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PubMed1999

Gastroesophageal reflux disease.

In this age of fast food, overeating, and busy schedules, many people frequently complain of heartburn or indigestion. Meal times are rarely consistent, so meal planning appears out of the question. What are the consequences of this lifestyle? Gastroesophageal reflux disease (GERD) is a common disorder that affects every population. This article defines this condition and provides a history, literature review, and pathophysiology for the disorder. Recommendations for diagnosis and guidelines for treatment and nursing care interventions also are given.

Antacids↗
PubMed1999

Lessons from a large outbreak of Escherichia coli O157:H7 infections: insights into the infectious dose and method of widespread contamination of hamburger patties.

Between November 1992 and February 1993, a large outbreak of Escherichia coli O157:H7 infections occurred in the western USA and was associated with eating ground beef patties at restaurants of one fast-food chain. Restaurants that were epidemiologically linked with cases served patties produced on two consecutive dates; cultures of recalled ground beef patties produced on those dates yielded E. coli O157:H7 strains indistinguishable from those isolated from patients, confirming the vehicle of illness. Seventy-six ground beef patty samples were cultured quantitatively for E. coli O157:H7. The median most probable number of organisms was 1.5 per gram (range, < 0.3-15) or 67.5 organisms per patty (range, < 13.5-675). Correlation of the presence of E. coli O157:H7 with other bacterial indicators yielded a significant association between coliform count and the presence of E. coli O157:H7 (P = 0.04). A meat traceback to investigate possible sources of contamination revealed cattle were probably initially colonized with E. coli O157:H7, and that their slaughter caused surface contamination of meat, which once combined with meat from other sources, resulted in a large number of contaminated ground beef patties. Microbiological testing of meat from lots consumed by persons who became ill was suggestive of an infectious dose for E. coli O157:H7 of fewer than 700 organisms. These findings present a strong argument for enforcing zero tolerance for this organism in processed food and for markedly decreasing contamination of raw ground beef. Process controls that incorporate microbiological testing of meat may assist these efforts.

Animals↗
PubMed1999

A case-control study of sporadic infection with O157 and non-O157 verocytotoxin-producing Escherichia coli.

Potential risk factors for sporadic verocytotoxin-producing Escherichia coli (VTEC) infection in Belgium were investigated in a matched case-control study. Thirty-seven cases, 8 infected with O157 VTEC strains (all eaeA-positive), 29 with non-O157 VTEC strains (13 eaeA-positive and 16 eaeA-negative) and 69 matched controls were interviewed. In a conditional logistic regression analysis, consumption of fish appeared to be a risk factor for infection (adjusted odds ratio (OR) 3.25, P = 0.04). Contact with dogs (OR 0.27, P = 0.04) and consumption of shellfish (OR 0.19, P = 0.05) showed a negative association, corresponding to a decrease in risk. These findings might be explained if low level environmental exposure to VTEC induces protective immunity. Eating raw meat, a frequent habit in Belgium, or hamburgers, or eating in a fast-food restaurant was not more frequently reported by cases than controls. The exposures causing sporadic infections with VTEC, in particular non-O157 strains, may be very different from those which led to outbreaks, and may account for more cases overall.

Adolescent↗
PubMed2005

Lipid peroxidation by "free" iron ions and myoglobin as affected by dietary antioxidants in simulated gastric fluids.

