All Posts tagged analysis

Menu Review for Juvenile Justice

Client

One of Australia’s leading juvenile justice services providing secure and safe care of up to 500 young offenders.

Needs

Review adequacy of summer and winter menus to address concerns raised to the State by the public.
Ensure compliance with Nutrient Reference Values for Australia and New Zealand
Ensure compliance with Dietary Guidelines for Children and Adolescents in Australia
Ensure compliance with Standards for Juvenile Custodial Facilities

Overview

Review of custodial health findings in various State jurisdictions around Australia and overseas.
Computer based macro and micro nutrient analysis of menus and individual recipes including protein, fat, carbohydrate and protein percentages
Computer based energy analysis of menus and individual recipes
Analysis of menus against nutrient reference values and appropriate recommendations.
Analysis of menus against dietary guidelines and appropriate recommendations
Analysis of food variety and appropriate recommendations
Analysis of special dietary needs and appropriate recommendations
Analysis of food choice and satisfaction and appropriate recommendations
Executive presentation

 

 

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Can Omega-3 foods prevent eye disease in seniors?

Eating a diet rich in omega-3 fatty acids appears to protect seniors against the onset of a serious eye disease known as age-related macular degeneration (AMD), a new analysis indicates.”Our study corroborates earlier findings that eating omega-3-rich fish and shellfish may protect against advanced AMD,” study lead author Sheila K. West, of the Wilmer Eye Institute at Johns Hopkins School of Medicine in Baltimore, said in a news release from the American Academy of Ophthalmology.

“While participants in all groups, including controls, averaged at least one serving of fish or shellfish per week, those who had advanced AMD were significantly less likely to consume high omega-3 fish and seafood,” she added.

The observations are published in the December issue of Ophthalmology.

West and her colleagues based their findings on a fresh analysis of a one-year dietary survey conducted in the early 1990s. The poll involved nearly 2,400 seniors between the ages of 65 and 84 living in Maryland's Eastern Shore region, where fish and shellfish are eaten routinely. After their food intake was assessed, participants underwent eye exams. About 450 had AMD, including 68 who had an advanced stage of the disease, which can lead to severe vision impairment or blindness. In the United States, AMD is the major cause of blindness in whites, according to background information in the news release.

Prior evidence suggested that dietary zinc is similarly protective against AMD, so the researchers looked to see if zinc consumption from a diet of oysters and crabs reduced risk of AMD, but no such association was seen. However, the study authors theorized that the low dietary zinc levels relative to zinc supplements could account for the absence of such a link.

Anand Swaroop, chief of the neurobiology, neuro-degeneration, and repair laboratory at the U.S. National Eye Institute, interpreted the findings with caution. “It does make huge sense theoretically,” he said. “Photoreceptors have a very high concentration of a specific type of fatty acids and lipids, relative to many other cell types. So it would make sense that omega-3 consumption would be beneficial. The theory is sound.”

“However, I wouldn't want people to start taking grams of omega-3 to protect against AMD based on this finding because I'm not really sure that this study has sufficient power to draw any conclusions,” Swaroop added. “This is just a one-year analysis and AMD is a long-term disease. The correlation is important, and it should be explored further. But we need larger studies with longer term follow-up before being able to properly assess the impact.”

SOURCE: Anand Swaroop, Ph.D senior investigator and chief of neurobiology, neurodegneration, and repair laboratory, U.S. National Eye Institute, Bethesda, Md.; American Academy of Ophthalmology, news release, Dec. 1, 2010

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Short people more likely to develop heart disease

Due to the many different ways that previous studies have investigated the association between height and heart disease, Dr Paajanen and her colleagues decided to compare the shortest group to the tallest group instead of using a fixed height limit.

From the total of 1,900 papers, the researchers selected 52 that fulfilled all their criteria for inclusion in their study. These included a total of 3,012,747 patients. On average short people were below 160.5 cms high and tall people were over 173.9 cms. When men and women were considered separately, on average short men were below 165.4 cms and short women below 153 cms, while tall men were over 177.5 cms and tall women over 166.4 cms.

Dr Paajanen and her colleagues found that compared to those in the tallest group, the people in the shortest group were nearly 1.5 times more likely to die from cardiovascular disease (CVD) or coronary heart disease (CHD), or to live with the symptoms of CVD or CHD, or to suffer a heart attack, compared with the tallest people.

Looking at men and women separately, short men were 37% more likely to die from any cause compared with tall men, and short women were 55% more likely to die from any cause compared with their taller counterparts.

“Due to the heterogeneity of studies, we cannot reliably answer the question on the critical absolute height,” write the authors in their study. “The height cut-off points did not only differ between the articles but also between men and women and between ethnic groups. This is why we used the shortest-vs.-tallest group setting.”

The findings have clinical implications. Dr Paajanen said: “The results of this systematic review and meta-analysis suggest that height may be considered as a possible independent factor to be used in calculating people's risk of heart disease. Height is used to calculate body mass index, which is a widely used to quantify risk of coronary heart disease.”

It is not known why short stature should be associated with increased risk of heart disease. Dr Paajanen said: “The reasons remain open to hypotheses. We hypothesize that shorter people have smaller coronary arteries and smaller coronary arteries may be occluded earlier in life due to factors that increase risk, such as a poorer socioeconomic background with poor nutrition and infections that result in poor foetal or early life growth. Smaller coronary arteries also might be more affected by changes and disturbances in blood flow. However, recent findings on the genetic background of body height suggest that inherited factors, rather than speculative early-life poor nutrition or birth weight, may explain the association between small stature and an increased risk of heart disease in later life. We are carrying out further research to investigate these hypotheses.”

