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Nutritional intake of women and men on the NCEP Step I and Step II diets.

OBJECTIVE: Restriction of dietary fat and cholesterol are recommended for treating hyperlipidemia, but may alter vitamin or mineral intakes. We evaluated changes in nutrients of individuals taught the National Cholesterol Education Program (NCEP) Step II diet. METHODS: Subjects participated in a randomized controlled trial of the cholesterol-lowering effect of the NCEP Step II diet. Eligibility criteria included elevated fasting plasma LDL-cholesterol, no lipid-altering medications, and diet not already fat-modified. Subjects attended eight weekly dietitian-led classes. Four-day food records collected 6 months post-intervention were compared to baseline records. RESULTS: Of 409 subjects with complete data, 123 met Step I and 166 met Step II diet criteria. Intakes of micronutrients associated with fruits and vegetables (beta-carotene and vitamin A, vitamin C, folic acid, magnesium, and potassium) increased on both diets. Patterns of decreased mean intake and/or fewer subjects consuming 2/3 Recommended Dietary Allowance were seen for calcium, vitamin E, and zinc. CONCLUSIONS: NCEP Step I and II diets generally match or exceed unmodified diet for vitamin and mineral content. Premenopausal women do not appear to be at increased risk of low iron intake. Vitamin E intake decreases, although the significance is unknown in the context of lower fat intake and increased intake of other antioxidants. Diet counseling and materials should encourage sources of calcium for women, and zinc for both women and men.

Adult↗

Aldosterone-induced sodium transport in lower intestine. Effects of varying NaCl intake.

Short-circuit current (SCC) and electrical potential difference (PD) were measured in two epithelia of the lower gut of the domestic fowl, coprodeum and colon, mounted in vitro in the Ussing-chamber. The birds were suddenly switched from a low-NaCl to a high-NaCl diet, and 24 h aldosterone treatment (3 X 42.7 micrograms/kg i.m.) given from zero to 5 days after dietary change. The effects on SCC and PD of addition of amino acids, and later amiloride, to the bathing media were measured, because a low-NaCl-diet which releases endogenous aldosterone, inhibits amino acid stimulation (in colon) and induces amiloride inhibition of SCC and PD (in both coprodeum and colon). Birds were slaughtered 4 h after the last injection as single injections of aldosterone showed maximal change of SCC and PD, and maximal amino acid and amiloride effects, at that time. Control intramuscular injections of aldosterone showed a mono-exponential decline of the plasma concentration with a half time of 47 min. In colon the aldosterone treatment induced the low-NaCl diet pattern of the transport parameters regardless of the delay after resalination. In coprodeum SCC declined gradually with time and reached 25% of the value at low-NaCl diet when aldosterone was given 5 days after resalination. The data suggest that colon maintains a high flush of sodium through the epithelial cells regardless of whether the entry is via the amiloride-blockable sodium channel or the non-electrolyte stimulated pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗

Do physicians discuss needed diet and nutrition health topics with adolescents?

PURPOSE: Preventive services guidelines recommend screening all adolescents for diet habits, physical activity and growth, counseling underweight teens about body image and dieting patterns, and counseling overweight or obese teens about dietary habits and exercise. In this study, we assess whether adolescents at risk for overweight or for eating disorders have discussed recommended diet and nutrition topics with their physicians. METHODS: We surveyed 14-18-year-old adolescents who had been seen for well care in primary care pediatric and family medicine practices. Adolescents self-reported their weight, height, body image, dieting habits, and issues they had discussed with their clinicians. Body mass index (BMI) was used to define those "at risk for an eating disorder" (< 5% BMI), "at risk of becoming overweight" (85%-95% BMI), and "overweight" (> 95% BMI). RESULTS: A total of 8384 adolescents completed surveys (72% completion rate). Nearly one-third of adolescents were "at risk" or overweight. Females were less likely to be overweight than males (9.4% vs. 15.7%; p < .001). Although 26.4% were attempting to lose weight, only 12.2% of all teens were actually overweight. Exercise and restricting intake were the preferred methods of weight loss. Physicians routinely discussed adolescents' weight during visits, and were more likely to discuss it with those "at risk" (p < .001). Body image was more often discussed with girls than with boys (52% vs. 44.6%, p < .001) and with those at risk (51.6% vs. 45.5%; p < .001). Discussion of healthy eating and weight loss occurred more often with adolescents "at risk" for becoming overweight (p < .001). CONCLUSIONS: Many adolescents are at risk for being overweight or are currently overweight, confirming the importance of clinicians discussing diet and nutrition health topics with all teens. Many adolescents also misclassify their body image, and hence perceive their body image to be different from their actual BMI; clinicians should discuss body image with all adolescents, not just those at risk for eating disorders. Better interventions are needed to promote healthy nutrition and physical activity to all adolescents.

