Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. This systematic review aims to identify the factors that affect HCPs decision-making around parenteral nutrition (PN) in advanced cancer.
Methods
A literature search was conducted by May 2023 via MEDLINE, Embase, PsycINFO, The Cochrane Library, CINAHL, PubMed, Web of Knowledge and PROSPERO. Fourteen additional papers were identified. Two reviewers independently screened all papers with consensus reached on inclusion. Three reviewers conducted quality appraisal independently. Reference checking and citation tracking were completed for all included papers.
Results
Of 458 papers identified, 5 papers met the eligibility criteria (3 online surveys, 2 qualitative studies). All papers were European. Papers were published between 2020 and 2023. Six themes were identified as affecting decision-making: clinical indications, quality of life, hope, the multidisciplinary team, barriers to facilitating home PN and the influence of relatives. Performance status was a commonly considered indicator of suitability for home PN. PN is more common for people with advanced cancer and intestinal failure (IF) in the UK. Barriers to providing PN included unclear clinical indication, colleague objections, lack of local expertise and poor communication between HCPs.
Conclusion
Collaborative working and effective communication are essential between acute services, IF centres and community services to facilitate decision-making around PN in advanced cancer. It is important for HCPs to set realistic expectations. Communication must be sensitive to the patient's values and culture.
{"title":"Factors Affecting Healthcare Professionals' Decision-Making Around Parenteral Nutrition in Advanced Cancer: A Systematic Review","authors":"Jennifer McCracken, Sabrina Bajwah, Clare Shaw","doi":"10.1111/jhn.70009","DOIUrl":"https://doi.org/10.1111/jhn.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. This systematic review aims to identify the factors that affect HCPs decision-making around parenteral nutrition (PN) in advanced cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was conducted by May 2023 via MEDLINE, Embase, PsycINFO, The Cochrane Library, CINAHL, PubMed, Web of Knowledge and PROSPERO. Fourteen additional papers were identified. Two reviewers independently screened all papers with consensus reached on inclusion. Three reviewers conducted quality appraisal independently. Reference checking and citation tracking were completed for all included papers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 458 papers identified, 5 papers met the eligibility criteria (3 online surveys, 2 qualitative studies). All papers were European. Papers were published between 2020 and 2023. Six themes were identified as affecting decision-making: clinical indications, quality of life, hope, the multidisciplinary team, barriers to facilitating home PN and the influence of relatives. Performance status was a commonly considered indicator of suitability for home PN. PN is more common for people with advanced cancer and intestinal failure (IF) in the UK. Barriers to providing PN included unclear clinical indication, colleague objections, lack of local expertise and poor communication between HCPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Collaborative working and effective communication are essential between acute services, IF centres and community services to facilitate decision-making around PN in advanced cancer. It is important for HCPs to set realistic expectations. Communication must be sensitive to the patient's values and culture.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Shan Lee, Nafisah Zulkifli, Yi Huan Lim, Shinee Ying Yi Lim, Benjamin Jian Wen Chow, Ennaliza Salazar, Seng Mun Wong
Background
Individuals on tube-feeding experience significant lifestyle changes and social isolation, but the barriers and support for travelling out while on tube-feeding to reintegrate into the community have not been studied. This research explores the factors influencing the decisions of individuals on tube-feeding and their carers to travel outside of their homes, their experiences, and perceived barriers and support when performing tube-feeding in public settings.
Methods
A qualitative design using purposive sampling explored the experiences of three individuals and five carers living at home on long-term tube-feeding. One-to-one semi-structured interviews were conducted and transcribed. Thematic analysis was conducted via open coding and merging of recurring codes to form themes.
Results
Six themes emerged: (1) Motivators and deterrents to going out: Motivators include desire for social normalcy. Deterrents include physical health, logistics and psychosocial considerations, such as fear of negative public perception and the loss of travelling and dining as motivating social activities. (2) Going out requires meticulous preparation and planning. (3) Inadequate tube-feeding facilities in the community contribute to ambivalence and discomfort to tube-feeding outside. Participants must accept potential negative emotions when confronted with public reaction to tube-feeding. (4) Ideal tube-feeding facilities should be private and hygienic, in highly frequented locations. (5) Community support and awareness are needed to support tube-feeding. (6) Adaptability is crucial when satisfactory feeding locations are absent during local and overseas travel.
