A simple dietary message to improve dietary quality: Results from a pilot investigation
ABSTRACT OBJECTIVE: The present study compared the feasibility of two simple messages (a high-fiber diet or a low saturated fat diet) to a combination message (high fiber/low saturated fat) on their potential to affect dietary quality and metabolic health. METHODS: Thirty-six subjects were randomized to one of three intervention conditions and received individual dietary counseling sessions. Study assessments occurred at baseline, 3 mo, and 6 mo. RESULTS: The sample was 84% female and 94% Caucasian. Mean body mass index was 31kg/m(2). At the 6-mo assessment phase, we retained all 12 patients in the high-fiber diet condition, 10 of 12 in the low saturated fat condition, and 9 of 12 in the combination condition. Participants reported that the dietary fiber intervention was easier to maintain compared with the other two intervention conditions (83% for high dietary fiber versus 60% for low saturated fat versus 33% for the combination, P=0.008). Overall dietary quality improved in all three conditions during the study (P=0.01). In addition to increasing fiber, the high-fiber condition decreased their saturated fat intake, even though a reduction in saturated fat was not a part of that intervention condition. Participants in all three conditions lost an average of 9 lb from baseline weight (P<0.001). CONCLUSION: A simple dietary message is feasible and can improve overall dietary quality. Results support the need for a larger randomized controlled trial that is powered to detect the efficacy of a simplified dietary recommendation for dietary quality and metabolic health.
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ABSTRACT: To describe the incidence and causes of glaucoma after Descemet membrane endothelial keratoplasty (DMEK). Nonrandomized prospective cohort study at a tertiary referral center. The incidence of glaucoma was evaluated in the first 275 consecutive eyes that underwent DMEK for Fuchs endothelial dystrophy (260 eyes) or bullous keratopathy (15 eyes). Glaucoma was defined as a postoperative intraocular pressure (IOP) elevation of ≥24 mm Hg, or ≥10 mm Hg from the preoperative baseline. If possible, the cause of glaucoma was identified, and best-corrected visual acuity (BCVA), endothelial cell density (ECD), and postoperative course were documented, with a mean follow-up of 22 (± 13) months. Overall, 18 eyes (6.5%) showed postoperative glaucoma after DMEK. Seven eyes (2.5%) had an exacerbation of a pre-existing glaucoma. Eleven eyes (4%) presented with a de novo IOP elevation, associated with air bubble-induced mechanical angle closure (2%), steroid response (0.7%), or peripheral anterior synechiae (0.4%), or without detectable cause (0.7%). Two eyes (0.7%) required glaucoma surgery after DMEK. At 6 months, all eyes had a BCVA of ≥20/40 (≥0.5), and 81% reached ≥20/25 (≥0.8) (n = 16); mean ECD was 1660 (± 554) cells/mm(2) (n = 15) (P > .1). Glaucoma after DMEK may be a relatively frequent complication that could be avoided by reducing the residual postoperative air bubble to 30% in phakic eyes, applying a population-specific steroid regime, and avoiding decentration of the Descemet graft. Eyes with a history of glaucoma may need close IOP monitoring in the first postoperative months, especially in eyes with an angle-supported phakic intraocular lens.American Journal of Ophthalmology 01/2012; 153(5):958-966.e1. DOI:10.1016/j.ajo.2011.10.003 · 4.02 Impact Factor
Journal of the American Academy of Nutrition and Dietetics 05/2012; 112(5):621-3. DOI:10.1016/j.jand.2012.01.024 · 2.44 Impact Factor
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ABSTRACT: Evidence from prospective studies is consistent in showing an inverse association between dietary fibre intake and risk of ischaemic heart disease (IHD), but whether dietary fibre from various food sources differ in their effect on IHD risk is less clear. The objective of this study was to assess the associations of total and food sources of dietary fibre with IHD mortality in the European Prospective Investigation into Cancer and Nutrition-Heart study. Participants were 306,331 men and women from eight European countries. Dietary fibre intake was assessed using centre or country-specific diet questionnaires and calibrated using a 24-h diet recall. After an average follow-up of 11.5 years, there were 2381 IHD deaths among participants without cardiovascular disease at baseline. The calibrated intake of dietary fibre was inversely related with IHD mortality; each 10 g/day was associated with a 15% lower risk (relative risk (RR) 0.85; 95% confidence interval (CI): 0.73-0.99, P=0.031). There was no difference in the associations of the individual food sources of dietary fibre with the risk of IHD mortality; RR for each 5 g/day higher cereal fibre intake was 0.91 (CI: 0.82-1.01), RR for each 2.5 g/day fruit fibre intake was 0.94 (CI: 0.88-1.01) and RR for each 2.5 g/day vegetable fibre intake was 0.90 (95% CI: 0.76-1.07). A higher consumption of dietary fibre is associated with a lower risk of fatal IHD with no clear difference in the association with IHD for fibre from cereals, fruits or vegetables.European journal of clinical nutrition 05/2012; 66(8):950-6. DOI:10.1038/ejcn.2012.51 · 2.95 Impact Factor