Adolescent↗

[Rational nutrition under the effect of occupational noise on the body].

Basing on medical literature data, the contributors deal with the positive role of diet therapy, including specific food substances and their complexes, in case with patients from noise-affected occupations. Prophylactic diet patterns are proposed specifically intended for workers engaged in intensive industrial noise professions.

Amino Acids↗

Patterns of weight loss and regain in wrestlers: has the tradition changed?

To assess current weight loss practices in wrestlers, 63 college wrestlers and 368 high school wrestlers completed a questionnaire that examined the frequency and magnitude of weight loss, weight control methods, emotions associated with weight loss, dieting patterns, and preoccupation with food. Clear patterns emerged showing frequent, rapid, and large weight loss and regain cycles. Of the college wrestlers, 41% reported weight fluctuations of 5.0-9.1 kg each week of the season. For the high school wrestlers, 23% lost 2.7-4.5 kg weekly. In the college cohort, 35% lost 0.5-4.5 kg over 100 times in their life, and 22% had lost 5.0-9.1 kg between 21 and 50 times in their life. Of the high school wrestlers, 42% had already lost 5.0-9.1 kg 1-5 times in their life. A variety of aggressive methods wer used to lose weight including dehydration, food restriction, fasting, and, for a few, vomiting, laxatives, and diuretics. "Making weight" was associated with fatigue, anger, and anxiety. Thirty to forty percent of the wrestlers, at both the high school and college level, reported being preoccupied with food and eating out of control after a match. The tradition of "making weight" still appears to be integral to wrestling. The potential physiological, psychological, and health consequences of these practices merit further attention.

Adolescent↗

Beneficial effect on serum apo AI, apo B and Lp AI levels of Ramadan fasting.

In order to investigate for the first time in Morocco the effect of fasting in Ramadan, the ninth lunar month of the muslim year, on lipoprotein metabolism, we determined the levels of serum apolipoproteins; apolipoprotein AI (apo AI), apo B, apo AIV and those of lipoprotein particles; apo AI-containing lipoprotein particles (Lp AI) and also apo AI and apo AII containing lipoprotein particles (Lp AI:AII) in a group of 32 healthy, volunteer adult males. Determination of all these parameters was carried out on each week of the month of Ramadan and the results are compared with the pre-fasting and the post-fasting values. Ramadan fasting reduces significantly serum apo B (P < 0.05), while serum apo AI is significantly increased (P < 0.05) compared with the pre-fasting period. The increase of apo AI occurred on day 29 of Ramadan by 11.8%. Serum apo AIV was unchanged during the fasting period indicating that food intake during Ramadan is not based on lipid diet. The observed diet pattern during Ramadan showed an increase of total energy intake based on carbohydrates (+1.4% of total energy), proteins (+0.4% of total energy) but not on fat (-0.7% of total energy), compared with a usual diet used in the rest of the year. The fat diet is high in monounsaturated (P < 0.05) and polyunsaturated fatty acid in contrast to saturated fatty acid which decreased (P < 0.05) during Ramadan. On the other hand, analysis of serum Lp AI and Lp AI:AII showed that the levels of Lp AI:AII were unchanged but those of Lp AI were significantly increased (P < 0.01) at the end of Ramadan. These findings show that feeding behaviour that occurs during Ramadan beneficially affects serum apolipoprotein metabolism and may contribute to prevention of cardiovascular diseases.

