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PubMed2002

An integrated child nutrition intervention improved growth of younger, more malnourished children in northern Viet Nam.

Integrated nutrition programs are widely used to prevent and/or reverse childhood malnutrition, but rarely rigorously evaluated. The impact of such a program on the physical growth of young rural Vietnamese children was measured. We randomized six communes to receive an integrated nutrition program implemented by Save the Children. We matched six communes to serve as controls. Our sample consisted of 238 children (n = 119 per group) who were 5 to 25 months old on entry. Between December 1999 and December 2000, we measured weight and height monthly for seven months and again at month 12. Principle outcomes were weight-for-age Z score (WAZ), height-for-age Z score (HAZ), and weight-for-height Z score (WHZ), and the changes among these measures. As expected, anthropometric indicators relative to international references worsened as the children aged. Overall, children in the intervention communes who were exposed to the integrated nutrition program did not show statistically significant better growth than comparison children. Intervention children who were younger (15 months or less) and more malnourished (less than-2 Z) at baseline, however, deteriorated significantly less than their comparable counterparts. Between baseline and month four, for example, intervention children who were malnourished and less than 15 months old at entry lost on average 0.05 WAZ while similar comparison children lost 0.25 WAZ (p = .02). Lack of overall impact on growth may be due to a lower than expected prevalence of malnutrition at baseline and/or deworming of comparison children. Targeting nutrition interventions at very young children will have the maximum impact on growth.

Age Factors↗
PubMed1981

Implementation of a multidisciplinary nutritional assessment program.

Depending on the severity of malnutrition, protein depletion is associated with general debilitation, inanition, slow healing of wounds, delayed convalescence, increased susceptibility to infection, and other pathophysiologic conditions. In an effort to decrease the incidence and severity of these complications, Hermann Hospital and the University of Texas Medical School at Houston have implemented a comprehensive nutritional assessment program to identify clinical and subclinical malnutrition and to implement aggressive, effective therapy. A multidisciplinary team approach to nutritional assessment, therapy, and research can lead to an increased awareness of the importance of nutritional support and optimal nutritional care for the hospitalized patient under all conditions at all times.

Anthropometry↗
PubMed1987

[Evaluation of a nutritional education program in nursery schools].

A study of the impact of nutrition education was carried out in 14 nursery schools of the Rhône department for one semester as part of an awareness program. The major themes used were: the need for a balanced diet, proper meal times during the day, avoidance of excesses (sugar, fats and salt), and usefulness of bread, tap-water, etc. Parents were informed of the study during meetings with the school physician. A questionnaire dealing with dietary habits was distributed before and at a distance from the educational program, using a control group. Statistical analysis of the response allowed for an evaluation of the program's impact.

Child, Preschool↗
PubMed1999

Description of a mixed ethnic, elderly population. I. Demography, nutrient/energy intakes, and income status.

BACKGROUND: Elderly participants in the Title III-C Nutrition Program, 60-103 years of age, were assessed for nutrient/energy intakes, relationship of income status to intakes, and comparison with data from the National Evaluation of the Elderly Nutrition Program (ENP). METHOD: Nonrandomized volunteers were interviewed in senior centers or in their homes. Chi-square, t test, and ANOVA were used to test for differences in dietary intakes with regard to ethnicity, gender, age, type of meal (congregate dining or home delivered), socialization factor (lived alone or with others), and income status. A new method of looking at diet quality, which conjoins nutrients and energy, was developed for this study. RESULTS: Six percent of the sample had adequate energy and nutrient intakes over a 3-day period; 53% were rated tenuous or marginal, and 41% submarginal or inadequate. The Title III-C noon meal provided 38%-44% of the average daily energy intake and 33%-65% of the average intake of selected nutrients. Diets of men were better than those of women (p < .05). Calcium (p < .01) and potassium (p < .05) were higher in diets of female elders above the poverty line than those below. Black women were most affected by poverty, with 92% below the poverty line. A trend was observed for higher intakes of fatty components (total fat, cholesterol, % fat calories) for both men and women in the below-poverty than in above-poverty groups. DeKalb Community Council on Aging subjects had higher intakes of Vitamin A than those in the ENP, but overall most nutrients were higher in both congregate and home delivery clients of ENP. CONCLUSIONS: Title III-C Nutrition Programs have been implemented since 1973, and nutrition education is an obligatory component. The high incidence of nutrient/energy inadequacy in this study was surprising, but consistent with previous reports. New ways of implementing better food intakes of senior citizens are needed. In addition, research is needed to establish differences in nutrient profiles of elderly clients below and above the poverty level.

