Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the nutrition care day survey 2010 Ekta AgarwalThe University of Queensland Maree Ferguson Princess Alexandra Hospital Merrilyn Banks Royal Brisbane & Womens Hospital Marijka Batterham University of Wollongong Judith BauerThe University of Queensland Recommended Citation Agarwal, E., Ferguson, M., Banks, M., Batterham, M., Bauer, J., Capra, S., & Isenring, E. (2013). Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the nutrition care day survey 2010. Retrieved from http://dx

The aim of this study was to assess the feasibility, acceptability and potential efficacy of a physical activity program for preschool children. A 20-week, 2-arm parallel cluster randomized controlled pilot trial was conducted. The intervention comprised structured activities for children and professional development for staff. The control group participated in usual care activities, which included designated inside and outside playtime. Primary outcomes were movement skill development and objectively measured physical activity. At follow-up, compared with children in the control group, children in the intervention group showed greater improvements in movement skill proficiency, with this improvement statically significant for overall movement skill development (adjust diff. = 2.08, 95% CI 0.76, 3.40; Cohen's d = 0.47) and significantly greater increases in objectively measured physical activity (counts per minute) during the preschool day (adjust diff. = 110.5, 95% CI 33.6, 187.3; Cohen's d = 0.46). This study demonstrates that a physical activity program implemented by staff within a preschool setting is feasible, acceptable and potentially efficacious.

BackgroundThe new Australian 24-Hour Movement Guidelines for the Early Years recommend that, for preschoolers, a healthy 24-h includes: i) ≥180 min of physical activity, including ≥60 min of energetic play, ii) ≤1 h of sedentary screen time, and iii) 10–13 h of good quality sleep. Using an Australian sample, this study reports the proportion of preschool children meeting these guidelines and investigates associations with social-cognitive development.MethodsData from 248 preschool children (mean age = 4.2 ± 0.6 years, 57% boys) participating in the PATH-ABC study were analyzed. Children completed direct assessments of physical activity (accelerometry) and social cognition (the Test of Emotional Comprehension (TEC) and Theory of Mind (ToM)). Parents reported on children’s screen time and sleep. Children were categorised as meeting/not meeting: i) individual guidelines, ii) combinations of two guidelines, or iii) all three guidelines. Associations were examined using linear regression adjusting for child age, sex, vocabulary, area level socio-economic status and childcare level clustering.ResultsHigh proportions of children met the physical activity (93.1%) and sleep (88.7%) guidelines, whereas fewer met the screen time guideline (17.3%). Overall, 14.9% of children met all three guidelines. Children meeting the sleep guideline performed better on TEC than those who did not (mean difference [MD] = 1.41; 95% confidence interval (CI) = 0.36, 2.47). Children meeting the sleep and physical activity or sleep and screen time guidelines also performed better on TEC (MD = 1.36; 95% CI = 0.31, 2.41) and ToM (MD = 0.25; 95% CI = −0.002, 0.50; p = 0.05), respectively, than those who did not. Meeting all three guidelines was associated with better ToM performance (MD = 0.28; 95% CI = −0.002, 0.48, p = 0.05), while meeting a larger number of guidelines was associated with better TEC (3 or 2 vs. 1/none, p < 0.02) and ToM performance (3 vs. 2, p = 0.03).ConclusionsStrategies to promote adherence to the 24-Hour Movement Behaviour Guidelines for the Early Years among preschool children are warranted. Supporting preschool children to meet all guidelines or more guidelines, particularly the sleep and screen time guidelines, may be beneficial for their social-cognitive development.

