Utilization of acute health care services accounts for a substantial proportion of health expenditures in Canada, and is associated with compromised health and autonomy for older persons. Using the Resident Assessment Instrument for Home Care (RAI-HC), this cross-sectional study of 683 elderly home care recipients sought to distinguish clients who were more likely to use acute health care services; i.e., hospital admissions, emergency room visits. Clients with nutritional problems were 2.58 times more likely to have used acute health care services than clients without nutritional problems. Among clients with a poor social support system, those with nutrition problems were 5.95 times as likely to have used acute health care services. Poor self-rated health, and greater functional dependency were also signif- icantly associated with acute health care use. This study provides a profile of elderly home care clients who are at risk of using acute health care services, which may facilitate targeted efforts to prevent unplanned acute health care use.
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.
Dietary habits among Arctic preschoolers are unknown. A cross-sectional health survey of 388 Inuit, aged 3-5 y, was conducted in 16 communities in Canada's Nunavut Territory. Twenty-four-hour recall and FFQ with parents and primary caregivers quantified diet from market and traditional foods (TF). The Institute of Medicine's Dietary Reference Intakes estimated adequacy comparing intakes with Estimated Average Requirement or Adequate Intakes (AI). High-sugar and high-fat food and sugar beverage consumption and the extent to which dietary habits followed the Canadian Food Guide were evaluated. The children's mean age was 4.4 +/- 0.9 y and the mean BMI percentile was 90.2%. Consumption of nutrient-poor and energy-dense food and beverages contributed to 35% of energy. Most children met the requirements for many nutrients despite not eating the recommended servings from Eating Well with Canada's Food Guide First Nations, Inuit and Métis. Higher intake of TF resulted in higher intakes of cholesterol, vitamins A and D, iron, magnesium, and zinc. The percent above the AI for vitamin D was 43.1, 56.8, and 83.2% among no, low, and high TF consumers, respectively (chi2 test; P-trend
To explore associations between diet-related greenhouse gas emissions (GHGE), nutrient intakes and adherence to the Nordic Nutrition Recommendations among Swedish adults.
Diet was assessed by 4d food records in the Swedish National Dietary Survey. GHGE was estimated by linking all foods to carbon dioxide equivalents, using data from life cycle assessment studies. Participants were categorized into quartiles of energy-adjusted GHGE and differences between GHGE groups regarding nutrient intakes and adherence to nutrient recommendations were explored.
Women (n 840) and men (n 627) aged 18-80 years.
Differences in nutrient intakes and adherence to nutrient recommendations between GHGE groups were generally small. The dietary intake of participants with the lowest emissions was more in line with recommendations regarding protein, carbohydrates, dietary fibre and vitamin D, but further from recommendations regarding added sugar, compared with the highest GHGE group. The overall adherence to recommendations was found to be better among participants with lower emissions compared with higher emissions. Among women, 27 % in the lowest GHGE group adhered to at least twenty-three recommendations compared with only 12 % in the highest emission group. For men, the corresponding figures were 17 and 10 %, respectively.
The study compared nutrient intakes as well as adherence to dietary recommendations for diets with different levels of GHGE from a national dietary survey. We found that participants with low-emission diets, despite higher intake of added sugar, adhered to a larger number of dietary recommendations than those with high emissions.
Not much is known about adherence to special diets in type 1 diabetes, characteristics of individuals with special diets, and whether such practices should raise concerns with respect to meeting the dietary recommendations. In this study, we assessed the frequencies of adherence to special diets, in a population of individuals with type 1 diabetes, and investigated the association between special diet adherence and dietary intake, measured as dietary patterns and nutrient intakes.
During the Finnish Diabetic Nephropathy Study visit, participants with type 1 diabetes (n?=?1429) were instructed to complete a diet questionnaire inquiring about the adherence to special diets. The participants also completed a food record, from which energy and nutrient intakes were calculated.
In all, 36.6% participants reported adhering to some special diet. Most commonly reported special diets were lactose-free (17.1%), protein restriction (10.0%), vegetarian (7.0%), and gluten-free (5.6%) diet. Special diet adherents were more frequently women, older, had longer diabetes duration, and more frequently had various diabetes complications. Mean carbohydrate intakes were close to the lower levels of the recommendation in all diet groups, which was reflected in low mean fibre intakes but high frequencies of meeting the sucrose recommendations. The recommendation for saturated fatty acid intake was frequently unmet, with the highest frequencies observed in vegetarians. Of the micronutrients, vitamin D, folate, and iron recommendations were most frequently unmet, with some differences between the diet groups.
Special diets are frequently followed by individuals with type 1 diabetes. The adherents are more frequently women, and have longer diabetes duration and more diabetes complications. Achieving the dietary recommendations differed between diets, and depended on the nutrient in question. Overall, intakes of fibre, vitamin D, folate, and iron fell short of the recommendations.
