Nutrition Program Research Articles

Head and Neck Cancer and Sarcopenia: An Integrative Clinical and Functional Review

Sarcopenia is recognized as a crucial factor impacting the prognosis, treatment responses, and quality of life of HNC patients. This review discusses various mechanisms, including common etiological factors, such as aging, chronic inflammation, and metabolic dysregulation. Cancer-related factors, including tumor locations and treatment modalities, contribute to the development of sarcopenia. The clinical implications of sarcopenia in HNC patients extend beyond reduced muscle strength; it affects overall mobility, reduces quality of life, and increases the risk of falls and fractures. Sarcopenia serves as an independent predictor of postoperative complications, chemotherapy dose-limiting toxicity, and treatment outcomes, which affect therapy planning and perioperative management decisions. Methods to assess sarcopenia in HNC patients encompass various techniques. A sarcopenia assessment offers a potentially efficient and readily available tool for clinical practice. Interventions and management strategies for sarcopenia involve exercise interventions as a cornerstone; however, challenges arise due to patient-specific limitations during cancer treatment. A routine body composition analysis is proposed as a valuable addition to HNC patient management, with ongoing research required to refine preoperative exercise and nutrition programs for improved treatment outcomes and survival.

Preventing Stunting Through Mujaer Fish Nuggets in Early Childhood Education

Background: Stunting significantly affects early childhood development, highlighting the need for effective nutritional interventions. Specific Background: The development of fish nugget products offers a novel strategy to enhance dietary diversity among young children through parental engagement. Knowledge Gap: However, there is limited understanding of how parental participation influences nutritional programs and stunting prevention in early childhood settings. Aims: This study investigates fish nugget production as a nutritional strategy and the role of parental involvement in a preschool context. Results: Through qualitative methods, including interviews and observations, the study reveals that 90.48% of parents expressed interest in preparing fish nuggets at home, leading to increased nutritional awareness and strengthened community ties. Novelty: This research presents a community-based model that utilizes local resources to address stunting while promoting parental engagement. Implications: The findings underscore the importance of collaborative efforts in nutritional education, suggesting that similar initiatives could be adopted in other communities to effectively combat stunting. Highlights : Emphasizes the role of parental involvement in improving children's nutrition. Highlights the effectiveness of community-based interventions in combating stunting. Demonstrates increased interest in healthy food preparation among parents. Keywords: Stunting, Nutritional Education, Parental Engagement, Fish Nuggets, Early Childhood

Geographical variation, socioeconomic inequalities of low birth weight, and its relationship with maternal dietary diversity: Insights from the maternal infant and young child nutrition programme in Bangladesh.

Globally, every year, 20 million neonates are born with weights below 2500 g and are considered low birth weight (LBW). About 90% of these births occur in low- and middle-income countries. Information regarding the geographical variation, socioeconomic inequalities of LBW neonates, and the relationship between maternal inadequate dietary diversity and LBW is limited in rural areas of Bangladesh. We aimed to explore the geographical disparities and socioeconomic inequalities in the prevalence of LBW and its association with inadequate maternal dietary diversity. We extracted data from a large-scale evaluation programme conducted as a part of the maternal infant and young child nutrition phase two in Bangladesh, implemented by BRAC. We used the concentration index (CIX) to measure the socioeconomic inequalities of LBW. We performed a cluster-adjusted multiple logistic regression analysis to determine the association between LBW and maternal dietary diversity. A total of 4651 children aged <5 years with their mother's information were included. The overall prevalence of LBW was 13.5%. About 16% of mothers living in the poorest wealth quintile gave birth to LBW babies, whereas 10% of mothers living in the richest households gave birth to LBW babies. The CIX exhibited LBW babies were more prevalent among the socioeconomically worst-off (poorest) group (CIX = -0.08), indicating mothers of the poorest households are vulnerable to giving birth to normal-weight babies. An adjusted multiple logistic regression model indicated that mothers with inadequate dietary diversity had higher odds (adjusted odds ratio (AOR) = 1.27; 95% confidence interval (CI) = 1.04, 1.54) of giving birth to LBW babies. Notably, in the interaction of mothers' age and dietary diversity, we found that adolescent mothers (aged ≤ 19 years) with inadequate dietary diversity had 2.56 times (AOR = 2.56; 95% CI = 1.14, 5.76) higher odds of giving birth to LBW babies compared to adult mothers (aged >19 years) who consumed diversified foods. Intervention strategies for reducing LBW prevalence should target the poorest households. Also, interventions for improving the dietary diversity of adolescent pregnant mothers are expected to reduce the number of LBW babies from the rural areas of Bangladesh.

