Relationship between Quality of Life and Nutritional Status in Colorectal Cancer Patients Undergoing Chemotherapy

Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL). Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C). Results: The majority of patients were Chinese, male, with a mean age of 57.1 ?± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p<0.05), and pain (p<0.001) compared to malnourished patients. PG-SGA was strongly correlated with the main domains of the QOL: global health status (r = -0.395, p<0.05), fatigue (r = 0.816, p<0.001), nausea and vomiting (r = 0.730, p<0.001) and pain (r= 0.629, p<0.001). The better the nutritional status (lower total mean score of PG-SGA), the higher the QOL (high mean score of global health status). Conclusion: The scored PG-SGA is suitable for use as a nutrition assessment tool to identify malnutrition and it is associated with QOL among this population

Improving the Nutritional Status of Patients with Colorectal Cancer Undergoing Chemotherapy through Intensive Individualised Diet and Lifestyle Counselling

Introduction: Malnutrition is common among patients with cancer and it is also associated with their negative health outcomes. Generally, cancer patients undergoing chemotherapy have a high risk of malnutrition, secondary to both the disease and the treatment. It is important that patients maintain a good nutritional status to improve the effects, and minimise the side effects of cancer treatment. A good nutritional status should be maintained for patients through nutritional intervention during cancer treatment. There appears to be no published studies on the effects of intense dietary counselling versus usual dietary care on the nutritional status of colorectal cancer (CRC) patients undergoing chemotherapy alone. Furthermore, there have been no randomised controlled trials (RC1) undertaken in Malaysia, where CRC is increasing. It is therefore important to undertake a RCT of a dietary and lifestyle counselling intervention of CRC outpatients undergoing chemotherapy. Methods: The intervention study was an open (masking not used), prospective, and Rcr to examine the effects of intensive individualised dietary and lifestyle counselling on dietary intake and nutritional status in CRC patients undergoing chemotherapy. It was designed as an 8-week program of intensive, individualised dietary and lifestyle counselling followed up with another 8-week post-intervention period without dietary and lifestyle counselling, and compared to a control arm given the usual care. A total of forty-two participants took part in this study and were randomised into two groups, namely, the intervention group (IG) (n=22) and the control group(CG) (n=20) at Kuala Lumpur Hospital and SelayangHospital, Malaysia. Results In this study, 67% of CRC patients were malnourished at baseline. In the IQ the prevalence of malnutrition dropped from 72.7% at baseline to 27.3% eight weeks after the intervention. This repesents a large, and clinically meaningful shift. In the CG, the prevalence of malnutrition, or at risk of malnutrition, was still at 75% at the end of the sixteen weeks. Conclusion: Intensive, individualised dietary and lifestyle counselling resulted in improved nutritional status in patients with CRC undergoing chemotherapy.

Improving the Nutritional Status of Patients with Colorectal Cancer Undergoing Chemotherapy through Intensive Individualised Diet and Lifestyle Counselling

Introduction: Malnutrition is common among patients with cancer and it is also associated with their negative health outcomes. Generally, cancer patients undergoing chemotherapy have a high risk of malnutrition, secondary to both the disease and the treatment. It is important that patients maintain a good nutritional status to improve the effects, and minimise the side effects of cancer treatment. A good nutritional status should be maintained for patients through nutritional intervention during cancer treatment. There appears to be no published studies on the effects of intense dietary counselling versus usual dietary care on the nutritional status of colorectal cancer (CRC) patients undergoing chemotherapy alone. Furthermore, there have been no randomised controlled trials (RC1) undertaken in Malaysia, where CRC is increasing. It is therefore important to undertake a RCT of a dietary and lifestyle counselling intervention of CRC outpatients undergoing chemotherapy. Methods: The intervention study was an open (masking not used), prospective, and Rcr to examine the effects of intensive individualised dietary and lifestyle counselling on dietary intake and nutritional status in CRC patients undergoing chemotherapy. It was designed as an 8-week program of intensive, individualised dietary and lifestyle counselling followed up with another 8-week post-intervention period without dietary and lifestyle counselling, and compared to a control arm given the usual care. A total of forty-two participants took part in this study and were randomised into two groups, namely, the intervention group (IG) (n=22) and the control group(CG) (n=20) at Kuala Lumpur Hospital and SelayangHospital, Malaysia. Results In this study, 67% of CRC patients were malnourished at baseline. In the IQ the prevalence of malnutrition dropped from 72.7% at baseline to 27.3% eight weeks after the intervention. This repesents a large, and clinically meaningful shift. In the CG, the prevalence of malnutrition, or at risk of malnutrition, was still at 75% at the end of the sixteen weeks. Conclusion: Intensive, individualised dietary and lifestyle counselling resulted in improved nutritional status in patients with CRC undergoing chemotherapy.

Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors

BACKGROUND/OBJECTIVES: Understanding individual's intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers. SUBJECTS/METHODS: This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used. RESULTS: Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation. CONCLUSION: Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.

Assessing the children's views on foods and consumption of selected food groups: outcome from focus group approach

The food choices in childhood have high a probability of being carried through into their adulthood life, which then contributes to the risk of many non-communicable diseases. Therefore, there is a need to gather some information about children's views on foods which may influence their food choices for planning a related dietary intervention or programme. This paper aimed to explore the views of children on foods and the types of foods which are usually consumed by children under four food groups (snacks, fast foods, cereals and cereal products; and milk and dairy products) by using focus group discussions. A total of 33 school children aged 7-9 years old from Selangor and Kuala Lumpur participated in the focus groups. Focus groups were audio-taped, transcribed and analyzed according to the listed themes. The outcomes show that the children usually consumed snacks such as white bread with spread or as a sandwich, local cakes, fruits such as papaya, mango and watermelon, biscuits or cookies, tea, chocolate drink and instant noodles. Their choices of fast foods included pizza, burgers, French fries and fried chicken. For cereal products, they usually consumed rice, bread and ready-to-eat cereals. Finally, their choices of dairy products included milk, cheese and yogurt. The reasons for the food liking were taste, nutritional value and the characteristics of food. The outcome of this study may provide additional information on the food choices among Malaysian children, especially in urban areas with regard to the food groups which have shown to have a relationship with the risk of childhood obesity.

Diet intervention to improve cardiovascular risk factors among Iranian postmenopausal women

Cardiovascular disease is a leading cause of death and disability and remains so in the future. The aim of this study was to detect the impact of a 6-month diet intervention on cardiovascular risk factors in postmenopausal Iranian women. It was a randomized controlled trial that carried out in the East Health Clinic in Ahvaz-Iran. This study started on June 2007 and was completed on May 2008. A total 64 healthy postmenopausal women recruited and randomly assigned to the intervention group (35) and control (29). Over the six months follow-up, the intervention group received five educational sessions (two face to face and three lecture discussion classes with slide demonstration) at the first month. These sessions were about menopause, cardiovascular disease and healthy diet. Every participant in the intervention group received one face to face education session at the 3rd month, and also received a telephone call at the end of each month starting with the second month to remain on the diet. Pre-intervention and post-intervention anthropometric measurements, blood pressure, blood lipids and dietary intake were assessed. Data analyzed using the SPSS version 15. Descriptive (means and SD), univariate (Paired-t test, Chi-Square and Independent T-test) and multivariate (GLM Repeated Measure) statistics were used. Participants in the diet group had significantly lower weight (-0.9 kg), body mass index (-0.4 kg/m2), and fasting blood sugar (-4.5 mg/dl). The diet group significantly increased their daily intake of fiber (+2.3 g, P = 0.05), decreased their intake of sodium (-28 mg, P = 0.04), and consumption of fruit and vegetable > or = 5 serving a day (80%, P = 0.03) compared to the control group. Post menopausal women are at a greater risk for cardiovascular disease. Healthy diet using educational intervention can be an effective means of reducing cardiovascular risk in postmenopausal women.