bluuebunny/crossref_metadata_2025 huggingface dataset:
The weaning diet of healthy Asian children living in Sheffield. 1. The level and composition of the diet in children from 4 to 40 months of age
Authors: Duggan M. B. , Harbottle L. , Noble C.
Published: March 2008

A cross sectional study was made of the weighed dietary intake of healthy Asian weanlings aged 4–40 months and living in Sheffield. A weighed 4–(5)‐day dietary inventory was recorded by means of the PETRA recording balance; anthropometric measurements were made, and iron status determined by haematological testing: 194 children were recruited from child‐health clinics, and 120 diet records were reliably completed. Linguistic communication was facilitated by three Asian Link workers.

Dietary composition was calculated from a standard food composition programme (Microdiet) with an extended nutrient data base. The mean daily intake of energy, protein and fat, iron and vitamin C was calculated according to age (and sex) grouped into 3‐monthly age brackets from 4 to 24 months and 6‐monthly thereafter. The mean energy intakes were compared with the FAO/WHO/UNU (1985) and Department of Health (1991) reference data; individual energy intakes were also expressed as ratios of the estimated basal metabolic rate (Black et al., 1991).

In older age groups, the mean level of energy intake was lower than FAO/WHO/UNU (1985) recommendations but reasonably close to recommendations based on experimental measurements of energy expenditure (Prentice et al., 1988). When energy intake was expressed as a ratio of estimated BMR [Black et al., 1991), the mode lay between BMR+ 1.25 and BMR+ 1.5.

The contribution of protein and of fat to the total energy intake was acceptable. At all ages <6 months, the mean intake of iron was lower than the estimated average requirement and below or close to the lower reference nutrient intake [DOH, 1991). The mean intake of vitamin C decreased with increasing age. Milk was a major energy source at all ages and supplied >50% total energy in all age groups <18 months. The observed mean weight and length at each age group suggested that the customary dietary intake had supported reasonable growth.

The percentage of dietary energy provided by protein and fat was acceptable at all ages. The observed low intake of dietary iron, largely from non‐haem sources, were associated with a high (34%) prevalence of iron deficiency in these otherwise healthy children (Duggan et al., 1991).
Diabetic foods and the diabetic diet: A British Diabetic Association Discussion Paper
Authors: Thomas B. J. , Thomas B. J. , Brenchley S. , Connor H. , Elkeles R. S. , Govindji A. , Hartland B. V. , Lean M. , Lord K. , Southgate D. A. T.
Published: March 2008

The role of special ‘Diabetic’ foods in the diabetic diet is considered and the following conclusions are drawn.

Most diabetic foods provide slightly, but not substantially, less energy than comparable non‐diabetic products.

Many diabetic foods have a higher fat content than their non‐diabetic equivalents. This is contrary to the requirements of the 1984 Food Labelling Regulations.

Many diabetic products have a relatively high content of protein.

In percentage terms, the greatest difference between diabetic and non‐diabetic foods remains that of carbohydrate content, particularly carbohydrate other than fructose or sorbitol. On a per portion basis (for instance per teaspoon of jam) the difference is relatively small and likely to be of minimal practical significance.

Diabetic foods cost between 1.5 and 4 times as much as their non‐diabetic equivalents.

Some ordinary reduced‐sugar/low‐calorie products are preferable to diabetic products in terms of fat and energy content and cost.

The promotion and widespread availability of diabetic foods tend to delude patients into believing that these products are advantageous, or even necessary. Their existence also undermines current dietary teaching by implying that diabetics cannot eat normal foods.

Diabetic foods offer no significant physiological or psychological benefits to diabetic patients and can even be counterproductive to good diabetic control. There is no longer a need for special diabetic foods in the modern dietary management of diabetes.
Food folates and the British total diet study
Authors: Farrar G. , BUSS D. H. , Loughridge J. , Leeming R. J. , Hughes K. , Blair J. A.
Published: March 2008

5‐methyltetrahydrofolate, the most bioavailable folate was measured by high‐performance liquid chromatography in the British total diet study, a survey designed primarily to monitor food contaminants. A total 5 MeTHF of 130.1 μg (±21.7, n=6) was measured in the food groups which made up the average daily food intake. This value compares well to the estimated average requirement (EAR) of folate recently set by the Department of Health at 150 μg/day. The survey present here is an accurate reflection of folate consumed as all food samples were prepared ready for consumption.
Validation of a new questionnaire for assessing habitual intake of starch, non‐starch polysaccharides, sugars and alcohol
Authors: Emmett Pauline , Symes Carol , Braddon Fiona , Heaton Kenneth
Published: March 2008

