Reasons for meal termination, eating frequency, and typical meal context differ between persons with and without a spinal cord injury.

Overeating associated with neurogenic obesity after spinal cord injury (SCI) may be related to how persons with SCI experience satiation (processes leading to meal termination), their eating frequency, and the context in which they eat their meals. In an online, cross-sectional study, adults with (n = 688) and without (Controls; n = 420) SCI completed the Reasons Individuals Stop Eating Questionnaire-15 (RISE-Q-15), which measures individual differences in the experience of factors contributing to meal termination on five scales: Physical Satisfaction, Planned Amount, Decreased Food Appeal, Self-Consciousness, and Decreased Priority of Eating. Participants also reported weekly meal and snack frequency and who prepares, serves, and eats dinner with them at a typical dinner meal. Analysis revealed that while Physical Satisfaction, Planned Amount, and Decreased Food Appeal were reported as the most frequent drivers of meal termination in both groups, scores for the RISE-Q-15 scales differed across the groups. Compared to Controls, persons with SCI reported Physical Satisfaction and Planned Amount as drivers of meal termination less frequently, and Decreased Food Appeal and Decreased Priority of Eating more frequently (all p < 0.001). This suggests that persons with SCI rely less on physiological satiation cues for meal termination than Controls and instead rely more on hedonic cues. Compared to Controls, persons with SCI less frequently reported preparing and serving dinner meals and less frequently reported eating alone (all p < 0.001), indicating differences in meal contexts between groups. Individuals with SCI reported consuming fewer meals than Controls but reported a higher overall eating frequency due to increased snacking (p ≤ 0.015). A decrease in the experience of physical fullness, along with a dependence on a communal meal context and frequent snacking, likely contribute to overeating associated with neurogenic obesity after SCI.

The role of exercise in aromatase inhibitor-induced arthralgia.

Aromatase inhibitors are prescribed in breast cancer due to their associated lower rate of cancer recurrence compared to tamoxifen. However, aromatase inhibitor-induced arthralgia (AIIA) is one of the leading causes of treatment nonadherence, increasing the risk of cancer recurrence. The pathophysiology of AIIA is poorly understood, and although current recommendations for AIIA include lifestyle changes and analgesics depending on the severity of symptoms, there is no established effective treatment. The aim of this study is to explore the presentation and mechanism of AIIA and investigate the feasibility and efficacy of different exercise interventions (aerobic, resistance, aerobic and resistance combined, and yoga or tai chi) in patients with AIIA to guide the development of formal exercise prescription guidelines. Findings indicate that a mixed-modality regimen of aerobic and resistance exercises is feasible and safe and may serve the most benefit in improving joint pain, functionality, and quality of life. More specifically, the weekly regimen should consist of 150 min of aerobic exercise with two sessions of at least six resistance exercises, 8 to 12 repetitions, three sets each. Supplementary yoga and tai chi may be recommended twice a week depending on a patient's target symptoms. Yoga was associated with improved physical functionality, whereas tai chi was related to improvements in mental health. However, the feasibility and impact of combined aerobic and resistance exercise protocols with yoga or tai chi in our target population were not investigated in this review. The use of large, randomized controlled trials is recommended for future studies.

Potential barriers to the use of anti-obesity medications in persons with spinal cord injuries and disorders.

Background: Anti-obesity medications (AOMs) may provide a viable option for obesity management. However, little is known about the use of AOMs in persons with SCI/D. Objective: Describe health care providers' (HCPs) views about barriers to AOM use in persons living with SCI/D. Methods: Descriptive qualitative design using in-depth interviews Descriptive statistics were used to calculate demographic and employment characteristics. Interviews were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases. Results: HCPs (n = 12) were from 11 different nationwide facilities. Most HCPs were male (75%), a large majority were white (67%), and most were 26-49 years of age. Participants were dietitians (75%), physicians (17%), and psychologists (8%). HCPs ranged from 1.5 to 15 years of providing SCI/D care. HCPs described four main thematic barriers to AOM use in persons with SCI/D: (1) AOM side effects that are especially concerning in persons with SCI/D; (2) AOMs contribute to poor eating habits; (3) availability, accessibility, and administration; and (4) lack of evidence, clinical agreement, and knowledge about AOM use in the SCI/D population. Conclusions: There are several potential barriers to AOM use in the SCI/D population. Barriers include AOM side effects which may cause or exacerbate conditions that are already concerns in persons with SCI/D, such as bowel and skin problems, and muscle loss. SCI/D HCPs reported a lack of evidence about AOM use in persons with SCI/D, but interest in obtaining more knowledge.

Nutrition and eating beliefs and behaviors among individuals with spinal cord injuries and disorders: Healthy or misconceived?

PURPOSE/OBJECTIVE: Nutrition knowledge, beliefs, and behaviors have important implications for managing and preventing chronic and injury-related secondary conditions in persons with spinal cord injuries and disorders (SCI/D). Yet, the unique dietary and nutritional needs and recommendations specific to individuals with SCI/D and their eating beliefs and behaviors have been understudied. Aim is to describe nutrition and eating beliefs and behaviors from the perspectives of individuals with SCI/D. RESEARCH METHOD/DESIGN: Descriptive qualitative design using in-depth semistructured interviews with a national sample of veterans with SCI/D (n = 33). Audio-recorded and transcribed verbatim transcripts were coded and analyzed using thematic analysis. RESULTS: Participants were male (61%), aged 29-84 years, and 55% had tetraplegia. Five key themes were identified: extreme fasting/caloric restriction, perceived healthy eating behaviors, perceived unhealthy eating behaviors, modified eating behaviors due to SCI/D-related symptoms, and food/preparation choices based on abilities/independence and access. CONCLUSIONS/IMPLICATIONS: Nutrition among veterans with SCI/D may be impacted by many factors, such as nutrition knowledge and beliefs/behaviors about "healthy" and "unhealthy" nutrition, fasting, caloric restriction, imbalanced intake of macro- and micronutrients, overconsumption relative to energy needs, injury-related secondary complications, postinjury body composition and function changes, impairments related to satiety and hunger signals, and difficulty in obtaining and preparing food. Study findings provide many areas that would benefit from intervention. Findings can be used to inform ideal nutrition and healthy eating beliefs and behaviors which are important because nutritional inadequacies can lead to diet-related diseases, may exacerbate SCI secondary conditions, and lead to poor overall health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).