Nutrition intervention program for the management of iron‐deficiency anemia in a group of pregnant women in Jordan

The impact of a nutrition education intervention program on the prevention of iron deficiency anemia in a group of pregnant Jordanian women was evaluated. The program was based on planned meals from local food sources in combination with nutritional counseling as an alternative approach to more costly iron supplementation.

Data on dietary intake, anthropometric measures, iron status indices and nutrition knowledge were used in evaluation of program effectiveness.

The treatment group showed increased nutrition knowledge, more adequate nutrient intake, normal weight gain and better iron status than the control group, which received only usual care including limited nutrition counseling.

Results of the study indicate the feasibility of the nutrition intervention program in the management of iron‐deficiency and prevention of anemia in women from communities of low socio‐economic status.     

Benefits of nutritional supplementation in free-living,frail, undernourished elderly people: a prospective randomized community trial

OBJECTIVE: To evaluate the impact of nutritional supplementation on nutritional status, muscle strength, perceived health, and functional status in a population of community-living, frail, undernourished elderly people. DESIGN: A 16-week intervention study in which subjects were randomized to an experimental or a control group and visited in their home on a monthly basis. Outcome variables were measured at the start and end of the study at subjects' homes by a dietitian blinded to treatment assignment. SUBJECTS/SETTING: 83 elderly people (experimental group: n=42; control group: n=41; mean age=80+/-7 years) receiving community home-care services and at high risk for undernutrition. INTERVENTION: Provision of a nutrient-dense protein-energy liquid supplement and encouragement to improve intake from other foods. OUTCOME MEASURES: Anthropometric indexes, handgrip strength, isometric elbow flexion and leg extension strength, lower extremity function, perceived health, and functional status. STATISTICAL ANALYSES: Study groups were compared on an "intention to treat" basis using analysis of variance for repeated measures and unpaired and paired t tests and their nonparametric equivalents where appropriate. RESULTS: Total energy intake (1,772 vs 1,440 kcal; P<.001) and weight gain (1.62 vs 0.04 kg; P<.001) were higher in the supplemented group. No significant changes were observed with respect to other anthropometric indexes, muscle strength, or functional variables; however, beneficial effects were observed in emotional role functioning (P<0.01) and number of days spent in bed (P=.04). APPLICATIONS/CONCLUSIONS: Nutrition intervention is feasible in free-living, frail, undernourished elderly people and results in significant improvement of nutritional status with respect to energy and nutrient intake and weight gain. Weight loss can be stopped and in some cases reversed; however, increased physical activity may also be required to improve health and functional status.     

上海市卢湾区老年公寓营养宣教与配膳管理的干预研究

[目的 ]　探讨老年公寓营养宣教与配膳管理干预效果和干预的可行性。　 [方法 ]　在上海市卢湾区的老年公寓中选取公办和民办各 1所 ,并各配 1所作对照。定性调查采用定性研究中的个人访谈方式进行资料收集 ;定量调查采用询问法、问卷法、查账法及血清生化指标检测。干预措施 :互动式访谈管理、编制营养宣教手册、集中健康教育、专题辅导、食谱分析与矫正、个别指导等。　 [结果 ]　干预组在营养管理方面的认识和态度上较对照组均有提高 ;干预组的营养知识显著提高 ;干预组营养素摄入量及膳食结构合理性提高 ;老年人贫血情况得到改善。　 [结论 ]　该综合性干预方案是有效的 ,对改善社区老年公寓居住老人的营养健康状况有促进作用 ,可用于指导社区老年公寓的营养宣教与配膳管理     

Can malnutrition in predialysis patients be prevented by dietetic intervention?

