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At least 1,063 records · Page 59Linked to original sources
PubMed1998

Growth of hypercholesterolemic children completing physician-initiated low-fat dietary intervention.

OBJECTIVE: To evaluate the growth of hypercholesterolemic children completing an innovative, physician-initiated, home-based nutrition education program or standard nutrition counseling that aims to lower dietary fat intake. STUDY DESIGN: From suburban pediatric practices, 261 3.9- to 9.9-year-old children with elevated cholesterol levels and 81 children with nonelevated cholesterol levels were identified. The children with hypercholesterolemia were randomly assigned to the home-based education program, standard nutrition counseling, or an at-risk control group. Height, weight, skinfold measures, and dietary intake were evaluated at baseline, 3, 6, and 12 months; changes in anthropometric measures among treatment groups were compared over time. RESULTS: The intervention groups demonstrated significant decreases in fat and saturated fat intake after the interventions; however, weight z-score, height z-weight-for-height-median, and sum of skinfolds did not vary among the treatment groups over the year. At baseline, height z-score, weight z-score, and weight-for-height-median were positively associated with caloric intake, whereas weight z-score, weight-for-height-median, and sum of skinfolds were positively associated with fat intake. When the groups were combined and the children were grouped by average fat intake quintiles, no association between fat intake and changes in weight z-score, height z-score, or weight-for-height-media was observed. Differences over time in sum of skinfolds among fat intake quintile groups (suggesting a negative association between fat intake and body fat) that approached statistical significance (p = 0.06) were observed. CONCLUSIONS: These results support the safety, with respect to growth, of physician-initiated dietary intervention and lower fat diets for children with hypercholesterolemia. In addition, low dietary fat intake was associated with lower body fat.

Body Height↗
PubMed1990

The Brisighella Heart Study: an interim report.

In 1972, the Brisighella Study was initiated to monitor the spontaneous trend of risk factors for atherosclerosis and the incidence of coronary heart disease (CHD) in a rural population. This study, which is one of the largest Italian studies on the epidemiology of atherosclerosis and cardiovascular disease, established a strong correlation between increased cholesterol levels and the incidence of CHD. The apparent unwillingness of the population to alter dietary and exercise habits independently led the researchers to establish the Brisighella Heart Study in 1984. This study attempted to reduce the risk of CHD by modifying the population's dietary habits through a nutritional education program. While the nutritional education program succeeded in lowering total cholesterol, a segment of the population still remained at risk. At this point, the high-risk strategy arm of the study was initiated. In 1988, those participants whose total cholesterol level was greater than 239 mg dl-1 were started on a twice-daily regimen of 600 mg of gemfibrozil. The Brisighella Heart Study High-Risk Project will continue for at least 5 years, during which all participants will be followed-up every 6 months and all fatal and non-fatal events will be recorded.

Age Factors↗
PubMed1986

Effect of total parenteral nutrition on the zinc, copper, and manganese status of patients with catabolic disease.

The zinc, copper, and manganese concentrations in liver and muscle and the serum zinc were measured in 24 malnourished patients before and after 10-12 days' parenteral nutrition with 3 different alimentation programs. The nutrition programs contained similar trace element substitutions. Malnutrition caused by different catabolic diseases resulted in an increase of zinc and copper contents in the liver and a rise of serum zinc in many patients and in a decrease of muscle zinc concentration in certain patients. Parenteral nutrition of any kind resulted in a decrease of liver zinc and copper content and of serum zinc, yielding subnormal zinc values in 25-58% of the patients in spite of a daily substitution of 1.9 mg zinc. There was no significant change in the manganese status because of malnutrition or parenteral alimentation. It is concluded that the serum zinc concentration does not show the real zinc status of the body in the patients with catabolism, that in certain catabolic diseases zinc and copper are redistributed to the liver, that certain catabolic diseases cause a zinc depletion of the muscle, that parenteral nutrition results in a fall of zinc and copper in the liver and in a decrease of serum zinc, which may be harmful from the healing point of view, and that the daily substitution of zinc used in this study, 1.9 mg/day, is not sufficient during parenteral nutrition of catabolic patients.

