J Am Diet Assoc
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Artificial nutrition is widely advocated as adjunctive care in patients with a variety of underlying diseases. In recent years more emphasis has been placed on delivering it directly into the gastrointestinal tract through tubes in the stomach or proximal small intestine (enteral nutrition). Because the efficacy of any therapeutic intervention is best established by demonstrating it in one or more randomized controlled trials, this review focuses on data from such studies. ⋯ Enteral nutrition was not helpful when given during the first week to patients with dysphagic strokes. Thus, the randomized controlled trials that have compared enteral nutrition to no artificial nutrition have only found benefit when the methodologic rigor of the studies is inadequate to prevent bias from interfering with the interpretation of the data. No high-quality data are available to prove that enteral nutrition is of benefit.
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Food and nutrition professionals can play a major role in reversing the diabetes epidemic by helping patients reduce their risk for diabetes and prevent its onset. The Diabetes Prevention Program (DPP) clinical trial, spearheaded by the National Institutes of Health, has provided the research-based evidence needed to demonstrate that type 2 diabetes can be delayed or prevented through a 5% to 7% weight loss and regular physical activity, such as 150 minutes a week of brisk walking. The National Diabetes Education Program, through its "Small Steps. ⋯ The initiative includes a health care professional toolkit, user-friendly weight-loss materials for patients, and a mass media campaign to increase awareness that diabetes can be delayed or prevented. Food and nutrition professionals can access these materials free of charge online or through the National Diabetes Education Program clearinghouse. By applying the lessons learned from the DPP to patients at risk for diabetes, food and nutrition professionals can make a substantial contribution to reversing the diabetes epidemic.
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Intravenous (parenteral) nutrition has been advocated widely as adjunctive care in patients with a variety of underlying diseases. However, the enthusiasm for this therapeutic intervention was based largely on expert opinion. Because the best way to assess the efficacy of any treatment is to test it in a randomized controlled trial, this review will focus on data that was derived from such studies. ⋯ Parenteral nutrition was harmful when provided to patients undergoing radiation or chemotherapy for cancer. Although no randomized controlled trials exist, it is assumed that parenteral nutrition is useful in patients with an inadequate gastrointestinal tract ("short gut"). Thus, for the most part, randomized controlled trials comparing intravenous nutrition to no artificial nutrition have not shown that this medical intervention is of benefit.
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To examine the relationship between consumption of sugar-sweetened beverages (eg, nondiet carbonated drinks and fruit drinks) and the prevalence of overweight among preschool-aged children living in Canada. ⋯ Regular sugar-sweetened beverage consumption between meals may put some young children at a greater risk for overweight. Parents should limit the quantity of sweetened beverages consumed during preschool years because it may increase propensity to gain weight.