Daily Meal Plan Research Articles

Application of ChatGPT to Support Nutritional Recommendations for Dialysis Patients – A Qualitative and Quantitative Evaluation

ObjectivesThe diversity of food preferences and the need for personalized care can be challenging for renal dietitians. We explored ChatGPT-4 to support nutritional advice given to dialysis patients. DesignIn this simulation study, we tasked ChatGPT-4 with generating a personalized daily meal plan, including nutritional information. SettingThe study used virtual “patients” generated through Monte Carlo simulation. SubjectsData from a randomly selected virtual patient were presented to ChatGPT. InterventionWe provided to ChatGPT patient demographics, food preferences, laboratory data, clinical characteristics, and available budget, to generate a one-day sample menu with recipes and nutritional analyses. The generated content was rated by a renal dietitian and compared with a USDA-approved nutrient analysis software. ChatGPT also analyzed nutrition information of two recipes published online. We also requested a translation of the output into Spanish, Mandarin, Hungarian, German, and Dutch. Main outcome measureThe outcome measures were the accuracy of ChatGPT's nutritional analysis, the quality of recipe and cooking instructions on a five-point Likert scale, and a quantitative nutritional analysis. ResultsChatGPT generated a daily menu with five recipes. The renal dietitian rated the recipes at 3 (3,3) [median (Q1, Q3)], the cooking instructions at 5 (5,5), and the nutritional analysis at 2 (2,2) on the five-point Likert scale. ChatGPT’s nutritional analysis underestimated calories by 36% (95% CI: 44-88%), protein by 28% (25-167%), fat 48% (29-81%), phosphorus 54% (15-102%), potassium 49% (40-68%), and sodium 53% (14-139%). The nutritional analysis of online available recipes differed only by 0 to 35%. The translations were rated as reliable by native speakers (4 on the five-point Likert scale). ConclusionWhile ChatGPT-4 shows promise in providing personalized nutritional guidance for diverse dialysis patients, improvements are necessary. This study highlights the importance of thorough qualitative and quantitative evaluation of AI-generated content, especially regarding medical use cases.

AI nutrition recommendation using a deep generative model and ChatGPT

In recent years, major advances in artificial intelligence (AI) have led to the development of powerful AI systems for use in the field of nutrition in order to enhance personalized dietary recommendations and improve overall health and well-being. However, the lack of guidelines from nutritional experts has raised questions on the accuracy and trustworthiness of the nutritional advice provided by such AI systems. This paper aims to address this issue by introducing a novel AI-based nutrition recommendation method that leverages the speed and explainability of a deep generative network and the use of novel sophisticated loss functions to align the network with established nutritional guidelines. The use of a variational autoencoder to robustly model the anthropometric measurements and medical condition of users in a descriptive latent space, as well as the use of an optimizer to adjust meal quantities based on users’ energy requirements enable the proposed method to generate highly accurate, nutritious and personalized weekly meal plans. Coupled with the ability of ChatGPT to provide an unparalleled pool of meals from various cuisines, the proposed method can achieve increased meal variety, accuracy and generalization capabilities. Extensive experiments on 3000 virtual user profiles and 84000 daily meal plans, as well as 1000 real profiles and 7000 daily meal plans, demonstrate the exceptional accuracy of the proposed diet recommendation method in generating weekly meal plans that are appropriate for the users in terms of energy intake and nutritional requirements, as well as the easiness with which it can be integrated into future diet recommendation systems.

AI dietician: Unveiling the accuracy of ChatGPT's nutritional estimations

We investigate the accuracy and reliability of ChatGPT, an artificial intelligence model developed by OpenAI, in providing nutritional information for dietary planning and weight management. The results have a reasonable level of accuracy, with energy values having the highest level of conformity: 97% of the artificial intelligence values fall within a 40% difference from United States Department of Agriculture data. Additionally, ChatGPT displayed consistency in its provision of nutritional data, as indicated by relatively low coefficient of variation values for each nutrient. The artificial intelligence model also proved efficient in generating a daily meal plan within a specified caloric limit, with all the meals falling within a 30% bound of the United States Department of Agriculture's caloric values. These findings suggest that ChatGPT can provide reasonably accurate and consistent nutritional information. Further research is recommended to assess the model's performance across a broader range of foods and meals.<END ABSTRACT>

In Silico Validation of Personalized Safe Intervals for Carbohydrate Counting Errors.

