Journal of the Academy of Nutrition and Dietetics最新文献

Background: Consultation with rural dietitians can inform the development of rural telehealth Medical Nutrition Therapy (MNT) interventions and contribute to their effectiveness.

Objective: This study aimed to explore dietitians' experiences and perceptions delivering in-person and telehealth MNT in rural primary healthcare settings in New South Wales (NSW), Australia, to inform the development of a rural-based telehealth MNT intervention for cardiovascular disease (CVD) risk reduction.

Design: Qualitative study design whereby semi-structured interviews were conducted between March and April 2021. Interview topic areas included experiences and perceptions of working in rural areas, delivering telehealth consultations, key factors for successful dietetic consults, the impact of dietetic care on CVD prevention, relationships with other health professionals, and the importance of continuity of care.

Participants and setting: Dietitians in rural NSW, Australia, who held Accredited Practising Dietitian (APD) status or qualified for APD status were eligible to be interviewed.

Data interpretation: Interview data were interpreted thematically. Actionable items were developed through iterative discussion and applied to a rural telehealth MNT intervention design.

Results: All dietitians recruited (n=9) participated in an interview. Key themes interpreted from the data included building trusting therapeutic relationships, using telehealth as a nuanced tool and valuing each healthcare team member. Actionable items developed from these themes included recruiting rural-based dietitians for service delivery, training dietitians in online rapport-building skills and telehealth software, providing a flexible telehealth service, and ensuring the service facilitates optimal communication with General Practitioners (GPs).

Conclusions: Consultation with dietitians working in rural areas can offer valuable insight into rural dietetic practice and inform the development of rural telehealth MNT interventions. Future research investigating telehealth MNT interventions could consider using the actionable items developed in this research study. Researchers and service designers may also consider consultation with local practitioners to inform place-based solutions for their own telehealth interventions.

Background: A common, underrecognized symptom in cancer is early satiety (ES), which is classified as an orphan symptom. No systematic or scoping review focusing on ES has been published previously.

Objective: This scoping review aimed to detail the available evidence and knowledge gaps surrounding ES in individuals with cancer.

Methods: Five databases (Cochrane, EBSCOhost, Embase, PubMed, and Web of Science) were searched from inception until August 9, 2023. Inclusion criteria were original data on ES in cancer, human studies, peer-reviewed, and full text in English. Extracted data included characteristics, tools used, and results on ES.

Results: Seventy-eight reports were included. All but 1 was quantitative. A quarter used validated tools to screen for ES. Where a description of ES was given (n = 40), 20 were unique. Median prevalence in mixed cancer cohorts was 44%. ES was the most common symptom postesophagectomy. ES was associated with cachexia, malnutrition, lower handgrip strength, lower quality of life, and reduced survival in cancer compared with those without ES. No clear pathophysiology was identified. No 2 studies investigated the same intervention, and none investigated nonpharmacologic interventions. Healthcare professionals reported lacking knowledge regarding the identification and management of ES. It was therefore among the least treated symptoms in practice.

Conclusions: ES is a highly prevalent symptom, with multiple potentially negative associations with health. Despite this, there are large knowledge deficits in identification practices, influence, pathophysiology, and appropriate treatment because no specific pathophysiology or treatment was identified. Future work should form a consensus definition, investigate pathophysiology, and trial both pharmaceutical and nonpharmaceutical interventions.

Background: Consistent evidence indicates existing associations between food parenting practices and children's dietary quality, yet these associations are likely to be different in adolescents as they are exposed to a wider social network.

Objective: To expand the existing literature by examining sex-specific associations between maternal and paternal food parenting practices and the dietary quality of male and female adolescents using sex-stratified analyses.

Design: A cross-sectional study was conducted between October 2021 and January 2022.

Participants/setting: A total of 2000 adolescents and their parents were recruited from 16 schools located in the western region of Saudi Arabia. A triadic dataset of 656 adolescents (aged 11 to 18 years) and their mothers and fathers was included in the analytic sample.

Main outcome measures: Food parenting practices questionnaires were completed for each adolescent by their mothers and fathers separately using the Comprehensive Feeding Practice Questionnaire-Arabic. Dietary quality of adolescents was assessed using a modified version of the Short Form Food Frequency Questionnaire.

Statistical analyses performed: Sex-stratified linear regression analyses were conducted to examine the association between each food parenting practice and dietary quality score of adolescents, adjusting for adolescents' age, maternal education status, city of residence, and family income.

Results: In male adolescents, maternal modeling, teaching about nutrition, and monitoring (B = .37; 95% CI, 0.14 to 0.60; B = .26, 95% CI, 0.01 to 0.51; and B = .31; 95% CI, 0.08 to .54, respectively) and paternal restriction for weight (B = .22; 95% CI, 0.01 to 0.44) were associated with higher dietary quality scores. In female adolescents, maternal restriction for health was associated with a lower dietary quality score (B = -.24; 95% CI, -0.43 to -0.05), whereas paternal teaching about nutrition was positively associated (B = .21; 95% CI, 0.02 to 0.40).

Conclusions: Findings suggest distinct patterns of association between maternal and paternal food parenting practices and dietary quality within male and female adolescents. Future interventions aimed at enhancing adolescent dietary quality may benefit from considering sex-specific associations between parental practices and dietary quality.

Background: Children from low-income neighborhoods and of Black or Hispanic/Latinx minorities are at relatively high risk for accelerated unhealthy weight gain during prolonged school break times when children lose access to a structured environment that provides healthy meals and snacks and opportunities for physical activity.

Objective: To identify child and caregiver perceptions of the neighborhood- and household-level environmental barriers and facilitators to healthy eating and active living during the summer months in low-income neighborhoods with a high percentage of Hispanic/Latinx residents.

Design: Qualitative study, using the Healthy Eating Active Living: Mapping Assets using Participatory Photographic Surveys^TM protocol, to conduct in-depth interviews and participant photographs.

Participants: /setting: A convenience sample of elementary-school-aged children (n=22; Kindergarten-6^th grade) and their caregivers (n=12) living in low-income neighborhoods with a high percentage of Hispanic/Latinx residents in Cleveland, OH; June - August 2021 MAIN OUTCOME MEASURES: Participating child(ren) and their caregivers provided their perceptions of barriers and facilitators to healthy eating and active living during the summer months.

Data analysis: A priori categories from the HEALth MAPPS™ protocol framed the analysis. Researchers (n=2) used comparative analysis to develop a codebook and determine major themes.

Results: Ten major themes emerged within four priori categories of (i) Facilitators to Healthy Eating, (ii) Barriers to Healthy Eating, (iii) Facilitators to Active Living and (iv) Barriers to Active Living. Participants contextualized these barriers and facilitators through comparisons of the summertime vs. the school year.

Conclusions: Future efforts should further and more expansively explore the food and physical activity environmental disparities that persist among low-income, minority populations that are most greatly affected by childhood obesity. Appropriate interventions, particularly during the summertime when children are out of school and interact with these environments more extensively, should be developed.