Some eating habits of Scottish children: Implicaths for the diabetic child

Review Articles

On behalf of the Scottish Study Group for the Care of Young Diabetics

Some eating habits of Scottish children: implicaths for the diabetic child

Alison Johnston SRD Senior Dietitian, Royal Hospital for Sick Children, Glasgow Wendy Massie SRD Senior Dietitian, Glasgow Royal Infirmary

Kathleen Ross SRD Senior Dietitian, Royal Aberdeen Children’s Hospital Eileen Young SRD Senior Dietitian, Ninewells Hospital, Dundee

Present post: Community Dietetic Department, Russell Institute, Paisley J 0 Craig MB FRCP (Edinburgh & Glasgow) Consultant Paediatrician (retired), Royal Hospital for Sick Children, Glasgow

Correspondence: Dr J 0 Craig, 24 Victoria Park Gardens North, Glasgow GI1 7EJ

Summary The diet of Scottish children is sur-

veyed in terms of the particular foods eaten. There is evidence of improvement in eating habits and some old beliefs seem out-dated. In the teenage years, however, a deterioration in eating habits occurs. The full implementation of a national dietary policy, as in Norway, is mentioned and reference is made to the education of the individual in dietetics. Recent signs of improvement in the national diet suggest that the diet of the diabetic child is not as far from “normal” as it once was.

Introduction “The diet of the diabetic child should be as

near to that of the normal child as possible” is a facile statement if one does not know what the normal child eats. The mem- bers of the Scottish Study Group for the Care ofYoung Diabetics decided that the eating habits of non-diabetic children should be investigated. Several studies deal with protein, carbohydrate, fat, energy, vitamins and minerals, one car- ried out in Glasgow (from whence 50% of the present sample come) being most relevant to the present study (Ref I). A major report has been commissioned by the Department of Health and Social Security (Ref 2) but is still only in its pre- liminary stages. Although in the main it deals with the major nutrients it does comment on 30 particular foods, the per- centage of children taking each food in the course of a week and the average weight of each food taken daily.

The literature on individual foods, such as crisps, apples and eggs, remains scanty, and it is hoped that the present study, dealing with individual foods in some detail, may be regarded as com- plementary to other studies. This paper deals with the pawns of nutritional strategy which must be considered if the above opening sentence is to have meaning.

Method and materials Five ways of assessing dietary intake

are in common use and the retrospective questionnaire used is justified when dealing with large numbers (Ref 3).

Questionnaires were issued to the mothers of 200 children who were in hospital or the siblings of those in hospital. Seventy-five of these were from the Royal Hospital for Sick Children, Glas- gow, 25 from Glasgow Royal Infirmary and 50 each from the Royal Aberdeen Children’s Hospital and Ninewells Hos- pital, Dundee. In two instances two children from one family were involved. All the children were white native-born Scots, except for three white immigrants from England. The form of the questionnaire is implicit in the results quoted, but copies may be obtained from JOC.

The age-group chosen was 5-11 years with an average age of 7.43 years, rang- ing from 7.36 in Dundee to 7.58 in Aberdeen.

It was shown in Glasgow (Ref 4) that the heights of nine-year-old boys varied almost as much within social class I11 (depending on the area studied) as between classes I and V. In addition, some obser- vers (Ref 5), have found no major differences in protein, carbohydrate, fat and energy intake between high, middle and low social classes. For these reasons no attempt was made to balance the study by social class although, as the study was hospital-based, the balance may have been tilted slightly below the middle class.

The cases chosen were “cold” in that there was no acute parental worry. If any- body in the house was on a special diet, the child was excluded. Only those who would still be in hospital two days after the issue of the questionnaire were included. The criteria for inclusion proved to be more strict than originally thought likely and the study took a year to complete (1985-6). The answers were given anonymously.

The questionnaire was issued with a written explanation of the study supplemented by individual explanation by the dietitian. The mothers were allowed two days to complete their answers. The hope was that the dietitian would go through the completed questionnaire with the mother but in fact she was not always available at the moment the mother returned the questionnaire, often when taking the child home. This, combined with strict anonymity preclud- ing follow-up, led to blanks in some questionnaires. The lowest response to any question was 96% and the “no answer” group has therefore been disregarded in giving results. Percentages quoted refer to those who did reply.

