Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
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Caffeine and related methylxanthine compounds are recognized as having a diuretic action, and consumers are often advised to avoid beverages containing these compounds in situations where fluid balance may be compromised. The aim of this review is to evaluate the available literature concerning the effect of caffeine ingestion on fluid balance and to formulate targeted and evidence-based advice on caffeinated beverages in the context of optimum hydration. ⋯ The most ecologically valid of the published studies offers no support for the suggestion that consumption of caffeine-containing beverages as part of a normal lifestyle leads to fluid loss in excess of the volume ingested or is associated with poor hydration status. Therefore, there would appear to be no clear basis for refraining from caffeine containing drinks in situations where fluid balance might be compromised.
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Obesity is on the increase yet within the National Health Service (NHS) treatment approaches differ greatly and service is patchy. Our aim was to compare current practice within a general dietetic clinic with a new clinic developed specifically for patients of higher morbidity risk. ⋯ Lifestyle clinics facilitate beneficial lifestyle changes which impact positively on morbidity risk factors demonstrating an improvement on current service offered within the NHS. There is an obvious resource implication of offering an intensive management package. There is need for a randomized control trial with analysis to evaluate whether there is cost benefit from this type of intervention.
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Vitamin D deficiency has been described in the Asian migrants to the UK from the early 1960s. In spite of some suggestions that this problem is declining, we continue to see clinical cases of vitamin D deficiency with osteomalacia presenting to hospital. As the aetiology of this condition is associated with social, cultural and dietary factors, we screened associated family members of 18 index cases (three males 15 females, age range 12-73 years) who presented with clinical vitamin D deficiency to hospital. ⋯ Some subjects also had hypocalcaemia (n=2), low PO4 (n=7), raised PTH (n=8) and raised alkaline phosphatase (n=11), indicating severe symptomatic, but unrecognized, vitamin D deficiency. Family screening seems an effective way of identifying Asian subjects with vitamin D deficiency who otherwise remain undiagnosed. A preventative policy with implementation is long overdue for this easily treatable condition.
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Comparative Study
A reassessment of the fat intake of children from meat and meat products and an estimate of haem iron intakes.
It is possible that fat intake from red meat has declined as a consequence of changes in animal husbandry and butchery practices. In particular, a study of the intake of vegetarian and meat-eating children concluded that their fat intakes were similar, but the most recent information on the fat content of meat was not available. In addition, iron availability is probably as important as the total amount of iron consumed but estimates of haem iron intake are rarely made. ⋯ The original estimates of the intake of fat of these omnivorous children from meat and meat products do appear to have been overestimates, but only as the weight of fat consumed not as a percentage of energy. Haem iron was found to supply a substantial proportion of the iron intake of these children and may account for their higher haemoglobin values.