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Nutritional Intake (nutritional + intake)

Distribution by Scientific Domains

Medical Sciences	96%

Distribution within Medical Sciences

Pediatrics	11%
Nursing General	7%

Selected Abstracts

Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2005
Paula Ravasco MD
Abstract Background. We aimed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer, specifically, nutritional outcome, morbidity, and quality of life (QOL), during and 3 months after radiotherapy. Methods. Seventy-five patients with head and neck cancer who were referred for radiotherapy (RT) were randomized to the following groups: group 1 (n = 25), patients who received dietary counseling with regular foods; group 2 (n = 25), patients who maintained usual diet plus supplements; and group 3 (n = 25), patients who maintained intake ad lib. Nutritional intake (determined by diet history) and status (determined by Ottery's Subjective Global Assessment), and QOL (determined by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire version 3.0 [EORTC QLQ-C30]) were evaluated at baseline, at the end of RT, and at 3 months. Results. Energy intake after RT increased in both groups 1 and 2 (p , .05). Protein intake also increased in both groups 1 and 2 (p , .006). Both energy and protein intake decreased significantly in group 3 (p < .01). At 3 months, group 1 maintained intakes, whereas groups 2 and 3 returned to or below baseline levels. After RT, >90% of patients experienced RT toxicity; this was not significantly different between groups, with a trend for reduced symptomatology in group 1 versus group 2/group 3 (p < .07). At 3 months, the reduction of incidence/severity of grade 1+2 anorexia, nausea/vomiting, xerostomia, and dysgeusia was different: 90% of the patients improved in group 1 versus 67% in group 2 versus 51% in group 3 (p < .0001). After RT, QOL function scores improved (p < .003) proportionally with improved nutritional intake and status in group 1/group 2 (p < .05) and worsened in group 3 (p < .05); at 3 months, patients in group 1 maintained or improved overall QOL, whereas patients in groups 2 and 3 maintained or worsened overall QOL. Conclusions. During RT, nutritional interventions positively influenced outcomes, and counseling was of similar/higher benefit; in the medium term, only counseling exerted a significant impact on patient outcomes. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]

The French longitudinal study of growth and nutrition: data in adolescent males and females

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2002
M. Deheeger
Abstract Objectives To assess nutritional intake, growth parameters, physical activity and television viewing in French adolescents. Method A longitudinal study of dietary intake and anthropometric data recorded in the same children (n = 94) from 10 to 16 years of age is presented here. Results Energy intake increased from age 10,16 years in boys, whereas it decreased in girls from the age of 14. Height and weight increased in both males and females over the same period of time. Energy intake was positively associated with age at menarche. Nutritional intake, such as fat and calcium, did not meet recommendations for French adolescents. Height was higher than reference values, but the difference was not significant for girls between 14 and 16 years. Overweight (BMI > 97th percentile of the French reference) was found to be 13,14% between age 10 and 16 years. Time watching TV/computer increased with age from 1.4 to 2.2 h day,1 from 10 to 16 years. Active children had nutritional intake closer to recommendations. Conclusion In conclusion, this study shows that during adolescence, some nutritional variations can be explained by normal individual growth processes. Low intake of calcium in girls and sedentary lifestyle are of particular concern. [source]

Effect of Maternal Nutrient Restriction in Early Gestation on Responses of the Hypothalamic-Pituitary-Adrenal Axis to Acute Isocapnic Hypoxaemia in Late Gestation Fetal Sheep

EXPERIMENTAL PHYSIOLOGY, Issue 1 2000
Paul Hawkins
Epidemiological and experimental evidence suggests that maternal undernutrition during pregnancy may alter development of fetal organ systems. We have demonstrated previously that fetal hypothalamic-pituitary-adrenal (HPA) axis responses to exogenous corticotropin-releasing hormone (CRH) + arginine vasopressin (AVP), or adrenocorticotrophin hormone (ACTH), are reduced in fetuses of mildly undernourished ewes. To examine these effects further we tested HPA axis responses to acute isocapnic hypoxaemia in fetal sheep at 114-129 days gestation (dGA), following 15% reduction in maternal nutritional intake between 0 and 70 dGA. Fetuses from control (C) and nutrient-restricted (R) ewes were chronically catheterised and plasma ACTH and cortisol responses were determined at 114-115, 120-123 and 126-129 dGA during hypoxaemia (1 h) induced by lowering the maternal inspired O2 fraction (FI,O2). Basal plasma cortisol concentrations and HPA axis responses at 114-115 and 120-123 dGA did not differ between C and R fetuses. At 126-129 dGA, both plasma ACTH (P < 0.01) and cortisol (P < 0.05) responses were smaller in R fetuses compared to C fetuses. Fetal blood gas status, fetal body weight, body proportions and organ weights did not differ between the groups. We conclude that mild maternal undernutrition alters development of the fetal HPA axis producing a reduction in pituitary and adrenal responsiveness to endogenous stimuli. [source]

