May 2009 New in Review

May 2009 New in Review

from the association NEW IN REVIEW IN THIS ISSUE PERIODICALS 939 SITES IN REVIEW 945 Œ PERIODICALS Periodical articles of special interest to n...

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from the association

NEW IN REVIEW

IN THIS ISSUE PERIODICALS

939

SITES IN REVIEW

945

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PERIODICALS Periodical articles of special interest to nutrition professionals are cited or abstracted in this section. Articles that have been abstracted are marked with a darkened circle (●). Literature abstracts and citations are prepared by the Journal editors. Articles are selected from scientific and professional publications chosen to convey fundamental knowledge in nutritional science and to span the specialty practice fields of readers. A list of the publications reviewed for this section is published each year in the January issue. The current list, which includes contact information for each title, appears on page 174 of the January 2009 issue. Readers who want information about any article or publication appearing in New in Review should use this directory to locate the authors or editors of the original article or publication. AMERICAN FAMILY PHYSICIAN Vol 79, February 1, 2009 (www.aafp.org/ afp) Œ

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Osteoporosis Screening: Mixed Messages in Primary Care. Gourley M. 189-190. Diagnosis and Treatment of Osteoporosis. (Review). Sweet MG. 193200. Osteoporosis: Information from Your Family Doctor. (Patient Information). Eip201-202.

AMERICAN JOURNAL OF CLINICAL NUTRITION, THE Vol 89, February 2009 (pubs.nutrition.org)s Œ

Can a Small-Changes Approach Help Address the Obesity Epidemic? A Report of the Joint Task





Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. Hill JO. 477484. Serum Hepacidin Is Significantly Associated with Iron Absorption from Food and Supplemental Sources in Healthy Young Women. Young MF, Glahn FP, Ariza-Nieto M, Inglis J, Olbina G, Westerman M, O’Brien KO. 533-538. Optimization of a Phytase-Containing Micronutrient Powder with Low Amounts of Highly Bioavailable Iron for In-Home Fortification of Complementary Foods. Troesch B, Egli I, Zeder C, Hurrell RF, de Pee S, Zimmermann MB. 539-544. Protein Supplementation before and after Exercise Does Not Further Augment Skeletal Muscle Hypertrophy after Resistance Training in Elderly Men. Verdijk LB, Jonkers RA, Gleeson BG, Bellen M, Meijer K, Savelberg HH, Wodzig WK, Dendale P, van Loon LJ. 608-616.

Enhancing iron fortification. Iron fortification of food is hampered by low absorption and competition by other nutrients such as phytates. The purpose of this randomized blinded controlled study was to investigate the feasibility of promoting maximum iron absorption through the use of a low-iron micronutrient powder containing the enzyme phytase within a high-phytate meal. A convenience sample of 101 healthy Swiss women (mean body mass index 20.3, premenopausal, non-anemic) were assigned in groups of 16 to one of six maize porridge test meals labeled with isotopical compounds just prior to feeding. Meals contained different combinations of 60 mg ascorbic acid, 200 mg calcium, 3 mg iron, and 10 mg phytase commercial enzyme (DSM Nutritional Products, FS Phytase, Delft, The Netherlands). All test meals were fortified with a micronutrient powder. Participants consumed the test meal after an overnight fast. Blood was drawn at baseline and day 16 of the study. The outcome variable was change in iron status after the 14-day incorporation period. Results were statistically compared by paired and

© 2009 by the American Dietetic Association

nonpaired t-tests with log transformation of data that was not normally distributed. The use of phytase significantly increased the iron absorption by 7.4% with and without ascorbic acid compared to the baseline formula absorption of 1.5% with no correlation on length of time to consume the test meal. Iron absorption can be enhanced regardless of phytate content of meal by providing the phytase enzyme as part of the fortification procedure. Funding provided by the Foundation Nutrition Industry, Basel, Switzerland. Protein and resistance training. Most athletes believe that they must immediately replace protein after resistance training to maintain muscle mass. This randomized, placebo-controlled, double-blind clinical trial assigned 26 healthy sedentary elderly men (mean age 72⫾2 years) to a progressive 12week resistance exercise program with a 20-g protein or placebo supplement beverage after each of three weekly training sessions. One-repetition maximum (IRM) tests were used to control progressive workload. Outcome variables were changes in muscle hypertrophy assessed by whole body dual-energy x-ray absorptiometry, limb computed tomography, and muscle fiber biopsy from baseline to end of study. Blood samples, urine samples, and multiple day dietary intake records were also collected. Standardized test meals (57% carbohydrate, 13% protein, 30% fat) were provided on testing dates. Data analysis used a mixed-model repeatedmeasures analysis of variance both within and between groups. Groups were comparable at baseline. The IRM level increased by 25% to 35% in both groups with similar rise in both leg and quadriceps muscle mass. Muscle biopsy analysis of type I and type II fibers showed a slightly greater nonsignificant increase in muscle hypertrophy with type II. There was no statistical difference between the groups in all other outcome measures. Funding support by Anna Foundation and SCM Food Specialties in The Netherlands.