Conclusions
Carers and healthcare professionals are pivotal in encouraging patients to disregard public curiosity, planning tube-feeding logistics, and advocating for the right to tube feed in public spaces without shame. Public awareness, carer support, and availability of tube-feeding facilities should be improved for patients to live, work and engage meaningfully in the community.
{"title":"The Impact of Home Enteral Tube-Feeding on the Intent and Experience of Going Out in Public: A Qualitative Study on Patients' and Caregivers' Perspectives","authors":"Yan Shan Lee, Nafisah Zulkifli, Yi Huan Lim, Shinee Ying Yi Lim, Benjamin Jian Wen Chow, Ennaliza Salazar, Seng Mun Wong","doi":"10.1111/jhn.70018","DOIUrl":"https://doi.org/10.1111/jhn.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individuals on tube-feeding experience significant lifestyle changes and social isolation, but the barriers and support for travelling out while on tube-feeding to reintegrate into the community have not been studied. This research explores the factors influencing the decisions of individuals on tube-feeding and their carers to travel outside of their homes, their experiences, and perceived barriers and support when performing tube-feeding in public settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative design using purposive sampling explored the experiences of three individuals and five carers living at home on long-term tube-feeding. One-to-one semi-structured interviews were conducted and transcribed. Thematic analysis was conducted via open coding and merging of recurring codes to form themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six themes emerged: (1) Motivators and deterrents to going out: Motivators include desire for social normalcy. Deterrents include physical health, logistics and psychosocial considerations, such as fear of negative public perception and the loss of travelling and dining as motivating social activities. (2) Going out requires meticulous preparation and planning. (3) Inadequate tube-feeding facilities in the community contribute to ambivalence and discomfort to tube-feeding outside. Participants must accept potential negative emotions when confronted with public reaction to tube-feeding. (4) Ideal tube-feeding facilities should be private and hygienic, in highly frequented locations. (5) Community support and awareness are needed to support tube-feeding. (6) Adaptability is crucial when satisfactory feeding locations are absent during local and overseas travel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Carers and healthcare professionals are pivotal in encouraging patients to disregard public curiosity, planning tube-feeding logistics, and advocating for the right to tube feed in public spaces without shame. Public awareness, carer support, and availability of tube-feeding facilities should be improved for patients to live, work and engage meaningfully in the community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adopting plant-forward diets is essential for achieving climate targets. As the second-largest provider of public sector meals in the UK, the National Health Service (NHS) can significantly reduce its environmental impact by transitioning to plant-forward menus, contributing to its goal of being a net-zero healthcare service by 2045. This study evaluates the extent to which NHS hospitals currently align with sustainable practices by assessing the plant-forward nature of in-patient menus.
Methods
Green Plans from 40 hospital trusts were analysed to assess commitment to plant-forward, lower-emission menus. Freedom of Information requests were sent to 50 NHS trusts, and 36 menus from the spring/summer season of 2024 were analysed. A novel scoring system was developed to assess the hospital menus, with subscores reflecting the availability of plant-based meals, ruminant-meat meals, and menu strategies to encourage plant-forward choices.
Results
Green Plans showed limited commitment to increasing plant-based food options. Hospital menus scored poorly overall (average score of 20/100, range: 9–38). The lowest subscores were observed in the provision of fully plant-based meals and nudging techniques. The provision of ruminant meat varied (subscore range: 0–100) and all hospitals included processed meat on their menu. Hospitals with outsourced catering scored higher than those with in-house catering.
Conclusion
Despite national recommendations to shift towards plant-forward diets, NHS hospitals currently show little commitment and provide limited offerings in this regard. The novel scoring system offers a practical framework for monitoring progress and guiding hospitals towards environmentally sustainable, plant-forward menus.
