Overcoming Barriers to Latino Participation in Alzheimer's Disease Research.

There is a critical need to increase Latino participation in research on Alzheimer's disease and related disorders (ADRD). Applying principles of community-based participatory research, we convened a community advisory board (CAB) to identify barriers and recommend strategies to increase participation of older Latinos in a longitudinal observational research study of ADRD at the Shiley-Marcos Alzheimer's Disease Research Center. Six major barriers were identified and programmatic changes to overcome them were implemented. Changes resulted in a nearly three-fold increase in the number of Latino individuals recruited, with the proportion of all newly recruited participants who were Latino increasing from 12.2% to 57.4%. Newer Latino recruits were more representative of the elderly Latino population in San Diego County than those recruited pre-CAB and remained highly agreeable to blood draw and neuroimaging, though less so to lumbar puncture and autopsy. Results demonstrate the value of CAB involvement in enhancing diversity in ADRD research.

Attitudes and Perceptions of Blenderized Tube Feed Use Among Physicians and Advanced Practice Providers.

BACKGROUND: Blenderized tube feeds (BTFs) have increased in popularity among enteral patients and their caregivers as an alternative to commercial formula. Motivations include ingredient flexibility, increased tolerance, and inclusion in family meals. Research has explored the attitudes and perceptions of patients, caregivers, and registered dietitian nutritionists but not those of physicians and advanced practice providers (APPs). The purpose of this study was to evaluate their attitudes and perceptions of BTFs. METHODS: A survey created via Research Electronic Data Capture tools was distributed to physicians and APPs to evaluate clinical practice characteristics, experience, knowledge, and perceptions of BTFs. RESULTS: Survey response rate was 17.3% (n = 206). Half of respondents reported familiarity with BTFs, but 95% of respondents had received no formal training regarding BTFs. Physicians reported higher levels of confidence in BTF knowledge than APPs. However, the overall level of confidence in BTF knowledge was poor, with a majority of respondents (73.3% [n = 151]) reporting either "not very confident" or "not confident at all." The most perceived benefits included tailoring diet to better fit the patients' needs (70.9% [146]) and psychological benefits (59.2% [122]). Barriers that most concerned respondents included tube occlusions (59.7% [123]) and nutrition inadequacy (47.6% [98]). χ2 Analysis revealed no relationship between type of provider and perceived benefits or barriers. CONCLUSION: A majority of physicians and APPs are willing to support BTF use but lack education or guidance, resulting in poor confidence. Increased familiarity with BTF use and awareness of available education materials are required to help physicians and APPs support patients utilizing BTFs.

Effect of annatto-extracted tocotrienols and green tea polyphenols on glucose homeostasis and skeletal muscle metabolism in obese male mice.

Skeletal muscle is the major site for glucose uptake and thus plays an important role in initiating insulin resistance in type 2 diabetes mellitus. This study evaluated the effects of tocotrienols (TT) and green tea polyphenols (GTP) individually or in combination on glucose homeostasis and skeletal muscle metabolism in obese mice with insulin resistance and elevation of blood glucose. Forty-eight male mice were fed a high-fat diet and assigned to 4 groups in a 2 (no TT vs. 400 mg TT/kg diet) × 2 (no GTP vs. 0.5% vol/wt GTP in water) for 14 weeks. Both GTP and TT improved area under curve of insulin intolerance; while GTP increased serum insulin levels in obese mice, probably due to the addition of sweetener in drinking water. An interaction (TT×GTP) was observed in glucose tolerance test, total pancreas insulin concentration, and citrate synthase activity of soleus in mice. Neither TT nor GTP affected insulin and glucagon protein expression in pancreas based on immunohistochemistry. Both TT and GTP individually increased soleus muscle weight of mice; while only GTP increased gastrocnemius muscle weight of mice. The TT+GTP group had the greatest gastrocnemius muscle cross sectional area than other groups. GTP, not TT, induced cytochrome c oxidase activity and reduced thiobarbituric acid reactive substances levels in soleus muscle. Our results suggest that TT and GTP, individually or synergistically have the potential to improve skeletal muscle metabolism in obese mice by improving glucose homeostasis, reducing lipid peroxidation, and increasing rate limiting enzymes of oxidative phosphorylation.

Impact of culinary medicine elective on medical students' culinary knowledge and skills.

Diet has an important role in the treatment and prevention of chronic illnesses. Physicians are regarded as having proficient knowledge about nutrition, but most believe that they lack an understanding of clinical nutrition. In fall 2016, a group of medical students developed a culinary medicine elective for 20 students at Texas Tech University Health Sciences Center School of Medicine in Lubbock that included four didactic sessions and four interactive cooking labs that culminated in a final contest. The elective was meant to educate medical students about nutrition and dietary habits for their own benefit and that of their future patients. Surveys were administered to participants before and after the elective. Results showed a significant increase in confidence in overall culinary skill level, knowledge of ingredients, knowledge of cooking techniques, and ability to use kitchen supplies (P = 0.002, 0.002, 0.0004, and 0.003, respectively). The culinary medicine elective appears to be a valuable addition to the medical school curriculum.