Transformational leadership of clinical nutrition managers.

OBJECTIVE: To identify leadership qualities of clinical nutrition managers and associate these leadership qualities with selected demographic variables (eg, training/degree, length of time in management, number of people supervised, income, and participation in advanced practice activities). DESIGN: The theory of transformational leadership, that is, leadership that incorporates specific interpersonal behaviors of the leader and his or her actions within the organization, provided the framework for the study. Specific transformational leadership qualities--leader behavior, leader personal characteristics, and the effect of the leader on organizational functioning and culture--were measured using the Leadership Behavior Questionnaire (LBQ). The reliability and validity of the LBQ have been reported previously. Other data were obtained using two demographic surveys. SAMPLE: Demographic surveys were mailed to 1,599 members of the Clinical Nutrition Management dietetic practice group. From the 951 (59.8%) respondents, a study sample of 150 clinical nutrition managers and their subordinates was selected to receive the LBQ; 116 (77.3%) instrument sets were used for analysis. STATISTICAL ANALYSIS: Descriptive statistics were used to analyze the demographic surveys. A specified mixed linear model repeated measures Statistical Analysis System procedure was used to compare the clinical manager and subordinate LBQ scores. Association of the selected demographic variables with leadership qualities was measured by lambda, a predictive value measure, using the BMDP 4F program. RESULTS: Clinical nutrition managers exhibited transformational leadership qualities as rated by the LBQ, rating lowest on the communication leadership score and highest on the respectful leadership score. Most of the clinical nutrition manager self LBQ scores were significantly higher than the clinical nutrition manager LBQ scores rated by subordinates. The selected demographic variables appeared to have the strongest predictive effect for the visionary culture building subscore of the LBQ. The visionary culture building subscore is a measure of how well the leader interacts with and affects the functioning of an organization. APPLICATIONS/CONCLUSIONS: More research is needed to define leadership in dietetics: this study can serve as a possible model. One way clinical nutrition managers may be able to enhance their leadership behaviors is to strengthen their skills in communicating their vision. Programs are needed to help clinical nutrition managers shape their organizations to foster leadership development in their subordinates.

Effects of fish oil on serum lipids in men during a controlled feeding trial.

Effects of fish-oil (FO) feeding on serum lipids were investigated in a 42-d controlled diet study. Fifteen healthy male college students were assigned to one of three groups: control (0 g FO); 5 g FO, supplying 2 g n - 3 (omega-3) fatty acids (FAs); or 20 g FO, supplying 8 g n - 3 FAs. In an initial 7-d period subjects consumed a basal diet with no FO. Then FO replaced an equivalent amount of margarine for 5 wk. FO feeding significantly (p less than 0.05) decreased the serum n - 6 FAs, linoleic acid, eicosatrienoic acid, and arachidonic acid. A significant increase in the n - 3 FAs, eicosapentaenoic acid and docosahexaenoic acid, was noted in serum, platelet, and neutrophil phospholipids. The 20-g-FO group showed a 30% decrease (p less than 0.01) in triglycerides after 2 wk FO with no further decrease observed. Thus, 20 g FO produced changes in both FA patterns and triglyceride concentrations whereas 5 g FO produced changes in FA patterns only. Neither FO amount resulted in significant changes in total or HDL cholesterol, apolipoprotein A-I, or apolipoprotein B-100.

Riboflavin status in urban adolescents.

We compared riboflavin status in 284 healthy adolescents attending an urban university hospital clinic with that of 43 adolescents with a variety of chronic medical conditions. Riboflavin status was determined by erythrocyte glutathione reductase activity and 24-hour dietary recall of riboflavin intake. The mean activity coefficient for the healthy adolescents was 1.08 (SD +/- 0.09) and 1.10 (SD +/- 1.01) in the chronically ill group. Significantly higher values were found in females of both groups (z = 4.90, p less than 0.0001). Seventeen (7%) of the healthy teenagers and seven (16%) of the chronically ill group had biochemical evidence of riboflavin deficiency (p less than 0.02). Although the mean daily intake of riboflavin for the total group exceeded the recommended daily allowance, there was significantly lower riboflavin intake in the subgroup of adolescents who had abnormal activity coefficients (z = 3.29, p less than 0.001). These data suggest that subclinical riboflavin deficiency may occur in adolescents and that deficiency may be related to dietary intake of riboflavin.

Selenium content of foods purchased or produced in Ohio.

Approximately 450 samples of about 100 types of foods consumed by rural and urban Ohioans were analyzed for selenium. Meat, dairy products, eggs, and grain products produced in Ohio have considerably lower selenium content than corresponding products produced in high selenium areas, such as South Dakota. Retail Ohio foods with interregional distribution tended to be higher in selenium content than corresponding foods produced in Ohio. Best sources of selenium in Ohio foods commonly consumed were meat and pasta products. Poor sources of selenium were fruits, most vegetables, candies, sweeteners, and alcoholic and nonalcoholic beverages. Establishment of an accurate data base for selenium depends on knowledge of the interregional distribution of foods, the selenium content of foods at their production site, and the selenium content of foods with wide local distribution.

Evaluating work experience in the selection of dietary managers.

