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The Journal of Pediatrics Apr 2018
Topics: Child; Gastrointestinal Diseases; Humans; Milk Hypersensitivity; Proctocolitis; Risk Factors
PubMed: 29336792
DOI: 10.1016/j.jpeds.2017.12.027 -
The Journal of Nutrition Nov 2021Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein... (Review)
Review
Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein quality should be emphasized as a key characteristic during protein food selection within the larger context of healthy dietary patterns, especially when considering the wide variance of protein quality across animal- and plant-based foods. However, the USDA Dietary Guidelines for Americans (DGA) do not address specific protein quality recommendations within their protein foods ounce equivalents guidance or as a component of Healthy U.S. Style, Healthy Vegetarian, and Healthy Mediterranean Style dietary patterns. In addition, the protein foods ounce equivalents within the DGA are not established on any obvious metabolic equivalency characteristic [i.e., energy, protein, or essential amino acid (EAA) content], which creates misleading messaging of equivalent functional and metabolic benefit across protein foods. EAA content is a key characteristic of protein quality and can be a practical focal point for protein intake recommendations and achieving healthy dietary patterns. This review discusses the importance of protein quality, the state of messaging within DGA recommendations, and proposes EAA density (i.e., EAA content relative to total energy) as one practical approach to improve current dietary recommendations. Two recent publications that evaluated the DGA protein foods ounce equivalents based on metabolic effect and their application within DGA recommended dietary patterns are discussed.
Topics: Amino Acids, Essential; Animals; Diet; Health Status; Nutrition Policy; United States
PubMed: 34386826
DOI: 10.1093/jn/nxab262 -
Academic Radiology Mar 2021Quotes such as "an ounce of prevention is worth a pound of cure" (Benjamin Franklin) and "a good doctor cures the disease, but a great doctor cures the cause" (Amit...
Quotes such as "an ounce of prevention is worth a pound of cure" (Benjamin Franklin) and "a good doctor cures the disease, but a great doctor cures the cause" (Amit Kalantri), are poignant reminders of the overwhelming power of preventive medicine on population health. Why, then, would it not be that the health of our medical system would not benefit from the same sort of ideas? Medical imaging is considered over utilized and numerous strategies have attempted to address this including "Choosing Wisely," American College of Radiology appropriateness criteria, clinical decision support instruments and others. Most of these have been partially successful, but none have yet to turn the tide of over imaging. Here, we propose a multipronged strategy to target education of all audiences - medical students, residents/fellows, and practicing physicians. Education on the breadth of imaging options, the limitations of radiology tests, when not to image, as well as when to use highly specific imaging tests, here serves as the preventive measure to curb the spread of overutilization.
Topics: Curriculum; Diagnostic Imaging; Humans; Radiography; Radiology; Students, Medical
PubMed: 32622743
DOI: 10.1016/j.acra.2020.06.011 -
The Journal of Allergy and Clinical... Jun 2020
Topics: Case-Control Studies; Food Hypersensitivity; Humans; Immunoglobulin E; Vaccination; Whooping Cough
PubMed: 32499040
DOI: 10.1016/j.jaip.2020.01.005 -
Heart, Lung & Circulation Sep 2021
Topics: Coronary Artery Bypass; Coronary Artery Bypass, Off-Pump; Humans; Reoperation; Treatment Outcome
PubMed: 34244068
DOI: 10.1016/j.hlc.2021.06.449 -
Mayo Clinic Proceedings. Innovations,... Apr 2021The sudden outbreak and global spread of COVID-19 demanded a tremendous amount of attention for viral respiratory infections (VRIs) in modern times. Evidence accumulated... (Review)
Review
The sudden outbreak and global spread of COVID-19 demanded a tremendous amount of attention for viral respiratory infections (VRIs) in modern times. Evidence accumulated over the past few decades increasingly suggests the importance of recognizing the background and context of lifestyle factors in the prevention of VRIs recurrence. The focus of attention has specifically been on how to optimize respiratory barrier function and immune function during the period of the pandemic outbreak. This viewpoint discusses the impact of a healthy lifestyle on VRIs and demonstrates a practical approach to preventing the occurrence of VRIs based on contemporary evidence.
PubMed: 33585798
DOI: 10.1016/j.mayocpiqo.2020.12.008 -
Journal of the American Academy of... Sep 2021Globally, depression is among the leading neuropsychiatric disorders of adolescence. Conventional wisdom indicates that an "ounce of prevention is worth a pound of...
Globally, depression is among the leading neuropsychiatric disorders of adolescence. Conventional wisdom indicates that an "ounce of prevention is worth a pound of cure," a perspective bolstered by some studies demonstrating that psychological interventions for subthreshold depression reduce acute symptoms and prevent the onset of major depressive disorder (MDD) over short-term follow-up. However, the meta-analysis by Cuijpers et al., the first to pool results from all available relevant studies in the field, provides evidence that would seem to challenge this conventional wisdom. The meta-analysis included 12 randomized controlled trials of children and adolescents. This editorial focuses on the 10 studies with adolescents (age range, 13.5-17.4 years), who were recruited from schools (n = 6), medical settings (n = 3), and mass mailings (n = 1). The youths received short-term psychotherapies ranging from 6 to 16 sessions, primarily cognitive-behavioral therapy or interpersonal therapy, or inactive control/care as usual. Results showed significant short-term benefits in reducing acute depression symptoms, even though effect size was small to medium (number needed to treat = 8.4). At 6-18 months of follow-up, however, the likelihood of meeting full criteria for MDD was not significantly different between the intervention and control conditions. We child and adolescent psychiatrists have difficulty yielding our commitment to conventional wisdom and look for evidence that this meta-analysis is not the last word on the value of early interventions for subthreshold depression to prevent MDD in adolescents.
