Human ecology requires both oxygen and water with the generation from food of an immediate energy source, ATP, by oxidative phosphorylation. A continuing balance between oxidation and antioxidation is necessary for longer less-disabled lives, taking account of oxidative stresses and the critical roles of oxidants in defence against infection, tissue repair and signalling. Antioxidant capacity is derived both exogenously (from food, beverage and sunlight) and endogenously (from enzymatic and non-enzymatic pathways). A number of oxidant food factors service antioxidant metallo-enzymes. The capacity operates extra- or intracellularly. Uric acid is the major antiox- idant in primate blood. Uric acid synthesis is increased by dietary fructose from fruit, sugary foods and drinks. This indirect antioxidant effect of fruit is separate from that attributable to its flavonoids. Alcohol also increases serum uric acid. Urate excess and retention is associated with disease. The high prevalence of hyperuricaemia in NE Asia presents a major public health dilemma in regard to putative benefits and risks. Foods with high antioxi- dant activity include berries, nuts and legumes, tomatoes and sweet potato leaves. Each of the antioxidants in the- se foods is pleiotropic being inter-alia anti-inflammatory, anti-angiogenic or anti-neoplastic. Moreover, food ma- trices and patterns contribute to the safety of antioxidant consumption. There is no evidence to date that isolated antioxidants as food supplements improve health outcomes or survival; and some that indicate unacceptable risk. Their use as biomarkers of food cannot justify their isolated use. Nevertheless, a spectrum of dietary pluripotential antioxidants for tissues, metabolic and immune systems is advantageous.
Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic in- flammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross- sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjust- ment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, -0.094; p<0.001). It was found that in individuals who consumed 1 unit of foods containing high die- tary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the varia- tion in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.
Obesity is related to hyperlipidemia and risk of cardiovascular disease. Health benefits of vegetarian diets have well-documented in the Western countries where both obesity and hyperlipidemia were prevalent. We studied the association between BMI and various lipid/lipoprotein measures, as well as between BMI and predicted coronary heart disease probability in lean, low risk populations in Southern China. The study included 170 Buddhist monks (vegetarians) and 126 omnivore men. Interaction between BMI and vegetarian status was tested in the multivaria- ble regression analysis adjusting for age, education, smoking, alcohol drinking, and physical activity. Compared with omnivores, vegetarians had significantly lower mean BMI, blood pressures, total cholesterol, low density li- poprotein cholesterol, high density lipoprotein cholesterol, total cholesterol to high density lipoprotein ratio, trig- lycerides, apolipoprotein B and A-I, as well as lower predicted probability of coronary heart disease. Higher BMI was associated with unfavorable lipid/lipoprotein profile and predicted probability of coronary heart disease in both vegetarians and omnivores. However, the associations were significantly diminished in Buddhist vegetarians. Conclusions: Vegetarian diets not only lower BMI, but also attenuate the BMI-related increases of atherogenic li- pid/lipoprotein and the probability of coronary heart disease.
Hair mineral analysis using an X-ray fluorescence spectrometer as a method of estimating body fat percentage (BF%) was investigated. Body fat percentage of 24 healthy Japanese, aged 20-27 years, was measured using a hand-held impedance analyzer (BF%IMP). X-ray (Kα-ray) intensities of sulfur, chlorine, potassium, calcium, tita- nium, and iron (Fe) in hair were measured using an X-ray fluorescence spectrometer. Body fat percentage was also measured using a Hologic whole body dual energy X-ray absorptiometer (BF%DXA) in nine subjects selected from the above 24 subjects based on their BF%IMP. Correlations of the two BF%s with Fe-Kα were significant (BFIMP: r = 0.60 n = 24, p <0.01; BFDXA: r = 0.67 n = 9, p<0.05). The mean (±SD) biases (measured minus esti- mated using multiple regression equations by Fe-Kα) for BF%IMP and BF%DXA were 2.97 ± 2.25% and 1.77 ± 1.33%, respectively. The SEEs for the two equations for BF%IMP and for BF%DXA were less than 4%. These re- sults suggest that Fe-Kα may be a predictor of body fat percentage. However, the subjects were few and only Jap- anese in their twenties, so that further investigation is needed for methodological generalization.
