Showing papers in "Journal of The American Dietetic Association in 1988"

Sources of data for developing and maintaining a nutrient database

Abstract: A nutrient database that contains current, reliable data is a prerequisite for accurate calculation of dietary intakes. Most nutrient databases are expanded from data supplied by the U.S. Department of Agriculture and may include additional foods or nutrients or data from more recent analyses, food manufacturers, or foreign food tables. Guidelines must be established for selection of reliable values from appropriate sources. A system for precise documentation of data sources provides a means for determining whether individual nutrient values were derived from chemical analyses, recipe calculations, or imputations. This article identifies data sources used by the Nutrition Coordinating Center at the University of Minnesota for its nutrient database and describes the procedures used to select and document nutrient values.

The effect of diet on plasma lipids, lipoproteins, and coronary heart disease.

Abstract: The role that diet plays in the management of plasma lipid levels is discussed in this review It has long been recognized that saturated fatty acids and cholesterol raise the plasma cholesterol level whereas polyunsaturated fatty acids lower it Recently, the effects of other dietary constituents in the management of plasma lipid levels have been established In particular, monounsaturated fatty acids, soluble fiber, and vegetarian diets favorably affect plasma lipid levels Overweight and obesity adversely affect plasma lipid levels Omega-3 fatty acids are hypotriglyceridemic, and high carbohydrate diets low in saturated fatty acids are hypocholesterolemic Further work is required to establish the long-term consequences of alcohol and coffee consumption on the plasma lipid response A variety of alternative dietary strategies can be employed in conjunction with traditional dietary recommendations (ie, reduce total fat, especially saturated fatty acids and dietary cholesterol) for the management of plasma lipid levels The expected plasma total cholesterol (specifically low-density-lipoprotein cholesterol) reduction is approximately 10% to 20% when dietary saturated fatty acids and cholesterol are decreased to less than or equal to 7% of calories and less than or equal to 200 mg of cholesterol per day Further dietary modifications, such as increasing soluble fiber, may lead to additional reductions of 1% to 10% in plasma total cholesterol

Iron nutrition and absorption: dietary factors which impact iron bioavailability.

Abstract: Iron deficiency is widely observed worldwide, yet, paradoxically, iron is the most plentiful heavy metal in the earth's crust. Although absorption of iron from the gastrointestinal tract is strictly controlled, excretion is limited to iron lost from exfoliation of skin and gastrointestinal cells, customary and abnormal blood loss, and menses. Individuals highly vulnerable to iron deficiency have high iron needs, as during growth or pregnancy; high iron loss, as during marked hemorrhage or excessive and/or frequent menstrual losses; or diets with low iron content or bioavailability. Food iron is classified as heme or nonheme. Approximately half of the iron in meat, fish, and poultry is heme iron. Depending on an individual's iron stores, 15% to 35% of heme iron is absorbed. Food contains more nonheme iron and, thus, it makes the larger contribution to the body's iron pool despite its lower absorption rate of 2% to 20%. Absorption of nonheme iron is markedly influenced by the levels of iron stores and by concomitantly consumed dietary components. Enhancing factors, such as ascorbic acid and meat/fish/poultry, may increase nonheme iron bioavailability fourfold.

Prediction of body weight for the nonambulatory elderly from anthropometry

Abstract: Body weight is one of the most important measurements in assessing nutritional status. Weight is also an important variable in equations that are needed to predict caloric expenditure and in indexes of body composition. Equations to predict the body weight of nonambulatory elderly persons with known errors should make use of body measurements that are indexes of the actual constituents of body composition and that can be collected regardless of an elderly person's level of mobility. The study samples consisted of a validation sample of 228 ambulatory white elderly persons, a cross-validation sample, and a clinical-validation sample of nonambulatory white elderly persons. Equations to predict body weight in the validation sample were derived from recumbent measures of arm and calf circumferences, triceps and subscapular skinfolds, and knee height. The accuracy, sensitivity, and validity of the equations were independently tested in the cross-validation sample; mean signed differences in actual and predicted weight ranged from 0.1 to 1.8 kg. In the clinical-validation sample, the mean differences were larger. Prediction equations are presented using two, three, and four body measurements to allow the selection of an equation based upon those measurements that are possible to collect from a nonambulatory person on an individual basis.

