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Nutrition Department provides pointers for getting started with your research. It includes links to library subscription resources, including article databases, journals, and books, as well as open authoritative web content. If you would like additional help with your Oncology research projects, or on learning how to use Library resources, don't hesitate to contact Library through email ILL@kfshrc.edu.sa.
Despite evidence that nutrition can play a substantial role in curbing the burden of chronic disease, findings reported in the nutrition literature have been plagued with debate and uncertainty, including questions about the confidence we can place in evidence from observational studies, the validity of dietary intake data, and the applicability of randomised trials to real-world patients or members of the public. Structured nutrition users’ guides (NUGs) to evaluate common research study designs (ie, randomised trials, cohort studies, systematic reviews and clinical practice guidelines) addressing nutrition questions will help clinicians and their patients, as well as health service workers and policy-makers, use the evidence to make more informed decisions on disease management and prevention. In addition, NUGs will provide comprehensive teaching materials for nutrition trainees on how to appraise, interpret and apply the research evidence.
We hereby introduce a series of structured NUGs for the literature on nutrients, foods and dietary patterns and programmes. Each article will address three key components when assessing different study designs used to assess nutrition interventions or exposures, including (1) assessing the methodological quality of the study, (2) interpreting study results (magnitude and precision of treatment or exposure effects for outcomes of benefit and harm) and (3) applying the results to unique patient or population scenarios based on their health-related values and preferences related to the potential benefits, harms, convenience and cost of an intervention.
This series of articles will serve to empower clinicians, health service workers and health policy-makers to better understand the validity, interpretability and applicability of the nutrition literature, while also helping practitioners and their clients make more evidence-based, value-sensitive and preference-sensitive nutrition decisions.
Sarcopenia has become a significant health issue, particularly as a common consequence of COVID-19 in older adults.
This study aimed to explore the clinical and psychological effects of integrated physical training with a high-protein diet compared with a regular protein diet in community-dwelling older men who had recovered from COVID-19 and exhibited symptoms of sarcopenia.
This is a single-blinded, randomised, controlled study conducted from March 2020 to December 2023 at the University hospital. The eligible participants were randomly assigned to two groups using the block randomisation method. The first group underwent integrated physical training with a high-protein diet (group A; n=38), with an average age of 64.1±3.8 years, while the second group underwent integrated physical training with a regular protein diet (group B; n=38), with an average age of 64.5±3.6 years over an 8-week period. Clinical parameters (handgrip strength and muscle mass—cross-sectional area CSA) and psychological measures (kinesiophobia and quality of life) were assessed at baseline, the fourth week, the eighth week and at a 6-month follow-up. The data were analysed using a 4x2 mixed model for repeated measures at different time points.
Demographic characteristics such as age, height, weight and body mass index did not show any statistically significant differences between the groups (p>0.05). After the 8-week intervention and at the 6-month follow-up, handgrip strength decreased by –5.0 (95% CI –6.21 to –3.78), midthigh CSA decreased by –3.7 (95% CI –6.53 to –0.86), midcalf CSA decreased by –4.4 (95% CI –6.80 to –2.00), kinesiophobia level increased by 8.1 (95% CI 7.16 to 9.03) and quality of life decreased by –6.3 (95% CI –9.0 to –3.5). The findings indicated significantly greater improvement (p<0.001) in group A compared with group B, although there was no significant difference in muscle CSA in the arm region (p>0.05).
Integrated physical training with a high-protein diet led to improvements in clinical (muscle strength and muscle mass) and psychological (kinesiophobia and quality of life) parameters compared with integrated physical training with a regular protein diet in older men recovering from COVID-19 and displaying symptoms of sarcopenia.
Most hospitals still lag behind in their policies to stimulate healthier dietary choices by their patients. This study investigates whether a multicomponent nudging intervention, designed to prompt healthy food choices, can influence dietary choices of hospitalised patients.