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The article presents a combined, shared pedagogical practice implemented in two parts: a shared project-based practice “Curious and useful tips for food and drink” in grade VIII and an extracurricular school practice “Week of healthy foods and nutrition” for high school students. The practice is a way to inform, increase competences, build a model for a critical choice of food and drinks and for a balanced, complete, high-quality, regular and healthy diet of teenagers. Students learn to use digital health and energy calculator applications, calculate BMI (body mass index) and BEE (basal energy metabolism), determine their health status in relation to food and nutrition, combine foods correctly, create personal nutrition programs, select foods according to your blood type and their color. In “Healthy Foods and Nutrition Week”, students participate in various competitions, learn about the science of nutrition, carving techniques, design and presentation of healthy foods and traditional foods from European countries. The practice builds up the knowledge, skills and habits of the students of Professional School of Design “Elisaveta Vazova” for healthy eating and a healthy lifestyle.

Clinical Data Flow in Botswana Clinics: Protocol for a Mixed-Methods Assessment.

Botswana has made significant investments in its health care information infrastructure, including vertical programs for child health and nutrition, HIV care, and tuberculosis. However, effectively integrating the more than 18 systems in place for data collection and reporting has proved to be challenging. The Botswana Health Data Collaborative Roadmap Strategy (2020-24) states that "there exists parallel reporting systems and data is not integrated into the mainstream reports at the national level," seconded by the Botswana National eLearning strategy (2020), which states that "there is inadequate information flow at all levels, proliferation of systems, reporting tools are not synthesized; hence too many systems are not communicating." The objectives of this study are to (1) create a visual representation of how data are processed and the inputs and outputs through each health care system level; (2) understand how frontline workers perceive health care data sharing across existing platforms and the impact of data on health care service delivery. The setting included a varied range of 30 health care facilities across Botswana, aiming to capture insights from multiple perspectives into data flow and system integration challenges. The study design combined qualitative and quantitative methodologies, informed by the rapid assessment process and the technology assessment model for resource limited settings. The study used a participatory research approach to ensure comprehensive stakeholder engagement from its inception. Survey instruments were designed to capture the intricacies of data processing, sharing, and integration among health care workers. A purposive sampling strategy was used to ensure a wide representation of participants across different health care roles and settings. Data collection used both digital surveys and in-depth interviews. Preliminary themes for analysis include perceptions of the value of health care data and experiences in data collection and sharing. Ethical approvals were comprehensively obtained, reflecting the commitment to uphold research integrity and participant welfare throughout the study. The study recruited almost 44 health care facilities, spanning a variety of health care facilities. Of the 44 recruited facilities, 27 responded to the surveys and participated in the interviews. A total of 75% (112/150) of health care professionals participating came from clinics, 20% (30/150) from hospitals, and 5% (8/150) from health posts and mobile clinics. As of October 10, 2023, the study had collected over 200 quantitative surveys and conducted 90 semistructured interviews. This study has so far shown enthusiastic engagement from the health care community, underscoring the relevance and necessity of this study's objectives. We believe the methodology, centered around extensive community engagement, is pivotal in capturing a nuanced understanding of the health care data ecosystem. The focus will now shift to the analysis phase of the study, with the aim of developing comprehensive recommendations for improving data flow within Botswana's health care system. DERR1-10.2196/52411.

Study protocol for a single-arm pilot trial investigating the feasibility of a multimodal digital technology for managing metabolic syndrome in patients with chronic obstructive pulmonary disease

Individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD) are exposed to an increased risk of metabolic syndrome (MetS), which negatively affects their health outcomes and quality of life. Lifestyle interventions have shown promise in managing MetS. This study outlines the protocol for a web-based multimodal self-care program, Digital Metabolic Rehabilitation, for managing MetS in patients with COPD. The Digital Metabolic Rehabilitation is a single-arm pilot trial that integrates the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) Program and a web-based wellness platform. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which integrates a holistic, multicomponent approach to promote wellness. The intervention will primarily focus on lifestyle changes for patients with COPD. Over 6 months, participants will use the web-based wellness platform and engage in weekly online support group sessions. Fifty patients diagnosed with stage I-II COPD and MetS will participate. Blood tests, anthropometrics, body composition, physical function, muscle strength, physical activity, energy metabolism, quality of life and mental health will be assessed at baseline, 3, and 6 months. The Digital Metabolic Rehabilitation program aims to explore whether a multimodal integrative intervention delivered through a web-based wellness platform can be implemented by patients with COPD with MetS. By combining the expertise of the CHANGE Program with the digital delivery format, the intervention seeks to enhance self-monitoring and foster better self-management practices. The protocol outlines a novel and potentially impactful intervention for managing MetS in patients with COPD.

