Surinder Baines

Probiotic viability and physico-chemical and sensory properties of plain and stirred fruit yogurts made from goat’s milk

Probiotic plain and stirred fruit yogurts were made from goats milk using bacterial cultures comprising, Lactobacillus acidophilus LA-5, Bifidobacterium animalis subsp. lactis BB-12 and Propionibacterium jensenii 702. The products were stored at 4°C for 4weeks, during which time the viability of the yogurt starter culture and probiotic bacteria was analysed weekly. P. jensenii 702 demonstrated the highest viability (10(8)cfu/g) in all types of yogurt throughout the storage period, while the viability of the bifidobacteria (∼10(7)cfu/g) also remained above the minimum therapeutic level. The viability of L. acidophilus LA-5 fell below 10(6)cfu/g in yogurts, however, the addition of fruit juice appeared to support the viability of lactobacilli, with higher microorganism numbers observed in fruit yogurts than in plain yogurt throughout the shelf life. Addition of fruit juice significantly increased the syneresis, and decreased viscosity and water holding capacity of yogurts (p<0.05), and also enhanced their sensory acceptability.

Association between eating frequency, weight and health

There is speculation amongst health professionals, the media, and the public regarding eating frequency (EF) and its impact on weight and health. Nutritional weight-loss and -maintenance interventions of longer than 1 weeks duration were reviewed for associations between EF and weight and health. Of the 176 studies identified, 25 relevant studies matched the criteria and only 10 of these were weight-loss interventions. Generally, sample sizes were small, interventions were short-term, and a wide array of definitions was used to define an eating occasion. Several key outcomes such as physical activity, adherence to assigned EF, and hunger were often not measured. The limited evidence available suggests there is no association between EF and weight or health in either weight-loss or -maintenance interventions, with a possible inverse association between EF and lipids in weight-maintenance interventions. Longer term, larger studies that include important weight and health outcomes are needed.

A Systematic Review and Meta-analysis of Measurements of Tongue and Hand Strength and Endurance Using the Iowa Oral Performance Instrument (IOPI)

The purpose of this systematic review was to examine the evidence for the use of the Iowa Oral Performance Instrument (IOPI) to measure strength and endurance of the tongue and hand in healthy populations and those with medical conditions. A systematic search of the scientific literature published since 1991 yielded 38 studies that addressed this purpose. The IOPI was used primarily for tongue strength (38 studies) and endurance (15 studies) measurement; relatively few studies measured hand strength (9 studies) or endurance (6 studies). The majority of the studies identified used the IOPI as an evaluation tool, although four used it as an intervention tool. Half the studies were conducted in healthy people, primarily adults. Most of the other participants had disorders with dysphagia, primarily Parkinson’s disease or head or neck cancer. Age and gender, as well as a number of medical conditions, influence the values of tongue and hand strength. There is sufficient evidence to support the use of the IOPI as a suitable tool for measuring tongue strength and endurance and as an assessment tool for intervention studies, and there is growing support for its use to assess hand strength and endurance in healthy and clinical populations.

How does the health and well-being of young Australian vegetarian and semi-vegetarian women compare with non-vegetarians?

OBJECTIVE To compare the sociodemographic characteristics, health status and health service use of vegetarians, semi-vegetarians and non-vegetarians. DESIGN In cross-sectional data analyses of the Australian Longitudinal Study on Womens Health in 2000, 9113 women (aged 22-27 years) were defined as non-vegetarians if they reported including red meat in their diet, as semi-vegetarians if they excluded red meat and as vegetarians if they excluded meat, poultry and fish from their diet. RESULTS The estimated prevalence was 3% and 10% for vegetarian and semi-vegetarian young women. Compared with non-vegetarians, vegetarians and semi-vegetarians were more likely to live in urban areas and to not be married. Vegetarians and semi-vegetarians had lower body mass index (mean (95% confidence interval): 22.2 (21.7-22.7) and 23.0 (22.7-23.3) kg m(-2)) than non-vegetarians (23.7 (23.6-23.8) kg m(-2)) and tended to exercise more. Semi-vegetarians and vegetarians had poorer mental health, with 21-22% reporting depression compared with 15% of non-vegetarians (P < 0.001). Low iron levels and menstrual symptoms were also more common in both vegetarian groups. Vegetarian and semi-vegetarian women were more likely to consult alternative health practitioners and semi-vegetarians reported taking more prescription and non-prescription medications. Compared with non-vegetarians, semi-vegetarians were less likely and vegetarians much less likely to be taking the oral contraceptive pill. CONCLUSION The levels of physical activity and body mass indices of the vegetarian and semi-vegetarian women suggest they are healthier than non-vegetarians. However, the greater reports of menstrual problems and the poorer mental health of these young women may be of clinical significance.

