WorldWideScience

Sample records for current dietary guidelines

  1. Dietary guidelines

    DEFF Research Database (Denmark)

    Jelsøe, Erling

    2015-01-01

    Dietary guidelines are issued regularly in most developed countries. In almost all cases they are concerned solely with the nutritional aspects of food and eating and are based on an understanding of food exclusively as a source of nutrients. In recent years, however, a growing number of proposals...... in a number of countries have addressed the issue of making dietary guidelines that integrate health and sustainability, but in all cases they have been met with different kinds of resistance. This article reviews the development towards an integrated understanding of health and sustainability in relation...... and the role of expert cultures for the elaboration and communication of messages about health and sustainability. Finally, the article briefly points to some answers to the complexity of issues surrounding the creation of dietary guidelines...

  2. Health Risk Assessment of Dietary Cadmium Intake: Do Current Guidelines Indicate How Much is Safe?

    Science.gov (United States)

    Satarug, Soisungwan; Vesey, David A.; Gobe, Glenda C.

    2017-01-01

    Background: Cadmium (Cd), a food-chain contaminant, is a significant health hazard. The kidney is one of the primary sites of injury after chronic Cd exposure. Kidney-based risk assessment establishes the urinary Cd threshold at 5.24 μg/g creatinine, and tolerable dietary intake of Cd at 62 μg/day per 70-kg person. However, cohort studies show that dietary Cd intake below a threshold limit and that tolerable levels may increase the risk of death from cancer, cardiovascular disease, and Alzheimer’s disease. Objective: We evaluated if the current tolerable dietary Cd intake guideline and urinary Cd threshold limit provide sufficient health protection. Discussion: Staple foods constitute 40–60% of total dietary Cd intake by average consumers. Diets high in shellfish, crustaceans, mollusks, spinach, and offal add to dietary Cd sources. Modeling studies predict the current tolerable dietary intake corresponding to urinary Cd of 0.70–1.85 μg/g creatinine in men and 0.95–3.07 μg/g creatinine in women. Urinary Cd levels of protection from this pervasive toxic metal. Citation: Satarug S, Vesey DA, Gobe GC. 2017. Health risk assessment of dietary cadmium intake: do current guidelines indicate how much is safe? Environ Health Perspect 125:284–288; http://dx.doi.org/10.1289/EHP108 PMID:28248635

  3. The mean dietary protein intake at different stages of chronic kidney disease is higher than current guidelines.

    Science.gov (United States)

    Moore, Linda W; Byham-Gray, Laura D; Scott Parrott, J; Rigassio-Radler, Diane; Mandayam, Sreedhar; Jones, Stephen L; Mitch, William E; Osama Gaber, A

    2013-04-01

    The actual dietary protein intake of adults without and with different stages of chronic kidney disease is not known. To evaluate this we performed cross-sectional analyses of 16,872 adults (20 years of age and older) participating in the National Health and Nutrition Examination Survey 2001-2008 who completed a dietary interview by stage of kidney disease. Dietary protein intake was assessed from 24-h recall systematically collected using the Automated Multiple Pass Method. Complex survey analyses were used to derive population estimates of dietary protein intake at each stage of chronic kidney disease. Using dietary protein intake of adults without chronic kidney disease as the comparator, and after adjusting for age, the mean dietary protein intake was 1.30 g/kg ideal body weight/day (g/kgIBW/d) and was not different from stage 1 or stage 2 (1.28 and 1.25 g/kgIBW/d, respectively), but was significantly different in stage 3 and stage 4 (1.22 and 1.13 g/kgIBW/d, respectively). These mean values appear to be above the Institute of Medicine requirements for healthy adults and the NKF-KDOQI guidelines for stages 3 and 4 chronic kidney disease. Thus, the mean dietary protein intake is higher than current guidelines, even after adjusting for age.

  4. Revised dietary guidelines for Koreans.

    Science.gov (United States)

    Jang, Young Ai; Lee, Haeng Shin; Kim, Bok Hee; Lee, Yoonna; Lee, Hae Jeung; Moon, Jae Jin; Kim, Cho-il

    2008-01-01

    With rapidly changing dietary environment, dietary guidelines for Koreans were revised and relevant action guides were developed. First, the Dietary Guidelines Advisory Committee was established with experts and government officials from the fields of nutrition, preventive medicine, health promotion, agriculture, education and environment. The Committee set dietary goals for Koreans aiming for a better nutrition state of all after a thorough review and analysis of recent information related to nutritional status and/or problems of Korean population, changes in food production/supply, disease pattern, health policy and agricultural policy. Then, the revised dietary guidelines were proposed to accomplish these goals in addition to 6 different sets of dietary action guides to accommodate specific nutrition and health problems of respective age groups. Subsequently, these guidelines and guides were subjected to the focus group review, consumer perception surveys, and a public hearing for general and professional comments. Lastly, the language was clarified in terms of public understanding and phraseology. The revised Dietary guidelines for Koreans are as follows: eat a variety of grains, vegetables, fruits, fish, meat, poultry and dairy products; choose salt-preserved foods less, and use less salt when you prepare foods; increase physical activity for a healthy weight, and balance what you eat with your activity; enjoy every meal, and do not skip breakfast; if you drink alcoholic beverages, do so in moderation; prepare foods properly, and order sensible amounts; enjoy our rice-based diet.

  5. Dietary Guidelines should reflect new understandings about adult protein needs

    Directory of Open Access Journals (Sweden)

    Layman Donald K

    2009-03-01

    Full Text Available Abstract Dietary Guidelines for Americans provide nutrition advice aimed at promoting healthy dietary choices for life-long health and reducing risk of chronic diseases. With the advancing age of the population, the 2010 Dietary Guidelines confront increasing risks for age-related problems of obesity, osteoporosis, type 2 diabetes, Metabolic Syndrome, heart disease, and sarcopenia. New research demonstrates that the meal distribution and amount of protein are important in maintaining body composition, bone health and glucose homeostasis. This editorial reviews the benefits of dietary protein for adult health, addresses omissions in current nutrition guidelines, and offers concepts for improving the Dietary Guidelines.

  6. What's a Pregnant Woman to Eat? A Review of Current USDA Dietary Guidelines and MyPyramid

    OpenAIRE

    2006-01-01

    The purpose of this article is to clarify the nutritional recommendations for pregnant women in light of the new Food Guide Pyramid, known as “MyPyramid,” along with the Dietary Guidelines for Americans 2005 and recommendations by the Institute of Medicine. The differences between the Food Guide Pyramid (introduced in 1992) and the more recent, color-coded MyPyramid (introduced in 2005) are discussed. A list of nutritional recommendations for pregnant women is presented, which may serve as a ...

  7. Climate friendly dietary guidelines

    DEFF Research Database (Denmark)

    Trolle, Ellen; Mogensen, Lisbeth; Thorsen, Anne Vibeke

    2014-01-01

    The aim of this study was to investigate how the present Danish diet could be changed in a climate friendly direction that follows the recommendations of a healthy diet. The carbon footprint (CF) of an average Danish diet was calculated and compared to CF of a recommended healthy diet by 1......%, if the healthy diet was eaten instead of the average current diet. However, if the diet was climate optimized by choosing foods with a low CF within the food groups; meat, vegetables and fruit, CF of this diet may be reduced by 23 % compared to CF of the average diet....

  8. The Dietary Guidelines For Americans 2005: Executive Summary

    Science.gov (United States)

    Health Educator, 2005

    2005-01-01

    The Dietary Guidelines for Americans [Dietary Guidelines] provides science-based advice to promote health and to reduce risk for major chronic diseases through diet and physical activity. Major causes of morbidity and mortality in the United States are related to poor diet and a sedentary lifestyle. Some specific diseases linked to poor diet and…

  9. The 2015 Dutch food-based dietary guidelines

    NARCIS (Netherlands)

    Kromhout, D.; Spaaij, C.J.K.; Goede, de J.; Weggemans, R.M.; Brug, Johannes; Geleijnse, Johanna M.; Goudoever, van Johannes B.; Hoes, Arno W.; Hopman, Maria T.E.; Iestra, Jolein A.; Mensink, Ronald P.; Pijl, Hanno; Romijn, Johannes A.; Schols, Annemie M.W.J.; Seidell, Jaap C.; Veer, van 't Pieter; Visser, Marjolein; Zwietering, Marcel H.

    2016-01-01

    The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and f

  10. The 2015 Dutch food-based dietary guidelines

    NARCIS (Netherlands)

    Kromhout, D; Spaaij, C J K; de Goede, J; Weggemans, R M; Iestra, JA; Hoes, Arno W.

    2016-01-01

    The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food

  11. Are Malaysian Children Achieving Dietary Guideline Recommendations?

    Science.gov (United States)

    Koo, Hui Chin; Poh, Bee Koon; Lee, Shoo Thien; Chong, Kar Hau; Bragt, Marjolijn C E; Abd Talib, Ruzita

    2016-07-01

    A large body of epidemiological data has demonstrated that diet quality follows a sociodemographic gradient. Little is known, however, about food group intake patterns among Malaysian children. This study aimed to assess consumption pattern of 7 food groups, including cereals/grains, legumes, fruits, vegetables, fish, meat/poultry, and milk/dairy products, among children 7 to 12 years of age. A total of 1773 children who participated in SEANUTS Malaysia and who completed the Food Frequency Questionnaire were included in this study. A greater proportion of children aged 10 to 12 years have an inadequate intake of cereals/grains, meat/poultry, legumes, and milk/dairy products compared with children 7 to 9 years old. With the exception of meat/poultry, food consumption of Malaysian children did not meet Malaysian Dietary Guidelines recommendations for the other 6 food groups, irrespective of sociodemographic backgrounds. Efforts are needed to promote healthy and balanced dietary habits, particularly for foods that fall short of recommended intake level.

  12. Current Cervical Carcinoma Screening Guidelines

    Directory of Open Access Journals (Sweden)

    Megan J. Schlichte

    2015-05-01

    Full Text Available A formidable threat to the health of women, cervical carcinoma can be prevented in many cases with adequate screening. The current guidelines for cervical carcinoma screening were created as joint recommendations of the American Cancer Society (ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP and the American Society for Clinical Pathology (ASCP in 2012, and later accepted and promoted by the American Congress of Obstetricians and Gynecologists (ACOG. The 2012 recommendations underscore the utility of molecular testing as an adjunct to cytology screening for certain women and provide guidance to clinicians based on different risk-benefit considerations for different ages. This manuscript will review screening techniques and current recommendations for cervical cancer screening and human papilloma virus (HPV testing, as well as possible future screening strategies.

  13. Dietary guideline adherence for gastroesophageal reflux disease

    Science.gov (United States)

    2014-01-01

    Background Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Recently described side effects of long-term acid suppression have increased the interest in nonpharmacologic methods for alleviating GERD symptoms. We aimed to examine whether GERD patients follow recommended dietary guidelines, and if adherence is associated with the severity and frequency of reflux symptoms. Methods We conducted a population-based cross-sectional study within the Kaiser Permanente Northern California population, comparing 317 GERD patients to 182 asymptomatic population controls. All analyses adjusted for smoking and education. Results GERD patients, even those with moderate to severe symptoms or frequent symptoms, were as likely to consume tomato products and large portion meals as GERD-free controls and were even more likely to consume soft drinks and tea [odds ratio (OR) = 2.01 95% confidence interval (CI) 1.12-3.61; OR = 2.63 95% CI 1.24-5.59, respectively] and eat fried foods and high fat diet. The only reflux-triggering foods GERD patients were less likely to consume were citrus and alcohol [OR = 0.59; 95% CI: 0.35-0.97 for citrus; OR = 0.41 95% CI 0.19-0.87 for 1 + drink/day of alcohol]. The associations were similar when we excluded users of proton pump inhibitors. Conclusions GERD patients consume many putative GERD causing foods as frequently or even more frequently than asymptomatic patients despite reporting symptoms. These findings suggest that, if dietary modification is effective in reducing GERD, substantial opportunities for nonpharmacologic interventions exist for many GERD patients. PMID:25125219

  14. Nutritional policies and dietary guidelines in Japan.

    Science.gov (United States)

    Nakamura, Teiji

    2011-01-01

    The national government settled on "Healthy Japan 21" as the premier preventive policy of lifestyle related diseases in 2000. In 2005, the effectiveness of the campaign was conducted, but the results did not turn out as expected. The Ministry of Health, Labor and Welfare made the "Japanese Food Guide Spinning Top (JFG-ST)" as a practical and easy way to improve eating habits for all of the people. The JFG-ST falls down when the balance of the diets worsens and expresses a stable thing in what a turn (exercise) does. Eyes down quantity to take out of each group per day is shown in the basic form by the 5 distinction from grain dishes, vegetable dishes, fish and meat dishes, milk, and fruits. In 2005, the Basic Law on Dietary Education was enacted to promote the dietary education about the importance of eating proper meals in order to solve problems such as inappropriate eating habits and nutrition intake, disturbances in diets, increases in lifestyle-related diseases, a fall in the rate of food self-sufficiency and so forth. The Ministry of Education and Science started a program to train people to become "diet and nutrition teacher" in primary school. JFG- ST is developed in a dietary education campaign as a standard method of the dietary education. In May, 2011, the government has announced the second dietary education promotional basic plan to assume five years.

  15. Food, plant food, and vegetarian diets in the US dietary guidelines: conclusions of an expert panel.

    Science.gov (United States)

    Jacobs, David R; Haddad, Ella H; Lanou, Amy Joy; Messina, Mark J

    2009-05-01

    We summarize conclusions drawn from a panel discussion at the "Fifth International Congress on Vegetarian Nutrition" about the roles of and emphasis on food, plant food, and vegetarianism in current and future US dietary guidelines. The most general recommendation of the panel was that future dietary guidelines, following the lead of the 2005 Dietary Guidelines Advisory Committee, should emphasize food-based recommendations and thinking to the full extent that evidence allows. Although nutrient-based thinking and Dietary Reference Intakes (DRIs) may help ensure an adequate diet in the sense that deficiency states are avoided, the emphasis on DRIs may not capture many important nutritional issues and may inhibit a focus on foods. More generally, in the context of the conference on vegetarian nutrition, this report focuses on the history and structure of the Dietary Guidelines Advisory Committee, on various plant food-oriented recommendations that are supported by literature evidence, and on mechanisms for participating in the process of forming dietary guidelines. Among recommendations that likely would improve health and the environment, some are oriented toward increased plant food consumption and some toward vegetarianism. The literature on health effects of individual foods and whole lifestyle diets is insufficient and justifies a call for future food-oriented research, including expanding the evidence base for plant-based and vegetarian diets. The Dietary Guidelines Advisory Committee's role should be carried forward to creation of a publicly accessible icon (eg, the current pyramid) and related materials to ensure that the science base is fully translated for the public.

  16. Food-Based Dietary Guidelines for the Arab Gulf Countries

    Directory of Open Access Journals (Sweden)

    Abdulrahman O. Musaiger

    2012-01-01

    Full Text Available The concept of food-based dietary guidelines (FBDG has been promoted by several international organizations. However, there are no FBDG for the countries in the Arab region. As the Arab Gulf countries share similar a socioeconomic and nutrition situation, an attempt was made to develop FBDG for these countries. This paper summarizes the steps taken to develope such guidelines by the Arab Center for Nutrition. The FBDG were developed through 6 steps: (1 determination of the purpose and goals for establishing FBDG, (2 characteristics of FBDG, (3 determination of the food consumption patterns, (4 review the current nutrition situation, (5 determination of the lifestyle patterns that are associated with diet-related diseases and (6 formulating the FBDG. The FBDG consist of 14 simple and practical pieces of advice taking into consideration the sociocultural status and nutritional problems in the Arab Gulf countries. The FBDG can be a useful tool in educating the public in healthy eating and prevention of diet-related chronic diseases.

  17. Consumer involvement in dietary guideline development: opinions from European stakeholders.

    Science.gov (United States)

    Brown, Kerry A; Hermoso, Maria; Timotijevic, Lada; Barnett, Julie; Lillegaard, Inger Therese L; Řehůřková, Irena; Larrañaga, Ainhoa; Lončarević-Srmić, Azra; Andersen, Lene Frost; Ruprich, Jiří; Fernández-Celemín, Laura; Raats, Monique M

    2013-05-01

    The involvement of consumers in the development of dietary guidelines has been promoted by national and international bodies. Yet, few best practice guidelines have been established to assist with such involvement. Qualitative semi-structured interviews explored stakeholders' beliefs about consumer involvement in dietary guideline development. Interviews were conducted in six European countries: the Czech Republic, Germany, Norway, Serbia, Spain and the UK. Seventy-seven stakeholders were interviewed. Stakeholders were grouped as government, scientific advisory body, professional and academic, industry or non-government organisations. Response rate ranged from 45 % to 95 %. Thematic analysis was conducted with the assistance of NVivo qualitative software. Analysis identified two main themes: (i) type of consumer involvement and (ii) pros and cons of consumer involvement. Direct consumer involvement (e.g. consumer organisations) in the decision-making process was discussed as a facilitator to guideline communication towards the end of the process. Indirect consumer involvement (e.g. consumer research data) was considered at both the beginning and the end of the process. Cons to consumer involvement included the effect of vested interests on objectivity; consumer disinterest; and complications in terms of time, finance and technical understanding. Pros related to increased credibility and trust in the process. Stakeholders acknowledged benefits to consumer involvement during the development of dietary guidelines, but remained unclear on the advantage of direct contributions to the scientific content of guidelines. In the absence of established best practice, clarity on the type and reasons for consumer involvement would benefit all actors.

  18. a food-based dietary guideline for South Africa

    African Journals Online (AJOL)

    2013-04-11

    Apr 11, 2013 ... fatty acids for health and disease, revision of the previous food-based dietary guideline (FBDG), “Eat fat ...... of MUFAs has potential benefits on the blood lipid profile ..... (sweets containing fat, e.g. chocolates and toffees).

  19. Sugar and health: a food-based dietary guideline for South Africa

    African Journals Online (AJOL)

    2013-04-12

    Apr 12, 2013 ... Food-Based Dietary Guidelines for South Africa: Sugar and health: a food-based dietary guidelines for South .... information came from the Cardiovascular Risk Study in ... Africa because of factors such as age, gender, socio-.

  20. Improved dietary guidelines for vitamin D

    DEFF Research Database (Denmark)

    Cashman, Kevin D; Ritz, Christian; Kiely, Mairead

    2017-01-01

    )D concentrations >25, 30, and 50 nmol/L across the population are 10, 13, and 26 µg/day, respectively. In contrast, standard meta-regression analyses with aggregate data (as used by several agencies in recent years) from the same RCTs estimated that a vitamin D intake requirement of 14 µg/day would maintain 97......Dietary Reference Values (DRVs) for vitamin D have a key role in the prevention of vitamin D deficiency. However, despite adopting similar risk assessment protocols, estimates from authoritative agencies over the last 6 years have been diverse. This may have arisen from diverse approaches to data......-regression, which is increasingly recognized as best practice, from seven winter-based RCTs (with 882 participants ranging in age from 4 to 90 years) of the vitamin D intake-serum 25-hydroxyvitamin D (25(OH)D) dose-response. Our IPD-derived estimates of vitamin D intakes required to maintain 97.5% of 25(OH...

  1. Foods, Nutrients, and Dietary Patterns: Interconnections and Implications for Dietary Guidelines.

    Science.gov (United States)

    Tapsell, Linda C; Neale, Elizabeth P; Satija, Ambika; Hu, Frank B

    2016-05-01

    Dietary guidelines provide evidence-based statements on food choices to meet nutritional requirements and reduce the risk of prevailing chronic disease. They involve a substantial amount of research translation, and their implementation has important health consequences. Foods, however, are complex combinations of nutrients and other compounds that act synergistically within the food and across food combinations. In addition, the evidence base underpinning dietary guidelines accesses research that reflects different study designs, with inherent strengths and limitations. We propose a systematic approach for the review of evidence that begins with research on dietary patterns. This research will identify the combinations of foods that best protect, or appear deleterious to, health. Next, we suggest that evidence be sought from research that focuses on the effects of individual foods. Finally, nutrient-based research should be considered to explain the mechanisms by which these foods and dietary patterns exert their effects, take into account the effects of ingredients added to the food supply, and enable assessments of dietary sufficiency. The consideration of individual nutrients and food components (e.g., upper limits for saturated fat, added sugar, and sodium) provides important benchmarks for evaluating overall diet quality. The concepts of core and discretionary foods (nutrient-rich and nutrient-poor foods, respectively) enable distinctions between foods, and this has implications for the relation between food policy and food manufacturing. In summary, evidence supporting healthy dietary patterns provides the foundation for the development of dietary guidelines. Further reference to individual foods and nutrients follows from the foundation of healthy dietary patterns.

  2. In the face of contradictory evidence: report of the Dietary Guidelines for Americans Committee.

    Science.gov (United States)

    Hite, Adele H; Feinman, Richard David; Guzman, Gabriel E; Satin, Morton; Schoenfeld, Pamela A; Wood, Richard J

    2010-10-01

    Concerns that were raised with the first dietary recommendations 30 y ago have yet to be adequately addressed. The initial Dietary Goals for Americans (1977) proposed increases in carbohydrate intake and decreases in fat, saturated fat, cholesterol, and salt consumption that are carried further in the 2010 Dietary Guidelines Advisory Committee (DGAC) Report. Important aspects of these recommendations remain unproven, yet a dietary shift in this direction has already taken place even as overweight/obesity and diabetes have increased. Although appealing to an evidence-based methodology, the DGAC Report demonstrates several critical weaknesses, including use of an incomplete body of relevant science; inaccurately representing, interpreting, or summarizing the literature; and drawing conclusions and/or making recommendations that do not reflect the limitations or controversies in the science. An objective assessment of evidence in the DGAC Report does not suggest a conclusive proscription against low-carbohydrate diets. The DGAC Report does not provide sufficient evidence to conclude that increases in whole grain and fiber and decreases in dietary saturated fat, salt, and animal protein will lead to positive health outcomes. Lack of supporting evidence limits the value of the proposed recommendations as guidance for consumers or as the basis for public health policy. It is time to reexamine how US dietary guidelines are created and ask whether the current process is still appropriate for our needs.

  3. Awareness of Dietary and Alcohol Guidelines Among Colorectal Cancer Survivors.

    Science.gov (United States)

    Hawkins, Nikki A; Berkowitz, Zahava; Rodriguez, Juan L

    2015-12-01

    Although dietary habits can affect colorectal cancer (CRC) survivors' health, it is unclear how familiar survivors are with dietary guidelines, what they believe about healthy eating and alcohol consumption, and what hinders healthy dietary habits after cancer. This study assessed CRC survivors' familiarity with dietary guidelines, their eating and drinking habits, and perceived facilitators and barriers to healthy eating after cancer, including social support and self-efficacy for maintaining a healthy diet and limiting alcohol. A total of 593 individuals (50% female; mean age, 74 years) diagnosed with CRC approximately 6 years prior to study entry in early 2010 were identified through California Cancer Registry records and participated in a cross-sectional mailed survey assessing health behavior after cancer (46% adjusted response rate). Analyses were conducted in 2014-2015. Survivors were most familiar with-and most likely to follow-recommendations to choose low-fat foods; 15% had never heard of recommendations to limit alcohol. Survivors were more aware of recommendations involving messages to limit/avoid versus approach/choose certain foods. The most common barrier to a healthy diet involved the effort required (26%). Survivors received more family/friend support and provider recommendations for healthy eating than limiting alcohol. Results provide an overview of awareness of and adherence to dietary recommendations among CRC survivors, highlighting the need for increasing awareness of recommendations that are especially relevant for survivors. Suggestions are made for modifying diet-related messages to facilitate comprehension and recall among CRC survivors, and increasing awareness among groups with the lowest awareness levels. Published by Elsevier Inc.

  4. Invisalign: current guidelines for effective treatment.

    Science.gov (United States)

    Kuncio, Daniel A

    2014-03-01

    Invisalign is an increasingly popular technique for aligning teeth and correcting malocclusions orthodontically. This article analyzes the current professional literature published on Invisalign and the benefits and risks of using the technique for both patients and doctors. The steady increase in the number of cases treated with Invisalign and where the technique is going in the future is investigated. Ten guidelines for Invisalign treatment and patient selection are given, along with case examples.

  5. Correlation between Intake of Dietary Fiber and Adherence to the Korean National Dietary Guidelines in Adolescents from Jeonju

    Science.gov (United States)

    Park, Sunmi; Na, Woori; Kim, Misung; Kim, Eunsoo; Sohn, Cheongmin

    2012-01-01

    This study surveyed dietary intake and adherence to the Korean national dietary guidelines in Korean adolescents. To elucidate basic data for use in nutrition education, which aims to improve adolescent compliance with the national dietary guidelines and to increase the intake of dietary fiber, we evaluated the sources of fiber in adolescent diets. This study included 182 male and 212 female students from 2 middle schools in the Jeonju province. From November 15~20, 2011, we surveyed the students for general characteristics, adherence to the Korean national dietary guidelines, and dietary intake. Dietary fiber intake was 16.57 ± 6.95 g/day for male students and 16.14 ± 7.11 g/day for female students. The food groups that contributed most to dietary fiber intake were (in descending order) cereals, vegetables, seasoning, and fruits. The fiber-containing food items consumed most were cabbage- kimchi, cooked rice, instant noodles, and cabbage. Based on adherence to the Korean national dietary guidelines, the vegetable-based intake of dietary fiber in groups 1 (score 15~45), 2 (score 46~52), and 3 (score 53~75) were 4.41 ± 2.595 g/day, 4.12 ± 2.692 g/day, and 5.49 ± 3.157 g/day, respectively (pdietary fiber varied significantly among the three groups (pdietary guidelines correlates with improved intake of dietary fiber. Therefore, marketing and educational development is needed to promote adherence to the Korean national dietary guidelines. In addition, nutritional education is needed to improve dietary fiber consumption through the intake of vegetables and fruits other than kimchi. PMID:24471093

  6. Guidelines for dietary management of menopausal women with simple obesity.

    Science.gov (United States)

    Brończyk-Puzoń, Anna; Piecha, Dariusz; Nowak, Justyna; Koszowska, Aneta; Kulik-Kupka, Karolina; Dittfeld, Anna; Zubelewicz-Szkodzińska, Barbara

    2015-03-01

    The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient's needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.

  7. Guidelines for dietary management of menopausal women with simple obesity

    Directory of Open Access Journals (Sweden)

    Anna Brończyk-Puzoń

    2015-01-01

    Full Text Available The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman’s life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient’s needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska. For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.

  8. Federal communication about obesity in the Dietary Guidelines and checkoff programs.

    Science.gov (United States)

    Wilde, Parke E

    2006-06-01

    The new Dietary Guidelines for Americans focus on obesity prevention. They recommend increased consumption of whole grains, fruits, vegetables, fish, and low-fat dairy products, within a balanced diet whose total calories have been moderately reduced. Meanwhile, other well-known and well-funded federally sponsored consumer communications promote increased total consumption of beef, pork, and dairy products, including energy dense foods such as bacon cheeseburgers, barbecue pork ribs, pizza, and butter. These latter communications are sponsored by the federal government's commodity promotion programs, known as "checkoff" programs. The programs are established by Congress, approved by a majority of the commodity's producers, managed jointly by a producer board and the U.S. Department of Agriculture, and funded through a tax on the producers. The federal government enforces the collection of more than 600 million US dollars annually in mandatory assessments, approves the advertising and marketing programs, and defends checkoff communication in court as the federal government's own message-in legal jargon, as its own "government speech." Federal support for promoting fruits and vegetables is small by comparison. The checkoff programs recently have become more clearly identified as federal programs. After a recent decision by the U.S. Supreme Court upholding the constitutionality of the checkoff programs, calls for consistency with the Dietary Guidelines may get louder. The current inconsistencies in federal communication undermine the effectiveness of the Dietary Guidelines as an antidote to the shortcomings of the private sector market for information about weight and obesity.

  9. Are the dietary guidelines for meat, fat, fruit and vegetable consumption appropriate for environmental sustainability? A review of the literature.

    Science.gov (United States)

    Reynolds, Christian John; Buckley, Jonathan David; Weinstein, Philip; Boland, John

    2014-06-12

    This paper reviews the current literature around the environmental impacts of dietary recommendations. The focus of the review is on collating evidence relating to environmental impacts of the dietary advice found in the World Health Organisation guidelines, and environmental impact literature: reducing the consumption of fat, reducing the consumption of meat-based protein and animal-based foods, and increasing the consumption of fruit and vegetables. The environmental impact of reducing dietary fat intake is unclear, although reducing consumption of the food category of edible fats and oils appears to have little impact. However most, but not all, studies support environmental benefits of a reduced consumption of animal-based foods and increased consumption of fruit and vegetables. In general, it appears that adhering to dietary guidelines reduces impact on the environment, but further study is required to examine the environmental impacts of animal-based foods, and fruit and vegetable intake in depth.

  10. Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines

    DEFF Research Database (Denmark)

    Scarborough, Peter; Kaur, Asha; Cobiac, Linda

    2016-01-01

    Objectives To model food group consumption and price of diet associated with achieving UK dietary recommendations while deviating as little as possible from the current UK diet, in order to support the redevelopment of the UK food-based dietary guidelines (now called the Eatwell Guide). Design...... Optimisation modelling, minimising an objective function of the difference between population mean modelled and current consumption of 125 food groups, and constraints of nutrient and food-based recommendations. Setting The UK. Population Adults aged 19 years and above from the National Diet and Nutrition...... Survey 2008–2011. Main outcome measures Proportion of diet consisting of major foods groups and price of the optimised diet. Results The optimised diet has an increase in consumption of ‘potatoes, bread, rice, pasta and other starchy carbohydrates’ (+69%) and ‘fruit and vegetables’ (+54%) and reductions...

  11. Evaluation of dietary intake in Danish adults by means of an index based on food-based dietary guidelines

    DEFF Research Database (Denmark)

    Knudsen, Vibeke K; Fagt, Sisse; Trolle, Ellen

    2012-01-01

    The diet quality index is a useful tool in assessing food and nutrient intake in individuals with high vs. low degree of compliance towards the dietary guidelines, and provides a valuable tool in future studies investigating variations in dietary intakes with respect to lifestyle, demographic...

  12. Evaluating the effects of the Dietary Guidelines for Americans on consumer behavior and health: methodological challenges.

    Science.gov (United States)

    Guthrie, Joanne F; Smallwood, David M

    2003-12-01

    The Dietary Guidelines for Americans is the official nutrition policy statement for the United States. Government involvement in providing information on private behavior, such as food choice, is justified by the high cost of poor diets, as measured in medical expenses and lost productivity. The Guidelines are intended to provide an up-to-date, consistent information base for federal nutrition education and information efforts and food assistance program regulations. Through these policy mechanisms, the Guidelines are assumed to improve dietary behavior, and, ultimately, health. By law, the Dietary Guidelines for Americans must be updated every five years; however, there is no mandate for evaluation. Evaluation could provide useful information to assess the extent to which the Guidelines positively influence health and provide insights into reasons for their successes and limitations. However, evaluation would also present considerable challenges. This paper discusses the critical data and methodological needs for improving evaluation of the Dietary Guidelines for Americans.

  13. Validation of the MEDFICTS dietary questionnaire: A clinical tool to assess adherence to American Heart Association dietary fat intake guidelines

    Directory of Open Access Journals (Sweden)

    Bindeman Jody

    2003-06-01

    Full Text Available Abstract Background Dietary assessment tools are often too long, difficult to quantify, expensive to process, and largely used for research purposes. A rapid and accurate assessment of dietary fat intake is critically important in clinical decision-making regarding dietary advice for coronary risk reduction. We assessed the validity of the MEDFICTS (MF questionnaire, a brief instrument developed to assess fat intake according to the American Heart Association (AHA dietary "steps". Methods We surveyed 164 active-duty US Army personnel without known coronary artery disease at their intake interview for a primary prevention cardiac intervention trial using the Block food frequency (FFQ and MF questionnaires. Both surveys were completed on the same intake visit and independently scored. Correlations between each tools' assessment of fat intake, the agreement in AHA step categorization of dietary quality with each tool, and the test characteristics of the MF using the FFQ as the gold standard were assessed. Results Subjects consumed a mean of 36.0 ± 13.0% of their total calories as fat, which included saturated fat consumption of 13.0 ± 0.4%. The majority of subjects (125/164; 76.2% had a high fat (worse than AHA Step 1 diet. There were significant correlations between the MF and the FFQ for the intake of total fat (r = 0.52, P 70 [high fat diet] was negligible (kappa statistic = 0.036. The MF was accurate at the extremes of fat intake, but could not reliably identify the 3 AHA dietary classifications. Alternative MF cutpoints of 50 (high fat diet were highly sensitive (96%, but had low specificity (46% for a high fat diet. ROC curve analysis identified that a MF score cutoff of 38 provided optimal sensitivity 75% and specificity 72%, and had modest agreement (kappa = 0.39, P Conclusions The MEDFICTS questionnaire is most suitable as a tool to identify high fat diets, rather than discriminate AHA Step 1 and Step 2 diets. Currently recommended

  14. Correlation between Intake of Dietary Fiber and Adherence to the Korean National Dietary Guidelines in Adolescents from Jeonju.

    Science.gov (United States)

    Park, Sunmi; Na, Woori; Kim, Misung; Kim, Eunsoo; Sohn, Cheongmin

    2012-12-01

    This study surveyed dietary intake and adherence to the Korean national dietary guidelines in Korean adolescents. To elucidate basic data for use in nutrition education, which aims to improve adolescent compliance with the national dietary guidelines and to increase the intake of dietary fiber, we evaluated the sources of fiber in adolescent diets. This study included 182 male and 212 female students from 2 middle schools in the Jeonju province. From November 15~20, 2011, we surveyed the students for general characteristics, adherence to the Korean national dietary guidelines, and dietary intake. Dietary fiber intake was 16.57 ± 6.95 g/day for male students and 16.14 ± 7.11 g/day for female students. The food groups that contributed most to dietary fiber intake were (in descending order) cereals, vegetables, seasoning, and fruits. The fiber-containing food items consumed most were cabbage- kimchi, cooked rice, instant noodles, and cabbage. Based on adherence to the Korean national dietary guidelines, the vegetable-based intake of dietary fiber in groups 1 (score 15~45), 2 (score 46~52), and 3 (score 53~75) were 4.41 ± 2.595 g/day, 4.12 ± 2.692 g/day, and 5.49 ± 3.157 g/day, respectively (p<0.001). In addition, the total intake of dietary fiber varied significantly among the three groups (p<0.001) as follows: Group 1, 14.99 ± 6.374 g/day; Group 2, 15.32 ± 6.772 g/day; and Group 3, 18.79 ± 7.361 g/day. In this study, we discovered that adherence to the Korean national dietary guidelines correlates with improved intake of dietary fiber. Therefore, marketing and educational development is needed to promote adherence to the Korean national dietary guidelines. In addition, nutritional education is needed to improve dietary fiber consumption through the intake of vegetables and fruits other than kimchi.

  15. Orthopaedic thromboprophylaxis: limitations of current guidelines

    DEFF Research Database (Denmark)

    Warwick, D.; Dahl, O.E.; Fisher, W.D.

    2008-01-01

    research into 'evidence-based' advice. Guidelines should, in theory, benefit patient care by ensuring that every patient routinely receives the best prophylaxis; without guidelines, it is argued, patients may fail to receive treatment or be exposed to protocols which are ineffective, dangerous or expensive...

  16. Adherence to dietary guidelines and cardiovascular disease risk in the EPIC-NL cohort

    NARCIS (Netherlands)

    Struijk, E.A.; May, A.M.; Wezenbeek, N.L.W.J.; Fransen, H.; Soedamah-Muthu, S.S.; Geelen, A.; Boer, J.; Schouw, van der Y.T.; Bueno de Mesquita, H.B.; Beulens, J.W.J.

    2014-01-01

    Background Global and national dietary guidelines have been created to lower chronic disease risk. The aim of this study was to assess whether greater adherence to the WHO guidelines (Healthy Diet Indicator (HDI)); the Dutch guidelines for a healthy diet (Dutch Healthy Diet-index (DHD-index)); and t

  17. Food Intakes by Preschool Children in Flanders Compared with Dietary Guidelines

    Directory of Open Access Journals (Sweden)

    Inge Huybrechts

    2008-12-01

    Full Text Available The objective of this study was to compare food group intakes among preschool children with food-based dietary guidelines (FBDG and to determine the proportion of children meeting these guidelines. Food consumption of preschool children (2.5-6.5 years living in Flanders (Belgium were assessed in a cross-sectional study, using proxy reported 3d estimated dietary records (EDR (n 696. Statistical modelling was used to account for within-individual variation in the 3d EDR. Mean daily intakes of most food groups (beverages, vegetables, fruit and milk were below the minimum recommendations. Only ‘grains and potatoes’ and ‘meat products’ were in line with the recommendations and ‘bread and cereals’ showed borderline intakes. Mean intakes of energy-dense and low-nutritious foods, which are discouraged within a healthy diet (like snacks and sugared drinks, were high. Furthermore, the percentage of children complying with the different food-based dietary guidelines was for most food groups extremely low (ranging from approximately 4% for fluid and vegetable intakes up to 99% for potato intakes. Boys had in general higher mean intakes of the recommended food groups. In conclusion, preschool children in Flanders follow eating patterns that do not meet Flemish FBDG. Although the impact of these eating habits on preschooler’s current and future health should be further investigated, it is clear that nutrition education and intervention are needed among preschool children and their parents in Flanders.

  18. Standard guidelines for electrosurgery with radiofrequency current

    Directory of Open Access Journals (Sweden)

    Mutalik Sharad

    2009-08-01

    Full Text Available Definition: Radiofrequency (RF induces thermal destruction of the targeted tissue by an electrical current at a frequency of 0.5 MHz (RF. As the electrode tip is not heated, there is minimal thermal damage to the surrounding tissues, producing good esthetic results. Therefore, RF ablation is also known as cold ablation or "coblation." Modality: It has three modes of operation: (a Cut, (b cut and coagulate and (c coagulate. Therefore, it can be used for various purposes like incision, ablation, fulguration, shave excision and coagulation. Because of the coagulation facility, hemostasis can be achieved and operation becomes easier and faster. Indications: It is effective in treating various skin conditions like dermatosis papulosa nigra, warts, molluscum contagiosum, colloid milia, acquired junctional, compound and dermal melanocytic nevi, seborrheic keratosis, skin tags, granuloma pyogenicum, verrucous epidermal nevi, xanthelesma, rhinophyma, superficial basal cell carcinoma and telangiectasia. It can also be used for cosmetic indications such as resurfacing, earlobe repair and blepharoplasty. Anesthesia: The procedure is accomplished either under topical anesthesia eutactic mixture of local anesthetics or local injectable anesthesia, under all aseptic precautions. Procedure: While operating, only the tip of the electrode should come in contact with the tissue. Actual contact of the electrode with the tissue should be very brief in order to prevent excessive damage to the deeper tissues. This can be accomplished by moving the electrode quickly. Complications: Complications are uncommon and mainly occur due to an improper technique. The treating physician should be aware of the contraindications of the procedure as listed in these guidelines. Physician qualification: RF surgery may be performed by a dermatologist who has acquired adequate training during post-graduation or through recognized fellowships and workshops dedicated to RF surgery. He

  19. Analytical approaches to food-based dietary guidelines in the European setting

    NARCIS (Netherlands)

    Hulshof, K.F.A.M.; Valsta, L.M.; Welten, D.C.; Löwik, M.R.H.

    2001-01-01

    Objective: To show the effects of statistical approaches of data analysis to be used in the development of Food-Based Dietary Guidelines (FBDG). Setting: Databases from dietary surveys in 6 European countries. Results: Quantile analysis based on iron intake among adult women resulted in differences

  20. 76 FR 15225 - Incorporating the 2010 Dietary Guidelines for Americans Into the Proposed School Meal Patterns

    Science.gov (United States)

    2011-03-21

    ... Food and Nutrition Service 7 CFR Parts 210 and 220 Incorporating the 2010 Dietary Guidelines for Americans Into the Proposed School Meal Patterns AGENCY: Food and Nutrition Service (FNS), USDA. ACTION: Request for comments. SUMMARY: This document informs the public about a change in the Dietary...

  1. [Update on Current Care Guideline: Insomnia].

    Science.gov (United States)

    Partinen, Markku; Huutoniemi, Anne; Kajaste, Soili; Lagerstedt, Rea; Markkula, Juha; Mäkinen, Erkki; Paakkari, Ilari; Partonen, Timo; Polo, Päivi; Saarenpää-Heikkilä, Outi; Seppälä, Maaria; Kukkonen-Harjula, Katriina; Tuunainen, Arja

    2016-01-01

    Insomnia symptoms must be differentiated from insomnia disorder. The correct aiagnosis or insomnia aisoraer is important, as insomnia may also be a symptom of many other diseases. Cognitive behavioral methods are recommended as first-line treatment options. Treatment of acute insomnia with hypnotics should not exceed two weeks. In elderly persons adverse effects of hypnotics may exceed their beneficial effects in long-term use. Antidepressive medications acting on the histamine-1 system may be used in very small doses. The new guideline includes e.g. insomnia in pregnant and menopausal women and in cancer patients, and driving issues.

  2. Perspective: Improving nutritional guidelines for sustainable health policies: Current status and perspectives

    DEFF Research Database (Denmark)

    Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio

    2017-01-01

    application of these concepts requires the translation of scientific information into practical approaches that have a tangible and measurable impact at both individual and population levels. The agenda for the future is expected to support available methodology in nutrition research to personalize guideline...... a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic...

  3. Occlusion on oral implants: current clinical guidelines.

    Science.gov (United States)

    Koyano, K; Esaki, D

    2015-02-01

    Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future.

  4. Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia.

    Science.gov (United States)

    Robien, Kim; Ness, Kirsten K; Klesges, Lisa M; Baker, K Scott; Gurney, James G

    2008-11-01

    Recent studies indicate that survivors of childhood acute lymphoblastic leukemia (ALL) are at increased risk of obesity and cardiovascular disease, conditions that healthy dietary patterns may help ameliorate or prevent. To evaluate the usual dietary intake of adult survivors of childhood ALL, food frequency questionnaire data were collected from 72 participants, and compared with the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention recommendations, the Dietary Approaches to Stop Hypertension (DASH) diet, and the 2005 United States Department of Agriculture (USDA) Food Guide. Mean daily energy intake was consistent with estimated requirements; however, mean body mass index was 27.1 kg/m2 (overweight). Dietary index scores averaged fewer than half the possible number of points on all 3 scales, indicating poor adherence to recommended guidelines. No study participant reported complete adherence to any set of guidelines. Although half the participants met minimal daily goals for 5 servings of fruits and vegetables (WCRF/AICR recommendations) and Food Guide), participants reported dietary sodium and added sugar intake considerably in excess of recommendations, and suboptimal consumption of whole grains. Guideline adherence was not associated with either body mass index or waist circumference, perhaps due to the low dietary index scores. These findings suggest that dietary intake for many adult survivors of childhood ALL is not concordant with dietary recommendations that may help reduce their risk of obesity, cardiovascular disease, or other treatment-related late effects.

  5. Evidence to support a food-based dietary guideline on sugar consumption in South Africa

    Directory of Open Access Journals (Sweden)

    Steyn Nelia P

    2012-07-01

    Full Text Available Abstract Background To review studies undertaken in South Africa (SA which included sugar intake associated with dental caries, non-communicable diseases, diabetes, obesity and/or micronutrient dilution, since the food-based dietary guideline: “Use foods and drinks that contain sugar sparingly and not between meals” was promulgated by the Department of Health (DOH in 2002. Methods Three databases (PubMed, Cochrane Library, and ScienceDirect, and SA Journal of Clinical Nutrition (SAJCN, DOH and SA Medical Research Council (SAMRC websites were searched for SA studies on sugar intake published between 2000 and January 2012. Studies were included in the review if they evaluated the following: sugar intake and dental caries; sugar intake and non-communicable diseases; sugar and diabetes; sugar and obesity and/or sugar and micronutrient dilution. Results The initial search led to 12 articles in PubMed, 0 in Cochrane, 35 in ScienceDirect, 5 in the SAJCN and 3 reports from DOH/SAMRC. However, after reading the abstracts only 7 articles from PubMed, 4 from SAJCN and 3 reports were retained for use as being relevant to the current review. Hand searching of reference lists of SAJCN articles produced two more articles. Intake of sugar appears to be increasing steadily across the South African (SA population. Children typically consume about 50 g per day, rising to as much as 100 g per day in adolescents. This represents about 10% of dietary energy, possibly as much as 20%. It has been firmly established that sugar plays a major role in development of dental caries. Furthermore, a few studies have shown that sugar has a diluting effect on the micronutrient content of the diet which lowers the intake of micronutrients. Data from numerous systematic reviews have shown that dietary sugar increases the risk for development of both obesity and type 2 diabetes. Risk for development of these conditions appears to be especially strong when sugar is consumed

  6. Evidence to support a food-based dietary guideline on sugar consumption in South Africa

    Science.gov (United States)

    2012-01-01

    Background To review studies undertaken in South Africa (SA) which included sugar intake associated with dental caries, non-communicable diseases, diabetes, obesity and/or micronutrient dilution, since the food-based dietary guideline: “Use foods and drinks that contain sugar sparingly and not between meals” was promulgated by the Department of Health (DOH) in 2002. Methods Three databases (PubMed, Cochrane Library, and ScienceDirect), and SA Journal of Clinical Nutrition (SAJCN), DOH and SA Medical Research Council (SAMRC) websites were searched for SA studies on sugar intake published between 2000 and January 2012. Studies were included in the review if they evaluated the following: sugar intake and dental caries; sugar intake and non-communicable diseases; sugar and diabetes; sugar and obesity and/or sugar and micronutrient dilution. Results The initial search led to 12 articles in PubMed, 0 in Cochrane, 35 in ScienceDirect, 5 in the SAJCN and 3 reports from DOH/SAMRC. However, after reading the abstracts only 7 articles from PubMed, 4 from SAJCN and 3 reports were retained for use as being relevant to the current review. Hand searching of reference lists of SAJCN articles produced two more articles. Intake of sugar appears to be increasing steadily across the South African (SA) population. Children typically consume about 50 g per day, rising to as much as 100 g per day in adolescents. This represents about 10% of dietary energy, possibly as much as 20%. It has been firmly established that sugar plays a major role in development of dental caries. Furthermore, a few studies have shown that sugar has a diluting effect on the micronutrient content of the diet which lowers the intake of micronutrients. Data from numerous systematic reviews have shown that dietary sugar increases the risk for development of both obesity and type 2 diabetes. Risk for development of these conditions appears to be especially strong when sugar is consumed as sugar

  7. Revised food-based dietary guidelines for South Africa: challenges ...

    African Journals Online (AJOL)

    designed and adopted by the Department of Health as “official” dietary .... include evaluation components10 to monitor processes and outcomes, and both the ... caregivers of infants and children, primary school children, adolescent girls and ...

  8. Evaluation of dietary intake in Danish adults by means of an index based on food-based dietary guidelines

    Directory of Open Access Journals (Sweden)

    Vibeke K. Knudsen

    2012-04-01

    Full Text Available Background: Data on dietary intake and physical activity has been collected from a representative sample of the Danish population from 2003–2008. Objectives: The aim of the present study was to describe the habitual diet in Denmark and to evaluate the overall diet quality using a diet quality index based on the National Food-Based Dietary Guidelines (FBDG, which consists of seven guidelines regarding diet and one regarding physical activity. Design: Data from the Danish National Survey of Diet and Physical Activity 2003–2008 (n=3354 were included. The diet quality index was constructed based on five of the seven dietary guidelines. Individuals were categorised according to quartiles of the diet quality index, and food and nutrient intakes were estimated in each of the groups. Results: Macronutrient distribution did not meet recommendations in any of the groups, as energy from total fat and especially saturated fat was too high. A high intake of high-fat milk products, fat on bread and processed meat contributed to a high intake of total fat and saturated fat, and sugar-sweetened soft drinks contributed to a high intake of added sugars in the group below the lowest quartile of the diet quality index. Individuals above in the highest quartile had higher intakes of ‘healthy foods’ such as fish, fruit and vegetables, rye bread, and also a higher consumption of water and wine. Overall, intakes of micronutrients were sufficient in all groups. Conclusions: The diet quality index is a useful tool in assessing food and nutrient intake in individuals with high vs. low degree of compliance towards the dietary guidelines, and provides a valuable tool in future studies investigating variations in dietary intakes with respect to lifestyle, demographic and regional differences in Denmark.

  9. [The cost of meeting dietary guidelines for low-income Brazilian families].

    Science.gov (United States)

    Borges, Camila Aparecida; Claro, Rafael Moreira; Martins, Ana Paula Bortoletto; Villar, Betzabeth Slater

    2015-01-01

    The objective was to identify the cost of meeting the Brazilian National Dietary Guidelines and analyze the impact on family budget. Data from the Brazilian Household Budget Survey for 2008 were used. Food purchases were recorded for seven days in 55,970 households. A subset of low-income families (≤ BRL 415.00 per capita/month and ≤ US$ 1.00 per capita/day) was used for the analysis. We estimated per capita calorie availability, total food expenditures, and food prices aggregated in 8 food groups based on the Brazilian Guidelines. Each food group's share in total calories was estimated and compared to the recommendations. Actual purchases exceeded the recommendations for beans, oils/fats, sweets, and meat/eggs, and fell short for fruits, vegetables, dairy products, and grains. Meeting the recommendations would increase food expenditures by 58% among individuals with per capita income ≤ US$ 1.00/day and by 39% for those with per capita income ≤ BRL 415.00. Adoption of the recommendations would require 145% of total income. Meeting current recommendations would demand an increase in income or a policy to reduce food prices.

  10. Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines

    Science.gov (United States)

    Scarborough, Peter; Cobiac, Linda; Owens, Paul; Parlesak, Alexandr; Sweeney, Kate; Rayner, Mike

    2016-01-01

    Objectives To model food group consumption and price of diet associated with achieving UK dietary recommendations while deviating as little as possible from the current UK diet, in order to support the redevelopment of the UK food-based dietary guidelines (now called the Eatwell Guide). Design Optimisation modelling, minimising an objective function of the difference between population mean modelled and current consumption of 125 food groups, and constraints of nutrient and food-based recommendations. Setting The UK. Population Adults aged 19 years and above from the National Diet and Nutrition Survey 2008–2011. Main outcome measures Proportion of diet consisting of major foods groups and price of the optimised diet. Results The optimised diet has an increase in consumption of ‘potatoes, bread, rice, pasta and other starchy carbohydrates’ (+69%) and ‘fruit and vegetables’ (+54%) and reductions in consumption of ‘beans, pulses, fish, eggs, meat and other proteins’ (−24%), ‘dairy and alternatives’ (−21%) and ‘foods high in fat and sugar’ (−53%). Results within food groups show considerable variety (eg, +90% for beans and pulses, −78% for red meat). The modelled diet would cost £5.99 (£5.93 to £6.05) per adult per day, very similar to the cost of the current diet: £6.02 (£5.96 to £6.08). The optimised diet would result in increased consumption of n-3 fatty acids and most micronutrients (including iron and folate), but decreased consumption of zinc and small decreases in consumption of calcium and riboflavin. Conclusions To achieve the UK dietary recommendations would require large changes in the average diet of UK adults, including in food groups where current average consumption is well within the recommended range (eg, processed meat) or where there are no current recommendations (eg, dairy). These large changes in the diet will not lead to significant changes in the price of the diet. PMID:28003292

  11. Developing Food-Based Dietary Guidelines to Promote Healthy Diets and Lifestyles in the Eastern Caribbean

    Science.gov (United States)

    Albert, Janice L.; Samuda, Pauline M.; Molina, Veronika; Regis, Theresa Marietta; Severin, Merlyn; Finlay, Betty; Prevost, Jacqueline Lancaster

    2007-01-01

    Obesity, cardiovascular diseases, and diabetes are becoming leading causes of morbidity and mortality in the Eastern Caribbean countries of St. Vincent and the Grenadines, Saint Lucia, Grenada, and Dominica. To promote healthful diets and lifestyles and encourage behavioral changes, Food-Based Dietary Guidelines (FBDG) were developed for the…

  12. Identification of attributes that promote the adoption and implementation of 2005 Dietary Guidelines for Americans

    Science.gov (United States)

    As part of a larger study, this research was to identify attributes of the Dietary Guidelines for Americans (DGAs) that would promote their adoption and implementation by participants in a nutrition intervention. Project procedures were guided by the Diffusion of Innovations (DOI) theory. To identif...

  13. 77 FR 65384 - Announcement of Intent To Establish the 2015 Dietary Guidelines Advisory Committee and...

    Science.gov (United States)

    2012-10-26

    ..., women, and persons with disabilities. Individuals will be appointed to serve as members of the Committee... their term of appointment on the Committee, and as such are subject to the ethical standards of conduct... HUMAN SERVICES Announcement of Intent To Establish the 2015 Dietary Guidelines Advisory Committee...

  14. Food science challenge: Translating the Dietary Guidelines for Americans to Bring About Real Behavior Change

    Science.gov (United States)

    Food scientists and nutrition scientists (dietitians and nutrition communicators) are tasked with creating strategies to more closely align the American food supply and the public's diet with the Dietary Guidelines for Americans (DGA). This paper is the result of 2 expert dialogues to address this m...

  15. Linear programming to build food-based dietary guidelines: Romanian food baskets

    DEFF Research Database (Denmark)

    Parlesak, Alexandr; Robertson, Aileen; Hondru, Gabriela

    basket that incorporates only WHO food-based dietary guidelines does not meet all the recommended nutrient intake values for, for example, vitamins A, D, K, iodine and calcium. • The version of a Romanian fully nutritious, health-promoting food basket for a family (two adults, two children) costs 19.......65 lei (~€ 4.46) for a day. • Key nutrients, primarily vitamin D, calcium, potassium and iron, were found to control the overall price. • The least expensive basket (one day’s rations) is monotonous and the linear programming approach is used to select a wide range of foods that can be recommended......, potatoes and fish and considerably less meat, fats, oils and sugar. In conclusion, the linear programming methodology can facilitate the development of national dietary recommendations that meet both recommended nutrient intake values and WHO food-based dietary guidelines in a cost-efficient manner. How...

  16. Management of asthma: the current US and European guidelines.

    Science.gov (United States)

    Reddy, Ashwini P; Gupta, Meera R

    2014-01-01

    Asthma management guidelines aim to improve the implementation of current knowledge into daily clinical practice by establishing a consensus of scientific practices for the management of asthma. Initial guidelines were based on consensus of expert opinion in order to employ a severity-based classification system as a guide to treatment. However, advances in asthma research led to the development of evidence-based guidelines and a major paradigm shift to control-based asthma management. Control-based management is central to the published guidelines developed by The National Heart, Lung, and Blood Institute (NHLBI), The Global Initiative for Asthma (GINA), and The British Thoracic Society (BTS), each one using the same volume of evidence but emphasizing aspects particular to their specific patient populations and socioeconomic needs. This chapter summarizes the evolution of these guidelines and summarizes the key points and evidence used in the recommendations for the assessment, monitoring, and management of asthma in all ages, with particular emphasis on the NHLBI guidelines.

  17. Relationship between adhering to dietary guidelines and the risk of obesity in Korean children.

    Science.gov (United States)

    Yu, Soo Hyun; Song, YoonJu; Park, Mijung; Kim, Shin Hye; Shin, Sangah; Joung, Hyojee

    2014-12-01

    Dietary guidelines for Korean children were released in 2009. The goal of the present study was to examine diet quality in terms of adherence to these dietary guidelines as well as explore the association between guideline adherence and risk of obesity in Korean children. Children aged 5-11 years (mean age = 8.9 years old, n = 191, 80.6% girls) were recruited from a university hospital in Seoul, Korea. Adherence to dietary guidelines for Korean children was calculated using the Likert scale (1-5), and children were then categorized into low, moderate, and high groups based on adherence scores. Obesity or being overweight was determined based on an age- and gender- specific percentile for body mass index (BMI) of the 2007 Korean National Growth Charts. Diet quality was evaluated from 3 days of dietary intake data. Children in the high adherence group were characterized by significantly lower BMI percentiles and paternal BMIs as well as higher percentages of fathers with a high level of education and higher household incomes compared to those in the low or moderate group. Children in the high adherence group consumed significantly higher amounts of milk and dairy products, were less likely to consume lower than the EAR of phosphorus and iron, and had higher NARs for calcium, phosphorus, iron, zinc, and MAR than those in low groups. The ORs for obesity (BMI ≥ 95(th) percentile) or being overweight including obesity (BMI ≥ 85(th) percentile) were significantly lower in the high adherence group compared to the low adherence group (OR: 0.33, 95% CI = 0.13-0.82, P for trend = 0.019; OR: 0.26, 95% CI: 0.11-0.61 P for trend = 0.002). Korean children who adhered to dietary guidelines displayed better diet quality and a reduced risk of obesity.

  18. An Exposition of Current Mobile Learning Design Guidelines and Frameworks

    Science.gov (United States)

    Teall, Ed; Wang, Minjuan; Callaghan, Vic; Ng, Jason W. P.

    2014-01-01

    As mobile devices with wireless access become more readily available, learning delivered via mobile devices of all types must be designed to ensure successful learning. This paper first examines three questions related to the design of mobile learning: 1) what mobile learning (m-learning) guidelines can be identified in the current literature, 2)…

  19. An Exposition of Current Mobile Learning Design Guidelines and Frameworks

    Science.gov (United States)

    Teall, Ed; Wang, Minjuan; Callaghan, Vic; Ng, Jason W. P.

    2014-01-01

    As mobile devices with wireless access become more readily available, learning delivered via mobile devices of all types must be designed to ensure successful learning. This paper first examines three questions related to the design of mobile learning: 1) what mobile learning (m-learning) guidelines can be identified in the current literature, 2)…

  20. Australian Pregnant Women’s Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action

    Directory of Open Access Journals (Sweden)

    Khlood Bookari

    2016-01-01

    Full Text Available Background. Excessive gestational weight gain (GWG can negatively impact on maternal and foetal health. Guidelines based on Institute of Medicine (IOM encourage managing GWG by following healthy eating recommendations and increasing physical activity. This study investigated pregnant women’s knowledge of their optimal GWG and recommended dietary approaches for GWG management. Method. English-speaking pregnant women were recruited from five hospitals in New South Wales (Australia and an online link. Prepregnancy Body Mass Index (BMI was calculated from self-reported height and prepregnancy weight. Participants identified their recommended GWG. A survey assessed practical dietary knowledge and asked about broad dietary recommendations to prevent excessive GWG. Chi square and logistic regression analyses were used. Results. N=326 pregnant women completed the surveys; 49% entered pregnancy overweight (25.2% or obese (23.6%; and knowledge of recommended GWG was lacking. Prepregnancy BMI was a significant predictor of GWG recommendation knowledge (P<0.000. Pregnant women were highly knowledgeable about broad dietary recommendations but had poor knowledge of detailed recommendations. Conclusions. Limited knowledge of IOM’s GWG guidelines and of specific dietary recommendations for pregnancy should be addressed by health care providers and education initiatives to assist the high number of women who enter pregnancy overweight or obese.

  1. Interpreting the Australian Dietary Guideline to “Limit” into Practical and Personalised Advice

    Directory of Open Access Journals (Sweden)

     Flavia Fayet-Moore

    2015-03-01

    Full Text Available Food-based dietary guidelines shift the focus from single nutrients to whole diet. Guideline 3 of the Australian Dietary Guidelines (ADG recommends “limiting” discretionary foods and beverages (DF—Those high in saturated fat, added sugars, salt, and/or alcohol. In Australia, DF contribute 35% of total energy intake. Using the ADG supporting documents, the aim of this study was to develop a food‑based educational toolkit to help translate guideline 3 and interpret portion size. The methodology used to produce the toolkit is presented here. “Additional energy allowance” is specific to gender, age, height and physical activity level, and can be met from core foods, unsaturated fats/oils/spreads and/or DF. To develop the toolkit, additional energy allowance was converted to serves equaling 600 kJ. Common DF were selected and serves were determined based on nutrient profile. Portion sizes were used to calculate number of DF serves. A consumer brochure consisting of DF, portion sizes and equivalent number of DF serves was developed. A healthcare professional guide outlines the methodology used. The toolkit was designed to assist dietitians and consumers to translate guideline 3 of the ADF and develop a personalized approach to include DF as part of the diet.

  2. Are the current Australian sun exposure guidelines effective in maintaining adequate levels of 25-hydroxyvitamin D?

    Science.gov (United States)

    Kimlin, Michael; Sun, Jiandong; Sinclair, Craig; Heward, Sue; Hill, Jane; Dunstone, Kimberley; Brodie, Alison

    2016-01-01

    An adequate vitamin D status, as measured by serum 25-hydroxyvitamin D (25(OH)D) concentration, is important in humans for maintenance of healthy bones and muscle function. Serum 25(OH)D concentration was assessed in participants from Melbourne, Australia (37.81S, 144.96E), who were provided with the current Australian guidelines on sun exposure for 25(OH)D adequacy (25(OH)D ≥50 nmol/L). Participants were interviewed in February (summer, n=104) and August (winter, n=99) of 2013. Serum 25(OH)D concentration was examined as a function of measures of sun exposure and sun protection habits with control of key characteristics such as dietary intake of vitamin D, body mass index (BMI) and skin colour, that may modify this relationship. The mean 25(OH)D concentration in participants who complied with the current sun exposure guidelines was 67.3 nmol/L in summer and 41.9 nmol/L in winter. At the end of the study, 69.3% of participants who complied with the summer sun exposure guidelines were 25(OH)D adequate, while only 27.6% of participants who complied with the winter sun exposure guidelines were 25(OH)D adequate at the end of the study. The results suggest that the current Australian guidelines for sun exposure for 25(OH)D adequacy are effective for most in summer and ineffective for most in winter. This article is part of a Special Issue entitled '17th Vitamin D Workshop'.

  3. The CSIRO Healthy Diet Score: An Online Survey to Estimate Compliance with the Australian Dietary Guidelines

    Directory of Open Access Journals (Sweden)

    Gilly A. Hendrie

    2017-01-01

    Full Text Available There are few dietary assessment tools that are scientifically developed and freely available online. The Commonwealth Scientific and Industrial Research Organisation (CSIRO Healthy Diet Score survey asks questions about the quantity, quality, and variety of foods consumed. On completion, individuals receive a personalised Diet Score—reflecting their overall compliance with the Australian Dietary Guidelines. Over 145,000 Australians have completed the survey since it was launched in May 2015. The average Diet Score was 58.8 out of a possible 100 (SD = 12.9. Women scored higher than men; older adults higher than younger adults; and normal weight adults higher than obese adults. It was most common to receive feedback about discretionary foods (73.8% of the sample, followed by dairy foods (55.5% and healthy fats (47.0%. Results suggest that Australians’ diets are not consistent with the recommendations in the guidelines. The combination of using technology and providing the tool free of charge has attracted a lot of traffic to the website, providing valuable insights into what Australians’ report to be eating. The use of technology has also enhanced the user experience, with individuals receiving immediate and personalised feedback. This survey tool will be useful to monitor population diet quality and understand the degree to Australians’ diets comply with dietary guidelines.