OBJECTIVE: This study aimed to discover if the documented decline in nutritional status in predialysis patients could be prevented by dietetic intervention. DESIGN: Longitudinal prospective interventional study. SETTING: General hospital nephrology clinic. PATIENTS: Eleven patients with progressive chronic renal failure not yet requiring dialysis, all with creatinine clearance below 25 mL/min were studied. Mean age was 63.9 +/- 14.5 years. INTERVENTION: Patients received nutritional counseling from a renal dietitian on at least 3 occasions over a period of 6 months. Following assessment, patients were advised on dietary changes according to individual need, aiming for adequate energy intake to achieve or maintain a body mass index of 20 to 25 and protein intake of 0.8 to 1.0 g/kg/d. Dietary supplements were prescribed when necessary. OUTCOME MEASURES: Changes in nutritional status were assessed by Subjective Global Assessment, anthropometric measures (weight, triceps skinfold thickness, mid arm muscle circumference, and grip strength), and biochemical markers (serum albumin, serum transferrin, and insulin-like growth factor-1). RESULTS: None of the patients showed decline in Subjective Global Assessment category, and 2 of the patients improved. All anthropometric and biochemical measures of nutritional status were stable or increased over the course of the study, and mid arm muscle circumference increased significantly (P <.05), contrasting with published data showing a decline in these measures in patients not receiving dietetic intervention. CONCLUSION: With dietetic intervention, it may be possible to maintain or improve nutritional status in this group.     

包头市高校餐厅从业者营养教育效果分析

目的 了解干预前后包头市高校餐厅从业人员营养知识、态度和行为的差异,探寻对相关人群行之有效的营养教育方法.方法 自行设计问卷对332名包头市本科院校餐厅从业者进行普查,再从中整群抽取102名进行营养教育干预,并进行干预后效果评价.结果 被试人群营养知识水平普遍偏低,营养教育干预后营养基础知识及营养与相关疾病知识知晓率均提高,与干预前差异均有统计学意义(P值均＜0.01);该人群在干预后较干预前,对营养知识感兴趣的人数明显增多(P＜0.01);在饮食行为方面,干预后得分升高,与干预前差异有统计学意义(P＜0.01).多因素分析发现,营养知识、学历、工种与饮食行为得分均呈正相关(P值均＜0.05).结论 营养教育可提高高校餐厅从业人员的营养知识水平,改善营养态度,使不良饮食行为得到一定的转变.     

The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior,dietary behavior,nutrition risk level and nutrient intake

This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P < 0.001) and of depression (P < 0.001) improved significantly and that dietary behavior scores also improved significantly (P < 0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects'' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P < 0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.     

妇女产褥期饮食、行为的营养保健宣教干预研究

目的:评价妇女产褥期饮食、行为的营养保健宣教干预效果。方法:选择湖北省城乡地区孕晚期妇女作为研究对象,随机分为干预组和对照组,在干预组中开展产褥期营养保健知识宣教。采用宣教前后知识水平测试,干预组和对照组产褥期饮食、行为及健康状况比较的方法来评价干预效果。结果:干预组对象的营养保健知识水平较宣教前有显著提高;产褥期蔬菜、水果、大豆类等食物摄入量,钙、维生素C等营养素摄入量,做产后体操、洗澡洗头等行为的发生率均明显高于对照组;便秘、手足抽搐、关节痛、恶露时间延长等的发生率均显著低于对照组。结论:多途径、针对性强的宣教方法能有效提高妇女营养保健知识水平,并改善其产褥期饮食、行为及健康状况。     

Nutritional Evaluation of "Advantaged" Elderly Persons Residing in a Life Care Retirement Center

The nutritional status of a defined group of 49 older men and women living in a non-profit life care retirement center was assessed by means of analysis of dietary intake from food records, anthropometry and biochemical indices. The individuals ranged in age from 70 through 91 years, were generally healthy, had attended college, engaged in professional careers and were of upper socioeconomic status. The mean energy and nutrient intakes were calculated from food composition tables and compared to the 1980 Recommended Dietary Allowances. Dietary, anthropometric and biochemical characteristics of these "advantaged" elderly persons were compared with the nutritional status of free living persons of low and middle socioeconomic status as reported in the literature. The "advantaged" elderly individuals generally had higher nutrient and energy intakes, less subcutaneous fat, lower serum cholesterol and higher serum ascorbic acid values. The apparently better nutrition status of the "advantaged" subjects could be attributed to their good health and appetities, regular physical activity, positive outlook on life, high degree of social interaction and educational attainment, and an income level high enough to permit them to reside in a center which provided total medical care, individual apartments and dining, social and sport facilities.     

