ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00069.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The image of the dietitian is frequently discussed but few systematic studies identify (a) how dietitians perceive themselves, or (b) how others perceive the profession. This paper does not include a systematic study but includes a discussion which outlines some views on the evolution of the dietetic profession. Views are expressed on the science of dietetics, the unique role of the dietitian and professional image. One aim for the future should be to develop a post‐graduate academic college of dietetic

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00070.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

This study was initiated to assess the dietary intakes of particular vitamins (A, D, B,2) and trace minerals (iron, zinc and copper) which we do not routinely supplement in children undergoing chronic peritoneal dialysis. Eight children were studied and all were receiving protein and energy supplements. The mean dietary intakes of the above micronutrients with the exception of Vitamins A and B12were below UK RDA values for chronological age but all were comparable to age and sex matched controls. No clinical deficiencies were detected in the short term but patients on long‐term dialysis may require a more comprehensive vitamin and trace mineral supplemen

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00071.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Thirty‐eight patients with particularly troublesome irritable bowel syndrome (IBS) were selected for trial on a 2‐week exclusion diet. Eighteen patients improved dramatically and, with two exceptions, subsequently identified foods to which they were intolerant. Follow‐up by postal questionnaire showed that at least 10 were still following their dietary restrictions 3–45 months later.Twelve of the 16 food intolerant patients were intolerant to more than one food. Fifteen patients found their symptoms did not improve on the exclusion diet. Five patients refused to try or were unable to complete the exclusion diet. The use of an appropriate exclusion diet for selected patients with IBS is reco

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00072.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Although many manufacturer's state that their systems are ‘single‐use only’, some authors are now recommending that enteral feed delivery systems can be re‐used, particularly in the home, in order to reduce the expense of enteral feeding.The purpose of this study was to evaluate the effectiveness of a range of currently recommended cleaning and disinfection procedures in removing bacteria from five commonly used enteral feeding systems. The systems used were, a collapsible, top‐fill reservoir with integral giving set, a plastic enteral nutrition bag with side port and integral giving set, and three different types of rigid plastic reservoirs with separate giving sets.The systems were filled with 1000‐ml portions of feed experimentally contaminated with either Klebsiella aerogenes or Escherichia coli and the feed perfused through the systems for 15 h; viable counts increased from 102‐‐103to 107‐‐109cfu ml‐1. The systems were then cleaned by a range of methods including rinsing and/or immersing them in sterile water, sterile water and detergent, and/or disinfection with hypochlorite solutions. When the systems were refilled with sterile feed it was found that residual bacteria in the systems multiplied to yield levels ≤109cfu ml‐1after 15 h.The results of the present study demonstrate that none of the methods tested can be recommended as being totally effective in removing bacteria

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00073.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Factors influencing compliance with dietary advice were investigated in the Diet and Reinfarcation Trial (DART). In terms of achieved intakes, smokers had a lower mean P/S ratio and fibre intake than non‐smokers; manual workers had a lower mean fibre intake than non‐manual workers; and obese men had a higher percentage of energy from fat and lower P/S ratio than non‐obese men. However the effect of the advice (difference in intakes of those advised and thosen not advised) was similar in smokers and non‐smokers and was similar in all social classes. The effect of fat advice was less among obese men than among non‐obese men, probably as a result of weight‐reducing advice given to all overweight men. Fat advice tended to have a greater effect among those who gave up smoking after their heart attack than among non‐smokers and those who continued to smoke but the difference was not statistically significant. This suggests that advice on diet and smoking can be given simultaneously and still

