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Article ; Online: The missing piece of the puzzle - The key role of the dietitian in the management of Parkinson's disease.

Flanagan, Richelle / Rusch, Carley / Lithander, Fiona E / Subramanian, Indu

2024 Volume 121, Page(s) 106021

Abstract: The current paradigm for the multidisciplinary management of Parkinson's Disease (PD) does not include regular nutritional assessment despite research showing that 90 % of people living with Parkinson's (PwP) lack access to basic dietetic services. Since ...

Abstract	The current paradigm for the multidisciplinary management of Parkinson's Disease (PD) does not include regular nutritional assessment despite research showing that 90 % of people living with Parkinson's (PwP) lack access to basic dietetic services. Since many non-motor symptoms such as dysphagia, constipation and orthostatic hypotension and PD complications such as weight loss and sarcopenia can be improved through dietary intervention, dietitians are a critical missing piece of the PD management puzzle. This paper serves to review the role of dietitians and medical nutrition therapy in management of PD as well as a call to action for future studies to investigate improvement of nutritional status and quality of life for all PwP.
MeSH term(s)	Humans ; Parkinson Disease/complications ; Parkinson Disease/therapy ; Nutritionists ; Quality of Life ; Delivery of Health Care ; Constipation/etiology
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1311489-x
ISSN	1873-5126 ; 1353-8020
ISSN (online)	1873-5126
ISSN	1353-8020
DOI	10.1016/j.parkreldis.2024.106021
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Article ; Online: Parkinson's disease: the nutrition perspective - CORRIGENDUM.

Ó Breasail, Mícheál / Smith, Matthew D / Tenison, Emma / Henderson, Emily J / Lithander, Fiona E

The Proceedings of the Nutrition Society

2022 Volume 82, Issue 4, Page(s) 487

MeSH term(s)	Humans ; Parkinson Disease ; Nutritional Status
Language	English
Publishing date	2022-02-04
Publishing country	England
Document type	Journal Article
ZDB-ID	391142-1
ISSN	1475-2719 ; 0029-6651
ISSN (online)	1475-2719
ISSN	0029-6651
DOI	10.1017/S0029665122000787
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Article ; Online: Working with public contributors in Parkinson's research: What were the changes, benefits and learnings? A critical reflection from the researcher and public contributor perspective.

Lithander, Fiona E / Tenison, Emma / Jones, David Ashford / Stocker, Sue / Hopewell-Kelly, Noreen / Gibson, Andy / McGrath, Carmel

Health expectations : an international journal of public participation in health care and health policy

2023

Abstract: Introduction: This paper provides a critical reflection from both the researcher and public contributor (PC) perspective on the benefits and the learnings taken from involving PCs in research related to Parkinson's. APPROACH TO PATIENT AND PUBLIC ... ...

Abstract	Introduction: This paper provides a critical reflection from both the researcher and public contributor (PC) perspective on the benefits and the learnings taken from involving PCs in research related to Parkinson's. APPROACH TO PATIENT AND PUBLIC INVOLVEMENT (PPI): This paper reports on how PCs shaped the design and development of the PRIME-UK research programme study materials through input into information leaflets, consent forms and other patient-facing documents used across three studies within the PRIME-UK research programme. The PRIME-UK research programme is designed to improve the quality of life of people with Parkinson's and this project included three studies: a cross-sectional study, a randomised control trial and a qualitative study. We captured these impacts using Public Involvement Impact Logs, which provide a framework allowing researchers and PCs to report on the learnings, immediate outcomes and impacts from PPI. For this project, the impact logs enabled us to provide reflections from PCs and researchers on the process of involving 'the public' in Parkinson's research. Findings: This paper builds on existing evidence of the range of benefits and challenges that emerge from working with patients and the public in Parkinson's research; this includes reflecting on the changes made to the study materials and benefits for the people involved. Four themes emerged from the reflections that were common to the researchers and PCs; these were the importance of providing a supportive environment; recognition of the benefit of the evaluation of the impact of PPI; acknowledgement that engagement of PPI can make a positive difference to the research process and that timely communication and the use of face-to-face communication, where available, is key. Furthermore, we demonstrate how impact logs provide a useful and straightforward tool for evaluating public involvement practices and supporting the feedback process. Conclusion: We offer key recommendations for involving patients and the public in Parkinson's research and suggest approaches that could be implemented to capture the impacts of public involvement. Public contribution: Public contributors (PCs) were involved in the design and development of the participant information leaflets, consent forms and other patient-facing documents used for studies within the PRIME-UK research programme. In addition, PCs evaluated their involvement using impact logs and co-authored this paper.
Language	English
Publishing date	2023-11-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2119434-8
ISSN	1369-7625 ; 1369-6513
ISSN (online)	1369-7625
ISSN	1369-6513
DOI	10.1111/hex.13914
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Article ; Online: Parkinson's disease: the nutrition perspective.