Adult↗

Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low-density lipoprotein cholesterol.

We demonstrated for the first time in a Moroccan population that fasting during Ramadan, the ninth lunar month of the Muslims' year, affected lipid and lipoprotein metabolism in a group of 32 healthy adult male volunteers. This investigation was conducted to study the changes in serum total cholesterol, triglycerides, cholesterol in high-density lipoprotein (HDL) and low-density lipoprotein (LDL), glucose, and body weight during Ramadan. The results showed a significant decrease (7.9%, p < 0.001) in serum total cholesterol concentration during Ramadan as compared with the prefasting period. Also, we obtained a significant decrease of serum triglyceride concentration (30%, p < 0.001) during Ramadan fasting as compared to the period before Ramadan. The reduction of both serum triglycerides and total cholesterol was maintained 1 month after Ramadan. By the end of Ramadan, serum HDL cholesterol had markedly increased (14.3%, p < 0.001) and remained elevated 1 month after Ramadan in contrast to LDL cholesterol which showed a significant decrease (11.7%, p < 0.0001) also maintained 1 month after Ramadan. Mean body weight declined by 2.6% (p < 0.01) on day 29 of Ramadan, whereas during Ramadan, the diet pattern used by our subjects showed an increase of total energy intake due to carbohydrates (+ 1.4% of total energy), proteins (+ 0.4% of total energy) but not fat (-0.7% of total energy) compared to a usual diet used throughout the rest of the year. Moreover, the fat diet is high in monounsaturated (p < 0.05) and polyunsaturated fatty acid in contrast to saturated fatty acid which significantly (p < 0.05) decreased during Ramadan. These findings suggest that feeding behavior that occurs during Ramadan beneficially affects plasma lipids and lipoproteins.

Adult↗

Hospital employee cholesterol screening: modification of dietary behavior.

1. The author used a survey tool to measure attitudes of individuals toward health and social factors specific to a low fat/low cholesterol diet. 2. Participants attending the cholesterol screening were healthy and already motivated to be aware of their cholesterol counts. The percent of diet pattern change was not influenced by knowledge of either a low, borderline, or high cholesterol level. 3. Although further testing of this instrument is needed, raw individual scores seem to indicate that motivated screening participants feel a diet low in fat and cholesterol has positive health implications and is not a social inconvenience. 4. There was no significant difference between the traditional and goal setting teaching methods in teaching hospital employee cholesterol screening participants to reduce dietary fat intake.

Adult↗

The effects of a low-fat/high-fiber diet on sex hormone levels and menstrual cycling in premenopausal women: a 12-month randomized trial (the diet and hormone study).

BACKGROUND: Reduction of cumulative exposure to endogenous ovarian steroid hormones is a postulated method for reducing the risk of carcinoma of the breast and other malignancies. Although there are data from trials evaluating the effect of low-fat and high-fiber diets on sex hormone levels in premenopausal women, to the authors' knowledge none of these trials has combined a relatively large number of participants, follow-up of > 2-3 months, parallel controls receiving a usual diet, and careful timing of blood sampling within the menstrual cycle. METHODS: A total of 213 healthy women, ages 20-40 years, were randomly assigned to follow their usual diet or to adopt an isocaloric diet with goals of 20% calories as fat, total fiber of 25 g/day, and at least 8 fruit or vegetable servings per day. Serum levels of total estradiol (E2), sex hormone-binding globulin (SHBG), non-SHBG-bound estradiol (NSBE2), SHBG, and progesterone were evaluated during a menstrual cycle at baseline, and at 4 cycles (C4) and 12 cycles (C12) after the start of the intervention. Serum was collected during each test cycle 7-9 days after the detection of an luteinizing hormone peak in the urine. One hundred eighty-nine women provided serum at C4 and 176 women at C12. RESULTS: Serum E2 decreased by an average of 7.5% or 7.8 pg/mL (95% confidence interval [95% CI], -16.0-0.04) at C12 in the intervention group, versus a decrease of 0.9% or 0.9 pg/mL (95% CI, -9.5-7.7) in the control group (the P value for the difference between the treatment groups was 0.25). Results for NSBE2 were very similar to those for total estradiol. There were no material effects found to result from intervention with regard to SHBG or progesterone. The results did not differ by baseline age, body mass index, or baseline hormone level above or below the median, and were not likely to be affected by weight change, which amounted to a mean loss of only 0.23 kg in the diet group versus a gain of 0.17 kg in the control group. The decrease in serum E2 associated with intervention was not greater when subjects were stratified by self-reported adherence to the dietary goals. CONCLUSIONS: The results of the current study suggest that the effects of this isocaloric low-fat, high-fiber diet pattern on circulating ovarian steroids were modest or nonexistent. However, the observed 7.5% reduction in estradiol could have biologic significance if it persisted over many years. Moreover, underestimation of the true dietary effect could have occurred because of incomplete adherence to assigned diets. Weight loss and weight control through midlife could be a more effective and feasible approach to dietary intervention in reducing the risk of breast carcinoma.