This study describes Japanese mothers’ knowledge and attitudes towards breastfeeding using the Iowa Infant Feeding Attitudes Scale (IIFAS). A cross-sectional survey of 1,612 mothers was conducted in Japan in 2007. The participants were recruited at the free health checks conducted for infants at 18 months of age. The survey was self-administered using the Japanese version of the IIFAS. Descriptive statistics were used to summarise sample characteristics and IIFAS score followed by multiple logistic regression to identify association between total IIFAS score and breastfeeding duration. While the IIFAS showed that the majority recognized some benefits of breastfeeding, their overall knowledge and attitudes towards breastfeeding were neutral and more positive to- wards the use of infant formula. It is important to provide accurate prenatal education that focuses on methods and long-term benefits of infant feeding to mothers, family and health professionals.
This study aimed to translate and validate a Chinese (simplified) version of the Iowa Infant Feeding Attitude Scale (IIFAS) and compare the infant feeding attitudes of Chinese mothers living in Perth Australia and in Chengdu P.R. China. A survey was undertaken on 200 Chinese mothers living in Perth and 1620 mothers living in Chengdu. The simplified Chinese version of IIFAS had a moderate level of internal consistency with a Cronbach’s alpha of 0.69 for mothers in Australia and 0.55 for mothers in China. The mean IIFAS scores in both country groups lay in the range of ‘neutral breastfeeding attitudes’. Higher IIFAS scores were significantly asso- ciated with the likelihood of both breastfeeding initiation (OR: 3.85; CI: 2.49-5.96; p<0.001) and longer (≥8 months) breastfeeding duration (OR: 2.52; CI: 1.87-3.40; p<0.001). Chinese mothers in Perth (mean IIFAS score=60.0±6.3) tended to have more positive attitudes towards breastfeeding than mothers in Chengdu (mean IIFAS score=57.7±5.1, p<0.001), and had a longer duration of ‘any breastfeeding’ (10.0±6.2 months in Perth compared to 7.4±4.3 months in Chengdu, p<0.001). In conclusion, higher scores on the IIFAS in simplified Chi- nese are associated with breastfeeding initiation and duration in Chinese populations.
The aim of the present study was to clarify clinical factors in low birth weight infants and their mothers associat- ed with exclusive breastfeeding at both neonatal intensive care unit (NICU) discharge and the start of comple- mentary feeding. One hundred and fifteen low birth weight children and 98 mothers attending the follow-up clin- ic of two tertiary NICUs in Nara prefecture (Japan), between June and September, 2011, were enrolled. The rela- tionship between the feeding categories at NICU discharge or the start of complementary feeding, and clinical factors of the mothers and low birth weight infants collected by either their charts or a face-to-face interview was analyzed. The prevalence of exclusive breastfeeding was 22.6% at NICU discharge, and 15.7% at the start of complementary feeding. In logistic analysis, exclusive breastfeeding at NICU discharge was associated with mother’s younger age at delivery and an earlier start of oral nutrition. Among 26 exclusively breast-fed infants at NICU discharge, fifteen infants (57.7%) were still being exclusively breast-fed at the start of complementary feeding. In low birth weight infants, a shorter stay at NICU and an earlier start of oral nutrition were associated factors with exclusive breastfeeding at the start of complementary feeding. None of maternal factors were found to be associated with exclusive breastfeeding at the start of complementary feeding. Conclusively, starting of oral nutrition as early as possible is thought to be crucial for introducing exclusive breastfeeding in low birth weight infants both at NICU discharge and the start of complementary feeding.
Purpose: To describe the fatty acid composition of human colostrum in three different regions of China. Methods: Women were recruited from river/lake, coastal and inland regions of China during late pregnancy. Their diet frequency was assessed during the 34th week of pregnancy. Colostrum samples were collected between post- partum days 3 and 5. Thirty-one different fatty acids were separated and identified in colostrum. Results: There were significant differences among the women in the three regions with respect to food and culinary oil consump- tion patterns. The mean±SD fat content (g/100 g) of colostrum from river/lake, coastal and inland regions was 2.17±1.26, 2.50±1.39 and 2.68±1.26, respectively (p=0.265, adjusted by pregnant women’s age). The main satu- rated, monounsaturated, n-6 polyunsaturated and n-3 polyunsaturated fatty acids in colostrum were 16:0, 18:1n9, 18:2n6 and 18:3n3, respectively. Colostrum from river/lake region had the lowest composition of total SFA and of total n-6 PUFA and the highest composition of total MUFA and of total n-3 PUFA. The amount of DHA (22:6n3) in colostrum (mean±SD, % wt/wt) was 0.51±0.18, 0.52±0.20 and 0.35±0.13 in the river/lake, coastal and inland regions, respectively (p=0.0002, adjusted by pregnant women’s age). Frequency of maternal marine fish intake during the late pregnancy was positively correlated with DHA in colostrum (r=0.203, p=0.040). Con- clusions: The fatty acid composition of colostrum differs across geographical regions in China, which may be re- lated to differences in maternal dietary pattern.