Impact of nutrition on outcome: A prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy

Minimising undernutrition in the older inpatient

INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2007
Dawn Vanderkroft BSc internshipNutr&Diet APD
Abstract Background, Malnutrition among elderly hospitalised patients is widespread and has been shown to lead to adverse health outcomes. The effectiveness of interventions to minimise undernutrition in elderly inpatients is not well documented. Objectives, To identify the best available practices, in the hospital setting, that minimise undernutrition or the risk of undernutrition, in the acute care patient especially for the older patient. The review will assesses the effectiveness of a range of interventions designed to promote adequate nutritional intake in the acute care setting, with the aim of determining what practices minimise malnutrition in the elderly inpatients. Search strategy, English language articles from 1980 onwards were sought using Medline, Premedline, Cinahl, Austrom-Australasian Medical Index and AustHealth, Embase and Science Citations Index. Selection criteria, For inclusion the study had to include an intervention aiming to minimise undernutrition in hospitalised elderly patients aged 65 years or older. All study designs were included. Data collection and analysis, Two independent reviewers assessed the eligibility of each study for inclusion into the review, critically appraised the study quality and extracted data using standardised tools. For each outcome measure results were tabulated by intervention type and discussed in a narrative summary. Results from randomised controlled trials were pooled in meta-analyses where appropriate. Main results, Twenty-nine studies met the inclusion criteria, with a total of 4021 participants. The focus of 15 interventions was the supplying of oral supplements to the participants, six focused on enteral nutrition therapy, four interventions made changes to the foods provided as part of the hospital diet, one included the services of an additional staff member and three incorporated the implementation of evidence-based guidelines. Ten meta-analyses were conducted from which the main findings were: significant improvements in weight status and arm muscle circumferences with an oral supplement intervention, P < 0.05. Reviewers' conclusions, The findings of the review support the use of oral supplements to minimise undernutrition in elderly inpatients. The results also emphasise the need for more high-quality research using appropriate outcome measures in the area of minimisation of undernutrition, particularly interventions that make alterations to the hospital diet and address support for feeding patients at the ward level. [source]

Feeding and dementia: a systematic literature review

JOURNAL OF ADVANCED NURSING, Issue 1 2006
Roger Watson PhD RN FIBiol FRSA
Aim., This paper reports a systematic review of the literature on interventions to promote oral nutritional intake of older people with dementia and feeding difficulty between 1993 and 2003. Background., Older people with dementia commonly experience difficulty with feeding, especially in the later stages of the condition. This topic and related nursing care was reviewed in 1993 and the conclusion was that there was little research into interventions that nurses could use to alleviate feeding difficulty. Method., A systematic review of the literature was carried out using the CINAHL, Medline, EMBASE and Cochrane databases and the search terms ,feeding', ,eating' and ,dementia' combined as follows: ,(feeding or eating) and (dementia)'. A second search was carried out combining the search terms ,mealtimes' and ,dementia' as follows: ,mealtimes and dementia'. The literature search was carried out on 1 December 2003 and papers were included in the review if retrieved by 31 December 2003. English language papers only were retrieved. Results., Sixty-seven papers were retrieved, of which 13 addressed interventions aimed at helping older people with dementia to feed. All studies reported positive outcomes but only one randomized controlled trial was reported. Music was the most common intervention but there were no standardized interventions or outcomes across the studies and none reported the use of power analysis to decide on sample size. There were problems in some studies with confounding variables. Conclusions., Further research is needed into interventions aimed at how nurses can help older people with dementia to feed. There are some promising lines of enquiry, with music being one of these, but future studies need to use adequate samples and to use power calculations and account adequately for confounding variables. There is also a need to standardize interventions and outcomes across such studies to facilitate meta-analysis. [source]