As no major differences appeared between the three cities in the study the answers are given collectively.

Results Breakfast

Solids in some form were taken by 95%. Three per cent took a drink only and 2% took nothing at all. Acereal was taken by 89.5%. Toast, bread, etc, were taken by 72%. Those who took bread, etc, averaged 1.30 slices each. Forty-two per cent also took marmalade or jam. Fruit juice (excluding squashes) was taken by 42.5%. Milk at breakfast (with cereal or as a drink) was taken by 94%, with an average of 6.93 fluid ounces (196.1 ml). A cooked breakfast was taken by 7%, most often a boiled egg and a further 3% took a cooked breakfast three times a week or less. Comment

Although it is true that few take a cooked breakfast, the great majority take adequate carbohydrate and milk.

Bread throughout the day Ninety-six per cent took bread. The

average was 2.35 slices per day. The type of bread taken was answered by 192, of

227 Practical Diabetes September/October 1988 Vol5 No 5

Review Articles

whom 35 took both white and brown. Of the remaining 157, 68.6% took white only, 31.4% took brown only, a ratio of 2.2:l. Comment

In 1974, the ratio of white to brown bread sold in Scotland was 15:1, the ratio falling t o 5: 1 in 1984 (Refs6,k). Whereas these figures represent the amount of bread sold, our figures are for the number of children taking each type, which is not the same thing. Neverthe- less, the ratio quoted above of just over 2:l does suggest that the move towards brown bread continues.

Vegetables See Table 1.

Comment All 200 answered this question. The

"sometimes" column shows little varia- tion and comparison between columns one and three seems of greater value. It is perhaps not surprising that corn is low on the list, but the rating of tomatoes and salads is unsatisfactory. It is even more unsatisfactory that nearly half the subjects took vegetables only occasionally or not at all.

Fruit See Table 2.

Comment 198 took fruit. two did not. The aver-

age of the 200 was 7.73 pieces per week. Three pieces of fruit (an apple. an orange and a banana. of average size. with their skins on) weigh about 18 oz (511 g); this means that the average child taking 7.73 pieces a week takes about 1.32 kg. The figure for fresh fruit con- sumed per head per week in Scotland (Ref&) is 15.32 oz (0.43 kg). The conclu- sion is that a blanket figure for an entire population seriously underestimates the amount of fruit taken by children under twelve. ie. kids eat more fruit than grown-ups. a fair guess in the first place. The intake of fruit is good and partly compensates for the lack of vegetables.

lunches 26.5% took all week-day lunches at

school: 2Y.5'% took them all at home: and 8% always took a packed lunch: 32% varied from day t o day: 3.5% were not yet at school. Comment

School meals and packed lunches appear to be taken less frequently in Scotland than in England (Ref 6b).

Snacks Snacking is important in childhood

and adolescence in particular and is here considered under three headings: day- time snacks: visits to the ice-cream van;

Some eating habits of Scottish children: implications for the diabetic child

Table 1 Consumption of vegetables

Type of vegetable Peas Greens Beans (including baked) Carrot and turnip Corn Tomato Salad All types

Never 33.5 35. I 16.1 26.8 47.5 56.9 51.3 8.5

Times taken % Sometimes More than once a week

34.5 31.8 32.5 32.5 47.2 36.7 44.4 28.8 44.9 7.6 33.0 10.2 36.2 12.6 40.5 51.0

Table 2 Consumption of fruit

I Times taken %

More than once More than once Type of fruit Never Sometimes a week a day

5.0 22.6 56.8 15.6 20.3 39.6 32.5 7.6

4oPleS Oranges Tangerines 19.8 46.7 29.4 4.1 Bananas 10.6 36.7 45.2 7.5 Pears 34.3 43.6 18.5 3.6

Table 3 Choice of snacks, daytime

Chocolate biscuits Plain biscuits Fruit Crisps Chocolate Sweets or ices Nuts (eg. peanuts) Milk

Often 8.7

22.5 44.4 49.5 11. I 28.3 3.5

38.7

Times taken % Sometimes

71.9 69.0 48.0 47.5 72.9 60.6 35.2 41.2

NB. Under the heading "Others" cheese was most common.