  4. The CSIRO Healthy Diet Score: An Online Survey to Estimate Compliance with the Australian Dietary Guidelines

    Science.gov (United States)

    Hendrie, Gilly A.; Baird, Danielle; Golley, Rebecca K.; Noakes, Manny

    2017-01-01

    There are few dietary assessment tools that are scientifically developed and freely available online. The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Healthy Diet Score survey asks questions about the quantity, quality, and variety of foods consumed. On completion, individuals receive a personalised Diet Score—reflecting their overall compliance with the Australian Dietary Guidelines. Over 145,000 Australians have completed the survey since it was launched in May 2015. The average Diet Score was 58.8 out of a possible 100 (SD = 12.9). Women scored higher than men; older adults higher than younger adults; and normal weight adults higher than obese adults. It was most common to receive feedback about discretionary foods (73.8% of the sample), followed by dairy foods (55.5%) and healthy fats (47.0%). Results suggest that Australians’ diets are not consistent with the recommendations in the guidelines. The combination of using technology and providing the tool free of charge has attracted a lot of traffic to the website, providing valuable insights into what Australians’ report to be eating. The use of technology has also enhanced the user experience, with individuals receiving immediate and personalised feedback. This survey tool will be useful to monitor population diet quality and understand the degree to Australians’ diets comply with dietary guidelines. PMID:28075355

  5. Probiotics in dietary guidelines and clinical recommendations outside the European Union.

    Science.gov (United States)

    Ebner, Stephan; Smug, Linda N; Kneifel, Wolfgang; Salminen, Seppo J; Sanders, Mary Ellen

    2014-11-21

    Fermented foods have been consumed for centuries across many geographical locales and have traditionally been considered healthy foods, partly because of the live microbes contained in them. The concept of "probiotics" further requires that the microbes be defined and their health effects be demonstrated through human intervention studies or other suitable investigations before marketing with corresponding health messages. Here, we review recommendations for fermented foods and probiotics in several countries outside the EU, focusing on food-based dietary guidelines. We emphasize recommendations on yoghurt and probiotics made by expert bodies. We found that dietary guidelines commonly advocate the consumption of yoghurt or similar products, but specific comments on probiotics are rare. Further, we reviewed guidelines from clinical associations. In general, they acknowledge the beneficial effects of probiotics, but often suggest the need for further research. This is true despite good quality evidence supporting the role of probiotics for certain health effects, such as prevention of eczema in infants, management of side effects from antibiotics and alleviation of functional bowel symptoms. Additional research to support future dietary recommendations should focus on determining effect size, identifying responders and non-responders, clarifying strain-specificity of effects and confirming mechanisms.

  6. The Mexican Dietary and Physical Activity Guidelines: Moving Public Nutrition Forward in a Globalized World.

    Science.gov (United States)

    Pérez-Escamilla, Rafael

    2016-09-01

    The objective of this article is to explain the process of the development of and to assess the Mexican food-based dietary and physical activity guidelines (FBDGs). The FBDGs were developed by an intersectoral and interdisciplinary committee of 11 national experts with input from 11 external advisors. The sectors represented were research and academic institutions, the Ministry of Health, and a nongovernmental organization. The evidence-based process included the following: literature reviews of local, national, and international evidence; review of dietary patterns of the Mexican population; key national and international recommendations; and review of FBDGs and visual icons from other countries. The guidelines' report follows the life-course socioecological model rooted in a deep understanding of the epidemiology and underlying causes of malnutrition in Mexico. The guidelines are summarized in 10 pretested main recommendations that include, and go beyond, simply promoting the consumption of a healthy and varied diet that includes fresh fruits, vegetables, legumes, and whole grains and staying within caloric needs and staying active. The guidelines strongly emphasize healthy cooking habits, enjoyable meals with family and friends, drinking water, and avoiding the consumption of sweetened beverages, grain-based desserts, and highly processed foods. Detailed guidelines specific to different groups (on the basis of age and physiologic status) are also included. An innovative aspect of the Mexican FBDGs is the inclusion of dietary guidance of children Mexican FBDGs in the context of addressing the national obesity epidemic deserves to be initiated and formally assessed through the lens of evidence-based, public nutrition complex adaptive systems.

  7. Diabetes and Hypertension: A Comparative Review of Current Guidelines.

    Science.gov (United States)

    Cryer, Michael J; Horani, Tariq; DiPette, Donald J

    2016-02-01

    Cardiovascular disease plays a major role in the morbidity and mortality of patients with diabetes mellitus. In turn, hypertension is a major risk factor for cardiovascular disease, and its prevalence is increased in diabetes mellitus. Therefore, the detection and management of elevated blood pressure (BP) is a critical component of the comprehensive clinical management of diabetics. Despite significant advances in our understanding of the pathogenesis and treatment of hypertension, there continues to be debate regarding the pharmacologic treatment of hypertension, especially in high-risk groups such as in patients with diabetes mellitus with and without chronic kidney disease (CKD). This debate largely involves at what BP (ie, treatment threshold BP) to initiate pharmacologic antihypertensive therapy and subsequently what treatment target BP should be achieved (ie, goal BP). Presently, there are several guidelines that address hypertension in diabetes mellitus, including the recently released guideline from the Eighth Report of the Joint National Committee (JNC 8). Therefore, this review will compare and contrast these current guidelines, as they relate to the management and treatment of hypertension in diabetes mellitus. Since diabetes mellitus and CKD are significantly inter-related, the presence of CKD as it relates to patients with diabetes mellitus will also be addressed. ©2015 Wiley Periodicals, Inc.

  8. Current indicators of nutritional care in children with type 1 diabetes in India: Do we need a national nutritional guideline?

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2017-01-01

    Full Text Available Background: Nutrition is an important pillar of management in children with type 1 diabetes. Indian food is heavily influenced by region, religion, traditions, seasons, and cultural choices. This survey was done to assess current practices and the need for India specific nutritional guidelines for children with type 1 diabetes. Materials and Methods: Two 12-item questionnaires were administered to forty health-care professionals across India. The first questionnaire evaluated current clinical practice indicators for nutrition in these children and second assessed practices for counseling a child on dietary habits. Results: There is great heterogeneity across the country with regard to dietary advice offered to children with type 1 diabetes. 97.5% of the respondents feel there is a need for an Indian dietary guideline for children with type 1 diabetes. Conclusion: There is need of India specific nutritional guidelines that should be made considering key variants such as age, region, cultural preference, economic burden and psychosocial beliefs, to offer guidance to diabetes care professionals.

  9. Management and prevention of neonatal anemia: current evidence and guidelines.

    Science.gov (United States)

    von Lindern, Jeannette S; Lopriore, Enrico

    2014-04-01

    Neonatal anemia is a common disorder, particularly in (very) preterm neonates. Management of neonatal anemia is based principally on red blood cell (RBC) transfusion. Although the use of blood products is nowadays widespread in neonatal medicine, evidence on the potential benefit is extremely limited. Recent studies suggest that RBC transfusions in newborns may be associated with an increased risk for necrotizing enterocolitis, transfer of infectious agents and negative effects on neurodevelopmental outcome. Whether the benefits of RBC transfusions outweigh the risks is controversial and requires further studies. In this review, we summarize the current evidence on the management of neonatal anemia and compare the various international guidelines. In addition, we discuss the various strategies to prevent neonatal anemia and reduce the need for RBC transfusions and discuss important trials currently enrolling patients to improve the management in neonatal anemia.

  10. Linear programming to build food-based dietary guidelines: Romanian food baskets

    DEFF Research Database (Denmark)

    Parlesak, Alexandr; Robertson, Aileen; Hondru, Gabriela

    As in many Member States of the WHO European Region, Romania is seeing an increase in the prevalence of overweight and obesity, particularly among children and adolescents. This is a major risk factor for the development of noncommunicable diseases (NCDs), and innovative approaches using...... approach using linear programming methodology to design national dietary recommendations which aim to prevent both NCDs and micronutrient deficiencies and still be affordable by low income groups. This new approach is applied within the context of food availability in Romania in 2014. Eating the same food...... basket that incorporates only WHO food-based dietary guidelines does not meet all the recommended nutrient intake values for, for example, vitamins A, D, K, iodine and calcium. • The version of a Romanian fully nutritious, health-promoting food basket for a family (two adults, two children) costs 19...

  11. Food science challenge: translating the dietary guidelines for Americans to bring about real behavior change.

    Science.gov (United States)

    Rowe, Sylvia; Alexander, Nick; Almeida, Nelson; Black, Richard; Burns, Robbie; Bush, Laina; Crawford, Patricia; Keim, Nancy; Kris-Etherton, Penny; Weaver, Connie

    2011-01-01

    Food scientists and nutrition scientists (dietitians and nutrition communicators) are tasked with creating strategies to more closely align the American food supply and the public's diet with the Dietary Guidelines for Americans (DGA). This paper is the result of 2 expert dialogues to address this mandate, which were held in Chicago, Illinois, and Washington, D.C., in early October 2010 between these 2 key scientific audiences. It is an objective that has largely eluded public health experts over the past several decades. This document takes the perspective of food scientists who are tasked with making positive modifications to the food supply, both in innovating and reformulating food products, to respond to both the DGA recommendations, and to consumer desires, needs, and choices. The paper is one of two to emerge from those October 2010 discussions; the other article focuses on the work of dietitians and nutrition communicators in effecting positive dietary change.

  12. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2011-06-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  13. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2012-02-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  14. The Norwegian dietary guidelines and colorectal cancer survival (CRC-NORDIET) study: a food-based multicentre randomized controlled trial.

    Science.gov (United States)

    Henriksen, Hege Berg; Ræder, Hanna; Bøhn, Siv Kjølsrud; Paur, Ingvild; Kværner, Ane Sørlie; Billington, Siv Åshild; Eriksen, Morten Tandberg; Wiedsvang, Gro; Erlund, Iris; Færden, Arne; Veierød, Marit Bragelien; Zucknick, Manuela; Smeland, Sigbjørn; Blomhoff, Rune

    2017-01-30

    Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study. Men and women aged 50-80 years diagnosed with primary invasive colorectal cancer (Stage I-III) are invited to this randomized controlled, parallel two-arm trial 2-9 months after curative surgery. The intervention group (n = 250) receives an intensive dietary intervention lasting for 12 months and a subsequent maintenance intervention for 14 years. The control group (n = 250) receives no dietary intervention other than standard clinical care. Both groups are offered equal general advice of physical activity. Patients are followed-up at 6 months and 1, 3, 5, 7, 10 and 15 years after baseline. The study center is located at the Department of Nutrition, University of Oslo, and patients are recruited from two hospitals within the South-Eastern Norway Regional Health Authority. Primary outcomes are disease-free survival and overall survival. Secondary outcomes are time to recurrence, cardiovascular disease-free survival, compliance to the dietary recommendations and the effects of the intervention on new comorbidities, intermediate biomarkers, nutrition status, physical activity, physical function and quality of life. The current study is designed to gain a better understanding of the role of a healthy diet aimed at dampening inflammation and oxidative stress on long-term disease outcomes and survival in colorectal cancer patients. Since previous research on the role of diet for

  15. British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults.

    Science.gov (United States)

    McKenzie, Y A; Alder, A; Anderson, W; Wills, A; Goddard, L; Gulia, P; Jankovich, E; Mutch, P; Reeves, L B; Singer, A; Lomer, M C E

    2012-06-01

     Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder. Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians. Questions relating to diet and IBS symptom management were developed by a guideline development group. These included the role of milk and lactose, nonstarch polysaccharides (NSP), fermentable carbohydrates in abdominal bloating, probiotics and empirical or elimination diets. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines: Cinahl, Cochrane Library, Embase, Medline, Scopus and Web of Science. Evidence statements, recommendations, good practice points and research recommendations were developed. Thirty studies were critically appraised. A dietetic care pathway was produced following a logical sequence of treatment and formed the basis of these guidelines. Three lines of dietary management were identified. first line: Clinical and dietary assessment, healthy eating and lifestyle management with some general advice on lactose and NSP. Second line: Advanced dietary interventions to improve symptoms based on NSP, fermentable carbohydrates and probiotics. Third line: Elimination and empirical diets. Research recommendations were also identified relating to the need for adequately powered and well designed randomised controlled trials. These guidelines provide evidence-based details of how to achieve the successful dietary management of IBS. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  16. Updated US Department of Agriculture Food Patterns meet goals of the 2010 dietary guidelines.

    Science.gov (United States)

    Britten, Patricia; Cleveland, Linda E; Koegel, Kristin L; Kuczynski, Kevin J; Nickols-Richardson, Sharon M

    2012-10-01

    The US Department of Agriculture Food Patterns were updated for the 2010 Dietary Guidelines for Americans to meet new nutrition goals and incorporate results of food pattern modeling requested by the Dietary Guidelines Advisory Committee. The purpose of this article is to describe the process used and changes in the updated patterns. Changes include renaming the Meat and Beans and Milk Groups to the Protein Foods and Dairy Groups, respectively, to be more encompassing of foods in each. Vegetable subgroups now provide more achievable intake recommendations. Calcium-fortified soymilk is now included in the Dairy Group because of its similarity to foods in that group. Increased amounts of seafoods are recommended in the Protein Foods Group, balanced by decreased amounts of meat and poultry. A limit on calories from solid fats and added sugars is included, replacing the previous discretionary calorie allowance and emphasizing the need to choose nutrient-dense forms of foods. Lacto-ovo vegetarian and vegan patterns that meet nutrition goals were created by making substitutions in the Protein Foods Group, and for vegan patterns, in the Dairy Group. Patterns identify food choices that meet nutritional needs within energy allowances and encourage choosing a variety of foods. They rely on foods in nutrient-dense forms, including a limited amount of calories from solid fats and added sugars. The Food Patterns provide a useful template for educating consumers about healthful food choices while highlighting a large gap between choices many Americans make and healthy eating patterns.

  17. Dietary guidelines in the Czech Republic III.: Challenge for the 3rd millennium.

    Science.gov (United States)

    Brázdová, Z; Ruprich, J; Hrubá, D; Petráková, A

    2001-02-01

    In developed countries, dietary guidelines are more and more often used as a source of binding information not only in public health, food production, nutrition and agricultural policy, but in ecology and economy as well. In view of that, it is imperative to formulate such guidelines that would be supported by relevant population studies and correspond to the European model of WHO/CINDI guidelines. At the turn of the millennium, the Czech guidelines were updated in order that serving sizes of 5 basic food groups were brought closer to contemporary trends emphasizing lower protein intakes and at the same time, by setting limit ranges, they were able to meet specific need of people of different age group, sex, physiological status, physical activity, etc. The conversion of recommended servings to nutrients was compared with the results of the actual food basket of the Czech population and specific recommendations for amendments in proportions of individual food items in food groups and subgroups were given. On the basis of diet guidelines, conclusions describing tasks for the beginning of the third millennium were made. Besides them the most important are: production or health information systems with special emphasis to food intake and nutritional status report, policies to increase the access to vegetables and fruit for vulnerable groups, legislation to curb advertising high-fat energy-dense foods to children, policy to strengthen the operational targets of Innocenti Declaration and to increase the number of Baby Friendly Hospitals, legislation regarding food control systems based on international standards, sustainable campaigns to promote safe healthy diet, policies to ensure sustainable food production.

  18. Guidelines for asthma management: a review and comparison of 5 current guidelines.

    Science.gov (United States)

    Myers, Timothy R

    2008-06-01

    The first clinical practice guidelines for the assessment and management of asthma were published over 20 years ago in New Zealand and Australia. During the same period, British and Scottish groups were collaborating on a United Kingdom version of asthma guidelines. Shortly after the introduction of the New Zealand and Canadian guidelines, the National Heart, Lung, and Blood Institute of the United States National Institutes of Health participated in 2 additional asthma guideline endeavors, which were published in the early 1990s. The National Heart, Lung, and Blood Institute formed the National Asthma Education and Prevention Program to develop asthma guidelines for the United States, and participated with an international task force to develop guidelines for the treatment of asthma in all countries, which resulted in the formation of the Global Initiative for Asthma in the mid-1990s. The asthma guidelines issued by professional societies and other groups prior to the late 1990s were primarily based on consensus or expert opinion in each guideline committee, though those opinions were based on the available studies. The early guidelines played a vital role in bridging the gap between various treatment options and recent discoveries in basic science, and served as the vehicle to implementation into daily clinical practice. Asthma guidelines have been published and revised in dozens of countries around the world and have become reputable directives or "road maps" in asthma diagnosis, treatment, and management for patients of all ages. The guidelines have similar formats. The dissemination and implementation of the early guidelines was inconsistent, and they were criticized for not being evidence-based. As the knowledge of asthma pathophysiology continues to expand, along with basic science research on asthma diagnosis, treatment, and management, as well as education of the asthma patient, it is essential that the asthma guidelines be frequently updated and based on

  19. Interests and values in the Recommended Dietary Allowances and nutritional guidelines for Americans.

    Science.gov (United States)

    Kunkel, H O

    1996-09-01

    Evidence is provided showing that interests, values and belief systems have affected the development of Recommended Dietary Allowances (RDAs) and nutrition guidelines for Americans in the past and can be expected to do so in the future. The conflicts of the 1980s relative to the nutritional guidelines for Americans and the RDAs illustrate the tension among values that can parallel a conflict of interests. In the conflicts of the 1980s, we saw an apparent conflict between those policies that attempt to optimize outcomes for a large class of affected parties and those policies that attempt to establish constraints on actions which appear to threaten individual autonomy and freedom of choice. The former approach derives from utilitarian, consequential moral philosophy which evaluates policies by evaluating costs and harms, and weighing them against benefits to all parties. The latter has its strongest advocates in contemporary libertarianism which takes individual freedom to be the bottom line. Ethical vegetarianism, a belief system which would limit RDAs and guidelines to those that can be translated to vegan and other vegetarian diets, has been a more recent entry into the discussions. Such human value issues suggest that a set of RDAs or of nutrition guidelines is analogous to and may be considered to be an ethic. An ethic is a theory reached via the method of reflective equilibrium that is a coherent ordered triple set of beliefs: a set of considered moral judgments, a set of moral principles, and a set of relevant scientific background theories. The reasoning, however, can become circular and unsound when the considered moral judgments, moral principles and relevant background are not independent sources of information. If they are mixed or, for example, an intuition is mistaken for a scientific conclusion, the reasoning can be flawed.

  20. Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil.

    Science.gov (United States)

    Monteiro, Carlos Augusto; Cannon, Geoffrey; Moubarac, Jean-Claude; Martins, Ana Paula Bortoletto; Martins, Carla Adriano; Garzillo, Josefa; Canella, Daniela Silva; Baraldi, Larissa Galastri; Barciotte, Maluh; Louzada, Maria Laura da Costa; Levy, Renata Bertazzi; Claro, Rafael Moreira; Jaime, Patrícia Constante

    2015-09-01

    To present and discuss the dietary guidelines issued by the Brazilian government in 2014. The present paper describes the aims of the guidelines, their shaping principles and the approach used in the development of recommendations. The main recommendations are outlined, their significance for the cultural, socio-economic and environmental aspects of sustainability is discussed, and their application to other countries is considered. Brazil in the twenty-first century. All people in Brazil, now and in future. The food- and meal-based Brazilian Dietary Guidelines address dietary patterns as a whole and so are different from nutrient-based guidelines, even those with some recommendations on specific foods or food groups. The guidelines are based on explicit principles. They take mental and emotional well-being into account, as well as physical health and disease prevention. They identify diet as having cultural, socio-economic and environmental as well as biological and behavioural dimensions. They emphasize the benefits of dietary patterns based on a variety of natural or minimally processed foods, mostly plants, and freshly prepared meals eaten in company, for health, well-being and all relevant aspects of sustainability, as well as the multiple negative effects of ready-to-consume ultra-processed food and drink products. The guidelines' recommendations are designed to be sustainable personally, culturally, socially, economically and environmentally, and thus fit to face this century. They are for foods, meals and dietary patterns of types that are already established in Brazil, which can be adapted to suit the climate, terrain and customs of all countries.

  1. Applicability of the current hypertension guidelines in Latin America.

    Science.gov (United States)

    Alcocer, Luis; Meaney, Eduardo; Hernandez-Hernandez, Hector

    2015-08-01

    Recent research has focused on the development of evidence-based guidelines that are intended to regulate the conduct of physicians in the diagnosis and control of hypertension, with the goal of achieving greater effectiveness and equity at the lowest possible cost. In Latin America, guidelines are available for the management of hypertension at three levels: national, regional and international. The national and regional Latin American and Caribbean (LAC) guidelines are in fact adaptations of the international guidelines. The potential benefit of applying guidelines developed in other regions to local healthcare decision making is that it will enable decision makers to take advantage of existing analyses and transfer or adapt them to their local contexts. However, this adaptation precludes the assessment of their generalizability and potential transferability. In addition, this region is characterized by wide socioeconomic differences between its inhabitants, both among and within nations. Therefore, new guidelines for the LAC region must include recommendations that are common to all hypertensive patients in the region. Moreover, we advocate the inclusion of a specific section that makes comprehensive recommendations and provides strategies for implementation according to the socioeconomic conditions of particular groups. In addition to developing guidelines that are truly applicable to the LAC region, it seems sensible to consider information that is specific to this region. Furthermore, developing evidence-based guidelines is not enough to affect positively the burden of disease caused by hypertension. Therefore, professional programs are required for the implementation of such guidelines as well as the auditing of their results. Achieving these ambitious goals will require collaborative efforts by many groups including policymakers, international organizations, healthcare providers, universities and society.

  2. Dietary Guidelines for Chinese Residents (2016):comments and comparisons

    Institute of Scientific and Technical Information of China (English)

    Shan-shan WANG; Sovichea LAY; Hai-ning YU; Sheng-rong SHEN

    2016-01-01

    A high quality diet is believed to play a functional role in promoting the healthy growth of mankind and preventing many kinds of chronic degenerative diseases, including cancer, cardiovascular disease, diabetes, and obesity. Adherence to a high quality diet has been strongly associated with a lower risk of mortality. To help promote healthy lifestyles and physical strength, the Chinese government has produced a new revised version of the Dietary Guidelines for Chinese Residents (2016) and the Chinese Food Pagoda, as guidance for dietary intake among its population. Similarly, the Japanese government has produced the Japanese Food Guide Spinning Top Model, and the US government has recently published revised dietary recommendations in its 2015–2020 eighth edition of Dietary Guidelines for Americans. The evidence from al respective cohort studies involved in producing these guidelines shows a reduced risk of many chronic diseases and mortality if the guidelines are folowed. Al scientific findings support encouraging the general population to consume a broad variety of food on the basis of nutrient and food intakes in order to prevent deficiency diseases and a surplus of energy and nutrients, and recommend daily physical activity for health promotion.%题目:中国居民膳食指南(2016):评价和比较  概高质量的膳食在促进人类健康成长和防治包括癌症、心血管疾病、糖尿病和肥胖在内的多种慢性疾病中起着重要的作用。坚持高质量的膳食能有效地降低死亡率。为了帮助形成健康的生活方式,增强体质,中国政府发布了新的中国居民膳食指南(2016)和膳食宝塔,用来指导居民膳食的摄入。同样,日本政府早期发布了日本膳食指南陀螺模型,美国政府最近也出版了修订后的第八版美国居民膳食指南(2015–2020)。与指南相关的同期证据表明,遵循指南进行膳食指导,许多慢性疾病的发病率和

  3. Current evidence on dietary pattern and cognitive function.

    Science.gov (United States)

    Cheung, Bernice H K; Ho, Ivan C H; Chan, Ruth S M; Sea, Mandy M M; Woo, Jean

    2014-01-01

    With global aging population, age-related cognitive decline becomes epidemic. Lifestyle-related factor is one of the key preventative measures. Dietary pattern analysis which considers dietary complexity has recently used to examine the linkage between nutrition and cognitive function. A priori approach defines dietary pattern based on existing knowledge. Results of several dietary pattern scores were summarized. The heterogeneity of assessment methods and outcome measurements lead to inconsistent results. Posteriori approach derives a dietary pattern independently of the existing nutrition-disease knowledge. It showed a dietary pattern abundant with plant-based food, oily fish, lower consumption of processed food, saturated fat, and simple sugar which appears to be beneficial to cognitive health. Despite inconclusive evidence from both approaches, diet and exercise, beneficial for other diseases, remains to be the two key modifiable factors for cognitive function. Large-scale prospective studies in multiethics population are required to provide stronger evidence in the future.

  4. Barriers and facilitators for consumer adherence to the dietary guidelines for Americans: the HEALTH study.

    Science.gov (United States)

    Nicklas, Theresa A; Jahns, Lisa; Bogle, Margaret L; Chester, Deirdra N; Giovanni, Maria; Klurfeld, David M; Laugero, Kevin; Liu, Yan; Lopez, Sandra; Tucker, Katherine L

    2013-10-01

    The majority of the US population does not meet recommendations for consumption of milk, whole grains, fruit, and vegetables. The goal of our study was to understand barriers and facilitators to adherence to the Dietary Guidelines for Americans for four nutrient-rich food groups in fifth-grade children and unrelated adult caregivers across six sites in a multistate study. A total of 281 unrelated adult caregivers (32% African American, 33% European American, and 35% Hispanic American) and 321 children (33% African American, 33% European American, and 34% Hispanic American) participated in 97 Nominal Group Technique sessions. Nominal Group Technique is a qualitative method of data collection that enables a group to generate and prioritize a large number of issues within a structure that gives everyone an equal voice. The core barriers specific to unrelated adult caregivers were lack of meal preparation skills or recipes (whole grains, fruit, vegetables); difficulty in changing eating habits (whole grains, fruit, vegetables), cost (milk, whole grains, fruit, vegetables), lack of knowledge of recommendation/portion/health benefits (milk, vegetables), and taste (milk, whole grains, vegetables). Specific to children, the core barriers were competing foods (ie, soda, junk foods, sugary foods [whole grains, milk, fruit, vegetables]), health concerns (ie, milk allergy/upset stomach [milk]), taste/flavor/smell (milk, whole grains, fruit, vegetables), forget to eat them (vegetables, fruit), and hard to consume or figure out the recommended amount (milk, fruit). For both unrelated adult caregivers and children, reported facilitators closely coincided with the barriers, highlighting modifiable conditions that could help individuals to meet the Dietary Guidelines for Americans.

  5. Recent dietary guidelines to prevent and treat cardiovascular disease, diabetes, and obesity.

    Science.gov (United States)

    Wylie-Rosett, Judith; Mossavar-Rahmani, Yasmin; Gans, Kim

    2002-01-01

    Nutrition guidelines are emphasizing dietary patterns as primary and secondary prevention trials provide increasing evidence of the importance of lifestyle changes to prevent/control cardiovascular disease (CVD) risk factors such as diabetes and hypertension. Despite the increasing evidence that weight loss and modified dietary patterns are effective, there is considerable debate about the level of carbohydrate that will be most beneficial. Epidemiologic studies indicate that certain ethnic and racial minority groups have increased CVD risk with higher rates of obesity, hypertension, diabetes, and stroke. Immigrant and Native American populations have had a dramatic rise in obesity, diabetes, and ultimately CVD with acculturation, accompanied by a higher fat intake and decreased physical activity. Culturally tailored intervention approaches are being used to reduce risk. The lack of third-party payment still limits the availability of nutrition services. However, medical nutrition therapy is covered by Medicare for diabetes and pending legislation will extend coverage to CVD. Medical education researchers have developed tools such as the WAVE (Weight, Activity, Variety and Excess) pocket guide as a quick method to facilitate addressing referral for medical nutrition therapy that can be readily incorporated into practice settings.

  6. A review of consumer awareness, understanding and use of food-based dietary guidelines.

    Science.gov (United States)

    Brown, Kerry A; Timotijevic, Lada; Barnett, Julie; Shepherd, Richard; Lähteenmäki, Liisa; Raats, Monique M

    2011-07-01

    Food-based dietary guidelines (FBDG) have primarily been designed for the consumer to encourage healthy, habitual food choices, decrease chronic disease risk and improve public health. However, minimal research has been conducted to evaluate whether FBDG are utilised by the public. The present review used a framework of three concepts, awareness, understanding and use, to summarise consumer evidence related to national FBDG and food guides. Searches of nine electronic databases, reference lists and Internet grey literature elicited 939 articles. Predetermined exclusion criteria selected twenty-eight studies for review. These consisted of qualitative, quantitative and mixed study designs, non-clinical participants, related to official FBDG for the general public, and involved measures of consumer awareness, understanding or use of FBDG. The three concepts of awareness, understanding and use were often discussed interchangeably. Nevertheless, a greater amount of evidence for consumer awareness and understanding was reported than consumer use of FBDG. The twenty-eight studies varied in terms of aim, design and method. Study quality also varied with raw qualitative data, and quantitative method details were often omitted. Thus, the reliability and validity of these review findings may be limited. Further research is required to evaluate the efficacy of FBDG as a public health promotion tool. If the purpose of FBDG is to evoke consumer behaviour change, then the framework of consumer awareness, understanding and use of FBDG may be useful to categorise consumer behaviour studies and complement the dietary survey and health outcome data in the process of FBDG evaluation and revision.

  7. North and South American countries food-based dietary guidelines: A comparison.

    Science.gov (United States)

    Montagnese, Concetta; Santarpia, Lidia; Iavarone, Fabio; Strangio, Francesca; Caldara, Anna Rita; Silvestri, Eufemia; Contaldo, Franco; Pasanisi, Fabrizio

    2017-10-01

    Food-based dietary guidelines (FBDGs) are regularly updated educational documents that provide scientific information on nutritional needs and food composition to the general population. The aim of this study was to review the FBDGs of countries in the Americas and compare them based on their pictorial representation, food grouping, and associated messages on healthy eating and behavior, considering intercultural differences. FBDGs from 30 countries in the Americas were collected, representing 97% of the entire North and South American population. Of these FBDGs, 93% (28 of 30) have adopted a food guide illustration shape that conveys local traditions and classifies foods into six or seven groups. The main food groups are vegetables, fruits, cereals, starchy vegetables and fruits, legumes, milk and dairy, protein-rich foods, oils and fats, and sugar and sweeteners. Some differences include single food classifications. Despite the dietary pattern resulting from geographic conditions and cultural heritages, the main nutritional keypoints are similar among the different American FBDGs as follows: (1) Consume large amounts of fruits, vegetables, and cereals; and (2) limit intake of fat, simple sugars, and salt. Although there is general agreement on the basic nutritional messages, FBDGs remain insufficient regarding food groups and the identification of subgroup population nutritional requirements, particularly in countries where both excess and deficit malnutrition are present. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The current state of epilepsy guidelines: A systematic review.

    Science.gov (United States)

    Sauro, Khara M; Wiebe, Samuel; Dunkley, Colin; Janszky, Jozsef; Kumlien, Eva; Moshé, Solomon; Nakasato, Nobukazu; Pedley, Timothy A; Perucca, Emilio; Senties, Horacio; Thomas, Sanjeev V; Wang, Yuping; Wilmshurst, Jo; Jetté, Nathalie

    2016-01-01

    The International League Against Epilepsy (ILAE) Epilepsy Guidelines Task Force, composed of 14 international members, was established in 2011 to identify, using systematic review methodology, international epilepsy clinical care guidelines, assess their quality, and determine gaps in areas of need of development. A systematic review of the literature (1985-2014) was performed in six electronic databases (e.g. Medline, Embase) using a broad search strategy without initial limits to language or study design. Six gray literature databases (e.g., American Academy of Neurology [AAN], ILAE) were also searched to minimize publication bias. Two independent reviewers screened abstracts, reviewed full text articles, and performed data abstraction. Descriptive statistics and a meta-analysis were generated. The search identified 10,926 abstracts. Of the 410 articles selected for full text review, 63 met our eligibility criteria for a guideline. Of those included, 54 were in English and 9 were in other languages (French, Spanish, and Italian). Of all guidelines, 29% did not specify the target age groups, 27% were focused on adults, 22% included only children, and 6% specifically addressed issues related to women with epilepsy. Guidelines included in the review were most often aimed at guiding clinical practice for status epilepticus (n = 7), first seizure (n = 6), drug-resistant epilepsy (n = 5), and febrile seizures (n = 4), among others. Most of the guidelines were therapeutic (n = 35) or diagnostic (n = 16) in nature. The quality of the guidelines using a 1-7 point scale (7 = highest) varied and was moderate overall (mean = 4.99 ± 1.05 [SD]). We identified substantial gaps in topics (e.g., epilepsy in the elderly) and there was considerable heterogeneity in methodologic quality. The findings should offer a valuable resource for health professionals caring for people with epilepsy, since they will help guide the prioritization, development, and dissemination of future

  9. Steps Ahead: Adaptation of physical activity and dietary guidelines for reducing unhealthy weight gain in the Lower Misissippi Delta

    Science.gov (United States)

    The purpose of our study was to test the effectiveness of adapting the Dietary Guidelines for Americans (2010) (DG), with and without a physical activity (PA) component, in reducing weight gain in the Lower Mississippi Delta region (LMD) of the United States. A sample of 121 White and African-Americ...

  10. Development of the SoFAS(solid fats and added sugars) concept: The 2010 Dietary Guidelines for Americans

    Science.gov (United States)

    The diets of most U.S. children and adults are poor, as reflected by low diet quality scores, when compared with the recommendations of the Dietary Guidelines for Americans (DGAs). Contributing to these low scores is that most Americans overconsume solid fats, which may contain saturated fatty acids...

  11. Suitability Assessment of Printed Dietary Guidelines for Pregnant Women and Parents of Infants and Toddlers From 7 European Countries.

    Science.gov (United States)

    Garnweidner-Holme, Lisa Maria; Dolvik, Stina; Frisvold, Cathrine; Mosdøl, Annhild

    2016-02-01

    To evaluate selected European printed dietary guidelines for pregnant women and parents of infants and toddlers using the suitability assessment of materials (SAM) method. A descriptive study to determine the suitability of 14 printed dietary guidelines from 7 European countries based on deductive quantitative analyses. Materials varied greatly in format and content: 35.7% of materials were rated superior and 64.3% were rated adequate according to the overall SAM score for patient education material. None of the materials were scored not suitable. Among the categories, the highest average scores were for layout and typography and the lowest average scores were for cultural appropriateness and learning stimulation and motivation. Interrater reliability ranged from Cohen's kappa of 0.37 to 0.62 (mean, 0.41), indicating fair to moderate agreement among the 3 investigators. Overall, the suitability of the assessed printed dietary guidelines was adequate. Based on the SAM methodology, printed dietary guidelines may increase in suitability by emphasizing aspects related to health literacy and accommodating the needs of different food cultures within a population. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. The Dietary guideline 2005 and physical activities role in weight management of University Arkansas at Pine Bluff

    Science.gov (United States)

    To evaluate the effectiveness of the weight loss initiative, researchers at the University of Arkansas at Pine Bluff conducted an obesity prevention intervention based on the Dietary Guidelines for Americans approach. A 12 month study was conducted that focused on interventions to improve physical ...

  13. Current codex guidelines for assessment of potential protein allergenicity.

    Science.gov (United States)

    Ladics, G S

    2008-10-01

    A rigorous safety assessment process exists for GM crops. It includes evaluation of the introduced protein as well as the crop containing such protein with the goal of demonstrating the GM crop is "as-safe-as" non-transgenic crops in the food supply. One of the major issues for GM crops is the assessment of the expressed protein for allergenic potential. Currently, no single factor is recognized as an identifier for protein allergenicity. Therefore, a weight-of-evidence approach, which takes into account a variety of factors and approaches for an overall assessment of allergenic potential, is conducted [Codex Alimentarious Commission, 2003. Alinorm 03/34: Joint FAO/WHO Food Standard Programme, Codex Alimentarious Commission, Twenty-Fifth Session, Rome, Italy, 30 June-5 July, 2003. Appendix III, Guideline for the conduct of food safety assessment of foods derived from recombinant-DNA plants, and Appendix IV, Annex on the assessment of possible allergenicity, pp. 47-60]. This assessment is based on what is known about allergens, including the history of exposure and safety of the gene(s) source; protein structure (e.g., amino acid sequence identity to human allergens); stability to pepsin digestion in vitro [Thomas, K. et al., 2004. A multi-laboratory evaluation of a common in vitro pepsin digestion assay protocol used in assessing the safety of novel proteins. Regul. Toxicol. Pharmacol. 39, 87-98]; an estimate of exposure of the novel protein(s) to the gastrointestinal tract where absorption occurs (e.g., protein abundance in the crop, processing effects); and when appropriate, specific IgE binding studies or skin prick testing. Additional approaches may be considered (e.g., animal models; targeted sera screening) as the science evolves; however, such approaches have not been thoroughly evaluated or validated for predicting protein allergenicity.

  14. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on establishing Food-Based Dietary Guidelines

    DEFF Research Database (Denmark)

    Tetens, Inge

    This Opinion of the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) provides guidance on the translation of nutrient based dietary advice into guidance, intended for the European population as a whole, on the contribution of different foods or food groups to an overall diet...... that would help to maintain good health through optimal nutrition (food-based dietary guidelines). The main focus of this Opinion is put on the scientific process of developing food-based dietary guidelines (FBDG) for the diverse European populations, following a stepwise approach which should ideally...... of the outcome. FBDG should be consistent with other public policies that have an impact on food availability and be integrated with other policies related to health promotion. Once established, FBDG should be implemented and their impact monitored and evaluated....

  15. Food and dietary pattern-based recommendations: an emerging approach to clinical practice guidelines for nutrition therapy in diabetes.

    Science.gov (United States)

    Sievenpiper, John L; Dworatzek, Paula D N

    2013-02-01

    Clinical practice guidelines (CPGs) for the nutritional management of diabetes mellitus have evolved considerably over the last 25 years. As major diabetes associations have focussed on the individualization of nutrition therapy, there has been a move toward a broader more flexible macronutrient distribution that emphasizes macronutrient quality over quantity. There is now a call for the integration of food- and dietary pattern-based approaches into diabetes association CPGs. The main argument has been that an approach that focuses on nutrients alone misses important nutrient interactions oversimplifying the complexity of foods and dietary patterns, both of which have been shown to have a stronger influence on disease risk than nutrients alone. Although cancer and heart associations have begun to integrate this approach into their dietary guidelines, diabetes associations have not yet adopted this approach. We provide a rationale for the adoption of this approach for The Canadian Diabetes Association (CDA) 2013 CPGs for nutrition therapy. The systematic review for the development of these guidelines revealed emerging evidence to support the use of vegetarian, Mediterranean, and Dietary Approaches to Stop Hypertension (DASH) dietary patterns as well as specific foods such as dietary pulses and nuts in people with diabetes. Popular and conventional weight loss diets were also found to have similar advantages in people with diabetes, although poor dietary adherence remains an issue with these diets. The CDA 2013 CPGs will support an even greater individualization of nutrition therapy for people with diabetes and appeal to a broader range of practice styles of health professionals. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  16. Eating Habits and Dietary Intake: Is Adherence to Dietary Guidelines Associated with Importance of Healthy Eating among Undergraduate University Students in Finland?

    Science.gov (United States)

    El Ansari, Walid; Suominen, Sakari; Samara, Anastasia

    2015-12-01

    Poor eating habits among young adults are a public health concern. This survey examined the eating habits of undergraduate university students in Finland. We assessed students' dietary intake of a variety of food groups, their adherence to international dietary guidelines (whole sample and by gender), and the associations between importance of eating healthy and dietary guidelines adherence (whole sample and by gender). During the 2013-2014 academic year, 1,189 undergraduate students enrolled at the University of Turku in southwestern Finland completed an online self-administered questionnaire. Students reported their eating habits of 12 food groups, the number of daily servings of fruits/vegetables they consume and how important it is for them to eat healthy. For dietary adherence recommendations, we employed WHO guidelines. Chi-square statistic tested the differences in dietary guidelines adherence between males and females and also the associations between the gradients of importance of healthy eating and the self reported eating habits for each of the food groups, for the whole sample and by gender. We observed high levels of dietary adherence (>70%) for most of the 'unhealthy food' items (cake/cookies, snacks, fast food/canned food, and lemonade/soft drinks), and moderate adherence for most of the 'healthy food' items (>50%) (dairy/dairy products, fruit/vegetables servings/day, fresh fruit, salads/raw vegetables and cereal/cereal products). Fish/seafood, meat/sausage products and cooked vegetables had levels sausage products, fast food/canned food and for most 'healthy food' items (p≤0.001), whereas men had better adherence for sweets (difference=12.8%, p≤0.001), lemonade/soft drinks (difference=16.7%, p≤0.001) and fish/seafood (difference=6.6%, p=0.040) compared to women. Most students considered important to eat healthy (78.8%). The importance of eating healthy was significantly associated with adherence for all food groups besides sweets and cake

  17. [Update on current care guidelines: urinary tract infections].

    Science.gov (United States)

    Wuorela, Maarit; Kouri, Timo; Laato, Matti; Lipponen, Pertti; Sammalkorpi, Kari; Uhari, Matti; Uusitalo, Leena; Vuento, Risto

    2011-01-01

    This guideline is focused on the diagnostics and treatment of acute, recurrent and relapsing urinary tract infections in adults and children. Sexually transmitted diseases are not addressed, but must be considered in differential diagnostics. The resistance prevalence of the causative microbes and the ecological adverse effects of antimicrobial agents were considered important factors in selecting optimal therapeutic choices for the guideline. Diagnosis and management of cystitis in otherwise healthy women aged 18-65 years can be based on structured telephone interviews. Primary antimicrobiotic drugs are nitrofurantoin, pivmesillinam and trimetoprim for three days.

  18. Dietary supplements and their future in health care: commentary on draft guidelines proposed by the Food and Drug Administration.

    Science.gov (United States)

    Umhau, John C; Garg, Keva; Woodward, Albert M

    2012-03-01

    The Dietary Supplement and Health and Education Act of 1994 gives the U.S. Food and Drug Administration (FDA) responsibility for oversight of the dietary supplement industry. Recent draft guidelines proposed by the FDA to insure the safety of new dietary ingredients would significantly alter the ability of manufacturers to bring new dietary ingredients to market, and may cause many products introduced since 1994 to be discontinued. These changes will have an impact on health care, but with limited research on dietary supplements and how their use affects the health care system, there is no way to predict what their overall effect on health will be. Since the natural raw materials for dietary supplements are often inexpensive and generally cannot be patented, manufactures have little incentive to conduct the research which might otherwise be warranted. Appropriate clinical trials that evaluate the use and efficacy of various supplements may be critical for our health care system. If inexpensive dietary supplements are found to be safe and effective, such research could yield significant cost savings as well as health benefits.

  19. Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

  20. Economic evaluation guidelines in Latin America: a current snapshot.

    Science.gov (United States)

    Augustovski, Federico; Garay, Osvaldo Ulises; Pichon-Riviere, Andres; Rubinstein, Adolfo; Caporale, Joaquín E

    2010-10-01

    Economic evaluation guidelines are widespread in developed countries with fourth hurdle systems but as of yet not in Latin America. In the present article, a systematic search was conducted in order to retrieve regional guidelines in PubMed, Latin American and Caribbean Health Sciences Literature (LILACS) and the gray literature. Four national guidelines were found: Brazil, Colombia, Cuba and Mexico. We report a thorough review of these documents, as well as a comparison among them. We conclude that, despite some differences found, they are broadly similar, and are broadly in accordance with international documents. The existence of these documents, together with other experiences in the region that explicitly use economic evaluation information for health decision making clearly shows that this global tendency is gaining momentum in Latin America, although there is still a long way to go. In the near future we will be able to see if these documents were successfully used and applied for transparent and evidence-based decision making.

  1. Core Stability in Athletes: A Critical Analysis of Current Guidelines.

    Science.gov (United States)

    Wirth, Klaus; Hartmann, Hagen; Mickel, Christoph; Szilvas, Elena; Keiner, Michael; Sander, Andre

    2017-03-01

    Over the last two decades, exercise of the core muscles has gained major interest in professional sports. Research has focused on injury prevention and increasing athletic performance. We analyzed the guidelines for so-called functional strength training for back pain prevention and found that programs were similar to those for back pain rehabilitation; even the arguments were identical. Surprisingly, most exercise specifications have neither been tested for their effectiveness nor compared with the load specifications normally used for strength training. Analysis of the scientific literature on core stability exercises shows that adaptations in the central nervous system (voluntary activation of trunk muscles) have been used to justify exercise guidelines. Adaptations of morphological structures, important for the stability of the trunk and therefore the athlete's health, have not been adequately addressed in experimental studies or in reviews. In this article, we explain why the guidelines created for back pain rehabilitation are insufficient for strength training in professional athletes. We critically analyze common concepts such as 'selective activation' and training on unstable surfaces.

  2. Improving Asthma during Pregnancy with Dietary Antioxidants: The Current Evidence

    Directory of Open Access Journals (Sweden)

    Vicki L. Clifton

    2013-08-01

    Full Text Available The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS. Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health.

  3. Improving asthma during pregnancy with dietary antioxidants: the current evidence.

    Science.gov (United States)

    Grieger, Jessica A; Wood, Lisa G; Clifton, Vicki L

    2013-08-14

    The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS). Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i) review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii) provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health.

  4. Improving Asthma during Pregnancy with Dietary Antioxidants: The Current Evidence

    Science.gov (United States)

    Grieger, Jessica A.; Wood, Lisa G.; Clifton, Vicki L.

    2013-01-01

    The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS). Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i) review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii) provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health. PMID:23948757

  5. The role of yogurt in improving the quality of the American diet and meeting dietary guidelines.

    Science.gov (United States)

    Webb, Densie; Donovan, Sharon M; Meydani, Simin Nikbin

    2014-03-01

    The Dietary Guidelines for Americans (DGA) recommend three daily servings of low- or nonfat dairy products, yet two-thirds of individuals in the United States do not meet that goal. Including low- or nonfat yogurt as part of an overall healthful diet can be a positive step toward meeting the DGA recommendations. Yogurt naturally contains calcium and potassium, and some products are fortified with vitamin D. All of these nutrients were identified in the DGA as "nutrients of concern," because typical intake falls far short of recommended intakes. Yogurt can also be an excellent source of high-quality protein, which promotes satiety, helps in maintaining a healthy body weight, and aids muscle and bone growth. In addition, yogurt is low in sodium and contributes 1.0% or less of added sugars to the diets of most individuals in the United States; however, 90% of children and adults consume less than 8 ounces (1 cup) of yogurt per week. Thus, consuming 1 serving of yogurt per day would help to meet the DGA-recommended dairy servings and would provide nutrients of concern.

  6. Endothelial function, arterial stiffness, and adherence to the 2010 Dietary Guidelines for Americans: a cross-sectional analysis

    Science.gov (United States)

    Sauder, Katherine A.; Proctor, David N.; Chow, Mosuk; Troy, Lisa M.; Wang, Na; Vita, Joseph A.; Vasan, Ramachandran S.; Mitchell, Gary F.; Jacques, Paul F.; Hamburg, Naomi M.; West, Sheila G.

    2015-01-01

    Endothelial dysfunction and arterial stiffness are early predictors of cardiovascular disease. Intervention studies suggest that diet is related to vascular health, but most prior studies tested individual foods or nutrients and relied on small samples of younger adults. The purpose of this study was to examine relations between adherence to the 2010 Dietary Guidelines for Americans and vascular health in a large, cross-sectional analysis. In 5887 adults in the Framingham Heart Study Offspring and Third Generation cohorts, diet quality was quantified with the 2010 Dietary Guidelines for Americans Index (DGAI-2010). Endothelial function was assessed via brachial artery ultrasound and arterial stiffness via arterial tonometry. In age-, sex-, and cohort-adjusted analyses, higher DGAI-2010 score (greater adherence) was modestly associated with lower resting flow velocity, hyperemic response, mean arterial pressure, carotid-femoral pulse wave velocity, and augmentation index, but not associated with resting arterial diameter or flow-mediated dilation. In multivariable models adjusting for cardiovascular risk factors, only the association of higher DGAI-2010 with lower baseline flow and augmentation index persisted (β=−0.002, P=0.003 and β=−0.05 ± 0.02, Pscores with lower mean arterial pressure, pulse wave velocity, and augmentation index was more pronounced among adults younger than 50 years. Better adherence to the 2010 Dietary Guidelines for Americans, particularly in younger adults, is associated with lower peripheral blood flow velocity and arterial wave reflection but not flow-mediated dilation. Our results suggest a link between adherence to the Dietary Guidelines and favorable vascular health. PMID:25885520

  7. The Food Dome: dietary guidelines for Arab countries La Cúpula alimentaria: guías dietéticas para los países árabes

    Directory of Open Access Journals (Sweden)

    A. O. Musaiger

    2012-02-01

    Full Text Available Dietary guidelines are important tool for selection a healthy diet. There is no special dietary guidelines for Arab people. Health Institutes are mainly using the Western dietary guidelines, such as American Food Pyramid. The objective of this paper therefore, was to summarize the steps taken by Arab Centers for Nutrition to establish "Food Dome", the dietary guidelines for the Arab countries. The development of Food Dome was done in eight steps as: 1 Identification of the current nutrition problems, 2 Identification of current food consumption patterns, 3 Identification of food groups used in the region, 4 Identification of specific foods within each group, 5 Estimation of nutritional profile for each group, 6 Identification the serving sizes for each group, 7 Incorporating physical activity into the food guidelines, 8 Identification of the pictorial illustration for the food guidelines. This Food Dome provides dietary guidelines for the Arab people to prevent the risk of diet-related diseases. It is also a useful tool for nutrition education. However, more testing in the target population is needed to evaluate the understanding of messages delivered by this Food Dome.Las guías dietéticas son una herramienta importante para la selección de una dieta saludable. No existen guías dietéticas específicas para las personas de origen árabe. Los Institutos de Salud utilizan principalmente las guías dietéticas occidentales, como la Pirámide americana de la alimentación. Por lo tanto, el objetivo de este artículo es el de resumir los pasos dados por los Centros Árabes para la Nutrición para establecer la "Cúpula alimentaria", las guías dietéticas para los países árabes. El desarrollo de la Cúpula alimentaria se realizó en ocho pasos: 1 Identificación de los problemas nutricionales actuales; 2 Identificación de los patrones actuales de consumo de alimentos; 3 Identificación de los grupos de alimentos usados en la región; 4

  8. “Enjoy a variety of foods”: as a food-based dietary guideline for ...

    African Journals Online (AJOL)

    2013-04-08

    Apr 8, 2013 ... enjoying meals together as a family or with friends.30. Unique use of ... Eating dinner with others is associated with better markers of dietary .... of regular meal frequency on dietary thermogenesis, insulin, sensitivity and fasting ...

  9. Screening for prostate cancer: the current evidence and guidelines controversy.

    Science.gov (United States)

    Gomella, Leonard G; Liu, Xiaolong S; Trabulsi, Edouard J; Kelly, Wm Kevin; Myers, Ronald; Showalter, Timothy; Dicker, Adam; Wender, Richard

    2011-10-01

    Prostate cancer presents a global public health dilemma. While screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years, the potential for negative effects from over-diagnosis and treatment cannot be ignored. We reviewed Medline for recent articles that discuss clinical trials, evidence based recommendations and guidelines from major medical organizations in the United States and worldwide concerning prostate cancer screening. Results from the European Randomized Screening for Prostate Cancer (ERSPC), the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, and Göteborg Swedish trials regarding prostate screening are controversial with the ERSPC and Göteborg showing a reduction in prostate cancer mortality and the PLCO trial showing no benefit. Recommendations from the American Urological Association (AUA), Japanese Urological Association (JUA), and National Comprehensive Cancer Network (NCCN) have recommended that all men obtain a baseline PSA beginning at age 40. The American Cancer Society (ACS) stratifies screening recommendations based on age and risk, but states that screening should take place only after an informed discussion between provider and patient. The United States Preventative Health Service Task Force (USPSTF) states that evidence is insufficient to assess the risks and benefits of prostate cancer screening in men younger than 75 years. Other major international health organizations offer a similar reserved approach or recommend against screening for prostate cancer. Most groups indicate that screening to determine who should undergo prostate biopsy typically includes both a serum PSA and digital rectal examination, with the latest ACS publications noting that the rectal exam is optional. A common theme from all groups is that an informed discussion with the patients is strongly recommended and that screening does increase the number of men diagnosed with non

  10. Low Adherence to Dietary Guidelines in Spain, Especially in the Overweight/Obese Population: The ANIBES Study.

    Science.gov (United States)

    Rodríguez-Rodríguez, Elena; Aparicio, Aránzazu; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Serra-Majem, Lluis; Varela-Moreiras, Gregorio; Ortega, Rosa M

    2017-01-01

    The objective of this study was to analyze the dietary intake of the Spanish population according to ponderal status and body fat distribution. Data were obtained from ANIBES (Anthropometry, Intake, and Energy Balance in Spain), a cross-sectional study of a nationally representative sample (1013 men, 996 women) of the Spanish population (18-64 years). The final fieldwork was carried out from mid-September to November (three months) 2013. A 3-day dietary record provided information about food and beverage consumption. Height, weight, and waist circumference were assessed, and body mass index (BMI) and waist-height ratio (WHtR) calculated. The Spanish population had a low consumption of fruits and vegetables, cereals, whole cereals, and dairy and high consumption of meat products. Individuals with overweight/obesity (BMI ≥ 25 kg/m(2)) and abdominal adiposity (WHtR ≥ 0.5) showed lower compliance with dietary guidelines. In the male group, adjusting by age, inadequate consumption of cereals (adherence to dietary guidelines.

  11. Current clinical practice guidelines in atrial fibrillation: a review

    Directory of Open Access Journals (Sweden)

    osé Kelvin Galvez-Olortegui

    2016-03-01

    Full Text Available El objetivo del presente estudio es la evaluación metodológica de las guías de práctica clínica en fibrilación auricular. Este es el segundo de una serie de artículos de revisión, análisis, valoración metodológica y contenido de las guías de práctica clínica en cardiología. De todas las guías de práctica clínica se seleccionaron la Guía Americana, Canadiense y la del National Institute for Health and Care Excellence, (NICE, por su sigla en inglés, y se utilizó el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE II para evaluar cada una de ellas En general, las guías obtuvieron el menor puntaje en el dominio de aplicabilidad (media 36,1%; mientras que el mayor puntaje fue para el dominio de claridad en la presentación (media 93,5%. El menor puntaje hallado fue en el dominio de independencia editorial (Guía Canadiense y el mayor de todos los puntajes fue en el dominio “Claridad de la presentación” (guía The National Institute for Health and Care Excellence, NICE. Al evaluar la calidad global de las guías de práctica clínica analizadas, NICE es la que mejor puntuaciones obtiene al aplicar el instrumento Appraisal of Guidelines for Research and Evaluation II (AGREE, seguido de la americana, siendo ambas recomendadas sin modificaciones.

  12. Galeazzi fractures: Is DRUJ instability predicted by current guidelines?

    Science.gov (United States)

    Tsismenakis, Tony; Tornetta, Paul

    2016-07-01

    Clinically significant distal radioulnar joint (DRUJ) injuries can occur with radial shaft fractures. Several radiographic methods of diagnosis, such as radial shortening of >5mm or fracture line within 7.5cm from the lunate facet, have been proposed but not clinically validated. The purpose of this study was to compare radiographic measurements of radial shaft fractures associated with and without clinically significant DRUJ injury (i.e., true Galeazzi fracture-dislocation) in order to evaluate the predictive value of reported parameters of DRUJ injury. A retrospective record and radiographic review was performed of 66 consecutive skeletally mature patients with isolated radial shaft fractures from 2004 to 2014 treated at one level 1 academic trauma center. Intraoperatively determined DRUJ instability after radial shaft fixation was used as the gold standard for diagnosis of a Galeazzi fracture-dislocation. Average age was 34 years old (range: 18-90). By thirds, there were 10 proximal (15%), 27 middle (41%), and 29 distal (44%) fractures. 13 (20%) had an associated ulnar styloid fracture. 7 (11%) patients had DRUJ instability after radial fixation. Radial shortening averaged 4.4±5.2mm (-2.6-22), and 21 had shortening of >5mm. Twenty-six (39%) fractures were within 7.5cm of the wrist joint. Previous guidelines were only moderately accurate. Even greater shortening did not predict instability (3/7 patients with >10mm shortening had a true injury). Four out of 7 cases with instability had ulnar styloid fractures (p=0.02). Using a larger data set than has historically been evaluated, previously reported radiographic guidelines are only moderately accurate. The presence of an ulnar styloid fracture can be helpful. Surgeons should be aware of these associations but rely primarily on intraoperative assessment of the DRUJ after radial fixation to determine treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Dietary patterns, food groups and telomere length: a systematic review of current studies.

    Science.gov (United States)

    Rafie, N; Golpour Hamedani, S; Barak, F; Safavi, S M; Miraghajani, M

    2017-02-01

    Telomere length (TL) is recognized as a biomarker of aging and shorter telomeres are linked with shorter lifespan. Inter-individual variability in telomere length is highly heritable. However, there has been a resurgence of interest in the controversial relationship between diet and TL. Evaluating the impact of diet at the food group and dietary pattern level will provide greater insight into the effect of diet on TL dynamics, which are of significant importance in health and longevity. This article reports the first systematic review of the relation between food groups, dietary patterns and TL in human populations based on PRISMA guidelines.

  14. Do current sports nutrition guidelines conflict with good oral health?

    Science.gov (United States)

    Broad, Elizabeth M; Rye, Leslie A

    2015-01-01

    For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs.

  15. Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes, and related disorders in Asian Indians.

    Science.gov (United States)

    Misra, Anoop; Sharma, Rekha; Gulati, Seema; Joshi, Shashank R; Sharma, Vinita; Ghafoorunissa; Ibrahim, Ahamed; Joshi, Shilpa; Laxmaiah, Avula; Kurpad, Anura; Raj, Rebecca K; Mohan, Viswanathan; Chandalia, Hemraj; Krishnaswamy, Kamala; Boindala, Sesikeran; Gopalan, Sarath; Bhattiprolu, Siva Kumar; Modi, Sonal; Vikram, Naval K; Makkar, Brij Mohan; Mathur, Manju; Dey, Sanjit; Vasudevan, Sudha; Gupta, Shashi Prabha; Puri, Seema; Joshi, Prashant; Khanna, Kumud; Mathur, Prashant; Krishnaswamy, Sheela; Madan, Jagmeet; Karmarkar, Madhukar; Seth, Veenu; Passi, Santosh Jain; Chadha, Davinder; Bhardwaj, Swati

    2011-06-01

    India is undergoing rapid nutritional transition, resulting in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and low intake of fiber. Such dietary transition and a sedentary lifestyle have led to an increase in obesity and diet-related non-communicable diseases (type 2 diabetes mellitus [T2DM], cardiovascular disease [CVD], etc.) predominantly in urban, but also in rural areas. In comparison with the previous guidelines, these consensus dietary guidelines include reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of fiber, lower intake of saturated fats, optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar. While these guidelines are applicable to Asian Indians in any geographical setting, they are particularly applicable to those residing in urban and in semi-urban areas. Proper application of these guidelines will help curb the rising "epidemics" of obesity, the metabolic syndrome, hypertension, T2DM, and CVD in Asian Indians.

  16. Dietary Guidelines for the Spanish population (SENC, diciembre 2016); the new graphic icon of healthy food

    Science.gov (United States)

    Aranceta Bartrina, Javier; Arija Val, Victoria; Maíz Aldalur, Edurne; Martínez de Victoria Muñoz, Emilio; Ortega Anta, Rosa María; Pérez-Rodrigo, Carmen; Quiles Izquierdo, Joan; Rodríguez Martín, Amelia; Román Viñas, Blanca; Salvador Castell, Gemma; Tur Marí, Josep Antoni; Varela Moreira, Gregorio; Serra Majem, Lluis

    2016-12-07

    Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientific evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

  17. Translating MyPlate into Food Selections that Meet Dietary Guidelines Recommendations

    Directory of Open Access Journals (Sweden)

    Jessica Bachman

    2016-10-01

    Full Text Available The objective was to determine if individuals could plan a diet that met the Dietary Guidelines (DG using MyPlate as a guide. Participants (n=73 were 38.9±17.0 years of age, with 97% being Non-Hispanic White, 95% having some college education, and Body Mass Index (BMI of 26.7±5.9. Participants used MyPlate to plan a one-day menu using food models. Nutrition literacy, nutrition scanning behavior, and nutrition information-seeking experience were assessed. Menus were analyzed using Nutrition Data Systems for Research and were compared to individualized DG recommendations. A multiple linear regression examined what characteristics predicted energy difference scores (difference between energy from menu and DG. Participant menus were lower in energy, grains, and dairy; and higher in fruits and vegetables than DGs (p < 0.001. The regression model was significant (R2 = 0.24; p < 0.01 with sex (B = -386.92; p < 0.05, BMI (B = 29.29; p < 0.05 with nutrition information-seeking experience (B = 44.90; p < 0.05 predicting energy difference score. Being male, having a higher BMI, and experiencing more frustration during nutrition informationseeking were associated with higher energy difference scores. It was challenging for this sample of well-educated individuals to make food selections that met the DGs using MyPlate. Extension professionals should not assume that consumers understand and can apply the key messages of MyPlate.

  18. Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition

    Science.gov (United States)

    Aranceta Bartrina, Javier; Arija Val, Victoria; Maíz Aldalur, Edurne; Martínez de la Victoria Muñoz, Emilio; Ortega Anta, Rosa María; Pérez-Rodrigo, Carmen; Quiles Izquierdo, Joan; Rodríguez Martín, Amelia; Román Viñas, Blanca; Salvador Castell, Gemma; Tur Marí, Josep Antoni; Varela Moreiras, Gregorio; Serra Majem, Lluis

    2016-12-07

    Objective: The Spanish Society of Community Nutrition (SENC) designed in 1994 a food guide for the Spanish population, updated in 2001. This report presents a new updated edition based on the best scientifi c evidence available. Methods: From a health in all policies approach, a group of experts in nutrition and public health associated with SENC was convened to review the evidence on diet-health, nutrition intake and food consumption in the Spanish population, as well as food preparation and consumption habits, determinants and impact of diet on environmental sustainability. Existing systematic reviews, updates, reports, meta-analysis and the latest quality studies have been considered. The collaborative group contributed to draft the document and design the graphic icon, then subject of a consultation process, discussion and qualitative evaluation, particularly relevant through the Advisory Group for the SENC-December 2016 Dietary Guidelines. Results: The new recommendations and its graphical representation highlights as basic considerations the practice of physical activity, emotional balance, energy balance to maintain body weight at adequate levels, healthy cooking procedures and adequate water intake. The recommendations promote a balanced, varied and moderate diet that includes whole grains, fruits, vegetables, legumes, varying amounts of dairy and alternating consumption of fi sh, eggs and lean meats, along with the preferential use of extra virgin olive oil for cooking and seasoning. Reinforce the interest in a healthy, sympathetic, supportive, sustainable diet, based on seasonal and local products, axis for conviviality, devoting adequate time and encourage the use of nutrition labelling information. Conclusions: The analysis of the evidence available and updated information on food consumption in Spain highlights the need to strengthen and implement the recommendations contained in this document to progressively achieve a greater adherence.

