Knowledge of appropriate foods and beverages needed for weight loss and diet of patients in an Obesity Clinic.

BACKGROUND/OBJECTIVE: Knowledge does not automatically translate into behaviour change. This study examined the relationship between knowledge of appropriate foods and beverages needed for weight loss and the diet of patients seeking weight management. SUBJECTS/METHODS: A cross-sectional study of 104 consecutive first-time patients (55 women and 49 men) seeking weight management, with a mean age of 37.3 ± 11.8 years and a BMI of 44.9 ± 9.4 kg/m(2), was carried out; 67.3% of these patients had a BMI of 40 kg/m(2) or greater. Patients were told to design a detailed weight-loss diet that they would recommend to a person with the same characteristics (recommended diet or RD) as themselves and asked whether the RD was similar to their own. Consumed diet (CD) was assessed by a different dietitian through a 24-h diet recall. Estimated energy requirement (EER), energy content of RD and CD and number of fruit, vegetable, cereal and sweetened-beverage portions were calculated. Statistical differences were assessed through the Pearson's correlation and the Wilcoxon's rank-sum tests. RESULTS: RD and CD were 1104 ± 243 and 1976 ± 708 kcal for women and 1254 ± 287 and 2743 ± 1244 kcal for men, with statistical differences for both genders (P<0.001). Energy content of the RD was lower than the EER in men and women (P<0.001); CD was lower than the EER in women (P=0.033). Number of fruit/vegetable portions was lower in CD than in the RD in women (P<0.001), whereas cereal and sweetened-beverage portions were higher in CD than in the RD in both genders (P<0.001). RD was not followed by 46.1% of the patients. CONCLUSIONS: Patients with obesity seeking care have knowledge of the appropriate dietary strategies needed for weight loss, but do not translate it into practice. Treatment approaches should include tools that help patients to implement their nutrition knowledge.

Environmental and personal correlates of fruit and vegetable consumption in low income, urban Mexican children.

BACKGROUND: Epidemiological evidence suggests that populations with high fruit and vegetable (FV) consumption have a lower risk for childhood obesity, cancer and cardiovascular diseases. There are no studies that address the correlates of FV intake in Mexican children; therefore, the aim of this study was to identify the frequency of FV consumption by children in Mexico City's low income state schools and their personal (preferences, expectancy, knowledge and self-efficacy) and environmental (accessibility and person in charge of cooking at home) correlates. METHODS: A validated questionnaire to assess accessibility, expectancy, self-efficacy, preference and knowledge; and a 2-day dietary recall were used to assess the FV intake and its correlates in 327 children. Statistical analysis included chi-square and stepwise logistic regression. RESULTS: Average consumption of FV was once a day with a higher proportion of girls consuming FV 3 or more times per day (15.2% versus 6.7%; P < 0.01). The environmental factors that influenced a higher consumption of FV were the mother being responsible for cooking at home (P < 0.02) and accessibility to FV (P < 0.01); whereas the personal factors were self-efficacy (P < 0.05) and preference (P < 0.03) to vegetables. CONCLUSION: Correlates of fruit and vegetable consumption in children from Mexico City's State Schools were being female and accessibility to fruits and vegetables. Home and school environments are decisive for the children to increase FV consumption. Creative ways to encourage FV consumption in boys should be explored. These factors should be considered when designing programmes aimed at increasing consumption of fruits and vegetables in children.

[Evaluation of a breakfast as screening test for the detection of gestational diabetes]. / Evaluación de un desayuno como prueba de tamiz para la detección de diabetes gestacional.

A standard breakfast was evaluated as a screening test (BT) for gestational diabetes in a case-control study. The breakfast had a high carbohydrate content and was designed based on women's preferences in a similar sample. Women were selected with a standard 50 g, 1 hour glucose screening test (GT). Fifteen women had a positive GT and 15 had a negative test. A glucose tolerance test (GTT) and a standard breakfast (719 kcal) were performed to all women. Age, weight, height, tricipital and subscapular skinfold thicknesses were obtained by previously standardized personnel and glucose levels were determined by an automatic technique (oxidase glucose). Ten women had gestational diabetes. Sensitivity and specificity were calculated for the GT and several values of the BT, in order to identify the threshold and optimum time. Concordance of both screening tests with GTT was calculated through Kappa test. For the BT, a sensitivity of 0.90 and specificity of 1.00 with a glucose level > or = 140 mg/L (7.2 mmol/L) at 60 and 90 minutes were found. The 60 minutes timing were preferred due to a shorter waiting time to performed the test. Concordance of GTT with GT and BT was 0.53 and 0.92 respectively, both statistically significant. GT had high frequency of false negative values (6/15) that explain the low kappa value. Standard breakfast can be used as an alternative method for assessing carbohydrate tolerance in pregnancy with a better physiological response in these women.

[Clinical nutrition training in medical schools of Mexico]. / Formación nutriológica en las escuelas de medicina de México.

OBJECTIVE: To describe the efforts carried out to strengthen nutrition education in Mexican medical schools. Emphasis was placed on the status previous to the program implementation, the design of a new basic curriculum, and the description of the main program strategies implemented. METHODS: a) Analysis of available medical curricula; b) Application of a questionnaire to the school deans; c) Assessment of knowledge of nutrition of advanced medical students; d) Design of a basic curriculum of clinical nutrition; e) Edition of a textbook; f) Design and implementation of program strategies to strengthen nutrition education. RESULTS: Clinical nutrition was not a topic included in most curricula analyzed and, when present, it was incorporated to related clinical subjects. Usually, emphasis was placed on basic topics of nutrition while clinical and applied subjects were considered less frequently. Lack of a specialized faculty and weakness of teaching infrastructure were some problems identified. A basic curriculum adaptable to different contexts was designed, and a textbook on clinical nutrition was edited and published. Training and formation of nutrition specialists were among the key programs implemented.