Nutritional care in the cardiac rehabilitation program

There is some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation: nutritional care has a relevant role in the secondary prevention of cardiovascular disease. The dietitian is the qualified sanitary professional for nutritional care. The aim of this study was to define the role of dietitians within a health care team in programs of cardiac rehabilitation. In this setting, nutritional care starts with a dietary assessment, which includes a measurement of the anthropometric parameters, and a survey of the patient knowledge and eating habits. If there is no need for change in the patient lifestyle, the patient is addressed to the normal cardiac rehabilitation program with no further nutritional intervention except one session of counseling. When lifestyle changes are needed, the dietitian defines, together with the patient, therapeutic aims and expected results. The following phase is represented by group session with patients and their relatives during which nutritional topics are discussed and nutritional education is provided Afterwards, self-monitoring sheets of eating habits are individually discussed in one visit; a last individual visit is used for a final assessment of nutritional knowledge, dietary habits, and anthropometric parameters. In case of unsatisfactory results, patients are invited to participate to three group session to be held biweekly, during which they interact with the dietitian and take part to exercises and group discussions. When the established targets are reached, the nutritional program includes individual follow up visits at six and twelve months for further assessment of medium term results

[Mediterranean diet: not only food].

The proposal of a Mediterranean way of life is much more than advise how to eat. The Mediterranean Diet, a model of Sustainable Diet, is an example of how to combine personal choices, economic, social and cultural rights, protective of human health and the ecosystem. There is in fact fundamental interdependence between dietary requirements, nutritional recommendations, production and consumption of food. In literature studies and nutritional and epidemiological monitoring activities at national and international level have found a lack of adherence to this lifestyle, due to the spread of the economy, lifestyles of the Western type and globalization of the production and consumption. To encourage the spread of a culture and a constant practice of the Mediterranean Diet, there are some tools that are presented in this article. The Mediterranean Diet Pyramid in addition to the recommendations on the frequency and portions of food, focuses on the choice of how to cook and eat food. The "Double Food Pyramid" encourages conscious food choices based on "healthy eating and sustainability. All the nutrition professionals and dietitians in particular should be constantly striving to encourage the adoption of a sustainable and balanced nutrition

The role of Dietitian in cardiac rehabilitation and secondary prevention

Rehabilitation and secondary prevention programs are recognized as an essential part of the overall care of patients with cardiovascular disease. They consist of multidisciplinary strategies aiming at the reduction of modifiable risk factors for cardiovascular disease. There are some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation. In 2007, the Italian Association of Dietitians (ANDID) appointed a working group of dietitians, skilled in nutrition applied in cardiovascular disease, with the aim to make an overview of the available scientific literature and to develop a Professional Position Paper on the role of Dietitian in cardiac rehabilitation and secondary prevention. The first Position Paper, developed in 2008, covered the available evidence about the dietitian professional role and contribution in the management of the topic. The working group has recently updated the contents by introducing, in agreement with the work done by ANDID, the methodology of the Nutrition Care Process and Model (NCP), a systematic problem-solving method intended to stimulate critical thinking, decision-making and address issues related to food and nutritional assistance, in order to provide a safe, effective and high quality care

The role of Dietitian in cardiac rehabilitation and prevention

Rehabilitation and secondary prevention programs are recognized as an essential part of the overall care of patients with cardiovascular disease. They consist of multidisciplinary strategies aiming at the reduction of modifiable risk factors for cardiovascular disease. Cardiac rehabilitation includes non-pharmacological interventions as: Patients’ evaluation. Nutritional counseling. Risk factors management (serum lipids, blood pressure, weight, diabetes, smoking). Psychosocial interventions. Physical activity and cardiovascular physical training counseling. Their effectiveness in the reduction of mortality through the decrease of risk factors has been proven in the last twenty years. Guidelines on appropriate and well-framed interventions have been released and nutritional interventions have a ringside seat in all programs. During 2007, the Italian Association of Dietitians, ANDID, created a working group of expert dietitians, with the goals of making a review of available scientific literature and of elaborating a Professional Position Papers on the role of Dietitian in cardiac rehabilitation and prevention. This Position Paper retrieves and remarks the available evidence that are important for the dietitians, according to their professional role and their contribution in the management of the topic

Human oral squamous cell carcinoma proliferation and migration prevented by two flavonoids

