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PubMed1989

A commentary on "Achieving Health for All: a Framework for Health Promotion".

In November 1986, the Minister of National Health and Welfare released a discussion paper called Achieving Health for All: A Framework for Health Promotion. The aim of this document is to present a new vision for health in Canada and to propose health promotion as a process to improve health for all Canadians. A framework of health challenges, health promotion mechanisms and implementation strategies is presented as a model to guide health programs and policies. Achieving Health for All builds upon the concepts and principles of health and health promotion that have been developing in Canada and other countries over the last 10-15 years. This article reviews the strengths and limitations of the framework and suggests its use in conjunction with the Ottawa Charter for Health Promotion, which was released in November, 1986. Implications of the framework for The Canadian Dietetic Association and dietitian/nutritionists are also presented. Dietetic and nutrition professionals are challenged to become familiar with the concepts and principles of Achieving Health for All and to assume a leadership role in promoting food and nutrition programs and policies as part of this new vision for health for all Canadians.

Canada↗
PubMed2004

Delivery of nutrition services in health systems in sub-Saharan Africa: opportunities in Burkina Faso, Mozambique and Niger.

BACKGROUND: In sub-Saharan Africa, underweight and micronutrient deficiencies account for an estimated 25% of the burden of disease. As the coverage of national health systems expands, increased opportunities exist to address the needs of children and women, the most vulnerable to these deficiencies, through high-quality nutrition services. OBJECTIVES: To assess health providers' knowledge and practice with regard to essential nutrition services for women and children in Burkina Faso, Mozambique and Niger, in order to assist the development of a standard guide and tools to assess and monitor the quality of the nutrition services delivered through national health systems. FINDINGS: The three surveys reveal the extent of missed opportunities to deliver nutrition services during routine prenatal, postnatal and child-care consultations for the prevention and treatment of highly prevalent nutritional deficiencies. CONCLUSION: A commitment to improving the quality of facility-based nutrition services is necessary to impact on the health outcomes of women and children 'covered' by national health systems. Rigorous assessment and monitoring of the quality of nutrition services should inform health programme and policy development. Building on the lessons learned in these three assessments, Helen Keller International has developed a standard Guide and Tools to assess the quality of the nutrition services delivered through national health systems. These tools can be adapted to assess ongoing nutrition services in health facilities, provide a framework for nutrition programming, inform the development of pre-service as well as in-service nutrition training curricula for providers, and evaluate the impact of nutrition training on providers' practices.

Adult↗
PubMed2001

A nutrition and exercise intervention program for controlling weight in Samoan communities in New Zealand.

OBJECTIVE: To promote weight loss in Samoan church communities through an exercise program and nutrition education. METHODS: A quasi-experimental design was used to assess weight change, over 1 y, in cohorts of people aged 20-77 y from three non-randomised Samoan church communities (two intervention, n=365 and one control, n=106) in Auckland, New Zealand. The intervention churches received aerobics sessions and nutrition education about dietary fat. RESULTS: Baseline body mass index for the intervention and control churches was (mean+/-s.e.) 34.8+/-0.4 and 34.3+/-0.9 kg/m(2), respectively. The intervention churches lost an average of 0.4+/-0.3 kg compared to a 1.3+/-0.6 kg weight gain in the control church (P=0.039, adjusted for confounders). The number of people who were vigorously active increased by 10% in the intervention churches compared to a 5% decline in the control church (P=0.007). Nutrition education had little apparent impact on knowledge or behaviour. CONCLUSION: Samoan communities in New Zealand are very obese and have high rates of annual weight gain. A community-based intervention program arrested this weight gain in the short term.

Adult↗
PubMed1985

A nutrition-physical fitness intervention program for low-income black parents.

