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PubMed1985

Dietary therapy slows the return of hypertension after stopping prolonged medication.

This study asks whether prolonged antihypertensive therapy will "cure" a substantial percent of rigorously treated hypertensive patients and whether nutritional change will add an antihypertensive effect and reduce the relapse rate. Of 584 eligible patients normotensive while receiving therapy, 496 were randomized into control and discontinued-medication groups with and without dietary intervention. At 56 weeks, 50% of those who were no longer receiving medication remained normotensive by study criteria. Randomization either to weight-loss group (mean loss of 4.5 kg [10 lb]) or to sodium-restriction group (mean reduction of 40 mEq/day) increased the likelihood of remaining without drug therapy, with an adjusted odds ratio of 2.17 for the sodium group and 3.43 for the weight group. Highest success rates were in the nonoverweight mild hypertensives with sodium restriction (78%) and the overweight mild hypertensives who were reducing their weight (72%). These data demonstrate that weight loss or sodium restriction, in hypertensives controlled for five years, more than doubles success in withdrawal of drug therapy.

Clinical Trials as Topic↗
PubMed1985

[Average body height of the middle and lower social classes in the middle European Germanic settlement area from the early Middle Ages to modern times].

This paper reviews the body height data of middle and low social classes of North and Central European populations from the early Middle Ages until the beginning of the 17th century. It is mainly based on anthropological data from the ancient Germans, but considers also some historical reports. From the data presented here it is seen that the initially rather considerable body heights in these two social groups are decreasing during the Middle Ages. This could be observed on population samples from the Central German Highlands and from Southern Germany as well as on samples from the utmost Western Teutonic settlement: Greenland. The reasons for these variations are most likely to be seen in nutritional changes, in increasing hard physical work due to the transition to predominating agriculture, in biological effects of birthrights, and in deteriorating hygienic conditions.

Anthropology, Physical↗
PubMed1985

Reliability of the total lymphocyte count as a parameter of nutrition.

To evaluate the total lymphocyte count as a means of nutritional assessment, body composition studies (a proven method of nutritional assessment) and total lymphocyte determinations were performed simultaneously in 153 patients. The total lymphocyte count correlated poorly with both the body cell mass and the nutritional state measured by the Nae to Ke ratio. For diagnosing malnutrition, the total lymphocyte count had a false-positive rate of 34% and a false-negative rate of 50%. In a group of 78 patients who received total parenteral nutrition for 2 weeks, the total lymphocyte count did not accurately reflect the nutritional changes. Due to its poor sensitivity and specificity, the total lymphocyte count is of no value as a measure of the nutritional state.

Body Composition↗
PubMed1984

Community-based prevention of hypertension in North Karelia, Finland.

A model programme for hypertension control in the community has been implemented in North Karelia, Finland, since 1972. The treatment status of the patients was improved and blood pressure levels were reduced during 1972 to 1977. This improvement started to level off during 1977 to 1982, although more than 10% of the population aged 35-64 years were treated with antihypertensive drugs. Several analyses were done to find out which dietary factors contributed to the blood pressure level and to its change in the community. The study material consisted of random samples of the population aged 30-59 years in two counties in Eastern Finland, who participated in the surveys in 1972, 1977 and 1982. The analyses confirmed that high BMI, high fat intake, alcohol drinking and high Na intake were associated significantly with blood pressure and also with its change both in the general population and in hypertensive persons. The high levels of these nutritional factors were also associated with unsatisfactory outcome of drug treatment in the hypertensive patients. Thus, it is likely that nutritional changes that can reduce the levels of BMI, the intake of fat, alcohol, and Na would contribute significantly both to primary prevention and to the effective treatment of elevated blood pressure in the community. In Eastern Finland the levels of alcohol intake have increased both in men and women, BMI increased in men and decreased in women and serum cholesterol levels dropped both in men and women between 1972 to 1982. The results of a community-based programme to reduce salt intake in North Karelia from 1979 to 1982 confirmed that Na intake level is high in Finland. The North Karelia Salt Project showed that it is difficult to reduce salt intake at the community level during a three-year period. A slight reduction in Na intake was seen only in women both in North Karelia and in the reference area. In men Na intake did not decrease. In conclusion our results suggest that primary prevention of hypertension at the community level is not easy and that a well conceived programme for a relatively long time period is needed.

Adolescent↗
PubMed1984

Historical aspects of minerals and vitamins in parenteral nutrition.