OBJECTIVE -The aim of this study was to examine the effect of a moderate-fat diet inclusive of walnuts on blood lipid profiles in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS -This was a parallel randomized controlled trial comparing three dietary advice groups each with 30% energy as fat: low fat, modified low fat, and modified low fat inclusive of 30 g of walnuts per day. Fifty-eight men and women, mean age 59.3 Ϯ 8.1 years, started the trial. Dietary advice was given at baseline with monthly follow-up and fortnightly phone calls for support. Body weight, percent body fat, blood lipids, HbA 1c , total antioxidant capacity, and erythrocyte fatty acid levels were measured at 0, 3, and 6 months. Data were assessed by repeated-measures ANOVA with an intention-to-treat model. RESULTS -The walnut group achieved a significantly greater increase in HDL cholesterolto-total cholesterol ratio (P ϭ 0.049) and HDL (P ϭ 0.046) than the two other treatment groups. A 10% reduction in LDL cholesterol was also achieved in the walnut group, reflecting a significant effect by group (P ϭ 0.032) and time (P ϭ 0.036). There were no significant differences between groups for changes in body weight, percent body fat, total antioxidant capacity, or HbA 1c levels. The higher dietary polyunsaturated fat-to-saturated fat ratio and intakes of -3 fatty acids in the walnut group were confirmed by erythrocyte biomarkers of dietary intake.CONCLUSIONS -Structured "whole of diet" advice that included 30 g of walnuts/day delivering substantial amounts of polyunsaturated fatty acid improved the lipid profile of patients with type 2 diabetes. The literature on recommendations varies to a minor degree, and cultural differences may have an influence (9), but a total fat level of Յ30% energy (10) and Ͻ10% saturated fat is reasonably well accepted (11,12). There is some concern that PUFAs are more susceptible to oxidation and therefore may be more atherogenic (11), so a level of Ͻ10% energy for PUFAs is seen with greater flexibility in the proportions of carbohydrate and MUFA (13). Within the PUFA fraction of the diet, the ratio of -6 to -3 fatty acids is also considered (9) with daily recommendations for a 2,000-kcal diet of 0.65 g for the long-chain -3s (EPA ϩ DHA) and 2.22 g for ALA (14) and the -6 -to--3 ratio reduced to substantially Ͻ10 (14a). Diabetes CareFish are the major source of EPA ϩ DHA, but fish oil supplements produce a decreased oxidative stability of plasma LDL (15,16). In contrast, consumption of fish itself may be protective against type 2 diabetes (17). Nuts provide substantial amounts of dietary PUFA, and nut consumption is inversely associated with the risk of type 2 diabetes in women (18). There is no net effect on glucose homeostasis from nut supplementation, but more interestingly, no net weight gain when nuts were used as a replacement food (19). In subjects with dyslipidemia (total cholesterol Ͼ5.17; LDL Ͼ3.36; triglycerides Ͼ2.26 mmol/l), a low-fat diet supplemented with walnuts was found to reduce total choles...

Hypertension is a major risk factor for developing cardiovascular disease, stroke, and kidney disease. To lower blood pressure (BP), several lifestyle changes are recommended such as weight loss, exercise, and following a healthy diet. Investigating the effect of single nutrients may have positive results, but food is consumed as part of a whole diet, resulting in nutrient interactions. The aim of this systematic review and meta-analysis was to assess the effect of dietary patterns on BP in adults. Studies that were published between January 1999 and June 2014 were retrieved using Scopus, Web of Science, and the MEDLINE database. Seventeen randomized controlled trials were included in the meta-analysis. The results suggest that healthy dietary patterns such as the Dietary Approaches to Stop Hypertension diet, Nordic diet, and Mediterranean diet significantly lowered systolic BP and diastolic BP by 4.26 mm Hg and 2.38 mm Hg, respectively. These diets are rich in fruit, vegetables, whole grains, legumes, seeds, nuts, fish, and dairy and low in meat, sweets, and alcohol. Lifestyle factors such as exercise and weight loss in combination with dietary changes may also reduce BP. Further research is needed to establish the effect of dietary patterns on BP in different cultures other than those identified in this review. The review was registered on PROSPERO (International prospective register of systematic reviews) as CRD42015016272.

