Protests in the streets are not a surprise. We started out in a COVID-19 era earlier this year and now we are in a post-George Floyd murder era that reinforces the fact that African Americans and other minorities have continuously been...
moreProtests in the streets are not a surprise. We started out in a COVID-19 era earlier this year and now we are in a post-George Floyd murder era that reinforces the fact that African Americans and other minorities have continuously been victims of racism. We know racism leads to poor health outcomes. However, racism affects all of us and is a public health issue.
Preface. List of tables and figures. Abbreviations. Part one: Geriatric Nutrition. Part two: Nutritional Status Assessment. Part three: Impact of Medications on Nutritional Status in the Elderly. Part four: Screening for Nutritional Risk....
morePreface. List of tables and figures. Abbreviations. Part one: Geriatric Nutrition. Part two: Nutritional Status Assessment. Part three: Impact of Medications on Nutritional Status in the Elderly. Part four: Screening for Nutritional Risk. Part five: Nutrition in the Prevention and Treatment of Disease. Part six: Nutritional Intervention in Common Medical Problems. Part seven: Dietary Guidelines for the Elderly. Part eight: Food Sources of Nutrients. Part nine: Nutritional Resources for the Elderly. References and Suggested Readings.
This third edition reviews the epidemiology policies programs and outcome indicators that are used to determine improvements in nutrition and health that lead to development. This greatly expanded third edition provides policy makers...
moreThis third edition reviews the epidemiology policies programs and outcome indicators that are used to determine improvements in nutrition and health that lead to development. This greatly expanded third edition provides policy makers nutritionists students scientists and professionals with the most recent and up-to-date knowledge regarding major health and nutritional problems in developing countries. Policies and programs that address the social and economic determinants of nutrition and health are now gaining in importance as methods to improve the status of the most vulnerable people in the world. This volume provides the most current research and strategies so that policy makers program managers researchers and students have knowledge and resources that they can use to advance methods for improving the public’s health and the development of nations. The third edition of Nutrition and Health in Developing Countries takes on a new context where the word “developing” is now a verb ...
Here, we discuss the link between nutrition, non-communicable chronic diseases and socio-economic standing, with a special focus on the microbiota. We provide a theoretical framework and several lines of evidence from both animal and...
moreHere, we discuss the link between nutrition, non-communicable chronic diseases and socio-economic standing, with a special focus on the microbiota. We provide a theoretical framework and several lines of evidence from both animal and human studies that support the idea that income inequality is an underlying factor for the maladaptive changes seen in the microbiota in certain populations. We propose that this contributes to the health disparities that are seen between lower-income and higher-income populations in high-income countries.
A series of focus groups was used to study the knowledge, attitudes and practices of students (ages 11-18 years) towards obesity in Jamaica. Specifically the study sought to: Understand whether obesity is considered a nutritional disorder...
moreA series of focus groups was used to study the knowledge, attitudes and practices of students (ages 11-18 years) towards obesity in Jamaica. Specifically the study sought to: Understand whether obesity is considered a nutritional disorder or disease among secondary school students in Jamaica. Understand whether obseity is accepte, and if so what are the specific cultural influences? Describe any difficulties between urban and rural atitudes towards obesity. Provide information to assist the development of public health messages that may be most beneficial for health programmes to utilize, for secondary school students in combatting the problems of obesity. Fifteen focus groups with a total of 180 students were drawn form a total of one thousand and twenty-two (1,022) students, from two schools: one located in the urban area of Kingston, St. Andrew; and the other located in the rural area of Ewarton, in the parish of St. Catherine. Samples of students from the two schoos were divided into three categories: Young-for-Grade; Average-for-Grade and Old-for-Grade. Students were further grouped into all boys, all girls, and mixed groups of boya and girls. Group interviews were tape recorded, and all recordings were transcribed verbatim. Notes were also made during each session. Following the standard procedures outlined in grounded methods of groupd interviews, open coding of the transcriptions was done. Concepts were identified and developed in terms of their properties and dimensions. Similar questions werelabelled and grouped to form categories relating to each research question. Analysis of the sessions showed that there was no significant difference in the knowledge of causes of obesity among students in diffferent grades. The majority of male students showed a negative attitude or feeling toward being obese. Yet many preferred women who were heavier or had a lower body distribution of adipose tissue which was referred to as a "coca-cola bottle shape" (gynoid obesity), rather than women with an upper-body or abdominal distribution of adipose tissue (android obesity). The majority of female students expressed a positive attitude toward gynoid obesity, but disliked android obesity. In addition, many of the female students expressed their dislike for obese men. Studnts' knowledge about the causes of obesity and prevention measures was not very consistent with their dietary patterns. Most of the students who participated in the focus group sessions did not think of obesity as a nutritional disease, but rather regarded it as a sign of wealth, good living, or access to an abundance of food (AU)
Abstract Background. The integration of cancer prevention education (CPE) into medical school curricula is occurring at a discouragingly slow rate despite current trends in curricular reform and professional and educational...
