May 16: Issue 114

Page 9 Sugar and Salt an Addictive Combination

1 International Sweeteners Association (2013). Development of sweet taste. September 2013

2 Dewar G (2009). Wired for fast track learning? The newborn senses of taste and smell. Parenting Science: Accessed 29-2-16

3 Stein LJ (2012). The development of salty taste acceptance is related to dietary experience in human infants: a prospective study. Am J Clin Nut. Vol 95, no 1 p123-129

4 SACN (2003). Salt and health. TSO

5 Food Standards Agency (2002).

6 NHS Choices: Accessed 8-3-16

7 Public Health England (2015). Tackling high blood pressure. From evidence into action November 2014

8 Food and Drink Federation: Accessed 8-3-16

9 Public Health England (2016). Data on salt consumption levels. March 2016

10 George G et al (2013). Association between cardiovascular events and sodium-containing effervescent, dispersible and soluble drugs: nested case-control study BMJ 347 November

11 WHO Accessed 2-2-16

12 SACN (2015). Carbohydrates and health. TSO

13 COMA (1991). Dietary Reference Values of Food Energy and Nutrients for the United Kingdom

14 Public Health England and Food Standards Agency (2014). National Diet and Nutrition Survey: Results from Years 1-4 (combined) of the Rolling Programme (2008/2009-2011/12) Executive summary:

15 Sugar Tax and budget (2016). Accessed 12-4-16

16 Public Health England (2016). March (Accessed 12-4-16)

17 Nigella Lawson: Accessed 29-2-16

18 Small DM, Jones-Gotman M, Dagher A (2003). Feeding-induced dopamine release in dorsal striatum correlates with meal pleasantness ratings in healthy human volunteers. Neuroimage 2003; 19: 1709-1715

Page 13 The Role of Vitamin D in Older Adults

1 NIH Vitamin D Factsheet for Health Professional:

2 NICE guideline PH56, Vitamin D: increasing supplement use in at-risk groups:

3 Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010

4 SACN 2015. Draft Vitamin D and Health

5 SACN 2007. Update on Vitamin D:

6 NHS Choices - How to Get Vitamin D From Sunlight:

7 National Diet and Nutrition Survey: results from Years 1 to 4 (combined) of the rolling programme for 2008 and 2009 to 2011 and 2012:

8 Vitamin D - advice on supplements for at risk groups - letter from UK Chief Medical Officers:

9 Appendix 2, Chapter 8 Dietary vitamin D intakes and plasma 25 hydroxyvitamin D concentration of the UK population tables:


The article on Vitamin D in older adults by Maeve Hanan (NHD issue 114 pg 14) incorrectly quotes the safe upper level for vitamin D as 25 micrograms/day with reference to a draft report on vitamin D and health by the Scientific Advisory Committee on Nutrition (SACN).1 Please note the following from the SACN. Draft Vitamin D and Health report:

604. [Tolerable Upper Intake Levels] TULs for vitamin D, of 100µg/d (4,000 IU) for adults and children aged 11-17 years, 50µg/d (2,000 IU) for children aged 1-10 years, and 25µg/d (1,000 IU) for infants, as recommended by EFSA,2 are considered appropriate. The TULs do not distinguish between total and supplementary vitamin D intake since dietary intakes of vitamin D make only a small contribution to total exposures at the TULs.


1 SACN. Draft Vitamin D and Health report. (2015)

2 EFSA Scientific Opinion on the Tolerable Upper Intake Level of vitamin D. EFSA Journal 2012 10(7):2813.

Page 20 Dying For a Drink:Dehydration in Residential Aged Care Facilities

1 Scandal of Dehydrated Pensioners by Daniel Martin for The Daily Mail Published: 16:02, 12 January 2013. Updated: 17:40, 12 January 2013

2 Guidance - Commissioning Excellent Nutrition and Hydration 2015-2018. NHS England

3 Mentes JC. Evidence based practice guideline: hydration management, Journal of Gerontological Nursing. 2013. Vol 39, no 2, p11-19

4 Wolff A, Stuckler D et al. Are patients admitted to hospitals from care homes dehydrated? A retrospective analysis of hypernatraemia and in-hospital mortality. Journal of the Royal Society of Medicine. 2015. 108(7). p259-265

5 Hooper L et al. Which Frail Older People Are Dehydrated? The UK DRIE Study. J Gerontol A Biol Sci Med Sci. 2015 Nov 9

6 Burger S. Malnutrition and dehydration in nursing homes: key issues in prevention and treatment. National Citizens’ Coalition for Nursing Home Reform. June 2000

7 Tortora G., and B Derrickson (2010). Introduction to the human body: the essentials of anatomy and physiology. 8th ed. New York: John Wiley & Sons