An 8-week program taught nutrition and aerobic exercise to obese, low-income black mothers of children under 3 years. A reduction in risk factors for cardiovascular disease in the mothers was anticipated. Culturally adapted aerobic dancing was well-suited for exercise. It was assumed that children would ultimately adopt their parents' changed life style. The program demonstrated a significant reduction in heart rates at rest, but no significant change in heart rates with stress. A significant reduction in body-fat percentage was measured, whereas overall weight reduction was not significant. The consumption of vitamin C, protein, fat, and sodium was reduced. Intake of calcium, iron, carbohydrates, and vitamin A rose significantly. The results indicate the potential effectiveness of such dual intervention programs. Further study would be necessary for more conclusive results and recommendations.

Adult↗
PubMed2006

Nutrition in emergencies: WFP experiences and challenges.

WFP and its partners have made significant strides in the last decade towards tackling malnutrition in emergencies. Since malnutrition is an important determinant of mortality, food interventions play a key role in saving lives through their impact on the nutrition and health of affected populations. Humanitarian interventions aiming to prevent the deterioration, or promote recovery, of nutritional status have to be carefully tailored to the nature of each crisis and seek to address underlying causes. There are three elements crucial to successful action: Ensuring that a nutritionally-appropriate food basket is formulated to meet local needs, that it arrives on time and in coordinated fashion (not one commodity one month, another the next). Some food commodities are needed in small amounts (iodized salt and fortified blended foods) but their inclusion and delivery are often critical to positive nutrition outcomes. The importance of micronutrients in achieving the goals of emergency operations is increasingly well-understood and there is evidence of the need for greater use of fortified foods than in the past. Coupling food with essential nonfood inputs is important in nutrition programming. Cash resources are required by WFP for a variety of nutrition and public health activities, including local milling/fortification of cereals, local procurement of fortified blended foods, and support for complementary activities such as nutrition education, training, and deworming. An ability to offer sustained improvements in nutrition will depend on strong collaboration with partners skilled in nutrition and public health, including information management. Better linking of emergency programming with nonemergency activities is required so that underlying processes contributing to serious malnutrition are effectively tackled in the long run.

Developing Countries↗
PubMed1997

An evaluation of breastfeeding promotion through peer counseling in Mississippi WIC clinics.

OBJECTIVE: This study evaluates the effectiveness of a peer counseling program at increasing breastfeeding by participants in the Mississippi Special Supplemental Nutrition Program for Women, Infants and Children (WIC). METHODS: Data from the 1989-1993 Pediatric Nutrition Surveillance System were analyzed to compare breastfeeding rates in clinics with and without peer counseling programs. A questionnaire completed by program staff to describe the program in greater detail helped identify characteristics associated with greater success. RESULTS: The incidence of breastfeeding rose from 12.3% to 19.9% in those clinics with peer counseling programs, but only from 9.2% to 10.7% in clinics without a program. Clinics that started a program earlier showed greater changes in breastfeeding incidence. However, the presence of lactation specialists or consultants in the clinic appeared to be more important than the presence of less-trained peer counselors. Peer counselors who spent more than 45 minutes per participant were more effective than those spending less time. CONCLUSIONS: The peer counseling program significantly increased the incidence of breastfeeding, particularly in clinics with lactation specialists and consultants. Success can be enhanced by ensuring that peer counselors spend a great deal of time with the participants.

Adult↗
PubMed1982

Nutrition knowledge and attitudes of elementary school students after receiving nutrition education.

The effect of a nine-week nutrition education program on nutrition knowledge and selected nutrition/food attitudes of kindergarten through sixth grade pupils was examined. Children in the experimental group participated in the program for a nine-week instructional period; those in the control group participated later. Knowledge and attitude assessment instruments were administered to both groups immediately before and after the instructional period. In the lower grades (kindergarten through grade 3), responses on two of the three attitude scales were positively influenced by the nutrition education program. On the third attitude scale there was a trend toward a positive effect in all but one of the lower grades, but the trend was significant only in first grade. In the upper grade levels (4 through 6), the effect of nutrition education on the nutrition and food attitude scale responses was mixed; it tended to be most positive in grade 4 and least positive in grade 6. The nutrition education program also had a significant positive effect on the nutrition knowledge score of pupils in all grades except sixth. In this grade, the trend was positive but was not significant.

