Maureen A. Murtaugh

Self-reported dietary habits, overall dietary quality and symptomatology of breast cancer survivors: a cross-sectional examination.

Little information is available about the relationship between quality of life of women who have survived breast cancer (specifically, symptoms including those of menopause and depression) and the quality of their diet. In this cross-sectional study, 117 women with known primary breast cancer completed a self-administered food frequency questionnaire (FFQ) reflecting usual diet during the past year, a Survey of Feelings and Attitudes using the Center for Epidemiologic Studies Depression scale (CES-D) and a survey that includes menopausal symptoms among others common to women with a history of breast cancer. When womens responses to the FFQ were scored using the Healthy Eating Index (HEI), most often diets were evaluated as those that ‘need improvement’ with a mean total HEI score of 67.2. With regard to the CES-D scores, study women averaged 9.5, with 19 women being classified as clinically depressed. HEI and CES-D scores were inversely related (ρu2009=u2009−0.22, pu2009=u20090.02). A negative correlation was also observed between energy-adjusted calcium intakes and CES-D scores (ρu2009=u2009−0.19, pu2009=u20090.04). Clinical depressed women had not only lower HEI scores and calcium intakes, but also lower grain and variety scores. Comparisons to national data for disease-free women and that available for those with breast cancer suggest that our study women consumed diets low in energy and dietary variety. Diet quality may be an important factor influencing the manifestation of depressive symptoms in breast cancer survivors or conversely, poorer diet quality may be an outcome of depression.

Psychological symptoms are greater among weight cycling women with severe binge eating behavior

OBJECTIVEnTo identify psychological characteristics and eating behaviors associated with weight cycling and binge eating behaviors in overweight women (body mass index > 27.3).nnnDESIGNnQuestionnaires measuring self-esteem, self-efficacy, coping strategies, psychological symptoms, depression, binge eating, restrained eating, disinhibition, and hunger were administered to female weight cyclers who were overweight. Psychological characteristics were compared between subjects grouped by binge eating disorder classification and by binge eating severity.nnnSUBJECTSnA convenience sample of 62 female weight cyclers who were overweight was recruited from the Chicago, Ill, area. Questionnaires were administered individually or in small groups in subjects homes or other private settings.nnnSTATISTICAL ANALYSESnStudents t tests or Mann-Whitney U tests were used to assess differences in psychological characteristics.nnnRESULTSnThirty-six weight cyclers (58%) met the criteria for binge eating disorder and 26 (42%) did not. Weight cyclers with binge eating disorder reported greater severity of binge eating (P < .0005) and disinhibition (P < .0005) and poorer eating self-efficacy (P < .0005) than weight cyclers without binge eating disorder. Weight cyclers with severe binge eating behaviors reported greater psychological distress (P < .0005) and depression (P < .005) and lower self-esteem (P = .0001) and used less healthful coping strategies (P = .0027) than weight cyclers with no binge eating to moderate binge eating problems. Weight cyclers with severe binge eating behavior also reported more hunger (P < .0005) and used less cognitive restraint (P = .0024) than those with no binge eating to moderate binge eating problems.nnnAPPLICATIONSnOperational definitions of weight cycling and binge eating are needed to facilitate research on effective weight-loss treatments. Persons seeking to lose weight (especially weight cyclers) should be assessed for binge eating severity, problematic eating behaviors, and psychological symptoms.

Estimation of Individual Intakes of Folate in Women of Childbearing Age With and Without Simulation of Folic Acid Fortification

OBJECTIVESnThe objectives of this study were to examine variability of folate intake in order to estimate the number of days needed to accurately estimate intakes in women of childbearing age and to simulate the effect of folic acid fortification of cereals and grains on individual folate intake.nnnDESIGNnObservational study of food intake over a 60-day period.nnnSAMPLINGnA convenience sample of 21 women completed food records on randomly assigned days within a 60-day period.nnnOUTCOMES MEASUREDnFolate intake and variance ratios of folate intake.nnnSTATISTICAL ANALYSISnRepeated measures analysis of variance.nnnRESULTSnSix days of food records were needed to describe folate intake of these women of childbearing age (18 to 45 years) with 20% attenuation of a correlation coefficient between dietary folate intake and another biological variable. Seven days of records were needed with simulated folic acid fortification (assuming fortification of 140 micrograms folic acid per 100 g flour) and 5 days were needed with supplements containing 200 to 400 micrograms folic acid in addition to folic acid fortification. Food folate intake was 288 +/- 195 micrograms; only 2 of the participants consumed the recommended 400 micrograms. With fortification, folate intake increased to 550 +/- 279 micrograms without supplements and 609 +/- 327 micrograms with supplements.nnnAPPLICATIONSnIndividual intakes of folate should be assessed with at least 7 days of dietary records (20% attenuation). In this sample, when folic acid fortification was added to dietary intake, routine supplementation was not necessary to achieve folate intakes of 400 micrograms in the majority of participants. The practice of routine folic acid supplementation should be considered carefully to ensure that individual intakes of folate do not exceed the upper limits of safety.

