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Objective To assess the impact of the Child and Adult Care Food Program (CACFP) on diet and 3 health outcomes—weight-for-height status, dental caries (tooth decay) score, and number of days of illness—among preschool children attending 2 urban day care centers.

Design Dietary intake and health outcome measures were assessed and compared for children attending 2 day-care centers in an urban community. Data were obtained for 14 days of dietary intake, which were analyzed for energy and 15 nutrients and 6 food groups; anthropometric measures, including weight-for-height; dental caries; and days of illness.

Subjects/setting Forty 3- to 5-year-old black children from 2 day-care centers participated. One center participates in the CACFP. At the other center, children bring all meals and snacks from home.

Statistical analyses performed Data from the 2 groups of children were compared using parametric and nonparametric t tests.

Results Children receiving CACFP meals at day care had significantly higher mean daily intakes of vitamin A (804±191 vs 595±268 retinol equivalents), riboflavin (1.45±0.32 vs 1.21±0.22 mg), and calcium (714±180 vs 503±143 mg) than the children who brought all of their meals and snacks from home. Children who received CACFP meals also consumed significantly more servings of milk (2.9±0.9 servings vs 1.5±0.7) and vegetables (1.8±0.5 vs 1.2±0.5 servings) and significantly fewer servings of fats/sweets (4.6±1.3 vs 5.4±1.1 servings) than children who brought their meals. Weight-for-height status and dental caries scores did not differ between the 2 groups. Children from the center participating in the CACFP have significantly fewer days of illness (median 6.5 vs 10.5 days) than children from the nonparticipating center.

Applications Nutritious meals provided by the CACFP can improve diets and may promote health among young, urban children. Registered dietitians can contribute to food assistance programs by intervening to enhance the quality of meals served and by examining the impact of participation on measures of diet quality and diet-related health outcomes. J Am Diet Assoc. 1999;99:1529–1535.  相似文献   


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Dietary ribonucleotides and health   总被引:2,自引:0,他引:2  
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Dietary calcium and health   总被引:5,自引:0,他引:5  

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The effect of high nitrogen Criticare and Vivonex on nutritional repletion was evaluated in 12 patients with malnutrition secondary to pancreatic insufficiency. The patients were randomized to receive either Criticare HN or Vivonex HN for a total period of 9 days. Each patient received 3000 kcal/day of either preparation, in addition to 1000 kcal of solid food. A significant weight gain was encountered in the group of patients receiving Criticare HN. Increased blood urea nitrogen was encountered in both groups of patients. All patients tolerated both diets well without evidence of relapse of their pancreatitis. No significant complications were encountered. Our results indicate that Criticare HN is of superior nutritional value, but both preparations resulted in increased blood urea nitrogen retention.  相似文献   

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Dietary protein and bone health   总被引:2,自引:0,他引:2  
The effects of dietary protein on bone health are paradoxical and need to be considered in context of the age, health status and usual diet of the population. Over the last 80 years numerous studies have demonstrated that a high protein intake increases urinary Ca excretion and that on average 1 mg Ca is lost in urine for every 1 g rise in dietary protein. This relationship is primarily attributable to metabolism of S amino acids present in animal and some vegetable proteins, resulting in a greater acid load and buffering response by the skeleton. However, many of these early studies that demonstrated the calciuric effects of protein were limited by low subject numbers, methodological errors and the use of high doses of purified forms of protein. Furthermore, the cross-cultural and population studies that showed a positive association between animal-protein intake and hip fracture risk did not consider other lifestyle or dietary factors that may protect or increase the risk of fracture. The effects of protein on bone appear to be biphasic and may also depend on intake of Ca- and alkali-rich foods, such as fruit and vegetables. At low protein intakes insulin-like growth factor production is reduced, which in turn has a negative effect on Ca and phosphate metabolism, bone formation and muscle cell synthesis. Although growth and skeletal development is impaired at very low protein intakes, it is not known whether variations in protein quality affect the achievement of optimal peak bone mass in adolescents and young adults. Prospective studies in the elderly in the USA have shown that the greatest bone losses occur in elderly men and women with an average protein intake of 16-50 g/d. Although a low protein intake may be indicative of a generally poorer diet and state of health, there is a need to evaluate whether there is a lower threshold for protein intake in the elderly in Europe that may result in increased bone loss and risk of osteoporotic fracture.  相似文献   