Vitamin E, vitamin B-6, vitamin B-12, and folate status of gastric bypass surgery patients.

Abstract: The vitamin E, vitamin B-6, vitamin B-12, and folate status of 22 gastric bypass subjects aged 23 to 60 years was evaluated before surgery and at 6 and 12 months after surgery. Before surgery, 77% of subjects had adequate plasma vitamin E levels; 36%, adequate plasma pyridoxal phosphate levels; 100%, adequate plasma vitamin B-12 levels; and 45%, adequate plasma folate levels. The food intake of all subjects was sharply reduced after surgery. After surgery, subjects were classified into three vitamin supplement groups on the basis of average daily vitamin supplement intake. Subjects taking higher levels of supplements containing the vitamins in question had significantly higher plasma concentrations of the vitamins than those taking low or moderate levels. The mean plasma vitamin values in the moderate supplement group were indicative of adequate status for all vitamins, but plasma vitamin B-12 levels at 12 months post-surgery were significantly lower than pre-surgery levels. In the low supplement group, mean plasma vitamin levels were in or near marginal or deficient ranges. The majority of subjects consuming supplements of vitamin E, vitamin B-6, and folate near the US RDA maintained normal vitamin status. Subjects taking more than 100 µg vitamin B-12 daily had adequate vitamin B-12 status. Significant correlations (r=. 67 to. 94) were observed between vitamin supplement levels and the respective plasma vitamin concentrations. J Am Diet Assoc 88:579, 1988.

Individual dietary intake methodology: a 50-year review of progress.

Abstract: This article provides an overview of five decades (1936 through 1987) of publications on individual dietary assessment methodology, such as dietary histories, estimated and weighed food records, food frequency questionnaires, and 24-hour recalls. Representative studies were selected to characterize data collection and analyses methods of each decade. During the 1930s and 1940s, dietary intake methodology was in its initial stages; popular methods were the dietary history technique and lengthy food records. The 1950s were characterized by extensive comparisons of methodologies, which now often included shorter-term food records and 24-hour recalls. The 1960s ushered in large scale epidemiological studies, the food frequency technique, and use of computer technology for computation; the 24-hour recall was still widely used in that decade and the next. Advances of the 1970s and 1980s include expansion of nutrient databases, sophisticated statistical techniques for analysis, and refinement of data collection methodologies for analysis, and refinement of data collection methodologies. The chronological approach used in this review not only highlights progress of each decade but also identifies the repetitive efforts of some studies. The need for creative approaches is emphasized as current research needs are identified.

Accuracy of methods estimating calcium and phosphorus intake in daily diets.

Abstract: Three different methods of estimating calcium and phosphorus content were compared with the chemical analysis of 20 daily diets taken from general hospital and cafeteria menus, individual food records, and menus designed for research. Comparisons of chemical analyses with estimated values showed an insignificant trend toward underestimation of calcium content; all methods significantly underestimated phosphorus content. On the average, estimates of phosphorus content deviated from actual by approximately 250 mg/day. Diets with a greater proportion of processed, convenience, or restaurant foods deviated by more than 350 mg/day. Our findings suggest that estimates of calcium intake calculated from available food composition tables are within an acceptable range of error; however, phosphorus intake is significantly underestimated by 15% to 25% of the actual level. For accurate calculation of phosphorus content, nutrient composition sources must be updated to reflect present industrial use of phosphate-containing additives.