For patients with Type 1 diabetes mellitus (T1DM), accurate carbohydrate counting (CC) is essential for successful blood glucose regulation. Unfortunately, mistakes are common and may lead to an incorrect dosage of prandial insulin. In this work, we aim to demonstrate that each person has their own limits for CC errors, which can be computed using patient-specific data. To validate the proposed method, we tested it using several scenarios to investigate the effect of different CC errors on postprandial blood glucose. Virtual subjects from the T1DM Simulator were used in a clinical trial involving 450 meals over 90 days, all following the same daily meal plan but with different intervals for CC errors near, below, and above the limit computed for each patient. The results show that CC errors within personalized limits led to acceptable postprandial glycemic fluctuations. In contrast, experiments where 50% and 97.5% of the meals present a CC error outside the computed safe interval revealed a pronounced degradation of the time in range. Given these results, we consider the proposed method for obtaining personalized limits for CC errors an excellent starting point for an initial assessment of patients' capabilities in CC and to provide appropriate ongoing education.

Nutritional rehabilitation of malnourished children: are nutritional supplements a must?

Objective Malnutrition threatens children worldwide. The objective of the current study was to highlight the role of nutritional screening, evaluate the effectiveness of nutritional intervention program, and whether nutritional supplements have surplus benefit. Patients and methods Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) was used to screen 3640 clinically stable 2–5 years old children recruited from the outpatient clinics, Children’s Hospital, Ain Shams University. A total of 100 patients at high risk of malnutrition were enrolled. Full nutritional assessment was done and according to the distribution of the calories in the daily meal plan, the patients were randomly divided into two groups each comprised 50 patients. Group A received tailored nutritional dietary rehabilitation plan including dietary supplements, while Group B received only dietary advice. Anthropometric measurements, laboratory tests, as well as STAMP scoring were reassessed after the nutritional rehabilitation programs. Results Nutritional screening revealed that 5.14% were at high risk of malnutrition. Both studied groups showed significant improvement in caloric intake and all anthropometric measurements upon nutritional rehabilitation, except for the height z scores. Patients who received nutritional supplements showed significantly better changes regarding weight, BMI, caloric intake, and hemoglobin. Regarding STAMP categories during follow up, Group A had only 6% of the patients still in the high-risk category and 76% were at low risk compared to 14% high risk and only 54% were at low risk in Group B. Conclusions Nutritional screening in pediatric outpatient facilities can lead to implementing prompt nutritional rehabilitation, which can reflect on the patients’ overall health. Tailored nutritional plan can accomplish good response in terms of improvement of caloric intake, anthropometric measurements and laboratory parameters. Adding a nutritional supplement to the dietary plan during nutritional rehabilitation isn’t a must but it ensures superior goal achievement.

PROTEIN AI Advisor: A Knowledge-Based Recommendation Framework Using Expert-Validated Meals for Healthy Diets.

AI-based software applications for personalized nutrition have recently gained increasing attention to help users follow a healthy lifestyle. In this paper, we present a knowledge-based recommendation framework that exploits an explicit dataset of expert-validated meals to offer highly accurate diet plans spanning across ten user groups of both healthy subjects and participants with health conditions. The proposed advisor is built on a novel architecture that includes (a) a qualitative layer for verifying ingredient appropriateness, and (b) a quantitative layer for synthesizing meal plans. The first layer is implemented as an expert system for fuzzy inference relying on an ontology of rules acquired by experts in Nutrition, while the second layer as an optimization method for generating daily meal plans based on target nutrient values and ranges. The system’s effectiveness is evaluated through extensive experiments for establishing meal and meal plan appropriateness, meal variety, as well as system capacity for recommending meal plans. Evaluations involved synthetic data, including the generation of 3000 virtual user profiles and their weekly meal plans. Results reveal a high precision and recall for recommending appropriate ingredients in most user categories, while the meal plan generator achieved a total recommendation accuracy of 92% for all nutrient recommendations.

