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PubMed2001

Indigenous mucuna tempe as functional food.

The aim of the present study was to obtain the nutritive and bioactive compounds of mucuna tempe and the consumer preference of its formulated snack. The tempe was made traditionally from mucuna prurience seeds using 'ragi tempe' as inoculants. Proximate, vitamin, mineral and dietary fibre analysis was done using the methods of the Association of Official Analytical Chemists, isoflavone was analysed using high performance liquid chromatography (HPLC) with an RP-18 column and a UV detector. The preference test was done using scoring methods by trained panelists. The study demonstrates that compared with soybean tempe, mucuna tempe had a higher dietary fibre level, but lower vitamin E content. The mucuna tempe contains 31.5% protein, 7.3% fat, 3.0% ash, 58.1% carbohydrate and 9.1% fibre. It contains 0.551 mg/L isoflavone aglucone; daidzin is the highest, followed by Factor II (6,7,4 trihydroxy isoflavone) that is much higher than that of soybeans tempe. These are much higher isoflavone aglucone contents than found in soybeans tempe. The preference score for a 20% mucuna tempe-based snack was not significantly different compared with control or with the preference score for a 10% soybean tempe-based snack. This preliminary study needs to be followed by both in vitro and in vivo studies.

Biological Availability↗

PubMed2002

Intrafamilial transmission of Salmonella oranienburg.

BACKGROUND: There were diffuse outbreaks of Salmonella oranienburg in Japan since March 1999 which included 1505 patients. The outbreak was caused through ingestion of a dried squid snack contaminated with S. oranienburg. Such a large number of cases has not been previously recorded in Japan or other countries. METHODS: A 9-month-old boy was admitted to our hospital with enteritis and bacteremia due to S. oranienburg. His older brother had eaten the contaminated snack. We detected S. oranienburg in the stools of five out of his six family members. RESULTS: With the exception of the index case's brother, no other family members had eaten the contaminated snack. The S. oranienburg strain detected in the family was confirmed to be the same strain by pulse field gel electrophoresis. Therefore, we presumed there had been a series of household transmissions. CONCLUSION: Our observation of intrafamilial transmission suggests that S. oranienburg may be highly infectious.

Animals↗

PubMed2001

Combined effects of red pepper and caffeine consumption on 24 h energy balance in subjects given free access to foods.

The effects of red pepper and caffeine ingestion on energy and macronutrient balances were examined in eight Caucasian male subjects. All subjects participated in two randomly assigned conditions: control and experimental (red pepper and caffeine). After ingesting a standardized breakfast, subjects ate three meals ad libitum (lunch, dinner and breakfast) and snacks which were served approximately 2 h after the lunch and dinner over a 24 h period. Two appetizers with or without 3 g red pepper) were given before lunch and dinner, and a drink (decaffeinated coffee with or without 200 mg caffeine) was served at all meals and snacks except for the after-dinner snack. It is also important to note that on the experimental day, 8.6 and 7.2 g red pepper were also added to lunch and dinner respectively. Red pepper and caffeine consumption significantly reduced the cumulative ad libitum energy intake and increased energy expenditure. The mean difference in energy balance between both conditions was 4000 kJ/d. Moreover, the power spectral analysis of heart rate suggested that this effect of red pepper was associated with an increase in sympathetic:parasympathetic nervous system activity ratio. These results indicate that the consumption of red pepper and caffeine can induce a considerable change in energy balance when individuals are given free access to foods.

Adult↗

PubMed1985

Dietary fiber and cancer: a supplement for intervention studies.

