Time for food - training physiatrists in nutritional prescription

Polak, Rani; Dacey, Marie; Phillips, Edward M.

doi:10.2340/16501977-2178

Cited by 3 publications

(2 citation statements)

References 83 publications

(118 reference statements)

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“…Latest literature recommends that nutritional counseling focused on micro-/macronutrients (such as vitamins, minerals, saturated fat, proteins, etc.) does not end up with adequate development in eating behaviors and may also cause an unnecessary increase in supplements consumption [108]. Additionally, due to reduced dietary intake and changed metabolism and absorption, cancer survivors often do not respond well to nutritional supplements [11].…”

Section: How Can We Implement This Knowledge In Clinical Practice?mentioning

confidence: 99%

Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors?

Yılmaz

Malfliet

Elma

et al. 2022

JCM

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Evidence for the relationship between chronic pain and nutrition is mounting, and chronic pain following cancer is gaining recognition as a significant area for improving health care in the cancer survivorship population. This review explains why nutrition should be considered to be an important component in chronic pain management in cancer survivors by exploring relevant evidence from the literature and how to translate this knowledge into clinical practice. This review was built on relevant evidence from both human and pre-clinical studies identified in PubMed, Web of Science and Embase databases. Given the relationship between chronic pain, inflammation, and metabolism found in the literature, it is advised to look for a strategic dietary intervention in cancer survivors. Dietary interventions may result in weight loss, a healthy body weight, good diet quality, systemic inflammation, and immune system regulations, and a healthy gut microbiota environment, all of which may alter the pain-related pathways and mechanisms. In addition to being a cancer recurrence or prevention strategy, nutrition may become a chronic pain management modality for cancer survivors. Although additional research is needed before implementing nutrition as an evidence-based management modality for chronic pain in cancer survivors, it is already critical to counsel and inform this patient population about the importance of a healthy diet based on the data available so far.

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Section: How Can We Implement This Knowledge In Clinical Practice?mentioning

confidence: 99%

Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors?

Yılmaz

Malfliet

Elma

et al. 2022

JCM

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“…Nutrition plays an important role in promoting functional independence, such as in preventing and treating obesity [ 18 - 20 ], but it is unclear how prepared physiatrists feel to provide nutrition counseling to patients. Polak and colleagues [ 21 ] note that nutrition is rarely considered in the specialty’s literature, and introduce basic concepts in nutrition and behavioral counseling to physiatrists, emphasizing that they need additional education on the subject in order to gain expertise.…”

Section: Introductionmentioning

confidence: 99%

Nutrition Education, Understanding, and Counseling Practices Among Physiatrists: A Survey Study

Calandra¹,

Shofer²,

Chao³

et al. 2022

Cureus

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Introduction: Nutritional counseling is relevant to physiatry practice. However, physiatrists' nutrition knowledge base and their frequency of incorporating nutritional education into routine clinical encounters are currently unknown. The objective of this study was to assess physiatrists' nutrition education, nutrition knowledge, willingness to implement nutrition counseling in clinical practice, and perceived barriers to providing nutritional counseling to patients, using an online survey. The hypothesis was that few physiatrists offer dietary counseling to their patients on a routine basis and that barriers likely include time constraints in a typical office visit, lack of provider confidence in providing dietary recommendations, and lack of provider reimbursement.Methods: This study was a cross-sectional online survey that was distributed via email to a convenience sample of 179 resident, fellow, and attending physiatrists associated with two major academic institutions. The survey consisted of 26 questions regarding demographics, nutrition counseling practices and attitudes, basic nutrition knowledge, and perceived barriers to providing nutrition counseling.Results: Of 59 participants, 78% reported receiving education in nutrition and/or behavioral counseling in medical school. In contrast, 39% of participants did not feel adequately trained to discuss nutrition and dietrelated issues with patients. Barriers to providing nutritional counseling were time constraints (83%), socioeconomic factors outside of patients' control preventing them from adhering to a healthier diet (76%), and not having enough nutrition knowledge to do so appropriately (62%). Respondents (86%) either agreed or strongly agreed that additional training in nutrition would allow them to provide better clinical care in the prevention of progressive cardiovascular and neurovascular disease. Further, respondents (85%) either agreed or strongly agreed that they would be interested in a web-based continuing medical education training in nutrition behavioral counseling and evidence-based dietary recommendations.Conclusions: The findings refuted the hypothesis that few physiatrists in the sample offer dietary counseling to their patients on a routine basis. Results demonstrated that many of them acknowledge its relevance and would be interested in further education on the subject. Physiatrists also appear to have perceived barriers to offering nutritional counseling, but some of them varied by the amount of medical experience. Based on these findings, this study demonstrated that it would be worthwhile to develop such a continuing medical education activity with a focus on populations commonly treated by physiatrists.

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Eating habits and nutritional status of women with musculo-skeletal diseases

Motoașcă

Irsay

Iliescu

et al. 2023

Balneo and PRM Research Journal

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Different theories link chronic musculoskeletal pain with lifestyle components, including diet. However, nutritional assesment and optimization is not routinely included into the medical management of patients with muskuloskeletal diseases (MSKD). In this study we aimed to evaluate the diet and nutritional status of a group of women with MSKD and to assess the extent to which they comply with the general recommendations for a healthy diet. The results showed that 97% of the subjects included were overweight or obese, and the compliance to different general nutritional recommandations ranged between 3% to 57%. Furthermore, the quality of life of this patients measured through SF-36 question-naire was severly affected and the reported pain intensity on numeric pain scale had a mean of 8 (±1.3) in our study group. Although there are currently no specific guidelines for the nutrition of patients with chronic pain, an important first step would be to guide these patients towards an increase in diet quality and a healthy lifestyle by adhering to general nutritional recommendations regarding healthy eating.

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Time for food - training physiatrists in nutritional prescription

Abstract: Training physiatrists to address nutrition is a step-wise process, described here.

Cited by 3 publications

References 83 publications

Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors?

Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors?

Nutrition Education, Understanding, and Counseling Practices Among Physiatrists: A Survey Study

Eating habits and nutritional status of women with musculo-skeletal diseases

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