A newly developed food frequency questionnaire designed to estimate habitual intake of non‐starch polysaccharide (NSP), intrinsic and extrinsic sugars, starch and alcohol was compared with 4‐d weighed records using the semi‐automatic Petra system in 154 subjects, men aged 40–69 years and women aged 25–69 years. There was no statistical difference between the two methods for average intake of NSP (soluble and insoluble) intrinsic sugar and Vitamin C. Where a significant difference did occur, notably in extrinsic sugar and starch, it did not exceed 12%, the food frequency questionnaire giving the higher result. With most food components, 4547% were classified in the same tertile and only 54% of subjects were classified in opposite tertiles by the two methods. We conclude that this questionnaire is a valid method of assessing habitual intake of these food components in large groups of subjects.
The role of low fat diets in the management of gall‐bladder disease
Authors: Madden Angela
Published: March 2008

This paper presents the results obtained from 87 questionnaires completed by dietitians about the dietary management of gall‐biadder disease. Of the patients referred to the dietitians, 86% were referred by surgeons. Of the dietitians that responded 77% thought that there was a role for low fat diets in the management of these patients; 92% would advise a low fat diet to help avoid pain, and 11% would advise a low fat diet to patients with gall‐bladder disease who did not have pain, steatorrhoea or obesity.

The paper reviews the available evidence concerning the effect of dietary fat on the gall‐bladder; it is concluded that, at present, there is little data to support the therapeutic use of a low fat diet for individuals with gall‐stones.
Nutritional status in alcoholism
Authors: Wood B. , Nicholls K. M. , Breen K. J.
Published: March 2008

An intensive study of 39 alcoholic patients with liver disease indicated a wide range of nutritional status; severe malnutrition was uncommon.

Normal values for all measurements of anthropometry and vitamin status were observed in 41 and 13% of 39 subjects respectively. Mild protein‐energy malnutrition (by anthropometry) was observed in 22%. The incidence of abnormal biochemical levels of the micronutrients were: riboflavin (69%), magnesium (54%), zinc (50%). thiamin (44%), pyridoxine (21%), ascorbate (19%), and folate (18%).
Nutrient intake and growth in preschool children. II. Intake of minerals and vitamins
Authors: Payne J. A. , Belton N. R.
Published: March 2008

Between May 1988 and April 1990, the nutrient intake of 153 pre‐school children from Edinburgh aged 2–5 years was assessed using the 7‐d weighed inventory method. Fifty‐four children were studied twice at an interval of 12 months. Results for the intake of minerals and vitamins are presented, by age and gender, and related to Dietary Reference Values (DoH, 1991).

The mineral and vitamin intake of pre‐school children varied considerably. A minority of children were found to have very low intakes of iron, zinc, vitamin A and vitamin C relative to dietary reference values, and all children had low dietary intakes of vitamin D. Intake of these nutrients was not related to rate of growth. However, strong positive relationships were found for intake of nutrients during the initial and repeat surveys of children studied twice, suggesting that poor nutrient intakes persist.
Milk consumption and prevalence of coronary heart disease in men and women from the Scottish Heart Health Study
Authors: Bolton‐Smith C. , Brown C. A. , Woodward M. , Tunstall‐Pedoe H.
Published: March 2008

This report uses cross‐sectional results from the Scottish Heart Health Study to investigate whether milk consumption has an independent effect on the prevalence of coronary heart disease. Milk consumption was assessed by questionnaire in men and women aged 40–59 years (n = 10359) who participated in a survey of risk factors for coronary heart disease between 1984 and 1986. Odds ratios for coronary heart disease were calculated according to volume and type of milk consumed for subjects with and without symptoms of coronary heart disease. Statistical adjustment was made for the classicial risk factors.

A higher percentage of men and women with diagnosed coronary heart disease (CHD) usually consume low‐fat milk, compared with asymptomatic controls. Odds ratios for having undiagnosed heart disease did not differ significantly with volume or type of milk. However, the odds ratios for having diagnosed heart disease were lower in the moderate (0.5–1 pint/d) milk consumption group. Patterns of milk consumption in patients diagnosed as having CHD are likely to be confounded by dietary changes post‐diagnosis. Milk consumption appears to have little independent effect on the prevalence of coronary heart disease in this Scottish population.
Traditional Indian beliefs about the dietary management of diabetes—an exploratory study of the implications for the management of Gujarati diabetics in Britain
Authors: Khajuria Seema , Thomas Jane
Published: March 2008

The aim of this small study was to explore the extent to which traditional beliefs about diet, health and diabetes, as described in the classics of Ayurvedic medicine, are held by Indian (Gujarati) diabetics in Britain. This was undertaken to give insight into the patients' perspective on appropriate management of their condition and to identify and possible areas of conflict between traditional remedies and western treatment of diabetes. In addition, eating habits were examined in order to assess the extent to which the dietary modifications advocated by either medical system were being followed.

Patients satisfaction with the advice given by doctors and dietitians and its appropriateness to their eating habits was also investigated.

The results indicated that the traditional belief in the value of bitter foods and bitter herbs in the management of diabetes was common amongst Gujarati patients attending the diabetes clinics at two London Hospitals. The majority ate karela, guar, tindora or methi leaves once a fortnight or more frequently as part of a meal. But only a small minority (18%) used bitter foods or bitter herbs therapeutically, giving rise to little conflict between traditional and western medicine.