Changes in the nutritional profile of medicine students during the COVID-19 pandemic period and its correlation with anxiety: a prospective cross-sectional observational study

Introduction: Pandemics cause strong social, economic, and political impacts. Social isolation to reduce the virus’ impact and to retard the health system breakdown caused by SARS-Cov-2 have affected the population’s lifestyle, including medical students. Objective: Identity which impacts the daily meal plan has the COVID-19’s Pandemic caused in medical students; Correlate data obtained in different grades of the medical course and present the nutritional profile of the students, who attended the study. Methods: Survey realized in students of a private medical course in the São Paulo northwestern region, with a questionary containing open questions and tests, sent online in conjunction with the Term of Consent. This study was analyzed and approved by the Research Ethics Committee according to a substantiated opinion number 4.373.785, and obtaining the patient's consent through the Informed Consent Form. Results: 117 students, between the 1st and 4th grade of the course, have attended the following study, 75 female, 42 male, allocated in similar proportions in the 4 initial grades of the course, ages between 17 and 31 years old; Most of the students feel more anxiety (78,6%), associated with changes in the nutritional profile, with the increase of high-energy food, highlighted by the bigger propension of this group to the consumption of sweets and white-wheat pasta in the daily meal plan. It is important to notice that many other food groups have suffered an enhancement in consumption as well, such as legumes, dried meat, vegetal oil, olive oil, and greenery. Conclusion: The COVID-19 Pandemic brought impacts to the daily meal plan of the medical students, especially in the ones who feel more anxious. The enhancement of the daily consumption of food by the medical students is notable, in the most diverse food classifications. However, it is concluded in this study that it cannot be said that anxiety and/or self-declared stress is a risk factor for the increase in food consumption observed, as well as a pattern of its impacts on the students' food, cannot be defined.

Tackling constipation in patients on high dose antipsychotics

AimsThe aim of this audit was to look into patients on high dose antipsychotics who had developed complications of constipation in the PICU setting .BackgroundAntipsychotics are usually used in the treatment of Schizophrenia and other psychotic illnesses. Drug such as Clozapine mainly has a higher risk profile due to gastrointestinal hypo motility. It could present as constipation, fecal impaction or a bowel obstruction and could even lead to death.MethodDuring ward rounds enquired on bowel habits and diet.Physical examination of patients complaining of abdominal pain.Screened notes in past to see how many patients complained of constipation and interventions suggested and used.I65.Result3 of the 10 patients on PICU were on high dose antipsychotics and 2 of them had reported constipation. Of which one required daily review and vigorous treatment with laxatives and dietary changes.RecommendationBristol stool chart introduced as part of care plan for all patients.Teaching presentation of constipation and its treatment management was given to the PICU team.Involving medical team early on for assessment and prophylactic laxatives prescription.Liaison with the pantry team to include more options of fruits and vegetables into daily meal plan for patients.Data and material handed over to next trainee to Re-audit and complete audit cycle.ConclusionAppropriate prevention and early management of side effects can enhance the benefits of antipsychotics. Bowel function monitoring and the use of prophylactic laxatives for patient on high dose antipsychotics such as clozapine is advisable to prevent complications related to it.

Rationale and design of the frequency of eating and Satiety Hormones (FRESH) study: A randomized cross-over clinical trial

BackgroundThe goal of the Frequency of Eating and Satiety Hormones (FRESH) Study is to understand the relationship between eating frequency (EF) and biomarkers of appetite and disease risk. This report gives the study rationale and design.MethodsThe FRESH study was conducted in n = 50 overweight and obese, but otherwise healthy, male and female adults aged 18–50 years. The protocol included four in-person clinic visits for protocol instruction, blood draws, anthropometry, and meal testing; all other activities were done at home. Participants completed two 21-day phases in random order with a two-week washout between phases. One phase was high EF (6 eating occasions/day) and the other was low EF (3 eating occasions/day). Each phase specified time of day for each eating occasion. Participants prepared their own meals throughout the study using study-provided individualized, structured meal plans ensuring that calories, macronutrients and micronutrients were identical during both study phases. Fasting blood was collected before and after each phase to test intervention effects on the biomarkers. At the end of each phase participants also completed extended appetite testing with meals prepared by the study clinic.ResultsParticipants were recruited using print, radio, and digital ads. 60 participants consented to enroll; 10 dropped out due to work or school scheduling conflicts and 50 (target sample size) completed the study. Compliance was assessed by completion of daily on-line meal plan checklists.ConclusionsThe FRESH study will provide data on whether higher vs. lower daily EF in the context of constant energy and nutrient intake may be harmful or beneficial based on intervention effects on biomarkers of health and disease risk.

