bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of increasing the dietary fibre content of diets of patients with chronic renal failure treated by haemodialysis at home
Authors: Pender Frederic T.
Published: March 2008

The study described tested the hypothesis that increasing amounts of dietary fibre (DF) in the diet of patients on haemodialysis (HD) may achieve positive clinical benefit without adversely affecting serum potassium and plasma phosphate. The current diet of 20 home HD patients was supplemented with 15g unprocessed wheat bran incorporated into three ‘bran muffins’ eaten daily for a trial period of 28 days. During this period patients reported an improvement in bowel habit. Serum potassium decreased slightly but not significantly (P=0.242) but there was a significant rise in plasma phosphate (P=0.004). These findings suggest that when increasing DF in devising HD dietary regimes, plasma phosphate is possibly the more sensitive biochemical variable following introduction of wheat bran.
Dietary recommendations for children and adolescents with diabetes†
Authors: Kinmonth A‐L. , Magrath G. , Reckless J.P.D. , Connor H. , Court S. , Govindji A. , Hartland B. , Hockaday T.D.R. , Lean M.E.J. , Lord K. , Mann J.I. , Metcalfe J. , Southgate D. , Thomas B.J.
Published: March 2008

Dietary advice for diabetes has changed significantly over the last ten years, the emphasis being on a total energy intake matched to individual requirements and on the physical as well as chemical structure of food and meals. It is recommended that energy intake is still distributed through the day as regular meals and snacks using a carbohydrate exchange system, but with 50% of dietary energy being derived from carbohydrate sources mainly in complex and unrefined form. This paper considers how far the dietary recommendations for adults can be applied to children.
Energy intakes and growth from two months to three years in initially breast‐fed children
Authors: Paul A. A. , Whitehead R. G. , Black A. E.
Published: March 2008

Quantitative longitudinal data of breastmilk and total food intake of 48 Cambridge children have been analysed to calculate total energy intake from two months to 3 years of age. All children were breast‐fed until at least 4 months old, with very little formula milk being given. Energy intakes per kg body weight started at 114 and 110 kcal/kg at 2 months in the boys and girls, respectively, fell rapidly to 86 and 85 kcal/kg by 6 months, and rose to 89 kcal/kg in both sexes by one year. Although below Dietary Recommendations, these intakes were compatible with other recent measurements of total energy expenditure. Individual variation was wide, but there was strong longitudinal within subject correlation of energy intake, which could be partly attributed to body weight. It is suggested that level of eating in infancy establishes the pattern for early childhood. A smaller accumulation of subcutaneous fat is attributed to the less liberal feeding practices compared to a generation ago.
Sodium and potassium contents of home‐cooked and cafeteria foods
Authors: Greenfield Heather , Loong Carolyn Y. , Smith Alison M. , Wills R. B. H.
Published: March 2008

Nineteen main meal foods from cafeterias and six from households were analysed for sodium and potassium. Similar home‐cooked and commercially‐prepared foods did not differ in sodium contents, except for roast beef. In addition to salt, ingredients such as spreads, bottled sauces and stock cubes contributed sodium to the foods. Potassium levels were higher in four of the home‐cooked foods, possibly due to more conservative cooking methods and the use of potassium‐rich ingredients such as herbs.
Dietary guidelines: a critical appraisal
Authors: Gibney M. J.
Published: March 2008

Dietary guidelines are issued in some countries in quantitative terms while in others a qualitative approach is preferred. The latter allows for greater flexibility while the former implies that our knowledge is sufficiently adequate to set such goals. Data are presented to show that that is not necessarily the case. Equally, a popular approach to determining which foods should be targeted for a reduction is to determine key sources of fat, usually meat and dairy products. Evidence is presented to show that these foods do not distinguish between high and low fat diets. Frequently the major determinant of the percentage of energy from fat is the percentage of energy from sugar.
Infant feeding: a review of weaning
Authors: Clark Brenda J. , Laing S. C.
Published: March 2008

Current advice on mixed feeding for the infant is reviewed, with reference to recent reports in the UK. Changes in practice are illustrated and the relevance to the infant of current advice for a prudent diet in adulthood is discussed. It is suggested that future reports on infant feeding may need to be more fully extended to the pre‐school child.
Portion weights of spreading fats
Authors: Wise A. , Enright D. E. , Summerbell C. D. , Moody R. C.
Published: March 2008

Data from four separate surveys have been re‐analysed to investigate the portion weights of spreading fats that were associated with bread in different types of meal. The weight of margarine spread was lower than butter, and was least for wholemeal bread. Weights of both bread and spreads were highest at lunch but the weight of spread per 100 g bread did not differ greatly with meal type. Eighteen pharmacy students participated in a controlled study of the spreadability of the different products and the portions were weighed. The inter‐individual variabilities of the weights of spread were 4–9 times greater than the intra‐individual variabilities for different types of product. Portions of butter were generally heaviest and polyunsaturated margarine lightest. Males spread more of the products than females, people spread more on thick than thin bread, and on toast compared to bread, but there was no difference between the weight of spread on hot or cold toast. Prior knowledge of the type of spread had no general effect on the results.
Evaluation methodologies for food and health policies
Authors: Gibson Liz , Poulter Jennifer , Winkler J.
Published: March 2008

In 1986 and 1987 work was carried out to investigate the quality and extent of evaluation processes associated with implementation of local food health policies (LFHP). The responses from two national postal questionnaires suggest the following trends:

Most Health Authorities and Health Boards (HA & HBs) with a formally approved LFHP recognize the need for evaluation.