Effect of a nutritional intervention promoting the Mediterranean food pattern on anthropometric profile in healthy women from the Québec city metropolitan area

OBJECTIVE: To evaluate the impact of a nutritional intervention promoting a Mediterranean food pattern on anthropometric profile in healthy women. DESIGN: Nutritional intervention study. SETTING: Laval University, Canada. SUBJECTS: Seventy-seven healthy women started the study and four did not complete the study. METHODS: A 12-week nutritional intervention in free-living conditions consisted of two group courses on nutrition and seven individual sessions with a dietitian. A follow-up visit was performed 12 weeks after the end of the intervention (week 24). A Mediterranean dietary score (MedScore), based on the 11 components of the Mediterranean pyramid, was established to evaluate the adherence to the Mediterranean food pattern. RESULTS: Small but significant decreases in body weight and waist circumference were observed after 12 weeks of intervention (0.5 kg and 1.2 cm, respectively (P<0.01)). Increase in partial MedScore for legumes, nuts and seeds (increase in consumption) as well as increase in partial MedScore for sweets (decrease in consumption) were significantly associated with changes in waist circumference (r=-0.36, P=0.001; r=0.24, P=0.05, respectively). No association was observed between changes in anthropometric profile and changes in the consumption of olive oil. CONCLUSION: Changes in dietary food pattern, more specifically an increase in the consumption of legumes, nuts and seeds, and a decrease in the consumption of sweets, were associated with some beneficial changes in anthropometric profile.     

江西省城乡居民营养素养调查分析

目的了解江西省成年居民营养相关素养状况,为开展营养教育提供依据。方法在江西省南昌市选取两个大型企业,随机抽取400名成年人作为城市组调查对象。在江西省南丰县选取两个村庄,随机抽取402名成年人作为农村组调查对象。利用"营养教育效果综合评价问卷"对全部802名调查对象进行营养相关素养状况评价。结果城市居民营养知识、营养态度及问卷总得分高于农村居民。女性在饮食行为、社会环境影响、总得分方面高于男性,反映了女性对营养更为关注。营养素养在不同年龄组间差异未见显著性。随着受教育程度的提高,居民的营养素养状况逐渐提升,营养知识、营养态度、社会环境影响均在大专及以上组得分最高。结论此次调查反映了江西省城乡普通成年居民的营养素养状况,整体而言其处于中等偏下水平;其营养素养的高低受城乡、性别及受教育程度的影响,城市居民、女性及较高的受教育程度对营养素养是积极因素,应该在今后的营养改善及营养教育活动中加以充分考虑。     

Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent.

Low-income pregnant women of Mexican descent were studied to determine whether their food habits could be improved by nutrition education. Biochemical indices of nutritional status were also investigated. Twenty-four-hour dietary recalls were obtained at an initial interview and again at a final interview after a nutrition education program, which was offered to a randomly selected treatment group. At the initial interview, the mean nutrient intakes that were most often below two-thirds of the Recommended Dietary Allowance (RDA) were iron, vitamin A, thiamin, and calcium. The mean energy value of the diets was also frequently below the RDA. At the final intakes, although the mean energy values and the calcium and carbohydrate of both the control and treatment groups increased significantly, the following improvements in dietary intakes were seen only within the treatment group: 1) there were significant increases in the mean intake of protein, ascorbic acid, niacin, riboflavin, and thiamin, 2) there were significant decreases in the percentage of intakes below two-thirds of the RDA for ascorbic acid and riboflavin, and 3) there was a significant decrease in the incidence of multiple low nutrient intakes. These dietary improvements, which occurred only in the treatment group, suggest the effectiveness of the nutrition education program. The most common biochemical deficiencies were of folic acid, thiamin, and riboflavin. Except for an improvement in mean serum folate levels, the biochemical indices for the treatment group did not appear to be influenced by the nutrition education. It is possible that the vitamin and mineral supplements which were taken by 80% of the women could have obscured improvements in biochemical indices which may have been due to the education program.     

