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At least 991 records · Page 55Linked to original sources

PubMed1999

Nutritionally complete prepared meal plan to reduce cardiovascular risk factors: a randomized clinical trial.

OBJECTIVE: To compare a nutritionally complete prepared meal plan that meets national dietary guidelines to usual-care dietary therapy for hypertension, dyslipidemia, and glycemic control. DESIGN: Randomized, controlled trial. SUBJECTS/SETTING: Outpatients with hypertension, dyslipidemia, or diabetes mellitus (n = 251) were recruited at 6 medical centers in the United States and Canada. INTERVENTION: The prepared meal plan, which was developed by university-based nutrition and cardiovascular scientists and food technologists at Campbell's Center for Nutrition & Wellness (CCNW), provided the optimal levels of macronutrients and micronutrients recommended for cardiovascular risk reduction in a variety of prepackaged meals and snacks. After a 4-week pretrial period to assess baseline state, participants were randomized to the CCNW plan or "usual-care" diet for 10 weeks. MAIN OUTCOME MEASURES: Blood pressure, carbohydrate metabolism, lipoproteins, homocysteine, weight, nutrient intake, compliance. STATISTICAL ANALYSES PERFORMED: Repeated measures analysis of variance. RESULTS: Lipoproteins, carbohydrate metabolism, blood pressure, and weight improved on both plans. Mean differences (+/- standard deviation) between baseline and follow-up for the CCNW plan and the usual-care plan, respectively, were total cholesterol, -0.41 +/- 0.64 and -0.20 +/- 0.50 mmol/L (between-group P < .01); plasma glucose, -0.7 +/- 1.7 and -0.3 +/- 1.3 mmol/L (P < .05); systolic blood pressure, -5.2 +/- 10.0 and -4.7 +/- 9.0 mm Hg (P = .67), diastolic blood pressure, -3.8 +/- 5.9 and -2.2 +/- 5.5 mm Hg (P < .05); and homocysteine, -1.3 +/- 3.8 and 0.2 +/- 3.4 mumol/L (P < .01). The CCNW plan led to greater weight loss than the usual-care diet (-5.5 +/- 3.8 kg vs -3.0 +/- 3.2 kg, P < .0001). APPLICATIONS/CONCLUSION: The nutritionally complete CCNW plan offers greater improvements in lipids, blood sugars, homocysteine, and weight loss than usual-care diet therapy. This prepackaged comprehensive nutrition program can augment both the prescription and practice of optimal dietary therapy.

Adult↗

PubMed1999

Stages of change and the intake of dietary fat in African-American women: improving stage assignment using the Eating Styles Questionnaire.

OBJECTIVE: To develop an algorithm for determining the stage of change for dietary fat intake in African-American women. DESIGN: We examined the relationships between stage of change, dietary fat intake, and associated eating behaviors and developed an assessment tool for placing subjects in their appropriate stage of change. SUBJECTS: Working class and middle-income African-American women in Nashville, Tenn; 174 in study 1 and 208 in study 2. STATISTICAL ANALYSES: Fat and fiber intake by stage of change was examined using multivariate analysis of variance. Hierarchical cluster analysis was performed using Ward's method. RESULTS: A significant difference in fat intake was noted between women trying to change their intake and those not trying to change in study 1 (P < .001) and study 2 (P < .03). Of those trying to change, only 34% (study 1) and 9% (study 2) of subjects reported fat intakes below the Healthy People 2000 goal of 30% of energy from fat. In study 1, cluster analysis identified 14 groups of foods that significantly separated subjects into not trying, noncompliant, and compliant categories. Compliant subjects ate out less; ate fewer snack foods and less chicken, meat, and fat; and ate more fruits, vegetables, breakfast foods, and low-fat products. These results led to development of the Eating Styles Questionnaire (study 2), which facilitated more appropriate placement of the noncompliant group in stages of change for dietary fat intake. APPLICATIONS/CONCLUSIONS: These data support the stage construct of the Transtheoretical Model for dietary fat reduction in African-American women. Moreover, the Eating Styles Questionnaire (ESQ) can improve determination of stage of change for this group of women. The ESQ can be used to diagnose the eating styles that contribute to a high-fat intake and help in the design of interventions to lower fat intakes.

