Free Essay

Nutrition

In: Science

Submitted By peilu
Words 1845
Pages 8
Interpreting and understanding meta-analysis graphs
A practical guide
Ideally, clinical decision making ought to be based on the latest evidence available. However, to keep abreast with the continuously increasing number of publications in health research, a primary health care professional would need to read an unsurmountable number of articles every day covered in more than 13 million references and over 4800 biomedical and health journals in Medline alone.1 With the view to address this challenge, the systematic review method was developed.2 This article provides a practical guide for appraising systematic reviews for relevance to clinical practice and interpreting meta-analysis graphs as part of quantitative systematic reviews. A systematic review is a synthesis of primary research studies investigating a clearly formulated clinical question using systematic, explicit and reproducible methods. The Cochrane Library is probably the most comprehensive collection of regularly updated systematic reviews in the health field and is freely accessible in Australia.3 Some systematic reviews qualify for a quantitative statistical summary of comparable study findings, the meta-analysis. While useful guides to systematic review methodology and critical appraisal of systematic reviews are plentiful, 4–6 there is a paucity of practical guides to appraisal of meta-analysis for the nonstatistician. This article provides a practical guide to appraisal of meta-analysis graphs, and has been developed as part of the Primary Health Care Research Evaluation Development (PHCRED) capacity building program for training general practitioners and other primary health care professionals in research methodology. meta-analysis before diving into the fine points of the meta-analysis results and drawing conclusions on patient treatment. Table 1 can guide the assessment.

PROFESSIONAL PRACTICE Research

Karin Ried PhD, MSc, GDPH, is Research Fellow & PHCRED Program Manager, Discipline of General Practice, The University of Adelaide, South Australia. karin.ried@adelaide.edu.au

Meta-analysis graphs
Meta-analysis results are commonly displayed graphically as ‘forest plots’. Figures 1 and 2 give examples of metaanalysis graphs. Figure 1 illustrates a graph with a binary outcome variable whereas Figure 2 depicts a forest plot with a continuous outcome variable. Some features of meta-analyses using binary and continuous variables and outcome measures are compared in Table 2. The majority of meta-analyses combine data from randomised controlled trials (RCTs), which compare the outcomes between an intervention group and a control group. While outcomes for binary variables are expressed as ratios, continuous outcomes measures are usually expressed as ‘weighted mean difference (WMD)’ in metaanalyses (Table 2). The details of the meta-analysis are commonly displayed above the graph: • review: title/research question of the systematic review and meta-analysis • comparison: intervention versus control group; a range of comparisons may have been done in a systematic review, and • outcome: the primary outcome measure analysed and depicted in the graph below. Meta-analysis graphs can principally be divided into six columns. Individual study results are displayed in rows. The first column (‘study’) lists the individual study IDs included in the meta-analysis, usually the first author and year are displayed. The second column relates to the intervention groups, and the third column to the control groups. • Figure 1: in meta-analyses with binary outcomes (eg. disease/no disease) the individual study findings are displayed as ‘n/N’, whereby: n = the number of participants with the outcome (eg. Figure 1. Adverse

Critical appraisal of systematic reviews and meta-analyses
It is important to assess the methods and quality of the systematic review and appropriateness of the

Reprinted from Australian Family Physician Vol. 35, No. 8, August 2006 635

PROFESSIONAL PRACTICE Interpreting and understanding meta-analysis graphs – a practical guide

Table 1. Assessment of systematic reviews and meta-analyses
When can a systematic review and meta-analysis give further insight into primary study results? • Existing studies gave disparate results • Bigger study population (sample size) can increase power, generalisability and precision of findings (effect estimate) • Subgroup analyses may be possible and could generate new hypotheses Is the meta-analysis clinically sensible? • Did the studies summarised in the systematic review address the same research question? • Are the studies included in the meta-analysis of comparable quality (selection bias, attrition rates, confounding variables)? • Are the studies comparable (eg. population, duration/dosage of treatment)? Will the results help in caring for my patients? • Are the studied populations comparable to my patients? • Are the results clinically important? • Are all clinically important outcomes considered? • Were benefits, harms and costs considered?

