Relating Stool Microbial Metabolite Levels, Inflammatory Markers and Dietary Behaviors to Screening Colonoscopy Findings in a Racially/Ethnically Diverse Patient Population

Science.gov (United States)

Bridges, Kristina M.; Diaz, Francisco J.; Wang, Zhiwen; Ahmed, Ishfaq; Sullivan, Debra K.; Umar, Shahid; Buckles, Daniel C.; Greiner, K. Allen; Hester, Christina M.

2018-01-01

Colorectal cancer (CRC) is the third leading cause of cancer death for both men and women in the United States, yet it is treatable and preventable. African Americans have higher incidence of CRC than other racial/ethnic groups, however, it is unclear whether this disparity is primarily due to environmental or biological factors. Short chain fatty acids (SCFAs) are metabolites produced by bacteria in the colon and are known to be inversely related to CRC progression. The aim of this study is to investigate how stool SCFA levels, markers of inflammation in stool and dietary intake relate to colonoscopy findings in a diverse patient population. Stool samples from forty-eight participants were analyzed for SCFA levels and inflammatory markers (lysozyme, secretory IgA, lactoferrin). Additionally, participants completed the National Cancer Institute’s Diet History Questionnaire II (DHQ II) to report dietary intake over the past year. Subsequently, the majority of participants underwent screening colonoscopy. Our results showed that African Americans had higher total levels of SCFAs in stool than other racial/ethnic groups, significantly lower intake of non-starchy vegetables and similar inflammatory marker expression and colonoscopy outcomes, compared to others. This work is an initial exploration into the biological and clinical factors that may ultimately inform personalized screening approaches and clinical decision-making to improve colorectal cancer disparities for African Americans. PMID:29495356

Outcomes in cervical screening using various cytology technologies

DEFF Research Database (Denmark)

Barken, Sidsel S; Rebolj, Matejka; Lynge, Elsebeth

2013-01-01

of samples with atypical squamous cells of undetermined significance or worse (≥ASCUS) by age and technology phase. We included 391 140 samples. The proportion of ≥ASCUS increased steadily from 3.8% in phase 1 to 6.0% in phase 5. This pattern varied considerably across age groups. In women aged 23-34 years......Unlike for human papillomavirus screening, little is known about the possible age-dependent variation in the outcomes of cervical cytology screening. The aim of our study was to describe age-related outcomes of five cytological technologies in a population-based screening program targeting women...... aged 23-59 years. All cervical cytology from women residing in Copenhagen has been analyzed in the laboratory of the Department of Pathology, Hvidovre University Hospital. We studied five technology phases: (1) conventional cytology with manual reading, (2) conventional cytology with 50% automatically...

Are screen-based sedentary behaviors longitudinally associated with dietary behaviors and leisure-time physical activity in the transition into adolescence?

Science.gov (United States)

Gebremariam, Mekdes K; Bergh, Ingunn H; Andersen, Lene F; Ommundsen, Yngvar; Totland, Torunn H; Bjelland, Mona; Grydeland, May; Lien, Nanna

2013-01-25

There is a need for more longitudinal studies investigating the associations between screen-based sedentary behaviors (SB), dietary behaviors and leisure-time physical activity (PA). In the HEIA cohort study, 908 children were followed from age 11 to age 13 (September 2007-May 2009). The children self-reported their intake of fruits, vegetables, soft drinks with sugar and snacks. TV/DVD use, computer/game use and leisure-time PA were also self-reported. Multilevel generalized linear mixed model analysis was used to assess longitudinal associations between the screen-based SB and each of the two other behaviors. Twenty-month changes in TV/DVD use and computer/game use were positively associated with changes in the consumption of soft drinks with sugar and unhealthy snacks in the same period; and inversely associated with change in vegetable consumption. Change in computer/game use was also inversely related to change in fruit consumption. An inverse but non-substantive association was found between change in TV/DVD use and change in leisure-time PA. Change in computer/game use was not significantly associated with change in leisure-time PA. Changes in screen-based SB were associated with multiple unfavorable changes in dietary habits, although the associations were weak. These associations need to be further investigated in intervention/experimental studies, to assess whether changing screen-based SB will result in clinically relevant changes in dietary behaviors. However, the findings of this study suggest that screen-based SB and leisure-time PA are largely independent behaviors which should be addressed separately in health promotion activities.

Carbohydrates, Dietary Fiber, and Resistant Starch in White Vegetables: Links to Health Outcomes12

Science.gov (United States)

Slavin, Joanne L.

2013-01-01

Vegetables are universally promoted as healthy. Dietary Guidelines for Americans 2010 recommend that you make half of your plate fruits and vegetables. Vegetables are diverse plants that vary greatly in energy content and nutrients. Vegetables supply carbohydrates, dietary fiber, and resistant starch in the diet, all of which have been linked to positive health outcomes. Fiber lowers the incidence of cardiovascular disease and obesity. In this paper, the important role of white vegetables in the human diet is described, with a focus on the dietary fiber and resistant starch content of white vegetables. Misguided efforts to reduce consumption of white vegetables will lower intakes of dietary fiber and resistant starch, nutrients already in short supply in our diets. PMID:23674804

Characteristics and screening outcome of women referred twice at screening mammography

International Nuclear Information System (INIS)

Setz-Pels, Wikke; Duijm, Lucien E.M.; Jansen, Frits H.; Louwman, Marieke W.J.; Roumen, Rudi M.H.; Voogd, Adri C.

2012-01-01

To determine the characteristics and screening outcome of women referred twice at screening mammography. We included 424,703 consecutive screening mammograms and collected imaging, biopsy and surgery reports of women with screen-detected breast cancer. Review of screening mammograms was performed to determine whether or not an initial and second referral comprised the same lesion. The overall positive predictive value of referral for cancer was 38.6% (95% CI 37.3-39.8%). Of 147 (2.6%) women referred twice, 86 had been referred for a different lesion at second referral and 32 of these proved malignant (37.2%, 95% CI 27.0-47.4%). Sixty-one women had been referred twice for the same lesion, of which 22 proved malignant (36.1%, 95% CI 24.1-48.0%). Characteristics of these women were comparable to women with cancer diagnosed after first referral. Compared with women without cancer at second referral for the same lesion, women with cancer more frequently showed suspicious densities at screening mammography (86.4% vs 53.8%, P = 0.02) and work-up at first referral had less frequently included biopsy (22.7% vs 61.5%, P = 0.004). Cancer risk in women referred twice for the same lesion is similar to that observed in women referred once, or referred for a second time but for a different lesion. (orig.)

Receptor-based high-throughput screening and identification of estrogens in dietary supplements using bioaffinity liquid-chromatography ion mobility mass spectrometry.

Science.gov (United States)

Aqai, Payam; Blesa, Natalia Gómez; Major, Hilary; Pedotti, Mattia; Varani, Luca; Ferrero, Valentina E V; Haasnoot, Willem; Nielen, Michel W F

2013-11-01

A high-throughput bioaffinity liquid chromatography-mass spectrometry (BioMS) approach was developed and applied for the screening and identification of recombinant human estrogen receptor α (ERα) ligands in dietary supplements. For screening, a semi-automated mass spectrometric ligand binding assay was developed applying (13)C2, (15) N-tamoxifen as non-radioactive label and fast ultra-high-performance-liquid chromatography-electrospray ionisation-triple-quadrupole-MS (UPLC-QqQ-MS), operated in the single reaction monitoring mode, as a readout system. Binding of the label to ERα-coated paramagnetic microbeads was inhibited by competing estrogens in the sample extract yielding decreased levels of the label in UPLC-QqQ-MS. The label showed high ionisation efficiency in positive electrospray ionisation (ESI) mode, so the developed BioMS approach is able to screen for estrogens in dietary supplements despite their poor ionisation efficiency in both positive and negative ESI modes. The assay was performed in a 96-well plate, and all these wells could be measured within 3 h. Estrogens in suspect extracts were identified by full-scan accurate mass and collision-cross section (CCS) values from a UPLC-ion mobility-Q-time-of-flight-MS (UPLC-IM-Q-ToF-MS) equipped with a novel atmospheric pressure ionisation source. Thanks to the novel ion source, this instrument provided picogram sensitivity for estrogens in the negative ion mode and an additional identification point (experimental CCS values) next to retention time, accurate mass and tandem mass spectrometry data. The developed combination of bioaffinity screening with UPLC-QqQ-MS and identification with UPLC-IM-Q-ToF-MS provides an extremely powerful analytical tool for early warning of ERα bioactive compounds in dietary supplements as demonstrated by analysis of selected dietary supplements in which different estrogens were identified.

Carbohydrates, Dietary Fiber, and Resistant Starch in White Vegetables: Links to Health Outcomes12

OpenAIRE

Slavin, Joanne L.

2013-01-01

Vegetables are universally promoted as healthy. Dietary Guidelines for Americans 2010 recommend that you make half of your plate fruits and vegetables. Vegetables are diverse plants that vary greatly in energy content and nutrients. Vegetables supply carbohydrates, dietary fiber, and resistant starch in the diet, all of which have been linked to positive health outcomes. Fiber lowers the incidence of cardiovascular disease and obesity. In this paper, the important role of white vegetables in ...

miRNAs modified by dietary lipids in Caco-2 cells. A microarray screening

Directory of Open Access Journals (Sweden)

Lidia Daimiel

2015-09-01

Full Text Available We performed a screening of miRNAs regulated by dietary lipids in a cellular model of enterocytes, Caco-2 cells. Our aim was to describe new lipid-modified miRNAs with an implication in lipid homeostasis and cardiovascular disease [1,2]. For that purpose, we treated differentiated Caco-2 cells with micelles containing the assayed lipids (cholesterol, conjugated linoleic acid and docosahexaenoic acid and the screening of miRNAs was carried out by microarray using the μParaflo®Microfluidic Biochip Technology of LC Sciences (Huston, TX, USA. Experimental design, microarray description and raw data have been made available in the GEO database with the reference number of GSE59153. Here we described in detail the experimental design and methods used to obtain the relative expression data.

A review of associations between family or shared meal frequency and dietary and weight status outcomes across the lifespan.

Science.gov (United States)

Fulkerson, Jayne A; Larson, Nicole; Horning, Melissa; Neumark-Sztainer, Dianne

2014-01-01

To summarize the research literature on associations between family meal frequency and dietary outcomes as well as weight status across the lifespan. Reviewed literature of family or shared meals with dietary and weight outcomes in youth, adults, and older adults. Across the lifespan, eating with others, particularly family, is associated with healthier dietary outcomes. Among children and adolescents, these findings appear to be consistent for both boys and girls, whereas mixed findings are seen by gender for adult men and women. The findings of associations between family or shared meals and weight outcomes across the lifespan are less consistent and more complicated than those of dietary outcomes. Now is the time for the field to improve understanding of the mechanisms involved in the positive associations seen with family meal frequency, and to move forward with implementing interventions aimed at increasing the frequency of, and improving the quality of, food served at family meals, and evaluating their impact. Given the more limited findings of associations between family or shared meals and weight outcomes, capitalizing on the positive benefits of family and shared meals while addressing the types of foods served, portion sizes, and other potential mechanisms may have a significant impact on obesity prevention and reduction. Future research recommendations are provided. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

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.

Meta-analyses of workplace physical activity and dietary behaviour interventions on weight outcomes

NARCIS (Netherlands)

Verweij, L.M.; Coffeng, J.; Mechelen, W. van; Proper, K.I.

2011-01-01

This meta-analytic review critically examines the effectiveness of workplace interventions targeting physical activity, dietary behaviour or both on weight outcomes. Data could be extracted from 22 studies published between 1980 and November 2009 for meta-analyses. The GRADE approach was used to

Maternal dietary intake in pregnancy and lactation and allergic disease outcomes in offspring.

Science.gov (United States)

Venter, Carina; Brown, Kari R; Maslin, Kate; Palmer, Debra J

2017-03-01

As the prevalence of allergic disease dramatically rises worldwide, prevention strategies are increasingly being considered. Given the potential modulatory effect of nutritional factors on disease, altering maternal diet during pregnancy and/or lactation has been considered in preventing allergic disease in offspring. Although there are a number of observational studies that have examined possible associations between maternal diet and allergic outcomes in offspring, interventional trials are limited. Furthermore, there is a paucity of studies that have prospectively studied maternal dietary intake as well as measuring maternal and infant biologic samples (blood, urine, breast milk) and their relation to allergic outcomes in infants. There is also a particular need to define terminology such as 'fruit and vegetables intake', 'healthy diet', and 'diet diversity' in order to make studies comparable. In this review, we discuss current evidence of maternal dietary factors during pregnancy and/or lactation that may play a role in the offspring developing allergic disease, including factors such as overall dietary intake patterns, specific whole food consumption (fish, fruit and vegetables, and common allergic foods), and individual immunomodulatory nutrient intakes. Additionally, we discuss the limitations of previous studies and propose improvements to study design for future investigation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improving clinical outcomes in psychiatric care with touch-screen technology.

Science.gov (United States)

Newnham, Elizabeth A; Doyle, Emma L; Sng, Adelln A H; Hooke, Geoffrey R; Page, Andrew C

2012-05-01

Patient-focused research, which uses clinical characteristics to predict outcomes, is a field in which information technology has been effectively integrated with practice. The present research used touch-screen technology to monitor the daily self-report measures of 1,308 consecutive inpatients and day patients participating in a 2-week cognitive-behavioral therapy group. Providing regular feedback was effective in reducing symptoms for patients at risk of poor outcomes (Newnham, Hooke, & Page, 2010b). The use of touch screens in psychiatric monitoring encourages a collaborative dialogue between patients and therapists and promotes engagement in the process of progress monitoring and treatment evaluation.

Development of a screening tool for detecting undernutrition and dietary inadequacy among rural elderly in Malaysia: simple indices to identify individuals at high risk.

Science.gov (United States)

Shahar, S; Dixon, R A; Earland, J

1999-11-01

Undernutrition and the consumption of poor diets are prevalent among elderly people in developing countries. Recognising the importance of the early identification of individuals at high nutritional risk, this study aimed to develop a simple tool for screening. A cross-sectional study was conducted on 11 randomly selected villages among the 62 in Mersing District, Malaysia. Undernutrition was assessed using body mass index, plasma albumin and haemoglobin on 285 subjects. Dietary inadequacy (a count of nutrients falling below two-thirds of the Recommended Dietary Allowances) was examined for 337 subjects. Logistic regression analysis was performed to identify significant predictors of undernutrition and dietary inadequacy from social and health factors, and to derive appropriate indices based on these predictions. The multivariate predictors of undernutrition were 'no joint disease', 'smoker', 'no hypertension', 'depended on others for economic resource', 'respiratory disease', 'perceived weight loss' and 'chewing difficulty', with a joint sensitivity of 56% and specificity of 84%. The equivalent predictors of dietary inadequacy were 'unable to take public transport', 'loss of appetite', 'chewing difficulty', 'no regular fruit intake' and 'regularly taking less than three meals per day', with a joint sensitivity of 77% and specificity of 47%. These predictions, with minor modification to simplify operational use, led to the production of a simple screening tool. The tool can be used by public health professionals or community workers or leaders as a simple and rapid instrument to screen individual at high risk of undernutrition and/or dietary inadequacy.

Depression screening and patient outcomes in pregnancy or postpartum : A systematic review

NARCIS (Netherlands)

Thombs, Brett D.; Arthurs, Erin; Coronado-Montoya, Stephanie; Roseman, Michelle; Delisle, Vanessa C.; Leavens, Allison; Levis, Brooke; Azoulay, Laurent; Smith, Cheri; Ciofani, Luisa; Coyne, James C.; Feeley, Nancy; Gilbody, Simon; Schinazi, Joy; Stewart, Donna E.; Zelkowitz, Phyllis

Objective: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or

Dietary patterns in infancy are associated with child diet and weight outcomes at 6 years.

Science.gov (United States)

Rose, C M; Birch, L L; Savage, J S

2017-05-01

To assess whether patterns of dietary exposures at 9 months are associated with child diet and weight at 6 years. Data for this study were from the Infant Feeding Practices Study II and Year 6 Follow-Up Studies. All data were self-reported monthly. Results of a previous latent class analysis revealed five dietary patterns varying in milk and solid food intake. These five infant dietary patterns were used in the current study to predict child diet and weight outcomes at 6 years, while controlling for confounding variables. Infants with dietary patterns higher in fruit and vegetable intake at 9 months had higher fruit and vegetable intake at 6 years. Similarly, infants with the dietary pattern characterized by foods high in energy density (that is, French Fries and sweet desserts) continued to have higher consumption of these foods at 6 years, and had a higher prevalence of overweight at 6 years (43%) compared with the other classes. Formula-fed infants had higher sugar-sweetened beverage intake and fewer met the dietary guidelines for fruit and vegetable intake at 6 years than breastfed infants, controlling for factors such as income. Early decisions about milk-feeding, and the types of solid foods offered in infancy can foreshadow dietary patterns and obesity risk later in childhood. Infants who were offered energy-dense foods had higher intake of these foods at 6 years of age.

Meta-analyses of workplace physical activity and dietary behaviour interventions on weight outcomes.

Science.gov (United States)

Verweij, L M; Coffeng, J; van Mechelen, W; Proper, K I

2011-06-01

This meta-analytic review critically examines the effectiveness of workplace interventions targeting physical activity, dietary behaviour or both on weight outcomes. Data could be extracted from 22 studies published between 1980 and November 2009 for meta-analyses. The GRADE approach was used to determine the level of evidence for each pooled outcome measure. Results show moderate quality of evidence that workplace physical activity and dietary behaviour interventions significantly reduce body weight (nine studies; mean difference [MD]-1.19 kg [95% CI -1.64 to -0.74]), body mass index (BMI) (11 studies; MD -0.34 kg m⁻² [95% CI -0.46 to -0.22]) and body fat percentage calculated from sum of skin-folds (three studies; MD -1.12% [95% CI -1.86 to -0.38]). There is low quality of evidence that workplace physical activity interventions significantly reduce body weight and BMI. Effects on percentage body fat calculated from bioelectrical impedance or hydrostatic weighing, waist circumference, sum of skin-folds and waist-hip ratio could not be investigated properly because of a lack of studies. Subgroup analyses showed a greater reduction in body weight of physical activity and diet interventions containing an environmental component. As the clinical relevance of the pooled effects may be substantial on a population level, we recommend workplace physical activity and dietary behaviour interventions, including an environment component, in order to prevent weight gain. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes.

Science.gov (United States)

Loth, K A; Friend, S; Horning, M L; Neumark-Sztainer, D; Fulkerson, J A

2016-12-01

This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8-12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment. Food restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes. An obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores. Greater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control. Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded

Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer.

Science.gov (United States)

Ripping, Theodora Maria; Hubbard, Rebecca A; Otten, Johannes D M; den Heeten, Gerard J; Verbeek, André L M; Broeders, Mireille J M

2016-04-01

Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected breast cancer, interval cancer, and false-positive results, in women screenees aged 50-75 and 40-75, with and without a first-degree relative with a history of breast cancer at the start of screening. Data on screening attendance, recall and breast cancer detection were collected for each woman living in Nijmegen (The Netherlands) since 1975. We used a discrete time survival model to calculate the cumulative probability of each major screening outcome over 19 screening rounds. Women with a family history of breast cancer had a higher risk of all screening outcomes. For women screened from age 50-75, the cumulative risk of screen-detected breast cancer, interval cancer and false-positive results were 9.0, 4.4 and 11.1% for women with a family history and 6.3, 2.7 and 7.3% for women without a family history, respectively. The results for women 40-75 followed the same pattern for women screened 50-75 for cancer outcomes, but were almost doubled for false-positive results. To conclude, women with a first-degree relative with a history of breast cancer are more likely to experience benefits and harms of screening than women without a family history. To complete the balance and provide risk-based screening recommendations, the breast cancer mortality reduction and overdiagnosis should be estimated for family history subgroups. © 2015 UICC.

The use of presurgical psychological screening to predict the outcome of spine surgery.

Science.gov (United States)

Block, A R; Ohnmeiss, D D; Guyer, R D; Rashbaum, R F; Hochschuler, S H

2001-01-01

Several previous studies have shown that psychosocial factors can influence the outcome of elective spine surgery. The purpose of the current study was to determine how well a presurgical screening instrument could predict surgical outcome. The study was conducted by staff of a psychologist's office. They performed preoperative screening for spine surgery candidates and collected the follow-up data. Presurgical screening and follow-up data collection was performed on 204 patients who underwent laminectomy/discectomy (n=118) or fusion (n=86) of the lumbar spine. The outcome measures used in the study were visual analog pain scales, the Oswestry Disability Questionnaire, and medication use. A semi-structured interview and psychometric testing were used to identify specific, quantifiable psychological, and "medical" risk factors for poor surgical outcome. A presurgical psychological screening (PPS) scorecard was completed for each patient, assessing whether the patient had a high or low level of risk on these psychological and medical dimensions. Based on the scorecard, an overall surgical prognosis of "good," "fair," or "poor" was generated. Results showed spine surgery led to significant overall improvements in pain, functional ability, and medication use. Medical and psychological risk levels were significantly related to outcome, with the poorest results obtained by patients having both high psychological and medical risk. Further, the accuracy of PPS surgical prognosis in predicting overall outcome was 82%. Only 9 of 53 patients predicted to have poor outcome achieved fair or good results from spine surgery. These findings suggest that PPS should become a more routine part of the evaluation of chronic pain patients in whom spine surgery is being considered.

Psychometric Properties of a Scale to Assess Parental Self-Efficacy for Influencing Children's Dietary, Physical Activity, Sedentary, and Screen Time Behaviors in Disadvantaged Areas.

Science.gov (United States)

Norman, Åsa; Bohman, Benjamin; Nyberg, Gisela; Schäfer Elinder, Liselotte

2018-02-01

According to social cognitive theory, self-efficacy is central to behavior change. Consequently, parental self-efficacy (PSE) for influencing children's dietary, physical activity (PA), sedentary, and screen time behaviors is important for child obesity prevention. The aim of this study was to evaluate the psychometric properties of an instrument to measure PSE regarding these behaviors in disadvantaged areas. Parents ( n = 229) of whom 47% had completed secondary school or less, and who participated in the Healthy School Start trial, responded to a 15-item PSE instrument. Children's diet and screen time were measured through parent reports. PA and sedentary behaviors were measured using accelerometers. Construct validity was assessed using exploratory factor analysis (EFA), criterion validity by correlations with child behaviors, and internal consistency by Cronbach's alpha. The EFA yielded three factors: (a) PSE for promoting PA; (b) PSE for limiting intake of unhealthy foods, unhealthy drinks, and screen time; and (c) PSE for promoting intake of fruits and vegetables, all with acceptable to good internal consistency (α = .77-.81). Significant correlations ( p children's dietary ( r s = -.19 to -.29) and screen time ( r = -.29) behaviors and Factor 2, and dietary behaviors and Factor 3 ( r s = .20-.39) but not regarding PA and sedentary behaviors and Factor 1. The instrument demonstrated good construct validity and acceptable to good internal consistency regarding all but PA behaviors. It may be useful for assessing PSE in child obesity prevention interventions in disadvantaged settings after some refinement.

Dietary patterns and risk of advanced colorectal neoplasms: A large population based screening study in Germany.

Science.gov (United States)

Erben, Vanessa; Carr, Prudence R; Holleczek, Bernd; Stegmaier, Christa; Hoffmeister, Michael; Brenner, Hermann

2018-06-01

Specific components of the diet such as red and processed meat have been associated with the risk of developing colorectal cancer. However, evidence on the association of dietary patterns with colorectal neoplasms is sparse. The aim of this study was to analyze the association of dietary patterns with prevalence of advanced colorectal neoplasms among older adults in Germany. A cross-sectional study was conducted among participants of screening colonoscopy in Saarland, Germany, who were enrolled in the KolosSal study (Effektivität der Früherkennungs-Koloskopie: eine Saarland-weite Studie) from 2005 to 2013. Information on diet and lifestyle factors was obtained through questionnaires and colonoscopy results were extracted from physicians' reports. Associations of a priori defined dietary patterns (vegetarian or adapted versions of the Healthy Eating Index [HEI] and the Dietary Approaches to Stop Hypertension [DASH] index) with the risk of advanced colorectal neoplasms were assessed by multiple logistic regression analyses with comprehensive adjustment for potential confounders. A total of 14,309 participants were included (1561 with advanced colorectal neoplasms). Healthier eating behavior was associated with lower prevalence of advanced colorectal neoplasms in a dose-response manner. Adjusted odds ratios (95% confidence intervals) comparing the highest with the lowest categories of adapted HEI and DASH were 0.61 (0.50, 0.76) and 0.70 (0.55, 0.89), respectively. No significant associations were observed for a vegetarian eating pattern (adjusted OR 0.80 (0.55, 1.17)). Healthy dietary patterns, as described by a high HEI or DASH score, but not a vegetarian diet alone, are associated with reduced risk of advanced colorectal neoplasms. Copyright © 2018 Elsevier Inc. All rights reserved.

Impact of quality of research on patient outcomes in the Institute of Medicine 2013 report on dietary sodium.

Science.gov (United States)

Lucko, Aaron; Doktorchik, Chelsea Ta; Campbell, Norm Rc

2018-02-01

The 2013 Institute of Medicine report entitled "Sodium Intake in Populations: Assessment of Evidence" found inconsistent evidence of health benefit with dietary sodium intake sodium and health outcomes. This review investigates the association of methodological rigor and outcomes of studies in the Institute of Medicine report. For the 13 studies that met all methodological criteria, nine found a detrimental impact of high sodium consumption on health, one found a health benefit, and in three the effect was unclear (P = .068). For the 22 studies that failed to meet all criteria, 11 showed a detrimental impact, four a health benefit, and seven had unclear effects from increasing dietary sodium (P = .42). ©2018 Wiley Periodicals, Inc.

Dietary transition, nutritional and health outcomes, and changing agrifood production and trade patterns

DEFF Research Database (Denmark)

Yu, Wusheng; Jensen, Hans Grinsted; Cao, Lijuan

efficiency and welfare consequences. Realizing that changing dietary trends are likely to be costly, in a more refined scenario, we consider public policy options to influence consumer choices for purposes of reaching a given alternative diet target. Since the costs of the policy intervention...... and health outcomes of diet transition and alternative diets on the one hand and the associated agricultural and food production and trade effects on the other hand, using the Chinese case as an example. We base this analysis in a modified GTAP model featuring the demand, production and supply and trade...... of major agricultural and food products. Taking advantages of recent methodological advances in building calorie and other nutrition data sourced from the FAO into the GTAP model and database, we further represent current and predicted dietary patterns for China in a baseline projection. The projected...

The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet?

Science.gov (United States)

Poti, Jennifer M; Duffey, Kiyah J; Popkin, Barry M

2014-01-01

Although fast food consumption has been linked to adverse health outcomes, the relative contribution of fast food itself compared with the rest of the diet to these associations remains unclear. Our objective was to compare the independent associations with overweight/obesity or dietary outcomes for fast food consumption compared with dietary pattern for the remainder of intake. This cross-sectional analysis studied 4466 US children aged 2-18 y from NHANES 2007-2010. Cluster analysis identified 2 dietary patterns for the non-fast food remainder of intake: Western (50.3%) and Prudent. Multivariable-adjusted linear and logistic regression models examined the association between fast food consumption and dietary pattern for the remainder of intake and estimated their independent associations with overweight/obesity and dietary outcomes. Half of US children consumed fast food: 39.5% low-consumers (≤30% of energy from fast food) and 10.5% high-consumers (>30% of energy). Consuming a Western dietary pattern for the remainder of intake was more likely among fast food low-consumers (OR: 1.51; 95% CI: 1.24, 1.85) and high-consumers (OR: 2.21; 95% CI: 1.60, 3.05) than among nonconsumers. The remainder of diet was independently associated with overweight/obesity (β: 5.9; 95% CI: 1.3, 10.5), whereas fast food consumption was not, and the remainder of diet had stronger associations with poor total intake than did fast food consumption. Outside the fast food restaurant, fast food consumers ate Western diets, which might have stronger associations with overweight/obesity and poor dietary outcomes than fast food consumption itself. Our findings support the need for prospective studies and randomized trials to confirm these hypotheses.

PSA-Based Screening Outcomes, Dietary Heterocyclic Amine Exposure, and Prostate Cancer Risk in African-Americans

National Research Council Canada - National Science Library

Bogen, Kenneth

2006-01-01

... as more abnormal results from screening tests that correlate with current or eventual PC. A 3-year prospective clinic-based study is studying the performance of current (PSA and DRE) vs. (% free PSA...

Evidence of dietary calcium and vitamin D inadequacies in a population of dental patients.

Science.gov (United States)

Pehowich, Daniel J; Pehowich, Enid D

2016-12-01

To determine the dietary calcium and vitamin D intake of a cohort of dental patients identified as being at risk of inadequacy based on a 24-hour food recall. A retrospective chart analysis was carried out on 5-day food record and nutrient analyses of 670 dental patients aged 18 to 82 years obtained over a 10-year period. All patients had scored poorly on a 24-hour food recall survey during their initial examination. The overall mean and median calcium and vitamin D intakes of the patients were significantly lower than the current estimated needs for the general population. Although calcium intake did not change over the 10-year period, vitamin D consumption decreased. The greatest dietary intake inadequacies for both calcium and vitamin D were seen in both male and female patients over age 50 years. A 24-Hour Food Recall Questionnaire may be an effective means for the oral health professional to screen patients for calcium and vitamin D and other nutrient inadequacies. Screening for potential dietary inadequacies of calcium and vitamin D may identify patients potentially at risk for poor bone health. Our results indicate that the dental health professional can obtain evidence necessary to change patient dietary behavior and thus contribute to successful treatment outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Developing self-regulation for dietary temptations: intervention effects on physical, self-regulatory and psychological outcomes.

Science.gov (United States)

McKee, Heather C; Ntoumanis, Nikos

2014-12-01

We aimed to investigate whether a self-regulatory skills intervention can improve weight loss-related outcomes. Fifty-five participants (M BMI = 32.60 ± 4.86) were randomized into self-regulation training and advice groups and received two training workshops and weekly practice tasks. The self-regulation training group was trained to use six self-regulatory skills: Delayed gratification, thought control, goal setting, self-monitoring, mindfulness, and coping. The advice group received dietary and physical activity advice for weight loss. Physical, self-regulatory, and psychological measures were taken at baseline, end of intervention (week 8) and at follow-up (week 12). Using intention-to-treat analysis, weight, waist circumference, body fat and body mass index (BMI) were significantly reduced at follow-up for both groups. There were significant increases in all six self-regulatory skills and the psychological measures of self-efficacy, self-regulatory success, and physical self-worth for both groups. Results indicate that self-regulatory skills training might be as effective as dietary and physical activity advice in terms of weight loss and related outcomes.

Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer

NARCIS (Netherlands)

Ripping, Theodora Maria; Hubbard, Rebecca A.; Otten, Johannes D. M.; den Heeten, Gerard J.; Verbeek, André L. M.; Broeders, Mireille J. M.

2016-01-01

Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected

Effects of Screening for Psychological Distress on Patient Outcomes in Cancer: a Systematic Review

Science.gov (United States)

Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

2013-01-01

Objective Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes. Methods CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT. Results There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement. Conclusion Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening. PMID:23751231

Cost and health outcomes associated with mandatory MRSA screening in a special care nursery.

Science.gov (United States)

Garcia, Robin; Vonderheid, Susan; McFarlin, Barbara; Djonlich, Michelle; Jang, Catherine; Maghirang, Jeffrey

2011-06-01

Methicillin-resistant Staphylococcus aureus (MRSA) rates continue to rise and pose a threat to patient health and limited hospital resources. In 2007, Illinois passed a legislative mandate requiring active surveillance cultures to screen for MRSA in all patients in hospital intensive care units. However, professional guidelines do not support mandated universal surveillance cultures, and funding to cover screening costs was not included. The purpose of the study was to examine the costs (personnel, screening test, and supply) associated with the mandated universal MRSA screening and to examine the infant health-related outcomes and costs associated with implementing MRSA screening in a special care nursery. Personnel-54 observations of staff members in a community-based hospital in a large midwestern city. Infants-445 infants admitted from January 2008 through January 2009. Time and motion (related to screening activities by registered nurses) based on observations of staff during MRSA screenings, and abstraction of health and cost data from the infant log, infant medical records, and financial reports. Costs (laboratory tests, personnel, and supplies) and infant health outcomes. A prospective descriptive study. Mandatory screening leads to increased costs, problems related to false-positives, and unintended consequences (eg, decision whether to treat non-MRSA organisms identified on screening cultures, possibility of legal implications, adverse family psychosocial affects, and questionable validity of the polymerase chain reaction test). The average total costs of laboratory, supply, and personnel were $15,270.12 ($34.31 per infant or $19.58 per screen). A screening test for MRSA with a high positive predictive value, low cost, and quick turnaround (providers require evidence when determining best practices, legislators should require adequate evidence before passing policy.

Interval lung cancer after a negative CT screening examination: CT findings and outcomes in National Lung Screening Trial participants

International Nuclear Information System (INIS)

Gierada, David S.; Pinsky, Paul F.; Duan, Fenghai; Garg, Kavita; Hart, Eric M.; Kazerooni, Ella A.; Nath, Hrudaya; Watts, Jubal R.; Aberle, Denise R.

2017-01-01

This study retrospectively analyses the screening CT examinations and outcomes of the National Lung Screening Trial (NLST) participants who had interval lung cancer diagnosed within 1 year after a negative CT screen and before the next annual screen. The screening CTs of all 44 participants diagnosed with interval lung cancer (cases) were matched with negative CT screens of participants who did not develop lung cancer (controls). A majority consensus process was used to classify each CT screen as positive or negative according to the NLST criteria and to estimate the likelihood that any abnormalities detected retrospectively were due to lung cancer. By retrospective review, 40/44 cases (91%) and 17/44 controls (39%) met the NLST criteria for a positive screen (P < 0.001). Cases had higher estimated likelihood of lung cancer (P < 0.001). Abnormalities included pulmonary nodules ≥4 mm (n = 16), mediastinal (n = 8) and hilar (n = 6) masses, and bronchial lesions (n = 6). Cancers were stage III or IV at diagnosis in 32/44 cases (73%); 37/44 patients (84%) died of lung cancer, compared to 225/649 (35%) for all screen-detected cancers (P < 0.0001). Most cases met the NLST criteria for a positive screen. Awareness of missed abnormalities and interpretation errors may aid lung cancer identification in CT screening. (orig.)

Interval lung cancer after a negative CT screening examination: CT findings and outcomes in National Lung Screening Trial participants

Energy Technology Data Exchange (ETDEWEB)

Gierada, David S. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, Box 8131, St. Louis, MO (United States); Pinsky, Paul F. [National Cancer Institute, Bethesda, MD (United States); Duan, Fenghai [Brown University School of Public Health, Department of Biostatistics and Center for Statistical Sciences, Providence, RI (United States); Garg, Kavita [University of Colorado School of Medicine, Mail Stop F726, Box 6510, Aurora, CO (United States); Hart, Eric M. [Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Kazerooni, Ella A. [University of Michigan Health System, Department of Radiology, Ann Arbor, MI (United States); Nath, Hrudaya; Watts, Jubal R. [University of Alabama at Birmingham School of Medicine, Department of Radiology-JTN370, Birmingham, AL (United States); Aberle, Denise R. [David Geffen School of Medicine at UCLA, Department of Radiological Sciences, Los Angeles, CA (United States)

2017-08-15

This study retrospectively analyses the screening CT examinations and outcomes of the National Lung Screening Trial (NLST) participants who had interval lung cancer diagnosed within 1 year after a negative CT screen and before the next annual screen. The screening CTs of all 44 participants diagnosed with interval lung cancer (cases) were matched with negative CT screens of participants who did not develop lung cancer (controls). A majority consensus process was used to classify each CT screen as positive or negative according to the NLST criteria and to estimate the likelihood that any abnormalities detected retrospectively were due to lung cancer. By retrospective review, 40/44 cases (91%) and 17/44 controls (39%) met the NLST criteria for a positive screen (P < 0.001). Cases had higher estimated likelihood of lung cancer (P < 0.001). Abnormalities included pulmonary nodules ≥4 mm (n = 16), mediastinal (n = 8) and hilar (n = 6) masses, and bronchial lesions (n = 6). Cancers were stage III or IV at diagnosis in 32/44 cases (73%); 37/44 patients (84%) died of lung cancer, compared to 225/649 (35%) for all screen-detected cancers (P < 0.0001). Most cases met the NLST criteria for a positive screen. Awareness of missed abnormalities and interpretation errors may aid lung cancer identification in CT screening. (orig.)

DIETARY VITAMIN E DEFICIENCY AS A MODIFIER OF THE ASSOCIATIONS OF RESPIRATORY OUTCOMES WITH AIR POLLUTION IN ADOLESCENTS

Science.gov (United States)

Introduction: We investigated whether low dietary intake of the lipophilic antioxidant vitamin E may act as a modifier of chronic air pollution's associations with respiratory outcomes among adolescents due to an increased respiratory response to the oxidative effects of air pol...

The association of fast food consumption with poor dietary outcomes and obesity among children: is it the fast food or the remainder of the diet?123

Science.gov (United States)

Poti, Jennifer M; Duffey, Kiyah J

2014-01-01

Background: Although fast food consumption has been linked to adverse health outcomes, the relative contribution of fast food itself compared with the rest of the diet to these associations remains unclear. Objective: Our objective was to compare the independent associations with overweight/obesity or dietary outcomes for fast food consumption compared with dietary pattern for the remainder of intake. Design: This cross-sectional analysis studied 4466 US children aged 2–18 y from NHANES 2007–2010. Cluster analysis identified 2 dietary patterns for the non–fast food remainder of intake: Western (50.3%) and Prudent. Multivariable-adjusted linear and logistic regression models examined the association between fast food consumption and dietary pattern for the remainder of intake and estimated their independent associations with overweight/obesity and dietary outcomes. Results: Half of US children consumed fast food: 39.5% low-consumers (≤30% of energy from fast food) and 10.5% high-consumers (>30% of energy). Consuming a Western dietary pattern for the remainder of intake was more likely among fast food low-consumers (OR: 1.51; 95% CI: 1.24, 1.85) and high-consumers (OR: 2.21; 95% CI: 1.60, 3.05) than among nonconsumers. The remainder of diet was independently associated with overweight/obesity (β: 5.9; 95% CI: 1.3, 10.5), whereas fast food consumption was not, and the remainder of diet had stronger associations with poor total intake than did fast food consumption. Conclusions: Outside the fast food restaurant, fast food consumers ate Western diets, which might have stronger associations with overweight/obesity and poor dietary outcomes than fast food consumption itself. Our findings support the need for prospective studies and randomized trials to confirm these hypotheses. PMID:24153348

Find and treat or find and lose? Tuberculosis treatment outcomes among screened newly arrived asylum seekers in Germany 2002 to 2014.

Science.gov (United States)

Kuehne, Anna; Hauer, Barbara; Brodhun, Bonita; Haas, Walter; Fiebig, Lena

2018-03-01

BackgroundGermany has a low tuberculosis (TB) incidence. A relevant and increasing proportion of TB cases is diagnosed among asylum seekers upon screening. Aim: We aimed to assess whether cases identified by screening asylum seekers had equally successful and completely reported treatment outcomes as cases diagnosed by passive case finding and contact tracing in the general population. Methods: We analysed characteristics and treatment outcomes of pulmonary TB cases notified in Germany between 2002 and 2014, stratified by mode of case finding. We performed three multivariable analyses with different dependent variables: Model A: successful vs all other outcomes, Model B: successful vs documented non-successful clinical outcome and Model C: known outcome vs lost to follow-up. Results: TB treatment success was highest among cases identified by contact tracing (87%; 3,139/3,591), followed by passive case finding (74%; 28,804/39,019) and by screening asylum seekers (60%; 884/1,474). Cases identified by screening asylum seekers had 2.4 times higher odds of not having a successful treatment outcome as opposed to all other outcomes (A), 1.4 times higher odds of not having a successful treatment outcome as opposed to known non-successful outcomes (B) and 2.3 times higher odds of loss to follow-up (C) than cases identified by passive case finding. Conclusion: Screened asylum seekers had poorer treatment outcomes and were more often lost to follow-up. Linking patients to treatment facilities and investigating potential barriers to treatment completion are needed to secure screening benefits for asylum seekers and communities.

Find and treat or find and lose? Tuberculosis treatment outcomes among screened newly arrived asylum seekers in Germany 2002 to 2014

Science.gov (United States)

Kuehne, Anna; Hauer, Barbara; Brodhun, Bonita; Haas, Walter; Fiebig, Lena

2018-01-01

Background Germany has a low tuberculosis (TB) incidence. A relevant and increasing proportion of TB cases is diagnosed among asylum seekers upon screening. Aim: We aimed to assess whether cases identified by screening asylum seekers had equally successful and completely reported treatment outcomes as cases diagnosed by passive case finding and contact tracing in the general population. Methods: We analysed characteristics and treatment outcomes of pulmonary TB cases notified in Germany between 2002 and 2014, stratified by mode of case finding. We performed three multivariable analyses with different dependent variables: Model A: successful vs all other outcomes, Model B: successful vs documented non-successful clinical outcome and Model C: known outcome vs lost to follow-up. Results: TB treatment success was highest among cases identified by contact tracing (87%; 3,139/3,591), followed by passive case finding (74%; 28,804/39,019) and by screening asylum seekers (60%; 884/1,474). Cases identified by screening asylum seekers had 2.4 times higher odds of not having a successful treatment outcome as opposed to all other outcomes (A), 1.4 times higher odds of not having a successful treatment outcome as opposed to known non-successful outcomes (B) and 2.3 times higher odds of loss to follow-up (C) than cases identified by passive case finding. Conclusion: Screened asylum seekers had poorer treatment outcomes and were more often lost to follow-up. Linking patients to treatment facilities and investigating potential barriers to treatment completion are needed to secure screening benefits for asylum seekers and communities. PMID:29560856

Dietary fat intake and risk of pancreatic cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.

Science.gov (United States)

Arem, Hannah; Mayne, Susan T; Sampson, Joshua; Risch, Harvey; Stolzenberg-Solomon, Rachael Z

2013-09-01

Epidemiologic and experimental studies suggest that dietary fat intake may affect risk of pancreatic cancer, but published results are inconsistent. We examined risk associations for specific types of dietary fat intakes and related food sources among 111,416 participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. We used Cox proportional hazards regression to examine associations between fat intake and pancreatic cancer risk. Over a mean 8.4 years of follow-up, 411 pancreatic cancer cases were identified. We observed an inverse association between saturated fat intake and pancreatic cancer risk (hazard ratio [HR], 0.64 comparing extreme quintiles; 95% confidence interval [CI], 0.46-0.88), but the association became weaker and nonsignificant when individuals with fewer than 4 years of follow-up were excluded to avoid possible reverse causation (HR, 0.88; 95% CI, 0.58-1.33). Total fat intake showed a similar pattern of association, whereas intakes of monounsaturated and polyunsaturated fats and fats from animal or plant sources showed no associations with risk. These results do not support the hypothesis of increased pancreatic cancer risk with higher fat consumption overall or by specific fat type or source. Dietary changes owing to undetected disease may explain the observed inverse association with saturated fat. Published by Elsevier Inc.

Digital Breast Tomosynthesis with Synthesized Two-Dimensional Images versus Full-Field Digital Mammography for Population Screening: Outcomes from the Verona Screening Program.

Science.gov (United States)

Caumo, Francesca; Zorzi, Manuel; Brunelli, Silvia; Romanucci, Giovanna; Rella, Rossella; Cugola, Loredana; Bricolo, Paola; Fedato, Chiara; Montemezzi, Stefania; Houssami, Nehmat

2018-04-01

Purpose To examine the outcomes of a breast cancer screening program based on digital breast tomosynthesis (DBT) plus synthesized two-dimensional (2D) mammography compared with those after full-field digital mammography (FFDM). Materials and Methods This prospective study included 16 666 asymptomatic women aged 50-69 years who were recruited in April 2015 through March 2016 for DBT plus synthetic 2D screening in the Verona screening program. A comparison cohort of women screened with FFDM (n = 14 423) in the previous year was included. Screening detection measures for the two groups were compared by calculating the proportions associated with each outcome, and the relative rates (RRs) were estimated with multivariate logistic regression. Results Cancer detection rate (CDR) for DBT plus synthetic 2D imaging was 9.30 per 1000 screening examinations versus 5.41 per 1000 screening examinations with FFDM (RR, 1.72; 95% confidence interval [CI]: 1.30, 2.29). CDR was significantly higher in patients screened with DBT plus synthetic 2D imaging than in those screened with FFDM among women classified as having low breast density (RR, 1.53; 95% CI: 1.13, 2.10) or high breast density (RR, 2.86; 95% CI: 1.42, 6.25). The positive predictive value (PPV) for recall was almost doubled with DBT plus synthetic 2D imaging: 23.3% versus 12.9% of recalled patients who were screened with FFDM (RR, 1.81; 95% CI: 1.34, 2.47). The recall rate was similar between groups (RR, 0.95; 95% CI: 0.84, 1.06), whereas the recall rate with invasive assessment was higher for DBT plus synthetic 2D imaging than for FFDM (RR, 1.93; 95% CI: 1.31, 2.03). The mean number of screening studies interpreted per hour was significantly lower for screening examinations performed with DBT plus synthetic 2D imaging (38.5 screens per hour) than with FFDM (60 screens per hour) (P < .001). Conclusion DBT plus synthetic 2D imaging increases CDRs with recall rates comparable to those of FFDM. DBT plus synthetic 2D imaging

The effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on longer-term maternal and early childhood outcomes

DEFF Research Database (Denmark)

Dodd, Jodie M.; Grivell, Rosalie M.; Louise, Jennie

2017-01-01

Background: The aim of this individual participant data meta-analysis (IPDMA) is to evaluate the effects of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood outcomes at ages 3-5 years. Methods/design: We will build...... or is being undertaken. The primary maternal outcome is a diagnosis of maternal metabolic syndrome. The primary childhood outcome is BMI above 90%. We have identified 7 relevant trials, involving 5425 women who were overweight or obese during pregnancy, with approximately 3544 women and children with follow......-up assessments available for inclusion in the meta-analysis. Discussion: The proposed IPDMA provides an opportunity to evaluate the effect of dietary and lifestyle interventions among pregnant women who are overweight or obese on later maternal and early childhood health outcomes, including risk of obesity...

Psychosocial constructs and postintervention changes in physical activity and dietary outcomes in a lifestyle intervention, HUB City Steps, 2010

Science.gov (United States)

Purpose: To examine relationships among psychosocial constructs (PSC) of behavior change and post-intervention changes in physical activity (PA) and dietary outcomes. Design: Non-controlled, pre- post-experimental intervention. Setting: Midsized, southern United States city. Subjects: 269 prima...

Outcomes related to nutrition screening in community living older adults: A systematic literature review.

Science.gov (United States)

Hamirudin, Aliza Haslinda; Charlton, Karen; Walton, Karen

2016-01-01

Nutrition screening is an initial procedure in which the risk of malnutrition is identified. The aims of this review were to identify malnutrition risk from nutrition screening studies that have used validated nutrition screening tools in community living older adults; and to identify types of nutrition interventions, pathways of care and patient outcomes following screening. A systematic literature search was performed for the period from January 1994 until December 2013 using SCOPUS, CINAHL Plus with Full Text, PubMed and COCHRANE databases as well as a manual search. Inclusion and exclusion criteria were determined for the literature searches and the methodology followed the PRISMA guidelines. Fifty-four articles were eligible to be included in the review and malnutrition risk varied from 0% to 83%. This large range was influenced by the different tools used and heterogeneity of study samples. Most of the studies were cross sectional and without a subsequent nutrition intervention component. Types of nutrition intervention that were identified included dietetics care, nutrition education, and referral to Meals on Wheels services and community services. These interventions helped to improve the' nutritional status of older adults. Timely nutrition screening of older adults living in the community, if followed up with appropriate intervention and monitoring improves the nutritional status of older adults. This indicates that nutrition intervention should be considered a priority following nutrition screening for malnourished and at risk older adults. Further evaluation of outcomes of nutrition screening and associated interventions, using structured pathways of care, is warranted. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Screening in high-risk group of gestational diabetes mellitus with its maternal and fetal outcomes

Directory of Open Access Journals (Sweden)

Angadi Rajasab Nilofer

2012-01-01

Full Text Available Background: Gestational diabetes mellitus (GDM is a metabolic disorder defined as glucose intolerance with the onset or first recognition during pregnancy. Women with GDM are at increased risk for adverse obstetric and perinatal outcome. The complications associated with GDM can be prevented by early recognition, intense monitoring and proper treatment. Aims: The present study was done to screen the high-risk pregnancy group for GDM, to find the incidence of abnormal results on screening and to correlate the abnormal results with the maternal and fetal outcomes. The study was done in a tertiary care hospital and teaching institute. It was a prospective cohort study. Materials and Methods: Selective screening for GDM was done in 150 pregnant women with high-risk factors. Screening was done with 50 g glucose challenge test (GCT after 18 weeks, and if GCT was negative then the test was repeated after 28 weeks of pregnancy. The patients who were having an abnormal GCT were subjected to 100 g oral glucose tolerance test (OGTT. All GDM patients were followed up and treated with diet and/or insulin therapy till delivery to know maternal and fetal outcomes. The period of study was from April 2008 to March 2009. Results: 7.3% of study population was OGCT positive. 6% of the study population was OGTT positive. Age >25 years, obesity, family history of DM, and past history of GDM were the risk factors significantly associated with GDM. One newborn had hypoglycemia and one had hyperbilirubinemia. The fetal and maternal outcome in GDM patients was good in our study due to early diagnosis and intervention. Conclusion: Women with GDM are at an increased risk for adverse obstetric and perinatal outcome. The increased morbidity in GDM is preventable by meticulous antenatal care.

Neurological outcomes in symptomatic congenital cytomegalovirus-infected infants after introduction of newborn urine screening and antiviral treatment.

Science.gov (United States)

Nishida, Kosuke; Morioka, Ichiro; Nakamachi, Yuji; Kobayashi, Yoko; Imanishi, Takamitsu; Kawano, Seiji; Iwatani, Sota; Koda, Tsubasa; Deguchi, Masashi; Tanimura, Kenji; Yamashita, Daisuke; Nibu, Ken-Ichi; Funakoshi, Toru; Ohashi, Masanobu; Inoue, Naoki; Iijima, Kazumoto; Yamada, Hideto

2016-02-01

Newborn screening for urinary cytomegalovirus (CMV) and early introduction of antiviral treatment are expected to improve neurological outcomes in symptomatic congenital CMV-infected infants. This cohort study prospectively evaluated neurological outcomes in symptomatic congenital CMV-infected infants following the introduction of hospital-based newborn urinary CMV screening and antiviral treatment. Following institutional review board approval and written informed consent from their parents, newborns were prospectively screened from 2009 to 2014 for urinary CMV-DNA by PCR within 1 week after birth at Kobe University Hospital and affiliated hospitals. CMV-positive newborns were further examined at Kobe University Hospital, and those diagnosed as symptomatic were treated with valganciclovir for 6 weeks plus immunoglobulin. Clinical neurological outcomes were evaluated at age ⩾12 months and categorized by the presence and severity of neurologic sequelae. Urine samples of 6348 newborns were screened, with 32 (0.50%) positive for CMV. Of these, 16 were diagnosed with symptomatic infection and 12 received antiviral treatment. Four infants developed severe impairment (33%), three developed mild impairment (25%), and five developed normally (42%). This is the first Japanese report of neurological assessments in infants with symptomatic congenital CMV infection who received early diagnosis and antiviral treatment. Urinary screening, resulting in early diagnosis and treatment, may yield better neurological outcomes in symptomatic congenital CMV-infected infants. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Clinical outcomes for young people with screening-detected and clinically-diagnosed rheumatic heart disease in Fiji.

Science.gov (United States)

Engelman, Daniel; Mataika, Reapi L; Ah Kee, Maureen; Donath, Susan; Parks, Tom; Colquhoun, Samantha M; Carapetis, Jonathan R; Kado, Joseph H; Steer, Andrew C

2017-08-01

Echocardiographic screening is under consideration as a disease control strategy for rheumatic heart disease (RHD). However, clinical outcomes of young people with screening-detected RHD are unknown. We aimed to describe the outcomes for a cohort with screening-detected RHD, in comparison to patients with clinically-diagnosed RHD. A retrospective cohort study included all young people with screening-detected RHD in the Central Division of Fiji in the primary cohort. Screen-negative and clinically-diagnosed comparison groups were matched 1:1 to the primary cohort. Data were collected on mortality, clinical complications and healthcare utilisation from the electronic and paper health records and existing databases. Seventy participants were included in each group. Demographic characteristics of the groups were similar (median age 11years, 69% female, median follow-up 7years). There were nine (12.9%) RHD-related deaths in the clinically-diagnosed group and one (1.4%) in the screening-detected group (Incident Rate Ratio: 9.6, 95% CI 1.3-420.6). Complications of RHD were observed in 39 (55.7%) clinically-diagnosed cases, four (20%) screening-detected cases and one (1.4%) screen-negative case. There were significant differences in the cumulative complication curves of the groups (pFiji. The prognosis of clinically-diagnosed RHD remains poor, with very high mortality and complication rates. Further studies in other settings will inform RHD screening policy. Comprehensive control strategies are required for disease prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

OBGYN screening for environmental exposures: A call for action.

Science.gov (United States)

Grindler, N M; Allshouse, A A; Jungheim, E; Powell, T L; Jansson, T; Polotsky, A J

2018-01-01

Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae. Our objective was to determine the frequency of environmental exposure screening by obstetricians and gynecologists (OBGYNs) at initial patient visits. Practicing OBGYNs were approached at the University of Colorado and by social media. The survey instrument queried demographics, environmental literacy, and screening practices. Statistical analysis was performed using Chi-square and two-sample t-test. We received 312 online survey responses (response rate of 12%). Responding OBGYNs were predominantly female (96%), board-certified (78%), generalists (65%) with a mean age of 37.1 years. Fewer than half of physicians screened for the following factors: occupational exposures, environmental chemicals, air pollution, pesticide use, personal care products, household cleaners, water source, use of plastics for food storage, and lead and mercury exposure. Eighty five percent of respondents reported that they did not feel comfortable obtaining an environmental history and 58% respondents reported that they performed no regular screening of environmental exposures. A higher frequency of screening was associated with > 4 years of practice (p = 0.001), and having read the environmental committee opinion (p = counseling patients may enhance screening for exposures that affect reproductive health.

Three-year effects on dietary quality of health education

DEFF Research Database (Denmark)

Maindal, Helle Terkildsen; Toft, Ulla; Lauritzen, Torsten

2012-01-01

Healthy diet is a core component in prevention and self-management of type 2 diabetes and cardiovascular disease. The long-term efficacy was assessed of a theory-based health education programme 'Ready to Act' on dietary quality in people with screen-detected dysglycaemia.......Healthy diet is a core component in prevention and self-management of type 2 diabetes and cardiovascular disease. The long-term efficacy was assessed of a theory-based health education programme 'Ready to Act' on dietary quality in people with screen-detected dysglycaemia....

Is the relationship between sedentary behaviour and cardiometabolic health in adolescents independent of dietary intake? A systematic review.

Science.gov (United States)

Fletcher, E; Leech, R; McNaughton, S A; Dunstan, D W; Lacy, K E; Salmon, J

2015-09-01

Screen time, but not overall sedentary behaviour, is consistently related to cardiometabolic health in adolescents. Because of the associations screen time has with dietary intake, diet may be an important factor in the screen time and health relationship; however, evidence has not previously been synthesized. Thus, the aim of this systematic review was to explore whether the associations between various sedentary behaviours and cardiometabolic risk markers are independent of dietary intake in adolescents. Online databases and personal libraries were searched for peer-reviewed original research articles published in English before March 2014. Included studies assessed associations between sedentary behaviour and cardiometabolic markers in 12- to 18-year-olds and adjusted for dietary intake. Twenty-five studies met the inclusion criteria. From the 21 studies examining sedentary behaviour and adiposity, the majority found significant positive associations between television viewing, screen time and self-reported overall sedentary behaviour with markers of adiposity, independent of dietary intake. No significant associations between screen time with blood pressure and cholesterol were reported. Sedentary behaviour appears to be associated with adiposity in adolescents, irrespective of dietary intake. However, the variability of dietary variables between studies suggests further work is needed to understand the role of dietary intake when examining these associations in youth. © 2015 World Obesity.