Adult↗

PubMed2004

[Brief survey about feeding and obesity].

How the epidemic obesity appeared in the United States during the eighties. Respective intake of fats, proteins and carbohydrates (ch) in the diet is notified. Ch such as sucrose provide pleasure and reward specially by infants and children. Lactose occurs in the life of the newborn with a peculiar situation; its sweetening effect is weak and devoid of any neurochemical stimulation. The amounts of lipids and ch in the daily diet are frequently excessive if physical activity is inappropriate. TV dinners are specially endangered. Eating too much snacks disrupts the physiological rhythm of the digestive economy. The carbonated soft beverages are used instead of water, affording large amounts of inapparent sugars. Ice creams are often too rich in ch and lipids. Fruits and vegetable fibers fail in the diet.

Child↗

PubMed2003

Nutrition and dental caries.

Promotion of sound dietary practices is an essential component of caries management, along with fluoride exposure and oral hygiene practices. Scientific discoveries have lead to better understanding of the caries process, the ever-expanding food supply, and the interaction between the two. Fermentable carbohydrates interact dynamically with oral bacteria and saliva, and these foods will continue to be a major part of a healthful diet. Dental health professionals can serve their patients and the public by providing comprehensive oral health care and by promoting lifestyle behaviors to improve oral and general health within the time constraints of their practice. Dietary advice given should not contradict general health principles when providing practical guidance to reduce caries risk. The following principles should guide messages: * Encourage balanced diets based on moderation and variety as depicted by the Food Guide Pyramid and the Dietary Guidelines for Americans to provide a sound approach. Avoid references to "bad" foods and focus on "good" diets that include a variety of foods. * Give examples of how combining and sequencing foods can enhance mastication, saliva production, and oral clearance at each eating occasion. Combining dairy foods with sugary foods, raw foods with cooked, and protein-rich foods with acidogenic foods are all good examples. Suggest that eating and drinking be followed by cariostatic foods such as xylitol chewing gum. * Drink water to satisfy thirst and hydration needs as often as possible. Restrict consumption of sweetened beverages to meal and snack times when they can be combined with other cariostatic foods. * When a patient reports excessive dietary intake of a fermentable carbohydrate to the point of displacing other important foods in the diet, identify alternatives that will help the patient maintain or achieve a healthy body weight, oral health status, and a nutrient-dense intake.

Dental Caries↗

PubMed2003

Recognition and management of eating disorders in the dental office.

Extensive damage to the teeth may result from self-induced vomiting. Recognition of the oral signs of eating disorders is a responsibility of dental care providers. Young women with BN and AN may seek dental care before seeking medical treatment because they are concerned about their appearance. Early identification of oral changes by the dental practitioner and referral to medical and psychiatric therapists can reduce the risk of further physical damage to the body or greater loss of tooth surface enamel. Home care instructions will be followed when the reasons for timing of toothbrushing, rinsing after vomiting, and use of fluoride are explained. Careful selection of beverages and snacks will help reduce the risk of further erosion and dental caries. Comprehensive dental procedures should not be undertaken until significant improvement in vomiting behavior or complete recovery has occurred.

Counseling↗

PubMed1989

A generalized model for the prediction of lead body burdens.

A compartmental model of a typical 70-kg male for lead intake, distribution, and transport has been developed based on previous pharmacokinetic models and experimental results for lead in the human body. A set of first-order, linear ordinary differential equations with constant coefficients is solved to predict lead levels in blood, bone, and other compartments as a function of time resulting from inputs from air and/or ingestion. The model has been shown to be in excellent agreement with the measurements of blood lead for a controlled study by M. B. Rabinowitz et al. (1976, J. Clin. Invest., 58, 260-270). Favorable agreement was also found with blood and urine results reported by T. B. Griffin et al. (1975, "Lead," pp. 221-240) providing that an allowance was made for an unmeasured input of lead, originating from smoking, snacks, etc. The predictions of the newly formulated model are compared with those of the established Bernard model (S. F. Bernard, 1977, Health Phys., 32, 44-46). Predictions of blood lead concentration for short periods (on the order of months) are fitted better by the new model, while both models predict similar behavior over the longer term (on the order of 5 years and greater).

