bluuebunny/crossref_metadata_2025 huggingface dataset:
Parenteral nutrition in acute renal failure
Authors: Forrest C. E. , Hartley G. H.
Published: March 2008

This article reviews the current practice of parenteral feeding in patients with acute renal failure. Assessment of nutritional requirements and the provision of nutrients are discussed. Practical guidelines are provided for dietitians to use in the clinical setting.
The effects of guar gum, sugar beet fibre and wheat bran supplementation on serum lipoprotein levels in normocholesterolaemic volunteers
Authors: Tredger J. A. , Morgan L. M. , Travis J. , Marks V.
Published: March 2008

The effect of dietary supplementation with guar gum, sugar beet fibre (SBF) and wheat bran on serum lipoprotein leveh was assessed in normocholesterolemic men. Each fibre preparation was incorporated into bread and subjects ate half a loaf a day which provided 20 g of the fibre preparation. Each bread was eaten for 14 days with a 21‐dey rest period between each stage of the study. Twelve subjects consumed each type of fibre‐supplemented bread.

During fibre supplementation dietary non‐starch polysaccharide (NSP) intake increased significantly (P < 0.025) and the mean daily fat and energy intakes increased but not significantly. Serum total cholesterol levels were reduced by an average of 11.7% (s.e. 1.8) (P<0.01) during guar supplementation and 4.6% (s.e. 1.9) (P < 0.025) during SBF supplementation. Bran supplementation was without effect. Mean HDL cholesterol, serum triglycerides and plasma glucose and insulin levels were unaffected by supplementation with any of the fibres. Mean serum total bile acids were significantly reduced by guar (P < 0.01) and SBF (P < 0.025) but not bran supplementation. Mean apo B levels were only significantly reduced by guar (P < 0.05). Apo A1 levels were not affected by any of the fibres. There was a significant correlation between apo B and total cholesterol levels (P<0.01) and between apo A1 and HDL cholesterol levels (P < 0.01) throughout each stage of the trial.

This study demonstrates that dietary supplementation with 20 g guar or sugar beet fibre has a favourable effect on both cholesterol and apoprotein levels.
The effect of a moderate increase in dietary fibre on the nutrient intake of 15 young women
Authors: Mason P. M. , Judd P. A.
Published: March 2008

Fifteen young women increased the fibre content of their diet from 19 g/d to 40 g/d for a period of 10 weeks using conventional food sources. They weighed and recorded all their food and drink intake. There was no change in energy intake, but the proportion of energy derived from fat fell from 40 to 34%. The intake of nearly all the vitamins and minerals increased. It was concluded that a moderate increase in dietary fibre has positive nutritional consequences for the whole diet.
Nutrient intakes of men in South Wales: a comparison of surveys taken in 1980–1983 and 1990
Authors: O'Neill O. , Fehily A. M.
Published: March 2008

Nutrient intakes calculated from T‐day, weighed, intake records obtained from a representative community sample of 98 men in 1990 were compared with those obtained from 665 men in the same community in 1980–83. The total energy intake decreased by 8% and this was accounted for by a fall in the intakes of fat, carbohydrate and alcohol. The percentage of total energy from fat fell from 37.3 to 35.5% and the percentage of food energy from fat fell from 39.5 to 35.5%. The percentages of total energy from saturated and monounsaturated fatty acids decreased from 17.3 to 15.3% and from 15.0 to 13.S%, respectively, and polyunsaturated fatty acids increased from 5.0 to 6.2%. The ratio of polyunsaturated: saturated fatty acids increased from 0.31 to 0.43. There was also a small increase in dietary fibre and vitamin C intakes (2 g/d and 11 mg/d respectively). The increased age of the cohort was found to account for approximately half of the fall in energy intake, but age did not account for some of the other dietary changes observed.
The distribution of energy and nutrient intakes within households
Authors: Bull N. L.
Published: March 2008

The assessment of dietary adequacy, using data from household food surveys, relies on the assumption that intakes of energy and nutrients are distributed within households in the same pattern as the recommended levels against which adequacy is being assessed. That this assumption is probably ill‐founded has been demonstrated by Nelson (1986). However, very little information is available on the actual distributions of dietary intake within households because dietary surveys usually cover either the household as a single unit or only a single member of each household. As part of a larger study, 73 individuals within 23 households all provided information using the 24‐h dietary recall technique. This data has been analysed using the method described by Nelson (1986) and the Fesults lend further support to the suggestion that the interpretation of dietary adequacy in household food surveys should take into account the distribution of nutrient intakes within the households.
Nutrition and mental development of 4–5‐year‐old children on macrobiotic diets
Authors: Herens M. C. , Dagnelie P. C. , Kleber R. J. , Mol M. C. J. , van Staveren W. A.
Published: March 2008

