Dentition and weight status in community-dwelling older adults.

BACKGROUND/OBJECTIVE: Tooth loss is common among older adults and can affect dietary intake and weight status. This study investigated associations between dentition status and body mass index (BMI) in older adults. MATERIALS AND METHODS: This was a cross-sectional study of data from a convenience sample of older adults (65-89 years) treated at an urban U.S. dental school clinic. Clinical and demographic data were obtained from electronic health records. Dentition status was determined based on data from odontograms. Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of having a non-normal weight status for each measure of dentition status, after adjusting for covariates. RESULTS: Patients (n = 1765) were 54.1% female, 51.5% White, 41.6% African American and 22.5% Hispanic/Latino. The median (interquartile range [IQR]) age was 71 (67.0-75.0) years; the mean (±SD) BMI was 28.5 (±5.7) kg/m2 ; 72.5% were overweight or obese. The median (IQR) number of remaining teeth was 20.0 (13.0-24.0); the median numbers of anterior and posterior occluding pairs of teeth were 5.0 (2.0-6.0) and 2.0 (0.0-5.0), respectively; and 44.9% had a functional dentition (≥21 teeth). Having a higher number of remaining teeth and more posterior occluding pairs were associated with lower odds of obesity (OR = 0.980, 95% CI = 0.964, 0.997, p = .022 and OR = 0.931, 95% CI = 0.885, 0.980, p = .006, respectively). Lack of a functional dentition was associated with higher odds of obesity (OR = 1.400, 95% CI = 1.078, 1.818, p = .012), after controlling for covariates. CONCLUSION: Older adults with tooth loss - especially loss of posterior occlusion and lack of a functional dentition - were more likely to be obese than of normal weight.

A user-centered approach to the development of a diet education tool for older adults with tooth loss.

BACKGROUND: Tooth loss is associated with suboptimal nutrient intake and greater risk of malnutrition. OBJECTIVE: To develop and field-test a stakeholder-informed diet education tool that addresses the unique needs of older adults with tooth loss who do not wear dentures. METHODS: An iterative user-centered approach was used. Initial content was developed based on findings from previous research. Stakeholder panels of older adults with 20 or fewer teeth, and dentists, were conducted at two time points to obtain feedback on the tool, which was revised following each panel. The tool was field-tested in a dental school clinic and evaluated using the Patient Education Materials Assessment Tool; it was further revised based on feedback. RESULTS: A diet education tool entitled "Eating Healthier With Tooth Loss" was developed. Sections for fruits and vegetables, grains, and proteins food groups, and one addressing socioemotional aspects of eating with missing teeth were included. Panel members provided constructive, positive feedback; recommendations for editing text, images, design, and content were integrated. Field-testing in the dental clinic with 27 pairs of student dentists and their patients resulted in scores of 95.7% for understandability and 96.6% for actionability, with over 85% agreement with each item. The tool was revised based on field-testing feedback. CONCLUSION: A diet education tool for older adults with tooth loss was developed using a user-centered approach, integrating the 'patient voice' and patient experiences with US dietary guidelines. Use of this tool is feasible in a dental clinic setting. Future research should explore usage in larger settings.

Transitioning the eating experience in survivors of head and neck cancer.

PURPOSE: Applying the Social Cognitive Transition (SCT) Model of Adjustment as an interpretive framework, this mixed-methods case series explored how head and neck cancer (HNC) survivors participate in the dimensions of the eating experience (described as physiological, psychological, social, cultural). METHODS: This was a sub-study of a primary study, "The Natural History and Impact of Taste Change in Oncology Care." Qualitative interviews and quantitative data (questionnaires and exams) were intersected to examine and describe the complexities of transitioning the eating experience after treatment for HNC. Triangulation of qualitative and quantitative data within and across cases was examined to produce rich descriptions of the changes and transitions in the eating experience. RESULTS: Four case studies were detailed. All reported some taste and/or smell changes. Each case described worry about weight loss and the decreased ability to engage and finding meaning in the eating experience. Each expressed coping strategies that drew upon the social and cultural dimensions of their prior eating experience that brought meaning and purpose to the post-treatment eating experience. CONCLUSIONS: This case series explored the impact of taste and oral function and the participant's pre- and post-treatment mental model of the eating experience. Application of the SCT Model of Adjustment to the eating experience in adults with HNC provided a deeper insight into how cognitive adaptation and coping strategies supported transition in identity related to the eating experience following cancer therapy.

