Association of Sugar Intake with Inflammation- and Angiogenesis-Related Biomarkers in Newly Diagnosed Colorectal Cancer Patients
Evidence suggests a positive association between sugar intake and colorectal cancer (CRC) outcomes. We sought to investigate inflammation and angiogenesis as underlying mechanisms behind increased sugar intake and worse CRC outcomes. Pre-surgery serum samples were obtained from 191 patients diagnosed with primary invasive stage I-IV CRC. Biomarkers of inflammation (CRP, SAA, IL-6, IL-8, MCP-1, TNFα) and angiogenesis (VEGFA, VEGFD, sICAM-1 and sVCAM-1) were analyzed (Meso-Scale-Discovery). Fructose, glucose, sucrose, and total sugar intake (calories/day, % total calories) were assessed by FFQ. Pearson’s correlation and multiple linear regression analyses were performed. Patients were on average 64 years old, 64% were male, the majority was diagnosed with stage II-III (58%) cancers, and 67% were either overweight or obese. Among normal-weight individuals (BMI <25 kg/m2), we observed a significant inverse association between VEGFD and any type of sugar intake in cal/day (sucrose: p = 0.01, glucose and fructose: p < 0.001) and MCP-1 and fructose intake (p = 0.05). The magnitude of reduction in VEGF ranged between -1.24 for sucrose to 4.49 for glucose intake, and -2.64 for fructose intake for MCP-1 levels. Sugar intake was associated with some inflammation or angiogenesis biomarkers, among CRC patients; differences were observed by adiposity that warrant further investigation.
When Weight Holds Too Much Weight
This is a paper outlining clinical tools for assessing eating and movement habits, instead of just weight. Published in the dietetic practice group journal Dietitians in Medical Nutrition Therapy put out by the Academy of Nutrition and Dietetics (AND is the national accrediting organization of dietitians).
Predicting weight gain in patients with cystic fibrosis on triple combination modulator
Abstract
Background: Cystic fibrosis (CF) is caused by CF transmembrane conductance regulator (CFTR) gene mutations producing dysfunctional CFTR proteins leading to progressive clinical disease. Elexacaftor-tezacaftor-ivacaftor (ETI) remarkably improves lung disease but is associated with substantial weight gain.
Study design and methods: We performed a single-center longitudinal study predicting 6-month weight gain after ETI initiation. We used linear mixed effects modeling (LME) to determine association of ETI treatment with changing body mass index (BMI). Using linear regression, we examined BMI prediction models with distinct combinations of main effects to identify a model useful for patient counseling. We used up to eight commonly observed clinical characteristics as input variables (age, sex, percent predicted FEV1 [FEV1%], F508del homozygous state, pancreatic sufficiency, HgbA1c, prior modulator use and prior year number of pulmonary exacerbations).
Results: We evaluated 154 patients (19-73 years old, 54% female, FEV1% = 19-121, 0-6 prior year pulmonary exacerbations). LME demonstrated an association between ETI use and weight increases. Exhaustive testing suggested a parsimonious linear regression model well-fitted to data that is potentially useful for counseling. The two variable model shows that on average, BMI decreases by 0.045 (95% Confidence Interval [CI] = -0.069 to -0.021, p < 0.001) for every year of age and increases by 0.322 (CI = 0.142 to 0.502, p = 0.001) for each additional prior year exacerbation at the time of ETI initiation.
Interpretation: Young patients with many prior year pulmonary exacerbations likely have the largest 6 month weight gain after starting ETI.
Feasibility of Broadly Inclusive Culinary Medicine Shared Medical Visits: Pairing Culinary Instruction with Tailored Medical Advice
Abstract
An unhealthful diet is a leading risk factor for death and chronic disease globally. Culinary medicine interventions build cooking confidence and improve nutrition related behavior and are aimed to lessen the burden of chronic disease.
This article describes the implementation and feasibility of a broadly inclusive hands-on culinary medicine shared medical appointment program for patients with chronic disease at a university outpatient clinic utilizing standard billing practices.
Methods: The authors developed and implemented a hands-on culinary medicine program to teach culinary skills to patients through a series of three shared medical appointments. Adult patients were eligible to participate if they had at least one chronic medical condition influenced by dietary intervention. Appointments included hands-on food preparation experiences for each patient, nutrition education, tailored chronic disease medical care, mindful eating practices, and goal setting targeting long-term behavior change. Primary outcomes included attendance rates and program costs.
Results: From March 2022 to July 2023, 109 patients participated in at least one appointment in the program and 66 (60.6%) patients completed the program. Patients attended an average of 2.5 (SD = 0.7) appointments and there was a total of 268 patient encounters. The most prevalent chronic disease among participants was obesity affecting 66 patients. The average cost for food was $57 per session equaling less than $5 per serving.
Conclusions: Culinary medicine taught through shared medical appointments is feasible in an outpatient setting with low start-up costs and with broad inclusion criteria and offers practical guidance to improve dietary behaviors for patients with chronic disease.
Building Flavor and Confidence in the Kitchen: A Pilot Virtual Cooking Class on Healthy Snacking
Abstract
Cooking meals at home is associated with more healthful eating and even other healthy behaviors, such as increased physical activity, but for many there are numerous barriers to making this a reality. Healthy teaching kitchen interventions aim to help patients overcome these barriers. Our pilot program worked to address this issue by demonstrating the feasibility and acceptability of a virtual culinary medicine session designed for outpatient clinic patients. Participants were recruited from a single community primary care clinic for a virtual culinary medicine session. Of the 29 subjects who attended the class, 13 (45%) filled out the pre-course survey, and 8 (26%) filled out the post-course survey. Average participant confidence in preparing snacks at home from fresh ingredients increased from 3.62 to 4.38 out of 5 after attending this session, though the results were not statistically (OR .47; P = .172; 95% CI .16 to 1.3). Post-participation comments were overwhelmingly positive. This study showed that a virtual cooking class is feasible in a community clinic setting and is positively received. In addition, a culinary class teaching healthy cooking techniques paired with nutrition training may improve patient’s confidence in the kitchen.
Presentations
Presenter “Empowering Patients, Enhancing Care: The CGM Revolution” Mountain West Cystic Fibrosis Consortium. June 27 2025
Presenter “Be Where Your Feet Are: Practicing Mindful Living and Eating” Cystic Fibrosis Registered Dietitian and Social Work Consortium. May 6 2025
Presenter “Aging Well with CF: A Nutrition Perspective” North American Cystic Fibrosis Conference 2023
Panelist “One Size Doesn’t Fit All: CF Nutrition in a New Era” ResearchCon via Cystic Fibrosis Foundation. April 26 2023.
Stewart, KL and Spadafora, A. “Caring for our Transgender CF Patients” Cystic Fibrosis Registered Dietitian and Social Work Consortium. April 5 2023.
Annually teach class “Motivational Interviewing for the RD” to students in Coordinated Master’s in Nutrition Program at the University of Utah. 2018 to on-going.
Stewart, KL and Satterthwaite, CJ. “When Weight Holds Too Much Weight” Cincinnati Children’s Hospital. March 2 2022.
Stewart, KL and Satterthwaite, CJ. “When Weight Holds Too Much Weight” Mid Atlantic Cystic Fibrosis Consortium Conference. April 29 2022.
Stewart, KL and Satterthwaite, CJ. “When Weight Holds Too Much Weight” National Cystic Fibrosis Foundation 365 Webinar. May 18 2022.