Some confusion probably exists between the processes of collecting baseline data, monitoring {checking on the progress by repeatedly collecting data using similar methods), evaluation (determining effectiveness of an action or series of actions), and review (deciding to continue, stop or modify action).

Most evaluation of LFHP activity appears to have taken place within the NHS.

Questionnaires appear to be the most frequently used (71%) research tool.

Most research aims to assess levels of nutritional knowledge or dietary behaviour, with little attention being paid to investigations of food availability. Recommendations for the future development of evaluative processes for LFHPs are made.
How much of the prescribed volume of enteral feed does the hospitalized patient actually receive?
Authors: Robertson Shona M.
Published: March 2008

This pilot study was carried out to establish how many interruptions occurred to patients receiving continuous enteral feeding regimens and the associated percentage of feed losses. It measured how much of a prescribed volume of feed patients actually received during a period of enteral nutritional support. The data for 15 patients (medical and surgical) who were maintained on a standard feeding regimen for a minimum period of five days (range 5–10 days) were analysed. All feeds were administered using Abbott Flexiflo enteral feeding pumps. The patients' weight and serum albumin values were recorded prior to, and at the end of, the study. Although all patients received significantly less feed than had been prescribed there were no significant changes in either of these variables.
What can people eat to meet the dietary goals: and how much does it cost?
Authors: Cade Janet , Booth S.
Published: March 2008

In order to meet the UK dietary goals, changes in the usual diet will need to be made. We analysed the diets of 2340 middle‐aged men and women in three English towns who had completed a 1‐day food record. A majority consumed more fat, more sugar and less carbohydrate and fibre than recommended. Nutrient intakes for those meeting the goals were compared with those who did not meet them. Fewer subjects met a combination of goals, for example, only 7% met all three COMA fat goals. The 28 subjects who met a combination of the goals for total fat/saturated fat/PS ratio/carbohydrate or sugar/fibre (the combined goals group) were compared with a similar number (the average group) from subjects whose nutrient intakes were within the twenty‐fifth and seventy‐fifth percentiles. Nutrient and food intakes were compared. The combined goals group ate, for example, more cereals, wholemeal and brown bread and less white bread than the others. The average daily cost of the food intake for the combined goals group was (excluding alcohol) £2.03 and for the average group £1.86.
Malnutrition in children with malignant solid tumours
Authors: Smith D. E. , Stevens M. C. G. , Booth I. W.
Published: March 2008

Forty‐eight children with newly diagnosed malignant solid tumours underwent prospective longitudinal anthropometric assessment. At diagnosis there was a marked discrepancy between the results of conventional assessment, which relies on height‐for‐age and weight‐for‐height and the results of arm anthropometry: the study group did not differ from controls or from reference standards in height‐for‐age or weight‐for‐height, but had significantly lower mid‐upper‐arm circumference and triceps skinfold thickness. Only 7% of patients were identified as malnourished by conventional assessment, compared with 26% by arm anthropometry. Conversely, during therapy, change in weight‐for‐height appeared to over‐estimate deterioration in nutritional status.

We suggest that these observations are largely accounted for by the effects of tumour mass, which by adding to body weight at diagnosis, inevitably elevates weight‐for‐height and by decreasing during therapy exaggerates any loss of true body weight.

At diagnosis the prevalence of malnutrition identified by arm anthropometry was 27%. During therapy this increased to 46% (P= 0.04), despite supplementary enteral or parenteral feeding in one third of patients.

Patients with abdominal primary disease were the most likely to be malnourished, both at diagnosis and during therapy. Patients with Wilm's tumour were particularly poorly nourished.

These results suggest that there is a greater need than previously realized for nutritional support in children with malignancy. There are also implications for the assessment and monitoring of nutritional status, not only in children with cancer but also in children with malnutrition secondary to other causes.
A survey of the use of special food products by diabetics
Authors: Fairchild R. M. , Daniels C. E. J. , Ellis P. R.
Published: March 2008

A food frequency of consumption questionnaire was completed by 137 diabetic outpatients attending the University of Wales Hospital in Cardiff, to provide information about the use of special dietary products.

