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Improvement in knowledge, social cognitive theory variables, and movement through stages of change after a community-based diabetes education program.

The objective of this program was to demonstrate the impact of a community-based diabetes education program. Participants were adults (N=239; mean age+/-standard deviation=63+/-10 years) with diabetes or caretakers. Community-based education incorporating Social Cognitive Theory and Stages of Change Theory included three group sessions focused on meal planning with cooking demonstrations. Knowledge and Social Cognitive Theory/Stages of Change variables were assessed pre- and postintervention. At posttest, significantly more (P<.05) used herbs in place of salt, cooked with olive or canola oils, used artificial sweeteners in baking (Stages of Change Theory), and were confident to change their diet and to prepare healthful meals. Knowledge of diabetes and nutrition increased (P<.05) and was a factor in postintervention belief in ability to use food labels and that meal planning was helpful. This community-based diabetes education intervention resulted in positive impacts on knowledge, health beliefs, and self-reported behaviors. Improvement in knowledge can be instrumental in moving individuals to an action or maintenance stage and in improving self-efficacy.

Cognition↗

Alternatives to the exchange system for teaching meal planning to persons with diabetes.

Although the most well known, exchange lists are not the only meal-planning approach for persons with diabetes. This paper outlines the steps in the nutrition education process, including initial and continued education stages, and presents six alternative approaches for individualizing meal planning. These include the High Carbohydrate-High Fiber Exchange System, Calorie/Fat Counting, Total Available Glucose, the Point System, Month of Meals, and Individualized Sample Menus. The approaches are rated according to emphasis on weight loss, glucose control, and ease of learning and according to type of diabetes. A complete resource guide is provided.

Diabetes Mellitus↗

Identification of factors affecting purchasing and preparation of fruit and vegetables by stage of change for low-income African American mothers using the think-aloud method.

The objective of this study was to identify factors affecting the purchase and preparation of fruits and vegetables according to stage of change for low-income African American women with young children. The think-aloud method was used to collect verbalization data in grocery stores as women shopped (N=70) and in their homes during meal preparation (N=68). Audiotaped verbalizations were transcribed verbatim before encoding. Content analysis procedures were used to identify common themes by stage of change. Factors affecting decision making that varied by stage of change were preferences and specific needs (eg, for meals, for family members). Preferences regarding variety, quantity, color, and liking were more often expressed by women in later stages. Women in the later stages also often used meal-planning skills to include fruits and vegetables in meals. Interventions could be tailored according to selected factors regarding purchase and preparation of fruits and vegetables by stage of change to contribute to greater changes in intake.

Adult↗

Food systems for space travel.

Space food systems have evolved from tubes and cubes to Earth-like food being planned for the International Space Station. The weight, volume, and oxygen-enriched atmosphere constraints of earlier spacecraft severely limited the type of food that could be used. Food systems improved as spacecraft conditions became more habitable. Space food systems have traditionally been based upon the water supply. This presentation summarizes the food development activities from Mercury through Shuttle, Shuttle/Mir, and plans for the International Space Station. Food development lessons learned from the long-duration missions with astronauts on the Mir station are also discussed. Nutritional requirements for long-duration missions in microgravity and problems associated with meeting these requirements for Mir will be elucidated. The psychological importance of food and the implications for food development activities are summarized.

Eating↗

Ensuring good management of diabetes in intercurrent illness.

When diabetic patients become unwell with another illness, hyperglycaemia will result and patients' usual self-management techniques may be inadequate. Education for patients with diabetes should be as much about planning how they would manage their diabetes during a period of illness as well as coping at the time. This article outlines the aims stated within the National Service Framework for Diabetes (Department of Health, 2001) and provides both theoretical background and practical application to preventing diabetic ketoacidosis and hyperosmolar non-ketotic syndrome.

Blood Glucose Self-Monitoring↗

Use of carbohydrate counting for meal planning in type I diabetes.

Certain questions often arise regarding carbohydrate counting, such as: Why use carbohydrate counting? Where does one start? How much carbohydrate is prescribed? How does one balance the diet? How is carbohydrate counting taught to patients? Which patients are the best candidates for carbohydrate counting? This article provides possible answers to these questions based on clinical experience at the Vanderbilt University Medical Center Diabetes Research and Training Center, and the Diabetes Control and Complications Trial.

Diabetes Mellitus, Type 1↗

[Individualized Reception Project at school and for school food services for children with a food allergy].

