Austin Milton, Natalie Frech, Anna Shadid, Nicholas Hollman, Sarah Beth Bell, Marianna S. Wetherill
{"title":"Evaluation of a Trauma-Informed Nutrition Curriculum for Women With Children Living in Transitional Housing","authors":"Austin Milton, Natalie Frech, Anna Shadid, Nicholas Hollman, Sarah Beth Bell, Marianna S. Wetherill","doi":"10.1111/jhn.70015","DOIUrl":"https://doi.org/10.1111/jhn.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study describes the implementation of a 6-week nutrition and culinary education curriculum at a transitional housing facility for single mothers in Tulsa, Oklahoma, United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a novel, trauma-informed approach to nutrition education, we delivered the <i>Around the Table: Nourishing Families</i> curriculum across three, small group cohorts (<i>n</i> = 15) over a period of 2 years. Lessons emphasized small group dialogue and group-directed learning on the topics of toxic stress, food as nourishment and family resilience combined with hands-on recipe preparation by the group. We evaluated process measures of participation and attrition and outcome measures of self-reported food skills, dietary intake, emotional well-being, and other indicators of nutrition self-care using a pre–post design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Food skills significantly improved post-curriculum (<i>p</i> = 0.026) with additional improvement in several areas of dietary intake, mindful eating, nutrition self-care and greater use of healthy foods at family mealtimes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hands-on, participatory nutrition and cooking education that emphasizes mind–body connections to food can be a feasible strategy for teaching introductory food skills and may also support socioemotional healing in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renske M. van Lonkhuijzen, Suzanne Prins, Fleur van Loghem, Jeanne H. M. de Vries, Annemarie Wagemakers
{"title":"Pregnant Women's Experiences With a Collaborative Midwife-Dietitian Empowerment Programme to Improve Diet Quality","authors":"Renske M. van Lonkhuijzen, Suzanne Prins, Fleur van Loghem, Jeanne H. M. de Vries, Annemarie Wagemakers","doi":"10.1111/jhn.70027","DOIUrl":"https://doi.org/10.1111/jhn.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pregnancy is a crucial period prompting increased intentions for lifestyle changes. Suboptimal diet quality during pregnancy can cause adverse health outcomes for both mother and child. The Power 4 a Healthy Pregnancy (P4HP) programme aims to improve the diet quality of pregnant women through empowerment, by providing four additional consultations to discuss nutrition with a midwife and dietitian. This research aimed to study the experiences of pregnant women engaged in the P4HP programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study using in-depth interviews was conducted. Participants were recruited through purposive sampling from women who completed the P4HP programme. Semi-structured interviews were conducted using time-lining as an explorative tool. Interview transcripts underwent thematic analysis following Braun and Clarke's six-phase process, combining inductive and deductive coding approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two interviews were conducted with women from eight midwifery practices. Four main themes emerged: (1) women report various dietary improvements, influenced by diverse factors, (2) most pregnant women evaluate the P4HP programme positively, (3) the dietitian plays a key role in empowering pregnant women towards healthy dietary intakes and (4) midwives support pregnant women in maintaining dietary improvements. Participants viewed the P4HP consultations favourably, which facilitated empowerment through personalized guidance, reassurance, and increased awareness and confidence levels. Motivated by their desire to ensure optimal nutrition for their babies, women made multiple improvements in their diet quality. While the guidance of the midwife served as a motivational factor to sustain these changes, it was the personalized nutritional guidance provided by the dietitian that women found instrumental in achieving actual dietary changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our outcomes emphasize the importance of integrating dietitian consultations in standard antenatal care to promote enhancements in the diet quality of pregnant women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioanna Kontele, Demosthenes Panagiotakos, Mary Yannakoulia, Tonia Vassilakou