moreAbstract Background. The integration of cancer prevention education (CPE) into medical school curricula is occurring at a discouragingly slow rate despite current trends in curricular reform and professional and educational recommendations. Methods and results. An assessment of medical school web sites revealed only one school incorporating cancer prevention education into its curriculum. Additionally, a thorough literature review and listserv survey indicated that 15 medical schools had included a CPE component in their curricula. Conclusions. The limited number of medical schools that can be demonstrated to teach cancer prevention illustrates the need for curricular reform in this direction to fulfill existing prevention recommendations.
To study the difference in myocardial damage produced by the same defibrillation energy delivered at frequent, low-energy discharges vs infrequent, high-energy discharges, experiments were performed on 48 dogs. In Part I, a total of 3000...
moreTo study the difference in myocardial damage produced by the same defibrillation energy delivered at frequent, low-energy discharges vs infrequent, high-energy discharges, experiments were performed on 48 dogs. In Part I, a total of 3000 Wsec energy was delivered; in Part II, a total of 600 Wsec was delivered; and in Parts III and IV, a total of 1800 Wsec was delivered. In half the dogs, the energy was delivered in three shocks within 135 sec. In the other half, the shocks were delivered by 10 smaller shocks at 15-sec intervals. The degree of myocardial damage assessed by ST-segment elevation on precordial mapping or necrotic index from gross and microscopic examination 4 days after the shocks showed no significant difference. However, the three high-energy shocks (600 to 100 Wsec) resulted in ventricular fibrillation or complete heart block in 33% (6 of 18) of the dogs. These arrhythmias were not observed in the animals receiving low-energy (60-, 200-, or 300-Wsec) discharges.
The Dietary Guidelines for Americans were developed in 1990 by the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (USDHHS) to provide Americans with more specific recommendations on how to eat...
moreThe Dietary Guidelines for Americans were developed in 1990 by the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (USDHHS) to provide Americans with more specific recommendations on how to eat to reduce the risk of certain chronic diseases. These guidelines are appropriate for all ages including the elderly population.
Nutritional status assessment (NSA) is the foundation for the provision of optimal nutritional care to patients of all ages. An NSA for the elderly should include four components: (1) Diet History and Evaluation, Including Socioeconomic...
moreNutritional status assessment (NSA) is the foundation for the provision of optimal nutritional care to patients of all ages. An NSA for the elderly should include four components: (1) Diet History and Evaluation, Including Socioeconomic and Functional Status, (2) Anthropometric Measurements, (3) Biochemical Evaluation, and (4) Nutrition Physical Examination (see Table 2.1). These four components, with the clinician’s expertise, provide direction for the development of the nutritional care plan. However, in geriatric nutrition many accepted procedures for determining nutritional assessment are affected by the aging process (see Table 1.1), thereby increasing the difficulty of assessing nutritional status.
A cross-sectional investigation was made into ascariasis and nutritional status in Panamanian preschool children from October 1983 to July 1984. Within this framework, an analysis was undertaken of possible relationships between a range...
moreA cross-sectional investigation was made into ascariasis and nutritional status in Panamanian preschool children from October 1983 to July 1984. Within this framework, an analysis was undertaken of possible relationships between a range of intestinal helminthiases and the socioeconomic status of the participants. Attention was paid to caregiver's education, parental occupation, family earnings, quality of housing and sanitation in the assessment of socioeconomic status. On this basis, strong associations were established between the socioeconomic status of the children and infection with Ascaris lumbricoides, Trichuris trichiura and hookworm. In general, the prevalence of single and multiple helminth infections was significantly higher in children living in housing made of wood or bamboo than in those living in housing made of concrete blocks. The same pattern applied to levels of sanitation. Ascaris lumbricoides occurred more frequently in children of mothers with the least formal education and in children living in relatively crowded conditions. Evidence was also obtained to indicate that the intensity of the intestinal helminth infections was greater in the children from the poorer environment. Since children from poorer socioeconomic conditions might be more exposed to infective stages than those from a better environment, the possible role of socioeconomic factors in contributing to the predisposition of some individuals to harbour large worm burdens of intestinal helminths was briefly discussed.
