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PubMed1992

Food habits and nutritional knowledge of Portuguese participants in an elderly nutrition program.

Massachusetts has the largest population of immigrant Portuguese in the United States, yet few elder service programs specifically designed to meet their needs exist. Therefore, a special nutrition program was developed in Somerville, Massachusetts to provide culturally appropriate lunches twice a week, followed by socialization activities. A survey of the participants showed that only 11% of respondents met recommended intake of dairy, protein, fruits and vegetables, as determined by the Basic Four Scoring System. The most frequently lacking food among the remaining participants were fruits and vegetables, followed by grains, as well as dairy products. The recommended protein intake was met by all but two respondents. The majority of respondents were able to identify a high sodium food, a food high in Vitamin C, a nutritionally balanced meal, and identified calcium as a necessary nutrient throughout the lifespan. Fewer respondents were able to identify foods high in protein, high in calories, and high in fiber, although their diets contained substantial amounts of these nutrients.

Aged↗
PubMed1989

[Case study: operation of a mother-child nutrition program in El Salvador].

One of the oldest international efforts in their combat of malnutrition have been the mother-child food programs (MCFP). The purpose of the study herein discussed was to detect the problems that affect the operation of the MCFP of the Ministry of Health of El Salvador, and to identify feasible measures to apply in a short term. This work analyzed the following: a) the operation of the program from the selection of the beneficiary to the delivery of the ration; b) the evolution of the beneficiaries, and c) the perception of the MCFP on mothers' part. The study covered 40 Health Services selected from all over the country; the revision of 556 children's files, and interviews to 136 mothers. It was found that the nurse is the person who plays the main role in the MCFP; that the most used criterion to enter or leave the program is the nutritional condition of the beneficiaries; that priority is given to children over pregnant women; that for most of the children there is a control kept on growth and vaccinations; and that what is mostly supervised is food handling and beneficiaries. Study of the children's files revealed that the average age of the children who enter the program is 18 months and at departure, 24 months, with a permanence of five months; and that the weight-for-age retardation when entering and leaving was similar for all the children studied, although it was different when the analysis was made by permanence and by age groups. Mothers' opinion on the MCFP permitted inference of what occurs at household levels with the donated foods; nevertheless, it is a subject that merits further study. Results of the study confirm some findings of others, although since they are specific for this Program, they allowed the appropriate decision-making for corrective measures of the MCPF.

Analysis of Variance↗
PubMed1998

Impact of a large-scale immunization initiative in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

CONTEXT: Inner-city immunization rates have lagged behind those in other areas of the country. OBJECTIVE: To evaluate the impact of an initiative linking immunization with distribution of food vouchers in the inner city. DESIGN: Retrospective analysis of immunization data gathered in 1996 and 1997. SETTING: Nineteen Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) sites serving 30% of the Chicago, III, birth cohort. PARTICIPANTS: A total of 16581 children 24 months old or younger. INTERVENTIONS: Voucher incentives (varying frequency of food voucher issuance based on immunization status) and assessment of immunization status and referral to immunization provider. MAIN OUTCOME MEASURES: Age-appropriate immunization rates and WIC enrollment rates. RESULTS: During the 15-month period of evaluation, immunization rates increased from 56% to 89% at sites performing voucher incentives. The proportion of children needing voucher incentives declined from 51% to 12%. Sites performing assessment and referral, but not providing voucher incentives, showed no evidence of improvement in immunization coverage. No difference was observed in enrollment rates between sites performing voucher incentives and those that did not. CONCLUSION: Applied in a large-scale, programmatic fashion, voucher incentives in WIC can rapidly increase and sustain high childhood immunization rates in an inner-city population.

Chicago↗
PubMedDate not supplied

[Development and evaluation of food supplements for the education, health, and nutrition program].