Review: nurses can improve patient nutrition in intensive care

JOURNAL OF CLINICAL NURSING, Issue 17 2009
Caroline Ros
Aims and objectives., To review the literature and identify opportunities for nutritional practice improvement in the critically ill and opportunities to improve nurses' knowledge relating to enteral feeding. Background., The literature reports varying nutritional practices in intensive care. Design., Systematic review. Methods., A systematic search, selection, analysis and review of nursing, medical and dietetic primary research articles was undertaken. Fifteen studies met the selection criteria. Results., Delivery of nutrition to the critically ill varied widely. Patients were frequently underfed and less frequently, overfed. Both under- and overfeeding have been linked with unacceptable consequences including infections, extended weaning from mechanical ventilation, increased length of stay and increased mortality. Underfeeding was related to slow initiation and advancement of nutrition support and avoidable feed interruptions. The most common reasons for interrupting feeds were gastrointestinal intolerance and fasting for procedures. Certain nursing practices contributed to underfeeding such as the management of gastric residual volumes. Conclusions., Consistent and reliable nutrition support in intensive care units is hampered by a lack of evidence leading to varying nutrition practices. Factors impeding delivery of enteral nutrition were considered avoidable. A new concept of a therapeutic range of energy delivery in the critically ill has emerged implying the need for re-evaluation of energy recommendations and improved delivery of enteral nutrition. Relevance to clinical practice., This review supports the multi-disciplinary development and implementation of an evidence-based enteral feeding protocol in intensive care units as a strategy to improve adequacy of nutritional intake. Critical care nurses are well placed to improve this process. [source]

Nutritional factors associated with survival following enteral tube feeding in patients with motor neurone disease

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2010
A. Rio
Abstract Background: Motor neurone disease (MND) is a progressive neurodegenerative disease leading to limb weakness, wasting and respiratory failure. Prolonged poor nutritional intake causes fatigue, weight loss and malnutrition. Consequently, disease progression requires decisions to be made regarding enteral tube feeding. The present study aimed to investigate the survival, nutritional status and complications in patients with MND treated with enteral tube feeding. Methods: A retrospective case note review was performed to identify patients diagnosed with MND who were treated with enteral tube feeding. A total of 159 consecutive cases were identified suitable for analysis. Patients were treated with percutaneous endoscopic gastrostomy (PEG), radiologically inserted gastrostomy (RIG) or nasogastric feeding tube (NGT). Nutritional status was assessed by body mass index (BMI) and % weight loss (% WL). Serious complications arising from tube insertion and prescribed daily energy intake were both recorded. Results: Median survival from disease onset was 842 days [interquartile range (IQR) 573,1263]. Median time from disease onset to feeding tube was PEG 521 days (IQR 443,1032), RIG 633 days (IQR 496,1039) and NGT 427 days (IQR 77,781) (P = 0.28). Median survival from tube placement was PEG 200 (IQR 106,546) days, RIG 216 (IQR 83,383) days and NGT 28 (IQR 14,107) days. Survival between gastrostomy and NGT treated patients was significant (P , 0.001). Analysis of serious complications by nutritional status was BMI (P = 0.347) and % WL (P = 0.489). Conclusions: Nutritional factors associated with reduced survival were weight loss, malnutrition and severe dysphagia. Serious complications were not related to nutritional status but to method of tube insertion. There was no difference in survival between PEG and RIG treated patients. [source]

Improving clinical outcome in patients with intestinal failure using individualised nutritional advice

