Exercise levels and preferences in cancer patients: A cross-sectional study

Background: Despite the benefits related to physical exercise, large numbers of cancer patients are not sufficiently active. Methods: To investigate exercise levels and preferences in cancer patients, a cross-sectional study was conducted on a random sample of 392 cancer outpatients who anonymously completed a questionnaire investigating general and medical characteristics, and expressed willingness to participate in exercise programs. Current exercise levels were estimated with the Leisure Score Index (LSI). Results: Most patients (93%) were insufficiently active but 80% declared an interest in exercise programs. Patients preferred oncologist-instructed programs and specified particular exercise needs. Multivariate logistic regression showed that willingness to exercise was associated with education (OR: 1.87; 95% CI: 1.15–3.04 beyond age 14 years vs. up to 14 years) and current physical activity (OR: 1.92; 95% CI: 1.92–3.63 for sweat-inducing activity >2 times/week vs. <1 time/week). Patients given chemotherapy were less inclined to exercise (OR: 0.45; 95% CI: 0.23–0.86) than those who did not. LSI was lower if cancer stage was advanced (β:-0.36; 95% CI: −0.75 to −0.02) than if it was in remission. High LSI was also associated with longer education, lower BMI, and longer time after diagnosis. Conclusion: Cancer patients are insufficiently active but are willing to participate in personalized exercise programs. Information from this survey may help in designing personalized interventions so these patients will achieve sufficient exercise

Body composition as a modulator of response to immunotherapy in lung cancer: time to deal with it

[no abstract available

A cross-sectional study evaluating the exercise discussion with oncologist during cancer consultation: the CONNECT study

Background: Evidence demonstrates that physical exercise confers several psycho-physical benefits on patients with cancer. This study aims to investigate the role of oncologists in exercise promotion. Patients and methods: A multicenter, cross-sectional study was conducted by distributing an anonymous, self-administered questionnaire to patients with cancer. The questionnaire enclosed demographic, health, and exercise variables. The exercise-related questions included in the study used the Godin-Shephard Leisure-Time Physical Activity Questionnaire to measure the amount of physical exercise. In addition, the survey gathered information on whether exercise was discussed with patients, and whether oncologists followed the assess, advise, reinforce, and refer (AARR) process regarding exercise. The survey also asked if patients preferred that exercise be discussed during their consultations. Descriptive statistics and logistic regression were applied. Results: With a response rate of 75%, a total of 549 patients completed the survey. Regarding the exercise discussion, 38% of patients stated that their oncologist initiated an exercise discussion, 14% started the discussion themselves, and 48% said that the issue was not considered. Overall, 35% of patients reported that the oncologist assessed their exercise level, 22% and 42% received advice or reinforcement to increase their exercise, respectively, and 10% were referred to a dedicated service. Regarding preferences, 72% of patients thought that the oncologists should initiate an exercise discussion, 2% that only patients should start the discussion, and 26% thought that the issue should not be discussed. Similarly, 74% of patients are willing to receive the exercise assessment, 59% and 75% the advice and reinforcement to increase their exercise, and 46% to be referred to an exercise service. Conclusions: Although exercise promotion rates are low, patients are willing to receive exercise information. Dedicated strategies should be developed to support oncologists in promoting exercise to their patients

Body composition parameters, immunonutritional indexes, and surgical outcome of pancreatic cancer patients resected after neoadjuvant therapy: A retrospective, multicenter analysis

