Dietary Changes, Motivators, and Barriers Affecting Diet and Physical Activity among Overweight and Obese: A Mixed Methods Approach

The aims of this study were to examine (1) effects of nutritional guidance and physical activity on dietary habits among overweight and obese after an intervention and one year after follow-up (quantitative study) and (2) barriers and motivators for changes in diet and physical activity (qualitative study). A total of 98 participants with a mean age of 46.8 ± 10.2 years were included and divided into a Training Group (TG) (n = 51) or a Nutritional Guidance and Training Group (NTG) (n = 47). At baseline, after 33 weeks, and one year after the intervention, participants answered a questionnaire. Interviews gave data to elicit motivations and challenges related to diet and exercise. A GLM repeated measures analysis was used to investigate differences and interactions between factors. Participants ate healthier after starting to exercise. After 33 weeks, the NTG ate significantly more vegetables (p = 0.026) and legumes (p < 0.01) than the TG. No significant differences were found one year after follow-up. General health was the most important motivator for changing diet and exercise. Barriers to changing diet were related to work, family, meal size, and participants’ internal decisions to change habits. Barriers to exercise were holidays and time constraints. Planning purchases and regular exercise were important factors to achieve and maintain weight loss.

EP.TU.575One Man's Meat: Nutritional guidance for ileostomy care should consider pre-existing comorbidities

Aims (1) To assess the prevalence of comorbidities which can be influenced by dietary changes in a cohort of our patients with ileostomies and (2) To compare the standard dietary recommendations for these conditions against nutritional advice for patients with ileostomies. Methods We performed a cross-sectional study of patients with ileostomies identified from a prospectively maintained database in January 2020. Patient demographics, comorbidities and records of formal nutritional advice were analysed. Dietary recommendations for common chronic illnesses were obtained through a literature review. Results Twenty-one patients (15 men, 6 women) were included. Median (IQR) age was 63 (51-73) years. The median (IQR) length of time for which patients had ileostomies was 60 (24-144) months. The most common chronic illnesses include hypertension (38%), diabetes (24%) and chronic kidney disease (14%). All patients received standard dietary advice for ileostomy management without consideration of pre-existing comorbidities. Literature review revealed a lack of high-quality evidence for dietary recommendations in patients with ileostomies and conflicting advice for those with comorbidities. Conclusion Existing nutritional guidance for patients with ileostomies lacks a firm evidence base and does not consider the potential modifications required for pre-existing comorbidities.

Changes in Physical and Oral Function after a Long-Term Care Prevention Program in Community-Dwelling Japanese Older Adults: A 12-Month Follow-Up Study

Background: The aim of this prospective cohort study was to clarify changes in physical and oral function in older adults after completing a 3-month health program combining physical and oral exercise, oral health instruction, and nutritional guidance. Methods: Subjects were 34 women aged at least 70 years (mean age 79.2 years) in Bungotakada City, Oita Prefecture, Japan. Physical and oral function was investigated on the first day (baseline), at the end of the program, and 6 and 12 months after completing the health program. Physical function was measured using handgrip strength test, timed up and go (TUG) test and one-leg standing time test. Oral diadochokinesis test and repetitive saliva swallowing test (RSST) were employed to assess oral function. Results: TUG scores were significantly lower at 6 and 12 months than at baseline in participants aged ≥70 and <80 years. The repetition rate of the monosyllables /pa/, /ta/, and /ka/ was improved at the end of program in participants aged ≥70 and <80 years and increased to more than 6 times/second at 12 months. Conclusions: Our 3-month health program maintained improvements in oral and physical function in older women 1 year after completing the program.

