Previous studies have shown that the dietary habits of cancer patients and survivors have significant implications for their recovery and quality of life. The current study examined the effectiveness ...of an innovative culinary group intervention on cancer patients' quality of life through changes in their eating behaviors, as manifested by an increase in their tendency towards intuitive eating and healthy food choices.
In total, 190 cancer patients participated in this study, and were allocated to an intervention or a wait-list control group. A battery of self-report questionnaires assessing food choices, intuitive eating, health-related quality of life, and subjective well-being was administered at two time points: Before the intervention (T1) and at the end of the three month intervention (T2).
Analyses revealed an increase in health-related quality of life and well-being among the intervention group. Intuitive eating and healthy food choices also increased among the intervention but not wait-list control group. Finally, results indicated that participation in the culinary group intervention and improvements in health-related quality of life and well-being were mediated by changes in eating behaviors.
Our findings demonstrate that nutrition and eating behaviors have a significant effect on cancer patients' physical and emotional adjustment. A culinary group intervention seems to target patients' physical and emotional needs and promote their adjustment.
•We studied the effect of eating behaviors on cancer patients' adjustment.•Culinary group intervention improves cancer patients' quality of life (QoL).•QoL improvements were mediated by an increase in healthy food choices.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Background: Arterial wall stiffening is linked to a heightened risk of cardiovascular morbidity and mortality. To date, the influence of changes in nutritional components on arterial flexibility, ...during intentional weight loss program in patients with metabolic syndrome (MS), remains unexplored Methods: 69 MS (38/31m/f) participants were enrolled into a 1-year weight loos program. Nutritional recommendation consisted of moderate low calorie/high protein Mediterranean diet. Baseline characteristics: age 53.0±12.2 years; (BMI) 34.3±4.0 kg/m2; Flow Mediated Dilation % (FMD) 7.62±4.65; Pulse Wave Velocity (PWV; m/sec) 9.2±2.5; common carotid artery (CCA pmeters) 778±139; Insulin 28±19.5 (mU/mL); HbA1C 5.8±0.5%. Asymmetric Dimethylarginine (ADMA) 0.535±0.16 (pmol/L); L Arginine 44.9±16.15 (pmol/L); Nutritional components were registered over 7 days before and by 1year of treatment, with detailed questionnaires analyzed by software Results: Within the 1 year, BMI declined by 9.1±6.4% (p= 0.000). Correlations existed between the decrease in PWV and decrease in dietary energy (r=-0.304 p=0.034) and increase in dietary Zinc (r=0.350 p=0.014) and decrease in blood creatinine (r=0.383 p=0.009). Further correlations were found between the decrease in CCA and an increase in L Arginine (r=0.296 p=0.025), increase in protein intake (r=- 0.265 p=0.032), decreases in blood glucose (r=-0.278 p=0.024) and cholesterol (r=-0.257 p=0.045). FMD increase correlated with the decrease in carbohydrate intake (r= 0.255 p= 0.040), increase in potassium intake (r= -0.325 p= 0.008), and decrease in blood insulin (r= 0.333 p= 0.026). There was a correlation between Insulin reduction and ADMA reduction (r= 0.364 p= 0.021) Conclusions: Changes in food components, including overall macro-and micronutrients, are associated with improved vascular flexibility
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
3.
Weigh More, Lose Less Bone Tai, Brurya; Shefer, Gabi; Sack, Jessica ...
