular risk factors) intervention study is designed to evaluate the effectiveness and potential of the developed MoKaRi concept. The MoKaRi concept comprises three components, each designed to improve dietary behavior. The first component entails using daily menu plans to implement a defined “cardioprotective diet”. This diet consists of seasonal menu plans which are characterized by:(i) a personalized energy supply depending on his or her age, gender, level of physical activity.(ii) an adequate intake of carbohydrates, protein, fat, vitamins, minerals, and trace elements according to the guidelines of the German Society of Nutrition (DGE).(iii) a recommended intake of saturated fatty acids (SFA; < 7% of caloric intake (En%)), monounsaturated fatty acids (MUFA; > 10 En%), polyunsaturated fatty acids.(PUFA; approx. 10 En%), and long-chain n-3 PUFA (≥500 mg per day).(iv) measures to encourage consumption of vegetables and fruits, and.(v) eating more than 40 g dietary fiber every day.Half of the participants will be scheduled to consume an additional 3 g of long-chain n- 3 PUFA every day in the form of fish oil.The second component consists of regular one-on-one nutritional counseling, while a variety of further incentives make up the third component of the MoKaRi concept.The MoKaRi study will provide essential insights into the relationship between defined nutrient intake, markers of food intake and health status. Our specific aim is to investigate the influence of dietary and lifestyle choices have on cardiovascular health.The information and practical tools suitable for daily use, such as the personalized menu plans, could help to transfer knowledge on nutritional facts to the general population. In this way, the validated MoKaRi concept may contribute to the prevention and therapy of cardiovascular diseases. MethodsIn line with our power calculation, we will enroll 60 participants and randomly assign them to one of two parallel arms. Each participant will receive personalized menu plans for each day of the study and will be provided with one-on-one nutritional counseling sessions every two weeks for a study period of 20 weeks (140 days). During this period, blood samples will be taken every 14 days (11 time points) and twice during a 20-weeks follow-up period. Incentives such as a supply of foods approved according t the standards of the study, a sports program, individual feedback on study parameters reflecting health status, and group activities round off the MoKaRi concept.Low-density cholesterol is the primary outcome measure of the MoKaRi study, and the secondary endpoints comprise markers of nutrient status (e.g. fatty acid distribution in plasma and erythrocyte lipids), a metabolomic profiling, diabetes risk markers, clotting markers, and further cardiovascular risk factors, such as blood lipids, homocysteine and high-sensitive c-reactive protein.The MoKaRi study was registered before launch at ClinicalTrials.gov (identifier NCT02637778; https://clinicaltrials.gov/ct2/show/NCT02637778).

Assessment of knowledge regarding diet among hospitalized patients undergoing treatment for chronic ailments in a tertiary care hospital from Hyderabad

Background: Nutrition plays important tole in the health, and specially in chronic diseases. It plays important role in all levels if prevention. Thus awareness of patients, suffering from chronic diseases is important in view of secondary and tertiary levels of prevention.Methods: The present cross sections study was carried out with 20 question predesigned and tested questionnaire, in patients admitted to hospital for chronic diases with stay more than 15 days. Scores were calculated from the questionnaire administered and results compared.Results: it was observed that awareness of patients about diet in chronic conditions was not adequate. Average scores on the 40-point questionnaire scale was 13.34, with SD±2.23. It was observed that awareness increased as education, socio economic status increases.Conclusions: It is recommended to have special nutritional counselling sessions for patients.

Increased Frequency of Nutritional Counseling Improves Weight Status and Lipids in Renal Transplant Recipients

Patients commonly experience excessive weight gain (&gt;10%) within 6 months to 1 year after renal transplant. The aim of this retrospective study of electronic medical records was to examine the association between number of nutritional counseling sessions with a registered dietitian nutritionist (RDN) with weight gain and lipids post-transplant. An analysis of covariance controlling for age and time between pre- and postmeasurements for weight, body mass index (BMI), and lipids was used to compare tertiles. Patients in tertile 1 (1–2 visits with RDN) experienced weight gain while patients in tertile 2 (3 visits) and tertile 3 (4–9 visits) did not gain weight. The change in weight was correlated with the changes in cholesterol (r = 0.23, P = .003) and triglyceride (r = 0.3, P = .0004). There were no differences among tertiles for female patients. Males in tertile 3 lost weight and improved BMI compared with male patients in tertile 1. Four or more visits with an RDN following renal transplantation are beneficial in preventing excessive weight gain. The change in weight was positively associated with blood lipids.

Study protocol: a lifestyle intervention for African American and Hispanic prostate cancer survivors on active surveillance and their partners

BackgroundProstate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Active surveillance is a treatment option for low- or very low-risk prostate cancer survivors, and lifestyle interventions have been found to reduce the disease progression and improve the quality of life for both survivors and their partners. To date, no lifestyle interventions that specifically target African American or Hispanic men and their partners exist. This protocol describes a study that tests the feasibility of a randomized controlled trial, a lifestyle intervention developed to enhance healthy lifestyle and quality of life among African American and Hispanic men on active surveillance and their partners.MethodsA mixed-method study, including a two-arm randomized controlled trial (n = 30 dyads in the intervention arm and n = 10 dyads in the control arm) and in-depth interviews, will be conducted. Intervention arm participants will receive bi-weekly health coaching calls (a total of 12 calls based on Motivational Interviewing), as well as physical activity-specific (e.g., power point slides, print materials about physical activity, and activity trackers for self-monitoring) and nutrition-specific education (e.g., two nutrition counseling sessions from a registered dietitian, print materials about nutrition, and food intake recording for self-monitoring) over 6 months. All participants will be assessed at baseline, month 3, and month 6. Blood will be collected at baseline and month 6 from the prostate cancer survivors. Finally, in-depth interviews will be conducted with subsamples (up to n = 15 dyads in the intervention arm and up to n = 5 dyads in the control arm) at baseline and months 3 and 6 to conduct a process evaluation and further refine the intervention.DiscussionIf effective, the intervention may have a higher health impact compared with a typical lifestyle intervention targeting only survivors (or partners), as it improves both survivors’ (tertiary prevention) and partners’ health (primary prevention). Results from this study will provide important information regarding recruiting racial/ethnic minority cancer survivors and their partners. Lessons learned from this study will be used to apply for a large-scale grant to test the impact of the dyadic intervention in a fully powered sample.Trial registrationClinicalTrials.gov (NCT No. 03575832) registered on 3 July 2018.