Dietary patterns and relationship to obesity-related health outcomes and mortality in adults 75 years of age or greater

Science.gov (United States)

Background: The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-relat...

Effects of dietary n-3 and n-6 fatty acids on clinical outcome in a porcine model on postoperative infection

DEFF Research Database (Denmark)

Langerhuus, Sine Nygaard; Tønnesen, Else Kirstine; Jensen, Karin Hjelholt

2012-01-01

, daily body-weight gain was determined in both periods. The preoperative changes in plasma and erythrocyte n-3 and n-6 LC-PUFA concentrations reflected the fatty acid compositions of the dietary treatments given, and plasma PGE2 metabolite concentration decreased in the fish oil treatment (P ...The present study was performed to evaluate the effects of dietary n-3 and n-6 long-chain PUFA (LC-PUFA) on clinical outcome in a porcine model on early aortic vascular prosthetic graft infection (AVPGI). A total of eighty-four pigs were randomised to a 35 d dietary treatment with 10 % (w/w) fish......·001). In the post-operative period, feed intake (P = 0·004) and body-weight gain (P = 0·038) were higher in the fish oil treatment compared with the sunflower oil treatment. The dietary treatments did not affect the number of days pigs were showing fever, weakness in the hindquarters or impaired general appearance...

Nutritional screening for improving professional practice for patient outcomes in hospital and primary care settings.

Science.gov (United States)

Omidvari, Amir-Houshang; Vali, Yasaman; Murray, Susan M; Wonderling, David; Rashidian, Arash

2013-06-06

Given the prevalence of under-nutrition and reports of inadequate nutritional management of patients in hospitals and the community, nutritional screening may play a role in reducing the risks of malnutrition. Screening programmes can invoke costs to health systems and patients. It is therefore important to assess the effectiveness of nutritional screening programmes. To examine the effectiveness of nutritional screening in improving quality of care (professional practice) and patient outcomes compared with usual care. We searched the following databases: CENTRAL (The Cochrane Library), MEDLINE, EMBASE and CINAHL up to June 2012 to find relevant studies. Randomised controlled studies, controlled clinical trials, controlled before-after studies and interrupted time series studies assessing the effectiveness of nutritional screening were eligible for inclusion in the review. We considered process outcomes (for example patient identification, referral to dietitian) and patient outcomes (for example mortality, change in body mass index (BMI)). Participants were adult patients aged 16 years or over. We included studies conducted in different settings, including hospitals, out-patient clinics, primary care or long term care settings. We independently assessed the risk of bias and extracted data from the included studies. Meta-analysis was considered but was not conducted due to the discrepancies between the studies. The studies were heterogeneous in their design, setting, intervention and outcomes. We analysed the data using a narrative synthesis approach. After conducting initial searches and screening the titles and abstracts of the identified literature, 77 full text papers were retrieved and read. Ultimately three studies were included. Two controlled before-after studies were conducted in hospital settings (one in the UK and one in the Netherlands) and one cluster randomised controlled trial was conducted in a primary care setting (in the USA).The study conducted in

Efficacy and outcome of expanded newborn screening for metabolic diseases - Report of 10 years from South-West Germany *

Directory of Open Access Journals (Sweden)

Mengel Eugen

2011-06-01

Full Text Available Abstract Background National newborn screening programmes based on tandem-mass spectrometry (MS/MS and other newborn screening (NBS technologies show a substantial variation in number and types of disorders included in the screening panel. Once established, these methods offer the opportunity to extend newborn screening panels without significant investment and cost. However, systematic evaluations of newborn screening programmes are rare, most often only describing parts of the whole process from taking blood samples to long-term evaluation of outcome. Methods In a prospective single screening centre observational study 373 cases with confirmed diagnosis of a metabolic disorder from a total cohort of 1,084,195 neonates screened in one newborn screening laboratory between January 1, 1999, and June 30, 2009 and subsequently treated and monitored in five specialised centres for inborn errors of metabolism were examined. Process times for taking screening samples, obtaining results, initiating diagnostic confirmation and starting treatment as well as the outcome variables metabolic decompensations, clinical status, and intellectual development at a mean age of 3.3 years were evaluated. Results Optimal outcome is achieved especially for the large subgroup of patients with medium-chain acyl-CoA dehydrogenase deficiency. Kaplan-Meier-analysis revealed disorder related patterns of decompensation. Urea cycle disorders, organic acid disorders, and amino acid disorders show an early high and continuous risk, medium-chain acyl-CoA dehydrogenase deficiency a continuous but much lower risk for decompensation, other fatty acid oxidation disorders an intermediate risk increasing towards the end of the first year. Clinical symptoms seem inevitable in a small subgroup of patients with very early disease onset. Later decompensation can not be completely prevented despite pre-symptomatic start of treatment. Metabolic decompensation does not necessarily result in

Screening, intervention and outcome in autism and other developmental disorders: the role of randomized controlled trials

OpenAIRE

Fernell, Elisabeth; Wilson, Philip; Hadjikhani, Nouchine; Bourgeron, Thomas; Neville, Brian; Taylor, David; Minnis, Helen; Gillberg, Christopher

2014-01-01

We draw attention to a number of important considerations in the arguments about screening and outcome of intervention in children with autism and other developmental disorders. Autism screening in itself never provides a final clinical diagnosis, but may well identify developmental deviations indicative of autism—or of other developmental disorders—that should lead to referral for further clinical assessment. Decisions regarding population or clinic screening cannot be allowed to be based on...

Interactions of commonly used dietary supplements with cardiovascular drugs: a systematic review

Directory of Open Access Journals (Sweden)

Kanji Salmaan

2012-05-01

Full Text Available Abstract Background The objective of this systematic review was to examine the benefits, harms and pharmacokinetic interactions arising from the co-administration of commonly used dietary supplements with cardiovascular drugs. Many patients on cardiovascular drugs take dietary supplements for presumed benefits and may be at risk for adverse supplement-drug interactions. Methods The Allied and Complementary Medicine Database, the Cochrane Library, EMBASE, International Bibliographic Information on Dietary Supplements and MEDLINE were searched from the inception of the review to October 2011. Grey literature was also reviewed. Two reviewers independently screened records to identify studies comparing a supplement plus cardiovascular drug(s with the drug(s alone. Reviewers extracted data using standardized forms, assessed the study risk of bias, graded the strength of evidence and reported applicability. Results Evidence was obtained from 65 randomized clinical trials, 2 controlled clinical trials and 1 observational study. With only a few small studies available per supplement, evidence was insufficient for all predefined gradable clinical efficacy and harms outcomes, such as mortality and serious adverse events. One long-term pragmatic trial showed no benefit from co-administering vitamin E with aspirin on a composite cardiovascular outcome. Evidence for most intermediate outcomes was insufficient or of low strength, suggesting no effect. Incremental benefits were noted for triglyceridemia with omega-3 fatty acid added to statins; and there was an improvement in levels of high-density lipoprotein cholesterol with garlic supplementation when people also consumed nitrates Conclusions Evidence of low-strength indicates benefits of omega-3 fatty acids (plus statin, or calcium channel blockers and antiplatelets and garlic (plus nitrates or warfarin on triglycerides and HDL-C, respectively. Safety concerns, however, persist.

Psychometric Properties of a Scale to Assess Parental Self-Efficacy for Influencing Children's Dietary, Physical Activity, Sedentary, and Screen Time Behaviors in Disadvantaged Areas

Science.gov (United States)

Norman, Åsa; Bohman, Benjamin; Nyberg, Gisela; Schäfer Elinder, Liselotte

2018-01-01

Background: According to social cognitive theory, self-efficacy is central to behavior change. Consequently, parental self-efficacy (PSE) for influencing children's dietary, physical activity (PA), sedentary, and screen time behaviors is important for child obesity prevention. The aim of this study was to evaluate the psychometric properties of an…

Adherence to, and outcomes of, a galactomannan screening protocol in high-risk hematology patients.

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Harricharan, S; Biederman, K; Bombassaro, A M; Lazo-Langner, A; Elsayed, S; Fulford, A; Delport, J A; Xenocostas, A

2018-04-01

A twice-weekly galactomannan (gm) screening protocol was implemented in high-risk hematology inpatients. Study objectives were to determine adherence to the protocol, use of selected resources, and patient outcomes. This retrospective cohort study compared outcomes of interest before and after implementation of gm screening. Adults undergoing matched related allogeneic hematopoietic stem-cell transplantation or induction chemotherapy for acute leukemia were eligible. Patients could be enrolled more than once and were evaluated as episodes. Adherence to the gm protocol was assessed in post-implementation episodes. Use of broad-spectrum antifungals (bsafs), consultations (infectious diseases, respirology), and diagnostic procedures (computed tomography imaging, bronchoalveolar lavage) were compared between phases, as were the patient outcomes of all-cause mortality and clinical success (alive and not taking a bsaf). Of 182 episodes consecutively screened, 70 per phase were enrolled. Clinical characteristics and duration of assessment were similar for the phases. Full or partial adherence to the protocol was observed in 61 post-implementation episodes (87%), with full adherence in 40 episodes (57%). More episodes in the pre-implementation phase than in the post-implementation phase involved receipt of bsafs, consultations, and diagnostics (27% vs. 7%, p = 0.02; 46% vs. 26%, p = 0.014; and 46% vs. 31%, p = 0.083 respectively). Although mortality was similar in the two phases, clinical success at the final assessment was observed in fewer pre-implementation than post-implementation episodes (79% vs. 98%, p < 0.001). Implementation of a gm screening protocol was feasible and associated with significantly fewer episodes involving receipt of bsafs and consultations, and with significantly more episodes showing clinical success.

At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study.

Science.gov (United States)

Kivelä, Laura; Kaukinen, Katri; Huhtala, Heini; Lähdeaho, Marja-Leena; Mäki, Markku; Kurppa, Kalle

2017-04-01

To assess whether children at risk for celiac disease should be screened systematically by comparing their baseline and follow-up characteristics to patients detected because of clinical suspicion. Five hundred four children with celiac disease were divided into screen-detected (n = 145) and clinically detected cohorts (n = 359). The groups were compared for clinical, serologic, and histologic characteristics and laboratory values. Follow-up data regarding adherence and response to gluten-free diet were compared. Subgroup analyses were made between asymptomatic and symptomatic screen-detected patients. Of screen-detected patients, 51.8% had symptoms at diagnosis, although these were milder than in clinically detected children (P celiac disease had symptoms unrecognized at diagnosis. The severity of histologic damage, antibody levels, dietary adherence, and response to treatment in screen-detected cases is comparable with those detected on a clinical basis. The results support active screening for celiac disease among at-risk children. Copyright © 2017 Elsevier Inc. All rights reserved.

The relations between dietary antioxidant vitamins intake and oxidative stress in follicular fluid and ART outcomes

OpenAIRE

Kazemi, Ashraf; Ramezanzadeh, Fatemeh; Nasr-Esfahani, Mohammad Hosein

2015-01-01

Background: Oxidative stress (OS) in the follicular environment may affect on oocyte competence and antioxidant vitamins may modify its effects. Objective: This study was conducted to examine the effect of dietary intake of vitamin A, C and E on OS in follicular environment and assisted reproduction technology (ART) outcomes. Materials and Methods: In this obsevationalprospective study, the intake levels of vitamin A, C, and E were matured by validated food frequency questionnaire and ...

[Value of nutritional risk screening in evaluating adverse clinical outcomes in children with severe pneumonia].

Science.gov (United States)

Guo, Xiao-Hui; Sun, Yan-Feng; Wang, Jiang-Bo; Han, Shu-Zhen; Miao, Jing; Cui, Min

2017-03-01

To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes. According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53). Fasting blood samples were collected to measure the levels of insulin-like growth factor-1 (IGF-1), adiponectin, leptin, non-esterified fatty acid (NEFA), albumin, transferrin, prealbumin, and retinol binding protein (RBP). The adverse clinical outcomes were recorded. Compared with the MR and LR groups, the HR group had significantly lower serum levels of IGF-1, leptin, adiponectin, prealbumin, and RBP, as well as a significantly higher serum level of NEFA (Prisk screening has an important value in evaluating the clinical outcome of children with severe pneumonia, and children at a higher nutritional risk tend to have more adverse clinical outcomes.

Stage of presentation and visual outcome of patients screened for familial retinoblastoma: nationwide registration in the Netherlands

NARCIS (Netherlands)

Imhof, S. M.; Moll, A. C.; Schouten-van Meeteren, A. Y. N.

2006-01-01

In the Netherlands a comprehensive programme for screening just after birth for familial retinoblastoma is taking place. In this report the stage of the disease at the time of detection, by way of screening, and the long term visual outcome in these patients was evaluated. A nationwide,

Using a portable ion mobility spectrometer to screen dietary supplements for sibutramine.

Science.gov (United States)

Dunn, Jamie D; Gryniewicz-Ruzicka, Connie M; Kauffman, John F; Westenberger, Benjamin J; Buhse, Lucinda F

2011-02-20

In response to recent incidents of undeclared sibutramine, an appetite suppressant found in dietary supplements, we developed a method to detect sibutramine using hand-held ion mobility spectrometers with an analysis time of 15 s. Ion mobility spectrometry is a high-throughput and sensitive technique that has been used for illicit drug, explosive, volatile organic compound and chemical warfare detection. We evaluated a hand-held ion mobility spectrometer as a tool for the analysis of supplement extracts containing sibutramine. The overall instrumental limit of detection of five portable ion mobility spectrometers was 2 ng of sibutramine HCl. When sample extractions containing 30 ng/μl or greater of sibutramine were analyzed, saturation of the ionization chamber of the spectrometer occurred and the instrument required more than three cleaning cycles to remove the drug. Hence, supplement samples suspected of containing sibutramine should be prepared at concentrations of 2-20 ng/μl. To obtain this target concentration range for products containing unknown amounts of sibutramine, we provided a simple sample preparation procedure, allowing the U.S. Food and Drug Administration or other agencies to screen products using the portable ion mobility spectrometer. Published by Elsevier B.V.

FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients.

Science.gov (United States)

Gleason, Lauren Jan; Benton, Emily A; Alvarez-Nebreda, M Loreto; Weaver, Michael J; Harris, Mitchel B; Javedan, Houman

2017-12-01

There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. Retrospective cohort study. Level 1 trauma center. A total of 175 consecutive patients over age 70 years admitted to co-managed orthopedic trauma and geriatrics services. The FRAIL scale (short 5-question assessment of fatigue, resistance, aerobic capacity, illnesses, and loss of weight) classified the patients into 3 categories: robust (score = 0), prefrail (score = 1-2), and frail (score = 3-5). Postoperative outcome variables collected were postoperative complications, unplanned intensive care unit admission, length of stay (LOS), discharge disposition, and orthopedic follow-up after surgery. Thirty-day outcomes measured were 30-day readmission and 30-day mortality. Analysis of variance (1-way) and Kruskal-Wallis tests were used to compare continuous variables across the 3 FRAIL categories. Fisher exact tests were used to compare categorical variables. Multiple regression analysis, adjusted by age, sex, and Charlson index, was conducted to study the association between frailty category and outcomes. FRAIL scale categorized the patients into 3 groups: robust (n = 29), prefrail (n = 73), and frail (n = 73). There were statistically significant differences between groups in terms of age, comorbidity, dementia, functional dependency, polypharmacy, and rate of institutionalization, being higher in the frailest patients. Hip fracture was the most frequent fracture, and it was more frequent as the frailty of the patient increased (48%, 61%, and 75% in robust, prefrail, and frail groups, respectively). The American

Determinants of dietary supplement use--healthy individuals use dietary supplements.

Science.gov (United States)

Kofoed, Christina L F; Christensen, Jane; Dragsted, Lars O; Tjønneland, Anne; Roswall, Nina

2015-06-28

The prevalence of dietary supplement use varies largely among populations, and previous studies have indicated that it is high in the Danish population compared with other European countries. The diversity in supplement use across countries indicates that cultural and environmental factors could influence the use of dietary supplements. Only few studies investigating the use of dietary supplements have been conducted in the Danish population. The present cross-sectional study is based on 54,948 Danes, aged 50-64 years, who completed self-administrated questionnaires on diet, dietary supplements and lifestyle between 1993 and 1997. A health index including smoking, physical activity, alcohol and diet, and a metabolic risk index including waist circumference, urinary glucose and measured hypertension were constructed. Logistic regression was used to investigate these determinants in relation to the intake of dietary supplements. We found that 71 % of the participants were dietary supplement users; female sex, older age groups and higher educated participants were more likely to be users of any dietary supplements. One additional point in the health index was associated with 19, 16 and 9 % higher likelihood of being user of any, more common and less common supplements, respectively. In the metabolic risk index, one additional point was associated with 17 and 16 % lower likelihood of being user of any supplement and more common supplements, respectively. No significant association was found for less common supplement use. In conclusion, those with the healthiest lifestyle were more likely to use dietary supplements. Thus, lifestyle and dietary composition should be considered as confounders on supplement use and health outcomes.

Dietary interventions in overweight and obese pregnant women: a systematic review of the content, delivery, and outcomes of randomized controlled trials.

Science.gov (United States)

Flynn, Angela C; Dalrymple, Kathryn; Barr, Suzanne; Poston, Lucilla; Goff, Louise M; Rogozińska, Ewelina; van Poppel, Mireille N M; Rayanagoudar, Girish; Yeo, SeonAe; Barakat Carballo, Ruben; Perales, Maria; Bogaerts, Annick; Cecatti, Jose G; Dodd, Jodie; Owens, Julie; Devlieger, Roland; Teede, Helena; Haakstad, Lene; Motahari-Tabari, Narges; Tonstad, Serena; Luoto, Riitta; Guelfi, Kym; Petrella, Elisabetta; Phelan, Suzanne; Scudeller, Tânia T; Hauner, Hans; Renault, Kristina; Sagedal, Linda Reme; Stafne, Signe N; Vinter, Christina; Astrup, Arne; Geiker, Nina R W; McAuliffe, Fionnuala M; Mol, Ben W; Thangaratinam, Shakila

2016-05-01

Interventions targeting maternal obesity are a healthcare and public health priority. The objective of this review was to evaluate the adequacy and effectiveness of the methodological designs implemented in dietary intervention trials for obesity in pregnancy. A systematic review of the literature, consistent with PRISMA guidelines, was performed as part of the International Weight Management in Pregnancy collaboration. Thirteen randomized controlled trials, which aimed to modify diet and physical activity in overweight and obese pregnant women, were identified. There was significant variability in the content, delivery, and dietary assessment methods of the dietary interventions examined. A number of studies demonstrated improved dietary behavior in response to diet and/or lifestyle interventions. Nine studies reduced gestational weight gain. 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 the evidence in clinical practice. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Assessing the effectiveness and cost effectiveness of adaptive e-Learning to improve dietary behaviour: protocol for a systematic review.

Science.gov (United States)

Edwards, Phil; Felix, Lambert; Harris, Jody; Ferguson, Elaine; Free, Caroline; Landon, Jane; Lock, Karen; Michie, Susan; Miners, Alec; Murray, Elizabeth

2010-04-21

The composition of habitual diets is associated with adverse or protective effects on aspects of health. Consequently, UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is e-Learning, the use of interactive electronic media to facilitate teaching and learning on a range of issues, including diet and health. The aims of this systematic review are to determine the effectiveness and cost-effectiveness of adaptive e-Learning for improving dietary behaviours. The research will consist of a systematic review and a cost-effectiveness analysis. Studies will be considered for the review if they are randomised controlled trials, involving participants aged 13 or over, which evaluate the effectiveness or efficacy of interactive software programmes for improving dietary behaviour. Primary outcome measures will be those related to dietary behaviours, including estimated intakes of energy, nutrients and dietary fibre, or the estimated number of servings per day of foods or food groups. Secondary outcome measures will be objective clinical measures that are likely to respond to changes in dietary behaviours, such as anthropometry or blood biochemistry. Knowledge, self-efficacy, intention and emotion will be examined as mediators of dietary behaviour change in order to explore potential mechanisms of action. Databases will be searched using a comprehensive four-part search strategy, and the results exported to a bibliographic database. Two review authors will independently screen results to identify potentially eligible studies, and will independently extract data from included studies, with any discrepancies at each stage settled by a third author. Standardised forms and criteria will be used.A descriptive analysis of included studies will describe study design, participants, the

Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet

DEFF Research Database (Denmark)

Paci, Eugenio; Lynge, Elsebeth

2012-01-01

To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women.......To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women....

Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study.

Science.gov (United States)

Mangano, Kelsey M; Sahni, Shivani; Kiel, Douglas P; Tucker, Katherine L; Dufour, Alyssa B; Hannan, Marian T

2017-03-01

Background: Above-average dietary protein, as a single nutrient, improves musculoskeletal health. Evaluating the link between dietary protein and musculoskeletal health from a whole-diet perspective is important, as dietary guidelines focus on dietary patterns. Objective: We examined the prospective association of novel dietary protein food clusters (derived from established dietary pattern techniques) with appendicular lean mass (ALM), quadriceps strength (QS), and bone mineral density (BMD) in 2986 men and women, aged 19-72 y, from the Framingham Third Generation Study. Design: Total protein intake was estimated by food-frequency questionnaire in 2002-2005. A cluster analysis was used to classify participants into mutually exclusive groups, which were determined by using the percentage of contribution of food intake to overall protein intake. General linear modeling was used to 1 ) estimate the association between protein intake (grams per day) and BMD, ALM, appendicular lean mass normalized for height (ALM/ht 2 ), and QS (2008-2011) and to 2 ) calculate adjusted least-squares mean outcomes across quartiles of protein (grams per day) and protein food clusters. Results: The mean ± SD age of subjects was 40 ± 9 y; 82% of participants met the Recommended Daily Allowance (0.8 g · kg body weight -1 · d -1 ). The following 6 dietary protein food clusters were identified: fast food and full-fat dairy, fish, red meat, chicken, low-fat milk, and legumes. BMD was not different across quartiles of protein intake ( P -trend range = 0.32-0.82); but significant positive trends were observed for ALM, ALM/ht 2 ( P dietary protein is associated with ALM and QS but not with BMD. In this study, dietary protein food patterns do not provide further insight into beneficial protein effects on muscle outcomes. © 2017 American Society for Nutrition.

Vascular injury outcomes with screening implementation

Directory of Open Access Journals (Sweden)

James D. Weinberg, MD

2017-09-01

Full Text Available Blunt carotid and vertebral artery injuries (BCVI are generally viewed as rare events. Screening guidelines based on the Memphis and Denver data were put into place at Palmetto Health Richland in August of 2008. This study aims to look at the incidence of BCVI 2 years before the guidelines were put into place and then 2 years after. A total of 11,005 trauma patients presented during our study period. 98 patients were determined to have BCVI and met inclusion criteria: 21 in the Control group and 77 in the Screening group. A total of 16 deaths and 14 strokes were recorded in the study population. The odds of patients in the Screening group dying were 29% lower than that of a patient in the Control group [OR: 0.71, (95% CI: 0.20–2.50; p = 0.59], after adjusting for ISS. The odds of developing a stroke in the Screening group were 69% lower than the Control group [OR: 0.31 (0.09–1.08; p = 0.067]. These differences were not statistically significant. The increased BCVI incidence rate and decreased stroke and mortality rate following screening implementation further support the importance of having screening criteria for blunt vascular injury following trauma.

Neonatal screening for inborn errors of metabolism: cost, yield and outcome.

Science.gov (United States)

Pollitt, R J; Green, A; McCabe, C J; Booth, A; Cooper, N J; Leonard, J V; Nicholl, J; Nicholson, P; Tunaley, J R; Virdi, N K

1997-01-01

OBJECTIVES. To systematically review the literature on inborn errors of metabolism, neonatal screening technology and screening programmes in order to analyse the costs and benefits of introducing screening based on tandem mass-spectrometry (tandem MS) for a wide range of disorders of amino acid and organic acid metabolism in the UK. To evaluate screening for cystic fibrosis, Duchenne muscular dystrophy and other disorders which are tested on an individual basis. HOW THE RESEARCH WAS CONDUCTED. Systematic searches were carried out of the literature on inborn errors of metabolism, neonatal screening programmes, tandem MS-based neonatal screening technology, economic evaluations of neonatal screening programmes and psychological aspects of neonatal screening. Background material on the biology of inherited metabolic disease, the basic philosophy, and the history and current status of the UK screening programme was also collected. Relevant papers in the grey literature and recent publications were identified by hand-searching. Each paper was graded. For each disease an aggregate grade for the state of knowledge in six key areas was awarded. Additional data were prospectively collected on activity and costs in UK neonatal screening laboratories, and expert clinical opinion on current treatment modalities and outcomes. These data were used to construct a decision-analysis model of neonatal screening technologies, comparing tandem MS with the existing phenylketonuria screening methods. This model determined the cost per additional case identified and, for each disease, the additional treatment costs per case, and the cost per life-year saved. All costs and benefits were discounted at 6% per annum. One-way sensitivity analysis was performed showing the effect of varying the discount rate, the incidence rate of each disorder, the number of neonates screened and the cost of tandem MS, on the cost per life-year gained. RESEARCH FINDINGS. The UK screening programmes for

Dietary Patterns in women with Inflammatory Bowel Disease and Risk of Adverse Pregnancy Outcomes: Results from The Norwegian Mother and Child Cohort Study (MoBa).

Science.gov (United States)

Myklebust-Hansen, Thea; Aamodt, Geir; Haugen, Margaretha; Brantsæter, Anne Lise; Vatn, Morten H; Bengtson, May-Bente

2017-12-19

The aim of the study was to examine dietary patterns and risk of adverse pregnancy outcomes among mothers with inflammatory bowel disease (IBD) in the Norwegian Mother and Child Cohort Study (MoBa). MoBa enrolled participants from all over Norway between 1999 and 2008, and the study comprised 83,988 mothers, of whom there were 183 mothers with Crohn's disease (CD) and 240 with ulcerative colitis (UC). An additional questionnaire was submitted to mothers with IBD in 2013. We extracted three exploratory dietary patterns: a "Prudent," a "Western," and a "Traditional" pattern. We explored the relationship between dietary patterns and IBD and dietary patterns and adverse pregnancy outcomes: small for gestational age (SGA) and preterm delivery (PTD). IBD mothers had a significantly lower adherence to the Traditional dietary pattern [mean score -0.10 (95% CI: - 0.2 - - 0.01)] than non-IBD mothers. In IBD mothers, middle and high adherence to the Traditional dietary pattern was associated with lower risk of SGA [OR tertile 2 vs. tertile 1: 0.44 (95% CI: 0.20 - 0.97) and OR tertile 3 vs. tertile 1: 0.23 (95% CI: 0.08-0.61)] than in IBD and non-IBD mothers with low adherence. In the IBD-subset analyses, similar results were demonstrated for UC mothers [OR tertile 2 vs. tertile 1: 0.21 (95% CI: 0.05 - 0.80) and OR tertile 3 vs. tertile 1: 0.16 (95% CI: 0.04 - 0.60)]. In IBD mothers, higher adherence to a Traditional dietary pattern, characterized by high consumption of lean fish, fish products, potatoes, rice porridge, cooked vegetables, and gravy, was associated with lower risk of SGA. © 2017 Crohn’s & Colitis Foundation of America. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Screening, intervention and outcome in autism and other developmental disorders: the role of randomized controlled trials.

Science.gov (United States)

Fernell, Elisabeth; Wilson, Philip; Hadjikhani, Nouchine; Bourgeron, Thomas; Neville, Brian; Taylor, David; Minnis, Helen; Gillberg, Christopher

2014-08-01

We draw attention to a number of important considerations in the arguments about screening and outcome of intervention in children with autism and other developmental disorders. Autism screening in itself never provides a final clinical diagnosis, but may well identify developmental deviations indicative of autism-or of other developmental disorders-that should lead to referral for further clinical assessment. Decisions regarding population or clinic screening cannot be allowed to be based on the fact that prospective longitudinal RCT designs over decades could never be performed in complex developmental disorders. We propose an alternative approach. Early screening for autism and other developmental disorders is likely to be of high societal importance and should be promoted and rigorously evaluated.

Comparing the outcomes of two strategies for colorectal tumor detection: Policy-promoted screening program versus health promotion service

Directory of Open Access Journals (Sweden)

Ping-Hsiu Wu

2013-06-01

Conclusion: In comparison with the outcomes of the HPS database, the screening efficacy of the PPS database is even for detecting colorectal carcinoma but is limited in detecting advanced adenoma. HPS may provide comprehensive validity indicators and will be helpful in adjusting current policies for improving screening performance.

OBGYN screening for environmental exposures: A call for action

Science.gov (United States)

Allshouse, A. A.; Jungheim, E.; Powell, T. L.; Jansson, T.; Polotsky, A. J.

2018-01-01

Background Prenatal exposures have known adverse effects on maternal and neonatal outcomes. Professional societies recommend routine screening for environmental, occupational, and dietary exposures to reduce exposures and their associated sequelae. Objective Our objective was to determine the frequency of environmental exposure screening by obstetricians and gynecologists (OBGYNs) at initial patient visits. Study design Practicing OBGYNs were approached at the University of Colorado and by social media. The survey instrument queried demographics, environmental literacy, and screening practices. Statistical analysis was performed using Chi-square and two-sample t-test. Results We received 312 online survey responses (response rate of 12%). Responding OBGYNs were predominantly female (96%), board-certified (78%), generalists (65%) with a mean age of 37.1 years. Fewer than half of physicians screened for the following factors: occupational exposures, environmental chemicals, air pollution, pesticide use, personal care products, household cleaners, water source, use of plastics for food storage, and lead and mercury exposure. Eighty five percent of respondents reported that they did not feel comfortable obtaining an environmental history and 58% respondents reported that they performed no regular screening of environmental exposures. A higher frequency of screening was associated with > 4 years of practice (p = 0.001), and having read the environmental committee opinion (p = <0.001). Conclusion The majority of OBGYNs did not incorporate screening for known environmental exposures into routine practice. Reading the environmental committee opinions was strongly and significantly associated with a higher rate of screening. Improving physician comfort in counseling patients may enhance screening for exposures that affect reproductive health. PMID:29768418

Evaluating the outcomes of a hearing screening service for grade one learners in urban areas at Durban, South Africa

Directory of Open Access Journals (Sweden)

Samantha Govender

2016-05-01

Full Text Available Early intervention through hearing screening can reduce the negative impact of hearing loss for children. Optimal outcomes are achieved when an appropriate screening protocol is selected, a pathway for follow up care is established, and when a hearing conservation component is included. This study aimed to describe the outcomes of a hearing screening service provided to grade one learners in urban areas at Durban. A cross-sectional design was employed. Learners (n=241 were conveniently sampled from six randomly selected schools. They were screened using otoscopy, tympanometry and pure tone audiometry. Fifty eight participants (24% obtained a refer result, with 33% referred for diagnostic assessments, 29% for middle ear pathology and 38% for cerumen management. Findings further revealed that only 33% of referrals were followed up indicating poor compliance. Association between test results and income levels (P=0.38 as well as distance to the nearest health care facility (P=0.22 did not influence test outcomes. School aged children do present with common ear problems. Appropriate protocol selection, ensuring compliance to recommendations and education on hearing conservation are essential components of any health initiative.

Outcome of breast cancer screening in Denmark

DEFF Research Database (Denmark)

Lynge, Elsebeth; Bak, Martin; von Euler-Chelpin, My

2017-01-01

were node negative and 40% ≤10 mm. False-positive rate was around 2%; higher for North Denmark Region than for the rest of Denmark. Three out of 10 breast cancers in screened women were diagnosed as interval cancers. Conclusions: High coverage by examination and low interval cancer rate are required...... for screening to decrease breast cancer mortality. Two pioneer local screening programs starting in the 1990s were followed by a decrease in breast cancer mortality of 22-25%. Coverage by examination and interval cancer rate of the national program were on the favorable side of values from the pioneer programs...... Region than in the rest of Denmrk. Detection rate was slightly below 1% at first screen, 0.6% at subsequent screens, and one region had some fluctuation over time. Ductal carcinoma in situ (DCIS) constituted 13-14% of screen-detected cancers. In subsequent rounds, 80% of screen-detected invasive cancers...

Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

LENUS (Irish Health Repository)

O Caoimh, Rónán

2014-09-19

Functional decline and frailty are common in community dwelling older adults, increasing the risk of adverse outcomes. Given this, we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults, using the Risk Instrument for Screening in the Community (RISC).

Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.

Science.gov (United States)

Abdelsattar, Zaid M; Wong, Sandra L; Regenbogen, Scott E; Jomaa, Diana M; Hardiman, Karin M; Hendren, Samantha

2016-03-15

Although colorectal cancer (CRC) screening guidelines recommend initiating screening at age 50 years, the percentage of cancer cases in younger patients is increasing. To the authors' knowledge, the national treatment patterns and outcomes of these patients are largely unknown. The current study was a population-based, retrospective cohort study of the nationally representative Surveillance, Epidemiology, and End Results registry for patients diagnosed with CRC from 1998 through 2011. Patients were categorized as being younger or older than the recommended screening age. Differences with regard to stage of disease at diagnosis, patterns of therapy, and disease-specific survival were compared between age groups using multinomial regression, multiple regression, Cox proportional hazards regression, and Weibull survival analysis. Of 258,024 patients with CRC, 37,847 (15%) were aged Cancer Society.

[Renal risks of dietary complements: a forgotten cause].

Science.gov (United States)

Dori, Olympia; Humbert, Antoine; Burnier, Michel; Teta, Daniel

2014-02-26

The use of dietary complements like vitamins, minerals, trace elements, proteins, aminoacids and plant-derived agents is prevalent in the general population, in order to promote health and treat diseases. Dietary complements are considered as safe natural products and are easily available without prescription. However, these can lead to severe renal toxicity, especially in cases of unknown pre-existing chronic kidney disease (CKD). In particular, Chinese herbs including aristolochic acid, high doses of vitamine C, creatine and protein complements may lead to acute and chronic renal failure, sometimes irreversible. Dietary complement toxicity should be suspected in any case of unexplained renal impairement. In the case of pre-existing CKD, the use of potentially nephrotoxic dietary complements should be screened for.

The Outcomes of an Educational Program Involving Men as Motivators to Encourage Women to Be Screened for Cervical Cancer.

Science.gov (United States)

Rwamugira, Jeniffer; Maree, Johanna E; Mafutha, Nokuthula

2017-11-14

Cervical cancer is a major health problem in South Africa. Despite having a national, population-based screening program, screening coverage is as low as 13%. Based on the role men could play in increasing cervical cancer screening and the low level of knowledge, men living in the study setting had about this health issue, we developed and pilot tested an educational program aimed at empowering men to teach their female partners and family members about cervical cancer and motivate them to be screened. The study setting was Ward 23 in Muldersdrift, a semi-urban, resource poor area situated northeast of Johannesburg. We used an intervention research design to assess the outcomes of our educational program. The primary outcome was screening uptake, with knowledge the secondary outcome. Statistics and face-to-face and telephone interviews, guided by questionnaires, were used to collect the data which were analyzed by means of descriptive statistics and content analysis. A total of 120 men (n = 120) participated in the educational program and 100 (n = 100) completed the post-test questionnaire. Only 30 women (n = 30) reported for screening. The men's knowledge improved after the education program but did not guarantee that they would educate women about cervical cancer as only 55% (n = 66) indicated they taught a female family member or their partner. Cultural restrictions were the most common reason presented for not teaching women about this health issue. Ways of supporting men to overcome cultural barriers prohibiting them from discussing matters related to sexuality should be explored, before refining and replicating the intervention.

A crucial role for maternal dietary methyl donor intake in epigenetic programming and fetal growth outcomes.

Science.gov (United States)

McGee, Meghan; Bainbridge, Shannon; Fontaine-Bisson, Bénédicte

2018-06-01

The fetal origins of health and disease framework has identified extremes in fetal growth and birth weight as factors associated with the lifelong generation of chronic diseases such as obesity, diabetes, cardiovascular disease, and hypertension. Maternal nutrition plays a critical role in fetal and placental development, in part by providing the methyl groups required to establish the fetus's genome structure and function, notably through DNA methylation. The goal of this narrative review is to describe the role of maternal dietary methyl donor (methionine, folate, and choline) and cofactor (zinc and vitamins B2, B6, and B12) intake in one-carbon metabolism and DNA methylation in the fetus and placenta, as well as their impacts on fetal growth and lifelong health outcomes, with specific examples in animals and humans. Based on the available evidence, it is concluded that intake of different amounts of dietary methyl donors and cofactors during pregnancy may alter fetal growth and development, thus establishing a major link between early environmental exposure and disease development in the offspring later in life.

Three-question set from Michigan Neuropathy Screening Instrument adds independent prognostic information on cardiovascular outcomes

DEFF Research Database (Denmark)

Seferovic, Jelena P; Pfeffer, Marc A; Claggett, Brian

2018-01-01

AIMS/HYPOTHESIS: The self-administered Michigan Neuropathy Screening Instrument (MNSI) is used to diagnose diabetic peripheral neuropathy. We examined whether the MNSI might also provide information on risk of death and cardiovascular outcomes. METHODS: In this post hoc analysis of the Aliskiren...

Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis.

Science.gov (United States)

Harris, J; Felix, L; Miners, A; Murray, E; Michie, S; Ferguson, E; Free, C; Lock, K; Landon, J; Edwards, P

2011-10-01

UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is 'e-learning', the use of interactive electronic media to facilitate teaching and learning on a range of issues including health. The high level of accessibility, combined with emerging advances in computer processing power, data transmission and data storage, makes interactive e-learning a potentially powerful and cost-effective medium for improving dietary behaviour. This review aims to assess the effectiveness and cost-effectiveness of adaptive e-learning interventions for dietary behaviour change, and also to explore potential psychological mechanisms of action and components of effective interventions. Electronic bibliographic databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Dissertation Abstracts, EMBASE, Education Resources Information Center, Global Health, Health Economic Evaluations Database, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science) were searched for the period January 1990 to November 2009. Reference lists of included studies and previous reviews were also screened; authors were contacted and trial registers were searched. Studies were included if they were randomised controlled trials, involving participants aged ≥ 13 years, which evaluated the effectiveness of interactive software programs for improving dietary behaviour. Primary outcomes were measures of dietary behaviours, including estimated intakes or changes in intake of energy, nutrients, dietary fibre, foods or food groups. Secondary outcome measures were clinical outcomes such as anthropometry or blood biochemistry. Psychological mediators of dietary behaviour change were also investigated. Two review authors independently screened results and extracted data from

Presenting Symptoms and Dysphagia Screen Predict Outcome in Mild and Rapidly Improving Acute Ischemic Stroke Patients.

Science.gov (United States)

Gadodia, Gaurav; Rizk, Nibal; Camp, Deborah; Bryant, Katja; Zimmerman, Susan; Brasher, Cynthia; Connelly, Kerrin; Dunn, Joshua; Frankel, Michael; Ido, Moges Seymour; Lugtu, James; Nahab, Fadi

2016-12-01

There are limited data on which patients not treated with intravenous (IV) tissue-type plasminogen activator (tPA) due to mild and rapidly improving stroke symptoms (MaRISS) have unfavorable outcomes. Acute ischemic stroke (AIS) patients not treated with IV tPA due to MaRISS from January 1, 2009 to December 31, 2013 were identified as part of the Georgia Coverdell Acute Stroke Registry. Multivariable regression analysis was used to identify factors associated with a lower likelihood of favorable outcome, defined as discharge to home. There were 1614 AIS patients who did not receive IV tPA due to MaRISS (median National Institutes of Health stroke scale [NIHSS] 1], of which 305 (19%) did not have a favorable outcome. Factors associated with lower likelihood of favorable outcome included Medicare insurance status (odds ratio [OR]: .53, 95% confidence interval [CI]: .34-.84), arrival by emergency medical services (OR: .46, 95% CI: .29-.73), increasing NIHSS score (per unit OR: .89, 95% CI: .84-.93), weakness as the presenting symptom (OR: .50, 95% CI: .30-.84), and a failed dysphagia screen (OR: .43, 95% CI: .23-.80). During the study period, dysphagia screen identify a subgroup of patients who are more likely to have an unfavorable outcome. Whether IV tPA treatment can improve the outcome in this subgroup of patients needs to be evaluated in a randomized placebo-controlled trial. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

Energy Technology Data Exchange (ETDEWEB)

Kim, David H.; Pooler, B.D.; Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Weiss, Jennifer M. [University of Wisconsin School of Medicine and Public Health, Section of Gastroenterology, Department of Internal Medicine, Madison, WI (United States)

2012-07-15

To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [{+-}SD] age 56.9 {+-} 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 {+-} 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

International Nuclear Information System (INIS)

Kim, David H.; Pooler, B.D.; Pickhardt, Perry J.; Weiss, Jennifer M.

2012-01-01

To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [±SD] age 56.9 ± 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 ± 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

Dysphagia in Patients with Acute Ischemic Stroke: Early Dysphagia Screening May Reduce Stroke-Related Pneumonia and Improve Stroke Outcomes.

Science.gov (United States)

Al-Khaled, Mohamed; Matthis, Christine; Binder, Andreas; Mudter, Jonas; Schattschneider, Joern; Pulkowski, Ulrich; Strohmaier, Tim; Niehoff, Torsten; Zybur, Roland; Eggers, Juergen; Valdueza, Jose M; Royl, Georg

2016-01-01

Dysphagia is associated with poor outcome in stroke patients. Studies investigating the association of dysphagia and early dysphagia screening (EDS) with outcomes in patients with acute ischemic stroke (AIS) are rare. The aims of our study are to investigate the association of dysphagia and EDS within 24 h with stroke-related pneumonia and outcomes. Over a 4.5-year period (starting November 2007), all consecutive AIS patients from 15 hospitals in Schleswig-Holstein, Germany, were prospectively evaluated. The primary outcomes were stroke-related pneumonia during hospitalization, mortality, and disability measured on the modified Rankin Scale ≥2-5, in which 2 indicates an independence/slight disability to 5 severe disability. Of 12,276 patients (mean age 73 ± 13; 49% women), 9,164 patients (74%) underwent dysphagia screening; of these patients, 55, 39, 4.7, and 1.5% of patients had been screened for dysphagia within 3, 3 to 72 h following admission. Patients who underwent dysphagia screening were likely to be older, more affected on the National Institutes of Health Stroke Scale score, and to have higher rates of neurological symptoms and risk factors than patients who were not screened. A total of 3,083 patients (25.1%; 95% CI 24.4-25.8) had dysphagia. The frequency of dysphagia was higher in patients who had undergone dysphagia screening than in those who had not (30 vs. 11.1%; p dysphagia had a higher rate of pneumonia than those without dysphagia (29.7 vs. 3.7%; p dysphagia was associated with increased risk of stroke-related pneumonia (OR 3.4; 95% CI 2.8-4.2; p dysphagia was independently correlated with an increase in mortality (OR 3.2; 95% CI 2.4-4.2; p Dysphagia exposes stroke patients to a higher risk of pneumonia, disability, and death, whereas an EDS seems to be associated with reduced risk of stroke-related pneumonia and disability. © 2016 S. Karger AG, Basel.

European breast cancer service screening outcomes: a first balance sheet of the benefits and harms.

Science.gov (United States)

Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig; Puliti, Donella; Duffy, Stephen William

2014-07-01

A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast cancer overdiagnosis, and false-positive results. On the basis of the studies reviewed, the authors present a first estimate of the benefit and harm balance sheet. For every 1,000 women screened biennially from ages 50 to 51 years until ages 68 to 69 years and followed up until age 79 years, an estimated seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer death being avoided by population-based mammography screening of appropriate quality is more than that of overdiagnosis by screening. These outcomes should be communicated to women offered service screening in Europe. ©2014 American Association for Cancer Research.

Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses.

Science.gov (United States)

Callec, R; Lamy, C; Perdriolle-Galet, E; Patte, C; Heude, B; Morel, O

2015-08-01

To evaluate the performance of screening for small-for-gestational-age (SGA) fetuses by ultrasound biometry at 30-35 weeks' gestation, and to determine the impact of screening on obstetric and neonatal outcomes. For this prospective cohort study, pregnant women were recruited from two French university maternity centers between 2003 and 2006. Performance measures of third-trimester biometry for the prediction of SGA, defined as estimated fetal weight third-trimester ultrasound had a sensitivity of 29.0% (95% CI, 22.5-36.6%) and specificity of 94.2% (95% CI, 93.0-95.2%). Positive and negative predictive values were 30.8% (95% CI, 23.9-38.7%) and 93.7% (95% CI, 92.5-94.8%), respectively. One hundred and ten SGA neonates went undiagnosed at ultrasound. Compared to the TN neonates considered as of normal weight at ultrasound, planned preterm delivery (before 37 weeks) and elective Cesarean section for a fetal growth indication were 2.4 (P = 0.01) and 2.85 (P = 0.003) times more likely to occur, respectively, in the FP group of non-SGA neonates, diagnosed incorrectly as SGA during the antenatal period. There was no statistically significant difference in 5-min Apgar score third-trimester ultrasound screening for SGA seems poor, as it misses the diagnosis of a large number of SGA neonates. The consequences of routine screening for SGA in a low-risk population may lead to unnecessary planned preterm deliveries and elective Cesarean sections in FP pregnancies, without improved neonatal outcome in the FN pregnancies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Analyzing Screening Policies for Childhood Obesity

Science.gov (United States)

Yang, Yan; Goldhaber-Fiebert, Jeremy D.; Wein, Lawrence M.

2013-01-01

Due to the health and economic costs of childhood obesity, coupled with studies suggesting the benefits of comprehensive (dietary, physical activity and behavioral counseling) intervention, the United States Preventive Services Task Force recently recommended childhood screening and intervention for obesity beginning at age six. Using a longitudinal data set consisting of the body mass index of 3164 children up to age 18 and another longitudinal data set containing the body mass index at ages 18 and 40 and the presence or absence of disease (hypertension and diabetes) at age 40 for 747 people, we formulate and numerically solve – separately for boys and girls – a dynamic programming problem for the optimal biennial (i.e., at ages 2, 4, …, 16) obesity screening thresholds. Unlike most screening problem formulations, we take a societal viewpoint, where the state of the system at each age is the population-wide probability density function of the body mass index. Compared to the biennial version of the task force’s recommendation, the screening thresholds derived from the dynamic program achieve a relative reduction in disease prevalence of 3% at the same screening (and treatment) cost, or – due to the flatness of the disease vs. screening tradeoff curve – achieves the same disease prevalence at a 28% relative reduction in cost. Compared to the task force’s policy, which uses the 95th percentile of body mass index (from cross-sectional growth charts tabulated by the Centers for Disease Control and Prevention) as the screening threshold for each age, the dynamic programming policy treats mostly 16 year olds (including many who are not obese) and very few males under 14 years old. While our results suggest that adult hypertension and diabetes are minimized by focusing childhood obesity screening and treatment on older adolescents, the shortcomings in the available data and the narrowness of the medical outcomes considered prevent us from making a

Screening and identification of dietary oils and unsaturated fatty acids in inhibiting inflammatory prostaglandin E2 signaling in fat stromal cells

Directory of Open Access Journals (Sweden)

Ruan Diana

2012-08-01

Full Text Available Abstract Background The molecular mechanisms of dietary oils (such as fish oil and unsaturated fatty acids, which are widely used by the public for anti-inflammation and vascular protection, have not been settled yet. In this study, prostaglandin E2 (PGE2-mediated calcium signaling was used to screen dietary oils and eight unsaturated fatty acids for identification of their anti-inflammatory mechanisms. Isolated fat/stromal cells expressing endogenous PGE2 receptors and an HEK293 cell line specifically expressing the recombinant human PGE2 receptor subtype-1 (EP1 were cultured and used in live cell calcium signaling assays. The different dietary oils and unsaturated fatty acids were used to affect cell signaling under the specific stimulation of a pathological amount of inflammatory PGE2. Results It was identified that fish oil best inhibited the PGE2 signaling in the primary cultured stromal cells. Second, docosahexaenoic acid (DHA, found in abundance in fish oil, was identified as a key factor of inhibition of PGE2 signaling. Eicosapentaenoic acid (EPA, another major fatty acid found in fish oil and tested in this study was found to have small effect on EP1 signaling. The study suggested one of the four PGE2 subtype receptors, EP1 as the key target for the fish oil and DHA target. These findings were further confirmed by using the recombinant EP1 expressed in HEK293 cells as a target. Conclusion This study demonstrated the new mechanism behind the positive effects of dietary fish oils in inhibiting inflammation originates from the rich concentration of DHA, which can directly inhibit the inflammatory EP1-mediated PGE2 receptor signaling, and that the inflammatory response stimulated by PGE2 in the fat stromal cells, which directly related to metabolic diseases, could be down regulated by fish oil and DHA. These findings also provided direct evidence to support the use of dietary oils and unsaturated fatty acids for protection against heart

Effect of dietary approaches to stop hypertension diet plan on pregnancy outcome patients with gestational diabetes mellitus

Directory of Open Access Journals (Sweden)

Jie Yao

2015-12-01

Full Text Available The purpose of this study is to test the effects of Dietary Approaches to Stop Hypertension (DASH diet plan on pregnancy outcomes patients with gestational diabetes mellitus. This randomized controlled clinical trial was performed among 33 women diagnosed with gestational diabetes. These patients were randomly distributed to the control group (n = 16 or DASH diet group (n = 17 for 4 weeks. Whereas 47.1% of women in the DASH diet needed to have a cesarean section, this percentage of mean gestational age in control diet was 81.3% (p<0.01. Approximately 23.5% of women in the DASH diet and 75% of women in control diet needed to commence insulin therapy after intervention (p<0.01. In conclusion, the effect of DASH diet improved pregnancy outcomes patients with gestational diabetes.

Assessing the effectiveness and cost effectiveness of adaptive e-Learning to improve dietary behaviour: protocol for a systematic review

Directory of Open Access Journals (Sweden)

Michie Susan

2010-04-01

Full Text Available Abstract Background The composition of habitual diets is associated with adverse or protective effects on aspects of health. Consequently, UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is e-Learning, the use of interactive electronic media to facilitate teaching and learning on a range of issues, including diet and health. The aims of this systematic review are to determine the effectiveness and cost-effectiveness of adaptive e-Learning for improving dietary behaviours. Methods/Design The research will consist of a systematic review and a cost-effectiveness analysis. Studies will be considered for the review if they are randomised controlled trials, involving participants aged 13 or over, which evaluate the effectiveness or efficacy of interactive software programmes for improving dietary behaviour. Primary outcome measures will be those related to dietary behaviours, including estimated intakes of energy, nutrients and dietary fibre, or the estimated number of servings per day of foods or food groups. Secondary outcome measures will be objective clinical measures that are likely to respond to changes in dietary behaviours, such as anthropometry or blood biochemistry. Knowledge, self-efficacy, intention and emotion will be examined as mediators of dietary behaviour change in order to explore potential mechanisms of action. Databases will be searched using a comprehensive four-part search strategy, and the results exported to a bibliographic database. Two review authors will independently screen results to identify potentially eligible studies, and will independently extract data from included studies, with any discrepancies at each stage settled by a third author. Standardised forms and criteria will be used. A descriptive analysis of included

Women's dietary changes before and during pregnancy: A systematic review

OpenAIRE

Hillier, S.E.; Olander, E. K.

2017-01-01

Background\\ud \\ud dietary intake before and during pregnancy has significant health outcomes for both mother and child, including a healthy gestational weight gain. To ensure effective interventions are successfully developed to improve dietary intake during pregnancy, it is important to understand what dietary changes pregnant women make without intervention.\\ud Aims\\ud \\ud to systematically identify and review studies examining women's dietary changes before and during pregnancy and to iden...

The serological screening of deceased tissue donors within the English Blood Service for infectious agents--a review of current outcomes and a more effective strategy for the future.

Science.gov (United States)

Kitchen, A D; Gillan, H L

2010-04-01

The overall effectiveness of the NHSBT screening programme for infectious agents in deceased tissue donors is examined and evaluated in terms of current outcomes and how to improve upon these outcomes. The screening results and any subsequent confirmatory results from a total of 1659 samples from NHSBT deceased donors referred to NTMRL for screening for infectious agents were included in the analysis. Overall 1566/1659 (94.4%) of the samples were screen negative. A total of 93 were repeat reactive on screening for one or more of the mandatory markers screened for, of which only 12 (13%) were subsequently confirmed to be positive on confirmatory testing. The majority of the repeat reactive samples were demonstrating non-specific reactivity with the screening assays in use. Overall, the NHSBT screening programme for infectious agents in deceased tissue donors is very effective with a relatively low overall loss of donors because of non-specific reactivity. However, unnecessary loss of tissue products is not acceptable, and although this programme compares favourably with the outcomes of other such programmes, the confirmatory results obtained demonstrate both the need and the potential for improving the outcomes. This is particularly important as one donor may donate more than one product, and can be achieved very easily with a change to the screening algorithm followed, using the confirmatory data obtained to support and validate this change. CONTENTS SUMMARY: Critical analysis of the NHSBT screening programme for infectious agents in deceased tissue donors and a strategy involving the design and use of a different screening algorithm to improve these outcomes.

Comparison of dietary habits and plans for dietary changes in black and white women seeking bariatric surgery.

Science.gov (United States)

McLean, Kendall L; Moore, Carolyn E; Miketinas, Derek C; Champagne, Catherine M

2018-01-01

Achieving weight loss after bariatric surgery depends on the individual's ability to sustain lifestyle changes involving dietary modifications. Presurgical dietary assessment is critical to evaluate usual dietary habits and identify the need for intervention before surgery. The objective of this study was to identify usual dietary habits of black and white women seeking bariatric surgery and to examine potential differences between these ethnic groups. An additional aim was to describe participants' plans to change dietary behaviors after surgery. This study examined data from an observational study sponsored by a benefits management group in Louisiana. In this cross-sectional study, a presurgical dietary assessment interview questionnaire collected information on dietary habits. Participants (n = 200) were adult women being screened for bariatric surgery; 54% were white, and 46% were black. Descriptive statistics were calculated and differences between groups were tested using 2-way analysis of the variance. Participants reported consuming fast food 2.9 ± 2.6 times per week, fried foods 2.1 ± 1.8 times per week, and desserts 3.4 ± 3.2 times per week. Blacks reported more frequent consumption of fast food (P<.01), sugar-sweetened sodas (P<.05), and sugar-sweetened tea (P<.01) compared with whites. Plans for changing dietary behaviors after surgery were similar between ethnic groups. Findings indicated that frequent consumption of fast foods, fried foods, desserts, and sugar-sweetened beverages was common among women seeking bariatric surgery. Blacks tended to consume these foods and beverages more often than whites. Current dietary habits and future plans to change dietary behaviors should be addressed before surgery for success. Follow-up studies investigating the assessment instrument's ability to predict dietary adherence and weight loss after surgery are warranted. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All

Projected national impact of colorectal cancer screening on clinical and economic outcomes and health services demand.

Science.gov (United States)

Ladabaum, Uri; Song, Kenneth

2005-10-01

Colorectal cancer (CRC) screening is effective and cost-effective, but the potential national impact of widespread screening is uncertain. It is controversial whether screening colonoscopy can be offered widely and how emerging tests may impact health services demand. Our aim was to produce integrated, comprehensive estimates of the impact of widespread screening on national clinical and economic outcomes and health services demand. We used a Markov model and census data to estimate the national consequences of screening 75% of the US population with conventional and emerging strategies. Screening decreased CRC incidence by 17%-54% to as few as 66,000 cases per year and CRC mortality by 28%-60% to as few as 23,000 deaths per year. With no screening, total annual national CRC-related expenditures were 8.4 US billion dollars. With screening, expenditures for CRC care decreased by 1.5-4.4 US billion dollars but total expenditures increased to 9.2-15.4 US billion dollars. Screening colonoscopy every 10 years required 8.1 million colonoscopies per year including surveillance, with other strategies requiring 17%-58% as many colonoscopies. With improved screening uptake, total colonoscopy demand increased in general, even assuming substantial use of virtual colonoscopy. Despite savings in CRC care, widespread screening is unlikely to be cost saving and may increase national expenditures by 0.8-2.8 US billion dollars per year with conventional tests. The current national endoscopic capacity, as recently estimated, may be adequate to support widespread use of screening colonoscopy in the steady state. The impact of emerging tests on colonoscopy demand will depend on the extent to which they replace screening colonoscopy or increase screening uptake in the population.

Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes.

Science.gov (United States)

Trentham-Dietz, Amy; Kerlikowske, Karla; Stout, Natasha K; Miglioretti, Diana L; Schechter, Clyde B; Ergun, Mehmet Ali; van den Broek, Jeroen J; Alagoz, Oguzhan; Sprague, Brian L; van Ravesteyn, Nicolien T; Near, Aimee M; Gangnon, Ronald E; Hampton, John M; Chandler, Young; de Koning, Harry J; Mandelblatt, Jeanne S; Tosteson, Anna N A

2016-11-15

Biennial screening is generally recommended for average-risk women aged 50 to 74 years, but tailored screening may provide greater benefits. To estimate outcomes for various screening intervals after age 50 years based on breast density and risk for breast cancer. Collaborative simulation modeling using national incidence, breast density, and screening performance data. United States. Women aged 50 years or older with various combinations of breast density and relative risk (RR) of 1.0, 1.3, 2.0, or 4.0. Annual, biennial, or triennial digital mammography screening from ages 50 to 74 years (vs. no screening) and ages 65 to 74 years (vs. biennial digital mammography from ages 50 to 64 years). Lifetime breast cancer deaths, life expectancy and quality-adjusted life-years (QALYs), false-positive mammograms, benign biopsy results, overdiagnosis, cost-effectiveness, and ratio of false-positive results to breast cancer deaths averted. Screening benefits and overdiagnosis increase with breast density and RR. False-positive mammograms and benign results on biopsy decrease with increasing risk. Among women with fatty breasts or scattered fibroglandular density and an RR of 1.0 or 1.3, breast cancer deaths averted were similar for triennial versus biennial screening for both age groups (50 to 74 years, median of 3.4 to 5.1 vs. 4.1 to 6.5 deaths averted; 65 to 74 years, median of 1.5 to 2.1 vs. 1.8 to 2.6 deaths averted). Breast cancer deaths averted increased with annual versus biennial screening for women aged 50 to 74 years at all levels of breast density and an RR of 4.0, and those aged 65 to 74 years with heterogeneously or extremely dense breasts and an RR of 4.0. However, harms were almost 2-fold higher. Triennial screening for the average-risk subgroup and annual screening for the highest-risk subgroup cost less than $100 000 per QALY gained. Models did not consider women younger than 50 years, those with an RR less than 1, or other imaging methods. Average-risk women

The outcome of a quality-controlled mammography screening program: Experience from a population-based study in Taiwan

Directory of Open Access Journals (Sweden)

Huay-Ben Pan

2014-10-01

Conclusion: From the outcome review of this national mammography screening, there is still room to ameliorate our performance through comprehensive and continued education, to improve the competence of cancer detection and decrease false negative (FN cases.

Health and Dietary Patterns of the Elderly in Botswana

Science.gov (United States)

Maruapula, Segametsi; Chapman-Novakofski, Karen

2007-01-01

Objective: To describe associations among socioeconomic conditions and dietary patterns of Botswana elderly. Design: Secondary analysis from a cross-sectional nationwide survey. Participants: Subjects (N = 1086, 60-99 years old) were selected after multistage sampling. Main Outcome Measures: Dietary patterns were dependent variables; health and…

PATIENT SATISFACTION AND DIETARY OUTCOMES FROM ATTENDING A MULTIDISCIPLINARY CYSTINURIA CLINIC

Directory of Open Access Journals (Sweden)

Angela Doherty

2012-06-01

Patients had varying degrees of success with making changes to each dietary parameter. Multi-source diet analysis allowed us to develop tailored consultations. All patients made some positive dietary changes which may help prevent stone formation. The areas of least change were fluid (due to changes made prior to clinic attendance and vegetable protein. Our results support the need for continued dietetic input. These results should be re-audited to check that patients are maintaining the changes made.

Dietary Carcinogens and Breast Cancer.

Science.gov (United States)

1997-07-01

detected by autoradiography on X-ray film with intensifying screens at - 70 0C. Using this TLC separation system, we have observed one abundant adduct...report in Science, published earlier this year, showed that resveratrol (a phytochemical found in many plant species) inhibited both cyclooxygenase I...the dietary phytochemical resveratrol significantly inhibits PhIP-DNA adduct formation in primary cultures of human mammary epithelial cells. From

Comparing the outcomes of two strategies for colorectal tumor detection: policy-promoted screening program versus health promotion service.

Science.gov (United States)

Wu, Ping-Hsiu; Lin, Yu-Min; Liao, Chao-Sheng; Chang, Hung-Chuen; Chen, Yu-Hung; Yang, Kuo-Ching; Shih, Chia-Hui

2013-06-01

The Taiwanese government has proposed a population-based colorectal tumor detection program for the average-risk population. This study's objectives were to understand the outcomes of these screening policies and to evaluate the effectiveness of the program. We compared two databases compiled in one medical center. The "policy-promoted cancer screening" (PPS) database was built on the basis of the policy of the Taiwan Bureau of National Health Insurance for cancer screening. The "health promotion service" (HPS) database was built to provide health check-ups for self-paid volunteers. Both the PPS and HPS databases employ the immunochemical fecal occult blood test (iFOBT) and colonoscopy for colorectal tumor screening using different strategies. A comparison of outcomes between the PPS and HPS included: (1) quality indicators-compliance rate, cecum reaching rate, and tumor detection rate; and (2) validity indicators-sensitivity, specificity, positive, and negative predictive values for detecting colorectal neoplasms. A total of 10,563 and 1481 individuals were enrolled in PPS and HPS, respectively. Among quality indicators, there was no statistically significant difference in the cecum reaching rate between PPS and HPS. The compliance rates were 56.1% for PPS and 91.8% for HPS (p performance. Copyright © 2013. Published by Elsevier B.V.

"Am I carrier?" The patient's lived experience of thrombophilia genetic screening and its outcome.

Science.gov (United States)

Graffigna, Guendalina; Leone, Daniela; Vegni, Elena

2014-01-01

How do patients with thrombophilia experience a physician's request to undergo a genetic test? How do they experience the test outcome? To answer these questions, we conducted an interpretative phenomenological analysis study, based on 10 in-depth interviews with patients who underwent genetic testing for thrombophilia in Italy, half with positive and half with negative results. The experience of undergoing genetic screening for thrombophilia plays an important role in reconfiguring patients' signification of their illness experience. A positive outcome becomes a cue to reorganize in a more adaptive way the illness meaning at the cognitive and emotive levels, whereas a negative outcome appears more distressing and confusing. As a clinical implication of the study, clinicians should consider communicating carefully with the patients regardless from the positive/negative test results and they should explore the patient's specific reaction and understanding of test result.

Using the web for recruitment, screen, tracking, data management, and quality control in a dietary assessment clinical validation trial.

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Arab, Lenore; Hahn, Harry; Henry, Judith; Chacko, Sara; Winter, Ashley; Cambou, Mary C

2010-03-01

Screening and tracking subjects and data management in clinical trials require significant investments in manpower that can be reduced through the use of web-based systems. To support a validation trial of various dietary assessment tools that required multiple clinic visits and eight repeats of online assessments, we developed an interactive web-based system to automate all levels of management of a biomarker-based clinical trial. The "Energetics System" was developed to support 1) the work of the study coordinator in recruiting, screening and tracking subject flow, 2) the need of the principal investigator to review study progress, and 3) continuous data analysis. The system was designed to automate web-based self-screening into the trial. It supported scheduling tasks and triggered tailored messaging for late and non-responders. For the investigators, it provided real-time status overviews on all subjects, created electronic case reports, supported data queries and prepared analytic data files. Encryption and multi-level password protection were used to insure data privacy. The system was programmed iteratively and required six months of a web programmer's time along with active team engagement. In this study the enhancement in speed and efficiency of recruitment and quality of data collection as a result of this system outweighed the initial investment. Web-based systems have the potential to streamline the process of recruitment and day-to-day management of clinical trials in addition to improving efficiency and quality. Because of their added value they should be considered for trials of moderate size or complexity. Copyright 2009 Elsevier Inc. All rights reserved.

Screening Characteristics of TIMI Score in Predicting Acute Coronary Syndrome Outcome; a Diagnostic Accuracy Study

Directory of Open Access Journals (Sweden)

Mostafa Alavi-Moghaddam

2017-01-01

Full Text Available Introduction: In cases with potential diagnosis of ischemic chest pain, screening high risk patients for adverse outcomes would be very helpful. The present study was designed aiming to determine the diagnostic accuracy of thrombolysis in myocardial infarction (TIMI score in Patients with potential diagnosis of ischemic chest pain.Method: This diagnostic accuracy study was designed to evaluate the screening performance characteristics of TIMI score in predicting 30-day outcomes of mortality, myocardial infarction (MI, and need for revascularization in patients presenting to ED with complaint of typical chest pain and diagnosis of unstable angina or Non-ST elevation MI.Results: 901 patients with the mean age of 58.17 ± 15.00 years (19-90 were studied (52.9% male. Mean TIMI score of the studied patients was 0.97 ± 0.93 (0-5 and the highest frequency of the score belonged to 0 to 2 with 37.2%, 35.3%, and 21.4%, respectively. In total, 170 (18.8% patients experienced the outcomes evaluated in this study. Total sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio of TIMI score were 20 (95% CI: 17 – 24, 99 (95% CI: 97 – 100, 98 (95% CI: 93 – 100, 42 (95% CI: 39 – 46, 58 (95% CI: 14 – 229, and 1.3 (95% CI: 1.2 – 1.4, respectively. Area under the ROC curve of this system for prediction of 30-day mortality, MI, and need for revascularization were 0.51 (95% CI: 0.47 – 0.55, 0.58 (95% CI: 0.54 – 0.62 and 0.56 (95% CI: 0.52 – 0.60, respectively.Conclusion: Based on the findings of the present study, it seems that TIMI score has a high specificity in predicting 30-day adverse outcomes of mortality, MI, and need for revascularization following acute coronary syndrome. However, since its sensitivity, negative predictive value, and negative likelihood ratio are low, it cannot be used as a proper screening tool for ruling out low risk patients in ED.

Models of Community-Based Hepatitis B Surface Antigen Screening Programs in the U.S. and Their Estimated Outcomes and Costs

Science.gov (United States)

Rein, David B.; Lesesne, Sarah B.; Smith, Bryce D.; Weinbaum, Cindy M.

2011-01-01

Objectives Information on the process and method of service delivery is sparse for hepatitis B surface antigen (HBsAg) testing, and no systematic study has evaluated the relative effectiveness or cost-effectiveness of different HBsAg screening models. To address this need, we compared five specific community-based screening programs. Methods We funded five HBsAg screening programs to collect information on their design, costs, and outcomes of participants during a six-month observation period. We categorized programs into four types of models. For each model, we calculated the number screened, the number screened as per Centers for Disease Control and Prevention (CDC) recommendations, and the cost per screening. Results The models varied by cost per person screened and total number of people screened, but they did not differ meaningfully in the proportion of people screened following CDC recommendations, the proportion of those screened who tested positive, or the proportion of those who newly tested positive. Conclusions Integrating screening into outpatient service settings is the most cost-effective method but may not reach all people needing to be screened. Future research should examine cost-effective methods that expand the reach of screening into communities in outpatient settings. PMID:21800750

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.

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.

Dietary pattern and asthma: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Lv N

2014-08-01

Full Text Available Nan Lv,1 Lan Xiao,1 Jun Ma1,2 1Palo Alto Medical Foundation Research Institute, 2Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Background: The literature on the relationship between diet and asthma has largely focused on individual nutrients, with conflicting results. People consume a combination of foods from various groups that form a dietary pattern. Studying the role of dietary patterns in asthma is an emerging area of research. The purpose of this study was to systematically review dietary patterns and asthma outcomes in adults and children, to review maternal diet and child asthma, and to conduct a meta-analysis on the association between asthma prevalence and dietary patterns in adults. Methods: We searched Medline, Scopus, and ISI Web of Knowledge up to January 2014. Two researchers independently reviewed studies meeting the inclusion criteria using the American Dietetic Association quality criteria. A linear mixed model was used to derive the pooled effect size (95% confidence interval for each of three dietary pattern categories (healthy, unhealthy, and neutral. Results: Thirty-one studies were identified (16 cross-sectional, one case-control, 13 cohort, and one randomized controlled trial, including 12 in adults, 13 in children, five in pregnant woman–child pairs, and one in both children and pregnant woman–child pairs. Six of the 12 adult studies reported significant associations between dietary patterns and asthma outcomes (eg, ever asthma and forced expiratory volume in one second. Seven of ten studies examining the Mediterranean diet showed protective effects on child asthma and/or wheeze. Four of the six studies in mother-child pairs showed that maternal dietary patterns during pregnancy were not associated with child asthma or wheeze. The meta-analysis including six adult studies, the primary outcome of which was the prevalence of current or ever asthma, showed no association with healthy

Detection of antibiotic resistance in probiotics of dietary supplements

KAUST Repository

Wong, Aloysius Tze

2015-09-14

Background Probiotics are live microorganisms that confer nutrition- and health-promoting benefits if consumed in adequate amounts. Concomitant with the demand for natural approaches to maintaining health is an increase in inclusion of probiotics in food and health products. Since probiotic bacteria act as reservoir for antibiotic resistant determinants, the transfer of these genes to pathogens sharing the same intestinal habitat is thus conceivable considering the fact that dietary supplements contain high amounts of often heterogeneous populations of probiotics. Such events can confer pathogens protection against commonly-used drugs. Despite numerous reports of antibiotic resistant probiotics in food and biological sources, the antibiogram of probiotics from dietary supplements remained elusive. Findings Here, we screened five commercially available dietary supplements for resistance towards antibiotics of different classes. Probiotics of all batches of products were resistant towards vancomycin while batch-dependent resistance towards streptomycin, aztreonam, gentamycin and/or ciprofloxacin antibiotics was detected for probiotics of brands Bi and Bn, Bg, and L. Isolates of brand Cn was also resistant towards gentamycin, streptomycin and ciprofloxacin antibiotics. Additionally, we also report a discrepancy between the enumerated viable bacteria amounts and the claims of the manufacturers. Conclusions This short report has highlighted the present of antibiotic resistance in probiotic bacteria from dietary supplements and therefore serves as a platform for further screenings and for in-depth characterization of the resistant determinants and the molecular machinery that confers the resistance.

Longitudinal motivational predictors of dietary self-care and diabetes control in adults with newly diagnosed type 2 diabetes mellitus.

Science.gov (United States)

Nouwen, Arie; Ford, Teri; Balan, Andreea Teodora; Twisk, Jos; Ruggiero, Laurie; White, David

2011-11-01

This prospective study examined relationships between constructs from social-cognitive theory (Bandura, 1986) and self-determination theory (Deci & Ryan, 1985; Deci & Ryan, 1991) and the diabetes outcomes of dietary self-care and diabetes control. Longitudinal data were collected from 237 people newly diagnosed with Type 2 diabetes who filled in questionnaires on dietary self-care, and motivational factors derived from social-cognitive theory and self-determination theory. Blood samples were taken to assess diabetes control (HbA1c). Repeated measurements were taken every 3-4 months for a total of five time points over 18 months. Predictor measures included autonomy support, autonomous and controlled motivation, amotivation, dietary self-efficacy, positive and negative outcome expectancies for dietary self-care and self-evaluation. Age, sex, BMI, and diabetes knowledge were included as control measures. Using Generalized Estimating Equations (GEE) analyses two models were tested: a standard model reflecting longitudinal associations between absolute values of predicted and outcome variables; and a change model examining motivational predictors of changes over time in diabetes outcomes of dietary self-care and diabetes control (HbA1c). Dietary self-care was longitudinally associated with self-efficacy, self-evaluation (the strongest predictor) autonomy support and autonomous motivation, but not with controlled motivation or outcome expectancies. Changes in dietary self-care were predicted by changes in self-efficacy, self-evaluation, and controlled motivation but not by changes in autonomous motivation or autonomy support. Negative outcome expectancies regarding diet were longitudinally associated with HbA1c, and changes in negative outcome expectancies predicted changes in HbA1c. However, there were indications that dietary self-care predicted changes in HbA1c. The results indicate that autonomy support, self-efficacy and, in particular, self-evaluation are key

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…

[Gender-specific influences on incidence, screening, treatment, and outcome of colorectal cancer].

Science.gov (United States)

Grundmann, R T; Meyer, F

2013-08-01

This overview comments on potential gender-specific differences in incidence, anatomic site, screening, treatment, and outcome in patients with colorectal cancer (CRC). For the literature review, the Medline database (PubMed) was searched under the key words "colorectal carcinoma AND gender" and "gender differences AND colorectal cancer". Publications of the last 9 years (2005-2013) were firstly retrieved. CRC is more commonly observed in men than in women, with the higher tumour risk for men being limited to the distal colon and rectum. Risk factors for the development of CRC include overweight and obesity, this relationship is more pronounced for men than for women. The extent to which gender is a prognostic factor for patient survival is controversial. A better survival of women compared to men is found especially in the younger age groups, from which can be derived a protective effect of oestrogens on the development of CRC. As for the frequency with which men and women undergo a screening of CRC, sometimes higher screening rates have been reported for men than women, however, the socio-economic status of persons invited to participate has much more influence on screening attendance than gender. An analysis of surgical procedures indicates that it is more difficult to perform the low anterior resection of the rectum in men than women, with the result that men managed by less experienced surgeons are more likely to receive abdominoperineal excision. Furthermore, the risk of anastomotic leakage is higher in men than women. The essential gender difference, however, is the longer life expectancy of women compared to men which has been not always clearly (risk adjusted) elaborated in the studies available so far. This difference alone can already explain at a high rate the poorer prognosis of right-sided colon cancers compared to left-sided cancers. Comparable levels of CRC risk are reached in women as compared to men at a higher age. This may influence the

Dietary Advanced Glycation End Products and Cardiometabolic Risk.

Science.gov (United States)

Luévano-Contreras, Claudia; Gómez-Ojeda, Armando; Macías-Cervantes, Maciste Habacuc; Garay-Sevilla, Ma Eugenia

2017-08-01

This report analyzes emerging evidence about the role of dietary advanced glycation end products (AGEs) as a cardiometabolic risk factor. Two important aspects are discussed: First, the modulation of AGE load by dietary AGEs; second, if the evidence of clinical and observational studies is enough to make dietary recommendations towards lowering AGE intake. Clinical studies in subjects with diabetes mellitus have shown that high intake of dietary AGEs increases inflammation markers, oxidative stress, and could impair endothelial function. In subjects at risk for cardiometabolic diseases (with overweight, obesity, or prediabetes), dietary AGE restriction decreases some inflammatory molecules and improves insulin sensitivity. However, studies in healthy subjects are limited, and not all of the studies have shown a decrease in circulating AGEs. Therefore, it is still unclear if dietary AGEs represent a health concern for people potentially at risk for cardiometabolic diseases. The evidence shows that dietary AGEs are bioavailable and absorbed, and the rate of excretion depends on dietary intake. The metabolic fate of most dietary AGEs remains unknown. Regardless, most studies have shown that by diminishing AGE intake, circulating levels will also decrease. Thus, dietary AGEs can modulate the AGE load at least in patients with DM, overweight, or obesity. Studies with specific clinical outcomes and large-scale observational studies are needed for a better risk assessment of dietary AGEs and to establish dietary recommendations accordingly.

The balance sheet of benefits and harms of breast cancer population-based screening in Europe: outcome research, practice and future challenges.

Science.gov (United States)

Broeders, Mireille; Paci, Eugenio

2015-11-01

Breast cancer screening programs are still object of harsh debate. In 2012, the Independent UK Panel reviewed the benefits and harms of mammography screening based on randomized trials and the EUROSCREEN Working Group reviewed European observational outcome studies. The conclusion was that screening programs should continue, while acknowledging that harms, such as the occurrence of false-positive results and overdiagnosis, can have a negative impact on a woman's life. Information on the balance sheet of the benefits and harms of breast cancer screening should help women and their physicians to make an informed choice. The future challenge for breast screening programs is to assess the feasibility, acceptability, effectiveness and impact of risk-based screening in order to maximize benefit-to-harm ratios.

Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet.

Science.gov (United States)

Paci, Eugenio

2012-01-01

To construct a European 'balance sheet' of key outcomes of population-based mammographic breast cancer screening, to inform policy-makers, stakeholders and invited women. From the studies reviewed, the primary benefit of screening, breast cancer mortality reduction, was compared with the main harms, over-diagnosis and false-positive screening results (FPRs). Pooled estimates of breast cancer mortality reduction among invited women were 25% in incidence-based mortality studies and 31% in case-control studies (38% and 48% among women actually screened). Estimates of over-diagnosis ranged from 1% to 10% of the expected incidence in the absence of screening. The combined estimate of over-diagnosis for screened women, from European studies correctly adjusted for lead time and underlying trend, was 6.5%. For women undergoing 10 biennial screening tests, the estimated cumulative risk of a FPR followed by non-invasive assessment was 17%, and 3% having an invasive assessment. For every 1000 women screened biennially from age 50-51 until age 68-69 and followed up to age 79, an estimated seven to nine lives are saved, four cases are over-diagnosed, 170 women have at least one recall followed by non-invasive assessment with a negative result and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe.

Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

Science.gov (United States)

Spjut Jansson, Birgitta; Miniscalco, Carmela; Westerlund, Joakim; Kantzer, Anne-Katrin; Fernell, Elisabeth; Gillberg, Christopher

2016-01-01

Background Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. PMID:27621636

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. © 2014 Elsevier Inc. All rights reserved.

Variations in screening outcome among pairs of screening radiologists at non-blinded double reading of screening mammograms: a population-based study

NARCIS (Netherlands)

Klompenhouwer, E. G.; Duijm, L. E. M.; Voogd, A. C.; den Heeten, G. J.; Nederend, J.; Jansen, F. H.; Broeders, M. J. M.

2014-01-01

Substantial inter-observer variability in screening mammography interpretation has been reported at single reading. However, screening results of pairs of screening radiologists have not yet been published. We determined variations in screening performances among pairs of screening radiologists at

Is there an association between dietary intake and academic achievement: a systematic review.

Science.gov (United States)

Burrows, T; Goldman, S; Pursey, K; Lim, R

2017-04-01

The majority of literature examining the effect of dietary behaviour on academic achievement has focused on breakfast consumption only. Here, we aim to systematically review the literature investigating the broader effects of dietary intake and behaviours on school-aged children's academic achievement. A search was undertaken across seven databases using keywords. For studies to be included, they needed to be conducted in: school-aged children (5-18 years); assess and report: (i) a measure of academic performance; (ii) a measure of dietary intake/behaviour; and (iii) the association between dietary intake/behaviours and academic performance. Forty studies were included in the review. The majority of studies were cross-sectional in design (n = 33) and studied children aged >10 years, with very few reports in younger age groups. More than 30 different dietary assessment tools were used, with only 40% of those using a validated/standardised assessment method. Half the studies collected outcomes of academic achievement objectively from a recognised educational authority, whereas 10 studies used self-reported measures. The dietary outcomes most commonly reported to have positive associations with academic achievement were: breakfast consumption (n = 12) and global diet quality/meal patterns (n = 7), whereas negative associations reported with junk/fast food (n = 9). This review highlights that moderate associations exist for dietary intakes characterised by regular breakfast consumption, lower intakes of energy-dense, nutrient-poor foods and overall diet quality with respect to outcomes of academic achievement. Future studies should consider the use of validated dietary assessment methods and standardised reporting of academic achievement. © 2016 The British Dietetic Association Ltd.

Outdoor time and dietary patterns in children around the world.

Science.gov (United States)

Chaput, Jean-Philippe; Tremblay, Mark S; Katzmarzyk, Peter T; Fogelholm, Mikael; Mikkilä, Vera; Hu, Gang; Lambert, Estelle V; Maher, Carol; Maia, Jose; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tudor-Locke, Catrine; LeBlanc, Allana G

2018-04-19

Whether outdoor time is linked to dietary patterns of children has yet to be empirically tested. The objective of this study was to examine the association between outdoor time and dietary patterns of children from 12 countries around the world. This multinational, cross-sectional study included 6229 children 9-11 years of age. Children self-reported the time that they spent outside before school, after school and on weekends. A composite score was calculated to reflect overall daily outdoor time. Dietary patterns were assessed using a food frequency questionnaire, and two components were used for analysis: healthy and unhealthy dietary pattern scores. On average, children spent 2.5 h outside per day. After adjusting for age, sex, parental education, moderate-to-vigorous physical activity, screen time and body mass index z-score, greater time spent outdoors was associated with healthier dietary pattern scores. No association was found between outdoor time and unhealthy dietary pattern scores. Similar associations between outdoor time and dietary patterns were observed for boys and girls and across study sites. Greater time spent outside was associated with a healthier dietary pattern in this international sample of children. Future research should aim to elucidate the mechanisms behind this association.

Systematic review of dietary interventions with college students: directions for future research and practice.

Science.gov (United States)

Kelly, Nichole R; Mazzeo, Suzanne E; Bean, Melanie K

2013-01-01

To clarify directions for research and practice, research literature evaluating nutrition and dietary interventions in college and university settings was reviewed. Systematic search of database literature. Postsecondary education. Fourteen research articles evaluating randomized controlled trials or quasi-experimental interventions targeting dietary outcomes. Diet/nutrition intake, knowledge, motivation, self-efficacy, barriers, intentions, social support, self-regulation, outcome expectations, and sales. Systematic search of 936 articles and review of 14 articles meeting search criteria. Some in-person interventions (n = 6) show promise in improving students' dietary behaviors, although changes were minimal. The inclusion of self-regulation components, including self-monitoring and goal setting, may maximize outcomes. Dietary outcomes from online interventions (n = 5) were less promising overall, although they may be more effective with a subset of college students early in their readiness to change their eating habits. Environmental approaches (n = 3) may increase the sale of healthy food by serving as visual cues-to-action. A number of intervention approaches show promise for improving college students' dietary habits. However, much of this research has methodological limitations, rendering it difficult to draw conclusions across studies and hindering dissemination efforts. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Impact Exerted by Nutritional Risk Screening on Clinical Outcome of Patients with Esophageal Cancer

OpenAIRE

Rui Wang; Hongfei Cai; Yang Li; Caiwen Chen; Youbin Cui

2018-01-01

Objective. Preoperative nutritional status of patients is closely associated with their recovery after the surgery. This study aims to ascertain the impact exerted by the nutritional risk screening on clinical outcome of patients with esophageal cancer. Methods. 160 patients with esophageal cancer aged over 60, having got therapy at the First Hospital of Jilin University from Jun 2016 to Feb 2017 were evaluated by adopting the NRS2002. 80 cases of patients got active therapy of nutritional su...

FitKids360: Design, Conduct, and Outcomes of a Stage 2 Pediatric Obesity Program

Directory of Open Access Journals (Sweden)

Jared M. Tucker

2014-01-01

Full Text Available This paper describes FitKids360, a stage 2 pediatric weight management program. FitKids360 is a physician-referred, multicomponent, low-cost healthy lifestyle program for overweight and obese youth 5–16 years of age and their families. FitKids360 provides an evidence-based approach to the treatment of pediatric overweight by targeting patients’ physical activity, screen time, and dietary behaviors using a family-centered approach. The intervention begins with a two-hour orientation and assessment period followed by six weekly sessions. Assessments include lifestyle behaviors, anthropometry, and the Family Nutrition and Physical Activity (FNPA survey, which screens for obesogenic risk factors in the home environment. Outcomes are presented from 258 patients who completed one of 33 FitKids360 classes. After completing FitKids360, patients increased moderate to vigorous physical activity by 14 minutes (P=0.019, reduced screen time by 44 minutes (P<0.001, and improved key dietary behaviors. Overall, FNPA scores increased by 9% (P<0.001 and 69% of patients with “high risk” FNPA scores at baseline dropped below the “high risk” range by followup. Patients also lowered BMIs (P=0.011 and age- and sex-adjusted BMI z-scores (P<0.001 after completing the 7-week program. We hope this report will be useful to medical and public health professionals seeking to develop stage 2 pediatric obesity programs.

Young Children's Screen Activities, Sweet Drink Consumption and Anthropometry

DEFF Research Database (Denmark)

Olafsdottir, Steingerdur; Ahrens, Wolfgang; Siani, Alfonso

2014-01-01

Background/Objectives: This longitudinal study describes the relationship between young children’s screen time, dietary habits and anthropometric measures. The hypothesis was that television viewing and other screen activities at baseline result in increased consumption of sugar-sweetened beverages...... children, both on their consumption of sugary drinks and on an increase in BMI and central obesity. Our findings suggest that television viewing seems to have a stronger effect on food habits and anthropometry than other screen activities in this age group....

Gut microbiota and cardiometabolic outcomes: influence of dietary patterns and their associated components.

Science.gov (United States)

Wong, Julia M W

2014-07-01

Many dietary patterns have been associated with cardiometabolic risk reduction. A commonality between these dietary patterns is the emphasis on plant-based foods. Studies in individuals who consume vegetarian and vegan diets have shown a reduced risk of cardiovascular events and incidence of diabetes. Plant-based dietary patterns may promote a more favorable gut microbial profile. Such diets are high in dietary fiber and fermentable substrate (ie, nondigestible or undigested carbohydrates), which are sources of metabolic fuel for gut microbial fermentation and, in turn, result in end products that may be used by the host (eg, short-chain fatty acids). These end products may have direct or indirect effects on modulating the health of their host. Modulation of the gut microbiota is an area of growing interest, and it has been suggested to have the potential to reduce risk factors associated with chronic diseases. Examples of dietary components that alter the gut microbial composition include prebiotics and resistant starches. Emerging evidence also suggests a potential link between interindividual differences in the gut microbiota and variations in physiology or predisposition to certain chronic disease risk factors. Alterations in the gut microbiota may also stimulate certain populations and may assist in biotransformation of bioactive components found in plant foods. Strategies to modify microbial communities may therefore provide a novel approach in the treatment and management of chronic diseases. © 2014 American Society for Nutrition.

Dietary Patterns and Human Reproduction

NARCIS (Netherlands)

M. Vujkovic (Marijana)

2010-01-01

textabstractPart 1 of the thesis focuses on dietary patterns and fatty acid intake in couples undergoing IVF/ICSI fertility treatment. The studies described in Chapter 2, 3 and 4 are based on the FOod Lifestyle and Fertility Outcome study (FOLFO), a prospective cohort study examining the influence

Relative validity and reproducibility of a food frequency questionnaire to assess dietary fiber intake in Danish adults

DEFF Research Database (Denmark)

Vuholm, Stine; Lorenzen, Janne Kunchel; Kristensen, Mette Bredal

2014-01-01

months later. Results: Estimates of mean dietary fiber intake were 24.999.8 and 28.199.4 g/day when applying the FFQ and DR, respectively, where FFQ estimates were 12% lower (pB0.001). Pearson’s correlation coefficient between the estimated dietary fiber intake of the two methods was r0.63 (pB0......: The developed FFQ showed moderate underestimation of dietary fiber intake (g/day), adequate ranking of subjects according to their dietary fiber intake, and good reproducibility. The FFQ is therefore believed to be a valuable tool for epidemiology and screening in human interventions, where intake of dietary...

Adherence to the USDA Food Guide, DASH Eating Plan, and Mediterranean dietary pattern reduces risk of colorectal adenoma.

Science.gov (United States)

Dixon, L Beth; Subar, Amy F; Peters, Ulrike; Weissfeld, Joel L; Bresalier, Robert S; Risch, Adam; Schatzkin, Arthur; Hayes, Richard B

2007-11-01

The 2005 Dietary Guidelines for Americans include quantitative recommendations for 2 eating patterns, the USDA Food Guide and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan, to promote optimal health and reduce disease risk. A Mediterranean dietary pattern has also been promoted for health benefits. Our objective was to determine whether adherence to the USDA Food Guide recommendations, the DASH Eating Plan, or a Mediterranean dietary pattern is associated with reduced risk of distal colorectal adenoma. In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, men and women aged 55-74 y were screened for colorectal cancer by sigmoidoscopy at 10 centers in the U.S. After adjusting for potential confounders, men who most complied with the USDA Food Guide recommendations had a 26% reduced risk of colorectal adenoma compared with men who least complied with the recommendations (OR USDA score >or= 5 vs. dietary pattern. Women who most complied with the USDA Food Guide recommendations had an 18% reduced risk for colorectal adenoma, but subgroup analyses revealed protective associations only for current smokers (OR USDA score >or= 5 vs. or= 5 vs. dietary recommendations or a Mediterranean dietary pattern is associated with reduced risk of colorectal adenoma, especially in men.

Outcome of breast cancer screening in Denmark

DEFF Research Database (Denmark)

Lynge, Elsebeth; Bak, Martin; von Euler-Chelpin, My

2017-01-01

were node negative and 40% ≤10 mm. False-positive rate was around 2%; higher for North Denmark Region than for the rest of Denmark. Three out of 10 breast cancers in screened women were diagnosed as interval cancers. Conclusions: High coverage by examination and low interval cancer rate are required...... for screening to decrease breast cancer mortality. Two pioneer local screening programs starting in the 1990s were followed by a decrease in breast cancer mortality of 22-25%. Coverage by examination and interval cancer rate of the national program were on the favorable side of values from the pioneer programs...... calculated coverage by examination; participation after invitation; detection-, interval cancer- and false-positive rates; cancer characteristics; sensitivity and specificity, for Denmark and for the five regions. Results: At the national level coverage by examination remained at 75-77%; lower in the Capital...

Effect of ingredient particle sizes and dietary viscosity on digestion and faecal waste of striped catfish (Pangasianodon hypophthalmus)

NARCIS (Netherlands)

Tran, Tu; Hien, T.T.T.; Bosma, R.H.; Heinsbroek, L.T.N.; Verreth, J.A.J.; Schrama, J.W.

2017-01-01

The ingredients' particle size and dietary viscosity may alter digestion, performance and faecal waste management of fish. This study aimed to assess the effect of grinding screen sizes of feed ingredients and dietary viscosity on digestibility, faecal waste and performance of striped catfish

Effect of ingredient particle sizes and dietary viscosity on digestion and faecal waste of striped catfish (Pangasianodon hypophthalmus)

NARCIS (Netherlands)

Tran, Tu; Hien, T.T.T.; Bosma, R.H.; Heinsbroek, L.T.N.; Verreth, J.A.J.; Schrama, J.W.

2018-01-01

The ingredients' particle size and dietary viscosity may alter digestion, performance and faecal waste management of fish. This study aimed to assess the effect of grinding screen sizes of feed ingredients and dietary viscosity on digestibility, faecal waste and performance of striped catfish

Rural-Urban Differences of Dietary Patterns, Overweight, and Bone Mineral Status in Chinese Students

Directory of Open Access Journals (Sweden)

Yang Yang

2016-09-01

Full Text Available China is an urban and rural social model country. In the past three decades, the developing speed of rural areas has been much slower than urban areas, which may lead to the differences in dietary patterns. This study aimed to investigate the disparities of dietary structures from urban and rural children, and to analyze the effects of different dietary patterns on their adverse outcome. Among 1590 students, aged 11 years to 17 years, from primary and middle schools, a cross-sectional study was conducted. There were three dietary patterns recognized: Westernization structure, meat diet structure, and Western and Chinese structure. Compared with rural students, more urban students were in the highest categories of the whole dietary patterns (p < 0.001. Overweight/obesity and central adiposity were more prevailing among urban students, while rural students had a more prevailing risk of bone fracture (p < 0.05. Through the adjustment for all confounding factors, the Westernization structure could increase the risk of overweight/obesity and central adiposity, the meat structure could increase the risk of elevated blood pressure/hypertension, while the risk of low bone mineral quality could be reduced by the Chinese and Western structure. In conclusion, a rural-urban disparity in dietary patterns was found in our study, and different dietary patterns were associated with the risk of some adverse outcomes. Therefore, there were different prevalences of the adverse outcomes between rural and urban students.

Outcome of Congenitally Hypothyroid Screening Program in Isfahan: Iran From Prevention to Treatment

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Mahin Hashemipour

2010-01-01

Full Text Available Objectives: Early and proper treatment is crucial to prevent neuropsychologic deficits in congenital hypothyroidism (CH. Considering the high prevalence of CH in Isfahan, the aim of this study was to evaluate the outcome of treatment in CH patients.Methods: In this study CH neonates diagnosed during screening program in Isfahan from May 2002 to September 2009 were studied. Frequent visits were performed to CH patients to monitor and follow their treatments. Quality of treatment was assessed by evaluating mean age of treatment initiation and mean TSH and T4 levels before and after treatment and during the first and second years according to their normal reference ranges.Results: Of 225,224 screened neonates, 536 were diagnosed as CH patients. The prevalence of CH was 1/420 live births. Mean age at starting treatment was 22.9  13.2 days. In 93.7% of patients, treatment was begun before the 45th day of life. In the first measurement after initiating the treatment, T4 and TSH were not in their acceptable range in 3.9% and 9.8% of CH patients, respec-tively. Mean T4 and TSH reached to normal range during the treatment period. T4 reached the normal range earlier than TSH.Conclusions: The mean age of treatment initiation was in acceptable range but the findings suggest that both early and high-dose treatments are crucial for optimal treatment, especially in patients with severe CH. Further studies are needed to determine the outcome of treatment specially regarding to different etiologies of CH.

Prebiotics, Fermentable Dietary Fiber, and Health Claims.

Science.gov (United States)

Delcour, Jan A; Aman, Per; Courtin, Christophe M; Hamaker, Bruce R; Verbeke, Kristin

2016-01-01

Since the 1970s, the positive effects of dietary fiber on health have increasingly been recognized. The collective term "dietary fiber" groups structures that have different physiologic effects. Since 1995, some dietary fibers have been denoted as prebiotics, implying a beneficial physiologic effect related to increasing numbers or activity of the gastrointestinal microbiota. Given the complex composition of the microbiota, the demonstration of such beneficial effects is difficult. In contrast, an exploration of the metabolites of dietary fiber formed as a result of its fermentation in the colon offers better perspectives for providing mechanistic links between fiber intake and health benefits. Positive outcomes of such studies hold the promise that claims describing specific health benefits can be granted. This would help bridge the "fiber gap"-that is, the considerable difference between recommended and actual fiber intakes by the average consumer. © 2016 American Society for Nutrition.

Dietary outcomes in a Spanish-language randomized controlled diabetes prevention trial with pregnant Latinas.

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Kieffer, Edith C; Welmerink, Diana B; Sinco, Brandy R; Welch, Kathleen B; Rees Clayton, Erin M; Schumann, Christina Y; Uhley, Virginia E

2014-03-01

We evaluated the effectiveness of a community-based healthy lifestyle intervention in improving dietary behaviors of pregnant Latinas from 2004 to 2006 in Detroit, Michigan. The 11-week, culturally tailored, Spanish-language Healthy Mothers on the Move (MOMs) intervention offered home visits, group classes, related activities, and social support from trained community health workers (CHWs) and peers. Dietary behaviors were measured by food frequency questionnaire. Linear mixed models estimated pre- and post-intervention changes, within and between MOMs intervention and minimal intervention (MI) groups. MOMs (n = 139) and MI (n = 139) participants had similar baseline characteristics and dietary intake. Post-intervention, MOMs participants showed significant improvement in all dietary behaviors, except fruit and fiber consumption. Compared with MI participants, MOMs participants had significantly decreased consumption of added sugar (P = .05), total fat (P < .05), saturated fat (P < .01), percentage of daily calories from saturated fat (P < .001), solid fats and added sugars (P < .001), and had increased vegetable consumption (P < .001). Their increase in fiber consumption (P < .05) was significant relative to MI participants' decrease in fiber intake. We confirmed the hypothesis that a community-planned, CHW-led healthy lifestyle intervention could improve dietary behaviors of low-income Latina women during pregnancy.

Dietary nutraceuticals as novel radioprotectors

International Nuclear Information System (INIS)

Jagetia, Ganesh Chandra

2012-01-01

There is long standing need to protect humans from the deleterious effects of ionizing radiation in the event of radiation related calamities or otherwise. Various dietary ingredients have formed an integral part of daily human diets. Most of the ingredients used in the Indian diet possess medicinal properties. However, little attention has been paid to screen the radioprotective ability of dietary ingredients. It is possible that use of dietary agents could protect against the deleterious effects of ionizing radiations more effectively than other exotic synthetic agents simply because they are from natural biological sources, and may be more biocompatible than any other synthetic counterparts. Their acceptance for therapeutic purpose will be acceptable as they are part of daily human diets and do not have any known toxicity. This has been a stimulation to investigate the radioprotective ability of certain dietary ingredients including naringin and mangiferin in vivo and in vitro using micronuclei or survival assays. Treatment of mice with various doses of naringin or mangiferin reduced the symptoms of radiation-induced sickness including listlessness, irritability, lethargy, reduction in food and water intake, diarrhea, lacrimation, facial edema weight loss, emaciation, and epilation. Mice receiving various doses of naringin reduced the radiation-induced micronuclei formation and chromosome aberrations in bone marrow. Likewise, treatment of human peripheral blood lymphocytes with various concentrations of mangiferin reduced the radiation-induced DNA damage. The putative mechanisms of radioprotection are free radical scavenging, increased GSH accompanied by reduced lipid peroxidation. The use of dietary ingredients for radioprotection shall be encouraged as they are consumed daily and toxic implications are negligible. (author)

Correlates of anaemia in pregnant urban South Indian women: a possible role of dietary intake of nutrients that inhibit iron absorption.

Science.gov (United States)

Samuel, Tinu Mary; Thomas, Tinku; Finkelstein, Julia; Bosch, Ronald; Rajendran, Ramya; Virtanen, Suvi M; Srinivasan, Krishnamachari; Kurpad, Anura V; Duggan, Christopher

2013-02-01

To identify correlates of anaemia during the first trimester of pregnancy among 366 urban South Indian pregnant women. Cross-sectional study evaluating demographic, socio-economic, anthropometric and dietary intake data on haematological outcomes. A government maternity health-care centre catering predominantly to the needs of pregnant women from the lower socio-economic strata of urban Bangalore. Pregnant women (n 366) aged ≥18 and ≤40 years, who registered for antenatal screening at ≤14 weeks of gestation. Mean age was 22·6 (sd 3·4) years, mean BMI was 20·4 (sd 3·3) kg/m2 and 236 (64·5 %) of the pregnant women were primiparous. The prevalence of anaemia (Hb poultry (1·94; 1·29, 2·91). Low dietary intake of multiple micronutrients, but higher intakes of nutrients that inhibit Fe absorption such as Ca and P, may help explain high rates of maternal anaemia in India.

The non-advertising effects of screen-based sedentary activities on acute eating behaviours in children, adolescents, and young adults. A systematic review.

Science.gov (United States)

Marsh, Samantha; Ni Mhurchu, Cliona; Maddison, Ralph

2013-12-01

Sedentary screen time may be an important determinant of childhood obesity. A number of potential mechanisms to explain the link between screen time and increased bodyweight have been proposed; however, the relationship appears to be best explained by the effects on dietary intake, which is attributed to either food advertising or effects independent of food advertising. Technological advances have allowed for greater accessibility and exposure to advertisement-free screen-based media. This review was conducted to systematically synthesise the evidence from laboratory based studies which have investigated the non-advertising effects of screen time (TV viewing, sedentary video games, and computer use) on dietary intake in children, adolescents, and young adults. MEDLINE, PubMed, PsychInfo, CINAHL, and Embase were searched from inception through 5 July 2013. Ten trials met the inclusion criteria and were included in the review. Risk of study bias was judged to range from low to high. Screen time in the absence of food advertising was consistently found to be associated with increased dietary intake compared with non-screen behaviours. Suggested explanations for this relationship included: distraction, interruption of physiologic food regulation, screen time as a conditioned cue to eat, disruption of memory formation, and the effects of the stress-induced reward system. Due to the limited number of high-quality studies available for this review, our findings are preliminary. More work is required to better establish the link between dietary intake and advertisement-free screen time and assess whether differences exist between the different screen-based activities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Detection of sibutramine in adulterated dietary supplements using attenuated total reflectance-infrared spectroscopy.

Science.gov (United States)

Deconinck, E; Cauwenbergh, T; Bothy, J L; Custers, D; Courselle, P; De Beer, J O

2014-11-01

Sibutramine is one of the most occurring adulterants encountered in dietary supplements with slimming as indication. These adulterated dietary supplements often contain a herbal matrix. When customs intercept these kind of supplements it is almost impossible to discriminate between the legal products and the adulterated ones, due to misleading packaging. Therefore in most cases these products are confiscated and send to laboratories for analysis. This results inherently in the confiscation of legal, non-adulterated products. Therefore there is a need for easy to use equipment and techniques to perform an initial screening of samples. Attenuated total reflectance-infrared (ATR-IR) spectroscopy was evaluated for the detection of sibutramine in adulterated dietary supplements. Data interpretation was performed using different basic chemometric techniques. It was found that the use of ATR-IR combined with the k-Nearest Neighbours (k-NN) was able to detect all adulterated dietary supplements in an external test set and this with a minimum of false positive results. This means that a small amount of legal products will still be confiscated and analyzed in a laboratory to be found negative, but no adulterated samples will pass the initial ATR-IR screening. Copyright © 2014 Elsevier B.V. All rights reserved.

Integration of metabolic and gene regulatory networks modulates the C. elegans dietary response.

Science.gov (United States)

Watson, Emma; MacNeil, Lesley T; Arda, H Efsun; Zhu, Lihua Julie; Walhout, Albertha J M

2013-03-28

Expression profiles are tailored according to dietary input. However, the networks that control dietary responses remain largely uncharacterized. Here, we combine forward and reverse genetic screens to delineate a network of 184 genes that affect the C. elegans dietary response to Comamonas DA1877 bacteria. We find that perturbation of a mitochondrial network composed of enzymes involved in amino acid metabolism and the TCA cycle affects the dietary response. In humans, mutations in the corresponding genes cause inborn diseases of amino acid metabolism, most of which are treated by dietary intervention. We identify several transcription factors (TFs) that mediate the changes in gene expression upon metabolic network perturbations. Altogether, our findings unveil a transcriptional response system that is poised to sense dietary cues and metabolic imbalances, illustrating extensive communication between metabolic networks in the mitochondria and gene regulatory networks in the nucleus. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of a low fat versus a low carbohydrate weight loss dietary intervention on biomarkers of long term survival in breast cancer patients ('CHOICE'): study protocol.

Science.gov (United States)

Sedlacek, Scot M; Playdon, Mary C; Wolfe, Pamela; McGinley, John N; Wisthoff, Mark R; Daeninck, Elizabeth A; Jiang, Weiqin; Zhu, Zongjian; Thompson, Henry J

2011-07-06

Weight loss in overweight or obese breast cancer patients is associated with an improved prognosis for long term survival. However, it is not clear whether the macronutrient composition of the chosen weight loss dietary plan imparts further prognostic benefit. A study protocol is presented for a dietary intervention to investigate the effects of weight loss dietary patterns that vary markedly in fat and carbohydrate contents on biomarkers of exposure to metabolic processes that may promote tumorigenesis and that are predictive of long term survival. The study will also determine how much weight must be lost for biomarkers to change in a favorable direction. Approximately 370 overweight or obese postmenopausal breast cancer survivors (body mass index: 25.0 to 34.9 kg/m²) will be accrued and assigned to one of two weight loss intervention programs or a non-intervention control group. The dietary intervention is implemented in a free living population to test the two extremes of popular weight loss dietary patterns: a high carbohydrate, low fat diet versus a low carbohydrate, high fat diet. The effects of these dietary patterns on biomarkers for glucose homeostasis, chronic inflammation, cellular oxidation, and steroid sex hormone metabolism will be measured. Participants will attend 3 screening and dietary education visits, and 7 monthly one-on-one dietary counseling and clinical data measurement visits in addition to 5 group visits in the intervention arms. Participants in the control arm will attend two clinical data measurement visits at baseline and 6 months. The primary outcome is high sensitivity C-reactive protein. Secondary outcomes include interleukin-6, tumor necrosis factor-α, insulin-like growth factor-1 (IGF), IGF binding protein-3, 8-isoprostane-F2-alpha, estrone, estradiol, progesterone, sex hormone binding globulin, adiponectin, and leptin. While clinical data indicate that excess weight for height is associated with poor prognosis for long term

Effect of a low fat versus a low carbohydrate weight loss dietary intervention on biomarkers of long term survival in breast cancer patients ('CHOICE': study protocol

Directory of Open Access Journals (Sweden)

Daeninck Elizabeth A

2011-07-01

Full Text Available Abstract Background Weight loss in overweight or obese breast cancer patients is associated with an improved prognosis for long term survival. However, it is not clear whether the macronutrient composition of the chosen weight loss dietary plan imparts further prognostic benefit. A study protocol is presented for a dietary intervention to investigate the effects of weight loss dietary patterns that vary markedly in fat and carbohydrate contents on biomarkers of exposure to metabolic processes that may promote tumorigenesis and that are predictive of long term survival. The study will also determine how much weight must be lost for biomarkers to change in a favorable direction. Methods/Design Approximately 370 overweight or obese postmenopausal breast cancer survivors (body mass index: 25.0 to 34.9 kg/m2 will be accrued and assigned to one of two weight loss intervention programs or a non-intervention control group. The dietary intervention is implemented in a free living population to test the two extremes of popular weight loss dietary patterns: a high carbohydrate, low fat diet versus a low carbohydrate, high fat diet. The effects of these dietary patterns on biomarkers for glucose homeostasis, chronic inflammation, cellular oxidation, and steroid sex hormone metabolism will be measured. Participants will attend 3 screening and dietary education visits, and 7 monthly one-on-one dietary counseling and clinical data measurement visits in addition to 5 group visits in the intervention arms. Participants in the control arm will attend two clinical data measurement visits at baseline and 6 months. The primary outcome is high sensitivity C-reactive protein. Secondary outcomes include interleukin-6, tumor necrosis factor-α, insulin-like growth factor-1 (IGF, IGF binding protein-3, 8-isoprostane-F2-alpha, estrone, estradiol, progesterone, sex hormone binding globulin, adiponectin, and leptin. Discussion While clinical data indicate that excess weight

A multicentre observational study of the outcomes of screening detected sub-aneurysmal aortic dilatation

DEFF Research Database (Denmark)

Wild, J B; Stather, P W; Biancari, F

2013-01-01

of patients with screening detected sub aneurysmal aortic dilatation. DESIGN AND METHODS: Individual patient data was obtained from 8 screening programmes that had performed long term follow up of patients with sub aneurysmal aortic dilatation. Outcome measures recorded were the progression to true aneurysmal...... dilatation (aortic diameter 30 mm or greater), progression to size threshold for surgical intervention (55 mm) and aneurysm rupture. RESULTS: Aortic measurements for 1696 men and women (median age 66 years at initial scan) with sub-aneurysmal aortae were obtained, median period of follow up was 4.0 years...... (range 0.1-19.0 years). Following Kaplan Meier and life table analysis 67.7% of patients with 5 complete years of surveillance reached an aortic diameter of 30 mm or greater however 0.9% had an aortic diameter of 54 mm. A total of 26.2% of patients with 10 complete years of follow up had an AAA...

Dietary supplements for football.

Science.gov (United States)

Hespel, P; Maughan, R J; Greenhaff, P L

2006-07-01

Physical training and competition in football markedly increase the need for macro- and micronutrient intake. This requirement can generally be met by dietary management without the need for dietary supplements. In fact, the efficacy of most supplements available on the market is unproven. In addition, players must be cautious of inadequate product labelling and supplement impurities that may cause a positive drug test. Nonetheless, a number of dietary supplements may beneficially affect football performance. A high endurance capacity is a prerequisite for optimal match performance, particularly if extra time is played. In this context, the potential of low-dose caffeine ingestion (2 - 5 mg . kg body mass(-1)) to enhance endurance performance is well established. However, in the case of football, care must be taken not to overdose because visual information processing might be impaired. Scoring and preventing goals as a rule requires production of high power output. Dietary creatine supplementation (loading dose: 15 - 20 g . day(-1), 4 - 5 days; maintenance dose: 2 - 5 g g . day(-1)) has been found to increase muscle power output, especially during intermittent sprint exercises. Furthermore, creatine intake can augment muscle adaptations to resistance training. Team success and performance also depend on player availability, and thus injury prevention and health maintenance. Glucosamine or chondroitin may be useful in the treatment of joint pain and osteoarthritis, but there is no evidence to support the view that the administration of these supplements will be preventative. Ephedra-containing weight-loss cocktails should certainly be avoided due to reported adverse health effects and positive doping outcomes. Finally, the efficacy of antioxidant or vitamin C intake in excess of the normal recommended dietary dose is equivocal. Responses to dietary supplements can vary substantially between individuals, and therefore the ingestion of any supplement must be assessed

Designing Second Generation Anti-Alzheimer Compounds as Inhibitors of Human Acetylcholinesterase: Computational Screening of Synthetic Molecules and Dietary Phytochemicals.

Directory of Open Access Journals (Sweden)

Hafsa Amat-Ur-Rasool

Full Text Available Alzheimer's disease (AD, a big cause of memory loss, is a progressive neurodegenerative disorder. The disease leads to irreversible loss of neurons that result in reduced level of acetylcholine neurotransmitter (ACh. The reduction of ACh level impairs brain functioning. One aspect of AD therapy is to maintain ACh level up to a safe limit, by blocking acetylcholinesterase (AChE, an enzyme that is naturally responsible for its degradation. This research presents an in-silico screening and designing of hAChE inhibitors as potential anti-Alzheimer drugs. Molecular docking results of the database retrieved (synthetic chemicals and dietary phytochemicals and self-drawn ligands were compared with Food and Drug Administration (FDA approved drugs against AD as controls. Furthermore, computational ADME studies were performed on the hits to assess their safety. Human AChE was found to be most approptiate target site as compared to commonly used Torpedo AChE. Among the tested dietry phytochemicals, berberastine, berberine, yohimbine, sanguinarine, elemol and naringenin are the worth mentioning phytochemicals as potential anti-Alzheimer drugs The synthetic leads were mostly dual binding site inhibitors with two binding subunits linked by a carbon chain i.e. second generation AD drugs. Fifteen new heterodimers were designed that were computationally more efficient inhibitors than previously reported compounds. Using computational methods, compounds present in online chemical databases can be screened to design more efficient and safer drugs against cognitive symptoms of AD.

Designing Second Generation Anti-Alzheimer Compounds as Inhibitors of Human Acetylcholinesterase: Computational Screening of Synthetic Molecules and Dietary Phytochemicals.

Science.gov (United States)

Amat-Ur-Rasool, Hafsa; Ahmed, Mehboob

2015-01-01

Alzheimer's disease (AD), a big cause of memory loss, is a progressive neurodegenerative disorder. The disease leads to irreversible loss of neurons that result in reduced level of acetylcholine neurotransmitter (ACh). The reduction of ACh level impairs brain functioning. One aspect of AD therapy is to maintain ACh level up to a safe limit, by blocking acetylcholinesterase (AChE), an enzyme that is naturally responsible for its degradation. This research presents an in-silico screening and designing of hAChE inhibitors as potential anti-Alzheimer drugs. Molecular docking results of the database retrieved (synthetic chemicals and dietary phytochemicals) and self-drawn ligands were compared with Food and Drug Administration (FDA) approved drugs against AD as controls. Furthermore, computational ADME studies were performed on the hits to assess their safety. Human AChE was found to be most approptiate target site as compared to commonly used Torpedo AChE. Among the tested dietry phytochemicals, berberastine, berberine, yohimbine, sanguinarine, elemol and naringenin are the worth mentioning phytochemicals as potential anti-Alzheimer drugs The synthetic leads were mostly dual binding site inhibitors with two binding subunits linked by a carbon chain i.e. second generation AD drugs. Fifteen new heterodimers were designed that were computationally more efficient inhibitors than previously reported compounds. Using computational methods, compounds present in online chemical databases can be screened to design more efficient and safer drugs against cognitive symptoms of AD.

Dietary arachidonic acid in perinatal nutrition: a commentary.

