May

May 2002 Highlights from the Journal of the American Dietetic Association

Below are summaries of several nutrition research articles published in the May 2002 issue of the Journal of the American Dietetic Association and reactions to the studies from ADA spokespeople. For more information, or to receive a faxed copy of a JADA article, please call Bridget McManamon 800/877-1600, ext. 4769; or e-mail bmcmana@eatright.org.

Healthful eating may fatten your wallet

Eating a healthful diet may make you thinner, but according to researchers at the University of Buffalo, a well-balanced diet may have the opposite effect on your wallet. Researchers evaluated families with obese eight- to- 12-year old children to find out if a nutritious diet was more costly than the standard American diet. Children were placed for one year on the Traffic Light Diet -- foods are categorized as green, yellow or red based on their nutrient density -- and encouraged to take part in at least 180 minutes of physical activity a week. Results showed that these families significantly reduced their energy intake and were consuming fewer than 30 percent of energy from fat. In addition, they were consuming more nutrient-dense foods and their food costs were significantly less one year after treatment, suggesting that a more healthful diet is not more expensive than the typical American diet.

"While many people think a healthful diet costs more money, this research clearly indicates that a well-balanced diet may help keep you in good nutritional and financial standing, " says New York-based registered dietitian and ADA spokesperson Wahida Karmally, associate research scientist and director of nutrition at Columbia University's Irving Center for Clinical Research.

After-school snack attacks

"Who wants ice cream?" Ask this of a classroom of elementary school students and most likely all will answer with an enthusiastic "Me!" According to the USDA, children consume a minimum of one to two snacks per day, totaling up to 42 percent of their total daily energy intake. While the most popular snack items are traditionally high in calories, fat and sodium, researchers from the University of Kansas found that eating a low-fat snack after school improved the total nutritional quality of elementary children's diets. Children were given an eight-ounce portion of low-fat, fortified ice cream after school three days per week for four weeks. Researchers found that the percentage of calories from fat was significantly lower and total iron and calcium intakes were significantly greater. In addition, the low-fat snack improved the nutritional quality of the children's total daily nutrient intake. Researchers suggest that parents provide healthful snack choices to their children and that school foodservice administrators ensure that healthful snacks are provided at school.

"After-school snacks are an important part of a healthy eating plan," says Palo Alto-based registered dietitian and ADA spokesperson Jo Ann Hattner. "Whether your kids come right home from school or have after-school activities, make sure they have healthful snacks available. There is no better time than the early years to make an impact on the lifelong eating habits that contribute to health maintenance and disease prevention."

Mild depression linked to poor diet

Major clinical depression is strongly associated with unhealthful dietary practices and eating disorders. Does the same hold true for people with mild depression or anxiety? According to a study led by researchers at the Fred Hutchinson Cancer Research Center, the answer is yes. The researchers conducted a nationally representative study of adults with psychological distress and found that those with modest symptoms of depression and anxiety were strongly associated with unhealthful dietary habits and binge eating. According to the Surgeon General, about five percent of the U.S. population suffers from major clinical depression, and 20 percent have mild psychological illness.

"Poor diets often result from depression. Energy level and drive are much lower than usual and enthusiasm for most things, including meals, is lost," says Pittsburgh-based registered dietitian and ADA spokesperson Leslie Bonci. "Focusing on a well-balanced diet and eating several small meals throughout the day may help to control binge eating and supply nutrients to the body," says Bonci, director of sports medicine at the University of Pittsburgh.

Position of the American Dietetic Association:
Ethical and legal issues in nutrition, hydration and feeding

Registered dietitians are the leading source of food and nutrition information and have an active role in determining the nutrition and hydration requirements of individuals. Across the life span, there are many instances when providing, withholding or withdrawing nutrition and hydration creates ethical dilemmas. The RD, as a member of the health care team, has the responsibility to identify the nutritional and hydration needs of each individual patient. Development of ethical guidelines for when feeding may or may not be in the patient's best interest can help the patient and the health-care team implement appropriate therapy. Below is ADA's position statement.

It is the position of the American Dietetic Association that the development of clinical and ethical criteria for the nutrition and hydration of persons through the life span should be established by members of the health care team. Registered dietitians should work collaboratively to make nutrition, hydration and feeding recommendations in individual cases.

"The great strength of this position paper is that it presents registered dietitians as key members of the bioethics team," said Phoenix-based registered dietitian Jeff Hampl, an ADA spokesperson. "As always, health-care professionals should respect patients' autonomy and self-determination, but when ethical questions are posed, dietitians are uniquely qualified to share their expertise related to nutrition support, hydration and quality of life," say Hampl, assistant professor of nutrition at Arizona State University.