Findings also indicate that despite their generally poor understanding of English, patients were aware of the principles of the diabetic diet advocated by doctors and dietitians. These were not however always put into practice. This might be due in part to a lack of specificity in advice, possibly arising from a lack of detailed knowledge concerning the foods, eating habits and beliefs of these patients.
Comparative study of the dietary characteristics of Asian toddlers with iron deficiency in Sheffield
Authors: Harbottle Lynn , Duggan Maureen B.
Published: March 2008

The iron status and weighed dietary intake of healthy Asian children in Sheffield, aged 4–40 months, having been established by means of a crosssectional study undertaken over a 1‐year period (Duggan et al., 1992), was studied to clarify whether or not there were any significant dietary differences between children with iron deficiency and those of normal iron status. The dietary characteristics of a subgroup of 12 unequivocally iron‐deficient children were therefore compared with those of a subset of 20 ‘control’ children with normal iron status and of similar age. Iron deficiency was defined using combined biomarkers of iron status (Hercberg et al., 1987). Diets in the two groups of children were similar in many respects; observed mean energy intakes were low in comparison with EARS (Estimate of Average Requirements; DOH, 1991) but customary intake evidently sustained adequate growth. Protein and fat intakes were acceptable. The total iron intake and its haem component was low in both groups. The prominence of cow's milk as a major energy source was striking, particularly in iron‐deficient children. Other differences were relatively minor, although inspection of the data suggested a trend towards more varied and mature dietary patterns among the children with normal status. We recommend targeted nutrition education to achieve more rapid progression through the stages of weaning.
A comparison of the nutritional beliefs of human immunodeficiency virus (HIV) seropositive and seronegative homosexual men
Authors: Summerbell C. D. , Catalan J. , Gazzard B.
Published: March 2008

One‐hundred and eighty‐eight HIV‐seropositive (index cases) and 45 HIV‐seronegative (controls) homosexual men completed a questionnaire to assess their nutritional beliefs and practices, their psychosocial characteristics and information sources. Most individuals, irrespective of their HIV serological status, perceived the need to change their diet. Dietary changes were those which would be perceived as healthy by the general population, for example, a low‐fat, high‐fibre diet. Most HIV‐seropositive individuals believed that vitamin and mineral supplements were especially important for their health and this was mirrored in their relative increased use of these substances compared to controls. Dietetic advice was not effective in terms of reported changes in dietary practice.

This work shows that although dietetic advice could be important in the management of HIV infection, in terms of altering dietary intake to promote weight gain, current practice needs to be reviewed in an attempt to improve efficacy. These results highlight the need to consider psychological characteristics when monitoring dietary compliance.
Persuasiveness of nutritional messages
Authors: Murphy M. , Wise A. , McLeish A.
Published: March 2008

Mothers in a shopping centre were asked to rank messages for persuasiveness. The messages chosen concerned the fat in chips, salt in soups, sugar in soft drinks and dietary fibre in bread. They were written in a combination of styles, for example, a technical statement that was positive and guilt‐evoking or a non‐technical statement that was negative and non‐guilt‐evoking. There were eight messages for each food, arranged in a Latin square, to avoid bias. It was concluded that the percBived persuasiveness was enhanced by positive, and reduced by, technical language. The use of guilt‐evoking ideas regarding mothers responsibility to family health did not influence the overall persuasiveness of the messages.
Nutritional counselling in bulimia nervosa. A case study
Authors: Kirk Sara
Published: March 2008

This case study outlines a strategy for the dietetic management of individuals with eating disorders. It shows the progress made by a young woman with bulimia nervosa, who, with the assistance of dietary advice, was able to reduce the occurrence of binge‐eating and purging, and normalize her eating behaviour.
The effects of a high‐fibre cereal‐based breakfast on daily dietary intakes and bowel function
Authors: Turconi G. , Bazzano R. , Caramella R. , Tagliabue A. , Lanzola E.
Published: March 2008

The aim of this study was to assess whether large amounts of cereal fibre, contained in a high‐carbohydrate breakfast meal, could modify habitual daily intakes of energy and macronutrients and quantitative and qualitative composition of meals, and ultimately, affect bowel function.

Twenty‐four healthy adult volunteers (12 males and 12 females aged between 21 and 36) were recruited into the trial. All of them were either university students or graduates. Two high‐fibre cereals (Kellogg's ‘Bran Flakes’ and Kellogg's ‘All Bran’) were ingested for 2 non‐consecutive weeks in a breakfast meal that accounted for about 20% of the total daily energy intake. Dietary intakes were recorded for 3 days (2 week‐days and 1 non‐working day), and bowel function was also evaluated (using a questionnaire) before and during the trial.

The ANOVA two‐way test showed a significant variation (P<0.05) in dietary fibre ingestion during the trial; however, no significant differences emerged with regard to energy and macronutrient intakes, or to the qualitative/quantitative composition of the subjects' habitual diet.