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NEW IN REVIEW US White and Black Adults. Reis JP, Araneta MR, Wingard DL, Macera CA, Lindsay SP, Marshall SJ. 134-142.

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY Vol 200, February 2009 (www.ajog.org) Œ

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Prospective Evidence that Lactation Protects against Cardiovascular Disease in Women. (Editorial). Gunderson EP. 119-120. Duration of Lactation and Incidence of Myocardial Infarction in Middle to Late Adulthood. Stuebe AM, Michels KB, Willett WC, Manson JE, Rexrode K, Rich-Edwards JW. 138.e1-138.e8.

AMERICAN JOURNAL OF PREVENTIVE MEDICINE Vol 36, February 2009, (www.ajpm.com) Œ

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Reducing Low Birth Weight through Home Visitation: A Randomized Controlled Trial. Lee E, MitchellHerzfeld SD, Lowenfels AA, Greene R, Dorabawila V, DuMont KA. 154160. Behavioral Change Interventions Delivered by Mobile Telephone Short-Message Service. Fjeldsoe BS, Marshall AL, Miller YD. 165173.

Vol 36, February 2009, Supplement 1 Œ

Study Designs and Analytic Strategies for Environmental and Policy Research on Obesity, Physical Activity, and Diet: Recommendations from a Meeting of Experts. Sallis JF, Story M, Lou D. S72-A77.

AMERICAN JOURNAL OF PUBLIC HEALTH Vol 99, February 2009 (www.ajph.org) Œ

Best-Practice Physical Activity Programs in Older Adults: Findings from the National Impact Study. Hughes SL, Seymour RB, Campbell RT, Whitelaw N, Bazzarre T. 362368.

ANNALS OF EPIDEMIOLOGY Vol 19, February 2009 (www.elsevier.org/ annepidem) Œ

Overall Obesity and Abdominal Adiposity as Predictors of Mortality in

ARCHIVES OF INTERNAL MEDICINE Vol 169, February 23, 2009 (www. archinternmed.com) ●

APPETITE Vol 52, February 2009 (www.elsevier.com) Œ



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Changes in Dietary Habits Following Temporal Migration. The Case of International Students in Belgium. Perez-Cueto F, Verbeke W, Lachat C, Remaut-De Winter A. 83-88. Increases in Energy, Protein, and Fat Intake Following the Addition of Sauce to an Older Person’s Meal. Appleton KA. 161-165. Food Cues in Children’s Television Programs. Radnitz C, Byrne S, Goldman R, Sparks M, Gantshar M, Tung K. 230-233. Development of Food Variety in Children. Nichlaus S. 253-255.

Sauce and appetite. As people age, their appetites may decrease, promoting malnutrition. This interventional open-label controlled study investigated the effect of the addition of a sauce to a single luncheon meal (meat, two vegetables, potato) in a cohort of 28 older, healthy-weight adults (seven men, 21 women, ⱖ65 year of age) residing in one of five Irish residential homes. Participants were served two different meals both with and without a sauce (gravy, mustard sauce, white sauce, vegetable-based) in the standard communal dining setting on separate consecutive weeks resulting in four total ratings. Pre-post food weight was recorded. Hunger and desire was rated on a five-point Likert scale. A 2⫻2 mixed analysis of variance and repeated measures t-tests were used to analyze the data. Results showed participants ingested significantly greater calories in the form of protein and fat during meals containing sauces. Carbohydrate intake was not changed. There was no difference in pre-post meal hunger or satisfaction rating. The primary difference was increased energy density provided by the sauce. No funding source was identified.