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2009
A. Culkin
Abstract Background: Patients with intestinal failure are required to adhere to a complex regimen. Written information may increase knowledge leading to improvements in clinical outcomes. The present study aimed to evaluate the effectiveness of nutrition advice incorporating the use of a booklet. Methods: Each patient completed a questionnaire evaluating their knowledge of the regime and quality of life and kept a diet and gastrointestinal output diary. The diary was assessed and they were given the booklet with a verbal explanation tailored to individual requirements. The booklet explained the causes of intestinal failure, diet and fluid recommendations in relation to intestinal anatomy, information on medications and long-term monitoring. Patients were reassessed at their next appointment using the same tools. The primary endpoint was an improvement in knowledge. Secondary endpoints were an improvement in oral nutritional intake, nutritional status, quality of life and the content of home parenteral nutrition. Results: Forty-eight patients completed the study. Knowledge improved significantly after dietetic intervention in association with the provision of the booklet (P < 0.001). Oral energy (P = 0.04) and fat (P = 0.003) intake increased with an improvement in body mass index (P = 0.02). Patients on home parenteral nutrition showed a reduction in parenteral energy (P = 0.02), nitrogen (P = 0.003), volume (P = 0.02) and frequency (P = 0.003). Conclusions: A booklet for patients with intestinal failure in conjunction with personalised dietary counselling improves knowledge and clinical outcomes. [source]

A review of low and reduced carbohydrate diets and weight loss in type 2 diabetes

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2008
P. A. Dyson
Abstract Background, Recent evidence from randomized controlled trials of hypocaloric low carbohydrate diets in people without diabetes has shown that they promote significant weight loss over the short term. There is very little evidence for any effects of reduced carbohydrate intakes on body weight, glycaemia and cardiovascular risk in people with type 2 diabetes. Methods, An electronic search was performed using MEDLINE (1966 to March 2007), EMBASE (1988 to March 2007) and Cochrane Central Register of Controlled Trials (1991 to March 2007) using the keywords low carbohydrate, type 2 diabetes and weight loss. Studies including subjects with type 2 diabetes who adopted a reduced carbohydrate weight loss diet were identified. Data were extracted on study design, weight loss, effects on glycaemia and cardiovascular risk and potential adverse effects. Results, Six studies investigating the effects of hypocaloric reduced carbohydrate diets in people with type 2 diabetes were identified. The studies were heterogenous and most included small numbers, were short-term and provided varying amounts of carbohydrate. No studies were identified that were both low carbohydrate (<50 g day,1) and also designed as randomized controlled trials. All studies reported reductions in both body weight and glycated haemoglobin, with no deleterious effects on cardiovascular risk, renal function or nutritional intake. Conclusions, Conclusions are limited by study design and small numbers, but it appears that reduced carbohydrate diets are safe and effective over the short term for people with type 2 diabetes. [source]

Investigation into the nutritional status, dietary intake and smoking habits of patients with chronic obstructive pulmonary disease

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2004
W. J. Cochrane
Abstract Background and aims Weight loss and reduced fat-free mass are prevalent amongst patients with chronic obstructive pulmonary disease (COPD). However, the causes of this weight loss are not clear. The aims of this study are to investigate the factors affecting body weight and dietary intake in a group of outpatients with COPD, and to investigate any differences between adequately nourished and malnourished patients. Methods In 103 stable outpatients, nutritional status was assessed using Body Mass Index (BMI) and upper arm anthropometry. Lung function, smoking status, exercise tolerance, dietary intake, dietary problems and health-related quality of life were assessed. Patients were classed as either adequately nourished or malnourished. Results Twenty-three per cent of subjects were classed as malnourished. The malnourished subjects had lower lung function measurements, suffered more dietary problems and had lower nutritional intake compared with the adequately nourished subjects. They also had poorer fatigue scores. In linear regression analysis, the factors that had the most effect on BMI were a low transfer factor, presence of early satiety, and being a current smoker. Conclusion Important differences were found between adequately nourished and malnourished subjects. These differences move us closer to understanding how best to screen and treat this group of patients. [source]

Palliative management of cancer of the oesophagus , opportunities for dietetic intervention