effects) in the intervention (column 2) or control group (column 3), and N = the total number of participants in the intervention (column 2) or control group (column 3) • Figure 2: in meta-analyses with continuous outcome variables (eg. fasting blood glucose level) the individual study findings are given as ‘N’ and ‘mean (SD)', whereby N = the total number of participants in the intervention (column 2) or control group (column 3), and mean SD = the arithmetic mean and standard deviation (SD) of the outcome measure in either the intervention (column 2) or control group (column 3). The fourth column visually displays the study results. The line in the middle is called ‘the line of no effect’, which has the value of either 1 in case of a binary outcome variable (eg. odds ratio (OR) or relative risk [RR]), or 0

Study IDs

Details of review N = total number in group n = number in group with the outcome

Outcome effect measure Shown graphically and numerically Fixed effect model used for meta-analysis

Review: Supplementation with M in condition X Comparison: 01 Supplement M versus placebo Outcome: 01 Adverse effects Study Intervention group n/N 1/141 7/27 1/100 Control group n/N 2/142 9/29 0/100

Influence of studies on overall meta-analysis

Relative risk (fixed) 95% CI

Weight (%) 17.8 77.7 4.5

Relative risk (fixed) 95% CI 0.50 [0.05, 5.49] 0.84 [0.36, 1.93] 3.00 [0.12, 72.77]

Study A Study B Study C

Total (95% CI)

268

271

100.0 Overall effect

0.87 [0.41, 1.87]

Total events: 9 (supplement M), 11 (control) Test for heterogeneity Chi-square=0.79 df=2 p=0.67 I2=0.0% Test for overall effect z=0.35 p=0.7

p value indicating level of statistical significance Heterogeneity (I2) = diversity between studies
Figure 1. Meta-analysis of binary outcome measure

0.01 0.1 1 Favours intervention

10 100 Favours control Scale of treatment effect

Line of no effect

636 Reprinted from Australian Family Physician Vol. 35, No. 8, August 2006

Interpreting and understanding meta-analysis graphs – a practical guide PROFESSIONAL PRACTICE

Study IDs

Details of review N = total number in group Mean (standard deviation) of outcome

Outcome effect measure Shown graphically and numerically Fixed effect model used for meta-analysis

Review: Medicines for condition X Comparison: 01 Medicine Z versus placebo Outcome: 01 Fasting blood glucose levels (mmol/L) Study Intervention group N mean (SD) 34 9.77 (2.93) 36 8.40 (1.90) 30 10.26 (2.96) Control group N mean (SD) 34 10.29 (3.43) 36 8.90 (3.00) 30 12.09 (3.24)

Influence of studies on overall meta-analysis

Weighted mean difference (fixed) 95% CI

Weight (%) 27.5 46.9 25.6

WMD (fixed) 95% CI –0.52 [–2.04, 1.00] –0.50 [–1.66, 0.66] –1.83 [–3.40, –0.26]

Study A Study B Study C

Total (95% CI)

100

100

100.0 Overall effect

–0.85 [–1.64, –0.05]

Test for heterogeneity Chi-square=2.03 df=2 p=0.36 I2=1.4% Test for overall effect z=2.09 p=0.04

p value indicating level ofstatistical significance Heterogeneity (I2) = diversity between studies
Figure 2. Meta-analysis of continuous outcome measures

–4.0 –2.0 0 Favours intervention

2.0 4.0 Favours control Scale of treatment effect

Line of no effect

in case of a continuous outcome variable (eg. WMD). There is no difference between the intervention and the control group, if OR or RR = 1 or WMD = 0. The boxes are situated in line with the outcome value of the individual studies, also called the effect estimates (eg. OR, RR or WMD). The value axis is at the bottom of the graph. The size of the box is directly related to the 'weighting' of the study in the meta-analysis. The horizontal lines (whiskers) through the boxes depict the length of the confidence intervals (CI). The longer the lines, the wider the CI, the less precise the study results. Arrows indicate that the CI is wider than there is space in the graph. The weight (in %) in the fifth column

