OBSERVED COOKING BEHAVIORS OF FAMILIES WITH AND WITHOUT CHILDHOOD CANCER SURVIVORS AND THE DEVELOPMENT OF A HEALTHY COOKING ASSESSMENT TOOL

Diet is a modifiable risk factor for several cancers and other chronic diseases. Cooking skills are a target for dietary intervention, with much of the general population reporting infrequent and inadequate home preparation of meals. Childhood cancer survivors (CCS) are a population at high risk of several chronic conditions including secondary cancers that may be influenced by home cooking behaviors. We conducted observations of food preparation practices in 29 parents of healthy school-aged children and 11 parents of CCS. Observations included an audio and video recording of one evening meal per family. Parents were asked to wear a small body camera unit (eButton) during the cooking session. Ingredient amounts were be observed and recorded during the video sessions and final prepared foods analyzed for micronutrient and macronutrient quantities. Resulting videos were coded for healthy cooking behaviors using the Healthy Cooking Score (HCS) coding system, based on a conceptual framework previously developed by the authors. Families were assigned HCS based on the video analysis. Parents filled out a healthy cooking behavior questionnaire constructed from the conceptual framework. Height and weight was assessed from children and general family demographics and parenting practices collected from parents. Observed and self-reported healthy cooking behaviors were shown to be significantly different, with nine HCS items responsible for the majority of discrepancy between self report and observed cooking behaviors. The eButton images were examined and compared to audio/video observations of the cooking sessions. The eButton closely approximated the audio/video observations, but failed to collect usable images in 5 out of 40 cases. CCS cooking habits were compared to non CCS families and showed similar cooking habits. Qualitative analysis of the CCS family cooking videos revealed four major meal planning values in the sample including health, budget, effort and preferences. Several of these values were impacted by the cancer experience. Taken together, this study provides preliminary data for the assessment and development of healthy cooking programming in CCS and the general populatio

Brighter Sights: Using Photovoice for a Process Evaluation of a Food Co-op Style Nutrition Intervention

Access to healthy food is a critical factor impacting childhood obesity. Brighter Bites is a school-based program that addresses the issue of fresh food access among low-income families living in food deserts using a food co-op model. The aim of this study is to evaluate initial parent participant reactions to the ongoing Brighter Bites program using Photovoice. A predominately Hispanic, economically disadvantaged, urban school was chosen as the site for the Photovoice project. A total of seven Brighter Bites parent participants were enrolled and six completed the study. The participants developed research questions, took documentary photographs, completed a group analysis of the resulting photos, selected key images and created accompanying captions for a community event. During analysis of the photographs by the group, eight major themes emerged including: impact on the family food budget, produce quality, exposure to unknown fruits and vegetables, socializing with other parents, strategies to use/get children to eat produce, child curiosity of program, and children having fun helping with produce. These themes informed researchers of possible target areas for future program development and quality improvement. The positive nature of most photographs and comments suggests the program is being accepted in the community and impacting local families with regard to food access, food security and healthy eating behaviors

Increasing Referral of LBJ Patients to the Active Living After Cancer (ALAC) Program

https://openworks.mdanderson.org/sumexp21/1032/thumbnail.jp

Feasible Diet and Circadian Interventions Reduce In Vivo Progression of FLT3-ITD-Positive Acute Myeloid Leukemia

