To read the abstract, go to Inadequate Dietary Protein Increases Hunger and Desire to Eat in Younger and Older Men.

CAN WAIST CIRCUMFERENCE MEASUREMENT IMPROVE IDENTIFICATION OF PATIENTS WITH HIGH CARDIOMETABOLIC RISK?

An expert panel was convened by Shaping America's Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association in December 2006 to address four questions dealing with waist circumference (WC) and cardiometabolic risk. 

1. What does WC measure?

2. What are the biological mechanisms responsible for the association between WC and cardiometabolic risk?

3. What is the power of WC to predict adverse cardiometabolic outcomes? How does the predictive power of WC compare with that of BMI? Does measuring WC in addition to BMI improve predictability?

4. Should WC be measured in clinical practice?

BMI provides information about body volume and mass, while WC assesses body shape.  Generally, they are correlated but WC provides a better measure of fat distribution, specifically intraabdominal adipose tissue.  Recently, it has been suggested that increased WC may indicate an impaired energy storage system which results in increased intraabdominal adipose tissue. Data indicate that WC can identify persons at greater cardiometabolic risk than those identified by BMI alone. Results from weight-loss and exercise training trials show that reductions in WC coincide with reductions in obesity-related cardiometabolic risk factors and disease.

Since WC measurement would increase patient assessment time, the panel concluded it should only be done if it provides additional information that affects patient management.  NHANES III data indicate that 99.9% of men and 98.49% of women would have received identical treatment if WC assessment had been added to an evaluation of BMI and other cardiovascular risk factors.  However, an analysis of NHANES III and Canadian Heart Health Surveys data found that BMI-specific WC cutpoints provided a better indicator of risk than did the recommended WC standards.  Measurement of WC would be more informative if the WC cutpoints were BMI-related.  As a result, the real value of WC assessment might be in identifying "metabolically obese, lean" patients who would otherwise not be considered for treatment because of a normal BMI.  WC could also identify "metabolically normal, obese" patients who would not require treatment despite an elevated BMI because they did not have increased cardiometabolic risk.

To read the full text, go to Waist circumference and cardiometabolic risk: a consensus statement from Shaping America's Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association.  No abstract available.

FREE NUTRITION EDUCATION KIT FOR 4TH AND 5TH GRADES DESIGNED TO FACILITATE TEACHER/DIETITIAN COLLABORATION IN THE CLASSROOM

Choose Well is a 4th-5th grade math and nutrition curriculum that delivers important messages about how to choose nutrient-rich foods in appropriate portion sizes.  The kit includes the following components:

• Eight classroom activities covering the five food groups, nutrition facts labels and how to understand appropriate portion sizes

• A teacher backgrounder
• A large poster identifying the five food groups, the nutrients found in each and the appropriate portions from each
• A MyPyramid for Kids poster
• A video, Food!, with a music component teaching how to “choose well”
• An action computer game, teaching how to balance calories with the appropriate number of servings from each food group
• Two handouts for parents with messages from the teacher explaining what children are learning in the Choose Well curriculum and fun, family recipes

With the current mandate to focus on core curricula in schools, many classroom teachers are struggling with the challenges of teaching nutrition and healthy lifestyles to their students.  Choose Well is designed to maximize opportunities for making RDs a valued resource to schools.  Any or all of the eight activities can be taught or enhanced by RDs.  This RD/teacher collaboration provides the opportunity for RDs to become school wellness resources on the variety of nutrition issues facing schools.

To order a free Choose Well kit, e-mail School Wellness, put Choose Well in the subject line, and provide your name and UPS shipping information.

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