indicates the weighting or influence of the study on the overall results of the metaanalysis of all included studies. The higher the percentage weight, the bigger the box, the more influence the study has on the overall results. The influence or ‘weight’ of a study on the overall results is determined by the study’s sample size and the precision of the study results provided as a CI. In general, the bigger the sample size and the narrower the CI, the greater the weight of the study. The sixth column gives the numerical results for each study (eg. OR or RR and 95% CI) which are identical to the graphical display in the fourth column. The diamond in the last row of the graph illustrates the overall result of the meta-

analysis. The middle of the diamond sits on the value for the overall effect estimate (eg. OR, RR or WMD) and the width of the diamond depicts the width of the overall CI. The overall numerical results are given in column six. The total number of participants in the intervention groups (column 2) and the control groups (column 3) is also summarised in the same row. If the diamond doesn’t cross the ‘line of no effect’, the calculated difference between the intervention and control groups can be considered as statistically significant. Numerically, the CI does not include 1 for binary outcome variables, measured as OR or RR; the CI does not include 0 for continuous outcome variables, measured as WMD. Statistical significance of the overall result

Reprinted from Australian Family Physician Vol. 35, No. 8, August 2006 637

PROFESSIONAL PRACTICE Interpreting and understanding meta-analysis graphs – a practical guide

Table 2. Comparison of meta-analyses of either binary or continuous variables and outcome effect measures
Examples for variables Outcome effect measure Line of no effect Treatment scale a) If outcome effect measure is adverse (eg. disease present, weight gain) or b) if decreased outcome effect measure is desirable (eg. lowered blood pressure) Treatment scale c) If outcome effect measure is desirable (eg. stopped smoking, increased walking speed) Binary Yes/no, disease/no disease, alive/dead Ratios, often RR or OR 1 Favours intervention on left hand side of treatment scale (ratio 0)

is also expressed with the probability value (p value) in the 'test for overall effect'. Commonly, the result is regarded as statistically significant if p…...

Similar Documents

Premium Essay

Nutrition

...Nutrition is a process by which a living organism assimilates food and uses it for ones growth and replacement of tissues. Many common health problems can be prevented by the intake of healthy diet. On the contrary, a poor diet may have injurious health effects such as obesity, kwashiorkor, etc. Asia is home to a more diversified community in comparison to any other part of the world. Like its diversified nations and peoples, the climate and geography of Asia are also diverse. From the lush rice paddies of the Philippines to the tropical rainforests of Indonesia, there is a huge variety of spices, food and fruit in this part of the world. During the last decade, the South-East Asian countries have shown a general uptrend in the food production. Despite a marked increase in population in many of the South-East Asian countries, there was a significantly higher production per capita in 1988-90 especially in Malaysia, Cambodia, Indonesia and Vietnam. But, no evident uptrend has been seen in respect to milk, pulses, horticultural products, meat or poultry production. An unfortunate feature of nutrition is the prevailing high incidence of the birth of low birth weight babies which reflects the state of maternal malnutrition during pregnancy. There is a considerable decline in the florid nutritional deficiency diseases over the last decade, but iron deficiency anemia and goiter are still the major health problems amongst people. With the changing trends and cultures among the......

Words: 654 - Pages: 3

Free Essay

Nutrition

...Nutrition and Academic Performance 1 NUTRITION AND ITS EFFECTS ON ACADEMIC PERFORMANCE HOW CAN OUR SCHOOLS IMPROVE? By Amy Ross SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS EDUCATION AT NORTHERN MICHIGAN UNDERSITY July 28, 2010 APPROVED BY: DATE: Derek L. Anderson, Ed.D. August 2, 2010 Nutrition and Academic Performance 2 Table of contents Abstract ...…………………………………………………………………………………………3 Chapter I: Introduction…………………………………………………………………………….…4 Statement of Problems…………………………………………………………………….8 Research Questions…………………………………………………………………….…9 Definition of Terms ……………………………….…………………………………….10 Chapter II: Review of the Literature Nutrition and Cognition ………………………..……………………………………….11 Food Insufficiency …………………………..………………………………………….24 School Food Programs ……………………………...…………………………………..35 Chapter III: Results and Analysis …………………………..…………………………………..51 Chapter IV: Recommendations and Conclusion ……………………...………………………..54 References...………………………………………………………………………………..…...59 Nutrition and Academic Performance 3 Abstract The purpose of this paper was to review existing literature about past research that highlighted studies concerning nutrition and its relationship to brain function, cognition, learning, and social behaviors. There is evidence that school breakfast and lunch programs are not up to par with current United States Department of Agriculture standards and that USDA standards may not be utilizing the latest research...