{"title":"How Sustainable Are Hospital Menus in the United Kingdom? Identifying Untapped Potential Based on a Novel Scoring System for Plant-Based Provisions","authors":"Isabelle Sadler, Alexander Bauer, Shireen Kassam","doi":"10.1111/jhn.70019","DOIUrl":"10.1111/jhn.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adopting plant-forward diets is essential for achieving climate targets. As the second-largest provider of public sector meals in the UK, the National Health Service (NHS) can significantly reduce its environmental impact by transitioning to plant-forward menus, contributing to its goal of being a net-zero healthcare service by 2045. This study evaluates the extent to which NHS hospitals currently align with sustainable practices by assessing the plant-forward nature of in-patient menus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Green Plans from 40 hospital trusts were analysed to assess commitment to plant-forward, lower-emission menus. Freedom of Information requests were sent to 50 NHS trusts, and 36 menus from the spring/summer season of 2024 were analysed. A novel scoring system was developed to assess the hospital menus, with subscores reflecting the availability of plant-based meals, ruminant-meat meals, and menu strategies to encourage plant-forward choices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Green Plans showed limited commitment to increasing plant-based food options. Hospital menus scored poorly overall (average score of 20/100, range: 9–38). The lowest subscores were observed in the provision of fully plant-based meals and nudging techniques. The provision of ruminant meat varied (subscore range: 0–100) and all hospitals included processed meat on their menu. Hospitals with outsourced catering scored higher than those with in-house catering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite national recommendations to shift towards plant-forward diets, NHS hospitals currently show little commitment and provide limited offerings in this regard. The novel scoring system offers a practical framework for monitoring progress and guiding hospitals towards environmentally sustainable, plant-forward menus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Graeme O'Connor, Shelley Cleghorn, Maleena Salam, Kelly Watson
<div> <section> <h3> Background</h3> <p>Enteral tube feeding is used for children who are unable to meet their nutritional requirements orally. Gastrointestinal symptoms are some complications that can occur in enteral tube-fed patients. Blended tube feeds (BTFs) for children who are gastrotomy tube-fed have significantly increased in the last decade. BTF refers to homemade food that has been liquidised for enteral tube feeds. An increasing amount of evidence suggests that children on BTF have improved feed tolerance. It is unknown whether children admitted to a hospital established on a BTF can continue a BTF due to the potential barriers such as catering processes, staffing hours (limited to syringe bolus feeding) and food safety concerns. This national cross-sectional survey aimed to explore the use of BTF in a paediatric hospital setting.</p> </section> <section> <h3> Methods</h3> <p>This was a prospective, cross-sectional, practice-based survey of registered paediatric dietitians who work in an inpatient care setting to explore the use of BTF. The final survey consisted of 13 questions and took dietitians approximately 15 min to complete. The questions focused on the dietitian's experience, knowledge and confidence in children on a BTF.</p> </section> <section> <h3> Results</h3> <p>Across the United Kingdom, 51 hospitals completed the survey. Of these, 16 of 19 were specialist children's hospitals (79% response rate) and 35 of 89 were general paediatric hospitals (39% response rate). All responders were paediatric dietitians. 49 of 51 (96%) dietitians knew of the British Dietetic Association (BDA) Practice Toolkit for Blended diets. Dietitians were asked to estimate on average per month how many children were admitted on a BTF; 41% (21 of 51) of dietitians reported that on average there are one to five children admitted on a BTF. There was no significant difference in the number of children admitted on a BTF between a specialist and a general children's hospital (<i>χ</i><sup>2</sup> statistic = 4.96, <i>p</i> value < 0.08). The number of dietitians who had clinical guidelines to support children admitted on a BTF was 49% (25 of 51). Specialist children's hospitals were more likely to have a clinical guideline compared with a general hospital (χ<sup>2</sup> statistic = 6.348, <i>p</i> value = 0.01). However, only 18 of 51 (35%) dietitians reported being confident or very confident to review a child on a BTF. The most common perceived benefit was that parents/carers could incorporate family foods into their child's diet. 26% reported that a varied diet was beneficial in relation to the gut microbiome. If a BTF was contraindicated for children admitted to a hospital (immunocompromised, post-pyloric feedi
