November 2017 VOL 8, NO 11
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Category VIII: Survivorship and End of Life, Eighth Annual AONN+ Conference Abstracts
The Healthy Forks Survivorship Series…Fighting Cancer One Fork at a Time
Jennifer Fitzgibbon, MS, RDN, CSO, CDN
Background: Cancer patients must juggle doctor appointments; combat treatment side effects, while trying to maintain a sense of normalcy; and handle financial struggles. Stony Brook is a state-funded healthcare institution; many of our patients have limited resources, and many are unable to access healthcare insurance or subsidies due to their immigrant status. It is vital to offer these patients and their families the resources needed to practice a healthy lifestyle. Finances are a significant barrier to many patients, and most insurance companies do not cover nutritional counseling. “Healthy Forks” is a program that provides education and helps patients with their ability to utilize their resources to adhere to an optimal nutrition regimen. The American Cancer Society, National Cancer Institute, and American Institute for Cancer Research (AICR) all advocate for nutritional education for oncology patients.
Objectives: The mission of “Healthy Forks” is to provide the participants with the resources necessary to understand the necessity of providing healthy meals, at a reasonable cost, for themselves and their families, while increasing their mindfulness of the importance of stress reduction and increase in physical activity and mental stimulation. This series provides participants with practical information, healthy recipes, and ideas for easy and quick, hands-on meal preparation, along with knowledge to last a lifetime. Based on AICR cancer prevention recommendations, one should try to be lean; physically active 30 minutes a day; avoid sugary drinks; eat more vegetables, fruits, and whole grains; limit red meat consumption; avoid processed meats; limit alcoholic drinks; limit consumption of salty food; and not smoke or chew tobacco.
Methods: The program is divided into 3 sessions; each 1 hour long.
Session #1: Includes an overview of nutrition basics and an antioxidant smoothie demonstration, led by our oncology registered dietitian. In this session, the dietitian reviews nutritional influences with diseases, importance of eating a plant-based diet, body weight/shape factors, simple measuring tools, and ways to achieve these recommendations. Each participant also receives a Healthy Forks Nutrition Survivorship Booklet, a comprehensive resource for cancer patients and survivors. This physician-reviewed booklet is informative, reviewing AICR recommendations, weight issues, food controversy, label language, physical activity, meal plans, and more.
Session #2: Focuses on mental relaxation and inflammation in the body, led by a physical therapist. Participants are invited to take part in “5 MINUTES of FITNESS,” which gets everyone moving while still remaining in their chairs. All movements are non-intimidating and modified for each participant as needed. Each participant receives anti-inflammatory snacks to sample.
Session #3: Led by our oncology dietitian, who provides a tour of the local supermarket, allowing participants to learn how to read labels and navigate the market. Cancer patients are sometimes vulnerable to media-hyped nutritional products and habits. A simple visit to a popular supermarket can dispel many nutritional myths and optimize eating habits.
Results: Following each session, participants are asked to complete surveys, which help us to continually assess the success of our program. More detailed questions will be included in future surveys so that our data are not based on anecdotal information only. A new patient survey will be developed for use prior to and after the program to assess the benefit to the participants and to help continuously improve our content and the effectiveness of program delivery.
It is estimated that 10 to 20 patients and their family members attend each session of the program. These are oncology patients 18 years of age and older. The demographics include primarily Caucasian, Hispanic, and African American adults. Approximately 40% of our patients require some type of financial assistance. In the past year, over 200 patients have participated in the program.
Conclusions: While education is important, the impact of any program is only viable if the material taught easily translates to practical solutions. The Healthy Forks Survivorship Program was created and has been found to be non-intimidating, easy to manage, fun to do, and offers each participant a sense of accomplishment.
Nutrition and Cancer References
Ogden CL, Carroll MD, Lawman HG, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA. 2016;315:2292-2299.
Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311:806-814.
Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body fatness and cancer—viewpoint of the IARC Working Group. N Engl J Med. 2016;375:794-798.
Setiawan VW, Yang HP, Pike MC, et al. Type I and II endometrial cancers: have they different risk factors? J Clin Oncol. 2013;31:2607-2618.
Dougan MM, Hankinson SE, Vivo ID, et al. Prospective study of body size throughout the life-course and the incidence of endometrial cancer among premenopausal and postmenopausal women. Int J Cancer. 2015;137:625-637.
Hoyo C, Cook MB, Kamangar F, et al. Body mass index in relation to oesophageal and oesophagogastric junction adenocarcinomas: a pooled analysis from the International BEACON Consortium. Int J Epidemiol. 2012;41:1706-1718.
Chen Y, Liu L, Wang X, et al. Body mass index and risk of gastric cancer: a meta-analysis of a population with more than ten million from 24 prospective studies. Cancer Epidemiol Biomarkers Prev. 2013;22:1395-1408.
Chen Y, Wang X, Wang J, et al. Excess body weight and the risk of primary liver cancer: an updated meta-analysis of prospective studies. Eur J Cancer. 2012;48:2137-2145.
Campbell PT, Newton CC, Freedman ND, et al. Body mass index, waist circumference, diabetes, and risk of liver cancer for U.S. adults. Cancer Res. 2016;76:6076-6083.
American Cancer Society
Academy of Nutrition and Dietetics (AND)
American Institute for Cancer Research (AICR)
National Cancer Institute (NCI)
National Institutes of Health - Office of Dietary Supplements
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