SUMMARYRelationships between ascariasis and lactose digestion and between ascariasis and food transit time from mouth to caecum were investigated in young children from Chiriqui Province, Republic of Panama. The breath hydrogen method was...
moreSUMMARYRelationships between ascariasis and lactose digestion and between ascariasis and food transit time from mouth to caecum were investigated in young children from Chiriqui Province, Republic of Panama. The breath hydrogen method was used in both studies.Ascaris-infected children showed a significantly poorer degree of lactose digestion following a test oral load than uninfected children. Recovery of the capacity of the children to digest lactose was still not fully complete for at least 3 weeks following anthelmintic treatment. On average, the mouth-to-caecum transit time was similar in infected and uninfected children, but among theAscaris-infected children the transit time tended to be shorter in relation to the intensity of infection. Evidence from a cross-sectional survey indicated that ascariasis was significantly associated with reduced plasma vitamin A and carotenoid concentrations. This relationship remained after controlling for a range of socio-economic variables.Asc...
The authors report 2-year follow-up information on 179 of 198 eyes (90%) enrolled in a previously published multicenter, randomized, controlled clinical trial comparing pneumatic retinopexy (PR) with scleral buckling (SB) for the...
moreThe authors report 2-year follow-up information on 179 of 198 eyes (90%) enrolled in a previously published multicenter, randomized, controlled clinical trial comparing pneumatic retinopexy (PR) with scleral buckling (SB) for the management of selected retinal detachments. Scleral buckling was compared with PR with regard to redetachment after the initial 6-month follow-up period (1% versus 1%), overall attachment (98% versus 99%), subsequent cataract surgery (18% versus 4%; P less than 0.05), preoperative visual acuity (no significant difference), and final visual acuity of 20/50 or better in eyes with macular detachment for a period of 14 days or less (67% versus 89%; P less than or equal to 0.05). Reoperations after a failed PR attempt did not adversely affect visual outcome. After 2 years, PR continues to compare favorably with SB.
Energy underreporting occurs in 2% to 85% and overreporting in 1% to 39% of various populations. Efforts are needed to understand the psychosocial and behavioral characteristics associated with misreporting to help improve the accuracy of...
moreEnergy underreporting occurs in 2% to 85% and overreporting in 1% to 39% of various populations. Efforts are needed to understand the psychosocial and behavioral characteristics associated with misreporting to help improve the accuracy of dietary self-reporting. Past research suggests that higher social desirability and greater eating restraint are key factors influencing misreporting, while a history of dieting and being overweight are more moderately associated. Eating disinhibition, body image, depression, anxiety, and fear of negative evaluation may be related to energy misreporting, but evidence is insufficient. This review will provide a detailed discussion of the published associations among psychosocial and behavioral characteristics and energy misreporting.
Physical activity questionnaires (PAQs) are considered the most cost-efficient method to estimate total energy expenditure (TEE) in epidemiological studies. However, relatively few PAQs have been validated using doubly labeled water (DLW)...