Attitude to Health↗
PubMed1989

Efficacy of a nonrestricted fat diet in patients with cystic fibrosis.

We sought to determine if an increased oral intake with a noninvasive nutrition program in patients with cystic fibrosis could influence growth, weight gain, and pulmonary function. Thirty-seven patients, aged 2 to 27 years, were instructed to consume a nonrestricted fat diet during an intervention period of 4 years. The results showed that patients increased the mean energy intake significantly to a level of more than 120% of the recommended daily allowance. The enhanced intake resulted in significant weight gain. Pulmonary function (forced expiratory flow 25%-75%) deteriorated during the 2-year preintervention period but stabilized during the 4-year intervention period. Both male and female patients were able to maintain their established height and weight scores during adolescence. The recommendation for a high-energy diet with no restrictions placed on the fat intake and the control of the steatorrhea by administration of an optimal enzyme dosage is supported by our data. Individualized nutritional counseling should be attempted before implementing invasive nutritional intervention programs.

Adolescent↗
PubMedDate not supplied

A large-scale, short-term, media-based weight loss program.

BACKGROUND: This article describes the evaluation of a media-based weight loss and nutrition program. METHODS: Fifteen broadcasts were aired on a Chicago television news program over a three-week period in November of 1986. Some participants (n = 37) received the television program and an accompanying manual, and some (n = 37) received, in addition to the television and media interventions, encouragement to attend self-help groups dealing with obesity. RESULTS: Repeated measures analysis of variance tests were performed, and planned comparisons were conducted only if main effects were significant. At posttesting, those participants attending the self-help groups lost an average of more than nine pounds, whereas those provided only the television program and manual had decreased by less than a pound. Those attending the groups had significantly decreased their percent of dietary fat intake, significantly increased aerobic exercise, and had significantly more hopefulness, motivation, and stimulus control. DISCUSSION: The findings suggest that short-term mass media programs by themselves were probably not very effective, but when supplemented by a self-help manual and support groups may be able to produce significant short-term weight loss.

Adult↗
PubMed1985

Interactive computer programs for applied nutrition education.

DIET2 and DIET3 are programs written for a Dec2050 computer and intended for teaching applied nutrition to students of nutrition, dietetics, home economics, and hotel and institutional administration. DIET2 combines all the facilities of the separate dietary programs already available at Robert Gordon's Institute of Technology into a single package, and extends these to give students a large amount of relevant information about the nutritional balance of foods (including DHSS and NACNE recommendations) prior to choosing them for meals. Students are also helped by the inclusion of typical portion weights. They are presented with an analysis of nutrients and their balance in the menu created, with an easy mechanism for ammendation of the menu and addition of foods which provide the nutrients that are lacking. At any stage the computer can give the proportion of total nutrient provided by each meal. DIET3 is a relatively simple program that displays the nutritional profile of foods and diets semigraphically.

Computer-Assisted Instruction↗
PubMed1997

Effect of smoking cessation on lipoprotein A-I and lipoprotein A-I:A-II levels.

Cigarette smoking is associated with low plasma high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (apo) A-I levels, which may explain, in part, its deleterious effects on coronary heart disease (CHD). In a group of ex-smokers, we assessed the influence of smoking cessation on apo A-I particle levels. Plasma lipid, apolipoprotein, and lipoparticle concentrations of 58 subjects who had completely stopped smoking (ex-smokers) were compared with those of 37 subjects who had continued smoking (smokers) before and after a smoking cessation counseling program. Nutritional intake was recorded before and after the program to adjust for potential interaction with plasma lipid variables. Smokers and ex-smokers were similar in gender distribution, age, body mass index (BMI), social status, and nutrient intake. There were significantly greater increases in total cholesterol (P < .04), HDL-C (P < .005), HDL2-C (P < .008), and lipoprotein (Lp) A-I:A-II (P < .04) in ex-smokers than in smokers. After smoking cessation, ex-smokers consumed more vegetable protein (P < .02) and polysaccharides (P < .04) and had higher plasma levels of HDL-C (P < .0004), apo A-I (P < .001), Lp A-I (P < .007), and Lp A-I:A-II (P < .01) than smokers. Adjustments on nutritional variables did not show any additional difference between ex-smokers and smokers, suggesting that smoking per se effects Lp A-I and Lp A-I:A-II levels. In conclusion, HDL particles including Lp A-I and Lp A-I:A-II are higher in ex-smokers than in smokers.

