bluuebunny/crossref_metadata_2025_split huggingface dataset:
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).
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.
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.
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.
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.
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.
The weaning diet of healthy Asian children living in Sheffield. 1. The level and composition of the diet in children from 4 to 40 months of age
Authors: Duggan M. B. , Harbottle L. , Noble C. 
Published: March 2008

A cross sectional study was made of the weighed dietary intake of healthy Asian weanlings aged 4–40 months and living in Sheffield. A weighed 4–(5)‐day dietary inventory was recorded by means of the PETRA recording balance; anthropometric measurements were made, and iron status determined by haematological testing: 194 children were recruited from child‐health clinics, and 120 diet records were reliably completed. Linguistic communication was facilitated by three Asian Link workers.Dietary composition was calculated from a standard food composition programme (Microdiet) with an extended nutrient data base. The mean daily intake of energy, protein and fat, iron and vitamin C was calculated according to age (and sex) grouped into 3‐monthly age brackets from 4 to 24 months and 6‐monthly thereafter. The mean energy intakes were compared with the FAO/WHO/UNU (1985) and Department of Health (1991) reference data; individual energy intakes were also expressed as ratios of the estimated basal metabolic rate (Black et al., 1991).In older age groups, the mean level of energy intake was lower than FAO/WHO/UNU (1985) recommendations but reasonably close to recommendations based on experimental measurements of energy expenditure (Prentice et al., 1988). When energy intake was expressed as a ratio of estimated BMR [Black et al., 1991), the mode lay between BMR+ 1.25 and BMR+ 1.5.The contribution of protein and of fat to the total energy intake was acceptable. At all ages <6 months, the mean intake of iron was lower than the estimated average requirement and below or close to the lower reference nutrient intake [DOH, 1991). The mean intake of vitamin C decreased with increasing age. Milk was a major energy source at all ages and supplied >50% total energy in all age groups <18 months. The observed mean weight and length at each age group suggested that the customary dietary intake had supported reasonable growth.The percentage of dietary energy provided by protein and fat was acceptable at all ages. The observed low intake of dietary iron, largely from non‐haem sources, were associated with a high (34%) prevalence of iron deficiency in these otherwise healthy children (Duggan et al., 1991).
Diabetic foods and the diabetic diet: A British Diabetic Association Discussion Paper
Authors: Thomas B. J. , Thomas B. J. , Brenchley S. , Connor H. , Elkeles R. S. , Govindji A. , Hartland B. V. , Lean M. , Lord K. , Southgate D. A. T. 
Published: March 2008

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

Most diabetic foods provide slightly, but not substantially, less energy than comparable non‐diabetic products.
Many diabetic foods have a higher fat content than their non‐diabetic equivalents. This is contrary to the requirements of the 1984 Food Labelling Regulations.
Many diabetic products have a relatively high content of protein.
In percentage terms, the greatest difference between diabetic and non‐diabetic foods remains that of carbohydrate content, particularly carbohydrate other than fructose or sorbitol. On a per portion basis (for instance per teaspoon of jam) the difference is relatively small and likely to be of minimal practical significance.
Diabetic foods cost between 1.5 and 4 times as much as their non‐diabetic equivalents.
Some ordinary reduced‐sugar/low‐calorie products are preferable to diabetic products in terms of fat and energy content and cost.
The promotion and widespread availability of diabetic foods tend to delude patients into believing that these products are advantageous, or even necessary. Their existence also undermines current dietary teaching by implying that diabetics cannot eat normal foods.
Diabetic foods offer no significant physiological or psychological benefits to diabetic patients and can even be counterproductive to good diabetic control. There is no longer a need for special diabetic foods in the modern dietary management of diabetes.
The role of low fat diets in the management of gall‐bladder disease
Authors: Madden Angela 
Published: March 2008

This paper presents the results obtained from 87 questionnaires completed by dietitians about the dietary management of gall‐biadder disease. Of the patients referred to the dietitians, 86% were referred by surgeons. Of the dietitians that responded 77% thought that there was a role for low fat diets in the management of these patients; 92% would advise a low fat diet to help avoid pain, and 11% would advise a low fat diet to patients with gall‐bladder disease who did not have pain, steatorrhoea or obesity.The paper reviews the available evidence concerning the effect of dietary fat on the gall‐bladder; it is concluded that, at present, there is little data to support the therapeutic use of a low fat diet for individuals with gall‐stones.
Nutritional status in alcoholism
Authors: Wood B. , Nicholls K. M. , Breen K. J. 
Published: March 2008

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

Between May 1988 and April 1990, the nutrient intake of 153 pre‐school children from Edinburgh aged 2–5 years was assessed using the 7‐d weighed inventory method. Fifty‐four children were studied twice at an interval of 12 months. Results for the intake of minerals and vitamins are presented, by age and gender, and related to Dietary Reference Values (DoH, 1991).The mineral and vitamin intake of pre‐school children varied considerably. A minority of children were found to have very low intakes of iron, zinc, vitamin A and vitamin C relative to dietary reference values, and all children had low dietary intakes of vitamin D. Intake of these nutrients was not related to rate of growth. However, strong positive relationships were found for intake of nutrients during the initial and repeat surveys of children studied twice, suggesting that poor nutrient intakes persist.