Never 19.4 8.5 7.6 3.0

16. I 11.1 61.3 20.1

and bed-time snacks. The popularity of various snacks taken during the day appears in Eible 3. The ice-cream van intrudes into the lives of most children. In the present series. 59% had an ice- cream van readily available outside their homes at certain times. Of that 59%. 94% visited the van. the average number o f visits being 4.24 per week. One energetic Glasgow five-year-old visited four times per i f q One can only hope that the exercise this involved got rid of the extra calories.

Several children quoted two or more choices so the following figures add up t o more than the 1 1 0 who visited a van.

had 78 mentions and toast. 76. Much less common were sandwiches. 32.

Cereals follow with 29 and cheese kvith 21. Only two took cake. Thirty-eight took nothing. their average age being 7.16 years. a little below the average age o f the group studied. Comment

Crisps are popular for day-time snacks. but fruit and milk are also high on the list. Sweets are taken mainly in the late afternoon or early evening and starches at bed-time. For both chocolate and chocolate biscuits "never" exceeds "often".

"Tenpenny bags" were chosen by 55. crism bv 54. ices bv 45. other sweets hv Sweets and crisps 28. br i iks by 19 anh nuts by three.

At bed-time there were again multiple answers to specific questions. Biscuits

It is clear from the above that there is a degree o f overlap between day-time snacks and the ice-cream van. Separate


Review Articles

questions were therefore asked on the total number of packets of crisps eaten and the amount of money spent on sweets each week. Two did not take crisps. The average intake of the others was 5.86 packets per week. Three or more packets a day were taken by 2.5%. The money spent on sweets divided as follows: nil, 1%; up to 2Op, 7.5%; 21- Sop, 22.1%; 5 1 ~ 4 1 , 40.2%; more than E l , 29 .I%. Taking the midpoints of these groups (eg. 51p-El is taken as 75p and more than E l is taken arbitrarily as f1.50) the average weekly amount spent on sweets is 82p. The average age of those spending more than f l was 7.64 years, just over the average age for the group, but the record of f5.50 was attained by the same five-year-old who visited the ice-cream van four times a day. Comment

The average child spends near lyf l per week on sweets and takes almost one packet of crisps per day.

Drinks 97.5% of children take squashes or

aerated waters, 12.4% of these less than once daily; 33.0% once daily; and 54.6% more than once daily. There appears to be quite a gap between those who drink a little and those who drink a lot, the average number of tumblers in the “more than once daily” group being 3.35.

When asked about choice between drinks many could not be sure, so again there are multiple answers. There were YO mentions of squashes, 75 of milk, 55 of aerated waters, 36 of tea or coffee and 18 of fruit juices. The average age of those who mentioned milk only (N = 40) was 7.40 years, very close to the average age of the group, suggesting that a child’s intake of milk is constant during the early school years. Comment

The preponderance of squashes over aerated waters may be due to cost. Milk scored better than expected.

Milk throughout the day Three did not take milk. Of the

others, 21.4% took less than half a pint in the day including the milk taken at


breakfast; 48.5% took a half to one pint; 26.5% took up to two pints; and 1.5% took more than two pints. The mid-point average is 0.85 of a pint (402 ml).

In reply to the type of milk taken, the above 197 divided as follows: whole milk, 69 .O% ; semi-skimmed milk, 22.8%; whole and semi-skimmed milk, 4.6%; skimmed milk, 2.0%; skimmed and semi-skimmed milk, 1.0%. Comment

Almost a third (30.4%) are taking steps to reduce the fat intake from milk.

Eggs Thirty-nine did not take eggs. The

average number of eggs taken per week by the remaining 161 was 3.52. There were again multiple answers to the form of cooking. Boiling was mentioned 132 times; scrambling 85; frying 47; and poaching 27. Comment

low. Poaching may be a vanishing art.

Butter and margarine See Tabfe 4.

Comment Polyunsaturated margarine is

favoured by only one in five of those using margarine and by one in eight of those using spreading fats. Cost may be hindering its dietetic progress.