Considerable improvements in bowel function were reported in virtually all of the subjects during the trial period. The findings indicate that although habitual daily intakes did not vary significantly, energy and nutrients were more rationally distributed during the course of the day; the intake of milk increased, and bowel function improved. Therefore an increase in dietary fibre has positive nutritional consequences for the overall diet.
A new approach for evaluation of meal quality and meal patterns
Authors: Lennernäs Maria A‐C. , Åkerstedt. Torbjörn , Hagman Ulla , Bruce Åke , Hambraeus Leif
Published: March 2008

An objective, nutritionally orientated classification system is necessary to evaluate the frequency, nutritional quality and temporal distribution of eating events in dietary surveys. In this paper a system to classify eating events qualitatively with regard to the types of food items consumed is described and demonstrated. It comprises eight food categories and criteria for their combination into four types of meals and three types of snacks of various nutrient composition. The food categories represent food items of animal and plant origin, and also food products containing sucrose and beverages containing alcohol or lacking energy and nutrients.

Classification requires individual data collected by established food‐record or recall methods. Data on consumed amounts is not required to classify qualitatively the eating events per se, but is required for quantitative calculations of their content, composition and relative contribution to total intakes. The application of the system to dietary data (80 repeated 24‐h recalls, 517 eating events) of 16 male three‐shift workers showed that classification of eating events was easy and largely unequivocal compared to traditional methods. Subsequent calculations showed expected differences between eating types with regard to content and relative quality. The meal‐classification system might be used as a cost‐effective method to evaluate the nutritional profile of meal patterns in surveys.
Risks of microbiological contamination of enteral feeds during the set up of enteral feeding systems
Authors: Weenk G. H. , Kemen M. , Werner H.‐P.
Published: March 2008

Four enteral feeding systems were compared in terms of their ability to limit the chance of introducing microbial contamination during the set up of the systems. The systems incorporated a variety of containers and giving sets, thus resulting in different methods of assembly. The systems were tested under ward conditions in two hospitals and under the worst possible conditions in a simulated ward study. The Steriflo system performed best. Even in the worst possible situation, counts remained very low and the number of Steriflo feeds remaining sterile throughout the feeding period was more than 85% (P< 0.05). The Bag system performed worst: at the end of the recommended feeding period counts of more than 1000 colony forming units/ml were obtained and the number of sterile feeds was significantly lower than for the other systems (P< 0.05). Crown cork bottle and Container performed equally well, but not as well as the Steriflo system. Taking <100 micro‐organisms/ml as a criterion, the differences however were not statistically significant.

Decanting of sterile feeds was shown to impose a risk of introducing microbial contaminants to enteral feeds. This however was shown to be strongly dependent on the system design.

The results obtained in the hospital trials clearly show that enteral feeding systems can be set up safely when hygienic procedures are followed carefully. When systems were handled with contaminated hands, as simulated in a laboratory trial, the chance of introducing microbial contamination in the feeds increases significantly. Taking into account that hygienic procedures are not always adhered to in hospitals, it is concluded that the Steriflo system offers the best chance, compared with other currently available systems, that enteral feeds will remain microbiologically safe throughout feeding. Practical implications of these findings are discussed.
Dietary patterns in Asian and Caucasian men in Bradford: differences and implications for nutrition education
Authors: Smith Z. , Knight T. , Sahota P. , Kernohan E. , Baker M.
Published: March 2008

As part of a study of risk markers for ischaemic heart disease in Bradford, dietary intakes were assessed for 286 male manual workers of Asian and Caucasian origins using a 3‐day diet diary and a food‐frequency questionnaire.

Caucasian men were found to eat more variable diets, the choice of foods being partly dependent on the canteen facilities in the workplace. Processed meat products and sweet baked goods featured almost daily, whereas intake of fresh fruit and salads did not. Most Asian meals followed the traditional pattern of curry (lamb/mutton, chicken, vegetable and occasionally white fish) with chapatis and, less frequently, rice. Salad and yoghurt were often eaten with the curry and fresh fruit was frequently consumed after the meal. Such meals were consumed one or more times per day. Although overall vegetable consumption was of a similar frequency in both ethnic groups, the Asian men ate a greater variety. The frequency of ‘fried food’ consumption was similar for both Asian and Caucasian diets although different types of foods were consumed.

These different dietary patterns were reflected in higher estimated intakes of protein and sugar amongst Caucasians and lower intakes of fibre, compared with Asian men. Total fat intakes and P:S ratios were highest in the Hindu group although both Caucasian and Asian men were estimated to consume more total fat than is currently recommended.

The results of this study highlight the need for ‘healthy eating’ advice to be designed specifically for the ethnic group in question, rather than for general healthy eating messages to be translated into the appropriate language. Although conducted within one population only, this study should be of interest to all dietitians working in multi‐cultural communities.
Consumption and sources of sugars in the diets of British schoolchildren: are high‐sugar diets nutritionally inferior?
Authors: Gibson Sigrid A.
Published: March 2008

Data files of the food intakes of 2705 schoolchildren surveyed in 1983 (DoH, 1989a) were reanalysed to provide an estimate of the total intake of sugars and major sources of sugars in the diet. The relationships between intake of sugars, nutrients and nutrient density were examined by comparing between tertiles, firstly of total sugars (g/day) and subsequently of percentage energy from sugars. The results are presented separately for boys and girls in two age‐groups (10–11 years and 14–15 years). The estimated mean intake of sugars (123 g/day, s.d. 42 g) was equivalent to 23% of dietary energy. Major sources were confectionery (18%), table sugar (16%), cakes and biscuits (13%), milk (10%), soft drinks (9%) and puddings (9%).