Black or African American↗
PubMedDate not supplied

[International review of health educational programs for nutrition in the elderly].

Progressive increase of the elderly may well explain the interest to educational programs at this age. Different chronic conditions such as cardiovascular diseases, diabetes and osteoporosis may be controlled and prevented by proper educational campaigns. In our review, the role of nutritional educational on quality of life has been evaluated, either in healthy subjects or in those with chronic disease. Evaluation tools and outcome index have been described. It is emphasized that applying specific projects may improve nutritional attitudes and lifestyle even in older adults. Proper educational intervention should be implemented, but socio-cultural characteristics of the target population should be taken into account.

Aged↗
PubMed2000

Food safety knowledge and behavior of expanded food and nutrition education program participants in Arizona.

Consumer education is one of the focus points to reduce foodborne illness within the food safety continuum "from farm to table." A survey was conducted to determine the food safety knowledge and practices of the U.S. Department of Agriculture's Expanded Food and Nutrition Education Program participants in Maricopa and Pima counties of Arizona. Two hundred sixty-eight surveys were completed between 1 January and 31 December 1998. Survey participants consisted of 222 (85%) females and 39 (15%) males with an average age and education level of 31.5 and 11.7 years, respectively. The racial characteristics of this group included 53% whites, 32% Hispanics, 22% African-Americans, and 7% other. A majority of the survey participants (67%) were either unsure or felt it was appropriate to let food cool to room temperature prior to refrigeration. In addition 56% were in disagreement with or unsure about the need to cool foods in shallow containers. Fifty-two percent of respondents reported having no previous formal food safety education; for those who had, work was the most common source. Television news was the primary source of current food safety information for 50% of respondents. The most commonly consumed high-risk (i.e., raw or undercooked animal food or food purchased from unlicensed vendor) food was unpasteurized dairy products. Women scored significantly better than men on food safety knowledge and practice test parameters. Participants over age 50 had significantly higher food safety practice scores than the youngest age group. The food safety knowledge score of whites was significantly higher than that of Hispanics. It was determined for all participants that the food safety knowledge score had a small, positive effect on food safety practice score.

Adolescent↗
PubMedDate not supplied

[Impact of a nutrition education program on the lipid profile and food habits of a working adult population].

To evaluate the influence of health care education of the diet, we studied, in a sample of 68 workers (47 men and 21 women), the usual food intake (by means of a weekly registration technique), the anthropometry and the lipid profile, before and after giving a nutritional information program which lasted one year. At the end thereof, we observed a significant reduction in the global caloric intake, at the expense of a lower supply of proteins and fats (mainly saturated fats), which translated into a percentile distribution of macronutrients, which more closely resembles the dietary recommendations. The average anthropometric parameters did not vary. With respect to the lipid profile, a decrease of the plasma levels of LDL and HDL cholesterol was observed. These results confirm the capacity of educational interventions in changing the eating habits to a more healthy style, with repercussions on the lipid profile.

Adult↗
PubMed2003

Increasing fruit and vegetable intake in homebound elders: the Seattle Senior Farmers' Market Nutrition Pilot Program.

