Subjective satiety and other experiences of a Paleolithic diet compared to a diabetes diet in patients with type 2 diabetes.

BACKGROUND: We found marked improvement of glycemic control and several cardiovascular risk factors in patients with type 2 diabetes given advice to follow a Paleolithic diet, as compared to a diabetes diet. We now report findings on subjective ratings of satiety at meal times and participants' other experiences of the two diets from the same study. METHODS: In a randomized cross-over study, 13 patients with type 2 diabetes (3 women and 10 men), were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts, and a diabetes diet designed in accordance with dietary guidelines, during two consecutive 3-month periods. In parallel with a four-day weighed food record, the participants recorded their subjective rating of satiety. Satiety quotients were calculated as the intra-meal quotient of change in satiety during a meal and consumed energy or weight of food and drink for that specific meal. All participants answered the same three open-ended questions in a survey following each diet: "What thoughts do you have about this diet?", "Describe your positive and negative experiences with this diet" and "How do you think this diet has affected your health?". RESULTS: The participants were equally satiated on both diets. The Paleolithic diet resulted in greater satiety quotients for energy per meal (p = 0.004), energy density per meal (p = 0.01) and glycemic load per meal (p = 0.02). The distribution of positive and negative comments from the survey did not differ between the two diets, and the comments were mostly positive. Among comments relating to recurring topics, there was no difference in distribution between the two diets for comments relating to tastelessness, but there was a trend towards more comments on the Paleolithic diet being satiating and improving blood sugar values, and significantly more comments on weight loss and difficulty adhering to the Paleolithic diet. CONCLUSIONS: A Paleolithic diet is more satiating per calorie than a diabetes diet in patients with type 2 diabetes. The Paleolithic diet was seen as instrumental in weight loss, albeit it was difficult to adhere to.

Many fathers visit the child health care centre, but few take part in parents' groups.

Fathers are expected to play an increasing part in the care of children, but fathers are not automatically included in studies of early childhood. In this paper we present Swedish fathers' experiences of child health care. In the study, a total of 237 out of 279 (85%) fathers of small children were telephone interviewed using a structured questionnaire. As many as 165 (70%) had visited the child health centre at some time - 91 (38%) regularly or quite often - and we found an association between visits to the child health centre and physician contacts on account of the child's illness. A common feature throughout was the fathers' positive view of the child health centre and its activities, with as many as 77 percent grading it as very good or good. Sixty-seven fathers (28%) had taken part in a parents' group, and here there was a positive association with being a first-time father and knowing about the child's birth weight and vaccinations. We conclude that professionals must find new ways to get fathers to come to child health care, and especially to parents' groups.

Swedish child health care in a changing society.

BACKGROUND: Staff in Swedish child health care today feel a gap between policy and practice. By revealing the main lines in the development of child health care, we hoped to achieve a better understanding of the current trends and problems in today's Swedish child health care. METHODS: A selection of official documents about the development of child health care during the period 1930-2000 was studied with the aid of discourse analysis. RESULTS: Four discourses were identified, which serve as a foundation for a periodization of the development of child health care. In the first period the main task of child health care, alongside checking on the development of the child, was to inform and educate the mothers. During the second period health supervision became the crucial task, to identify risks and discover abnormalities and disabilities. The third period focused on the discussion concerning the identification of health-related and social 'risk groups', and the work of child health care was increasingly geared to supervision of the parents' care of their children. Parents were to be given support so that they could cope with their difficulties by themselves. During the current period child health care is increasingly expected to direct its work towards the child's surroundings and the family as a whole and is now explicitly defined as an institution that should strengthen parents' self-esteem and competence. The level of responsibility for the child's health changed gradually during the different periods, from public responsibility to parental responsibility. The focus of efforts in child health care was changed from being general in the first and second periods to general and selective in period three, and then gradually becoming selective again in period four. While control of the child's physical health was central during the first two periods, psychosocial health came into focus in the last two, along with the importance of supporting the parents to enable them to handle their difficulties by themselves. CONCLUDING REMARKS: We noted that it was difficult to translate policy recommendations into practice. One reason was the shifting focus in child health care from the child's physical health to psychosocial problems which in itself meant a shift from descriptions of concrete and well-defined duties to more abstract and general descriptions of tasks which are by definition open to interpretation. Another reason for the noted difficulty was the transition from unambiguously described measures in terms of paternalistic regulation to more participatory and at the same time more expansive definitions of roles and responsibilities.

Training programme for parents of teenagers: active parental participation in development and implementation.

In Sweden, all new parents should be offered parental training, but up until now, the programmes have been provided only within maternity and child healthcare, and they have been initiated and planned by central public authorities. We describe the process whereby a training programme for parents of teenagers was developed, in co-operation with the parents themselves, and we report the results of a brief questionnaire survey to the participating parents. A 'parents' school' was planned by 36 parents and a project leader, and between 14 and 26 parents participated in four planning meetings. Four lecture evenings, including group discussions, were arranged, a total of 105 parents registered their interest in participating, and between 50 and 70 attended each lecture. The majority of the parents reported being basically satisfied, feeling that they had acquired knowledge and insights about the teenage phase, and they wanted the 'parents' school' to continue.