Adult↗

PubMed1989

Non-aqueous size-exclusion chromatography coupled on-line to reversed-phase high-performance liquid chromatography. Interface development and applications to the analysis of low-molecular-weight contaminants and additives in foods.

An interface has been developed which permits the on-line coupling of size-exclusion chromatography in tetrahydrofuran with aqueous reversed-phase high-performance liquid chromatography. The interface isolates the required size exclusion chromatography fraction and dilutes it with water to ensure reconcentration of analytes on the reversed-phase column prior to gradient elution. Operational parameters and the influence of analyte polarity have been examined in detail. A predictive system is presented for determining the applicability of the system to any analyte, based on solute retention times on an ODS phase eluted with a methanol-water gradient. The method is illustrated with examples of direct analyses of crude lipid extracts from a snack product for 2,6-di-tert.-4-methylphenol and from chocolate for dibutyl phthalate. Detection limits of ca. 0.5 mg/kg have been achieved.

Chromatography, Gel↗

PubMed1986

The roles of diet and exercise in the management of patients with insulin-dependent diabetes mellitus.

Current dietary recommendations for patients with diabetes are similar to those for the US population in general, including a moderate intake of sucrose. Awareness of the carbohydrate content of meals will allow adjustments of the dose of meal-related short-acting insulin when the size of the meal is altered; thus, meal planning can be flexible without sacrificing glycemic control. Although exercise may have potential benefits for patients with diabetes, it is also associated with greater risk in these persons than in their nondiabetic counterparts and frequently complicates the management of their disease. If there are no contraindications to regular, vigorous exercise and the patient desires to participate, careful self-monitoring of blood glucose, combined with snacks and insulin dose adjustment, should enable the intensively treated patient to exercise safely.

Absorption↗

PubMed2001

Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight.

Although a large body of research has assessed direct genetic links between parent and child weight status, relatively little research has assessed the extent to which parents (particularly parents who are overweight) select environments that promote overweight among their children. Parents provide food environments for their children's early experiences with food and eating. These family eating environments include parents' own eating behaviors and child-feeding practices. Results of the limited research on behavioral mediators of familial patterns of overweight indicate that parents' own eating behaviors and their parenting practices influence the development of children's eating behaviors, mediating familial patterns of overweight. In particular, parents who are overweight, who have problems controlling their own food intake, or who are concerned about their children's risk for overweight may adopt controlling child-feeding practices in an attempt to prevent overweight in their children. Unfortunately, research reveals that these parental control attempts may interact with genetic predispositions to promote the development of problematic eating styles and childhood overweight. Although the authors have argued that behavioral mediators of family resemblances in weight status, such as parents' disinhibited or binge eating and parenting practices are shaped largely by environmental factors, individual differences in these behaviors also have genetic bases. A primary public health goal should be the development of family-based prevention programs for childhood overweight. The findings reviewed here suggest that effective prevention programs must focus on providing anticipatory guidance on parenting to foster patterns of preference and food selection in children more consistent with healthy diets and promote children's ability to self-regulate intake. Guidance for parents should include information on how children develop patterns of food intake in the family context. Practical advice for parents includes how to foster children's preferences for healthy foods and how to promote acceptance of new foods by children. Parents need to understand the costs of coercive feeding practices and be given alternatives to restricting food and pressuring children to eat. Providing parents with easy-to-use information regarding appropriate portion sizes for children is also essential as are suggestions on the timing and frequency of meals and snacks. Especially during early and middle childhood, family environments are the key contents for the development of food preferences, patterns of food intake, eating styles, and the development of activity preferences and patterns that shape children's developing weight status. Designing effective prevention programs will, however, require more complete knowledge than currently available regarding behavioral intermediaries that foster overweight, including the family factors that shape activity patterns, meals taken away from home, the impact of stress on family members' eating styles, food intake, activity patterns, and weight gain. The research presented here provides an example of how ideas regarding the effects of environmental factors and behavioral mediators on childhood overweight can be investigated. Such research requires the development of reliable and valid measures of environmental variables and behaviors. Because childhood overweight is a multifactorial problem, additional research is needed to develop and test theoretic models describing how a wide range of environmental factors and behavioral intermediaries can work in concert with genetic predispositions to promote the development of childhood overweight. The crucial test of these theoretic models will be in preventive interventions.