济南市市中区小学生营养知识、态度及饮食行为干预效果评价

目的评价营养健康教育对济南市中区小学生的影响效果,为改善小学生营养状况提供依据。方法抽取市中区不同层次三所小学2~5年级学生1 609人开展为期1年的以"营养课堂"和"快乐10分钟"为主的营养干预,并在干预前后对调查对象进行肥胖相关问卷调查和体格检查,并对干预效果进行评估。结果营养干预后,小学生营养知识知晓率有60%的问题有明显提高(P0.05),"中国居民膳食宝塔知晓率"增长26.3%;营养态度有明显改善;营养行为得分有所提高;营养状况方面改善不明显。结论以"营养课堂"和"快乐10分钟"活动为主的综合干预措施提高了小学生营养知识知晓率,改善了营养健康态度,并改善了不良饮食行为,对预防肥胖的发生起到了积极的作用。     

The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people

BACKGROUND & AIMS: The elderly are at an increased risk of poor nutritional status which is mutually interacting with functional status. We evaluated the effects of a liquid nutrition supplement on anthropometric and functional indices in elderly people. METHODS: Subjects (n=68; mean age=82+/-7 years) with body mass index 相似文献   

Impact of food aid on food variety and dietary diversity of an elderly community in Sharpeville, South Africa

Objective  The objective of this paper was to discuss the impact of a two-year food aid intervention programme on dietary diversity and adequacy of an elderly community. This project was undertaken amongst the elderly (n=300), voluntarily attending a day care centre in Sharpeville, South Africa. In a baseline study (2004) in this community the dietary diversity scoring (DDS) method revealed low dietary diversity (3.41) and food variety (4.77) scores (FVS), and a trend that higher scores resulted in a better mean nutrient adequacy ratio. An intervention study, implemented in 2005, aimed to improve the dietary diversity of this elderly community by providing breakfast and lunch five days a week at the care centre. The impact of this food aid was investigated by comparing the DDS, FVS and nutrient adequacy ratios (NAR) before and after the intervention. Methods  The methods included socio-demographic, health, food frequency questionnaire (FFQ), 24 hour-recall (24h-recall), anthropometric and biochemical measurements in 107 elderly people who regularly attended the care centre since 2004. Results  At baseline, the majority of respondents (n=82, 55.1%) were classified with low DDS utilizing 0–3 food groups compared to after the intervention, where 98.1% (n=105) was classified with a high dietary diversity utilizing all nine nutritious food groups. The mean individual DDS of 3.41 that improved to 8.5 after the intervention further supported this. The mean adequacy ratio (MAR) showed a statistically significant improvement from baseline (0.77±0.48) to 1.02±0.66 after the intervention, indicating improvement of the adequacy of the overall diet to meet the daily requirements for this elderly community. Conclusions  The results of this study represent the first demonstration that food aid proved to be an effective short term nutrition intervention that improved the level of dietary diversity. Other food-based approaches or nutrition education activities should be implemented simultaneously to improve self-sufficiency in such a community for long-term effectiveness in terms of nutrient inadequacy and dietary diversity.     

基于潜在类别分析的养老机构老年人营养知识及态度与膳食指南符合率的关联性研究

目的 了解养老机构老年人营养知识和态度的潜在类别及其与膳食指南符合率之间关系,为养老机构老年人的营养分类管理提供研究基础。方法 采用便利取样法,对宁夏3所养老机构350名老年人进行营养知识、态度和膳食摄入情况问卷调查。采用潜在类别分析法对研究对象的营养知识及态度进行分类,比较不同营养知识及态度类别间膳食指南符合率的差异。结果 养老机构老年人营养知识可分为营养知识一般（38.98%）和营养知识缺乏（61.02%）两个潜在类别;营养态度可分为营养态度积极（45.86%）、营养态度一般（27.28%）和营养态度消极（26.86%）三个潜在类别。养老机构老年人谷类、薯类、蔬菜类、蛋类及奶类食物的膳食指南符合率在不同营养知识类别中存在差异（x2=44.49,20.80,10.51,8.35,15.66,均P<0.05）;谷类、粗杂粮、水产类、蛋类及奶类食物膳食指南符合率在不营养态度类别中存在差异（x2=30.95,14.23,24.07,14.40,18.33,均P<0.05）。结论 养老机构老年人营养知识及态度欠佳,膳食指南符合率较低,应对不同营养知识及态度类别的老年人提供有针对性的精细化指导。     

