ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718480

出版商:Routledge    

年代:1995

数据来源: Taylor

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718481

出版商:Routledge    

年代:1995

数据来源: Taylor

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718482

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

In 1975 Thomas Chalmers analyzed the possible effect of vitamin C on the common cold by calculating the average difference in the duration of cold episodes in vitamin C and control groups in seven placebo-controlled studies. He found that episodes were 0.11 +/−0.24 (SE) days shorter in the vitamin C groups and concluded that there was no valid evidence to indicate that vitamin C is beneficial in the treatment of the common cold. Chalmers' review has been extensively cited in scientific articles and monographs. However, other reviewers have concluded that vitamin C significantly alleviates the symptoms of the common cold. A careful analysis of Chalmers' review reveals serious shortcomings. For example, Chalmers did not consider the amount of vitamin C used in the studies and included in his meta-analysis was a study in which only 0.025-0.05 g/day of vitamin C was administered to the test subjects. For some studies Chalmers used values that are inconsistent with the original published results. Using data from the same studies, we calculated that vitamin C (1-6 g/day) decreased the duration of the cold episodes by 0.93 +/−0.22 (SE) days; the relative decrease in the episode duration was 21%. The current notion that vitamin C has no effect on the common cold seems to be based in large part on a faulty review written two decades ago.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718483

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

A comprehensive review of the literature indicates that populations with long-term consumption of higher than RDA levels of vitamin C (>or = 60 mg/day) from foods and/or supplements have reduced risks of cancer at several sites, cardiovascular disease, and cataracts. The safety of higher than RDA intakes of vitamin C is confirmed in eight placebo-controlled, double-blind studies and six non-placebo clinical trials in which up to 10,000 mg of vitamin C was consumed daily for up to 3 years. There are no clinical data which suggest that vitamin C's enhancement of non-heme iron absorption in individuals with low iron status could be a critical factor in the possible increased risk of heterozygous hemochromatosis-related cardiovascular disease. In fact, the cumulative data do not confirm that iron status is related to risk of cardiovascular disease. Moreover, higher than RDA intakes of vitamin C have been associated with several indices of lowered cardiovascular disease risk including increases in HDL, and decreases in LDL oxidation, blood pressure and cardiovascular mortality.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718484

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that health professionals recognize the importance of drug-nutrient interactions and educate patients to prevent adverse effects. Drug-nutrient interactions are an important issue in medical practice, but it is not clear how or if physicians are trained in this issue.This investigation was a needs assessment that examined attitudes and knowledge about drug-nutrient interactions that was examined in a national sample of 834 family medicine residents in 56 residency programs.Most reported they had little or no formal training in drug-nutrient interactions in medical school (83%) or residency (80%). However, 79% believed it was the physician's responsibility to inform patients about drug-nutrient interactions, although many thought pharmacists (75%) and dietitians (66%) share this responsibility. Overall, residents correctly answered 61% +/−19 of fourteen drug-nutrient interaction knowledge items. There was a slight increase in drug-nutrient knowledge as year of residency increased.Physicians' knowledge of drug-nutrient interactions may be improved by including nutrition education in the topics taught by physicians, nutritionists, and pharmacists using several educational strategies. Nutrition educators in particular can play a role in curriculum development about drug-nutrient interactions by developing, refining, and evaluating materials and educational tools. Nutrition educators need to provide this information in academic settings for the training of all health professionals as well as in patient education settings such as hospitals and public health clinics.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718485

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

The relationship between diet and glycemic control was examined among a racially mixed population of male and female adults with non-insulin dependent diabetes mellitus (NIDDM).Data from 3-day dietary records and glycosylated hemoglobin (HbA1c) were analyzed for two-hundred eighty two patients of a Family Practice Ambulatory Care Unit and a community-based health center in Winston-Salem, North Carolina. Correlations were calculated for individual nutrients to determine their strength of association with glycemic control. Analyses by tertiles of HbA1c were also conducted for each race/gender group. Regression analysis was used to determine independent dietary predictors of HbA1c.For all subjects, energy, energy per kilogram of body weight, fat, carbohydrates saturated fat, and cholesterol were significantly correlated with HbA1c. Nutritional differences across tertile levels of HbA1c for all subjects were not significant. For black females, consumption of energy, protein and fat was significantly higher among upper tertile subjects compared to the lowest tertile; and intake of energy, protein, fat, and saturated fat was significantly correlated with HbA1c in this group. For black males, energy intake was highest among upper tertile subjects compared to those in the middle tertile, while energy per kilogram of body weight, and percent of calories from protein, were significantly correlated with HbA1c. For white males, energy intake expressed as a function of body weight was highest among subjects in the upper tertile and a significant positive correlation with HbA1c was observed. No relationship between nutritional intake and HbA1c was found among white females. Racial differences in nutrient intake were also compared for males and females in the upper tertile of HbA1c. Black females in the upper tertile consumed significantly more energy, protein, and significantly less dietary fiber per 1000 kilocalories. No significant differences were observed between black and white males in the upper tertile, although higher cholesterol consumption in black males compared to white males approached significance. Regression analysis revealed that total energy intake significantly predicted HbA1c for all subjects and all white subjects, while a similar observation was made for total fat intake among all black subjects and among black females.These findings confirm that diet, especially total energy, is an important contributor to glycemic control. Dietary fat is also associated with glycemic control among blacks, especially black females, who are especially prone to more dire health consequences of NIDDM. Strict monitoring of diet should lead to improved glycemic control and less mortality and morbidity in this population.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718486