Dietary fiber is one of several variables being considered in the study of the relationship between diet and cancer. Intervention trials in which dietary fiber is increased are the most direct way of assessing the possible role of fiber in this disease. Two dietary snack products have been developed for use in a fiber intervention study: the high-fiber snack (HFS), which supplies 23 g of dietary fiber per day (mostly from wheat bran) and the low-fiber product (LFS), which provides 3.5 g. Over a 12-week period, 28 volunteers consumed the HFS for 6 weeks and the LFS for 6 weeks. Compliance, as assessed by reports, through recovery of a riboflavin marker in the urine and fecal fiber analysis, was good. The only adverse effects reported were mild abdominal discomfort and gas. Serum ferritin and calcium decreased in some subjects, indicating a need to supplement the products with these essential minerals. Consumption of the snacks did not affect total energy intake or the intake of the nutrients monitored.

Adult↗

PubMed1997

Frequency of eating and risk of colorectal cancer in women.

Numerous dietary constituents have been extensively studied with regard to colorectal cancer risk, but food intake patterns have been studied less frequently. The purpose of these analyses was to describe associations between frequency of eating and colorectal cancer risk in women. Female Wisconsin residents aged 30-74 years with a diagnosis of colorectal cancer within two years were identified through the statewide tumor registry. Control subjects were randomly selected from lists of licensed drivers (< 65 yrs old) and Medicare beneficiaries (65-74 yrs old). Meal and snack frequency was obtained on a subset of case (n = 189) and control (n = 322) subjects. Odds ratios and 95% confidence intervals (CIs) obtained from conditional logistic regression models were used to estimate multivariate-adjusted relative risks. Compared with women consuming three or four meals daily, women consuming one to two meals daily had an adjusted relative risk of 0.57 (95% CI = 0.34-0.94). Snacking frequency and frequency of meals + snacks were not associated with cancer risk. These results are consistent with other reports and suggest that meal frequency is associated with colorectal cancer risk.

Adult↗

PubMed2004

Evening ready-to-eat cereal consumption contributes to weight management.

OBJECTIVES: Post dinner snacking may constitute a significant proportion of total daily energy intake and contribute to overweight and obesity in some individuals (night snackers). This study tested the hypothesis that providing a structured snack in the form of a "ready-to-eat" breakfast cereal would help regulate excess energy intake and contribute to weight loss in night snackers. METHODS: Adults (18 to 65 years of age, BMI kg/m2 > or = 25), with self-reported night snacking behaviors, were randomized into a cereal group (CR) and a no-cereal group (NC). During a period of 4 weeks, the cereal group was instructed to consume a serving of ready-to-eat cereal with low-fat milk 90 minutes after their evening meal. Concurrently, the non-cereal group continued their regular diet ad libitum. RESULTS: At baseline, there were no significant differences between groups for age, body weight, body mass index, daily caloric intake, or evening caloric intake. There was a correlation between number of days of compliance with post-dinner cereal consumption and weight loss (r = -0.36, p = 0.057). After 4 weeks, the compliant subjects (cereal intake > or = 20 d) lost -1.85 +/- 3.56 lbs vs. -0.39 +/- 3.1 lb for the NC group (p = 0.06). Compared to baseline, the compliant CR group reduced their total daily caloric intake by -396.50 +/- 641.6 kcal (p < 0.02), whereas, the NC group experienced a reduction of -23.22 +/- 889.60 kcal/day during the same period (p = ns). Reduction in post-dinner calorie intake for the compliant CR group was significantly greater compared to the NC group (-141.74 +/- 385.58 kcal vs. 85.82 +/- 374.70 kcal; p = 0.042). CONCLUSION: Eating ready-to-eat cereal after the evening meal may attenuate caloric intake in night snackers and promote weight loss in compliant individuals.

Adolescent↗

PubMed1996

Muscle glycogen storage after prolonged exercise: effect of the frequency of carbohydrate feedings.