OBJECTIVE: The purpose of this study was to investigate preschool children’s body size and image, and analyze the impact of the primary caregiver on a child’s body size and awareness in Taiwan. METHODS: In a cross- sectional survey, 699 preschool children and their primary caregivers participated in this study. Our study used an anonymous self-administered questionnaire, which was divided into parts A and part B. Part A was a question- naire for the primary caregivers, including their demographic and anthropometric information, and expectation for children’s body size. Part B was a two part questionnaire for children, including the children’s expectation on their own body size and their consciousness in terms of body size evaluation by parents and teachers. Data was analyzed by chi-square analysis. RESULTS: In our study, the majority of boys and girls have a normal body size (69.0% and 64.6%, respectively). There was a significant positive correlation (p<0.05) between children and pri- mary caregivers’ body size, and a negative correlation (p<0.05) between children body size and caregivers’ edu- cation level. Furthermore, we found that caregiver’s satisfaction and evaluation of the children’s body size had significantly affected the children’s satisfaction towards their body size. CONCLUSION: Influences by the pri- mary caregiver is an important factor that affects a preschool child’s body size and body image in Taiwan. Body size evaluation by caregivers will influence the child’s satisfaction level.
The aims of this study were: 1) to explore the individual perceptions, experience and understandings of vitamin D deficiency (VDD) amongst African migrant women residing in high-rise public housing, 2) to identify the most useful sources of information about VDD among this population, and 3) to document the barriers and enablers to addressing VDD. The Health Belief Model was used to guide the study. Convenience sampling was used with women living in particular high-rise public housing. Five focus group discussions were conducted (n=30). The- matic analysis was used to code and categorise the data to develop a deeper, conceptual understanding of the is- sue. We found that participants were aware of VDD and could identify the impacts that VDD had on their health. Barriers to addressing VDD included the women’s: 1) living conditions in Australia, 2) risk of skin cancer, and 3) cultural roles in the family. The most positive strategy for preventing and addressing VDD was peer information sharing. This study has highlighted the significant need for health promotion strategies to combat VDD in this population. Future health promoting public health strategies for this population should encompass community- based peer education programs. This study demonstrates the critical role of qualitative inquiry in gaining a deeper understanding of VDD in a particular migrant community. It is clear that this issue requires a coordinated solution that must involve the community themselves. Health care professionals must take into consideration the multiple barriers that exist to address VDD which is a significant public health issue.
Knowledge of the dietary intake of essential and toxic elements in fast-developing Southeast Asian countries such as Vietnam is limited. Iron and Zn deficiency in Asia is a well-known problem and is partly due to rice constitut- ing a major part of the diet. Dietary habits are changing and there is a need to build more knowledge so authori- ties can give dietary recommendations. The aim of this study was to determine the total dietary intake of essential and potentially toxic elements and to assess the nutritional quality and food safety risks of the average Hanoi diet. Twenty-two foods or food groups were identified and 14 samples of each food group were collected from markets and/or supermarkets in the period 2007-2009. Water spinach, water dropwort, watercress, water mimosa and pond fish are typically produced in wastewater-fed systems. Therefore, these samples were collected both at mar- kets and from wastewater-fed production systems. The results showed little or no risk of toxic elements from the Hanoi diet in general. Further, element contributions from wastewater-fed products were low and does not seem to constitute a problem with respect to potentially toxic elements. A comparison of the average Hanoi dietary in- take of essential elements to required intakes shows that the Hanoi diet is sufficient in most elements. However, the diet may be insufficient in Ca, Cr, Fe, K and possibly Zn for which dietary diversification of biofortification might provide solutions.