{"title":"Socio-Demographic Determinants of Mediterranean Diet Adherence: Results of the EU-National Health Interview Survey (EHIS-3)","authors":"Ioanna Kontele, Demosthenes Panagiotakos, Mary Yannakoulia, Tonia Vassilakou","doi":"10.1111/jhn.70023","DOIUrl":"https://doi.org/10.1111/jhn.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the well-known benefits of the Mediterranean diet (MD), low adherence is observed globally, highlighting the need to investigate the underlying causes of this trend. Large-scale, periodically repeated surveys, such as the European Health Interview Survey (EHIS), could be useful for the investigation of the factors that influence adherence to healthy dietary patterns. National EHIS-3 in Greece was designed to collect data on the consumption of all food groups, making it possible to determine adherence to MD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This study aimed to investigate the socioeconomic factors that influence MD adherence by conducting a secondary data analysis from 7706 participants aged 15–85 years who participated in the 2019 national EHIS. MD adherence was evaluated by MedDietScore. Bivariate comparisons between the score tertiles and socioeconomic groups were performed. Logistic regression analyses were used to estimate the association between MedDietScore tertiles and demographic and socioeconomic factors, using high adherence as the reference category. Finally, cluster analysis was applied to identify the most significant factors in relation to the classification of the participants in MD adherence groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Educational level, followed by income status, emerged as the most significant factor associated with adherence to MD. Individuals who have attained only primary education had a 3.80 times higher likelihood of presenting low MD adherence instead of high MD adherence compared to persons with tertiary education. Individuals in the lower income group had 2.53 times higher odds of being in the low MD adherence instead of high MD adherence than individuals in the higher income group. These relationships remained statistically significant after adjusting for confounding factors. The group that most frequently adhered to high MD (53.4%) comprised individuals who had tertiary education, higher income, and were couples without children. Conversely, those with primary or secondary education who are single parents or live in one-person households and fall into the lower and medium income groups are most likely to have low MD adherence (44.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Public policies to promote MD adherence should consider socioeconomic factors. Integrating questions to evaluate adherence to dietary patterns into EHIS would allow for future intercountry and longitudinal comparisons.</p>\u0000 </section>\u0000 ","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Expert Opinions on an Optimal Infant Feeding Quantitative Data Framework: A Mixed Methods Delphi-Style Study in the UK","authors":"Rochelle Embling, Rachel Evans, Niamh Mchugh, Anna Kolosowska, Varsha Nagaraj, Rachel Bath","doi":"10.1111/jhn.70025","DOIUrl":"https://doi.org/10.1111/jhn.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to explore how expert stakeholders involved in research, policy and practice would define an ideal dataset for collecting infant feeding data, to better align efforts to monitor and evaluate breastfeeding across the UK four nations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Using the Delphi method, two phases of consultation were completed with a total of 42 stakeholders. First, qualitative (Round 1) and quantitative (Round 2) surveys were distributed to an interdisciplinary panel of experts, to identify individual-level agreement for key terms and timepoints for data collection relevant to infant age. Second, policy-led stakeholders discussed outcomes from Phase 1, before contributing to a written consultation response for their nation to indicate group-level agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across Phase 1 surveys, 13 of 15 indicators reached consensus for definitions, and 11 of 13 reached consensus for timepoints. During Phase 2, 5 of 7 indicators reached a level of final agreement. Data collection was suggested to focus on the intention to breastfeed (around birth), and the early initiation of feeding (from birth to 10 days). Monitoring of ‘exclusive’ breastfeeding from 0 to 6 months, ‘any’ breastfeeding from 0 to 24 months, and complementary feeding at 6 and 12 months, were identified as key touchpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Principal Conclusions</h3>\u0000 \u0000 <p>To support the feasibility of data reforms across UK nations, these results identify consensus for a shortlist of shared data indicators (see Supplementary Figure 1), highlighting opportunities for data collection that close the gap with international standards, and align with existing monitoring frameworks and healthcare practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dietary Energy and Nutrient Intake Among Pregnant Women in Sri Lanka: Findings From the Sri Lanka Mother and Newborn Growth Cohort Study","authors":"Malshani Lakshika Pathirathna, Megumi Haruna, Satoshi Sasaki, Kaori Yonezawa, Yuriko Usui, Yasuhiro Hagiwara","doi":"10.1111/jhn.70020","DOIUrl":"https://doi.org/10.1111/jhn.