Nutrient intakes were not significantly lower, and indeed were often higher, in those groups consuming most sugars, by either method of defining tertiles. Energy intake appeared to be the major influence on intakes of nutrients. Nutrient densities (mg or μg/MJ) showed different trends: vitamin A, vitamin C and thiamin concentrations were similar across all tertiles, while those for calcium and riboflavin tended to rise with increasing sugars intake and those for iron and nicotinic acid tended to fall, although not all of these differences were significant in all age/sex groups at the 1% level. There was a significant reciprocal (inverse) relationship between sugars and percentage energy from fat. Iron intakes were low in girls, irrespective of consumption of sugars. These data therefore provide little support for the ‘empty calorie’ hypothesis

Schoolchildren with low energy intakes in combination with high proportional intakes of sugar may constitute a theoretical at‐risk group, particularly with regard to iron intake. However, because the possibility cannot be excluded that habitual food intake may be underrepresented in dietary records, further investigation of such groups by methods incorporating clinical/biochemical assessments are warranted.
Food intolerance in a child with urticaria
Authors: Booth J.
Published: March 2008

This case study illustrates the effectiveness of dietary advice in a young boy with chronic idiopathic urticaria. An azo dye and preservative‐free diet was initially advised, resulting in a total improvement in urticarial symptoms. Double‐blind challenges confirmed the boy was intolerant to E127 (erythrosine), E122 (carmoisine), 128 (red 2G), and E102 (tartrazine) but not to E211 (sodium benzoate).
The use of an elemental feed in the nutritional support of an unusual case of diarrhoea
Authors: Frost G. , Wynick D. , Gilbey S. , Bloom S. R.
Published: March 2008

A patient with a pancreatic tumour suffered severe diarrhoea as a result of abnormal secretions of vasoactive intestinal polypeptide. Initial elemental feeding and continued nutritional support improved her nutritional status. The patient currently supports her nutritional needs from a normal diet.
Audit of nasogastric feeding practice at two acute hospitals: is early enteral feeding associated with reduced mortality and hospital stay?
Authors: Taylor S. J.
Published: March 2008

Hospital malnutrition is common and thought to be a cause of morbidity and mortality. Nasogastric (NG) feeding is the most commonly used invasive technique of nutritional support used at the acute Bolton hospitals. A prospective observational study was initiated to audit the use of NG feeding in patients in whom oral energy intake was virtually nil at the time of commencement of tube feeding.

Patients who were starved for 0–5 days prior to commencement of NG feeding had a lower mortality than patients starved >5 days (a) during their feeding episode and (b) during their hospital stay subsequent to cessation of oral intake. The difference in mortality was not related to age or sex. However, in patients of <65 years mortality was only non‐significantly higher in patients starved >5 days compared with those starved 0–5 days. In patients of >64 years the difference in mortality between those starved 0–5 vs. >5 days remained significant: (a) during the feeding episode and (b) during the hospital stay. The fact that starvation has a disproportionate effect on mortality in old patients may indicate that older patients are more susceptible to starvation. In surviving patients there was a positive correlation between the length of starvation and: (a) the duration of the NG feeding episode and (b) hospital stay subsequent to cessation of oral intake. Disease severity was not measured therefore its effect on outcome and speed of rehabilitation cannot be excluded.

The study indicates a possible relationship between the duration of starvation and mortality, the duration of NG feeding and the length of hospital stay. Definitive testing of this association would require a prospective trial which controls for age and disease severity.
A patient infected with HIV as a result of intravenous drug misuse
Authors: Penman Caroline
Published: March 2008

This case study demonstrates that the stereotype image of drug users as being non‐compliant and uncaring about their health is not always correct. This article demonstrates that it is possible to promote weight gain in a patient infected with HIV as a result of intravenous drug misuse with a rather chaotic, addictive life‐style.

This patient gained a significant amount of weight, even after being diagnosed as suffering from AIDS 3 years previously, and continues to maintain his weight and have relatively few medical problems.
Factors affecting dietary intake and nutritional status of tenants in sheltered housing
Authors: Caughey P. , Seaman C. , Parry D. , Farquhart D. , MacLennant W. J.
Published: March 2008

Two hundred and thirty‐five sheltered housing tenants (59 men and 176 women) were studied to investigate the relationship between age, sex, marital status, living arrangement, mobility, self care ability, mood, cognitive function and social engagement, and energy and nutrient intake and ratio of weight to demi‐span. Men had higher energy intakes than women and energy intake had an inverse relationship to age. There was a decline in the weight to demi‐span ratio with age which was statistically significant only in women. There was no relationship between physical, mental and social characteristics, and nutritional or anthropometric status.
Intake of ‘low‐fat’ foods in a representative sample of the Paris area: anthropometric, nutritional and socio‐demographic correlates
Authors: Bellisle France , Rolland‐Cachera Marie‐Frangoise , Deheeger Michèle , Preziosi Paul , Hercberg Serge
Published: March 2008