Existing Australian diet quality indices have assumed links to health outcomes but their validity for this has not been reported. We extend the features of existing indices for Australian adults by constructing a new diet quality index (Aussie-DQI) using the national dietary guidelines linked to the Australia National Health Priority Areas. Construct validity was assessed using 24 hour dietary recalls from the 1995 National Nutrition Survey (n=10,851 adults aged 19 years and older). Construct and criterion validity were assessed using food frequency question- naire data from the Nambour Skin Cancer study (n=1355), a community-based longitudinal study with 16 year follow-up and cause-specific mortality outcomes. Generalised linear regression was used to assess associations between Aussie-DQI scores and socio-economic, demographic, health-behaviour characteristics, and food and nutrient intakes, while Cox proportional-hazards modeling was used to assess associations with cancer and all- cause mortality. A high Aussie-DQI score was associated with being female, being older, non-smoking status, and BMI in the normal range in both study populations; and Aussie-DQI scores were inversely associated with cancer mortality among men in multivariable-adjusted analyses (hazard ratio = 0.30, 95% CI: 0.11, 0.83; p for trends = 0.06). In conclusion, Aussie-DQI successfully discriminated diet quality and showed that men, younger adults, current smokers and those overweight/obese were less likely to consume foods that meet dietary recom- mendations; and that a high diet quality is associated with decreased risk of cancer mortality among men. This study adds further evidence to clarify the role of diet quality in decreasing mortality from chronic diseases.
In Japan, the "Food Education Basic Law" (The Basic Law on Shokuiku, food education) was enacted in 2005. The comprehensive food education programs, namely Shokuiku, aim to improve dietary practices to reduce lifestyle-related diseases. Dental caries is one of the diseases associated with inappropriate dietary habits. Thus, food education may influence the prevalence of dental caries. However, there are no data regarding the association between public based-food education and dental caries. The aim of the present study was to investigate the relationship between knowledge about comprehensive food education (Shokuiku) and dental caries experience in Japanese university students. A total of 2,184 students (1,240 men, 944 women), aged 18-20 years, were examined. They had attended the Shokuiku program while in junior/senior high school. The numbers of teeth present, and decayed, missing and filled teeth (DMFT) (dental caries experience) were recorded. Addi- tional information was collected via a questionnaire regarding knowledge about food education, dietary habits and oral health behavior. Of the students, 315 men (20.7%) and 345 women (52.8%) reported that they know and can explain the meaning and content of the word "Shokuiku". After adjusting for potential confounding factors, subjects who did not have knowledge about Shokuiku had higher adjusted odds ratio (OR) for dental caries expe- rience (DMFT >0) than those who had (adjusted OR, 1.23; 95% CI, 1.02-1.48; p<0.05). These observations re- vealed that having knowledge about comprehensive food education in university students correlates with low prevalence of dental caries.
Recently, choline has been associated with neurodevelopment, cognitive function and neural tube defect inci- dence. However, data on usual intakes are limited, and estimates of dietary intakes of choline and its metabolite betaine, are not available for New Zealanders. The objective of the present study was to determine usual intake and food sources of choline and betaine in a group of New Zealand reproductive age women. Dietary intake data were collected from a sample of 125 women, aged 18-40 years, by means of a 3-day weighed food record, and usual choline and betaine intake distributions were determined. The mean (SD) daily intakes of choline and betaine were 316 (66) mg and 178 (66) mg, respectively. The total choline intake relative to energy intake and body weight was 0.18 mg/kcal and 5.1 mg/kg, respectively. Only 16% of participants met or exceeded the Adeuate Intake (AI) for adult women of 425 mg of choline. The top five major food contributors of choline were eggs, red meat, milk, bread and chicken; and of betaine were bread, breakfast cereal, pasta, grains and root vege- tables (carrots, parsnips, beetroot, swedes). Our findings contribute towards the recent emergence of published reports on the range of dietary choline and betaine intakes consumed by free-living populations. In our sample of New Zealand women, few participants were meeting or exceeding the AI level. Given recent epidemiological evidence suggesting health benefits of increased choline and betaine intakes, recommendations should be made to encourage the consumption of choline and betaine-rich foods.