浦东新区民工小学学生营养健康教育效果评价

探讨营养健康教育对提升小学生营养知识和改善饮食行为的作用,为制定有效的营养干预措施提供依据.方法 采用分层随机整群抽样的方法,对上海市浦东新区4所民工小学的720名小学生营养知识和饮食行为进行基线调查.随机选择其中的2所学校作为干预组,开展为期6个月的营养健康教育,具体包括营养与专题讲座、营养知识征文、制作宣传册,另外2所学校作为对照组,不做任何干预,教育后对干预效果进行评价.结果 干预组学生对营养健康知识的总体知晓率由干预前的17.6%提高到干预后的83.3%(x2=273.568,P<0.01),对营养健康的积极态度率由干预前的85.2%增加到干预后的99.1%(x2=49.677,P<0.01),健康饮食行为总体形成率由干预前的60.7%增加到干预后的76.4%(x2=16.826,P0.05).结论 营养健康教育可有效提高民工小学学生的营养知识水平,改善饮食行为,促进学生健康成长.     

营养教育对幼儿家长营养知识·态度·行为的影响

目的了解营养教育对合肥市幼儿家长营养知识、态度与行为的影响,以便为制定幼儿营养干预措施的制定提供科学依据.方法采取随机、分层、整群抽样的方法在合肥市选取8所幼儿园,随机分为干预组和对照组.在干预组幼儿园定期举办家长营养知识培训班,并将编写的幼儿营养知识手册分发给家长学习.采用自拟调查问卷对干预前、干预中期和终期幼儿家长营养知识、态度与行为进行调查.结果组间比较显示,干预组家长的营养知识水平明显提高,每周吃1～2次及以上水果、牛奶、鱼类的人数增加.自身对照研究显示,通过营养教育,干预组家长每周吃1～2次及以上杂粮、牛奶、水产品、海带和紫菜的人数增加,而吃畜肉、街头小吃、西餐的人数减少.无论是干预组还是对照组,家长对接受营养知识均持积极的态度.结论营养教育对家长的营养知识、态度和行为有积极的影响,可通过书籍、报刊、杂志、电视节目、专家义务讲座等途径进行.     

郑州某高校护理专业学生营养KAP调查分析

目的了解护理专业学生的营养“知识、态度、行为”(KAP)现状,为护理专业学生的营养教育和临床营养护理提供依据及指导。方法采取问卷方式对郑州某校的520名护理专业学生进行营养知识(K)、态度(A)及行为(P)调查。结果护理专业学生对营养知识缺乏全面深入的了解,营养知识及格率为66.9%,营养知识各题回答正确率最低达28.3%;护理专业学生对待营养的态度较好,营养态度及格率为88.5%;行为评分较差,及格率50%,各题回答正确率最低为11.2%。营养知识、态度、行为三者间呈正相关(p<0.01)。结论为促进护理专业学生适应社会的需求及提高学生的身体素质,应加强护理专业学生营养知识健康教育和饮食行为的正确引导。     

营养教育对饮食行为的影响初探

目的营养教育是以改善营养状况目的的,通过传播相关营养信息,指导个人、家庭和社区人群选择健康食物,最终改变人群饮食行为的一系列有计划的活动。通过不同方式的营养教育,可以在人群中普及膳食营养知识,摒弃不健康的生活方式,指导公众建立良好的饮食行为。本文综述了营养教育对儿童、青年学生及中老年人群饮食行为的影响,以及实施营养教育中遇到的问题。为了取得更加满意的干预效果,在营养教育实践中,应注意大众传播和人际传播两种途径相结合,注意保持教育的长期性与有效性,并尽量涵盖不同年龄段和知识层次的人群。     

