bluuebunny/crossref_metadata_2025_split huggingface dataset:
Milk consumption and prevalence of coronary heart disease in men and women from the Scottish Heart Health Study
Authors: Bolton‐Smith C. , Brown C. A. , Woodward M. , Tunstall‐Pedoe H. 
Published: March 2008

This report uses cross‐sectional results from the Scottish Heart Health Study to investigate whether milk consumption has an independent effect on the prevalence of coronary heart disease. Milk consumption was assessed by questionnaire in men and women aged 40–59 years (n = 10359) who participated in a survey of risk factors for coronary heart disease between 1984 and 1986. Odds ratios for coronary heart disease were calculated according to volume and type of milk consumed for subjects with and without symptoms of coronary heart disease. Statistical adjustment was made for the classicial risk factors.A higher percentage of men and women with diagnosed coronary heart disease (CHD) usually consume low‐fat milk, compared with asymptomatic controls. Odds ratios for having undiagnosed heart disease did not differ significantly with volume or type of milk. However, the odds ratios for having diagnosed heart disease were lower in the moderate (0.5–1 pint/d) milk consumption group. Patterns of milk consumption in patients diagnosed as having CHD are likely to be confounded by dietary changes post‐diagnosis. Milk consumption appears to have little independent effect on the prevalence of coronary heart disease in this Scottish population.
Traditional Indian beliefs about the dietary management of diabetes—an exploratory study of the implications for the management of Gujarati diabetics in Britain
Authors: Khajuria Seema , Thomas Jane 
Published: March 2008

The aim of this small study was to explore the extent to which traditional beliefs about diet, health and diabetes, as described in the classics of Ayurvedic medicine, are held by Indian (Gujarati) diabetics in Britain. This was undertaken to give insight into the patients' perspective on appropriate management of their condition and to identify and possible areas of conflict between traditional remedies and western treatment of diabetes. In addition, eating habits were examined in order to assess the extent to which the dietary modifications advocated by either medical system were being followed.Patients satisfaction with the advice given by doctors and dietitians and its appropriateness to their eating habits was also investigated.The results indicated that the traditional belief in the value of bitter foods and bitter herbs in the management of diabetes was common amongst Gujarati patients attending the diabetes clinics at two London Hospitals. The majority ate karela, guar, tindora or methi leaves once a fortnight or more frequently as part of a meal. But only a small minority (18%) used bitter foods or bitter herbs therapeutically, giving rise to little conflict between traditional and western medicine.Findings also indicate that despite their generally poor understanding of English, patients were aware of the principles of the diabetic diet advocated by doctors and dietitians. These were not however always put into practice. This might be due in part to a lack of specificity in advice, possibly arising from a lack of detailed knowledge concerning the foods, eating habits and beliefs of these patients.
A comparison of the nutritional beliefs of human immunodeficiency virus (HIV) seropositive and seronegative homosexual men
Authors: Summerbell C. D. , Catalan J. , Gazzard B. 
Published: March 2008

One‐hundred and eighty‐eight HIV‐seropositive (index cases) and 45 HIV‐seronegative (controls) homosexual men completed a questionnaire to assess their nutritional beliefs and practices, their psychosocial characteristics and information sources. Most individuals, irrespective of their HIV serological status, perceived the need to change their diet. Dietary changes were those which would be perceived as healthy by the general population, for example, a low‐fat, high‐fibre diet. Most HIV‐seropositive individuals believed that vitamin and mineral supplements were especially important for their health and this was mirrored in their relative increased use of these substances compared to controls. Dietetic advice was not effective in terms of reported changes in dietary practice.This work shows that although dietetic advice could be important in the management of HIV infection, in terms of altering dietary intake to promote weight gain, current practice needs to be reviewed in an attempt to improve efficacy. These results highlight the need to consider psychological characteristics when monitoring dietary compliance.
The effects of a high‐fibre cereal‐based breakfast on daily dietary intakes and bowel function
Authors: Turconi G. , Bazzano R. , Caramella R. , Tagliabue A. , Lanzola E. 
Published: March 2008

