Diet - High Fiber Intake Linked With Longer Life - NYTimes.com

A study of almost 400,000 people aged 50 to 71 has found a strong link between a high-fiber diet and a longer life.

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Specifically, subjects who ate a diet rich in whole grains, fruits and vegetables (adding up to 29 grams of fiber per day for men, 26 grams for women) were 22 percent less likely to die after nine years than those who ate the least fiber (13 and 11 grams per day), according to the study, in Archives of Internal Medicine.

Those in the high-fiber group were less likely to die of cardiovascular disease, infectious disease and respiratory disease; a high-fiber diet was also associated with fewer cancer deaths in men, though not in women.

The lower death rates were associated with dietary fiber from whole grains, said the lead author, Dr. Yikyung Park, a staff scientist at the National Cancer Institute.

“One of our findings was that fiber has anti-inflammatory properties,” Dr. Park said, adding that grains are also rich in beneficial vitamins, minerals and chemicals.

People who ate more fiber were generally healthier, more educated and more physically active to begin with, the authors noted. But the study adjusted for these differences.

At the start of the study, all participants filled out 124-item food frequency questionnaires. Nine years later, 20,126 men and 11,330 women had died.

via nytimes.com

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Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis -- Lipitz-Snyderman et al. 342 -- bmj.com

The US Institute of Medicine highlighted the serious problem of patient safety and importance of evidence based quality improvement initiatives to reduce adverse events.1 Evidence that quality improvement initiatives intended to reduce adverse events result in a measurable impact on other important outcomes, such as mortality and length of hospital stay, is limited. Without this evidence, hospitals and healthcare payers face uncertainty about whether investment in any specific quality improvement intervention will significantly benefit patients and represent a good use of limited financial resources.

The Michigan Health and Hospital Association Keystone ICU (intensive care unit) project, developed by researchers at Johns Hopkins and undertaken by the Michigan Health and Hospital Association, about 80 of its member hospitals, and researchers at Johns Hopkins Medical Institutions, is a recent example of a successful, large scale quality improvement initiative.2 3 4 The project adopted a comprehensive approach to improving patient safety that included promoting a culture of safety, improving communication between providers, and implementing evidence based practices to reduce rates of catheter related bloodstream infections and ventilator associated pneumonia. Evidence based interventions for preventing catheter related bloodstream infections were promoting handwashing, full barrier precautions, skin antisepsis with chlorhexidine, avoiding the femoral site during catheter insertion, and removing unnecessary catheters. Interventions to prevent ventilator associated pneumonia included a mechanical ventilator “bundle” consisting of use of semirecumbent positioning, daily interruption of sedation infusions, and prophylaxis for peptic ulcer disease and deep venous thrombosis.5 The project showed that measures of culture and infection rates in the intensive care unit were substantially improved for up to 36 months after implementing the quality improvement measures.2 4 5 6

via bmj.com

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