Nutritional Risk Factors Research Articles

Indicators of nutritional risk in hospital inpatients: a narrative review

Malnutrition is common in the acute care setting. Despite the existence of a plethora of screening tools, many malnourished patients remain undiagnosed and untreated, in part due to competing responsibilities for screening staff, under- or over-referral to dietetics services, and inadequate dietetics resources. Better identification of patients at risk of malnutrition would enable optimised care provision and streamlined care pathways. This narrative review of reviews aimed to collate and synthesise literature documenting nutritional risk factors in adult hospital inpatients, to generate a comprehensive list of nutritional risk indicators from high methodological quality review articles. Six electronic databases were searched (Medline, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database, Embase and Scopus) using a systematic search strategy. Three researchers screened the resulting 5889 citations, identifying 59 reviews summarising original studies that investigated associations between indicators and measures of malnutrition, undernutrition or nutritional risk. After quality appraisal by two researchers, using the American Dietetic Association Quality Criteria Checklist for Review Articles, seven reviews were classified as high quality, identifying fifty-seven unique indicators of nutritional risk (disease status/condition – twenty-three; eating/appetite/digestion – twelve; type of diet – five; cognition/psychology/social factors – five; medication-related – two; miscellaneous – ten). This is the first comprehensive list of nutritional risk factors in adult hospital inpatients, derived from only the highest methodological quality reviews. This list contributes to the development of practice and evidence-informed systems-level approaches to the identification of nutritional risk in the acute care setting.

Nutritional Status in patients with Neuro-Behçet's disease.

Background/aim The aim of this study was to assess the nutritional status and risk factors for malnutrition in Behçet’s disease (BD) and neuro-Behçet’s disease (NBD) patients.Materials and methods Medical recordings of 74 patients with BD without neurological involvement (BDWoNI), 72 patients with NBD, and 50 patients with other diseases (carpal tunnel syndrome or lumbar discopathy) were analyzed retrospectively. The serum analyses were performed in the inactive period of disease. Chronic malnutrition was defined as low levels of serum albumin (<3.5 g/dL) with normal sedimentation rate and normal serum CRP levels.Results Six (8.3%) of the patients in NBD group, 1 (1.4%) of the patients in BDWoNI group, and none of the patients in control group had chronic malnutrition (p = 0.029). Malnutrition rate was higher in NBD than control group (p = 0.036). The mean expanded disability status scale score was 2.92 ± 3.35 (range: 0–8) in patients with malnutrition and 1.44 ± 1.76 (range: 0–9) in patients without malnutrition in NBD group (p = 0.457). The ratio of patients having a progressive disease course was 33.3% and 7.6% in patients with and without malnutrition in NBD group, respectively. The median value of the duration of neurological involvement was 2 years (0–16) in patients with malnutrition and 6.5 years (0–18) in patients without malnutrition in NBD group (p = 0.046). There was no association between malnutrition and medications, disability scores, functional system involvement or findings on brain MRI.ConclusionMalnutrition was higher in patients with NBD. Higher disability level and progressive disease course may be risk factors for malnutrition in NBD. Malnutrition may be seen more frequently in earlier phases of neurological involvement.

Wiedza młodych dorosłych na temat żywieniowych czynników erozji zębowej

The knowledge of young adults on the subject of dental erosion Dental erosion is a result of the contact between tooth surfaces and acids, processes occur that result in progressive hard tooth tissue reduction. Its characterized by progressive and irreversible changes that not only affect the aesthetics of a tooth, but also oral health. Poor eating and hygienic habits, as well as some diseases, significantly increase the risk and rate at which erosion develops. The purpose of this study was to evaluate the knowledge of young adults on the subject of dental erosion, and specifically to assess their knowledge about the nutritional factors that may predispose them to dental erosion. The study involved 250 individuals between the age of 18–30 who were divided into two groups. The study was conducted in 2020 using a survey, and was then statistically analyzed using the STATISTICA PL 10 program (UJ license). Differences in the distributions between the two groups were verified using the chi-squared test and the non-parametric Mann-Whitney U test at the significance level ≤0.05. In results 13.2% of participants declared that they experience dental erosion The study has evaluated the general knowledge of the young adults as being sufficient. Most of the young adults did not differentiate dental erosion from tooth decay, and had difficulty in answering questions on nutritional and hygienic risk factors. The groups did not differ from each other in terms of general knowledge about dental erosion. Both groups had a similar frequency of consuming high dental erosion products and drinks (sweetened carbonated beverages, citrus fruits, energy or isotonic drinks). The groups also differed in terms of reported symptoms and diagnosed conditions, in which tooth sensitivity and eating disorders significantly affected young adults with dental erosion. The young adults showed many gaps in their knowledge of dental erosion. That is why education plays a key role in this area and is extremely important, especially in regards to nutritional factors and hygienic habits.