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Folic Acid, Pyridoxine, and Cyanocobalamin Combination Treatment and Age-Related Macular Degeneration in Women. The Women’s Antioxidant and Folic Acid Cardiovascular Study. Christen WG, Glynn RJ, Chew EY, Albert CM, Manson JE. 335-341. Association between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. Ginde A, Mansbach J, Camargo C. 384-390. Dairy Food, Calcium, and Risk of Cancer in the NIH-AARP Diet and Health Study. Park Y, Leitzmann MF, Subar AF, Hollenbeck A, Schatzkin A. 391-401.

Age-related macular degeneration. Homocysteine has been identified as a potential modifiable risk for age-related macular degeneration (AMD), and serum homocysteine can be reduced by a combination vitamin therapy. This randomized, double-blind, placebo-controlled clinical trial investigated the effect of combined folic acid (2.5 mg/day), pyridoxine hydrochloride (50 mg/day), and cyanocobalamin (1 mg/day) or placebo on the incidence of AMD within the prospective Women’s Antioxidant and Folic Acid Cardiovascular Study (WAFACS). The WAFACS focused on reduction of cardiovascular risk in a cohort of more than 5,000 female health care professionals ⱖ40 years of age (mean baseline age 62.2 years) with pre-existing or ⱖ3 cardiovascular risk factors. Data from 1998-2005 were analyzed with collection of outcome measures for incidence of either total AMD or visually significant AMD. AMD was self-reported with mailed ophthalmologist follow-up. Cox proportional hazards relative risk (RR) ratios were calculated between treatment groups and age-specified groups. A total of 7.3 years of follow-up resulted in 55 cases of total AMD in the treatment group compared to 82 cases in the placebo group (RR 0.66). For visually significant AMD, the RR of 0.59 was found for the same 26/44 case comparison of treatment/placebo. This approach may be a feasible alternative in women for AMD risk reduction. Funding was provided by the National Heart, Lung, and

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NEW IN REVIEW Blood Institute and the National Eye Institute with industry donation of trial product. BEHAVIORAL MODIFICATION Vol 33, February 2009 (www.sagepub.org) Œ

Effects of an Informational Brochure, Lottery-Based Financial Incentive, and Public Posting on Absenteeism of Director-Care Human Services Employees. Luiselli JK, Reed FD, Christian WP, Markowski A, Rue HC, St Amand C, Ryan CJ. 175-181.

BJOG: AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY Vol 116, February 2009 (www.blackwell. publishing/bjog) ●

High Maternal Vitamin E Intake by Diet or Supplements Is Associated with Congenital Heart Defects in the Offspring. Smedts HP, de Vries JH, Rakhshandehroo M, Wildhagen MF, Verkleij-Hagoort AC, Steegers EA, Stegers-Theunissen RP. 416423.

Vitamin E and heart defects. Congenital heart defects are thought to be a combination of genetic errors and intrauterine maternal exposures. This Dutch HAVEN study is an ongoing case-control study assessing the etiology of congenital heart defects diagnosed in the first year of life. This analysis specifically looked at the role of maternal intake of vitamin E and retinol (diet and supplements) on cases of congenital heart defects. Controls were obtained from collaboration with public child health centers delivering standard care to infants without congenital heart defects. A 195-item semi-quantitative food frequency questionnaire was used to estimate intake along with general demographic and lifestyle data. All variables were calculated as medians and percentiles prior to odds ratio estimates and 95% confidence intervals. Data were available for 276 case and 324 control mothers. Vitamin E dietary intake was significantly higher in case mothers (13.3 vs 12.6 mg/day, P⫽0.05), with no difference in retinol. When vitamin E supplements were added to the analysis, the risk was increased five to nine times for congenital heart defects. Higher use in periconception

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posed higher risk. This intake was above the Dutch recommended intake of 9.3 mg/day but lower than the American recommended daily allowance of 15 mg/day during pregnancy. The physiological process for this risk is unknown. Funding is provided by the Corporate Development International Grant and the Netherlands Heart Foundation.

DIABETES CARE Vol 32, February 2009 (www.diabetes.org/ diabetescare)

CANCER EPIDEMIOLOGY BIOMARKERS AND PREVENTION Vol 18, February 2009 (www.cebp. aacrjournals.org)

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Dietary Intake of ␻-6 and ␻-3 Fatty Acids and Risk of Colorectal Cancer in a Prospective Cohort of US Men and Women. Daniel CR, McCullough ML, Patel RC, Jacobs EJ, Flanders WD, Thun MJ, Calle EE. 516525.

