The Contribution of Fortified Ready-to-Eat Cereal to Vitamin and Mineral Intake in the U.S. Population,NHANES 2007–2010

Micronutrients play a pivotal role in achieving and maintaining optimum health across all life stages. Much of the U.S. population fails to meet Estimated Average Requirements (EARs) for key nutrients. This analysis aims to assess the contribution of fortified ready-to-eat cereals (RTEC) to micronutrient intake for U.S. residents aged 2–18, 19–99, and 2–99 years of age according to National Health and Nutrition Examination Survey (NHANES) 2007–2010 data. We used the National Cancer Institute (NCI) method to assess usual intake of 21 micronutrients and the percentage of the population under EARs and above Tolerable Upper Intake Levels (UL). Without fortification of RTECs, the percentage of those aged 2–18 years that were below EARs increased by 155%, 163%, 113%, and 35% for niacin, iron, thiamin, and vitamin A, respectively. For vitamins B6 and zinc, the respective numbers were 118% and 60%. Adults aged 19–99 and 2–99 had lower percentages but similar outcomes. RTECs are associated with improved nutrient adequacy and do not widely affect prevalence above the UL. The data indicate that large proportions of the population fail to achieve micronutrient sufficiency without fortification, and that its use can help Americans reach national nutrient intake goals.     

Adequacy of essential fatty acid, vitamin D and vitamin E intake: Implications for the 'core' and 'extras' food group concept of the Australian Guide to Healthy Eating

Objective: To assess the implications of new recommendations for essential fatty acids, vitamin D and vitamin E on the classification of margarines and vegetable oils as ‘extras’ in the current Australian Guide to Healthy Eating. Design: The role of margarines and vegetable oils as sources of essential fatty acids, vitamin D and vitamin E was examined in two ways. First, data from the 1995 National Nutrition Survey were assessed and, second, sample diets conforming to the Australian Guide to Healthy Eating were modelled and analysed. Subjects: For the assessment of national intake, subjects were a representative sample of 13 858 Australians, surveyed in the 1995 National Nutrition Survey. Main outcome measures: Relative contributions of margarines and oils, the ‘core’ food groups and ‘extras’ categories of the Australian Guide to Healthy Eating to intakes of essential fatty acids and vitamins D and E; changes in nutrient profiles of baseline diets conforming to the Australian Guide to Healthy Eating with or without varying amounts of margarines and oils. Results: ‘Core’ foods and ‘extras’ contributed similar amounts of essential fatty acids and vitamins D and E to the Australian diet, margarines and oils being the major contributor among ‘extras’. The simulated low‐fat, low‐saturated‐fat baseline diets generally failed to meet the adequate intakes for n‐3 and n‐6 polyunsaturates and vitamin D, and vitamin E in some instances. The addition of 25 g of sunflower margarine, but not comparable amounts of canola margarine, olive oil and butter, markedly increased the ratio of polyunsaturated to saturated fatty acids and generally delivered the adequate intakes, vitamin D being the exception. Conclusion: The inclusion of margarines and vegetable oils in diets based on the current Australian Guide to Healthy Eating, and guidance on choice among these foods, is required to provide adequate intakes of linoleic acid, α‐linolenic acid and vitamins D and E and to achieve fatty acid profiles consistent with the prevention of chronic disease.     

The role of Taiwan's National Health Insurance program in influencing adequate prenatal care

This paper reviews achievements in the utilization of prenatal care by pregnant women in Taiwan by analysing the 1989 and 1996 National Maternal and Infant Health Survey data. More precisely, it identifies and examines the programmatic and non-programmatic factors that influence prenatal care utilization, thus determining the areas that require further attention from the programe. Logistic regression results show that the adequacy of prenatal care use was significantly associated with the implementation of the National Health Insurance (NHI). A higher likelihood of adequate care utilization was found among women who were married or employed, had a higher level of education, had more experience with regard to pregnancy and were at higher risk in terms of obstetrics. The effect of facility choice showed variations after the implementation of the NHI programme. Prior to NHI, no differences were noted between the use of clinics and hospitals. After the implementation of NHI, on the other hand, women who received most of their care from clinics had a higher likelihood of receiving more adequate prenatal care than those who received care from hospitals. Regional differences in seeking adequate prenatal care were also evident. Mothers who were living in southern areas were less likely to receive adequate prenatal care despite the implementation of NHI. The Bureau of NHI, therefore, still needs to work on mechanisms to ensure that more attention is given to the distribution of its medical resources and that additional health care accessibility is provided to pregnant women in these areas.     