Nutritional Status Based on Body Mass Index Is Associated With Morbidity and Mortality in Mechanically Ventilated Critically Ill Children in the PICU.

OBJECTIVE: To determine the influence of admission anthropometry on clinical outcomes in mechanically ventilated children in the PICU. DESIGN: Data from two multicenter cohort studies were compiled to examine the unique contribution of nutritional status, defined by body mass index z score, to 60-day mortality, hospital-acquired infections, length of hospital stay, and ventilator-free days, using multivariate analysis. SETTING: Ninety PICUs from 16 countries with eight or more beds. PATIENTS: Children aged 1 month to 18 years, admitted to each participating PICU and requiring mechanical ventilation for more than 48 hours. MEASUREMENTS AND MAIN RESULTS: Data from 1,622 eligible patients, 54.8% men and mean (SD) age 4.5 years (5.1), were analyzed. Subjects were classified as underweight (17.9%), normal weight (54.2%), overweight (14.5%), and obese (13.4%) based on body mass index z score at admission. After adjusting for severity of illness and site, the odds of 60-day mortality were higher in underweight (odds ratio, 1.53; p < 0.001) children. The odds of hospital-acquired infections were higher in underweight (odds ratio, 1.88; p = 0.008) and obese (odds ratio, 1.64; p < 0.001) children. Hazard ratios for hospital discharge were lower among underweight (hazard ratio, 0.71; p < 0.001) and obese (hazard ratio, 0.82; p = 0.04) children. Underweight was associated with 1.3 (p = 0.001) and 1.6 (p < 0.001) fewer ventilator-free days than normal weight and overweight, respectively. CONCLUSIONS: Malnutrition is prevalent in mechanically ventilated children on admission to PICUs worldwide. Classification as underweight or obese was associated with higher risk of hospital-acquired infections and lower likelihood of hospital discharge. Underweight children had a higher risk of mortality and fewer ventilator-free days.

The eating experience in long-term survivors of head and neck cancer: a mixed-methods study.

PURPOSE: This study explored the eating experience in long-term survivors of head and neck cancer (HNC) ≥3 years post concurrent chemoradiation. Quality of life (QOL) and the meanings and perceptions survivors had as it related to the eating experience were explored. METHODS: Purposive sampling was utilized; 10 long-term survivors of HNC participated in the study. A mixed-methods approach was used; exploratory qualitative research using content analysis and summary statistics was used to describe demographic and clinical characteristics and the Vanderbilt Head and Neck Symptom Survey version 2.0 scores (VHNSS 2.0). RESULTS: Four categories (psychological, social impact, functional status, and the current eating experience) containing 15 subthemes and 1 overarching theme (adaptation) emerged. Current health status, QOL, and QOL related to eating were viewed favorably despite the impact of treatment late effects on participants' daily lives. Adaptation and maladaptation in regard to food choice and downplaying of symptoms were recognized. Interviews as well as the VHNSS 2.0 scores indicated that xerostomia, mucosal sensitivity, swallowing difficulty, length of time required to eat, and dysgeusia remained problematic. CONCLUSION: Psychological, functional, and social losses associated with eating were identified. Participants modify or avoid foods that are challenging yet report enjoyment with eating. Challenges with eating were downplayed. Due to the potential negative nutritional and social implications of avoiding specific food/food groups, standard of care in long-term survivors of HNC should include assessment of the eating experience and functional challenges. Nutrition professional can help patients optimize dietary intake and the eating experience.

Improvements in Cardiometabolic Risk Factors Among Overweight and Obese Employees Participating in a University Worksite Wellness Program.

OBJECTIVE: To determine immediate changes in weight and cardiometabolic risk of participants in a university worksite wellness program (WWP). It was hypothesized that there would be significant improvements in weight and waist circumference after 12 weeks. METHOD: Employees volunteered for enrollment in a 12-week WWP that provided educational sessions in-person or online. At baseline and after 12 weeks, participants had one-on-one appointments with the study registered dietitian who measured clinical outcome markers (cardiometabolic risk factors) and provided individualized counseling. RESULTS: Among 79 participants who returned for 12-week appointments, there were statistically significant improvements in weight (p < .0001), waist circumference (p < .0001), and other cardiometabolic risk factors from baseline to 12-weeks. CONCLUSIONS: Improvements in cardiometabolic risk factors may be observed in a relatively short period of time among those who enrolled in a WWP.