The figure for frying is surprisingly

Main meals Main meals are worth a study of their

own and only a tentative approach was made in this paper. Twenty-one food- stuffs were considered and each was given a frequency scale of nought to four (from “Never, or less than once a month“ to “Daily, or more”). The higher the average score for any food, the more popular it is. Only a few findings merit comment.

Boiled or mashed potatoes were most often taken (3.24) with red meat second (2.97). In addition, however, cold meat scored 2.24 and white meat 2.08. Fries rated 2.67 and chips 2.60, usually taken with fries. All that can be said is that boiled and mashed potatoes are more often taken than chips.

The best information comes from the

Table 4 Uses of butter and margarine

Butter only 35.8%

100%

Poly-unsaturated, 19.1% 77.3% 0.9% Both above,

Not stated, 2.7%

} 63.6% { Ordinary, Margarine only 52.6‘2:

Both, 11.0%

I I Neither, 0.5%

definite “Nevers”. Cottage cheese was never taken by 86.2%, cream by 49.7%, baked potatoes by 41.5%, pizza by 39.6% and cheese spread by 38.9%. Comment

The tag “chips with everything” n o longer holds good and boiled or mashed potato are more popular. Baked potatoes are not yet popular and cottage cheese is almost ignored.

Discussion This survey is by no means complete.

The average number of non-chocolate biscuits eaten per week is known (14.77) but the figure is of little value without considering the great range of types available, in itself a considerable study. Nor has any differentiation been made between fresh, frozen and processed foods. We realize that the fibre content varies in different types of brown bread. The findings presented should be regarded as indicators of the current situa- tion rather than as a complete answer to all that is being eaten.

Eating habits are the product of use. preference and liking (Ref 7). ’Food ‘A’ may be liked more than ‘Food B‘ because of sweetness or flavour but ’Food B’ may be preferred as being better for health. Food use involves preference and liking but they are further modified by cost and availability. The present study is concerned with food use without going into preference and liking in any detail.

There are three studies with which comparison can be made. First. a study of the diets of immigrant children in Glasgow included a group of ethnic Scots (Ref 8)7 of which 40% were in the six-I0 years age-group. The number is small and the method used was one- week recall. A child who does not take a food during one week cannot be directly compared to one who never takes it at all. However, comparisons are possible with foods taken daily. In that study it was found that 100% took fruit (99% in the present series). The average daily intake of milk was 667 ml (483 ml). but school milk was stopped. except for the under sevens, between the two studies. That study refers also to the poor intake of green vegetables but perhaps t h e most interesting fact is an apparent swing t o margarine from butter (Table 5). The figures suggest (but do not prove) that most of those who took both butter and margarine have turned t o margarinc only.

Another paper relevant to this one describes some eating habits of 270 girls aged 14-16 years, again in Glasgow fRef9). The results are not strictly comparable because girls eat less than boys. especially in adolescence (Ref 10). Further, the method adopted was 24-

Practical Diabetes September/October 1988 Vol5 No 5 229

Review Articles

hour recall, and two cross-sectional studies d o not add up t o one longitudinal study. Nevertheless, the difference between Glasgow boys and girls in the present study and Glasgow adolescent girls are so striking as to be worth recording (Table6). It seems safe to deduce that the eating habits of children deteriorate badly when they enter adolescence, presumably due to the increased per- sonal buying-power of the adolescent, associated with an increase in social snack eatingoutside the home. It isappa- rent that the eating habits of diabetic children (our original focus of attention) must be kept under close review during the pre-adolescent and adolescent years, however well they may have mastered dietetic principles during the years of childhood.

Third. there is the report (Ref2) which uses data collected in 1983. This again is "one week recall" and comparisons are subject to the provisos given above. However, as with Goel's paper, it is possible to bring out certain differences (Table 7). Here again there is a picture of improving nutrition, from whole milk to skimmed, from butter to margarine and from white bread to brown. The changes may seem too great to have occurred in a short space of time, but it should be remembered that publicity about good nutrition reached a peak. particularly on television, about 1983-85. A report pub- lished in 1987 using data collected in 1983-4 (Ref 11) comments on improvement. mainlyqualitative. compared with an earlier study (Ref 5) and adds that. in view of the difficulty in improving dietary habits. the results represent a considerable achievement in a short time.