Seventy‐four per cent of the diabetics used special dietary products, the most popular of which were artificial sweeteners (45%) and preserves (47%), followed by squash (34%), sweets (31%) and chocolate (31%). Twenty per cent of diabetics consumed biscuits and tinned fruit. Cake and other products (e.g. jelly), were used by less than 10% of the respondents. Over half of all the diabetics consumed one or more products on a daily basis. The use of special products bore no significant relationship to the sex of the respondents, nor to the duration of the diabetes. However, a significantly higher proportion of the Insulin Dependent Diabetics (IDDM) group used dietary products compared with the Non‐Insulin Dependent Diabetics (NIDDM) group. This can be explained largely by the differences in age between the diabetics; the under‐18‐year‐old age group (who were all IDDM respondents) were the greatest users of sweets, chocolate and squash.

Forty‐three per cent of diabetics who did not use special food products cited at least one reason for non‐use. The reasons included dietetic advice (NIDDM respondents only), high cost, poor palatability, lack of availability and unsuitability for other members of the family.
Comparison of short‐term and long‐term palatability of six commercially available oral supplements
Authors: Bolton J. , Shannon L. , Smith V. , Abbott R. , Bell S. J. , Stubbs L. , Slevin M. L.
Published: March 2008

The acceptability of commercially available oral supplements has a great influence on their long‐term use by cancer patients with a poor nutritional status. This study compares short‐term and long‐term palatability of six oral supplements used widely in hospitals throughout the UK, and their effect on the nutritional intake of the patient.
A study of the eating habits of 11‐ and 12‐year‐old children before and one year after the start of a healthy eating campaign in Northumberland
Authors: Hackett A. F. , Jarvis S. N. , Matthews J. N. S.
Published: March 2008

In 1987/88 a marketing orientated ‘Healthy Eating’ campaign was introduced across all Northumberland schools. Six middle schools (9–13 year olds) also piloted an additional change in school meals policy to a restricted ‘fixed price’ menu. A before and after evaluation of this campaign is described using questionnaires, self‐completed by some 700 children aged 11–13 years in 4 middle schools chosen to represent contrasting policies and socio‐economic status. There were important favourable changes associated with the campaign both in food ‘aggregates’ (e.g. sugary, fibrous) and also of individual ‘indicator’ foods (e.g. chips, low fat milk) eaten during the previous day. These changes were detected in both cross sectional and longitudinal analyses.
Non‐starch polysaccharide intake of a representative sample of British adults
Authors: Bingham S. A. , Pett S. , Day K. C.
Published: March 2008

Existing food records of the food intake of 63 randomly selected men and women in a Cambridgeshire village have been re‐analysed to determine the intake of dietary fibre, measured as non‐starch polysaccharides by the Englyst technique. Average non‐starch polysaccharide intake was 11.6 g/day, of which 5.6 g were supplied by vegetables, and 4.4 g by cereals. The range of individual intakes of non‐starch polysaccharides, measured over 7 days, was from 5.1 to 24.7 g. The average intake of approximately 12 g non‐starch polysaccharides in these adults was similar to estimates from the National Food Survey.
An enquiry into the attitudes of Muslim Asian mothers regarding infant feeding practices and dental health
Authors: Williams Sonia A. , Sahota Pinki
Published: March 2008

Recent studies have highlighted some unfavourable dietary practices among Asian infants in the UK. A number of reasons for such nutritional patterns have been suggested. In the present study, attitudes, beliefs and expectations of 100 first‐generation Muslim Asian mothers regarding infant feeding practices were explored through group discussions in their mother tongue.

It was found that mothers generally favoured breast‐feeding but lacked knowledge of weaning practices. There was great emphasis on the consumption of milk. The advice from health professionals to discontinue using a feeding bottle by 12 months of age was not considered acceptable. Some mothers thought the change might cause infants to stop drinking milk and that there was little alternative suitable nourishing food available for that age group. The main requirement for infant foods was that they must be halal. Sugar was used either because it ensured that more milk would be consumed, or because it was considered to be intrinsically beneficial. Some mothers fed children on demand, some stated that children chose what they wanted to eat, and that mothers lacked firm control of dietary intake.

Against a background of conflicting advice from health professionals, pressure from in‐laws, and the powerful influence of advertising, there is considerable scope for the training of health professionals and for continuing education for families and communities.
Developments in nutrition labelling legislation: a major issue for dietitians and corporate nutritionists
Authors: Kirk T. R.
Published: March 2008

The paper reviews the types of nutrition information currently used in food labelling and advertising. An update is given on the existing and proposed guidelines and legislation which aim to prevent misleading nutrition information and ensure that such information benefits the consumer. The efficacy of these controls will be a major factor determining whether autrition labelling can be of value in health education in the 1990s.
Vitamin, mineral and trace element supplementation of children on chronic peritoneal dialysis
Authors: Coleman Janet E. , Watson A. R.
Published: March 2008

