1,721,102 research outputs found
High-quality nutrition counselling for hypercholesterolaemia by public health nurses in rural areas does not affect total blood cholesterol - commentary
No full textBackground: Diet affects coronary heart disease(CHD). People living in remote areas seldom have access to nutritionist-based intervention strategies exist to improve dietary behaviour. It has been suggested thata public health nurse-based nutrition counselling service might be benefit people with hypercholesterolaemiain rural areas.Objective: To assess the effectiveness in rural areas of an intervention programme by public health nurses in facilitating dietary counselling for hypercholesterolaemia.Setting: Rural county health departments in North Carolina, United States; recruitment August 1994 to November 1996.Method: Cluster randomised controlled trial. PARTICIPANTS Seventeen rural county health departments (incorporating 468 individuals) were randomised. Individuals were included if they were aged between 20 and 70 years; had a total cholesterol levelof >4.7mmol/L within the previous 12 months, and were not being treated for hypercholesterolaemia (either medication- or counselling-based). People with severe chronic or acute medical conditions were excluded from the initial screen. People screened were then enrolled in the study if their low-density lipoprotein-cholesterol (LDL-C) was either >100mg/dL (2.59mmol/L) with known coronary heart disease (CHD), 130 to 159mg/dL (3.37 to 4.12mmol/L) with two or more CHD risk factors, or >4160mg/dL (4.14mmol/L).Intervention: The control ‘minimum’ intervention (nine departments; 252 people) consisted of routine counselling for high cholesterol by a public health nurse. The special intervention (eight departments; 216 people) comprised three individual diet counselling sessions by a public health nurse, referral to a nutritionist if lipid goals were not attained after 3 months and a follow-up phone call and newsletters. Follow-up was 12 months.Main Outcomes: Total cholesterol, LDL-C, body weight and dietary risk assessment (DRA) score based on a food frequency questionnaire.Main Results: There was no significant difference in the total reduction of blood cholesterol between the two groups at either 3 (p=0.9) or12months (p=0.6) follow-up. Weight loss was significantly greater in the special group at 3 (p=0.02) and 6 months (p=0.04), but not by 12 months (p=0.13). The average reduction in total dietary risk assessment score (indicating dietary improvement) was significantly greater in the special intervention group at both 3 (p=0.0006) and 12 months (p=0.005) follow -up.Author's Conclusions: Intensive dietary counselling does not seem to improve blood cholesterol compared with minimal counselling
Meta-analysis of the health effects of using the glycaemic index in meal-planning
No full textDiabetes mellitus and CVD are some of the leading causes of mortality and morbidity. Accumulating data indicate that a diet characterised by low-glycaemic index (GI) foods may improve the management of diabetes or lipid profiles. The objective of the present meta-analysis was to critically analyse the scientific evidence that low-GI diets have beneficial effects on carbohydrate and lipid metabolism compared with high-GI diets. We searched for randomised controlled trials with a crossover or parallel design published in English between 1981 and 2003, investigating the effect of low-GI v. high-GI diets on markers for carbohydrate and lipid metabolism. Unstandardised differences in mean values were examined using the random effects model. The main outcomes were fructosamine, glycated Hb (HbA1c), HDL-cholesterol, LDL-cholesterol, total cholesterol and triacylglycerol. Literature searches identified sixteen studies that met the strict inclusion criteria. Low-GI diets significantly reduced fructosamine by -0·1 (95 % CI -0·20, 0·00) mmol/l (P=0·05), HbA1c by 0·27 (95 % CI -0·5, -0·03) % (P=0·03), total cholesterol by -0·33 (95 % CI -0·47, -0·18) mmol/l (P<0·0001) and tended to reduce LDL-cholesterol in type 2 diabetic subjects by -0·15 (95 % CI -0·31, -0·00) mmol/l (P=0·06) compared with high-GI diets. No changes were observed in HDL-cholesterol and triacylglycerol concentrations. No substantial heterogeneity was detected, suggesting that the effects of low-GI diets in these studies were uniform. Results of the present meta-analysis support the use of the GI as a scientifically based tool to enable selection of carbohydrate-containing foods to reduce total cholesterol and to improve overall metabolic control of diabetes
Prevalence of risk of undernutrition is associated with poor health status in older people in the UK
No full textObjectives: To establish the prevalence of the risk of undernutrition, using criteria similar to those used by the Malnutrition Advisory Group (MAG), in people aged 65 y and over, and to identify relationships between risk of undernutrition and health and demographic characteristics.Design: A cross-sectional nationally representative sample of free-living and institutionalized older people in the UK (65 y of age and over). Secondary analysis of the National Diet and Nutrition Survey based on 1368 people aged 65 y and over.Results: About 14% (21% in those living in institutions) were at medium or high risk of undernutrition based on a composite measure of low body mass index and recent reported weight loss. Having a long-standing illness was associated with a statistically significantly increased risk of undernutrition (odds ratio: men 2.34, 95% CI 1.20-4.58; women 2.98; 1.58-5.62). The risk of undernutrition increased: in women reporting bad or very bad health status; in men living in northern England and Scotland; for those aged 85 y and older; for those hospitalized in the last year, and those living in an institution. Lower consumption of energy, meat products or fruit and vegetables and lower blood measures of zinc, vitamins A, D, E and C were associated with statistically significantly increased risk of undernutrition.Conclusions: A substantial proportion of the older population of the UK is at risk of undernutrition. High-risk subjects are more likely to have poorer health status. It is unlikely that the individuals at high risk are being detected currently, and therefore effective care is not being provided, either in the community or in institutions.Sponsorship: This analysis was partly funded by a grant from the Department of Health. We are grateful for helpful comments from Professor MJ Wiseman and the anonymous reviewers.<br/
Evidence-based nutrition - using a meta-analysis to review the literature