  19. Perioperative anesthetic documentation: Adherence to current Australian guidelines

    Directory of Open Access Journals (Sweden)

    Islam Elhalawani

    2013-01-01

    Full Text Available Purpose: The lack of adequate perioperative documentation has legal implications and can potentially affect the quality and safety of patient care. Despite the presence of guidelines, the adequacy of perioperative documentation in Australasia has not been adequately assessed. The aim of this study is to assess the adequacy of anesthetic documentation on the pre and intraoperative encounters and to test the hypotheses that documentation is incomplete in the settings of emergency vs. elective procedures, regional vs. general anesthesia, and manual vs. electronic documentation. Materials and Methods: The study was an observational retrospective study in the setting of a 250-bed teaching hospital in metropolitan Adelaide, Australia. The perioperative records of 850 patients were analyzed. A scoring system was designed, based on a policy statement from the Australian and New Zealand College of Anesthetists and a survey of the hospital anesthetists. Scored and categorical data was analyzed using Chi-square test. Numerical data was analyzed using student t-test. The null hypothesis was accepted or rejected at 0.05 significance. Results: There were significant deficiencies in the adequacy of preanesthetic and intraoperative records. This has been shown to be true in all cases. Documentation was found to be poorer in the emergency setting when compared to elective cases (median scores 15 vs. 21 P = 0.03 as well as documentation of airway assessment for cases done solely under regional anesthesia (42 vs. 85%, P = 0.05. There were no significant differences in the adequacy of electronic vs. manual records ( P = 0.92. Conclusion: There are significant deficiencies in the adequacy of perioperative records. This has been shown to be true in all cases, but is especially so in emergency cases and for patients having only regional anesthesia.

  20. Revision of food-based dietary guidelines for Ireland, Phase 2: recommendations for healthy eating and affordability.

    Science.gov (United States)

    Flynn, Mary A T; O'Brien, Clare M; Ross, Victoria; Flynn, Cliona A; Burke, Sarah J

    2012-03-01

    To revise the food-based dietary guidelines for Ireland and assess the affordability of healthy eating. An iterative process was used to develop 4 d food intake patterns (n 22) until average intakes met a range of nutrient and energy goals (at moderate and sedentary activity levels) that represented the variable nutritional requirements of all in the population aged 5 years and older. Dietary guidelines were formulated describing the amounts and types of foods that made up these intake patterns. Foods required for healthy eating by typical households in Ireland were priced and affordability assessed as a proportion of relevant weekly social welfare allowances. Government agency/community. General population aged 5+ years. Food patterns developed achieved energy and nutrient goals with the exception of dietary fibre (inadequate for adults with energy requirements food group to guide on fats/oils intake was developed. Servings within the Bread, Cereal and Potato group were sub-categorized on the basis of energy content. Recommendations on numbers of servings from each food group were developed to guide on energy and nutrient requirements. Healthy eating is least affordable for families with children who are dependent on social welfare. Daily supplementation with vitamin D is recommended. Wholemeal breads and cereals are recommended as the best source of energy and fibre. Low-fat dairy products and reduced-fat unsaturated spreads are prioritized to achieve saturated fat and energy goals. Interventions are required to ensure that healthy eating is affordable.

  1. Is "processed" a four-letter word? The role of processed foods in achieving dietary guidelines and nutrient recommendations.

    Science.gov (United States)

    Dwyer, Johanna T; Fulgoni, Victor L; Clemens, Roger A; Schmidt, David B; Freedman, Marjorie R

    2012-07-01

    This paper, based on the symposium "Is 'Processed' a Four-Letter Word? The Role of Processed Foods in Achieving Dietary Guidelines and Nutrient Recommendations in the U.S." describes ongoing efforts and challenges at the nutrition-food science interface and public health; addresses misinformation about processed foods by showing that processed fruits and vegetables made important dietary contributions (e.g., fiber, folate, potassium, vitamins A and C) to nutrient intake among NHANES 2003-2006 participants, that major sources of vitamins (except vitamin K) were provided by enrichment and fortification and that enrichment and fortification helped decrease the percentage of the population below the Estimated Average Requirement for vitamin A, thiamin, folate, and iron; describes how negative consumer perceptions and consumer confusion about processed foods led to the development of science-based information on food processing and technology that aligns with health objectives; and examines challenges and opportunities faced by food scientists who must balance consumer preferences, federal regulations, and issues surrounding food safety, cost, unintended consequences, and sustainability when developing healthful foods that align with dietary guidelines.

  2. Do current national and international guidelines have specific recommendations for older adults with bipolar disorder?

    DEFF Research Database (Denmark)

    Dols, Annemiek; Kessing, Lars Vedel; Strejilevich, Sergio A

    2016-01-01

    and compared recommendations from current national and international guidelines that specifically address geriatric or older individuals with BD (from year 2005 onwards). RESULTS: There were 34 guidelines, representing six continents and 19 countries. The majority of guidelines had no separate section on OABD...... a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world. METHODS: The International Society of Bipolar Disorders OABD task force compiled...... and mostly not informed by specific research evidence. CONCLUSIONS: There is a lack of emphasis of OABD-specific issues in existing guidelines. Given the substantial clinical heterogeneity in BD across the life span, along with the rapidly expanding population of older individuals worldwide, and limited...

  3. Informed consent in human subject research: a comparison of current international and Nigerian guidelines.

    Science.gov (United States)

    Fadare, Joseph O; Porteri, Corinna

    2010-03-01

    Informed consent is a basic requirement for the conduct of ethical research involving human subjects. Currently, the Helsinki Declaration of the World Medical Association and the International Ethical Guidelines for Biomedical Research of the Council for International Organizations of Medical Sciences (CIOMS) are widely accepted as international codes regulating human subject research and the informed consent sections of these documents are quite important. Debates on the applicability of these guidelines in different socio-cultural settings are ongoing and many workers have advocated the need for national or regional guidelines. Nigeria, a developing country, has recently adopted its national guideline regulating human subject research: the National Health Research Ethics Committee (NHREC) code. A content analysis of the three guidelines was done to see if the Nigerian guidelines confer any additional protection for research subjects. The concept of a Community Advisory Committee in the Nigerian guideline is a novel one that emphasizes research as a community burden and should promote a form of "research friendship" to foster the welfare of research participants. There is also the need for a regular update of the NHREC code so as to address some issues that were not considered in its current version.

  4. [Comments on current guidelines of type 2 diabetes mellitus treatment].

    Science.gov (United States)

    Martinka, Emil

    In an effort to facilitate the widest possible application of recent findings in diabetology and the related medical fields, with regard to characteristics of medicines and current possibilities of using modern procedures, but also to their limitations due to the financial capacities of health insurance companies, SDS innovates its therapeutic recommendations for the treatment of diabetes mellitus on a regular basis. The most recent recommendations were issued by SDS in August 2016. The review discusses and describes several factors which the authors considered during their preparation: (1) Compliance with the findings of evidence-based medicine, compliance with reference recommendations (therapeutic recommendations ADA/EASD), compliance with summary characteristics of active substances in the treatment of diabetes mellitus and approved possibilities of their use, and compliance with indica-tive restrictions (IO) which define medical and economic conditions for health insurance covered treatment. (2) Certain departure from the "glucocentric" approach to therapy, in favour of the approach preferring the selection of drugs based on clinical characteristics of the patient and proven benefits/risks of individual drugs (3) Preference of groups as well as individual active substances within groups based on evidence medicine regarding the individual active substances for specific patient groups. (4) Emphasis on individualization of goals for glycemic control (5) Emphasis on the right classification of diabetes mellitus as the basic condition for the selection of an optimum thera-peutic procedure, and (6) Emphasis on education and overcoming of clinical inertia, and patient medication adherence and medication "literacy" as the basic condition for successful therapy. The discussion also considers the outcomes of the most recent studies including of the studies focusing on empagliflozin and liraglutide, as well as recent modifications of the therapeutic recommendations of

  5. The role of traditional foods in food-based dietary guidelines - A South African case study on maas (cultured milk).

    Science.gov (United States)

    Du Plooy, Z; Schönfeldt, H C; Hall, N

    2018-01-01

    With the revision of the South African food-based dietary guidelines (FBDGs) a new guideline specifically recommending the daily consumption of dairy products including maas (cultured milk) was introduced. This paper aims to evaluate the relevance of including maas as a traditional food product in the FBDGs. It was found that maas is a culturally relevant and traditional food product in South Africa. The nutrient profile of maas has changed notably over time since the first nutrient analysis was performed in 1995. The health benefits of maas, together with its popularity and its cultural relevance as part of the South African diet, make maas a suitable traditional food product to be included in the South African FBDGs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Dietary copper and human health: Current evidence and unresolved issues.

    Science.gov (United States)

    Bost, Muriel; Houdart, Sabine; Oberli, Marion; Kalonji, Esther; Huneau, Jean-François; Margaritis, Irène

    2016-05-01

    Although copper (Cu) is recognized as an essential trace element, uncertainties remain regarding Cu reference values for humans, as illustrated by discrepancies between recommendations issued by different national authorities. This review examines human studies published since 1990 on relationships between Cu intake, Cu balance, biomarkers of Cu status, and health. It points out several gaps and unresolved issues which make it difficult to assess Cu requirements. Results from balance studies suggest that daily intakes below 0.8 mg/day lead to net Cu losses, while net gains are consistently observed above 2.4 mg/day. However, because of an incomplete collection of losses in all studies, a precise estimation of Cu requirements cannot be derived from available data. Data regarding the relationship between Cu intake and potential biomarkers are either too preliminary or inconclusive because of low specificity or low sensitivity to change in dietary Cu over a wide range of intakes. Results from observation and intervention studies do not support a link between Cu and a risk of cardiovascular disease, cognitive decline, arthritis or cancer for intakes ranging from 0.6 to 3mg/day, and limited evidence exists for impaired immune function in healthy subjects with a very low (0.38 mg/day) Cu intake. However, data from observation studies should be regarded with caution because of uncertainties regarding Cu concentration in various foods and water. Further studies that accurately evaluate Cu exposure based on reliable biomarkers of Cu status are needed.

  7. Poor adherence to dietary guidelines among adult survivors of childhood acute lymphoblastic leukemia

    OpenAIRE

    Robien, Kim; Ness, Kirsten K.; Klesges, Lisa M.; Baker, K. Scott; Gurney, James G.

    2008-01-01

    Recent studies indicate that survivors of childhood acute lymphocytic leukemia (ALL) are at increased risk of obesity and cardiovascular disease, conditions that healthy dietary patterns may help ameliorate or prevent. To evaluate the usual dietary intake of adult survivors of childhood ALL, food frequency questionnaire data were collected from 72 participants, and compared with the 2007 WCRF/AICR Cancer Prevention recommendations, the DASH diet, and the 2005 USDA Food Guide. Mean daily energ...

  8. Infective endocarditis prophylaxis: current practice trend among paediatric cardiologists: are we following the 2007 guidelines?

    Science.gov (United States)

    Naik, Ronak J; Patel, Neil R; Wang, Ming; Shah, Nishant C

    2016-08-01

    In 2007, the American Heart Association modified the infective endocarditis prophylaxis guidelines by limiting the use of antibiotics in patients with cardiac conditions associated with the highest risk of adverse outcomes after infective endocarditis. Our objective was to evaluate current practice for infective endocarditis prophylaxis among paediatric cardiologists. A web-based survey focussing on current practice, describing the use of antibiotics for infective endocarditis prophylaxis in various congenital and acquired heart diseases, was distributed via e-mail to paediatric cardiologists. The survey was kept anonymous and was distributed twice. Data from 253 participants were analysed. Most paediatric cardiologists discontinued infective endocarditis prophylaxis in patients with simple lesions such as small ventricular septal defect, patent ductus arteriosus, and bicuspid aortic valve without stenosis or regurgitation; however, significant disagreement persists in prescribing infective endocarditis prophylaxis in certain conditions such as rheumatic heart disease, Fontan palliation without fenestration, and the Ross procedure. Use of antibiotic prophylaxis in certain selected conditions for which infective endocarditis prophylaxis has been indicated as per the current guidelines varies from 44 to 83%. Only 44% follow the current guidelines exclusively, and 34% regularly discuss the importance of oral hygiene with their patients at risk for infective endocarditis. Significant heterogeneity still persists in recommending infective endocarditis prophylaxis for several cardiac lesions among paediatric cardiologists. More than half of the participants (56%) do not follow the current guidelines exclusively in their practice. Counselling for optimal oral health in patients at risk for infective endocarditis needs to be optimised in the current practice.

  9. A Mismatch Between Athlete Practice and Current Sports Nutrition Guidelines Among Elite Female and Male Middle- and Long-Distance Athletes.

    Science.gov (United States)

    Heikura, Ida A; Stellingwerff, Trent; Mero, Antti A; Uusitalo, Arja Leena Tuulia; Burke, Louise M

    2017-08-01

    Contemporary nutrition guidelines promote a variety of periodized and time-sensitive recommendations, but current information regarding the knowledge and practice of these strategies among world-class athletes is limited. The aim of this study was to investigate this theme by implementing a questionnaire on dietary periodization practices in national/international level female (n = 27) and male (n = 21) middle- and long-distance runners/race-walkers. The questionnaire aimed to gain information on between and within-day dietary choices, as well as timing of pre- and posttraining meals and practices of training with low or high carbohydrate (CHO) availability. Data are shown as percentage (%) of all athletes, with differences in responses between subgroups (sex or event) shown as Chi-square x(2) when p key sessions. Twenty-six percent of athletes (11% of middle vs 42% of long-distance athletes [x(2) (1, n = 46) = 4.308, p = .038, phi = 0.3])) reported to undertake training in the fasted state, while 11% said they periodically restrict CHO intake, with 30% ingesting CHO during training sessions. Our findings show that elite endurance athletes appear to execute pre- and post-key session nutrition recovery recommendations. However, very few athletes deliberately undertake some contemporary dietary periodization approaches, such as training in the fasted state or periodically restricting CHO intake. This study suggests mismatches between athlete practice and current and developing sports nutrition guidelines.

  10. Dietary intervention in the management of phenylketonuria: current perspectives

    Directory of Open Access Journals (Sweden)

    Rocha JC

    2016-12-01

    Full Text Available Júlio César Rocha,1-3 Anita MacDonald4 1Centro de Genética Médica, Centro Hospitalar do Porto – CHP, 2Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 3Center for Health Technology and Services Research (CINTESIS, Porto, Portugal; 4The Children’s Hospital, Birmingham, UK Abstract: Phenylketonuria (PKU is a well-described inborn error of amino acid metabolism that has been treated for >60 years. Enzyme deficiency causes accumulation of phenylalanine (Phe and if left untreated will lead to profound and irreversible intellectual disability in most children. Traditionally, it has been managed with a low-Phe diet supplemented with a Phe-free protein substitute although newer treatment options mainly in combination with diet are available for some subgroups of patients with PKU, for example, sapropterin, large neutral amino acids, and glycomacropeptide. The diet consists of three parts: 1 severe restriction of dietary Phe; 2 replacement of non-Phe L-amino acids with a protein substitute commonly supplemented with essential fatty acids and other micronutrients; and 3 low-protein foods from fruits, some vegetables, sugars, fats and oil, and special low-protein foods (SLPF. The prescription of diet is challenging for health professionals. The high-carbohydrate diet supplied by a limited range of foods may program food preferences and contribute to obesity in later life. Abnormal tasting and satiety-promoting protein substitutes are administered to coincide with peak appetite times to ensure their consumption, but this practice may impede appetite for other important foods. Intermittent dosing of micronutrients when combined with L-amino acid supplements may lead to their poor bioavailability. Much work is required on the ideal nutritional profiling for special SLPF and Phe-free L-amino acid supplements. Although non-diet treatments are being studied, it is important to continue to fully understand all the consequences of diet

  11. Dietary reference intakes for vitamin D based on the revised 2010 dietary guidelines are not being met by children in Alberta, Canada.

    Science.gov (United States)

    Munasinghe, Lalani L; Willows, Noreen; Yuan, Yan; Veugelers, Paul J

    2015-11-01

    Canadian children have been shown to be not meeting the revised (2010) dietary recommended intake (DRI) for vitamin D through diet alone. However, no study has evaluated whether diet and supplementation together are supporting Canadian children in meeting the DRIs for vitamin D intake. This study assessed the adequacy of vitamin D intake through diet and supplements among Albertan children and the determinants of meeting dietary guidelines. 2686 grade 5 students aged 10 to 11 years in Alberta, Canada were surveyed. We hypothesized that less than 50% of children would meet the DRI. Vitamin D intake from diet and supplements was assessed using a food frequency questionnaire. The adequacy of vitamin D intake was estimated using the Estimated Average Requirement (EAR) of 400 IU (International Units) and Recommended Dietary Allowance (RDA) of 600 IU. Random effect multiple logistic regression was used to identify correlates of meeting DRIs. Forty five percent of children met the EAR and 22% met the RDA for vitamin D. When vitamin D intake from diet alone was considered, only 16% and 2% met the EAR and RDA, respectively. Parental education, household income and physical activity were positively correlated with meeting DRIs, and students attending metropolitan area schools were more likely to meet the EAR than students attending rural area schools (OR = 1.28; P = .043). The majority of children did not meet the DRI for vitamin D. Health promotion strategies aiming to improve the vitamin D status of Albertan children are necessary given the importance of vitamin D for children's health and development.

  12. A review of current guidelines for the management of Helicobacter pylori infection in children and adolescents

    OpenAIRE

    Jones, Nicola L.

    2004-01-01

    Helicobacter pylori infection is acquired in childhood and plays a causative role in chronic gastritis, peptic ulcer disease and the development of gastric cancer. The present review focuses on recent advances in the management of H pylori infection in children and provides an update of current Canadian guidelines regarding clinical sequelae, diagnosis and treatment.

  13. Critical analysis of the current treatment guidelines for complex ptsd in adults

    NARCIS (Netherlands)

    de Jongh, A.; Resick, P.A.; Zoelner, L.A.; van Minnen, A.; Lee, C.W.; Monson, C.M.; Foa, E.B.; Wheeler, K.; ten Broeke, E.; Feeny, N.; Rauch, S.A.M.; Chard, K.M.; Mueser, K.T.; Sloan, D.M.; van der Gaag, M.; Rothbaum, B.O.; Neuner, F.; de Roos, C.; Hehenkamp, L.M.J.; Rosner, R.; Bicanic, I.A.E.

    2016-01-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a “stabilization phase.” This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused

  14. CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS

    NARCIS (Netherlands)

    De Jongh, Ad; Resick, Patricia A.; Zoellner, Lori A.; Van Minnen, Agnes; Lee, Christopher W.; Monson, Candice M.; Foa, Edna B.; Wheeler, Kathleen; Broeke, Erik Ten; Feeny, Norah; Rauch, Sheila A M; Chard, Kathleen M.; Mueser, Kim T.; Sloan, Denise M.; Van Der Gaag, Mark; Rothbaum, Barbara Olasov; Neuner, Frank; De Roos, Carlijn; Hehenkamp, Lieve M J; Rosner, Rita; Bicanic, Iva A E

    2016-01-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused

  15. The evaluation of uveitis in juvenile idiopathic arthritis (JIA) patients : are current ophthalmologic screening guidelines adequate?

    NARCIS (Netherlands)

    Reininga, J K; Los, L I; Wulffraat, N M; Armbrust, W

    2008-01-01

    OBJECTIVE: The aims of this study are to examine in our juvenile idiopathic arthritis (JIA) population: 1) the prevalence and characteristics of uveitis, 2) the complications and outcome of uveitis, 3) prognostic factors, and 4) the adequacy of the current ophthalmologic screening guidelines. METHOD

  16. The evaluation of uveitis in juvenile idiopathic arthritis (JIA) patients : are current ophthalmologic screening guidelines adequate?

    NARCIS (Netherlands)

    Reininga, J K; Los, L I; Wulffraat, N M; Armbrust, W

    2008-01-01

    OBJECTIVE: The aims of this study are to examine in our juvenile idiopathic arthritis (JIA) population: 1) the prevalence and characteristics of uveitis, 2) the complications and outcome of uveitis, 3) prognostic factors, and 4) the adequacy of the current ophthalmologic screening guidelines. METHOD

  17. Building an information security strategy for EHR: guidelines for assessing the current situation.

    Science.gov (United States)

    Mohammad, Yara; Stergioulas, Lampros

    2010-01-01

    This paper is looking at electronic health record (EHR) systems and their information security strategy. It focuses on the first step of building an information security strategy which is analysing the current situation of an EHR system. This research is based on different research methods applied to different EHR systems. In this paper we define eight elements that can be used as guidelines for how best to assess the current situation of any EHR system.

  18. Food and beverage choices contributing to dietary guidelines adherence in the Lower Mississippi Delta

    Science.gov (United States)

    The objectives of this study were to evaluate dietary quality among Lower Mississippi Delta (LMD) residents using the Healthy Eating Index-2005 (HEI-2005), determine the major food sources contributing to HEI-2005 components, and investigate demographic differences in HEI-2005 scores and major food ...

  19. An introduction to the revised food-based dietary guidelines for ...

    African Journals Online (AJOL)

    2013-04-08

    Apr 8, 2013 ... The perception that “people eat foods and not nutrients” led ... effort was a response to the World Declaration and Plan of Action ... is to simultaneously ensure the adoption of adequate diets .... the relationships between dietary intakes and health, led ... technical support paper according to a specific terms-.

  20. Dietary prevention of allergic disease in children : Are current recommendations really based on good evidence?

    NARCIS (Netherlands)

    Brand, Paul L. P.; Vlieg-Boerstra, Berber J.; Dubois, Anthony E. J. .

    2007-01-01

    We provide a critical appraisal of the literature on the effects of dietary prevention of atopic disease in children. In our view, currently available studies suffer from lack of blinding which is a major problem if the primary end point is subjective (Such as the diagnosis of eczema). In addition,

  1. [Methodology for the development and update of practice guidelines: current state].

    Science.gov (United States)

    Barrera-Cruz, Antonio; Viniegra-Osorio, Arturo; Valenzuela-Flores, Adriana Abigail; Torres-Arreola, Laura Pilar; Dávila-Torres, Javier

    2016-01-01

    The current scenario of health services in Mexico reveals as a priority the implementation of strategies that allow us to better respond to the needs and expectations of individuals and society as a whole, through the provision of efficient and effective alternatives for the prevention, diagnosis and treatment of diseases. In this context, clinical practice guidelines constitute an element of management in the health care system, whose objective is to establish a national bechmark for encouraging clinical and management decision making, based on recommendations from the best available evidence, in order to contribute to the quality and effectiveness of health care. The purpose of this document is to show the methodology used for the development and updating of clinical practice guidelines that the Instituto Mexicano del Seguro Social has developed in line with the sectorial model in order to serve the user of these guidelines.

  2. Qualitative study among African American parents to inform an intervention to promote adoption of the dietary guidelines for Americans food and phyical activity recommendations

    Science.gov (United States)

    This qualitative study was conducted to enable the research team to culturally tailor an intervention to increase adherence to the dietary guidelines for Americans (DGA) in African American parents and their children living in Lower Mississippi Delta (LMD) Communities. Focus group results guided the...

  3. Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health

    DEFF Research Database (Denmark)

    Stephen, Alison M; Champ, Martine M-J; Cloran, Susan J

    2017-01-01

    Research into the analysis, physical properties and health effects of dietary fibre has continued steadily over the last 40-50 years. From the knowledge gained, countries have developed guidelines for their populations on the optimal amount of fibre to be consumed each day. Food composition table...

  4. Current practices and guidelines for clinical next-generation sequencing oncology testing

    Institute of Scientific and Technical Information of China (English)

    Samuel P. Strom

    2016-01-01

    Next-generation sequencing (NGS) has been rapidly integrated into molecular pathology, dramatically increasing the breadth genomic of information available to oncologists and their patients. This review will explore the ways in which this new technology is currently applied to bolster care for patients with solid tumors and hematological malignancies, focusing on practices and guidelines for assessing the technical validity and clinical utility of DNA variants identified during clinical NGS oncology testing.

  5. Decreased suicide rate after induced abortion, after the Current Care Guidelines in Finland 1987-2012.

    Science.gov (United States)

    Gissler, Mika; Karalis, Elina; Ulander, Veli-Matti

    2015-02-01

    Women with a recent induced abortion have a 3-fold risk for suicide, compared to non-pregnant women. The increased risk was recognised in unofficial guidelines (1996) and Current Care Guidelines (2001) on abortion treatment, highlighting the importance of a check-up 2 - 3 weeks after the termination, to monitor for mental health disorders. We studied the suicide trends after induced abortion in 1987 - 2012 in Finland. We linked the Register on Induced Abortions (N = 284,751) and Cause-of-Death Register (N = 3798 suicides) to identify women who had committed suicide within 1 year after an induced abortion (N = 79). The abortion rates per 100,000 person-years were calculated for 1987 - 1996 (period with no guidelines), 1997 - 2001 (with unofficial guidelines) and 2002 - 2012 (with Current Care Guidelines). The suicide rate after induced abortion declined by 24%, from 32.4/100,000 in 1987 - 1996 to 24.3/100,000 in 1997 - 2001 and then 24.8/100,000 in 2002 - 2012. The age-adjusted suicide rate among women aged 15 - 49 decreased by 13%; from 11.4/100,000 to 10.4/100,000 and 9.9/100,000, respectively. After induced abortions, the suicide rate increased by 30% among teenagers (to 25/100,000), stagnated for women aged 20 - 24 (at 32/100,000), but decreased by 43% (to 21/100,000) for women aged 25 - 49. The excess risk for suicide after induced abortion decreased, but the change was not statistically significant. Women with a recent induced abortion still have a 2-fold suicide risk. A mandatory check-up may decrease this risk. The causes for the increased suicide risk, including mental health prior to pregnancy and the social circumstances, should be investigated further. © 2014 the Nordic Societies of Public Health.

  6. Refractory Immune Thrombocytopenic Purpura and Cytomegalovirus Infection: A Call for a Change in the Current Guidelines

    Directory of Open Access Journals (Sweden)

    Alex Shimanovsky

    2016-01-01

    Full Text Available Immune thrombocytopenic purpura (ITP is characterized by a decreased platelet count caused by excess destruction of platelets and inadequate platelet production. In many cases the etiology is not known, but viral illness is thought to play a role in the development of some cases of ITP. The current (2011 American Society of Hematology ITP guidelines recommend initial diagnostic studies to include testing for HIV and Hepatitis C. The guidelines suggest that initial treatment consist of observation, therapy with corticosteroids, IVIG or anti D. While most cases respond to the standard therapy such that the steroids may be tapered and the platelet counts remain at a hemostatically safe level. Some patients with ITP are dependent on long term steroid maintenance and the thrombocytopenia persists with the tapering of the steroids. Recent case reports demonstrate that ITP related to cytomegalovirus (CMV can persist in spite of standard therapy and that antiviral therapy maybe indicated. Herein we report a case of a 26-year-old female with persistent ITP that resolved after the delivery of a CMV infected infant and placenta. Furthermore we review the current literature on CMV-associated ITP and propose that the current ITP guidelines be amended to include assessment for CMV as part of the work-up for severe and refractory ITP prior to splenectomy.

  7. Review of the current management of upper urinary tract injuries by the EAU Trauma Guidelines Panel.

    Science.gov (United States)

    Serafetinides, Efraim; Kitrey, Noam D; Djakovic, Nenad; Kuehhas, Franklin E; Lumen, Nicolaas; Sharma, Davendra M; Summerton, Duncan J

    2015-05-01

    The most recent European Association of Urology (EAU) guidelines on urological trauma were published in 2014. To present a summary of the 2014 version of the EAU guidelines on upper urinary tract injuries with the emphasis upon diagnosis and treatment. The EAU trauma guidelines panel reviewed literature by a Medline search on upper urinary tract injuries; publication dates up to December 2013 were accepted. The focus was on newer publications and reviews, although older key references could be included. A full version of the guidelines is available in print and online. Blunt trauma is the main cause of renal injuries. The preferred diagnostic modality of renal trauma is computed tomography (CT) scan. Conservative management is the best approach in stable patients. Angiography and selective embolisation are the first-line treatments. Surgical exploration is primarily for the control of haemorrhage (which may necessitate nephrectomy) and renal salvage. Urinary extravasation is managed with endourologic or percutaneous techniques. Complications may require additional imaging or interventions. Follow-up is focused on renal function and blood pressure. Penetrating trauma is the main cause of noniatrogenic ureteral injuries. The diagnosis is often made by CT scanning or at laparotomy, and the mainstay of treatment is open repair. The type of repair depends upon the severity and location of the injury. Renal injuries are best managed conservatively or with minimally invasive techniques. Preservation of renal units is feasible in most cases. This review, performed by the EAU trauma guidelines panel, summarises the current management of upper urinary tract injuries. Patients with trauma benefit from being accurately diagnosed and treated appropriately, according to the nature and severity of their injury. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  8. Cancer screening in the United States, 2016: A review of current American Cancer Society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Andrews, Kimberly; Brooks, Durado; DeSantis, Carol E; Fedewa, Stacey A; Lortet-Tieulent, Joannie; Manassaram-Baptiste, Deana; Brawley, Otis W; Wender, Richard C

    2016-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines, including the update of the breast cancer screening guideline, discuss quality issues in colorectal cancer screening and new developments in lung cancer screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey.

  9. Yoghurt and probiotic bacteria in dietary guidelines of the member states of the European Union.

    Science.gov (United States)

    Smug, L N; Salminen, S; Sanders, M E; Ebner, S

    2014-03-01

    Beneficial microbes enter the food supply primarily through fermented foods (largely milks) and addition of probiotics. Fermented milks are a significant component of the diet of some geographical regions, including Europe. The fermentation process serves to preserve safety, nutritional quality and palatability of milk. In addition, the microbes associated with fermented milks and probiotics are associated with human health benefits. However, in the area of health claims only one claim for beneficial microbes has been approved in the European Union, that is for yoghurt to improve lactose tolerance. We searched for health messages that include probiotics or fermented milks in nutrition guidelines and recommendations in thirteen countries of the EU plus Switzerland. Such messages are allowed when they are made by non-commercial government bodies. Our analysis revealed that five EU member states have national nutrition guidelines or recommendations that include either probiotics or fermented milks with live bacteria. This supports that some EU member states recognise health benefits associated with consumption of live microbes, even if commercial marketing claims are not authorised. Harmonisation between recommendations and approved health-claims would benefit consumers and public health.

  10. Addressing malnutrition in young children in South Africa. Setting the national context for paediatric food-based dietary guidelines.

    Science.gov (United States)

    Bourne, Lesley T; Hendricks, Michael K; Marais, Debbie; Eley, Brian

    2007-10-01

    Despite various national nutrition and primary healthcare programmes being initiated in South Africa over the last decade, child health has deteriorated. This is seen by the rise in infant and child mortality rates, the high prevalence of preventable childhood diseases, e.g. diarrhoea and lower respiratory tract infections, and the coexistence of under-nutrition along with HIV/AIDS. Poor dietary intake, food insecurity and poor quality of basic services prevail within this precarious causal web. The national Integrated Nutrition Programme is a comprehensive nutrition strategy that focuses on children below 6 years old, at-risk pregnant and lactating women, and those affected by communicable and non-communicable diseases. Focus areas relevant to pre-school children include disease-specific nutrition treatment, support and counselling; growth monitoring and promotion (GMP); micronutrient malnutrition control; breastfeeding promotion, protection and support; contributions to household food security; nutrition interventions among HIV-infected children; and nutrition promotion, education and advocacy. Progress towards this includes the Baby-Friendly Hospital Initiative; mandatory fortification of maize meal and wheat flour with multiple micronutrients; vitamin A supplementation coverage and mandatory iodization of salt by legislation; the provision of free road-to-health charts for GMP; and the National School Nutrition Programme. Since 2003, the basis of the nutrition education strategy has been the locally developed food-based dietary guidelines (FBDGs), directed at adults and school-going children. This review sketches the backdrop to and motivation for the introduction of specifically targeted paediatric FBDGs, for mothers and caregivers of children from birth to age 7 years, as a national initiative.

  11. Protein needs in athletes and dietary-nutrition guidelines to gain muscle mass

    Directory of Open Access Journals (Sweden)

    Aritz Urdampilleta

    2014-05-01

    Full Text Available One of the most important effects of strength training is muscular hypertrophy. Athletes should optimize their nutritional management in order to compensate their own genetic limitations. The aim of this review is to analyze the scientific evidence concerning protein intake as a tool to achieve muscle hypertrophy. Depending on the expenditure and energy intake of athlete, a daily protein ranging between 10-15% of total dietary intake is needed. However in sports diets, it is preferable to estimate the amount of protein needed per kilogram of body weight in each individual. In this regard athletes should ingest an amount between 1.2 g and 1.8 g of proteins/kg of body mass/day to maintain their lean mass. In order to increase muscle mass (0.5 kg/week, athletes should take between 1.6 g and 1.8 g of protein/kg/day with an increase of 400-500 kcal in their daily diet. These needs will depend on the sport, muscular catabolic status, the athlete’s lean mass and glycogen stores. Protein needs will increase if muscle and liver glycogen stores are empty. Excess of protein intake (more than 2 g/kg/day, with full glycogen stores, does not benefit the athlete and could cause an increase in circulating ketones and urea, thereby producing an early dehydration.

  12. Limited percentages of adults in Washington State meet the Dietary Guidelines for Americans recommended intakes of fruits and vegetables.

    Science.gov (United States)

    Ta, Myduc L; VanEenwyk, Juliet; Bensley, Lillian

    2012-05-01

    Nutritious diets that include sufficient intake of fruits and vegetables promote health and reduce risk for chronic diseases. The 2005 Dietary Guidelines for Americans recommend four to 13 servings of fruits and vegetables daily for energy intake levels of 1,000 to 3,200 kcal, including seven to 13 servings for 1,600 to 3,000 kcal/day as recommended for adults aged ≥25 years. The 2006-2007 Washington Adult Health Survey, a cross-sectional study designed to measure risk factors for cardiovascular disease among a representative sample of Washington State residents aged ≥25 years, included a food frequency questionnaire (FFQ). The FFQ included approximately 120 food items and summary questions for fruits and vegetables that were used to compute energy intake and two measures of fruit and vegetable intake. Measure 1 was computed as the sum of intake of individual FFQ fruit and vegetable items; Measure 2 combined the summary questions with selected individual FFQ fruit and vegetable items. Depending on the measure used, approximately 14% to 22% of 519 participants with complete information met the guidelines for fruits, 11% to 15% for vegetables, and 5% to 6% for both fruits and vegetables. Participants aged ≥65 years and women were more likely to meet recommendations, compared with younger participants and men. Despite decades of public health attention, the vast majority of Washington State residents do not consume the recommended amount of fruits or vegetables daily. These findings underscore the need for developing and evaluating new approaches to promote fruit and vegetable consumption.

  13. Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

    Science.gov (United States)

    Daly, S.; Rainford, L.; Butler, M. L.

    2014-03-01

    Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

  14. Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

    Directory of Open Access Journals (Sweden)

    Donny L. F. Chang

    2013-01-01

    Full Text Available Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

  15. Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel.

    Science.gov (United States)

    Lumen, Nicolaas; Kuehhas, Franklin E; Djakovic, Nenad; Kitrey, Noam D; Serafetinidis, Efraim; Sharma, Davendra M; Summerton, Duncan J

    2015-05-01

    The most recent European Association of Urology (EAU) guidelines on urologic trauma were published in 2014. To present a summary of the 2014 version of the EAU guidelines on urologic trauma of the lower urinary tract with an emphasis on diagnosis and treatment. The EAU Trauma Panel reviewed the English-language literature via a Medline search for lower urinary tract injury (LUTI) up to November 2013. The focus was on newer publications and reviews, although older key references could be included. A full version of the guidelines is available in print (EAU Guidelines 2014 edition, ISBN/EAN 978-90-79754-65-6) and online (www.uroweb.org). Blunt trauma is the main cause of LUTI. The preferred diagnostic modality for bladder and urethral injury is cystography and urethrography, respectively. In the treatment of bladder injuries, it is important to distinguish between extra- and intraperitoneal ruptures. Treatment of male anterior urethral injuries depends on the cause (blunt vs penetrating vs penile-fracture-related injury). Blunt posterior urethral injuries can be corrected by immediate/early endoscopic realignment. If this is not possible, such injuries are managed by suprapubic urinary diversion and deferred (>3 mo) urethroplasty. Treatment of female urethral injuries depends on the location of the injury and is usually surgical. Correct treatment of LUTIs is important to minimise long-term urinary symptoms and sexual dysfunction. This review performed by the EAU trauma panel summarises the current management of LUTIs. Patients with trauma to the lower urinary tract benefit from accurate diagnosis and appropriate treatment according to the nature and severity of their injury. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  16. [Treatment of arterial hypertension in pregnancy in relation to current guidelines of the Polish Society of Arterial Hypertension from 2011].

    Science.gov (United States)

    Szczepaniak-Chicheł, Ludwina; Tykarski, Andrzej

    2012-10-01

    Arterial hypertension concerns 7-10% of pregnancies and leads to an increased risk of complications for both, the mother and the child. This rate will probably rise in the years to come due to the notable tendency among women to delay the decision to become pregnant - values of blood pressure and occurrence of arterial hypertension increase with age, as well as due to the growing problem of obesity resulting from inappropriate dietary habits and lack of regular everyday physical activity. Difficulties with management of that clinical condition are partly related with lack of unified and widely accepted guidelines. Different opinions in the subject of terminology and classification of pregnancy hypertension or indications for pharmacotherapy as well as choice of the optimal antihypertensive drug, emerge from objective causes such as combination of various pathogenetic factors typical for arterial hypertension itself and those connected with pregnancy elsewhere stressed priorities of therapy from the point of view of the health of the mother and of the fetus, as well as lack of randomized clinical trials due to obvious ethical purposes, but also from the fact that pregnancy hypertension is a focus of attention for different specialists - obstetricians, hypertensiologists and perinatologists. A good cooperation regarding experience and information among all of these specializations would be the most beneficial for pregnant women and their children. Lack of new modern antihypertensive agents, safe and effective in pregnancy while the older ones are being withdrawn from the market as their production is no longer cost-effective for pharmacological companies, has become an increasing problem in many countries, and Poland among them. The aim of the following publication was to present the statement on management of pregnancy hypertension from the current guidelines of the Polish Society of Arterial Hypertension 2011 to gynecologists and obstetricians, with a commentary

  17. [Motivations and barriers of chilean children; threats or opportunities for the implementation of 2013 food based dietary guidelines].

    Science.gov (United States)

    Olivares, Sonia; Zacarías, Isabel; González, Carmen Gloria

    2014-08-01

    Implementation of the updated Food Based Dietary Guidelines (FBDG) for the Chilean population requires the design of innovative strategies and effective. To determine motivations and barriers for children and mothers of preschool-age children to follow new FBDG messages, aiming to identify challenges and opportunities for designing effective communication and implementation strategies. A qualitative study based on 12 focus groups of 9 to 13 age children and 6 focus groups of mothers of preschool-age children, living in the north, central and south regions of the country, to analyze their reaction to each one of the 2013 FBDG messages. Answers of children and mothers did not show differences by gender (in the case of the children) or region of the country. Results show the most frequent and representative comments regarding each message. Challenges to reducing the consumption of foods high in energy, fat, sugar and salt include advertisements and plentiful supply and low prices for these types of foods, both in the school environment and on the street. Opportunities identified included the advertisement of fruits, vegetables and dairy products to promote their consumption, as well as the coming implementation of Law 20.606, which is expected to be an effective way to support this initiative. The results of this study show that the design of strategies based on values, desires and needs of different groups will contribute to optimizing the implementation of the 2013 Chilean FBDG. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Combining estimates of interest in prognostic modelling studies after multiple imputation: current practice and guidelines

    Directory of Open Access Journals (Sweden)

    Holder Roger L

    2009-07-01

    Full Text Available Abstract Background Multiple imputation (MI provides an effective approach to handle missing covariate data within prognostic modelling studies, as it can properly account for the missing data uncertainty. The multiply imputed datasets are each analysed using standard prognostic modelling techniques to obtain the estimates of interest. The estimates from each imputed dataset are then combined into one overall estimate and variance, incorporating both the within and between imputation variability. Rubin's rules for combining these multiply imputed estimates are based on asymptotic theory. The resulting combined estimates may be more accurate if the posterior distribution of the population parameter of interest is better approximated by the normal distribution. However, the normality assumption may not be appropriate for all the parameters of interest when analysing prognostic modelling studies, such as predicted survival probabilities and model performance measures. Methods Guidelines for combining the estimates of interest when analysing prognostic modelling studies are provided. A literature review is performed to identify current practice for combining such estimates in prognostic modelling studies. Results Methods for combining all reported estimates after MI were not well reported in the current literature. Rubin's rules without applying any transformations were the standard approach used, when any method was stated. Conclusion The proposed simple guidelines for combining estimates after MI may lead to a wider and more appropriate use of MI in future prognostic modelling studies.

  19. CT pulmonary angiography utilization in the emergency department: diagnostic yield and adherence to current guidelines.

    Science.gov (United States)

    Perelas, Apostolos; Dimou, Anastasios; Saenz, Augustina; Rhee, Ji Hyun; Teerapuncharoen, Krittika; Rowden, Adam; Eiger, Glenn

    2015-01-01

    The aim is to investigate the patterns of computed tomography pulmonary angiography (CTPA) use and adherence to current guidelines. Medical records of patients investigated with CTPA for pulmonary embolism (PE) in a single academic hospital from January 2011 until December 2012 were reviewed. Wells scores were calculated retrospectively by researchers blinded to the results of the CTPA. "Avoidable imaging" was defined as imaging performed against current recommendations of the European Society of Cardiology or the PIOPED investigation group. A total of 646 patients underwent testing; 61 cases of PE were diagnosed (9.4%). Potentially avoidable imaging was performed in 49.5% and 71.5% of patients, depending on the criteria used; 11.5% of imaging studies were performed in low-risk patients with negative D-dimer assays. There is evidence of CTPA overuse and D-dimer underuse. Adherence to guidelines and appropriate use of D-dimer assay might reduce avoidable imaging and ionizing radiation exposure. © The Author(s) 2014.

  20. Cost of treating chronic hepatitis B: Comparison of current treatment guidelines

    Institute of Scientific and Technical Information of China (English)

    Monica Robotin; Yumi Patton; Melanie Kansil; Andrew Penman; Jacob George

    2012-01-01

    AIM:To compare program costs of chronic hepatitis B (CHB) screening and treatment using Australian and other published CHB treatment guidelines.METHODS:Economic modeling demonstrated that in Australia a strategy of hepatocellular cancer (HCC)prevention in patients with CHB is more cost-effective than current standard care,or HCC screening.Based upon this model,we developed the B positive program to optimize CHB management of Australians born in countries of high CHB prevalence.We estimated CHB program costs using the B positive program algorithm and compared them to estimated costs of using the CHB treatment guidelines published by the AsianPacific,American and European Associations for the Study of Liver Disease (APASL,AASLD,EASL) and those suggested by an independent United States hepatology panel.We used a Markov model that factored in the costs of CHB screening and treatment,individualized by viral load and alanine aminotransferase levels,and calculated the relative costs of program components.Costs were discounted by 5% and calculated in Australian dollars (AUD).RESULTS:Using the B positive algorithm,total program costs amount to 13 979 224 AUD,or 9634 AUD per patient.The least costly strategy is based upon using the AASLD guidelines,which would cost 34% less than our B positive algorithm.Using the EASL and the United States Expert Group guidelines would increase program costs by 46%.The largest expenditure relates to the cost of drug treatment (66.9% of total program costs).The contribution of CHB surveillance (20.2%)and HCC screening and surveillance (6.6%) is small -and together they represent only approximately a quarter of the total program costs.CONCLUSION:The significant cost variations in CHB screening and treatment using different guidelines are relevant for clinicians and policy makers involved in designing population-based disease control programs.(C) 2012 Baishideng.All rights reserved.

  1. Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States

    Science.gov (United States)

    Moore, Andrew; Nelson, Christina; Molins, Claudia; Mead, Paul

    2016-01-01

    In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. Sensitivity of 2-tiered testing is low (30%–40%) during early infection while the antibody response is developing (window period). For disseminated Lyme disease, sensitivity is 70%–100%. Specificity is high (>95%) during all stages of disease. Use of other diagnostic tests for Lyme disease is limited. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics. PMID:27314832

  2. Challenges in pancreatic adenocarcinoma surgery - National survey and current practice guidelines

    Science.gov (United States)

    Dhayat, Sameer A.; Mirgorod, Philip; Lenschow, Christina; Senninger, Norbert

    2017-01-01

    Background Pancreatic ductal adenocarcinoma (PDAC) remains one of the most deadly cancers in Europe and the USA. There is consensus that radical tumor surgery is the only viable option for any long-term survival in patients with PDAC. So far, limited data are available regarding the routine surgical management of patients with advanced PDAC in the light of surgical guidelines. Methods A national survey on perioperative management of patients with PDAC and currently applied criteria on their tumor resectability in German university and community hospitals was carried out. Results With a response rate of 81.6% (231/283) a total of 95 (41.1%) participating departments practicing pancreatic surgery in Germany are certified as competence and reference centers for surgical diseases of the pancreas in 2016. More than 95% of them indicate to carry out structured and interdisciplinary therapies along with an interdisciplinary pre- and postoperative tumor board. The majority of survey respondents prefer the pylorus-preserving partial pancreatoduodenectomy (93.1%) with standard lymphadenectomy for cancer of the pancreatic head. Intraoperative histological evaluation of the resection margins is used regularly by 99% of the survey respondents. 98.7% of survey respondents carry out partial or complete vein resection, 126 respondents (54.5%) would resect tumor adjacent arteries, and 102 respondents (44.2%) would perform metastasectomy if complete PDAC resection (R0) is possible. Conclusion Evidence-based and standardized pancreatic surgery is practiced by a large number of hospitals in Germany. However, a significant number of survey respondents support an extended radical tumor resection in patients with advanced PDAC even when not indicated by current clinical guidelines. PMID:28267771

  3. [Update on current care guidelines: physical activity and exercise training for adults in sickness and in health].

    Science.gov (United States)

    2011-01-01

    The purpose of the aforementioned guideline is to promote physical activity in the prevention, treatment and rehabilitation of diseases. Physical activity, either alone or combined with other lifestyle modifications, plays a key role in the management of several chronic diseases. In this guideline, the following diseases will be discussed: musculoskeletal, endocrinological, cardiovascular and respiratory diseases, as well as cancer, depression and urinary incontinence. In addition, physical activity during pregnancy and in senior citizens is discussed. Physical activity and exercise training have also been mentioned in 27 other Current Care clinical guidelines.

  4. Dietary supplementation in patients with alcoholic liver disease:a review on current evidence

    Institute of Scientific and Technical Information of China (English)

    Zeinab Ghorbani; Masoomeh Hajizadeh; Azita Hekmatdoost

    2016-01-01

    BACKGROUND: Alcoholic liver disease (ALD) is one of the main causes of liver disease worldwide. Although the patho-genesis of ALD has not yet been well elucidated, the oxidative metabolites of ethanol such as acetaldehyde and reactive oxy-gen species play a pivotal role in the clinical and pathological spectrum of the disease. This review summarizes the existing evidences on dietary supplements considered to have antioxi-dant, and/or anti-inlfammatory properties, and their role in the management of ALD and the proposed mechanisms. DATA SOURCES: The present study reviewed all studies pub-lished in PubMed, ScienceDirect and Scopus, from 1959 to 2015, indicating the role of different dietary supplementation in attenuation of many pathophysiological processes involved in development and progression of ALD. Full-texts of citations were used except for those that were published in languages other than English. RESULTS: Signiifcant progress has been made to understand the key events and molecular players for the onset and pro-gression of ALD from both experimental and clinical studies;however, there is no successful treatment currently available. The present review discussed the role of a variety of dietary supplements (e.g. vitamin A, carotenoids, vitamins B3, C and E, in addition to antioxidants and anti-inlfammatory agents) in treating ALD. It has been shown that supplementation with some carotenoids, vitamin B3, vitamin C, silymarin, curcumin, probiotics, zinc, S-adenosylmethionine and garlic may have potential beneifcial effects in animal models of ALD; however, the number of clinical studies is very limited. In addition, sup-plementation should be accompanied with alcohol cessation. CONCLUSIONS: Since oxidative stress and inlfammation are involved in the pathogenesis of ALD, dietary supplements that can modulate these pathologies could be useful in the treat-ment of ALD. In addition to alcohol cessation, these supple-ments have shown beneifcial effects on animal

  5. Current status of preventive cardiology training among United States cardiology fellowships and comparison to training guidelines.

    Science.gov (United States)

    Pack, Quinn R; Keteyian, Steven J; McBride, Patrick E; Weaver, W Douglas; Kim, Henry E

    2012-07-01

    We evaluated preventive cardiology education in United States cardiology fellowship programs and their adherence to Core Cardiovascular Training Symposium training guidelines, which recommend 1 month of training, faculty with expertise, and clinical experience in cardiac rehabilitation, lipid disorder management, and diabetes management as a part of the prevention curricula. We sent an anonymous survey to United States cardiology program directors and their chief fellow. The survey assessed the program curricula, rotation structure, faculty expertise, obstacles, and recommended improvements. The results revealed that 24% of surveyed programs met the Core Cardiovascular Training Symposium guidelines with a dedicated 1-month rotation in preventive cardiology, 24% had no formalized training in preventive cardiology, and 30% had no faculty with expertise in preventive cardiology, which correlated with fewer rotations in prevention than those with specialized faculty (p = 0.009). Fellows rotated though the following experiences (% of programs): cardiac rehabilitation, 71%; lipid management, 37%; hypertension, 15%; diabetes, 7%; weight management/obesity, 6%; cardiac nutrition, 6%; and smoking cessation, 5%. The program directors cited "lack of time" as the greatest obstacle to providing preventive cardiology training and the chief fellows reported "lack of a developed curriculum" (p = 0.01). The most recommended improvement was for the American College of Cardiology to develop a web-based curriculum/module. In conclusion, most surveyed United States cardiology training programs currently do not adhere to basic preventive cardiovascular medicine Core Cardiovascular Training Symposium recommendations. Additional attention to developing curricular content and structure, including the creation of an American College of Cardiology on-line knowledge module might improve fellowship training in preventive cardiology.

  6. Whole-grain intake in middle school students achieves dietary guidelines for Americans and MyPlate recommendations when provided as commercially available foods: a randomized trial.

    Science.gov (United States)

    Radford, Allyson; Langkamp-Henken, Bobbi; Hughes, Christine; Christman, Mary C; Jonnalagadda, Satya; Boileau, Thomas W; Thielecke, Frank; Dahl, Wendy J

    2014-09-01

    In accordance with the 2010 Dietary Guidelines for Americans, at least half of total grain intake should be whole grains. Adolescents are currently not consuming the recommended daily intake of whole grains. Research is needed to determine whether whole grains are acceptable to adolescents and whether changing their food environment to include whole-grain foods will improve intake. The aim of this study was to determine the effect of providing refined-grain or whole-grain foods to adolescents, with encouragement to eat three different grain-based foods per day, on total grain and whole-grain intakes. Middle school students (n=83; aged 11 to 15 years) were randomly assigned to either refined-grain or whole-grain foods for 6 weeks. Participants and their families were provided with weekly grains (eg, bread, pasta, and cereals), and participants were provided grain snacks at school. Intake of grains in ounce equivalents (oz eq) was determined through eight baseline and intervention targeted 24-hour diet recalls. Participants consumed 1.1±1.3 oz eq (mean±standard deviation) of whole grains at baseline, out of 5.3±2.4 oz eq of total grains. During intervention, whole-grain intake increased in the whole-grain group (0.9±1.0 to 3.9±1.8 oz eq/day), whereas those in the refined-grain group reduced whole-grain intake (1.3±1.6 to 0.3±0.3 oz eq/day; Pgrain intake achieved was 6.4±2.1 oz eq/day and did not differ across intervention groups. Providing adolescents with whole-grain foods in their school and home environments was an effective means of achieving recommendations.

  7. Adherence to the Dietary Guidelines for Americans Is Associated with Psychological Resilience in Young Adults: A Cross-Sectional Study.

    Science.gov (United States)

    Lutz, Laura J; Gaffney-Stomberg, Erin; Williams, Kelly W; McGraw, Susan M; Niro, Philip J; Karl, J Philip; Cable, Sonya J; Cropper, Thomas L; McClung, James P

    2017-03-01

    The 2010 Healthy Eating Index (HEI-2010), a measure of diet quality, is used to quantify adherence to the Dietary Guidelines for Americans. Better HEI scores have been associated with positive health outcomes; however, the relationship between diet quality and psychological resilience, a mental health attribute for coping with adversity, has not been assessed. The objective of the present study was to assess the relationship between diet quality and psychological resilience, and the relationship between resilience and demographics, anthropometrics, socioeconomic status, and health behavior. In this cross-sectional study, HEI-2010 scores and resilience were assessed using the Block food frequency questionnaire and the Connor-Davidson Resilience Scale. Other factors that can affect the relationship between HEI-2010 scores and resilience were assessed using surveys, and height and weight were measured to calculate body mass index. Male and female Army and Air Force recruits (n=834) enrolled in a randomized controlled trial and 656 (mean±standard deviation [SD] age=21±3.3 years) were included in this analysis. Data were collected before the initiation of military training at Fort Sill, OK (2012-2013) and Lackland Air Force Base, TX (2013-2014). Participants were split into low- and high-resilience groups based on Connor-Davidson Resilience Scale scores. Student's t test and χ(2) tests were used to determine differences between groups for continuous and categorical variables, respectively. Logistic regression was utilized to identify predictors of resilience. Better diet quality was associated with resilience; higher HEI predicted an increased likelihood (odds ratio=1.02; 95% CI 1.01 to 1.04) of a participant being in the high-resilience group after including race, ethnicity, education, smoking, age, body mass index, sex, and military branch in the full model. The data indicate that with every 10-point increase in HEI score, there was a 22% increased likelihood of

  8. Current management of bipolar affective disorder: is it reflective of the BAP guidelines?

    Science.gov (United States)

    Farrelly, N; Dibben, C; Hunt, N

    2006-01-01

    In October 2003 the British Association of Psychopharmacology (BAP) published evidence-based guidelines on the management of bipolar disorder. The aim of this study was to assess whether the guidelines could provide the basis for examining clinical decisions and the extent to which practice accords with these guidelines. Case notes of out patients with bipolar disorder were reviewed. Demographic details, and treatment recommendations were determined. The management of affective episodes was evaluated and compared with BAP guidelines. In 84 subjects, 224 affective episodes were identified. Treatment was consistent with BAP guidelines in 72% of episodes. Mania was more likely to be managed in accordance with guidelines than depression or mixed episodes. The use of antidepressant medication was the most likely intervention to deviate from recommendations. Reasons for treatments at odds with the guidelines were identified. Our study demonstrates that clinical practice among a range of psychiatrists broadly reflects the guidelines that have been issued by the British Association of Psychopharmacology (BAP). The BAP guidelines offer a practical and auditable basis for the short- and long-term treatment of bipolar affective disorder.

  9. Low Body Mass Index Can Identify Majority of Osteoporotic Inflammatory Bowel Disease Patients Missed by Current Guidelines

    Directory of Open Access Journals (Sweden)

    Ashish Atreja

    2012-01-01

    Full Text Available Background. Patients with inflammatory bowel disease (IBD are at high risk of developing osteoporosis. Our objective was to determine the usefulness of IBD guidelines in identifying patients at risk for developing osteoporosis. Methods. We utilized institutional repository to identify patients seen in IBD center and extracted data on demographics, disease history, conventional, and nonconventional risk factors for osteoporosis and Dual Energy X-ray Absorptiometry (DXA findings. Results. 59% of patients (1004/1703 in our IBD cohort had at least one risk factor for osteoporosis screening. DXA was documented in 263 patients with indication of screening (provider adherence, 26.2%, and of these, 196 patients had DXA completed (“at-risk” group. Ninety-five patients not meeting guidelines-based risk factors also had DXA completed (“not at-risk” group. 139 (70.9% patients in “at-risk” group had low BMD, while 51 (53.7% of “not-at-risk” patients had low BMD. Majority of the patients with osteoporosis (83.3% missed by the current guidelines had low BMI. Multivariate logistic regression analysis showed that low BMI was the strongest risk factor for osteoporosis (OR 3.07; 95% CI, 1.47–6.42; P=0.003. Conclusions. Provider adherence to current guidelines is suboptimal. Low BMI can identify majority of the patients with osteoporosis that are missed by current guidelines.

  10. Retinal damage by optical radiation. An alternative approach to current, ACGIH-inspired guidelines

    NARCIS (Netherlands)

    Vos, J.J.; Norren, D. van

    2005-01-01

    Background: The ACGIH guidelines for protection against retinal damage by optical radiation are often difficult to apply due to their lack of transparency. The less known guidelines by the Netherlands Health Council (HCN), dating from 1978 and updated in 1993, might offer a way out in many cases. Me

  11. Current Evidence Supporting the Link Between Dietary Fatty Acids and Cardiovascular Disease.

    Science.gov (United States)

    Hammad, Shatha; Pu, Shuaihua; Jones, Peter J

    2016-05-01

    Lack of consensus exists pertaining to the scientific evidence regarding effects of various dietary fatty acids on cardiovascular disease (CVD) risk. The objective of this article is to review current evidence concerning cardiovascular health effects of the main dietary fatty acid types; namely, trans (TFA), saturated (SFA), polyunsaturated (PUFA; n-3 PUFA and n-6 PUFA), and monounsaturated fatty acids (MUFA). Accumulating evidence shows negative health impacts of TFA and SFA; both may increase CVD risk. Policies have been proposed to reduce TFA and SFA consumption to less than 1 and 7 % of energy intake, respectively. Cardiovascular health might be promoted by replacing SFA and TFA with n-6 PUFA, n-3 PUFA, or MUFA; however, the optimal amount of PUFA or MUFA that can be used to replace SFA and TFA has not been defined yet. Evidence suggests of the potential importance of restricting n-6 PUFA up to 10 % of energy and obtaining an n-6/n-3 ratio as close as possible to unity, along with a particular emphasis on consuming adequate amounts of essential fatty acids. The latest evidence shows cardioprotective effects of MUFA-rich diets, especially when MUFA are supplemented with essential fatty acids; namely, docosahexaenoic acid. MUFA has been newly suggested to be involved in regulating fat oxidation, energy metabolism, appetite sensations, weight maintenance, and cholesterol metabolism. These favorable effects might implicate MUFA as the preferable choice to substitute for other fatty acids, especially given the declaration of its safety for up to 20 % of total energy.

  12. Dietary recommendations: comparing dietary guidelines from Brazil and the United States Recomendações dietéticas: comparação entre os guias alimentares brasileiro e americano

    Directory of Open Access Journals (Sweden)

    Rosely Sichieri

    2010-11-01

    Full Text Available The Brazilian dietary guidelines are based in part on mainstream United States' recommendations, in spite of the criticisms and shortcomings of the American guidelines. In this paper, Brazilian food guidelines are summarized and discussed in comparison with the USA recommendations. American and Brazilian dietary recommendations are quite similar in many aspects, particularly those related to variety in the diet, the importance of physical activity and weight management. Different to American guidelines, those from Brazil advise people to choose fresh foods, to prefer healthier types of fat, to limit trans fat intake and to eat good sources of protein, but does not recommend the consumption of whole grains. Besides the challenges related to their implementation, indicators for the evaluation of the effectiveness of these guidelines should be established from the beginning, particularly those related to changes in dietary habits and the prevalence of obesity.O guia alimentar brasileiro é baseado parcialmente nas recomendações americanas a despeito das críticas e problemas identificados no documento dos Estados Unidos. Neste artigo, as recomendações alimentares para o Brasil são resumidas e discutidas em comparação com as recomendações estadunidenses. Os guias alimentares brasileiro e americano são bastante similares em diversos aspectos, particularmente aqueles relacionados com a variação da dieta, a importância da atividade física e o gerenciamento do peso. Diferentemente dos Estados Unidos, o guia brasileiro estimula o consumo de alimentos frescos, aconselha o uso de fontes saudáveis de gorduras, a limitação do consumo de gordura trans, o consumo de boas fontes de proteínas, mas não indica o consumo de grãos integrais. Além dos desafios relacionados com a sua implantação, os indicadores para a avaliação da eficácia dos guias alimentares devem ser estabelecidos desde sua implantação, particularmente, os relacionados

  13. Adequacy of Physicians Knowledge Level of Cardiopulmonary Resuscitation to Current Guidelines

    Directory of Open Access Journals (Sweden)

    Ümmu Kocalar

    2016-01-01

    Full Text Available Aim: The purpose of this study is to test the level of information on CPR and suitability to current application of the phsicians practicing in hospital ANEAH. Material and Method: The form of a test of 20 questions fort his purpose has been prepared in accordance with the 2010 AHA-ERC CPR guidelines. This form distributed to volunteer physicians to fill in. A total of 173 physicians agreed to participate in he study. The results were analyzed statistically and tried to determine the factors affecting the level of information. Results:According to the results of the study physicians gender, age and the total duration of physicians and medical asistance doesn%u2019t affect the level of information. The number of CPR within 1 month positively affect the level of knowledge. The number of theoretical and practical training in medical school, have taken the positive impact the level of knowledge of physicians. The training period after graduation, significantly increased the level of physicians information. The order of these training sessions with the asistant courses, congress, seminars and lessions on the sempozims are effective. Discussion: CPR trainig programs for physicians should be standardized, updated and expanded. Recurent in-service trainig should be provided to increase phsicians knowledge on skills.

  14. The Investigators' Brochure: a comparison of the draft international conference on harmonisation guideline with current Food and Drug Administration requirements.

    Science.gov (United States)

    Cocchetto, D M

    1995-12-01

    For several years, the United States Food and Drug Administration (FDA) has participated in a collaborative effort to harmonize the technical procedures for development and regulatory approval of human pharmaceuticals in multiple countries. This harmonization effort is the work of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). At this point, ICH focuses on achieving harmonization of technical requirements in three major regions of the world, i.e., the United States, European Union, and Japan. One area for which harmonization is being sought is the format and content of the Investigators' Brochure. On October 27, 1993, the ICH Steering Committee agreed that the ICH draft guideline on the Investigators' Brochure should be made available for public comment. On August 9, 1994, the FDA published the draft guideline for the format and content of the Investigators' Brochure. This draft guideline was prepared by the Efficacy Expert Working Group of the ICH. FDA solicited written comments on this draft guideline until October 11, 1994. Ultimately, FDA intends to adopt the ICH Steering Committee's final guidelines on Investigators' Brochures as part of a larger document on good clinical practices. Therefore, the content of this draft guideline warrants careful attention. In this paper, ICH's proposed information for inclusion in the Investigators' Brochure is reviewed and compared with current regulatory requirements of FDA. The expanded contents of the Investigators' Brochure proposed by ICH, which represent potential new requirements beyond current FDA regulations, are highlighted. The major controversial elements of this draft guideline are summarized.

  15. Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines

    Science.gov (United States)

    In 2013, the American Heart Association and American College of Cardiology published the "Guideline on Lifestyle Management to Reduce Cardiovascular Risk," which was based on a systematic review originally initiated by the National Heart, Lung, and Blood Institute. The guideline supports the America...