Adult↗
PubMedDate not supplied

[Records and documentation system. Its location within a program of alimentary, nutritional and metabolic intervention].

OBJECTIVES: To present the Records and Documentation System of the Metabolic, Nutrient and Feeding Intervention Program (PRINUMA), as conducted by the Nutritional Support Group (GAN) of the "Hermanos Ameijeiras" Hospital (Havana City, Cuba). BACKGROUND: Every action conducted upon the patient must have a document backup. Likewise, this action should be exhaustively described in a Standerdized Operating Procedure (SPO). The Records and Documentation System must provide with: (1) Primmary records for registering the actions conducted upon the patients, (2) SOP manuals gathering the actions prescribed in the PRINUMA for the recognition, treatment and prevention of hospital malnutrition (HM), and (3) Computerized clinical registries for storing, manipulation and dissemination of data collected by the GAN during its local operation. METHODS: The ISO 9001-9003 standard was adopted for describing the actions prescribed by the PRINUMA into the corresponding SOPs. Access 7.0 for Windows (Microsoft, USA) was used for the programming and operation of the GAN'S computerized Clinical Registry. Three phases were defined for the implementation of this System: I: start-up (minimal); II: extended; III: total (global). RESULTS: System implementation is in phase II. A Procedure Manual has been written with clinical, anthropometric, dietetic, dietotherapeutical and analytical actions prescribed by the PRINUMA for the treatment of HM. There is a second Manual reuniting the actions fostered by the PRINUMA's Quality Control & Assurance and the Records & Documentations Systems. GAN also has a Nutritional Clinical History and a computerized Clinical Registryt serving as digital counterpart of the former. The Registry stores data of varying type collected from over 1.800 patients attended in the 8 years of the GAN existence. CONCLUSIONS: The implementation of the PRINUMA's Records and Documentation System has allowed the elaboration of judgements about the utility and safety of the intervention measures installed in the institution by the GAN. Likewise, the System has supported the research activity of the Group, and has been particularly useful in the conduction of continuous education activities within the institution.

Cuba↗
PubMedDate not supplied

The health impact of worksite nutrition and cholesterol intervention programs.

PURPOSE: To summarize and provide a critical review of worksite health promotion program evaluations published between 1980 and 1995 that address nutrition and hypercholesterolemia. The article discusses and critiques both intervention methods and research methodologies to identify the most effective strategies. METHODS: Core articles are 26 original, data-based studies that report on measures of health status, behavior, attitudes, and knowledge as outcomes of worksite nutrition and cholesterol interventions. Only work published since 1980 that clearly describes nutrition or cholesterol interventions and that includes identifiable nutrition-related outcomes is reviewed. The main search method was the same one used for this special issue; supplementary sources included those found in earlier reviews or identified through backward searches or expert contact. SUMMARY OF IMPORTANT FINDINGS: Ten worksite nutrition education programs were reviewed and were categorized as group education, group education plus individual counseling/instruction, cafeteria-based programs, and group education plus cafeteria-based programs. Four of these were randomized studies, and one used the worksite as the unit of randomization and analysis. Sixteen worksite cholesterol programs were reviewed, in five categories: monitoring; individual counseling; group sessions or classes; mediated methods using print, audiovisual, telephone, and self-help kits; and combination approaches. Of these, eight were randomized controlled trials; most tested interventions for persons with elevated cholesterol levels, although four studies reported cholesterol education programs for the general employee population. Six large controlled trials of worksite nutrition and cholesterol interventions in progress are also described. MAJOR CONCLUSIONS: The conclusions that can be drawn from this review are limited by the study designs used, which often lacked control groups, used nonrandomized designs, or relied on self-selected high-risk or volunteer participants. Our rating for the quality of the evidence in the literature as a whole lies between suggestive and indicative. It is clear that worksite nutrition and cholesterol programs are feasible and that participants benefit in the short-term. Conclusive evidence about a causal relationship between worksite nutrition and cholesterol programs and improved behavior or health is not yet available, although studies currently underway hold promise for providing more solid evidence about the potential efficacy of these interventions.

