An insight of Romanians’ knowledge about dietary fibers in relationship with cancer

Objectives: To estimate the relationship between socio-demographic characteristics of Romanian population, and their knowledge towards dietary fiber intake, the information sources preferred and perception of cancer related health risks. Methods: We used a convenient cross-sectional survey, and the data were collected using a validated questionnaire, disseminated online. Six different Romanian counties with 57 cities were selected in 2015, with 670 participants, and we used the SPSS program 22.0 for statistical purpose. Results: The knowledge about dietary fibers intake was low in our sample, also was the ingestion of foods rich in fiber (fruits, vegetables and cereals). Compared to men, women agree significantly more frequent that fibers in appropriate amounts can prevent or treat diseases (U=44607, z=-4.66, p<0.001, r=0.18) and separately related to specific diseases, that fibers can prevent and/or treat cardio-vascular diseases, cholesterol, bowel cancer, breast cancer, constipation, and diabetes, but with no differences regarding the deficiency of vitamins and minerals (p=0.774) or obesity (p=0.399). The in-depth analysis of factors that are able to influence Romanian’s knowledge and attitudes towards food fibers, defined the social profile of the respondents with interest on dietary fiber intake, which is: young females, with at least high school education, that considers internet and television like main sources of information regarding fibers. Comparing to other EU countries, Romanian consumers have good information about dietary fibers importance for health but the daily intake is lower. Conclusions: Based on our results, we can elaborate efficient community and school intervention programs, more focused on modern information technology and communication skills, fit to the consumer’s profile in order to promote a healthy nutrition behavior and proper knowledge.info:eu-repo/semantics/publishedVersio

Intake Differences between Subsequent 24-h Dietary Recalls Create Significant Reporting Bias in Adults with Obesity

In depth understanding of the dietary patterns of individuals with obesity is needed in practice and research, in order to support dietitians and physicians in the design and implementation of nutritional management. We aimed to analyze the consistency of energy, macro-, and micronutrient reported intakes in four non-consecutive 24-h dietary recalls from 388 adults with obesity using information collected in the NutriGen Study (ClinicalTrials.gov, NCT02837367). Significant decreases were identified for reported energy and several, macro- and micronutrient intakes, between the first and subsequent 24-h recalls. Significant differences of reported intakes were identified in sensitivity analyses, suggesting that the first recall (also the only one performed on site, face-to-face) might be a point of bias. A comparison of the differences in intakes between weekend and weekday, after adjustment for false discovery rate were non-statistically significant either in male, females, or in total. To overcome this potential bias, studies should be carefully conducted, starting from the design phase, through to the analysis and interpretation phases of the study. Prior to averaging specific intakes across all sessions of reporting, a preliminary analysis must be conducted to identify if a certain time point had significant differences from all other time points and overview potential sources of bias: reporting bias, training bias, or behavioral changes could be responsible for such differences

Reliability and Validity of the Emotional Eater Questionnaire in Romanian Adults

Negative emotions and chronic stress trigger abnormal compensatory behaviors known as emotional eating (EE). EE is a well-known mediator for increased body mass index and weight gain. Our aim was to analyze the factor structure and validity and reliability of the Emotional Eater Questionnaire (EEQ) in a sample of 200 Romanian adults with excess weight. Principal component analysis (PCA) was used to assess the construct validity. The mindful eating questionnaire (MEQ) was used to test concurrent validity. Cronbach’s alpha and Spearman correlations were used to analyze internal and external reliability. The socio-demographic characteristics were used as factors for convergent validity. PCA revealed the existence of three major factors, disinhibition, type of food, and guilt, which accounted for 64.9% of the variance. Concurrent validity showed medium to large associations with MEQ (r = 0.650; p p < 0.001). Reliability was adequate with Cronbach’s alfa = 0.841 and ICC = 0.775. In a multivariate model, the highest contribution to the EE score was the age (beta = −0.327), followed by feminine gender (beta = 0.321), high levels of perceived stress (beta = 0.215), BMI (beta = 0.184) and lower perceived health status (beta = 0.184). The Romanian version of the EEQ is a reliable and valid tool for measuring emotional eating in adults with excess weight

Mindful Eating Questionnaire: Validation and Reliability in Romanian Adults

Mindful eating may play an important role in long-term weight maintenance. In interventions aiming at weight reduction, increasing the levels of mindful eating was associated with higher levels of success and lower levels of weight rebound in the long run. This study aimed to determine the validity and reliability of a mindful eating questionnaire for Romanian adults using Framson&rsquo;s Mindful Eating Questionnaire (MEQ). To calculate the internal (n = 495) and external (n = 45) reliability, a general population sample was taken. Construct validity was assessed using the &ldquo;known groups&rdquo; method: dietitians (n = 70), sports professionals (n = 52), and individuals with overweight and obesity (n = 200). Convergent validity tested the association between the MEQ score and demographic characteristics of the total sample (n = 617). The internal (0.72) and external (0.83) reliability were adequate. Dietitians and sports professionals had overall lower scores, meaning more mindful eating compared to the group of individuals with overweight and obesity. The lower mindful eating practice was associated with the presence of excess weight, suboptimal health status perception, higher levels of stress and younger age. The Romanian version of the MEQ is a reliable and valid tool for measuring mindfulness of eating in adults