BACKGROUND: Acute myeloid leukemia (AML) with an internal tandem duplication in the fms-like tyrosine kinase receptor 3 gene (FLT3-ITD) is associated with poor survival, and few studies have examined the impact of modifiable behaviors, such as nutrient quality and timing, in this subset of acute leukemia. METHODS: The influence of diet composition (low-sucrose and/or low-fat diets) and timing of diet were tested in tandem with anthracycline treatment in orthotopic xenograft mouse models. A pilot clinical study to test receptivity of pediatric leukemia patients to macronutrient matched foods was conducted. A role for the circadian protein, BMAL1 (brain and muscle ARNT-like 1), in effects of diet timing was studied by overexpression in FLT3-ITD-bearing AML cells. RESULTS: Reduced tumor burden in FLT3-ITD AML-bearing mice was observed with interventions utilizing low-sucrose and/or low-fat diets, or time-restricted feeding (TRF) compared to mice fed normal chow ad libitum. In a tasting study, macronutrient matched low-sucrose and low-fat meals were offered to pediatric acute leukemia patients who largely reported liking the meals. Expression of the circadian protein, BMAL1, was heightened with TRF and the low-sucrose diet. BMAL1 overexpression and treatment with a pharmacological inducer of BMAL1 was cytotoxic to FLT3-ITD AML cells. CONCLUSIONS: Mouse models for FLT3-ITD AML show that diet composition and timing slows progression of FLT3-ITD AML growth in vivo, potentially mediated by BMAL1. These interventions to enhance therapy efficacy show preliminary feasibility, as pediatric leukemia patients responded favorable to preparation of macronutrient matched meals

Feasible Diet and Circadian Interventions Reduce In Vivo Progression of FLT3-ITD-Positive Acute Myeloid Leukemia

BACKGROUND: Acute myeloid leukemia (AML) with an internal tandem duplication in the fms-like tyrosine kinase receptor 3 gene (FLT3-ITD) is associated with poor survival, and few studies have examined the impact of modifiable behaviors, such as nutrient quality and timing, in this subset of acute leukemia. METHODS: The influence of diet composition (low-sucrose and/or low-fat diets) and timing of diet were tested in tandem with anthracycline treatment in orthotopic xenograft mouse models. A pilot clinical study to test receptivity of pediatric leukemia patients to macronutrient matched foods was conducted. A role for the circadian protein, BMAL1 (brain and muscle ARNT-like 1), in effects of diet timing was studied by overexpression in FLT3-ITD-bearing AML cells. RESULTS: Reduced tumor burden in FLT3-ITD AML-bearing mice was observed with interventions utilizing low-sucrose and/or low-fat diets, or time-restricted feeding (TRF) compared to mice fed normal chow ad libitum. In a tasting study, macronutrient matched low-sucrose and low-fat meals were offered to pediatric acute leukemia patients who largely reported liking the meals. Expression of the circadian protein, BMAL1, was heightened with TRF and the low-sucrose diet. BMAL1 overexpression and treatment with a pharmacological inducer of BMAL1 was cytotoxic to FLT3-ITD AML cells. CONCLUSIONS: Mouse models for FLT3-ITD AML show that diet composition and timing slows progression of FLT3-ITD AML growth in vivo, potentially mediated by BMAL1. These interventions to enhance therapy efficacy show preliminary feasibility, as pediatric leukemia patients responded favorable to preparation of macronutrient matched meals

The Timing of Differentiation of Adult Hippocampal Neurons Is Crucial for Spatial Memory

Adult neurogenesis in the dentate gyrus plays a critical role in hippocampus-dependent spatial learning. It remains unknown, however, how new neurons become functionally integrated into spatial circuits and contribute to hippocampus-mediated forms of learning and memory. To investigate these issues, we used a mouse model in which the differentiation of adult-generated dentate gyrus neurons can be anticipated by conditionally expressing the pro-differentiative gene PC3 (Tis21/BTG2) in nestin-positive progenitor cells. In contrast to previous studies that affected the number of newly generated neurons, this strategy selectively changes their timing of differentiation. New, adult-generated dentate gyrus progenitors, in which the PC3 transgene was expressed, showed accelerated differentiation and significantly reduced dendritic arborization and spine density. Functionally, this genetic manipulation specifically affected different hippocampus-dependent learning and memory tasks, including contextual fear conditioning, and selectively reduced synaptic plasticity in the dentate gyrus. Morphological and functional analyses of hippocampal neurons at different stages of differentiation, following transgene activation within defined time-windows, revealed that the new, adult-generated neurons up to 3–4 weeks of age are required not only to acquire new spatial information but also to use previously consolidated memories. Thus, the correct unwinding of these key memory functions, which can be an expression of the ability of adult-generated neurons to link subsequent events in memory circuits, is critically dependent on the correct timing of the initial stages of neuron maturation and connection to existing circuits