Mental development of 4–5‐year old children on macrobiotic diets (almost devoid of animal foods and fat) with long‐term growth deficits, was studied using the Snijders‐Oomen Non‐verbal Intelligence (SON) scale. In addition, food consumption and behavioural style of the children, and family and parent characteristics were assessed. Parents were highly educated: 69% of the fathers and 47% of the mothers had completed college or university education. The children's energy intake was only 70% and calcium intake 40% of that reported for children of similar age on conventional diets. Fifteen out of 44 children (33%) did not complete the SON‐test, mainly due to difficulties in concentration. The non‐completers tended to score lower on parts of the SON‐test and the educational level of their fathers was slightly lower: no other differences were observed. Intelligence quotients (IQ) of the children who completed the test were high (IQ=126) compared to the reference population (IQ= 100 by definition). No significant relationship between IQ's and educational level of parents was observed, possibly due to lack of varation in educational level within the study population. Family size was inversely related with IQ. It was concluded that long‐standing mild to moderate malnutrition may not affect mental development in pre‐school children if the children grow up in a stimulating social environment.
Exacerbation of hepatic encephalopathy by branched‐chain amino acids—a case report
Authors: Chuah S. Y. , Ellis B. J. , Mayberry J. F.
Published: March 2008

A 49‐year‐old alcoholic developed hepatic encephalopathy following dietary supplementation with branched‐chain amino acid (BCAA). He became lucid within 24 hours of withdrawing BCAA. Subsequent re‐challenge with BCAA again precipitated hepatic encephalopathy. In future, BCAA should be prescribed with care.
Comparison of three oral sip‐feed supplements in patients with cancer
Authors: Bolton J. , Abbott R. , Kiely M. , Alleyne M. , Bell S. , Stubbs L. , Slevin M.
Published: March 2008

This study set out to compare the long‐term palatability of three oral sip‐feed supplements. Sixty patients with various malignancies were randomized to receive one of three products—Build‐Up, Fortimel and Fortisip. Participants were encouraged to take as much of the supplements each day for as long as they could manage. At the initial tasting, palatability and acceptability of the products was recorded and this was repeated throughout the trial period. Patients' reasons for discontinuing the trial were noted.

Build‐Up was found to be the best‐tolerated product of the three. It was taken for a significantly longer time than either Fortimel or Fortisip. There was an indication that Build‐Up was more acceptable at the initial tasting than Fortisip but not Fortimel. A smaller proportion of patients stopped taking Build‐Up due to flavour‐related reasons compared to Fortisip but there was no significant difference between Build‐Up and Fortimel. In all, 54% of the patients discontinued the trial for flavour‐related reasons. Thirty‐five per cent found that the sip‐feeds they had been allotted unpalatable at the initial tasting, while 19% stopped the trial due to ‘flavour fatigue’. Only 10% of the sample continued taking their allotted product for 90 days or more.
An investigation of supplementary naso‐gastric feeding in malnourished children undergoing treatment for malignancy: results of a pilot study
Authors: Smith D. E. , Handy D. J. , Holden C. E. , Stevens M. C. G. , Booth I. W.
Published: March 2008

Although parenteral nutrition is frequently administered to children undergoing treatment for malignancy, the use of naso‐gastric feeding had been little studied. A randomized, controlled trial of supplementary naso‐gastric feeding in children with newly diagnosed malignancy was therefore performed. Results showed that, contrary to popular belief, naso‐gastric feeding is acceptable to and tolerated by children with malignancy even shortly after diagnosis and is welcomed by their parents. Naso‐gastric feeding increased energy intake, promoted improvement in nutritional status as measured by mid‐upper arm circumference and appeared to increase general well‐being. Further studies are being undertaken to determine whether naso‐gastric supplementary feeding is also of objective benefit.
Sources of fibre in the diet of irritable bowel patients prescribed a high‐fibre diet
Authors: Lambert Janet P. , Morrison Valerie , Brunt P. W. , Mowat N. A. G. , Eastwood M. A. , Dickerson J. W. T.
Published: March 2008

Seventy‐two patients (27 male and 45 female) with irritable bowel syndrome were prescribed a high‐fibre diet. They were given a diet sheet and variable amounts of individual dietetic counselling. After 6 months they kept a 7‐day weighed food inventory. Median (mean) intake of dietary fibre was 19.5 (21.6)g, 57% of which was provided by cereal sources, mainly breads and breakfast cereals. Patients also frequently ate low‐fibre and energy‐dense foods. Average fibre intakes were greater at the evening (main) meal of the day. However, the largest intakes by individuals were at breakfast and the lunch (snack) meal, which suggests that dietary advice should put emphasis on the consumption of high‐fibre breakfast cereals and wholemeal bread at these two meals.
Nutritional support for the child with acute renal failure
Authors: Coleman Janet E. , Watson Alan R.
Published: March 2008

Nutritional therapy plays a major role in the management of the child with acute renal failure. The dietitian should be involved a the t and should maintain a close liaison with the family and team members.