Making Childhood Obesity a Priority : A Qualitative Study of Healthcare Professionals' Perspectives on Facilitating Communication and Improving Treatment

In Romania, one in four children has excess weight. Because childhood obesity is a sensitive topic, many healthcare professionals find it difficult to discuss children's excess weight with parents. This study aims to identify barriers and facilitators in childhood obesity-related communication, as perceived by healthcare professionals in Romania. As part of the STOP project, healthcare professionals (family physicians, pediatricians, and dieticians) who treat children with excess weight were invited to a telephone interview. The semi-structured questions were translated from a questionnaire previously used at the Swedish study site of the STOP project. Interviews were transcribed and then used for thematic analysis. Fifteen doctors and three dieticians (16 females and 2 males), with average 18.2 ± 10.1 years of experience, were interviewed. Four main themes were identified. Professionals reported that when children began experiencing obesity-related stigma or comorbidities, this became the tipping point of weight excess, where parents felt motivated to begin treatment. Barriers in communication were part of several layers of distrust, recognized as tension between professionals and caregivers due to conflicting beliefs about excess weight, as well as lack of trust in medical studies. Most respondents felt confident using models of good practice, consisting of a gentle approach and patient-centered care. Nonetheless, professionals noted systemic barriers due to a referral system and allocation of clinical time that hinder obesity treatment. They suggested that lack of specialized centers and inadequate education of healthcare professional conveys the system does not prioritize obesity treatment and prevention. The interviewed Romanian doctors and dieticians identified patient-centered care as key to treating children with obesity and building trust with their caregivers. However their efforts are hindered by healthcare system barriers, including the lack of specialized centers, training, and a referral system. The findings therefore suggest that, to improve childhood obesity prevention and treatment, systemic barriers should be addressed. Trial Registration: ClinicalTrials.gov, NCT03800823; 11 Jan 2019

An insight of Europeans’ knowledge about dietary fibers in relationship with obesity

Objectives: To estimate the relationship between socio-demographic characteristics of Romanian population, and their knowledge towards dietary fibre intake, the information sources preferred and perception of obesity related health risks. Methods: We used a convenient cross-sectional survey, and the data were collected using a validated questionnaire, disseminated online. Six different Romanian counties with 57 cities were selected in 2016, with 670 participants, and we used the SPSS program 22.0 for statistical purpose. The same questionnaire was applied in other 7 European countries, part of an international project design. Results: The knowledge about dietary fibres intake was low in Romanian sample, also was the ingestion of foods rich in fibre (fruits, vegetables and cereals). Compared to men, women agree significantly more frequent that fibres in appropriate amounts can prevent or treat diseases (U=44607, z=-4.66, p<0.001, r=0.18) and separately related to specific diseases, that fibres can prevent and/or treat cardio-vascular diseases, cholesterol, bowel cancer, breast cancer, constipation, and diabetes, but with no differences regarding the deficiency of vitamins and minerals (p=0.774) or obesity (p=0.399). Regarding the differences observed by countries, the highest fruit consumption was found for Portugal (11.7 portions per week), while the lowest was for Hungary (7.4) and Latvia (7.1). Turkey that had the highest interest for food labelling (4.0 points), contrarily to Macedonia (3.0) with the lowest value, and Hungary with 3.6 points. The indepth analysis of factors that are able to influence European’s knowledge and attitudes towards food fibres, defined the social profile of the respondents with interest on dietary fibre intake, which is: young females, with at least high school education, that considers internet and television like main sources of information regarding fibres. Conclusions: Based on our results, we can elaborate efficient community and school intervention programs, more focused on modern information technology and communication skills, fit to the consumer’s profile in order to promote a healthy nutrition behavior and proper knowledge.info:eu-repo/semantics/publishedVersio

Long-Term Effects of Continuous Positive Airway Pressure (CPAP) Therapy on Obesity and Cardiovascular Comorbidities in Patients with Obstructive Sleep Apnea and Resistant Hypertension—An Observational Study

