Biomedical subjects

M Bollella

Publications and source records attributed to M Bollella.

7 recordsLinked to original sources

PubMed1997

Management of childhood obesity in pediatric practice.

Evaluation of obese children and adolescents in the pediatric office or clinic should include baseline assessment of weight for height and body fatness; rule out endocrine and genetic causes of obesity; and evaluate other health-risk factors, such as those for cardiovascular disease, cancer, diabetes, and hypertension. Treatment of obesity is most successful if realistic goals are set; a balanced low-fat/high-fiber diet is stressed; a safe rate of weight loss of 1 to 2 pounds per week is achieved through a moderate reduction of caloric intake (approximately 20-25% decrease); increased physical activity is stressed as much as diet; parental support is strong; and behavior therapy is provided during the course of treatment to help both child and parent achieve the diet, exercise, and behavior goals.

Adolescent↗

PubMed1995

Soluble fiber enhances the hypocholesterolemic effect of the step I diet in childhood.

BACKGROUND: Psyllium, a water-soluble fiber, has been shown to have a cholesterol-lowering effect in studies of adults. A small number of studies in children have produced variable results. METHODS: A 12-week, randomized, single-blind, placebo-controlled, parallel clinical trial was conducted to test the effectiveness of psyllium in lowering total (TC) and low-density lipoprotein cholesterol (LDL-C) in 50 healthy 2 to 11 year old children. Children with two baseline LDL-C levels > or = 110 mg/dL were invited to participate in the trial, and were randomly assigned to follow a usual Step I (Control) diet of low dietary fat, saturated fat and cholesterol, or a Step I diet enriched with psyllium. Children consumed two 1-oz boxes of cereal per day, with each box of psyllium-enriched cereal containing 3.2 g of soluble fiber, and each box of placebo cereal containing less than 0.5 g of soluble fiber. RESULTS: Greater reduction of total and LDL-cholesterol, and increase in HDL-cholesterol were noted after 12 weeks of the psyllium-enriched Step I diet compared to the Step I control diet. Total cholesterol decreased 21 mg/dL for the high fiber group compared with 11.5 mg/dL for the control group. LDL-C decreased 23 mg/dL for the high fiber group compared with 8.5 mg/dL for the control group. HDL-C increased 4 mg/dL for the high fiber group compared with 1 mg/dL for the controls. TC/HDL and LDL/HDL ratios decreased significantly more so for the high fiber group as well. CONCLUSIONS: In this 12-week study, soluble fiber (psyllium) provided added benefit to the Step I diet in the treatment of hypercholesterolemia.

Anticholesteremic Agents↗

PubMed1995

Is a high-fiber diet safe for children?

OBJECTIVES: Although dietary fiber is associated with important health benefits in childhood, there have been concerns that very high fiber diets may result in adverse health effects. This report reviews the major safety concerns associated with consumption of very high fiber diets, estimates the amount of fiber that may cause adverse physiologic effects in children, and proposes safe levels of dietary fiber intake for children and adolescents. METHODS: Published studies on dietary fiber intake in childhood were reviewed to determine major safety concerns, to document adverse effects, to characterize subjects involved and the dose and type of fiber consumed, and to estimate potential relevance to US children and adolescents. Levels of dietary fiber reported to have adverse health effects were compared with recommended levels of fiber intake for children older than 2 years of age. RESULTS AND CONCLUSIONS: A review of the scientific literature suggests that a small loss of energy, protein, and fat may occur with a high intake of dietary fiber. However, this small loss of energy is unlikely to be significant to children consuming adequate levels of major nutrients, especially at conservative fiber intakes as recommended by the American Health Foundation's age plus 5 formula. In addition, it is estimated that even with a doubling of current dietary fiber, there is unlikely to be an adverse effect on serum vitamin and mineral concentrations in healthy US children consuming a balanced diet containing adequate levels of nutrients. Thus, evidence suggests that for US children, a moderate increase in dietary fiber is more likely to be healthful than harmful.

