BMC Nutrition: Editor picks of 2018

2018 was an exciting year for BMC Nutrition, which published a wide range of interesting articles. Here are a few of the Editor’s favorite articles published over the last year.

Take a break to avoid a snack

Excessive sedentary time has been identified as a contributing factor to cardiovascular disease, but sedentary behavior is nevertheless becoming more common in the workplace. Alongside the adverse health effects associated with sedentary behavior, prolonged sitting also provides opportunity to snack, and subsequently the consumption of junk food is also linked to an increased chance of cardiovascular disease. Although sedentary behavior and diet are separate life style concerns, interventions addressing poor diet are often combined with interventions that address physical activity. Much is already known about combined interventions that address overall diet and physical activity, but much less is known about combined interventions that tackle both diet and sedentary behavior.

Snacking at work

This study by Casey et al investigates whether reduction of sedentary behavior leads to an alteration in caloric intake. To test this, participants were split up into one group of women having two 15 minute breaks a day, and another group of women having 1-2 minute breaks every half hour. The results of the study suggest that, overall, taking breaks during sedentary time at work reduces caloric intake over time. The researchers suggest that sedentary breaks should be further explored as a means to improve health outcomes for women.

Altered eating framework: improving the food-related quality of life for cancer survivors

Weight loss and eating-related concerns are commonly reported symptoms in advanced cancer patients and survivors. Despite its prevalence, there are no effective interventions to assess or improve food related quality of life for these individuals. Most studies related to this topic assess eating-related difficulties during treatment, but fail to address long term impacts of the ability to “eat well.” Additionally, studies that investigate eating-related difficulties usually focus on the functional aspect of eating, whilst the social and emotional aspects tend to be ignored. Aiming to improve of the food-related quality of life of cancer survivors, the authors consider a more holistic approach to “altered eating”.

I can’t join in the conversation with anybody else … because I can’t control the food in my mouth and I need to concentrate so hard on what I’m doing, you’re not part of the social group anyway

In order to assess and address the altered eating related difficulties experienced by cancer survivors, Watson et al worked alongside 25 head and neck cancer survivors and their partners. Over the course of 6 years, their workshops identified seven areas of life that affect or are affected by altered eating. These areas include not only anatomical, functional, and sensory alterations, but also the cognitive and behavioral labor of eating, as well as the alterations in social life and identity. As part of their study, the authors have developed a framework that allows assessment and treatment of altered eating, to improve food-related quality of life in cancer survivors.

Discrepancies between estimates of wasting measurements for classification of nutrition crisis severity

In areas experiencing widespread malnutrition, the prevalence of wasting found in the community acts as a benchmark to inform humanitarian aides on the scale and scope of the response needed. The current standards used by the World Health Organisation, United Nations High Commissioner for Refugees, International Federation of Red Cross, and World Food Programme are based on prevalence of wasting criteria as assessed by the weight-for-height Z scores (WHZ). In addition to WHZ, mid-upper arm circumference (MUAC) can be used as an independent measure of wasting. Although MUAC has become the recommended measure by the World Health Organisation and other public health agencies, there are no separate thresholds to classify crises assessed by MUAC.

Mother holding malnourished child
© dpa (Deutsche Presse-Agentur)

Previous research has demonstrated that there is substantial discrepancy in diagnosis of children as wasted using WHZ and MUAC. As a result, the validity of applying WHZ-based thresholds to MUAC-based estimates of wasting has been called into question. In their study, Bilukha and Leidman investigated the concordance of prevalence of wasting by WHZ and MUAC at the population level. The authors report that there is a poor correlation between population prevalence of wasting as measured by WHZ and MUAC.  Furthermore, they assert that surveys based on MUAC measurements will result in poor concordance with WHZ-based crisis thresholds. The data presented in this study suggest that MUAC may not be the best choice to use as a measurement to classify prevalence of wasting at the population level.

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