Two-year follow-up of patients treated with a very-low-calorie diet and exercise training

Abstract: A study assessed the effect of exercise in a very-low-calorie diet (VLCD) program in combination with behavioral techniques, nutrition education, and group therapy. The results suggested that excerise may have had a beneficial role beyond its assumed purpose. Two-year follow-up results indicated that exercisers had less weight regain than non-exercisers

Copper nutriture, bioavailability, and the influence of dietary factors

Abstract: Copper is known to be an essential nutrient for human beings, but a Recommended Dietary Allowance has not yet been established. A safe and adequate range of intake was established in 1980 for copper and five other trace elements. The range for copper, 2 to 3 mg/day, is higher than the usual dietary copper intake of many individuals in this country. On the basis of balance studies, a requirement of 1.3 mg/day has been suggested. Recent data on copper intake and bioavailability should aid in reevaluating the dietary copper requirement. Copper deficiency symptoms have seldom been observed in human beings. When copper deficiency has been recognized, it has been under unusual conditions, such as in patients receiving parenteral nutrition. Interactions between copper and other dietary components may alter copper status, but the impact of those interactions is not yet well understood. Dietary factors that may affect the bioavailability of copper include the levels of copper, zinc, and molybdenum in the diet; iron deficiency; ascorbic acid intake; intake of carbohydrates, including fructose, glucose, and starch; and fiber and phytate intakes. Some drugs may also affect copper bioavailability.

Comparison of the effects of psyllium and wheat bran on gastrointestinal transit time and stool characteristics.

Abstract: Gastrointestinal transit time, frequency of defecation, stool weight, and stool consistency were studied in 12 subjects who were each given fiber supplements containing wheat bran, psyllium gum, a combination of wheat bran and psyllium gum, or a low-fiber control for 2 weeks Gastrointestinal transit time was measured using four different markers: plastic pellets, chromium mordanted bran, cobalt-ethylenediamine-tetraacetic acid, and terbium oxide The wet weight and dry weight of stools were measured, and a questionnaire accessed subjects' perceptions of the consistency of their stools Fiber supplementation decreased transit time and increased the daily number of defecations and the wet weight and dry weight of stools Bran had a greater effect on transit time than psyllium Psyllium had a greater effect on the amount of water found in the stools and the total stool weight On the days that stools were passed, 50% of the daily stool ratings were scored as "hard" when subjects received the control supplement Less than 10% of the ratings were scored as "hard" when subjects received the high-fiber supplements The type of marker used did not significantly affect the transit time measured

Educational attainment and nutrient consumption patterns: the Minnesota Heart Survey.

Abstract: To explore whether dietary patterns differ according to educational attainment, we examined the associations of nutrient intake with educational level in a sample of 825 male and 893 female Twin Cities (Minneapolis and St. Paul) residents aged 25 to 74 years who were surveyed between 1980 and 1982. Of particular interest was the pattern of macronutrient consumption, since the proportion of fat and type of fat in the diet is thought to be related to the development of chronic disease. Estimates of nutrient intake were based on 24-hour dietary recalls, while information on education was obtained through interview. Educational attainment was positively associated with nutrient consumption patterns that may decrease risk of chronic disease for both men and women. For women, the proportion of dietary fat was less (p=.03) and carbohydrate greater (p=.004) with increasing education. For men, the Keys dietary score decreased as education increased (p=.05) (high scores indicate greater blood cholesterol-raising effect of the diet). Inverse associations of average total serum cholesterol level with education in both men (p=.02) and women (p=.06) support these dietary associations. These results suggest that educational attainment is related positively to eating patterns that may carry a decreased risk of cardiovascular and other chronic disease. Whether or not this association is causal, it would appear to point to a need for more effective nutrition education strategies for those with less education. J Am Diet Assoc 88:1230, 1988.

A saturated fat/cholesterol avoidance scale: sex and ethnic differences in a biethnic population.

