Cholesterol levels have been shown to be related to the development of coronary heart disease and can be lowered through dietary measures (National Institute of Health, 2003). Dietary counseling alone as well as in conjunction with pharmacotherapy has been demonstrated by research to lower blood cholesterol levels. A problem exists in that dietary counseling is underused for the treatment of hyperlipidemia. The purpose of this study is to identify the different types of dietary counseling and their benefits in the treatment of hyperlipidemia as demonstrated through research. Nursing and interdisciplinary research literature published between 1990 and 2003 regarding dietary intake and hyperlipidemia was reviewed and synthesized. The benefits of dietary counseling were synthesized in relation to the outcome measures of: reduced cholesterol levels according to different types of dietary counseling and diets, cost-effectiveness, synergistic effects with pharmacological and other non-pharmacological treatment, and reduced medication-related adverse affects. Different diets and dietary counseling that significantly reduced cholesterol are reported. Limitations in synthesizing these studies were related to different variables, designs, diets, and client types, as well as the fact most research on dietary counseling is not related specifically to nursing but is interdisciplinary. This study will be significant for nursing practice because nurses are often the health care professionals who counsel the patient prior to discharge, during a routine visit, or in any preventive setting, such as health fairs, clinics, consumer education via media, or other community sites. As benefits are clearly identified, nurses will gain a better appreciation for their role in dietary counseling with patients with hyperlipidemia. Recommendations for nursing education, practice, and research were included in this study based on findings synthesized.

Background: Dietary and serum antioxidants and physical activity can effect inflammation, which is associated with breast cancer risk and recurrence. This study investigated the relationship between diet, serum antioxidant capacity, physical activity, and inflammation in breast cancer survivors and individuals without cancer. Methods: Existing demographic, dietary intake, and physical activity data of 78 breast cancer survivors and 30 individuals without cancer from the Day and Night Study conducted at Virginia Commonwealth University were used. Participants were recruited from southern Virginia. Metabolic equivalents were calculated through type, intensity, and duration of physical activity. Dietary antioxidant intake (FRAP) was calculated from Harvard Food Frequency Questionnaire data. Serum samples were analyzed for inflammation (hsCRP,IL-6,IL-1,and TNF alpha) and serum antioxidant capacity (ORAC) at Virginia Tech. Results: Anthropometrics and inflammation were higher, and FRAP and ORAC lower in breast cancer survivors compared to individuals without cancer, although not significant. There was a significant direct relationship between FRAP and ORAC and inverse relationship between FRAP and hsCRP. Breast cancer survivors 6+ years since diagnosis showed significant direct FRAP and IL-1 association, and inverse ORAC and TNF-alpha association. BMI was directly associated with IL-6 and CRP. Inflammation was not associated with METs or weekly activity, although there was an increasing inverse relation between METs, IL-1 and TNF- α with increasing ORAC. Conclusion: There is a significant relationship between dietary antioxidant intake and serum antioxidant capacity and inflammation. Increased body mass index increases inflammation. Diets high in antioxidants and maintaining a healthy weight may help reduce inflammation in breast cancer survivors. / Master of Science / Background: Dietary and serum antioxidants and physical activity can effect inflammation, which is associated with breast cancer risk and recurrence. This study investigates the relationship between diet, serum antioxidant capacity, physical activity, and inflammation in breast cancer survivors and individuals without cancer. Methods: Demographic, dietary intake, and physical activity data of 78 breast cancer survivors and 30 individuals without cancer from the Day and Night Study conducted at Virginia Commonwealth University were used. Participants were recruited in southern Virginia. Metabolic equivalents, a measure of physical activity, were calculated from type, intensity, and duration of physical activity. Dietary antioxidant intake (FRAP) was calculated from Harvard Food Frequency Questionnaire data. Serum samples were analyzed for inflammation (hsCRP, IL-6, IL-1, and TNF-alpha) and serum antioxidant capacity (ORAC) at Virginia Tech. Results: Anthropometrics and inflammation were higher in breast cancer survivors while FRAP and ORAC were lower. Significance existed between dietary antioxidant intake and serum antioxidant capacity as well as dietary antioxidant intake and hsCRP. Higher body mass index was associated with increased inflammation. Breast cancer survivors 6+ years since diagnosis with higher dietary antioxidant intake had lower IL-1, and with serum antioxidant capacity and TNF-alpha. Conclusion: In this population there is a significant relationship between dietary and serum antioxidant capacity, as well as dietary antioxidant capacity and hsCRP. In breast cancer survivors 6+ years since diagnosis there are significant associations in antioxidant capacity and inflammation. This is evidence that dietary antioxidants and maintaining a healthy weight can help reduce inflammation.