It is an advantage to have adequate knowledge of the underlying condition and its clinical course. Close monitoring of the clinical and biochemical parameters will allow the dietitian to apply dietetic skills and anticipate changes in management. Most children require supplementary tube feeding to meet estimated nutritional requirements. The prognosis for recovery is generally good in children with acute renal failure.
Dietetic implications of pregnancy following gastric partitioning surgery*
Authors: Boyce Rosalie A. , O'Donnell Sandy Z.
Published: March 2008

Gastric partitioning surgery has been an accepted procedure for more than two decades. Despite the recognition that women are the primary group undergoing surgery, little research has been conducted into the nutritional implications of subsequent pregnancy. Pregnancy following gastric partitioning surgery is a high‐risk nutritional scenario from both maternal and neonatal perspectives. Appropriate assessment and dietetic advice may prevent hospitalization and the need for invasive nutritional support techniques during the course of the pregnancy. Dietitians can demonstrate the effectiveness of timely nutritional intervention and have an important health promotion role to play in this setting.
The dietary habits of doctors and teachers
Authors: Chambers R.
Published: March 2008

A questionnaire was completed by 408 general practitioners and 385 secondary school teachers about their own dietary intake with response rates of 48% and 45% respectively. Over half of each group were of ideal weight and only 3% of the total were obese.

The group of general practitioners, reported that they ate significantly less fats and salt and significantly more fibre and polyunsaturated fats in their diet than the teachers. Teachers were significantly more likely to avoid food additives in their diet, 70% made an effort to avoid them compared to 47% of doctors.
Home artificial nutritional support in Cambridge Health District—1988–1990
Authors: Weekes E. , Cottee S. M. , Elia M.
Published: March 2008

A 2‐year prospective study was undertaken to assess the indications for, prevalence and outcome of home artificial nutritional support (HANS) in the Cambridge Health District (CHD), England. Thirty‐nine patients were identified, 33 receiving home enteral‐tube feeding (HETF) and six receiving home total‐parenteral nutrition (HTPN). About half the patients received HETF to treat chronic anorexia and the remaining half received it because of swallowing difficulties. All HTPN patients had intestinal failure. Patients receiving HTPN were young to middle aged adults, whereas the majority (80%) of those receiving HETF were either children (<16 years) of elderly patients (>60 years). Patients in both the HETF and HTPN groups tended to be either short‐term or long‐term feeders. There was a high disease‐related mortality rate among the HETF patients (45.5% over 2 years) but there were no deaths in the HTPN group. It is concluded that HANS is provided for a small number of severely disabled individuals, many of whom have a poor prognosis.
Professional Practice Development Groups—a method of reviewing clinical practice
Authors: Ferguson R. M. , Morgan J. , Morley C. M.
Published: March 2008

A new tool, the Professional Practice Development Group, is proposed for the evaluation of clinical aspects of a dietetic service. This tool relies on giving individuals specific roles in order to break down the task. This paper outlines the nature and purpose of the group. A professional practice development group could form part of a clinical audit programme and also act as a method of self‐development for staff.
An observational study of herbal tea use in infancy—a short report
Authors: van den Boom S. A. M. , Kimber A. C. , Morgant J. B.
Published: March 2008

An investigation into infant feeding practices in Madrid revealed the administration of herbal teas to young infants. Herbal teas were statistically significantly more often given to infants in the lower socio‐economic group than to infants in the middle and higher socio‐economic groups (P≤.04). There was no evidence that usage of herbal drinks was related to the sex of the child (P>0.05). Teas were given for their supposed pharmaceutical effect. The different herbs are discussed and a recommendation for further study in this field is proposed.
Comparison of nutrient intakes of South African elderly rural Black women in 1969 and 1989
Authors: Walker A. R. P. , Walker B. F. , Walker A. J.
Published: March 2008

In 1989, an investigation was made of the dietary intakes of a representative sample of 141 elderly Black women living in adjacent villages, in Western Transvaal. Results are compared with those obtained in 1969 on 43 women in a village in the same region. Energy intake averaged 6% higher, not essentially a significant increase. Fat provided 24% of energy compared with 19% in 1969, and protein, 14% versus 12% in 1969. Maize meal intake fell by a half, being replaced largely by bread, mainly brown. Intake of beans decreased slightly. Intake of vegetables and fruit rose by 40%, and of meat and dairy produce, both very low, by 75% and 20%, respectively. Sugar intake trebled. Changes were associated with significant rises in mean Body Mass Index, serum cholesterol level, and urinary calcium creatinine ratio.
Comparison of estimated nutrient intake by two methods: validation of a food frequency questionnaire
Authors: Gelissen Ingrid C. , Roberts David C. K.
Published: March 2008

The validity of a quantitative self‐administered food frequency questionnaire (FFQ) was tested by comparison with 7‐d weighed food records (7DWR). Subjects for the study were 24 females between 20 and 43 years of age (mean = 24 years). The main aim of the FFQ was to classify subjects according to their total fat intake.

The mean nutrient intakes estimated by the FFQ were consistently and significantly higher than the estimates by the 7DWR. Rank correlations showed that the FFQ was able to rank subjects similarly for total energy intake, fat, alcohol and fibre intake as well as for the percentage contribution of macronutrients to energy intake. Intra‐class correlations showed that the two methods did not agree at the individual level for energy and macronutrient intake except alcohol. These results suggest that the FFQ was suitable for ranking the subjects according to their total fat intake but was not suitable for estimating the individual nutrient intake or average nutrient intake of this relatively small group.
Food consumption patterns analysed as food portions rather than nutrients in east coast Kenya: a cluster sample survey
Authors: Salfield J. R. , Oppenheimer S. J. , Fulford A. J. , Powers H. J. , Harrison C. , Mugambe M.
Published: March 2008

Food consumption patterns in the Kilifi District of Kenya are described. Data were collected by 24‐h dietary recalls from 414 individuals, as part of a wider health survey.