This epidemiological study compared consumers and non‐consumers of several ‘low‐fat’ foods typical of the French diet: skimmed milk, ‘low‐fat’ butter, ‘low‐fat’ cheese, ‘low‐fat’ yogurt. The population was selected at random from the Val de Marne, a district close to Paris. A sample of 741 people, aged 18–65 years (416 women, 325 men) agreed to report habitual intake according to the Dietary History Method. Many anthropometric differences appeared between female consumers and non‐consumers of ‘low‐fat’ foods. Consumers were slightly older and heavier as measured by the Body Mass Index (weight/height2) and had greater waist, hip and thigh circumference values. Women consumers ate less in terms of daily energy and various food choices: potatoes, pasta, rice, sugar. Intake differences were most apparent in the groups of younger women (18–29 years). The vitamin and mineral density of the diet was greater in women consumers. Male consumers of ‘low‐fat’ foods ingested less alcohol regardless of age, but they ate more chocolate, jam and honey. The vitamin and mineral density of their diet was also greater. The majority of men ate enough to meet recommended nutrient allowances. This was often not the case in women, and improving the nutritional density of their diet might yield long‐term benefits.
Research and evaluation: the involvement of community dietitians
Authors: Loach Jackie , Oxford Liz
Published: March 2008

The recent document Dietitians in the Community: Opportunities for the Future (BDA, 1993) highlighted the importance of strengthening the evaluation and research base of the practice of dietitians working in the community.

Members of the Community Nutrition Group of the BDA were surveyed by postal questionnaire in March 1992 to gather information to facilitate implementation of the report's recommendations. Thirty‐six per cent of the members (n = 125) responded. Over half (56%) reported recent involvement in a research project and 97% expressed a need for better training and support in one or more aspects of the research process. Information was also gathered about the types of projects undertaken, preferred forms of support, previous training, evaluation and research, collaborative links and perceptions of the role of the BDA Research Committee and Metabolic Research Groups. This information is presented and discussed.

In conclusion, relatively few community dietitians are actively involved in evaluation and research. Various modes of support are necessary to increase the number of dietitians engaged in this area, if the stated commitment of professional managers and the British Dietetic Association is to be fulfilled.
Antioxidants and cancer
Authors: Burr Michael L.
Published: March 2008

This review considers the published evidence concerning the suggestion that the risk of acquiring cancer may be reduced by antioxidants found in fruit and vegetables. Evidence from studies of different designs is systematically reviewed: ecological studies; case controlled studies; cohort studies and randomized controlled trials. The mechanisms whereby antioxidant vitamins may inhibit neoplasia are indicated. Although evidence supports the view that eating plenty of fruit and vegetables reduces the risk of acquiring cancer, the role of antioxidants in this protective effect is still unproven.
Evaluation of a semi‐elemental enteral feed in patients with malabsorption and/or disease‐related malnutrition
Authors: Edington J. , McMaster C. , Macklin J.
Published: March 2008

A semi‐elemental energy‐dense enteral feed was evaluated to determine its effect on nutritional repletion and tolerance in a diverse group of patients with malabsorption and/or disease‐related malnutrition. Forty‐nine patients (26 male, 23 female) entered and completed this multicentre study. Mean daily energy requirements were 2107 kcals of which 1704 kcals were prescribed from the enteral feed. Mean daily energy intake from the feed was 1472 kcals and patients consumed the feed for a mean of 13.2 days either as sole source of nutrition or as a supplement. Body weight changes were related to duration of feeding: patients who were fed for more than 14 days experienced a mean increase in body weight of 0.56 kg. Biochemical parameters of nutritional status, i.e. mean total protein and serum albumin, improved during the feeding period. Tolerance of the feed and clinical response to feeding were satisfactory. In patients with malabsorption and/or malnutrition a semi‐elemental enteral feed represents a viable and palatable alternative to elemental diets when everyday food and whole protein feeds are not tolerated.
Energy intakes and losses in cystic fibrosis
Authors: Morrison J. M. , O'Rawe A. , McCracken K. J. , Redmond A. O. B. , Dodge J. A.
Published: March 2008