OBJECTIVE: To develop and evaluate nutritional supplements destined to a program of social assistance. MATERIAL AND METHODS: In the design of the nutritional supplements a series of criteria were considered including nutrient composition, physicochemical properties and feasibility of production and utilization. Final products were initially evaluated to determine the level of acceptance in 40 children, 52 pregnant women and 62 lactating women in Mexico City. A community trial was also carried out to determine acceptance and consumption in 108 children and 128 women from a rural community in the state of Morelos. RESULTS: The specific formulation and technical processes of production of the nutritional supplements are presented. Products proved to be widely accepted, with average scores of 4.11-4.29 for the children's beverage, and 3.98-4.15 for a more viscous pap (range of scores was 1 to 5). Products for women received average scores from 4.75 to 5.70 in pregnant and from 4.8 to 5.4 in lactating women (range of scores from 1 to 7). In the community trial, supplements were very well accepted. Average consumption was > 75% among children and > 98% among women. Mean energy intake from supplements was 244 Kcal/day for women, and for children, 168 Kcal/day with the pap and 147 Kcal/day with the beverage. Consumption was consistent in all cases along the study. CONCLUSIONS: Nine nutritional supplements were developed and evaluated which comply with the necessary nutritional, physicochemical and hygienic characteristics for the target population, besides being relatively simple to prepare, and widely well accepted and consumed.

Adult↗
PubMed1990

Comparing nutrition programs conducted by public health and Cooperative Extension personnel.

We surveyed 218 county extension agents, 75 state extension specialists, 163 public health nutritionists, and 87 public health administrators in 16 states to compare the nutrition program characteristics of extension personnel with public health personnel. Public health personnel were most strongly influenced by funding regulations--more than 80% of public health nutritionists cited infant/preschool nutrition and nutrition for pregnant/lactating women as program topics. About half of the extension agents listed food preservation and preparation as the dominant topics provided. Public health personnel most frequently designed programs for pregnant and lactating women and low-income clientele; 91% of the nutritionists ranked one-to-one counseling as one of their three most important delivery methods. Extension personnel designed programs more often for homemakers/adults and youth and ranked a combination of group and media delivery methods as most important. Public health personnel use anthropometric measures and food intake records to evaluate their programs; extension personnel use written questionnaires and program records. More than 50% of the nutritionists ranked improving the health of their clients as one of the three most important impacts of their programs; more than 50% of the extension agents ranked increasing knowledge and improving skills as their most important impacts.

Dietary Services↗
PubMed1989

Assessing productivity of foodservice systems in nutrition programs for the elderly.

A pilot study was conducted to develop a monitoring instrument for the measurement of productivity in nutrition programs for the elderly. Observations of foodservice activities were collected for 3 days in each of three senior centers utilizing cook/serve production models. Direct work activity categories included processing, service, transportation, clerical, cleaning, and receiving. Delay activities included personal delay and idle time. Information was gathered on the number of meals served. A method to recognize the equivalent work of senior citizen volunteers was developed. Productivity ratios were calculated as average labor minutes in each activity per meal served. Labor time was consistent within centers, and productivity varied with number of meals served. Average productivity ranged from 12.95 to 19.30 labor minutes per meal.

Aged↗
PubMed1978

Title VII--Nutrition Program for the Elderly. I. Contribution to one day's dietary intake.

Food records kept by 466 individuals participating in the federally funded Nutrition Program for the Elderly show that those eating at the meal site on the day of the food record consumed more energy, protein, and calcium than non-participants and participants who did not eat there on the day of the record. Dietary ratings, which included eight nutrients and energy, indicated they also had better overall diets than non-participants. Non-participants consumed more iron than participants. The daily intake of all nutrients, except calcium, of those eating at the meal site reflected what was offered. Between 40 and 50 per cent of the total daily intake was consumed at the meal center. Women consumed a significantly greater proportion of their daily intake of most nutrients from the food provided by program than the men. The desirability of providing a high proportion of the recommended allowances for protein and other nutrients through the meal program menus is emphasized. The results of the study demonstrated the importance of nutritionists in administrative roles at the state and area levels in determining the effectiveness of a meal program, since food intake reflected menu planning.

