Nutrition research from respiration and vitamins to cholesterol and atherosclerosis.
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Biomedical subjects
Publications and source records attributed to F J Stare.
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Food purchasing and preparation practices were modified in two boarding high schools to increase the polyunsaturated-to-saturated fat ratio (P/S) of the diet of students by changing food products rather than attempting to change eating behaviors. During years when fat-modified products were served, the P/S of males increased by 75 percent, versus a decrease of 6 percent during control years. For females, P/S increased by 53 percent during intervention years, versus an increase of 6 percent during control years.
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To judge the effect on blood pressure, sodium intake of students at two boarding high schools was reduced by 15-20% through changes in food purchasing and in preparation practices in the schools' kitchens. Students were not asked to change their usual eating habits. Each school served alternately as the control or intervention school for one school year. Blood pressure was monitored among 341 subjects during control years and 309 subjects during intervention years. Analysis of blood pressure differences between early in the school year and near the end of the school year, with adjustment for sex and initial blood pressure, showed the effect of the dietary intervention to be -1.7 mmHg for systolic (95% CI = -0.6, -2.9, p = 0.003) and -1.5 mmHg for diastolic pressure (95% CI = -0.6, -2.5, p = 0.002). Such modest and easily attainable changes in sodium intake, if maintained, could have a significant effect on the future risk of essential hypertension among young people.
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An environmental program directed at the food service departments of two boarding high schools has been tested in a concurrently controlled longitudinal investigation in which the intervention was applied to each school in alternate years. It has been demonstrated that changes in food purchasing and preparation practices can markedly decrease sodium and modify the fat composition of foods, and that such practices result in significant changes in the nutrient intake of students. Even without an educational component for students, who maintained their usual dietary practices, the changes by food service workers led to 15-20% less sodium intake, 20% less saturated fat intake, and an increase in the P/S ratio from 0.46 to 0.84 among students. The change in sodium intake over a school year resulted in lower blood pressure among students receiving the intervention. Adjusting for sex and baseline blood pressure, the estimated effect of the intervention on systolic pressure was -1.7 mmHg (95% C.I. -0.6, -2.9; p = 0.003); for diastolic pressure, it was -1.5 mmHg (95% C.I. -0.6, -2.5; p = 0.002). Such modifications by school food service workers are well accepted and produce very palatable foods. The widespread dissemination of such practices could favorably affect cardiovascular risk factors of students everywhere.
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In a prospective epidemiologic study of 1001 middle-aged men, we examined the relation between dietary information collected approximately 20 years ago and subsequent mortality from coronary heart disease. The men were initially enrolled in three cohorts: one of men born and living in Ireland, another of those born in Ireland who had emigrated to Boston, and the third of those born in the Boston area of Irish immigrants. There were no differences in mortality from coronary heart disease among the three cohorts. In within-population analyses, those who died of coronary heart disease had higher Keys (P = 0.06) and modified Hegsted (P = 0.02) dietary scores than did those who did not (a high score indicates a high intake of saturated fatty acids and cholesterol and a relatively low intake of polyunsaturated fatty acids). These associations were significant (P = 0.03 for the Keys and P = 0.04 for the modified Hegsted scores) after adjustment for other risk factors for coronary heart disease. Fiber intake (P = 0.04) and a vegetable-foods score, which rose with increased intake of fiber, vegetable protein, and starch (P = 0.02), were lower among those who died from coronary heart disease, though not significantly so after adjustment for other risk factors. A higher Keys score carried an increased risk of coronary heart disease (relative risk, 1.60), and a higher fiber intake carried a decreased risk (relative risk, 0.57). Overall, these results tend to support the hypothesis that diet is related, albeit weakly, to the development of coronary heart disease.
Sophisticated consumers of the future will not only feed themselves better; they will be far less prone to the victims of ignorance, the misplaced enthusiasm of the food faddist, the hucksterism of the charlatan, and the malice of those who inflate their egos, and earn their living by alarming others. There is much to be concerned about in the years ahead and our efforts should be expended on the right points -- and one of these right points will be an orderly and intelligent expansion of the concept of food fortification. The rationale for this is because too many of us, and far more in other parts of the world, do not consume, or have the opportunity to consume, a variety of foods that provide in adequate amounts the some 50 nutrients known to be necessary for good nutrition. A proper variety of foods, when available and when consumed, will provide the best nutrition each of us can obtain genetically. Intelligent fortification of certain key foods will assist in obtaining this adequate nutrition by those who do not or cannot consume this desired and proper variety of foods.
A questionnaire survey attempted to define the prevalence of symptoms characteristic of the "Chinese restaurant syndrome" (CRS) in the general adult population. Forty-three per cent of 3,222 respondents associated unpleasant symptoms with specific foods and eating environments; however, only 1 to 2 per cent reported symptoms characteristic of the CRS, and only 0.19 per cent associated these characteristic symptoms with consumption of Chinese food. Most respondents who were "aware" of the syndrome and most of those who believed they had experienced it reported non-specific symptoms. If the word "syndrome" is to be used to describe symptoms attributed to specific food ingredients, the limits of the "syndrome" must be specified.
An average reduction in serum cholesterol approximating 10 per cent was achieved in a short-term, family-centered study in which intakes of cholesterol and saturated fats were decreased and sunflower oil and margarine were added as the major sources of polyunsaturated fats. Dietary Achievement Scores demonstrated shifts in food consumption between baseline and diet periods. Changes were evident in all fat-containing food groups; meat was the least altered. A high degree of cooperation was evident in participating families, implying the possibilities for complete family cooperation in preventive or therapeutic dietary programs. Approximately three months after the end of the test period, cholesterol levels had returned to pre-diet levels, indicating the need for continuation of the changed regimen if cholesterol-lowering is to be maintained.