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Dietary phyto-oestrogens and bone health   总被引:4,自引:0,他引:4  
The use of dietary phyto-oestrogens as a possible option for the prevention of osteoporosis has raised considerable interest because of the increased concern about the risks associated with the use of hormone-replacement therapy. However, the evidence in support of a bone-sparing effect in post-menopausal women is still not sufficiently convincing. Most studies have been performed on soyabean isoflavones (genistein and daidzein), either in the purified form or as a soyabean-based product or extract. In vitro studies using primary cell cultures or stabilised cell lines indicate that treatment with genistein may lead to a reduction in bone resorption, but effects on bone formation have also been shown. Investigations using animal models have provided convincing evidence of major improvements in bone mass or bone turnover following soyabean feeding. Cross-sectional observations in South-East Asian populations with moderately high intakes of soyabean isoflavones (50 mg/d) have shown that women in the high quartile of intake have higher bone mineral density (BMD) and reduced bone turnover, an effect that has not been shown in populations with low average intakes. Human trials have given an indication of a possible effect on lumbar spine BMD, although they have been either short term (<6 months) or methodologically weak. Unresolved issues are: the optimal dose compatible with safety; the individual differences in response that can be related to diet and genotypes; the duration of exposure. Furthermore, there needs to be an evaluation of the relative biological effects of phyto-oestrogens other than isoflavones (lignans, resorcylic acid lactones, flavanols, coumestans) that are also present in European diets.  相似文献   

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Dietary silicon and bone health   总被引:1,自引:0,他引:1  
Summary  Silicon (Si) is the third most abundant trace element of the human body and is especially associated with connective tissues such as in bone, skin and blood vessels. Dietary Si is predominately derived from plant-foods and, generally, is readily broken down and absorbed in the gastrointestinal tract in the form of orthosilicic acid. Cereals and cereal products (especially beer), green beans and some mineral water are examples of major dietary sources of Si. The majority of absorbed Si is then excreted in urine although some is taken up into tissues. Average Si intakes are around 25 mg/day in the Western World. In this review, dietary sources of Si, its metabolism and evidence for its biological role in bone health are presented.  相似文献   

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This paper provides econometric evidence linking a country's per capita government health expenditures and per capita income to two health outcomes: under-five mortality and maternal mortality. Using instrumental variables techniques (GMM-H2SL), we estimate the elasticity of these outcomes with respect to government health expenditures and income while treating both variables as endogenous. Consequently, our elasticity estimates are larger in magnitude than those reported in literature, which may be biased up. The elasticity of under-five mortality with respect to government expenditures ranges from -0.25 to -0.42 with a mean value of -0.33. For maternal mortality the elasticity ranges from -0.42 to -0.52 with a mean value of -0.50. For developing countries, our results imply that while economic growth is certainly an important contributor to health outcomes, government spending on health is just as important a factor.  相似文献   

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Background

Recent research has linked overall dietary patterns to survival in older adults.

Objectives

The objective of this study was to determine the dietary patterns of a cohort of older adults, and to explore associations of these dietary patterns with survival over a 10-year period. A secondary goal was to evaluate participants' quality of life and nutritional status according to their dietary patterns.

Design

The Health, Aging, and Body Composition Study is a prospective cohort study of 3,075 older adults. In this study, all-cause mortality was assessed from baseline through Year 10. Food intake was estimated with a modified Block food frequency questionnaire, and dietary patterns of 2,582 participants with complete data were derived by cluster analysis.

Results

Six dietary pattern clusters were identified, including a Healthy Foods cluster, characterized by higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables. Both the High-Fat Dairy Products and Sweets and Desserts clusters had a 1.4-fold higher risk of mortality than the Healthy Foods cluster after adjusting for potential confounders. The Healthy Foods cluster also had significantly more years of healthy life and more favorable levels of selected nutritional biomarkers than the other clusters.

Conclusions

A dietary pattern consistent with current guidelines to consume relatively high amounts of vegetables, fruit, whole grains, poultry, fish, and low-fat dairy products may be associated with superior nutritional status, quality of life and survival in older adults.  相似文献   

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Dietary patterns of women smokers and non-smokers   总被引:4,自引:1,他引:4  
The 1-day food intakes of 1,338 women, aged 19 to 50, who were respondents in the 1985 Continuing Survey of Food Intake by Individuals, were studied. The energy, nutrient, and food intake patterns of smokers, those how had quit smoking, and those who had never smoked cigarettes were compared. Mean energy intakes of smokers (1,627 kcal), those who had never smoked (1,620 kcal), and those who had quit at least 1 year before the interview (1,719 kcal) were not significantly different. Self-reported body weight was significantly different between never-smokers and smokers (p less than .01) and quitters (p less than .05) only for the oldest category of women (ages 41 to 50 years). The consumption of fruits (p less than .001) and vegetables (p less than .01) was significantly lower and the intake of eggs (p less than .01), sugars (p less than .001), regular carbonated soft drinks (p less than .01), coffee (p less than .001), and alcoholic beverages (p less than .001) was significantly higher for women smokers than for non-smokers. After controlling through regression analysis for physical activity, health status, and demographic characteristics, we found that smokers, compared with never-smokers, had significantly lower protein (p less than .04), dietary fiber (p less than .001), vitamin C (p less than .001), and thiamin (p less than .01) intakes and higher cholesterol (p less than .02) intakes per 1,000 kcal.  相似文献   

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