Is Buying Local Food a Sustainable Practice? A Scoping Review of Consumers’ Preference for Local Food

Access to healthy food and the introduction of sustainable nutrition practices are two important issues today. The COVID-19 pandemic has brought new challenges to food security but it has also provided opportunities for local food production. The discussion on local food has been gaining attention in recent years, but there is still a lack of clear understanding of the term ‘local food’ in the literature. The relationship between local food and sustainability issues is still unclear and has various connotations. This discordance leads to further discussions on whether buying local food should be considered a sustainable behavior and whether consumer preference for local food can be perceived as a sustainable practice. A scoping literature review was conducted in order to fill this gap and to shed light on the main tendencies of the scientific literature regarding this topic. The outcomes of the research revealed three dimensions of ‘local food’ definitions in the literature: geographical, geopolitical, and organic; while the problem of a unified local food definition remains open. The studied literature did not show any sound evidence for sustainability attributes in the definition of local food and consumer perception of local food.

To feed, or not to feed? Evaluating enteral nutrition practices in surgical neonates

Background: Early enteral feeding initiation following surgical procedures in neonates has demonstrated several benefits. In high income countries, where parenteral nutrition is readily available, enteral feeding initiation is often delayed. This study seeks to examine clinical factors and decision-making processes that guide nutrition practices in surgical neonates in the United States (US) and Kenya. Methods: A REDCap survey was developed and distributed to pediatric surgery attendings and fellows at Riley and Peyton Manning Children’s Hospitals in Indiana (US) and Shoe4Africa Children’s and AIC Kijabe Hospitals in Kenya. Nine responses were collected during the initial two-week long pilot, then analyzed using REDCap and SPSS 25. Results: Responses were collected from eight pediatric surgery attendings and a fellow practicing in Indianapolis, IN. The three most highly ranked clinical factors important for initiation of enteral feeds were stability of the patient, nasogastric or orogastric output color, and gastric output volume. Factors most highly ranked for advancement of feeds included frequency and volume of emesis and abdominal distension. These factors were similarly ranked for foregut and hindgut procedures. Protocols for pyloric stenosis (n=6) include initiation of enteral nutrition within 24-48 hours. Four of nine respondents felt that surgeons at their institution are not aggressive enough in feeding surgical neonates. The primary perceived barrier to achieving full enteral nutrition was patient gut dysmotility (n=8). All respondents felt that they were similarly (n=4) or more (n=5) proactive in feeding surgical neonates compared to their peers. Conclusions and Impact: Feeding practices in surgical neonates are dependent on individual clinician decision-making processes and patient factors. Once the data from the Kenyan surgeons is collected, comparisons between practice patterns will be analyzed. Real-world enteral feeding practices will be evaluated in an adjunct observational study, which we hope will inform protocols with earlier enteral feeding initiation in the future.

Oral Health’s Transformative Impact on Diet and Systemic Health Outcomes

The 2020-25 Dietary Guidelines for Americans identified dental caries as a major diet-related chronic disease of public health concern and suggested in the section for adults over 60, “Good dental health is critical to overall health, as well as the ability to chew foods properly." Poor oral health can lead to chronic diseases and impede one’s ability to chew fruits, vegetables, whole grains, and other nutrient-rich foods across the life span. Almost 90 percent of adults ages 20 to 64 years and 96 percent of those over 65 years of age have dental caries. The overall prevalence of complete tooth loss is 2.2 percent among adults ages 20 to 64 years and jumps to 17.3 percent for those over age 65. As a result of COVID-19, some seniors are not seeking regular oral health services, which increases the need for preventive oral health practices and consuming a healthy dietary pattern recommended in the new Dietary Guidelines. Recent research will underscore the importance of saliva and oral health in cancer patients on radiation and in other chronic diseases. Saliva has also been shown to reduce specific infections that are related to influenza and HIV. Participants in this session will gain understanding of factors linking poor oral health and nutrition practices to chronic diseases and guidance on critical preventive oral health practices to increase saliva flow and decrease dental caries through all stages of the life cycle. Promoting oral health is the responsibility of the interdisciplinary team overseeing older adults.

Do Temporal Eating Patterns Differ in Healthy Versus Unhealthy Overweight/Obese Individuals?

This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41–13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11–5.13) (OR = 2.33, 95% CI 1.03–5.32) (OR = 4.45, 95% CI 1.71–11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.