The circulars of 1992, 1993 and more recently of 10th November 1999, illustrate the significant progress of schools in the reception of sick children and the help in execution of the medical regulations. The National Education physician is a privileged interlocutor of families, the treating physician and the education authority to make the link between the caregivers and the school. Application of the 1999 circular, which has the objective of taking into account the food allergies in the 1993 plan of action, raises difficulties of three types: Difficulties of a medical type raised by the frequent confusion between the Protocol for urgent intervention and the individualised reception plan. The Protocol for urgent intervention, of which the National Education physician is the recipient, must be accompanied by a letter from the allergy physician that takes into consideration simple immunological sensitization and true allergy and to appreciate the risks that concern food disparities that are not always the same. The almost systematic prescription of adrenaline in protocols for urgent intervention, without argument and in the absence of commercialisation of an auto-injectable pen at the time of distribution of the circular, was a source of resistance by education authorities to catering services. Difficulties of a human type concerning the creation of fear in families, in the education authorities, in the catering services and the time-lag between some families and their careful vigilance with regard to the dietary observance and the conduct to be taken in the case of acute symptoms. Difficulties of administrative or legal types knowing that the scholars catering is a service which does not have the obligatory character of the teaching plan, and which accepts the sole competence of the authorities for 1st degree education. In total the teaching plan and pupil catering for children with a food allergy needs making the parents aware of the responsibility between the allergy physician and the National Education physician who have equal responsibility. With clear and well argued diagnostic and therapeutic information the National Education physician will be able to contribute to the installation of a calm climate that is indispensable to a quality reception.

Child↗

Price of amino acids as a basis for planning protein adequate diets.

This paper considers the needs of field level nutrition educators in developing countries for an easy method of giving usable dietary advice suited to specific family compositions, incomes, production patterns, seasons, and food preferences. It describes the development and application of a tool which combines available data on seasonal food prices, amino acid requirements, and amino acid compositions of foods. The accuracy and implications of the tool are discussed.

Adolescent↗

Weight loss and diet plans.

This article examines popular diet plans for weight loss and provides information about their efficacy. Diets covered include: very-low-calorie and low-calorie diets; low-fat and very-low-fat diets; moderate-fat, low-calorie diets; and low-carbohydrate, high-protein diets. The importance of portion size and behavioral change is also discussed.

Caloric Restriction↗

Nutrient analysis of Exchange Lists for Meal Planning. I. Variation in nutrient levels.

Using available food composition data, individual Exchange Lists within the revised Exchange Lists for Meal Planning were evaluated for calories; protein; fat; calcium; phosphorus; iron; sodium; potassium; vitamin A; thiamin; riboflavin; niacin; ascorbic acid; saturated, oleic, and linoleic fatty acids; cholesterol; and crude fiber. Mean values, standard deviations, and ranges are reported for the above nutrients. Mean values agreed well with those suggested in the booklet for grams of carbohydrates, protein, and fat and for calories for all lists except milk. However, a wide range in values exists for food within each Exchange List.

Diet↗

Work measurement for estimating food preparation time of a bioregenerative diet.

During space missions, such as the prospective Mars mission, crew labor time is a strictly limited resource. The diet for such a mission (based on crops grown in a bioregenerative life support system) will require astronauts to prepare their meals essentially from raw ingredients. Time spent on food processing and preparation is time lost for other purposes. Recipe design and diet planning for a space mission should therefore incorporate the time required to prepare the recipes as a critical factor. In this study, videotape analysis of an experienced chef was used to develop a database of recipe preparation time. The measurements were highly consistent among different measurement teams. Data analysis revealed a wide variation between the active times of different recipes, underscoring the need for optimization of diet planning. Potential uses of the database developed in this study are discussed and illustrated in this work.

Astronauts↗

Vegetarian diet planning for adolescents with diabetes.

Adolescents with insulin dependent diabetes mellitus (IDDM) who choose to be vegetarian have complex nutritional needs because of their continued physical growth and development, their participation in strenuous activities, and their need to consume sufficient carbohydrates to match their insulin doses. Since diet control is a cornerstone of diabetes management, the adolescent who chooses a vegetarian diet may cause their parents needless anxiety. Nurses working with these adolescents can provide support and guidance and liaison with the endocrinologist, nutritionist or dietitian, and diabetic educator. Although adolescent diabetic vegetarians have not been studied extensively as a population, facts about nutrition and diabetes can be used to assist in meal planning. A complete growth and nutritional assessment must be done to search for any problem areas. If protein dense flesh food is eliminated and a largely carbohydrate diet is consumed, there are additional areas of concern in regulating insulin needs. Blood glucose should be monitored very carefully during diet changes. Vegetarian girls with diabetes also should be carefully monitored for the adequacy of their diet because they may be at risk of developing an eating disorder.

Adolescent↗

Evaluating a food bank recipe-tasting program.