Background and aims: Body composition parameters and immunonutritional indexes provide useful information on the nutritional and inflammatory status of patients. We sought to investigate whether they predict the postoperative outcome in patients with pancreatic cancer (PC) who received neoadjuvant therapy (NAT) and then pancreaticoduodenectomy. Methods: Data from locally advanced PC patients who underwent NAT followed by pancreaticoduodenectomy between January 2012 and December 2019 in four high-volume institutions were collected retrospectively. Only patients with two available CT scans (before and after NAT) and immunonutritional indexes (before surgery) available were included. Body composition was assessed and immunonutritional indexes collected were: VAT, SAT, SMI, SMA, PLR, NLR, LMR, and PNI. The postoperative outcomes evaluated were overall morbidity (any complication occurring), major complications (Clavien-Dindo ≥ 3), and length of stay. Results: One hundred twenty-one patients met the inclusion criteria and constituted the study population. The median age at the diagnosis was 64 years (IQR16), and the median BMI was 24 kg/m2 (IQR 4.1). The median time between the two CT-scan examined was 188 days (IQR 48). Skeletal muscle index (SMI) decreased after NAT, with a median delta of −7.8 cm2/m2 (p < 0.05). Major complications occurred more frequently in patients with a lower pre-NAT SMI (p = 0.035) and in those who gained in subcutaneous adipose tissue (SAT) compartment during NAT (p = 0.043). Patients with a gain in SMI experienced fewer major postoperative complications (p = 0.002). The presence of Low muscle mass after NAT was associated with a longer hospital stay [Beta 5.1, 95%CI (1.5, 8.7), p = 0.006]. An increase in SMI from 35 to 40 cm2/m2 was a protective factor with respect to overall postoperative complications [OR 0.43, 95% (CI 0.21, 0.86), p < 0.001]. None of the immunonutritional indexes investigated predicted the postoperative outcome. Conclusion: Body composition changes during NAT are associated with surgical outcome in PC patients who receive pancreaticoduodenectomy after NAT. An increase in SMI during NAT should be favored to ameliorate the postoperative outcome. Immunonutritional indexes did not show to be capable of predicting the surgical outcome

Factors behind consumers' choices for healthy fruits: a review of pomegranate and its food derivatives

Due to the rising interest in healthy products, superfoods such as pomegranate have begun to spread widely on the international market in recent years. Identification of the consumer choice determinants is a key factor behind the success of innovative products. Nevertheless, to date, there has been no comprehensive analysis of consumers’ preferences for pomegranate. The aim of this study is to understand the characteristics of pomegranate and its derivatives that are most preferred by consumers and to identify the buyers’ profiles by performing a systematic review (SR). The results suggest that there is not equal interest in the literature in all areas of the review. Indeed, most efforts have been made in characterizing the products, whereas consumers’ profiles and their willingness to pay for the various products features have been scarcely investigated. The SR highlights that consumer preference is first correlated with taste and, in particular, with the sweetness (positively) and astringency (negatively) of the product. The red colour and uniform shape of the husk are attractive attributes for consumers, as is the juiciness of the arils. Some innovative methods of product storage, such as intermittent heating (for fruits) and the use of pectin methyl esterase (for arils), guarantee higher consumer acceptability due to the maintenance of product genuineness. Moreover, familiarity with the product seems to be the main driver influencing consumers’ purchase decisions; in addition, people who are more “future oriented” are more willing to pay for pomegranate because of the nutraceutical attributes stressed on the label

Is it really a piece of cake to label Geographical Indications with the Nutri-Score? Consumers’ behaviour and policy implications

To improve the dietary habits of the population, the EU, within the Farm to Fork strategy (F2F), is strongly supporting the Nutri-Score (NS) Front Of Pack (FOP) label. Under the NS system, Geographical Indications (GIs) are generally scored as “unhealthy” food, given the predominance of products of animal origin among GIs which are, notoriously, high-fat products. This study aims to determine the impact of the NS label on consumers’ preferences for two Protected Designation of Origin (PDO) cheeses, in comparison with generic ones. A Discrete Choice Experiment (DCE) was conducted on 600 Italian consumers through the estimation of a Random Parameter Logit model. Results highlighted that Italian consumers are generally not familiar with the NS and perceive it as a positive characteristic of the product, even if it is signalling an unhealthy choice (D score). However, consumers aware of the Nutri-Score meaning are willing to pay less to buy a product considered “unhealthy” according to this system. Furthermore, we found that consumers who already knew the NS system have homogeneous behaviours in rejecting the product, independently of the association with a PDO certification. This result has important implications on the agri-food sector. If the Nutri-Score becomes mandatory in the EU, consumers might refuse many GIs due to their negative Nutri-Score values. However, the quality of these products is recognized and protected worldwide. In this vein, the GI policy could be questioned by the F2F strategy: both of them aims to reduce information asymmetry producing, at the same time, contrasting results. Within the Geographical Indication policy, the PDO and PGI goods are protected for their quality attributes, which are strictly linked to their geographical origin of the products and traditional know-how. However, the EU adoption of the Nutri-Score could damage these products, reducing their perceived quality/value