This study was initiated to assess the dietary intakes of particular vitamins (A, D, B,2) and trace minerals (iron, zinc and copper) which we do not routinely supplement in children undergoing chronic peritoneal dialysis. Eight children were studied and all were receiving protein and energy supplements. The mean dietary intakes of the above micronutrients with the exception of Vitamins A and B12 were below UK RDA values for chronological age but all were comparable to age and sex matched controls. No clinical deficiencies were detected in the short term but patients on long‐term dialysis may require a more comprehensive vitamin and trace mineral supplement.
Energy utilization and repletion during endurance exercise: an historical perspective
Authors: Noakes T. D.
Published: March 2008

Some of the first studies of the effects of diet on exercise performance were reported in the late 1920s. These studies established that eating a high carbohydrate diet before, and ingesting glucose during prolonged exercise delayed the onset of fatigue and enhanced performance, in part by preventing the development of hypoglycaemia.

The next significant advance came with the introduction of the muscle biopsy needle which allowed muscle carbohydrate (glycogen) content to be measured for the first time. This technique focused attention on the role of muscle glycogen as possibly the more important factor explaining fatigue during prolonged exercise. Subsequent research inevitably focused on the identification of techniques that would either increase muscle glycogen storage before exercise or decrease the rate of muscle glycogen utilization during subsequent exercise, or both.

Coincidentally, studies of fluid balance and of the control of gastric emptying during exercise suggested (a) that dehydration posed a serious health risk especially to marathon runners and (b) that dehydration could only be prevented during prolonged exercise if water alone was ingested. Thus the ‘state of the art’ knowledge in 1970 was that a high carbohydrate diet should be eaten before competition; that muscle glycogen depletion was the main cause of fatigue during prolonged exercise; and that water alone should be ingested in large volumes during exercise. The value of carbohydrate ingestion during exercise was systematically ignored despite the evidence from the classical studies of the 1920s.

Fortunately commercial interests came to the rescue of exercise physiology in the mid‐1980s. Whereas water is without commercial value, carbohydrate added to the water and ingested by millions of athletes throughout the world has attractive commercial potential. Thus research funded and orchestrated largely by the commercial sector has established that adequate fluid delivery can be provided from drinks containing carbohydrate and that the ingestion of carbohydrate during prolonged exercise can prevent the onset of premature fatigue caused by liver glycogen depletion, hypoglycaemia and a low rate of carbohydrate oxidation.

Thus the ‘state of the art’ knowledge in 1990 is that there is no proven value of ingesting water alone during prolonged exercise: that liver glycogen depletion is an important and preventable cause of fatigue during prolonged exercise: and that although muscle glycogen depletion is an important contributor, the real biochemical explanation for fatigue during prolonged exercise is still not clearly established. Nevertheless, there is clear evidence that the provision of exogenous carbohydrate at high rates is essential to delay fatigue and optimize performance during prolonged exercise. It has also become apparent that high rates of both carbohydrate and fluid delivery can be achieved by the adoption of appropriate drinking techniques during exercise.
Guilt and obsessive‐compulsive traits in female dieters
Authors: Chamove A. S. , Graham P. A. M. , Wallis C. M.
Published: March 2008

To extend previous findings that patients with eating disorders show high levels of obsessive‐compulsive traits and guilt, we compared 84 dieters with 81 non‐dieters. Dieters reported more obsessive‐compulsive characteristics (both food‐ and non‐food‐related), more indecisiveness, and tended to have a lower desire for control. Under‐weight dieters were more extreme in these traits than over‐weight dieters. Guilt was not related to perceptions of overweight, rather guilt (both food‐ and non‐food) was significantly higher in those who diet more frequently. Perhaps if food cannot be used as an anxiolytic, any anxiety may be reduced by repetitive behaviour or reinterpreted as guilt.
Nutrition teaching in European dental schools
Authors: Beeley Josie A.
Published: March 2008

A survey has been carried out on nutrition teaching in European dental schools. Whilst The Netherlands and some Scandinavian countries report high levels of teaching with 40 or more hours on average devoted to the subject, others report little or none. With the exception of the former, the extent of teaching of this subject is very varied and in the majority of cases, inadequate.

Only 5 schools reported separate courses in nutrition; elsewhere the hours refer to information related to nutrition included in other courses in the curriculum. Whilst current curriculum revision in some countries may improve the situation, in the absence of either European or national guidelines, amelioration will continue to depend on enthusiasm within individual dental schools and medical faculties.
Patterns of referral and distribution of workload in a dietetic department of a district general hospital
Authors: Hankey C. R. , Taylor R. F. , Stone M.
Published: March 2008

Given the present National Health Service reorganization, appraisal of the work of a dietetic department is of current importance. This study provides baseline information and outlines the work of a dietetics service within a district acute‐unit. The majority of dietetics referrals were from medical consultants and general practitioners whereas fewer referrals were received from surgical consultants and other medical specialities. Time allocation for the dietitians was predominantly either patient support (35.0%) or management, administrative and clerical duties (33.0%). Catering related duties accounted for 11.0% of the dietitians time.