Science.gov (United States)

Lauritzen, Lotte; Fewtrell, Mary; Agostoni, Carlo

2015-01-01

Arachidonic acid (AA) is supplied together with docosahexaenoic acid (DHA) in infant formulas, but we have limited knowledge about the effects of supplementation with either of these long-chain polyunsaturated fatty acids (LCPUFA) on growth and developmental outcomes. AA is present in similar levels in breast milk throughout the world, whereas the level of DHA is highly diet dependent. Autopsy studies show similar diet-dependent variation in brain DHA, whereas AA is little affected by intake. Early intake of DHA has been shown to affect visual development, but the effect of LCPUFA on neurodevelopment remains to be established. Few studies have found any functional difference between infants supplemented with DHA alone compared to DHA+AA, but some studies show neurodevelopmental advantages in breast-fed infants of mothers supplemented with n-3 LCPUFA alone. It also remains to be established whether the AA/DHA balance could affect allergic and inflammatory outcomes later in life. Disentangling effects of genetic variability and dietary intake on AA and DHA-status and on functional outcomes may be an important step in the process of determining whether AA-intake is of any physiological or clinical importance. However, based on the current evidence we hypothesize that dietary AA plays a minor role on growth and development relative to the impact of dietary DHA.

Feasibility and outcomes of screening for cardiovascular risk factors in the emergency department.

Science.gov (United States)

Tan, Natalie; Taylor, David McDonald

2013-04-01

The present study aimed to determine the prevalence of undiagnosed and undertreated hypercholesterolaemia and hypertension (HT) among ED patients and to evaluate the effects of a formal referral back to the general practitioner (GP) for further management. This was a cross-sectional study of ED patients with follow up, if indicated. Patients aged ≥35 years, without substantial illness or communication difficulties, were enrolled. Data were collected using a researcher-administered questionnaire, a point-of-care Accutrend® Plus System machine (Roche Diagnostic Australia Pty Ltd, Castle Hill, NSW, Australia) and digital sphygmomanometer. Patients with total cholesterol (TC) ≥6.0 mmol/L and/or BP ≥140/90 were given a referral letter and advised to consult their GP. The investigators made follow-up telephone calls 5 weeks later. Of 827 presentations, 534 patients were enrolled (mean age 56.7 ± 13.3 years, 300 [56.2%] male). One hundred and eleven patients (20.7%, 95% CI 17.5-24.5) had TC ≥6.0 mmol/L. Patients with/without elevated TC differed significantly (P age, gender, GP ownership and attendance, and previous screening. Sixty-six patients consulted with their GP. Thirty had their TC levels retested, 18 received dietary/lifestyle advice and four had lipid-lowering medication prescribed or adjusted. Ninety-six patients (18.0%, 95% CI 14.9-21.6) had HT. Whereas 53 consulted their GP, no action was taken in 43 cases. Investigations were ordered for three and nine had antihypertensive medication prescribed or adjusted. Substantial proportions of ED patients have undiagnosed and undertreated hypercholesterolaemia and/or HT. GP referral initiated interventions for many patients with hypercholesterolaemia, but fewer with HT. The ED has potential as a useful venue for the opportunistic screening of hypercholesterolaemia. © 2013 The Authors. EMA © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Brief Screening and Intervention for Alcohol and Drug Use in a College Student Health Clinic: Feasibility, Implementation, and Outcomes

Science.gov (United States)

Amaro, Hortensia; Reed, Elizabeth; Rowe, Erin; Picci, Jennifer; Mantella, Philomena; Prado, Guillermo

2010-01-01

Objective: Evaluation of the Brief Alcohol Screen and Intervention in College Students (BASICS) in a university primary care setting. Participants/Methods: Undergraduates (N = 449) participated in BASICS and electronic surveys assessing frequency/quantity of alcohol and drug use, psychosocial and mental health outcomes, and demographic…

New genes tied to endocrine, metabolic, and dietary regulation of lifespan from a Caenorhabditis elegans genomic RNAi screen.

Directory of Open Access Journals (Sweden)

Malene Hansen

2005-07-01

Full Text Available Most of our knowledge about the regulation of aging comes from mutants originally isolated for other phenotypes. To ask whether our current view of aging has been affected by selection bias, and to deepen our understanding of known longevity pathways, we screened a genomic Caenorhabditis elegans RNAi library for clones that extend lifespan. We identified 23 new longevity genes affecting signal transduction, the stress response, gene expression, and metabolism and assigned these genes to specific longevity pathways. Our most important findings are (i that dietary restriction extends C. elegans' lifespan by down-regulating expression of key genes, including a gene required for methylation of many macromolecules, (ii that integrin signaling is likely to play a general, evolutionarily conserved role in lifespan regulation, and (iii that specific lipophilic hormones may influence lifespan in a DAF-16/FOXO-dependent fashion. Surprisingly, of the new genes that have conserved sequence domains, only one could not be associated with a known longevity pathway. Thus, our current view of the genetics of aging has probably not been distorted substantially by selection bias.

New Genes Tied to Endocrine, Metabolic, and Dietary Regulation of Lifespan from a Caenorhabditis elegans Genomic RNAi Screen.

Directory of Open Access Journals (Sweden)

2005-07-01

Full Text Available Most of our knowledge about the regulation of aging comes from mutants originally isolated for other phenotypes. To ask whether our current view of aging has been affected by selection bias, and to deepen our understanding of known longevity pathways, we screened a genomic Caenorhabditis elegans RNAi library for clones that extend lifespan. We identified 23 new longevity genes affecting signal transduction, the stress response, gene expression, and metabolism and assigned these genes to specific longevity pathways. Our most important findings are (i that dietary restriction extends C. elegans' lifespan by down-regulating expression of key genes, including a gene required for methylation of many macromolecules, (ii that integrin signaling is likely to play a general, evolutionarily conserved role in lifespan regulation, and (iii that specific lipophilic hormones may influence lifespan in a DAF-16/FOXO-dependent fashion. Surprisingly, of the new genes that have conserved sequence domains, only one could not be associated with a known longevity pathway. Thus, our current view of the genetics of aging has probably not been distorted substantially by selection bias.

European Breast Cancer Service Screening Outcomes

DEFF Research Database (Denmark)

Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig

2014-01-01

A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast...... seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer...... cancer overdiagnosis, and false-positive results. On the basis of the studies reviewed, the authors present a first estimate of the benefit and harm balance sheet. For every 1,000 women screened biennially from ages 50 to 51 years until ages 68 to 69 years and followed up until age 79 years, an estimated...

Companion Animals Symposium: dietary management of feline lower urinary tract symptoms.

Science.gov (United States)

Kerr, K R

2013-06-01

Experimental and clinical investigations have confirmed the importance of dietary modifications in medical protocols designed to treat and prevent feline lower urinary tract signs (LUTS). The objective of this review is to discuss common medical conditions contributing to feline LUTS and to present currently used and potential preventative dietary modifications. Feline LUTS are a set of clinical conditions with similar symptoms related to inappropriate urine elimination due to a combination of genetics, stress and frustration reactions, environment, and medical condition or conditions, for example, idiopathic cystitis, urolithiasis, urethral obstruction, and urinary tract infection. The main goals of dietary modifications to prevent LUTS are 1) promote large dilute volumes of urine, 2) decrease the relative supersaturation of urine for specific stone types, and 3) promote healthy bacterial populations in the gastrointestinal and urogenital tracts. The impact of dietary composition, including dietary moisture, protein concentration and digestibility, mineral concentrations (i.e., Na, Cl, Ca, P, and Mg), inclusion of acidifiers and alkalinizing agents, inclusion of vitamin B6, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and γ-linolenic acid, fiber concentration and characteristics, and oxalate degrading probiotics, on these outcomes is discussed, and dietary guidelines for cats are provided. Because of the complex interaction of diet composition, environment, and animal physiology, there is a need for clinical research linking current recommendations or dietary options for the treatment and prevention of LUTS with physiological outcomes (i.e., decreased relative supersaturation and LUTS recurrence). Additionally, for many recommendations (e.g., probiotic administration, EPA, DHA), extrapolation from other species was necessary. Research is needed in feline patients with LUTS on these dietary components.

Dietary habits of colorectal neoplasia patients in comparison to their first-degree relatives.

Science.gov (United States)

Kajzrlikova, Ivana Mikoviny; Vitek, Petr; Chalupa, Josef; Dite, Petr

2014-05-07

healthier dietary habits than men. Modification of screening guidelines according to sex may improve the efficiency of screening programs.

Probabilistic dietary risk assessment of pesticide residues in foods for the German population based on food monitoring data from 2009 to 2014.

Science.gov (United States)

Sieke, Christian; Michalski, Britta; Kuhl, Thomas

2018-01-01

Dietary risks for the German population owing to pesticide residues in foods were assessed based on food monitoring data, consumption surveys for children and adults and compound specific toxicological reference values or general thresholds of toxicological concern. A tiered probabilistic modelling was conducted to screen 700 pesticides for significant long- and short-term dietary exposures. Especially for the short-term dietary exposure, the probabilistic methodology used allows simultaneous consideration of the complete daily consumption, whereas most regulatory bodies still rely on single commodity approaches. After screening, refined exposure assessments were conducted for 19 compounds under consideration of conversion factors for toxicologically relevant metabolites, processing information, experimentally derived variability factors and the edible portion for each food item. In total, for 693 compounds the dietary exposure was unlikely to present a chronic or acute public health concern for the German population. In contrast, the refined assessments indicate that the short-term dietary exposure for chlorpyrifos and the cumulative short-term dietary exposure for dimethoate and omethoate may present a public health concern. For copper, owing to exposure assessment limitations, as well as for dimethylvinphos, halfenprox and tricyclazole, which exceeded the thresholds of toxicological concern, the dietary risk assessment remained inconclusive.

Development and validation of a rapid resolution liquid chromatography method for the screening of dietary plant isoprenoids: carotenoids, tocopherols and chlorophylls.

Science.gov (United States)

Stinco, Carla M; Benítez-González, Ana M; Hernanz, Dolores; Vicario, Isabel M; Meléndez-Martínez, Antonio J

2014-11-28

A rapid resolution liquid chromatography (RRLC) method was developed and validated for the simultaneous determination of nine carotenoids compounds (violaxanthin, lutein, zeaxanthin, β-cryptoxanthin, α-carotene, β-carotene, lycopene, phytoene, phytofluene), four tocopherols and four chlorophylls and derivates (chlorophylls and pheophytins). The methodology consisted in a micro-extraction procedure with or without saponification and subsequent analysis by RRLC. The limits of detection were saponification step was performed. The recovery of the method without the saponification step ranged from 92% to 107%, whilst that when saponification was carried out ranged from 60% for α-tocopherol to 82% for β-carotene. Finally, the applicability of the method was demonstrated by the identification and quantification of isoprenoids in different samples. The methodology is appropriate for the high-throughput screening of dietary isoprenoids in fruits and vegetables. Copyright © 2014 Elsevier B.V. All rights reserved.

Dietary reference values for vitamin D

DEFF Research Database (Denmark)

Sjödin, Anders Mikael

2016-01-01

synthesis and dietary sources, can be used as a biomarker of vitamin D status in adult and children populations. The Panel notes that the evidence on the relationship between serum 25(OH)D concentration and musculoskeletal health outcomes in adults, infants and children, and adverse pregnancy-related health...

Processed red meat contribution to dietary patterns and the associated cardio-metabolic outcomes.

Science.gov (United States)

Lenighan, Yvonne M; Nugent, Anne P; Li, Kaifeng F; Brennan, Lorraine; Walton, Janette; Flynn, Albert; Roche, Helen M; McNulty, Breige A

2017-08-01

Evidence suggests that processed red meat consumption is a risk factor for CVD and type 2 diabetes (T2D). This analysis investigates the association between dietary patterns, their processed red meat contributions, and association with blood biomarkers of CVD and T2D, in 786 Irish adults (18-90 years) using cross-sectional data from a 2011 national food consumption survey. All meat-containing foods consumed were assigned to four food groups (n 502) on the basis of whether they contained red or white meat and whether they were processed or unprocessed. The remaining foods (n 2050) were assigned to twenty-nine food groups. Two-step and k-means cluster analyses were applied to derive dietary patterns. Nutrient intakes, plasma fatty acids and biomarkers of CVD and T2D were assessed. A total of four dietary patterns were derived. In comparison with the pattern with lower contributions from processed red meat, the dietary pattern with greater processed red meat intakes presented a poorer Alternate Healthy Eating Index (21·2 (sd 7·7)), a greater proportion of smokers (29 %) and lower plasma EPA (1·34 (sd 0·72) %) and DHA (2·21 (sd 0·84) %) levels (Pprocessed red meat consumption as a risk factor for CVD and T2D may need to be re-assessed.

Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study.

Science.gov (United States)

Ghosh-Jerath, Suparna; Devasenapathy, Niveditha; Singh, Archna; Shankar, Anuraj; Zodpey, Sanjay

2015-03-20

Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes. A household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented. Almost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not. Pregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in

Optimizing Outcomes of Colorectal Cancer Screening

NARCIS (Netherlands)

R.G.S. Meester (Reinier)

2017-01-01

markdownabstractColorectal cancer is a leading cause of cancer deaths. Screening for colorectal cancer is implemented in an increasing number of settings, but performance of programs is often suboptimal. In this thesis, advanced modeling, informed by empirical data, was used to identify areas for

Effect of a low fat versus a low carbohydrate weight loss dietary intervention on biomarkers of long term survival in breast cancer patients ('CHOICE'): study protocol

International Nuclear Information System (INIS)

Sedlacek, Scot M; Playdon, Mary C; Wolfe, Pamela; McGinley, John N; Wisthoff, Mark R; Daeninck, Elizabeth A; Jiang, Weiqin; Zhu, Zongjian; Thompson, Henry J

2011-01-01

Weight loss in overweight or obese breast cancer patients is associated with an improved prognosis for long term survival. However, it is not clear whether the macronutrient composition of the chosen weight loss dietary plan imparts further prognostic benefit. A study protocol is presented for a dietary intervention to investigate the effects of weight loss dietary patterns that vary markedly in fat and carbohydrate contents on biomarkers of exposure to metabolic processes that may promote tumorigenesis and that are predictive of long term survival. The study will also determine how much weight must be lost for biomarkers to change in a favorable direction. Approximately 370 overweight or obese postmenopausal breast cancer survivors (body mass index: 25.0 to 34.9 kg/m 2 ) will be accrued and assigned to one of two weight loss intervention programs or a non-intervention control group. The dietary intervention is implemented in a free living population to test the two extremes of popular weight loss dietary patterns: a high carbohydrate, low fat diet versus a low carbohydrate, high fat diet. The effects of these dietary patterns on biomarkers for glucose homeostasis, chronic inflammation, cellular oxidation, and steroid sex hormone metabolism will be measured. Participants will attend 3 screening and dietary education visits, and 7 monthly one-on-one dietary counseling and clinical data measurement visits in addition to 5 group visits in the intervention arms. Participants in the control arm will attend two clinical data measurement visits at baseline and 6 months. The primary outcome is high sensitivity C-reactive protein. Secondary outcomes include interleukin-6, tumor necrosis factor-α, insulin-like growth factor-1 (IGF), IGF binding protein-3, 8-isoprostane-F2-alpha, estrone, estradiol, progesterone, sex hormone binding globulin, adiponectin, and leptin. While clinical data indicate that excess weight for height is associated with poor prognosis for long term

Prebiotics, Fermentable Dietary Fiber, and Health Claims12

Science.gov (United States)

Aman, Per; Courtin, Christophe M; Hamaker, Bruce R; Verbeke, Kristin

2016-01-01

Since the 1970s, the positive effects of dietary fiber on health have increasingly been recognized. The collective term “dietary fiber” groups structures that have different physiologic effects. Since 1995, some dietary fibers have been denoted as prebiotics, implying a beneficial physiologic effect related to increasing numbers or activity of the gastrointestinal microbiota. Given the complex composition of the microbiota, the demonstration of such beneficial effects is difficult. In contrast, an exploration of the metabolites of dietary fiber formed as a result of its fermentation in the colon offers better perspectives for providing mechanistic links between fiber intake and health benefits. Positive outcomes of such studies hold the promise that claims describing specific health benefits can be granted. This would help bridge the “fiber gap”—that is, the considerable difference between recommended and actual fiber intakes by the average consumer. PMID:26773010

Overcoming consumer inertia to dietary guidance.

Science.gov (United States)

Webb, Densie; Byrd-Bredbenner, Carol

2015-07-01

Despite 35 y of dietary guidance, there has been no substantial shift in consumer compliance. Consumers report that they seek information on nutrition and healthy eating, but most are not paying attention to dietary recommendations. For guidance to be effective, it must be realistic. Even with increasingly detailed nutrition information and evidence that diet affects health outcomes, convenience and taste remain the strongest determinants of food choices. It is up to health educators to clear up confusion and give consumers control with nutrition messages that are realistic, positive, easy to understand, and actionable without an expectation that consumers will surrender foods they love. © 2015 American Society for Nutrition.

Depression Screening and Patient Outcomes in Cancer : A Systematic Review

NARCIS (Netherlands)

Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael E.; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.

2011-01-01

Background: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer

Economic growth and the demand for dietary quality

DEFF Research Database (Denmark)

Burggraf, Christine; Teuber, Ramona; Brosig, Stephan

2015-01-01

The increasing incidence of nutrition-related chronic diseases worldwide has raised people's awareness of dietary quality. Most existing studies on the topic of changing nutrition patterns measure dietary quality by single macronutrient indicators or anthropometric outcomes. However...... econometric results imply an income elasticity of vitamins and minerals of 0.051, and an income elasticity of fats of 0.073. Overall, our results are in line with an ongoing nutrition transition in the Russian Federation, which is marked by decreasing deficiencies in vitamins and minerals, as well...

Supplementary Material for: Detection of antibiotic resistance in probiotics of dietary supplements

KAUST Repository

Wong, Aloysius Tze

2015-01-01

Abstract Background Probiotics are live microorganisms that confer nutrition- and health-promoting benefits if consumed in adequate amounts. Concomitant with the demand for natural approaches to maintaining health is an increase in inclusion of probiotics in food and health products. Since probiotic bacteria act as reservoir for antibiotic resistant determinants, the transfer of these genes to pathogens sharing the same intestinal habitat is thus conceivable considering the fact that dietary supplements contain high amounts of often heterogeneous populations of probiotics. Such events can confer pathogens protection against commonly-used drugs. Despite numerous reports of antibiotic resistant probiotics in food and biological sources, the antibiogram of probiotics from dietary supplements remained elusive. Findings Here, we screened five commercially available dietary supplements for resistance towards antibiotics of different classes. Probiotics of all batches of products were resistant towards vancomycin while batch-dependent resistance towards streptomycin, aztreonam, gentamycin and/or ciprofloxacin antibiotics was detected for probiotics of brands Bi and Bn, Bg, and L. Isolates of brand Cn was also resistant towards gentamycin, streptomycin and ciprofloxacin antibiotics. Additionally, we also report a discrepancy between the enumerated viable bacteria amounts and the claims of the manufacturers. Conclusions This short report has highlighted the present of antibiotic resistance in probiotic bacteria from dietary supplements and therefore serves as a platform for further screenings and for in-depth characterization of the resistant determinants and the molecular machinery that confers the resistance.

Association between dietary pattern scores and the prevalence of colorectal adenoma considering population subgroups.

Science.gov (United States)

Haslam, Alyson; Wagner Robb, Sara; Hébert, James R; Huang, Hanwen; Ebell, Mark H

2018-04-01

The purpose of the current study is to examine the dietary patterns in a diverse cohort of individuals and to see if the identified dietary patterns predict the prevalence of adenoma in a cross-sectional study. Factor analysis was used to derive both sex- and population subgroup-specific dietary patterns among participants in the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Logistic regression was used to assess associations between identified factor scores and colorectal adenoma (CRA) in sex-specific subgroups. Three diet patterns were observed in this cohort: 'Fruits and vegetables', 'Western' and 'Sweet and salty'. Foods that loaded on each factor were similar between the racial subgroups. In men, being in the highest quintile of 'Western' dietary scores was associated with higher odds of any (adjusted odds ratio (aOR) = 1.21; 95% confidence interval (CI) = 1.03-1.42), advanced (aOR = 1.32; 95% CI = 1.07-1.63) or multiple (>1; aOR = 1.51; 95% CI = 1.17-1.94) adenoma, compared to those in the lowest quintile. These results were most notably seen in Caucasian men. In women, having a 'Fruits and vegetable' score in the highest quintile was associated with lower odds of multiple adenoma (>1; aOR = 0.53; 95% CI = 0.28-1.00). Of the three dietary factors, the 'Western' diet pattern was most strongly associated with prevalent CRA in Caucasian men. Further research is needed to examine the association between dietary factor scores and adenomas in the proximal colon, where there are larger racial disparities in prevalence. © 2017 Dietitians Association of Australia.

Global dietary patterns and diets in childhood: implications for health outcomes

Science.gov (United States)

This article provides an overview of child feeding recommendations and how these relate to actual practice and dietary adequacy, primarily in developing countries. From birth to 6 months, recommendations focus on optimal breastfeeding practices, although these are still suboptimal in about one third...

Benefits and harms of prostate cancer screening – predictions of the ONCOTYROL prostate cancer outcome and policy model

Directory of Open Access Journals (Sweden)

Nikolai Mühlberger

2017-06-01

Full Text Available Abstract Background A recent recalibration of the ONCOTYROL Prostate Cancer Outcome and Policy (PCOP Model, assuming that latent prostate cancer (PCa detectable at autopsy might be detectable by screening as well, resulted in considerable worsening of the benefit-harm balance of screening. In this study, we used the recalibrated model to assess the effects of familial risk, quality of life (QoL preferences, age, and active surveillance. Methods Men with average and elevated familial PCa risk were simulated in separate models, differing in familial risk parameters. Familial risk was assumed to affect PCa onset and progression simultaneously in the base-case, and separately in scenario analyses. Evaluated screening strategies included one-time screening at different ages, and screening at different intervals and age ranges. Optimal screening strategies were identified depending on age and individual QoL preferences. Strategies were additionally evaluated with active surveillance by biennial re-biopsy delaying treatment of localized cancer until grade progression to Gleason score ≥ 7. Results Screening men with average PCa risk reduced quality-adjusted life expectancy (QALE even under favorable assumptions. Men with elevated familial risk, depending on age and disutilities, gained QALE. While for men with familial risk aged 55 and 60 years annual screening to age 69 was the optimal strategy over most disutility ranges, no screening was the preferred option for 65 year-old men with average and above disutilities. Active surveillance greatly reduced overtreatment, but QALE gains by averted adverse events were opposed by losses due to delayed treatment and additional biopsies. The effect of active surveillance on the benefit-harm balance of screening differed between populations, as net losses and gains in QALE predicted for screening without active surveillance in men with average and familial PCa risk, respectively, were both reduced

Application of Adverse Outcome Pathways to U.S. EPA's Endocrine Disruptor Screening Program.

Science.gov (United States)

Browne, Patience; Noyes, Pamela D; Casey, Warren M; Dix, David J

2017-09-01

The U.S. EPA's Endocrine Disruptor Screening Program (EDSP) screens and tests environmental chemicals for potential effects in estrogen, androgen, and thyroid hormone pathways, and it is one of the only regulatory programs designed around chemical mode of action. This review describes the EDSP's use of adverse outcome pathway (AOP) and toxicity pathway frameworks to organize and integrate diverse biological data for evaluating the endocrine activity of chemicals. Using these frameworks helps to establish biologically plausible links between endocrine mechanisms and apical responses when those end points are not measured in the same assay. Pathway frameworks can facilitate a weight of evidence determination of a chemical's potential endocrine activity, identify data gaps, aid study design, direct assay development, and guide testing strategies. Pathway frameworks also can be used to evaluate the performance of computational approaches as alternatives for low-throughput and animal-based assays and predict downstream key events. In cases where computational methods can be validated based on performance, they may be considered as alternatives to specific assays or end points. A variety of biological systems affect apical end points used in regulatory risk assessments, and without mechanistic data, an endocrine mode of action cannot be determined. Because the EDSP was designed to consider mode of action, toxicity pathway and AOP concepts are a natural fit. Pathway frameworks have diverse applications to endocrine screening and testing. An estrogen pathway example is presented, and similar approaches are being used to evaluate alternative methods and develop predictive models for androgen and thyroid pathways. https://doi.org/10.1289/EHP1304.

Maternal nutrition and birth outcomes.

Science.gov (United States)

Abu-Saad, Kathleen; Fraser, Drora

2010-01-01

In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

A review of sugar consumption from nationally representative dietary surveys across the world

OpenAIRE

Newens, K. J.; Walton, J.

2015-01-01

Abstract Background Government and health organisations worldwide have recently reviewed the evidence on the role of dietary sugars in relation to health outcomes. Hence, it is timely to review current intakes of dietary sugars with respect to this guidance and as a benchmark for future surveillance. Methods This review collates data from nationally representative dietary surveys across the world and reports estimates of intakes of total and added sugars, and sucrose in different population s...

The Impact of Providing Vision Screening and Free Eyeglasses on Academic Outcomes: Evidence from a Randomized Trial in Title I Elementary Schools in Florida

Science.gov (United States)

Glewwe, Paul; West, Kristine L.; Lee, Jongwook

2018-01-01

More than 20 percent of all school-aged children in the United States have vision problems, and low-income and minority children are disproportionately likely to have unmet vision care needs. Vision screening is common in U.S. schools, but it remains an open question whether screening alone is sufficient to improve student outcomes. We implemented…

Applicability of western chemical dietary exposure models to the Chinese population.

Science.gov (United States)

Zhao, Shizhen; Price, Oliver; Liu, Zhengtao; Jones, Kevin C; Sweetman, Andrew J

2015-07-01

A range of exposure models, which have been developed in Europe and North America, are playing an increasingly important role in priority setting and the risk assessment of chemicals. However, the applicability of these tools, which are based on Western dietary exposure pathways, to estimate chemical exposure to the Chinese population to support the development of a risk-based environment and exposure assessment, is unclear. Three frequently used modelling tools, EUSES, RAIDAR and ACC-HUMANsteady, have been evaluated in terms of human dietary exposure estimation by application to a range of chemicals with different physicochemical properties under both model default and Chinese dietary scenarios. Hence, the modelling approaches were assessed by considering dietary pattern differences only. The predicted dietary exposure pathways were compared under both scenarios using a range of hypothetical and current emerging contaminants. Although the differences across models are greater than those between dietary scenarios, model predictions indicated that dietary preference can have a significant impact on human exposure, with the relatively high consumption of vegetables and cereals resulting in higher exposure via plants-based foodstuffs under Chinese consumption patterns compared to Western diets. The selected models demonstrated a good ability to identify key dietary exposure pathways which can be used for screening purposes and an evaluative risk assessment. However, some model adaptations will be required to cover a number of important Chinese exposure pathways, such as freshwater farmed-fish, grains and pork. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical benefit of gluten-free diet in screen-detected older celiac disease patients

Directory of Open Access Journals (Sweden)

Vilppula Anitta

2011-12-01

Full Text Available Abstract Background The utility of serologic screening for celiac disease is still debatable. Evidence suggests that the disorder remains undetected even in the older population. It remains obscure whether screening makes good or harm in subjects with long-standing gluten ingestion. We evaluated whether older subjects benefit from active detection and subsequent gluten free dietary treatment of celiac disease. Methods Thirty-five biopsy-proven patients aged over 50 years had been detected by serologic mass screening. We examined the disease history, dietary compliance, symptoms, quality of life and bone mineral density at baseline and 1-2 years after the commencement of a gluten-free diet. Symptoms were evaluated by gastrointestinal symptom rating scale and quality of life by psychological general well-being questionnaires. Small bowel biopsy, serology, laboratory parameters assessing malabsorption, and bone mineral density were investigated. Results Dietary compliance was good. The patients had initially low mean serum ferritin values indicating subclinical iron deficiency, which was restored by a gluten-free diet. Vitamin B12, vitamin D and erythrocyte folic acid levels increased significantly on diet. Celiac patients had a history of low-energy fractures more often than the background population, and the diet had a beneficial effect on bone mineral density. Alleviation in gastrointestinal symptoms was observed, even though the patients reported no or only subtle symptoms at diagnosis. Quality of life remained unchanged. Of all the cases, two thirds would have been diagnosed even without screening if the family history, fractures or concomitant autoimmune diseases had been taken carefully into account. Conclusions Screen-detected patients benefited from a gluten-free diet. We encourage a high index of suspicion and active case-finding in celiac disease as an alternative to mass screening in older patients.

Dietary assessment and counseling for dental erosion.

Science.gov (United States)

Marshall, Teresa A

2018-02-01

Dental erosion occurs after exposure to intrinsic or extrinsic acids. Exposure to intrinsic gastrointestinal acids is associated with anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. Extrinsic dietary acids from foods or beverages also can cause erosion, particularly when exposure is prolonged by holding or swishing behaviors. Clinicians should screen patients exhibiting dental erosion for anorexia nervosa, bulimia nervosa, rumination syndrome, and gastroesophageal reflux disease. Clinicians should screen patients without a medical explanation for their erosion for exposure to acidic foods and beverages, particularly for habits that prolong exposure. Identification of intrinsic and extrinsic acid exposures and recommendations to minimize exposures are important to prevent erosion and maintain oral health. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong.

Science.gov (United States)

Iu, L Pl; Lai, C Hy; Fan, M Cy; Wong, I Yh; Lai, J Sm

2017-02-01

Studies on the prevalence and severity of retinopathy of prematurity in the local population are scarce. This study aimed to evaluate the prevalence, screening, and treatment outcome of retinopathy of prematurity in a tertiary hospital in Hong Kong. This cross-sectional study with internal comparison was conducted at Queen Mary Hospital, Hong Kong. The study evaluated 89 premature infants who were born at the hospital and were screened for retinopathy of prematurity, in accordance with the 2008 British Guidelines, between January 2013 and December 2013. The prevalences of retinopathy of prematurity and severe retinopathy requiring treatment were studied. The mean (± standard deviation) gestational age at birth was 30 +2 weeks ± 16.5 days (range, 24 +1 to 35 +5 weeks). The mean birth weight was 1285 g ± 328 g (range, 580 g to 2030 g). A total of 15 (16.9%) infants developed retinopathy of prematurity and three (3.4%) required treatment. In a subgroup analysis of extremely-low-birth-weight infants of prematurity and 17.6% required treatment. Multivariate logistic regression analysis suggested low birth weight and patent ductus arteriosus were significantly associated with development of retinopathy of prematurity (Pprematurity, all regressed successfully after one laser treatment. Retinopathy of prematurity is a significant problem among premature infants in Hong Kong, especially those with extremely low birth weight. Our screening service for retinopathy of prematurity was satisfactory and treatment results were good. Strict adherence to international screening guidelines and vigilance in infants at risk are key to successful management of retinopathy of prematurity.

An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers.

Science.gov (United States)

Rao, Nisha; Spiller, Henry A; Hodges, Nichole L; Chounthirath, Thiphalak; Casavant, Marcel J; Kamboj, Amrit K; Smith, Gary A

2017-09-01

The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity. There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.

Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review.

Science.gov (United States)

O'Brien, O A; McCarthy, M; Gibney, E R; McAuliffe, F M

2014-07-01

Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women.

Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment?

Science.gov (United States)

Black, Christina; Moon, Graham; Baird, Janis

2016-01-01

This review summarises the evidence for inequalities in community and consumer nutrition environments from ten previous review articles, and also assesses the evidence for the effect of the community and consumer nutrition environments on dietary intake. There is evidence for inequalities in food access in the US but trends are less apparent in other developed countries. There is a trend for greater access and availability to healthy and less healthy foods relating to better and poorer dietary outcomes respectively. Trends for price show that higher prices of healthy foods are associated with better dietary outcomes. More nuanced measures of the food environment, including multi-dimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions. PMID:24200470

Dietary Lycopene, Angiogenesis, and Prostate Cancer: A Prospective Study in the Prostate-Specific Antigen Era

Science.gov (United States)

2014-01-01

Background The role of lycopene in prostate cancer prevention remains controversial. We examined the associations between dietary lycopene intake and prostate cancer, paying particular attention to the influence of prostate-specific antigen screening, and evaluated tissue biomarkers in prostate cancers in relation to lycopene intake. Methods Among 49898 male health professionals, we obtained dietary information through questionnaires and ascertained total and lethal prostate cancer cases from 1986 through January 31, 2010. Cox regression was used to estimate multivariable hazard ratios (HRs) and 95% confidence intervals (CIs). Tissue microarrays and immunohistochemistry were used to assess tumor biomarker expression in a subset of men. Two-sided χ2 tests were used to calculate the P values. Results Higher lycopene intake was inversely associated with total prostate cancer and more strongly with lethal prostate cancer (top vs bottom quintile: HR = 0.72; 95% CI = 0.56 to 0.94; P trend = .04). In a restricted population of screened participants, the inverse associations became markedly stronger (for lethal prostate cancer: HR = 0.47; 95% CI = 0.29 to 0.75; P trend = .009). Comparing different measures of dietary lycopene, early intake, but not recent intake, was inversely associated with prostate cancer. Higher lycopene intake was associated with biomarkers in the cancer indicative of less angiogenic potential. Conclusions Dietary intake of lycopene was associated with reduced risk of lethal prostate cancer and with a lesser degree of angiogenesis in the tumor. Because angiogenesis is a strong progression factor, an endpoint of lethal prostate cancer may be more relevant than an endpoint of indolent prostate cancer for lycopene in the era of highly prevalent prostate-specific antigen screening. PMID:24463248

Dietary sodium and health: more than just blood pressure.

Science.gov (United States)

Farquhar, William B; Edwards, David G; Jurkovitz, Claudine T; Weintraub, William S

2015-03-17

Sodium is essential for cellular homeostasis and physiological function. Excess dietary sodium has been linked to elevations in blood pressure (BP). Salt sensitivity of BP varies widely, but certain subgroups tend to be more salt sensitive. The mechanisms underlying sodium-induced increases in BP are not completely understood but may involve alterations in renal function, fluid volume, fluid-regulatory hormones, the vasculature, cardiac function, and the autonomic nervous system. Recent pre-clinical and clinical data support that even in the absence of an increase in BP, excess dietary sodium can adversely affect target organs, including the blood vessels, heart, kidneys, and brain. In this review, the investigators review these issues and the epidemiological research relating dietary sodium to BP and cardiovascular health outcomes, addressing recent controversies. They also provide information and strategies for reducing dietary sodium. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Effect of dietary linoleate/alpha-linolenate balance on the brain lipid composition, reproductive outcome and behavior of rats during their prenatal and postnatal development.

Science.gov (United States)

Cheon, S H; Huh, M H; Lee, Y B; Park, J S; Sohn, H S; Chung, C W

2000-11-01

The effect of the dietary linoleate (LA)/alpha-linolenate (LNA) balance during development on the brain lipid composition, reproductive outcome and behavior of rats was studied. Female rats were fed on experimental diets during pregnancy and the resulting pups for 16 weeks. The dietary LA/LNA ratios were 1.07 (LA1), 2.64 (LA2), 4.45 (LA3), 7.68 (LA4) and 10.35 (LA5). The relative content of docosahexaenoate (DHA) in the brain of pups tended to increase with decreasing LA/LNA ratio at 0 and 3 weeks, while the level of DHA was maintained constant at 16 weeks regardless of the dietary LA/LNA ratio. The learning ability was measured at 12 weeks of age, and there was no difference among the groups. In an open field test, the exploratory index was significantly lower in the LA1 group than in the LA2 group. The LA1 group had a smaller litter size and lower survival rate than the other groups. We conclude that if the diet contained appropriate amounts and balance of LA and LNA, it was possible for rats to synthesize an appropriate amount of DHA and have normal behavioral activity without DHA supplementation.

Screen-time Weight-loss Intervention Targeting Children at Home (SWITCH: A randomized controlled trial study protocol

Directory of Open Access Journals (Sweden)

Tsai Midi

2011-06-01

Full Text Available Abstract Background Approximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33% do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet. Methods/Design The study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention or control (no change. At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI and standardized body mass index (zBMI. Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity. Discussion This study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous, Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight

Does comorbid chronic pain affect posttraumatic stress disorder diagnosis and treatment? Outcomes of posttraumatic stress disorder screening in Department of Veterans Affairs primary care.

Science.gov (United States)

Outcalt, Samantha D; Hoen, Helena Maria; Yu, Zhangsheng; Franks, Tenesha Marie; Krebs, Erin E

2016-01-01

Because posttraumatic stress disorder (PTSD) is both prevalent and underrecognized, routine primary care-based screening for PTSD has been implemented across the Veterans Health Administration. PTSD is frequently complicated by the presence of comorbid chronic pain, and patients with both conditions have increased symptom severity and poorer prognosis. Our objective was to determine whether the presence of pain affects diagnosis and treatment of PTSD among Department of Veterans Affairs (VA) patients who have a positive PTSD screening test. This retrospective cohort study used clinical and administrative data from six Midwestern VA medical centers. We identified 4,244 VA primary care patients with a positive PTSD screen and compared outcomes for those with and without a coexisting pain diagnosis. Outcomes were three clinically appropriate responses to positive PTSD screening: (1) mental health visit, (2) PTSD diagnosis, and (3) new selective serotonin reuptake inhibitor (SSRI) prescription. We found that patients with coexisting pain had a lower rate of mental health visits than those without pain (hazard ratio: 0.889, 95% confidence interval: 0.821-0.962). There were no significant differences in the rate of PTSD diagnosis or new SSRI prescription between patients with and without coexisting pain.

Interviewee Perceptions of Employment Screening Interviews: Relationships among Perceptions of Communication Satisfaction, Interviewer Credibility and Trust, Interviewing Experience, and Interview Outcomes.

Science.gov (United States)

Jablin, Fredric M.; And Others

A study examined employment screening interviews to determine the relationships between an interviewee's perceptions of interview communication satisfaction, interviewer credibility and trust, previous interviewing experiences, and a number of interview outcomes, including expectation of a second interview. Data were collected from 69 students…

Overcoming Consumer Inertia to Dietary Guidance12

Science.gov (United States)

Webb, Densie; Byrd-Bredbenner, Carol

2015-01-01

Despite 35 y of dietary guidance, there has been no substantial shift in consumer compliance. Consumers report that they seek information on nutrition and healthy eating, but most are not paying attention to dietary recommendations. For guidance to be effective, it must be realistic. Even with increasingly detailed nutrition information and evidence that diet affects health outcomes, convenience and taste remain the strongest determinants of food choices. It is up to health educators to clear up confusion and give consumers control with nutrition messages that are realistic, positive, easy to understand, and actionable without an expectation that consumers will surrender foods they love. PMID:26178023

Comparison of first-tier cell-free DNA screening for common aneuploidies with conventional publically funded screening.

Science.gov (United States)

Langlois, Sylvie; Johnson, JoAnn; Audibert, François; Gekas, Jean; Forest, Jean-Claude; Caron, André; Harrington, Keli; Pastuck, Melanie; Meddour, Hasna; Tétu, Amélie; Little, Julian; Rousseau, François

2017-12-01

This study evaluates the impact of offering cell-free DNA (cfDNA) screening as a first-tier test for trisomies 21 and 18. This is a prospective study of pregnant women undergoing conventional prenatal screening who were offered cfDNA screening in the first trimester with clinical outcomes obtained on all pregnancies. A total of 1198 pregnant women were recruited. The detection rate of trisomy 21 with standard screening was 83% with a false positive rate (FPR) of 5.5% compared with 100% detection and 0% FPR for cfDNA screening. The FPR of cfDNA screening for trisomies 18 and 13 was 0.09% for each. Two percent of women underwent an invasive diagnostic procedure based on screening or ultrasound findings; without the cfDNA screening, it could have been as high as 6.8%. Amongst the 640 women with negative cfDNA results and a nuchal translucency (NT) ultrasound, only 3 had an NT greater or equal to 3.5 mm: one had a normal outcome and two lost their pregnancy before 20 weeks. cfDNA screening has the potential to be a highly effective first-tier screening approach leading to a significant reduction of invasive diagnostic procedures. For women with a negative cfDNA screening result, NT measurement has limited clinical utility. © 2017 John Wiley & Sons, Ltd.

Evaluation of Simulation Models that Estimate the Effect of Dietary Strategies on Nutritional Intake: A Systematic Review.

Science.gov (United States)

Grieger, Jessica A; Johnson, Brittany J; Wycherley, Thomas P; Golley, Rebecca K

2017-05-01

Background: Dietary simulation modeling can predict dietary strategies that may improve nutritional or health outcomes. Objectives: The study aims were to undertake a systematic review of simulation studies that model dietary strategies aiming to improve nutritional intake, body weight, and related chronic disease, and to assess the methodologic and reporting quality of these models. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the search strategy with studies located through electronic searches [Cochrane Library, Ovid (MEDLINE and Embase), EBSCOhost (CINAHL), and Scopus]. Study findings were described and dietary modeling methodology and reporting quality were critiqued by using a set of quality criteria adapted for dietary modeling from general modeling guidelines. Results: Forty-five studies were included and categorized as modeling moderation, substitution, reformulation, or promotion dietary strategies. Moderation and reformulation strategies targeted individual nutrients or foods to theoretically improve one particular nutrient or health outcome, estimating small to modest improvements. Substituting unhealthy foods with healthier choices was estimated to be effective across a range of nutrients, including an estimated reduction in intake of saturated fatty acids, sodium, and added sugar. Promotion of fruits and vegetables predicted marginal changes in intake. Overall, the quality of the studies was moderate to high, with certain features of the quality criteria consistently reported. Conclusions: Based on the results of reviewed simulation dietary modeling studies, targeting a variety of foods rather than individual foods or nutrients theoretically appears most effective in estimating improvements in nutritional intake, particularly reducing intake of nutrients commonly consumed in excess. A combination of strategies could theoretically be used to deliver the best improvement in outcomes. Study quality was moderate to

Prebiotics and synbiotics: dietary strategies for improving gut health.

Science.gov (United States)

Krumbeck, Janina A; Maldonado-Gomez, Maria X; Ramer-Tait, Amanda E; Hutkins, Robert W

2016-03-01

A wide range of dietary carbohydrates, including prebiotic food ingredients, fermentable fibers, and milk oligosaccharides, are able to produce significant changes in the intestinal microbiota. These shifts in the microbial community are often characterized by increased levels of bifidobacteria and lactobacilli. More recent studies have revealed that species of Faecalibacterium, Akkermansia, and other less well studied members may also be enriched. We review the implications of these recent studies on future design of prebiotics and synbiotics to promote gastrointestinal health. Investigations assessing the clinical outcomes associated with dietary modification of the gut microbiota have shown systemic as well as specific health benefits. Both prebiotic oligosaccharides comprised of a linear arrangement of simple sugars, as well as fiber-rich foods containing complex carbohydrates, have been used in these trials. However, individual variability and nonresponding study participants can make the outcome of dietary interventions less predictable. In contrast, synergistic synbiotics containing prebiotics that specifically stimulate a cognate probiotic provide additional options for personalized gut therapies. This review describes recent research on how prebiotics and fermentable fibers can influence the gut microbiota and result in improvements to human health.

Dietary Supplement Use in Patients With Celiac Disease in the United States.

Science.gov (United States)

Nazareth, Samantha; Lebwohl, Benjamin; Tennyson, Christina A; Simpson, Suzanne; Greenlee, Heather; Green, Peter H

2015-08-01

There has been increasing interest in the use of complementary and alternative medicine (CAM) in the general population. Little is known about CAM use in patients with celiac disease (CD). We aimed to determine the demographics and clinical characteristics of patients with biopsy-proven CD who use dietary supplements to treat their symptoms. CD patients completed a questionnaire on demographics, types of dietary supplement use, attitudes toward CAM, and 3 validated scales: CD-related Quality Of Life (CD-QOL), the CD Symptoms Index (CSI), and the CD Adherence Test (CDAT). Of 423 patients, 100 (23.6%) used dietary supplements to treat CD symptoms. The most frequently used supplement was probiotics (n=59). Supplement users had a higher CD-QOL score (75.06 vs. 71.43, P=0.04) but had more symptoms based on CSI (35.64 vs. 32.05, P=0.0032). On multivariable analysis, adjusting for age, sex, education, symptom improvement following a gluten-free diet, and where the survey was completed, patients presenting with classic symptoms (OR, 2.56; 95% CI, 1.01-6.44) or nonclassic symptoms (OR, 2.75; 95% CI, 1.04-7.24) were significantly more likely to use supplements than those with asymptomatic/screen-detected CD. Patients with biopsy-proven CD who have symptoms at diagnosis tend to use dietary supplements more than those that are screen detected. Those using supplements report persistent symptoms, but a higher quality of life. The contribution of the gluten-free diet and supplement use to quality of life in the symptomatic CD patient needs to be determined.

Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings.

Science.gov (United States)

Stoutenberg, Mark; Stanzilis, Katie; Falcon, Ashley

2015-06-01

Lifestyle modification programs (LMPs) can provide individuals with behavioral skills to sustain long-term changes to their physical activity (PA) levels and dietary habits. Yet, there is much work to be done in the translation of these programs to community settings. This review identified LMPs that focused on changing both PA and dietary behaviors and examined common features and barriers faced in their translation to community settings. A search of multiple online databases was conducted to identify LMPs that included participants over the age of 18 who enrolled in LMPs, offered in community settings, and had the goal of improving both PA and dietary behaviors. Data were extracted on participant demographics, study design characteristics, and study outcome variables including changes in PA, dietary habits, body weight, and clinical outcomes. We identified 27 studies that met inclusion criteria. Despite high levels of retention and adherence to the interventions, varying levels of success were observed in increasing PA levels, improving dietary habits, reducing body weight, and improving clinic outcomes. LMPs addressing issues of PA and dietary habits can be successfully implemented in a community setting. However, inconsistent reporting of key components in the translation of these studies (participant recruitment, utilization of behavioral strategies) may limit their replication and advancement of future programs. Future efforts should better address issues such as identifying barriers to participation and program implementation, utilization of community resources, and evaluating changes across multiple health behaviors.

Dietary Patterns Associated with Alzheimer’s Disease: Population Based Study

Directory of Open Access Journals (Sweden)

Katarzyna Gustaw-Rothenberg

2009-04-01

Full Text Available Recently dietary pattern analysis has emerged as a way for examining diet-disease relations in Alzheimer’s disease. In contrast with the conventional approach, which focuses on a single nutrient or a few nutrients or foods, this method considers overall eating patterns. We examined the dietary patterns defined by factor analysis using data collected with a food-frequency questionnaire in people with Alzheimer’s disease (AD as compared to healthy controls. The diet data were obtained during population based study of the prevalence of Alzheimer’s disease in a population in Poland. Stratified sampling and random selection strategies were combined to obtain a representative population for screening (age group > 55. From the population screened three times, 71 people were diagnosed with Alzheimer’s according to DSM-IV, and were recruited for further diet risk factors assessment. A group of people with Alzheimer disease (n = 71; F/M 42/29 and the same number of healthy, age and gender matched control were recruited for the study. Patients and their caregivers as well as controls were presented with a food frequency questionnaire based on the 12 food groups. Factor analysis (principal component was used to derive food patterns. The analysis was conducted using the factor procedure. The factors were rotated by an orthogonal transformation (Varimax rotation to achieve simpler structure with greater interpretability. Using factor analysis, we identified major eating patterns, one for Alzheimer’s patients and a different one for control group. The AD dietary pattern, FACTOR AD was characterized by a high intake of meat, butter, high-fat dairy products, eggs, and refined sugar, whereas the other pattern, (FACTOR C was characterized by a high intake of grains and vegetables. These data indicate the existence of dietary patterns defined by factor analysis with data from a food frequency questionnaire, characteristic for Alzheimer’s disease in a

Tuberculosis screening in patients with HIV

DEFF Research Database (Denmark)

Bjerrrum, Stephanie; Bonsu, Frank; Hanson-Nortey, Nii Nortey

2016-01-01

BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...... May and October 2014, before and after a performance feedback intervention in August 2014. The outcomes of interest were overall tuberculosis suspicion rate during consultations and provider adherence to the International Standards for Tuberculosis Care and the World Health Organizations' guidelines...

Derivation of soil screening thresholds to protect chisel-toothed kangaroo rat from uranium mine waste in northern Arizona

Science.gov (United States)

Hinck, Jo E.; Linder, Greg L.; Otton, James K.; Finger, Susan E.; Little, Edward E.; Tillitt, Donald E.

2013-01-01

Chemical data from soil and weathered waste material samples collected from five uranium mines north of the Grand Canyon (three reclaimed, one mined but not reclaimed, and one never mined) were used in a screening-level risk analysis for the Arizona chisel-toothed kangaroo rat (Dipodomys microps leucotis); risks from radiation exposure were not evaluated. Dietary toxicity reference values were used to estimate soil-screening thresholds presenting risk to kangaroo rats. Sensitivity analyses indicated that body weight critically affected outcomes of exposed-dose calculations; juvenile kangaroo rats were more sensitive to the inorganic constituent toxicities than adult kangaroo rats. Species-specific soil-screening thresholds were derived for arsenic (137 mg/kg), cadmium (16 mg/kg), copper (1,461 mg/kg), lead (1,143 mg/kg), nickel (771 mg/kg), thallium (1.3 mg/kg), uranium (1,513 mg/kg), and zinc (731 mg/kg) using toxicity reference values that incorporate expected chronic field exposures. Inorganic contaminants in soils within and near the mine areas generally posed minimal risk to kangaroo rats. Most exceedances of soil thresholds were for arsenic and thallium and were associated with weathered mine wastes.

Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment?

Science.gov (United States)

Black, Christina; Moon, Graham; Baird, Janis

2014-05-01

This review summarises the evidence for inequalities in community and consumer nutrition environments from ten previous review articles, and also assesses the evidence for the effect of the community and consumer nutrition environments on dietary intake. There is evidence for inequalities in food access in the US but trends are less apparent in other developed countries. There is a trend for greater access and availability to healthy and less healthy foods relating to better and poorer dietary outcomes respectively. Trends for price show that higher prices of healthy foods are associated with better dietary outcomes. More nuanced measures of the food environment, including multidimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions. © 2013 The Authors. Published by Elsevier Ltd All rights reserved.

The effectiveness of workplace dietary modification interventions: a systematic review.

Science.gov (United States)

Geaney, F; Kelly, C; Greiner, B A; Harrington, J M; Perry, I J; Beirne, P

2013-11-01

To evaluate the effectiveness of workplace dietary modification interventions alone or in combination with nutrition education on employees' dietary behaviour, health status, self-efficacy, perceived health, determinants of food choice, nutrition knowledge, co-worker support, job satisfaction, economic cost and food-purchasing patterns. Data sources included PubMed, Medline, Embase, Psych Info., Web of Knowledge and Cochrane Library (November 2011). This review was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Studies were randomised controlled trials and controlled studies. Interventions were implemented for at least three months. Cochrane Collaboration's risk of bias tool measured potential biases. Heterogeneity precluded meta-analysis. Results were presented in a narrative summary. Six studies conducted in Brazil, the USA, Netherlands and Belgium met the inclusion criteria. Four studies reported small increases in fruit and vegetable consumption (≤half serving/day). These studies involved workplace dietary modifications and three incorporated nutrition education. Other outcomes reported included health status, co-worker support, job satisfaction, perceived health, self-efficacy and food-purchasing patterns. All studies had methodological limitations that weakened confidence in the results. Limited evidence suggests that workplace dietary modification interventions alone and in combination with nutrition education increase fruit and vegetable intakes. These interventions should be developed with recommended guidelines, workplace characteristics, long-term follow-up and objective outcomes for diet, health and cost. © 2013.

Women's dietary changes before and during pregnancy: A systematic review.

Science.gov (United States)

Hillier, Sarah E; Olander, Ellinor K

2017-06-01

dietary intake before and during pregnancy has significant health outcomes for both mother and child, including a healthy gestational weight gain. To ensure effective interventions are successfully developed to improve dietary intake during pregnancy, it is important to understand what dietary changes pregnant women make without intervention. to systematically identify and review studies examining women's dietary changes before and during pregnancy and to identify characteristics of the women making these changes. a systematic search strategy was employed using three databases (Web of Science, CINAHL and PubMed) in May 2016. Search terms included those relating to preconception, pregnancy and diet. All papers were quality assessed using the Scottish Intercollegiate Guidelines Network methodology checklist for cohort studies.The search revealed 898 articles narrowed to full-text review of 23 studies. In total, 11 research articles were included in the review, describing nine different studies. The findings were narratively summarised in line with the aims of the review. the included studies showed marked heterogeneity, which impacts on the findings. However, the majority report an increase in energy intake (kcal or kJ) during pregnancy. Of the studies that reported changes through food group comparisons, a majority reported a significant increase in fruit and vegetable consumption, a decrease in egg consumption, a decrease in fried and fast food consumption and a decrease in coffee and tea consumption from before to during pregnancy. The characteristics of the women participating in these studies, suggest that age, education and pregnancy intention are associated with healthier dietary changes; however these factors were only assessed in a small number of studies. the 11 included articles show varied results in dietary intake during pregnancy as compared to before. More research is needed regarding who makes these healthy changes, this includes consistency regarding

Hospitalized Patients with Cirrhosis Should Be Screened for Clostridium difficile Colitis.

Science.gov (United States)

Saab, Sammy; Alper, Theodore; Sernas, Ernesto; Pruthi, Paridhima; Alper, Mikhail A; Sundaram, Vinay

2015-10-01

Clostridium difficile infection (CDI) is an important public health problem in hospitalized patients. Patients with cirrhosis are particularly at risk of increased associated morbidity, mortality, and healthcare utilization from CDI. The aim of this study was to assess the pharmacoeconomic impact of CDI screening on hospitalized patients with cirrhosis. A Markov model was used to compare costs and outcomes of two strategies for the screening of CDI. The first strategy consisted of screening all patients for CDI and treating if detected (screening). In the second strategy, only patients found to have symptomatic CDI were treated (no screening). The probability of underlying CDI prevalence, symptomatic CDI infection, and likelihood of recurrent infection were varied in a sensitivity analysis. The costs of antibiotics and hospitalization were also assessed. Differences in outcome were expressed in ratio of the total costs associated with screening to the total costs associated without screening. The results of our model showed that screening for CDI was consistently associated with improved healthcare outcomes and decreased healthcare utilization across all variables in the one- and two-way sensitivity analyses. Using baseline assumptions, the costs associated with the no screening strategy were 3.54 times that of the screening strategy. Moreover, the mortality for symptomatic CDI was lower in the screening strategy than the no screening strategy. The screening strategy results in less healthcare utilization and improved clinical outcomes. Screening for CDI measures favorably.

Young Children's Screen Habits are Associated with Consumption of Sweetened Beverages Independently of Parental Norms

DEFF Research Database (Denmark)

Olafsdottir, Steingerdur; Eiben, Gabriele; Prell, Hillevi

2014-01-01

Objectives: This study investigated the associations between children’s screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child’s screen and dietary habits in a similar direction, our specific aim was to examine whether these associati......Objectives: This study investigated the associations between children’s screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child’s screen and dietary habits in a similar direction, our specific aim was to examine whether...... and diets. Results: Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline...... (OR 1.4, 95 % CI 1.1–1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1–3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2–1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3–2.1). TV viewing time...

Breast Cancer Screening

International Nuclear Information System (INIS)

Altaf, Fadwa J.

2004-01-01

Breast cancer is a very common health problem in Saudi females that can be reduced by early detection through introducing breast cancer screening. Literature review reveals significant reduction in breast cancer incidence and outcome after the beginning of breast cancer screening. The objectives of this article are to highlight the significance of breast cancer screening in different international societies and to write the major guidelines of breast cancer screening in relation to other departments involved with more emphasis on the Pathology Department guidelines in tissue handling, diagnostic criteria and significance of the diagnosis. This article summaries and acknowledges major work carried out before, and recommends similar modified work in order to meet the requirement for the Saudi society. (author)

Outcomes of domestic violence screening at an acute London trust: are there missed opportunities for intervention?