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maternal nutrition during pregnancy is crucial to ensure positive outcomes for both the mother and newborn. Despite its importance, maternal nutritional status remains poor, particularly in low- and middle-income countries, where social, cultural and economic factors play a pivotal role. This study assessed the adequacy of energy and dietary nutrient intake among Sri Lankan pregnant women compared to their dietary reference intakes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was part of the Sri Lanka Mother and Newborn Growth study, a nationwide prospective cohort of 2000 pregnant women. We prospectively investigated maternal dietary intake using a validated food frequency questionnaire during the first, second and third trimesters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed an imbalanced macronutrient distribution, with carbohydrates contributing over 67% of total median energy intake, while protein and fat contributed approximately 11% and 17%, respectively. Ethnic and socio-economic disparities in energy and macronutrient intake were notable. The Sinhalese ethnic group showed the highest median percentage of energy consumption derived from carbohydrates at 68.0% (IQR: 64.6%‒71.1%), significantly exceeding the intake of Tamil and Moor groups. Estate residents reported the lowest proportion of energy from protein (10.6%, IQR: 10.1%‒11.3%), which was significantly lower than the intakes of urban and rural residents. Additionally, women in the lowest income group had a lower total energy intake (1871 kcal/day, IQR: 1464–2392) than those in higher income groups, highlighting socio-economic influences on maternal nutrition. Micronutrient deficiencies were pervasive, particularly for vitamin B2 (88.6%–91.0%), folate (99.3%–99.8%), vitamin B12 (97.8%–99.5%), calcium (80.8%–91.4%) and iron (91.1%–96.5%). Sodium intake exceeded recommended levels for over 75% of women across all trimesters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Imbalances in macronutrient intake and widespread micronutrient deficiencies among Sri Lankan pregnant women underscore the urgent need for interventions targeting maternal nutrition. Addressing socio-economic disparities is critical to improving maternal and neonatal health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutrition Status of People Experiencing Homelessness Residing in Temporary Accommodation in London","authors":"Hannah Style, Victoria Vickerstaff, Adrian Brown","doi":"10.1111/jhn.70024","DOIUrl":"https://doi.org/10.1111/jhn.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>London has the highest proportion of people experiencing homelessness (PEH) living in temporary accommodation in the United Kingdom. PEH have poorer health outcomes, greater dietary inequalities, and die younger than the general population. Despite this, little is known about the nutrition status of PEH. This study aimed to examine the dietary health inequalities experienced by PEH in London, specifically assessing malnutrition among PEH living in temporary accommodation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective cross-sectional study in 18 hostels in London. Participants were recruited from the temporary accommodation in which they resided through a combination of purposive, snowballing and convenience sampling. Demographic information was gathered, including age, gender, ethnicity and hostel of residence. The primary outcome was malnutrition risk assessed by the Malnutrition Universal Screening Tool (MUST), other outcomes included body composition, dietary intake and quality, mental health and food insecurity. Ethical approval was obtained from the University College London Ethics Committee (16191/006).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Two hundred participants were recruited between July and December 2023. The majority were male (84.5%), were of White ethnicity (61%), with a mean (SD) age of 45.7 years (11.6) and a BMI of 23.4 kg/m<sup>2</sup> (4.7). The median MUST score was 2 (interquartile range [IQR]: 0.0, 3.0), and 60% had a risk of malnutrition. The median mental health score was 6 (3.0, 10.0), with 55% having moderate to severe depression/anxiety. Median food security score was low (4.5 [(0.0, 8.0]), with 44% experiencing very low food security. The median dietary quality score was low (8.0 [6.0, 9.0]) with low intakes of energy, fibre, and micronutrients, including vitamin D, iron, folate, and calcium, with a higher intake of free sugars compared with UK dietary recommendations and intakes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to show that PEH living in temporary residences had a high risk of malnutrition and experienced dietary inequalities related to poor diet quality and severe food insecurity. There is an urgent need for improved food environments, dietary quality of donated foods and improved nutrition screening and nutrition support provision for PEH in temporary accommodation. Findings could help inform policymakers, health services and food aid charities to set nutrition standards for temporary accommodation to prom","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guiomar Masip, Jantje Goerdten, Tooba Asif, Antje Hebestreit, Monica Hunsberger, Lauren Lissner, Denes Molnar, Valeria Pala, Paola Russo, Michael Tornaritis, Toomas Veidebaum, Maike Wolters, Luis A. Moreno, Leonie H. Bogl