Health Knowledge, Attitudes, Practice↗
PubMed1989

Work-site health promotion: the effects of a goal-setting program on nutrition-related behaviors.

A Goal Attainment Scaling procedure was used to quantify and evaluate change in nutrition-related behaviors of participants in a work-site wellness program. Goal Attainment Scaling is a procedure for quantifying change over time, in five categories varying from "less than expected" success to "more than expected" success. The sample consisted of 60 enlisted military personnel who had indicated, on a screening questionnaire, their desire to improve dietary practices. The subjects were assigned to three groups but remained unaware throughout the study that nutrition was being investigated. The Goal-Setting/Goal Attainment group (GSGA, no. = 19) received a full 8-week health promotion program, based on goal-setting, fitness information, and skill development (12 sessions). The Goal-Setting group (GS, no. = 19) received only the part of the program that focused on setting goals (two sessions). The control group (no. = 22) received no instruction. Results from analysis of variance indicated that GSGA had significantly higher "Change Scores" in nutrition-related behaviors than the control group (p less than .05); "Change Scores" reflect degree of dietary improvement. Frequency data indicate that dietary improvements were sustained for 84% of the GSGA members, 64% of the GS members, and 37% in the control group. These findings suggest goal-setting skills enhance individuals' capabilities for making and maintaining improvements in nutrition-related behaviors.

Adult↗
PubMed2006

[Comparison of two national food surveys (INCA 1 1998-99 and Health Nutrition Barometer 2002) with regard to five food recommendations of the National Nutrition and Health Program].

BACKGROUND: Monitoring the dietary intake of the French population requires the implementation and regular renewal of representative national survey. As these surveys can use different methodologies (food frequency questionnaire, 24 hour recall, 3 or 7-day dietary record...), it seems useful to check whether they supply similar results. The aim of this study is to determine whether two representative national surveys with different methodologies can be used alternately to monitor changes in food consumption of the French population. METHOD: Percentages of consumers aged 15-75 were compared between two national food surveys (Health Nutrition Barometer 2002 and INCA 1 1998-99) with respect to five food frequency recommendations of the French National Nutrition and Health Program. RESULTS: The same public health priorities were found in both surveys: the food groups were graded according to the same hierarchy of adequate food intake prevalences (ascending: fruits and vegetables, dairy products, fish, starchy foods and meat-fish-egg products). On the other hand, significant statistical different elements were pointed out in a few food groups which may be explained by methodological patterns. Definitions of portions and food groups, survey duration and seasons are indeed important parameters to be considered when comparing surveys. CONCLUSION: The results show the need to elaborate standardized methods for comparison of food consumption surveys, which can be useful for the evaluation of the national nutritional recommendations. The methodological limitations described in this study also indicate that the quantitative description of food intake trends should improve when established by the results of the same regularly repeated survey.

Adolescent↗
PubMed1991

Programming by early nutrition in man.

Whether early diet influences long-term health or achievement is a key question in nutrition. Such long-term consequences would invoke the concept of 'programming'--a more general process whereby a stimulus or insult at a critical period of development has lasting or lifelong significance. Data from small mammals and primates show that early nutrition may have potentially important long-term effects, for example on blood lipids, plasma insulin, obesity, atherosclerosis, behaviour and learning. Corresponding studies in man have been largely retrospective and difficult to interpret. The preterm infant is however an important model for human research because formal random assignment to early diet is practical. A large prospective randomized multicentre study has been undertaken on 926 preterm infants to test the hypothesis that early diet influences long-term outcome. Diets included human milk, standard formula and nutrient-enriched preterm formula. The diet consumed for on average the first month post partum had a major impact on subsequent developmental attainment, growth and allergic status in early childhood. That such a brief period of dietary manipulation has lasting significance implies that the neonatal period is critical for nutrition after preterm birth. These data may have broader implications for human nutrition.

Animals↗
PubMed1993

Nutrition knowledge and practices of physicians in a family-practice residency program: the effect of an education program provided by a physician nutrition specialist.

