A Review of Web-Based Nutrition Information in Spanish for Cancer Patients and Survivors.

Nutrition education resources are of interest for cancer patients and survivors throughout the cancer continuum. We examined the web-based nutrition information in Spanish for cancer patients and survivors provided by national cancer organizations (NCOs). The Guide to Internet Resources for Cancer and the membership list of the Union for International Cancer Control were searched to identify the NCOs. The International Patients Decisions Aid Standards (IPDAS) was used to describe the quality of the available information. We identified 20 NCOs that provided nutrition information aimed at a general audience on their websites. Web-based resources of nine NCOs were selected for presentation in this review. Website scores ranged between 20 and 24 in the IPDAS scale (maximum score = 31). The selected NCOs offered reliable and safe information. Healthy eating information for cancer patients and management of side-effects was provided by all websites. Information was more limited for cancer survivors. We recommend that NCOs increase the possibilities for personalized recommendations and interaction with the content by including instrumental tools on their websites.

Economic benefit of dietetic-nutritional treatment in the multidisciplinary primary care team / Beneficio económico del tratamiento dietético-nutricional en el equipo multidisciplinario de atención primaria

Chronic diseases and aging are placing an ever increasing burden on healthcare services worldwide. Nutritional counselling is a priority for primary care because it has shown substantial cost savings. This review aims to evaluate the evidence of the cost-effectiveness of nutritional care in primary care provided by health professionals. A literature search was conducted using PubMed/MEDLINE between January 2000 and February 2019. The review included thirty-six randomized controlled trials (RCTs) and systematic reviews conducted in healthy people and people with obesity, type-2 diabetes mellitus, cardiovascular risk or malnutrition. All the RCTs and reviews showed that nutritional intervention led by dietitians-nutritionists in people with obesity or cardiovascular risk factors was cost-effective. Dietary interventions led by nurses were cost-effective in people who needed to lose weight but not in people at high cardiovascular risk. Some dietary changes led by a primary care team in people with diabetes were cost-effective. Incorporating dietitians-nutritionists into primary care settings, or increasing their presence, would give people access to the healthcare professionals who are best qualified to carry out nutritional treatment, and may be the most cost-effective intervention in terms of health expenditure. Notwithstanding the limitations described, this review suggests that incorporating dietitians-nutritionists into primary health care as part of the multidisciplinary team could be regarded as an investment in health. Even so, more research is required to confirm the conclusions

Las enfermedades crónicas y el envejecimiento suponen una carga cada vez mayor para los servicios de salud en todo el mundo. El asesoramiento nutricional es una prioridad para la atención primaria porque ha demostrado ahorros sustanciales de costes. Esta revisión tiene como objetivo evaluar la evidencia de la relación coste-efectividad de la atención nutricional en la atención primaria proporcionada por profesionales de la salud. Se realizó una búsqueda bibliográfica utilizando PubMed/MEDLINE entre enero de 2000 y febrero de 2019. La revisión incluyó 36 ensayos controlados aleatorios (ECA) y revisiones sistemáticas realizadas en personas sanas y personas con obesidad, diabetes mellitus de tipo 2, riesgo cardiovascular o desnutrición. Todos los ECA y las revisiones mostraron que la intervención nutricional dirigida por dietistas-nutricionistas en personas con obesidad o factores de riesgo cardiovascular fue coste-efectiva. Las intervenciones dietéticas dirigidas por enfermeras fueron coste-efectivas en personas que necesitaban perder peso pero no en personas con alto riesgo cardiovascular. Algunos de los cambios en la dieta dirigidos por un equipo de atención primaria en personas con diabetes también fueron coste-efectivos. La incorporación de dietistas-nutricionistas en entornos de atención primaria, o aumentar su presencia, daría a las personas acceso a los profesionales de la salud mejor calificados para llevar a cabo el tratamiento nutricional, y resultaría más rentable en términos de gasto en salud. A pesar de las limitaciones descritas, esta revisión sugiere que incorporar dietistas-nutricionistas en atención primaria como parte del equipo multidisciplinario podría considerarse una inversión en salud. Aun así, se requiere más investigación para confirmar las conclusiones

Economic benefit of dietetic-nutritional treatment in the multidisciplinary primary care team.