The type of dietary treatments reflects the general‐hospital's function, with most being qualitative in nature, and few specialist treatments. Patients failure‐to‐attend rate was considerable (15.0%).
Collaboration between the dietetic profession and the food industry in health education—a discussion paper
Authors: Kirk T. R.
Published: March 2008

The predicted trend towards increased use of nutrition and health information in food marketing in the 1990's is likely to promote consumer interest in nutrition. In order to capitalize on this trend, the author contends that the dietetic profession should increase the priority given to nutrition education campaigns aimed at improving the diets of consumers. In practice however, the resources available to dietitians to implement substantial nutrition education campaigns are likely to be minimal, unless innovative approaches are considered. The author puts forward two suggestions for consideration by dietitians. First, nutrition education campaigns should use nutrition and health information provided on food labels and in advertisements as major resources.

Secondly, an effective way of resourcing nutrition education campaigns could be by collaboration between the dietetic profession and the food industry. This paper elaborates these proposals and examines implications for the British Dietetic Association (BDA).
Sucrose and fructose in the diabetic diet
Authors: Connor H.
Published: March 2008

Briefing paper from the Nutrition Subcommittee of the British Diabetic Association's Professional Advisory Committee

This paper reviews the available evidence on the effects of sucrose, fructose and sorbitol on metabolic homeostasis in diabetic patients and makes recommendations for the use of these carbohydrates.
Food‐choice and nutrient‐intakes of male Nigerian students in Aberdeen
Authors: Lockie G. M. , Dickerson J. W. T.
Published: March 2008

Fifty‐one male Nigerian students completed a questionnaire on their food‐habits in Aberdeen and Nigeria. Few changes to food‐habits were made during their stay in Aberdeen. Forty‐five of the subjects used a food‐diary to record their food‐intake, Portion‐weights from weighed intakes carried out by male Nigerian students were used to calculate nutrient‐intake. The results differed from those reported in studies on Caucasians. Intake of some vitamins was low. Fibre‐intake was a little lower than that reported for Africans by other researchers and the same as that reported for European students. The amount of energy supplied by carbohydrate, fat and saturated fat was in line with current recommendations for the United Kingdom.
Bacterial colonization of enteral feeding tubes
Authors: Anderton A. , Nwoguh C. E.
Published: March 2008

An in‐vitro model system was used to determine the number of bacteria infused into a ‘patient’ when three types of polyurethane enteral feeding‐tubes that had been experimentally contaminated with feed containing K. aerogenes on day I, were then perfused with sterile feed for periods of 8 h on three consecutive days (days 2–4). The tubes were syringed with 20 ml sterile water at regular intervals. Viable counts were made on syringe washings, feed collected from the ends of the tubes and feed from the nutrient containers.

On day 1, the total number of K. aerogenes in feed samples collected from the nutrient containers and the ends of the tubes rose from 102 to 103–104 cfu ml‐1 over 8 h. On days 2–4 no organisms were detected in the feed samples from the nutrient containers whereas viable counts on feed samples collected from the tubes and syringe washings rose from 104 to 107 and from 101 to 107 cfu ml‐1 respectively.

It can be concluded that a single incidence of feed contamination could lead to a patient receiving contaminated feed from an enteral feeding‐tube colonized with bacteria which will not be detected by normal monitoring of the remainder of the system.
Does exercise affect large gut function?
Authors: Bingham S.
Published: March 2008

The effect of exercise on large intestinal function has been determined in 14 healthy but normally sedentary men and women, aged 22–34 years while on a constant diet.

For an initial 3–5 week period (control) no activity was allowed. Six subjects then undertook a 9 week training schedule by the end of which they were capable of jogging for 1 h/day, 5 days a week. A further six subjects undertook a similar training schedule that lasted for only 7 weeks, at the end of which they were jogging for 45 min/day. Finally, two subjects were studied continuously while taking light exercise for 6 weeks and then jogging for a further 3 weeks.

Physical fitness was monitored and showed significant changes with maximum aerobic capacity increasing from 2.4+0.5 to 3.1+0.4 l/min, maximum heart rate after a step test falling from 1524–8 to 129+5 beats/min, and resting pulse rate also falling from 56+4 to 50+5 beats/min. High‐density lipoprotein cholesterol also increased significantly.

Colonic function was assessed by measurement of stool weight and transit time, using the continuous radio‐opaque marker technique, faecal pH, nitrogen excretion, and ammonia concentration.

No change was observed overall in mean daily faecal weight (124 + 39 (control) and 129+49 g/day (exercise), transit time (55+20 (control) and 54+23 h (exercise)), nor in faecal frequency, dry stool weight, pH, ammonia, or in total nitrogen excretion. Significant changes did occur in five individuals with significant slowing of transit time in two and speeding up in three. Overall transit time increased in nine subjects and decreased in five.

