Impact of a Virtual Culinary Medicine Curriculum on Biometric Outcomes, Dietary Habits, and Related Psychosocial Factors among Patients with Diabetes Participating in a Food Prescription Program

Culinary medicine is an evidence-based approach that blends the art of cooking with the science of medicine to inculcate a healthy dietary pattern. Food prescription programs are gaining popularity in the Unites States, as a means to improve access to healthy foods among patient populations. The purpose of this paper is to describe the implementation and preliminary impact of A Prescription for Healthy Living (APHL) culinary medicine curriculum on biometric and diet-related behavioral and psychosocial outcomes among patients with diabetes participating in a clinic-led food prescription (food Rx) program. We used a quasi-experimental design to assess APHL program impact on patient biometric outcome data obtained from electronic health records, including glycosylated hemoglobin (HbA1c), body mass index (BMI), and blood pressure (n = 33 patients in the APHL group, n = 75 patients in the food Rx-only group). Pre-post surveys were administered among those in the APHL group to monitor program impact on psychosocial and behavioral outcomes. Results of the outcome analysis showed significant pre-to-post reduction in HbA1c levels among participants within the APHL group (estimated mean difference = −0.96% (−1.82, −0.10), p = 0.028). Between-group changes showed a greater decrease in HbA1c among those participating in APHL as compared to food Rx-only, albeit these differences were not statistically significant. Participation in APHL demonstrated significant increases in the consumption of fruits and vegetables, fewer participants reported that cooking healthy food is difficult, increased frequency of cooking from scratch, and increased self-efficacy in meal planning and cooking (p < 0.01). In conclusion, the results of our pilot study suggest the potential positive impact of a virtually-implemented culinary medicine approach in improving health outcomes among low-income patients with type 2 diabetes, albeit studies with a larger sample size and a rigorous study design are needed.

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Outcome Analysis

Quality Management and Accreditation in Hematopoietic Stem Cell Transplantation and Cellular Therapy ◽

10.1007/978-3-030-64492-5_6 ◽

2021 ◽

pp. 43-52

Author(s):

Anne Emmett

Keyword(s):

Positive Impact ◽

Outcome Data ◽

Haematopoietic Stem Cell ◽

Outcome Analysis ◽

Related Risk ◽

Car T ◽

Recent Developments ◽

Practice Variations ◽

High Treatment ◽

Transplant Procedure

AbstractTo understand and hence improve the positive impact of any healthcare activity, procedure or intervention, it is essential that there is an objective analysis of the activity, procedure or intervention based on predetermined standards.In the field of haematopoietic stem cell transplantation, outcome analysis is the process by which the results of a transplant procedure are formally assessed. It includes a series of reviews for evaluating the effectiveness of the health care provided and for identifying the most promising therapies and transplant approaches, given the available medical evidence and healthcare resources.Outcome analysis allows the transplant team to understand the effects of their practice and improve quality. Its relevance is due to transplant involving high treatment-related risk, significant practice variations, and continual practice developments – for example, recent developments in CAR-T and IEC therapies.The main aim of this chapter is to discuss how to find outcome data and how and when to present it. This will need to be adapted to the local programme.

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Impact of a Medication Therapy Management Clinic on Glycosylated Hemoglobin, Blood Pressure, and Resource Utilization

Annals of Pharmacotherapy ◽

10.1177/1060028018794860 ◽

2018 ◽

Vol 53 (1) ◽

pp. 13-20 ◽

Cited By ~ 2

Author(s):

Jessica J. Tilton ◽

Mansi G. Edakkunnathu ◽

Kellyn M. Moran ◽

Anna Markel Vaysman ◽

Jessica L. DaPisa ◽

...