{"title":"Exploring Dietitians' Experience of Blended Tube Feed in Paediatric Inpatient Settings: National Cross-Sectional Survey, United Kingdom","authors":"Graeme O'Connor, Shelley Cleghorn, Maleena Salam, Kelly Watson","doi":"10.1111/jhn.70016","DOIUrl":"10.1111/jhn.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Enteral tube feeding is used for children who are unable to meet their nutritional requirements orally. Gastrointestinal symptoms are some complications that can occur in enteral tube-fed patients. Blended tube feeds (BTFs) for children who are gastrotomy tube-fed have significantly increased in the last decade. BTF refers to homemade food that has been liquidised for enteral tube feeds. An increasing amount of evidence suggests that children on BTF have improved feed tolerance. It is unknown whether children admitted to a hospital established on a BTF can continue a BTF due to the potential barriers such as catering processes, staffing hours (limited to syringe bolus feeding) and food safety concerns. This national cross-sectional survey aimed to explore the use of BTF in a paediatric hospital setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, cross-sectional, practice-based survey of registered paediatric dietitians who work in an inpatient care setting to explore the use of BTF. The final survey consisted of 13 questions and took dietitians approximately 15 min to complete. The questions focused on the dietitian's experience, knowledge and confidence in children on a BTF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across the United Kingdom, 51 hospitals completed the survey. Of these, 16 of 19 were specialist children's hospitals (79% response rate) and 35 of 89 were general paediatric hospitals (39% response rate). All responders were paediatric dietitians. 49 of 51 (96%) dietitians knew of the British Dietetic Association (BDA) Practice Toolkit for Blended diets. Dietitians were asked to estimate on average per month how many children were admitted on a BTF; 41% (21 of 51) of dietitians reported that on average there are one to five children admitted on a BTF. There was no significant difference in the number of children admitted on a BTF between a specialist and a general children's hospital (<i>χ</i><sup>2</sup> statistic = 4.96, <i>p</i> value < 0.08). The number of dietitians who had clinical guidelines to support children admitted on a BTF was 49% (25 of 51). Specialist children's hospitals were more likely to have a clinical guideline compared with a general hospital (χ<sup>2</sup> statistic = 6.348, <i>p</i> value = 0.01). However, only 18 of 51 (35%) dietitians reported being confident or very confident to review a child on a BTF. The most common perceived benefit was that parents/carers could incorporate family foods into their child's diet. 26% reported that a varied diet was beneficial in relation to the gut microbiome. If a BTF was contraindicated for children admitted to a hospital (immunocompromised, post-pyloric feedi","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yvonne Jeanes, Lidia Orlandi, Humayun Muhammad, Sue Reeves
Introduction
A gluten-free (GF) diet, the only treatment for people living with coeliac disease (CD), is challenging, and international guidelines highlight the valuable role of healthcare professionals in enabling self-management. The study aimed to explore the acceptability of telephone and online video consultations for adults with CD.
Methods
A cross-sectional study consisting of an online and paper survey was promoted to adults with CD.
Results
Data from 496 adults with CD (87% female, 96% White) are presented, and 44% were adhering to the GF diet. Over half (58%) were very confident in understanding food labels from supermarkets, whereas only 38% were very confident when shopping online. The largest proportion of patients preferred in-person healthcare appointments for CD (44%), with 20% reporting no preference and 21% preferring telephone appointments. Only 15% preferred online video consultations; of these, 97% were confident with online technology. A higher proportion of patients from a lower household income requested ‘in-person’ appointments compared with those with a higher income (65% vs. 45% (p < 0.01)). Likewise, 58% of patients without a degree qualification requested ‘in-person’ appointments compared with 45% of degree-educated patients (p = 0.027).
Conclusions
We highlight a significant proportion of adults with CD prefer an in-person appointment. The paper survey enabled the views of a broader range of digitally confident patients to contribute to the study. With a global shift towards telemedicine and online resources, access and digital literacy is an important consideration for equitable healthcare to optimize patient self-management of the GF diet.