Desfecho intra-hospitalar de pacientes críticos com alto risco nutricional relacionado a adequação calórico-proteica

Introduction: Nutritional therapy in intensive care involves the careful assessment of nutritional risk based on variables that influence the clinical outcome of critically ill patients, with daily monitoring being a parameter used to assess the quality of care. The aim of the study was to evaluate whether calorie and protein targets would be met at the end of hospitalization in addition to nutritional risk factors and the severity of patients relative to length of hospitalization. Methods: The evaluation was performed at the intensive care unit (ICU) of a private hospital and 79 patients receiving enteral and/or parenteral nutritional therapy (NT) with follow-up of up to 30 days after the onset of NT were assessed. Data were collected retrospectively using forms, medical records and databases. The outcomes were categorized using the ROC curve and logistic regression was performed. Results: The targets were more easily achieved in the most severe group (92.9%; p=0.003), suggesting that the assessment of nutritional risk prompts greater attention and commitment from the multidisciplinary team. Shorter hospital stays were observed among patients at high nutritional risk who met only the calorie target during hospitalization (73.2% vs. 4.2%; p&lt;0.001). Conclusions: The NUTRIC score showed a better performance associated with other patient outcome scores, with the SAPS 3 having a better result with which to correlate the achievement of the calorie-protein target.

Wiedza dorosłych mieszkańców Małopolski w zakresie żywieniowych czynników rozwoju raka jelita grubego

Knowledge of adult inhabitants of Małopolska on nutritional fac tors in the development of color ectal cancer Most cases of colorectal cancer are related to lifestyle, including eating habits. The aim of the study was to assess the level of knowledge of the inhabitants of the Małopolskie Voivodeship regarding specific food ingredients and nutritional behaviors that are important in the development of colorectal cancer depending on selected socio-demographic factors, as well as the assessment of the nutritional status of the respondents. The study was conducted among 144 adults, residents of Krakow and the village of Gródek nad Dunajcem. The analyzes included responses from 126 people (89 women and 36 men). The diagnostic survey method was used, while the research tool was the original questionnaire. The first part of the survey concerned selected nutritional behaviors of the studied group, while the second part assessed the knowledge of nutritional risk factors for colorectal cancer. In addition, data on lifestyle, socio-economic data and participation in screening tests for the diagnosis of the lower gastrointestinal tract in the year preceding the study were collected. In the adopted assessment scale, the level of knowledge of the respondents differed significantly, taking into account the place of residence (p = 0.0363), where 41% of Krakow’s residents found it very good, while 43.8% of rural residents found it insufficient. People living in the city have almost three times greater chance of getting a higher level of knowledge than people living in the countryside. Also, the knowledge of the respondents who declared higher consumption of portions of fruit and vegetables was 2–3 times higher than those who consumed these products less frequently. The level of knowledge on nutritional behaviors related to the development of colorectal cancer is insufficient among rural residents. People who demonstrate favorable nutritional behavior have greater knowledge about modifiable cancer risk factors.

