The aim of this 5-year longitudinal study of 593 girls (9-20-year-old) was to examine whether the internalization of the thinness ideal in terms of 'a wish to be thinner' might be related to lifestyle factors and longitudinally increase the risk of disturbed eating over time. Results showed that a wish to be thinner was related to lifestyle factors, eating attitudes and body mass index (BMI) longitudinally. Girls who wished to be thinner dieted more often, thought that they would be more popular if they were thinner, skipped meals, were eating breakfast more often alone and had a higher BMI compared to the girls without such a wish. Girls who wished to be thinner were 4 times more likely to develop disturbed eating attitudes over a 5-year period. These findings point to the importance of helping adolescents to establish regular eating habits, to avoid unhealthy dieting practices and to prevent sedentary behaviours that might lead to overweight and or obesity in early childhood.
This paper discusses activity concentrations of (210)Po, (210)Pb, (40)K and (137)Cs in edible wild berries and mushrooms collected from Øvre Dividalen national park, Northern Norway and derives committed effective ingestion doses to man based on high consumption rates of these wild foods. Edible wild berries and mushrooms accumulated similar levels of (210)Pb, but mushrooms accumulated higher levels of (210)Po and (40)K than berries. There appears to be a clear difference in the ability of Leccinum spp. of fungi to accumulate (210)Po and/or translocate (210)Po to mushrooms compared to Russula spp. of fungi. Activity concentrations of (137)Cs in edible wild berries and mushrooms from Øvre Dividalen national park reflected the lower levels of fallout of this radionuclide in Northern Norway compared to more central areas following the Chernobyl accident. For mushrooms, ingestion doses are dominated by (210)Po, while for berries, (40)K is typically the main contributor to dose. Based on high consumption rates, ingestion doses arising from the combination of (210)Po, (210)Pb and (40)K were up to 0.05 mSv/a for berries and 0.50 mSv/a for mushrooms. Consumption of such wild foods may result in a significant contribution to total annual doses when consumed in large quantities, particularly when selecting mushrooms species that accumulate high activity concentrations of (210)Po.
To evaluate the nutritional and clinical consequences of changing from a centralized food delivery system to decentralized bulk food portioning; a system in which meal portioning occurs on residents' floors of a nursing home.
A pilot study with a pre-post design
The study took place on one floor of a home for elderly persons with dementia. Of the 34 residents, 22 (1 man) participated in this study. Average age was 82 years (range = 55 to 94 years). Nutritional status was verified before introduction of the bulk food portioning system by 3 nonconsecutive days of observed food intakes, anthropometric measurements (height, weight, triceps skinfold thickness, mid-upper-arm circumference), and biochemical parameters (albumin, lymphocytes, glucose, sodium, potassium, transferrin, vitamin B-12, folate, hemoglobin). Trained dietitians collected the dietary and anthropometric data and validated the food intake estimates and anthropometric measurements. Data were also collected 10 weeks after implementation of the new food distribution system.
Paired t tests adjusted by a Bonferroni correction assessed differences between values measured before and after introduction of the new food distribution system.
Average food consumption increased substantially and significantly after introduction of the bulk food portioning system. Mean energy intakes rose from 1,555 to 1,924 kcal/day and most other nutrients also increased, many significantly, but there were no changes in anthropometric values or biochemical parameters, except for albumin level which decreased to the lower normal limit.
Portioning of food in the residents' dining room simulates a homelike atmosphere thereby encouraging increased food consumption. With well-trained and enthusiastic staff, this system could contribute to improved nutritional status in the very elderly, even those who have dementia. Dietitians have a key role to play in overseeing residents' nutritional needs and in training, supervising, and motivating foodservice personnel.
Acarbose for the prevention of Type 2 diabetes, hypertension and cardiovascular disease in subjects with impaired glucose tolerance: facts and interpretations concerning the critical analysis of the STOP-NIDDM Trial data.
Research Centre, Centre hospitalier de l'Université de Montréal-Hôtel-Dieu, Department of Medicine, University of Montreal, 3850 St. Urbain Street, Rm 8-202, Montreal, Quebec H2W 1T7, Canada. firstname.lastname@example.org
The STOP-NIDDM Trial has shown that acarbose treatment in subjects with impaired glucose tolerance is associated with a significant risk reduction in the development of diabetes, hypertension and cardiovascular complications. Kaiser and Sawicki have accused the investigators of the STOP-NIDDM Trial of major biases in the conduct of the study, of manipulating the data and of conflict of interest. The aim of this paper is to present data and explanations refuting these allegations. In the STOP-NIDDM Trial, 61 subjects were excluded from the efficacy analysis before unblinding for legitimate reasons: failure to satisfy major entry criteria (n=17) and lack of post-randomisation data (n=44). Blinding and randomisation were carried out by an independent biostatistician. Titration of placebo/acarbose is well described in the protocol and in the study design paper. Of the study population, 9.3% had a fasting plasma glucose of > or =7.0 mmol/l at screening and could have been diabetic according to the new diagnostic criteria. However, even if these subjects are excluded, patients having acarbose treatment still saw a significant risk reduction in the development of diabetes (p=0.0027). The changes in weight are consistent in different publications and are related to different times of follow-up and assessment. Weight change does have an effect on the development of diabetes, but acarbose treatment is still effective even after adjusting for this (p=0.0063). The cardiovascular endpoints were a clearly designated assessment in the original protocol, and only those defined in the protocol and ascertained by the independent Cardiovascular Event Adjudication Committee were used in the analysis. Hypertension was defined according to the most recent diagnostic criteria. The STOP-NIDDM Trial results are scientifically sound and credible. The investigators stand strongly behind these results demonstrating that acarbose treatment is associated with a delay in the development of diabetes, hypertension and cardiovascular complications in a high-risk population with IGT.