Adult↗

PubMedDate not supplied

Effects of 2-week ingestion of (-)-hydroxycitrate and (-)-hydroxycitrate combined with medium-chain triglycerides on satiety and food intake.

The aim of this study was to assess the effects of 2 weeks of supplementation with (-)-hydroxycitrate (HCA) and HCA combined with medium-chain triglycerides (MCT) on satiety and energy intake. The experimental design consisted of three intervention periods of 2 weeks separated by washout periods of 2 or 6 weeks in a double-blind, placebo-controlled, randomized, and crossover design. Seven male and 14 female normal to moderately obese subjects (mean+/-S.D.; age, 43+/-10 years; body mass index, 27.6+/-2.0 kg/m(2)) participated in this study. Subjects consumed three self-selected meals and four isoenergetic snacks daily with either no supplementation (PLA), with 500 mg HCA (HCA), or 500 mg HCA and 3 g MCT (HCA+MCT). Each intervention period ended with a test day, consisting of a standardized breakfast and ad libitum a lunch and a dinner. There was a significant body weight (BW) loss during the 2 weeks of intervention (PLA, -0.5+/-0.3 kg, P<.05; HCA, -0.4+/-0.2 kg, P<.05; HCA+MCT, -0.7+/-0.2 kg, P<.01), but this reduction was not different between treatments. Twenty-four-hour energy intake (PLA, 8.1+/-0.3 MJ; HCA, 8.3+/-0.3 MJ; HCA+MCT, 8.4+/-0.3 MJ) and the area under the curve of the appetite-related parameters during the test day were similar for all treatments. Two weeks of supplementation with HCA and HCA combined with MCT did not result in increased satiety or decreased energy intake compared to placebo in subjects losing BW.

Adult↗

PubMed1998

Salt preference in adolescence is predicted by common prenatal and infantile mineralofluid loss.

We investigated early determinants of salt preference in humans. In animals, physiological events, among them perinatal mineralofluid loss, contribute to long-term salt intake. Recent findings suggest that in humans prenatal mineralofluid loss (high levels of maternal vomiting) may increase the lifelong avidity for salt in offspring. Here we report that commonly occurring events that cause mild fluid loss and electrolyte imbalance in infancy, as well as prenatally, predict the avidity for salt in adolescents. Using questionnaires, 50 mothers recalled incidence and severity of infantile diarrhea and vomiting in their adolescent offspring. The adolescents' avidity for salt was determined by testing the preferred concentration of salt in soup, voluntary consumption of salty snack items, and by self report of salt use habits, and a dietary questionnaire. A reported history of mineralofluid loss including maternal vomiting and infantile vomiting and diarrhea increases the avidity for salt but not for sweet. Thus, commonly occurring early mineralofluid loss may contribute to lifelong salt intake. The findings raise the possibility that other causes of mineralofluid loss such as hemorrhage, exercise-induced dehydration, or neonatal diuretic therapy may also increase the avidity for salt, and its attendant health risks.

Adolescent↗

PubMed1998

Interaction of stress, smoking, and dietary restraint in women.

Smoking cessation often results in weight gain but certain subtypes of smokers may be more likely than others to gain weight. Women high in dietary restraint ("restrainers") increase food intake and gain more weight than nonrestrainers during smoking cessation. Restrainers have also been reported to increase food intake following laboratory stressors. Therefore, the present study was designed to measure the influence of stress on food intake and subjective distress during acute smoking abstinence in restrained and nonrestrained women. Participants were 48 women, 18-40 years old, comprising six groups (n = 8 per group) in a 2 x 3 x 2 design. Groups consisted of two levels of restraint (restrained and nonrestrained) and three levels of smoking (ad lib. smokers, abstinent smokers, and nonsmokers), whereas the within-participant manipulation involved two sessions differing in stress (stress and control). Snack foods were available for consumption. Results showed that distress, measured by the Stress-Arousal Checklist and visual analogue measures of tension and anxiety, was higher in the stress session for all groups except for restrainers who smoked ad lib. Furthermore, distress was significantly higher in smoke-abstinent restrainers during the stress session than all other conditions. However, despite differences in distress, no effect was observed for food intake. Desire for a cigarette showed a sharper increase over the stress session for restrainers compared with nonrestrainers but did not differ in the control session. These data suggest that restrainers may use smoking to reduce distress and may increase smoking, but not eating, during stress.

