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Weight faltering (WF) has been associated with stunting and with long-term adverse consequences for health and development. Nutritional care for managing WF may consist of giving nutritional advice (NA) and/or provision of oral nutrition supplements (ONSs). In this study, we aimed to evaluate practical management options in the community for infants with WF aged 6–12 months. This nonrandomized clinical trial was conducted in the community of Makassar, South Sulawesi, from March 2022 to March 2023. A total of 1013 infants were enrolled for screening. Anthropometric measures were performed in 913 infants, of which 170 showed WF below the 15th percentile of the WHO weight increment table without stunting. Infants with a weight increment below P5th were assigned to receive NA plus ONS, while infants between P5th and below P15th were assigned to receive only NA. At the second and third months, ONSs were administered to WF infants who were below P15th. One month after the intervention, 87/105 infants in the NA-plus-ONS group (82.8%) and 52/65 infants in the NA-only group (80%) were no longer WF. After 3 months, infants in the NA-plus-ONS group achieved greater weight gain than infants in the NA group (264.1 g vs. 137.4 g, p < 0.001) as well as greater length gain (2.35 cm vs. 2.14 cm, p < 0.001). WF management should be started at below P15th to achieve a better result. Infants with greater nutritional deficits should be assigned to receive the combination of NA plus ONSs to achieve a higher rate of resolution of growth. [ABSTRACT FROM AUTHOR]

This research aims to understand fitness instructors and personal trainers' perception of their qualifications and competence to prescribe dietary supplements. To this end, a questionnaire was applied to 154 fitness instructors and personal trainers with professional functions in health clubs/gyms. The results obtained show that the sale of these products in gyms is seen as stimulating their consumption and that most fitness professionals consider professionals in this area do not have competence to prescribe this type of service. The lack of confidence about knowledge of dietary supplements; degree courses with a weak curriculum in this domain; and the shortage of curricular units related to dietary supplements are possible reasons for these professionals not feeling sure about giving advice on this matter. Regarding ways of updating knowledge, although these professionals consider academic journals, conferences, congresses and nutrition courses as the most reliable sources of information, they resort more frequently to the Internet, despite considering this source as the least reliable. These results can have direct implications for various stakeholders, particularly for consumers to be more informed about the risks involved in consuming dietary supplements without due orientation; for fitness professionals who have little knowledge about this type of substance; for gym managers who need to understand the implications of selling this type of product in their establishments; for teaching institutions, who should reflect on, and organize their academic curricula in order to provide sufficient grounding for fitness professionals to feel safe and confident about their knowledge in this area; and for the producers of these products, in order to improve information about, and the safety of the substances they put on the market. [ABSTRACT FROM AUTHOR]

Previous studies have shown that shift workers are more prone to non-communicable diseases. The aim of the present crossover study is to investigate whether it is possible to improve the health status of shift workers. Nineteen male shift workers (38.5 years ± 7.4) received every other month a dietary counseling for one year. All subjects kept a seven-day diet diary during a night shift, received bioelectrical impedance analysis, and a laboratory examination was performed at the beginning of the study, after one year and at the end of the study. The laboratory blood test included the main metabolic parameters, melatonin and serotonin. Beside subjects were also motivated to incorporate more physical training into their daily routine. After the intervention period, participants reduced energy intake, mean portion size, table salt, consumption of sugar and saturated fat. C-reactive protein (CRP), mean corpuscular volume (MCV), liver enzymes, triglycerides, and uric acid decreased, while melatonin level increased. Participants lost body weight and reduced waist circumference after the intervention. Lifestyle modification and dietary information could contribute to the health of shift workers. However, further studies are needed to investigate whether this can prevent disease and whether melatonin production can be influenced by diet. [ABSTRACT FROM AUTHOR]

Malaysia is a reputed destination for health tourism in the Asia Pacific region for its hospitable nature and good quality of service. Patients' satisfaction has been a key concern in health tourism to maintain the flow of tourists' arrival for medical purposes. By considering the importance of health tourism and patients' satisfaction in Malaysia, this study aimed to examine the influence of hospital environment, nutritional advice, perceived value on patients' satisfaction. This study is cross-sectional in nature and follows a quantitative approach. The researchers used questionnaires as a survey tool to obtain information from the respondents. The sample of this is chosen from Chinese exchange students in Malaysia. Using a systematic random sampling technique, 205 usable responses were selected from the respondents and proceeded with further analysis. The study conducted structural equation modeling using Smart PLS version 3. The results found that hospital environment, nutritional advice, and perceived value significantly influence patients' satisfaction in Malaysia.