The aim of this study was to assess whether large amounts of cereal fibre, contained in a high‐carbohydrate breakfast meal, could modify habitual daily intakes of energy and macronutrients and quantitative and qualitative composition of meals, and ultimately, affect bowel function.Twenty‐four healthy adult volunteers (12 males and 12 females aged between 21 and 36) were recruited into the trial. All of them were either university students or graduates. Two high‐fibre cereals (Kellogg's ‘Bran Flakes’ and Kellogg's ‘All Bran’) were ingested for 2 non‐consecutive weeks in a breakfast meal that accounted for about 20% of the total daily energy intake. Dietary intakes were recorded for 3 days (2 week‐days and 1 non‐working day), and bowel function was also evaluated (using a questionnaire) before and during the trial.The ANOVA two‐way test showed a significant variation (P<0.05) in dietary fibre ingestion during the trial; however, no significant differences emerged with regard to energy and macronutrient intakes, or to the qualitative/quantitative composition of the subjects' habitual diet.Considerable improvements in bowel function were reported in virtually all of the subjects during the trial period. The findings indicate that although habitual daily intakes did not vary significantly, energy and nutrients were more rationally distributed during the course of the day; the intake of milk increased, and bowel function improved. Therefore an increase in dietary fibre has positive nutritional consequences for the overall diet.
A new approach for evaluation of meal quality and meal patterns
Authors: Lennernäs Maria A‐C. , Åkerstedt. Torbjörn , Hagman Ulla , Bruce Åke , Hambraeus Leif 
Published: March 2008

An objective, nutritionally orientated classification system is necessary to evaluate the frequency, nutritional quality and temporal distribution of eating events in dietary surveys. In this paper a system to classify eating events qualitatively with regard to the types of food items consumed is described and demonstrated. It comprises eight food categories and criteria for their combination into four types of meals and three types of snacks of various nutrient composition. The food categories represent food items of animal and plant origin, and also food products containing sucrose and beverages containing alcohol or lacking energy and nutrients.Classification requires individual data collected by established food‐record or recall methods. Data on consumed amounts is not required to classify qualitatively the eating events per se, but is required for quantitative calculations of their content, composition and relative contribution to total intakes. The application of the system to dietary data (80 repeated 24‐h recalls, 517 eating events) of 16 male three‐shift workers showed that classification of eating events was easy and largely unequivocal compared to traditional methods. Subsequent calculations showed expected differences between eating types with regard to content and relative quality. The meal‐classification system might be used as a cost‐effective method to evaluate the nutritional profile of meal patterns in surveys.
Risks of microbiological contamination of enteral feeds during the set up of enteral feeding systems
Authors: Weenk G. H. , Kemen M. , Werner H.‐P. 
Published: March 2008

Four enteral feeding systems were compared in terms of their ability to limit the chance of introducing microbial contamination during the set up of the systems. The systems incorporated a variety of containers and giving sets, thus resulting in different methods of assembly. The systems were tested under ward conditions in two hospitals and under the worst possible conditions in a simulated ward study. The Steriflo system performed best. Even in the worst possible situation, counts remained very low and the number of Steriflo feeds remaining sterile throughout the feeding period was more than 85% (P< 0.05). The Bag system performed worst: at the end of the recommended feeding period counts of more than 1000 colony forming units/ml were obtained and the number of sterile feeds was significantly lower than for the other systems (P< 0.05). Crown cork bottle and Container performed equally well, but not as well as the Steriflo system. Taking <100 micro‐organisms/ml as a criterion, the differences however were not statistically significant.Decanting of sterile feeds was shown to impose a risk of introducing microbial contaminants to enteral feeds. This however was shown to be strongly dependent on the system design.The results obtained in the hospital trials clearly show that enteral feeding systems can be set up safely when hygienic procedures are followed carefully. When systems were handled with contaminated hands, as simulated in a laboratory trial, the chance of introducing microbial contamination in the feeds increases significantly. Taking into account that hygienic procedures are not always adhered to in hospitals, it is concluded that the Steriflo system offers the best chance, compared with other currently available systems, that enteral feeds will remain microbiologically safe throughout feeding. Practical implications of these findings are discussed.
Dietary patterns in Asian and Caucasian men in Bradford: differences and implications for nutrition education
Authors: Smith Z. , Knight T. , Sahota P. , Kernohan E. , Baker M. 
Published: March 2008

As part of a study of risk markers for ischaemic heart disease in Bradford, dietary intakes were assessed for 286 male manual workers of Asian and Caucasian origins using a 3‐day diet diary and a food‐frequency questionnaire.Caucasian men were found to eat more variable diets, the choice of foods being partly dependent on the canteen facilities in the workplace. Processed meat products and sweet baked goods featured almost daily, whereas intake of fresh fruit and salads did not. Most Asian meals followed the traditional pattern of curry (lamb/mutton, chicken, vegetable and occasionally white fish) with chapatis and, less frequently, rice. Salad and yoghurt were often eaten with the curry and fresh fruit was frequently consumed after the meal. Such meals were consumed one or more times per day. Although overall vegetable consumption was of a similar frequency in both ethnic groups, the Asian men ate a greater variety. The frequency of ‘fried food’ consumption was similar for both Asian and Caucasian diets although different types of foods were consumed.These different dietary patterns were reflected in higher estimated intakes of protein and sugar amongst Caucasians and lower intakes of fibre, compared with Asian men. Total fat intakes and P:S ratios were highest in the Hindu group although both Caucasian and Asian men were estimated to consume more total fat than is currently recommended.The results of this study highlight the need for ‘healthy eating’ advice to be designed specifically for the ethnic group in question, rather than for general healthy eating messages to be translated into the appropriate language. Although conducted within one population only, this study should be of interest to all dietitians working in multi‐cultural communities.
Consumption and sources of sugars in the diets of British schoolchildren: are high‐sugar diets nutritionally inferior?
Authors: Gibson Sigrid A. 
Published: March 2008

