ABSTRACT
BACKGROUND: Head and neck radiotherapy (H&N RT) patients are at risk for malnutrition following treatment due to dysphagia and alterations in taste quality. This project studied feasibility of a food skills intervention strategy support food preparation, cooking confidence, and individualized dietary choices to support nutritional status in this patient population. METHODS: We piloted a monthly cooking class (called "Eat to Live") from November 2018 to January 2019. Every class included cooking and nutrition domains, organized around a specific meal of the day (i.e., breakfast, lunch, or dinner). Seven participants (4 patients, 3 caregivers) attended at least one class, with four participants (3 patients, 1 caregiver) completing all three classes. Pre- and post-study measures (self-administered questionnaires) assessed changes in cooking behavior, dietary choices, and taste sensation before and after the intervention. RESULTS: Healthful eating scores increased modestly from start to finish of the class (1.5 to 1.7 on a 3-point scale), with averaged patient preference scores for healthy foods increasing incrementally. This took place despite physical taste scores declining across the 3-month study. After completing the class, participants were more likely to select fresh fruits and vegetables, grains, lean cuts of meat, and dairy products. Patients also adopted positive behavioral modifications to their diets, such as eating out at restaurants less often and baking/grilling foods instead of frying. CONCLUSIONS: To our knowledge, this is the first published report on feasibility and patient acceptance of an evidence-based culinary medicine intervention in H&N RT patients. We observed objective improvements in dietary choices and cooking confidence in a small cohort of patient/caregiver dyads. This pilot work justifies follow-on development of a more comprehensive intervention optimized for patient convenience and longitudinal support.
Subject(s)
Attitude to Health , Cooking , Deglutition Disorders/diet therapy , Deglutition Disorders/etiology , Head and Neck Neoplasms/radiotherapy , Patient Education as Topic/methods , Radiation Injuries/diet therapy , Adult , Community-Based Participatory Research , Cooking/methods , Feasibility Studies , Female , Fruit , Head and Neck Neoplasms/diet therapy , Humans , Male , Middle Aged , Nutrition Therapy/methods , Nutritional Physiological Phenomena , Patient Acceptance of Health Care , Pilot Projects , Program Evaluation , Radiation Injuries/etiology , Surveys and Questionnaires , VegetablesABSTRACT
Migraine has been characterized by interictal cortical hyperresponsivity. We compared event-related brain potentials (ERPs) to unattended tone pairs in migraineurs (interictal) versus non-headache controls, with particular interest in attention-related activity (i.e., the N1 component). Electroencephalograms were recorded from 11 interictal migraineurs and 14 headache-free controls while they watched a silent video. Pairs of 50-ms tones with 500-ms inter-tone intervals were presented with inter-pair intervals of 1 or 5 s. P1, N1, P2, and N2 components were analyzed. N1 peak amplitudes were larger in migraineurs than in controls, especially after the 5-s inter-pair interval. However, there was no difference between groups in the attenuation of the N1 (i.e., no interaction). P2 peak amplitudes were larger in migraineurs, but only after the first tone in the pair. The three migraineurs without aura had larger N1s than the eight with aura. Our findings are consistent with interictal hyperresponsivity of cortical generators of these ERPs in migraineurs. However, areas that inhibit the responses with stimulus repetition do not seem to be affected.