Yes / Supermarkets, with vast product ranges and relatively low prices, are an established solution to problems of availability of healthy foodstuffs in areas of limited retail access. However, where they may indeed raise consumption of desirable goods they also open up new opportunities to buy less healthful items for less, a situation which potentially undermines their ability to improve diet. Using under-reported diary data from the Seacroft Intervention Study in the United Kingdom takes this paper beyond the extant fruit and vegetable focus, giving it scope to explore the full effect of supermarkets. Quantile regressions show existing behaviours are reinforced, and intervention stores may do little to improve diet. Switching to Tesco Seacroft is shown to increase the portions of unhealthy food consumed by almost 1 portion per day for the least healthy. Managing demand through promoting balanced diets and restricting offers on unhealthy items will be more effective than intervention, and is an essential accompaniment to new large format retailers if they are not to entrench dietary inequality further. Policymakers and practitioners alike should avoided being distracted by aggregate conclusions if food deserts are to be truly tackled.

No / Microwear patterns and formation processes are examined in modern browsing and grazing Gotland sheep from Denmark. Clear differences in microwear patterning are identified between Gotland sheep, which included a high proportion of leaves, bark and twigs of deciduous trees and shrubs in their diet, and those which primarily had access to graze species, with the browsing group exhibiting enamel surfaces dominated by pitted microwear features, the grazers a predominance of striations. Analysis of abrasives in dung suggests that these trends can be attributed to higher levels of soil ingestion in the grazing population and are a consequence both of grassland management practices and height of feeding within the vegetation canopy. These findings question previous interpretations of microwear patterning in browsing and grazing ungulates, which have equated striated enamel features with the ingestion of high levels of opal phytoliths, and thus have significant implications for palaeodietary reconstruction in such species, both within archaeological and palaeontological contexts. To address further the implications of these results, comparison is made between the Gotland sheep and modern grazing and fodder-fed sheep and goats from elsewhere in Europe. It is concluded that dental microwear analysis has the potential to address questions relating to grassland management practices and the use of certain fodders, such as leafy-hay, but that it may ultimately prove more difficult to distinguish `fresh¿ browsing sheep from some grazing populations, specifically those in which levels of soil ingestion are reduced.

No / This study presents the results of an isotopic analysis of nine naturally mummified individuals—three adults, two adolescents, one juvenile, and three infants—recovered from the Hets Mountain Cave site in southern Mongolia, where they had been secondarily deposited. All of the individuals show evidence of violent perimortem trauma, but no skeletal indicators of nutritional or disease-related stress. Multi-isotopic data (δ13C, δ15N, δ18O, 87Sr/86Sr, and 20nPb/204Pb) were characterized in multiple tissues from each individual when possible, in order to reconstruct diet composition and residential origin at different points in life. Specifically, δ13C and δ15N in bone carbonate and collagen (N = 8) and hair keratin (N = 4) were coupled with enamel carbonate δ18O and δ13C (N = 3) and enamel 87Sr/86Sr, and 20nPb/204Pb (N = 3) to assess diet and residential mobility in relation to skeletal indicators of health and trauma. Results are consistent with a persistence of mixed C3/C4 pastoral subsistence and general stability of diet composition over the life course, in contrast to contemporary accounts of widespread famine and a dependence on grains imported from China throughout the region. However, results also suggest that at least some individuals may have migrated to this region of southern Mongolia from elsewhere during life, meaning that their dietary isotopic profiles may not represent local subsistence patterns near the Hets Mountain Cave site. Overall, these results speak to the utility of life course oriented multi-isotopic analysis in complementing more top-down historical analyses in understanding variation in subsistence, nutrition, and migration in regions undergoing significant political and economic turmoil.