Words: 16993 - Pages: 68

Premium Essay

Nutrition

...Nutrition I have always had a strong desire to help others.  Nutrition has always fascinated me. I constantly look for updated information on our health and nutrition, but I haven’t had the opportunity to consult with anyone in my field, until I met Renita Dastrup. The interview gave me a great outlook on nutrition.  As a result of the interview I found out that I want to study the physiological approach to nutrition rather than the Chemistry aspect. After a few days of playing phone tag, I contacted Dastrup. She gladly accepted the opportunity to let me interview her. I was able to meet with her, it was late afternoon. A slight breeze blew and the heavy clouds moved slowly resulting in brief moments of piercing sunlight. We agreed to meet outside the clubhouse of my apartment building. She is a blonde-haired blue eyed lady, she has and athletic build.  As she looked in my direction,  her eyes lit up, and the corners of her mouth displayed her smile, it beamed like a perfect pearl necklace. The dimples in her cheeks appeared as her whole face showed amusement upon meeting me. Dastrup a mother of two, worked as a Real Estate and Mortgage Broker for over eighteen years. She enjoyed her job, but she wasn’t where she wanted to be.  Her choice to go back to school at the age of thirty eight was very difficult. When she decided to go back to school, she quit her job so she could pursue her passion. She has always been interested in nutrition, but she never thought she would......

Words: 1048 - Pages: 5

Premium Essay

Nutrition

...Toni Mia Duran Bio 314- Nutrition Professor Sillanpaa October 16, 2013 The Differences There is lipid and proteins in many things we eat. One healthy example of a lipid would be grilled chicken. Chicken is a good source of protein when it is not soaked in olive oil and the extra fattening products that can be added. Grilling the chicken cuts back the intake of lipids. An unhealthy lipid would be a hamburger. Either way you get the hamburger meat whether you get the patties ready or make them yourselves, they are filled with grease. Unlike chicken, the grease stays in the hamburger patty. There are also healthy and unhealthy amino acids and proteins. Fish would be a good example of healthy protein. It is considered on of the best intakes for protein. It is not only good for that, but helps the brain too. An example for an unhealthy amino acid and protein would be maltodextrin. This is used is in artificial dietary fiber. It is made from corn and is very hard to digest. One thing it does do is make a person feel full for the meantime. As bad as it is, I like some fatty foods such as hamburgers. I do not eat them every day, but they are fast and easy. Chicken is very good as well. It is so easy to eat junk food. It is so convenient and so fast to either grab or even make at home. One thing I do not like AT ALL is fish, any of it. Although it is very healthy and good for my body, fish is something I will avoid. Learning about the effects of lipids opens my eyes to see...

Words: 354 - Pages: 2

Premium Essay

Nutrition

...Nutrition and fitness as active parts of our lives In other times, the recommendations in the field of nutrition and fitness suggested that the majority of the people should carry out an intense physical activity during a minimum of twenty minutes a day. Scientists and health professionals have realized that this level of activity is excessive for most people. In addition, it has been discovered that do not need to strive both to obtain the benefits that exercise contributes to our health. Brisk walking or almost all the days for approximately thirty minutes helps improve physical and mental well-being. Physical exercise in brief sessions, for example, two or three sessions of ten minutes each, is almost as effective as exercise steadily during the same time and is easier to adapt to the pace of life today. For those who don't like or making it impossible to do exercise in a planned way, the fact to avoid or reduce the time spent in sedentary activities can be equally beneficial. For example, the simple fact of stand for one hour a day instead of sitting down to watch TV consumes the equivalent of 1-2 kg of fat per year. Obese people should choose carefully the type of exercise they are going to perform in order to avoid any injury to the joints caused by the practice of intense activities in which they have to support their own weight. Swimming and biking are two good options for people who are overweight. A good nutrition and fitness increases life expectancy......

