Factors contributing to weight loss, nutrition-related concerns and advice received by adults undergoing cancer treatment.

PURPOSE: The opinions and perceptions of patients are crucial throughout the cancer treatment process, as treatment is more effective when patient concerns are addressed. The present study was designed to identify history of weight loss since initiation of cancer treatment, specific nutrition-related problems and concerns (including food aversions, factors contributing to poor food intake and perceived nutrition-related problems), nutrition advice received by cancer treatment patients, and relations between items studied and reported unintentional weight loss. MATERIAL AND METHODS: A 23-item survey was completed by a convenience sample of 79 patients from treatment centers at a community hospital and oncologist office, of which 66 were included in the final analysis. Descriptive statistics included means, standard error, 95% confidence intervals, and frequency distributions. ANOVA and Pearson chi2 were used to evaluate differences in responses by treatment type and relations between items studied and reported unintentional weight loss. Twenty-seven (41%) of the 66 (27 males, 39 females) were receiving radiation, 20 (30%) chemotherapy, and 19 (29%) both. RESULTS: Unintentional weight loss occurred for 41% since initiation of treatment (13% deficit), 27% had food aversions, 52% reported factors contributing to poor food intake, 50% had nutrition-related problems since initiation of treatment, and 89% had received nutrition advice. The prevalence of unintentional weight loss was significantly greater among patients who reported having food aversions, factors that had contributed to poor food intake, or nutrition-related problems. CONCLUSIONS: This study demonstrates that adults commonly present with factors that contribute to poor food intake and perceive nutrition-related problems resulting from cancer treatment. Further, there is a greater prevalence of unintentional weight loss among those who report food aversions and perceive nutrition-related problems. The findings provide a framework that may aid healthcare providers in recognizing nutrition-related concerns and needs of cancer patients.

Supplements of interest for sport-related injury and sources of supplement information among college athletes.

PURPOSE: This study examined incidence of sport-related injury, interest in supplements to treat injury, and sources of supplement information among 145 college athletes (89 males, 56 females). MATERIALS AND METHODS: A survey was used to assess sport-related injuries, interest in three categories of supplements to treat injury, and sources of supplement information among college athletes who used athletic training room and weight training facilities. Pearson chi2 was used to evaluate differences in frequency distribution of responses by sex. RESULTS: Sport-related injuries were experienced by 91% of athletes (93% males, 88% females). Overall, 17% of participants were interested in supplements to improve circulation, 34% for joint and soft tissue repair, and 22% to reduce inflammation. Significant sex differences were not found for any supplements in any categories evaluated. Males were more likely than females to rely on strength coaches (37%, 20%) for supplement information. Athletic trainers (71% of athletes), coaches (60%), and physicians (41%) were the primary professionals, and the internet (79%), magazines (68%), and television (52%) the most popular sources of media for supplement information. CONCLUSIONS: The majority of athletes experience injury during their college athletic career and 17% to 34% express an interest in supplements for injury treatment. Athletes would benefit from scientifically sound guidance to identify appropriate supplements for injury treatment and internet sites for supplement information. Future research should identify if athletes are more likely to increase supplement use when they are injured or if supplement use is more prevalent among athletes who are prone to injury.

Energy expenditure and intake in children with sickle cell disease during acute illness.

BACKGROUND: Children with sickle cell disease have frequent bouts of pain and infection which may increase energy expenditure, decrease energy intake and lead to a subsequent energy deficit. METHODS: Two groups of African-American children with sickle cell disease-SS genotype were enrolled in this study upon hospital admission for a sickle cell disease related illness: a younger (<6 years, n=14, 7 M) and older group (> or =6 years, n=17, 8 M). Body composition and dietary intake were assessed, and sleeping (younger) or resting energy expenditure (older) were measured by indirect calorimetry at admission and one month later at steady state. RESULTS: Energy expenditure was not different between the two timepoints for younger children, but was slightly elevated at steady state (+50 kcal/d, P=0.049) in the older group. After controlling for gender, changes in fat-free mass and dietary intake, the significance disappeared. Energy intake in both groups was significantly depressed at admission compared to follow-up (P<0.01). CONCLUSIONS: These children and adolescents did not expend excess energy during their acute illness, however, an energy deficit was observed secondary to poor energy intake. Since 20% of patients with sickle cell disease have multiple hospitalizations per year, these results provide justification for the development and evaluation of nutrition care protocols to maintain adequate caloric intake during hospitalization and recovery.

Impact of acute illness on nutritional status of infants and young children with sickle cell disease.

OBJECTIVE: To evaluate changes in growth, nutritional status, body composition, and energy and nutrient intakes during illness and usual state of health in infants and young children with sickle cell disease. DESIGN: Sixteen children, aged 0.4 to 5.6 years, with SS type sickle cell disease (SCD-SS) were assessed at the time of hospital admission for an acute illness episode and during an 18-hour overnight follow-up visit 2 to 6 weeks after the acute illness episode when in a state of usual health. Main outcome measures included growth in height and weight compared with reference standards, body composition determined by the skinfold thickness technique and total body electrical conductivity, and dietary intake determined by 24-hour recall during hospital admission and at follow-up. RESULTS: Height, weight, and weight-for-height z scores did not differ from national reference data; triceps skinfold thickness and arm fat area z scores were less. Mean +/- standard error body fat was 15.6 +/- 2.1% at the time of hospital admission, as measured by total body electrical conductivity, and was not significantly different from the follow-up value (16.2 +/- 2.2%). Mean energy intake was 44 +/- 9% of Recommended Dietary Allowances at the time of admission and differed significantly from the follow-up value of 90 +/- 9% (P < .05). APPLICATIONS: Infants and children with sickle cell disease appear to be at nutritional risk during an acute illness episode, as indicated by body fat measures and inadequate intakes of energy and macronutrients. Energy intake may be suboptimal for several days surrounding an admission for an acute illness in children with sickle cell disease. Physicians and other health practitioners should be alert to inadequate nutrient intakes of their patients during this time period and may consider supplemental energy to avoid a potential net negative energy balance.