There was a very strong reliance on one staple, maize; the main supplementary foods being coconut milk, cowpeas, green leafy vegetables and fresh and dried sea fish.

Breast feeding was almost universal, with virtually no use of artificial baby milks.

The data were recorded as the number of portions of each food eaten daily: the foods were grouped together into ten food groups. Malnourished and well nourished children showed no significant difference in their frequency of intake of individual food groups.

A composite figure was devised to reflect the overall adequacy of the diet; this was defined as the proportion of total food portions eaten that were staples. A highly significant correlation was found between this proportion and distance from the coast (r=0.55: P<0.001). This variable also showed a significant negative correlation with stunting (per cent height for age of the National Center for Health Statistics (NCHS) median) (r=0.17; P<0.01) and a positive correlation with wasting (per cent weight for height of the NCHS median) (r‐0.22; P<0.001). After controlling for the confounding factors of age, distance from the coast and malaria endemicity, significant correlations were still seen.

The proportion of food portions that were staples was negatively correlated with red‐cell folate levels (r=0.24; P<0.001). For individual food groups, the frequency of intake of beans and fat‐rich foods were positively correlated with red‐cell folate levels and negatively correlated with serum iron levels.

Twenty‐four‐h dietary recalls in conjunction with analysis of food portions rather than nutrient values, produced significant correlations with anthropometric and biochemical indices of nutritional status. These results provide some degree of validation for this rapid and relatively cheap method of dietary investigation which would be useful for the assessment of food consumption patterns of groups of people in a community‐based health survey.
Review of some computer software packages for dietary analysis
Authors: Seaman C.
Published: March 2008

The increasing use of computers in dietetics has been matched by an increase in the number and types of software packages available. The functions which ‘dietetic’ software can carry out vary widely, and certain information is essential for the dietitian looking for a package for clinical or research work.

Where dietary analyses are carried out, the number of foods listed in the database and the accuracy with which cooking method, for example, can be specified are vital.

This mini‐series of reviews examines several packages on the market. They carry out a variety of tasks, including dietary analyses and menu planning.

Demonstration disks can usually be obtained, allowing interested dietitians to examine the package in greater detail.
Nutrient intake and growth in preschool children. I, Comparison of energy intake and sources of energy with growth
Authors: Payne J. A. , Belton N. R.
Published: March 2008

This is the first UK study for 20 years to relate nutrient intake to growth in pre‐school children. Between May 1988 and April 1990, 153 healthy children aged 2–5 years from Edinburgh were studied. A subset of 54 children were assessed twice, 12 months apart. Nutrient intake was determined by the 7‐d weighed inventory method. Anthropometric measurements included height, weight and skinfold thickness. Data were grouped by age and gender.

Despite low group mean energy intakes of 80–85% of the current UK Estimated Average Requirement of energy (DoH, 1991), the children were apparently growing normally. Anthropometric measurements were within the normal range for age and no significant relationship was found between energy intake and rate of growth, suggesting that energy intake was adequate.

Considerable variation was found in the composition of diets. A highly significant negative correlation was found between the % energy from fat and the % energy from sugars and a significant positive correlation between total energy intake and fibre intake. However, as no relationship was found between energy intake and % energy from fat, sugars and starch, the composition of the diet did not apparently influence total energy intake.
Raised thyroid stimulating hormone associated with kelp intake in British vegan men
Authors: Key T. J. A. , Thorogood M. , Keenan J. , Long A.
Published: March 2008

To explore the hypothesis that the iodine intake of vegans might be inadequate, thyroid stimulating hormone concentrations were measured in plasma samples from 101 British men, of whom 48 were vegans and 53 were omnivores. The geometric mean thyroid stimulating hormone concentration, adjusted for age and body mass index, was 47% higher in the vegans than in the omnivores (P= 0.001). Five vegans but none of the omnivores had a thyroid stimulating hormone concentration above the reference upper limit of 5 mU/1 (P=0.022). High concentrations of thyroid stimulating hormone are usually indicative of marginal iodine status, but can also result from excessive iodine intake. The three vegans with the highest values of thyroid stimulating hormone reported regular use of kelp tablets or kelp powder. None of the other vegans, and none of the omnivores, reported taking kelp. After exclusion of the three vegans who took kelp, the remaining vegans had an adjusted geometric mean thyroid stimulating hormone concentration 29% higher than that of the omnivores (P=0.012). It was concluded that use of kelp can be associated with raised thyroid stimulating hormone, and that the iodine status of vegans who do not use kelp requires further investigation.
Energy and protein intakes of patients with cystic fibrosis
Authors: Ellis J. A. , Bond S. A. , Wootton S. A.
Published: March 2008