Adolescent↗

PubMed1994

Oral health knowledge, attitudes, behaviour and skills of children entering school in urban and rural areas in Tanzania.

This study analysed the prevailing oral health-related knowledge, attitudes and behaviour of children entering school in Tanzania. The assessment was conducted in a random sample of 200 children who were newly enrolled in first grade in urban and rural areas of the Ilala district, by means of interviews, oral hygiene check-ups and practical exercises. Toothbrushing was a prevalent habit among these children, but its efficiency was low. Modern toothbrushes were commonly used and preferred to wooden toothbrushes. Toothpaste was considered essential and commonly used in urban areas but, instead, charcoal or ash were used in rural areas. The children's sugar consumption was low, but they widely valued sugary snacks. They had low awareness of gum disease and tooth decay, and poor knowledge about the causes and prevention of these diseases. These findings indicate gaps in the children's oral health ideas and practices acquired from home. The ongoing school oral health education is a crucial opportunity for the required improvements.

Adolescent↗

PubMed1979

Energy regulation in morbid obesity by multidisciplinary therapy.

Regulation of energy expenditure should be directed toward fat mobilization and oxidation with concomitant preservation of lean body mass. This requires a multidisciplinary approach. The key surgical component of a gastric bypass is a properly sized pouch and stoma outlet. Compliance with a diet of approximately 800 to 1200 kcal per day, limited to three small meals and two snacks is the desired result. Weight loss should average 10 to 15 pounds monthly when surgery is added to intense medical, nutritional, and behavior therapy to ensure that the weight is reduced to desirable levels.

Diet, Reducing↗

PubMed1997

Inhibition of lipid absorption as an approach to the treatment of obesity.

A reduction in fat intake may be achieved by making educated choices to reduce total calorie intake, to consume a lower quantity of total fats, or to modify the ratio of saturated-to-polyunsaturated lipids. Leptin agonists or NPY or CCK antagonists may prove to be useful to diminish appetite and thereby reduce the total intake of food. But eating has such cultural, social, and hedonistic attributes that such a single-pronged approach is unlikely to be successful. The use of fat substitutes may prove to be popular to provide a wide range of snack food options, but these are likely to be of minimal use in weight reduction programs because of their distribution of additives in only a limited number of foods. The inhibitors of lipid digestion will be modestly successful in the short term; their long-term success will be influenced by gastrointestinal adverse effects and the need to consume fat-soluble vitamin supplements to prevent the development of fat-soluble vitamin deficiencies. The inhibition of lipid absorption is an attractive targeted approach for the treatment of obesity, since this would reduce the uptake of visible as well as invisible fats, which would potentially offer convenient dosing, and could also be a means to inhibit secondarily the uptake of carbohydrate calories.

Animals↗

PubMed2003

Reverse versus forward order reporting and the accuracy of fourth-graders' recalls of school breakfast and school lunch.

BACKGROUND: Do children recall school breakfast and school lunch intake during 24-h recalls more accurately when prompted to report meals and snacks in reverse versus forward order? METHODS: One hundred twenty-one fourth-graders stratified by race (Black, White) and gender were each observed and interviewed twice (once per order) regarding the previous day's intake. Omission and intrusion rates determined accuracy for reporting items. Total inaccuracy determined accuracy for reporting items and amounts. RESULTS: Results failed to indicate significant effects of interviewer, weekday, sequence (first or second recall), or race on omission rates, intrusion rates, or total inaccuracy. A significant order by gender interaction was found for omission rates, which were lower (i.e., better) for males for reverse (53%) versus forward recalls (62%), but not females (61 versus 53%) (P < 0.008). Intrusion rates were acceptable for males for 54% of reverse recalls and 40% of forward recalls (P = 0.095). Means were 57 and 32%, and 6.4 servings for omission rate, intrusion rate, and total inaccuracy for reverse recalls, and 56 and 39%, and 6.9 servings for forward recalls. CONCLUSIONS: Prompting children to report in reverse versus forward order improved omission and intrusion rates for males more so than females. Regardless of reverse or forward order, children reported <50% of items observed; furthermore, >30% of items reported were not observed. Research is needed to enhance accuracy of children's dietary recalls.

