Mediterranean Diet: Outcomes from an Education Session Among Patients With Cancer and Nursing Staff.

BACKGROUND: Strong evidence supports the benefits of the Mediterranean diet, but little is reported among patients and nurses regarding knowledge about the diet and its health benefits. OBJECTIVES: A pre-/post-test practice initiative was implemented to identify level of knowledge about the Mediterranean diet in patients with cancer and nursing staff and to provide education about the diet's health benefits. METHODS: A 17-item survey was developed to assess knowledge and willingness to try or recommend the Mediterranean diet, current practices, and general nutrition knowledge. A 10-minute education session was provided to patients and nursing staff. Descriptive statistics were used. FINDINGS: The majority of patients reported eating from one to four servings of fruits and vegetables daily. For patients and nursing staff, post-education session scores demonstrated increased knowledge, willingness to try the diet, and perceived effectiveness of the diet.

Higher Caloric Exposure in Critically Ill Patients Transiently Accelerates Thyroid Hormone Activation.

INTRODUCTION: The inflammatory response of critical illness is accompanied by nonthyroidal illness syndrome (NTIS). Feeding has been shown to attenuate this process, but this has not been explored prospectively over time in critically ill patients. OBJECTIVE: To explore the impact of calorie exposure on NTIS over time in critically ill patients. METHODS: Mechanically ventilated patients with systemic inflammatory response syndrome (SIRS) were randomized to receive either 100% or 40% of their estimated caloric needs (ECN). Thyroid hormones were measured daily for 7 days or until intensive care unit discharge or death. Mixed level regression modeling was used to explore the effect of randomization group on plasma triiodothyronine (T3), reverse triiodothyronine (rT3), thyroxine (T4), and thyroid stimulating hormone (TSH), as well as the T3/rT3 ratio. RESULTS: Thirty-five participants (n=19 in 100% ECN; n=16 in 40% ECN) were recruited. Adjusting for group differences in baseline T3/rT3 ratio, the parameters defining the fitted curves (intercept, linear effect of study day, and quadratic effect of study day) differed by randomization group (P = 0.001, P = 0.01, and P = 0.02 respectively). Plots of the fitted curves revealed that participants in the 100% ECN group had a 54% higher T3/rT3 ratio on postintervention day 1 compared with the 40% ECN group, a difference which attenuated over time. This was driven by a 23% higher plasma T3 and 10% lower plasma rT3 levels on postintervention 1. CONCLUSIONS: Higher caloric exposure in NTIS patients transiently attenuates the drop of the plasma T3/rT3 ratio, an effect that is minimized and finally lost over the following 3 days of continued higher caloric exposure.

Differentiating Sarcopenia and Cachexia Among Patients With Cancer.

Patients with cancer are at an increased risk for muscle loss via 2 distinct mechanisms: sarcopenia, defined as the age-associated decrease in muscle mass related to changes in muscle synthesis signaling pathways, and/or cachexia, defined as cytokine-mediated degradation of muscle and adipose depots. Both wasting disorders are prevalent; among patients with cancer, 15%-50% are sarcopenic and 25%-80% are cachectic. Muscle mass may be difficult to quantify in overweight/obese individuals. Often, overweight/obese patients with cancer are assumed to be normally nourished when in fact severe muscle depletion may be present. No universally accepted treatment exists for preventing or reversing sarcopenia or cachexia in patients with cancer. Current treatment options are limited to nutrition therapy and exercise, which may lead to difficulties in adherence during cancer treatment. Future treatments may provide pharmaceutical therapy that targets muscle degradation and synthesis pathways. There is a need to determine a multimodal treatment plan for muscle depletion to improve quality of life, survival, and therapy complications in patients with cancer.

Associations between Parenting Style and Parent and Toddler Mealtime Behaviors.

Background: By the time a child is 24 mo old, 50% of parents report experiencing picky eating behaviors with their child. These behaviors include consuming an inadequate dietary variety, eating the same foods repeatedly, and an unwillingness to try either new or familiar foods. Previous research has established relations with regard to the impact of parent feeding strategies on child mealtime behaviors and how parent feeding strategies are influenced by parenting style; however, to our knowledge, no studies have investigated whether there is an association between parenting style and perceived child mealtime behaviors specifically related to picky eating. Objective: The purpose of this study was to investigate whether a relation exists between general parenting style and both parent feeding strategies and perceived picky eater and non-picky eater (NPE) behaviors. Methods: Parents of 2- to 5-y-old children (n = 525) completed 2 online surveys: 1) the Mealtime Assessment Survey, which measures the frequency of parent and child mealtime behaviors, and 2) the Parenting Styles and Dimensions Questionnaire, which measures authoritative, authoritarian, and permissive parenting styles. Spearman's correlation analysis was conducted to determine the relations between parenting style and mealtime behavior. Results: Positive correlations were found between an authoritative parenting style and NPE behaviors, as well as parent mealtime strategies that promote positive eating habits. Authoritarian and permissive parenting styles were positively correlated with child behaviors associated with picky eating and parent mealtime strategies that can negatively influence child feeding. Conclusions: These findings suggest that a relation exists between general parenting style and both parent and child mealtime behaviors; however, the directionality of the relation remains unknown. The positive correlations seen within the authoritative parenting style with regard to NPE behaviors suggest the use of authoritative feeding methods to overcome feeding difficulties.