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A computer-assisted instructional program for teaching portion size versus serving size.

Obesity is becoming an increasingly important community health threat, accounting for more than 300,000 deaths per year in the United States. The cumulative economic impact of obesity and overeating is enormous. Factors contributing to the problem include eating food away from home, consuming large or excessive quantities of soft drinks and snack foods, and large portion sizes. Discriminating between portion and serving sizes and determining the appropriate number of serving sizes to consume on a daily basis are key to maintaining a healthy diet. The purpose of this project was to create a computer-assisted instructional tool delineating serving size from portion size. The tool can be used by health care professionals to provide direct instruction to individuals or as part of a group approach to healthy eating.

Computer-Assisted Instruction↗

Nutrition and the life cycle 4: the healthy diet for the adult.

The previous three articles in this series reviewed current nutritional advice to help maintain health during pregnancy (Vol 9(17): 1133-8), weaning (Vol 9(21): 2205-16) and in childhood (Vol 10(1): 26-310. This article reviews current thinking on what constitutes a health diet for the individual who has left childhood behind, but has not yet encountered many of the changes associated with old age. Most people enjoy food, and also believe that a good diet will improve their health. This article aims to review current thinking on what constitutes a healthy diet for the adult.

Adult↗

Nutrition and the life cycle 5: nutritional needs of older adults.

The previous four articles in this series on nutrition and the life cycle reviewed the nutritional needs during pregnancy (Vol 9(17): 1133-8), infancy (Vol 9(21): 2205-16), childhood (Vol 10(1): 26-31) and adulthood (Vol 10(6): 362-9). This article, the last in the series, will review the special nutritional needs of the older person. Older adults form an increasing proportion of our society, and it is important that nurses appreciate their special needs. The article concentrates on the health older adult, and reviews what nutritional advice nurses should be providing order to help them achieve maximal health.

Age Factors↗

Care of head and neck cancer patients with swallowing difficulties.

Cancers of the head and neck include oral cavity, oropharynx, hypopharynx, nasopharynx, larynx, nasal fossa, paranasal sinuses, thyroid, salivary glands and vermilion surfaces (Parker et al, 2004). Incidence of these cancers has risen in the past 30 years, particularly in people under the age of 65 years. Risk factors include cigarette smoking and excessive alcohol abuse. At time of diagnosis patients often present with swallowing difficulties due to tumour location and size. Further oncological treatments such as surgery and radiotherapy can exacerbate these difficulties and cause major nutritional problems. Dietary management in relation to texture modification and nutritional content of meals needs to be addressed as well as feeding strategies recommended by the speech and language therapist. Good communication between all members of the multidisciplinary team is paramount in ensuring that patients have the necessary support, education and quality of life they need.

Communication↗

Are you feeding the patient or the garbage can?

In a question and answer format, frequent clinical and food production problems that occur in long term care facilities are addressed. Subject matter includes the handling of food complaints, accommodating food preferences, maintaining safe food temperatures despite a wide variety of food consistencies, accommodating a resident's small appetite and maintaining the nutritional adequacy of the puree diet. The emphasis is on simplified food production which utilizes menu items that fit many diet consistencies. Various tested solutions to these problems are offered. The authors welcome additional questions.

Aged↗

Serve Our Seniors, Inc.--a demonstration program for proposed California menu guidelines for senior nutrition. California Department of Aging.

Revised menu guidelines, written by the California Department of Aging (CDA) for senior nutrition programs, were tested by Serve Our Seniors, Inc. in a demonstration program from January '91 through June '92. Results showed improved nutrient value of the meals through increasing fiber, and decreasing sugar and fat. New menus were accepted by senior participants with little resistance. Project food costs increased 4%. Guidelines were used in a variety of project kitchens, with minimal staff training. Limited storage was a problem. Vendors were encouraged to identify appropriate foods and control costs.

Aged↗

Time for assessment of nutrition services in assisted living facilities.

State regulations on the food and nutrition service components of care influence both care and service delivery of the elderly in assisted living facilities. Information on such regulations was abstracted from a survey of 50 states that had been carried out by the National Academy for State Health Policy. These data were supplemented by examining relevant state websites and by follow up phone calls. They were then evaluated using criteria recommended by expert groups. Forty-five states had some relevant food service and nutrition regulations, and five had no specific regulations. No state had regulations meeting all the criteria examined. The availability and completeness of food and nutrition regulations and standards in assisted living facilities may have life safety implications for older adults, and they deserve further evaluation.

Aged↗

Men can cook! Development, implementation, and evaluation of a senior men's cooking group.

This study reports on the process and outcome evaluation of a community-based nutrition and cooking education program for senior men. As part of Evergreen Action Nutrition, a community-organized, nutrition education program, a registered dietitian led a Men's Cooking Group in a seniors' recreation facility. Written questionnaires were completed by most of the men (n = 19) at the beginning and end of the evaluation year, and ten men participated in personal key informant interviews. The majority of participants gained cooking confidence, increased their cooking activities at home, developed healthy cooking skills, and improved cooking variety through the program. The men also identified social benefits to the program. Overall, this preliminary evaluation suggests that community-based nutrition and cooking education for older men is a beneficial nutrition education activity.

Aged↗

An environmental intervention to promote lower-fat food choices in secondary schools: outcomes of the TACOS Study.

OBJECTIVES: We evaluated an environmental intervention intended to increase sales of lower-fat foods in secondary school cafeterias. METHODS: Twenty secondary schools were randomly assigned to either an environmental intervention or a control group for a 2-year period. The intervention increased the availability of lower-fat foods and implemented student-based promotions. RESULTS: A steeper rate of increase in sales of lower-fat foods in year 1 (10% intervention vs -2.8% control, P =.002) and a higher percentage of sales of lower-fat foods in year 2 (33.6% intervention vs 22.1% control, P =.04) were observed. There were no significant changes in student self-reported food choices. CONCLUSIONS: School-based environmental interventions to increase availability and promotion of lower-fat foods can increase purchase of these foods among adolescents.

Adolescent↗

A cookery book for self-catering mentally handicapped.

The more able patients from hospitals for the mentally handicapped in Southmead Health District Bristol, are being established in minimal-support homes. Dietitians were asked to advise on how to teach practical cookery skills and encourage good nutrition. They were unable to recommend any of the available cookery books, and have designed a recipe folder in picture form of suitable meals for one week. The mentally handicapped patient's background is discussed as it relates to the practical problems of rehabilitation.

Adult↗