Aged↗
PubMedDate not supplied

[The participation of pharmacy services in evaluating parenteral nutrition programs].

The situation of parenteral nutrition practised in our hospital over one year was analyzed from the standpoint of Pharmacy Services, with a random sample of 26 patients with 322 days on parenteral nutrition. The most important results showed that the degree of compliance of the application sheets was 85.3%. The protocolized nutrient units were used in 80.1% of total days on parenteral nutrition, with an average of 0.97 +/- 0.60 modifications per day 855.0% electrolytes and 39.9% insulin). During the follow-up of parenteral nutrition, analytical determinations were performed every 2.3 +/- 1.8 and 4.2 +/- 2.6 days in blood and urine respectively. 30 biochemical alterations were observed, in particular hyperglycaemia (26.7%), hypoglycaemia (10%), hyperpotassemia (13.3%) and hyponatraemia (13.3%). In 70% of cases, corrective action was taken within 24 hours. The average number of multidisciplinary communications was 4.5 per patient. The initiative was taken by the pharmacist in 75.8% of cases, and the most frequent reason for communication was analysis of biochemical situation of patient and proposal for modification in daily intake.

Adult↗
PubMed1979

Title VII--Nutrition Program for the Elderly. II. Relationship of socioeconomic factors to one day's nutrient intake.

Food records from 466 participants in the Title VII Nutrition Program for the Elderly were analyzed to determine the relationship of eating at the program site to improvement in dietary intake and to socioeconomic factors. The subjects were divided into three groups: (a) Participants who ate at the meal site on the day of the food record, (b) participants who did not eat there on the day of the food record, and (c) non-participants. Eating at the meal site erased significant differences in dietary intake of nutrients consumed at home related to sex, education, and occupation. Seven nutrients and energy were significantly associated with these factors for both groups of persons not eating at the meal site on the day of the record. However, only sex was related to intake of nutrients (energy, protein, and thiamin) for those eating at the meal site. Women and the socioeconomically disadvantaged benefited the most from the program.

Aged↗
PubMed2001

Postpartum iron status in nonlactating participants and nonparticipants in the special supplemental nutrition program for women, infants, and children.

BACKGROUND: Iron deficiency, a pervasive problem among low-income women of childbearing age, threatens maternal health and pregnancy outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was designed to alleviate health problems and provides supplemental nutritious foods, nutrition education, and health care referrals. OBJECTIVES: The aim of this study was to examine the benefits associated with participation in WIC in terms of biochemical tests of postpartum iron status in nonlactating women. DESIGN: WIC participants (n = 57) and eligible nonparticipants (n = 53), matched by race and age, were followed bimonthly over 6 mo postpartum. Finger stick blood samples (500 microL) were collected for measurement of plasma ferritin, transferrin receptor (TfR), and hemoglobin (Hb). RESULTS: The mean (+/-SE) Hb concentration of participants exceeded that of nonparticipants from months 2 through 6. At 6 mo, the mean Hb concentration of participants was significantly higher than that of nonparticipants (8.01+/-0.12 and 7.63+/-0.12 mmol/L, respectively; P< 0.05) and the prevalence of anemia was significantly lower (17% and 51%, respectively; P<0.05). TfR and ferritin concentrations (consistently within the reference ranges) and dietary iron intakes did not differ significantly between participants and nonparticipants and were not correlated with Hb concentrations. CONCLUSIONS: Our results suggest that WIC participants were significantly less likely to become anemic if uninterrupted postpartum participation lasted for 6 mo. The lack of correlation among iron status indicators suggests that the lower mean Hb concentration in nonparticipants at 6 mo may not have been related to improved iron status in participants but to other nutrient deficiencies or differences in access to health care and health and nutrition education.

Adult↗
PubMed1985

Increasing malnutrition during hospitalization: documentation by a nutritional screening program.