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2003
A. Holdoway
Introduction: Cancer of the oesophagus develops insidiously and when patients present with symptoms such as dysphagia to solids/semi-solids and in some cases liquids, the disease is often advanced and patients are frequently poorly nourished and cachectic (Angorn, 1981; Larrea, 1992). In our own unit we were aware that patients were only referred to the dietitian once an oesophageal stent was inserted or radiotherapy commenced, thereby possibly missing opportunities to treat or prevent malnutrition earlier. We therefore evaluated the nutritional status and care pathways of patients diagnosed with cancer of the oesophagus in whom palliative treatment was the only option, with the aim of assessing the extent of malnutrition and identifying opportunities for earlier dietetic intervention to prevent or slow the development of malnutrition. Method: Data were collated on all patients referred to the hospital's dysphagia clinic and diagnosed with inoperable cancer of the oesophagus. Height, weight, body mass index, degree of dysphagia, period of dysphagia, percentage weight loss (data collected as standard practice in the dysphagia clinic) and time to stent insertion/radiotherapy and survival time was collected from the medical notes. Results: Data were available on 58 patients, 33 male, 25 female, mean age 75 years (range 49,92 years). The mean length of survival was 10.2 months (0,24 months). At diagnosis, 47% experienced dysphagia with solids, 33% with semi-solids and 16% experienced a degree of dysphagia with liquids. The period of dysphagia was 1 month to 2 years. Eighty-three per cent of patients had lost weight at diagnosis. Mean percentage weight loss per individual was 13% (range 0,45%). Thirty-five per cent had a BMI <20 kg/m2. Median time from diagnosis to radiotherapy (n = 8) was 2 months with range, 1,6 months. Median time from diagnosis to the placement of the oesophageal stent (n = 12) was 1 month with range, 0,7 months. Discussion: These data illustrate that malnutrition remains a significant problem in this patient group. These results demonstrate that dysphagia and malnutrition, as indicated by weight loss, is developing in the community before diagnosis. Opportunities for earlier dietetic intervention exist between diagnosis and date at which other treatments commence, i.e. stent insertion. Further opportunities exist to educate community health professionals on treating and preventing malnutrition when dysphagia presents. Survival times support the need for dietetic follow-up. In our unit the results of this audit helped to improve care pathways for patients with cancer of the oesophagus. In response to the above findings, a nutritional screening tool is now completed by a nurse specialist at the first clinic attended. This has enabled appropriate and timely advice to be given on modified texture and fortification of food to optimize nutritional intake at diagnosis. [source]

The French longitudinal study of growth and nutrition: data in adolescent males and females

Oral pemphigus vulgaris occurring during pregnancy

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 2 2002
Joseph K. Muhammad
Abstract There have been few reports describing the occurrence of pemphigus vulgaris (PV) during pregnancy. The patient described in this case report is interesting because the PV that developed during her pregnancy was confined to her mouth. It has been suggested that prompt treatment with systemic steroids prevents development of PV in cutaneous tissues. In this case, early control of the condition is believed to have eliminated the need for high dose steroids throughout the remainder of the pregnancy. In addition, this therapeutic approach could have contributed to the birth of a baby free of PV. Resolution of the presenting oral symptoms allowed the mother to resume a normal diet, allaying her anxiety about the possible effects of poor nutritional intake on foetal development. Aspects of clinical management considered in this report include the choice of immunospuppressive therapy and the multidisciplinary care involving both dental and obstetric specialists. [source]

Audit of feeding practices in babies <1200 g or 30 weeks gestation during the first month of life

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 7-8 2006
Barbara E Cormack
Aim: In 2002, the composition of the breast milk fortifier used in our hospital changed, giving increased protein and energy. We therefore decided to prospectively audit nutritional management in our unit and to compare nutritional intake and growth in our babies with published data. Methods: Data were prospectively collected over a 3-month period on infants <1200 g or 30 weeks gestation. Prescribed and delivered volumes of all parenteral and enteral fluids were recorded. Babies were weighed as per unit protocol. Results: Thirty-four infants met the audit criteria. Data are median (range). After the first week of life, energy and protein intakes were 147 (78,174) kcal/kg/day and 3.9 (2.1,4.8) g/kg/day respectively. Daily weight gain was 17 (,3.2,35.4) g/kg and was significantly associated with both energy and protein intakes (P < 0.001). However, standard deviation scores for weight fell from 0.15 (,1.9,2.0) at birth to ,1.0 (,2.9,0.8) by 36 weeks corrected age. Time to commencing enteral feeds was 1 (1,3) day and to full enteral feeds was 8 (5,28) days. One infant was diagnosed with necrotising enterocolitis and eight with chronic lung disease. Mean protein intake was significantly lower in babies with chronic lung disease (P = 0.005). Conclusion: Overall, nutritional intakes and weight gain in this cohort of babies lie within the recommended ranges, although protein intakes in the smallest babies are at the lower end of the range. Enteral feeds are introduced early and advanced rapidly, but we have a low incidence of necrotising enterocolitis. However, babies still fell across weight centiles, suggesting that actual intakes for these tiny babies may be inadequate. [source]

Review article: the clinical importance of growth in children with inflammatory bowel disease: is it important to the gastroenterologist?

