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To assess injured military veterans' experiences, beliefs, and daily physical and psychosocial functioning in relation to food and nutrition. We used a convergent mixed-methods study design and the International Classification of Functioning, Disability, and Health to operationalize the core constructs and influencing factors related to physical and psychosocial functioning, food, and nutrition. Three Veterans Affairs polytrauma rehabilitation centers. Veterans who served in the United States military on or after September 11, 2001, and whose medical diagnoses met the criteria for polytrauma; at least 1 mild traumatic brain injury and at least 1 associated comorbidity (eg, posttraumatic stress disorder, chronic musculoskeletal pain, vestibular disturbances), for a total N of 43. None. Themes from survey responses and semistructured interview data were pooled into core constructs and influencing factors. Thirty-seven veterans completed all surveys and participated in recorded interviews. Based on qualitative and quantitative data, veterans' relation to food and nutrition (ie, nutritional functioning) was found to be characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning was found to be shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relations, current beliefs, and current behaviors. Nutritional functioning (food background, nutrition knowledge, meal aptitude, resource navigation, navigation to/of food spaces) among injured veterans is complex and shaped by multiple physical, psychosocial, economic, and cultural factors. [ABSTRACT FROM AUTHOR]

To use the International Classification of Functioning, Disability and Health (ICF) to operationalize "nutritional functioning" in military veterans with mild brain injury, by 1) evaluating physical and psychosocial functioning in relation to nutrition, and 2) assessing how veterans' experiences shape their use of food. A convergent mixed methods study comprised of semi-structured interviews and quantitative surveys. Interview guides were developed using the ICF as a framework. Outpatient polytrauma rehabilitation centers at 3 VA medical centers: Palo Alto, California, San Antonio, Texas, and Tampa, Florida. Veterans who served after 9/11, met diagnostic criteria for polytrauma (mild brain injury and 1+ comorbidity), and had received care at 1 of the 3 rehabilitation centers were eligible. 37 veterans completed all surveys and participated in an interview. None. Themes from survey responses and semi-structured interview data were pooled into core constructs, and influencing factors. Nutritional functioning is characterized by 5 core constructs, including food background, nutrition knowledge, meal aptitude, resource navigation, and navigation to/of food spaces. Nutritional functioning is also shaped by 5 influencing factors, including injuries and health conditions, ideological and cultural exposures, relationships, current beliefs, and current behaviors. We were able to identify previously unexplored factors that shape how this population conceives of nutrition in their daily lives. In addition to daily struggles arising from their injuries, Veterans strongly identify with military cultural expectations. These expectations not only influence how injured Veterans view nutrition and health, but also shape their perceptions of their injuries and their core identities. As a result, nutritional functioning comprises far more than economic concerns or adequate food access. The results of this study are being used to create a measure of nutritional functioning that can be used to develop integrative nutrition interventions aimed at improving injured veterans' psychosocial functioning. This presentation is based on work supported, in part, by the Department of Veterans Affairs, but does not necessarily represent the views of the Department of Veterans Affairs or the US Government. [ABSTRACT FROM AUTHOR]

Nutritional and body weight recommendations for cardiovascular diseases are well established, yet there are no equivalent guidelines for peripheral arterial disease (PAD). This cross-sectional study measured the prevalence of cardiovascular-related nutritional and body composition risk factors in sixty PAD patients and their association with PAD severity. A diet that exceeds daily recommended intake of fat and that falls short of recommended intakes of fiber, folate, and vitamin D was associated with increased leg pain and walking difficulty. Increased body fat and waist circumference were associated with diminished walking ability and poorer psychosocial quality of life. Future prospective investigations are merited to inform both PAD clinical care and disease management guidelines. [ABSTRACT FROM AUTHOR]

Peripheral arterial disease (PAD) has not been as extensively investigated as other cardiovascular diseases. However, the available data suggest that nutrition-based treatment strategies have the potential to reduce the cost- economic burden of PAD substantially. Abdominal obesity is associated with PAD and prospective and cross-sectional studies have shown that a low dietary intake of folate and reduced synthesis of vitamin D are associated with an increased risk of PAD and severe walking impairment in patients who have the disease. However, dietary patterns that are associated with decreased cardiovascular risk might protect against PAD. A small number of clinical trials have provided evidence that increased intakes of niacin and insoluble fiber might be associated with decreased levels of LDL cholesterol and thrombogenic biomarkers, as well as increased serum levels of HDL cholesterol in patients with PAD. However, little evidence that antioxidants, vitamins B6 and B12 or essential fatty acid supplements improve clinical outcomes in these patients exists. Overall, data on the effects of nutrition, body composition, and nutritional supplementation on the risk, progression, and prognosis of PAD are scarce. Further research into these areas is required to allow the development of evidence-based nutritional guidelines for the prevention and treatment of the disease. [ABSTRACT FROM AUTHOR]