摘要:

Vitamin A is known to accumulate in patients with chronic renal failure (CRF), but it is present in many micronutrient and all complete nutritional supplements. Measurements were made of serum vitamin A concentrations in eight children (mean age 6 years, range 2–15 years) on chronic dialysis six continuous cyclic peritoneal dialysis patients (CCPD) and two haemodialysis (HD) patients, before and 6 months and 12 months after commencing a daily supplement containing vitamins A and D (Ketovite Liquid; Paines&Byrne Ltd, West Byfleet, Surrey, UK). Seven children were receiving complete nutritional supplements (two oral, five via gastrostomy buttons). Dietary energy and vitamin A intakes were determined by 3‐day dietary records. Prior to Ketovite Liquid supplementation, a mean of 68% (range 28–103%) of the reference nutrient intake (RNI) for vitamin A was provided by the diet, with a significant contribution from complete nutritional supplements. When receiving Ketovite Liquid supplementation, mean vitamin A intakes exceeded twice the RNI. Mean serum vitamin A concentrations (2.7±0.8μmol/l) at baseline were above the revised normal reference range. Levels rose significantly post Ketovite Liquid supplementation at 6 months (mean 4.2±0.6μmol/l,P<0.05) and 12 months (mean 4.8±0.8 μmol/l,P<0.05). This study confirms that vitamin A supplementation should be avoided in children on chronic dialysis. Any dietary supplement, either micronutrient or complete, must be carefully analysed for its potential contribution to total vitam

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00464.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty‐five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficienc

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00459.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

The fatty acid composition of the diet of seven free‐living subjects (five men and two women) aged 41–56 years was altered for 1 month. The aim was to increase the intake of monounsaturated fatty acids (MUFAs) from subjects current habitual levels of 12% dietary energy to a target intake of 18% dietary energy, and to decrease saturated fatty acid (SFA) from habitual levels of 16% dietary energy to target levels of 10% dietary energy. The change in fatty acid intake was achieved by supplying volunteers with foods prepared using MUFA‐containing spreads or olive oil (ready meals, sweet biscuits and cakes) and also by supplying spreads, cooking oil and MUFA‐enriched milk for domestic use. Body weight and plasma total cholesterol measurements were made at baseline and at 2 and 4 weeks on the diet as an aid to maintaining subject compliance. MUFA consumption was significantly increased from 12% dietary energy to 16% dietary energy (P<0.01), and SFA intake was reduced from 16% dietary energy to 6% dietary energy (P<0.01) during the 4‐week intervention. The diet failed to achieve the target increase in MUFA but exceeded the target reduction in SFA. This was due to the fact that subjects reduced their total fat intake from a mean habitual level of 38% dietary energy to a mean level of 30% dietary energy. During the dietary period, mean plasma cholesterol levels were lower at 2 weeks (P<0.01) and at 4 weeks (P<0.01) than the baseline, with a mean reduction of 20% over the dietary period. This study demonstrates the difficulty of achieving increased MUFA intakes (by SFA substitution) in free‐living populations when only a limited range of fatty‐acid modified food products are provided

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00461.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Restriction of dietary sugars is often advocated for weight control, alongside a reduced fat and energy intake. This project examined data from the Dietary and Nutritional Survey of British Adults (Gregoryet al., 1990) to evaluate the associations between non‐milk extrinsic (NME) sugars (as a percentage of food energy) and body mass index (BMI), energy intake and percentage energy from fat. The influence of dieting and potential under reporting on these relationships was also explored. BMI was inversely associated with percentage energy from NME sugars. The relationship was weak, but did not appear to be a mere artifact of dieting and/or under reporting. The well‐recognized reciprocal relationship between sugars energy and fat energy was also seen with saturated, monounsaturated and polyunsaturated fatty acids, but not withtransfatty acids. As a result of the sugar : fat see‐saw effect only 2% of men and women met the current dietary targets for both fat and NME sugars, suggesting that these may be incompatible on a practical level. These analyses suggest that high (NME) sugar diets appear to be weakly related to leanness rather than obesity, although the relationship is weaker than the inverse association between sugars and fat. It is hypothesized that overweight and diet‐restrained individuals often choose to restrict NME sugars: a strategy which can result in a higher (proportional) fat diet and weight gain. Emphasis on reducing NME sugars intakes may be counterproductive to attempts to reduce proportional fat intake and body

