Journal of the Academy of Nutrition and Dietetics
-
Food insecurity acts as a chronic stressor independent of poverty. Food-insecure adults may consume more highly palatable foods as a coping mechanism, leading to poorer diet quality and increased risks of chronic disease over time. Using data from the 1999-2008 National Health and Nutrition Examination Surveys, this study aimed to examine the cross-sectional differences in dietary intake and diet quality by household food security among 8,129 lower-income adults (≤300% of the federal poverty level). ⋯ No differences were observed for intakes of total energy and macronutrients. Food insecurity was significantly associated with lower Healthy Eating Index-2005 (P trend<0.0001) and Alternate Healthy Eating Index-2010 scores (P trend<0.0001). Despite no macronutrient differences, food insecurity was associated with characteristics of poor diet quality known to increase chronic disease risk.
-
Observational Study
Delivery of enteral nutrition after the introduction of practice guidelines and participation of dietitians in pediatric critical care clinical teams.
Provision of optimal nutrition is often difficult to achieve in the critically ill child, but can improve with better nutritional support practices. This study evaluated the joint impact of the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds on enteral nutrition (EN) intake and practices in children in intensive care. Nutritional intake and EN practices were audited before (period A) and after (period B) the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds in a pediatric intensive care unit. ⋯ In the same group, the percentage of daily fluid intake delivered as EN increased post implementation (period A: median=66.8%; interquartile range=40.9 vs period B: median=79.6%; interquartile range=35.2; P<0.001). No significant changes were seen in patients admitted for corrective heart surgery. Implementation of better EN support practice can improve nutritional intake in some patients in critical care, but can have limited benefit for children admitted for corrective heart surgery.
-
Stress has been associated with eating patterns in human studies with differences due to the type and duration of stressor, type of food, and individual susceptibility factors. Laboratory and smaller epidemiological studies have reported stress-associated preferences for foods high in sugar and fat; associations have been found more consistently among women and people who are obese. Larger studies are needed to sufficiently test these relationships. ⋯ Among those with high perceived stress vulnerability, perceived stress was associated with fewer eating occasions (P for interaction <0.0001). Although associations were small, significant relationships were found for perceived stress arising from everyday experiences among an older, mostly white population. These findings have public health implications and suggest that stress may be important to consider in programs promoting healthy eating.