{"title":"Development and Validation of Healthy and Unhealthy Plant-Based Diet Propensity Scores in European Children, Adolescents and Adults From the I.Family Study","authors":"Guiomar Masip, Jantje Goerdten, Tooba Asif, Antje Hebestreit, Monica Hunsberger, Lauren Lissner, Denes Molnar, Valeria Pala, Paola Russo, Michael Tornaritis, Toomas Veidebaum, Maike Wolters, Luis A. Moreno, Leonie H. Bogl","doi":"10.1111/jhn.70021","DOIUrl":"https://doi.org/10.1111/jhn.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Plant-based dietary patterns may reduce the risk of chronic diseases, but their benefits and risks in younger populations remain unclear due to variations in diet quality and nutrient adequacy. Robust tools to assess adherence to these patterns are essential. The aim of this study was to develop and validate three plant-based diet propensity (PBDP) scores – overall, healthy and unhealthy – to capture plant-based dietary patterns and assess their associations with nutrient intakes and health indicators in children, adolescents and adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study of children, adolescents and adults used data from the I.Family study (<i>n</i> = 15,780 participants) from eight European countries. Dietary intake was assessed using a food frequency questionnaire. The overall PBDP score was constructed by categorising all plant-based food groups as positive and animal-based food groups as negative. The healthy PBDP emphasised healthy plant-based food groups, whereas the unhealthy PBDP emphasised less healthy plant-based food groups. Validity was assessed through correlations with nutrient intakes and comparison across demographic groups. Associations with health indicators were also analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PBDP scores showed expected associations with nutrient intakes. Higher overall and healthy PBDP scores were observed in females, adults, individuals with higher parental educational levels and those from Belgium and Spain. The healthy PBDP score was associated with higher HDL cholesterol, improved bone stiffness and lower triglycerides. The unhealthy PBDP score was associated with lower HDL cholesterol in adults, but not in children or adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PBDP scores describe plant-based dietary patterns across demographic groups and are valid and reliable in adults. The findings highlight challenges in assessing dietary patterns in children and adolescents. Future research should address these challenges to enhance the validity of PBDP scores in younger populations and further explore their potential in guiding dietary recommendations across all age groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors Affecting Healthcare Professionals' Decision-Making Around Parenteral Nutrition in Advanced Cancer: A Systematic Review","authors":"Jennifer McCracken, Sabrina Bajwah, Clare Shaw","doi":"10.1111/jhn.70009","DOIUrl":"https://doi.org/10.1111/jhn.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many factors beyond clinical guidelines may influence healthcare professionals' (HCPs) decision-making. This systematic review aims to identify the factors that affect HCPs decision-making around parenteral nutrition (PN) in advanced cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A literature search was conducted by May 2023 via MEDLINE, Embase, PsycINFO, The Cochrane Library, CINAHL, PubMed, Web of Knowledge and PROSPERO. Fourteen additional papers were identified. Two reviewers independently screened all papers with consensus reached on inclusion. Three reviewers conducted quality appraisal independently. Reference checking and citation tracking were completed for all included papers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 458 papers identified, 5 papers met the eligibility criteria (3 online surveys, 2 qualitative studies). All papers were European. Papers were published between 2020 and 2023. Six themes were identified as affecting decision-making: clinical indications, quality of life, hope, the multidisciplinary team, barriers to facilitating home PN and the influence of relatives. Performance status was a commonly considered indicator of suitability for home PN. PN is more common for people with advanced cancer and intestinal failure (IF) in the UK. Barriers to providing PN included unclear clinical indication, colleague objections, lack of local expertise and poor communication between HCPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Collaborative working and effective communication are essential between acute services, IF centres and community services to facilitate decision-making around PN in advanced cancer. It is important for HCPs to set realistic expectations. Communication must be sensitive to the patient's values and culture.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Shan Lee, Nafisah Zulkifli, Yi Huan Lim, Shinee Ying Yi Lim, Benjamin Jian Wen Chow, Ennaliza Salazar, Seng Mun Wong