The energy intake of a group of 30 patients with cystic fibrosis (CF) was compared with 30 age/gender matched controls. Dietary intakes were determined from 7‐day weighed food records using computerized food composition tables. Absolute energy intakes of the CF group were comparable to those of the controls: when expressed as energy per kg body‐weight, the CF group consumed approximately 34% more energy (P<0.01). Growth retardation in the CF group was illustrated by a lower mean weight (P < 0.01) and height when expressed as a height percentile or height standard deviation score (both P< 0.01). The majority of CF patients in this study consumed high intakes of energy per unit body‐weight yet still exhibited growth deficits. The challenge for the future lies in attempting to improve these already high energy intakes and evaluating the effects on growth, prognosis and quality of life.
An investigation of some implications of coeliac disease
Authors: Twist S. R. , Hackett A. F.
Published: March 2008

Following even ‘simple’ dietary advice for long periods is problematic and substantial disruption of home and social life is likely. The variety and extent of problems faced by coeliacs has received little attention compared, for example, to that given to diabetics. Therefore the inconvenience caused to coeliacs by their diets was investigated using a simple questionnaire. Usable replies were obtained from 46 adult coeliacs and were compared to information from 46 matched ‘control’ subjects. There was evidence that coeliac disease did restrict activities and was a constant source of worry. About a quarter of coeliacs thought that it was impossible to have a normal social life. It is possible that women in particular, showed indications of an unacceptable level of anxiety. The Coeliac Society is an excellent vehicle for help but greater awareness of such problems amongst health‐care professionals would also be beneficial.
Development milestones related to feeding status: evidence from the Child Health Supplement to the 1981 National Health Interview Survey
Authors: Worobey John
Published: March 2008

This study examines maternal reports of the health and attainment of developmental milestones for 1374 breast‐fed v. 1414 formula‐fed infants. Data were drawn from the 1981 Child Health Supplement to the National Health Interview Survey (NHIS‐CHS), a nationally representative sample of some 40 000 households in the United States of America. The results showed smiling to be reported earlier for the infants of breast‐feeding mothers. Formula‐feeding mothers were quicker to introduce their infants to solid foods, and also reported earlier success in toilet‐training their infants than did breast‐feeding mothers. Ratings of physical health were comparatively better for the breastfed than for the bottle‐fed infants. Although partially accounted for by duration of breast‐feeding, demographic factors of low family income and maternal education predicted poorer infant health. These findings suggest that feeding method may modestly influence infant social development and physical well‐being.
Dietary sources of energy, protein, unavailable carbohydrate and fat in 11–12‐year‐old English children in 1990 compared with results in 1980
Authors: Adamson A. J. , Rugg‐Gum A. J. , Appleton D. R. , Butler T. J. , Hackett A. F.
Published: March 2008

There is little information on the food intake of adolescents or on how the intake of adolescents has changed. Yet this information is essential to assess the effect of dietary health education and is valuable in formulating future advice. This paper reports the dietary sources of energy, protein, unavailable carbohydrate and fat in the diet of 379 11– and 12‐year‐old schoolchildren in 1990, and compares these data with similar information collected in 1980. Each child completed two 3‐day dietary records between January and July, and was interviewed by one dietitian to verify and enlarge upon the information recorded to obtain a quantitative measure of food intake. The children attended the same seven middle schools in south Northumberland as 375 children of the same age who recorded their diet using the same method 10 years previously (Hackett et al., 1983). Food tables were used to calculate nutrient intake.

Although the total intakes of energy, protein, unavailable carbohydrate and fat changed little over the 10‐year period, there were changes in the importance of food groups as contributors to total intakes. Notably, an increase in the role played by confectionery which became the second largest contributor to total energy intake and an increase in the importance of meat and its products as a source of energy, protein and fat. The proportion of energy, protein and fat being derived from milk decreased. Chips remained the largest single source of unavailable carbohydrate, and an important energy and fat source, while the role played by ‘wholemeal’ breads in unavailable carbohydrate intake had increased.
Nutrition knowledge, attitudes and fat intake: application of the theory of reasoned action
Authors: Shepherd R. , Towler G.
Published: March 2008

Validated questionnaires eliciting information on nutrition knowledge and attitudes, related to fat intake from meat, meat products, dairy products and fried foods, were completed by 538 subjects. There were high correlations (ranging from 0.40 to 0.77) between the sums of belief‐evaluations, attitudes, intention and self‐reported behaviour, with similar correlations for a subgroup of males aged 35–54 years. Nutrition knowledge, showed some statistically significant (but small) negative correlations with components of attitudes. Females had higher nutrition knowledge scores and more negative views of the foods than did males. Fat intake, measured using %day weighed intakes, correlated with self‐reported behaviour (r = 0.55, P <0.01) in a subsample of 30 males, aged 35–54 years. Thus, nutrition knowledge seems less clearly related to consumption of these foods than are more specific beliefs and attitudes.
The uses of a patient‐based dietetic data‐collection systern
Authors: Morley C. M.
Published: March 2008