Adult↗

Lifestyle and hypertension--an overview.

Dietary and other lifestyle factors play a major role in the prevalence of hypertension. Many of the behaviours likely to reduce blood pressure also have independent beneficial effects on other cardiovascular risk factors to general health and survival. This is particularly the case with weight control, exercise, dietary patterns characterised by a low intake of saturated fat and a high intake of fruit, vegetables and fish and moderation of heavy alcohol consumption. High salt intakes remain a major contributor to hypertension, especially when potassium intake is low. Smoking has a dominant effect in increasing cardiovascular risk in hypertensives. Clustering of risk factors is often associated with clustering of unhealthy lifestyle characteristics and both are most prominent in lower socio-economic groups and in Developing Countries adopting a more sedentary lifestyle and Western diet patterns. Recent trials suggest substantial cardiovascular benefits by a combination of weight control and sodium moderation in the elderly, by non-vegetarian diets rich in fruit and vegetables and low in saturated fat, and by incorporation of regular fish meals into weight control diets.

Alcohol Drinking↗

[Arguments demonstrating a low dietary intake of potassium in the genesis and perpetuation of arterial hypertension].

The failure to find correlation between sodium intake and blood pressure in within population studies led to a search for other environmental factors. Bunge postulated that potassium would antagonize the effect of sodium. Japanese studies suggested that a high potassium intake might block some hypertension. Meneely hypothesized, and demonstrated in the rat, that potassium would partially block sodium-produced hypertension. The low-salt tribes are also high -potassium tribes. Walker, in Baltimore, showed a negative correlation between potassium and blood pressure, and Langford and Watson showed a significant correlation between Na/K ratio in the urine and diastolic blood pressure. Five studies in the United States have shown that blacks, who have much more hypertension than whites, excrete much less potassium. Studies on the habitual diet patterns of high and low potassium intake individuals have just begun. Changing potassium intake by dietary change has proven difficult.

Adolescent↗

Behavior therapy techniques applied to eating, exercise, and diet modification in childhood obesity.

Behavior therapy techniques are receiving increasing attention in the treatment of childhood obesity. This paper provides a selective review of experimental studies of childhood obesity that have utilized behavior therapy techniques with preadolescent populations. It further defines and describes specific behavior therapy techniques utilized in the modification of eating, exercise, and diet patterns in childhood obesity, including stimulus control, stimulus and response generalization, prompting, positive reinforcement, shaping, contingency contracting, and generalization and maintenance strategies.

Behavior Therapy↗

The effects of nutritional supplementation on the diets of low-income families at risk of malnutrition.