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2007
J. A. TAMINIAU
Summary Background, Growth in children with inflammatory bowel disease is often compromised. Aim, To explore the origins of growth retardation in paediatric inflammatory bowel disease and to consider management strategies. Methods, Relevant literature was identified and reviewed. Results, A combination of the following factors results in growth retardation: insufficient food intake, malabsorption, increased catabolism, disease activity, disease extension, complications of disease and the side-effects of treatment. Conclusions, Failure of normal growth in a child with inflammatory bowel disease is an indicator of insufficient and unsuccessful therapy. The major causative factor is chronic anorexia because of chronic catabolic illness. Growth resumes to normal after effective control of the disease and nutritional intake. Regular follow-up of growth in these children is mandatory, and the measurement of both height and weight is an ideal indication of effective treatment. Failure of sustained growth in a child or adolescent with inflammatory bowel disease is a warning to consider a change of clinical strategy. [source]

Review article: anorexia and cachexia in gastrointestinal cancer

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2005
J. OCKENGA
Summary In patients with gastrointestinal malignancies, i.e. cancers of the stomach, colon, liver, biliary tract or pancreas, progressive undernutrition can be regularly observed during the course of illness. Undernutrition significantly affects the patients' quality of life, morbidity and survival. Pathogenetically, two different causes are relevant in the development of undernutrition in patients with gastrointestinal cancer. One cause is reduced nutritional intake. This condition is referred to as anorexia and can be worsened by the side effects of cancer therapy. The other cause is the release of endogenous transmitters and/or other products of the tumour leading to the cachexia syndrome, which is characterized by loss of body weight, negative nitrogen balance and fatigue. Cancer anorexia and cancer cachexia may have synergistic negative effects in affecting the patients' status. In this review, current nutritional support strategies with respect to different clinically relevant situations are described. An algorithm of the treatment strategies, including dietetic counselling, oral supplements, enteral and parenteral nutritional support is given. One focus is the approach of nutrition-focused patient care, which shows promising results. In addition, the possibilities of pharmacological intervention are discussed. [source]

Dietary intake in sensitized children with recurrent wheeze and healthy controls: a nested case,control study

ALLERGY, Issue 4 2006
C. S. Murray
Background:, The rising prevalence of asthma and allergic disease remains unexplained. Several risk factors have been implicated including diet, in particular poly-unsaturated fats and antioxidant intake. Methods:, A nested case,control study comparing the dietary intake of sensitized children with recurrent wheeze (age 3,5 years) and nonsensitized children who had never wheezed was carried out within an unselected population-based cohort. Cases and controls were matched for age, sex, parental atopy, indoor allergen exposure and pet ownership. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire and nutrient analysis program. Results:, Thirty-seven case,control pairs (23 male, mean age 4.4 years) participated. Daily total polyunsaturated fat intake was significantly higher in sensitized wheezers (g/day, geometric mean, 95% confidence intervals: 7.1, 6.4,7.9) compared with nonsensitized nonwheezy children (5.6, 5.0,6.3, P = 0.003). Daily omega-3 and omega-6 fat intakes were not significantly different between the two groups. No significant differences were found in intake of any antioxidant or antioxidant cofactors between the groups. Conclusions:, Young sensitized wheezy children had a significantly higher total polyunsaturated fat intake compared with nonsensitized nonwheezy children. However, we were unable to distinguish a significant difference in specific poly-unsaturated fat intakes. Otherwise the children in both groups had a very similar nutritional intake. [source]

Deficiencies in nutritional intake in patients admitted with diabetes-related foot complications