601. Disparities in Diabetes Care: Smoking Cessation among Women and Minorities Living with HIV at an Urban Academic Medical Center

BackgroundPeople living with HIV (PLWH) and diabetes mellitus are at increased risk of developing significant medical complications such as atherosclerotic cardiovascular disease. Disproportionate rates of diabetes and HIV among minority groups raise the issue of how demographic disparities may impact care. The American Diabetes Association (ADA) 2020 guidelines for diabetes care recommend optimal glycemic levels (A), blood pressure control (B), lipid reduction (C), and smoking cessation (N), commonly referred to as ABC or ABCN criteria. This quality assessment project examines diabetes management in PLWH by gender, race/ethnicity, and BMI, in a predominantly minority-serving clinic, as assessed by rates of guideline adherence to the above metrics.MethodsThis project was reviewed and approved by the Rutgers IRB. Patients from an HIV registry of University Hospital Infectious Disease Outpatient clinic in Newark, NJ were reviewed for a diagnosis of diabetes and both a clinic visit and an A1c score recorded between 2/1/2019 and 1/31/2020. Achieving glycemic target was defined as HbA1c < 7.5 for patients < 65 and HbA1c < 8 for patients > 65. Target adherence criteria also included a blood pressure average of < 140/90 over this period and an LDL-c of < 100 mg/dL. Non-smoking status includes both former and never smokers.ResultsOf 1035 patients reviewed, a total of 172 met criteria. Adherence rate for achieving goal HbA1c was 61.6% (95% CI 54.2-68.6, n=172). Blood pressure and LDL-c adherence rates were 65.1% (95% CI 57.7-71.8, n=172) and 67.4% (95% CI 60.1-74.0, n=172), respectively. ABC and ABCN rates were 24.4% (95% CI 18.6-31.4, n=172) and 18.6% (95% CI 13.5-25.1, n=172). The overall smoking rate, as well as the rates in the female subgroup, those with BMI 18.5-24.9, and the non-Hispanic black subgroup were significantly higher than the national average (P< 0.05).Table 1: Demographic Data of PLWH and Diabetes Table 2: Adherence to ABCN Criteria in Diabetes Care by Demographics for PLWH from 2/1/2019 – 1/31/2020 ConclusionFor diabetic PLWH, smoking cessation requires improvement, particularly in female, normal BMI, and non-Hispanic black subgroups. These findings, in addition to a majority overweight patient population, highlight the need for increased education and interventions aimed at nutritional counseling and risk factor mitigation among all patient subgroups.Disclosures All Authors: No reported disclosures

Dietary pattern amongst Medical college students, Delhi

Background: India is experiencing a transitional shift with more of new cases of Non Communicable Disease observed specially in young adults. One of the major reasons of this upsurge is faulty dietary habits, resulting in overweight and obesity and further rise in NCDs. The purpose of this study is to assess eating habits and nutritional risk factors for NCDs in a medical student of Medical college of Delhi. Methods: After explaining the purpose of the study in individual classroom explained questionnaire was mailed to all 300 medical college undergraduate students currently studying in this medical college. The form consists of questions on sociodemographic details including information about weights, height and eating habits including, drinking and smoking habits. Results: Filled forms were returned by 220 students out of which 204 were found to be complete and were considered for further analysis. Of total 204 students, 72 (35.3%) were females and 132 (64.7%) were males in our study. Regarding meals only 154 (75.5%) were found to be taking meals regularly i.e. more than 3 times a day and 82.4% (168) were having breakfast on regularly basis. Daily consumption of vegetable and legumes against recommended two times were found only in 41.2 (84) students, similarly daily fruit consumption against recommended two times was found only in 30.4% (62) students only. However fast-food consumption on daily basis was as high as 23.5% (48).Smoking was absent in students and alcohol intake was present in 3% of males (06) and reportedly absent in females. About 22.5% (46) was reported of doing some sort of exercise in a week but only 20 (9.8 %) were found to be doing exercise on daily basis. 156 (76.5%) sought some sort of information regarding balanced diet and 120 (58.8%) had reported to have adequate information about balance diet. Conclusion: Eating habits were found to be irregular among undergraduate medical students with regard to meals and daily intake of fruits and vegetables was found to be less than recommended norms. More efforts are required for improving eating practices of the students and also for adequate nutrition and its implication on health. Keywords: Eating Practices, MBBS students, Balanced diet, Junk food, Regular meals, Non comunicable diseases.