The associations between dairy product intake, fatigue status, and physical activity among postpartum women in Saudi Arabia: a cross-sectional study

BackgroundFatigue is a major issue that affects women during the postpartum period. A healthy dietary pattern and increased physical activity (PA) are commonly recommended lifestyle modifications to promote health during this time. However, little is known about the interrelationship between dairy product intake, PA level, and postpartum fatigue (PPF) among women. The aim of this study was to evaluate whether PPF is associated with dairy product intake in relation to PA level.MethodsA total of 242 women were included in this cross-sectional study. Data related to dairy product intake and PA were collected using a food frequency questionnaire and the International Physical Activity Questionnaire—Short Form, respectively. PPF was assessed using the Fatigue Severity Scale. Logistic regression models were used to examine associations between the intake of dairy products and PPF among women engaged in low, moderate, and high levels of PA while controlling for potential confounders.ResultsHigher consumption rates of yogurt and total dairy predicted lower odds of PPF in women engaged in moderate levels of PA (aOR = 0.24 [95% CI = 0.07, 0.86] and 0.70 [95% CI = 0.53, 0.93], respectively). In women engaged in high levels of PA, lower odds of experiencing PPF were predicted by higher consumption rates of milk (aOR = 0.24 [95% CI = 0.07, 0.89]), yogurt (aOR = 0.21 [95% CI = 0.05, 0.83]), laban (aOR = 0.16 [95% CI = 0.03, 0.86]), and total dairy (aOR = 0.66 [95% CI = 0.47, 0.92]). However, no association was observed between dairy product intake and PPF in women with low levels of PA.ConclusionsHigher consumption rates of dairy products were associated with lower odds for experiencing PPF, particularly for women engaged in moderate to high levels of PA. These findings support nutritional and PA promotion programs to moderate issues with PPF. However, the cross-sectional design of this study could limit the ability to infer causality between dairy intake, PA, and PPF. Further longitudinal studies are needed to establish causality and explore the mechanisms underlying these associations.

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.

Long-Run Impacts of an Early-life Nutrition Program: Evidence from the Introduction of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

To study how access to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during the prenatal and early childhood periods affects long-term health outcomes of the affected cohorts. In order to identify the effects of the WIC program, we exploit variations in the timing of its introduction in different counties and analyze future health indicators of affected cohorts. We use the restricted version of the Panel Study of Income Dynamics, which includes county-level identifiers through the interview year 2019. Our findings suggest that extending WIC access by one month correlates with a 0.2-0.3% point decrease in asthma incidence (p < 0.1 to p < 0.01) of affected cohorts. Although the connection between WIC and asthma is not fully understood, existing studies suggest potential pathways. Micronutrient deficiencies during early life can impact immune function and inflammation, both relevant to asthma. Moreover, adopting healthier dietary habits may improve microbiome composition, lowering asthma risk. Other indirect benefits of WIC, such as increased use of preventive healthcare services, may also contribute to the prevention of asthma. Despite uncertainties, these estimates remain robust across various model specifications. Our study implies that early-life nutritional support programs such as WIC may alleviate the burden of asthma, although the specific mechanisms and effect sizes remain unclear. Given the substantial impact of asthma in the U.S., our findings underscore the potential long-term benefits of early-life nutritional support programs for lifelong health.

Protecting the human epigenome with nutritional epigenetics intervention programs

Protecting the human epigenome with nutritional epigenetics intervention programs Dr Renee J. Dufault, Executive Director at the Food Ingredient and Health Research Institute, explains the significance of nutritional epigenetics in understanding the impact of nutrients and dietary chemicals on gene expression patterns, as well as their role in the development of conditions such as autism and ADHD. Rising rates of autism, attention-deficit/ hyperactivity disorder, and type-2 diabetes are occurring worldwide and can be explained by changes in the human epigenome. Nutrients and dietary chemicals can alter or modify the expression of genes and impact their behavior patterns across generations. (1) Nutritional epigenetics is the field of research where scientists study the effects of nutrients and dietary chemicals on gene expression. (2), (3) The inheritable and reversible patterns of gene expression result from changes in DNA chromatin structure, which occur most commonly through mechanisms of methylation. (2) Genes may be methylated (silenced) or demethylated (turned on) at distinct locations in the human genome, which contains all of the genes. Inheritable DNA methylation patterns are reversible depending on prenatal dietary exposures to nutrients and dietary chemicals. (3), (4)

