Journal of the American Dietetic Association RSS feed: Current Issue. The Journal of the American Dietetic Association is the premier source for the practice and science of food, nutrition, and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, foodservice systems, leadership and management, and dietetics education. The Journal's impact factor is 2.868 (Journal Citation Reports® 2009, published by Thomson Reuters). The impact factor is a measure of the frequency with which the "average article" has been cited in a particular period. The Journal receives nearly 500 solicited and unsolicited manuscripts annually; the average time from submission to publication is 13.5 months.http://www.adajournal.org/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Journal of the American Dietetic Association0002-82231102February 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.adajournal.org/article/PIIS0002822309020628/abstract?rss=yesTable of Contents10.1016/S0002-8223(09)02062-8Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5155155http://www.adajournal.org/article/PIIS000282230902063X/abstract?rss=yesThis Month in the Journal of the American Dietetic Association10.1016/S0002-8223(09)02063-XJournal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5163163http://www.adajournal.org/article/PIIS0002822309020823/abstract?rss=yesLast month, we presented the updated author guidelines and encouraged prospective authors to take careful note. In addition, it might be of further interest to recognize the relatively liberal policies associated with the rights of authors who publish in the Journal. You may be surprised to learn just how much liberty you have to present and anticipate your own publication. Some of these opportunitites are summarized below.More Info for AuthorsLinda Van Horn10.1016/j.jada.2009.12.012Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Editor's Outlook165165http://www.adajournal.org/article/PIIS0002822309020811/abstract?rss=yesHealthy People provides science-based, 10-year national objectives for promoting health and preventing disease. Since 1979, Healthy People has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of our prevention activity ().Healthy People 2020, ADA, and YouJessie M. Pavlinac10.1016/j.jada.2009.12.011Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5President's Page166166http://www.adajournal.org/article/PIIS0002822309019634/abstract?rss=yesIt is an honor and privilege to be recognized by my peers and the Association as the 2009 Lenna Frances Cooper Memorial Lecturer. I am in awe of the previous lecturers and honorees and am humbled by the opportunity to share this distinction.2009 Lenna Frances Cooper Memorial Lecture: Living with Enteral and Parenteral Nutrition: How Food and Eating Contribute to Quality of LifeMarion F. Winkler10.1016/j.jada.2009.12.002Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Topics of Professional Interest169177http://www.adajournal.org/article/PIIS0002822309019683/abstract?rss=yesThe buzz phrase “cultural competency” has made a splash in the scientific literature of late, with many organizations and authors emphasizing why it is important, analyzing the effectiveness of programs that teach it, and working to establish some uniformity in how it is defined. Variation lies even in whether to label cultural competence as a process, outcome, or skill ().Moving Cultural Competency from Abstract to ActKaren Stein10.1016/j.jada.2009.12.007Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Topics of Professional Interest180187http://www.adajournal.org/article/PIIS000282230901966X/abstract?rss=yesYou might not consider yourself the “retiring type”—and you're not alone. “[Retirement] is no longer an end. It's a turning point. A chance to take a break and then reinvent yourself,” according to Ken Dychtwald, author of several books on aging-related issues and founder of Age Wave, a consulting firm that specializes in services for baby boomers and mature adults. In an interview with U.S. News & World Report, Dychtwald predicted retirement will move towards becoming a “cyclical blend” of work, education, and leisure activities, rather than a full-time vacation and break from the daily grind, especially because very few individuals can afford to live well on a fixed income for 15 or 20 years (). In other words, reinventing what retirement means is tethered to two primary motivators: psychological and financial.No Desire to Fully Retire? ADA Offers Retirees a Variety of Options to Stay Active and InvolvedTony Peregrin10.1016/j.jada.2009.12.005Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Business of Dietetics188189http://www.adajournal.org/article/PIIS0002822309019658/abstract?rss=yesAs with all health professions, dietetic practice is regulated. Health professionals from physicians to chiropractors are required to follow the letter of the law in every task they perform in order to protect the public by maintaining a minimum quality of service. The federal government dictates some of these standards through agencies within the US Department of Health and Human Services; however, states also regulate, and the states have the authority to implement higher standards than the federal