Urban-Rural Differences in Sarcopenia Prevalence and Nutritional Risk Factors: The NHANES (2001–2002 and 2011–2014)

Background: Older adults living in rural areas experience health inequities compared to their urban counterparts. These include comorbidities, poor diet and physical inactivity; known risk factors for sarcopenia. No studies examining urban-rural differences in the prevalence of sarcopenia and slow gait speed among older adults in the United States exist. Objective: To compare the prevalence of sarcopenia and slow gait speed between urban and rural older adults living in the United States. As a secondary aim, we examined relationships between rural residency, total energy and total protein on gait speed and grip strength. Methods: We performed a secondary data analysis of two cohorts in the continuous NHANES (2001-2002 and 2011-2014), using gait speed or grip strength data, along with urban-rural status, dietary, examination, questionnaire and demographic data in older (≥ 60 yrs.) adults. Results: The prevalence of GripBMI weakness was higher in urban vs. rural participants (27.4% vs. 19.2%), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). Total energy, total protein and relative protein intakes were similar between urban and rural participants. Total energy intake was associated with gait speed and grip strength. Conclusions: Older adults living in urban areas of the United States, were weaker compared to their rural counterparts. Rural residency was not associated with gait speed or grip strength. Total energy intake was associated with slower gait speed but higher grip strength. This report is the first to examine urban-rural differences in sarcopenia and slow gait speed in older adults living in the United States.

Prevalence of Malnutrition in a National Sample of Older Adults Residing in Community or Residential Care: NHATS 2017

The national prevalence of malnutrition in older adults living in the community and residential care (non-nursing home) is not known. We determined the prevalence of malnutrition (Mini-Nutritional Assessment) in a representative sample (N=4472) living in the community (95%) or residential care (5%), and examined known nutrition risk factors (inflammation [hsCRP, IL-6], socio-demographic variables). The majority (68%) were nourished, 26% were at risk, and 6% were malnourished. Those living in residential care vs community were more likely to be malnourished (12% vs 5%, respectively p<.01). Compared to nourished group, those with malnutrition were more likely to have hsCRP greater than median (1.36) (OR = 1.45 [95% CI 1.01-1.92]) and those at nutritional risk were more likely to have IL-6 greater than median (4.22) (OR=1.34 [95% CI 1.09-1.63]). Malnourished older adults were more likely to be older, female, live alone, report worse self-reported health, and use Meals on Wheels (p <.05).

Computed-Tomography Body Composition Analysis Complements Pre-Operative Nutrition Screening in Colorectal Cancer Patients on an Enhanced Recovery after Surgery Pathway

Pre-operative nutrition screening is recommended to identify cancer patients at risk of malnutrition, which is associated with poor outcomes. Low muscle mass (sarcopenia) and lipid infiltration to muscle cells (myosteatosis) are similarly associated with poor outcomes but are not routinely screened for. We investigated the prevalence of sarcopenia and myosteatosis across the nutrition screening triage categories of the Patient-Generated Subjective Global Assessment Short Form (PG-SGASF) in a pre-operative colorectal cancer (CRC) cohort. Data were prospectively collected from patients scheduled for surgery at two sites in Edmonton, Canada. PG-SGASF scores ≥ 4 identified patients at risk for malnutrition; sarcopenia and myosteatosis were identified using computed-tomography (CT) analysis. Patients (n = 176) with a mean age of 63.8 ± 12.0 years, 52.3% male, 90.3% with stage I–III disease were included. Overall, 25.2% had PG-SGASF score ≥ 4. Sarcopenia alone, myosteatosis alone or both were identified in 14.0%, 27.3%, and 6.4% of patients, respectively. Sarcopenia and/or myosteatosis were identified in 43.4% of those with PG-SGASF score < 4 and in 58.5% of those with score ≥ 4. Overall, 32.9% of the cohort had sarcopenia and/or myosteatosis with PG-SGASF score < 4. CT-defined sarcopenia and myosteatosis are prevalent in pre-operative CRC patients, regardless of the presence of traditional nutrition risk factors (weight loss, problems eating); therefore, CT image analysis effectively adds value to nutrition screening by identifying patients with other risk factors for poor outcomes.