  16. Could a revision of the current guidelines for cancer drug use improve the quality of cancer treatment?

    Directory of Open Access Journals (Sweden)

    Lippert TH

    2014-01-01

    Full Text Available Theodor H Lippert,1 Hans-Jörg Ruoff,1 Manfred Volm2 1Medical Faculty, University of Tübingen, Tübingen, Germany; 2Medical Faculty, University of Heidelberg, Heidelberg, Germany Abstract: Clinical practice guidelines are indispensable for such a variable disease as malignant solid tumors, with the complex possibilities of drug treatment. The current guidelines may be criticized on several points, however. First, there is a lack of information on the outcome of treatment, such as the expected success and failure rates. Treating not only drug responders but also nonresponders, that is, patients with drug resistance, must result in failures. There is no mention of the possibility of excluding the drug nonresponders, identifiable by special laboratory tests and no consideration is given to the different side effects of the recommended drug regimens. Nor are there any instructions concerning tumor cases for which anticancer drug treatment is futile. In such cases, early palliative care may lead to significant improvements in both life quality and life expectancy. Not least, there is no transparency concerning the preparation of the guidelines: persons cannot be identified who could give a statement of conflicts of interest, and responsibility is assumed only by anonymous medical associations. A revision of the current guidelines could considerably improve cancer treatment. Keywords: anticancer drugs, quality of guidelines, critical remarks

  17. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Manassaram-Baptiste, Deana; Brooks, Durado; Doroshenk, Mary; Fedewa, Stacey; Saslow, Debbie; Brawley, Otis W; Wender, Richard

    2015-01-01

    Each year, the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection along with a report on data and trends in cancer screening rates and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines. The latest data on utilization of cancer screening from the National Health Interview Survey (NHIS) also is described, as are several issues related to screening coverage under the Affordable Care Act, including the expansion of the Medicaid program.

  18. Can current dietary exposure models handle aggregated intake from different foods? A simulation study for the case of two foods

    NARCIS (Netherlands)

    Slob, W.; Boer, de W.J.; Voet, van der H.

    2010-01-01

    Current dietary exposure models provide estimates of long-term intake distributions using short-term food consumption survey data, by statistically modeling the aggregated intakes from different foods consumed on the same day for each participant of the survey. Food consumption behaviour in a popula

  19. Can current dietary exposure models handle aggregated intake from different foods? A simulation study for the case of two foods.

    NARCIS (Netherlands)

    Slob, W.; de Boer, W.J.; van der Voet, H.

    2010-01-01

    Current dietary exposure models provide estimates of long-term intake distributions using short-term food consumption survey data, by statistically modeling the aggregated intakes from different foods consumed on the same day for each participant of the survey. Food consumption behaviour in a popula

  20. Revision of OECD Guidelines for Genotoxicity Testing: Current Status and Next Steps

    Science.gov (United States)

    Over the past 30 years, assays have been developed to evaluate chemical genotoxicity. OECD Genotoxicity Test Guidelines (TG) describe assay procedures for regulatory safety testing. Since the last OECD TG revision (1997), there has been tremendous scientific and technological pro...

  1. Are the current IHS guidelines for migraine drug trials being followed?

    DEFF Research Database (Denmark)

    Hougaard, Anders; Tfelt-Hansen, Peer

    2010-01-01

    In 2000, the Clinical Trials Subcommittee of the International Headache Society (IHS) published the second edition of its guidelines for controlled trials of drugs in migraine. The purpose of this publication was to improve the quality of such trials by increasing the awareness amongst...... or not double-blinded. Adherence to international guidelines like these of IHS is important to ensure that only high-quality trials are performed, and to provide the consensus that is required for meta analyses. The primary efficacy measure for trials of acute treatment should be "pain free" and not "headache...... investigators of the methodological issues specific to this particular illness. Until now the adherence to these guidelines has not been systematically assessed. We reviewed all published controlled trials of drugs in migraine from 2002 to 2008. Eligible trials were scored for compliance with the IHS guidelines...

  2. Cancer screening in the United States, 2017: A review of current American Cancer Society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Andrews, Kimberly S; Brooks, Durado; Fedewa, Stacey A; Manassaram-Baptiste, Deana; Saslow, Debbie; Brawley, Otis W; Wender, Richard C

    2017-03-01

    Answer questions and earn CME/CNE Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the authors summarize current American Cancer Society cancer screening guidelines, describe an update of their guideline for using human papillomavirus vaccination for cancer prevention, describe updates in US Preventive Services Task Force recommendations for breast and colorectal cancer screening, discuss interim findings from the UK Collaborative Trial on Ovarian Cancer Screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey. CA Cancer J Clin 2017;67:100-121. © 2017 American Cancer Society. © 2017 American Cancer Society.

  3. Evolution of Asthma Concept and Effect of Current Asthma Management Guidelines

    OpenAIRE

    2010-01-01

    Concept of asthma has changed from symptom-complex or airway hypersensitivity to airway inflammation and airway remodeling. Based on this concept asthma management guidelines (JGL) has been developed in Japan. Death from asthma has decreased drastically since the publication of the guidelines, although it is still high in elderly population. Further works are expected for "zero-death" from asthma and for tighter control of airway inflammation and resultant airway remodeling.

  4. Current guidelines for high-density lipoprotein cholesterol in therapy and future directions

    Directory of Open Access Journals (Sweden)

    Subedi BH

    2014-04-01

    Full Text Available Bishnu H Subedi,1,2 Parag H Joshi,1 Steven R Jones,1 Seth S Martin,1 Michael J Blaha,1 Erin D Michos1 1Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, 2Greater Baltimore Medical Center, Baltimore, MD, USA Abstract: Many studies have suggested that a significant risk factor for atherosclerotic cardiovascular disease (ASCVD is low high-density lipoprotein cholesterol (HDL-C. Therefore, increasing HDL-C with therapeutic agents has been considered an attractive strategy. In the prestatin era, fibrates and niacin monotherapy, which cause modest increases in HDL-C, reduced ASCVD events. Since their introduction, statins have become the cornerstone of lipoprotein therapy, the benefits of which are primarily attributed to decrease in low-density lipoprotein cholesterol. Findings from several randomized trials involving niacin or cholesteryl ester transfer protein inhibitors have challenged the concept that a quantitative elevation of plasma HDL-C will uniformly translate into ASCVD benefits. Consequently, the HDL, or more correctly, HDL-C hypothesis has become more controversial. There are no clear guidelines thus far for targeting HDL-C or HDL due to lack of solid outcomes data for HDL specific therapies. HDL-C levels are only one marker of HDL out of its several structural or functional properties. Novel approaches are ongoing in developing and assessing agents that closely mimic the structure of natural HDL or replicate its various functions, for example, reverse cholesterol transport, vasodilation, anti-inflammation, or inhibition of platelet aggregation. Potential new approaches like HDL infusions, delipidated HDL, liver X receptor agonists, Apo A-I upregulators, Apo A mimetics, and gene therapy are in early phase trials. This review will outline current therapies and describe future directions for HDL therapeutics. Keywords: high-density lipoprotein, lipids, cholesterol, atherosclerosis, cardiovascular disease, therapy

  5. Evaluation of current care effectiveness: a survey of hypertension guideline implementation in Finnish health centres

    DEFF Research Database (Denmark)

    Alanen, Seija I; Johannala-Kemppainen, Riitta; Ijäs, Jarja J;

    2007-01-01

    OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information implement......OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information...... implementers or disseminators respectively). DESIGN: A cross-sectional study. Development of a questionnaire and criteria for assessing the extent and style of implementation of the HT Guideline. SETTING: Primary healthcare. SUBJECTS: All head physicians and senior nursing officers in Finnish health centres (n...... =290). MAIN OUTCOME MEASURES: The extent of adoption of the HT Guideline in health centres and the characteristics associated with the implementation style. RESULTS: Responses were received from 410 senior medical staff (246 senior nursing officers and 164 head physicians) representing altogether 264...

  6. Do current national and international guidelines have specific recommendations for older adults with bipolar disorder? A brief report.

    Science.gov (United States)

    Dols, Annemiek; Kessing, Lars Vedel; Strejilevich, Sergio A; Rej, Soham; Tsai, Shang-Ying; Gildengers, Ariel G; Almeida, Osvaldo P; Shulman, Kenneth I; Sajatovic, Martha

    2016-12-01

    Older adults with bipolar disorder (OABD) are a growing segment of patients with bipolar disorder (BD) for which specific guidelines are warranted. Although, OABD are frequently excluded from randomized controlled trials due to their age or somatic comorbidity, more treatment data from a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world. The International Society of Bipolar Disorders OABD task force compiled and compared recommendations from current national and international guidelines that specifically address geriatric or older individuals with BD (from year 2005 onwards). There were 34 guidelines, representing six continents and 19 countries. The majority of guidelines had no separate section on OABD. General principles for treating OABD with medication are recommended to be similar to those for younger adults, with special caution for side effects due to somatic comorbidity and concomitant medications. Therapeutic lithium serum levels are suggested to be lower but recommendations are very general and mostly not informed by specific research evidence. There is a lack of emphasis of OABD-specific issues in existing guidelines. Given the substantial clinical heterogeneity in BD across the life span, along with the rapidly expanding population of older individuals worldwide, and limited mental health workforce with geriatric expertise, it is critical that additional effort and resources be devoted to studying treatment interventions specific to OABD and that treatment guidelines reflect research findings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Guias alimentares para a população brasileira: implicações para a Política Nacional de Saúde Bucal Dietary guidelines for the Brazilian population: implications for the Brazilian National Policy on Oral Health

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Matias Freire

    2012-01-01

    Full Text Available Guias alimentares são documentos que orientam sobre práticas alimentares e políticas que visam à promoção da saúde e prevenção de doenças nas populações. Este artigo tem como objetivo apresentar e discutir os guias alimentares para a população brasileira, buscando identificar aspectos que possam subsidiar as estratégias propostas na Política Nacional de Saúde Bucal. Foram revisados os dois guias oficiais do Ministério da Saúde disponíveis até o momento: o Guia Alimentar para Crianças Menores de 2 Anos e o Guia Alimentar para a População Brasileira. Os guias apresentam recomendações sobre a redução do consumo de açúcar, fundamental na prevenção da cárie, bem como outras diretrizes que podem contribuir para a prevenção da erosão dentária e do câncer bucal. Constituem, assim, um componente importante da estratégia de promoção da saúde geral e bucal, e as recomendações devem ser integradas à Política Nacional de Saúde Bucal.Dietary guidelines are intended to orient dietary habits and policies for health promotion and disease prevention. This article discusses Brazil's national dietary guidelines, aiming to identify issues that can support the strategies proposed by the National Policy on Oral Health. The two currently available official guidelines produced by the Ministry of Health were reviewed: the Dietary Guidelines for Children under Two and the Population Dietary Guidelines. The guidelines recommend reduction in sugar intake, essential for caries prevention, and other measures to prevent tooth decay and oral cancer. These guidelines are thus a key part of an oral and overall health promotion strategy and should be integrated into the National Policy on Oral Health.

  8. Toward best practice in Human Machine Interface design for older drivers: A review of current design guidelines.

    Science.gov (United States)

    Young, K L; Koppel, S; Charlton, J L

    2017-09-01

    Older adults are the fastest growing segment of the driving population. While there is a strong emphasis for older people to maintain their mobility, the safety of older drivers is a serious community concern. Frailty and declines in a range of age-related sensory, cognitive, and physical impairments can place older drivers at an increased risk of crash-related injuries and death. A number of studies have indicated that in-vehicle technologies such as Advanced Driver Assistance Systems (ADAS) and In-Vehicle Information Systems (IVIS) may provide assistance to older drivers. However, these technologies will only benefit older drivers if their design is congruent with the complex needs and diverse abilities of this driving cohort. The design of ADAS and IVIS is largely informed by automotive Human Machine Interface (HMI) guidelines. However, it is unclear to what extent the declining sensory, cognitive and physical capabilities of older drivers are addressed in the current guidelines. This paper provides a review of key current design guidelines for IVIS and ADAS with respect to the extent they address age-related changes in functional capacities. The review revealed that most of the HMI guidelines do not address design issues related to older driver impairments. In fact, in many guidelines driver age and sensory cognitive and physical impairments are not mentioned at all and where reference is made, it is typically very broad. Prescriptive advice on how to actually design a system so that it addresses the needs and limitations of older drivers is not provided. In order for older drivers to reap the full benefits that in-vehicle technology can afford, it is critical that further work establish how older driver limitations and capabilities can be supported by the system design process, including their inclusion into HMI design guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Practice Patterns and Opinions on Current Clinical Practice Guidelines Regarding the Management of Delirium in the Intensive Care Unit.

    Science.gov (United States)

    Mo, Yoonsun; Zimmermann, Anthony E; Thomas, Michael C

    2017-04-01

    The aim of this study was to determine current delirium practices in the intensive care unit (ICU) setting and evaluate awareness and adoption of the 2013 Pain, Agitation, and Delirium (PAD) guidelines with emphasis on delirium management. A large-scale, multidisciplinary, online survey was administered to physician, pharmacist, nurse, and mid-level practitioner members of the Society of Critical Care Medicine (SCCM) between September 2014 and October 2014. A total of 635 respondents completed the survey. Nonpharmacologic interventions such as early mobilization were used in most ICUs (83%) for prevention of delirium. A majority of respondents (97%) reported using pharmacologic agents to treat hyperactive delirium. Ninety percent of the respondents answered that they were aware of the 2013 PAD guidelines, and 75% of respondents felt that their delirium practices have been changed as a result of the new guidelines. In addition, logistic regression analysis of this study showed that respondents who use delirium screening tools were twice more likely to be fully aware of key components of the updated guidelines (odds ratio [OR] = 2.07, 95% confidence interval [CI] = 1.20-3.60). Most critical care practitioners are fully aware and knowledgeable of key recommendations in the new guidelines and have changed their delirium practices accordingly.

  10. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review.

    Science.gov (United States)

    Movassagh, Elham Z; Vatanparast, Hassan

    2017-01-01

    Nutrition is an important modifiable factor that affects bone health. Diet is a complex mixture of nutrients and foods that correlate or interact with each other. Dietary pattern approaches take into account contributions from various aspects of diet. Findings from dietary pattern studies could complement those from single-nutrient and food studies on bone health. In this study we aimed to conduct a scoping review of the literature that assessed the impact of dietary patterns (derived with the use of both a priori and data-driven approaches) on bone outcomes, including bone mineral status, bone biomarkers, osteoporosis, and fracture risk. We retrieved 49 human studies up to June 2016 from the PubMed, Embase, and CINAHL databases. Most of these studies used a data-driven method, especially factor analysis, to derive dietary patterns. Several studies examined adherence to a variety of the a priori dietary indexes, including the Mediterranean diet score, the Healthy Eating Index (HEI), and the Alternative Healthy Eating Index (AHEI). The bone mineral density (BMD) diet score was developed to measure adherence to a dietary pattern beneficial to bone mineral density. Findings revealed a beneficial impact of higher adherence to a "healthy" dietary pattern derived using a data-driven method, the Mediterranean diet, HEI, AHEI, Dietary Diversity Score, Diet Quality Index-International, BMD Diet Score, Healthy Diet Indicator, and Korean Diet Score, on bone. In contrast, the "Western" dietary pattern and those featuring some aspects of an unhealthy diet were associated inversely with bone health. In both a priori and data-driven dietary pattern studies, a dietary pattern that emphasized the intake of fruit, vegetables, whole grains, poultry and fish, nuts and legumes, and low-fat dairy products and de-emphasized the intake of soft drinks, fried foods, meat and processed products, sweets and desserts, and refined grains showed a beneficial impact on bone health. Overall

  11. Are the current IHS guidelines for migraine drug trials being followed?

    DEFF Research Database (Denmark)

    Hougaard, Anders; Tfelt-Hansen, Peer

    2010-01-01

    In 2000, the Clinical Trials Subcommittee of the International Headache Society (IHS) published the second edition of its guidelines for controlled trials of drugs in migraine. The purpose of this publication was to improve the quality of such trials by increasing the awareness amongst investigat......In 2000, the Clinical Trials Subcommittee of the International Headache Society (IHS) published the second edition of its guidelines for controlled trials of drugs in migraine. The purpose of this publication was to improve the quality of such trials by increasing the awareness amongst...... investigators of the methodological issues specific to this particular illness. Until now the adherence to these guidelines has not been systematically assessed. We reviewed all published controlled trials of drugs in migraine from 2002 to 2008. Eligible trials were scored for compliance with the IHS guidelines...... by using grading scales based on the most essential recommendations of the guidelines. The primary efficacy measure of each trial was also recorded. A total of 145 trials of acute treatment and 52 trials of prophylactic treatment were eligible for review. Of the randomized, double-blind trials, acute...

  12. Current Practice vs. Guideline Based Imaging in Abdominal Radiology in the German Speaking Area: Results of an Online Survey.

    Science.gov (United States)

    Schreyer, A G; Wessling, J; Grenacher, L

    2016-03-01

    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80% of the questions, were included in the statistical evaluation. 27% of all participants were registered radiologists while 73% represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging. • In German speaking countries indications for abdominal radiological examinations are performed with a high compliance to published guidelines. • There is a significant heterogeneity regarding the acquisition of different contrast phases for parenchymal abdominal organs. • There is an urgent need to

  13. Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives

    National Research Council Canada - National Science Library

    Santangelo, Carmela; Zicari, Alessandra; Mandosi, Elisabetta; Scazzocchio, Beatrice; Mari, Emanuela; Morano, Susanna; Masella, Roberta

    2016-01-01

    ... and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis...

  14. Preventive fluid and dietary therapy for urolithiasis: An appraisal of strength, controversies and lacunae of current literature.

    Science.gov (United States)

    Agarwal, Mayank Mohan; Singh, Shwaran K; Mavuduru, Ravimohan; Mandal, Arup K

    2011-07-01

    Regulation of fluid and dietary intake habits is essential in comprehensive preventive management of urolithiasis. However, despite large body of epidemiological database, there is dearth of good quality prospective interventional studies in this regard. Often there is conflict in pathophysiological basis and actual clinical outcome. We describe conflicts, controversies and lacunae in current literature in fluid and dietary modifications in prevention of urolithiasis. Adequate fluid intake is the most important conservative strategy in urolithiasis-prevention; its positive effects are seen even at low volumes. Of the citrus, orange provides the most favorable pH changes in the urine, equivalent to therapeutic alkaline citrates. Despite being richest source of citrate, lemon does not increase pH significant due to its acidic nature. Fructose, animal proteins and fats are implicated in contributing to obesity, which is an established risk factor for urolithiasis. Fructose and proteins also contribute to lithogenecity of urine directly. Sodium restriction is commonly advised since natriuresis is associated with calciuresis. Calcium restriction is not advisable for urolithiasis prevention. Adequate calcium intake is beneficial if taken with food since it reduces absorption of dietary oxalate. Increasing dietary fiber does not protect against urolithiasis. Evidence for pyridoxine and magnesium is not robust. There is no prospective interventional study evaluating effect of many dietary elements, including citrus juices, carbohydrate, fat, dietary fiber, sodium, etc. Due to lack of good-quality prospective interventional trials it is essential to test the findings of pathophysiological understanding and epidemiological evidence. Role of probiotics and phytoceuticals needs special attention for future research.

  15. Preventive fluid and dietary therapy for urolithiasis: An appraisal of strength, controversies and lacunae of current literature

    Directory of Open Access Journals (Sweden)

    Mayank Mohan Agarwal

    2011-01-01

    Full Text Available Regulation of fluid and dietary intake habits is essential in comprehensive preventive management of urolithiasis. However, despite large body of epidemiological database, there is dearth of good quality prospective interventional studies in this regard. Often there is conflict in pathophysiological basis and actual clinical outcome. We describe conflicts, controversies and lacunae in current literature in fluid and dietary modifications in prevention of urolithiasis. Adequate fluid intake is the most important conservative strategy in urolithiasis-prevention; its positive effects are seen even at low volumes. Of the citrus, orange provides the most favorable pH changes in the urine, equivalent to therapeutic alkaline citrates. Despite being richest source of citrate, lemon does not increase pH significant due to its acidic nature. Fructose, animal proteins and fats are implicated in contributing to obesity, which is an established risk factor for urolithiasis. Fructose and proteins also contribute to lithogenecity of urine directly. Sodium restriction is commonly advised since natriuresis is associated with calciuresis. Calcium restriction is not advisable for urolithiasis prevention. Adequate calcium intake is beneficial if taken with food since it reduces absorption of dietary oxalate. Increasing dietary fiber does not protect against urolithiasis. Evidence for pyridoxine and magnesium is not robust. There is no prospective interventional study evaluating effect of many dietary elements, including citrus juices, carbohydrate, fat, dietary fiber, sodium, etc. Due to lack of good-quality prospective interventional trials it is essential to test the findings of pathophysiological understanding and epidemiological evidence. Role of probiotics and phytoceuticals needs special attention for future research.

  16. Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies.

    Science.gov (United States)

    Hendrani, Aditya D; Adesiyun, Tolulope; Quispe, Renato; Jones, Steven R; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

    2016-02-26

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

  17. Dyslipidemia management in primary prevention of cardiovascular disease:Current guidelines and strategies

    Institute of Scientific and Technical Information of China (English)

    Aditya D Hendrani; Tolulope Adesiyun; Renato Quispe; Steven R Jones; Neil J Stone; Roger S Blumenthal; Seth S Martin

    2016-01-01

    Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making costeffective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

  18. Diabetic Dyslipidemia Review: An Update on Current Concepts and Management Guidelines of Diabetic Dyslipidemia.

    Science.gov (United States)

    Dake, Andrew W; Sora, Nicoleta D

    2016-04-01

    Cardiovascular disease is the most common cause of morbidity and mortality in patients with diabetes and the major source of cost in the care of diabetes. Treatment of dyslipidemia with cholesterol-lowering medications has been shown to decrease cardiovascular events. However, available guidelines for the treatment of dyslipidemia often contain significant differences in their recommendations. Lipid guidelines from National Cholesterol Education Program Adult Treatment Panel III, American Association of Clinical Endocrinologists, American Diabetes Association and American Heart Association/American College of Cardiology were reviewed. In addition a literature review was performed using PubMed to research diabetic peculiarities to the topic of lipids. Summarized within this article are the aforementioned, commonly-used guidelines as they relate to diabetes, as well as information regarding the diabetic phenotype of dislipidemia and the association between statins and new-onset diabetes. While the multitude of guidelines and the differences between them may contribute to confusion for practitioners, they are best viewed as tools to help tailor appropriate treatment plans for individual patients. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  19. Current guidelines and recommendations for the management of skin and soft tissue infections.

    Science.gov (United States)

    Montravers, Philippe; Snauwaert, Aurelie; Welsch, Camille

    2016-04-01

    The incidence of severe skin and soft tissue infections (SSTIs) has significantly increased over the last years. In addition, major ecological changes have been reported with the emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA), involved in a large proportion of these cases. A large number of expert opinions, guidelines, and recommendations for the management of SSTIs have been published over the last decade. The purpose of this review is to compare these guidelines. A total of six official publications have presented recommendations for the management of SSTIs. During the same period, other guidelines for the management of MRSA infections have also been published, including some recommendations for SSTIs. The applicability of the guidelines is questionable in many ways. The distinction between necrotizing/nonnecrotizing infections is valuable but difficult to apply prior to surgical management. The prescribers should choose a pragmatic approach to empirical antibiotic therapy, taking into account the patient's initial severity, the extent of infection and risk factors for resistant microorganisms essentially related to healthcare-associated circumstances.

  20. Elderly patients with community-acquired pneumonia are not treated according to current guidelines

    DEFF Research Database (Denmark)

    Lindhardt Damsgaard, Tove; Klausen, Henrik Hedegaard; Christiansen, Christina

    2013-01-01

    Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigated in-hospital compliance...... with guidelines for treatment and care of patients with CAP....

  1. How current Clinical Practice Guidelines for low back pain reflect Traditional Medicine in East Asian Countries: a systematic review of Clinical Practice Guidelines and systematic reviews.

    Directory of Open Access Journals (Sweden)

    Hyun-Woo Cho

    Full Text Available OBJECTIVES: The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs and evidence from current systematic reviews and meta-analyses (SR-MAs and to analyze the impact of this gap on present CPGs. METHODS: We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. RESULTS: Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54% mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure. However, the CPGs did not recommend acupuncture (or acupressure. Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (subacute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (subacute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. CONCLUSIONS: The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.

  2. A Prospective Real World Experience of Moxonidine Use in Indian Hypertensive Patients–Prescription beyond Current Guidelines

    Science.gov (United States)

    Sagarad, Suresh V; Biradar-Kerure, Sudha; MR, Ramakrishna; Kumar S, Chaitanya; Reddy, S S

    2013-01-01

    Objective: The primary objective of this study was to assess the use of moxonidine, a centrally acting anti–hypertensive agent in real world practice. Material and Methods: Patients who attended out-patients clinic with diagnosis of hypertension were enrolled in the study. Demographics with co-morbid illnesses of all patients were recorded. Patient’s prescriptions were recorded and anti-hypertensive medications were also analysed. Results: A total of 990 patients were eligible during the study period. Moxonidine was used in 4.54% of patients. Two groups could be identified in moxonidine users – one Group with resistant hypertension (30 patients, 3.03% of total, 66.66% of moxonidine users) on multiple drugs to control BP and another Group with intolerance to conventional, first line drugs (15 patients 1.51% of total, 33.33% of moxonidine users). Moxonidine was not used in newly diagnosed hypertension cases. Resistant hypertension and renal failure predicted the use of moxonidine. Majority of drug used was as per current guidelines. Conclusions: Our study results reflected real world practice of current anti-hypertensive therapy. Patients generally receive medications in accordance with current recommendations and guidelines. Small but significant proportion of patients may require use of drugs like moxonidine to control high BP. Guidelines need to incorporate these real world practices. PMID:24298479

  3. Overweight, elevated blood pressure, acanthosis nigricans and adherence to recommended dietary and physical activity guidelines among Hmong and white middle school students.

    Science.gov (United States)

    Voorhees, Julia; Goto, Keiko; Wolff, Cindy

    2014-04-01

    This cross-sectional study was conducted among low-income middle-school students (N = 426) in rural northern California to compare rates of overweight, elevated blood pressure and acanthosis nigricans (AN) between Hmong and white students. Associations among rates of overweight, elevated blood pressure, AN, and scores for adherence to recommended dietary guidelines were also examined. Fifty-two percent (52%) of white students were overweight/obese compared to 38% of Hmong students. Higher fruit consumption was associated with a lower BMI among white, but not Hmong students. Whereas 7% of white students were classified as pre-hypertensive/hypertensive, the rate for Hmong students was 17%. Additionally, at 13 versus 2%, six-fold more Hmong students had an elevated blood pressure with a normal BMI compared to white students, respectively. Ethnicity was also an independent predictive factor for AN. Hmong students appear to be at higher risk for both hypertension and AN than white students irrespective of BMI.

  4. Current and potential cyber attacks on medical journals; guidelines for improving security.

    Science.gov (United States)

    Dadkhah, Mehdi; Seno, Seyed Amin Hosseini; Borchardt, Glenn

    2017-03-01

    At the moment, scholarly publishing is faced with much academic misconduct and threats such as predatory journals, hijacked journals, phishing, and other scams. In response, we have been discussing this misconduct and trying to increase the awareness of researchers, but it seems that there is a lack of research that presents guidelines for editors to help them protect themselves against these threats. It seems that information security is missing in some parts of scholarly publishing that particularly involves medical journals. In this paper, we explain different types of cyber-attacks that especially threaten editors and academic journals. We then explain the details involved in each type of attack. Finally, we present general guidelines for detection and prevention of the attacks. In some cases, we use small experiments to show that our claim is true. Finally, we conclude the paper with a prioritization of these attacks.

  5. Speaker-Oriented Classroom Acoustics Design Guidelines in the Context of Current Regulations in European Countries

    DEFF Research Database (Denmark)

    Pelegrin Garcia, David; Brunskog, Jonas; Rasmussen, Birgit

    2014-01-01

    experienced at work. With the aim of improving working conditions for teachers, this article presents guidelines for classroom acoustics design that meet simultaneously criteria of vocal comfort and speech intelligibility, which may be of use in future discussions for updating regulatory requirements...... in classroom acoustics. Two room acoustic parameters are shown relevant for a speaker: the voice support, linked to vocal effort, and the decay time derived from an oral-binaural impulse response, linked to vocal comfort. Theoretical prediction models for room-averaged values of these parameters are combined...... with a model of speech intelligibility based on the useful-to-detrimental ratio and empirical models of signal-to-noise ratio in classrooms in order to derive classroom acoustic guidelines, taking into account physical volume restrictions linked to the number of students present in a classroom. The recommended...

  6. Issues in the management of acute agitation: how much current guidelines consider safety?

    Directory of Open Access Journals (Sweden)

    Bruno ePacciardi

    2013-05-01

    Full Text Available Agitated behavior constitutes up to 10% of emergency psychiatric interventions. Pharmacological tranquilization is often used as a valid treatment for agitation but a strong evidence base does not underpin it. Available literature shows different recommendations, supported by research data, theoretical considerations or clinical experience. Rapid tranquilization is mainly based on parenteral drug treatment and the few existing guidelines on this topic, when suggesting the use of first generation antipsychotics and benzodiazepines, include drugs with questionable tolerability profile such as chlorpromazine, haloperidol, midazolam and lorazepam. In order to systematically evaluate safety concerns related to the adoption of such guidelines, we reviewed them independently from principal diagnosis while examining tolerability data for suggested treatments. There is a growing evidence about safety profile of second generation antipsychotics for rapid tranquilization but further controlled studies providing definitive data in this area are urgently needed.

  7. [Update on current care guidelines: diagnosis and treatment of sexually transmitted infections].

    Science.gov (United States)

    Hiltunen-Back, Eija; Alanen, Anna; Heikkilä, Elina; Puolakkainen, Mirja; Reunala, Timo; Suni, Jukka; Suomalainen, Pekka; Valtonen, Kirsi; Varis, Tiina; Vuento, Risto

    2010-01-01

    Recognition of common sexually transmitted infection (STI) syndromes allows more efficient diagnosis and treatment. These evidence-based guidelines provide advice on the management of STIs, including the use of the appropriate diagnostic methods and therapeutic regimens. Early and appropriate therapy has the potential to significantly reduce the long-term complications of STIs. The prevention of further infection through the counselling and treatment of partners contributes to the sexual health of patients.

  8. Management of Breast Cancer during Pregnancy: Are We Compliant with Current Guidelines?

    Science.gov (United States)

    Shlensky, Victoria; Hallmeyer, Sigrun; Juarez, Lourdes; Parilla, Barbara V.

    2017-01-01

    Introduction The purpose of this study was to evaluate the management of patients with breast cancer in pregnancy treated at the Advocate Health Care, to determine whether these patients were treated according to guidelines for pregnant patients, which aim to maximize both fetal and maternal outcomes. Methods A retrospective chart review was performed at the Advocate Lutheran General Hospital, Christ Medical Center, and Illinois Masonic Medical Center from 2002 to 2012 on patients diagnosed with breast cancer during pregnancy using ICD-9 (International Classification of Diseases - 9th version) codes. Results Eleven patients between 12 and 37 weeks' gestation matched the search criteria. One patient terminated the pregnancy. Patients in our study were treated appropriately according to guidelines with the following exceptions. Trastuzumab was used in one patient during pregnancy which likely caused the oligohydramnios resulting in an induction of labor at 33 weeks. Three patients were delivered preterm between 34 and 36 weeks without an obstetric indication. Two patients underwent sentinel node biopsy. Conclusion The diagnosis of breast cancer in pregnancy is an infrequent but devastating diagnosis that is likely to increase. Although sentinel lymph node biopsy is not generally recommended in pregnancy, this may be an outdated guideline as using a low-dose lymphoscintigraphic technique appears to be safe in pregnancy. PMID:28255521

  9. It is time to revisit current dietary recommendations for saturated fat.

    Science.gov (United States)

    Lamarche, Benoît; Couture, Patrick

    2014-12-01

    The extent to which a high intake of saturated fat (SFA) increases the risk of cardiovascular disease (CVD) has become a highly controversial topic. Dietary SFA primarily raises low-density lipoprotein cholesterol, while having a relatively neutral impact on other key CVD risk factors. Recent epidemiological data also challenge the concept that SFA increases the risk of CVD. This short review provides arguments for the urgency to re-assess the association between dietary SFA and CVD risk in light of recent data on the subject.

  10. Could gestational diabetes mellitus be managed through dietary bioactive compounds? Current knowledge and future perspectives.

    Science.gov (United States)

    Santangelo, Carmela; Zicari, Alessandra; Mandosi, Elisabetta; Scazzocchio, Beatrice; Mari, Emanuela; Morano, Susanna; Masella, Roberta

    2016-04-14

    Gestational diabetes mellitus (GDM) is a serious problem growing worldwide that needs to be addressed with urgency in consideration of the resulting severe complications for both mother and fetus. Growing evidence indicates that a healthy diet rich in fruit, vegetables, nuts, extra-virgin olive oil and fish has beneficial effects in both the prevention and management of several human diseases and metabolic disorders. In this review, we discuss the latest data concerning the effects of dietary bioactive compounds such as polyphenols and PUFA on the molecular mechanisms regulating glucose homoeostasis. Several studies, mostly based on in vitro and animal models, indicate that dietary polyphenols, mainly flavonoids, positively modulate the insulin signalling pathway by attenuating hyperglycaemia and insulin resistance, reducing inflammatory adipokines, and modifying microRNA (miRNA) profiles. Very few data about the influence of dietary exposure on GDM outcomes are available, although this approach deserves careful consideration. Further investigation, which includes exploring the 'omics' world, is needed to better understand the complex interaction between dietary compounds and GDM.

  11. The contribution of school meals to energy and nutrient intake of Swedish children in relation to dietary guidelines

    Directory of Open Access Journals (Sweden)

    Christine Persson Osowski

    2015-10-01

    Full Text Available Background: In Sweden, school meals are served free of charge and Swedish law states that school meals must be nutritious. Nevertheless, data on children's energy and nutrient intake from school meals are scarce. Objective: The aim was to describe the contribution of school meals to Swedish children's nutrient and energy intake during weekdays and compare this to the reference values based on the Nordic Nutrition Recommendations (NNR, which have been adopted as the official Swedish recommendations. Design: A cross-sectional food consumption survey was performed on 1,840 Swedish children attending Grade 2 (mean age 8.6 and Grade 5 (mean age 11.7. The children's nutrient and energy intake was compared to the reference values based on the NNR. Results: The mean intake from school meals of energy, carbohydrates, dietary fiber, polyunsaturated fatty acids (PUFA, and vitamins D and E did not reach the reference values and the intake of saturated fatty acids (SFA and sodium exceeded the reference values in both age groups (significant differences, all p≤0.001. Additionally, the pupils in Grade 5 did not reach the reference values for folate, potassium, calcium, magnesium, iron, selenium, and zinc (significant differences, all p≤0.001. Standardized for energy, dietary fiber, PUFA, and vitamins D and E did not reach the reference values, whereas the reference values for SFA and sodium were exceeded in both age groups (significant differences, all p≤0.001. Conclusions: The study pointed to some central nutrients in need of improvement as regards school meals in Sweden, namely the quality of fat, dietary fiber, sodium, vitamin D, and iron. Some of these results may be attributed to the children not reporting eating the recommended number of calories, the children omitting some components of the meal, or underreporting, as a consequence of which the reference values for several nutrients were not met.

  12. The management of compound leg injuries in the West Midlands (UK): are we meeting current guidelines?

    Science.gov (United States)

    Allison, K; Wong, M; Bolland, B; Peart, F; Porter, K

    2005-07-01

    The joint British Association of Plastic Surgeons and British Orthopaedic Association (BAPS/BOA) guidelines for the management of patients with open tibia fractures were published in 1991 and 1997 and provided a synopsis of injury epidemiology and best care. We present a retrospective review of 66 patients treated over a 2-year period (January 2001-February 2003) at a regional plastic surgery unit. There were 33 direct admissions and 33 transfers from other hospitals in which the average delay in transfer was 7.8 days (1-28) and in whom 26 (79%) patients had already undergone surgery. Plastic surgeons were involved in 46 (62%) of the 66 patient cohort and 27 (82%) transferred patients. The delay after admission until soft tissue cover was 3.8 days (0-15). Twenty-nine (44%) complications were recorded, 20 (69%) of these were in the transferred group and additional orthopaedic intervention was needed in 11 (42%) of patients who had been operated on in other hospitals. Despite widespread dissemination and teaching of the BAPS/BOA guidelines, complex extremity trauma is often not managed well in our region. There are unacceptable delays in admission, late communication, poor note keeping and follow up. The initial surgery/fixation is often sub-optimal and soft tissue reconstruction has to be considered at the least advantageous time period for the patient, leading to an increased hospital stay and complications.

  13. The management of hypertension in Canada: a review of current guidelines, their shortcomings and implications for the future

    OpenAIRE

    McAlister, Finlay A; Campbell, Norman R.C.; Zarnke, Kelly; Levine, Mitchell; Graham, Ian D

    2001-01-01

    CLINICIANS ARE EXPOSED to numerous hypertension guidelines. However, their enthusiasm for these guidelines, and the impact of the guidelines, appears modest at best. Barriers to the successful implementation of a guideline can be identified at the level of the clinician, the patient or the practice setting; however, the shortcomings of the guidelines themselves have received little attention. In this paper, we review the hypertension guidelines that are most commonly encountered by Canadian c...

  14. APA guidelines: their importance and a plan to keep them current: 2013 annual report of the Policy and Planning Board.

    Science.gov (United States)

    2014-01-01

    When guidelines are approved by APA, they become association policy, and it is imperative that they remain current. The revision of guidelines poses several challenges to the association. These challenges range from the availability and allocation of resources to support the complicated processes involved in developing and updating these policies to the lack of a clearly defined process that includes identification of tasks, assignments of responsibilities, and so forth. For this reason, the APA Board of Directors asked the Policy and Planning Board (P&P) to work with the boards of the four directorates (i.e., the Education Directorate, the Practice Directorate, the Public Interest Directorate, and the Science Directorate) to create a proposal that would (a) make recommendations with regard to how the review and revision of guidelines documents might best be accomplished in accordance with the APA Strategic Plan and existing policies and procedures and (b) make suggestions regarding the association resources that might be required. The Board of Directors approved the proposed review process in December 2013. 2014 APA, all rights reserved

  15. Current issues in determining dietary protein and amino-acid requirements

    DEFF Research Database (Denmark)

    Pencharz, P; Jahoor, F; Kurpad, A

    2014-01-01

    Pregnancy and the first two years of life are periods of rapid growth and yet the knowledge of requirements for protein and dietary indispensable amino acids is very limited. The development of carbon oxidation methods opens the way to studies that should fill these important gaps in knowledge.Eu.......European Journal of Clinical Nutrition advance online publication, 15 January 2014; doi:10.1038/ejcn.2013.297....

  16. Upper extremity sarcoma: impact of current practice guidelines and controversies on reconstructive approaches

    Directory of Open Access Journals (Sweden)

    Dobke Marek

    2017-01-01

    Full Text Available The goals of sarcoma management include both a cure and the functional preservation of involved tissues and adjacent critical structures with common opinions favoring immediate reconstruction. The question arises whether these goals are contradictory. This paper discusses the question based on the experience of 28 patients with different types of extremity sarcoma, with 24 surgically treated by the University of California San Diego (UCSD orthopedic and plastic surgery team (2011–2016 and the collection of evidence from published practice guidelines, reviews, case studies, and clinical trials. Included are the impact of limb-sparing and functional reconstructive concepts, efforts regarding the adequacy of surgical margins, and the rationale of immediate versus delayed reconstructive approaches, and the disease-free status of sarcoma management.

  17. Improved Dietary Guidelines for Vitamin D: Application of Individual Participant Data (IPD)-Level Meta-Regression Analyses.

    Science.gov (United States)

    Cashman, Kevin D; Ritz, Christian; Kiely, Mairead; Odin Collaborators

    2017-05-08

    Dietary Reference Values (DRVs) for vitamin D have a key role in the prevention of vitamin D deficiency. However, despite adopting similar risk assessment protocols, estimates from authoritative agencies over the last 6 years have been diverse. This may have arisen from diverse approaches to data analysis. Modelling strategies for pooling of individual subject data from cognate vitamin D randomized controlled trials (RCTs) are likely to provide the most appropriate DRV estimates. Thus, the objective of the present work was to undertake the first-ever individual participant data (IPD)-level meta-regression, which is increasingly recognized as best practice, from seven winter-based RCTs (with 882 participants ranging in age from 4 to 90 years) of the vitamin D intake-serum 25-hydroxyvitamin D (25(OH)D) dose-response. Our IPD-derived estimates of vitamin D intakes required to maintain 97.5% of 25(OH)D concentrations >25, 30, and 50 nmol/L across the population are 10, 13, and 26 µg/day, respectively. In contrast, standard meta-regression analyses with aggregate data (as used by several agencies in recent years) from the same RCTs estimated that a vitamin D intake requirement of 14 µg/day would maintain 97.5% of 25(OH)D >50 nmol/L. These first IPD-derived estimates offer improved dietary recommendations for vitamin D because the underpinning modeling captures the between-person variability in response of serum 25(OH)D to vitamin D intake.

  18. Appraisal of biochemical classes of radioprotectors: evidence, current status and guidelines for future development.

    Science.gov (United States)

    Mishra, Krishnanand; Alsbeih, Ghazi

    2017-10-01

    The search for efficient radioprotective agents to protect from radiation-induced toxicity, due to planned or accidental radiation exposure, is still ongoing worldwide. Despite decades of research and development of widely different biochemical classes of natural and derivative compounds, a safe and effective radioprotector is largely unmet. In this comprehensive review, we evaluated the evidence for the radioprotective performance of classical thiols, vitamins, minerals, dietary antioxidants, phytochemicals, botanical and bacterial preparations, DNA-binding agents, cytokines, and chelators including adaptogens. Where radioprotection was demonstrated, the compounds have shown moderate dose modifying factors ranging from 1.1 to 2.7. To date, only few compounds found way to clinic with limited margin of dose prescription due to side effects. Most of these compounds (amifostine, filgratism, pegfilgrastim, sargramostim, palifermin, recombinant salmonella flagellin, Prussian blue, potassium iodide) act primarily via scavenging of free radicals, modulation of oxidative stress, signal transduction, cell proliferation or enhance radionuclide elimination. However, the gain in radioprotection remains hampered with low margin of tolerance. Future development of more effective radioprotectors requires an appropriate nontoxic compound, a model system and biomarkers of radiation exposure. These are important to test the effectiveness of radioprotection on physiological tissues during radiotherapy and field application in cases of nuclear eventualities.

  19. Optimal screening of children with acute malnutrition requires a change in current WHO guidelines as MUAC and WHZ identify different patient groups

    DEFF Research Database (Denmark)

    Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard;

    2014-01-01

    BACKGROUND: Timely treatment of acute malnutrition in children 500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm...

  20. [Therapeutic strategies. Evolution and current status of the European Guidelines on Cardiovascular disease prevention].

    Science.gov (United States)

    Guijarro, Carlos; García-Díaz, Juan de Dios

    2013-01-01

    The European Guidelines on Dyslipidaemias (2011) and Cardiovascular Prevention (2012) have incorporated important changes. Firstly, it highlights the identification of a group of "very high risk" patients: patients with atherosclerotic disease in any vascular area, diabetes with associated risk factors, advanced chronic renal failure, or a SCORE estimate >10%. Patients with diabetes and no other risk factors, moderate renal failure, severe hypertension, genetic dyslipidaemias, or a SCORE estimate 5-10%, are considered as "high risk". The HDL cholesterol and triglycerides levels are considered as modulators of risks, but not therapeutic objectives per se. The therapeutic objectives are set at LDL cholesterol levels < 70 mg/dl (or at least a reduction of at least 50%) for patients at very high risk, and an LDL < 100 mg/dl for high risk patients. As well as the changes in lifestyle, pharmacological treatment with statins is the focal point of lipid lowering treatments. Other pharmacological options may be considered if the treatment with the maximum tolerable doses of statins do not achieve the therapeutic objectives. Copyright © 2013 Elsevier España, S.L. y SEA. All rights reserved.

  1. Current Practice of Heart Donor Evaluation in Germany: Multivariable Risk Factor Analysis Confirms Practicability of Guidelines

    Directory of Open Access Journals (Sweden)

    Sylke Ruth Zeissig

    2013-01-01

    Full Text Available Background. Organ shortage has liberalised the acceptance criteria of grafts for heart transplantation, but which donor characteristics ultimately influence the decision to perform transplantation? For the first time this was evaluated using real-time donor data from the German organ procurement organization (DSO. Observed associations are discussed with regard to international recommendations and guidelines. Methods. 5291 German donors (2006–2010 were formally eligible for heart donation. In logistic regression models 160 donor parameters were evaluated to assess their influence on using grafts for transplantation (random split of cases: 2/3 study sample, 1/3 validation sample. Results. Successful procurement was determined by low donor age (OR 0.87 per year; 95% CI [0.85–0.89], P<0.0001, large donor height (OR 1.04 per cm; 95% CI [1.02–1.06], P<0.0001, exclusion of impaired left ventricular function or wall motion (OR 0.01; 95% CI [0.002–0.036], P<0.0001, arrhythmia (OR 0.05; 95% CI [0.009–0.260], P=0.0004, and of severe coronary artery disease (OR 0.003; 95% CI [<0.001–0.01], P<0.0001. Donor characteristics differed between cases where the procedure was aborted without and with allocation initiated via Eurotransplant.

  2. Short Tools to Assess Young Children's Dietary Intake: A Systematic Review Focusing on Application to Dietary Index Research

    Directory of Open Access Journals (Sweden)

    Lucinda K. Bell

    2013-01-01

    Full Text Available Dietary indices evaluate diet quality, usually based on current dietary guidelines. Indices can therefore contribute to our understanding of early-life obesity-risk dietary behaviours. Yet indices are commonly applied to dietary data collected by onerous methods (e.g., recalls or records. Short dietary assessment instruments are an attractive alternative to collect data from which to derive an index score. A systematic review of studies published before April 2013 was conducted to identify short (≤50 items tools that measure whole-of-diet intake of young children (birth-five years and are applicable to dietary indices, in particular screening obesogenic dietary behaviours. The search identified 3686 papers of which 16, reporting on 15 tools (n=7, infants and toddlers birth-24 months; n=8, preschoolers 2–5 years, met the inclusion criteria. Most tools were food frequency questionnaires (n=14, with one innovative dietary questionnaire identified. Seven were tested for validity or reliability, and one was tested for both. Six tools (n=2, infants and toddlers; n=4, preschoolers are applicable for use with current dietary indices, five of which screen obesogenic dietary behaviours. Given the limited number of brief, valid and reliable dietary assessment tools for young children to which an index can be applied, future short tool development is warranted, particularly for screening obesogenic dietary behaviours.

  3. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice

    Institute of Scientific and Technical Information of China (English)

    Stefania Angeloni; Cinzia Leboffe; Antonella Parente; Mario Venditti; Alessandra Giordano; Manuela Merli; Oliviero Riggio

    2008-01-01

    AIM:To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis (SBP) in clinical practice.METHODS:All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study.SBP was diagnosed when the ascitic fluid polymorphonuclear (PMN) cell count was>250 cells/mm3,and empirically treated with cefotaxime.RESULTS:Thirty-eight SBP episodes occurred in 32 cirrhotics (22 men/10 women;mean age:58.6±11.2 years).Prevalence of SBP,in our population,was 17%.Ascitic fluid culture was positive in nine (24%)cases only.Eleven episodes were nosocomial and 71%community-acquired.Treatment with cefotaxime was successful in 59% of cases,while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h.Change of antibiotic therapy led to the resolution of infection in 87% of episodes.Among the cases with positive culture,the initial antibiotic therapy with cefotaxime failed at a percentage (44%) similar to that of the whole series.In these cases,the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime.CONCLUSIOM:In clinical practice,ascitic PMN count is a valid tool for starting a prompt antibiotic treatment and evaluating its efficacy.The initial treatment with cefotaxime failed more frequently than expected.An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding.A different first-line antibiotic treatment should be investigated.

  4. Atopic Dermatitis in Children: Current Clinical Guidelines for Diagnosis and Therapy

    Directory of Open Access Journals (Sweden)

    L. S. Namazova-Baranova

    2016-01-01

    Full Text Available Atopic dermatitis is a chronic multifactorial skin disease that is common enough in childhood. The article presents the current data on epidemiology and dynamics of incidence of pathological symptoms, pathogenesis basics, and key factors of the disease development, shows the current classification of the disease. The authors consider in detail the key principles of the diagnosis and peculiarities of a clinical aspect depending on age. Algorithms of a therapeutic approach, as well as basics of an individual hypoallergenic diet are proposed. General recommendations and possible prognosis for pediatric patients with atopic dermatitis are given.

  5. Current guidelines in melanoma treatment. Melanoma Working Group of Gent and Bordet.

    Science.gov (United States)

    Brochez, L; Verhaeghe, E; Sales, F; Del Marmol, V; Deraemaecker, R; Vossaert, K; Naeyaert, J M

    2000-01-01

    This article focuses on the actual management of cutaneous melanoma, dealing both with established, internationally well-accepted standard procedures and interventions which are still being investigated. It wants to offer a global picture to the dermatologist of what is currently available in the therapeutic arsenal against melanoma.

  6. Several grain dietary patterns are associated with better diet quality and improved shortfall nutrient intakes in US children and adolescents: a study focusing on the 2015-2020 Dietary Guidelines for Americans.

    Science.gov (United States)

    Papanikolaou, Yanni; Jones, Julie Miller; Fulgoni, Victor L

    2017-02-20

    The present study identified the most commonly consumed grain food patterns in US children and adolescents (2-18 years-old; N = 8,367) relative to those not consuming grains and compared diet quality and nutrient intakes, with focus on 2015-2020 Dietary Guidelines for Americans (2015-2020 DGA) shortfall nutrients. Cluster analysis using data from the National Health and Nutrition Examination Survey 2005-2010, identified 8 unique grain food patterns: a) no consumption of main grain groups, b) cakes, cookies and pies, c) yeast bread and rolls, d) cereals, e) pasta, cooked cereals and rice, f) crackers and salty snacks, g) pancakes, waffles and French toast and other grains, and h) quick breads. Energy intake was higher for all grain cluster patterns examined, except 'cereals', compared to no grains. Children and adolescents in the 'yeast bread and rolls', 'cereals', 'pasta, cooked cereals and rice', and 'crackers and salty snacks' patterns had a higher diet quality relative to no grains (all p patterns, ranging from 1.8 - 2.8 g more per day (all p patterns, except cakes, cookies and pies had higher EA daily folate relative to children in the no grains pattern (all p pattern (all p patterns relative to no grains (all p patterns in children and adolescents were associated with improved 2015-2020 DGA shortfall nutrient intakes and diet quality as compared to those consuming no grains.

  7. Investigation of assumptions underlying current safety guidelines on EM-induced nerve stimulation

    Science.gov (United States)

    Neufeld, Esra; Vogiatzis Oikonomidis, Ioannis; Iacono, Maria Ida; Angelone, Leonardo M.; Kainz, Wolfgang; Kuster, Niels

    2016-06-01

    An intricate network of a variety of nerves is embedded within the complex anatomy of the human body. Although nerves are shielded from unwanted excitation, they can still be stimulated by external electromagnetic sources that induce strongly non-uniform field distributions. Current exposure safety standards designed to limit unwanted nerve stimulation are based on a series of explicit and implicit assumptions and simplifications. This paper demonstrates the applicability of functionalized anatomical phantoms with integrated coupled electromagnetic and neuronal dynamics solvers for investigating the impact of magnetic resonance exposure on nerve excitation within the full complexity of the human anatomy. The impact of neuronal dynamics models, temperature and local hot-spots, nerve trajectory and potential smoothing, anatomical inhomogeneity, and pulse duration on nerve stimulation was evaluated. As a result, multiple assumptions underlying current safety standards are questioned. It is demonstrated that coupled EM-neuronal dynamics modeling involving realistic anatomies is valuable to establish conservative safety criteria.

  8. Review of current typhoid fever vaccines, cross-protection against paratyphoid fever, and the European guidelines.

    Science.gov (United States)

    Zuckerman, Jane N; Hatz, Christoph; Kantele, Anu

    2017-10-01

    Typhoid and paratyphoid fever remain a global health problem, which - in non-endemic countries - are mainly seen in travelers, particularly in VFRs (visiting friends and relatives), with occasional local outbreaks occurring. A rise in anti-microbial resistance emphasizes the role of preventive measures, especially vaccinations against typhoid and paratyphoid fever for travelers visiting endemic countries. Areas covered: This state-of-the-art review recapitulates the epidemiology and mechanisms of disease of typhoid and paratyphoid fever, depicts the perspective of non-endemic countries and travelers (VFRs), and collectively presents current European recommendations for typhoid fever vaccination. We provide a brief overview of available (and developmental) vaccines in Europe, present current data on cross-protection to S. Paratyphi, and aim to provide a background for typhoid vaccine decision-making in travelers. Expert commentary: European recommendations are not harmonized. Experts must assess vaccination of travelers based on current country-specific recommendations. Travel health practitioners should be aware of the issues surrounding vaccination of travelers and be motivated to increase awareness of typhoid and paratyphoid fever risks.

  9. A REVIEW OF GRAPHICAL REPRESENTATIONS USED IN THE DIETARY GUIDELINES OF SELECTED COUNTRIES IN THE AMERICAS, EUROPE AND ASIA.

    Science.gov (United States)

    Altamirano Martínez, Martha Betzaida; Cordero Muñoz, Aida Yanet; Macedo Ojeda, Gabriela; Márquez Sandoval, Yolanda Fabiola; Vizmanos, Barbara

    2015-09-01

    Introducción: las Guías Alimentarias Basadas en Alimentos “Food-Based Dietary Guidelines” (FBDG) son una propuesta de la Food and Agriculture Organization of the United Nations (FAO) y la World Health Organization (WHO) para que cada país plantee sus principios de educación nutricional de manera clara y concreta con el fin de orientar y promover la buena salud en la población. Muchas de estas guías incluyen una representación gráfica (GR) como ayuda visual en el proceso de orientación alimentaria. Objetivos: analizar las características de las GR de países de tres continentes, para conocer las tendencias internacionales de los mensajes gráficos y para facilitar su transmisión durante el proceso educativo a la población a la que van dirigidos. Métodos: revisión de las GR de las FBDG de países de América, Europa y Asia, cuya información estuviera accesible, en español o en inglés. Resultados y discusión: las figuras más utilizadas son el círculo y la pirámide. Las GR ilustran las siguientes recomendaciones: todas (n = 37) grupos de alimentos, 21 actividad física, 17 consumo de agua, 7 restricción de sal, 1 convivencia familiar, 1 relajación y 10 recomendaciones cuantitativas. Las GR de Grecia y Estados Unidos no muestran imágenes de alimentos. Los aspectos considerados en las GR dependen de la región, la cultura y algunas características epidemiológicas de cada país. Se observa una tendencia al uso de la figura del círculo en países como Estados Unidos, España y México, además de incluir recomendaciones sobre el estilo de vida en la ilustración. Las recomendaciones cuantitativas pueden clarificar la información en el proceso educativo.

  10. Current status and guidelines for the assessment of tumour vascular support with dynamic contrast-enhanced computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Miles, K.A. [University of Sussex, Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Falmer (United Kingdom); Lee, T.Y. [Robarts Research Institute, Imaging Research Laboratories, London, Ontario (Canada); Goh, V. [St Thomas' Hospital, Division of Imaging Sciences and Biomedical Engineering, King' s College London, London (United Kingdom); Klotz, E. [Computed Tomography H IM CT PLM-E PA, Siemens Healthcare Sector, Forchheim (Germany); Cuenod, C. [INSERM U970 PARCC, Hopital Europeen Georges Pompidou (HEGP), Paris (France); Bisdas, S. [Eberhard Karls University, Department of Neuroradiology, Tuebingen (Germany); Groves, A.M. [University College London, University College Hospital, Institute of Nuclear Medicine, London (United Kingdom); Hayball, M.P. [Cambridge Computed Imaging Ltd, Cambridge (United Kingdom); Alonzi, R. [Mount Vernon Cancer Centre, Northwood (United Kingdom); Brunner, T. [Gray Institute for Radiation, Oncology and Biology, Oxford (United Kingdom)

    2012-07-15

    Dynamic contrast-enhanced computed tomography (DCE-CT) assesses the vascular support of tumours through analysis of temporal changes in attenuation in blood vessels and tissues during a rapid series of images acquired with intravenous administration of iodinated contrast material. Commercial software for DCE-CT analysis allows pixel-by-pixel calculation of a range of validated physiological parameters and depiction as parametric maps. Clinical studies support the use of DCE-CT parameters as surrogates for physiological and molecular processes underlying tumour angiogenesis. DCE-CT has been used to provide biomarkers of drug action in early phase trials for the treatment of a range of cancers. DCE-CT can be appended to current imaging assessments of tumour response with the benefits of wide availability and low cost. This paper sets out guidelines for the use of DCE-CT in assessing tumour vascular support that were developed using a Delphi process. Recommendations encompass CT system requirements and quality assurance, radiation dosimetry, patient preparation, administration of contrast material, CT acquisition parameters, terminology and units, data processing and reporting. DCE-CT has reached technical maturity for use in therapeutic trials in oncology. The development of these consensus guidelines may promote broader application of DCE-CT for the evaluation of tumour vascularity. (orig.)

  11. Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective.

    Science.gov (United States)

    Phillips, Jane L; Lovell, Melanie; Luckett, Tim; Agar, Meera; Green, Anna; Davidson, Patricia

    2015-01-01

    Cancer pain remains a major public health concern. Despite effective treatments being available to manage the majority of cancer pain, this debilitating symptom is frequently under treated. As cancer has becomes a chronic disease a range of health professionals, including community nurses in Australia are increasingly caring for people living with cancer related pain. Yet, little is known about community nurses capacity to assess and manage cancer pain in accordance with best available evidence. This study aimed to: identify the barriers and facilitators to adult cancer pain assessment and management as perceived by Australian health professionals; identify if cancer pain guidelines are currently used; identify barriers and facilitators to guideline use; and establish the need for Australian cancer pain guidelines. This article reports on community nurses' perceptions of managing cancer pain in the community setting. A cross-sectional survey was administered online. Invitations were circulated via peak bodies and clinical leaders seeking the views and experiences of health professionals involved in caring for people living with cancer pain. Descriptive statistics were used to summarise the quantitative data, and thematic content analysis were used to describe the qualitative data. Sixty-two community nurses responded to the survey, representing 29% of the total sample. These participants reported high levels of adherence to accepted cancer pain management practices in their workplace, with 71% nominating the Palliative Care Therapeutic Guideline V.3 as being most frequently used to manage community patients' cancer related pain. Key barriers to effective cancer pain management in the community were: difficulties accessing non-pharmacological interventions (89%), lack of coordination by multiple providers (89%), and impact of distance on ability to access pain-related services for patients (86%). A range of system, health professional and consumer barriers limit

  12. Evaluation of Functional Lower Urinary Tract Dysfunction in Children: Are the Physicians Complying with the Current Guidelines?

    Directory of Open Access Journals (Sweden)

    Mesrur Selcuk Silay

    2013-01-01

    were used for statistical analyses. Results. Of the 117 departments a total of 93 have completed the survey (n: 58 urology; n: 35 paediatric nephrology. Routine use of a questionnaire with validated symptom scoring system was found to be 13.9%. Of the participants, only 38.7% were asking all of the patients to fill the bladder diary. During treatment, only 24.7% were applying standard urotherapy for every patient. Almost half of the clinicians (45.1% believed that they were personally insufficient during the evaluation of those children. Finally, 86% reported that children with LUTD were not adequately approached. Conclusions. Evaluation of LUTD in children is not complying with the current guidelines. General approach for those children needs to be revisited by the clinicians.

  13. Utilization study of antidiabetic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines

    Directory of Open Access Journals (Sweden)

    Sushrut Varun Satpathy

    2016-01-01

    Full Text Available Objective: Diabetes has gradually emerged as one of the most serious public health problems in our country. This underlines the need for timely disease detection and decisive therapeutic intervention. This prospective cross-sectional observational study aims at analyzing the utilization pattern of antidiabetic agents in a remote North-East Indian tertiary care teaching hospital in the perspective of current standard treatment guidelines. Materials and Methods: Diabetic patients receiving antidiabetic medication, both as outpatients and inpatients in our hospital over a period of 12 months (May 2013–May 2014, were included in this study. The data obtained were sorted and analyzed on the basis of gender, type of therapy, and hospital setting. Results: A total of 310 patients were included in the study. Metformin was the single most frequently prescribed antidiabetic agent (66.8% followed by the sulfonylureas group (37.4%. Insulin was prescribed in 23.2% of the patients. Combination antidiabetic drug therapy (65.1% was used more frequently than monotherapy (34.8%. The use of biguanides (P < 0.0001 and sulfonylureas (P = 0.02 in combination was significant as compared to their use as monotherapy. A total of 48% of all antidiabetic combinations used, comprised metformin and sulfonylureas (n = 96. Insulin use was significantly higher as monotherapy and in inpatients (P< 0.0001. The utilization of drugs from the National List of Essential Medicines was 51.2%, while 11% of antidiabetics were prescribed by generic name. Conclusion: The pattern of utilization largely conforms to the current standard treatment guidelines. Increased use of generic drugs is an area with scope for improvement.

  14. Current role of rufinamide in the treatment of childhood epilepsy: literature review and treatment guidelines.

    Science.gov (United States)

    Coppola, Giangennaro; Besag, Frank; Cusmai, Raffaella; Dulac, Olivier; Kluger, Gerhard; Moavero, Romina; Nabbout, Rima; Nikanorova, Marina; Pisani, Francesco; Verrotti, Alberto; von Stülpnagel, Celina; Curatolo, Paolo

    2014-11-01

    The literature on the efficacy and safety of rufinamide in childhood-onset epilepsy syndromes currently includes approximately 600 paediatric patients. This paper summarizes the views of a panel of experienced European epileptologists with regard to the current role of rufinamide in the treatment of childhood epilepsies. Rufinamide is effective in decreasing the seizure frequency in the Lennox-Gastaut syndrome (LGS), especially tonic and atonic seizures. It might consequently be preferred to other drugs as a second-line treatment for LGS when drop-attacks are frequent. The mean responder rate in the published studies is 38% with seizure freedom achieved in 2.4% of patients. Rufinamide has shown some efficacy in epileptic encephalopathies other than LGS. It can be also effective as adjunctive therapy in children and adolescents with drug-resistant partial seizures. The available data suggest that rufinamide has an acceptable risk/benefit ratio with quite a low risk of aggravating seizures. Common adverse effects (somnolence, nausea and vomiting) are usually mild and self-limiting; they are more frequently observed during titration than in the maintenance phase, suggesting that low escalation rates might be associated with fewer adverse effects. Rufinamide appears to have a favourable cognitive profile compared with other antiepileptic drugs. Rufinamide is only approved for adjunctive treatment of seizures associated with LGS in children 4 years of age and older. There are very few data on rufinamide treatment at the onset of LGS or early in the course of the disorder; whether early treatment will improve outcome has yet to be determined. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  15. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS).