Science.gov (United States)

Warren-Gash, Charlotte; Bartley, Angela; Bayly, Jude; Dutey-Magni, Peter; Edwards, Sarah; Madge, Sara; Miller, Charlotte; Nicholas, Rachel; Radhakrishnan, Sheila; Sathia, Leena; Swarbrick, Helen; Blaikie, Dee; Rodger, Alison

2016-01-04

Domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous hospital attendances of affected patients and (3) assess referrals to an in-house domestic violence advisor from Camden Safety Net. A series of observational studies. Three outpatient clinics at the Royal Free London NHS Foundation Trust. 10,158 patients screened for domestic violence in community gynaecology, genitourinary medicine (GUM) and HIV medicine clinics between 1 October 2013 and 30 June 2014. Also 2253 Camden Safety Net referrals over the same period. (1) Percentage reporting domestic violence by age group gender, ethnicity and clinic. (2) Rates of hospital attendances in the past 3 years for those screening positive and negative. (3) Characteristics, uptake and risk assessment results for hospital in-house domestic violence referrals compared with Camden Safety Net referrals from other sources. Of the 10,158 patients screened, 57.4% were female with a median age of 30 years. Overall, 7.1% reported ever-experiencing domestic violence, ranging from 5.7% in GUM to 29.4% in HIV services. People screening positive for domestic violence had higher rates of previous emergency department attendances (rate ratio (RR) 1.63, 95% CI 1.09 to 2.48), emergency inpatient admissions (RR 2.27, 95% CI 1.37 to 3.84) and day-case admissions (RR 2.03, 95% CI 1.23 to 3.43) than those screening negative. The 77 hospital referrals to the hospital-based domestic violence advisor during the study period were more likely to be taken up and to be classified as high risk than referrals from elsewhere. Selective screening for domestic violence in high-risk hospital clinic populations has the potential to identify affected patients and promote good uptake of referrals for in

The Danish Cardiovascular Screening Trial (DANCAVAS)

DEFF Research Database (Denmark)

Diederichsen, Axel Cosmus Pyndt; Rasmussen, Lars Melholt; Søgaard, Rikke

2015-01-01

to cardiovascular seven-faceted screening examinations at one of four locations. The screening will include: (1) low-dose non-contrast CT scan to detect coronary artery calcification and aortic/iliac aneurysms, (2) brachial and ankle blood pressure index to detect peripheral arterial disease and hypertension, (3...... events, and whether the possible health benefits are cost effective. OUTCOME: Registry-based follow-up on all cause death (primary outcome), and costs after 3, 5 and 10 years (secondary outcome). RANDOMIZATION: Each of the 45,000 individuals is, by EPIDATA, given a random number from 1-100. Those....../iliac aneurysms) and measurements of the ankle brachial blood pressure index (ABI) as part of a multifocal screening and intervention program for CVD in men aged 65-74. Attendance rate and compliance to initiated preventive actions must be expected to become of major importance. TRIAL REGISTRATION: Current...

Diabetic retinopathy screening: can the viewing monitor influence the reading and grading outcomes.

Science.gov (United States)

Ting, D S W; Tay-Kearney, M L; Vignarajan, J; Kanagasingam, Y

2012-12-01

To evaluate the accuracy of different viewing monitors for image reading and grading of diabetic retinopathy (DR). Single-centre, experimental case series-evaluation of reading devices for DR screening. A total of 100 sets of three-field (optic disc, macula, and temporal views) colour retinal still images (50 normal and 50 with DR) captured by FF 450 plus (Carl Zeiss) were interpreted on 27-inch iMac, 15-inch MacBook Pro, and 9.7-inch iPad. All images were interpreted by a retinal specialist and a medical officer. We calculated the sensitivity and specificity of 15-inch MacBook Pro and 9.7-inch iPad in detection of DR signs and grades with reference to the reading outcomes obtained using a 27-inch iMac reading monitor. In detection of any grade of DR, the 15-inch MacBook Pro had sensitivity and specificity of 96% (95% confidence interval (CI): 85.1-99.3) and 96% (95% CI: 85.1-99.3), respectively, for retinal specialist and 91.5% (95% CI: 78.7-97.2) and 94.3% (95% CI: 83.3-98.5), respectively, for medical officer, whereas for 9.7-inch iPad, they were 91.8% (95% CI: 79.5-97.4) and 94.1% (95% CI: 82.8-98.5), respectively, for retinal specialist and 91.3% (95% CI: 78.3-97.1) and 92.6% (95% CI: 81.3-97.6), respectively, for medical officer. The 15-inch MacBook Pro and 9.7-inch iPad had excellent sensitivity and specificity in detecting DR and hence, both screen sizes can be utilized to effectively interpret colour retinal still images for DR remotely in a routine, mobile or tele-ophthalmology setting. Future studies could explore the use of more economical devices with smaller viewing resolutions to reduce cost implementation of DR screening services.

Improved parental dietary quality is associated with children's dietary intake through the home environment

OpenAIRE

Fl?rez, K. R.; Richardson, A. S.; Ghosh?Dastidar, M. B.; Beckman, R.; Huang, C.; Wagner, L.; Dubowitz, T.

2017-01-01

Summary Background Improving access to supermarkets has been shown to improve some dietary outcomes, yet there is little evidence for such effects on children. Relatedly, there is a dearth of research assessing the impact of a structural change (i.e. supermarket in a former food desert) on the home environment and its relationship with children's diet. Objective Assess the relative impact of the home environment on children's diet after the introduction of a new supermarket in a food desert. ...

Impact of age at onset and newborn screening on outcome in organic acidurias

DEFF Research Database (Denmark)

Heringer, Jana; Valayannopoulos, Vassili; Lund, Allan M

2016-01-01

analyses, symptomatic patients were divided into those presenting with first symptoms during (i.e. early onset, EO) or after the newborn period (i.e. late onset, LO). RESULTS: Patients identified by newborn screening (NBS) had a significantly lower median age of diagnosis (8 days) compared to the LO group...... % versus 39 %, p = 0.002; GA1: 26 % versus 73 %, p age-adjusted intake of natural protein and calories was significantly higher in LO patients than in EO patients reflecting different disease severities. Variable drug...... combinations, ranging from 12 in MMA-Cbl(-) to two in isovaleric aciduria, were used for maintenance treatment. The effects of specific metabolic treatment strategies on the health outcomes remain unclear because of the strong influences of age at onset (EO versus LO), diagnostic mode (NBS versus selective...

Dietary sodium and potassium intake were associated with hypertension, kidney damage and adverse perinatal outcome in pregnant women with preeclampsia.

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Yılmaz, Zehra Vural; Akkaş, Elif; Türkmen, Gülenay Gençosmanoğlu; Kara, Özgür; Yücel, Aykan; Uygur, Dilek

2017-02-01

In this study, we hypothesized that dietary salt and potassium intake may be related with blood pressure, kidney damage and perinatal outcome in pregnants with preeclampsia (PE). In total, 200 women (50 control women with healthy pregnancy, 150 women with PE) were recruited for the study. Daily salt and potassium intake was estimated based on calculation of 24-hour urinary sodium U[Na+] and potassium U[K+] excretion. U[Na+]/[K+] was calculated by dividing U[Na+] by U[K+]. At the end of the measurements, the pregnant women with PE (n=150) were divided into tertiles according to U[Na+]/[K+]: low Na/K group (n=50, mean U[Na+]/[K+]: 1,04±0,32), medium Na/K group (n=50, mean U[Na+]/[K+]: 2,49± 0,54), high Na/K group (n=50, mean U[Na+]/[K+]: 6,62±3,41). The mean SBP and DBP levels were significantly lower in low Na/K group compared with medium or high Na/K groups (p=0.024, p=0.0002; respectively). Serum creatinine was significantly lower in low Na/K group than high Na/K group (p=0.025). Frequency of severe preeclampsia is lower in low Na/K group than medium or high Na/K groups (p=0.002, p=0.0001; respectively). Birth weight and gestational age at birth were higher in low Na/K group compared with high Na/K group (p=0.045, p=0.0002; respectively). After adjusting for covariates, SBP and DBP and creatinine levels were independently associated with 24 hours urinary [Na+]/[K+] Conclusion: These findings suggest that pregnant with PE with high dietary salt and low potassium intake may have greater maternal and neonatal morbidity risk than pregnant with PE under low dietary salt and high potassium intake.

Screening for Cervical Cancer: A Review of Outcome among Infertile ...

African Journals Online (AJOL)

the second leading female cancer world-wide and the most common female ... Interestingly, it has a pre-invasive stage, which can be detected through screening. ... primarily to screen for cervical cancer and where they exist, the acceptance ...

Dietary supplements for body-weight reduction: a systematic review.

Science.gov (United States)

Pittler, Max H; Ernst, Edzard

2004-04-01

Compliance with conventional weight-management programs is notoriously poor, and a plethora of over-the-counter slimming aids are sold with claims of effectiveness. The objective of the study was to assess the evidence from rigorous clinical trials, systematic reviews, and meta-analyses on the effectiveness of dietary supplements in reducing body weight. The study was a systematic review. Literature searches were conducted on Medline, Embase, Amed, Cinahl, and the Cochrane Library until March 2003. Hand searches of medical journals, the authors' own files, and bibliographies of identified articles were conducted. There were no restrictions regarding the language of publication. The screening of studies, selection, validation, data extraction, and the assessment of methodologic quality were performed independently by the 2 reviewers. To be included, trials were required to be randomized and double-blind. Systematic reviews and meta-analyses of dietary supplements were included if they were based on the results of randomized, double-blind trials. Five systematic reviews and meta-analyses and 25 additional trials were included and reviewed. Data on the following dietary supplements were identified: chitosan, chromium picolinate, Ephedra sinica, Garcinia cambogia, glucomannan, guar gum, hydroxy-methylbutyrate, plantago psyllium, pyruvate, yerba maté, and yohimbe. The reviewed studies provide some encouraging data but no evidence beyond a reasonable doubt that any specific dietary supplement is effective for reducing body weight. The only exceptions are E. sinica- and ephedrine-containing supplements, which have been associated with an increased risk of adverse events. The evidence for most dietary supplements as aids in reducing body weight is not convincing. None of the reviewed dietary supplements can be recommended for over-the-counter use.

Sleep and dietary habits in the urban environment: the role of chrono-nutrition.

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Pot, Gerda K

2017-10-25

The urban environment has changed vastly over past decades, which also has had an impact on our sleep and dietary patterns and possibly health outcomes. Some studies have shown that sleep duration and sleep quality has declined over past decades, especially in children. In parallel, our lifestyle and dietary patterns have also changed including more shift work, more meals outside the home or family setting and more irregular eating patterns, including breakfast skipping and late-night eating. This new area of research in nutritional sciences studying the impact of the timing of eating on health outcomes is called chrono-nutrition, and combines elements from nutritional research with chrono-biology. The objectives of this paper were to discuss secular trends in sleep patterns and related dietary patterns, introduce basic concepts and mechanisms of chrono-nutrition and discuss the evidence for the importance of sleep and chrono-nutrition in relation to health outcomes. Overall, chrono-nutrition could mediate the effects between sleep, diet and urbanisation, and more research is needed to elucidate the importance of chrono-nutrition for metabolic health and its impact on public health.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) in a Polish Emergency Department: Three-Month Outcomes of a Randomized, Controlled Clinical Trial*

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Cherpitel, Cheryl J.; Moskalewicz, Jacek; Swiatkiewicz, Grazyna; Ye, Yu; Bond, Jason

2009-01-01

Objective: A randomized, controlled trial of screening, brief intervention, and referral to treatment (SBIRT) for drinking and related problems among at-risk and dependent drinkers was conducted in an emergency department (ED) in Sosnowiec, Poland, among patients ages 18 years and older. Method: Data were collected over a 23-week period, from 4:00 pm to midnight, and resulted in 446 patients being recruited into the study (90% of those who screened positive) and randomized to three conditions following a two-stage process: screened only (n = 147), assessed (n = 152), and received intervention (n = 147). Patients in the assessment (85%) and intervention (83%) conditions were blindly reassessed at 3 months via a telephone interview. Results: At 3-month follow-up, both groups showed significant decreases in the proportion who were positive for at-risk drinking, the primary outcome variable. Both groups also showed significant decreases in drinking days per week, drinks per drinking day, maximum drinks per occasion, and negative consequences of drinking. Using analysis of covariance to control for baseline measures and demographic characteristics, no difference in outcome measures was found between intervention and assessment conditions. Subgroup analysis found some significant interactions between intervention and secondary outcomes. Conclusions: Although the main findings were similar to those from other brief-intervention studies in Western cultures, findings here also suggest that intervention may have differential benefits for specific subgroups of patients in the ED, an area of research that may warrant additional study of brief intervention in the ED setting. PMID:19895777

Dietary Vitamin C in Human Health.

Science.gov (United States)

Granger, Matthew; Eck, Peter

Vitamin C is essential to prevent scurvy in humans and is implicated in the primary prevention of common and complex diseases such as coronary heart disease, stroke, and cancer. This chapter reviews the latest knowledge about dietary vitamin C in human health with an emphasis on studies of the molecular mechanisms of vitamin C maintenance as well as gene-nutrient interactions modifying these relationships. Epidemiological evidence indicates 5% prevalence for vitamin C deficiency and 13% prevalence for suboptimal status even in industrialized countries. The daily intake (dose) and the corresponding systemic concentrations (response) are related in a saturable relationship, and low systemic vitamin C concentrations in observational studies are associated with negative health outcomes. However, there is no evidence that vitamin C supplementation impacts the risks for all-cause mortality, impaired cognitive performance, reduced quality of life, the development of eye diseases, infections, cardiovascular disease, and cancers. This might be related to the fact that prevention would not be realized by supplementation in populations already adequately supplied through dietary sources. Recent genetic association studies indicate that the dietary intake might not be the sole determinant of systemic concentrations, since variations in genes participating in redox homeostasis and vitamin C transport had been associated with lowered plasma concentrations. However, impact sizes are generally low and these phenomena might only affect individual of suboptimal dietary supply. © 2018 Elsevier Inc. All rights reserved.

Secular trends in regional differences in nutritional biomarkers and self-reported dietary intakes among American adults: National Health and Nutrition Examination Survey (NHANES) 1988-1994 to 2009-2010.

Science.gov (United States)

Kant, Ashima K; Graubard, Barry I

2018-04-01

To understand the contribution of regional differentials in dietary exposures to regional gradients in health, we examined 20-year trends in the association of US census region of residence with nutritional biomarkers and dietary intakes of American adults. Observational. The biomarker and 24 h dietary recall data were from the National Health and Nutrition Examination Surveys (NHANES) conducted during 1988-1994 and 1999-2010. The US census region was operationalized as Northeast, Midwest, South and West. Nutritional biomarker outcomes were serum folate, vitamins B6, B12, C, D and E, and carotenoids; dietary outcomes were intakes of nutrients, food groups and eating patterns. US adults, n>8000-40 000 for biomarkers and >43 000 for dietary outcomes. The interactions of survey time period and region were not significant for the examined biomarker and dietary outcomes, indicating similar secular trends among regions. The main effect of region was significant for all nutritional biomarkers except serum vitamin B6, most dietary micronutrients, food groups and eating patterns (P<0·001). The mean serum folate, vitamins B12, C and E, and all carotenoid (except lycopene) biomarker levels, and intakes of dietary fibre, vitamins A, E, C and B6, folate, K, Ca, Mg and Fe, fruits, vegetables and whole grains, were higher in the West and Northeast regions, relative to the South and Midwest regions. Overall, the regional gradients in dietary exposure, expressed objectively as biomarkers or as self-reported nutrient and food group intakes, paralleled trajectories reported for health outcomes and were remarkably persistent over time.

Effects of vitamins, fatty acids, minerals, and other dietary supplements on schizophrenic symptoms in people with schizophrenia

OpenAIRE

Smedslund, Geir; Berg, Rigmor C.

2011-01-01

ENGLISH: There is considerable scientific disagreement about the possible effects of dietary supplements on mental health and illness. Do dietary supplements (possibly in megadoses) have an effect on symptoms and consequences of schizophrenia? We critically appraised randomized controlled trials about supplemental vitamins, fatty acids and other dietary supplements given to people diagnosed with schizophrenia. The primary outcome was symptoms of schizophrenia. We evaluated the evidence to be ...

Dietary Fiber and the Human Gut Microbiota: Application of Evidence Mapping Methodology

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Caleigh M. Sawicki

2017-02-01

Full Text Available Interest is rapidly growing around the role of the human gut microbiota in facilitating beneficial health effects associated with consumption of dietary fiber. An evidence map of current research activity in this area was created using a newly developed database of dietary fiber intervention studies in humans to identify studies with the following broad outcomes: (1 modulation of colonic microflora; and/or (2 colonic fermentation/short-chain fatty acid concentration. Study design characteristics, fiber exposures, and outcome categories were summarized. A sub-analysis described oligosaccharides and bacterial composition in greater detail. One hundred eighty-eight relevant studies were identified. The fiber categories represented by the most studies were oligosaccharides (20%, resistant starch (16%, and chemically synthesized fibers (15%. Short-chain fatty acid concentration (47% and bacterial composition (88% were the most frequently studied outcomes. Whole-diet interventions, measures of bacterial activity, and studies in metabolically at-risk subjects were identified as potential gaps in the evidence. This evidence map efficiently captured the variability in characteristics of expanding research on dietary fiber, gut microbiota, and physiological health benefits, and identified areas that may benefit from further research. We hope that this evidence map will provide a resource for researchers to direct new intervention studies and meta-analyses.

Validity and Reproducibility of a Habitual Dietary Fibre Intake Short Food Frequency Questionnaire.

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Healey, Genelle; Brough, Louise; Murphy, Rinki; Hedderley, Duncan; Butts, Chrissie; Coad, Jane

2016-09-10

Low dietary fibre intake has been associated with poorer health outcomes, therefore having the ability to be able to quickly assess an individual's dietary fibre intake would prove useful in clinical practice and for research purposes. Current dietary assessment methods such as food records and food frequency questionnaires are time-consuming and burdensome, and there are presently no published short dietary fibre intake questionnaires that can quantify an individual's total habitual dietary fibre intake and classify individuals as low, moderate or high habitual dietary fibre consumers. Therefore, we aimed to develop and validate a habitual dietary fibre intake short food frequency questionnaire (DFI-FFQ) which can quickly and accurately classify individuals based on their habitual dietary fibre intake. In this study the DFI-FFQ was validated against the Monash University comprehensive nutrition assessment questionnaire (CNAQ). Fifty-two healthy, normal weight male (n = 17) and female (n = 35) participants, aged between 21 and 61 years, completed the DFI-FFQ twice and the CNAQ once. All eligible participants completed the study, however the data from 46% of the participants were excluded from analysis secondary to misreporting. The DFI-FFQ cannot accurately quantify total habitual dietary fibre intakes, however, it is a quick, valid and reproducible tool in classifying individuals based on their habitual dietary fibre intakes.

Reproducibility of data-driven dietary patterns in two groups of adult Spanish women from different studies.

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Castelló, Adela; Lope, Virginia; Vioque, Jesús; Santamariña, Carmen; Pedraz-Pingarrón, Carmen; Abad, Soledad; Ederra, Maria; Salas-Trejo, Dolores; Vidal, Carmen; Sánchez-Contador, Carmen; Aragonés, Nuria; Pérez-Gómez, Beatriz; Pollán, Marina

2016-08-01

The objective of the present study was to assess the reproducibility of data-driven dietary patterns in different samples extracted from similar populations. Dietary patterns were extracted by applying principal component analyses to the dietary information collected from a sample of 3550 women recruited from seven screening centres belonging to the Spanish breast cancer (BC) screening network (Determinants of Mammographic Density in Spain (DDM-Spain) study). The resulting patterns were compared with three dietary patterns obtained from a previous Spanish case-control study on female BC (Epidemiological study of the Spanish group for breast cancer research (GEICAM: grupo Español de investigación en cáncer de mama)) using the dietary intake data of 973 healthy participants. The level of agreement between patterns was determined using both the congruence coefficient (CC) between the pattern loadings (considering patterns with a CC≥0·85 as fairly similar) and the linear correlation between patterns scores (considering as fairly similar those patterns with a statistically significant correlation). The conclusions reached with both methods were compared. This is the first study exploring the reproducibility of data-driven patterns from two studies and the first using the CC to determine pattern similarity. We were able to reproduce the EpiGEICAM Western pattern in the DDM-Spain sample (CC=0·90). However, the reproducibility of the Prudent (CC=0·76) and Mediterranean (CC=0·77) patterns was not as good. The linear correlation between pattern scores was statistically significant in all cases, highlighting its arbitrariness for determining pattern similarity. We conclude that the reproducibility of widely prevalent dietary patterns is better than the reproducibility of more population-specific patterns. More methodological studies are needed to establish an objective measurement and threshold to determine pattern similarity.

Mental, psychomotor, neurologic, and behavioral outcomes of 2-year-old children born after preimplantation genetic screening : follow-up of a randomized controlled trial

NARCIS (Netherlands)

Middelburg, Karin J.; van der Heide, Maaike; Houtzager, Bregje; Pereboom, Marjolein; Fidler, Vaclav; Bos, Arend F.; Kok, Joke; Hadders-Algra, Mijna

Objective: To evaluate the effect of preimplantation genetic screening (PGS) on neurodevelopmental outcomes in children. Design: Prospective, assessor-blinded, follow-up study of children born to women randomly assigned to in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) with or

Reduced or modified dietary fat for preventing cardiovascular disease

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Lee Hooper

Full Text Available ABSTRACT: BACKGROUND: Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol, but their effects on important health outcomes are less clear. OBJECTIVE: To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. METHODS: Search methods: For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL, Medline and Embase, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria: Trials fulfilled the following criteria: 1 randomized with appropriate control group, 2 intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions, 3 not multi factorial, 4 adult humans with or without cardiovascular disease, 5 intervention at least six months, 6 mortality or cardiovascular morbidity data available. Data collection and analysis: Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. MAIN RESULTS: This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%. Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides, of at least two years duration and in studies of men (not of women. There were no clear effects of dietary fat

Reduced or modified dietary fat for preventing cardiovascular disease

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Hooper, Lee; Summerbell, Carolyn D; Thompson, Rachel; Sills, Deirdre; Roberts, Felicia G; Moore, Helen; Smith, George Davey

2014-01-01

Background Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. Objectives To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. Search methods For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Data collection and analysis Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. Main results This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0

Impact of different dietary approaches on glycemic control and cardiovascular risk factors in patients with type 2 diabetes: a protocol for a systematic review and network meta-analysis.

Science.gov (United States)

Schwingshackl, Lukas; Chaimani, Anna; Hoffmann, Georg; Schwedhelm, Carolina; Boeing, Heiner

2017-03-20

Dietary advice is one of the cornerstones in the management of type 2 diabetes mellitus. The American Diabetes Association recommended a hypocaloric diet for overweight or obese adults with type 2 diabetes in order to induce weight loss. However, there is limited evidence on the optimal approaches to control hyperglycemia in type 2 diabetes patients. The aim of the present study is to assess the comparative efficacy of different dietary approaches on glycemic control and blood lipids in patients with type 2 diabetes mellitus in a systematic review including a standard pairwise and network meta-analysis of randomized trials. We will conduct searches in Cochrane Central Register of Controlled Trials (CENTRAL) on the Cochrane Library, PubMed (from 1966), and Google Scholar. Citations, abstracts, and relevant papers will be screened for eligibility by two reviewers independently. Randomized controlled trials (with a control group or randomized trials with at least two intervention groups) will be included if they meet the following criteria: (1) include type 2 diabetes mellitus, (2) include patients aged ≥18 years, (3) include dietary intervention (different type of diets: e.g., Mediterranean dietary pattern, low-carbohydrate diet, low-fat diet, vegetarian diet, high protein diet); either hypo, iso-caloric, or ad libitum diets, (4) minimum intervention period of 12 weeks. For each outcome measure of interest, random effects pairwise and network meta-analyses will be performed in order to determine the pooled relative effect of each intervention relative to every other intervention in terms of the post-intervention values (or mean differences between the changes from baseline value scores). Subgroup analyses are planned for study length, sample size, age, and sex. This systematic review will synthesize the available evidence on the comparative efficacy of different dietary approaches in the management of glycosylated hemoglobin (primary outcome), fasting glucose

Overview of diagnosis, management and outcome of congenital hypothyroidism: A call for a national screening programme in Sudan

OpenAIRE

Babiker, Amir M. I.; Jurayyan, Nasir A. Al; Mohamed, Sarar H.; Abdullah, Mohamed A.

2012-01-01

Congenital hypothyroidism (CH) is the commonest preventable cause of mental retardation in children worldwide. It continued to be a major health problem amongst Sudanese children. The lack of a screening programme in Sudan may be the major factor of missing the diagnosis in newborns with such a condition that can present very subtle clinically, yet with poor neurodevelopmental consequences. The outcome is very good when the condition is noticed early (in the first 2 - 3 weeks of life). Howeve...

Development and Pilot Study of Group-Based Dietary Self-Management Program for Community Dwellers with Hypertension

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Arfiza Ridwan

2012-08-01

Full Text Available Background: In most countries worldwide, hypertension is considered as an important problem. Moreover, an increasing trend in the prevalence and incidence has been reported in most countries. This increasing trend requires an innovative approach to improve the lifestyle modification of hypertensive sufferers including their dietary behaviors. Objective: This developmental research aims to develop a program for improving the dietary behaviors of community dwellers with hypertension. Method: The process of this program development includes a literature review related to the self-management programs for hypertension, and dietary behavior outcomes, expert validation, and pilot testing. Result: The setting, strategies, duration, and outcome measurement from the literature review were taken into consideration to develop the new program. The newly developed group-based self-management program consists of: 1 the sharing and reflecting of individual current dietary behavior, 2 group educational session, 3 individual comparison of behavior and reflection of obstacles, 4 individual goal setting, and 5 follow up. In the educational session, the DASH eating plan is used as the reference as it is commonly used in studies about diet for hypertension. Key words: hypertension, self-management, group based program, dietary behaviors.

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study

Science.gov (United States)

Fitzgerald, Sarah; Murphy, Aileen; Kirby, Ann; Geaney, Fiona; Perry, Ivan J

2018-01-01

Objective To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Design Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Setting Four multinational manufacturing workplaces in Cork, Ireland. Participants 517 randomly selected employees (18–65 years) from four workplaces. Interventions Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. Outcomes The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. Results The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is

Identification of dietary patterns associated with obesity in a nationally representative survey of Canadian adults: application of a priori, hybrid, and simplified dietary pattern techniques.

Science.gov (United States)

Jessri, Mahsa; Wolfinger, Russell D; Lou, Wendy Y; L'Abbé, Mary R

2017-03-01

Background: Analyzing the effects of dietary patterns is an important approach for examining the complex role of nutrition in the etiology of obesity and chronic diseases. Objectives: The objectives of this study were to characterize the dietary patterns of Canadians with the use of a priori, hybrid, and simplified dietary pattern techniques, and to compare the associations of these patterns with obesity risk in individuals with and without chronic diseases (unhealthy and healthy obesity). Design: Dietary recalls from 11,748 participants (≥18 y of age) in the cross-sectional, nationally representative Canadian Community Health Survey 2.2 were used. A priori dietary pattern was characterized with the use of the previously validated 2015 Dietary Guidelines for Americans Adherence Index (DGAI). Weighted partial least squares (hybrid method) was used to derive an energy-dense (ED), high-fat (HF), low-fiber density (LFD) dietary pattern with the use of 38 food groups. The associations of derived dietary patterns with disease outcomes were then tested with the use of multinomial logistic regression. Results: An ED, HF, and LFD dietary pattern had high positive loadings for fast foods, carbonated drinks, and refined grains, and high negative loadings for whole fruits and vegetables (≥|0.17|). Food groups with a high loading were summed to form a simplified dietary pattern score. Moving from the first (healthiest) to the fourth (least healthy) quartiles of the ED, HF, and LFD pattern and the simplified dietary pattern scores was associated with increasingly elevated ORs for unhealthy obesity, with individuals in quartile 4 having an OR of 2.57 (95% CI: 1.75, 3.76) and 2.73 (95% CI: 1.88, 3.98), respectively ( P -trend obesity ( P -trend dietary patterns with healthy obesity and unhealthy nonobesity were weaker, albeit significant. Conclusions: Consuming an ED, HF, and LFD dietary pattern and lack of adherence to the recommendations of the 2015 DGAI were associated with

Objective assessment of dietary patterns by use of metabolic phenotyping

DEFF Research Database (Denmark)

Garcia-Perez, Isabel; Posma, Joram M; Gibson, Rachel

2017-01-01

BACKGROUND: Accurate monitoring of changes in dietary patterns in response to food policy implementation is challenging. Metabolic profiling allows simultaneous measurement of hundreds of metabolites in urine, the concentrations of which can be affected by food intake. We hypothesised that metabo......BACKGROUND: Accurate monitoring of changes in dietary patterns in response to food policy implementation is challenging. Metabolic profiling allows simultaneous measurement of hundreds of metabolites in urine, the concentrations of which can be affected by food intake. We hypothesised...... fats, sugars, and salt). Participants attended four inpatient stays (72 h each, separated by at least 5 days), during which they were given one dietary intervention. The order of diets was randomly assigned across study visits. Randomisation was done by an independent investigator, with the use...... is registered with ISRCTN, number ISRCTN43087333. FINDINGS: Between Aug 13, 2013, and May 18, 2014, we contacted 300 people with a letter of invitation. 78 responded, of whom 26 were eligible and invited to attend a health screening. Of 20 eligible participants who were randomised, 19 completed all four 72 h...

Everything in Moderation: Moderate Use of Screens Unassociated with Child Behavior Problems.

Science.gov (United States)

Ferguson, Christopher J

2017-12-01

The impact of children's use of "screen" media including television and computer games, continues to be debated. The American Academy of Pediatrics (AAP) until recently recommended a relatively restrictive screen time diet of 2 h or less for most youth. A representative correlational sample of youth were assessed for links between screen time and risky behavioral outcomes. Data collection occurred in 2013 conducted by the State of Florida. Use of screens that was moderately high, in excess of the AAP's former recommendations, but not excessive (1 SD or higher than average), was not associated with delinquency, risky behaviors, sexual behaviors, substance abuse, reduced grades or mental health problems. Even excessive screen use (1 SD or higher) was only weakly associated with negative outcomes related to delinquency, grades and depression only, and at levels unlikely to be practically significant. Results conceptually replicate those of Przybylski (2014) with a US sample for depression and delinquency as outcomes. Moderate use of screens, though in excess of the AAP's historical recommendations, are unassociated with problem outcomes. Excessive use of screens is only weakly associated with negative outcomes, and only those related to depression and delinquency as well as reduced grades, but not risky driving, substance use, risky sex or disordered eating. Although an "everything in moderation" message when discussing screen time with parents may be most productive, results do not support a strong focus on screen time as a preventative measure for youth problem behaviors.

On Enzyme-Based Anticancer Molecular Dietary Manipulations

Directory of Open Access Journals (Sweden)

Andrea Sapone

2012-01-01

Full Text Available Evidence from both epidemiological and experimental observations has fuelled the belief that the high consumption of fruits and vegetables rich in nutrients and phytochemicals may help prevent cancer and heart disease in humans. This concept has been drastically simplified from the dietary approaches to the use of single bioactive components both as a single supplement or in functional foods to manipulate xenobiotic metabolism. These procedures, which aim to induce mutagen/carcinogen detoxification or inhibit their bioactivation, fail to take into account the multiple and paradoxical biological outcomes of enzyme modulators that make their effects unpredictable. Here, we show that the idea that the physiological roles of specific catalysts may be easily manipulated by regular long-term administration of isolated nutrients and other chemicals derived from food plants is not viable. In contrast, we claim that the consumption of healthy diets is most likely to reduce mutagenesis and cancer risk, and that both research endeavours and dietary recommendations should be redirected away from single molecules to dietary patterns as a main strategy for public health policy.

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. �

The impact of HPV vaccination on future cervical screening

DEFF Research Database (Denmark)

Hestbech, Mie Sara; Lynge, Elsebeth; Kragstrup, Jakob

2015-01-01

intraepithelial neoplasia (CIN) grade 2+ and 3+ as cut-off values. RESULTS: The proportion of positive screening tests was reduced from 8.7% before vaccination to 6.5% after vaccination, and the proportion of false-positive screening tests using CIN2+ as a cut-off was reduced from 5.5% pre-vaccination to 4......OBJECTIVES: To explore the interplay between primary and secondary prevention of cervical cancer by estimating future screening outcomes in women offered human papillomavirus (HPV) vaccination when they were sexually naïve. DESIGN: Estimation of outcome of liquid-based cytology screening for a post...... vaccinated for HPV before sexual debut. All identified studies were reviewed by two authors, and weighted pooled estimates of vaccine efficacies were used. MAIN OUTCOME MEASURES: Proportions of positive and false-positive cervical cytologies and positive predictive value (PPV) were calculated using cervical...

Tuberculosis screening in patients with HIV

DEFF Research Database (Denmark)

Bjerrum, Stephanie Mia Katrine; Bonsu, Frank; Hanson-Nortey, Nii Nortey

2016-01-01

BACKGROUND: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice...... is scarce. OBJECTIVES: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana. DESIGN: Healthcare providers at 10 large HIV care clinics prospectively registered patient consultations during...

Protective effects of short-term dietary restriction in surgical stress and chemotherapy.

Science.gov (United States)

Brandhorst, Sebastian; Harputlugil, Eylul; Mitchell, James R; Longo, Valter D

2017-10-01

Reduced caloric intake including fasting, as well as the dietary composition or the timing of food intake, impact longevity, likely through a modification in the onset or the severity of chronic aging-related diseases such as cancer. As with pre- and post-operative dietary recommendations, evidence-based nutritional advice from healthcare professionals during and after cancer treatment is often vague or conflicting. We hypothesize that preventive dietary recommendations can help in the context of both chronic cancer treatment efficacy and the avoidance of development of secondary malignancies, as well as in the context of protection from the acute stress of surgery. In this perspective review, we will discuss the latest findings on the potential role of short-term dietary restriction in cancer treatment and improvement of surgical outcome. Copyright © 2017. Published by Elsevier B.V.

Performance of third-trimester combined screening model for prediction of adverse perinatal outcome.

Science.gov (United States)

Miranda, J; Triunfo, S; Rodriguez-Lopez, M; Sairanen, M; Kouru, H; Parra-Saavedra, M; Crovetto, F; Figueras, F; Crispi, F; Gratacós, E

2017-09-01

To explore the potential value of third-trimester combined screening for the prediction of adverse perinatal outcome (APO) in the general population and among small-for-gestational-age (SGA) fetuses. This was a nested case-control study within a prospective cohort of 1590 singleton gestations undergoing third-trimester evaluation (32 + 0 to 36 + 6 weeks' gestation). Maternal baseline characteristics, mean arterial blood pressure, fetoplacental ultrasound and circulating biochemical markers (placental growth factor (PlGF), lipocalin-2, unconjugated estriol and inhibin A) were assessed in all women who subsequently had an APO (n = 148) and in a control group without perinatal complications (n = 902). APO was defined as the occurrence of stillbirth, umbilical artery cord blood pH < 7.15, 5-min Apgar score < 7 or emergency operative delivery for fetal distress. Logistic regression models were developed for the prediction of APO in the general population and among SGA cases (defined as customized birth weight < 10 th centile). The prevalence of APO was 9.3% in the general population and 27.4% among SGA cases. In the general population, a combined screening model including a-priori risk (maternal characteristics), estimated fetal weight (EFW) centile, umbilical artery pulsatility index (UA-PI), estriol and PlGF achieved a detection rate for APO of 26% (area under receiver-operating characteristics curve (AUC), 0.59 (95% CI, 0.54-0.65)), at a 10% false-positive rate (FPR). Among SGA cases, a model including a-priori risk, EFW centile, UA-PI, cerebroplacental ratio, estriol and PlGF predicted 62% of APO (AUC, 0.86 (95% CI, 0.80-0.92)) at a FPR of 10%. The use of fetal ultrasound and maternal biochemical markers at 32-36 weeks provides a poor prediction of APO in the general population. Although it remains limited, the performance of the screening model is improved when applied to fetuses with suboptimal fetal growth. Copyright © 2016 ISUOG. Published by John Wiley & Sons

Maternal and paternal parenting practices and their influence on children's adiposity, screen-time, diet and physical activity.

Science.gov (United States)

Lloyd, Adam B; Lubans, David R; Plotnikoff, Ronald C; Collins, Clare E; Morgan, Philip J

2014-08-01

The primary aim of this study was to examine a range of potential behavioral and maternal/paternal correlates of adiposity in children. Secondary aims were to examine (a) correlates of screen-time, diet and physical activity and (b) if there were differences in maternal and paternal physical activity- and dietary-related parenting practices. Cross-sectional analysis was conducted using 70 families with children (59% boys (41/70), mean age 8.4 (±2.4) years). Parenting practices were measured using the Parenting Strategies for Eating and Activity Scale. Children's outcomes included: 7-day pedometry (physical activity), screen-time, percent energy from core foods (Food frequency questionnaire) and BMI z-score. Multiple regression models were generated to examine the associations between maternal and paternal parenting practices and children's variables. In the regression analyses, fathers' BMI (p parenting practices [limit setting (p = .01), reinforcement (p = .02)] and child screen-time (p = .02) were significantly associated with intake of core foods. Despite some similarities within families, three out of five parenting constructs were significantly different between mothers and fathers. Mothers and fathers have different parental influences on their children's weight status and lifestyle behaviors and both should be included in lifestyle interventions targeting children. A focus on maternal parenting specifically relating to screen-time and diet, and father's physical activity parenting and weight status may support their children in developing more healthy behaviors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dietary patterns in obese pregnant women; influence of a behavioral intervention of diet and physical activity in the UPBEAT randomized controlled trial.

Science.gov (United States)

Flynn, Angela C; Seed, Paul T; Patel, Nashita; Barr, Suzanne; Bell, Ruth; Briley, Annette L; Godfrey, Keith M; Nelson, Scott M; Oteng-Ntim, Eugene; Robinson, Sian M; Sanders, Thomas A; Sattar, Naveed; Wardle, Jane; Poston, Lucilla; Goff, Louise M

2016-11-29

Understanding dietary patterns in obese pregnant women will inform future intervention strategies to improve pregnancy outcomes and the health of the child. The aim of this study was to investigate the effect of a behavioral intervention of diet and physical activity advice on dietary patterns in obese pregnant woman participating in the UPBEAT study, and to explore associations of dietary patterns with pregnancy outcomes. In the UPBEAT randomized controlled trial, pregnant obese women from eight UK multi-ethnic, inner-city populations were randomly assigned to receive a diet/physical activity intervention or standard antenatal care. The dietary intervention aimed to reduce glycemic load and saturated fat intake. Diet was assessed using a food frequency questionnaire (FFQ) at baseline (15 +0 -18 +6 weeks' gestation), post intervention (27 +0 -28 +6 weeks) and in late pregnancy (34 +0 -36 +0 weeks). Dietary patterns were characterized using factor analysis of the baseline FFQ data, and changes compared in the control and intervention arms. Patterns were related to pregnancy outcomes in the combined control/intervention cohort (n = 1023). Four distinct baseline dietary patterns were defined; Fruit and vegetables, African/Caribbean, Processed, and Snacks, which were differently associated with social and demographic factors. The UPBEAT intervention significantly reduced the Processed (-0.14; 95% CI -0.19, -0.08, P obese pregnant women an intensive dietary intervention improved Processed and Snack dietary pattern scores. African/Caribbean and Processed patterns were associated with an increased risk of gestational diabetes, and provide potential targets for future interventions. Current controlled trials; ISRCTN89971375.

Dietary, food service, and mealtime interventions to promote food intake in acute care adult patients.

Science.gov (United States)

Cheung, Grace; Pizzola, Lisa; Keller, Heather

2013-01-01

Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common intervention with demonstrated effectiveness. "Food first" approaches have also been developed and evaluated. This scoping review identified and summarized 35 studies (41 citations) that described and/or evaluated dietary, foodservice, or mealtime interventions with a food first focus. There were few randomized control trials. Individualized dietary treatment leads to improved food intake and other positive outcomes. Foodservices that promote point-of-care food selection are promising, but further research with food intake and nutritional outcomes is needed. Protected mealtimes have had insufficient implementation, leading to mixed results, while mealtime assistance, particularly provided by volunteers or dietary staff, appears to promote food intake. A few innovative strategies were identified but further research to develop and evaluate food first approaches is needed.

Contribution of dietary amino acids composition to incidence of cardiovascular outcomes: A prospective population-based study.

Science.gov (United States)

Mirmiran, P; Bahadoran, Z; Ghasemi, A; Azizi, F

2017-07-01

Considering the limited data on the cardiovascular effects of dietary amino acid intakes, we assessed possible association of dietary amino acids with the risk of cardiovascular (CVD) events in a prospective population-based study. Participants without CVD (n = 2369) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 6.7 years. Dietary protein and amino acid intakes were assessed at baseline (2006-2008); demographic, lifestyle and biochemical variables were evaluated at baseline and follow-up examination (2012-2014). Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary amino acids. Mean total protein intake was 76.9 ± 27.5 g/d, and dietary protein had no significant association with the risk of CVD (HR = 1.23, 95% CI = 0.65-2.31, and HR = 0.52, 95% CI = 0.19-1.41, in the second and third tertiles, respectively). After adjustment of potential confounders, the amino acid pattern with higher load of glycine, cysteine, arginine and tryptophan, was negatively associated with CVD (HR = 0.28, 95% CI = 0.09-0.88, P for trend = 0.08). Higher intake of sulfur-containing amino acids (cysteine and methionine), and potentially cardioprotective amino acids (arginine, cysteine, glutamic acid, glycine, histidine, leucine and tyrosine) corresponded to 73% (HR = 0.27, 95% CI = 0.09-0.86) and 74% (HR = 0.26, 95% CI = 0.09-0.78) decreased risk of CVD events. Higher intake of glutamic acid and proline (% of dietary total protein) increased the risk of CVD (HR = 1.30, 95% CI = 1.03-1.64, and HR = 1.33, 95% CI = 1.10-1.60, respectively). These novel data provide evidence to suggest that amino acid composition of diet may modify the risk of CVD events. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of

Adherence to the healthy Nordic food index, dietary composition, and lifestyle among Swedish women

Science.gov (United States)

Roswall, Nina; Eriksson, Ulf; Sandin, Sven; Löf, Marie; Olsen, Anja; Skeie, Guri; Adami, Hans-Olov; Weiderpass, Elisabete

2015-01-01

Background Studies examining diet scores in relation to health outcomes are gaining ground. Thus, control for dietary factors not part of the score, and lifestyle associated with adherence, is required to allow for a causal interpretation of studies on diet scores and health outcomes. Objective The study objective is to describe and investigate dietary composition, micronutrient density, lifestyle, socioeconomic factors, and adherence to the Nordic Nutrition Recommendations across groups defined by their level of adherence to a healthy Nordic food index (HNFI). The paper examines both dietary components included in the HNFI as well as dietary components, which are not part of the HNFI, to get a broad picture of the diet. Design The study is cross-sectional and conducted in the Swedish Women's Lifestyle and Health cohort. We included 45,277 women, aged 29–49 years at baseline (1991–1992). The HNFI was defined by six items: wholegrain bread, oatmeal, apples/pears, cabbages, root vegetables and fish/shellfish, using data from a food frequency questionnaire. Proportions, means and standard deviations were calculated in the entire cohort and by adherence groups. Results Women scoring high on the HNFI had a higher energy intake, compared to low adherers. They had a higher intake of fiber and a higher micronutrient density (components of the HNFI), but also a higher intake of items not included in the HNFI: red/processed meats, sweets, and potatoes. They were on average more physically active and less likely to smoke. Conclusions Adherence to the HNFI was associated with a generally healthier lifestyle and a high intake of health-beneficial components. However, it was also associated with a higher energy intake and a higher intake of foods without proven health benefits. Therefore, future studies on the HNFI and health outcomes should take into account potential confounding of dietary and lifestyle factors associated with the HNFI. PMID:25773303

Infant outcomes among women with Zika virus infection during pregnancy: results of a large prenatal Zika screening program.

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Adhikari, Emily H; Nelson, David B; Johnson, Kathryn A; Jacobs, Sara; Rogers, Vanessa L; Roberts, Scott W; Sexton, Taylor; McIntire, Donald D; Casey, Brian M

2017-03-01

Zika virus infection during pregnancy is a known cause of congenital microcephaly and other neurologic morbidities. We present the results of a large-scale prenatal screening program in place at a single-center health care system since March 14, 2016. Our aims were to report the baseline prevalence of travel-associated Zika infection in our pregnant population, determine travel characteristics of women with evidence of Zika infection, and evaluate maternal and neonatal outcomes compared to women without evidence of Zika infection. This is a prospective, observational study of prenatal Zika virus screening in our health care system. We screened all pregnant women for recent travel to a Zika-affected area, and the serum was tested for those considered at risk for infection. We compared maternal demographic and travel characteristics and perinatal outcomes among women with positive and negative Zika virus tests during pregnancy. Comprehensive neurologic evaluation was performed on all infants delivered of women with evidence of possible Zika virus infection during pregnancy. Head circumference percentiles by gestational age were compared for infants delivered of women with positive and negative Zika virus test results. From March 14 through Oct. 1, 2016, a total of 14,161 pregnant women were screened for travel to a Zika-affected country. A total of 610 (4.3%) women reported travel, and test results were available in 547. Of these, evidence of possible Zika virus infection was found in 29 (5.3%). In our population, the prevalence of asymptomatic or symptomatic Zika virus infection among pregnant women was 2/1000. Women with evidence of Zika virus infection were more likely to have traveled from Central or South America (97% vs 12%, P Zika virus infection. Additionally, there was no difference in mean head circumference of infants born to women with positive vs negative Zika virus testing. No microcephalic infants born to women with Zika infection were identified

Relative validity and reproducibility of a food frequency questionnaire to assess dietary fiber intake in Danish adults.

Science.gov (United States)

Vuholm, Stine; Lorenzen, Janne K; Kristensen, Mette

2014-01-01

Differences in habitual dietary fiber intake may modify effects of dietary fiber interventions, thus measurement of habitual dietary fiber intake is relevant to apply in intervention studies on fiber-rich foods, and food frequency questionnaire (FFQ) is a commonly used method. Rye bread is the major contributor of dietary fiber in the Danish population, and a nation-specific FFQ is therefore needed. The aim of this study was to assess the relative validity and reproducibility of a self-administered quantitative FFQ designed to assess total dietary fiber intake among Danish adults. In order to assess the relative validity of the FFQ, a total of 125 participants completed both a 7-day weighed dietary recording (DR) and an FFQ consisting of 60 questions. To evaluate the reproducibility of the FFQ, a sub-group of 12 participants subsequently completed an FFQ approximately 6 months later. Estimates of mean dietary fiber intake were 24.9±9.8 and 28.1±9.4 g/day when applying the FFQ and DR, respectively, where FFQ estimates were ~12% lower (pfiber intake of the two methods was r=0.63 (pfiber intake (g/day), adequate ranking of subjects according to their dietary fiber intake, and good reproducibility. The FFQ is therefore believed to be a valuable tool for epidemiology and screening in human interventions, where intake of dietary fibers is of specific interest.

No. 185-HIV Screening in Pregnancy.

Science.gov (United States)

Keenan-Lindsay, Lisa; Yudin, Mark H

2017-07-01

The purpose of this guideline is to provide recommendations to obstetric health care providers and to minimize practice variations for HIV screening, while taking provincial and territorial recommendations into account. The risk of transmission of HIV from mother to fetus is significant if the mother is not treated. The primary outcome of screening for and treating HIV in pregnancy is a marked decrease in the rate of vertical transmission of HIV from mother to fetus. Secondary outcomes include confirmation of HIV infection in the woman, which allows optimization of her health and long-term management. The Cochrane Library and Medline were searched for English-language articles published related to HIV screening and pregnancy. Additional articles were identified through the references of these articles. All study types were reviewed. Copyright © 2017. Published by Elsevier Inc.

Prospective study on dietary intakes of folate, betaine, and choline and cardiovascular disease risk in women.

NARCIS (Netherlands)

Dalmeijer, G.W.; Olthof, M.R.; Verhoef, P.; Bots, M.L.; van der Schouw, Y.T.

2008-01-01

Objective: To investigate the association between dietary intakes of folate, betaine and choline and the risk of cardiovascular disease (CVD). Design: Prospective cohort study. Subjects: A total of 16165 women aged 49-70 years without prior CVD. Subjects were breast cancer screening participants in

Differences in Mothers' and Children's Dietary Intake during Physical and Sedentary Activities: An Ecological Momentary Assessment Study.

Science.gov (United States)

O'Connor, Sydney G; Koprowski, Carol; Dzubur, Eldin; Leventhal, Adam M; Huh, Jimi; Dunton, Genevieve Fridlund

2017-08-01

Physical activity and diet are major modifiable health behaviors contributing to obesity risk. Although patterns of these behaviors tend to cluster within individuals and within family units, it is unknown to what extent healthy and unhealthy dietary intake might differentially accompany sedentary and physical activities in mothers compared with their children. Our goal was to examine differences in co-occurrence of activities and dietary intake between mothers and children, as measured in real time using ecological momentary assessment. This study examined cross-sectional data from 175 mothers and their children aged 8 to 12 years. Participants completed 8 days of ecological momentary assessment surveys, reporting on whether the following activities had occurred during the past 2 hours: sedentary screen activity, physical activity, and intake of healthy (ie, fruits and vegetables) and unhealthy (ie, fast food, chips/fries, pastries/sweets, and soda/energy drinks) foods. Multilevel logistic regression models estimated the adjusted odds of consuming healthy and unhealthy dietary intake for mothers and children during time periods reporting physical activity (vs no physical activity) or sedentary screen activity (vs no sedentary screen activity). Post hoc tests compared estimates for mothers vs children. Children were significantly more likely than their mothers to consume unhealthy foods during 2-hour windows that included physical activity (odds ratio [children] 1.85, 95% CI 1.47 to 2.31; odds ratio [mothers] 0.83, 95% CI 0.58 to 1.20; P diff sedentary screen activity (P diff =0.067). In addition, children and their mothers did not differ in their likelihood of consuming healthy foods during 2-hour windows with sedentary screen activity (P diff  =0.497) or physical activity (P diff  =0.170). Results indicate that the consumption of unhealthy foods may be more likely to co-occur within a 2-hour window including physical activity in children as compared to their

Second trimester cardiac diagnosis : screening standards and outcomes

NARCIS (Netherlands)

Clur, Sally-Ann B.; Bilardo, Caterina M.

2014-01-01

Second trimester screening for congenital heart defects occurs during the routine 18-20 weeks' anomaly scan in many countries. Most congenital heart defects can be prenatally detected by experts in foetal echocardiography working in tertiary centres with high-risk pregnancies. Many studies, however,

Second trimester cardiac diagnosis: screening standards and outcomes

NARCIS (Netherlands)

Clur, Sally-Ann B.; Bilardo, Caterina M.

2014-01-01

Second trimester screening for congenital heart defects occurs during the routine 18-20 weeks' anomaly scan in many countries. Most congenital heart defects can be prenatally detected by experts in foetal echocardiography working in tertiary centres with high-risk pregnancies. Many studies, however,

Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting.

Science.gov (United States)

van Bokhorst-de van der Schueren, Marian A E; Guaitoli, Patrícia Realino; Jansma, Elise P; de Vet, Henrica C W

2014-02-01

Numerous nutrition screening tools for the hospital setting have been developed. The aim of this systematic review is to study construct or criterion validity and predictive validity of nutrition screening tools for the general hospital setting. A systematic review of English, French, German, Spanish, Portuguese and Dutch articles identified via MEDLINE, Cinahl and EMBASE (from inception to the 2nd of February 2012). Additional studies were identified by checking reference lists of identified manuscripts. Search terms included key words for malnutrition, screening or assessment instruments, and terms for hospital setting and adults. Data were extracted independently by 2 authors. Only studies expressing the (construct, criterion or predictive) validity of a tool were included. 83 studies (32 screening tools) were identified: 42 studies on construct or criterion validity versus a reference method and 51 studies on predictive validity on outcome (i.e. length of stay, mortality or complications). None of the tools performed consistently well to establish the patients' nutritional status. For the elderly, MNA performed fair to good, for the adults MUST performed fair to good. SGA, NRS-2002 and MUST performed well in predicting outcome in approximately half of the studies reviewed in adults, but not in older patients. Not one single screening or assessment tool is capable of adequate nutrition screening as well as predicting poor nutrition related outcome. Development of new tools seems redundant and will most probably not lead to new insights. New studies comparing different tools within one patient population are required. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Self-Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST).

Science.gov (United States)

Sandhu, Amindeep; Mosli, Mahmoud; Yan, Brian; Wu, Thomas; Gregor, Jamie; Chande, Nilesh; Ponich, Terry; Beaton, Melanie; Rahman, Adam

2016-05-01

Malnutrition is common in patients with inflammatory bowel disease (IBD) and is associated with poor outcomes. Our aim is to determine if patient self-administered malnutrition screening using the malnutrition universal screening tool (MUST) is reliable by comparing patient scores with those derived from the healthcare practitioner (HCP), the gold standard. We conducted a prospective validation study at a tertiary Canadian academic center that included 154 adult outpatients with IBD. All patients with IBD completed a self-administered nutrition screening assessment using the MUST score followed by an independent MUST assessment performed by HCPs. The main outcome measure was chance-corrected agreement (κ) of malnutrition risk categorization. For patient-administered MUST, the chance-corrected agreement κ (95% confidence interval [CI]) was 0.83 (0.74-0.92) when comparing low-risk and combined medium- and high-risk patients with HCP screening. Weighted κ analysis comparing all 3 risks groups yielded a κ (95% CI) of 0.85 (0.77-0.93) between patient and HCP screening. All patients were able to screen themselves. Overall, 96% of patients reported the MUST questionnaire as either very easy or easy to understand and to complete. Self-administered nutrition screening in outpatients with IBD is valid using the MUST screening tool and is easy to use. If adopted, this tool will increase utilization of malnutrition screening in hectic outpatient clinic settings and will help HCPs determine which patients require additional nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

Directory of Open Access Journals (Sweden)

Spjut Jansson B

2016-09-01

Full Text Available Birgitta Spjut Jansson,1–3 Carmela Miniscalco,1,4 Joakim Westerlund,1,5 Anne-Katrin Kantzer,1,6 Elisabeth Fernell,1 Christopher Gillberg1 1Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, 2Unit of Child and Adolescent Habilitation, 3Department of Psychology, University of Gothenburg, 4Division of Speech and Language Pathology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, 5Department of Psychology, University of Stockholm, Stockholm, 6Department of Child and Adolescent Psychiatry, NU Hospital Organization, Trollhättan, Sweden Background: Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods: Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL – in two settings, which included home- and preschool-based (IL Regular and only home-based (IL Modified and eclectic interventions.Results: There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion: The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. Keywords: autism spectrum disorder, preschool children, early intervention, ABA, cognitive function, follow-up

Dietary patterns and the risk of colorectal adenomas: the Black Women's Health Study.

Science.gov (United States)

Makambi, Kepher H; Agurs-Collins, Tanya; Bright-Gbebry, Mireille; Rosenberg, Lynn; Palmer, Julie R; Adams-Campbell, Lucile L

2011-05-01

Colorectal adenomas are benign lesions that may be precursors to colorectal cancer. No studies of African American women have investigated dietary patterns and the risk of developing colorectal adenomas. We examined data from the Black Women's Health Study to determine whether dietary patterns are associated with the risk of developing colorectal adenomas. This is a prospective cohort study of 59,000 participants followed biennially since 1995. During 155,414 person-years of follow-up from 1997 to 2007 among women who had had at least one screening colonoscopy, 620 incident cases of colorectal adenomas were identified. By using Cox regression models, we obtained incidence rate ratios (IRR) for colorectal adenoma in relation to quintiles of each of two dietary patterns, adjusting for other colorectal adenoma risk factors. Two dietary patterns, Western and prudent, were utilized to assess the association between dietary intake and adenoma risk. The highest quintile of prudent diet, relative to the lowest quintile, was significantly associated with 34% lower colorectal adenoma risk overall (IRR = 0.66; 95% CI, 0.50-0.88; P(trend) pattern were associated with a higher risk of developing colorectal adenoma (IRR = 1.42; 95% CI, 1.09-1.85 for the highest quintile relative to the lowest; P(trend) = 0.01). Our findings suggest that African American women may be able to reduce their risk of developing colorectal adenomas by following a prudent dietary pattern and avoiding a more Western pattern. A dietary modification could have a strong impact in colorectal adenoma prevention in African American women. ©2011 AACR.