Topics: Adolescent; Child; Cognitive Behavioral Therapy; Depression; Depressive Disorder, Major; Humans
PubMed: 33667603
DOI: 10.1016/j.jaac.2021.02.015 -
Gastrointestinal Endoscopy Nov 2020
Topics: Colonoscopy; Curriculum; Ergonomics; Humans; Musculoskeletal Diseases
PubMed: 33160489
DOI: 10.1016/j.gie.2020.07.035 -
Nutrients Jun 2023The Dietary Guidelines for Americans (DGA) recommends consuming a variety of "Protein Foods" based on "ounce-equivalent" (oz-eq) portions. No study has assessed the same... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of Consuming Ounce-Equivalent Portions of Animal- vs. Plant-Based Protein Foods, as Defined by the Dietary Guidelines for Americans on Essential Amino Acids Bioavailability in Young and Older Adults: Two Cross-Over Randomized Controlled Trials.
BACKGROUND
The Dietary Guidelines for Americans (DGA) recommends consuming a variety of "Protein Foods" based on "ounce-equivalent" (oz-eq) portions. No study has assessed the same oz-eq portions of animal- vs. plant-based protein foods on essential amino acid (EAA) bioavailability for protein anabolism in young and older adults.
OBJECTIVES
We assessed the effects of consuming two oz-eq portions of pork, eggs, black beans, and almonds on postprandial EAA bioavailability in young and older adults.
METHODS
We conducted two investigator-blinded, randomized crossover trials in young ( = 30; mean age ± SD: 26.0 ± 4.9 y) and older adults ( = 25; mean age ± SD: 64.2 ± 6.6 y). Participants completed four testing sessions where they consumed a standardized meal with two oz-eq of either unprocessed lean pork, whole eggs, black beans, or sliced almonds. Blood samples were taken at baseline and 30, 60, 120, 180, 240, and 300 min postprandially. Plasma EAA bioavailability was based on postprandial integrated positive areas under the curve.
RESULTS
Participant age did not affect EAA bioavailability among the four protein foods tested. Two oz-eq portions of pork (7.36 g EAA) and eggs (5.38 g EAA) resulted in greater EAA bioavailability than black beans (3.02 g EAA) and almonds (1.85 g EAA) in young and older adults, separately or combined ( < 0.0001 for all). Pork resulted in greater EAA bioavailability than eggs in young adults ( < 0.0001), older adults ( = 0.0007), and combined ( < 0.0001). There were no differences in EAA bioavailability between black beans and almonds.
CONCLUSIONS
The same "oz-eq" portions of animal- and plant-based protein foods do not provide equivalent EAA content and postprandial bioavailability for protein anabolism in young and older adults.
Topics: Animals; Humans; Amino Acids, Essential; Biological Availability; Eggs; Nutrition Policy; Randomized Controlled Trials as Topic; United States; Cross-Over Studies
PubMed: 37447197
DOI: 10.3390/nu15132870 -
Journal of Developmental and Behavioral... 2017Paul is an 8-year-old boy with a long-standing history of encopresis and enuresis. Potty training was initiated when he was 2 years old. At this time, his mother was...
Paul is an 8-year-old boy with a long-standing history of encopresis and enuresis. Potty training was initiated when he was 2 years old. At this time, his mother was absent from the home for 6 weeks when she cared for her ill father in a different city. The process of teaching Paul to use the bathroom was described as "inconsistent" due to multiple caretakers.Paul never successfully mastered bowel and bladder control. He continues to wet and soil his clothes on a daily basis at home and school. According to his parents, he does not accept responsibility and comments about his soiling such as, "I didn't do it; someone else must have put it there." One of Paul's teachers commented that she could tell at the beginning of the school day whether he would maintain bowel and bladder control. If he was "agitated and talkative" in the early morning, he would often soil that day.He had a pediatric gastroenterological evaluation at the age of 5 years when he was having daily episodes of stool soiling. Physical examination revealed normal anal tone, normal placement of the anus, and moderate stool in the rectal vault. An abdominal radiograph revealed moderate stool throughout the colon. He was treated with Miralax and instructed to sit on the toilet twice daily. Paul did not respond to these interventions and was diagnosed with "overflow incontinence secondary to stool withholding." When he was taking Miralax, he had a normal barium enema radiograph. He was admitted to the hospital for a cleanout with a polyethylene glycol/electrolyte solution.Although abdominal radiographs demonstrated absence of colonic stool for the following 5 months, he continued to soil his clothing. Play therapy and biofeedback did not change the chronic soiling and wetting pattern. An evaluation at the Continence Clinic resulted in a rigorous program including stooling after each meal, wearing a vibrating watch reminding him to void every 2 hours, drinking 60 ounces of water per day, tracking elimination patterns on a calendar, and a daily laxative (polyethylene glycol). A neuropsychological evaluation revealed a superior aptitude associated with unresolved early childhood issues of self-control, self-care, and frustration tolerance. Family therapy was initiated. However, daily fecal soiling and wetting persisted.Paul was born full-term without prenatal or perinatal complications. He was breast fed for 1 year and described as an easy baby. He achieved motor, social, and language milestone on time. Paul had difficulty with separation and aggression in preschool (e.g., biting). In school, teachers report inattention, fidgetiness, and difficulty following directions. He has been obese since age 3 years; his current body mass index is 29.
Topics: Child; Encopresis; Fecal Incontinence; Humans; Male
PubMed: 28141711
DOI: 10.1097/DBP.0000000000000392