No / The Pictish and Medieval site at Portmahomack contained four skeletal populations belonging respectively to the late Iron-Age/early Pictish period (6th/7th century), to a monastery of the late Pictish/early medieval period (8th century), to a Norse and Scottish trading place (9th to 11th century) and to a late medieval parish (15th century). Carbon and nitrogen isotope analyses of bone and tooth root collagen from sample individuals from each period were measured for dietary reconstruction. Faunal bone collagen was also assessed to provide dietary comparisons. The results demonstrate a marked change in diet between the early and late medieval communities at Portmahomack. Faunal data also presented dietary differences between the early and later medieval periods, perhaps related to a change in husbandry practices. Due to the dearth of carbon and nitrogen isotope studies on medieval skeletal collections in many areas of Britain and Ireland, this study provides valuable data to enhance our knowledge of food consumption and subsistence in the medieval period. / Historic Scotland provided funding the isotope analysis

Yes / Objective: This project sought to investigate whether an association may be observed between isotopic stress indicators and skeletal evidence of pathological conditions. Materials: Deciduous and permanent teeth of 15 non-adults from two contemporaneous mid-19th century London burial grounds (City Bunhill, Lukin Street). Methods: δ13C and δ15N was measured in the incrementally sectioned dentine collagen. Isotopic profiles for each individual included death during tooth development. Results: Individuals with skeletal evidence of chronic pathological conditions (e.g., rickets, tuberculosis) exhibited raised δ15N values of 0.5-1.7‰ in the months prior to death. Isotopic change consistent with chronic physiological stress prior to death was also recorded in two individuals with no skeletal evidence of disease. An offset was observed between co-forming bone and dentine δ15N values in both populations, indicating that bone and dentine are not recording the same isotopic changes. Conclusions: Isotopic change consistent with chronic physiological stress was observed in both those with and without skeletal evidence of disease, suggesting that adaptation to chronic stress in childhood was not uncommon within these 19th century London populations. Significance: Chronic physiological stress prior to death may be seen in the incrementally sampled dentine of non-adults who die during tooth formation. Limitations: The temporal resolution of current dentine micro-sampling methods may mask or minimise visibility of shorter-term periods of stress or dietary change. Suggestions for further research: Future research should further explore the relationship between specific skeletal pathologies and isotopic evidence for stress.

The purpose of this study was to find the difference, if any, between the weight gain patterns during pregnancy of women attending public health clinics in Northern Virginia who were enrolled in the NIC program and women not enrolled in the NIC program. Women on the NIC program during pregnancy were identified from NIC files. The control group was chosen from among women who were shown to be both nutritionally at risk and eligible for NIC based on income, but who were not receiving NIC benefits during pregnancy. The sample consisted of M8 subjects in each group who met certain other selection criteria. With the exception of income, there was no statistically significant difference when selected maternal and infant variables were compared. There was no significant difference (p>.O5) between total weight gain of the two groups, although the NIC mothers gained slightly more during pregnancy than the non-NIC mothers. A series of t-tests, performed between the means of the weekly weight gains, showed no significant difference in the weekly weight gain of the two samples at any week of pregnancy. Both samples had increased weekly weight gains near the end of pregnancy - the mean of the non-WIC group was higher and occurred slightly later than did that of the WIC group. These higher means near the end of pregnancy for the non-WIC group resulted in statistically significant differences in the two groups when comparing the last part of pregnancy and suggest that the non-WIC group is gaining a larger amount of weight very late in pregnancy. / Master of Science

