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Metabolic impact of a nutrition education program for the promotion of fruit and vegetable consumption with people with severe mental disorders (DIETMENT).
Foguet-Boreu, Q, Vilamala-Orra, M, Vaqué-Crusellas, C, Roura-Poch, P, Assens Tauste, M, Bori Vila, J, Santos-López, JM, Del Río Sáez, R
BMC research notes. 2022;15(1):122
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In patients with severe mental disorders, motivation to follow a healthy diet and lifestyle might be low. A diet rich in fruits and vegetables may improve metabolic syndrome, cardiovascular health and mental health. This randomised community-based clinical trial included seventy-four patients with severe mental disorders out of which 37.8% of the participants had schizophrenia or related disorders, 29.7% had bipolar disorder, 25.7% had depressive disorder, 4.1% had a personality disorder, and 2.7% had obsessive-compulsive disorder. The intervention group followed a four-week food education programme (DIETMENT) aimed at promoting fruit and vegetable consumption. A five-month post-intervention analysis showed no increase in participants diagnosed with metabolic syndrome in the intervention group, but an increase in participants diagnosed with metabolic syndrome in the control group. There was a significant reduction in the glomerular filtrate rate in the intervention group. In patients with severe mental disorders, more studies should be conducted to examine the health-promoting effects of adding more fruits and vegetables to the diet. Health professionals can use the results of this study to understand how fruits and vegetables contribute to reducing metabolic syndrome and heart disease risk.
Abstract
OBJECTIVES The aim of this study is to determine the metabolic impact of a nutrition education program on metabolic parameters and the presence of metabolic syndrome (MetS). RESULTS Seventy-four patients were included (mean age, 48.7 years [Standard deviation, SD: 10.8], 55.4% men). The diagnoses of SMD were 37.8% schizophrenia and related disorders; 29.7% bipolar disorder; 25.7% depressive disorder; 4.1% personality disorders; and 2.7% obsessive compulsive disorders. Thirty-seven individuals were distributed in both the intervention group (IG) and the control group (CG). In the IG the presence of MetS was 56.3% and in the CG 46.7%, with no statistically significant difference (p = 0.309). At the end of the study, glomerular filtrate decreased in the IG, body mass index and abdominal perimeter increased in both groups, and there were no changes in metabolic parameters between the groups. Between the baseline and the end of the study, there was no increase in the number of patients diagnosed with MetS (14 at both points); and in the CG the increase was from 8 to 12 (p = 0.005). An intervention based on fruit and vegetable intake could prevent progression to MetS in individuals with SMD, decreasing the likelihood of cardiovascular disease. Trial registration The trial was retrospectively registered on International Standard Randomised Controlled Trial Number (ISRCTN) Register on 11 March 2022 (ISRCTN12024347).
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Design of Culturally and Linguistically Tailored Nutrition Education Materials to Promote Healthy Eating Habits among Pakistani Women Participating in the PakCat Program in Catalonia.
Mohamed-Bibi, S, Vaqué-Crusellas, C, Alonso-Pedrol, N
Nutrients. 2022;(24)
Abstract
(1) Background: Pakistani women are among one of Catalonia's most affected groups by obesity and cardiovascular disease. The design of health education strategies for them has become a compelling need. This paper aims to enlighten the elaboration and evaluation procedure of culturally and linguistically tailored nutrition education materials for Pakistani women participating in the PakCat Program, which aims to evaluate the efficacy of a nutrition education strategy allowing the participants to become ambassadors of healthy eating habits for their community. (2) Methods: In this Randomised Control Trial (RCT), 137 Pakistani women (70 from the intervention and 67 from the control group) took part. We conducted 10 sessions for the intervention group and 3 sessions for the control group in the form of small groups. The sessions were conducted in Urdu and Punjabi, and the material was translated into Urdu, Catalan, Spanish and English. For some sessions, we elaborated on new materials and for others, we adapted them from the existing nutrition material in aspects of language and culture. We evaluated the nutritional material from the observation carried out by the dietician who developed the sessions, participants' feedback at the end of the sessions and a satisfaction questionnaire. (3) Results: We summarised the elaborated material in form of two multilingual nutritional guidelines about portion size and heart-healthy foods. We also registered several materials generated for the PakCat program such as an infographic about myths and beliefs related to food, a booklet to read and interpret the food labels, a recipe book for healthy snacks, and an infographic of 10 tips for healthy eating. We also organised a PhotoVoice exhibition of 70 healthy plates elaborated by the intervention group participants. The participants highly appreciated the material in terms of visualization, cultural and linguistic adequacy, and level of comprehension through all three evaluation methods. (4) Conclusions: The design of culturally and linguistically tailored nutrition education material for Pakistani women living in Catalonia is attainable and effective to meet their specific needs. The healthy dietary recommendation can be adapted to them preserving their traditional dietary pattern, and they acquire the confidence to start following a healthy diet.
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Pakistani Women: Promoting Agents of Healthy Eating Habits in Catalonia-Protocol of a Culturally and Linguistically Appropriate Randomized Control Trial (RCT) Based on the Transtheoretical Model.
