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PubMed1996

Nutritional status of children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children--United States, 1988-1991.

Recent increases in the prevalence of overweight among school-aged children (1) and adults (2) in the United States have prompted concern about an increase in overweight among preschool-aged children and a possible association with the foods provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). To assess and compare weight status and nutrient intake among WIC participants and other low-income children, CDC analyzed data from phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1991. This report summarizes the results of this analysis, which indicate that foods provided by WIC are not associated with increased overweight among preschool-aged children.

Adult↗
PubMed1993

Developing nutrition programs for high producing dairy herds.

Herd average milk production continues to increase in the US. Average milk production in Holstein herds enrolled in DHI testing programs surpassed 9000 kg in some states in 1991. Individual dairy herds have produced > 14,000 kg per cow per lactation. The upper limit for milk production per cow continues to increase. A challenge exists in developing nutrition programs for these herds. The goal is to attain efficient and profitable levels of milk production while maintaining herd health and reproductive performance. Evaluation of rations currently fed to high producing herds indicate that these rations are consistent with current nutrient requirement guidelines. Many high producing herds have average DMI > 4% of BW. Ration formulation principles and nutrient requirements used in development of feeding programs for high producing herds are similar to methods already in use. Optimizing DMI, optimizing rumen fermentation, and providing supplemental nutrients are key factors in meeting tissue nutrient demands in this formulation process.

Animal Feed↗
PubMed1988

Commercial foodservice considerations in providing consumer-driven nutrition program elements. Part I. Consumer health objectives and associated employee education needs.

Commercial, public foodservices are experiencing an increasing demand for menu selections consumers see as healthful. Demographic, economic and lifestyle forces are resulting in a growing proportion of individuals and families who eat away from home more frequently. Many are seeking prudent food choices not only at home, but also in foodservice operations. To them, nutrition represents one controllable lifestyle element which can influence their personal health. Weight control and preventive nutrition are the nutrition-related objectives of most consumers interested in foodservice nutrition. They look to dietary guidelines, both those which are specific to their particular health concerns, (e.g. weight control), and those intended as eating-style changes to reduce the risk of such diet-related conditions and diseases as obesity, atherosclerosis, high blood pressure, diabetes and certain forms of cancer. Focusing on these health objectives, interested foodservice operators should offer items which allow consumers to avoid certain foods and food preparation methods which add up to too much of the following: total calories; fat; refined carbohydrates; cholesterol; sodium; and certain controversial substances, (e.g., caffeine). They seek to replace some of the 'avoid' items with a variety of choices of minimally-processed plant foods, and with less-fatty animal foods. Employee education to support menuing nutrition should begin with the development of an awareness of specific target market health concerns. Employees can then be made familiar with methods to translate these dietary wants and needs into appealing, well-tuned products and service elements. The success of nutrition program elements relies heavily on this understanding by employees in their roles from recipe development to table service.

Attitude↗
PubMed2001

Contamination of gastrostomy feeding systems in children in a home-based enteral nutrition program.

BACKGROUND: There are few data concerning the risk of contamination of enteral feeding systems via gastrostomy in children, and none for conditions that pertain to home-based care. METHODS: To investigate the risk of contamination of enteral feeding systems during the home-based care of 20 children receiving gastrostomy tube feeding, five samples were taken for analysis: two samples before the enteral feeding period (gastrostomy, enteral feeding system) and three after this period (gastrostomy, distal giving set, liquid remained in container). Microorganisms were identified and counted. Different factors were studied to elucidate their role in bacterial colonization: acid suppressive therapy, gastrostomy tube or button, hanging feeding time, rate of enteral feeding, gastric pullulation and retrograde contamination, manipulation error, and use of open or closed enteral feeding systems. RESULTS: Overgrowth was defined as a microorganismal load exceeding 10(4) colony-forming units (cfu)/mL. Overgrowth was present in 85% of gastrostomy samples before enteral nutrition started. Most microorganisms belonged to gastric flora. Some bacteria had an environmental origin or derived from cutaneous flora. Forty-five percent of the lines showed overgrowth at the end of enteral nutrition period, mainly with the same microorganism found in the gastrostomy. Closed enteral bags remained sterile, even if manipulation error occurred. Duration, rate of enteral feeding, and acid suppression treatment were not risk factors for overgrowth. CONCLUSIONS: Retrograde contamination of gastrostomy feeding systems occurs frequently. The preferential use of closed enteral feeding systems is recommended for home-based enteral nutrition programs.

