The contribution of ready-to-eat cereals to daily nutrient intake and breakfast quality in a Mediterranean setting

OBJECTIVES: To examine if and how ready-to-eat cereals (RTEC) contribute to the quality of the diet of children, adolescents and young adults in a Mediterranean setting. METHODS: A random sample of 3534 subjects aged 2 to 24 years in Spain was studied. Food and nutrient intakes were determined by a 24 hour recall. RTEC consumption was assessed by a quantitative food frequency questionnaire. Additional questions on socioeconomic level and nutritional knowledge were administered. Cereal consumption was classified into non-consumers and daily intakes between 1 and 20g, 21 and 40g, and more than 40g. After excluding the underreporters the final sample consisted of 2852 individuals. RESULTS: About half of the population (49.8%) reported eating RTEC. Macronutrient profile improved with increasing cereal consumption. Intakes of thiamine, riboflavin and vitamin B6 increased significantly with increasing consumption of RTEC in all age-sex groups, whereas niacin and folate intake improved in almost all groups and calcium, iron and vitamin D in at least half of the groups. Except for magnesium, vitamin B12 and vitamin E in males, consumption of RTEC was significantly associated with increased coverage of the daily nutrient requirements for all micronutrients studied. Higher levels of RTEC consumption was associated with a greater consumption of dairy products, and related to better breakfast quality. CONCLUSIONS: Level of RTEC consumption is associated with a better nutritional profile in the diets of Spanish children, adolescents and young adults and a lower risk for inadequate micronutrient intakes. RTEC consumers have better quality breakfasts, in terms of both food choices as well as energy and nutrient content.     

An on-line computer system for monitoring respiratory and cardiac functions of patients

A computer-based noninvasive and continuous patient monitoring system for breath-by-breath assessment of cardiorespiratory functions was developed. Transthoracic impedance changes caused by respiratory and cardiac activities were measured with separate impedance plethysmographs of different frequencies. A mini-computer system calculated on-line eight respiratory parameters (VT, f, VE, PETO2, PETCO2, VO2, VCO2, and R) in cooperation with expired gas analysis data from a mass-spectrometer, and three cardiac parameters (SV, HR and Q). These parameters were displayed simultaneously at the end of each breath. In order to improve the signal-to-noise ratio of the impedance cardiogram to a level allowing computer determination, an ensemble averaging technique was utilized. The computer-derived cardiorespiratory parameters obtained during voluntary hyperventilation and a passive tilt demonstrated reasonable changes.     

Number of food items as an indicator of nutrient intake

Total food duplicates for 24 hours were collected from farmers in Japan, once in 1977–1981 (109 subjects) and then in 1991–1992 (72 subjects). Nutrients (including energy, protein, fat, some minerals, and several vitamins) in each food item in the food duplicate were estimated taking advantage of the values given in the Standard Tables of Food Compositions in Japan. The number of the food items in each food duplicate was counted excluding duplication. Analyses demonstrated that the daily nutrient intake (especially that of energy, protein and vitamin B₁) has a significant association with the number of items of food taken a day, that the daily intake of most nutrients is sufficient when 30 food items were taken a day, but that the sufficient supply of calcium and iron needs an intake of more than 30 food items.     

Adult nutrient intake as a risk factor for Parkinson's disease

BACKGROUND: This population-based case-control study evaluated nutrient intake as a risk factor for Parkinson's disease (PD) among people aged > or =50 years in metropolitan Detroit. METHODS: Cases (n = 126) were diagnosed between 1991 and 1995 and neurologist-confirmed. Controls (n = 432) were frequency-matched for sex, age (+/-5 years) and race. Using a standardized food frequency questionnaire, subjects reported the foods they ate within the past year. RESULTS: Estimating the association between PD and risk of being in the highest versus the lowest intake quartile, there were elevated odds ratios for total fat (OR 1.94, 95% confidence interval [CI] : 1.05-3.58), cholesterol (OR 2.11, 95% CI: 1.14-3.90), lutein (OR 2.52, 95% CI: 1.32-4.84) and iron (OR 1.88, 95% CI: 1.05-3.38). CONCLUSIONS: These results suggest an association of PD with high intake of total fat, saturated fats, cholesterol, lutein and iron.     

Low nutrient intake contributes to adverse clinical outcomes in hospitalized elderly patients

A prospective cohort study on hospitalized elderly patients revealed that inadequate nutrient intake during hospitalization was associated with adverse clinical outcomes and increased morbidity. Because this occurred in patients who were initially assessed as being in good health, it emphasizes the need for continuous nutritional surveillance of hospitalized elderly patients.     

An on-line clinical information system in family practice.

An interactive on-line clinical information system is in operation within the residency of the Department of Family Practice at the Medical University of South Carolina in Charleston. This approach eliminates some of the traditional sources of error in collecting clinical information. Particular attention is given to flexibility of data presentation: data may be segregated by time, by disease entity, by age and sex of the patient, by physician, by year of residency, and by disease class. The responsiveness of this on-line technology allows the production of complete, up-to-date practice reports within 24 hours of a request.     

An integrated clinical computer system: implications for a medical information services department

The hybrid record--both paper and electronic--is a cumbersome byproduct of the evolution to the computer-based patient record. Nancy Walker describes how William Beaumont Hospital managed its information services with this mixed media record. Her article provides practical solutions for health information managers including downtime procedures, report distribution plans, release of information steps, and audit procedures for maintaining confidentiality.     

Variability of nutrient intake over a 3-day period

This study was designed to assess the magnitude of variation in nutrient intake of individuals over a 3-day period. It is based on an analysis of 3-day food intake records of 21,867 participants in the Nationwide Food Consumption Study (NFCS), 1977-78. Results from a subsample of 7,287 subjects showed a significantly greater variation from the median than from the mean for protein, vitamin A, and iron. Fewer than 30% of the respondents had intakes of any of the 11 nutrients studied within +/- 15% of the mean on all days. For all nutrients except energy and magnesium, less than 50% of the respondents had intakes within +/- 25% of the mean. Variability in intake was greatest for vitamins A and C, with 85% and 82% of respondents, respectively, having low and high daily intakes deviating by more than 25% from the mean. These findings document that 1-day food records alone are of limited value in assessing nutrient adequacy of an individual and quantify the magnitude of the variation over a 3-day period. The more adequate the mean nutrient intake, the less variability in intake from day to day. Similarly, the more consistent the meal pattern, the less the variability in intake.     

The computer as an aid in clinical management

Clinical dietitians' time and expertise have been allocated much more efficiently at Fairview General Hospital through computer analysis of information that is readily available in existing mainframe programs. Other health care institutions may be able to achieve similar results by examining information about patient populations and diet orders stored in their computers.     

Evaluation of a rapid method for measuring theophylline in a clinical setting

The need to determine rapidly the theophylline levels of patients in ambulatory settings such as family practice offices has led to the development of instruments purported to be fast, reliable, and cost-effective. This study evaluated one such instrument, the Ames Seralyzer, and compared the findings with those of the Du Pont aca. Forty-six patient samples were split and run on both instruments by trained laboratory personnel. Validation studies yielded a correlation coefficient of r = .9680 (N = 46). Precision assays showed the 27.5 and 82.5 mumol/L (5 and 15 mg/L) levels of theophylline found in control samples produced day-to-day coefficients of variation of 8.8% (n = 43) and 5.8% (n = 35), respectively. After initial evaluation of the Seralyzer, duplicate assays were performed because of erratic results. The evaluators felt that a major source of error was in the diluting and pipetting steps involved in the procedure. The Seralyzer was easy to run but did require some technique-dependent skills.