Effect of nutrition education on iodine deficiency disorders and iodized salt intake in south west Ethiopian women: a cluster randomized controlled trial

BackgroundAlthough iodine nutrition status is improving globally, the progress is not uniform throughout the world due to several factors. Among these, poor knowledge, negative attitude and improper practice of iodized salt are the main risk factors for poor iodine nutrition in Ethiopia. This study was aimed to assess the effect of nutrition education intervention on knowledge, attitude and practice (KAP) of iodine deficiency and iodized salt utilization.MethodsA cluster randomized controlled trial was carried out among 652 women of reproductive age group in southwest Ethiopia. A total of 24 clusters were selected and randomized in to an intervention and control villages. Women in the intervention village received iodine nutrition related education for 6 months; while those in the control village did not receive any education. Baseline and endline data were collected from both groups. Generalized Estimating Equations (GEE) was used to determine the effect of intervention.ResultsA total of 647 (99.2%) participants were successfully involved in the study. In the intervention group the median attendance was 10 out of 12 sessions. Women in the intervention group had shown statistically significant change in knowledge, attitude and practice scores as compared to control one. In multivariable GEE linear model, after adjusting for other background characteristics, the mean difference (95% CI) scores were 8.81 (8.46, 9.16) for knowledge, 3.35 (3.17, 3.54) for attitude and 2.90 (2.74, 3.05) for practice in the intervention arm.ConclusionsWell designed and community-based iodine nutrition education is an effective strategy to improve the KAP of iodine deficiency disorders and iodized salt utilization.Trial registration PACTR201809544276357 (Retrospectively registered on 14, Sept. 2018).https://www.pactr.org.

Nutritional related cardiovascular risk factors in patients with premature coronary artery disease

Rationale: Premature Coronary artery disease (PCAD) is one of the major cause of death in recent decades. The aim of this study was to evaluate the association of dietary patterns among Iranian patients with PCAD.

Use of weekly mobile phone call-unit to screen pregnant women and their newborns for acute respiratory and gastrointestinal illness symptoms in rural Bangladesh

Background/Aims Acute respiratory and gastrointestinal illnesses are major contributors to morbidity and mortality worldwide, particularly in vulnerable populations of pregnant women and infants. It is critical to understand the burden of these illnesses in low-resource settings where infectious, nutritional, and immunotoxicological risk factors overlap and access to medical care may be limited.Methods We established a birth cohort (NCT03930017) at the JiVitA Maternal and Child Health and Nutrition Research Project site in rural Bangladesh enrolling pregnant women during gestational weeks 13-16. In collaboration with the Government of Bangladesh Institute of Epidemiology, Disease Control and Research (IEDCR), we established a mobile phone-based research support system call-center to ascertain acute respiratory and gastrointestinal symptoms in the cohort of pregnant women and their newborns at weekly intervals from study enrollment to 3-months postpartum. Further, if a participant reported acute respiratory illness or influenza-like illness (ILI) symptoms a confirmatory nasal swab specimen was collected, and real time qPCR analysis and subtyping was conducted for influenza types A and B.Results From October 2018 to January 2020, IEDCR completed 24,915 weekly mobile phone call-based interviews with 765 mothers (94% completion rate) and 11,230 weekly call-based interviews with caretakers who described morbidity for 638 infants (93% completion rate). Incident cases of ILI were recorded at a rate of 3.2 per 100 interviews among mothers and 7.7 per 100 interviews for infants. We also observed 1.6 and 1.8 incident cases of diarrhea per 100 interviews among mothers and infants, respectively. 850 nasal swabs were collected for confirmatory RT-qPCR analysis.Conclusions A mobile phone call-unit was established and produced high degree of data completeness in a pregnancy and birth cohort in rural Bangladesh. These longitudinal acute respiratory and gastrointestinal morbidity symptom data can support future planned analyses of associations with biomarkers of co-infections, micronutrient deficiency, and immunotoxicant exposure.