    Science.gov (United States)

    Lefaucheur, Jean-Pascal; Antal, Andrea; Ayache, Samar S; Benninger, David H; Brunelin, Jérôme; Cogiamanian, Filippo; Cotelli, Maria; De Ridder, Dirk; Ferrucci, Roberta; Langguth, Berthold; Marangolo, Paola; Mylius, Veit; Nitsche, Michael A; Padberg, Frank; Palm, Ulrich; Poulet, Emmanuel; Priori, Alberto; Rossi, Simone; Schecklmann, Martin; Vanneste, Sven; Ziemann, Ulf; Garcia-Larrea, Luis; Paulus, Walter

    2017-01-01

    A group of European experts was commissioned by the European Chapter of the International Federation of Clinical Neurophysiology to gather knowledge about the state of the art of the therapeutic use of transcranial direct current stimulation (tDCS) from studies published up until September 2016, regarding pain, Parkinson's disease, other movement disorders, motor stroke, poststroke aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease, tinnitus, depression, schizophrenia, and craving/addiction. The evidence-based analysis included only studies based on repeated tDCS sessions with sham tDCS control procedure; 25 patients or more having received active treatment was required for Class I, while a lower number of 10-24 patients was accepted for Class II studies. Current evidence does not allow making any recommendation of Level A (definite efficacy) for any indication. Level B recommendation (probable efficacy) is proposed for: (i) anodal tDCS of the left primary motor cortex (M1) (with right orbitofrontal cathode) in fibromyalgia; (ii) anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC) (with right orbitofrontal cathode) in major depressive episode without drug resistance; (iii) anodal tDCS of the right DLPFC (with left DLPFC cathode) in addiction/craving. Level C recommendation (possible efficacy) is proposed for anodal tDCS of the left M1 (or contralateral to pain side, with right orbitofrontal cathode) in chronic lower limb neuropathic pain secondary to spinal cord lesion. Conversely, Level B recommendation (probable inefficacy) is conferred on the absence of clinical effects of: (i) anodal tDCS of the left temporal cortex (with right orbitofrontal cathode) in tinnitus; (ii) anodal tDCS of the left DLPFC (with right orbitofrontal cathode) in drug-resistant major depressive episode. It remains to be clarified whether the probable or possible therapeutic effects of tDCS are clinically meaningful and how to optimally perform t

  16. Nutrition support and dietary interventions for patients with lung cancer: current insights

    Directory of Open Access Journals (Sweden)

    Kiss N

    2016-01-01

    Full Text Available Nicole Kiss1,2 1Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia; 2Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia Abstract: Malnutrition and weight loss are prevalent in patients with lung cancer. The impact of malnutrition on patients with cancer, and specifically in patients with lung cancer, has been demonstrated in a large number of studies. Malnutrition has been shown to negatively affect treatment completion, survival, quality of life, physical function, and health care costs. Emerging evidence is providing some insight into which lung cancer patients are at higher nutritional risk. In lung cancer patients treated with radiotherapy, stage III or more disease, treatment with concurrent chemotherapy and the extent of radiotherapy delivered to the esophagus appear to confer a higher risk of weight loss during and post-treatment. Studies investigating nutrition interventions for lung cancer patients have examined intensive dietary counseling, supplementation with fish oils, and interdisciplinary models of nutrition and exercise interventions and show promise for improved outcomes from these interventions. However, further research utilizing these interventions in large clinical trials is required to definitively establish effective interventions in this patient group. Keywords: lung cancer, nutrition, malnutrition

  17. Nutrition support and dietary interventions for patients with lung cancer: current insights.

    Science.gov (United States)

    Kiss, Nicole

    2016-01-01

    Malnutrition and weight loss are prevalent in patients with lung cancer. The impact of malnutrition on patients with cancer, and specifically in patients with lung cancer, has been demonstrated in a large number of studies. Malnutrition has been shown to negatively affect treatment completion, survival, quality of life, physical function, and health care costs. Emerging evidence is providing some insight into which lung cancer patients are at higher nutritional risk. In lung cancer patients treated with radiotherapy, stage III or more disease, treatment with concurrent chemotherapy and the extent of radiotherapy delivered to the esophagus appear to confer a higher risk of weight loss during and post-treatment. Studies investigating nutrition interventions for lung cancer patients have examined intensive dietary counseling, supplementation with fish oils, and interdisciplinary models of nutrition and exercise interventions and show promise for improved outcomes from these interventions. However, further research utilizing these interventions in large clinical trials is required to definitively establish effective interventions in this patient group.

  18. REVIEW ON CURRENT WORLDWIDE STATUS, DISTRIBUTION, ECOLOGY AND DIETARY HABITS OF GOLDEN JACKAL, CANIS AUREUS

    Directory of Open Access Journals (Sweden)

    Tripti Negi

    2014-12-01

    Full Text Available The golden jackal is a medium-sized predator and omnivore, with a range covering the southern parts of the Palearctic, South Asia and northeastern Africa. The entire jackal population is now confined to a few clusters grouped into 7 sub-areas with criteria such as connectivity and isolation. Causes of decline seem to be related to the limited habitat availability due to changes in human agro-pastoral activities, which resulted mainly in reduced day-cover availability and possibly reduced food base. This review summarizes the basic aspects of golden jackal distribution, ecology and dietary habits, analyses the main threats and problems of jackal management. The jackals seem to do well in moderately modified agro-systems with non- invasive human activities. Barriers for jackal expansion and population recovery seems to be the mountains with extensive high forests or unbroken scrub, heavy snowy winters and irregular food supply, large intensively cultivated areas without cover, urbanization and established wolf populations. Agro pastoral changes during the past 25-30 years has resulted in habitat and human use changes, which have largely contributed to the massive jackal population declines. Following a short introduction on phylogeny, classification, and evolutionary ecology of the Canidae, this review provides the latest information on the distribution, biology and conservation status of Canid aureus species, organized by geographical region.

  19. [Current recommendations about the diagnosis and treatment of testosterone deficit syndrome: Clinical guidelines].

    Science.gov (United States)

    Valero Rosa, José; Márquez López, Javier; Campos Hernández, Pablo; Puigvert Martínez, Ana; Prieto Castro, Rafael

    2013-09-01

    Testosterone deficit syndrome (TDS) is a clinical and biochemical syndrome associated with advanced age and characterized by some typical symptoms and decrease in serum testosterone levels, which can affect multiple organs and systems, deteriorating the quality of life of the males who suffer it. Due to the low specificity of the clinical picture, as well as that of the commonly used questionnaires, when there is a diagnostic suspicion, serum testosterone determination is necessary, without a current universally accepted determination method. The increased survival of males in the western world and their demand of a better quality of life,including the preservation of sexual activity, up to increasingly more advanced ages: together with the appearance of new ways of testosterone delivery, make this entity, clinical-biochemical, acquirean increasingly greater importance. From a therapeutic point of view, testosterone replacement therapy has precise indications, with individualized evaluation in each patient on the basis of risk/benefit, and with an adequate, well defined follow up, that will allow the control of possible adverse events. TRT is recommended in patients with diminished testosterone associated with muscle mass and strength loss, decrease of bone density of the lumbar spine or diminished libido and quality of erection. Contraindications for therapy would include active or non treated prostate cancer, PSA >4 ng/ml before evaluation, breast cancer, severe sleep apnea, infertility, hematocrit over 50% or severe LUTS due to BPH.

  20. Remotely-Supervised Transcranial Direct Current Stimulation (tDCS for Clinical Trials: Guidelines for Technology and Protocols

    Directory of Open Access Journals (Sweden)

    Leigh E Charvet

    2015-03-01

    Full Text Available The effect of transcranial direct current stimulation (tDCS is cumulative. Treatment protocols typically require multiple consecutive sessions spanning weeks or months. However, traveling to clinic for a tDCS session can present an obstacle to subjects and their caregivers. With modified devices and headgear, tDCS treatment can be administered remotely under clinical supervision, potentially enhancing recruitment, throughput, and convenience. Here we propose standards and protocols for clinical trials utilizing remotely-supervised tDCS with the goal of providing safe, reproducible and well-tolerated stimulation therapy outside of the clinic. The recommendations include: 1 training of staff in tDCS treatment and supervision, 2 assessment of the user’s capability to participate in tDCS remotely, 3 ongoing training procedures and materials including assessments of the user and/or caregiver, 4 simple and fail-safe electrode preparation techniques and tDCS headgear, 5 strict dose control for each session, 6 ongoing monitoring to quantify compliance (device preparation, electrode saturation/placement, stimulation protocol, with corresponding corrective steps as required, 7 monitoring for treatment-emergent adverse effects, 8 guidelines for discontinuation of a session and/or study participation including emergency failsafe procedures tailored to the treatment population’s level of need. These guidelines are intended to provide a minimal level of methodological rigor for clinical trials seeking to apply tDCS outside a specialized treatment center. We outline indication-specific applications (Attention Deficit Hyperactivity Disorder, Depression, Multiple Sclerosis, Palliative Care following these recommendations that support a standardized framework for evaluating the tolerability and reproducibility of remote-supervised tDCS that, once established, will allow for translation of tDCS clinical trials to a greater size and range of patient populations.

  1. Feasibility of wavelength dispersive X-ray fluorescence spectrometry for the determination of metal impurities in pharmaceutical products and dietary supplements in view of regulatory guidelines.

    Science.gov (United States)

    Figueiredo, Alexandra; Fernandes, Tânia; Costa, Isabel Margarida; Gonçalves, Luísa; Brito, José

    2016-04-15

    The aim of this study was to investigate the feasibility of Wavelength Dispersive X-ray Fluorescence (WDXRF) spectrometry for the measurement of As, Cd, Cr, Cu, Hg, Ir, Mn, Mo, Ni, Os, Pb, Pd, Pt, Rh, Ru and V impurities in pharmaceuticals and dietary supplements, in view of the requirements by EMA and USP for the measurement of elemental impurities in drug products and according to the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH guidelines). For that purpose, a 4 kW WDXRF spectrometer (S4 Pioneer, Bruker AXS) was used after system calibration. The linearity of the method was demonstrated by correlation coefficients in excess of 0.9 and by appropriate test of lack of fit, except for Cd, Hg, Pd, V and As, which were excluded from analysis. The calculated limits of detection and quantification were in the ranges 0.6-5.4 μg/g and 1.7-16.4 μg/g meeting defined acceptance criteria, except for Pb. The accuracy of the method, determined by the percent recovery (R) of known amounts of each element added to a selected drug, at 3 different concentration levels, was in the acceptance range 70-150% except for Os and Pt, in which case R was marginally outside that range. The repeatability of the method, assessed as the % residual standard deviation (%RSD) of 3 replicate measurements at 3 concentration levels, produced %RSD values lower than 20%, as required. These results show that the WDXRF method complies with the validation requirements defined by the European Pharmacopeia for Cu, Cr, Ir, Mn, Mo, Ni, Os, and Pt, and by the United States Pharmacopeia for Ir, Ni, Os and Pt. Therefore, it may be an alternative to the compendial analytical procedures recommended for such elements. The novelty of the present work is the application of WDXRF to final medicines and not only to active pharmaceutical ingredients and/or excipients.

  2. Allermatch™, a webtool for the prediction of potential allergenicity according to current FAO/WHO Codex alimentarius guidelines

    Directory of Open Access Journals (Sweden)

    Nap Jan

    2004-09-01

    Full Text Available Abstract Background Novel proteins entering the food chain, for example by genetic modification of plants, have to be tested for allergenicity. Allermatch™ http://allermatch.org is a webtool for the efficient and standardized prediction of potential allergenicity of proteins and peptides according to the current recommendations of the FAO/WHO Expert Consultation, as outlined in the Codex alimentarius. Description A query amino acid sequence is compared with all known allergenic proteins retrieved from the protein databases using a sliding window approach. This identifies stretches of 80 amino acids with more than 35% similarity or small identical stretches of at least six amino acids. The outcome of the analysis is presented in a concise format. The predictive performance of the FAO/WHO criteria is evaluated by screening sets of allergens and non-allergens against the Allermatch databases. Besides correct predictions, both methods are shown to generate false positive and false negative hits and the outcomes should therefore be combined with other methods of allergenicity assessment, as advised by the FAO/WHO. Conclusions Allermatch™ provides an accessible, efficient, and useful webtool for analysis of potential allergenicity of proteins introduced in genetically modified food prior to market release that complies with current FAO/WHO guidelines.

  3. Allermatch, a webtool for the prediction of potential allergenicity according to current FAO/WHO Codex alimentarius guidelines.

    Science.gov (United States)

    Fiers, Mark W E J; Kleter, Gijs A; Nijland, Herman; Peijnenburg, Ad A C M; Nap, Jan Peter; van Ham, Roeland C H J

    2004-09-16

    Novel proteins entering the food chain, for example by genetic modification of plants, have to be tested for allergenicity. Allermatch http://allermatch.org is a webtool for the efficient and standardized prediction of potential allergenicity of proteins and peptides according to the current recommendations of the FAO/WHO Expert Consultation, as outlined in the Codex alimentarius. A query amino acid sequence is compared with all known allergenic proteins retrieved from the protein databases using a sliding window approach. This identifies stretches of 80 amino acids with more than 35% similarity or small identical stretches of at least six amino acids. The outcome of the analysis is presented in a concise format. The predictive performance of the FAO/WHO criteria is evaluated by screening sets of allergens and non-allergens against the Allermatch databases. Besides correct predictions, both methods are shown to generate false positive and false negative hits and the outcomes should therefore be combined with other methods of allergenicity assessment, as advised by the FAO/WHO. Allermatch provides an accessible, efficient, and useful webtool for analysis of potential allergenicity of proteins introduced in genetically modified food prior to market release that complies with current FAO/WHO guidelines.

  4. Daas: A Web-based System for User-specific Dietary Analysis and Advice for the Public Healthcare Domain

    Institute of Scientific and Technical Information of China (English)

    Deirdre Nugent; Kudakwashe Dube; Wu Bing

    2003-01-01

    This paper presents a Dietary Analysis and Advice System (DAAS), a web-based system for providing, within the public healthcare domain, user-specific diet advice based on a preliminary analysis of current diet or eating habits and lifestyle, using knowledge from domain expertise and experts' interpretation of national dietary guidelines.

  5. Current issues in dietary acrylamide:formation,mitigation and risk assessment

    DEFF Research Database (Denmark)

    Pedreschi, F.; Salome Mariotti, M.; Granby, Kit

    2014-01-01

    Acrylamide (AA) is known as a neurotoxin in humans and it is classified as a probable human carcinogen by the International Agency of Research on Cancer. AA is produced as by-product of the Maillard reaction in starchy foods processed at high temperatures (>120 °C). This review includes...... of the final product. Sugars in potatoes may be reduced by blanching. Levels of AA in different foods show large variations and no general upper limit is easily applicable, since some formation will always occur. Current policy is that practical measures should be taken voluntarily to reduce AA formation...

  6. Australian survey of current practice and guideline use in adult cancer pain assessment and management: perspectives of oncologists.

    Science.gov (United States)

    Luckett, Tim; Davidson, Patricia Mary; Boyle, Frances; Liauw, Winston; Agar, Meera; Green, Anna; Lovell, Melanie

    2014-06-01

    Cancer pain continues to be undertreated in up to half of cases, despite the availability of evidence-based guidelines. This study aimed to: (i) identify barriers and facilitators to adult cancer pain assessment and management, as perceived by Australian health professionals; (ii) establish the perceived need for new Australian guidelines and implementation strategy; (iii) identify which guidelines are used; (iv) identify barriers and facilitators to guideline use. This article focuses on the perceptions of responding oncologists. A cross-sectional survey was administered online. Invitations were circulated via peak bodies and clinical leaders. Comments were coded independently by two researchers. In all 76 oncologists self-reported high concordance with evidence-based recommendations, except validated pain scales. Perceived barriers to pain management included insufficient non-pharmacological interventions, access to /coordination between services, and time. Only 22 percent of respondents reported using pain guidelines. Perceived barriers to guideline use included lack of access, awareness and any single standard. Respondents were generally supportive of new Australian guidelines and especially an implementation strategy. Barriers to evidence-based practice and guideline use identified by our survey might be addressed via a clinical pathway that gives step-by-step guidance on evidence-based practice along with a framework for evaluation. Particular attention should be paid to promoting use of validated scales, patient education and non-pharmacological interventions, training of an appropriately skilled workforce and improving care coordination. Challenges are discussed. © 2012 Wiley Publishing Asia Pty Ltd.

  7. Contemporary Atrial Fibrillation Management: A Comparison of the Current AHA/ACC/HRS, CCS, and ESC Guidelines.

    Science.gov (United States)

    Andrade, Jason G; Macle, Laurent; Nattel, Stanley; Verma, Atul; Cairns, John

    2017-08-01

    In this article we compare and contrast the current recommendations, and highlight the important differences, in the American College of Cardiology/American Heart Association/Heart Rhythm Society, European Society of Cardiology, and Canadian Cardiovascular Society atrial fibrillation (AF) guidelines. Although many of the recommendations of the various societies are similar, there are important differences in the methodologies underlying their development and the specific content. Specifically, key differences can be observed in: (1) the definition of nonvalvular AF, which subsequently affects anticoagulation choices and candidacy for non-vitamin K antagonist oral anticoagulants; (2) the symptom score used to guide management decisions and longitudinal patient profiling; (3) the stroke risk stratification algorithm used to determine indications for oral anticoagulant therapy; (4) the role of acetylsalicylic acid in stroke prevention in AF; (5) the antithrombotic regimens used in the context of coronary artery disease, acute coronary syndromes, and percutaneous coronary intervention; (6) the rate control target and medications recommended to achieve the target; and (7) the role of "first-line" catheter ablation, open surgical ablation, and left atrial appendage exclusion. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  8. Towards environmentally sound dietary guidelines

    OpenAIRE

    Lagerberg Fogelberg, Charlotte

    2013-01-01

    The Swedish National Food Agency (NFA) has until recently focused its environmental work on the direct environmental impact of its actions, such as on heating, waste separation and travelling. However, since 2006 the Agency has been given another role with increased sector responsibilities regarding national environmental quality objectives and is now expected to coordinate and support players at the national level to strive towards ecologically sustainable development. With this report, the...

  9. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines.

    Science.gov (United States)

    Eichenfield, Lawrence F; Ahluwalia, Jusleen; Waldman, Andrea; Borok, Jenna; Udkoff, Jeremy; Boguniewicz, Mark

    2017-04-01

    Atopic dermatitis (AD) is a chronic pruritic inflammatory disease that commonly presents in the pediatric population. Although definitions and diagnosis of AD have largely been agreed upon, allergists and dermatologists have similar and divergent approaches to the management of AD. This review facilitated integration of the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Joint Task Force 2012 AD Practice Parameter and the 2014 American Academy of Dermatology guidelines to highlight the basic principles of AD management and discuss therapies and management of AD from the distinct perspectives of the allergist and dermatologist. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Comparison of dietary profile of a rural south Indian population with the current dietary recommendations for prevention of non-communicable diseases (CURES 147

    Directory of Open Access Journals (Sweden)

    Narasimhan Sowmya

    2016-01-01

    Interpretation & conclusions: The dietary profile of this rural south Indian population reflected unhealthy choices, with the high consumption of refined cereals in the form of polished white rice and low intake of protective foods like fruits, vegetables, n-3 poly and monounsaturated fatty acids. This could potentially contribute to the increase in prevalence of NCDs like diabetes, hypertension and cardiovascular diseases in rural areas and calls for appropriate remedial action.

  11. Alignment of Healthy Dietary Patterns and Environmental Sustainability: A Systematic Review.

    Science.gov (United States)

    Nelson, Miriam E; Hamm, Michael W; Hu, Frank B; Abrams, Steven A; Griffin, Timothy S

    2016-11-01

    To support food security for current and future generations, there is a need to understand the relation between sustainable diets and the health of a population. In recent years, a number of studies have investigated and compared different dietary patterns to better understand which foods and eating patterns have less of an environmental impact while meeting nutritional needs and promoting health. This systematic review (SR) of population-level dietary patterns and food sustainability extends and updates the SR that was conducted by the 2015 US Dietary Guidelines Advisory Committee, an expert committee commissioned by the federal government to inform dietary guidance as it relates to the committee's original conclusions. In the original SR, 15 studies met the criteria for inclusion; since then, an additional 8 studies have been identified and included. The relations between dietary intake patterns and both health and environmental outcomes were compared across studies, with methodologies that included modeling, life cycle assessment, and land use analysis. Across studies, consistent evidence indicated that a dietary pattern higher in plant-based foods (e.g., vegetables, fruits, legumes, seeds, nuts, whole grains) and lower in animal-based foods (especially red meat), as well as lower in total energy, is both healthier and associated with a lesser impact on the environment. This dietary pattern differs from current average consumption patterns in the United States. Our updated SR confirms and strengthens the conclusions of the original US Dietary Guidelines Advisory Committee SR, which found that adherence to several well-characterized dietary patterns, including vegetarian (with variations) diets, dietary guidelines-related diets, Mediterranean-style diets, the Dietary Approaches to Stop Hypertension (DASH) diet, and other sustainable diet scenarios, promotes greater health and has a less negative impact on the environment than current average dietary intakes.

  12. [Update on Current Care Guideline: Physical activity and exercise training for adults in sickness and in health].

    Science.gov (United States)

    Rauramaa, Rainer; Kukkonen-Harjula, Katriina; Arokoski, Jari; Hohtari, Hannele; Ketola, Eeva; Kettunen, Jyrki; Komulainen, Pirjo; Kujala, Urho; Laukkanen, Jari; Pylkkänen, Liisa; Savela, Salla; Savonen, Kai; Tikkanen, Heikki

    2016-01-01

    The purpose of the guideline is to promote physical activity in the prevention, treatment and rehabilitation of diseases. Physical activity plays a key role in the management of several chronic noncommunicable diseases. In this guideline, the following diseases are discussed: endocrinological, cardiovascular, musculoskeletal and respiratory diseases, as well as depression and cancer. In addition, physical activity during pregnancy and in senior citizens is reviewed. Exercise counseling should be included as part of disease management and lifestyle guidance.

  13. Dietary intake and nutritional status of micronutrients in adults with cystic fibrosis in relation to current recommendations.

    Science.gov (United States)

    Li, Li; Somerset, Shawn

    2016-08-01

    An increased prevalence of cystic fibrosis (CF) related complications such as impaired bone health and diabetes has accompanied increased survival of patients with CF. This review was conducted to determine the extent to which adults with CF are meeting current nutrition recommendations for micronutrients in association with CF-related complications management. Although dietary intake and nutritional status in CF has improved significantly in recent decades, micronutrient status seems to have diverged. While vitamin A and E intakes appear adequate, frequent vitamin D and K deficiency/insufficiency and compromised bone health in CF, occurs despite supplementation. Although deficiency of water-soluble vitamins and minerals is uncommon, ongoing surveillance will enhance overall health outcomes, particularly in cases of CF-related liver disease and deteriorated lung function and bone health. Salt and fluid status in CF may also need attention due to diminished thirst sensation and voluntary rehydration. Further investigation in micronutrient status optimisation in CF will inform the development of more effective and targeted nutrition therapies to enable integration of more refined recommendations for micronutrient intakes in CF based on individual needs and disease progression.

  14. Current European guidelines for management of arterial hypertension: Are they adequate for use in primary care? Modelling study based on the Norwegian HUNT 2 population

    Directory of Open Access Journals (Sweden)

    Hetlevik Irene

    2009-10-01

    Full Text Available Abstract Background Previous studies indicate that clinical guidelines using combined risk evaluation for cardiovascular diseases (CVD may overestimate risk. The aim of this study was to model and discuss implementation of the current (2007 hypertension guidelines in a general Norwegian population. Methods Implementation of the current European Guidelines for the Management of Arterial Hypertension was modelled on data from a cross-sectional, representative Norwegian population study (The Nord-Trøndelag Health Study 1995-97, comprising 65,028 adults, aged 20-89, of whom 51,066 (79% were eligible for modelling. Results Among individuals with blood pressure ≥120/80 mmHg, 93% (74% of the total, adult population would need regular clinical attention and/or drug treatment, based on their total CVD risk profile. This translates into 296,624 follow-up visits/100,000 adults/year. In the Norwegian healthcare environment, 99 general practitioner (GP positions would be required in the study region for this task alone. The number of GPs currently serving the adult population in the study area is 87 per 100,000 adults. Conclusion The potential workload associated with the European hypertension guidelines could destabilise the healthcare system in Norway, one of the world's most long- and healthy-living nations, by international comparison. Large-scale, preventive medical enterprises can hardly be regarded as scientifically sound and ethically justifiable, unless issues of practical feasibility, sustainability and social determinants of health are considered.

  15. How dietary patterns could have a role in prevention, progression, or management of diabetes mellitus? Review on the current evidence

    Directory of Open Access Journals (Sweden)

    Zahra Maghsoudi

    2012-01-01

    Full Text Available Objective: To investigate the role of dietary patterns in prevention and management of type 2 diabetes mellitus. Materials and Methods: A systematic review of databases which were published in ISI, Cochrane Central Register of Controlled Trials databases, PubMed, Iran Medex, and MagIran was performed. "Diabetes" and "dietary pattern" were used as the keywords. Results: A total of 58 studies which aimed to focus on diabetes mellitus, insulin resistance, metabolic syndrome, dietary pattern, and other related key words were reviewed. More than 47,447 articles were found and 46,709 entries of the extracted studies were excluded on the basis of the title and abstracts. The major dietary patterns were: "Healthy," "Western," "Traditional," "Prudent," "Unhealthy," "Mediterranean," "Modern," and "Dietary Approach to Stop Hypertension" (DASH diets. Comparison of the effects of different diets revealed that dietary patterns containing fiber-rich foods have a protective role in managing diabetes mellitus. "Healthy," "Mediterranean," "Prudent," and "DASH" dietary patterns were associated with lower risk of hyperglycemia. Conclusions: The adherence to the "Mediterranean," "Prudent," or "DASH" diets could control hyperglycemia. The higher intake of vegetables, fruits, nuts, whole grains, and lower intake of red meat could reduce the risk of type 2 diabetes mellitus.

  16. Dietary Magnesium and Genetic Interactions in Diabetes and Related Risk Factors: A Brief Overview of Current Knowledge

    Directory of Open Access Journals (Sweden)

    Adela Hruby

    2013-12-01

    Full Text Available Nutritional genomics has exploded in the last decade, yielding insights—both nutrigenomic and nutrigenetic—into the physiology of dietary interactions and our genes. Among these are insights into the regulation of magnesium transport and homeostasis and mechanisms underlying magnesium’s role in insulin and glucose handling. Recent observational evidence has attempted to examine some promising research avenues on interaction between genetics and dietary magnesium in relation to diabetes and diabetes risk factors. This brief review summarizes the recent evidence on dietary magnesium’s role in diabetes and related traits in the presence of underlying genetic risk, and discusses future potential research directions.

  17. Dietary management practices in phenylketonuria across European centres

    NARCIS (Netherlands)

    Ahring, Kirsten; Belanger-Quintana, Amaya; Dokoupil, Katharina; Ozel, Hulya Gokmen; Lammardo, Anna Maria; MacDonald, Anita; Motzfeldt, Kristina; Nowacka, Maria; van Rijn, Margreet; Robert, M.

    Background: Dietary phenylalanine restriction is the cornerstone of phenylketonuria (PKU) management. However, there are no European consensus guidelines for its optimal dietary care. Methods: Detailed information on the routine dietary management of PKU was obtained from 10 European centres using

  18. EVALUATION OF THE CONFORMITY OF CARDIOVASCULAR THERAPY TO CURRENT CLINICAL GUIDELINES IN THE IMPROVEMENT OF OUTCOMES IN PATIENTS AFTER STROKE (ACCORDING TO THE LIS-2 REGISTER

    Directory of Open Access Journals (Sweden)

    A. Yu. Suvorov

    2015-01-01

    Full Text Available Aim. To study the conformity of preventative therapy prescribed to patients during a hospital stay and at a discharge to clinical guidelines using a special algorithm, and to assess the impact of the results on a long-term mortality based on the LIS-2 register (Lyubertsy study of mortality in patients after cerebral stroke.Material and methods. The scales to assess the quality of cardiovascular care for the prevention of recurrent stroke along with the prevention of recurrent ischemic attacks index (PRIA index for this assessment were developed according to current clinical guidelines. Analysis of the therapy was performed using PRIA index on survived hospital patients from LIS-2 register (N=753. The impact of PRIA index results on a long-term mortality (Me=2.3 years was studied.Results. Based upon the results of the assessment obtained with PRIA index, higher treatment conformity to clinical guidelines resulted in a significantly better long-term survival. Non-conformity to clinical guidelines was due to the lack of prescription of drugs with proven efficacy and irrational choice of preventive therapy. Median of treatment quality assessment was 44.4% (22.2; 44.4.Conclusion. Low conformity of preventive therapy to clinical guidelines is found in the LIS-2 register. The algorithm for the assessment of preventive cardiovascular therapy quality allows identifying limitations in the prevention of recurrent stroke, and can serve as an example of implementation of evidence-based medicine in clinical practice.

  19. 脑出血相关治疗指南与临床现状%Guideline and current status on prevention and treatment of intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    宋水江; 戴加勇; 汤永国

    2013-01-01

    The AHA/ASA guideline for intracerebral hemorrhage has been published nearly 2 years,however,the clinicians pay much less attention to it than the guideline of cerebral ischemia.At present there's big gaps between the status of control for intracerebral hemorrhage and guideline.Based on the analysis of current situation,comparing with the requirements of guideline,we hope to make the treatment of intracerebral hemorrhage in our country accord with the principle of guideline,making more patients benefit from the treatment.%美国心脏协会(AHA)和美国卒中学会(ASA)制定的《自发性脑出血诊疗指南》发表已逾3年,但临床医生对于脑出血指南的重视程度远不如缺血性脑血管病指南.目前有关脑出血的防治现状与指南存在较大差距.文章通过对现状的分析,对照指南的要求,希望能使中国脑出血的治疗更符合指南的精神,使更多脑出血患者从治疗中获益.

  20. Guideline appraisal with AGREE II: Systematic review of the current evidence on how users handle the 2 overall assessments

    Science.gov (United States)

    Siering, Ulrich; Neugebauer, Edmund A. M.; Brockhaus, Anne Catharina; Lampert, Ulrike; Eikermann, Michaela

    2017-01-01

    Introduction The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use). The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments. Materials and methods A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: “yes”, “yes, with modifications”, “no”) was examined using a multinomial regression model. Results 118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 (“yes” vs. “no”) and Domains 3 and 5 (“yes, with modifications” vs. “no”). Conclusions The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis

  1. Recreational drugs and HIV in Europe: current use of recreational drugs and principal HIV guidelines related recommendations

    Directory of Open Access Journals (Sweden)

    Noe Garin Escriva

    2014-11-01

    Full Text Available Introduction: Recreational drug consumption has been associated with both higher rates of risk activities related to HIV transmission and also worse adherence and management of HIV patients under HAART treatment. Moreover, relevant interactions may be present in patients under HAART treatment. Our aim is to present the European trends of drug consumption per country and age groups and assess the way drug consumption is addressed in general HIV guidelines. Materials and Methods: Last 12-month prevalence drug use was obtained from the European Monitoring Centre for Drugs and Drug Addiction for the four most consumed drugs (cannabis, cocaine, amphetamines, ecstasys. Consumption rates were collected and analyzed by country and age. Principal HIV guidelines were assessed to identify the degree of incorporation of drug use issues at three levels: transmission risk, adherence to the HAART and management of interactions. Guidelines: (a WHO; (b EACS; (c BHIVA; (d US DHHS; (e IAS-USA; (f GESIDA; (g French CPG; (h Italian CPG. Results: Data on drugs of abuse consumption was obtained from 29 European countries, with results showing relevant drug utilization in Europe. Cannabis was the most frequent drug across all countries, with 10 countries over 5% of prevalence over the last year. Other drugs prevalence accounted for about 0.5–1%, reaching up to: 2.1% for cocaine in Spain, 1.4% for ecstasy in the Netherlands and 1.1% for amphetamines in Estonia. 15–24 and 25–34 years old subgroups had the highest prevalence, although notable use of cannabis and cocaine was also found in the 35–44 and 45–54 subgroups. From the eight guidelines assessed, six considered recreational drugs at any point. Recommendations for specific drugs were given in 50% of the guidelines. From those guidelines addressing drug consumption: three assessed risk habits which related to transmission risk, six appraised issues on adherence to HAART and five comprised data on

  2. Ethical issues in the translation of social neuroscience: a policy analysis of current guidelines for public dialogue in human research.

    Science.gov (United States)

    Zimmerman, Emma; Racine, Eric

    2012-01-01

    Social neuroscience and its potential implications create an interesting case study for examining human research ethics policies on the topic of public communication of research. We reviewed mainstream national and international human research ethics guidelines and policies on issues of public communication of research. Our analysis relied on five thematic nets to capture the interactions between research and the public: public understanding, knowledge translation, public participation, social outcomes, and dual use. Coverage of these topics is sparse and inconsistent in mainstream policies and guidelines. We identify three options to address these gaps and analyze their strengths and weaknesses.

  3. Adherence to current guidelines for chronic obstructive pulmonary disease (COPD among patients treated with combination of long-acting bronchodilators or inhaled corticosteroids

    Directory of Open Access Journals (Sweden)

    Asche CV

    2012-03-01

    Full Text Available Carl Victor Asche1,2, Shelah Leader3, Craig Plauschinat4, Swetha Raparla1, Ming Yan1, Xiangyang Ye1, Dave Young11Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, Utah, 2Center for Outcomes Research, University of Illinois College of Medicine at Peoria, Peoria, Illinois, 3Formerly of Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, 4Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USABackground: To estimate the potential cost savings by following the current Global Initiative for Chronic Obstructive Lung Disease (GOLD guideline recommendations in patients being treated for chronic obstructive pulmonary disease (COPD with the combination of long-acting β2-agonist (LABA, long-acting muscarinic antagonist (LAMA or inhaled corticosteroids (ICS.Methods: The Geisinger Health System (GHS database was utilized to identify subjects between January 1, 2004 to March 12, 2007. The index date was based on the first prescription of a LAMA plus LABA, LAMA plus LABA/ICS, or LABA plus ICS. Patients were included in the study if they: had a COPD diagnosis; had data representative of treatment 12 months prior to and 12 months post index date; were 40 years of age or over; had no prior diagnosis for asthma; and had pulmonary function test (PFT data. We examined the baseline characteristics of these patients along with their healthcare resource utilization. Based on PFT data within 30 days of the index date, a subgroup was classified as adhering or non-adhering to GOLD guidelines.Results: A total of 364 subjects could be classified as adhering or non-adherent to current GOLD guidelines based on their PFT results. The adherent subgroup received COPD medications consistent with current GOLD guidelines. Of the LAMA plus LABA cohort, 25 patients adhered and 39 patients were non-adherent to current GOLD guidelines. In the

  4. Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening.

    Science.gov (United States)

    Smith, Robert A; Brooks, Durado; Cokkinides, Vilma; Saslow, Debbie; Brawley, Otis W

    2013-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low-dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010.

  5. Incidence of late vitamin K deficiency bleeding in newborns in the Netherlands in 2005 : Evaluation of the current guideline

    NARCIS (Netherlands)

    IJland, M.M.; Pereira, R.R.; Cornelissen, E.A.M.

    2008-01-01

    Vitamin K prophylaxis is recommended to prevent the hazard of haemorrhage caused by vitamin K deficiency in newborns. The present Dutch guideline recommends 1 mg of vitamin K1 orally at birth, followed by a daily dose of 25 μg of vitamin K1 from 1 to 13 weeks of age for breastfed infants. Since the

  6. Pain management in trauma patients in (pre)hospital based emergency care: current practice versus new guideline

    NARCIS (Netherlands)

    Scholten, A.C.; Berben, S.A.A.; Westmaas, A.H.; Grunsven, P.M.; Vaal, de E.T.; Rood, Pleunie P.M.; Hoogerwerf, N.; Doggen, C.J.M.; Schoonhoven, L.

    2015-01-01

    Introduction Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was devel

  7. Pain management in trauma patients in (pre)hospital based emergency care: current practice versus new guideline

    NARCIS (Netherlands)

    Scholten, A.C.; Berben, S.A.A.; Westmaas, A.H.; Grunsven, P.M. van; Vaal, E.T. de; Hoogerwerf, N.; Doggen, C.J.; Schoonhoven, L.

    2015-01-01

    INTRODUCTION: Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was deve

  8. Identification of NSAID users at risk for gastrointestinal complications: a systematic review of current guidelines and consensus agreements.

    NARCIS (Netherlands)

    Tielemans, M.M.; Eikendal, T.; Jansen, J.B.M.J.; Oijen, M.G.H. van

    2010-01-01

    NSAIDs are among the most often used drugs worldwide. Numerous NSAID users are at risk for developing gastrointestinal complications. The purpose of this review was to identify and stratify risk factors for gastrointestinal complications in NSAID users documented in guidelines and consensus agreemen

  9. Current perspectives on the health risks associated with the consumption of advanced glycation end products: recommendations for dietary management

    Directory of Open Access Journals (Sweden)

    Palimeri S

    2015-09-01

    Full Text Available Sotiria Palimeri,* Eleni Palioura,* Evanthia Diamanti-KandarakisEndocrine Unit, Medical School University of Athens, Athens, Greece*These authors contributed equally to this workAbstract: Advanced glycation end products (AGEs constitute a complex group of compounds produced endogenously during the aging process and under conditions of hyperglycemia and oxidative stress. AGEs also have an emerging exogenous origin. Cigarette smoke and diet are the two main exogenous sources of AGEs (glycotoxins. Modern Western diets are rich in AGEs which have been implicated in the pathogenesis of several metabolic and degenerative disorders. Accumulating evidence underlies the beneficial effect of the dietary restriction of AGEs not only in animal studies but also in patients with diabetic complications and metabolic diseases. This article reviews the evidence linking dietary glycotoxins to several disorders from diabetic complications and renal failure to liver dysfunction, female reproduction, eye and cognitive disorders as well as cancer. Furthermore, strategies for AGE reduction are discussed with a focus on dietary modification.Keywords: AGEs, dietary glycotoxins, dietary restriction, PCOS, MSR-1, RAGE

  10. Recreational drugs and HIV in Europe: current use of recreational drugs and principal HIV guidelines related recommendations

    OpenAIRE

    Noe Garin Escriva; Cesar Velasco Muñoz; Jan Thomas De Pourcq; Belen Lopez Garcia; Josep Maria Haro Abad; Maria Antonia Mangues Bafalluy; Antoni Trilla Garcia

    2014-01-01

    Introduction: Recreational drug consumption has been associated with both higher rates of risk activities related to HIV transmission and also worse adherence and management of HIV patients under HAART treatment. Moreover, relevant interactions may be present in patients under HAART treatment. Our aim is to present the European trends of drug consumption per country and age groups and assess the way drug consumption is addressed in general HIV guidelines. Materials and Methods: Last 12-month ...

  11. Dietary fructose intolerance, fructan intolerance and FODMAPs.

    Science.gov (United States)

    Fedewa, Amy; Rao, Satish S C

    2014-01-01

    Dietary intolerances to fructose, fructans and FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are common, yet poorly recognized and managed. Over the last decade, they have come to the forefront because of new knowledge on the mechanisms and treatment of these conditions. Patients with these problems often present with unexplained bloating, belching, distension, gas, abdominal pain, or diarrhea. Here, we have examined the most up-to-date research on these food-related intolerances, discussed controversies, and have provided some guidelines for the dietary management of these conditions. Breath testing for carbohydrate intolerance appears to be standardized and essential for the diagnosis and management of these conditions, especially in the Western population. While current research shows that the FODMAP diet may be effective in treating some patients with irritable bowel syndrome, additional research is needed to identify more foods items that are high in FODMAPs, and to assess the long-term efficacy and safety of dietary interventions.

  12. Copper-2 Hypothesis for Causation of the Current Alzheimer's Disease Epidemic Together with Dietary Changes That Enhance the Epidemic.

    Science.gov (United States)

    Brewer, George J

    2017-03-20

    Alzheimer's disease, the most common cause of dementia, is at epidemic proportions (15 to 44% depending on age, of those age 65 to 84) in the U.S. and other developed countries but remains relatively rare in undeveloped countries. Surprisingly, solid historical data reveal the epidemic is a creature of the last century. That is, the disease was also rare in developed countries, until the 20th century. It is disappointing that these historical and demographic facts have been ignored by the Alzheimer's disease scientific community. Disappointing because these facts clearly point at an environmental change in the 20th century in developed countries as a major factor in causing the epidemic. Some scientists have discarded the claimed rarity of the disease in the 19th century as incorrect, saying that Alzheimer's disease is a disease of aging and that the increasing lifespan of people accounts for the current high prevalence of the disease, but this cavalier attitude ignores historical data indicating there were many elderly people in the 19th century who were not getting Alzheimer's disease with any significant frequency. In this review, after documenting that the observed assertions about historical and demographic facts are correct, evidence is amassed that the main environmental culprit causing the Alzheimer's epidemic is ingestion of divalent copper or copper-2. The two sources of copper-2 ingestion are drinking water and multimineral supplement pills containing copper. The increase in copper plumbing use in developed countries parallels the increasing prevalence of Alzheimer's disease. It has been shown that enough copper is leached from copper plumbing in most households to cause Alzheimer's disease, using the Alzheimer's disease animal model studies as a guide to toxic levels. It is relatively easy to avoid or greatly diminish copper-2 ingestion by not using copper containing supplement pills and testing drinking water for copper levels. If the copper in water

  13. Dietary Intakes and Eating Habits of College Athletes: Are Female College Athletes Following the Current Sports Nutrition Standards?

    Science.gov (United States)

    Shriver, Lenka H.; Betts, Nancy M.; Wollenberg, Gena

    2013-01-01

    Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards. Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May…

  14. Dietary Intakes and Eating Habits of College Athletes: Are Female College Athletes Following the Current Sports Nutrition Standards?

    Science.gov (United States)

    Shriver, Lenka H.; Betts, Nancy M.; Wollenberg, Gena

    2013-01-01

    Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards. Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May…

  15. Dietary antioxidants for chronic periodontitis prevention and its treatment: a review on current evidences from animal and human studies

    Directory of Open Access Journals (Sweden)

    Alfonso Varela-López

    2015-09-01

    Full Text Available Objectives: Given the relationship between chronic periodontitis and high levels of oxidative stress, this review aims to clarify what role can played the dietary intake of different antioxidants in maintaining a healthy periodontium and in reducing chronic periodontitis risk, as well as possible use of dietary therapies based on them for this disease treatment. Methods: The database of the National Library of Medicine, Washington, DC (MEDLINE PubMed was used and all the studies in animals and humans are on the subject of interest in English writing online available from inception of the database until May 2015 were collected. Results: Antioxidants analyzed in this regard include vitamin C, vitamin A, carotenoids and some polyphenols, and coenzyme Q; as well as minerals iron, copper and zinc that are constituents of antioxidant enzymes. Still, there is a paucity of studies with few human studies, mostly observational. Among the various antioxidants, vitamin E and polyphenols seem to have more evidence for its beneficial effect, but in general the studies are insufficient to rule out or establish what antioxidants are useful and which are not. Conclusions: Overall, the data presented indicate that dietary antioxidants are beneficial for periodontal health, at least under certain circumstances. However more studies are needed to establish the relationship between chronic periodontitis and each specific antioxidant and to design useful dietary interventions for this disease management.

  16. The prevalence and correlates of meeting the current physical activity for health guidelines in older people: a cross-sectional study in Brazilian women.

    Science.gov (United States)

    Vagetti, Gislaine Cristina; Barbosa Filho, Valter Cordeiro; Moreira, Natália Boneti; de Oliveira, Valdomiro; Mazzardo, Oldemar; de Campos, Wagner

    2013-01-01

    This study aimed to identify the prevalence and correlates of meeting the current physical activity for health (PAfH) guidelines, proposed by the World Health Organization in 2010, in community-dwelling older women from Brazil. A cross-sectional study was performed with 1806 women (aged 60.0-92.7 years) who were randomly selected from eighteen care centers. The short version of the International Physical Activity Questionnaire was used to determine the weekly time spent in physical activities, and this variable was categorized into three categories (0high blood pressure (OR=1.33, 95% CI: 1.09-1.62) were more likely to meet the current PAfH guidelines than their peers with primary incomplete education, negative self-rated health, and normal blood pressure. Increasing age was inversely associated with meeting the PAfH guidelines (odds ranging: 0.77-0.48). These results highlighted the elderly population subgroups, in a developing country, that needspecific guidelinesfor inclusion inhealth programs andmotivation toparticipate in physical activities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Role of Nutritional Supplements Complementing Nutrient-Dense Diets: General Versus Sport/Exercise-Specific Dietary Guidelines Related to Energy Expenditure

    Science.gov (United States)

    Kleiner, Susan; Greenwood, Mike

    A nutrient-dense diet is a critical aspect in attaining optimal exercise training and athletic performance outcomes. Although including safe and effective nutritional supplements in the dietary design can be extremely helpful in promoting adequate caloric ingestion, they are not sufficient for promoting adequate caloric ingestion based on individualized caloric expenditure needs without the proper diet. Specifically, a strategic and scientifically based nutrient-dense dietary profile should be created by qualified professionals to meet the sport/exercise-specific energy demands of any individual involved in select training intensity protocols. Finally, ingesting the right quantity and quality of nutrient dense calories at precise windows of opportunity becomes vital in attaining desired training and/or competitive performance outcomes.

  18. A new dietary strategy for long-term treatment of the metabolic syndrome is compared with the American Heart Association (AHA) guidelines: the MEtabolic Syndrome REduction in NAvarra (RESMENA) project.

    Science.gov (United States)

    de la Iglesia, Rocio; Lopez-Legarrea, Patricia; Abete, Itziar; Bondia-Pons, Isabel; Navas-Carretero, Santiago; Forga, Luis; Martinez, J Alfredo; Zulet, M Angeles

    2014-02-01

    The long-term effects of dietary strategies designed to combat the metabolic syndrome (MetS) remain unknown. The present study evaluated the effectiveness of a new dietary strategy based on macronutrient distribution, antioxidant capacity and meal frequency (MEtabolic Syndrome REduction in NAvarra (RESMENA) diet) for the treatment of the MetS when compared with the American Heart Association guidelines, used as Control. Subjects with the MetS (fifty-two men and forty-one women, age 49 (se 1) years, BMI 36·11 (se 0·5) kg/m²) were randomly assigned to one of two dietary groups. After a 2-month nutritional-learning intervention period, during which a nutritional assessment was made for the participants every 15 d, a 4-month self-control period began. No significant differences were found between the groups concerning anthropometry, but only the RESMENA group exhibited a significant decrease in body weight ( - 1·7%; P= 0·018), BMI ( - 1·7%; P= 0·019), waist circumference ( - 1·8%; P= 0·021), waist:hip ratio ( - 1·4%; P= 0·035) and android fat mass ( - 6·9%; P= 0·008). The RESMENA group exhibited a significant decrease in alanine aminotransferase and aspartate aminotransferase (AST) concentrations ( - 26·8%; P= 0·008 and - 14·0%; P= 0·018, respectively), while the Control group exhibited a significant increase in glucose (7·9%; P= 0·011), AST (11·3%; P= 0·045) and uric acid (9·0%; P< 0·001) concentrations. LDL-cholesterol (LDL-C) concentrations were increased (Control group: 34·4%; P< 0·001 and RESMENA group: 33·8%; P< 0·001), but interestingly so were the LDL-C:apoB ratio (Control group: 28·7%; P< 0·001, RESMENA group: 17·1%; P= 0·009) and HDL-cholesterol concentrations (Control group: 21·1%; P< 0·001, RESMENA group: 8·7; P= 0·001). Fibre was the dietary component that most contributed to the improvement of anthropometry, while body-weight loss explained changes in some biochemical markers. In conclusion, the RESMENA diet is a good

  19. Variability in delivered dose and respirable delivered dose from nebulizers: are current regulatory testing guidelines sufficient to produce meaningful information?

    Science.gov (United States)

    Hatley, Ross HM; Byrne, Sarah M

    2017-01-01

    Background To improve convenience to patients, there have been advances in the operation of nebulizers, resulting in fast treatment times and less drug lost to the environment. However, limited attention has been paid to the effects of these developments on the delivered dose (DD) and respirable delivered dose (RDD). Published pharmacopoeia and ISO testing guidelines for adult-use testing utilize a single breathing pattern, which may not be sufficient to enable effective comparisons between the devices. Materials and methods The DD of 5 mg of salbutamol sulfate into adult breathing patterns with inhalation:exhalation (I:E) ratios between 1:1 and 1:4 was determined. Droplet size was determined by laser diffraction and RDD calculated. Nine different nebulizer brands with different modes of operation (conventional, venturi, breath-enhanced, mesh, and breath-activated) were tested. Results Between the non-breath-activated nebulizers, a 2.5-fold difference in DD (~750–1,900 µg salbutamol) was found; with RDD, there was a more than fourfold difference (~210–980 µg). With increasing time spent on exhalation, there were progressive reductions in DD and RDD, with the RDD at an I:E ratio of 1:4 being as little as 40% of the dose with the 1:1 I:E ratio. The DD and RDD from the breath-activated mesh nebulizer were independent of the I:E ratio, and for the breath-activated jet nebulizer, there was less than 20% change in RDD between the I:E ratios of 1:1 and 1:4. Conclusion Comparing nebulizers using the I:E ratio recommended in the guidelines does not predict relative performance between the devices at other ratios. There was significant variance in DD or RDD between different brands of non-breath-activated nebulizer. In future, consideration should be given to revision of the test protocols included in the guidelines, to reflect more accurately the potential therapeutic dose that is delivered to a realistic spectrum of breathing patterns. PMID:28203110

  20. Optimal screening of children with acute malnutrition requires a change in current WHO guidelines as MUAC and WHZ identify different patient groups

    DEFF Research Database (Denmark)

    Laillou, Arnaud; Prak, Sophonneary; de Groot, Richard

    2014-01-01

    BACKGROUND: Timely treatment of acute malnutrition in children 500,000 deaths annually. Screening at community level is essential to identify children with malnutrition. Current WHO guidelines for community screening for malnutrition recommend a Mid Upper Arm...... Circumference (MUAC) of malnutrition (SAM). However, it is currently unclear how MUAC relates to the other indicator used to define acute malnutrition: weight-for-height Z-score (WHZ). METHODS: Secondary data from >11,000 Cambodian children, obtained by different surveys between...... 2010 and 2012, was used to calculate sensitivity and ROC curves for MUAC and WHZ. FINDINGS: The secondary analysis showed that using the current WHO cut-off of 115 mm for screening for severe acute malnutrition over 90% of children with a weight-for-height z-score (WHZ)

  1. Dietary sodium in chronic kidney disease: a comprehensive approach.

    Science.gov (United States)

    Wright, Julie A; Cavanaugh, Kerri L

    2010-01-01

    Despite existing guidelines, dietary sodium intake among people worldwide often exceeds recommended limits. Research evidence is growing in both animal and human studies showing indirect and direct adverse consequences of high dietary sodium on the kidney. In patients with kidney disease, dietary sodium may have important effects on proteinuria, efficacy of antiproteinuric pharmacologic therapy, hypertension control, maintaining an optimal volume status, and immunosuppressant therapy. Dietary sodium intake is an important consideration in patients with all stages of chronic kidney disease, including those receiving dialysis therapy or those who have received a kidney transplant. We review in detail the dietary sodium recommendations suggested by various organizations for patients with kidney disease. Potential barriers to successfully translating current sodium intake guidelines into practice include poor knowledge about the sodium content of food among both patients and providers, complex labeling information, patient preferences related to taste, and limited support for modifications in public policy. Finally, we offer existing and potential solutions that may assist providers in educating and empowering patients to effectively manage their dietary sodium intake.

  2. Controlled-protein dietary regimens for Parkinson's disease.

    Science.gov (United States)

    Cereda, Emanuele; Barichella, Michela; Pezzoli, Gianni

    2010-02-01

    Continuous levodopa replacement still is the most efficacious treatment for patients with Parkinson's disease. Unfortunately, the neutral aromatic amino acids contained in dietary proteins may compete with this drug for intestinal absorption and transport across the blood-brain barrier, thus limiting its efficacy and being responsible for the occurrence of motor fluctuations. Current guidelines recommend low-protein dietary regimens with protein redistribution, as shifting protein intake to the evening has proved to ameliorate the response to levodopa. However, adherence to this dietary regimen does not seem to be satisfactory and response is variable. Recent studies have shown that low-protein products designed for chronic renal failure patients are safe, tasty, well-tolerated and useful in improving both adherence to low-protein dietary regimens and levodopa-related motor fluctuations. However, there still is the need to define the selection criteria for the patients who may benefit the most from adherence to this regimen.

  3. Dietary patterns extracted from the current Japanese diet and their associations with sodium and potassium intakes estimated by repeated 24 h urine collection.

    Science.gov (United States)

    Fujiwara, Aya; Asakura, Keiko; Uechi, Ken; Masayasu, Shizuko; Sasaki, Satoshi

    2016-10-01

    To identify dietary patterns in the current Japanese diet and evaluate the associations between these patterns and Na and K intakes. Dietary patterns were extracted by factor analysis from the intakes of food groups assessed with a validated self-administrated diet history questionnaire. Na and K intakes and urinary Na:K were assessed by repeated 24 h urine collection. Healthy Japanese adults aged 20-69 years (353 men and 349 women). Twenty study areas in twenty-three prefectures in Japan. Result Four dietary patterns were identified in each sex. After adjustment for several confounding factors, the 'Fish and vegetable' pattern was associated with higher urinary Na excretion, but the association was not significant (P=0·37 in men and P=0·06 in women). This pattern was also associated with higher K excretion in both sexes. The 'Noodle' pattern tended to be associated with higher urinary Na excretion (P=0·17 in men and P=0·04 in women) and higher Na:K (P=0·02 in men). The 'Meat, vegetable and oil' (in men)/'Meat and oil' (in women) and 'Bread and confectioneries' patterns were not associated with urinary Na excretion (in men) or were negatively associated (in women). Contrary to the case in Western countries, the 'Fish and vegetable' and 'Noodle' patterns contributed to higher Na intake in Japan. Target foods for salt reduction should be set based on careful consideration of the relationships between dietary patterns and Na and K intakes in the target population.

  4. The Current Recommended Vitamin D Intake Guideline for Diet and Supplements During Pregnancy Is Not Adequate to Achieve Vitamin D Sufficiency for Most Pregnant Women.

    Directory of Open Access Journals (Sweden)

    Fariba Aghajafari

    Full Text Available The aims of this study were to determine if pregnant women consumed the recommended vitamin D through diet alone or through diet and supplements, and if they achieved the current reference range vitamin D status when their reported dietary intake met the current recommendations.Data and banked blood samples collected in second trimester from a subset of 537 women in the APrON (Alberta Pregnant Outcomes and Nutrition study cohort were examined. Frozen collected plasma were assayed using LC-MS/MS (liquid chromatography-tandem mass spectrometry to determine 25(OHD2, 25(OHD3, 3-epi-25(OHD3 concentrations. Dietary data were obtained from questionnaires including a Supplement Intake Questionnaire and a 24-hour recall of the previous day's diet.Participants were 87% Caucasian; mean (SD age of 31.3 (4.3; BMI 25.8 (4.7; 58% were primiparous; 90% had education beyond high school; 80% had a family income higher than CAN $70,000/year. 25(OHD2, 25(OHD3, and 3-epi-25(OHD3 were identified in all of the 537 plasma samples;3-epi-25(OHD3 contributed 5% of the total vitamin D. The median (IQR total 25(OHD (D2+D3 was 92.7 (30.4 nmol/L and 20% of women had 25(OHD concentration 75 nmol/L in some pregnant women who are residing in higher latitudes (Calgary, 51°N in Alberta, Canada and the current vitamin D recommendations for Canadian pregnant women need to be re-evaluated.

  5. Dietary sodium

    DEFF Research Database (Denmark)

    Graudal, Niels

    2015-01-01

    The 2013 Institute of Medicine (IOM) report "Sodium Intake in Populations: Assessment of Evidence" did not support the current recommendations of the IOM and the American Heart Association (AHA) to reduce daily dietary sodium intake to below 2,300 mg. The report concluded that the population...... Control (CDC), other public health advisory bodies, and major medical journals have continued to support the current policy of reducing dietary sodium.......-based health outcome evidence was not sufficient to define a safe upper intake level for sodium. Recent studies have extended this conclusion to show that a sodium intake below 2,300 mg/day is associated with increased mortality. In spite of this increasing body of evidence, the AHA, Centers for Disease...

  6. What current literature tells us about sustainable diets: emerging research linking dietary patterns, environmental sustainability, and economics.

    Science.gov (United States)

    Auestad, Nancy; Fulgoni, Victor L

    2015-01-01

    The concept of sustainable diets, although not new, is gaining increased attention across the globe, especially in relation to projected population growth and growing concerns about climate change. As defined by the FAO (Proceedings of the International Scientific Symposium, Biodiversity and Sustainable Diets 2010; FAO 2012), "Sustainable diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations." Consistent and credible science that brings together agriculture, food systems, nutrition, public health, environment, economics, culture, and trade is needed to identify synergies and trade-offs and to inform guidance on vital elements of healthy, sustainable diets. The aim of this article is to review the emerging research on environmental and related economic impacts of dietary patterns, including habitual eating patterns, nutritionally balanced diets, and a variety of different dietary scenarios. Approaches to research designs, methodologies, and data sources are compared and contrasted to identify research gaps and future research needs. To date, it is difficult to assimilate all of the disparate approaches, and more concerted efforts for multidisciplinary studies are needed.

  7. Dietary and nutritional treatments for attention-deficit/hyperactivity disorder: current research support and recommendations for practitioners.

    Science.gov (United States)

    Hurt, Elizabeth A; Arnold, L Eugene; Lofthouse, Nicholas

    2011-10-01

    Evidence for dietary/nutritional treatments of attention-deficit/hyperactivity disorder (ADHD) varies widely, from double-blind, placebo-controlled trials to anecdotal. In guiding patients, clinicians can apply the SECS versus RUDE rule: treatments that are Safe, Easy, Cheap, and Sensible (SECS) require less evidence than those that are Risky, Unrealistic, Difficult, or Expensive (RUDE). Two nutritional treatments appear worth general consideration: Recommended Daily Allowance/Reference Daily Intake multivitamin/mineral supplements as a pediatric health intervention not specific to ADHD and essential fatty acids, especially a mix of eicosapentaenoic acid, docosahexaenoic acid, and γ-linolenic acid as an ADHD-specific intervention. Controlled studies support the elimination of artificial food dyes to reduce ADHD symptoms, but this treatment may be more applicable to the general pediatric population than to children with diagnosed ADHD. Mineral supplementation is indicated for those with documented deficiencies but is not supported for others with ADHD. Carnitine may have a role for inattention, but the evidence is limited. Dimethylaminoethanol probably has a small effect. Herbs, although "natural," are actually crude drugs, which along with homeopathic treatments have little evidence of efficacy. Consequences of delayed proven treatments need consideration in the risk-benefit assessment of dietary/nutritional treatments.

  8. National Children's Study Dietary Assessment Workshop

    Science.gov (United States)

    The National Children's Study dietary assessment workshop was an opportunity for experts in dietary assessment methodology to gather and discuss the current state of knowledge about methodologies used to assess dietary intake during pregnancy, lactation, infancy, childhood, and adolescence.

  9. National Children's Study Dietary Assessment Workshop

    Science.gov (United States)

    The National Children's Study dietary assessment workshop was an opportunity for experts in dietary assessment methodology to gather and discuss the current state of knowledge about methodologies used to assess dietary intake during pregnancy, lactation, infancy, childhood, and adolescence.

  10. Study of quality assurance regulations for linear accelerators in Korea: A comparison study between the current status in Korea and the international guidelines

    CERN Document Server

    Lee, Hyunho; Jo, Yunhui; Yoon, Myonggeun

    2015-01-01

    Quality assurance (QA) for medical linear accelerators is indispensable for appropriate cancer treatment. Some international organizations and western advanced countries provide QA guidelines for linear accelerators. Currently, QA regulations for linear accelerators in Korean hospitals specify a system in which each hospital stipulates its independent hospital-based protocols for QA procedures (HP_QAPs) and conducts QA based on these HP_QAPs while regulatory authorities verify whether items under these HP_QAPs have been performed. However, because this regulatory method cannot guarantee the quality of universal treatment, and QA items with tolerance criteria are different in many hospitals, the presentation of standardized QA items and tolerance criteria is essential. In this study, QA items in HP_QAPs from various hospitals and those presented by international organizations. Concordance rates between QA items for linear accelerators that were presented by the aforementioned organizations and those currently ...

  11. A review of dietary influences on cardiovascular health: part 1: the role of dietary nutrients.

    Science.gov (United States)

    Stradling, Clare; Hamid, Mash; Fisher, Katherine; Taheri, Shahrad; Thomas, G Neil

    2013-12-01

    Lifestyle modification, including diet, is a key strategy for prevention and regression of cardiovascular disease (CVD), a leading cause of death worldwide. Traditionally, the study of the relationship between diet and CVD has focused on the analysis of single nutrients, or foods, in relation to CVD risk. In part one of this review, we present current epidemiologic and clinical evidence on nutrition and cardiovascular health with regards to specific foods and nutrients aimed at preventing CVD. The Cochrane Library database between 2006 and 2012 was searched for studies on effects of dietary factors on cardiovascular health. Evidence is presented on soy protein, fats, fish, nuts, fruit, vegetables, electrolytes, vitamins, and carbohydrate including fibre, glycaemic index, and wholegrains. Evidence from specific foods underpins current dietary CVD prevention guidelines, that advise on replacing saturated with unsaturated fat, consuming carbohydrate foods that are wholegrain or of low glycaemic index, increased consumption of fruit, vegetables (particularly cruciferous), nuts, and oily fish. Other nutrients (such as soya protein, or reducing sodium intake) reduce CVD risk via favourable effects on disease contributors (such as LDL-cholesterol or blood pressure), but also infer/promote dietary change that impacts other nutrients (using less animal or processed foods, resulting in saturated fat reduction). The complexity and limitations of interpreting dietary epidemiologic studies is reviewed. With the general ineffectiveness of nutrient-based intervention, recently the shift has been towards the examination of associations between dietary patterns and cardiovascular health, which will be examined in the second part of this review.

  12. Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors.

    Science.gov (United States)

    Gillingham, Leah G; Harris-Janz, Sydney; Jones, Peter J H

    2011-03-01

    Over 50 years of research has sought to define the role dietary fat plays in cardiovascular disease (CVD) risk. Although optimal dietary fat quantity has been keenly pursued over past decades, attention has recently centered on the value of dietary fat quality. The purpose of the present review is to provide a critical assessment of the current body of evidence surrounding efficacy of dietary monounsaturated fatty acids (MUFA) for reduction of traditional risk factors defining metabolic syndrome (MetS) and CVD. Due to existing and emerging research on health attributes of MUFA rich diets, and to the low prevalence of chronic disease in populations consuming MUFA rich Mediterranean diets, national dietary guidelines are increasingly recommending dietary MUFA, primarily at the expense of saturated fatty acids (SFA). Consumption of dietary MUFA promotes healthy blood lipid profiles, mediates blood pressure, improves insulin sensitivity and regulates glucose levels. Moreover, provocative newer data suggest a role for preferential oxidation and metabolism of dietary MUFA, influencing body composition and ameliorating the risk of obesity. Mounting epidemiological and human clinical trial data continue to demonstrate the cardioprotective activity of the MUFA content of dietary fat. As the debate on the optimal fatty acid composition of the diet continues, the benefit of increasing MUFA intakes, particularly as a substitute for dietary SFA, deserves considerable attention.