Grilled red turkey muscle (Doner Kabab) is a real "fast food" containing approximately 200 microM hydroperoxides, homogenized in simulated gastric fluid and oxidized more rapidly at pH 3.0 than at pH 5.0, after 180 min, producing 1200 and 600 microM hydroperoxides, respectively. The effects of "free" iron ions and metmyoglobin, two potential catalyzers of lipid peroxidation in muscle foods, were evaluated for linoleic acid peroxidation at pH 3.0 of simulated gastric fluid. The prooxidant effects of free iron ions on linoleic acid peroxidation in simulated gastric fluid was evaluated in the presence of ascorbic acid. At low concentrations of ascorbic acid, the effects were prooxidative, which was reversed at high concentrations. In the presence of metmyoglobin, ascorbic acid with or without free iron enhanced the antioxidative effect. Lipid peroxidation by an iron-ascorbic acid system was inhibited totally by 250-500 microM catechin at pH 3.0. The catechin antioxidant effect was determined also in the iron-ascorbic acid system containing metmyoglobin. In this system, catechin totally inhibited lipid peroxidation at a concentration 20-fold lower than without metmyoglobin. The ability of catechin to inhibit lipid peroxidation was also determined at a low pH with beta-carotene as a sensitive target molecule for oxidation. The results show that a significant protection was achieved only with almost 100-fold higher antioxidant concentration. Polyphenols from different groups were determined for the antioxidant activity at pH 3.0. The results show a high antioxidant activity of polyphenols with orthodihydroxylated groups at the B ring, unsaturation, and the presence of a 4-oxo group in the heterocyclic ring, as demonstrated by quercetin.

Animals↗
PubMed1999

Problems and our solutions for implementing telemedicine systems.

There are several problems on the practical use of telemedicine, for example, the difficulties involved in promoting communication between medical facilities, uncooperative clinicians, and the absence of high-speed circuits and high-resolution CRT. From the Japanese point of view, we suggest ways to resolve these problems. We will analyze and propose scenarios for realizing successful communications among medical institutions, medical communication and its characteristics, barriers to the promotion of communications among medical institutions, second-opinion centers, and separate satellites and separate circuits. We also mention the World Wide Web for teleconsultation, provision of assistance to people with data handicaps via a communications satellite, and assistance to programs designed for training telemedicine specialists. Using a communication satellite, we offer programs that explain preventive medicine, support activities for nursing at home, explain the risks of fast food, and support activities for the handicapped and women in a simple manner to computer illiterates.

Communication↗
PubMed2006

The impact of financial and nonfinancial incentives on business-unit outcomes over time.

Unlike previous behavior management research, this study used a quasi-experimental, control group design to examine the impact of financial and nonfinancial incentives on business-unit (21 stores in a fast-food franchise corporation) outcomes (profit, customer service, and employee turnover) over time. The results showed that both types of incentives had a significant impact on all measured outcomes. The financial incentive initially had a greater effect on all 3 outcomes, but over time, the financial and nonfinancial incentives had an equally significant impact except in terms of employee turnover.

Adolescent↗
PubMed1976

Gastric pathology and aphagia following lateral hypothalamic lesions in rats: effects of preoperative weight reduction.

The body weights of male albino rats were reduced gradually to 80% of normal body weight by resricting food intake (dieting), and then the rats were given lateral hypothalamic (LH) lesions. Compared with rats of normal body weight sustaining similar brain lesions, the dieted group displayed a shorter period of postoperative aphagia and less gastric pathology. In a second experiment, a group of rats was reduced to 80% of normal body weight by withholding all food (fasting) and then given LH lesions. Compared with dieted rats sustaining similar brain damage, the fasted group displayed a longer period of post operative aphagia and greater gastric pathology. Since the duration of aphagia could be shortened or lengthened by simple manipulations of preoperative body weight, the adequacy of sensorimotor or motivational hypotheses to account for aphagia is questioned. The results are more consistent with the suggestion that gastric abnormalities produced by LH lesions inhibit eating.

Animals↗
PubMed2006

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: the children study.