Other impressions from the present study were that boiled potatoes were taking over from chips and that boiled or scrambled eggs were taken more often than fried. Indeed. Scots seem no longer to live entirely out of the frying pan, if ever they did. But there is no ground for complacency. particularly if the eating habits of the adolescent girls are remembered. How should we proceed in the future'?

At Government level. there is the Norwegian example t o be considered (Ref 12). Therc, an lntcrministerial Co- ordinating Commitee on Nutrition has imposed controls on processed foods and arrangcd a freight subsidy to control prices i n outlying areas. with a grant to outlying stores, provided they stock nutritionally valuable foods. It may be true that Interdepartmental Committees are slow to produce results. but there does seem to be a case for some such organisation in Britain. Central Govern- ment is linked to local government by mandatory and enabling Acts and the extent, i f any. to which central govcrn- ment should be involved in. say, the


Table 5 Choice between butter and margarine: changes in the past few years

Age Butter only Margarine only Both Other, ornot known

Present study Goel, 1974-6 5- 11 years 0-16 years

35.8% 41.2% 52.6% 12.7% 11.0% 42.3% 0.5% 3.8%

Table 6 Certain eating habits:

a comparison between Scottish children and Scottish adolescents

Source Present study Cresswellet al Subjects Children 5-11 yrs Adolescentgirls At breakfast

Cereal 89.5% 41% Cooked breakfast 70/, 4 % Fruit or fruit juice 42.5% 7%

At snacks Crisps, at least three packets daily 2.5% 12 Yo Fruit 44% * I Yo

* Those who replied "often" in Table 3. The figures are not strictly comparable but even if the present figure is halved the difference remains gross.

Table 7 Milk, spreading fats and bread:

Scottish figures contrasted with recent figures for Britain

Source Wenlock et al Present Study

Food taken Date 1983 1985-6

Whole milk 98% 69%

alone or with whole 3 Yo 30% Butter, alone or with margarine 70% 46% Margarine, alone or with butter 56% 64Y" White bread, alone or with brown 97% 73% Brown bread, alone or with white 43 yo 43 Yo

Skimmed milk orsemi-skimmed,

financing of school meals is a matter for discussion. Certainly there seems to be awareness among local education authorities of good nutritional standards.

One hesitates to designate the media a5 altruistic but there seems little doubt that i t , along with manufacturers and stores. has played a large part in educating the public. The main source of worry now seems to be lack of dietary cduca- t ion in schools.

There used to be a tendency to link nutrition education with older children. particularly with girls studying home economics. The eating habits of teenage girls already referred to suggest that this may be beginning too late. There is now a move towards teaching the principles o f nutrition in the primary school, vary- ing from area to area and. indeed. from

school to school. depending on the attitudes and resources of the local education authority. head teachers. class teachers and community dietitians. There is academic support for the value of teaching nutrition in the elementary school (Ref 13). There remain two considerable problems: which educational methods are the best to employ (Rqf5 14.15): and how. when. where. and by whom. are the potential educators to be educated'?

Serious dietary aberration leading t o anorexia nervosa and bulimia in young diabetic women. with the early appear- ance of severe complications. has been described (Rqf16). eight of 15 cases hav- ing developed diabetes before their teens. Among the many stresses of diabetes. that o f keeping to a "different" diet was strong. If nutrition were to be


widely taught in primary schools, might not the diabetic child feel less isolated? In ‘a national nutrition programme this may seem a minor point but it could be a major one for the diabetic child.