  13. Developing and implementing health and sustainability guidelines for institutional food service.

    Science.gov (United States)

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

    2012-05-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

  14. Beyond current guidelines: reduction in minimum administered radiopharmaceutical activity with preserved diagnostic image quality in pediatric hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fahey, Frederic; Markelewicz, Robert; Grant, Frederick; Drubach, Laura; Treves, S. Ted [Harvard Medical School, Division of Nuclear Medicine and Molecular Imaging, Boston Children' s Hospital, Boston, MA (United States); Harvard Medical School, Joint Program in Nuclear Medicine, Boston (United States); Zukotynski, Katherine [University of Toronto, Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto (Canada); Harvard Medical School, Joint Program in Nuclear Medicine, Boston (United States); Zurakowski, David [Boston Children' s Hospital, Departments of Anesthesia and Surgery, Boston (United States); Falone, Anthony; Vitello, Marie; Cao, Xinhua [Harvard Medical School, Division of Nuclear Medicine and Molecular Imaging, Boston Children' s Hospital, Boston, MA (United States); Vija, A.H.; Bhattacharya, Manojeet; Ding, Xinhong [Siemens Medical Solutions USA, Inc., Molecular Imaging, Malvern, PA (United States); Bar-Sever, Zvi [Schneider Children' s Medical Center, Petach Tikvah (Israel); Tel-Aviv University, Tel-Aviv (Israel); Gelfand, Michael [Cincinnati Children' s Hospital, Cincinnati, OH (United States)

    2014-12-15

    To determine if the minimum administered radiopharmaceutical activity for hepatobiliary scintigraphy can be reduced while preserving diagnostic image quality using enhanced planar processing (EPP). A total of 40 infants between 10 and 270 days old (body mass 2.2 - 6.5 kg) had hepatobiliary scintigraphy during the period 2004 - 2010 following the intravenous administration of either {sup 99m}Tc-mebrofenin (18 patients) or {sup 99m}Tc-disofenin (22 patients). Due to the small size of these patients, they all received the minimum administered activity of 18.5 MBq consistent with the North American Consensus Guidelines. Six nuclear medicine physicians subjectively graded the acceptability of the image quality for clinical interpretation using a four-point scale (not acceptable, fair, good, excellent). Each physician independently graded seven image sets including the original study (full activity) and simulated reduced activity studies using binomial subsampling (50 % of full activity, 25 % of full activity and activity reduced by weight), with and without EPP. For full-activity studies, 98 % were deemed acceptable by the six physicians for clinical interpretation. The percentages of acceptable 50 % reduced activity studies with and without EPP were not significantly different from the percentage of acceptable full-activity studies (P = 0.193 and P = 0.998, respectively). The percentage of acceptable 25 % reduced activity studies without EPP was significantly different from the percentage of acceptable full-activity studies (P < 0.001); however, this difference vanished when EPP was applied (P = 0.482). The activity reduced by weight ranged from 1.85 to 4.81 MBq (10 % to 26 % of full dose) and the percentages of acceptable studies with and without EPP were significantly different from the percentage of acceptable full-activity studies (P < 0.001 and P = 0.02, respectively). Clinically interpretable hepatobiliary scintigraphy images can be obtained in infants when the

  15. Author Guidelines

    OpenAIRE

    Istadi Istadi

    2011-01-01

    AUTHOR GUIDELINES Indian Journal of Community Health (IJCH) accepts only online submission of manuscript(s) by using Open Journal software (OJS) at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH)? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly ...

  16. EURRECA-Estimating zinc requirements for deriving dietary reference values.

    Science.gov (United States)

    Lowe, Nicola M; Dykes, Fiona C; Skinner, Anna-Louise; Patel, Sujata; Warthon-Medina, Marisol; Decsi, Tamás; Fekete, Katalin; Souverein, Olga W; Dullemeijer, Carla; Cavelaars, Adriënne E; Serra-Majem, Lluis; Nissensohn, Mariela; Bel, Silvia; Moreno, Luis A; Hermoso, Maria; Vollhardt, Christiane; Berti, Cristiana; Cetin, Irene; Gurinovic, Mirjana; Novakovic, Romana; Harvey, Linda J; Collings, Rachel; Hall-Moran, Victoria

    2013-01-01

    Zinc was selected as a priority micronutrient for EURRECA, because there is significant heterogeneity in the Dietary Reference Values (DRVs) across Europe. In addition, the prevalence of inadequate zinc intakes was thought to be high among all population groups worldwide, and the public health concern is considerable. In accordance with the EURRECA consortium principles and protocols, a series of literature reviews were undertaken in order to develop best practice guidelines for assessing dietary zinc intake and zinc status. These were incorporated into subsequent literature search strategies and protocols for studies investigating the relationships between zinc intake, status and health, as well as studies relating to the factorial approach (including bioavailability) for setting dietary recommendations. EMBASE (Ovid), Cochrane Library CENTRAL, and MEDLINE (Ovid) databases were searched for studies published up to February 2010 and collated into a series of Endnote databases that are available for the use of future DRV panels. Meta-analyses of data extracted from these publications were performed where possible in order to address specific questions relating to factors affecting dietary recommendations. This review has highlighted the need for more high quality studies to address gaps in current knowledge, in particular the continued search for a reliable biomarker of zinc status and the influence of genetic polymorphisms on individual dietary requirements. In addition, there is a need to further develop models of the effect of dietary inhibitors of zinc absorption and their impact on population dietary zinc requirements.

  17. Implementation workshop of WHO guidelines on evaluation of malaria vaccines: Current regulatory concepts and issues related to vaccine quality, Pretoria, South Africa 07 Nov 2014.

    Science.gov (United States)

    Ho, Mei Mei; Baca-Estrada, Maria; Conrad, Christoph; Karikari-Boateng, Eric; Kang, Hye-Na

    2015-08-26

    The current World Health Organization (WHO) guidelines on the quality, safety and efficacy of recombinant malaria vaccines targeting the pre-erythrocytic and blood stages of Plasmodium falciparum were adopted by the WHO Expert Committee on Biological Standardization in 2012 to provide guidance on the quality, nonclinical and clinical aspects of recombinant malaria vaccines. A WHO workshop was organised to facilitate implementation into African (national/regional) regulatory practices, of the regulatory evaluation principles outlined in the guidelines regarding quality aspects. The workshop was used also to share knowledge and experience on regulatory topics of chemistry, manufacturing and control with a focus on vaccines through presentations and an interactive discussion using a case study approach. The basic principles and concepts of vaccine quality including consistency of production, quality control and manufacturing process were presented and discussed in the meeting. By reviewing and practicing a case study, better understanding on the relationship between consistency of production and batch release tests of an adjuvanted pre-erythrocytic recombinant malaria vaccine was reached. The case study exercise was considered very useful to understand regulatory evaluation principles of vaccines and a suggestion was made to WHO to provide such practices also through its Global Learning Opportunities for Vaccine Quality programme.

  18. Dietary Fat and Risk of Cardiovascular Disease: Recent Controversies and Advances.

    Science.gov (United States)

    Wang, Dong D; Hu, Frank B

    2017-08-21

    Health effects of dietary fats have been extensively studied for decades. However, controversies exist on the effects of various types of fatty acids, especially saturated fatty acid (SFA), on cardiovascular disease (CVD). Current evidence supports that different types of dietary fatty acids have divergent effects on CVD risk, and the effects also depend strongly on the comparison or replacement macronutrient. A significant reduction in CVD risk can be achieved if SFAs are replaced by unsaturated fats, especially polyunsaturated fatty acids. Intake of industrially produced trans fat is consistently associated with higher CVD risk. Both n-6 and n-3 polyunsaturated fatty acids are associated with lower CVD risk, although the effects of fish oil supplementation remains inconsistent. The 2015-2020 Dietary Guidelines for Americans place greater emphasis on types of dietary fat than total amount of dietary fat and recommend replacing SFAs with unsaturated fats, especially polyunsaturated fatty acids for CVD prevention.

  19. Dietary Assessment

    Science.gov (United States)

    EGRP's goals in Dietary Assessment are to increase the precision of dietary intake estimates by improving self-report of dietary intake and the analytic procedures for processing reported information.

  20. Dietary cholesterol and plasma lipoprotein profiles: Randomized controlled trials

    Science.gov (United States)

    Early work suggested that dietary cholesterol increased plasma total cholesterol concentrations in humans. Given the relationship between elevated plasma cholesterol concentrations and cardiovascular disease risk, dietary guidelines have consistently recommended limiting food sources of cholesterol....

  1. THE TRENDS IN AWARENESS RATE OF THE DIETARY GUIDELINES FOR CHINESE RESIDENTS AND THE EFFECT ON DIETARY PATTERN%2004~2011年成年居民《中国居民膳食指南》知晓率的变化及其对膳食的影响

    Institute of Scientific and Technical Information of China (English)

    黄绯绯; 王惠君; 张继国; 翟凤英; 张兵

    2015-01-01

    ObjectiveTo understand the change of adults’ awareness of the dietary guidelines for Chinese residents and nutrition knowledge from 2004 to 2011 and analyze the effect of the awareness on their diet and intake of nutrients. MethodThe residents aged 18 and above were enrolled from China Health and Nutrition Survey Project (2004, 2006, 2009 and 2011). Data were analyzed by SPSS 13.0.ResultsThe awareness rates of the dietary guidelines in adults in 9 provinces in 2004, 2006, 2009 and 2011 were 7.8%, 11.9%, 14.6%, 24.4%, respectively, which showed a rising tendency. The awareness rate in Beijing, Shanghai and Chongqing in 2011 was 40.8% which was higher than that of the 9 provinces. The awareness rate in urban areas was significantly higher than that of rural areas and people under the age of 45 was significantly higher than those older than 45. The fundamental nutrition knowledge level, the consumption of fruit, meat, eggs, milk and the intake of protein, vitamin B2, and calcium among people who knew the dietary guidelines were all higher than those who didn’t.ConclusionThe awareness rate of the dietary guidelines for Chinese residents increased in the past 10 years, but was still low. People who knew the dietary guidelines for Chinese residents were better than those who didn’t in nutrition knowledge, dietary consumption, nutrients intake.%目的:了解我国成年居民2004~2011年对《中国居民膳食指南》及相关营养知识知晓情况的变化,分析知晓状况对于居民膳食及营养素摄入情况的影响。方法以2004~2011年“中国健康与营养调查”项目中18岁以上调查的资料作为研究对象,通过入户问卷面访及膳食调查了解成年居民对《中国居民膳食指南》知晓情况及其膳食状况,使用SPSS软件对数据库资料进行统计分析。结果我国9省区成年居民《中国居民膳食指南》的知晓率呈现增长的趋势,2004、2006、2009和2011年知晓率分别为7.8%

  2. Dietary intake of phytoestrogens

    NARCIS (Netherlands)

    Bakker MI; SIR

    2004-01-01

    The dietary intake of phytoestrogens supposedly influences a variety of diseases, both in terms of beneficial and adverse effects. This report describes current knowledge on dietary intakes of phytoestrogens in Western countries, and briefly summarizes the evidence for health effects. The predominan

  3. Dietary intake of phytoestrogens

    NARCIS (Netherlands)

    Bakker MI; SIR

    2004-01-01

    The dietary intake of phytoestrogens supposedly influences a variety of diseases, both in terms of beneficial and adverse effects. This report describes current knowledge on dietary intakes of phytoestrogens in Western countries, and briefly summarizes the evidence for health effects. The

  4. The emergence of international food safety standards and guidelines: understanding the current landscape through a historical approach.

    Science.gov (United States)

    Ramsingh, Brigit

    2014-07-01

    Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an International Codex Alimentarius (or 'food code') which emerged in 1963. The Codex Committee on Food Hygiene (CCFH) was charged with the task of developing microbial hygiene standards, although it found itself embroiled in debate with the WHO over the nature these standards should take. The WHO was increasingly relying upon the input of biometricians and especially the International Commission on Microbial Specifications for Foods (ICMSF) which had developed statistical sampling plans for determining the microbial counts in the final end products. The CCFH, however, was initially more focused on a qualitative approach which looked at the entire food production system and developed codes of practice as well as more descriptive end-product specifications which the WHO argued were 'not scientifically correct'. Drawing upon historical archival material (correspondence and reports) from the WHO and FAO, this article examines this debate over microbial hygiene standards and suggests that there are many lessons from history which could shed light upon current debates and efforts in international food safety management systems and approaches.

  5. Guidelines for Better Heart Health

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 ... women either had or did not have CVD. Guidelines at a Glance: Prevention should be tailored to ...

  6. [Requirements for the prevention of nosocomial infections. German Guideline 2009 and reality. Current data from hospitals in Frankfurt am Main, Germany].

    Science.gov (United States)

    Heudorf, U; Exner, M

    2011-03-01

    In 2009, the new directive of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) entitled Human and Organizational Requirements for the Prevention of Nosocomial Infections was published, including detailed information on the needs of hygiene professionals in hospital settings. Compared to the needs calculated according to the above policy, the current staff hygiene health professionals (HHPs) in the hospitals of Frankfurt am Main (Frankfurt/M), Germany, was on average 27.6%: 36% in the large hospitals (>600 beds), 21.6% in medium hospitals (300-600 beds), and 19.8% in small hospitals (hospitals had a full-time hygienist. The demands of the KRINKO policy have not been met by any of the hospitals. Hospitals with lower percentages of hospital hygiene staff not only had a lower rating of hygienic quality, they also showed a lower usage of hand disinfection per patient-day. In Germany, there is currently a lack of trained HHPs and hygienists to meet the needs of the KRINKO policy. Therefore, the reactions of the hospitals in Frankfurt/M ranged from the establishment of additional jobs for HHPs to changes in structures and organization of hospital hygiene. Thus, the new KRINKO guideline in Frankfurt/M did not result in a wave of recruitment of health professionals, but at least resulted in organizational and structural improvements in hygiene.

  7. 世界各国高血压临床指南的现状分析和循证评价%Analysis on current status of clinical guidelines for hypertension in the world and evaluation on evidence-based clinical guidelines with Appraisal of Guidelines for Research and Evaluation instrument

    Institute of Scientific and Technical Information of China (English)

    唐海沁; 符赵鑫; 张勇; 丁琳; 李瑾

    2014-01-01

    Objective To assess and analyze the current status of clinical guidelines for hypertension in the world by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.Methods The clinical guidelines for hypertension were identified and approved by searching China hownet,WANFANG database,PUBMED database,MEDLINE,Embase and related institutions and authorization web site from 1995 to January 2012,and relevant Web sites of agencies and organizations that produce and/or endorse guidelines.Names of the guidelines,published years and organizations,methodology of development and reference number were descriptively analyzed.AGREE instrument was used to evaluate the qualities of latest edited clinical guidelines for hypertension in countries all over the world.Results Nine guidelines were enrolled.The results showed that the hypertension guidelines scored the highest average of 88.4% for clarity of presentation and reliability field; for applicability fields,scored an average of 86.1%; the scope and goal field scored an average of 83.8%; participants field scored an average of 71.7%; editorial independence field scored an average of 64.1% ; rigor of development field scored the lowest average of 62.9%.The overall assessment showed that NICE 2011,Canada 2012,ESC 2009,Australia 2010 editions were the positively recommended guidelines,JNC7,Japan 2009,China Taiwan 2010,China 2010,South Africa 2011 editions were the recommended guidelines (still need to supplement and improve).No recommend or uncertain guide was found.Conclusions The quality of the hypertension guidelines is higher in general,but some common deficiency in the rigor of development and editorial independence in Asian and African guidelines formulated by the states still exists.There still exist certain gaps in evidence-based medical requirement.And the contents and quality are needed for further regulating and enhancing.A set of scientific systemic hypertension clinical guidelines

  8. Dietary Supplement Ingredient Database

    Science.gov (United States)

    ... and US Department of Agriculture Dietary Supplement Ingredient Database Toggle navigation Menu Home About DSID Mission Current ... values can be saved to build a small database or add to an existing database for national, ...

  9. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....

  10. Guideline.gov: A Database of Clinical Specialty Guidelines.

    Science.gov (United States)

    El-Khayat, Yamila M; Forbes, Carrie S; Coghill, Jeffrey G

    2017-01-01

    The National Guidelines Clearinghouse (NGC), also known as Guideline.gov, is a database of resources to assist health care providers with a central depository of guidelines for clinical specialty areas in medicine. The database is provided free of charge and is sponsored by the U.S. Department of Health and Human Services and the Agency for Healthcare Research and Quality. The guidelines for treatment are updated regularly, with new guidelines replacing older guidelines every five years. There are hundreds of current guidelines with more added each week. The purpose and goal of NGC is to provide physicians, nurses, and other health care providers, insurance companies, and others in the field of health care with a unified database of the most current, detailed, relevant, and objective clinical practice guidelines.

  11. Are recommendations for psychological treatment of borderline personality disorder in current U.K. guidelines justified? Systematic review and subgroup analysis.

    Science.gov (United States)

    Omar, Hussein; Tejerina-Arreal, Maria; Crawford, Mike J

    2014-08-01

    Current U.K. guidelines on the management of borderline personality disorder include specific recommendations about the duration of therapy and number of sessions per week that patients should be offered. However, very little research has been conducted to examine the impact of these aspects of treatment process on patient outcomes. We therefore undertook a systematic review to examine the impact of treatment duration, number of sessions per week and access group-based therapy on general mental health, depression, social functioning and deliberate self-harm. We identified 25 randomized trials for possible inclusion in the review. However, differences in outcome measures used meant that only 12 studies could be included in the analysis. Statistically significant reductions in self-harm and depression and improvement in social functioning were found for treatments that include more than one session per week and those that included group-based sessions but were not found for those that deliver in individual sessions or one or fewer sessions per week. Longer term outcomes of short-term interventions have not been examined. Further research is needed to examine the impact of shorter term interventions and to compare the effects of group-based versus individual therapies for people with borderline personality disorder.

  12. Care of critically ill surgical patients using the 80-hour Accreditation Council of Graduate Medical Education work-week guidelines: a survey of current strategies.

    Science.gov (United States)

    Gordon, Chad R; Axelrad, Alex; Alexander, James B; Dellinger, R Phillip; Ross, Steven E

    2006-06-01

    As a result of the recently mandated work-hour restrictions, it has become more difficult to provide 24-hour intensive care unit (ICU) in-house coverage by the general surgical residents. To assess the current state of providing appropriate continuous care to surgical critical care patients during the era of resident work-hour constraints, a national survey was conducted by the Association of Program Directors of Surgery. The results revealed that 37 per cent of programs surveyed have residents other than general surgery housestaff providing cross-coverage and writing orders for surgical ICU patients. Residents in emergency medicine, anesthesia, family medicine, otorhinolaryngology, obstetrics/gynecology, internal medicine, urology, and orthopedic surgery have provided this cross-coverage. Some found it necessary to use physician extenders (i.e., nurse practitioners or physician assistants), thereby decreasing the burden of surgical housestaff coverage. The results indicated that 30 per cent use physician extenders to help cover the ICU during daytime hours and 11 per cent used them during nighttime hours. In addition, 24 per cent used a "night-float" system in an attempt to maintain continuous care, yet still adhere to the mandated guidelines. In conclusion, our survey found multiple strategies, including the use of physician extenders, a "night-float" system, and the use of nongeneral surgical residents in an attempt to provide continuous coverage for surgical ICU patients. The overall outcome of these new strategies still needs to be assessed before any beneficial results can be demonstrated.

  13. Current activity guidelines for CABG patients are too restrictive: comparison of the forces exerted on the median sternotomy during a cough vs. lifting activities combined with valsalva maneuver.

    Science.gov (United States)

    Parker, R; Adams, J L; Ogola, G; McBrayer, D; Hubbard, J M; McCullough, T L; Hartman, J M; Cleveland, T

    2008-06-01

    The current activity guidelines for coronary artery bypass graft surgery (CABG) patients are overly restrictive, hindering recovery. As the sternotomy repair must withstand repeated coughs during convalescence, this provides a benchmark for the force tending to separate the incision that can be tolerated. Nine volunteers performed 5 weightlifting activities (lifting 5 lbs [2.3 kg], lifting a 25-lb simulated grandchild [11.4 kg], lifting a 30-lb suitcase [13.6 kg], lifting two 20-lb weights [18.2 kg], and lifting a gallon of milk to a counter [3.7 kg]), plus coughing. Valsalva forces were detected using a mouthpiece configured with an Ashcroft Inc. expiratory pressure gauge (model N10-120CMW). Three measurements were taken for each activity to calculate the mean internal forces while external forces on the sternotomy were calculated using vector algebra. Total force exerted on the sternotomy by the cough was compared to the total force exerted by each of the 5 activities using paired T-tests. The cough exerted a significantly greater force across the median sternotomy (mean 27.5 kg-mass) than any of the five weightlifting activities ( P force on the median sternotomy incision than a cough. The strength of the repair is significantly greater than is implied by the recommendation to "not lift more than 5 lbs".

  14. Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy

    Directory of Open Access Journals (Sweden)

    Holly Ockenden

    2016-11-01

    Full Text Available The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey, related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG, as well as pregnancy-related health behaviours. Constructs addressed within the questionnaire include self-efficacy, locus of control, perceived barriers, and facilitators of physical activity and diet, outcome expectations, social environment and health practices. Content validity was examined using an expert panel (n = 7 and pilot testing items in a small sample (n = 5 of pregnant women and recent mothers (target population. Test re-test reliability was assessed among a sample (n = 71 of the target population. Reliability scores were calculated for all constructs (r and intra-class correlation coefficients (ICC, those with a score of >0.5 were considered acceptable. The content validity of the questionnaire reflects the degree to which all relevant components of excessive GWG risk in women are included. Strong test-retest reliability was found in the current study, indicating that responses to the questionnaire were reliable in this population. The EMat Health Survey adds to the growing body of literature on maternal health and gestational weight gain by providing the first comprehensive questionnaire that can be self-administered and remotely accessed. The questionnaire can be completed in 15–25 min and collects useful data on various social determinants of health and GWG as well as associated health behaviours. This online tool may assist researchers by providing them with a platform to collect useful information in developing and tailoring interventions to better support women in achieving recommended weight gain targets in pregnancy.

  15. Organochlorine pesticides and polychlorinated biphenyls in human adipose tissue from northern Tunisia: Current extent of contamination and contributions of socio-demographic characteristics and dietary habits.

    Science.gov (United States)

    Achour, Amani; Derouiche, Abdelkader; Barhoumi, Badreddine; Kort, Badreddine; Cherif, Driss; Bouabdallah, Sondes; Sakly, Mohsen; Rhouma, Khémais Ben; Touil, Soufiane; Driss, Mohamed Ridha; Tebourbi, Olfa

    2017-07-01

    The aims of the present study were to investigate the current exposure levels of persistent organochlorine compounds (OCs) in adipose tissues intraoperatively collected from 40 patients over 20 years undergoing non-cancer-related surgery residing in Northern region of Tunisia (Bizerte), which constitutes an exemplary case, and examined association between levels of contamination and both socio-demographic characteristics and dietary habits. Concentration of hexachlorobenzene (HCB), hexachlorocyclohexane isomers (α-HCH, β-HCH, γ-HCH and δ-HCH), dichlorodiphenyltrichloroethane isomers (p,p'-DDT and o,p'-DDT) and metabolites (p,p'-DDE, o,p'-DDE, p,p'-DDD and o,p'-DDD) and 12 polychlorinated biphenyls (PCBs) congeners were measured using capillary gas chromatography with electron capture detector. Overall, residue levels of OCs followed the decreasing order of DDTs > PCBs > HCB > HCHs. DDTs levels ranged from 74.49 to 1834.76ngg(-1) lipid and contributing to more than 90% to the sum of organochlorine pesticides (OCPs). p,p'-DDE was the most abundant in all samples and the p,p'-DDT/p,p'-DDE ratio (range between 1.85% and 58.45%) suggesting recent and ongoing exposure to banned commercial DDT products. PCB concentrations varied from 29.27 to 322.58ngg(-1) lipid and PCB-180, PCB-153 and PCB-138 were the dominant congeners accounting for 70% of total PCBs. We did not find significant correlations between OC exposure levels and sex, parity, habitat areas and smoking habits. In females, the adipose tissue concentrations of DDTs, HCB and PCB-118 were positively correlated with age. There was statistically significant relationship between body mass index (BMI) changes and the adipose tissue levels of HCB and HCHs. No association was found between OCPs levels and dietary factors. However, our study suggests that fish consumption may be an important contributor of PCBs adipose tissue content of PCBs in Tunisian people. The presented work is highly significant, being the

  16. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity.

    Science.gov (United States)

    Kushi, Lawrence H; Doyle, Colleen; McCullough, Marji; Rock, Cheryl L; Demark-Wahnefried, Wendy; Bandera, Elisa V; Gapstur, Susan; Patel, Alpa V; Andrews, Kimberly; Gansler, Ted

    2012-01-01

    The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published approximately every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and they reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines focus on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk. These recommendations for community action recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the 2010 Dietary Guidelines for Americans and the 2008 Physical Activity Guidelines for Americans.

  17. Exercise in patients with hypertrophic cardiomyopathy: A review of current evidence, national guideline recommendations and a proposal for a new direction to fitness.

    Science.gov (United States)

    Hindieh, Waseem; Adler, Arnon; Weissler-Snir, Adaya; Fourey, Dana; Harris, Sarah; Rakowski, Harry

    2017-04-01

    Hypertrophic cardiomyopathy is a common genetic disorder with a prevalence of 1:500 in the general population. Amongst a varied spectrum of clinical presentations, the most feared complication of this cardiac disorder is sudden cardiac death. Although only a minority of patients with hypertrophic cardiomyopathy who suffer sudden cardiac death or resuscitated cardiac arrest do so during exercise, strenuous physical activity is regarded as an important trigger for these tragic outcomes. Furthermore, during exercise, patients with hypertrophic cardiomyopathy may develop augmentation of left ventricular outflow tract obstruction, myocardial ischemia, diastolic dysfunction and/or inappropriate vasodilation in non-exercising vascular beds. This in turn may lead to exertional dyspnea, chest pain or syncope. Accordingly, patients with hypertrophic cardiomyopathy are disqualified from competitive sports and in many cases are recommended to avoid strenuous physical activity of any kind. Nevertheless, avoidance of physical activity comes with a price. The positive effects of regular exercise have been extensively reported to convey a wide range of benefits including reduced cardiovascular events, weight reduction and improved wellbeing. Therefore, finding the right exercise level that will offer some of the benefits of physical activity without increasing the risk of sudden cardiac death is of utmost importance. In this review, we discuss the current evidence for and against exercise in this patient population and review national guideline recommendations. We also propose alternative fitness strategies including a novel fitness program implemented by our hypertrophic cardiomyopathy center which may be of particular usefulness for hypertrophic cardiomyopathy patients. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Transparent Guideline Methodology Needed

    DEFF Research Database (Denmark)

    Lidal, Ingeborg; Norén, Camilla; Mäkelä, Marjukka

    2013-01-01

    As part of learning at the Nordic Workshop of Evidence-based Medicine, we have read with interest the practice guidelines for central venous access, published in your Journal in 2012.1 We appraised the quality of this guideline using the checklist developed by The Evidence-Based Medicine Working ...... are based on best currently available evidence. Our concerns are in two main categories: the rigor of development, including methodology of searching, evaluating, and combining the evidence; and editorial independence, including funding and possible conflicts of interest....... Group.2 Similar criteria for guideline quality have been suggested elsewhere.3 Our conclusion was that this much needed guideline is currently unclear about several aspects of the methodology used in developing the recommendations. This means potential users cannot be certain that the recommendations...

  19. Usual Dietary Intakes: SAS Macros for the NCI Method

    Science.gov (United States)

    SAS macros are currently available to facilitate modeling of a single dietary component, whether consumed daily or episodically; ratios of two dietary components that are consumed nearly every day; multiple dietary components, whether consumed daily or episodically.

  20. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group.

  1. Low Quality of Free Coaching Apps With Respect to the American College of Sports Medicine Guidelines: A Review of Current Mobile Apps.

    Science.gov (United States)

    Modave, François; Bian, Jiang; Leavitt, Trevor; Bromwell, Jennifer; Harris Iii, Charles; Vincent, Heather

    2015-07-24

    Low physical activity level is a significant contributor to chronic disease, weight dysregulation, and mortality. Nearly 70% of the American population is overweight, and 35% is obese. Obesity costs an estimated US$ 147 billion annually in health care, and as many as 95 million years of life. Although poor nutritional habits remain the major culprit, lack of physical activity significantly contributes to the obesity epidemic and related lifestyle diseases. Over the past 10 years, mobile devices have become ubiquitous, and there is an ever-increasing number of mobile apps that are being developed to facilitate physical activity, particularly for active people. However, no systematic assessment has been performed about their quality with respect to following the parameters of sound fitness principles and scientific evidence, or suitability for a variety of fitness levels. The aim of this paper is to fill this gap and assess the quality of mobile coaching apps on iOS mobile devices. A set of 30 popular mobile apps pertaining to physical activity programming was identified and reviewed on an iPhone device. These apps met the inclusion criteria and provided specific prescriptive fitness and exercise programming content. The content of these apps was compared against the current guidelines and fitness principles established by the American College of Sports Medicine (ACSM). A weighted scoring method based on the recommendations of the ACSM was developed to generate subscores for quality of programming content for aerobic (0-6 scale), resistance (0-6 scale), and flexibility (0-2 scale) components using the frequency, intensity, time, and type (FITT) principle. An overall score (0-14 scale) was generated from the subscores to represent the overall quality of a fitness coaching app. Only 3 apps scored above 50% on the aerobic component (mean 0.7514, SD 1.2150, maximum 4.1636), 4 scored above 50% on the resistance/strength component (mean 1.4525, SD 1.2101, maximum 4

  2. German Guidelines.

    Science.gov (United States)

    Kruis, Wolfgang; Nguyen, Gia P; Leifeld, Ludger

    2016-10-01

    Because of its frequency, diverticular disease is a burden on health care systems. Only few formal guidelines covering all aspects of the disease exist. Here, some selected statements from the German guidelines are given. The guidelines include significant recommendations for the diagnosis and management of diverticular disease. Both diagnosis and management depend definitely on clear definitions of the situation of an individual patient. Therefore, a new classification is proposed that is based on earlier suggestions. An internationally established classification would not only enable better patient care but could also lead to studies with comparable results.

  3. Summary guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Painuly, J.P.; Turkson, J.; Meyer, H.J.; Markandya, A.

    1999-09-01

    This document is a summary version of the methodological guidelines for climate change mitigation assessment developed as part of the Global Environment Facility (GEF) project Economics of Greenhouse Gas Limitations; Methodological Guidelines. The objectives of this project have been to develop a methodology, an implementing framework and a reporting system which countries can use in the construction of national climate change mitigation policies and in meeting their future reporting obligations under the FCCC. The methodological framework developed in the Methodological Guidelines covers key economic concepts, scenario building, modelling tools and common assumptions. It was used by several country studies included in the project. (au) 13 refs.

  4. Web Accessibility and Guidelines

    Science.gov (United States)

    Harper, Simon; Yesilada, Yeliz

    Access to, and movement around, complex online environments, of which the World Wide Web (Web) is the most popular example, has long been considered an important and major issue in the Web design and usability field. The commonly used slang phrase ‘surfing the Web’ implies rapid and free access, pointing to its importance among designers and users alike. It has also been long established that this potentially complex and difficult access is further complicated, and becomes neither rapid nor free, if the user is disabled. There are millions of people who have disabilities that affect their use of the Web. Web accessibility aims to help these people to perceive, understand, navigate, and interact with, as well as contribute to, the Web, and thereby the society in general. This accessibility is, in part, facilitated by the Web Content Accessibility Guidelines (WCAG) currently moving from version one to two. These guidelines are intended to encourage designers to make sure their sites conform to specifications, and in that conformance enable the assistive technologies of disabled users to better interact with the page content. In this way, it was hoped that accessibility could be supported. While this is in part true, guidelines do not solve all problems and the new WCAG version two guidelines are surrounded by controversy and intrigue. This chapter aims to establish the published literature related to Web accessibility and Web accessibility guidelines, and discuss limitations of the current guidelines and future directions.

  5. Epetra developers coding guidelines.

    Energy Technology Data Exchange (ETDEWEB)

    Heroux, Michael Allen; Sexton, Paul Michael

    2003-12-01

    Epetra is a package of classes for the construction and use of serial and distributed parallel linear algebra objects. It is one of the base packages in Trilinos. This document describes guidelines for Epetra coding style. The issues discussed here go beyond correct C++ syntax to address issues that make code more readable and self-consistent. The guidelines presented here are intended to aid current and future development of Epetra specifically. They reflect design decisions that were made in the early development stages of Epetra. Some of the guidelines are contrary to more commonly used conventions, but we choose to continue these practices for the purposes of self-consistency. These guidelines are intended to be complimentary to policies established in the Trilinos Developers Guide.

  6. On defining dietary fibre.

    Science.gov (United States)

    DeVries, Jonathan W

    2003-02-01

    Establishing a definition for dietary fibre has historically been a balance between nutrition knowledge and analytical method capabilities. While the most widely accepted physiologically-based definitions have generally been accurate in defining the dietary fibre in foods, scientists and regulators have tended, in practice, to rely on analytical procedures as the definitional basis in fact. As a result, incongruities between theory and practice have resulted in confusion regarding the components that make up dietary fibre. In November 1998 the president of the American Association of Cereal Chemists (AACC) appointed an expert scientific review committee and charged it with the task of reviewing and, if necessary, updating the definition of dietary fibre. The committee was further charged with assessing the state of analytical methodology and making recommendations relevant to the updated definition. After due deliberation, an updated definition of dietary fibre was delivered to the AACC Board of Directors for consideration and adoption (Anon, 2000; Jones 2000b). The updated definition includes the same food components as the historical working definition used for approximately 30 years (a very important point, considering that the majority of the research of the past 30 years delineating the positive health effects of dietary fibre is based on that working definition). However, the updated definition more clearly delineates the make-up of dietary fibre and its physiological functionality. As a result, relatively few changes will be necessary in analytical methodology. Current methodologies, in particular AACC-approved method of analysis 32-05 (Grami, 2000), Association of Official Analytical Chemists' official method of analysis 985.29 (Horwitz, 2000a) or AACC 32-07 (Grami, 2000) Association of Official Analytical Chemists 991.43 (Horwitz, 2000a) will continue to be sufficient and used for most foods. A small number of additional methods will be necessary to

  7. Addition of high-risk HPV testing improves the current guidelines on follow-up after treatment for cervical intraepithelial neoplasia

    NARCIS (Netherlands)

    M.A.E. Nobbenhuis (Marielle); C.J.L.M. Meijer (Chris); A.J.C. van den Brule; L. Rozendaal (Lawrence); F. Voorhorst (Feja); E.K.J. Risse (Elle); R.H.M. Verheijen (René); T.J.M. Helmerhorst (Theo)

    2001-01-01

    textabstractWe assessed a possible role for high-risk human papillomavirus (HPV) testing in the policy after treatment for cervical intraepithelial neoplasia (CIN) 2 or 3 (moderate to severe dysplasia). According to the Dutch guidelines follow-up after treatment consists of cervical cytology at 6, 1

  8. Addition of high-risk HPV testing improves the current guidelines on follow-up after treatment for cervical intraepithelial neoplasia

    NARCIS (Netherlands)

    M.A.E. Nobbenhuis (Marielle); C.J.L.M. Meijer (Chris); A.J.C. van den Brule; L. Rozendaal (Lawrence); F. Voorhorst (Feja); E.K.J. Risse (Elle); R.H.M. Verheijen (René); T.J.M. Helmerhorst (Theo)

    2001-01-01

    textabstractWe assessed a possible role for high-risk human papillomavirus (HPV) testing in the policy after treatment for cervical intraepithelial neoplasia (CIN) 2 or 3 (moderate to severe dysplasia). According to the Dutch guidelines follow-up after treatment consists of cervical cytology at 6, 1

  9. Metadata Guidelines

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document provides guidelines on metadata and metadata requirements for ServCat documents. Information on metadata is followed by an instructional flowchart and...

  10. Vitamin D supplementation guidelines.

    Science.gov (United States)

    Pludowski, Pawel; Holick, Michael F; Grant, William B; Konstantynowicz, Jerzy; Mascarenhas, Mario R; Haq, Afrozul; Povoroznyuk, Vladyslav; Balatska, Nataliya; Barbosa, Ana Paula; Karonova, Tatiana; Rudenka, Ema; Misiorowski, Waldemar; Zakharova, Irina; Rudenka, Alena; Łukaszkiewicz, Jacek; Marcinowska-Suchowierska, Ewa; Łaszcz, Natalia; Abramowicz, Pawel; Bhattoa, Harjit P; Wimalawansa, Sunil J

    2017-02-12

    Research carried out during the past two-decades extended the understanding of actions of vitamin D, from regulating calcium and phosphate absorption and bone metabolism to many pleiotropic actions in organs and tissues in the body. Most observational and ecological studies report association of higher serum 25-hydroxyvitamin D [25(OH)D] concentrations with improved outcomes for several chronic, communicable and non-communicable diseases. Consequently, numerous agencies and scientific organizations have developed recommendations for vitamin D supplementation and guidance on optimal serum 25(OH)D concentrations. The bone-centric guidelines recommend a target 25(OH)D concentration of 20ng/mL (50nmol/L), and age-dependent daily vitamin D doses of 400-800IU. The guidelines focused on pleiotropic effects of vitamin D recommend a target 25(OH)D concentration of 30ng/mL (75nmol/L), and age-, body weight-, disease-status, and ethnicity dependent vitamin D doses ranging between 400 and 2000IU/day. The wise and balanced choice of the recommendations to follow depends on one's individual health outcome concerns, age, body weight, latitude of residence, dietary and cultural habits, making the regional or nationwide guidelines more applicable in clinical practice. While natural sources of vitamin D can raise 25(OH)D concentrations, relative to dietary preferences and latitude of residence, in the context of general population, these sources are regarded ineffective to maintain the year-round 25(OH)D concentrations in the range of 30-50ng/mL (75-125nmol/L). Vitamin D self-administration related adverse effects, such as hypercalcemia and hypercalciuria are rare, and usually result from taking extremely high doses of vitamin D for a prolonged time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. 北京市海淀区"两个指南"健康教育效果分析%STUDY ON THE EFFECTS OF "THE DIETARY GUIDELINES FOR CHINESE RESIDENTS" AND "GUIDELINES ON SNACKS FOR CHINESE CHILDREN AND ADOLESCENTS" NUTRITION EDUCATION PROJECT

    Institute of Scientific and Technical Information of China (English)

    李园; 王洪波; 徐红; 胡爱丽; 刘雷; 于冬梅; 赵丽云

    2011-01-01

    [目的]在北京市海淀区开展"中国居民膳食指南"、"中国儿童青少年零食消费指南'健康教育,对项目效果进行评估.[方法]选取小学、中学各1所和1个社区开展营养教育干预活动,并随机整群抽取小学生、中学生和成年居民各115、109和94人进行干预前后营养与健康知信行问卷调查.[结果]营养教育后,小学生、中学生和成年人膳食指南知晓率分别达100.0%、99.1%和100.0%,营养与健康知识知晓率和对营养与健康问题持正确态度的比例均显著提高.中小学生偏食、经常吃油炸食品、甜点、含糖饮料等不健康饮食行为比例显著下降,经常吃早餐、主动饮水、几乎每天吃蔬菜水果和奶类等健康饮食行为的比例均显著提高.成年人食物选择多样化、主动饮水、点餐时考虑营养价值的比例增加,不经常吃早餐、口味偏咸、经常吃油炸食品和每天吃蔬菜水果的行为没有明显改善.[结论]受干预人群的营养与健康知信行水平得到有效提高,项目取得了预期效果.%[Objective]To evaluate the effects of "the dietary guidelines for Chinese residents" and "guidelines on snacks for Chinese children and adolescents" nutrition education project carried out in Haidian district of Beijing.[Methods]Nutrition education activities were conducted in an elementary school, a middle school and a community.Subjects randomly selected from the target people were interviewed before and after the intervention using the knowledge-attitudes-practice questionnaires on nutrition and health.[Results]The interviewed subjects of elementary school students, middle school students and adult residents were 113, 109 and 94, respectively.After the nutrition education, the awareness rate of the "the dietary guidelines for Chinese residents" of elementary school students, middle school students and adult residents were 100.0%, 99.1% and 100.0%, respectively.And the rate of

  12. Dietary proteins and angiogenesis.

    Science.gov (United States)

    Medina, Miguel Ángel; Quesada, Ana R

    2014-01-17

    Both defective and persistent angiogenesis are linked to pathological situations in the adult. Compounds able to modulate angiogenesis have a potential value for the treatment of such pathologies. Several small molecules present in the diet have been shown to have modulatory effects on angiogenesis. This review presents the current state of knowledge on the potential modulatory roles of dietary proteins on angiogenesis. There is currently limited available information on the topic. Milk contains at least three proteins for which modulatory effects on angiogenesis have been previously demonstrated. On the other hand, there is some scarce information on the potential of dietary lectins, edible plant proteins and high protein diets to modulate angiogenesis.

  13. Nutritional requirements in pregnancy and use of dietary supplements.

    Science.gov (United States)

    Williamson, Claire; Wyness, Laura

    2013-08-01

    A new British Nutrition Foundation (BNF) Task Force report has been published, which looks in detail at the impact of early life nutrition on health and the risk of diseases in later life, including obesity, diabetes, cardiovascular disease, cancer, bone health, allergic disease and cognitive function. One of the aspects that the report covers in detail is the health and nutrition of pregnant women and where improvements in the maternal diet could be made. This article focuses on the report's findings with regard to the essential nutrients folic acid and vitamin D, including current intakes and status, uptake of supplements and vulnerable groups that are falling short of dietary guidelines.

  14. Dietary Fiber

    Science.gov (United States)

    Fiber is a substance in plants. Dietary fiber is the kind you eat. It's a type of carbohydrate. You may also see it listed on a food label as soluble ... types have important health benefits. Good sources of dietary fiber include Whole grains Nuts and seeds Fruit and ...

  15. [Reflections on residency training under the current recommendations of the European Union of Medical specialists and the European Board of Anaesthesia (UEMS/EBA guidelines)].

    Science.gov (United States)

    Sáez Fernández, A; Sistac Ballarín, J M; Martínez Torrente, F; Calvo Vecino, J M; Olmos Rodríguez, M

    2011-01-01

    The recent publication of guidelines for postgraduate training in anesthesiology, pain, and intensive care issued by the European Board of Anaesthesia (EBA) and the European Union of Medical Specialists (UEMS) (http://www.sedar.es/revistasedar/uems.pdf) specifies directions we must take with our residents. The training section of the Sociedad Española de Anestesiología y Reanimación (SEDAR) has decided to make the guidelines available on the association's website so that the UEMS/EBA proposals can be compared to the training program drafted by the Spanish national board for our specialty. Our aim is to identify points of convergence between the two proposals and to target gaps where improvements can be made so that Spanish residency training in this specialty is in harmony with the European framework.

  16. Is point of care testing in Irish hospitals ready for the laboratory modernisation process? An audit against the current national Irish guidelines.

    LENUS (Irish Health Repository)

    O'Kelly, R A

    2013-04-11

    BACKGROUND: The Laboratory modernisation process in Ireland will include point of care testing (POCT) as one of its central tenets. However, a previous baseline survey showed that POCT was under-resourced particularly with respect to information technology (IT) and staffing. AIMS: An audit was undertaken to see if POCT services had improved since the publication of National Guidelines and if such services were ready for the major changes in laboratory medicine as envisaged by the Health Service Executive. METHODS: The 15 recommendations of the 2007 Guidelines were used as a template for a questionnaire, which was distributed by the Irish External Quality Assessment Scheme. RESULTS: Thirty-nine of a possible 45 acute hospitals replied. Only a quarter of respondent hospitals had POCT committees, however, allocation of staff to POCT had doubled since the first baseline survey. Poor IT infrastructure, the use of unapproved devices, and low levels of adverse incident reporting were still major issues. CONCLUSIONS: Point of care testing remains under-resourced, despite the roll out of such devices throughout the health service including primary care. The present high standards of laboratory medicine may not be maintained if the quality and cost-effectiveness of POCT is not controlled. Adherence to national Guidelines and adequate resourcing is essential to ensure patient safety.

  17. Uniform guidelines improve client care.

    Science.gov (United States)

    Barnett, B

    1994-12-01

    Uniform national guidelines on the delivery of family planning methods and services improve client care, assuming these guidelines are based on current scientific information. Compliance with these guidelines yields safe and efficient delivery of family planning services. Service providers need information, training, supplies, and guidelines to deliver quality services. Guidelines contribute to consistency among family planning programs in different settings. Even though clinics may not provide the same services, the guidelines allow them to provide the same standards of care. Specifically, eligibility criteria, contraindications, and follow-up schedules are the same regardless of the service delivery point. Various international health organizations (such as World Health Organization, USAID, Program for International Training in Health, International Planned Parenthood Federation, and Association for Voluntary Surgical Contraception) have developed guidelines for family planning service delivery. Governments can use these documents to develop national family planning guidelines and policies. They should adapt the guidelines to local needs and consider program resources. After development of the national guidelines, training, workshops, and dissemination of written materials should be provided for policymakers, physicians, nurses, and other health providers. Countries that have either developed or are working to draft their own national guidelines are Cameroon, Ghana, Mexico, and Nepal.

  18. [Outlook for recurrence prevention from the viewpoint of the guidelines on urolithiasis].

    Science.gov (United States)

    Miyazawa, Katsuhito; Morita, Nobuyo; Suga, Kodai; Moriyama, Manabu T; Suzuki, Koji

    2012-12-01

    In Japan, the number of patients with urolithiasis has continued to increase at a faster rate, with a lifetime morbidity in 2005 of 15.1% for males and 6.8% for females, possibly due to : 1) westernization of dietary habits and lifestyle, 2) improvement of diagnostic technologies (CT and ultrasound examination), and 3) aging of the population. Additionally, this disease has a higher recurrence rate ; for example, approximately 50% for calcium-containing calculi. The guidelines on urolithiasis consist primarily of the guidelines for treatment and recurrence prevention, and the items concerning recurrence prevention were added in the 2007 updated Guidelines on Urolithiasis by the European Association of Urology (EAU) and the American Urological Association (AUA) (EAU/AUA guidelines). These facts reflect the importance of recurrence prevention. On the other hand, the Japanese guidelines on urolithiasis are now being revised and will adopt the form of "clinical questions". This paper provides an overview of the examination methods for recurrence, lifestyle guidance, and drug therapies based on the current guidelines for diagnosis and treatment of urolithiasis as well as the points for clinical questions to be included in the revised guidelines for a deeper understanding and, consequently, return to routine clinical practice.

  19. New Asthma Guidelines: What You Should Know

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Special Section New Asthma Guidelines: What You Should Know Past Issues / ... and chairs the Expert Panel that established the new guidelines. The report gives health care professionals new ...

  20. Current practice vs. guideline based imaging in abdominal radiology in the German speaking area. Results of an online survey; Versorgungsrealitaet vs. leitliniengerechte Bildgebung in der Abdominalradiologie im deutschsprachigen Raum. Ergebnisse einer Online-Umfrage

    Energy Technology Data Exchange (ETDEWEB)

    Schreyer, A.G. [University Hospital Regenburg (Germany). Dept. of Radiology; Wessling, J. [Clemens Hospital Muenchen (Germany). Dept. of Radiology; Grenacher, L. [Diagnostic Muenchen (Germany). Diagnostic Imaging Center

    2016-03-15

    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80 % of the questions, were included in the statistical evaluation. 27 % of all participants were registered radiologists while 73 % represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging.

  1. Instructional Guidelines. Welding.

    Science.gov (United States)

    Fordyce, H. L.; Doshier, Dale

    Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

  2. AUTHOR GUIDELINES

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-12-01

    Full Text Available AUTHOR GUIDELINESIndian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/loginOnline SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.SectionsEditorial:On issues of current public health needAbout 1000 – 1200 wordsReferences: 5 – 10 (PubMed - Citation preferredInvited Commentary:Brief, provocative, opinionated communicationsOn issues of current public health needMain Text: 750-1000 words excluding referencesReferences: 5 – 10 (PubMed - Citation preferredOriginal Article:Articles from Original ResearchStructured abstract: 250 wordsMain Text: 2500 - 3000 words, IMRD formatKey Words: 5 - 8References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4*Certificate of clearance from respective Institutional Ethical Committee (IECReview Article:On subject of public health relevanceAbstract: 250 wordsMain Text: 2500 - 3000 wordsKey Words: 3 - 4References: 20 – 25 (PubMed - Citation preferredTables / Figures: 3 – 4Short Communication / Article:Short report of a research project / outbreakMain Text : 1000 – 1200 wordsReferences: 10 – 15 (PubMed - Citation preferredTable / Figure: 01*Certificate of clearance from respective Institutional Ethical Committee (IECReport from the field

  3. [Obligation of guideline recommendations: Perception survey among guideline developers].

    Science.gov (United States)

    Weberschock, Tobias; Dreher, Andreas; Follmann, Markus; Nothacker, Monika; Kopp, Ina; Rosumek, Stefanie; Nast, Alexander

    2016-01-01

    Specific recommendations form the centerpiece of medical guidelines. The intended strength of a recommendation is usually expressed by the use of different wordings. Recent investigations showed that guideline users (recipients) interpret the binding character of wordings in different ways. The perception of different wording and their binding character of the strength of guideline recommendations among guideline developers (sender) have so far not been investigated in the German-speaking area. German-speaking guideline developers were invited online and at specialist meetings to participate in a survey investigating 13 different terms used in guideline recommendations. The aim was to measure their perceived binding character on a visual analog scale (VAS: 0-100). Additional demographic and occupational data were collected. The results were compared with data from a previous survey among guideline users. Overall, 136 guideline developers with an average of 4.2 (median 3) guideline (co-) authorships participated in the survey. While guideline developers interpreted the two imperative recommendations "must" and "must not" with a similarly high level of obligation, the level of obligation was not rated homogenously for strong and weak recommendations like "shall" or "should". Two out of five negative formulations were perceived as more binding than their corresponding positive formulations. In comparisons with the ratings of the guideline users the terms "darf nicht" (must not), (-5.8 VAS, p≤0.0001) and "muss" (must), (-2.9 VAS, p≤0.0006) were perceived as less binding by the guideline developers, as was "sollte nicht"(should not) (-6.6 VAS, p≤0.0001) and "kann nicht empfohlen werden" (cannot be recommended) (-9.4 VAS, p≤0.0001). Only "soll" (shall) was perceived as more binding (+8.7 VAS, p≤0.0001). The current survey demonstrates that guideline developers perceive the binding character of terms used in guideline recommendations in a similar way as it was

  4. Clinical guidelines: their implementation in general practice.

    OpenAIRE

    M Conroy; Shannon, W

    1995-01-01

    In recent years the development of clinical guidelines has received increasing attention from medical educators and those involved in standard setting, and has been initiated at both central and local levels. This review article outlines the current state of knowledge with regard to clinical guideline implementation in medical practice. It deals with the main aspects of the current guideline debate, such as, clinical freedom and doctor autonomy, the importance of ownership in guideline implem...

  5. Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy.

    Science.gov (United States)

    Ryan, D; Gerth van Wijk, R; Angier, E; Kristiansen, M; Zaman, H; Sheikh, A; Cardona, V; Vidal, C; Warner, A; Agache, I; Arasi, S; Fernandez-Rivas, M; Halken, S; Jutel, M; Lau, S; Pajno, G; Pfaar, O; Roberts, G; Sturm, G; Varga, E M; Van Ree, R; Muraro, A

    2017-08-29

    The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe. We undertook a mixed-methods, situational analysis. This involved a purposeful literature search, and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe. The 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence-based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32-48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers. Successful working with primary care providers is essential to scaling-up AIT provision in Europe, but to achieve this the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Dietary polyphenol intake in Europe

    DEFF Research Database (Denmark)

    Zamora-Ros, Raul; Knaze, Viktoria; Rothwell, Joseph A

    2016-01-01

    . The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort. METHODS: Dietary data at baseline......BACKGROUND/OBJECTIVES: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations...... were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing. RESULTS: Mean total...

  7. GRADE guidelines

    DEFF Research Database (Denmark)

    Guyatt, Gordon H; Thorlund, Kristian; Oxman, Andrew D

    2013-01-01

    and absolute effects, presenting the ratio of the means of intervention and control groups, and presenting the results in minimally important difference units. We outline the merits and limitations of each alternative and provide guidance for meta-analysts and guideline developers....

  8. Dietary Supplements

    Science.gov (United States)

    Dietary supplements are vitamins, minerals, herbs, and many other products. They can come as pills, capsules, powders, drinks, and energy bars. Supplements do not have to go through the testing that drugs do. Some supplements ...

  9. Lack of current implantable cardioverter defibrillator guidelines application for primary prevention of sudden cardiac death in Latin American patients with heart failure: a cross-sectional study.

    Science.gov (United States)

    Gonzalez-Zuelgaray, Jorge; Pellizon, Oscar; Muratore, Claudio A; Oropeza, Elsa Silva; Rabinovich, Rafael; Ramos, José Luis; Tentori, Maria Cristina; Reyes, Nicolás; Aguayo, Rubén; Marin, Jorge; Peterson, Brett J

    2013-02-01

    This cross-sectional study evaluated the application of accepted international implantable cardioverter defibrillator (ICD) guidelines for primary prevention of sudden cardiac death in patients with heart failure. The PLASMA (Probabilidad de Sufrir Muerte Arritmica) study was designed to characterize management of cardiac patients in Latin America. Twelve centres included 1958 consecutively admitted patients in cardiology units in 2008 and 2009. Discharged patients were evaluated for primary prevention, ICD indication and prescription by general cardiologists. Of 1711 discharged patients, 1525 (89%) had data available for evaluating indication status. Class I indications for ICD therapy were met for 153 (10%) patients based on collected data. Only 20 (13%, 95% confidence interval: 7.7-18.4%) patients with indication were prescribed an ICD. Patients prescribed an ICD were younger than patients who were not prescribed an ICD (62 vs. 68 years, P < 0.01). The reasons given by cardiologists for not prescribing an ICD for 133 patients with an indication were: indication criteria not met (75%), life expectancy <1 year (9.7%), rejection by the patient (5.2%), no medical coverage paying for the device (3.7%), psychiatric patient (2.2%), and other reasons (4.2%). In Latin America, international guidelines for primary prevention ICD implantation are not well followed. The main reason is that cardiologists believe that patients do not meet indication criteria, even though study data confirm that criteria are met. This poses a significant challenge and underlines the importance of continuous and improved medical education.

  10. Examining Guidelines for School-Based Breakfast Programs in Canada: A Systematic Review of the Grey Literature.

    Science.gov (United States)

    Godin, Katelyn M; Kirkpatrick, Sharon I; Hanning, Rhona M; Stapleton, Jackie; Leatherdale, Scott T

    2017-02-01

    School breakfast programs are widespread and serve varying objectives regarding youth health promotion. Evidence-based guidelines for breakfast programs may be important in maximizing their effectiveness related to student outcomes, yet it is unclear what is available in Canada. A systematic review was conducted to identify and compare Canadian guidelines related to breakfast programs. Data sources included grey literature databases, customized search engines, targeted websites, and content expert consultations. Eligible guidelines met the following criteria: government and nongovernment sources at the federal and provincial/territorial levels, current version, and intended for program coordinators. Recommendations for program delivery were extracted, categorized, and mapped onto the 4 environments outlined in the ANGELO framework, and they were classified as "common" or "inconsistent" across guidelines. Fifteen sets of guidelines were included. No guidelines were available from federal or territorial governments and 4 provincial governments. There were few references to peer-reviewed literature within the guidelines and despite many common recommendations for program delivery, conflicting recommendations were also identified. Potential barriers to program participation, including a lack of consideration of allergies and other dietary restrictions, were identified. Future research should identify how guidelines are implemented and evaluate what effect their implementation has on program delivery and student outcomes.

  11. Dietary Patterns and CKD Progression.

    Science.gov (United States)

    Banerjee, Tanushree; Liu, Yang; Crews, Deidra C

    2016-01-01

    Chronic kidney disease (CKD) patients and their clinicians seek ways to mitigate the risk of CKD progression and its associated complications. Emerging data suggest that dietary modifications may be beneficial adjuvant approaches to reducing the risk of adverse CKD outcomes. This review focuses on several different dietary patterns, including the Dietary Approaches to Stop Hypertension and Mediterranean diets, and their kidney health benefits. We discuss how healthful dietary patterns are lower in dietary acid load and how improving diet quality may slow the progression of CKD. We also discuss some barriers that may impede socially disadvantaged individuals from following healthful diets. Dietary patterns low in dietary acid load might slow the progression of CKD. Current evidence suggests that a reduction in dietary acid load could be beneficial in patients with CKD, but the supremacy of any particular diet is yet to be established. Additional randomized controlled dietary interventions among CKD patients are needed to inform evidence-based recommendations, which can be tailored to an individual's preferences and ability to access healthful foods. © 2016 S. Karger AG, Basel.

  12. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2015-12-01

    Full Text Available Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s.  http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionPAGE CONTENTSGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic-only material should be submitted and sent for peer review simultaneously with the primary manuscript.2. Reporting GuidelinesReporting guidelines have been developed for different study designs; examples include CONSORT for randomized trials, STROBE for observational studies, PRISMA for systematic reviews and meta-analyses, and STARD for studies of diagnostic accuracy. Journals are encouraged to ask authors to follow these guidelines because

  13. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    Full Text Available AUTHOR GUIDELINES Indian Journal of Community Health (IJCH accepts only online submission of manuscript(s by using Open Journal software (OJS at http://www.iapsmupuk.org/journal/index.php/IJCH/login Online SubmissionsAlready have a Username/Password for Indian Journal of Community Health (IJCH? GO TO LOGINNeed a Username/Password?GO TO REGISTRATIONNote: Registration and login are required to submit items online and to track the status of current submissions.Author GuidelinesIJCH strictly adheres on the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals as per the standard universal guidelines given by International Committee of Medical Journal Editors (ICMJE - Recommendations for Uniform Requirements for Manuscripts. Authors are requested to visit http://www.icmje.org/index.html before making online submission of their manuscript(s. http://www.icmje.org/recommendations/browse/manuscript-preparation/preparing-for-submission.html Preparing for SubmissionGeneral PrinciplesReporting GuidelinesManuscript SectionsTitle PageAbstractIntroductionMethodsResultsDiscussionReferencesTablesIllustrations (FiguresUnits of MeasurementAbbreviations and Symbols 1. General PrinciplesThe text of articles reporting original research is usually divided into Introduction, Methods, Results, and Discussion sections. This so-called “IMRAD” structure is not an arbitrary publication format but a reflection of the process of scientific discovery. Articles often need subheadings within these sections to further organize their content. Other types of articles, such as meta-analyses, may require different formats, while case reports, narrative reviews, and editorials may have less structured or unstructured formats.Electronic formats have created opportunities for adding details or sections, layering information, cross-linking, or extracting portions of articles in electronic versions. Supplementary electronic

  14. European Food Safety Authority; Outcome of the Public Consultation on the Draft Opinion of the Scientific Panel on Dietetic Products, Nutrition, and Allergies (NDA) on establishing Food-Based Dietary Guidelines

    DEFF Research Database (Denmark)

    Tetens, Inge

    taken into account in the final opinion. EFSA had received 60 contributions from 19 interested parties (individuals, non-governmental organisations, industry organisations, academia and national assessment bodies). After a meeting with national experts on Dietary Reference Values which was held...

  15. Dietary fat and cardiovascular disease?

    Directory of Open Access Journals (Sweden)

    Lie T. Merijanti

    2016-04-01

    Full Text Available Dietary saturated fat (SF intake has been shown to increase low density lipoprotein (LDL cholesterol and therefore has been associated with increased risk of cardiovascular disease (CVD. This evidence coupled with inferences from epidemiologic studies and clinical trials, had led to longstanding public health recommendations for limiting SF intake as a means of preventing CVD. However the relationship between SF and CVD risk remains controversial, due at least in part to the intrinsic limitations of clinical studies that have evaluated this relationship. A recent meta analysis showed that current evidence does not clearly support cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids (PUFA and low consumption of total SF. They found weak positive associations between circulating palmitic and stearic acids (found largely in palm oil and animal fats, respectively and CVD, whereas circulating margaric acid (a dairy fat significantly reduced the risk of CVD.(2,3 Saturated fat are not associated with all cause mortality, CVD, CHD, ischemic stroke or type 2 diabetes, but the evidence is heterogenous with methodological limitations.

  16. 2015 Evidence Analysis Library Evidence-Based Nutrition Practice Guideline for the Management of Hypertension in Adults.

    Science.gov (United States)

    Lennon, Shannon L; DellaValle, Diane M; Rodder, Susan G; Prest, Melissa; Sinley, Rachel C; Hoy, M Katherine; Papoutsakis, Constantina

    2017-09-01

    Hypertension (HTN) or high blood pressure (BP) is among the most prevalent forms of cardiovascular disease and occurs in approximately one of every three adults in the United States. The purpose of this Evidence Analysis Library (EAL) guideline is to provide an evidence-based summary of nutrition therapy for the management of HTN in adults aged 18 years or older. Implementation of this guideline aims to promote evidence-based practice decisions by registered dietitian nutritionists (RDNs), and other collaborating health professionals to decrease or manage HTN in adults while enhancing patient quality of life and taking into account individual preferences. The systematic review and guideline development methodology of the Academy of Nutrition and Dietetics were applied. A total of 70 research studies were included, analyzed, and rated for quality by trained evidence analysts (literature review dates ranged between 2004 and 2015). Evaluation and synthesis of related evidence resulted in the development of nine recommendations. To reduce BP in adults with HTN, there is strong evidence to recommend provision of medical nutrition therapy by an RDN, adoption of the Dietary Approaches to Stop Hypertension dietary pattern, calcium supplementation, physical activity as a component of a healthy lifestyle, reduction in dietary sodium intake, and reduction of alcohol consumption in heavy drinkers. Increased intake of dietary potassium and calcium as well as supplementation with potassium and magnesium for lowering BP are also recommended (fair evidence). Finally, recommendations related to lowering BP were formulated on vitamin D, magnesium, and the putative role of alcohol consumption in moderate drinkers (weak evidence). In conclusion, the present evidence-based nutrition practice guideline describes the most current recommendations on the dietary management of HTN in adults intended to support the practice of RDNs and other health professionals. Copyright © 2017 Academy of

  17. Worldwide trends in dietary sugars intake.

    Science.gov (United States)

    Wittekind, Anna; Walton, Janette

    2014-12-01

    Estimating trends in dietary intake data is integral to informing national nutrition policy and monitoring progress towards dietary guidelines. Dietary intake of sugars is a controversial public health issue and guidance in relation to recommended intakes is particularly inconsistent. Published data relating to trends in sugars intake are relatively sparse. The purpose of the present review was to collate and review data from national nutrition surveys to examine changes and trends in dietary sugars intake. Only thirteen countries (all in the developed world) appear to report estimates of sugars intake from national nutrition surveys at more than one point in time. Definitions of dietary sugars that were used include 'total sugars', 'non-milk extrinsic sugars', 'added sugars', sucrose' and 'mono- and disaccharides'. This variability in terminology across countries meant that comparisons were limited to within countries. Hence trends in dietary sugars intake were examined by country for the whole population (where data permitted), and for specific or combined age and sex subpopulations. Findings indicate that in the majority of population comparisons, estimated dietary sugars intake is either stable or decreasing in both absolute (g/d) and relative (% energy) terms. An increase in sugars intake was observed in few countries and only in specific subpopulations. In conclusion, the findings from the present review suggest that, in the main, dietary sugars intake are decreasing or stable. A consistent approach to estimation of dietary sugars intake from national nutrition surveys is required if more valid estimates of changes in dietary sugars intakes are required in the future.