This pre-postintervention study included a baseline phase and an intervention phase (7+7 months) and was carried out at the cardiology ward of a large hospital. All 2419 cardiac patients admitted to the ward during this period, and their 7559 meals were part of this study. The nudging intervention consisted of choice architecture, visual cues and informational nudges (eg, traffic light menus, posters). Data on dietary choices (vegetarian, fish, meat, side salad and fruit salad) were collected from the electronic food ordering system. As a secondary outcome, the intention to eat healthy after discharge was measured using the 20-item long Dutch Dietary Intention Evaluation Tool.
During the intervention period, there was a statistically significant increase in the selection of vegetarian meals (20.1% vs 16.3%, p<0.001), fish meals (24.6% vs 18.7%, p<0.001), side salads (54.5% vs 49.5%, p<0.001) and fruit salads (12.8% vs 8.6%, p<0.001) when compared with the baseline period. In addition, patients in the intervention period expressed a significantly higher intention to eat healthy after discharge compared with the baseline period (β=0.167, SE=0.083, p=0.045).
This study demonstrates that a straightforward, easily implementable nudging intervention effectively promotes healthy dietary choices among in-hospital cardiac patients and enhances their intention to eat healthy after discharge.
Mechanistic studies indicated beneficial effects of choline and betaine on glucose homeostasis during pregnancy. However, limited human studies explored the associations of biomarkers of choline and its related metabolites with gestational diabetes mellitus (GDM) and results remained inconsistent. This study aimed to explore associations of serum choline, betaine and trimethylamine N-oxide (TMAO) with GDM odds among Han Chinese women.
Pregnant women with singleton gestation were enrolled during GDM screening between 24 and 28 weeks of gestation at the Seventh People’s Hospital in Shanghai, China. Women with GDM cases (n=173) and non-GDM controls (healthy women without pregnancy-related complications, n=158) were enrolled. Serum metabolites were measured by ultra-high performance liquid chromatography-multiple reaction monitoring-tandem mass spectrometry method. Multivariable logistic regression analyses were used to estimate ORs and their 95% CIs for the associations of these three metabolites with likelihood of GDM.
Compared with the lowest tertile of serum choline and betaine, women in the highest tertile had a multivariate-adjusted OR (95% CI) for GDM odds of 0.55 (0.30, 1.00) and 0.55 (0.30, 1.00), respectively. No significant association was found between serum TMAO and GDM odds. In addition, the stratified analysis results showed that among women with abnormal weight gain during pregnancy, there was a significant inverse association between serum betaine and GDM odds [OR (95% CI), 0.26 (0.13, 0.57)].
Serum choline and betaine, but not TMAO, tend to be inversely associated with GDM odds among Han Chinese women with singleton gestation. Especially among those women with abnormal weight gain during pregnancy, higher serum betaine was associated with lower GDM likelihood.
The aim of the present study was to analyse the associations of family meals and social eating behaviour (SEB) with experiential avoidance (EA) in adolescents from Spain.
This cross-sectional study involved 617 adolescents (aged 12–17 years, 56.7% females) from the Eating Habits and Daily Life Activities study from Valle de Ricote (Region of Murcia, Spain). Variables were analysed using visual techniques including Shapiro-Wilk test and density and quantile-quantile plots. Continuous data were displayed using medians and IQRs, while categorical data was shown as percentages. The frequency of family meals was assessed by asking participants to indicate how many times their family had shared a meal together during the previous week. SEB was self-reported by the adolescents through responses to three statements. To measure EA, we used the Acceptance and Action Questionnaire-II (AAQ-II). Generalised linear models were employed to ascertain the associations of family meals or SEB with EA.