Abstract: Avoidance of saturated fat and cholesterol by 1,210 Mexican Americans and 866 non-Hispanic whites was assessed as part of a population-based survey of diabetes and cardiovascular risk factors. Participants ranged in age from 25 to 64 years and resided in three socioeconomically distinct neighborhoods of San Antonio, TX: low income, middle income, and upper income. A scale was constructed to assess the degree to which individuals avoided six dietary sources of saturated fat and cholesterol. Women of both ethnic groups were found to avoid saturated fat and cholesterol to a greater degree than men, scoring higher on five of the six components of the scale. Saturated fat/cholesterol avoidance increased significantly with increased socioeconomic status in both ethnic groups. Although there were no ethnic differences in overall saturated fat/cholesterol avoidance, more non-Hispanic whites recognized milk, eggs, and visible fat on meat as food sources to avoid. The scale described in this paper provides useful information about the specific food components recognized as dietary sources of saturated fat and cholesterol and helps identify those population groups that would benefit from nutrition education programs. Because of its simplicity and ease of administration, the scale may be a useful tool in epidemiological research. J Am Diet Assoc 88:172, 1988.

Estimation of food portion sizes: effectiveness of training.

Abstract: This study compared the effectiveness of two types of training on the ability to estimate food portion sizes. Training consisted of a 10-minute group session in which subjects practiced measuring various solid and liquid foods with household measures. A second group of subjects viewed food models of solids and liquids. Immediately following training, subjects individually quantified portion sizes of foods displayed as a breakfast, lunch, and dinner. A third group, whose members received no training, also estimated the same food portion sizes. Results indicated no statistically significant difference (p greater than .05) between the two types of training using both parametric and non-parametric tests. When the trained groups were combined and compared with the untrained group, MANOVA analysis indicated training made a significant difference (p less than .05) in improving estimation for some food items. A Kolmogorov-Smirnov test also supported the hypothesis that training improved estimation for some, but not all, food items. Although a significant difference was not found for all food items, the data lend some support to the practice of using food models or household measures to enhance the ability to estimate food portion sizes more accurately, even when training is undertaken in short group sessions.

Evaluation study of the California Expanded Food and Nutrition Education Program: 24-hour food recall data.

Abstract: The California Expanded Food and Nutrition Education program (EFNEP) Evaluation Study evaluated the effectiveness of the California program. The eating. habits of 6 3 persons were studied in a group receiving EFNEP instruction (355 participants) and a control group (328 participants) that received no instruction: The 24-hour food recall was used to assess eating habits using the Synectics method. At the beginning of the study, there were no differences in food recall scores between the EFNEP and the control groups. After 6 months of instruction in the EFNEP group, there was a significant increase in food recall score for that group and no change in the control group. The improvements observed in the EFNEP group resulted from increased intakes from the milk, protein, and fruit and vegetable food groups. The program characteristics that led to those changes were determined to be in the length of the EFNEP visit, the number of EFNEP visits, and the EFNEP instruction topics. These results show that the California EFNEP is effective in producing significant changes in the eating habits of the low-income individuals it serves. J Am Diet Assoc 88:185, 1988.

Body composition and nutrient intakes of college men and women basketball players.

Abstract: Computer analysis of diet records was used to compare adequacy of nutrient intake for 16 male and 10 female intercollegiate basketball players. Significant differences (p less than .05) between men and women were observed for the provision of nutrients from food alone; mean percent RDAs of all nutrients except vitamins A and D was greater for men. This was due primarily to caloric intakes by the men, which averaged twice those of the women. Nutrient supplements had a significant effect on the women's total intake. With the exceptions of energy, protein, and vitamin C, differences between men and women in percent RDAs were eliminated when the contribution of nutrient supplements was included. The data made apparent the need for dietitians familiar with sports nutrition to counsel female athletes on means of obtaining nutrients via an adequate diet.

Guidelines for use of dietary intake data.