A cross sectional study on risk factors associated with acute lower respiratory tract infection among children aged 6 to 60 months

Background: Acute lower respiratory tract infection (ALRI) is leading cause of hospitalization and mortality among children under 5 years age in developing societies. Risk factors such as socioeconomic status, overcrowding, parental education, passive smoking, exposure to biomass fuels, kerosene lamps etc should also be considered in possible etiology of ALRI. Knowledge of risk factors would help prevention through proper health education efforts and other interventional community development initiatives. The objective of the study was to study various socio-demographic and nutritional risk factors associated with acute lower respiratory tract infection among 6 to 60 months aged childrenMethods: This cross-sectional study was conducted in a tertiary care institute Gujarat state of India. All the children in the age group of 6 months to 60 months admitted in paediatrics ward with ALRI were included in study. Data collection was done using a pretested questionnaire including socio-demographic factors. Data was analyzed using Statistical package for social sciences (SPSS) and excel and p&lt;0.05 was considered as statistically significant.Results: Higher percentage (32%) of malnutrition was observed in age group of 13 months to 36 months (p&lt;0.05). Lack of maternal education is significantly associated with malnutrition in patients of acute lower respiratory tract infection (LRTI) (p&lt;0.05). Passive smoking was found among 38.1% of ALRI patients in urban area while it was among 25.6% of patients in rural patients (p&lt;0.05). Difference in exposure to biomass fuel among rural and urban patients is statistically significant (p&lt;0.05). Giving pre-lacteal feeding (63.9%), incomplete immunization (56.8%), no birth spacing (50.2%), no predominant breast feeding (47.7%) are some of the leading causes of acute LRTI.Conclusion: Socio-demographic factors and malnutrition impact ALRI among 6 to 60 months age group of children according to place of residence.

Self-Reported Diet Quality Differentiates Nutrient Intake, Blood Nutrient Status, Mood, and Cognition: Implications for Identifying Nutritional Neurocognitive Risk Factors in Middle Age.

Evidence for diet quality representing a modifiable risk factor for age-related cognitive decline and mood disturbances has typically come from retrospective, cross-sectional analyses. Here a diet screening tool (DST) was used to categorize healthy middle-aged volunteers (n = 141, 40–65 years) into “optimal” or “sub-optimal” diet groups to investigate cross-sectional associations between diet quality, cognitive function, and mood. The DST distinguished levels of nutrient intake as assessed by Automated Self-Administered 24-h dietary recall and nutrient status, as assessed by blood biomarker measures. Compared with the “sub-optimal” group, the “optimal” diet group showed significantly higher intake of vitamin E (p = 0.007), magnesium (p = 0.001), zinc (p = 0.043) and fiber (p = 0.015), higher circulating levels of vitamin B6 (p = 0.030) and red blood cell folate (p = 0.026) and lower saturated fatty acids (p = 0.012). Regarding psychological outcomes, the “optimal” diet group had significantly better Stroop processing than those with a “sub-optimal” diet (p = 0.013). Regression analysis revealed that higher DST scores were associated with fewer mood disturbances (p = 0.002) and lower perceived stress (p = 0.031), although these differences were not significant when comparing “optimal” versus “sub-optimal” as discrete groups. This study demonstrates the potential of a 20-item diet screen to identify both nutritional and psychological status in an Australian setting.

Effectiveness of Individual Real-Time Video Counseling on Smoking, Nutrition, Alcohol, Physical Activity, and Obesity Health Risks: Systematic Review.