Oral health and multimorbidity: is diet the chicken or the egg?

Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition and oral and systemic diseases that contribute to multimorbidity. Diet- and nutrient-related risk factors for oral diseases include high intakes of free sugars, low intakes of fruits and vegetables and nutrient-poor diets which are similar to diet- and nutrient-related risk factors for systemic diseases. Oral diseases are chronic diseases. Once the disease process is initiated, it persists throughout the lifespan. Pain and tissue loss from oral disease leads to oral dysfunction which contributes to impaired biting, chewing, oral motility and swallowing. Oral dysfunction makes it difficult to eat nutrient-dense whole grains, fruits and vegetables associated with a healthy diet. Early childhood caries (ECC) associated with frequent intake of free sugars is one of the first manifestations of oral disease. The presence of ECC is our 'canary in the coal mine' for diet-related chronic diseases. The dietary sugars causing ECC are not complementary to an Eatwell Guide compliant diet, but rather consistent with a diet high in energy-dense, nutrient-poor foods - typically ultra-processed in nature. This diet generally deteriorates throughout childhood, adolescence and adulthood increasing the risk of diet-related chronic diseases. Recognition of ECC is an opportunity to intervene and disrupt the pathway to multimorbidities. Disruption of this pathway will reduce the risk of multimorbidities and enable individuals to fully engage in society throughout the lifespan.

Effect of Lactobacillus rhamnosus LGG® and Bifidobacterium animalis ssp. lactis BB-12® on health-related quality of life in college students affected by upper respiratory infections.

College students are susceptible to upper respiratory infections (URI) due to inadequate sleep, stress and close living quarters. Certain probiotic strains modulate immune function and may improve health-related quality of life (HRQL) during URI. The present study recruited apparently healthy college students and assessed the effect of probiotics on HRQL outcomes (i.e. self-reported duration, symptom severity and functional impairment of URI) in those who developed URI. Missed school and work days due to URI were also considered. Subjects (n 231) were apparently healthy college students living on campus in residence halls at the Framingham State University (Framingham, MA, USA), and were randomised to receive placebo (n 117) or probiotic-containing powder (daily dose of minimum 1 billion colony-forming units of each Lactobacillus rhamnosus LGG® (LGG®) and Bifidobacterium animalis ssp. lactis BB-12® (BB-12®); n 114) for 12 weeks. Subjects completed The Wisconsin Upper Respiratory Symptom Survey-21 to assess HRQL during URI. The final analyses included 198 subjects (placebo, n 97 and probiotics, n 101). The median duration of URI was significantly shorter by 2 d and median severity score was significantly lower by 34% with probiotics v. placebo (P,0·001), indicating a higher HRQL during URI. Number of missed work days was not different between groups (P=0·429); however, the probiotics group missed significantly fewer school days (mean difference = 0·2 d) compared to the placebo group (P=0·002). LGG® and BB-12® may be beneficial among college students with URI for mitigating decrements in HRQL. More research is warranted regarding mechanisms of action associated with these findings and the cost-benefit of prophylactic supplementation.

Symptom burden in head and neck cancer: impact upon oral energy and protein intake.

PURPOSE: This study explored relationships between oral symptom burden (xerostomia, thick secretions, and mucosal sensitivity), energy and protein intake, and weight change over time among head and neck cancer (HNC) patients who have completed concurrent chemoradiation (CCR). METHODS: Symptom burden was assessed utilizing the Vanderbilt Head and Neck Symptom Survey version 2.0. Weight change was measured from diagnosis to treatment completion, and to the early, mid, and late recovery stage. Energy and protein intake were determined utilizing 24-h diet recalls. RESULTS: Forty-three adult patients treated for HNC enrolled in the study. Mean percentage weight loss from diagnosis to treatment completion was 7.91 ± 4.06 %. Within the mid-recovery stage significant inverse relationships were found between oral protein intake and xerostomia and mucosal sensitivity (r = -0.818, p = 0.012; r = -0.726, p = 0.032, respectively). After controlling for weight change, significant inverse relationships were found within the mid-recovery stage between oral energy intake and xerostomia and mucosal sensitivity (r = -0.740, p = 0.046; r = -0.751, p = 0.043, respectively). Significant, inverse relationships were also found between oral protein intake and xerostomia and mucosal sensitivity (r = -0.835, p = 0.019; r = -0.726, p = 0.033, respectively). CONCLUSIONS: Xerostomia and mucosal sensitivity were significantly related to oral energy and protein intake post-CCR in mid-recovery. Weight loss was greatest from diagnosis to treatment completion and continued through the mid-recovery stage. Assessment of oral symptom burden (xerostomia and mucosal sensitivity) and its impact on oral intake and weight post-CCR should be conducted routinely in good patient care.