Nutritional status can change during hospitalization. To evaluate the degree of change, a nutrition screening program (NSP) that included admission and 3-week reassessment was implemented. NSP parameters were weight for height, percentage of weight loss, arm muscle circumference, triceps skinfold, serum albumin, and total lymphocyte count. Nutritional risk factors (NRF) were also recorded: cancer, nothing by mouth (NPO) for 3 or more days, loss of appetite, difficulty chewing or swallowing, persistent fever, and cancer chemotherapy or radiation therapy. Of 15,876 patients admitted during the period of March 1982 through December 1982, 583 (3.67%) were found to be suffering from malnutrition or to have NRFs. Of the 583 patients, 182 received nutritional support and were excluded from the study. The remaining patients were reassessed after 3 weeks and had significant decreases in nutritional parameters; 622 patients with deficits in one parameter (visceral or somatic) on admission had a significant decrease in all parameters (p less than .001) on 3-week assessment. There was a deterioration in nutritional status in those patients entering the hospital with NRFs only or with one low parameter.

Body Weight↗
PubMed1987

Nutritional and biochemical effects of nutrition programs in the elderly.

The nutritional status of this population of elderly was generally quite good. However, these individuals were interested in the program and able to participate in the program. As age in years increases and the aging process continues, all the factors mentioned earlier may combine to contribute to less frequent or nonattendance and perhaps to deterioration of nutritional status. For example, an 80-year-old may be able to drive to a site, but a 90-year-old may not. Also, the older elderly may be more likely to live alone, with all the disincentives to eat well that living alone may be associated with at any age. Therefore, one cannot assume that all of the old elderly are as adequately nourished as this group. The less well nourished may be those not participating in programs for the elderly. Finally, the data presented here illustrate the need to learn more about the differences between middle-aged elderly and the old elderly, and to better differentiate pathologic from normal aging processes.

Aged↗
PubMed1983

Pharmacy department costs and patient charges associated with a home parenteral nutrition program.

The pharmacy department costs of a home parenteral nutrition (HPN) program were identified, and the patient charges for HPN were compared with the charges for hospitalization for parenteral nutrition. Ten patients were randomly selected from 55 patients active in the HPN program at the University of Washington Hospital. Cost identification included quantification of supplies, personnel, equipment, freight, miscellaneous, and indirect costs. Patient charges were identified through billing documents. Charges included clinic visits and laboratory tests. Inpatient charges were identified in a similar manner and included a standard daily hospital charge. Average yearly costs to the pharmacy department were nearly +9000 per HPN patient. Patient charges for HPN were +48.19 per infusion day compared with +205.68 per infusion day for the hospitalized patient. The cost savings of HPN to the patient and the hospital were clearly demonstrated.

Costs and Cost Analysis↗
PubMed1982

[Nutrition programs and levels of health care].

Population health and nutrition situations present different degrees of complexity which must be met with different degrees of technological complexity. This can be accomplished by organizing, in a progressive way, the resources of the health service system to constitute different levels of attention. In this paper, the concept of levels of attention of the health service system is analyzed on the basis of the aforementioned ideas, and comments are made on the increasing administrative complexity required to keep pace with the increasing technological complexity. Mention is made of the criteria which must be taken into account in order to select nutrition activities to be performed in the health sector and the way in which these activities must conform to the different levels, according to their degree of specialization and complexity. Special reference is made of experiences where the basic or primary level activities involving community participation are particularly important. Finally, the incorporation of nutrition as a part of the attention routine at the various levels is discussed; here, the importance of the necessary mechanisms for coordination and support among the various levels is stressed.

Adult↗
PubMed1995

Evaluating community-based nutrition programs: comparing grocery store and individual-level survey measures of program impact.