Data files of the food intakes of 2705 schoolchildren surveyed in 1983 (DoH, 1989a) were reanalysed to provide an estimate of the total intake of sugars and major sources of sugars in the diet. The relationships between intake of sugars, nutrients and nutrient density were examined by comparing between tertiles, firstly of total sugars (g/day) and subsequently of percentage energy from sugars. The results are presented separately for boys and girls in two age‐groups (10–11 years and 14–15 years). The estimated mean intake of sugars (123 g/day, s.d. 42 g) was equivalent to 23% of dietary energy. Major sources were confectionery (18%), table sugar (16%), cakes and biscuits (13%), milk (10%), soft drinks (9%) and puddings (9%).Nutrient intakes were not significantly lower, and indeed were often higher, in those groups consuming most sugars, by either method of defining tertiles. Energy intake appeared to be the major influence on intakes of nutrients. Nutrient densities (mg or μg/MJ) showed different trends: vitamin A, vitamin C and thiamin concentrations were similar across all tertiles, while those for calcium and riboflavin tended to rise with increasing sugars intake and those for iron and nicotinic acid tended to fall, although not all of these differences were significant in all age/sex groups at the 1% level. There was a significant reciprocal (inverse) relationship between sugars and percentage energy from fat. Iron intakes were low in girls, irrespective of consumption of sugars. These data therefore provide little support for the ‘empty calorie’ hypothesisSchoolchildren with low energy intakes in combination with high proportional intakes of sugar may constitute a theoretical at‐risk group, particularly with regard to iron intake. However, because the possibility cannot be excluded that habitual food intake may be underrepresented in dietary records, further investigation of such groups by methods incorporating clinical/biochemical assessments are warranted.
Audit of nasogastric feeding practice at two acute hospitals: is early enteral feeding associated with reduced mortality and hospital stay?
Authors: Taylor S. J. 
Published: March 2008

Hospital malnutrition is common and thought to be a cause of morbidity and mortality. Nasogastric (NG) feeding is the most commonly used invasive technique of nutritional support used at the acute Bolton hospitals. A prospective observational study was initiated to audit the use of NG feeding in patients in whom oral energy intake was virtually nil at the time of commencement of tube feeding.Patients who were starved for 0–5 days prior to commencement of NG feeding had a lower mortality than patients starved >5 days (a) during their feeding episode and (b) during their hospital stay subsequent to cessation of oral intake. The difference in mortality was not related to age or sex. However, in patients of <65 years mortality was only non‐significantly higher in patients starved >5 days compared with those starved 0–5 days. In patients of >64 years the difference in mortality between those starved 0–5 vs. >5 days remained significant: (a) during the feeding episode and (b) during the hospital stay. The fact that starvation has a disproportionate effect on mortality in old patients may indicate that older patients are more susceptible to starvation. In surviving patients there was a positive correlation between the length of starvation and: (a) the duration of the NG feeding episode and (b) hospital stay subsequent to cessation of oral intake. Disease severity was not measured therefore its effect on outcome and speed of rehabilitation cannot be excluded.The study indicates a possible relationship between the duration of starvation and mortality, the duration of NG feeding and the length of hospital stay. Definitive testing of this association would require a prospective trial which controls for age and disease severity.
A patient infected with HIV as a result of intravenous drug misuse
Authors: Penman Caroline 
Published: March 2008

This case study demonstrates that the stereotype image of drug users as being non‐compliant and uncaring about their health is not always correct. This article demonstrates that it is possible to promote weight gain in a patient infected with HIV as a result of intravenous drug misuse with a rather chaotic, addictive life‐style.This patient gained a significant amount of weight, even after being diagnosed as suffering from AIDS 3 years previously, and continues to maintain his weight and have relatively few medical problems.
Research and evaluation: the involvement of community dietitians
Authors: Loach Jackie , Oxford Liz 
Published: March 2008