Keyword(s):

Blood Pressure ◽

Low Income ◽

Hospital Admissions ◽

Glycosylated Hemoglobin ◽

Medication Management ◽

Medication Therapy Management ◽

Therapy Management ◽

Medication Therapy ◽

Institutional Review ◽

Patients With Diabetes

Background: Medication therapy management is widely promoted to improve care. However, few well-controlled studies have evaluated its impact. Objectives: We evaluated whether enrollment in a comprehensive medication therapy management clinic (MTMC) was associated with improved 12-month outcomes. Methods: This institutional review board approved study was a retrospective controlled cohort study in an academic health center serving low-income, African American and Latino populations. Between 2001 and 2011 MTMC patients were matched to control patients by age, gender, and comorbidities. Outcomes were mean change in glycosylated hemoglobin (A1C), diastolic (DBP) and systolic blood pressure (SBP), and emergency department (ED) and hospital admissions at 6 and 12 months. A difference-in-difference analysis was conducted for each outcome of interest, adjusting for observed, unmatched confounders. Results: Patients with diabetes and receiving MTMC had greater A1C improvements, compared with controls, of 0.54% (P = 0.0067) at 6 months and 0.63% (P = 0.0160) at 12 months. At 6 months, SBP and DBP decreased in MTMC patients by 6.5 mm Hg (P = 0.0108) and 3.8 mm Hg (P = 0.0136) more than controls, respectively. At 12 months, those receiving MTMC services had SBP and DBP decreases, respectively, of 8.2 mm Hg (P = 0.0018) and 1.7 mm Hg (P = 0.2691) compared with controls. ED and hospital visits were not statistically significantly different between groups. Conclusion and Relevance: This MTMC potentially improved outcomes for referred patients in whom target goals were difficult to achieve and can serve as a model for other similar medication management programs.

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Diet and Nutrition in Gynecological Disorders: A Focus on Clinical Studies

Nutrients ◽

10.3390/nu13061747 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1747

Author(s):

Sadia Afrin ◽

Abdelrahman AlAshqar ◽

Malak El Sabeh ◽

Mariko Miyashita-Ishiwata ◽

Lauren Reschke ◽

...

Keyword(s):

Fruits And Vegetables ◽

Dietary Habits ◽

Healthy Lifestyle ◽

Positive Impact ◽

Polycystic Ovary ◽

Gynecological Disorders ◽

Balanced Diet ◽

Development Data ◽

Reduced Physical Activity ◽

Nutritional Data

A healthy lifestyle and a balanced diet play a paramount role in promoting and maintaining homeostatic functions and preventing an array of chronic and debilitating diseases. Based upon observational and epidemiological investigations, it is clear that nutritional factors and dietary habits play a significant role in gynecological disease development, including uterine leiomyoma, endometriosis, polycystic ovary syndrome, and gynecological malignancies. Diets rich in fruits and vegetables, Mediterranean diets, green tea, vitamin D, and plant-derived natural compounds may have a long-term positive impact on gynecological diseases, while fats, red meat, alcohol, and coffee may contribute to their development. Data regarding the association between dietary habits and gynecological disorders are, at times, conflicting, with potential confounding factors, including food pollutants, reduced physical activity, ethnic background, and environmental factors limiting overall conclusions. This review provides a synopsis of the current clinical data and biological basis of the association between available dietary and nutritional data, along with their impact on the biology and pathophysiology of different gynecological disorders, as well as an outlook on future directions that will guide further investigational research.

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Eating NAFTA

10.1525/california/9780520291805.001.0001 ◽

2018 ◽

Cited By ~ 21

Author(s):

Alyshia Gálvez

Keyword(s):

Public Health ◽

Chronic Disease ◽

Low Income ◽

Food System ◽

Dietary Habits ◽

Trade Agreement ◽

Well Being ◽

Health Crisis ◽

The North ◽

The World

In the two decades since the North American Free Trade Agreement (NAFTA) went into effect, Mexico has seen an epidemic of diet-related illness. While globalization has been associated with an increase in chronic disease around the world, in Mexico, the speed and scope of the rise has been called a public health emergency. The shift in Mexican foodways is happening at a moment when the country’s ancestral cuisine is now more popular and appreciated around the world than ever. What does it mean for their health and well-being when many Mexicans eat fewer tortillas and more instant noodles, while global elites demand tacos made with handmade corn tortillas? This book examines the transformation of the Mexican food system since NAFTA and how it has made it harder for people to eat as they once did. The book contextualizes NAFTA within Mexico’s approach to economic development since the Revolution, noticing the role envisioned for rural and low-income people in the path to modernization. Examination of anti-poverty and public health policies in Mexico reveal how it has become easier for people to consume processed foods and beverages, even when to do so can be harmful to health. The book critiques Mexico’s strategy for addressing the public health crisis generated by rising rates of chronic disease for blaming the dietary habits of those whose lives have been upended by the economic and political shifts of NAFTA.