morePhysical activity questionnaires (PAQs) are considered the most cost-efficient method to estimate total energy expenditure (TEE) in epidemiological studies. However, relatively few PAQs have been validated using doubly labeled water (DLW) in women or in samples with diverse ethnic backgrounds. This study was conducted to validate the Arizona Activity Frequency Questionnaire (AAFQ) for estimation of TEE and physical activity energy expenditure (PAEE) over 1 month using DLW as a reference method. Thirty-five relatively sedentary women completed the AAFQ before participating in an 8-d DLW protocol to measure TEE. TEE and PAEE were estimated from the AAFQ by calculating resting metabolic rate (RMR) using the equation of Mifflin et al. (AAFQmif), by measuring RMR using indirect calorimetry (AAFQic), and using MET conversion (AAFQmet). A predictive equation for TEE was generated. The mean +/- SD for TEE and PAEE from DLW were 9847 +/- 2555 kJ x d(-1) and 5578 +/- 2084 kJ x d(-1), respectively. Formulas using RMR to calculate the TEE and PAEE from the AAFQ tended to underestimate TEE and PAEE, whereas those that included only weight tended to overestimate TEE and PAEE. On the basis of the Mifflin et al. equation, the AAFQ tends to underestimate PAEE by 13%. This underestimation may be explained by the low lean body mass of the sample population and by effectiveness of the METs/RMR ratio in the obese. The following predictive equation was calculated: TEE (kJ x d(-1)) = (86.0 * average total daily METs) + (2.23 * RMRmif) - 6726. When the predictive equation is used, TEE calculated from the AAFQ is highly correlated with DLW TEE (adjusted r(2) = 0.70, P < 0.001). The AAFQ is an effective tool for the prediction of TEE and PAEE in epidemiological studies.
This article reports on the use of focus groups and an experimental participatory activity to investigate factors influencing participants' decisions about what to eat and what to report on food records and food frequency...
moreThis article reports on the use of focus groups and an experimental participatory activity to investigate factors influencing participants' decisions about what to eat and what to report on food records and food frequency questionnaires. Four focus groups examined participants' experience with diet records and 3 focus groups explored the topic of food portions using a group consensus activity. Twenty-two women participated in the diet record focus groups, and 15 participated in portion estimation groups. Focus group participants were equally distributed by age and body mass index values. Each woman completed a 10-day doubly labeled water protocol to measure total energy expenditure, 7 days of diet records (before and during total energy expenditure), and a food frequency questionnaire after the total energy expenditure. Transcripts of the focus groups were coded to index categories of responses and to identify themes within and across those responses. Themes discussed in this article are those that were discussed most often and at greatest length by all groups. The diet record focus groups revealed that 2 major factors influenced reporting on diet records: honesty vs social acceptability, and simplifying food intake. The portion estimation focus groups revealed 5 factors that influenced perceptions of portion size: the role of food in the meal, the type of food, personal preferences, product serving sizes, and comparison of personal servings with those of others. The validity and reliability of self-reported food consumption is greatly influenced by the ways people interpret and respond to dietary assessment instruments. These findings indicate that dietetics professionals need to take extra steps to address issues of accurately recording "bad" foods when training patients to complete diet records. Extra probing is needed when dietary records do not include snacks and include simple meals and a large amount of prepared and packaged food because this may indicate that changes in normal dietary patterns were made in order to more easily complete a dietary record.
Peer education in the Arizona 5-a-Day project achieved lasting improvements in fruit and vegetable intake among multicultural employees. Measures monitored implementation of peer education from peer educators’ logs, the program’s reach...
morePeer education in the Arizona 5-a-Day project achieved lasting improvements in fruit and vegetable intake among multicultural employees. Measures monitored implementation of peer education from peer educators’ logs, the program’s reach from employee surveys, and employees’ use in terms of employees’ dietary change. Peer educators logged 9,182 coworker contacts. Contacts averaged 10.9 minutes, according to coworkers. Coworkers read an average of 4.7 booklets and 2.23 newsletters. Many employees talked with peer educators (59%) and read materials (54%) after the program finished. Employee reports of peer educator contact were positively associated with fruit and vegetable intake. Peer education was implemented as intended and reached many coworkers. It continued after program completion, reached into coworkers’ families, and was used by employees to improve intake. This method can be used with employees who rely on informal sources and whose work presents barriers to wellness activities.
Background: The impact that dietary carbohydrates have on children developing type 2 diabetes remains controversial. Furthermore, there are limited pediatric longitudinal studies on changes in body mass index (BMI) and diet related to the...
moreBackground: The impact that dietary carbohydrates have on children developing type 2 diabetes remains controversial. Furthermore, there are limited pediatric longitudinal studies on changes in body mass index (BMI) and diet related to the development of acanthosis nigricans (AN), a risk factor associated with type 2 diabetes. Methods: Two 24 h dietary records were collected for 558 children, 2–8 years of age, at baseline and at a 2-year follow-up. Data on age, sex, BMI, and the presence of AN were also collected at each time point from the Children’s Healthy Living Program. Logistic regression was used to determine factors associated with the presence of AN at follow-up. Multinominal regression was used to determine factors associated with changes in AN status. Linear regression was used to measure the associations between changes in dietary intake and in the Burke Score for AN. Results: AN was present in 28 children at baseline and 34 children at follow-up. Adjusting for the presen...