government. This is a source of great opportunity for registered dietitians (RDs) and dietetic technicians, registered (DTRs) to be recognized as the qualified providers of nutrition and dietary services in programs and facilities in your state. Increasing the quality of nutrition and food services and supporting the employment of RDs and DTRs in health facilities nationwide must happen at the state administrative level, often through regulations.Setting the Standard: Including the RD and DTR in State and Facility PoliciesDana L. Whitley10.1016/j.jada.2009.12.004Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Public Policy News190191http://www.adajournal.org/article/PIIS0002822309018124/abstract?rss=yesThe obesity pandemic is a defining public health challenge of the 21st century (). Global obesity trends are changing at a rate that exceeds our ability to identify and implement solutions () and will lead to increased rates of chronic diseases and disability at levels that policymakers and civil society worldwide have not yet fully acknowledged (). This global health crisis is attributed to broad macroenvironmental changes in food production, costs, processing, and distribution that have encouraged increased intakes of high-calorie foods and beverages beyond the energy needs of most individuals. Changes in eating patterns, accompanied by sedentary lifestyles and overall reductions in energy expenditure, have contributed to population-level energy imbalance and weight gain ().A Public Health Perspective on Healthy Lifestyles and Public–Private Partnerships for Global Childhood Obesity PreventionVivica I. Kraak, Mary Story10.1016/j.jada.2009.10.036Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Commentary192200http://www.adajournal.org/article/PIIS0002822309019671/abstract?rss=yesThe dietetics profession has been guided by advances in science that are translated to clinical practice guidelines. Inherent to advancing practice is the ongoing scientific dialogue. Progress made in clinical practice reflects the evolution of ideas and opinions that are subjected to additional scientific experimentation to advance our understanding and resolve “debates.” A good example of ongoing dialogue is the discussion about n-6 polyunsaturated fatty acids (PUFAs) and heart health. The National Academies and the Dietary Guidelines Advisory Committee 2005 have recommended that PUFAs provide 5% to 10% of energy (). By comparison, the American Dietetic Association Fatty Acid Position paper advised that PUFAs provide 3% to 10% of energy. Although linoleic acid (LA) has long been recognized as an essential nutrient, the dialogue about how much LA to consume beyond the requirement is based on the extent to which higher PUFA intakes have beneficial or harmful effects. Proponents of the position that intake should be set at a level no higher than that which prevents an essential fatty acid deficiency (around 1% to 2% of energy) assert that higher PUFA intakes have deleterious health effects and, as a result, believe that n-6 PUFA intakes (and current dietary recommendations) should be decreased. Advocates of a higher PUFA intake disagree, citing evidence for health benefits with higher intakes. The purpose of this Commentary is to present these different perspectives and to discuss the American Heart Association Science Advisory on n-6 PUFA that supports the current dietary recommendation of 5% to 10% of energy for heart health.The Debate about n-6 Polyunsaturated Fatty Acid Recommendations for Cardiovascular HealthPenny Kris-Etherton, Jennifer Fleming, William S. Harris10.1016/j.jada.2009.12.006Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Commentary201204http://www.adajournal.org/article/PIIS0002822309018136/abstract?rss=yesAbstract: Objective: Weight loss and consumption of viscous fibers both lower low-density lipoprotein (LDL) cholesterol levels. We evaluated whether or not a whole-grain, ready-to-eat (RTE) oat cereal containing viscous fiber, as part of a dietary program for weight loss, lowers LDL cholesterol levels and improves other cardiovascular disease risk markers more than a dietary program alone.Design: Randomized, parallel-arm, controlled trial.Subjects/setting: Free-living, overweight and obese adults (N=204, body mass index 25 to 45) with baseline LDL cholesterol levels 130 to 200 mg/dL (3.4 to 5.2 mmol/L) were randomized; 144 were included in the main analysis of participants who completed the trial without significant protocol violations.Intervention: Two portions per day of whole-grain RTE oat cereal (3 g/day oat b-glucan) or energy-matched low-fiber foods (control), as part of a reduced energy (∼500 kcal/day deficit) dietary program that encouraged limiting consumption of foods high in energy and fat, portion control, and regular physical activity.Main outcome measures: Fasting lipoprotein levels, waist circumference, triceps skinfold thickness, and body weight were measured at baseline and weeks 4, 8, 10, and 12.Results: LDL cholesterol level was reduced significantly more with whole-grain RTE oat cereal vs control (−8.7±1.0 vs −4.3±1.1%, P=0.005). Total cholesterol (−5.4±0.8 vs −2.9±0.9%, P=0.038) and non–high-density lipoprotein-cholesterol (−6.3±1.0 