Background Previous studies have suggested that providing dietary guidance along with denture treatment may improve dietary diversity in edentulous patients; however, none have examined the effects on nutritional blood biomarkers. This study investigated the effects of individualized dietary guidance combined with complete denture treatment on nutritional blood biomarker levels, dietary intake, and masticatory function. Materials and methods This was a prospective, randomized, open-label, controlled trial. Patients seeking new dentures with at least one edentulous arch were randomly allocated to Group A (denture treatment only) or Group B (dietary guidance followed by denture treatment). Individualized dietary guidance was provided exclusively to Group B by dentists based on baseline assessments. Baseline and post-treatment assessments included blood tests, a dietary survey using the Brief-type Self-Administered Diet History Questionnaire (BDHQ), occlusal force measurements using pressure-sensitive film, and masticatory performance tests using gummy jelly. The results from the baseline and post-treatment assessments were compared within each group, and exploratory comparisons of changes were conducted between groups. Results A total of 39 individuals completed the protocol (20 in Group A and 19 in Group B; mean age 73.4 ± 10.6 years; 17 males, 22 females). Both groups showed a significant increase in occlusal force after treatment ( P = 0.007 for Group A; P = 0.011 for Group B), while no improvement in blood biomarkers was observed. In Group B, the intake of fish with bones ( P = 0.035) and non-oily fish ( P = 0.030), as evaluated using the BDHQ, significantly increased after treatment. Group B also showed significantly greater increases than Group A in methionine ( P = 0.012), lysine ( P = 0.048), and total essential amino acids ( P = 0.029), as evaluated by blood tests, as well as the intake of fish with bones ( P = 0.043). Conclusion Although denture treatment may increase occlusal force, combining dietary guidance with prosthetic treatment appears to further enhance dietary habits and support the nutritional status of edentulous patients., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Showa University Research Ethics Review Board issued approval 2023-080-A. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This work was supported by JSPS KAKENHI (grant numbers 24K19975 and 24K13014). Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sako et al.)

Objective: Despite adequate dialysis, the prevalence of hyperkalemia in Chinese hemodialysis (HD) patients remains elevated. This study aims to evaluate the effectiveness of a dietary recommendation system driven by generative pretrained transformers (GPTs) in managing potassium levels in HD patients., Methods: We implemented a bespoke dietary guidance tool utilizing GPT technology. Patients undergoing HD at our center were enrolled in the study from October 2023 to November 2023. The intervention comprised of two distinct phases. Initially, patients were provided with conventional dietary education focused on potassium management in HD. Subsequently, in the second phase, they were introduced to a novel GPT-based dietary guidance tool. This artificial intelligence (AI)-powered tool offered real-time insights into the potassium content of various foods and personalized dietary suggestions. The effectiveness of the AI tool was evaluated by assessing the precision of its dietary recommendations. Additionally, we compared predialysis serum potassium levels and the proportion of patients with hyperkalemia among patients before and after the implementation of the GPT-based dietary guidance system., Results: In our analysis of 324 food photographs uploaded by 88 HD patients, the GPTs system evaluated potassium content with an overall accuracy of 65%. Notably, the accuracy was higher for high-potassium foods at 85%, while it stood at 48% for low-potassium foods. Furthermore, the study examined the effect of GPT-based dietary advice on patients' serum potassium levels, revealing a significant reduction in those adhering to GPTs recommendations compared to recipients of traditional dietary guidance (4.57 ± 0.76 mmol/L vs. 4.84 ± 0.94 mmol/L, P = .004). Importantly, compared to traditional dietary education, dietary education based on the GPTs tool reduced the proportion of hyperkalemia in HD patients from 39.8% to 25% (P = .036)., Conclusion: These results underscore the promising role of AI in improving dietary management for HD patients. Nonetheless, the study also points out the need for enhanced accuracy in identifying low potassium foods. It paves the way for future research, suggesting the incorporation of extensive nutritional databases and the assessment of long-term outcomes. This could potentially lead to more refined and effective dietary management strategies in HD care., (Copyright © 2024 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Objectives: This systematic review was aimed to examine the effectiveness of nutritional advise interventions compared with usual care, or exercise, or exercise combined with nutritional advice as a means of improving the body weight, body composition, physical function, and psychosocial well-being of frail, obese older adults.Methods: CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, and Scopus databases were searched to identify relevant studies. The quality of the included studies was assessed using Cochrane's risk of bias tool 2. Meta-analysis was performed with respect to body weight and fat mass. Other outcomes were synthesized narratively.Results: Eight articles (from two studies) with a total of 137 participants were included in the review. The results revealed that nutritional advice was more effective than exercise in reducing body weight and fat mass. The nutritional advice was also beneficial in enhancing physical function and psychosocial well-being. However, it was less effective than exercise or combined interventions in increasing muscle strength and preventing lean mass loss.Conclusions: Nutritional advice is an essential intervention for reducing body weight and fat mass, for enhancing physical function, and for improving the psychosocial well-being of obese older adults experiencing frailty. The limited number of studies included in this review suggests that there is a need for more well-designed interventional studies in order to confirm these findings.