Obesity (Silver Spring, Md.),
11/2023, Volume:
31
Journal Article
Peer reviewed
Background: Several reports indicated that intentional weight loss can result in reduction in bone mineral density (BMD), particularly in postmenopausal women, and older individuals. This is a ...post-hoc analysis of a prospective multidisciplinary weight loss trial, in search of predictors of bone loss in the Metabolic Syndrome (MS). Methods: 73 MS subjects (ATPIII criteria; F/M = 34/39) participated in a 1-year intensive multidisciplinary treatment, based on personalized physical training and a low calorie/high protein Mediterranean diet. Baseline (±SD): age 53.3 ± 11.2 years; weight 98.6 kg ± 16.8; BMI 34.4 ± 3.8 kg/m2; lean body mass (LBM) 55.48 kg ± 11.66 kg; Spine BMD 1.21 ± 016 g/cm2, femur neck BMD 0.99 ± 0.13 g/cm2. Results: By the end of 1-year BMI declined by 9.1% (p < 0.001); LBM declined by 2.68% (p < 0.001). There were no significant overall changes in spine or femur BMD; no difference in the change in BMD between participants under the age of 50 years or above 51 years, and between male and female subjects. Despite the lack of overall change in BMD during weight loss, when individual changes in spinal BMD were analyzed, participants who clustered above the median post-treatment versus pre-treatment BMD level, showed a higher initial BMI compared to participants whose change in spinal BMD was below the median level (BMI 35.6 ± 3.6 vs. 32.5 ± 3.52 kg/m2, respectively (p < 0.0001). Conclusions: In subjects with MS undergoing intensive and closely supervised multidisciplinary intentional 1 year weight loss program, higher initial weight is associated with lesser spine bone loss.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Less attention has been given to the detection and nutritional status and needs of obese frail/sarcopenic older subjects. The aim of this study was to characterize the nutritional composition in ...older (≥65 years), frail-prone, obese subjects (defined by either waist circumference WC or body mass index BMI).
A cross-sectional study with analysis of the national survey “Mabat Zahav”. Random sample of 1751 community dwelling Israeli older adults (≥65 years). Eleven nutritional factors formerly linked to frailty were a-priori selected based on the current literature. Data was extracted from a 24-hour dietary recall. Adherence for each nutritional factor was defined using the Dietary Reference Intakes (DRI), and aggregated into a sum score of the overall adherence (ranging from “0” to “11”, where “fair” adherence was defined as ≥6; inadequate adherence otherwise). Frailty likelihood was estimated using a validated non-direct model, and associations of nutritional factors with frailty-likelihood in obese vs non-obese individuals were examined. Additionally, a decision tree procedure based on machine learning was applied in order to capture nutritional factors related to frailty, stratified by gender, as well as by WC and/or BMI.
Overall, the prevalence rates of frailty and pre-frailty were 7.1 and 57.6%, respectively. A “fair nutritional adherence” was less common among frail-prone compared to robust subjects (23.1% vs. 32.1%; p < 0.0001). The intake of most frailty-related nutritional factors did not co-segregate according to the presence of abdominal or BMI-defined obesity. Still, compared to robust normal/overweight subjects, frail-prone obese (by BMI) individuals had a higher rate of inadequate nutritional adherence (odds-ratio 1.842; p < 0.05). Of all 11 nutritional factors, folate in obese women and vitamin A (as retinol) and calcium in non-obese and obese men, respectively, were recognized as the most prominent predictors of frail-prone prevalence by the machine learning process. Although BMI was more closely associated with impaired intake of the 11 selected nutritional components than WC, this association was eliminated when frailty status, low income and education were considered.
Frail-prone subjects differed from robust subjects in their nutritional intake. Nutritional inadequacies related to frailty-likelihood were mostly seen among obese women and non-obese men. In the prediction of inadequate adherence to the DRI of 11 nutritional components, obesity is a weaker predictor than frailty, lower education and low income in older Israeli adults.
•Nutritional intake differed among frail-prone obese/non-obese.•Low intake of folate in obese women was strongest frailty predictor.•Low intake of vitamin A in leaner men was strongest frailty predictor.•Frailty is superior to obesity in explaining the impaired nutritional intake.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Exclusion of the proximal gut from nutrient absorption entails significant metabolic benefits. The duodenal-jejunal bypass liner (DJBL) is the first endoscopic device that excludes the first part of ...the gut by covering it.
To assess weight and glycemic control at the end of treatment and after 1 year of follow-up.
Bariatric endoscopy service in a tertiary medical center.
Diabetic patients were treated with DJBL and followed prospectively between 2013 and 2016. Data were collected during scheduled visits.
Out of 51 patients treated, 39 completed at least 9 months with the device. Complications were recorded for the entire cohort. Percent of total weight loss was 15.05% ± 6.0% after 12 months of treatment (P < .001 versus baseline). Twelve months postretrieval, percent of total weight loss decreased to 8.75% ± 5.07% (P < .001 versus baseline). Patients with baseline body mass index ≥35 kg/m
experienced greater percent total weight loss changes over time (P < .001). There was a significant effect on hemoglobin A1C levels over time (P = .003), and the nadir was reached at 9 months of treatment (median 6.05% versus 7.20% at baseline, P < .001). Insulin users had consistently higher median hemoglobin A1C values compared with insulin nonusers (P < .001). Adverse events were experienced by 12 of 51 patients (23.5%), of which 4 cases (7.8%) were severe.