vs −3.3±1.1%, P=0.046) were also lowered significantly more with whole-grain RTE oat cereal, whereas high-density lipoprotein and triglyceride responses did not differ between groups. Weight loss was not different between groups (−2.2±0.3 vs −1.7±0.3 kg, P=0.325), but waist circumference decreased more (−3.3±0.4 vs −1.9±0.4 cm, P=0.012) with whole-grain RTE oat cereal. Larger reductions in LDL, total, and non–high-density lipoprotein cholesterol levels and waist circumference were evident as early as week 4 in the whole-grain RTE oat cereal group.Conclusions: Consumption of a whole-grain RTE oat cereal as part of a dietary program for weight loss had favorable effects on fasting lipid levels and waist circumference.Whole-Grain Ready-to-Eat Oat Cereal, as Part of a Dietary Program for Weight Loss, Reduces Low-Density Lipoprotein Cholesterol in Adults with Overweight and Obesity More than a Dietary Program Including Low-Fiber Control FoodsKevin C. Maki, Jeannemarie M. Beiseigel, Satya S. Jonnalagadda, Carolyn K. Gugger, Matthew S. Reeves, Mildred V. Farmer, Valerie N. Kaden, Tia M. Rains10.1016/j.jada.2009.10.037Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Original Research205214http://www.adajournal.org/article/PIIS0002822309018112/abstract?rss=yesAbstract: Background: Although eating and physical activity behaviors have been previously individually investigated with regard to overweight in children, multidimensional lifestyle patterns, based on these behaviors, have not been explored.Objective: To assess lifestyle patterns in relation to body mass index (BMI), in a nationally representative sample of the Greek pediatric populationDesign: Cross-sectional study. Data were collected from May through July 2007.Subjects: The sample consisted of 1,305 children and adolescents (ages 3 to 18 years).Main outcome measures: Information on participants' dietary intake, eating behaviors, physical activity habits, and BMI were collected. Adherence to the Mediterranean diet guidelines was evaluated using the KIDMED Mediterranean diet quality index; the higher the score in this index the more favorable the dietary pattern. The Goldberg cut-off limits for the ratio of energy intake/basal metabolic rate were used to evaluate dietary low energy reporting and participants were accordingly classified as low-energy reporters.Statistical analysis: Principal component analysis was performed to identify participants' lifestyle patterns. Associations between BMI and lifestyle patterns were further evaluated using multiple linear regression analyses, after controlling for potential confounders.Results: Principal component analysis identified seven lifestyle patterns explaining 85% of the total variance of lifestyle habits. A lifestyle pattern characterized by higher eating frequency, breakfast consumption and higher KIDMED score was negatively associated with BMI (standardized β=−.125, P<0.001), after controlling for age, sex, and parental education. The association remained significant even when low-energy reporters were excluded from the analysis.Conclusions: Results from the study suggest a potential intercorrelation and protective action of selected eating behaviors, namely eating frequency, breakfast consumption, and adherence to the Mediterranean diet, against overweight and obesity in children and adolescents.Associations between Lifestyle Patterns and Body Mass Index in a Sample of Greek Children and AdolescentsMeropi D. Kontogianni, Anastasia-Eleni Farmaki, Nikoletta Vidra, Stavroula Sofrona, Flora Magkanari, Mary Yannakoulia10.1016/j.jada.2009.10.035Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Original Research215221http://www.adajournal.org/article/PIIS0002822309018094/abstract?rss=yesAbstract: Objective: To assess maternal perceptions of children's current and ideal body sizes, and the meaning of and factors contributing to overweight in infancy and early childhood among Mexican-origin mothers living in Mexico and in California.Design: A quali-quantitative study combining focus groups and a self-administered questionnaire.Subjects/setting: A purposive sample of 84 low-income, Mexican-origin mothers of 4- to 6-year-old children recruited between March 2006 and January 2008 from rural and urban communities in Mexico and California.Statistical analyses: Bivariate, multivariate, and qualitative analyses of maternal perceptions of children's actual and ideal body size supplemented by qualitative analyses of meaning of and factors contributing to childhood overweight/obesity.Results: Ideal child body size was considerably lower among Mexican-origin mothers living in California (3.86±0.56) than it was among mothers living in Mexico (4.32±0.83), and this difference was significant (P=0.001) after adjusting for sociodemographic covariates. Among mothers of overweight children, 82% of mothers in California were dissatisfied with their child's weight compared with 29% of mothers in Mexico (P=0.003). Focus-group results suggest that these differences in the perception of children's ideal body size can be attributable to differences in body size norms among mothers and awareness of the negative effects of obesity that occur after migration to California.Conclusions: Maternal perceptions of early childhood overweight appear to differ among Mexican-origin women living in Mexico and California. Recognition of the negative health consequences of obesity and identification of barriers to achieving weight control are important first steps toward childhood obesity prevention. Interventions directed at Mexican-origin mothers should focus on culturally acceptable ways of transmitting weight-control information.Maternal Perceptions of Early Childhood Ideal Body Weight Differ among Mexican-Origin Mothers Residing in Mexico Compared to CaliforniaSylvia Guendelman, Lia C.H. Fernald, Lynnette M. Neufeld, Elena Fuentes-Afflick10.1016/j.jada.2009.10.033Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Original Research222229http://www.adajournal.org/article/PIIS0002822309018100/abstract?rss=yesAbstract: Background: National survey data indicate few adolescents or young adults consume whole grains in the amount recommended to prevent chronic disease and maintain a healthful weight. Interventions are needed to address this gap; however, little is known about what modifiable factors influence whole-grain intake among youth.Objective: This study aimed to identify socioenvironmental, personal, and behavioral correlates of whole-grain intake among adolescents and young adults.Design: Data for this cross-sectional analysis were drawn from Project EAT (Eating Among Teens)-II, the second wave of a population-based study in Minnesota. Mailed surveys and food frequency questionnaires were completed by male (44.8%) and female (55.2%) participants in 2003-2004, including 792 adolescents (mean age=17.2 years) and 1,686 young adults (mean age=20.5 years). Linear regression models adjusted for demographic characteristics were used to identify factors associated with energy-adjusted daily intake of whole grains.Results: Mean daily intake of whole grains was lower than recommended among adolescents (males: 0.59±0.04 servings, females: 0.61±0.04 servings) and young adults (males: 0.68±0.03 servings, females: 0.58±0.03 servings). Home availability of whole-grain bread, self-efficacy to consume ≥3 daily servings of whole grains, and preference for the taste of whole-grain bread were positively associated with whole-grain intake during adolescence and young adulthood across sex. Conversely, fast-food intake was associated with lower intake of whole grains among adolescents and young adults of both sexes. The factors examined in this study explained 28% to 34% of variance in whole-grain intake across sex and the two age groups.Conclusions: The findings suggest nutrition interventions should address the availability of whole-grain foods in homes and restaurants. In addition, young people should be provided with opportunities to taste a variety of whole-grain foods to enhance taste preferences and self-efficacy to consume whole-grain products.Whole-Grain Intake Correlates among Adolescents and Young Adults: Findings from Project EATNicole I. Larson, Dianne Neumark-Sztainer, Mary Story, Teri Burgess-Champoux10.1016/j.jada.2009.10.034Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Original Research230237http://www.adajournal.org/article/PIIS0002822309018082/abstract?rss=yesAbstract: Autism spectrum disorders comprise a complex set of related developmental disorders that are characterized by impairments in communication, social interaction, and repetitive behaviors. Impairments in sensory processing are also extremely common. The prevalence of autism spectrum disorders is increasing and is currently estimated to affect 1 in 150 children. Autism spectrum disorders are considered to be a major health and educational problem, affecting many areas of daily living, including eating. Children with autism spectrum disorders are often described as picky or selective eaters. This article provides a comprehensive narrative review of the empirical literature over the last 25 years on food selectivity and nutritional adequacy in children with autism spectrum disorders. The possible contributions of sensory factors, such as sensory sensitivity, to food selectivity are discussed. The need for an interdisciplinary approach to managing atypical eating patterns in children with autism spectrum disorders is highlighted.Food Selectivity and Sensory Sensitivity in Children with Autism Spectrum DisordersSharon A. Cermak, Carol Curtin, Linda G. Bandini10.1016/j.jada.2009.10.032Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Review238246http://www.adajournal.org/article/PIIS0002822309018069/abstract?rss=yesAbstract: Adherence to highly restrictive diets is critical for women of childbearing age who have inborn errors of metabolism such as phenylketonuria. The purpose of this study was to explore attitudes about diet, barriers to and facilitators of dietary adherence, and experiences with the health care system in promoting dietary adherence among adolescent and adult women with inborn errors of metabolism to identify policy-level interventions to improve adherence. We analyzed the results of four focus groups including a total of 19 women between the ages of 12 and 52 years with phenylketonuria, methylmalonic acidemia, or maple syrup urine disease attending an educational