Advances in knowledge of the requirements for vitamins and minerals have been essential in the success of total parenteral nutrition (TPN) for improving or maintaining good nutritional status for increasing periods of time. The availability of all known vitamins by the late 1940's and advances in vitamin technology resulted in stable single-vitamin or multivitamin solutions for i.v. use. Improved physician experience in vitamin usage and modified and more complete formulations are reflected in improved patient treatment. However, requirements for certain vitamins in hypermetabolic states and for prolonged use remain to be elucidated. TPN has also focused attention on the needs for macro- and microminerals. It has emphasized the importance of electrolytes, including inorganic phosphate, in human nutrition. Changes in the sources of amino acids from protein hydrolysates to crystalline amino acids have resulted in increasingly purified solutions essentially free of trace elements. This has focused attention on human requirements and the need for provision of increasing numbers of these ions.

Amino Acids↗
PubMed1978

Complications of jejunoileal bypass.

Jejunoileal bypass for morbid obesity is accompanied by excessive morbidity and significant mortality. Weight loss is achieved at the expense of major nutritional changes which in and of themselves produce complications. The operation should be considered investigational and be limited to those centers with special interest in the problem and where longterm follow-up and management can be carried out.

Adult↗
PubMed1992

Consistent improvement in the nutritional status of Colombian children between 1965 and 1989.

Three national anthropometric surveys carried out in Colombia in 1965-1966, 1977-1980, and 1986-1989 provide a reasonably standardized basis for comparing the nutritional status of infants and young children in those years. That comparison, presented here together with appropriate socioeconomic data, indicates marked reduction of malnutrition paralleling strong socioeconomic gains.

Adult↗
PubMed1988

The use of anthropometry to assess nutritional status.

Anthropometry (the use of body measurements to assess nutritional status) is a practical and immediately applicable technique for assessing children's development patterns during the first years of life. An evaluation of their growth also provides useful insights into the nutrition and health situation of entire population groups. Anthropometric indicators are less accurate than clinical and biochemical techniques when it comes to assessing individual nutritional status. In many field situations where resources are severely limited, however, anthropometry can be used as a screening device to identify individuals at risk of undernutrition, followed by a more elaborate investigation using other techniques. Similarly, growth monitoring permits the detection of individuals with faltering growth, who can then be appropriately referred to specialized care. Thanks to the standardization that has taken place in recent years, changes in trends over time with respect to the nutritional situation can be evaluated in countries where national food and nutrition surveillance systems have been developed, or where nationally representative cross-sectional surveys have been conducted some years apart using identical, or nearly identical, methodologies. Although data that can be used to evaluate trends are limited, some insight can be gained into the nutritional situation and changes occurring over time in a number of countries. Prevalence figures for underweight (low weight-for-age) have been prepared using standard methods of data collection, analysis and presentation, for several countries in Africa, the Americas and Asia. As such, they fail to differentiate between wasting and stunting, or to evaluate differences between age groups. Also, they do not necessarily reflect trends in other countries in the same or other regions. Still, it is interesting, if not statistically significant, that there has been a general improvement in the nutritional status of preschool children. Intercountry trend comparisons are difficult for two main reasons. Firstly, the time between surveys is occasionally different and, secondly, despite efforts to standardize data analysis and presentation, different cut-off points have been used to calculate prevalence figures and estimate the extent of undernutrition. However, the use of identical cut-off points is not essential for making intercountry trend analyses since it is the general trends in growth deficit and nutritional status over time which are being evaluated.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1977

Reducing the risk of cardiovascular disease: effects of a community-based campaign on knowledge and behavior.

In 1972 the Stanford Heart Disease Prevention Program launched a three-community field study. A multimedia campaign was conducted for two years in two California communities (Watsonville and Gilroy), in one of which (Watsonville) it was supplemented by an intensive-instruction program with high-risk subjects. A third community (Tracy) was used as a control. The campaigns were designed to increase participants' knowledge of the risk factors for cardiovascular disease, to change such risk-producing behavior as cigarette smoking, and to decrease the participants' dietary intake of calories, salt, sugar, saturated fat, and cholesterol. Results of a sample survey indicate that substantial gains in knowledge, in behavioral modification, and in the estimated risk of cardiovascular disease can be produced by both methods of intervention. The intensive-instruction program, when combined with the mass-medica campaign, emerged as the most effective for those participants who were initially evaluated to be at high risk. The results after two years of intervention are reported for effects on knowledge and behavioral change for the total participant samples and for the high-risk subsamples in each of the three communities.

Attitude to Health↗
PubMed1984

Growth charts and the assessment of infant feeding practices in the western world and in developing countries.