  18. Methodological guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Halsnaes, K.; Callaway, J.M.; Meyer, H.J.

    1999-04-01

    The guideline document establishes a general overview of the main components of climate change mitigation assessment. This includes an outline of key economic concepts, scenario structure, common assumptions, modelling tools and country study assumptions. The guidelines are supported by Handbook Reports that contain more detailed specifications of calculation standards, input assumptions and available tools. The major objectives of the project have been provided a methodology, an implementing framework and a reporting system which countries can follow in meeting their future reporting obligations under the FCCC and for GEF enabling activities. The project builds upon the methodology development and application in the UNEP National Abatement Coasting Studies (UNEP, 1994a). The various elements provide countries with a road map for conducting climate change mitigation studies and submitting national reports as required by the FCCC. (au) 121 refs.

  19. Jogging Guidelines.

    Science.gov (United States)

    President's Council on Physical Fitness and Sports, Washington, DC.

    Jogging guidelines are set forth under the following headings: a) What Is Jogging; c) Why One Should Jog; c) How To Begin; d) What To Wear (with the emphasis on proper shoes); e) When and Where To Jog; and f) How To Jog. A 16-week basic program, outlined for inactive adults, recommends for each week the number of days to exercise, the distance,…

  20. Relationships among food label use, motivation, and dietary quality

    National Research Council Canada - National Science Library

    Miller, Lisa M Soederberg; Cassady, Diana L; Applegate, Elizabeth A; Beckett, Laurel A; Wilson, Machelle D; Gibson, Tanja N; Ellwood, Kathleen

    2015-01-01

    Nutrition information on packaged foods supplies information that aids consumers in meeting the recommendations put forth in the US Dietary Guidelines for Americans such as reducing intake of solid fats and added sugars...

  1. Comparison of acrylamide intake from Western and guideline based diets using probabilistic techniques and linear programming.

    Science.gov (United States)

    Katz, Josh M; Winter, Carl K; Buttrey, Samuel E; Fadel, James G

    2012-03-01

    Western and guideline based diets were compared to determine if dietary improvements resulting from following dietary guidelines reduce acrylamide intake. Acrylamide forms in heat treated foods and is a human neurotoxin and animal carcinogen. Acrylamide intake from the Western diet was estimated with probabilistic techniques using teenage (13-19 years) National Health and Nutrition Examination Survey (NHANES) food consumption estimates combined with FDA data on the levels of acrylamide in a large number of foods. Guideline based diets were derived from NHANES data using linear programming techniques to comport to recommendations from the Dietary Guidelines for Americans, 2005. Whereas the guideline based diets were more properly balanced and rich in consumption of fruits, vegetables, and other dietary components than the Western diets, acrylamide intake (mean±SE) was significantly greater (Plinear programming and results demonstrate that linear programming techniques can be used to model specific diets for the assessment of toxicological and nutritional dietary components.

  2. Current status of grassroots clinical guidelines of chronic diseases at home and abroad%国内外慢性病基层临床指南现状分析

    Institute of Scientific and Technical Information of China (English)

    蒋品; 唐海沁; 何伟; 张勇

    2015-01-01

    Objective To review the current status of grassroots clinical guidelines of chronic diseases at home and abroad by applying AGREE Ⅱ instrument, and provide reference for developing and formulating grassroots clinical guidelines of chronic diseases in China. Methods The databases of CBM, CNKI, VIP Database, WanFang Database and PubMed, and related websits to issuing and data of guidelines were retrieved from 2008 to 2014. The publushed grassroots clinical guidelines of chronic diseases were included and language was limited in Chinese and English. The names, publishing years and organizations, development methods and quantity of references of included guidelines were descriptively analyzed. Results ①There were totally 11 guidelines included from USA, Australia, Europe and China, and publish years were from 2008 to 2014. ②These guidelines covered hypertension, cardiovascular diseases, diabetes, chronic obstructive pulmonary disease (COPD) and bronchia asthma. ③The quantity of reference was from 0 to 146. ④The average score was, respectively, 88.1%, 50.2%, 31.4%, 90.1%, 49.7%and 38.3%in 6 domains of included guidelines including range and purpose, participants, preciseness, pellucidity, applicability and editor’s independence, and among them, there were 3 domains lower than 50%. All 11 included guidelines did not describe methods and evidence of retrieving and update program. Conclusion ①At present, the grassroots clinical guidelines of chronic diseases are less with slow development and lower quality in the world. ②The grassroots clinical guidelines of chronic diseases and the guidelines for grassroots common diseases including coronary heart disease and COPD are relatively few. It is suggested to develop simple and practical grassroots clinical guidelines of chronic diseases based on learning from foreign experience, aiming at Chinese situations and characteristics of grassroots general clinicians, and regarding prevention and treatment of chronic

  3. Assessment of possible allergenicity of hypothetical ORFs in common food crops using current bioinformatic guidelines and its implications for the safety assessment of GM crops.

    Science.gov (United States)

    Young, Gregory J; Zhang, Shiping; Mirsky, Henry P; Cressman, Robert F; Cong, Bin; Ladics, Gregory S; Zhong, Cathy X

    2012-10-01

    Before a genetically modified (GM) crop can be commercialized it must pass through a rigorous regulatory process to verify that it is safe for human and animal consumption, and to the environment. One particular area of focus is the potential introduction of a known or cross-reactive allergen not previously present within the crop. The assessment of possible allergenicity uses the guidelines outlined by the Food and Agriculture Organization (FAO) and World Health Organization's (WHO) Codex Alimentarius Commission (Codex) to evaluate all newly expressed proteins. Some regulatory authorities have broadened the scope of the assessment to include all DNA reading frames between stop codons across the insert and spanning the insert/genomic DNA junctions. To investigate the utility of this bioinformatic assessment, all naturally occurring stop-to-stop frames in the non-transgenic genomes of maize, rice, and soybean, as well as the human genome, were compared against the AllergenOnline (www.allergenonline.org) database using the Codex criteria. We discovered thousands of frames that exceeded the Codex defined threshold for potential cross-reactivity suggesting that evaluating hypothetical ORFs (stop-to-stop frames) has questionable value for making decisions on the safety of GM crops.

  4. Diagnosing attention-deficit hyperactivity disorder (ADHD) in children involved with child protection services: are current diagnostic guidelines acceptable for vulnerable populations?

    Science.gov (United States)

    Klein, B; Damiani-Taraba, G; Koster, A; Campbell, J; Scholz, C

    2015-03-01

    Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.

  5. International CPR guidelines - perspectives in CPR.

    Science.gov (United States)

    Nolan, Jerry P

    2013-09-01

    The International Liaison Committee on Resuscitation (ILCOR) co-ordinates regular reviews of cardiopulmonary resuscitation (CPR) science and publishes consensus on science statements and treatment recommendations. These outputs are used by international resuscitation organisations to generate clinical guidelines. This review will outline the history behind the development of international CPR guidelines and will provide a detailed description of the current guideline generating process. A perspective is provided on the future of this process and the prospects for completely unified international CPR guidelines.

  6. ADHD Rehabilitation through Video Gaming: A Systematic Review Using PRISMA Guidelines of the Current Findings and the Associated Risk of Bias

    Science.gov (United States)

    Strahler Rivero, Thiago; Herrera Nuñez, Lina Maria; Uehara Pires, Emmy; Amodeo Bueno, Orlando Francisco

    2015-01-01

    Empirical research studies have highlighted the need to investigate whether video game can be useful as a tool within a neuropsychological rehabilitation program for attention deficit hyperactivity disorder (ADHD) patients. However, little is known about the possible gains that this kind of video game-based interventions can produce and even if these gains can be transferred to real life abilities. The present paper aims to uncover key information related to the use of video game in ADHD neuropsychological rehabilitation/intervention by focusing on its gains and its capability to transfer/generalize these gains to real life situation via a systematic review of the empirical literature. The PRISMA guidelines were adopted. Internet-based bibliographic searches were conducted via seven major electronic databases (i.e., PsycARTICLES, PsycINFO, Web of Science, Core Collection BIOSIS Citation Index, MEDLINE, SciELO Citation Index, and PubMed) to access studies examining the association between video game interventions in ADHD patients and behavioral and cognitive outcomes. A total of 14 empirical studies meeting the inclusion criteria were identified. The studies reported the attention, working memory, and the behavioral aspects as the main target of the intervention. Cognitive and behavioral gains were reported after the video game training (VGT). However, many bias related to the choice of outcome instruments, sampling and blindness of assessors, weaken the results power. Additional researches are important to clarify the effects and stability of the VGT programs, and an important effort should be made to construct better methods to assess improvements on everyday cognitive abilities and real world functioning. PMID:26557098

  7. ADHD rehabilitation through video gaming: A systematic review using PRISMA guidelines of the current findings and the associated risk of bias.

    Directory of Open Access Journals (Sweden)

    Thiago eStrahler Rivero

    2015-10-01

    Full Text Available Empirical research studies have highlighted the need to investigate whether video game can be useful as a tool within a neuropsychological rehabilitation program for Attention Deficit Hyperactivity Disorder patients. However, little is known about the possible gains that this kind of video game based interventions can produce and even if these gains can be transferred to real life abilities. The present paper aims to uncover key information related to the use of video game in ADHD neuropsychological rehabilitation/intervention by focusing on its gains and its capability to transfer/generalize these gains to real life situation via a systematic review of the empirical literature. The PRISMA guidelines were adopted. Internet-based bibliographic searches were conducted via seven major electronic databases (i.e., PsycARTICLES, PsycINFO, Web of Science, Core Collection BIOSIS Citation Index, MEDLINE, SciELO Citation Index, and PubMed to access studies examining the association between video game interventions in ADHD patients and behavioral and cognitive outcomes. A total of 14 empirical studies meeting the inclusion criteria were identified. The studies reported the attention, working memory and the behavioral aspects as the main target of the intervention. Cognitive and behavioral gains were reported after the video game training. However, many bias related to the choice of outcome instruments, sampling and blindness of assessors, weaken the results power. Additional researches are important to clarify the effects and stability of the video games training programs, and an important effort should be made to construct better methods to assess improvements on everyday cognitive abilities and real world functioning.

  8. ADHD Rehabilitation through Video Gaming: A Systematic Review Using PRISMA Guidelines of the Current Findings and the Associated Risk of Bias.

    Science.gov (United States)

    Strahler Rivero, Thiago; Herrera Nuñez, Lina Maria; Uehara Pires, Emmy; Amodeo Bueno, Orlando Francisco

    2015-01-01

    Empirical research studies have highlighted the need to investigate whether video game can be useful as a tool within a neuropsychological rehabilitation program for attention deficit hyperactivity disorder (ADHD) patients. However, little is known about the possible gains that this kind of video game-based interventions can produce and even if these gains can be transferred to real life abilities. The present paper aims to uncover key information related to the use of video game in ADHD neuropsychological rehabilitation/intervention by focusing on its gains and its capability to transfer/generalize these gains to real life situation via a systematic review of the empirical literature. The PRISMA guidelines were adopted. Internet-based bibliographic searches were conducted via seven major electronic databases (i.e., PsycARTICLES, PsycINFO, Web of Science, Core Collection BIOSIS Citation Index, MEDLINE, SciELO Citation Index, and PubMed) to access studies examining the association between video game interventions in ADHD patients and behavioral and cognitive outcomes. A total of 14 empirical studies meeting the inclusion criteria were identified. The studies reported the attention, working memory, and the behavioral aspects as the main target of the intervention. Cognitive and behavioral gains were reported after the video game training (VGT). However, many bias related to the choice of outcome instruments, sampling and blindness of assessors, weaken the results power. Additional researches are important to clarify the effects and stability of the VGT programs, and an important effort should be made to construct better methods to assess improvements on everyday cognitive abilities and real world functioning.

  9. Assessment of current dietary intake of organochlorine contaminants and polycyclic aromatic hydrocarbons in killer whales (Orcinus orca) through direct determination in a group of whales in captivity.

    Science.gov (United States)

    Formigaro, Costanza; Henríquez-Hernandez, Luis A; Zaccaroni, Annalisa; Garcia-Hartmann, Manuel; Camacho, María; Boada, Luis D; Zumbado, Manuel; Luzardo, Octavio P

    2014-02-15

    We determined the levels of 16 polycyclic aromatic hydrocarbons (PAHs), 19 organochlorine pesticides (OCPs) and 18 polychlorinated biphenyls (PCBs) in the plasma of captive adult killer whales and in their food. The goal of this research was the assessment of the dietary exposure of killer whales to these pollutants to gain insight on what is the actual magnitude of the exposure in this species, which is considered among the most contaminated in the planet. Plasma median ∑OCP and ∑PCB contents were 3150.3 and 7985.9 ng g(-1)l.w., respectively. A total of 78.9% of the PCBs were marker-PCBs, and 21.1% were dioxin-like PCBs (6688.7 pg g(-1)l.w. dioxin toxic equivalents). This is the first report of the blood levels of PAHs in killer whales, and their median value was 1023.1 ng g(-1)l.w. In parallel, we also determined the levels of these contaminants in the fish species that are used to feed these animals to estimate the orcas' average daily dietary intake of pollutants. All the contaminants in the fish were detected in the plasma of the killer whales, and proportionality between the intake and the blood levels was observed in all the animals. The calculated intake was extremely high for certain contaminants, which is a concern, giving a glimpse of what possibly occurs in the wild, where exposure to these contaminants can be even higher. Therefore, although many of these chemicals have been banned for decades, even today, the levels of these chemicals could reach very toxic concentrations in the tissues of these endangered animals because of their diet. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Impact of Dietary Carbohydrate and Protein Levels on Carbohydrate Metabolism

    Science.gov (United States)

    Lasker, Denise Ann

    2009-01-01

    The goal of this dissertation was to investigate the impact of changing dietary carbohydrate (CARB) intakes within recommended dietary guidelines on metabolic outcomes specifically associated with glycemic regulations and carbohydrate metabolism. This research utilized both human and animal studies to examine changes in metabolism across a wide…

  11. Pregnant immigrant Nigerian women: an exploration of dietary intakes

    LENUS (Irish Health Repository)

    Lindsay, K.L

    2014-07-01

    The aim of the study is to explore the dietary intakes of a prominent ethnic minority group of women from Sub-Saharan Africa during pregnancy, in order to identify nutritional issues of concern which may impact on pregnancy outcomes and whether different food based dietary guidelines may be required to meet their needs.

  12. Pregnant immigrant Nigerian women: an exploration of dietary intakes.

    LENUS (Irish Health Repository)

    Lindsay, K L

    2014-07-01

    The aim of the study is to explore the dietary intakes of a prominent ethnic minority group of women from Sub-Saharan Africa during pregnancy, in order to identify nutritional issues of concern which may impact on pregnancy outcomes and whether different food based dietary guidelines may be required to meet their needs.

  13. Impact of Dietary Carbohydrate and Protein Levels on Carbohydrate Metabolism

    Science.gov (United States)

    Lasker, Denise Ann

    2009-01-01

    The goal of this dissertation was to investigate the impact of changing dietary carbohydrate (CARB) intakes within recommended dietary guidelines on metabolic outcomes specifically associated with glycemic regulations and carbohydrate metabolism. This research utilized both human and animal studies to examine changes in metabolism across a wide…

  14. Dietary fiber.

    Science.gov (United States)

    Madar, Z; Thorne, R

    1987-01-01

    Studies done on dietary fiber (DF) over the past five years are presented in this Review. The involvement of dietary fiber in the control of plasma glucose and lipid levels is now established. Two dietary fiber sources (soybean and fenugreek) were studied in our laboratory and are discussed herein. These sources were found to be potentially beneficial in the reduction of plasma glucose in non-insulin dependent diabetes mellitus subjects. They are shown to be acceptable by human subjects and are easy to use either in a mixture of milk products and in cooking. The mechanism by which dietary fiber alters the nutrient absorption is also discussed. The effect of DF on gastric emptying, transit time, adsorption and glucose transport may contribute to reducing plasma glucose and lipid levels. DF was found to be effective in controlling blood glucose and lipid levels of pregnant diabetic women. Dietary fiber may also be potentially beneficial in the reduction of exogenous insulin requirements in these subjects. However, increased consumption of DF may cause adverse side effects; the binding capabilities of fiber may affect nutrient availability, particularly that of minerals and prolonged and high DF dosage supplementation must be regarded cautiously. This is particularly true when recommending such a diet for pregnant or lactating women, children or subjects with nutritional disorders. Physiological effects of DF appear to depend heavily on the source and composition of fiber. Using a combination of DF from a variety of sources may reduce the actual mass of fiber required to obtain the desired metabolic effects and will result in a more palatable diet. Previously observed problems, such as excess flatus, diarrhea and mineral malabsorption would also be minimized.

  15. Cardiovascular benefits of dietary fiber.

    Science.gov (United States)

    Satija, Ambika; Hu, Frank B

    2012-12-01

    The relationship between dietary fiber and risk of cardiovascular disease (CVD) has been extensively studied. There is considerable epidemiological evidence indicating an inverse association between dietary fiber intake and CVD risk. The association has been found to be stronger for cereal fiber than for fruit or vegetable fiber, and several studies have also found increased whole grain consumption to be associated with CVD risk reduction. In light of this evidence, recent US dietary guidelines have endorsed increased consumption of fiber rich whole grains. Regular consumption of dietary fiber, particularly fiber from cereal sources, may improve CVD health through multiple mechanisms including lipid reduction, body weight regulation, improved glucose metabolism, blood pressure control, and reduction of chronic inflammation. Future research should focus on various food sources of fiber, including different types of whole grains, legumes, fruits, vegetables, and nuts, as well as resistant starch in relation to CVD risk and weight control; explore the biological mechanisms underlying the cardioprotective effect of fiber-rich diets; and study different ethnic groups and populations with varying sources of dietary fiber.

  16. Evolution of dietary antioxidants.

    Science.gov (United States)

    Benzie, Iris F F

    2003-09-01

    Oxygen is vital for most organisms but, paradoxically, damages key biological sites. Oxygenic threat is met by antioxidants that evolved in parallel with our oxygenic atmosphere. Plants employ antioxidants to defend their structures against reactive oxygen species (ROS; oxidants) produced during photosynthesis. The human body is exposed to these same oxidants, and we have also evolved an effective antioxidant system. However, this is not infallible. ROS breach defences, oxidative damage ensues, accumulates with age, and causes a variety of pathological changes. Plant-based, antioxidant-rich foods traditionally formed the major part of the human diet, and plant-based dietary antioxidants are hypothesized to have an important role in maintaining human health. This hypothesis is logical in evolutionary terms, especially when we consider the relatively hypoxic environment in which humans may have evolved. In this paper, the human diet is discussed briefly in terms of its evolutionary development, different strategies of antioxidant defence are outlined, and evolution of dietary antioxidants is discussed from the perspectives of plant need and our current dietary requirements. Finally, possibilities in regard to dietary antioxidants, evolution, and human health are presented, and an evolutionary cost-benefit analysis is presented in relation to why we lost the ability to make ascorbic acid (vitamin C) although we retained an absolute requirement for it.

  17. Japanese Guideline for Allergic Rhinitis

    OpenAIRE

    Kimihiro Okubo; Yuichi Kurono; Shigeharu Fujieda; Satoshi Ogino; Eiichi Uchio; Hiroshi Odajima; Hiroshi Takenaka; Kohtaro Baba

    2011-01-01

    Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 6th editi...

  18. 金坛市小学生膳食健康教育干预效果评价%Effects of health education on Chinese Dietary Guidelines and relative nutritional knowledge, attitude and behavior among primary school students in Jintan city

    Institute of Scientific and Technical Information of China (English)

    贾根梅; 孙桂菊; 沈洁; 张朋; 刘福康; 黄桂玲; 王少康; 杨瑾; 杨立刚; 艾月仙

    2011-01-01

    目的 通过健康教育,提高江苏省金坛市小学生相关知识、态度、行为水平,培养小学生的良好饮食习惯.方法 选取金坛市2所小学307名五年级学生为调查对象,对其进行膳食指南相关营养知识、态度、行为调查,选择其中1所学校为干预学校,进行相关营养知识健康教育,另1所学校作为对照,3个月后对干预效果进行评价.结果 干预学校学生基线调查和终期调查营养知识得分分别为(4.51±2.32)、(9.82±2.65)分,差异有统计学意义(t=-28.74,P<0.05);对照学校学生基线调查和终期调查营养知识得分分别为(5.18±1.98)、(5.86±1.75)分,差异无统计学意义;干预学校小学生健康教育干预后的营养知识明显提高,饮食行为趋于合理,听说过膳食指南的学生由15.5%(17/109)提高到84.4%(92/109)(χ2=103.21,P<0.05),每天吃早餐的学生由59.8%(65/109)上升到72.5%(79/109)(χ20=4.01,P=0.045),每周不吃膨化食品的学生由16.5%(18/109)上升到35.7%(39/109)(χ2=10.48,P=0.001),差异均有统计学意义.结论 营养健康教育可提高小学生的营养知识水平,改善其饮食理念和饮食行为.%Objective To improve knowledge, attitude, practice (KAP) of dietary nutrition among primary school students through health education. Methods A self-administered questionnaire survey was conducted among 307 students of grade 5 in 2 primary schools in Jintan city,Jiangsu province. The students in one school were given health education on the Chinese Dietary Guidelines 2007 for 3 months and the other school was taken as control group. The effect was evaluated 3 months after the education. Results After the education, the nutritional knowledge of the students improved significantly and their dietary behavior became more reasonable. The students who learnd the Chinese Dietary Guidelines rised from 15.5 % ( 17/109 ) to 84.4 % ( 92/109 ) (X2 = 103. 21, P < 0. 05 ) and the percentage of the students having

  19. UVB exposure of farm animals: study on a food-based strategy to bridge the gap between current vitamin D intakes and dietary targets.

    Science.gov (United States)

    Schutkowski, Alexandra; Krämer, Julia; Kluge, Holger; Hirche, Frank; Krombholz, Andreas; Theumer, Torsten; Stangl, Gabriele I

    2013-01-01

    Vitamin D deficiency is a global health problem. This study aimed to investigate the efficacy of ultraviolet (UV) B radiation for improving vitamin D3 content of eggs and meat. In a two-factorial design hens that received diets with 0 (-D3) or 3,000 IU (+D3) vitamin D3/kg were non-exposed (-UVB) or exposed to UVB radiation (+UVB) for 3 h daily over 4 weeks. Data show that UVB radiation was very effective in raising the vitamin D3 content of egg yolk and meat. Egg yolk from +UVB/-D3 hens had a higher vitamin D3 content (17.5±7.2 µg/100 g dry matter (DM)) than those from the -UVB/+D3 group (5.2±2.4 µg/100 g DM, pradiation (32.4±10.9 µg/100 g DM). The content of 25-hydroxyvitamin D3 (25(OH)D3) in the egg yolk also increased in response to UVB, although less pronounced than vitamin D3. Meat revealed about 4-fold higher vitamin D3 contents in response to UVB than to dietary vitamin D3 (pfoods from animal sources.

  20. Dietary supplements in sport.

    Science.gov (United States)

    Burke, L M; Read, R S

    1993-01-01

    Studies of the dietary practices of athletes report that nutritional supplements are commonly used. Supplementation practices vary between sports and individual athletes; however, there is evidence that at least some athletes use a large number of supplements concurrently, often in doses that are very high in comparison with normal dietary intakes. In exploring supplementation practices we propose a classification system separating the supplements into dietary supplements and nutritional erogogenic aids. The dietary supplement is characterised as a product which can be used to address physiological or nutritional issues arising in sport. It may provide a convenient or practical means of consuming special nutrient requirements for exercise, or it may be used to prevent/reverse nutritional deficiencies that commonly occur among athletes. The basis of the dietary supplement is an understanding of nutritional requirements and physiological effects of exercise. When the supplement is used to successfully meet a physiological/nutritional goal arising in sport it may be demonstrated to improve sports performance. While there is some interest in refining the composition or formulation of some dietary supplements, the real interest belongs to the use or application of the supplement; i.e. educating athletes to understand and achieve their nutritional needs in a specific sports situation. The sports drink (carbohydrate-electrolyte replacement drink) is a well known example of a dietary supplement. Scientific attitudes towards the sports drink have changed over the past 20 years. Initial caution that carbohydrate-electrolyte fluids compromise gastric emptying during exercise has now been shown to be unjustified. Numerous studies have shown that 5 to 10% solutions of glucose, glucose polymers (maltodextrins) and other simple sugars all have suitable gastric emptying characteristics for the delivery of fluid and moderate amounts of carbohydrate substrate. The optimal

  1. Dietary fiber and retrograde starch.

    Science.gov (United States)

    Zivković, R

    1998-01-01

    The history of the recognition of the importance of dietary fiber, their current classification into water-soluble and water-insoluble fiber, and lignin, a single non-carbohydrate fiber, and the physiologic role of dietary fiber, with particular reference to retrograde starch resistance to small intestine digestion, are briefly presented. Dietary fiber are highly hygroscopic, thus they greatly contribute to stool voluminosity by binding water, decrease the glycemic index, and exert a protective action, via an as yet unknown mechanism, against the occurrence of colon cancer. It should be added that some dietary fiber decrease the concentration of cholesterol in the blood, i.e. in the human body. The importance of the methodology used for NSP determination is underlined, since some methods determine only some of the polysaccharides, other also measure some other substances, whereas Englyst's method determines NSP only.

  2. EAU guidelines on iatrogenic trauma.

    Science.gov (United States)

    Summerton, Duncan J; Kitrey, Noam D; Lumen, Nicolaas; Serafetinidis, Efraim; Djakovic, Nenad

    2012-10-01

    The European Association of Urology (EAU) Trauma Guidelines Panel presents an updated iatrogenic trauma section of their guidelines. Iatrogenic injuries are known complications of surgery to the urinary tract. Timely and adequate intervention is key to their management. To assess the optimal evaluation and management of iatrogenic injuries and present an update of the iatrogenic section of the EAU Trauma Guidelines. A systematic search of the literature was conducted, consulting Medline and the Cochrane Register of Systematic reviews. No time limitations were applied, although the focus was on more recent publications. The expert panel developed statements and recommendations. Statements were rated according to their level of evidence, and recommendations received a grade following a rating system modified from the Oxford Centre for Evidence-based Medicine. Currently, only limited high-powered studies are available addressing iatrogenic injuries. Because the reporting of complications or sequelae of interventions is now increasingly becoming a standard requirement, this situation will likely change in the future. This section of the trauma guidelines presents an updated overview of the treatment of iatrogenic trauma that will be incorporated in the trauma guidelines available at the EAU Web site (http://www. uroweb.org/guidelines/online-guidelines/). Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. Guidelines for Description

    NARCIS (Netherlands)

    Links, P.; Horsman, Peter; Kühnel, Karsten; Priddy, M.; Reijnhoudt, Linda; Merenmies, Mark

    2013-01-01

    The Guidelines follow the conceptual metadata model (deliverable 17.2). They include guidelines for description of collection-holding institutions, document collections, organisations, personalities, events, camps and ghettos. As much as possible the guidelines comply with the descriptive standards

  4. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-10-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the Content 1.1.1   Subheading of the Content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  5. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the content 1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  6. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2014-09-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education.To be considered for publication, the article should be presented in the following system:First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page.Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion.Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1         INTRODUCTION1.1      Subheading of the content 1.1.1   Subheading of the content  For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table.For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure.The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press.Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www

  7. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2016-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second p age and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the Content 1.1.1 Subheading of the Content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples:   Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v. whole-class activities. Retrieved October 1, 2012 from http://www.teachingenglish.org

  8. Author Guidelines

    Directory of Open Access Journals (Sweden)

    Yunisrina Qismullah Yusuf

    2015-03-01

    Full Text Available Guidelines for Article Submission SiELE journal accepts articles on research and development in the field of teaching and learning of English, linguistics, educational development, policy and cultural studies in education. To be considered for publication, the article should be presented in the following system: First page: include a title page with the full title of the paper (must not exceed 16 words, the author(s’ name(s, affiliation(s, phone number(s and e-mail address of the corresponding author. A brief bio-data of the author(s (maximum of 100 words is provided in this page. Second page and subsequent page: Submissions should be between 4000-6000 (including abstract, table(s, figure(s and references in A4 size paper with margins as the following: top 3 cm, bottom 3 cm, right 2.5 cm and left 4 cm. The font is Times New Roman, size 12 and single spaced. The article should generally consist of the following sections: introduction, review of literature, method, findings, discussion and conclusion. Headings and subheadings should be presented as follows (provide a space between the headings and sub-headings. 1 INTRODUCTION 1.1 Subheading of the content 1.1.1 Subheading of the content For Tables, the title size is 12 and the content size is 10. Please number the tables subsequently throughout your article and the title is written above the table. For Figures, the title size is 12 and the content size (if any is 10. Please number the figures subsequently throughout your article and the title is written below the figure. The reference list should be arranged alphabetically following the guidelines of the Publication Manual of the American Psychological Association (5th ed.. See the following examples: Back Matter| 79 80 | STUDIES IN ENGLISH LANGUAGE AND EDUCATION, Volume 1, Number 1, March 2014 Book: Ellis, R. (2003. Task-based language learning and teaching. Oxford: Oxford University Press. Internet source: Andrewes, S. (2003. Group work v

  9. Editorial: can China master the guideline challenge?

    Directory of Open Access Journals (Sweden)

    Yang Kehu

    2013-01-01

    Full Text Available Abstract China is experiencing increased health care use and expenditures, without sufficient controls to ensure quality and value. Transparent, cost-conscious and patient-centered guidelines based on the best available evidence could help establishing these quality and practice measures. We examined how guidelines could support the Chinese health reform. Specifically, we summarized the current state of the art and related challenges in guideline development and explored possible solutions in the context of the Chinese health reform. China currently lacks capacity for evidence-based guideline development and coordination by a central agency. Most Chinese guideline users rely on recommendations developed by professional groups that lack demonstration of transparency (including conflict of interest management and evidence synthesis and quality. These deficiencies appear larger than in other regions of the world. In addition, misperceptions about the role of guidelines in assisting practitioners as opposed to providing rules requiring adherence, and a perception that traditional Chinese medicine (TCM cannot be appropriately incorporated in guidelines are present. China’s capacity could be strengthened by a central guideline agency to provide or coordinate evidence synthesis for guideline development and to oversee the work of guideline developers. China can build on what is known and work with the international community to develop methods to meet the challenges of evidence-based guideline development.

  10. Overconsumption of Energy and Excessive Discretionary Food Intake Inflates Dietary Greenhouse Gas Emissions in Australia

    Directory of Open Access Journals (Sweden)

    Gilly A. Hendrie

    2016-10-01

    Full Text Available Population dietary guidelines have started to include information about the environmental impacts of food choices, but more quantifiable evidence is needed, particularly about the impacts associated with discretionary foods. This paper utilised the 2011–2012 Australian Health Survey food intake data along with a highly disaggregated input–output model to estimate the greenhouse gas emissions (GHGe of Australians’ dietary intake, and compare current patterns of eating which vary in diet quality and GHGe to the recommended diet. The average dietary GHGe were 18.72 ± 12.06 and 13.73 ± 8.72 kg CO2e/day for male and female adults, respectively. The correlation between total energy and GHGe was r = 0.54 (p < 0.001. Core foods contributed 68.4% and discretionary foods 29.4%. Within core foods, fresh meat and alternatives (33.9% was the greatest contributor. The modelling of current dietary patterns showed the contribution of discretionary foods to GHGe was 121% greater in the average diet and 307% greater in the “lower quality, higher GHGe” diet compared to the recommended diet. Reducing discretionary food intake would allow for small increases in emissions from core foods (in particular vegetables, dairy and grains, thereby providing a nutritional benefit at little environmental expense. Public health messages that promote healthy eating, eating to one’s energy needs and improved diet quality will also contribute to lowering GHGe.

  11. Sociodemographic differences in dietary habits described by food frequency questions

    DEFF Research Database (Denmark)

    Dynesen, Anja Weirsøe; Haraldsdottír, Johanna; Holm, Lotte;

    2003-01-01

    be a valuable supplement to traditional quantitative dietary surveys in monitoring sociodemographic changes in eating patterns. The results also underline the influence of sociodemographic status on dietary habits. SPONSORSHIP: The Danish Nutrition Council funded the study.......OBJECTIVES: To investigate whether a modest number of food frequency questions are sufficient to describe sociodemographic differences in dietary habits, and to identify sociodemographic characteristics of subjects adhering to food-based dietary guidelines operationalised in a "healthy-diet index...... frequency questions, a question on type of fat spreads used on bread, questions on seven sociodemographic variables. RESULTS: The summary of the healthy-diet index showed that the subjects who adhered to food-based dietary guidelines (top quintile) compared to those who did not (bottom quintile) were most...

  12. Association of dietary diversity score with anxiety in women.

    Science.gov (United States)

    Poorrezaeian, Mina; Siassi, Fereydoun; Qorbani, Mostafa; Karimi, Javad; Koohdani, Fariba; Asayesh, Hamid; Sotoudeh, Gity

    2015-12-15

    Evidence suggests that diet plays an important role in the development of mental disorders, especially anxiety. Dietary diversity score is an indicator for assessing diet quality. However, its association with anxiety has not been investigated. The aim of this study was to examine the association of dietary diversity score with anxiety. A cross-sectional study was conducted among 360 women attending health centers in the south of Tehran in 2014. General information among others were collected. Weight, height and waist circumference were measured and body mass index (BMI) was calculated. Dietary intake and anxiety score were assessed using a 24-h dietary recall and Depression, Anxiety, Stress Scales (DASS) questionnaires, respectively. Dietary diversity score was computed according to the guidelines of FAO. About 35% of the participants were found to exhibit anxiety. The dietary diversity score in 12.5% of the subjects were between 1 and 3 (low dietary diversity score) but 87.5% scored between 4 and 7 (high dietary diversity score). The adjusted mean of anxiety score in subjects with high dietary diversity score was significantly lower than those with low dietary diversity score. Dietary diversity score was found to be inversely associated with anxiety. However, the causality between anxiety and dietary diversity could not be determined.

  13. [Preoperative fasting guidelines: an update].

    Science.gov (United States)

    López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

    2015-03-01

    Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Current situation and influencing factors of dietary behaviors among children in Wuxi city%无锡市儿童饮食行为现状及影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    华玲玲

    2016-01-01

    目的:调查江苏省无锡市7月龄~3岁儿童饮食行为现状及其影响因素。方法于2015年2—9月,采用便利抽取方法,应用《儿童饮食行为调查问卷》对无锡市627名7月龄~3岁儿童进行问卷调查,了解儿童的一般资料、儿童饮食行为问题以及扶养人对儿童饮食行为问题的应对方式。结果无锡市7月龄~3岁儿童饮食行为问题检出率为67.6%,2~3岁儿童问题检出率达最高水平,其中儿童饮食行为问题最严重的是“不良进食习惯”,80.9%的抚养者选择用不当方式应对;多元回归分析结果显示:早产儿、低体重儿更容易产生饮食行为问题,抚养者文化程度尤其是母亲的文化程度及家庭经济收入水平是儿童饮食行为问题中的影响因素(P<0.05),家长有不良喂养行为的儿童更易产生饮食行为问题(P<0.05)。结论无锡市7月龄~3岁儿童饮食行为问题较为突出,护理人员应该尽早对儿童的饮食行为实施干预。%Objective To explore the current situation and influencing factors of dietary behaviors among children aged 7 months up to 3 years old in Wuxi of Jiangsu province .Methods According to the convenience sampling, the study investigated 627 parents of seven months to three years old children by “Children′s dietary behavior questionnaire” in Wuxi city from February to September 2015.The data were collected including the general information , children′s dietary behavior problems , and parents′responses to these problems .Results The average prevalence rate of dietary behavior problems was 67.62%in children aged from 7 months to 3 years old, with the highest prevalence rate among 2-3 years old children .The most prevalent problem was “the bad diet habit”, however, 80.9%parents responded by wrong coping methods .The logistic analysis demonstrated that the preterm infants and infants with low birth weight tended to have

  15. Are current UK National Institute for Health and Clinical Excellence (NICE) obesity risk guidelines useful? Cross-sectional associations with cardiovascular disease risk factors in a large, representative English population.

    Science.gov (United States)

    Tabassum, Faiza; Batty, G David

    2013-01-01

    The National Institute for Health and Clinical Excellence (NICE) has recently released obesity guidelines for health risk. For the first time in the UK, we estimate the utility of these guidelines by relating them to the established cardiovascular disease (CVD) risk factors. Health Survey for England (HSE) 2006, a population-based cross-sectional study in England was used with a sample size of 7225 men and women aged ≥35 years (age range: 35-97 years). The following CVD risk factor outcomes were used: hypertension, diabetes, total and high density lipoprotein cholesterol, glycated haemoglobin, fibrinogen, C-reactive protein and Framingham risk score. Four NICE categories of obesity were created based on body mass index (BMI) and waist circumference (WC): no risk (up to normal BMI and low/high WC); increased risk (normal BMI & very high WC, or obese & low WC); high risk (overweight & very high WC, or obese & high WC); and very high risk (obese I & very high WC or obese II/III with any levels of WC. Men and women in the very high risk category had the highest odds ratios (OR) of having unfavourable CVD risk factors compared to those in the no risk category. For example, the OR of having hypertension for those in the very high risk category of the NICE obesity groupings was 2.57 (95% confidence interval 2.06 to 3.21) in men, and 2.15 (1.75 to 2.64) in women. Moreover, a dose-response association between the adiposity groups and most of the CVD risk factors was observed except total cholesterol in men and low HDL in women. Similar results were apparent when the Framingham risk score was the outcome of interest. In conclusion, the current NICE definitions of obesity show utility for a range of CVD risk factors and CVD risk in both men and women.

  16. Long-term dietary habits and interventions in solid-organ transplantation.

    Science.gov (United States)

    Zeltzer, Stuart M; Taylor, David O; Tang, W H Wilson

    2015-11-01

    Diet and nutrition are moving to the forefront of modern primary and preventive care to help address the rising burden of chronic diseases among the general population. Such a movement has yet to occur formally across the field of transplantation. We therefore looked to establish the current base of knowledge regarding diet, nutrition and solid-organ transplantation. A limited number of focused studies looking into the dietary habits of solid-organ transplant patients have been performed and many of the available studies have detailed the nutritional status in the peri-operative period. Frequently described, however, is the heavy incidence of metabolic abnormalities, such as obesity, dyslipidemia and diabetes, occurring after solid-organ transplantation. Optimistically, several studies have noted improvement in several metabolic abnormalities with the use of dietary interventions in the post-transplant period. Despite these positive results, few consensus guidelines for post-transplant diet have been established and nutritional support among transplant programs remains limited. Although there are many hurdles to implementation of detailed dietary recommendations and nutritional support for transplant patients, creating such programs and guidelines could dramatically impact long-term outcomes and burden of chronic metabolic disease for transplant recipients.

  17. Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

    OpenAIRE

    Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

    2012-01-01

    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability ...

  18. Dietary biomarkers: advances, limitations and future directions

    Directory of Open Access Journals (Sweden)

    Hedrick Valisa E

    2012-12-01

    Full Text Available Abstract The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status.

  19. Dietary biomarkers: advances, limitations and future directions.

    Science.gov (United States)

    Hedrick, Valisa E; Dietrich, Andrea M; Estabrooks, Paul A; Savla, Jyoti; Serrano, Elena; Davy, Brenda M

    2012-12-14

    The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure) without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status.

  20. Importance of dietary fiber in childhood.

    Science.gov (United States)

    Williams, C L

    1995-10-01

    Dietary fiber has important health benefits in childhood, especially in promoting normal laxation. Currently, children consume amounts of dietary fiber that appear to be inadequate for optimal health promotion and disease prevention. It is prudent to recommend that children older than 2 years of age increase dietary fiber intake to an amount equal to or greater than their age + 5 g/day. According to the "age + 5" rule dietary fiber intake would increase from 8 g/day at age 3 years to 25 g/day by age 20 years. After age 20, dietary fiber levels of 25 to 35 g/day are recommended. Dietary fiber intake should be increased gradually in childhood by increasing consumption of a variety of fruits, vegetables, legumes, cereals, and other whole-grain products. Although very high fiber intake in childhood could have adverse effects, the potential health benefits of a moderate increase in dietary fiber substantially outweigh the possible risks, especially in highly industrialized countries such as the United States. A safe range of dietary fiber intake for children may be between age + 5 and age + 10 g/day. This range is considered safe even for children and adolescents with marginal intakes of some vitamins and minerals; should provide enough dietary fiber for normal laxation; and may provide enough added dietary fiber to help prevent chronic diseases.

  1. [AWMF-guideline: disorders related to cannabis].

    Science.gov (United States)

    Bonnet, U; Harries-Hedder, K; Leweke, F M; Schneider, U; Tossmann, P

    2004-06-01

    Actually, guidelines for treatment of substance-related disorders were written under the overall control of the DG-Sucht e. V. and the DGPPN e. V. This appears within the framework of the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft (AWMF). The leading objective of these guidelines is the description of the current scientifically proven and evidence-based medicine in addiction to derive recommendations to therapy. In this context, the guideline for treatment of cannabis-related disorders is introduced.

  2. [Update on current care guidelines: ovarian cancer].

    Science.gov (United States)

    Leminen, Arto; Auranen, Annika; Bützow, Ralf; Hietanen, Sakari; Komulainen, Marja; Kuoppala, Tapio; Mäenpää, Johanna; Puistola, Ulla; Vuento, Maarit; Vuorela, Piia; Yliskoski, Merja

    2012-01-01

    Ovarian cancer is the most lethal gynaecological cancer. It appears that seemingly ovarian or primary peritoneal carcinomas, in fact, originate from fimbriae. BRCA1/2 mutation carriers are recommended for the removal of ovaries and fimbriae, to reduce the risk of cancer. Treatment of epithelial ovarian cancer is based on the combination of surgery and chemotherapy. The residual tumour volume at the primary operation is the most important predictive factor of survival. The best response at the primary treatment is observed with combination chemotherapy with taxane and platinum. Adding bevacitzumab to first line chemotherapy may improve survival.

  3. Current guidelines in defining therapeutic strategies.

    Science.gov (United States)

    Ferrajoli, Alessandra; Keating, Michael J

    2004-08-01

    The past three decades have brought major changes in the approach toward chronic lymphocytic leukemia (CLL). This disease was considered a simple form of leukemia for which the only goal of treatment was control of the leukocytosis and of the symptoms related to disease expansion. Many biologic discoveries have increased our understanding of the disease process. New prognostic markers have been identified and are being incorporated into clinical practice. Now, CLL is considered a complex and challenging leukemia for which multiple treatment options are emerging, from chemotherapy to monoclonal antibodies, from vaccines to immunomodulatory strategies. The evaluation of treatment results also has been revolutionized: clones carrying genetic aberrations are monitored, and patients who have had a response are assessed for the presence of minimal residual disease.

  4. [Update on current care guidelines. Neck pain].

    Science.gov (United States)

    2009-01-01

    Neck pain is very common. Age, female gender, obesity, and several physical and psychological work related factors increase the risk while physical activity appears to decrease it. Non-specific neck pain is most common but serious or specific illness must be ruled out and neural compression identified. Patients are encouraged to remain active and improve their ergonomics. Acute neck pain often disappears without any special treatment. Paracetamol is the primary pain medication. Multidisciplinary treatment is recommended if disabling pain has lasted for two months, and intensive muscle exercises in chronic neck pain. Progressive muscle weakness and myelopathy indicate a surgical assessment.

  5. [Update on Current Care Guideline: Headache (children)].

    Science.gov (United States)

    HämäläInen, Mirja; Katri, Laimi; Laukkala, Tanja; Nokelainen, Pekka; Raisio, Mikael; Rantala, Heikki; Aanttila, Pirjo; Sätilä, Heli

    2016-01-01

    The majority of children with recurrent headaches can be effectively treated in the primary health care. Paracetamol and ibuprofen are the recommended first-line pain medications. Limited evidence is available on the effectiveness of triptans in children and adolescents. However, nasal sumatriptan and possibly oral rizatriptan and nasal zolmitriptan can be considered for children and adolescents, as well as oral almotriptan for adolescents. Propranolol is the first-line prophylactic medication for migraine.

  6. Current Consensus Guidelines for Treatment of Neurocysticercosis

    Science.gov (United States)

    García, Hector H.; Evans, Carlton A. W.; Nash, Theodore E.; Takayanagui, Osvaldo M.; White, A. Clinton; Botero, David; Rajshekhar, Vedantam; Tsang, Victor C. W.; Schantz, Peter M.; Allan, James C.; Flisser, Ana; Correa, Dolores; Sarti, Elsa; Friedland, Jon S.; Martinez, S. Manuel; Gonzalez, Armando E.; Gilman, Robert H.; Del Brutto, Oscar H.

    2002-01-01

    Taenia solium neurocysticercosis is a common cause of epileptic seizures and other neurological morbidity in most developing countries. It is also an increasingly common diagnosis in industrialized countries because of immigration from areas where it is endemic. Its clinical manifestations are highly variable and depend on the number, stage, and size of the lesions and the host's immune response. In part due to this variability, major discrepancies exist in the treatment of neurocysticercosis. A panel of experts in taeniasis/cysticercosis discussed the evidence on treatment of neurocysticercosis for each clinical presentation, and we present the panel's consensus and areas of disagreement. Overall, four general recommendations were made: (i) individualize therapeutic decisions, including whether to use antiparasitic drugs, based on the number, location, and viability of the parasites within the nervous system; (ii) actively manage growing cysticerci either with antiparasitic drugs or surgical excision; (iii) prioritize the management of intracranial hypertension secondary to neurocysticercosis before considering any other form of therapy; and (iv) manage seizures as done for seizures due to other causes of secondary seizures (remote symptomatic seizures) because they are due to an organic focus that has been present for a long time. PMID:12364377

  7. [Update on Current Care Guideline: Sinusitis].

    Science.gov (United States)

    Hytönen, Maija; Nokso-Koivisto, Johanna; Huovinen, Pentti; Ilkko, Eero; Jousimaa, Jukkapekka; Kivistö, Juho; Korppi, Matti; Liira, Helena; Malmivaara, Antti; Numminen, Jura; Pirilä, Tapio

    2013-01-01

    Patients with common cold have often symptoms similar to sinusitis. These symptoms often resolve in time, but symptomatic treatment (e.g. analgesics, decongestants) may be used. If symptoms continue for over 10 days, or severe symptoms continue for over 3 days, or symptoms turn worse in the course of the disease, bacterial sinusitis should be suspected. Diagnosis is based on clinical findings, and can be confirmed with ultrasound examination. Amoxicillin, penicillin or doxicyclin are recommended for bacterial sinusitis. Patients with chronic or recurrent sinusitis should be referred to specialist care.

  8. Dietary carbohydrate restriction as the first approach in diabetes management

    DEFF Research Database (Denmark)

    Feinman, Richard D; Pogozelski, Wendy K; Astrup, Arne;

    2015-01-01

    , in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns......The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications...... side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least...

  9. Dietary carbohydrate restriction as the first approach in diabetes management

    DEFF Research Database (Denmark)

    Feinman, Richard D; Pogozelski, Wendy K; Astrup, Arne;

    2015-01-01

    , in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns...... side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least......The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications...

  10. Dietary treatments of obesity.

    Science.gov (United States)

    Moloney, M

    2000-11-01

    Numerous dietary treatments that purport to promote something unique for stimulating weight loss have been published. These treatments include fad diets, diets formulated by various commercial slimming clubs, very-low-energy diets (VLCD) and conventional diets. Fad diets may possibly reduce some weight short-term; however, there is no scientific basis to their long-term use. Commercial slimming clubs may be suitable for some individuals but they need to be properly assessed professionally. There are specific guidelines for the use of VLCD, which are only appropriate for short-term use. There is scientific evidence to suggest that conventional diets can produce both short- and long-term weight loss. A successful weight-loss programme depends on a multidisciplinary team approach. Management strategies should be devised for addressing issues such as goals, monitoring, follow-up, relapse and evaluation. Initial assessments should include medical, laboratory and anthropometric data, fitness level and dietary and behavioural attitudes. These results will form the basis of the treatment plan. Frequent visits to the clinic are fundamental in promoting continuing weight loss during the long-term maintenance stage of treatment. The visits should be made worthwhile for the patient. Realistic and attainable goals for diet, exercise and behaviour modification should be made. The diet should have a novel approach and be tailored to the needs of the patient. It should be adequate nutritionally, low in energy and fat. The overall aim should be to promote lifelong changes in lifestyle, improvement in quality of life and health risks.

  11. Role of Dietary Salt and Potassium Intake in Cardiovascular Health and Disease: A Review of the Evidence

    Science.gov (United States)

    Aaron, Kristal J.; Sanders, Paul W.

    2013-01-01

    The objective of this review is to provide a synthesis of the evidence on the effect of dietary salt and potassium intake on population blood pressure, cardiovascular disease, and mortality. Dietary guidelines and recommendations are outlined, current controversies regarding the evidence are discussed, and recommendations are made based on the evidence. Designed search strategies were used to search various databases for available studies. Randomized trials of the effect of dietary salt reduction and/or increased potassium intake on blood pressure, target organ damage, cardiovascular disease, and mortality were included. Fifty-two publications from January 1, 1990 to January 31, 2013 were identified for inclusion. Evidence from these studies demonstrate that a high salt intake not only increases blood pressure but also plays a role in endothelial dysfunction, cardiovascular structure and function, albuminuria and kidney disease progression, and cardiovascular morbidity and mortality in the general population. Conversely, dietary potassium attenuates these effects showing a linkage to reduction in stroke rates and cardiovascular disease risk. Various sub-populations, such as overweight and obese individuals and the aging adult, exhibit a greater sensitivity to the effects of reduced salt intake and may gain the most benefits. A diet that includes modest salt restriction while increasing potassium intake serves as a strategy to prevent and/or control hypertension and decrease cardiovascular morbidity and mortality. Thus, the body of evidence supports population-wide sodium reduction and recommended increases in dietary potassium as outlined by current guidelines as an essential public health effort to prevent kidney disease, stroke, and cardiovascular disease. PMID:24001491

  12. EAU guidelines on primary urethral carcinoma

    NARCIS (Netherlands)

    Gakis, G.; Witjes, J.A.; Comperat, E.; Cowan, N.C.; Santis, M. de; Lebret, T.; Ribal, M.J.; Sherif, A.M.

    2013-01-01

    CONTEXT: The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE: To review the curre

  13. EAU guidelines on primary urethral carcinoma

    NARCIS (Netherlands)

    Gakis, G.; Witjes, J.A.; Comperat, E.; Cowan, N.C.; Santis, M. de; Lebret, T.; Ribal, M.J.; Sherif, A.M.

    2013-01-01

    CONTEXT: The European Association of Urology (EAU) Guidelines Group on Muscle-Invasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). OBJECTIVE: To review the curre

  14. Beyond Sodium, Phosphate and Potassium: Potential Dietary Interventions in Kidney Disease.

    Science.gov (United States)

    Kelly, Jaimon T; Rossi, Megan; Johnson, David W; Campbell, Katrina L

    2017-05-01

    People with kidney disease are advised to restrict individual nutrients, such as sodium, potassium, and phosphate, in line with current best practice guidelines. However, there is limited evidence to support the efficacy of single nutrient strategies, and compliance remains a challenge for clinicians to overcome. Many factors contribute to poor compliance with dietary prescriptions, including conflicting priorities for single nutrient restriction, the arduous self-monitoring required, and the health-related knock-on effects resulting from targeting these nutrients in isolation. This paper reviews the evidence base for the overall pattern of eating as a potential tool to deliver a diet intervention in which all the nutrients and foods work cumulatively and synergistically to improve clinical outcomes. These interventions may assist in kidney disease management and overcome these innate challenges that single nutrient interventions possess. Healthy dietary patterns are typically plant-based and lower in sodium and animal proteins. These patterns may have numerous mechanistic benefits for cardiovascular health in kidney disease, most notably through the increase in fruit, vegetables, and plant-based protein, as well as improved gut health through the increase in dietary fiber. The evidence to date on optimal dietary patterns points toward use of a predominantly plant-based diet, and suggests its adoption may improve clinical outcomes in dialysis patients. However, clinical trials are needed to determine whether these diet interventions are feasible, safe, and effective in this patient population. © 2017 Wiley Periodicals, Inc.

  15. Marketplace analysis demonstrates quality control standards needed for black raspberry dietary supplements.

    Science.gov (United States)

    Lee, Jungmin

    2014-06-01

    There is currently no standard for the minimum anthocyanin concentration a black raspberry dietary supplement must contain for legal sale in the US. All consumer available black raspberry products (n = 19), packaged as dietary supplements or otherwise prepared (freeze-dried whole and pre-ground powders), were purchased and analyzed for their anthocyanin composition and concentration. Seven of the 19 samples contained no anthocyanins from black raspberry fruit, while three of those seven (without black raspberry fruit) had no anthocyanins of any kind. There was a wide range of anthocyanin concentration within the remaining products (18.1-2,904.8 mg/100 g; n = 12). When expressed as per capsule or per ∼1 teaspoon, concentration ranged from 0.1 to 145.2 mg (average 28 mg; n = 12). Until US dietary supplement labeling comes under regulatory oversight similar to food guidelines, foods are a more dependable source for dietary phenolics than supplements.

  16. Self-reported dietary intake of youth with recent onset of type 2 diabetes: results from the TODAY study.

    Science.gov (United States)

    Delahanty, Linda; Kriska, Andrea; Edelstein, Sharon; Amodei, Nancy; Chadwick, Jennifer; Copeland, Kenneth; Galvin, Bryan; El Ghormli, Laure; Haymond, Morey; Kelsey, Megan M; Lassiter, Chad; Milaszewski, Kerry; Syme, Amy; Mayer-Davis, Elizabeth

    2013-03-01

    Despite the widely recognized importance of diet in managing diabetes, few studies have documented usual dietary intake in young people with type 2 diabetes. The objectives of our study were to assess dietary intake among a large, ethnically diverse cohort of young people with type 2 diabetes and compare intake to current recommendations. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study is a multicenter randomized clinical trial of 699 youth aged 10 to 17 years. At baseline, following a run-in period that included standard diabetes education, diet was assessed using a food frequency questionnaire between 2004 and 2009. Analysis of variance and nonparametric tests were used to compare mean and median nutrient intakes; logistic regression was used to compare the odds of meeting predefined dietary intake recommendation cutpoints between subgroups of age, sex, and race-ethnicity. Percent of energy from saturated fat was consistently 13% to 14% across all subgroups-substantially exceeding national recommendations. Overall, only 12% of youth met Healthy People 2010 guidelines for intake of Diabetes Association recommendations for intake of fruit consumption goals, 5% met vegetable consumption goals, and 67% met grain intake goals. Overall, dietary intake in this large cohort of young people with type 2 diabetes fell substantially short of recommendations, in ways that were consistent by sex, age, and race-ethnicity. The data suggest a critical need for better approaches to improve dietary intake of these young people.

  17. Research on Rationalization of Basketball Player Nutrition Dietary Pattern

    OpenAIRE

    Junsheng Zuo; Jia Li

    2015-01-01

    Reasonable nutritional dietary pattern is the good protection which can promote hoopster fatigue restoring, enhance exercise training effect and promote sport performance. This study analyzes necessity and significance of rationalizing research of hoopster nutritional dietary pattern by the summary of hoopster nutritional dietary pattern. And it concludes insufficient and drawback which current our country hoopster nutritional dietary pattern existing. And then it generalizes the unreasonable...

  18. Dietary intake, food processing, and cooking methods among Amish and non-Amish adults living in Ohio Appalachia: relevance to nutritional risk factors for cancer.

    Science.gov (United States)

    Cuyun Carter, Gebra B; Katz, Mira L; Ferketich, Amy K; Clinton, Steven K; Grainger, Elizabeth M; Paskett, Electra D; Bloomfield, Clara D

    2011-11-01

    This study's purpose was to examine the source, storage, preparation, and intake of food among Amish and non-Amish adults to understand dietary practices as a potential contributing factor to lower cancer incidence rates. Interviews were conducted with a random sample of 134 Amish and 154 non-Amish adults including questions about dietary practices and a 24-h dietary recall. Amish compared to non-Amish adults reported (1) less refrigeration in homes (85% vs. 100%, P food from restaurants and grocery stores (P cancer although neither group achieves current diet and cancer prevention guidelines. Lifestyle factors, screening, and healthcare access may be contributing to the lower cancer incidence rates among the Amish and these results suggest areas of intervention to reduce the cancer burden.

  19. International clinical guideline for the management of classical galactosemia: diagnosis, treatment, and follow-up.

    Science.gov (United States)

    Welling, Lindsey; Bernstein, Laurie E; Berry, Gerard T; Burlina, Alberto B; Eyskens, François; Gautschi, Matthias; Grünewald, Stephanie; Gubbels, Cynthia S; Knerr, Ina; Labrune, Philippe; van der Lee, Johanna H; MacDonald, Anita; Murphy, Elaine; Portnoi, Pat A; Õunap, Katrin; Potter, Nancy L; Rubio-Gozalbo, M Estela; Spencer, Jessica B; Timmers, Inge; Treacy, Eileen P; Van Calcar, Sandra C; Waisbren, Susan E; Bosch, Annet M

    2017-03-01

    Classical galactosemia (CG) is an inborn error of galactose metabolism. Evidence-based guidelines for the treatment and follow-up of CG are currently lacking, and treatment and follow-up have been demonstrated to vary worldwide. To provide patients around the world the same state-of-the-art in care, members of The Galactosemia Network (GalNet) developed an evidence-based and internationally applicable guideline for the diagnosis, treatment, and follow-up of CG. The guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A systematic review of the literature was performed, after key questions were formulated during an initial GalNet meeting. The first author and one of the working group experts conducted data-extraction. All experts were involved in data-extraction. Quality of the body of evidence was evaluated and recommendations were formulated. Whenever possible recommendations were evidence-based, if not they were based on expert opinion. Consensus was reached by multiple conference calls, consensus rounds via e-mail and a final consensus meeting. Recommendations addressing diagnosis, dietary treatment, biochemical monitoring, and follow-up of clinical complications were formulated. For all recommendations but one, full consensus was reached. A 93 % consensus was reached on the recommendation addressing age at start of bone density screening. During the development of this guideline, gaps of knowledge were identified in most fields of interest, foremost in the fields of treatment and follow-up.

  20. 21 CFR 101.45 - Guidelines for the voluntary nutrition labeling of raw fruits, vegetables, and fish.

    Science.gov (United States)

    2010-04-01

    ... listings for trans fat, dietary fiber, and sugars may be omitted from the charts or individual nutrition... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Guidelines for the voluntary nutrition labeling of... Nutrition Labeling Requirements and Guidelines § 101.45 Guidelines for the voluntary nutrition labeling of...

  1. [Elaboration and critical evaluation of clinical guidelines].

    Science.gov (United States)

    García Villar, C

    2015-11-01

    Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written.

  2. REVIEW OF REVISION OF CURRENT GOOD MANUFACTURING PRACTICE FOR DIETARY SUPPLEMENTS IN THE UNITED STATES%美国膳食补充剂良好生产规范及其制修订过程

    Institute of Scientific and Technical Information of China (English)

    刘奂辰; 张志强; 张立实

    2010-01-01

    [目的]了解美国膳食补充剂良好生产规范(Current Good Manufacturing Practice for Dietary Supplements)在制修订过程中的主要变化、特点和影响,为我国相关法规的修订提供参考.[方法]收集美国食品药品监督管理局发布的各版本膳食补充剂良好生产规范,比较其主要差异及主要影响.[结果]美国的膳食补充剂良好生产规范从提议到发布历经13年,共有3个不同版本发布,从原料检验、标准操作规范、记录、召回等方面傲了越来越严格的规定.[结论]在规范的修订过程中国,应尽量征求多方面的意见,尤其是中小企业的意见,以便使规范的实施更具可行性.

  3. Development of clinical practice guidelines.

    Science.gov (United States)

    Hollon, Steven D; Areán, Patricia A; Craske, Michelle G; Crawford, Kermit A; Kivlahan, Daniel R; Magnavita, Jeffrey J; Ollendick, Thomas H; Sexton, Thomas L; Spring, Bonnie; Bufka, Lynn F; Galper, Daniel I; Kurtzman, Howard

    2014-01-01

    Clinical practice guidelines (CPGs) are intended to improve mental, behavioral, and physical health by promoting clinical practices that are based on the best available evidence. The American Psychological Association (APA) is committed to generating patient-focused CPGs that are scientifically sound, clinically useful, and informative for psychologists, other health professionals, training programs, policy makers, and the public. The Institute of Medicine (IOM) 2011 standards for generating CPGs represent current best practices in the field. These standards involve multidisciplinary guideline development panels charged with generating recommendations based on comprehensive systematic reviews of the evidence. The IOM standards will guide the APA as it generates CPGs that can be used to inform the general public and the practice community regarding the benefits and harms of various treatment options. CPG recommendations are advisory rather than compulsory. When used appropriately, high-quality guidelines can facilitate shared decision making and identify gaps in knowledge.

  4. Inventory of Cancer Guidelines: a tool to advance the guideline enterprise and improve the uptake of evidence.

    Science.gov (United States)

    Brouwers, Melissa C; Rawski, Ellen; Spithoff, Karen; Oliver, Thomas K

    2011-04-01

    The Inventory of Cancer Guidelines (ICG) was designed to mitigate challenges associated with inconsistencies in the quality of cancer guidelines, keeping guidelines current and the duplication of effort in guideline development. The ICG is a searchable database of quality-appraised guidelines in cancer control that also includes designations of guidelines in progress, those in need of an update and those currently being updated. From a clinical perspective, the majority of the completed guidelines target breast, lung, colorectal and prostate cancers, and focus on the treatment stage of the cancer continuum. There is considerable variability in guideline quality both within and across guideline developers, as measured by the Appraisal of Guidelines for Research and Evaluation II. Quality domains of applicability and editorial independence are the guideline quality domains that score the poorest. While the ability to inform on the status of cancer control guidelines is important, the real potential of the ICG is in its ability to leverage positive change in the guideline enterprise. Pilot projects are underway to use data from the ICG to tailor audit and feedback interventions for guideline developers and to pursue collaborative updating and guideline adaptation initiatives, using the ICG as the platform from which these partnerships can evolve.

