Dietary Methodology Workshop for the Third National Health and Nutrition Examination Survey

The Dietary Survey Methodology Workshop (March 16-18, 1986) was sponsored by the National Center for Health Statistics for the purposes of reviewing, evaluating, and making recommendations for the selection of dietary methodologies for the third National Health and Nutrition Examination Survey (NHANES Ill), Presented are the background papers, consensus statements, and rationale for the dietary methodologies selected for NHANES Ill.Edited by Ronette R. Briefel and Christopher T. Sempos."Sponsored by the National Center for Health Statistics."The Workshop was held in Airlie, Va. from Mar. 16 to 18, 1986."March 1992."Also available via the World Wide Web.Includes bibliographical references.Briefel RB, Sempos CT, eds. Dietary methodology workshop for the third National Health and Nutrition Examination Survey. National Center for Health Statistics Vital Health Stat 4(27) 1992

Time-scarcity, ready-meals, ill-health and the obesity epidemic

In this 3-part paper, we firstly review the interaction of time-scarcity with food-choices, specifically ready-meals, and potential health consequences from their consumption. Secondly we review declared nutrients, in relation to the standard 30% of Guideline Daily Amounts, concluding that popular ready-meals from major UK supermarkets are currently nutritionally haphazard. Thirdly, we present a simple scheme to establish standards for nutritional composition of ready-meals: unless otherwise specified, any meal (the smallest unit of nutrition) as recommended to be eaten or as offered should provide 30%+10% of GDA for energy and pro rata for key nutrients (e.g. sodium, sat fat, vitamin C)

Effects of lifestyle education program for type 2 diabetes patients in clinics: study design of a cluster randomized trial

<p>Abstract</p> <p>Background</p> <p>The number of patients with type 2 diabetes is drastically increasing worldwide. It is a serious health problem in Japan as well. Lifestyle interventions can reduce progression from impaired glucose tolerance to type 2 diabetes, and glycemic control has been shown to improve postprandial plasma glucose levels. Moreover, several studies have suggested that continuous interventions (combined diet and exercise) can improve the plasma glucose level and reduce dosage of hypoglycemic agents.</p> <p>Although many interventional studies of lifestyle education for persons with diabetes in hospitals have been reported, only a few have been clinic-based studies employing an evidence-based lifestyle education program. This article describes the design of a cluster randomized controlled trial of the effectiveness of lifestyle education for patients with type 2 diabetes in clinics by registered dietitians.</p> <p>Methods/Design</p> <p>In Japan, general practitioners generally have their own medical clinics to provide medical care for outpatients in the community, including those with type 2 diabetes. With the collaboration of such general practitioners, the study patients were enrolled in the present study. Twenty general practitioners were randomly allocated to each provide patients for entry into either an intervention group (10) or a control group (10). In total, 200 participants will be included in the study. The intervention group will receive intensive education on lifestyle improvement related to type 2 diabetes by registered dietitians in clinics. Lifestyle education will be conducted several times during the study period. The control group will receive information on dietary intake and standard advice on glycemic control by registered dietitians. The primary endpoint is the change from the baseline value of HbA1c at 6 months. Data on health behavior and related issues will be gathered continuously over a 6-month period.</p> <p>Discussion</p> <p>This is the first study to evaluate lifestyle education in clinics by a cluster randomization trial in Japan. The proposed study will provide practical information about the usefulness of the intensive lifestyle improvement education program in primary care settings. The study was started in September 2007 and entry of subjects was completed in December 2010. Data on the effect evaluation will be available in 2011.</p> <p>Trial Registration</p> <p>UMIN000004049</p

Peas, please! Food familiarization though picture books helps parents introduce vegetables into preschoolers' diets

Repeated taste exposure is an established means of increasing children’s liking and intake of fruit and vegetables. However, parents find it difficult to offer children disliked foods repeatedly, often giving up after a few attempts. Studies show that familiarizing children to fruit and vegetables through picture books can increase their interest in tasting targeted foods. This study explored whether looking at picture books before providing foods to taste improved the outcomes of a home-delivered taste exposure regime. Parents of 127 toddlers (aged 21-24 months) identified two ‘target’ foods they wanted their child to eat (1 fruit, 1 vegetable). Families were randomly assigned to one of three groups. Parents and children in two experimental groups looked at books about either the target fruit or vegetable every day for two weeks; the control group did not receive a book. Parents in all three groups were then asked to offer their child both target foods every day during a 2-week taste-exposure phase. Parental ratings of children’s liking and consumption of the foods were collected at baseline, immediately following taste-exposure (post-intervention), and 3 months later (follow-up). In all groups, liking of both foods increased following taste exposure and remained above baseline at follow-up (all ps<.001). In addition, compared to the control group who experienced only taste exposure, looking at vegetable books enhanced children’s liking of their target vegetable post-intervention (p<.001) and at follow-up (p<.05), and increased consumption of the vegetable at follow-up (p<.01). Exposure to vegetable books was also associated with smaller increases in neophobia and food fussiness over the period of the study compared to controls (ps<.01), suggesting that picture books may have positive, long-term impacts on children’s attitudes towards new foods

Perspective: The Application of A Priori Diet Quality Scores to Cardiovascular Disease Risk-A Critical Evaluation of Current Scoring Systems.

Healthy dietary habits are the cornerstone of cardiovascular disease (CVD) prevention. Numerous researchers have developed diet quality indices to help evaluate and compare diet quality across and within various populations. The availability of these new indices raises questions regarding the best selection relevant to a given population. In this perspective, we critically evaluate a priori-defined dietary indices commonly applied in epidemiological studies of CVD risk and mortality. A systematic literature search identified 59 observational studies that applied a priori-defined diet quality indices to CVD risk factors and/or CVD incidence and/or CVD mortality. Among 31 different indices, these scores were categorized as follows: 1) those based on country-specific dietary patterns, 2) those adapted from distinct dietary guidelines, and 3) novel scores specific to key diet-related factors associated with CVD risk. The strengths and limitations of these indices are described according to index components, calculation methods, and the application of these indices to different population groups. Also, the importance of identifying methodological challenges faced by researchers when applying an index are considered, such as selection and weighting of food groups within a score, since food groups are not necessarily equivalent in their associations with CVD. The lack of absolute cutoff values, emphasis on increasing healthy food without limiting unhealthy food intake, and absence of validation of scores with biomarkers or other objective diet assessment methods further complicate decisions regarding the best indices to use. Future research should address these limitations, consider cross-cultural and other differences between population groups, and identify translational challenges inherent in attempting to apply a relevant diet quality index for use in CVD prevention at a population level