The F.I.P. (Financial Information Project) dietetic package allows the collection of basic patient data, which then can be processed to give valuable clinical and management information for use by all dietitians in a dietetic department. The advent of the Korner Reports (DHSS, 1984a) and their implementation highlighted the need to computerize certain aspects of data collection in dietetic departments. Within the West Midlands Regional Health Authority a group of dietitians worked with the Regional Management Services Department to adapt a community nursing system, F.I.P., for use by dietitians. The system was piloted for all paramedical services in 1987 with one health district (North Warwickshire) piloting the dietetic package. It is now used by a range of dietetic and paramedical departments. This paper outlines the system and its uses.
Review of current practice in ‘clean’ diets in the UK
Authors: Pattison Amanda J.
Published: March 2008

A survey of current practice in the provision of ‘clean’ diets at UK bone‐marrow transplant (BMT) centres was carried out as a basis for updating the information given to patients at Sheffield Children's Hospital (SCH). ‘Clean’ diets are used to minimize the risk of infection from food in immuno‐suppressed patients.

Information received varied greatly from sterile diets to modified ward diets. It was found difficult to collate the results for this reason. In addition, there has been little documented evidence on the use and effectiveness of these diets.

In general, there appears to be a move away from a stringent sterile diet towards a more relaxed diet, giving patients a greater choice of foods. Following this survey, the information given to BMT patients at SCH was modified to allow greater freedom of choice, whilst maintaining sensible food hygiene guidelines.
Patterns of food and nutrient intake in a suburb of Dublin with chronically high unemployment
Authors: Gibney Michael J. , Lee Pauline
Published: March 2008

The diet‐history (7 typical recent days) method was used to determine patterns of food and nutrient intake in 50 families, randomly selected from the electoral register of a socially disadvantaged Dublin suburb. Some 66% of income was from unearned social security or other payments. Financial assistance was sought from money lenders by 11 of the 50 families. There was little evidence to suggest that nutrient intakes among males or among children were inadequate. Women, because of a low energy intake and a below average intake of meat, had low intakes of iron (8.1 ±2.3 mg/d). Women also had low intakes of fibre and vitamin C (14 ± 5 and 45 ± 18 mg/d, respectively). These low intakes of fibre and vitamin C among women relative to the RDAs were characterized by low intakes of fruits, vegetables, cereals and pulses. Single mothers (n –10) had the lowest intakes of iron, vitamin C or fibre although their incomes and food expenditures were average. The children of single‐parent families had identical intakes of nutrients to all other children. The estimated cost of the average energy intake of adolescent children (e.g. boys 11–18 years, IRE15‐10/week) well exceeded their social security payments.
The pharmacist as a nutrition educator? An assessment of nutritional knowledge and undergraduate training of community pharmacists
Authors: Macdiarmid J. I. , Gatenby S. J. , Mason P. M.
Published: March 2008

A nutrition knowledge questionnaire was sent to 240 randomly selected community pharmacists in the UK, with a response rate of 31% (n –75). The questions were designed to assess knowledge of nutrition, knowledge of current dietary recommendations and the practical application of this knowledge. In addition, some questions were asked about the educational background of the pharmacist. The overall mean score on the nutrition section was 67.5% (range 35–90%) which was better than possibly anticipated when considering their lack of nutritional education. The survey of nutrition content of courses within pharmacy schools indicated that the teaching of nutrition is limited. Only two schools reported separate courses in nutrition, elsewhere the subject was incorporated into other courses with an average time allocation of only 2 h. However, as a result of the questionnaire some of the pharmacists made comments suggesting concern about the inadequacy of their knowledge of, and undergraduate and postqualification training in, nutrition.
Food and health at work–a review. The costs and benefits of a policy approach
Authors: Poulter Jennifer , Torrance Ian
Published: March 2008

The workplace is an important setting for health promotion and provides an ideal opportunity for shaping healthy eating patterns in occupational groups for whom inequalities have been identified (DHSS, 1980). Workplace food/health policies provide an intermediate and pragmatic step towards achieving the dietary targets set out in the Government's white paper Health of the Nation and the most recent COMA report (DoH, 1991,1992).

Food/health policies have been widely adopted in the NHS (Gibson & Kallevik, 1990) and preliminary research suggests that they are an effective means of intervention (Wallis & Poulter, 1988; Frost et al., 1991). Industry has been slower to link food and health promotion to a policy making process. Surveys imply that action on healthy eating in companies often originates in the occupational health department and is based on individualistic approaches with little energy being put into preventive activities which would originate in the canteen (Mclnerney & Cooper, 1989; Poulter, 1990).

Policies provide a means of balancing the environmental and educational paradigms of health promotion. If food/health policies are to grow in the private sector then industry has to be convinced that the benefits Justify the costs. Some philanthropic employers are motivated by interests other than financial gain, but others are commercially led. There is little hard evidence to demonstrate that any type of employer‐sponsored healthy eating initiative provides a favourable return for investment. It has been ‘guesstimates’ and extrapolation from other situations which have provided the justification for UK companies to allocate any resources towards addressing food/health issues.

