Nutrition Assessment - Science topic

There is a growing debate over the validity and value of data derived from memory-based dietary assessment methods (M-BMs) such as FFQs, food diaries, and 24HRs. My empirically supported position is that all forms of M-BMs are pseudo-scientific, produce non-falsifiable and physiologically implausible data, and should not be used in nutrition research. Please see the recent 'Controversy & Debate' Series in the Journal of Clinical Epidemiology for details: Archer E, Marlow ML, Lavie CJ. The Fatal Flaws of Food Frequency Questionnaires and Other Memory-Based Dietary Assessment Methods. Journal of Clinical Epidemiology. 2018.

Link: Archer E, Marlow ML, Lavie CJ. Controversy and Debate: Memory-Based Dietary Assessment Methods Paper #3. Journal of Clinical Epidemiology. 2018. Link:

QUESTION "Your tests are equally prone to error as self reported diet and exercise."  How can scientific testing done correctly be equal to self-reporting?  ANSWER: Scientific testing produces false positives and false negatives, which cause more testing.  I believe that tests for prostate cancer in men have been stopped because they resulted in more damage than good.  This is true in the testing for preeclampsia but when it comes to women there is not the fear of doing damage as we see in the sky high rates of cesarean and induction, which do kill women. In interviews with doctors, most people do tend to tell some truths when they visit the doctor and the problem is not false positives, but the doctor being skilled enough or interested enough to ask them the right questions.  For example, instead of asking do you smoke, one can ask, how many cigarettes do you smoke per 24 hours?  Look for signs of smoking.   One can insist on a three day diet diary.

QUESTION "And once you make a home visit, then there is no error." A home visit is no guarantee of truthfulness, obviously one cannot watch them every day! ANSWER: I would guess that you are not familiar with home visits.  At home visits, you see exactly what is going on if you pay attention.  Just open the refrigerator and the food cabinets and go to the bathroom.  If one is interested, there is very little one can hide at a properly conducted home visit.  People are not going to go stock up on tons of foods that they never eat.

I dont know how the conversation got changed from tests for preeclampsia to infertility, but infertility is of course very related to diet and life style and whether the couple are copulating.

 Thanks for your questions.

Ok, According to A.S.P.E.N guideline in determination of required fluid in ml/ day by multiply % water in formula times daily formula in mL to determine water contribution of EN.

Subtract formula water from total fluid requirements to determine water flushes.

For example,

Patient needs 2200 ml fluid

2000 ml formula * 84% water = 1680 ml

So, 2200 - 1680 = 520 ml of additional water ( by IV or medication dilution).

spectrophotometric method.

Very intelligently placed question on a very intriguing issue , which needs to be addressed in providing the comprehensive schedule of fertigation , instead of regulating NPK through fertigation and practicing foliar spray for micronutrients. Lets listen from our colleagues , why there are limited efforts on fertigation of micronutrients, regardless of crops . Is it because of better efficacy of foliar spray over fertigation  or any other reasons .

The Truth about L-Carnitine Side Effects

by Dr. Julian Whitaker

Filed Under: Heart Health, Nutritional Support

Last Reviewed 03/28/2014

The Truth about L-Carnitine Side Effects

As you may have read or heard in the news lately, a new study published in the journal Nature Medicine suggests that the L-carnitine, not the saturated fat, found in red meat is the real culprit in heart disease risk and that L-carnitine supplements are unsafe and have side effects. Folks, this is just the latest example of the pitfalls associated with mainstream media reporting and medical research.

First of all, the study authors state that gut bacteria convert carnitine into a compound called trimethylamine-N-oxide (TMAO), and they believe that TMAO allows cholesterol to build up in artery walls, thereby raising heart disease risk. However, even if carnitine is converted to TMAO, it is highly unlikely to be a primary player in red meat’s adverse health effects, as the researchers theorized. Here’s why.

A pound of steak contains approximately 400 mg of carnitine, some of which is likely converted to TMAO. But a pound of fish contains 1,700 mg of TMAO. So if TMAO is the real culprit then why is fish, which contains much more TMAO than what your body would convert from the L-carnitine found in red meat, universally accepted as being cardio-protective?