Manipulating the symbolic meaning of meat to encourage greater acceptance of fruits and vegetables and less proclivity for red and white meat.

The present study tested the extent to which dietary preferences are altered by making aspects of the symbolic meaning of meat salient to participants. Individuals in the treatment group were informed of a previous scientific study which found that people who endorse social hierarchy and human dominance over nature consume more red and white meat, and that people who reject hierarchy and dominance eat more fruits and vegetables. The results showed that, compared to a control group, individuals in the treatment group who reject hierarchy and dominance (most participants) perceived red and white meat less favourably, decreased their liking of red and white meat, decreased their object identification with red and white meat, anticipated that they would eat more fruits and vegetables in the subsequent three days, and indeed consumed more fruits and vegetables in a follow-up study three weeks later. Moreover, the salience manipulations ability to induce a negative response toward red and white meat and greater acceptance of fruits and vegetables was strongest for individuals in the treatment group for whom the salience manipulation made sense, individuals with less confidence in their diet choices, those who had previously considered reducing their meat consumption, and low/normal weight persons. These findings have implications for health promotion and for theories of food choice.

Determinants of breastfeeding indicators among children less than 24 months of age in Tanzania : a secondary analysis of the 2010 Tanzania Demographic and Health Survey

Objective To examine the prevalence of key WHO breastfeeding indicators and identify determinants of suboptimal breastfeeding practices among children aged less than 24 months in Tanzania. Design, setting and participants Secondary analyses of cross-sectional data from the 2010 Tanzania Demographic and Health Survey. The survey used a stratified two-stage cluster sample of 10 312 households from eight geographical zones of Tanzania. The sample consisted of 3112 children aged 0–23 months. Main outcome measures Outcome measures were factors significantly associated with delayed initiation of breastfeeding, non-exclusive breastfeeding and predominant breastfeeding in the first 6 months. Results Breastfeeding was initiated within the first hour of birth in 46.1% of mothers. In infants aged less than 6 months, the prevalence of exclusive breastfeeding was 49.9% but only 22.9% were exclusively breastfed at 4–5 months. Seventeen per cent of infants, less than 6 months of age, were ‘predominantly breastfed’. At 12–15 months, 94.0% of infants were still breastfed but the proportion decreased to 51.1% at 20–23 months of age. Multivariate analysis revealed that the risk of delayed initiation of breastfeeding within 1 h after birth was significantly higher among young mothers aged <24 years, uneducated and employed mothers from rural areas who delivered by caesarean section and those who delivered at home and were assisted by traditional birth attendants or relatives. The risk factors associated with non-exclusive breastfeeding, during the first 6 months, were lack of professional assistance at birth and residence in urban areas. The risk of predominant breastfeeding was significantly higher among infants from the Zanzibar geographical zone. Conclusions Early initiation of breastfeeding and exclusive breastfeeding indicators were unsatisfactory and are below the national targets for Tanzania. To improve breastfeeding practices, national level programmes will be required, but with a focus on the target groups with suboptimal breastfeeding practices.

Factors associated with inappropriate complementary feeding practices among children aged 6–23 months in Tanzania

Inappropriate complementary feeding is one of the major causes of undernutrition among young children in Tanzania. Prevalence of newly developed World Health Organization complementary feeding indicators and their associated factors were determined among 2402 children aged 6-23 months in Tanzania using data from the 2010 Tanzania Demographic and Health Survey. The survey used a multistage cluster sample of 10 300 households from the eight geographical zones in the country. The prevalence of the introduction of soft, semi-solid or solid foods among infants aged 6-8 months was 92.3%. Of all the children aged 6-23 months, the prevalence of minimum dietary diversity, meal frequency and acceptable diet were 38.2%, 38.6% and 15.9%, respectively. Results from multivariate analyses indicated that the main risk factors for inappropriate complementary feeding practices in Tanzania include young childs age (6-11 months), lower level of paternal/maternal education, limited access to mass media, lack of post-natal check-ups, and poor economic status. Overall, complementary feeding practices in Tanzania, as measured by dietary diversity, meal frequency and acceptable diet, are not adequately met, and there is a need for interventions to improve the nutritional status of young children in Tanzania.