The purpose of this study was to determine the effects of a nutrition-education program provided by a physician nutrition specialist in a family-practice residency program on residents' and faculty members' nutrition knowledge and nutrition-related patient care, their patients' perceptions of the importance of nutrition, and the physicians' dietary patterns. The nutrition specialist provided recommendations for nutrition patient-care practices to the physicians for 6 mo. Pre- and post-intervention assessments included 1) nutrition exams for physicians and patients, 2) patient questionnaires concerning attitudes towards nutrition, 3) chart reviews, and 4) diet records for physicians. The educational intervention caused a small but statistically significant (P < 0.01) increase in physicians' nutrition-knowledge scores and a significantly higher (P < 0.05) frequency of physicians discussing nutrition and recommending diets for their patients. Effects were greater among residents than among faculty members. The results suggest that a physician nutrition specialist can provide effective nutrition education within a residency program.

Diet Records↗
PubMed1999

The impact of the AFDC and Food Stamp programs on child nutrition: empirical evidence from New Orleans.

This study tests the hypotheses that the participation in the Aid to Families with Dependent Children (AFDC) and Food Stamp programs has a positive impact on children's nutritional status, after controlling for other potentially important household- and individual-level characteristics. The analysis is based on the responses of a health facility survey of 246 pairs of low-income mothers and children in New Orleans. The results indicate that participation in the AFDC and Food Stamp programs is associated with increased anthropometric status of children, but the foods consumed by children in families receiving welfare benefits were of significantly lower nutritional value than foods consumed by other children. Among the study's conclusions are the following: (1) in this low-income setting, AFDC and Food Stamp benefits are associated with higher food expenditures, higher anthropometric levels, but inferior diets, and (2) female-headed households spend more on food expenditures than other households, after controlling for other individual- and household-level characteristics.

Adult↗
PubMedDate not supplied

Status of nutrition surveillance activities in 24 State and metropolitan health departments.

A study was undertaken to examine nutrition surveillance activities and their usefulness in managing programs of nutrition intervention. Questionnaires were returned by 24 of 26 directors of nutrition units in State or metropolitan health departments participating in 1981 in the coordinated nutrition surveillance system of the Centers for Disease Control, which monitors high risk pediatric patients and pregnant women. The mean years of experience in surveillance activities among the agencies was 4. Only 25 percent of the responding departments reported a self-sufficient computerized surveillance system. Personnel most involved in the coordinating, analyzing, and interpreting of the data were nutritionists who spent an average of 17 hours per month. Major uses of surveillance data reported for purposes of the nutrition programs were to (a) identify collection sites with problems such as errors in measuring heights and weights and hematocrits warranting checks for quality control, (b) define the extent of nutrition-related disorders in the target populations, (c) provide objective local data to assist in decision-making and program planning, (d) enhance followup of specific clients, and (e) provide feedback to clinic staffs about the quality and relative impact of their services. The survey results yielded evidence that nutrition surveillance activities have important consequences for the planning, implementation, and evaluation of programs of nutritional intervention.

Allied Health Personnel↗
PubMed1997

Meeting the special nutritional needs of sick infants with a percutaneous central venous catheter quality assurance program.

Adequate nutrition is important in infancy because it can affect brain growth. A critical period for brain growth is the end of the fetal growth period and the first 2 years of life. Delivery of nutrition to infants in the neonatal intensive care unit is challenging because illness and prematurity increase nutritional need and create access difficulties. One technique, percutaneous central venous catheter (PCVC) placement, eliminates access difficulties. Nevertheless, safe delivery of parenteral nutrition through PCVCs is dependent on minimizing infectious and mechanical complications. With the implementation of a PCVC quality assurance program, problems can be identified early, and appropriate, timely interventions can be initiated.

Catheterization, Central Venous↗
PubMed1991

[PEDINFUS computer program for total parenteral nutrition of children].

The computer program PEDINFUS permits the fast and simple definition of the individual nutrient amounts and infusion volumes in accordance with age, weight and possible metabolic complications for children up to 18 years. All components needed for total parenteral nutrition are taken into account. The conditions necessary for the optimal satisfaction of the individual needs of each patient by means of combined solutions have thus been created.

Adolescent↗