Dietary Guidelines - health. Download the full document . Population Ages 2 Years and Older to the 2. Dietary Guidelines, as Measured by Average Total Healthy Eating Index- 2.

HEI- 2. 01. 0) Scores. Figure I- 2. Percentage of Adults Meeting the Physical Activity Guidelines (Aerobic and Muscle- Strengthening Recommendations)Figure I- 3. Science, Policy, Implementation: Developing the 2. Dietary Guidelines for Americans.

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Figure 1- 2. Fatty Acid Profiles of Common Fats and Oils. Figure 2- 1. Dietary Intakes Compared to Recommendations. Percent of the U. S. Population Ages 1 Year and Older Who Are Below, At, or Above Each Dietary Goal or Limit. Figure 2- 3. Average Daily Food Group Intakes by Age- Sex Groups, Compared to Ranges of Recommended Intake Figure 2- 4. Average Vegetable Subgroup Intakes in Cup- Equivalents per Week by Age- Sex Groups, Compared to Ranges of Recommended Intakes per Week. Figure 2- 5. Average Whole and Refined Grain Intakes in Ounce- Equivalents per Day by Age- Sex Groups, Compared to Ranges of Recommended Daily Intake for Whole Grains and Limits for Refined Grains.

Figure 2- 6. Average Protein Foods Subgroup Intakes in Ounce- Equivalents per Week by Age- Sex Groups, Compared to Ranges of Recommended Intake. Figure 2- 7. Average Intakes of Oils and Solid Fats in Grams per Day by Age- Sex Group, in Comparison to Ranges of Recommended Intake for Oils. Figure 2- 8. Typical Versus Nutrient- Dense Foods and Beverages.

Figure 2- 9. Average Intakes of Added Sugars as a Percent of Calories per Day by Age- Sex Group, in Comparison to the Dietary Guidelines Maximum Limit of Less Than 1. Percent of Calories. Figure 2- 1. 0Food Category Sources of Added Sugars in the U. S. Population Ages 2 Years and Older. Figure 2- 1. 1Average Intakes of Saturated Fats as a Percent of Calories per Day by Age- Sex Group, in Comparison to the Dietary Guidelines Maximum Limit of Less Than 1.

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Percent of Calories. Figure 2- 1. 2Food Category Sources of Saturated Fats in the U. S. Population Ages 2 Years and Older. Figure 2- 1. 3Average Intakes of Sodium in Milligrams per Day by Age- Sex Groups, Compared to Tolerable Upper Intake Levels (UL)Figure 2- 1. Food Category Sources of Sodium in the U.

S. Population Ages 2 Years and Older. Figure 3- 1. A Social- Ecological Model for Food and Physical Activity Decisions. Figure 3- 2. Implementation of the Dietary Guidelines Through My.

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Kangaroo Mother Care and Neonatal Outcomes: A Meta- analysis . We then identified 2. KMC through crosscheck of reference lists, communication with an author,3. After 1. 00. 6 duplicates were removed, 1. Of those, 5. 27 did not meet inclusion criteria.

Full- text articles for the remaining 5. This review and meta- analysis includes 1. KMC and . One hundred eleven (9.

English, 7 (6%) in Portuguese, 4 (3%) in Spanish, and 2 (2%) in Farsi. We e- mailed 8 authors to obtain additional information.

Study Characteristics. Of the 1. 24 included studies, 1. Table 1). Seventy- six studies (6. Fifty- five (4. 4%) were RCTs, 8 (6%) were randomized crossover trials, and 6.

Most studies (n = 1. TABLE 1. Characteristics of Included Studies (n = 1. Among studies reporting gestational age, the majority (n = 6. Similarly, 4. 7 studies (5. LBW infants (. Forty- three studies (3. Most studies (n = 7.

KMC as SSC only, 1. KMC as SSC plus promotion of exclusive breastfeeding, 2. KMC intervention. SSC was initiated immediately after birth in 7 studies (8%), whereas 4.

SSC initiation, and 2. Eleven studies (1. SSC around the time of an infant procedure.

Fifty- two studies (6. SSC per day, 2. 0 (2. Thirty- eight studies (3. SSC was initiated, and 4. SSC mothers were instructed to practice.

Information on duration of SSC actually practiced rather than promoted was only available in 1. Details of each included study are presented in Supplemental Table 1. Meta- analysis. Summary RR estimates for dichotomous outcomes are reported in Table 2, and MD estimates for continuous outcomes are reported in Table 3. TABLE 2. RR and 9.

CI for the Effect of KMC Compared With Conventional Care on Dichotomous Neonatal Outcomes. TABLE 3. MD and 9. CI for the Effect of KMC Compared With Conventional Care on Continuous Neonatal Outcomes. Mortality. Compared with conventional care, KMC was associated with a 2. CI, 0. 6. 0, 0. 9.

I2 = 6. 7%) (Fig 2). Among 1. 1 studies reporting mortality during the first 4. KMC (9. 5% CI, 0. I2 = 7. 7%), whereas the 7 studies reporting mortality at 3, 6, or 1.

KMC groups compared with controls (9. CI, 0. 4. 3 to 0. I2 = 0%) (Table 2). FIGURE 2. Forest plot for effect of KMC compared with conventional care on mortality at latest follow- up time, grouped by follow- up time. BW, birth weight. Among LBW newborns < 2.