Omega fatty acids and colorectal cancer. Inflammation may be reduced with dietary intake of n-3 and n-6 polyunsaturated fatty acids but their role in preventing cancer is not well known. This database analysis of the prospective Cancer Prevention Study (CPS) II Nutrition Cohort (⬎150,000 adults) was used to examine the relationship between reported cases of incident colorectal cancer and dietary intake. Participants completed a questionnaire on medical history, lifestyle, and demographics in 1999. A 152item, validated food frequency questionnaire was also used to estimate n-3 and n-6 intake. Data through June 2005 were analyzed by sex, estimating cancer risk using the Cox proportional hazards model by age-stratified groups. Quartiles of intake were used to calculate specific risk by food categories (total n-3, short chain n-3 alpha-linolenic acid, long-chain marine n-3, and total n-6). Complete data were available for 99,080 adults (44% men) from which 869 (452 men, 417 women) reported colorectal cancer. General ratios of n-3 to n-6 intake were not associated with cancer incidence but inverse relationships with intake were seen by sex which deserves future investigation. Funding for the CPS II is from the American Cancer Society.

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One-Year Comparison of a HighMonosaturated Fat Diet with a High-Carbohydrate Diet in Type 2 Diabetes. Brehm BJ, Lattin LB, Summer SS, Boback JA, Gilchrist GM, Jandacek RJ, D’Alessio DA. 215-220. Food Intake Patterns Associated with Incident Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study. Liese AD, Weis KE, Schulz M, Tooze JA. 263-268.

EUROPEAN JOURNAL OF CLINICAL NUTRITION Vol 63, February 2009, Supplement 1 (www.nature.com/ejcn) Œ

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Nutrition in Advanced Age: Dietary Assessment in the Newcastle 85⫹ Study. Adamson AJ, Collerton J, Davies K, Foster E, Jagger C, Stamp E, Mathers JC, Kirkwood T. S6-S18. Cognitive Processes in Children’s Dietary Recalls: Insight from Methodological Studies. Baxter SD. S19S32. Use of Technology in Dietary Assessment. (Workshop Summary). Winter J, Boushey CJ. S75-S77. Use of Surrogate Reporters in the Assessment of Dietary Intake. (Workshop Summary). Emmett P. S78-S79. Novel Approaches for Estimating Portion Sizes. (Workshop Summary) Wrieden Wl, Momen NC. S80-S81.

FOOD POLICY Vol 34, February 2009 (www. pergamonpress.com) Œ

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The Role of Collective Action in the Marketing of Underutilized Plant Species: Lessons from a Case Study on Minor Millets in South India. Gruere G, Nagarajan L, King ED. 39-45. Reaching the Rural Poor through Rural Producer Organizations? A Study of Agricultural Marketing Cooperatives in Ethiopia. Bernard T, Spielman DJ. 60-69.

NEW IN REVIEW GASTROENTEROLOGY Vol 136, February 2009 (www.gastrojournal. org) Œ

Elevated Serum Alanine Aminotransferase and ␥-Glutamyltransferase and Mortality in the United States Population. Ruhl CE, Everhart JE. 477-485.e11.

HARVARD BUSINESS REVIEW Vol 85, February 2009 (www.hbr.org) Œ

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Generation Y in the Workforce. HBR Case Study. Erickson TJ, Alsop R, Nicholson P, Miller J. 43-49. Seize Advantage in a Downturn. Rhodes D, Stelter D. 50-58. Stop Overdoing Your Strengths. Kaplan RE, Kaiser RB. 100-103.

BMI. Highest risk factors were history of sexual abuse or experience of violence, poor parental rapport, early pubertal timing, depression or suicide attempt, and body dissatisfaction. More than 50% of all boys surveyed expressed some concern with physical image. Funding was provided by the Swiss Federal Office of Public Health. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY Vol 123, February 2009 (www.jaci.org)

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Trying to Fit Square Pegs in Round Holes: Eating Disorders in Males. (Editorial). Lock JD. 99-100. Disordered Eating Behavior: What About Boys? Domine F, Berchtold D, Akre C, Michaud PA, Suris JC. 111-117.