Abstract: This article presents the guidelines from the report of the ad hoc Expert Panel on Guidelines for Use of Dietary Intake Data. The report was prepared under terms of a contract with the Life Sciences Research Office of the Federation of American Societies for Experimental Biology to provide the Food and Drug Administration with a working reference for evaluating dietary intake data. The guidelines represent the Expert Panel's conclusions on appropriate ways to interpret dietary data relating to (a) prevalence of consumption of particular levels of foods or food components, (b) comparisons of intake of different groups within the U.S. population, (c) time trends in consumption of foods or food components, and (d) relationships of intake of a food or food component to a given health outcome. The guidelines address general issues concerning dietary data collection and statistical concerns as well as specific issues important in interpretation of dietary data. J Am Diet Assoc 88:1258, 1988.

Comparison of a computerized and a manual method of food coding for nutrient intake studies.

Abstract: The Dietary Data Collection (DDC) microcomputer system is currently being developed as a tool for the standardized and detailed collection of dietary intake data for human nutrition research studies. The system operates interactively, soliciting all necessary information on menu selection screens to ensure user entry of complete food descriptions and quantity information. The descriptive data are then automatically converted to food codes and gram weights for subsequent calculation of nutrient content. At the completion of the first phase of system development, a preliminary test was performed to compare the amount of time required to enter food intake data into the DDC system with the amount of time required to accomplish the same food coding task manually. Test subjects consisted of four experienced food coders and one coder trainee. Using a crossover design, each coder manually coded 16 1-day food records and entered another 16 records into the DDC system for automatic coding. Four of the five coders took significantly less time to code and enter descriptive dietary intake information using the DDC system than they took for manual coding and data entry. Time savings ranged between 9% and 44% among the test subjects. J Am Diet Assoc 88:1263, 1988.

Upper arm anthropometric norms in elderly white subjects.

Abstract: The purpose of this study was to develop percentile norms for upper arm anthropometry for use in the nutrition assessment of the elderly. This survey involved the measurement of four parameters: triceps skinfold thickness, mid-upper arm circumference, mid-upper arm muscle circumference, and mid-upper arm muscle area. Measurements were collected from 746 white, noninstitutionalized ambulatory elderly persons living in the Cincinnati area. Age- and sex-specific percentile distributions for the four parameters indicated age-related trends. All four parameters were lowered with advancing age in elderly women and men aged 60 to 89 years. The degree of change with age varied among parameters but was consistently greater in elderly women than in men. Elderly women had larger triceps skinfold thickness but smaller mid-upper arm circumference, mid-upper arm muscle circumference, and mid-upper arm muscle area measurements than did elderly men. These anthropometric findings provide useful standards for ambulatory white elderly people. It is evident that upper arm anthropometry changes with age. As a result, an elderly person's nutritional status should not be evaluated with a single standard for the elderly. Surveys of the elderly should use appropriate age standards to ensure an accurate estimation of obesity or undernutrition in the elderly.

Factors influencing duration of breast feeding among low-income women.

Abstract: Forty low-income breast feeding primiparous women were interviewed to determine whether family member and peer attitudes toward breast feeding and available postpartum support were associated with continued or early termination of breast feeding Mean breast feeding duration equalled 205 weeks (range, 1 to 52 weeks) When an outside source of assistance (a doula) was available during the first 2 weeks postpartum, mean duration was 234 weeks compared with 123 weeks when a doula was unavailable (p less than 05) Breast feeding duration was independent of the doula's attitude regarding breast feeding Duration of breast feeding was significantly longer for breast feeding women who participated in the USDA Special Supplemental Program for Women, Infants, and Children (WIC) than for those who did not participate All of the women claimed to like breast feeding; 93% of the husbands or boyfriends, 83% of the women's mothers, and 81% of the women's best friends had positive attitudes toward breast feeding The more breast feeding friends the woman had, the longer she breast fed (r = 32, p less than 05) Termination of breast feeding was not due to perceived negative attitudes of family members and peers regarding breast feeding