Mixed-effect Bayesian network reveals personal effects of nutrition

Nutrition experts know by their experience that people can react very differently to the same nutrition. If we could systematically quantify these differences, it would enable more personal dietary understanding and guidance. This work proposes a mixed-effect Bayesian network as a method for modeling the multivariate system of nutrition effects. Estimation of this network reveals a system of both population-wide and personal correlations between nutrients and their biological responses. Fully Bayesian estimation in the method allows managing the uncertainty in parameters and incorporating the existing nutritional knowledge into the model. The method is evaluated by modeling data from a dietary intervention study, called Sysdimet, which contains personal observations from food records and the corresponding fasting concentrations of blood cholesterol, glucose, and insulin. The model’s usefulness in nutritional guidance is evaluated by predicting personally if a given diet increases or decreases future levels of concentrations. The proposed method is shown to be comparable with the well-performing Extreme Gradient Boosting (XGBoost) decision tree method in classifying the directions of concentration increases and decreases. In addition to classification, we can also predict the precise concentration level and use the biologically interpretable model parameters to understand what personal effects contribute to the concentration. We found considerable personal differences in the contributing nutrients, and while these nutritional effects are previously known at a population level, recognizing their personal differences would result in more accurate estimates and more effective nutritional guidance.

Nutritional Characteristics, Sites of Origin, and Cost of Foods Consumed during School Hours and Their Relationship to Nutritional Status of Schoolchildren in Mexico City

Access, nutritional characteristics, preferences, and cost can affect food intake at school. A cross-sectional study was performed to determine the nutritional characteristics, sites of origin, and cost of foods consumed during school hours. Three hundred and sixty-nine children from five public elementary schools in Mexico City participated. The children gave information about the foods that they consumed five days out of the week during school hours, including the place of acquisition, cost of the food, and portion size. Anthropometric measurements of height and weight of the children were taken. Caloric consumption and percentage of recommended daily energy intake from food during school hours was determined. Children were 10.9 ± 0.9 years old; 55.6% were girls, 26% were overweight, 23% were obese, and 3.3% were of low height for age. The average calorie intake was 515 kilocalories (kcal) (boys, 535 kcal; girls, 476 kcal, p = 0.051); calorie intake was higher when school meal intakes included foods from home, school, and outside of school. No significant differences were found in calorie intake by children’s nutritional status. The cost in Mexican pesos per 100 kcal consumed showed differences according to the nutritional status of the children; it was 4.0 Mexican pesos for children with normal weight and 4.2 and 3.8 pesos in children who were overweight or obese, respectively. The information obtained in this study should be used to provide nutritional guidance. The food portion size intake during school hours should be reduced, and the food should come from one or at most two sites, because each extra food represents an increase in the total kilocalorie intake.

RISK FACTORS IN PULMONARY TUBERCULOSIS TREATMENT FAILURE

Pulmonary tuberculosis (TB) is a global health problem and has become the leading cause of death. Tuberculosis eradication is inhibited due to the tendency of patients to not complete the TB treatment. The purpose of this study was to determine the relationship between knowledge, nutritional status, oral medication adherence, and family support as risk factors for pulmonary tuberculosis treatment failure. The design of this study is that of case-control, and this study involved samples of pulmonary TB patients who were declared not cured after treatment (14 people), and control samples of pulmonary TB patients who were declared cured (28 people). The data were obtained through measurements of nutritional status and interviews, while treatment failure was based on data from the TB 01 form. Data was analysed using univariable and bivariable analyses, and the magnitude of risk factors was based on the odds ratio (OR) and 95% confidence interval (CI). The results showed that the factors associated with failure of pulmonary TB treatment are knowledge (p = 0.022; OR = 6.6; 95% CI = 1.48 - 29.36), nutritional status (p = 0.005; OR = 9.16; 95% CI = 2.11 - 39.85), and medication adherence (p = 0.003; OR =11.0; 95% CI = 2.37 - 54.14), whereas the unrelated factor is family support (p = 0.47). It is recommended to provide counselling, nutritional guidance, medication assistance, and family support to patients during the treatment period for pulmonary tuberculosis. Keywords: treatment failure, knowledge, nutritional status, compliance