Aspirations and Worries: The Role of Parental Intrinsic Motivation in Establishing Oral Health Practices for Indigenous Children

Aboriginal and Torres Strait Islander (respectfully, subsequently referred to as Indigenous) children in Australia experience oral disease at a higher rate than non-Indigenous children. A history of colonisation, government-enforced assimilation, racism, and cultural annihilation has had profound impacts on Indigenous health, reflected in oral health inequities sustained by Indigenous communities. Motivational interviewing was one of four components utilised in this project, which aimed to identify factors related to the increased occurrence of early childhood caries in Indigenous children. This qualitative analysis represents motivational interviews with 226 participants and explores parents’ motivations for establishing oral health and nutrition practices for their children. Findings suggest that parental aspirations and worries underscored motivations to establish oral health and nutrition behaviours for children in this project. Within aspirations, parents desired for children to ‘keep their teeth’ and avoid false teeth, have a positive appearance, and preserve self-esteem. Parental worries related to child pain, negative appearance, sugar consumption, poor community oral health and rotten teeth. A discussion of findings results in the following recommendations: (1) consideration of the whole self, including mental health, in future oral health programming and research; (2) implementation of community-wide oral health programming, beyond parent-child dyads; and (3) prioritisation of community knowledge and traditions in oral health programming.

Prediction Model of Balanced Nutrition Practices among University Students in the COVID-19 Outbreak

AIM: Students included in the category of youth need balanced nutrition practices, especially during the COVID-19 outbreak. This study aims to determine the model of balanced nutrition behavior in youth in Gowa Regency, Makassar, Indonesia. MATERIALS AND METHODS: This study was a quantitative study with a cross-sectional study, in which primary data were collected from June to July 2020. The respondents were 597 students at public and private universities located in Gowa Regency who filled the questionnaires. RESULTS: The bivariate analysis results, which were based on the respondents’ characteristics, showed that only age significantly affected balanced nutrition practices (p = 0.048). Based on the independent variables studied, poor knowledge (p = 0.000, ORcrude = 2.229 [CI 1.601–3.105]) and poor attitude (p = 0.001, ORcrude = 1.735 [CI 1.250-2.409]) obtained a significant correlation with poor balanced nutrition practices. The final model of balanced nutrition practices using multivariate analysis indicated that knowledge was the biggest predictor of balanced nutrition (p = 0.000, OR = 2.067 [CI 1.476–2.893]). The number implied that respondents with good knowledge had 2.067 times the opportunity to take balanced nutrition practices than those with less knowledge after controlling for age and attitude variables. CONCLUSION: Producing well-balanced nutrition behavior requires well-balanced nutrition knowledge, including university students who belong to the late adolescent stage.

Establishing the need for provider education on cancer and nutrition (PECAN): Survey results on nutrition practices at a large community oncology practice.

49 Background: Oncology providers and patients benefit from evidence-based nutritional resources to support cancer care. For patients, proper nutrition care can prevent inappropriate weight loss, improve treatment tolerance, and improve quality of life. Recent literature has noted the lack of both adequate dietitian resources at outpatient centers and comprehensive nutrition guidelines in cancer care. At a large community practice with 210 locations across Texas and Oklahoma, a survey was developed and administered to assess nutrition practices. Methods: Clinic directors in the practice completed a survey to assess for the presence or absence of a malnutrition screen; how nutrition concerns are addressed; and the availability of a dietitian. Results: A total of 26 responses detailed the nutrition processes at 50 unique locations. At 37 (74%) locations, a malnutrition screening tool was utilized and of these, 30 (81%) locations reported utilizing the Malnutrition Screening Tool (MST), a brief, validated tool for outpatient settings including oncology. Seven (19%) sites did not specify what tool was used. Of the clinics that reported completing a malnutrition screen for patients, the screen was completed by the advanced practice provider (APP)/physician in 18 (49%) clinics, a nurse in 4 (11%) clinics, a dietitian in 4 (11%) clinics and a medical assistant in 1 (3%) clinic. At 10 sites more than one provider type was responsible for completing the screen. Nutrition issues were addressed by physicians, APPs, and nurses in 15 (50%), 35 (70%), and 9 (14%) sites respectively (see table). Twenty-two locations (44%) reported referring patients to a dietitian and 10 sites (20%) had a dietitian available in clinic. Forty-one (82%) clinics employed more than one method for addressing nutrition issues. Sixteen of 26 respondents (62%) reported that increased dietitian access would be helpful; this included respondents whose locations already had a dietitian available. Conclusions: Overall, 74% of reporting locations used a malnutrition screening tool and 20% had access to a dietitian on site. Forty-four percent of sites referred to a dietitian if there was a need. This indicates that multiple providers are involved in the nutritional care of oncology patients. In response to these findings, the multidisciplinary PECAN Taskforce was created to develop comprehensive malnutrition screening, implement a referral process for all at-risk patients, enhance nutrition education, and expand dietitian services. Further study will measure the impact of expanded nutrition access on patient outcomes.[Table: see text]