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

Patients with alcoholic hepatitis frequently have moderate or severe malnutrition. Dietary protein intake may be restricted in these patients because of concurrent hepatic encephalopathy. To further evaluate the relationship between dietary protein intake and hepatic encephalopathy in alcoholic hepatitis, we evaluated prospectively gathered data from a study of 136 placebo-treated patients with moderate or severe alcoholic hepatitis conducted at eight Department of Veterans Affairs Medical Centers.Physical examination, laboratory tests, and grade of hepatic encephalopathy were recorded at entry and every seventh day for the first 28 days of study. Average daily protein intake was calculated from dietary evaluation obtained by a registered dietitian at entry and again three times a week.Sixty-three percent of patients had hepatic encephalopathy at entry. Hepatic encephalopathy decreased over time. Time dependent regression analysis found low protein intake, along with high blood urea nitrogen (BUN) and high serum creatinine, to be independently associated with worsening hepatic encephalopathy. Similar analysis found low BUN and less malnutrition at entry into the study to be independently associated with improved hepatic encephalopathy. Higher protein intake was associated with improved hepatic encephalopathy in univariate (p = 0.01), but not multivariate, analysis.In patients with alcoholic hepatitis who can be treated with standard anti-encephalopathy medications (e.g., lactulose and neomycin), low protein intake is associated with worsening hepatic encephalopathy while a higher protein intake correlates with improvement in hepatic encephalopathy.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718487

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

This study was conducted to determine whether individuals attending an urban outpatient clinic met the National Health Promotion and Disease Prevention nutritional objectives and to assess factors associated with poor dietary habits.Individuals who attended the general medicine outpatient clinic at the State University of New York Health Science Center in Syracuse were interviewed using an expanded version of the Health Habits and History Questionnaire. Usual dietary intake, medical history, occupation, stress, physical activity, tobacco use and other life-style factors were recorded. Of particular interest were the percentage of calories from fat in the diet and whether individuals consumed the daily requirements of the base-foods in the USDA Pyramid (grains, vegetables and fruits). Unconditional logistic regression was used to determine odds ratios (OR) and 95% confidence intervals for variables associated with high fat consumption and low consumption of vegetables, fruit and high-fiber grains.None of the patients met the minimal recommended daily servings for the three base-food categories combined (grains, vegetables and fruits) and 84% of subjects had fat intakes which constituted over 30% of daily energy intake. Individuals with less education, who were disabled or unemployed, and who participated in little physical activity were twice as likely to have poor dietary habits (i.e. low consumption of vegetables, fruit, and/or high-fiber grains) as other subjects (por = 50 years of age). Nonwhite subjects were less likely to consume high-fiber grains and whole-wheat breads than white patients (p = 0.04).Nutritional screening should be considered for all patients attending similar inner-city general medicine clinics, regardless of the primary diagnosis in order to provide early dietary intervention. In particular, young adults, the unemployed, and the disabled should not be overlooked.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718488

出版商:Routledge    

年代:1995

数据来源: Taylor

摘要:

We tested the hypothesis that continuous maternal oxygen (O2) therapy leads to an increase in fetal survival, improvement in fetal growth, and correction of decreased placental calcium (Ca) transport, in pregnant rats who underwent uterine artery ligation.We measured on Day 21 of pregnancy, the unidirectional maternofetal clearance of 45Ca (Kmf45Ca) and 51Cr-EDTA (Kmf51Cr-EDTA) across in-situ perfused placentas of rats randomized on Day 17 to a modified Wigglesworth (bilateral uterine artery ligation) procedure (group WW, n = 8), to modified Wigglesworth and supplemental maternal O2 treatment (FiO2 0.40) (group WWO2, n = 8), or to a sham operation (group Sh, n = 8). Kmf51Cr-EDTA provides a measure of placental“porosity”or passive permeability.Maternal O2 therapy did not improve fetal survival, fetal growth, or placental Ca transport. CONCLUSION AND SPECULATION: Bilateral uterine ligation in the pregnant rat leads to IUGR and decreased placental Ca transport which cannot be corrected by maternal O2 therapy.

ISSN:0731-5724    

DOI:10.1080/07315724.1995.10718489

出版商:Routledge    

年代:1995

数据来源: Taylor