Adolescent↗
PubMed1998

Infant nutrition program effectively prevents iron-deficiency anemia in a First Nations community.

Iron-deficiency anemia (IDA) has received relatively little attention in Canada, with no national public health initiatives even among high-risk infants. IDA has a high prevalence in First Nations children and has been shown to cause developmental delay. This study is a before/after prevalence survey studying the effect of a public health intervention, conducted on a First Nations reserve off the central coast of British Columbia (BC). We screened for IDA one cohort of infants born January 1993 to August 1994 and between the ages of 6 and 24 months. Twenty-five of a possible 37 infants were screened. We found 13 (52%) of the 25 had anemia, with a hemoglobin less than 100 g/L. The average hemoglobin was 98.9 +/- 19.2 g/L. The subsequent implementation of an infant nutrition program focused on educating parents and encouraging the use of iron-fortified formula for nonbreast-fed infants. In the year following program implementation, the cohort of infants born between September 1994 and September 1995 were screened for IDA when they were between the ages of 6 and 15 months. Twenty-four of 27 infants participated. Only one infant was anemic with a hemoglobin less than 100 g/L. The average hemoglobin was 116.6 +/- 11.6 g/L. The increase in the average hemoglobin and the decrease in the prevalence of anemia were both highly significant (p < .01). We judged our intervention to be very effective and would recommend similar programs for other First Nations communities.

Anemia, Iron-Deficiency↗
PubMedDate not supplied

Home parenteral nutrition programs.

The technique of home parenteral nutrition (HPN) is becoming a more widely used method to treat patients who cannot eat for prolonged periods; to date, more than 500 patients have been trained nationwide. Training has been limited for the most part to larger centers which have more experience in providing this complex patient education. As this technique becomes more widely accepted, however, other less experienced health care professionals will be called upon to develop HPN training programs. For this reason, it is important to simplify these training programs, with initial attention directed toward the procedures used to prepare the total parenteral nutrition solution. The chance of potential errors can be reduced by using amino acid solutions with electrolytes included in the formulation. When possible, complexity can be reduced by administering vitamins and extra electrolytes orally. The teaching program can be simplified by developing or using existing training manuals, which standardize procedures so that consistent methods are taught and performed. The manual can serve as a reference for patient and teacher alike. Distribution of supplies can be simplified by employing commercially available shipment programs; but, while these are very convenient for the patient and pharmacy, the costs of such programs could be a limitation. Finally, the extensive work required to arrange reimbursement for services and supplies also can be simplified. Often a social worker can facilitate this process because of experience and training in dealing with payment problems. In addition, training fees should be negotiated with third party payors early in the development of HPN programs. By simplifying these basic elements in an HPN, the task of training patients is less imposing and can be made more widely available to those who need this treatment modality.

Adult↗
PubMed1981

Pharmacist involvement in home parenteral nutrition programs.

The results of a national survey of hospital-based home parenteral nutrition (HPN) programs are reported. Questionnaires were mailed to 70 hospitals that were though to have HPN programs. The response rate was 90%, with 51 (73%) usable questionnaires. The "typical" hospital providing HPN services was a private, nonprofit greater-than-400-bed, university-affiliated teaching hospital. HPN programs had been in operation a mean of three years; most served two patients or less. Hospital pharmacies prepared the nutrition solutions 57% of the time; in 25% of the programs, the fluids were prepared at home. Most HPN programs had patient education and training activities. Pharmacists and physicians were most commonly responsible fo monitoring patients' laboratory results. Most HPN programs (90%) were reimbursed for solutions and supplies; 20% were reimbursed for patient education.