For each further point in SEB, a lower estimated marginal mean (M) of the AAQ-II was observed (–0.86 points, 95% CI –1.39 to –0.33, p=0.001). In terms of family meal status, the highest AAQ-II score was found in those with low family meal status (M=20.1, 95% confidence interval [CI] 18.1 to 22.2), followed by participants with medium family meal status (M=19.2, 95% CI 17.0 to 21.4) and those with high family meal status (M=18.8, 95% CI 16.1 to 21.0). Significant differences were observed between participants with high SEB status and their counterparts with medium SEB (p=0.004) or low SEB (p<0.001).
This research revealed a significant relationship between SEB and EA and a non-significant relationship between the frequency of family meals and EA. Promoting positive social eating environments and increasing family meal participation could help reduce the prevalence of EA and its negative consequences in adolescents.
While many countries use guidance and policies based on nutrients and food groups to support citizens to consume healthy diets, fewer have explicitly adopted the concept of ultra-processed foods (UPF). UPF consumption is associated with many adverse health outcomes in cohort studies. In the UK, a nutrient profiling model (NPM) is used to identify foods high in fat, salt or sugar (HFSS) and several policies target these. It is not known how well the NPM also captures UPF. We aimed to quantify the proportion of food and drink items consumed in the UK that are HFSS, UPF, both or neither and describe the food groups making the largest contributions to each category. We analysed data from the National Diet and Nutrition Survey, between 2008/2009 and 2018/2019, using descriptive statistics. We used three metrics of food consumption: all foods, percentage of energy in all foods (reflecting that different foods are consumed in different portion sizes and are of different energy densities) and percentage of food weight in all foods (reflecting that some UPFs have few calories but are consumed in large volumes). We found that 33.4% of foods, 47.4% of energy and 16.0% of food weight were HFSS; 36.2%, 59.8% and 32.9%, respectively, were UPFs; 20.1%, 35.1% and 12.6% were both and 50.5%, 27.9% and 63.7% were neither. In total, 55.6% of UPF foods, 58.7% of energy from UPFs and 38.3% of food weight from UPF consumed were also HFSS. The most common food groups contributing to foods that were UPF but not HFSS were low-calorie soft drinks and white bread. The UK NPM captures at best just over half of UPFs consumed in the UK. Expanding the NPM to include ingredients common in UPFs (eg, non-nutritive sweeteners, emulsifiers) would capture a larger percentage of UPFs and could incentivise ‘deformulation’ of UPF products.
Nutrition is a critical component of healthcare, with healthcare professionals playing a pivotal role in encouraging proper nutrition care among patients. Consequently, it is imperative for all healthcare professionals to have proficiency in nutrition relevant to the prevention and treatment of diseases. This study, to the best of the author’s knowledge, is the first study to examine the current level of nutrition competencies among health professionals and medical students in Kazakhstan, as well as the factors influencing these competencies. The findings may potentially help to inform future clinical nutrition educational strategies and improve health outcomes in the region.
This cross-sectional study surveyed 200 healthcare professionals in Kazakhstan via a 17-item questionnaire adapted from the NUTrition COMPetence tool, which assesses the self-perceived competence of primary health professionals in providing nutrition care, particularly for patients with chronic diseases. It measures several dimensions of competence, including confidence in nutrition knowledge, skills and counselling, and has established reliability and validity. Recruitment was conducted using convenience and snowball sampling methods. Fisher’s exact test was used for statistical analysis to identify significant associations.
Most healthcare professionals self-reported their nutrition knowledge as ‘average’ (52.7%) or ‘good’ (29.5%). Although 40.2% felt ‘somewhat confident’ and 27.6% felt ‘very confident’ in applying this knowledge clinically, half indicated they ‘rarely’ provide nutrition care. Additionally, the current study found that nutrition education received before entering practice was strongly linked to participants’ current level of nutrition knowledge (p=0.011).
The gap between self-reported knowledge and practical application suggests barriers to integrating clinical nutrition education into practice. The quality of nutrition education received during medical training is crucial for shaping current competencies, highlighting the necessity for improved nutrition education in healthcare training programmes
Sawsan Albalawi