Food banks mitigate immediate food insecurity, but their ability to promote healthy nutrition is constrained by how often recipients may visit and the range of foods available. In a descriptive study, a formative evaluation was completed of a combined heart-healthy recipe-tasting and education program that aims to promote healthy eating knowledge and skills in a group of food bank recipients in Hamilton, Ontario. Fifty-five adults were surveyed about food bank attendance, program awareness, perceived enhancement of knowledge and skills, and suggestions for program improvement. Most participants (73%) were positive about the program, and 91% wanted the program to continue. In addition, 78% would prepare the recipes sampled. In contrast, program awareness and planning food bank visits to coincide with the program were generally low. Food banks are potential sites for effective nutrition promotion programs. To reach more recipients, more frequent implementation and seeking the use of a designated room are suggested for the current program. The findings also suggest that the sampling approach to promoting healthy eating to food bank recipients deserves further study. For example, monitoring the selection of featured recipe ingredients would be a useful indicator of behaviour.

Adult↗

Lactose intolerance.

Although lactose intolerance is very common it is not a serious health condition. The diagnosis is relatively simple and minimally invasive. Treatment is geared towards a life-long plan of management. Persons who have difficulty digesting lactose will learn by trial and error what food items cause distress and learn to avoid offending milk sugars. In addition many products are available over-the-counter to aid in digestion of lactose. Often these additives enable the person to consume lactose. Adequate amounts of calcium may be consumed by eating a carefully chosen diet containing lactose free sources of calcium in order to maintain healthy bone, nerve, and muscle development.

Adolescent↗

Conventional vs. formulated foods in school lunches. II. Cost of food served, eaten, and wasted.

School lunches containing all conventional foods were designed to provide one-third or one-half the recommended allowances for elementary students. The same nutrient levels were planned in meals containing some formulated items. Each type of meal was served for five days, and total food costs and costs of food served, consumed, and wasted were calculated. At the same nutritional level, mean preparation costs of partially formulated meals were lower than for meals composed of all conventional foods. Meals providing one-half the allowances and containing formulated items cost slightly less than totally conventional meals which provided one-third of the allowances. Cost of waste was lower with partially formulated meals.

Age Factors↗

Food guides for the vegetarian.

Special consideration must be given to providing key risk nutrients in planning food guides for vegetarians especially if the diet chosen excludes all animal products, such as dairy foods and eggs. The practical use of food guides for education is also important. Several food guides for adult vegans, including pregnant vegan women, were analyzed by computer for nutritional adequacy using 7-d menus and comparisons were made with the RDA for energy, protein, iron, calcium, and riboflavin. Several patterns were identified that supply the RDA for protein, iron, calcium, and riboflavin and have educational merit. None of the patterns provide sufficient energy to meet the RDA.

Adult↗

Conventional vs. formulated foods in school lunches. I. Comparison of students' food and nutrient intakes.

School lunches containing all conventional foods were designed to provide either one-third or one-half the Recommended Dietary Allowances for elementary students. The same nutrient goals were used in planning meals containing some formulated foods. Goals and specified portion sizes for first through third graders were distinct from those for fourth through sixth graders, and data from the two groups were maintained separately. Nutrients in meals and plate waste were analyzed to compare nutrient intake among the treatments. Formulated meals weighed less than control and conventional meals, and students ate higher percentages of both the weight and the nutrients served in formulated meals. Nutrient intake was higher when half the allowances was served, but waste was also higher.

Age Factors↗

Meals at medical specialty society annual meetings: a preliminary assessment.

Little isd known about how meals are chosen for medical meetings. We surveyed the annual meeting planners for 20 major specialty societies. Thirteen (65%) responded; all were currently planning their next meeting. Attendance in 2000 was reported at 113,477 physicians, with 2 million planned meals and snacks. No physician was named as responsible for food choices; the meeting planner and staff were primarily responsible for deciding what food to serve, excluding exhibit halls. Twelve (92%) respondents rated "available budget" as the most important factor. "Nutritional guidelines" were rated "very important" by eight of 13 (63%). However, no specific nutritional guidelines could be identified by any planner. All respondents indicated that members would attend a meeting if "healthy" food were the only option. For 2000, 100% of respondents indicated that for each lunch and for each dinner, a dessert had been included. No annual meeting and no planned 2001 meeting excluded potato chips, snack mixes, or candies at breaks; soda pop was offered at each break. Most respondents (89%) relied on a concluding questionnaire about the meeting facilities to evaluate the food. Respondents reported no difference in charges for "special meals," including vegetarian and kosher meals. Physicians may be unaware that some food served at medical meetings may impair learning, with excessive calorie, fat, and carbohydrate consumption. Small changes can improve the quality of food and beverages selected, without increased cost, and provide choices that conform to national nutritional guidelines. Medical meetings should serve flavorful, healthful food.

Congresses as Topic↗