NUTRITION & DIETETICS, Issue 3 2007
Sarah PITT
Abstract Aim:, Adequate nutritional intake is an essential component for timely wound healing. The present research aimed to identify the frequency of inadequate dietary intake, including the specific nutritional elements most frequently lacking, in a group of patients admitted with diabetes-related foot complications. Methods:, Consecutive patients admitted to a diabetic foot unit underwent a dietary assessment, which included the retrospective collection of a seven-day food history for the period just prior to admission. The collected data were entered into FoodWorks, and comparisons were made with recommendations made by national guidelines. Results:, Thirty-five patients underwent nutritional assessment, 74% male and 26% having impaired renal function. Protein consumption was in excess of daily recommended intake, and although the overall fat intake as a percentage of total calories consumed was in keeping with national guidelines, the intake of saturated fat was inappropriately high. Of the 12 micronutrients assessed, niacin and vitamin C were appropriately consumed by all; average intake of potassium, phosphorus and thiamine approached recommended levels, while the intake of magnesium, calcium, zinc, riboflavin, folate and vitamin A all fell short of recommended daily requirements. No dietary differences were identified between individuals with normal and abnormal renal function, but deficiencies in calcium and iron were identified only in women. Conclusion:, Dietary deficiencies of macronutrients were not identified in individuals admitted with diabetes-related foot complications, but many patients were found to be consuming well below the daily recommended daily intake of one or more of the micronutrients deemed necessary for normal wound healing. [source]

Physical activity, sport, and pediatric diabetes

PEDIATRIC DIABETES, Issue 1 2006
MC Riddell
Abstract:, The benefits derived from regular physical activity include improved cardiovascular fitness, increased lean mass, improved blood lipid profile, enhanced psychosocial well-being, and decreased body adiposity. The benefits for children with diabetes may also include blood glucose control and enhanced insulin sensitivity. However, for these children, engagement in vigorous physical activity and sport must be properly controlled through modifications in insulin therapy and nutritional intake so that the benefits of exercise outweigh the risks. The following review describes the various physiological and metabolic factors which occur both during exercise and during sport while describing specific recommendations to control glucose excursions by proper insulin management and diet. [source]

Functional Outcomes after Circumferential Pharyngoesophageal Reconstruction

THE LARYNGOSCOPE, Issue 7 2005
Jan S. Lewin PhD
Abstract Objective: To determine functional speech and swallowing outcomes, morbidity, and complication rates after reconstruction of circumferential pharyngoesophageal defects using a jejunal versus an anterolateral thigh (ALT) flap. Study Design: Retrospective analysis. Methods: We reviewed the medical records of 58 patients with circumferential pharyngoesophageal defects, 27 with ALT flap reconstruction, and 31 with jejunal interposition. We compared complication rates, intensive care unit (ICU) and hospital stays, nutritional intake, number of tracheoesophageal punctures (TEPs) performed, TE speech fluency, and functional use. Modified barium swallow studies assessed swallowing physiology. Results: Patient characteristics were similar. Total flap loss occurred in one (3.7%) patient with an ALT flap and two (6.5%) patients with jejunal interposition (P = 1.000), fistula in two (7.4%) ALT patients and one (3.2%) jejunal patient (P = .5931), and anastomotic stricture in four (15%) ALT patients and six (19.4%) jejunal patients (P = .7371). ICU and hospital stays were greater for jejunal patients (P = .001, <.001, respectively). TEPs were performed in eight jejunal patients and nine ALT patients. Eighty-nine percent of ALT patients and 63% of jejunal patients were fluent, whereas 78% of ALT patients and 25% of jejunal patients used TE speech to communicate. Ninety-one percent of ALT patients and 73% of jejunal patients resumed oral intake (P = .151). The most common causes of dysphagia were impaired tongue base retraction (62% jejunum) and disordered motility (62% jejunum, 67% ALT). Conclusions: For circumferential pharyngoesophageal reconstruction, the ALT flap results in similar complication rates, but shorter ICU and hospital stays, and better speech and swallowing compared with jejunal reconstruction. [source]

Fruit and vegetable consumption among older adults by tooth loss and socio-economic status