{"title":"The Impact of Home Enteral Tube-Feeding on the Intent and Experience of Going Out in Public: A Qualitative Study on Patients' and Caregivers' Perspectives","authors":"Yan Shan Lee, Nafisah Zulkifli, Yi Huan Lim, Shinee Ying Yi Lim, Benjamin Jian Wen Chow, Ennaliza Salazar, Seng Mun Wong","doi":"10.1111/jhn.70018","DOIUrl":"https://doi.org/10.1111/jhn.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individuals on tube-feeding experience significant lifestyle changes and social isolation, but the barriers and support for travelling out while on tube-feeding to reintegrate into the community have not been studied. This research explores the factors influencing the decisions of individuals on tube-feeding and their carers to travel outside of their homes, their experiences, and perceived barriers and support when performing tube-feeding in public settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative design using purposive sampling explored the experiences of three individuals and five carers living at home on long-term tube-feeding. One-to-one semi-structured interviews were conducted and transcribed. Thematic analysis was conducted via open coding and merging of recurring codes to form themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six themes emerged: (1) Motivators and deterrents to going out: Motivators include desire for social normalcy. Deterrents include physical health, logistics and psychosocial considerations, such as fear of negative public perception and the loss of travelling and dining as motivating social activities. (2) Going out requires meticulous preparation and planning. (3) Inadequate tube-feeding facilities in the community contribute to ambivalence and discomfort to tube-feeding outside. Participants must accept potential negative emotions when confronted with public reaction to tube-feeding. (4) Ideal tube-feeding facilities should be private and hygienic, in highly frequented locations. (5) Community support and awareness are needed to support tube-feeding. (6) Adaptability is crucial when satisfactory feeding locations are absent during local and overseas travel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Carers and healthcare professionals are pivotal in encouraging patients to disregard public curiosity, planning tube-feeding logistics, and advocating for the right to tube feed in public spaces without shame. Public awareness, carer support, and availability of tube-feeding facilities should be improved for patients to live, work and engage meaningfully in the community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Sustainable Are Hospital Menus in the United Kingdom? Identifying Untapped Potential Based on a Novel Scoring System for Plant-Based Provisions","authors":"Isabelle Sadler, Alexander Bauer, Shireen Kassam","doi":"10.1111/jhn.70019","DOIUrl":"10.1111/jhn.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adopting plant-forward diets is essential for achieving climate targets. As the second-largest provider of public sector meals in the UK, the National Health Service (NHS) can significantly reduce its environmental impact by transitioning to plant-forward menus, contributing to its goal of being a net-zero healthcare service by 2045. This study evaluates the extent to which NHS hospitals currently align with sustainable practices by assessing the plant-forward nature of in-patient menus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Green Plans from 40 hospital trusts were analysed to assess commitment to plant-forward, lower-emission menus. Freedom of Information requests were sent to 50 NHS trusts, and 36 menus from the spring/summer season of 2024 were analysed. A novel scoring system was developed to assess the hospital menus, with subscores reflecting the availability of plant-based meals, ruminant-meat meals, and menu strategies to encourage plant-forward choices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Green Plans showed limited commitment to increasing plant-based food options. Hospital menus scored poorly overall (average score of 20/100, range: 9–38). The lowest subscores were observed in the provision of fully plant-based meals and nudging techniques. The provision of ruminant meat varied (subscore range: 0–100) and all hospitals included processed meat on their menu. Hospitals with outsourced catering scored higher than those with in-house catering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite national recommendations to shift towards plant-forward diets, NHS hospitals currently show little commitment and provide limited offerings in this regard. The novel scoring system offers a practical framework for monitoring progress and guiding hospitals towards environmentally sustainable, plant-forward menus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":54803,"journal":{"name":"Journal of Human Nutrition and Dietetics","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}