{"title":"Telemedicine in Coeliac Disease: In-Person Appointments Are Favoured by Patients With a Lower Education Attainment and Lower Household Income","authors":"Yvonne Jeanes, Lidia Orlandi, Humayun Muhammad, Sue Reeves","doi":"10.1111/jhn.70014","DOIUrl":"10.1111/jhn.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A gluten-free (GF) diet, the only treatment for people living with coeliac disease (CD), is challenging, and international guidelines highlight the valuable role of healthcare professionals in enabling self-management. The study aimed to explore the acceptability of telephone and online video consultations for adults with CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study consisting of an online and paper survey was promoted to adults with CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 496 adults with CD (87% female, 96% White) are presented, and 44% were adhering to the GF diet. Over half (58%) were very confident in understanding food labels from supermarkets, whereas only 38% were very confident when shopping online. The largest proportion of patients preferred in-person healthcare appointments for CD (44%), with 20% reporting no preference and 21% preferring telephone appointments. Only 15% preferred online video consultations; of these, 97% were confident with online technology. A higher proportion of patients from a lower household income requested ‘in-person’ appointments compared with those with a higher income (65% vs. 45% (<i>p</i> < 0.01)). Likewise, 58% of patients without a degree qualification requested ‘in-person’ appointments compared with 45% of degree-educated patients (<i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We highlight a significant proportion of adults with CD prefer an in-person appointment. The paper survey enabled the views of a broader range of digitally confident patients to contribute to the study. With a global shift towards telemedicine and online resources, access and digital literacy is an important consideration for equitable healthcare to optimize patient self-management of the GF diet.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"‘The Weight of Expectation’–How Weight Stigma Is Impacting Dietetic Practice","authors":"Adrian Brown, Stuart W. Flint, Lauren Ball","doi":"10.1111/jhn.70017","DOIUrl":"10.1111/jhn.70017","url":null,"abstract":"","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Understanding the dietary patterns of populations is crucial in addressing chronic health conditions that are influenced by diet and lifestyle. We aimed to identify the dietary patterns among adult Caucasian Canadians and examine their associations with socioeconomic and sociodemographic factors and chronic health conditions.
Methodology
We used two comprehensive national nutrition surveys: Canadian Community Health Survey (CCHS)2015 and CCHS Cycle 2.2 Nutrition 2004, which encompass sociodemographic and socioeconomic profiles, nutrient-rich food diet quality scores and prevalence of chronic conditions. Through cluster analysis, dietary patterns were identified among Caucasians and further analysed with stratification by age/sex groups.
Results
Our analysis of dietary patterns among Caucasian adults showed a transition from “High-Fibre” and “Mixed” patterns in 2004 to “Unhealthy,” “Healthy-like” and “Potato, Beef and Vegetables” in 2015. In 2004, the “Mixed” pattern was prevalent, but by 2015, a shift towards the “Unhealthy” pattern was notable, with a significant portion of the population, 18.8%, reporting chronic diseases and 19.6% being classified as obese. The “Healthy-like” pattern in 2015 saw lower rates of chronic diseases (6.8%) and obesity (6.1%). Gender-specific patterns showed women favoring healthier options like “Healthy-like” in 2015. The prevalence of chronic diseases and obesity varied significantly with dietary patterns. The “High-Fibre” pattern in 2004 showed lower prevalence rates of chronic diseases (6.6%) and obesity (5.8%) compared to the “Unhealthy” pattern in 2015.
Conclusions
The findings highlight the impact of dietary choices on health outcomes over time, underscoring the importance of promoting healthier eating habits to mitigate the risk of chronic diseases and obesity.
{"title":"Dietary Patterns Among Canadian Caucasians and Their Association With Chronic Conditions","authors":"Pardis Keshavarz, Ginny Lane, Punam Pahwa, Jessica Lieffers, Hassan Vatanparast","doi":"10.1111/jhn.70013","DOIUrl":"10.1111/jhn.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding the dietary patterns of populations is crucial in addressing chronic health conditions that are influenced by diet and lifestyle. We aimed to identify the dietary patterns among adult Caucasian Canadians and examine their associations with socioeconomic and sociodemographic factors and chronic health conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>We used two comprehensive national nutrition surveys: Canadian Community Health Survey (CCHS)2015 and CCHS Cycle 2.2 Nutrition 2004, which encompass sociodemographic and socioeconomic profiles, nutrient-rich food diet quality scores and prevalence of chronic conditions. Through cluster analysis, dietary patterns were identified among Caucasians and further analysed with stratification by age/sex groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis of dietary patterns among Caucasian adults showed a transition from “High-Fibre” and “Mixed” patterns in 2004 to “Unhealthy,” “Healthy-like” and “Potato, Beef and Vegetables” in 2015. In 2004, the “Mixed” pattern was prevalent, but by 2015, a shift towards the “Unhealthy” pattern was notable, with a significant portion of the population, 18.8%, reporting chronic diseases and 19.6% being classified as obese. The “Healthy-like” pattern in 2015 saw lower rates of chronic diseases (6.8%) and obesity (6.1%). Gender-specific patterns showed women favoring healthier options like “Healthy-like” in 2015. The prevalence of chronic diseases and obesity varied significantly with dietary patterns. The “High-Fibre” pattern in 2004 showed lower prevalence rates of chronic diseases (6.6%) and obesity (5.8%) compared to the “Unhealthy” pattern in 2015.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings highlight the impact of dietary choices on health outcomes over time, underscoring the importance of promoting healthier eating habits to mitigate the risk of chronic diseases and obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several reviews have highlighted that the Patient-Generated Subjective Global Assessment (PG-SGA) is the best diagnostic tool for assessing nutritional status in cancer patients. However, previous meta-analyses summarizing the prevalence of malnutrition and overall survival in patients with gastrointestinal (GI) cancer are quite limited. This study aims to determine the overall prevalence and association between malnutrition, as defined by the PG-SGA, and mortality in adults with GI cancer.
Methods
A comprehensive systematic review of articles published from 2005 to 2023 was conducted using Google Scholar, PubMed, Web of Sciences and Scopus. The PRISMA guideline was followed to organize the entire content. A random-effects meta-analysis model using R Studio was performed to quantify the pooled proportion and hazard ratios (HRs). Publication bias was assessed using Egger's test and funnel plots. Heterogeneity was evaluated using I2 and Baujat plots. This study was registered in PROSPERO under the protocol number CRD42023465685.
Results
In this study, 46 publications with 23,235 participants were included in the final meta-analysis. The overall prevalence of malnutrition among adults with GI cancer, as determined by the PG-SGA, was 61% (95% CI: 51%–70%, I2 = 99%). The pooled prevalence of moderate and severe malnutrition were 38% (95% CI: 31%–45%, I2 = 96%) and 21% (95% CI: 13%–31%, I2 = 98%), respectively. By cancer type, malnutrition was more common in patients with oesophageal cancer (78%, 95% CI: 45%–94%, I2 = 99%) and gastric cancer (75%, 95% CI: 68%–81%, I2 = 87%). Additionally, the overall risk (pooled HR) of malnutrition on mortality among GI cancer patients was 2.02 (95% CI: 1.63–2.5, I2 = 23%).
Conclusion
Malnutrition is common in adults with GI cancer and doubles the risk of all-cause mortality. These results emphasize the importance of ongoing efforts in prevention, early assessment, and intervention for malnutrition to minimize mortality rates.
{"title":"Malnutrition Diagnosed by Patient-Generated Subjective Global Assessment and the Risk of All-Cause Mortality in Adults With Gastrointestinal Cancer: A Systematic Review and Meta-Analysis","authors":"Awole Seid, Zelalem Debebe, Abebe Ayelign, Melsew Abeje, Bilal Shikur Endris, Mathewos Assefa, Ahmedin Jemal","doi":"10.1111/jhn.70012","DOIUrl":"10.1111/jhn.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Several reviews have highlighted that the Patient-Generated Subjective Global Assessment (PG-SGA) is the best diagnostic tool for assessing nutritional status in cancer patients. However, previous meta-analyses summarizing the prevalence of malnutrition and overall survival in patients with gastrointestinal (GI) cancer are quite limited. This study aims to determine the overall prevalence and association between malnutrition, as defined by the PG-SGA, and mortality in adults with GI cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive systematic review of articles published from 2005 to 2023 was conducted using Google Scholar, PubMed, Web of Sciences and Scopus. The PRISMA guideline was followed to organize the entire content. A random-effects meta-analysis model using R Studio was performed to quantify the pooled proportion and hazard ratios (HRs). Publication bias was assessed using Egger's test and funnel plots. Heterogeneity was evaluated using <i>I</i><sup>2</sup> and Baujat plots. This study was registered in PROSPERO under the protocol number CRD42023465685.