Ó Breasail, Mícheál / Smith, Matthew D / Tenison, Emma / Henderson, Emily J / Lithander, Fiona E

The Proceedings of the Nutrition Society

2021 Volume 81, Issue 1, Page(s) 12–26

Abstract: Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and affects about 1% of the population over the age of 60 years in industrialised countries. The aim of this review is to examine nutrition in PD ... ...

Abstract	Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and affects about 1% of the population over the age of 60 years in industrialised countries. The aim of this review is to examine nutrition in PD across three domains: dietary intake and the development of PD; whole body metabolism in PD and the effects of PD symptoms and treatment on nutritional status. In most cases, PD is believed to be caused by a combination of genetic and environmental factors and although there has been much research in the area, evidence suggests that poor dietary intake is not a risk factor for the development of PD. The evidence about body weight changes in both the prodromal and symptomatic phases of PD is inconclusive and is confounded by many factors. Malnutrition in PD has been documented as has sarcopaenia, although the prevalence of the latter remains uncertain due to a lack of consensus in the definition of sarcopaenia. PD symptoms, including those which are gastrointestinal and non-gastrointestinal, are known to adversely affect nutritional status. Similarly, PD treatments can cause nausea, vomiting and constipation, all of which can adversely affect nutritional status. Given that the prevalence of PD will increase as the population ages, it is important to understand the interplay between PD, comorbidities and nutritional status. Further research may contribute to the development of interventional strategies to improve symptoms, augment care and importantly, enhance the quality of life for patients living with this complex neurodegenerative disease.
MeSH term(s)	Humans ; Malnutrition/etiology ; Middle Aged ; Neurodegenerative Diseases/complications ; Nutritional Status ; Parkinson Disease/complications ; Quality of Life
Language	English
Publishing date	2021-10-04
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	391142-1
ISSN	1475-2719 ; 0029-6651
ISSN (online)	1475-2719
ISSN	0029-6651
DOI	10.1017/S0029665121003645
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Article ; Online: Needs of patients with parkinsonism and their caregivers: a protocol for the PRIME-UK cross-sectional study.

Tenison, Emma / Lithander, Fiona E / Smith, Matthew D / Pendry-Brazier, Danielle / Ben-Shlomo, Yoav / Henderson, Emily J

BMJ open

2022 Volume 12, Issue 5, Page(s) e057947

Abstract: Introduction: People with parkinsonism are a highly heterogeneous group and the disease encompasses a spectrum of motor and non-motor symptoms which variably emerge and manifest across the disease course, fluctuate over time and negatively impact ... ...