Hence, when diet is constant, exercise has marked effects on physical fitness but no consistent effect on large bowel function.
Nutrient sources in non‐manual and manual occupational groups. Results from the Scottish Heart Health Study (SHHS)
Authors: Bolton‐Smith C. , Brown C. A. , Tunstall‐Pedoe H.
Published: March 2008

The food sources for the macro‐nutrients and the antioxidant vitamins in the diets of non‐manual and manual occupational groups were assessed. Nearly 10,000 men and women aged 40–59 years completed food frequency questionnaires as part of a study of risk factors for coronary heart disease (the Scottish Heart Health Study). Twenty‐five food groups are identified and their percentage contribution to each of the nutrients are reported. Clear differences in the nutrient sources occur between both the sexes and the social class groups. Quantitatively, the top four food items for men are alcoholic drinks, milk, potatoes and bread, and for women are milk, bread, fresh fruit and potatoes. Meat products (as distinct from carcass meat) and hard margarines are responsible for most of the differences in total fat, and saturated fat intake between the social class groups. Key differences occur in the percentage of vitamin C and fibre from fruit juice, fresh fruit, green vegetables and potatoes. The importance of carrots to carotene intake varies by social class and, in the manual groups, a greater percentage of vitamin E is derived from eggs and hard margarine than from soft margarine and vegetable oils. These data complement the findings that nutrient intakes differ between social class groups by highlighting the foods which bring this about. The information is relevant to dietitians and health educators who may wish to bring about dietary change in populations.
Changes in dietary fibre intake in two British towns
Authors: Barasi Mary E. , Burr Michael L. , Robshaw Emma J. E. , Poor David J.
Published: March 2008

A postal survey of dietary fibre intake was conducted in two British towns in 1983, and repeated five years later. Consumption of dietary fibre had risen, the rise being greater in the town where the initial intake was higher. Changes in intake appeared to be related to health‐consciousness as reflected by changes in body mass index (BMI) and smoking habit. Although dietary fibre consumption in Britain is rising overall, local differences may be widening rather than narrowing.
Continuing education—a study of dietitians participation in and attitudes to continuing education
Authors: Bond C. , Firmin Celia
Published: March 2008

It is now generally acknowledged that education and training is a continuing and lifelong process. It is also increasingly clear that education may take many forms, not all of them traditional. No longer can a person's education be associated exclusively with the period of induction and learning which occurs in the first 20 or so years of life. Nowhere is this more evident than in the professions.

The pace of scientific, technological, social and political change is now so rapid and intense that an initial period of professional training can only provide the foundations of knowledge, skills and attitudes on which further education and training must be built, if they are to remain current and valid.

This study seeks to inform the current debate within the profession, on the development of an education and training strategy for State Registered Dietitians. It reviews current participation in and attitudes towards continuing education among a random sample of British Detetic Association members.

The authors conclude from the results that dietitians are aware of the need for continuing education but need to be more actively involved in initiating and directing their own professional development. Some suggestions as to how this may be achieved are included at the end of this article.
Post‐graduate education of dietitians and their potential role in medical education
Authors: Robertson A. , James W. P. T.
Published: March 2008

One dilemma of teaching nutrition to medical students includes the problem of translating nutritional science into practical therapy. Medical clinical nutritionists and dietitians need to join forces to solve this problem. For the purposes of this paper, a clinical nutritionist is defined as a medically qualified doctor with post‐graduate qualifications in nutrition (e.g. M.D or Ph.D) followed by a significant number of years (e.g. 10) in post‐doctoral nutritional research; a dietitian is someone who qualifies with BSc. in nutrition and/or dietetics followed by or including 6 months clinical training leading to state registration in dietetics (S.R.D.). The question is how can these two disciplines integrate and develop their skills? One mechanism for linking these two professional groups is in the training of medical students. In addition, a joint approach could ensure that nutritional prescription and dietetic therapy are more readily accepted and implemented within patient care.
Introducing nutrition into the pre‐clinical curriculum—Caribbean experience
Authors: Landman J. P. , Jackson A. A.
Published: March 2008

The paper describes how nutrition was incorporated into the crowded pre‐clinical medical curriculum in the University of the West Indies which trains doctors for its 14 member states. Close consultation with dietetics, nutrition and clinical departments in Jamaica, Trinidad and Barbados ensured the curriculum was relevant to regional health problems and the medical curriculum. The main goals were to: (1) instil positive attitudes towards nutrition in the students; (2) teach nutrition integrated with biochemistry and physiology; and (3) lay the scientific basis for applying nutrition to clinical medicine. The paper outlines which key concepts were taught and the strategies used. The curriculum was evaluated twice, after 5 and 9 years.