Purpose: People living with and beyond cancer often experience nutrition-related issues and should receive appropriate advice on nutrition that is consistent and evidence based. The aim of this study was to investigate current practice for the provision of nutritional care by healthcare professionals (HCPs) from a UK national survey produced by the National Institute for Health Research (NIHR) Cancer and Nutrition Collaboration. Methods: An online survey sent to professional groups and networks included questions on discussing nutrition, providing information, awareness of guidelines, confidence in providing nutritional advice, training and strategies for improving nutritional management. Results: There were 610 HCPs who responded including nurses (31%), dietitians (25%), doctors (31%) and speech and language therapists (9%). The majority of HCPs discusses nutrition (94%) and provides information on nutrition (77%). However, only 39% of HCPs reported being aware of nutritional guidelines, and just 20% were completely confident in providing nutritional advice. Awareness of guidelines varied between the different professional groups with most but not all dietitians reporting the greatest awareness of guidelines and GPs the least (p = 0.001). Those HCPs with a greater awareness of guidelines had received training (p = 0.001) and were more likely to report complete confidence in providing nutritional advice (p = 0.001). Conclusion: Whilst HCPs discuss nutrition with cancer patients and may provide information, many lack an awareness of guidelines and confidence in providing nutritional advice. To ensure consistency of practice and improvements in patient care, there is scope for enhancing the provision of appropriate nutrition education and training. [ABSTRACT FROM AUTHOR]

