Nutrition Screening Index for Older Adults (SCREEN II©) Demonstrates Sex and Age Invariance

Testing and refining nutrition screening tools that have demonstrated validity and reliability is important to ensure that mechanisms for allocating nutrition resources to those most in need are as efficient as possible. Using structural equation modelling, a nutrition screening instrument for community-dwelling seniors (SCREEN II©) was tested to determine its factor structure and to understand how it measures nutrition risk. Further, this analysis was completed to identify a model that works equivalently for men and women and older and younger seniors. The screening tool was completed by 190 men and 417 women. Age groups (50–74 years, and 75+ years) were evenly split. Dietary intake and challenges influencing intake were identified as two factors representing the screening items. The final model showed good fit when tested for all participants. The model contained a core group of risk factors within SCREEN II© that showed sex and age invariance. This set of risk factors can help guide refinement of nutrition screening instruments and is useful for health professionals to consider regularly as they work with community-dwelling older adults.     

Dieting and Binge Eating among Adolescents: What Do They Really Mean?

The study objectives were to gain insight into how the terms “dieting” and “binge eating” are understood and used by adolescents and to assess whether interpretations of these terms are consistent across age and gender. Twenty-five focus groups were conducted with 203 adolescents (138 girls and 65 boys) in urban public junior and senior high schools. Respondents were asked questions about dieting and binge eating behaviors. In the majority of groups (n=19), healthful eating behaviors, such as eating less fat or more fruits and vegetables, were mentioned in reference to dieting. However, in many of the groups (n=13) unhealthful eating behaviors, such as skipping meals or “starvation,” were also described. Dieting was frequently described as an umbrella term for different behaviors aimed at weight control (ie, physical activity) or in nonbehavioral terms (ie, as a desire or plan for weight loss). Although binge eating was described as overeating by many participants, often it was not clear if youth were referring to uncontrolled overeating. In nearly half of the groups, participants indicated unfamiliarity with the term “binge eating.” There was some confusion between binge eating and other forms of disordered eating. The findings suggest that prevalence rates of self-reported dieting and binge eating behaviors should be interpreted with caution and it should not be assumed that the majority of adolescents who self-report dieting are engaging in unhealthful behaviors. In providing nutrition counseling to youth, and in assessing dieting and binge eating behaviors in clinical settings and in research studies, specific behaviors should be defined. J Am Diet Assoc. 1998;98:446-450.     

Allaying Fears and Fallacies about Lactose Intolerance

Public awareness and misunderstandings of lactose intolerance are at an all-time high. Many people erroneously believe they are lactose intolerant or develop gastrointestinal symptoms after intake of lactose. Consequently, lactose-containing foods such as milk and other dairy foods may be eliminated unnecessarily from the diet. Because these foods are a major source of calcium, low intake of them can compromise calcium nutriture. This, in turn, can increase the risk of major chronic diseases such as osteoporosis (porous bones) and hypertension. This review is intended to help dietetics professionals alleviate clients' fears about lactose intolerance and recommend dietary strategies to improve tolerance to lactose. Scientific findings indicate that the prevalence of lactose intolerance is grossly overestimated. Other physiologic and psychologic factors can contribute to gastrointestinal symptoms that mimic lactose intolerance. Scientific findings also indicate that people with laboratory-confirmed low levels of the enzyme lactase can consume 1 serving of milk with a meal or 2 servings of milk per day in divided doses at breakfast and dinner without experiencing symptoms. Several dietary strategies are available to help lactose maldigesters include milk and other dairy foods in their diet without experiencing symptoms. J Am Diet Assoc. 1998;98:671-676.     

Incorporation of continuous quality improvement in a hospital dietary department's quality management program

What techniques or steps are necessary to overcome obstacles and achieve the incorporation of continuous quality improvement (CQI) methods in existing quality management programs? Education of staff, identification of customers' expectations, and implementation of a plan to administer activities are critical to a positive outcome of CQI efforts. Our article outlines one approach to the transition from quality assurance to CQI using the FOCUS-PDCA® technique. We use the example of improving the timeliness of late tray deliveries to demonstrate how to implement the conversion to CQI using the FOCUS-PDCA® technique. The dietetics practitioners may apply the sequential steps described in the article to successfully incorporate the CQI concept in most hospital dietary department's quality management activities.     

Yoga and pilates: Associations with body image and disordered‐eating behaviors in a population‐based sample of young adults

Objective

To examine associations between participating in mind‐body activities (yoga/Pilates) and body dissatisfaction and disordered eating (unhealthy and extreme weight control practices and binge eating) in a population‐based sample of young adults.

Method

The sample included 1,030 young men and 1,257 young women (mean age: 25.3 years, SD = 1.7) who participated in Project EAT‐III (Eating and Activity in Teens and Young Adults).

Results

Among women, disordered eating was prevalent in yoga/Pilates participants and nonparticipants, with no differences between the groups. Men participating in yoga/Pilates were more likely to use extreme weight control behaviors (18.6% vs. 6.8%, p = .006) and binge eating (11.6% vs. 4.2%, p = .023), and marginally more likely to use unhealthy weight control behaviors (49.1% vs. 34.5%; p = .053), than nonparticipants after adjusting for sociodemographics, weight status, and overall physical activity.

Discussion

Findings suggest the importance of helping yoga/Pilates instructors recognize that their students may be at risk for disordered eating. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010     

Radionuclide venography in iliac and inferior vena caval obstruction

Thirteen cases are presented to demonstrate normal and various abnormal radionuclide venographic patterns following obstruction of the inferior vena cava or common iliac veins. In these patients, obstruction was due to surgery, thrombosis, or neoplasm. Contrast venography was also performed in seven patients to confirm the radionuclide findings. Radionuclide venograms did not visualize the same collateral patterns that contrast venograms did. Most notably, the anterior parietal vessels were seen in many cases with radionuclide venography, and the paraspinal veins were seen more commonly with contrast venography.     

Nutritional Status of Patients with Alzheimer's Disease: A 1-Year Study

Objective To describe the effects of activity level and energy intake over time on the body weight of patients with Alzheimer's disease compared with cognitively normal subjects.Design Repeated measures, case-control design with measurements taken at quarterly intervals for 12 months. Subjects were grouped by gender and activity level (sedentary or active) within cognitive status.Setting The Alzheimer's disease Special Care Unit, The Clinical Research Center at University of California, San Diego, and the Fred Kasch Exercise Physiology Laboratories at San Diego State University.Patients Seventeen institutionalized subjects with Alzheimer's disease and 23 community-dwelling control subjects successfully completed the 1-year study.Measurements Before admission to the nursing home, the patients with Alzheimer's disease had a formal assessment for dementia, which showed that they met the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association work group for probable or possible Alzheimer's disease. Control subjects were screened using the Information-Memory-Concentration Mental Status Test and were found to have no cognitive disabilities. Baseline and quarterly measurements included height, weight, bioimpedance for body composition, and activity by accelerometer counts. Dietary intake of energy and protein was determined at baseline and at 6 and 12 months.Results Patients with Alzheimer's disease had a significantly higher energy intake than patients in the control group. Both women and men with Alzheimer's disease maintained their weight. Women with Alzheimer's disease had higher percentage of fat-free mass than the control group, but there were no differences in body composition between the groups of men.Conclusion Subjects with Alzheimer's disease can maintain their weight if they are given a diet with adequate energy (35 kcal/kg of body weight). J Am Diet Assoc. 1996; 96:1013-1018.