Male eating disorders. Eating disorder studies and literature have centered on females. This incidence of male disordered eating behavior (DEB) was assessed using the 2002 Swiss Multicenter Adolescent Survey on Health (SMASH02) database, a mandatory secondary school–level survey for adolescents 16 to 20 years of age. The analysis was restricted to the 3,890 males (51.5% of database) who completed the self-administered anonymous questionnaire. The outcome variable was responses to selected items subsequently divided into four DEB severity groups. Analysis of variance was used for statistical comparison of the groups while controlling for independent variables from other questionnaire responses such as demographics, family structure, school history, parent-adolescent relationship, violence events, and other DEB health behaviors. Incidence in the highest DEB group was 20.5% (n⫽798) with 3% having a body mass index (BMI) ⬍10th percentile for age. One in 10 boys in the lowest DEB group expressed concern with physical image with 5.4% having the same low

JOURNAL OF CLINICAL EPIDEMIOLOGY Vol 62, February 2009 (www.elsevier.com/ jclinepi) Œ

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JOURNAL OF ADOLESCENT HEALTH Vol 44, February 2009 (www.elsevier.com)

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Complementary and Alternative Medicine: Herbs, Phytochemicals, and Vitamins and Their Immunologic Effects. (Review). Mainardi T, Kapoor S, Bielory L. 283-294.e10. Continuing Medical Education Examination. 295-296. The Perfectly Potent Peanut. (Editorial). Shreffler WG. 352-353. Househood Peanut Consumption as a Risk Factor for the Development of Peanut Allergy. Fox AT, Sasieni P, du Toit G, Syed H, Lack G. 417423. Early Peanut Consumption: Postpone or Promote? (Editorial). Burks AW. 424-425.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY Vol 53, February 2009 (www.onlinejacc. org) Œ

Lowering Glucose to Prevent Adverse Cardiovascular Outcomes in a Critical Care Setting. (Review). Ceriello A, Zarich SW, Testa R. S9-S13.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY Vol 57, February 2009 (www. blackwellpublishing.com) Œ

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Using the Osteoporosis Self-Assessment Tool for Referring Older Men for Bone Densitometry: A Decision Analysis. Ito K, Hollenberg JP, Charlson ME. 218-224. Improving Medical Student Attitudes toward Older Patients through a “Council of Elders” and Reflective Writing Experience. Westmoreland GR, Counsell SR, Sennour Y, Schubert C, Frank KI, Wu J, Frankel RM,

Litzelman DK, Bogdewic SP, Inui TS. 315-320. Pharmacological Management of Osteoporosis in Nursing Home Populations: A Systematic Review. (Review). Parikh S, Avorn J, Solomon DH. 327-334.

A Theory-Based Cross-Sectional Survey Demonstrated the Important Role of Awareness in Guideline Implementation. Rutten G, Kremers S, Rutten S, Harting J. 167.e1176.e1.

JOURNAL OF HUMAN NUTRITION AND DIETETICS Vol 22, February 2009 (www. blackwellpublishing.com/journals/jhn) Œ

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The Role of Diet in the Management of Gout: A Comparison of Knowledge and Attitudes to Current Evidence. Shulten P, Thomas J, Miller M, Smith M, Ahern M. 3-11 Video-Recorded Participant Behaviours: The Association between Food Choice and Observed Behaviors from a Web-Based Diet History Interview. Probst YC, De Agnoli K, Batterham M, Tapsell L. 21-28.

JOURNAL OF NUTRITIONAL BIOCHEMISTRY Vol 20, February 2009 (www.intl. elsevierhealth.com) Œ

Antiangiogenic and Anticancer Potential of Unsaturated Vitamin E (Tocotrienol). (Review). Miyazawa T, Shibata A, Sookwong P, Kawakami Y, Eitsuka T, Asai A, Oikawa S, Nakagawa K. 79-86.

JOURNAL OF PEDIATRICS Vol 154, February 2009 (journals. elsevierhealth.com/periodicals/ympd) Œ

Parent Modeling: Perceptions of Parents’ Physical Activity Predict Girls’ Activity throughout Adoles-

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NEW IN REVIEW cence. Madsen KA, McCulloch CE, Crawford PB. 278.e2-283.e2. Œ

LANCET, THE Vol 373, January 31-February 6, 2009 (www.thelancet.com) Œ

Dietary Fibre: An Agreed Definition. Cummings JH, Mann JI, Nichida C, Vorster HH. 365-366.