In April 1990 the National Grid Company adopted a comprehensive food/health policy. This paper draws on the experiences in developing and implementing the policy document to discuss the issues around evaluative activity in a commercial setting. Views are expressed on the feasibility of measurement and the value of the informaton collected. One aim of the future should be to research this under‐examined area to establish a solid body of information. This would raise the level of debate from one which is currently based on anecdotal evidence to a sounder scientific footing and, therefore, ensure the future growth of such policies in the corporate sector.
Do we need information about portion sizes to rank individuals by their nutrient intakes?
Authors: Fehily Ann M. , Hopkinson Tracey
Published: March 2008

Nutrient intakes calculated from 7‐day weighed intake records for a community sample of 99 men and women were compared with those estimated from the same records, but with mean portion weights substituted for the actual weights. For many nutrients, approximately half of the mean portion records yielded intakes within 10% of the weighed record values. Correlation coefficients between the two estimates of intakes were high (0.64‐0.97). Between 58 and 74 subjects were classified in the same third of the nutrient distributions and only between zero and four classified in opposite thirds. Using estimated portion weights is likely to reduce the degree of misclassification only slightly. It is therefore concluded that for most nutrients a diary with standard portion weights may be as likely to detect diet‐disease relationships in population studies as a diary with estimated weights and only slightly less likely to detect such associations than a weighed intake survey.
Proximate composition of some ready‐meal foods–total fat, fatty acids and tocopherols
Authors: Leighfield M. , Ghebremeskel K. , Doyle W. , Crawford M. A.
Published: March 2008

Total fat, fatty acids and tocopherols of 21 ready‐meal foods were determined. Of these, only two met the recommendations for the overall level of these nutrients. Sixteen of the foods were high both in total and saturated fats. Essential fatty acids were below the recommended lower limit in six of the meals and above the upper range in four. Most were virtually devoid of arachidonic and docosahexaenoic acids. Twelve of the samples had marginal to inadequate levels of a‐tocopherol and this may be particularly significant because lipid hydroperoxides and other reactive free radicals may be generated during storage and reheating.

Ready‐meal foods are often highly processed and important nutrients are lost and it is possible that harmful products are produced during preparation, storage, cooking and reheating. Consumers should therefore be encouraged to eat other foods along with these meals to offset possible nutrient imbalances and/or deficits. Nuts, seeds or grains would help to balance the relative insufficiency of a‐tocopherol and complex carbohydrates such as rice and potatoes can provide bulk and reduce the proportions of energy from fat and saturates. Due to changes in life‐style and purchasing patterns, ready meals are increasing in popularity and some are purported to promote health. Consequently, there is a need for comprehensive nutrient information.
Management of severe obesity by a short period of intensive in‐patient dietary restriction and counselling: an evaluation of effectiveness
Authors: Bush A. , Wood D. F. , Parrott D. , Johnston D. G.
Published: March 2008

Nineteen obese patients (mean BMI 44.6) were admitted for 5 days on a 2720 kj (650 kcals) per day diet and intensive dietary counselling. Seventeen of the patients had serious co‐existent medical conditions or complications of their obesity. All patients lost weight on the hospital diet (mean weight loss 1.8 kg). Ten patients (53%) completed the subsequent 12‐month follow‐up. Of these, only one achieved significant weight loss, losing 38% of the initial excess weight. The other nine either maintained or gained weight. Forty‐seven per cent were lost to follow‐up at 3 or 6 months. The results confirm the tendency of the severely obese to default from follow‐up and to regain weight previously lost. It is concluded that short‐term admission on a 2720 k) (650 kcal) per day diet is ineffective in the long‐term management of refractory obese patients, even in those with co‐existent medical conditions.
Evaluation of a nutrition education programme for people with multiple sclerosis
Authors: Doidge Mary J.
Published: March 2008

A nutrition education programme was designed specifically to meet the needs of people with multiple sclerosis (MS) and implemented in five self‐help groups. The programme was evaluated by means of two 7‐day weighed food and drink records carried out before and after the programme, by an attitude questionnaire and subjectively by the dietitians and participants.

Although the diets of the 48 participants were good before the programme, there were significant improvements in the mean intakes of added sugar, saturated fatty acids, N‐3 PUFA, P/S ratio and energy from N‐3 PUFA in both males and females. RNls for all mean intakes of vitamins and minerals were met by males and females both before and after the programme and intakes were generally better than mean values for the British adult population.

Seventy‐five per cent of the group took food supplements before the programme and 65% after. The diets of those people who took supplements before the programme were better, compared with those who did not, in terms of fibre, vitamin C, saturated fatty acids, N‐3 and N‐6 PUFAs. The supplemented group also made more significant changes in their diets compared with the unsupplemented group.

Attitudes towards diet were found to be positive both before and after the programme. Dietitians and participants subjectively evaluated the programme and their suggested alterations were incorporated into the programme.
Are practice nurses an effective means of delivering dietary advice as part of health promotion in primary health care? Evaluation of practice nurse training in Somerset
Authors: Kyle Alison
Published: March 2008

The introduction of the GP contract in April 1990 has given the primary health care team greater incentive to carry out health promotion activities. One area of health promotion which many practice nurses (PNs) have undertaken is the provision of dietary advice to patients in both preventive and disease management roles.