To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke.
Eating difficulties are prevalent and serious problems in patients with stroke. Screening for eating difficulties can predict undernutrition and subsequent care needs. For optimal care, information transferred between care settings has to be comprehensive and accurate.
The study investigated a sample of 15 triads, each including one patient with stroke along with his patient record and discharge summary and two nursing staff in the municipal care to whom the patient was discharged. Data were collected by observations of patients' eating, record audits and interviews with nurses. Data were analysed using content analysis and descriptive statistics.
Accuracy of recorded information on patients' eating difficulties and informational continuity were poor, as was accuracy in the transferred information according to nursing staff's perceptions. All patients were at risk of undernutrition and in too poor a state to receive rehabilitation. Nevertheless, patients' eating difficulties were described in a vague and unspecific language in the patient records. Co-ordinated care planning and management continuity related to eating difficulties were largely lacking in the documentation. Despite their important role in caring for patients with eating difficulties, little information on eating difficulties seemed to reach licensed practical nurses in the municipalities.
Comprehensiveness in the documentation of eating difficulties and accuracy of transferred information were poor based on record audits and as perceived by the municipal nursing staff. Although all patients were at risk of undernutrition, had multiple eating difficulties and were in too poor a state for rehabilitation, explicit care plans for nutritional problems were lacking.
Lack of accuracy and continuity in discharge information on eating difficulties may increase risk of undernutrition and related complications for patients in continuous stroke care. Therefore, the discharge process must be based on comprehensive and accurate documentation.
This study examines the adequacy of the dietary intake based on age, sex, and level of nutritional risk among 98 frail elderly persons receiving home care through Community Care Access Centres. The dietary intakes were measured using 24-hour recalls and were compared with the dietary reference intake. The participants' intakes of both macronutrients and micronutrients were found to be inadequate. On average, elderly persons were consuming more than the recommended amount of protein, but the average intakes of many vitamins and minerals were less than optimal based on the average intakes. Paradoxically, more than half of elderly participants were overweight or obese. The results highlight the need for appropriate nutrition, education, and support for elderly persons receiving home care.
This paper is a report of a study to investigate the stability of self-reported eating disorder symptoms, factors associated with them and the predictors of their recurrence.
In western cultures, eating-related problems during adolescence are common but usually temporary. However, in approximately 10% of cases disordered eating is sustained, increasing the risk of a full-blown eating disorder. To distinguish adolescents with temporary eating problems from those whose problems are likely to continue, healthcare providers need to understand the progress of disordered eating and the features of high-risk adolescents.
The two-stage prospective survey was conducted with a school-based sample of adolescents aged 15-17 years. At baseline, in 2003-2004, the SCOFF ('Sick', 'Control', 'One', 'Fat' and 'Food') questionnaire was administered to students in the 9th year of schooling in Finland. Follow-up assessment took place 1 year later, and 372 students provided data at both assessments. Binary logistic regression analysis was performed to investigate which factors predict the recurrence of eating disorder symptoms, defined as the occurrence of eating disorder symptoms at both assessments.
Five per cent of the students reported eating disorder symptoms at both assessments. Typically, they had multiple psychological problems and health complaints. Anxiety perceived earlier in adolescence resulted in an estimated odds ratio of the logistic model of 20 for the recurrence of eating disorder symptoms.
Earlier anxiety rather than dissatisfaction with appearance had a statistically significant effect on the progress of eating problems. Longitudinal research is needed to confirm the results. Until further knowledge is available, nurses should follow-up all adolescents with disordered eating to identify a possible need for intervention.
OBJECTIVE: To estimate flavonoid intake in the Australian population. DESIGN: Flavonoid consumption was estimated from 24-hour recall data and apparent consumption data using US Department of Agriculture flavonoid composition data. SUBJECTS: The National Nutrition Survey 1995 assessed dietary intake (24-hour recall) in a representative sample (n=13,858) of the Australian population aged 2 years and over. RESULTS: Analysis of the 24-hour recall data indicated an average adult intake (>18 years) of 454 mg day(-1) (92% being flavan-3-ols). Apple was the highest quercetin source until age 16-18 years, after which onion became an increasingly important prominent source. Variations in hesperetin consumption reflected orange intake. Apple, apricot and grapes were the major sources of epicatechin and catechin for children, but subsided as wine consumption increased in adulthood. Wine was the main source of malvidin. Naringenin intake remained static as a percentage of total flavonoid intake until age 19-24 years, corresponding to orange intake, and then increased with age from 19-24 years, corresponding to grapefruit intake. Apparent dietary flavonoid consumption was 351 mg person(-1) day(-1), of which 75% were flavan-3-ols. Black tea was the major flavonoid source (predominantly flavan-3-ols) representing 70% of total intake. Hesperetin and naringenin were the next most highly consumed flavonoids, reflecting orange intake. Both 24-hour recall and apparent consumption data indicated that apigenin intake was markedly higher in Australia than reported in either the USA or Denmark, presumably due to differences in consumption data for leaf and stalk vegetables and parsley. CONCLUSIONS: Tea was the major dietary flavonoid source in Australia. Flavonoid consumption profiles and flavonoid sources varied according to age. More consistent methodologies, survey tools validated for specific flavonoid intakes and enhanced local flavonoid content data for foods would facilitate better international comparisons of flavonoid intake.