Marchi M, Paganelli M, Folli F, Pontiroli AE. 110-114. From Chronic Overnutrition to Insulin Resistance: The Role of FatStoring Capacity and Inflammation. (Review). Lionetti L, Mollica MP, Lombardi A, Cavaliere G, Gifuni G, Barletta A. 146-152.

PAEDIATRICS AND CHILD HEALTH Vol 19, February 2009 (www. blackwellpublishing.com)

Vol 373, February 14-20, 2009 Œ Œ

Intensive Insulin Therapy for Patients in Paediatric Intensive Care: A Prospective, Randomised, Controlled Study. Vlasselaers D, Milants I, Desmet L, Wouters PJ, Vanhorebeek I, van den Heuvel I, Mesotten D, Casaer MP, Meyfroidt G, Ingels C, Muller J, van Cromphaut S, Scheta M, van den Berghe G. 547-556.

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PATIENT EDUCATION AND COUNSELING Vol 70, February 2008 (www.elsevier.com) Œ

METABOLISM: CLINICAL AND EXPERIMENTAL Vol 58, February 2009 (www.elsevier.com/ metabolism) Œ Œ

The Atypical Presentation of the Metabolic Syndrome Components in Black African Women: The Relationship with Insulin Resistance and the Influence of Regional Adipose Tissue Distribution. Jennings CL, Lambert EV, Collins M, Levitt NA, Goedecke JH. 149-157.

NUTRITION Vol 25, February 2009 (www.elsevier.com) Œ

Wernicke’s Syndrome during Parenteral Feeding: Not an Unusual Complication. Francini-Pesenti F, Brocadello F, Manara R, Santelli L, Laroni A, Caregaro L. 142-146.

NUTRITION, METABOLISM, AND CARDOVASCULAR DISEASES Vol 19, February 2009 (www.elsevier.com) Œ

Effect of Weight Loss through Laparoscopic Gastric Banding on Blood Pressure, Plasma Renin Activity, and Aldosterone Levels in Morbid Obesity. Dall’Asta C, Vedani P, Manunta P, Pizzocri P,

Diagnosing Autism. (Invited Symposium). Yates K, Le Couteur A. 55-59. Behavioral Eating Disorders. (Invited Symposium). Nicholls S, Grindrod C. 60-66.

Computer-Tailored Health Interventions Delivered over the Web: Review and Analysis of Key Components. (Review). Lustria ML, Cortese J, Noar SM, Glueckauf RL. 156-173. Lexicon Creation to Promote Faculty Development in Medical Communication. Arnold RW, Losh DP, Mauksch LB, Maresca TM, Storck MG, Wenrich MD, Goldstein EA. 179-183.

PREVENTIVE MEDICINE Vol 48, February 2009 (www.elsevier.com) Œ

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Review of Physical Activity Measurement Using Accelerometers in Older Adults: Considerations for Research Design and Conduct. (Review). Murphy SL. 108-114. Gender Differences in Obesity Related Cardiovascular Risk Factors in Spain. Cordero A, Leon M, Andres E, Ordonez B, Laclaustra M, Grima A, Pascual I, Luengo E, Civeira F, Pocovi M, Alegria E, Casasnovas JA on behalf of the MESYAS Registry Investigators. 134-139. Randomized Trial of Three Strategies to Promote Physical Activity in General Practice. Armit GM, Brown WJ, Marshall AL, Ritchie CB, Trost SG, Green A, Bauman AE. 156-163.

Physical activity strategies. Physical activity (PA) has been identified as pro-

moting health, yet key strategies to accomplish activity goals remain elusive, particularly as adults age. This 24-week Australian randomized interventional clinical trial recruited 136 healthy sedentary adults aged 50 to 70 years of age from general medicine practices. Each group of ⬎40 participants was assigned to a brief physician encounter (PE), or PE plus activity advice from an exercise scientist (ES), or PE⫹ES plus a pedometer (P). Outcome variables were changes from baseline of each participant’s score on the Active Australian Physical Activity Questionnaire, resting blood pressure, heart rate response to the Canadian Home Fitness Test, and a general questionnaire (motivation, knowledge, activity barriers). Groups were compared by repeated measures analysis of variance with Tukey adjustment for multiple post-hoc tests using an intention-to-treat analysis. Logistic regression was used to determine associations. Odds ratios were calculated. The group demographics included mean age 58 years, 30% to 48% men, employed, English speaking. Overall PA increased to an average of 128 minutes per week with the pedometer group (PE⫹ES⫹P) compared to the PE group (odds ratio 2.39). No significant changes were seen in blood pressure or heart rate. Funding was provided by a National Heart Foundation grant.