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00074.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00075.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Some of the first studies of the effects of diet on exercise performance were reported in the late 1920s. These studies established that eating a high carbohydrate diet before, and ingesting glucose during prolonged exercise delayed the onset of fatigue and enhanced performance, in part by preventing the development of hypoglycaemia.The next significant advance came with the introduction of the muscle biopsy needle which allowed muscle carbohydrate (glycogen) content to be measured for the first time. This technique focused attention on the role of muscle glycogen as possibly the more important factor explaining fatigue during prolonged exercise. Subsequent research inevitably focused on the identification of techniques that would either increase muscle glycogen storage before exercise or decrease the rate of muscle glycogen utilization during subsequent exercise, or both.Coincidentally, studies of fluid balance and of the control of gastric emptying during exercise suggested (a) that dehydration posed a serious health risk especially to marathon runners and (b) that dehydration could only be prevented during prolonged exercise if water alone was ingested. Thus the ‘state of the art’ knowledge in 1970 was that a high carbohydrate diet should be eaten before competition; that muscle glycogen depletion was the main cause of fatigue during prolonged exercise; and that water alone should be ingested in large volumes during exercise. The value of carbohydrate ingestion during exercise was systematically ignored despite the evidence from the classical studies of the 1920s.Fortunately commercial interests came to the rescue of exercise physiology in the mid‐1980s. Whereas water is without commercial value, carbohydrate added to the water and ingested by millions of athletes throughout the world has attractive commercial potential. Thus research funded and orchestrated largely by the commercial sector has established that adequate fluid delivery can be provided from drinks containing carbohydrate and that the ingestion of carbohydrate during prolonged exercise can prevent the onset of premature fatigue caused by liver glycogen depletion, hypoglycaemia and a low rate of carbohydrate oxidation.Thus the ‘state of the art’ knowledge in 1990 is that there is no proven value of ingesting water alone during prolonged exercise: that liver glycogen depletion is an important and preventable cause of fatigue during prolonged exercise: and that although muscle glycogen depletion is an important contributor, the real biochemical explanation for fatigue during prolonged exercise is still not clearly established. Nevertheless, there is clear evidence that the provision of exogenous carbohydrate at high rates is essential to delay fatigue and optimize performance during prolonged exercise. It has also become apparent that high rates of both carbohydrate and fluid delivery can be achieved by the adoption of appropriate drinking techniques during

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00076.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Exercise is not regarded as a major risk factor for ischaemic heart disease (IHD). Nevertheless, physically active individuals have a lower risk than their sedentary counterparts, possibly because of favourable modifications of lipoprotein metabolism. In particular, endurance‐trained men and women have markedly higher concentrations of high‐density lipoprotein cholesterol than sedentary controls. Although the results of exercise intervention studies are less consistent than cross‐sectional observations, many do show an increase in high density lipoprotein cholesterol with training. However, most studies have involved high‐intensity exercise, usually running, and adherence to these sort of training regimens is poor. Exercise will only influence the risk of IHD in the population if the amount and type of exercise needed to confer benefit is attractive and attainable to large numbers of people. Consequently, there is a need to examine the potential of more socially acceptable, low‐intensity exercise to influence risk factors for IHD. In a study at Loughborough University 42 women (mean age 44.9 years) were studied for one year. Twenty‐eight followed a programme of brisk walking, whilst 16 acted as controls. After 12 months the walkers showed an 11% increase in maximal oxygen uptake (Mean±s.e.m.) (26.7±‐0.7 ml/kg/mincf. 29.7±0.8 ml/kg/min, P<0.01) but no change in body mass or the sum of four skinfolds. Plasma total cholesterol was not significantly different at 12 months for either group but walkers showed a 27% increase in plasma high‐density lipoprotein cholesterol (1.17 ± 0.08 mmol/lcf. 1.49±0.06 mmol/l, P<0.01). Brisk walking was therefore a sufficient exercise stimulus to improve fitness and influence lipoprotein metabolism in these previously sedentar

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00077.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The problems of rehydration during exercise are addressed. Dehydration will reduce circulatory capacity, cooling and exercise efficiency and hence reduce athletic performance. However, athletes attempting to supplement fluid intake during performance commonly complain of gastrointestinal (GI) discomfort.Experiments are described investigating the relationship between GI function and fluid supplementation. The authors conclude that fluids should be taken early in the exercise period, before dehydration sets in.

ISSN:0952-3871    

DOI:10.1111/j.1365-277X.1991.tb00078.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY