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Sample records for nutritional risk index

  1. The Geriatric Nutritional Risk Index Predicts Survival in Elderly Esophageal Squamous Cell Carcinoma Patients with Radiotherapy

    PubMed Central

    Wang, Kunlun; Liu, Yang; You, Jie; Cui, Han; Zhu, Yiwei; Yuan, Ling

    2016-01-01

    The impact of nutritional status on survival among elderly esophageal squamous cell carcinoma (ESCC) patients undergoing radiotherapy is unclear. In this study, we aimed at validating the performance of the geriatric nutritional risk index (GNRI) in predicting overall survival time in elderly ESCC patients with radiotherapy. A retrospective cohort study was conducted on 239 ESCC patients aged 60 and over admitted consecutively from January 2008 to November 2014 in the Department of Radiotherapy, Henan Tumor Hospital (Affiliated Tumor Hospital of Zhengzhou University), Zhengzhou, Henan, China. All patients were subjected to nutritional screening using GNRI, and were followed for the occurrence of lymphatic node metastasis, radiation complication and mortality. The Kaplan–Meier method with Log-rank test was used to estimate survival curves. Univariable Cox regression analysis was used to identify variables associated with overall survival time. Among the 239 patients, 184 patients (76.9%) took no nutritional risk, 32 patients (13.4%) took moderate risk of malnutrition, and 23 patients (9.7%) took a high risk of malnutrition. Univariable Cox regression showed that both high nutritional risk group and moderate nutritional risk group were significantly less likely to survive than no nutritional risk patients (hazard ratio (HR) = 1.688, 95% confidence interval (CI) = 1.019–2.798 for moderate risk group, and HR = 2.699, 95% CI = 1.512–4.819 for high risk group, respectively). The GNRI is an independent prognostic factor for overall survival time in elderly ESCC patients with radiotherapy. A GNRI ≤98 can be suggested as an indicator of surviving less. PMID:27196126

  2. Geriatric Nutritional Risk Index (GNRI) Independently Predicts Amputation Inchronic Criticallimb Ischemia (CLI)

    PubMed Central

    Luo, Han; Yang, Hongliu; Huang, Bin; Yuan, Ding; Zhu, Jingqiang; Zhao, Jichun

    2016-01-01

    Objective General malnutrition usually occurs in critical limb ischemia (CLI) patients because of shortness of appetite and sleeplessness leaded by chronic pain. And amputation frequently is end-point of CLI patients. So the aim of this study was to assess the predictive ability of Geriatric nutritional risk index (GNRI) for predicting amputation in patients with CLI. Methods A retrospective study was designed. Demographics, history, comorbidity, and risk factors for peripheral vascular disease of admitted patients, and laboratory study were documented. Patients’ height, weight and BMI were recorded. Amputation was identified as end-point during follow-up. Patients’ amputation-free survival (AFS) was recorded. Result 172 patients were identified, with mean age 71.98±3.12. Geriatric nutritional risk index (GNRI) = 90 was taken as cutoff value of high risk of amputation for CLI patients via using receiver operating characteristic (ROC) curve. Span of follow-up was 12–48 months. During follow-up, 60 patients (36.04%) received amputation surgery. And analyzed by Cox proportional hazards model, it is found that GNRI was the independent predictive factor for amputation in long term. Conclusion This study revealed that GNRI was a reliable and effective predictive marker for AFS. GNRI could identify patients with high risk for amputation in early time. PMID:27010532

  3. Malnutrition Identified by the Nutritional Risk Index and Poor Prognosis in Advanced Epithelial Ovarian Carcinoma.

    PubMed

    Yim, Ga Won; Eoh, Kyung Jin; Kim, Sang Wun; Nam, Eun Ji; Kim, Young Tae

    2016-07-01

    Ovarian cancer is a chronic disease with a risk of malnutrition. Nutritional Risk Index (NRI) has been reported as a simple and accurate tool to assess the nutritional status. We sought to explore the prevalence of malnutrition and its association with survival in ovarian cancer. A retrospective study was conducted in 213 advanced ovarian cancer patients. NRI was calculated before and at the end of treatment using patients' body weight and serum albumin level. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier method, and associations were assessed using a Cox proportional hazards analysis adjusted for known prognostic variables. Moderate to severely malnourished patients had lower 5-yr OS (45.3%) compared to normal to mild group (64.0%), respectively (P = 0.024). Adjusted for covariates, the relative risk of death was 5.8 times higher in moderate/severely malnourished group identified at the last course of chemotherapy (HR = 5.896, 95% CI = 2.723-12.764, P < 0.001). Similarly, this cohort had shorter PFS compared with normal to mild risk group (median 15 vs. 28 months, P = 0.011). Malnutrition is prevalent among ovarian cancer patients and is found to be a significant predictor for mortality. PMID:27044606

  4. Relationship of nutritional risk, Body Mass Index (BMI), and cognitive functioning in preschoolers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To determine the relationships, if any, between nutritional risk, BMI z-score, and cognitive function in preschoolers. Background: Excessive adipose tissue found in obesity places children at increased health risk. Considerable research has documented that obesity leads to increased ri...

  5. Usefulness of Geriatric Nutritional Risk Index for Assessing Nutritional Status and Its Prognostic Impact in Patients Aged ≥65 Years With Acute Heart Failure.

    PubMed

    Honda, Yasuyuki; Nagai, Toshiyuki; Iwakami, Naotsugu; Sugano, Yasuo; Honda, Satoshi; Okada, Atsushi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2016-08-15

    Malnutrition is becoming one of the most important determinants of worse clinical outcomes in patients with acute heart failure (AHF). However, appropriate tools for evaluating the nutritional status in patients aged ≥65 years with AHF remain unclear. We examined 490 consecutive patients aged ≥65 years with AHF. They were divided into 2 groups according to Geriatric Nutritional Risk Index (GNRI; cut-off value = 92). During a median period of 189 days, the mortality rate was significantly higher in the lower GNRI group than the higher GNRI group (p <0.001). In multivariate analyses, lower GNRI was an independent determinant of adverse events (HR 0.92, 95% CI 0.88 to 0.95, p <0.001). The GNRI showed the best prognostic value (C-statistic: 0.70) among other nutritional indexes. Adding GNRI to an existing outcome prediction model for mortality in AHF significantly increased the C-statistic from 0.68 to 0.74 (p = 0.017). The net reclassification improvement afforded by GNRI was 60% overall, 27% for events, and 33% for nonevents (p <0.001). In conclusion, lower GNRI on admission was independently associated with worse clinical outcomes in patients aged ≥65 years with AHF, and it was superior to other nutritional parameters. Furthermore, the assessment of nutritional status using GNRI is very helpful for risk stratification. PMID:27324158

  6. Validation of nutritional risk index method against patient-generated subjective global assessment in screening malnutrition in colorectal cancer patients

    PubMed Central

    Faramarzi, Elnaz; Mohammad-Zadeh, Mohammad; Nasirimotlagh, Behnam

    2013-01-01

    Objective To validate malnutrition screening tool of nutrition risk index (NRI) against patient-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiotherapy. Methods Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA (gold standard method) and NRI. Serum albumin levels of patients were determined by colorimetric method. A contingency table was used to determine the sensitivity, specificity, and predictive value of the NRI in screening patients at risk of malnutrition, in comparison with the PG-SGA in patients before radiotherapy. Results The findings of PG-SGA and NRI showed that 52% and 45% of patients in our study were moderately or severely malnourished respectively. The NRI had a sensitivity of 66% and a specificity of 60% against PG-SGA. The positive predictive value was 64% and the negative predicative value was 62%. The agreement between NRI and PG-SGA was statistically insignificant (kappa =0.267; P>0.05). Conclusions The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer. Moreover, NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer. It seems that the combination of anthropometric, laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients. PMID:24255578

  7. The energy intake through regular nontherapeutic meals provision in long-term care: impact on nutritional status and related Geriatric Nutritional Risk Index.

    PubMed

    Sturtzel, Baerbel; Elmadfa, Ibrahim; Ohrenberger, Gerald

    2016-01-01

    To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p < 0.001, body fat (p = 0.001) and phase angle (PA) of bio impedance measurement (p = 0.018) and likewise the GNRI (p = 0.021) of the completers decreased significantly. At the beginning and at the end of observation time energy intake correlated significantly with PA (p = 0.028/p < 0.001) and GNRI (p = 0.436/p = 0.004). Also GNRI and PA correlated significantly at the beginning (p = 0.001) and at the end (p < 0.001) of observation time. The energy intake through non therapeutic meals provision was too low for sustaining the nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time. PMID:26933634

  8. Effects of nutrition and exercise health behaviors on predicted risk of cardiovascular disease among workers with different body mass index levels.

    PubMed

    Huang, Jui-Hua; Huang, Shu-Ling; Li, Ren-Hau; Wang, Ling-Hui; Chen, Yu-Ling; Tang, Feng-Cheng

    2014-05-01

    Workplace health promotion programs should be tailored according to individual needs and efficient intervention. This study aimed to determine the effects of nutrition and exercise health behaviors on predicted risk for cardiovascular disease (CVD) when body mass index (BMI) is considered. In total, 3350 Taiwanese workers were included in this cross-sectional study. A self-reported questionnaire was used to measure their nutrition and exercise behaviors. Data on anthropometric values, biochemical blood determinations, and predicted CVD risk (using the Framingham risk score) were collected. In multiple regression analyses, the nutrition behavior score was independently and negatively associated with CVD risk. Exercise was not significantly associated with the risk. However, the interactive effect of exercise and BMI on CVD risk was evident. When stratified by BMI levels, associations between exercise and CVD risk were statistically significant for ideal weight and overweight subgroups. In conclusion, nutrition behavior plays an important role in predicting the CVD risk. Exercise behavior is also a significant predictor for ideal weight and overweight workers. Notably, for underweight or obese workers, maintaining health-promoting exercise seems insufficient to prevent the CVD. In order to improve workers' cardiovascular health, more specific health-promoting strategies should be developed to suit the different BMI levels. PMID:24785541

  9. Effects of Nutrition and Exercise Health Behaviors on Predicted Risk of Cardiovascular Disease among Workers with Different Body Mass Index Levels

    PubMed Central

    Huang, Jui-Hua; Huang, Shu-Ling; Li, Ren-Hau; Wang, Ling-Hui; Chen, Yu-Ling; Tang, Feng-Cheng

    2014-01-01

    Workplace health promotion programs should be tailored according to individual needs and efficient intervention. This study aimed to determine the effects of nutrition and exercise health behaviors on predicted risk for cardiovascular disease (CVD) when body mass index (BMI) is considered. In total, 3350 Taiwanese workers were included in this cross-sectional study. A self-reported questionnaire was used to measure their nutrition and exercise behaviors. Data on anthropometric values, biochemical blood determinations, and predicted CVD risk (using the Framingham risk score) were collected. In multiple regression analyses, the nutrition behavior score was independently and negatively associated with CVD risk. Exercise was not significantly associated with the risk. However, the interactive effect of exercise and BMI on CVD risk was evident. When stratified by BMI levels, associations between exercise and CVD risk were statistically significant for ideal weight and overweight subgroups. In conclusion, nutrition behavior plays an important role in predicting the CVD risk. Exercise behavior is also a significant predictor for ideal weight and overweight workers. Notably, for underweight or obese workers, maintaining health-promoting exercise seems insufficient to prevent the CVD. In order to improve workers’ cardiovascular health, more specific health-promoting strategies should be developed to suit the different BMI levels. PMID:24785541

  10. Validity of nutrition risk index as a malnutrition screening tool compared with subjective global assessment in end-stage renal disease patients on peritoneal dialysis

    PubMed Central

    Prasad, N.; Sinha, A.; Gupta, A.; Bhadauria, D.; Manjunath, R.; Kaul, A.; Sharma, R. K.

    2016-01-01

    We undertook this study to compare subjective global assessment (SGA) and nutrition risk index (NRI) as malnutrition screening tools in peritoneal dialysis (PD) patients. Nutrition status of the patients was categorized into low, moderate and high risk of malnutrition based on both NRI and SGA. The sensitivity, specificity and predictive values of NRI were compared with SGA, an already validated tool of nutrition status assessment in PD patients. Two hundred and eighty-three end-stage renal disease patients (age 50.02 ± 13.76 years; 204 males, 150 diabetic) were included. Based on SGA, 71/283 (25.08%) had normal nutrition, 192/283 (67.84%) mild–moderate and 20/283 (7.07%) severe malnutrition. Based on NRI, 38/283 (13.43%) patients had normal nutritional status, 193/283 (68.20%) mild-moderate and 52/283 (18.37%) severe malnutrition. Twenty-three of 283 (8.1%) were correctly classified as normal by NRI (true negative) and 197/283 (69.6%) as malnourished (true positive), 15/283 (5.3%) as false negative, 48/283 (16.96%) were misclassified as malnourished (false positive). NRI has sensitivity of 92.9% and specificity of 32.39%. Positive predictive value and Negative predictive values (NPVs) of NRI are 80.41% and 60.53%, respectively. Accuracy of the test is 78%. The receiver operating characteristic curve of NRI is 0.63. To conclude, NRI carries high sensitivity but low specificity as compared to SGA. It can be used as screening tool but not as a diagnostic tool for assessment of nutritional status in PD patients because of its low specificity and NPV. PMID:26937075

  11. Nutrition and CVD risk

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is a wide range of dietary approaches purported to decrease the risk of developing cardiovascular disease (CVD). Some were first identified early in the 20th century whereas others have been recognized more recently. Some have stood the test of time and others have not. None are without contro...

  12. Preconception care: nutritional risks and interventions

    PubMed Central

    2014-01-01

    Introduction There is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy. Methods A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Results Maternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight. Conclusion All women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition

  13. Proposal of a Nutritional Quality Index (NQI) to Evaluate the Nutritional Supplementation of Sportspeople

    PubMed Central

    Palacin-Arce, Alba; Monteagudo, Celia; Beas-Jimenez, Juan de Dios; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

    2015-01-01

    Background Numerous supplements are used by sportspeople. They are not always appropriate for the individual or the sports activity and may do more harm than good. Vitamin and mineral supplements are unnecessary if the energy intake is sufficient to maintain body weight and derives from a diet with an adequate variety of foods. The study objectives were to evaluate the main nutrients used as supplements in sports and to propose a nutritional quality index (NQI) that enables sportspeople to optimize their use of supplements and detect and remedy possible nutritional deficits. Material and Methods A nutritional study was performed in 485 sportspeople recruited from Centros Andaluces de Medicina del Deporte, (CAMD). All completed socio-demographic, food frequency, and lifestyle questionnaires. The nutritional quality of their diet and need for supplementation were evaluated by scoring their dietary intake with and without supplementation, yielding two NQI scores (scales of 0-21 points) for each participant. Results A superior mean NQI score was obtained when the supplements taken by participants were not included (16. 28 (SD of 3.52)) than when they were included (15.47 (SD: 3.08)), attributable to an excessive intake of some nutrients through supplementation. Conclusions These results indicate that sportspeople with a varied and balanced diet do not need supplements, which appear to offer no performance benefits and may pose a health risk. PMID:25938239

  14. Nutritional Risk among Oklahoma Congregate Meal Participants

    ERIC Educational Resources Information Center

    Quigley, Kimberly K.; Hermann, Janice R.; Warde, William D.

    2008-01-01

    Objective: To determine if there were differences by demographic variables in response rates to Nutrition Screening Initiative (NSI) Checklist statements reported by over 50% of Oklahoma Older Americans Act Nutrition Program (OAANP) congregate meal participants categorized at high nutritional risk based on cumulative NSI Checklist scores. Design:…

  15. Nutritional risk and cognitive impairment in the elderly.

    PubMed

    Lee, Kang Soo; Cheong, Hae-Kwan; Kim, Eun A; Kim, Kyung Ran; Oh, Byoung Hoon; Hong, Chang Hyung

    2009-01-01

    The purpose of this study was to determine the relationship between nutritional risk and cognitive impairment in the elderly living in the community. Data obtained from 2934 subjects (912 men and 2022 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study (GDEMCIS). The study questionnaire comprised demographic characteristics, history of current and past illnesses, drug history, Korean version-Mini Mental State Examination (K-MMSE), and Nutritional Screening Initiative (NSI) checklist. Additionally, we examined the blood pressure, fasting serum glucose level, lipid profile, body mass index, and ApoE genotype. Of the total, 1942 (66.2%) demonstrated good nutritional state (NSI checklist score< or =2) and 992 (33.8%) were at moderate or high nutritional risk (NSI checklist score>2). Multiple logistic regression analysis revealed that moderate or high nutritional risk subjects were associated with an increased risk of cognitive impairment (K-MMSE score< or =17) after adjustment for age, sex, educational level, and Korean version of Short form Geriatric Depression Scale (K-SGDS) score (Odds ratio=OR=1.71, 95%; confidence interval=CI=1.17-2.50). These results suggest that nutritional risk may be associated with cognitive impairment in the elderly. PMID:18160145

  16. Index of Free and Inexpensive Food and Nutrition Information Materials.

    ERIC Educational Resources Information Center

    Gordon, Kathleen, Comp.; And Others

    This annotated index contains approximately 2,000 free or inexpensive pamphlets or brochures about food and nutrition. The prime criterion for inclusion of materials was that they be easily available and inexpensive; the cut-off cost was set at $3.00. The majority of materials listed were produced in either Canada or the United States. These…

  17. Parenteral nutrition: risks, complications, and management.

    PubMed

    Worthington, Patricia H; Gilbert, Karen A

    2012-01-01

    Parenteral nutrition is a life-saving modality, but one that also carries risks for potentially life-threatening complications. Comprehensive management of patients receiving parenteral nutrition includes careful selection of candidates, individualizing formulas to meet patients' unique needs, monitoring response to therapy, and implementing strategies designed to avoid complications. Measures to mitigate the risk of central line-associated bloodstream infections are particularly important. As with all complex therapies, a collaborative, multidisciplinary approach promotes optimal outcomes. PMID:22222292

  18. ["Nutritional risk screening 2002"--in clinical pneumology].

    PubMed

    Priegnitz, C; Galetke, W; Treml, M; Randerath, W J

    2014-07-01

    Malnutrition is a frequent problem for hospitalized patients. It is a relevant risk factor for morbidity and mortality. The aim of this study was to detect undernutrition and the risk of malnutrition (RM) in patients admitted to a university-affiliated respiratory care clinic. Undernutrition was assessed by body mass index (BMI<18.5 kg/m²) and RM by using the "Nutritional Risk Screening 2002" (NRS 2002) in 705 consecutive patients (BMI: measured in 689 patients/NRS: 680 patients assessed). Data was analysed with regard to age, sex, length of hospital stay as well as underlying pneumological disorders. In 14.3% of 680 patients, RM was detected by NRS. In 2.5% out of 689 patients, undernutrition was identified by BMI. In patients older than 65 years (n=365), these numbers were 19.6% (NRS) and 1.5% (BMI<18.5 kg/m²). Age was a significant risk factor for RM (OR 1.054 per year). Gender, however, was not associated with undernutrition or RM. In a sub-analysis, RM was more frequent in patients with pneumonia and chronic obstructive lung disease (23% and 16%, respectively). Patients with cancer were more frequently at RM as compared to patients with sleep-disordered breathing (OR: 2.33 in cancer, OR: 0.04 in sleep-disordered breathing). RM was associated with a significant increase in length of hospital stay (10.2 ± 9.5 vs. 5.4 ± 6.0 days). Besides the BMI, the NRS provides a valid tool for screening patients at RM. PMID:24901544

  19. Preoperative body mass index-to-prognostic nutritional index ratio predicts pancreatic fistula after pancreaticoduodenectomy

    PubMed Central

    Tamura, Toshihisa; Minagawa, Noritaka; Hirata, Keiji

    2016-01-01

    Background Estimating or scoring the risk of post-operative pancreatic fistula (POPF) may help with selection of high-risk patients and individualized patient consent. However, there are no simple and reliable preoperative predictors of POPF used in daily clinical practice. Methods We investigated the utility of body mass index-to-prognostic nutritional index (BMI/PNI) ratio as a preoperative marker to predict the development of POPF in 87 patients undergoing pancreaticoduodenectomy. Results The overall incidence of clinical (grade B/C) POPF was 17% (15 of 87 patients). Among various pre-, intra-, and post-operative variables analyzed, higher BMI and lower PNI were identified as independent predictors for POPF by multivariate analysis. We therefore investigated BMI/PNI ratio as a preoperative predictor for POPF. BMI/PNI ratio was significantly higher in patients with POPF than in those without POPF (0.54 vs. 0.45, P=0.0007). A receiver operating characteristic (ROC) curve analysis demonstrated a fair capability of BMI/PNI ratio to predict the occurrence of POPF (area under the ROC curve 0.781). With a cut-off value of 0.5, the sensitivity, specificity, and diagnostic accuracy of BMI/PNI ratio to predict POPF was 73%, 74%, and 74%, respectively. In particular, when restricted to a subgroup of elderly (≥75 years old) male patients, the sensitivity, specificity, and diagnostic accuracy of BMI/PNI ratio was 100%, 100%, and 100%, respectively. Conclusions The BMI/PNI ratio is a simple preoperative marker to predict the occurrence of POPF after pancreaticoduodenectomy. PMID:27275468

  20. 2013 Nutrition Risk Evidence Review Panel. Evidence Review for: The Risk Factor of Inadequate Nutrition

    NASA Technical Reports Server (NTRS)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 20 - 21, 2013. The SRP reviewed the new Evidence Report for the Risk Factor of Inadequate Nutrition (from here on referred to as the 2013 Nutrition Evidence Report), as well as the Research Plan for this Risk. Overall, the SRP thinks the well-qualified research team has compiled an excellent summary of background information in the 2013 Nutrition Evidence Report. The SRP would like to commend the authors in general and particularly note that while the 2013 Nutrition Evidence Report has been written using a single nutrient approach, the research plan takes a much more integrated and physiologically based approach.

  1. Nutritional Risk Factors for Age-Related Macular Degeneration

    PubMed Central

    Ersoy, Lebriz; Lechanteur, Yara T.; Hoyng, Carel B.; Kirchhof, Bernd; den Hollander, Anneke I.

    2014-01-01

    Purpose. To evaluate the role of nutritional factors, serum lipids, and lipoproteins in late age-related macular degeneration (late AMD). Methods. Intake of red meat, fruit, fish, vegetables, and alcohol, smoking status, and body mass index (BMI) were ascertained questionnaire-based in 1147 late AMD cases and 1773 controls from the European Genetic Database. Serum levels of lipids and lipoproteins were determined. The relationship between nutritional factors and late AMD was assessed using logistic regression. Based on multivariate analysis, area-under-the-curve (AUC) was calculated by receiver-operating-characteristics (ROC). Results. In a multivariate analysis, besides age and smoking, obesity (odds ratio (OR): 1.44, P = 0.014) and red meat intake (daily: OR: 2.34, P = 8.22 × 10−6; 2–6x/week: OR: 1.67, P = 7.98 × 10−5) were identified as risk factors for developing late AMD. Fruit intake showed a protective effect (daily: OR: 0.52, P = 0.005; 2–6x/week: OR: 0.58, P = 0.035). Serum lipid and lipoprotein levels showed no significant association with late AMD. ROC for nutritional factors, smoking, age, and BMI revealed an AUC of 0.781. Conclusion. Red meat intake and obesity were independently associated with increased risk for late AMD, whereas fruit intake was protective. A better understanding of nutritional risk factors is necessary for the prevention of AMD. PMID:25101280

  2. Healthy eating index and breast cancer risk among Malaysian women.

    PubMed

    Shahril, Mohd Razif; Sulaiman, Suhaina; Shaharudin, Soraya Hanie; Akmal, Sharifah Noor

    2013-07-01

    Healthy Eating Index-2005 (HEI-2005), an index-based dietary pattern, has been shown to predict the risk of chronic diseases among Americans. This study aims to examine the ability of HEI-2005 in predicting the probability for risk of premenopausal and postmenopausal breast cancer among Malaysian women. Data from a case-control nutritional epidemiology study among 764 participants including 382 breast cancer cases and 382 healthy women were extracted and scored. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to evaluate the relationship between the risk of breast cancer and quartiles (Q) of HEI-2005 total scores and its component, whereas the risk prediction ability of HEI-2005 was investigated using diagnostics analysis. The results of this study showed that there is a significant reduction in the risk of breast cancer, with a higher HEI-2005 total score among premenopausal women (OR Q1 vs. Q4=0.34, 95% CI; 0.15-0.76) and postmenopausal women (OR Q1 vs. Q4=0.20, 95% CI; 0.06-0.63). However, HEI-2005 has a sensitivity of 56-60%, a specificity of 55-60%, and a positive predictive value and negative predictive value of 57-58%, which indicates a moderate ability to predict the risk of breast cancer according to menopausal status. The breast cancer incidence observed poorly agrees with risk outcomes from HEI-2005 as shown by low κ statistics (κ=0.15). In conclusion, although the total HEI-2005 scores were associated with a risk of breast cancer among Malaysian women, the ability of HEI-2005 to predict risk is poor as indicated by the diagnostic analysis. A local index-based dietary pattern, which is disease specific, is required to predict the risk of breast cancer among Malaysian women for early prevention. PMID:23702680

  3. Nutrition and the risk of Alzheimer's disease.

    PubMed

    Hu, Nan; Yu, Jin-Tai; Tan, Lin; Wang, Ying-Li; Sun, Lei; Tan, Lan

    2013-01-01

    Alzheimer's disease (AD) is a progressive neurodegenerative disorder that accounts for the major cause of dementia, and the increasing worldwide prevalence of AD is a major public health concern. Increasing epidemiological studies suggest that diet and nutrition might be important modifiable risk factors for AD. Dietary supplementation of antioxidants, B vitamins, polyphenols, and polyunsaturated fatty acids are beneficial to AD, and consumptions of fish, fruits, vegetables, coffee, and light-to-moderate alcohol reduce the risk of AD. However, many of the results from randomized controlled trials are contradictory to that of epidemiological studies. Dietary patterns summarizing an overall diet are gaining momentum in recent years. Adherence to a healthy diet, the Japanese diet, and the Mediterranean diet is associated with a lower risk of AD. This paper will focus on the evidence linking many nutrients, foods, and dietary patterns to AD. PMID:23865055

  4. Bleeding Risk Index in an Anticoagulation Clinic

    PubMed Central

    Aspinall, Sherrie L; DeSanzo, Beth E; Trilli, Lauren E; Good, Chester B

    2005-01-01

    BACKGROUND The Outpatient Bleeding Risk Index (BRI) prospectively classified patients who were at high, intermediate, or low risk for warfarin-related major bleeding. However, there are only 2 published validation studies of the index and neither included veterans. OBJECTIVE To determine the accuracy of the BRI in patients attending a Veterans Affairs (VA) anticoagulation clinic and to specifically evaluate the accuracy of the BRI in patients with atrial fibrillation. DESIGN Retrospective cohort study. PATIENTS AND MEASUREMENTS Using the BRI, all patients managed by the Anticoagulation Clinic between January 1, 2001 and December 31, 2002 were classified as high, intermediate, or low risk for major bleeding. Bleeds were identified via quality-assurance reports. Poisson regression was used to determine whether there was an association between the index and the development of bleeding. RESULTS The rate of major bleeding was 10.6%, 2.5%, and 0.8% per patient-year of warfarin in the high-, intermediate-, and low-risk groups, respectively. Patients in the high-risk category had 14 times the rate of major bleeding of those in the low-risk group (incidence rate ratio (IRR) 14; 95% confidence interval (CI), 1.9 to 104.7). The rate of major bleeding was significantly different between the high- and intermediate-risk categories (P<.001). Among those with atrial fibrillation, patients in the high-risk category had 6 times the major bleeding rate of those in the intermediate- and low-risk groups combined (IRR=6; 95% CI, 2.4 to 15.3). CONCLUSIONS The BRI discriminates between high- and intermediate-risk patients in a VA anticoagulation clinic, including those with atrial fibrillation. PMID:16307625

  5. Evaluation of Handgrip Strength and Nutritional Risk of Congregate Nutrition Program Participants in Florida.

    PubMed

    Springstroh, Kelly A; Gal, Nancy J; Ford, Amanda L; Whiting, Susan J; Dahl, Wendy J

    2016-01-01

    The aim of this study was to determine if handgrip strength (HGS) is a predictor of nutritional risk in community-dwelling older adults. A cross-sectional study was carried out to determine the relationship between HGS and nutritional risk using SCREEN 1. The setting was Congregate Nutrition program meal sites (n = 10) in North Central Florida and included community-dwelling older adults participating in the Congregate Nutrition program. Older adults (n = 136; 77.1 ± 8.9 y; 45 M, 91 F) participated in the study. Nutritional risk was identified in 68% of participants, with 10% exhibiting clinically relevant weakness (men, HGS < 26 kg; women, HGS < 16 kg), suggesting a vulnerable population. HGS was weakly associated with nutritional risk as assessed by SCREEN 1 (AUC = 0.59), but alternate cutpoints, 33 kg for men (mean of both hands) and 22 kg for women (highest of either hand), provided the best comparison to nutritional risk. In community-dwelling older adults, HGS was weakly associated with nutritional risk assessed using traditional screening. However, as existing research supports the inclusion of HGS in malnutrition screening in acute care, further research into the usefulness of HGS and possibly other measures of functional status in nutrition risk screening of community-dwelling older adults may be warranted. PMID:27559854

  6. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals.

    PubMed

    Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K; Hercberg, Serge; Péneau, Sandrine

    2015-08-01

    In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19-31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products. PMID:26305255

  7. Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals

    PubMed Central

    Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K.; Hercberg, Serge; Péneau, Sandrine

    2015-01-01

    In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19–31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products. PMID:26305255

  8. On the risk criterion and the index of risk

    SciTech Connect

    Wang, J.C.; Johnson, R.O.; Lee, D.W.

    1996-06-10

    The development of a means to quantify risk, the determination of a risk criterion, and the establishment of a method to compare risks are three essential components in a probabilistic safety assessment. In this paper, the quantitative definition of risk given by Kaplan and Garrick is converted from a table to a graph to accommodate Farmer`s method of constructing a risk criterion. Farmer`s criterion is limited to a straight line, but its slope is made a free parameter. The high-frequency small-consequence problem noted by Farmer is solved by using an auxiliary vertical line to exclude scenarios with insignificant consequences. To compare risks associated with various accident scenarios, an index of risk relative to the straight-line risk criterion is proposed and developed. The results allow various accident scenarios to be ranked according to their weighted risks and, in turn, provide a measure of the effectiveness of mitigation.

  9. Comprehensive Guide and Topical Index. Nutrition in Primary Care Series.

    ERIC Educational Resources Information Center

    Battafarano, Annette M.

    Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

  10. HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

    PubMed

    Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Castro-Calvo, Jesús; Giménez-García, Cristina

    2016-08-01

    The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people. PMID:27125242

  11. Seafood: nutritional benefits and risk aspects.

    PubMed

    Oehlenschläger, Jörg

    2012-06-01

    Seafood, such as fish, crustacean and molluscan shellfish, and echinoderms, provides in the edible part (e. g., filet, abdominal muscle) many nutritional components beneficial for the human diet like n-3 polyunsaturated long chain fatty acids (PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), essential elements such as selenium and iodine, high potassium and low sodium concentrations, and the vitamins D, A, E, and B(12), as well as taurine (2-aminoethanesulfonic acid) among others. Its protein is highly digestible due to low connective tissue content, and cholesterol content is also low in fish. Lean fish species are extremely low in fat content (<1 %), while fatty species are extremely rich in PUFAs. However, being subject to environmental influences from its habitat, seafood also entails water-borne health risks such as organic pollutants, toxins, parasites, and heavy metals. Nevertheless, the vast majority of experimental and epidemiological studies have proven that the benefits of fish intake exceed the potential risks even for vulnerable consumer groups. PMID:23258397

  12. The French National Nutrition and Health Program score is associated with nutritional status and risk of major chronic diseases.

    PubMed

    Estaquio, Carla; Castetbon, Katia; Kesse-Guyot, Emmanuelle; Bertrais, Sandrine; Deschamps, Valérie; Dauchet, Luc; Péneau, Sandrine; Galan, Pilar; Hercberg, Serge

    2008-05-01

    Few studies have found that adherence to dietary guidelines reduces the incidence of chronic disease. In 2001, a National Nutrition and Health Program (Program National Nutrition Santé) was implemented in France and included 9 quantified priority nutritional goals involving fruit, vegetable, and nutrient intakes, nutritional status, and physical activity. We developed an index score that includes indicators of these public health objectives and examined the association between this score and the incidence of major chronic diseases in the Supplémentation en Vitamines et Minéraux AntioXydants cohort. Data from middle-aged adults free of major chronic diseases and who provided at least 3 24-h dietary records during the first 2 y of follow-up have been included in the present analysis (n = 4,976). Major chronic disease, documented during the 8-y follow-up period (n = 455), was defined as the combination of cardiovascular disease (n = 131), cancer (n = 261), or death (n = 63), whichever came first. In fully adjusted Cox models, men in the top tertile score compared with those in the lowest one had a 36% lower risk of major chronic diseases (hazard ratio = 0.64; 95% CI: 0.44-0.96). No association was found in women. Healthy diet and lifestyle were associated with a lower risk of chronic diseases, particularly in men, thereby underlying relevance of the French nutritional recommendations. PMID:18424606

  13. Waist-to-Height Ratio and Body Mass Index as Indicators of Cardiovascular Risk in Youth

    ERIC Educational Resources Information Center

    Keefer, Daniel J.; Caputo, Jennifer L.; Tseh, Wayland

    2013-01-01

    Background: The purpose of this investigation was to determine if waist-to-height ratio (WHTR) or body mass index (BMI) is the better indicator of cardiovascular disease risk in children and adolescents of varying ages. Methods: Data from children and adolescents (N?=?2300) who were part of the 2003-2004 National Health and Nutrition Examination…

  14. Novel immunological and nutritional-based prognostic index for gastric cancer

    PubMed Central

    Sun, Kai-Yu; Xu, Jian-Bo; Chen, Shu-Ling; Yuan, Yu-Jie; Wu, Hui; Peng, Jian-Jun; Chen, Chuang-Qi; Guo, Pi; Hao, Yuan-Tao; He, Yu-Long

    2015-01-01

    AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer. METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias. RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively. CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer. PMID:26019461

  15. Nutrition and health risks in the elderly: the nutrition screening initiative.

    PubMed Central

    Posner, B M; Jette, A M; Smith, K W; Miller, D R

    1993-01-01

    OBJECTIVES. The Nutrition Screening Initiative is a national collaborative effort committed to the identification and treatment of nutritional problems in older persons. METHODS. A 14-item checklist of characteristics associated with nutritional status was administered to a random sample of Medicare beneficiaries, aged 70 years and older, in New England. Regression analysis was used to derive item weights that would predict poor nutrient intakes and low perceived health status. Sensitivity and specificity values were reviewed to define low, moderate, and high nutritional risk scores. RESULTS. A revised checklist containing 10 yes/no items was adopted. Scores of 6 or more points defined persons at high nutritional risk. Twenty-four percent of the Medicare population was estimated to be at high nutritional risk according to the checklist. Among those in the high-risk group, 56% perceived their health to be "fair" or "poor" and 38% had dietary intakes below 75% of the recommended dietary allowances for three or more nutrients. CONCLUSIONS. The Nutrition Screening Initiative Checklist is a brief, easily scored instrument that can accurately identify noninstitutionalized older persons at risk for low nutrient intake and health problems. PMID:8328619

  16. Application of a Functional Mathematical Index to the Evaluation of the Nutritional Quality of Potatoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper describes the derivation and application of a new functional mathematical index that was used to evaluate the nutritional, safety, and processing quality aspects of potatoes. The index introduces the concept of an “optimal potato”, using appropriate distance and N-dimensional parameter sp...

  17. [Preoperative evaluation of surgery for intractable aspiration based on the prognostic nutritional index].

    PubMed

    Uchida, Masaya; Hashimoto, Keiko; Mukudai, Shigeyuki; Ushijima, Chihisa; Dejima, Kenji

    2014-12-01

    Because there is no absolute indicator of the nutritional status and prognosis in patients with severe aspiration problems, it is quite difficult to arrive at a true long-time prognosis. By performing surgery for intractable aspiration on such patients, both the prognosis and QOL of the patients could be expected to improve. In our department, we have experienced patients dying within 6 months after surgery. In these cases, the patient's preoperative nutritional status was not good. Therefore, we consider that, when we adopt this procedure, there should be some indicators we should use which could have an effect on the prognosis of such nutritionally-challenged patients. In patients who underwent surgery for intractable aspiration; we examined the relationship between their survival and the prognostic nutritional index (PNI) which is an indicator of the risk of complications such as post-operative events in the surgical field. We investigated the relationship between the prognosis and the postoperative indicators of each of the following: WBC, CRP, serum albumin level, and PNI. Out of a total of 31 cases, the average O-PNI of eight cases in which death occurred was 29.45, and the average of six cases in which death occurred within 6 months after surgery was 28.26. The average O-PNI of the survivors was 36.01. A significant association was noted between the early postoperative deaths and some of the four indicators namely that serum albumin level and O-PNI. Based on the ROC curve, the O-PNI offered higher precision than the albumin level. The cut-off value of the O-PNI value for early postoperative mortality rate was 32. The early postoperative mortality rate was 44.4% in patients with less than 32 O-PNI in the preoperative examination, but if it were O-PNI 32 or more, the early postoperative mortality rate was 9.1%, significantly lower. Therefore, O-PNI could be useful as one of the prognostic evaluation factors in the case of preoperative surgery for intractable

  18. Development of the Nutrition and Swallowing Checklist, a Screening Tool for Nutrition Risk and Swallowing Risk in People with Intellectual Disability.

    ERIC Educational Resources Information Center

    Stewart, Lyn

    2003-01-01

    This article discusses nutrition problems in people with intellectual disabilities, the need for nutrition risk screening, and the development of the Nutrition and Swallowing Checklist in New South Wales. The checklist ensures carer involvement in identifying risks and an interdisciplinary approach to the assessment and management of nutrition and…

  19. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk

    PubMed Central

    Prescott, Jennifer; Setiawan, Veronica W.; Wentzensen, Nicolas; Schumacher, Fredrick; Yu, Herbert; Delahanty, Ryan; Bernstein, Leslie; Chanock, Stephen J.; Chen, Chu; Cook, Linda S.; Friedenreich, Christine; Garcia-Closas, Monserrat; Haiman, Christopher A.; Le Marchand, Loic; Liang, Xiaolin; Lissowska, Jolanta; Lu, Lingeng; Magliocco, Anthony M.; Olson, Sara H.; Risch, Harvey A.; Shu, Xiao-Ou; Ursin, Giske; Yang, Hannah P.; Kraft, Peter; De Vivo, Immaculata

    2015-01-01

    Genome-wide association studies (GWAS) have identified common variants that predispose individuals to a higher body mass index (BMI), an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS) based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002). For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%). However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78). Heterogeneity by BMI did not reach statistical significance (P = 0.06), and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58). In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10−5). Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk. PMID:26606540

  20. Difference in nutritional risk between mild cognitive impairment group and normal cognitive function elderly group.

    PubMed

    Lee, Kang Soo; Hong, Chang Hyung; Cheong, Hae-Kwan; Oh, Byoung Hoon

    2009-01-01

    The purpose of this study was to delineate the difference in nutritional risk between mild cognitive impairment (MCI) groups and normal cognitive function (NCF) elderly groups in the community. Data obtained from 490 subjects (237 NCF elderly and 253 MCI subjects) between 60 and 90 years of age were analyzed. The study protocol comprised demographic characteristics, history of current and past illnesses, drug history, Korean version of short-form Geriatric Depression Scale (K-SGDS), and nutritional screening initiative (NSI) checklist. Cognitive function was assessed by digit span, Korean short version of Boston naming test (K-BNT), simple Rey figure test, auditory verbal learning test (AVLT), controlled oral word association test (COWAT), stroop, go-no go, and contrasting program. Also, we examined the blood pressure, fasting serum glucose level, lipid profile, body mass index (BMI), and ApoE genotype. Multiple logistic regression analysis found that MCI was associated with moderate or high nutritional risk after adjustment for age, sex, educational level, and K-SGDS score (odds ratio (OR)=1.13, 95%; confidence interval (CI)=1.01-1.26). These results suggest that MCI may be associated with nutritional risk. Screening for nutritional risk should be included in multidimensional geriatric evaluation. PMID:18524396

  1. Nutritional Risk Needs Assessment of Community-Living Seniors: Prevalence of Nutrition Problems and Priorities for Action.

    ERIC Educational Resources Information Center

    Keller, Heather H.; Hedley, Margaret R.

    2002-01-01

    Surveyed community-dwelling older adults to examine the prevalence of nutritional risk, specific nutrition problems, and educational format preferences. Results revealed that nutrition problems and risk were prevalent among community-dwelling older adults. Common problems included significant weight change in 6 months and low intake of fruits,…

  2. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon

    PubMed Central

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Background and Aims Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. Methods In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Results Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2–12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22–44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32–55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5–19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Conclusions Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index. PMID:26919440

  3. Evidence Report: Risk Factor of Inadequate Nutrition

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; Zwart, Sara R.; Heer, Martina

    2015-01-01

    The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

  4. Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents

    PubMed Central

    de Oliveira, Patrícia Morais; da Silva, Fabiana Almeida; Oliveira, Renata Maria Souza; Mendes, Larissa Loures; Pereira, Michele; Cândido, Ana Paula Carlos

    2016-01-01

    Abstract Objective: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective. PMID:26542380

  5. Body Mass Index, Nutrient Intakes, Health Behaviours and Nutrition Knowledge: A Quantile Regression Application in Taiwan

    ERIC Educational Resources Information Center

    Chen, Shih-Neng; Tseng, Jauling

    2010-01-01

    Objective: To assess various marginal effects of nutrient intakes, health behaviours and nutrition knowledge on the entire distribution of body mass index (BMI) across individuals. Design: Quantitative and distributional study. Setting: Taiwan. Methods: This study applies Becker's (1965) model of health production to construct an individual's BMI…

  6. [Research progress on index system of regional ecological risk assessment].

    PubMed

    Meng, Ji-Jun; Zhao, Chun-Hong

    2009-04-01

    Regional ecological risk assessment (RERA) covers the assessments of multiple risk sources, receptors, and endpoints, while the selection of assessment indices is quite complicated, being a hotspot in regional environment management research. Domestic and international researches on RERA revealed that three processes in RERA are of vital, i.e., risk probability assessment measured by risk probability index, status and value assessment of ecosystem at regional scale indicated by ecological index, and vulnerability assessment of each ecosystem in a region under risk measured by vulnerability index. The main problems in the establishment of RERA index system are the strong subjectivity and poor comparability, and thus, the index system should be set up in the three key processes under the principles of objectivity, integration, hierarchy, and comparability. Due to the fact that the status and value assessment of ecosystem is most complicated, the index system should be formulated by compulsory and optional components to increase the comparability of RERA results between regions. PMID:19565785

  7. Mother's body mass index as a predictor of infant's nutritional status in the post-emergency phase of a flood.

    PubMed

    Goudet, Sophie; Griffths, Paula; Bogin, Barry A

    2011-10-01

    Maternal nutritional status is a determinant of child health. This paper studies the association between a mother's body mass index (BMI) and her infant's nutritional status over a one year time frame after the 1998 flood crisis in Bangladesh. The paper uses secondary analysis of data collected from 757 households in seven rural areas of Bangladesh affected by the 1998 flood using multiple-stage probability sampling techniques (n = 143). Logistic regression models were employed to investigate the predictive impact of maternal BMI on infant's nutritional status after controlling for a range of child and maternal factors. An underweight mother was a significant factor with regard to the risk of infants suffering stunting (odds ratio (OR) = 4.45, 95 per cent confidence interval (CI) = 1.04-18.94) and being underweight (OR = 3.51, 95 per cent CI = 1.02-12.05) a year later, but not wasting (OR = 2.09, 95 per cent CI = 0.51-8.67). The findings suggest that there is a post-emergency link between maternal and infant nutritional health. PMID:21913932

  8. An index for longevity risk transfer

    NASA Astrophysics Data System (ADS)

    Denuit, Michel M.

    2009-08-01

    This paper discusses the choice of an appropriate longevity index to track the improvements in mortality in industrialized countries. Period life expectancies computed from national life tables turn out to be efficient in this context. A detailed analysis of the predictive distribution of this longevity index is performed in the Lee-Carter model where the period life expectancy is just a functional of the underlying time index.

  9. Nutritional risk, malnutrition and nutritional support among hospitalized patients in orthopedics/spinal surgery of a Hohhot teaching hospital.

    PubMed

    Wang, Nannan; Dong, Yalin; Huo, Ting; Shao, Yanqing; Xing, Wenhua; Li, Shuwen

    2016-01-01

    The evolution of nutritional status (the prevalence of nutritional risk, malnutrition, overweight and obesity) and the nutritional support of the hospitalized patients from admission to discharge or over a two-week period in orthopedics/ spinal surgery of a teaching hospital in Hohhot were investigated. 432 patients from two wards of the orthopedics/spinal surgery from Jan to Dec 2013, the traditional spinal surgery and the minimally invasive spinal surgery, were selected and detected in this study. The Nutritional Risk Score 2002 (NRS 2002) was used to determine the patients' nutritional status within 48 h after admission and during their hospitalization. The overall prevalence of nutritional risk, malnutrition, overweight and obesity at admission was 11.6%, 12.7%, 35.9% and 7.41%, respectively. Overall, there were 88.0% of the patients who were at nutritional risk received nutritional support, while 14.1% of non-risk patients received a redundant nutritional support. The overall prevalence of nutritional risk changed from 11.6% at admission to 19.4% upon discharge (p<0.05), and the prevalence of malnutrition changed from 12.7% to 20.6% (p<0.05). The prevalence of overweight and obesity, which changed from 35.9% to 31.0% and from 7.41% to 5.79% respectively, didn't experience statistically significant evolution. NRS 2002 was a feasible nutritional risk screening tool for patients in spinal surgery of orthopedics department. Patients' prevalence of nutritional risk and malnutrition increased significantly in spinal surgery of this hospital. Some inappropriate uses of nutritional support were observed in orthopedics/spinal surgery, and nutritional support guidelines or protocols should be promoted by a professional committee. PMID:27222410

  10. [Alternative nutrition of children. Its advantages and risks].

    PubMed

    Grüttner, R

    1988-05-01

    Food faddism is a growing scenery. Since children are also involved in these unusual food habits of their parents, the pediatrician is faced with new nutritional problems. The consequence may be failure to thrive in infancy and childhood noticed mainly in families with strictly vegetarian food habits. Moreover the pediatrician should know the possible sequelae of all the other forms of food faddism. Only a careful nutritional history paralleling the usual medical history may then uncover the origin of a chronic failure to thrive. First and foremost infants after weaning are at special risk in respect to protein, calcium and vitamin deficiencies. PMID:3043204

  11. WHO European Childhood Obesity Surveillance Initiative: School Nutrition Environment and Body Mass Index in Primary Schools

    PubMed Central

    Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Sjöberg, Agneta; Eldin, Nazih; Yngve, Agneta; Kunešová, Marie; Starc, Gregor; Rito, Ana I.; Duleva, Vesselka; Hassapidou, Maria; Martos, Éva; Pudule, Iveta; Petrauskiene, Ausra; Farrugia Sant’Angelo, Victoria; Hovengen, Ragnhild; Breda, João

    2014-01-01

    Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%−95% of schools) and school nutrition environment scores (range: 0.30−0.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.20−1.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school

  12. Nutrition and Gastric Cancer Risk: An Update

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Data from epidemiologic, experimental, and animal studies indicate that diet plays an important role in the etiology of gastric cancer. High intake of fresh fruit and vegetable, lycopene and lycopene-containing food products, and potentially vitamin C and selenium may reduce the risk for gastric can...

  13. Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients

    PubMed Central

    Shan, Xizheng; Liu, Jinming; Luo, Yanrong; Xu, Xiaowen; Han, Zhiqing; Li, Hailing

    2015-01-01

    Objective The nutritional status of chronic obstructive pulmonary disease (COPD) patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients. Methods A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33) and nutritional risk group (n=25) according to the Nutritional Risk Screening (NRS, 2002) criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients. Results Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group (P<0.05). The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group (P<0.05). Besides, the peak VO2 (peak oxygen uptake), peak O2 pulse (peak oxygen pulse), and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group (P<0.05) and there were significantly negative correlations between the NRS score and peak VO2, peak O2 pulse, or peak load (r<0, P<0.05). Conclusion The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study. PMID:26150712

  14. [Effectiveness of the Body Mass Index in the nutritional diagnosis of pregnant adolescents].

    PubMed

    Rached-Paoli, Ingrid; Henriquez-Pérez, Gladys

    2010-06-01

    The purpose of this study was to analyze the diagnostic capacity of different classification criteria based on Body Mass Index in the assessment of nutritional status and to evaluate their effectiveness. The sample comprised 367 healthy pregnant adolescents in their first trimester of gestation, from a socioeconomic level IV, between Oct. 1999 and Dec. 2008. Two methodologies were applied for the nutritional classification: (1) Integral nutritional diagnosis (gold standard), and (2) Body Mass Index (BMI), using local reference values: Proyecto Venezuela and the Transversal Study of Caracas, and international reference values: Frisancho and WHO 2006. Concordances, kappa, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and the Youden index were calculated. According to the gold standard and BMI, the percentage of well-nourished pregnant women ranged between 62.4% and 80.6%. Within the deficit range, Frisancho was the most effective with kappa: 0.80; sensitivity: 87.3%; specificity: 94.8%; positive likelihood ratio: 16.9, and negative likelihood ratio: 0.13; Youden index: 0.82. Within the excess range, Frisancho and the Transversal Study of Caracas were the most effective with Youden index: 0.86 and 0.83, respectively. These results revealed that Frisancho was the best criterion to diagnose malnutrition in deficit in pregnant women. All references have an adequate diagnostic capacity for the excess range, of which Frisancho and the Transversal Study of Caracas are the best. We recommend using such reference values to optimize the efficiency of the BMI indicator in diagnosing malnutrition in deficit and in excess in the first trimester of gestation in pregnant adolescents within populations with similar characteristics. PMID:21427881

  15. Risk assessment of genetically modified crops for nutrition and health.

    PubMed

    Magaña-Gómez, Javier A; de la Barca, Ana M Calderón

    2009-01-01

    The risk assessment of genetically modified (GM) crops for human nutrition and health has not been systematic. Evaluations for each GM crop or trait have been conducted using different feeding periods, animal models, and parameters. The most common result is that GM and conventional sources induce similar nutritional performance and growth in animals. However, adverse microscopic and molecular effects of some GM foods in different organs or tissues have been reported. Diversity among the methods and results of the risk assessments reflects the complexity of the subject. While there are currently no standardized methods to evaluate the safety of GM foods, attempts towards harmonization are on the way. More scientific effort is necessary in order to build confidence in the evaluation and acceptance of GM foods. PMID:19146501

  16. Socio-Cognitive and Nutritional Factors Associated with Body Mass Index in Children and Adolescents: Possibilities for Childhood Obesity Prevention

    ERIC Educational Resources Information Center

    O'Dea, Jennifer A.; Wilson, Rachel

    2006-01-01

    A large national study of schoolchildren aged 6-18 years was conducted to assess nutritional and socio-cognitive factors associated with body mass index (BMI). A questionnaire was used to assess nutritional quality of breakfast, importance of physical activity and food variety score, among 4441 students from randomly selected schools in all states…

  17. Use of body mass index of adults in assessing individual and community nutritional status.

    PubMed Central

    Bailey, K. V.; Ferro-Luzzi, A.

    1995-01-01

    Adult malnutrition is much more widespread than is commonly recognized. Described in this article is the use of body mass index (BMI = weight in kg/(height in metres)2) as a measure of adult nutritional status, both of individuals and of communities. Concurrent assessment of the nutritional status of children and adults permits conclusions to be drawn about whether there is generalized undernutrition in a community or whether other factors (e.g., childhood infections or feeding practices) are more important in childhood malnutrition. Included is a tabular presentation that permits rapid assessment of both thinness or underweight (BMI values < 16, 17 and 18.5) and overweight (BMI > 25, 30 and 40). Examples of the use of BMI in both clinical and public health practice are also given. PMID:8846494

  18. Syncrude`s fire hazard index priorities risks

    SciTech Connect

    Kelly, B.

    1997-05-01

    To quantify fire hazard risks within large production facilities and help establish priorities for additional fire controls, Syncrude Canada Ltd. created a fire hazard index, to identify high-priority risks. The fire hazard index scoring system assigns a number score to each facility or work area. The numerical score represents the composite fire risk associated with the area of concern. The resulting scores are used as a comparative tool to determine which fire risks receive top priority for additional controls and fire inspections/surveys. Unlike other fire hazard indices, the Syncrude index can be used for all facilities regardless of whether they handle flammable material. As a result, the potential fire hazard associated with vehicles, shops, offices, computer rooms, and mechanical equipment can be assessed. 1 ref., 2 figs., 1 tab.

  19. Clinical Significance of the Prognostic Nutritional Index for Predicting Short- and Long-Term Surgical Outcomes After Gastrectomy

    PubMed Central

    Lee, Jee Youn; Kim, Hyoung-Il; Kim, You-Na; Hong, Jung Hwa; Alshomimi, Saeed; An, Ji Yeong; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong-Bai

    2016-01-01

    Abstract To evaluate the predictive and prognostic significance of the prognostic nutritional index (PNI) in a large cohort of gastric cancer patients who underwent gastrectomy. Assessing a patient's immune and nutritional status, PNI has been reported as a predictive marker for surgical outcomes in various types of cancer. We retrospectively reviewed data from a prospectively maintained database of 7781 gastric cancer patients who underwent gastrectomy from January 2001 to December 2010 at a single center. From this data, we analyzed clinicopathologic characteristics, PNI, and short- and long-term surgical outcomes for each patient. We used the PNI value for the 10th percentile (46.70) of the study cohort as a cut-off for dividing patients into low and high PNI groups. Regarding short-term outcomes, multivariate analysis showed a low PNI (odds ratio [OR] = 1.505, 95% CI = 1.212–1.869, P <0.001), old age, male sex, high body mass index, medical comorbidity, total gastrectomy, and combined resection to be independent predictors of postoperative complications. Among these, only low PNI (OR = 4.279, 95% CI = 1.760–10.404, P = 0.001) and medical comorbidity were independent predictors of postoperative mortality. For long-term outcomes, low PNI was a poor prognostic factor for overall survival, but not recurrence (overall survival: hazard ratio [HR] = 1.383, 95% CI = 1.221–1.568, P < 0.001; recurrence-free survival: HR = 1.142, 95% CI = 0.985–1.325, P = 0.078). PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. Although PNI was an independent prognostic factor for overall survival, the index was not associated with cancer recurrence. PMID:27149460

  20. Low Omega-3 Index in Pregnancy Is a Possible Biological Risk Factor for Postpartum Depression

    PubMed Central

    Markhus, Maria Wik; Skotheim, Siv; Graff, Ingvild Eide; Frøyland, Livar; Braarud, Hanne Cecilie; Stormark, Kjell Morten; Malde, Marian Kjellevold

    2013-01-01

    Background Depression is a common disorder affecting 10–15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy. Methods In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28th gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression. Results In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles. Conclusion In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum. PMID:23844041

  1. Phytogenic pigments in animal nutrition: potentials and risks.

    PubMed

    Faehnrich, Bettina; Lukas, Brigitte; Humer, Elke; Zebeli, Qendrim

    2016-03-01

    Phytogenic pigments are secondary plant compounds responsible for coloring effects in plant tissues. In particular, phenolic flavonoids and terpenoid carotenoids, but also rare compounds like curcumin and betalain, form this group of biochemical agents used in animal nutrition. From the perspective of ecological mutuality between plants and animals, these compounds are of crucial importance because they serve as visual attraction for herbivores but also signal nutritional and/or health-promoting values. This review focuses on the properties of phytogenic pigments which are likely to impact feed intake and preferences of livestock. Also natural prophylactic and/or therapeutic properties and, in particular, the potential of pigments to enhance quality and health value of animal products for human consumption are important issues. Nevertheless, reasonable limits of use due to possible adverse indications have been suggested recently. Pathways of digestion, metabolism and excretion in animals play a crucial role not only in the evaluation of effectiveness but also in the prediction of potential risks for human consumption. The popularity of natural feed additives is growing; therefore, more research work is needed to better understand metabolic pathways in the animal's body and to better estimate the potentials and risks of pigmenting plant compounds used in animal nutrition. © 2015 Society of Chemical Industry. PMID:26415572

  2. 2013 Nutrition Risk Research Plan Review Final Report. Research Plan Review for: The Risk Factor of Inadequate Nutrition

    NASA Technical Reports Server (NTRS)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) was impressed by the degree of progress the nutrition discipline has made with the research plan presented since the 2012 Nutrition Risk SRP WebEx/teleconference. The scientists and staff associated with the nutrition discipline have, in addition, continued their impressive publication track record. Specifically the SRP found that the novel and important progress in the ocular health research area (Gap N7.3) represents an important advance in understanding the etiology and potential countermeasures for this condition and thinks that the work will not only be valuable for vision, but may have implications for cardiovascular health, as well. The SRP also considered the bone countermeasure data presented a potentially valuable tool for investigating bone metabolism under the unique conditions of space travel, specifically the innovation of variable use of stable Ca isotopes for bone synthesis and equal contribution for bone to investigate bone metabolism, as well as, the impact of the advanced resistive exercise device (ARED) on body composition during spaceflight. Finally, the SRP considers the planned Integrated Nutrition task to be an important and necessary strategic part of the research plan. The SRP is concerned that the risks observed in previous research on Low Earth Orbit (LEO) may not capture all the risks of longer duration flight beyond LEO. In particular, the SRP believes that there may be a much greater likelihood of an intensified chronic inflammatory response compared to the very minimal evidence seen to date and that modest effects seen in LEO, such as the reduction in appetite, may not predict an absence in longer duration flight out of LEO. The added complications of longer duration flight, greater bio-behavioral stress, radiation exposure, poorer communication, and inability to respond to unforeseen exigencies may create different risks. Thus, preparation for

  3. Platelet activation risk index as a prognostic thrombosis indicator.

    PubMed

    Zlobina, K E; Guria, G Th

    2016-01-01

    Platelet activation in blood flow under high, overcritical shear rates is initiated by Von Willebrand factor. Despite the large amount of experimental data that have been obtained, the value of the critical shear rate, above which von Willebrand factor starts to activate platelets, is still controversial. Here, we recommend a theoretical approach to elucidate how the critical blood shear rate is dependent on von Willebrand factor size. We derived a diagram of platelet activation according to the shear rate and von Willebrand factor multimer size. We succeeded in deriving an explicit formula for the dependence of the critical shear rate on von Willebrand factor molecule size. The platelet activation risk index was introduced. This index is dependent on the flow conditions, number of monomers in von Willebrand factor, and platelet sensitivity. Probable medical applications of the platelet activation risk index as a universal prognostic index are discussed. PMID:27461235

  4. Development of an operational specific CAT risk (SCATR) index

    NASA Technical Reports Server (NTRS)

    Keller, J. L.; Haines, P. A.; Luers, J. K.

    1983-01-01

    The original formulations of Roach (1970) and Oard (1974) for the calculation of clear air turbulence (CAT) potential from synoptic scale data were extended. An index which gives a measure of the specific risk of encountering CAT - the specific clear air turbulence risk (SCATR) index - was defined. This index takes into account both the locally and advected contributions to the energy necessary for CAT. The advected contribution is associated with the role of atmospheric gravity waves. The SCATR index was calculated for a number of cases where documented encounters with CAT occurred. Of particular interest were those made for cases involving severe CAT. The results for the two severe CAT cases run were quite impressive and elicited considerable interest from operational aviation meteorologists.

  5. Platelet activation risk index as a prognostic thrombosis indicator

    PubMed Central

    Zlobina, K. E.; Guria, G. Th.

    2016-01-01

    Platelet activation in blood flow under high, overcritical shear rates is initiated by Von Willebrand factor. Despite the large amount of experimental data that have been obtained, the value of the critical shear rate, above which von Willebrand factor starts to activate platelets, is still controversial. Here, we recommend a theoretical approach to elucidate how the critical blood shear rate is dependent on von Willebrand factor size. We derived a diagram of platelet activation according to the shear rate and von Willebrand factor multimer size. We succeeded in deriving an explicit formula for the dependence of the critical shear rate on von Willebrand factor molecule size. The platelet activation risk index was introduced. This index is dependent on the flow conditions, number of monomers in von Willebrand factor, and platelet sensitivity. Probable medical applications of the platelet activation risk index as a universal prognostic index are discussed. PMID:27461235

  6. Developing a risk-based air quality health index

    NASA Astrophysics Data System (ADS)

    Wong, Tze Wai; Tam, Wilson Wai San; Yu, Ignatius Tak Sun; Lau, Alexis Kai Hon; Pang, Sik Wing; Wong, Andromeda H. S.

    2013-09-01

    We developed a risk-based, multi-pollutant air quality health index (AQHI) reporting system in Hong Kong, based on the Canadian approach. We performed time series studies to obtain the relative risks of hospital admissions for respiratory and cardiovascular diseases associated with four air pollutants: sulphur dioxide, nitrogen dioxide, ozone, and particulate matter with an aerodynamic diameter less than 10 μm (PM10). We then calculated the sum of excess risks of the hospital admissions associated with these air pollutants. The cut-off points of the summed excess risk, for the issuance of different health warnings, were based on the concentrations of these pollutants recommended as short-term Air Quality Guidelines by the World Health Organization. The excess risks were adjusted downwards for young children and the elderly. Health risk was grouped into five categories and sub-divided into eleven bands, with equal increments in excess risk from band 1 up to band 10 (the 11th band is 'band 10+'). We developed health warning messages for the general public, including at-risk groups: young children, the elderly, and people with pre-existing cardiac or respiratory diseases. The new system addressed two major shortcomings of the current standard-based system; namely, the time lag between a sudden rise in air pollutant concentrations and the issue of a health warning, and the reliance on one dominant pollutant to calculate the index. Hence, the AQHI represents an improvement over Hong Kong's existing air pollution index.

  7. Nutrition deficiency increases the risk of stomach cancer mortality

    PubMed Central

    2012-01-01

    Background The purpose of the study is to determine whether exposure to malnutrition during early life is associated with increased risk of stomach cancer in later life. Methods The design protocol included analyzing the trend of gastric cancer mortality and nutrition and evaluating the association between nutrient deficiency in early life and the risk of gastric cancer by hierarchical age–period–birth cohort (APC) analysis using general log-linear Poisson models and to compare the difference between birth cohorts who were exposed to the 1959–1961 Chinese famine and those who were not exposed to the famine. Data on stomach cancer mortality from 1970 to 2009 and the dietary patterns from 1955 to 1985 which included the 1959–1961 Chinese famine period in the Zhaoyuan County population were obtained. The nutrition information was collected 15 years prior to the mortality data as based on the latest reference of disease incubation. Results APC analysis revealed that severe nutrition deficiency during early life may increase the risk of stomach cancer. Compared with the 1960–1964 birth cohort, the risk for stomach cancer in all birth cohorts from 1900 to 1959 significantly increased; compared with the 1970–1974 cohort, the risk for stomach cancer in the 1975–1979 cohort significantly increased, whereas the others had a steadily decreased risk; compared with 85–89 age group in the 2005–2009 death survey, the ORs decreased with younger age and reached significant levels for the 50–54 age group after adjusting the confounding factors. The 1930 to 1964 group (exposed to famine) had a higher mortality rate than the 1965 to 1999 group (not exposed to famine). For males, the relative risk (RR) was 2.39 and the 95% confidence interval (CI) was 1.51 to 3.77. For females, RR was 1.64 and 95% CI was 1.02 to 2.62. Conclusion The results of the present study suggested that prolonged malnutrition during early life may increase the risk of stomach cancer

  8. The Social Environment of Schools and Adolescent Nutrition: Associations between the School Nutrition Climate and Adolescents' Eating Behaviors and Body Mass Index

    ERIC Educational Resources Information Center

    Cvjetan, Branko; Utter, Jennifer; Robinson, Elizabeth; Denny, Simon

    2014-01-01

    Background: The aim of this study was to determine the association between the school nutrition climate and students' eating behaviors and body mass index (BMI). Methods: Data were collected as part of Youth'07, a nationally representative health survey of high school students in New Zealand. Overall, 9107 randomly selected students from…

  9. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  10. Increasing Risk Awareness: The Coastal Community Resilience Index

    ERIC Educational Resources Information Center

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  11. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences.

    PubMed

    Locher, Julie L; Ritchie, Christine S; Roth, David L; Baker, Patricia Sawyer; Bodner, Eric V; Allman, Richard M

    2005-02-01

    This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital. For all ethnic-gender groups, greater restriction in independent life-space (an indicator of social isolation) was associated with increased nutritional risk. For black women and white men, not having adequate transportation (also an indicator of social isolation) was associated with increased nutritional risk. Additionally, for black and white women and white men, lower income was associated with increased nutritional risk. For white women only, the perception of a low level of social support was associated with increased nutritional risk. For black men, not being married (an indicator of social support) and not attending religious services regularly, restricting activities for fear of being attacked, and perceived discrimination (indicators of social capital) were associated with increased nutritional risk. Black females had the greatest risk of poor nutritional health, however more indicators of social isolation, support, and capital were associated with nutritional risk for black men. Additionally, the indicators of social support and capital adversely affecting nutritional risk for black men differed from those associated with nutritional risk in other ethnic-gender groups. This research has implications for nutritional policies directed towards older adults. PMID:15571893

  12. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences

    PubMed Central

    Locher, Julie L.; Ritchie, Christine S.; Roth, David L.; Baker, Patricia Sawyer; Bodner, Eric V.; Allman, Richard M.

    2009-01-01

    This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital. For all ethnic–gender groups, greater restriction in independent life–space (an indicator of social isolation) was associated with increased nutritional risk. For black women and white men, not having adequate transportation (also an indicator of social isolation) was associated with increased nutritional risk. Additionally, for black and white women and white men, lower income was associated with increased nutritional risk. For white women only, the perception of a low level of social support was associated with increased nutritional risk. For black men, not being married (an indicator of social support) and not attending religious services regularly, restricting activities for fear of being attacked, and perceived discrimination (indicators of social capital) were associated with increased nutritional risk. Black females had the greatest risk of poor nutritional health, however more indicators of social isolation, support, and capital were associated with nutritional risk for black men. Additionally, the indicators of social support and capital adversely affecting nutritional risk for black men differed from those associated with nutritional risk in other ethnic–gender groups. This research has implications for nutritional policies directed towards older adults. PMID:15571893

  13. Body Mass Index Is a Marker of Nutrition Preparation Sufficiency Before Surgery for Crohn's Disease From the Perspective of Intra-Abdominal Septic Complications

    PubMed Central

    Zhang, Min; Gao, Xiang; Chen, Yuanhan; Zhi, Min; Chen, Huangwei; Tang, Jian; Su, Minli; Yao, Jiayin; Yang, Qingfan; Chen, Junrong; Hu, Pinjin; Liu, Huanliang

    2015-01-01

    Abstract Poor preoperative nutritional status for individuals with Crohn's disease (CD) is associated with intra-abdominal septic complications (IASCs). The present study aimed to investigate the association of the common nutrition indices serum albumin and body mass index (BMI) with IASCs. Sixty-four CD patients who had received elective intestinal operations were retrospectively investigated. Among these patients, 32 had received individualized fortified nutrition support. IASCs occurred in 7 patients (10.9%). Compared with non-IASC patients, IASC patients had a lower BMI (17.6 ± 2.7 vs 15.6 ± 1.3 kg/m2, P = 0.048). The area under the receiver operating characteristic curve according to the BMI-based IASC prediction was 0.772 (95% confidence interval [CI], 0.601–0.944; P = 0.020) with an optimum diagnostic cutoff value of 16.2 kg/m2. A BMI < 16.2 kg/m2 significantly increased the risk of developing an IASC (odds ratio [OR], 10.286; 95% CI, 1.158–91.386). Even after correction with the simplified CD activity index (CDAI), a low BMI level remained associated with IASCs (OR, 7.650; 95% CI, 0.808–72.427; P = 0.076). Serum albumin was not associated with IASCs. Although the fortified nutrition support group had an albumin level comparable to the control group, this group had a higher simplified CDAI score, a lower BMI level, and a comparable incidence rate of IASCs. Thus, BMI more accurately reflects the basic preoperative nutritional status of CD patients than serum albumin. BMI can aid in guiding preoperative nutrition support and judging the appropriate operation time for CD. PMID:26334908

  14. Novel Threat-risk Index Using Probabilistic Risk Assessment and Human Reliability Analysis - Final Report

    SciTech Connect

    George A. Beitel

    2004-02-01

    In support of a national need to improve the current state-of-the-art in alerting decision makers to the risk of terrorist attack, a quantitative approach employing scientific and engineering concepts to develop a threat-risk index was undertaken at the Idaho National Engineering and Environmental Laboratory (INEEL). As a result of this effort, a set of models has been successfully integrated into a single comprehensive model known as Quantitative Threat-Risk Index Model (QTRIM), with the capability of computing a quantitative threat-risk index on a system level, as well as for the major components of the system. Such a threat-risk index could provide a quantitative variant or basis for either prioritizing security upgrades or updating the current qualitative national color-coded terrorist threat alert.

  15. Effect of Parental Migration Background on Childhood Nutrition, Physical Activity, and Body Mass Index

    PubMed Central

    Bottai, Matteo; Kull, Inger; Wickman, Magnus; Wolk, Alicja; Moradi, Tahereh

    2014-01-01

    Background. Poor nutrition, lack of physical activity, and obesity in children have important public health implications but, to date, their effects have not been studied in the growing population of children in Sweden with immigrant parents. Methods. We estimated the association between parental migration background and nutrition, physical activity, and weight in 8-year-old children born in Stockholm between 1994 and 1996 of immigrants and Swedish parents (n = 2589). Data were collected through clinical examination and questionnaires filled out by parents. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using multivariable logistic regression. Results. Children of immigrants complied more closely with Nordic Nutrition Recommendations compared with those of Swedes (OR = 1.35, 95% CI 1.11–1.64). They had higher intake of dietary fibre, vitamins C, B6, and E, folic acid, and polyunsaturated fatty acids (omega-3 and omega-6) reflecting higher consumption of foods of plant origin, but lower intake of vitamins A and D, calcium, and iron reflecting lower consumption of dairy products. Children of immigrants had higher intake of sucrose reflecting higher consumption of sugar and sweets. Furthermore, these children had a higher risk of having low physical activity (OR = 1.31, 95% CI 1.06–1.62) and being overweight (OR = 1.33, 95% CI 1.06–1.65) compared with children of Swedish parents. The odds of having low physical activity and being overweight were even higher in children whose parents were both immigrants. A low level of parental education was associated with increased risk of low physical activity regardless of immigration background. Conclusions. Culturally appropriate tools to capture the diverse range of ethnic foods and other lifestyle habits are needed. Healthcare professionals should be aware of the low levels of physical activity, increased weight, and lack of consumption of some important vitamins among children of immigrants

  16. Parent, but not teacher, weight bias correlates with nutritional risk in preschool children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Maladaptive eating behaviors have been reported among youth who report experiencing weight bias, so it is important to study whether nutritional risk and zBMI of young children correlate with weight biases held by caregivers. A previous analysis of these data showed that nutritional risk...

  17. Nutrition

    MedlinePlus

    Nutrition Health Education During the 2 years preceding the study: • The percentage of states that provided funding for staff development or offered staff development on nutrition and dietary behavior to those who teach health ...

  18. Nutrition

    MedlinePlus

    ... into your diet. These include brightly colored and dark fruits and vegetables. Balance the food you eat ... can also order your free copy of Nutrition Matters and visit our Ask about Nutrition forum. << Back ...

  19. Rural Middle School Nutrition and Physical Activity Environments and the Change in Body Mass Index during Adolescence

    ERIC Educational Resources Information Center

    Demment, Margaret; Wells, Nancy; Olson, Christine

    2015-01-01

    Background: For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from…

  20. Development and evaluation of a method for calculating the Healthy Eating Index-2005 using the Nutrition Data System for Research

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objective: To develop and evaluate a method for calculating the Healthy Eating Index-2005 (HEI-2005) with the widely used Nutrition Data System for Research (NDSR) based on the method developed for use with the US Department of Agriculture’s (USDA) Food and Nutrient Dietary Data System (FNDDS) and M...

  1. Patterns of Risk: The Nutritional Status of the Rural Poor.

    ERIC Educational Resources Information Center

    Shotland, Jeffrey; Loonin, Deanne

    Nutrition and health are underlying influences to education performance. This report is a collection and analysis of data on nutrition and the rural poor in the United States. It presents an empirical assessment of critical nutritional and social-service problems experienced by the rural poor population. The first section of the report uses data…

  2. Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region

    PubMed Central

    Musaiger, Abdulrahman O; Al-Hazzaa, Hazzaa M

    2012-01-01

    This paper reviews the current situation concerning nutrition-related noncommunicable diseases (N-NCDs) and the risk factors associated with these diseases in the Eastern Mediterranean region (EMR). A systematic literature review of studies and reports published between January 1, 1990 and September 15, 2011 was conducted using the PubMed and Google Scholar databases. Cardiovascular disease, type 2 diabetes, metabolic syndrome, obesity, cancer, and osteoporosis have become the main causes of morbidity and mortality, especially with progressive aging of the population. The estimated mortality rate due to cardiovascular disease and diabetes ranged from 179.8 to 765.2 per 100,000 population, with the highest rates in poor countries. The prevalence of metabolic syndrome was very high, ranging from 19% to 45%. The prevalence of overweight and obesity (body mass index ≥25 kg/m2) has reached an alarming level in most countries of the region, ranging from 25% to 82%, with a higher prevalence among women. The estimated mortality rate for cancer ranged from 61.9 to 151 per 100,000 population. Osteoporosis has become a critical problem, particularly among women. Several risk factors may be contributing to the high prevalence of N-NCDs in EMR, including nutrition transition, low intake of fruit and vegetables, demographic transition, urbanization, physical inactivity, hypertension, tobacco smoking, stunting of growth of preschool children, and lack of nutrition and health awareness. Intervention programs to prevent and control N-NCDs are urgently needed, with special focus on promotion of healthy eating and physical activity. PMID:22399864

  3. Association among salivary flow rate, caries risk and nutritional status in pre-schoolers.

    PubMed

    Rodríguez, Patricia N; Martínez Reinoso, Josefina; Gamba, Carlota A; Salgado, Pablo A; Mateo, María Teresa; Manto, María del Carmen; Molgatini, Susana L; Iglesias, Verónica; Argentieri, Ángela B

    2015-01-01

    Modeer T. et al.(2011) claim that there is association between decreased salivary flow rate and caries in obese adolescents. The aim of this study was to determine the association among nutritional status, salivary flow rate and caries risk in preschoolers. The study comprised 60 children aged 3 to 6 years attending kindergartens in areas immediately adjacent to Buenos Aires City, Argentina. Body weight and height of the children were determined. Body mass index was calculated and the population was classified anthropometrically according to the WHO 2007 (WHO Anthro. Program). Caries risk was determined. Saliva was collected in sterile graduated widemouth containers, without stimulation and without food restrictions. Salivary flow rate (SFR) was determined. Statistical analysis was performed using Pearson's test. It was found that 56.7% (IC95%: 37.7-74.0) of anthropometrically adequate children (Ad) and 37.0% (IC95%: 20.1-57.5) of overweight and obese children (OW/Ob) had caries. The odds ratio for caries (OR=3.78; IC95%: 1.2-11.8, p=0.02) was almost 4 times higher in adequate children than in the others. SFR was 0.534 0.318 ml/min in Ad and 0.439 } 0.234 ml/min in OW/Ob. Pearson's test showed no correlation between SFR and nutritional status (r= 0.004592, p= 0.5977). Although the presence of caries was lower in overweight and obese children, no correlation was found between nutritional status and salivary flow rate. PMID:26355891

  4. Vitamin D nutritional status and the risk for cardiovascular disease

    PubMed Central

    LIU, MIN; LI, XIANCHI; SUN, RONGRONG; ZENG, YI; CHEN, SHUANG; ZHANG, PEIYING

    2016-01-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality. CVD has a significant impact on health care systems worldwide and over 23 million individuals are expected to succumb to the disease by 2030. Early onset of atherosclerosis in childhood along with other risk factors of CVD, including elevated circulating lipids, have been shown to persist in adulthood and lead to CVD. Vitamin D deficiency is considered a risk factor for the pathogenesis of CVD, with childhood nutritional status of vitamin D being an important determinant of the development of CVD. Low levels of 25-hydroxyvitamin D can arise due to reduced intake as well as geographical location, and other diseases/conditions such as chronic kidney disease and obesity. Childhood vitamin D deficiency can progress and lead to atherosclerosis and other CVDs in adulthood. Early intervention with vitamin D supplementation is an ideal approach towards preventive therapy. However, there is no clear consensus regarding the role of vitamin D in childhood CVD. In the present study, we reviewed the available evidence in favor of and against such a role for this vitamin. PMID:27073421

  5. A Computerized Risk Index Screening Program for At-Risk Students.

    ERIC Educational Resources Information Center

    Stowitschek, Joseph J.; And Others

    This paper describes a data-based screening tool for identifying at-risk students. It is intended to complement referral and other qualitative means of identification. The Computerized Risk Index Screening Program (CRISP) is an application of a commonly available data management program that: (1) provides a school-based screening system; (2) can…

  6. Children-at-Risk for Poor Nutrition: Expanding the Approach of Future Professionals in Educational Institutions

    ERIC Educational Resources Information Center

    Shor, Ron

    2011-01-01

    Objectives: To examine how the subject of nutrition is being addressed in the work with children at risk of poor nutrition in educational institutions and what the barriers are which may hinder inclusion of this subject. Methods: A structured questionnaire was constructed for the purpose of this study and was implemented with 111 students in…

  7. Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children.

    PubMed

    Zhang, Xinyu; Zhu, Yanna; Cai, Li; Ma, Lu; Jing, Jin; Guo, Li; Jin, Yu; Ma, Yinghua; Chen, Yajun

    2016-04-01

    The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China. PMID:26944225

  8. Participation and cardiovascular risk reduction in a voluntary worksite nutrition and physical activity program

    PubMed Central

    Thorndike, Anne N.; Healey, Erica; Sonnenberg, Lillian; Regan, Susan

    2010-01-01

    Objective In a cohort of employees participating in a worksite nutrition and physical activity program, we compared program completion and changes in cardiovascular risk factors by baseline body mass index. Methods In 2007, 774 employees enrolled in a 10 week program at a hospital in Boston, MA. Program completion and change in weight, cholesterol, and blood pressure were compared between obese (BMI≥30), overweight (BMI=25–29.9), and normal weight (BMI<25) participants. Results At baseline, 63% were obese or overweight and had higher blood pressure and cholesterol compared to normal weight participants. Program completion was 82% and did not differ by BMI. Mean weight loss was 1.9 kg at end of program (p<0.001) and 0.4 kg at 1 year (p=0.002). At end of program, participants with BMI≥30 lost 3.0% body weight vs. 2.7% for BMI=25–29.9 and 1.7% for BMI<25 (p<0.001), but weight loss at 1 year did not differ by BMI. Mean cholesterol and blood pressure were lower at end of program and 1 year (p all <0.005) but did not differ by BMI. Conclusions Worksite programs can successfully initiate cardiovascular risk reduction among employees, but more intensive interventions are needed to make significant improvements in the health of higher risk obese employees. PMID:21130804

  9. Nutrition

    NASA Technical Reports Server (NTRS)

    Lane, Helen W.

    1990-01-01

    This is a collection of viewgraphs on the Johnson Space Center's work on nutrition for long duration space missions. Nutritional requirements are affected by isolation, workloads, and cold as well as the psychological needs, metabolism, and fluid balance of an individual.

  10. Variation in nutritional risk among Mexican American and non-Mexican American homebound elders who receive home-delivered meals.

    PubMed

    Sharkey, Joseph R

    2004-01-01

    Good nutritional health is essential to prevent functional decline and improve quality of life. Little is known of disparities in the extent of risk for poor nutritional health among homebound Mexican American (MA) elders who receive Older American Act Nutrition Program (OAANP) home-delivered meals. In order to assist OAANP service providers in understanding racial/ethnic differences in nutritional risk, this study examined routinely collected data on 908 homebound MA and non-MA in the Texas Lower Rio Grande Valley. Homebound MA were more likely to report poverty, risk factors for and indicators of poor nutritional health. Independent of poverty and covariates,MA were more likely to report very high nutritional risk. This underscores the importance of understanding racial/ethnic disparities in the extent of risk for poor nutritional health for the development, implementation, and evaluation of effective strategies to alleviate nutritional health disparities. PMID:15149938

  11. Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

    PubMed Central

    Sullivan, Helen W.; Beckjord, Ellen Burke; Finney Rutten, Lila J.; Hesse, Bradford W.

    2008-01-01

    This study tested whether the Risk Perception Attitude Framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey (HINTS) were analyzed to assess respondents’ reported likelihood of developing cancer (risk) and perceptions of whether they could lower their chances of getting cancer (efficacy). Respondents with higher efficacy were more likely to report that good nutrition can prevent cancer and reported more preventive dietary changes compared to respondents with lower efficacy. Respondents with higher efficacy were more likely to report intentions to change their diets to prevent cancer and reported more preventive dietary changes to their own diets, but only at higher levels of risk. Results suggest that to improve cognitions about the role of nutrition in cancer prevention, interventions should target cancer prevention efficacy; however, to increase intentions to change nutrition behaviors, interventions should target efficacy and risk perceptions. PMID:19011220

  12. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

    PubMed Central

    Øverby, Nina Cecilie; Sonestedt, Emily; Laaksonen, David E.; Birgisdottir, Bryndis Eva

    2013-01-01

    The aim of this study is to review recent data on dietary fiber (DF) and the glycemic index (GI), with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective cohort and intervention studies carried out in the Nordic countries. All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet. All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes; lower risk of cardiovascular disease, type 2 diabetes, colorectal and breast cancer. None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy populations, although association was found in sub-groups, e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes. It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions. There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall. However, there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals. Issues regarding methodology, validity and practicality of the GI remain to be clarified. PMID:23538683

  13. Effects of Playing a Serious Computer Game on Body Mass Index and Nutrition Knowledge in Women

    PubMed Central

    Hallinan, Sean; Seif El-Nasr, Magy; Subramanian, Shree; Castaneda-Sceppa, Carmen

    2016-01-01

    Background Obesity and weight gain is a critical public health concern. Serious digital games are gaining popularity in the context of health interventions. They use persuasive and fun design features to engage users in health-related behaviors in a non-game context. As a young field, research about effectiveness and acceptability of such games for weight loss is sparse. Objective The goal of this study was to evaluate real-world play patterns of SpaPlay and its impact on body mass index (BMI) and nutritional knowledge. SpaPlay is a computer game designed to help women adopt healthier dietary and exercise behaviors, developed based on Self-Determination theory and the Player Experience of Need Satisfaction (PENS) model. Progress in the game is tied to real-life activities (e.g., eating a healthy snack, taking a flight of stairs). Methods We recruited 47 women to partake in a within-subject 90-day longitudinal study, with assessments taken at baseline, 1-, 2-, and 3- months. Women were on average, 29.8 years old (±7.3), highly educated (80.9% had BA or higher), 39% non-White, baseline BMI 26.98 (±5.6), who reported at least contemplating making changes in their diet and exercise routine based on the Stages of Change Model. We computed 9 indices from game utilization data to evaluate game play. We used general linear models to examine inter-individual differences between levels of play, and multilevel models to assess temporal changes in BMI and nutritional knowledge. Results Patterns of game play were mixed. Participants who reported being in the preparation or action stages of behavior change exhibited more days of play and more play regularity compared to those who were in the contemplation stage. Additionally, women who reported playing video games 1-2 hours per session demonstrated more sparse game play. Brief activities, such as one-time actions related to physical activity or healthy food, were preferred over activities that require a longer commitment (e

  14. Body Mass Index and Risk of Rheumatoid Arthritis

    PubMed Central

    Feng, Jian; Chen, Qi; Yu, Feifei; Wang, Zhiyong; Chen, Shuqi; Jin, Zhichao; Cai, Qing; Liu, Yu; He, Jia

    2016-01-01

    Abstract Although many epidemiological studies have investigated the association between body mass index (BMI) and risk of rheumatoid (RA), the results have been inconsistent. Therefore, we performed a dose-response meta-analysis to quantify the dose-response association between BMI and RA risk. We systematically searched PubMed, Embase, and Web of Science databases and reference lists of articles for relevant studies published before August 2014 using terms related to BMI and RA. Fixed or random-effects models were used to estimate the pooled relative risk (RR) with 95% confidence interval (CI). Several subgroup analyses, sensitivity analyses, and publication bias tests were performed to explore potential study heterogeneity and bias Thirteen studies involving 400,609 participants and 13,562 RA cases were included. The RR of RA was 1.21 (95% CI: 1.02–1.44) for obesity, 1.05 (95% CI: 0.97–1.13) for overweight. The risk of RA increased by 13% (RR: 1.13; 95% CI: 1.01–1.26) for every 5 kg/m2 increase in BMI. The subgroup analyses showed a positive association between BMI and RA risk only in women with an RR of 1.26 (95% CI: 1.12–1.40) for obesity and 1.12(95% CI: 1.07–1.18) for every 5 kg/m2 increase in BMI. Also, an increased risk of RA was found in sero-negative subgroup with an RR of 1.47 (95% CI: 1.11–1.96) for obesity and 1.21 (95% CI: 1.06–1.39) for every 5 kg/m2 increase in BMI. There is evidence that obesity is a risk factor for developing of RA. Furthermore, the positive association between BMI and RA risk may be stronger among women than men. PMID:26937917

  15. Using the standardized precipitation index for flood risk monitoring

    NASA Astrophysics Data System (ADS)

    Seiler, R. A.; Hayes, M.; Bressan, L.

    2002-09-01

    Flood risk and the critical time of occurrence are difficult to monitor and detect. The availability and application of adapted indices may allow not only continuous monitoring of hydrological conditions in flood-prone areas, but also the potential threat of possible flood events in order to promote preventive actions to mitigate the impacts of the phenomenon. The standardized precipitation index (SPI) was developed for drought detection and monitoring. However, because of its characteristics, the SPI can also be used as a tool to monitor wetter-than-normal conditions. The aim of this paper, based on the recurrent floods affecting the southern Cordoba Province in Argentina, is to analyse the potential of the SPI as a tool for monitoring flood risk in that region. Results indicate that the SPI satisfactorily explains the development of conditions leading up to the three main flood events to occur in the region during the past 25 years. This fact supports the proposal for applying the SPI as an effective component of a regional system for climate risk monitoring.

  16. A toxicity risk index, an index for warning idiosyncratic drug toxicity.

    PubMed

    Morimoto, Miyoshi; Samizo, Kazuo; Ohta, Shin; Mizuma, Takashi

    2013-09-01

    Drug toxicity impedes drug development and its clinical use. In the present study, a toxicity risk index (TRI), which is an index for warning idiosyncratic drug toxicity (IDT), was proposed. The TRI of drugs was defined as a function of dose, pharmacokinetic parameters, and toxicokinetic data from covalent binding experiment. Twenty drugs, which were classified into three categories by a report (Nakayama S, Atsumi R, Takakusa H, Kobayashi Y, Kurihara A, Nagai Y, Nakai D, Okazaki O. 2009. Drug Metab Dispos 37:1970-1977), were studied with TRI. The three categories were BBW (drugs with a block box warning for IDT), WNG (drugs without a black box warning but with a warning for IDT), and SAFE (drugs without any warning). The TRIs of drugs classified as SAFE were distinctly different from those classified as BBW. The TRI of the SAFE drugs were lower than 0.456 (nmol/mg protein). In contrast, the TRI of the BBW drugs were higher than 1.10 (nmol/mg protein). These results warned us that a drug candidate, where the TRI is higher than 1.0 nmol/mg protein, should be categorized as a BBW drug. Further study with more data of TRI will give a cutoff value with a statistical meaning. Thus, TRI may be useful for decision making in drug development and its clinical use. PMID:23666879

  17. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    PubMed

    Polzer, Stanislav; Gasser, T Christian

    2015-12-01

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. PMID:26631334

  18. Nutrition

    MedlinePlus

    ... you would like to see a registered dietitian nutritionist for nutritional guidance when you have lung cancer. ... seek out the expertise of a registered dietitian nutritionist (RDN) who works with lung cancer patients. This ...

  19. Nutrition in the adolescent.

    PubMed

    Wahl, R

    1999-02-01

    This article reviews the nutritional requirements of puberty and the clinical assessment of nutritional status, and discusses the nutritional risks imposed by vegetarian diets, pregnancy, and athletic involvement. Energy (calories) and protein are essential in pubertal development. Adolescent females require approximately 2200 calories/day, whereas male adolescents require 2500-3000 calories/day. Additional intake requirements include fat, calcium, iron, zinc, vitamins, and fiber. The clinical assessment of nutritional status begins with obtaining a good diet history of the patient and this could be offered by the body mass index. Nutritional deficiencies and poor eating habits established during adolescence can have long-term consequences, including delayed sexual maturation, loss of final adult height, osteoporosis, hyperlipidemia, and obesity. As for vegetarian adolescents, nutritional risks include lack of iodine, vitamin B12, vitamin D, and some essential fatty acids. In addition, substances in some grains reduce gut absorption, thus increasing mineral deficiencies. Pregnancy may also be a risk factor for poor nutrition during adolescence. A pregnant adolescent has different nutritional needs because she is still growing. Among adolescent athletes many are turning to nutritional supplements in an attempt to improve athletic performance. A balanced, varied diet provides adequate calories and nutrition to meet the needs of most adolescents. They also have greater water needs than do adult athletes. Details on adolescent health concerns are further discussed in this article. PMID:10036686

  20. Body mass index, physical activity, and risk of multiple myeloma

    PubMed Central

    Birmann, Brenda M.; Giovannucci, Edward; Rosner, Bernard; Anderson, Kenneth C.; Colditz, Graham A.

    2013-01-01

    Several studies have reported a positive relation of baseline body mass index (BMI) with multiple myeloma, but data on other correlates of energy balance are limited. We undertook the present analyses to further examine the role of energy balance in multiple myeloma etiology in two large prospective cohorts with biennially updated exposure data. We followed members of the Nurses’ Health Study and Health Professionals Follow-up Study cohorts from baseline until multiple myeloma diagnosis, death, or 2002. Adult height and current weight were reported at enrollment, and weight every 2 years thereafter. Physical activity was queried at baseline and updated every 2-4 years. We computed age-adjusted relative risks (RR) of multiple myeloma for categories of BMI and physical activity using Cox proportional hazards regression. We conducted analyses on each cohort separately and on both cohorts combined. We confirmed 215 incident cases of multiple myeloma in the combined cohort of 136,623 individuals (>2.1 million person-years at risk). BMI was positively associated with multiple myeloma in all analyses. The association was strongest in men with BMI ≥30 kg/m2 (v. BMI <22.0 kg/m2; RR=2.4, 95% confidence interval (CI)=1.0-6.0) and modest in overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥30 kg/m2) women (v. BMI <22.0 kg/m2; RR (95% CI)=1.6 (1.0-2.7) and 1.2 (0.7-2.2), respectively). Physical activity was not significantly related to multiple myeloma risk, although an inverse association was suggested in women. In conclusion, obesity appears to have an etiologic role in multiple myeloma, but the role of other correlates of energy balance remains uncertain. PMID:17627013

  1. A Risk Index for Living Donor Kidney Transplantation.

    PubMed

    Massie, A B; Leanza, J; Fahmy, L M; Chow, E K H; Desai, N M; Luo, X; King, E A; Bowring, M G; Segev, D L

    2016-07-01

    Choosing between multiple living kidney donors, or evaluating offers in kidney paired donation, can be challenging because no metric currently exists for living donor quality. Furthermore, some deceased donor (DD) kidneys can result in better outcomes than some living donor kidneys, yet there is no way to compare them on the same scale. To better inform clinical decision-making, we created a living kidney donor profile index (LKDPI) on the same scale as the DD KDPI, using Cox regression and adjusting for recipient characteristics. Donor age over 50 (hazard ratio [HR] per 10 years = 1.15 1.241.33 ), elevated BMI (HR per 10 units = 1.01 1.091.16 ), African-American race (HR = 1.15 1.251.37 ), cigarette use (HR = 1.09 1.161.23 ), as well as ABO incompatibility (HR = 1.03 1.271.58 ), HLA B (HR = 1.03 1.081.14 ) mismatches, and DR (HR = 1.04 1.091.15 ) mismatches were associated with greater risk of graft loss after living donor transplantation (all p < 0.05). Median (interquartile range) LKDPI score was 13 (1-27); 24.2% of donors had LKDPI < 0 (less risk than any DD kidney), and 4.4% of donors had LKDPI > 50 (more risk than the median DD kidney). The LKDPI is a useful tool for comparing living donor kidneys to each other and to deceased donor kidneys. PMID:26752290

  2. Nontraditional risk factors for cardiovascular disease and visceral adiposity index among different body size phenotypes

    PubMed Central

    Du, T; Zhang, J; Yuan, G; Zhang, M; Zhou, X; Liu, Z; Sun, X; Yu, X

    2014-01-01

    Background and Aims Increased cardiovascular disease and mortality risk in metabolically healthy obese (MHO) individuals remain highly controversial. Several studies suggested risk while others do not. The traditional cardiovascular risk factors may be insufficient to demonstrate the complete range of metabolic abnormalities in MHO individuals. Hence, we aimed to compare the prevalence of elevated lipoprotein (a), apolipoprotein B, and uric acid (UA) levels, apolipoprotein B/apolipoprotein A1 ratio, and visceral adiposity index (VAI) scores, and low apolipoprotein A1 levels among 6 body size phenotypes (normal weight with and without metabolic abnormalities, overweight with and without metabolic abnormalities, and obese with or without metabolic abnormalities). Methods and Results We conducted a cross-sectional analysis of 7765 Chinese adults using data from the nationwide China Health and Nutrition Survey 2009. MHO persons had intermediate prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low apolipoprotein A1 levels between metabolically healthy normal-weight (MHNW) and metabolically abnormal obese individuals (P < 0.001 for all comparisons). Elevated apolipoprotein B and UA concentrations, apolipoprotein B/apolipoprotein A1 ratio, and VAI scores were all strongly associated with the MHO phenotype (all P < 0.01). Conclusions Prevalence of elevated apolipoprotein B and UA levels, apolipoprotein B/apolipoprotein A1 ratio and VAI scores, and low levels of apolipoprotein A1 was higher among MHO persons than among MHNW individuals. The elevated levels of the nontraditional risk factors and VAI scores in MHO persons could contribute to the increased cardiovascular disease risk observed in long-term studies. PMID:25159728

  3. TOTAL LYMPHOCYTE COUNT AND SERUM ALBUMIN AS PREDICTORS OF NUTRITIONAL RISK IN SURGICAL PATIENTS

    PubMed Central

    ROCHA, Naruna Pereira; FORTES, Renata Costa

    2015-01-01

    Background: Early detection of changes in nutritional status is important for a better approach to the surgical patient. There are several nutritional measures in clinical practice, but there is not a complete method for determining the nutritional status, so, health professionals should only choose the best method to use. Aim: To evaluate the total lymphocyte count and albumin as predictors of identification of nutritional risk in surgical patients. Methods: Prospective longitudinal study was conducted with 69 patients undergoing surgery of the gastrointestinal tract. The assessment of nutritional status was evaluated by objective methods (anthropometry and biochemical tests) and subjective methods (subjective global assessment). Results: All parameters used in the nutritional assessment detected a high prevalence of malnutrition, with the exception of BMI which detected only 7.2% (n=5). The albumin (p=0.01), the total lymphocytes count (p=0.02), the percentage of adequacy of skinfolds (p<0.002) and the subjective global assessment (p<0.001) proved to be useful as predictors of risk of postoperative complications, since the smaller the values of albumin and lymphocyte count and higher the score the subjective global assessment were higher risks of surgical complications. Conclusions: A high prevalence of malnutrition was found, except for BMI. The use of albumin and total lymphocyte count were good predictor for the risk of postoperative complications and when used with other methods of assessing the nutritional status, such as the subjective global assessment and the percentage of adequacy of skinfolds, can be useful for identification of nutritional risk and postoperative complications. PMID:26537145

  4. Body mass index, height and risk of lymphoid neoplasms in a large United States cohort.

    PubMed

    Patel, Alpa V; Diver, W Ryan; Teras, Lauren R; Birmann, Brenda M; Gapstur, Susan M

    2013-06-01

    Results from epidemiologic studies examining associations between body size and risk of non-Hodgkin lymphoma (NHL) are inconsistent, and etiology may vary by histologic subtype of disease. Using Cox proportional hazards regression, multivariable relative risks (RRs) and 95% confidence intervals (CIs) were computed for associations of body mass index (BMI) and height with NHL in the prospective American Cancer Society Cancer Prevention Study-II Nutrition Cohort. From 1992 to 2007, 2074 incident cases of NHL were identified among 152 423 men and women. Obese individuals (BMI ≥ 30 kg/m(2)) had 23% higher incidence of NHL (95% CI 1.08-1.40) compared to those with normal weight (BMI 18.5-< 25 kg/m(2)). Height was positively associated with NHL (RR = 1.25, 95% CI 1.10-1.43, sex-specific quintile 5 vs. 1). BMI associations were strongest for diffuse large B-cell lymphoma. Height was most strongly associated with chronic lymphocytic leukemia/small lymphocytic lymphoma and to a lesser extent with multiple myeloma. These findings provide further evidence that body size may play a role in the etiology of NHL, which is of public health importance given the rapid rise in obesity worldwide. PMID:23098244

  5. Association between the Family Nutrition and Physical Activity screening tool and cardiovascular disease risk factors in 10-year old children

    NASA Astrophysics Data System (ADS)

    Yee, Kimbo Edward

    Purpose. To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool, a behaviorally based screening tool designed to assess the obesogenic family environment and behaviors, with cardiovascular disease (CVD) risk factors in 10-year old children. Methods. One hundred nineteen children were assessed for body mass index (BMI), percent body fat (%BF), waist circumference (WC), total cholesterol, HDL-cholesterol, and resting blood pressure. A continuous CVD risk score was created using total cholesterol to HDL-cholesterol ratio (TC:HDL), mean arterial pressure (MAP), and WC. The FNPA survey was completed by parents. The associations between the FNPA score and individual CVD risk factors and the continuous CVD risk score were examined using correlation analyses. Results. Approximately 35% of the sample were overweight (19%) or obese (16%). The mean FNPA score was 24.6 +/- 2.5 (range 18 to 29). Significant correlations were found between the FNPA score and WC (r = -.35, p<.01), BMI percentile (r = -.38, p<.01), %BF (r = -.43, p<.01), and the continuous CVD risk score (r = -.22, p = .02). No significant association was found between the FNPA score and TC:HDL (r=0.10, p=0.88) or MAP (r=-0.12, p=0.20). Conclusion. Children from a high-risk, obesogenic family environment as indicated with a lower FNPA score have a higher CVD risk factor profile than children from a low-risk family environment.

  6. A theory-based newsletter nutrition education program reduces nutritional risk and improves dietary intake for congregate meal participants.

    PubMed

    Francis, Sarah L; MacNab, Lindsay; Shelley, Mack

    2014-01-01

    At-risk older adults need community-based nutrition programs that improve nutritional status and practices. This 6-month study assessed the impact of the traditional Chef Charles (CC) program (Control) compared to a theory-based CC program (Treatment) on nutritional risk (NR), dietary intakes, self-efficacy (SE), food security (FS), and program satisfaction for congregate meal participants. Participants were mostly educated, single, "food secure" White females. NR change for the treatment group was significantly higher (P = 0.042) than the control group. No differences were noted for SE or FS change and program satisfaction between groups. The overall distribution classification levels of FS changed significantly (P < .001) from pre to post. Over half (n = 46, 76.7%) reported making dietary changes and the majority (n = 52, 86.7%) rated CC as good to excellent. Results suggest the theory-based CC program (treatment) is more effective in reducing NR and dietary practices than the traditional CC program (control). PMID:24827061

  7. Prenatal nutrition, epigenetics and schizophrenia risk: can we test causal effects?

    PubMed Central

    Kirkbride, James B; Susser, Ezra; Kundakovic, Marija; Kresovich, Jacob K; Smith, George Davey; Relton, Caroline L

    2014-01-01

    We posit that maternal prenatal nutrition can influence offspring schizophrenia risk via epigenetic effects. In this article, we consider evidence that prenatal nutrition is linked to epigenetic outcomes in offspring and schizophrenia in offspring, and that schizophrenia is associated with epigenetic changes. We focus upon one-carbon metabolism as a mediator of the pathway between perturbed prenatal nutrition and the subsequent risk of schizophrenia. Although post-mortem human studies demonstrate DNA methylation changes in brains of people with schizophrenia, such studies cannot establish causality. We suggest a testable hypothesis that utilizes a novel two-step Mendelian randomization approach, to test the component parts of the proposed causal pathway leading from prenatal nutritional exposure to schizophrenia. Applied here to a specific example, such an approach is applicable for wider use to strengthen causal inference of the mediating role of epigenetic factors linking exposures to health outcomes in population-based studies. PMID:22690666

  8. Nutrition-Related Cancer Prevention Cognitions and Behavioral Intentions: Testing the Risk Perception Attitude Framework

    ERIC Educational Resources Information Center

    Sullivan, Helen W.; Beckjord, Ellen Burke; Finney Rutten, Lila J.; Hesse, Bradford W.

    2008-01-01

    This study tested whether the risk perception attitude framework predicted nutrition-related cancer prevention cognitions and behavioral intentions. Data from the 2003 Health Information National Trends Survey were analyzed to assess respondents' reported likelihood of developing cancer (risk) and perceptions of whether they could lower their…

  9. Nutrition.

    ERIC Educational Resources Information Center

    Saur, Susan

    An elementary level nutrition unit provides teachers with student background information, suggested activities, and student worksheets. Part 1 focuses on the relationship of food to growth, health, and energy. In part 2, students learn about the four main food groups. Part 3 deals with nutrients and provides information about carbohydrates, fats,…

  10. Clinical Significance of the Prognostic Nutritional Index for Predicting Short- and Long-Term Surgical Outcomes After Gastrectomy: A Retrospective Analysis of 7781 Gastric Cancer Patients.

    PubMed

    Lee, Jee Youn; Kim, Hyoung-Il; Kim, You-Na; Hong, Jung Hwa; Alshomimi, Saeed; An, Ji Yeong; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong-Bai

    2016-05-01

    To evaluate the predictive and prognostic significance of the prognostic nutritional index (PNI) in a large cohort of gastric cancer patients who underwent gastrectomy.Assessing a patient's immune and nutritional status, PNI has been reported as a predictive marker for surgical outcomes in various types of cancer.We retrospectively reviewed data from a prospectively maintained database of 7781 gastric cancer patients who underwent gastrectomy from January 2001 to December 2010 at a single center. From this data, we analyzed clinicopathologic characteristics, PNI, and short- and long-term surgical outcomes for each patient. We used the PNI value for the 10th percentile (46.70) of the study cohort as a cut-off for dividing patients into low and high PNI groups.Regarding short-term outcomes, multivariate analysis showed a low PNI (odds ratio [OR] = 1.505, 95% CI = 1.212-1.869, P <0.001), old age, male sex, high body mass index, medical comorbidity, total gastrectomy, and combined resection to be independent predictors of postoperative complications. Among these, only low PNI (OR = 4.279, 95% CI = 1.760-10.404, P = 0.001) and medical comorbidity were independent predictors of postoperative mortality. For long-term outcomes, low PNI was a poor prognostic factor for overall survival, but not recurrence (overall survival: hazard ratio [HR] = 1.383, 95% CI = 1.221-1.568, P < 0.001; recurrence-free survival: HR = 1.142, 95% CI = 0.985-1.325, P = 0.078).PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. Although PNI was an independent prognostic factor for overall survival, the index was not associated with cancer recurrence. PMID:27149460

  11. [Effectiveness of body mass index in the nutritional diagnosis of pregnant women].

    PubMed

    Rached-Paoli, Ingrid; Henriquez-Pérez, Gladys; Azuaje-Sánchez, Arelis

    2005-03-01

    Our goal was to analyze the concordances and non-concordances of the nutritional classification in pregnant women and to evaluate their effectiveness when different BMI classification methodologies were applied. The study consisted of 314 adult healthy pregnant women in their first trimester, of socioeconomic status IV. In all of them, two nutritional classification criteria were applied: the integral nutritional diagnosis (IND) and different BMI reference values (Institute of Medicine, FAO/OMS, Frisancho, Bray, and Atalah). Kappa, concordance and nonconcordance, sensitivity, specificity, positive and negative predictive values were calculated. The highest frequency of concordance between IND and the analyzed classification criteria in comparing four and three nutritional categories was Frisancho's with the following results 89.2%, Kappa = 0.81 in the first case, and 91.4, Kappa = 0.84 in the second case. In deficit, the Bray and Atalah classification criteria were the highest sensitivities. In excess, FAO/ OMS, Frisancho, and Bray had a high sensitivity (1 - 0.99). Frisancho, in addition, had a high specificity with respect to FAO/OMS and Bray. Frisancho's classification criteria are the best choice for diagnosing adult pregnant women's nutritional status during the first trimester within population groups with these characteristics. PMID:16187677

  12. Low Prognostic Nutritional Index (PNI) Predicts Unfavorable Distant Metastasis-Free Survival in Nasopharyngeal Carcinoma: A Propensity Score-Matched Analysis

    PubMed Central

    Hong, Shaodong; Chen, Haiyang; Liang, Shaobo; Peng, Peijian; Chen, Yong

    2016-01-01

    Background Poor nutritional status is associated with progression and advanced disease in patients with cancer. The prognostic nutritional index (PNI) may represent a simple method of assessing host immunonutritional status. This study was designed to investigate the prognostic value of the PNI for distant metastasis-free survival (DMFS) in patients with nasopharyngeal carcinoma (NPC). Methods A training cohort of 1,168 patients with non-metastatic NPC from two institutions was retrospectively analyzed. The optimal PNI cutoff value for DMFS was identified using the online tool “Cutoff Finder”. DMFS was analyzed using stratified and adjusted analysis. Propensity score-matched analysis was performed to balance baseline characteristics between the high and low PNI groups. Subsequently, the prognostic value of the PNI for DMFS was validated in an external validation cohort of 756 patients with NPC. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of different prognostic scores. Results The optimal PNI cutoff value was determined to be 51. Low PNI was significantly associated with poorer DMFS than high PNI in univariate analysis (P<0.001) as well as multivariate analysis (P<0.001) before propensity score matching. In subgroup analyses, PNI could also stratify different risks of distant metastases. Propensity score-matched analyses confirmed the prognostic value of PNI, excluding other interpretations and selection bias. In the external validation cohort, patients with high PNI also had significantly lower risk of distant metastases than those with low PNI (Hazards Ratios, 0.487; P<0.001). The PNI consistently showed a higher AUC value at 1-year (0.780), 3-year (0.793) and 5-year (0.812) in comparison with other prognostic scores. Conclusion PNI, an inexpensive and easily assessable inflammatory index, could aid clinicians in developing individualized treatment and follow-up strategies for patients

  13. Premorbid body mass index and risk of amyotrophic lateral sclerosis.

    PubMed

    O'Reilly, Éilis J; Wang, Hao; Weisskopf, Marc G; Fitzgerald, Kathryn C; Falcone, Guido; McCullough, Marjorie L; Thun, Michael; Park, Yikyung; Kolonel, Laurence N; Ascherio, Alberto

    2013-04-01

    Our objective was to determine if amyotrophic lateral sclerosis (ALS) risk varies according to body mass index (BMI) captured up to three decades earlier. At baseline 537,968 females and 562,942 males in five ongoing cohorts reported height, current weight and weight at age 18/21 years. During 14-28 years of follow-up, 1153 participants developed ALS. Cohort-specific Cox proportional hazards models were used to estimate rates that were then pooled with random-effects models. Results showed that lower BMI at baseline was associated with ALS; for each 5-unit increase in BMI, ALS rates were 21% lower (95% CI 14% 27%). Compared to individuals with healthy BMI, ALS rates were significantly lower among the overweight (RR = 0.76 (95% CI 0.62-0.93)) and obese (RR = 0.73 (95% CI 0.55-0.96)). Among never smokers the association persisted: RR = 0.75 (95% CI 0.65-0.85) for each 5-unit increase. Excluding the first seven years of follow-up, the associations were materially unchanged suggesting that weight loss from undiagnosed disease does not fully explain the findings. Overall, 75% of males and females had a healthy BMI at age 18/21 years, 15% of males and 8% of females were overweight or obese; there was no association with ALS although numbers with an unhealthy weight were small. In conclusion, these findings support an association between lower premorbid BMI and ALS. PMID:23134505

  14. Obesity risk in urban adolescent girls: nutritional intentions and health behavior correlates.

    PubMed

    Groth, Susan W; Morrison-Beedy, Dianne

    2011-01-01

    Obesity is an expanding epidemic and minority adolescent girls are at high risk. One way to tailor interventions for obesity prevention is to target intention to engage in particular behaviors. Data collected from adolescent girls' intentions and behaviors regarding nutrition, physical activity, and sleep patterns were used to examine nutritional intentions in relation to healthy behaviors. Adolescent girls reported behaviors that increased their risks for obesity. Nutritional intentions were significantly associated with physical activity and sleep. These results suggest that healthy behaviors tend to occur in clusters, possibly extending the theory of planned behavior beyond individual behaviors to groups of related behaviors. Nurses can intervene with high-risk adolescent girls by promoting healthy diets, recommended levels of physical activity, and adequate sleep. PMID:22187861

  15. Anthropometry of Arm: Nutritional Risk Indicator in Amyotrophic Lateral Sclerosis.

    PubMed

    Salvioni, Cristina Cleide Dos Santos; Stanich, Patricia; Oliveira, Acary Souza Bulle; Orsini, Marco

    2015-12-29

    The aim of the paper is to examine the correlation between clinical data, nutritional, respiratory and functional parameters in amyotrophic lateral sclerosis (ALS). This is a descriptive study of 111 ALS patients [91 spinal onset (GS) and 20 bulbar onset (GB)] carried on using nutritional and respiratory parameters and amyotrophic lateral sclerosis functional rating scale (ALSFRS). ALSFRS was analyzed in the main domains (D1, D2 and D3). Forced vital capacity and anthropometric measurements, there was significant association for GS and GB, and in GS there was positive correlation with midarm circumference (MAC) (r=0.30; P=0.020), midarm muscle circumference (r=0.29; P=0.026), arm muscle area (r=0.28; P=0.033) and protein-caloric malnutrition score (r=0.27; P=0.039), while for GB only with body weight (r=0.64; P=0.024). On correlation of nutritional parameters and ALSFRS for GS patients we observed that MAC and %MAC presented positive association with both issues of D1 and D2. For GB, the total score in addition to correlate positively with anthropometric parameters related to lean body mass also presented negative association with a parameter associated with body fat. In summary, it is suggested that the application of anthropometry of arm could be useful in routine monitoring of ALS patients. PMID:26788263

  16. Anthropometry of Arm: Nutritional Risk Indicator in Amyotrophic Lateral Sclerosis

    PubMed Central

    Stanich, Patricia; Oliveira, Acary Souza Bulle; Orsini, Marco

    2015-01-01

    The aim of the paper is to examine the correlation between clinical data, nutritional, respiratory and functional parameters in amyotrophic lateral sclerosis (ALS). This is a descriptive study of 111 ALS patients [91 spinal onset (GS) and 20 bulbar onset (GB)] carried on using nutritional and respiratory parameters and amyotrophic lateral sclerosis functional rating scale (ALSFRS). ALSFRS was analyzed in the main domains (D1, D2 and D3). Forced vital capacity and anthropometric measurements, there was significant association for GS and GB, and in GS there was positive correlation with midarm circumference (MAC) (r=0.30; P=0.020), midarm muscle circumference (r=0.29; P=0.026), arm muscle area (r=0.28; P=0.033) and protein-caloric malnutrition score (r=0.27; P=0.039), while for GB only with body weight (r=0.64; P=0.024). On correlation of nutritional parameters and ALSFRS for GS patients we observed that MAC and %MAC presented positive association with both issues of D1 and D2. For GB, the total score in addition to correlate positively with anthropometric parameters related to lean body mass also presented negative association with a parameter associated with body fat. In summary, it is suggested that the application of anthropometry of arm could be useful in routine monitoring of ALS patients. PMID:26788263

  17. Analysis of risk factors for pharyngocutaneous fistula after total laryngectomy with particular focus on nutritional status.

    PubMed

    Mattioli, F; Bettini, M; Molteni, G; Piccinini, A; Valoriani, F; Gabriele, S; Presutti, L

    2015-10-01

    Pharyngocutaneous fistula (PCF) is the most common complication following total laryngectomy and the most difficult to manage. It often causes increased morbidity, delays starting adjuvant therapy, prolongs hospitalisation, increases treatment costs and reduces the quality of life (QoL). The objective of this study is to analyse the predisposing factors and the most important nutritional parameters related to the development of PCF in patients undergoing total laryngectomy and to suggest medical alternatives that might improve results. We performed a retrospective study of 69 patients who underwent either primary or salvage total laryngectomy in our department between January 2008 and January 2012. Risk factors for fistula formation were analysed including tumour characteristics (histology, grading, AJCC stage), treatment (primary or salvage surgery, extent of resection, flap reconstruction, preoperative radiotherapy), comorbidity and nutritional status (preoperative haemoglobin, albumin and prealbumin levels and their changes during hospitalisation). Twenty-four patients developed a PCF (overall incidence 34.8%). Fistula formation was significantly higher in patients with diabetes, preoperative malnutrition (identified from low preoperative albumin and prealbumin levels). After specific nutritional evaluation and support, no patient developed a PCF. Risk factors for PCF formation are extensively treated in the literature but identification of high-risk patients is still controversial. Our study demonstrates that nutritional status of the patient, assessed by preoperative albumin, is also an important risk factor for PCF formation in addition to classical factors. Maintenance of a normal perioperative nutritional status can be helpful to avoid this complication. PMID:26824210

  18. Use of the Dietary Guideline Index to assess cardiometabolic risk in adolescents.

    PubMed

    Chan She Ping-Delfos, Wendy L; Beilin, Lawrence J; Oddy, Wendy H; Burrows, Sally; Mori, Trevor A

    2015-06-14

    The long-term adherence to the dietary guidelines has not been evaluated against emergence of cardiometabolic risks in adolescents with increasing rates of obesity. The present study aimed to (1) determine the level of adherence to the guidelines using the Australian Dietary Guideline Index for Children and Adolescents (DGI-CA) in adolescents of age 14 and 17 years and to (2) examine the relationship between their assessed diet quality and concurrently measured cardiometabolic risk factors over time. Data were analysed from the Western Australian Pregnancy Cohort (Raine) Study. The DGI-CA was determined from a FFQ. Anthropometry and fasting biochemical measures were taken using standard procedures. Hierarchical linear mixed models examined associations between cardiometabolic risk factors and DGI-CA, adjusting for socio-economic status, physical activity, BMI, and sex, and examining for interactions. The mean DGI-CA scores were 47·1 (SD 10·2) at 14 years (n 1419) and 47·7 (SD 11·0) at 17 years (n 843), and were not different between sex. There was a significant inverse association between DGI-CA and insulin, homeostasis model assessment score and heart rate. The DGI-CA was positively associated with BMI (P= 0·029) but negatively with waist:hip ratio (P= 0·026). It was not associated with lipids or blood pressure, with the exception of a negative association with TAG (P= 0·011). The degree of adherence in the Raine Study adolescents was suboptimal but similar to the Australian Children's Nutrition and Physical Activity Survey. The present study shows that, at any particular time, better diet quality was associated with better insulin sensitivity and TAG levels and decreased abdominal fatness. PMID:25873301

  19. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Objective Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15–4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk. PMID:25250626

  20. Role of the nutrition professional in high-risk obstetrics inpatient teams.

    PubMed

    Gurau, Julia; Cronk, Aleris; Pelliccia, Maria; Vandenbussche, Katherine

    2013-01-01

    Beyond the management of gestational diabetes and weight control, limited literature exists on nutritional management in high-risk pregnancies. This study is a starting point for understanding the role of the registered dietitian (RD) in high-risk obstetrics (HRO) inpatient teams. Demographic information was gathered on Ontario HRO inpatient units and patient characteristics, and the RD's role in this setting was explored. Representatives from all six HRO units in Ontario completed a questionnaire. Five of the HRO units had an RD on the team. The RDs stated that their primary role in the unit involved providing nutrition education and support, screening patients for nutritional risk, and writing vitamin and mineral orders. This was the first study in which RDs' role in HRO inpatient units was examined. Existing literature supports the role of good nutrition in preventing and treating the conditions seen in HRO units; however, RDs' specific role remains unclear. Future studies are needed to analyze the effect of nutrition on these HRO conditions, and to support the development of best practice guidelines. PMID:23750979

  1. State of the art in benefit-risk analysis: food and nutrition.

    PubMed

    Tijhuis, M J; de Jong, N; Pohjola, M V; Gunnlaugsdóttir, H; Hendriksen, M; Hoekstra, J; Holm, F; Kalogeras, N; Leino, O; van Leeuwen, F X R; Luteijn, J M; Magnússon, S H; Odekerken, G; Rompelberg, C; Tuomisto, J T; Ueland, Ø; White, B C; Verhagen, H

    2012-01-01

    Benefit-risk assessment in food and nutrition is relatively new. It weighs the beneficial and adverse effects that a food (component) may have, in order to facilitate more informed management decisions regarding public health issues. It is rooted in the recognition that good food and nutrition can improve health and that some risk may be acceptable if benefit is expected to outweigh it. This paper presents an overview of current concepts and practices in benefit-risk analysis for food and nutrition. It aims to facilitate scientists and policy makers in performing, interpreting and evaluating benefit-risk assessments. Historically, the assessments of risks and benefits have been separate processes. Risk assessment is mainly addressed by toxicology, as demanded by regulation. It traditionally assumes that a maximum safe dose can be determined from experimental studies (usually in animals) and that applying appropriate uncertainty factors then defines the 'safe' intake for human populations. There is a minor role for other research traditions in risk assessment, such as epidemiology, which quantifies associations between determinants and health effects in humans. These effects can be both adverse and beneficial. Benefit assessment is newly developing in regulatory terms, but has been the subject of research for a long time within nutrition and epidemiology. The exact scope is yet to be defined. Reductions in risk can be termed benefits, but also states rising above 'the average health' are explored as benefits. In nutrition, current interest is in 'optimal' intake; from a population perspective, but also from a more individualised perspective. In current approaches to combine benefit and risk assessment, benefit assessment mirrors the traditional risk assessment paradigm of hazard identification, hazard characterization, exposure assessment and risk characterization. Benefit-risk comparison can be qualitative and quantitative. In a quantitative comparison, benefits

  2. Heated apple juice supplemented with onion has greatly improved nutritional quality and browning index.

    PubMed

    Lee, Bonggi; Seo, Jeong Dae; Rhee, Jin-Kyu; Kim, Choon Young

    2016-06-15

    Although fruit juices are very popular, enzymatic browning occurs easily. Browning of fruit juice deteriorates nutrition value and product quality due to oxidation of polyphenol compounds. Therefore, development of natural food additives that reduce browning will be beneficial for improving quality of fruit juices. Onion has been reported to be a potent natural anti-browning agent. Here, we compared unheated and heated apple juices pre-supplemented with onion with respect to browning and nutritional quality. The unheated apple juice supplemented with onion showed reduced browning as well as increased total soluble solid, total phenol concentration, radical scavenging activities, and ferric reducing and copper chelating activities without any change in flavonoid concentration. On the other hand, heated juice supplemented with onion not only showed improved values for these parameters but also markedly increased flavonoid concentration. Thus, we conclude that application of heating and onion addition together may greatly improve quality of apple juice. PMID:26868582

  3. Nutrition and risk of dementia: overview and methodological issues.

    PubMed

    Morris, Martha Clare

    2016-03-01

    After two decades of research on nutrition and dementia there is strong evidence for preventive effects of vitamin E, B vitamins, and n-3 fatty acids and deleterious effects of saturated fat on dementia. Among specific foods with evidence of neuroprotection are green leafy vegetables, other vegetables, berries, and seafood. A number of studies have examined dietary patterns, particularly the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension), neither of which is tailored to the specific foods and nutrients that have been identified as neuroprotective. A new diet called MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) incorporates many elements of the Mediterranean diet and DASH but with modifications that reflect current evidence for brain neuroprotection. The evidence in support of the relation of various nutrients and the Mediterranean diet to dementia has been inconsistent. The inconsistencies may be explained by inattention to nutrient/food intake levels in the interpretation of study findings and trial design, including a shifting metric among studies for scoring adherence to the Mediterranean diet. Future studies should pay particular attention to levels of intake in the design and analyses of nutritional studies. PMID:27116239

  4. Weight-for-age as an index of risk of death in children.

    PubMed

    Kielmann, A A; McCord, C

    1978-06-10

    Between April, 1968, and May, 1973, the Department of International Health of Johns Hopkins University studied the effects of the interaction of nutrition and infection in fourteen villages of Punjab, North India. Serial anthropometric measurements (used as index of nutritional status) and vital statistics of almost 3000 children aged 1-36 months showed that, on average, child mortality doubled with each 10% decline below 80% of the Harvard weight median. The relation between season and mortality showed that mortality-rates were highest just before and during the main (wheat) harvest, reflecting the effects of food scarcity, relative child neglect, and climate on child deaths among those already underweight. PMID:78007

  5. Nutritional approaches in the risk reduction and management of Alzheimer's disease.

    PubMed

    Mi, Weiqian; van Wijk, Nick; Cansev, Mehmet; Sijben, John W C; Kamphuis, Patrick J G H

    2013-09-01

    Alzheimer's disease (AD) is a heterogeneous and devastating neurodegenerative disease with increasing socioeconomic burden for society. In the past 30 y, notwithstanding advances in the understanding of the pathogenesis of the disease and consequent development of therapeutic approaches to novel pathogenic targets, no cure has so far emerged. This contribution focuses on recent nutritional approaches in the risk reduction and management of AD with emphasis on factors providing a rationale for nutritional approaches in AD, including compromised nutritional status, altered nutrient uptake and metabolism, and nutrient requirements for synapse formation. Collectively these factors are believed to result in specific nutritional requirement in AD. The chapter also emphasizes investigated nutritional interventions in patients with AD, including studies with single nutrients and with the specific nutrient combination Fortasyn Connect and discusses the current shift of paradigm to intervene in earlier stages of AD, which offers opportunities for investigating nutritional strategies to reduce the risk for disease progression. Fortasyn Connect was designed to enhance synapse formation and function in AD by addressing the putative specific nutritional requirements and contains docosahexaenoic acid, eicosapentaenoic acid, uridine-5'-mono-phosphate, choline, phospholipids, antioxidants, and B vitamins. Two randomized controlled trials (RCTs) with the medical food Souvenaid, containing Fortasyn Connect, showed that this intervention improved memory performance in mild, drug-naïve patients with AD. Electroencephalography outcome in one of these clinical studies suggests that Souvenaid has an effect on brain functional connectivity, which is a derivative of changed synaptic activity. Thus, these studies suggest that nutritional requirements in AD can be successfully addressed and result in improvements in behavioral and neuro-physiological alterations that are characteristic to AD

  6. Rationale and Development of a Security Assurance Index with Application toward the Development of a World Risk Index

    SciTech Connect

    M. M. Plum; G. A. Beitel, PhD

    2006-06-01

    Assurance categories were previously developed to support the Department of Homeland Security’s efforts in the mitigation of Cyber Control System events. Defined according to the risk of life and economic loss, the minimum range is designated by policy, whereas the maximum limit seems to be constrained only by limits and interdependencies of the event. Use of this life / assets scale has proven to be helpful in managing risk due to the scale's ease of use, communication, and understanding. Suggestions have been made that this scale could be applied to all events of terror, disaster, and calamity of an international scale, with equally good results. This paper presents the history of some existing scales of disaster and assurance, the rationale behind the development of the original Security Assurance Index, and our proposed scale of disaster and calamity as a World Risk Index.

  7. Heart Healthy Knowledge, Food Patterns, Fatness, and Cardiac Risk Factors in Children Receiving Nutrition Education.

    ERIC Educational Resources Information Center

    Stewart, Kerry J.; And Others

    1995-01-01

    Elementary students (n=900) received a nutrition education program focusing on cognitive and behavioral aspects of cardiovascular health. Assessments of their health knowledge and behavior were conducted at baseline and at five follow-up periods. Children increased their knowledge and improved food patterns, but among the cardiac risk factors,…

  8. Nutritional evaluation of children in high-risk rural and indigenous populations in Panama

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Panama continues to have a substantial incidence of malnutrition. Among the most affected populations are children in rural areas and in indigenous populations. We evaluated nutritional status of preschool (PS) and school-aged (SA) children in two high-risk areas in Panama to determine the prevalenc...

  9. Nutritional Status and Risk Factors for Chronic Disease in Urban-Dwelling Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Braunschweig, Carol L.; Gomez, Sandra; Sheean, Patricia; Tomey, Kristin M.; Rimmer, James; Heller, Tamar

    2004-01-01

    Nutritional status and biochemical risk factors for chronic disease were assessed in 48 community-dwelling adults with Down syndrome in the Chicago area. Dietary intake was measured using a food frequency questionnaire completed by the participant's primary caregiver; anthropometric measures included height and weight and waist circumference.…

  10. Oral contraceptives, reproductive history and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition

    PubMed Central

    Tsilidis, K K; Allen, N E; Key, T J; Bakken, K; Lund, E; Berrino, F; Fournier, A; Olsen, A; Tjønneland, A; Overvad, K; Boutron-Ruault, M-C; Clavel-Chapelon, F; Byrnes, G; Chajes, V; Rinaldi, S; Chang-Claude, J; Kaaks, R; Bergmann, M; Boeing, H; Koumantaki, Y; Stasinopoulou, G; Trichopoulou, A; Palli, D; Tagliabue, G; Panico, S; Tumino, R; Vineis, P; Bueno-de-Mesquita, H B; van Duijnhoven, F J B; van Gils, C H; Peeters, P H M; Rodríguez, L; González, C A; Sánchez, M-J; Chirlaque, M-D; Barricarte, A; Dorronsoro, M; Borgquist, S; Manjer, J; van Guelpen, B; Hallmans, G; Rodwell, S A; Khaw, K-T; Norat, T; Romaguera, D; Riboli, E

    2010-01-01

    Background: Oral contraceptive use and reproductive factors may initiate long-term changes to the hormonal milieu and thereby, possibly influence colorectal cancer risk. Methods: We examined the association of hormonal and reproductive factors with risk of colorectal cancer among 337 802 women in the European Prospective Investigation into Cancer and Nutrition, of whom 1878 developed colorectal cancer. Results: After stratification for center and age, and adjustment for body mass index, smoking, diabetes mellitus, physical activity and alcohol consumption, ever use of oral contraceptives was marginally inversely associated with colorectal cancer risk (hazard ratio (HR), 0.92; 95% confidence interval (CI), 0.83–1.02), although this association was stronger among post-menopausal women (HR, 0.84; 95% CI: 0.74–0.95). Duration of oral contraceptive use and reproductive factors, including age at menarche, age at menopause, type of menopause, ever having an abortion, parity, age at first full-term pregnancy and breastfeeding, were not associated with colorectal cancer risk. Conclusion: Our findings provide limited support for a potential inverse association between oral contraceptives and colorectal cancer risk. PMID:21045829

  11. Preoperative Nutritional Therapy Reduces the Risk of Anastomotic Leakage in Patients with Crohn's Disease Requiring Resections

    PubMed Central

    Guo, Zhen; Guo, Dong; Gong, Jianfeng; Zhu, Weiming; Zuo, Lugen; Sun, Jing; Li, Ning; Li, Jieshou

    2016-01-01

    Background. The rate of anastomotic leakage is high in surgeries for Crohn's disease, and therefore a temporary diverting stoma is often needed. We conducted this study to investigate whether preoperative nutritional therapy could reduce the risk of anastomotic leakage while decreasing the frequency of temporary stoma formation. Methods. This was a retrospective study. Patients requiring bowel resections due to Crohn's disease were reviewed. The rate of anastomotic leakage and temporary diverting stoma was compared between patients who received preoperative nutritional therapy and those on a normal diet before surgery. Possible predictive factors for anastomotic leakage were also analyzed. Results. One hundred and fourteen patients undergoing 123 surgeries were included. Patients in nutritional therapy (NT) group had a significantly lower level of C-reactive protein on the day before surgery. Patients in NT group suffered less anastomotic leakage (2.3% versus 17.9%, P = 0.023) and less temporary diverting stoma (22.8% versus 40.9%, P = 0.036). Serum albumin of the day before surgery ≤35 g/L and preoperative nutritional therapy were identified as factors which independently affected the rate of anastomotic leakage. Conclusion. Preoperative nutritional therapy reduced the risk of anastomotic leakage and the frequency of temporary diverting stoma formation in patients with Crohn's disease requiring resections. PMID:26858749

  12. Prospective association between cancer risk and an individual dietary index based on the British Food Standards Agency Nutrient Profiling System.

    PubMed

    Donnenfeld, Mathilde; Julia, Chantal; Kesse-Guyot, Emmanuelle; Méjean, Caroline; Ducrot, Pauline; Péneau, Sandrine; Deschasaux, Mélanie; Latino-Martel, Paule; Fezeu, Léopold; Hercberg, Serge; Touvier, Mathilde

    2015-11-28

    The Food Standards Agency Nutrient Profiling System (FSA-NPS) constitutes the basis for the Five-Colour Nutrition Label suggested in France to be put on the front-of-pack of food products. At the individual level, a dietary index (FSA-NPS DI) has been derived and validated and corresponds to a weighted mean of all FSA-NPS scores of foods usually consumed by the individual, reflecting the nutritional quality of his/her diet. Our aim was to investigate the association between the FSA-NPS DI and cancer risk in a large cohort. This prospective study included 6435 participants to the SUpplémentation en VItamines et Minéraux AntioXydants cohort (1994-2007) who completed at least six 24 h dietary records during the first 2 years of follow-up. FSA-NPS DI was computed for each subject (higher values representing lower nutritional quality of the diet). After a median follow-up of 12·6 years, 453 incident cancers were diagnosed. Associations were characterised by multivariate Cox proportional hazards models. The FSA-NPS DI was directly associated with overall cancer risk (hazard ratio (HR)for a 1-point increment=1·08 (95 % CI 1·01, 1·15), P trend=0·02; HRQ5 v. Q1=1·34 (95 % CI 1·00, 1·81), P trend=0·03). This association tended to be more specifically observed in subjects with moderate energy intake (≤median, HRfor a 1-point increment=1·10 (95 % CI 1·01-1·20), P trend=0·03). No association was observed in subjects with higher energy intake (P trend=0·3). Results were not statistically significant for breast and prostate cancer risks. For the first time, this study investigated the prospective association between the FSA-NPS individual score and cancer risk. The results suggest that unhealthy food choices may be associated with a 34 % increase in overall cancer risk, supporting the public health relevance of developing front-of-pack nutrition labels based on this score. PMID:26393396

  13. A Land-Use Perspective for Birdstrike Risk Assessment: The Attraction Risk Index.

    PubMed

    Coccon, Francesca; Zucchetta, Matteo; Bossi, Giulia; Borrotti, Matteo; Torricelli, Patrizia; Franzoi, Piero

    2015-01-01

    Collisions between aircraft and birds, birdstrikes, pose a serious threat to aviation safety. The occurrence of these events is influenced by land-uses in the surroundings of airports. Airports located in the same region might have different trends for birdstrike risk, due to differences in the surrounding habitats. Here we developed a quantitative tool that assesses the risk of birdstrike based on the habitats within a 13-km buffer from the airport. For this purpose, we developed Generalized Linear Models (GLMs) with binomial distribution to estimate the contribution of habitats to wildlife use of the study area, depending on season. These GLMs predictions were combined to the flight altitude of birds within the 13-km buffer, the airport traffic pattern and the severity indices associated with impacts. Our approach was developed at Venice Marco Polo International airport (VCE), located in northeast Italy and then tested at Treviso Antonio Canova International airport (TSF), which is 20 km inland. Results from the two airports revealed that both the surrounding habitats and the season had a significant influence to the pattern of risk. With regard to VCE, agricultural fields, wetlands and urban areas contributed most to the presence of birds in the study area. Furthermore, the key role of distance of land-uses from the airport on the probability of presence of birds was highlighted. The reliability of developed risk index was demonstrated since at VCE it was significantly correlated with bird strike rate. This study emphasizes the importance of the territory near airports and the wildlife use of its habitats, as factors in need of consideration for birdstrike risk assessment procedures. Information on the contribution of habitats in attracting birds, depending on season, can be used by airport managers and local authorities to plan specific interventions in the study area in order to lower the risk. PMID:26114958

  14. A Land-Use Perspective for Birdstrike Risk Assessment: The Attraction Risk Index

    PubMed Central

    Coccon, Francesca; Zucchetta, Matteo; Bossi, Giulia; Borrotti, Matteo; Torricelli, Patrizia; Franzoi, Piero

    2015-01-01

    Collisions between aircraft and birds, birdstrikes, pose a serious threat to aviation safety. The occurrence of these events is influenced by land-uses in the surroundings of airports. Airports located in the same region might have different trends for birdstrike risk, due to differences in the surrounding habitats. Here we developed a quantitative tool that assesses the risk of birdstrike based on the habitats within a 13-km buffer from the airport. For this purpose, we developed Generalized Linear Models (GLMs) with binomial distribution to estimate the contribution of habitats to wildlife use of the study area, depending on season. These GLMs predictions were combined to the flight altitude of birds within the 13-km buffer, the airport traffic pattern and the severity indices associated with impacts. Our approach was developed at Venice Marco Polo International airport (VCE), located in northeast Italy and then tested at Treviso Antonio Canova International airport (TSF), which is 20 km inland. Results from the two airports revealed that both the surrounding habitats and the season had a significant influence to the pattern of risk. With regard to VCE, agricultural fields, wetlands and urban areas contributed most to the presence of birds in the study area. Furthermore, the key role of distance of land-uses from the airport on the probability of presence of birds was highlighted. The reliability of developed risk index was demonstrated since at VCE it was significantly correlated with bird strike rate. This study emphasizes the importance of the territory near airports and the wildlife use of its habitats, as factors in need of consideration for birdstrike risk assessment procedures. Information on the contribution of habitats in attracting birds, depending on season, can be used by airport managers and local authorities to plan specific interventions in the study area in order to lower the risk. PMID:26114958

  15. Idiosyncratic risk in the Dow Jones Eurostoxx50 Index

    NASA Astrophysics Data System (ADS)

    Daly, Kevin; Vo, Vinh

    2008-07-01

    Recent evidence by Campbell et al. [J.Y. Campbell, M. Lettau B.G. Malkiel, Y. Xu, Have individual stocks become more volatile? An empirical exploration of idiosyncratic risk, The Journal of Finance (February) (2001)] shows an increase in firm-level volatility and a decline of the correlation among stock returns in the US. In relation to the Euro-Area stock markets, we find that both aggregate firm-level volatility and average stock market correlation have trended upwards. We estimate a linear model of the market risk-return relationship nested in an EGARCH(1, 1)-M model for conditional second moments. We then show that traditional estimates of the conditional risk-return relationship, that use ex-post excess-returns as the conditioning information set, lead to joint tests of the theoretical model (usually the ICAPM) and of the Efficient Market Hypothesis in its strong form. To overcome this problem we propose alternative measures of expected market risk based on implied volatility extracted from traded option prices and we discuss the conditions under which implied volatility depends solely on expected risk. We then regress market excess-returns on lagged market implied variance computed from implied market volatility to estimate the relationship between expected market excess-returns and expected market risk.We investigate whether, as predicted by the ICAPM, the expected market risk is the main factor in explaining the market risk premium and the latter is independent of aggregate idiosyncratic risk.

  16. Bioelectrical impedance vectorial analysis and nutritional status of older women according to body mass index

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Longitudinal studies, both epidemiological and clinical, have shown that elderly with high body mass index (BMI) are able to better face stressing factors, and have better survival rate as consequence. The aim of the present study was to evaluate if higher BMI values were associated with improved nu...

  17. The relationship between dental status, food selection, nutrient intake, nutritional status, and body mass index in older people.

    PubMed

    Marcenes, Wagner; Steele, Jimmy George; Sheiham, Aubrey; Walls, Angus Willian Gilmour

    2003-01-01

    This paper reviewed the findings from a national survey in Great Britain which assessed whether dental status affected older people's food selection, nutrient intake, and nutritional status. The survey analyzed national random samples of free-living and institution subjects for dental examination, interview, and four-day food diary as well as blood and urine tests In the free-living sample, intakes of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C were significantly lower in edentulous as compared to dentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly non-starch polysaccharides. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and retinol were the only analytes significantly associated with dental status. Having 21 or more teeth increased the likelihood of having an acceptable body mass index (BMI). Thus, maintaining a natural and functional dentition defined as having more than twenty teeth into old age plays an important role in having a healthy diet rich in fruits and vegetables, a satisfactory nutritional status, and an acceptable BMI. PMID:12806483

  18. A Late Life Risk Index for Severe Cognitive Impairment in Mexico

    PubMed Central

    Downer, Brian; Veeranki, Sreenivas P.; Wong, Rebeca

    2016-01-01

    Background Several dementia risk indices have been developed for older adults in high-income countries. However, no index has been developed for populations in low- or middle-income countries. Objective To create a risk index for predicting severe cognitive impairment among adults aged ≥60 in Mexico and to compare the accuracy of this index to the Dementia Screening Indicator (DSI). Methods This study included 3,002 participants from the Mexican Health and Aging Study (MHAS) interviewed in 2001 and 2012. The MHAS risk index included sociodemographic, health, and functional characteristics collected in 2001. A point value based on the beta coefficients from a multivariable logistic regression model was assigned to each risk factor and the total score was calculated. Results The MHAS risk index (AUC = 0.74 95% CI = 0.70–0.77) and DSI (AUC = 0.72 95% CI = 0.69–0.77) had similar accuracy for discriminating between participants who developed severe cognitive impairment from those who did not. A score of ≥16 on the MHAS risk index had a sensitivity of 0.69 (95% CI = 0.64–0.70) and specificity of 0.67 (95% CI = 0.66–0.69). A score of ≥23 on the DSI had a sensitivity of 0.56 (95% CI = 0.50–0.63) and specificity of 0.78 (95% CI = 0.76–0.79). Discussion The MHAS risk index and DSI have moderate accuracy for predicting severe cognitive impairment among older adults in Mexico. This provides evidence that existing dementia risk indices may be applicable in low- and middle-income countries such as Mexico. Future research should seek to identify additional risk factors that can improve the accuracy of the MHAS risk index. PMID:27060940

  19. Sensitivity analysis of the Ohio phosphorus risk index

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Phosphorus (P) Index is a widely used tool for assessing the vulnerability of agricultural fields to P loss; yet, few of the P Indices developed in the U.S. have been evaluated for their accuracy. Sensitivity analysis is one approach that can be used prior to calibration and field-scale testing ...

  20. Primer on dietary carbohydrates and utility of the glycemic index in equine nutrition.

    PubMed

    Harris, Patricia; Geor, Raymond J

    2009-04-01

    The feeding of "low carbohydrate" or "low glycemic" diets has been recommended for management of horses with metabolic and endocrine disorders in which insulin resistance is a component. A "low carbohydrate" diet is a misnomer, however, because horses require that a significant proportion of their daily ration comprises structural carbohydrates (fiber/forage) to maintain gut health and mental wellbeing. This article provides a detailed description of the different carbohydrates in equine feeds. It also reviews the terminology used to describe glucose and insulin responses to the ingestion of carbohydrates, in particular the concept of the glycemic index. Some of the factors that influence glycemic index in humans and the glycemic response to a meal in horses are also discussed. PMID:19303548

  1. Early Nutrition and Weight Gain in Preterm Newborns and the Risk of Retinopathy of Prematurity

    PubMed Central

    VanderVeen, Deborah K.; Martin, Camilia R.; Mehendale, Reshma; Allred, Elizabeth N.; Dammann, Olaf; Leviton, Alan

    2013-01-01

    Objective To identify nutritional and weight gain limitations associated with retinopathy of prematurity (ROP) severity among very preterm newborns. Patients and Methods 1180 infants <28 weeks GA at birth with ROP examination results were grouped and analyzed by quartile of weekly total calorie, carbohydrate, protein, and lipid intake, as well as growth velocity between postnatal days 7 and 28 (adjusted for GA and birth weight Z-score). ROP was categorized by development of no, mild (nutritional intake and ROP severity were compared. Results Greater risk for Type 1 ROP (risk/95% confidence intervals) was found for infants with lowest quartile receipt of lipids (2.1/1.1, 3.8), total calories (2.2/1.4, 3.6), and carbohydrates (1.7/1.1, 2.9). Development of zone 1 ROP was associated with lipid or total calorie intake in the lowest quartile, and development of stage 3 ROP was associated with lowest quartile of total calorie intake. Growth velocity in the lowest quartile was associated with increased risk of any ROP, including type 1 ROP. Conclusion The risk of developing severe ROP in extremely premature infants might be reduced by improving nutritional support, specifically targeting lipids and total calories, and perhaps by improving weight gain. PMID:23734194

  2. Nutrition Risk in Home-Bound Older Adults: Using Dietician-Trained and Supervised Nutrition Volunteers for Screening and Intervention

    ERIC Educational Resources Information Center

    Laforest, Sophie; Goldin, Benita; Nour, Kareen; Roy, Marie-Andree; Payette, Helene

    2007-01-01

    Nutrition screening and early intervention in home-bound older adults are key to preventing unfavourable health outcomes and functional decline. This pilot study's objectives were (a) to test the reliability of the Elderly Nutrition Screening Tool (ENS [C]) when administered by dietician-trained and supervised nutrition volunteers, and (b) to…

  3. Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia

    PubMed Central

    Song, Su Jin; Lee, Jung Eun; Paik, Hee-Young; Park, Min Sun

    2012-01-01

    Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, ≥ 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population. PMID:22977690

  4. [Vegetarian nutrition: Preventive potential and possible risks. Part 1: Plant foods].

    PubMed

    Ströhle, Alexander; Waldmann, Annika; Wolters, Maike; Hahn, Andreas

    2006-10-01

    Today vegetarian nutrition is more accepted and widespread in Europe than in former years. For a long time scientific research on vegetarian diets has focused mostly on malnutrition, whereas nowadays research centers increasingly on the preventive potential of plant-based diets. We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE research was performed for all plant food groups relevant for a vegetarian diet (key words: all relevant food groups, "vegetarian diet", "chronic disease", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. Based on the evidence criteria of the WHO/FAO, cancer risk reduction by a high intake of vegetables and fruits is assessed as probable or possible, while a lowered risk of cardiovascular disease is convincing and a lowered risk of osteoporosis is probable. The evidence of a risk reducing effect of whole grain relating to colorectal cancer is assessed as possible, whereas it is probable relating to cardiovascular disease and diabetes mellitus type 2. There is an insufficient risk-reducing effect of legumes like soja relating to epithelial tumours and cardiovascular disease. The evidence of a risk-reducing effect of nuts to cardiovascular disease is assessed as probable, and in relation to cholelithiasis and diabetes mellitus type 2 as possible and insufficient, respectively. In conclusion, high consumption of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases. PMID:17136332

  5. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study.

    PubMed

    McKenzie, Fiona; Biessy, Carine; Ferrari, Pietro; Freisling, Heinz; Rinaldi, Sabina; Chajès, Veronique; Dahm, Christina C; Overvad, Kim; Dossus, Laure; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Bueno-de-Mesquita, H Bas; May, Anne; Peeters, Petra H; Weiderpass, Elisabete; Sanchez, Maria-Jose; Navarro, Carmen; Ardanaz, Eva; Ericson, Ulrika; Wirfält, Elisabet; Travis, Ruth C; Romieu, Isabelle

    2016-04-01

    It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men. PMID:27100409

  6. Healthy Lifestyle and Risk of Cancer in the European Prospective Investigation Into Cancer and Nutrition Cohort Study

    PubMed Central

    McKenzie, Fiona; Biessy, Carine; Ferrari, Pietro; Freisling, Heinz; Rinaldi, Sabina; Chajès, Veronique; Dahm, Christina C.; Overvad, Kim; Dossus, Laure; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Bueno-de-Mesquita, H. Bas; May, Anne; Peeters, Petra H.; Weiderpass, Elisabete; Sanchez, Maria-Jose; Navarro, Carmen; Ardanaz, Eva; Ericson, Ulrika; Wirfält, Elisabet; Travis, Ruth C.; Romieu, Isabelle

    2016-01-01

    Abstract It has been estimated that at least a third of the most common cancers are related to lifestyle and as such are preventable. Key modifiable lifestyle factors have been individually associated with cancer risk; however, less is known about the combined effects of these factors. This study generated a healthy lifestyle index score (HLIS) to investigate the joint effect of modifiable factors on the risk of overall cancers, alcohol-related cancers, tobacco-related cancers, obesity-related cancers, and reproductive-related cancers. The study included 391,608 men and women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The HLIS was constructed from 5 factors assessed at baseline (diet, physical activity, smoking, alcohol consumption, and anthropometry) by assigning scores of 0 to 4 to categories of each factor, for which higher values indicate healthier behaviors. Hazard ratios (HR) were estimated by Cox proportional regression and population attributable fractions (PAFs) estimated from the adjusted models. There was a 5% lower risk (adjusted HR 0.952, 95% confidence interval (CI): 0.946, 0.958) of all cancers per point score of the index for men and 4% (adjusted HR 0.961, 95% CI: 0.956, 0.966) for women. The fourth versus the second category of the HLIS was associated with a 28% and 24% lower risk for men and women respectively across all cancers, 41% and 33% for alcohol-related, 49% and 46% for tobacco-related, 41% and 26% for obesity-related, and 21% for female reproductive cancers. Findings suggest simple behavior modifications could have a sizeable impact on cancer prevention, especially for men. PMID:27100409

  7. Body Mass Index Categories and Mortality Risk in US Adults: The Effect of Overweight and Obesity on Advancing Death

    PubMed Central

    Samuel, Lalitha

    2014-01-01

    Objectives. We examined the association of body mass index with all-cause and cardiovascular disease (CVD)–specific mortality risks among US adults and calculated the rate advancement period by which death is advanced among the exposed groups. Methods. We used data from the Third National Health and Nutrition Examination Survey (1988–1994) linked to the National Death Index mortality file with follow-up to 2006 (n = 16 868). We used Cox proportional hazards regression to estimate the rate of dying and rate advancement period for all-cause and CVD-specific mortality for overweight and obese adults relative to their normal-weight counterparts. Results. Compared with normal-weight adults, obese adults had at least 20% significantly higher rate of dying of all-cause or CVD. These rates advanced death by 3.7 years (grades II and III obesity) for all-cause mortality and between 1.6 (grade I obesity) and 5.0 years (grade III obesity) for CVD-specific mortality. The burden of obesity was greatest among adults aged 45 to 64 years for all-cause and CVD-specific mortality and among women for all-cause mortality. Conclusions. These findings highlight the impact of the obesity epidemic on mortality risk and premature deaths among US adults. PMID:24432921

  8. Some Educational Implications for Students with Profound Disabilities at Risk for Inadequate Nutrition and the Nontherapeutic Effects of Medication.

    ERIC Educational Resources Information Center

    Ault, Marilyn Mulligan; And Others

    1994-01-01

    This paper examines the educational relevance for students with profound disabilities of being at risk for poor nutrition and for problems caused by the nontherapeutic effects of some medications. Two classroom-based cases describe the resolution of a nutritional and a medication problem, including the role of the teacher and health-related…

  9. Nutritional status and physical activity level as risk factor for traumatic dental injuries occurrence: a systematic review

    PubMed Central

    Goettems, Marília Leão; Schuch, Helena Silveira; Hallal, Pedro Curi; Torriani, Dione Dias; Demarco, Flávio Fernando

    2014-01-01

    Aim To systematically review epidemiological articles assessing traumatic dental injuries (TDI) rates according to the physical activity habits and nutritional status. Methods A search was conducted using PubMed, ISI, Scopus, SciELO, LILACS, and gray literature in Brazilian Theses Databank. We searched for dental trauma, traumatic dental injuries, tooth injuries, tooth fractures, physical activity, motor activity, exercise, sedentary lifestyle, sports, obesity, body mass index (BMI), overweight, and fatness. Databases were searched in duplicate from their earliest records until 2012. Additional studies were identified by searching bibliographies of the articles. Two reviewers performed data extraction and analyzed study procedural quality using the Newcastle–Ottawa scale. PRISMA guidelines for reporting systematic reviews were followed. Results We found 1159 articles, of whom 14 reports involving 13 studies were selected. One article was a birth cohort, one had a case–control design, and the others were cross-sectional. The quality of evidence varied across the studies and was high (9) in 3. Eleven of the studies included assessed influence of nutritional status: five show a positive association between dental trauma and overweight and six do not show any association. Regarding physical activity level, five studies assessed its effect on trauma occurrence: two detected that physical activity acts as a protective factor and two that physical active increases the risk of dental injuries, and one showed no differences in TDI occurrence. Physical activity estimated from questionnaires and BMI were the most frequently used measures, but methodological differences prevent the comparison of results. Conclusion The results suggest that no truly causal relationship exists between dental trauma and physical activity and nutritional status. Due to the relatively low level of evidence currently present, studies with more robust design, for example, prospective cohort

  10. Risk Assessment to Underpin Food Regulatory Decisions: An Example of Public Health Nutritional Epidemiology

    PubMed Central

    Baines, Janis; Cunningham, Judy; Leemhuis, Christel; Hambridge, Tracy; Mackerras, Dorothy

    2011-01-01

    The approach used by food regulation agencies to examine the literature and forecast the impact of possible food regulations has many similar features to the approach used in nutritional epidemiological research. We outline the Risk Analysis Framework described by FAO/WHO, in which there is formal progression from identification of the nutrient or food chemical of interest, through to describing its effect on health and then assessing whether there is a risk to the population based on dietary exposure estimates. We then discuss some important considerations for the dietary modeling component of the Framework, including several methodological issues that also exist in research nutritional epidemiology. Finally, we give several case studies that illustrate how the different methodological components are used together to inform decisions about how to manage the regulatory problem. PMID:22254081

  11. Body shape index versus body mass index as correlates of health risk in young healthy sedentary men.

    PubMed

    Malara, Marzena; Kęska, Anna; Tkaczyk, Joanna; Lutosławska, Grażyna

    2015-01-01

    Recently a new simply calculated index of body composition -a body shape index (ABSI) has been introduced as an index more reliable than BMI of association between body composition and all-cause mortality. However, until now associations between ABSI and metabolic risk factors have not been evaluated. A total of 114 male university students not engaged in any planned physical activity participated in the present study. Anthropometric measurements (weight, height, waist circumference) were recorded. Body mass index (BMI) was calculated from weight and height, body shape index (ABSI) was calculated from waist circumference, weight, height and BMI. Blood was withdrawn after an overnight fast from the antecubital vein. Triacylglycerols, total cholesterol and HDL-cholesterol levels in plasma were determined using colorimetric methods and Randox commercial kits. Plasma LDL-cholesterol concentrations were calculated according to the Friedewald formula. Circulating insulin was assayed using a standard radioimmunological method with monoclonal antibodies against insulin and BioSource commercial kits. BMI was slightly, but significantly correlated only with circulating TG (r=0.330, p < 0.001) In contrast, ABSI was slightly, but significantly correlated with plasma levels of insulin (r=0.360, p<0.001), TC (r=0.270, p<0.002), LDL-C and non-HDL-C (r=0.300, p<0.001). In participants at the upper quartile of BMI circulating TG was higher (by 50%, p<0.05) than in their counterparts at the lower BMI quartile. Subjects representing the upper quartile of ABSI were characterized by higher plasma levels of insulin, TC, LDL-C and non-HDL in comparison with subjects at the lower ABSI quartile. (by 92 %, 11. %, 29 % and 21 % respectively, p<0.001). ABSI, a new simply calculated index of body fat seems to more accurately depict the variability in circulating insulin and lipoproteins than BMI at least in young, healthy male subjects. PMID:25890016

  12. Impact of genetic risk assessment on nutrition-related lifestyle behaviours

    PubMed Central

    Vernarelli, Jacqueline A.

    2013-01-01

    Genetic susceptibility testing for common complex disease is a practice that is currently in clinical use. There are two types of gene mutations, and therefore, two varieties of genotype testing: deterministic and susceptibility. As the term suggests, deterministic genes determine whether or not a person will develop a given trait in Mendelian fashion, such as Huntington’s disease. Genotype screening for such deterministic mutations has existed for decades, and is commonly used in routine medical practice. In recent years, the sequencing of the human genome has identified several ‘susceptibility genes’ or genes with incomplete penetrance. Mutations in these genes may increase disease susceptibility, but are not causative for disease. Genetic susceptibility testing allows unaffected individuals to obtain risk information for a variety of common complex diseases and health conditions including Alzheimer’s disease (AD), CVD, cancer and diabetes. The availability of genetic susceptibility testing has increased over the past decade, and several studies are now focusing on the impact that genetic testing has on health and other lifestyle behaviours related to nutrition. The aim of this paper is to review the literature and evaluate what, if any, impact genetic risk assessment has on behaviours related to nutrition and physical activity. This paper summarises seven clinical studies that evaluated the impact of disclosing genetic risk information for disease on nutrition-related health behaviour changes. Of these seven studies, only three studies reported that health behaviour change was influenced by genotype disclosure. PMID:23095764

  13. Correlations between Poor Micronutrition in Family Members and Potential Risk Factors for Poor Diet in Children and Adolescents Using Korean National Health and Nutrition Examination Survey Data.

    PubMed

    Lee, Hye Ah; Park, Hyesook

    2015-08-01

    Based on data from the 2010-2011 Korean National Health and Nutrition Examination Survey, we investigated correlations between micronutrients in the diet of family members and the possible risk factors for children and adolescents consuming an inadequate diet. We examined two-generation households with children aged 2-18 years. The quality of the family diet with regard to the following nine nutrients (protein, calcium, phosphorous, iron, vitamin A, vitamin B1, vitamin B2, niacin, and vitamin C) was assessed based on the Index of Nutritional Quality. Correlations between quality of diet and selected variables were analyzed using the Statistical Analysis for Genetic Epidemiology software, and those between diet quality and potential risk factors for poor diet in offspring were analyzed using multinomial logistic regression. Overall, calcium was the most commonly under-consumed micronutrient. More than half of sons and daughters showed insufficient vitamin A, vitamin C, and iron intake, and both mothers and fathers showed insufficiency with respect to vitamin A, vitamin B2, and vitamin C. The correlation between a poor diet in parents and that in offspring was 0.17 (p < 0.0001), and this correlation coefficient was higher between mothers and offspring than between fathers and offspring. Additionally, eating breakfast provided a significant protective effect against the risk of poor nutrition in offspring, even after adjusting for covariates. Our results add to evidence indicating that children should be encouraged to eat breakfast to improve the quality of their diet. PMID:26247964

  14. Evaluation of finger millet incorporated noodles for nutritive value and glycemic index.

    PubMed

    Shukla, Kamini; Srivastava, Sarita

    2014-03-01

    The present study was undertaken to develop finger millet incorporated noodles for diabetic patients. Finger millet variety VL-149 was taken. The finger millet flour and refined wheat flour (RWF) were evaluated for nutrient composition. The finger millet flour (FMF) was blended in various proportions (30 to 50%) in refined wheat flour and used for the preparation of noodles. Control consisted of RWF noodles. Sensory quality and nutrient composition of finger millet noodles was evaluated. The 30% finger millet incorporated noodles were selected best on the basis of sensory evaluation. Noodles in that proportion along with control were evaluated for glycemic response. Nutrient composition of noodles showed that 50% finger millet incorporated noodles contained highest amount of crude fat (1.15%), total ash (1.40%), crude fiber (1.28%), carbohydrate (78.54%), physiological energy (351.36 kcal), insoluble dietary fiber (5.45%), soluble dietary fiber (3.71%), iron (5.58%) and calcium (88.39%), respectively. However, control RWF noodles contained highest amount of starch (63.02%), amylose (8.72%) and amylopectin (54.29%). The glycemic index (GI) of 30% finger millet incorporated noodles (best selected by sensory evaluation) was observed significantly lower (45.13) than control noodles (62.59). It was found that finger millet flour incorporated noodles were found nutritious and showed hypoglycemic effect. PMID:24587528

  15. Body mass index and risk of tuberculosis and death

    PubMed Central

    Hanrahan, Colleen F.; Golub, Jonathan E.; Mohapi, Lerato; Tshabangu, Nkeko; Modisenyane, Tebogo; Chaisson, Richard E.; Gray, Glenda E.; McIntyre, James A.; Martinson, Neil A.

    2011-01-01

    Background High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa. Methods A clinical cohort of 3456 HIV-infected adults from South Africa was prospectively followed from 2003 to 2008 with regular monitoring. The primary exposure was BMI and the outcomes of interest were all-cause mortality and a newly diagnosed episode of TB. Cox proportional hazard models assessed associations with risk of mortality or incident TB. Results Incidence rates of mortality were 10.4/100 person-years for baseline BMI of 18.5 or less, 3.6/100 person-years for baseline BMI 18.6–25, 1.7/100 person-years for baseline BMI 25.1–30, and 1.6/100 person-years for baseline BMI more than 30. Compared to those with normal BMI, overweight and obese participants had a significantly reduced risk of mortality [adjusted hazard ratio 0.59 (95% confidence interval, CI 0.40–0.87) and 0.48 (95% CI 0.29–0.80), respectively]. Incidence rates of TB by baseline BMI were 7.3/100 person-years for underweight, 6.0/100 person-years for normal, 3.2/100 person-years for overweight, and 1.9/100 person-years for obese. Compared to those with normal BMI, those with overweight and obese BMI were at a significantly reduced risk of developing TB [adjusted hazard ratio 0.56 (95% CI 0.38–0.83) and 0.33 (95% CI 0.19–0.55), respectively]. Conclusion HIV-infected individuals with obese and overweight BMI have a significantly reduced risk of both mortality and TB, after adjusting for HAART use and CD4 cell count. PMID:20505496

  16. Human Research Program Human Health Countermeasures Element Nutrition Risk Standing Review Panel

    NASA Technical Reports Server (NTRS)

    Bistrian, Bruce

    2009-01-01

    The Nutrition Risk Standing Review Panel (SRP) reviewed and discussed the specific gaps and tasks for the Human Health Countermeasures (HHC) Element related to nutrition identified in the Human Research Program (HRP) Integrated Research Plan. There was general consensus that the described gaps and proposed tasks were critical to future NASA mission success. The SRP acknowledged the high scientific quality of the work currently being undertaken by the Nutritional Biochemistry group under the direction of Dr. Scott Smith. In review of the entire HRP, four new gaps were identified that complement the Element's existing research activities. Given the limitations of ground-based analogs for many of the unique physiological and metabolic alterations in space, future studies are needed to quantify nutritional factors that change during actual space flight. In addition, future tasks should seek to better evaluate the time course of physiological and metabolic alterations during flight to better predict alterations during longer duration missions. Finally, given the recent data suggesting a potential role for increased inflammatory responses during space flight, the role of inflammation needs to be explored in detail, including the development of potential countermeasures and new ground based analogs, if this possibility is confirmed.

  17. Increasing Prevalence, Changes in Diagnostic Criteria, and Nutritional Risk Factors for Autism Spectrum Disorders

    PubMed Central

    Neggers, Yasmin H.

    2014-01-01

    The frequency of autism spectrum disorders (ASD) diagnoses has been increasing for decades, but researchers cannot agree on whether the trend is a result of increased awareness, improved detection, expanding definition, or an actual increase in incidence or a combination of these factors. Though both genetic and multiple environmental risk factors have been studied extensively, many potentially modifiable risk factors including nutritional and immune function related risk factors such as vitamin D, folic acid, and metabolic syndrome have not received sufficient attention. Several recent studies have put forward hypotheses to explain the mechanism of association between both folic acid and vitamin D and autism. A continuous rise in the prevalence of autism in the USA has coincided with a significant enhancement of maternal folate status with FDA mandated folic acid fortification of certain foods starting in 1998. There is also a growing body of research that suggests that vitamin D status either in utero or early in life may be a risk for autism. In this communication, controversies regarding increase in estimate of prevalence, implications of changes in definition, and possible association between some modifiable nutritional risk factors such as folic acid and vitamin D and ASD will be discussed. PMID:24967269

  18. Adherence to French nutritional guidelines is associated with lower risk of metabolic syndrome.

    PubMed

    Kesse-Guyot, Emmanuelle; Fezeu, Léopold; Galan, Pilar; Hercberg, Serge; Czernichow, Sébastien; Castetbon, Katia

    2011-06-01

    A decrease in metabolic syndrome (MetS) prevalence may lower the cardiovascular disease (CVD) burden. The predictive value of nutritional recommendations for the incidence of MetS has not yet been evaluated. We assessed, in a population-based study, the association between the French National Nutrition and Health Program Guideline Score (PNNS-GS) and 6-y risk of MetS. Participants in the Supplémentation en Vitamines et Minéraux Antioxydants study were followed-up from 1994-1996 to 2001-2002. MetS was defined according to International Diabetes Federation criteria. We also defined "mild" and "severe" MetS as waist criteria plus 2, or more than 2, other criteria. Prospective associations between the PNNS-GS at baseline (either as a continuous variable or in quartiles) and incident MetS were assessed using binary or multinomial logistic regression to provide OR and 95% CI in participants free of MetS at baseline (n = 2763). In multivariate models, each unit increase in the PNNS-GS score was associated with a 9% lower risk of MetS (OR = 0.91; 95% CI = 0.83-1.00). This association was even stronger with the risk of severe MetS (OR = 0.76; 95% CI = 0.63-0.91). After adjustment for baseline and change in BMI, this association remained significant for severe MetS but did not reach significance for overall MetS. These findings support a potential beneficial impact of nutritional guidelines upon primary prevention of MetS. Improvement in compliance with nutritional recommendations may help to reduce the burden of CVD disease in the general population. PMID:21490288

  19. Nutritional status of children and adolescents based on body mass index: agreement between World Health Organization and International Obesity Task Force

    PubMed Central

    Cavazzotto, Timothy Gustavo; Brasil, Marcos Roberto; Oliveira, Vinicius Machado; da Silva, Schelyne Ribas; Ronque, Enio Ricardo V.; Queiroga, Marcos Roberto; Serassuelo, Helio

    2014-01-01

    Objective: To investigate the agreement between two international criteria for classification of children and adolescents nutritional status. Methods: The study included 778 girls and 863 boys aged from six to 13 years old. Body mass and height were measured and used to calculate the body mass index. Nutritional status was classified according to the cut-off points defined by the World Health Organization and the International Obesity Task Force. The agreement was evaluated using Kappa statistic and weighted Kappa. Results: In order to classify the nutritional status, the agreement between the criteria was higher for the boys (Kappa 0.77) compared to girls (Kappa 0.61). The weighted Kappa was also higher for boys (0.85) in comparison to girls (0.77). Kappa index varied according to age. When the nutritional status was classified in only two categories - appropriate (thinness + accentuated thinness + eutrophy) and overweight (overweight + obesity + severe obesity) -, the Kappa index presented higher values than those related to the classification in six categories. Conclusions: A substantial agreement was observed between the criteria, being higher in males and varying according to the age. PMID:24676189

  20. Association of body mass index and aerobic physical fitness with cardiovascular risk factors in children☆

    PubMed Central

    Gonçalves, Reginaldo; Szmuchrowski, Leszek Antony; Damasceno, Vinícius Oliveira; de Medeiros, Marcelo Lemos; Couto, Bruno Pena; Lamounier, Joel Alves

    2014-01-01

    Objective: To identify the association between both, body mass index and aerobic fitness, with cardiovascular disease risk factors in children. Methods: Cross-sectional study, carried out in Itaúna-MG, in 2010, with 290 school children ranging from 6 to 10 years-old of both sexes, randomly selected. Children from schools located in the countryside and those with medical restrctions for physical activity were not included. Blood sample was collected after a 12-hour fasting period. Blood pressure, stature and weight were evaluated in accordance with international standards. The following were considered as cardiovascular risk factors: high blood pressure, high total cholesterol, LDL, triglycerides and insulin levels, and low HDL. The statistical analysis included the Spearman's coefficient and the logistic regression, with cardiovascular risk factors as dependent variables. Results: Significant correlations were found, in both sexes, among body mass index and aerobic fitness with most of the cardiovascular risk factors. Children of both sexes with body mass index in the fourth quartile demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Moreover, girls with aerobic fitness in the first quartile also demonstrated increased chances of having high blood insulin and clustering cardiovascular risk factors. Conclusion: The significant associations and the increased chances of having cardiovascular risk factors in children with less aerobic fitness and higher levels of body mass index justify the use of these variables for health monitoring in Pediatrics. PMID:25479851

  1. A Preoperative Nutritional Index for Predicting Cancer-Specific and Overall Survival in Chinese Patients With Laryngeal Cancer

    PubMed Central

    Fu, Yan; Chen, Shu-Wei; Chen, Shi-Qi; Ou-Yang, Dian; Liu, Wei-Wei; Song, Ming; Yang, An-Kui; Zhang, Quan

    2016-01-01

    Abstract Pinato prognostic nutritional index (PNI) adequately predicts long-term outcomes of various malignancies. However, its value in predicting outcomes in laryngeal squamous cell carcinoma (LSCC) is unknown. All patients newly diagnosed with LSCC presenting to the Department of Head and Neck Oncology at Sun Yat-sen University Cancer Center between January 1, 1990 and July 31, 2010 were eligible. The PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count/L. The Cutoff Finder software program was used to classify the patients into 3 groups for which the PNI score was at least 70% sensitive, at least 70% specific, or equivocal. Cancer-specific survival was estimated using the Kaplan–Meier method, and predictors were assessed with Cox regression analysis. Median time between surgery and PNI administration for the 975 eligible patients was 83 months. Index score groups were significantly associated with age, T stage, TNM stage, and type of surgery. Five-year CSS and OS were 57.3% and 56.6% in patients with PNI scores below 48.65 (low-probability of survival), 72.8% and 71.3% with scores between 48.65 and 56.93 (moderate-probability of survival), and 77.6% and 75.3% with scores above 56.93 (high-probability of survival); 10-year CSS and OS were 44.2% and 42.7%, 61.6% and 55.6%, 68.3% and 63.5%, respectively. The PNI score groups significantly predicted CSS and OS (P < 0.001). The PNI is an inexpensive and readily available score that predicted survival in patients with LSCC after curative laryngectomy. PMID:26986105

  2. Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort.

    PubMed

    Molina-Montes, Esther; Sánchez, María-José; Zamora-Ros, Raul; Bueno-de-Mesquita, H B As; Wark, Petra A; Obon-Santacana, Mireia; Kühn, Tilman; Katzke, Verena; Travis, Ruth C; Ye, Weimin; Sund, Malin; Naccarati, Alessio; Mattiello, Amalia; Krogh, Vittorio; Martorana, Caterina; Masala, Giovanna; Amiano, Pilar; Huerta, José-María; Barricarte, Aurelio; Quirós, José-Ramón; Weiderpass, Elisabete; Angell Åsli, Lene; Skeie, Guri; Ericson, Ulrika; Sonestedt, Emily; Peeters, Petra H; Romieu, Isabelle; Scalbert, Augustin; Overvad, Kim; Clemens, Matthias; Boeing, Heiner; Trichopoulou, Antonia; Peppa, Eleni; Vidalis, Pavlos; Khaw, Kay-Tee; Wareham, Nick; Olsen, Anja; Tjønneland, Anne; Boutroun-Rualt, Marie-Christine; Clavel-Chapelon, Françoise; Cross, Amanda J; Lu, Yunxia; Riboli, Elio; Duell, Eric J

    2016-10-01

    Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow-up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center-stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable-adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95-1.11 and 1.02; 95% CI: 0.89-1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91-1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort. PMID:27184434

  3. Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort

    PubMed Central

    Molina‐Montes, Esther; Zamora‐Ros, Raul; Bueno‐de‐Mesquita, H.B(as); Wark, Petra A.; Obon‐Santacana, Mireia; Kühn, Tilman; Katzke, Verena; Travis, Ruth C.; Ye, Weimin; Sund, Malin; Naccarati, Alessio; Mattiello, Amalia; Krogh, Vittorio; Martorana, Caterina; Masala, Giovanna; Amiano, Pilar; Huerta, José‐María; Barricarte, Aurelio; Quirós, José‐Ramón; Weiderpass, Elisabete; Angell Åsli, Lene; Skeie, Guri; Ericson, Ulrika; Sonestedt, Emily; Peeters, Petra H.; Romieu, Isabelle; Scalbert, Augustin; Overvad, Kim; Clemens, Matthias; Boeing, Heiner; Trichopoulou, Antonia; Peppa, Eleni; Vidalis, Pavlos; Khaw, Kay‐Tee; Wareham, Nick; Olsen, Anja; Tjønneland, Anne; Boutroun‐Rualt, Marie‐Christine; Clavel‐Chapelon, Françoise; Cross, Amanda J.; Lu, Yunxia; Riboli, Elio; Duell, Eric J.

    2016-01-01

    Despite the potential cancer preventive effects of flavonoids and lignans, their ability to reduce pancreatic cancer risk has not been demonstrated in epidemiological studies. Our aim was to examine the association between dietary intakes of flavonoids and lignans and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 865 exocrine pancreatic cancer cases occurred after 11.3 years of follow‐up of 477,309 cohort members. Dietary flavonoid and lignan intake was estimated through validated dietary questionnaires and the US Department of Agriculture (USDA) and Phenol Explorer databases. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using age, sex and center‐stratified Cox proportional hazards models, adjusted for energy intake, body mass index (BMI), smoking, alcohol and diabetes status. Our results showed that neither overall dietary intake of flavonoids nor of lignans were associated with pancreatic cancer risk (multivariable‐adjusted HR for a doubling of intake = 1.03, 95% CI: 0.95–1.11 and 1.02; 95% CI: 0.89–1.17, respectively). Statistically significant associations were also not observed by flavonoid subclasses. An inverse association between intake of flavanones and pancreatic cancer risk was apparent, without reaching statistical significance, in microscopically confirmed cases (HR for a doubling of intake = 0.96, 95% CI: 0.91–1.00). In conclusion, we did not observe an association between intake of flavonoids, flavonoid subclasses or lignans and pancreatic cancer risk in the EPIC cohort. PMID:27184434

  4. Association of Nut Consumption with Cardiometabolic Risk Factors in the 2008/2009 New Zealand Adult Nutrition Survey

    PubMed Central

    Brown, Rachel C.; Tey, Siew Ling; Gray, Andrew R.; Chisholm, Alexandra; Smith, Claire; Fleming, Elizabeth; Parnell, Winsome

    2015-01-01

    Nut consumption has been associated with improvements in risk factors for chronic disease in populations within North America, Europe and Iran. This relationship has not been investigated in New Zealand (NZ). The associations between nut consumption and cardiometabolic risk factors among New Zealanders were examined. Data from the 24-h diet recalls of 4721 participants from the NZ Adult Nutrition Survey 2008/2009 (2008/2009 NZANS) were used to determine whole and total nut intake. Anthropometric data and blood pressure were collected, as well as blood samples analysed for total cholesterol (total-C) and HDL cholesterol (HDL-C), glycated haemoglobin (HbA1c), C-reactive protein (CRP) and folate. Participants were classified according to their five-year cardiovascular disease (CVD) risk. Both whole and total nut consumers had significantly lower weight, body mass index (BMI), waist circumference and central adiposity than non-nut consumers (all p ≤ 0.044). Whole blood, serum and red blood cell folate concentrations were significantly higher among whole nut consumers compared to non-whole nut consumers (all p ≤ 0.014), with only serum folate higher in total nut consumers compared to non-total nut consumers (p = 0.023). There were no significant differences for blood pressure, total-C, HDL-C and HbA1c; however, significant negative associations between total nut consumption and CVD risk category (p < 0.001) and CRP (p = 0.045) were apparent. Nut consumption was associated with more favourable body composition and a number of risk factors, which could collectively reduce chronic disease. PMID:26371037

  5. Looking beyond borders: integrating best practices in benefit-risk analysis into the field of food and nutrition.

    PubMed

    Tijhuis, M J; Pohjola, M V; Gunnlaugsdóttir, H; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken-Schröder, G; Poto, M; Tuomisto, J T; Ueland, O; White, B C; Holm, F; Verhagen, H

    2012-01-01

    An integrated benefit-risk analysis aims to give guidance in decision situations where benefits do not clearly prevail over risks, and explicit weighing of benefits and risks is thus indicated. The BEPRARIBEAN project aims to advance benefit-risk analysis in the area of food and nutrition by learning from other fields. This paper constitutes the final stage of the project, in which commonalities and differences in benefit-risk analysis are identified between the Food and Nutrition field and other fields, namely Medicines, Food Microbiology, Environmental Health, Economics and Marketing-Finance, and Consumer Perception. From this, ways forward are characterized for benefit-risk analysis in Food and Nutrition. Integrated benefit-risk analysis in Food and Nutrition may advance in the following ways: Increased engagement and communication between assessors, managers, and stakeholders; more pragmatic problem-oriented framing of assessment; accepting some risk; pre- and post-market analysis; explicit communication of the assessment purpose, input and output; more human (dose-response) data and more efficient use of human data; segmenting populations based on physiology; explicit consideration of value judgments in assessment; integration of multiple benefits and risks from multiple domains; explicit recognition of the impact of consumer beliefs, opinions, views, perceptions, and attitudes on behaviour; and segmenting populations based on behaviour; the opportunities proposed here do not provide ultimate solutions; rather, they define a collection of issues to be taken account of in developing methods, tools, practices and policies, as well as refining the regulatory context, for benefit-risk analysis in Food and Nutrition and other fields. Thus, these opportunities will now need to be explored further and incorporated into benefit-risk practice and policy. If accepted, incorporation of these opportunities will also involve a paradigm shift in Food and Nutrition benefit-risk

  6. ENSO-Based Index Insurance: Approach and Peru Flood Risk Management Application

    NASA Astrophysics Data System (ADS)

    Khalil, A. F.; Kwon, H.; Lall, U.; Miranda, M. J.; Skees, J. R.

    2006-12-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable, and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations data are inadequate to develop an index due to short time-series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here, ENSO related climate indices are explored for use as a proxy to extreme rainfall in one of the departments of Peru -- Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions (MFIs) to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods, but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many micro-enterprises. The reliability and quality of the local rainfall data is variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (a) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall; (b) the potential for clustering of payoffs; (c) the potential that the index could be predicted with some lead time prior to the flood season; and (d) evidence for climate change or non-stationarity in the flood exceedance probability from the long ENSO record. Finally, prospects for

  7. Characterization of Patients with Type 2 Diabetes according to Body Mass Index: Korea National Health and Nutrition Examination Survey from 2007 to 2011

    PubMed Central

    Lee, Dong-Hwa; Jung, Kyong Yeun; Park, Kyeong Seon; Kim, Kyoung Min; Moon, Jae Hoon; Lim, Soo; Jang, Hak Chul

    2015-01-01

    Background The present study aimed to investigate the clinical characteristics of type 2 diabetes mellitus (T2DM) in Korean adults according to body mass index (BMI) and to analyze the association with cardiovascular disease (CVD). Methods We conducted a cross-sectional study of data from the Korea National Health and Nutrition Examination Survey from 2007 to 2011. A total of 3,370 patients with T2DM were divided into categories according to BMI. We conducted a comparison of the T2DM patient population composition by BMI category between different countries. We investigated the prevalence of awareness, treatment, and target control of T2DM according to BMI. Results Patients with T2DM had a higher BMI, and were more likely to have a history of CVD than healthy controls. For Korean adults with T2DM, 8% had BMI ≥30 kg/m2. By contrast, the population of patients with T2DM and BMI ≥30 kg/m2 was 72% in patients in the USA and 56% in the UK. The rate of recognition, treatment, and control has worsened in parallel with increasing BMI. Even in patients with BMI 25 to 29.9 kg/m2, the prevalence of CVD or high risk factors for CVD was significantly higher than in patients with BMI 18.5 to 22.9 kg/m2 (odds ratio, 2.07). Conclusion Korean patients with T2DM had lower BMI than those in Western countries. Higher BMI was associated with lower awareness, treatment, and control of diabetes, and a positive association was observed between CVD or high risk factors for CVD and BMI, even for patients who were overweight but not obese. PMID:26354494

  8. Model risk for European-style stock index options.

    PubMed

    Gençay, Ramazan; Gibson, Rajna

    2007-01-01

    In empirical modeling, there have been two strands for pricing in the options literature, namely the parametric and nonparametric models. Often, the support for the nonparametric methods is based on a benchmark such as the Black-Scholes (BS) model with constant volatility. In this paper, we study the stochastic volatility (SV) and stochastic volatility random jump (SVJ) models as parametric benchmarks against feedforward neural network (FNN) models, a class of neural network models. Our choice for FNN models is due to their well-studied universal approximation properties of an unknown function and its partial derivatives. Since the partial derivatives of an option pricing formula are risk pricing tools, an accurate estimation of the unknown option pricing function is essential for pricing and hedging. Our findings indicate that FNN models offer themselves as robust option pricing tools, over their sophisticated parametric counterparts in predictive settings. There are two routes to explain the superiority of FNN models over the parametric models in forecast settings. These are nonnormality of return distributions and adaptive learning. PMID:17278472

  9. Informing Early Childhood Policy: An Analysis of the Sensitivity of a School Readiness Risk Index to Changes in Indicator Selection

    ERIC Educational Resources Information Center

    Schumacher, Krista S.

    2015-01-01

    The importance of school readiness to both the future of an individual child and society as a whole has given rise to several state-specific indexes designed to measure county-level risk for starting school unprepared to learn. One such index is the Oklahoma School Readiness Risk Index (OK SRRI), comprised of indicators known to be associated with…

  10. A comparison of the environmental impact of different AOPs: risk indexes.

    PubMed

    Giménez, Jaime; Bayarri, Bernardí; González, Óscar; Malato, Sixto; Peral, José; Esplugas, Santiago

    2015-01-01

    Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs) applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil) and on materials and energy consumption. An Environmental Risk Index (E), constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi) for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj) for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP) or aspect (E/NAS) involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared. PMID:25558859

  11. The physical and empirical basis for a specific clear-air turbulence risk index

    NASA Technical Reports Server (NTRS)

    Keller, J. L.

    1985-01-01

    An improved operational CAT detection and forecasting technique is developed and detailed. This technique is the specific clear air turbulence risk (SCATR) index. This index shows some promising results. The improvements seen using hand analyzed data, as a result of the more realistic representation of the vertical shear of the horizontal wind, are also realized in the data analysis used in the PROFS/CWP application. The SCATR index should improve as database enhancements such as profiler and VAS satellite data, which increase the resolution in space and time, are brought into even more sophisticated objective analysis schemes.

  12. A priori-defined Diet Quality Indexes and Risk of Type 2 diabetes: The Multiethnic Cohort

    PubMed Central

    Jacobs, Simone; Harmon, Brook E.; Boushey, Carol J.; Morimoto, Yukiko; Wilkens, Lynne R.; Le Marchand, Loic; Kröger, Janine; Schulze, Matthias B.; Kolonel, Laurence N.; Maskarinec, Gertraud

    2014-01-01

    Aim Dietary patterns have been associated with type 2 diabetes incidence, but little is known about the impact of ethnicity on this relation. This study evaluated the association of four a priori dietary quality indexes and type 2 diabetes risk among whites, Japanese Americans, and Native Hawaiians in the Hawaii component of the Multiethnic Cohort (MEC). Methods After excluding participants with prevalent diabetes and missing values, the analysis included 89,185 participants (11,217 cases). Dietary intake was assessed at baseline with a quantitative food frequency questionnaire designed for use in the relevant ethnic populations. Sex- and ethnicity-specific hazard ratios were calculated for the Healthy Eating Index-2010 (HEI-2010), the alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH). Results We observed significant inverse associations between higher scores of the DASH index and type 2 diabetes risk in white men and women, as well as in Japanese American women and Native Hawaiian men with respective risk reductions of 37, 31, 19 and 21% (highest compared to lowest index category). A higher adherence to the AHEI-2010 and aMED diet was related to a 13–28% lower type 2 diabetes risk in white participants but not in other ethnic groups. No significant associations with type 2 diabetes risk were observed for the HEI-2010 index. Conclusions The small ethnic differences in type 2 diabetes risk associated with scores of a priori-defined dietary patterns may be due to different consumption patterns of food components and the fact that the original indexes were not based on Asians and Pacific Islanders. PMID:25319012

  13. Importance of Simultaneous Evaluation of Multiple Risk Factors for Hemodialysis Patients’ Mortality and Development of a Novel Index: Dialysis Outcomes and Practice Patterns Study

    PubMed Central

    2015-01-01

    Background For hemodialysis (HD) patients, many risk factors for death are associated with each other intricately. However, they are often considered separately in clinical settings. We evaluated the maintenance HD patients’ risk of death within one year from multiple risk factors simultaneously considering their interrelationships using a novel index (survival index, SI) for HD patients in the United States developed using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Methods We analyzed data from 3899 and 3765 patients to develop and validate SI, respectively. To predict death within one year, candidate models were developed using logistic regression models. The final model was determined by comparing the accuracy among the models for the prediction of deaths. Results The model included age; body mass index; serum creatinine, albumin, total cholesterol and phosphorus levels; history of cardiovascular diseases; and arteriovenous fistula use. SI showed a higher accuracy in predicting death (c-statistic, 0.739) than geriatric nutritional risk index (0.647) and serum albumin level (0.637). The probability of death predicted on the basis of SI matched the observed number of deaths. Cox proportional hazard models for time-dependent SI showed that patients with low SI had a higher risk of death than patients with high SI [reference, Group 4 (26.1≤SI)]; Group 1 (SI<12.7), adjusted hazard ratio, 7.97 (95% CI, 5.02, 12.65); Group 2 (12.7≤SI<19.0), 3.18 (95% CI, 1.96, 5.16); Group 3 (19.0≤SI<26.1), 2.20 (95% CI, 1.33, 3.66). Conclusion Results of this study suggest that the simultaneous evaluation of multiple risk factors can more accurately assess patients’ prognosis and identify patients at an increased risk of death than single factors. PMID:26030526

  14. Energy and macronutrient intake and risk of differentiated thyroid carcinoma in the European Prospective Investigation into Cancer and Nutrition study.

    PubMed

    Zamora-Ros, Raul; Rinaldi, Sabina; Tsilidis, Konstantinos K; Weiderpass, Elisabete; Boutron-Ruault, Marie-Christine; Rostgaard-Hansen, Agnetha Linn; Tjønneland, Anne; Clavel-Chapelon, Françoise; Mesrine, Sylvie; Katzke, Verena A; Kühn, Tilman; Förster, Jana; Boeing, Heiner; Trichopoulou, Antonia; Lagiou, Pagona; Klinaki, Eleni; Masala, Giovanna; Sieri, Sabina; Ricceri, Fulvio; Tumino, Rosario; Mattiello, Amalia; Peeters, Petra H M; Bueno-de-Mesquita, H B As; Engeset, Dagrun; Skeie, Guri; Argüelles, Marcial; Agudo, Antonio; Sánchez, María-José; Chirlaque, María-Dolores; Barricarte, Aurelio; Chamosa, Saioa; Almquist, Martin; Tosovic, Ada; Hennings, Joakim; Sandström, Maria; Schmidt, Julie A; Khaw, Kay-Thee; Wareham, Nicholas J; Cross, Amanda J; Slimani, Nadia; Byrnes, Graham; Romieu, Isabelle; Riboli, Elio; Franceschi, Silvia

    2016-01-01

    Incidence rates of differentiated thyroid carcinoma (TC) have increased in many countries. Adiposity and dietary risk factors may play a role, but little is known on the influence of energy intake and macronutrient composition. The aim of this study was to investigate the associations between TC and the intake of energy, macronutrients, glycemic index (GI) and glycemic load in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,274 middle-age participants (70.2% women) from ten European countries. Dietary data were collected using country-specific validated dietary questionnaires. Total carbohydrates, proteins, fats, saturated, monounsaturated and polyunsaturated fats (PUFA), starch, sugar, and fiber were computed as g/1,000 kcal. Multivariable Cox regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence interval (CI) by intake quartile (Q). After a mean follow-up time of 11 years, differentiated TC was diagnosed in 556 participants (90% women). Overall, we found significant associations only with total energy (HRQ4 vs .Q1 , 1.29; 95% CI, 1.00-1.68) and PUFA intakes (HRQ4 vs .Q1 , 0.74; 95% CI, 0.57-0.95). However, the associations with starch and sugar intake and GI were significantly heterogeneous across body mass index (BMI) groups, i.e., positive associations with starch and GI were found in participants with a BMI ≥ 25 and with sugar intake in those with BMI < 25. Moreover, inverse associations with starch and GI were observed in subjects with BMI < 25. In conclusion, our results suggest that high total energy and low PUFA intakes may increase the risk of differentiated TC. Positive associations with starch intake and GI in participants with BMI ≥ 25 suggest that those persons may have a greater insulin response to high starch intake and GI than lean people. PMID:26190646

  15. Development and validation of risk index for cognitive decline using blood-derived markers

    PubMed Central

    Ayonayon, Hilsa; Harris, Tamara; Phillips, Caroline; Rosano, Caterina; Satterfield, Suzanne; Yaffe, Kristine

    2015-01-01

    Objective: We sought to develop and validate a risk index for prospective cognitive decline in older adults based on blood-derived markers. Methods: The index was based on 8 markers that have been previously associated with cognitive aging: APOE genotype, plasma β-amyloid 42/40 ratio, telomere length, cystatin C, glucose, C-reactive protein, interleukin-6, and albumin. The outcome was person-specific cognitive slopes (Modified Mini-Mental State Examination) from 11 years of follow-up. A total of 1,445 older adults comprised the development sample. An index based on dichotomized markers was divided into low-, medium-, and high-risk categories; the risk categories were validated with the remaining sample (n = 739) using linear regression. Amyloid was measured on a subsample (n = 865) and was included only in a secondary index. Results: The risk categories showed significant differences from each other and were predictive of prospective cognitive decline in the validation sample, even after adjustment for age and baseline cognitive score: the low-risk group (24.8%) declined 0.32 points/y (95% confidence interval [CI]: −0.46, −0.19), the medium-risk group (58.7%) declined 0.55 points/y (95% CI: −0.65, 0.45), and the high-risk group (16.6%) declined 0.69 points/y (95% CI: −0.85, −0.54). Using the secondary index, which included β-amyloid 42/40 (validation n = 279), the low-risk group (26.9%) declined 0.20 points/y (95% CI: −0.42, 0.01), the medium-risk group (61.3%) declined 0.55 points/y (95% CI: −0.72, −0.38), and the high-risk group (11.8%) declined 0.83 points/y (95% CI: −1.14, −0.51). Conclusions: A risk index based on 8 blood-based markers was modestly able to predict cognitive decline over an 11-year follow-up. Further validation in other cohorts is necessary. PMID:25609760

  16. Diet and Colorectal Cancer Risk: Evaluation of a Nutrition Education Leaflet

    ERIC Educational Resources Information Center

    Dyer, K. J.; Fearon, K. C. H.; Buckner, K.; Richardson, R. A.

    2005-01-01

    Objective: To evaluate the effect of a needs-based, nutrition education leaflet on nutritional knowledge. Design: Comparison of nutritional knowledge levels before and after exposure to a nutrition education leaflet. Setting: A regional colorectal out-patient clinic in Edinburgh. Method: A nutrition education leaflet, based on an earlier…

  17. Consumer adoption of personalised nutrition services from the perspective of a risk-benefit trade-off.

    PubMed

    Berezowska, Aleksandra; Fischer, Arnout R H; Ronteltap, Amber; van der Lans, Ivo A; van Trijp, Hans C M

    2015-11-01

    Through a Privacy Calculus (i.e. risk-benefit trade-off) lens, this study identifies factors that contribute to consumers' adoption of personalised nutrition services. We argue that consumers' intention to adopt personalised nutrition services is determined by perceptions of Privacy Risk, Personalisation Benefit, Information Control, Information Intrusiveness, Service Effectiveness, and the Benevolence, Integrity, and Ability of a service provider. Data were collected in eight European countries using an online survey. Results confirmed a robust and Europe-wide applicable cognitive model, showing that consumers' intention to adopt personalised nutrition services depends more on Perceived Personalisation Benefit than on Perceived Privacy Risk. Perceived Privacy Risk was mainly determined by perceptions of Information Control, whereas Perceived Personalisation Benefit primarily depended on Perceived Service Effectiveness. Services that required increasingly intimate personal information, and in particular DNA, raised consumers' Privacy Risk perceptions, but failed to increase perceptions of Personalisation Benefit. Accordingly, to successfully exploit personalised nutrition, service providers should convey a clear message regarding the benefits and effectiveness of personalised nutrition services. Furthermore, service providers may reduce Privacy Risk by increasing consumer perceptions of Information Control. To enhance perceptions of both Information Control and Service Effectiveness, service providers should make sure that consumers perceive them as competent and reliable. PMID:26407608

  18. A new comorbidities index for risk stratification for treatment of unruptured cerebral aneurysms.

    PubMed

    Newman, William C; Neal, Dan W; Hoh, Brian L

    2016-09-01

    OBJECTIVE Comorbidities have an impact on risk stratification for outcomes in analyses of large patient databases. Although the Charlson Comorbidity Index (CCI) and the Elixhauser Comorbidity Index (ECI) are the most commonly used comorbidity indexes, these have not been validated for patients with unruptured cerebral aneurysms; therefore, the authors created a comorbidity index specific to these patients. METHODS The authors extracted all records involving unruptured cerebral aneurysms treated with clipping, coiling, or both from the Nationwide Inpatient Sample (2002-2010). They assessed the effect of 37 variables on poor outcome and used the results to create a risk score for these patients. The authors used a validation data set and bootstrapping to evaluate the new index and compared it to CCI and ECI in prediction of poor outcome, mortality, length of stay, and hospital charges. RESULTS The index assigns integer values (-2 to 7) to 20 comorbidities: neurological disorder, renal insufficiency, gastrointestinal bleeding, paralysis, acute myocardial infarction, electrolyte disorder, weight loss, metastatic cancer, drug abuse, arrhythmia, coagulopathy, cerebrovascular accident, psychosis, alcoholism, perivascular disease, valvular disease, tobacco use, hypothyroidism, depression, and hypercholesterolemia. Values are summed to determine a patient's risk score. The new index was better at predicting poor outcome than CCI or ECI (area under the receiver operating characteristic curve [AUC] 0.814 [95% CI 0.798-0.830], vs 0.694 and 0.712, respectively, for the other indices), and it was also better at predicting mortality (AUC 0.775 [95% CI 0.754-0.792], vs 0.635 and 0.657, respectively, for CCI and ECI). CONCLUSIONS This new comorbidity index outperforms the CCI and ECI in predicting poor outcome, mortality, length of stay, and total charges for patients with unruptured cerebral aneurysm. Reevaluation of other patient cohorts is warranted to determine the impact of

  19. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic

    PubMed Central

    Dizdar, Oguzhan Sıtkı; Baspınar, Osman; Kocer, Derya; Dursun, Zehra Bestepe; Avcı, Deniz; Karakükcü, Cigdem; Çelik, İlhami; Gundogan, Kursat

    2016-01-01

    Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission. PMID:26938553

  20. Safety nets can help address the risks to nutrition from increasing climate variability.

    PubMed

    Alderman, Harold

    2010-01-01

    Models of climate change predict increased variability of weather as well as changes in agro-ecology. The increased variability will pose special challenges for nutrition. This study reviews evidence on climate shocks and nutrition and estimates the economic consequences in terms of reduced schooling and economic productivity stemming from nutritional insults in childhood. Panel data covering up to 20 y indicate that that short-term climate shocks have long-term impacts on children that persist, often into their adult lives. Other studies document the potential for relief programs to offset these shocks providing that the programs can be implemented with flexible financing, rapid identification of those affected by the shock, and timely scale-up. The last of these presumes that programs are already in place with contingency plans drawn up. Arguably, direct food distribution, including that of ready-to-use therapeutic food, may be part of the overall strategy. Even if such programs are too expensive for sustainable widespread use in the prevention of malnutrition, scalable food distribution programs may be cost effective to address the heightened risk of malnutrition following weather-related shocks. PMID:19923387

  1. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic.

    PubMed

    Dizdar, Oguzhan Sıtkı; Baspınar, Osman; Kocer, Derya; Dursun, Zehra Bestepe; Avcı, Deniz; Karakükcü, Cigdem; Çelik, İlhami; Gundogan, Kursat

    2016-03-01

    Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient's admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission. PMID:26938553

  2. Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009-2010.

    PubMed

    Kim, Yirang; Han, Byoung-Duck; Han, Kyungdo; Shin, Koh Eun; Lee, Halla; Kim, Tae Ri; Cho, Kyung Hwan; Kim, Do Hoon; Kim, Yang Hyun; Kim, Hyunjin; Nam, Ga Eun

    2015-11-01

    The possible association between low skeletal muscle mass and cardiovascular disease (CVD) risk factors necessitates estimation of muscle mass even in subjects with normal body mass index (BMI). This study was aimed to investigate optimal cutoffs for skeletal muscle mass reflecting CVD risk factors and to evaluate the relationship between skeletal muscle mass and CVD risk factors in the general population and in subjects with normal BMI using these cutoffs. This cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey 2009-2010. We enrolled 5120 men and 6559 women aged ≥20 years. Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass measured by dual-energy X-ray absorptiometry. Using receiver operating characteristic curve analyses, SMI cutoffs associated with CVD risk factors were determined. Lower SMI was significantly associated with an increased prevalence of CVD risk factors. The first cutoffs in men and women were 32 and 25%, respectively, and the second cutoffs were 30 and 23.5%. Subjects in stage I and stage II SMI categories showed increased prevalence and risk for several CVD risk factors. These tendencies persisted in the association between cardiometabolic characteristics and SMI even in subjects with normal BMI. Using cutoffs of low skeletal muscle mass reflecting CVD risk factors, lower skeletal muscle mass was associated with increased prevalence and risk of several CVD risk factors. A higher prevalence of cardiometabolic abnormalities was observed among subjects with normal BMI but low skeletal muscle mass. PMID:25862070

  3. Development of nutritionally at-risk young children is predicted by malaria, anemia, and stunting in Pemba, Zanzibar

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nutritionally at-risk children suffer delays in physical growth and motor and language development. Infectious diseases such as malaria pose an additional risk. We examined the cross-sectional relationships among malaria infection, hemoglobin (Hb) concentration, length-for-age Z-scores (LAZ), motor ...

  4. Innovation in drought risk management: exploring the potential of weather index insurance

    NASA Astrophysics Data System (ADS)

    Iglesias, E.; Baez, K.

    2012-04-01

    Many family farming and indigenous communities depend on grazing livestock activities and are particularly prone to drought risks. Vulnerability to drought limits the ability of these households to exit poverty and in many cases leads to environmental degradation. It is well known that uninsured exposure exacerbates income inequality in farming systems and eventually results in welfare losses for rural families. The advantages of farmers who have access to financial tools have been widely acknowledged. However, high administrative costs of traditional insurance hinder small farmers' access to risk management tools. One of the main problems in insurance design relates to the lack of quality data to estimate the risk premium. In rural areas where there are no historical records of farm production data on adverse events such as drought. New technologies such as remote sensing help to overcome this problem and generate information from these areas that otherwise would be impossible or too expensive to obtain. In this paper, we use a satellite based vegetation index (NDVI) and develop a stochastic model to analyse the potential of index insurance to address the risk of drought in Chilean grazing lands. Our results suggest that contract design is a key issue to improve the correlation of the index with individual farm losses, thus reducing basis risk. In particular, we find that the definition of homogeneous areas and the selection of the triggering index threshold are critical issues and show the incidence of different contract designs on (i) the probability that the farmer experience losses but does not receive compensation (false negative) and (ii) the probability that the index triggers compensation but the farmer does not experience drought losses (false negative). Both aspects are key issues to offer the farmer an adequate protection against droughts and guarantee the affordability of the risk premium.

  5. The serum lipoprotein profile in veterans with paraplegia: the relationship to nutritional factors and body mass index.

    PubMed

    Zlotolow, S P; Levy, E; Bauman, W A

    1992-07-01

    Individuals with spinal cord injury have a shortened life expectancy, with coronary heart disease as a leading cause of death. Identifying potentially reversible risk factors would be expected to be of value in the long-term care of the person with a spinal cord injury. We addressed the relationships among diet, body mass index, and serum lipid levels in 28 veterans with paraplegia compared to 52 age-matched ambulatory veteran controls. There are no significant differences in body mass index or in total caloric, saturated fat, or cholesterol intake between those with paraplegia and the control group. The serum HDL cholesterol level is significantly lower in those with paraplegia compared to the control group (35 +/- 2 vs 49 +/- 2 mg/dL). There are no significant differences noted in serum total cholesterol, LDL cholesterol, or triglycerides between the groups. Total caloric intake decreases significantly with age in the control subjects but not in the subjects with paraplegia. Inverse correlations are found between serum HDL cholesterol and serum triglycerides levels both in those with paraplegia (r = -0.54, p less than 0.005) and in the controls (r = -0.42, p less than 0.001). In our group of subjects with paraplegia, serum lipid levels appear to be independent of dietary intake and body weight. PMID:1500941

  6. Sports Nutrition.

    ERIC Educational Resources Information Center

    Houtkooper, Linda; And Others

    This kit provides coaches, physical education teachers, and health professionals with current nutrition information and guidelines for applying that information in classes and athletic training programs. The kit contains four components. A "Key Terms" section provides an index to nutrition-fitness terminology and concepts. The instructional…

  7. Nutrition and physical activity randomized control trial in child care centers improves knowledge, policies, and children’s body mass index

    PubMed Central

    2014-01-01

    Background To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children’s body mass index (BMI). Methods A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center’s written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children’s nutritional intake, physical activity, and height and weight pre- and post-intervention. Results Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers’ and parents’ knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children’s zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. Conclusions The NAP SACC intervention, as delivered by

  8. The physical and empirical basis for a specific clear-air turbulence risk index

    NASA Technical Reports Server (NTRS)

    Keller, J. L.

    1986-01-01

    The fundamental emphasis of this research was to develop a technique which would be a significant improvement over those currently used for flight planning to avoid clear air turbulence (CAT). The technique should, ideally, be both quantitative in determining potential intensity and specific in locating regions of relatively high risk. Furthermore, it should not rely on specialized data but be functional using the currently available rawinsonde observation (raob) system. Encouraging results documented in an earlier investigation were considered compelling enough to warrant a closer look into the possibilities of a Specific Clear Air Turbulence Risk (SCATR) index approach to the clear air turbulence problem. Unlike that research, which considered sustained periods of flight in light to moderate clear air turbulence, this study focuses on several cases of documented severe CAT. Results of these case studies suggest that a SCATR index is not an unrealizable goal and that uses of such an index, event in its current prototype level of development, are also apparent.

  9. Parent/Student Risk and Protective Factors in Understanding Early Adolescent's Body Mass Index

    ERIC Educational Resources Information Center

    Fitzpatrick, Kevin M.; Willis, Don

    2016-01-01

    This article's aim is to examine correlates of middle school students' body mass index (BMI). Little research simultaneously has considered both child and parent correlates in predicting child's BMI; we examine the interrelationships between middle school students and their parent's risks and protective factors and their impact on the child's BMI.…

  10. The Aggregate Risk Index: An intuitive tool providing the health risks of air pollution to health care community and public

    NASA Astrophysics Data System (ADS)

    Sicard, Pierre; Talbot, Charles; Lesne, Olivia; Mangin, Antoine; Alexandre, Nicolas; Collomp, Rémy

    2012-01-01

    In the framework of the European project PASODOBLE (FP7), we set up downstream information services by combining environmental and health data with a view to support the health care community and to improve vulnerable people welfare. Indeed there is a profound relationship between human health, well-being and air pollution levels. The main objectives are to establish correlations between air quality, exposure of populations and their reactivity, to develop and validate air quality indexes and to construct a prediction model of this sanitary index. This index will be implemented on 3 European sites: Greece (Athens and Thessaloniki), the Netherlands and "Provence Alpes Côte d'Azur" (South East of France). The selected region and cities are among the most affected by the atmospheric pollution in Europe and leads to serious sanitary concerns. The service aims to provide up-to-date, detailed information on air quality discomfort. The Aggregate Risk Index is based on the Cairncross's concept, obtained from the Relative Risk associated with short-term exposure to common air pollutants and takes into account the possible effects of a mixture of pollutants. This communication tool, easy to use and intuitive, about the levels of air pollution and the associated health risks, will be used to communicate information to the general population, authorities and to the health care community and will provide advanced warning of potentially health-damaging air pollution events.

  11. [Relationship between groundwater quality index of nutrition element and organic matter in riparian zone and water quality in river].

    PubMed

    Hua-Shan, Xu; Tong-Qian, Zhao; Hong-Q, Meng; Zong-Xue, Xu; Chao-Hon, Ma

    2011-04-01

    Riparian zone hydrology is dominated by shallow groundwater with complex interactions between groundwater and surface water. There are obvious relations of discharge and recharge between groundwater and surface water. Flood is an important hydrological incident that affects groundwater quality in riparian zone. By observing variations of physical and chemical groundwater indicators in riparian zone at the Kouma section of the Yellow River Wetland, especially those took place in the period of regulation for water and sediment at the Xiaolangdi Reservoir, relationship between the groundwater quality in riparian zone and the flood water quality in the river is studied. Results show that there will be great risk of nitrogen, phosphorus, nitrate nitrogen and organic matter permeating into the groundwater if floodplain changes into farmland. As the special control unit of nitrogen pollution between rivers and artificial wetlands, dry fanning areas near the river play a very important role in nitrogen migration between river and groundwater. Farm manure as base fertilizer may he an important source of phosphorus leak and loss at the artificial wetlands. Phosphorus leaks into the groundwater and is transferred along the hydraulic gradient, especially during the period of regulation for water and sediment at the Xiaolangdi Reservoir. The land use types and farming systems of the riparian floodplain have a major impact on the nitrate nitrogen contents of the groundwater. Nitrogen can infiltrate and accumulate quickly at anaerobic conditions in the fish pond area, and the annual nitrogen achieves a relatively balanced state in lotus area. In those areas, the soil is flooded and at anaerobic condition in spring and summer, nitrogen infiltrates and denitrification significantly, but soil is not flooded and at aerobic condition in the autumn and winter, and during these time, a significant nitrogen nitrification process occurs. In the area between 50 m and 200 m from the river

  12. Combined genetic and nutritional risk models of triple negative breast cancer.

    PubMed

    Lee, Eunkyung; Levine, Edward A; Franco, Vivian I; Allen, Glenn O; Gong, Feng; Zhang, Yanbin; Hu, Jennifer J

    2014-01-01

    Triple negative breast cancer (TNBC) presents clinical challenges due to unknown etiology, lack of treatment targets, and poor prognosis. We examined combined genetic and nutritional risk models of TNBC in 354 breast cancer cases. We evaluated 18 DNA-repair nonsynonymous single nucleotide polymorphisms (nsSNPs) and dietary/nutritional intakes. Multivariate Adaptive Regression Splines models were used to select nutrients of interest and define cut-off values for logistic regression models. Our results suggest that TNBC was associated with 6 DNA-repair nsSNPs, ERCC4 R415Q (rs1800067), MSH3 R940Q (rs184967), MSH6 G39E (rs1042821), POLD1 R119H (rs1726801), XRCC1 R194W (rs1799782), and XPC A499V (rs2228000) and/or deficiencies in 3 micronutrients (zinc, folate, and β-carotene). Combined analyses of these 6 nsSNPs and 3 micronutrients showed significant association with TNBC: odds ratios = 2.77 (95% confidence interval = 1.01-7.64) and 10.89 (95% confidence interval = 3.50-33.89) for 2 and at least 3 risk factors, respectively. To the best of our knowledge, this is the first study to suggest that multiple genetic and nutritional factors are associated with TNBC, particularly in combination. Our findings, if validated in larger studies, will have important clinical implication that dietary modulations and/or micronutrient supplementations may prevent or reverse TNBC phenotype, so tumors can be treated with less toxic therapeutic strategies, particularly in genetically susceptible women. PMID:25023197

  13. Parenteral Nutrition and Infection Risk in the Intensive Care Unit: A Practical Guide for the Bedside Clinician.

    PubMed

    McCleary, Emily J; Tajchman, Sharla

    2016-08-01

    The safety of parenteral nutrition (PN) administration in critically ill patients has been the subject of much controversy. Historically, PN administration has been associated with an increased risk of bacterial and fungal infections, leading to significant morbidity and mortality. Much of the data showing increased infectious complications compared with either no nutrition or enteral nutrition was derived from early studies conducted in the 1980s-2000s. Poor glucose control and hyperalimentation are confounding factors in many early studies, making it difficult to determine the true PN infection risks. While PN studies conducted during the past 10 years have failed to show the same infection rates, these risks continue to be cited as dogma. Potential reasons for such discordant results include improved glycemic control, avoidance of overfeeding, and improved sterility and central venous catheter care. Understanding the true infectious risk of PN administration in the intensive care unit is necessary to optimize patient care, as inappropriately withholding such nutrition is potentially deleterious. This review is meant to serve as a practical guide to the bedside clinician who is evaluating the risks and benefits of initiating PN in a critically ill patient. Each component of PN will be evaluated based on risk of infection, and the potential ways to mitigate risks will be discussed. PMID:27317614

  14. Job level risk assessment using task level strain index scores: a pilot study.

    PubMed

    Drinkaus, Phillip; Bloswick, Donald S; Sesek, Richard; Mann, Clay; Bernard, Thomas

    2005-01-01

    This paper explores 2 methods of modifying the Strain Index (SI) to assess the ergonomic risk of multi-task jobs. Twenty-eight automotive jobs (15 cases and 13 controls) were studied. The first method is based on the maximum task SI score, and the second method is modeled on the NIOSH Composite Lifting Index (CLI) algorithm, named cumulative assessment of risk to the distal upper extremity (CARD). Significant odds ratios of 11 (CI 1.7-69) and 24 (CI 2.4-240) were obtained using the modified maximum task and CARD, respectively. This indicates that modification of the SI may be useful in determining the risk of distal upper extremity injury associated with a multi-task job. PMID:15938764

  15. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States

    PubMed Central

    Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S.; Massey, Suena H.; Mayes, Linda C.; Ganiban, Jody M.; Reiss, David; Shaw, Daniel S.; Leve, Leslie D.; Neiderhiser, Jenae M.

    2016-01-01

    We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development. PMID:27010541

  16. The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States.

    PubMed

    Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S; Massey, Suena H; Mayes, Linda C; Ganiban, Jody M; Reiss, David; Shaw, Daniel S; Leve, Leslie D; Neiderhiser, Jenae M

    2016-01-01

    We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development. PMID:27010541

  17. Assessment of Under Nutrition Using Composite Index of Anthropometric Failure (CIAF) amongst Toddlers Residing in Urban Slums of Raipur City, Chhattisgarh, India

    PubMed Central

    Soni, G.P.; Jain, Kamlesh; Agrawal, Shubhra

    2015-01-01

    Introduction Several indicators have been used for measurement of under nutrition in the past. They are overlapping and none individually provide a comprehensive number of under nourished in the community. The effort has been to discuss the use of an alternative indicator of malnutrition – the composite index of anthropometric failure (CIAF). Aim To study the prevalence of under nutrition of Toddlers using CIAF and compare the prevalence of under nutrition obtained by primitive indicators and CIAF. Materials and Methods Cross-sectional community based study was carried out in urban slums of Raipur (C.G) during Jan 01,2014 to Sept 30, 2014 using sample size of 602. Slums were selected by multistage random sampling and the subjects were selected by convenient sampling, i.e. starting from a random point house to house survey was carried out until desired number of subjects (According to PPS) were covered assuming that slum population is evenly distributed. Attendant of Toddlers were interviewed with semi structured proforma and Height and Weight were measured by measuring tape and Salter’s weighing machine respectively. Informed consent was obtained. MS excel was used for data analysis after compilation. Results Girls and boys were 50% each. By CIAF the prevalence of under nutrition was found to be 62.1% while, Underweight, Stunting and Wasting showed it to be 45.2%, 46.6% and 17.8% respectively. Conclusion Primitive indices under estimate the burden of under nutrition and CIAF should be used a screening tool for assessing under nutrition. PMID:26393147

  18. Leukocytes as risk markers for cardiovascular disease in adolescents: association with birth characteristics, nutritional status and biochemical tests

    PubMed Central

    do Prado, Pedro Paulo; de Faria, Franciane Rocha; de Faria, Eliane Rodrigues; Franceschini, Sylvia do Carmo Castro; Priore, Silvia Eloiza

    2016-01-01

    Abstract Objective: To evaluate the correlation between the number of leukocytes and cardiovascular risks associated with birth characteristics, nutritional status and biochemical tests. Methods: Cross-sectional study developed with 475 adolescents, born between 1992 and 2001, in the municipality of Viçosa (MG). Maternal medical records were analyzed in the hospital units, and the following was recorded: birth weight and length, head circumference, chest circumference, Apgar score, gestational age. In adolescents, body mass index, skinfold thickness, body composition, blood count, biochemical tests and clinical variables were also assessed. The statistical analyses was carried out using Statistical Package for Social Sciences (SPSS) version 20.0 and Data Analysis and Statistical Software (STATA) with Kruskal–Wallis, Mann–Whitney, chi-square or Fisher's exact tests and Linear Regression. Significance level was set at α<0.05. The study was approved by the Research Ethics Committee of UFV for studies with human subjects. Results: Weight and birth length, head and chest circumference were higher among boys. In adolescents, the number of leukocytes was higher in individuals with excess weight and body fat and high adiposity index, waist-to-height ratio and waist circumference. Only altered triglycerides showed differences between leukocyte medians. Regardless of the anthropometric variable of the final regression model, the stage of adolescence, number of platelets, eosinophils, monocytes and lymphocytes were associated with the increase in leukocytes. Conclusions: The birth variables were not associated with changes in leukocyte numbers, whereas the anthropometric variables were good indicators for a higher leukocyte count, regardless of the stage of adolescence and gender. PMID:26572104

  19. The Healthy Eating Index 2005 and Risk for Pancreatic Cancer in the NIH–AARP Study

    PubMed Central

    2013-01-01

    Background Dietary pattern analyses characterizing combinations of food intakes offer conceptual and statistical advantages over food- and nutrient-based analyses of disease risk. However, few studies have examined dietary patterns and pancreatic cancer risk and none focused on the 2005 Dietary Guidelines for Americans. We used the Healthy Eating Index 2005 (HEI-2005) to estimate the association between meeting those dietary guidelines and pancreatic cancer risk. Methods We calculated the HEI-2005 score for 537 218 men and women in the National Institutes of Health–American Association of Retired Persons Diet and Health Study using responses to food frequency questionnaires returned in 1995 and 1996. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of pancreatic cancer according to HEI-2005 quintiles and explored effect modification by known risk factors. P interaction values were calculated using the Wald test. All statistical tests were two-sided. Results We identified 2383 incident, exocrine pancreatic cancer cases (median = 10.5 years follow-up). Comparing participants who met the most dietary guidelines (Q5) with those who met the fewest guidelines (Q1), we observed a reduced risk of pancreatic cancer (HR = 0.85, 95% CI = 0.74 to 0.97). Among men there was an interaction by body mass index (P interaction = .03), with a hazard ratio of 0.72 (95% CI = 0.59 to 0.88) comparing Q5 vs Q1 in overweight/obese men (body mass index ≥25kg/m2) but no association among normal weight men. Conclusions Our findings support the hypothesis that consuming a high-quality diet, as scored by the HEI-2005, may reduce the risk of pancreatic cancer. PMID:23949329

  20. Multifactorial Risk Index for Predicting Postoperative Respiratory Failure in Men After Major Noncardiac Surgery

    PubMed Central

    Arozullah, Ahsan M.; Daley, Jennifer; Henderson, William G.; Khuri, Shukri F.

    2000-01-01

    Objective To develop and validate a preoperative risk index for predicting postoperative respiratory failure (PRF). Summary Background Data Respiratory failure is an important postoperative complication. Method Based on a prospective cohort study, cases from 44 Veterans Affairs Medical Centers (n = 81,719) were used to develop the models. Cases from 132 Veterans Affairs Medical Centers (n = 99,390) were used as a validation sample. PRF was defined as mechanical ventilation for more than 48 hours after surgery or reintubation and mechanical ventilation after postoperative extubation. Ventilator-dependent, comatose, do not resuscitate, and female patients were excluded. Results PRF developed in 2,746 patients (3.4%). The respiratory failure risk index was developed from a simplified logistic regression model and included abdominal aortic aneurysm repair, thoracic surgery, neurosurgery, upper abdominal surgery, peripheral vascular surgery, neck surgery, emergency surgery, albumin level less than 30 g/L, blood urea nitrogen level more than 30 mg/dL, dependent functional status, chronic obstructive pulmonary disease, and age. Conclusions The respiratory failure risk index is a validated model for identifying patients at risk for developing PRF and may be useful for guiding perioperative respiratory care. PMID:10903604

  1. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions.

    PubMed

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission. PMID:26714309

  2. Weather-Related Flood and Landslide Damage: A Risk Index for Italian Regions

    PubMed Central

    Messeri, Alessandro; Morabito, Marco; Messeri, Gianni; Brandani, Giada; Petralli, Martina; Natali, Francesca; Grifoni, Daniele; Crisci, Alfonso; Gensini, Gianfranco; Orlandini, Simone

    2015-01-01

    The frequency of natural hazards has been increasing in the last decades in Europe and specifically in Mediterranean regions due to climate change. For example heavy precipitation events can lead to disasters through the interaction with exposed and vulnerable people and natural systems. It is therefore necessary a prevention planning to preserve human health and to reduce economic losses. Prevention should mainly be carried out with more adequate land management, also supported by the development of an appropriate risk prediction tool based on weather forecasts. The main aim of this study is to investigate the relationship between weather types (WTs) and the frequency of floods and landslides that have caused damage to properties, personal injuries, or deaths in the Italian regions over recent decades. In particular, a specific risk index (WT-FLARI) for each WT was developed at national and regional scale. This study has identified a specific risk index associated with each weather type, calibrated for each Italian region and applicable to both annual and seasonal levels. The risk index represents the seasonal and annual vulnerability of each Italian region and indicates that additional preventive actions are necessary for some regions. The results of this study represent a good starting point towards the development of a tool to support policy-makers, local authorities and health agencies in planning actions, mainly in the medium to long term, aimed at the weather damage reduction that represents an important issue of the World Meteorological Organization mission. PMID:26714309

  3. Managing the financial risk of low water levels in Great Lakes with index-based contracts

    NASA Astrophysics Data System (ADS)

    Meyer, E.; Characklis, G. W.; Brown, C. M.; Moody, P.

    2014-12-01

    Low water levels in the Great Lakes have recently had significant financial impacts on the region's commercial shipping, responsible for transporting millions of dollars' worth of bulk goods each year. Low lake levels can significantly affect shipping firms, as cargo capacity is a function of draft, or the distance between water level and the ship's bottom. Draft increases with weight, and lower lake levels force ships to reduce cargo to prevent running aground in shallow harbors, directly impacting the finances of shipping companies. Risk transfer instruments may provide adaptable, yet unexplored, alternatives for managing these financial risks, at significantly less expense than more traditional solutions (e.g., dredging). Index-based financial instruments can be particularly attractive as contract payouts are directly linked to well-defined transparent metrics (e.g., lake levels), eliminating the need for subjective adjustors, as well as concerns over moral hazard. In developing such instruments, a major challenge is identifying an index that is well correlated with financial losses, and thus a contract that reliably pays out when losses are experienced (low basis risk). In this work, a relationship between lake levels and shipping revenues is developed, and actuarial analyses of the frequency and magnitude of revenue losses is completed using this relationship and synthetic water level data. This analysis is used to develop several types of index-based contracts. A standardized suite of binary contracts is developed, with each indexed to lake levels and priced according to predefined thresholds. These are combined to form portfolios with different objectives (e.g. options, collars), with optimal portfolio structure and length of coverage determined by limiting basis risk and contract cost, using simulations over the historic dataset. Results suggest that portfolios of these binary contracts can substantially reduce the risk of financial losses during periods of

  4. The spatial distribution characteristics of a comprehensive drought risk index in southwestern China and underlying causes

    NASA Astrophysics Data System (ADS)

    Han, Lanying; Zhang, Qiang; Ma, Pengli; Jia, Jianying; Wang, Jinsong

    2016-05-01

    Drought is a serious problem in southwestern China, where drought risk exceeds the national average. Climate change is likely to exacerbate the problem, thereby endangering China's food security. In this paper, we used the analytic hierarchy process and meteorological, geographic, soil, and remote-sensing data to develop a drought risk assessment model based on the drought hazard, environmental vulnerability, sensitivity and exposure of the values at risk, and capacity to prevent or mitigate the problem. Using the model, we assessed the drought risk (defined using a comprehensive drought risk index, R) and its spatial distribution in southwestern China and revealed complex zonality. The eastern part of the study area had an extremely high risk, and risk was generally greater in the north than in the south, and increased from southwest to northeast. The comprehensive risk ( R) was lowest in Yunnan province. It was highest in Sichuan Province and Chongqing Municipality. The contribution of the risk factors to R was highest for the capacity for prevention and mitigation, followed by the drought hazard, sensitivity and exposure, and environmental vulnerability.

  5. Endothelial function in a cardiovascular risk population with borderline ankle–brachial index

    PubMed Central

    Syvänen, Kari; Korhonen, Päivi; Partanen, Auli; Aarnio, Pertti

    2011-01-01

    Introduction: The diagnosis of peripheral arterial disease (PAD) can be made by measuring the ankle–brachial index (ABI). Traditionally ABI values > 1.00–1.40 have been considered normal and ABI ≤ 0.90 defines PAD. Recent studies, however, have shown that individuals with ABI values between 0.90–1.00 are also at risk of cardiovascular events. We studied this cardiovascular risk population subgroup in order to determine their endothelial function using peripheral arterial tonometry (PAT). Methods: We selected 66 individuals with cardiovascular risk and borderline ABI. They all had hypertension, newly diagnosed glucose disorder, metabolic syndrome, obesity, or a ten year risk of cardiovascular disease death of 5% or more according to the Systematic Coronary Risk Evaluation System (SCORE). Subjects with previously diagnosed diabetes or cardiovascular disease were excluded. Endothelial function was assessed by measuring the reactive hyperemia index (RHI) from fingertips using an Endo-PAT device. Results: The mean ABI was 0.95 and mean RHI 2.11. Endothelial dysfunction, defined as RHI < 1.67, was detected in 15/66 (23%) of the subjects. There were no statistically significant differences in RHI values between subjects with different cardiovascular risk factors. The only exception was that subjects with impaired fasting glucose (IFG) had slightly lower RHI values (mean RHI 1.91) than subjects without IFG (mean RHI 2.24) (P = 0.02). Conclusions: In a cardiovascular risk population with borderline ABI nearly every fourth subject had endothelial dysfunction, indicating an elevated risk of cardiovascular events. This might point out a subgroup of individuals in need of more aggressive treatment for their risk factors. PMID:21415923

  6. Early and Long-term Undernutrition in Female Rats Exacerbates the Metabolic Risk Associated with Nutritional Rehabilitation.

    PubMed

    Lizárraga-Mollinedo, Esther; Fernández-Millán, Elisa; García-San Frutos, Miriam; de Toro-Martín, Juan; Fernández-Agulló, Teresa; Ros, Manuel; Álvarez, Carmen; Escrivá, Fernando

    2015-07-31

    Human studies have suggested that early undernutrition increases the risk of obesity, thereby explaining the increase in overweight among individuals from developing countries who have been undernourished as children. However, this conclusion is controversial, given that other studies do not concur. This study sought to determine whether rehabilitation after undernutrition increases the risk of obesity and metabolic disorders. We employed a published experimental food-restriction model. Wistar female rats subjected to severe food restriction since fetal stage and controls were transferred to a moderately high-fat diet (cafeteria) provided at 70 days of life to 6.5 months. Another group of undernourished rats were rehabilitated with chow. The energy intake of undernourished animals transferred to cafeteria formula exceeded that of the controls under this regime and was probably driven by hypothalamic disorders in insulin and leptin signal transduction. The cafeteria diet resulted in greater relative increases in both fat and lean body mass in the undernourished rats when compared with controls, enabling the former group to completely catch up in length and body mass index. White adipose tissues of undernourished rats transferred to the high-lipid regime developed a browning which, probably, contributed to avoid the obesigenic effect observed in controls. Nevertheless, the restricted group rehabilitated with cafeteria formula had greater accretion of visceral than subcutaneous fat, showed increased signs of macrophage infiltration and inflammation in visceral pad, dyslipidemia, and ectopic fat accumulation. The data indicate that early long-term undernutrition is associated with increased susceptibility to the harmful effects of nutritional rehabilitation, without causing obesity. PMID:26105051

  7. Development of prolonged standing strain index to quantify risk levels of standing jobs.

    PubMed

    Halim, Isa; Omar, Abdul Rahman

    2012-01-01

    Many occupations in industry such as metal stamping workers, electronics parts assembly operators, automotive industry welders, and lathe operators require working in a standing posture for a long time. Prolonged standing can contribute to discomfort and muscle fatigue particularly in the back and legs. This study developed the prolonged standing strain index (PSSI) to quantify the risk levels caused by standing jobs, and proposed recommendations to minimize the risk levels. Risk factors associated with standing jobs, such as working posture, muscles activity, standing duration, holding time, whole-body vibration, and indoor air quality, were the basis for developing the PSSI. All risk factors were assigned multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness. multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness. PMID:22429532

  8. Assessment of ICU readmission risk with the Stability and Workload Index for Transfer score*

    PubMed Central

    Oakes, Daiane Ferreira; Borges, Ingrid Nemitz Krás; Forgiarini, Luiz Alberto; Rieder, Marcelo de Mello

    2014-01-01

    Patient discharge from the ICU is indicated on the basis of clinical evidence and the result of strategies aimed at improving health care. Nevertheless, some patients might be discharged too early. We attempted to identify risk factors for unplanned ICU readmission, using a score for risk assessment, designated the Stability and Workload Index for Transfer (SWIFT) score. We evaluated 100 patients discharged from an ICU and found that the SWIFT score can be used as a tool for improving the assessment of ICU patients and the appropriateness of ICU discharge, thus preventing readmission. PMID:24626273

  9. [Nutritional therapy of gout].

    PubMed

    Nickolai, Beate; Kiss, Caroline

    2016-01-01

    Nutrition and nutritional behaviours have been found to play a major role in the development of gout. Studies show that body mass index (BMI), as well as excessive intake of alcoholic beverages, meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee have been seen to decrease the risk of hyperuricemia and gout, as they increase the excretion of uric acid. Flares of gout are often caused by large meals and high alcohol consumption. Each additional intake of meat portion per day increases the risk of gout by 21 %. Taking total alcohol consumption into account, the risk of gout increases after one to two standard drinks. In contrast to previous assumptions purine-rich plant foods like legumes and vegetables do not increase the risk of gout. The current dietary guidelines take into account nutritional factors, which not only consider purine intake, but also their endogenous production and their influence on renal excretion. A balanced diet based on the Swiss healthy eating guideline pyramid as well as the Mediterranean diet is appropriate for this patient population. The treatment of gout is multi-faceted, since this patient population presents other comorbidities such as obesity, diabetes mellitus, dyslipidemia and hypertension. Collectively, these risk factors are diet dependent and require a treatment strategy that is centered on modifying one's nutrition and nutritional behaviours. The aim of such therapy is to educate the patient as well as treat the accompanying comorbidities with the goal of decreasing serum uric acid values. Motivated patients require consultation and follow-up care in order to be able to actively decrease the serum uric acid. PMID:27008448

  10. Body mass index and colon cancer risk in Chinese people: Menopause as an effect modifier

    PubMed Central

    Hou, Lifang; Ji, Bu-Tian; Blair, Aaron; Dai, Qi; Gao, Yu-Tang; Potter, John D.; Chow, Wong-Ho

    2006-01-01

    High body mass index (BMI) has consistently been associated with increased colon cancer risk in men, but not in women. It is hypothesised that menopause-related changes in oestrogen levels play a role in gender-specific risk patterns. Most studies have been conducted in Western countries, where high incidence rates are coupled with a high prevalence of obesity and relatively common use of hormone replacement therapy (HRT) in post-menopausal women. This study evaluated the correlation between body mass index (BMI) and colon cancer risk in a relatively lean population, comprising 931 cases and 1552 controls, in Shanghai, China, where HRT use was extremely rare among women, during 1990–1993. Among men, colon cancer risk significantly increased with increasing BMI (P-trend = 0.005). Among women, the risk varied with age and menopause status in a similar pattern. Within each menopause stratum, however, the BMI-related risk was similar for those aged under 55 years and those aged 55 years and over, indicating a menopause rather than age effect. Among pre-menopausal women, the odds ratios (ORs) for subjects in the highest versus lowest quintile were 1.9 (95% CI 1.1–4.9) for those under 55 years of age, and 2.2 (95% CI 1.4–8.2) for those aged 55 years and over. Among post-menopausal women, the corresponding ORs were 0.6 (95% CI 0.5–0.91) and 0.7 (95% CI 0.5–0.95), respectively. Our findings suggest that BMI predicts colon cancer risk in both genders. Among women, however, the risk is modified by menopause status, possibly through altered endogenous oestrogen levels. PMID:16321519

  11. Study on the application of the Kent index method on the risk assessment of disastrous accidents in subway engineering.

    PubMed

    Lu, Hao; Wang, Mingyang; Yang, Baohuai; Rong, Xiaoli

    2013-01-01

    With the development of subway engineering, according to uncertain factors and serious accidents involved in the construction of subways, implementing risk assessment is necessary and may bring a number of benefits for construction safety. The Kent index method extensively used in pipeline construction is improved to make risk assessment much more practical for the risk assessment of disastrous accidents in subway engineering. In the improved method, the indexes are divided into four categories, namely, basic, design, construction, and consequence indexes. In this study, a risk assessment model containing four kinds of indexes is provided. Three kinds of risk occurrence modes are listed. The probability index model which considers the relativity of the indexes is established according to the risk occurrence modes. The model provides the risk assessment process through the fault tree method and has been applied in the risk assessment of Nanjing subway's river-crossing tunnel construction. Based on the assessment results, the builders were informed of what risks should be noticed and what they should do to avoid the risks. The need for further research is discussed. Overall, this method may provide a tool for the builders, and improve the safety of the construction. PMID:23710136

  12. Screening and risk factors of exocrine pancreatic insufficiency in critically ill adult patients receiving enteral nutrition

    PubMed Central

    2013-01-01

    Introduction Malnutrition is a frequent problem associated with detrimental clinical outcomes in critically ill patients. To avoid malnutrition, most studies focus on the prevention of inadequate nutrition delivery, whereas little attention is paid to the potential role of exocrine pancreatic insufficiency (EPI). In this trial, we aim to evaluate the prevalence of EPI and identify its potential risk factors in critically ill adult patients without preexisting pancreatic diseases. Methods In this prospective cross-sectional study, we recruited 563 adult patients with critical illnesses. All details of the patients were documented, stool samples were collected three to five days following the initiation of enteral nutrition, and faecal elastase 1 (FE-1) concentrations were assayed using an enzyme-linked immunosorbent assay kit. Blood samples were also taken to determine serum amylase and lipase activity. Results The percentages of recruited patients with EPI (FE-1 concentration <200 μg/g) and severe EPI (FE-1 concentration <100 μg/g) were 52.2% and 18.3%, respectively. The incidences of steatorrhea were significantly different (P < 0.05) among the patients without EPI, with moderate EPI (FE-1 concentration = 100 to 200 μg/g) and severe EPI (FE-1 concentration < 100 μg/g). Both multivariate logistic regression analysis and z-tests indicated that the occurrence of EPI was closely associated with shock, sepsis, diabetes, cardiac arrest, hyperlactacidemia, invasive mechanical ventilation and haemodialysis. Conclusions More than 50% of critically ill adult patients without primary pancreatic diseases had EPI, and nearly one-fifth of them had severe EPI. The risk factors for EPI included shock, sepsis, diabetes, cardiac arrest, hyperlactacidemia, invasive mechanical ventilation and haemodialysis. Trial registration NCT01753024 PMID:23924602

  13. Eating disorder risk, exercise dependence, and body weight dissatisfaction among female nutrition and exercise science university majors

    PubMed Central

    Harris, Natalie; Gee, David; D’Acquisto, Debra; Ogan, Dana; Pritchett, Kelly

    2015-01-01

    Background and Aims Past research has examined eating disorder risk among college students majoring in Nutrition and has suggested an increased risk, while other studies contradict these results. Exercise Science majors, however, have yet to be fully examined regarding their risk for eating disorders and exercise dependence. Based on pressures to fit the image associated with careers related to these two disciplines, research is warranted to examine the potential risk for both eating disorder and exercise dependence. The purpose of this study is to compare eating disorder risk, exercise dependence, and body weight dissatisfaction (BWD) between Nutrition and Exercise Science majors, compared to students outside of these career pathways. Methods Participants (n = 89) were divided into three groups based on major; Nutrition majors (NUTR; n = 31), Exercise Science majors (EXSC; n = 30), and other majors (CON; n = 28). Participants were given the EAT-26 questionnaire and the Exercise Dependence Scale. BWD was calculated as the discrepancy between actual BMI and ideal BMI. Results The majority of participants expressed a desire to weigh less (83%) and EXSC had significantly (p = .03) greater BWD than NUTR. However, there were no significant differences in eating disorder risk or exercise dependence among majors. Discussion and Conclusions This study suggested there was no significant difference in eating disorder risk or exercise dependence between the three groups (NUTR, EXSC, and CON). PMID:26551912

  14. A multidisciplinary QA program for enteral nutrition in high-risk patients.

    PubMed

    D'Addario, V; Danek, M

    1991-01-01

    An increase in elderly patients and severity of illness rates means greater use of nasogastric feeding tubes for both high-risk acutely ill and chronically ill patients. When the QA screening process at Booth Memorial Medical Center revealed a certain percentage of complications with small bore, weight-tipped feeding tubes inserted through the nares, a multidisciplinary peer review committee (MPRC) was formed to review the enteral nutrition program. After a literature review to determine possible complications, the MPRC identified lung perforations due to tube misplacement, tube feeding aspiration into the lungs leading to possible aspiration pneumonia, and an internal tip separation from the tube product failure. Unconscious incubated patients on ventilators were shown as at high risk for feeding tube misplacement in an initial MPRC patient study. A second study evaluated several different feeding tube products in the medical, respiratory and surgical ICU. The MPRC established a credentialing process for physician assistants, interns and residents in feeding tube placement. The MPRC proceedings were presented to the hospital-wide QA committee for review, endorsement and recommendations on all policy and procedure changes. The conclusions were that a more concerted effort must be made to improve medical management and encourage ongoing education in the administration of enteral feedings to high-risk patients. PMID:10113670

  15. Scanning laser edema index: a reliable tool to correlate with diabetic retinopathy and systemic risk factors?

    PubMed

    Peyman, Mohammadreza; Tajunisah, Iqbal; Loo, Angela; Chuah, Khai Choon; Subrayan, Visvaraja

    2012-01-01

    To correlate Heidelberg Retina Tomograph (HRT) derived macular edema (DME) index with severity of diabetic retinopathy and systemic factors. A total of 300 diabetic patients were recruited for the study for each of them a value for the macular edema index was obtained using the HRT II. Patients' age, gender, duration and type of diabetes mellitus, latest HbA1c result and presence or absence of co-morbid factors (hypertension, ischemic heart disease, nephropathy) were recorded together with the stage of diabetic retinopathy. These were correlated with DME. Out of 300 patients, HRT defined macula edema was seen in 68 patients (22.6%). There is a wider and higher range (95% percentile) of macula edema index in the severe non proliferative diabetic retinopathy (NPDR) group. Independent samples t test showed significant difference between the severe NPDR group and no DR group (p<0.001), mild NPDR group (p<0.05) and moderate NPDR group (p<0.05). A higher macula edema index was also found to have a low degree of correlation with more advanced stages of retinopathy (r=0.310; p<0.001). Also nephropathy showed a strong and significant correlation with DME. Hypertension had moderately significant correlation with DME. This study found no correlation between ischemic heart disease and DME. HRT derived scanning laser edema index is a reliable objective tool to evaluate diabetic retinopathy and systemic risk factors. PMID:22520399

  16. Assessment of cardiovascular risk in rheumatoid arthritis: impact of the new EULAR recommendations on the score cardiovascular risk index.

    PubMed

    Gómez-Vaquero, Carmen; Robustillo, Montserrat; Narváez, Javier; Rodríguez-Moreno, Jesús; González-Juanatey, Carlos; Llorca, Javier; Nolla, Joan Miquel; González-Gay, Miguel Angel

    2012-01-01

    To assess the impact of the application of the European League against Rheumatism (EULAR) task force recommendations in the cardiovascular (CV) risk of a series of Spanish patients diagnosed with rheumatoid arthritis (RA). Two hundred consecutive RA patients seen at the rheumatology outpatient clinics of Bellvitge Hospital, Barcelona, were studied. Information on clinical features of the disease, classic CV risk factors, and history of CV events was assessed. Both the systematic coronary risk evaluation (SCORE) CV risk index and the modified SCORE (mSCORE) according to the last EULAR recommendations were calculated. Based on the classic CV risk factors, the mean ± standard deviation SCORE was 2.1 ± 2.3% (median, 2; interquartile range [IQR], 1-3). Twenty-three (11%) patients were above the threshold of high CV risk for the Spanish population (≥5%). Following the EULAR recommendations, a change in the score was required in 119 (59%) patients. Therefore, the mean mSCORE was 2.7 ± 2.9% (median, 2; IQR, 1-3) and, due to this, 28 (14%) patients were above the threshold of high CV risk. Nine (5%) had at least one ischemic CV event. Patients with CV events were older and had more CV risk factors and higher SCORE and mSCORE than those without CV events. Although a large proportion of patients from this series fulfilled the criteria for the application of the EULAR recommendations, the final impact on the calculated CV risk was low and clinically significant in only a few patients. However, an association between the mSCORE and the presence of ischemic CV events was observed. PMID:21567119

  17. A disease risk index for patients undergoing allogeneic stem cell transplantation

    PubMed Central

    Gibson, Christopher J.; Cutler, Corey; Ho, Vincent T.; Koreth, John; Alyea, Edwin P.; Ritz, Jerome; Sorror, Mohamed L.; Lee, Stephanie J.; Deeg, H. Joachim; Storer, Barry E.; Appelbaum, Frederick R.; Antin, Joseph H.; Soiffer, Robert J.; Kim, Haesook T.

    2012-01-01

    The outcome of allogeneic HSCT varies considerably by the disease and remission status at the time of transplantation. Any retrospective or prospective HSCT study that enrolls patients across disease types must account for this heterogeneity; yet, current methods are neither standardized nor validated. We conducted a retrospective study of 1539 patients who underwent transplantation at Dana-Farber Cancer Institute/Brigham and Women's Hospital from 2000 to 2009. Using multivariable models for overall survival, we created a disease risk index. This tool uses readily available information about disease and disease status to categorize patients into 4 risk groups with significantly different overall survival and progression-free survival on the basis of primarily differences in the relapse risk. This scheme applies regardless of conditioning intensity, is independent of comorbidity index, and was validated in an independent cohort of 672 patients from the Fred Hutchinson Cancer Research Center. This simple and validated scheme could be used to risk-stratify patients in both retrospective and prospective HSCT studies, to calibrate HSCT outcomes across studies and centers, and to promote the design of HSCT clinical trials that enroll patients across diseases and disease states, increasing our ability to study nondisease-specific outcomes in HSCT. PMID:22709687

  18. Utility of the Shock Index and Other Risk-Scoring Tools in Patients with Gastrointestinal Bleeding.

    PubMed

    Ratra, Atul; Rassameehiran, Supannee; Parupudi, Sreeram; Nugent, Kenneth

    2016-03-01

    Patients with upper gastrointestinal (GI) bleeding frequently require hospitalization and have a mortality rate that ranges from 6% to 14%. These patients need rapid clinical assessment to determine the urgency of endoscopy and the need for endoscopic treatment. Risk-scoring tools, such as the Rockall score and the Glasgow-Blatchford score, are commonly used in this assessment. These tools clearly help identify high-risk patients but do not necessarily have good predictive value in identifying important outcomes. Their diagnostic accuracy in identifying rebleeding and mortality ranges from poor to fair. The shock index (heart rate divided by systolic blood pressure) provides an integrated assessment of the cardiovascular status. It can be easily calculated during the initial evaluation of patients and monitoring after treatment. The shock index has been used in a few studies in patients with acute GI bleeding, including studies to determine which patients need emergency endoscopy, to predict complications after corrosive ingestions, to identify delayed hemorrhage following pancreatic surgery, and to evaluate the utility of angiograms to identify sites of GI bleeding. Not all studies have found the shock index to be useful in patients with GI bleeding, however. This may reflect the unpredictable natural history of various etiologies of GI bleeding, comorbidity that may influence blood pressure and/or heart rate, and inadequate data acquisition. The shock index needs more formal study in patients with GI bleeding admitted to medical intensive care units. Important considerations include the initial response to resuscitation, persistent bleeding following initial treatment, and rebleeding following a period of stabilization. In addition, it needs correlation with other risk-scoring tools. PMID:26954657

  19. Assessment of Under Nutrition of Bangladeshi Adults Using Anthropometry: Can Body Mass Index Be Replaced by Mid-Upper-Arm-Circumference?

    PubMed Central

    Sultana, Tania; Karim, Md. Nazmul; Ahmed, Tahmeed; Hossain, Md. Iqbal

    2015-01-01

    Background and Objective Body-mass-index (BMI) is widely accepted as an indicator of nutritional status in adults. Mid-upper-arm-circumference (MUAC) is another anthropometric-measure used primarily among children. The present study attempted to evaluate the use of MUAC as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition, and thus to suggest a suitable cut-off value. Methods A cross-sectional study in 650 adult attendants of the patients of Dhaka-Hospital, of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) was conducted during 2012. Height, weight and MUAC of 260 male and 390 female aged 19–60 years were measured. Curve estimation was done to assess the linearity and correlation of BMI and MUAC. Sensitivity and specificity of MUAC against BMI<18.5 was determined. Separate Receiver-operating-characteristic (ROC) analyses were performed for male and female. Area under ROC curve and Youden's index were generated to aid selection of the most suitable cut-off value of MUAC for undernutrition. A value with highest Youden's index was chosen for cut-off. Results Our data shows strong significant positive correlation (linear) between MUAC and BMI, for males r = 0.81, (p<0.001) and for females r = 0.828, (p<0.001). MUAC cut-off <25.1 cm in males (AUC 0.930) and <23.9 cm in females (AUC 0.930) were chosen separately based on highest corresponding Youden's index. These values best correspond with BMI cut-off for under nutrition (BMI <18.5) in either gender. Conclusion MUAC correlates closely with BMI. For the simplicity and easy to remember MUAC <25 cm for male and <24 cm for female may be considered as a simpler alternative to BMI cut-off <18.5 to detect adult undernutrition. PMID:25875397

  20. Effect of a child care center-based obesity prevention program on body mass index and nutrition practices among preschool-aged children.

    PubMed

    Natale, Ruby A; Lopez-Mitnik, Gabriela; Uhlhorn, Susan B; Asfour, Lila; Messiah, Sarah E

    2014-09-01

    This study examined the effect of an early childhood obesity prevention program on changes in Body Mass Index (BMI) z-score and nutrition practices. Eight child care centers were randomly assigned to an intervention or attention control arm. Participants were a multiethnic sample of children aged 2 to 5 years old (N = 307). Intervention centers received healthy menu changes and family-based education focused on increased physical activity and fresh produce intake, decreased intake of simple carbohydrate snacks, and decreased screen time. Control centers received an attention control program. Height, weight, and nutrition data were collected at baseline and at 3, 6, and 12 months. Analysis examined height, weight, and BMI z-score change by intervention condition (at baseline and at 3, 6, and 12 months). Pearson correlation analysis examined relationships among BMI z-scores and home activities and nutrition patterns in the intervention group. Child BMI z-score was significantly negatively correlated with the number of home activities completed at 6-month post intervention among intervention participants. Similarly, intervention children consumed less junk food, ate more fresh fruits and vegetables, drank less juice, and drank more 1% milk compared to children at control sites at 6 months post baseline. Ninety-seven percent of those children who were normal weight at baseline were still normal weight 12 months later. Findings support child care centers as a promising setting to implement childhood obesity prevention programs in this age group. PMID:24662896

  1. Air quality trends and potential health effects - Development of an aggregate risk index

    NASA Astrophysics Data System (ADS)

    Sicard, Pierre; Lesne, Olivia; Alexandre, Nicolas; Mangin, Antoine; Collomp, Rémy

    2011-02-01

    The "Provence Alpes Côte d'Azur" (PACA) region, in the South East of France, is one of Europe's regions most influenced by the atmospheric pollution. During the last 15 years, the industrial emissions decrease caused an evolution of the atmospheric pollution nature. Nowadays, atmospheric pollution is more and more influenced by the road traffic, the dominating pollution source in urban zones for the PACA region. Combined with this intense road traffic, the strong hot season of the Mediterranean climate contributes to the region bad air quality; it is known to be one of the worse in Europe. The recognized air pollution effects over public health include increased risk of hospital admissions and mortality by respiratory or cardiovascular diseases. The combination of these serious pollution related health hazards with senior and children vulnerabilities leads to serious sanitary concerns. Over the 1990-2005 period, we obtained, using the non-parametric Mann-Kendall test from annual mortality dataset (CépiDC), decreasing trends for Asthma (-5.00% year -1), Cardiovascular (-0.73% year -1), Ischemic (-0.69% year -1) and cerebrovascular diseases (-3.10% year -1). However, for "Other heart diseases" (+0.10% year -1) and "Respiratory" (+0.10% year -1) an increase was observed. The development of an adequate tool to understand impacts of pollution levels is of utmost importance. Different pollutants have different health endpoints, information may be lost through the use of a single index consequently, in this study we present the modified formula of air quality index, based on Cairncross's concept the Aggregate Risk Index (ARI). ARI is based on the relative risk of the well-established increased daily mortality, or morbidity, enabling an assessment of additive effects of short-term exposure to the main air pollutants: PM 2.5, PM 10, SO 2, O 3 and NO 2 in order to account for the reality of the multiple exposures impacts of chemical agents. The ARI, developed per pathology

  2. The Association between Psoriasis Area and Severity Index and Cardiovascular Risk Factor in Korean Psoriasis Patients

    PubMed Central

    Ku, Sang Hyeon; Kwon, Won Joo; Cho, Eun Byul; Park, Eun Joo; Kim, Kwang Ho

    2016-01-01

    Background Psoriasis is associated with increased risk of cardiovascular morbidities, especially in severe cases. Severity of the disease has been known to be associated with higher prevalence of these risk factors. However, in the absence of robust measurements, studies to date relied mostly on treatment spectrum as a proxy for the severity. Objective To evaluate the relationship between psoriasis area and severity index (PASI) and cardiovascular risk factors in Korean patients. Methods Presence of diabetes mellitus (DM), hypertension, smoking history was surveyed through questionnaires and serum lipid profile analysis were done after fasting overnight. The severity of psoriasis was assessed using PASI scores: mild, <10; moderate to severe, ≥10. Cardiovascular risk factors such as smoking, hypertension, diabetes and dyslipidemia were compared between the mild group and moderate to severe group. The prevalence of diabetes and hypertension was compared among these two groups of psoriasis patients and the general population based control; age and gender were matched among three groups accordingly prior to analysis. Results A total of 256 patients with plaque type psoriasis were included. Between mild group and moderate to severe group, significant differences of cardiovascular risk factors including lipid profile were not discovered except in triglyceride level. Comparing to general population, prevalence of diabetes was found significantly higher in psoriasis patients while that of hypertension was similar. Conclusion Our results suggest that among cardiovascular risks, presence of DM and triglyceride level seem to be associated with the presence of psoriasis in Korean psoriasis patients, while other factors may not contribute meaningfully. PMID:27274635

  3. Association of body mass index with chromosome damage levels and lung cancer risk among males.

    PubMed

    Li, Xiaoliang; Bai, Yansen; Wang, Suhan; Nyamathira, Samuel Mwangi; Zhang, Xiao; Zhang, Wangzhen; Wang, Tian; Deng, Qifei; He, Meian; Zhang, Xiaomin; Wu, Tangchun; Guo, Huan

    2015-01-01

    Epidemiological studies have shown an etiological link between body mass index (BMI) and cancer risk, but evidence supporting these observations is limited. This study aimed to investigate potential associations of BMI with chromosome damage levels and lung cancer risk. First, we recruited 1333 male workers from a coke-oven plant to examine their chromosome damage levels; and then, a cohort study of 12,052 males was used to investigate the association of BMI with lung cancer incidence. We further carried out a meta-analysis for BMI and male lung cancer risk based on cohort studies. We found that men workers with excess body weight (BMI ≥ 25 kg/m(2)) had lower levels of MN frequencies than men with normal-weight (BMI: 18.5-24.9). Our cohort study indicated that, the relative risk (RR) for men with BMI ≥ 25 to develop lung cancer was 35% lower than RR for normal-weight men. Further meta-analysis showed that, compared to normal-weight men, men with BMI ≥ 25 had decreased risk of lung cancer among both the East-Asians and others populations. These results indicate that men with excess body weight had significant decreased chromosome damage levels and lower risk of lung cancer than those with normal-weight. However, further biological researches were needed to validate these associations. PMID:25820198

  4. Association of Body Mass Index with Chromosome Damage Levels and Lung Cancer Risk among Males

    PubMed Central

    Li, Xiaoliang; Bai, Yansen; Wang, Suhan; Nyamathira, Samuel Mwangi; Zhang, Xiao; Zhang, Wangzhen; Wang, Tian; Deng, Qifei; He, Meian; Zhang, Xiaomin; Wu, Tangchun; Guo, Huan

    2015-01-01

    Epidemiological studies have shown an etiological link between body mass index (BMI) and cancer risk, but evidence supporting these observations is limited. This study aimed to investigate potential associations of BMI with chromosome damage levels and lung cancer risk. First, we recruited 1333 male workers from a coke-oven plant to examine their chromosome damage levels; and then, a cohort study of 12 052 males was used to investigate the association of BMI with lung cancer incidence. We further carried out a meta-analysis for BMI and male lung cancer risk based on cohort studies. We found that men workers with excess body weight (BMI ≥ 25 kg/m2) had lower levels of MN frequencies than men with normal-weight (BMI: 18.5–24.9). Our cohort study indicated that, the relative risk (RR) for men with BMI ≥ 25 to develop lung cancer was 35% lower than RR for normal-weight men. Further meta-analysis showed that, compared to normal-weight men, men with BMI ≥ 25 had decreased risk of lung cancer among both the East-Asians and others populations. These results indicate that men with excess body weight had significant decreased chromosome damage levels and lower risk of lung cancer than those with normal-weight. However, further biological researches were needed to validate these associations. PMID:25820198

  5. Validity of a PCI Bleeding Risk Score in patient subsets stratified for body mass index

    PubMed Central

    Dobies, David R; Barber, Kimberly R; Cohoon, Amanda L

    2015-01-01

    Objective An accurate tool with good discriminative for bleeding would be useful to clinicians for improved management of all their patients. Bleeding risk models have been published but not externally validated in independent clinical data set. We chose the National Cardiovascular Data Registry (NCDR) percutaneous coronary intervention (PCI) score to validate within a large, multisite community data set. The aim of the study was validation of this Bleeding Risk Score (BRS) tool among a subgroup of patients based on body mass index. Methods This is a large-scale retrospective analysis of a current registry utilising data from a 37-hospital health system. The central repository of patients with coronary heart disease undergoing PCI between 1 June 2009 and 30 June 2012 was utilised to validate the NCDR PCI BRS among 4693 patients. The primary end point was major bleeding. Validation analysis calculating the receiver operating characteristic curve was performed. Results There were 143 (3%) major bleeds. Mean BRS was 14.7 (range 3–42). Incidence of bleeding by risk category: low (0.5%), intermediate (1.7%) and high risk (7.6%). Tool accuracy was poor to fair (area-under-the curve (AUC) 0.78 heparin, 0.65 bivalirudin). Overall accuracy was 0.71 (CI 0.66 to 0.76). Accuracy did not improve when confined to just the intermediate risk group (AUC 0.58; CI 0.55 to 0.67). Tool accuracy was the lowest among the low BMI group (AUC 0.62) though they are at increased risk of bleeding following PCI. Conclusions Bleeding risk tools have low predictive value even among subgroups of patients at higher risk. Adjustment for anticoagulation use resulted in poor discrimination because bivalirudin differentially biases outcomes toward no bleeding. The current state of bleeding risk tools provide little support for diagnostic utility in regards to major bleeding and therefore have limited clinical applicability. PMID:25745565

  6. Mendelian randomization study of body mass index and colorectal cancer risk

    PubMed Central

    Thrift, Aaron P.; Gong, Jian; Peters, Ulrike; Chang-Claude, Jenny; Rudolph, Anja; Slattery, Martha L.; Chan, Andrew T.; Locke, Adam E.; Kahali, Bratati; Justice, Anne E.; Pers, Tune H.; Gallinger, Steven; Hayes, Richard B; Baron, John A.; Caan, Bette J.; Ogino, Shuji; Berndt, Sonja I.; Chanock, Stephen J.; Casey, Graham; Haile, Robert W.; Du, Mengmeng; Harrison, Tabitha A.; Thornquist, Mark; Duggan, David J.; Le Marchand, Loïc; Lindor, Noralane M.; Seminara, Daniela; Song, Mingyang; Wu, Kana; Thibodeau, Stephen N.; Cotterchio, Michelle; Win, Aung Ko; Jenkins, Mark A.; Hopper, John L.; Ulrich, Cornelia M.; Potter, John D.; Newcomb, Polly A.; Hoffmeister, Michael; Brenner, Hermann; White, Emily; Hsu, Li; Campbell, Peter T.

    2015-01-01

    Background High body mass index (BMI) is consistently linked to increased risk of colorectal cancer (CRC) for men, whereas the association is less clear for women. As risk estimates from observational studies may be biased and/or confounded, we conducted a Mendelian randomization study to estimate the causal association between BMI and CRC. Methods We used data from 10,226 CRC cases and 10,286 controls of European ancestry. The Mendelian randomization analysis used a weighted genetic risk score, derived from 77 genome-wide association study identified variants associated with higher BMI, as an instrumental variable (IV). We compared the IV odds ratio (IV-OR) with the OR obtained using a conventional covariate-adjusted analysis. Results Individuals carrying greater numbers of BMI-increasing alleles had higher CRC risk (per weighted allele OR, 1.31; 95% confidence interval [CI], 1.10–1.57). Our IV estimation results support the hypothesis that genetically influenced BMI is directly associated with risk for CRC (IV-OR per 5 kg/m2, 1.50; 95% CI, 1.13–2.01). In the sex-specific IV analyses higher BMI was associated with higher risk of CRC among women (IV-OR per 5 kg/m2, 1.82; 95% CI, 1.26–2.61). For men, genetically influenced BMI was not associated with CRC (IV-OR per 5 kg/m2, 1.18; 95% CI, 0.73–1.92). Conclusions High BMI was associated with increased CRC risk for women. Whether abdominal obesity, rather than overall obesity, is a more important risk factor for men requires further investigation. Impact Overall, conventional epidemiologic and Mendelian randomization studies suggest a strong association between obesity and the risk of CRC. PMID:25976416

  7. Association between food and nutrition insecurity with cardiometabolic risk factors in childhood and adolescence: a systematic review

    PubMed Central

    Rocha, Naruna Pereira; Milagres, Luana Cupertino; de Novaes, Juliana Farias; Franceschini, Sylvia do Carmo Castro

    2016-01-01

    Abstract Objective: To address the association between food and nutrition insecurity and cardiometabolic risk factors in childhood and adolescence. Data source: Articles were selected from the Medline, Lilacs and SciELO databases with no publication date limit, involving children and adolescents, using the descriptors: food and nutrition security, diabetes mellitus, hypertension, metabolic syndrome, stress and dyslipidemia. The terms were used in Portuguese, English and Spanish. The search was carried out systematically and independently by two reviewers. Data synthesis: Exposure to food insecurity during childhood and adolescence ranged from 3.3% to 82% in the selected publications. Exposure to food insecurity was associated with stress, anxiety, greater chance of hospitalization, nutritional deficiencies, excess weight and inadequate diets with reduced intake of fruits and vegetables and increased consumption of refined carbohydrates and fats. Conclusions: Food and nutrition insecurity was associated with the presence of cardiometabolic risk factors in the assessed publications. Childhood and adolescence constitute a period of life that is vulnerable to food insecurity consequences, making it extremely important to ensure the regular and permanent access to food. Because this is a complex association, some difficulties are found, such as the synergy between risk factors, the assessment of heterogeneous groups and extrapolation of data to other populations, in addition to the influence of environmental factors. PMID:26564327

  8. VALIDATION OF A MODIFIED-MULTIDIMENSIONAL PROGNOSTIC INDEX (m-MPI) INCLUDING THE MINI NUTRITIONAL ASSESSMENT SHORT-FORM (MNA-SF) FOR THE PREDICTION OF ONE-YEAR MORTALITY IN HOSPITALIZED ELDERLY PATIENTS

    PubMed Central

    SANCARLO, D.; D’ONOFRIO, G.; FRANCESCHI, M.; SCARCELLI, C.; NIRO, V.; ADDANTE, F.; COPETTI, M.; FERRUCCI, L.; FONTANA, L.; PILOTTO, A.

    2016-01-01

    Background The mortality prediction represents a key factor in the managing of elderly hospitalized patients. Since in older subjects mortality results from a combination of biological, functional, nutritional, psychological and environmental factors, a Multidimensional Prognostic Index (MPI) that predict short- and long-term mortality based on a standardized comprehensive geriatric assessment (CGA) has recently been developed and validated. Objective This study compares the accuracy in predicting the mortality of the MPI with a modified version of the MPI (m-MPI) that included the Mini Nutritional Assessment-Short Form (MNA-SF) instead of the standard MNA. Design This prospective study with a one-year follow-up included 4088 hospitalized patients aged 65 years and older. A standardized CGA that included information on functional (Activities of Daily Living, ADL and Instrumental-ADL), cognitive (Short Portable Mental Status Questionnaire), risk of pressure sore (Exton-Smith Scale), comorbidities (CIRS Index), medications, living status and nutritional status (MNA and MNA-SF) was used to calculate the MPI using a previously validated algorithm. Results Higher MPI values were significantly associated with higher mortality rates with a close agreement between the estimated and the observed mortality both after 1-month (MPI1=2.8% versus m-MPI1=2.8%, p=0.946; MPI2=8.9% versus m-MPI2=9%, p=0.904; MPI3=21.9% versus m-MPI3=21.9, p=0.978) and 1-year of follow-up (MPI1=10.8% versus m-MPI1=10.5%, p=0.686; MPI2=27.3% versus m-MPI2=28%, p=0.495; MPI3=52.8% versus m-MPI3=52.7%, p=0.945). The estimated areas under the receiver operating characteristics (ROC) curves suggested a clinically negligible difference between the two indices. Conclusion The m-MPI is as sensitive as the MPI in stratifying hospitalized elderly patients into groups at varying risk of short- and long-term mortality, but with fewer items. PMID:21369662

  9. Nutritional Status, Body Surface, and Low Lean Body Mass/Body Mass Index Are Related to Dose Reduction and Severe Gastrointestinal Toxicity Induced by Afatinib in Patients With Non-Small Cell Lung Cancer

    PubMed Central

    De la Torre-Vallejo, Martha; López-Macías, Diego; Orta, David; Turcott, Jenny; Macedo-Pérez, Eleazar-Omar; Sánchez-Lara, Karla; Ramírez-Tirado, Laura-Alejandra; Baracos, Vickie E.

    2015-01-01

    Background. The main reason for dose reduction of afatinib is gastrointestinal toxicity (GT). In a phase II study, we analyzed anthropometrical, nutritional, and biochemical factors associated with GT induced by afatinib. Materials and Methods. Patients diagnosed with non-small cell lung cancer who progressed to prior chemotherapy received 40 mg of afatinib. Malnutrition was determined by Subjective Global Assessment, and lean body mass (LBM) was determined by computed tomography scan analysis using a pre-established Hounsfield unit threshold. Toxicity was obtained during four cycles by Common Terminology Criteria for Adverse Events. Results. Eighty-four patients were enrolled. Afatinib was administered as the second, third, and fourth line of treatment in 54.8%, 38.1%, and 7.12% of patients, respectively. Severe diarrhea, mucositis, and overall severe GT were present in 38.9%, 28.8%, and 57.5%, respectively. Of the patients, 50% developed dose-limiting toxicity (DLT). Patients with malnutrition have higher risk for severe GT. Patients with lower LBM and body mass index developed more DLT (71.4% vs. 18.8%). Conclusion. Malnutrition is associated with a higher risk of severe GT induced by afatinib. Determination of nutritional status and body composition are helpful in identifying patients at higher risk of severe GT and could allow initiating treatment with lower doses according to tolerance. Implications for Practice: Body composition analysis, specifically lean body mass quantification, and nutritional status assessment are significant clinical variables to take into account when assessing oncological patients. This study on patients with non-small cell lung cancer treated with afatinib showed the important impact that malnutrition and low lean body mass have on the risk for developing dose-limiting toxicity and severe gastrointestinal toxicity. Still more research needs to be done to explore dose adjustment according to lean body mass, especially in drugs that

  10. Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study.

    PubMed

    McKenzie, Fiona; Ferrari, Pietro; Freisling, Heinz; Chajès, Veronique; Rinaldi, Sabina; de Batlle, Jordi; Dahm, Christina C; Overvad, Kim; Baglietto, Laura; Dartois, Laureen; Dossus, Laure; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Krogh, Vittorio; Panico, Salvatore; Tumino, Rosario; Rosso, Stefano; Bueno-de-Mesquita, H B As; May, Anne; Peeters, Petra H; Weiderpass, Elisabete; Buckland, Genevieve; Sanchez, Maria-Jose; Navarro, Carmen; Ardanaz, Eva; Andersson, Anne; Sund, Malin; Ericson, Ulrika; Wirfält, Elisabet; Key, Tim J; Travis, Ruth C; Gunter, Marc; Riboli, Elio; Vergnaud, Anne-Claire; Romieu, Isabelle

    2015-06-01

    Breast cancer is the most common cancer among women and prevention strategies are needed to reduce incidence worldwide. A healthy lifestyle index score (HLIS) was generated to investigate the joint effect of modifiable lifestyle factors on postmenopausal breast cancer risk. The study included 242,918 postmenopausal women from the multinational European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, with detailed information on diet and lifestyle assessed at baseline. The HLIS was constructed from five factors (diet, physical activity, smoking, alcohol consumption and anthropometry) by assigning scores of 0-4 to categories of each component, for which higher values indicate healthier behaviours. Hazard ratios (HR) were estimated by Cox proportional regression models. During 10.9 years of median follow-up, 7,756 incident breast cancer cases were identified. There was a 3% lower risk of breast cancer per point increase of the HLIS. Breast cancer risk was inversely associated with a high HLIS when fourth versus second (reference) categories were compared [adjusted HR = 0.74; 95% confidence interval (CI): 0.66-0.83]. The fourth versus the second category of the HLIS was associated with a lower risk for hormone receptor double positive (adjusted HR = 0.81, 95% CI: 0.67-0.98) and hormone receptor double negative breast cancer (adjusted HR = 0.60, 95% CI: 0.40-0.90). Findings suggest having a high score on an index of combined healthy behaviours reduces the risk of developing breast cancer among postmenopausal women. Programmes which engage women in long term health behaviours should be supported. PMID:25379993

  11. Women's higher health risks in the obesogenic environment: a gender nutrition approach to metabolic dimorphism with predictive, preventive, and personalised medicine

    PubMed Central

    2013-01-01

    Women's evolution for nurturing and fat accumulation, which historically yielded health and longevity advantages against scarcity, may now be counteracted by increasing risks in the obesogenic environment, recently shown by narrowing gender health gap. Women's differential metabolism/disease risks, i.e. in fat accumulation/distribution, exemplified during puberty/adolescence, suggest gender dimorphism with obesity outcomes. Women's higher body fat percentage than men, even with equal body mass index, may be a better risk predictor. Differential metabolic responses to weight-reduction diets, with women's lower abdominal fat loss, better response to high-protein vs. high-carbohydrate diets, higher risks with sedentariness vs. exercise benefits, and tendency toward delayed manifestation of central obesity, metabolic syndrome, diabetes, cardiovascular disease, and certain cancers until menopause—but accelerated thereafter—suggest a need for differing metabolic and chronological perspectives for prevention/intervention. These perspectives, including women's differential responses to lifestyle changes, strongly support further research with a gender nutrition emphasis within predictive, preventive, and personalized medicine. PMID:23311512

  12. TRANSMISSION AND RISK FACTORS FOR LATENT TUBERCULOSIS INFECTIONS AMONG INDEX CASE-MATCHED HOUSEHOLD CONTACTS.

    PubMed

    Faksri, Kiatichai; Reechaipichitkul, Wipa; Pimrin, Wilailuk; Bourpoern, Janpen; Prompinij, Supapim

    2015-05-01

    An understanding of the risk factors associated with acquiring and transmitting Mycobacterium tuberculosis (MTB) is required for controlling tuberculosis (TB). We aimed to determine the risk factors and transmission factors for latent tuberculosis infection (LTBI) in northeastern Thailand. Household contact persons (n = 70) and matched index patients with pulmonary TB (n = 42) who presented to Srinagarind Hospital, Khon Kaen, Thailand were interviewed from September 1, 2012 to March 31, 2014. LTBI was determined by positive results on both a tuberculin skin test and the QuantiFERON-TB Gold In-Tube test. Multivariate analysis of host and environmental risk factors was performed. Among contact persons, being aged 20 years (adjusted OR=14.0; 95% CI: 1.2-159.5), having a family relationship with a TB subject such as being a spouse or parent (adjusted OR=24.9; 95% CI: 2.4-263.9) and exposure to a TB subject for 5 hours/day (adjusted OR=9.2; 95% CI: 1.4-58.1) were risk factors for LTBI. Having a high bacillary load (adjusted OR=2; 95% CI: 1.26-3.17) or a moderate bacillary load (adjusted OR=1.39; 95% CI: 1.04-1.84) among TB subjects correlated with increased transmissibility compared to having a low bacillary load. The type of dwelling and density of household members were not found to be risk factors for LTBI in our study. We conclude being aged 20 years and having a relationship with a TB patient as a spouse or parent were risk factors for acquiring LTBI, and having a higher bacillary load was a risk factor for transmitting TB. Keywords: latent tuberculosis infection, transmission factor, risk factor, Mycobacterium tuberculosis, interferon-gamma release assay, Thailand PMID:26521523

  13. The Aftershock Risk Index - quantification of aftershock impacts during ongoing strong-seismic sequences

    NASA Astrophysics Data System (ADS)

    Schaefer, Andreas; Daniell, James; Khazai, Bijan; Wenzel, Friedemann

    2016-04-01

    The occurrence and impact of strong earthquakes often triggers the long-lasting impact of a seismic sequence. Strong earthquakes are generally followed by many aftershocks or even strong subsequently triggered ruptures. The Nepal 2015 earthquake sequence is one of the most recent examples where aftershocks significantly contributed to human and economic losses. In addition, rumours about upcoming mega-earthquakes, false predictions and on-going cycles of aftershocks induced a psychological burden on the society, which caused panic, additional casualties and prevented people from returning to normal life. This study shows the current phase of development of an operationalised aftershock intensity index, which will contribute to the mitigation of aftershock hazard. Hereby, various methods of earthquake forecasting and seismic risk assessments are utilised and an integration of the inherent aftershock intensity is performed. A spatio-temporal analysis of past earthquake clustering provides first-hand data about the nature of aftershock occurrence. Epidemic methods can additionally provide time-dependent variation indices of the cascading effects of aftershock generation. The aftershock hazard is often combined with the potential for significant losses through the vulnerability of structural systems and population. A historical database of aftershock socioeconomic effects from CATDAT has been used in order to calibrate the index based on observed impacts of historical events and their aftershocks. In addition, analytical analysis of cyclic behaviour and fragility functions of various building typologies are explored. The integration of many different probabilistic computation methods will provide a combined index parameter which can then be transformed into an easy-to-read spatio-temporal intensity index. The index provides daily updated information about the probability of the inherent seismic risk of aftershocks by providing a scalable scheme fordifferent aftershock

  14. A risk index for multicriterial selection of a logging system with low environmental impact

    SciTech Connect

    Horodnic, Sergiu Andrei

    2015-02-15

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up.

  15. Dairy products and risk of hepatocellular carcinoma: the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Duarte-Salles, Talita; Fedirko, Veronika; Stepien, Magdalena; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Lukanova, Annekatrin; Trepo, Elisabeth; Overvad, Kim; Tjønneland, Anne; Halkjaer, Jytte; Boutron-Ruault, Marie-Christine; Racine, Antoine; Cadeau, Claire; Kühn, Tilman; Aleksandrova, Krasimira; Trichopoulos, Dimitrios; Tsiotas, Konstantinos; Boffetta, Paolo; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Sacerdote, Carlotta; Panico, Salvatore; Bueno-de-Mesquita, H B as; Dik, Vincent K; Peeters, Petra H; Weiderpass, Elisabete; Torhild Gram, Inger; Hjartåker, Anette; Ramón Quirós, Jose; Fonseca-Nunes, Ana; Molina-Montes, Esther; Dorronsoro, Miren; Navarro Sanchez, Carmen; Barricarte, Aurelio; Lindkvist, Björn; Sonestedt, Emily; Johansson, Ingegerd; Wennberg, Maria; Khaw, Kay-Tee; Wareham, Nick; Travis, Ruth C; Romieu, Isabelle; Riboli, Elio; Jenab, Mazda

    2014-10-01

    Intake of dairy products has been associated with risk of some cancers, but findings are often inconsistent and information on hepatocellular carcinoma (HCC) risk is limited, particularly from prospective settings. The aim of our study was to investigate the association between consumption of total and specific dairy products (milk/cheese/yogurt) and their components (calcium/vitamin D/fats/protein), with first incident HCC (N(cases) = 191) in the European Prospective Investigation into Cancer and Nutrition cohort, including a nested case-control subset (N(cases) = 122) with the assessment of hepatitis B virus/hepatitis C virus infections status, liver damage and circulating insulin-like growth factor (IGF)-I levels. For cohort analyses, multivariable-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). For nested case-control analyses, conditional logistic regression was used to calculate odds ratios and 95% CI. A total of 477,206 participants were followed-up for an average of 11 years (person-years follow-up = 5,415,385). In the cohort study, a significant positive HCC risk association was observed for total dairy products (highest vs. lowest tertile, HR = 1.66, 95% CI: 1.13-2.43; p(trend) = 0.012), milk (HR = 1.51, 95% CI: 1.02-2.24; p(trend) = 0.049), and cheese (HR = 1.56, 95% CI: 1.02-2.38; p(trend) = 0.101), but not yogurt (HR = 0.94, 95% CI: 0.65-1.35). Dietary calcium, vitamin D, fat and protein from dairy sources were associated with increased HCC risk, whereas the same nutrients from nondairy sources showed inverse or null associations. In the nested case-control study, similar results were observed among hepatitis-free individuals. Results from this large prospective cohort study suggest that higher consumption of dairy products, particularly milk and cheese, may be associated with increased HCC risk. Validation of these findings in other populations is necessary. Potential biologic

  16. Exploiting Nutritional Value of Staple Foods in the World's Semi-Arid Areas: Risks, Benefits, Challenges and Opportunities of Sorghum.

    PubMed

    Proietti, Ilaria; Frazzoli, Chiara; Mantovani, Alberto

    2015-01-01

    Sorghum (Sorghum bicolor (L.) Moench) is a drought-resistant crop and an important food resource in terms of nutritional as well as social-economic values, especially in semi-arid environments. Cultivar selection and processing methods have been observed to impact on composition and functional and nutritional value of sorghum. Amino acid imbalance, cyanogenic glycosides, endogenous anti-nutrients, mycotoxins and toxic elements are among factors impairing its nutritional value. This paper reviews possible approaches (varieties selection, production practices, cooking processes) to improve the benefits-to-risks balance of sorghum meal, to mitigate the risk of deficiencies and/or imbalances and to improve effects on human nutrition. Opportunity for avoiding dietary diversification in high sorghum consumers is also discussed, e.g., tryptophan and niacin deficits potentially related to pellagra, or unavailability of proteins and divalent cations (e.g., Fe, Zn) due to the antinutrient activity of phytic acid and tannins. As potential candidate for production investments, the role of sorghum in preserving biological diversity is also considered. PMID:27417755

  17. Association between the Fatty Liver Index and Risk of Type 2 Diabetes in the EPIC-Potsdam Study

    PubMed Central

    Jäger, Susanne; Jacobs, Simone; Kröger, Janine; Stefan, Norbert; Fritsche, Andreas; Weikert, Cornelia; Boeing, Heiner; Schulze, Matthias B.

    2015-01-01

    The fatty liver index (FLI) predicts fatty liver by using BMI, waist circumference, γ-glutamyltransferase and triglycerides. We investigated the association between the FLI and the risk of type 2 diabetes and evaluated to what extent single FLI components contribute to the diabetes risk. We analysed a case-cohort study (random sub-cohort: 1922; incident cases: 563) nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. The proportion of exposure effect (PEE) explained by single FLI components was evaluated and effect decomposition using inverse probability weighting (IPW) was applied. Women and men with a FLI ≥60 compared to those with a FLI <30 had a multivariable-adjusted Hazard Ratio (HR) of 17.6; 95% confidence interval (CI) 11.1-28.0 and HR: 10.9; 95% CI 6.22-19.2, respectively. Adjustment for BMI or waist circumference attenuated this association in men [PEEBMI (95% CI) = 53.8% (43.9%-65.8%); PEEwaist (95% CI) = 54.8% (44.2%-68.8%)]. In women, adjustment for waist circumference attenuated the association to a lesser degree than in men [PEEwaist (95% CI) = 31.1%; (21.9%-43.1%)] while BMI had no appreciable effect [PEEBMI (95% CI) = 11.0% (2.68%-21.0%)]. γ-glutamyltransferase and triglycerides showed only a small attenuation in women [PEEGGT(95% CI) = 3.11% (-0.72%-4.48%); PEETG (95% CI) = 6.36% (3.81%-9.92%)] and in men [PEEGGT = 0%; PEETG (95% CI) = 6.23% (2.03%-11.8%)]. In women, the total effect was decomposed into a direct effect and 4 indirect effects (HRBMI = 1.10; HRwaist = 1.28; HRGGT = 0.97 and HRTG = 1.03). In men, the 4 indirect effects were HRBMI = 1.25; HRwaist = 1.29; HRGGT = 0.97 and HRTG = 0.99. These data suggest that the FLI, as a proxy for fatty liver, is associated with risk of type 2 diabetes. This association is only partly explained by standard estimates of overall and abdominal body fatness, particularly among women. PMID:25902304

  18. Determination of the health of Lunyangwa wetland using Wetland Classification and Risk Assessment Index

    NASA Astrophysics Data System (ADS)

    Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.; Msilimba, Golden

    2016-04-01

    Wetlands are major sources of various ecological goods and services including storage and distribution of water in space and time which help in ensuring the availability of surface and groundwater throughout the year. However, there still remains a poor understanding of the range of values of water quality parameters that occur in wetlands either in its impacted state or under natural conditions. It was thus imperative to determine the health of Lunyangwa wetland in Mzuzu City in Malawi in order to classify and determine its state. This study used the Escom's Wetland Classification and Risk Assessment Index Field Guide to determine the overall characteristics of Lunyangwa wetland and to calculate its combined Wetland Index Score. Data on site information, field measurements (i.e. EC, pH, temperature and DO) and physical characteristics of Lunyangwa wetland were collected from March, 2013 to February, 2014. Results indicate that Lunyangwa wetland is a largely open water zone which is dominated by free-floating plants on the water surface, beneath surface and emergent in substrate. Furthermore, the wetland can be classified as of a C ecological category (score = 60-80%), which has been moderately modified with moderate risks of the losses and changes occurring in the natural habitat and biota in the wetland. It was observed that the moderate modification and risk were largely because of industrial, agricultural, urban/social catchment stressors on the wetland. This study recommends an integrated and sustainable management approach coupled with continuous monitoring and evaluation of the health of the wetland for all stakeholders in Mzuzu City. This would help to maintain the health of Lunyangwa wetland which is currently at risk of being further modified due to the identified catchment stressors.

  19. Symposium on 'The challenge of translating nutrition research into public health nutrition'. Session 5: Nutrition communication. The challenge of effective food risk communication.

    PubMed

    McGloin, Aileen; Delaney, Liam; Hudson, Eibhlin; Wall, Pat

    2009-05-01

    A chronology of food scares combined with a rapid, unchecked, rise in lifestyle-related diseases such as obesity highlights the need for a focus on effective food risk communication. However, food risk communication is highly complex. Many factors will affect its success, including the demeanour and conduct of the source, its transparency, interaction with the public, acknowledgement of risks and timely disclosure. How the message is developed is also important in terms of language, style and pretesting with target audiences, as is the choice of appropriate channels for reaching target audiences. Finally, there are many personal factors that may affect risk perception such as previous experience, knowledge, attitudes and beliefs, personality, psychological factors and socio-demographic factors, many of which remain unexplored. While there is evidence that campaigns that communicate health risk have been associated with behaviour change in relation to major public health and safety issues in the past, it is unknown at this stage whether targeting risk information based on risk-perception segmentation can increase the effectiveness of the messages. PMID:19243666

  20. Prevalence and Risk Factors of Chronic Otitis Media: The Korean National Health and Nutrition Examination Survey 2010–2012

    PubMed Central

    Park, Mina; Lee, Ji Sung; Lee, Jun Ho; Oh, Seung Ha; Park, Moo Kyun

    2015-01-01

    Background The performance of nationwide studies of chronic otitis media (COM) in adults has been insufficient in Korea. We evaluated the prevalence and risk factors of COM in Korea. Methods This study was conducted using data from the fifth Korean National Health and Nutrition Examination Survey (n = 23,621). After excluding the subjects under 20 year old and suffered from cancers, 16,063 patients were evaluated for COM. Participants underwent a medical interview, physical examination, endoscopic examination, and blood and urine test. COM was diagnosed by trained residents in the Department of Otorhinolaryngology using an ear, nose, and throat questionnaire and otoendoscopy findings. Data on the presence and absence of COM were collected. Multivariate logistic regression analyses were performed to identify its risk factors. Results Of the 16,063 participants aged above 20 year old, the weighted prevalence of COM was 3.8%. In the multivariate analyses, the following factors showed high odds ratios (ORs) for COM: pulmonary tuberculosis (adjusted OR, 1.78; 95% confidence interval [CI], 1.06-3.01), chronic rhinosinusitis (adjusted OR, 1.87; 95% CI, 1.17-2.98), mild hearing impairment (adjusted OR, 1.95; 95% CI, 1.34-2.85), moderate hearing impairment (adjusted OR, 4.00; 95% CI, 2.21-7.22), tinnitus (adjusted OR, 1.82; 95% CI, 1.34-2.49), increased hearing thresholds in pure tone audiometry in the right ear (adjusted OR, 1.02; 95% CI, 1.01-1.03), and left ear (adjusted OR, 1.03; 95% CI, 1.02-1.04). The following factors showed low odds ratios for COM: hepatitis B (adjusted OR, 0.28; 95% CI, 0.08-0.94) and rhinitis (adjusted OR, 0.60; 95% CI, 0.42-0.88). In addition, high levels of vitamin D, lead, and cadmium, EQ-5D index; and low red blood cell counts were associated with development of COM (Student’s t-test, P < 0.01). Conclusions Our population-based study showed that COM is not rare in Korea, and its development may be associated with various host and

  1. Obesity Indexes and Total Mortality among Elderly Subjects at High Cardiovascular Risk: The PREDIMED Study

    PubMed Central

    Martínez-González, Miguel A.; García-Arellano, Ana; Toledo, Estefanía; Bes-Rastrollo, Maira; Bulló, Mónica; Corella, Dolores; Fito, Montserrat; Ros, Emilio; Lamuela-Raventós, Rosa Maria; Rekondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Santos-Lozano, Jose Manuel; Serra-Majem, Lluis; Martínez, J. Alfredo; Eguaras, Sonia; Sáez-Tormo, Guillermo; Pintó, Xavier; Estruch, Ramon

    2014-01-01

    Background Different indexes of regional adiposity have been proposed for identifying persons at higher risk of death. Studies specifically assessing these indexes in large cohorts are scarce. It would also be interesting to know whether a dietary intervention may counterbalance the adverse effects of adiposity on mortality. Methods We assessed the association of four different anthropometric indexes (waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and height) with all-cause mortality in 7447 participants at high cardiovascular risk from the PREDIMED trial. Forty three percent of them were men (55 to 80 years) and 57% were women (60 to 80 years). All of them were initially free of cardiovascular disease. The recruitment took place in 11 recruiting centers between 2003 and 2009. Results After adjusting for age, sex, smoking, diabetes, hypertension, intervention group, family history of coronary heart disease, and leisure-time physical activity, WC and WHtR were found to be directly associated with a higher mortality after 4.8 years median follow-up. The multivariable-adjusted HRs for mortality of WHtR (cut-off points: 0.60, 0.65, 0.70) were 1.02 (0.78–1.34), 1.30 (0.97–1.75) and 1.55 (1.06–2.26). When we used WC (cut-off points: 100, 105 and 110 cm), the multivariable adjusted Hazard Ratios (HRs) for mortality were 1.18 (0.88–1.59), 1.02 (0.74–1.41) and 1.57 (1.19–2.08). In all analyses, BMI exhibited weaker associations with mortality than WC or WHtR. The direct association between WHtR and overall mortality was consistent within each of the three intervention arms of the trial. Conclusions Our study adds further support to a stronger association of abdominal obesity than BMI with total mortality among elderly subjects at high risk of cardiovascular disease. We did not find evidence to support that the PREDIMED intervention was able to counterbalance the harmful effects of increased adiposity on total mortality. Trial

  2. [Community nutrition].

    PubMed

    Aranceta Bartrina, J; Pérez Rodrigo, C; Serra Majem, L I

    2006-01-01

    A growing body of scientific and epidemiological evidence indicates that diet and health are related: diet may be a risk factor or have potential protective effects. As a consequence, the focus of nutrition research has experienced a shift towards qualitative aspects of diet which could influence chronic disease, longevity, quality of life and physical and cognitive performance, leading to the development of Community Nutrition. The main undertakings in a Community Nutrition Unit are related to the identification, assessment and monitoring of nutrition problems at the community level and to planning, design, implementation and evaluation of nutrition intervention programs. Such programs combine a number of suitable strategies in a whole population approach, a high risk approach or an approach targeted at specific population groups, and are implemented in different settings, such as the work place, schools or community organizations. Community nutrition interventions aim to gradually achieve change in eating patterns towards a healthier profile. Community Nutrition programs require the use of a combination of strategies and a working group of people from different backgrounds. Many factors influence the nutritional status of an individual or a population. In order to gain effective work output, sound understanding of these patterns and a practical surveillance system are required. PMID:17424768

  3. Risk of malignancy index as an evaluation of preoperative pelvic mass

    PubMed Central

    Bouzari, Zinatossadat; Yazdani, Shahla; Shirkhani Kelagar, Ziba; Abbaszadeh, Narges

    2011-01-01

    Background: Risk of malignancy index (RMI) is the best method for discriminating benign and malignant pelvic masses. The aim of this study was to determine the RMI for preoperative evaluation of pelvic mass. Methods: This study was performed on 182 women with adenexal mass referred to Yahyahnejiad Hospital of Babol University of Medical Sciences in Iran from 2007 to 2009.The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of menopausal status, ultrasound finding of pelvic mass and level of serum CA-125, separately or combined into the RMI were calculated and compared. Results: The mean age of patients was 39.9±9.3 years. The RMI with the cut-off point of 265 had a sensitivity of 91.3%, specificity of 96.2 %, PPV of 77.7% and NPV of 98.7% for diagnosis of malignant masses. Conclusion: Risk of malignancy index should be an effective method for evaluating a patient with adnexal masses before operation and a cut-off point of 265 which has a very high sensitivity, specificity and positive and negative predictive values for discriminating malignant and benign pelvic masses. PMID:24551441

  4. Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation.

    PubMed

    Armand, Philippe; Kim, Haesook T; Logan, Brent R; Wang, Zhiwei; Alyea, Edwin P; Kalaycio, Matt E; Maziarz, Richard T; Antin, Joseph H; Soiffer, Robert J; Weisdorf, Daniel J; Rizzo, J Douglas; Horowitz, Mary M; Saber, Wael

    2014-06-01

    Because the outcome of allogeneic hematopoietic cell transplantation (HCT) is predominantly influenced by disease type and status, it is essential to be able to stratify patients undergoing HCT by disease risk. The Disease Risk Index (DRI) was developed for this purpose. In this study, we analyzed 13,131 patients reported to the Center for International Blood and Marrow Transplant Research who underwent HCT between 2008 and 2010. The DRI stratified patients into 4 groups with 2-year overall survival (OS) ranging from 64% to 24% and was the strongest prognostic factor, regardless of age, conditioning intensity, graft source, or donor type. A randomly selected training subgroup of 9849 patients was used to refine the DRI, using a multivariable regression model for OS. This refined DRI had improved prediction ability for the remaining 3282 patients compared with the original DRI or other existing schemes. This validated and refined DRI can be used as a 4- or 3-group index, depending on the size of the cohort under study, for prognostication; to facilitate the interpretation of single-center, multicenter, or registry studies; to adjust center outcome data; and to stratify patients entering clinical trials that enroll patients across disease categories. PMID:24744269

  5. Increased Dietary Inflammatory Index (DII) Is Associated With Increased Risk of Prostate Cancer in Jamaican Men

    PubMed Central

    Shivappa, Nitin; Jackson, Maria D.; Bennett, Franklyn; Hébert, James R.

    2015-01-01

    Purpose Prostate cancer is the most common non-skin malignancy; and it accounts for the most cancer deaths among Jamaican males. Diet has been implicated in the etiology of prostate cancer, including through its effects on inflammation. Method We examined the association between a newly developed dietary inflammatory index (DII) and prostate cancer in a case-control study of 40-80 year-old Jamaican males. A total of 229 incident cases and 250 controls attended the same urology out-patient clinics at 2 major hospitals and private practitioners in the Kingston, Jamaica Metropolitan area between March 2005 and July 2007. The DII was computed based on dietary intake assessed using a previously validated food frequency questionnaire (FFQ) that was expanded to assess diet and cancer in this Jamaican population. Multivariable logistic regression was used to estimate odds ratios, with DII as continuous and expressed as quartiles. Logistic regression analysis adjusted for age, total energy intake, education, body mass index (BMI), smoking status, physical activity and family history of prostate cancer. Results Men in the highest quartile of the DII were at higher risk of prostate cancer [odds ratio (OR) = 2.39; 95% confidence interval (CI) =1.14–5.04 (Ptrend = 0.08)] compared to men in the lowest DII quartile. Conclusion These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for prostate cancer in Jamaican men. PMID:26226289

  6. Polymorphisms in DNA Repair Pathway Genes, Body Mass Index, and Risk of Non-Hodgkin Lymphoma

    PubMed Central

    Chen, Yingtai; Zheng, Tongzhang; Lan, Qing; Kim, Christopher; Qin, Qin; Foss, Francine; Chen, Xuezhong; Holford, Theodore; Leaderer, Brian; Boyle, Peter; Wang, Chengfeng; Dai, Min; Liu, Zhenjiang; Ma, Shuangge; Chanock, Stephen J.; Rothman, Nathaniel; Zhang, Yawei

    2013-01-01

    We conducted a population-based case-control study in Connecticut women to test the hypothesis that genetic variations in DNA repair pathway genes may modify the relationship between body mass index (BMI) and risk of non-Hodgkin lymphoma (NHL). Compared to those with BMI < 25, women with BMI ≥ 25 had significantly increased risk of NHL among women who carried BRCA1 (rs799917) CT/TT, ERCC2 (rs13181) AA, XRCC1 (rs1799782) CC, and WRN (rs1801195) GG genotypes, but no increase in NHL risk among women who carried BRCA1 CC, ERCC2 AC/CC, XRCC1 CT/TT, and WRN GT/TT genotypes. A significant interaction with BMI was only observed for WRN (rs1801195, P=0.004) for T-cell lymphoma and ERCC2 (rs13181, P=0.002) for diffuse large B-cell lymphoma. The results suggest that common genetic variation in DNA repair pathway genes may modify the association between BMI and NHL risk. PMID:23619945

  7. Weight-for-height indices to assess nutritional status--a new index on a slide-rule.

    PubMed

    Cole, T J; Donnet, M L; Stanfield, J P

    1981-09-01

    The protein-energy malnutrition classification schemes of Waterlow and McLaren, although similar in other respects, assess the weight-for-height of children in quite different ways. The drawbacks of their two methods are described, and an alternative method is presented which overcomes them. The new index is called weight/height2-for-age, and consists of the ratio weight/height2 expressed as a percentage of the same ratio for a reference child of the same age. Although the index is not age independent, it is insensitive to all but the grossest errors in age for children over 12 months old. The index is equally appropriate for the assessment of obesity. A slide-rule based on the Tanner standard is available to do the calculation. PMID:6792899

  8. Body mass index and the risk of incident functional disability in elderly Japanese

    PubMed Central

    Zhang, Shu; Tomata, Yasutake; Sugiyama, Kemmyo; Kaiho, Yu; Honkura, Kenji; Watanabe, Takashi; Tanji, Fumiya; Sugawara, Yumi; Tsuji, Ichiro

    2016-01-01

    Abstract The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear. We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21–<23, 23–<25, 25–<27[reference], 27–<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models. A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70–3.63) for BMI <21 and 2.25 (1.54–3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40–3.35). There was no significant relationship between BMI and disability due to stroke. The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population. PMID:27495075

  9. The Relationship between Native American Ancestry, Body Mass Index and Diabetes Risk among Mexican-Americans

    PubMed Central

    Hu, Hao; Huff, Chad D.; Yamamura, Yuko; Wu, Xifeng; Strom, Sara S.

    2015-01-01

    Higher body mass index (BMI) is a well-established risk factor for type 2 diabetes, and rates of obesity and type 2 diabetes are substantially higher among Mexican-Americans relative to non-Hispanic European Americans. Mexican-Americans are genetically diverse, with a highly variable distribution of Native American, European, and African ancestries. Here, we evaluate the role of Native American ancestry on BMI and diabetes risk in a well-defined Mexican-American population. Participants were randomly selected among individuals residing in the Houston area who are enrolled in the Mexican-American Cohort study. Using a custom Illumina GoldenGate Panel, we genotyped DNA from 4,662 cohort participants for 87 Ancestry-Informative Markers. On average, the participants were of 50.2% Native American ancestry, 42.7% European ancestry and 7.1% African ancestry. Using multivariate linear regression, we found BMI and Native American ancestry were inversely correlated; individuals with <20% Native American ancestry were 2.5 times more likely to be severely obese compared to those with >80% Native American ancestry. Furthermore, we demonstrated an interaction between BMI and Native American ancestry in diabetes risk among women; Native American ancestry was a strong risk factor for diabetes only among overweight and obese women (OR = 1.190 for each 10% increase in Native American ancestry). This study offers new insight into the complex relationship between obesity, genetic ancestry, and their respective effects on diabetes risk. Findings from this study may improve the diabetes risk prediction among Mexican-American individuals thereby facilitating targeted prevention strategies. PMID:26501420

  10. Body mass index and risk of colorectal cancer according to tumor lymphocytic infiltrate.

    PubMed

    Hanyuda, Akiko; Ogino, Shuji; Qian, Zhi Rong; Nishihara, Reiko; Song, Mingyang; Mima, Kosuke; Inamura, Kentaro; Masugi, Yohei; Wu, Kana; Meyerhardt, Jeffrey A; Chan, Andrew T; Fuchs, Charles S; Giovannucci, Edward L; Cao, Yin

    2016-08-15

    Higher body mass index (BMI), higher body adiposity and obesity have been associated with increased risk of colorectal cancer. Evidence suggests that excess energy balance may influence systemic immune and inflammatory status. Thus, we hypothesized that the positive association between BMI and colorectal cancer risk might differ according to colorectal carcinoma subtypes according to levels of histopathological lymphocytic reaction to tumor. We collected biennial questionnaire data on weight and baseline height information in two prospective cohort studies, the Nurses' Health Study (1980-2010) and the Health Professionals Follow-up Study (1986-2010). Utilizing duplication-method Cox proportional hazards regression models, we prospectively assessed the association between BMI and risk of colorectal cancer subtypes according to the degree of Crohn's-like lymphoid reaction, peritumoral lymphocytic reaction, intratumoral periglandular reaction, tumor-infiltrating lymphocytes, the overall lymphocytic reaction score, or T-cell [CD3(+) , CD8(+) , CD45RO (PTPRC)(+) or FOXP3(+) ] density in tumor tissue. Statistical significance level was adjusted for multiple hypotheses testing by Bonferroni correction. During follow up of 1,708,029 men and women (over 3,346,752 person-years), we documented 1,436 incident rectal and colon cancer cases with available formalin-fixed paraffin-embedded tumor tissue materials and pathological immunity data. BMI was significantly associated with higher risk of overall colorectal cancer (Ptrend  < 0.001); however, the association of BMI with colorectal carcinoma risk did not significantly differ by the level of lymphocytic reaction or T-cell infiltration in tumor tissue status (Pheterogeneity  > 0.10). BMI may be associated with risk of colorectal cancer regardless of levels of lymphocytic response to tumor. PMID:27037951

  11. The Relationship between Native American Ancestry, Body Mass Index and Diabetes Risk among Mexican-Americans.

    PubMed

    Hu, Hao; Huff, Chad D; Yamamura, Yuko; Wu, Xifeng; Strom, Sara S

    2015-01-01

    Higher body mass index (BMI) is a well-established risk factor for type 2 diabetes, and rates of obesity and type 2 diabetes are substantially higher among Mexican-Americans relative to non-Hispanic European Americans. Mexican-Americans are genetically diverse, with a highly variable distribution of Native American, European, and African ancestries. Here, we evaluate the role of Native American ancestry on BMI and diabetes risk in a well-defined Mexican-American population. Participants were randomly selected among individuals residing in the Houston area who are enrolled in the Mexican-American Cohort study. Using a custom Illumina GoldenGate Panel, we genotyped DNA from 4,662 cohort participants for 87 Ancestry-Informative Markers. On average, the participants were of 50.2% Native American ancestry, 42.7% European ancestry and 7.1% African ancestry. Using multivariate linear regression, we found BMI and Native American ancestry were inversely correlated; individuals with <20% Native American ancestry were 2.5 times more likely to be severely obese compared to those with >80% Native American ancestry. Furthermore, we demonstrated an interaction between BMI and Native American ancestry in diabetes risk among women; Native American ancestry was a strong risk factor for diabetes only among overweight and obese women (OR = 1.190 for each 10% increase in Native American ancestry). This study offers new insight into the complex relationship between obesity, genetic ancestry, and their respective effects on diabetes risk. Findings from this study may improve the diabetes risk prediction among Mexican-American individuals thereby facilitating targeted prevention strategies. PMID:26501420

  12. Risk Factors and Disease Prevention. Nutrition in Health Promotion Series, Number 19.

    ERIC Educational Resources Information Center

    Roehrig, Karla L.

    Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

  13. Climate Risk and Production Shocks: Using Index Insurance to Link Climate Science to Policy for Sustainable Development

    NASA Astrophysics Data System (ADS)

    McCarney, G. R.; Osgood, D. E.

    2011-12-01

    Smallholder farmers in developing countries are often severely impacted by droughts and other climate related events. However, agricultural insurance programs are largely unavailable in lower-income countries because of limitations in traditional loss-based indemnity insurance. As a result, it is often the case that farmers who are the most vulnerable to climate shocks lack access to the insurance tools that could help to reduce their production risk. Index insurance, a recent financial innovation, has the potential to increase access to insurance for smallholder farmers (Barrett et al. 2007). Index insurance allows farmers to insure their production risk based on a weather index (such as total seasonal rainfall) rather than on crop yields. The use of a weather index addresses many of the perverse incentive problems found in traditional crop insurance, and greatly reduces the costs of insuring smallholder farmers. The trade-off in index insurance, however, is limited accuracy in calibrating payouts to actual losses, a phenomenon commonly known as basis risk. While index insurance has promise as a risk-smoothing instrument, many argue it has greater promise as a mechanism for improving access to credit for smallholder farmers in developing countries (e.g. Barnett, Barrett & Skees 2008). In these areas, farmers are often fully exposed to climate shocks, which greatly affect their willingness to borrow. By smoothing the uncertainty in climate shocks, insurance may allow farmers to take credit for productive risks. There has been much discussion as to the optimal strategy for combining index insurance with credit, specifically if the financial institutions or the individual farmers themselves should hold the insurance policy. Many existing insurance implementations insure the farmer directly. However, since a weather index is a proxy for yield loss based on regional data, there is basis risk due to uninsured idiosyncratic differences between farmers. As a response to

  14. Association between Body-Mass Index and Risk of Death in More Than 1 Million Asians

    PubMed Central

    Zheng, Wei; McLerran, Dale F.; Rolland, Betsy; Zhang, Xianglan; Inoue, Manami; Matsuo, Keitaro; He, Jiang; Gupta, Prakash Chandra; Ramadas, Kunnambath; Tsugane, Shoichiro; Irie, Fujiko; Tamakoshi, Akiko; Gao, Yu-Tang; Wang, Renwei; Shu, Xiao-Ou; Tsuji, Ichiro; Kuriyama, Shinichi; Tanaka, Hideo; Satoh, Hiroshi; Chen, Chien-Jen; Yuan, Jian-Min; Yoo, Keun-Young; Ahsan, Habibul; Pan, Wen-Harn; Gu, Dongfeng; Pednekar, Mangesh Suryakant; Sauvaget, Catherine; Sasazuki, Shizuka; Sairenchi, Toshimi; Yang, Gong; Xiang, Yong-Bing; Nagai, Masato; Suzuki, Takeshi; Nishino, Yoshikazu; You, San-Lin; Koh, Woon-Puay; Park, Sue K.; Chen, Yu; Shen, Chen-Yang; Thornquist, Mark; Feng, Ziding; Kang, Daehee; Boffetta, Paolo; Potter, John D.

    2014-01-01

    Background Most studies that have evaluated the association between the body-mass index (BMI) and the risks of death from any cause and from specific causes have been conducted in populations of European origin. Methods We performed pooled analyses to evaluate the association between BMI and the risk of death among more than 1.1 million persons recruited in 19 cohorts in Asia. The analyses included approximately 120,700 deaths that occurred during a mean follow-up period of 9.2 years. Cox regression models were used to adjust for confounding factors. Results In the cohorts of East Asians, including Chinese, Japanese, and Koreans, the lowest risk of death was seen among persons with a BMI (the weight in kilograms divided by the square of the height in meters) in the range of 22.6 to 27.5. The risk was elevated among persons with BMI levels either higher or lower than that range — by a factor of up to 1.5 among those with a BMI of more than 35.0 and by a factor of 2.8 among those with a BMI of 15.0 or less. A similar U-shaped association was seen between BMI and the risks of death from cancer, from cardiovascular diseases, and from other causes. In the cohorts comprising Indians and Bangladeshis, the risks of death from any cause and from causes other than cancer or cardiovascular disease were increased among persons with a BMI of 20.0 or less, as compared with those with a BMI of 22.6 to 25.0, whereas there was no excess risk of either death from any cause or cause-specific death associated with a high BMI. Conclusions Underweight was associated with a substantially increased risk of death in all Asian populations. The excess risk of death associated with a high BMI, however, was seen among East Asians but not among Indians and Bangladeshis. PMID:21345101

  15. Comparative Analysis of Normal versus Fetal Growth Restriction in Pregnancy: The Significance of Maternal Body Mass Index, Nutritional Status, Anemia, and Ultrasonography Screening

    PubMed Central

    Sawant, Laxmichaya D.; Venkat, Shirin

    2013-01-01

    Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. The objective of this study was twofold: first to examine the correlation between maternal parameters such as body mass index (BMI), nutritional status, anemia, and placental weight and diameter, and their effects on fetal growth and then to evaluate the effect of early screening by ultrasonography (USG) on the outcome of growth restricted pregnancies. In this study, 53 cases of fetal growth restriction were compared to 53 normal fetuses delivered in consecutive sequence. Growth restricted fetuses were delivered earlier in gestation, when compared with normal growth fetuses. Maternal anemia and malnutrition have significant association with the fetal growth restriction. Maternal anthropometry, such as low BMI, had effects on placental diameter and weight, which, in turn, adversely affected fetal weight. Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction. PMID:25763389

  16. Husband's preference for a son and women's nutrition: examining the role of actual and desired family composition on women's anaemia and body mass index in India.

    PubMed

    Sabarwal, Shagun; Subramanian, S V; McCormick, Marie C; Silverman, Jay G

    2012-01-01

    This study examines the relationship between the husband's preference for a son, sex composition of children and risk of anaemia and underweight among married Indian women. Information was collected regarding 29,517 couples having at least one child in the nationally representative 2005-06 National Family Health Survey of India. The exposures were husband's preference for a son and sex composition of children: sons only, daughters only and mixed. Outcome included maternal underweight and moderate/severe anaemia. Husband's preference for a son was not found to be associated with his wife's risk of anaemia or underweight. Sex composition of the children was modestly associated with increased odds of anaemia among women from households with daughters only as compared with those with sons only [AOR: 1.19; 95% CI 1.04, 1.35]. The findings from this population-based study of socio-cultural norms around preference for a son and married Indian women's nutritional status do not support the hypothesis that husband's preference for sons influences the nutritional status of their wives. However, having daughters only is associated with maternal anaemia for reasons that remain to be established. PMID:22150711

  17. Body mass index as a predictor of fracture risk: a meta-analysis.

    PubMed

    De Laet, C; Kanis, J A; Odén, A; Johanson, H; Johnell, O; Delmas, P; Eisman, J A; Kroger, H; Fujiwara, S; Garnero, P; McCloskey, E V; Mellstrom, D; Melton, L J; Meunier, P J; Pols, H A P; Reeve, J; Silman, A; Tenenhouse, A

    2005-11-01

    Low body mass index (BMI) is a well-documented risk factor for future fracture. The aim of this study was to quantify this effect and to explore the association of BMI with fracture risk in relation to age, gender and bone mineral density (BMD) from an international perspective using worldwide data. We studied individual participant data from almost 60,000 men and women from 12 prospective population-based cohorts comprising Rotterdam, EVOS/EPOS, CaMos, Rochester, Sheffield, Dubbo, EPIDOS, OFELY, Kuopio, Hiroshima, and two cohorts from Gothenburg, with a total follow-up of over 250,000 person years. The effects of BMI, BMD, age and gender on the risk of any fracture, any osteoporotic fracture, and hip fracture alone was examined using a Poisson regression model in each cohort separately. The results of the different studies were then merged. Without information on BMD, the age-adjusted risk for any type of fracture increased significantly with lower BMI. Overall, the risk ratio (RR) per unit higher BMI was 0.98 (95% confidence interval [CI], 0.97-0.99) for any fracture, 0.97 (95% CI, 0.96-0.98) for osteoporotic fracture and 0.93 (95% CI, 0.91-0.94) for hip fracture (all p <0.001). The RR per unit change in BMI was very similar in men and women ( p >0.30). After adjusting for BMD, these RR became 1 for any fracture or osteoporotic fracture and 0.98 for hip fracture (significant in women). The gradient of fracture risk without adjustment for BMD was not linearly distributed across values for BMI. Instead, the contribution to fracture risk was much more marked at low values of BMI than at values above the median. This nonlinear relation of risk with BMI was most evident for hip fracture risk. When compared with a BMI of 25 kg/m(2), a BMI of 20 kg/m(2) was associated with a nearly twofold increase in risk ratio (RR=1.95; 95% CI, 1.71-2.22) for hip fracture. In contrast, a BMI of 30 kg/m(2), when compared with a BMI of 25 kg/m(2), was associated with only a 17

  18. Utility of Braden Scale Nutrition Subscale Ratings as an Indicator of Dietary Intake and Weight Outcomes among Nursing Home Residents at Risk for Pressure Ulcers

    PubMed Central

    Kennerly, Susan; Boss, Lisa; Yap, Tracey L.; Batchelor-Murphy, Melissa; Horn, Susan D.; Barrett, Ryan; Bergstrom, Nancy

    2015-01-01

    The Braden Scale for Pressure Sore Risk© is a screening tool to determine overall risk of pressure ulcer development and estimate severity of specific risk factors for individual residents. Nurses often use the Braden nutrition subscale to screen nursing home (NH) residents for nutritional risk, and then recommend a more comprehensive nutritional assessment as indicated. Secondary data analysis from the Turn for Ulcer ReductioN (TURN) study’s investigation of U.S. and Canadian NH residents (n = 690) considered at moderate or high pressure ulcer (PrU) risk was used to evaluate the subscale’s utility for identifying nutritional intake risk factors. Associations were examined between Braden Nutritional Risk subscale screening, dietary intake (mean % meal intake and by meal timing, mean number of protein servings, protein sources, % intake of supplements and snacks), weight outcomes, and new PrU incidence. Of moderate and high PrU risk residents, 61.9% and 59.2% ate a mean meal % of <75. Fewer than 18% overall ate <50% of meals or refused meals. No significant differences were observed in weight differences by nutrition subscale risk or in mean number protein servings per meal (1.4 (SD = 0.58) versus 1.3 (SD = 0.53)) for moderate versus high PrU risk residents. The nutrition subscale approximates subsequent estimated dietary intake and can provide insight into meal intake patterns for those at either moderate or high PrU risk. Findings support the Braden Scale’s use as a preliminary screening method to identify focused areas for potential intervention. PMID:27417802

  19. Utility of Braden Scale Nutrition Subscale Ratings as an Indicator of Dietary Intake and Weight Outcomes among Nursing Home Residents at Risk for Pressure Ulcers.

    PubMed

    Kennerly, Susan; Boss, Lisa; Yap, Tracey L; Batchelor-Murphy, Melissa; Horn, Susan D; Barrett, Ryan; Bergstrom, Nancy

    2015-01-01

    The Braden Scale for Pressure Sore Risk(©) is a screening tool to determine overall risk of pressure ulcer development and estimate severity of specific risk factors for individual residents. Nurses often use the Braden nutrition subscale to screen nursing home (NH) residents for nutritional risk, and then recommend a more comprehensive nutritional assessment as indicated. Secondary data analysis from the Turn for Ulcer ReductioN (TURN) study's investigation of U.S. and Canadian NH residents (n = 690) considered at moderate or high pressure ulcer (PrU) risk was used to evaluate the subscale's utility for identifying nutritional intake risk factors. Associations were examined between Braden Nutritional Risk subscale screening, dietary intake (mean % meal intake and by meal timing, mean number of protein servings, protein sources, % intake of supplements and snacks), weight outcomes, and new PrU incidence. Of moderate and high PrU risk residents, 61.9% and 59.2% ate a mean meal % of <75. Fewer than 18% overall ate <50% of meals or refused meals. No significant differences were observed in weight differences by nutrition subscale risk or in mean number protein servings per meal (1.4 (SD = 0.58) versus 1.3 (SD = 0.53)) for moderate versus high PrU risk residents. The nutrition subscale approximates subsequent estimated dietary intake and can provide insight into meal intake patterns for those at either moderate or high PrU risk. Findings support the Braden Scale's use as a preliminary screening method to identify focused areas for potential intervention. PMID:27417802

  20. Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial

    PubMed Central

    2013-01-01

    Background Prospective studies in non-Mediterranean populations have consistently related increasing nut consumption to lower coronary heart disease mortality. A small protective effect on all-cause and cancer mortality has also been suggested. To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain, a Mediterranean country with a relatively high average nut intake per person. Methods We evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions (Mediterranean diets supplemented with nuts or olive oil and control diet) in the PREDIMED (‘PREvención con DIeta MEDiterránea’) study. Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index. Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess the association between yearly repeated measurements of nut consumption and mortality. Results During a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths and 130 cancer deaths occurred. Nut consumption was associated with a significantly reduced risk of all-cause mortality (P for trend <0.05, all). Compared to non-consumers, subjects consuming nuts >3 servings/week (32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI 0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality was observed. Participants allocated to the Mediterranean diet with nuts group who consumed nuts >3 servings/week at baseline had the lowest total mortality risk (HR 0.37; 95% CI 0.22 to 0.66). Conclusions Increased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk. Please see related commentary: http://www.biomedcentral.com/1741-7015/11/165. Trial registration Clinicaltrials

  1. Nutrition and primary prevention of breast cancer: foods, nutrients and breast cancer risk.

    PubMed

    Hanf, Volker; Gonder, Ulrike

    2005-12-01

    Worldwide, each year approximately one million women are newly diagnosed with breast cancer (BC), in Germany 65 new cases per 100,000 inhabitants are registered, yearly. The fact that incidence has been rising in parallel with economic development indicates that environmental factors might play a role in the causation of BC. Migrational data have pointed to nutrition as one of the more relevant external factors involved. Preventive dietary advice often includes a reduction of alcohol, red meat and animal fat and increasing the intake of vegetables, fruit and fibre and lately, phyto-estrogens from various sources. Clearly, the scientific basis for these recommendations appears sparse. The available prospective data from epidemiological studies and interventional trials do not support the overall hypothesis that higher fat-intakes are a relevant risk factor for BC development, more important seems the relative distribution of various fatty acids. A non-vegetarian eating habit (consumption of animal products) per se does not elevate BC risk, while consumption of broiled or deep fried meats cannot be ruled out as a risk factor in genetically susceptible individuals. It appears prudent to abstain from regular and increased alcohol consumption. This should be particularly true for pubescent girls, in whom glandular breast tissue is particularly vulnerable. In general, if alcohol is consumed on a regular basis, a sufficient supply of fresh vegetables and fruit is essential. While there is no overall protective effect of a high fruit and vegetable consumption speculation remains over possible beneficial effects of certain subcategories, especially brassica vegetables like broccoli, cauliflower and cabbage. In essence, regional differences in BC incidence are probably partially attributable to life long dietary habits. There is no need to adopt a foreign dietary plan in order to protect oneself against BC. Traditional western diets also have their beneficial ingredients

  2. Nottingham prognostic index plus (NPI+) predicts risk of distant metastases in primary breast cancer.

    PubMed

    Green, Andrew R; Soria, D; Powe, D G; Nolan, C C; Aleskandarany, M; Szász, M A; Tőkés, A M; Ball, G R; Garibaldi, J M; Rakha, E A; Kulka, J; Ellis, I O

    2016-05-01

    The Nottingham prognostic index plus (NPI+) is based on the assessment of biological class combined with established clinicopathologic prognostic variables providing improved patient outcome stratification for breast cancer superior to the traditional NPI. This study aimed to determine prognostic capability of the NPI+ in predicting risk of development of distant disease. A well-characterised series of 1073 primary early-stage BC cases treated in Nottingham and 251 cases from Budapest were immunohistochemically assessed for cytokeratin (Ck)5/6, Ck18, EGFR, oestrogen receptor (ER), progesterone receptor, HER2, HER3, HER4, Mucin 1 and p53 expression. NPI+ biological class and prognostic scores were assigned using individual algorithms for each biological class incorporating clinicopathologic parameters and investigated in terms of prediction of distant metastases-free survival (MFS). The NPI+ identified distinct prognostic groups (PG) within each molecular class which were predictive of MFS providing improved patient outcome stratification superior to the traditional NPI. NPI+ PGs, between series, were comparable in predicting patient outcome between series in luminal A, basal p53 altered and HER2+/ER+ (p > 0.01) tumours. The low-risk groups were similarly validated in luminal B, luminal N, basal p53 normal tumours (p > 0.01). Due to small patient numbers the remaining PGs could not be validated. NPI+ was additionally able to predict a higher risk of metastases at certain distant sites. This study may indicate the NPI+ as a useful tool in predicting the risk of metastases. The NPI+ provides accurate risk stratification allowing improved individualised clinical decision making for breast cancer. PMID:27116185

  3. Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study

    PubMed Central

    Leung, Ying-Ying; Allen, John Carson; Noviani, Maria; Ang, Li-Wei; Wang, Renwei; Yuan, Jian-Min; Koh, Woon-Puay

    2014-01-01

    Purpose Data on the association between body mass index (BMI) and risk of knee osteoarthritis (KOA) are sparse for Asian populations who are leaner than Western populations. We evaluated the association between BMI and risk of total knee replacement (TKR) due to severe KOA among Chinese in Singapore. Methods We used data from the Singapore Chinese Health Study, a population based prospective cohort of 63,257 Chinese men and women, aged 45–74 years at enrollment from 1993 to 1998. Information on height, weight, diet and lifestyle factors were obtained via in-person interviews. TKR cases for severe KOA were identified via linkage with the nationwide hospital discharge database through 2011. Cox regression and weighted least squares regression were used in the analysis. Results The mean BMI among cohort participants was 23.1 kg/m2, and more than two-thirds had BMI below 25 kg/m2. A total of 1,649 had TKR attributable to severe KOA. Risk of TKR increased in a strong dose-dependent manner with increasing BMI throughout the 15–32 kg/m2 range and became less clear at BMI > 32 kg/m2. In the BMI range 16–27 kg/m2, there was a 27% increase in TKR risk for each unit increase in BMI (p for trend < 0.001). Compared to BMI 19–20 kg/m2, the risk estimates of TKR were all statistically significant with increasing unit of BMI ≥ 21 kg/m2. Results were similar for men and women. Conclusion Our results provided evidence for a constant mechanical mechanism underlying BMI and KOA initiation and/or progression. PMID:25450848

  4. Body mass index and risk of luminal, HER2-overexpressing, and triple negative breast cancer.

    PubMed

    Chen, Lu; Cook, Linda S; Tang, Mei-Tzu C; Porter, Peggy L; Hill, Deirdre A; Wiggins, Charles L; Li, Christopher I

    2016-06-01

    Triple negative (TN, tumors that do not express estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER2)) and HER2-overexpressing (H2E, ER-/HER2+) tumors are two particularly aggressive subtypes of breast cancer. There is a lack of knowledge regarding the etiologies of these cancers and in particular how anthropometric factors are related to risk. We conducted a population-based case-case study consisting of 2659 women aged 20-69 years diagnosed with invasive breast cancer from 2004 to 2012. Four case groups defined based on joint ER/PR/HER2 status were included: TN, H2E, luminal A (ER+/HER2-), and luminal B (ER+/HER2+). Polytomous logistic regression was used to estimate odds ratios (ORs) and associated 95 % confidence intervals (CIs) where luminal A patients served as the reference group. Obese premenopausal women [body mass index (BMI) ≥30 kg/m(2)] had an 82 % (95 % CI 1.32-2.51) increased risk of TN breast cancer compared to women whose BMI <25 kg/m(2), and those in the highest weight quartile (quartiles were categorized based on the distribution among luminal A patients) had a 79 % (95 % CI 1.23-2.64) increased risk of TN disease compared to those in the lowest quartile. Among postmenopausal women obesity was associated with reduced risks of both TN (OR = 0.74, 95 % CI 0.54-1.00) and H2E (OR = 0.47, 95 % CI 0.32-0.69) cancers. Our results suggest obesity has divergent impacts on risk of aggressive subtypes of breast cancer in premenopausal versus postmenopausal women, which may contribute to the higher incidence rates of TN cancers observed among younger African American and Hispanic women. PMID:27220749

  5. Body mass index in relation to serum prostate-specific antigen levels and prostate cancer risk.

    PubMed

    Bonn, Stephanie E; Sjölander, Arvid; Tillander, Annika; Wiklund, Fredrik; Grönberg, Henrik; Bälter, Katarina

    2016-07-01

    High Body mass index (BMI) has been directly associated with risk of aggressive or fatal prostate cancer. One possible explanation may be an effect of BMI on serum levels of prostate-specific antigen (PSA). To study the association between BMI and serum PSA as well as prostate cancer risk, a large cohort of men without prostate cancer at baseline was followed prospectively for prostate cancer diagnoses until 2015. Serum PSA and BMI were assessed among 15,827 men at baseline in 2010-2012. During follow-up, 735 men were diagnosed with prostate cancer with 282 (38.4%) classified as high-grade cancers. Multivariable linear regression models and natural cubic linear regression splines were fitted for analyses of BMI and log-PSA. For risk analysis, Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) and natural cubic Cox regression splines producing standardized cancer-free probabilities were fitted. Results showed that baseline Serum PSA decreased by 1.6% (95% CI: -2.1 to -1.1) with every one unit increase in BMI. Statistically significant decreases of 3.7, 11.7 and 32.3% were seen for increasing BMI-categories of 25 < 30, 30 < 35 and ≥35 kg/m(2) , respectively, compared to the reference (18.5 < 25 kg/m(2) ). No statistically significant associations were seen between BMI and prostate cancer risk although results were indicative of a positive association to incidence rates of high-grade disease and an inverse association to incidence of low-grade disease. However, findings regarding risk are limited by the short follow-up time. In conclusion, BMI was inversely associated to PSA-levels. BMI should be taken into consideration when referring men to a prostate biopsy based on serum PSA-levels. PMID:26914149

  6. Dietary carbohydrate intake, glycaemic load, glycaemic index and ovarian cancer risk in African-American women.

    PubMed

    Qin, Bo; Moorman, Patricia G; Alberg, Anthony J; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Schildkraut, Joellen M; Bandera, Elisa V

    2016-02-28

    Epidemiological evidence regarding the association between carbohydrate intake, glycaemic load (GL) and glycaemic index (GI) and risk of ovarian cancer has been mixed. Little is known about their impact on ovarian cancer risk in African-American women. Associations between carbohydrate quantity and quality and ovarian cancer risk were investigated among 406 cases and 609 controls using data from the African American Cancer Epidemiology Study (AACES). AACES is an ongoing population-based case-control study of ovarian cancer in African-Americans in the USA. Cases were identified through rapid case ascertainment and age- and site-matched controls were identified by random-digit dialling. Dietary information over the year preceding diagnosis or the reference date was obtained using a FFQ. Multivariable logistic regression models were used to estimate odds ratios and 95% CI adjusted for covariates. The OR comparing the highest quartile of total carbohydrate intake and total sugar intake v. the lowest quartile were 1·57 (95% CI 1·08, 2·28; P trend=0·03) and 1·61 (95% CI 1·12, 2·30; P trend<0·01), respectively. A suggestion of an inverse association was found for fibre intake. Higher GL was positively associated with the risk of ovarian cancer (OR 1·18 for each 10 units/4184 kJ (1000 kcal); 95% CI 1·04, 1·33). No associations were observed for starch or GI. Our findings suggest that high intake of total sugars and GL are associated with greater risk of ovarian cancer in African-American women. PMID:26669283

  7. Metabolic and Nutritional Needs to Normalize Body Mass Index by Doubling the Admission Body Weight in Severe Anorexia Nervosa

    PubMed Central

    Gentile, Maria Gabriella; Lessa, Chiara; Cattaneo, Marina

    2013-01-01

    Anorexia nervosa exhibits one of the highest death rates among psychiatric patients and a relevant fraction of it is derived from undernutrition. Nutritional and medical treatment of extreme undernutrition present two very complex and conflicting tasks: (1) to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; and (2) to avoid “underfeeding” caused by a too cautious refeeding. To obtain optimal treatment results, the caloric intake should be planned starting with indirect calorimetry measurements and electrolyte abnormalities accurately controlled and treated. This article reports the case of an anorexia nervosa young female affected by extreme undernutrition (BMI 9.6 kg/m2) who doubled her admission body weight (from 22.5 kg to 44 kg) in a reasonable time with the use of enteral tube feeding for gradual correction of undernutrition. Refeeding syndrome was avoided through a specialized and flexible program according to clinical, laboratory, and physiological findings. PMID:23645991

  8. Improving index-based drought insurance in varying topography: evaluating basis risk based on perceptions of Nicaraguan hillside farmers.

    PubMed

    Kost, André; Läderach, Peter; Fisher, Myles; Cook, Simon; Gómez, Lorena

    2012-01-01

    This paper discusses a methodology to model precipitation indices and premium prices for index-based drought insurance for smallholders. Spatial basis risk, which is borne by the insured, is a problem, especially in variable topography. Also, site-specific drought risk needs to be estimated accurately in order to offer effective insurance cover and ensure financial sustainability of the insurance scheme. We explore farmers' perceptions on drought and spatial climate variability and draw conclusions concerning basis risk with regards to the proposed methodology. There are technically many options to represent natural heterogeneity in index insurance contracts while serving the customer adequately and keeping transaction costs low. PMID:23240020

  9. Improving Index-Based Drought Insurance in Varying Topography: Evaluating Basis Risk Based on Perceptions of Nicaraguan Hillside Farmers

    PubMed Central

    Kost, André; Läderach, Peter; Fisher, Myles; Cook, Simon; Gómez, Lorena

    2012-01-01

    This paper discusses a methodology to model precipitation indices and premium prices for index-based drought insurance for smallholders. Spatial basis risk, which is borne by the insured, is a problem, especially in variable topography. Also, site-specific drought risk needs to be estimated accurately in order to offer effective insurance cover and ensure financial sustainability of the insurance scheme. We explore farmers' perceptions on drought and spatial climate variability and draw conclusions concerning basis risk with regards to the proposed methodology. There are technically many options to represent natural heterogeneity in index insurance contracts while serving the customer adequately and keeping transaction costs low. PMID:23240020

  10. Dietary Inflammatory Index and Risk of Colorectal Cancer: A Case-Control Study in Korea

    PubMed Central

    Cho, Young Ae; Lee, Jeonghee; Oh, Jae Hwan; Shin, Aesun; Kim, Jeongseon

    2016-01-01

    The role of diet-associated inflammation in colorectal cancer is of interest. Accordingly, we aimed to examine whether the dietary inflammatory index (DII) was associated with the risk of colorectal cancer in a case-control study conducted in Korea. The DII was based on dietary intake, which was determined by a 106-item semi-quantitative food frequency questionnaire completed by 923 colorectal cancer cases and 1846 controls. Logistic regression was used to estimate odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted by the anatomical site of the cancer, sex, and other risk factors. Higher DII scores were associated with an increased incidence of colorectal cancer (OR (95% CI) = 2.16 (1.71, 2.73) for highest vs. lowest tertile). The magnitude differed by anatomical site and sex. This association was slightly weaker in subjects with proximal colon cancer (1.68 (1.08, 2.61)) and was stronger in women (2.50 (1.64, 3.82)). Additionally, stronger associations were observed in subjects who were older than 50 years (p for interaction = 0.004) and engaged in physical activity (p for interaction < 0.001). Results from this study suggest that diet-associated inflammation may increase the risk of colorectal cancer, and this effect may differ by certain factors, such as anatomical site, age, sex, and lifestyle. PMID:27483316

  11. Effects of maternal nutrition, resource use and multi-predator risk on neonatal white-tailed deer survival.

    PubMed

    Duquette, Jared F; Belant, Jerrold L; Svoboda, Nathan J; Beyer, Dean E; Lederle, Patrick E

    2014-01-01

    Growth of ungulate populations is typically most sensitive to survival of neonates, which in turn is influenced by maternal nutritional condition and trade-offs in resource selection and avoidance of predators. We assessed whether resource use, multi-predator risk, maternal nutritional effects, hiding cover, or interactions among these variables best explained variation in daily survival of free-ranging neonatal white-tailed deer (Odocoileus virginianus) during their post-partum period (14 May-31 Aug) in Michigan, USA. We used Cox proportional hazards mixed-effects models to assess survival related to covariates of resource use, composite predation risk of 4 mammalian predators, fawn body mass at birth, winter weather, and vegetation growth phenology. Predation, particularly from coyotes (Canis latrans), was the leading cause of mortality; however, an additive model of non-ideal resource use and maternal nutritional effects explained 71% of the variation in survival. This relationship suggested that dams selected areas where fawns had poor resources, while greater predation in these areas led to additive mortalities beyond those related to resource use alone. Also, maternal nutritional effects suggested that severe winters resulted in dams producing smaller fawns, which decreased their likelihood of survival. Fawn resource use appeared to reflect dam avoidance of lowland forests with poor forage and greater use by wolves (C. lupus), their primary predator. While this strategy led to greater fawn mortality, particularly by coyotes, it likely promoted the life-long reproductive success of dams because many reached late-age (>10 years old) and could have produced multiple generations of fawns. Studies often link resource selection and survival of ungulates, but our results suggested that multiple factors can mediate that relationship, including multi-predator risk. We emphasize the importance of identifying interactions among biological and environmental factors when

  12. High tendency to the substantial concern on body shape and eating disorders risk of the students majoring Nutrition or Sport Sciences

    PubMed Central

    Bilgiç, Pelin; Yabancı, Nurcan

    2014-01-01

    BACKGROUND/OBJECTIVES Studies have indicated that university students majoring in nutrition and dietetics or sport sciences may have more obsessions associated with eating attitudes and body shape perception compared to other disciplines i.e. social sciences. Therefore, this study aimed to assess and compare the risk of eating disorders and body shape perception. MATERIALS/METHODS Data was collected from 773 undergraduate students at the Departments of Nutrition and Dietetics (NDD) (n = 254), Physical Education and Sports (PESD) (n = 263), and Social Sciences (SOC) (n = 256).A socio-demographic and personal information questionnaire, Eating Attitudes Test (EAT-40), Body Shape Questionnaire (BSQ-34), Perceived Figure Rating Scale (FRS) were applied; and body weights and heights were measured. RESULTS Mean EAT-40 scores showed that, both male and female students of PESD had the highest scores (17.4 ± 11.6) compared with NDD (14.3 ± 8.3) and SOC (13.0 ± 6.2) (P < 0.05). According to EAT-40 classification, high risk in abnormal eating behavior was more in PESD (10.7%) compared to NDD (2.9%) and SOC (0.4%) students (P < 0.05). Students of PESD, who skipped meal, had higher tendency to the risk of eating disorders (P < 0.05). In parallel, body shape perception was found to be marked with higher scores in NDD (72.0 ± 28.7) and PESD (71.5 ± 32.8) compared with SOC (64.2 ± 27.5) students (P < 0.05). Considering BSQ-34 classification, high concern (moderate and marked) for body shape were more in PESD (7.4 %) compared to NDD (5.2%) and SOC (1.9%) students (P < 0.05). The body size judgement via obtained by the FRS scale were generally correlated with BMI. The Body Mass Index levels were in normal range (Mean BMI: 21.9 ± 2.8 kg/m2) and generally consistent with FRS data. CONCLUSIONS Tendency to the abnormal eating behavior and substantial body shape perception were higher in PESD students who have more concern on body shape and were not well-educated about nutrition

  13. Reducing Production Basis Risk through Rainfall Intensity Frequency (RIF) Indexes: Global Sensitivity Analysis' Implication on Policy Design

    NASA Astrophysics Data System (ADS)

    Muneepeerakul, Chitsomanus; Huffaker, Ray; Munoz-Carpena, Rafael

    2016-04-01

    The weather index insurance promises financial resilience to farmers struck by harsh weather conditions with swift compensation at affordable premium thanks to its minimal adverse selection and moral hazard. Despite these advantages, the very nature of indexing causes the presence of "production basis risk" that the selected weather indexes and their thresholds do not correspond to actual damages. To reduce basis risk without additional data collection cost, we propose the use of rain intensity and frequency as indexes as it could offer better protection at the lower premium by avoiding basis risk-strike trade-off inherent in the total rainfall index. We present empirical evidences and modeling results that even under the similar cumulative rainfall and temperature environment, yield can significantly differ especially for drought sensitive crops. We further show that deriving the trigger level and payoff function from regression between historical yield and total rainfall data may pose significant basis risk owing to their non-unique relationship in the insured range of rainfall. Lastly, we discuss the design of index insurance in terms of contract specifications based on the results from global sensitivity analysis.

  14. Persistent diarrhea in children: epidemiology, risk factors, pathophysiology, nutritional impact, and management.

    PubMed

    Lima, A A; Guerrant, R L

    1992-01-01

    A review of data on the morbidity and mortality caused by persistent diarrhea (more than 14 days' duration) was undertaken from studies in several geographic areas, including Bangladesh, Brazil, Ethiopia, India, Indonesia, and Peru, over the last 3 decades. An estimated 3-5 billion diarrheal illnesses and 5-10 million diarrhea-related deaths occur annually among 3 billion people in Africa, Asia, and Latin America. Mostly the 338 million to 1 billion episodes and 4.6 million deaths annually. A study from India showed that the incidence of persistent diarrhea was greater in the age group 0-11 months (31 episodes/100 child-years) than at age 12-23 months (9 episodes/100 child years) or 24-35 months (6 episodes/100 child-year). Similar results were obtained in periurban Peru, periurban northeastern Brazil, and rural guatemala. Diarrhea is believed to precipitate and exacerbate malnutrition while malnutrition predisposes to diarrhea. 2 studies in both Bangladesh and Peru indicate that the risk of developing diarrhea inversely parallels delayed-type hypersensitivity reactions to standard skin-test antigens. In a cohort of 175 children under 5 years of age over a 28-month period in an urban slum in northeastern Brazil the children had an average of 11 episodes/year and spent 82 days/year with diarrhea. The leading potential pathogens seen with persistent diarrhea in some areas are enteroaggregative E. coli and Cryptosporidium. Other pathogens include Shigella, Salmonella, enteropathogenic (LA (local)) E. coli, and variably Giardia lamblia. Recent nutritional management promotes breast feeding, dietary supplementation with vitamin A, zinc, iron, folate, and vitamin B 12, and improved oral rehydration solutions with glucose polymers (such as rice starch) and possibly neutral amino acids (such as alanine or glycine) and glutamine. PMID:1289113

  15. Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review.

    PubMed

    Bouchenak, Malika; Lamri-Senhadji, Myriem

    2013-03-01

    of the nutritional quality of legumes and their potential contribution in cardiometabolic risk prevention. PMID:23398387

  16. Glycemic index, glycemic load, dietary carbohydrate, and dietary fiber intake and risk of liver and biliary tract cancers in Western Europeans

    PubMed Central

    Fedirko, V.; Lukanova, A.; Bamia, C.; Trichopolou, A.; Trepo, E.; Nöthlings, U.; Schlesinger, S.; Aleksandrova, K.; Boffetta, P.; Tjønneland, A.; Johnsen, N. F.; Overvad, K.; Fagherazzi, G.; Racine, A.; Boutron-Ruault, M. C.; Grote, V.; Kaaks, R.; Boeing, H.; Naska, A.; Adarakis, G.; Valanou, E.; Palli, D.; Sieri, S.; Tumino, R.; Vineis, P.; Panico, S.; Bueno-de-Mesquita, H. B(as).; Siersema, P. D.; Peeters, P. H.; Weiderpass, E.; Skeie, G.; Engeset, D.; Quirós, J. R.; Zamora-Ros, R.; Sánchez, M. J.; Amiano, P.; Huerta, J. M.; Barricarte, A.; Johansen, D.; Lindkvist, B.; Sund, M.; Werner, M.; Crowe, F.; Khaw, K. T.; Ferrari, P.; Romieu, I.; Chuang, S. C.; Riboli, E.; Jenab, M.

    2013-01-01

    Background The type and quantity of dietary carbohydrate as quantified by glycemic index (GI) and glycemic load (GL), and dietary fiber may influence the risk of liver and biliary tract cancers, but convincing evidence is lacking. Patients and methods The association between dietary GI/GL and carbohydrate intake with hepatocellular carcinoma (HCC; N = 191), intrahepatic bile duct (IBD; N = 66), and biliary tract (N = 236) cancer risk was investigated in 477 206 participants of the European Prospective Investigation into Cancer and Nutrition cohort. Dietary intake was assessed by country-specific, validated dietary questionnaires. Hazard ratios and 95% confidence intervals were estimated from proportional hazard models. HBV/HCV status was measured in a nested case–control subset. Results Higher dietary GI, GL, or increased intake of total carbohydrate was not associated with liver or biliary tract cancer risk. For HCC, divergent risk estimates were observed for total sugar = 1.43 (1.17–1.74) per 50 g/day, total starch = 0.70 (0.55–0.90) per 50 g/day, and total dietary fiber = 0.70 (0.52–0.93) per 10 g/day. The findings for dietary fiber were confirmed among HBV/HCV-free participants [0.48 (0.23–1.01)]. Similar associations were observed for IBD [dietary fiber = 0.59 (0.37–0.99) per 10 g/day], but not biliary tract cancer. Conclusions Findings suggest that higher consumption of dietary fiber and lower consumption of total sugars are associated with lower HCC risk. In addition, high dietary fiber intake could be associated with lower IBD cancer risk. PMID:23123507

  17. A basin scale risk assessment using a lotic ecosystem trophic index

    SciTech Connect

    Matlock, M.; Storm, D.; Henley, W.J.; Burks, S.L.

    1994-12-31

    Nutrient enrichment, specifically nitrogen and phosphorus, are principal contaminants to lotic ecosystems from agricultural nonpoint sources. Increased nutrient loading associated with human activity results in accelerated eutrophication of the lotic ecosystem. The authors have developed an in-situ method for estimating the primary productivity of a lotic ecosystem, determining the limiting nutrient at a given site, estimating the maximum potential productivity of a stream reach, and predicting the lotic ecosystem response to increased levels of specific nutrients. This method employs a quantifiable nutrient enrichment system based on passive diffusion across a semipermeable membrane. Using this system, the authors have monitored the trophic status of seven stream reaches within sensitive watersheds in the Upper Illinois River Basin in Oklahoma to determine the ecological risk posed by agricultural activities. The authors have developed a lotic ecosystem trophic status index based on the ratio of base-line primary productivity to maximum potential productivity. This trophic status index has been coupled with SIMPLE, a GIS-based terrestrial nutrient transport model, to link ecological effects with nonpoint sources of pollution.

  18. Repeated measures of body mass index and risk of health related outcomes.

    PubMed

    Claessen, Heiner; Brenner, Hermann; Drath, Christoph; Arndt, Volker

    2012-03-01

    Most studies examining the association between body mass index (BMI) and mortality neglected changes in weight over time, which may have led to underestimation of the true association. The aim of this study is to examine the relationship between BMI and health related outcomes while accounting for variations of BMI over time. The association between BMI and both mortality and occupational disability was examined in a follow-up of 5,554 male construction workers in Württemberg/Germany, who participated at least two times in routine occupational health examinations between 1986 and 2005. Using Cox proportional hazards model with time dependent variables, hazard ratios were calculated with normal weight (<25 kg/m²) as reference after adjustment for potential confounding factors. Overall, an U-shaped association between baseline BMI and mortality (370 events) as well as occupational disability (658 events) was observed, with lowest risk at BMI levels between 25 and 30 kg/m². Men with a baseline BMI ≥ 30 kg/m² experienced a 10% higher mortality and disability risk than normal weight men. The association between BMI and occupational disability became stronger after accounting for temporal variability of BMI with a significant increased risk of 1.26 (95% confidence interval: 1.01-1.56) among obese men. In contrast, the association between BMI and mortality did not materially change after accounting for time dependent effects. Stable obesity as defined by a BMI of 30 kg/m² and above increases risk of disability in male construction workers. Accounting for changes of BMI over time is crucial for disclosing full impact of obesity. PMID:22388768

  19. Risk of Mortality According to Body Mass Index and Body Composition Among Postmenopausal Women.

    PubMed

    Bea, Jennifer W; Thomson, Cynthia A; Wertheim, Betsy C; Nicholas, J Skye; Ernst, Kacey C; Hu, Chengcheng; Jackson, Rebecca D; Cauley, Jane A; Lewis, Cora E; Caan, Bette; Roe, Denise J; Chen, Zhao

    2015-10-01

    Obesity, often defined as a body mass index (BMI; weight (kg)/height (m)(2)) of 30 or higher, has been associated with mortality, but age-related body composition changes can be masked by stable BMI. A subset of Women's Health Initiative participants (postmenopausal women aged 50-79 years) enrolled between 1993 and 1998 who had received dual-energy x-ray absorptiometry scans for estimation of total body fat (TBF) and lean body mass (LBM) (n = 10,525) were followed for 13.6 (standard deviation, 4.6) years to test associations between BMI, body composition, and incident mortality. Overall, BMI ≥35 was associated with increased mortality (adjusted hazard ratio (HR) = 1.45, 95% confidence interval (CI): 1.16, 1.82), while TBF and LBM were not. However, an interaction between age and body composition (P < 0.001) necessitated age stratification. Among women aged 50-59 years, higher %TBF increased risk of death (HR = 2.44, 95% CI: 1.38, 4.34) and higher %LBM decreased risk of death (HR = 0.41, 95% CI: 0.23, 0.74), despite broad-ranging BMIs (16.4-69.1). However, the relationships were reversed among women aged 70-79 years (P < 0.05). BMI did not adequately capture mortality risk in this sample of postmenopausal women. Our data suggest the clinical utility of evaluating body composition by age group to more robustly assess mortality risk among postmenopausal women. PMID:26350478

  20. Dietary inflammatory index and risk of pancreatic cancer in an Italian case–control study

    PubMed Central

    Shivappa, Nitin; Bosetti, Cristina; Zucchetto, Antonella; Serraino, Diego; La Vecchia, Carlo; Hébert, James R.

    2015-01-01

    Previous studies have shown that various dietary components may be implicated in the aetiology of pancreatic cancer. However, the possible relationship between diet-related inflammation and the risk of pancreatic cancer has not yet been investigated. We examined the ability of a newly developed literature-derived dietary inflammatory index (DII) to predict the risk of pancreatic cancer in a case–control study conducted in Italy between 1991 and 2008. This included 326 incident cases and 652 controls admitted to the major teaching and general hospitals for non-neoplastic diseases, frequency-matched to cases by study centre, sex and age. The DII was computed based on dietary intake assessed using a validated and reproducible seventy-eight-item FFQ. Logistic regression models were used to estimate multivariable OR adjusted for age, sex, study centre, education, BMI, smoking status, alcohol drinking and history of diabetes. Energy adjustment was performed using the residual method. Subjects with higher DII scores (i.e. representing a more pro-inflammatory diet) had a higher risk of pancreatic cancer, with the DII being used as both a continuous variable (ORcontinuous 1·24, 95 % CI 1·11, 1·38) and a categorical variable (i.e. compared with the subjects in the lowest quintile of the DII, those in the second, third, fourth and fifth quintiles had, respectively, ORquintile2 v. 1 1·70, 95 % CI 1·02, 2·80; ORquintile3 v. 1 1·91, 95 % CI 1·16, 3·16; ORquintile4 v. 1 1·98, 95 % CI 1·20, 3·27; ORquintile5 v. 1 2·48, 95 % CI 1·50, 4·10; Ptrend = 0·0015). These data suggest that a pro-inflammatory diet increases the risk of pancreatic cancer. PMID:25515552

  1. Evaluation of the Modified Asthma Predictive Index in High-Risk Preschool Children

    PubMed Central

    Chang, Timothy S.; Lemanske, Robert F.; Guilbert, Theresa W.; Gern, James E.; Coen, Michael H.; Evans, Michael D.; Gangnon, Ronald E.; Page, C. David; Jackson, Daniel J.

    2013-01-01

    BACKGROUND Prediction of subsequent school-age asthma during the preschool years has proven challenging. OBJECTIVE To confirm in a post hoc analysis the predictive ability of the modified Asthma Predictive Index (mAPI) in a high-risk cohort and a theoretical unselected population. We also tested a potential mAPI modification with a 2-wheezing episode requirement (m2API) in the same populations. METHODS Subjects (n = 289) with a family history of allergy and/or asthma were used to predict asthma at age 6, 8, and 11 years with the use of characteristics collected during the first 3 years of life. The mAPI and the m2API were tested for predictive value. RESULTS For the mAPI and m2API, school-age asthma prediction improved from 1 to 3 years of age. The mAPI had high predictive value after a positive test (positive likelihood ratio ranging from 4.9 to 55) for asthma development at years 6, 8, and 11. Lowering the number of wheezing episodes to 2 (m2API) lowered the predictive value after a positive test (positive likelihood ratio ranging from 1.91 to 13.1) without meaningfully improving the predictive value of a negative test. Posttest probabilities for a positive mAPI reached 72% and 90% in unselected and high-risk populations, respectively. CONCLUSIONS In a high-risk cohort, a positive mAPI greatly increased future asthma probability (eg, 30% pretest probability to 90% posttest probability) and is a preferred predictive test to the m2API. With its more favorable positive posttest probability, the mAPI can aid clinical decision making in assessing future asthma risk for preschool-age children. PMID:24187656

  2. Feasibility of body roundness index for identifying a clustering of cardiometabolic abnormalities compared to BMI, waist circumference and other anthropometric indices: the China Health and Nutrition Survey, 2008 to 2009.

    PubMed

    Tian, Simiao; Zhang, Xiuzhi; Xu, Yang; Dong, Huimin

    2016-08-01

    The body mass index (BMI) and waist circumference (WC) are commonly used anthropometric measures for predicting cardiovascular diseases risk factors, but it is uncertain which specific measure might be the most appropriate predictor of a cluster of cardiometabolic abnormalities (CMA) in Chinese adults. A body shape index (ABSI) and body roundness index (BRI) have been recently developed as alternative anthropometric indices that may better reflect health status. The main aims of this study were to investigate the predictive capacity of ABSI and BRI in identifying various CMA compared to BMI, WC, waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), and to determine whether there exists a best single predictor of all CMA.We used data from the 2009 wave of the China Health and Nutrition Survey, and the final analysis included 8126 adults aged 18 to 85 years with available fasting blood samples and anthropometric measurements. Receiver-operating characteristic (ROC) analyses were conducted to assess the best anthropometric indices to predict the risk of hypertension, diabetes, dyslipidemia, hyperuricemia, and metabolic syndrome (MetS). Logistic regression models were fit to evaluate the OR of each CMA according to anthropometric indices.In women, the ROC analysis showed that BRI and WHtR had the best predictive capability in identifying all of CMA (area under the curves [AUCs] ranged from 0.658 to 0.721). In men, BRI and WHtR were better predictor of hypertension, diabetes, and at least 1 CMA (AUC: 0.668, 0.708, and 0.698, respectively), whereas BMI and WC were more sensitive predictor of dyslipidemia, hyperuricemia, and MetS. Furthermore, the ABSI showed the lowest AUCs for each CMA. According to the multivariate logistic regression analysis, BRI and WHtR were superior in discriminating hyperuricemia and at least 1 CMA while BMI performed better in predicting hypertension, diabetes, and MetS in women. In men, WC and BRI were the 2 best predictor of all CMA

  3. Oatmeal consumption is associated with better diet quality and lower body mass index in adults: the National Health and Nutrition Examination Survey (NHANES), 2001-2010.

    PubMed

    Fulgoni, Victor L; Chu, YiFang; O'Shea, Marianne; Slavin, Joanne L; DiRienzo, Maureen A

    2015-12-01

    Data from the 2001-2010 National Health and Nutrition Examination Survey were analyzed to assess the relationship between oatmeal consumption and nutrient intake, diet quality, and physiological measures in adults 19 years and older (n = 22,823). We hypothesized that oatmeal consumption is associated with a more favorable nutrient intake profile, better diet quality, and healthier physiological end points. Oatmeal consumers (n = 1429) were defined as those who had consumed any amount of cooked oatmeal cereal during a 24-hour recall period. Multiple regression analysis, after transforming variables to normality and using appropriate sample weights to ensure national representation, was used to assess differences between oatmeal consumers and nonconsumers in terms of demographics, and covariate-adjusted analysis of variance was used to assess differences between consumers and nonconsumers in nutrient intakes, diet quality (calculated using the Healthy Eating Index-2010), and physiological measures. Our results show that oatmeal consumers were older than nonconsumers and more likely to be female; they also were less likely to smoke and consumed less alcohol. Consumers had higher intakes of protein, dietary fiber, vitamin A, thiamin, calcium, phosphorus, magnesium, iron, copper, selenium, and potassium and lower intakes of total, monounsaturated, and saturated fats; cholesterol; and vitamin B12. Oatmeal consumers had higher Healthy Eating Index-2010 scores and lower body weights, waist circumferences, and body mass indices. To conclude, our results suggest that consuming oatmeal is consistent with better nutrient intakes and a higher diet quality. PMID:26494025

  4. Alzheimer,s Disease Risk and Progression: The Role of Nutritional Supplements and their Effect on Drug Therapy Outcome

    PubMed Central

    Giulietti, A.; Vignini, A.; Nanetti, L.; Mazzanti, L.; Primio, R. Di; Salvolini, E.

    2016-01-01

    Alzheimer's disease (AD) is the most common neurodegenerative disease in the elderly population. Despite significant advancements in understanding the genetic and molecular basis of AD, the pathology still lacks treatments that can slow down or reverse the progression of cognitive deterioration. Recently, the relationship between nutrient deficiency and dementia onset has been highlighted. AD is in fact a multifactorial pathology, so that a multi-target approach using combinations of micronutrients and drugs could have beneficial effects on cognitive function in neurodegenerative brain disorders leading to synaptic degeneration. Primarily, this review examines the most recent literature regarding the effects of nutrition on the risk/progression of the disease, focusing attention mostly on antioxidants agents, polyunsaturated fatty acids and metals. Secondly, it aims to figure out if nutritional supplements might have beneficial effects on drug therapy outcome. Even if nutritional supplements showed contrasting evidence of a likely effect of decreasing the risk of AD onset that could be studied more deeply in other clinical trials, no convincing data are present about their usefulness in combination with drug therapies and their effectiveness in slowing down the disease progression. PMID:26415975

  5. Individualized nutritional recommendations: do we have the measurements needed to assess risk and make dietary recommendations?

    PubMed

    Arab, Lenore

    2004-02-01

    Is the information currently available to adjust nutritional recommendations and develop individualized nutrition? No. There is not even the information needed for setting dietary recommendations with confidence now at the group level. Will it be available soon? The answer to this question depends on the drive and will of the nutritional community, the success in recruiting funding to the area, the education of nutritionists and the spawning of great ideas and approaches. The emerging tools of genomics, proteomics and metabolomics are enabling the in-depth study of relationships between diet, genetics and metabolism. The advent of technologies can be compared with the discovery of the microscope and the new dimensions of scientific visualization enabled by that discovery. Nutritionists stand at the crest of new waves of data that can be generated, and new methods for their digestion will be required. To date, the study of dietary requirements has been based largely on a black box approach. Subjects are supplemented or depleted and clinical outcomes are observed. Few recommendations are based on metabolic outcomes. Metabolomics and nutrigenomics promise tools with which recommendations can be refined to meet individual requirements and the potential of individualized nutrition can be explored. As yet, these tools are not being widely applied in nutritional research and are rarely being applied by nutritionists. The result is often interesting research that is frequently nutritionally flawed, resulting in inappropriate conclusions. Nutritional education is needed to put nutritionists at the forefront of the development of applications for these technologies, creating a generation of nutrigenomicists. A new generation of nutritionists should be working interdisciplinarily with geneticists, molecular biologists and bioinformaticians in the development of research strategies. The present paper reviews the current status of nutrigenomic research, the current

  6. Assessment of nutritional status by composite index for anthropometric failure: a study among slum children in Bankura, West Bengal.

    PubMed

    Shit, Subhadeep; Taraphdar, Pranita; Mukhopadhyay, Dipta K; Sinhababu, Apurba; Biswas, Akhil B

    2012-01-01

    A community-based cross-sectional study was conducted to find out the prevalence of composite index of anthropometric failure (CIAF) among 117 slum dwelling under-five children in Bankura town, West Bengal and its relation with some common socio-economic factors. Among study population, the prevalence of underweight was 41.6%, whereas CIAF was 80.3%. CIAF gave a near complete estimation of undernutrition unlike underweight. Children who were unimmunized, with more number of siblings, living in a nuclear family, or with illiterate mothers were more likely to be undernourished. PMID:23354144

  7. A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis.

    PubMed

    Teasdale, Scott B; Ward, Philip B; Rosenbaum, Simon; Watkins, Andrew; Curtis, Jackie; Kalucy, Megan; Samaras, Katherine

    2016-06-01

    Severe mental illness is characterised by a 20-year mortality gap due to cardiometabolic disease. Poor diet in those with severe mental illness is an important and modifiable risk factor. The present study aimed to (i) examine baseline nutritional intake in youth with first-episode psychosis (FEP), (ii) evaluate the feasibility and acceptability of nutritional intervention early in FEP and (iii) to evaluate the effectiveness of early dietary intervention on key nutritional end points. Participants were recruited over a 12-month period from a community-based programme specifically targeting young people aged 15-25 years with newly diagnosed FEP. Individual dietetic consultations and practical group sessions were offered as part of a broader lifestyle programme. Dietary assessments were conducted before and at the end of the 12-week intervention. Participants exceeded recommended energy and Na intakes at baseline. Retention within the nutrition intervention was 67 %, consistent with other interventions offered to FEP clients. There was a 47 % reduction in discretionary food intake (-94 g/d, P<0·001) and reductions in daily energy (-24 %, P<0·001) and Na (-26 %, P<0·001) intakes. Diet quality significantly improved, and the mean change was 3·6 (95 % CI 0·2, 6·9, P<0·05), although this finding was not significant after Bonferroni's correction. Increased vegetable intake was the main factor contributing to improved diet quality. Nutrition intervention delivered shortly after initiation of antipsychotic medication is feasible, acceptable and effective in youth with FEP. Strategies to prevent weight gain and metabolic decline will contribute to prevent premature cardiometabolic disease in this vulnerable population. PMID:27153205

  8. A Hazard Assessment and Proposed Risk Index for Art, Architecture, Archive and Artifact Protection: Case Studies for Assorted International Museums

    NASA Astrophysics Data System (ADS)

    Kirk, Clara J.

    This study proposes a hazard/risk index for environmental, technological, and social hazards that may threaten a museum or other place of cultural storage and accession. This index can be utilized and implemented to measure the risk at the locations of these storage facilities in relationship to their geologic, geographic, environmental, and social settings. A model case study of the 1966 flood of the Arno River and its impact on the city of Florence and the Uffizi Gallery was used as the index focus. From this focus an additional eleven museums and their related risk were assessed. Each index addressed a diverse range of hazards based on past frequency and magnitude. It was found that locations nearest a hazard had exceptionally high levels of risk, however more distant locations could have influences that would increase their risk to levels similar to those locations near the hazard. Locations not normally associated with a given natural hazard can be susceptible should the right conditions be met and this research identified, complied and assessed those factions found to influence natural hazard risk at these research sites.

  9. The role of Body Mass Index in child pedestrian injury risk.

    PubMed

    O'Neal, Elizabeth E; Plumert, Jodie M; McClure, Leslie A; Schwebel, David C

    2016-05-01

    The goal of the current investigation was to examine obesity as a potential risk factor for childhood pedestrian injury. A racially diverse sample of 7- and 8-year-old children completed a road-crossing task in a semi-immersive virtual environment and two pedestrian route selection tasks. Multiple linear regression analyses revealed that children with a higher Body Mass Index (BMI) waited less before crossing, had a smaller temporal buffer between themselves and oncoming traffic while crossing, and had more collisions with traffic. Girls were more cautious than boys when crossing the virtual roadway. Unlike the results from the virtual road-crossing task, BMI was not associated with risky route selection. Instead, race emerged as the strongest predictor, with African-American children selecting riskier routes for crossing. Together, these findings suggest overweight and obese children may be at increased risk for pedestrian injury. The discussion considers explanations for why obese children may exhibit riskier road-crossing behavior. PMID:26890078

  10. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach.

    PubMed

    Chang, J W; Chen, C Y; Yan, B R; Chang, M H; Tseng, S H; Kao, Y M; Chen, J C; Lee, C C

    2014-06-01

    Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods. PMID:24631976

  11. Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia

    PubMed Central

    Huang, Ya-Kai; Kang, Wei-Ming; Ma, Zhi-Qiang; Liu, Yu-Qin; Zhou, Li; Yu, Jian-Chun

    2016-01-01

    Abstract Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized. A case–control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted. After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR = 1.87, 95% CI = 1.24–2.81) and women (adjusted OR = 2.72, 95% CI = 1.44–5.16). The 2 highest BMI categories (27.5–29.9 and ≥30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI = 27.5–29.9: adjusted OR = 1.78, 95% CI = 1.02–3.10; BMI ≥ 30.0: adjusted OR = 2.54, 95% CI = 1.27–5.08) and women (BMI = 27.5–29.9: adjusted OR = 2.88, 95% CI = 1.27–6.55; BMI ≥ 30.0: adjusted OR = 2.77, 95% CI = 1.36–5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR = 1.98, 95% CI = 1.25–3.14) and women (adjusted OR = 2.88, 95% CI = 1.43–5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR = 1.83, 95% CI = 1.25–2.69) in women. Increased BMI was associated with an increased risk

  12. Body Mass Index and the Risk of Incident Non-Communicable Diseases after Starting Antiretroviral Therapy

    PubMed Central

    Koethe, J. R.; Jenkins, C. A.; Turner, M.; Bebawy, S.; Shepherd, B. E.; Wester, C. W.; Sterling, T. R.

    2014-01-01

    Objective Obesity and HIV-infection are associated with an increased incidence of non-infectious co-morbid medical conditions, but the relationship between body mass index (BMI) and the development of non-communicable diseases (NCDs) among individuals on antiretroviral therapy (ART) has not been well-characterized. Methods A cohort study of adults initiating ART between 1998 and 2010 at an academic center with systematic laboratory and clinical data collection, including AIDS and NCD diagnoses. The relationship between BMI at ART initiation and the risk of incident cardiovascular, hepatic, renal or oncologic NCDs was assessed using Cox proportional hazard models. BMI was fit using restricted cubic splines and models adjusted for age, sex, race, CD4+ count, protease inhibitor use, year of initiation, and prior AIDS-defining illness. Results Among 1089 patients in the analysis cohort, 54% had normal BMI, 28% were overweight, and 18% were obese. Baseline BMI was associated with developing an incident NCD (p=<0.01) but the relationship was non-linear. Compared to a BMI of 25 kg/m2, a BMI of 30 kg/m2 conferred a lower risk of an incident NCD diagnosis (HR 0.59; 95% CI: 0.40, 0.87). This protective effect was attenuated at a BMI of 35 kg/m2 (HR 0.78; 95% CI: 0.49, 1.23). Results were similar in sensitivity analyses incorporating tobacco, alcohol and drug use, statin and antihypertensive exposure, and virologic suppression. Conclusions Overweight individuals starting ART have a lower risk of developing NCDs compared to normal BMI individuals, which may reflect a biological effect of adipose tissue versus differences in patient or provider behaviors. PMID:25230709

  13. Dietary Inflammatory Index (DII) and risk of colorectal cancer in Iowa Women's Health Study

    PubMed Central

    Shivappa, Nitin; Prizment, Anna E; Blair, Cindy K.; Jacobs, David R.; Steck, Susan E.; Hébert, James R.

    2014-01-01

    Background Colorectal cancer (CRC), the third most common cancer in the United States, has a natural history that usually encompasses several decades. Dietary components have been implicated in the etiology of CRC, perhaps through their effect on inflammation. Methods We examined the ability of the dietary inflammatory index (DII) to predict CRC in the Iowa Women's Health Study. The DII was computed based on dietary intake assessed by a 121-item food frequency questionnaire in this cohort of 34,703 women, aged 55–69 years, free of any self-reported prior malignancy at enrollment in 1986. Incident CRC cases were identified through linkage with the State Health Registry of Iowa (a Surveillance, Epidemiology and End Results program member). Cox proportional hazards regression was used to estimate hazard ratios (HR). Through the end of 2010, 1636 incident CRCs were identified, including 1329 colon and 325 rectal cancers. Results Multivariable analysis, adjusting for BMI, smoking status, pack-years of smoking, hormone replacement therapy, education, diabetes and total energy intake, revealed positive associations between higher DII and CRC risk (HR for DIIcontinuous: 1.07 per unit increase in DII (corresponding to 0.5 standard deviation unit increase); 95%CI 1.01- 1.13; HR for DIIquintiles: Q5vsQ1=1.20; 95%CI 1.01- 1.43). HRs for DII were similar for colon cancer and rectal cancer, though not statistically significant for rectal cancer. Conclusions These results indicate that a pro-inflammatory diet, as indicated by higher DII scores, was associated with higher risk of developing CRC. Impact Pro-inflammatory diets are associated with increased risk of CRC. PMID:25155761

  14. Childhood body mass index and adult mammographic density measures that predict breast cancer risk.

    PubMed

    Hopper, John L; Nguyen, Tuong L; Stone, Jennifer; Aujard, Kelly; Matheson, Melanie C; Abramson, Michael J; Burgess, John A; Walters, E Haydn; Dite, Gillian S; Bui, Minh; Evans, Christopher; Makalic, Enes; Schmidt, Daniel F; Ward, Gail; Jenkins, Mark A; Giles, Graham G; Dharmage, Shyamali C; Apicella, Carmel

    2016-02-01

    The aim of the present study is to determine if body mass index (BMI) during childhood is associated with the breast cancer risk factor 'adult mammographic density adjusted for age and BMI'. In 1968, the Tasmanian Longitudinal Health Study studied every Tasmanian school child born in 1961. We obtained measured heights and weights from annual school medical records across ages 7-15 years and imputed missing values. Between 2009 and 2012, we administered to 490 women a questionnaire that asked current height and weight and digitised at least one mammogram per woman. Absolute and percent mammographic densities were measured using the computer-assisted method CUMULUS. We used linear regression and adjusted for age at interview and log current BMI. The mammographic density measures were negatively associated: with log BMI at each age from 7 to 15 years (all p < 0.05); with the average of standardised log BMIs across ages 7-15 years (p < 0.0005); and more strongly with standardised log BMI measures closer to age 15 years (p < 0.03). Childhood BMI measures explained 7 and 10 % of the variance in absolute and percent mammographic densities, respectively, and 25 and 20 % of the association between current BMI and absolute and percent mammographic densities, respectively. Associations were not altered by adjustment for age at menarche. There is a negative association between BMI in late childhood and the adult mammographic density measures that predict breast cancer risk. This could explain, at least in part, why BMI in adolescence is negatively associated with breast cancer risk. PMID:26907766

  15. El Niño-Southern Oscillation-based index insurance for floods: Statistical risk analyses and application to Peru

    NASA Astrophysics Data System (ADS)

    Khalil, Abedalrazq F.; Kwon, Hyun-Han; Lall, Upmanu; Miranda, Mario J.; Skees, Jerry

    2007-10-01

    Index insurance has recently been advocated as a useful risk transfer tool for disaster management situations where rapid fiscal relief is desirable and where estimating insured losses may be difficult, time consuming, or subject to manipulation and falsification. For climate-related hazards, a rainfall or temperature index may be proposed. However, rainfall may be highly spatially variable relative to the gauge network, and in many locations, data are inadequate to develop an index because of short time series and the spatial dispersion of stations. In such cases, it may be helpful to consider a climate proxy index as a regional rainfall index. This is particularly useful if a long record is available for the climate index through an independent source and it is well correlated with the regional rainfall hazard. Here El Niño-Southern Oscillation (ENSO) related climate indices are explored for use as a proxy to extreme rainfall in one of the districts of Peru, Piura. The ENSO index insurance product may be purchased by banks or microfinance institutions to aid agricultural damage relief in Peru. Crop losses in the region are highly correlated with floods but are difficult to assess directly. Beyond agriculture, many other sectors suffer as well. Basic infrastructure is destroyed during the most severe events. This disrupts trade for many microenterprises. The reliability and quality of the local rainfall data are variable. Averaging the financial risk across the region is desirable. Some issues with the implementation of the proxy ENSO index are identified and discussed. Specifically, we explore (1) the reliability of the index at different levels of probability of exceedance of maximum seasonal rainfall, (2) the effect of sampling uncertainties and the strength of the proxy's association to local outcome, (3) the potential for clustering of payoffs, (4) the potential that the index could be predicted with some lead time prior to the flood season, and (5) evidence

  16. The validity of the fatigue and risk index for predicting impairments of health and safety under different shift schedules in the context of risk assessments.

    PubMed

    Greubel, Jana; Nachreiner, Friedhelm; Dittmar, Ole; Wirtz, Anna; Schomann, Carsten

    2010-07-01

    In Germany, risk assessment of the working time arrangement is legally required, and within this context the authors assessed the usefulness of the fatigue and risk index (FRI) to predict any detrimental effects to health and safety. This assessment was made using data from two different surveys. Each contained records of working hours over a 4-wk period plus information on occupational accidents and health complaints. The independent variables drawn from the FRI parameters included the maxima, means, variances, and index factor scores. Phi-correlations between the FRI (dichotomized to the index of the reference system) and the incidence of an occupational accident were rather moderate, with a maximum correlation of .22 using the mean fatigue index (FI). Correlations between the two index factor scores and health complaints (sleep problems, stomach pain, eructation/heartburn) revealed the FI component, but not the risk index (RI) component, was related to those health complaints. Forward stepwise logistic regression analysis indicated the FI (but not the RI) predicted occupational accidents (FI(factor) odds ratio [OR] = 1.90, confidence interval [CI] 1.23-2.93). When using multiple regression analyses, the FI was able to predict sleep problems and other circadian related-problems, but the regression coefficients were moderate. In general, the results were not considered sufficient to justify a mandatory use of the FRI. PMID:20636222

  17. Dietary intakes and risk of lymphoid and myeloid leukemia in the European Prospective Investigation into Cancer and Nutrition (EPIC).

    PubMed

    Saberi Hosnijeh, Fatemeh; Peeters, Petra; Romieu, Isabelle; Kelly, Rachel; Riboli, Elio; Olsen, Anja; Tjønneland, Anne; Fagherazzi, Guy; Clavel-Chapelon, Françoise; Dossus, Laure; Nieters, Alexandra; Teucher, Birgit; Trichopoulou, Antonia; Naska, Androniki; Valanou, Elisavet; Mattiello, Amalia; Sieri, Sabina; Parr, Christine L; Engeset, Dagrun; Skeie, Guri; Dorronsoro, Miren; Barricarte, Aurelio; Sánchez, Maria-José; Ericson, Ulrika; Sonestedt, Emily; Bueno-de-Mesquita, H Bas; Ros, Martine M; Travis, Ruth C; Key, Timothy J; Vineis, Paolo; Vermeulen, Roel

    2014-01-01

    The etiology of leukemias cannot entirely be explained by known risk factors, including ionizing radiation, benzene exposure, and infection with human T cell leukemia virus. A number of studies suggested that diet influences the risk of adult leukemias. However, results have been largely inconsistent. We examined the potential association between dietary factors and risk of leukemias among participants of the European Prospective Investigation into Cancer and Nutrition study. Among the 477,325 participants with mean follow-up of 11.34 yr (SD = 2.47), 773 leukemias (373 and 342 cases of lymphoid and myeloid leukemia, respectively) were identified. Diet over the previous 12 mo was assessed at baseline using a validated country-specific dietary questionnaire. Cox proportional hazards regression was used to explore the association between dietary factors that have previously been associated with leukemia risk, including red and processed meat, poultry, offal, fish, dairy products, vegetables, fruits, and seeds/nuts, and risk of both lymphoid and myeloid leukemias. No significant associations were observed between dietary measures and total, lymphoid, and myeloid leukemias. Additional subtype analyses showed no dietary association with risk of major subtypes of leukemias. In summary, this study did not support a possible link between selected dietary factors and risk of leukemias. PMID:24279598

  18. Dietary fat intake and risk of epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Merritt, Melissa A; Riboli, Elio; Weiderpass, Elisabete; Tsilidis, Konstantinos K; Overvad, Kim; Tjønneland, Anne; Hansen, Louise; Dossus, Laure; Fagherazzi, Guy; Baglietto, Laura; Fortner, Renée T; Ose, Jennifer; Steffen, Annika; Boeing, Heiner; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Lagiou, Pagona; Masala, Giovanna; Sieri, Sabina; Mattiello, Amalia; Tumino, Rosario; Sacerdote, Carlotta; Bueno-de-Mesquita, H B As; Onland-Moret, N Charlotte; Peeters, Petra H; Hjartåker, Anette; Gram, Inger Torhild; Quirós, J Ramón; Obón-Santacana, Mireia; Molina-Montes, Esther; Huerta Castaño, José María; Ardanaz, Eva; Chamosa, Saioa; Sonestedt, Emily; Idahl, Annika; Lundin, Eva; Khaw, Kay-Tee; Wareham, Nicholas; Travis, Ruth C; Rinaldi, Sabina; Romieu, Isabelle; Chajes, Veronique; Gunter, Marc J

    2014-10-01

    There are inconsistent and limited data available to assess the relationship between fat intake and risk of epithelial ovarian cancer (EOC). We examined the consumption of total fat, fat sources and fat subtypes in relation to risk of EOC and its major histologic subtypes in the European Prospective Investigation into Cancer and Nutrition which includes incident invasive (n=1095) and borderline (n=96) EOC. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). In multivariate models, we observed no association with consumption of total fat, animal or plant fat, saturated fat, cholesterol, monounsaturated fat, or fatty fish and risk of invasive EOC. There was, however, an increased risk of invasive EOC in the highest category of intake (Quartile 4 vs. Quartile 1) of polyunsaturated fat (HR=1.22, 95% CI=1.02-1.48, P(trend)=0.02). We did not observe heterogeneity in the risk associations in comparisons of serous and endometrioid histologic subtypes. This study does not support an etiological role for total fat intake in relation to EOC risk; however, based on observations of a positive association between intake of polyunsaturated fat and invasive EOC risk in the current and previous studies, this fat subtype warrants further investigation to determine its potential role in EOC development. PMID:25155210

  19. Dietary intake of acrylamide and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

    PubMed Central

    Obón-Santacana, M; Kaaks, R; Slimani, N; Lujan-Barroso, L; Freisling, H; Ferrari, P; Dossus, L; Chabbert-Buffet, N; Baglietto, L; Fortner, R T; Boeing, H; Tjønneland, A; Olsen, A; Overvad, K; Menéndez, V; Molina-Montes, E; Larrañaga, N; Chirlaque, M-D; Ardanaz, E; Khaw, K-T; Wareham, N; Travis, R C; Lu, Y; Merritt, M A; Trichopoulou, A; Benetou, V; Trichopoulos, D; Saieva, C; Sieri, S; Tumino, R; Sacerdote, C; Galasso, R; Bueno-de-Mesquita, H B; Wirfält, E; Ericson, U; Idahl, A; Ohlson, N; Skeie, G; Gram, I T; Weiderpass, E; Onland-Moret, N C; Riboli, E; Duell, E J

    2014-01-01

    Background: Three prospective studies have evaluated the association between dietary acrylamide intake and endometrial cancer (EC) risk with inconsistent results. The objective of this study was to evaluate the association between acrylamide intake and EC risk: for overall EC, for type-I EC, and in never smokers and never users of oral contraceptives (OCs). Smoking is a source of acrylamide, and OC use is a protective factor for EC risk. Methods: Cox regression was used to estimate hazard ratios (HRs) for the association between acrylamide intake and EC risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Acrylamide intake was estimated from the EU acrylamide monitoring database, which was matched with EPIC questionnaire-based food consumption data. Acrylamide intake was energy adjusted using the residual method. Results: No associations were observed between acrylamide intake and overall EC (n=1382) or type-I EC risk (n=627). We observed increasing relative risks for type-I EC with increasing acrylamide intake among women who both never smoked and were non-users of OCs (HRQ5vsQ1: 1.97, 95% CI: 1.08–3.62; likelihood ratio test (LRT) P-value: 0.01, n=203). Conclusions: Dietary intake of acrylamide was not associated with overall or type-I EC risk; however, positive associations with type I were observed in women who were both non-users of OCs and never smokers. PMID:24937665

  20. Body Mass Index and Risk of Nonalcoholic Fatty Liver Disease: Two Electronic Health Record Prospective Studies

    PubMed Central

    Kabadi, Shaum; Preiss, David; Hyde, Craig; Bonato, Vinicius; St. Louis, Matthew; Desai, Jigar; Gill, Jason M. R.; Welsh, Paul; Waterworth, Dawn

    2016-01-01

    Context: The relationship between rising body mass index (BMI) and prospective risk of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is virtually absent. Objective: Determine the extent of the association between BMI and risk of future NAFLD diagnosis, stratifying by sex and diabetes. Design: Two prospective studies using Humedica and Health Improvement Network (THIN) with 1.54 and 4.96 years of follow-up, respectively. Setting: Electronic health record databases. Participants: Patients with a recorded BMI measurement between 15 and 60 kg/m2, and smoking status, and 1 year of active status before baseline BMI. Patients with a diagnosis or history of chronic diseases were excluded. Interventions: None. Main Outcome Measure: Recorded diagnosis of NAFLD/NASH during follow-up (Humedica International Classification of Diseases, Ninth Revision code 571.8, and read codes for NAFLD and NASH in THIN). Results: Hazard ratios (HRs) were calculated across BMI categories using BMI of 20–22.5 kg/m2 as the reference category, adjusting for age, sex, and smoking status. Risk of recorded NAFLD/NASH increased linearly with BMI and was approximately 5-fold higher in Humedica (HR = 4.78; 95% confidence interval, 4.17–5.47) and 9-fold higher in THIN (HR = 8.93; 7.11–11.23) at a BMI of 30–32.5 kg/m2 rising to around 10-fold higher in Humedica (HR = 9.80; 8.49–11.32) and 14-fold higher in THIN (HR = 14.32; 11.04–18.57) in the 37.5- to 40-kg/m2 BMI category. Risk of NAFLD/NASH was approximately 50% higher in men and approximately double in those with diabetes. Conclusions: These data quantify the consistent and strong relationships between BMI and prospectively recorded diagnoses of NAFLD/NASH and emphasize the importance of weight reduction strategies for prevention and management of NAFLD. PMID:26672639

  1. Development of a Risk Index for Serious Prescription Opioid‐Induced Respiratory Depression or Overdose in Veterans’ Health Administration Patients

    PubMed Central

    Xie, Lin; Wang, Li; Joyce, Andrew; Vick, Catherine; Brigham, Janet; Kariburyo, Furaha; Baser, Onur; Murrelle, Lenn

    2015-01-01

    Abstract Objective Develop a risk index to estimate the likelihood of life‐threatening respiratory depression or overdose among medical users of prescription opioids. Subjects, Design, and Methods A case‐control analysis of administrative health care data from the Veterans’ Health Administration identified 1,877,841 patients with a pharmacy record for an opioid prescription between October 1, 2010 and September 30, 2012. Overdose or serious opioid‐induced respiratory depression (OSORD) occurred in 817. Ten controls were selected per case (n = 8,170). Items for an OSORD risk index (RIOSORD) were selected through logistic regression modeling, with point values assigned to each predictor. Modeling of risk index scores produced predicted probabilities of OSORD; risk classes were defined by the predicted probability distribution. Results Fifteen variables most highly associated with OSORD were retained as items, including mental health disorders and pharmacotherapy; impaired drug metabolism or excretion; pulmonary disorders; specific opioid characteristics; and recent hospital visits. The average predicted probability of experiencing OSORD ranged from 3% in the lowest risk decile to 94% in the highest, with excellent agreement between predicted and observed incidence across risk classes. The model's C‐statistic was 0.88 and Hosmer–Lemeshow goodness‐of‐fit statistic 10.8 (P > 0.05). Conclusion RIOSORD performed well in identifying medical users of prescription opioids within the Veterans’ Health Administration at elevated risk of overdose or life‐threatening respiratory depression, those most likely to benefit from preventive interventions. This novel, clinically practical, risk index is intended to provide clinical decision support for safer pain management. It should be assessed, and refined as necessary, in a more generalizable population, and prospectively evaluated. PMID:26077738

  2. Copula-based drought risk assessment combined with an integrated index in the Wei River Basin, China

    NASA Astrophysics Data System (ADS)

    Chang, Jianxia; Li, Yunyun; Wang, Yimin; Yuan, Meng

    2016-09-01

    It is critical to assess drought risk based on a reliably integrated drought index incorporating comprehensive information of meteorology, hydrology and agriculture drought indices, which is of great value for further understanding the future drought tendency, prevention and mitigation. Thus, the primary objective of this study was to focus on constructing a multivariate integrated drought index (MIDI) by coupling four drought indices (i.e., Precipitation Anomaly Percentage (PAP), Runoff Anomaly Percentage (RAP), Standardized Precipitation Index with 6-month aggregation time step (SPI6) and Modified Palmer Drought Severity Index (MPDSI)) to objectively and comprehensively investigate drought risk. The variable fuzzy set theory and entropy weight method are used during the MIDI construction process. Based on the MIDI, a drought event including drought duration and severity is redefined using run theory. Then copula-based drought risk is fully assessed through the joint probability distribution of drought duration and severity. Results indicate the following: (1) the constructed MIDI is consistent with the Standardized Precipitation Index (SPI) and Runoff Anomaly Percentage (RAP) series, and it is more sensitive and effective to capture historical drought events; (2) the drought characteristics present noticeable spatial variability among five subzones, and the entire basin has 49 droughts with the longest drought duration spanning 8.55 months; and (3) the mainstream, especially the middle and lower reaches, has higher occurrences of severe droughts for approximately every 10 years.

  3. ASSESSING ASSOCIATIONS BETWEEN CARIES PREVALENCE AND BODY MASS INDEX AND NUTRITIONAL DATA AMONG CHILDREN AGED 6-12 YEARS.

    PubMed

    Mitrakul, Kemthong; Asvanund, Yuwadee; Arunakul, Malee; Srisuchat, Natchanon; Chotthanakarn, Nutcha; Praisuwanna, Nathaporn; Luckamnuyporn, Natasan

    2016-01-01

    The purpose of this cross sectional study was to examine associations between dental caries and body mass index (BMI) and diet in 6 to 12 year old children. One hundred subjects were included in the study. The number of decayed, missing and filled teeth (DMFT), height and weight were examined in each subject. The primary caregiver for each subject completed a diet questionnaire. The data were analyzed using a chi-square test, a Fisher's exact test, a Kruskal-Wallis test and an independent sample t-test. Associations between variables and caries were examined using a Spearman's correlation with significance set at a p-value < 0.05. The mean age, BMI and number of DMFT were 9.21 ± 2.1 years old, 18.52 ± 4.8 kg/m2, and 4.03 ± 4.36, respectively. Sixty-seven percent of subjects had a normal BMI, 24% were overweight, and 9% were underweight. Twenty-three percent of subjects had no dental caries (DMFT score = 0), 23% had moderate to many caries (DMFT scores = 3.1-6.9), 22% had very many caries (DMFT scores ≥ 7), 17% had few caries (DMFT scores < 3). Overweight and underweight children did not have a significantly different number of DMFT than normal weight children. The number of DMFT did not correlate with reported sugar (R = -0.128) or carbohydrate (R = -0.174) consumption. There was no significant association between BMI and dental caries and amount of sugar and carbohydrate consumption and dental caries. PMID:27086436

  4. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China.

    PubMed

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-08-01

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

  5. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China

    PubMed Central

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-01-01

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

  6. Indexing Disease Progression at Study Entry with Individuals At-Risk for Huntington Disease

    PubMed Central

    Zhang, Ying; Long, Jeffrey D.; Mills, James A.; Warner, John H.; Lu, Wenjing; Paulsen, Jane S.

    2011-01-01

    The identification of clinical and biological markers of disease in persons at risk for Huntington Disease (HD) has increased in efforts to better quantify and characterize the epoch of prodrome prior to clinical diagnosis. Such efforts are critical in the design and implementation of clinical trials for HD so that interventions can occur at a time most likely to increase neuronal survival and maximize daily functioning. A prime consideration in the examination of prodromal individuals is their proximity to diagnosis. It is necessary to quantify proximity so that individual differences in key marker variables can be properly interpreted. We take a data-driven approach to develop an index that can be viewed as a proxy for time to HD diagnosis known as the CAG-Age Product Scaled or CAPS. CAPS is an observed utility variable computed for all genetically at-risk individuals based on age at study entry and CAG repeat length. Results of a longitudinal receiver operating characteristic (ROC) analysis showed that CAPS had a relatively strong ability to predict individuals who became diagnosed, especially in the first 2 years. Bootstrap validation provided evidence that CAPS computed on a new sample from the same population could have similar discriminatory power. Cutoffs for the empirical CAPS distribution can be used to create a classification for mutation-positive individuals (Low-Med-High) that is useful for comparison with the naturally occurring mutation-negative Control group. The classification is an improvement over the one currently in use as it is based on observed data rather than model-based estimated values. PMID:21858921

  7. Mortality Attributable to Excess Body Mass Index in Iran: Implementation of the Comparative Risk Assessment Methodology

    PubMed Central

    Djalalinia, Shirin; Moghaddam, Sahar Saeedi; Peykari, Niloofar; Kasaeian, Amir; Sheidaei, Ali; Mansouri, Anita; Mohammadi, Younes; Parsaeian, Mahboubeh; Mehdipour, Parinaz; Larijani, Bagher; Farzadfar, Farshad

    2015-01-01

    Background: The prevalence of obesity continues to rise worldwide with alarming rates in most of the world countries. Our aim was to compare the mortality of fatal disease attributable to excess body mass index (BMI) in Iran in 2005 and 2011. Methods: Using standards implementation comparative risk assessment methodology, we estimated mortality attributable to excess BMI in Iranian adults of 25–65 years old, at the national and sub-national levels for 9 attributable outcomes including; ischemic heart diseases (IHDs), stroke, hypertensive heart diseases, diabetes mellitus (DM), colon cancer, cancer of the body of the uterus, breast cancer, kidney cancer, and pancreatic cancer. Results: In 2011, in adults of 25–65 years old, at the national level, excess BMI was responsible for 39.5% of total deaths that were attributed to 9 BMI paired outcomes. From them, 55.0% were males. The highest mortality was attributed to IHD (55.7%) which was followed by stroke (19.3%), and DM (12.0%). Based on the population attributed fractions estimations of 2011, except for colon cancer, the remaining 6 common outcomes were higher for women than men. Conclusions: Despite the priority of the problem, there is currently no comprehensive program to prevention or control obesity in Iran. The present results show a growing need to comprehensive implications for national and sub-national health policies and interventional programs in Iran. PMID:26644906

  8. N100 Repetition Suppression Indexes Neuroplastic Defects in Clinical High Risk and Psychotic Youth

    PubMed Central

    Gonzalez-Heydrich, Joseph; Bosquet Enlow, Michelle; D'Angelo, Eugene; Seidman, Larry J.; Gumlak, Sarah; Kim, April; Woodberry, Kristen A.; Rober, Ashley; Tembulkar, Sahil; O'Donnell, Kyle; Hamoda, Hesham M.; Kimball, Kara; Rotenberg, Alexander; Oberman, Lindsay M.; Pascual-Leone, Alvaro; Keshavan, Matcheri S.; Duffy, Frank H.

    2016-01-01

    Highly penetrant mutations leading to schizophrenia are enriched for genes coding for N-methyl-D-aspartate receptor signaling complex (NMDAR-SC), implicating plasticity defects in the disease's pathogenesis. The importance of plasticity in neurodevelopment implies a role for therapies that target these mechanisms in early life to prevent schizophrenia. Testing such therapies requires noninvasive methods that can assess engagement of target mechanisms. The auditory N100 is an obligatory cortical response whose amplitude decreases with tone repetition. This adaptation may index the health of plasticity mechanisms required for normal development. We exposed participants aged 5 to 17 years with psychosis (n = 22), at clinical high risk (CHR) for psychosis (n = 29), and healthy controls (n = 17) to an auditory tone repeated 450 times and measured N100 adaptation (mean amplitude during first 150 tones − mean amplitude during last 150 tones). N100 adaptation was reduced in CHR and psychosis, particularly among participants <13 years old. Initial N100 blunting partially accounted for differences. Decreased change in the N100 amplitude with tone repetition may be a useful marker of defects in neuroplastic mechanisms measurable early in life. PMID:26881109

  9. Can the Air Pollution Index be used to communicate the health risks of air pollution?

    PubMed

    Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

    2015-10-01

    The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. PMID:26057478

  10. Childhood body mass index and height and risk of histologic subtypes of endometrial cancer

    PubMed Central

    Aarestrup, J; Gamborg, M; Ulrich, L G; Sørensen, T I A; Baker, J L

    2016-01-01

    Background: Endometrial cancer risk factors include adult obesity and taller stature, but the influence of size earlier in life is incompletely understood. We examined whether childhood body mass index (BMI; kg m−2) and height were associated with histologic subtypes of endometrial cancer. Methods: From the Copenhagen School Health Records Register, 155 505 girls born 1930–1989 with measured weights and heights from 7 to 13 years were linked to health registers. BMI and height were transformed to age-specific z-scores. Hazard ratios (HRs) and 95% confidence intervals were estimated by Cox regressions. Results: A total of 1020 endometrial cancers were recorded. BMI was non-linearly associated with all endometrial cancers, oestrogen-dependent cancers and the subtype of endometrioid adenocarcinomas; associations were statistically significant and positive above a z-score=0 and non-significant below zero. Compared with a 7-year-old girl with a BMI z-score=0, an equally tall girl who was 3.6 kg heavier (BMI z-score=1.5) had a hazard ratio=1.53 (95% confidence interval: 1.29–1.82) for endometrioid adenocarcinoma. BMI was not associated with non-oestrogen-dependent cancers, except at the oldest childhood ages. Height at all ages was statistically significant and positively associated with all endometrial cancers, except non-oestrogen-dependent cancers. At 7 years, per ~5.2 cm (1 z-score), the risk of endometrioid adenocarcinoma was 1.18 (95% confidence interval: 1.09–1.28). Among non-users of unopposed oestrogens, associations between BMI and endometrioid adenocarcinoma strengthened, but no effects on height associations were observed. Conclusions: Endometrial carcinogenesis is linked to early-life body size, suggesting that childhood BMI and height may be useful indicators for the risk of later development of endometrial cancer and might aid in the early prevention of obesity-related endometrial cancers. PMID:27121254

  11. Body Mass Index as a Predictor of Sudden Cardiac Death and Usefulness of the Electrocardiogram for Risk Stratification.

    PubMed

    Eranti, Antti; Aro, Aapo L; Kerola, Tuomas; Tikkanen, Jani T; Rissanen, Harri A; Anttonen, Olli; Junttila, M Juhani; Knekt, Paul; Huikuri, Heikki V

    2016-02-01

    Evidence of the role of body mass index (BMI) as a risk factor for sudden cardiac death (SCD) is conflicting, and how electrocardiographic (ECG) SCD risk markers perform in subjects with different BMIs is not known. In this study, a general population cohort consisting of 10,543 middle-aged subjects (mean age 44 years, 52.7% men) was divided into groups of lean (BMI <20, n = 374), normal weight (BMI 20.0 to 24.9, n = 4,334), overweight (BMI 25.0 to 29.9, n = 4,390), and obese (BMI >30, n = 1,445) subjects. Cox proportional hazards models adjusted for confounders were used to assess the risk for SCD associated with BMI and the risk for SCD associated with ECG abnormalities in subjects with different BMIs. The overweight and obese subjects were at increased risk for SCD (hazard ratios [95% CIs] were 1.33 [1.13 to 1.56], p = 0.001 and 1.79 [1.44 to 2.23], p <0.001 for overweight and obese subjects, respectively). The risk of non-SCD had a similar relation with BMI as SCD. Hazard ratios associated with ECG abnormalities were 3.03, 1.75, 1.74, and 1.34 in groups of lean, normal weight, overweight, and obese subjects, respectively, but no statistical significance was reached in the obese. ECG abnormalities improved integrated discrimination indexes and continuous net reclassification indexes statistically significantly only in the normal weight group. In conclusion, the overweight and obese are at increased risk for SCD but also for non-SCD, and ECG abnormalities are associated with increased risk of SCD also in normal weight subjects presenting with less traditional cardiovascular risk factors. PMID:26723105

  12. Preoperative Evaluation of Risk of Ovarian Malignancy Algorithm Index in Prediction of Malignancy of Adnexal Masses

    PubMed Central

    Farzaneh, Farah; Honarvar, Zahra; Yaraghi, Mansoore; Yaseri, Mehdi; Arab, Maliheh; Hosseini, Maryamsadat; Ashrafgangoi, Tahereh

    2014-01-01

    Background: Differentiation between benign and malignant ovarian neoplasms is essential to create a system for patient referrals. Objectives: The aim of the present prospective trial was to analyze the value of the risk of ovarian malignancy algorithm (ROMA) in prediction of adnexal masses malignancy in pre- and post-menopause women before operation. Materials and Methods: Preoperative serum samples were tested for CA125 and HE4 using fully automated methods (Abbott architect) and gained best cutoff. The ROMA index was analyzed in 99 patients (including 68 pre-menopause and 31 menopause) with adnexal masses referred to Imam Hossein Hospital/Tehran/Iran and had been scheduled for operation. The pathological results showed 43 cases (22 menopause) with malignant adnexal masses and 56 cases (9 menopauses) with benign adnexal masses. Demographical data, clinical symptoms and the ROMA index were separately analyzed and contrasted in benign and malignant in both menopause and pre-menopause patients. Results: The only significant difference was the older age of the malignant group vs. benign group (P = 0.001) regarding demographic findings. As concerns the clinical symptoms, presence of abdominal discomfort in pre-diagnosis period was the only significant parameter in malignant group (P = 0.001). Additionally, data analysis of patients as a total group showed that specificity (96.4%), positive predictive value (PPV) (94.1%), area under the curve (AUC) (0.907), and diagnostic accuracy (DA) (86.9%) of the ROMA were higher than HE4 (91.1%, 85.7%, 0.857 and 81.8%. respectively) and CA125 (87.9%, 67.3%, 0.828 and 75.8%, respectively) alone. Besides, negative predictive value (NPV) (86.4%) and sensitivity (86.1%) of CA125 were higher than HE4 (79.7% and 69.8%, respectively). In contrast, specificity of HE4 (91.1%) was higher than CA125 (67.9%). Data analysis of patients as two groups (pre and post menopause groups) showed the same results. Conclusions: Specificity, DA and AUC of

  13. Some indicators of nutritional status are associated with activity and exploration in infants at risk for vitamin and mineral deficiencies.

    PubMed

    Aburto, Nancy J; Ramirez-Zea, Manuel; Neufeld, Lynnette M; Flores-Ayala, Rafael

    2009-09-01

    Severe malnutrition, both protein-energy and micronutrient deficiency, results in decreased activity, but the results regarding mild-to-moderate malnutrition are equivocal. Our objective in this investigation was to describe the activity and exploratory behavior of Mexican infants and describe the relationship among nutritional status, activity, and exploration in this population at high risk for mild-to-moderate micronutrient deficiency, but at low risk for severe malnutrition. The participants were infants, 4-12 mo old, of low socioeconomic status from 3 states in southern Mexico. We measured anthropometrics using standard techniques. We measured hemoglobin (Hb) concentration in the field and adjusted values for altitude before analysis. We measured activity and exploration by direct observation during 15 min of individual play in a novel environment. Cluster analysis generated mutually exclusive activity clusters and exploration clusters based on patterns of bodily movement and exploratory behavior, respectively. We categorized the clusters as higher or lower activity or higher or lower exploration. A higher Hb concentration and height-for-age Z-score (HAZ) significantly increased the odds of being in the high-activity cluster. Iron deficiency, stunting, and wasting significantly decreased the odds of being in the high-activity cluster. Higher HAZ and weight-for-age Z-score significantly increased the odds of being in a higher exploration cluster. In Mexican infants at risk for mild-to-moderate micronutrient deficiency but at low risk of severe malnutrition, some indicators of nutritional status were related to increased activity and exploration. PMID:19640971

  14. [Nutritional screening tool versus anthropometric assessment in hospitalized children: which method is better associated to clinical outcomes?].

    PubMed

    Márquez Costa, María Verónica; Alberici Pastore, Carla

    2015-03-01

    Hospitalization contributes to worsening of the nutritional status and malnutrition is associate to increase in morbidity and mortality. The aim of the study was to asses nutritional status/risk using anthropometry and the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), comparing their results to clinical outcomes. For that propose, was conducted an observational longitudinal study with children up to one month of life, hospitalized in Pediatric ward of a teaching hospital. Nutritional status was assessed by Body Mass Index for age and weight for age. Nutritional risk was classified as high, intermediate or low. The length of stay, clinical outcome and complications were taken of the medical records. This project was approved by the Ethics Committee on Research. Were evaluated 181 children, from both sexes. The median age was 8.8 (IQR 3.3; 26.9) months and the median length of stay was 7 (IQR 4; 10) days. There was 20.8% of malnutrition in children younger than one year. Most of the children (55.3%) were classified as in intermediate nutritional risk. The length of stay was associated to nutritional risk, while anthropometry was associated to only in those younger than one year. There were five infectious complication, not associated to nutritional status/risk. Therefore, nutritional risk was significantly associated to length of stay, showing that STRONGkids was a better method compared to anthropometric nutritional assessment to predict this outcome. PMID:26320301

  15. Prospective study of Helicobacter pylori antigens and gastric noncardia cancer risk in the nutrition intervention trial cohort.

    PubMed

    Murphy, Gwen; Freedman, Neal D; Michel, Angelika; Fan, Jin-Hu; Taylor, Philip R; Pawlita, Michael; Qiao, You-Lin; Zhang, Han; Yu, Kai; Abnet, Christian C; Dawsey, Sanford M

    2015-10-15

    Helicobacter pylori (H. pylori) infection is the strongest known risk factor for gastric noncardia adenocarcinoma (GNCA). We used multiplex serology to determine whether seropositivity to 15 H. pylori proteins is associated with the subsequent development of noncardia gastric cancer in Linxian, China. We included 448 GNCA cases and 1242 controls from two time points within the Linxian General Population Nutrition Intervention Trial, Linxian. H. pylori multiplex seropositivity was defined as positivity to ≥4 of the 15 included antigens. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for major GNCA risk factors. In addition, we undertook a meta-analysis combining H. pylori multiplex serology data from both time points. H. pylori multiplex seropositivity was associated with a significant increase in risk of GNCA at one time point (1985; OR: 3.44, 95% CI: 1.91, 6.19) and this association remained significant following adjustment for H. pylori or CagA ELISA seropositivity (OR: 2.92, 95% CI: 1.56, 5.47). Combining data from both time points in a meta-analysis H. pylori multiplex seropositivity was associated with an increased risk of GNCA, as were six individual antigens: GroEL, HP0305, CagA, VacA, HcpC and Omp. CagM was inversely associated with risk of GNCA. We identified six individual antigens that confer an increase in risk of GNCA within this population of high H. pylori seroprevalence, as well as a single antigen that may be inversely associated with GNCA risk. We further determined that the H. pylori multiplex assay provides additional information to the conventional ELISA methods on risk of GNCA. PMID:25845708

  16. Skin manifestations of nutritional deficiency disease in children: modern day contexts.

    PubMed

    Lee, Lara Wine; Yan, Albert C

    2012-12-01

    Nutritional deficiency syndromes, such as scurvy, pellagra, and beriberi are of historical significance but have largely disappeared from modern society. However, certain populations of children in modern society are at risk of severe nutritional complications. The rarity of these syndromes and lack of understanding about modern-day risk factors for nutritional deficiency often delays diagnosis. Dermatologists must maintain an appropriate index of suspicion for these characteristic syndromes as many of the deficiency states present with cutaneous manifestations. Here we review the cutaneous manifestations of macronutrient and micronutrient deficiency syndromes as well as those populations of children that remain at risk for developing severe disease. PMID:23171006

  17. Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index.

    PubMed

    Fahrion, A S; Beilage, E grosse; Nathues, H; Dürr, S; Doherr, M G

    2014-06-01

    Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the

  18. Development of a Convection Risk Index to forecast severe weather, and application to predict maximum wind speeds

    NASA Astrophysics Data System (ADS)

    Bhuiyan, M. A. E.; Wanik, D. W.; Scerbo, D.; Anagnostou, E. N.

    2015-12-01

    We have developed a tool, the Convection Risk Index (CRI), to represent the severity, timing and location of convection for select geographic areas. The CRI is calculated from the Convection Risk Matrix (CRM), a tabulation of numerous meteorological parameters which are categorized into four broad factors that contribute to convection (surface and lower level moisture, atmospheric instability, vertical wind shear, and lift); each of these factors have historically been utilized by meteorologists to predict the likelihood for development of thunderstorms. The CRM ascribes a specific threshold value to each parameter in such a way that it creates a unique tool used to calculate the risk for seeing the development of thunderstorms. The parameters were combined using a weighted formula and which when calculated, yields the Convection Risk Index 1 to 4 scale, with 4 being the highest risk for seeing strong convection. In addition, we also evaluated the performance of the parameters in the CRM and CRI for predicting the maximum wind speed in areas where we calculated the CRI using nonparametric tree-based model, Bayesian additive trees (BART). The use of the CRI and the predicted wind speeds from BART can be used to better inform emergency preparedness efforts in government and industry.We have developed a tool, the Convection Risk Index (CRI), to represent the severity, timing and location of convection for select geographic areas. The CRI is calculated from the Convection Risk Matrix (CRM), a tabulation of numerous meteorological parameters which are categorized into four broad factors that contribute to convection (surface and lower level moisture, atmospheric instability, vertical wind shear, and lift); each of these factors have historically been utilized by meteorologists to predict the likelihood for development of thunderstorms. The CRM ascribes a specific threshold value to each parameter in such a way that it creates a unique tool used to calculate the risk for

  19. Remote Sensing and GIS Based Risk Index Map For Predicting Forest Fire Danger - Evaluation From Forestry Datasets, India

    NASA Astrophysics Data System (ADS)

    Prasad, V. K.; Badarinath, K. V. S.

    Forest fires constitute one of the most serious ecological as well as environmental problems affecting most vegetation zones across the world, including India. In this study, we evaluated forest fire risk for sixteen different forest and vegetation types of India. Data from Normalized Difference Vegetation Index (NDVI) from NOAA AVHRR data has been integrated with bioclimatic data and fuel value index to quantify the forest fire risk. Biomass data for different forest types in different pools has been used as ancillary data. In using the fuel value index, calorific value of wood content for 60 species has been collected and aggregated, for specific species. Results from NDVI and precipitation correlations were found to be highly significant for tropical dry deciduous and moist deciduous forests. Spatial patterns in NDVI closely followed seasonal trends in precipitation for most of the forests. An integrated GIS framework with biophysical, biomass, thermo chemical and bioclimatic parameters allowed the calculation of risk indices for the different forest types. The methodology followed in the study and the maps produced are found to be useful for evaluating forest fire risk and for predicting forest fire danger in different vegetation zones in India.

  20. Residential radon exposure and risk of incident hematologic malignancies in the Cancer Prevention Study-II Nutrition Cohort.

    PubMed

    Teras, Lauren R; Diver, W Ryan; Turner, Michelle C; Krewski, Daniel; Sahar, Liora; Ward, Elizabeth; Gapstur, Susan M

    2016-07-01

    Dosimetric models show that radon, an established cause of lung cancer, delivers a non-negligible dose of alpha radiation to the bone marrow, as well as to lymphocytes in the tracheobronchial epithelium, and therefore could be related to risk of hematologic cancers. Studies of radon and hematologic cancer risk, however, have produced inconsistent results. To date there is no published prospective, population-based study of residential radon exposure and hematologic malignancy incidence. We used data from the American Cancer Society Cancer Prevention Study-II Nutrition Cohort established in 1992, to examine the association between county-level residential radon exposure and risk of hematologic cancer. The analytic cohort included 140,652 participants (66,572 men, 74,080 women) among which 3019 incident hematologic cancer cases (1711 men, 1308 women) were identified during 19 years of follow-up. Cox proportional hazard regression was used to calculate multivariable-adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for radon exposure and hematologic cancer risk. Women living in counties with the highest mean radon concentrations (>148Bq/m(3)) had a statistically significant higher risk of hematologic cancer compared to those living in counties with the lowest (<74Bq/m(3)) radon levels (HR=1.63, 95% CI:1.23-2.18), and there was evidence of a dose-response relationship (HRcontinuous=1.38, 95% CI:1.15-1.65 per 100Bq/m(3); p-trend=0.001). There was no association between county-level radon and hematologic cancer risk among men. The findings of this large, prospective study suggest residential radon may be a risk factor for lymphoid malignancies among women. Further study is needed to confirm these findings. PMID:27015563

  1. Ryegrass cv. Lema and guava cv. Paluma biomonitoring suitability for estimating nutritional contamination risks under seasonal climate in Southeastern Brazil.

    PubMed

    Bulbovas, Patricia; Camargo, Carla Z S; Domingos, Marisa

    2015-08-01

    The risks posed by nutrient deposition due to air pollution on ecosystems and their respective services to human beings can be appropriately estimated by bioindicator plants when they are well acclimated to the study region environmental conditions. This assumption encouraged us to comparatively evaluate the accumulation potential of ryegrass cv. Lema and guava cv. Paluma macro and micronutrients. We also indicated the most appropriate species for biomonitoring nutrient contamination risks in tropical areas of Southeastern Brazil, which are characterized by marked dry and wet seasons and complex mixtures of air pollutants from different sources (industries, vehicle traffic and agriculture). The study was conducted in 14 sites with different neighboring land uses, within the Metropolitan Region of Campinas, central-eastern region of São Paulo State. The exposure experiments with ryegrass and guava were consecutively repeated 40 (28 days each) and 12 (84 days each) times, respectively, from Oct/2010 to Sept/2013. Macro and micronutrients were analyzed and background concentrations and enrichment ratios (ER) were estimated to classify the contamination risk within the study region. Significantly higher ER suggested that ryegrass were the most appropriate accumulator species for N, S, Mg, Fe, Mn, Cu and Zn deposition and guava for K, Ca, P and B deposition. Based on these biomonitoring adjustments, we concluded that the nutrient deposition was spatially homogeneous in the study area, but clear seasonality in the contamination risk by nutritional inputs was evidenced. Significantly higher contamination risk by S, Fe, K and B occurred during the dry season and enhanced contamination risk by Mn, Cu and Zn were highlighted during the wet season. Distinctly high contamination risk was estimated for S, Fe and Mn in several exposure experiments. PMID:25938695

  2. A Rapidly Prototyped Vegetation Dryness Index Developed for Wildfire Risk Assessment at Stennis Space Center

    NASA Technical Reports Server (NTRS)

    Ross, Kenton; Graham, William D.; Prados, Donald; Spruce, Joseph

    2006-01-01

    A remote sensing index was developed to allow improved monitoring of vegetation dryness conditions on a regional basis. This remote sensing index was rapidly prototyped at Stennis Space Center in response to drought conditions in the local area in spring 2006.

  3. Assessment of nutritional risk in community-dwelling older adults (65 to 75 years) in Kolkata, India.

    PubMed

    Majumder, Mondrita; Saha, Indranil; Chaudhuri, Debnath

    2014-01-01

    This study was conducted to profile nutritional risk factors in a population of community-dwelling older adults in Kolkata, India. We applied the short version of the Mini Nutritional Assessment-Short Form (MNA-SF) questionnaire among 500 participants (65 to 75 years)--263 males and 237 females. The prevalence of undernutrition was 8.8% in females and 4.9% in males; a risk of undernutrition was found in 24.5% females and 17.5% males. All those with undernutrition or at-risk were studied further using the full version of the MNA. Data regarding education, occupation, socioeconomic status, and food intake pattern were also collected. Females had a significantly lower (P < 0.01) education level than males; 73.4% males were financially independent, whereas 72.7% females were financially dependent on others. Moderate appetite loss was commonly found (64.9%), and in 24.3% of the participants appetite loss was severe. Digestive and chewing problems were present in 32.4% and 21.6% of study participants, respectively. The rate of psychological stress and/or acute disease 3 months prior to study was 47%, and 62.2% of the study population were taking 3 or more medicines per day. Weight loss of greater than 3 kg and of 1 to 3 kg during past 3 months of the study period was observed in 27% and 32.5% of the population, respectively. Undernourished individuals were also found to consume fewer protein-rich foods. We hypothesize that low education levels and lack of financial independence were the strongest underlying causes of high undernutrition in this population, particularly, among females. PMID:24827063

  4. Breakfast patterns and their likelihood of increased risk of overweight/obesity and risk factors for metabolic syndrome in adults 19+ years: National Health and Nutrition Examination Survey 2001-2008

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Little is known about the relationship of specific types of breakfast consumed and the risk of overweight/obesity or risk factors for metabolic syndrome. Cluster analysis using National Health and Nutrition Examination Survey 2001-2008 data identified 12 breakfast clusters—including no breakfast, in...

  5. Is Body Mass Index Associated With the Development of Age-Related Hearing Impairment in Koreans? The Korean National Health and Nutrition Examination Survey 2009–2012

    PubMed Central

    Jung, Da Jung; Jang, Jeong Hun; Lee, Kyu-Yup

    2016-01-01

    Objectives The aim of this study was to evaluate whether body mass index (BMI) is associated with age-related hearing loss (ARHL) in the Asian elderly population. Methods Data from the Korean National Health and Nutrition Examination Survey 2009–2012 were used for the analyses. The pure tones at 0.5 and 1 kHz of both ears of each subject were averaged to obtain the low-frequency, those at 2 and 3 kHz were averaged to obtain the mid-frequency, and those at 4 and 6 kHz were averaged to obtain the high-frequency. The average hearing threshold (AHT) was calculated as pure tone average at 4 frequencies in the better ear. ARHL was defined as the AHT >25 dB. Results Univariate analyses revealed an increase in the BMI tertile in men was associated with a decreased low-frequency threshold, while an increase in the BMI tertile in women was associated with decreased mid- and high-frequency thresholds. Multivariate analyses adjusted for confounders show no significant differences in low-, mid-, or high-frequency. There was no significant difference in the prevalence of ARHL by BMI tertiles. Linear regression analyses show no association between BMI and low-, mid-, and high-frequency or AHTs. The area under the receiver operating characteristic curve values for AHT was 0.515 in men and 0.522 in women. The logistic regression analyses showed no association between BMI and ARHL in either sex. Conclusion BMI is not advantageous for the prediction of ARHL. In future epidemiological studies, BMI as a covariate of obesity may be replaced by other active metabolic parameters that have better predictive ability of ARHL than BMI. PMID:27090278

  6. Associations of Urinary Phthalates with Body Mass Index, Waist Circumference, and Serum Lipids Among Females: National Health and Nutrition Examination Survey 1999–2004

    PubMed Central

    Yaghjyan, Lusine; Sites, Samantha; Ruan, Yujie; Chang, Su-Hsin

    2016-01-01

    Background/Objectives Exposure to environmental chemicals could be one of the contributors to the increasing obesity epidemic. Very little is known about the association of phthalates, ubiquitous chemicals widely used in consumer products, with obesity and lipid metabolism. This study investigated the association of urinary phthalate metabolites and, for the first time, the ratios of the major metabolites of the most common phthalate, di-2-ethylhexyl phthalate (DEHP), with body mass index (BMI), waist circumference, and serum lipid levels in the U.S. female population. Methods This cross-sectional study used the data from the National Health and Nutrition Examination Survey, 1999–2004 and was restricted to women aged ≥18 years, who were not pregnant and had no history of diabetes. Using multivariate ordered logistic regression, we examined associations of seven urinary phthalate metabolites and their metabolic ratios with the BMI, waist circumferences, total cholesterol, triglycerides, and high-density and low-density lipoprotein cholesterol. Results BMI was positively associated with monobutyl phthalate (MBP) and mono-2-ethylhexyl phthalate (MEHP) (OR=1.13, 95% CI, 1.03-1.23 and OR=1.12, 95% CI, 1.03-1.23, respectively). Waist circumference was positively associated with MBP (OR=1.13, 95% CI, 1.03-1.24). A higher ratio of MEHP to mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was positively associated with both BMI (OR=1.21, 95% CI, 1.09-1.34) and waist circumference (OR=1.20, 95% CI, 1.10-1.31). There were no other significant associations. Conclusions A higher metabolic ratio of MEHP to MEHHP, reflective of slower oxidative conversion of MEHP, is associated with greater BMI and waist circumference. PMID:25644057

  7. Economic development and its influences and risks for nutrition, cuisine and health.

    PubMed

    McKay, John

    2004-01-01

    This paper reviews the evidence on some of the major trends in economic development at a global level and assess their influence on food, nutrition and health. Food and nutrition are themselves broad topics, and each is influenced by a myriad of local and international forces, making them both interesting and important, but also challenging in their complexity. It is especially difficult to deal with such a vast and complicated terrain in such a short paper, and one must inevitably deal only superficially with a number of complex areas. This paper will review a number of key forces for change in the global system, with a focus on the implications of each for food and nutrition. Each area is central to the experience of economic, social and political development, particularly in the period since 1945, and each is tied in various ways with that complex and interrelated set of changes that we call globalisation. Seven key factors will be explored: global population growth, leading to strong pressures on world availability of arable land and food; increasing integration in the global economy, as measured through such things as trade, financial flows and information exchanges, and with specific implications for the food industry and for trade in food products; growing gaps between rich and poor countries; similar increases in disparities between rich and poor segments within individual countries; the rapid growth of cities in the developing world, resulting in massive challenges for the food supply systems of many nations; the growth within some countries, for example in a number of Asian countries, of a "new middle class" with distinctive patterns of consumption; and, high levels of population movements between countries resulting in the creation of significant communities of immigrants in a number of nations. Examples will be drawn from the two regions familiar to the author, Asia and Sub-Saharan Africa, but with a particular emphasis on East Asia. PMID:15228985

  8. Nutrition Surveillance. Annual Summary 1982.

    ERIC Educational Resources Information Center

    Centers for Disease Control (DHHS/PHS), Atlanta, GA.

    This report summarizes information, including selected indices of nutritional status, as reported from 28 states and the District of Columbia to the Nutritional Status Surveillance System. This system has two components, one addressing nutritional status among high-risk pediatric populations, and the other addressing nutritional status among…

  9. Assessing dietary patterns in Barbados highlights the need for nutritional intervention to reduce risk of chronic disease

    PubMed Central

    Sharma, S.; Cao, X.; Harris, R.; Hennis, A. J. M.; Wu, S.-Y.; Leske, M. C.

    2009-01-01

    Background The dietary habits of the Caribbean have been changing to include more fast foods and a less nutrient dense diet. The aims of this study are to examine dietary patterns in Barbados and highlight foods for a nutritional intervention. Methods Four-day food diaries collected from control participants in the population-based, case-control Barbados National Cancer Study (BNCS). Results Forty-nine adult participants (91% response) completed the diaries providing 191 days of dietary data. Total energy intake was almost identical to data collected 5-years earlier in the Barbados Food Consumption and Anthropometric Survey 2000, but the percent energy derived from fat was from 2.1% to 5.2% higher. Sugar intake exceeded the Caribbean recommendation almost four-fold, while intakes of calcium, iron (women only), zinc and dietary fibre were below recommendations. Fish and chicken dishes were the two largest sources of energy and fat. Sweetened drinks and juices provided over 40% of total sugar intake. Conclusions These data provide existing dietary patterns and strongly justify a nutritional intervention program to reduce dietary risk factors for chronic disease. The intervention could focus on the specific foods highlighted, both regarding frequency and amount of consumption. Effectiveness can be evaluated pre- and post-intervention using our Food Frequency Questionnaire developed for BNCS. PMID:18339055

  10. Life Satisfaction and Risk of Chronic Diseases in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany Study

    PubMed Central

    Feller, Silke; Teucher, Birgit; Kaaks, Rudolf; Boeing, Heiner; Vigl, Matthaeus

    2013-01-01

    Objective The aim of the study was to examine the prospective association between life satisfaction and risk of type 2 diabetes mellitus, myocardial infarction, stroke, and cancer. Previous studies suggested that psychosocial factors may affect the development of chronic diseases but the impact of positive attitudes, in particular life satisfaction, is yet to be determined. Methods The analysis included 50,358 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany study in Potsdam and Heidelberg. Life satisfaction was assessed in a baseline interview and incident cases of chronic diseases were identified and verified during follow-up. Hazard ratios were calculated using Cox proportional hazards regression models that were systematically multivariable-adjusted for established risk factors and prevalent diseases. Results During an average of 8 years of follow-up 2,293 cases of cancer, 1,840 cases of type 2 diabetes mellitus, 440 cases of stroke, and 562 cases of myocardial infarction were observed. Women who were unsatisfied with life at baseline showed in all models a significantly increased risk of cancer (HR: 1.45; 95% CI: 1.18-1.78) and stroke (HR: 1.69; 95% CI: 1.05-2.73) as well as an increased risk of type 2 diabetes mellitus by trend across categories (p-trend=0.04) compared to women very satisfied with life. In men, a relationship between life satisfaction and stroke was found but did not persist after consideration of lifestyle factors and prevalent diseases. No significant association was observed between life satisfaction and risk of myocardial infarction. Conclusions The results of this study suggest that reduced life satisfaction is related to the development of chronic diseases—particularly in women and partly mediated by established risk factors. PMID:23977388

  11. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Steffen, Annika; Huerta, José-Maria; Weiderpass, Elisabete; Bueno-de-Mesquita, H B As; May, Anne M; Siersema, Peter D; Kaaks, Rudolf; Neamat-Allah, Jasmine; Pala, Valeria; Panico, Salvatore; Saieva, Calogero; Tumino, Rosario; Naccarati, Alessio; Dorronsoro, Miren; Sánchez-Cantalejo, Emilio; Ardanaz, Eva; Quirós, J Ramón; Ohlsson, Bodil; Johansson, Mattias; Wallner, Bengt; Overvad, Kim; Halkjaer, Jytte; Tjønneland, Anne; Fagherazzi, Guy; Racine, Antoine; Clavel-Chapelon, Françoise; Key, Tim J; Khaw, Kay-Tee; Wareham, Nick; Lagiou, Pagona; Bamia, Christina; Trichopoulou, Antonia; Ferrari, Pietro; Freisling, Heinz; Lu, Yunxia; Riboli, Elio; Cross, Amanda J; Gonzalez, Carlos A; Boeing, Heiner

    2015-08-01

    General obesity, as reflected by BMI, is an established risk factor for esophageal adenocarcinoma (EAC), a suspected risk factor for gastric cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by waist circumference (WC), relates to these cancers remains largely unexplored. Using measured anthropometric data from 391,456 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) study and 11 years of follow-up, we comprehensively assessed the association of anthropometric measures with risk of EAC, GCC and GNCC using multivariable proportional hazards regression. One hundred twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After mutual adjustment, BMI was unrelated to EAC, while WC showed a strong positive association (highest vs. lowest quintile HR = 1.19; 95% CI, 0.63-2.22 and HR = 3.76; 1.72-8.22, respectively). Hip circumference (HC) was inversely related to EAC after controlling for WC, while WC remained positively associated (HR = 0.35; 0.18-0.68, and HR=4.10; 1.94-8.63, respectively). BMI was not associated with GCC or GNCC. WC was related to higher risks of GCC after adjustment for BMI and more strongly after adjustment for HC (highest vs. lowest quintile HR = 1.91; 1.09-3.37, and HR = 2.23; 1.28-3.90, respectively). Our study demonstrates that abdominal, rather than general, obesity is an indisputable risk factor for EAC and also provides evidence for a protective effect of gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further shows that general obesity is not a risk factor for GCC and GNCC, while the role of abdominal obesity in GCC needs further investigation. PMID:25598323

  12. Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

    PubMed Central

    Sacks, Frank M.; Carey, Vincent J.; Anderson, Cheryl A. M.; Miller, Edgar R.; Copeland, Trisha; Charleston, Jeanne; Harshfield, Benjamin J.; Laranjo, Nancy; McCarron, Phyllis; Swain, Janis; White, Karen; Yee, Karen; Appel, Lawrence J.

    2015-01-01

    IMPORTANCE Foods that have similar carbohydrate content can differ in the amount they raise blood glucose. The effects of this property, called the glycemic index, on risk factors for cardiovascular disease and diabetes are not well understood. OBJECTIVE To determine the effect of glycemic index and amount of total dietary carbohydrate on risk factors for cardiovascular disease and diabetes. DESIGN, SETTING, AND PARTICIPANTS Randomized crossover-controlled feeding trial conducted in research units in academic medical centers, in which 163 overweight adults (systolic blood pressure, 120–159 mm Hg) were given 4 complete diets that contained all of their meals, snacks, and calorie-containing beverages, each for 5 weeks, and completed at least 2 study diets. The first participant was enrolled April 1, 2008; the last participant finished December 22, 2010. For any pair of the 4 diets, there were 135 to 150 participants contributing at least 1 primary outcome measure. INTERVENTIONS (1) A high–glycemic index (65% on the glucose scale), high-carbohydrate diet (58% energy); (2) a low–glycemic index (40%), high-carbohydrate diet; (3) a high–glycemic index, low-carbohydrate diet (40% energy); and (4) a low–glycemic index, low-carbohydrate diet. Each diet was based on a healthful DASH-type diet. MAIN OUTCOMES AND MEASURES The 5 primary outcomes were insulin sensitivity, determined from the areas under the curves of glucose and insulin levels during an oral glucose tolerance test; levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides; and systolic blood pressure. RESULTS At high dietary carbohydrate content, the low– compared with high–glycemic index level decreased insulin sensitivity from 8.9 to 7.1 units (−20%, P = .002); increased LDL cholesterol from 139 to 147 mg/dL (6%, P ≤ .001); and did not affect levels of HDL cholesterol, triglycerides, or blood pressure. At low carbohydrate content, the

  13. The impact of state-level nutrition-education program funding on BMI: evidence from the behavioral risk factor surveillance system.

    PubMed

    McGeary, Kerry Anne

    2013-04-01

    Currently, there is insufficient evidence regarding which policies will improve nutrition, reduce BMI levels and the prevalence of obesity and overweight nationwide. This preliminary study investigates the impact of a nutrition-education policy relative to price policy as a means to reduce BMI in the United States (US). Model estimations use pooled cross-sectional data at the individual-level from the Centers for Disease Control's (CDC), Behavioral Risk Factor Surveillance System (BRFSS), state-level food prices from the American Chamber of Commerce Research Association (ACCRA) and funding for state-specific nutrition-education programs from the United States Department of Agriculture (USDA) from 1992 to 2006. The total number of observations for the study is 2,249,713 over 15 years. During this period, federal funding for state-specific nutrition-education programs rose from approximately $660 thousand for seven states to nearly $248 million for all fifty-two states. In 2011, federal funding for nutrition-education programs reached $375 million. After controlling for state-fixed effects, year effects and state specific linear and quadratic time trends, we find that nutrition education spending has the intended effect on BMI, obese and overweight in aggregate. However, we find heterogeneity as individuals from certain, but not all, income and education levels respond to nutrition-education funding. The results regarding nutrition-education programs suggest that large scale funding of nutrition-education programs may improve BMI levels and reduce obesity and overweight. However, more study is required to determine if these funds are able make the requisite dietary improvements that may ultimately improve BMI for individuals from low income and education-levels. PMID:23453319

  14. Cardiovascular Event Risk Dynamics Over Time in Older Patients on Dialysis: A Generalized Multiple-Index Varying Coefficient Model Approach

    PubMed Central

    Estes, Jason P.; Nguyen, Danh V.; Dalrymple, Lorien S.; Mu, Yi; Şentürk, Damla

    2014-01-01

    Among patients on dialysis, cardiovascular disease and infection are leading causes of hospitalization and death. Although recent studies have found that the risk of cardiovascular events is higher after an infection-related hospitalization, studies have not fully elucidated how the risk of cardiovascular events changes over time for patients on dialysis. In this work, we characterize the dynamics of cardiovascular event risk trajectories for patients on dialysis while conditioning on survival status via multiple time indices: (1) time since the start of dialysis, (2) time since the pivotal initial infection-related hospitalization and (3) the patient’s age at the start of dialysis. This is achieved by using a new class of generalized multiple-index varying coefficient (GM-IVC) models. The proposed GM-IVC models utilize a multiplicative structure and one-dimensional varying coefficient functions along each time and age index to capture the cardiovascular risk dynamics before and after the initial infection-related hospitalization among the dynamic cohort of survivors. We develop a two-step estimation procedure for the GM-IVC models based on local maximum likelihood. We report new insights on the dynamics of cardiovascular events risk using the United States Renal Data System database, which collects data on nearly all patients with end-stage renal disease in the U.S. Finally, simulation studies assess the performance of the proposed estimation procedures. PMID:24766178

  15. Dietary inflammatory index is related to asthma risk, lung function and systemic inflammation in asthma

    PubMed Central

    Wood, Lisa G; Shivappa, Nitin; Berthon, Bronwyn S; Gibson, Peter G; Hebert, James R

    2014-01-01

    Background Asthma prevalence has increased in recent years and evidence suggests that diet may be a contributing factor. Increased use of processed foods has led to a decrease in diet quality, which may be creating a pro-inflammatory environment, thereby leading to the development and/or progression of various chronic inflammatory diseases and conditions. Recently, the Dietary Inflammatory Index (DII) has been developed and validated to assess the inflammatory potential of individual diets. Objective This study aimed to examine the DII in subjects with asthma compared to healthy controls and to relate the DII to asthma risk, lung function and systemic inflammation. Methods Subjects with asthma (n=99) and healthy controls (n=61) were recruited. Blood was collected and spirometry was performed. The DII was calculated from food frequency questionnaires administered to study subjects. Results The mean DII score for the asthmatics was higher than the DII score for healthy controls (−1.40 versus −1.86, p=0.04), indicating their diets were more pro-inflammatory. For every 1 unit increase in DII score the odds of having asthma increased by 70% (OR: 1.70, 95% CI: 1.03, 2.14; p=0.040). FEV1 was significantly associated with DII score (β=−3.44, 95% CI: −6.50,−0.39; p=0.020), indicating that for every 1 unit increase in DII score, FEV1 decreased by 3.44 times. Furthermore, plasma IL-6 concentrations were positively associated with DII score (β=0.13, 95% CI: 0.05, 0.21;p=0.002). Conclusion and clinical relevance As assessed using the DII score, the usual diet consumed by asthmatics in this study was pro-inflammatory relative to the diet consumed by the healthy controls. The DII score was associated with increased systemic inflammation and lower lung function. Hence, consumption of pro-inflammatory foods may contribute to worse asthma status and targeting an improvement in DII in asthmatics, as an indicator of suitable dietary intake, might be a useful strategy for

  16. Risk Stratification of Patients with Peripheral Arterial Disease and Abdominal Aortic Aneurysm Using Aortic Augmentation Index

    PubMed Central

    Beckmann, Marianne; Husmann, Marc

    2015-01-01

    Background Central augmentation index (cAIx) is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures. Aim To assess and compare cAIx in patients with peripheral arterial disease (PAD) and / or abdominal aortic aneurysm (AAA). Methods cAIx was assessed by radial applanation tonometry (Sphygmocor) in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease. Results In the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (%) was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55) than males (28.4 ± 8.2, n = 129), and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22) than in those under 80 years (30.0 ± 8.2, n = 162). Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5). cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006). Conclusion Non-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease. PMID:26452151

  17. Role of nutrition in preventing insulin resistance in children.

    PubMed

    Blasetti, Annalisa; Franchini, Simone; Comegna, Laura; Prezioso, Giovanni; Chiarelli, Francesco

    2016-03-01

    Nutrition during prenatal, early postnatal and pubertal period is crucial for the development of insulin resistance and its consequences. During prenatal period fetal environment and nutrition seems to interfere with metabolism programming later in life. The type of dietary carbohydrates, glycemic index, protein, fat and micronutrient content in maternal nutrition could influence insulin sensitivity in the newborn. The effects of lactation on metabolism and nutritional behavior later in life have been studied. Dietary habits and quality of diet during puberty could prevent the onset of a pathological insulin resistance through an adequate distribution of macro- and micronutrients, a diet rich in fibers and vegetables and poor in saturated fats, proteins and sugars. We want to overview the latest evidences on the risk of insulin resistance later in life due to both nutritional behaviors and components during the aforementioned periods of life, following a chronological outline from fetal development to adolescence. PMID:26630690

  18. Nutrition education.

    PubMed

    Chauliac, M; Masse-raimbault, A M; D'agostino, M

    1991-01-01

    This paper presents an overview of the experience of an International Children's Center (ICC) team following many years of work in the field of education for nutrition in developing and industrialized countries. Nutrition education, a long term intervention in which individuals of all ages are active participants who acquire the knowledge, skills, and attitude pertaining to food and nutrition in the context of socioeconomic and cultural limitations. The discussion covers the concepts of attitude, behavior, and eating conduct. Attitude is defined as a way of viewing or internal disposition adopted by any person in a specific situation. Attitudes grow out of knowledge, beliefs, and values and personal predisposition. On the other hand, behavior denotes an observable act and results in a certain manner of acting in response to external stimuli. Eating conduct is expressed differently and in varying extents depending on living conditions and dietary resources. These concepts correspond to the different degrees of information, awareness, and participation achieved by individuals during the educational program. While examination of conduct and dietary resources are necessary for any education for nutrition programs, more attention and investigation should be given to the "negotiation" phase with the people. The community must be ready to take risks, made aware of the implications of the choices to be made to the professionals and to the general public. In this issue, the ICC team highlights important points concerning nutrition education programs. PMID:12295489

  19. Dietary components and risk of total, cancer and cardiovascular disease mortality in the Linxian Nutrition Intervention Trials cohort in China

    PubMed Central

    Wang, Jian-Bing; Fan, Jin-Hu; Dawsey, Sanford M.; Sinha, Rashmi; Freedman, Neal D.; Taylor, Philip R.; Qiao, You-Lin; Abnet, Christian C.

    2016-01-01

    Although previous studies have shown that dietary consumption of certain food groups is associated with a lower risk of cancer, heart disease and stroke mortality in western populations, limited prospective data are available from China. We prospectively examined the association between dietary intake of different food groups at baseline and risk of total, cancer, heart disease and stroke mortality outcomes in the Linxian Nutrition Intervention Trials(NIT) cohort. In 1984–1991, 2445 subjects aged 40–69 years from the Linxian NIT cohort completed a food frequency questionnaire. Deaths from esophageal and gastric cancer, heart disease and stroke were identified through up to 26 years of follow-up. We used Cox proportional hazard models to calculate hazard ratios and 95% confidence intervals for associations between intake of groups of food items and these mortality endpoints. We concluded that higher intake of certain food groups was associated with lower risk of gastric cancer, heart disease and stroke mortality in a prospective cohort in rural China. Our findings provide additional evidence that increasing intake of grains, vegetables, beans, fruits and nuts may help reduce mortality from these diseases. PMID:26939909

  20. Use of the Youth Risk Behavior Survey to Monitor Trends for Nutrition and Physical Activity in a Midwest City School District

    ERIC Educational Resources Information Center

    Edwards, Jane U.; Magel, Rhonda

    2007-01-01

    Background: The Youth Risk Behavior Survey (YRBS) was used by a city school district (approximately 11,000 students) in the upper Midwest to monitor trends for nutrition and physical activity (PA) behaviors both within and between years and to compare with national 2003 data. Methods: Independent random samples were obtained in 1999 (387 middle…

  1. Adolescent Nutrition and Physical Fitness. Selected Indicators. Findings for 9th-12th Grade Students from the 1993 North Carolina Youth Risk Behavior Survey.

    ERIC Educational Resources Information Center

    Mikow, Victoria A.

    A survey of 2,439 high school students (the 1993 Youth Risk Behavior Survey) in North Carolina found that students present a mixed picture of healthy and risky physical, nutritional, and weight management practices. The survey examined perception of body weight; weight control by gender; method of weight control; consumption of fruit or fruit…

  2. Using a Systematic Conceptual Model for a Process Evaluation of a Middle School Obesity Risk-Reduction Nutrition Curriculum Intervention: "Choice, Control & Change"

    ERIC Educational Resources Information Center

    Lee, Heewon; Contento, Isobel R.; Koch, Pamela

    2013-01-01

    Objective: To use and review a conceptual model of process evaluation and to examine the implementation of a nutrition education curriculum, "Choice, Control & Change", designed to promote dietary and physical activity behaviors that reduce obesity risk. Design: A process evaluation study based on a systematic conceptual model. Setting: Five…

  3. Nutrition, Balance and Fear of Falling as Predictors of Risk for Falls among Filipino Elderly in Nursing Homes: A Structural Equation Model (SEM)

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Ines, Joanna Louise C.; Inofinada, Nina Josefa A.; Ituralde, Nielson Louie J.; Janolo, John Robert E.; Jerezo, Jnyv L.; Jhun, Hyae Suk J.

    2013-01-01

    While a number of empirical studies have been conducted regarding risk for falls among the elderly, there is still a paucity of similar studies in a developing country like the Philippines. This study purports to test through Structural Equation Modeling (SEM) a model that shows the interaction between and among nutrition, balance, fear of…

  4. Association Between Age at Menarche and Risk Factors for Cardiovascular Diseases in Korean Women: The 2010 to 2013 Korea National Health and Nutrition Examination Survey.

    PubMed

    Won, Jong Chul; Hong, Jae Won; Noh, Jung Hyun; Kim, Dong-Jun

    2016-05-01

    Early menarche is strongly associated with adulthood obesity; however, the relationship between age at menarche and cardiovascular disease (CVD) in Korean women remains poorly understood. Here, we investigated the association between early menarche and risk factors for developing CVD during adulthood using a nationwide population database.In total, 12,336 women (weighted n = 17,483,406; weighted age, 45.7 years) who participated in the Korean National Health and Nutrition Examination Survey 2010 to 2013 were included in this study. Participants were scored using the National Cholesterol Education Program Adult Treatment Panel III criteria for metabolic syndrome. Risk of CVD was estimated using the 10-year Framingham Coronary Heart Disease Risk Point Scale (10-year FRS).Early menarche (≤11 years) was reported in 5.2% (weighted n = 917,493) of subjects. The weighted prevalences of metabolic syndrome and ≥20% 10-year FRS were 23.6% [95% confidence interval (95% CI), 22.7-24.6] and 7.7% (7.1-8.3), respectively. Women with early menarche reported a significantly higher body mass index and waist circumference, along with a higher prevalence of hypertension, diabetes, and metabolic syndrome than those with later menarche (≥13 years). Furthermore, the prevalence of women with a ≥10% or ≥20% 10-year FRS was higher in those with early menarche than in other groups after adjusting for age, smoking, education level, and menstruation. Logistic regression analyses controlling for these and other confounding factors revealed odds ratios of 2.29 (95% CI = 1.25-4.19) and 1.78 (0.96-3.30) for ≥10% and ≥20% 10-year FRS in women with early menarche, respectively, compared with those in the latest menarche group (≥17 years).Taken together, this nationwide study revealed that women with early menarche are at increased risks of metabolic syndrome and CVD. Early menarche may therefore represent an important marker for early preventive interventions. PMID

  5. Impact of nutritional supplementation on immune response, body mass index and bioelectrical impedance in HIV-positive patients starting antiretroviral therapy

    PubMed Central

    2013-01-01

    Background Challenges to HIV care in resource limited settings (RLS) include malnutrition. Limited evidence supports the benefit of nutritional supplementation when starting antiretroviral therapy (ART) in RLS. Methods Randomized controlled pilot study. HIV-positive ART-naive adults with self-reported weight loss were randomized to receive ART plus FutureLife porridge® nutritional supplement (NS) (388 kcal/day) or ART alone (Controls) for 6 months. Patients returned for monthly assessments and blood was drawn at enrolment and 6 months on ART. Differences in body composition, biochemical and laboratory parameters were estimated at 6 months on treatment. Results Of the 36 randomized patients, 26 completed the 6 month follow-up (11 NS vs 15 Controls). At enrolment, groups were similar in terms of age, gender, body mass index (BMI) and bioelectrical impedance. NS patients had a lower median CD4 count (60 cells/mm3 [IQR 12–105 vs 107 cells/mm3 [IQR 63–165]; p = 0.149) and hemoglobin (10.3 g/dL [IQR 9.0-11.3] vs 13.1 g/dL [IQR 11.1-14.7]; p = 0.001). At 6 months, NS patients increased their median CD4 count by 151 cells/mm3 [IQR 120–174) vs 77 cells/mm3 [IQR 33–145] in the Controls. NS patients had higher mean percentage change in body weight (12.7% vs 4.9%; p = 0.047), BMI (7.8% vs 5.5%; p = 0.007), absolute CD4 count (83.0% vs 46.4%, p = 0.002) and hemoglobin (9.5% vs 1.0%; p = 0.026). Patients in the NS arm had a higher mean percentage fat-free mass (16.7% vs −3.5%, p = 0.036), total body water (13.0% vs −1.9%, p = 0.026), intracellular water (16.1% vs −4.1%, p = 0.010) and basal metabolic rate (5.3% vs −0.2%, p = 0.014) compared to Controls. Patients in the NS arm also showed an improvement in physical activity at 6 months post-ART initiation compared to Controls (p = 0.037). Conclusion Preliminary results are encouraging and suggest that NS taken concurrently with ART can promote weight gain

  6. Impact of consumption of vegetable, fruit, grain, and high glycemic index foods on aggressive prostate cancer risk

    PubMed Central

    Hardin, Jill; Cheng, Iona; Witte, John S.

    2011-01-01

    Prostate cancer is a common but complex disease, and distinguishing modifiable risk factors such as diet for more aggressive disease is extremely important. Previous work has detected intriguing associations between vegetable, fruit, and grains and more aggressive prostate cancer, although these remain somewhat unclear. Here we further investigate such potential relationships with a case-control study of 982 men (470 more aggressive prostate cancer cases and 512 control subjects). Comparing the highest to lowest quartiles of intake, we found that increasing intakes of leafy vegetables were inversely associated with risk of aggressive prostate cancer (adjusted odds ratio (OR) =0.66, 95% CI: 0.46, 0.96, P-trend=0.02), as was higher consumption of high carotenoid vegetables (OR=0.71, 95% CI: 0.48, 1.04; P-trend=0.04). Conversely, increased consumption of high glycemic index foods were positively associated with risk of aggressive disease (OR=1.64, 95% CI: 1.05, 2.57; P-trend=0.02). These results were driven by a number of specific foods within the food groups. Our findings support the hypothesis that diets high in vegetables and low in high glycemic index foods decrease risk of aggressive prostate cancer. PMID:21774611

  7. Risk Factors for Pterygium in Korea: The Korean National Health and Nutrition Examination Survey V, 2010–2012

    PubMed Central

    Lim, Chi-Yeon; Kim, Sung-Hyun; Chuck, Roy S.; Lee, Jimmy K.; Park, Choul Y.

    2015-01-01

    Abstract The aim of this study is to report general and age-specific risk factors for pterygium prevalence in the Korean population. This in an observational case series study. Data from total 24,812 participants (age 40 years or older) from the Korean National Health and Nutrition Examination Surveys conducted from 2010 to 2012 were retrieved. After applying exclusion criteria, data from 13,204 participants (821 with pterygium and 12,383 without) were used for univariate and multivariate analyses. General risk factors were identified and participants were grouped by decade: 40 s, 50 s, 60 s, 70 s, and 80+. Age-specific risk factors were investigated for each group. After univariate analysis, 2 multiple regression models were constructed. Model 1: age + sex + spherical equivalent (SE) + sun exposure hours + occupation (indoor vs outdoor) + residency area (rural vs urban) + education level; model 2: age + sex + SE + sun exposure hours. In model 1, older age (odds ratio [OR]: 1.05 95% confidence interval [CI]: 1.05–1.06), male gender (OR: 1.28, 95% CI: 1.01–1.61), and longer sun exposure hours (OR: 1.47, 95% CI: 1.11–1.94) were significant risk factors for pterygium prevalence whereas higher level of education (elementary school vs college, OR: 3.98, 95% CI: 2.24–7.06) and urban residency (vs rural residency, OR: 0.56, 95% CI: 0.45–0.70) were protective factors. Higher SE (OR 1.11, 95% CI: 1.03–1.19) refractive error was considered a risk factor when using model 2 for the analysis. Age-specific risk factors were different in each age group. Male gender was associated with higher pterygium prevalence in younger age groups while longer sun exposure (5+ hours/day) increased pterygium prevalence in older age groups. Previously characterized risk factors were also found in this large population study. However, we found that risk factors may vary according to the age group. Myopic eyes were found to have lower

  8. Use of drinking water treatment residuals as a potential best management practice to reduce phosphorus risk index scores.

    PubMed

    Dayton, E A; Basta, N T

    2005-01-01

    The P risk index system has been developed to identify agricultural fields vulnerable to P loss as a step toward protecting surface water. Because of their high Langmuir phosphorus adsorption maxima (P(max)), use of drinking water treatment residuals (WTRs) should be considered as a best management practice (BMP) to lower P risk index scores. This work discusses three WTR application methods that can be used to reduce P risk scores: (i) enhanced buffer strip, (ii) incorporation into a high soil test phosphorus (STP) soil, and (iii) co-blending with manure or biosolids. The relationship between WTR P(max) and reduction in P extractability and runoff P was investigated. In a simulated rainfall experiment, using a buffer strip enhanced with 20 Mg WTR ha(-1), runoff P was reduced by from 66.8 to 86.2% and reductions were related to the WTR P(max). When 25 g kg(-1) WTR was incorporated into a high STP soil of 315 mg kg(-1) determined using Mehlich-3 extraction, 0.01 M calcium chloride-extractable phosphorus (CaCl(2)-P) reductions ranged from 60.9 to 96.0% and were strongly (P < 0.01) related to WTR P(max). At a 100 g kg(-1) WTR addition, Mehlich 3-extractable P reductions ranged from 41.1 to 86.7% and were strongly (P < 0.01) related to WTR P(max). Co-blending WTR at 250 g kg(-1) to manure or biosolids reduced CaCl(2)-P by >75%. The WTR P(max) normalized across WTR application rates (P(max) x WTR application) was significantly related to reductions in CaCl(2)-P or STP. Using WTR as a P risk index modifying factor will promote effective use of WTR as a BMP to reduce P loss from agricultural land. PMID:16275711

  9. Dietary insulin index and insulin load in relation to endometrial cancer risk in the Nurses’ Health Study

    PubMed Central

    Prescott, Jennifer; Bao, Ying; Viswanathan, Akila N.; Giovannucci, Edward L.; Hankinson, Susan E.; De Vivo, Immaculata

    2014-01-01

    Background While unopposed estrogen exposure is considered the main driver of endometrial carcinogenesis, factors associated with states of insulin resistance and hyperinsulinemia are independently associated with endometrial cancer risk. We used dietary insulin load and insulin index scores to represent the estimated insulin demand of overall diets and assessed their association with endometrial cancer risk in the prospective Nurses’ Health Study. Methods We estimated incidence rate ratios (RRs) and 95% confidence intervals (CI) for risk of invasive endometrial cancer using Cox proportional hazards models. Between the baseline dietary questionnaire (1980) and 2010, we identified a total of 798 incident invasive epithelial endometrial adenocarcinomas over 1,417,167 person-years of follow-up. Results Dietary insulin scores were not associated with overall risk of endometrial cancer. Comparing women in the highest to the lowest quintile, the multivariable-adjusted RRs of endometrial cancer were 1.07 (95% CI: 0.84, 1.35) for cumulative average dietary insulin load and 1.03 (95% CI: 0.82, 1.31) for cumulative average dietary insulin index. Findings did not vary substantially by alcohol consumption, total dietary fiber intake, or BMI and/or physical activity (Pheterogeneity ≥ 0.10). Conclusions Intake of a diet predicted to stimulate a high postprandial insulin response was not associated with endometrial cancer risk in this large prospective study. Considering the complex interplay of diet, lifestyle and genetic factors contributing to the hyperinsulinemic state, dietary measures alone may not sufficiently capture absolute long-term insulin exposure. Impact This study is the first to investigate dietary insulin scores in relation to endometrial cancer risk. PMID:24859872

  10. Nanotechnology and patents in agriculture, food technology, nutrition and medicine - advantages and risks: worldwide patented nano- and absorber particles in food nutrition and agriculture.

    PubMed

    Benckiser, Gero

    2012-12-01

    The keywords nanotechnology, super absorber, agriculture, nutrition, and food technology exhibited 28,149 positive matches under more than 68 million patents worldwide. A closer look at the first 500 nanotechnology, agriculture, nutrition and biotechnology related patents, published during 2011-2012, unveiled that 64% are parts of machines and control devices while about 36% comprise metal oxides, fertilizers, pesticides and drugs, which are compounds and often applied in combination with inorganic or organic super absorbing polymeric structures. The latter compounds are in the focus of this special issue. PMID:23061649

  11. Diet and risk of kidney stones in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC).

    PubMed

    Turney, Benjamin W; Appleby, Paul N; Reynard, John M; Noble, Jeremy G; Key, Timothy J; Allen, Naomi E

    2014-05-01

    The lifetime prevalence of kidney stones is around 10 % and incidence rates are increasing. Diet may be an important determinant of kidney stone development. Our objective was to investigate the association between diet and kidney stone risk in a population with a wide range of diets. This association was examined among 51,336 participants in the Oxford arm of the European Prospective Investigation into Cancer and Nutrition using data from Hospital Episode Statistics in England and Scottish Morbidity Records. In the cohort, 303 participants attended hospital with a new kidney stone episode. Cox proportional hazards regression was performed to calculate hazard ratios (HR) and their 95 % confidence intervals (95 % CI). Compared to those with high intake of meat (>100 g/day), the HR estimates for moderate meat-eaters (50-99 g/day), low meat-eaters (<50 g/day), fish-eaters and vegetarians were 0.80 (95 % CI 0.57-1.11), 0.52 (95 % CI 0.35-0.8), 0.73 (95 % CI 0.48-1.11) and 0.69 (95 % CI 0.48-0.98), respectively. High intakes of fresh fruit, fibre from wholegrain cereals and magnesium were also associated with a lower risk of kidney stone formation. A high intake of zinc was associated with a higher risk. In conclusion, vegetarians have a lower risk of developing kidney stones compared with those who eat a high meat diet. This information may be important to advise the public about prevention of kidney stone formation. PMID:24752465

  12. Dietary intake of acrylamide and epithelial ovarian cancer risk in the european prospective investigation into cancer and nutrition (EPIC) cohort.

    PubMed

    Obón-Santacana, Mireia; Peeters, Petra H M; Freisling, Heinz; Dossus, Laure; Clavel-Chapelon, Françoise; Baglietto, Laura; Schock, Helena; Fortner, Renée T; Boeing, Heiner; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Menéndez, Virginia; Sanchez, Maria-José; Larrañaga, Nerea; Huerta Castaño, José María; Barricarte, Aurelio; Khaw, Kay-Tee; Wareham, Nick; Travis, Ruth C; Merritt, Melissa A; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Orfanos, Philippos; Masala, Giovanna; Sieri, Sabina; Tumino, Rosario; Vineis, Paolo; Mattiello, Amalia; Bueno-de-Mesquita, H B; Onland-Moret, N Charlotte; Wirfält, Elisabeth; Stocks, Tanja; Idahl, Annika; Lundin, Eva; Skeie, Guri; Gram, Inger T; Weiderpass, Elisabete; Riboli, Elio; Duell, Eric J

    2015-01-01

    Acrylamide, classified in 1994 by the International Agency for Research on Cancer (IARC) as "probably carcinogenic" to humans, was discovered in 2002 in some heat-treated, carbohydrate-rich foods. The association between dietary acrylamide intake and epithelial ovarian cancer risk (EOC) has been previously studied in one case-control and three prospective cohort studies which obtained inconsistent results and could not further examine histologic subtypes other than serous EOC. The present study was carried out in the European Prospective Investigation into Cancer and Nutrition (EPIC) subcohort of women (n = 325,006). Multivariate Cox proportional hazards models were used to assess the association between questionnaire-based acrylamide intake and EOC risk. Acrylamide was energy-adjusted using the residual method and was evaluated both as a continuous variable (per 10 μg/d) and in quintiles; when subgroups by histologic EOC subtypes were analyzed, acrylamide intake was evaluated in quartiles. During a mean follow-up of 11 years, 1,191 incident EOC cases were diagnosed. At baseline, the median acrylamide intake in EPIC was 21.3 μg/d. No associations and no evidence for a dose-response were observed between energy-adjusted acrylamide intake and EOC risk (HR10μg/d,1.02; 95% CI, 0.96-1.09; HRQ5vsQ1, 0.97; 95% CI, 0.76-1.23). No differences were seen when invasive EOC subtypes (582 serous, 118 endometrioid, and 79 mucinous tumors) were analyzed separately. This study did not provide evidence that acrylamide intake, based on food intake questionnaires, was associated with risk for EOC in EPIC. Additional studies with more reliable estimates of exposure based on biomarkers may be needed. PMID:25300475

  13. Dietary intake of acrylamide and epithelial ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

    PubMed Central

    Obón-Santacana, Mireia; Peeters, Petra H.M.; Freisling, Heinz; Dossus, Laure; Clavel-Chapelon, Françoise; Baglietto, Laura; Schock, Helena; Fortner, Renée T.; Boeing, Heiner; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Menéndez, Virginia; Sanchez, Maria-José; Larrañaga, Nerea; Castaño, José María Huerta; Barricarte, Aurelio; Khaw, Kay-Tee; Wareham, Nick; Travis, Ruth C.; Merritt, Melissa A.; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Orfanos, Philippos; Masala, Giovanna; Sieri, Sabina; Tumino, Rosario; Vineis, Paolo; Mattiello, Amalia; Bueno-de-Mesquita, H.B.; Onland-Moret, N. Charlotte; Wirfält, Elisabeth; Stocks, Tanja; Idahl, Annika; Lundin, Eva; Skeie, Guri; Gram, Inger T.; Weiderpass, Elisabete; Riboli, Elio; Duell, Eric J

    2014-01-01

    Acrylamide, classified in 1994 by IARC as ‘probably carcinogenic’ to humans, was discovered in 2002 in some heat-treated, carbohydrate-rich foods. The association between dietary acrylamide intake and epithelial ovarian cancer risk (EOC) has been previously studied in one case-control and three prospective cohort studies which obtained inconsistent results, and could not further examine histological subtypes other than serous EOC. The present study was carried out in the European Prospective Investigation into Cancer and Nutrition (EPIC) sub-cohort of women (n=325,006). Multivariate Cox proportional hazards models were used to assess the association between questionnaire-based acrylamide intake and EOC risk. Acrylamide was energy-adjusted using the residual method, and was evaluated both as a continuous variable (per 10μg/day) and in quintiles; when subgroups by histological EOC subtypes were analyzed, acrylamide intake was evaluated in quartiles. During a mean follow-up of 11 years, 1,191 incident EOC cases were diagnosed. At baseline, the median acrylamide intake in EPIC was 21.3 μg/day. No associations, and no evidence for a dose-response were observed between energy-adjusted acrylamide intake and EOC risk (HR10μg/day:1.02, 95%CI:0.96-1.09; HRQ5vsQ1:0.97, 95%CI:0.76-1.23). No differences were seen when invasive EOC subtypes (582 serous, 118 endometrioid, and 79 mucinous tumors) were analyzed separately. This study did not provide evidence that acrylamide intake, based on food intake questionnaires, was associated with risk for EOC in EPIC. Additional studies with more reliable estimates of exposure based on biomarkers may be needed. PMID:25300475

  14. Nutritional Biochemistry

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.

    2010-01-01

    This slide presentation reviews some of the effects that space flight has on humans nutritional biochemistry. Particular attention is devoted to the study of protein breakdown, inflammation, hypercatabolism, omega 3 fatty acids, vitamin D, calcium, urine, folate and nutrient stability of certain vitamins, the fluid shift and renal stone risk, acidosis, iron/hematology, and the effects on bone of dietary protein, potassium. inflammation, and omega-3 fatty acids

  15. Use of Segregation Indices, Townsend Index, and Air Toxics Data to Assess Lifetime Cancer Risk Disparities in Metropolitan Charleston, South Carolina, USA

    PubMed Central

    Rice, LaShanta J.; Jiang, Chengsheng; Wilson, Sacoby M.; Burwell-Naney, Kristen; Samantapudi, Ashok; Zhang, Hongmei

    2014-01-01

    Background: Studies have demonstrated a relationship between segregation and level of education, occupational opportunities, and risk behaviors, yet a paucity of research has elucidated the association between racial residential segregation, socioeconomic deprivation, and lifetime cancer risk. Objectives: We examined estimated lifetime cancer risk from air toxics by racial composition, segregation, and deprivation in census tracts in Metropolitan Charleston. Methods: Segregation indices were used to measure the distribution of groups of people from different races within neighborhoods. The Townsend Index was used to measure economic deprivation in the study area. Poisson multivariate regressions were applied to assess the association of lifetime cancer risk with segregation indices and Townsend Index along with several sociodemographic measures. Results: Lifetime cancer risk from all pollution sources was 28 persons/million for half of the census tracts in Metropolitan Charleston. Isolation Index and Townsend Index both showed significant correlation with lifetime cancer risk from different sources. This significance still holds after adjusting for other sociodemographic measures in a Poisson regression, and these two indices have stronger effect on lifetime cancer risk compared to the effects of sociodemographic measures. Conclusions: We found that material deprivation, measured by the Townsend Index and segregation measured by the Isolation index, introduced high impact on lifetime cancer risk by air toxics at the census tract level. PMID:24852759

  16. Pathway analysis of body mass index genome-wide association study highlights risk pathways in cardiovascular disease

    PubMed Central

    Zhao, Xin; Gu, Jinxia; Li, Ming; Xi, Jie; Sun, Wenyu; Song, Guangmin; Liu, Guiyou

    2015-01-01

    Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. It is reported that body mass index (BMI) is risk factor for CVD. Genome-wide association studies (GWAS) have recently provided rapid insights into genetics of CVD and its risk factors. However, the specific mechanisms how BMI influences CVD risk are largely unknown. We think that BMI may influences CVD risk by shared genetic pathways. In order to confirm this view, we conducted a pathway analysis of BMI GWAS, which examined approximately 329,091 single nucleotide polymorphisms from 4763 samples. We identified 31 significant KEGG pathways. There is literature evidence supporting the involvement of GnRH signaling, vascular smooth muscle contraction, dilated cardiomyopathy, Gap junction, Wnt signaling, Calcium signaling and Chemokine signaling in CVD. Collectively, our study supports the potential role of the CVD risk pathways in BMI. BMI may influence CVD risk by the shared genetic pathways. We believe that our results may advance our understanding of BMI mechanisms in CVD. PMID:26264282

  17. The influence of body mass index, age and sex on inflammatory disease risk in semi-captive Chimpanzees.

    PubMed

    Obanda, Vincent; Omondi, George Paul; Chiyo, Patrick Ilukol

    2014-01-01

    Obesity and ageing are emerging issues in the management of captive primates, including Chimpanzees, Pan troglodytes. Studies on humans show that obesity and old age can independently increase the risk of inflammatory-associated diseases indicated by elevated levels of pro-inflammatory cells and proteins in the blood of older or obese compared to levels in younger or non-obese individuals. In humans, sex can influence the outcomes of these risks. Health management of these problems in chimpanzee populations requires an understanding of similarities and differences of factors influencing inflammatory disease risks in humans and in chimpanzees. We examined the relationship between age, sex and Body Mass Index (BMI) with hematological biomarkers of inflammatory disease risk established for humans which include the neutrophil to lymphocyte ratio (NLR), and neutrophil, white blood cell (WBC), platelet microparticle and platelet counts. We found that higher values of NLR, neutrophil count and platelet microparticle count were associated with higher BMI values and older age indicating increased inflammation risk in these groups; a similar pattern to humans. There was a strong sex by age interaction on inflammation risk, with older males more at risk than older females. In contrast to human studies, total WBC count was not influenced by BMI, but like humans, WBC and platelet counts were lower in older individuals compared to younger individuals. Our findings are similar to those of humans and suggest that further insight on managing chimpanzees can be gained from extensive studies of ageing and obesity in humans. We suggest that managing BMI should be an integral part of health management in captive chimpanzee populations in order to partially reduce the risk of diseases associated with inflammation. These results also highlight parallels in inflammation risk between humans and chimpanzees and have implications for understanding the evolution of inflammation related

  18. The Influence of Body Mass Index, Age and Sex on Inflammatory Disease Risk in Semi-Captive Chimpanzees

    PubMed Central

    Obanda, Vincent; Omondi, George Paul; Chiyo, Patrick Ilukol

    2014-01-01

    Obesity and ageing are emerging issues in the management of captive primates, including Chimpanzees, Pan troglodytes. Studies on humans show that obesity and old age can independently increase the risk of inflammatory-associated diseases indicated by elevated levels of pro-inflammatory cells and proteins in the blood of older or obese compared to levels in younger or non-obese individuals. In humans, sex can influence the outcomes of these risks. Health management of these problems in chimpanzee populations requires an understanding of similarities and differences of factors influencing inflammatory disease risks in humans and in chimpanzees. We examined the relationship between age, sex and Body Mass Index (BMI) with hematological biomarkers of inflammatory disease risk established for humans which include the neutrophil to lymphocyte ratio (NLR), and neutrophil, white blood cell (WBC), platelet microparticle and platelet counts. We found that higher values of NLR, neutrophil count and platelet microparticle count were associated with higher BMI values and older age indicating increased inflammation risk in these groups; a similar pattern to humans. There was a strong sex by age interaction on inflammation risk, with older males more at risk than older females. In contrast to human studies, total WBC count was not influenced by BMI, but like humans, WBC and platelet counts were lower in older individuals compared to younger individuals. Our findings are similar to those of humans and suggest that further insight on managing chimpanzees can be gained from extensive studies of ageing and obesity in humans. We suggest that managing BMI should be an integral part of health management in captive chimpanzee populations in order to partially reduce the risk of diseases associated with inflammation. These results also highlight parallels in inflammation risk between humans and chimpanzees and have implications for understanding the evolution of inflammation related

  19. Nutrition and Physical Activity Knowledge Assessment: Development of Questionnaires and Evaluation of Reliability in African American and Latino Children

    ERIC Educational Resources Information Center

    Roberts, Lindsay S.; Sharma, Sushma; Hudes, Mark L.; Fleming, Sharon E.

    2012-01-01

    Background: African-American and Latino children living in neighborhoods with a low-socioeconomic index are more at risk of obesity-associated metabolic disease than their higher socioeconomic index and/or white peers. Currently, consistent and reliable questionnaires to evaluate nutrition and physical activity knowledge in these children are…

  20. Edge-of-field evaluation of the Ohio phosphorus risk index

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Phosphorus Index (PI) has been the cornerstone for phosphorus (P)-based management and planning over the past twenty years; yet, field-scale evaluation of many state PIs has been limited. In this study, measured P loads in surface runoff and tile discharge from 40 agricultural fields in Ohio wit...

  1. Alcohol consumption and the risk of renal cancers in the European prospective investigation into cancer and nutrition (EPIC).

    PubMed

    Wozniak, Magdalena B; Brennan, Paul; Brenner, Darren R; Overvad, Kim; Olsen, Anja; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Fagherazzi, Guy; Katzke, Verena; Kühn, Tilman; Boeing, Heiner; Bergmann, Manuela M; Steffen, Annika; Naska, Androniki; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Saieva, Calogero; Grioni, Sara; Panico, Salvatore; Tumino, Rosario; Vineis, Paolo; Bueno-de-Mesquita, H B As; Peeters, Petra H; Hjartåker, Anette; Weiderpass, Elisabete; Arriola, Larraitz; Molina-Montes, Esther; Duell, Eric J; Santiuste, Carmen; Alonso de la Torre, Ramón; Barricarte Gurrea, Aurelio; Stocks, Tanja; Johansson, Mattias; Ljungberg, Börje; Wareham, Nick; Khaw, Kay-Tee; Travis, Ruth C; Cross, Amanda J; Murphy, Neil; Riboli, Elio; Scelo, Ghislaine

    2015-10-15

    Epidemiologic studies have reported that moderate alcohol consumption is inversely associated with the risk of renal cancer. However, there is no information available on the associations in renal cancer subsites. From 1992 through to 2010, 477,325 men and women in the European Prospective Investigation into Cancer and Nutrition cohort were followed for incident renal cancers (n = 931). Baseline and lifetime alcohol consumption was assessed by country-specific, validated dietary questionnaires. Information on past alcohol consumption was collected by lifestyle questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models. In multivariate analysis, total alcohol consumption at baseline was inversely associated with renal cancer; the HR and 95% CI for the increasing categories of total alcohol consumption at recruitment versus the light drinkers category were 0.78 (0.62-0.99), 0.82 (0.64-1.04), 0.70 (0.55-0.90), 0.91 (0.63-1.30), respectively, (ptrend  = 0.001). A similar relationship was observed for average lifetime alcohol consumption and for all renal cancer subsites combined or for renal parenchyma subsite. The trend was not observed in hypertensive individuals and not significant in smokers. In conclusion, moderate alcohol consumption was associated with a decreased risk of renal cancer. PMID:25866035

  2. LA Sprouts Randomized Controlled Nutrition, Cooking and Gardening Program Reduces Obesity and Metabolic Risk in Latino Youth

    PubMed Central

    Gatto, Nicole M.; Martinez, Lauren C.; Spruijt-Metz, Donna; Davis, Jaimie N.

    2015-01-01

    Objective To assess the effects of a 12-week gardening, nutrition, and cooking intervention (“LA Sprouts”) on dietary intake, obesity parameters and metabolic disease risk among low-income, primarily Hispanic/Latino youth in Los Angeles. Methods Randomized control trial involving four elementary schools [2 schools randomized to intervention (172, 3rd–5th grade students); 2 schools randomized to control (147, 3rd–5th grade students)]. Classes were taught in 90-minute sessions once a week to each grade level for 12 weeks. Data collected at pre- and post-intervention included dietary intake via food frequency questionnaire (FFQ), anthropometric measures [BMI, waist circumference (WC)], body fat, and fasting blood samples. Results LA Sprouts participants had significantly greater reductions in BMI z-scores (0.1 versus 0.04 point decrease, respectively; p=0.01) and WC (−1.2 cm vs. no change; p<0.001). Fewer LA Sprouts participants had the metabolic syndrome (MetSyn) after the intervention than before, while the number of controls with MetSyn increased. LA Sprouts participants had improvements in dietary fiber intake (+3.5% vs. −15.5%; p=0.04) and less decreases in vegetable intake (−3.6% vs. −26.4%; p=0.04). Change in fruit intake before and after the intervention did not significantly differ between LAS and control subjects. Conclusions LA Sprouts was effective in reducing obesity and metabolic risk. PMID:25960146

  3. Nutritional Solutions to Reduce Risks of Negative Health Impacts of Air Pollution

    PubMed Central

    Péter, Szabolcs; Holguin, Fernando; Wood, Lisa G.; Clougherty, Jane E.; Raederstorff, Daniel; Antal, Magda; Weber, Peter; Eggersdorfer, Manfred

    2015-01-01

    Air pollution worldwide has been associated with cardiovascular and respiratory morbidity and mortality, particularly in urban settings with elevated concentrations of primary pollutants. Air pollution is a very complex mixture of primary and secondary gases and particles, and its potential to cause harm can depend on multiple factors—including physical and chemical characteristics of pollutants, which varies with fine-scale location (e.g., by proximity to local emission sources)—as well as local meteorology, topography, and population susceptibility. It has been hypothesized that the intake of anti-oxidant and anti-inflammatory nutrients may ameliorate various respiratory and cardiovascular effects of air pollution through reductions in oxidative stress and inflammation. To date, several studies have suggested that some harmful effects of air pollution may be modified by intake of essential micronutrients (such as B vitamins, and vitamins C, D, and E) and long-chain polyunsaturated fatty acids. Here, we review the existing literature related to the potential for nutrition to modify the health impacts of air pollution, and offer a framework for examining these interactions. PMID:26690474

  4. Nutritional Solutions to Reduce Risks of Negative Health Impacts of Air Pollution.

    PubMed

    Péter, Szabolcs; Holguin, Fernando; Wood, Lisa G; Clougherty, Jane E; Raederstorff, Daniel; Antal, Magda; Weber, Peter; Eggersdorfer, Manfred

    2015-12-01

    Air pollution worldwide has been associated with cardiovascular and respiratory morbidity and mortality, particularly in urban settings with elevated concentrations of primary pollutants. Air pollution is a very complex mixture of primary and secondary gases and particles, and its potential to cause harm can depend on multiple factors-including physical and chemical characteristics of pollutants, which varies with fine-scale location (e.g., by proximity to local emission sources)-as well as local meteorology, topography, and population susceptibility. It has been hypothesized that the intake of anti-oxidant and anti-inflammatory nutrients may ameliorate various respiratory and cardiovascular effects of air pollution through reductions in oxidative stress and inflammation. To date, several studies have suggested that some harmful effects of air pollution may be modified by intake of essential micronutrients (such as B vitamins, and vitamins C, D, and E) and long-chain polyunsaturated fatty acids. Here, we review the existing literature related to the potential for nutrition to modify the health impacts of air pollution, and offer a framework for examining these interactions. PMID:26690474

  5. Nutritional Status Parameters as Risk Factors for Mortality in Cancer Patients.

    PubMed

    Mauricio, Sílvia Fernandes; Ribeiro, Helem Sena; Correia, Maria Isabel Toulson Davisson

    2016-01-01

    The aim of this study was to verify the relationship between weight loss, handgrip strength (HGS) and phase angle (PA) before the beginning of chemotherapy with overall survival in cancer patients. Patients diagnosed with gastrointestinal and breast cancer who were over 18 years old and were scheduled to undergo adjuvant treatment at Hospital Borges da Costa/Brazil were evaluated. The exclusion criteria were neoadjuvant treatment, patients with kidney and liver disease and using diuretics. Weight, HGS and PA tests were performed by trained dietitians. The Kaplan-Meier survival method and the log-rank test, cox regression and ROC curve were used and p < 0.05 was considered significant. Two-hundred and twenty-eight patients were evaluated.The median survival time was higher among the patients who showed weight loss of less than 10% of usual body weight (p < 0.05). Regarding HGS, patients with decreased HGS had a 22.0 month survival versus 34.2 months for those with normal values (p < 0.05). 146 patients had normal PA values, and these patients had increased survival time compared to those with inappropriate values (p < 0.05). In the Cox regression, weight loss and PA were predictors of mortality, HGS wasn't significantly associated with mortality. ROC analysis revealed that weight loss was the nutritional status parameter with the most predictive power. PMID:27348185

  6. Relationship between Blood Mercury Level and Risk of Cardiovascular Diseases: Results from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2008–2009

    PubMed Central

    Kim, Young-Nam; Kim, Young A; Yang, Ae-Ri; Lee, Bog-Hieu

    2014-01-01

    Limited epidemiologic data is available regarding the cardiovascular effects of mercury exposure. The purpose of this study was to determine the relationship between mercury exposure from fish consumption and cardiovascular disease in a nationally representative sample of Korean adults using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV 2008~2009). Survey logistic regression models accounting for the complex sampling were used to estimate the odds ratios (OR) adjusted for fish consumption frequency, age, education, individual annual income, household annual income, body mass index (BMI), waist circumference (WC), alcohol consumption status, and smoking status. The mean blood mercury level in the population was 5.44 μg/L. Trends toward increased blood mercury levels were seen for increased education level (P=0.0011), BMI (P<0.0001), WC (P<0.0001), and fish (i.e., anchovy) consumption frequency (P=0.0007). The unadjusted OR for hypertension in the highest blood mercury quartile was 1.450 [95% confidential interval (CI): 1.106~1.901] times higher than that of the lowest quartile. The fish consumption-adjusted OR for hypertension in the highest blood mercury quartile was 1.550 (95% CI: 1.131~2.123) times higher than that of the lowest quartile, and the OR for myocardial infarction or angina in the highest blood mercury quartile was 3.334 (95% CI: 1.338~8.308) times higher than that of the lowest quartile. No associations were observed between blood mercury levels and stroke. These findings suggest that mercury in the blood may be associated with an increased risk of hypertension and myocardial infarction or angina in the general Korean population. PMID:25580399

  7. Vitamin D Status and the Risk of Anemia in Community-Dwelling Adults: Results from the National Health and Nutrition Examination Survey 2001-2006.

    PubMed

    Monlezun, Dominique J; Camargo, Carlos A; Mullen, John T; Quraishi, Sadeq A

    2015-12-01

    Low vitamin D status has been implicated in several chronic medical conditions and unfavorable health outcomes. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are a potentially modifiable risk factor for anemia in a nationally representative cohort of community-dwelling individuals in the United States. We performed a cross-sectional study of 5456 individuals (≥17 years) from the National Health and Nutrition Examination Survey from 2001 to 2006. Locally weighted scatterplot smoothing (LOWESS) was used to graphically depict the relationship between serum 25OHD levels and the cumulative frequency of anemia. Multivariable logistic regression models were then used to assess the independent association of 25OHD levels with anemia, while controlling for age, sex, race, body mass index, chronic kidney disease, as well as serum levels of C-reactive protein, ferritin, iron, vitamin B12, and folic acid. The mean (standard error) 25OHD and hemoglobin levels in the analytic group were 23.5 (0.4) ng/mL and 14.4 (0.1) g/dL, respectively. Prevalence of anemia was 3.9%. Locally weighted scatterplot smoothing analysis demonstrated a near-linear relationship between vitamin D status and cumulative frequency of anemia up to 25OHD levels of approximately 20  ng/mL. With increasing 25OHD levels, the curve flattened out progressively. Multivariable regression analysis demonstrated an inverse association of 25OHD levels with the risk of anemia (adjusted odds ratio 0.97; 95% confidence interval 0.95-0.99 per 1  ng/mL change in 25OHD). Compared to individuals with ≥20  ng/mL, individuals with 25OHD levels <20  ng/mL were more likely to be anemic (adjusted odds ratio 1.64; 95% confidence interval 1.08-2.49). In a nationally representative sample of community-dwelling individuals in the United States, low 25OHD levels were associated with increased risk of anemia. Randomized controlled trials are needed to determine whether optimizing vitamin D

  8. Development and validation testing of a short nutrition questionnaire to identify dietary risk factors in preschoolers aged 12–36 months

    PubMed Central

    Rice, Niamh; Gibbons, Helena; McNulty, Breige A.; Walton, Janette; Flynn, Albert; Gibney, Michael J.; Nugent, Anne P.

    2015-01-01

    Background Although imbalances in dietary intakes can have short and longer term influences on the health of preschool children, few tools exist to quickly and easily identify nutritional risk in otherwise healthy young children. Objectives To develop and test the validity of a parent-administered questionnaire (NutricheQ) as a means of evaluating dietary risk in young children (12–36 months). Design Following a comprehensive development process and internal reliability assessment, the NutricheQ questionnaire was validated in a cohort of 371 Irish preschool children as part of the National Preschool Nutrition Survey. Dietary risk was rated on a scale ranging from 0 to 22 from 11 questions, with a higher score indicating higher risk. Results Children with higher NutricheQ scores had significantly (p<0.05) lower mean daily intakes of key nutrients such as iron, zinc, vitamin D, riboflavin, niacin, folate, phosphorous, potassium, carotene, retinol, and dietary fibre. They also had lower (p<0.05) intakes of vegetables, fish and fish dishes, meat and infant/toddler milks and higher intakes of processed foods and non-milk beverages, confectionery, sugars and savoury snack foods indicative of poorer dietary quality. Areas under the curve values of 84.7 and 75.6% were achieved for ‘medium’ and ‘high’ dietary risk when compared with expert risk ratings indicating good consistency between the two methods. Conclusion NutricheQ is a valid method of quickly assessing dietary quality in preschoolers and in identifying those at increased nutritional risk. In Context Analysis of data from national food and nutrition surveys typically identifies shortfalls in dietary intakes or quality of young children. This can relate to intakes of micronutrients such as iron or vitamin D as well as to the balance of macronutrients they consume (e.g. fat or sugar). Alongside this lie concerns regarding overweight and obesity and physical inactivity. This combination of risk factors has

  9. Biodex Fall Risk Assessment in the Elderly With Ataxia: A New Age-Dependent Derived Index in Rehabilitation

    PubMed Central

    Prometti, Paola; Olivares, Adriana; Gaia, Giuseppina; Bonometti, Giampietro; Comini, Laura; Scalvini, Simonetta

    2016-01-01

    Abstract The aim of this study was to evaluate if the Biodex Fall Risk Assessment could provide an age-adjusted index useful for classifying patients at “risk of fall.” This was a cohort study conducted on 61 chronic patients, in stable conditions, having a history of ataxia, difficulty in walking or loss of balance, and aged >64 years. These patients were coming from home to our Institute undergoing a period of in-hospital standard rehabilitation. Assessment of clinical parameters was performed at entry. Functional scales (Functional Independence Measure [FIM] for motor and cognitive function, Barthel G, Tinetti POMA), and the Biodex Fall Risk Index (FRI) were performed at entry and discharge. The Normalized FRI, obtained adjusting FRI to the reported maximum predictive FRI for the relevant age, identified 2 types of patients: those with a greater risk of fall than expected for that age, labeled Case 1 (Normalized FRI>1); and those with an equal or even lesser risk of fall than expected for that age, labeled Case 0 (Normalized FRI≤1). FRI, Normalized FRI as well as independent variables as age, sex, pathology group, FIM, BarthelG, were considered in a multiple regression analysis to predict the functional improvement (i.e., delta Tinetti Total score) after rehabilitation. Normalized FRI is useful in assessing patients at risk of falls both before and after rehabilitation. At admission, the Normalized FRI evidenced high fall risk in 46% of patients (Case 1) which decreased to 12% after rehabilitation, being greater than age-predicted in 7 patients (Case 1–1) despite the functional improvement observed after the rehabilitation treatment. Normalized FRI evidenced Case 1–1 patients as neurological, “very old” (86% in age-group 75–84 years), and with serious events at 18 to 24 months’ follow-up. Normalized FRI, but not FRI, at admission was a predictor of improvement in Tinetti Total scores. The normalized FRI effectively indicated patients at higher

  10. Association between nutritional awareness and diet quality: evidence from the observation of cardiovascular risk factors in Luxembourg (ORISCAV-LUX) study.

    PubMed

    Alkerwi, Ala'a; Sauvageot, Nicolas; Malan, Leoné; Shivappa, Nitin; Hébert, James R

    2015-04-01

    This study examined the association between nutritional awareness and diet quality, as indicated by energy density, dietary diversity and adequacy to achieve dietary recommendations, while considering the potentially important role of socioeconomic status (SES). Data were derived from 1351 subjects, aged 18-69 years and enrolled in the ORISCAV-LUX study. Energy density score (EDS), dietary diversity score (DDS) and Recommendation Compliance Index (RCI) were calculated based on data derived from a food frequency questionnaire. Nutritional awareness was defined as self-perception of the importance assigned to eating balanced meals, and classified as high, moderate, or of little importance. Initially, a General Linear Model was fit that adjusted for age, sex, country of birth, and body mass index (BMI). Furthermore, simultaneous contributions to diet quality of individual-level socioeconomic factors, education, and household income were examined across levels of nutritional awareness. Attributing high importance was associated inversely with energy density (p = 0.02), positively with both dietary diversity (p < 0.0001), and adequacy to dietary recommendations (p < 0.0001), independent of demographic factors, weight status and SES. Further adjustment for household income in the EDS-related multivariable model, reduced the β coefficient by 47% for the "moderate importance" category and 36% for the "high importance" category. Likewise, the β coefficient decreased by 13.6% and 10.7% in the DDS-related model, and by 12.5%, and 7.1% in the RCI-related model, respectively, across awareness categories. Nutritional awareness has a direct effect on diet quality, with a minor component of variance explained by improved income. The impact of nutritional awareness on diet quality seems to be a promising area for both health promotion and health policy research. PMID:25875122

  11. [Study on building index system of risk assessment of post-marketing Chinese patent medicine based on AHP-fuzzy neural network].

    PubMed

    Li, Yuanyuan; Xie, Yanming; Fu, Yingkun

    2011-10-01

    Currently massive researches have been launched about the safety, efficiency and economy of post-marketing Chinese patent medicine (CPM) proprietary Chinese medicine, but it was lack of a comprehensive interpretation. Establishing the risk evaluation index system and risk assessment model of CPM is the key to solve drug safety problems and protect people's health. The clinical risk factors of CPM exist similarities with the Western medicine, can draw lessons from foreign experience, but also have itself multi-factor multivariate multi-level complex features. Drug safety risk assessment for the uncertainty and complexity, using analytic hierarchy process (AHP) to empower the index weights, AHP-based fuzzy neural network to build post-marketing CPM risk evaluation index system and risk assessment model and constantly improving the application of traditional Chinese medicine characteristic is accord with the road and feasible beneficial exploration. PMID:22292377

  12. Adolescents at Risk for Violence: An Initial Validation of the Life Challenges Questionnaire and Risk Assessment Index

    ERIC Educational Resources Information Center

    Grinberg, Ilyse; Dawkins, Marva; Dawkins, Marvin P.; Fullilove, Constance

    2005-01-01

    Initial validation was sought for the Life-Challenges Questionnaire-Teen Form, a 120-item youth-risk assessment tool. The questionnaire was administered to 99 students enrolled in an adolescent detention facility and a comparison group of 305 students attending high school. The survey items included correlates of youth violence and categorized…

  13. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age--Analysis from the ROLO Randomised Controlled Trial.

    PubMed

    Horan, Mary K; McGowan, Ciara A; Gibney, Eileen R; Byrne, Jacinta; Donnelly, Jean M; McAuliffe, Fionnuala M

    2016-01-01

    Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age. PMID:26742066

  14. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age—Analysis from the ROLO Randomised Controlled Trial

    PubMed Central

    Horan, Mary K.; McGowan, Ciara A.; Gibney, Eileen R.; Byrne, Jacinta; Donnelly, Jean M.; McAuliffe, Fionnuala M.

    2016-01-01

    Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age. PMID:26742066

  15. Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition

    PubMed Central

    Norat, Teresa; Bingham, Sheila; Ferrari, Pietro; Slimani, Nadia; Jenab, Mazda; Mazuir, Mathieu; Overvad, Kim; Olsen, Anja; Tjønneland, Anne; Clavel, Françoise; Boutron-Ruault, Marie-Christine; Kesse, Emmanuelle; Boeing, Heiner; Bergmann, Manuela M.; Nieters, Alexandra; Linseisen, Jakob; Trichopoulou, Antonia; Trichopoulos, Dimitrios; Tountas, Yannis; Berrino, Franco; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Vineis, Paolo; Bueno-de-Mesquita, H Bas; Peeters, Petra H. M.; Engeset, Dagrun; Lund, Eiliv; Skeie, Guri; Ardanaz, Eva; González, Carlos; Navarro, Carmen; Quirós, J Ramón; Sanchez, María-José; Berglund, Göran; Mattisson, Irene; Hallmans, Göran; Palmqvist, Richard; Day, Nicholas E.; Khaw, Kay-Tee; Key, Timothy J.; San Joaquin, Miguel; Hémon, Bertrand; Saracci, Rodolfo; Kaaks, Rudolf; Riboli, Elio

    2005-01-01

    Background Current evidence suggests that high red meat intake is associated with increased colorectal cancer risk. High fish intake may be associated with a decreased risk, but the existing evidence is less convincing. Methods We prospectively followed 478 040 men and women from 10 European countries who were free of cancer at enrollment between 1992 and 1998. Information on diet and lifestyle was collected at baseline. After a mean follow-up of 4.8 years, 1329 incident colorectal cancers were documented. We examined the relationship between intakes of red and processed meat, poultry, and fish and colorectal cancer risk using a proportional hazards model adjusted for age, sex, energy (nonfat and fat sources), height, weight, work-related physical activity, smoking status, dietary fiber and folate, and alcohol consumption, stratified by center. A calibration substudy based on 36 994 subjects was used to correct hazard ratios (HRs) and 95% confidence intervals (CIs) for diet measurement errors. All statistical tests were two-sided. Results Colorectal cancer risk was positively associated with intake of red and processed meat (highest [>160 g/day] versus lowest [<20 g/day] intake, HR = 1.35, 95% CI = 0.96 to 1.88; Ptrend=.03) and inversely associated with intake of fish (>80 g/day versus <10 g/day, HR = 0.69, 95 % CI = 0.54 to 0.88; Ptrend<.001), but was not related to poultry intake. Correcting for measurement error strengthened the associations between colorectal cancer and red and processed meat intake (per 100-g increase HR = 1.25, 95% CI =1.09 to 1.41, Ptrend= .001 and HR = 1.55, 95% CI = 1.19 to 2.02, Ptrend= .001 before and after calibration, respectively) and forfish (per 100 g increase HR = 0.70, 95% CI = 0.57 to 0.87, Ptrend<.001 and HR = 0.46, 95% CI = 0.27 to 0.77, Ptrend= .003; before and after correction, respectively). In this study population, the absolute risk of development of colorectal cancer within 10 years for a study subject aged 50 years was 1

  16. Body Mass Index, Modulated by Lateral Posterior Tibial Slope, Predicts ACL Injury Risk

    PubMed Central

    Bojicic, Katherine M.; Beaulieu, Melanie L.; Krieger, Daniel Imaizumi; Ashton-Miller, James A.; Wojtys, Edward M.

    2016-01-01

    Objectives: Intervention strategies to prevent ACL injury rely on increasing knowledge of risk factors. While several modifiable and non-modifiable risk factors for ACL rupture have been identified, the interaction between them remains unknown. The aim of this study was to quantify the relationship between BMI and several knee geometries as potential risk factors for ACL injury. We hypothesized that an increased BMI in the presence of an increased posterior tibial slope or middle cartilage slope would increase risk of ACL injury. We also hypothesized that an increased BMI in the presence of a decreased posterior meniscal height or meniscal bone angle would result in an increased risk of ACL injury. Methods: Sagittal knee MRI files from 76 ACL-injured and 42 non-injured subjects were gathered from the institution’s archive. The PTS, MCS, PMH, and MBA were measured using the circle method and compared with BMI from the subject demographic. Data were analyzed using univariate and multivariate logistical regression. Figure 1 details measurements made for each knee geometry. Results: Univariate analysis of PTS showed increases in PTS significantly increase the odds of ACL tear (p = 0.043, OR =1.12). Univariate analysis of MCS showed increases of MCS significantly increase the odds of ACL tear (p = 0.037, OR = 1.12). Multivariate analysis of PTS and BMI centered around the mean (PTS*cBMI) showed increases of PTS in combination with increases in cBMI significantly increases the odds of ACL rupture (p value = .050, OR = 1.03). Table 1 shows predicted increases in ACL injury risk for combinations of increases in PTS and BMI. Conclusion: An increase in BMI will increase the risk of ACL tear when an increase in lateral posterior tibial slope is present. An increase in lateral posterior tibial slope or lateral middle cartilage slope increases the risk of an ACL tear.

  17. Body Mass Index and Risk of Breast Cancer: A Nonlinear Dose-Response Meta-Analysis of Prospective Studies

    PubMed Central

    Xia, Xiaoping; Chen, Wei; Li, Jiaoyuan; Chen, Xueqin; Rui, Rui; Liu, Cheng; Sun, Yu; Liu, Li; Gong, Jing; Yuan, Peng

    2014-01-01

    The role of Body Mass Index (BMI) for Breast Cancer (BC) remains to be great interest for a long time. However, the precise effect of nonlinear dose-response for BMI and BC risk is still unclear. We conducted a dose-response meta-analysis to quantitatively assess the effect of BMI on BC risk. Twelve prospective studies with 4,699 cases identified among 426,199 participants and 25 studies of 22,809 cases identified among 1,155,110 participants in premenopausal and postmenopausal groups, respectively, were included in this meta-analysis. Significant non-linear dose-response (P < 0.001) association was identified between BMI and BC risk in postmenopausal women. Individuals with BMI of 25, 30, and 35 kg/m2 yielded relative risks (RRs) of 1.02 [95% confidence interval (CI): 0.98–1.06], 1.12 (95% CI: 1.01–1.24), and 1.26 (95% CI: 1.07–1.50), respectively, when compared to the mean level of the normal BMI range. However, inverse result though not significant was observed in premenopausal women. In conclusion, the results of this meta-analysis highlighted that obesity contributed to increased BC risk in a nonlinear dose-response manner in postmenopausal women, and it is important to realize that body weight control may be a crucial process to reduce BC susceptibility. PMID:25504309

  18. Body-esteem, body mass index, and risk for disordered eating among adolescents in synchronized swimming.

    PubMed

    Ferrand, Claude; Magnan, Claire; Philippe, Roberta Antonini

    2005-12-01

    The aim of this study was to examine dimensions of body-esteem, Body Mass Index, and their relations with eating disorder symptoms among 42 elite adolescent athletes engaged in competitive synchronized swimming (M = 15.4 yr., SD = 1.2) and to compare them with 40 athletes in sports with no emphasis on leanness (M = 16.5 yr., SD = .93), and 50 nonathlete college female students (M = 16.3 yr., SD = 1.1). They completed the Body-esteem Scale and the Eating Attitudes Test, and the Body Mass Index was computed. Analysis showed synchronized swimmers reported greater negative feelings about their appearance than the two other groups and low perceptions of how others evaluate their physical appearance. Participants did not differ on the EAT-26. Regression analyses showed that Body Mass Index and Body-esteem Appearance accounted for 38% of the variance in log-transformed Dieting scores of synchronized swimmers. Results are discussed in relation to the literature. PMID:16491692

  19. Acne: risk indicator for increased body mass index and insulin resistance.

    PubMed

    Melnik, Bodo C; John, Swen Malte; Plewig, Gerd

    2013-11-01

    Acne appears to represent a visible indicator disease of over-activated mTORC1 signalling, an unfavour-able metabolic deviation on the road to serious common Western diseases of civilisation associated with increased body mass index and insulin resistance. Exaggerated mTORC1 signalling by Western diet explains the association of acne with increased body mass index, insulin resistance, and early onset of menarche. Both, a high glycaemic load and increased consumption of milk and milk products, staples of Western diet, aggravate mammalian target of rapamycin complex 1 signalling. This review of the literature summarises present evidence for an association between acne, increased body mass index, insulin resistance and Western diet. By dietary intervention with a Palaeolithic-type diet, the dermatologist has the chance to attenuate patients' increased mTORC1 signalling by reducing glycaemic load and milk consumption, which may not only improve acne but may delay the march to more serious mTORC1-driven diseases of civilisation. PMID:23975508

  20. Smoking and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

    PubMed Central

    Rohrmann, S; Linseisen, J; Allen, N; Bueno-de-Mesquita, H B; Johnsen, N F; Tjønneland, A; Overvad, K; Kaaks, R; Teucher, B; Boeing, H; Pischon, T; Lagiou, P; Trichopoulou, A; Trichopoulos, D; Palli, D; Krogh, Vittorio; Tumino, R; Ricceri, F; Argüelles Suárez, M V; Agudo, A; Sánchez, M-J; Chirlaque, M-D; Barricarte, A; Larrañaga, N; Boshuizen, H; van Kranen, H J; Stattin, P; Johansson, M; Bjartell, A; Ulmert, D; Khaw, K-T; Wareham, N J; Ferrari, Pietro; Romieux, I; Gunter, M J R; Riboli, Elio; Key, T J

    2013-01-01

    Background: Smoking is not associated with prostate cancer incidence in most studies, but associations between smoking and fatal prostate cancer have been reported. Methods: During 1992 and 2000, lifestyle information was assessed via questionnaires and personal interview in a cohort of 145 112 European men. Until 2009, 4623 incident cases of prostate cancer were identified, including 1517 cases of low-grade, 396 cases of high grade, 1516 cases of localised, 808 cases of advanced disease, and 432 fatal cases. Multivariable Cox proportional hazards regression models were used to examine the association of smoking status, smoking intensity, and smoking duration with the risk of incident and fatal prostate cancer. Results: Compared with never smokers, current smokers had a reduced risk of prostate cancer (RR=0.90, 95% CI: 0.83–0.97), which was statistically significant for localised and low-grade disease, but not for advanced or high-grade disease. In contrast, heavy smokers (25+ cigarettes per day) and men who had smoked for a long time (40+ years) had a higher risk of prostate cancer death (RR=1.81, 95% CI: 1.11–2.93; RR=1.38, 95% CI: 1.01–1.87, respectively). Conclusion: The observation of an increased prostate cancer mortality among heavy smokers confirms the results of previous prospective studies. PMID:23169298

  1. Development of a Modified BODE Index as a Mortality Risk Measure Among Older Adults With and Without Chronic Obstructive Pulmonary Disease

    PubMed Central

    Roberts, Melissa H.; Mapel, Douglas W.; Bruse, Shannon; Petersen, Hans; Nyunoya, Toru

    2013-01-01

    The BODE index was developed as a prognostic mortality risk tool for persons with chronic obstructive pulmonary disease (COPD). It incorporates 4 measures: body mass index, lung obstruction, dyspnea, and exercise capacity. The intent of this study was to examine how well a BODE-like index constructed using a simpler lung function measure, peak expiratory flow, in combination with physical functioning and symptom information more readily found in survey data (a quasi-BODE index), performs in identifying persons at higher risk of mortality and whether it may be extended as an assessment of mortality risk to persons without diagnosed COPD. Using US national survey data from the Health Retirement Study for 2006–2010, each unit increase in the quasi-BODE index score was associated with a multiplicative 50% increase in mortality risk (odds ratio = 1.50, 95% confidence interval: 1.41, 1.59). The quasi-BODE index is a multidimensional health status instrument based on the BODE index, which is a good predictor of mortality. The quasi-BODE index was compiled using simple measures of physical and respiratory function. It is a potentially useful prognostic instrument for older adult populations with or without COPD, including those with severe physical limitations, particularly when combined with demographic factors and comorbid conditions. PMID:23928262

  2. Body Mass Index and Risk of Gallbladder Cancer: Systematic Review and Meta-Analysis of Observational Studies

    PubMed Central

    Tan, Wenbin; Gao, Min; Liu, Ning; Zhang, Guoan; Xu, Tong; Cui, Wen

    2015-01-01

    OBJECTIVES: To provide a quantitative assessment of the association between excess body weight, interpreted as increased body mass index (BMI), and the risk of gallbladder cancer (GBC). METHODS: We identified eligible studies in Medline and EMBASE up to 1 February 2015, and reference lists of retrieved articles. Summary relative risks with their 95% confidence intervals were calculated in a random-effects model. Subgroup analyses were performed according to study design, gender, geographic location, ascertainment of exposure and adjustment for confounders. RESUITS: A total of 12 cohort studies and 8 case-control studies were included in the meta-analysis. Overall, compared with “normal” weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04–1.25) for overweight individuals (BMI 25–30 kg/m2) and 1.56 (95% CI, 1.41–1.73) for obese individuals (BMI > 30 kg/m2). Obese women had a higher risk of GBC than men did (women: SRRs 1.67, 95% CI 1.38–2.02; men: SRRs 1.42, 95% CI 1.21–1.66), and there was significant association between overweight and GBC risk in women (SRRs 1.26, 95% CI 1.13–1.40), but not in men (SRRs 1.06, 95% CI 0.94–1.20). CONCLUSIONS: Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC, especially in women. Overweight is associated with GBC risk only in women. PMID:26426043

  3. Reduced risk of Parkinson's disease associated with lower body mass index and heavy leisure-time physical activity.

    PubMed

    Sääksjärvi, Katri; Knekt, Paul; Männistö, Satu; Lyytinen, Jukka; Jääskeläinen, Tuija; Kanerva, Noora; Heliövaara, Markku

    2014-04-01

    The risk factors for Parkinson's disease (PD) are not well established. We therefore examined the prediction of various lifestyle factors on the incidence of PD in a cohort drawn from the Finnish Mobile Clinic Health Examination Survey, conducted in 1973-1976. The study population comprised 6,715 men and women aged 50-79 years and free of PD at the baseline. All of the subjects completed a baseline health examination (including height and weight measurements) and a questionnaire providing information on leisure-time physical activity, smoking, and alcohol consumption. During a 22-year follow-up, 101 incident cases of PD occurred. The statistical analyses were based on Cox's model including age, sex, education, community density, occupation, coffee consumption, body mass index (BMI), leisure-time physical activity, smoking and alcohol consumption as independent variables. At first, BMI was not associated with PD risk, but after exclusion of the first 15 years of follow-up, an elevated risk appeared at higher BMI levels (P for trend 0.02). Furthermore, subjects with heavy leisure-time physical activity had a lower PD risk than those with no activity [relative risk (RR) 0.27, 95 % confidence interval (CI) 0.08-0.90]. In variance with findings for other chronic diseases, current smokers had a lower PD risk than those who had never smoked (RR 0.23, 95 % CI 0.08-0.67), and individuals with moderate alcohol intake (at the level of <5 g/day) had an elevated PD risk compared to non-drinkers. The results support the hypothesis that lifestyle factors predict the occurrence of Parkinson's disease, but more research is needed. PMID:24633681

  4. Measuring daily Value-at-Risk of SSEC index: A new approach based on multifractal analysis and extreme value theory

    NASA Astrophysics Data System (ADS)

    Wei, Yu; Chen, Wang; Lin, Yu

    2013-05-01

    Recent studies in the econophysics literature reveal that price variability has fractal and multifractal characteristics not only in developed financial markets, but also in emerging markets. Taking high-frequency intraday quotes of the Shanghai Stock Exchange Component (SSEC) Index as example, this paper proposes a new method to measure daily Value-at-Risk (VaR) by combining the newly introduced multifractal volatility (MFV) model and the extreme value theory (EVT) method. Two VaR backtesting techniques are then employed to compare the performance of the model with that of a group of linear and nonlinear generalized autoregressive conditional heteroskedasticity (GARCH) models. The empirical results show the multifractal nature of price volatility in Chinese stock market. VaR measures based on the multifractal volatility model and EVT method outperform many GARCH-type models at high-risk levels.

  5. Making sense of Arctic maritime traffic using the Polar Operational Limits Assessment Risk Indexing System (POLARIS)

    NASA Astrophysics Data System (ADS)

    Stoddard, M. A.; Etienne, L.; Fournier, M.; Pelot, R.; Beveridge, L.

    2016-04-01

    Maritime traffic volume in the Arctic is growing for several reasons: climate change is resulting in less ice in extent, duration, and thickness; economic drivers are inducing growth in resource extraction traffic, community size (affecting resupply) and adventure tourism. This dynamic situation, coupled with harsh weather, variable operating conditions, remoteness, and lack of straightforward emergency response options, demand robust risk management processes. The requirements for risk management for polar ship operations are specified in the new International Maritime Organization (IMO) International Code for Ships Operating in Polar Waters (Polar Code). The goal of the Polar Code is to provide for safe ship operations and protection of the polar environment by addressing the risk present in polar waters. Risk management is supported by evidence-based models, including threat identification (types and frequency of hazards), exposure levels, and receptor characterization. Most of the information used to perform risk management in polar waters is attained in-situ, but increasingly is being augmented with open-access remote sensing information. In this paper we focus on the use of open-access historical ice charts as an integral part of northern navigation, especially for route planning and evaluation.

  6. Effects of age, sex and smoking on ankle-brachial index in a Finnish population at risk for cardiovascular disease

    PubMed Central

    Syvänen, Kari; Aarnio, Pertti; Jaatinen, Pekka; Korhonen, Päivi

    2007-01-01

    BACKGROUND Smoking is a well-known risk factor for peripheral arterial disease (PAD). Data regarding differences in the prevalence of PAD between sexes are somewhat controversial. In addition, most studies indicate that the prevalence of PAD increases with age in both sexes. In the present study, the effects of sex, age and smoking on the ankle-brachial index (ABI) in a Finnish cardiovascular risk population were investigated. OBJECTIVES To investigate the relationship between the ankle-brachial index, and age, sex and smoking in a Finnish population at risk for cardiovascular disease. METHODS All men and women between 45 and 70 years of age living in a rural town (Harjavalta, Finland; total population 7700) were invited to participate in a population survey (Harmonica study). Patients with previously diagnosed diabetes or vascular disease were excluded. In total, 2856 patients were invited to participate in the study. From these subjects, a cardiovascular risk population was screened. Complete data were available from 1028 persons. ABI (the ratio between the posterior tibial or dorsalis pedis artery and brachial artery pressures) was measured, and questionnaires were used to detect smoking status and relevant medical history. Only current smoking status was taken into account. RESULTS The mean ABI for the entire study population was 1.10 (range 0.56 to 1.64). Current smokers had a lower mean ABI (1.06; P<0.001). There was no statistically significant difference in ABI values among age groups, although the majority of patients with ABI values below 0.9 were older than 60 years of age. There was no statistically significant difference in ABI between sexes. CONCLUSION As previously reported, the present study shows the significant effect of smoking in the development of PAD. No statistically significant difference was found among age groups, but the tendency was toward lower ABIs in the oldest age groups. Sex had a minimal effect on the ABI. PMID:22477327

  7. Exploiting Nutritional Value of Staple Foods in the World’s Semi-Arid Areas: Risks, Benefits, Challenges and Opportunities of Sorghum

    PubMed Central

    Proietti, Ilaria; Frazzoli, Chiara; Mantovani, Alberto

    2015-01-01

    Sorghum (Sorghum bicolor (L.) Moench) is a drought-resistant crop and an important food resource in terms of nutritional as well as social-economic values, especially in semi-arid environments. Cultivar selection and processing methods have been observed to impact on composition and functional and nutritional value of sorghum. Amino acid imbalance, cyanogenic glycosides, endogenous anti-nutrients, mycotoxins and toxic elements are among factors impairing its nutritional value. This paper reviews possible approaches (varieties selection, production practices, cooking processes) to improve the benefits-to-risks balance of sorghum meal, to mitigate the risk of deficiencies and/or imbalances and to improve effects on human nutrition. Opportunity for avoiding dietary diversification in high sorghum consumers is also discussed, e.g., tryptophan and niacin deficits potentially related to pellagra, or unavailability of proteins and divalent cations (e.g., Fe, Zn) due to the antinutrient activity of phytic acid and tannins. As potential candidate for production investments, the role of sorghum in preserving biological diversity is also considered. PMID:27417755

  8. Nutrition in chronic pancreatitis

    PubMed Central

    Rasmussen, Henrik Højgaard; Irtun, Øivind; Olesen, Søren Schou; Drewes, Asbjørn Mohr; Holst, Mette

    2013-01-01

    The pancreas is a major player in nutrient digestion. In chronic pancreatitis both exocrine and endocrine insufficiency may develop leading to malnutrition over time. Maldigestion is often a late complication of chronic pancreatic and depends on the severity of the underlying disease. The severity of malnutrition is correlated with two major factors: (1) malabsorption and depletion of nutrients (e.g., alcoholism and pain) causes impaired nutritional status; and (2) increased metabolic activity due to the severity of the disease. Nutritional deficiencies negatively affect outcome if they are not treated. Nutritional assessment and the clinical severity of the disease are important for planning any nutritional intervention. Good nutritional practice includes screening to identify patients at risk, followed by a thoroughly nutritional assessment and nutrition plan for risk patients. Treatment should be multidisciplinary and the mainstay of treatment is abstinence from alcohol, pain treatment, dietary modifications and pancreatic enzyme supplementation. To achieve energy-end protein requirements, oral supplementation might be beneficial. Enteral nutrition may be used when patients do not have sufficient calorie intake as in pylero-duodenal-stenosis, inflammation or prior to surgery and can be necessary if weight loss continues. Parenteral nutrition is very seldom used in patients with chronic pancreatitis and should only be used in case of GI-tract obstruction or as a supplement to enteral nutrition. PMID:24259957

  9. A Rapidly Prototyped Vegetation Dryness Index Evaluated for Wildfire Risk Assessment at Stennis Space Center

    NASA Technical Reports Server (NTRS)

    Ross, Kenton; Graham, William; Prados, Don; Spruce, Joseph

    2007-01-01

    MVDI, which effectively involves the differencing of NDMI and NDVI, appears to display increased noise that is consistent with a differencing technique. This effect masks finer variations in vegetation moisture, preventing MVDI from fulfilling the requirement of giving decision makers insight into spatial variation of fire risk. MVDI shows dependencies on land cover and phenology which also argue against its use as a fire risk proxy in an area of diverse and fragmented land covers. The conclusion of the rapid prototyping effort is that MVDI should not be implemented for SSC decision support.

  10. A Nested Case–Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)

    PubMed Central

    Murphy, Neil; Cross, Amanda J.; Abubakar, Mustapha; Jenab, Mazda; Aleksandrova, Krasimira; Boutron-Ruault, Marie-Christine; Dossus, Laure; Racine, Antoine; Kühn, Tilman; Katzke, Verena A.; Tjønneland, Anne; Petersen, Kristina E. N.; Overvad, Kim; Quirós, J. Ramón; Jakszyn, Paula; Molina-Montes, Esther; Dorronsoro, Miren; Huerta, José-María; Barricarte, Aurelio; Khaw, Kay-Tee; Wareham, Nick; Travis, Ruth C.; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Masala, Giovanna; Krogh, Vittorio; Tumino, Rosario; Vineis, Paolo; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Siersema, Peter D.; Peeters, Petra H.; Ohlsson, Bodil; Ericson, Ulrika; Palmqvist, Richard; Nyström, Hanna; Weiderpass, Elisabete; Skeie, Guri; Freisling, Heinz; Kong, So Yeon; Tsilidis, Kostas; Muller, David C.; Riboli, Elio; Gunter, Marc J

    2016-01-01

    Background Obesity is positively associated with colorectal cancer. Recently, body size subtypes categorised by the prevalence of hyperinsulinaemia have been defined, and metabolically healthy overweight/obese individuals (without hyperinsulinaemia) have been suggested to be at lower risk of cardiovascular disease than their metabolically unhealthy (hyperinsulinaemic) overweight/obese counterparts. Whether similarly variable relationships exist for metabolically defined body size phenotypes and colorectal cancer risk is unknown. Methods and Findings The association of metabolically defined body size phenotypes with colorectal cancer was investigated in a case–control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolic health/body size phenotypes were defined according to hyperinsulinaemia status using serum concentrations of C-peptide, a marker of insulin secretion. A total of 737 incident colorectal cancer cases and 737 matched controls were divided into tertiles based on the distribution of C-peptide concentration amongst the control population, and participants were classified as metabolically healthy if below the first tertile of C-peptide and metabolically unhealthy if above the first tertile. These metabolic health definitions were then combined with body mass index (BMI) measurements to create four metabolic health/body size phenotype categories: (1) metabolically healthy/normal weight (BMI < 25 kg/m2), (2) metabolically healthy/overweight (BMI ≥ 25 kg/m2), (3) metabolically unhealthy/normal weight (BMI < 25 kg/m2), and (4) metabolically unhealthy/overweight (BMI ≥ 25 kg/m2). Additionally, in separate models, waist circumference measurements (using the International Diabetes Federation cut-points [≥80 cm for women and ≥94 cm for men]) were used (instead of BMI) to create the four metabolic health/body size phenotype categories. Statistical tests used in the analysis were all two-sided, and a

  11. Development & Application of the SEDCON Index for Resource and Risk Assessment of Coral Ecosystems

    NASA Astrophysics Data System (ADS)

    Daniels, C. A.; Hallock, P.; Lidz, B. H.

    2005-05-01

    Resource managers need inexpensive bioindicators to evaluate the health of coral ecosystems and to guide decisions on when and where to utilize more expensive assessment techniques. Following USEPA Guidelines for Evaluating Ecological Indicators, we are developing a rapid-assessment protocol, termed the SEDCON Index, that utilizes reef sediment constituents to assess the integrity of coral-reef communities. The underlying assumption of the index is that community structure is reflected by proportions of recognizable remnants of calcareous shells and skeletal remains of autotrophic (calcareous and coralline algae), mixotrophic (zooxanthellate corals and larger foraminifers) and heterotrophic (e.g., bryozoans, molluscs, smaller foraminifers) benthic organisms, and of unrecognizable debris as a proxy for bioerosion. Implementation and assessment of this diagnostic tool is currently underway for the Florida Middle Grounds (FMG) and the Coral Reef Monitoring Program (CRMP) sites in the Florida Keys National Marine Sanctuary (FKNMS). We are calibrating SI data with benthic community data from CRMP. Data from samples collected in FKNMS between 2001 and 2004 indicate dominance of the sediments by bioerosional debris, while samples collected in the early 1980s from the FKNMS and the FMG in 2003 contained higher proportions of identifiable mixotrophic components. Application of the SI provides an assessment of ecosystem condition on scales of years and will be used to supply reef baseline data for detecting changes associated with the Comprehensive Everglades Restoration Plan.

  12. Dietary glycemic load, glycemic index, and carbohydrates on the risk of primary liver cancer among Chinese women and men

    PubMed Central

    Vogtmann, E.; Li, H. L.; Shu, X. O.; Chow, W. H.; Ji, B. T.; Cai, H.; Gao, J.; Zhang, W.; Gao, Y. T.; Zheng, W.; Xiang, Y. B.

    2013-01-01

    Background Dietary glycemic index (GI) and glycemic load (GL) typically have a positive relationship with obesity and diabetes, which are risk factors for liver cancer. However, studies on their association with liver cancer have yielded inconsistent results. Therefore, we assessed the association of GI, GL, and carbohydrates with liver cancer risk. Patients and methods A total of 72 966 women and 60 207 men from the Shanghai Women's Health Study (SWHS) and the Shanghai Men's Health Study (SMHS) were included for analysis. Food frequency questionnaire (FFQ) data were used to calculate daily dietary GI, GL, and carbohydrate intake. These values were energy adjusted and categorized into quintiles. The hazard ratios (HRs) and 95% confidence intervals (CI) were calculated with adjustment for potential confounders. Results After a median follow-up time of 11.2 years for the SWHS and 5.3 years for the SMHS, 139 and 208 incident liver cancer cases were identified in the SWHS and SMHS, respectively. In multivariable Cox regression models, no statistically significant trends by quintile of GI, GL, or carbohydrate intake were observed. Stratification by chronic liver disease/hepatitis, diabetes, or body mass index (BMI) did not alter the findings. Conclusions There is little evidence that dietary GI, GL, or carbohydrates affect the incidence of liver cancer in this Asian population. PMID:22898034

  13. Constructing the Suicide Risk Index (SRI): does it work in predicting suicidal behavior in young adults mediated by proximal factors?

    PubMed

    O'Connor, Maebh; Dooley, Barbara; Fitzgerald, Amanda

    2015-01-01

    Suicide is a key concern among young adults. The aim of the study was to (1) construct a suicide risk index (SRI) based on demographic, situational, and behavioral factors known to be linked to suicidal behavior and (2) investigate whether the association between the SRI and suicidal behavior was mediated by proximal processes (personal factors, coping strategies, and emotional states). Participants consisted of 7,558 individuals aged 17-25 years (M = 20.35, SD = 1.91). Nearly 22% (n = 1,542) reported self-harm and 7% (n = 499) had attempted suicide. Mediation analysis revealed both a direct effect (ß = .299, 95% CI = [.281, .317], p < .001), and a mediated effect (ß = .204, 95% CI = [.186, .222], p < .001), between the risk index and suicidal behavior. The strongest mediators were levels of self-esteem, depression, and avoidant coping. Interventions to increase self-esteem, reduce depression, and encourage adaptive coping strategies may prevent suicidal behavior in young people. PMID:25058873

  14. Predicting Dyslexia at Age 11 from a Risk Index Questionnaire at Age 5

    ERIC Educational Resources Information Center

    Helland, Turid; Plante, Elena; Hugdahl, Kenneth

    2011-01-01

    This study focused on predicting dyslexia in children ahead of formal literacy training. Because dyslexia is a constitutional impairment, risk factors should be seen in preschool. It was hypothesized that data gathered at age 5 using questions targeting the dyslexia endophenotype should be reliable and valid predictors of dyslexia at age 11. A…

  15. Maternal Height and Infant Body Mass Index Are Possible Risk Factors for Developmental Dysplasia of the Hip in Female Infants.

    PubMed

    Atalar, Hakan; Gunay, Cuneyd; Yavuz, Osman Yuksel; Camurdan, Aysu Duyan; Uras, Ismail; Eren, Ali

    2015-01-01

    Developmental dysplasia of the hip (DDH) is a wide-spectrum disease with a multifactorial etiology and, despite its prevalence, no definitive etiology has yet been established. The aim of this study was to investigate new risk factors for DDH by evaluating newly defined potential risk factors. A total of 71 infants were separated into 2 groups:Group I, 28 female first-born infants diagnosed with DDH and their mothers;and Group II, 43 healthy female first-born infants and their mothers. The maternal height and weight before pregnancy, infant height and weight at birth, and body mass index (BMI) of both mother and infant were determined. Calculations were made of the ratios between these parameters. Of the examined risk factors, only maternal height and the ratio of maternal height to infant BMI (MH/I-BMI) were found to be significant for DDH in infants. In conclusion, the results of this study show that a short maternal height and a low MH/I-BMI increase the risk of DDH. Further studies with a larger series are necessary to confirm these results. PMID:26690245

  16. Associations of Body Mass Index with Sexual Risk-Taking and Injection Drug Use among US High School Students

    PubMed Central

    Lowry, Richard; Robin, Leah; Kann, Laura; Galuska, Deborah A.

    2014-01-01

    The purpose of this study was to determine if body mass index (BMI) is associated with behaviors that may increase risk for HIV and other sexually transmitted diseases (STDs) among US high school students. We analyzed nationally representative data from the 2005–2011 national Youth Risk Behavior Surveys (YRBS) to examine associations of BMI categories with sexual risk behaviors and injection drug use among sexually active high school students, using sex-stratified logistic regression models. Controlling for race/ethnicity and grade, among female and male students, both underweight (BMI < 5th percentile) and obesity (BMI ≥ 95th percentile) were associated with decreased odds of being currently sexually active (i.e., having had sexual intercourse during the past 3 months). However, among sexually active female students, obese females were more likely than normal weight females to have had 4 or more sex partners (odds ratio, OR = 1.59), not used a condom at last sexual intercourse (OR = 1.30), and injected illegal drugs (OR = 1.98). Among sexually active male students, overweight (85th percentile ≤ BMI < 95th percentile) was associated with not using a condom at last sexual intercourse (OR = 1.19) and obesity was associated with injection drug use (OR = 1.42). Among sexually active students, overweight and obesity may be indicators of increased risk for HIV and other STDs. PMID:25105024

  17. Nutrition and nutritional supplementation

    PubMed Central

    Manissier, Patricia

    2009-01-01

    Skin acts as a natural barrier between internal and external environments thus plays an important role in vital biological functions such as protection against mechanical/chemical damages, micro-organisms, ultraviolet damage. Nutrition has a critical impact on strengthening skin’s capabilities to fight against these multiple aggressions. Nutritional deficiencies are often associated with skin health disorders, while diets can either positively or negatively influence skin condition. More recently, the concept of nutritional supplementation has emerged as a new strategy in the daily practice of dermatology as well as a complementary approach to topical cosmetics in the field of beauty. Focusing on human clinical data, this paper proposes to illustrate the link between skin health and nutrition and to exemplify the beneficial actions of nutritional supplementation in skin health and beauty. PMID:20808515

  18. The Nutrition Attitude Survey: associations with dietary habits, psychological and physical well-being, and coronary risk factors.

    PubMed

    Hollis, J F; Carmody, T P; Connor, S L; Fey, S G; Matarazzo, J D

    1986-01-01

    Attitudes play an important role in the adoption and maintenance of a variety of health habits. In the present study, the Nutrition Attitude Survey (NAS) was developed to measure attitudes pertaining to the adoption of a low-fat, low-cholesterol diet. Factor analysis identified four primary attitudinal factors: Helpless and Unhealthy, Food Exploration, Meat Preference, and Health Consciousness. For a community sample of 415 healthy men and women, relationships were examined among these attitudinal factors and dietary habits, family food patterns, medical and psychological symptoms, and traditional coronary risk factors. For both men and women, the Helpless and Unhealthy factor was associated with increased meat consumption, weight, emotional distress, reported medical and psychological symptoms, total cholesterol, and low-density lipoprotein cholesterol. The Food Exploration factor was more characteristic of younger men and women and positively associated with men's reported involvement in family food preparation activities. For both sexes, Meat Preference scores were positively associated with meat consumption and inversely associated with consumption of meatless meals, beans, and fruit. Health Consciousness factor scores were associated with less meat consumption, more meatless meals, and better overall dietary adherence scores for both men and women. Overall, the findings provide initial support for the reliability and predictive validity of the NAS and underscore the importance of assessing and addressing the attitudes and preferences of participants in dietary intervention programs. PMID:3757988

  19. Nutritional and Hygienic Quality of Raw Milk in the Mid-Northern Region of Algeria: Correlations and Risk Factors

    PubMed Central

    Adjlane-Kaouche, Soumeya; Benhacine, Rafik; Ghozlane, Faiçal; Mati, Abderrahmane

    2014-01-01

    This paper aims to study the overall quality of raw milk in the mid-northern region of Algeria. The analysis results showed a decrease in the average temperature for the delivery of 1,54°C with P<0.001. However, no significant variation (P>0.05) was observed in almost all the physical and nutritional parameters studied (pH, fat content, and protein content) between M1 and M2. The average contamination by total mesophilic aerobic bacteria (TMAB), coliforms, yeasts, molds, and different pathogens in samples taken at M1 showed significant changes at M2. This was confirmed by the decrease of reduction time of methylene blue (RTMB), about 54%. The variation was described as follows: (P>0.05) for yeasts and (P<0.05) for molds in M1 and M2, (P<0.05) for TMAB in M1, and (P<0.001) for TC, FC, and TMAB in M2. The analysis for the detection of Salmonella spp. showed no contamination in all samples tested, while antibiotic residues were detected in 35% of milks delivered. In conclusion, several risk factors have been identified in this study, namely, the effect of the season and the distance between the farm and the dairy unit. PMID:25374932

  20. Nutritional and hygienic quality of raw milk in the mid-northern region of Algeria: correlations and risk factors.

    PubMed

    Adjlane-Kaouche, Soumeya; Benhacine, Rafik; Ghozlane, Faiçal; Mati, Abderrahmane

    2014-01-01

    This paper aims to study the overall quality of raw milk in the mid-northern region of Algeria. The analysis results showed a decrease in the average temperature for the delivery of 1,54°C with P<0.001. However, no significant variation (P>0.05) was observed in almost all the physical and nutritional parameters studied (pH, fat content, and protein content) between M1 and M2. The average contamination by total mesophilic aerobic bacteria (TMAB), coliforms, yeasts, molds, and different pathogens in samples taken at M1 showed significant changes at M2. This was confirmed by the decrease of reduction time of methylene blue (RTMB), about 54%. The variation was described as follows: (P>0.05) for yeasts and (P<0.05) for molds in M1 and M2, (P<0.05) for TMAB in M1, and (P<0.001) for TC, FC, and TMAB in M2. The analysis for the detection of Salmonella spp. showed no contamination in all samples tested, while antibiotic residues were detected in 35% of milks delivered. In conclusion, several risk factors have been identified in this study, namely, the effect of the season and the distance between the farm and the dairy unit. PMID:25374932

  1. The Visceral Adiposity Index: Relationship with cardiometabolic risk factors in obese and overweight postmenopausal women--a MONET group study.