Temporomandibular Joint Disorders and the Eating Experience.

Temporomandibular joint disorder (TMD) is a chronic disorder that significantly affects oral function. It can affect appetite and the mechanical components involved with eating, including mandibular opening, biting, chewing, and even swallowing. Thus, dietary intake and, subsequently, nutrition status are affected. The functional challenges presented by the disorder affect eating-related quality of life and can affect food choices and diet quality and composition. This article addresses disorder-related factors affecting the eating experience of adults with TMDs and approaches to diet management.

Screening for diabetes risk using the diabetes risk test and point-of-care hemoglobin A1C values in adults seen in a dental clinic.

OBJECTIVE: To explore the feasibility of screening for type 2 diabetes (T2DM) and the prevalence of adult patients seen in a dental clinic at risk for T2DM based on American Diabetes Association (ADA) diabetes risk test (DRT) scores and point of care hemoglobin A1C (A1C) values. METHOD AND MATERIALS: This was a cross-sectional analysis of data from adults 18 to 89 years old seen in an academic dental clinic between November 2019 and April 2022 without prior history of diabetes. Clinical and demographic data were obtained from electronic health records and odontograms. Frequency distributions, chi-square, and Mann-Whitney U tests were used for data analysis. RESULTS: Of the 13,519 patients whose data were included, 54.7% (n = 7,389) were women. Of those with race and ethnicity data, 53.6% (n = 2,871) were white, 40.2% (n = 2,153) were African American, and 29.5% (n = 1,559) were Hispanic/Latino. Mean ± SD age was 47.0 + 17.0 years; mean ± SD body mass index was 28.0 ± 6.1 kg/m2. Thirty-five percent (n = 4,774) had diabetes risk test scores reflecting T2DM risk. Those at risk were more likely to be older, male, and overweight/obese than those not at risk (P < .001). Of those at risk who consented to a point of care A1C (9.8%, n = 470), 40.2% (n = 189) had values consistent with dysglycemia (A1C ≥ 5.7%); 34.9% (n = 164) reflecting prediabetes (A1C = 5.7% to 6.4%) and 5.3% (n = 25) diabetes (A1C ≥ 6.5%). CONCLUSIONS: Diabetes screening in a dental clinic identified that over one-third of adults without T2DM were at risk based on diabetes risk test scores. Of those who had point of care A1Cs conducted; 40% had dysglycemia. Diabetes screening in an academic dental clinic can help identify patients at risk for T2DM.

School-based interventions for overweight and obesity in minority school children.

The prevalence of childhood overweight and obesity in the United States has resulted in a number of school-based health interventions. This article provides a review of research that addressed childhood overweight and obesity in minority, U.S. elementary schools. All studies reported some benefits in health behaviors and/or anthropometric measures. Effectiveness was greater when program objectives were specific, implemented across the school environments, extended into the community, and were culturally relevant. Because minority school children are disproportionately affected by overweight and obesity and poor health behaviors, and since schools may be the primary setting to address childhood overweight and obesity in communities, school nurses can be an advocate for school-based programs and facilitate success.

Challenges to Provision of Adequate Medical Nutrition Therapy in a Critically Ill COVID-19 Patient Fed in the Prone Position.

Adults with acute respiratory distress syndrome (ARDS) may experience enteral nutrition (EN) intolerance. They often require mechanical ventilation and other specialized management including prone positioning. There is a controversy as to whether patients fed in prone position experience more EN intolerance than when they are in supine position. This narrative review synthesizes the literature published between 2001 and 2021 in adults with ARDS who are fed EN while in the prone position to determine safety and tolerance. A case of an adult patient with Down syndrome who developed ARDS due to COVID-19 and required EN while in prone position is presented.

Adverse perioperative outcomes among patients undergoing gastrointestinal cancer surgery: Quantifying attributable risk from malnutrition.