We reported previously that intake of carbohydrate foods with a high glycemic index (GI) produced greater glycogen storage and greater postprandial glucose and insulin responses during 24 h of postexercise recovery than did intake of low-GI carbohydrate foods. In the present study we examined the importance of the greater incremental glucose and insulin concentrations on glycogen repletion by comparing intake of large carbohydrate meals ("gorging") with a pattern of frequent, small, carbohydrate snacks ("nibbling"), which simulates the flattened glucose and insulin responses after low-GI carbohydrate meals. Eight well-trained triathletes [x +/- SEM: 25.6 +/- 1.5 y of age, weighing 70.2 +/- 1.9 kg, and with a maximal oxygen uptake (VO2max) of 4.2 +/- 0.2 L/min] undertook an exercise trial (2 h at 75% VO2max followed by four 30-s sprints) to deplete muscle glycogen on two occasions, 1 wk apart For 24 h after each trial, subjects rested and consumed the same diet composed exclusively of high-GI carbohydrate foods, providing 10 g carbohydrate/kg body mass. The "gorging" trial provided the food as four large meals of equal carbohydrate content eaten at 0, 4, 8, and 20 h of recovery, whereas in the "nibbling" trial each of the meals was divided into four snacks and fed at hourly intervals (0-11, 20-23 h). However, there was no significant difference in muscle glycogen storage between the two groups over the 24 h (gorging: 74.1 +/- 8.0 mmol/kg wet wt; nibbling: 94.5 +/- 14.6 mmol/kg wet wt). The results of this study suggest that there is no difference in postexercise glycogen storage over 24 h when a high-carbohydrate diet is fed as small frequent snacks or as large meals, and that a mechanism other than lowered blood glucose and insulin concentrations needs to be sought to explain the reduced rate of glycogen storage after consumption of low-GI carbohydrate foods.

Adult↗

PubMed1999

Dietary variety within food groups: association with energy intake and body fatness in men and women.

BACKGROUND: Short-term experimental studies suggest that dietary variety may influence body fatness but no long-term human studies have been reported. OBJECTIVE: The purpose of this study was to determine whether dietary variety within food groups influences energy intake and body fatness. DESIGN: Seventy-one healthy men and women (aged 20-80 y), who provided accurate reports of dietary intake and completed a body-composition assessment, were studied. RESULTS: Dietary variety was positively associated with energy intake within each of 10 food groups (r = 0.27-0.56, P < 0.05). In multiple regression analysis with age and sex controlled for, dietary variety of sweets, snacks, condiments, entrées, and carbohydrates (as a group) was positively associated with body fatness (partial r = 0.38, P = 0.001) whereas variety from vegetables was negatively associated (partial r = -0.31, P = 0.01) (R2 = 0.46, P < 0.0001). In separate models, both a variety ratio (variety of vegetables/variety of sweets, snacks, condiments, entrées, and carbohydrates) and percentage dietary fat were significant predictors of body fatness (controlled for age and sex, partial r = -0.39 and 0.31, respectively, P < 0.01). However, dietary fat was no longer significantly associated with body fatness when the variety ratio and dietary fat were included in the same model. CONCLUSIONS: Our data, coupled with those of previous short-term studies, suggest that a high variety of sweets, snacks, condiments, entrées, and carbohydrates coupled with a low variety of vegetables promotes long-term increases in energy intake and body fatness. These findings may help explain the rising prevalence of obesity.

Adipose Tissue↗

PubMed2002

Validation of energy intake measurements determined from observer-recorded food records and recall methods compared with the doubly labeled water method in overweight and obese individuals.

BACKGROUND: Measurements of dietary intake in obese and overweight populations are often inaccurate because food intakes are underestimated. OBJECTIVE: The purpose of this study was to evaluate the validity of the combined use of observer-recorded weighed-food records and 24-h snack recalls in estimating energy intakes in overweight and obese individuals. DESIGN: Subjects were 32 healthy women and 22 healthy men with mean body mass indexes (in kg/m(2)) of 29.5 and 30.3, respectively. Energy intake (EI) was measured over 2 wk in a university cafeteria. No restrictions were made on meal frequency or EI. To document food consumed outside the cafeteria, 24-h snack recalls were conducted before meals. Energy expenditure (EE) was measured with the doubly labeled water (DLW) method (EE(DLW)). Energy balance was determined by measuring body weight at the beginning and end of the 2-wk period. RESULTS: The mean EI in the women (10.40 +/- 1.94 MJ/d) and men (14.37 +/- 3.21 MJ/d) was not significantly lower than the EE(DLW) in the women (10.86 +/- 1.76 MJ/d) and men (14.14 +/- 2.83 MJ/d). The mean EI represented 96.9 +/- 17.0% and 103 +/- 18.9% of the measured EE for women and men, respectively. There were no significant changes in weight in the group as a whole or by sex at the end of the testing period; the men lost 0.23 +/- 1.58 kg and the women lost 0.25 +/- 1.09 kg. CONCLUSION: The combination of observer-recorded food records and 24-h snack recalls is a valid method for measuring EI in overweight and obese individuals.