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Good Glycemic Control for a Low Cardiovascular Risk in Children Suffering from Diabets

Revista de Chimie ◽

10.37358/rc.17.2.5453 ◽

2017 ◽

Vol 68 (2) ◽

pp. 358-361

Author(s):

Camelia Busila ◽

Mariana Cretu Stuparu ◽

Aurel Nechita ◽

Camelia Ana Grigore ◽

Gabriela Balan

Keyword(s):

Glycosylated Hemoglobin ◽

Control Group ◽

Sex Distribution ◽

Good Glycemic Control ◽

Rural And Urban ◽

Lipid Panel ◽

Patients With Diabetes ◽

Kolmogorov Smirnov ◽

Low Cardiovascular Risk

The study is a prospective and operational one, ant its was conducted on 58 patients with diabetes type 1 and 2. The patients sex distribution was homogenious and they come from both rural and urban environment. The statistical analisys was carried out using the programme SPSS 17.0 for Windows. The distribution normality was cheked using the Kolmogorov - Smirnov Z test. he values of glycemia, glycosylated hemoglobin, lipid panel, blood pressure have been measured and compared to the ones belonging to the control group.

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Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽

10.1136/bmjopen-2020-041599 ◽

2021 ◽

Vol 11 (3) ◽

pp. e041599 ◽

Cited By ~ 1

Author(s):

Mary McCauley ◽

Joanna Raven ◽

Nynke van den Broek

Keyword(s):

Low Income ◽

Online Survey ◽

Positive Impact ◽

Healthcare Providers ◽

International Medical ◽

Middle Income ◽

Use Of Resources ◽

The Uk ◽

Medical Volunteers ◽

The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

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Healthy eating: a matter of prioritisation by households or policymakers?

Public Health Nutrition ◽

10.1017/s1368980021000677 ◽

2021 ◽

pp. 1-3

Author(s):

Joreintje Dingena Mackenbach

Keyword(s):

Decision Making ◽

Healthy Eating ◽

Low Income ◽

Fruits And Vegetables ◽

Food System ◽

Vegetable Consumption ◽

Fruit And Vegetable Consumption ◽

Healthy Foods ◽

Fruit And Vegetable ◽

Decision Making Processes

Abstract I reflect upon the potential reasons why American low-income households do not spend an optimal proportion of their food budgets on fruits and vegetables, even though this would allow them to meet the recommended levels of fruit and vegetable consumption. Other priorities than health, automatic decision-making processes and access to healthy foods play a role, but solutions for the persistent socio-economic inequalities in diet should be sought in the wider food system which promotes cheap, mass-produced foods. I argue that, ultimately, healthy eating is not a matter of prioritisation by individual households but by policymakers.

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Fish Consumption: A Review of Its Effects on Metabolic and Hormonal Health

Nutrition and Metabolic Insights ◽

10.1177/11786388211022378 ◽

2021 ◽

Vol 14 ◽

pp. 117863882110223

Author(s):

Carlos O Mendivil

Keyword(s):

Metabolic Syndrome ◽

Fish Consumption ◽

Dietary Habits ◽

Positive Impact ◽

Polycystic Ovary ◽

Scientific Evidence ◽

Endocrine Disorders ◽

Omega 3 ◽

The Metabolic Syndrome ◽

The Impact

Dietary habits are a major determinant of the risk of chronic disease, particularly metabolic and endocrine disorders. Fish as a food group are a unique source of nutrients with metabolic and hormonal importance including omega-3 fatty acids, iodine, selenium, vitamin D, taurine and carnitine. Fish are also a source of high quality protein and have in general low caloric density. The impact of these nutrients on cardiovascular risk has been extensively reviewed, but the impact of fish on the broader field of endocrine and metabolic health is sometimes not sufficiently appreciated. This article aimed to summarize the impact the effect of regular fish consumption on conditions like the metabolic syndrome, obesity, diabetes, hypothyroidism, polycystic ovary syndrome and the menopausal transition, which are in and of themselves significant causes of morbidity and mortality worldwide. The review revealed that scientific evidence from food science, translational research, epidemiologic studies and interventional trials shows that regular fish consumption has a positive impact on thyroid homeostasis, facilitates maintenance of a healthy body weight, reduces the magnitude of age-associated increases in blood pressure, improves glucose homeostasis helping prevent diabetes and the metabolic syndrome, and has a positive impact on muscle mass preservation among the elderly. These effects are mediated by multiple mechanisms, only some of which have been identified. For most of these effects it holds true that the potential benefits are more substantial when baseline fish consumption is low.