Proximal bowel bypass by DJBL is an effective tool for weight reduction and glycemic control. Metabolic achievements are partially preserved at 1 year after device removal. Because DJBL entails a considerable rate of side effects, strategies to mitigate them are warranted.
Background:
Diabetic subjects with life-long massive obesity that have reached old age, often develop heart failure, severe hypertension and renal failure. Fluid retention necessitates increasing ...doses of diuretics, with further decline in renal function.
Rationale:
In older obese subjects who failed numerous standard dietary attempts and have developed complications which preclude bariatric surgery, prolonged periods of long and repetitive intermittent fasting may lead to a) regular fasting diuresis, such that will lessen the need for diuretics; b) fat loss. Both may ameliorate intractable comorbidities.
Goal:
To examine whether or not complete intermittent fasting can positively impact fluid overload, functional status and life quality in old obese diabetic subjects with heart and renal failure.
Methods:
Two 77y/o outpatient men were instructed to avoid any caloric intake, but consume calorie-free fluids ad libitum for 36 hours (last evening meal on the pre-fasting day; first next meal◊ breakfast on the post- fasting day), twice a week (total fasting hours 72/168 weekly hours) over 17 patient A; A and 13 months patient B; B. Insulin, GLP-1 analogs and oral drugs were individually adjusted for each fasting interval.
Results: Extent of Experience
: We accrued experience of 30 patient months.
Effects:
within this time frame, the following effects were observed: 1) Weight (and BMI) declined from 92 to 77kg (37.8->31.6kg/m2) and 108 to 84.6kg (40◊31kg/m2) in A, and B, respectively. 2) Heart failure (diastolic dysfunction with preserved systolic function) and functional capacity: we recorded: I. Improvement from NYHA class IV and III to II in B, A); II. Cessation of pulmonary edema events ( vs. 2 events/ patient in the preceding year); III: decrease >50% in the doses of furosemide; d/c of IV furosemide; IV: disappearance of peripheral edema; 3) Improvement in renal function in B (eGFR 15.7-->36.7cc/min) and stabilization in A (35cc/ml); 4) Improvement in anemia: hemoglobin rose by 2Gr% in B and 0.8gr% in A; 5) HgA1C was unchanged in A (7.8, 7.7%) in A and declined in B (6.7% ->5% in B). 5) Hypertension was not affected.
Safety:
hypoglycemia was not detected with regular, multiple point home glucose monitoring on the fasting days. Hyperkalemia was present
a priori
in both patients, required continuous f/u and treatment, but no other electrolyte and mineral abnormalities were seen.
Compliance:
Several events of partial/complete skipping of fasting resulted in fluid accumulation and leg edema, following which self-reported compliance has been nearly complete. At the present time, these subjects refuse to get off the protocol. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.
Ovarian transposition before planned pelvic irradiation can preserve ovarian function in young patients with pelvic malignancies. The transposed ovaries are fixed to the posterolateral abdominal ...wall. We described the use of a titanium spiral tack as a fixation device and compared it with other methods of oophoropexy.
Medical and surgical records of all consecutive patients who underwent oophoropexy in our institution between 2007 and 2013 were reviewed. Demographic and clinical data were summarized; follicle-stimulating hormone values, recorded; and imaging scans, reviewed.
Oophoropexy was performed in 30 patients: 28 with cervical carcinomas and 2 with pelvic sarcomas. The procedure was done through laparoscopy in 13 patients and through laparotomy in 17. Titanium spiral tack was used for ovarian fixation in 14 patients, Vicryl suturing in 14, and in 2 cases the ovaries were pulled up through a retroperitoneal tunnel and fixed to the peritoneum with sutures. Titanium spiral tack fixation took a few seconds to perform. There were no immediate intraoperative or postoperative complications. Ovarian function was preserved in 15 patients (7/14 with spiral tack, 6/14 with sutures, and in both patients with retroperitoneal tunneling). Postoperative imaging results showed that all ovaries retained their extrapelvic location for a median period of 11.6 months (range, 2.3-63 months).
Spiral tack is a simple, reliable method for oophoropexy before pelvic irradiation. Its efficacy is comparable with that of suture fixation, with the added advantage of ultrashort operative time. It is therefore worth considering as an alternative to suturing.
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