Effects of fructose feeding on blood parameters and blood pressure in impaired glucose-tolerant subjects

Abstract: The effects of fructose and glucose on selected blood parameters and blood pressure after 4 weeks of oral ingestion were investigated in nine impaired glucose-tolerant subjects (IGTS) and nine normal glucose-tolerant subjects (NGTS). The criteria for IGTS were (1)1- or 2-hour postprandial glucose levels between 160 and 200 mg/dL (8.8 to 11.1 mmol/L); (2) compliance with the diet; and (3) no cardiac or renal complication. The mean increment in the area under the plasma glucose and insulin curves after a glucose load was significantly greater following glucose than following fructose ingestion in both IGTS and NGTS (p

Sodium, potassium, calcium, magnesium, and phosphorus intakes of infants and children: Bogalusa Heart Study.

Abstract: Electrolyte and mineral intakes assessed by 24-hour dietary recall were examined for race and sex differences in cohorts of infants and school-age children at 6 months and at 1, 2, 3, 4, 10, 13, 15, and 17 years. A fourfold increase in sodium intake occurred from 6 months to 4 years, and potassium intake doubled. Sodium increased from 0.88 gm at 6 months to 3.21 gm at 4 years and 3.67 gm by 17 years; a slight increase for potassium was noted from 4 to 17 years for boys. Calcium intake was relatively constant from 6 months to 17 years. Boys had higher intakes of sodium and sodium per kilogram body weight than did girls. Black children at 2, 3, and 4 years had significantly higher sodium, potassium, calcium, phosphorus, and magnesium expressed as total intake and per kilogram body weight than white children did. At 6 months, 66% of the infants exceeded the National Research Council's recommended range for sodium. At 1 to 10 years, 90% to 100% and at 13 to 17 years, 60% to 65% exceeded the recommended range. In contrast, 58% to 77% of preschool children and only 5% to 20% of school-age children surpassed the recommended potassium range. Fifty percent to 70% of children more than 10 years old achieved the recommended range for potassium. Approximately half of the children 6 months through 4 years of age met the Recommended Dietary Allowance (RDA) for calcium. Sixty percent to 80% of adolescents ingested less than two-thirds the RDA. Girls had lower intakes than did boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Vitamin-mineral supplement use: association with dietary intake and iron status of adults.

Abstract: Although vitamin-mineral supplement use is increasing in the United States, few researchers have examined whether supplement users have better nutritional status than do nonusers. Data from 10,515 persons examined in the second National Health and Nutrition Examination Survey (NHANES II) were used to compare mean dietary intakes of several nutrients and food groups, hemoglobin, mean corpuscular volume, transferrin saturation, erythrocyte protoporphyrin, and serum ferritin between regular supplement users and nonusers aged 16 to 74 years. Prevalences of impaired iron status also were compared between user groups. Users consumed more vitamin C and ate fruits and vegetables more frequently than did nonusers in all age/sex groups. No significant differences in mean iron status indicators were observed except in the 65 to 74 year age/sex groups: transferrin saturation among men and mean corpuscular volume, erythrocyte protoporphyrin, and serum ferritin among women. In each case, users had higher values than nonusers in this age group. Prevalences of impaired iron status did not differ between users and nonusers in any age/sex group. In general, iron status was not associated with supplement use.

Blood phenylalanine levels and intelligence of 10-year-old children with PKU in the National Collaborative Study.