Background Electronic health (eHealth) obesity programs offer benefits to traditionally delivered programs and have shown promise in improving obesity-related behaviors in children. Objective This study aimed to assess the efficacy of a parent-focused, internet-based healthy lifestyle program for preschool-aged children, who are overweight or at or above the fiftieth percentile for body mass index (BMI) for their age and sex, on child BMI, obesity-related behaviors, parent modeling, and parent self-efficacy. Methods The Time2bHealthy randomized controlled trial was conducted in Australia, during 2016 to 2017. Participants were recruited both online and through more traditional means within the community. Parent or carer, and child (aged 2-5 years) dyads were randomized into an intervention or comparison group. Intervention participants received an 11-week internet-based healthy lifestyle program, underpinned by social cognitive theory, followed by fortnightly emails for 3 months thereafter. Intervention participants set goals and received individual feedback from a dietitian. They were also encouraged to access and contribute to a closed Facebook group to communicate with other participants and the dietitian. Comparison participants received email communication only. Objectively measured child BMI was the primary outcome. Secondary outcomes included objectively measured physical activity, parent-measured and objectively measured sleep habits, and parent-reported dietary intake, screen time, child feeding, parent modeling, and parent self-efficacy. All data were collected at face-to-face appointments at baseline, 3 months, and 6 months by blinded data collectors. Randomization was conducted using a computerized random number generator post baseline data collection. Results A total of 86 dyads were recruited, with 42 randomized to the intervention group and 44 to the comparison group. Moreover, 78 dyads attended the 3- and 6-month follow-ups, with 7 lost to follow-up and 1 withdrawing. Mean child age was 3.46 years and 91% (78/86) were in the healthy weight range. Overall, 69% (29/42) of participants completed at least 5 of the 6 modules. Intention-to-treat analyses found no significant outcomes for change in BMI between groups. Compared with children in the comparison group, those in the intervention group showed a reduced frequency of discretionary food intake (estimate −1.36, 95% CI −2.27 to −0.45; P =.004), and parents showed improvement in child feeding pressure to eat practices (−0.30, 95% CI 0.06 to −0.00; P =.048) and nutrition self-efficacy (0.43, 95% CI 0.10 to 0.76; P =.01). No significant time by group interaction was found for other outcomes. Conclusions The trial demonstrated that a parent-focused eHealth childhood obesity prevention program can provide support to ...

Background/Objectives: Most dietary interventions have metabolic effects in the short term, but long-term effects may require dietary fat changes to influence body composition and insulin action. This study assessed the effect of sustained high polyunsaturated fatty acids (PUFA) intake through walnut consumption on metabolic outcomes in type II diabetes. Subjects/Methods: Fifty overweight adults with non-insulin-treated diabetes (mean age 54±8.7 years) were randomized to receive low-fat dietary advice ± 30 g per day walnuts targeting weight maintenance (around 2000 kcal, 30% fat) for 1 year. Differences between groups were assessed by changes in anthropometric values (body weight, body fat, visceral adipose tissue) and clinical indicators of diabetes over treatment time using the general linear model. Results: The walnut group consumed significantly more PUFA than the control (P ¼ 0.035), an outcome attributed to walnut consumption (contributing 67% dietary PUFA at 12 months). Most of the effects were seen in the first 3 months. Despite being on weight maintenance diets, both groups sustained a 1-2 kg weight loss, with no difference between groups (P ¼ 0.680). Both groups showed improvements in all clinical parameters with significant time effects (Po0.004), bar triacylglycerol levels, but these were just above normal to begin with. The walnut group produced significantly greater reductions in fasting insulin levels (P ¼ 0.046), an effect seen largely in the first 3 months. Conclusions: Dietary fat can be manipulated with whole foods such as walnuts, producing reductions in fasting insulin levels. Long-term effects are also apparent but subject to fluctuations in dietary intake if not of the disease process.

No abstract