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Cognitive approach to nutrition in a patient centered approach: implementing tailored nutrition advice for oncology patients

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Abstract

This theoretical overview stresses the importance of a personalized approach to the study of the relationship between nutrition and prevention by the use of a cognitive approach. An adequate nutrition program should play a fundamental aspect of patient-centered care, but also is the best prevention strategy in disease-free subjects. We argue that an integrated methodology, based on a patient-centered and tailored approach, must assess all the factors involved within individual food choices in order to recognize values, beliefs and needs related to food intake, both in cancer patients and in disease-free patients. An integrated approach is advocated, since the tailoring process requires both biological and psychological data in order to appraise the individual’s needs and promote adequate action plans. This process of integrating information delivered from different sources is what we call a “cognitive approach” to nutrition.

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... Consequently, an increasing amount of information included genetic features and patients' preferences, are needed to find the best solution in a given situation. In this framework, a patient-centred model should be adopted [11, 12] (Mazor et al 2012; Lucchiari, Masiero, Pravettoni, 2013). However, little research is now available in this domain and most physicians, at least in Italian hospitals are advised to use a more directive paternalistic approach in this context. ...
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Improving diet and exercise can reduce survivors' risk of cancer-related fatigue, poor physical functioning, and potential recurrence. A cancer diagnosis can represent a 'teachable moment', leading survivors to make positive changes in diet and exercise behaviors; however, little is known about how often this occurs or about factors that enhance or limit survivors' ability to make these changes. This cross-sectional descriptive study investigated both the prevalence and clustering of self-reported changes in diet and exercise and how these changes related to ongoing cancer-related symptoms, social support, and stressful life events among long-term breast cancer survivors. Survivors (n=227, response rate=72%) of a prior Cancer and Leukemia Group B treatment trial, on average 12 years post-diagnosis, completed a mailed survey assessing health behavior changes since diagnosis and current symptoms, social support, and stressful life events. Over half of survivors reported making positive exercise or diet changes since diagnosis: over 25% reported making exercise and diet changes. Analyses of covariance models showed that survivors who reported increasing their exercise also reported lower fatigue. Trends were also found between increased fruit and vegetable intake and decreased fatigue and between increased exercise and increased social support. These results underscore the need for health promotion efforts among survivors. Exercise promotion is especially needed since more survivors attempted to change dietary behaviors than exercise on their own. Further, fatigue may limit survivors' ability to change their health behaviors; alternatively, survivors who increase their exercise may experience less fatigue.
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