Adolescent↗

PubMed1995

A new recommendation for dietary fiber in childhood.

OBJECTIVE: The consumption of dietary fiber in childhood is associated with important health benefits, especially with respect to promoting normal laxation. Dietary fiber also may help reduce the future risk of cardiovascular disease, some cancers, and adult-onset diabetes. At present, there are few specific guidelines for dietary fiber intake in childhood. Our goals were to review the benefits and risks of dietary fiber in childhood and to propose a safe and effective quantitative recommendation for the US pediatric population. METHOD: Current intake of dietary fiber in childhood was reviewed, including data from the US Department of Agriculture Nationwide Food Consumption (1987-1988) and National Health and Nutrition Examination II (1976-1980) Survey. Current intake was compared with existing fiber recommendations, including the 0.5-g/kg guideline proposed by the American Academy of Pediatrics Committee on Nutrition. Recommended fiber intake was reviewed with respect to levels required for specific health benefits, as well as levels that may result in adverse health effects. RESULTS AND CONCLUSIONS: A new recommendation for dietary fiber intake was developed, based on the age of the child, health benefits, and safety concerns. We recommended that children older than 2 years of age consume a minimal amount of dietary fiber equivalent to age plus 5 g/d. A safe range of dietary fiber intake for children is suggested to be between age plus 5 and age plus 10 g/d. This range of dietary fiber intake is thought to be safe even if intake of some vitamins and minerals is marginal, should provide enough fiber for normal laxation, and may help prevent future chronic disease.

Adolescent↗

PubMed1994

Preventive cardiology in primary care.

Primary care physicians play a pivotal role in the successful implementation of the National Cholesterol Educational Program (NCEP) guidelines for both population and high-risk approaches to reduce blood cholesterol levels in children and adults. Increasingly, in this era of health cost containment, the primary care physician is recognized as (1) the main and sometimes the only source of health care for large numbers of individuals; (2) the affordable physician and (3) the gatekeeper for referral to medical specialists. Achievement of NCEP guidelines for cholesterol reduction, American Heart Association (AHA) guidelines for prevention of cardiovascular disease, and Year 2000 National Objectives for Health Promotion and Disease Prevention will all rely heavily on the active cooperation and support of practicing internists, pediatricians, and family/general practitioners in providing patient education, risk factor evaluation and intervention. Although the majority of primary care physicians intuitively support the concept of preventive cardiology and generally have a high level of knowledge of cardiovascular risk factors, a significant gap remains between physician knowledge and attitudes and the actual practice of preventive cardiology in clinical practice. Despite these limitations in implementation of clinical guidelines, significant progress has been made in the past decade in reaching NCEP and Year 2000 goals for population-wide cholesterol reduction.

Adult↗

PubMed1993

Treatment of childhood obesity in pediatric practice.

Evaluation of obese children and adolescents in the pediatric office or clinic should include baseline assessment of weight for height, and body fatness; should rule out endocrine and genetic causes of obesity; and should evaluate other cardiovascular risk factors. Treatment of obesity is most successful if realistic goals are set; if a safe rate of weight loss of one to two pounds per week can be achieved through a reduction of caloric intake that amounts to 500 calories less per day; if increased physical activity is stressed as much as diet; if parental support is strong; and if behavior therapy is provided during the course of treatment to help both child and parent achieve the diet, exercise, and behavior goals.

Adolescent↗

PubMedDate not supplied

Guidelines for screening, evaluating, and treating children with hypercholesterolemia.

Hypercholesterolemia is the most frequently identified coronary heart disease risk factor in childhood, with 25% or more of children in the United States reported to have borderline high or high levels. This article provides a summary of current recommendations for cholesterol screening, evaluation, treatment, and follow-up in the pediatric office or clinic setting. Detection and treatment of pediatric dyslipidemia, however, is only one component of preventive cardiology and should be addressed in routine well child and adolescent care along with major efforts to prevent cigarette smoking, obesity, inactivity, and hypertension.

Adolescent↗