A Food Recommender System Considering Nutritional Information and User Preferences

The World Health Organization identifies the overall increasing of noncommunicable diseases as a major issue, such as premature heart diseases, diabetes, and cancer. Unhealthy diets have been identified as the important causing factor of such diseases. In this context, personalized nutrition emerges as a new research field for providing tailored food intake advices to individuals according to their physical, physiological data, and further personal information. Specifically, in the last few years, several types of research have proposed computational models for personalized food recommendation using nutritional knowledge and user data. This paper presents a general framework for daily meal plan recommendations, incorporating as main feature the simultaneous management of nutritional-aware and preference-aware information, in contrast to the previous works which lack this global viewpoint. The proposal incorporates a pre-filtering stage that uses AHPSort as multi-criteria decision analysis tool for filtering out foods which are not appropriate to the current user characteristics. Furthermore, it incorporates an optimization-based stage for generating a daily meal plan whose goal is the recommendation of food highly preferred by the user, not consumed recently, and satisfying his/her daily nutritional requirements. A case study is developed for testing the performance of the recommender system.

Multidisciplinary Smartphone-Based Interventions to Empower Patients With Acute Coronary Syndromes: Qualitative Study on Health Care Providers' Perspectives.

BackgroundPostdischarge interventions are limited in patients with acute coronary syndrome (ACS) due to few scheduled visits to outpatient clinics and travel from remote areas. Smartphones have become a viable lifestyle technology to deliver educational and health interventions following discharge from hospital.ObjectiveThe purpose of this study was to identify the requirements for the delivery of a mobile health intervention for the postdischarge management of patients with ACS via a multidisciplinary focus group.MethodsWe conducted a focus group among health care professionals (n=10) from a large metropolitan hospital in May 2017. These participants from a multidisciplinary team contributed to a 1-hour discussion by responding to 8 questions relating to the applicability of smartphone-based educational and health interventions. Descriptive statistics of the focus group data were analyzed using SPSS. The qualitative data were analyzed according to relevant themes extracted from the focus group transcription, using a qualitative description software program (NVivo 11) and an ontology-based concept mapping approach.ResultsThe mean age of the participants was 47 (SD 8) years: 3 cardiologists; 2 nurse practitioners; 2 clinical nurses; 2 research scientists; and 1 physiotherapist. Of these participants, 70% (7/10) had experience using electronic health intervention during their professional practice. A total of 7 major themes and their subthemes emerged from the qualitative analysis. Health care providers indicated that comprehensive education on diet, particularly providing daily meal plans, is critical for patients with ACS. In terms of ACS symptoms, a strong recommendation was to focus on educating patients instead of daily monitoring of chest pain and shortness of breathing due to subjectivity and insufficient information for clinicians. Participants pointed that monitoring health measures such as blood pressure and body weight may result in increased awareness of patient physical health, yet may not be sufficient to support patients with ACS via the smartphone-based intervention. Therefore, monitoring pain and emotional status along with other health measures was recommended. Real-time support via FaceTime or video conferencing was indicated as motivational and supportive for patient engagement and self-monitoring. The general demographics of patients with ACS being older, having a low educational level, and a lack of computer skills were identified as potential barriers for engagement with the smartphone-based intervention.ConclusionsA smartphone-based program that incorporates the identified educational materials and health interventions would motivate patients with ACS to engage in the multidisciplinary intervention and improve their health outcomes following discharge from hospital.

