Population-based, cross-sectional assessment of dietary patterns and supplement use in mitochondrial disease.

BACKGROUND & AIMS: Mitochondrial diseases (MITO) are a large group of rare genetic conditions that manifest in high-energy organ systems and impair mitochondrial oxidative phosphorylation. Therapeutic management often involves the use of dietary supplements and special dietary patterns. METHODS: A questionnaire assessing dietary patterns and supplement use was administered to diagnosed patients or their surrogate caregivers through various MITO-related patient and advocacy organizations and social media internationally from March to September 2021. Secondary outcomes assessed information available to participants regarding supplements, and factors influencing use, knowledge, and adherence to dietary supplements. Supplements were classified using standard criteria. A total of 236 responses were used for the analysis. RESULTS: The average number of supplements taken among patients was 7.0 (±5.0 SD) with over 70% reporting taking more than 4 supplements. Sixty percent of respondents reported dietary restrictions, while 14% were tube fed or parenterally fed. Uncertainty regarding supplement cost, use, and availability were a significant source of stress for most participants with 61% of patients reporting no financial coverage for supplementation and 45% reporting no coverage for special dietary needs. CONCLUSIONS: Adequate scientific evidence for the widespread use of dietary supplements in MITO is lacking. As a result, there is excessive supplementation in MITO that imposes significant stress on patients. Future studies are needed to evaluate the efficacy of specific supplements as well as special dietary patterns to enable physicians and pharmacists to provide evidence-based recommendations to patients to reduce symptoms, as well as the emotional and financial strain associated with supplement use.

Social support and physical activity for cancer survivors: a qualitative review and meta-study.

PURPOSE: Physical activity (PA) is important for well-being and coping among cancer survivors. Social support (SS) encourages adoption and maintenance of PA behavior, and PA contexts can provide opportunities for obtaining support for coping with cancer. The qualitative literature examining cancer survivors' experience with SS in and for PA could inform understanding of behaviors experienced as supportive. The purpose of this meta-study was to synthesize the research on adult cancer survivors' experiences with SS related to PA. METHODS: Following meta-study guidelines, we searched nine databases and retrieved 39 articles describing intervention and observation studies, and extracted, analyzed, and synthesized information addressing SS and PA in cancer survivors. RESULTS: Results emphasized ways that PA contexts facilitate relationships, which are a foundation for obtaining supportive behaviors that enable PA (e.g., providing encouragement and accountability) and assist with coping with cancer (e.g., understanding and talking about cancer). Some themes identified were unique to studies with female breast cancer, advanced cancer, interventions or programs, and that used interviews versus focus groups. CONCLUSIONS: Understanding supportive behaviors could improve PA and coping with cancer in interventions. Future research should focus on identifying supportive behaviors, incorporating theory and methods to address the development of supportive relationships, and recruiting more diverse samples of participants in terms of gender, race/ethnicity, and cancer type. IMPLICATIONS FOR CANCER SURVIVORS: PA can provide opportunities for positive social connections ranging from loose to close social ties, and this research identifies several behaviors in the PA context that may be supportive of PA behavior (e.g., providing actionable information), and coping with cancer (e.g., opportunities but low obligation to talk about cancer).

Dietary and Supplement-Based Complementary and Alternative Medicine Use in Pediatric Autism Spectrum Disorder.

Previous literature has shown that complementary and alternative medicine (CAM) is steadily increasing in autism spectrum disorder (ASD). However, little data is currently available regarding its use, safety, and efficacy in children with ASD. Thus, the purpose of this study is to describe the use of supplement-based CAM therapies in children between the ages of 4 to 17 years with ASD. This population-based, cross-sectional study evaluated children with ASD regarding supplement use. A total of 210 participants were recruited from a variety of sources including educational and physical activity programs, and social media to complete a questionnaire. Primary caregivers provided information on current supplement based CAM use. Data evaluated the proportion of children that used supplement therapies, the types of supplements used, reasons for use, perceived safety, and demographic factors associated with use (e.g. income, parental education, severity of disorder). Seventy-five percent of children with ASD consumed supplements with multivitamins (77.8%), vitamin D (44.9%), omega 3 (42.5%), probiotics (36.5%), and magnesium (28.1%) as the most prevalent. Several supplements, such as adrenal cortex extract, where product safety has not yet been demonstrated, were also reported. A gluten free diet was the most common specialty diet followed amongst those with restrictions (14.8%). Health care professionals were the most frequent information source regarding supplements; however, 33% of parents reported not disclosing all their child's supplements to their physician. In conclusion, the use of supplement therapies in children with ASD is endemic and highlights the need for further research concerning public health education surrounding safety and efficacy.