BACKGROUND: This paper examines whether an "environmental indicator"--a survey of grocery store product displays--can provide a realistic alternative to individual-level telephone surveys for the evaluation of community-based nutrition programs. METHODS: Telephone and grocery store measures were used separately to evaluate three community-level dietary interventions that were part of the Kaiser Family Foundation Community Health Promotion Grants Program (CHPGP). Both surveys were conducted in the three intervention and seven control communities at three points in time: 1988, 1990, and 1992. The grocery store survey recorded the relative availability of low-fat and high-fiber products and the amount of store-provided health-education information. Self-reported dietary intake of residents was obtained in the same communities using a telephone survey. RESULTS: In the one community in which the intervention seemed to have contributed to reduced fat consumption, the grocery store and telephone surveys showed very similar relative changes for the only variable they had in common, low-fat milk consumption. In another community, both survey approaches indicated that there was no change or perhaps a slight worsening in the treatment relative to the controls. The third community produced the only contradictory results: the telephone survey suggested no change or perhaps a worsening, while the grocery store results were generally positive, though not statistically significant. CONCLUSION: These results, combined with the much lower cost of the grocery store survey, justify further pursuit of environmental indicators as an evaluation tool.

Diet↗
PubMed1990

Fatty acid pattern outcomes of a nutritional program for overweight and hyperlipidemic Australian men.

There is growing recognition of the value of changing tissue fatty acid patterns in their own right as coronary risk factors. To examine the effects of a conventional nutritional program on plasma triglyceride (TG), cholesterol ester, and phospholipid fatty acid patterns, a group of 20 hyperlipidemic men and a control group (n = 6) of normolipidemic men were followed for 6 months. As an index of change in energy balance in the hyperlipidemic men, body mass index decreased from 26.5 to 24.4 kg m-2 (an 8% decrease) at 6 months. Saturated fat intake fell from 46.7 to 25.3 g/day (a 46% decrease). Dietary polyunsaturated:saturated fat ratio (P:S) rose from 0.38 and to 0.70 (an 84% increase) at the 6-month review. Ethanol intake fell from 18 to 15 g/day (a 17% decrease). Changes in plasma fatty acid (FA) patterns were found in TG, cholesterol ester, and phospholipid fractions at the 6-week to 3-month period, and these changes were maintained at 6 months. Of the factors possibly contributory to plasma FA pattern change in these men, dietary FA intake underwent the greatest percentage shift and therefore probably makes an important contribution to the change. It was of interest that fatty acid patterns in plasma neutral lipids (triglyceride, cholesterol ester, and phospholipid) significantly predicted body mass index and serum total cholesterol, triglyceride, and high-density-lipoprotein cholesterol.

Adult↗
PubMedDate not supplied

Nutritional program for heart transplantation.

Methodist Hospital has completed 52 heart transplants during its 4 1/2-year history. Dietary restrictions for patients have been deemed necessary to offset the side effects from medication. The purpose of this article is to provide information regarding the nutritional program for heart transplant recipients. Evaluation of the dietary program, changes made, and problems encountered are discussed. The first 10 patients were instructed on a type IIA hyperlipoproteinemia (300 mg cholesterol), no concentrated sweets, and 2 to 4 gm sodium-restriction diet with no fresh fruit or vegetables for 6 weeks after the transplantation. These patients had limited follow-up dietary instruction. Of these patients, 50% (five of 10) gained 50 pounds or more above their pretransplant and/or desirable weight; two died within 1 year, and another two within 18 months with accelerated coronary atherosclerosis documented at autopsy. These results were considered unacceptable. The current diet after heart transplantation is 200 mg cholesterol, low saturated fat, low total fat, high fiber, 4 to 5 gm sodium, with limited concentrated sweets. The goals of this diet are discussed. Patients receive nutritional assessment before and after transplantation, care monitoring, and individualized dietary instruction, as well as outpatient follow-up done by the transplant team dietitian as needed. Of these patients, 20% (five of 25) gained 50 pounds or more, and one died with arteriosclerotic-related complications within the first year. The patient's nutritional status before transplant, previous eating habits, educational level, consistency in physician and team member reinforcement of diet are all major factors in long-term compliance.

Adult↗