scholarly journals Preoperative Nutrition Intervention in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3205
Author(s):  
Irene Deftereos ◽  
Justin M.-C. Yeung ◽  
Janan Arslan ◽  
Vanessa M. Carter ◽  
Elizabeth Isenring ◽  
...  
Keyword(s):  
Weight Loss ◽  
Nutrition Intervention ◽  
Nutrition Support ◽  
Preoperative Weight Loss ◽  
Percentage Weight Loss ◽  
Point Prevalence Study ◽  
Preoperative Nutrition ◽  
Percentage Weight ◽  
Preoperative Weight ◽  
Upper Gastrointestinal

Background: Preoperative nutrition intervention is recommended prior to upper gastrointestinal (UGI) cancer resection; however, there is limited understanding of interventions received in current clinical practice. This study investigated type and frequency of preoperative dietetics intervention and nutrition support received and clinical and demographic factors associated with receipt of intervention. Associations between intervention and preoperative weight loss, surgical length of stay (LOS), and complications were also investigated. Methods: The NOURISH Point Prevalence Study was conducted between September 2019 and May 2020 across 27 Australian tertiary centres. Subjective global assessment and weight were performed within 7 days of admission. Patients reported on preoperative dietetics and nutrition intervention, and surgical LOS and complications were recorded. Results: Two-hundred patients participated (59% male, mean (standard deviation) age 67 (10)). Sixty percent had seen a dietitian preoperatively, whilst 50% were receiving nutrition support (92% oral nutrition support (ONS)). Patients undergoing pancreatic surgery were less likely to receive dietetics intervention and nutrition support than oesophageal or gastric surgeries (p < 0.001 and p = 0.029, respectively). Neoadjuvant therapy (p = 0.003) and malnutrition (p = 0.046) remained independently associated with receiving dietetics intervention; however, 31.3% of malnourished patients had not seen a dietitian. Patients who received ≥3 dietetics appointments had lower mean (SD) percentage weight loss at the 1-month preoperative timeframe compared with patients who received 0–2 appointments (1.2 (2.0) vs. 3.1 (3.3), p = 0.001). Patients who received ONS for >2 weeks had lower mean (SD) percentage weight loss than those who did not (1.2 (1.8) vs. 2.9 (3.4), p = 0.001). In malnourished patients, total dietetics appointments ≥3 was independently associated with reduced surgical complications (odds ratio 0.2, 95% confidence interval (CI) 0.1, 0.9, p = 0.04), and ONS >2 weeks was associated with reduced LOS (regression coefficient −7.3, 95% CI −14.3, −0.3, p = 0.04). Conclusions: Despite recommendations, there are low rates of preoperative dietetics consultation and nutrition support in this population, which are associated with increased preoperative weight loss and risk of increased LOS and complications in malnourished patients. The results of this study provide insights into evidence–practice gaps for improvement and data to support further research regarding optimal methods of preoperative nutrition support.

scholarly journals Assessment of Nutritional Status and Nutrition Impact Symptoms in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3349
Author(s):  
Irene Deftereos ◽  
Justin M. C. Yeung ◽  
Janan Arslan ◽  
Vanessa M. Carter ◽  
Elizabeth Isenring ◽  
...  
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Regression Coefficient ◽  
Point Prevalence ◽  
Unintentional Weight Loss ◽  
Point Prevalence Study ◽  
Poor Appetite ◽  
Preoperative Nutrition ◽  
Nutrition Impact Symptoms ◽  
Upper Gastrointestinal