OBJECTIVE: To record the prevalence of overweight, obesity and hypertension in primary schoolchildren living in one of the poorest regions in Europe and furthermore to identify certain behavioural, lifestyle and physiological parameters associated with body mass index (BMI) and blood pressure (BP). DESIGN: Cross-sectional study. SETTING: Nineteen primary schools within the county of Ioannina, Greece. SUBJECTS AND METHODS: Demographic, dietary and physical activity data as well as anthropometrical, BP and cardiorespiratory fitness measurements were obtained from a representative sample of 312 school children (153 boys and 159 girls) attending 5th grade. Inclusion of subjects in the study was voluntary. One-way analysis of variance and multiple linear regression analysis were mainly applied for the evaluation of the tested hypotheses. RESULTS: The prevalence of overweight and obesity was 29.4 and 11.8% for boys and 39.0 and 7.5% for girls. The prevalence of systolic and diastolic hypertension was 28.1 and 7.8% for boys and 26.4 and 17.0% for girls. Furthermore, BMI and BP (systolic and diastolic) were positively related to frequency of fast food meals (rho: + 0.28, P = 0.033, rho: + 1.09, P = 0.03 and rho: +0.86, P = 0.014, respectively) but negatively to leisure time physical activity (rho: -5.55, P = 0.005, rho: -3.32 x 10(-2), P < 0.001 and rho: -2.08 x 10(-2), P < 0.001, respectively). CONCLUSIONS: The current study revealed an increased prevalence of overweight, obesity and hypertension among schoolchildren in Ioannina, indicating the need for early preventive measures in one of the less privileged regions of Europe.

Analysis of Variance↗
PubMed1998

The pursuit of thinness: a study of Dublin schoolgirls aged 15 y.

Despite increasing trends in the prevalence of overweight and obesity, fatness phobia is common during female adolescence. This study has demonstrated a high level of dissatisfaction with body weight in a sample of Dublin schoolgirls aged 15 y. Of 420 subjects, 59% reported that they wanted to be slimmer and 68% had previously tried to lose weight. Contrary to expectations, overweight girls were not found to hold the monopoly on such dissatisfactions. Normal weight and even underweight girls also expressed a desire to be thinner and reported using unhealthy weight control practices including random avoidance of staple foods, fasting, smoking and purging, in their pursuit of the 'perfect' female figure. Obesity prevention programmes which target adolescent girls 'at risk' of overweight and obesity, must take cognizance of their profound fear of fatness, otherwise the use of harmful slimming strategies may be further increased as teenage girls frantically try to lose weight and to avoid the stigma associated with female fatness.

Adolescent↗
PubMed2004

Feasibility of a partial meal replacement plan for weight loss in low-income patients.

BACKGROUND: Low-income patients are disproportionately affected by obesity. Routine care is available to this population at the Venice Family Clinic (VFC) in Los Angeles. The current study examined the effectiveness of nutrition clinic utilizing meal replacements (Slim-Fast, Slim-Fast Foods Co., FL, USA) in low-income patients over a 6-month period compared with the routine care by their primary care physician (PMD) prior to enrolling in the nutrition clinic at similar time intervals. METHODS: In total, 63 patients (51 F; 49+/-0.8 yo) who had been followed at the VFC by their PMD for at least 6 months were enrolled in this study. Patients had a body mass index (BMI) of 40+/-1.1 kg/m2, were 72% Hispanic, 25% Caucasian, and 3% African American. They had the following co-morbidities: hypertension (HTN) 45%, diabetes mellitus II (DM II) 50%, gastroesophageal reflux disease (GERD) 34%, osteoarthritis 51%, and hypercholesterolemia 48%. All patients were provided with meal replacements to be taken twice a day and were instructed to consume one complete low calorie meal per day. Weights at the first visit to the nutrition clinic, 1, 3, and 6 months after enrollment in nutrition clinic were compared to their weights at the same time intervals during routine visits to their PMD prior to enrollment in the nutrition clinic. RESULTS: There was no significant weight change during the 6 months prior to enrollment in the nutrition program despite receiving care by a PMD. At 6 months after participating in the nutrition program, there was a mean decrease of 7% body weight with a reduction in BMI from 40-37 kg/m2 (P< or =0.05). CONCLUSION: Implementation of nutrition clinic utilizing meal replacements in this low-income patient population was effective in achieving a significant reduction in weight over 6 months of treatment..