The recent document Dietitians in the Community: Opportunities for the Future (BDA, 1993) highlighted the importance of strengthening the evaluation and research base of the practice of dietitians working in the community.Members of the Community Nutrition Group of the BDA were surveyed by postal questionnaire in March 1992 to gather information to facilitate implementation of the report's recommendations. Thirty‐six per cent of the members (n = 125) responded. Over half (56%) reported recent involvement in a research project and 97% expressed a need for better training and support in one or more aspects of the research process. Information was also gathered about the types of projects undertaken, preferred forms of support, previous training, evaluation and research, collaborative links and perceptions of the role of the BDA Research Committee and Metabolic Research Groups. This information is presented and discussed.In conclusion, relatively few community dietitians are actively involved in evaluation and research. Various modes of support are necessary to increase the number of dietitians engaged in this area, if the stated commitment of professional managers and the British Dietetic Association is to be fulfilled.
What is the HACCP (hazard analysis critical control point) approach and how can it be applied to enteral tube feeding?
Authors: Anderton Annette 
Published: March 2008

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

In order to ascertain the reasons for low uptake of breast‐feeding and to suggest strategies for improvement, 576 mothers attending an antenatal booking clinic were given a questionnaire on their feeding intentions and followed up until 28 days post‐partum,Intention to bottle‐feed increased with parity [p0 (31%), pi (45%), p2 (58%)] as mothers who were previously undecided or who tried and failed to breast‐feed reverted to feeding with a bottle. Primagravida who were influenced by outside sources, either professional (e.g. GPs), or non‐professional (e.g. relatives, the media) were more than twice as likely (2.2, CI 1.8‐2.7) to breast‐feed than those who were not. At birth 272 mothers breast‐fed (47%) which at discharge fell to 244 (42%). Intending breast‐feeders were more likely to fail if given a general anaesthetic (2.33, CI 1.2–4.5), or if they complemented with dextrose (1.94, CI 1.1–3.4).Twenty three per cent (56) of mothers who were breast‐feeding at discharge gave up before 28 days post‐partum. The babies of mothers who gave up because of perceived poor weight gain did not significantly differ in weight from those whose mothers continued to breast‐feed.Whilst many mothers have decided to bottle‐feed before entering hospital, the success of those who wish to breast‐feed is greatly influenced by medical and midwifery practice.
The effects of psyllium on blood lipids in hypercholesterolaemic subjects
Authors: Summerbell C. D. , Manley P. , Barnes D. , Leeds A. 
Published: March 2008

This study was designed to investigate whether psyllium has an intrinsic hypocholesterolaemic effect on serum blood lipids. The 9‐week, two‐phase study was a double‐blind, placebo‐controlled trial in subjects (n= 37) with mild to moderate hypercholesterolaemia (serum cholesterol levels 5.2–7.8 mmol/1). After the first 3‐week phase, in which subjects adhered to a low‐fat diet, the subjects were randomly assigned to one of two groups for a further period of 6 weeks. One group consumed 60 g of a high‐fibre breakfast cereal daily, containing 9.6 g of soluble fibre from psyllium, and the other (control) group consumed 60 g of a high‐fibre breakfast cereal daily, containing negligible amounts of soluble fibre. Both groups maintained a low‐fat diet (30% energy from fat).During phase I, total and low‐density lipoprotein (LDL) cholesterol levels were reduced in all subjects; randomization resulted in similar phase I changes in both the psyllium (‐ 8.9% and ‐ 11.1%, respectively) and control (‐ 8.9% and ‐ 12.8%, respectively) groups. During phase II, total and LDL cholesterol levels were further reduced in the psyllium group (‐ 7.3% and ‐ 10.6%, respectively), but not in controls [‐2.7 and ‐ 6.0%, respectively). Changes in high‐density lipoprotein (HDL) cholesterol levels and body weights over the study period were not significant. Differences between the psyllium and control groups in total, LDL and HDL cholesterol levels were not significant.
Preliminary survey of attitudes to, and factors affecting perceived success or failure among adults attending a hospital lipid clinic
Authors: Wright C. A. 
Published: March 2008

A questionnaire for self‐completion was given to 40 patients attending follow up appointments at the Lipid Clinic at Hope Hospital, over an 8 week period. The questions were designed to assess the importance placed by patients on both blood cholesterol levels and diet, and the patients' perceived ability to comply with the lipid lowering diet. Opportunity was given for patients to comment on services offered, and to suggest improvements.Most patients appeared well motivated (although some by fear) and believed that changes in diet are effective, and perceived that they followed the dietary advice ‘quite well’. Many patients thought in terms of ‘good’ and ‘bad’ foods, and ‘sticking to the diet’. This was shown by comments of feeling deprived of favourite foods and being ‘forced’ to eat boring or unpopular foods.Recommendations are made that instead of focusing on motivation or compliance, health professionals should facilitate behaviour change by identifying obstacles to compliance and enabling patients to set their own dietary targets and self‐monitoT their diets.