Le végétarisme, le végétalisme et le véganisme diminuent le risque de développer un diabète de type 2, une maladie ou un accident cardio-vasculaire, un syndrome métabolique, voire certains cancers. Ces régimes présentent néanmoins des risques s'ils sont mal conduits. Il convient de prévenir la carence en vitamines B12 et D, en fer, iode, calcium, zinc et oméga-3. Le pharmacien doit accompagner les personnes souhaitant adopter ce mode d'alimentation et leur conseiller les complémentations alimentaires utiles. Vegetarianism, dietary veganism and veganism reduce the risk of developing type 2 diabetes, cardiovascular disease or stroke, metabolic syndrome and even certain cancers. However, these diets do present risks if they are poorly conducted. It is necessary to prevent deficiencies in vitamins B12 and D, iron, iodine, calcium, zinc and omega-3. The pharmacist should accompany people who wish to adopt this type of diet and advise them on useful food supplements. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this randomized controlled trial study was to assess the effects of medical nutrition therapy (MNT) compared with general nutritional advice (NA) on nutritional status in esophageal cancer (EC) patients during Chemoradiation (CRT). METHOD: The sample includes one hundred newly diagnosed patients with EC. The MNT group received individualized nutritional therapy. The NA group received general nutritional advice at the beginning of the participation. Patient-Generated- Subjective Global Assessment (PG-SGA), anthropometric indices, body composition, dietary intake, laboratory tests, and nutrition-related complications were assessed. RESULTS: Forty-nine cases were in the MNT group. The MNT group had significantly more favorable energy (26.4±14.1 vs. 18.2±11.2 kcal/kgw.day) and protein (1±0.6 vs. 0.7±0.4 g/kgw.day) intake than the NA group at the final evaluation. The PG-SGA score diminished but not significantly in both groups (11±6 vs. 12±6). As compared to the NA group, patients in the MNT group experienced more frequently no weight loss (21% vs. 11%) or mild weight loss (40% vs 35%) during the treatment. Meanwhile, moderate weight loss was more frequently observed in the NA group (26% vs. 44%). In the MNT group, those with severe weight loss had not proper adherence to the nutritional protocol. Mid-upper arm circumference, body composition, laboratory tests, physical performance, and nutrition-related complications were not significantly different between the two groups. CONCLUSION: As compared to general NA, MNT improved energy and macronutrients intake in patients with EC undergoing CRT which resulted in less severe weight loss and potentially better nutritional status. [ABSTRACT FROM AUTHOR]

Complementary feeding practices are debated among pediatricians, primarily regarding whether nutritional needs or developmental readiness should be prioritized in recommendations for starting complementary feeding. The aim of the present study was to analyze the timing of the start of complementary feeding and the related motivations with an 8-item online survey administered to active members of the Italian Society of Primary Care Pediatricians. The participation rate was 43.3% (350 of 808), and 213 (60.9%) and 137 (39.1%) of the participants chose items related to developmental readiness and nutritional needs, respectively, as the criteria for starting complementary feeding. Approximately 74% of the participants reported that they recommended starting complementary feeding between 5 and 6 months of age, 17% recommended starting before 5 months, and 8% recommended starting after 6 months. Predefined schemes were proposed by 38% of the participants, and a responsive feeding modality was proposed by 13%, while the majority (49%) recommended both modalities depending on family characteristics. Regarding recommendations based on nutritional needs, 89% of pediatricians reported providing indications concerning the quantity of meat consumed during the first year of life, and 91% reported recommending introducing added salt only after 12 months of age. Compared with pediatricians who emphasized developmental readiness, those who prioritized nutritional needs suggested earlier complementary feeding start and a higher use of predefined schemes and were more likely to make recommendations regarding meat quantity and added salt (p < 0.0001).Conclusions: Pediatricians who used a developmental readiness criterion for starting complementary feeding may less frequently provide nutritional advice to parents, even if a trend to harmonize the different positions regarding complementary feeding start time is emerging.What is Known:• Pediatricians make suggestions for introducing complementary feeding based on scientific evidence, local traditions, and personal beliefs.• Either infants' nutritional needs or their developmental readiness currently is used as determinant for the timing of complementary feeding.What is New:• More than 60% of Italian pediatricians consider developmental readiness a priority for introducing complementary feeding.• Pediatricians following the criterion of developmental readiness may less frequently give detailed nutritional advice. [ABSTRACT FROM AUTHOR]

Background/objectives: The primary objective of this study was to explore physicians' adherence to the dietary pattern known as the Mediterranean diet (MD). As a secondary objective we assessed physicians' awareness on the benefits of the MD and of the possibility of prescribing it.Subjects/methods: Physicians' adherence to the MD was evaluated through the Spanish associations SEMERGEN and CAMFIC, who sent the validated PREDIMED screener to their affiliates. The results reflected a high, medium, low or very low level of adherence depending on total score. The sample was drawn between 2014 and 2016. The second questionnaire evaluated the physicians' knowledge of the MD and their opinion about recommending it.Results: The PREDIMED test was answered by 422 Spanish physicians. In 8 out of 14 questions, more than 50% of the individuals scored only 1 point. However, 3 questions resulted in 1 point being scored by almost all physicians. Thus, on average, 55% of questions obtained 1-point scoring. The second questionnaire was answered by 212 physicians; 70% of them considered themselves to be aware of the benefits of the MD. More than 60% said they could invest 5 min of their time to recommend the MD.Conclusions: Primary care physicians do not show a high level of adherence to the MD and emphasize the need for creating tools to evaluate it in their patients. This research can be useful as both a database and a justification for the creation of a new protocol to help physicians increase their own and their patients' MD adherence. [ABSTRACT FROM AUTHOR]