Words: 303 - Pages: 2

Premium Essay

Nutrition

...it is because nutrient rich food is consumed over a longer period of time or because it contains a wider variety of complex nutrients, the reason is unknown. The results, however, remain apparent. Some dietary factors leading to good health simply cannot be found in supplements and nothing can substitute for a healthy balanced diet of whole foods. * * * * * * * References American Heart Association. (2014, February 26). Vitamin supplements: Healthy or hoax?. Retrieved April 14, 2014 from http://www.heart.org/HEARTORG/Conditions/Vitamin-Supplements-Healthy-or-Hoax_UCM_432104_Article.jsp Mayo Clinic Staff. (2013, January 19). Supplements: Nutrition in a pill?. Nutrition and Healthy Eating. Retrieved April 13, 2014 from http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/supplements/art-20044894?pg=1...

Words: 499 - Pages: 2

Premium Essay

Nutrition

...PERSONALIZED NUTRITION AND EXERCISE PLAN 2 Personalized Nutrition and Exercise Plan Identify the health and nutrition problem that may be targeted. Discuss the disease/issue The current health problem I have is my family has a history of heart disease and Type II diabetes. I went to the doctor's office recently where she drew blood for a variety of tests. She was concerned about my blood sugar levels. Everything turned out fine but it made me realize that I could stand to lose some weight and start eating healthier. I do not want to face this problem again and do not want the family history to affect my future. Plus, if I am blessed with children, I want to be a healthy example for them. Discuss four nutritional and/or physical exercise goals My biggest goal is to lose a minimum of 50 pounds. In the past six months, I have gained about twenty pounds, especially in my middle. This is driving me nuts. So, on top of getting rid of the extra weight altogether, I want to erase my “muffin top”. Along with slimming my waist, I would like to tone my arms. One final goal, although I am not sure this one is attainable due to a bad knee, is to start jogging. When class started, I was more active than near the end of class. When I utilized the pyramid activity tracker in week 6, the results did not surprise me. I knew that I had fallen off the wagon so to speak. My average PA Score on www.mypyramidtracker.gov was 65.3 which was mostly due to an afternoon......

Words: 1971 - Pages: 8

Premium Essay

Nutrition

...Nutrition and Recovery Nutrition and Recovery Nutrition affects every part of our daily lives. We eat nutritional foods to stay healthy and live active lives. We also eat nutritiously to regain our lives after an accident or surgery. This paper highlights the importance of nutrition after surgery. Nutrition plays an important role in the reducing the risk of infection and wound healing after surgery. Understanding how nutrition can benefit as well as hurt recovery after surgery when caring for all patients. Malnutrition as a result of critical illness has been defined as ‘acute disease or injury-related malnutrition’, which is associated with severe, acute inflammation. During periods of critical illness, the inflammatory response elevates energy expenditure and nitrogen excretion that is only partially attenuated by the provision of nutritional support. Contributing to this weight loss is inadequate nutritional intake with ICU patients only receiving 60–80% of their prescribed energy and protein requirements.( JCN, 2014) These suboptimal intakes result from delays in initiating feeding and feed interruptions due to nausea, vomiting, abdominal distension, large gastric aspirates, tube displacement, investigations and prolonged fasting for procedures. Oral diet following extubation from mechanical ventilation has also been shown to be inadequate. Peterson assessed the oral intake of 50 patients for the first...