Adult↗
PubMed2003

Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood.

OBJECTIVE: To evaluate the prevalence of overweight and obesity among Iranian adolescents and their relationship with modifiable environmental factors. METHODS: The subjects of the present study were 1000 girls and 1000 boys, aged between 11 and 18 years selected by multistage random sampling, their parents (n = 2000) and their school staff (n = 500 subjects) in urban and rural areas of two provinces in Iran. Data concerning body mass index (BMI), nutrition and the physical activity of the subjects were analyzed by SPSSV10/Win software. RESULTS: The prevalence of 85th percentile </= body mass index (BMI) < 95th percentile and BMI > 95th percentile in girls was significantly higher than boys (10.7 +/- 1.1 and 2.9 +/- 0.1%vs 7.4 +/- 0.9 and 1.9 +/- 0.1%, respectively; P < 0.05). The mean BMI value was significantly different between urban and rural areas (25.4 +/- 5.2 vs 23.2 +/- 7.1 kg/m2, respectively; P < 0.05). A BMI> 85th percentile was more prevalent in families with an average income than in high-income families (9.3 +/- 1.7 vs 7.2 +/- 1.4%, respectively; P < 0.05) and in those with lower-educated mothers (9.2 +/- 2.1 vs 11.5 +/- 2.4 years of mothers education, respectively). The mean total energy intake was not different between overweight or obese and normal-weight subjects (1825 +/- 90 vs 1815 +/- 85 kCal, respectively; P > 0.05), but the percentage of energy derived from carbo-hydrates was significantly higher in the former group compared with the latter (69.4 vs 63.2%, respectively; P < 0.05). Regular extracurricular sports activities were significantly lower and the time spent watching tele-vision was significantly higher in overweight or obese than non-obese subjects (time spent watching telelvision: 300 +/- 20 vs 240 +/- 30 min/day, P < 0.05). A significant linear association was shown between the frequency of consumption of rice, bread, pasta, fast foods and fat/salty snacks and BMI (beta = 0.05-0.06; P < 0.05). A significant correlation was shown between BMI percentiles and serum triglyceride, high-density lipoprotein-cholesterol and systolic blood pressure (Pearson's r = 0.38, -0.32 and 0.47, respectively). CONCLUSIONS: Enhanced efforts to prevent and control overweight from childhood is a critical national priority, even in developing countries. To be successful, social, cultural and economic influences should be considered.

Adolescent↗
PubMed2004

[Risk behaviour in association with addictive drugs - data and insights on treatment].

About one third of the economical costs, which are due to death, sickness and life quality deficits in higher developed industrial countries, are caused by pollutants such as nicotine, alcohol and false eating habits. Within a period of one year 183,000 people in Germany die on tobacco associated sickness effects, 73,000 on direct or indirect aftermath of alcohol usage and a proportional amount of mostly adipoptic people on the hereoff resulting sickness effects. These risk trias, decided by every person mainly for himself by his own behaviour or mis-behaviour, are even aggravated by the free enterprise sanctioned drug politics of the highly profitable mega markets of the tobacco-, alcohol- and fast-food-industry. Health orientated drug politic, which is based on independence and solidarity and an exhaustive primary prevention within the scope of early nationalization authorities can therefore only have a limited effect. Even though, standardized, therapeutic short interventions used by hazardous alcohol- and drug usage, the qualified detoxification on addiction illness and an way to little used meanwhile time- and cost optimized withdrawal treatment have been proven to be quite effective. Exhaustive established ambulant smoking-withdrawal treatment programs are of special importance, because with continuously sinking of first contact, nicotine is know to be the "gate way drug" with the strongest addiction potential among all legalized and non-legalized drugs. In canon of mean while worldwide (except for Germany) started drug-control politics one will be able to start a health orientated drug politic in the future, which is including especially the drug economic aspects for the benefit of all as well as for the national budgets.