Sammanfattning   Bakgrund: Övervikt och fetma har blivit en hälsofarlig nödsituation i västvärlden, i synnerhet bukfetma som är en av de viktigaste riskfaktorerna för kardiovaskulära sjukdomar. Den västerländska dieten domineras av högt förädlade livsmedel till låg kostnad vilket snabbt har utvecklat övervikt och överviktsrelaterade sjukdomar. Det finns olika behandlingsmetoder för att minska övervikt och fetma, där kost är en viktig komponent. Lågkolhydratkost kommer alltmer i fokus, som ett alternativ till de rådande näringsrekommendationerna. För att stödja och motivera personer med övervikt och fetma kan sjuksköterskan förmedla en personcentrerad egenvård enligt Orem. Sjuksköterskan skall enligt lag arbeta evidensbaserat och det krävs ständig uppdatering av forskningsläget. Syfte: Syftet var att studera effekten av lågkolhydratkost hos personer med övervikt och fetma. Metod: Litteraturöversikten är av kvantitativ metod och innehåller 15 vetenskapliga artiklar. Analysmodellen som användes var Fribergs analys. Resultat: Effekter av lågkolhydratkost visar signifikanta förbättringar i framförallt viktnedgång men även i blodtryck, blodfetter och blodsocker. De största effekterna av de olika variablerna sågs efter sex månader. Dessa effekter gav ofta en minskad användning av antidiabetika som följd. Slutsats: Då lågkolhydratkost har gynnsamma effekter på viktnedgång, blodfetter och blodsocker är behovet stort av långtidsstudier. Sjuksköterskan har en viktig roll att stödja och motivera personer med övervikt och fetma till livsstilsförändringar. Nyckelord: Viktnedgång, ketogen kost, lågkolhydratkost, egenvård / Summary Low-carbohydrate diets for overweight and obesity - A literature review   Background: Overweight and obesity has become a health hazard emergency in the western world, especially abdominal obesity which is one of the major risk factors for cardiovascular diseases. The Western diet is dominated by highly processed food at low cost, which has rapidly developed obesity and obesity related diseases. There are various treatment methods to reduce overweight and obesity by diet which is an important component. Low-carbohydrate diet comes increasingly into focus, as an alternative to the current nutritional recommendations. To support and motivate people with overweight and obesity, the nurse can convey a person-centered self-care according to Orem. The nurse should, by law, set their work based on evidence and that requires a continuous update of available research. Objective: The objective was to study the effect of low-carbohydrate diet in people with overweight and obesity. Method: The literature review is the quantitative method and contains 15 scientific articles. The analysis model used was Friberg analysis. an important role to support and motivate people with overweight Result: Effects of low-carbohydrate show significant improvements especially in weight loss but also in blood pressure, blood fats and blood sugar. The main effects of the different variables were observed after six months. These effects often gave a reduced use of antidiabetic drugs as a result. Conclusion: Since low-carbohydrate proven to have beneficial effects on weight loss, blood fat and blood sugar there is a great need for long-term studies. The nurse has and obesity to lifestyle changes. Keywords: Weight loss, ketogenic diet, low-carbohydrate diet, self-care

This paper reviewed the mechanisms of systemic inflammation and the nutritional status of the individuals who suffer from chronic diseases including rheumatoid arthritis, systemic lupus erythematous, chronic obstructive pulmonary disease, irritable bowel diseases include ulcerative colitis and Crohn’s disease, asthma, and atherosclerosis. Treatment modalities such as diet regimens will also be discussed. The Anti-Inflammatory diet, Mediterranean Diet, and the Dash diet will be discussed. Nutritional status and inflammation go hand in hand according to the findings available today. There is still more research required to completely understand the mechanisms that occur in inflammation.