Abstract: Dietary intakes and blood phenylalanine levels of 125 10-year-old children with PKU are reported. Of those patients, 59 discontinued the special diet at 6 years, 16 discontinued at 8 years, 5 discontinued at 6 years but returned to the diet at 8½ years, and 45 continued the diet to 10 years. Phenylalanine intake was determined by 2-day diet records. Blood phenylalanine concentrations revealed a lack of clear distinction between the diet groups; therefore, regression analysis was performed on the group as a whole. The analyses revealed significant relationships between blood phenylalanine levels from ages 6 to 10 years and each of the cognitive outcome variables, after the influences of parental IQ and the age at which treatment was initiated were controlled for. Intelligence test scores were also related to phenylalanine levels between ages 3½ and 5½ years. The findings suggest that dietary restriction of phenylalanine should continue in patients with PKU through at least 10 years of age. J Am Diet Assoc 88:1226, 1988.

Contemporary diet and body weight of Navajo women receiving food assistance: An ethnographic and nutritional investigation

Abstract: Preceded by 6 months of ethnographic research, a survey of 107 Navajo women, primarily food assistance participants, was conducted to describe and evaluate the contemporary Navajo diet. On the basis of results of 1-day dietary recalls, mean nutrient intakes were found to be below the RDA for calcium, phosphorus, iron, vitamin A, and energy. Sixty-three percent of the women in the sample were overweight or obese. The overall percentages of energy from fat, carbohydrate, and protein were closer to those recommended in the Dietary Goals than those in the current U.S. diet. The fat in the diet appeared to be primarily saturated, however, and fiber intake was lower than the U.S. average. Traditional foods were infrequently consumed. Women with higher incomes tended to have better diets. Commodity foods supplied by USDA's Food Distribution Program provided 43% of caloric intake and 37% to 57% of the intakes of all other nutrients except fat and vitamin C for the 72% of the sample participating in that program. It is concluded that the Food Distribution Program provides an important nutritional contribution to the contemporary Navajo diet.

Trace element status of children with PKU and normal children

Abstract: The trace mineral (chromium, copper, iron, selenium, and zinc) status of 10 children (4 to 13.8 years) with phenylketonuria (PKU) and 9 normal children (6.5 to 15.9 years) was assessed. The children with PKU were treated with a phenylalanine-free L-amino acid mix that supplied the following percentages (mean ± standard deviation) of total daily intake: energy, 45 ± 13; protein, 75 ± 11; copper (Cu), 62 ± 10; iron (Fe), 82 ± 7; selenium (Se), 40 ± 20; and zinc (Zn) 87 ± 8. Diet records and blood samples were collected from each subject. Children with PKU had significantly greater mean intakes of Cu, Fe, and Zn than normal children. Mean serum Cu, Fe, and Zn concentrations of the children with PKU and normal children were not different despite significantly greater intakes by the children with PKU. Normal children had a significantly greater mean serum Se concentration and a mean blood chromium concentration 1.6 times that of children with PKU. Individuals whose primary source of protein is an elemental diet are especially at risk for multiple trace mineral deficiencies. Manufacturers of chemically defined medical foods should evaluate composition, specifically molar ratios between minerals, as a basis for product formulation. J Am Diet Assoc 88:459, 1988.

Does dietary fiber affect food intake and body weight

Abstract: The effect of dietary fiber on energy intake or body weight has been the subject of numerous clinical studies. Critical examination of the studies shows that many have methodological problems that limit their usefulness. Problems include the absence of a placebo treatment, confounding with time, inadequate measurement of food intake, very low doses of fiber, inappropriately short treatment and observation periods, and multiple changes in the diet. The reviewed evidence indicates that supplementation with wheat bran has no effect on energy intake or body weight; however, other types of fiber may have an effect. Four studies showed that fiber supplementation resulted in a 0.2 to 0.4 kg/week greater weight loss in the treatment than in the control subjects. One study showed a decrease of 1,071 kcal/week in a subject's spontaneous intake. None of the studies reviewed followed subjects for longer than 3 months.

Caffeine intakes of children from a biracial population: the Bogalusa Heart Study.