Caregiver Perspectives on Improving Government Nutrition Benefit Programs.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) provide essential nutrition support for low-income families. However, many eligible families do not receive or fully redeem these benefits. We aimed to understand current and former WIC and SNAP beneficiaries' perceptions of and suggestions for improving both programs. We conducted semistructured phone interviews with caregivers of pediatric patients who were current or former WIC and SNAP beneficiaries at 2 academic pediatric primary care clinics. Interviews were recorded, transcribed, and coded by 2 independent coders using thematic analysis, resolving discrepancies by consensus. Interviews continued until data saturation was reached. We interviewed 40 caregivers who were predominantly Black (88%) mothers (90%), with 53% and 83% currently using WIC and SNAP, respectively. We identified 4 themes related to participation barriers: (1) limited product variety available through WIC, (2) inconvenience and stigma associated with purchasing WIC products, (3) SNAP income-based eligibility criteria, and (4) burdensome SNAP enrollment and recertification processes. We identified 3 themes related to suggestions for improvement: (a) decreasing stigma associated with participation, (b) allowing online or phone-based enrollment, and (c) improving coordination with health care systems. WIC and SNAP beneficiaries identified several modifiable barriers to enrollment and benefits redemption. Pediatric providers should advocate for programmatic improvements that make it easier for families to access and redeem benefits and should consider implementing innovative cross-sector interventions like medical-financial partnerships, direct WIC and SNAP referrals, and data sharing with government assistance offices.

The Supplemental Nutrition Program for Women, Infants, and Children and Birth Outcomes Among Hispanic Mothers in California: A Sibling Control Design.

Participation in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) during pregnancy appears to reduce risks of preterm birth and low birthweight. Many pregnant women who receive WIC benefits, however, also participate in Medicaid (Medi-Cal in California). This co-participation raises the question of whether WIC per se confers these perinatal health benefits. We use a unique, sibling-linked dataset of California births to estimate birth outcomes relating to program receipt (i.e., No WIC or Medi-Cal; WIC alone; Medi-Cal alone; and WIC and Medi-Cal). We also contribute to the literature by focusing on Hispanic mothers who represent the largest fraction of births in California, as well as the highest proportion of WIC recipients in the state. We specifically assessed the relation of differential program receipt on preterm birth (< 37weeks) and low birthweight (< 2500g). We restrict our analytic sample to births between 2007 and 2015 (n = 942,274). Our sibling-control results show lower odds of low birthweight (OR: 0.82, 95% CI: 0.77, 0.87) and preterm birth (OR: 0.87, 95% CI: 0.83, 0.90) when Hispanic mothers receive WIC benefits during pregnancy compared to when the mothers do not receive WIC benefits. While births associated with receipt of both WIC and Medi-Cal also exhibit lower odds of preterm birth (OR: 0.86, 95% CI: 0.79, 0.92), the protective findings do not extend to low birthweight. Our results extend previous work in other states and should stimulate additional research on whether participation in multiple means-tested programs reduce racial/ethnic disparities in adverse birth outcomes.

The effect of immigration policy regime change on state-level participation rates of the special supplemental nutrition program for women, infants, and children in the United States

AbstractThe change in immigration policy in state-level participation rates of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the United States by citizenship and ethnicity was estimated over the period 2013-2018 using the Triple Difference estimate method. The principal finding was that the state-level WIC participation rate for Hispanic non-citizens was lower by 8.6% relative to all other groups (Hispanic citizens, non-Hispanic citizens, and non-Hispanic non-citizens). This study then not only provides quantitative evidence concerning the ongoing debate about the impact of the immigration policy changes under the Trump administration but also extends the extant literature by estimating the causal effects of immigration policy regime change on WIC participation of non-citizens.