summer camp in 2008. Themes were identified after independent analysis of transcripts. Most participants were highly knowledgeable about their dietary requirements and some could describe their own specific negative experiences of nonadherence. Many reported specific challenges, such as feelings of being different, that they experienced in elementary and middle school. Friends and family play an important role in maintaining dietary adherence. Participants identified one registered dietitian in particular who has played an important supportive role. Insurance coverage for medical foods was a common concern. Most participants identified concerns about transitioning from pediatric to adult medical services. We identified four specific strategies for future evaluation that may improve dietary adherence and health outcomes for women and their potential offspring: symptom-based dietary monitoring for some, educating school officials about medical diets, expanding the role of registered dietitians; and assisting with the transition from pediatric to adult health care providers.Perspectives on Dietary Adherence among Women with Inborn Errors of MetabolismAlex R. Kemper, Cheryl A. Brewer, Rani H. Singh10.1016/j.jada.2009.10.030Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Qualitative Research247252http://www.adajournal.org/article/PIIS0002822309018070/abstract?rss=yesAbstract: Dietary and lifestyle changes in Mexico have been linked to an increase in chronic diseases such as obesity and cardiovascular disease. Important dietary changes such as an increase in the consumption of energy-dense foods (high in oils, animal or processed fats, and sugars) have been recently reported. The objective of this study was to identify how key dietary energy sources correlated with other indexes of cardiovascular disease in a Mexican school-age population. From 2004 to 2006, a convenience sample (n=228) of 9- to 13-year-olds, 48.2% girls and 51.8% boys, from three public urban schools were included. Anthropometric, blood pressure, and dietary assessment (two multiple pass 24-hour recalls) were done. More than half of children did not meet the fruit and vegetable recommended intake. High-fat dairy foods (14% of total energy intake), refined carbohydrates (13.5%), red/processed meat (8.5%), added sugars/desserts (7%), corn tortilla (6.5%), and soft drinks/sweetened beverages (5%) were the highest dietary energy sources consumed. In a subgroup of children (n=185), a fasting blood sample was collected for biochemical analysis. A positive association was observed between glucose and diastolic blood pressure with the intake of soft drinks/sweetened beverages, insulin concentrations and the intake of white bread, and triglyceride concentrations with the intake of added fats. Unhealthful dietary energy sources are frequently consumed by these children. Culturally competent nutrition counseling should be offered to Mexican-American children and their families with a significant risk of cardiovascular disease. Efforts should be made to design and implement nutrition education and health promotion strategies in schools.Correlates of Dietary Energy Sources with Cardiovascular Disease Risk Markers in Mexican School-Age ChildrenOtilia Perichart-Perera, Margie Balas-Nakash, Ameyalli Rodríguez-Cano, Cinthya Muñoz-Manrique, Adriana Monge-Urrea, Felipe Vadillo-Ortega10.1016/j.jada.2009.10.031Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Practice Innovations253260http://www.adajournal.org/article/PIIS0002822309018057/abstract?rss=yesAbstract: Childhood obesity and related health consequences continue to be major clinical and public health issues in the United States. Schools provide an opportunity to implement obesity prevention strategies to large and diverse pediatric audiences. Healthier Options for Public Schoolchildren was a quasiexperimental elementary school-based obesity prevention intervention targeting ethnically diverse 6- to 13-year-olds (kindergarten through sixth grade). Over 2 school years (August 2004 to June 2006), five elementary schools (four intervention, one control, N=2,494, 48% Hispanic) in Osceola County, FL, participated in the study. Intervention components included integrated and replicable nutrition, physical activity, and lifestyle educational curricula matched to state curricula standards; modified school meals, including nutrient-dense items, created by registered dietitians; and parent and staff educational components. Demographic, anthropometric, and blood pressure data were collected at baseline and at three time points over 2 years. Repeated measures analysis showed significantly decreased diastolic blood pressure in girls in the intervention group compared to controls (P<0.05). Systolic blood pressure decreased significantly for girls in the intervention group compared to controls during Year 1 (fall 2004 to fall 2005) (P<0.05); while not statistically significant the second year, the trend continued through Year 2. Overall weight z scores and body mass index z scores decreased significantly for girls in the intervention group compared to controls (P<0.05 and P<0.01, respectively). School-based prevention interventions, including nutrition and physical