Words: 519 - Pages: 3

Free Essay

Nutrition

...PART 1 NUTRITION AND ATHLETE HEALTH The sport of athletics includes a wide range of events whose requirements range from speed to endurance, from a light physique to explosive power, and from multiple events lasting less than a minute to a single race lasting more than 2–3 hours. Despite the extreme contrast in these characteristics, all athletes share some common nutrition goals (see Table 6-1). This chapter will briefly explore these goals. Table 6-1. The athlete’s nutrition goals. Characteristic Everyday eating or training diet The athlete’s nutrition-related goals • Achieve and maintain a physique that is suited to the event • Eat to stay healthy and injury-free • Train hard and promote optimal adaptations and recovery from the training programme • Practice competition eating in training to fine tune strategies • Prepare adequate fuel stores for the event • Eat and drink well on competition day to prepare for an event and to recover between multiple events • During prolonged events (> 1 hour), replace fluid and carbohydrate to enhance performance • Achieve competition strategies when traveling • Make use of specialised sports foods to meet nutritional goals when it is impractical to eat everyday foods • Make wise decisions about the use of nutritional ergogenic aids based on cost: benefit analysis Competition eating Sports foods and dietary supplements A. The Training Diet 1. Achieving Energy Needs Energy needs vary according to body size, the energy cost of......

Words: 6154 - Pages: 25

Premium Essay

Nutrition

...Comparing Nutrition Labels Nutrition labels are intended to help people make healthier choices when it comes to the food they eat. Consumers recognize nutrition labels as tools to help improve their health and can find an abundance of valuable information pertaining to specific items. The presence of nutritional information may influence the consumer to switch from unhealthy food products towards healthy food products, but only if they understand how to read a nutrition label. Reading a food label at first can be confusing, however it will help the consumer to select foods that will provide the accurate amount of nutrients and energy that the body needs. There are specific things to look for on a food label that can differentiate an unhealthy food from a healthy food. When comparing an avocado to Ben and Jerry’s Chunky Monkey ice cream, we know that an avocado is the healthier choice, but it is important to understand why. When comparing nutrition labels, the first place you should start is the serving size and the number of servings in the package. Serving size is used to make it easier to compare similar foods. The serving size on a package affects the number of calories and all nutrient amounts within the product. For example, the serving size for an avocado is based on 1/5 of a medium avocado, or 1 oz. With such a small portion size, an avocado is packed with vitamins, minerals, and essential. Conversely, Ben and Jerry’s Chunky Monkey nutrition label offers a much......

Words: 1206 - Pages: 5

Premium Essay

Nutrition

...NUTRITION PROJECT I think my diet is very interesting and shows both sides of how I can eat. As you can see, three of my entries show how much salt, fat and calories I can consume along with not drinking enough water. There is also an entry I added to show my current eating habit which is optimal. I just purchased an elliptical/treadmill and started working out for at least an hour a day with my heart rate up and sweating. When I start working out, I am conscious of what I eat. I drink more water, lay off processed and refined foods and honestly I feel better mentally and physically. I will begin with the first three entries logged on my fitness pal. My diet is defiantly high in sodium. I should know better because at the age of 25 (and in a high stress/competitive nursing school) I was hypertensive and taking 10 mg of lisinopril a day. I feel poor diet choices, lack of exercise and low water consumption may have added to this. Luckily now, at the age of 31, I am no longer taking any sort of medication for this. The average recommended dietary intake of sodium for adults is 1,500 mg. The human body actually only needs approximately 180-500 mg/day according to the Centers for Disease Control and prevention. Their website also gives information stating the tolerable level of sodium defined: which is "the highest daily level of sodium that poses no risk of adverse health effects to almost all individuals" is 2,300...

Words: 858 - Pages: 4

Premium Essay

Nutrition

...| Module One : Introduction to Nutrition Hot Sheet |   |   |   |   |   |   | | The following provides you with a "Hot Sheet" of helpful bullet points that you can refer to for information on this module, as well as suggestions for your journal entry for this module. Remember, working though these journal entries at the end of each module will help you create your Final learning statement at the end of the course. So take a moment to use your journal and write down your thoughts to the questions below. |   | | | Journal Entry #1 : Preparation for Your Final Learning Statement |   |   |   | So far in this module we have covered the definitions of nutrition and energy, label reading, the USDA Pyramid Food Guidance System, USDA Dietary Guidelines and the Exchange System for menu planning. In preparation for your final learning statement that is submitted at the end of the course. I would like you to:Log onto: www.mypyramid.gov and calculate your personal food intake needed to maintain your current weight, etc. Most of us learn by applying concepts, especially about nutrition and health to our own lives. There is a wealth of information and tracking sheets that the USDA has created that you may choose to use in your daily lives.Please write in your journal your thoughts on the concepts learned in this module. Review the sections if you need to. After looking at your MyPyramid Plan comment on your intake of adequate calories and whether or not you meet any of these......