Spatial analysis and associated factors of underweight, overweight and obesity among non-pregnant women of reproductive age in Zambia

Introduction: Malnutrition in women in reproductive age (WRA) is associated with distinct types of public health problems such as preterm birth, low birth weight, malnourished children, poor psychological health and high mortality. The study aimed at investigating the risk factors associated with underweight, overweight and obesity among WRA and map their spatial distribution. Methods: The study used the 2013/2014 Zambia Demographic Health Survey (ZDHS) data and survey proportional odds model was fitted to the data. Spatial effects were modeled using Quantum Geographic Information System (QGIS) version 2.18.1 to develop univariate choropleth maps. Results: 14,377 WRA were enrolled into the study. Overweight was more prevalent (15.87%) compared to underweight (10.22%) and obesity (6.47%). The findings revealed that a higher wealth index, age, having a car, using contraceptives, being married or divorced similarly increased the odds of being at or beyond a particular category of nutrition status. The spatial analysis also suggested Lusaka and Copperbelt were more prone to overweight and obesity, whereas Western had increased prevalence of underweight. Conclusion: Appropriate nutritional and economic programs are highly recommended in specific provinces of Zambia. Programs to curb overweight and obesity should be directed more to Lusaka and Copperbelt while underweight programs to Western province. Keywords: Underweight; overweight; obesity

Pelatihan Metode SPEOS (Stimulasi Pijat Endhorpin, Pijat Oksitosin dan Sugesti) Ibu Nifas Pada Tim Pendamping Keluarga di Wilayah Puskesmas Danau Marsabut Kecamatan Sipirok

Based on the 2018 Riskesdas results, the proportion of breastfeeding patterns for babies aged 0-5 months in Indonesia is 37.3% exclusive breastfeeding, 9.3% partial breastfeeding and 3.3% predominant breastfeeding. Predominant breastfeeding is breastfeeding the baby but giving a little water or a water-based drink, for example tea, as a prelacteal food/drink before the milk comes in. Meanwhile, partial breastfeeding is breastfeeding a baby and giving artificial food other than breast milk such as formula milk, porridge or other food before the baby is 6 months old, whether given continuously or as prelacteal food. North Sumatra Province Nutrition Program Data in 2018. The percentage of exclusive breastfeeding for babies 0-6 months in North Sumatra in 2018 was 65.57 percent, an increase compared to the percentage of exclusive breastfeeding in 2017, namely 54.4 percent (Sumatra Provincial Health Service, 2017). 2018). In the breastfeeding process, problems sometimes arise that can prevent giving breast milk to babies. Problems that mothers often experience when breastfeeding include inverted nipples, swollen breasts, sore and painful nipples, blocked milk ducts, breast inflammation and insufficient milk production (Purwoastuti, 2015). There are many non-pharmacological methods that can help postpartum mothers increase breast milk production, ranging from marmet massage, oxytocin massage, Woolwich massage to areola and rolling massage. Currently, based on the results of related research, there are non-pharmacological methods that are cheaper, easier, non-invasive and acceptable to respondents and without side effects. Nursing interventions that can be applied to help increase lactation in post partum mothers are the SPEOS method (Endorphin, Oxytocin and Suggestive Massage Stimulation).

Strengthening nutrition policy and service delivery: Lessons learned from a six-country assessment of Alive and Thrive's technical assistance.

Alive & Thrive (A&T) provides strategic technical assistance (TA) to develop effective policies; improve maternal, infant, and young child nutrition (MIYCN) programme design and implementationand enhance system capacity to sustain quality MIYCN service delivery at scale. A qualitative assessment was conducted using document review and stakeholder interviews (n = 79) to describe a selection of A&T's TA in six countries and systematically assess the contextual and TA process-related factors that influenced the results achieved and document the lessons learned about MIYCN TA design and implementation. To facilitate the selection of different types of TA, we classified TA into two levels of stakeholder engagement and intensity. Under the Technical Advisor TA category, we assessed A&T's support to strengthen national policy formulation, monitoring, and implementation of the International Code of Marketing of Breast-milk Substitutes. For Capacity Development TA, we assessed A&T support to scale-up maternal nutrition services and to increase strategic use of data. Factors important for TA provision included identifying and engaging with the right people, using evidence to support advocacy and decision-making, using multiple ways to strengthen capacity, developing packages of tools to support programme scale-up, and reinforcing feedback mechanisms to improve service provision and data quality. Challenges included shifts in the political context, poorly functioning health systems, and limited resources to replicate or sustain the progress made. Continued investment in evidence-based and practical TA that strengthens the institutionalization of nutrition across all stakeholders-including government, medical associations, civil societyand development partners-is essential. Future TA must support governments to strengthen system capacity for nutrition, including financial and human resource gaps that hamper full scale-up.

Participants in a peer-based nutrition and health program in Zimbabwe value dialogue, peer support, and tangible action: A qualitative exploration of peer group experiences.