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00463.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

Following a low phenylalanine diet for life has been advocated for those with phenylketonuria. The Medical Research Council (MRC) Working Party on phenylketonuria (1993a, 1993b) suggests that serum phenylalanine levels between 120 and 700μmol/l should be achieved and maintained during adolescence and adult life (other than preconceptionally and during pregnancy). A significant proportion of older children with phenylketonuria struggle to comply with the even distribution of protein substitute and phenylalanine exchanges throughout the day, as advised nationally (Asplin&MacDonald, 1994). This preliminary study sought to compare the control of serum phenylalanine in young people suffering from phenylketonuria who were prescribed the nationally advised regimen (Group A) and youngsters given one of two alternative regimens (Group B and Group C) known to be favoured by some youngsters. These alternative regimens provided all nutritional requirements over the day, but the distribution of protein substitute and phenylalanine exchanges differed in the two groups and was not as even as in Group A. The results show that all three study groups attained serum phenylalanine levels within the range 120–700μmol/l at all times blood samples were obtained. Whether or not this makes each of the three regimens acceptable is discussed. Despite careful control of the diet prescription, the amount of phenylalanine consumed can greatly exceed the prescription due to the consumption of «free foods». This does not appear to jeopardize control. The mean variation in serum phenylalanine levels over the 24‐h period was different for each group. Not all individuals within any one group gave the same 24‐h serum phenylalanine profile. This suggested that the present practice of monitoring control in phenylketonuria by one blood test at a consistent time of day is not ideal. It is not possible to predict an individual's 24‐h profile from one blood result even when the dietary prescription at each meal is known. Changes in serum phenylalanine levels occurring during an overnight fast were monitored. Further research is required to ascertain the dietary components that reduce the rate of increase in serum phenylalanine

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00462.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

This randomized controlled pilot study was designed to measure the effect of additional dietary information on change in reported percentage energy from fat (% fat), total daily energy intake (TDEI), body mass index (BMI) and serum cholesterol in 13 hyperlipidaemic subjects, referred from the Cardiology Unit of St. Bartholomew's Hospital, over 12 weeks. At baseline (visit 1), % fat and TDEI were assessed using a validated food frequency questionnaire (Paisleyet al., 1996), and BMI and fasting lipids were measured. «Standard» low‐fat dietary advice was given to all patients. Subjects were randomized at 4 weeks (visit 2) to receive either further «standard» dietary advice (control group) or further «standard» dietary advice plus an additional information package (intervention group). At 12 weeks (visit 3), % fat, TDEI, BMI and fasting lipids were reassessed. Both groups reported a significant reduction in % fat; a 23% reduction (P=0.00) in the intervention group, and an 11% reduction (P=0.005) in the control group. However, there was no significant difference in the reported % fat at the end of the study between the two groups (P=0.57). Plasma cholesterol was not significantly reduced in either the intervention or the control group (mean 7.3–6.7 mmol/l, 7.2–6.6 mmol/l, respectively). Reported energy intake was significantly reduced in both groups, but the extent of energy reduction was not reflected in the degree of weight lost. These results suggest that the provision of additional dietary information affects reported rather than actual compliance to a l

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00465.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY

摘要:

This paper discusses a collaborative multidisciplinary exploratory audit project to examine the nutritional care received by patients within Norwich Community Health Partnership NHS Trust. A project team was formed to identify the key areas and develop an audit tool. An audit assistant was employed to assist the team with this particular project. Eleven community hospitals were involved; catering, nursing, dietetic staff and patients took part. The key areas that the audit project examined were nutritional adequacy, documentation and recording of nutritional assessments, nurses» nutritional knowledge base, patients» perceptions of the meal service, and good nutritional practice. Overall the results were better than initially anticipated. Where pertinent issues were identified, discussions are taking place within the Trust to write an action plan, implement recommendations and re‐au

ISSN:0952-3871    

DOI:10.1046/j.1365-277X.1996.00466.x

出版商:Blackwell Science Ltd    

年代:1996

数据来源: WILEY