When less isn't more and more isn't less: is there an overlap between “protected designation of origin”, “mountain product” and “organic” in Italy?

PurposeUsing a generic cheese as an anchor product, in this study consumers' preferences for different EU quality schemes have been investigated. Specifically, the study aims to understand whether "Protected Designation of Origin" (PDO), "Organic" and "Mountain Product" labels are independent or if there are some synergies existing between them, questioning - at the same time - whether this alleged exchange of value plays a positive or negative role in terms of consumers' willingness to pay.Design/methodology/approachA discrete choice experiment (DCE) was conducted on 600 Italian consumers performing a random parameter logit model. The respondents were representative of the Italian population in terms of age, gender and geographical distribution. Consumers' preferences for the presence of "Organic" and "Mountain product" labels were assessed in the DCE, together with the effect of price, for both PDO and generic cheeses.FindingsConsumers are willing to pay a premium in price for "Organic" and "Mountain Product" per se, for cheese with and without the PDO denomination. Considering the interaction effects, results showed that the combined use of "Organic" and "Mountain Product" labels do not decrease consumers' intention to buy. However, when applied on a PDO product, these attributes generate a lower consumers' willingness to pay in comparison with the generic ones, highlighting a possible overlapping between them.Originality/valueDespite the abundant literature on EU quality schemes in many food categories, this study represents one of the first attempts to measure the interaction effect between different EU quality schemes

Analysing farmers\u2019 intention to adopt web marketing under a technology-organisation-environment perspective: A case study in Italy

This study explores the factors that affect the intention to adopt web marketing (WM) at farm level as an innovation for business purposes. Data were collected from a direct survey among Italian farmers. The paper applies the Technology-Organisation-Environment (TOE) framework. Among the variables considered, the results mainly show that a higher perceived usefulness of WM leads to a greater intention to adopt it from farmers. Similarly, the intention to adopt WM is positively influenced by the customers\u2018 readiness to use this technology and the perceived ease of use. Moreover, the intention to adopt is lower for the farms showing a greater size. Surprisingly, the perception of cus-tomers\u2019 positive expectation about WM adoption by the farm shows a negative effect, suggesting that external pressures can inhibit farmers\u2019 intention. Findings are valuable to understand how to develop policies to support WM adoption among farmers, that is important to gain access to the market especially for smallholders

Does Italian origin really determine a price premium for fluid milk? Evidences from a hedonic price analysis

The regulation 1169/2011, which aims to protect the consumers in relation to food information, stresses the fact that the country of origin is become a key attribute for consumers in their purchasing decision. In 2014, the Italian Ministry of Agricultural, Food and Forestry Policies, with the Decree of 9 December 2016 \ue2' based on art. 26 of Reg. 1169/2011-introduced the obligation of labelling the country origin of milk used in all dairy products and therefore for the first time for uht milk. In this context, the aim of the study is to evaluate the price premium of different quality attributes on uht milk sold in Italy, with particular regard to the country of origin of milk. From the analysis, it emerges that Italian origin of milk has a significant and positive effect on price, together with the type of retailer (i.e. hypermarket), notorious brands, plastic packaging, high and middle placement on the shelves, organic attribute and the enrichment with omega 3, phosphorus or fibre