INTRODUCTION: Diets that are high in fruits and vegetables lower an individual's risk of chronic disease and contribute to healthy aging. Homebound seniors often have low intake of fruits and vegetables and limited access to fruits and vegetables with the most protective nutrients and phytochemicals. From June through October 2001, the Seattle Senior Farmers' Market Nutrition Pilot Program delivered bi-weekly market baskets that included a variety of fresh, locally grown produce to 480 low-income Meals on Wheels participants. The purpose of this study was to determine if the program increased fruit and vegetable intake in individuals who received the baskets. METHODS: One hundred basket recipients were recruited to complete a telephone survey before and at the end of the farmers' market basket season. Fifty-two low-income homebound seniors who lived outside the project service area were recruited to serve as control respondents. Fruit and vegetable intake was determined with modified versions of the 6 fruits and vegetables questions in the Behavior Risk Factor Surveillance System. RESULTS: Seniors who received the baskets reported consuming an increase of 1.04 servings of fruits and vegetables. The difference between the mean servings in the seniors who received the baskets compared to the controls was 1.31 (95% CI, 0.68-1.95, P < .001). At baseline, 22% of the basket recipients were consuming 5 or more servings of fruits and vegetables per day, but by the end of the season, 39% reported consuming 5 or more per day. CONCLUSION: Home delivery of fruits and vegetables is an effective way to increase fruit and vegetable intake in homebound seniors.

Aged↗
PubMed1984

Neonatal total parenteral nutrition: a program for computer-generated profiles.

This article describes a unique microcomputer program for the calculation of a profile for neonatal parenteral nutrition. It describes functions of the program and the parameters on which the calculations are based. A printed profile is shown and discussed in detail. It is recommended that the purchase or lease of a microcomputer is worth the necessary expenditures to reduce the tedious calculations involved with total parenteral nutrition in neonatal patients and to improve the accuracy of these calculations.

Computers↗
PubMed2006

Medical nutrition: a comprehensive, school-wide curriculum review.

BACKGROUND: A school-wide nutrition program was established in 1982 and a required medical nutrition course (MNC) was established in 1985 at the University of Nevada School of Medicine. Emphasis was placed on developing an integrated curriculum and on using innovative methods to incorporate nutrition into the existing curriculum. OBJECTIVE: The objective of this review was to establish a baseline and make positive curricular changes to comply with the recommendations of the Liaison Committee on Medical Education for accreditation. The MNC and the nutrition curriculum were evaluated as part of this 3-y comprehensive, school-wide evaluation process. DESIGN: The MNC was invited for review (December 2004) because of its position in the curriculum (first year), special content and methods, and relation to other courses. A review team, which consisted of the Assistant Dean for Medical Education (who chaired the team), a curriculum coordinator, faculty representatives, and a medical student, was appointed. The MNC coordinator prepared a review book that included the requested documentation. The initial 3-h review meeting culminated in a formal evaluation and recommendations. Follow-up meetings at 1 mo and 1 y were scheduled. RESULTS: The review was a positive process that reaffirmed the uniqueness of the nutrition program at the University. It supported the MNC as an important part of the required curriculum. Recommendations included use of the Web, encouragement to identify new opportunities with interested faculty, and a structure to further integrate and align nutrition into existing courses. CONCLUSIONS: A positive, proactive review process supports the importance of nutrition in the medical school curriculum and encourages further integration.

Curriculum↗
PubMed1995

Use of performance ratios to calculate the economic impact of thin cows in a beef cattle herd.