  5. Dietary Salt Intake and Hypertension

    Science.gov (United States)

    2014-01-01

    Over the past century, salt has been the subject of intense scientific research related to blood pressure elevation and cardiovascular mortalities. Moderate reduction of dietary salt intake is generally an effective measure to reduce blood pressure. However, recently some in the academic society and lay media dispute the benefits of salt restriction, pointing to inconsistent outcomes noted in some observational studies. A reduction in dietary salt from the current intake of 9-12 g/day to the recommended level of less than 5-6 g/day will have major beneficial effects on cardiovascular health along with major healthcare cost savings around the world. The World Health Organization (WHO) strongly recommended to reduce dietary salt intake as one of the top priority actions to tackle the global non-communicable disease crisis and has urged member nations to take action to reduce population wide dietary salt intake to decrease the number of deaths from hypertension, cardiovascular disease and stroke. However, some scientists still advocate the possibility of increased risk of CVD morbidity and mortality at extremes of low salt intake. Future research may inform the optimal sodium reduction strategies and intake targets for general populations. Until then, we have to continue to build consensus around the greatest benefits of salt reduction for CVD prevention, and dietary salt intake reduction strategies must remain at the top of the public health agenda. PMID:25061468

  6. Modeling dietary fiber intakes in US adults: implications for public policy

    Science.gov (United States)

    The goal of this study was to simulate the application of the dietary recommendations to increase dietary fiber (DF)-containing foods. This study used 24-hour dietary recalls from NHANES 2003-2006 to model the impact of different approaches of increasing DF with current dietary patterns of US adults...

  7. Dietary prebiotics: Current status and new definition

    Science.gov (United States)

    In November 2008, a group of scientists met at the 6th Meeting of the International Scientific Association of Probiotics and Prebiotics (ISAPP) in London, Ontario. The aim was to discuss the functionality of prebiotics. As a result of this, it was decided that the prebiotic field as it stands is dom...

  8. CDC grand rounds: dietary sodium reduction - time for choice.

    Science.gov (United States)

    2012-02-10

    Excess dietary sodium is a major contributor to hypertension (high blood pressure) and a critical public health issue in the United States. Nearly one in three U.S. adults, or 68 million persons, has hypertension, and half of those do not have their condition under control. Hypertension is a major contributor to cardiovascular diseases, which are a leading cause of death, disability, and health-care costs in the United States. The average sodium intake among persons in the United States aged ≥2 years is 3,266 mg/day (excluding table salt). Current dietary guidelines recommend that reducing consumption of sodium to sodium intake by most U.S. residents considerably exceeds recommended levels. Reducing sodium intake to 2,300 mg/day potentially could prevent 11 million cases of hypertension and save billions of dollars in health-care expenditures; reducing sodium intake further would yield additional benefits. To achieve those reductions and help consumers make healthful choices, expanded educational efforts and monitoring of the sodium content of the food supply are needed. Increased availability of lower sodium products and reductions in the amount of sodium in foods served or sold in the marketplace also are needed.

  9. Dietary Restriction and Nutrient Balance in Aging

    Directory of Open Access Journals (Sweden)

    Júlia Santos

    2016-01-01

    Full Text Available Dietary regimens that favour reduced calorie intake delay aging and age-associated diseases. New evidences revealed that nutritional balance of dietary components without food restriction increases lifespan. Particular nutrients as several nitrogen sources, proteins, amino acid, and ammonium are implicated in life and healthspan regulation in different model organisms from yeast to mammals. Aging and dietary restriction interact through partially overlapping mechanisms in the activation of the conserved nutrient-signalling pathways, mainly the insulin/insulin-like growth factor (IIS and the Target Of Rapamycin (TOR. The specific nutrients of dietary regimens, their balance, and how they interact with different genes and pathways are currently being uncovered. Taking into account that dietary regimes can largely influence overall human health and changes in risk factors such as cholesterol level and blood pressure, these new findings are of great importance to fully comprehend the interplay between diet and humans health.

  10. Obesity: Have new guidelines overlooked the role of diet composition?

    Science.gov (United States)

    Astrup, Arne; Brand-Miller, Jennie

    2014-03-01

    New US guidelines for the management of overweight and obesity have disregarded robust evidence from intervention trials demonstrating the importance of dietary factors for weight control and disease prevention. This omission implies that diet composition does not matter, a stance that is potentially counterproductive for prevention and treatment strategies.

  11. Current assessment of the effects of environmental chemicals on the mammary gland in guideline rodent studies by the U.S. Environmental Protection Agency (U.S. EPA), Organisation for Economic Co-operation and Development (OECD), and National Toxicology Program (NTP).

    Science.gov (United States)

    Makris, Susan L

    2011-08-01

    Evaluation of the structural and/or functional integrity of the mammary gland (MG) across life stages is integral to the assessment of developmental, reproductive, and carcinogenic risk for environmental chemicals. In this commentary I characterize MG assessment recommended in U.S. Environmental Protection Agency, Organisation for Economic Co-operation and Development, and National Toxicology Program guideline toxicology study protocols and identify any information gaps for the evaluation of MG development, structure, and function. Several data gaps, issues, and challenges were identified. Current guidelines that include a lactation phase do not provide specific recommendations to record observations on maternal or offspring lactation or nursing behavior. In guideline studies, the assessment of MG toxicity often relies upon indirect, nonspecific, or surrogate end points, and information that could be useful in the interpretation of these data (e.g., mode of action or toxicokinetics) is often unavailable. Most guideline studies designed to assess general organ toxicity do not expose test animals during sensitive stages of MG development; histopathological evaluation of the developing MG is not routinely conducted; and evaluation of MG tissue for both sexes is inconsistently recommended. I propose the following general recommendations to enhance MG assessment in guideline toxicology studies: a) inclusion of more specific criteria for the evaluation of MG end points in guideline language, b) inclusion of histopathological evaluation of MG development (using whole-mount techniques) in existing or new guideline protocols that include offspring with perinatal and/or pubertal treatment, c) incorporation of perinatal exposures into rodent subchronic and carcinogenicity assays, and d) expansion of the histopathological evaluation of male MG tissue.

  12. Dietary Crude Lecithin Increases Systemic Availability of Dietary Docosahexaenoic Acid with Combined Intake in Rats.

    Science.gov (United States)

    van Wijk, Nick; Balvers, Martin; Cansev, Mehmet; Maher, Timothy J; Sijben, John W C; Broersen, Laus M

    2016-07-01

    Crude lecithin, a mixture of mainly phospholipids, potentially helps to increase the systemic availability of dietary omega-3 polyunsaturated fatty acids (n-3 PUFA), such as docosahexaenoic acid (DHA). Nevertheless, no clear data exist on the effects of prolonged combined dietary supplementation of DHA and lecithin on RBC and plasma PUFA levels. In the current experiments, levels of DHA and choline, two dietary ingredients that enhance neuronal membrane formation and function, were determined in plasma and red blood cells (RBC) from rats after dietary supplementation of DHA-containing oils with and without concomitant dietary supplementation of crude lecithin for 2-3 weeks. The aim was to provide experimental evidence for the hypothesized additive effects of dietary lecithin (not containing any DHA) on top of dietary DHA on PUFA levels in plasma and RBC. Dietary supplementation of DHA-containing oils, either as vegetable algae oil or as fish oil, increased DHA, eicosapentaenoic acid (EPA), and total n-3 PUFA, and decreased total omega-6 PUFA levels in plasma and RBC, while dietary lecithin supplementation alone did not affect these levels. However, combined dietary supplementation of DHA and lecithin increased the changes induced by DHA supplementation alone. Animals receiving a lecithin-containing diet also had a higher plasma free choline concentration as compared to controls. In conclusion, dietary DHA-containing oils and crude lecithin have synergistic effects on increasing plasma and RBC n-3 PUFA levels, including DHA and EPA. By increasing the systemic availability of dietary DHA, dietary lecithin may increase the efficacy of DHA supplementation when their intake is combined.

  13. 5 CFR 1312.10 - Systematic review guidelines.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security Officer will prepare and keep current such guidelines as are required by Executive Order 12958 for...

  14. Treatment Guidelines for Children and Adolescents with Bipolar Disorder

    Science.gov (United States)

    Kowatch, Robert A.; Fristad, Mary; Birmaher, Boris; Wagner, Karen Dineen; Findling, Robert L.; Hellander, Martha

    2005-01-01

    Clinicians who treat children and adolescents with bipolar disorder desperately need current treatment guidelines. These guidelines were developed by expert consensus and a review of the extant literature about the diagnosis and treatment of pediatric bipolar disorders. The four sections of these guidelines include diagnosis, comorbidity, acute…

  15. Updated guidelines on digital media use by children.

    Science.gov (United States)

    Licata, Joseph Isaac; Baker, Amy Elizabeth

    2017-04-01

    Given the speed at which mobile media has grown recently, the updated American Academy of Pediatrics guidelines for digital technology use by children are a welcome addition to the toolbox of pediatric healthcare providers. This article discusses the changes to the guidelines as well as other useful current research not specifically included in those guidelines.

  16. EAU guidelines on chronic pelvic pain.

    Science.gov (United States)

    Fall, Magnus; Baranowski, Andrew P; Elneil, Sohier; Engeler, Daniel; Hughes, John; Messelink, Embert J; Oberpenning, Frank; de C Williams, Amanda C

    2010-01-01

    These guidelines were prepared on behalf of the European Association of Urology (EAU) to help urologists assess the evidence-based management of chronic pelvic pain (CPP) and to incorporate the recommendations into their clinical practice. To revise guidelines for the diagnosis, therapy, and follow-up of CPP patients. Guidelines were compiled by a working group and based on a systematic review of current literature using the PubMed database, with important papers reviewed for the 2003 EAU guidelines as a background. A panel of experts weighted the references. The full text of the guidelines is available through the EAU Central Office and the EAU Web site (www.uroweb.org). This article is a short version of the full guidelines text and summarises the main conclusions from the guidelines on the management of CPP. A guidelines text is presented including chapters on chronic prostate pain and bladder pain syndromes, urethral pain, scrotal pain, pelvic pain in gynaecologic practice, neurogenic dysfunctions, the role of the pelvic floor and pudendal nerve, psychological factors, general treatment of CPP, nerve blocks, and neuromodulation. These guidelines have been drawn up to provide support in the management of the large and difficult group of patients suffering from CPP.

  17. The comparison of current and previous (2002) editions of American clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome%美国新版《儿童睡眠呼吸暂停综合征诊治指南》与2002版指南的比较

    Institute of Scientific and Technical Information of China (English)

    邓力; 印根权

    2013-01-01

    2012年8月27日,美国儿科学会杂志在线发布了新版,意在指导初级保健医师对儿童青少年OSAS的诊断与治疗.自从前一版 (2002版) 指南发表后,有关OSAS研究的文献质量有明显提高.新版指南是在参考1999至2010年间发表的3 166篇文献中的350篇文献相关数据基础上所制定的.本文主要比较新版指南与2002版的不同,以及十年间对儿童OSAS认识的变化.%The current clinical practice guideline, diagnosis and management of childhood obstructive sleep apnea syndrome (OSAS), was issued in Pediatrics on line by American academy of pediatrics on August 27th, 2012. This revised guideline, intended for use by primary earc clinicians, provides recommesdations for the diagnosis and management of OSAS in children and adolescents. Since the previous guideline (version 2002) was published, studies of OSAS have bees improved significantly. The current guideline was formulated according to the relevant data from 350 of 3166 articles published from 1999 to 2010. What are the differences between the two guidelines? What are the greatest changes in cbildhood OSAS in the past 10 years? This article will focus on the comparison between these two guidelines.

  18. Dietary interventions in overweight and obese pregnant women

    DEFF Research Database (Denmark)

    Flynn, Angela C; Dalrymple, Kathryn; Barr, Suzanne

    2016-01-01

    : A systematic review of the literature, consistent with PRISMA guidelines, was performed as part of the International Weight Management in Pregnancy collaboration. STUDY SELECTION: Thirteen randomized controlled trials, which aimed to modify diet and physical activity in overweight and obese pregnant women...... gestational weight gain. CONCLUSION: This review reveals large methodological variability in dietary interventions to control gestational weight gain and improve clinical outcomes in overweight and obese pregnant women. This lack of consensus limits the ability to develop clinical guidelines and apply...

  19. Managing Ulcerative Colitis – The Guidelines and Beyond

    Directory of Open Access Journals (Sweden)

    Mitchell RKL Lie

    2013-11-01

    Full Text Available Management guidelines offer clinicians clear, evidence-based and often succinct treatment advice. For ulcerative colitis these guidelines describe the use of 5-ASA, corticosteroids, thiopurines, cyclosporine, and anti-TNFα therapies. However, guidelines do have some drawbacks, mainly a lack of concrete advice concerning patients resistant to these aforementioned therapies. This review gives a short overview of current guidelines and addresses treatment alternatives for conventional therapies.

  20. Adherence to cancer prevention guidelines and risk of breast cancer.

    Science.gov (United States)

    Catsburg, Chelsea; Miller, Anthony B; Rohan, Thomas E

    2014-11-15

    Healthy eating patterns and keeping physically active are potentially more important for chronic disease prevention than intake or exclusion of specific food items or nutrients. To this end, many health organizations routinely publish dietary and lifestyle recommendations aimed at preventing chronic disease. Using data from the Canadian National Breast Screening Study, we investigated the association between breast cancer risk and adherence to two sets of guidelines specific for cancer prevention, namely the American Cancer Society (ACS) Guidelines and the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations. At baseline, 49,613 women completed dietary and lifestyle questionnaires and height and weight measurements were taken. During a mean follow-up of 16.6 years, 2,503 incident cases of breast cancer were ascertained. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of meeting each guideline, and number of guidelines met, with breast cancer risk. The two sets of guidelines yielded similar results. Specifically, adherence to all six ACS guidelines was associated with a 31% reduction in breast cancer risk when compared to subjects adhering to at most one guideline (HR=0.69; 95% CI=0.49-0.97); similarly, adherence to six or seven of the WCRF/AICR guidelines was also associated with a 31% reduction in breast cancer risk (HR=0.69; 95% CI=0.47-1.00). Under either classification, meeting each additional guideline was associated with a 4-6% reduction in breast cancer risk. These results suggest that adherence to cancer prevention guidelines is associated with a reduced risk of breast cancer. © 2014 UICC.

  1. Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis.

    Science.gov (United States)

    Watanabe, Sumio; Hashimoto, Etsuko; Ikejima, Kenichi; Uto, Hirofumi; Ono, Masafumi; Sumida, Yoshio; Seike, Masataka; Takei, Yoshiyuki; Takehara, Tetsuo; Tokushige, Katsutoshi; Nakajima, Atsushi; Yoneda, Masashi; Saibara, Toshiji; Shiota, Goshi; Sakaida, Isao; Nakamuta, Makoto; Mizuta, Toshihiko; Tsubouchi, Hirohito; Sugano, Kentaro; Shimosegawa, Tooru

    2015-04-01

    Nonalcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease in industrialized countries worldwide, and has become a serious public health issue not only in Western countries but also in many Asian countries including Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease, which often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma. In turn, a large proportion of NAFLD/NASH is the liver manifestation of metabolic syndrome, suggesting that NAFLD/NASH plays a key role in the pathogenesis of systemic atherosclerotic diseases. Currently, a definite diagnosis of NASH requires liver biopsy, though various noninvasive measures are under development. The mainstays of prevention and treatment of NAFLD/NASH include dietary restriction and exercise; however, pharmacological approaches are often necessary. Currently, vitamin E and thiazolidinedione derivatives are the most evidence-based therapeutic options, although the clinical evidence for long-term efficacy and safety is limited. This practice guideline for NAFLD/NASH, established by the Japanese Society of Gastroenterology in cooperation with The Japan Society of Hepatology, covers lines of clinical evidence reported internationally in the period starting from 1983 to January 2012, and each clinical question was evaluated using the GRADE system. Based on the primary release of the full version in Japanese, this English summary provides the core essentials of this clinical practice guideline comprising the definition, diagnosis, and current therapeutic recommendations for NAFLD/NASH in Japan.

  2. Assessing the perceived quality of brachial artery Flow Mediated Dilation studies for inclusion in meta-analyses and systematic reviews: Description of data employed in the development of a scoring ;tool based on currently accepted guidelines

    Directory of Open Access Journals (Sweden)

    Arno Greyling

    2016-09-01

    Full Text Available Brachial artery Flow Mediated Dilation (FMD is widely used as a non-invasive measure of endothelial function. Adherence to expert consensus guidelines on FMD measurement has been found to be of vital importance to obtain reproducible data. This article lists the literature data which was considered in the development of a tool to aid in the objective judgement of the extent to which published studies adhered to expert guidelines for FMD measurement. Application of this tool in a systematic review of FMD studies (http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.011 (Greyling et al., 2016 [1] indicated that adherence to expert consensus guidelines is strongly correlated to the reproducibility of FMD data.

  3. Dietary Sodium Intake in Type 2 Diabetes.

    Science.gov (United States)

    Provenzano, Laura Ferreira; Stark, Sue; Steenkiste, Ann; Piraino, Beth; Sevick, Mary Ann

    2014-07-01

    Patients with type 2 diabetes have an increased risk for cardiovascular and chronic kidney disease. Superimposed hypertension further increases the risk and is associated with increased dietary sodium intake. There are few data available on dietary sodium intake in type 2 diabetes. The aim of this study was to quantify dietary sodium intake in a cohort of self-referred patients with type 2 diabetes and to identify sociodemographic characteristics associated with it. Sodium intake in this cohort was far greater than current recommendations. Increased awareness of sodium intake in this population might lead to target interventions to reduce sodium intake and potentially improve long-term outcomes.

  4. Dietary strategies for cancer prevention.

    Science.gov (United States)

    Bal, D G; Foerster, S B

    1993-08-01

    Two-thirds of cancer cases are associated with two lifestyle practices: 35% with the typical American diet, and 30% with tobacco use. In contrast to the field of tobacco control, research and resources dedicated to the field of nutrition have been limited, in part because dietary change has been considered controversial and requires a more complex set of interventions. This series of papers reviews the science base underlying diet as a cancer control strategy, including research about diet-cancer relationships, current nutrition policy recommendations, American dietary trends, models of dietary behavior change, and diet in health care delivery. The history of technology transfer of new knowledge into widespread application will be compared and contrasted with other cancer control measures. There is scientific and policy agreement about three priority dietary goals for the year 2000: increase fruit and vegetable consumption to 5 or more servings every day, increase breads, cereals, and legumes to 6 or more servings daily, and decrease fat to no more than 30% of total calories. Current data do not indicate that these goals will be reached. As yet there is no organized effort, with clearly identified steps, to translate research into practice. The parallel with delays in implementing other cancer control measures, including Papanicolaou testing, mammography, and tobacco intervention, is striking. Without resources dedicated to dietary modification in the general population, it is not likely that the potential savings of more than 300,000 new cases, 160,000 deaths, and the $25 billion in associated costs will be realized in the foreseeable future.

  5. Evaluation of methodologies for assessing the overall diet: dietary quality scores and dietary pattern analysis.

    Science.gov (United States)

    Ocké, Marga C

    2013-05-01

    This paper aims to describe different approaches for studying the overall diet with advantages and limitations. Studies of the overall diet have emerged because the relationship between dietary intake and health is very complex with all kinds of interactions. These cannot be captured well by studying single dietary components. Three main approaches to study the overall diet can be distinguished. The first method is researcher-defined scores or indices of diet quality. These are usually based on guidelines for a healthy diet or on diets known to be healthy. The second approach, using principal component or cluster analysis, is driven by the underlying dietary data. In principal component analysis, scales are derived based on the underlying relationships between food groups, whereas in cluster analysis, subgroups of the population are created with people that cluster together based on their dietary intake. A third approach includes methods that are driven by a combination of biological pathways and the underlying dietary data. Reduced rank regression defines linear combinations of food intakes that maximally explain nutrient intakes or intermediate markers of disease. Decision tree analysis identifies subgroups of a population whose members share dietary characteristics that influence (intermediate markers of) disease. It is concluded that all approaches have advantages and limitations and essentially answer different questions. The third approach is still more in an exploration phase, but seems to have great potential with complementary value. More insight into the utility of conducting studies on the overall diet can be gained if more attention is given to methodological issues.

  6. Public informations guidelines

    Energy Technology Data Exchange (ETDEWEB)

    None

    1986-06-01

    The purpose of these Public Information Guidelines is to provide principles for the implementation of the NWPA mandate and the Mission Plan requirements for the provision of public information. These Guidelines set forth the public information policy to be followed by all Office of Civilian Radioactive Waste Management (OCRWM) performance components. The OCRWM offices should observe these Guidelines in shaping and conducting public information activities.

  7. Current role of MDCT in the diagnosis of coronary artery disease (2011). A clinical guideline of the Austrian Societies of Cardiology and Radiology; Aktueller Stellenwert der MSCTA in der Koronargefaessdiagnostik (2011). Klinischer Leitfaden der Oesterreichischen Gesellschaften fuer Kardiologie und Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Hergan, K. [Salzburger Landeskliniken, Paracelsus Medizinische Privatuniv. (Austria). Universitaetsinst. fuer Radiologie; Globits, S. [Landesklinikum St. Poelten (Austria). 3. Medizinische Abt./Kardiologie; Loewe, C. [Medizinische Univ. Wien (AT). Universitaetsklinik fuer Radiodiagnostik] (and others)

    2011-10-15

    The clinical guideline of the Austrian Societies for Cardiology and Radiology on the actual role of MDCT in the diagnosis of coronary artery diseases includes the following issues: CT calcium scoring; CT angiography (CTA) of the coronaries; actually recommended application of MDCR; generally inappropriate use of the technique for specific patients; radiation exposure; structural and organizational framework.

  8. a food-based dietary guideline for South Africa

    African Journals Online (AJOL)

    2013-04-09

    Apr 9, 2013 ... growth and high energy needs of infants under two years of age, reduced-fat milk .... considered in situations in which overweight and obesity are of concern, for .... responsible lactase gene, haplotype, and found that the derived allele is ..... Milk and acid-base balance: proposed hypothesis versus scientific ...

  9. After Guidelines, What?

    Directory of Open Access Journals (Sweden)

    Dennis M Bowie

    2004-01-01

    Full Text Available In a recent survey, Canadian Thoracic Society (CTS members indicated that they feel our association should be involved in the production of guidelines (1. There is evidence in the literature that suggests guidelines can have some effect in changing behaviour, although this is variable and modest at best. Certainly, the production of guidelines is not without costs, particularly in time spent by experts in reviewing the literature and producing them. For good reasons, delays frequently occur in their production, often leading to recommendations that may be outdated. People sometimes forget that one of the most important reasons for producing guidelines is to identify questions that require future research.

  10. American Clinical Neurophysiology Society Guideline 7: Guidelines for EEG Reporting.

    Science.gov (United States)

    Tatum, William O; Olga, Selioutski; Ochoa, Juan G; Munger Clary, Heidi; Cheek, Janna; Drislane, Frank; Tsuchida, Tammy N

    2016-08-01

    This EEG Guideline incorporates the practice of structuring a report of results obtained during routine adult electroencephalography. It is intended to reflect one of the current practices in reporting an EEG and serves as a revision of the previous guideline entitled "Writing an EEG Report." The goal of this guideline is not only to convey clinically relevant information, but also to improve interrater reliability for clinical and research use by standardizing the format of EEG reports. With this in mind, there is expanded documentation of the patient history to include more relevant clinical information that can affect the EEG recording and interpretation. Recommendations for the technical conditions of the recording are also enhanced to include post hoc review parameters and type of EEG recording. Sleep feature documentation is also expanded upon. More descriptive terms are included for background features and interictal discharges that are concordant with efforts to standardize terminology. In the clinical correlation section, examples of common clinical scenarios are now provided that encourages uniformity in reporting. Including digital samples of abnormal waveforms is now readily available with current EEG recording systems and may be beneficial in augmenting reports when controversial waveforms or important features are encountered.

  11. [Management of hypertension (ESC Guideline 2007/DHL Guideline 2008)].

    Science.gov (United States)

    Krauss, Timothy; Schunkert, Heribert

    2009-02-01

    The 2007 ESH/ESC (European Society of Hypertension/European Society of Cardiology) guidelines for the management of arterial hypertension focus on the individual patient with his specific cardiovascular risk profile. The existing hypertension classification remains the same as in previous editions. However, specific patient characteristics and risk profiles require a more individualized approach. Recommended diagnostic procedures have been extended in order to detect existing subclinical organ damage and/or established cardiovascular or renal diseases at an early stage. Urgency and mode of therapeutic approach can directly be derived from the relevant risk stratification matrix which continues to be an integral component of the current guidelines. The primary goal of treatment of the hypertensive patient is to achieve a maximum reduction in the long-term total risk of cardiovascular morbidity and mortality. Since blood pressure lowering per se is thought to be of major importance to achieve these goals, a number of well-established pharmaceutical substances remain at hand of the practitioner. In addition, lifestyle changes are increasingly regarded to be of high importance. In patients with established comorbidities and in young subjects the choice of a specific pharmaceutical substance class is fundamental. The gap between guideline recommendations and poor blood pressure control in medical practice remains and needs to be closed. Therefore, a collective striving of all parties involved for early detection and effective treatment is needed to overcome the current and future burden of arterial hypertension.

  12. Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials.

    Science.gov (United States)

    Chiavaroli, L; Mirrahimi, A; Sievenpiper, J L; Jenkins, D J A; Darling, P B

    2015-07-01

    Chronic kidney disease (CKD) is a major health concern associated with increased risk of cardiovascular disease, morbidity and mortality. Current CKD practice guidelines overlook dietary fiber, which is chronically low in the renal diet. However, increasing dietary fiber has been proposed to ameliorate the progress of CKD. We therefore conducted a systematic review and meta-analysis on the effect of dietary fiber intake on serum urea and creatinine as classical markers of renal health in individuals with CKD. We searched MEDLINE, EMBASE, CINHAL and the Cochrane Library for relevant clinical trials with a follow-up ⩾7 days. Data were pooled by the generic inverse variance method using random-effects models and expressed as mean difference (MD) with 95% confidence intervals (95% CIs). Heterogeneity was assessed by the Cochran Q statistic and quantified by I(2). A total of 14 trials involving 143 participants met the eligibility criteria. Dietary fiber supplementation significantly reduced serum urea and creatinine levels in the primary pooled analyses (MD, -1.76 mmol/l (95% CI, -3.00, -0.51), Pdietary fiber in the CKD population demonstrating a reduction in serum urea and creatinine, as well as highlighting the lack of clinical trials on harder end points. Larger, longer, higher-quality clinical trials measuring a greater variety of uremic toxins in CKD are required (NCT01844882).

  13. DIMA – Annotation guidelines for German intonation

    DEFF Research Database (Denmark)

    Kügler, Frank; Smolibocki, Bernadett; Arnold, Denis

    2015-01-01

    easier since German intonation is currently annotated according to different models. To this end, we aim to provide guidelines that are easy to learn. The guidelines were evaluated running an inter-annotator reliability study on three different speech styles (read speech, monologue and dialogue......This paper presents newly developed guidelines for prosodic annotation of German as a consensus system agreed upon by German intonologists. The DIMA system is rooted in the framework of autosegmental-metrical phonology. One important goal of the consensus is to make exchanging data between groups...

  14. Dietary supplement use and colorectal tumors : from prevention to diagnosis

    NARCIS (Netherlands)

    Bröring, R.C.

    2015-01-01

    Background: Expert guidelines formulated by the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) advised no use of dietary supplements for cancer prevention. However, it is unclear whether those recommendations also apply to populations at high

  15. Japanese Guideline for Allergic Rhinitis 2014

    OpenAIRE

    Kimihiro Okubo; Yuichi Kurono; Shigeharu Fujieda; Satoshi Ogino; Eiichi Uchio; Hiroshi Odajima; Hiroshi Takenaka

    2014-01-01

    Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 7th editi...

  16. Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

    NARCIS (Netherlands)

    Peter, W.F.H.; Jansen, M.J.; Hurkmans, E.J.; Bloo, H.; Dekker-Bakker, L.M.M.C.J.; Dilling, R.G.; Hilberdink, W.K.H.A.; Kersten-Smit, C.; Rooij, M. de; Veenhof, C.; Vermeulen, H.M.; Vos, R.J. de; Schoones, J.W.; Vliet Vlieland, T.P.M.

    2011-01-01

    BACKGROUND: An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. METHODS: A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial

  17. Tolerability and safety of commonly used dietary supplements and nutraceuticals with lipid-lowering effects.

    Science.gov (United States)

    Cicero, Arrigo F G; Ferroni, Alienor; Ertek, Sibel

    2012-09-01

    Cardiovascular diseases are one of the highest causes of death and disability in industrialized countries, whereas a large portion of patients in primary prevention have cardiovascular disease risk factors that remain uncontrolled. Lifestyle interventions, including dietary supplementation with natural compounds possessing known lipid-lowering effects, are strongly supported by the international guidelines for cardiovascular disease prevention. This review provides insights on issues concerning the safety of the most commonly used dietary supplements and nutraceuticals with demonstrated lipid-lowering actions. Soluble fibers, phytosterols, soy proteins, omega 3 polyunsaturated fatty acids, monakolines, policosanols, berberine and garlic extracts are all discussed and a specific focus has been placed on their pharmacological interactions. A relatively large amount of preclinical, epidemiological and clinical evidence has demonstrated the tolerability and safety of the most commonly used dietary supplements and nutraceuticals with demonstrated lipid-lowering action. However, for most supplements and nutraceuticals, no evidence is currently available from long-term trials on morbidity and mortality. Detailed knowledge of specific health risks and pharmacological interactions for each individual compound is needed for the management of frail patients, such as children, the elderly, patients with liver or renal failure, high-risk patients, and patients consuming numerous drugs.

  18. Vietnam recommended dietary allowances 2007.

    Science.gov (United States)

    Khan, Nguyen Cong; Hoan, Pham Van

    2008-01-01

    It has been well acknowledged that Vietnam is undergoing a nutrition transition. With a rapid change in the country's reform and economic growth, food supply at the macronutrient level has improved. Changes of the Vietnamese diet include significantly more foods of animal origin, and an increase of fat/oils, and ripe fruits. Consequently, nutritional problems in Vietnam now include not only malnutrition but also overweight/obesity, metabolic syndrome and other chronic diseases related to nutrition and lifestyles. The recognition of these shifts, which is also associated with morbidity and mortality, was a major factor in the need to review and update the Recommended Dietary Allowances (RDA) for the Vietnamese population. This revised RDA established an important science-based tool for evaluation of nutrition adequacy, for teaching, and for scientific communications within Vietnam. It is expected that the 2007 Vietnam RDA and its conversion to food-based dietary guidelines will facilitate education to the public, as well as the policy implementation of programs for prevention of non-communicable chronic diseases and addressing the double burden of both under and over nutrition.

  19. Engineering Technology Curriculum Guidelines

    Science.gov (United States)

    Gershon, J. J.

    1977-01-01

    Summarizes curriculum guidelines for the following engineering technologies: chemical, industrial, mining, petroleum, nuclear, civil, mechanical, electrical, automotive, and manufacturing. In a few years, these Engineering Council for Professional Development committee guidelines are intended to become the criteria by which programs will be judged…

  20. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D.; Dakin, B.; German, A.

    2012-04-01

    The purpose of this measure guideline on ventilation cooling is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  1. Measure Guideline: Ventilation Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Springer, D. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), David, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), David, CA (United States)

    2012-04-01

    The purpose of this measure guideline is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  2. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

    The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

  3. Nonstructural seismic restraint guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Butler, D.M.; Czapinski, R.H.; Firneno, M.J.; Feemster, H.C.; Fornaciari, N.R.; Hillaire, R.G.; Kinzel, R.L.; Kirk, D.; McMahon, T.T.

    1993-08-01

    The Nonstructural Seismic Restraint Guidelines provide general information about how to secure or restrain items (such as material, equipment, furniture, and tools) in order to prevent injury and property, environmental, or programmatic damage during or following an earthquake. All SNL sites may experience earthquakes of magnitude 6.0 or higher on the Richter scale. Therefore, these guidelines are written for all SNL sites.

  4. Maintenance Trades Guidelines

    Science.gov (United States)

    Weidner, Theodore J.

    2008-01-01

    In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents…

  5. Evidence-based guidelines

    DEFF Research Database (Denmark)

    Rovira, Àlex; Wattjes, Mike P; Tintoré, Mar

    2015-01-01

    diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal...

  6. D 59 Design Guidelines

    DEFF Research Database (Denmark)

    Burcharth, Hans F.; Lamberti, Alberto

    The present guidelines are specifically dedicated to Low Crested Structures on attempt to provide methodological tools both for the engineering design of structures and for prediction of performance and environmental impacts. It is anticipated that the guidelines will provide valuable inputs to c...

  7. Proposed Radiation Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Davey, C. S.

    2004-07-01

    Current scientific evidence is that radiation at low levels is not harmful, but beneficial. This is borne out by both radiobiology and epidemiology. The ICRP 26 recommended limits of 50 mSv and 5 mSv per annum are comparable with the average natural background levels in Iran and Norway, respectively, and levels five times higher than that quoted for Iran are to be found in some populated parts of this world. The new limits proposed for ionising radiation are generated by comparison to existing recommended limits for essential minerals. There is a range of acceptable exposures to radiation, just as there is for minerals. The replacement for the ICRP 60 recommendations (20 mSv and 1 mSv for radiation workers and public respectively) should be higher limits of 200 mSv and 50 mSv. There should also be minimum recommended annual levels of 10 mSv, for both radiation workers and the public. The consequences of not proposing this change are continuing huge negative impacts to society. In cancer therapy, even the older guidelines caused unnecessary expense and delays. The cost to Canada is astronomical, when one considers the effect of the existing limits on the use of nuclear power, and the resulting use of hydrocarbons and the consequent increase in acid rain, etc. Of course, the same thing can be said of the entire world limited funds are diverted from areas where they would be better applied, and alternative solutions to societal needs are implemented, solutions which increase pollution and cause injury and death. It is time to reverse the current, expensive trend into misapplied ALARA, based on the paranoia about all things nuclear, which has developed since the linear no-threshold hypothesis was first proposed.propose the transition to a realistic and balanced approach to ionising radiation. (Author)

  8. European Guidelines for Workplace Drug Testing in Oral Fluid.

    Science.gov (United States)

    Brcak, Michaela; Beck, Olof; Bosch, Tessa; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Taskinen, Sanna; Weinmann, Wolfgang

    2017-06-28

    These guidelines for Legally Defensible Workplace Drug Testing have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. These guidelines are relevant to laboratory-based testing only. These guidelines follow current best practices and are constantly under review. This article is protected by copyright. All rights reserved.

  9. Colorectal Cancer Screening: A Guide to the Guidelines

    Directory of Open Access Journals (Sweden)

    Douglas K Rex

    1999-01-01

    Full Text Available The two most recent guidelines for colorectal cancer screening are those of the Agency for Healthcare Policy and Research, and the American Cancer Society. The guidelines are similar in many regards and reflect current literature, consensus opinion and compromise between members of multidisciplinary panels. The emphasis of both guidelines is to increase the options available for colorectal cancer screening. Increasing choice should expand the attractiveness of colorectal cancer screening to more patients and physicians, and the development of guidelines should help compel payers to provide reimbursement for colorectal cancer screening. These guidelines are summarized and evaluated as they pertain to colorectal cancer screening.

  10. [Guidelines for clinical practice].

    Science.gov (United States)

    Vleugels, A M

    1997-01-01

    Clinical practice guidelines are systematically developed statements that are intended to support medical decision making in well-defined clinical situations. Essentially, their object is to reduce the variability in medical practice, to improve quality, and to make appropriated control of the financial resources possible. Internationally, ever more organisations, associations, and institutions are concerned with the development of guidelines in many different areas of care. Making implicit knowledge explicit is one of the associated advantages of guidelines: they have a potential utility in training, in process evaluation, and in the reevaluation of outcome studies. In liability issues, their existence has a double effect: they can be used to justify medical behaviour, and they constitute a generally accepted reference point. A derivative problem is the legal liability of the compilers of the guidelines. The principle of the guideline approach can be challenged academically: science cannot give a definition of optimal care with absolute certainty. What is called objectivity often rests on methodologically disputable analyses; also the opinion of opinion leaders is not always a guarantee for scientific soundness. Moreover, patients are not all identical: biological variability, situational factors, patient expectations, and other elements play a role in this differentiation. Clinicians are often hesitant with respect to clinical guidelines: they are afraid of cookbook medicine and curtailment of their professional autonomy. Patients fear reduction of individualization of care and the use of guidelines as a rationing instrument. The effects of the introduction of clinical practice guidelines on medical practice, on the results and on the cost of care vary but are generally considered to be favourable. The choice of appropriate strategies in development, dissemination, and implementation turns out to be of critical importance. The article ends with concrete

  11. The association between dietary sodium intake, ESRD, and all-cause mortality in patients with type 1 diabetes

    National Research Council Canada - National Science Library

    Thomas, Merlin C; Moran, John; Forsblom, Carol; Harjutsalo, Valma; Thorn, Lena; Ahola, Aila; Wadén, Johan; Tolonen, Nina; Saraheimo, Markku; Gordin, Daniel; Groop, Per-Henrik

    2011-01-01

    Many guidelines recommend reduced consumption of salt in patients with type 1 diabetes, but it is unclear whether dietary sodium intake is associated with mortality and end-stage renal disease (ESRD...

  12. Dietary Supplements: What Is Safe?

    Science.gov (United States)

    ... and side effects of dietary supplements Dietary supplement advertising and promotion Talking with your doctor about dietary ... Statistics Center Volunteer Learning Center Follow Us Twitter Facebook Instagram Cancer Information, Answers, and Hope. Available Every ...

  13. Dietary management practices in phenylketonuria across European centres

    DEFF Research Database (Denmark)

    Ahring, Kirsten; Bélanger-Quintana, Amaya; Dokoupil, Katharina

    2009-01-01

    BACKGROUND: Dietary phenylalanine restriction is the cornerstone of phenylketonuria (PKU) management. However, there are no European consensus guidelines for its optimal dietary care. METHODS: Detailed information on the routine dietary management of PKU was obtained from 10 European centres using...... and nutritionists varied widely; in some centres dietitians were responsible for managing the diet, while in others this was performed by a physician. There were marked differences in target blood phenylalanine concentrations, the dosages of protein substitutes, systems for allocating daily phenylalanine allowance......, and the definition of foods that could be eaten without restriction ('free foods'). Eighty percent (n=8/10) of centres encouraged breastfeeding together with protein substitute in infants with PKU. CONCLUSIONS: Important differences exist among centres across Europe in the dietary management of PKU, and in support...

  14. Dietary phosphorus, serum phosphorus, and cardiovascular disease.

    Science.gov (United States)

    Menon, Madhav C; Ix, Joachim H

    2013-10-01

    Recent epidemiologic studies have linked higher serum phosphorus concentrations to cardiovascular disease (CVD) events and mortality. This association has been identified in the general population and in those with chronic kidney disease (CKD). The risk of adverse outcomes appears to begin with phosphorus concentrations within the upper limit of the normal reference range. Multiple experimental studies have suggested pathogenetic mechanisms that involve direct and indirect effects of high phosphorus concentrations to explain these associations. Drawing from these observations, guideline-forming agencies have recommended that serum phosphorus concentrations be maintained within the normal reference range in patients with CKD and that dietary phosphorus restriction or use of intestinal phosphate binders should be considered to achieve this goal. However, outside the dialysis population, the links between dietary phosphorus intake and serum phosphorus concentrations, and dietary phosphorus intake and CVD events, are uncertain. With specific reference to the nondialysis populations, this review discusses the available data linking dietary phosphorus intake with serum phosphorus concentrations and CVD events.

  15. Dietary Impact of Adding Potassium Chloride to Foods as a Sodium Reduction Technique

    Directory of Open Access Journals (Sweden)

    Leo van Buren

    2016-04-01

    Full Text Available Potassium chloride is a leading reformulation technology for reducing sodium in food products. As, globally, sodium intake exceeds guidelines, this technology is beneficial; however, its potential impact on potassium intake is unknown. Therefore, a modeling study was conducted using Dutch National Food Survey data to examine the dietary impact of reformulation (n = 2106. Product-specific sodium criteria, to enable a maximum daily sodium chloride intake of 5 grams/day, were applied to all foods consumed in the survey. The impact of replacing 20%, 50% and 100% of sodium chloride from each product with potassium chloride was modeled. At baseline median, potassium intake was 3334 mg/day. An increase in the median intake of potassium of 453 mg/day was seen when a 20% replacement was applied, 674 mg/day with a 50% replacement scenario and 733 mg/day with a 100% replacement scenario. Reformulation had the largest impact on: bread, processed fruit and vegetables, snacks and processed meat. Replacement of sodium chloride by potassium chloride, particularly in key contributing product groups, would result in better compliance to potassium intake guidelines (3510 mg/day. Moreover, it could be considered safe for the general adult population, as intake remains compliant with EFSA guidelines. Based on current modeling potassium chloride presents as a valuable, safe replacer for sodium chloride in food products.

  16. The feasibility of meeting the WHO guidelines for sodium and potassium: a cross-national comparison study.

    Science.gov (United States)

    Drewnowski, Adam; Rehm, Colin D; Maillot, Matthieu; Mendoza, Alfonso; Monsivais, Pablo

    2015-03-20

    To determine joint compliance with the WHO sodium-potassium goals in four different countries, using data from nationally representative dietary surveys. Compared to national and international recommendations and guidelines, the world's population consumes too much sodium and inadequate amounts of potassium. The WHO recommends consuming less than 2000 mg sodium (86 mmol) and at least 3510 mg potassium (90 mmol) per person per day. Dietary surveillance data were obtained from the National Health and Nutrition Examination Survey (NHANES 2007-2010) for the USA; the Encuesta Nacional de Salud y Nutrición 2012 for Mexico; the Individual and National Study on Food Consumption (INCA2) for France; and the National Diet and Nutrition Survey (NDNS) for the UK. We estimated the proportion of adults meeting the joint WHO sodium-potassium goals in the USA, the UK, France and Mexico. The upper bounds of joint compliance with the WHO sodium-potassium goals were estimated at 0.3% in the USA, 0.15% in Mexico, 0.5% in France and 0.1% in the UK. Given prevailing food consumption patterns and the current food supply, implementing WHO guidelines will be an enormous challenge for global public health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. The feasibility of meeting the WHO guidelines for sodium and potassium: a cross-national comparison study

    Science.gov (United States)

    Drewnowski, Adam; Maillot, Matthieu; Mendoza, Alfonso; Monsivais, Pablo

    2015-01-01

    Objective To determine joint compliance with the WHO sodium–potassium goals in four different countries, using data from nationally representative dietary surveys. Setting Compared to national and international recommendations and guidelines, the world's population consumes too much sodium and inadequate amounts of potassium. The WHO recommends consuming less than 2000 mg sodium (86 mmol) and at least 3510 mg potassium (90 mmol) per person per day. Participants Dietary surveillance data were obtained from the National Health and Nutrition Examination Survey (NHANES 2007–2010) for the USA; the Encuesta Nacional de Salud y Nutrición 2012 for Mexico; the Individual and National Study on Food Consumption (INCA2) for France; and the National Diet and Nutrition Survey (NDNS) for the UK. Primary outcome measures We estimated the proportion of adults meeting the joint WHO sodium–potassium goals in the USA, the UK, France and Mexico. Results The upper bounds of joint compliance with the WHO sodium–potassium goals were estimated at 0.3% in the USA, 0.15% in Mexico, 0.5% in France and 0.1% in the UK. Conclusions Given prevailing food consumption patterns and the current food supply, implementing WHO guidelines will be an enormous challenge for global public health. PMID:25795689

  18. Dietary determinants of obesity

    NARCIS (Netherlands)

    Huaidong, D.U.; Feskens, E.J.M.

    2010-01-01

    Obesity has become a serious public health problem worldwide, and dietary composition can play a role in its prevention and treatment. However, available literature on the impacts of different dietary factors on weight change is inconsistent, or even conflicting. In this review, we briefly summarize

  19. Dietary determinants of obesity

    NARCIS (Netherlands)

    Huaidong, D.U.; Feskens, E.J.M.

    2010-01-01

    Obesity has become a serious public health problem worldwide, and dietary composition can play a role in its prevention and treatment. However, available literature on the impacts of different dietary factors on weight change is inconsistent, or even conflicting. In this review, we briefly summarize

  20. Dietary determinants of obesity

    NARCIS (Netherlands)

    Huaidong, D.U.; Feskens, E.J.M.

    2010-01-01

    Obesity has become a serious public health problem worldwide, and dietary composition can play a role in its prevention and treatment. However, available literature on the impacts of different dietary factors on weight change is inconsistent, or even conflicting. In this review, we briefly

  1. Narrative Dietary Counseling

    DEFF Research Database (Denmark)

    Søndergaard Jakobsen, Nina; Hennesser, Yvonne; Kaufmann, Lisbeth

    2017-01-01

    Using cases and empirical data from a research and development project at a Danish prevention center, this study explores whether and how the use of narrative dietary counseling can strengthen dietitians' relationships and collaboration with clients who are chronically ill. The results of the study...... dietary counseling empowered clients and improved relationship building and collaboration between client and dietitian....

  2. Primary care guidelines

    DEFF Research Database (Denmark)

    Ijäs, Jarja; Alanen, Seija; Kaila, Minna

    2009-01-01

    -sectional telephone survey. SETTING: All municipal health centres in Finland. SUBJECTS: Health centres where both the head physician and the senior nursing officer responded. MAIN OUTCOME MEASURES: Agreement in views of the senior executives on the adoption of clinical practices as recommended in the Hypertension......OBJECTIVE: To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres. DESIGN: A cross...... Guideline. RESULTS: Data were available from 143 health centres in Finland (49%). The views of head physicians and senior nursing officers on the adoption of the Hypertension Guideline were not consistent. Head physicians more often than senior nursing officers (44% vs. 29%, p

  3. EMI Messaging Guidelines

    CERN Document Server

    Cons, L.

    2011-01-01

    Guidelines for potential users of messaging within EMI. The goal is to provide enough practical information so that EMI product teams can start investigating whether using messaging in their products can be beneficial or not.

  4. Guidelines for Crisis Management.

    Science.gov (United States)

    Wimberley, Lloyd

    1985-01-01

    The article offers guidelines for crisis prediction, preplanning, support team development, and post-crisis management that can handle aggressive behavior and convey to the child the existence of a legitimate system for enhancing positive self control. (CL)

  5. London 2012 packaging guidelines

    OpenAIRE

    2013-01-01

    These guidelines are intended to provide supplemental advice to suppliers and licensees regarding the provisions of the LOCOG Sustainable Sourcing Code that relate to packaging design and materials selection.

  6. Curriculum Guidelines for Periodontics.

    Science.gov (United States)

    Journal of Dental Education, 1985

    1985-01-01

    Guidelines describe the interrelationships of this and other dental fields, give an overview of the curriculum and its primary educational objectives, and outline the suggested prerequisites, core content, specific behavioral objectives, sequencing, and faculty requirements. (MSE)

  7. The Dietary Patterns Methods Project: Synthesis of Findings across Cohorts and Relevance to Dietary Guidance1234

    Science.gov (United States)

    Liese, Angela D; Krebs-Smith, Susan M; Subar, Amy F; George, Stephanie M; Harmon, Brook E; Neuhouser, Marian L; Boushey, Carol J; Schap, TusaRebecca E; Reedy, Jill

    2015-01-01

    The Dietary Patterns Methods Project (DPMP) was initiated in 2012 to strengthen research evidence on dietary indices, dietary patterns, and health for upcoming revisions of the Dietary Guidelines for Americans, given that the lack of consistent methodology has impeded development of consistent and reliable conclusions. DPMP investigators developed research questions and a standardized approach to index-based dietary analysis. This article presents a synthesis of findings across the cohorts. Standardized analyses were conducted in the NIH-AARP Diet and Health Study, the Multiethnic Cohort, and the Women’s Health Initiative Observational Study (WHI-OS). Healthy Eating Index 2010, Alternative Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension (DASH) scores were examined across cohorts for correlations between pairs of indices; concordant classifications into index score quintiles; associations with all-cause, cardiovascular disease (CVD), and cancer mortality with the use of Cox proportional hazards models; and dietary intake of foods and nutrients corresponding to index quintiles. Across all cohorts in women and men, there was a high degree of correlation and consistent classifications between index pairs. Higher diet quality (top quintile) was significantly and consistently associated with an 11–28% reduced risk of death due to all causes, CVD, and cancer compared with the lowest quintile, independent of known confounders. This was true for all diet index–mortality associations, with the exception of AHEI-2010 and cancer mortality in WHI-OS women. In all cohorts, survival benefit was greater with a higher-quality diet, and relatively small intake differences distinguished the index quintiles. The reductions in mortality risk started at relatively lower levels of diet quality. Higher scores on each of the indices, signifying higher diet quality, were associated with marked reductions in mortality

  8. The Dietary Patterns Methods Project: synthesis of findings across cohorts and relevance to dietary guidance.

    Science.gov (United States)

    Liese, Angela D; Krebs-Smith, Susan M; Subar, Amy F; George, Stephanie M; Harmon, Brook E; Neuhouser, Marian L; Boushey, Carol J; Schap, TusaRebecca E; Reedy, Jill

    2015-03-01

    The Dietary Patterns Methods Project (DPMP) was initiated in 2012 to strengthen research evidence on dietary indices, dietary patterns, and health for upcoming revisions of the Dietary Guidelines for Americans, given that the lack of consistent methodology has impeded development of consistent and reliable conclusions. DPMP investigators developed research questions and a standardized approach to index-based dietary analysis. This article presents a synthesis of findings across the cohorts. Standardized analyses were conducted in the NIH-AARP Diet and Health Study, the Multiethnic Cohort, and the Women's Health Initiative Observational Study (WHI-OS). Healthy Eating Index 2010, Alternative Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension (DASH) scores were examined across cohorts for correlations between pairs of indices; concordant classifications into index score quintiles; associations with all-cause, cardiovascular disease (CVD), and cancer mortality with the use of Cox proportional hazards models; and dietary intake of foods and nutrients corresponding to index quintiles. Across all cohorts in women and men, there was a high degree of correlation and consistent classifications between index pairs. Higher diet quality (top quintile) was significantly and consistently associated with an 11-28% reduced risk of death due to all causes, CVD, and cancer compared with the lowest quintile, independent of known confounders. This was true for all diet index-mortality associations, with the exception of AHEI-2010 and cancer mortality in WHI-OS women. In all cohorts, survival benefit was greater with a higher-quality diet, and relatively small intake differences distinguished the index quintiles. The reductions in mortality risk started at relatively lower levels of diet quality. Higher scores on each of the indices, signifying higher diet quality, were associated with marked reductions in mortality. Thus

  9. Dietary Intake as a Link between Obesity, Systemic Inflammation, and the Assumption of Multiple Cardiovascular and Antidiabetic Drugs in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Bruna Guida

    2013-01-01

    Full Text Available We evaluated dietary intake and nutritional-inflammation status in ninety-six renal transplant recipients, years after transplantation. Patients were classified as normoweight (NW, overweight (OW, and obese (OB, if their body mass index was between 18.5 and 24.9, 25.0 and 29.9, and ≥30 kg/m2, respectively. Food composition tables were used to estimate nutrient intakes. The values obtained were compared with those recommended in current nutritional guidelines. 52% of the patients were NW, 29% were OW, and 19% were OB. Total energy, fat, and dietary n-6 PUFAs intake was higher in OB than in NW. IL-6 and hs-CRP were higher in OB than in NW. The prevalence of multidrug regimen was higher in OB. In all patients, total energy, protein, saturated fatty acids, and sodium intake were higher than guideline recommendations. On the contrary, the intake of unsaturated and n-6 and n-3 polyunsaturated fatty acids and fiber was lower than recommended. In conclusion, the prevalence of obesity was high in our patients, and it was associated with inflammation and the assumption of multiple cardiovascular and antidiabetic drugs. Dietary intake did not meet nutritional recommendations in all patients, especially in obese ones, highlighting the need of a long-term nutritional support in renal transplant recipients.

  10. Electrical safety guidelines

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

  11. Management of hypertension in CKD: beyond the guidelines.

    Science.gov (United States)

    Judd, Eric; Calhoun, David A

    2015-03-01

    Hypertension (HTN) and CKD are closely associated with an intermingled cause and effect relationship. Blood pressure (BP) typically rises with declines in kidney function, and sustained elevations in BP hasten progression of kidney disease. This review addresses current management issues in HTN in patients with CKD including altered circadian rhythm of BP, timing of antihypertensive medication dosing, BP targets, diagnostic challenges in evaluating secondary forms of HTN, and the role of salt restriction in CKD. HTN in patients with CKD is often accompanied by a decrease in the kidney's ability to remove salt. Addressing this salt sensitivity is critical for the management of HTN in CKD. In addition to the well-established use of an ACEI or angiotensin receptor blocker, dietary salt restriction and appropriate diuretic therapy make up the mainstay of HTN treatment in patients with CKD. Bedtime dosing of antihypertensive medications can restore nocturnal dips in BP, and future clinical practice guidelines may recommend bedtime dosing of 1 or more antihypertensive medications in patients with CKD.

  12. Algorithms for builder guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Balcomb, J D; Lekov, A B

    1989-06-01

    The Builder Guidelines are designed to make simple, appropriate guidelines available to builders for their specific localities. Builders may select from passive solar and conservation strategies with different performance potentials. They can then compare the calculated results for their particular house design with a typical house in the same location. Algorithms used to develop the Builder Guidelines are described. The main algorithms used are the monthly solar ratio (SLR) method for winter heating, the diurnal heat capacity (DHC) method for temperature swing, and a new simplified calculation method (McCool) for summer cooling. This paper applies the algorithms to estimate the performance potential of passive solar strategies, and the annual heating and cooling loads of various combinations of conservation and passive solar strategies. The basis of the McCool method is described. All three methods are implemented in a microcomputer program used to generate the guideline numbers. Guidelines for Denver, Colorado, are used to illustrate the results. The structure of the guidelines and worksheet booklets are also presented. 5 refs., 3 tabs.

  13. Ramadan major dietary patterns.

    Science.gov (United States)

    Shadman, Zhaleh; Poorsoltan, Nooshin; Akhoundan, Mahdieh; Larijani, Bagher; Soleymanzadeh, Mozhdeh; Akhgar Zhand, Camelia; Seyed Rohani, Zahra Alsadat; Khoshniat Nikoo, Mohsen

    2014-09-01

    There has been no data on population based dietary patterns during the Ramadan fasting month. The purpose of this study was to detect Ramadan major dietary patterns among those who fast in Tehran. This cross-sectional study included 600 subjects, aged 18-65 with body mass index (BMI) of 18.5-40, who had decided to fast during Ramadan. Anthropometric measurements, usual physical activity level and educational status were collected two weeks before Ramadan. Information on Ramadan dietary intakes was obtained using a food frequency questionnaire and factor analysis was used to identify major dietary patterns. We identified four major dietary patterns: 1) Western-like pattern; high in fast foods, salty snacks, nuts, potato, fish, poultry, chocolates, juices; 2) high cholesterol and high sweet junk food pattern; high in pickles, sweets and condiments, butter and cream, canned fish, visceral meats and eggs; 3) Mediterranean-like pattern; high in vegetables, olive oil, dates, dairy, dried fruits, fruits, red meats, tea and coffee and 4) Ramadan-style pattern; large consumption of Halim, soups, porridges, legumes and whole grains, soft drinks, Zoolbia and Bamieh. Age was positively and inversely associated with Mediterranean-like (P = 0.003; r = 0.17) and Ramadan style (P = 0.1; r = -0.13) dietary pattern, respectively. Pre-Ramadan physical activity level was associated with a Mediterranean-like dietary pattern (P < 0.0001; r = 0.20). This study showed a Ramadan-specific dietary pattern has unique characteristics, which has not yet been identified as a model of dietary pattern. Also, among identified dietary patterns, Mediterranean-like was the healthiest.

  14. Mechanisms linking dietary fiber, gut microbiota and colon cancer prevention.

    Science.gov (United States)

    Zeng, Huawei; Lazarova, Darina L; Bordonaro, Michael

    2014-02-15

    Many epidemiological and experimental studies have suggested that dietary fiber plays an important role in colon cancer prevention. These findings may relate to the ability of fiber to reduce the contact time of carcinogens within the intestinal lumen and to promote healthy gut microbiota, which modifies the host's metabolism in various ways. Elucidation of the mechanisms by which dietary fiber-dependent changes in gut microbiota enhance bile acid deconjugation, produce short chain fatty acids, and modulate inflammatory bioactive substances can lead to a better understanding of the beneficial role of dietary fiber. This article reviews the current knowledge concerning the mechanisms via which dietary fiber protects against colon cancer.

  15. Adipose gene expression prior to weight loss can differentiate and weakly predict dietary responders.

    Directory of Open Access Journals (Sweden)

    David M Mutch

    Full Text Available BACKGROUND: The ability to identify obese individuals who will successfully lose weight in response to dietary intervention will revolutionize disease management. Therefore, we asked whether it is possible to identify subjects who will lose weight during dietary intervention using only a single gene expression snapshot. METHODOLOGY/PRINCIPAL FINDINGS: The present study involved 54 female subjects from the Nutrient-Gene Interactions in Human Obesity-Implications for Dietary Guidelines (NUGENOB trial to determine whether subcutaneous adipose tissue gene expression could be used to predict weight loss prior to the 10-week consumption of a low-fat hypocaloric diet. Using several statistical tests revealed that the gene expression profiles of responders (8-12 kgs weight loss could always be differentiated from non-responders (<4 kgs weight loss. We also assessed whether this differentiation was sufficient for prediction. Using a bottom-up (i.e. black-box approach, standard class prediction algorithms were able to predict dietary responders with up to 61.1%+/-8.1% accuracy. Using a top-down approach (i.e. using differentially expressed genes to build a classifier improved prediction accuracy to 80.9%+/-2.2%. CONCLUSION: Adipose gene expression profiling prior to the consumption of a low-fat diet is able to differentiate responders from non-responders as well as serve as a weak predictor of subjects destined to lose weight. While the degree of prediction accuracy currently achieved with a gene expression snapshot is perhaps insufficient for clinical use, this work reveals that the comprehensive molecular signature of adipose tissue paves the way for the future of personalized nutrition.

  16. Dietary saturated and unsaturated fats as determinants of blood pressure and vascular function.

    Science.gov (United States)

    Hall, Wendy L

    2009-06-01

    The amount and type of dietary fat have long been associated with the risk of CVD. Arterial stiffness and endothelial dysfunction are important risk factors in the aetiology of CHD. A range of methods exists to assess vascular function that may be used in nutritional science, including clinic and ambulatory blood pressure monitoring, pulse wave analysis, pulse wave velocity, flow-mediated dilatation and venous occlusion plethysmography. The present review focuses on the quantity and type of dietary fat and effects on blood pressure, arterial compliance and endothelial function. Concerning fat quantity, the amount of dietary fat consumed habitually appears to have little influence on vascular function independent of fatty acid composition, although single high-fat meals postprandially impair endothelial function compared with low-fat meals. The mechanism is related to increased circulating lipoproteins and NEFA which may induce pro-inflammatory pathways and increase oxidative stress. Regarding the type of fat, cross-sectional data suggest that saturated fat adversely affects vascular function whereas polyunsaturated fat (mainly linoleic acid (18 : 2n-6) and n-3 PUFA) are beneficial. EPA (20 : 5n-3) and DHA (22 : 6n-3) can reduce blood pressure, improve arterial compliance in type 2 diabetics and dyslipidaemics, and augment endothelium-dependent vasodilation. The mechanisms for this vascular protection, and the nature of the separate physiological effects induced by EPA and DHA, are priorities for future research. Since good-quality observational or interventional data on dietary fatty acid composition and vascular function are scarce, no further recommendations can be suggested in addition to current guidelines at the present time.

  17. Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer

    DEFF Research Database (Denmark)

    Schwab, Ursula; Lauritzen, Lotte; Tholstrup, Tine

    2014-01-01

    of this systematic review (SR) was to assess the evidence of an effect of the amount and type of dietary fat on body weight (BW), risk factors, and risk of non-communicable diseases, that is, type 2 diabetes (T2DM), cardiovascular diseases (CVD), and cancer in healthy subjects or subjects at risk for these diseases...... were also included when limited or no data were available from other study types. Altogether 607 articles were quality graded and the observed effects in these papers were summarized. Convincing evidence was found that partial replacement of saturated fat (SFA) with polyunsaturated fat (PUFA......The effects of both the amount and quality of dietary fat have been studied intensively during the past decades. Previously, low-fat diets were recommended without much attention to the quality of fat, whereas there is general emphasis on the quality of fat in current guidelines. The objective...

  18. Saturated fats: what dietary intake?

    Science.gov (United States)

    German, J Bruce; Dillard, Cora J

    2004-09-01

    Public health recommendations for the US population in 1977 were to reduce fat intake to as low as 30% of calories to lower the incidence of coronary artery disease. These recommendations resulted in a compositional shift in food materials throughout the agricultural industry, and the fractional content of fats was replaced principally with carbohydrates. Subsequently, high-carbohydrate diets were recognized as contributing to the lipoprotein pattern that characterizes atherogenic dyslipidemia and hypertriacylglycerolemia. The rising incidences of metabolic syndrome and obesity are becoming common themes in the literature. Current recommendations are to keep saturated fatty acid, trans fatty acid, and cholesterol intakes as low as possible while consuming a nutritionally adequate diet. In the face of such recommendations, the agricultural industry is shifting food composition toward lower proportions of all saturated fatty acids. To date, no lower safe limit of specific saturated fatty acid intakes has been identified. This review summarizes research findings and observations on the disparate functions of saturated fatty acids and seeks to bring a more quantitative balance to the debate on dietary saturated fat. Whether a finite quantity of specific dietary saturated fatty acids actually benefits health is not yet known. Because agricultural practices to reduce saturated fat will require a prolonged and concerted effort, and because the world is moving toward more individualized dietary recommendations, should the steps to decrease saturated fatty acids to as low as agriculturally possible not wait until evidence clearly indicates which amounts and types of saturated fatty acids are optimal?

  19. Guidelines International Network: toward international standards for clinical practice guidelines.

    NARCIS (Netherlands)

    Qaseem, A.; Forland, F.; Macbeth, F.; Ollenschlager, G.; Phillips, S.; Wees, P.J. van der

    2012-01-01

    Guideline development processes vary substantially, and many guidelines do not meet basic quality criteria. Standards for guideline development can help organizations ensure that recommendations are evidence-based and can help users identify high-quality guidelines. Such organizations as the U.S. In

  20. Dietary lipids and cancer.

    Science.gov (United States)

    Granados, S; Quiles, J L; Gil, A; Ramírez-Tortosa, M C

    2006-05-01

    Cancer is one of the main causes of death in Western countries. Among the factors that contribute to the appearance of this disease, diet has a fundamental role, and specifically fats are the main component related to the increase in the incidence of cancerous diseases, particularly breast, colon-rectal, and prostate cancer. From dietary lipids, much attention has been given to the beneficial effects of fish oil, rich in polyunsaturated fatty acids n-3 serie, as well as of olive oil, rich in monounsaturated fatty acids--primarily oleic acid. On the contrary, a negative effect has been reported for polyunsaturated fatty acids n-6 serie and for saturated fatty acids. Nutrition constitutes an important aspect of the life of cancer patients. Currently, nutritional formulas are being designed with supplements of polyunsaturated n-3 fatty acids and other components such as arginine, RNA, lysine, etc., with the aim of ameliorating the effects of this pathology. The results demonstrate the lower morbility and therefore improved quality of life, a decline in mortality, and a reduction in related costs.