Background: Identification and treatment of malnutrition are essential in upper gastrointestinal (UGI) cancer. However, there is limited understanding of the nutritional status of UGI cancer patients at the time of curative surgery. This prospective point prevalence study involving 27 Australian tertiary hospitals investigated nutritional status at the time of curative UGI cancer resection, as well as presence of preoperative nutrition impact symptoms, and associations with length of stay (LOS) and surgical complications. Methods: Subjective global assessment, hand grip strength (HGS) and weight were performed within 7 days of admission. Data on preoperative weight changes, nutrition impact symptoms, and dietary intake were collected using a purpose-built data collection tool. Surgical LOS and complications were also recorded. Multivariate regression models were developed for nutritional status, unintentional weight loss, LOS and complications. Results: This study included 200 patients undergoing oesophageal, gastric and pancreatic surgery. Malnutrition prevalence was 42% (95% confidence interval (CI) 35%, 49%), 49% lost ≥5% weight in 6 months, and 47% of those who completed HGS assessment had low muscle strength with no differences between surgical procedures (p = 0.864, p = 0.943, p = 0.075, respectively). The overall prevalence of reporting at least one preoperative nutrition impact symptom was 55%, with poor appetite (37%) and early satiety (23%) the most frequently reported. Age (odds ratio (OR) 4.1, 95% CI 1.5, 11.5, p = 0.008), unintentional weight loss of ≥5% in 6 months (OR 28.7, 95% CI 10.5, 78.6, p < 0.001), vomiting (OR 17.1, 95% CI 1.4, 207.8, 0.025), reduced food intake lasting 2–4 weeks (OR 7.4, 95% CI 1.3, 43.5, p = 0.026) and ≥1 month (OR 7.7, 95% CI 2.7, 22.0, p < 0.001) were independently associated with preoperative malnutrition. Factors independently associated with unintentional weight loss were poor appetite (OR 3.7, 95% CI 1.6, 8.4, p = 0.002) and degree of solid food reduction of <75% (OR 3.3, 95% CI 1.2, 9.2, p = 0.02) and <50% (OR 4.9, 95% CI 1.5, 15.6, p = 0.008) of usual intake. Malnutrition (regression coefficient 3.6, 95% CI 0.1, 7.2, p = 0.048) and unintentional weight loss (regression coefficient 4.1, 95% CI 0.5, 7.6, p = 0.026) were independently associated with LOS, but no associations were found for complications. Conclusions: Despite increasing recognition of the importance of preoperative nutritional intervention, a high proportion of patients present with malnutrition or clinically significant weight loss, which are associated with increased LOS. Factors associated with malnutrition and weight loss should be incorporated into routine preoperative screening. Further investigation is required of current practice for dietetics interventions received prior to UGI surgery and if this mitigates the impact on clinical outcomes.

The Impact of Insect Infestation on Stored Purpled Cocoa Beans

2018 ◽  
Vol 1 (3) ◽  
pp. 176-181 ◽  
Author(s):  
E. Tettey
Keyword(s):  
Weight Loss ◽  
Insect Population ◽  
Insect Infestation ◽  
Percentage Weight Loss ◽  
Cocoa Beans ◽  
Significant Damage ◽  
Percentage Weight ◽  
Fermentation Period ◽  
The Impact

Under-fermentation of cocoa beans produces purple beans. The fermentation period is 6 to 7 days but some cocoa farmersunder-ferment their cocoa beans leading to the development of purple cocoa beans. This study determined the impact of insectinfestation on stored purple cocoa beans. Wet cocoa beans were fermented for 1, 2, 3, 4 and 5 days to produce the purple beans.Ephestia cautella and Tribolium castaneum, both singly and in combination, were introduced into the cocoa beans and storedfor different (30, 60, 90 and 120 days) period. Insect population, percentage weight loss and the contaminants produced bythese insects were determined. Cocoa beans infested with E. cautella alone had the highest population of 297.0 ± 22.7. Beansfermented for 3 days had the lowest insect population both singly and in combination after 120 days of storage. The highestpercentage weight loss was recorded in cocoa beans fermented for one day (10.1 ± 1.87%) and 4 days (10.1 ± 8.74%). T.castaneum did not cause much damage to the cocoa beans but E. cautella alone caused significant damage to stored cocoabeans. Insect infestation and poor fermentation contribute significantly to the reduction in quality of cocoa beans.

scholarly journals The use of Facebook in a community pharmacist-led weight management programme – a London-based proof of concept study

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i17-i18
Author(s):  
P Crilly ◽  
E Chibueze ◽  
M Khan ◽  
J Modha ◽  
S Satwaha ◽  
...  
Keyword(s):  
Weight Loss ◽  
Waist Circumference ◽  
Digital Technology ◽  
Technology Use ◽  
Management Programme ◽  
Proof Of Concept ◽  
Percentage Weight Loss ◽  
Weight Management Programme ◽  
Percentage Weight ◽  
Adults And Children