The National School Feeding Program (NSFP) aims complementing the student's feeding to improve his nutritional conditions and his learning capacity, besides educating with good eating habits. This present study intentioned evaluating the nutritional composing adequacy of menus for NSFP and the provisions' acceptability offered at a municipal school in São José do Calçado - ES. It was adopted the direct weighting to obtain the provisions' per capita offered in the mornings during five consecutive days for students cursing from the 1st to the 5th scholar year. The nutritional composing evaluation was held according to what was established by the program, in such a way to provide at least 20% of the daily nutritional necessities for the students. It was used a facial hedonics scale of five points to verify the acceptance on the food served. The average of proteins, iron and zinc of the menu were much higher than the recommended by the program. By contrast, the vitamin A, vitamin C and calcium averages were well below the amounts tabled by NSFP. The acceptance rate on the meals was of 75%. It was concluded that the feeding given at this analyzed school was not appropriate to major nutritional request based by NSFP and the meals' acceptability reported a lower rate compared to the baseline set on Brazilian legislation, what emphasizes an urge for food systematic monitoring - which is offered at school to assure that the served foods become more attractive and may guarantee proper quantities of nutrients to students' growth and evolution. [ABSTRACT FROM AUTHOR]

Background: Central obesity is associated with a higher risk of disease. Previously yoga reduced the BMI and waist circumference (WC) in persons with obesity. Additional anthropometric measures and indices predict the risk of developing diseases associated with central obesity. Hence the present study aimed to assess the effects of 12 weeks of yoga or nutritional advice on these measures. The secondary aim was to determine the changes in quality of life (QoL) given the importance of psychological factors in obesity.Material and Methods: Twenty-six adult females with central obesity in a yoga group (YOG) were compared with 26 adult females in a nutritional advice group (NAG). Yoga was practiced for 75 min/day, 3 days/week and included postures, breathing practices and guided relaxation. The NAG had one 45 min presentation/week on nutrition. Assessments were at baseline and 12 weeks. Data were analyzed with repeated measures ANOVA and post-hoc comparisons. Age-wise comparisons were with t-tests.Results: At baseline and 12 weeks NAG had higher triglycerides and VLDL than YOG. Other comparisons are within the two groups. After 12 weeks NAG showed a significant decrease in WC, hip circumference (HC), abdominal volume index (AVI), body roundness index (BRI), a significant increase in total cholesterol and LDL cholesterol. YOG had a significant decrease in WC, sagittal abdominal diameter, HC, BMI, WC/HC, a body shape index, conicity index, AVI, BRI, HDL cholesterol, and improved QoL. With age-wise analyses, in the 30–45 years age range the YOG showed most of the changes mentioned above whereas NAG showed no changes. In contrast for the 46–59 years age range most of the changes in the two groups were comparable.Conclusions: Yoga and nutritional advice with a diet plan can reduce anthropometric measures associated with diseases related to central obesity, with more changes in the YOG. This was greater for the 30–45 year age range, where the NAG showed no change; while changes were comparable for the two groups in the 46–59 year age range. Hence yoga may be especially useful for adult females with central obesity between 30 and 45 years of age.Trial registration: (CTRI/2018/05/014077).