Dr Paajanen said that it was important that short people should not be worried by her findings. “Height is only one factor that may contribute to heart disease risk, and whereas people have no control over their height, they can control their weight, lifestyle habits such as smoking, drinking and exercise and all of these together affect their heart disease risk. In addition, because the average height of populations is constantly increasing, this may have beneficial effect of deaths and illness from cardiovascular disease.”

In an editorial on the research published at the same time [2], Jaakko Tuomilehto, Professor of Public Health at the University of Helsinki, Helsinki, Finland, welcomed the study, writing: “The systematic review and meta-analysis on this topic . . . is well justified 60 years after the first observation and the hundreds of other papers which have been published since then on this topic. The results are unequivocal: short stature is associated with increased risk of coronary heart disease. This meta-analysis provides solid proof for this, but, as the authors conclude 'The possible pathophysiological, environmental, and genetic background of this peculiar association is not known'.”

He suspects that environmental events affecting growth before and after birth may be involved. “Socio-economic adversity in childhood is . . . associated with delayed early growth and shorter adult stature. The so-called catch-up growth during the first years of life among children who are born small has negative health effects in adulthood; much of the early growth is due to greater fat accumulation. Thus, it is most likely that short stature is the link to coronary heart disease, and that tallness is not a primary factor in preventing the disease, although it indicates healthy growth. Short stature seems to be a marker for risk.”

While more work is needed to understand the exact nature of the mechanisms at work, he writes that information on height can be used now for the prevention of heart disease and other chronic diseases linked to shortness. “Full term babies who are born small are likely to be short as adults. They should receive preventive attention early on. The primordial prevention of chronic diseases should start during foetal life, and health promotion should be targeted to all pregnant women with the aim of health development of the foetus. Low birth weight and some other birth characteristics can reveal potential problems during this period of life. After that, in babies with low birth weight, it is important to avoid excessive catch-up growth, i.e. early-life fatness.”

In adult life it becomes more difficult to discover best practices, but Prof Tuomilehto, thinks it is likely short adults would benefit from more aggressive risk factor reduction.

He concludes: “Most of us know approximately our own height ranking, and, if we are at the low end, we should take coronary risk factor control more seriously. On the other hand, tall people are not protected against coronary heart disease, and they also need to pay attention to the same risk factors as shorter people.”

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Replace Saturated Fat with Polyunsaturated Dat

Over the past several decades, the food industry has reduced the amount of saturated fat in many products, and the public has reduced the amount of saturated fat in their diet. However, there has been a wide variation in the types of nutrients that have replaced this saturated fat. For example, in many products saturated fats were replaced with trans fats, which have since been determined to be detrimental; and in the overall American diet saturated fat was generally replaced with increased consumption of refined carbohydrates and grains.

“The specific replacement nutrient for saturated fat may be very important,” said lead author Dariush Mozaffarian, assistant professor in the department of epidemiology at HSPH and the department of medicine at Harvard Medical School. “Our findings suggest that polyunsaturated fats would be a preferred replacement for saturated fats for better heart health.”

Results from prior individual randomized controlled trials of saturated fat reduction and heart disease events were very mixed, with most showing no significant effects. Other trials focused only on blood cholesterol levels, which are an indirect marker of risk. Large observational studies have also generally shown no relationship between saturated fat consumption and risk of heart disease events; for example, earlier this month in the American Journal of Clinical Nutrition, researchers from HSPH and Children's Hospital Oakland Research Institute performed a pooled meta-analysis of prior observational studies and found no evidence that overall consumption of saturated fat was related to risk of coronary heart disease or stroke events.

Some of these mixed findings may relate to absence of prior focus on the specific replacement nutrient for saturated fat; in other words, was saturated fat replaced primarily with carbohydrate, monounsaturated fats such as in olive oil, or polyunsaturated fats such as in most vegetable oils?

Mozaffarian and his HSPH colleagues, Renata Micha and Sarah Wallace, performed a systematic review and meta-analysis of all randomized controlled trials through June 2009 in which participants specifically increased their polyunsaturated fat consumption as a replacement for saturated fat and in which coronary heart disease events were documented. Eight trials met the inclusion criteria, totaling 13,614 participants with 1,042 coronary heart disease events.

The meta-analysis of the trials showed that increasing polyunsaturated fat consumption as a replacement for saturated fat reduced the risk of coronary heart disease events by 19%. For every 5% increase (measured as total energy) in polyunsaturated fat consumption, coronary heart disease risk was reduced by 10%. This is now just the second dietary intervention–consuming long-chain omega-3 fatty acids is the first — to show a reduction in coronary heart disease events in randomized controlled trials.

Currently, the Institute of Medicine guidelines recommend that a range of 5%-10% energy consumption come from polyunsaturated fats. In addition, some scientists and organizations have recently suggested that consumption of polyunsaturated fats (largely “omega-6” fatty acids) should actually be reduced due to theoretical concerns that such consumption could increase coronary heart disease risk.

The results from this study suggest that polyunsaturated fats from vegetable oils may be an optimal replacement for saturated fats, an important finding for dietary guidelines and for when food manufacturers and restaurants are making decisions on how to reduce saturated fat in their products. The findings also suggest that an upper limit of 10% energy consumption from polyunsaturated fats may be too low, as the participants in these trials who reduced their risk were consuming about 15% energy from polyunsaturated fats.

Support for this study was provided by the National Heart, Lung, and Blood Institute, NIH and a Searle Scholar Award from the Searle Funds at the Chicago Community Trust.

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