Child↗

PubMed1983

Sugars and dental decay.

Sugar is the principal cause of the most common disease in industrialised countries, dental caries. The sugars implicated in dental caries, in decreasing order of cariogenicity, are sucrose, glucose, and fructose; brown sugars are as cariogenic as white. The level of sugar consumption at which most of the population will not get dental caries is 15 kg/person/year. The goal should therefore be to reduce consumption to this level and below. The following policies should be introduced to achieve this goal: sugars should not be added to dietary items such as baby foods; a range of acceptable sugar-free snacks and drinks should be developed; non-cariogenic sweeteners should be substituted for added sucrose and glucose in foods, confections, and drinks; sugar-containing foods should be modified to make them less cariogenic; and the levels of added sugars in commonly used foods should be reduced. The transmission to the public of information on sugars and dental health should be improved.

Dental Caries↗

PubMed2000

Effect of decreasing afferent vagal activity with ondansetron on symptoms of bulimia nervosa: a randomised, double-blind trial.

BACKGROUND: Several lines of evidence have led us to postulate that afferent vagal hyperactivity could be an important factor in the pathophysiology of the eating disorder bulimia nervosa. Ondansetron is a peripherally active antagonist of the serotonin receptor 5-HT3, and is marketed for prevention of vagally-mediated emesis caused by cancer chemotherapeutic agents. We investigated the effects of ondansetron on bulimic behaviours in patients with severe and chronic bulimia nervosa in a randomised, double-blind, placebo-controlled study. METHODS: We enrolled patients with severe bulimia nervosa (at least seven coupled binge/vomit episodes per week). The patients were otherwise healthy, their weight was normal, and they were not receiving medical or psychiatric treatment. During the first week of the study, patients recorded all eating-behaviour events to establish a baseline. In the second week, all patients received placebo, but were told that they were receiving either placebo or active drug. At the end of this single-blind phase, patients were randomly assigned placebo or ondansetron (24 mg daily) for a further 4 weeks. The primary outcome measure was the number of binge/vomit episodes per week. Data were analysed by intention to treat. FINDINGS: 29 patients met the inclusion criteria, of whom 28 completed the baseline study, and 26 completed the single-blind placebo week. 12 patients were assigned placebo, and 14 ondansetron; one patient in the ondansetron group dropped out owing to accidental injury. During the 4th week of double-blind treatment, mean binge/vomit frequencies were 13.2 per week (SD 11.6) in the placebo group, versus 6.5 per week (3.9) in the ondansetron group (estimated difference 6.8 [95% CI 4.0-9.5]; p<0.0001). The ondansetron group also showed significant improvement, compared with the placebo group, in two secondary indicators of disease severity. The amount of time spent engaging in bulimic behaviours was decreased on average by 7.6 h per week in the ondansetron group, compared with 2.3 h in the placebo group (estimated difference 5.1 [0.6-9.7]). Similarly, the number of normal meals and snacks increased on average by 4.3 normal eating episodes without vomiting per week in the ondansetron group, compared with 0.2 in the placebo group (estimated difference 4.1 [1.0-7.2]). INTERPRETATION: The decrease in binge-eating and vomiting under ondansetron treatment was not achieved by compensatory changes in eating behaviour such as by a smaller number of binges of longer duration, or by not eating, or by binge-eating without vomiting. Instead, our findings indicate a normalisation of the physiological mechanism(s) controlling meal termination and satiation. Since meal termination and satiety are mainly vagally mediated functions, since binge-eating and vomiting produce intense stimulation of vagal afferent fibres, and since ondansetron and other 5-HT3 antagonists decrease afferent vagal activity, the symptom improvement may result from a pharmacological correction of abnormal vagal neurotransmission.

Adolescent↗