Eight World Health Organization (WHO) feeding indicators (FIs) and Demographic and Health Survey data for children <24 months were used to assess the relationship of child feeding with stunting and underweight in 14 poor countries. Also assessed were the correlations of FI with country gross national income (GNI). Prevalence of underweight and stunting increased with age and Ն50% of 12-23-month children were stunted. About 66% of babies received solids by sixth to eighth months; 91% were still breastfeeding through months 12-15. Approximately half of the children were fed with complementary foods at the recommended daily frequency, but <25% met food diversity recommendations. GNI was negatively correlated with a breastfeeding index (P < 0.01) but not with other age-appropriate FI. Regression modelling indicated a significant association between early initiation of breastfeeding and a reduction in risk of underweight (P < 0.05), but a higher risk of underweight for continued breastfeeding at 12-15 months (P < 0.001). For infants 6-8 months, consumption of solid foods was associated with significantly lower risk of both stunting and underweight (P < 0.001), as was meeting WHO guidance for minimum acceptable diet, iron-rich foods (IRF) and dietary diversity (P < 0.001); desired feeding frequency was only associated with lower risk of underweight (P < 0.05). Timely solid food introduction, dietary diversity and IRF were associated with reduced probability of underweight and stunting that was further associated with maternal education (P < 0.001). These results identify FI associated with growth and reinforce maternal education as a variable to reduce risk of underweight and stunting in poor countries.
The Sonya Slifka Longitudinal Multiple Sclerosis Study follows a population-based cohort of approximately 2000 people with multiple sclerosis (MS) to study demographic and clinical characteristics, course of illness, utilization and cost of health services, provider characteristics, use of MS specialists and disease modifying agents, and neurologic, economic and psychosocial outcomes. This report describes the study methodology, presents baseline demographic and clinical data, and evaluates the representativeness of the sample. A stratified random sample of persons with established and recently-diagnosed MS selected from the National Multiple Sclerosis Society (NMSS) mailing lists was supplemented with recently-diagnosed patients recruited through systematic nationwide outreach. Baseline data were collected by computer-assisted telephone interviews derived from standardized instruments; data collection continues at six-month intervals. The cohort was comparable to population-based and clinical samples with respect to demographics, course, relapse rate, symptoms, and severity of disability. Almost two-thirds of the cohort needed help with activities of daily living, three-quarters were limited in work or other activities, and half had emotional problems that compromised quality of life. The Slifka Study cohort is broadly representative of the MS population and the database can be used to address questions not answered by natural history studies, clinical databases, or population-based surveys.
In the Institute of Medicine (IOM) macronutrient report the Committee recommended a maximal intake of < or = 25% of energy from added sugars. The primary objectives of this study were to utilize National Health and Nutrition Examination Survey (NHANES) to update the reference table data on intake of added sugars from the IOM report and compute food sources of added sugars. We combined data from NHANES with the United States Department of Agriculture (USDA) MyPyramid Equivalents Database (MPED) and calculated individual added sugars intake as percent of total energy then classified individuals into 8 added sugars percent energy categories, calculated usual intake with the National Cancer Institute (NCI) method, and compared intakes to the Dietary Reference Intakes (DRIs). Nutrients at most risk for inadequacy based on the Estimated Average Requirements (EARs) were vitamins E, A, C, and magnesium. Nutrient intake was less with each 5% increase in added sugars intake above 5-10%. Thirteen percent of the population had added sugars intake > 25%. The mean g-eq added sugars intake of 83.1 g-eq/day and added sugars food sources were comparable to the mid-1990s. Higher added sugars intakes were associated with higher proportions of individuals with nutrient intakes below the EAR, but the overall high calorie and the low quality of the U.S. diet remained the predominant issue. With over 80% of the population at risk for select nutrient inadequacy, guidance may need to focus on targeted healthful diet communication to reach the highest risk demographic groups for specific life stage nutrient inadequacies.
Soldiers, like civilians, use large amounts of DSs, often in combination. Soldiers use more DSs purported to enhance performance than civilians use when matched for key demographic factors. These differences may reflect the unique occupational demands and stressors of military service.
This magnitude of effect is unusual in efforts to reduce antibiotic use in nursing homes. Outcomes could be attributed to the commitment of the providers; outreach to providers and staff; and a focus on common clinical situations in which antibiotics are generally not indicated; and suggest that similar results can be achieved on a wider scale if similar commitment is obtained and education provided.
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