These surveys found that students in their first clinical year were satisfied with nutrition teaching, especially when it was conducted by specialists. Despite changes in staff and a fall in the number of lecture hours, the goals of the programme were met. Successful co‐ordination depended upon flexibility and rapport with staff.
A new method of energy prescription to improve weight loss
Authors: Frost G. , Masters K. , Kin C. , Kelly M. , Hasan U. , Heavens P. , White R. , Stanford J.
Published: March 2008

Clinical outcome audit was carried out on two groups of obese out‐patients for a 3‐month follow‐up period. In the first audit group of 35 patients (A1), energy intake was prescribed by diet history, whereas in the second audit group of 27 patients (A2) energy intake was prescribed from an estimate of individual energy requirements based on age, sex and activity. There was no significant difference in age or initial BMI between the two groups and the failure‐to‐attend rate was the same in each group.

Patients in Group A2 received e significantly higher energy prescription (P<0.001) than Group Al, but this was still significantly more restricted than the recommended 500 kcal energy deficit from energy expenditure (P<0.05). Weight loss was significant in both groups, but was greater in Group A2 than in Group A1. There was no significant correlation between weight loss and energy deficit. In a selected group of patients from Group A2 who were prescribed energy intake close to the recommended deficit of 500 kcal. weight loss was found to be significantly greater (P<0.05) when compared to the weight loss in Group Ai. Results suggest that a diet prescription with an energy deficit below the estimated energy requirements does not lead to greater weight loss and probably reduces compliance. Estimating individual energy requirements rather than using dietary assessment may improve weight loss.
Dietary recommendations for people with diabetes: an update for the 1990s Nutrition Subcommittee of the British Diabetic Association's Professional Advisory Committee
Authors: Lean M. E. J. , Brenchley S. , Connor H. , Elkeles R. S. , Govindji A. , Hartland B. V. , Lord K. , Southgate D. A. T. , Thomas B. J.
Published: March 2008

The broad principles of the 1982 British Diabetic Association recommendations remain valid. For the overweight, reduction in energy intake remains the most important aim.

Carbohydrate should make up about 50–55% of the dietary energy intake, the majority of this coming from complex sources. preferably foods naturally high in dietary fibre or hydrolysis resistant starch. Up to 25 g of added sucrose may be allowed, provided it is part of a diet low in fat, high in fibre and that it substitutes for an isocaloric amount of fat or a high, glycaemic index food or other nutritive sweeteners. Some high carbohydrate diets have been shown to worsen glucose control and serum lipid abnormalities. Some previous recommendations for fibre intake have proved unrealistically high and of limited value. A modest increase to 30 g/d, concentrating on soluble fibre is recommended.

Reduction of fat intake to 30–35% of energy intake remains an important goal which should help to reduce the incidence of cardiovascular disease in people with diabetes and aid weight loss. Of this, only 10% of total energy should be saturated, 10% polyunsaturated and 10–15% may be mono‐unsaturated fat. The latter has been shown to provide a useful alternative energy source which may have beneficial effects on glucose control and serum lipids. Cholesterol intake should not exceed 300 mg/day.

Protein should comprise about 10–15% of energy intake. Reduction in protein intake and associated nutrients may help to slow down progression of nephropathy. Limitation of salt intake to 6 g/d is recommended Reduction in fat intake may be relatively more important in Type 2 diabetic patients, whereas limitation in protein intake more so in Type 1 diabetes.
The growth and development of vegan children
Authors: Sanders T. A. B. , Manning Joan
Published: March 2008

The results of prospective study on the growth and diets, estimated from 7‐day weighed food intake records, of 20 life vegan children (aged 5.8–12.8 years) are presented. The growth and development of the children were normal but they tended to be lighter in weight and exceptionally lean compared with standards. Heights were around the median of the Tanner‐Whitehouse standards but were lower than the medians recently proposed by the Department of Health. Energy intakes were similar to those reported in children of the same age in the general population, but dietary fibre intakes were very high which may have influenced the digestible energy. Sugar provided an average 15.6% of the dietary energy and this was supplied mainly by fruit and fruit juice. Mean fat intakes were close to the dietary reference values. Daily intakes of essential nutrients generally met the amounts recommended, with the exceptions of calcium and vitamin B12. Many children received supplementary sources of vitamin B12 and only two children had intakes below the lower recommended nutrient intake. Intakes of saturated fatty acids were low and those of linoleic acid were high. The ratio of linoleic/α‐linolenic acid was high. As docosahexaenoic acid is absent from vegan diets, it is suggested that vegans should use oils with a lower ratio of linoleic/α‐linolenic acid. Future studies should also consider the influence of a vegan diet on retinal function. None of the children was immunized against whooping cough and 11 had not been immunized against polio: 16 of the children had suffered from whooping cough. Future studies need to take into account factors other than diet when assessing the health of vegans. The results of this study show that children can be successfully reared on a vegan diet providing sufficient care is taken to avoid the known pitfalls of a bulky diet and vitamin B12 deficiency.
Effects of a nutrition education programme on the dietary habits of a population of students and staff at a centre for higher education
Authors: Liddell Judith A. , Lockie Gillian M. , Wise Alan
Published: March 2008

A programme of nutrition education and modification of catering practices was developed with the intention of influencing the eating habits of staff and students who attended a centre for higher education.