Background: Central obesity is associated with a higher risk of disease. Previously yoga reduced the BMI and waist circumference (WC) in persons with obesity. Additional anthropometric measures and indices predict the risk of developing diseases associated with central obesity. Hence the present study aimed to assess the effects of 12 weeks of yoga or nutritional advice on these measures. The secondary aim was to determine the changes in quality of life (QoL) given the importance of psychological factors in obesity. Material and Methods: Twenty-six adult females with central obesity in a yoga group (YOG) were compared with 26 adult females in a nutritional advice group (NAG). Yoga was practiced for 75 min/day, 3 days/week and included postures, breathing practices and guided relaxation. The NAG had one 45 min presentation/week on nutrition. Assessments were at baseline and 12 weeks. Data were analyzed with repeated measures ANOVA and post-hoc comparisons. Age-wise comparisons were with t -tests. Results: At baseline and 12 weeks NAG had higher triglycerides and VLDL than YOG. Other comparisons are within the two groups. After 12 weeks NAG showed a significant decrease in WC, hip circumference (HC), abdominal volume index (AVI), body roundness index (BRI), a significant increase in total cholesterol and LDL cholesterol. YOG had a significant decrease in WC, sagittal abdominal diameter, HC, BMI, WC/HC, a body shape index, conicity index, AVI, BRI, HDL cholesterol, and improved QoL. With age-wise analyses, in the 30–45 years age range the YOG showed most of the changes mentioned above whereas NAG showed no changes. In contrast for the 46–59 years age range most of the changes in the two groups were comparable. Conclusions: Yoga and nutritional advice with a diet plan can reduce anthropometric measures associated with diseases related to central obesity, with more changes in the YOG. This was greater for the 30–45 year age range, where the NAG showed no change; while changes were comparable for the two groups in the 46–59 year age range. Hence yoga may be especially useful for adult females with central obesity between 30 and 45 years of age. Trial registration: (CTRI/2018/05/014077). [ABSTRACT FROM AUTHOR]

Objective: Gaining too much or too little weight in pregnancy (according to Institute of Medicine (IOM) guidelines) negatively affects both mother and child, but many women find it difficult to manage their gestational weight gain (GWG). Here we describe the use of the intervention mapping protocol to design 'Come On!', an intervention to promote adequate GWG among healthy pregnant women.Design: We used the six steps of intervention mapping: (i) needs assessment; (ii) formulation of change objectives; (iii) selection of theory-based methods and practical strategies; (iv) development of the intervention programme; (v) development of an adoption and implementation plan; and (vi) development of an evaluation plan. A consortium of users and related professionals guided the process of development.Results: As a result of the needs assessment, two goals for the intervention were formulated: (i) helping healthy pregnant women to stay within the IOM guidelines for GWG; and (ii) getting midwives to adequately support the efforts of healthy pregnant women to gain weight within the IOM guidelines. To reach these goals, change objectives and determinants influencing the change objectives were formulated. Theories used were the Transtheoretical Model, Social Cognitive Theory and the Elaboration Likelihood Model. Practical strategies to use the theories were the foundation for the development of 'Come On!', a comprehensive programme that included a tailored Internet programme for pregnant women, training for midwives, an information card for midwives, and a scheduled discussion between the midwife and the pregnant woman during pregnancy. The programme was pre-tested and evaluated in an effect study. [ABSTRACT FROM AUTHOR]

Très longtemps, la recherche s’est focalisée sur ce qui pouvait être nocif dans les lipides et les composés de nature lipidique. L’objectif était de prévenir le risque associé à l’alimentation. Jusqu’à ce que, au milieu des années 1990, les Américains reconnaissent pour la première fois officiellement, dans un ouvrage intitulé « Carcinogens and Anticarcinogens in the Human Diet » [10], qu’en matière de cancérogenèse notre alimentation comprend des composés certes à éviter mais a aussi des composés protecteurs. Ainsi, l’ensemble fait un équilibre relativement harmonieux puisque dans nos populations les paramètres de santé sont pour l’instant meilleurs qu’ils ne l’ont jamais été et que notre espérance de vie continue de croître. Autrement dit, notre alimentation n’est pas aussi dangereuse que certains voudraient le prouver. Nous sommes ainsi entrés dans une nouvelle approche des apports nutritionnels. Les aliments « fonctionnels » à la mode ne sont rien d’autre que les éléments d’une alimention réellement adaptée à nos besoins, nous permettant de résister le plus longtemps possible et en bonne santé aux agressions auxquelles nous sommes exposés. Dans la classe des composés lipidiques, de très nombreuses substances ont un effet positif en matière de santé. Certains ont un effet négatif, mais l’aliment « fonctionnel » peut être un aliment appauvri en ces substances. On peut s’orienter fermement vers ces aliments « fonctionnels », à la condition toutefois, pour que la recherche puisse se développer, que les allégations positives soient autorisées et puissent être utilisées par les industriels. Ce qui, sur le plan de la réglementation, n’est pas gagné.