BACKGROUND: Preoperative malnutrition adversely impacts perioperative outcomes among patients with gastrointestinal (GI) cancer. The attributable risk (AR) that nutrition status contributes towards negative outcomes is poorly understood. METHODS: Adults undergoing GI cancer surgeries were identified within the American College of Surgeons National Surgical Quality Improvement Program database (2005-2017). Emergency surgeries, outpatients, and cases with an American Society of Anesthesiologists status above III were excluded. Adjusted multivariable models were constructed to determine the associations between markers of nutrition status (body mass index, >10% weight loss in last 6 months, functional status, and serum albumin level) and adverse perioperative outcomes (presence and number of complications, death, 30-day readmission, and length of stay). Predictive accuracy statistics and population AR (PAR) were determined. RESULTS: The final sample included 78,662 cases. Patients with >10% weight loss 6 months preceding surgery (compared with those who did not), had a significantly increased risk of complications (Relative Risk = 1.28; 95% CI, 1.20-1.37) and odds of death (odds ratio [OR] = 1.37; 95% CI, 1.18-1.59). A totally dependent functional status (compared with independent status) was associated with a 3.3-times higher odds of death (OR = 3.30; 95% CI, 1.53-7.15). Multivariable models were not predictive of adverse outcomes; PAR from the markers ranged 1%-2%. CONCLUSION: Ten percent weight loss in preceding 6 months was associated with increased risk of adverse perioperative outcomes among adults undergoing GI cancer surgery. The contribution of nutrition status markers to surgical outcomes as assessed by PAR was small (1%-2%), a finding not previously reported. Future intervention studies should include validated nutrition risk markers, control for effects of perioperative variables, and evaluate PAR within the immediate/long-term postoperative periods.

Structured Review of the Value Added by the Registered Dietitian to the Care of Gastrointestinal Cancer Patients.

BACKGROUND: Malnutrition is common among patients with gastrointestinal (GI) cancer and contributes to their morbidity and mortality. Nutrition interventions provided by a registered dietitian (RD) or dietitian may improve nutrition status and patient outcomes; however, there are few studies that attempt to define the contribution of the dietitian to these outcomes. OBJECTIVE: Our objective was to identify the value added by the dietitian to the care of patients with GI malignancies. METHODS: A structured review was conducted using PubMed, CINAHL, Scopus, Medline, and ClinicalKey (all dates up to December 2019). Patients included those with GI malignancies undergoing cancer treatment and receiving intervention provided by an dietitian. Intervention included provision of medical nutrition therapy by an dietitian in the form of counseling, diet advice, oral nutritional supplementation, and enteral and/or parenteral nutrition-directed recommendations. RESULTS: Ten relevant studies were identified and included for analysis. Studies suggest that nutrition counseling by a dietitian during cancer treatment results in improved weight maintenance and energy intake. Preoperative nutrition counseling and inpatient dietitian intervention seem to decrease length of stay after major surgery. CONCLUSIONS: We conclude that the dietitian, especially when providing nutrition counseling, improves the nutrition-related outcomes of patients with GI malignancies. The small number of existent studies highlights the need for further research to define the impact of dietitian interventions and to determine which particular interventions best improve patient outcomes.

Food Insecurity Among Health Sciences Graduate Students at a Large Northeastern University.

OBJECTIVE: To determine the prevalence of food insecurity and the factors associated with it among health sciences graduate students. METHODS: A cross-sectional web-based survey conducted in 2019 on an urban health sciences campus of a large, public northeastern university among health sciences graduate students. Food security status was assessed using the US Department of Agriculture validated 6-item short-form food security module. RESULTS: Of the 302 respondents (response rate, 8.8%), the mean age ± SD was 28.8 ± 7.30 years; 28.5% were food insecure. After adjusting for other covariates, receiving loans was independently associated with higher odds of being food insecure (P < 0.001). CONCLUSIONS AND IMPLICATIONS: Universities may consider screening graduate students for food insecurity risk, especially those receiving student loans. Future research on this topic with graduate students and program administrators in other universities may help identify potential interventions. The impacts of the coronavirus disease 2019 pandemic on food insecurity among graduate students merit exploration to develop context-specific interventions.

Case Report: Transitioning to a Mixed-Oil Intravenous Lipid Emulsion in an Adult Patient Receiving Home Parenteral Nutrition.

A potential risk of long-term parenteral nutrition (PN) is intestinal failure-associated liver disease (IFALD). One recommendation for mitigating risk is limiting the fat dose to reduce the harmful effects of the ω-6 fatty acids, which are the main ingredient in traditional fats. SMOFlipid (SMOF) (Kabi-Fresenius, Bad Homburg, Germany) is a combination of soybean oil, medium-chain triglycerides, olive oil, and fish oil emulsion. This fat source may alleviate the risk of IFALD and improve liver function tests. A patient with a long history of PN reliance and IFALD is presented in this case report. After 4 months on SMOF, total and direct bilirubin levels improved.

Diet Practices, Body Mass Index, and Oral Health-Related Quality of Life in Adults with Periodontitis- A Case-Control Study.

OBJECTIVES: To assess and compare dietpractices, body mass index (BMI), and oral health-related quality of life (OHRQoL) in adults with and without periodontitis. METHODS: Demographics, health-related behaviors, BMI, dental and periodontal parameters, diet practices, and Oral Health Impact Profile-14 (OHIP-14) were collected from 62periodontitis patients and 100 controls without periodontitis. RESULTS: Havingperiodontitis was positively associated with male sex (p=0.004), older age (p<0.001), smoking pack-years (p = 0.006), weight (p = 0.008), BMI (p = 0.003), number of meals per day (p<0.001) and had a negative associationwithdecayed teeth (p = 0.013), alcohol (p = 0.006), and sweets (p = 0.007) consumption.Periodontitis patients were more likely to avoid carbonated beverages (p = 0.028), hot (p = 0.003), and cold drinks (p = 0.013), cold (p = 0.028), hardtextured (p = 0.002), and fibrous foods (p = 0.02) thanthe controls, and exhibited higher global OHIP-14 (p<0.001) andmost domain scores. Age (p<0.001), BMI (p =0.045), number of meals per day (p = 0.024), and global OHIP-14 score (p<0.001) remained positivelyassociated with periodontitis in the multivariate analysis. CONCLUSIONS: Periodontitis patients exhibitedhigher BMI and altered dietpracticesand OHRQoL as compared to controls. Assessment of diet practices, BMI,and OHRQoLshould bepart of periodontal work-up. Dentists and dietitians shouldcollaborate to design strategies to addressthese challenges.

Survey of current job functions of renal dietitians.

OBJECTIVE: This cross-sectional study examined the current job functions of renal dietitians in relation to their demographic characteristics. SETTING AND PARTICIPANTS: Seven hundred and forty-seven dietitians of the Renal Dietitians Dietetic Practice Group of the American Dietetic Association and Council on Renal Nutrition of the National Kidney Foundation completed an electronic survey. Of 2566 surveys distributed, 29.1% (n=747) were returned and useable. MAIN OUTCOME MEASURE: Descriptive and inferential statistics were used. We performed chi(2) tests to identify relationships between reported job functions and demographic characteristics. Fisher's exact tests were used when greater than 20% of cells had an expected frequency of less than five. RESULTS: Dietitians' job functions were related to demographic characteristics. Dietitians with greater than 10 years of renal-dietitian experience were more likely to evaluate urea kinetic modeling frequently (chi(2)=32.95, P < .0005), or evaluate dialysis adequacy (chi(2)=24.16, P < .0005), than those with less renal-dietetics experience. Dietitians who worked in an outpatient facility were more likely to prescribe a renal diet frequently (chi(2)=13.39, P < .0005), recommend renal vitamins (chi(2)=9.81, P=.002), or evaluate interdialytic weight gain, or IDWG (chi(2)=32.24, P < .0005), versus those who did not work in an outpatient facility. CONCLUSIONS: This study documented the frequency of dietitians performing job functions related to renal dietetics. The results of this study document the variability in the role of renal dietitian, and suggest differing levels of practice within renal dietetics.

Chemopreventive role of fruits and vegetables in oropharyngeal cancer.

Oropharyngeal cancer is associated with lifestyle factors, including tobacco use, dietary habits, and alcohol consumption. Oropharyngeal cancers are one of the 10 most common types of cancers worldwide, and it is estimated that oropharyngeal cancers will have affected 30,990 men and women in the United States with a total of 7,430 deaths in 2008. The National Cancer Institute defines chemoprevention as "the use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or reccurrence of, cancer." Chemopreventive agents such as antioxidants are derived from dietary sources, including fruits and vegetables. This review addresses the chemopreventive role of dietary intake of fruits and vegetables in the development of oropharyngeal cancers. It focuses on the variability of the incidence of oropharyngeal cancers and possible reasons behind this phenomenon as it relates to dietary factors, specifically fruits and vegetables.