Mohamed-Bibi, S, Contreras-Hernández, J, Vaqué-Crusellas, C
International journal of environmental research and public health. 2022;(16)
Abstract
(1) Introduction: Dietary and lifestyle changes along with the cultural and linguistic barriers convert the immigrant women of Pakistani origin into a risk population for developing metabolic syndrome (MetS) and cardiovascular diseases (CVD). The objective of this project is to evaluate the efficacy of a culturally and linguistically appropriate food education program based on the Transtheoretical model that will allow the participants to become ambassadors of healthy eating habits for their community. (2) Methods: In this community-based RCT, any Pakistani adult woman with residence in Badalona and Santa Coloma de Gramenet will be able to participate. We will use a mixed model approach. From the quantitative perspective, the participants will answer a survey accompanied by a multilingual nutritionist that will help us to determine the sociodemographic, clinical, anthropometric, dietary data, and quality of life. From the qualitative perspective, we will conduct 6 focus groups (3 in each municipality) to determine the cultural and religious beliefs with the aim of tailoring the intervention to the target population. Hereafter, the participants from one municipality will randomly become the control group and from the other, the intervention group. The intervention group will participate in 10 weekly food education sessions based on the Transtheoretical model while the control group will receive 3 general educational sessions on food and health. During the evaluation procedure, we will assess the impact of the intervention considering the outcomes of the study. (3) Discussion: This study will establish intercultural bridges between health professionals and the Pakistani community living in Catalonia. The project will open the door for future interventions, and it will be sustainable in time as the participating women will become health promotion agents for the rest of their community.
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Applying the Stages of Change Model in a Nutrition Education Programme for the Promotion of Fruit and Vegetable Consumption among People with Severe Mental Disorders (DIETMENT).
Vilamala-Orra, M, Vaqué-Crusellas, C, Foguet-Boreu, Q, Guimerà Gallent, M, Del Río Sáez, R
Nutrients. 2021;13(6)
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People with severe mental disorders are prone to follow poor dietary choices. Seventy-four participants with severe mental disorders were enrolled in this community-based randomised controlled trial to evaluate changes in fruit and vegetable consumption, as well as changes in their motivation to consume five portions of fruits and vegetables a day. The participants with severe mental disorders in the intervention group participated in a food education programme (DIETMENT) based on the stages of change model to promote the consumption of fruit and vegetables prior to the evaluation. The intervention group showed an increase of 23% in fruit and vegetable consumption when compared to the control group, even though the difference was not statistically significant. The food education programme based on the stages of change model increased motivation, awareness and disposition in participants in the intervention group. In order to identify appropriate strategies for increasing fruit and vegetable consumption in patients with severe mental disorders, there is a need to conduct more robust studies. The results of this study may, however, provide healthcare professionals with a greater understanding of how a food education programme based on the stages of change framework encourages patients with severe mental disorders to consume fruit and vegetables.
Abstract
Despite growing evidence of the benefits of adequate intake of fruit and vegetables (F&V) and the recommendation to consume five servings daily, the adoption of these habits is poor among people with severe mental disorder (SMD). The main aim of the present study is to determine changes in the intake of F&V and motivation to do so among people with SMDs after participating in a food education programme. A community-based randomized controlled trial was conducted in Spain, with the intervention group (IG) participating in a food education programme based on the stages of change model to promote consumption of F&V and the control group (CG) receiving three informative sessions on basic healthy eating. The main outcomes were related to the intake of F&V and stages of change. Data collection was performed at baseline, post intervention, and 12-month follow-up. Seventy-four participants enrolled in the study and sixty completed the 12-month follow-up. An increase in motivation towards the intake of F&V was observed in the IG but not in the CG (McNemar's test p = 0.016, p = 0.625). No significant difference was observed for the intake of fruit, vegetables, or F&V. Basing food education strategies on the stages of change model shows positive results, increasing the awareness and disposition of people with SMD towards the intake of F&V. More research is needed to identify the most appropriate eating intervention to increase the intake of F&V.
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Measurement of availability and accessibility of food among youth: a systematic review of methodological studies.
Gebremariam, MK, Vaqué-Crusellas, C, Andersen, LF, Stok, FM, Stelmach-Mardas, M, Brug, J, Lien, N
The international journal of behavioral nutrition and physical activity. 2017;(1):22
Abstract
BACKGROUND Comprehensive and psychometrically tested measures of availability and accessibility of food are needed in order to explore availability and accessibility as determinants and predictors of dietary behaviors. The main aim of this systematic review was to update the evidence regarding the psychometric properties of measures of food availability and accessibility among youth. A secondary objective was to assess how availability and accessibility were conceptualized in the included studies. METHODS A systematic literature search was conducted using Medline, Embase, PsycINFO and Web of Science. Methodological studies published between January 2010 and March 2016 and reporting on at least one psychometric property of a measure of availability and/or accessibility of food among youth were included. Two reviewers independently extracted data and assessed study quality. Existing criteria were used to interpret reliability and validity parameters. RESULTS A total of 20 studies were included. While 16 studies included measures of food availability, three included measures of both availability and accessibility; one study included a measure of accessibility only. Different conceptualizations of availability and accessibility were used across the studies. The measures aimed at assessing availability and/or accessibility in the home environment (n = 11), the school (n = 4), stores (n = 3), childcare/early care and education services (n = 2) and restaurants (n = 1). Most studies followed systematic steps in the development of the measures. The most common psychometrics tested for these measures were test-retest reliability and criterion validity. The majority of the measures had satisfactory evidence of reliability and/or validity. None of the included studies assessed the responsiveness of the measures. CONCLUSIONS The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighborhood food environment.