AUSTRALIAN DENTAL JOURNAL, Issue 2 2010
DS Brennan
Abstract Background:, The aim of this study was to examine consumption of fruit and vegetables in relation to tooth loss and income. Methods:, Data were collected in 2004,06, using a three-stage, stratified clustered sample, involving a computer-assisted telephone interview (CATI), oral examination and mailed questionnaire followed by a food frequency questionnaire. Results:, A total of 14 123 adults responded to the CATI (49% response) of whom 5505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. In the nutrition sub-study, a total of n = 1218 persons were approached in New South Wales and Queensland, with n = 1129 responding (92.7% response rate). Among respondents aged 55 years or more 34.5% had <21 teeth. Adjusting for income the prevalence of infrequent consumption (,never or less than once a month') was associated with [PR = prevalence ratio (95% CI)] fewer teeth for the fruits, ,peach, nectarine, plum, apricot' PR = 1.91 (1.12, 3.25) and ,grapes or berries' PR = 1.69 (1.03, 2.76), and for the vegetables ,stir-fried or mixed' PR = 2.34 (1.14, 4.78), ,sweetcorn' PR = 1.45 (1.001, 2.10), ,mushrooms' PR = 1.62 (1.05, 2.50), ,lettuce' PR = 3.99 (1.31, 12.17) and ,soy beans' PR = 1.11 (1.01, 1.21). Conclusions:, An inadequate dentition was associated with lower consumption of a range of fruits and vegetables indicating that dentition-related impairment of chewing ability could have adverse consequences on nutritional intake among Australian adults. [source]

Body composition in infants with chronic lung disease after treatment with dexamethasone

ACTA PAEDIATRICA, Issue 7 2002
RJ Bolt
The aim of this study was to study the effect of chronic lung disease (CLD) and dexamethasone treatment on body composition in preterm infants (birthweight > 1500g). In addition, anthropo-metric measurement of body composition were compared with dual-energy X-ray absorptiometry (DXA). Fourteen preterm infants with CLD and a comparison group of 18 preterm infants were studied until 3 mo corrected age. CLD infants received approximately 20 kcal kg -1 per day extra nutritional intake during dexamethasone treatment until term. At term no differences were found between CLD and no CLD infants for percentage bone mass (1.4 ± 0.2 vs 1.4 ± 0.1%), fat mass (18.7 ± 4.5 vs 17.4 ± 3.5%), lean body mass (79.9 ± 4.6 vs 81.2 ± 3.5%) or bone mineral density (0.15 ± 0.02 vs 0.15 ± 0.01%). At 3 mo corrected age both groups were also similar for bone mass (1.6 ± 0.1 vs 1.6 ± 0.2%), fat mass (22.6 ± 5.5 vs 24.5 ± 5.7%), lean body mass (75.8 ± 5.7 vs 74.0 ± 5.8%) and bone mineral density (0.20 ± 0.02 vs 0.20 ±0.01%). All anthropometric measurements showed a high correlation with body composition. However, calculated fat mass was 56.7 ± 8.8% lower than fat mass measured with DXA. Conclusion: Body composition at term and 3 mo corrected age in preterm infants treated with dexamethasone for CLD, who received extra caloric intake until term, did not differ from that in preterm infants without CLD. [source]

Frequency of under- and overfeeding in mechanically ventilated ICU patients: causes and possible consequences

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2006
C. Reid
Abstract Introduction, In critically ill patients enteral nutrition (EN) is frequently associated with underfeeding and intolerance, whilst parenteral nutrition (PN) has been associated with a greater risk of infectious complications and overfeeding. Materials and methods The adequacy of nutritional support provided to critically ill patients was prospectively recorded and compared with estimated requirements. The incidence of, and practices contributing to, under- (<80% of energy requirements) and overfeeding (>110% of energy requirements) were identified. Results, Overall patients received approximately 81% and 76% of prescribed energy and protein intakes respectively. Underfeeding occurred on 50.3% of days. Reasons for patients failing to achieve adequate intakes included, fasting for airway management procedures (21%) and gastrointestinal intolerance (14%). Overfeeding, although less common (18.6% of days), was more likely to occur in patients with a tracheostomy requiring prolonged mechanical ventilation (>16 days). The combination of oral and nasogastric feeding or use of nutrient-dense feeds were most frequently associated with overfeeding. Discussion, The overall adequacy of nutritional intakes in the present study was similar to those reported elsewhere. However, the incidence of overfeeding was greater than anticipated and occurred in patients already experiencing delayed weaning from mechanical ventilation. [source]