Clinical survey done to find out the acceptability of modified and innovative neutropenic diet among hospitalized patients suffering with neutropenic and immune suppressed conditions

Background: Traditional neutropenic diets are normally quite monotous, unpalatable and unpleasant. Therefore following study was done to analyse and find out various methods and strategies to prevent food borne illnesses or infection in such patients. In following study the conventional neutropenic diet is modified in terms of content, preparation and service. Main approach towards patient was to maintain patient’s nutritional status, to enhance their appetite, to break monotony of diet . Methods: In the present case report, case studies of 25 patients were included who were provided safe and hygienic diet from the kitchen and were counselled by the dietetic department. They were also categorized as immune suppressed patients. At every step we checked the quality as well as the hygiene of food provided to the patients. Results: In the above study majority of the patients were quite active and supportive with the innovations and modifications done in their daily meal plan. With severe mucositis and lack of appetite still the tried to eat seeing the presentation and changes in daily menu. Through this study integrated approach and wholesomeness of quality has been emphasised in order to give the quality dietary services to the admitted patients . Conclusions: The relevance of the study in such areas is quite important and needed. The methodological step involved right from the procurement of the raw food till delivery of food to the patients is the most preferred form in order to achieve their satisfaction index. Therefore, such practice is on-going process.

Creating a nutritional traffic light able to help in education for diabetes self-management

Background Diabetes mellitus is a chronic disease that requires ongoing medical care, and education on self-management, in order to avoid acute complications and reduce the risk of chronic complications. Feeding recommendation for people with diabetes is no different from healthy people, being based on adequate intake of carbohydrates, proteins and fats adjusted to metabolic targets, energy needs and individual preferences. Educating and motivating people with diabetes to follow continuously eating plan is a major chronic challenge. Applying diabetes education through educational materials reinforcing the theory of good nutrition in order to facilitate the daily meal plan and food choices can be a strategy to improve adherence to nutritional therapy.

The microbes we eat: abundance and taxonomy of microbes consumed in a day’s worth of meals for three diet types

Far more attention has been paid to the microbes in our feces than the microbes in our food. Research efforts dedicated to the microbes that we eat have historically been focused on a fairly narrow range of species, namely those which cause disease and those which are thought to confer some “probiotic” health benefit. Little is known about the effects of ingested microbial communities that are present in typical American diets, and even the basic questions of which microbes, how many of them, and how much they vary from diet to diet and meal to meal, have not been answered.We characterized the microbiota of three different dietary patterns in order to estimate: the average total amount of daily microbes ingested via food and beverages, and their composition in three daily meal plans representing three different dietary patterns. The three dietary patterns analyzed were: (1) the Average American (AMERICAN): focused on convenience foods, (2) USDA recommended (USDA): emphasizing fruits and vegetables, lean meat, dairy, and whole grains, and (3) Vegan (VEGAN): excluding all animal products. Meals were prepared in a home kitchen or purchased at restaurants and blended, followed by microbial analysis including aerobic, anaerobic, yeast and mold plate counts as well as 16S rRNA PCR survey analysis.Based on plate counts, the USDA meal plan had the highest total amount of microbes at 1.3 × 109 CFU per day, followed by the VEGAN meal plan and the AMERICAN meal plan at 6 × 106 and 1.4 × 106 CFU per day respectively. There was no significant difference in diversity among the three dietary patterns. Individual meals clustered based on taxonomic composition independent of dietary pattern. For example, meals that were abundant in Lactic Acid Bacteria were from all three dietary patterns. Some taxonomic groups were correlated with the nutritional content of the meals. Predictive metagenome analysis using PICRUSt indicated differences in some functional KEGG categories across the three dietary patterns and for meals clustered based on whether they were raw or cooked.Further studies are needed to determine the impact of ingested microbes on the intestinal microbiota, the extent of variation across foods, meals and diets, and the extent to which dietary microbes may impact human health. The answers to these questions will reveal whether dietary microbes, beyond probiotics taken as supplements—i.e., ingested with food—are important contributors to the composition, inter-individual variation, and function of our gut microbiota.

Anonymized, genotype‐directed online nutrition guidance

Unaided tailoring of individual food selections to multiple genotype‐directed nutrient intake targets greatly exceeds the abilities of lay consumers and dietetic professionals alike. Previous draft versions provided proof‐of‐concept for computer‐assisted menu planning (http://www.nim.unc.edu/nutrition/guidance.html). Added functionalities and an expanded food database have now improved usability and consumer choice.The personal target sets depend on user characteristics and genetic data. The user never enters personally identifying information, DNA samples are identified by code.The algorithmic core calculates and ranks the sum of normalized parabolic distance functions relative to personal target sets of individually selectable nutrients and food groups in a potential menu. The program offers an initial choice of well‐matched daily meal plans. The user can then make unlimited modifications by replacing, adding or deleting items. Real‐time displays of color‐coded lists, which show alternative foods ranked by goodness‐of‐fit, make finding acceptable choices easy.Initial user tests indicate that this online tool effectively supports personalized meal planning based on complex genotype patterns.