activity components, show promise in improving health, particularly among girls. If healthy weight and blood pressure can be maintained from an early age, cardiovascular disease in early adulthood may be prevented.Healthier Options for Public Schoolchildren Program Improves Weight and Blood Pressure in 6- to 13-Year-OldsDanielle Hollar, Sarah E. Messiah, Gabriela Lopez-Mitnik, T. Lucas Hollar, Marie Almon, Arthur S. Agatston10.1016/j.jada.2009.10.029Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Practice Innovations261267http://www.adajournal.org/article/PIIS000282230901815X/abstract?rss=yesAbstract: Excess weight is associated with negative health outcomes. Meal replacements are effective in promoting favorable body composition changes in civilian populations; however, their efficacy with military service members who have unique lifestyles is unknown. The objective of this randomized controlled trial was to determine the efficacy of the Army's education-based weight-management program, “Weigh to Stay,” with and without meal replacements for improving blood lipids, and to promote weight and body fat loss in overweight US Army soldiers. Soldiers (n=113; 76 males/37 females) attending Weigh to Stay at Fort Bragg, NC, in 2006/2007 were randomized to Weigh to Stay only or a commercially available meal-replacement program (two meal replacements per day) in conjunction with Weigh to Stay, and followed until Army body fat standards were met or for 6 months if standards were not met. Study completers (n=46) in both treatment groups lost weight (Weigh to Stay: −2.7±4.3 kg; meal replacers: −3.8±3.5 kg) and fat mass (Weigh to Stay, −2.7±3.2 kg; meal replacers: −2.9±2.5 kg), and improved high-density lipoprotein cholesterol concentrations (Weigh to Stay: 13±9 mg/dL [0.34±0.23 mmol/L]; meal replacers: 8±7 mg/dL [0.21±0.18 mmol/L]; P<0.05); however, no between-group differences were observed. Attrition was lower (P=0.009) and success in meeting body fat standards tended to be higher (P=0.06) for the meal replacers vs Weigh to Stay participants. Intent-to-treat analysis demonstrated that meal replacers lost more weight (1.2±0.5 kg), percent body fat (1.0%±0.4%), and fat mass (0.8±0.4 kg) compared to Weigh to Stay volunteers (P<0.05). Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay.Efficacy of a Meal-Replacement Program for Promoting Blood Lipid Changes and Weight and Body Fat Loss in US Army SoldiersTracey J. Smith, Lori D. Sigrist, Gaston P. Bathalon, Susan McGraw, J. Philip Karl, Andrew J. Young10.1016/j.jada.2009.10.039Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Professional Briefs268273http://www.adajournal.org/article/PIIS0002822309018148/abstract?rss=yesAbstract: Early postpartum is a critical period that may initiate consumption of an unhealthful diet, which can lead to obesity and adverse lipid profiles. The Healthy Eating Index 2005 (HEI 2005) is a tool that assesses diet quality in terms of adherence to the 2005 Dietary Guidelines for Americans. Previous versions of HEI have shown to be associated with serum lipids. The aim of this research is to evaluate the diet quality of women in early postpartum using the HEI 2005 and to examine the relationship of index scores with serum lipids and anthropometrics. A convenience sample of 125 multiethnic, overweight/obese women in early postpartum was recruited from urban clinics from June 2004 through April 2007. Dietary intake was measured via the average of a 24-hour dietary recall and 2-day food intake records. The HEI 2005 scores were computed to assess diet quality and were compared to anthropometrics and serum lipids. Descriptive statistics, analysis of covariance, and linear regression were utilized. This sample had low mean scores in fruits, total vegetables, whole grains, and oil components. Conversely, participants consumed more than recommended amounts of sodium, saturated fats, and discretionary calories. The HEI 2005 scores inversely predicted body mass index and low-density lipoprotein and total cholesterol, and positively predicted high-density lipoprotein cholesterol. Low-income women in early postpartum exhibited poor diet quality, as indicated by low total index scores. Further studies are warranted to identify appropriate dietary modifications in this population and to confirm the association of diet quality, as assessed by this HEI 2005 index, with lipids and other markers of health.Diet Quality as Measured by the Healthy Eating Index and the Association with Lipid Profile in Low-Income Women in Early PostpartumBijal S. Shah, Jeanne H. Freeland-Graves, Jodi M. Cahill, Hongxing Lu, Glenn R. Graves10.1016/j.jada.2009.10.038Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Professional Briefs274279http://www.adajournal.org/article/PIIS0002822309018161/abstract?rss=yesAbstract: A direct link has been established between insulin resistance and obesity; however, the influence of body fat content on insulin sensitivity in normal-weight individuals has not been explored. The aim of this cross-sectional study was to examine differences in insulin sensitivity, glycemic control, and blood lipid levels in normal-weight, healthy participants differing in their body fat. Physical