Energy intakes in cystic fibrosis (CF) are affected by malabsorption, despite the use of enteric‐coated pancreatic enzymes. Relaxation of fat restrictions was introduced to aid consumption of a diet sufficient to compensate for malabsorption and help prevent malnutrition. We examined the energy intakes and losses of 50 CF patients on a normal fat intake (mean age 9.6 [s.d.=6.67] years, M:F ratio 33:17). Mean standard deviation scores for height and weight were –1.03 and –0.80, respectively. Nutrient balances were made by means of 7‐day weighed dietary inventories and 3‐day faecal collections. Mean metabolizable energy intake was 97.3 [s.d. 23.1)% RDA. Mean digestibility coefficient for energy was 0.89 (s.d. 0.07), reducing mean energy intakes to 91.9 (s.d. 24.0)% RDA. The results indicate that despite relaxation of dietary restrictions and the use of enteric‐coated pancreatic enzymes, energy intakes of CF patients are still inadequate. Closer monitoring of energy losses as well as intakes is required, to optimize growth and nutritional status in CF patients.
What is the HACCP (hazard analysis critical control point) approach and how can it be applied to enteral tube feeding?
Authors: Anderton Annette
Published: March 2008

The HACCP (hazard analysis critical control point) concept is now widely applied in the food industry and provides a structured and critical approach to the identification and control of hazards that may affect food safety. It has shifted the emphasis for control from retrospective end‐product testing to the effective control of raw materials and key processing operations.

This paper discusses how the HACCP approach can be applied to enteral feeding. This involves each unit assembling a multidisciplinary team of personnel involved in enteral feeding. This team will then carry out a detailed analysis of the process from selection of ingredients and feeding systems through to consumption of the feed by the patient by constructing a flow chart that relates specifically to each unit. They can then identify and assess the hazards associated with the handling of the product at each stage in the process. This will enable them to identify the points where control over an identified hazard can be achieved (critical control points, CCP) such as quality of ingredients, design of administration systems, preparation and distribution of the feeds and the procedures involved in the assembly and manipulation of the systems. Control and monitoring procedures can then be specified and implemented at relevant stages in the process. The major strengths of the HACCP procedure are that it entails a team effort from key personnel involved in the full range of activities associated with the product and each detailed analysis is specific to each unit's practices and resources and can be continually reviewed and modified in response to changing circumstances.
Why women fail to breast‐feed: a prospective study from booking to 28 days post‐partum
Authors: Wylie Jenny , Verber Ian
Published: March 2008

In order to ascertain the reasons for low uptake of breast‐feeding and to suggest strategies for improvement, 576 mothers attending an antenatal booking clinic were given a questionnaire on their feeding intentions and followed up until 28 days post‐partum,

Intention to bottle‐feed increased with parity [p0 (31%), pi (45%), p2 (58%)] as mothers who were previously undecided or who tried and failed to breast‐feed reverted to feeding with a bottle. Primagravida who were influenced by outside sources, either professional (e.g. GPs), or non‐professional (e.g. relatives, the media) were more than twice as likely (2.2, CI 1.8‐2.7) to breast‐feed than those who were not. At birth 272 mothers breast‐fed (47%) which at discharge fell to 244 (42%). Intending breast‐feeders were more likely to fail if given a general anaesthetic (2.33, CI 1.2–4.5), or if they complemented with dextrose (1.94, CI 1.1–3.4).

Twenty three per cent (56) of mothers who were breast‐feeding at discharge gave up before 28 days post‐partum. The babies of mothers who gave up because of perceived poor weight gain did not significantly differ in weight from those whose mothers continued to breast‐feed.

Whilst many mothers have decided to bottle‐feed before entering hospital, the success of those who wish to breast‐feed is greatly influenced by medical and midwifery practice.
Relational database for dietary products
Authors: Wise A.
Published: March 2008

Analytical data were collected for 426 dietetic products from 22 manufacturers. It was noted that manufacturers' data is very variable and it is suggested that standards should be developed for presentation of this data. A relational database was selected and a model created for the data. This was used for teaching dietetic students how to obtain data using Structured Query Language, which allows the selection of a wide range of data without the need to write a special program.
The assessment of oily fish intake in two clinic populations
Authors: Jones S. D. , Le Cornu K.
Published: March 2008

A dietary intake assessment by questionnaire was carried out on 96 patients attending dietetic clinics in Wolverhampton and West Birmingham to ascertain the oily fish consumption in the local population. Only 37.5% of the people questioned ate oily fish more than twice a week. This is the intake recommended by the Zutphen study to be protective against heart disease. The main reasons for the unpopularity of oily fish were: dislike taste/repeats, don't think about it, bones, smell, too oily, don't know how to use it, thought it was fattening. Seventy‐nine per cent of the sample said they would eat more oily fish if recommended by a health professional. Sardines, tuna, kippers and salmon respectively were the most commonly eaten oily fish.
The effects of psyllium on blood lipids in hypercholesterolaemic subjects
Authors: Summerbell C. D. , Manley P. , Barnes D. , Leeds A.
Published: March 2008

This study was designed to investigate whether psyllium has an intrinsic hypocholesterolaemic effect on serum blood lipids. The 9‐week, two‐phase study was a double‐blind, placebo‐controlled trial in subjects (n= 37) with mild to moderate hypercholesterolaemia (serum cholesterol levels 5.2–7.8 mmol/1). After the first 3‐week phase, in which subjects adhered to a low‐fat diet, the subjects were randomly assigned to one of two groups for a further period of 6 weeks. One group consumed 60 g of a high‐fibre breakfast cereal daily, containing 9.6 g of soluble fibre from psyllium, and the other (control) group consumed 60 g of a high‐fibre breakfast cereal daily, containing negligible amounts of soluble fibre. Both groups maintained a low‐fat diet (30% energy from fat).