Adult↗
PubMed1998

[Excess caloric intake induced severe hypercapnia in a patient with Duchenne muscular dystrophy on noninvansive positive pressure ventilation].

In many patients with neuromuscular diseases, respiratory failure is mainly caused by alveolar hypoventilation in their terminal stages. Malnutrition is one of the common and serious problems in patients with chronic respiratory failure. Energy consumption for breathing is remarkably high in respiratory compromised patients, causing subsequent increase of total energy expenditure. However, most patients have limited capacity of oral intake. Nutritional depletion is associated with wasting of respiratory muscles, impairment of respiratory drive, alteration of respiratory pattern, and pathological change of pulmonary parenchyma. These indicate that nutritional and ventilatory support is very important in these patients. However, overfeeding also may have detrimental influence on respiratory failure. We experienced a Duchenne muscular dystrophy (DMD) patient on noninvasive positive pressure ventilation (NIPPV) who developed hypercapnia after total parenteral nutrition (TPN). Analysis of clinical course of this patient revealed that there is a significant correlation between PaCO2 and caloric intake. Excess carbohydrate intake can precipitate fat synthesis which induces over-production of carbon dioxide (CO2). Since NIPPV doesn't have a closed circuit, there are some difficulties in respiratory management, such as air leakage to stomach and mouth, and airway obstruction. Failure to optimize NIPPV setting against increased CO2 load might cause hypercapnia in this patient. These suggest that evaluation of energy expenditure and design of nutritional program are essential to avoid hypercapnia due to nutritional support.

Adult↗
PubMed2006

[Study on the effect of malnutrition and anemia identified among general population in 2002 to the future productivity in China].

OBJECTIVE: To measure the social productivity loss and negative effect to economic development due to malnutrition in view of quantitative analysis. METHODS: Using the data of childhood stunting and population anemia status, collected by 2002 National Nutrition and Health Survey to analyse the effect on present and future productivity. PROFILES model was used to estimate two kinds of productivity losses: "Future productivity loss" was figured out based on the data of stunting and anemia status in 0-5 year-old children while "Current productivity loss" was from anemia data of the adults. RESULTS: If current prevalence levels of malnutrition remained unchange over the next ten years (from 2002 to 2012), the total net present value of future productivity lost would be 281.7 billion Yuan (RMB), equivalent to 2.70 % of the Gross Domestice Product( GDP) in 2002, with the productivity losses due to stunting, anemia in adults and children were 0.15 % , 0.46 % and 2.09% of the 2002 GDP, respectively. All the results of calculation mentioned above was restricted with the same assumption - the ignorance of the real cost. CONCLUSION: The social economic development and the improvement of nutrition program would have a huge effect to population nutritional status. The social benefit and return on investment should be significant.

