Elements of Effective Nutrition Education for Adults with Diabetes Mellitus in Resource-Poor Settings: a Review

This review article highlights the key factors that need consideration in planning an effective nutrition education programme for adults with type 2 diabetes mellitus in resource-poor settings. Type 2 diabetes is increasing to epidemic levels globally. Low socio-economic status is associated with poorer health outcomes and a higher economic burden. Individuals with diabetes cite dietary adherence as the most difficult self-care area. Effective nutrition education achieves the desired goals and outcomes; which include appropriate change in dietary behaviour; improved glycaemic control; plasma lipid levels; blood pressure and body weight; as well as improved potential mediators (knowledge; skills and attitudes). Elements that contribute to a successful nutrition education programme include interventions tailored to the needs; abilities and socio-cultural context of the target group; the active involvement of the patient; a behaviour-focused approach based on appropriate theory; suitable delivery methods and individual/group approaches. Adequate contact time with an educator ( 10 hours); the educator's competence; provision of social support and follow-up intervention are also crucial. Effectively educating diabetic individuals from resource-poor settings in nutrition is a challenging task. It needs innovative and skilled educators who are sensitive to the unique needs of the target group and who use appropriate approaches to address these needs

The Role of Long-Chain Polyunsaturated Fatty Acids in the Treatment of Cancer Cachexia and Tumour Growth in Patients with Malignant Diseases : a Review

Recent studies show that u-3 polyunsaturated fatty acids (PUFAs) have the capacity to modulate cancer outcomes. The body responds to cancer in the same way that it responds to inflammation and wound healing. Nutrients with anti-inflammatory effects could therefore be expected to play a role in cancer treatment. This review focuses on the role of u-3 PUFAs in tumourigenesis and cancer cachexia. Studies indicate that eicosapentaenoic acid (EPA) supplementation may promote arrest of tumour growth and reduce cell proliferation. Patients need to consume at least 2 g of EPA per day for it to have a therapeutic effect. Positive outcomes related to cachexia include diminished weight loss; increased appetite; improved quality of life and prolonged survival; although there is controversy regarding these clinical outcomes. The effects of u-3 PUFAs on tumourigenesis and cachexia are viewed in the context of altered lipid and protein metabolism. This altered metabolism usually experienced by cancer patients results in increased formation of proinflammatory eicosanoids and cytokines. Cytokines play an indirect role by stimulating the production of arachidonic acid-derived eicosanoids; which support inflammation; cell proliferation and angiogenesis; and inhibit apoptosis. It can be concluded that u-3 PUFA supplementation offers a means of augmenting cancer therapy; inhibiting tumouri- genesis and possibly contributing to cachexia alleviation