Protein-energy malnutrition in synergism with infection is a major problem for most developing countries, and inadequate food consumption is a critical factor in its development. Food supplementation programs can improve nutrient consumption but may also have unintended consequences. Changes in consumption of foods as well as nutrients need to be identified and evaluated. The effects of a food supplementation program on family diet patterns and protein-energy intake were investigated using data from nutritionally at risk families in Bogota, Colombia. Because food supplements are income transfers they need to substitute for purchases of similar food items. However, the results of our investigation reveal that food supplementation based on familiar foods that are part of the usual family diet are consumed in substantial quantities and result in net nutrient consumption increases. The food supplementation program increases consumption of preferred food items and introduces greater diversity into the family diet. These effects are enhanced when combined with a home education program.

Colombia↗

Risk of bladder cancer by geographic region in a U.S. cohort of male health professionals.

Large regional variations in bladder cancer rates have been observed for numerous decades in the United States and persist to date. We examined the incidence rates of bladder cancer by geographic region among U.S. male health professionals to determine whether diet or other lifestyle factors can account for variations observed. During 12 years of follow-up, 328 cases of bladder cancer were diagnosed in the Health Professionals Follow-up Study cohort. We inquired about diet, lifetime history of smoking, race, marital status, and other nondietary factors using mailed questionnaires. An elevated risk of bladder cancer was observed in the Northeast compared with the West [relative risk (RR) = 1.71, 95% confidence interval (CI) = 1.23-2.39], which was slightly attenuated after controlling for smoking (RR = 1.65, 95% CI = 1.18-2.30). Smoking patterns, diet, and other lifestyle factors could not account for all of the elevated bladder cancer risk in the Northeast. Bladder cancer risk was highest among men who had a long residency in the Northeast compared with a long residency in the West (RR = 1.77, 95% CI = 1.15-2.71, adjusted for smoking). Diet and other known characteristics do not appear to be responsible for the regional variations in bladder cancer rates in the United States.

Adult↗

A cluster analysis of alcohol-related attitudes and behaviors in the general population.

OBJECTIVE: Alcohol use typologies have previously focused on chronic alcohol abusers and alcohol-dependent populations. This empirical typology was created to profile lifestyle patterns associated with nonclinical patterns of alcohol use. METHOD: This study used two surveys sent to a commercial mailback panel, sampled to construct a study population demographically representative of the general U.S. population (N = 2,910). A K-means cluster analysis of alcohol use predictor variables and alcohol use generated the typology. RESULTS: The results suggest five distinct psychobehavioral clusters, referred to by the modal patterns of alcohol use for each cluster: nondrinkers, light drinkers, moderate drinkers, episodic drinkers and regular heavy drinkers. These clusters were found to have predictive validity using related health behaviors, psychosocial variables, personality self-descriptors, and media use as criteria. In particular, moderate drinkers had double the income of any other cluster and showed consistently healthy exercise, cigarette use, and diet patterns as well as a relatively high ranking of health as a personal value. Episodic drinkers had the highest levels of sensation-seeking and drug use and were not health oriented in values and behaviors, although their total weekly consumption was only marginally greater than the moderate drinkers. CONCLUSIONS: The profile of the moderate drinker cluster is consistent with concerns about lifestyle confounds in the relationship between moderate alcohol consumption and cardiovascular health. The episodic drinker profile is consistent with relatively high risk behaviors; this cluster may be a good target for harm-reduction education and intervention efforts.

Adult↗

Nutritional influence on risk of high blood pressure in Bangladesh: a population-based cross-sectional study.

