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decrease in BMI of 8% was the threshold level atwhich insulin sensitivity improved. As moreweight loss programs are designed for obese adolescents,it will be important to have reasonableweight loss goals that will yield improvements inmetabolic and cardiovascular disease risk factors.http://www.sciencedirect.com/science/article/pii/S0022347613004204Early parenteral nutrition and growth outcomes inpreterm infants: a systematic review and metaanalysis.Am J Clin Nutr. 2013 Apr;97(4):816-26.By Moyses HE, Johnson MJ, Leaf AA, Cornelius VR.From National Institute for Health ResearchFoundation Trust, Southampton, UK.h.e.moyses@soton.ac.ukBACKGROUND: The achievement of adequatenutritional intakes in preterm infants ischallenging and may explain the poor growth oftenseen in this group. The use of early parenteralnutrition (PN) is one potential strategy toaddress this problem, although the benefits andharms are unknown.OBJECTIVE: We determined whether earlieradministration of PN benefits growth outcomesin preterm infants.DESIGN: We conducted a systematicreview of randomized controlled trials(RCTs) and observational studies.RESULTS: Eight RCTs and 13 observationalstudies met the inclusion criteria (n = 553 and1796 infants). The meta-analysis was limited bydisparate growth-outcome measures. An assessmentof bias was difficult because of inadequatereporting. Results are given as mean differences(95% CIs). Early PN reduced the time to regainbirth weight by 2.2 d (1.1, 3.2 d) for RCTs and 3.2d (2.0, 4.4 d) in observational studies. The maximumpercentage weight loss with early PN waslower by 3.1 percentage points (1.7, 4.5 percentagepoints) for RCTs and by 3.5 percentage points(2.6, 4.3 percentage points) for observationalstudies. Early PN improved weight at dischargeor 36 wk postmenstrual age by 14.9 g (5.3, 24.5g) (observational studies only), but no benefitwas shown for length or head circumference.There was no evidence that early PN significantlyaffects risk of mortality, necrotizing enterocolitis,sepsis, chronic lung disease, intraventricularhemorrhage, or cholestasis.CONCLUSIONS: The results of this review,although subject to some limitations, show thatearly PN provides a benefit for some short-termgrowth outcomes. No evidence that early PN increasesmorbidity or mortality was found. Neonatalresearch would benefit from the developmentof a set of core growth outcome measures.http://ajcn.nutrition.org/content/97/4/816.longNonpharmacological interventions for ADHD: systematicreview and meta-analyses of randomizedcontrolled trials of dietary and psychological treatments.Am J Psychiatry. 2013 Mar 1;170(3):275-89. By Sonuga-Barke EJ, Brandeis D, Cortese S, etal and European ADHD Guidelines Group. FromDept of Psychology, University of Southampton,UK. ejb3@soton.ac.ukOBJECTIVE: Nonpharmacological treatmentsare available for attention deficit hyperactivitydisorder (ADHD), although their efficacy remainsuncertain. The authors undertook meta-analysesof the efficacy of dietary (restricted eliminationdiets, artificial food color exclusions, and freefatty acid supplementation) and psychological(cognitive training, neurofeedback, and behavioralinterventions) ADHD treatments.METHOD: Using a common systematic searchand a rigorous coding and data extraction strategyacross domains, the authors searched elec-16 Yang-Sheng (Nurturing Life) Volume 3, Issue No. 3
tronic databases to identify published randomizedcontrolled trias that involved individualswho were diagnosed with ADHD (or who met avalidated cutoff on a recognized rating scale) andthat included an ADHD outcome.RESULTS: Fifty-four of the 2,904 nonduplicatescreened records were included in the analyses.Two different analyses were performed.When the outcome measure was based on ADHDassessments by raters closest to the therapeuticsetting, all dietary (standardized mean differences=0.21-0.48) and psychological(standardized mean differences=0.40-0.64)treatments produced statistically significant effects.However, when the best probably blindedassessment was employed, effects remained significantfor free fatty acid supplementation(standardized mean difference=0.16) and artificialfood color exclusion (standardized mean difference=0.42)but were substantially attenuatedto nonsignificant levels for other treatments.Kevin W Chen, Ph.D., s an associateprofessor at the Center forIntegrative Medicine, Universityof Maryland. Dr. Chen was educatedin the universities of bothChina and the United States, andhas years of experience andtraining in blending eastern andwestern perspectives, and in thepractice of life-nurturing methods.As a long-time practitioner of Qigong Yang Sheng, he isone of the few scientists in the U.S. to have both hands-onknowledge of mind-body practice, and an active researchcareer in mind-body medicine, which is funded throughgrants by the National Institutes of Health (NIH) and variousfoundations. Dr. Chen devotes his career and life to thepractice of Yang Sheng, and promotion of self-healing andmind-body-spirit integration through the non-profit organization,World Institute for Self Healing (WISH) (http://www.wishus.org).CONCLUSIONS: Free fatty acid supplementationproduced small but significant reductions inADHD symptoms even with probably blinded assessments,although the clinical significance ofthese effects remains to be determined. Artificialfood color exclusion produced larger effects butoften in individuals selected for food sensitivities.Better evidence for efficacy from blinded assessmentsis required for behavioral interventions,neurofeedback, cognitive training, and restrictedelimination diets before they can be supported astreatments for core ADHD symptoms.June-July 2013 Yang-Sheng (Nurturing Life) 17
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Page 20 and 21: From The Doctor 医生之窗Rais
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Page 24 and 25: Meditation in Motion 动中冥
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