Low-fat dietary pattern and cancer incidence in the Women's Health Initiative Dietary Modification Randomized Controlled Trial.

Science.gov (United States)

Prentice, Ross L; Thomson, Cynthia A; Caan, Bette; Hubbell, F Allan; Anderson, Garnet L; Beresford, Shirley A A; Pettinger, Mary; Lane, Dorothy S; Lessin, Lawrence; Yasmeen, Shagufta; Singh, Baljinder; Khandekar, Janardan; Shikany, James M; Satterfield, Suzanne; Chlebowski, Rowan T

2007-10-17

The Women's Health Initiative Dietary Modification (DM) Randomized Controlled Trial evaluated the effects of a low-fat dietary pattern on chronic disease incidence, with breast cancer and colorectal cancer as primary outcomes. The trial protocol also listed ovarian cancer and endometrial cancer as outcomes that may be favorably affected by the intervention. A total of 48,835 postmenopausal women were randomly assigned during 1993-1998 to a DM intervention (n = 19,541) or comparison (usual diet; n = 29,294) group and followed up for an average of 8.1 years. The intervention goal was to reduce total fat intake to 20% of energy and to increase consumption of vegetables, fruits, and grains. Cancer outcomes were verified by pathology report review. We used weighted log-rank tests to compare incidence of invasive cancers of the ovary and endometrium, total invasive cancer, and invasive cancers at other sites between the groups. All statistical tests were two-sided. Ovarian cancer risk was lower in the intervention than in the comparison group (P = .03). Although the overall ovarian cancer hazard ratio (HR) was not statistically significantly less than 1.0, the hazard ratio decreased with increasing intervention duration (P(trend) = .01). For the first 4 years, the risk for ovarian cancer was similar in the intervention and control groups (0.52 cases per 1000 person-years in the intervention group versus 0.45 per 1000 person-years in the comparison group; HR = 1.16, 95% confidence interval [CI] = 0.73 to 1.84); over the next 4.1 years, the risk was lower in the intervention group (0.38 cases per 1000 person-years in the intervention group versus 0.64 per 1000 person-years in the comparison group; HR = 0.60, 95% CI = 0.38 to 0.96). Risk of cancer of the endometrium did not differ between the groups (P = .18). The estimated risk of total invasive cancer was slightly lower in the intervention group than in the control group (HR = 0.95, 95% CI = 0.89 to 1.01; P = .10). A low

Alignment of Healthy Dietary Patterns and Environmental Sustainability: A Systematic Review12

Science.gov (United States)

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

2016-01-01

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

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study.

Science.gov (United States)

Fitzgerald, Sarah; Murphy, Aileen; Kirby, Ann; Geaney, Fiona; Perry, Ivan J

2018-03-03

To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Four multinational manufacturing workplaces in Cork, Ireland. 517 randomly selected employees (18-65 years) from four workplaces. Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is considered in a cost-benefit analysis, whereby the system

Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome.

Science.gov (United States)

Salama, Amany Alsayed; Amine, Ezzat Khamis; Salem, Hesham Abd Elfattah; Abd El Fattah, Nesrin Kamal

2015-07-01

Polycystic ovary syndrome (PCOS) is of clinical and public health importance, affecting up to one in five women of reproductive age. It has significant and diverse clinical implications including reproductive, metabolic, and psychological features. The study was to investigate the effect of anti-inflammatory dietary combo on metabolic, endocrine, inflammatory, and reproductive profiles in overweight and obese women with PCOS. A total of 100 nonpregnant, overweight, and obese adult females with PCOS according to the Rotterdam criteria, were screened during the year 2012, and 75 completed the trial. At baseline and study end, fasting blood samples were drawn to measure biological markers, body fat percent (BFP), and visceral fat area (VFA) were assessed by the InBody720 device and anthropometric measurements were done for all participants who were subjected to an anti-inflammatory hypocaloric diet and physical activity for 12 weeks. At study completion, we achieved moderate weight loss of (± 7%) and significant improvements in body composition, hormones and menstrual cyclicity, blood pressure, glucose homeostasis, dyslipidemia, C-reactive protein (CRP), and serum amyloid A (SAA) (surrogate measures of cardiovascular risk (CVR)). This was a clinically relevant weight loss that is associated with a reduced prevalence of type 2 diabetes mellitus (DM2) and metabolic syndrome (MS) in the general population and improved fertility outcomes in PCOS. We achieved 63% regain of menstrual cyclicity and 12% spontaneous pregnancy rate within 12 week. We have explored an additional dietary treatment option with good prognostic metabolic and reproductive responses to weight loss that occur in overweight and obese PCOS.

Gestational diabetes mellitus screening, management and outcomes in the Cook Islands.

Science.gov (United States)

Aung, Yin Yin May; Sowter, Martin; Kenealy, Timothy; Herman, Josephine; Ekeroma, Alec

2015-04-17

To describe current practices for screening for gestational diabetes mellitus in the Cook Islands and consider the implications of alternative screening strategies. Eligible women had antenatal care from January 2009 to December 2012. A non-fasting 50 g glucose challenge between 24 and 28 weeks gestation (positive if 1-hour glucose greater than or equal to 7.8 mmol/L) was followed by a 75 g oral glucose tolerance test (gestational diabetes mellitus diagnosed if fasting glucose greater than or equal to 5.2 mmol/L or 2-hour glucose greater than or equal to 8.0 mmol/L; pregnancy impaired glucose tolerance if positive screen and negative diagnostic test). Uptake of the screening programme rose from 49.0% to 99.6% by the end of the study period. 646 women had a glucose challenge; for 186/646 (28.8%) the challenge was positive; 183 had an oral glucose tolerance test; 89/646 (13.8%) had pregnancy impaired glucose tolerance; 94/646 (13.9%) had gestational diabetes mellitus. Median maternal weight gain was 6 kg (gestational diabetes mellitus) and 10 kg (normal glucose tolerance); caesarean section rates were 25% and 11% respectively; baby birthweights were not significantly different. 59 women with gestational diabetes mellitus had a post-natal glucose tolerance test at their 6-week check and 21 (35.6%) had diabetes confirmed. The gestational diabetes mellitus screening programme has a high uptake and current management appears effective in reducing maternal and fetal weight gain. A proposed new screening programme is outlined.

Daily dietary intake

International Nuclear Information System (INIS)

Dang, H.S.

1998-01-01

As part of study on ''Reference Asian Man'' to strengthen radiation protection, the data on the dietary consumption patterns of the Asian region were collected. Eight provided dietary data - Bangladesh, China, India, Indonesia, Japan, Pakistan, Philippines, and Viet Nam. Whereas the dietary information from Bangladesh, Indonesia, Pakistan and Viet Nam are preliminary in nature, the dietary information from China, India, Japan and Philippines, on the other hand, is quite substantial. The population of the countries from which sufficient dietary data are available represents more than 2/3 of the population of the Asian region. The details of the individual data available on dietary parameters from different Asian countries are listed below

Overdiagnosis in mammographic screening for breast cancer in Europe

DEFF Research Database (Denmark)

Puliti, Donella; Duffy, Stephen W; Miccinesi, Guido

2012-01-01

Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service screening programmes....

Estimated dietary sodium intake in haemodialysis patients using food frequency questionnaires.

Science.gov (United States)

Gkza, Anastasia; Davenport, Andrew

2017-10-01

In clinical practice, dietary sodium assessment requires reliable and rapid screening tools. We wished to evaluate the usefulness of food frequency questionnaires (FFQ) in estimating dietary sodium intakes in haemodialysis patients. We used the Derby Salt Questionnaire (DSQ), and Scored Sodium Questionnaire (SSQ) to estimate sodium intake. Body composition was determined by bioimpedance. In total, 139 haemodialysis patients (95 men) completed the FFQs, with mean ± standard deviation age 67 ± 15 years. The mean FFQ scores were DSQ 3.5 ± 2.0 and SSQ 68.4 ± 24.5. Men had higher estimated dietary sodium intakes [DSQ median (range) 3.6 (0.6-10.1) versus female 2.2 (0.5-9.1), P = 0.007)]. Younger patients and those aged >75 years had the higher SSQ dietary sodium scores; 70.7 ± 27.8 and 76.8 ± 24.6 versus those aged 55-75 years, 61.8 ± 22.3, P = 0.04. Patients with greater estimated sodium intake had higher extracellular water (ECW) to intracellular water (ICW) ratios pre-dialysis [75.1 ±12.5 versus 67.7 ± 4.8, P sodium group (0.9 ± 13.7% versus 6.5 ± 14.1%, P = 0.04). Both questionnaires were acceptable to patients and identified higher estimated dietary sodium intake for men, those with greater ECW and, somewhat surprisingly, we found that older patients had a greater dietary sodium intake than expected. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

Dietary sodium to potassium ratio and the incidence of hypertension and cardiovascular disease: A population-based longitudinal study.

Science.gov (United States)

Mirmiran, Parvin; Bahadoran, Zahra; Nazeri, Pantea; Azizi, Fereidoun

2018-01-30

There is an interaction between dietary sodium/potassium intake in the pathogenesis of hypertension (HTN) and cardiovascular disease (CVD). The aim of this study was to investigate the association of dietary sodium to potassium (Na/K) ratio and the risk of HTN and CVD in a general population of Iranian adults. In this prospective cohort study, adults men and women with complete baseline data were selected from among participants of the Tehran Lipid and Glucose Study and were followed up for 6.3 years for incidence of HTN and CVD outcomes. Dietary sodium and potassium were assessed using a valid and reliable 168-item food frequency questionnaire. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between dietary sodium, potassium and their ratio and risk of outcomes. During the study follow-up, 291 (15.1%) and 79 (5.0%) new cases of HTN and CVD were identified, respectively. No significant association was observed between usual intakes of sodium, potassium and dietary Na/K ratio with the incidence of HTN. There was no significant association between dietary intakes of sodium and potassium per se and the risk of CVD, whereas when dietary sodium to potassium ratio was considered as exposure in the fully-adjusted Cox regression model, and participants in the highest compared to lowest tertile had a significantly increased risk of CVD (HR = 2.19, 95% CI = 1.16-4.14). Our findings suggest that high dietary Na/K ratio could contribute to increased risk of CVD events.

The 'Outcome Reporting in Brief Intervention Trials: Alcohol' (ORBITAL) framework: protocol to determine a core outcome set for efficacy and effectiveness trials of alcohol screening and brief intervention.

Science.gov (United States)

Shorter, G W; Heather, N; Bray, Jeremy W; Giles, E L; Holloway, A; Barbosa, C; Berman, A H; O'Donnell, A J; Clarke, M; Stockdale, K J; Newbury-Birch, D

2017-12-22

The evidence base to assess the efficacy and effectiveness of alcohol brief interventions (ABI) is weakened by variation in the outcomes measured and by inconsistent reporting. The 'Outcome Reporting in Brief Intervention Trials: Alcohol' (ORBITAL) project aims to develop a core outcome set (COS) and reporting guidance for its use in future trials of ABI in a range of settings. An international Special Interest Group was convened through INEBRIA (International Network on Brief Interventions for Alcohol and Other Drugs) to inform the development of a COS for trials of ABI. ORBITAL will incorporate a systematic review to map outcomes used in efficacy and effectiveness trials of ABI and their measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. This will support a multi-round Delphi study to prioritise outcomes. Delphi panellists will be drawn from a range of settings and stakeholder groups, and the Delphi study will also be used to determine if a single COS is relevant for all settings. A consensus meeting with key stakeholder representation will determine the final COS and associated guidance for its use in trials of ABI. ORBITAL will develop a COS for alcohol screening and brief intervention trials, with outcomes stratified into domains and guidance on outcome measurement instruments. The standardisation of ABI outcomes and their measurement will support the ongoing development of ABI studies and a systematic synthesis of emerging research findings. We will track the extent to which the COS delivers on this promise through an exploration of the use of the guidance in the decade following COS publication.

A thyrotoxicosis outbreak due to dietary pills in Paris

Directory of Open Access Journals (Sweden)

Vincent Ioos

2008-10-01

Full Text Available Vincent Ioos1, Vincent Das1, Eric Maury1,2, Jean-Luc Baudel1, Jérôme Guéchot3, Bertrand Guidet1,2, Georges Offenstadt1,21Réanimation Médicale; 2Université Pierre et Marie Curie-Paris 6, INSERM, UMR-S 707; 3Unité d’Hormonologie, APHP, Hôpital Saint Antoine, F-75012, Paris, FranceAbstract: Three women were consecutively admitted to our medical intensive care unit for thyrotoxicosis after the ingestion of dietary pills accidentally containing high levels of thyroxin. These cases were observed during an outbreak in the Paris area. Despite similar blood levels of thyroid hormones, their clinical presentation and outcome were very different. One patient developed febrile confusion and died from malignant hyperthermia. The second one had progressive confusion requiring mechanical plasma exchange therapy and had a favorable outcome. The third one had very moderate symptoms. These exceptional observations raise several issues concerning diagnosis, physiopathology and treatment of thyrotoxicosis factitia.Keywords: thyrotoxicosis, dietary pills, thyroxin

Certain dietary patterns are beneficial for the metabolic syndrome: reviewing the evidence.

Science.gov (United States)

Calton, Emily K; James, Anthony P; Pannu, Poonam K; Soares, Mario J

2014-07-01

The metabolic syndrome (MetS) is a global public health issue of increasing magnitude. The Asia-Pacific region is expected to be hardest hit due to large population numbers, rising obesity, and insulin resistance (IR). This review assessed the protective effects of dietary patterns and their components on MetS. A literature search was conducted using prominent electronic databases and search terms that included in combination: diet, dietary components, dietary patterns, and metabolic syndrome. Articles were restricted to prospective studies and high quality randomized controlled trials that were conducted on humans, reported in the English language, and within the time period of 2000 to 2012. Traditional factors such as age, gender, physical activity, and obesity were associated with risk of MetS; however, these potential confounders were not always accounted for in study outcomes. Three dietary patterns emerged from the review; a Mediterranean dietary pattern, dietary approaches to stop hypertension diet, and the Nordic Diet. Potential contributors to their beneficial effects on prevalence of MetS or reduction in MetS components included increases in fruits, vegetables, whole grains, dairy and dairy components, calcium, vitamin D, and whey protein, as well as monounsaturated fatty acids, and omega-3 fatty acids. Additional prospective and high quality randomized controlled trial studies that investigate Mediterranean dietary pattern, the dietary approaches to stop hypertension diet, and the Nordic Diet would cement the protective benefits of these diets against the MetS. Copyright © 2014 Elsevier Inc. All rights reserved.

Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening.

LENUS (Irish Health Repository)

Buckley, B S

2011-12-12

Background:  Gestational diabetes mellitus is a potentially serious condition that affects many pregnancies and its prevalence is increasing. Evidence suggests early detection and treatment improves outcomes, but this is hampered by continued disagreement and inconsistency regarding many aspects of its diagnosis. Methods:  The Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention (DALI) research programme aims to promote pan-European standards in the detection and diagnosis of gestational diabetes and to develop effective preventive interventions. To provide an overview of the context within which the programme will be conducted and its findings interpreted, systematic searching and narrative synthesis have been used to identify and review the best available European evidence relating to the prevalence of gestational diabetes, current screening practices and barriers to screening. Results:  Prevalence is most often reported as 2-6% of pregnancies. Prevalence may be lower towards the Northern Atlantic seaboard of Europe and higher in the Southern Mediterranean seaboard. Screening practice and policy is inconsistent across Europe, hampered by lack of consensus on testing methods, diagnostic glycaemic thresholds and the value of routine screening. Poor clinician awareness of gestational diabetes, its diagnosis and local clinical guidelines further undermine detection of gestational diabetes. Conclusions:  Europe-wide agreement on screening approaches and diagnostic standards for gestational diabetes could lead to better detection and treatment, improved outcomes for women and children and a strengthened evidence base. There is an urgent need for well-designed research that can inform decisions on best practice in gestational diabetes mellitus screening and diagnosis. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK.

How dietary evidence for the prevention and treatment of CVD is translated into practice in those with or at high risk of CVD: a systematic review.

Science.gov (United States)

Schumacher, Tracy L; Burrows, Tracy L; Neubeck, Lis; Redfern, Julie; Callister, Robin; Collins, Clare E

2017-01-01

CVD is a leading cause of mortality and morbidity, and nutrition is an important lifestyle factor. The aim of the present systematic review was to synthesise the literature relating to knowledge translation (KT) of dietary evidence for the prevention and treatment of CVD into practice in populations with or at high risk of CVD. A systematic search of six electronic databases (CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO and Scopus) was performed. Studies were included if a nutrition or dietary KT was demonstrated to occur with a relevant separate measureable outcome. Quality was assessed using a tool adapted from two quality checklists. Population with or at high risk of CVD or clinicians likely to treat this population. A total of 4420 titles and abstracts were screened for inclusion, with 354 full texts retrieved to assess inclusion. Forty-three articles were included in the review, relating to thirty-five separate studies. No studies specifically stated their aim to be KT. Thirty-one studies were in patient or high-risk populations and four targeted health professionals. Few studies stated a theory on which the intervention was based (n 10) and provision of instruction was the most common behaviour change strategy used (n 26). KT in nutrition and dietary studies has been inferred, not stated, with few details provided regarding how dietary knowledge is translated to the end user. This presents challenges for implementation by clinicians and policy and decision makers. Consequently a need exists to improve the quality of publications in this area.

Early first trimester maternal ‘high fish and olive oil and low meat’ dietary pattern is associated with accelerated human embryonic development

NARCIS (Netherlands)

Parisi, Francesca; Rousian, Melek; Steegers-Theunissen, Régine P.M.; Koning, Anton H.J.; Willemsen, Sten P.; Vries, de Jeanne H.M.; Cetin, Irene; Steegers, Eric A.P.

2018-01-01

Background/objectives: Maternal dietary patterns were associated with embryonic growth and congenital anomalies. We aim to evaluate associations between early first trimester maternal dietary patterns and embryonic morphological development among pregnancies with non-malformed outcome.

Determinants of dietary supplement use - healthy individuals use dietary supplements

DEFF Research Database (Denmark)

Kofoed, Christina L F; Christensen, Jane; Dragsted, Lars Ove

2015-01-01

influence the use of dietary supplements. Only few studies investigating the use of dietary supplements have been conducted in the Danish population. The present cross-sectional study is based on 54 948 Danes, aged 50-64 years, who completed self-administrated questionnaires on diet, dietary supplements...... and lifestyle between 1993 and 1997. A health index including smoking, physical activity, alcohol and diet, and a metabolic risk index including waist circumference, urinary glucose and measured hypertension were constructed. Logistic regression was used to investigate these determinants in relation...... to the intake of dietary supplements. We found that 71 % of the participants were dietary supplement users; female sex, older age groups and higher educated participants were more likely to be users of any dietary supplements. One additional point in the health index was associated with 19, 16 and 9 % higher...

Dietary inflammatory potential is linked to cardiovascular disease risk burden in the US adult population.

Science.gov (United States)

Tyrovolas, Stefanos; Koyanagi, Ai; Kotsakis, Georgios A; Panagiotakos, Demosthenes; Shivappa, Nitin; Wirth, Michael D; Hébert, James R; Haro, Josep Maria

2017-08-01

Dietary guidelines are a key tool in the public health quiver. Single nutrients have been linked to cardiovascular diseases, but existing metrics do not capture the overall effect of diet on inflammatory diseases. The aim of this study was to examine the association between dietary inflammatory potential and cardiovascular diseases risk factors (CVD-RFs) in a nationally-representative sample of non-institutionalized US adults using data from the continuous National Health and Nutrition Examination Survey (NHANES) (2007-2012). A sample of 7880 non-institutionalized US adults aged ≥20years provided data on dietary habits and CVD-RFs (obesity; diabetes mellitus; hypertension; hypercholesterolemia). The total number of CVD-RFs was summed for each individual to create a CVD-RF morbidity index (range 0-4) as the outcome variable, used both as ordinal and dichotomous (no CVD-RFs versus at least one CVD-RF) variables. The association between the Dietary Inflammatory Index (DII) and at least one CVD-RF was dose-dependent, with participants in the 3rd and 4th quartile of DII (i.e., more pro-inflammatory dietary habits) being 1.37 (95%CI=1.11-1.68) and 1.50 (95%CI=1.19-1.90) times more likely, respectively, to have at least one CVD-RF, as compared to participants in the 1st quartile of DII scores. Similar results were obtained for the ordinal logistic regression using the CVD-RF morbidity index as the outcome. Among US adults aged ≥20years, pro-inflammatory dietary patterns, as assessed by the DII, were associated with increased odds for CVD-RFs. Dietary guidelines aimed at lowering the DII may reduce the CVD-RF burden in US adults. Copyright © 2017 Elsevier B.V. All rights reserved.

The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

Energy Technology Data Exchange (ETDEWEB)

Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

2014-09-15

Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

International Nuclear Information System (INIS)

Roman, M.; Skaane, P.; Hofvind, S.

2014-01-01

Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

Energy Technology Data Exchange (ETDEWEB)

Schenberg, Tess [Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mitchell, Gillian [Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia); Taylor, Donna [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); BreastScreen Western Australia, Adelaide Terrace, Perth, Western Australia (Australia); Saunders, Christobel [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of General Surgery, St John of God Hospital, Perth, Western Australia (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

2015-09-15

Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening.

MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

International Nuclear Information System (INIS)

Schenberg, Tess; Mitchell, Gillian; Taylor, Donna; Saunders, Christobel

2015-01-01

Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening

Oxidative Stress and Dietary Fat Type in Relation to Periodontal Disease

Directory of Open Access Journals (Sweden)

Alfonso Varela-López

2015-04-01

Full Text Available Oxidative stress is one of the main factors studied to explain the pathophysiological mechanisms of inflammatory conditions, such as periodontitis. In this respect, nutrition may be of great importance. Actually, research on nutrients’ effects on periodontal diseases has expanded to include those influencing the redox status, which correlates to the inflammatory process. Dietary fat or lipids are often blamed as the major source of excess energy. Consequently, when caloric intake exceeds energy expenditure, the resultant substrate-induced increase in citric acid cycle activity generates an excess of reactive oxygen species (ROS. In addition, dietary fatty acid intake influences in relative fatty acid composition of biological membranes determining its susceptibility to oxidative alterations. From this standpoint, here, we reviewed studies analyzing the dietary fat role in periodontal disease. Research data suggest that periodontal health could be achieved by main dietary strategies which include substitution of saturated fats with monounsaturated fatty acids (MUFA and polyunsaturated fatty acids (PUFA, particularly n-3 PUFA. Maybe in the future, we should analyze the diet and provide some advice to periodontitis patients to improve treatment outcomes.

Validity of Dietary Assessment in Athletes: A Systematic Review

Directory of Open Access Journals (Sweden)

Louise Capling

2017-12-01

Full Text Available Dietary assessment methods that are recognized as appropriate for the general population are usually applied in a similar manner to athletes, despite the knowledge that sport-specific factors can complicate assessment and impact accuracy in unique ways. As dietary assessment methods are used extensively within the field of sports nutrition, there is concern the validity of methodologies have not undergone more rigorous evaluation in this unique population sub-group. The purpose of this systematic review was to compare two or more methods of dietary assessment, including dietary intake measured against biomarkers or reference measures of energy expenditure, in athletes. Six electronic databases were searched for English-language, full-text articles published from January 1980 until June 2016. The search strategy combined the following keywords: diet, nutrition assessment, athlete, and validity; where the following outcomes are reported but not limited to: energy intake, macro and/or micronutrient intake, food intake, nutritional adequacy, diet quality, or nutritional status. Meta-analysis was performed on studies with sufficient methodological similarity, with between-group standardized mean differences (or effect size and 95% confidence intervals (CI being calculated. Of the 1624 studies identified, 18 were eligible for inclusion. Studies comparing self-reported energy intake (EI to energy expenditure assessed via doubly labelled water were grouped for comparison (n = 11 and demonstrated mean EI was under-estimated by 19% (−2793 ± 1134 kJ/day. Meta-analysis revealed a large pooled effect size of −1.006 (95% CI: −1.3 to −0.7; p < 0.001. The remaining studies (n = 7 compared a new dietary tool or instrument to a reference method(s (e.g., food record, 24-h dietary recall, biomarker as part of a validation study. This systematic review revealed there are limited robust studies evaluating dietary assessment methods in athletes. Existing

Modulation of Telomerase Activity in Cancer Cells by Dietary Compounds: A Review

Directory of Open Access Journals (Sweden)

Takahiro Eitsuka

2018-02-01

Full Text Available Telomerase is expressed in ~90% of human cancer cell lines and tumor specimens, whereas its enzymatic activity is not detectable in most human somatic cells, suggesting that telomerase represents a highly attractive target for selective cancer treatment. Accordingly, various classes of telomerase inhibitors have been screened and developed in recent years. We and other researchers have successfully found that some dietary compounds can modulate telomerase activity in cancer cells. Telomerase inhibitors derived from food are subdivided into two groups: one group directly blocks the enzymatic activity of telomerase (e.g., catechin and sulfoquinovosyldiacylglycerol, and the other downregulates the expression of human telomerase reverse transcriptase (hTERT, the catalytic subunit of human telomerase, via signal transduction pathways (e.g., retinoic acid and tocotrienol. In contrast, a few dietary components, including genistein and glycated lipid, induce cellular telomerase activity in several types of cancer cells, suggesting that they may be involved in tumor progression. This review summarizes the current knowledge about the effects of dietary factors on telomerase regulation in cancer cells and discusses their molecular mechanisms of action.

'Mediterranean' dietary pattern for the primary prevention of cardiovascular disease.

Science.gov (United States)

Rees, Karen; Hartley, Louise; Flowers, Nadine; Clarke, Aileen; Hooper, Lee; Thorogood, Margaret; Stranges, Saverio

2013-08-12

The Seven Countries study in the 1960s showed that populations in the Mediterranean region experienced lower cardiovascular disease (CVD) mortality probably as a result of different dietary patterns. Later observational studies have confirmed the benefits of adherence to a Mediterranean dietary pattern on CVD risk factors. Clinical trial evidence is limited, and is mostly in secondary prevention. To determine the effectiveness of a Mediterranean dietary pattern for the primary prevention of CVD. We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 9 of 12, September 2012); MEDLINE (Ovid, 1946 to October week 1 2012); EMBASE (Ovid, 1980 to 2012 week 41); ISI Web of Science (1970 to 16 October 2012); Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database and Health Economics Evaluations Database (Issue 3 of 12, September 2012). We searched trial registers and reference lists of reviews and applied no language restrictions. We selected randomised controlled trials in healthy adults and adults at high risk of CVD. A Mediterranean dietary pattern was defined as comprising at least two of the following components: (1) high monounsaturated/saturated fat ratio, (2) low to moderate red wine consumption, (3) high consumption of legumes, (4) high consumption of grains and cereals, (5) high consumption of fruits and vegetables, (6) low consumption of meat and meat products and increased consumption of fish, and (7) moderate consumption of milk and dairy products. The comparison group received either no intervention or minimal intervention. Outcomes included clinical events and CVD risk factors. Two review authors independently extracted data and contacted chief investigators to request additional relevant information. We included 11 trials (15 papers) (52,044 participants randomised). Trials were heterogeneous in the participants recruited, in the number of dietary components and

Teleophthalmology: improving patient outcomes?

Directory of Open Access Journals (Sweden)

Sreelatha OK

2016-02-01

Full Text Available Omana Kesary Sreelatha,1 Sathyamangalam VenkataSubbu Ramesh2 1Ophthalmology Department, Sultan Qaboos University Hospital, Muscat, Oman; 2Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, India Abstract: Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP. Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR, glaucoma, age-related macular degeneration (ARMD, and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time

Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-Analysis of Controlled Trials.

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Chiavaroli, Laura; Nishi, Stephanie K; Khan, Tauseef A; Braunstein, Catherine R; Glenn, Andrea J; Mejia, Sonia Blanco; Rahelić, Dario; Kahleová, Hana; Salas-Salvadó, Jordi; Jenkins, David J A; Kendall, Cyril W C; Sievenpiper, John L

2018-05-25

The evidence for the Portfolio dietary pattern, a plant-based dietary pattern that combines recognized cholesterol-lowering foods (nuts, plant protein, viscous fibre, plant sterols), has not been summarized. To update the European Association for the Study of Diabetes clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of controlled trials using GRADE of the effect of the Portfolio dietary pattern on the primary therapeutic lipid target for cardiovascular disease prevention, low-density lipoprotein cholesterol (LDL-C), and other established cardiometabolic risk factors. We searched MEDLINE, EMBASE, and The Cochrane Library through April 19, 2018. We included controlled trials ≥ 3-weeks assessing the effect of the Portfolio dietary pattern on cardiometabolic risk factors compared with an energy-matched control diet free of Portfolio dietary pattern components. Two independent reviewers extracted data and assessed risk of bias. The primary outcome was LDL-C. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 -statistic). GRADE assessed the certainty of the evidence. Eligibility criteria were met by 7 trial comparisons in 439 participants with hyperlipidemia, in which the Portfolio dietary pattern was given on a background of a National Cholesterol Education Program (NCEP) Step II diet. The combination of a portfolio dietary pattern and NCEP Step II diet significantly reduced the primary outcome LDL-C by ~17% (MD, -0.73mmol/L, [95% CI, -0.89 to -0.56 mmol/L]) as well as non-high-density lipoprotein cholesterol, apolipoprotein B, total cholesterol, triglycerides, systolic and diastolic blood pressure, C-reactive protein, and estimated 10-year coronary heart disease (CHD) risk, compared with an NCEP Step 2 diet alone (PPortfolio dietary pattern leads to clinically

DIETARY DIVERSITY AND ITS RELATIONSHIP WITH NUTRITIONAL STATUS AMONG ADOLESCENTS AND ADULTS IN RURAL INDIA.

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Nithya, D J; Bhavani, R V

2018-05-01

SummaryDietary diversity is associated with household or individual food availability and intake of nutrients from different food groups and is an important component of nutritional outcome. This study examined the Nutrient Adequacy Ratio (NAR) and the Mean Adequacy Ratio (MAR) of three dietary diversity indices and their relationship with the nutritional status of adolescents and adults in rural regions of two states in India, Wardha district in Maharashtra and Koraput district in Odisha, in 2014. Individual dietary diversity was calculated using 24-hour diet recall (FS24hr) data and household dietary diversity was measured with food frequency data using Berry's index (DDI) and food scores (FSFFQ). The nutritional status of individuals was assessed using anthropometric indices. The diets in both locations were cereal dominated. It was observed that 51% of adolescent boys and 27% of adolescent girls had 'thinness' and stunting. The prevalence of undernutrition was higher among adult women (48%) than adult men (36%). The mean diversity indices were FS24hr of 8, DDI of 89-90 and FSFFQ of 64-66 in the two locations. The FS24hr was found to be positively correlated with the NAR of all nutrients while DDI and FSFFQ were correlated with seven and six nutrients, respectively. The DDI and FS24hr showed an association with MAR if the two locations were combined together. Sensitivity and specificity analysis showed that FS24hr gave more true positives than false positives and the area under the Receiver Operating Characteristic curve was 0.68, implying that this measure truly differentiates individuals having low dietary diversity with low MAR from those with low dietary diversity and a high MAR. All three measures of dietary diversity showed a linear association with the nutritional outcomes of adults, while in the adolescent group only DDI showed a relationship. It is concluded that 24-hour diet recall is a good measure for studying the relationship between dietary

Impact of Prostatic-specific Antigen Threshold and Screening Interval in Prostate Cancer Screening Outcomes: Comparing the Swedish and Finnish European Randomised Study of Screening for Prostate Cancer Centres.

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Saarimäki, Lasse; Hugosson, Jonas; Tammela, Teuvo L; Carlsson, Sigrid; Talala, Kirsi; Auvinen, Anssi

2017-08-10

The European Randomised Study of Screening for Prostate Cancer trial has shown a 21% reduction in prostate cancer (PC) mortality with prostate-specific antigen (PSA)-based screening. Sweden used a 2-yr screening interval and showed a larger mortality reduction than Finland with a 4-yr interval and higher PSA cut-off. To evaluate the impact of screening interval and PSA cut-off on PC detection and mortality. We analysed the core age groups (55-69 yr at entry) of the Finnish (N=31 866) and Swedish (N=5901) screening arms at 13 yr and 16 yr of follow-up. Sweden used a screening interval of 2 yr and a PSA cut-off of 3.0ng/ml, while in Finland the screening interval was 4 yr and the PSA cut-off 4.0ng/ml (or PSA 3.0-3.9ng/ml with free PSAprostate-specific antigen threshold of 3ng/ml versus 4ng/ml or a screening interval of 2 yr instead of 4 yr is unlikely to explain the larger mortality reduction achieved in Sweden compared with Finland. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Colorectal Cancer in Iran: Molecular Epidemiology and Screening Strategies

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Roya Dolatkhah

2015-01-01

Full Text Available Purpose. The increasing incidence of colorectal cancer (CRC in the past three decades in Iran has made it a major public health burden. This study aimed to report its epidemiologic features, molecular genetic aspects, survival, heredity, and screening pattern in Iran. Methods. A comprehensive literature review was conducted to identify the relevant published articles. We used medical subject headings, including colorectal cancer, molecular genetics, KRAS and BRAF mutations, screening, survival, epidemiologic study, and Iran. Results. Age standardized incidence rate of Iranian CRCs was 11.6 and 10.5 for men and women, respectively. Overall five-year survival rate was 41%, and the proportion of CRC among the younger age group was higher than that of western countries. Depending on ethnicity, geographical region, dietary, and genetic predisposition, mutation genes were considerably diverse and distinct among CRCs across Iran. The high occurrence of CRC in records of relatives of CRC patients showed that family history of CRC was more common among young CRCs. Conclusion. Appropriate screening strategies for CRC which is amenable to early detection through screening, especially in relatives of CRCs, should be considered as the first step in CRC screening programs.

Colorectal Cancer in Iran: Molecular Epidemiology and Screening Strategies

International Nuclear Information System (INIS)

Dolatkhah, R.; Somi, M. H.; Dolatkhah, R.; Kermani, I. A.; Dastgiri, S.

2015-01-01

The increasing incidence of colorectal cancer (CRC) in the past three decades in Iran has made it a major public health burden. This study aimed to report its epidemiologic features, molecular genetic aspects, survival, heredity, and screening pattern in Iran. Methods. A comprehensive literature review was conducted to identify the relevant published articles. We used medical subject headings, including colorectal cancer, molecular genetics, KRAS and BRAF mutations, screening, survival, epidemiologic study, and Iran. Results. Age standardized incidence rate of Iranian CRCs was 11.6 and 10.5 for men and women, respectively. Overall five-year survival rate was 41%, and the proportion of CRC among the younger age group was higher than that of western countries. Depending on ethnicity, geographical region, dietary, and genetic predisposition, mutation genes were considerably diverse and distinct among CRCs across Iran. The high occurrence of CRC in records of relatives of CRC patients showed that family history of CRC was more common among young CRCs. Conclusion. Appropriate screening strategies for CRC which is amenable to early detection through screening, especially in relatives of CRCs, should be considered as the first step in CRC screening programs.

Effects of norm referent salience on young people's dietary orientation.

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Tarrant, Mark; Khan, Sammyh S; Qin, Qi

2015-02-01

We examined the effects of making salient different norm referents on young people's dietary orientation. Participants were exposed to a referent who was either of similar age to themselves or older before reporting their normative beliefs, attitudes and intentions concerning dietary behavior. As predicted, exposure to the older referent was associated with stronger perceptions that eating five portions of fruit and vegetables each day was normative. Compared to those exposed to the same-age referent, participants exposed to the older referent reported more positive attitudes towards eating "five-a-day" and stronger intentions to do so over the coming week. Referent salience was also associated with a behavioral outcome, with those participants exposed to the older referent more likely to take a piece of fruit upon completion of the study (OR: 4.97, 95% CI: 1.39-17.82). The implications of these findings for norms-based interventions for changing dietary behavior are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sex differences in macronutrient intake and adherence to dietary recommendations: findings from the UK Biobank

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Bennett, E; Peters, SAE; Woodward, M

2018-01-01

Objectives: To characterise sex differences in macronutrient intakes and adherence to dietary recommendations in the UK Biobank population. Design: Cross-sectional population-based study. Setting: UK Biobank Resource. Participants: 210 106 (52.5% women) individuals with data on dietary behaviour. Main outcome measures: Women-to-men mean differences in nutrient intake in grams and as a percentage of energy and women-to-men ORs in non-adherence, adjusting for age, socioeconomic ...

Dietary adherence in the Women's Health Initiative Dietary Modification Trial.

Science.gov (United States)

2004-04-01

This article describes adherence to a low-fat dietary pattern (less than 20% energy from fat, five or more fruit/vegetable and six or more grain servings daily) in Years 1 and 5 of the Women's Health Initiative Dietary Modification Trial, which was designed to examine the effects of a low-fat dietary pattern on risk of breast and colorectal cancers and other chronic diseases in postmenopausal women. Participants were randomly assigned to a low-fat dietary intervention arm (40%, n=19,542) or a usual diet control arm (60%, n=29,294). Women in the intervention arm completed 18 group sessions during the first year, followed by quarterly annual maintenance sessions. Adherence was assessed as control minus intervention (C-I) group differences in percent total energy from fat as estimated by a food frequency questionnaire. Based on these self-reported dietary data, mean C-I was 10.9 percentage points of energy from fat at Year 1, decreasing to 9.0 at Year 5. Factors associated with poorer adherence were being older, being African American or Hispanic (compared with white), having low income, and being obese. Group session attendance was strongly associated with better dietary adherence. There are many limitations of self-reported dietary data, particularly related to social desirability and intervention-associated bias. Nonetheless, these data indicate that long-term dietary change was achieved in this clinical trial setting and reinforce the potential of the ongoing trial to answer questions of public health importance.

Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia

DEFF Research Database (Denmark)

Killie, M K; Kjeldsen-Kragh, J; Husebekk, A

2007-01-01

OBJECTIVES: To estimate the costs and health consequences of three different screening strategies for neonatal alloimmune thrombocytopenia (NAIT). DESIGN: Cost-utility analysis on the basis of a decision tree that incorporates the relevant strategies and outcomes. SETTING: Three health regions......-4 weeks before term. Severely thrombocytopenic newborn were transfused immediately with compatible platelets. MAIN OUTCOME MEASUREMENTS: Quality-adjusted life years (QALYs) and costs. RESULTS: Compared with no screening, a programme of screening and subsequent treatment would generate between 210 and 230...... additional QALYs among 100,000 pregnant women, and at the same time, reduce health care costs by approximately 1.7 million euros. The sensitivity analyses indicate that screening is cost effective or even cost saving within a wide range of probabilities and costs. CONCLUSION: Our calculations indicate...

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

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Richard Lowry

2015-01-01

Full Text Available Background. Physical activity (PA, sedentary behaviors, and dietary behaviors are each associated with overweight and obesity among youth. However, the associations of PA and sedentary behaviors with dietary behaviors are complex and not well understood. Purpose. To describe the associations of PA and sedentary behaviors with dietary behaviors among a representative sample of US high school students. Methods. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS. Using logistic regression models which controlled for sex, race/ethnicity, grade, body weight status, and weight management goals, we compared dietary behaviors among students who did and did not meet national recommendations for PA and sedentary behaviors. Results. Students who participated in recommended levels of daily PA (DPA and muscle strengthening PA (MSPA were more likely than those who did not to eat fruits and vegetables. Students who exceeded recommended limits for television (TV and computer/video game (C/VG screen time were less likely than those who did not to consume fruits and vegetables and were more likely to consume fast food and sugar-sweetened beverages. Conclusions. Researchers may want to address PA, sedentary behaviors, and dietary behaviors jointly when developing health promotion and obesity prevention programs for youth.

Maternal Dietary Patterns and Practices and Birth Weight in Northern Ghana.

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Abdulai Abubakari

Full Text Available Adequate maternal nutrition is a key factor for achieving good pregnancy outcomes. Moreover, inadequate dietary intake during pregnancy is considered an important contributor to maternal malnutrition in developing countries. Although some studies have examined the effect of the entire diet on birth outcome, most studies have been very narrow because they considered the effect of single nutrient. The single nutrient approach is a major setback because usually several nutrient deficiencies are more likely to occur than single deficiencies especially in low-income settings.The main aim of this study was to investigate the association between maternal dietary patterns, and practices and birth weight in Northern Ghana.A facility-based cross-sectional survey was performed in two districts in the Northern Region of Ghana. The selected districts were the Tamale Metropolis and Savelugu-Nanton District. These districts were purposively sampled to represent a mix of urban, peri-urban and rural populations, therefore ensuring that the distribution in social groups of the study population was similar to the entire population of the region. In all, 578 mothers who were drawing antenatal and postnatal care services were interviewed using a questionnaire, which asked the mothers about their frequency of consumption of individual foods per week since they became pregnant or when they were pregnant.We determined dietary patterns by applying a factor analysis with a varimax rotation using STATA. Multivariate analysis was used to establish association between maternal factors and dietary patterns. Logistic regression was used to assess the association between dietary practices and patterns and birth weight.Women who ate outside the home twice a week (OR = 1.6 & 95% CI; 1.1-2.45, P; 0.017 and those who practiced 'pica' (OR = 1.7 & 95% CI; 1.16-2.75, P; 0.008 had increased odds for low birth. Two dietary patterns were identified-namely 'health conscious' and 'non

Maternal Dietary Patterns and Practices and Birth Weight in Northern Ghana.

Science.gov (United States)

Abubakari, Abdulai; Jahn, Albrecht

2016-01-01

Adequate maternal nutrition is a key factor for achieving good pregnancy outcomes. Moreover, inadequate dietary intake during pregnancy is considered an important contributor to maternal malnutrition in developing countries. Although some studies have examined the effect of the entire diet on birth outcome, most studies have been very narrow because they considered the effect of single nutrient. The single nutrient approach is a major setback because usually several nutrient deficiencies are more likely to occur than single deficiencies especially in low-income settings. The main aim of this study was to investigate the association between maternal dietary patterns, and practices and birth weight in Northern Ghana. A facility-based cross-sectional survey was performed in two districts in the Northern Region of Ghana. The selected districts were the Tamale Metropolis and Savelugu-Nanton District. These districts were purposively sampled to represent a mix of urban, peri-urban and rural populations, therefore ensuring that the distribution in social groups of the study population was similar to the entire population of the region. In all, 578 mothers who were drawing antenatal and postnatal care services were interviewed using a questionnaire, which asked the mothers about their frequency of consumption of individual foods per week since they became pregnant or when they were pregnant. We determined dietary patterns by applying a factor analysis with a varimax rotation using STATA. Multivariate analysis was used to establish association between maternal factors and dietary patterns. Logistic regression was used to assess the association between dietary practices and patterns and birth weight. Women who ate outside the home twice a week (OR = 1.6 & 95% CI; 1.1-2.45, P; 0.017) and those who practiced 'pica' (OR = 1.7 & 95% CI; 1.16-2.75, P; 0.008) had increased odds for low birth. Two dietary patterns were identified-namely 'health conscious' and 'non-health conscious

Genetic Variations as Modifying Factors to Dietary Zinc Requirements—A Systematic Review

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Kaitlin J. Day

2017-02-01

Full Text Available Due to reduced cost and accessibility, the use of genetic testing has appealed to health professionals for personalising nutrition advice. However, translation of the evidence linking polymorphisms, dietary requirements, and pathology risk proves to be challenging for nutrition and dietetic practitioners. Zinc status and polymorphisms of genes coding for zinc-transporters have been associated with chronic diseases. The present study aimed to systematically review the literature to assess whether recommendations for zinc intake could be made according to genotype. Eighteen studies investigating 31 Single Nucleotide Polymorphisms (SNPs in relation to zinc intake and/or status were identified. Five studies examined type 2 diabetes; zinc intake was found to interact independently with two polymorphisms in the zinc-transporter gene SLC30A8 to affect glucose metabolism indicators. While the outcomes were statistically significant, the small size of the effect and lack of replication raises issues regarding translation into nutrition and dietetic practice. Two studies assessed the relationship of polymorphisms and cognitive performance; seven studies assessed the association between a range of outcomes linked to chronic conditions in aging population; two papers described the analysis of the genetic contribution in determining zinc concentration in human milk; and two papers assessed zinc concentration in plasma without linking to clinical outcomes. The data extracted confirmed a connection between genetics and zinc requirements, although the direction and magnitude of the dietary modification for carriers of specific genotypes could not be defined. This study highlights the need to summarise nutrigenetics studies to enable health professionals to translate scientific evidence into dietary recommendations.

Utilization of Away-From-Home Food Establishments, Dietary Approaches to Stop Hypertension Dietary Pattern, and Obesity.

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Penney, Tarra L; Jones, Nicholas R V; Adams, Jean; Maguire, Eva R; Burgoine, Thomas; Monsivais, Pablo

2017-11-01

Eating meals away from home has been associated with the consumption of unhealthy foods and increased body weight. However, more rigorous assessment of the contribution of different types of away-from-home food establishments to overall diet quality and obesity is minimal. This study examined usage of these food establishments, accordance to the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and obesity status in a nationally representative sample of adults in the United Kingdom. A cross-sectional analysis of data from a national survey (N=2,083 aged ≥19 years, from 2008 to 2012) with dietary intake measured using a 4-day food diary, and height and weight measured objectively. Exposures included usage of (i.e., by proportion of energy) all away-from-home food establishments combined, and fast-food outlets, restaurants, and cafés separately. Outcomes included accordance with the DASH diet, and obesity status. Multivariable logistic regressions were conducted in 2016 to estimate associations between food establishments, diet quality, and obesity. People consuming a higher proportion of energy from any away-from-home food establishment had lower odds of DASH accordance (OR=0.45, 95% CI=0.31, 0.67) and increased odds of obesity (OR=1.48, 95% CI=1.10, 1.99). After adjustment, only use of fast-food outlets was significantly associated with lower odds of DASH accordance (OR=0.48, 95% CI=0.33, 0.69) and higher odds of obesity (OR=1.30, 95% CI=1.01, 1.69). Although a greater reliance on eating away-from-home is associated with less-healthy diets and obesity, dietary public health interventions that target these food establishments may be most effective if they focus on modifying the use of fast-food outlets. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Clinical and psychological effects of excessive screen time on children.

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Domingues-Montanari, Sophie

2017-04-01

Over recent years, screen time has become a more complicated concept, with an ever-expanding variety of electronic media devices available throughout the world. Television remains the predominant type of screen-based activity among children. However, computer use, video games and ownership of devices, such as tablets and smart phones, are occurring from an increasingly young age. Screen time, in particular, television viewing, has been negatively associated with the development of physical and cognitive abilities, and positively associated with obesity, sleep problems, depression and anxiety. The physiological mechanisms that underlie the adverse health outcomes related to screen time and the relative contributions of different types of screen and media content to specific health outcomes are unclear. This review discusses the positive and negative effects of screen time on the physiological and psychological development of children. Furthermore, recommendations are offered to parents and clinicians. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Do negative screening test results cause false reassurance? A systematic review.

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Cooper, Grace C; Harvie, Michelle N; French, David P

2017-11-01

It has been suggested that receiving a negative screening test result may cause false reassurance or have a 'certificate of health effect'. False reassurance in those receiving a negative screening test result may result in them wrongly believing themselves to be at lower risk of the disease, and consequently less likely to engage in health-related behaviours that would lower their risk. The present systematic review aimed to identify the evidence regarding false reassurance effects due to negative screening test results in adults (over 18 years) screened for the presence of a disease or its precursors, where disease or precursors are linked to lifestyle behaviours. MEDLINE and PsycINFO were searched for trials that compared a group who had received negative screening results to an unscreened control group. The following outcomes were considered as markers of false reassurance: perceived risk of disease; anxiety and worry about disease; health-related behaviours or intention to change health-related behaviours (i.e., smoking, diet, physical activity, and alcohol consumption); self-rated health status. Nine unique studies were identified, reporting 55 measures in relation to the outcomes considered. Outcomes were measured at various time points from immediately following screening to up to 11 years after screening. Despite considerable variation in outcome measures used and timing of measurements, effect sizes for comparisons between participants who received negative screening test results and control participants were typically small with few statistically significant differences. There was evidence of high risk of bias, and measures of behaviours employed were often not valid. The limited evidence base provided little evidence of false reassurance following a negative screening test results on any of four outcomes examined. False reassurance should not be considered a significant harm of screening, but further research is warranted. Statement of contribution

Clinical inquiries: which women should we screen for gestational diabetes mellitus?

Science.gov (United States)

Namak, Shahla; Lord, Richard W; Zolotor, Adam J; Kramer, Rochelle

2010-08-01

It's unclear which women we should screen. No randomized controlled trials (RCTs) demonstrate that either universal screening or risk factor screening for gestational diabetes mellitus (GDM) prevents maternal and fetal adverse outcomes. That said, the common practice of universal screening is more sensitive than screening based on risk factors. Historic risk factors are poor predictors of GDM in a current pregnancy.

Impact of technology on cytology outcome in cervical cancer screening of young and older women

DEFF Research Database (Denmark)

Rask, J; Lynge, E; Franzmann, M

2014-01-01

in a third laboratory using manually read conventional cytology continually. Data were collected from the Danish National Health Care Registers. For each laboratory, we compared proportions of abnormal cytology defined as atypical squamous cells of undetermined significance or worse (ASCUS+) by age......Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This population-based study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends...... and technology phase. The study included 489,960 cytological samples with no recent abnormality from women aged 23-59 years, routinely screened between 1998 and 2007. Implementation of SurePath liquid-based cytology (LBC) was followed by an increase in abnormal cytology in women aged 23-29 years from 4.6 to 6...

Accelerometer determined sedentary behavior and dietary quality among US adults.

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Shuval, Kerem; Nguyen, Binh T; Yaroch, Amy L; Drope, Jeffrey; Gabriel, Kelley Pettee

2015-09-01

Scant evidence exists pertaining to objectively measured sedentary time and dietary quality among adults. Therefore, we examined the relationships between sedentary time, physical activity, and dietary quality. Cross-sectional analyses of a 4,910 US adults from two cycles (2003-2006) of the National Health and Nutrition Examination Survey. The primary independent variables were sedentary time and physical activity (continuous and categorical), while the outcomes were overall dietary quality (Healthy Eating Index (HEI) 2010), fruit and vegetable scores, and empty caloric intake (kcal). Multivariable analyses revealed that a 1min increase in daily sedentary behavior was associated with a 0.2kcal decrease in empty calories (-0.18, 95% CI=-0.34, -0.03); however, sedentary time was not significantly related to overall dietary quality (HEI) and fruit and vegetable intake. In comparison, a 1min increase in daily moderate-to-vigorous intensity physical activity was related to a 0.1 higher HEI score (0.08, 95% CI=0.04, 0.11), a 0.01 higher fruit score (0.01, 95% CI=0.01, 0.02), and conversely a 1.3kcal decrease in empty calories (-1.35, 95% CI=-2.01, -0.69). In addition, meeting physical activity guidelines was associated with a 2.8 point higher HEI score (2.82, 95% CI=1.40, 4.25), a 0.5 point higher fruit score (0.51, 95% CI=0.31-0.71), and 37.4 fewer empty calories (-37.43, 95% CI=-64.86, -9.10). Physical activity is significantly related to better overall dietary quality, while sedentary behavior is not. Findings suggest the need to promote physical activity and encourage adherence to dietary guidelines jointly, whereas sedentary behavior and overall dietary quality might need to be targeted independently. Copyright © 2015 Elsevier Inc. All rights reserved.

Endomyocardial fibrosis in Sub Saharan Africa: The geographical origin, socioeconomic status, and dietary habits of cases reported in Yaounde, Cameroon

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David Chelo

2015-01-01

Conclusion : Apart from geographical similarities all patients of our series shared the same dietary habits. Our study was conducted in a hospital setting; therefore a screening of the disease in the whole national territory would enable a more reliable mapping.

Dietary Quality and Adherence to Dietary Recommendations in Patients Undergoing Hemodialysis.

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Luis, Desiree; Zlatkis, Karyn; Comenge, Beatriz; García, Zoraida; Navarro, Juan F; Lorenzo, Victor; Carrero, Juan Jesús

2016-05-01

The multiple dietary restrictions recommended to hemodialysis patients may be difficult to achieve and, at the same time, may result in nutritional deficiencies rendering a poor dietary quality. We here assess the dietary quality and adherence to renal-specific guideline recommendations among hemodialysis patients from a single center in Canary Islands, Spain. Cross-sectional study, including 91 patients undergoing maintenance hemodialysis. Clinical data and 3-day dietary records were collected. We compared patient's reported nutrients intake with guideline recommendations. We also evaluated their alignment with current American Heart Association dietary guidelines for cardiovascular prevention. Seventy-seven percent and 50% of patients consumed less than the recommended daily energy and protein, respectively. Although half of the patients met the recommendations for dietary fat intake, this was accounted by an excess of saturated fat in 92% of them. Only 22% consumed sufficient fiber. A very small proportion of patients (less than 50%) met the requirements for vitamins and other micronutrients. Insufficient dietary intake was observed in most patients for all vitamins except for cobalamin. Similarly, inadequate dietary intake was observed for many minerals, by both excess (phosphorus, calcium, sodium, and potassium) and defect (magnesium). Most patients met the recommendations for iron and zinc in their diets. A large proportion of hemodialysis patients at our center did not meet current renal-specific dietary recommendations. The quality of the diet was considered poor and proatherogenic according to American Heart Association guidelines. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital; Outcomes and ocular healthcare-seeking behaviours

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Ruhi A. Khan

2017-03-01

Full Text Available Objectives: This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. Methods: This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA. Results: A total of 150 nurses participated in the study (response rate: 30.0%. The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%, 32 (21.3% and 10 (6.7% nurses, respectively. A total of 58 nurses (38.7% failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%. With regards to regular eye checkups, 77 participants (51.3% reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each. Conclusion: A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.

Inadequate dietary calcium and vitamin D intakes in renal-transplant recipients in Ireland.

LENUS (Irish Health Repository)

Lynch, Irene T

2012-02-03

OBJECTIVE: To quantify the dietary calcium and vitamin D intake in adult renal-transplant recipients attending at a large teaching hospital in Ireland for follow-up. SETTING: Outpatient renal-transplant follow-up clinic. SUBJECTS: Fifty-nine adult renal transplant recipients (58% male) with a mean age of 46 years, a median transplant duration of 6 years, and a mean estimated glomerular filtration rate (eGFR) of 50 mL\\/min per 1.73 m2. Fifty-three percent were at National Kidney Foundation stage 3 chronic kidney disease, and 14% had stage 4 chronic kidney disease. INTERVENTION: This cross-sectional, observational study used a tailored food frequency questionnaire specific for calcium and vitamin D intake in Irish adults, which was completed during a face-to-face interview with each subject. MAIN OUTCOME MEASURE: The main outcome measure was the average daily dietary and supplemented calcium and vitamin D intake. RESULTS: The median interquartile range (IQR) dietary calcium intake was 820 mg\\/day (range, 576-1,177 mg\\/day), and was similar in men and women (recommended intake > or = 1,000 mg\\/day in adult men and nonmenopausal adult women, > or = 1,500 mg\\/day in menopausal women). Five participants received calcium supplementation. Overall, 59% of men and 64% of women had total calcium intakes below the recommended amounts. The median IQR estimated dietary vitamin D intake was 5.2 microg\\/day (range, 2.4-6.4 microg\\/day) in women, and 4.6 microg\\/day (range, 2.2-6.6 microg\\/day) in men (recommended intake, > or = 10 microg\\/day). Six subjects received vitamin D supplementation. Total vitamin D intakes were suboptimal in 91% of men and 87% of women. Dietary calcium and vitamin D intakes significantly correlated with each other, but neither was significantly related to eGFR category, and was similarly low in both presumed menopausal women and in the initial year posttransplantation. CONCLUSION: These findings suggest that dietary and total calcium and

Long-term dietary intervention trials: critical issues and challenges

Directory of Open Access Journals (Sweden)

Crichton Georgina E

2012-07-01

Full Text Available Abstract Background There are many challenges involved in running randomised controlled dietary intervention trials that investigate health outcomes. The aim of this paper was to evaluate the recruitment process, retention of participants and challenges faced in our dairy intervention trial, and to provide strategies to combat the difficulties of running long-term dietary intervention trials. Methods A 12-month, randomised, two-way crossover study was conducted in overweight adults with habitually low dairy food consumption to assess the effects of a high dairy intake (4 servings of reduced-fat dairy per day compared with a low dairy intake (1 serving of reduced-fat dairy per day on measures of cardiometabolic and cognitive health. On completion of the high dairy intake phase, each participant was interviewed about their experience in the trial and responses were used to evaluate the key issues for study participants. Results Although the recruitment target was achieved, high rates of attrition (49.3% and difficulties maintaining participant compliance (reported by 37.8% of participants were major threats to the viability of the study. Factors that contributed to the high attrition included inability to comply with the dietary requirements of the study protocol (27.0%, health problems or medication changes (24.3% and time commitment (10.8%. Conclusion Attrition and adherence to study requirements present challenges to trials requiring longer-term dietary change. Including a run-in period to further assess the motivation, commitment and availability of participants, maintaining regular contact with participants during control phases, minimising time commitment, providing flexibility with dietary requirements, facilitating positive experiences, and stringent monitoring of diet are some key recommendations for future dietary intervention trials. Trial registration Australia and New Zealand Clinical Trials Registry (ACTRN 12608000538347

Dietary Acculturation among Filipino Americans.