Despite a general consensus and recognition of the importance of the “social gradient” on nutritional standards and ultimately people's health, ( Budrys, 2003; Marmot & Wilkinson, 1999; Marmot et al., 1991; Ross & Wu, 1995 ), the body of literature identifying and describing the actual underlying social mechanisms which could explain this association is small, fragmented and not contained within one single discipline of thought – the effects of this conundrum seem easier to describe than to explain. The aim of this article is therefore to explore and identify social mechanisms, which could help explain why people with low socio-economic status consume a disproportionate amount of unhealthy foods and therefore also observe poorer diets. It is therefore in many ways an exploration into the nature of (relative) poverty. The point of departure for this exploration and identification is historical descriptions (in the form of excerpts) from George Orwell's (1937) book “The Road to Wigan Pier” on the living conditions of the British working classes. These descriptions will be aligned with results from contemporary research into nutritional behaviour. Strong similarities are identified between George Orwell's historical descriptions of the working-class's unhealthy diet and the findings from contemporary research into nutritional behaviour of people with a low socio-economic status. Certain social mechanisms influencing nutritional choices are readily identifiable across disciplines, and even partly reproduced in different historical, social and spatial contexts, with stronger negative (nutritional) consequences for people with low socio-economic status. The disregard of social mechanisms, and therefore implicitly issues of class, could indicate a general “de-socialization” of nutritional advice also in its dispersal through various health-promotion initiatives and campaigns, which raises serious questions about the usefulness of much nutritional advice, already tentatively questioned by some nutritionist ( Burr et al., 2007 ) as well as “food” sociologist ( Smith & Holm, 2010 ). [ABSTRACT FROM AUTHOR]

The cardiovascular diseases (CVD) are the principal reasons of morbidity and mortality in the world. The cardiac rehabilitation is a program of secondary prevention to complement the effects of the cardiological treatment with the participation of the patient in the control of their habits of life, as a way of promotion of its own cardiovascular health. The aim of the present study is to evaluate the long-term effects of a cardiac rehabilitation program on some parameters of corporal composition in patients that have attended or not, to the phase the in of the program. The study was performed in subjects that suffered a cardiovascular event and they were members of the Association of Cardiac Patients of Granada and Province. All the members were offered the possibility of forming a part of the study. Some parameters of body composition were measured and a nutritional evaluation was performed in all the subjects. The visceral and body fat and, which play a key role in the cardiovascular pathology, are lower in the patients attending to the cardiac rehabilitation program, revealing that are better predictors of the cardiovascular risk. Thanks to the nutritional advice received, an increase in healthy nutrients is observed and the subjects attending to the program feature major phase angle, indicating that they have a better state of hydration, together with a better integrity of the cell membranes and distribution of water between the compartments intra- and extracellular compartments. [ABSTRACT FROM AUTHOR]