BACKGROUND: The nutritional determinants of hypertension in Bangladesh and other low-income countries are largely unknown. OBJECTIVE: We assessed the associations of general hypertension with nutrient intakes and diet patterns in Bangladesh. DESIGN: This was a cross-sectional analysis of 11 116 participants enrolled in the Health Effects of Arsenic Longitudinal Study in Bangladesh. Dietary intakes were measured by use of a validated food-frequency questionnaire. RESULTS: Three major dietary patterns were identified by using principal component analysis: 1) the "balanced" pattern, which was characterized by rice, some meat, small fish, fruit, and vegetables; 2) the "animal protein" pattern, which was more heavily weighted on meat, milk, poultry, eggs, bread, large fish, and fruit; and 3) the "gourd and root vegetable" pattern, which consisted largely of squashes and root and leafy vegetables. Adjusted prevalence odds ratios for general hypertension in increasing quintiles of balanced pattern scores were 1.00 (reference), 0.81 (95% CI: 0.79, 0.97), 0.82 (0.68, 0.97), 0.79 (0.66, 0.94), and 0.71 (0.59, 0.85) (P for trend < 0.01). Prevalence odds ratios for general hypertension in increasing quintiles of animal protein pattern scores were 1.00 (reference), 1.30 (1.01, 1.52), 1.20 (1.01, 1.47), 1.22 (1.00, 1.44), and 1.21 (1.03, 1.49) (P for trend = 0.23). Markers of high socioeconomic status were positively associated with the animal protein pattern. CONCLUSION: Our findings suggest the importance of dietary patterns in general hypertension in a low-income population undergoing the early stage of the epidemiologic transition.

Adult↗

Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases.

In a "nutrition transition", the consumption of foods high in fats and sweeteners is increasing throughout the developing world. The transition, implicated in the rapid rise of obesity and diet-related chronic diseases worldwide, is rooted in the processes of globalization. Globalization affects the nature of agri-food systems, thereby altering the quantity, type, cost and desirability of foods available for consumption. Understanding the links between globalization and the nutrition transition is therefore necessary to help policy makers develop policies, including food policies, for addressing the global burden of chronic disease. While the subject has been much discussed, tracing the specific pathways between globalization and dietary change remains a challenge. To help address this challenge, this paper explores how one of the central mechanisms of globalization, the integration of the global marketplace, is affecting the specific diet patterns. Focusing on middle-income countries, it highlights the importance of three major processes of market integration: (I) production and trade of agricultural goods; (II) foreign direct investment in food processing and retailing; and (III) global food advertising and promotion. The paper reveals how specific policies implemented to advance the globalization agenda account in part for some recent trends in the global diet. Agricultural production and trade policies have enabled more vegetable oil consumption; policies on foreign direct investment have facilitated higher consumption of highly-processed foods, as has global food marketing. These dietary outcomes also reflect the socioeconomic and cultural context in which these policies are operating. An important finding is that the dynamic, competitive forces unleashed as a result of global market integration facilitates not only convergence in consumption habits (as is commonly assumed in the "Coca-Colonization" hypothesis), but adaptation to products targeted at different niche markets. This convergence-divergence duality raises the policy concern that globalization will exacerbate uneven dietary development between rich and poor. As high-income groups in developing countries accrue the benefits of a more dynamic marketplace, lower-income groups may well experience convergence towards poor quality obseogenic diets, as observed in western countries. Global economic policies concerning agriculture, trade, investment and marketing affect what the world eats. They are therefore also global food and health policies. Health policy makers should pay greater attention to these policies in order to address some of the structural causes of obesity and diet-related chronic diseases worldwide, especially among the groups of low socioeconomic status.

Journal Article↗

Diet and exercise patterns in pet dogs.

A study was conducted to provide baseline data on pet dog diet and exercise patterns. In addition, the repeatability of a telephone questionnaire to determine these patterns was evaluated. Dogs seen at the Texas Veterinary Medical Center that were less than 3 years old and of medium, large, or giant purebreeds or mixed-breeds were included. Information was collected about background variables, brands, quantities, and types of foods fed, and types and frequency of exercise. Daily intake of metabolizable energy, calcium, fat, and protein were calculated from the diet. Sixty-nine dog owners completed the study. Most dogs were kept as pets in an urban/suburban environment. Most were also fed dry food. About 60% were fed dog biscuits or some other dog snack or treat, and about half of the dogs in the study were fed twice daily. Meat scraps and bones were the table foods most commonly fed. Most owners considered their dogs to be moderately or very active. Greater than 70% of the dogs were confined to a fenced yard. About 65% of the owners took their dogs for walks. Forty percent of dogs in the study exercised with other dogs daily. More than half of the owners reported playing retrieving games with their dogs, including playing with a flying disk. The questionnaire was shown to be repeatable.

Animal Feed↗