Moderate-intensity exercise sustained for 16 months is effective for weight management in young adults.

GlaxoSmithKline.

H e a l t h P r o m o t i o n a n d P r o t e c t i o n F o o d a n d N u t r i t i o n P r o g r a m Table 1: Minimum number of meals required to attain the level of energy needed from complementary foods with mean energy density of 0.6, 0.8, or 1.0 kcal/g for children in developing countries with low or average levels of breast milk energy intake (BME), by age and group. Table 2: Minimum dietary energy density (kcal/g) required to attain the level of energy needed from complementary foods in 2-5 meals/d by children in developing countries with low or average level of breast milk intake (BME) Table 3: Percentage of energy from complementary foods that should be provided as fat to prepare diets with 30% or 45% of total energy as fat, for children in developing countries, by age group and level of breast milk energy intake PA N A M E R I C A N H E A LT H O R G A N I Z AT I O N W O R L D H E A LT H O R G A N I Z AT I O N Celebrating 100 Years of Health G U I D I N G P R I N C I P L E S F O R C O M P L E M E N T A R Y F E E D I N G O F T H E B R E A S T F E D C H I L D T A B L E S I N T R O D U C T I O NAdequate nutrition during infancy and early childhood is fundamental to the development of each child's full human potential. It is well recognized that the period from birth to two years of age is a "critical window" for the promotion of optimal growth, health and behavioral development. Longitudinal studies have consistently shown that this is the peak age for growth faltering, deficiencies of certain micronutrients, and common childhood illnesses such as diarrhea.After a child reaches 2 years of age, it is very difficult to reverse stunting that has occurred earlier (Martorell et al., 1994). The immediate consequences of poor nutrition during these formative years include significant morbidity and mortality and delayed mental and motor development. In the long-term, early nutritional deficits are linked to impairments in intellectual performance, work capacity, reproductive outcomes and overall health during adolescence and adulthood. Thus, the cycle of malnutrition continues, as the malnourished girl child faces greater odds of giving birth to a malnourished, low birth weight infant when she grows up. Poor breastfeeding and complementary feeding practices, coupled with high rates of infectious diseases, are the principal proximate causes of malnutrition during the first two years of life. For this reason, it is essential to ensure that caregivers are provided with appropriate guidance regarding optimal feeding of infants and young children.Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk. The target age range for complementary feeding is generally taken to be 6 to 24 months of age, even though breastfeeding may continue beyond two years. A review of feeding guidelines promoted by various national and international organizations has sho...

OBJECTIVE -To compare the efficacy and safety of continuous subcutaneous insulin infusion (CSII) and multiple daily injection (MDI) in older adults with insulin-treated type 2 diabetes and to assess treatment satisfaction and quality of life.RESEARCH DESIGN AND METHODS -Adults (n ϭ 107) Ն60 years of age (mean age 66 years) with insulin-treated type 2 diabetes (mean duration 16 years, BMI 32 kg/m 2 , and HbA 1C [A1C] 8.2%) were randomized to CSII (using insulin lispro) or MDI (using insulin lispro and insulin glargine) in a two-center, 12-month, prospective, randomized, controlled clinical trial. Efficacy was assessed with A1C, safety by frequency of hypoglycemia, and treatment satisfaction and quality of life with the Diabetes Quality of Life Clinical Trial Questionnaire and the 36-item short-form health survey, version 2.RESULTS -Forty-eight CSII subjects (91%) and 50 MDI subjects (93%) completed the study. Mean A1C fell by 1.7 Ϯ 1.0% in the CSII group to 6.6% and by 1.6 Ϯ 1.2% in the MDI group to 6.4%. The difference in A1C between treatment groups was not statistically significant (P ϭ 0.20). Eighty-one percent of CSII subjects and 90% of MDI subjects experienced at least one episode of minor (self-treated) hypoglycemia (P ϭ 0.17), and three CSII and six MDI subjects experienced severe hypoglycemia (P ϭ 0.49). Rates of severe hypoglycemia were similarly low in the two groups (CSII 0.08 and MDI 0.23 events per person-year, P ϭ 0.61). Weight gain did not differ between groups (P ϭ 0.70). Treatment satisfaction improved significantly with both CSII and MDI (P Ͻ 0.0001), and the difference between groups was not statistically significant (P ϭ 0.58).CONCLUSIONS -In older subjects with insulin-treated type 2 diabetes, both CSII and MDI achieved excellent glycemic control with good safety and patient satisfaction. Diabetes Care 28:1568 -1573, 2005I n the U.S., Ͼ20% of adults Ͼ65 years of age have diabetes (1). The risk of micro-and macrovascular complications increases in elderly patients with diabetes and is associated with higher hemoglobin HbA 1C (A1C) and longer duration of diabetes (2). In middle-aged adults with type 2 diabetes, intensive glycemic management can delay or prevent the development of microvascular and neuropathic complications (3,4). While the benefits of glycemic management are less clearly established in older adults, both the American Diabetes Association and the American Geriatrics Society recommend that older adults with good functional status maintain A1C levels Ͻ7% (5,6). Despite these recommendations, surveys have shown that only onethird of diabetic patients 65-74 years of age had A1C levels Ͻ7%. Of those using insulin, only 27% had A1C levels Ͻ7%, whereas nearly half had A1Cs Ͼ8% (7).While lifestyle changes and oral antidiabetes medications can improve glycemic control early in the course of type 2 diabetes, insulin is often required to reach A1C goals later in the course of disease. Intensive insulin therapy regimens employ either continuous subcutaneous insulin infusion (CSII) or mul...