Human nutrition. Applied nutrition最新文献

This paper argues that dietetic interviews are strongly influenced by the traditional model of the medical consultation. Evidence concerning the limitations of this model, in terms of patient satisfaction and compliance, for both doctor-patient and dietitian-patient communication, is reviewed. The interpretation of this evidence suggests that dissatisfaction and non-compliance are related to two sets of variables: cognitive and socio-emotional. A programme of training on communication and counselling skills for dietetic students, which aims to enable students to address these problems, is described and a short-term evaluation by the students of this programme is reported. The paper concludes with an evaluation of the course by staff members and some comments as to possible future trends in dietetic education.

A sample of 4-year-olds from a London inner city area whose growth fell below the 10th population centile for height and weight were matched with children whose rate of growth was within normal limits. Neither food intake nor gross environmental variables distinguished the two groups. However, mealtime observations revealed considerably more disorganization and negative attitudes in case group families. Retrospective information obtained by interview indicates that these factors had been operative since early infancy. The findings suggest that in surveys of child nutrition the role of family dysfunction should be considered.

Nineteen-Eighty-Seven marks the 75th anniversary of the expedition to the South Pole led by Captain R.F. Scott, during which he and his party died. Between November 1985 and January 1986, three men manhauled sledges 875 miles, following Scott's original route to the South Pole. They consumed an energy dense diet which provided 20.5 MJ/man/day of which 57 per cent came from fat. Despite the diet being well tolerated and allowing for dehydration, the men lost between 6.7 and 10.5 kg, indicating a daily energy expenditure of 25 MJ/man/day. Estimates from daily diary records of periods spent in different classes of activity and the literature values for energy consumption assigned to those classes, suggest a daily energy expenditure of 29 MJ/man/day. These estimates of energy expenditure were higher than expected and suggest that on Scott's last expedition, emaciation, secondary to a diet grossly inadequate in energy content, might have been a more important factor in his demise than has previously been thought.

The food intake of 37 adult volunteers (12 M, 25 F) interested in eating a healthy diet was measured on two occasions by the 7-day weighed record method. In week 1 subjects consumed their habitual diet and in week 2 attempted to follow dietary recommendations (DR). Intakes were compared with recommended dietary allowances (RDA) and with dietary guidelines (DG). Validation of recorded energy intakes against changes in body weight, and sodium, potassium and nitrogen intakes against urine excretions suggested reliable dietary records in both study weeks. Mean dietary intakes in week 1 met the RDA for all nutrients studied except for energy (which was close) and zinc (in females only). Daily energy intake was 2160 kcal (9.04 MJ) in week 1 and 1810 kcal (7.56 MJ) in week 2, and subjects lost weight during week 2. Absolute intakes of vitamins and minerals were similar in both study weeks, thus increasing nutrient density in week 2 and suggesting improved dietary quality. Mean dietary intakes in week 1 conformed more closely to DG than commonly reported and changed in the direction recommended in week 2. Mean daily intakes in week 1 and week 2 respectively were: fibre, 31 and 34 g; sodium 114 and 90 mmol; Na:K ratio, 1.37 and 1.10; alcohol, 3.3 and 2.3 per cent of total energy; fat, 38.7 and 34.2 per cent of food energy or 37.4 and 33.4 per cent of total energy. Intake of fibre increased with respect to energy but sodium intake per unit energy did not decrease. Energy intake was positively related to sodium, fibre and zinc intakes and influenced ease of conformity to DR for these nutrients. It is concluded that our motivated subjects were able to make short-term dietary changes consistent with DR. Whether or not these changes continue in the long term is the subject of a follow-up study.

The paper discusses two dietary surveys of 100 children with diabetes mellitus carried out with an average interval of 1.8 years. The results showed that there had been very little improvement in dietary prescription during the interval but some improvements in intake had occurred. For current recommendations on diet for children with diabetes to be fully implemented regular review and advice concentrating less on CHO and sugars intake and more on restricting the intake of fat is necessary.

This report summarizes the main results of a survey completed by every dietitian employed by the National Health Service in Scotland on October 31, 1983. There are currently no norms or standards for dietetic services in the United Kingdom, but these results present an opportunity for comparison among health boards. Staffing is compared with 1977 figures and time spent in different activities is shown.

In a South Wales Community Study, 2512 men aged 45-59 years were screened for evidence of ischaemic heart disease. Dietary questionnaires were given to all the men and, in a representative sub-sample of 665 men, 7-day weighed intake records were completed. Nutrient intakes of those who had ECG evidence of ischaemia but no symptoms were compared with those of men who had no evidence of IHD. Differences between the two groups were small. Those who had evidence of ischaemia on ECG tended to have lower intakes of energy, alcohol and most other nutrients. However, most of these differences appeared to be due to the difference in energy intake between the two groups. Allowing for the effect of differences between the groups in the distributions of age and body mass index did not alter the overall conclusions.

Diabetes is one of the commonest long-term diseases to affect man; approximately 2 per cent of the population is affected and this figure is rising. This paper describes a project involving the production of a teaching package for insulin-dependent diabetic children. The package took the form of an illustrated booklet and its success was evaluated at a diabetic clinic in a Glasgow hospital. As a result of this evaluation it was concluded that the package was a useful means of teaching diabetic children.

The dietary intake of 83 people with multiple sclerosis (MS) was assessed by the 7-day weighed intake method prior to dietary advice and at 6-monthly intervals thereafter up to 36 months. The P:S ratio of the diet increased from an initial value of 0.8 to 1.5 after 6 months and 1.34 at 36 months. Biochemical investigation of plasma essential fatty acid (EFA) status specifically linoleic, eicosapentanoic and docosahexanoic acids showed significant correlations with diet. Concurrent 6-monthly neurological and physiotherapy assessments were also carried out, the neurological results are discussed in relation to a nutrient scoring system.