Although progress has been made in reducing dietary fat, it is thought (Ref 11) that the amount of carbohydrate pre- scribed for the diabetic child is still below the acceptable level. The child tends to compensate for the cut in fat by exceed- ing the previous prescription for carbohydrate, but largely in the form of sugars. This state of affairs needs to be rationalized for each individual. In doing so. one must bear in mind the relatively recent concept of the glycaemic indices of various carbohydrates. Not all carbohydrates affect the blood sugar to the degree they were once thought to do (Refy 17.18). Ice cream in moderate amounts is permissable in the diabetic diet (Ref 19). but ice-cream, crisps and whole milk are all popular snacks with a high fat content. a disadvantage not shared by fruit which is in the same glycaemic range. More fruit and about three packets of crisps per week, with average amounts of milk and ice-cream and the occasional chocolate or sweet immediately after meals should suit the diabetic. both socially and dietetically.

At the time of writing a diet giving 1% of the total energy from protein. 30% from fat and 55% from carbohydrate would be regarded as ideal for the diabetic child. including 30 g of fibre

Some eating habits of Scottish children: implications for the diabetic child Review Articles

News Round-up

per day, whereas twenty years ago the ratio was set at 20:40:40 with no mention of dietary fibre. The resistance of the individual to dietary change has to some extent been offset by an increased awareness in the general population of the need to improve eating habits. Tomor- row’s reality may come close to the ideals of today with comparatively little stress to the diabetic child who will be expected to adjust only slightly from the “normal” diet.

Acknowledgement The Scottish Study Group for the Care

of Young Diabetics wishes to thank Nordisk UK for their continuing interest and support.

References I . Durnin JVGA. Energ! hulmce in childhood and

odoleccence. Proc Nutr Soc 1Y84: 43: 271-9. 2. Wenlock RW. Disselduff MM. Skinner RF

et al. The d i m of Brirbh ~cltoolchildren. Nutrition Unit. Department o f Health and Social Security. and Social Survey Divivon. Office of Population Cenwws and Survey\. London I Y M : 12-3.

3. Boulton TJC. Purrwin ( I f food inruke in (hild- lttiod und udoIewiw(~o iord r id of Iurw diwct.se. o r “Thc owfit1 food., kid.\ iwt tiowud(ty+ intt\t he hod for rltcwt!” Auht NZ J Mcd IYXS: 15: 47S-X7.

4. Craig JO. The heighr\ o/ < ; l u y i n ~ hi!

nnd \ / i ( . i ( t / i~t~i t ( ,~tc~, \ . Hum Biol I Y M : 35: 524-3Y. 5 . Hackett AF. Rugg-Cunn AJ. Appleton DR

et al. .+I rii~ri-wur lorrgitttrlinol nttrririonul \ttri.c:v / I / 403 . ~ t i r r l r i t i i t h ~ ~ r l ~ i i t ~ l drililrur i t t i t id l~ i t g d 11. .i y u r \ . Brit J Nutr IYXJ : 51: 67-75,

6. Ministry of Agriculture. Fisheries and Food.

Household food consumption and expenditure. London, HMSO 1974: 64-9.

6a. ibid 1984: 48-50. 6b. ibid 1984: 109. 7. Rozin P, Vollmecke TA. Food likes and dislikes.

Ann Rev Nutr 1986: 6: 433-56. 8. Goel KM. A nutrition .survey of immigrant

children in Glasgow 11974-1976). Scottish Health Service Studies, No. 40. Scottish Home and Health Department. Edinburgh, 1979.

9. Cresswell J, Busby A , Young H et 81. Dietary patterns of rhird-year secondary .schoolgirls in Glasgow. Hum Nutr : Appl Nutr 1983: 37A: 301-6.

10. Whitehead RG, Paul AA, Cole IJ. Trends in food energy inrake throughout childhood from 1-18 years. Hum Nutr : Appl Nutr 1982: 36: 57-62.

11. Hacket AF, Court S, McCowen C et 81. To what extent have rhe currenr recommendation.\ on dier for diabetics been implemenred for children? Hum Nutr : Appl Nutr 1987: 41A: 403-8.

12. Norum KR. Ways and means of influencing nurrirional behatkwr - experience1 from the Nor- wegian nitrririon and food policy, Bibliotheca Nutr Dieta 1985: 36: 29-42,

13. Michela JL, Contento IR. Cbgnirive. m0rii.a- rionul. mrial and eni.ironmenra1 influences on child- renifood choices. Health Psqchol 1986: 3: 209-30.