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, 46 publications with 23,235 participants were included in the final meta-analysis. The overall prevalence of malnutrition among adults with GI cancer, as determined by the PG-SGA, was 61% (95% CI: 51%–70%, <i>I</i><sup>2</sup> = 99%). The pooled prevalence of moderate and severe malnutrition were 38% (95% CI: 31%–45%, <i>I</i><sup>2</sup> = 96%) and 21% (95% CI: 13%–31%, <i>I</i><sup>2</sup> = 98%), respectively. By cancer type, malnutrition was more common in patients with oesophageal cancer (78%, 95% CI: 45%–94%, <i>I</i><sup>2</sup> = 99%) and gastric cancer (75%, 95% CI: 68%–81%, <i>I</i><sup>2</sup> = 87%). Additionally, the overall risk (pooled HR) of malnutrition on mortality among GI cancer patients was 2.02 (95% CI: 1.63–2.5, <i>I</i><sup>2</sup> = 23%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Malnutrition is common in adults with GI cancer and doubles the risk of all-cause mortality. These results emphasize the importance of ongoing efforts in prevention, early assessment, and intervention for malnutrition to minimize mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stina Engelheart, Mikael Karlsson, Marleen A. H. Lentjes
Background
Meeting protein intake recommendations is relevant for maintaining muscle mass. This study aimed to describe protein intake and its association with meal patterns and dietary patterns.
Methods
An in-house designed, web-based 4-day record was used in the national dietary survey (in 2010/2011). Participants 60 years and older were included in the analysis (n = 533). Protein intake was described by hour of consumption, self-indicated meals and food source. Eating and drinking occasion (EDO) and food groups were defined, from which meal patterns and three a posteriori dietary patterns (using principal component analysis) were assessed.
Results
We observed a mean protein intake of just over 1 g/kg body weight (bw) in both men and women. Over 50% of the protein intake was sourced from the food groups meat, fish and milk/yoghurt. A bolus intake of 30 g protein per meal was observed in a small proportion of participants at breakfast and lunch, but was most common at dinner (41% women and 56% men). No strong correlations were observed between protein intake and neither dietary patterns nor the number of EDOs. A 5 g higher protein intake at any meal, but not higher EDO frequency, was associated with higher odds of meeting a protein intake over 1.1 g/kg bw.
Conclusions
Protein intake over 1.1 g/kg bw was met by 44% of the participants. Lunch and dinner were the highest contributors to protein intake. Dietary and meal patterns were weakly associated with protein intake. Only total daily protein intake was associated with reaching > 1.1 g/kg bw.
{"title":"Protein Intake and Its Association With Meal Patterns and Dietary Patterns in a Swedish Population of Older Adults","authors":"Stina Engelheart, Mikael Karlsson, Marleen A. H. Lentjes","doi":"10.1111/jhn.70011","DOIUrl":"10.1111/jhn.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Meeting protein intake recommendations is relevant for maintaining muscle mass. This study aimed to describe protein intake and its association with meal patterns and dietary patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An in-house designed, web-based 4-day record was used in the national dietary survey (in 2010/2011). Participants 60 years and older were included in the analysis (<i>n</i> = 533). Protein intake was described by hour of consumption, self-indicated meals and food source. Eating and drinking occasion (EDO) and food groups were defined, from which meal patterns and three a posteriori dietary patterns (using principal component analysis) were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed a mean protein intake of just over 1 g/kg body weight (bw) in both men and women. Over 50% of the protein intake was sourced from the food groups meat, fish and milk/yoghurt. A bolus intake of 30 g protein per meal was observed in a small proportion of participants at breakfast and lunch, but was most common at dinner (41% women and 56% men). No strong correlations were observed between protein intake and neither dietary patterns nor the number of EDOs. A 5 g higher protein intake at any meal, but not higher EDO frequency, was associated with higher odds of meeting a protein intake over 1.1 g/kg bw.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Protein intake over 1.1 g/kg bw was met by 44% of the participants. Lunch and dinner were the highest contributors to protein intake. Dietary and meal patterns were weakly associated with protein intake. Only total daily protein intake was associated with reaching > 1.1 g/kg bw.