A composite measure of diet has been preferred to an index of a single nutrient or food in the area of dietary assessment. However, the lack of such a tool for cross-national comparisons has restricted the ability to compare diet quality between countries using an overall measure of diet. In this study, we created a tool called the Diet Quality Index-International (DQI-I) for global monitoring and exploration of diet quality across countries. The major categories of the index components are variety, adequacy, moderation and overall balance. Using the tool, this research presents a cross-national comparison of diet quality between China and the United States, incorporating comparable national in-depth diet data. The mean of the DQI-I score was slightly higher in China than in the United States. By major categories of the DQI-I, dietary variety was better achieved in the U.S. diet; moderation and overall balance of intakes were better accomplished in China. The DQI-I was successful in capturing variability in intakes of food and nutrients in both countries. Some distinct patterns of poor quality diet in each country were also identified. As demonstrated in this study, the DQI-I provides an effective means of cross-national comparative work for global understanding of diet quality. Furthermore, the dietary problem areas identified by the DQI-I may be useful in guiding the development of programs to improve public health.

Endometrial ablation is a less invasive treatment for menorrhagia than is hysterectomy, and it preserves the uterus. This randomized controlled trial was undertaken to assess 10-year outcomes for 2 established methods of endometrial ablation in 120 women with heavy dysfunctional ablation who were enrolled in the years 1993 to 1995. Sixty-one of them were treated by endometrial coagulation and 59 by endometrial resection. All of these women would have undergone hysterectomy had ablation not been an option. Excluded from the study were women younger than 35 years, those whose uterus was more than twice the normal size or had a cavity depth exceeding 12 cm, and those for whom pelvic pain was a major problem.Only one death, from infection, was related to the initial treatment. Two-thirds of patients had had a single ablation when followed up 2 years after treatment, and the figure after 10 years was 63%. Twenty-six women had had a hysterectomy within 10 years of endometrial ablation. The likelihood of this happening was substantially greater in women less than 40 years of age than in older women (43% vs. 18%). In all, 78% of women had avoided major surgery. The major indications for hysterectomy were bleeding and lower abdominal pain. Only 7% of women still had episodic bleeding 10 years after initial treatment. None of them was more than 45 years of age. On a scale of 0 ("not satisfied") to 100 ("very satisfied"), the overall degree of satisfaction with the outcome of treatment was 84. Nearly 95% of women would recommend the same treatment.The investigators believe that endometrial ablation is an excellent way of treating heavy dysfunctional bleeding. In the present series, if a woman required no further intervention within 2 years of ablation, the chance of having a hysterectomy within 10 years after initial treatment was only 6%. GYNECOLOGY Volume 62, Number 7 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACTThe first established treatment for anovulatory women having polycystic ovarian syndrome (PCOS) who failed to respond to medical treatment was laparoscopic ovarian wedge resection. Since then, the risk of adhesion formation has prompted the development of less invasive surgical procedures such as ovarian wedge resection by minilaparotomy. This study compared the risk of adhesion formation in 37 anovulatory infertile women with PCOS who had failed to respond to clomiphene citrate and who had ovarian wedge resection by minilaparotomy (group I), and 39 others who underwent laparoscopic ovarian electrodrilling (group II). All participants had a second-look laparoscopy 1 week after the initial procedure. Adhesion formation was assessed using the American Fertility Society classification. The 2 treatment groups were similar demographically and with respect to serum gonadotropin levels.Three women in group II (7.7%) had periovarian adhesions. In contrast, 81% of group I women had periovarian adhesions, and 54% and 46%, respectively, had intra-abdominal and uterine adhesions. Adhesions at all 3 sites were Operative Gyneco...

Context Popular diets, particularly those low in carbohydrates, have challenged current recommendations advising a low-fat, high-carbohydrate diet for weight loss. Potential benefits and risks have not been tested adequately. Objective To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables. Design, Setting, and Participants Twelve-month randomized trial conducted in the United States from February 2003 to October 2005 among 311 free-living, overweight/obese (body mass index, 27-40) nondiabetic, premenopausal women. Intervention Participants were randomly assigned to follow the Atkins (n=77), Zone (n=79), LEARN (n=79), or Ornish (n=76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up. Main Outcome Measures Weight loss at 12 months was the primary outcome. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non-high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Outcomes were assessed at months 0, 2, 6, and 12. The Tukey studentized range test was used to adjust for multiple testing. Results Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months, and mean 12-month weight loss was significantly different between the Atkins and Zone diets (PϽ.05). Mean 12-month weight loss was as follows: Atkins, −4.7 kg (95% confidence interval [CI], −6.3 to −3.1 kg), Zone, −1.6 kg (95% CI, −2.8 to −0.4 kg), LEARN, −2.6 kg (−3.8 to −1.3 kg), and Ornish, −2.2 kg (−3.6 to −0.8 kg). Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups. Conclusions In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss. Trial Registration clinicaltrials.gov Identifier: NCT00079573

Living in low socioeconomic neighbourhoods, and in environments where healthy food is not readily available, is found to be associated with increased obesity risk. Unlike other studies which examined populations in other parts of the US, a positive association between living close to supermarkets and reduced obesity risk was not found in this study. A better understanding of the mechanisms by which neighbourhood physical characteristics influence obesity risk is needed.