Words: 4203 - Pages: 17

Free Essay

Nutrition

...Phoenix Nutritional Needs Nutrition is the major intrauterine environmental factor that alters expression of the fetal genome and may have lifelong consequences. This phenomenon, termed “fetal programming,” has led to the recent theory of “fetal origins of adult disease.” Namely, alterations in fetal nutrition and endocrine status may result in developmental adaptations that permanently change the structure, physiology, and metabolism of the offspring, thereby predisposing individuals to metabolic, endocrine, and cardiovascular diseases in adult life. Animal studies show that both maternal undernutrition and over nutrition reduce placental-fetal blood flows and stunt fetal growth. Impaired placental syntheses of nitric oxide (a major vasodilator and angiogenesis factor) and polyamines (key regulators of DNA and protein synthesis) may provide a unified explanation for intrauterine growth retardation in response to the 2 extremes of nutritional problems with the same pregnancy outcome. There is growing evidence that maternal nutritional status can alter the epigenetic state (stable alterations of gene expression through DNA methylation and histone modifications) of the fetal genome. This may provide a molecular mechanism for the impact of maternal nutrition on both fetal programming and genomic imprinting. Promoting optimal nutrition will not only ensure optimal fetal development, but will also reduce the risk of chronic diseases in adults. Maternal nutrition plays a......

Words: 4302 - Pages: 18

Free Essay

Nutrition

...DELIVERED BY : MR JAMES COURSE TITLE : FOOD AND BEVERAGE DIPLOMA CONTENTS * FOOD SAFETY * FOOD SAFETY CHECKLIST * WORK SAFETY * Biological hazards * Chemical hazards * WORK SAFETY CHECKLIST * NUTRITION AND DIETETICS * NUTRITION * Carbohydrate * Fats * Vitamins * Minerals * Water * NUTRITION DIETETIC FOOD SAYETY AND HYGIENE FOOD SAFETY Food safety is the condition which ensures that food will not cause harm to the consumer when prepared and/or eaten according to their intended use. Food safety is a scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness Safety is one of four basic groups of features along with nutrition, the organoleptic, and commercial make up the food quality .Food safety is responsible those who handle and prepared food commercially delivery to consumers who prepare and eat food in their home. IMPORTANCE OF FOOD SAFETY As everyone must eat food to live, everyone is at risk of getting food poisoning. Businesses are required to make sure the food they handle, store, display and sell is safe and suitable for people to eat. Everyone should use the......

Words: 959 - Pages: 4

Premium Essay

Nutrition

...it will enable you to understand and offer suitable foods to ensure your nutritional needs are met. Macronutrients are the nutrients that provide calories and energy in a diet, nutrients are needed for growth, metabolism and for other body functions. As “macro” means large, macronutrients are the nutrients needed in large amounts, There are three different types of macronutrients; carbohydrates which is made up of a large group of organic compounds occurring in foods and living tissues, these are included in starch, sugars and cellulose. Protein is the digestion to amino acids and has relationships with muscle mass; protein also affects the activity and metabolic rates. Lipids are the third main class of macronutrients needed in human nutrition. Lipids are found primarily in meats, and dairy foods. They are a class of organic compounds that are fatty acids. Micronutrients are different from macronutrients (like carbohydrates, proteins and fat) they are only necessary in tiny amounts. Nevertheless micronutrients are essential for good health, if you have a micronutrient deficiencies it can cause serious health problems. Micronutrient includes a lot of dietary minerals such as zinc and iodine these are necessary for the healthy functioning of your body’s system, from bone growth to brain function. Micronutrients are commonly known as “vitamins” the vitamins they hold are vitamin A, C, D, and K. Making sure that you eat these vitamins in a healthy balanced diet is really......

Words: 1848 - Pages: 8