ABSTRACT Food insecurity is associated with poor diet quality and increased diet-related disease risk. Food pantry clients (n = 194) completed one 24-h dietary recall and the Healthy Eating Index-2015 was used to evaluate diet quality....
moreABSTRACT Food insecurity is associated with poor diet quality and increased diet-related disease risk. Food pantry clients (n = 194) completed one 24-h dietary recall and the Healthy Eating Index-2015 was used to evaluate diet quality. Differences in diet quality relative to participants’ last food pantry visit and self-reported ethnicity were evaluated using two-way ANOVA. Food pantry visits within 1–4 days compared to ≥5 days were associated with higher diet quality in non-Hispanics (p= 0.01) but diet quality remained the same in Hispanics. Interventions to improve diet quality in food pantry users must consider potential ethnic differences when program planning.
Objectives Early infant diagnosis (EID) of HIV infection increases antiretroviral therapy initiation, which reduces pediatric HIV-related morbidity and mortality. This review aims to critically appraise the effects of interventions to...
moreObjectives Early infant diagnosis (EID) of HIV infection increases antiretroviral therapy initiation, which reduces pediatric HIV-related morbidity and mortality. This review aims to critically appraise the effects of interventions to increase uptake of early infant diagnosis. Design This is a systematic review and meta-analysis of interventions to increase the EID of HIV infection. We searched PubMed, EMBASE, CINAHL, and PsycINFO to identify eligible studies from inception of these databases to June 18, 2020. EID Uptake at 4–8 weeks of age was primary outcome assessed by the review. We conducted meta-analysis, using data from reports of included studies. The measure of the effect of dichotomous data was odds ratios (OR), with a 95% confidence interval. The grading of recommendations assessment, development, and evaluation (GRADE) approach was used to assess quality of evidence. Settings The review was not limited by time of publication or setting in which the studies conducted. Par...
Additional file 3: Table S3. PRISMA-ScR checklist*.
Additional file 2: Table S2. JBI Critical appraisal checklist for non-randomized experimental studies*.
Background D-limonene and its derivatives have demonstrated potential chemopreventive and anticancer activity in preclinical and clinical studies. The aim of this scoping review was to assess and critically appraise current literature on...
moreBackground D-limonene and its derivatives have demonstrated potential chemopreventive and anticancer activity in preclinical and clinical studies. The aim of this scoping review was to assess and critically appraise current literature on the effect of these bioactive citrus peel compounds on breast cancer in human trials and to identify knowledge gaps for exploration in future studies. Methods This study followed a scoping review framework. Peer-reviewed journal articles were included if they reported the effect of d-limonene or its derivatives on breast cancer in human subjects. Articles were retrieved from academic databases – PubMed, EMBASE, CINAHL, Web of Science, and Cochrane reviews – and iteratively through review of bibliographies of relevant manuscripts. Titles and abstracts were appraised against the aforementioned inclusion criteria in a first round of screening. Through consensus meetings and full article review by authors, a final set of studies were selected. Results w...
Today, formal and informal enterprises are increasingly contributing to the safety and nutritional ramifications of their food business activities. Enabling entrepreneurship in a sustainable manner means making profits, striving to...
moreToday, formal and informal enterprises are increasingly contributing to the safety and nutritional ramifications of their food business activities. Enabling entrepreneurship in a sustainable manner means making profits, striving to prevent ingress of harmful substances, and increasing the efficiency of using local natural resources and thus mitigating food hazardous footprints. Using examples from Nepal, Senegal and Ethiopia, this review provides information on microbial and chemical contamination and food adulteration that lead to having unsafe food in the market and on factors that are limiting growing food businesses. Four examples for how to accelerate food safety entrepreneurship are presented that include safely diversifying markets with animal sourced foods, sustainably using neglected and underutilized animal sources, expanding, and integrating innovative technologies with traditional practice and using digital technology to improving monitoring and safety along the food sup...