Abstract	Introduction: People with parkinsonism are a highly heterogeneous group and the disease encompasses a spectrum of motor and non-motor symptoms which variably emerge and manifest across the disease course, fluctuate over time and negatively impact quality of life. While parkinsonism is not directly the result of ageing, it is a condition that mostly affects older people, who may also be living with frailty and multimorbidity. This study aims to describe the broad range of health needs for people with parkinsonism and their carers in relation to their symptomatology, disability, disease stage, comorbidities and sociodemographic characteristics. Methods and analysis: In this single site cross-sectional study, people with parkinsonism will be sent a study information pack for themselves and their primary informal caregiver, if relevant. Data are collected via questionnaire, with additional support, if required, to maximise participation. A specific strategy has been developed to target and proactively recruit patients lacking capacity to consent, including those in residential care settings, with input from a personal consultee prior to completion of a bespoke questionnaire by a representative. Caregivers are also recruited to look at various health outcomes. Results will be displayed as descriptive statistics and regression models will be used to test simple associations and interactions. Ethics and dissemination: This protocol was approved by the London-Brighton & Sussex Research Ethics Committee (REC reference 20/LO/0890). The results of this protocol will be disseminated through publication in an international peer-reviewed journal; presentation at academic meetings and conferences; and a lay summary uploaded to the PRIME-Parkinson website. Trial registration number: ISRCTN11452969; Pre-results.
MeSH term(s)	Aged ; Caregivers ; Cross-Sectional Studies ; Humans ; Parkinsonian Disorders ; Quality of Life ; United Kingdom
Language	English
Publishing date	2022-05-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-057947
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Article ; Online: Exploring the acute effects of running on cerebral blood flow and food cue reactivity in healthy young men using functional magnetic resonance imaging.

Thackray, Alice E / Hinton, Elanor C / Alanazi, Turki M / Dera, Abdulrahman M / Fujihara, Kyoko / Hamilton-Shield, Julian P / King, James A / Lithander, Fiona E / Miyashita, Masashi / Thompson, Julie / Morgan, Paul S / Davies, Melanie J / Stensel, David J

Human brain mapping

2023 Volume 44, Issue 9, Page(s) 3815–3832

Abstract: Acute exercise suppresses appetite and alters food-cue reactivity, but the extent exercise-induced changes in cerebral blood flow (CBF) influences the blood-oxygen-level-dependent (BOLD) signal during appetite-related paradigms is not known. This study ... ...

Abstract	Acute exercise suppresses appetite and alters food-cue reactivity, but the extent exercise-induced changes in cerebral blood flow (CBF) influences the blood-oxygen-level-dependent (BOLD) signal during appetite-related paradigms is not known. This study examined the impact of acute running on visual food-cue reactivity and explored whether such responses are influenced by CBF variability. In a randomised crossover design, 23 men (mean ± SD: 24 ± 4 years, 22.9 ± 2.1 kg/m
MeSH term(s)	Humans ; Male ; Brain/physiology ; Cerebrovascular Circulation/physiology ; Cues ; Magnetic Resonance Imaging/methods ; Oxygen ; Running ; Cross-Over Studies
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-05-05
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1197207-5
ISSN	1097-0193 ; 1065-9471
ISSN (online)	1097-0193
ISSN	1065-9471
DOI	10.1002/hbm.26314
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Article ; Online: Wearable and Portable GPS Solutions for Monitoring Mobility in Dementia: A Systematic Review.

Cullen, Anisha / Mazhar, Md Khadimul Anam / Smith, Matthew D / Lithander, Fiona E / Ó Breasail, Mícheál / Henderson, Emily J

Sensors (Basel, Switzerland)

2022 Volume 22, Issue 9

Abstract: Dementia is the most common neurodegenerative disorder globally. Disease progression is marked by declining cognitive function accompanied by changes in mobility. Increased sedentary behaviour and, conversely, wandering and becoming lost are common. ... ...

Abstract	Dementia is the most common neurodegenerative disorder globally. Disease progression is marked by declining cognitive function accompanied by changes in mobility. Increased sedentary behaviour and, conversely, wandering and becoming lost are common. Global positioning system (GPS) solutions are increasingly used by caregivers to locate missing people with dementia (PwD) but also offer a non-invasive means of monitoring mobility patterns in PwD. We performed a systematic search across five databases to identify papers published since 2000, where wearable or portable GPS was used to monitor mobility in patients with common dementias or mild cognitive impairment (MCI). Disease and GPS-specific vocabulary were searched singly, and then in combination, identifying 3004 papers. Following deduplication, we screened 1972 papers and retained 17 studies after a full-text review. Only 1/17 studies used a wrist-worn GPS solution, while all others were variously located on the patient. We characterised the studies using a conceptual framework, finding marked heterogeneity in the number and complexity of reported GPS-derived mobility outcomes.
MeSH term(s)	Cognitive Dysfunction/diagnosis ; Dementia ; Disease Progression ; Geographic Information Systems ; Humans ; Wearable Electronic Devices
Language	English
Publishing date	2022-04-27
Publishing country	Switzerland
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s22093336
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Article ; Online: A high quality Aotearoa New Zealand dietary pattern adapting a Mediterranean diet for metabolic health: a feasibility study.