Adolescent↗
PubMed1983

Hemorrhagic colitis associated with a rare Escherichia coli serotype.

We investigated two outbreaks of an unusual gastrointestinal illness that affected at least 47 people in Oregon and Michigan in February through March and May through June 1982. The illness was characterized by severe crampy abdominal pain, initially watery diarrhea followed by grossly bloody diarrhea, and little or no fever. It was associated with eating at restaurants belonging to the same fast-food restaurant chain in Oregon (P less than 0.005) and Michigan (P = 0.0005) and with eating any of three sandwiches containing three ingredients in common (beef patty, rehydrated onions, and pickles). Stool cultures did not yield previously recognized pathogens. However, a rare Escherichia coli serotype, O157:H7, that was not invasive or toxigenic by standard tests was isolated from 9 of 12 stools collected within four days of onset of illness in both outbreaks combined, and from a beef patty from a suspected lot of meat in Michigan. The only known previous isolation of this serotype was from a sporadic case of hemorrhagic colitis in 1975. This report describes a clinically distinctive gastrointestinal illness associated with E. coli O157:H7, apparently transmitted by undercooked meat.

Adolescent↗
PubMed2005

Traditional v. modified dietary patterns and their influence on adolescents' nutritional profile.

Korea has experienced exceptionally rapid economic developments. Even though the country has managed to maintain aspects of its traditional diet, dietary habits are changing, especially among adolescents. This study was carried out to identify prevailing dietary patterns among Korean adolescents and to compare the nutrient intakes and dietary behaviours between the patterns. A 3 d diet record, collected from 671 Korean adolescents aged 12-14 years in Seoul, Korea, was assessed. By cluster analysis, subjects were classified into a modified (69.9 %) and a traditional (30.1 %) dietary pattern group. The modified group consumed more bread, noodles, cookies and pizza/hamburgers compared with the traditional group, which consumed mainly rice and kimchi (fermented cabbage). The modified group had significantly higher intakes of all nutrients. It had a higher total daily energy intake (7719 kJ), a higher daily energy intake from fat (29.8 %) and a higher cholesterol intake (326 mg/d), compared with the traditional group (6686 kJ, 24.8 % and 244 mg/d, respectively). The modified group was more likely to consume fast foods, fried foods and carbonated beverages even though they consumed more fresh fruits and milk, while the traditional group was more likely to have a rice-based diet and not to skip breakfast. These results suggest that monitoring dietary behaviours of adolescents, especially in a society experiencing a nutrition transition, is necessary in order to identify both negative and positive changes in respect of risk factors for nutrition-related chronic diseases as well as for undernutrition.

Adolescent↗
PubMed2006

The financial reality of overeating.

OBJECTIVE: Obesity has been linked to frequency of meals eaten outside the home and the associated large portion sizes. These large portions, which have been shown to promote overeating, are often offered for a small additional cost which may appear economical to the consumer. The aim of this study was to calculate additional costs from medical, gasoline, and increased caloric needs that result from weight gain attributable to overeating and thus provide consumers with added incentive not to upsize their meal, or overeat in general. METHODS: The effects and costs of overeating were estimated for men and women with a BMI of 22.5, 27.5, and 32.5 by conducting a Pubmed search for relevant literature combined with US statistics obtained from open Federal and other websites. RESULTS: Among fast food restaurants, the average upsized meal increases energy content of the meal from 927 to 1324 kcal at an added cost of Dollar 0.67. Because the regular meal is already 37% of a 2500 kcal diet, the extra energy of upsizing is likely to be in excess of need and thus potentially stored as 36 grams of added adipose tissue. This hypothesized weight gain predicts an average increase auto fuel cost by Dollar 0.05 for both men and women, maintenance food cost by Dollar 0.36 and Dollar 0.35 for men and women, respectively, and health care cost from Dollar 0.82 to Dollar 6.64. CONCLUSIONS: These calculated costs exceed the value of upsized meals and may provide motivation to some consumers not to upsize their meals. The same rationale can be applied to other environments notorious for encouraging overeating. Thus, this information could be presented to individuals along with other more well publicized health risks and consequences during weight control counseling.