Noncitrus Fruits as Novel Dietary Environmental Modifiers of Iron Stores in People With or Without HFE Gene Mutations

OBJECTIVE To investigate whether citrus fruit, noncitrus fruit, and other dietary factors act as environmental modifiers of iron status in the absence or presence of hemochromatotic HFE gene mutations. PARTICIPANTS AND METHODS Iron studies, HFE genotypic analyses, and dietary data from a survey conducted from March 21, 1994, through December 15, 1995, were analyzed for a group of 2232 residents (1105 men, 1127 women) aged 20 to 79 years recruited from the community electoral roll of Busselton in Western Australia. Data were analyzed by linear regression analysis and analysis of covariance. RESULTS Higher levels of fresh fruit intake (excluding citrus fruits and citrus juices) had a significant protective effect (P=.002) against high body iron status as gauged by ferritin levels in men, irrespective of HFE genotype. Consumption of 2 or more pieces of fruit per day on average reduced mean serum ferritin levels by 20% compared with average consumption of less than 1 piece of fruit per day. This effect was not observed in women. Consumption of citrus fruits and citrus juices had no significant effects in either sex. No protective effects were observed for tea consumption or any other dietary factors studied. Red meat and alcohol consumption correlated with high body iron stores (P<.05), consistent with previous studies, but did not interact with fruit with regard to effects on serum ferritin (P>.05). CONCLUSION Noncitrus fruits are environmental modifiers of iron status independent of HFE genotype. This could have important implications for the provision of evidence-based dietary advice to patients with other iron-storage disorders.

Reliability of Measurements of Tongue and Hand Strength and Endurance Using the Iowa Oral Performance Instrument with Healthy Adults

The purpose of this study was to investigate the reliability of tongue and handgrip strength and endurance measurements in healthy adults using the Iowa Oral Performance Instrument. Fifty-one healthy participants (21 males, 30 females; age range = 19–57 years) were tested on four occasions 1 week apart to determine test–retest reliability. The primary outcome measures were isometric tongue and handgrip strength (best of three trials) and sustained isometric endurance. Small increases (changes in group mean) in both anterior (1.7 %) and posterior (2.5 %) tongue strength and handgrip strength (5 %) between weeks 1 and 2 were observed with no change in subsequent weeks, suggesting that there is only a small learning effect for these measurements. The within-subject variation (mean-typical error expressed as a coefficient of variation [CV]) indicated higher than desirable initial variation for anterior (CV 10.8 %) and posterior (CV 11.8 %) tongue strength and handgrip strength (CV 15.2 %) but this was reduced in weeks 2–4. Intraclass correlation coefficients (ICC) indicated acceptable and improved reliability for both anterior (ICC 0.77–0.90) and posterior (ICC 0.79–0.86) tongue strength and handgrip strength (ICC 0.69–0.91) after week 1. Additional exploratory analyses were conducted with a subset of data to determine whether two values within 5 kPa (tongue) or 15 kPa (handgrip) provide superior strength reliability. Neither tongue nor hand endurance measurements were sufficiently reliable. These findings suggest that tongue and handgrip strength values demonstrate acceptable reliability, especially if familiarization is provided. Further investigation is needed to reduce sources of variability in tongue endurance measurements.

Changes in eating behavior after laparoscopic adjustable gastric banding: a systematic review of the literature.

This systematic review evaluates the current evidence base for eating behavior changes after laparoscopic adjustable gastric banding (LAGB). A literature search from 1990 to February 2010 was conducted to identify original studies that assessed eating behavior in adults who have undergone LAGB. Sixteen articles (14 separate studies) met inclusion criteria. Although strength of the evidence base was limited by observational study designs and methodological weaknesses, results suggest that positive changes in eating behavior occur after surgery, including reduced over-eating in response to emotional and situational cues. There is some evidence to suggest that uncontrolled eating behaviors persist in some individuals, and that this may be problematic for weight loss after surgery. Few studies examined the relationship between changes in eating behavior and weight loss; thus, optimal behavioral strategies for promoting positive weight outcomes remain unclear. Further interventional research addressing the inherent limitations of the current-evidence base is required to guide development of evidence-based management guidelines for LAGB in future.