activity, cardiorespiratory fitness, weight cycling, nutrient intake, and eating behavior were also assessed. Two groups of normal-weight (body mass index <25) young, healthy women were recruited: a high-body-fat group with body fat >30% of body weight (n=15) and a low-body-fat group (fat ≤30%, n=17). Data were collected between November 2003 and March 2004. Participants were matched for age and body fat distribution (assessed by the waist-to-hip ratio). The high-body-fat group displayed lower values of insulin sensitivity compared to the low-body-fat group (1/homeostasis model assessment of insulin resistance 1.003±0.083 vs 1.385±0.158, respectively; P<0.05), whereas no differences were observed on blood lipid levels and glycemic control between groups. High-body-fat participants had lower cardiorespiratory fitness (25.2±1.2 vs 28.2±1.4 mL/kg/min in the low-body-fat group, P<0.05) and higher incidence of weight cycling of 1.0 to 2.5 kg loss per lifetime (18±3 kg vs 8±2 kg in the low-body-fat group, P<0.05). The latter variable was the only factor significantly associated with body fat. These data suggest that increased adiposity in normal weight, healthy women may adversely affect insulin sensitivity and that it may be related to differences in physical fitness and eating behavior.Fitness and Weight Cycling in Relation to Body Fat and Insulin Sensitivity in Normal-Weight Young WomenCostas A. Anastasiou, Mary Yannakoulia, Vassiliki Pirogianni, Gianna Rapti, Labros S. Sidossis, Stavros A. Kavouras10.1016/j.jada.2009.10.040Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Professional Briefs280284http://www.adajournal.org/article/PIIS0002822309018185/abstract?rss=yesAbstract: Intervention studies in youth with obesity that can be translated into primary care are limited. We compared a lifestyle intervention to a brief intervention applied by primary care physicians (control group) for treating pediatric obesity in the primary care setting. Seventy-six youth with obesity (body mass index [BMI] >95th percentile or >90th percentile plus waist circumference >90th percentile, aged 9 to 17 years) participated in a 12-month, randomized, controlled trial, conducted at a primary care unit in Northern México from June 2006 through October 2007. Participants randomized to lifestyle intervention attended a family-centered program consisting of 12 sessions of behavioral curriculum, dietary advice from a registered dietitian (weekly for the first 3 months and monthly thereafter), and monthly consultations with a primary care physician. Control group participants attended monthly consultations with a primary care physician who received a brief training on obesity. Forty-three (57%) participants completed the 12 months of study. After 12 months, mean changes (95% confidence interval) in body weight for the lifestyle group and the control group were −0.8 kg (−3.2, 1.5) vs +5.6 kg (3, 8.2; P<0.001) and mean changes in BMI were −1.8 (−2.6, −0.9) vs +0.4 (−0.5, 1.3; P<0.001), respectively. Intention-to-treat analysis at 12 months confirmed significant differences in primary outcomes (weight −3.5 kg, P=0.02; BMI −1.2, P=0.03) in favor of the lifestyle group. This study provides preliminary evidence that primary care physicians supported by a registered dietitian and a behavioral curriculum can be a successful strategy for treating pediatric obesity in the primary care setting.Lifestyle Intervention in Primary Care Settings Improves Obesity Parameters among Mexican YouthRolando G. Díaz, Julián Esparza-Romero, Silvia Y. Moya-Camarena, Alma E. Robles-Sardín, Mauro E. Valencia10.1016/j.jada.2009.10.042Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Professional Briefs285290http://www.adajournal.org/article/PIIS0002822309018173/abstract?rss=yesAbstract: Previous research suggests that protein intake, particularly plant protein, may benefit blood pressure control. However, very little has been published regarding protein sources in diets of US adults and factors influencing these choices. The purpose of this report is to describe specific sources of animal and plant proteins in diets of PREMIER clinical trial participants at baseline and how the PREMIER intervention, along with participant demographics, affected protein sources. Adult participants (n=809) who completed the 18-month PREMIER lifestyle intervention trial and had at least one diet recall at each of three study visits were included. Participants were recruited from four clinical centers in the Eastern, Southern, and Northeastern regions of United States. The PREMIER trial, conducted from 1999 to 2002, compared the impact on blood pressure of two structured behavioral interventions focusing on the traditional lifestyle modifications for blood pressure control with or without the Dietary Approaches to Stop Hypertension dietary pattern. Protein sources were assessed by two unannounced 24-hour recalls at each of three study visits. Differences in protein sources were mainly related to participant demographics, with relatively moderate impact of the intervention. The top four protein sources for all the study participants were poultry, dairy, refined grains and beef, each contributing approximately 10% to 17% in descending order