No Studied L-Carnitine Side Effects with Normal Usage

As for the suggestion that L-carnitine side effects are harmful, this is simply a matter of guilt by association. The researchers state that when mice were fed the human equivalent of 26,000 mg of carnitine per day, they developed arterial blockages—that equate to 26–52 times the normal supplement dose of 500–1,000 mg!

Furthermore, all of the news reports neglected to mention any of the previous human clinical trials and other studies that demonstrated carnitine’s significant benefits, including those studies using rabbits, which are considered to be the best model of human heart disease.

The bottom line: I stand by my recommendation of 500–1,000 mg of supplemental L-carnitine per day.

Now it’s your turn: Do you take L-carnitine supplements?

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Protocol established by CSIRO might help you. 

Review these documents have a comprehensive approach to the issue.

Dear Priyabrata,

The following links may be of help.

De B, Nag G. Metabolic diversity in the grains of Indian varieties of rice. C R Biol. 2014 Apr;337(4):283-93. doi: 10.1016/j.crvi.2014.01.006. Epub 2014 Mar 11. PubMed PMID: 24702898.

Shobana S, Malleshi NG, Sudha V, Spiegelman D, Hong B, Hu FB, Willett WC, Krishnaswamy K, Mohan V. Nutritional and sensory profile of two Indian rice varieties with different degrees of polishing. Int J Food Sci Nutr. 2011

Dec;62(8):800-10. doi: 10.3109/09637486.2011.585962. Epub 2011 May 27. PubMed PMID: 21619458.

Ti H, Li Q, Zhang R, Zhang M, Deng Y, Wei Z, Chi J, Zhang Y. Free and bound

phenolic profiles and antioxidant activity of milled fractions of different

indica rice varieties cultivated in southern China. Food Chem. 2014 Sep

15;159:166-74. doi: 10.1016/j.foodchem.2014.03.029. Epub 2014 Mar 17. PubMed

PMID: 24767040.

Quantification of tocopherols, tocotrienols, and γ-oryzanol contents and their distribution in some commercial rice varieties in Taiwan.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959956/   

For tracking individual dietary patterns, FFQ's are more appropriate. 24 hour recalls are more appropriate if you are trying to gauge a specific demographic's eating patterns.

Helo Dr Sieber,

you can find good information about malnutrition in 

regards

Dear  Khushboo Verma,

The variation in the prevalence of these indicators is due to the population to which the measurements are taken. That is why several authors associate nutritional status with socioeconomic and demographic factors, and viceversa. It is important to understand the association and involvement of economic's factors and the access to some food that are also found related. I have built a table that show how in some cases when you do not have anthropometric measures for nutritional status, it is done through economic indicators. I leave the link if it's any response .

Regards.

You might want to specifically consider Iodine deficiency if you collect data on nutritional habits of people living in mountainous regions. From the Himalayas to the Balkans people suffer from Iodine deficiency disorders especially where the natural pattern includes alternating flood plains and mountains. Iodine deficiency is associated with high prevalence of endemic cretinism, goiter, short stature, and deafness resulting in loss of intellectual capacity.

Even in areas with moderate iodine deficiency (iodine ingestion 20 to 49 μg/day), clinically euthyroid children and adults often have definite abnormalities of psychomotor and intellectual development.

Delange F, Bürgi H, Chen ZP et al. Thyroid 2002;12:915–24

Berbel P, Obregón MJ, Bernal J et al. Trends Endocrinol

Metab 2007;18:338–43

Modern Nutrition 11th ed. Chapter 95

Hope that helps

IG

I'm guessing you are searching for international resources. I'm less familiar with those. However, in the US the Oley Foundation has educational resources for patients in need of home enteral and parenteral nutrition support. They also have an equipment exchange: http://www.oley.org/equipexchange.html.

Lesley Haynes no longer practises as a Registered Dietitian and is now retired.

Agree with Ali and Namukolo

At WHO data base  there is a data on  minerals and vitamins and their assessment methodds  

Send out short surveys.

In research studies where gender interferes with the results of the study, the more acceptable and rational way to neutralise its effect is: 1-to match the study groups regarding gender or 2- if possible, carry out the study in single gender, the most appropriate one.

Good Luck.

Hello George,

I think that one of the most reliable screening tools to assess malnutrition is the 'Malnutrition Universal Screening Tool' ('MUST'). Also, Onodera's prognostic nutritional index (OPNI) is an easily calculated scoring system for malnutrition.