Résumé: L’insuffisance cardiaque chronique est une maladie cachectisante amenant à une perte de poids fréquente, progressive et le plus souvent irréversible. La cachexie cardiaque est définie comme une perte de poids supérieure à 6 % par rapport au poids pré-morbide, non volontaire, en l’absence d’œdème. Elle s’accompagne d’une hypotrophie des muscles squelettiques et d’une hypotrophie myocardique. L’anorexie n’est impliquée que dans 10 à 20 % des cachexies cardiaques. La plupart du temps, les ingesta sont maintenus. Cependant ils ne permettent pas de couvrir l’augmentation des besoins secondaires à un hypermétabolisme de repos. Les autres mécanismes de cachexie cardiaque sont la malabsorption et l’entéropathie exsudative par hypoperfusion splanchnique/stase veineuse splanchnique, le déséquilibre neuro-endocrinien et immunologique associé à une hyperactivation de facteurs cataboliques (catécholamines, cortisol, TNF alpha) et une diminution ou résistance aux facteurs anaboliques (GH, IGF-1, insuline, DHEA, activité physique). Une évaluation alimentaire est nécessaire pour identifier les restrictions ou évictions instaurées dans le cadre d’une prévention cardiovasculaire et qui ne se justifient plus au stade de la cachexie cardiaque. L’enrichissement et le fractionnement de l’alimentation sont les premières interventions visant à couvrir les besoins énergétiques et protéiques. En cas d’échec, la nutrition entérale par sonde naso-gastrique est à envisager. La nutrition parentérale est à réserver aux cas d’intolérance ou d’échec de la nutrition entérale. [ABSTRACT FROM AUTHOR]

Background: Effective patient nutrition management can both improve people's health and reduce the cost of health care. In Australia, general practitioners (GPs) and dietitians are in a position to provide this service. However, there is a lack of information available on what influences the provision of the service. Objective: The objective was to determine qualitative factors that influence nutrition management by GPs and dietitians. Design: A convenience sample of GPs and dietitians was surveyed using a qualitative questionnaire. The questionnaire related to issues including influences on the GP's decision to initiate nutrition management, barriers to providing nutrition counseling, influences on the GP's decision to refer to a dietitian, and barriers to referral. Results: Fourteen of 20 GPs and 15 of 30 dietitians responded with usable data. The primary influence on a GP's decision to initiate nutrition management (GPs' and dietitians' responses) was the presentation of a patient who required nutrition advice. Barriers to providing nutrition counseling were time and knowledge (GP response), whereas dietitians saw time and lack of patient interest as issues. The primary influence on the GP's decision to refer to a dietitian was a patient presenting with complicated nutrition requirements (GP response), whereas dietitians considered a patient seeking nutrition knowledge as the key influencer. GPs identified cost to the patient as the main barrier to referring to a dietitian, whereas dietitians saw lack of knowledge of where to refer as the key issue. Conclusions: The differing responses suggest that more research is required to understand what influences patient nutrition management by GPs and dietitians in Australia. [ABSTRACT FROM AUTHOR]

Muscle invasive bladder cancer (MIBC) is commonly treated with radical cystectomy. Patients who require radical cystectomy are often frail, unwell, have multiple comorbidities, and can experience unmet supportive care needs. Due to these complexities, patients requiring radical cystectomy are often considered high risk for anesthetics, and therefore improving their physical and psychological well-being is crucial prior to radical surgery. Prehabilitation is the practice of enhancing a patient's functional and psychological capacity before surgery, with the aim of improving postoperative outcomes. This narrative review aims to identify and evaluate the role of physical exercise, nutritional intervention, and person-centered holistic approaches to prehabilitation in people affected by MIBC treated by radical cystectomy. Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and grey literature were searched using Google scholar until June 2020. Evidence to support specific prehabilitation clinical recommendations in people affected by MIBC is emerging. Prehabilitation including exercise prescription, nutritional intervention, and person-centered holistic support is an important part of the clinical pathway for people affected by MIBC. Individualized prehabilitation programs across the multidisciplinary team should be considered to provide specific individual recommendations to avoid "one size fits all". Given the limited research in this clinical area, future high-quality multi-center prospective trials are urgently needed. People affected by MIBC can experience a range of unmet supportive care needs in routine clinical care delivery at the time of diagnosis and into survivorship. Evidence is emerging around the role of multidisciplinary interventions in the form of exercise, nutritional input, and holistic supportive care to improve physical and psychological well-being prior to major surgery. Specialist nurses are ideally placed to ensure that individual holistic care needs are addressed, and appropriate care and support is provided. Nurses can trigger timely referrals to members of the multidisciplinary team to coordinate an integrated person-centered approach to prehabilitation service provision to address the unmet needs of people undergoing treatment for MIBC. [ABSTRACT FROM AUTHOR]