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Vargas, Persephone; Jurado, Leo-Felix

2015-12-22

Acculturation, the subsequent changes that occur in one culture after continuous first hand contact with another culture, impacts the dietary habits and health risks of individuals. This study examines the acculturation, dietary habits and anthropometric measurements in a sample of 210 first generation Filipino American immigrants in New Jersey (NJ). Acculturation was measured using the Short Acculturation Scale for Filipino Americans (ASASFA). Dietary acculturation was measured using the Dietary Acculturation Questionnaire for Filipino Americans (DAQFA) and dietary intake was determined using the Block's Brief Food Frequency Questionnaire (BFFQ). Anthropometric measurements were obtained including weight, height and waist circumference. Acculturation had a significant negative relationship with Filipino Dietary acculturation. Western dietary acculturation was significantly correlated with caloric intake (r(208) = 0.193, p Filipino dietary acculturation, dietary intake and anthropometric measurements. The results showed that Filipino American immigrants have increased risks including increased BMI, waist circumference and increased fat intake. Over all, this research highlighted some dietary changes and their effects on dietary intake and health status.

Effect of Dysphagia Screening Strategies on Clinical Outcomes After Stroke: A Systematic Review for the 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke.

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Smith, Eric E; Kent, David M; Bulsara, Ketan R; Leung, Lester Y; Lichtman, Judith H; Reeves, Mathew J; Towfighi, Amytis; Whiteley, William N; Zahuranec, Darin B

2018-03-01

Dysphagia screening protocols have been recommended to identify patients at risk for aspiration. The American Heart Association convened an evidence review committee to systematically review evidence for the effectiveness of dysphagia screening protocols to reduce the risk of pneumonia, death, or dependency after stroke. The Medline, Embase, and Cochrane databases were searched on November 1, 2016, to identify randomized controlled trials (RCTs) comparing dysphagia screening protocols or quality interventions with increased dysphagia screening rates and reporting outcomes of pneumonia, death, or dependency. Three RCTs were identified. One RCT found that a combined nursing quality improvement intervention targeting fever and glucose management and dysphagia screening reduced death and dependency but without reducing the pneumonia rate. Another RCT failed to find evidence that pneumonia rates were reduced by adding the cough reflex to routine dysphagia screening. A smaller RCT randomly assigned 2 hospital wards to a stroke care pathway including dysphagia screening or regular care and found that patients on the stroke care pathway were less likely to require intubation and mechanical ventilation; however, the study was small and at risk for bias. There were insufficient RCT data to determine the effect of dysphagia screening protocols on reducing the rates of pneumonia, death, or dependency after stroke. Additional trials are needed to compare the validity, feasibility, and clinical effectiveness of different screening methods for dysphagia. © 2018 American Heart Association, Inc.

Retrospective lifetime dietary patterns predict cognitive performance in community-dwelling older Australians.

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Hosking, Diane E; Nettelbeck, Ted; Wilson, Carlene; Danthiir, Vanessa

2014-07-28

Dietary intake is a modifiable exposure that may have an impact on cognitive outcomes in older age. The long-term aetiology of cognitive decline and dementia, however, suggests that the relevance of dietary intake extends across the lifetime. In the present study, we tested whether retrospective dietary patterns from the life periods of childhood, early adulthood, adulthood and middle age predicted cognitive performance in a cognitively healthy sample of 352 older Australian adults >65 years. Participants completed the Lifetime Diet Questionnaire and a battery of cognitive tests designed to comprehensively assess multiple cognitive domains. In separate regression models, lifetime dietary patterns were the predictors of cognitive factor scores representing ten constructs derived by confirmatory factor analysis of the cognitive test battery. All regression models were progressively adjusted for the potential confounders of current diet, age, sex, years of education, English as native language, smoking history, income level, apoE ɛ4 status, physical activity, other past dietary patterns and health-related variables. In the adjusted models, lifetime dietary patterns predicted cognitive performance in this sample of older adults. In models additionally adjusted for intake from the other life periods and mechanistic health-related variables, dietary patterns from the childhood period alone reached significance. Higher consumption of the 'coffee and high-sugar, high-fat extras' pattern predicted poorer performance on simple/choice reaction time, working memory, retrieval fluency, short-term memory and reasoning. The 'vegetable and non-processed' pattern negatively predicted simple/choice reaction time, and the 'traditional Australian' pattern positively predicted perceptual speed and retrieval fluency. Identifying early-life dietary antecedents of older-age cognitive performance contributes to formulating strategies for delaying or preventing cognitive decline.

Breast cancer screening-opportunistic use of registry and linked screening data for local evaluation.

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Roder, David; Farshid, Gelareh; Gill, Grantley; Kollias, Jim; Koczwara, Bogda; Karapetis, Chris; Adams, Jacqui; Joshi, Rohit; Keefe, Dorothy; Powell, Kate; Fusco, Kellie; Eckert, Marion; Buckley, Elizabeth; Beckmann, Kerri

2017-06-01

Screening has been found to reduce breast cancer mortality at a population level in Australia, but these studies did not address local settings where numbers of deaths would generally have been too low for evaluation. Clinicians, administrators, and consumer groups are also interested in local service outcomes. We therefore use more common prognostic and treatment measures and survivals to gain evidence of screening effects among patients attending 4 local hospitals for treatment. To compare prognostic, treatment, and survival measures by screening history to determine whether expected screening effects are occurring. Employing routine clinical registry and linked screening data to investigate associations of screening history with these measures, using unadjusted and adjusted analyses. Screened women had a 10-year survival from breast cancer of 92%, compared with 78% for unscreened women; and 79% of screened surgical cases had breast conserving surgery compared with 64% in unscreened women. Unadjusted analyses indicated that recently screened cases had earlier tumor node metastasis stages, smaller diameters, less nodal involvement, better tumor differentiation, more oestrogen and progesterone receptor positive lesions, more hormone therapy, and less chemotherapy. Radiotherapy tended to be more common in screening participants. More frequent use of adjunctive radiotherapy applied when breast conserving surgery was used. Results confirm the screening effects expected from the scientific literature and demonstrate the value of opportunistic use of available registry and linked screening data for indicating to local health administrations, practitioners, and consumers whether local screening services are having the effects expected. © 2016 John Wiley & Sons, Ltd.

Gastrointestinal symptoms and quality of life in screen-detected celiac disease.

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Paavola, Aku; Kurppa, Kalle; Ukkola, Anniina; Collin, Pekka; Lähdeaho, Marja-Leena; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri

2012-10-01

Active serological screening has proved an effective means of increasing the diagnostic rate in celiac disease. The effects of a long-term gluten-free diet on possible gastrointestinal symptoms and psychological well-being in screen-detected patients have nevertheless remained obscure. Abdominal symptoms and quality of life were measured in a large cohort of treated screen-detected celiac adults. Comparisons were made with corresponding symptom-detected patients and with non-celiac controls. Dietary adherence was assessed both by structured interview and by serological testing. In both screen- and symptom-detected celiac groups, 88% of the patients were adherent. On a diet, both screen- and symptom-detected patients reported significantly more gastrointestinal symptoms than non-celiac controls. Those screen-detected patients who reported having no symptoms at the time of diagnosis, also remained asymptomatic during the diet. Despite persistent symptoms, psychological well-being in screen-detected patients was comparable with that in non-celiac controls, whereas the symptom-detected patients showed lower quality of life. Long-term treated screen-detected celiac patients, especially women, suffer from gastrointestinal symptoms on a gluten free diet similarly to symptom-detected patients. However, despite a similar frequency of persistent symptoms, the quality of life was unimpaired in the screen found, but remained low in the symptom-detected group. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Dietary Habits and Health Related Behaviors in Iranian Children and Adolescents: The CASPIAN- IV Study

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Fatemeh Azizi-Soleiman

2016-07-01

Full Text Available Background: Obesity has a growing global epidemic with several risk factors including lifestyle habits, physical activity, and prolonged screen time. This study aimed to compare the dietary habits and self-reported health behaviors in a nationally representative sample of Iranian children and adolescents. Materials and Methods: This cross sectional nationwide study was conducted in the framework of the fourth survey of a national school-based surveillance program, entitled Childhood and Adolescence Surveillance and Prevention of Adult Non‑communicable disease (CASPIAN-IV Study. Participants were 14,880 students aged 6-18 years from 30 provinces in Iran. The World Health Organization- Global Student Health Survey questionnaire was utilized to assess their relationship with peers, body image, dietary, life-style and smoking habits, physical activity, and violence behaviors. Apart from the questionnaire, additional information on dietary habits was obtained as well. The Chi-square test and the student t-test were used to compare the groups. Results: Boys had higher proportions of obesity (P

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

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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

Dietary patterns and the risk of obesity, type 2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenerative diseases.

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Medina-Remón, Alexander; Kirwan, Richard; Lamuela-Raventós, Rosa M; Estruch, Ramón

2018-01-22

Diet and lifestyle play a significant role in the development chronic diseases; however the full complexity of this relationship is not yet understood. Dietary pattern investigation, which reflects the complexity of dietary intake, has emerged as an alternative and complementary approach for examining the association between diet and chronic diseases. Literature on this association has largely focused on individual nutrients, with conflicting outcomes, but individuals consume a combination of foods from many groups that form dietary patterns. Our objective was to systematically review the current findings on the effects of dietary patterns on chronic diseases. In this review, we describe and discuss the relationships between dietary patterns, such as the Mediterranean, the Dietary Approach to Stop Hypertension, Prudent, Seventh-day Adventists, and Western, with risk of obesity, type-2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenearive diseases. Evidence is increasing from both observational and clinical studies that plant-based dietary patterns, which are rich in fruits, vegetables, and whole grains, are valuable in preventing various chronic diseases, whereas a diet high in red and processed meat, refined grains and added sugar seems to increase said risk. Dietary pattern analysis might be especially valuable to the development and evaluation of food-based dietary guidelines.

Harmonization of Food-Frequency Questionnaires and Dietary Pattern Analysis in 4 Ethnically Diverse Birth Cohorts.

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de Souza, Russell J; Zulyniak, Michael A; Desai, Dipika; Shaikh, Mateen R; Campbell, Natalie C; Lefebvre, Diana L; Gupta, Milan; Wilson, Julie; Wahi, Gita; Atkinson, Stephanie A; Teo, Koon K; Subbarao, Padmaja; Becker, Allan B; Mandhane, Piushkumar J; Turvey, Stuart E; Sears, Malcolm R; Anand, Sonia S

2016-11-01

Canada is an ethnically diverse nation, which introduces challenges for health care providers tasked with providing evidence-based dietary advice. We aimed to harmonize food-frequency questionnaires (FFQs) across 4 birth cohorts of ethnically diverse pregnant women to derive robust dietary patterns to investigate maternal and newborn outcomes. The NutriGen Alliance comprises 4 prospective birth cohorts and includes 4880 Canadian mother-infant pairs of predominantly white European [CHILD (Canadian Healthy Infant Longitudinal Development) and FAMILY (Family Atherosclerosis Monitoring In earLY life)], South Asian [START (SouTh Asian birth cohoRT)-Canada], or Aboriginal [ABC (Aboriginal Birth Cohort)] origins. CHILD used a multiethnic FFQ based on a previously validated instrument designed by the Fred Hutchinson Cancer Research Center, whereas FAMILY, START, and ABC used questionnaires specifically designed for use in white European, South Asian, and Aboriginal people, respectively. The serving sizes and consumption frequencies of individual food items within the 4 FFQs were harmonized and aggregated into 36 common food groups. Principal components analysis was used to identify dietary patterns that were internally validated against self-reported vegetarian status and externally validated against a modified Alternative Healthy Eating Index (mAHEI). Three maternal dietary patterns were identified-"plant-based," "Western," and "health-conscious"-which collectively explained 29% of the total variability in eating habits observed in the NutriGen Alliance. These patterns were strongly associated with self-reported vegetarian status (OR: 3.85; 95% CI: 3.47, 4.29; r 2 = 0.30, P < 0.001; for a plant-based diet), and average adherence to the plant-based diet was higher in participants in the fourth quartile of the mAHEI than in the first quartile (mean difference: 46.1%; r 2 = 0.81, P < 0.001). Dietary data collected by using FFQs from ethnically diverse pregnant women can be

Abuse and Misuse of Selected Dietary Supplements Among Adolescents: a Look at Poison Center Data.

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Biggs, Jessica M; Morgan, Jill A; Lardieri, Allison B; Kishk, Omayma A; Klein-Schwartz, Wendy

2017-01-01

The use of dietary supplements has increased and is associated with adverse effects. Indications for use include recreation, body image concerns, mood enhancement, or control of medical conditions. The risk of adverse effects may be enhanced if agents are used improperly. The objective of this study was to determine the frequency of abuse and misuse of 4 dietary substances among adolescents reported nationally to poison centers. Secondary outcomes included an assessment of medical outcomes, clinical effects, location of treatments provided, and treatments administered. This descriptive retrospective review assessed data concerning the use of garcinia (Garcinia cambogia), guarana (Paullinia cupana), salvia (Salvia divinorum), and St John's wort (Hypericum perforatum) among adolescents reported nationally to poison centers from 2003 to 2014. Adolescents with a singlesubstance exposure to one of the substances of interest coded as intentional abuse or misuse were included. Poison center calls for drug information or those with unrelated clinical effects were excluded. Data were collected from the National Poison Data System. There were 84 cases: 7 cases of Garcinia cambogia, 28 Paullinia cupana, 23 Salvia divinorum, and 26 Hypericum perforatum. Garcinia cambogia was used more frequently by females (100% versus 0%), and Paullinia cupana and Salvia divinorum were used more frequently by males (61% versus 36% and 91% versus 9%, respectively). Abuse, driven by Salvia divinorum, was more common overall than misuse. Abuse was also more common among males than females (p <0.001). Use of these agents fluctuated over time. Overall, use trended down since 2010, except for Garcinia cambogia use. In 62 cases (73.8%), the medical outcome was minor or had no effect or was judged as nontoxic or minimally toxic. Clinical effects were most common with Paullinia cupana and Salvia divinorum. Treatment sites included emergency department (n = 33; 39.3%), non-healthcare facility (n = 24

Evidence-based medicine: the value of vision screening.

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Beauchamp, George R; Ellepola, Chalani; Beauchamp, Cynthia L

2010-01-01

To review the literature for evidence-based medicine (EBM), to assess the evidence for effectiveness of vision screening, and to propose moving toward value-based medicine (VBM) as a preferred basis for comparative effectiveness research. Literature based evidence is applied to five core questions concerning vision screening: (1) Is vision valuable (an inherent good)?; (2) Is screening effective (finding amblyopia)?; (3) What are the costs of screening?; (4) Is treatment effective?; and (5) Is amblyopia detection beneficial? Based on EBM literature and clinical experience, the answers to the five questions are: (1) yes; (2) based on literature, not definitively so; (3) relatively inexpensive, although some claim benefits for more expensive options such as mandatory exams; (4) yes, for compliant care, although treatment processes may have negative aspects such as "bullying"; and (5) economic productive values are likely very high, with returns of investment on the order of 10:1, while human value returns need further elucidation. Additional evidence is required to ascertain the degree to which vision screening is effective. The processes of screening are multiple, sequential, and complicated. The disease is complex, and good visual outcomes require compliance. The value of outcomes is appropriately analyzed in clinical, human, and economic terms.

Medical auditing of whole-breast screening ultrasonography.

Science.gov (United States)

Kim, Min Jung

2017-07-01

Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

Medical auditing of whole-breast screening ultrasonography

Energy Technology Data Exchange (ETDEWEB)

Kim, Min Jung [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2017-07-15

Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria.

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Rukuni, Ruramayi; Knight, Marian; Murphy, Michael F; Roberts, David; Stanworth, Simon J

2015-10-20

Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes. Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness. Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy. Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.

The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers.

LENUS (Irish Health Repository)

McGowan, Ciara A

2010-07-01

Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

Nutritional support and dietary interventions for women with polycystic ovary syndrome

Directory of Open Access Journals (Sweden)

Papavasiliou K

2017-09-01

Full Text Available Kleopatra Papavasiliou, Emilia Papakonstantinou Unit of Human Nutrition, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece Abstract: Polycystic ovary syndrome (PCOS is a common endocrine disorder in reproductive-aged women, which leads to reproductive, metabolic and hormonal abnormalities. Hyperinsulinemia, insulin resistance, androgen excess, ovulatory dysfunction, polycystic ovaries, gonadotropin abnormalities, obesity, adipose tissue dysfunction, difficulty to conceive and high-risk pregnancy are the most common PCOS-associated complications. The aim of this review was to describe and evaluate the effects of dietary interventions on PCOS-associated outcomes and to provide some evidence-based dietary advice for use in clinical practice. There is no optimal diet or macronutrient composition for PCOS. However, lifestyle modification, including a small-to-moderate weight loss of 5–10% (combined diet with regular physical activity with any dietary pattern of choice, depending on the individuals’ preferences, culture, habits and metabolic needs (ie, Mediterranean diet, Dietary Approaches to Stop Hypertension [DASH] diet or moderately low-carbohydrate diets [30–45% of energy], as well as alternative dietary interventions, including small, frequent meal (five to six meals daily consumption at regular times, with the majority of carbohydrates consumed at lunch time or equally distributed throughout the day, seems to offer the evidence-based first-line strategy for the management of PCOS symptoms and insulin resistance. No conclusions can be drawn at this time for high protein diets, polyunsaturated fatty acids or micronutrient supplementation. Keywords: nutrition, meal frequency, dietary strategies, insulin resistance 

Consensus on the guidelines for the dietary management of classical galactosemia.

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Kerckhove, Kristel Vande; Diels, Marianne; Vanhaesebrouck, Sigrid; Luyten, Karin; Pyck, Nancy; De Meyer, An; Van Driessche, Marleen; Robert, Martine; Corthouts, Karen; Caris, Ariane; Duchateau, Emilie; Dassy, Martine; Bihet, Genevieve

2015-02-01

Worldwide there is scientific discussion about the dietary management of galactosemia. The dietary management is very different in several countries among Europe, the US and Canada. The main points of discussion are related to the fact that i) despite a strict diet some patients still have poor outcomes; ii) there is lack of scientific knowledge about the role of endogenous production of galactose on disease evolution, with or without diet. The aim of the current work was the creation of a Belgian consensus on dietary guidelines for the management of galactosemia. A step-wise approach was used to achieve a consensus, including: a workshop, a Delphi round, discussion groups and a round table of different Belgian experts. The consensus is an agreement between strict guidelines (strict limitation of fruits, vegetables and soybean products/French guidelines) and the more liberal guidelines (comparable with a diet free of lactose/guidelines of UK and the Netherlands). The consensus document consists of different modules, including the medical context, the theoretical background of dietary guidelines and the age-specific practical dietary guidelines. A Belgian consensus on the guidelines for the dietary management of classical galactosemia was developed despite the uncertainties of the efficacy and practical application of these guidelines. The final consensus is based on scientific knowledge and practical agreement among experts. In the future, regular revision of the guidelines is recommended and a uniform European guideline is desirable. Copyright © 2014 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Quantifying the advantages and disadvantages of pre-placement genetic screening.

Science.gov (United States)

Palmer, K T; Poole, J; Rawbone, R G; Coggon, D

2004-05-01

Tests of genotype may enable workers at unusual risk of future ill-health to be identified. Using them to select for employment, however, entails gains and losses to employers and employees. Ensuring a fair balance between the rights and obligations of each group requires a value judgement, but the advantages and disadvantages to interested parties must first be quantified in a meaningful way. The purposes of pre-employment screening are reviewed, and several simple measures relevant to the separate interests of employers and job applicants proposed-number screened to prevent a single adverse outcome; number excluded to prevent a case; expected incidence of the adverse outcome in those excluded; and preventable fraction. The derivation of these measures is illustrated, and the factors that influence them (the prevalence of the prognostic trait, the relative risk that it carries for an adverse outcome, and the overall incidence of disease) are related algebraically and graphically, to aid judgement on the utility of screening under different circumstances. In sensitive areas such as genetic testing the onus should be on the employer to justify plans for pre-placement screening. Several quantitative measures can be used to inform the ethical and economic debate about screening and to evaluate alternative strategies for prevention.

Life Course Dietary Patterns and Bone Health in Later Life in a British Birth Cohort Study

Science.gov (United States)

Prentice, Ann; Kuh, Diana L; Adams, Judith E; Ambrosini, Gina L

2016-01-01

ABSTRACT Evidence for the contribution of individual foods and nutrients to bone health is weak. Few studies have considered hypothesis‐based dietary patterns and bone health. We investigated whether a protein‐calcium‐potassium–rich (PrCaK‐rich) dietary pattern over the adult life course, was positively associated with bone outcomes at 60 to 64 years of age. Diet diaries were collected at ages 36, 46, 53, and 60 to 64 years in 1263 participants (661 women) from the MRC National Survey of Health and Development. DXA and pQCT measurements were obtained at age 60 to 64 years, including size‐adjusted bone mineral content (SA‐BMC) and volumetric bone mineral density (vBMD). A food‐based dietary pattern best explaining dietary calcium, potassium, and protein intakes (g/1000 kcal) was identified using reduced rank regression. Dietary pattern Z‐scores were calculated for each individual, at each time point. Individual trajectories in dietary pattern Z‐scores were modeled to summarize changes in Z‐scores over the study period. Regression models examined associations between these trajectories and bone outcomes at age 60 to 64 years, adjusting for baseline dietary pattern Z‐score and other confounders. A consistent PrCaK‐rich dietary pattern was identified within the population, over time. Mean ± SD dietary pattern Z‐scores at age 36 years and age 60 to 64 years were –0.32 ± 0.97 and 2.2 ± 1.5 (women) and –0.35 ± 0.98 and 1.7 ± 1.6 (men), respectively. Mean trajectory in dietary pattern Z‐scores ± SD was 0.07 ± 0.02 units/year. Among women, a 0.02‐SD unit/year higher trajectory in dietary pattern Z‐score over time was associated with higher SA‐BMC (spine 1.40% [95% CI, 0.30 to 2.51]; hip 1.35% [95% CI, 0.48 to 2.23]), and vBMD (radius 1.81% [95% CI, 0.13 to 3.50]) at age 60 to 64 years. No statistically significant associations were found in men. During adulthood, an increasing score for a dietary

Depression screening among older adults attending low-vision rehabilitation and eye-care services: Characteristics of those who screen positive and client acceptability of screening.

Science.gov (United States)

Holloway, Edith E; Sturrock, Bonnie A; Lamoureux, Ecosse L; Keeffe, Jill E; Rees, Gwyneth

2015-12-01

To investigate characteristics associated with screening positive for depressive symptoms among older adults accessing low-vision rehabilitation and eye-care services and to determine client acceptability of depression screening using the Patient Health Questionnaire-2 (PHQ-2) in these settings. One-hundred and twenty-four older adults (mean = 77.02 years, SD = 9.12) attending low-vision rehabilitation and eye-care services across Australia were screened for depression and invited to complete a telephone-administered questionnaire to determine characteristics associated with depressive symptoms and client acceptability of screening in these settings. Thirty-seven per cent (n = 46/124) of participants screened positive for depressive symptoms, and the majority considered the new depression screening method to be a 'good idea' in vision services (85%). Severe vision loss (<6/60 in the better eye) was associated with an increased odds of screening positive for depressive symptoms (odds ratio 2.37; 95% confidence interval 1.08-6.70) even after adjusting for potential confounders. Participants who screened positive had a preference for 'talking' therapy or a combination of medication and 'talking therapy' delivered within their own home (73%) or via telephone (67%). The PHQ-2 appears to be an acceptable method for depression screening in eye-care settings among older adults. Targeted interventions that incorporate home-based or telephone delivered therapy sessions may improve outcomes for depression in this group. © 2014 ACOTA.

Acute phase nutritional screening tool associated with functional outcomes of hip fracture patients: A longitudinal study to compare MNA-SF, MUST, NRS-2002 and GNRI.

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Inoue, Tatsuro; Misu, Shogo; Tanaka, Toshiaki; Kakehi, Tetsuya; Ono, Rei

2018-02-15

Several hip fracture patients are malnourished, but no study has attempted to determine the optimal nutritional screening tool for predicting functional outcomes. We investigated the association between each nutritional status assessed by four nutritional screening tools at admission and functional outcomes during the postoperative acute phase in hip fracture patients. The Mini Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Score 2002 (NRS-2002) and the Geriatric Nutritional Risk Index (GNRI) were assessed at admission before surgery. We evaluated the motor domain of the functional independence measure (motor-FIM) score at discharge, efficiency on the motor-FIM (change in the motor-FIM score after postoperative rehabilitation divided by postoperative length of hospital stay), and 10-m walking speed at postoperative 14 days as functional outcomes. Two hundred and five patients (mean patient age, 83.5 ± 7.0 years; range, 65-100 years; 82% female) were included. The MNA-SF evaluation classified 56 patients as well-nourished, 103 as at risk of malnutrition and 46 as malnourished. The MUST evaluation classified 97 patients as low risk, 42 as medium risk and 66 as high risk. The NRS-2002 evaluation classified 89 patients as well-nourished, 69 as medium risk and 47 as nutritionally at risk. The GNRI evaluation classified 44 patients as no risk, 74 as low risk and 87 as a major risk. Multiple linear regression analysis revealed that MNA-SF had a significant association with discharge motor-FIM (well-nourished vs. at risk of malnutrition, standardised β = -0.06, p = 0.04; vs. malnourished, standardised β = -0.32, p hip fracture patients. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Early Detection and Screening for Breast Cancer.

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Coleman, Cathy

2017-05-01

To review the history, current status, and future trends related to breast cancer screening. Peer-reviewed articles, web sites, and textbooks. Breast cancer remains a complex, heterogeneous disease. Serial screening with mammography is the most effective method to detect early stage disease and decrease mortality. Although politics and economics may inhibit organized mammography screening programs in many countries, the judicious use of proficient clinical and self-breast examination can also identify small tumors leading to reduced morbidity. Oncology nurses have exciting opportunities to lead, facilitate, and advocate for delivery of high-quality screening services targeting individuals and communities. A practical approach is needed to translate the complexities and controversies surrounding breast cancer screening into improved care outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of radiographers’ mammography screen-reading accuracy in Australia

International Nuclear Information System (INIS)

Debono, Josephine C; Poulos, Ann E; Houssami, Nehmat; Turner, Robin M; Boyages, John

2015-01-01

This study aimed to evaluate the accuracy of radiographers’ screen-reading mammograms. Currently, radiologist workforce shortages may be compromising the BreastScreen Australia screening program goal to detect early breast cancer. The solution to a similar problem in the United Kingdom has successfully encouraged radiographers to take on the role as one of two screen-readers. Prior to consideration of this strategy in Australia, educational and experiential differences between radiographers in the United Kingdom and Australia emphasise the need for an investigation of Australian radiographers’ screen-reading accuracy. Ten radiographers employed by the Westmead Breast Cancer Institute with a range of radiographic (median = 28 years), mammographic (median = 13 years) and BreastScreen (median = 8 years) experience were recruited to blindly and independently screen-read an image test set of 500 mammograms, without formal training. The radiographers indicated the presence of an abnormality using BI-RADS®. Accuracy was determined by comparison with the gold standard of known outcomes of pathology results, interval matching and client 6-year follow-up. Individual sensitivity and specificity levels ranged between 76.0% and 92.0%, and 74.8% and 96.2% respectively. Pooled screen-reader accuracy across the radiographers estimated sensitivity as 82.2% and specificity as 89.5%. Areas under the reading operating characteristic curve ranged between 0.842 and 0.923. This sample of radiographers in an Australian setting have adequate accuracy levels when screen-reading mammograms. It is expected that with formal screen-reading training, accuracy levels will improve, and with support, radiographers have the potential to be one of the two screen-readers in the BreastScreen Australia program, contributing to timeliness and improved program outcomes

Evaluation of radiographers’ mammography screen-reading accuracy in Australia

Energy Technology Data Exchange (ETDEWEB)

Debono, Josephine C, E-mail: josephine.debono@bci.org.au [Westmead Breast Cancer Institute, Westmead, New South Wales (Australia); Poulos, Ann E [Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales (Australia); Houssami, Nehmat [Screening and Test Evaluation Program, School of Public Health (A27), Sydney Medical School, University of Sydney, Sydney, New South Wales (Australia); Turner, Robin M [School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales (Australia); Boyages, John [Macquarie University Cancer Institute, Macquarie University Hospital, Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales (Australia); Westmead Breast Cancer Institute, Westmead, New South Wales (Australia)

2015-03-15

This study aimed to evaluate the accuracy of radiographers’ screen-reading mammograms. Currently, radiologist workforce shortages may be compromising the BreastScreen Australia screening program goal to detect early breast cancer. The solution to a similar problem in the United Kingdom has successfully encouraged radiographers to take on the role as one of two screen-readers. Prior to consideration of this strategy in Australia, educational and experiential differences between radiographers in the United Kingdom and Australia emphasise the need for an investigation of Australian radiographers’ screen-reading accuracy. Ten radiographers employed by the Westmead Breast Cancer Institute with a range of radiographic (median = 28 years), mammographic (median = 13 years) and BreastScreen (median = 8 years) experience were recruited to blindly and independently screen-read an image test set of 500 mammograms, without formal training. The radiographers indicated the presence of an abnormality using BI-RADS®. Accuracy was determined by comparison with the gold standard of known outcomes of pathology results, interval matching and client 6-year follow-up. Individual sensitivity and specificity levels ranged between 76.0% and 92.0%, and 74.8% and 96.2% respectively. Pooled screen-reader accuracy across the radiographers estimated sensitivity as 82.2% and specificity as 89.5%. Areas under the reading operating characteristic curve ranged between 0.842 and 0.923. This sample of radiographers in an Australian setting have adequate accuracy levels when screen-reading mammograms. It is expected that with formal screen-reading training, accuracy levels will improve, and with support, radiographers have the potential to be one of the two screen-readers in the BreastScreen Australia program, contributing to timeliness and improved program outcomes.

Modeling Dynamic Food Choice Processes to Understand Dietary Intervention Effects.

Science.gov (United States)

Marcum, Christopher Steven; Goldring, Megan R; McBride, Colleen M; Persky, Susan

2018-02-17

Meal construction is largely governed by nonconscious and habit-based processes that can be represented as a collection of in dividual, micro-level food choices that eventually give rise to a final plate. Despite this, dietary behavior intervention research rarely captures these micro-level food choice processes, instead measuring outcomes at aggregated levels. This is due in part to a dearth of analytic techniques to model these dynamic time-series events. The current article addresses this limitation by applying a generalization of the relational event framework to model micro-level food choice behavior following an educational intervention. Relational event modeling was used to model the food choices that 221 mothers made for their child following receipt of an information-based intervention. Participants were randomized to receive either (a) control information; (b) childhood obesity risk information; (c) childhood obesity risk information plus a personalized family history-based risk estimate for their child. Participants then made food choices for their child in a virtual reality-based food buffet simulation. Micro-level aspects of the built environment, such as the ordering of each food in the buffet, were influential. Other dynamic processes such as choice inertia also influenced food selection. Among participants receiving the strongest intervention condition, choice inertia decreased and the overall rate of food selection increased. Modeling food selection processes can elucidate the points at which interventions exert their influence. Researchers can leverage these findings to gain insight into nonconscious and uncontrollable aspects of food selection that influence dietary outcomes, which can ultimately improve the design of dietary interventions.

Effect of gentamicin and levels of ambient sound on hearing screening outcomes in the neonatal intensive care unit: A pilot study.

Science.gov (United States)

Garinis, Angela C; Liao, Selena; Cross, Campbell P; Galati, Johnathan; Middaugh, Jessica L; Mace, Jess C; Wood, Anna-Marie; McEvoy, Lindsey; Moneta, Lauren; Lubianski, Troy; Coopersmith, Noe; Vigo, Nicholas; Hart, Christopher; Riddle, Artur; Ettinger, Olivia; Nold, Casey; Durham, Heather; MacArthur, Carol; McEvoy, Cynthia; Steyger, Peter S

2017-06-01

Hearing loss rates in infants admitted to neonatal intensive care units (NICU) run at 2-15%, compared to 0.3% in full-term births. The etiology of this difference remains poorly understood. We examined whether the level of ambient sound and/or cumulative gentamicin (an aminoglycoside) exposure affect NICU hearing screening results, as either exposure can cause acquired, permanent hearing loss. We hypothesized that higher levels of ambient sound in the NICU, and/or gentamicin dosing, increase the risk of referral on the distortion product otoacoustic emission (DPOAE) assessments and/or automated auditory brainstem response (AABR) screens. This was a prospective pilot outcomes study of 82 infants (4172 Hz) was 44%. DPOAE referrals were significantly greater for infants receiving >2 days of gentamicin dosing compared to fewer doses (p = 0.004). The effect of sound exposure and gentamicin treatment on hearing could not be determined due to the low number of NICU infants without gentamicin exposure (for control comparisons). All infants were exposed to higher levels of ambient sound that substantially exceed AAP guidelines. More referrals were generated by DPOAE assessments than with AABR screens, with significantly more DPOAE referrals with a high-frequency F2 range, consistent with sound- and/or gentamicin-induced cochlear dysfunction. Adding higher frequency DPOAE assessments to existing NICU hearing screening protocols could better identify infants at-risk for ototoxicity. Copyright © 2017 Elsevier B.V. All rights reserved.

Dietary cyanogen exposure and early child neurodevelopment: An observational study from the Democratic Republic of Congo.

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Kashala-Abotnes, Espérance; Sombo, Marie-Thérèse; Okitundu, Daniel L; Kunyu, Marcel; Bumoko Makila-Mabe, Guy; Tylleskär, Thorkild; Sikorskii, Alla; Banea, Jean-Pierre; Mumba Ngoyi, Dieudonné; Tshala-Katumbay, Désiré; Boivin, Michael J

2018-01-01

Dietary cyanogen exposure from ingesting bitter (toxic) cassava as a main source of food in sub-Saharan Africa is related to neurological impairments in sub-Saharan Africa. We explored possible association with early child neurodevelopmental outcomes. We undertook a cross-sectional neurodevelopmental assessment of 12-48 month-old children using the Mullen Scale of Early Learning (MSEL) and the Gensini Gavito Scale (GGS). We used the Hopkins Symptoms Checklist-10 (HSCL-10) and Goldberg Depression Anxiety Scale (GDAS) to screen for symptoms of maternal depression-anxiety. We used the cyanogen content in household cassava flour and urinary thiocyanate (SCN) as biomarkers of dietary cyanogen exposure. We employed multivariable generalized linear models (GLM) with Gamma link function to determine predictors of early child neurodevelopmental outcomes. The mean (SD) and median (IQR) of cyanogen content of cassava household flour were above the WHO cut-off points of 10 ppm (52.18 [32·79]) and 50 (30-50) ppm, respectively. Mean (SD) urinary levels of thiocyanate and median (IQR) were respectively 817·81 (474·59) and 688 (344-1032) μmole/l in mothers, and 617·49 (449·48) and 688 (344-688) μmole/l in children reflecting individual high levels as well as a community-wide cyanogenic exposure. The concentration of cyanide in cassava flour was significantly associated with early child neurodevelopment, motor development and cognitive ability as indicated by univariable linear regression (p child neurodevelopment remained the main predictors associated with the concentration of cyanide in cassava flour: coefficients of -0·08 to -.15 (p child linear growth, early child neurodevelopment, cognitive ability and motor development at both univariable and multivariable linear regression analyses coefficients of 1.44 to 7.31 (p early child neurodevelopment, cognitive abilities and motor development, even in the absence of clinically evident paralysis. There is a need for community

The 2015 Dietary Guidelines Advisory Committee Scientific Report: Development and Major Conclusions.

Science.gov (United States)

Millen, Barbara E; Abrams, Steve; Adams-Campbell, Lucile; Anderson, Cheryl Am; Brenna, J Thomas; Campbell, Wayne W; Clinton, Steven; Hu, Frank; Nelson, Miriam; Neuhouser, Marian L; Perez-Escamilla, Rafael; Siega-Riz, Anna Maria; Story, Mary; Lichtenstein, Alice H

2016-05-01

The Dietary Guidelines for Americans (DGA) is published every 5 y jointly by the Department of Health and Human Services (HHS) and the USDA and provides a framework for US-based food and nutrition programs, health promotion and disease prevention initiatives, and research priorities. Summarized in this report are the methods, major conclusions, and recommendations of the Scientific Report of the 2015 US Dietary Guidelines Advisory Committee (DGAC). Early in the process, the DGAC developed a conceptual model and formulated questions to examine nutritional risk and determinants and impact of dietary patterns in relation to numerous health outcomes among individuals aged ≥2 y. As detailed in the report, an expansive, transparent, and comprehensive process was used to address each question, with multiple opportunities for public input included. Consensus was reached on all DGAC's findings, including each conclusion and recommendation, and the entire report. When research questions were answered by original systematic literature reviews and/or with existing, high-quality expert reports, the quality and strength of the evidence was formally graded. The report was organized around the following 5 themes: 1) food and nutrient intakes and health: current status and trends; 2) dietary patterns, foods and nutrients, and health outcomes; 3) diet and physical activity behavior change; 4) food and physical activity environments; and 5) food sustainability and food safety. The following 3 cross-cutting topics were addressed: 1) sodium, 2) saturated fat, and 3) added sugars. Physical activity recommendations from recent expert reports were endorsed. The overall quality of the American diet was assessed to identify overconsumed and underconsumed nutrients of public health concern. Common food characteristics of healthy dietary patterns were determined. Features of effective interventions to change individual and population diet and physical activity behaviors in clinical, public

Assessment of dietary intake among pregnant women in a rural area of western China

Directory of Open Access Journals (Sweden)

Zhang Xueli

2009-07-01

Full Text Available Abstract Background Adequate maternal nutrient intake during pregnancy is important to ensure satisfactory birth outcomes. There are no data available on the usual dietary intake among pregnant women in rural China. The present study describes and evaluates the dietary intake in a cohort of pregnant women living in two counties of rural Shaanxi, western China. Methods 1420 pregnant women were recruited from a trial that examined the effects of micronutrient supplementation on birth outcomes. Dietary information was collected at the end of their trimester or after delivery with an interviewed-administrated semi-quantitative food frequency questionnaire (FFQ. Nutrients intake was calculated from the FFQ and compared to the Estimated Average Requirements (EAR. The EAR cut-offs based on the Chinese Nutrition Society Dietary Reference Intakes (DRIs were used to assess the prevalence of inadequate dietary intakes of energy, protein, calcium, zinc, riboflavin, vitamin C and folate. Mann-Whitney U and Kruskal Wallis tests were used to compare nutrient intakes across subgroups. Results The mean nutrient intakes assessed by the FFQ was similar to those reported in the 2002 Chinese National Nutrition and Health Survey from women living in rural areas except for low intakes of protein, fat, iron and zinc. Of the participants, 54% were at risk of inadequate intake of energy. There were high proportions of pregnant women who did not have adequate intakes of folate (97% and zinc (91%. Using the "probability approach", 64% of subjects had an inadequate consumption of iron. Conclusion These results reveal that the majority of pregnant women in these two counties had low intakes of nutrients that are essential for pregnancy such as iron and folate. Trial registration ISRCTN08850194.

Determinants of parental satisfaction with ultrasound hip screening in child health care.

Science.gov (United States)

Witting, Marjon; Boere-Boonekamp, Magda M; Fleuren, Margot A H; Sakkers, Ralph J B; Ijzerman, Maarten J

2012-06-01

Prior research has shown ultrasound (US) screening for developmental dysplasia of the hip (DDH) in preventive child health care to be more effective than the current screening method. In the present study, 3-month-old infants were screened for DDH with US. The objective of this study was to examine parental satisfaction with the screening and determinants that affect satisfaction. Parental satisfaction was measured using a questionnaire. Independent variables included socio-demographic determinants, structure, process and outcome-related determinants and the meeting of expectations. Satisfaction with the screening was high. Parents who perceived the screener as competent, had enough time to ask questions, perceived the proceeding as fluent, perceived a low burden on their infant and whose expectations were met, were more likely to be satisfied. Satisfaction was influenced by process-related factors and not by factors related to the structure and the outcome of the screening. Good information provision before the screening and communication during the screening are means by which parental satisfaction can be influenced positively.

Nudging in screening: Literature review and ethical guidance.

Science.gov (United States)

Hofmann, Bjørn; Stanak, Michal

2018-03-27

Nudging is the purposeful alteration of choices presented to people that aims to make them choose in predicted ways. While nudging has been used to assure high uptake and good outcome of screening programs, it has been criticized for being paternalistic, undermining free choice, and shared decision making. Accordingly, the objective of this study is to explore a) nudging strategies identified in screening, b) arguments for and against nudging; and on basis of this, to c) suggest a tentative conclusion on how to handle nudging in screening. Literature searches in Ovid MEDLINE and PsycINFO for combinations of screening and nudging. Screening based on content analysis of titles, abstracts, and articles. 239 references were identified and 109 were included. Several forms of nudging were identified: framed information, default bias, or authority bias. Uptake and public health outcome were the most important goals. Arguments for nudging were bounded rationality, unavoidability, and beneficence, while lack of transparency, crowding out of intrinsic values, and paternalism were arguments against it. The analysis indicates that nudging can be acceptable for screenings with (high quality) evidence for high benefit-harm ratio (beneficence), where nudging does not infringe other ethical principles, such as justice and non-maleficence. In particular, nudging should not only focus on attendance rates, but also on making people "better choosers." Four specific recommendations follow from the review and the analysis: 1) Nudging should be addressed in an explicit and transparent manner. 2) The means of nudging have to be in proportion to the benefit-harm ratio. 3) Disagreement on the evidence for either benefits or harms warrants special care. 4) Assessing and assuring the intended outcome of nudging appears to be crucial, as it can be context dependent. Copyright © 2018 Elsevier B.V. All rights reserved.

Capturing health and eating status through a nutritional perception screening questionnaire (NPSQ9) in a randomised internet-based personalised nutrition intervention: the Food4Me study.

Science.gov (United States)

San-Cristobal, Rodrigo; Navas-Carretero, Santiago; Celis-Morales, Carlos; Livingstone, Katherine M; Stewart-Knox, Barbara; Rankin, Audrey; Macready, Anna L; Fallaize, Rosalind; O'Donovan, Clare B; Forster, Hannah; Woolhead, Clara; Walsh, Marianne C; Lambrinou, Christina P; Moschonis, George; Manios, Yannis; Jarosz, Miroslaw; Daniel, Hannelore; Gibney, Eileen R; Brennan, Lorraine; Gundersen, Thomas E; Drevon, Christian A; Gibney, Mike; Marsaux, Cyril F M; Saris, Wim H M; Lovegrove, Julie A; Frewer, Lynn J; Mathers, John C; Martinez, J Alfredo

2017-12-11

National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β = -0.181, p nutritional status and to tailor nutritional advice. NCT01530139 .

Dietary Patterns in Relation to General and Central Obesity among Adults in Southwest China.

Science.gov (United States)

Zhang, Qiang; Chen, Xinguang; Liu, Zhitao; Varma, Deepthi S; Wan, Rong; Wan, Qingqing; Zhao, Shiwen

2016-11-03

Dietary patterns represent a broader picture of food consumption, and are better correlated with a variety of health outcomes. However, few studies have been conducted to explore the associations between dietary patterns and obesity in Southwest China. Data from the 2010-2012 National Nutrition Survey in the province of Yunnan, Southwest China, were analyzed ( n = 1604, aged 18-80 years). Dietary data were collected using the 24 h dietary recall over three consecutive days. Height, weight, and waist circumference were measured following standard methods. Exploratory factor analysis was used to identify dietary patterns. Logistic regression was used to explore the association between dietary patterns and obesity. Three distinct dietary patterns were identified, which were labeled as traditional, modern, and tuber according to their key components. With potential confounders adjusted, adults in the highest quartile of the modern pattern were at higher risk of general and central obesity (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15-3.48; OR 2.01, 95% CI 1.37-2.93). In contrast, adults in the highest quartile of the tuber pattern were at lower risk of general and central obesity (OR 0.34, 95% CI 0.15-0.61; OR 0.64, 95% CI 0.43-0.95) but at higher risk of underweight (OR 2.57, 95% CI 1.20-6.45). No significant association was found between the traditional pattern and obesity. Moreover, dietary pattern differences occurred due to the differences in socio-demographic characteristics. In conclusion, the modern dietary pattern was positively, and the tuber pattern negatively, associated with general and central obesity among adults in Southwest China.

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.

Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial.

Science.gov (United States)

Arnsrud Godtman, Rebecka; Holmberg, Erik; Lilja, Hans; Stranne, Johan; Hugosson, Jonas

2015-09-01

It has been shown that organized screening decreases prostate cancer (PC) mortality, but the effect of opportunistic screening is largely unknown. To compare the ability to reduce PC mortality and the risk of overdiagnosis between organized and opportunistic screening. The Göteborg screening study invited 10 000 randomly selected men for prostate-specific antigen (PSA) testing every 2 yr since 1995, with a prostate biopsy recommended for men with PSA ≥2.5 ng/ml. The control group of 10 000 men not invited has been exposed to a previously reported increased rate of opportunistic PSA testing. Both groups were followed until December 31, 2012. Observed cumulative PC incidence and mortality rates in both groups were calculated using the actuarial method. Using historical data from 1990-1994 (pre-PSA era), we calculated expected PC incidence and mortality rates in the absence of any PSA testing. The number needed to invite (NNI) and the number needed to diagnose (NND) were calculated by comparing the expected versus observed incidence and mortality rates. At 18 yr, 1396 men were diagnosed with PC and 79 men died of PC in the screening group, compared to 962 and 122, respectively, in the control group. In the screening group, the observed cumulative PC incidence/mortality was 16%/0.98% compared to expected values of 6.8%/1.7%. The corresponding values for the control group were 11%/1.5% and 6.9%/1.7%. Organized screening was associated with an absolute PC-specific mortality reduction of 0.72% (95% confidence interval [CI] 0.50-0.94%) and relative risk reduction of 42% (95% CI 28-54%). There was an absolute reduction in PC deaths of 0.20% (95% CI -0.06% to 0.47%) and a relative risk reduction of 12% (95% CI -5 to 26%) associated with opportunistic PSA testing. NNI and NND were 139 (95% CI 107-200) and 13 for organized biennial screening and 493 (95% CI 213- -1563) and 23 for opportunistic screening. The extent of opportunistic screening could not be measured

Risk of breast cancer after false-positive test results in screening mammography

DEFF Research Database (Denmark)

von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen

2012-01-01

Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests...

Dietary Acculturation among Filipino Americans

Directory of Open Access Journals (Sweden)

Persephone Vargas

2015-12-01

Full Text Available Acculturation, the subsequent changes that occur in one culture after continuous first hand contact with another culture, impacts the dietary habits and health risks of individuals. This study examines the acculturation, dietary habits and anthropometric measurements in a sample of 210 first generation Filipino American immigrants in New Jersey (NJ. Acculturation was measured using the Short Acculturation Scale for Filipino Americans (ASASFA. Dietary acculturation was measured using the Dietary Acculturation Questionnaire for Filipino Americans (DAQFA and dietary intake was determined using the Block’s Brief Food Frequency Questionnaire (BFFQ. Anthropometric measurements were obtained including weight, height and waist circumference. Acculturation had a significant negative relationship with Filipino Dietary acculturation. Western dietary acculturation was significantly correlated with caloric intake (r(208 = 0.193, p < 0.01, percentage fat intake (r(208 = 0.154, p < 0.05, percentage carbohydrate intake (r(208 = −0.172, p < 0.05, Body Mass Index (BMI (r(208 = 0.216, p < 0.01 and waist circumference (r(208 = 0.161, p < 0.01. There was no significant correlation between Filipino dietary acculturation, dietary intake and anthropometric measurements. The results showed that Filipino American immigrants have increased risks including increased BMI, waist circumference and increased fat intake. Over all, this research highlighted some dietary changes and their effects on dietary intake and health status.

A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent type 2 diabetes in India-Outcome of screening.

Science.gov (United States)

Priscilla, Susairaj; Nanditha, Arun; Simon, Mary; Satheesh, Krishnamoorthy; Kumar, Sathish; Shetty, Ananth Samith; Snehalatha, Chamukuttan; Johnston, Desmond G; Godsland, Ian F; Wareham, Nicholas J; Ramachandran, Ambady

2015-12-01

We describe a two-step screening approach using non-invasive risk assessment and glycated hemoglobin (HbA1c) to identify participants for a diabetes prevention trial. A total of 6030 non-diabetic persons of 35-55 years were screened using risk assessment for diabetes. Those with three or more risk factors were screened using point of care HbA1c test. For this study, participants in HbA1c categories of 6.0% (42.1 mmol/mol)-6.4% (46.4 mmol/mol) were selected and their characteristics were analyzed. Among 6030 persons, 2835 (47%) had three or more risk factors for diabetes. Among those screened with HbA1c, 43.2% (1225) had HbA1c values of <6.0% (42.1 mmol/mol), 46.8% (1327) had HbA1c values between 6.0% (42.1 mmol/mol) and ≤ 6.4% (46.4 mmol/mol) and 10% (283) had undiagnosed diabetes with ≥6.5% (47.5 mmol/mol). Positive family history was present in 53.2%, 81.7% were obese and 14.8% were overweight. Opportunistic screening using a two-step approach: diabetes risk profile and HbA1c measurement detected a large percentage of individuals with prediabetes. Prediabetic persons recruited to the trial had higher percentage of obesity and presence of positive family history than those who had lower HbA1c values. Outcomes from this trial will enable comparisons with the previous prevention studies that used blood glucose levels as the screening criteria. Copyright © 2015. Published by Elsevier Ireland Ltd.

Providing information about prenatal screening for Down syndrome

DEFF Research Database (Denmark)

Skjøth, Mette Maria; Draborg, Eva; Pedersen, Claus Duedal

2015-01-01

BACKGROUND: In recent decades there have been advances in the options for prenatal screening. Screening programmes for Down syndrome are well established in many countries. It is important that pregnant women are well informed about the benefits and risks of screening. A variety of interventions...... screening for Down syndrome. DESIGN: SYSTEMATIC REVIEW: METHODS: A systematic search was performed using the PUBMED and EMBASE databases. The search terms included MeSH terms and free text and were combined by Boolean terms (AND, OR) with no restriction on language or time. MAIN OUTCOME MEASURES: Main...... information about prenatal screening for Down syndrome can improve their ability to make an informed choice. This article is protected by copyright. All rights reserved....

Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement

OpenAIRE

Matthew Butawan; Rodney L. Benjamin; Richard J. Bloomer

2017-01-01

Methylsulfonylmethane (MSM) has become a popular dietary supplement used for a variety of purposes, including its most common use as an anti-inflammatory agent. It has been well-investigated in animal models, as well as in human clinical trials and experiments. A variety of health-specific outcome measures are improved with MSM supplementation, including inflammation, joint/muscle pain, oxidative stress, and antioxidant capacity. Initial evidence is available regarding the dose of MSM needed ...

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...

Investigating outcomes in the management of hypertension by ...

African Journals Online (AJOL)

Most of the persisting risk factors are related to behavioural and dietary practices among hypertensive subjects. Findings have implications for periodic clinical audit as a strategy for clinical governance and quality improvement. Keywords: clinical audit, outcome, hypertension management, specialist clinic, UPTH, Nigeria ...

Post-up study : Postpartum depression screening in well-child care and maternal outcomes

NARCIS (Netherlands)

Van Der Zee-Van Den Berg, Angarath I.; Boere-Boonekamp, Magda M.; Groothuis-Oudshoorn, Catharina G.M.; IJzerman, Maarten J.; Haasnoot-Smallegange, Riet M.E.; Reijneveld, Sijmen A.

2017-01-01

OBJECTIVES: Postpartum depression often remains unaddressed. Screening in well-child care (WCC) may improve early detection, promote maternal recovery, and reduce effects on child development. We assessed the effectiveness of screening for postpartum depression in WCC compared with care as usual

Post-Up Study : Postpartum Depression Screening in Well-Child Care and Maternal Outcomes

NARCIS (Netherlands)

van der Zee-van den Berg, Angarath I; Boere-Boonekamp, Magda M; Groothuis-Oudshoorn, Catharina G M; IJzerman, Maarten J; Haasnoot-Smallegange, Riet M E; Reijneveld, Sijmen A

2017-01-01

OBJECTIVES: Postpartum depression often remains unaddressed. Screening in well-child care (WCC) may improve early detection, promote maternal recovery, and reduce effects on child development. We assessed the effectiveness of screening for postpartum depression in WCC compared with care as usual

Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis.

Science.gov (United States)

Carlsson, Sigrid V; de Carvalho, Tiago M; Roobol, Monique J; Hugosson, Jonas; Auvinen, Anssi; Kwiatkowski, Maciej; Villers, Arnauld; Zappa, Marco; Nelen, Vera; Páez, Alvaro; Eastham, James A; Lilja, Hans; de Koning, Harry J; Vickers, Andrew J; Heijnsdijk, Eveline A M

2016-11-15

Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus "good practice." Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386-3393. © 2016 American Cancer Society. © 2016 American Cancer Society.

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial.

Science.gov (United States)

Fulkerson, Jayne A; Friend, Sarah; Horning, Melissa; Flattum, Colleen; Draxten, Michelle; Neumark-Sztainer, Dianne; Gurvich, Olga; Garwick, Ann; Story, Mary; Kubik, Martha Y

2018-02-01

Research has demonstrated a significant positive association between frequent family meals and children's dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial. To describe family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment Plus program, the first rigorously tested family meals intervention targeting childhood obesity prevention. Randomized controlled trial. Baseline, postintervention (12 months, 93% retention), and follow-up (21 months, 89% retention) data (surveys and dietary recalls) were collected. Children aged 8 to 12 years (N=160) and their parents were randomized to intervention (n=81) or control (n=79) groups. The intervention included five parent goal-setting calls and 10 monthly sessions delivered to families in community settings that focused on experiential nutrition activities and education, meal planning, cooking skill development, and reducing screen time. Family home food environment outcomes and nutrition-related child and parent personal and behavioral outcomes. Analyses used generalized linear mixed models. Primary comparisons were contrasts between intervention and control groups at postintervention and follow-up, with adjustments for child age and parent education. Compared with control parents, intervention parents showed greater improvement over time in scores of self-efficacy for identifying appropriate portion sizes, with significant differences in adjusted means at both post-intervention (P=0.002) and follow-up (P=0.01). Intervention children were less likely to consume at least one sugar-sweetened beverage daily at post-intervention than control children (P=0.04). The Healthy Home Offerings via the Mealtime Environment Plus program involved the entire family and targeted personal, behavioral, and

Household factors, family behavior patterns, and adherence to dietary and physical activity guidelines among children at risk for obesity.