BackgroundReal-time video communication technology allows virtual face-to-face interactions between the provider and the user, and can be used to modify risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity. No systematic reviews have examined the effectiveness of individual real-time video counseling for addressing each of the risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity.ObjectiveThis systematic review aims to examine the effectiveness of individually delivered real-time video counseling on risk factors for smoking, nutrition, alcohol consumption, physical activity, and obesity.MethodsThe MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Database), PsycINFO, Cochrane Register of Controlled Trials, and Scopus databases were searched for eligible studies published up to November 21, 2019. Eligible studies were randomized or cluster randomized trials that tested the effectiveness of individual real-time video communication interventions on smoking, nutrition, alcohol, physical activity, and obesity in any population or setting; the comparator was a no-intervention control group or any other mode of support (eg, telephone); and an English-language publication.ResultsA total of 13 studies were eligible. Four studies targeted smoking, 3 alcohol, 3 physical activity, and 3 obesity. In 2 of the physical activity studies, real-time video counseling was found to significantly increase physical activity when compared with usual care at week 9 and after 5 years. Two obesity studies found a significant change in BMI between a video counseling and a documents group, with significantly greater weight loss in the video counseling group than the in-person as well as the control groups. One study found that those in the video counseling group were significantly more likely than those in the telephone counseling group to achieve smoking cessation. The remaining studies found no significant differences between video counseling and telephone counseling or face-to-face counseling for smoking cessation, video counseling and face-to-face treatment on alcohol consumption, video counseling and no counseling for physical activity, and video counseling and face-to-face treatment on BMI. The global methodological quality rating was moderate in 1 physical activity study, whereas 12 studies had a weak global rating.ConclusionsVideo counseling is potentially more effective than a control group or other modes of support in addressing physical inactivity and obesity and is not less effective in modifying smoking and alcohol consumption. Further research is required to determine the relative benefits of video counseling in terms of other policy and practice decision-making factors such as costs and feasibility.

Cardiometabolic risk parameters of individuals with lower extremity amputation: What is the effect of adherence to DASH diet and Mediterranean diet?

Objectives The aim of our study was to investigate the relationship between nutrition (adherence to Mediterranean Diet [MD] and Dietary Approaches to Stop Hypertension [DASH] diets) and cardiovascular disease risk factors in patients with traumatic lower limb amputation (LLA).Patients and methods A total of 35 male patients (mean age 36.9±9.3 years; range, 21 to 54 years) with unilateral traumatic LLA between April 2019 and November 2019 were included. Data including age, education status, clinical data, level of amputation, time of amputation, comorbidities, physical activities, medications including nutritional supplements were collected. Blood pressure and anthropometric measurements including weight, height, waist, hip, and upper median arm circumferences were measured. Three-day food records were evaluated to determine daily nutrient intake of each patient. The patients were divided into groups according to their diet scores.Results The DASH scores showed a moderate, negative correlation with the body mass index (BMI), hip circumference, waist circumference, waist-to-hip ratio, waist-to-height ratio, serum total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C). The MD scores showed a moderate, negative correlation with the BMI, waist circumference, hip circumference, waist-to-height ratio, serum TC, TG, and LDL-C.ConclusionPatients with traumatic LLA should be monitored closely for accompanying conditions such as cardiovascular diseases, and it is necessary to encourage them for healthy nutrition habits.

Adherence to the new WCRF cancer prevention recommendations associates with a decreased cancer risk

Abstract Background Cancer remains one of the leading causes of death worldwide. In 2018, following its summary report, the World Cancer Research Fund (WCRF) issued its recommendations for cancer prevention based on the nutritional risk factors with a sufficient level of evidence. Our objective was to study whether adherence to these new recommendations leads to a reduced risk of cancer. Methods This study included 80,604 participants from the NutriNet-Santé population-based cohort study (2009-2019). Adherence to the 2018 WCRF recommendations was assessed using the operationalized score on a 7-point scale, proposed by Shams-White et al (Nutrients 2019), including: weight, physical activity, fruit and vegetables, dietary fibers, ultra-processed foods, red and processed meat, sugary drinks and alcohol. Usual dietary intakes were assessed using repeated 24h-dietary records and physical activity level using the IPAQ questionnaire. Multi-adjusted Cox proportional hazard models were used for the analyses. Results A total of 2,438 incident cancer cases were diagnosed during follow-up (median: 7.4 years). The median WCRF 2018 adherence score was 3.75 (IQR: 3.25-4.50). An increase of 1-point increment in the score was associated with a decreased risk of cancer overall (HR = 0.90; 95%CI 0.86-0.90; P&amp;lt;.0001), and of obesity-related cancers (n = 1549 cases, HR = 0.89; 0.84-0.94; P&amp;lt;.0001), aerodigestive cancers (n = 390, HR = 0.83; 0.74-0.93; P = 0.001), breast cancer (n = 749, HR = 0.92; 0.85-1.00; P = 0.04) and a non-significant trends for prostate (n = 332, HR = 0.89; 0.79-1.01; P = 0.07) and colorectal (n = 218, HR = 0.88; 0.76-1.03; P = 0.1) cancers. Conclusions Our results suggest that a higher adherence to the WCRF 2018 recommendations for cancer prevention is associated to a decreased risk of cancer. Given the consistency between overall food-based dietary guidelines and the WCRF cancer recommendations, our result support their general promotion to the general public and transposition as public health actions. Key messages Following the recommendations for cancer prevention issued by the WCRF in 2018 can contribute to decrease the burden of cancer. The WCRF cancer recommendations are consistent with overall food-based dietary guidelines and should be promoted to the general public and transposed as public health actions.