Although hypersensitivity to foods is often linked to exacerbations of symptoms of respiratory allergy, no such information is available regarding the foods traditionally considered to play a probable etiological role in respiratory allergy in India, which are in fact quite different from the ones implicated in the West. The present study was undertaken to investigate whether the practice of withholding certain common foods by parents and practitioners of indigenous systems of medicine (i.e. Ayurvedic and Unani systems of medicine) in children suffering from respiratory allergy had any scientific basis or explanation as judged by modern techniques of investigation. Skin prick tests were performed on 64 children with symptoms pertaining to respiratory allergy (32 each in study and control group) using crude antigenic food extracts. Oral food challenges were administered to children to confirm or rule out allergenicity of food (s) incriminated on the basis of the clinical history and/or a positive skin test. Parental history of food restriction alone, in absence of positive skin prick test was of little value in predicting a positive response to the food challenges (1 challenge positive out of 77 based on food restriction: 1.29%). Only 27.02% and 18.75% of positive skin tests were found to be clinically significant in study and control groups respectively. Traditionally, food beliefs were upheld in only 12.5% children for immediate onset clinical reactions (with 5.31% of the foods restricted in their diet) and 9.37% children for delayed onset clinical reactions (with 3.19% of the foods restricted in their diet). The present study shows that even though food restriction is a common practice in patients with respiratory allergy in India, objective documentation of Type I reactions due to these foods cannot be obtained in a majority of such children.
Information on weight loss is used in screening and assessment tools. It is essential that the data are correct. Anamnestic data of weight changes were compared with records for hospitalized patients and outpatients.
For hospitalized patients, anamnestic and recorded weight data were obtained. For outpatients, data of weight changes since last visit were obtained.
Of 34 hospitalized patients, 21 stated change of weight (15 lost, 6 gained). Weight loss in 9 and weight gain in 12 patients were recorded. Ten patients stated no change of weight. Weight loss in 4 and weight gain in 3 patients were recorded. Of 15 patients who stated weight loss, it was correct for 9 patients. Six of 21 patients stated weight changes opposite the records. Of 43 patients, 14 stated weight changes before admission; only 9 could indicate the time span. Ten patients stated 'Do not know' to the question of weight changes. For 156 outpatients, 86 stated change of weight (39 lost, 47 gained). Weight loss in 42 and weight gain in 47 patients were recorded. Fifty-eight patients stated no change of weight. Weight loss in 26 and weight gain in 29 patients were recorded. Of 38 patients who stated weight loss, it was correct for 31. Seventeen of 85 patients stated weight changes opposite the records.
Recollection of weight changes is poor for a large percentage of patients. In patients who stated weight loss it was only correct for 75%, and for patients who stated unchanged weight 25% have lost more than 1 kg. Thus, incorrect weight loss data can cause over- and underestimation of nutritional risk.
People suffering from the acquired immunodeficiency syndrome (AIDS) often experience involuntary weight loss and malnutrition. Altered body composition, recurrent opportunistic infection and a decline in immune function are associated with the progression of the human immunodeficiency virus (HIV) infection to AIDS. The factors that might affect nutritional status in AIDS are numerous and include a reduced food intake, increased metabolism, malabsorption and the acute phase response to infection. It is not clear what difference nutritional intervention can make to the progression of the disease. However, there is a consensus that it has an important role to play during the course of the disease. A report was compiled to assess the requirement for a dietitian in an HIV Clinic (the Southern Alberta Clinic) and the role of the dietitian in that position. Nutritional and anthropometric data were collected from medical records. In addition, Clinic physicians were sent a questionnaire. It was found that clients, when seen by the dietitian, had lost weight and had more gastrointestinal symptoms and a lower CD4+ lymphocyte count than the average Clinic patient at their initial Clinic visit. The report recommended that all Clinic staff use body mass index as a screening tool for referral to the dietitian and that good nutrition be promoted by the Clinic as an important part of the care of the HIV infected person. The assessment recommended a 0.4 full-time equivalent position within the Southern Alberta Clinic.
Canadian Aboriginal youth have poorer diet quality and higher rates of overweight and obesity than the general population. This research aimed to assess the impact of simple food provision programs on the intakes of milk and alternatives among youth in Kashechewan and Attawapiskat First Nations (FNs), Ontario, Canada.
A pilot school snack program was initiated in Kashechewan in May 2009 including coordinator training and grant writing support. A supplementary milk and alternatives program was initiated in Attawapiskat in February 2010. Changes in dietary intake were assessed using Web-based 24-hour dietary recalls in grade 6 to 8 students, pre- and 1-week post-program, with a 1-year follow-up in Kashechewan. Student impressions were collected after 1 week using open-ended questions in the Web survey. Teacher and administrator impressions were collected via focus groups after 1 year in Kashechewan.
After 1 week, calcium intake increased in Kashechewan (805.9 ± 552.0 to 1027.6 ± 603.7 mg, p = .044); however, improvements were not sustained at 1 year; milk and alternatives (1.7 ± 1.7 servings to 2.1 ± 1.4 servings, p = .034) and vitamin D (2.5 ± 2.6 to 3.5 ± 3.4 µg, p = .022) intakes increased in Attawapiskat. Impressions of the programs were positive, though limited resources, staff, facilities, and funding were barriers to sustaining the consistent snack provision of the 1-week pilot phase.
These illustrations show the potential of snack programs to address the low intakes of milk and alternatives among youth in remote FNs. Community-level constraints must be addressed for sustained program benefits.