Developing a conceptual model to define and measure healthy cooking behavior for cancer prevention

Cancer is a leading cause of mortality in the United States (U.S.), accounting for nearly a quarter of deaths. Obesity and diet are modifiable risk factors of particular concern for cancer prevention as the nation faces an obesity epidemic and population adherence to national diet recommendations remains dismally low. Food and diet have both a direct and indirect relationship to cancer risk. Cooking could potentially influence cancer risk through its effect on weight status and diet quality as well as carcinogenic compound development on food as it is being prepared. Research shows promise for cooking skill development as an avenue to control weight, improve diet and reduce cancer risk. A major limitation of the current research on cooking and its relationship to diet quality, cancer risk and health outcomes is the lack of validated, consistent tools for measuring cooking. The purpose of this project is to review the existing literature on cooking and identify gaps, develop a clear conceptual framework defining healthy cooking and create a coding system of healthy cooking skills for use in future studies.

Unique Features of a Web-Based Nutrition Website for Childhood Cancer Populations: Descriptive Study

BackgroundChildren with cancer experience a myriad of nutritional challenges that impact their nutrition status during treatment and into survivorship. Growing evidence suggests that weight at diagnosis impacts cancer outcomes, but provider guidance on nutrition and diet during treatment varies. Nutrition literacy and culinary resources may help mitigate some common nutritional problems; however, many patients may face barriers to accessing in-person classes. Along with dietitian-led clinical interventions, web-based resources such as the newly updated electronic cookbook (e-cookbook) created by The University of Texas MD Anderson Cancer Center, @TheTable, may facilitate access to nutrition and culinary education during treatment and into survivorship. ObjectiveWe sought to define and describe the features and content of the @TheTable e-cookbook and compare it with analogous resources for a lay audience of patients with childhood cancer and childhood cancer survivors as well as their families. MethodsWe evaluated freely available web-based resources via a popular online search engine (ie, Google). These searches yielded three web-based resources analogous to @TheTable: the American Institute for Cancer Research’s Healthy Recipes, The Children’s Hospital of San Antonio’s Culinary Health Education for Families Recipe for Life, and Ann Ogden Gaffney and Fred Hutchinson Cancer Research Center’s Cook for Your Life. These sites were analyzed for the following: number of recipes, search functionality, child or family focus, cancer focus, specific dietary guidance, videos or other media, and miscellaneous unique features. ResultsCook for Your Life and Culinary Health Education for Families Recipe for Life were the most comparable to @TheTable with respect to cancer focus and family focus, respectively. Healthy Recipes is the least user-friendly, with few search options and no didactic videos. ConclusionsThe @TheTable e-cookbook is unique in its offering of child- and family-focused content centered on the cancer and survivorship experience

Utility of eButton images for identifying food preparation behaviors and meal-related tasks in adolescents

Abstract Background Food preparation skills may encourage healthy eating. Traditional assessment of child food preparation employs self- or parent proxy-reporting methods, which are prone to error. The eButton is a wearable all-day camera that has promise as an objective, passive method for measuring child food preparation practices. Purpose This paper explores the feasibility of the eButton to reliably capture home food preparation behaviors and practices in a sample of pre- and early adolescents (ages 9 to 13). Methods This is a secondary analysis of two eButton pilot projects evaluating the dietary intake of pre- and early adolescents in or around Houston, Texas. Food preparation behaviors were coded into seven major categories including: browsing, altering food/adding seasoning, food media, meal related tasks, prep work, cooking and observing. Inter-coder reliability was measured using Cohen’s kappa and percent agreement. Results Analysis was completed on data for 31 participants. The most common activity was browsing in the pantry or fridge. Few participants demonstrated any food preparation work beyond unwrapping of food packages and combining two or more ingredients; actual cutting or measuring of foods were rare. Conclusions Although previous research suggests children who “help” prepare meals may obtain some dietary benefit, accurate assessment tools of food preparation behavior are lacking. The eButton offers a feasible approach to food preparation behavior measurement among pre- and early adolescents. Follow up research exploring the validity of this method in a larger sample, and comparisons between cooking behavior and dietary intake are needed