Objective:To examine the impacts of a Solar Market Garden 1-year solar-powered drip irrigation (SMG) programme in Kalalé district of northern Benin on mothers’ nutritional status and micronutrient levels.Design:Using a quasi-experimental...
moreObjective:To examine the impacts of a Solar Market Garden 1-year solar-powered drip irrigation (SMG) programme in Kalalé district of northern Benin on mothers’ nutritional status and micronutrient levels.Design:Using a quasi-experimental design, sixteen villages were assigned to four groups: (i) SMG women’s groups (WG); (ii) comparison WG; (iii) SMG non-WG (NWG); and (iv) comparison NWG. Difference-in-differences (DID) estimates were used to assess impacts on mothers’ food consumption, diversity, BMI, prevalence of underweight (BMI < 18·5 kg/m2) and anaemia, and deficiencies of iron (ID) and vitamin A (VAD).Setting:Kalalé district, northern Benin.Participants:Non-pregnant mothers aged 15–49 years (n 1737).Results:The SMG programme significantly increased mothers’ intake of vegetables (DID = 25·31 percentage points (pp); P < 0·01), dietary diversity (DID = 0·74; P < 0·01) and marginally increased their intake of flesh foods (DID = 10·14 pp; P < 0·1). Mean BMI was signific...
The Western Region Public Health Training Center (formally the Arizona Public Health Training Center) conducts competency-based needs assessments and provides workforce development assistance to public health agencies in the U.S....
moreThe Western Region Public Health Training Center (formally the Arizona Public Health Training Center) conducts competency-based needs assessments and provides workforce development assistance to public health agencies in the U.S. Department of Health and Human Services Region IX. Since its launch in 2012, the Center’s Public Health Essentials in Action Training has evolved. It is now offered in-person and online and has been adapted for rural communities. The evolution of the training, beginning with course planning and development, is described, as well as how factors in the public health workforce influenced the course’s evolution and how the course has been adapted for different platforms and populations. Finally, an overview of evaluation efforts offers insight into course effectiveness for this and other trainings offered by the Western Region Public Health Training Center.
To examine the effects of a challenge with monosodium glutamate (MSG) as compared to placebo on the symptoms of fibromyalgia (FM), in participants who initially experienced >30% remission of symptoms on an excitotoxin elimination diet....
moreTo examine the effects of a challenge with monosodium glutamate (MSG) as compared to placebo on the symptoms of fibromyalgia (FM), in participants who initially experienced >30% remission of symptoms on an excitotoxin elimination diet. Fifty-seven FM patients who also had irritable bowel syndrome (IBS) were placed on a 4-week diet that excluded dietary additive excitotoxins including MSG and aspartame. Thirty-seven people completed the diet and 84% of those reported that >30% of their symptoms resolved, thus making them eligible to proceed to challenges. Subjects who improved on the diet were then randomised to a 2-week double-blind placebo-controlled crossover challenge with MSG or placebo for 3 consecutive days each week. The primary outcome measure was total symptom score. Secondary outcome measures included visual analogue pain scales (VAS for FM and IBS), an IBS Quality of Life Questionnaire (IBS QOL) and the Fibromyalgia Impact Questionnaire-Revised (FIQR). Repeated meas...
Ideally, everyone should receive a complete nutritional assessment at some time throughout his/her life cycle. However, a comprehensive nutritional assessment may not always be necessary or economically feasible to complete. In this case,...
moreIdeally, everyone should receive a complete nutritional assessment at some time throughout his/her life cycle. However, a comprehensive nutritional assessment may not always be necessary or economically feasible to complete. In this case, nutritional screening can be used to identify individuals for whom a nutritional assessment is necessary.
Many patients may ask questions as to the best food sources of specific nutrients of which they may be trying to increase or restrict the intake. On the following pages of this section are tables to assist in educating patients as to the...
moreMany patients may ask questions as to the best food sources of specific nutrients of which they may be trying to increase or restrict the intake. On the following pages of this section are tables to assist in educating patients as to the dietary sources of several key nutrients. These tables provide representative, rather than complete, listings of nutrients in commonly consumed foods; each nutrient has numerous other dietary sources which would have been too cumbersome to list for the purposes intended by this handbook.
Page 1. Teaching and Learning in Medicine 1996, Vol. 8, No. 2, 102-110 Copyright 1996 by Lawrence Erlbaum Associates, Inc. Nutrition Curriculum in Medical Education: An Integrated and Comprehensive Approach Cheryl ...