Adult↗
PubMed2004

Evaluation of a Five-A-Day recipe booklet for enhancing the use of fruits and vegetables in low-income households.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) needs to evaluate appropriate nutrition education for its at risk audience, including Five-A-Day for Better Health educational material that promotes consumption of five servings a day of fruits and vegetables. An evaluation was conducted of a Five-A-Day recipe booklet for use with mothers having a child or children enrolled in WIC. Three clinic sites in eastern Washington State tested the booklet using a pretest (n = 225)/post-test (n = 167) design and an intervention protocol based on preliminary focus group data. The booklet featured information on fresh produce and was accordingly tested over the summer months. Participants were on average 28 years of age and mostly White (77%). After receiving the booklet, many WIC mothers reported feeling more confident about choosing good quality fresh produce (70%) and storing fruits and vegetables appropriately (68%), and also felt that it was easier to include fruits and vegetables in their family's meals (74%). Many mothers reportedly served more fruits and vegetables to their families after receiving the booklet. Notably, this occurred at numerous meals and snack times with both fruits and vegetables, and was independent of a reported trend to consume more fruits and vegetables in the summer. Mothers also favorably evaluated the format and content of the booklet. However, mothers' barriers related to fruits and vegetables did not change, and their estimated intake of fruits and vegetables decreased slightly over the intervention period. Adjustments to the protocol are suggested that may enhance the booklet's effect on WIC mothers' attitudes and behaviors.

Adult↗
PubMed2001

[Evaluation of nutrition instruction in a group of Senegalese students at the secondary level].

BACKGROUND: In Senegal, nutrition instruction was implanted in 1981 in the national curriculum of biology and has never been evaluated since. METHODS: The purpose of this study, was to evaluate the effect of a six weeks nutrition instruction program on improving nutrition knowledge and nutrition attitudes in an experimental group including 81 subjects aged 16.7+/-1.2 years and a control group including 80 subjects aged 15.7+/-1.3 years. These subjects came respectively from third and fourth grade. A questionnaire on knowledge and one on attitudes were administered to the experimental group, before and after the nutrition instruction, while the control group, who did not received any nutrition instruction, also answered the questionnaires. RESULTS: Results indicate that the adjusted mean knowledge posttest scores did not significantly increase in the experimental group compared to the control group. In addition, the adjusted mean attitude postscores of the boys and girls of the experimental group on the attitude scale "Nutrition affects health" were significantly higher from that of the control group. CONCLUSION: An evaluation of the nutrition curriculum and the teaching methods is suggested in order to improve the effectiveness of this nutrition program.

Adolescent↗
PubMedDate not supplied

Fit WIC: attitudes, perceptions and practices of WIC staff toward addressing childhood overweight.

OBJECTIVE: To assess the attitudes, perceptions, and practices of staff of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in providing nutrition education on childhood overweight topics with WIC participants. DESIGN: Descriptive and correlational study. SETTING: WIC clinics in Virginia. PARTICIPANTS: 106 employees working in direct contact with WIC participants. MEAN OUTCOME MEASURE(S): Demographic information; comfort level and frequency of discussing childhood overweight-related topics with participants; perception of WIC's ability to prevent and help address overweight among children and adults; body mass index (BMI); and attitudes toward personal weight. ANALYSIS: Descriptive statistics, regression, and analysis of variance. RESULTS: WIC staff in this study reported a lack of comfort, practice, and confidence in addressing and/or preventing childhood overweight with WIC participants, with differences existing based on job title (P < .05). Barriers to implementing programs included perceived attitudes of participants, transportation, time, cultural issues, and childcare. Staff BMIs were significantly correlated to ethnicity, age, feeling overweight, unhappiness with current weight, and comfort level discussing fruit and vegetable intake and physical activity (P < .05). CONCLUSIONS AND IMPLICATIONS: Staff training, health promotion programs, and culturally relevant educational materials are warranted for WIC staff to build a strong knowledge base and promote self-efficacy about childhood overweight-related topics.

Adult↗
PubMed1993

[A computer program for assessing nutritional status and diet preparation].

This computer program has been written in a BASIC language and designed to assess the nutritional status by means of anthropometrical, immunological and clinical data. Additionally, it is useful for the design and elaboration of personalized diets. The use of this program will allow to work with a great amount of nutritional information, besides, it will outstandingly reduce work time and increase accuracy to diagnose specific nutritional problems. The data base of this program has been made on the basis of current nutritional information and it can be easily updated when necessary.

Algorithms↗