Science.gov (United States)

Kunin-Batson, Alicia S; Seburg, Elisabeth M; Crain, A Lauren; Jaka, Meghan M; Langer, Shelby L; Levy, Rona L; Sherwood, Nancy E

2015-01-01

To describe the proportion of children adhering to recommended physical activity and dietary guidelines, and examine demographic and household correlates of guideline adherence. Cross-sectional (pre-randomization) data from a behavioral intervention trial designed to prevent unhealthy weight gain in children. A total of 421 children (aged 5-10 years) at risk for obesity (body mass index percentile, 70-95). Physical activity (accelerometry), screen time (parent survey), and fruit and vegetable and sugar-sweetened beverage intake (24-hour dietary recall). Proportions meeting guidelines were calculated. Logistic regression examined associations between demographic and household factors and whether children met recommended guidelines for (1) physical activity (≥ 60 min/d), (2) screen time (≤ 2 h/d), (3) fruit and vegetable intake (≥ 5 servings/d), and (4) sugar-sweetened beverage avoidance. Few children met more than 1 guideline. Only 2% met all 4 recommended guidelines and 19% met none. Each guideline had unique sociodemographic and domain-specific household predictors (ie, availability of certain foods and beverages, media, and active play and exercise equipment). Families equipped to promote healthy child behavior patterns in 1 activity or dietary domain may not be in others. Results have implications for the development of interventions to affect children's weight-related behaviors and growth trajectories. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Dietary patterns as predictors of successful ageing.

Science.gov (United States)

Hodge, A M; O'Dea, K; English, D R; Giles, G G; Flicker, L

2014-03-01

To examine associations between dietary patterns identified by factor analysis, and successful ageing. Prospective cohort study with diet measured in 1990-4, and successful ageing in 2003-7. Ordered logistic regression with outcome determined as dead/usual ageing/successful ageing was used to examine associations with quintile groups of dietary factor scores. Men and women (n=6308), without history of major illness at baseline, and aged >70 years at follow-up, or who had died before follow-up but would have been aged >70 at the commencement of follow-up, from the Melbourne Collaborative Cohort Study. Frequencies of intake of 121 foods at baseline were collected in a food frequency questionnaire. Anthropometry and other health and lifestyle data were collected. At follow-up, questionnaire data relating to mental health, physical function and medical history were used to define successful ageing. Four dietary factors were identified, characterized by higher loadings for (1) vegetables; (2) fruit, (3) feta, legumes, salad, olive oil, and inverse loadings for tea, margarine, cake, sweet biscuits and puddings; (4) meat, white bread, savoury pastry dishes and fried foods. In models excluding body size, the second factor 'Fruit' was positively associated with successful ageing (OR in top 20% vs lowest 20% of score 1.31, 95%CI (1.05-1.63), p trend across quintile groups 0.001); while the fourth factor 'Meat/fatty foods' was inversely associated (OR in top 20% vs lowest 20% of score 0.69, 95%CI (0.55-0.86), p trend across quintile groups 0.001). Factors 1 and 3 did not show significant associations with successful ageing. The association for 'Fruit' was little altered after adjustment for body size, while for 'Meat/fatty foods' the association was somewhat attenuated. A dietary pattern including plenty of fruit while limiting meat and fried foods may improve the likelihood of ageing successfully.

A review of the characteristics of dietary fibers relevant to appetite and energy intake outcomes in human intervention trials.

Science.gov (United States)

Poutanen, Kaisa S; Dussort, Pierre; Erkner, Alfrun; Fiszman, Susana; Karnik, Kavita; Kristensen, Mette; Marsaux, Cyril Fm; Miquel-Kergoat, Sophie; Pentikäinen, Saara P; Putz, Peter; Slavin, Joanne L; Steinert, Robert E; Mela, David J

2017-09-01

Background: Many intervention studies have tested the effect of dietary fibers (DFs) on appetite-related outcomes, with inconsistent results. However, DFs comprise a wide range of compounds with diverse properties, and the specific contribution of these to appetite control is not well characterized. Objective: The influence of specific DF characteristics [i.e., viscosity, gel-forming capacity, fermentability, or molecular weight (MW)] on appetite-related outcomes was assessed in healthy humans. Design: Controlled human intervention trials that tested the effects of well-characterized DFs on appetite ratings or energy intake were identified from a systematic search of literature. Studies were included only if they reported 1 ) DF name and origin and 2 ) data on viscosity, gelling properties, fermentability, or MW of the DF materials or DF-containing matrixes. Results: A high proportion of the potentially relevant literature was excluded because of lack of adequate DF characterization. In total, 49 articles that met these criteria were identified, which reported 90 comparisons of various DFs in foods, beverages, or supplements in acute or sustained-exposure trials. In 51 of the 90 comparisons, the DF-containing material of interest was efficacious for ≥1 appetite-related outcome. Reported differences in material viscosity, MW, or fermentability did not clearly correspond to differences in efficacy, whereas gel-forming DF sources were consistently efficacious (but with very few comparisons). Conclusions: The overall inconsistent relations of DF properties with respect to efficacy may reflect variation in measurement methodology, nature of the DF preparation and matrix, and study designs. Methods of DF characterization, incorporation, and study design are too inconsistent to allow generalized conclusions about the effects of DF properties on appetite and preclude the development of reliable, predictive, structure-function relations. Improved standards for

Foods, Nutrients, and Dietary Patterns: Interconnections and Implications for Dietary Guidelines12

Science.gov (United States)

Satija, Ambika; Hu, Frank B

2016-01-01

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. PMID:27184272

Dietary Advice on Prescription: A novel approach to dietary counseling

Directory of Open Access Journals (Sweden)

Gunnar Johansson

2011-05-01

Full Text Available This article describes a novel approach to giving dietary advice, which is called “Dietary Advice on Prescription” (DAP; Matordning på Recept [MoR] in Swedish. It is the same principle as prescription on medicine and “Physical Activity on Prescription” (PAP; Fysisk aktivitet på Recept [FaR] in Swedish. The main idea is that a written prescription will strengthen the oral advice and emphasize certain aspects of the dietary recommendation. The DAP is on the brink of being tested in a planned study.

Dietary Patterns and Risk of Death and Progression to ESRD in Individuals With CKD: A Cohort Study

Science.gov (United States)

Gutiérrez, Orlando M.; Muntner, Paul; Rizk, Dana V.; McClellan, William M.; Warnock, David G.; Newby, P.K.; Judd, Suzanne E.

2014-01-01

Background Nutrition is strongly linked with health outcomes in chronic kidney disease (CKD). However, few studies have examined relationships between dietary patterns and health outcomes in persons with CKD. Study Design Observational cohort study. Setting & Participants 3,972 participants with CKD (defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m2 or an albumin-creatinine ratio ≥30 mg/g at baseline) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a prospective cohort study of 30,239 black and white adults at least 45 years of age. Predictors Five empirically derived dietary patterns identified via factor analysis: “Convenience” (Chinese and Mexican foods, pizza, other mixed dishes), “Plant-Based” (fruits, vegetables), “Sweets/Fats” (sugary foods), “Southern” (fried foods, organ meats, sweetened beverages), and “Alcohol/Salads” (alcohol, green-leafy vegetables, salad dressing). Outcomes All-cause mortality and end-stage renal disease (ESRD). Results A total of 816 deaths and 141 ESRD events were observed over approximately 6 years of follow-up. There were no statistically significant associations of Convenience, Sweets/Fats or Alcohol/Salads pattern scores with all-cause mortality after multivariable adjustment. In Cox regression models adjusted for sociodemographic factors, energy intake, co-morbidities, and baseline kidney function, higher Plant-Based pattern scores (indicating greater consistency with the pattern) were associated with lower risk of mortality (HR comparing fourth to first quartile, 0.77; 95%CI, 0.61–0.97) whereas higher Southern pattern scores were associated with greater risk of mortality (HR comparing fourth to first quartile, 1.51; 95%CI, 1.19–1.92). There were no associations of dietary patterns with incident ESRD in multivariable-adjusted models. Limitations Missing dietary pattern data, potential residual confounding from lifestyle factors. Conclusions A

Effective translation of current dietary guidance: understanding and communicating the concepts of minimal and optimal levels of dietary protein.

Science.gov (United States)

Rodriguez, Nancy R; Miller, Sharon L

2015-04-29

Dietitians and health care providers have critical roles in the translation of the dietary guidance to practice. The protein content of diets for adults can be based on the Recommended Dietary Allowance (RDA) of 0.80 g/kg per day. Alternatively, the most recent Dietary Reference Intakes (DRIs) for macronutrients reflect expanded guidance for assessing protein needs and consider the relative relation of absolute amounts of protein, carbohydrate, and fat to total energy intake in the context of chronic disease prevention. The Acceptable Macronutrient Distribution Range (AMDR) reflects the interrelation between the macronutrients and affords dietitians and clinicians additional flexibility in diet planning. Accounting for the caloric value of RDAs for carbohydrate and fat, "flexible calories" emerge as an opportunity to create varied eating plans that provide for protein intakes in excess of the RDA but within the AMDR. Protein Summit 2.0 highlighted the growing body of scientific evidence documenting the benefits of higher protein intakes at amounts approximating twice the RDA, which include promotion of healthy body weight and preservation of lean body mass and functional ability with age. The essential amino acid (EAA) density of a food also emerged as a novel concept analogous to "nutrient density," which can enable the practitioner to calculate the caloric cost associated with a specific protein source to attain the daily requirement of EAAs to accomplish various health outcomes because these indispensable nutrients have a significant role in protein utilization and metabolic regulation. Tailoring recommendations unique to an individual's varying goals and needs remains a challenge. However, flexibility within the application of DRIs to include consideration of the AMDR provides a sound framework to guide practitioners in effective translation of current dietary guidance with a specific regard for the documented benefits of higher protein intakes. © 2015

Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

Science.gov (United States)

Caissutti, Claudia; Khalifeh, Adeeb; Saccone, Gabriele; Berghella, Vincenzo

2018-02-01

The aim of this study was to evaluate if women meeting criteria for gestational diabetes mellitus (GDM) by the One Step test as per International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by other less strict criteria have adverse pregnancy outcomes compared with GDM-negative controls. The primary outcome was the incidence of macrosomia, defined as birthweight > 4000 g. Electronic databases were searched from their inception until May 2017. All studies identifying pregnant women negative at the Two Step test, but positive at the One Step test for IADPSG criteria were included. We excluded studies that randomized women to the One Step vs. the Two Step tests; studies that compared different criteria within the same screening method; randomized studies comparing treatments for GDM; and studies comparing incidence of GDM in women doing the One Step test vs. the Two Step test. Eight retrospective cohort studies, including 29 983 women, were included. Five study groups and four control groups were identified. The heterogeneity between the studies was high. Gestational hypertension, preeclampsia and large for gestational age, as well as in some analyses cesarean delivery, macrosomia and preterm birth, were significantly more frequent, and small for gestational age in some analyses significantly less frequent, in women GDM-positive by the One Step, but not the Two Step. Women meeting criteria for GDM by IADPSG criteria but not by other less strict criteria have an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia and large for gestational age, compared with GDM-negative controls. Based on these findings, and evidence from other studies that treatment decreases these adverse outcomes, we suggest screening for GDM using the One Step IADPSG criteria. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Factors which may limit the value of dietary diversity and its association with nutritional outcomes in preschool children in high burden districts of India.

Science.gov (United States)

Nithya, Devanesan Jacinth; Bhavani, Ramanathapuram Vaidyanathan

2018-01-01

Dietary diversity plays a critical role in infants as they need energy and nutrient dense foods for both physical and mental development. This study examines whether three dietary diversity indices validate against Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) and studies the relationship of dietary diversity with nutritional status of preschool children, in two districts of India: Wardha district in Maharashtra state and Koraput district in Odisha state. Dietary diversity was calculated using: individual food scores calculated using 24 hour diet recall (FS24hr) data; household dietary diversity using Berry's index (DDI) and food scores calculated using food frequency data (FSFFQ). Nutritional status was assessed by anthropometric indices. It was observed that 42.7% of 1 to 5 years children were underweight, 38% stunted and 27.6% wasted across both locations. The dietary diversity was found to be relatively better in Wardha when compared with Koraput with mean diversity of FS24hr 7, DDI 90 and FSFFQ 63 in both locations. Preschool children in both locations consumed a cereal based diet. Apart from protein in both locations and energy in Koraput, the NAR of all nutrients consumed was indicating that dietary diversity calculated using 24 hour diet recall ensures nutrient adequacy but showed association only with Height-for-Age scores. Dietary diversity calculated using three methods did not show any correlation with nutritional status of 1 to 5 years children.

Screening for dietary fat intake of grade six children: self-assessment vs. maternal assessment.

Science.gov (United States)

Wenhold, Friede; MacIntyre, Una; Rheeder, Paul

2014-10-01

As part of justifiable nutrition promotion, this study aimed to determine internal consistency of a dietary fat screener and to compare self-assessment to maternal assessment of fat intake of grade six (about 12 years old) learners in a South African public primary school. The children completed in school a pictorial, quantitative food frequency-type screener consisting of 10 high-fat food categories; mothers individually completed a text version. Internal consistency was measured with item-total correlations, Cronbach's alpha and the split-half method. Child-mother comparison was based on kappa (κ) statistics, McNemar's tests, Wilcoxon signed-rank test and the Bland-Altman method. In total, 101 (93.5%) children and 78 (72.2%) mothers responded. The screener was internally consistent, regardless of data source and statistical technique. For portion sizes and frequency of intake, children consistently reported higher intake than mothers. This resulted in systematic error, also evidenced by a significant difference from zero for the difference between child's and mother's final test scores for the whole group, and for boys and girls separately (always P fat or prudent intake was identical, yet the chance-corrected agreement was poor (κ = 0.16) and non-agreement was non-symmetrical (P = 0.001). Children and mothers reported high fat intakes (93% and 75%, respectively). It was concluded that the dietary fat screener was internally consistent, yet children and mothers did not agree in their assessment. The high fat intakes reported by children and mothers warrant measurement refinement and implementation of primary prevention programmes. © 2012 John Wiley & Sons Ltd.

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.

Development of a Publicly Available, Comprehensive Database of Fiber and Health Outcomes: Rationale and Methods.

Directory of Open Access Journals (Sweden)

Kara A Livingston

Full Text Available Dietary fiber is a broad category of compounds historically defined as partially or completely indigestible plant-based carbohydrates and lignin with, more recently, the additional criteria that fibers incorporated into foods as additives should demonstrate functional human health outcomes to receive a fiber classification. Thousands of research studies have been published examining fibers and health outcomes.(1 Develop a database listing studies testing fiber and physiological health outcomes identified by experts at the Ninth Vahouny Conference; (2 Use evidence mapping methodology to summarize this body of literature. This paper summarizes the rationale, methodology, and resulting database. The database will help both scientists and policy-makers to evaluate evidence linking specific fibers with physiological health outcomes, and identify missing information.To build this database, we conducted a systematic literature search for human intervention studies published in English from 1946 to May 2015. Our search strategy included a broad definition of fiber search terms, as well as search terms for nine physiological health outcomes identified at the Ninth Vahouny Fiber Symposium. Abstracts were screened using a priori defined eligibility criteria and a low threshold for inclusion to minimize the likelihood of rejecting articles of interest. Publications then were reviewed in full text, applying additional a priori defined exclusion criteria. The database was built and published on the Systematic Review Data Repository (SRDR™, a web-based, publicly available application.A fiber database was created. This resource will reduce the unnecessary replication of effort in conducting systematic reviews by serving as both a central database archiving PICO (population, intervention, comparator, outcome data on published studies and as a searchable tool through which this data can be extracted and updated.

Newborn screening for congenital cytomegalovirus: Options for hospital-based and public health programs.

Science.gov (United States)

Grosse, Scott D; Dollard, Sheila; Ross, Danielle S; Cannon, Michael

2009-12-01

Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss (SNHL) and developmental disability in children. Early identification of infected children through screening could allow for early intervention and improvement in functional outcomes among the subset who develop sequelae. To outline potential options and strategies for screening newborns for congenital CMV infection and to discuss barriers to screening and data needs to inform future policy decisions. Commentary based on the literature and expert opinion on newborn dried blood spot screening, newborn hearing screening/Early Hearing Detection and Intervention (EHDI) programs, and congenital CMV. Although no population-based screening for congenital CMV is underway, pilot newborn screening studies using a variety of assays with urine or dried blood spot specimens are underway. Challenges to screening are both practical-uncertain sensitivity of blood spot assays suitable for large-scale screening and lack of infrastructure for collection of urine specimens; and evidentiary-the need to demonstrate improved outcomes and value of screening to offset the expense and potential adverse psychosocial consequences for children and families whose children require periodic monitoring but never develop sequelae. Screening for congenital CMV infection is a potentially important intervention that merits additional research, including the logistical feasibility of different screening options and psychosocial consequences for families.

Should we screen for emotional distress in type 2 diabetes mellitus?

DEFF Research Database (Denmark)

Pouwer, Francois

2009-01-01

Emotional problems such as depression, anxiety and diabetes-specific distress are common in patients with type 2 diabetes mellitus (T2DM) but often remain unrecognized and thus untreated. The present Review focuses on the extent of this problem and discusses whether we should screen for depression......DM have shown that screening for depression does not improve outcomes. On the other hand, collaborative care approaches for depression in patients with type 1 diabetes mellitus (T1DM) or T2DM seem to be effective. Intervention studies for anxiety or diabetes-specific emotional distress are currently...... assessments of emotional well-being in patients with T2DM. However, this recommendation is not based on strong evidence, as the effects of screening (case-finding) on psychological outcomes and diabetes outcomes have not been tested in a randomized controlled study. Results from studies in patients without T2...

Expectancies related to thinness, dietary restriction, eating, and alcohol consumption in women with bulimia nervosa.

Science.gov (United States)

Bruce, Kenneth; Mansour, Sandra; Steiger, Howard

2009-04-01

To investigate behavior-outcome expectancies relating to thinness, dietary restriction, eating, and alcohol consumption in women with bulimia nervosa (BN). Women with BN (N = 29), women with BN and a co-morbid lifetime alcohol use disorder (AUD; N = 18), and control women (N = 24), completed interviews and questionnaires assessing eating- and alcohol-related symptoms, as well as questionnaires measuring expectancies relating to thinness, dietary restriction, eating, and alcohol consumption. Compared with the control group, both bulimic groups reported greater positive expectancies relating to thinness, dietary restriction and eating; expectancy endorsements were also predictive of the severity of eating-related symptoms. Compared with the other groups, the bulimic group with comorbid lifetime AUD had elevated positive alcohol-related expectancies, and alcohol expectancy endorsements predicted severity of alcohol-related symptoms. Women with BN endorsed more positive expectancies relating to thinness, dietary restriction, and eating, whereas women with BN and a lifetime comorbid AUD endorsed more positive alcohol expectancies. The results are consistent with expectancy theory in that positive expectancy endorsements were associated with symptom severity in a syndrome-specific manner. Expectancies related to thinness, dietary restriction, eating, and alcohol consumption in women with BN. (c) 2008 by Wiley Periodicals, Inc.

Assessing the efficacy of cancer screening

Directory of Open Access Journals (Sweden)

Gemma Jacklyn

2017-07-01

Full Text Available Background: Population-based cancer screening has been established for several types of cancer in Australia and internationally. Screening may perform differently in practice from randomised controlled trials, which makes evaluating programs complex. Materials and methods: We discuss how to assess the evidence of benefits and harms of cancer screening, including the main biases that can mislead clinicians and policy makers (such as volunteer, lead-time, length-time and overdiagnosis bias. We also discuss ways in which communication of risks can inform or mislead the community. Results: The evaluation of cancer screening programs should involve balancing the benefits and harms. When considering the overall worth of an intervention and allocation of scarce health resources, decisions should focus on the net benefits and be informed by systematic reviews. Communication of screening outcomes can be misleading. Many messages highlight the benefits while downplaying the harms, and often use relative risks and 5-year survival to persuade people to screen rather than support informed choice. Lessons learned: An evidence based approach is essential when evaluating and communicating the benefits and harms of cancer screening, to minimise misleading biases and the reliance on intuition.

Association of Dietary Habits with Psychosocial Outcomes in Women with Fibromyalgia : The al-Ándalus Project

NARCIS (Netherlands)

Ruiz-Cabello, Pilar; Soriano-Maldonado, Alberto; Delgado-Fernandez, M; Alvarez-Gallardo, I C; Segura-Jimenez, V; Estevez-Lopez, F; Camiletti-Moirón, Daniel; Aparicio, Virgina A

2017-01-01

BACKGROUND: Fibromyalgia (FM) is a complex multidimensional disorder with pain as its main symptom. Fibromyalgia imposes a psychosocial burden on individuals that negatively impacts quality of life. The relationship of dietary habits with these psychosocial aspects is still unclear. OBJECTIVE: The

Development of a reference database for assessing dietary nitrate in vegetables.

Science.gov (United States)

Blekkenhorst, Lauren C; Prince, Richard L; Ward, Natalie C; Croft, Kevin D; Lewis, Joshua R; Devine, Amanda; Shinde, Sujata; Woodman, Richard J; Hodgson, Jonathan M; Bondonno, Catherine P

2017-08-01

Nitrate from vegetables improves vascular health with short-term intake. Whether this translates into improved long-term health outcomes has yet to be investigated. To enable reliable analysis of nitrate intake from food records, there is a strong need for a comprehensive nitrate content of vegetables database. A systematic literature search (1980-2016) was performed using Medline, Agricola and Commonwealth Agricultural Bureaux abstracts databases. The nitrate content of vegetables database contains 4237 records from 255 publications with data on 178 vegetables and 22 herbs and spices. The nitrate content of individual vegetables ranged from Chinese flat cabbage (median; range: 4240; 3004-6310 mg/kg FW) to corn (median; range: 12; 5-1091 mg/kg FW). The database was applied to estimate vegetable nitrate intake using 24-h dietary recalls (24-HDRs) and food frequency questionnaires (FFQs). Significant correlations were observed between urinary nitrate excretion and 24-HDR (r = 0.4, P = 0.013), between 24-HDR and 12 month FFQs (r = 0.5, P vegetables. It can be applied to dietary records to explore the associations between nitrate intake and health outcomes in human studies. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Effects of dietary counselling on food habits and dietary intake of Finnish pregnant women at increased risk for gestational diabetes - a secondary analysis of a cluster-randomized controlled trial.

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Kinnunen, Tarja I; Puhkala, Jatta; Raitanen, Jani; Ahonen, Suvi; Aittasalo, Minna; Virtanen, Suvi M; Luoto, Riitta

2014-04-01

The incidence of gestational diabetes mellitus (GDM) is increasing and GDM might be prevented by improving diet. Few interventions have assessed the effects of dietary counselling on dietary intake of pregnant women. This study examined the effects of dietary counselling on food habits and dietary intake of Finnish pregnant women as secondary outcomes of a trial primarily aiming at preventing GDM. A cluster-randomized controlled trial was conducted in 14 municipalities in Finland, including 399 pregnant women at increased risk for developing GDM. The intervention consisted of dietary counselling focusing on dietary fat, fibre and saccharose intake at four routine maternity clinic visits. Usual counselling practices were continued in the usual care municipalities. A validated 181-item food frequency questionnaire was used to assess changes in diet from baseline to 26-28 and 36-37 weeks gestation. The data were analysed using multilevel mixed-effects linear regression models. By 36-37 weeks gestation, the intervention had beneficial effects on total intake of vegetables, fruits and berries (coefficient for between-group difference in change 61.6 g day(-1), 95% confidence interval 25.7-97.6), the proportions of high-fibre bread of all bread (7.2% units, 2.5-11.9), low-fat cheeses of all cheeses (10.7% units, 2.6-18.9) and vegetable fats of all dietary fats (6.1% -units, 2.0-10.3), and the intake of saturated fatty acids (-0.67 energy-%-units, -1.16 to -0.19), polyunsaturated fatty acids (0.38 energy-%-units, 0.18-0.58), linoleic acid (764 mg day(-1), 173-1354) and fibre (2.07 g day(-1) , 0.39-3.75). The intervention improved diet towards the recommendations in pregnant women at increased risk for GDM suggesting the counselling methods could be implemented in maternity care. © 2012 John Wiley & Sons Ltd.

Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review123

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Movassagh, Elham Z

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

Cancer screening in patients infected with HIV.

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Sigel, Keith; Dubrow, Robert; Silverberg, Michael; Crothers, Kristina; Braithwaite, Scott; Justice, Amy

2011-09-01

Non-AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin's lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancer screening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancer screening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancer screening.

The association between dietary cholesterol intake and subclinical atherosclerosis in Korean adults: The Kangbuk Samsung Health Study.

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Rhee, Eun-Jung; Ryu, Seungho; Lee, Jong-Young; Lee, Sung Ho; Cheong, EunSun; Park, Se Eun; Park, Cheol-Young; Won, Yu Sam; Kim, Joon Mo; Cho, Dong-Sik; Chung, Hye-Kyung; Sung, Ki Chul

The Scientific Report of the Dietary Guidelines Advisory Committee (2015) concluded that restriction of dietary cholesterol is unnecessary in most adults for the prevention of cardiovascular disease. We aimed to assess the risk for subclinical atherosclerosis according to coronary artery calcium score (CACS), based on dietary cholesterol intake in apparently healthy Korean adults. This was a cross-sectional study performed in 30,068 participants (mean age 40.8 years; 84.5% men) in a health screening program in Korea. The data were collected from 2001 to 2013 and analyzed in 2015. Total energy intake and dietary cholesterol intake were assessed with a food frequency questionnaire. The participants were stratified according to quartile of dietary cholesterol intake. CACS was measured by multi-detector computed tomography. Lipid profiles were measured, and the participants were divided into 6 groups according to low-density lipoprotein cholesterol (LDL-C) level: 0. Dietary cholesterol intake did not correlate with mean value of serum LDL-C level. For both genders, the odds ratio for coronary artery calcification was not significantly greater with greater amounts of dietary cholesterol (as assessed by quartile). The risk for coronary artery calcification was not higher in subjects with LDL-C 70-129 mg/dL compared with those with LDL-C < 70 mg/dL; however, the risk was significantly greater in subjects with LDL-C ≥ 130 mg/dL compared with those with LDL-C < 70 mg/dL. Dietary cholesterol intake did not have an association with LDL-C level or with risk for coronary artery calcification in apparently healthy Korean adults. The results have to be translated with consideration of limitation of population-based studies. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Distressed or relieved? Psychological side effects of breast cancer screening in the Netherlands

NARCIS (Netherlands)

Scaf-Klomp, W; Sanderman, R; van de Wiel, HBM; Otter, R; van den Heuvel, WJA

1997-01-01

Study objectives-To assess the psychological impact of mammographic screening on women with non-malignant outcomes after attending the Netherlands' National Breast Cancer Screening Programme. Design-During one year all women with false positive test results (95) in a screening area were invited for

Dietary Approaches in the Management of Diabetic Patients with Kidney Disease.

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Ko, Gang Jee; Kalantar-Zadeh, Kamyar; Goldstein-Fuchs, Jordi; Rhee, Connie M

2017-07-31

Chronic kidney disease (CKD) is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease (DKD) have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. Among DKD patients with non-dialysis dependent CKD, expert panels recommend lower dietary protein intake of 0.8 g/kg of body weight/day, while higher dietary protein intake (>1.2 g/kg of body weight/day) is advised among diabetic end-stage renal disease patients receiving maintenance dialysis to counteract protein catabolism, dialysate amino acid and protein losses, and protein-energy wasting. Carbohydrates from sugars should be limited to less than 10% of energy intake, and it is also suggested that higher polyunsaturated and monounsaturated fat consumption in lieu of saturated fatty acids, trans-fat, and cholesterol are associated with more favorable outcomes. While guidelines recommend dietary sodium restriction to less than 1.5-2.3 g/day, excessively low sodium intake may be associated with hyponatremia as well as impaired glucose metabolism and insulin sensitivity. As patients with advanced DKD progressing to end-stage renal disease may be prone to the "burnt-out diabetes" phenomenon (i.e., spontaneous resolution of hypoglycemia and frequent hypoglycemic episodes), further studies in this population are particularly needed to determine the safety and efficacy of dietary restrictions in this population.

Daily Dietary Intake Patterns Improve after Visiting a Food Pantry among Food-Insecure Rural Midwestern Adults

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Breanne N. Wright

2018-05-01

Full Text Available Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, before-and-after design with a pantry visit as the intervention. Participants (n = 455 completed a demographic and food security assessment, and two 24-h dietary recalls. Adult food security was measured using the U.S. Household Food Security Survey Module. Dietary intake patterns were assessed using Automated Self-Administered 24-h Recall data and classified by Healthy Eating Index (HEI-2010 scores, dietary variety, number of eating occasions, and energy intake. Paired t-tests and Wilcoxon signed-rank tests compared outcomes before and after a pantry visit. Mean dietary variety increased after the pantry visit among both food-secure (p = 0.02 and food-insecure (p < 0.0001 pantry clients. Mean energy intake (p = 0.0003, number of eating occasions (p = 0.004, and HEI-2010 component scores for total fruit (p < 0.001 and whole fruit (p < 0.0003 increased among food-insecure pantry clients only. A pantry visit may improve dietary intake patterns, especially among food-insecure pantry clients.

Domestic violence screening in pregnancy.

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Bunn, Mikiko Yazawa; Higa, Nicole A; Parker, Willie J; Kaneshiro, Bliss

2009-11-01

Domestic violence is an important health concern that has been shown to have adverse effects on maternal and neonatal outcomes. The objectives of this study were to compare the prevalence of prenatal screening for domestic violence in a hospital-based resident clinic setting with screening practices in private obstetric offices in Honolulu, Hawai'i and to explore physician attitudes towards domestic violence screening during pregnancy. A retrospective chart review was conducted at Queen's Medical Center in Honolulu, Hawai'i in women who delivered between 2003 and 2004. A 6 item written survey was also given to all attending and resident physicians with obstetric privileges. Descriptive statistics including frequency measures were generated and chi square tests were used to compare categorical variables. A total of 270 charts were reviewed. There was a statistically significant difference (p obstetric practices (39.3 percent) that were screened for domestic violence. While the majority of respondents (77.6%) to the domestic violence survey were aware that the American College of Obstetricians and Gynecologists recommends domestic violence screening in pregnancy most respondents (69.0 percent) indicated that they "never or rarely" screened their patients for domestic violence. Despite professional recommendations and an awareness of these recommendations, between 2003 and 2004, routine prenatal screening for domestic violence was markedly lacking for patients in this study population.

Demographic features and visual outcomes of patients presenting to diabetic photo-screening and treated for sight threatening retinopathy in Fiji

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Riyaz Bhikoo

2017-05-01

Full Text Available AIM: To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy (STR in a low resource setting, Fiji. METHODS: A retrospective review of all new patients who presented for diabetic photo-screening at the Diabetic Eye Clinic, Suva in 2010. Fundus images were graded using standardised guidelines. Patient demographics, retinopathy grading and visual acuity data were extracted from the database and analyzed. Patients that received laser therapy and still attending follow up in 2012 were examined for disease progression RESULTS: Totally 2236 patients were photo-screened, 87% (3870/4472 of images were gradable. STR was observed in 26% (988/3870 with advanced STR (proliferative retinopathy/severe maculopathy in 10% (385/3870. Of those with STR, 59% had BCVA ≥6/18, 31% with advanced STR were <6/60. Male gender [odds ratio (OR 1.59; 1.20-2.12], history of hypertension (OR 1.36; 1.03-1.80 and peripheral neuropathy (OR 1.41; 1.01-1.95 were predictive of advanced STR. In 2012, 32% (315/988 attended follow up with 69% exhibiting advanced STR compared with 53% of the same cohort in 2010. Laser photocoagulation was administered to 212 eyes (212/3870, 5% with retinopathy and maculopathy progression observed in 52% and 33% respectively. BCVA ≥6/18 was noted in 67% (143/212 of treated eyes. Improved glycaemic control (OR 46.52; 1.50-1441.90 amongst those with advanced STR was predictive of eyes that maintained good vision. CONCLUSION: In Fiji, a quarter of new patients presenting to photo-screening have STR with a third of those with advanced STR having already loss vision. Improved glycaemic control and timely treatment of patients with sight threatening complications is important in halting disease progression.

Reliability and validity of a modified MEDFICTS dietary fat screener in South African schoolchildren are determined by use and outcome measures.

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Wenhold, Friedeburg Anna Maria; MacIntyre, Una Elizabeth; Rheeder, Paul

2014-06-01

In South Africa, noncommunicable diseases and obesity are increasing and also affect children. No validated assessment tools for fat intake are available. To determine test-retest reliability and relative validity of a pictorial modified meats, eggs, dairy, fried foods, fats in baked goods, convenience foods, table fats, and snacks (MEDFICTS) dietary fat screener. We determined test-retest reliability and diagnostic accuracy with the modified MEDFICTS as the index test and a 3-day weighed food record and parental completion of the screener as primary and secondary reference methods, respectively. Grade-six learners (aged 12 years, 4 months) in an urban, middle-class school (n=93) and their parents (n=72). Portion size, frequency of intake, final score, and classification of fat intake of the modified MEDFICTS, and percent energy from fat, saturated fatty acids, and cholesterol of the food record. For categorical data agreement was based on kappa statistics, McNemar's test for symmetry, and diagnostic performance parameters. Continuous data were analyzed with correlations, mean differences, the Bland-Altman method, and receiver operating characteristics. The classification of fat intake by the modified MEDFICTS was test-retest reliable. Final scores of the group did not differ between administrations (P=0.86). The correlation of final scores between administrations was significant for girls only (r=0.58; P=0.01). Reliability of portion size and frequency of intake scores depended on the food category. For girls the screener final score was significantly (P90%), but chance corrected agreement between the classifications was poor. Parents did not agree with their children. Test-retest reliability and relative validity of a modified MEDFICTS dietary fat screener in South African schoolchildren depended on the use and outcome measures applied. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Does breast screening offer a survival benefit? A retrospective comparative study of oncological outcomes of screen-detected and symptomatic early stage breast cancer cases.

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Újhelyi, M; Pukancsik, D; Kelemen, P; Kovács, E; Kenessey, I; Udvarhelyi, N; Bak, M; Kovács, T; Mátrai, Z

2016-12-01

Mammography screening reduces breast cancer mortality by up to 32%. However, some recent studies have questioned the impact of non-palpable breast cancer detection on mortality reduction. The aim of this study was to analyse the clinicopathological and long-term follow-up data of early stage screened and symptomatic breast cancer patients. The institutional prospectively led database was systematically analysed for breast cancer cases diagnosed via the mammography screening program from 2002 to 2009. As a control group, symptomatic early stage breast cancer patients were collected randomly from the same database and matched for age and follow-up period. All medical records were reviewed retrospectively. Data from 298 breast cancer patients were collected from 47,718 mammography screenings. In addition, 331 symptomatic breast cancer patients were randomly selected. The screened group presented a significantly lower median tumour size (P screened group (P screened group did not exhibit better overall (P = 0.717) or disease-free survival (P = 0.081) compared to the symptomatic group. Our results do not suggest that mammography screening does not reduce breast cancer mortality but the mammography screening did not bring any significant improvement in patient overall or disease-free survival for the early stage breast cancer patients compared to the symptomatic group. The drawback of symptomatic early stage tumours compared to non-palpable tumours could be equalized by modern multimodality oncology treatments. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

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Sophia Yui Kau Fong

2013-01-01

Full Text Available Background. Carbamazepine (CBZ is a first-line antiepileptic drug which may be prone to drug interactions. Systematic review of herb- and food-drug interactions on CBZ is warranted to provide guidance for medical professionals when prescribing CBZ. Method. A systematic review was conducted on six English databases and four Chinese databases. Results. 196 out of 3179 articles fulfilled inclusion criteria, of which 74 articles were reviewed and 33 herbal products/dietary supplement/food interacting with CBZ were identified. No fatal or severe interactions were documented. The majority of the interactions were pharmacokinetic-based (80%. Traditional Chinese medicine accounted for most of the interactions (n=17, followed by food (n=10, dietary supplements (n=3, and other herbs/botanicals (n=3. Coadministration of 11 and 12 of the studied herbal products/dietary supplement/food significantly decreased or increased the plasma concentrations of CBZ. Regarding pharmacodynamic interaction, Xiao-yao-san, melatonin, and alcohol increased the side effects of CBZ while caffeine lowered the antiepileptic efficacy of CBZ. Conclusion. This review provides a comprehensive summary of the documented interactions between CBZ and herbal products/food/dietary supplements which assists healthcare professionals to identify potential herb-drug and food-drug interactions, thereby preventing potential adverse events and improving patients’ therapeutic outcomes when prescribing CBZ.

Adverse outcome pathways (AOPs) to enhance EDC ...

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Screening and testing for endocrine active chemicals was mandated under 1996 amendments to the Safe Drinking Water Act and Food Quality Protection Act. Efficiencies can be gained in the endocrine disruptor screening program by using available biological and toxicological knowledge to facilitate greater use of high throughput screening data and other data sources to inform endocrine disruptor assessments. Likewise, existing knowledge, when properly organized, can help aid interpretation of test results. The adverse outcome pathway (AOP) framework, which organizes information concerning measureable changes that link initial biological interactions with a chemical to adverse effects that are meaningful to risk assessment and management, can aid this process. This presentation outlines the ways in which the AOP framework has already been employed to support EDSP and how it may further enhance endocrine disruptor assessments in the future. Screening and testing for endocrine active chemicals was mandated under 1996 amendments to the Safe Drinking Water Act and Food Quality Protection Act. Efficiencies can be gained in the endocrine disruptor screening program by using available biological and toxicological knowledge to facilitate greater use of high throughput screening data and other data sources to inform endocrine disruptor assessments. Likewise, existing knowledge, when properly organized, can help aid interpretation of test results. The adverse outcome pathway

Dietary Energy Density, Renal Function, and Progression of Chronic Kidney Disease

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Mohammad Hossein Rouhani

2016-01-01

Full Text Available Background. There is evidence of the association between dietary energy density and chronic diseases. However, no report exists regarding the relation between DED and chronic kidney disease (CKD. Objective. To examine the association between dietary energy density (DED, renal function, and progression of chronic kidney disease (CKD. Design. Cross-sectional. Setting. Three nephrology clinics. Subjects. Two hundred twenty-one subjects with diagnosed CKD. Main Outcome Measure. Dietary intake of patients was assessed by a validated food frequency questionnaire. DED (in kcal/g was calculated with the use of energy content and weight of solid foods and energy yielding beverages. Renal function was measured by blood urea nitrogen (BUN, serum creatinine (Cr, and estimated glomerular filtration rate (eGFR. Results. Patients in the first tertile of DED consumed more amounts of carbohydrate, dietary fiber, potassium, phosphorus, zinc, magnesium, calcium, folate, vitamin C, and vitamin B2. After adjusting for confounders, we could not find any significant trend for BUN and Cr across tertiles of DED. In multivariate model, an increased risk of being in the higher stage of CKD was found among those in the last tertile of DED (OR: 3.15; 95% CI: 1.30, 7.63; P=0.01. Conclusion. We observed that lower DED was associated with better nutrient intake and lower risk of CKD progression.

Prescription Omega-3 Fatty Acid Products and Dietary Supplements Are Not Interchangeable.

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Hilleman, Daniel; Smer, Aiman

2016-01-01

To provide an overview of prescription and dietary supplement omega-3 fatty acid (OM3-FA) products and considerations for clinical use. Narrative review. The PubMed database was searched for cardiovascular-related investigations focused on eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA) (limit: English-only articles). Additional regulatory information on prescription and dietary supplements was obtained from United States Food and Drug Administration online sources. Prescription QM3-FA products are supported by robust clinical development and safety monitoring programs, whereas dietary supplements are not required to demonstrate safety or efficacy prior to marketing. There are no over-the-counter OM3-FA products available in the United States. Investigations of OM3-FA dietary supplements show that quantities of EPA and DHA are highly variable within and between brands. Dietary supplements also may contain potentially harmful components, including oxidized OM3-FA, other lipids, cholesterol, and toxins. Prescription OM3-FA products may contain DHA and EPA or EPA alone. All prescription OM3-FA products have demonstrated statistically significant triglyceride reduction as monotherapy or in combination with statins in patients with hypertriglyceridemia. Differential effects between products containing EPA and DHA compared with a high-purity EPA product (icosapent ethyl) have clinical implications: Increases in low-density lipoprotein cholesterol associated with DHA have the potential to confound strategies for managing patients with dyslipidemia. Cardiovascular outcomes studies of prescription CM3-FA products are ongoing. OM3-FA dietary supplements should not be substituted for prescription products, and prescription OM3-FA products that contain DHA are not equivalent to or interchangeable with high-purity EPA (icosapent ethyl) and should not be substituted for it.

Design of a randomized controlled clinical trial assessing dietary sodium restriction and hemodialysis-related symptom profiles

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Maya N. Clark-Cutaia

2016-08-01

Conclusion: Curbing dietary sodium intake may lead to improvement in intradialytic symptom amelioration and potential for better long-term outcomes. Generating empirical support will be critical to ascertain, and espouse, the appropriate level of sodium intake for patients receiving HD.

Delivering colonoscopy screening for low-income populations in Suffolk County: strategies, outcomes, and benchmarks.

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Lane, Dorothy S; Messina, Catherine R; Cavanagh, Mary F; Anderson, Joseph C

2013-08-01

Current and pending legislation provides colorectal cancer screening reimbursement for previously uninsured populations. Colonoscopy is currently the screening method most frequently recommended by physicians for insured patients. The experience of the SCOPE (Suffolk County Preventive Endoscopy) demonstration project (Project SCOPE) at Stony Brook University Medical Center provides a model for delivering colonoscopy screening to low-income populations to meet anticipated increasing demands. Project SCOPE, based in the Department of Preventive Medicine, featured internal collaboration with the academic medical center's large gastroenterology practice and external collaboration with the Suffolk County Department of Health Services' network of community health centers. Colonoscopies were performed by faculty gastroenterologists or supervised fellows. Measures of colonoscopy performance were compared with quality indicators and differences between faculty and supervised fellows were identified. During a 40-month screening period, 800 initial colonoscopies were performed. Approximately 21% of women screened were found to have adenomatous polyps compared with 36% of men. Five cancers were detected. The majority of the population screened (70%) were members of minority populations. African American individuals had a higher percentage of proximally located adenomas (78%) compared with white individuals (65%) and Hispanics (49%), based on the location of the most advanced lesion. Hispanic individuals had a 36% lower risk of adenomas compared with white individuals. Performance measures including the percentage of procedures with adequate bowel preparation, cecum reached, scope withdrawal time, and adenoma detection rate met quality benchmarks when performed by either faculty or supervised fellows. Project SCOPE's operational strategies demonstrated a feasible method for an academic medical center to provide high-quality screening colonoscopy for low-income populations. �

Screening for heart transplantation and left ventricular assist system

DEFF Research Database (Denmark)

Lund, Lars H; Trochu, Jean-Noel; Meyns, Bart

2018-01-01

BACKGROUND: Heart transplantation (HTx) and implantable left ventricular assist systems (LVAS) improve outcomes in advanced heart failure but may be underutilized. We hypothesized that screening can identify appropriate candidates. METHODS AND RESULTS: The ScrEEning for advanced Heart Failure...... treatment (SEE-HF) study was a multicentre prospective study screening patients with existing cardiac resynchronization therapy (CRT) and/or implantable cardioverter-defibrillator (ICD) for ejection fraction ≤40% and New York Heart Association (NYHA) class III-IV, and subsequently for guideline-based HTx...

Economic growth and the demand for dietary quality: Evidence from Russia during transition.

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Burggraf, Christine; Teuber, Ramona; Brosig, Stephan; Glauben, Thomas

2015-12-01

The increasing incidence of nutrition-related chronic diseases worldwide has raised people's awareness of dietary quality. Most existing studies on the topic of changing nutrition patterns measure dietary quality by single macronutrient indicators or anthropometric outcomes. However, such an approach is often too narrow to provide a picture of overall dietary quality and is sometimes even misleading. This study contributes to the existing literature by taking into account that the analysis of dietary quality comprises two dimensions: the adequate intake of vitamins and minerals, as well as the moderate intake of nutrients that increase the risk of chronic diseases. Thereby, we apply Grossman's health investment model to the analysis of the demand for dietary quality, explicitly addressing the different dimensions of dietary quality and the intertemporal character of health investments. We apply our approach to Russia using data from the Russia Longitudinal Monitoring Survey from 1996 to 2008. Our results show that intake levels of vitamins and minerals as well as saturated and total fatty acids increased after 1998 along with economic recovery, while the intake of fiber decreased. Our econometric results imply an income elasticity of vitamins and minerals of 0.051, and an income elasticity of fats of 0.073. Overall, our results are in line with an ongoing nutrition transition in the Russian Federation, which is marked by decreasing deficiencies in vitamins and minerals, as well as the increasing consumption of fats with its accompanying negative health consequences. Copyright © 2015 Elsevier B.V. All rights reserved.

Newborn hearing screening vs later hearing screening and developmental outcomes in children with permanent childhood hearing impairment

NARCIS (Netherlands)

Korver, Anna M. H.; Konings, Saskia; Dekker, Friedo W.; Beers, Mieke; Wever, Capi C.; Frijns, Johan H. M.; Oudesluys-Murphy, Anne M.; de Vries, Jutte; Vossen, Ann; Kant, Sarina; van den Akker-van Marle, Elske; le Cessie, Saskia; Rieffe, Carolien; Ens-Dokkum, Martina; van Straaten, Irma; Uilenburg, Noelle; Elvers, Bert; Loeber, Gerard; Meuwese-Jongejeugd, Anneke; Maré, Marcel; van Zanten, Bert; Goedegebure, André; Coster, Francien; van Dijk, Pim; Goverts, Theo; Admiraal, Ronald; Cremers, Cor; Kunst, Dirk; de Leeuw, Marina; Dijkhuizen, Janette; Scharloo, Marleen; Hoeben, Dirk; Rijpma, Gerti; Graef, Wim; Linschoten, Dik; Kuijper, Jessica; Hof, Nanda; Koldewijn, Reinoud; Pans, Donné; Jorritsma, Frank; van Beurden, Maarten; ter Huurne, Christien; Brienesse, Patrick; Seekles, Lisanne; de Jong, Jantine; Thijssen, Andrea; Lievense, Andrea; van Egdom-van der Wind, Marina; Theunissen, Stephanie; Mooij, Sophie

2010-01-01

Newborn hearing screening programs have been implemented in many countries because it was thought that the earlier permanent childhood hearing impairment is detected, the less developmentally disadvantaged children would become. To date, however, no strong evidence exists for universal introduction

Asymptomatic bacteriuria: when to screen and when to treat.

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Nicolle, Lindsay E

2003-06-01

Asymptomatic bacteriuria is common. Populations with structural or functional abnormalities of the genitourinary tract may have an exceedingly high prevalence of bacteriuria, but even healthy individuals frequently have positive urine cultures. Asymptomatic bacteriuria is seldom associated with adverse outcomes. Pregnant women and individuals who are to undergo traumatic genitourinary interventions are at risk for complications of bacteriuria and benefit from screening and treatment programs. Although screening is recommended for renal transplant recipients, the benefits for these patients are less clear. For other populations, including most bacteriuric individuals, negative outcomes attributable to asymptomatic bacteriuria have not been described. Treatment of asymptomatic bacteriuria in these patients is not beneficial and, in fact, may be associated with harmful outcomes, such as increased short-term frequency of symptomatic infection, adverse drug effects, and reinfection with organisms of increased antimicrobial resistance. Screening for asymptomatic bacteriuria and treatment is recommended for only selected groups where benefit has been shown. Many research questions still need to be addressed. Different populations have unique risk factors, and the benefits and risks of different management approaches for asymptomatic bacteriuria must continue to be addressed systematically in appropriate clinical trials.

Food environments and dietary intakes among adults: does the type of spatial exposure measurement matter? A systematic review.

Science.gov (United States)

Bivoltsis, Alexia; Cervigni, Eleanor; Trapp, Gina; Knuiman, Matthew; Hooper, Paula; Ambrosini, Gina Leslie

2018-06-09

The relationships between food environments and dietary intake have been assessed via a range of methodologically diverse measures of spatial exposure to food outlets, resulting in a largely inconclusive body of evidence, limiting informed policy intervention. This systematic review aims to evaluate the influence of methodological choice on study outcomes by examining the within-study effect of availability (e.g., counts) versus accessibility (e.g., proximity) spatial exposure measures on associations with diet. (PROSPERO registration: CRD42018085250). PubMed, Web of Science, Scopus and ScienceDirect databases were searched for empirical studies from 1980 to 2017, in the English language, involving adults and reporting on the statistical association between a dietary outcome and spatial exposure measures of both availability and accessibility. Studies were appraised using an eight-point quality criteria with a narrative synthesis of results. A total of 205 associations and 44 relationships (i.e., multiple measures of spatial exposure relating to a particular food outlet type and dietary outcome) were extracted from 14 eligible articles. Comparative measures were dominated by counts (availability) and proximity (accessibility). Few studies compared more complex measures and all counts were derived from place-based measures of exposure. Sixteen of the 44 relationships had a significant effect involving an availability measure whilst only 8 had a significant effect from an accessibility measure. The largest effect sizes in relationships were mostly for availability measures. After stratification by scale, availability measure had the greatest effect size in 139 of the 176 pairwise comparisons. Of the 33% (68/205) of associations that reached significance, 53/68 (78%) were from availability measures. There was no relationship between study quality and reported study outcomes. The limited evidence suggests that availability measures may produce significant and greater

Dietary Patterns and Birth Weight—a Review

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Marte K.R. Kjøllesdal

2014-11-01

Full Text Available Being born with low birth weight (LBW is recognized as a disadvantage due to risk of early growth retardation, fast catch up growth, infectious disease, developmental delay, and death during infancy and childhood, as well as development of obesity and non-communicable diseases (NCDs later in life. LBW is an indicator of fetal response to a limiting intrauterine environment, which may imply developmental changes in organs and tissue. Numerous studies have explored the effect of maternal intake of various nutrients and specific food items on birth weight (BW. Taking into account that people have diets consisting of many different food items, extraction of dietary patterns has emerged as a common way to describe diets and explore the effects on health outcomes. The present article aims to review studies investigating the associations between dietary patterns derived from a posteriori analysis and BW, or being small for gestational age (SGA. A PubMed search was conducted with the Mesh terms “pregnancy” OR “fetal growth retardation” OR “fetal development” OR “infant, small for gestational age” OR “birth weight” OR “infant, birth weight, low” AND “diet” OR “food habits”. Final number of articles included was seven, all which assessed diet by use of food frequency questionnaire (FFQ. Five studies explored dietary patterns using principal component analyses (PCA, while one study used cluster analyses and one study logistic regression. The studies reported between one and seven dietary patterns. Those patterns positively associated with BW were labeled “nutrient dense”, “protein rich”, “health conscious”, and “Mediterranean”. Those negatively associated with BW were labeled “Western”, “processed”, “vegetarian”, “transitional”, and “wheat products”. The dietary patterns “Western” and “wheat products” were also associated with higher risk of SGA babies, whereas a �

Effect of a standardised dietary restriction protocol on multiple laboratory strains of Drosophila melanogaster.

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Richard C Grandison

Full Text Available Outcomes of lifespan studies in model organisms are particularly susceptible to variations in technical procedures. This is especially true of dietary restriction, which is implemented in many different ways among laboratories.In this study, we have examined the effect of laboratory stock maintenance, genotype differences and microbial infection on the ability of dietary restriction (DR to extend life in the fruit fly Drosophila melanogaster. None of these factors block the DR effect.These data lend support to the idea that nutrient restriction genuinely extends lifespan in flies, and that any mechanistic discoveries made with this model are of potential relevance to the determinants of lifespan in other organisms.

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.

False negative newborn screen and neonatal cholestasis in a premature child with cystic fibrosis

NARCIS (Netherlands)

Heidendael, J. F.; Tabbers, M. M.; de Vreede, I.

2014-01-01

Newborn screening for cystic fibrosis enables early diagnosis and treatment, leading to better outcomes for patients with cystic fibrosis. Although the sensitivity of several screening protocols is high, false negative screening results of the newborn patient still occur, which can lead to a

In vitro digestion methods to characterize the physicochemical properties of diets varying in dietary fibre source and content

DEFF Research Database (Denmark)

Zhou, Pan; Theil, Peter Kappel; Wu, De

2018-01-01

Co-products from food and agro industries – barley hulls (BH), pectin residue (PR), sugar beet pulp (SBP) and potato pulp (PP) – were collected, dried (PR, SBP, PP) and milled to pass a 1-, 2- and 4-mm screen. A total of 48 diets originating from these sources with four intended dietary fibre (DF...

Reducing Recreational Sedentary Screen Time: A Community Guide Systematic Review.

Science.gov (United States)

Ramsey Buchanan, Leigh; Rooks-Peck, Cherie R; Finnie, Ramona K C; Wethington, Holly R; Jacob, Verughese; Fulton, Janet E; Johnson, Donna B; Kahwati, Leila C; Pratt, Charlotte A; Ramirez, Gilbert; Mercer, Shawna L; Glanz, Karen

2016-03-01

Sedentary time spent with screen media is associated with obesity among children and adults. Obesity has potentially serious health consequences, such as heart disease and diabetes. This Community Guide systematic review examined the effectiveness and economic efficiency of behavioral interventions aimed at reducing recreational (i.e., neither school- nor work-related) sedentary screen time, as measured by screen time, physical activity, diet, and weight-related outcomes. For this review, an earlier ("original") review (search period, 1966 through July 2007) was combined with updated evidence (search period, April 2007 through June 2013) to assess effectiveness of behavioral interventions aimed at reducing recreational sedentary screen time. Existing Community Guide systematic review methods were used. Analyses were conducted in 2013-2014. The review included 49 studies. Two types of behavioral interventions were evaluated that either (1) focus on reducing recreational sedentary screen time only (12 studies); or (2) focus equally on reducing recreational sedentary screen time and improving physical activity or diet (37 studies). Most studies targeted children aged ≤13 years. Children's composite screen time (TV viewing plus other forms of recreational sedentary screen time) decreased 26.4 (interquartile interval= -74.4, -12.0) minutes/day and obesity prevalence decreased 2.3 (interquartile interval= -4.5, -1.2) percentage points versus a comparison group. Improvements in physical activity and diet were reported. Three study arms among adults found composite screen time decreased by 130.2 minutes/day. Among children, these interventions demonstrated reduced screen time, increased physical activity, and improved diet- and weight-related outcomes. More research is needed among adolescents and adults. Published by Elsevier Inc.

Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement

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Matthew Butawan

2017-03-01

Full Text Available Methylsulfonylmethane (MSM has become a popular dietary supplement used for a variety of purposes, including its most common use as an anti-inflammatory agent. It has been well-investigated in animal models, as well as in human clinical trials and experiments. A variety of health-specific outcome measures are improved with MSM supplementation, including inflammation, joint/muscle pain, oxidative stress, and antioxidant capacity. Initial evidence is available regarding the dose of MSM needed to provide benefit, although additional work is underway to determine the precise dose and time course of treatment needed to provide optimal benefits. As a Generally Recognized As Safe (GRAS approved substance, MSM is well-tolerated by most individuals at dosages of up to four grams daily, with few known and mild side effects. This review provides an overview of MSM, with details regarding its common uses and applications as a dietary supplement, as well as its safety for consumption.

Marketing dietary supplements in the United States: A review of the requirements for new dietary ingredients

International Nuclear Information System (INIS)

Noonan, Chris; Patrick Noonan, W.

2006-01-01

Since the passage of the Dietary Supplement Health and Education Act in 1994, the marketplace for dietary supplements has experienced dramatic growth. New products have redefined the entire marketplace, and new ingredients are introduced to consumers at lightning speed. As part of this act, laws were passed to ensure the safety of new dietary ingredients introduced into the United States marketplace. But more than 11 years later, these laws are frequently misunderstood, and more frequently ignored. This article reviews the regulatory landscape of new dietary ingredients and defines the issues manufacturers must contend with to legally market dietary supplements with new dietary ingredients in the U.S

DIETARY RISK FACTORS OF METABOLIC SYNDROME IN DIBRUGARH DISTRICT OF ASSAM