Abstract: To investigate caffeine intake patterns in children, dietary intakes were examined for a biracial sample of 1,284 infants and children. Twenty-four-hour dietary recalls were completed by parents of children aged 6 months and repeated at ages 1, 2, 3, and 4 years; children 10 years old served as their own respondents and were surveyed at ages 13, 15, and 17 years. The sample was 60% white and 40% black. Additional cohorts of 10-year-olds (no.= 686) were studied for temporal trend. Whites consumed significantly more caffeine than blacks as early as 1 year and persisted at a higher intake level from 2 to 17 years. This trend continued whether intake was measured in total milligrams, milligrams per 1,000 kcal, or milligrams per kilogram body weight. Significant sex differences in caffeine intakes per 1,000 kcal occurred among 15- and 17-year-olds (girls>boys). Peak periods of consumption occurred at ages 2, _3, 13, and 17. Snacks contributed large quantities of caffeine, particularly for 10-year-olds. Most frequent sources of caffeine were regular carbonated beverages, chocolate-containing foods, and tea. Mean intakes of caffeine for 10-year-olds were consistent from 1973 to 1982. Those observations document caffeine intakes beginning early in life. J Am Diet Assoc 88:466, 1988.

Nutritional status and phytate:zinc and phytate x calcium:zinc dietary molar ratios of lacto-ovo vegetarian Trappist monks: 10 years later.

Abstract: A nutrition assessment of 16 members of a community of lacto-ovo vegetarian Trappist monks was conducted in 1977. Plasma zinc was found to be low-normal, which was attributed primarily to high intakes of phytate-containing foods. Individual and group counseling were instituted over a 10-year period in an attempt to emphasize the importance of wise food selection within the constraints of lacto-ovo vegetarianism. In 1987, a more comprehensive nutrition assessment of 21 members of the same community was performed. Food composites were analyzed, and 3-day instead of 24-hour dietary records were kept. Intakes of phytate-containing foods had decreased from 4,569 to 972 mg/day; intake of dietary zinc had increased from 7.4 to 9.7 mg/day; and the phytate:zinc molar ratio had decreased from 67 to 14 for the years 1977 and 1987, respectively. An analyzed phytate:zinc molar ratio of 9.8 and an analyzed phytate x calcium:zinc molar ratio of 0.3 were representative of the 1987 community. Both were within normal ranges. Plasma zinc had risen to upper-normal levels. The 1987 nutrition assessment showed that it is possible to be adequately nourished with a lacto-ovo vegetarian diet provided one has proper knowledge of the phytate-containing foods and the methods for compensating with foods of greater mineral density (primarily zinc).

The National Cholesterol Education Program: implications for dietetic practitioners from the Adult Treatment Panel recommendations.

Abstract: The National Cholesterol Education Program (NCEP) was initiated to contribute to the prevention of illness and death from coronary heart disease by reducing the prevalence of high blood cholesterol. The report of an expert panel of this program provides guidelines for the treatment of high blood cholesterol in adults 20 years of age and over. Dietary therapy is the primary treatment. The goal of the recommended dietary therapy is to lower the LDL-cholesterol concentration, although measurement of total blood cholesterol can be used to monitor the response to diet. Dietary modification involves a progressive decrease in intake of saturated fatty acids and cholesterol. The Step-One Diet calls for an intake of total fat less than 30% of calories, saturated fatty acids less than 10% of calories, and cholesterol less than 300 mg/day. If the desired decrease in LDL-cholesterol is not achieved with that dietary change, then the Step-Two Diet is begun. It requires a reduction in saturated fatty acids to less than 7% of calories and cholesterol to less than 200 mg/day. This article provides background information on the organization and objectives of the NCEP and focuses on the recommendations of the Adult Treatment Panel (ATP), e.g., classification of risk for developing coronary heart disease based on total and low-density-lipoprotein cholesterol levels and recommendations for treatment of patients with high blood cholesterol. The emphasis of the discussion is on dietary treatment. The implications of the recommendations for the dietetic practitioner are discussed. These include an expanded leadership role to meet the education needs of health professionals and patients.