Dietary Education Provision Within a Cardiac Rehabilitation Programme in the UK: A Pilot Study Evaluating Nutritional Intakes Alongside Physical Activity Levels

Background/aims: The primary aim of this study was to evaluate the effectiveness of two 30-minute dietary education sessions, within cardiac rehabilitation (CR), as a means to optimise nutrient and energy intakes (EI). A secondary aim was to evaluate patients’ habitual physical activity (PA) levels. Methods: Thirty patients (males: n = 24, 61.8 ± 11.2 years; females: n = 6, 66.7 ± 8.5 years) attended a six-week early outpatient CR programme in the UK and received two 30-minute dietary education sessions emphasising Mediterranean diet principles. EI and nutrient intakes were measured through completion of three-day food diaries in weeks one and six (before and after the dietary education sessions) to assess the impact of these sessions on nutrient intakes. At the same time-points, a sub-group (n = 13) of patients had their PA levels assessed via accelerometery to assess the impact of the CR programme on PA. Findings: Estimated energy requirements (EER) at week one (1988 ± 366 kcal . d -1 ) were not matched by actual EI (1785 ± 561 kcal . d -1 ) ( P = 0.047, d = -0.36). EI reduced to 1655 ± 470 kcal . d -1 at week six ( P = 0.66, d = -0.33) whereas EER increased as a function of increased activity (CR sessions). Nutrient intakes remained suboptimal, while no significant increases were observed in healthy fats and fibre, which consist core elements of a Mediterranean diet. Statistically significant increases were not observed in PA however patients decreased sedentary time by 11 ± 12% in week six compared to week one ( P = 0.009; d = -0.54). Conclusion : The present study findings suggest that two 30-minute dietary education sessions did not positively influence EI and nutrient intakes, while habitual PA levels were not significantly increased as a result of the CR programme. Future research should explore means of optimising nutrition and habitual PA within UK CR

Immunotherapy of spontaneous mammary carcinoma with fusions of dendritic cells and mucin 1-positive carcinoma cells

The tumour-associated antigen mucin 1 (MUC1) is a multifunctional protein involved in protection of mucous membranes, signal transduction, and modulation of the immune system. More than 70% of cancers overexpress MUC1, making MUC1 a potential target for immunotherapy. In the present study, MUC1 transgenic mice were crossed with syngeneic strains that express the polyomavirus middle-T oncogene (PyMT) driven by the mouse mammary tumour virus promoter long-terminal repeat (MMTV-LTR). The resultant breed (MMT mice) developed spontaneous MUC1-expressing mammary carcinomas with 100% penetrance at 8–15 weeks of age. As found in human breast cancer, the mammary carcinoma in MMT mice arose in multiple stages. Immunization with fusions of dendritic cells and MUC1-positive tumour cells (FC/MUC1) induced MUC1-specific immune responses that blocked or delayed the development of spontaneous breast carcinomas. In contrast, there was no delay of tumour development in MMT mice immunized with irradiated MC38/MUC1 tumour cells. The efficacy of fusion cells was closely correlated with the timing of initial immunization. Immunization with FC/MUC1 initiated in MMT mice at < 1, 1–2 and 2–3 months of age rendered 33, 5 and 0% of mice free of tumour, respectively, up to 6 months. Whereas mice immunized in the later stage of tumour development succumbed to their disease, immunization resulted in control of tumour progression and prolongation of life. These results indicate that immunization with FC/MUC1 can generate an anti-MUC1 response that is sufficient to delay the development of spontaneous mammary carcinomas and control tumour progression in MMT mice