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Dietitians ensure that patients receive tailored medical nutrition therapy to integrate with pharmacotherapy safely. Dietitians require a pharmacological understanding to prevent detrimental food-drug interactions (FDIs). The study investigated dietitians' knowledge of FDIs and their information sourcing.</p> </section> <section> <h3> Methods</h3> <p>A cross-sectional online survey was conducted among registered South African dietitians to assess their knowledge of FDIs, the impact of food timing on drugs, and their sources of FDI information. The questionnaire included demographics, a 12-question knowledge assessment, and a qualitative section on information sourcing. Data from 70 valid responses, collected between 2 August and 19 September 2022, were analysed statistically using analysis of variance and chi-square tests to determine whether associations between knowledge scores and demographic factors were present.</p> </section> <section> <h3> Results and Discussion</h3> <p>Out of 70 responses, most participants were female (97.1%) and 47.1% had over 10 years of experience. The participants primarily worked in the areas of dietetics related to chronic and lifestyle-related disorders (75.7%) across various work settings, including in-patient care (32.8%), out-patient care (41.4%), and multi-disciplinary team environments (31.4%). Although not generalisable due to the low response rate (70 out of the 304 required responses for a 5% margin of error), knowledge deficiencies were observed. A cumulative mean knowledge score of 38.3% was observed, with gaps identified for fundamental FDIs. Drug package inserts (55.7%) and clinical websites (68.6%) were primarily used to source information regarding FDIs; however, the former did not always provide sufficient information. Participants proposed that knowledge deficiencies could be overcome with further education, and the development and/or use of mobile applications or summarisations that elaborate on FDIs.</p> </section> <section> <h3> Conclusion</h3> <p>Knowledge gaps and uncertainties were identified regarding fundamental FDIs; however, further research is needed to pinpoint the specific sources of these deficiencies and the factors influencing them. To improve dietitians' knowledge of FDIs and ensure alignment with their scope and standard of practice, undergraduate curricula should be bolstered and benchmarked to national needs to facilitate graduate development, and additional learning opportunities provided, such as webinars and continuing professional develo
{"title":"South African Dietitians' Knowledge and Perceptions of Food-Drug Interactions and Factors Affecting It","authors":"Christie Megaw, Natascha Olivier, Werner Cordier","doi":"10.1111/jhn.70010","DOIUrl":"10.1111/jhn.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dietitians ensure that patients receive tailored medical nutrition therapy to integrate with pharmacotherapy safely. Dietitians require a pharmacological understanding to prevent detrimental food-drug interactions (FDIs). The study investigated dietitians' knowledge of FDIs and their information sourcing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was conducted among registered South African dietitians to assess their knowledge of FDIs, the impact of food timing on drugs, and their sources of FDI information. The questionnaire included demographics, a 12-question knowledge assessment, and a qualitative section on information sourcing. Data from 70 valid responses, collected between 2 August and 19 September 2022, were analysed statistically using analysis of variance and chi-square tests to determine whether associations between knowledge scores and demographic factors were present.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Discussion</h3>\u0000 \u0000 <p>Out of 70 responses, most participants were female (97.1%) and 47.1% had over 10 years of experience. The participants primarily worked in the areas of dietetics related to chronic and lifestyle-related disorders (75.7%) across various work settings, including in-patient care (32.8%), out-patient care (41.4%), and multi-disciplinary team environments (31.4%). Although not generalisable due to the low response rate (70 out of the 304 required responses for a 5% margin of error), knowledge deficiencies were observed. A cumulative mean knowledge score of 38.3% was observed, with gaps identified for fundamental FDIs. Drug package inserts (55.7%) and clinical websites (68.6%) were primarily used to source information regarding FDIs; however, the former did not always provide sufficient information. Participants proposed that knowledge deficiencies could be overcome with further education, and the development and/or use of mobile applications or summarisations that elaborate on FDIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Knowledge gaps and uncertainties were identified regarding fundamental FDIs; however, further research is needed to pinpoint the specific sources of these deficiencies and the factors influencing them. To improve dietitians' knowledge of FDIs and ensure alignment with their scope and standard of practice, undergraduate curricula should be bolstered and benchmarked to national needs to facilitate graduate development, and additional learning opportunities provided, such as webinars and continuing professional develo","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号