The present study looks at nutrition training of PNs within Somerset FHSA. The aim was to evaluate the efficacy of the dietary training provided and also the quality of information being imparted to clients in terms of accuracy, the ability to tailor advice to suit individuals and that the information is positive.

Four different methods were used.

Basic questionnaire to assess how useful PNs found the nutrition training and how applicable it was in their role as health educators (n –83).

From these 83 PNs, three smaller groups were randomly selected to take part in further investigations.

A case study questionnaire to assess nutritional knowledge (n –10).

Tape‐recorded dietary interviews (n–10).

Observation interviews by a community dietitian (CD) (n –10).

There was a 78% response rate to the initial questionnaire. Of the PNs 74% rated their previous nutritional knowledge as ‘average’, whereas after training 72% perceived their knowledge to be ‘good’. When discussing dietary issues with patients, after training, 33% of PNs described their confidence to be ‘average’, 64%‘good’ and 3%‘excellent’. Only one PN felt the information in the training was too detailed. Of the PNs 31% requested input on additional topics and also the opportunity to sit in with a clinical dietitian.

Six case study questionnaires were returned. In questions requiring a specific answer on healthy eating issues, 50% of PNs gave the correct response and in most cases this was greater than 80%. However when asked what advice they would give a hypothetical patient there was still a tendency to offer ‘blanket’ healthy eating advice rather than tailoring it to the patient.

Tape‐recorded interviews proved to be unpopular and so these nurses agreed to observation interviews. Fourteen PNs were visited who saw a total of 17 patients and three groups. Using an assessment checklist each PN was given a score of 0–5 where O–‘of very little value to understanding’ and 5 –‘very comprehensive advice’. Scores obtained by the PNs were 2 (n–2), 3 (n–12), 4 (n – 3) and 5 (n – 3).

Results obtained from this small study would suggest that given adequate training, practice nurses can increase their knowledge and skills to enable them to deliver basic healthy eating advice. It was highlighted by the PNs however that this initial training should be followed up by regular study days to ensure PNs are kept up to date and have access to expert nutrition advice when needed. This will ensure that nutrition information is based on sound scientific and dietetic principles. In conclusion PNs can be a resource to help promote healthy eating.
A study of attitudes and use of the plate model among various health professionals giving dietary advice to diabetic patients
Authors: Nydahl Margaretha , Gustafsson Inga‐Britt , Eliasson Margit , Karlström Brita
Published: March 2008

The aims of this study were to determine how well different health professionals follow the recommendations concerning the plate model after being taught its principles and to obtain information regarding their attitudes towards this model and its use in dietary education.

To determine whether the energy and nutrient intake of the participants changed after they had been taught the principles of the plate model, they were asked to record their food intake at a lunch before and after receiving the information. It was found that (i) their energy intake decreased from 1830 ±625 to 1715 ±670 kj between the first and second recordings (non‐significant change), (ii) between the first and second recordings there was a significant decrease in protein intake from 19.7±6.4 to 17.7±6.8 g (P<0.05) and in cholesterol intake from 60 ±20 to 50 ± 20 mg (P<0.001), (iii) the total fat intake remained unchanged, while the relative intake of polyunsaturated fat increased significantly, from 5±3 to 8±4 energy% (P<0.001) and (iv) with regard to vitamins, the ascorbic acid intake was significantly higher at the second recording, 65 ±22 mg, than at the first. 58 ±18 mg (P<0.05).

In a questionnaire that was distributed to each participant, the majority listed numerous advantages of using the plate model and planned to include this teaching aid when giving dietary advice to diabetic patients and to patients of other categories. Further studies are required, however, to evaluate the plate model as a practical tool in patient education.
The role of breakfast cereals in the diets of 16–17‐year‐old teenagers in Britain
Authors: Crawley Helen F.
Published: March 2008

Dietary data was collected from almost 5000 16–17‐year‐old teenagers throughout Britain using 4‐day unweighed dietary diaries. The data was quantitatively coded and analysed to investigate the role of breakfast cereals in the diets of teenagers. The total daily nutrient intakes of consumers and non‐consumers of breakfast cereals have been examined, by both frequency of cereal consumption and type of cereal consumed. Using generalized linear‐modelling techniques, the relationships between nutrient intake, region, social class, frequency of breakfast cereal consumption and type of cereal consumed were investigated. Regular consumption of any type of breakfast cereal was associated with a significantly lower intake of fat when expressed as a percentage of energy intake, having allowed for regional or social‐class differences. Non‐consumers of breakfast cereals had significantly lower intakes of some micronutrients and a significant proportion of those who ate no breakfast cereal failed to achieve the reference nutrient intakes for riboflavin, vitamin B6 and folates. The consumption of breakfast cereals appears to be associated with an increased intake of micronutrients amongst teenagers in Britain, and while these associations may be due to the cereals (and milks consumed with them), they may also be due to the effect that eating cereals has on subsequent feeding during the day. However, this may be important amongst those consuming diets lower in energy or high in foods of low‐micronutrient density.