8 Godfrey H, Cloete J, Dymond E and Long A (2012). An exploration of hydration care of older people: a qualitative study. International Journal of Nursing Studies 49: 1200-11

9 Benton D, Young HA. Do small differences in hydration status affect mood and mental performance? Nutr Rev. 2015 Sep; 73 Suppl 2: 83-96

10 Faes M (2007). Dehydration in Geriatrics In press. Geriatrics and Aging

11 Rodrigues S. Factors associated with daily water intake and hydration status amongst institutionalized elderly people Preliminary results 4th Hydration Network Meeting, Barcelona, 26th June 2013

12 Begum MN and CS Johnson, A review of the literature on dehydration in the institutionalised elderly. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 2010. 5(1): p e47-e53

13 Manz F. Hydration and disease. J Am Coll Nutr, 2007. 26(5 Suppl): p535S-41S

14 Wilson L. Hydration and Older People in the UK: Addressing the Problem, Understanding the Solutions. On behalf of the Parliamentary Hydration Forum November 2014

15 Folden SL. Practice guidelines for the management of constipation in adults. Rehabilitation Nursing. 2002. 27(5), 169-175

16 Cumming K, Hoyle GE, Hutchison JD, Soiza RL. Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures

17 Robinson SB, Roshner RB. Can a beverage cart help improve hydration? Geriatr Nurs. 2002 Jul-Aug; 23(4): 208-11

18 Francis R (2013). Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: Stationery Office

Page 25 Home Enteral Feeding: Developing The Gloucestershire Service to Sustain The Future

1 Bertram-Barclay S (April 2011). Home enteral feeding in older adults and the elderly. NHD, 63, 23-24

2 CREST, Clinical Resource Efficiency Support Team (2004). Guidelines for the Management of Enteral Tube Feeding in Adults. ISBN 1-903982-0801, Stormont

3 Department of Health (2001). Valuing people: a new strategy for learning disability for the 21st century. London: The Department

4 Howard P (2001). The challenges of innovation in the organisation of home enteral tube feeding. Journal of Human Nutrition and Dietetics, 14, 3-11

5 NICE, National Institute for Clinical Excellence (2003). Clinical Guideline 32: Nutrition Support in Adults. London

6 Patel I, Ridgway J (May 2009). Establishing a multidisciplinary Home Enteral Nutrition Team. Clinical Nutrition Focus Vol 1 No2 17-19

7 Tuckman, Bruce W (1996). Theories and Applications of Educational Psychology, New York: McGraw Hill. Third edition with D Moneth, published 2001

Page 29 Parenteral Nutrition and its Role in the surgical Cardiothoracic Patient

1 Hill GL et al. Malnutrition in surgical patients. An unrecognised problem. Lancet, 1977. 1(8013): p689-92

2 Braga M et al. ESPEN Guidelines on Parenteral Nutrition: surgery. Clin Nutr, 2009. 28(4): p378-86

3 Weimann A et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation. Clin Nutr, 2006. 25(2): p224-44

4 Mangi AA et al. Gastrointestinal complications in patients undergoing heart operation: an analysis of 8,709 consecutive cardiac surgical patients. Ann Surg, 2005. 241(6): p895-901; discussion 901-4

5 Hashemzadeh K and S Hashemzadeh. Predictors and outcome of gastrointestinal complications after cardiac surgery. Minerva Chir, 2012. 67(4): p327-35

6 Engelman DT et al. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery. J Thorac Cardiovasc Surg, 1999. 118(5): p866-73

7 Jagoe RT, Goodship TH and Gibson GJ. The influence of nutritional status on complications after operations for lung cancer. Ann Thorac Surg, 2001. 71(3): p936-43

8 Malone DL et al. Surgical site infections: reanalysis of risk factors. J Surg Res, 2002. 103(1): p89-95

9 Mazolewski P et al. The impact of nutritional status on the outcome of lung volume reduction surgery: a prospective study. Chest, 1999. 116(3): p693-6

10 Sandstrom R et al. The effect of postoperative intravenous feeding (TPN) on outcome following major surgery evaluated in a randomised study. Ann Surg, 1993. 217(2): p185-95

11 Bartlett RH et al. Measurement of metabolism in multiple organ failure. Surgery, 1982. 92(4): p771-9

12 Kreymann KG et al. ESPEN Guidelines on Enteral Nutrition: Intensive care. Clin Nutr, 2006. 25(2): p210-23

13 Heyland DK et al. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr, 2003. 27(5): p355-73

14 Singer P et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr, 2009. 28(4): p387-400

15 Braunschweig CL et al. Enteral compared with parenteral nutrition: a meta-analysis. Am J Clin Nutr, 2001. 74(4): p534-42