Dietary Intake Patterns And Risk Of Energy Deficiency In Ncaa Endurance Athletes

PURPOSE: This study assessed dietary intake patterns among elite collegiate runners administered through a one-on-one counseling session with the team sports dietitian. METHODS: During the Fall sports seasons of 2015 to 2018, endurance runners from two NCAA Division I Cross-Country teams were asked to participate in a prospective study that focused on optimizing the health of the athletes. A 15 to 30-minute nutritional assessment involving the team sports dietitian was conducted. Runners in the current sample were non-injured. In the one-on-one nutrition counseling session, a standardized assessment evaluated the runner’s dietary intake patterns and nutritional risks. Data was analyzed using chi-square and independent-samples t-tests. RESULTS: Final analyses yielded data from 158 male and female runners (47.1% male; 52.9% female), averaging 66.2 ± 2.1 (males) and 49.0 ± 9.4 (females) miles per week. A total of 23.4% of runners reported not eating for >4 hours on 4 or more days of the week, while 92.4% reported eating within 30 minutes upon completing exercise. Average meals/day and snacks/day among the sample were 2.9 ± 0.50 and 2.6 ±1.1, respectively. Females, compared to males, were more likely to report eating <3 meals per day (23.2% of females vs. 2.7% of males, X2= 13.8, p<0.001), following a vegetarian or vegan diet (6.3% of females vs. 0% of males, X2= 4.7, p= 0.03), avoiding a food component or food group (31.6% of females vs. 11.0% of males, X2= 9.6, p= 0.002); Based on the one-on-one meeting/nutrition assessment, the sports RD noted higher proportion of female runners with an energy deficiency risk. (48.1% of female vs. 19.7% of males, X2= 12.1, p< 0.001). CONCLUSIONS: Most elite endurance runners reported eating a post-workout snack, which may aid in recovery efforts. As more females reported eating <3 meals per day it is recommended that females avoid skipping meals to reduce risk of energy deficiency and subsequent potential consequences to health and performance.

Abstract A053: Watchful Living: A pilot lifestyle intervention for African American and Hispanic prostate cancer patients on active surveillance and their partners

Abstract Background: Prostate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Prostate cancer mortality rate is 2.4 times higher among African American men than that among non-Hispanic white men. Further, Hispanic prostate cancer patients report poorer quality of life than their non-Hispanic white counterparts. Active surveillance is a safe treatment option for low-risk prostate cancer patients in which patients' conditions are actively monitored, and preliminary studies have shown that lifestyle interventions have a promise to reduce disease progression and improve quality of life for active surveillance patients. However, none have specifically targeted African American or Hispanic men. Also, none have included partners, who are the main source of support for prostate cancer patients. Objective: This ongoing study seeks to pilot test a lifestyle intervention, Watchful Living, for African American and Hispanic men on active surveillance and their partners. The primary aim is to determine the feasibility of recruiting and implementing Watchful Living. Secondary aims are to: 1) evaluate the preliminary efficacy of the intervention in improving diet, physical activity, quality of life, and inflammation and 2) conduct a process evaluation of the intervention. Methods: We will adapt an existing, evidence-based intervention. Our intervention adaptation process is based on the Intervention Mapping Adapt and typology of adaptation, which were specifically developed for racial/ethnic minorities. First, we will conduct a needs assessment (in-depth interview) with prostate cancer patients and their partners. Participants will be asked about their physical activity and eating behaviors, impacts of cancer, determinants of lifestyle behavior changes, social support for lifestyle behaviors from partners, and their interests in lifestyle behaviors program. All feedback will be used to revise existing intervention materials and components before implementation, to ensure that the intervention is responsive to dyads' needs and culturally relevant. Second, we will conduct an RCT in which 30 dyads will be assigned to intervention group and 10 dyads will be assigned to control group. Intervention group will receive biweekly telephone coaching calls and two nutrition counseling sessions over 6 months. Participants will be assessed at baseline, month 3, and month 6, and blood will also be collected at month 3 and 6. Finally, we will conduct a process evaluation to examine thoughts about strengths, weaknesses, and needed improvements; perceptions about outcomes and impact; and overall reactions to and satisfaction with the intervention. Results: This is an ongoing study and results are not yet available. Discussion: Recruiting minority prostate cancer patients and their partners is challenging and requires extensive planning and collaboration. Building teamwork with multiple hospitals and multidisciplinary teams probably may be a key to succeed. Citation Format: Dalnim Cho, Karen Basen-Engquist, Richard Simpson, Hilary Ma, Curtis Pettaway, Yisheng Li, Steven Canfield, Cindy Carmack, John Davis, Jeffrey Jones, Lorna H. McNeill. Watchful Living: A pilot lifestyle intervention for African American and Hispanic prostate cancer patients on active surveillance and their partners [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A053.