OBJECTIVE — To systematically review the incidence of posttransplantation diabetes (PTD), risk factors for its development, prognostic implications, and optimal management. RESEARCH DESIGN AND METHODS — We searched databases (MEDLINE, EMBASE, the Cochrane Library, and others) from inception to September 2000, reviewed bibliographies in reports retrieved, contacted transplantation experts, and reviewed specialty journals. Two reviewers independently determined report inclusion (original studies, in all languages, of PTD in adults with no history of diabetes before transplantation), assessed study methods, and extracted data using a standardized form. Meta-regression was used to explain between-study differences in incidence. RESULTS — Nineteen studies with 3,611 patients were included. The 12-month cumulative incidence of PTD is lower (10% in most studies) than it was 3 decades ago. The type of immunosuppression explained 74% of the variability in incidence (P 0.0004). Risk factors were patient age, nonwhite ethnicity, glucocorticoid treatment for rejection, and immunosuppression with high-dose cyclosporine and tacrolimus. PTD was associated with decreased graft and patient survival in earlier studies; later studies showed improved outcomes. Randomized trials of treatment regimens have not been conducted. CONCLUSIONS — Physicians should consider modification of immunosuppressive regimens to decrease the risk of PTD in high-risk transplant recipients. Randomized trials are needed to evaluate the use of oral glucose-lowering agents in transplant recipients, paying particular attention to interactions with immunosuppressive drugs. Diabetes Care 25:583–592, 2002

A systematic review of the literature

BACKGROUND\nObesity in childhood is associated with increased cardiovascular risk. It is uncertain whether this risk is attenuated in persons who are overweight or obese as children but not obese as adults.\n\n\nMETHODS\nWe analyzed data from four prospective cohort studies that measured childhood and adult body-mass index (BMI, the weight in kilograms divided by the square of the height in meters). The mean length of follow-up was 23 years. To define high adiposity status, international age-specific and sex-specific BMI cutoff points for overweight and obesity were used for children, and a BMI cutoff point of 30 was used for adults.\n\n\nRESULTS\nData were available for 6328 subjects. Subjects with consistently high adiposity status from childhood to adulthood, as compared with persons who had a normal BMI as children and were nonobese as adults, had an increased risk of type 2 diabetes (relative risk, 5.4; 95% confidence interval [CI], 3.4 to 8.5), hypertension (relative risk, 2.7; 95% CI, 2.2 to 3.3), elevated low-density lipoprotein cholesterol levels (relative risk, 1.8; 95% CI, 1.4 to 2.3), reduced high-density lipoprotein cholesterol levels (relative risk, 2.1; 95% CI, 1.8 to 2.5), elevated triglyceride levels (relative risk, 3.0; 95% CI, 2.4 to 3.8), and carotid-artery atherosclerosis (increased intima-media thickness of the carotid artery) (relative risk, 1.7; 95% CI, 1.4 to 2.2) (P ≤ 0.002 for all comparisons). Persons who were overweight or obese during childhood but were nonobese as adults had risks of the outcomes that were similar to those of persons who had a normal BMI consistently from childhood to adulthood (P>0.20 for all comparisons).\n\n\nCONCLUSIONS\nOverweight or obese children who were obese as adults had increased risks of type 2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. The risks of these outcomes among overweight or obese children who became nonobese by adulthood were similar to those among persons who were never obese. (Funded by the Academy of Finland and others.).

Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors EDITORIAL COMMENT

Objective To review research on consumer use and understanding of nutrition labels, as well as the impact of labelling on dietary habits. Design A systematic review was conducted by searching electronic databases. Relevant articles were screened by two reviewers and included if they met inclusion criteria, including eight methodological criteria. A total of 120 articles were included in the review, including cross-sectional surveys ( n 96), experimental designs ( n 17), ‘natural experiments’ ( n 7) and longitudinal population-based surveys ( n 2). Setting Articles covered seven jurisdictions: USA ( n 88), Europe ( n 12), Canada ( n 9), Australia and New Zealand ( n 4), Norway ( n 2), Thailand ( n 1) and Trinidad ( n 1). Subjects Participants were from a wide range of age groups, socio-economic strata and geographical regions. Results Nutrition labels on pre-packaged foods are among the most prominent sources of nutrition information. Nutrition labels are perceived as a highly credible source of information and many consumers use nutrition labels to guide their selection of food products. Evidence also shows a consistent link between the use of nutrition labels and healthier diets. However, the use of labels varies considerably across subgroups, with lower use among children, adolescents and older adults who are obese. Research also highlights challenges in terms of consumer understanding and appropriate use of labelling information. Conclusions Nutrition labels on pre-packaged foods are a cost-effective population-level intervention with unparalleled reach. However, to capitalize on their potential, governments will need to explore new formats and different types of information content to ensure that nutrition information is accessible and understandable.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/F28676122435F2FC22D404AA268C2DB0/S1368980010003290a.pdf/div-class-title-nutrition-labels-on-pre-packaged-foods-a-systematic-review-div.pdf

Nutrition labels on pre-packaged foods: a systematic review.

During the past decade, rates of food insecurity and obesity have risen, and an association has been made between these two seemingly paradoxical states Although this relationship has not been repeatedly seen in men, research suggests a correlation in women Studies have not been able to consistently show a relationship in children, because findings differ based on age, race/ethnicity, household income, and sex Several proposed hypotheses explain why a correlation between food insecurity and obesity exists in adults—especially women—but not in children This review proposes a conceptual framework linking the Food Stamp Program and other coping strategies to the food insecurity–obesity relationship This link has implications for Food Stamp Program policy changes, welfare reform, and poverty prevention

The Food Insecurity–Obesity Paradox: A Review of the Literature and the Role Food Stamps May Play

The effects of nutrition knowledge on food label use. A review of the literature

Parental Perceptions of School Meal Programs in Guilford County, North Carolina

The objective of this study was to examine food selection factors and influence on household food selection by newcomer immigrant and refugee adolescents. Participants (n = 68) reported healthfulne...

Food Selection Factors and Perceived Influence on Household Foods Post-Arrival to the U.S. of Newcomer Immigrant and Refugee Adolescents.

Perceived Child Influence on Family Dietary and Physical Activity Behaviors

Self-report is the primary dietary assessment method used in clinical practice. The ability of newly arrived Latino immigrants to accurately identify portion sizes is largely unknown. Latino youth (n = 51) and their parents (n = 28) participated in a 5-minute portion size estimation training and then estimated portion sizes of 17 food models. The mean error for child and parent underestimation was 30% and 22%, respectively, and overestimation was 102% and 34%, respectively. Both children and parents underand overestimated portion sizes. Healthcare professionals need to be aware of estimation errors when assessing intake, developing recommendations, and conducting education for newly arrived Latino patients.

Lauren Haldeman

Papers

Parental Perceptions of School Meal Programs in Guilford County, North Carolina

Food Selection Factors and Perceived Influence on Household Foods Post-Arrival to the U.S. of Newcomer Immigrant and Refugee Adolescents.

Perceived Child Influence on Family Dietary and Physical Activity Behaviors

Portion size estimation among newly arrived Latino immigrants.

Nondiet Weight-Neutral Curricula Limited in Current Accredited US Dietetic Programs