Plasma Vitamins E and C Concentrations of Adult Patients During Cardiopulmonary Bypass

OBJECTIVEnThis study was designed with two aims: 1) to determine if the coronary artery bypass graft (CABG) procedure alters plasma vitamin E and C concentrations of adult patients through repeated determinations of vitamin levels at time points before, during and following CABG, and 2) to assess whether plasma vitamin E concentrations reflect myocardial tissue content.nnnMETHODSnA consecutive sample of 38 patients undergoing CABG surgery at a Midwest tertiary care hospital was enrolled. Patients receiving blood transfusions before or during surgery were excluded.nnnRESULTSnPlasma vitamin E/total lipid ratios rose with reperfusion, remained elevated immediately following bypass, and fell to preoperative concentrations by 24 hours. Plasma vitamin E/total cholesterol levels varied little throughout this time course. Both plasma uric acid and ascorbate concentrations (corrected for hemodilution) also rose by the preischemic interval, and remained elevated until a return to preoperative levels by 24 hours. Corrected malondialdehyde (MDA) concentrations rose by pre-ischemia but returned more quickly to preoperative levels. Atrial appendage tissue vitamin E concentrations bore a significant relationship to those of plasma prior to surgery (r=+0.49, p=0.004). Reported supplement use, plasma concentrations and body mass index contributed to the variability in atrial tissue concentrations of vitamin E.nnnCONCLUSIONSnIn short, when not confounded by transfusions or hemodilution, several peripheral indices of antioxidants increase with the reperfusion segment of CABG procedure and return to baseline levels within 24 hours of surgery. Parallel changes in MDA were observed. The observed changes are consistent with the hypothesis that oxidative stress accompanies the ischemia-reperfusion components of the CABG procedure.

Individual nutrient effects on length of gestation and pregnancy outcome

A dequate macronutr ient and micronutr ient intakes are associated with positive fetal outcome. However, ensuring the adequate micronutr ient intakes for both populations and individuals who are pregnant is fraught with difficulties. Appropriate assessment of micronutrient status is challenging. Differences in bioavailability of nutrients between animal and vegetable food sources o f nutrients and between food sources and supplements complicate efforts to accurately predict need or quantify intake. However, nutrient supplementation and altering dietary intake are viewed as relatively safe, inexpensive, and noninvasive interventions. Therefore, the potential for altering fetal outcome or gestation durat ion via nutri t ion intervention is of great interest. This article will review the effects of marine n-3 fatty acids, calcium, folate, and zinc on length of gestation and fetal outcome. Recent interest in these nutrients lies in their potential to alter durat ion of gestation or fetal outcome.

Comparison of Ultrasound and Skinfold Measurements to Assess Subcutaneous Fat Thickness at Specific Sites During Pregnancy

Abstract Eleven healthy women, age 28.7 ± 4.9 and body mass indices between 18.2 and 37.3kg/m 2 , carrying singletons were measured at 20 ± 1 and 30 ± 1 week gestation. Tricep, bicep, mid-thigh, subscapular and suprailiac sites were measured in triplicate on the left side of the body using Lange skinfold calipers (Cambridge Scientific Industries, Cambridge, MD). Mid-arm, abdomen, hip and mid-thigh circumferences were measured using a non-strechable tape. Sonogrpahic measurements of fat thickness were performed using either a 3.5 or 5 MHZ probe. Mid-thigh fat thickness increased by 2.4mm, from 30.3mm at 20 weeks to 32.7mm at 30 weeks (8.0% increase) when measured by skinfold calipers. The mid-thigh fat thickness rose from 7.9mm to 9.8mm from 20 to 30 weeks, a 1.9mm or 23.8% increase when measured by ultrasound. The suprailiac fat thickness increased by 1.8mm using both methods of measurement (7.5% increase by skinfold calipers and 17.7% increase using ultrasound). Slight decreases in fat thickness were detected at the subscapular site (0.9mm using skinfold calipers, 0.3mm using ultrasound). No appreciable changes were detected in fat thickness at the tricep and bicep sites using either method. Using the SPSSPC+ statistical software version 4.1 (Chicago, IL) t-test, there was no significant difference between the two methods in estimating the change of fat thickness during this interval in singleton gestation.

Agreement Between Urine And Blood Ketones In Pregnant Women With Diabetes

Abstract LEARNING OUTCOME: To examine the agreement between measurments of urine and blood ketones in pregnant women with diabetes. Urine glucose measuremetns are no longer acceptable because of the confounding of fluid intake, interference by some drugs, a high renal threshold, and the ability to measure capillary glucose reflecting present glucose levels. Urine ketone measurement is subject to similar counfbunders, but is still the clinical standard for ketone measurement Therefore, the agreement between the clinical standard, urine ketone measurement, and a new direct method, capillary blood ketone measurement, was studied in a convenience sample of 18 pregnant women with pre-gestational or gestational diabetes. Urine ketones were measured using both the Kctostix ™ strips and the Acetest ™ tablets and blood ketones were measured using the Ketosite ™ meter in 100 samples. Capillary blood glucose, urine specific gravity, and time of last void were also measured Measurements from the Ketostix ™ strips (urine) and the Ketosite ™ meter (capillary) agreed 43% more than expected by chance (Cohens1 K*=0.43, p ™ tablets and Ketosite ™ meter agreed 21% more than expected by chance (Cohens‘ K=0.21, p ™ (p=0.004) and tended to be higher in those positive by Ketostix ™ (p–0.065). Capillary beta-hydroxybutyrate was higher in samples corresponding to urine samples which were positive for ketones with both methods (p=0.048). The urine and capillary ketone measures appear to be measuring the same thing, however, the agreement is not so close that the current clinical standard, urine measurement, should go unquestioned. Further research is needed to determine the relationship between urine and capillary ketone levels and to determine which method is a more accurate reflection of ketone status in pregnant women.