Parry-Strong, Amber / Gearry, Richard / Merry, Troy L / Weatherall, Mark / Davies, Cheryl / Worthington, Anna / Bishop, Rhiane / Wright, Summer Rangimaarie / Lithander, Fiona E / Foster, Meika / Krebs, Jeremy

BMC nutrition

2023 Volume 9, Issue 1, Page(s) 146

Abstract: Aim: To assess the feasibility of a family-based dietary intervention study using a meal kit home delivery service, in people at risk of cardio-metabolic disease.: Methods: A 12-week dietary intervention feasibility study of adults (termed the index ... ...

Abstract	Aim: To assess the feasibility of a family-based dietary intervention study using a meal kit home delivery service, in people at risk of cardio-metabolic disease. Methods: A 12-week dietary intervention feasibility study of adults (termed the index participants) at increased risk of metabolic and cardiovascular disease, enriched for Māori who are indigenous New Zealanders. The study sample also included the household/whānau members living with the index participant. All participants received a 12 week intervention using weekly home delivery of meal kits and groceries consistent with a Mediterranean dietary pattern. Outcomes were the metabolic syndrome severity score (MetSSS); feasibility and acceptability of the intervention; dietary intake; and other clinical and anthropometric measures. Results: There were 29 index participants recruited and in addition, 50 household/whānau members took part in the feasibility study. The mean (SD) household/whānau size was 3.45 (1.4) people, and the mean (SD) number of people in each household/whānau who participated in the study was 2.84 (1.2). The feasibility of intervention to households/whānau was proven in this context. The mean (SD) change in MetSSS was 0.03 (0.33), N = 27, P = 0.69 and there was a statistically significant decrease in body weight of 1.37 kg (95% CI 0.11 to 2.62), p = 0.034. The food deliveries were well received, the dinner kits more so than the grocery items. Conclusion: It is feasible to recruit individuals and households/whānau to a family-based dietary intervention. Use of a meal kit home delivery service to provide food which is consistent with the intervention dietary pattern was well received. This feasibility study identified improvements to be made such as nutrition behaviour change support, more variety in food provided, more recipes, and better matching of food quantity to family size. Trial registration: ANZCTR-ACTRN12621000856819p registered 2.JUN.2021 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382021&isReview=true.
Language	English
Publishing date	2023-12-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2809847-X
ISSN	2055-0928 ; 2055-0928
ISSN (online)	2055-0928
ISSN	2055-0928
DOI	10.1186/s40795-023-00805-x
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Article: He Rourou Whai Painga, an Aotearoa New Zealand dietary pattern for metabolic health and whānau wellbeing: protocol for a randomized controlled trial.

Lithander, Fiona E / Parry Strong, Amber / Braakhuis, Andrea / Worthington, Anna / Foster, Meika / Rolleston, Anna / Davies, Cheryl / Mullaney, Jane / Ross, Cecilia / Conroy, Denise / Merry, Troy L / Gearry, Richard / Weatherall, Mark / Krebs, Jeremy D

Frontiers in nutrition

2023 Volume 10, Page(s) 1298743

Abstract: Background: Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand. Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved ... ...