适宜、安全水氟浓度及总摄氟量的研究

调查了典型饮水型氟中毒流行区４个不同氟暴露水平地区的人群氟中毒和儿童龋齿患病率，并研究了它们与饮水氟浓度及总摄氟量的关系。提出了我国北方农村的适宜、安全饮水氟浓度分别为０．９５ｍｇ／Ｌ和１．２１ｍｇ／Ｌ；７～１５岁儿童适宜、安全总摄氟量为１．９ｍｇ和２．１ｍｇ／（人·日）；成人最大安全总摄氟量为３．４ｍｇ／（人·日）。该项研究还对饮水氟和总摄氟量造成的氟中毒的危险性进行了评价。     

Repeated femoral vein puncturing for maintenance haemodialysis vascular access.

BACKGROUND: When access cannot be achieved using a native arteriovenous fistula or a synthetic prosthetic graft, central venous catheters are usually placed. This mode of access is short-lived, prone to infection, stenosis and thrombosis of central veins. To overcome access problems, we developed a new native vascular access ('femoral vein access') and devices. We report here on our experience with the availability, longevity, procedure and morbidity of haemodialysis (HD) using femoral vein access. METHODS: Repeated (three times a week) patient's native femoral vein puncturing has been used as the vascular access (femoral vein access) for maintenance HD in 30 patients (mean age +/- SD: 61.70 +/- 15.27 years old; 18 female/12 male). The femoral vein was punctured beneath the inguinal ligament (on a length ranging from 30 to 100 mm) after disinfection and local anaesthesia. Long (effective length 56 mm) 19- and 18-gauge needles with four side holes were used for the femoral vein puncture as an arterial site of the extracorporeal circuit of HD and shorter (effective length 40 mm) similar gauge needles for the subcutaneous vein puncture used as the return site. The needle is inserted blind into the femoral vein after the femoral artery has been located by palpation and the perception of a pulse. Patients returned home the same day. RESULTS: The mean duration of HD treatment using femoral vein repeated puncture was 4.99 +/- 3.42 years (up to 16.0 years). This represented a total experience of 23 369 femoral vein punctures. The mean blood flow achieved on dialysis was 165 +/- 20 ml/min. The average Kt/V was 1.74 +/- 0.48 per session. CONCLUSIONS: The femoral vein repeated puncture technique has substantial advantages over venous catheters. It does not require surgery, while permitting adequate blood flow. This method can be used as a long-term (over 10 years) blood access. Apart from a few local haematomas, no serious complications have been observed. Moreover, it does not carry a heavy financial burden.     

Weight indicators and nutrient intake in children and adolescents do not vary by sugar content in ready-to-eat cereal: results from National Health and Nutrition Examination Survey 2001-2006

Few studies have explored the relationship between sugar content in cereal and health outcome among children and adolescents. This study was designed to investigate the associations between ready-to-eat cereals, categorized by sugar content, with weight indicators and nutrient intake profiles. Data collected from 6- to 18-year-old US children and adolescents (N = 9660) in the National Health and Nutrition Examination Survey 2001-06 were used to analyze cereal consumption. Body mass index (BMI), BMI-for-age, waist-to-height ratio, percent overweight or obese, mean day-1 intake, and usual daily intake of macronutrients and micronutrients were the dependent variables; day-1 cereal intake, categorized by tertiles of sugar content, was the main independent variable. Weighted regression with adjustment for the survey design was used to model the dependent variables as a function of day-1 cereal intake, adjusting for age group, sex, race/ethnicity, total day-1 intake of energy, calcium and sugar, the Healthy Eating Index-2005 total score, and household income. For all tertiles of sugar classifications of cereal, children who consumed cereal had significantly lower BMI compared with children who consumed no cereal (P's < .05). Similarly, when compared with children who consumed no cereal, those who ate cereal consumed significantly less fat and cholesterol and significantly more carbohydrates, sugar, whole grains, vitamin A, thiamin, riboflavin, niacin, vitamin B₆, folic acid, vitamin B₁₂, vitamin C, calcium, magnesium, iron, and zinc. Lower weight and positive nutrient profiles were associated with cereal consumption regardless of sugar content.