During phase I, total and low‐density lipoprotein (LDL) cholesterol levels were reduced in all subjects; randomization resulted in similar phase I changes in both the psyllium (‐ 8.9% and ‐ 11.1%, respectively) and control (‐ 8.9% and ‐ 12.8%, respectively) groups. During phase II, total and LDL cholesterol levels were further reduced in the psyllium group (‐ 7.3% and ‐ 10.6%, respectively), but not in controls [‐2.7 and ‐ 6.0%, respectively). Changes in high‐density lipoprotein (HDL) cholesterol levels and body weights over the study period were not significant. Differences between the psyllium and control groups in total, LDL and HDL cholesterol levels were not significant.
Preliminary survey of attitudes to, and factors affecting perceived success or failure among adults attending a hospital lipid clinic
Authors: Wright C. A.
Published: March 2008

A questionnaire for self‐completion was given to 40 patients attending follow up appointments at the Lipid Clinic at Hope Hospital, over an 8 week period. The questions were designed to assess the importance placed by patients on both blood cholesterol levels and diet, and the patients' perceived ability to comply with the lipid lowering diet. Opportunity was given for patients to comment on services offered, and to suggest improvements.

Most patients appeared well motivated (although some by fear) and believed that changes in diet are effective, and perceived that they followed the dietary advice ‘quite well’. Many patients thought in terms of ‘good’ and ‘bad’ foods, and ‘sticking to the diet’. This was shown by comments of feeling deprived of favourite foods and being ‘forced’ to eat boring or unpopular foods.

Recommendations are made that instead of focusing on motivation or compliance, health professionals should facilitate behaviour change by identifying obstacles to compliance and enabling patients to set their own dietary targets and self‐monitoT their diets.
Dietary fibre modification and the symptoms of irritable bowel syndrome–a review
Authors: Rees G. A. , Trevan M. , Davies G. J.
Published: March 2008

Increasing the dietary fibre intake of patients with Irritable Bowel Syndrome (IBS) is common practice, even though the therapeutic benefits of this form of treatment have not been confirmed by clinical trials. Studies evaluating the effect of cereal fibre on the symptoms of IBS are analysed critically with particular reference to the methodology. It is concluded that no consensus on the efficacy of fibre treatment in IBS can be reached due to variations in methodology employed and the existence of symptom‐specific sub‐groups of the disorder. Future studies need careful planning and standardisation.
Textured soft diets and feeding techniques among the elderly mentally ill
Authors: Burge Philippa
Published: March 2008

The elderly mentally ill with advanced stages of dementia are nutritionally at risk in both how they are fed and what they eat. This risk increases with a behaviour feeding problem or swallowing difficulties. Nevertheless it is common practice in institutions to alter the texture of the diet to a mechanically soft, minced or liquidized form. By such an alteration, these patients may be at a greater risk of developing swallowing problems than if a textured soft diet were used. The textured soft diet consists of soft food (soft enough to be mashed with a fork) but not liquidized. Mixed dishes with large pieces of food or food with different consistencies are excluded. Sticky foods may also cause problems with some patients. Correct feeding techniques are important, i.e. correct positioning, a relaxed environment, patient orientation, appropriate utensils and careful control of amount and rate of feeding. Multi‐disciplinary team work (involving the nursing staff, occupational therapist, speech and language therapist and dietitian) is therefore needed to prevent nutritional problems arising from feeding difficulties. A pilot study was undertaken to establish if these principles were being put into practice in a general psychiatric hospital. Having identified a number of poor practices, a brief staff training programme was implemented.
Nutrient intakes in North Glasgow: results from the Scottish MONICA studies of 1986 and 1989
Authors: Wrieden W. L. , Bolton‐Smith C. , Brown C. A. , Tunstall‐Pedoe H.
Published: March 2008

As part of the World Health Organisation MONICA project the nutrient intakes of more than 2000 men and women (aged 25–64) were assessed in two cross‐sectional surveys carried out in North Glasgow in 1986 and 1989. Mean energy and nutrient intakes were calculated from food frequency questionnaires and results are reported for each survey year for men and women who received only a school education and those who claimed to have completed further education. Mean energy intakes were lower in all groups in 1989 compared with 1986. Men with only a school education had higher mean intakes of energy, starch, total fat, saturated fat, retinol and cholesterol than men who went on to further education. Men and women who had only a school education had lower mean total fibre and vitamin C intakes than those educated beyond school. The percentage contribution of total fat to energy was higher than recent government recommendations in women but was within the guidelines for both groups of men. However alcohol consumption was generally high in both groups of men and this will have contributed to the comparatively low percentage of energy from fat.

Although the quality of the diet was generally better in those who had received further education, the only evidence of an improvement in diet from 1986 to 1989 was in a lower percentage of energy from total fat and saturated fat.