INTRODUCTION: Chronic diseases and aging are placing an ever increasing burden on healthcare services worldwide. Nutritional counselling is a priority for primary care because it has shown substantial cost savings. This review aims to evaluate the evidence of the cost-effectiveness of nutritional care in primary care provided by health professionals. A literature search was conducted using PubMed/MEDLINE between January 2000 and February 2019. The review included thirty-six randomized controlled trials (RCTs) and systematic reviews conducted in healthy people and people with obesity, type-2 diabetes mellitus, cardiovascular risk or malnutrition. All the RCTs and reviews showed that nutritional intervention led by dietitians-nutritionists in people with obesity or cardiovascular risk factors was cost-effective. Dietary interventions led by nurses were cost-effective in people who needed to lose weight but not in people at high cardiovascular risk. Some dietary changes led by a primary care team in people with diabetes were cost-effective. Incorporating dietitians-nutritionists into primary care settings, or increasing their presence, would give people access to the healthcare professionals who are best qualified to carry out nutritional treatment, and may be the most cost-effective intervention in terms of health expenditure. Notwithstanding the limitations described, this review suggests that incorporating dietitians-nutritionists into primary health care as part of the multidisciplinary team could be regarded as an investment in health. Even so, more research is required to confirm the conclusions.

INTRODUCCIÓN: Las enfermedades crónicas y el envejecimiento suponen una carga cada vez mayor para los servicios de salud en todo el mundo. El asesoramiento nutricional es una prioridad para la atención primaria porque ha demostrado ahorros sustanciales de costes. Esta revisión tiene como objetivo evaluar la evidencia de la relación coste-efectividad de la atención nutricional en la atención primaria proporcionada por profesionales de la salud. se realizó una búsqueda bibliográfica utilizando PubMed/MEDLINE entre enero de 2000 y febrero de 2019. La revisión incluyó 36 ensayos controlados aleatorios (ECA) y revisiones sistemáticas realizadas en personas sanas y personas con obesidad, diabetes mellitus de tipo 2, riesgo cardiovascular o desnutrición. Todos los ECA y las revisiones mostraron que la intervención nutricional dirigida por dietistas-nutricionistas en personas con obesidad o factores de riesgo cardiovascular fue coste-efectiva. Las intervenciones dietéticas dirigidas por enfermeras fueron coste-efectivas en personas que necesitaban perder peso pero no en personas con alto riesgo cardiovascular. Algunos de los cambios en la dieta dirigidos por un equipo de atención primaria en personas con diabetes también fueron coste-efectivos. La incorporación de dietistas-nutricionistas en entornos de atención primaria, o aumentar su presencia, daría a las personas acceso a los profesionales de la salud mejor calificados para llevar a cabo el tratamiento nutricional, y resultaría más rentable en términos de gasto en salud. A pesar de las limitaciones descritas, esta revisión sugiere que incorporar dietistas-nutricionistas en atención primaria como parte del equipo multidisciplinario podría considerarse una inversión en salud. Aun así, se requiere más investigación para confirmar las conclusiones.

Prevalence of Malnutrition and Nutritional Characteristics of Patients With Inflammatory Bowel Disease.

BACKGROUND AND AIMS: This study sought to determine the prevalence of malnutrition in patients with inflammatory bowel disease, to analyse the dietary beliefs and behaviours of these patients, to study their body composition, to evaluate their muscular strength and to identify the factors associated with malnutrition in these patients. METHODS: This was a prospective, multicentre study. Crohn's disease and ulcerative colitis patients from 30 Spanish centres, from the outpatient clinics, were included. A questionnaire of 11 items was applied to obtain data from patients' dietary behaviour and beliefs. Patients who accepted were evaluated to assess their nutritional status using Subjective Global Assessment and body mass index. Body composition was evaluated through bioelectrical impedance. RESULTS: A total of 1271 patients were included [51% women, median age 45 years, 60% Crohn's disease]. Of these, 333 patients underwent the nutritional evaluation. A total of 77% of patients declared that they avoided some foods to prevent disease relapse. Eighty-six per cent of patients avoided some foods when they had disease activity because of fear of worsening the flare. Sixty-seven per cent of patients modified their dietary habits after disease diagnosis. The prevalence of malnutrition was 16% [95% confidence interval = 12-20%]. In the multivariate analysis, history of abdominal surgery, active disease and avoidance of some foods during flares were associated with higher risk of malnutrition. CONCLUSIONS: The prevalence of malnutrition in inflammatory bowel disease patients was high. We identified some predictive factors of malnutrition. Most of the patients had self-imposed food restrictions, based on their beliefs.