CARPEM-LYNCH: a program linking hospital and NutriNet-Santé e-cohort data to test dynamic consent

Abstract Background Technological innovations have contributed to rapid changes in translational research, allowing greater amounts of shared data on an unprecedented scale. However, methods for involving patients in research have not kept pace with changes in research capacity. Modern tools offering more flexibility in the management of patient consent are needed. The CARPEM-LYNCH program aims to explore the acceptance and feasibility of the concept of dynamic informed consent. It is a pilot program to test a research platform at the interface between hospital follow-up clinical data and data provided by patients through the NutriNet-Santé e-cohort platform. Methods Patients diagnosed with Lynch Syndrome followed at the European hospital Georges Pompidou (HEGP) are recruited and followed-up within the NutriNet-Santé online platform. In addition to generic NutriNet questionnaires (very detailed data on diet, physical activity, lifestyle, etc.), participants receive specific questionnaires related to their syndrome, perception of nutritional risk factors, and quality of life. Clinical data collected during standard hospital care will be linked to NutriNet data for participants who provide a dynamic consent. This dispositive will allow to investigate multiple dimensions of dietary behaviors and their health impact in these at-risk patients. Results The pilot phase has started. The first 20 patients have been included, showing good acceptance of the dynamic consent. Qualitative analysis of their responses is ongoing to optimize tools before large-scale deployment and extension to other hospital centers. Conclusions This experience of merging hospital and e-cohort data through dynamic consent to advance knowledge on health impact of diet and lifestyle in Lynch patients opens up a multitude of perspectives. Key messages Dynamic informed consent offers opportunities for data sharing between clinicians, researchers and patients with a promising impact on translational research. Dynamic informed consent can provide practical and sustainable solutions to the challenges of recruiting and retaining participants, managing consent and it can also be a source of economic efficiency.

Determination of Risk Factors Associated with Postparturient Udder Edema in Dairy Goats

ABSTRACT:A proposed research was carried out to assess the potential risks of udder edema in dairy goats. In this report, 350 dairy goats, either pregnant, close to kidding or recently birthed, were involved. Diagnosis of udder edema was made based on noticeable and detectable udder tissue alterations. Parameters like breed, age at pregnancy, days in pregnancy, etc. were considered as potential risk factors. Every parameter involved was analyzed by the Chi square test, and the R variables were estimated. Results showed that the vulnerability of goat's parturited recently (1-2 days) to udder edema was 1.18 folds more relative to 3-5 days goats after kidding. At first parturition, the doe was 1.26 folds more prone than the doe in second parity to experience udder edema and so on. Doe was 3.60 folds more prone to encounter udder edema with kidding difficulty (dystokia) than doe that had usual kidding. Doe with Retained Fetal membranes (RFM) is 2.27 timesmore susceptible than without RFM to udder edema. Goats with a prior background of udder edema were 3.26 folds more prone than goats with no history of udder edema to experience udder edema. In conclusion, many host, nutrition and management related risk factors are correlated with udder edema in dairy goats.