Costs and Cost Analysis↗
PubMed2004

Meals identified as healthy choices on restaurant menus: an evaluation of accuracy.

This study evaluated the accuracy of restaurant entrees identified as healthy choices on menus at two fast food restaurant chains. Entrees were purchased at two different locations of each restaurant 35 days apart. Samples were processed in duplicate for total fat contents, sodium analysis, and adiabatic bomb calorimeter for total energy. t-Tests compared (a) the mean experimental values to claimed values for fat, energy, and sodium, (b) nutritional content at different locations for the same restaurant, and (c) the mean experimental values for fat, energy, and sodium levels to the recommended Daily Values. Results indicate that entrees identified as healthy choices at these selected restaurants are in fact healthy choices, are accurately labeled, and are consistent among different locations of the same restaurant chains.

California↗
PubMed2006

Carbonyl emissions from commercial cooking sources in Hong Kong.

Cooking fumes are an important carbonyl emission source, especially in a highly urbanized city, such as Hong Kong. Cooking exhaust from 15 commercial kitchens of a variety of cooking styles was sampled and analyzed for a suite of 13 carbonyl compounds. Carbonyl compositions were varied among the different cooking styles. Formaldehyde was generally the most abundant carbonyl, and its contribution to the total carbonyl amount on a molar basis ranged from 12 to 60%. Acrolein was also found to be an abundant carbonyl in the cooking exhaust. The highest contribution by acrolein to the total carbonyls was found to be 30% in the exhaust of a western-style steak restaurant. Long-chain saturated carbonyls, that is, heptanal, octanal, and nonanal, accounted for a significant fraction (> 40%) of the total carbonyls in kitchens that always used heated cooking oils. Two dicarbonyls, glyoxal and methylglyoxal, had a various presence in the cooking emissions, ranging from negligible to 10%. The presence of benzaldehyde and tolualdehyde was mostly negligible in the sampled kitchen exhaust. Annual emission rates of both individual carbonyls and total carbonyls were estimated for various types of commercial kitchens. Local-style fast-food shops contributed the highest total carbonyl emissions per year mainly because of the large number of this kind of restaurant in Hong Kong. The citywide annual emission rates of the three most toxic carbonyls, formaldehyde, acetaldehyde, and acrolein, were estimated assuming that the limited number of sampled restaurants were representative of the average restaurants. Such estimates of carbonyl emission rates were comparable to the estimated carbonyl emissions from vehicular sources, suggesting the importance of commercial cooking as a source for carbonyls in Hong Kong.

Air Pollutants, Occupational↗
PubMed2006

Advertising and obesity: a behavioral perspective.

Concern over the levels of obesity observed in Western countries has grown as researchers forecast a rapid growth in the medical care that a progressively more obese population will require. As health workers deal with increased incidences of diabetes and other obesity-related disorders, policymakers have examined the factors contributing to this problem. In particular, advertising that promotes high fat and high sugar products to children has come under increasing scrutiny. Advertisers have rejected claims that advertising contributes to obesity by arguing that it cannot coerce people into purchasing a product, and does not affect primary demand. This reasoning overlooks the role advertising plays in reinforcing and normalising behavior, however, and it assumes that only direct causal links merit regulatory attention. Ehrenberg's "weak" theory suggests advertising will support unhealthy eating behaviors, while the wide range of sales promotions employed will prompt trial and reward continued consumption. This article presents an alternative analysis of how marketing contributes to obesity and uses behavior modification theory to analyse the "fast-food" industry's promotions. We also review the New Zealand government's response to obesity and suggest policy interventions that would foster healthier eating behaviors.

Adolescent↗