Development and Validation of a Food Pyramid for Swiss Athletes

Food-guide pyramids help translate nutrient goals into a visual representation of suggested food intake on a population level. No such guidance system has ever been specifically designed for athletes. Therefore, the authors developed a Food Pyramid for Swiss Athletes that illustrates the number of servings per food group needed in relation to the training volume of an athlete. As a first step, an average energy expenditure of 0.1 kcal . kg(-1) . min(-1) for exercise was defined, which then was translated into servings of different food groups per hour of exercise per day. Variable serving sizes were defined for athletes' different body-mass categories. The pyramid was validated by designing 168 daily meal plans according to the recommendations of the pyramid for male and female athletes of different body-mass categories and training volumes of up to 4 hr/d. The energy intake of the meal plans met the calculated reference energy requirement by 97% +/- 9%. The carbohydrate and protein intakes were linearly graded from 4.6 +/- 0.6-8.5 +/- 0.8 g . kg(-1) . d(-1) and 1.6 +/- 0.2-1.9 +/- 0.2 g . kg(-1) . d(-1), respectively, for training volumes of 1-4 hr of exercise per day. The average micronutrient intake depended particularly on the dietary energy intake level but was well above the dietary reference intake values for most micronutrients. No tolerable upper intake level was exceeded for any micronutrient. Therefore, this Food Pyramid for Swiss Athletes may be used as a new tool in sports nutrition education (e.g., teaching and counseling).

Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control

Objective To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Methods Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Results Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels ( p = 0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education ( p = <0.01), older subjects ( p = 0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication ( p = <0.01). Conclusion There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. Practice implications This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.

Teaching children with diabetes about adequate dietary choices

Recent recommendations by the American Diabetes Association suggest that children with type 1 diabetes should follow the recommendations for age, sex and body size of the general population. In the case of being overweight or obese, weight-control strategies should be applied. Adherence to recommendations should be pursued by continuous nutritional education that should start at the onset of diabetes and maintained by means of nutritional counselling to the family. The second main target of nutritional intervention is to encourage a reproducible daily meal plan that can be maintained by acquiring good habits when making nutritional choices. Finally, children and parents should be taught how to count carbohydrates, which would help them manage exceptions in their daily meal plan. Specifically, nutritional recommendations for children with diabetes focus on limiting the intake of foods of animal origin (red meat, cheese, cold cuts), moderating fat intake and promoting the intake of foods that naturally contain fibre (mainly vegetables, legumes, fruit). There are two at-risk periods in the lives of children when nutritional education procedures as well as diabetes care in general are less likely to be effective: early years of life and adolescence. In the case of very young children, new behavioural-based intervention strategies to help parents improve mealtimes could be useful in teaching diabetic children to learn to follow a structured eating schedule, which is desirable for long-lasting efficacy in diabetes care. In adolescents, eating disorders and insulin misuse for weight control purposes are concrete and difficult problems to deal with. A good balance between eating for pleasure and maintaining one's health is a challenge for anyone. Appropriate nutritional education helps children with diabetes to find this balance and enjoy a better quality of life.

A survey of high‐fibre diet‐sheets used in the treatment of irritable bowel syndrome in Great Britain

Forty high‐fibre diet‐sheets used in the treatment of irritable bowel syndrome (IBS) were surveyed. They varied in their design and layout, presentation of information and in the dietary advice they provided. Although some thought had gone into their production, there was room for improvement by the use of published guidelines on instructional text design. Information on the amount of bran and fluid to take, and the degree of emphasis on the importance of consumption of specific fibre‐rich foods, was inconsistent. Daily meal plans, where provided, were open to wide interpretation, so that intakes of less than 20 g of dietary fibre per day were possible whilst adhering to the suggested plans.