Peer support groups are implemented globally, and viewed as cost-effective, scalable platforms for delivering health and nutrition programming. Quality is important for participation and achieving social and behavior change goals. Little research has explored the perspectives of peer group participants on quality. This manuscript describes community-based implementation research, and associated findings, which was conducted to learn how participants of a nutrition and health program define quality peer groups and how they suggest improving peer groups. In-depth interviews on experiences, benefits, and challenges were conducted with participants of health and nutrition peer groups, including group members (n = 64) and facilitators (n = 30), in three districts in Zimbabwe. Qualitative data were analyzed thematically and preliminary results were presented in six follow-up focus group discussions with interviewees to provide input on results and interpretation. Peer groups met some of participants' needs for knowledge, social support, and visible improvements in their lives and homes. Participants described generally positive experiences that sustained participation and motivated behavior change. They highlighted group dynamics, interactive facilitation, and community recognition which support the credibility and motivation of group facilitators. Implementation could be improved by strengthening family engagement and more hands-on learning for encouraging participation. Local adaptation of group activities can address influences on behavior change and increase relevance to participants' needs. The perspectives of core stakeholders are essential to understand what aspects of peer groups are most important to implement the approach with quality across contexts. Implementation research and continued monitoring to understand participant perspectives should be an integral part of all programs to ensure the application of adult learning principles and an appropriate balance between fidelity and adaptation for local relevance and engagement.

Retrofitting food and nutrition programmes to curb the global syndemic of undernutrition, obesity and climate change

Retrofitting food and nutrition programmes to curb the global syndemic of undernutrition, obesity and climate change

What do you want to eat? Cuisine and nutrition intervention preferences among people using a large food pantry in Texas

ObjectiveNutrition interventions delivered through food pantries could reduce health disparities for people experiencing food insecurity. We identified clients’ preferences for cuisines, nutrition interventions, and outcomes and whether preferences differ for subpopulations. MethodsCross-sectional study at a large pantry in Dallas, Texas (N = 200). Survey collected from February-May 2023 on demographics, cuisine preferences, nutrition intervention preferences, and outcomes clients hope to achieve when changing lifestyle (weight loss, feeling comfortable in clothes, feeling good about diet, wellbeing). A subsample (N = 130) had height and weight measured. We tested whether food security and BMI (categorical) were associated with intervention or outcome preferences using IBM SPSS Statistics (Version 29) to conduct analysis of variance. ResultsTop-rated cuisines were Mexican, Chinese, Italian. Participants reported a desire for interventions implemented through the pantry reflected by high Nutrition Intervention Index scores. The highest rated intervention was bringing more healthy food into the pantry and lowest rated was restricting unhealthy donations.Overall wellbeing was the most important outcome and weight loss the least important.Neither food security nor BMI were associated with desire for interventions. All outcomes were rated in a similar pattern, though people with obesity and overweight rated weight loss as more important than people with normal weight. ConclusionsMost participants demonstrated a strong desire for healthier, ethnically diverse options, and nutrition interventions delivered through the pantry. Our findings explore cuisines and outcomes preferred by people that use food pantries which can guide researchers, clinicians, and non-profit organizations in planning and promotion of nutrition programs for pantry clients.

Non-Pharmacological Management of Insomnia in Cancer Patients

Abstract Introduction. Insomnia is a common sleep disorder in cancer patients, characterized by a reduction in the quality or quantity of sleep. It can lead to fatigue, mood disturbances, and may contribute to immunosuppression, affecting both disease progression and quality of life. Materials and methods. In an attempt to answer the question: “Does non-pharmacological treatment of insomnia improve the quality of life in cancer patients?”, we conducted a systematic search in the international databases PubMed and ScienceDirect, following the PRISMA guidelines. The search keywords were “insomnia,” “sleep disorders,” “cancer,” and “quality of life.” Results. The systematic review included eight randomized trials that evaluated the effect of non-pharmacological therapies on insomnia and quality of life in oncology patients. Cognitive-behavioral therapy (CBT) is the first-line treatment with proven efficacy. Variants of CBT delivered through online platforms were found to be non-inferior in studies involving small patient groups. Another alternative treatment is acupuncture, which, while not as effective as CBT, improves sleep quality and enhances quality of life. Physical exercise, dance, nutrition programs, and psychological counseling also improve sleep and enhance quality of life compared to the usual hospital approaches. Conclusions. Non-pharmacological treatment of insomnia improves the quality of life in cancer patients.