OBJECTIVE: To determine gross income lost that was attributable to thin cows in a beef cattle herd, to estimate the cost of added nutrition necessary to prevent thin cows in the herd, and to determine the financial outcome of the improved nutritional practices. DESIGN: Prospective, observational study. ANIMALS: Four hundred and twenty-two Santa Gertrudis cows and their calves. PROCEDURE: At pregnancy examination in the fall of 1992, cows were assigned a body condition score (BCS), using a scale of 1 (emaciated) to 9 (obese), and the ratio of the productivity of BCS-3 and BCS-4 cow groups (thin cows), compared with the mean productivity of BCS-5 and BCS-6 cows (cows in good condition), was determined. Measures of productivity evaluated included pregnancy rates, weaning weights, and prices per hundredweight of calves. The performance ratios of BCS-3 and BCS-4 cows were multiplied by the mean gross income of BCS-5 and BCS-6 cows to calculate their gross income. This was then subtracted from the mean income of BCS-5 and BCS-6 cows to estimate the amount of lost gross income per thin cow. The cost of a nutritional program that would prevent thin cows in the herd was subtracted from the lost gross income of the thin cows to yield the amount of increased net income that could be generated from a nutritional program that would maintain cows in the herd at a BCS of 5 or 6. RESULTS: Cows with a BCS of 3 were 0.48 as productive, and cows with a BCS of 4 were 0.74 as productive as the average of the BCS-5 and BCS-6 cows combined. Each BCS-3 cow generated $215.06 less, and each BCS-4 cow generated $107.53 less gross income than the average gross income of BCS-5 and BCS-6 cows. The added cost of nutrition that would have reconditioned BCS-3 and BCS-4 cows to a BCS of 5.5 was $91.48/BCS-3 cow and $43.67/BCS-4 cow. Implementation of the reconditioning nutrition program the previous fall would have resulted in an extra net income of $123.58/BCS-3 cow and $63.86/BCS-4 cow, received over a 2-year period. The 262 thin cows in the herd accounted for a total net income loss of $19,897. CLINICAL IMPLICATIONS: The time of pregnancy examination is a strategic intervention point to estimate the past negative economic impact of thin cows and to implement a plan to prevent these losses in the future. Pregnancy examinations should be performed at least 100 days before the beginning of the calving season, and thin pregnant cows should be sorted into a special group and fed a reconditioning diet that will improve their body condition to an average BCS of 5.5 by the onset of the calving season.

Animal Husbandry↗
PubMed2006

Meal programs improve nutritional risk: a longitudinal analysis of community-living seniors.

OBJECTIVE: To determine the independent association of meal programs (eg, Meals On Wheels and other meal programs with a social component) and shopping help on seniors' nutritional risk. DESIGN: Cohort design. Baseline data were collected with an in-person interview and subjects were followed up for 18 months via telephone interview. SUBJECTS/SETTING: Cognitively well, vulnerable (ie, required informal or formal supports for activities of daily living) seniors were recruited through community service agencies in southwestern Ontario, Canada. Three hundred sixty-seven seniors participated in baseline interviews and 263 completed data collection at 18-month follow-up; 70% participated in meal programs at baseline. MAIN OUTCOME MEASURES: The 15-item Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN) questionnaire identified nutritional risk at 18 months. STATISTICAL ANALYSES PERFORMED: Descriptive and bivariate analyses were performed and significant associations (P<0.05) used to build the full multiple linear regression model. Meal and shopping variables were forced into the model as predictors of follow-up SCREEN questionnaire scores. RESULTS: Meals On Wheels use was independently associated with higher SCREEN questionnaire scores (ie, less risk), as was higher income. Baseline SCREEN questionnaire scores also strongly and positively predicted follow-up scores. Self-reported depression at baseline was associated with lower scores at follow-up. Although use of programs at baseline was associated with decreased risk, if participants experienced increased use of the program (eg, more meals) during the follow-up period this was associated with lower scores, or increased risk. CONCLUSIONS: Meal programs can improve or maintain nutritional risk for vulnerable seniors. Increased use of these programs over time may indicate a senior's declining status. Seniors who are in need of informal or formal supports for food shopping or preparation should be encouraged to participate in meal programs as a means of maintaining or improving their nutrition.

Activities of Daily Living↗
PubMedDate not supplied

The effect of two nutritional software programs used as adjuncts to the behavioral treatment of obesity.

The need to provide nutritional information in the behavioral treatment of obesity is now generally recognized. However, the comparative efficacy of various delivery modes remains to be demonstrated. Two commercial software packages (The Eating Machine and EATS) were embedded in Ferguson's (1975) prototypical behavioral program and contrasted with the Ferguson approach deployed alone. Assessments of weight, nutritional knowledge, eating behavior, and related cognitive variables were made at pretest, posttest, 1-month follow-up and 6-month follow-up occasions. No incremental effects attributable to the software programs appeared.