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Energy, macronutrient and fatty acid intake of French elderly community dwellers and association with socio-demographic characteristics: data from the Bordeaux sample of the Three-City Study

British Journal Of Nutrition ◽

10.1017/s0007114507756520 ◽

2007 ◽

Vol 98 (5) ◽

pp. 1046-1057 ◽

Cited By ~ 52

Author(s):

Catherine Féart ◽

Marthe A. Jutand ◽

Sophie Larrieu ◽

Luc Letenneur ◽

Cécile Delcourt ◽

...

Keyword(s):

Fatty Acid ◽

Dietary Intake ◽

Low Income ◽

Educational Level ◽

Dietary Habits ◽

Dietary Assessment ◽

The Elderly ◽

Demographic Characteristics ◽

Age Related ◽

Total Fat

Few data are available regarding dietary habits of the elderly, in particular about fatty acid consumption, whereas these are major risk or protective factors of several age-related diseases. The aim of the present study was to characterise the dietary intake of a French elderly population in terms of energy, macronutrients and fatty acids based on their socio-demographic characteristics. The study population (age range 67·7–94·9 years) consisted of 1786 subjects from Bordeaux (France), included in the Three-City cohort. Dietary assessment was performed by a 24 h recall, allowing the estimation of energy, protein, carbohydrate, total fat, SFA, MUFA and PUFA intakes. Socio-demographic characteristics (age, sex, marital status, educational level and income), practice of sports and BMI were registered. Total energy intake (EI) was lower in women and in older participants ( ≥ 85 years) but higher in single subjects. Higher EI was associated with higher income, but not with educational level. Mean contribution of macronutrients to EI (protein 18 %, carbohydrate 46 % and total fat 31 %) was higher in women than men, except for alcohol. The oldest individuals consumed less protein and more mono- and disaccharides. Excess saturated fat intake (43 % of total fat), associated with a relative deficit in MUFA consumption (36 % of total fat), was observed. The mean 18 : 2n-6 : 18 : 3n-3 ratio was 9.9 and decreased with higher educational level. The present results suggest that being female, older age, being widowed and low income level could be considered as risk factors of inadequate dietary intake.

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Measuring Attitudes and Health Beliefs Among Mexican Americans With Diabetes

The Diabetes Educator ◽

10.1177/014572179402000308 ◽

1994 ◽

Vol 20 (3) ◽

pp. 221-227 ◽

Cited By ~ 36

Author(s):

Terri Schwab ◽

Julie Meyer ◽

Rosa Merrell

Keyword(s):

Health Beliefs ◽

Low Income ◽

Cultural Sensitivity ◽

Mexican Americans ◽

Mexican American ◽

Health Belief ◽

Important Variable ◽

Patients With Diabetes ◽

Health Related ◽

Belief Model

Adherence to the treatment regimen for patients with diabetes is of major concern to healthcare practitioners, particularly when dealing with the high-risk, low-income, Mexican-American population. Assessing the attitudes and beliefs of this group is vital for planning effective and realistic intervention strategies. Therefore, we designed a culturally sensitive instrument to measure health beliefs and attitudes of low-income Mexican Americans with diabetes. The Health Belief Model (HBM) was used as a basis for this study because it is well accepted as a predictor of health-related behaviors. However, we found that the HBM was not an effective tool for assessing the health beliefs or attitudes of this patient population even after rigorous efforts to operationalize the HBM and after conducting extensive statistical analyses. Only two of the five subscales of the traditional HBM, barriers and benefits, were reliable. Scales to measure acculturation and fatalism were added to increase the cultural sensitivity of the tool. These added components were found to be an important variable in interpreting the results for low-income Mexican-American patients.

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