Adult↗

PubMed2006

Secular trends in patterns of self-reported food consumption of adult Americans: NHANES 1971-1975 to NHANES 1999-2002.

BACKGROUND: The contributors to trends in increasing prevalence of obesity in the US population are poorly understood. OBJECTIVE: We examined secular trends in food consumption behaviors to understand their possible contribution to increasing energy intakes and adiposity in the American population. DESIGN: We used dietary data from 4 consecutive National Health and Nutrition Examination Surveys (NHANES) to examine trends (1971-2002) in frequency of eating episodes, meal and snack consumption, quantity of food consumed, and the energy density of foods reported by adult Americans (n = 39 094). Logistic and linear regression methods were used to adjust for multiple covariates and survey design. RESULTS: The reported number of all eating episodes increased slightly in women from 4.90 in 1971-1975 to 5.04 in 1999-2002 (P for trend = 0.002). The amount (in g) of foods and beverages consumed, the energy density of foods, and energy intake per eating episode increased, but the mention of breakfast declined in both sexes (P for trend < 0.0001). The observed trends in mention of a snack (in men) and percentage of energy from evening food intake (in women) were downward. The amount (in g) of foods and their energy density were independent positive correlates of obesity in combined data from all surveys (P for trend < 0.0001). CONCLUSIONS: Our results do not support large increases in eating frequency, snacking, or evening eating by the American population from 1971 to 2002. The quantity of foods and their energy density increased beginning in NHANES III (1988-1994) with trajectories roughly parallel to the rates of prevalence of obesity in the US population. However, we urge cautious interpretation of these results because of concurrent changes in dietary methods during this period.

Adult↗

PubMed1999

Description of a mixed ethnic, elderly population. II. Food group behavior and related nonfood characteristics.

BACKGROUND: Elderly persons 60-103 years of age, who were participants in a Title III-C Nutrition Program, provided information regarding weekly frequencies of food group consumption, weekend meals and snack patterns, and several nonfood items that may affect food intakes. METHODS: Nonrandomized volunteers were interviewed in senior centers or in their homes. Chi-square, t test, and Pearson's product moment correlations were used to assess differences in the population sample with regard to six independent variables: ethnicity, gender, type meal (congregate or home delivered), age, proportion of noon meal usually eaten, and socialization factor (lived alone or with others). RESULTS: White subjects ate more fruits, dairy products, and weekend snacks than black subjects. White elders also consumed more caffeine, had larger incomes, and more often had sufficient money to buy food. Black subjects ate more pasta and desserts, and in sickness more often had help available. Men consumed more meats, dairy products, eggs, and starchy foods than women. There were no gender differences in income, but men ate more weekend meals in restaurants, spent more money weekly for food, more often were able to shop for food and leave home without assistance, and reported greater pleasure associated with eating. Home delivery clients ate more desserts and Sunday snacks and more frequently ate breakfast on the weekend than congregate clients. Congregate clients had more money to buy food, were better able to shop for and prepare food, and more frequently had help available in sickness. Young-old (<75 yr) and old-old (> r =75 yr) clients showed no difference in consumption of any of the food groups. Persons who usually ate all or most of the noon meal more frequently experienced pleasurability in eating, reported less anorexia, and had larger intakes of the vegetable and pasta groups. Persons living with others ate more meats, pasta, and desserts, spent more weekly for food, and ate more weekend meals in restaurants. CONCLUSION: The need for focus of the elderly nutrition program is greater in home delivery than congregate clients. The average home delivery client is older, has more chronic health problems and less physical prowess, less income, less frequently has help available in sickness, and has greater need for services other than the noon meal.