Because there is such a low correlation between the work experience inventory and examination scores, the work experience inventory may be measuring another dimension of performance. The use of the work experience inventory in conjunction with application forms and employment tests may provide a better indicator of potential performance than any of those methods alone. This concurrent validity study, however, should be followed by predictive validity studies to determine the effectiveness of the work experience inventory in predicting job success of the dietary manager.

Effect of moderate to very low fat defined formula diets on serum lipids in healthy subjects.

Serum total cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride levels were studied in healthy male and female subjects consuming for one-week periods a diet of conventional food (CF) providing 42% of energy as fat, principally butter fat, and then in random order nutritionally complete, defined formula diets of moderate (32%) to very low (1%) fat content. Compared to CF, the formula with 32% of energy as corn oil lowered serum cholesterol by 25% and the ratio of total to HDL-cholesterol by 13%. Low (9%) and very low (1-3%) fat formulas reduced HDL-cholesterol by as much as 40%, raised the total:HDL-cholesterol ratio by about 20% and raised serum triglyceride levels by as much as 100%. When low and very low fat formulas were ingested for three weeks, these effects persisted although maximal responses occurred during the first week. These results demonstrated that a moderate fat formula diet with a high P/S ratio had a more favorable effect on serum lipid levels than various low fat formulas. Low fat conventional food diets should be studied in long-term controlled metabolic experiments before such diets are recommended to the general population for coronary heart disease or cancer prevention.

Selenium status of a rural (predominantly Amish) community living in a low-selenium area.

Selenium intake and blood selenium and selenium-dependent glutathione peroxidase concentrations were assessed in a rural, 71% Amish, sample of residents in a region with low availability of soil selenium and in urban (Columbus, OH) residents. Subjects were interviewed (24-h dietary recalls) on three separate occasions over an 18-month period, and blood and food samples were taken for analysis (maximum subject observations = 452). Mean selenium intake of the entire population was 82.8 +/- 4.4 micrograms/day. Rural and urban residents at 82.0 +/- 4.9 and 83.6 +/- 4.4 micrograms/day, respectively, did not differ significantly in intake. A breakdown by gender within location demonstrated that rural males consumed the most selenium (104.7 +/- 6.1 micrograms/day) and rural females the least (59.3 +/- 6.3 micrograms/day). Rural subject groups had significantly lower mean whole blood, plasma, and erythrocyte selenium levels (12.5 to 14.5%) as well as blood selenium-dependent glutathione peroxidase concentrations (5.6 to 10.8%) than urban groups. Subjects in both cohorts were in adequate selenium status as judged by blood parameters, even though about one-fourth of the dietary observations were below the safe and adequate range of selenium intake established by the Food and Nutrition Board. The rural diet was 18.3% lower in selenium density than the urban diet. High selenium grain products (greater than 0.2 micrograms/g) were the most important dietary selenium source in both groups, providing 29.3 to 41.6% of total intake.

Gastric-emptying characteristics of two glucose polymer-electrolyte solutions.

Inadequate carbohydrate and fluids can limit physical performance; optimal delivery of both should be the goal of any beverage designed especially for the athlete. In this study, the gastric-emptying characteristics of two carbohydrate-electrolyte solutions were compared with water. The 5% carbohydrate solution contained 3% Polycose glucose polymers and 2% fructose, whereas the 7% solution contained 5% Polycose glucose polymers and 2% fructose. Both solutions contained similar amounts of sodium, potassium, calcium, magnesium, and chloride in the range suggested by the American College of Sports Medicine for rehydration solutions. Four hundred milliliters of each solution were administered to six male subjects and the amount of fluid emptied at 30 and 60 min by each subject was calculated. A non-absorbable dye, phenol red, was used to correct for gastric secretion. The gastric emptying of the 7% solution in healthy adult male subjects was not significantly different from the 5% solution or cold water. Inclusion of a polymerized form of glucose in a 7% glucose polymer-fructose solution can supply 70 g of carbohydrate per liter and also maximizes rehydration. This solution may be particularly useful in those activities where fluid and energy loss are particularly important.

Dietary-induced variations in urinary taurine levels of college women.

Dietary-induced variations in the urinary taurine excretion of healthy college women were investigated. Data were collected in three metabolic studies in which nutritionally adequate diets of constant composition were fed. Variables included isonitrogenous natural food and semi-purified diets; taurine, cystine and meat supplements; and kind and amount of dietary fat. Observed urinary taurine levels were low and ranges were narrower than those reported by other investigators. The low taurine excretion at the completion of the studies was considered evidence that urinary taurine levels in humans is related to the level of body taurine as well as to the level of dietary taurine. Urinary taurine excretion was shown to be related to dietary taurine intake rather than protein (nitrogen) intake. A relationship between kind of dietary fat and taurine excretion is suggested.

Dietary adequacy, feeding practices, and eating behavior of children with Down's syndrome.

The dietary adequacy, eating behavior, and feeding practices of children with Down's syndrome were studied. Half of the children obtained from their food less than the recommended allowances for food energy, calcium, iron, vitamin A, and thiamin; children under six were vulnerable to iron inadequacies. Three-fourths of the children exceeded the allowances for protein and ascorbic acid. Contrary to the belief that parents of handicapped children are permissive, parents seemed to control the food consumption patterns of their children by appropriate techniques. Weight status appeared to be compatible with height in the majority of the participants.