Nutrition Bytes

Nutritional status can be divided into four components: access to clean water, reliable and safe food sources, basic health care needs met, and nutritional literacy. Drawing from the beginnings of an original study and previous published studies, the problems related to each component were analyzed searching for possible policy actions that may improve the health outcomes of homeless people. The results suggest that declines in nutritional status parallel health status. Nutritional inputs are inadequate due to lack of nutrients and poor absorption from underlying disease processes and alcohol consumption, but for most individuals caloric intake is significant enough to maintain weight. Policy actions must include improving inputs (including vitamin supplements), increasing communication between providers and between clients and providers, and providing nutritional counseling in conjunction with existing case management programs that seek to better manage supplemental food expenditures.

Premenstrual syndrome (PMS) is one of the most common disorders in women in the United States. It is characterized by rapid changes in mood and physical symptoms that occur just before menses and that remit soon after. Calcium has been associated with modulating mood for many years now, and the interaction between estrogen and calcium has implicated it as a major factor in causing PMS symptomatology.

Diet regimens are widely prescribed by health care providers as a first line method of treatment and prevention for numerous medical conditions including obesity, type-2 diabetes mellitus, cardiovascular disease, osteoarthritis, and some forms of cancer. Diet control can be extremely effective in the treatment and prevention of these diseases. However, adherence to diet regimens poses a major problem in their use. Based on the premise that dietary compliance involves learning, planning, and implementation of a diet plan, current data suggests that prepared meal programs increase patient compliance by facilitating the planning and implementation stages. Although the number of studies investigating dietary compliance has increased markedly in the past decade, further study is warranted due to the strong presence of conflicting interests posed by commercial sponsorship.

Breastfeeding is the recommended method of nourishing infants for it has been shown to provide several health benefits for infants and mothers. Compared with formula-fed infants, breastfed infants have higher IQ's, fewer allergies, and experience fewer infections. Mothers who breastfeed tend to have a lower incidence of cancer than those women who choose to use formula exclusively. These facts have lead worldwide and national organizations to support varying degrees of breastfeeding. Unfortunately, there is no universally accepted position that clarifies the optimal length of breastfeeding. It is imperative that the medical community support the research that shows extended breastfeeding is beneficial. After reviewing the evidence, it is clear that physicians need to recommend at least 12 months of breastfeeding to mothers.

The field of obesity management is coming to appreciate the efficacy of pharmacological treatments. For the past twenty years the thermogenic effects of sympathetic stimulation have been known and described. Recent studies have demonstrated that treating patients with a drug combination including the sympathomimetic ephedrine, the stimulant caffeine, and the analgesic aspirin (ECA combination) will stimulate thermogenesis and result in lowered weight but maintained muscle mass. This protein-sparing lipolysis has been attributed to the elevated levels of cAMP generated by the ECA combination. In rat studies, the mechanism of action has been well characterized in vitro and although there is some discrepancy in humans, a similar mechanism seems to be active. Randomized placebo-controlled trials have demonstrated the short-term efficacy of the ECA combination, but long-term studies are lacking. Most studies have also demonstrated the incidence of short-term side effects associated with excessive sympathetic stimulation, and have shown them to be transient and mild. Future studies should focus on the long-term efficacy of the ECA combination, and the effects of stopping treatment on the maintenance of fat loss.