Black or African American↗

PubMed2004

Individualized feeding assistance care for nursing home residents: staffing requirements to implement two interventions.

BACKGROUND: Recommendations have been made to increase the number of nursing home (NH) staff available to provide feeding assistance during meals and to individualize care for residents. However, there are few data reflecting the number of residents responsive to feeding assistance during meals and what alternative interventions might be appropriate for other residents. The purpose of this study was to evaluate the effects and staffing requirements of two individualized feeding assistance interventions to improve oral food and fluid intake in NH residents. METHODS: Skilled nursing participants (n = 134) in 3 NHs received a 2-day trial of one-on-one feeding assistance during 6 meals. 68 participants who did not increase their oral intake in response to feeding assistance during meals received a 2-day intervention trial during which snacks were offered between meals 3 times daily. As part of both interventions, research staff provided adequate feeding assistance that enhanced the resident's self-feeding ability, social stimulation throughout the meal or snack period, and availability of choices for foods and fluids. RESULTS: 46% significantly increased their oral intake in response to one-on-one mealtime feeding assistance, and the staff time required to implement this intervention was 35 (+/- 8) minutes/meal per resident compared with usual NH care, which averaged 6 (+/- 9) minutes. 44% of the participants significantly increased their oral intake in response to the between-meal snack intervention, which required 12 (+/- 6) minutes of staff time per snack/resident compared with usual NH care (1 +/- 4 minutes). CONCLUSIONS: Most participants (90%) significantly increased their daily oral food and fluid intake in response to one of two individualized interventions. The staff time necessary to implement each intervention was significantly greater than the staff time currently being spent on feeding assistance care delivery. Suggestions are made to increase the efficiency of staff time when delivering feeding assistance.

Eating↗

PubMed1994

Iron supplementation improves appetite and growth in anemic Kenyan primary school children.

A randomized, double-blind, placebo-controlled iron supplementation trial was conducted in Kenya to examine the effect of iron supplements on appetite and growth in 87 primary school children. Sustained-release ferrous sulfate (150 mg) or placebo tablets were provided daily at school for 14 wk. Prior to tablet administration, baseline anthropometry, iron nutritional status (hemoglobin and serum ferritin), parasitic infections and clinical indicators of morbidity were measured. A baseline appetite test was conducted twice on each child by quantitatively measuring the ad libitum consumption of a midmorning snack. In addition, each child was asked for a subjective assessment of his or her appetite. Follow-up exams and appetite tests were identical to those at baseline. Findings indicated that provision of iron supplements resulted in improved growth and improved appetite (in terms of both energy intake of the snack and child report of appetite) as compared with children receiving the placebo. The increased energy intake from the snack was 10% of the daily estimated energy intake for children of this same age group living elsewhere in Kenya. Further research into the underlying physiological mechanisms may shed light on the relationship between iron nutritional status and appetite.

Anemia, Hypochromic↗

PubMed2003

Nutritional importance of animal source foods.

Animal source foods can provide a variety of micronutrients that are difficult to obtain in adequate quantities from plant source foods alone. In the 1980s, the Nutrition Collaborative Research Support Program identified six micronutrients that were particularly low in the primarily vegetarian diets of schoolchildren in rural Egypt, Kenya and Mexico: vitamin A, vitamin B-12, riboflavin, calcium, iron and zinc. Negative health outcomes associated with inadequate intake of these nutrients include anemia, poor growth, rickets, impaired cognitive performance, blindness, neuromuscular deficits and eventually, death. Animal source foods are particularly rich sources of all six of these nutrients, and relatively small amounts of these foods, added to a vegetarian diet, can substantially increase nutrient adequacy. Snacks designed for Kenyan schoolchildren provided more nutrients when animal and plant foods were combined. A snack that provided only 20% of a child's energy requirement could provide 38% of the calcium, 83% of the vitamin B-12 and 82% of the riboflavin requirements if milk was included. A similar snack that included ground beef rather than milk provided 86% of the zinc and 106% of the vitamin B-12 requirements, as well as 26% of the iron requirement. Food guides usually recommend several daily servings from animal source food groups (dairy products and meat or meat alternatives). An index that estimates nutrient adequacy based on adherence to such food guide recommendations may provide a useful method of quickly evaluating dietary quality in both developing and developed countries.