14. Moody R. frtoriries for ntttririon edrtcarion in die tecondury school. Hum Nutr : Appl Nutr 1982: 36A: 1X-21. 304.

15. Cay %I. Priorirks for nitrrition editcarion in rlte secondur! rclrool 1letrer). Hum Nutr : Appl Nutr 1982: 36A: 302.

16. Steel JSl. Young RJ. Lloyd GG et al. Clini- cull\ oppctreiir ectting dirordet.\ in yoitng diohetic ii~omen: us \ociurionc tt.irli painfit/ ncitropotlt~ ondorhur c~omp/icurion!. Brit Med J 19x7: 294: 859-62.

17. Jenkins DJA. Taylor RH. Wolever TMS. Thr, dicthcrtc diet. dicrar! corholi~drurc orid mid difference, in digevihiiir!. Diahctolosia IYS7: 23: 477-84.

I X . Jenkins DJA. Wolerer TMS. Jenkins AL et al . T/ie ~ l y c i w i i i i c reclitin\c r t i I urboh,vdrurc food\ Lancct IYSJ: ii: 3x8-Yl.

I Y . Sathan DM. Godine JE. Gauthier-Kelle? C et al. I w - m w i t irr rlrr dkr of i i r~ i t l t~r -d~~~~i~ i rd i~ i r t diu. h e t r ~ ~ p o r t ~ ” r t r ~ . JAMA I Y U : 251: 2S2.i-7.

Eli Lilly funds RCGP’s pilot facilitator scheme The Royal College of

Gcneral Practitioners, with funding from Eli Lilly. has appointed two diabetes facilitators to work with practices in the northern area health rcgion.

This pilot scheme. in line with the College’s commit- ment to educating general practitioners and their teams and t o promoting a preventa- tive approach t o health care. will enable a general practition- er and a nurse t o operate on a part-time basis for one year.

Their function will be to advise practices o n how to extend their services for diabetic patients. As diabetes affects two per cent of the population. thc College feels that the right place for care and treatment is with the pat ic n t ’s fam i I y doctor.

The facilitators will also liaise with local College

groups. the regional health authority. district health authorities and family prac- titioner committees.

The two facilitators are. Sister Mary Dant RGN. who qualified as an SRN at Adden- brookes Hospital. Cam- bridge. in 1967. and Dr Alan R Fraser MRCP MRCGP. w h o qualified at Bristol University in 1975.

Funding from Eli Lilly will allow about 40 working days for both facilitators. travelling expenses and secretarial as- sistance. After six months. the scheme will undergo an interim evaluation which will form part of a study day. Thc project will be fully evaluated after one year and will be written up and publishcd.

Further details about the scheme are available from. Dr Colin Waine FRCGP. Chair- man. Clinical and Research

Division. Royal College of General Practitioners. 14 Princes Gate. Hyde Park. London SW7 1 PU.

Diabetes food packs

Two food packs. designed to help people learn to visually estimate carbohydrate es- changes and to teach the con- tents o f balanced meals. have been produced by the British Diabetic Association. The packs. one for Caucasians. the other for Asians. each contain replica foods of appropriate portions. a measuring beaker and a set o f measuring spoons. They are designed for health professionals to use as teach-

professionals t o use as teaching aids with diabetics and include a wide range of high tibre foods as well as snacks and alcohol.

The Caucasian pack. \vhich costs f106.40 including VAT and postage. contains chicken breasts. beefburgers. fish fingers and a selection of breads. vegetables and cheeses as aell as fruit. desserts. liquids and snacks. Regular meals. ’pub‘ lunches and snacks can all be made up \vith the ingredients. The Asian pack costs f48.00 inclu- sive. and has mouthivateriug delicacies such as mung dahl. channa curry. chapatis. a selec- t ion o f rice and Yegetables and Indian sweets.

Free information brochures can be obtained from Azmina Govi ndj i . Diet i t i a 11. British Diabetic Association. 10 Queen Anne Street. London WIM OBD.

Practical Diabetes September/October 1988 Vol5 No 5 233

Some eating habits of Scottish children: Implicaths for the diabetic child

Documents

Transcript of Some eating habits of Scottish children: Implicaths for the diabetic child