Background: We sought to investigate whether long-term continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA) and resistant hypertension (RHTN) could attenuate the cardiovascular disease risk by lowering their body-mass index (BMI). Methods: This was a long-term observational study of RHTN patients diagnosed with OSA. Patients were evaluated with polysomnography initially and after a mean follow-up period of four years. The patients were divided into two groups based on their compliance to CPAP therapy. Results: 33 patients (aged 54.67 &plusmn; 7.5, 18 men, 54.5%) were included in the study, of which 12 were compliant to CPAP therapy. A significant reduction in BMI at follow-up was noted in patients compliant to CPAP therapy (1.4 &plusmn; 3.5 vs. &minus;1.6 &plusmn; 2.5, p = 0.006). We also noted a large effect size reduction in abdominal circumference at follow-up in the CPAP group. At follow-up evaluation, the mean heart rate (b/min) was lower in the CPAP group (58.6 &plusmn; 9.5 vs. 67.8 &plusmn; 7.8), while arrhythmia prevalence increased between initial (28.6%) and follow-up (42.9%) evaluation with an intermediate effect size in non-compliant patients. Conclusions: In our cohort of OSA patients with RHTN, long-term adherence to CPAP therapy was associated with weight loss and improvement in cardiac rhythm outcomes

High Carbohydrate Diet Is Associated with Severe Clinical Indicators, but Not with Nutrition Knowledge Score in Patients with Multiple Myeloma

Although the survival rate of patients diagnosed with multiple myeloma has doubled over the last few decades, due to the introduction of new therapeutic lines and improvement of care, other potential contributors to the therapeutic response/relapse of disease, such as nutrient intake, along with nutrition knowledge, have not been assessed during the course of the disease. The purpose of this research was to assess nutrition knowledge and diet quality in a group of patients with a diagnosis of multiple myeloma. Anthropometric, clinical and biological assessments and skeletal survey evaluations, along with the assessment of nutritional intake and general nutrition knowledge, were performed on 61 patients with a current diagnosis of multiple myeloma. A low carbohydrate diet score was computed, classified in tertiles, and used as a factor in the analysis. Patients in tertiles indicative of high carbohydrate or low carbohydrate intake showed significant alteration of clinical parameters, such as hemoglobin, uric acid, albumin, total proteins, beta-2 microglobulin, percentage of plasmacytes in the bone marrow and D-dimers, compared to patients in the medium carbohydrate intake tertile. Nutrition knowledge was not associated with clinical indicators of disease status, nor with patterns of nutrient intake. Better knowledge of food types and nutritional value of foods, along with personalized nutritional advice, could encourage patients with MM to make healthier decisions that might extend survival

Population preferences for sources that offers information about dietary fibres health effects - an international cross-sectional survey

Objective: To investigate the perceived importance of information about dietary fibre with regard to population socio -demographic characteristics and consumption patterns. Methods: The cross-sectional study was conducted from September to November, 2016, in six different counties and 57 cities across Romania, and was part of a larger project that had nine other countries as well. Data of the Romanian subjects was collected using a validated questionnaire that was disseminated across the 10 countries at the same time. Knowledge about dietary fibre was explored through 10 questions, and the respondents were asked to answer on a 5-point Likert scale varying from 1 (totally disagree) to 5 (totally agree). SPSS 22 was used for data anaylsis. Results: Of the 670 subjects, 358 (53.4%) were females, and the overall mean age was 35.81±15.61 years (range: 18-89 years). There were 298 (44.5%) subjects with a university degree, 314(46.9%) had completed high school and 57 (8.5%) had done primary school. Besides, 568 (84.8%) participants lived in an urban environment. Internet was the main source of getting information for 368(54.9%) subjects, while the lowest was hospitals 122 (18.2%). The percentage of correct answers regarding knowledge about health effects of dietary fibre was 23.12%. Most accurate answers were related to deficiency of vitamins and minerals 370 (55.5%), breast cancer 202(30.3%), vision problems 202(30.3%) and diabetes 168 (25.2%). The question with least accurate answer was the one about general preventive characteristics of dietary fibres 65 (9.7%). Conclusions: A proper and friendly way to transmit information about the importance of dietary fibre consumption is critical in promoting healthy diet patterns and in preventing non-transmissible diseases.info:eu-repo/semantics/publishedVersio

Intake Differences between Subsequent 24-h Dietary Recalls Create Significant Reporting Bias in Adults with Obesity

In depth understanding of the dietary patterns of individuals with obesity is needed in practice and research, in order to support dietitians and physicians in the design and implementation of nutritional management. We aimed to analyze the consistency of energy, macro-, and micronutrient reported intakes in four non-consecutive 24-h dietary recalls from 388 adults with obesity using information collected in the NutriGen Study (ClinicalTrials.gov, NCT02837367). Significant decreases were identified for reported energy and several, macro- and micronutrient intakes, between the first and subsequent 24-h recalls. Significant differences of reported intakes were identified in sensitivity analyses, suggesting that the first recall (also the only one performed on site, face-to-face) might be a point of bias. A comparison of the differences in intakes between weekend and weekday, after adjustment for false discovery rate were non-statistically significant either in male, females, or in total. To overcome this potential bias, studies should be carefully conducted, starting from the design phase, through to the analysis and interpretation phases of the study. Prior to averaging specific intakes across all sessions of reporting, a preliminary analysis must be conducted to identify if a certain time point had significant differences from all other time points and overview potential sources of bias: reporting bias, training bias, or behavioral changes could be responsible for such differences