Animals↗

PubMed2005

Dietary patterns and the risk of colorectal adenoma recurrence in a European intervention trial.

The relations between individual foods and nutrients to colorectal tumours are conflicting. Few studies have taken into account the interdependence between individual components of diet and their possible interactions. The aim of the study was to examine the associations between dietary patterns and the risk of colorectal adenoma recurrence in the European fibre-calcium intervention trial. Among the 640 patients with confirmed adenomas at the index colonoscopy, 592 had an initial dietary assessment using a diet history questionnaire. The present analysis was restricted to 277 men and 165 women without history of adenoma prior to the index colonoscopy and who completed the study. The main end point was the 3-year recurrence of adenomas. Principal component analysis was used to identify dietary patterns from 50 food groups. Ninety-two patients presented new colorectal adenomas at the 3-year colonoscopy (65 men and 27 women). In men, three meaningful dietary patterns emerged from analysis, explaining 21.3% of variability. They were called 'Mediterranean', 'Sweets and snacks' and 'High fat and proteins' patterns. None of them were significantly related to the overall recurrence of colorectal adenomas either in univariate or multivariate analyses. Among women, the 'Mediterranean', the 'Western' and the 'Snacks' patterns explained 21.9% of variability. The 'Mediterranean' pattern characterized by a high consumption of olive oil, vegetables, fruit, fish and lean meat significantly reduced adenoma recurrence [second tertile: adjusted odds ratio (OR)=0.50, 95% confidence interval (CI)=0.18-1.42; third tertile: adjusted OR=0.30, 95% CI=0.09-0.98; P for linear trend=0.04]. The 'Western' and 'Snacks' patterns were not associated with recurrence among women. In conclusion, this study suggests that the Mediterranean dietary pattern may reduce the recurrence of colorectal adenomas, at least in women. These exploratory results need to be confirmed by larger studies.

Adenoma↗

PubMed1987

Food intake at age 8. 3. Distribution and food density by meal.

This report describes how nutrient intake was distributed throughout the day, and the nutrient density according to meal, in 78 boys and 63 girls who have been studied from birth. The food intake was calculated from 4 day weighed records using the CSIRONET data bank based on British tables of food composition. The percentages of total energy from breakfast, lunch, evening meal, and snacks were 20, 26, 31, 23%. There was a very wide range of individual nutrient intake for each meal. The evening meal made the largest contribution to fat and protein intake. Most starch came from lunch (30%) and least from snacks (16%). Snacks contained a large portion of the simple sugars (39%). Breakfast was an important source of calcium and B vitamins, but with wide ranges of micronutrients occurring for each meal. This analysis of nutrient density and distribution contributes towards the formulation of practical recommendations about beneficial dietary changes.

Child↗

PubMed1996

Food habits and energy and nutrient intake in Swedish adolescents approaching the year 2000.