Abstract	Background: Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand. Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved metabolic health. This study aims to test whether an intervention including a Mediterranean dietary pattern incorporating high quality New Zealand foods (NZMedDiet pattern) and behavior change science can improve the metabolic health of participants and their household/whānau. Methods and analysis: This is a multi-center, three-stage trial with two parallel group superiority randomized controlled trials (RCTs), and a longitudinal cohort study embedded within the trial design. The first RCT (RCT 1) is a comparison of the NZMedDiet pattern compared to usual diet for 12 weeks. The Behavior Change Wheel was used to select and implement strategies to support participant adherence to the NZMedDiet, such as web-based nutrition education on healthy shopping and cooking. The second (RCT 2) compares online social support to no online social support for 12 weeks, administered to participants immediately following RCT 1. The third stage is a longitudinal cohort study where all participants are followed from the beginning of their start of the active intervention for 12 months in total. The primary outcome measure for each stage is the metabolic syndrome severity score (MetSSS). The duration of enrolment is 12-15 months. The total recruitment target is 200 index participants and their household/whānau members who participate with them, and the primary analyses will be intention to treat on index participants. Discussion: The trial will test whether the NZMedDiet pattern and behavior change support improves the cardiometabolic health of people in Aotearoa New Zealand. Clinical trial registration: https://www.anzctr.org.au/Default.aspx, identifier ACTRN12622000906752 and https://www.isrctn.com/, identifier ISRCTN89011056 (Spirit 2).
Language	English
Publishing date	2023-12-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2023.1298743
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Article ; Online: Evaluating Eating Behaviour, Energy Homeostasis, and Obesity in Childhood-Onset Craniopharyngioma: A Feasibility Study.

Hinton, Elanor C / Lithander, Fiona E / Elsworth, Rebecca L / Hawton, Katherine / Narayan, Kruthika / Szymkowiak, Sophie / Bedford, Holly L / Naeem, Nimra / Elson, Ruth / Taylor-Miller, Tashunka / Hamilton-Shield, Julian P / Crowne, Elizabeth C

Hormone research in paediatrics

2023 Volume 97, Issue 1, Page(s) 80–93

Abstract: Introduction: Craniopharyngiomas are rare brain tumours (incidence 1.1-1.7 cases/million/year). Although non-malignant, craniopharyngioma causes major endocrine and visual morbidities including hypothalamic obesity, yet mechanisms leading to obesity are ...

Abstract	Introduction: Craniopharyngiomas are rare brain tumours (incidence 1.1-1.7 cases/million/year). Although non-malignant, craniopharyngioma causes major endocrine and visual morbidities including hypothalamic obesity, yet mechanisms leading to obesity are poorly understood. This study investigated the feasibility and acceptability of eating behaviour measures in patients with craniopharyngioma to inform the design of future trials. Methods: Patients with childhood-onset craniopharyngioma and controls matched for sex, pubertal stage, and age were recruited. After an overnight fast, participants received the following measures: body composition, resting metabolic rate, oral glucose tolerance test including magnetic resonance imaging (patients only), appetite ratings, eating behaviour, and quality of life questionnaires, ad libitum lunch, and an acceptability questionnaire. Data are reported as median ± IQR, with effect size measure (Cliff's delta) and Kendall's tau for correlations, due to the small sample size. Results: Eleven patients (median age = 14 years; 5 F/6 M) and matched controls (median age = 12 years; 5 F/6 M) were recruited. All patients had received surgery, and 9/11 also received radiotherapy. Hypothalamic damage post-surgery was graded (Paris grading): grade 2 n = 6; grade 1 n = 1; grade 0 n = 2. The included measures were deemed highly tolerable by participants and their parent/carers. Preliminary data suggest a difference in hyperphagia between patients and controls (d = 0.5), and a relationship between hyperphagia with body mass index standard deviation score (BMISDS) in patients (τ = 0.46). Discussion: These findings demonstrate that eating behaviour research is feasible and acceptable to craniopharyngioma patients and there is an association between BMISDS and hyperphagia in patients. Thus, food approach and avoidance behaviours may be useful targets for interventions to manage obesity in this patient group.
MeSH term(s)	Humans ; Adolescent ; Child ; Craniopharyngioma/complications ; Feasibility Studies ; Pediatric Obesity/epidemiology ; Pediatric Obesity/complications ; Quality of Life ; Pituitary Neoplasms/epidemiology ; Pituitary Neoplasms/complications ; Hyperphagia/complications ; Feeding Behavior ; Homeostasis
Language	English
Publishing date	2023-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2537278-6
ISSN	1663-2826 ; 1663-2818
ISSN (online)	1663-2826
ISSN	1663-2818
DOI	10.1159/000530863
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