Oral Cancer (OC) is one of the most frequent cancer in Head and Neck district and Oral Squamous Cell Carcinoma (OSCC) constitutes the large majority of the neoplasia arising in oral cavity. OSCC remains a hampering matters for clinics, since the overall disease free survival has not significantly increased during the last decades and invasion to surrounding tissue and to regional lymph nodes is often reported. Therefore new strategies to prevent and inhibit OSCC growth and invasion are highly desirable and new therapeutic approaches are currently tempted also with the use of natural compounds. Myricetin (MYR) and Naringenin (NAR), two naturally occurring flavonoids, widely diffused in plants, fruits and vegetable, have recently gained consideration thanks to their anti oxidant, anti inflammatory and anti tumoral properties. In this study their potential anticancer effect has been evaluated on an OSCC cell line, SCC-25 and on spontaneously immortalized non tumoral keratinocytes, HaCaT cells. MYR and NAR induce a significant cell growth inhibition in SCC-25 cells, in addition NAR selectively affected cancer cells, since it does not impair HaCaT cell growth. Furthermore an additive effect of MYR and NAR has been highlighted. The cell proliferation inhibition is not related to apoptosis induction, as demonstrated by evaluation of phosphatidyl serine membrane translocation and dapi staining. On the contrary MYR and NAR effect depends on the cell cycle progression impairment. Wound-healing and cell invasion assays, respectively performed by cell monolayer scratch and Boyden Chamber transwell test, demonstrate that the two flavonoids are able to reduce motility and invasiveness on both SCC-25 and HaCaT cells. In conclusion the results of the present study show the anticancer potential of NAR and MYR on OSCC, since both flavonoids prevent cancer cell proliferation through a cytostatic effect, by the impairment of cell cycle progression. Moreover both the flavonoids inhibit cell migration, thus highlighting their potential effect as anti metastatic agents

Sviluppo di un toolkit per la tele-nutrizione nel follow-up delle malattie cardiovascolari

INTRODUZIONE Per garantire la continuità dell’assistenza nutrizionale in Riabilitazione Cardiologica (RC) durante l’epidemia da COVID 19, è stato elaborato un toolkit per il teleconsulto nutrizionale, rivolto a pazienti con fattori di rischio modificabili correlati alle abitudini alimentari ed a pazienti a rischio nutrizionale. Il metodo di riferimento del presente lavoro è quello del Nutrition Care Process Terminology dell’Academy of Nutrition and Dietetics (AND), che persegue l’obiettivo di implementare un’assistenza nutrizionale sicura, efficace, centrata sulla persona, tempestiva, efficiente ed equa. MATERIALI E METODI Il toolkit è composto da cartelle nutrizionali elettroniche per il follow-up telematico rivolte ai pazienti più fragili (a rischio di malnutrizione), o in sovrappeso/obesi, diabetici, dislipidemici, ipertesi. Inoltre, sono stati creati strumenti e materiale didattico informativo utili ai pazienti per lo svolgimento del consulto telefonico/videochiamata nutrizionale. CONCLUSIONI Il ricorso al teleconsulto potrebbe ottimizzare l’efficacia dell’assistenza nutrizionale e l’aderenza dei pazienti, tramite una riduzione delle distanze, dei tempi di attesa, dei costi e dei disagi in generale per i pazienti stessi. La nostra prospettiva è quella di sviluppare un progetto di ricerca presso i Centri di RC per stabilire l’efficacia dell’utilizzo del toolkit nella pratica clinica in termini di outcome desiderati e di tempo dedicato al follow-up dei pazienti

Validation of the Italian version of the questionnaire on nutrition knowledge by Moynihan

Background and aims. A series of validation studies was performed on the Moynihan questionnaire to obtain data on nutrition knowledge, translated and adapted to Italian eating habits. Higher scores mean lower knowledge. Methods. Test-retest reliability was assessed administering the questionnaire at a 15-day interval in 52 inpatients. Factor structure and correlation with demographic and anthropometric characteristics were studied on a larger sample, which included a number of health professionals. Finally, sensitivity to change induced by an educational program was verified in a sample of 11 patients with type 1 diabetes. Results. Test-retest reliability was satisfactory; factor structure suggested one single principal component. Test scores were inversely correlated with age (r=0.24; p=0.02), but not with body mass index or waist circumference. Patients with higher education show a greater degree of nutrition knowledge. Among type 1 diabetic patients, an educational program induces a significant improvement of test scores (from 20.6 [18.6-22.8] to 16.6 [15.5-17.7], p=0.003). Conclusions. The Italian version of the questionnaire appears to be psychometrically adequate for its use in clinical research

Development of a toolkit for telenutrition in follow-up for cardiovascular disease

INTRODUCTION To ensure the continuity of nutritional care in Cardiovascular Rehabilitation (CR) during the COVID-19 epidemic emergency, a toolkit for telenutritional follow-up was developed for patients at nutritional risk and patients with modifiable risk factors related to eating habits. The reference method for this work is represented by the Nutrition Care Process and Terminology by the Academy of Nutrition and Dietetics (AND), which pursues the goal of implementing safe, effective, person-centred, timely, efficient and equitable nutritional care. MATERIALS AND METHODS The toolkit is composed of digital records for nutritional teleconsultation aimed at the most fragile (at risk for malnutrition), or overweight/obese, diabetic, dyslipidemic, hypertensive patients. In addition, it provides tools and educational/informative material useful to patients for carrying out the telephone consultation/video call. CONCLUSIONS This work - and telenutrition in general - could optimize the effectiveness of nutritional care and patient’s adherence, by reducing distances, waiting times, costs and other inconveniences. Our future goal is to develop a research project involving CR centers to establish the effectiveness of using the toolkit in clinical practice, in terms of desired outcomes and follow-up dedicated time