KMC decreased mortality at latest follow- up time by 3. CI, 0. 4. 6 to 0. I2 = 7. 2%). In the 2 studies of infants of all birth weights, KMC did not significantly affect mortality (RR 1. CI, 0. 8. 2 to 1. I2 = 0%). Additional subgroup analyses of study characteristics and KMC components for mortality at latest follow- up are presented in Supplemental Table 4. We did not find important differences in the effect of KMC on mortality by location, country- level economy, or neonatal mortality rate.

Two studies whose KMC intervention included SSC, exclusive breastfeeding, early discharge, and close follow- up showed a stronger protective effect of KMC against mortality (RR 0. CI, 0. 1. 9 to 0. KMC definitions. Similarly, when mothers were encouraged to provide SSC plus .

There was no difference in mortality between studies including promotion of exclusive breastfeeding in their KMC definition compared with those that did not. Studies instructing mothers to start SSC after stability criteria was met showed a similarly protective effect against mortality (n = 9, RR 0. CI, 0. 3. 4 to 0. SSC immediately (n = 3, RR 0. CI, 0. 3. 3 to 0. Supplemental Fig 3).

Eleven studies promoting . KMC increased the likelihood of exclusive breastfeeding across nearly all subgroups of study, infant, and KMC characteristics (Supplemental Table 5). At 1- to 4- month follow- up, KMC increased the likelihood of exclusive breastfeeding by 3. CI, 1. 1. 1 to 1.

I2 = 6. 0%) (Table 2). KMC did not have a significant impact on the MD in time to breastfeeding initiation (n = 4; SMD .

Several studies looked at other feeding outcomes that were too heterogeneous to combine into a summary estimate. Infection. Risk of infection during study follow- up was not statistically different between KMC and control groups (n = 1. RR 0. 6. 7; 9. 5% CI, 0. I2 = 6. 0%) (Table 2). When data were stratified by infection type, however, KMC was associated with 4. CI, 0. 3. 4 to 0. I2 = 2. 5%) but did not have an effect on methicillin- resistant Staphylococcus aureus or other severe infections (n = 4; RR 1.

CI, 0. 4. 0 to 2. I2 = 7. 7%) (Supplemental Fig 6). KMC did not have a significant effect on risk of necrotizing enterocolitis (n = 3; RR 0. CI, 0. 4. 5 to 2. Table 2). All studies that examined sepsis and necrotizing enterocolitis were among infants < 2. Among RCTs, KMC decreased risk of infection by 4. CI, 0. 3. 2 to 0.

Supplemental Table 6). Nine studies that had stability criteria before initiating SSC showed a protective effect of KMC against infection (RR 0. CI, 0. 3. 3 to 0. RR 1. 0. 0; 9. 5% CI, 0. Heart Rate. KMC did not have a significant effect on mean heart rate (n = 1.

MD 0. 4. 1 beats per minute; 9. CI, . No statistical or clinically significant differences were noted in subgroup analysis of study, infant, or KMC characteristics (Supplemental Table 7). Respiration and Oxygenation.

Compared with conventional care, KMC was associated with a non–statistically significant reduction in risk of apnea among 6 studies of LBW infants < 2. RR 0. 3. 9; 9. 5% CI, 0. I2 = 4. 2%) (Table 2). On average, newborns receiving KMC had a respiratory rate 3 breaths per minute slower (n = 1.

CI, . Across subgroup analyses, KMC was associated with lower respiratory rate and higher oxygen saturation (Supplemental Tables 8 and 9). Temperature. Compared with conventional care, KMC was associated with 7. CI, 0. 1. 2 to 0.

I2 = 7. 1%) and 2. CI, 0. 5. 9 to 1. I2 = 0%) (Table 2). Mean body temperature of infants receiving KMC was 0. This effect was similar across subgroups of study, infant, and KMC characteristics (Supplemental Table 1.

Hypoglycemia and Cortisol. KMC was strongly protective against hypoglycemia in 2 studies of LBW infants (RR 0. CI, 0. 0. 5 to 0.

I2 = 0%) (Table 2). Standardized mean cortisol levels were not significantly different between KMC and control groups (n = 3; SMD . Length of hospital stay did not differ significantly between KMC and control groups (n = 1. MD . One study reported length of hospital and NICU stays stratified by birth weight and found shorter hospital stays in the KMC group compared with controls among infants < 1. NICU stay among infants 1. Growth. Various infant growth outcomes were examined across studies. We looked at the effect of KMC on measures of weight gain individually and by combining them using the SMD (Table 3, Supplemental Fig 1.

We did not find a significant association between KMC and the SMD in weight gain or body length growth. Infants receiving KMC had head circumference growth 0.

CI, 0. 0. 1 to 0. I2 = 8. 9%). Among studies reporting weight gain outcomes, there were no important differences in the effect of KMC by subgroups of study, infant, or KMC characteristics (Supplemental Table 1. One additional study examined the risk of being malnourished, overweight, or obese at 5 to 6 years old and found no difference between the KMC and control groups. Pain. Several studies examined pain- related outcomes, including crying, heart rate, and pain scores during and after painful procedures (Table 3).

According the Premature Infant Pain Profile scale, with a range from 0 to 2. SSC during a painful procedure had a mean pain score 0. CI, . When combined across scales using the SMD, a decrease in pain score was again noted in infants receiving SSC compared with conventional care (SMD . This effect was similar across subgroups (Supplemental Table 1. After a painful stimulus, infants receiving SSC cried on average 1. CI, . Among studies using infant heart rate during painful stimulus as a proxy pain measure, mean heart rate was 7 beats per minute slower in the SSC groups than controls (n = 3; 9.