to the total protein intake at baseline. Animal and plant protein each comprised approximately 66% and 34%, respectively, to the total daily protein intake at baseline, and such overall contribution pattern remained relatively constant over time. However, sex, race, age, and body weight status all influenced contribution patterns from different food groups significantly. These influences significantly impact choice and are essential elements to consider when designing intervention programs to alter protein contributions from animal vs plant sources.Factors Influencing Dietary Protein Sources in the PREMIER Trial PopulationPao-Hwa Lin, Saki Miwa, Yi-Ju Li, Yanfang Wang, Erma Levy, Katherine Lastor, Catherine Champagne10.1016/j.jada.2009.10.041Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Research and Professional Briefs291295http://www.adajournal.org/article/PIIS0002822309019646/abstract?rss=yesAbstract: It is the position of the American Dietetic Association that nutrition services provided by registered dietitians (RDs) and dietetic technicians, registered (DTRs), are essential components of comprehensive care for all people with developmental disabilities and special health care needs. Nutrition services should be provided throughout life in a manner that is interdisciplinary, family-centered, community-based, and culturally competent. People with developmental disabilities and special health care needs frequently have nutrition concerns, including growth alterations (failure to thrive, obesity, or growth retardation), metabolic disorders, poor feeding skills, medication–nutrient interactions, and sometimes partial or total dependence on enteral or parenteral nutrition. Individuals with special needs are also more likely to develop comorbid conditions such as obesity or endocrine disorders that require nutrition interventions. Poor health habits, limited access to services, and long-term use of multiple medications are considered health risk factors. Health maintenance and avoidance of complications can be promoted by timely and cost-effective nutrition interventions. Public policy for individuals with special needs has evolved over time, resulting in a transition from institutional facilities and programs to community living. The expansion of public access to technology and health information on the Internet challenges RDs and DTRs to provide accurate scientific information for those with developmental disabilities and special health care needs. Nationally credentialed RDs and DTRs are best prepared to provide appropriate nutrition information for wellness and quality of life.Position of the American Dietetic Association: Providing Nutrition Services for People with Developmental Disabilities and Special Health Care Needs10.1016/j.jada.2009.12.003Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5from the association296307http://www.adajournal.org/article/PIIS0002822309018197/abstract?rss=yesThe House of Delegates (HOD) approved the proposed position concept “Food and Nutrition Programs for Older Adults” in 2007. The development of this paper has been completed and it has been submitted to the HOD Leadership Team for approval. Publication is planned for spring 2010.Position Paper Update for 201010.1016/j.jada.2009.10.043Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5from the association308309http://www.adajournal.org/article/PIIS0002822309018203/abstract?rss=yesEditor's note: that accompany this article are available online at www.adajournal.org. American Dietetic Association: Revised Standards of Practice and Standards of Professional Performance for Registered Dietitians (Generalist, Specialty, and Advanced) in Oncology Nutrition CareKim Robien, Lori Bechard, Laura Elliott, Nicole Fox, Rhone Levin, Sarah Washburn10.1016/j.jada.2009.11.001Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5from the association310317.e23http://www.adajournal.org/article/PIIS0002822309019695/abstract?rss=yes 2010 ADA Food & Nutrition Conference & Expo November 6-9, 2010; Boston, MAFebruary 2010 People & Events10.1016/j.jada.2009.12.008Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5People & Events319319http://www.adajournal.org/article/PIIS000282230902080X/abstract?rss=yesEvery year the Journal of the American Dietetic Association is proud to present its readers with a variety of revealing and insightful articles that expand the perimeters of nutrition science. While every article featured in this publication reflects a worthy contribution to the dietetics profession, each year there are a select number of articles whose research and content are so exceptional that they deserve to be recognized by the Association.The Huddleson Award 2009: Recognize research excellence—Nominate an article published in the 2009 ADA Journal for the Huddleson10.1016/j.jada.2009.12.010Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5People & Events320320http://www.adajournal.org/article/PIIS0002822310000489/abstract?rss=yesFebruary 2010 Classified Advertisements10.1016/S0002-8223(10)00048-9Journal of the American Dietetic Association 110, 2 (2010)2010-02-01Journal of the American Dietetic Association2010-02-011102S0002-8223(09)X0015-5Classified Advertisements323324