16 Martindale RG et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive Summary. Crit Care Med, 2009. 37(5): p1757-61

17 McClave SA et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN J Parenter Enteral Nutr, 2009. 33(3): p277-316

18 Casaer MP et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med, 2011. 365(6): p506-17

19 Casaer MP et al. Role of disease and macronutrient dose in the randomised controlled EPaNIC trial: a post hoc analysis. Am J Respir Crit Care Med, 2013. 187(3): p247-55

20 Harvey SE et al. Trial of the route of early nutritional support in critically ill adults. N Engl J Med, 2014. 371(18): p1673-84

21 Brandi LS et al. Energy expenditure and severity of injury and illness indices in multiple trauma patients. Crit Care Med, 1999. 27(12): p2684-9

22 Paauw JD et al. Assessment of caloric needs in stressed patients. J Am Coll Nutr, 1984. 3(1): p51-9

23 Jiang H et al. Efficacy of hypocaloric parenteral nutrition for surgical patients: a systematic review and meta-analysis. Clin Nutr, 2011. 30(6): p730-7

24 Heyland DK, Cahill N and Day AG. Optimal amount of calories for critically ill patients: depends on how you slice the cake! Crit Care Med, 2011. 39(12): p2619-26

25 Villet S et al. Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr, 2005. 24(4): p502-9

26 Wilmore DW. Catabolic illness. Strategies for enhancing recovery. N Engl J Med, 1991. 325(10): p695-702

27 Kan MN et al. Estimation of energy requirements for mechanically ventilated, critically ill patients using nutritional status. Crit Care, 2003. 7(5): pR108-15

28 Pasquel FJ et al. Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalised patients. Diabetes Care, 2010. 33(4): p739-41

29 van den Berghe G et al. Intensive insulin therapy in critically ill patients. N Engl J Med, 2001. 345(19): p1359-67

30 Mirtallo J et al. Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr, 2004. 28(6): pS39-70

31 Huschak G et al. Olive oil based nutrition in multiple trauma patients: a pilot study. Intensive Care Med, 2005. 31(9): p1202-8

32 Hiesmayr M. Nutrition risk assessment in the ICU. Curr Opin Clin Nutr Metab Care, 2012. 15(2): p174-80

33 Buchman AL, Scolapio J and Fryer J. AGA technical review on short bowel syndrome and intestinal transplantation. Gastroenterology, 2003. 124(4): p1111-34

34 Nightingale J et al. Guidelines for management of patients with a short bowel. Gut, 2006. 55 Suppl 4: piv1-12

35 Van Gossum A et al. ESPEN Guidelines on Parenteral Nutrition: gastroenterology. Clin Nutr, 2009. 28(4): p. 415-27

Page 33 Faltering Growth

1 Raynor P, Rudolf M Anthropometric indices of failure to thrive Arch Dis Child, 2000, 82 364-5

2 The Royal College of Paediatrics and Child Health UK - WHO growth charts, 2009. Accessed April 2016

3 Hobbs CJ, Hanks HGI, Wynne JM. Child Abuse and Neglect: A Clinician's Handbook. Edinburgh: Churchill Livingstone, 1999

4 Skuse D. Non organic failure to thrive: a reappraisal. Arch Dis Child, 1985, 60 173-8

5 Blissett J, Harris J, Cunningham J et al. Faltering growth: a case study and recommendations for practice Community Practitioner, 2002, 11 424-7

6 Wright C, Birks E. Risk factors for failure to thrive: a population-based survey. Child Care Health Dev, 2000, 26 5-16

7 Harris G, Booth IW. The nature and management of eating disorders in pre-school children. In: Cooper P, Stein A (Eds) Monographs in Clinical Paediatrics; Feeding Problems and Eating Disorders. Chur, Switzerland: Harwood Academic, 1991

8 Hobbs C, Hanks HGI. A multidisciplinary approach for the treatment of children with failure to thrive. Child Care Health Dev, 1996, 22 273-84. Blithoney WG, McJunkin J, Michalek J et al. The effect of a multidisciplinary team approach on weight gain in non-organic failure to thrive children. Dev Behav Pediatr, 1991, 12 254-8

9 Maclean WC, Lopez de Romana G, Massa E et al. Nutritional management of chronic diarrhoea and malnutrition: primary reliance on oral feeding. J Paediatr, 1990, 97 316-23

10 What is the long-term outcome for children who fail to thrive? A systematic review. Arch Dis Child. 2005 Sep; 90 (9): 92 Rudolf MC, Logan S. 5-31. Epub 2005 May 12