The efficacy of dietetic intervention in patients with chronic obstructive pulmonary disease

Background: Clinical trials have shown that pulmonary rehabilitation can improve the functional status and quality of life of chronic obstructive pulmonary disease (COPD) patients (Lacasse, 2006) but there is no research examining the efficacy of group dietetic intervention during standard 8 week rehabilitation courses. Current input is usually limited to a 1 h nutrition education session. This pilot study aimed to investigate whether patients receiving additional dietetic intervention during pulmonary rehabilitation significantly increased their general nutritional knowledge, thereby facilitating improvements in dietary intake and nutritional status. Methods: Patients were recruited from two courses of pulmonary rehabilitation and randomly allocated to a control group or an intervention group. Anthropometry (height, weight, body mass index, mid arm circumference and triceps skinfold), 3 day food diaries and nutritional knowledge questionnaires covered guidelines, food groups, choosing healthy options and diet and COPD were completed at baseline and at the end of 8 weeks. In week 2 both groups received the same nutrition education session which covered healthy eating during periods of stability as well as advice on coping with loss of appetite and reduced intake during illness and exacerbations. The intervention group was followed up during weeks 4, 6 and 7 when further anthropometric measurements were taken and additional dietary advice was provided, which addressed issues raised by individual patients. Information from food diaries was converted to nutrients using Windiets dietary analysis software. Statistical analyses were carried out using SPSS (v14) and included Mann–Whitney U non parametric tests, paired t‐tests and Spearman correlations used for comparisons over time and between groups. For analysis purposes patients were classified as normal weight (NW) and overweight (OW). Approval was obtained from the appropriate Ethics Committee. Results: Changes reported were not statistically significant (P > 0.05). Complete data sets were obtained for six control (NW = 2, OW = 4) and five intervention (NW = 1, OW = 4) patients. Nutritional knowledge increased in the control group by 5% compared to 3% in the intervention group. Control NW patients increased their energy intake resulting in a mean weight gain of 0.5 kg (SD 3.3). OW control group patients increased their energy intake by 12.4% (16.9) with a mean weight gain of 0.2 kg (2.5). All control patients increased their intake of in total fat, saturated fatty acids (SFA), sugars and sodium. Conversely there was a decrease in energy intake in the intervention group of 14.4% (17.8) and a mean weight loss of 1.5 kg (1.2) (three out of four overweight patients lost weight). Improvements in diet were shown with reduced intakes of total fat, SFA, sugars and sodium. The NW patient in the intervention group regained weight that had previously been lost. These changes did not correlate with changes in nutritional knowledge. Discussion: An increase in nutritional knowledge was expected to facilitate appropriate changes in dietary intake and nutritional status. Despite the lack of correlation between dietary knowledge and intake, beneficial outcomes were none‐the‐less observed in the intervention group. The trend for weight gain in OW control group patients, and weight loss in OW intervention group patients contrasted with results seen by Slinde et al. (2002) where the control OW patients lost weight, and OW intervention patients gained weight. It is possible that in the current study, patients in the intervention group were motivated to lose weight with repeated exposure to the dietitian, rather than an increase in nutritional knowledge. Significant anthropometrical changes were unlikely to be observed in 8 weeks, and further follow up may be necessary to establish sufficient evidence for the most efficacious level of dietetic intervention. The small sample sizes, especially with regard to weight sub groups, limits the conclusions which can be drawn. Further research is recommended, using a larger sample size, in order to make recommendations for dietetic best practice. Conclusion: The results of this study did not show statistical significance and the association between nutritional knowledge and improved nutritional outcomes remains unclear. However, the findings may have clinical significance since they appear to show that additional dietetic intervention may benefit the nutritional status of patients with COPD attending pulmonary rehabilitation. References Lacasse, Y., Goldstein, R., et al. (2006) Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 4, CD003793. Slinde, F., Gronberg, A.M., et al. (2002) Individual dietary intervention in patients with COPD during multidisciplinary rehabilitation. Respir. Med. 96, 330–336.