Abstract Introduction In the United Kingdom (UK), 63% of adults are overweight,(1) costing the NHS £6.1 billion/year. With the public using digital technology over healthcare professionals (HCPs) for health advice, this warrants an investigation of technology use in community pharmacy, given its previous successful use.(2) Aim To determine the feasibility and perceptions of a community pharmacist (CP)-led weight management programme (WMP), enhanced by a Facebook support group (FSG). Methods A proof of concept study was conducted between January-March 2020. Recruitment was via a pharmacy, the university and a community Facebook group. Inclusion criteria: over 18 years; overweight; no medical conditions. Participants attended face-to-face meetings (ftf) with a CP and final year pharmacy student (PS) on two occasions (0 (baseline) and 4 weeks). At baseline, participants were given the NHS weight loss programme and set weight loss goals. During ftf, participants had height, weight, and waist circumference (WC) measurements by a CP/PS and discussed eating habits, exercise and alcohol. In between ftf, participants accessed the FSG (created (December 2019) and moderated by a CP). Here, they received posts about diet, exercise and motivation. Participants were to have their measurements taken ftf at 8-weeks, however, COVID-19 meant participants had to self-declare these via video call. Following the 8-week programme, participants completed a 4-section survey about their experience (signing up to the service; comparison to previous weight loss attempts; the FSG and overall perceptions). Question types included multiple choice, Likert scale and free text comments. Data were analysed in Excel (Microsoft Corporation 2016) with changes in height, weight, waist circumference, alcohol and exercise being calculated. Results Fifty-five participants were recruited. 18 were lost to follow-up, most (n=12/18) citing COVID-19. Of the 37 participants remaining (70.3% female, mean age=37 years), 22 were obese, the rest overweight. Mean weight loss, mean percentage weight loss and mean WC reduction at 4-weeks was 1.6 kg (SD+/- 1.7 kg), 1.8% (SD+/- 1.9%) and 2 cm (SD+/- 1.96 cm) respectively. At week 8 measurements were self-declared. Mean weight loss at 8-weeks from baseline was 2.7 kg (SD +/- 2.6 kg) and mean percentage weight loss was 3% (SD+/- 3%). Only five participants’ self-declared WC measurements at 8-weeks with mean reduction being 3.6 cm. Five participants moved to healthier BMI classifications by week 8. All participants accessed the FSG at least weekly with 13 accessing it daily. Diet posts were the most popular (n=20/37). Participants learned about portion control and increasing fruits/vegetables intake. All participants would recommend the programme to their friends/family. Conclusion An 8-week CPWMP, enhanced with FSG, supported participants to lose a mean of 3% body weight. Participants accessed the page regularly and were positive about its usefulness. One limitation was that the COVID-19 lockdown prevented the 8-week ftf, therefore, self-declared measurements were used. The pandemic has highlighted the importance of pharmacy embracing technology for service delivery, particularly when in-person contact is limited. The implication of this study is that it provides proof that the concept of digital service delivery could work in practice. References 1. GOV.UK. Tackling obesity: empowering adults and children to live healthier lives [Internet]. Department of Health and Social Care. 2020 [cited 2020 Aug 18]. Available from: https://www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives 2. Crilly P, Kayyali R. A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health. Pharmacy 2020;8(3):137. Available from: https://www.mdpi.com/2226–4787/8/3/137

Preoperative weight loss regimen, does it affect the outcomes of Bariatric surgery?

2018 ◽  
Vol 14 (11) ◽  
pp. S175
Author(s):  
Adel Zedan ◽  
Hatem Soltan ◽  
Mohammed Sabry ◽  
Rami R Mustafa ◽  
Mahmoud Hagag ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Preoperative Weight Loss ◽  
Preoperative Weight

Preoperative Weight Loss in Gastric Bypass

2020 ◽  
pp. 47-52
Author(s):  
Gustavo Peixoto Soares Miguel ◽  
Paulo Henrique Oliveira de Souza ◽  
Luize Giuri Palaoro ◽  
Caroline Gravel ◽  
Kassio Covre
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Preoperative Weight Loss ◽  
Preoperative Weight

scholarly journals Meta‐analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes

2018 ◽  
Vol 106 (3) ◽  
pp. 181-189 ◽  
Author(s):  
M. Roman ◽  
A. Monaghan ◽  
G. F. Serraino ◽  
D. Miller ◽  
S. Pathak ◽  
...  
Keyword(s):  
Weight Loss ◽  
Surgical Outcomes ◽  
Meta Analysis ◽  
Lifestyle Changes ◽  
Preoperative Weight Loss ◽  
Preoperative Weight

Effectiveness, Compliance, and Acceptability of Preoperative Weight Loss with a Liquid Very Low-Calorie Diet Before Bariatric Surgery in Real Practice

2018 ◽  
Vol 29 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Kamthorn Yolsuriyanwong ◽  
Komdej Thanavachirasin ◽  
Kimberly Sasso ◽  
Lauren Zuro ◽  
Jessica Bartfield ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Preoperative Weight Loss ◽  
Very Low Calorie Diet ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
Calorie Diet ◽  
Preoperative Weight ◽  
Real Practice
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