Changes during the past ten years in infant feeding practices are described and it is demonstrated that with the growing popularity of breast feeding, plus the later addition of solids, dietary energy intakes are substantially lower than they were. These dietary changes would appear to be associated with alterations in the detailed pattern of growth. When exclusively breast-fed, babies, if anything, grow more quickly than growth standard rates, but after 3-4 months a relative deceleration in growth velocity becomes apparent. The anthropometric and dietary findings are discussed in relation to the use of growth charts for the assessment of the adequacy of infant feeding practices in the western world and especially in the Third World. A reanalysis of data indicates that diet-related growth faltering probably does not occur in many developing country situations until later than would be suggested by growth standards currently in use.

Anthropometry↗
PubMed1987

Infant mortality and childhood nutritional status among Afghan refugees in Pakistan.

In 1984 and again in 1985, systematic surveys were undertaken to evaluate infant mortality and childhood nutritional status among the Afghan refugee population in Pakistan. The entire Afghan refugee population under the administration of the United Nations High Commissioner for Refugees was sampled. Infant mortality rates were estimated to be 156 per 1000 for 1984 and 119 per 1000 for 1985. A decline was also suggested in neonatal mortality rates from 61 per 1000 for 1984 to 46 per 1000 for 1985. For neither infant nor neonatal mortality was the difference statistically significant. Improvements were seen in the percentage of children who died before their fifth birthday (22.5% in 1984 and 18.8% in 1985), in the percentage of children who were malnourished (3.5% in 1984 and 2.3% in 1985), and an increase in the percentage of children above the WHO/NCHS/CDC weight-for-height reference median (26% in 1984 and 35% in 1985). Diarrhoea was the most frequently reported cause of death for both years and was a particularly important cause of death among one-year-old children. In 1985, measles was related to 24% of the deaths and neonatal tetanus to 9% of the deaths, an increase from 8% for measles and 6% for tetanus in 1984.

Afghanistan↗
PubMed1977

The infant food industry and international child health.

Declining breast-feeding, with accompanying increased marasmus and diarrhea, has occurred in developing countries because of many factors, including inappropriate health services, new urban life styles, and so forth. The infant food industry must bear a considerable burden of blame as a result of "unethical" advertising. Responses have most recently included various journalistic and legal actions. There is a need for revised roles for the infant food industry, and for mechanisms to monitor intrinsically harmful practices.

Advertising↗
PubMed1986

Consumption pattern of infant foods by Turkish immigrants.

Fifty-nine Turkish infants in metropolitan Stockholm and two adjacent communities have been studied regarding food consumption pattern. The infants were breastfed for a shorter period than expected in Turkey and shorter than in Swedish children. Illiterate mothers breastfed longer than those who had received some kind of education. Formula feeding was extensively used. Supplementary semisolid feeding was introduced, mainly at 4-6 months of age, much earlier than in Turkey but rather later than in Swedish families. Some problems were noted with the bottle feeding, most importantly with regard to hygienic practices, dangerous especially on summer visits to Turkey. Unsatisfactory handling of bottle feeding was linked to the mother's educational level. Further interest in nutrition education for this and other immigrant groups is important.

Animals↗
PubMed1992

Nutritional status of Brazilian children: trends from 1975 to 1989.

The prevalence of malnutrition among under-5-year-olds in Brazil fell by more than 60% between 1975 and 1989. The benefits were smaller for population strata that were more affected by malnutrition in the 1970s, i.e., children from the North and North-east regions and those from poor families in general. Regional and socioeconomic differentials in the prevalence of malnutrition therefore increased between 1975 and 1989. Trends in family income indicate extraordinary economic gains in the 1970s, some losses in the 1980s, and a modest net gain over the period 1975-89. The availability of sanitation, health, and education services, and the provision of preschool supplementary feeding programmes increased markedly in the 1970s and 1980s. Demographic trends were also positive, reducing the demand for services and programmes, increasing the economic efficiency of families, and concentrating the population in urban areas, where incomes, job opportunities, and social and material infrastructures are better. The observed nutritional improvement was therefore probably due to a moderate increase in family income associated with a substantial expansion in the provision of services and programmes, both of which were facilitated by favourable demographic trends. Also, the nutritional improvement was probably concentrated during the 1970s, while little, if any, occurred after 1980; prospects for the 1990s point to a stagnant situation. This is a reason for great concern particularly in the North and North-east regions of the country, where high rates of child malnutrition are still found.

Brazil↗