SITES IN REVIEW Celiac Sprue Association www.csaceliacs.org According to the Celiac Sprue Association, an estimated one in 133 Americans has celiac disease (CD) or gluten sensitive enteropathy. Many children and adults with CD can be asymptomatic or have a broad range of symptoms, which may account for why 95% of individuals with the disease remain undiagnosed. Founded in 1984, the aim of the Celiac Sprue Association (CSA), a donor-supported organization, is to provide education, support, and research focused on the diagnosis, treatment, and lifestyle modifications associated with CD, including food labeling policies promoting gluten-free diets. More than a hundred local chapters of CSA are established in the United

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NEW IN REVIEW States, a key component of its community outreach mission. The CSA Web site offers a variety of resources for those with CD, family members, and health professionals. The five key components of the CSA Web site address CD clinical issues, gluten-free diets, disease self-management, educational materials, and local support. Ten physicians who serve on the CSA Board and staff dietitians are the content providers for the site. The CSA site is frequently updated, listing the date of the most recent update towards the bottom of each Web page. Adults with CD can find a myriad of relevant resources, including a bibliographic index of CD research publications for the past 8 years, gluten-free recipe database, and step-by-step guidelines for adopting a gluten-free lifestyle. Users can also query the CSA chefs or staff dietitians with individual questions about gluten-free foods and related issues. In the Local Support section of the site, links to local CSA web sites are listed, featuring information about restaurants, grocery stores, and other food purveyors that offer gluten-free foods in the user’s community. Children with CD can tap into the CSA’s Cel-Kids Network section of the site to find age-appropriate materials designed to help these youth better cope with their disease. Kid-friendly gluten-free recipes, educational games (including the Gluten Dodge video game), and tips for managing CD at home, school, and social situations are offered in this section. Information about how to connect online or in-person with other children with CD in the community is also posted in this section. CSA offers continuing education opportunities for health professionals. Each fall, CSA sponsors an evidence-based conference for dietitians and other health professionals as well as individuals with CD. Research updates, clinical guidelines, and other highlights of the CSA conference are archived on the CSA Web site. The CSA plans to add a passwordprotected “Dietitian” section (free registration will be required) to its site in the near future. Food and nutrition professionals can download glutenfree diet materials, patient diet/medical history forms, diet assessment worksheets, and other related patient

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resources at no cost from this area of the site. The National Institute of Diabetes and Digestive and Kidney Diseases: Celiac Disease Awareness Campaign www.celiac.nih.gov In 2006, the National Institutes of Health launched its Celiac Disease Awareness Campaign as an effort to clarify physicians’ misperceptions that celiac disease (CD) is an “exceedingly rare disease” and educate clinicians as well as the general public about this less common but problematic disorder. The aims of the campaign are to heighten awareness about 1) incidence of CD in the US, 2) availability and validity of diagnostic blood tests, 3) health conditions correlated with CD, and 4) dispel the myth that CD is “just a gastrointestinal disease.” The Celiac Disease Awareness Campaign Web site is a gateway to CDrelated clinical practice guidelines, patient education materials (including those written in Spanish), clinical trials and research updates (from PubMed), and a comprehensive listing of related Web resources. The site is reviewed annually, although some of its materials are updated more often. Site users can subscribe to the Celiac Disease Awareness Campaign free electronic newsletter, showcasing the activities of this program. Descriptions of the campaign’s new or revised patient education materials as well as research updates, continuing education opportunities, and gluten-free recipes are also featured in this newsletter. In 2009, the Celiac Disease Awareness Campaign is introducing Provider Points, a new series of clinical reference fact sheets designed to help health care providers better identify the symptoms and complications of CD. These professional materials will also include clinical testing for CD in relationship to other autoimmune disorders. Health professionals will be able to access the downloadable Provider Points series from the Celiac Disease Awareness Campaign site.