No full textOne of the purposes of this series on evidence-based nutrition1,2 is to elucidate how students and researchers in nutrition, practitioners, health care providers and policy makers can apply basic principles and standardised methods to synthesise and make sense of large, often unmanageable amounts of information. This is necessary in order to draw conclusions from empirical studies and make decisions which will be evidence-based and not unduly influenced by bias and chance effects. The purpose of this paper in the series is to show how a meta-analysis can be used to do this by statistically combining results from independent but related studies into a composite measure of effect.A meta-analysis is a statistical technique used to combine the results of studies addressing the same question into a one number summary.3, 4 The meta-analysis method can be applied in the social-behavioural and biomedical sciences5 and is therefore particularly suitable for nutrition data. The term meta-analysis should not be confused with a systematic review. Egger and Smith4 suggest that the term meta-analysis should be used ‘to describe the statistical integration of separate studies whereas systematic review is most appropriate for denoting any review of a body of data that uses clearly defined methods and criteria’. According to this definition a meta-analysis can, if appropriate, be part of a systematic review. It is always appropriate and desirable to systematically review a body of data, but it may at times be inappropriate to pool results from separate studies.4 Because a systematic review is a structured, systematic qualitative and quantitative integration of comparable results of several independent studies, it can provide a firm basis for planning and policy recommendations.6 A meta-analysis has been described as ‘a quantitative approach to research reviews’,7 ‘aggregating data’,8 ‘the epidemiology of results’5 and ‘the application of statistical procedures to collections of empirical findings’.3 A meta-analysis uses specific statistical methods to combine, summarise and integrate comparable results from different studies. The unit of observation is therefore the study. A major purpose of pooling results in a meta-analysis is to increase statistical power and precision of estimates in smaller studies.3-9 There are excellent sources available3-10 with detailed, step-by-step guidelines, recommendations and numerous examples of how to do a meta-analysis. In this paper the advantages and limitations of a meta-analysis and the process of conducting one will be outlined briefly to motivate nutritionists when and how to use it in their interpretation of the literature, in drawing conclusions from studies with conflicting results, and in policy formulation
Validation analysis of probabilistic models of dietary exposure to food additives
No full textThe validity of a range of simple conceptual models designed specifically for the estimation of food additive intakes using probabilistic analysis was assessed. Modelled intake estimates that fell below traditional conservative point estimates of intake and above 'true' additive intakes (calculated from a reference database at brand level) were considered to be in a valid region. Models were developed for 10 food additives by combining food intake data, the probability of an additive being present in a food group and additive concentration data. Food intake and additive concentration data were entered as raw data or as a lognormal distribution, and the probability of an additive being present was entered based on the per cent brands or the per cent eating occasions within a food group that contained an additive. Since the three model components assumed two possible modes of input, the validity of eight (2^3) model combinations was assessed. All model inputs were derived from the reference database. An iterative approach was employed in which the validity of individual model components was assessed first, followed by validation of full conceptual models. While the distribution of intake estimates from models fell below conservative intakes, which assume that the additive is present at maximum permitted levels (MPLs) in all foods in which it is permitted, intake estimates were not consistently above 'true' intakes. These analyses indicate the need for more complex models for the estimation of food additive intakes using probabilistic analysis. Such models should incorporate information on market share and/or brand loyalty
Spring wheat production on irrigated sandy soils.
No full textThis archival publication may not reflect current scientific knowledge or recommendations.
Current information available from Minnesota Extension Service.Caldwell, A.C.; Thompson, R.L.; Schoper, R.P.; Simkins, C.A.; University of Minnesota, Agricultural Extension Service. (1978). Spring wheat production on irrigated sandy soils.. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/206119
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Dietary intake of flavonoids and asthma in adults
No full textEpidemiological studies have suggested that a high consumption of apples may protect against asthma and chronic obstructive pulmonary disease. This effect has been attributed to their high flavonoid content, but few studies have investigated the relationship between flavonoid intake and obstructive lung disease directly.In a population-based, case-control study of 1,471 adults aged 16–50 yrs in London (UK), the present study examined whether dietary intake of catechins, flavonols and flavones was negatively associated with asthma, asthma severity and chronic sputum production. Asthma was defined by positive responses to a standard screening questionnaire in 1996 and information about usual diet was obtained by a food frequency questionnaire in 1997.After controlling for potential confounders, dietary intake of these three flavonoid subclasses was not significantly associated with asthma, (odds ratio per quintile (95% confidence interval) = 0.94 (0.86–1.02); 1.00 (0.92–1.09); 0.98 (0.88 –1.08) for flavones, flavonols and total catechins, respectively) nor was it associated with asthma severity, or chronic sputum production.In conclusion, no evidence was found for a protective effect of three major subclasses of dietary flavonoids on asthma. It is possible that other flavonoids or polyphenols present in apples may explain the protective effect of apples on obstructive lung disease
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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