Students’ food intake from home-packed lunches in the traditional versus balanced school day

Purpose: To assess the type and quantity of foods children brought and consumed at school in the balanced school day (BSD), with two 20-minute eating periods, versus the traditional schedule (TS), with one 20-minute lunch. Methods: Direct observation identified food items and amounts in BSD and TS lunches of grade 3 and 4 students (n = 321). Results: The mean (SD) servings of foods packed in BSD lunches were significantly higher than the TS lunches for milk and alternatives (0.69 (0.70) vs 0.47 (0.49), P = 0.02), sugar-sweetened beverages (SSBs; 0.91 (1.24) vs 0.57 (0.99), P = 0.01), and snacks (2.74 (1.55) vs 2.24 (1.48), P \u3c 0.01). Regardless of schedule, only 40.8% of students had vegetables packed in their lunch, whereas 92.8% had snacks. When comparing foods eaten, SSBs and snacks remained significantly higher in the BSD (0.75 (1.02) vs 0.48 (0.83), P = 0.03; 2.37 (1.44) vs 1.93 (1.36), P = 0.01, respectively). The proportion of children (%) whose consumption met one-third of Canada’s Food Guide recommendations for vegetables and fruit was low (27.5% BSD, 31.0% TS). Conclusions: The BSD may have unintended negative consequences on the type and amount of foods packed in school lunches. Support for families should focus on encouraging more vegetables and fruit and fewer SSBs and snacks in packed lunches

Comparison of ethanol septal reduction therapy with surgical myectomy for the treatment of hypertrophic obstructive cardiomyopathy

AbstractOBJECTIVESThis study was designed to compare the hemodynamic efficacy of nonsurgical septal reduction therapy (NSRT) by intracoronary ethanol with standard therapy (surgical myectomy) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM).BACKGROUNDNonsurgical septal reduction therapy has gained interest as a new treatment modality for patients with drug-refractory symptoms of HOCM; however, its benefits in comparison to surgery are unknown.METHODSForty-one consecutive NSRT patients at Baylor College of Medicine with one-year follow-up were compared with age- and gradient-matched septal myectomy patients at the Mayo Clinic. All patients had left ventricular outflow obstruction with a resting gradient ≥40 mm Hg and none had concomitant procedures.RESULTSThere were no baseline differences in New York Heart Association class, severity of mitral regurgitation, use of cardiac medications or exercise capacity. One death occurred during NSRT because of dissection of the left anterior descending artery. At one year, all improvements in both groups were similar. After surgical myectomy, more patients were on medications (p < 0.05) and there was a higher incidence of mild aortic regurgitation (p < 0.05). After NSRT, the incidence of pacemaker implantation for complete heart block was higher (22% vs. 2% in surgery; p = 0.02). However, seven of the nine pacemakers in the NSRT group were implanted before a modified ethanol injection technique and the use of contrast echocardiography.CONCLUSIONSNonsurgical septal reduction therapy resulted in a significantly higher incidence of complete heart block, but the risk was reduced with contrast echocardiography and slow ethanol injection. Surgical myectomy resulted in a significantly higher incidence of mild aortic regurgitation. Nonsurgical septal reduction therapy, guided by contrast echocardiography, is an effective procedure for treating patients with HOCM. The hemodynamic and functional improvements at one year are similar to those of surgical myectomy