A questionnaire was used to assess the frequency of consumption of foods before and after the education programme. Seven‐day weighed inventories were conducted to obtain information about portion sizes eaten by the study group. Caterers' purchasing figures were collected and assessed to determine any changes in catering practices. The results indicated that eating habits and catering practices did change within the duration of the project. Intake of wholemeal bread more than doubled while consumption of whole milk was at least halved. The nutrient intake of the student population appeared to be adequate when compared to Dietary Reference Values, apart from the energy, folate and iron intakes of female students which were rather low, Following the education programme, female students reported that the amount of energy obtained from fat had reduced by three percentage points, from 38% to 35%, while male students reported a reduction of five percentage points, from 42% to 37%.
A comparison of nutritional intake, functional status and muscle strength between elderly day hospital and day centre attenders in South London
Authors: Mowat E. A. , Thomas S. , Hyatt R. , Maxwell J. D. , Whitelaw M. N.
Published: March 2008

Two sample groups of elderly were compared from a population living in South London. One group attended a local day centre (a socially orientated establishment), and the other attended a local day hospital (a therapeutically orientated establishment).

The aim of the study was to compare nutritional intake, functional status and muscle strength between these two groups.

The mean nutritional intakes of the day hospital and day centre attenders were similar. Intake of macronutrients, with the exception of fibre, met Recommended Daily Allowances (RDAs) in both groups. In take of folic acid, vitamin D and zinc fell below recommendations in both groups.

Low intake of folic acid was improved by supplementation, and some individual blood levels of folate reflected this. Blood folate levels were generally within normal limits. Low intake of vitamin D was improved by supplementation, but blood levels were generally normal anyway. There was, however, a tendency for the more dependent day hospital patients to have lower vitamin D levels. This group also had less sunshine exposure.

Communal dining, whether in the setting of day hospital or day centre, may have been an essential means of bolstering nutritional intake for many ‘at risk’ elderly.

There were significant differences in functional status and muscle strength in favour of the day centre group and these indicate that anthropometric indices rather than nutritional or biochemical indices were the most reliable markers of disease and disability in this study.

The effect of fortifying local meals‐on‐wheels was also highlighted, and suggests that this may be one means of preventing nutritional deficiencies in the vulnerable, house‐bound elderly.

Alcohol intake was reported as being modest. However, discrepancies were noted on review of biochemical indices known to be influenced by alcohol intake.
A study of infant feeding practices in an urban Indian community
Authors: Ruxton C. H. S.
Published: March 2008

Thirty mothers, attending either a paediatric clinic at a Government hospital or a private paediatrician's surgery, both in Tirupati, Andhra Pradesh, South East India, were questioned about their infant feeding practices. A sample of milk from their child's bottle was requested and subsequently analysed for the presence of dilution. Over‐dilution, defined as less than 75% of the standard concentration, was found to be common (P<.05). No significant correlations were found between the incidence of over‐dilution and either family income or educational status of the mothers due to the small sample size. The study suggests the need for practical education on the reconstitution of milk feeds.
Public attitudes to nutritional messages
Authors: Randall L. , Wise A. , McLeish A.
Published: March 2008

A random sample of 100 nutritional messages was analysed stylistically. Six different types of language were found to be present: commands or suggestions, written persuasively or factually, and either positive or negative. The majority of messages were positive commands giving factual information. Thirty‐two messages were written using combinations of these types of language and members of the public were asked to rank four groups of messages that were similar in content, but different in type of language. Messages were ranked differently, but preferences were not related to the type of language tested, nor to the number or length of words.
Dietary behaviour of an adolescent French male population
Authors: Spyckerelle Y. , Herbeth B. , Deschamps J.‐P.
Published: March 2008

The dietary history method was used to determine the total energy and macronutrient intake, the distribution of daily energy from the different meals and the energy contribution of various food groups, in a population of 299 boys, aged between 10 and 15 years. The effects of age, the social status of the father (SPS), the ponderal index, the importance of breakfast or lunch, and the level of energy intake on dietary indicators, were studied. In our population, energy intake increased with increasing age but the energy contribution of macronutrients did not vary. The diet of boys whose fathers were in the upper SPS classes differed from the diet of those boys whose fathers were manual workers: for example they consumed less energy and pastries, but more animal protein (in percentage of energy intake), more dairy products, and more fruit. The ponderal index was negatively related to energy intake but positively related to protein intake, especially from meat and meat products. The energy intake from protein, animal protein and the energy contribution of dairy products, meat and meat products, fish and vegetables was lower among large eaters than among small eaters. The energy contribution of pastries, sugar and sweets was higher among large eaters.

Similarily, the energy intake from morning and evening snacks was also higher among large eaters. It should be noted that boys who had a substantial breakfast took in less energy from all other meals (including snacks and main meals). Such informaton is necessary in order to develop an effective health programme.