11 Barker DJP. The fetal and infant origins of adult disease. Br Med J, 1990, 301 1111

12 Black MM, Dubowitz H, Krishnakumar A et al. Early intervention and recovery among children with failure to thrive: follow-up at age 8. Pediatrics, 2007, 120 59-60

Page 44 Coeliac disease and the gluten-free diet

1. Thompson T, Dennis M, Higgins LA, Lee AR, Sharrett MK. Gluten-free diet survey: Are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods? J Hum Nutr Dietet. 2005; 18: 163-169

2. Hallert C, Grant C, Green S et al. Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Aliment Pharmacol Ther 2002; 16: 1333-1339

3. Dickey W, Kearney N. Overweight in coeliac disease: Prevalence, clinical characteristics and effect of a gluten-free diet. Am J Gastroenterol 2006; 101; 2356-2359

4. Valente FX, Campos T et al. B Vitamins related to homocysteine metabolism in adult coeliac patients: A cross-sectional study. Nutrition Journal (2015) 14: 110

5. Lee AR, Ng DL, Dave EJ, Ciaccio E, Green PHR (2009). The effect of substituting alternative grains in the diet on the nutritional profile of the gluten-free diet. Journal of Human Nutrition and Dietetics. 22. 359-363

6. Downey L, Houten R, Murch S, Longson D. Guideline Development Group. Recognition, assessment and management of coeliac disease: Summary of updated NICE guidance. BMJ. 2015 Sep 2; 351:h4513. doi: 10.1136/bmj.h4513

7. Hill P, Austin A, Forsyth J, Holmes G. British Society of Gastroenterology guidelines on the diagnosis and management of coeliac disease. Gut. 2015 Apr; 64(4): 691-2. doi: 10.1136/gutjnl-2014-308420. Epub 2014 Oct 9

8. European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): Guidelines for the Diagnosis of Coeliac Disease (2012)

9. Academy of Nutrition and Dietetics ( and the Academy of Nutrition and Dietetics Evidence Analysis Library (

10. Burden M et al. Cost and availability of gluten-free food in the UK: in store and online. Postgrad Med J (2015) 1081: 622-6

11. Lee AR, Ng D, Zivin J, Green PHR (2007). Economic Burden of a gluten-free diet. J Hum Nutr Diet. 2007; 20(5): 423-30

12. Stevens L1, Rashid M. Gluten-free and regular foods: a cost comparison. Can J Diet Pract Res. 2008 Fall; 69(3): 147-50

13. Thompson T, Lee AR, Grace T. Gluten contamination of grains, seeds and flours in the United States; a pilot study. J Am Diet Assoc. 2010 Jun; 110(6): 937-40

Page 47 Galactosaemia: Suitable Cheese For People On A Low Galactose Diet

1 Berry G and Walter J: Chapter Disorders of Galactose Metabolism in Inborn Metabolic Diseases pub Springer Medizin Germany (2012) ISBN: 978-3-642-43420

2 Jumbo-Lucioni PP et al. Diversity of approaches to classic galactosaemia around the world: a comparison of diagnosis, intervention and outcomes; J Inherit Metab (2012) 1037-1049

3 Bosch A; Classic galactosaemia: dietary dilemmas; J Inherit Metab Dis (2011) 34:257-260

4 S Adam et al. How strict is galactose restriction in adults with galactosaemia? International practice; Mol. Genet.Metab. 115 (1) (2015), 23-26

5 Portnoi P and A MacDonald. Determination of the lactose and galactose content of cheese for use in the galactosaemia diet (2009) JHN Diet 22.2009 p 400-408

6 Van Calcar et al. A re-evaluation of life-long severe galactose restriction for the nutrition management of classic galactosaemia; Mol. Genet.Metab. 112 (2014) 191-197

7 Rutherford PJ, Davidson DC and Matthai SM. Dietary calcium in galactosaemia (2002). J Hum Nutr Dietet, 15, p 39-42

8 Portnoi P, MacDonald A. Chapter: Lactose and galactose content of cheese. Handbook of cheese in health: production, nutrition and medical sciences; Wageningen Academic Publishers. 10/2013: pages 496-513; ISBN: 978-90-8686-211-5

9 Portnoi PA, MacDonald A. The lactose content of Mini Babybel and suitability for galactosaemia. J Hum Nutr Diet. (2011) Dec; 24: 620-1

10 Portnoi PA, MacDonald A. The lactose and galactose content of cheese suitable for galactosaemia: new analysis (2105)JIMD Reports

11 Metabolic pathway from 'Galactosaemia - What's that?' leaflet (2015), printed by the Galactosaemia Support Group