Investigations of the association between an individual’s habitual amino acid intake and several types of health outcome require a comprehensive amino acid composition database. The lack of a database of the amino acid content of foods routinely consumed makes estimating daily amino acid intake difficult. The aim of this study was to develop an amino acid database for use in epidemiological studies, and to estimate amino acid intake among a Japanese population. Data were obtained from published food composition data, and when published da- ta were unavailable, calculated data were imputed using established criteria. Adequate data were available for 1100 food items. Using a purpose-developed amino acid composition table, we estimated amino acid intake among a Japanese population (121 women and 109 men aged 30 to 69 years) living in four areas in Japan using a 16-day diet record. All subjects met the estimated average requirements of the nine indispensable amino acids as reported by WHO/FAO/UNU. The major contributors to dietary amino acid intake were cereals, fish and shellfish, and meats, which accounted for approximately 60% of total intake. This database contains amino acid values of foods items frequently consumed in Japan, and represents a valuable tool for use in epidemiological studies.
Early postoperative nutrition improves outcomes. However, postoperative fasting is a tradition that persists in some areas of surgical practice. This retrospective audit was performed to benchmark current nutrition support practices on a mixed specialty surgical ward in a large tertiary-referral teaching hospital. Thirty-eight consecutive patients, who were undergoing gynaecological or urological surgical procedures between November 2010 and May 2011, had data collected including demographics, nutritional status, details of surgery performed, postopera- tive complications, modes of nutrition support and time taken to progress to solid oral diet. Energy and protein provision and adequacy was estimated for the first week postoperatively. Sixteen patients commenced parenteral nutrition postoperatively without any trial of oral or enteral nutrition. Reasons for using parenteral nutrition in- cluded observed or expected gut dysmotility and lack of enteral access for feeding. These patients did demon- strate longer length of stay and higher rates of postoperative complications. Given the proportion of patients initi- ated immediately on parenteral nutrition and maintained on it alone, it can be argued that these patients are not able to demonstrate tolerance and receive the benefits of early enteral feeding predicted by studies within these patient groups. None of the patients met their energy and protein requirements in the first week postoperatively. Despite support in the literature, it can be challenging to implement early postoperative nutrition support after pelvic surgery. It may be necessary to employ a variety of strategies to change this aspect of practice and promote earlier introduction of an oral diet or the use of enteral nutrition.
Background: NutritionDay is an annual worldwide cross-sectional multicentre audit. This report aimed to describe the results of nutritionDay 2010 in Jinling hospital, providing a map of the prevalence of malnutrition and actual nutrition therapy practice in different units. The risk factors to malnutrition and length of hospital stay were also investigated. Methods: The data was collected from 233 inpatients from Jinling hospital on Nov 4th, 2010, using standardized questionnaires. Malnutrition was objectively defined as BMI <20 or unintentional weight loss >5% in the past three months. Risk factors for malnutrition and the impact of multiple factors on length of hospital stay were analyzed. Results: 233 inpatients participated in this audit (143 M: 90 F; mean±SD age 50.6±18.5 years). Of the patients, 42.5%were malnourished. Multivariable analysis revealed three risk factors for malnutrition: gender, food intake and length of hospital stay before audit. Longer length of hospital stay prevailed in patients aged ≥65 years (p<0.001), and there was a positive and significant, but weak, correlation between length of hospital stay and age. Conclusions: The prevalence of malnutrition was high. Higher age may be the main contributor to longer length of hospital stay. This was the first study to obtain data from hospitalized patients’ nutritional status in China during the nutritionDay audit and the valuable results could supply evidence for clinical nutrition support.
Lack of protein and vitamin A influences the growth of student in impoverished mountain areas. The aim of the study was to assess the effects of egg and vitamin A supplementation on hemoglobin, serum retinol and anthro- pometric indices of 10-18 years old students of a low socioeconomic status. A total number of 288 students from four boarding schools were randomly selected by using cluster sampling method in Chongqing, and they were as- signed into supplement group and control group non-randomly. Students in supplement group received a single 200,000 international units vitamin A and 1 egg/day (including weekends) for 6 months. The control group did not receive any supplementation. We measured hemoglobin, serum retinol and height and weight at baseline and after supplementation. The supplementation increased the mean hemoglobin concentration by 7.13 g/L compared with 1.38 g/L in control group (p<0.001), the mean serum retinol concentration by 0.31 μmol/L compared with 0.09 μmol/L in the control group (p=0.005), the mean height-for-age z score by 0.05 compared with 0.03 in the control group (p=0.319), the mean weight-for-age z score by 0.05 compared with -0.12 in the control group (p<0.001). Our results revealed that egg and vitamin A supplementation is an effective, convenient, and practical method to improve the levels of hemoglobin, serum retinol and prevent the deterioration of growth in terms of weight for primary and middle school students from outlying poverty-stricken areas. Our intervention did not have a beneficial effect on linear growth.