Adult↗
PubMed2006

Clinical management after bariatric surgery: value of a multidisciplinary approach.

Comprehensive and collaborative longitudinal care is essential for optimal outcomes after bariatric surgery. This approach is important to manage the many potential surgical and medical comorbidities in patients who undergo bariatric surgery. Medical management programs require prompt and often frequent adjustment as the nutritional program changes and as weight loss occurs. Familiarity with the recommended nutritional program, monitoring and treatment of potential vitamin and mineral deficiencies, effects of weight loss on medical comorbid conditions, and common postoperative surgical issues should allow clinicians to provide excellent care. Patients must understand the importance of regularly scheduled medical follow-up to minimize potentially serious medical and surgical complications. Because the long-term success of bariatric surgery relies on patients' ability to make sustained lifestyle changes in nutrition and physical activity, we highlight the role of these 2 modalities in their overall care. Our guidelines are based on clinical studies, when available, combined with our extensive clinical experience. We present our multidisciplinary approach to postoperative care that is provided after bariatric surgery and that builds on our presurgical evaluation.

Bariatric Surgery↗
PubMed2002

Sustained positive deviant child care practices and their effects on child growth in Viet Nam.

Save the Children's (SC) successful integrated nutrition program in Viet Nam, the poverty alleviation and nutrition program (PANP), uses the positive deviance (PD) approach to identify key growth promoting behaviors and provides participatory adult education allowing mothers to develop skills related to these behaviors. We investigated whether improvements seen during a PANP intervention (1993-1995) were sustained three and four years after SC's departure. Cross-sectional surveys were administered to 46 randomly selected households in four communes that had previously participated in the PANP and 25 households in a neighboring comparison community in 1998 and 1999. Two children per household, an older child who had participated in the PANP and a younger sibling who had not, were measured (total n = 142 children), and their mothers were interviewed. Older SC children tended to be better nourished than their counterparts. Their younger siblings were significantly better nourished than those in the comparison group, with adjusted mean weight-for-age Z scores of -1.82 versus -2.45 (p = .007), weight-for-height Z scores of -0.71 versus -1.45 (p < .001), and height-for-age Z scores of -2.11 and -2.37 (ns, p = .4), respectively. SC mothers reporting feeding the younger siblings more than their counterparts did (2.9 versus 2.2 main meals per day, p < .001, and 96.2% versus 52% offering snacks, p < .01). SC mothers reported washing their hands "often" more than comparison mothers (100% vs. 76%, p < .001). Growth-promoting behaviors identified through PD studies and practiced through neighborhood-based rehabilitation sessions persisted years after program completion. These sustained behaviors contributed to better growth of younger siblings never exposed to the program.

Adult↗
PubMedDate not supplied

The reach of a computer-tailored nutrition education program in the Dutch heart health community intervention "Hartslag Limburg".

OBJECTIVE: To study the reach of an efficacious, computer-tailored nutrition education tool in a field setting. DESIGN: Data from self-administered questionnaires were used. SETTING: The computer-tailored nutrition education tool (CTT) was adopted by a regional public health service organization and implemented in a regional heart-health community project. PARTICIPANTS: The 1293 inhabitants of the region that requested the computer nutrition education tool during a 25-month implementation period. MAIN OUTCOME MEASURES: Demographic characteristics; intake of fat, fruit, and vegetables; and psychosocial behavioral determinants. ANALYSIS: Descriptive statistics. RESULTS: The CTT reached almost 1% of the targeted population. Most participants were female (82%), and almost half were low educated. Many participants had diets higher in fat and lower in fruits and vegetables than recommended, were unaware of their unfavorable diets, and had low self-efficacy and intentions towards change. CONCLUSIONS AND IMPLICATIONS: Only a small, but possibly important, part of the target population was reached. Additional ways to reach more people should be explored.

Adolescent↗