    PubMed

    Elisha, Belinda; Messier, Virginie; Karelis, Antony; Coderre, Lise; Bernard, Sophie; Prud'homme, Denis; Rabasa-Lhoret, Rémi

    2013-08-01

    A recent study suggested visceral adipose index (VAI) as an indicator of adipose tissue distribution and function associated with cardiometabolic risk. We aim to examine the association between VAI and visceral adipose tissue (VAT), insulin sensitivity, and a large panel of associated cardiometabolic risk factors, and to determine if changes in VAI after weight loss intervention will reflect changes in VAT. We performed a secondary analysis using the data of 99 overweight and postmenopausal women that completed a 6-month weight loss program (Montreal Ottawa New Emerging Team Study). VAI was calculated according to the equation by Amato et al. (2010; Diabetes Care, 33(4):920-922). At baseline, VAI was associated with VAT (r = 0.284, p < 0.01) but not with subcutaneous adipose tissue (SAT) while body mass index (BMI) and waist circumference (WC) were significantly related to both. BMI and WC demonstrated significantly stronger predictive value of VAT accumulation (area under the curve = 0.84 and 0.86, respectively) than VAI (area under the curve = 0.61; p < 0.01). However, VAT, BMI, WC, and VAI were similarly related to fasting insulin and glucose disposal rates. After a 6-month weight loss program, VAI decreased significantly and similarly in both intervention groups (p < 0.01). In addition, the percentage of change in VAI showed the significantly weakest correlation (r = 0.25) with the percentage of change in VAT than BMI (r = 0.56; p < 0.01 for r comparisons) and was not a significant predictor of interindividual percentage of change in VAT while BMI accounted for 33.7%. VAI is a weak indicator of VAT function and did not predict changes in VAT after weight loss. Furthermore, this index was not superior to BMI or WC. However, VAI is a good indicator of metabolic syndrome. PMID:23855278

  2. Body mass index and the risk of incident functional disability in elderly Japanese: The OHSAKI Cohort 2006 Study.

    PubMed

    Zhang, Shu; Tomata, Yasutake; Sugiyama, Kemmyo; Kaiho, Yu; Honkura, Kenji; Watanabe, Takashi; Tanji, Fumiya; Sugawara, Yumi; Tsuji, Ichiro

    2016-08-01

    The relationship between the body mass index (BMI) and the incidence of cause-specific disability remains unclear.We conducted a prospective cohort study of 12,376 Japanese individuals aged ≥65 years who were followed up for 5.7 years. Information on BMI and other lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. BMI was divided into 6 groups (<21, 21-<23, 23-<25, 25-<27[reference], 27-<29 and ≥29). Hazard ratios and 95% confidence intervals for cause-specific disability were estimated using Cox proportional hazards regression models.A U-shaped relationship between BMI and functional disability was observed, with a nadir at 26. The nadir BMI values with the lowest disability risk were 28 for dementia, 25 for stroke, and 23 for joint disease. A low BMI (<23) was a risk factor for disability due to dementia, the HR values (95% CI) being 2.48 (1.70-3.63) for BMI <21 and 2.25 (1.54-3.27) for BMI 21 to <23; a high BMI (≥29) was a risk factor for disability due to joint disease, the HR value (95% CI) being 2.17 (1.40-3.35). There was no significant relationship between BMI and disability due to stroke.The BMI nadirs for cause-specific disability differed: a low BMI (<23) was a risk factor for disability due to dementia, and a high BMI (≥29) was a risk factor for disability due to joint disease. Because BMI values of 23 to <29 did not pose a significantly higher risk for each cause of disability, this range should be regarded as the optimal one for the elderly population. PMID:27495075

  3. Milk Consumption and Framingham Risk Score: Analysis of the Korea National Health and Nutrition Examination Survey Data (2008-2011)

    PubMed Central

    Joo, Nam-Seok; Yang, Sung-Won; Park, Soo-Jung; Choi, Sung-Jin; Song, Byeng Chun

    2016-01-01

    Purpose The benefit of milk intake remains controversial. The association between milk consumption and Framingham Risk Score (FRS) in a population consuming relatively low amounts of dairy products is undetermined. Materials and Methods A total of 13736 adults (5718 male and 8018 female) aged 20-80 years from the Korea National Health and Nutrition Examination Survey (2008-2011) were divided into groups according to milk consumption (rarely, monthly, weekly, and daily) and compared according to FRS after relevant variable adjustments. Results The mean FRS in males and females were 6.53 and 5.74, respectively. Males who consumed milk daily (15.9%) had a significantly lower FRS than males having milk rarely (31.6%) or monthly (17.4%; p=0.007). Females who consumed milk daily (22.3%) also had significantly lower FRS than rarely (29.8%), monthly (13.8%), or weekly (34%; p=0.001) consumers. In particular, males ≥60 years old who consumed milk daily had a significantly lower FRS than males who consumed less milk (p<0.001). The odds ratio in this age group showed a significant and gradual increase in the weekly [OR=2.15; 95% confidence interval (CI) 1.14-4.03], monthly (OR=2.29; 95% CI 1.15-4.54), and rarely (OR=3.79; 95% CI 2.01-7.14) milk consumption groups when compared with the daily milk consumption group. Conclusion Milk consumption was associated with a lower FRS in a low milk-consuming population. In particular, daily milk consumption in males over 60 years old may be beneficial for those at risk for cardiovascular disease. PMID:26632401

  4. Selenium status is associated with colorectal cancer risk in the European prospective investigation of cancer and nutrition cohort.

    PubMed

    Hughes, David J; Fedirko, Veronika; Jenab, Mazda; Schomburg, Lutz; Méplan, Catherine; Freisling, Heinz; Bueno-de-Mesquita, H B as; Hybsier, Sandra; Becker, Niels-Peter; Czuban, Magdalena; Tjønneland, Anne; Outzen, Malene; Boutron-Ruault, Marie-Christine; Racine, Antoine; Bastide, Nadia; Kühn, Tilman; Kaaks, Rudolf; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Lagiou, Pagona; Panico, Salvatore; Peeters, Petra H; Weiderpass, Elisabete; Skeie, Guri; Dagrun, Engeset; Chirlaque, Maria-Dolores; Sánchez, Maria-Jose; Ardanaz, Eva; Ljuslinder, Ingrid; Wennberg, Maria; Bradbury, Kathryn E; Vineis, Paolo; Naccarati, Alessio; Palli, Domenico; Boeing, Heiner; Overvad, Kim; Dorronsoro, Miren; Jakszyn, Paula; Cross, Amanda J; Quirós, Jose Ramón; Stepien, Magdalena; Kong, So Yeon; Duarte-Salles, Talita; Riboli, Elio; Hesketh, John E

    2015-03-01

    Suboptimal intakes of the micronutrient selenium (Se) are found in many parts of Europe. Low Se status may contribute to colorectal cancer (CRC) development. We assessed Se status by measuring serum levels of Se and Selenoprotein P (SePP) and examined the association with CRC risk in a nested case-control design (966 CRC cases; 966 matched controls) within the European Prospective Investigation into Cancer and Nutrition. Se was measured by total reflection X-ray fluorescence and SePP by immunoluminometric sandwich assay. Multivariable incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression. Respective mean Se and SePP levels were 84.0 μg/L and 4.3 mg/L in cases and 85.6 μg/L and 4.4 mg/L in controls. Higher Se concentrations were associated with a non-significant lower CRC risk (IRR = 0.92, 95% CI: 0.82-1.03 per 25 μg/L increase). However, sub-group analyses by sex showed a statistically significant association for women (p(trend) = 0.032; per 25 μg/L Se increase, IRR = 0.83, 95% CI: 0.70-0.97) but not for men. Higher SePP concentrations were inversely associated with CRC risk (p(trend) = 0.009; per 0.806 mg/L increase, IRR = 0.89, 95% CI: 0.82-0.98) with the association more apparent in women (p(trend) = 0.004; IRR = 0.82, 95% CI: 0.72-0.94 per 0.806 mg/L increase) than men (p(trend) = 0.485; IRR = 0.98, 95% CI: 0.86-1.12 per 0.806 mg/L increase). The findings indicate that Se status is suboptimal in many Europeans and suggest an inverse association between CRC risk and higher serum Se status, which is more evident in women. PMID:25042282

  5. [Nutrition and health--potential health benefits and risks of vegetarianism and limited consumption of meat in the Netherlands].

    PubMed

    Dagnelie, P C

    2003-07-01

    In the latest Dutch national food consumption survey (1998) just over 1% of subjects (about 150,000 persons) claimed to be vegetarians; however, a much larger group (6% or approximately 1 million persons) ate meat < or = once a week. Vegetarianism can be subdivided into lacto-vegetarianism (a diet without meat and fish) and veganism (a diet without any animal foods whatsoever, including dairy products and eggs). A recent meta-analysis showed that vegetarians had a lower mortality from ischaemic heart disease than omniovorous subjects; however, cancer mortality and total mortality did not differ. Although a high consumption of red meat, which is rich in haeme iron and saturated fat, may increase the risk of cardiovascular disease and some types of cancer, this does not apply to white meat and fish. In fact, the most important protective effect would seem to be derived from the consumption of unrefined vegetable products (whole-grain cereals, vegetables, fruits, nuts and legumes) and fish. In other words, a prudent, omnivorous diet with moderate amounts of animal products, in which red meat is partly replaced by white meat and fish (especially fatty fish), together with the consumption of ample amounts of unrefined vegetable products, is thought to be just as protective as a vegetarian diet. On the other hand, the omission of meat and fish from the diet increases the risk of nutritional deficiencies. A vegan diet, in particular, leads to a strongly increased risk of deficiencies of vitamin B12, vitamin B2 and several minerals, such as calcium, iron and zinc. However, even a lacto-vegetarian diet produces an increased risk of deficiencies of vitamin B12 and possibly certain minerals, such as iron. Data from the latest Dutch food consumption survey suggest that 5-10% of all inhabitants of the Netherlands (up to 1 million persons) actually have a vitamin B12 intake below recommended daily levels. In medical practice, the possibility of vitamin B12 deficiency in subjects

  6. Nutrition Reconciliation and Nutrition Prophylaxis: Toward Total Health

    PubMed Central

    Tuso, Phillip; Beattie, Sam

    2015-01-01

    Malnutrition is a common and debilitating condition in the acute hospital setting that is associated with many adverse outcomes, including prolonged length of hospital stay, increased readmission rates, and increased mortality. However, malnutrition by definition may be an abnormality in either under- or overnutrition. With obesity rates rising, many patients admitted to the hospital may be overnourished from unhealthy eating habits. Unhealthy eating habits and obesity increase a patient’s risk for cardiovascular events and complications in the hospital setting. Nutrition risk screening or nutrition reconciliation is an underutilized tool in the hospital that would identify patients with over- and undernutrition. Nutrition intervention or nutrition prophylaxis initiated in the hospital may help reduce hospital days, readmissions, and mortality. Nutrition reconciliation is a new term developed to increase the awareness of nutrition in total health. Nutrition reconciliation means that all patients have their nutritional status reconciled on admission to and discharge from the hospital. Nutrition reconciliation is defined as the process of maximizing health by helping align an individual’s current diet to the diet prescribed for him or her by the health care team. Nutrition prophylaxis is a proactive intervention to prevent a medical complication. Mandatory nutrition reconciliation and nutrition prophylaxis is not widely performed in most hospitals. Such an intervention may help our patients by improving their short-and long-term health. In addition, nutrition reconciliation and nutrition prophylaxis may allow for a more effective use of resources to prevent a preventable disease. PMID:25902344

  7. Iodine nutritional status and risk factors for goitre among schoolchildren in South Tajikistan

    PubMed Central

    2013-01-01

    Background Iodine deficiency affects nearly 1.9 billion people worldwide, but it can be prevented by salt iodization. This cross-sectional survey assessed current iodine status, iodized salt coverage and risk factors for goitre among schoolchildren in South Tajikistan. Methods Ten primary schools in four districts in South Tajikistan were randomly selected. In schoolchildren aged 7 to 11 years, a spot urine sample was collected for measurement of urinary iodine, dried blood spots were collected for measurement of thyroglobulin, and goitre was assessed by palpation. Iodine content of salt samples and local selling points was determined by coloration using rapid test kits and titration method. Results Of 623 schoolchildren enrolled, complete data was obtained from 589. The overall median urinary iodine concentration (UIC) was 51.2 μg/L indicating mild-to-moderate iodine deficiency. Among all children, 46.6% (95% Confidence Interval (CI) = 42.4%-50.6%) of children were found to be goitrous (grade 1 goitre: 30.6%, 95% CI = 26.9%-34.5%; grade 2 goitre: 16.0%, 95% CI = 13.1%-19.2%). The risk factor for goitre remaining significant in the multivariable logistic regression model was 'buying salt once a month’ (OR = 2.89, 95% CI = 1.01-8.22) and 'buying salt once every six months’ (OR = 2.26, 95% CI = 1.01-5.04) compared to 'buying salt every one or two weeks’. The overall median thyroglobulin concentration was elevated at 13.9 μg/L. Of the salt samples from households and selling points, one third were adequately iodised, one third insufficiently and one third were not iodised. Conclusion Iodine deficiency remains a serious health issue among children in southern Tajikistan. There is a persisting high prevalence of goitre, elevated thyroglobulin and low UIC despite interventions implemented by Tajikistan and international partners. Quality control of salt iodine content needs to be improved. Continued efforts to raise awareness of the

  8. Application of a functional mathematical index (FMI) for predicting effects of the composition of jujube fruit on nutritional quality and health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the present study, we extend the concept of a Functional Mathematical Index (FMI) for the assessment and prediction of food quality and safety of jujube fruit, a medicinal food widely consumed in Asian countries. In this study the index has been applied to one field-grown jujube fruit harvested a...

  9. Nutrition in adult patients with inflammatory bowel disease.

    PubMed

    Hebuterne, Xavier; Filippi, Jerome; Schneider, Stephane M

    2014-01-01

    Seventy five percent of hospitalized patients with Crohn's disease suffer from malnutrition. One third of Crohn's disease patients have a body mass index below 20. Sixty percent of Crohn's disease patients have sarcopenia. However some inflammatory bowel disease (IBD) patients are obese or suffer from sarcopenic-obesity. IBD patients have many vitamin and nutrient deficiencies, which can lead to important consequences such as hyperhomocysteinemia, which is associated with a higher risk of thromboembolic disease. Nutritional deficiencies in IBD patients are the result of insufficient intake, malabsorption and protein-losing enteropathy as well as metabolic disturbances directly induced by the chronic disease and its treatments, in particular corticosteroids. Screening for nutritional deficiencies in chronic disease patients is warranted. Managing the deficiencies involves simple nutritional guidelines, vitamin supplements, and nutritional support in the worst cases. PMID:25266810

  10. The Relations between Cluster Indexes of Risk and Promotion and the Problem Behaviors of 6- and 7-Year-Old Children from Economically Disadvantaged Families.

    ERIC Educational Resources Information Center

    Ackerman, Brian P.; Schoff, Kristen; Levinson, Karen; Youngstrom, Eric; Izard, Carroll E.

    1999-01-01

    Examined relations between alternative representations of poverty cofactors and promotion processes, and problem behaviors of 6- and 7-year-olds from disadvantaged families. Found that single-index risk representations and promotion variables predicted aggression but not anxiety/depression. An additive model of individual risk indicators performed…

  11. Marbling and Its Nutritional Impact on Risk Factors for Cardiovascular Disease

    PubMed Central

    2016-01-01

    This review addresses the role of fat in beef palatability and healthfulness. Particular emphasis is placed on the content of oleic acid in beef, and how this increases with time when cattle are fed a grain-based diet. Oleic acid decreases the melting point of lipids from beef, increasing the perception of juiciness and improving beef flavor. Clinical trials have demonstrated that ground beef containing elevated oleic acid increases, or at the least has no negative effects on the concentration of HDL cholesterol. The amount of fat in published ground beef intervention trials greatly exceeds the amount of fat in equivalent portions of beef from U.S. domestic or Korean Hanwoo cattle. Thus, we conclude 1) Beef cattle should be raised under production conditions that increase the concentration of oleic acid in their edible tissues (i.e., by grain feeding over extended periods of time); and 2) The amount of fat consumed in a typical portion of beef will not increase risk factors for cardiovascular disease. PMID:27621682

  12. Marbling and Its Nutritional Impact on Risk Factors for Cardiovascular Disease.

    PubMed

    Smith, Stephen B

    2016-01-01

    This review addresses the role of fat in beef palatability and healthfulness. Particular emphasis is placed on the content of oleic acid in beef, and how this increases with time when cattle are fed a grain-based diet. Oleic acid decreases the melting point of lipids from beef, increasing the perception of juiciness and improving beef flavor. Clinical trials have demonstrated that ground beef containing elevated oleic acid increases, or at the least has no negative effects on the concentration of HDL cholesterol. The amount of fat in published ground beef intervention trials greatly exceeds the amount of fat in equivalent portions of beef from U.S. domestic or Korean Hanwoo cattle. Thus, we conclude 1) Beef cattle should be raised under production conditions that increase the concentration of oleic acid in their edible tissues (i.e., by grain feeding over extended periods of time); and 2) The amount of fat consumed in a typical portion of beef will not increase risk factors for cardiovascular disease. PMID:27621682

  13. Targeted Echocardiographic Screening for Latent Rheumatic Heart Disease in Northern Uganda: Evaluating Familial Risk Following Identification of an Index Case

    PubMed Central

    Aliku, Twalib; Sable, Craig; Scheel, Amy; Tompsett, Alison; Lwabi, Peter; Okello, Emmy; McCarter, Robert; Summar, Marshall; Beaton, Andrea

    2016-01-01

    Background Echocardiographic screening for detection of latent RHD has shown potential as a strategy to decrease the burden of disease. However, further research is needed to determine optimal implementation strategies. RHD results from a complex interplay between environment and host susceptibility. Family members share both and relatives of children with latent RHD may represent a high-risk group. The objective of this study was to use echocardiographic family screening to determine the relative risk of RHD among first-degree relatives of children with latent RHD compared to the risk in first-degree relatives of healthy peers. Methodology/Principal Findings Previous school-based screening data were used to identify RHD positive children and RHD negative peers. All first-degree relatives ≥ 5 years were invited for echocardiography screening (2012 World Heart Federation Criteria). Sixty RHD positive cases (30 borderline/30 definite RHD) and 67 RHD negative cases were recruited. A total of 455/667 (68%) family members were screened. Definite RHD was more common in childhood siblings of RHD positive compared to RHD negative (p = 0.05). Children with any RHD were 4.5 times as likely to have a sibling with definite RHD, a risk that increased to 5.6 times when considering only cases with definite RHD. Mothers of RHD positive and RHD negative cases had an unexpectedly high rate of latent RHD (9.3%). Conclusions/Significance Siblings of RHD positive cases with RHD are more likely to have definite RHD and the relative risk is highest if the index case has definite RHD. Future screening programs should consider implementation of sibling screening following detection of an RHD positive child. Larger screening studies of adults are needed, as data on prevalence of latent RHD outside of childhood are sparse. Future studies should prioritize implementation research to answer questions of how RHD screening can best be integrated into existing healthcare structures, ensuring

  14. Body mass index, effect modifiers, and risk of pancreatic cancer: a pooled study of seven prospective cohorts

    PubMed Central

    de Gonzalez, Amy Berrington; Hartge, Patricia; Pfeiffer, Ruth M.; Park, Yikyung; Freedman, D. Michal; Gail, Mitchell H.; Alavanja, Michael C. R.; Albanes, Demetrius; Beane Freeman, Laura E.; Chow, Wong-Ho; Huang, Wen-Yi; Hayes, Richard B.; Hoppin, Jane A.; Ji, Bu-tian; Leitzmann, Michael F.; Linet, Martha S.; Meinhold, Cari L.; Schairer, Catherine; Schatzkin, Arthur; Virtamo, Jarmo; Weinstein, Stephanie J.; Zheng, Wei; Stolzenberg-Solomon, Rachael Z.

    2010-01-01

    Objective To investigate whether the positive association of body mass index (BMI, kg/m2) with risk of pancreatic cancer is modified by age, sex, smoking status, physical activity, and history of diabetes. Methods In a pooled analysis of primary data of seven prospective cohorts including 458,070 men and 485,689 women, we identified 2,454 patients with incident pancreatic cancer during an average 6.9 years of follow-up. Cox proportional hazard regression models were used in data analysis. Results In a random-effects meta-analysis, for every 5 kg/m2 increment in BMI, the summary relative risk (RR) was 1.06 (95% confidence interval (CI) 0.99–1.13) for men and 1.12 (95% CI 1.05–1.19) for women. The aggregate analysis showed that compared with normal weight (BMI: 18.5 to <25), the adjusted RR was 1.13 (95% CI 1.03–1.23) for overweight (BMI: 25 to <30) and 1.19 (95% CI 1.05–1.35) for obesity class I (BMI: 30 to <35). Tests of interactions of BMI effects by other risk factors were not statistically significant. Every 5 kg/m2 increment in BMI was associated with an increased risk of pancreatic cancer among never and former smokers, but not among current smokers (P-interaction = 0.08). Conclusion The present evidence suggests that a high BMI is an independent risk factor of pancreatic cancer. PMID:20383573

  15. An index-based method to assess risks of climate-related hazards in coastal zones: The case of Tetouan

    NASA Astrophysics Data System (ADS)

    Satta, Alessio; Snoussi, Maria; Puddu, Manuela; Flayou, Latifa; Hout, Radouane

    2016-06-01

    The regional risk assessment carried out within the ClimVar & ICZM Project identified the coastal zone of Tetouan as a hotspot of the Mediterranean Moroccan coast and so it was chosen for the application of the Multi-Scale Coastal Risk Index for Local Scale (CRI-LS). The local scale approach provides a useful tool for local coastal planning and management by exploring the effects and the extensions of the hazards and combining hazard, vulnerability and exposure variables in order to identify areas where the risk is relatively high. The coast of Tetouan is one of the coastal areas that have been most rapidly and densely urbanized in Morocco and it is characterized by an erosive shoreline. Local authorities are facing the complex task of balancing development and managing coastal risks, especially coastal erosion and flooding, and then be prepared to the unavoidable impacts of climate change. The first phase of the application of the CRI-LS methodology to Tetouan consisted of defining the coastal hazard zone, which results from the overlaying of the erosion hazard zone and the flooding hazard zone. Nineteen variables were chosen to describe the Hazards, Vulnerability and Exposure factors. The scores corresponding to each variable were calculated and the weights assigned through an expert judgement elicitation. The resulting values are hosted in a geographic information system (GIS) platform that enables the individual variables and aggregated risk scores to be color-coded and mapped across the coastal hazard zone. The results indicated that 10% and 27% of investigated littoral fall under respectively very high and high vulnerability because of combination of high erosion rates with high capital land use. The risk map showed that some areas, especially the flood plains of Restinga, Smir and Martil-Alila, with distances over 5 km from the coast, are characterized by high levels of risk due to the low topography of the flood plains and to the high values of exposure

  16. An index-based method to assess risks of climate-related hazards in coastal zones: The case of Tetouan

    NASA Astrophysics Data System (ADS)

    Satta, Alessio; Snoussi, Maria; Puddu, Manuela; Flayou, Latifa; Hout, Radouane

    2016-06-01

    The regional risk assessment carried out within the ClimVar & ICZM Project identified the coastal zone of Tetouan as a hotspot of the Mediterranean Moroccan coast and so it was chosen for the application of the Multi-Scale Coastal Risk Index for Local Scale (CRI-LS). The local scale approach provides a useful tool for local coastal planning and management by exploring the effects and the extensions of the hazards and combining hazard, vulnerability and exposure variables in order to identify areas where the risk is relatively high. The coast of Tetouan is one of the coastal areas that have been most rapidly and densely urbanized in Morocco and it is characterized by an erosive shoreline. Local authorities are facing the complex task of balancing development and managing coastal risks, especially coastal erosion and flooding, and then be prepared to the unavoidable impacts of climate change. The first phase of the application of the CRI-LS methodology to Tetouan consisted of defining the coastal hazard zone, which results from the overlaying of the erosion hazard zone and the flooding hazard zone. Nineteen variables were chosen to describe the Hazards, Vulnerability and Exposure factors. The scores corresponding to each variable were calculated and the weights assigned through an expert judgement elicitation. The resulting values are hosted in a geographic information system (GIS) platform that enables the individual variables and aggregated risk scores to be color-coded and mapped across the coastal hazard zone. The results indicated that 10% and 27% of investigated littoral fall under respectively very high and high vulnerability because of combination of high erosion rates with high capital land use. The risk map showed that some areas, especially the flood plains of Restinga, Smir and Martil-Alila, with distances over 5 km from the coast, are characterized by high levels of risk due to the low topography of the flood plains and to the high values of exposure

  17. SU-E-T-316: The Design of a Risk Index Method for 3D Patient Specific QA

    SciTech Connect

    Cho, W; Wu, H; Xing, L; Suh, T

    2014-06-01

    Purpose: To suggest a new guidance for the evaluation of 3D patient specific QA, a structure-specific risk-index (RI) method was designed and implemented. Methods: A new algorithm was designed to assign the score of Pass, Fail or Pass with Risk to all 3D voxels in each structure by improving a conventional Gamma Index (GI) algorithm, which implied the degree of the risk of under-dose to the treatment target or over-dose to the organ at risks (OAR). Structure-specific distance to agreement (DTOA), dose difference and minimum checkable dose were applied to the GI algorithm, and additional parameters such as dose gradient factor and dose limit of structures were used to the RI method. Maximum passing rate (PR) and minimum PR were designed and calculated for each structure with the RI method. 3D doses were acquired from a spine SBRT plan by simulating the shift of beam iso-center, and tested to show the feasibility of the suggested method. Results: When the iso-center was shifted by 1 mm, 2 mm, and 3 mm, the PR of conventional GI method between shifted and non-shifted 3D doses were 99.9%, 97.4%, and 89.7% for PTV, 99.8%, 84.8%, and 63.2% for spinal cord, and 100%, 99.5%, 91.7% for right lung. The minimum PRs from the RI method were 98.9%, 96.9%, and 89.5% for PTV, and 96.1%, 79.3%, 57.5% for spinal cord, and 92.5%, 92.0%, 84.4% for right lung, respectively. The maximum PRs from the RI method were equal or less than the PRs from the conventional GI evaluation. Conclusion: Designed 3D RI method showed more strict acceptance level than the conventional GI method, especially for OARs. The RI method is expected to give the degrees of risks in the delivered doses, as well as the degrees of agreements between calculated 3D doses and measured (or simulated) 3D doses.

  18. PREPREGNANT BODY MASS INDEX, WEIGHT GAIN AND THE RISK OF DELIVERING LARGE BABIES AMONG NON-DIABETIC MOTHERS

    PubMed Central

    Kabali, Conrad; Werler, Martha M.

    2007-01-01

    Objective Pre-pregnancy over-weight and excess weight gain during pregnancy have each been associated with an increased risk of delivering large babies. However, previous studies have focused on the separate effects of these two indices of weight in diabetic women. Method This study analyzed both separate and combined effects of pre-pregnant body mass index and weight gain in relation to macrosomia (≥ 4000g) in offspring among 815 non-diabetic women, using data collected from a retrospective study. Result Compared to mothers with normal pre-pregnancy BMI and pregnancy weight gain, risk of macrosomia in offspring was significantly elevated only in over-weight women with excess weight gain (adjusted OR =2.6, 95%CI [1.2,5.4]) but not among normal weight mothers with excess gain (adjusted OR=1.1, 95%CI [0.5,2.4]) or overweight mothers with normal or low gain (adjusted OR=1.1, 95%CI [0.4,3.1]). Conclusion Given the complications that are associated with delivering large babies, overweight women may benefit from not gaining excess weight gain in pregnancy. Synopsis Mothers who are overweight when entering pregnancy and also gain excess weight during pregnancy have a 2.5-fold increased risk of delivering a macrosomic baby. PMID:17376448

  19. A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial

    PubMed Central

    Martínez-González, Miguel Angel; García-Arellano, Ana; Toledo, Estefanía; Salas-Salvadó, Jordi; Buil-Cosiales, Pilar; Corella, Dolores; Covas, Maria Isabel; Schröder, Helmut; Arós, Fernando; Gómez-Gracia, Enrique; Fiol, Miquel; Ruiz-Gutiérrez, Valentina; Lapetra, José; Lamuela-Raventos, Rosa Maria; Serra-Majem, Lluís; Pintó, Xavier; Muñoz, Miguel Angel; Wärnberg, Julia; Ros, Emilio; Estruch, Ramón

    2012-01-01

    Objective Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes. Design Cross-sectional assessment of all participants in the “PREvención con DIeta MEDiterránea” (PREDIMED) trial. Subjects 7,447 participants (55–80 years, 57% women) free of cardiovascular disease, but with either type 2 diabetes or ≥3 cardiovascular risk factors. Trained dietitians used both a validated 14-item questionnaire and a full-length validated 137-item food frequency questionnaire to assess dietary habits. Trained nurses measured weight, height and waist circumference. Results Strong inverse linear associations between the 14-item tool and all adiposity indexes were found. For a two-point increment in the 14-item score, the multivariable-adjusted differences in WHtR were −0.0066 (95% confidence interval, –0.0088 to −0.0049) for women and –0.0059 (–0.0079 to –0.0038) for men. The multivariable-adjusted odds ratio for a WHtR>0.6 in participants scoring ≥10 points versus ≤7 points was 0.68 (0.57 to 0.80) for women and 0.66 (0.54 to 0.80) for men. High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity. Conclusions A brief 14-item tool was able to capture a strong monotonic inverse association between

  20. Brain dysmaturity index for automatic detection of high-risk infants.

    PubMed

    Holthausen, K; Breidbach, O; Scheidt, B; Frenzel, J

    2000-03-01

    The definition of an electroencephalographic (EEG)-based brain dysmaturity index that could allow automatic detection of neonates who deviate from expected ontogenetic patterns is proposed. The investigation was performed in a group of 94 term and preterm infants (28-112 weeks postconceptional age). For each neonate, one continuous two-channel EEG of 1-6 hours was recorded. The cluster analysis of different age groups was performed with a self-referential neural network. The network performed a nonlinear discriminant analysis; the synaptic strength of input nodes indicates the relevance of an individual EEG feature. The most relevant EEG features are given by the average amplitude in the delta and theta bands and by the relative amplitudes of beta-1/theta and beta-1/delta, respectively. The correlation between the frequency shifts and the postconceptional age agreed with measures of brain dysmaturity in healthy preterm neonates. Thus the presented trend in early EEG development demonstrates that it is possible to establish clinically relevant age dysmaturity scores. PMID:10734248

  1. Managing water utility financial risks through third-party index insurance contracts

    NASA Astrophysics Data System (ADS)

    Zeff, Harrison B.; Characklis, Gregory W.

    2013-08-01

    As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

  2. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders

    PubMed Central

    Fevery, Davina; Peeters, Bob; Lenders, Sonia; Spanoghe, Pieter

    2015-01-01

    Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq) is used in environmental policy in Flanders (Belgium). The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN). The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders. PMID:26046655

  3. The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial).

    PubMed

    Weber, Bernardete; Bersch-Ferreira, Ângela Cristine; Torreglosa, Camila Ragne; Ross-Fernandes, Maria Beatriz; da Silva, Jacqueline Tereza; Galante, Andrea Polo; Lara, Enilda de Sousa; Costa, Rosana Perim; Soares, Rafael Marques; Cavalcanti, Alexandre Biasi; Moriguchi, Emilio H; Bruscato, Neide M; Kesties; Vivian, Lilian; Schumacher, Marina; de Carli, Waldemar; Backes, Luciano M; Reolão, Bruna R; Rodrigues, Milena P; Baldissera, Dúnnia M B; Tres, Glaucia S; Lisbôa, Hugo R K; Bem, João B J; Reolão, Jose B C; Deucher, Keyla L A L; Cantarelli, Maiara; Lucion, Aline; Rampazzo, Daniela; Bertoni, Vanessa; Torres, Rosileide S; Verríssimo, Adriana O L; Guterres, Aldair S; Cardos, Andrea F R; Coutinho, Dalva B S; Negrão, Mayara G; Alencar, Mônica F A; Pinho, Priscila M; Barbosa, Socorro N A A; Carvalho, Ana P P F; Taboada, Maria I S; Pereira, Sheila A; Heyde, Raul V; Nagano, Francisca E Z; Baumgartner, Rebecca; Resende, Fernanda P; Tabalipa, Ranata; Zanini, Ana C; Machado, Michael J R; Araujo, Hevila; Teixeira, Maria L V; Souza, Gabriela C; Zuchinali, Priccila; Fracasso, Bianca M; Ulliam, Karen; Schumacher, Marina; Pierotto, Moara; Hilário, Thamires; Carlos, Daniele M O; Cordeiro, Cintia G N C; Carvalho, Daniele A; Gonçalves, Marília S; Vasconcelos, Valdiana B; Bosquetti, Rosa; Pagano, Raira; Romano, Marcelo L P; Jardim, César A; de Abreu, Bernardo N A; Marcadenti, Aline; Schmitt, Alessandra R; Tavares, Angela M V; Faria, Christiane C; Silva, Flávia M; Fink, Jaqueline S; El Kik, Raquel M; Prates, Clarice F; Vieira, Cristiane S; Adorne, Elaine F; Magedanz, Ellen H; Chieza, Fernanda L; Silva, Ingrid S; Teixeira, Joise M; Trescastro, Eduardo P; Pellegrini, Lívia A; Pinto, Jéssika C; Telles, Cristina T; Sousa, Antonio C S; Almeida, Andreza S; Costa, Ariane A; Carmo, José A C; Silva, Juliana T; Alves, Luciana V S; Sales, Saulo O C; Ramos, Maria E M; Lucas, Marilia C S; Damiani, Monica; Cardoso, Patricia C; Ramos, Salvador S; Dantas, Clenise F; Lopes, Amanda G; Cabral, Ana M P; Lucena, Ana C A; Medeiros, Auriene L; Terceiro, Bernardino B; Leda, Neuma M F S; Baía, Sandra R D; Pinheiro, Josilene M F; Cassiano, Alexandra N; Melo, Andressa N L; Cavalcanti, Anny K O; Souza, Camila V S; Queiroz, Dayanna J M; Farias, Hercilla N C F; Souza, Larissa C F; Santos, Letícia S; Lima, Luana R M; Hoffmann, Meg S; Ribeiro, Átala S Silva; Vasconcelos, Daniel F; Dutra, Eliane S; Ito, Marina K; Neto, José A F; Santos, Alexsandro F; Sousa, Rosângela M L; Dias, Luciana Pereira P; Lima, Maria T M A; Modanesi, Victor G; Teixeira, Adriana F; Estrada, Luciana C N C D; Modanesi, Paulo V G; Gomes, Adriana B L; Rocha, Bárbara R S; Teti, Cristina; David, Marta M; Palácio, Bruna M; Junior, Délcio G S; Faria, Érica H S; Oliveira, Michelle C F; Uehara, Rose M; Sasso, Sandramara; Moreira, Annie S B; Cadinha, Ana C A H; Pinto, Carla W M; Castilhos, Mariana P; Costa, Mariana; Kovacs, Cristiane; Magnoni, Daniel; Silva, Quênia; Germini, Michele F C A; da Silva, Renata A; Monteiro, Aline S; dos Santos, Karina G; Moreira, Priscila; Amparo, Fernanda C; Paiva, Catharina C J; Poloni, Soraia; Russo, Diana S; Silveira, Izabele V; Moraes, Maria A; Boklis, Mirena; Cardoso, Quinto I; Moreira, Annie S B; Damaceno, Aline M S; Santos, Elisa M; Dias, Glauber M; Pinho, Cláudia P S; Cavalcanti, Adrilene C; Bezerra, Amanda S; Queiroga, Andrey V; Rodrigues, Isa G; Leal, Tallita V; Sahade, Viviane; Amaral, Daniele A; Souza, Diana S; Araújo, Givaldo A; Curvello, Karine; Heine, Manuella; Barretto, Marília M S; Reis, Nailson A; Vasconcelos, Sandra M L; Vieira, Danielly C; Costa, Francisco A; Fontes, Jessica M S; Neto, Juvenal G C; Navarro, Laís N P; Ferreira, Raphaela C; Marinho, Patrícia M; Abib, Renata Torres; Longo, Aline; Bertoldi, Eduardo G; Ferreira, Lauren S; Borges, Lúcia R; Azevedo, Norlai A; Martins, Celma M; Kato, Juliana T; Izar, Maria C O; Asoo, Marina T; de Capitani, Mariana D; Machado, Valéria A; Fonzar, Waléria T; Pinto, Sônia L; Silva, Kellen C; Gratão, Lúcia H A; Machado, Sheila D; de Oliveira, Susane R U; Bressan, Josefina; Caldas, Ana P S; Lima, Hatanne C F M; Hermsdorff, Helen H M; Saldanha, Tânia M; Priore, Sílvia E; Feres, Naoel H; Neves, Adila de Queiroz; Cheim, Loanda M G; Silva, Nilma F; Reis, Silvia R L; Penafort, Andreza M; de Queirós, Ana Paula O; Farias, Geysa M N; de los Santos, Mônica L P; Ambrozio, Cíntia L; Camejo, Cirília N; dos Santos, Cristiano P; Schirmann, Gabriela S; Boemo, Jorge L; Oliveira, Rosane E C; Lima, Súsi M B; Bortolini, Vera M S

    2016-01-01

    This article reports the rationale for the Brazilian Cardioprotective Nutritional Program (BALANCE Program) Trial. This pragmatic, multicenter, nationwide, randomized, concealed, controlled trial was designed to investigate the effects of the BALANCE Program in reducing cardiovascular events. The BALANCE Program consists of a prescribed diet guided by nutritional content recommendations from Brazilian national guidelines using a unique nutritional education strategy, which includes suggestions of affordable foods. In addition, the Program focuses on intensive follow-up through one-on-one visits, group sessions, and phone calls. In this trial, participants 45 years or older with any evidence of established cardiovascular disease will be randomized to the BALANCE or control groups. Those in the BALANCE group will receive the afore mentioned program interventions, while controls will be given generic advice on how to follow a low-fat, low-energy, low-sodium, and low-cholesterol diet, with a view to achieving Brazilian nutritional guideline recommendations. The primary outcome is a composite of death (any cause), cardiac arrest, acute myocardial infarction, stroke, myocardial revascularization, amputation for peripheral arterial disease, or hospitalization for unstable angina. A total of 2468 patients will be enrolled in 34 sites and followed up for up to 48 months. If the BALANCE Program is found to decrease cardiovascular events and reduce risk factors, this may represent an advance in the care of patients with cardiovascular disease. PMID:26699603

  4. Advanced Atherogenic Index for the Assessment of Consolidated Lipid Risk in Premature Coronary Artery Disease Patients in India

    PubMed Central

    Bansal, Sanjiv Kumar; Agarwal, Sarita; Daga, Mridul Kumar

    2016-01-01

    Introduction: The high prevalence, severity, and prematurity of coronary artery disease (CAD) in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. Aims and Objectives: To calculate newly defined advanced atherogenic index (AAI) in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. Material and Methods: One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL), small dense LDL (SD LDL), lipoprotein (a) apolipoprotein B (Apo B), and apolipoprotein A1 (Apo A1) were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI) and lipid pentad index (LPI). Results: The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20) as compared to controls (305.84 ± 21.80). AAI has shown better statistical significance and correlation (P < 0.0001, r = 0.737) as compared to the earlier indices such as AI (P < 0.01, r = 0.52), LTI (P < 0.001, r = 0.677) and LPI (P < 0.001, r = 0.622) in premature CAD. Kolmogorov D statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Conclusion: Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices. PMID:27365915

  5. Parenteral nutrition.

    PubMed

    Thibault, Ronan; Pichard, Claude

    2013-01-01

    Parenteral nutrition (PN) is a technique of nutritional support, which consists of intravenous administration of macronutrients (glucose, amino acids, and triglycerides), micronutrients (vitamins and trace elements), water, and electrolytes. Early studies indicate that the use of total PN was associated with increased mortality and infectious morbidity. These detrimental effects of PN were related to hyperglycemia and overfeeding at a period when PN was administered according to the principle that the higher calories the patients received, the better their outcome would be. Enteral nutrition (EN) then replaced PN as the gold standard of nutritional care in the intensive care unit (ICU). However, EN alone is frequently associated with insufficient energy coverage, and subsequent protein-energy deficit is correlated with a worse clinical outcome. Infectious and metabolic complications of PN could be prevented if PN is used by a trained team using a validated protocol, only when indicated, not within the first 2 days following ICU admission, and limited through the time. In addition, energy delivery has to be matched to the energy target, and adapted glucose control should be obtained. In patients with significant energy deficit (>40%), the combination of PN and EN, i.e. supplemental PN, from day 4 of the ICU stay, could improve the clinical outcome of ICU patients as compared with EN alone. Therefore, PN should be integrated in the management of ICU patients with the aim of prevent the worsening of energy deficits, allowing the preservation of lean body mass loss, and reducing the risk of undernutrition-related complications. PMID:23075587

  6. High-Sensitivity C-Reactive Protein and Ankle Brachial Index in a Finnish Cardiovascular Risk Population

    PubMed Central

    Syvänen, K.; Korhonen, P.; Jaatinen, P.; Vahlberg, T.; Aarnio, P.

    2011-01-01

    High-sensitivity C-reactive protein (hsCRP) has been previously linked to different forms of vascular disease. However, some studies have not found any relationship between hsCRP and atherosclerosis. Also, studies investigating correlation between hsCRP and ankle brachial index (ABI) are scarce. We studied hsCRP in a cardiovascular risk population with a special interest in correlation between hsCRP and ABI. All men and women aged 45 to 70 years from a rural town Harjavalta, Finland were invited to participate in a population survey. Diabetics and people with known vascular disease were excluded. Seventy-three percent (n = 2085) of the invited persons participated and 70% of the respondents (n = 1496) had at least one risk factor to cardiovascular diseases. These subjects were invited to further examinations. From them we measured ABI, hsCRP, leukocyte count, glucose tolerance, systemic coronary risk evaluation (SCORE), body mass index (BMI), and waist circumference. Mean hsCRP was 1.9 mg/L. Smokers had higher hsCRP (mean 2.2 mg/L) than nonsmokers (mean 1.8 mL/L). hsCRP in women was higher than in men (mean 2.0 mg/L versus 1.8 mg/L). Mean ABI was 1.10, and the prevalence of peripheral arterial disease was 3.1%. ABI correlated weakly with hsCRP (r = −0.077, p = 0.014), leukocyte count (r = −0.107, p = 0.001), and SCORE (r = −0.116, p = 0.001). It did not have correlation between age, weight, BMI, or waist circumference. hsCRP correlated with BMI (r = 0.208, p < 0.0001) and waist circumference (r = 0.325, p < 0.0001). When we excluded subjects with hsCRP >10 mg/L, ABI no longer correlated with hsCRP. In a cardiovascular risk population, hsCRP has only a weak correlation with ABI, and this correlation disappeared when we excluded subject with hsCRP >10 mg/L. Instead, hsCRP was correlated to the measures of obesity (waist circumference and BMI), indicating its role as a marker of adipose tissue–driven inflammation

  7. Dietary Re-education, Exercise Program, Performance and Body Indexes Associated with Risk Factors in Overweight/Obese Women

    PubMed Central

    Fett, Carlos; Fett, Waléria; Fabbro, Amaury; Marchini, Julio

    2005-01-01

    This study observed the effect of a dietary re-education plus regular physical activity on body composition, risk factors and physical test performance of sedentary overweight/obese women and to correlate these variables one with each other. Fifty women (36 ± 10 yrs; 31 ± 6 body mass index (BMI, kg/m2)) volunteered for the study. Body compositions were obtained by anthropometry and bioimpedance and some body indexes were established. One-repetition maximum (1-RM) and treadmill VO2max tests were carried out and blood samples were obtained for lipid, glucose and uric acid analyses before (T1) and after two months of intervention (T2). Diet was established by indirect calorimetry. Body fat, glucose, uric acid, total cholesterol, HDL-cholesterol and systolic blood pressure were significantly reduced. The 1-RM and VO2max tests were significantly increased. Neck circumference (NC) was correlated with body composition, back muscle 1-MR, HDL and LDL cholesterol, total cholesterol/HDL ratio, uric acid, and resting energy expenditure. BMI was found to be significantly correlated with waist/hip ratio, circumference sum, and body fat percentage by anthropometry and bioimpedance. Body fat percentage determined by bioimpedance and anthropometry was significantly correlated with arm fat area and arm fat area corrected respectively, and both with BMI at T1 and T2. This study suggests that a dietary reeducation plus physical activity around 200 min/week improved body composition and the health of these women. Many anthropometry measurements have correspondence to risk factors and NC could be a simple approach to reflect these results, without other more complex techniques. PMID:18500956

  8. Diagnostic Value of the Risk of Malignancy Index (RMI) for Detection of Pelvic Malignancies Compared with Pathology

    PubMed Central

    Karimi-Zarchi, Mojgan; Mojaver, Shokouh Paymani; Rouhi, Mitra; Hekmatimoghaddam, Seyed Hossein; Moghaddam, Reza Nafisi; Yazdian-Anari, Pouria; Teimoori, Soraya

    2015-01-01

    Introduction Pelvic masses are among most the common causes of patient admission into gynecology clinics and one of the most common reasons for referral to gynecologic oncology departments due to the risk of uterine or ovarian malignancies. The aim of this study is to compare the four indices of the risk of malignancy index (RMI 1–4), as a combination of menstrual status, radiological findings, and serum CA125 concentration, for discrimination of benign from malignant pelvic masses. Methods This retrospective descriptive and analytic study was conducted on 200 patients with pelvic mass, post-surgery, and who were referred to the oncology department in Shahid Sadoughi hospital of Yazd (Iran) between June 2007 and September 2011. Data regarding demographics, pathology reports, paraclinical and clinical tests were analyzed. The four RMI indices were separately used for determination of benign vs. malignant masses using the optimized cutoff points, ROC curve, sensitivity, specificity, predictive value of positive and negative, and accuracy. Finally, p value for each index was calculated, and a final discrimination power was measured by using SPSS version 17 software. Results The calculated p values in the four RMI indices in ultrasound findings indicated statistical significance, and the RMI 2 showed the highest level of accuracy or diagnostic performance. RMI 2 had a cutoff point of 90, an under-chart area 86.7, 79.36% sensitivity, 78.95% specificity, 58.44%, positive predictive value, 90.08% negative predictive value, and 78.93% accuracy, and a p value of 0.004. However, this relationship was found not to be meaningful using CT scan images. Conclusions Using RMI 2 for differentiation of malignant from benign pelvic masses is a reliable method with ultrasound findings. PMID:26767105

  9. Echocardiographic Left Ventricular Mass Index Predicts Incident Stroke in African Americans Atherosclerosis Risk in Communities (ARIC) Study

    PubMed Central

    Fox, Ervin R.; Alnabhan, Nabhan; Penman, Alan D.; Butler, Kenneth R.; Taylor, Herman A.; Skelton, Thomas N.; Mosley, Thomas H.

    2012-01-01

    Background and Purpose Despite theories that link stroke to left ventricular mass, few large, population-based studies have examined the predictive value of echocardiographically derived left ventricular mass index (LVMI) to incident stroke in African Americans. Methods Participants in the Jackson cohort of the Atherosclerotic Risk in Communities study have had extensive baseline evaluations, have undergone echocardiography during the third examination (1993–1995), and have been followed up for incident cardiovascular disease including ischemic stroke. Results The study population consisted of 1792 participants, of whom 639 (35.7%) were men and the mean ± SD age was 58.8 ± 5.7 years. Compared with those without ischemic stroke, those with ischemic stroke had a higher frequency of hypertension (85.6% vs 58.7%) and diabetes (46.9% vs 21.0%). Left ventricular hypertrophy was more prevalent in those with stroke (62.2% vs 38.6%). During a median follow-up of 8.8 years, 98 incident strokes occurred (6.5 per 1000 person-years). LVMI was independently associated with stroke after adjusting for age, sex, hypertension, systolic blood pressure, smoking, diabetes, total to HDL cholesterol ratio, body mass index, and low left ventricular ejection fraction (adjusted hazard ratio per 10 g/m2.7 increment of LVMI = 1.15; 95% CI, 1.02 to 1.28). The relation remained statistically significant after adding left atrial size and mitral annular calcification to the multivariable model. Conclusions In this large, population-based African American cohort, we found that echocardiographic LVMI was an independent predictor of incident ischemic stroke even after taking into account traditional clinical risk factors. PMID:17761924

  10. A genomewide study of body mass index and its genetic correlation with thromboembolic risk. Results from the GAIT project.

    PubMed

    Souto, Juan Carlos; Pena, Geórgia; Ziyatdinov, Audrey; Buil, Alfonso; López, Sonia; Fontcuberta, Jordi; Soria, José Manuel

    2014-11-01

    Thrombosis and obesity are complex epidemiologically associated diseases. The mechanism of this association is not yet understood. It was the objective of this study to identify genetic components of body mass index (BMI) and their possible role in the risk of thromboembolic disease. With the self-reported BMI of 397 individuals from 21 extended families enrolled in the GAIT (Genetic Analysis of Idiopathic Thrombophilia) Project, we estimated the heritability of BMI and the genetic correlation with the risk of thrombosis. Subjects were genotyped for an autosomal genome-wide scan with 363 highly-informative DNA markers. Univariate and bivariate multipoint linkage analyses were performed. The heritability for BMI was 0.31 (p=2.9×10⁻⁵). Thromboembolic disease (including venous and arterial) and BMI had a significant genetic correlation (ρG=0.54, p=0.005). Two linkage signals for BMI were obtained, one at 13q34 (LOD=3.36, p=0.0004) and other at 2q34, highly suggestive of linkage (LOD=1.95). Bivariate linkage analysis with BMI and thrombosis risk also showed a significant signal at 13q34 (LOD=3), indicating that this locus influences at the same time normal variation in the BMI phenotype as well as susceptibility to thrombosis. In conclusion, BMI and thrombosis are genetically correlated. The locus 13q34, which showed pleiotropy with both phenotypes, contains two candidate genes, which may explain our linkage pleiotropic signal and deserve further investigation as possible risk factors for obesity and thrombosis. PMID:25118907

  11. Renal resistive index as a new independent risk factor for new-onset diabetes mellitus after kidney transplantation.

    PubMed

    Mutinelli-Szymanski, Prisca; Caille, Agnès; Tranquart, François; Al-Najjar, Azmi; Büchler, Matthias; Barbet, Christelle; Marlière, Jean-Frédéric; Gatault, Philippe; Réault, Julie; Boin, Christopher; Chatelet, Valérie; Laouad, Inass; Nivet, Hubert; Lebranchu, Yvon; Halimi, Jean-Michel

    2012-04-01

    Pulse pressure and urinary albumin excretion were recently identified as risk factors of new-onset diabetes after renal transplantation (NODAT), suggesting that microvascular injury may be implicated in NODAT. However, the relationship between of microvascular injury and NODAT is unknown. In the present long-term (median follow-up: 5.7years; observation period: 4908 patient-years) retrospective study in 656 renal transplant recipients, the association between baseline renal resistance index (RI, used as a marker of widespread microvascular damage) and the incidence of NODAT was assessed. The incidence of NODAT was 11.2% and 14.6% at 5 and 10years, respectively, after transplantation. RI at 3months was a risk factor for NODAT [hazard ratio (HR) per 0.1: 2.19 (1.55-3.09), P<0.0001]. RI >0.75 (vs. 0≤0.75) was a potent a predictor of NODAT [HR: 3.29 (1.91-5.67), P<0.0001], even after adjustments [HR: 3.29 (1.50-7.24), P=0.0030] on age, weight, glucose, nephropathy, and arterial pressure. Similar results were observed when RI was measured at 1month [HR per 0.1:1.74 (1.33-2.27), P<0.0001] and 12months [HR per 0.1:1.74 (1.33-2.27), P<0.0001] after transplantation. High RI early after renal transplantation is a long-term risk factor for NODAT, and could be used to refine the individual risk of NODAT. PMID:22364312

  12. Survivorship: Nutrition and Weight Management, Version 2.2014

    PubMed Central

    Denlinger, Crystal S.; Ligibel, Jennifer A.; Are, Madhuri; Baker, K. Scott; Demark-Wahnefried, Wendy; Dizon, Don; Friedman, Debra L.; Goldman, Mindy; Jones, Lee; King, Allison; Ku, Grace H.; Kvale, Elizabeth; Langbaum, Terry S.; Leonardi-Warren, Kristin; McCabe, Mary S.; Melisko, Michelle; Montoya, Jose G.; Mooney, Kathi; Morgan, Mary Ann; Moslehi, Javid J.; O’Connor, Tracey; Overholser, Linda; Paskett, Electra D.; Peppercorn, Jeffrey; Raza, Muhammad; Rodriguez, M. Alma; Syrjala, Karen L.; Urba, Susan G.; Wakabayashi, Mark T.; Zee, Phyllis; McMillian, Nicole R.; Freedman-Cass, Deborah A.

    2015-01-01

    Healthy lifestyle habits have been associated with improved health outcomes and quality of life and, for some cancers, a reduced risk of recurrence and death. The NCCN Guidelines for Survivorship therefore recommend that cancer survivors be encouraged to achieve and maintain a healthy lifestyle, including attention to weight management, physical activity, and dietary habits. This section of the NCCN Guidelines focuses on recommendations regarding nutrition, weight management, and supplement use in survivors. Weight management recommendations are based on the survivor’s body mass index and include discussions of nutritional, weight management, and physical activity principles, with referral to community resources, dietitians, and/or weight management programs as needed. PMID:25313179

  13. Nutritional Care of Gastric Cancer Patients with Clinical Outcomes and Complications: A Review

    PubMed Central

    Choi, Wook Jin

    2016-01-01

    The incidence and mortality of gastric cancer have been steadily decreased over the past few decades. However, gastric cancer is still one of the leading causes of cancer deaths across many regions of the world, particularly in Asian countries. In previous studies, nutrition has been considered one of significant risk factors in gastric cancer patients. Especially, malnourished patients are at greater risk of adverse clinical outcomes (e.g., longer hospital stay) and higher incidence of complications (e.g., wound/infectious complications) compared to well-nourished patients. Malnutrition is commonly found in advanced gastric cancer patients due to poor absorption of essential nutrients after surgery. Therefore, nutritional support protocols, such as early oral and enternal feeding, have been proposed in many studies, to improve unfavorable clinical outcomes and to reduce complications due to delayed application of oral nutritional support or parental feeding. Also, the supplied with enternal immune-enriched diet had more benefits in improving clinical outcomes and fewer complications compared to a group supplied with control formula. Using nutritional screening tools, such as nutritional risk index (NRI) and nutritional risk screening (NRS 2002), malnourished patients showed higher incidence of complications and lower survival rates than non-malnourished patients. However, a long-term nutritional intervention, such as nutritional counseling, was not effective in the patients. Therefore, early assessment of nutritional status in patients using a proper nutritional screening tool is suggested to prevent malnutrition and adverse health outcomes. Further studies with numerous ethnic groups may provide stronger scientific evidences in association between nutritional care and recovery from surgery in patients with gastric cancer. PMID:27152296

  14. Nutritional Care of Gastric Cancer Patients with Clinical Outcomes and Complications: A Review.

    PubMed

    Choi, Wook Jin; Kim, Jeongseon

    2016-04-01

    The incidence and mortality of gastric cancer have been steadily decreased over the past few decades. However, gastric cancer is still one of the leading causes of cancer deaths across many regions of the world, particularly in Asian countries. In previous studies, nutrition has been considered one of significant risk factors in gastric cancer patients. Especially, malnourished patients are at greater risk of adverse clinical outcomes (e.g., longer hospital stay) and higher incidence of complications (e.g., wound/infectious complications) compared to well-nourished patients. Malnutrition is commonly found in advanced gastric cancer patients due to poor absorption of essential nutrients after surgery. Therefore, nutritional support protocols, such as early oral and enternal feeding, have been proposed in many studies, to improve unfavorable clinical outcomes and to reduce complications due to delayed application of oral nutritional support or parental feeding. Also, the supplied with enternal immune-enriched diet had more benefits in improving clinical outcomes and fewer complications compared to a group supplied with control formula. Using nutritional screening tools, such as nutritional risk index (NRI) and nutritional risk screening (NRS 2002), malnourished patients showed higher incidence of complications and lower survival rates than non-malnourished patients. However, a long-term nutritional intervention, such as nutritional counseling, was not effective in the patients. Therefore, early assessment of nutritional status in patients using a proper nutritional screening tool is suggested to prevent malnutrition and adverse health outcomes. Further studies with numerous ethnic groups may provide stronger scientific evidences in association between nutritional care and recovery from surgery in patients with gastric cancer. PMID:27152296

  15. Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status.

    PubMed

    Mão-de-Ferro, S; Serrano, M; Ferreira, S; Rosa, I; Lage, P; Alexandre, D P; Freire, J; Mirones, L; Casaca, R; Bettencourt, A; Pereira, A D

    2016-03-01

    Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Eleven patients were included: eight were moderate and three were severely malnourished. After stent placement, dysphagia improved in all patients. With regard to complications, one patient developed an esophageal perforation that required urgent esophagectomy. Four patients presented stent migration. Three of these patients required enteral nutrition and none was submitted to surgery because of poor nutritional status. Of the other six patients, only four were operated upon. Stent placement presented a high complication rate and did not prevent weight loss or malnutrition. Other alternatives, including naso-gastric tube placement or endoscopic percutaneous gastrostomy or jejunostomy, should be considered. PMID:26669568

  16. Body Mass Index in 1.2 Million Adolescents and Risk for End-Stage Renal Disease

    PubMed Central

    Vivante, Asaf; Golan, Eliezer; Tzur, Dorit; Leiba, Adi; Tirosh, Amir; Skorecki, Karl; Calderon-Margalit, Ronit

    2016-01-01

    Background The relationship between adolescent body mass index (BMI) and future risk for end-stage renal disease (ESRD) is not fully understood, nor is it known the extent to which this association is limited to diabetic ESRD. We evaluated the association between BMI in adolescence and the risk for all-cause, diabetic, and nondiabetic ESRD. Methods Medical data about 1 194 704 adolescents aged 17 years who had been examined for fitness for military service between January 1, 1967, and December 31, 1997, were linked to the Israeli ESRD registry in this nation-wide population-based retrospective cohort study. Incident cases of treated ESRD between January 1, 1980, and May 31, 2010, were included. Cox proportional hazards models were used to estimate the hazard ratio (HR) for treated ESRD among study participants for their BMI at age 17 years, defined in accord with the US Centers for Disease Control and Prevention BMI for age and sex classification. Results During 30 478 675 follow-up person-years (mean [SD], 25.51 [8.77] person-years), 874 participants (713 male and 161 female) developed treated ESRD, for an overall incidence rate of 2.87 cases per 100 000 person-years. Compared with adolescents of normal weight, overweight adolescents (85th to 95th percentiles of BMI) and obese adolescents (≥95th percentile of BMI) had an increased future risk for treated ESRD, with incidence rates of 6.08 and 13.40 cases per 100 000 person-years, respectively. In a multivariate model adjusted for sex, country of origin, systolic blood pressure, and period of enrollment in the study, overweight was associated with an HR of 3.00 (95% CI, 2.50-3.60) and obesity with an HR of 6.89 (95% CI, 5.52-8.59) for all-cause treated ESRD. Overweight (HR, 5.96; 95% CI, 4.41-8.06) and obesity (HR, 19.37; 95% CI, 14.13-26.55) were strong and independent risk factors for diabetic ESRD. Positive associations of overweight (HR, 2.17; 95% CI, 1.71-2.74) and obesity (HR, 3.41; 95% CI, 2.42-4.79) with

  17. Role of nutritional status and intervention in oesophageal cancer treated with definitive chemoradiotherapy: outcomes from SCOPE1

    PubMed Central

    Cox, S; Powell, C; Carter, B; Hurt, C; Mukherjee, Somnath; Crosby, Thomas David Lewis

    2016-01-01

    Background: Malnutrition is common in oesophageal cancer. We aimed to identify nutritional prognostic factors and survival outcomes associated with nutritional intervention in the SCOPE1 (Study of Chemoradiotherapy in OesoPhageal Cancer with or without Erbitux) trial. Methods: Two hundred and fifty eight patients were randomly allocated to definitive chemoradiotherapy (dCRT) +/− cetuximab. Nutritional Risk Index (NRI) scores were calculated; NRI<100 identified patients at risk of malnutrition. Nutritional intervention included dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariable and multivariable analyses using Cox proportional hazard modelling were conducted. Results: At baseline NRI<100 strongly predicted for reduced overall survival (hazard ratio (HR) 12.45, 95% CI 5.24–29.57; P<0.001). Nutritional intervention improved survival if provided at baseline (dietary advice (HR 0.12, P=0.004), oral supplementation (HR 0.13, P<0.001) or major intervention (HR 0.13, P=0.003)), but not if provided later in the treatment course. Cetuximab patients receiving major nutritional intervention had worse outcomes compared with controls (13 vs 28 months, P=0.003). Conclusions: Pre-treatment assessment and correction of malnutrition may improve survival outcomes in oesophageal cancer patients treated with dCRT. Nutritional Risk Index is a simple and objective screening tool to identify patients at risk of malnutrition. PMID:27328311

  18. Piloting a ‘Spatial Isolation’ Index: The Built Environment and Sexual and Drug Use Risks to Sex Workers

    PubMed Central

    Deering, Kathleen N; Rusch, Melanie; Amram, Ofer; Chettiar, Jill; Nguyen, Paul; Feng, Cindy X; Shannon, Kate

    2014-01-01

    Background Employing innovative mapping and spatial analyses of individual and neighborhood environment data, we examined the social, physical and structural features of overlapping street-based sex work and drug scenes and explored the utility of a ‘spatial isolation index’ in explaining exchanging sex for drugs and exchanging sex while high. Methods Analyses drew on baseline interview and geographic data (Jan/10-Oct/11) from a large prospective cohort of street and off-street sex workers (SWs) in Metropolitan Vancouver and external publically-available, neighborhood environment data. An index measuring ‘spatial isolation’ was developed from seven indicators measuring features of the built environment within 50m buffers (e.g. industrial or commercial zoning, lighting) surrounding sex work environments. Bivariate and multivariable logistic regression was used to examine associations between the two outcomes (exchanged sex for drugs; exchanged sex while high) and the index, as well as each individual indicator. Results Of 510 SWs, 328 worked in street-based/outdoor environments (e.g. streets, parks, alleys) and were included in the analyses. In multivariable analysis, increased spatial isolation surrounding street-based/outdoor SWs’ main places of servicing clients as measured with the index was significantly associated with exchanging sex for drugs. Exchanging sex for drugs was also significantly positively associated with an indicator of the built environment suggesting greater spatial isolation (increased percent of parks) and negatively associated with those suggesting decreased spatial isolation (increased percent commercial areas, increased count of lighting, increased building footprint). Exchanging sex while high was negatively associated with increased percent of commercial zones but this association was removed when adjusting for police harassment. Conclusions The results from our exploratory study highlight how built environment shapes risks

  19. Remote sensing (normalized difference vegetation index) classification of risk versus minimal risk habitats for human exposure to Ixodes pacificus (Acari: Ixodidae) nymphs in Mendocino County, California.

    PubMed

    Eisen, Rebecca J; Eisen, Lars; Lane, Robert S

    2005-01-01

    In California, Ixodes pacificus Cooley & Kohls nymphs have been implicated as the primary bridging vectors to humans of the spirochetal bacterium causing Lyme disease (Borrelia burgdorferi). Because the nymphs typically do not ascend emergent vegetation, risk of human exposure is minimal in grasslands, chaparral, and woodland-grass. Instead, woodlands with a ground cover dominated by leaf litter (hereinafter referred to as woodland-leaf) have emerged as a primary risk habitat for exposure to B. burgdorferi-infected nymphs. As a means of differentiating woodland-leaf habitats from others with minimal risk (e.g., chaparral, grassland, and woodland-grass), we constructed a maximum likelihood model of these habitat types within a 7,711-ha area in southeastern Mendocino County based on the normalized difference vegetation index derived from Landsat 5 Thematic Mapper imagery (based on a 30 by 30-m pixel size) over four seasons. The overall accuracy of the model to discriminate woodland-leaf, woodland-grass, open grassland, and chaparral was 83.85% (Kappa coefficient of 0.78). Validation of the accuracy of the model to classify woodland-leaf yielded high values both for producer accuracy (93.33% of validated woodland-leaf pixels correctly classified by the model) and user accuracy (96.55% of model-classified validation pixels correctly categorized as woodland-leaf). Woodland-leaf habitats were found to be highly aggregated within the examined area. In conclusion, our model successfully used remotely sensed data as a predictor of habitats where humans are at risk for Lyme disease in the far-western United States. PMID:15691012

  20. Nutrition therapy for chronic obstructive pulmonary disease and related nutritional complications.

    PubMed

    Fernandes, Amanda Carla; Bezerra, Olívia Maria de Paula Alves

    2006-01-01

    Chronic obstructive pulmonary disease is characterized by progressive and partially reversible airway obstruction. The innumerable complications that occur during the progression of the disease can affect the nutritional state of patients suffering from this illness. The objective of this study was to present a brief review of the literature regarding the nutrition therapy used in the treatment of chronic obstructive pulmonary disease. To that end, we performed a bibliographic search for related articles published within the last 18 years and indexed for the Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS, Latin American and Caribbean Health Sciences Literature) and Medline databases. Malnutrition is associated with a poor prognosis for patients with chronic obstructive pulmonary disease, since it predisposes such patients to infections, as well as reducing respiratory muscle force, exercise tolerance and quality of life. Despite the fact that such malnutrition is extremely common in chronic obstructive pulmonary disease patients, it should be recognized as an independent risk factor, since it can be modified through appropriate and efficacious diet therapy and monitoring. For patients with chronic obstructive pulmonary disease, nutrition therapy is initiated after the evaluation of the nutritional state of the patient, which identifies nutritional risk, thereby allowing the proper level of treatment to be established. In this evaluation, anthropometric and biochemical markers, as well as indicators of dietary consumption and body composition, should be used. The prescribed diet should contain appropriate proportions of macronutrients, micronutrients and immunonutrients in order to regain or maintain the proper nutritional state and to avoid complications. The physical characteristics of the diet should be tailored to the individual needs and tolerances of each patient. In the treatment of patients with chronic obstructive pulmonary disease

  1. Nutritional Status of Children with Autism Spectrum Disorders (ASDs): A Case-Control Study

    ERIC Educational Resources Information Center

    Marí-Bauset, Salvador; Llopis-González, Agustín; Zazpe-García, Itziar; Marí-Sanchis, Amelia; Morales-Suárez-Varela, María

    2015-01-01

    Children with autism spectrum disorder (ASD) have problems of food selectivity, implying risks of nutritional deficiencies. The aim was to compare intakes of macro and micronutrients and body mass index in ASD and typically developing (TD) children. In a case--control study, 3-day food diaries and anthropometric measurements were completed for ASD…

  2. Nutrition and Growth in Cystic Fibrosis.

    PubMed

    Lusman, Sarah; Sullivan, Jillian

    2016-08-01

    Close attention to nutrition and growth is essential in caring for children with cystic fibrosis (CF). Growth and nutritional status should be monitored as part of routine CF care. Children with CF should achieve growth and nutritional status comparable with that of well-nourished children without CF. Children with CF are at risk for nutritional deficiencies. Optimal nutritional and growth status may be difficult to attain in this population given risk of insufficient caloric intake and likelihood of increased caloric expenditure. Various methods to attain optimal nutritional status may be used, including oral supplementation, behavioral treatment, pharmacotherapy, and enteral nutrition. PMID:27469181

  3. The Impact of a Home-Delivered Meal Program on Nutritional Risk, Dietary Intake, Food Security, Loneliness, and Social Well-Being.

    PubMed

    Wright, Lauri; Vance, Lauren; Sudduth, Christina; Epps, James B

    2015-01-01

    Maintaining independence and continuing to live at home is one solution to manage the rising health care costs of aging populations in the United States; furthermore, seniors are at risk of malnutrition and food insecurity. Home-delivered meal programs are a tool to address food, nutrition, and well-being concerns of this population. Few studies have identified outcomes from these programs; this pilot study reviews the nutritional status, dietary intake, well-being, loneliness, and food security levels of seniors participating in a Meals on Wheels delivery service. Clients, new to the meal program, participated in pre- and postphone interviews, and 51 seniors completed the study. The survey was composed of five scales or questionnaires, and statistical analyses were conducted using SPSS. Improvements across all five measures were statistically significant after participating two months in the home-delivered meal program. Implications for further research, practice, and the Older Americans Act are discussed. PMID:26106989

  4. Adherence to a Healthy Nordic Food Index Is Associated with a Lower Risk of Type-2 Diabetes—The Danish Diet, Cancer and Health Cohort Study

    PubMed Central

    Lacoppidan, Sandra Amalie; Kyrø, Cecilie; Loft, Steffen; Helnæs, Anne; Christensen, Jane; Hansen, Camilla Plambeck; Dahm, Christina Catherine; Overvad, Kim; Tjønneland, Anne; Olsen, Anja

    2015-01-01

    Background: Type-2 diabetes (T2D) prevalence is rapidly increasing worldwide. Lifestyle factors, in particular obesity, diet, and physical activity play a significant role in the etiology of the disease. Of dietary patterns, particularly the Mediterranean diet has been studied, and generally a protective association has been identified. However, other regional diets are less explored. Objective: The aim of the present study was to investigate the association between adherence to a healthy Nordic food index and the risk of T2D. The index consists of six food items: fish, cabbage, rye bread, oatmeal, apples and pears, and root vegetables. Methods: Data was obtained from a prospective cohort study of 57,053 Danish men and women aged 50–64 years, at baseline, of whom 7366 developed T2D (median follow-up: 15.3 years). The Cox proportional hazards model was used to assess the association between the healthy Nordic food index and risk of T2D, adjusted for potential confounders. Results: Greater adherence to the healthy Nordic food index was significantly associated with lower risk of T2D after adjusting for potential confounders. An index score of 5−6 points (high adherence) was associated with a statistically significantly 25% lower T2D risk in women (HR: 0.75, 95%CI: 0.61–0.92) and 38% in men (HR: 0.62; 95%CI: 0.53–0.71) compared to those with an index score of 0 points (poor adherence). Conclusion: Adherence to a healthy Nordic food index was found to be inversely associated with risk of T2D, suggesting that regional diets other than the Mediterranean may also be recommended for prevention of T2D. PMID:26506373

  5. The Plausibility of Maternal Nutritional Status Being a Contributing Factor to the Risk for Fetal Alcohol Spectrum Disorders: The Potential Influence of Zinc Status as an Example

    PubMed Central

    Keen, Carl L.; Uriu-Adams, Janet Y.; Skalny, Anatoly; Grabeklis, Andrei; Grabeklis, Sevil; Green, Kerri; Yevtushok, Lyubov; Wertelecki, W. W.; Chambers, Christina D.

    2010-01-01

    There is increasing evidence that human pregnancy outcome can be significantly compromised by suboptimal maternal nutritional status. Poor diet results in a maternal-fetal environment in which the teratogenicity of other insults such as alcohol might be amplified. As an example, there is evidence that zinc (Zn) can interact with maternal alcohol exposure to influence the risk for fetal alcohol spectrum disorders (FASD). Studies with experimental animals have shown that the teratogenicity of alcohol is increased under conditions of Zn deficiency, while its teratogenicity is lessened when animals are given Zn supplemented diets or Zn injections prior to the alcohol exposure. Alcohol can precipitate an acute phase response resulting in a subsequent increase in maternal liver metallothionein, which can sequester Zn and lead to decreased Zn transfer to the fetus. Importantly, the teratogenicity of acute alcohol exposure is reduced in metallothionein knockout mice,