Isoflavone in soybean and its products have numerous beneficial health effects. A number of clinical studies have demonstrated that dietary soy isoflavone can relieve menopausal symptoms, lower risks of breast cancer, and lower cholesterol and glucose. Among the various effects of isoflavone, the role of cholesterol and glucose reduc- tion seems to be well documented; however, other effects such as reproductive hormones were inconclusive and inconsistent. The main objective of the present study was to investigate the effects of six-month dietary traditional fermented soybean intake on BMI, reproductive hormones, lipids, and glucose among postmenopausal women. Subjects were women with their last menstrual period occurring at least 12 months prior to selection by interview and health screening from Baan Tham Village, Phayao Province, Thailand. A total of 60 women were divided in- to 2 groups: experimental group (n=31) and reference group (n=29). The experimental group was permitted to continue their usual diet, and supplemented with fermented soybean for 6 months. The fermented soybean pro- vided approximately 60 mg of isoflavone per day. The remarkable findings were that dietary fermented soybean had favorable effects on progesterone and cholesterol, but had no effects on estradiol, glucose, and triglycerides. Although estradiol and glucose in the experimental group did not change, a decrease of estradiol and an increase of glucose were found in the reference group. Our results, therefore, suggest that fermented soybean may have beneficial effects on reproductive hormones and cholesterol, and they would be warrant further detail investiga- tions.
Background: While previous studies have reported that feeding protocols improved clinical outcomes in critical care settings, the evidence supporting the application of feeding protocols in older patients has not yet been as- sessed. Here, we evaluated the effects of a feeding protocol in older patients fed through percutaneous endoscopic gastrostomy (PEG) tubes. Methods: We conducted a retrospective chart review of 109 patients aged ≥65 who un- derwent PEG placement between April 2010 and March 2012 at a single acute care hospital. The protocol group was administered enteral nutrition (EN) according to a feeding protocol, while the non-protocol group was ad- ministered EN at the attending physician’s discretion. Results: Length of hospital stay (LOS) overall and after EN initiation were significantly shorter in the protocol group than in the non-protocol group. (LOS: p=0.001; LOS af- ter EN initiation: p=0.026). During the second week after EN initiation, significantly fewer patients had percuta- neous oxygen saturation (SpO2) <93% and required oxygen therapy in the protocol group (p=0.032 for both com- parisons). Nutrition intakes via PEG in the protocol group were significantly greater from Days 6 to 13 for energy and from Days 6 to 11 for protein compared with the non-protocol group. Conclusion: The application of a feed- ing protocol after PEG placement in older patients was associated with shorter LOS, more efficient EN delivery, and lower incidence of low SpO2 than non-protocol group. Larger prospective studies are required to determine whether a feeding protocol is useful in improving health outcomes in this population.
Aim: Limited research in young overweight and obese women indicates that they are difficult to recruit to weight management trials, with attrition higher and weight loss success lower than middle to older age participants. This study aimed to evaluate the effectiveness of different recruitment strategies for a clinical weight loss trial in overweight and obese Generation Y women. Methods: Overweight and obese (BMI ≥27.5 kg/m-2) women aged 18-25 years (n=70) were required for a 12 month clinical weight management trial including diet, exercise and behaviour modification. Contact with researchers and eventual recruitment are reported for the various strategies employed to engage participants. Data reported as % or mean±SE. Results: Recruitment was challenging with only 50 of the total 70 participants recruited within the scheduled time frame (24 months). Just over one quarter (27%) of volunteers assessed were recruited. Flyers posted around local tertiary education campuses were the most successful method, yielding 36% of included participants. This was followed by advertisements on the local area health service intranet (26%) and in local and metropolitan newspapers (16%). Conclusions: Recruitment of overweight and obese Generation Y women for a clinical weight loss trial was difficult. Multiple strategies tar- geted at this age and gender group were required. Less rigorous selection criteria and reduced face-to-face inter- vention time may improve recruitment and retention rates into clinical trials for this age group.