In 1993-94 a nutritional survey of 15-year-old adolescents was carried out in Uppsala, a university city in eastern Sweden, and in Trollhättan, an industrial town in the western part of the country. The study was the beginning of a longitudinal nutritional survey of 193 boys and 218 girls randomly selected from the official population register. The dietary methods used were a food frequency questionnaire (FFQ) and a combined estimated and weighed 7-day dietary record. According to the FFQ both boys and girls consumed cereals, butter or margarine and something from the group meat/fish/eggs every day. Milk, milk products, sweets and snacks were consumed more than once per day. Vegetables and fruit/roots were consumed less often. There was relatively good correlation between the FFQ and the 7-day record results. The mean daily energy intakes of the 15-year-old boys and girls were 10.2 and 8.3 MJ, respectively, in Uppsala, and 9.8 and 7.4 MJ in Trollhättan. The mean daily intakes of sucrose were 74 and 58 g in boys and 64 and 52 g in girls. The average daily dietary fibre intake was 1.8 g/MJ. The daily intake of energy obtained from breakfast was 18% on weekdays and 22% on weekends; 18 and 11% from prepared lunch; 24 and 30% from dinner, 21 and 14% from light meals; and 16 and 28% from snacks, in Uppsala and Trollhättan respectively. The lowest energy intake from a prepared lunch meal was noted during weekends. On both weekdays and weekends, considerable energy was obtained from light meals and snacks. However, nearly 40% of the girls and 28% of the boys had an energy intake from fat of < 30 energy%. The mean intakes of vitamin D and selenium and, in the case of girls, iron and zinc, were below the official Swedish Nutrition Recommendations. The daily median intake of iron was 18.7 mg in boys and 14.1 mg in girls. The iron intakes varied between 6 and 35 mg per day. Low serum ferritin concentrations, defined as s-ferritin < 12 micrograms/L, were found in 7 boys (3.7% and in 29 girls (13.9%). Significant negative correlations were found between smoking and frequency of consumption of vegetables, roots, fruits and meat. A negative correlation was also found between smoking and the intake of energy and a number of nutrients. Socioeconomic factors seem to be less important for the food habits of teenagers than for those noted during childhood. Only frequent consumption of vegetables was positively correlated to the mothers' educational level.

Adolescent↗

PubMed2006

Tagging-based, electronically cleansed CT colonography: evaluation of patient comfort and image readability.

PURPOSE: To prospectively compare the homogeneity, adequacy, and patient acceptance of nonionic iodine-based regimens with those of a barium-based regimen for computed tomographic (CT) colonography with electronic subtraction cleansing. MATERIALS AND METHODS: After institutional review board approval and informed consent were obtained, 68 subjects (41 men (60%) men, 27 (40%) women; mean age, 60 years +/- 6 [standard deviation]) with average or moderate risk factors for development of colorectal carcinoma were recruited and placed into three study groups. Group 1 (n = 25) ingested 150-mL aliquots of 2% barium sulfate suspension with meals and snacks for 48 hours prior to imaging, without other diet modification or a cathartic. Group 2 (n = 21) ingested 10-mL aliquots of nonionic iodinated contrast material (iopromide) with a concentration of 300 mg per milliliter with meals and snacks for 2 days before imaging, without diet modification or a cathartic. Group 3 (n = 22) ingested nonionic iodinated contrast material (iohexol) with a concentration of 300 mg per milliliter with meals and snacks for 2 days before imaging and ingested 34 g of magnesium citrate the evening prior to imaging. CT colonography was also performed on 10 control subjects who ingested polyethylene glycol electrolyte solution prior to imaging. Subjective and numerical measures of bowel preparation quality, homogeneity, and patient comfort among the noncathartic and cathartic cohorts were compared with nonparametric analysis of variance, the Fisher exact test, and the F test, as appropriate. The study was HIPAA compliant. RESULTS: Study subjects who received tagging preparations reported significantly improved discomfort scores when compared with those of the control subjects (P < .05, each comparison). There was no significant difference in discomfort scores among groups 1, 2, and 3. For each reader, scores of subtracted image readability were highest for group 3. Dichotomized rates of preparation "success" were also greatest for group 3. CONCLUSION: In this series, the patient discomfort scores were significantly improved with tagging preparations for CT colonography. Nonionic iodinated contrast material in conjunction with a hyperosmotic laxative (magnesium citrate) was associated with the best subjective and numerical indices of readability.

Aged↗