Home Nursing↗
PubMed1983

Development of a total parenteral nutrition program in a community hospital.

The article outlines a Total Parenteral Nutrition (TPN) program now existing in a community hospital which could be introduced in other community hospitals. It also describes the role of the pharmacist as the instigator in the formation of a TPN Committee and as a contributing member of the TPN Committee.

Hospital Bed Capacity, 300 to 499↗
PubMed1990

Hemodynamic changes after an intensive short-term exercise and nutrition program in hypertensive and obese patients with and without coronary artery disease.

PURPOSE: To assess the effectiveness of the Pritikin diet and exercise program on cardiovascular hemodynamics using the noninvasive technique of Thoracic Electrical Bioimpedance (TEB). MATERIAL AND METHODS: Twenty subjects divided in two groups, according to their body habitus and hemodynamic disturbances. These data were compared to a group of 10 healthy individuals not involved in the program. Hemodynamic parameters were collected at admission and at the end of the intensive 26-day program of exercise and nutrition. RESULTS: In obese and hypertensive subjects not on medication we observed that cardiac index increased from 3.27 +/- 0.4 to 3.58 + 0.5 L/min/m2; mean arterial pressure decreased from 100 +/- 8.5 to 94.8 +/- 7.9 mmHg while systemic vascular resistance index decreased from 2362 +/- 391 to 1934 +/- 357 dynes. sec. cm-5/m2; p less than 0.05 (Data obtained in supine position). Also documented was a improvement in ventricular performance after postural changes from upright to supine based on indices of left ventricular performance, uniquely obtained by the TEB technique. From admission to discharge, changes were: Ejection fraction 48% to 53%; Peak flow index 295 to 316 ml/s/m2 and Index of contractility 40 to 47 s-1, explained by a shift on the ascending limb of the Starling curve. CONCLUSION: In a selected population, this rehabilitation program is effective for hemodynamic improvement that can be partially explained by metabolic and biochemical changes already reported from this Center.

Adult↗
PubMed1992

Effect of including parents in a school-based exercise and nutrition program for children.

The purpose of this study was to examine the effect of parental involvement in a school-based program about exercise and nutrition. One fifth grade and one sixth grade class were randomly assigned to each of the three different treatment conditions, a school-and-home condition (n = 45), a school-only condition (n = 43), and a control condition (n = 44). In the school-and-home condition, the children's parents were also asked to participate in nutritional and exercise activities at home as a family "home team." A multivariate analysis of variance on change scores was completed on the following variables: height, weight, skinfold, sit-and-reach, sit-ups, mile run, exercise knowledge, saturated fat, cholesterol, percent calories from fat, percent calories from carbohydrates, and nutrition knowledge. There was a significant difference among groups. The school-and-home and school-only groups showed significantly greater improvement than the control group but were not significantly different from each other. Univariate analyses on posttest scores indicated that the school-and-home children scored significantly higher than the control group on sit-and-reach flexibility and nutrition knowledge. The results indicate that including the family was primarily effective in facilitating children's improvements in flexibility and nutrition knowledge rather than in diet and exercise behaviors.

Child↗
PubMed1989

The relationship between a nutrition education program and nutrition knowledge and eating behaviors of the elderly.

An experimental study was conducted to examine the relationship between a nutrition education program and nutrition knowledge and eating behaviors of older adults. Twenty-four subjects were randomly assigned to an experimental or a control group. Prior to any intervention, all subjects completed a demographic data sheet, a 25-item True/False questionnaire and a 24-Hour Dietary Recall interview. The experimental group attended four one-hour nutrition education classes over a two-week period. Following the educational intervention, both groups of subjects again completed the True/False questionnaire and the 24-Hour Dietary Recall interview. Controlling for pretest, posttest differences on the two dependent variables were tested using repeated measures analysis of variance. No significant differences were found between the two groups.

Aged↗
PubMed1998

[Evaluation of a supplementary nutrition program].

The objective of this study was to evaluate the impact of a feeding supplementation program on the growth of undernourished children younger than 5 years in the city of Guariba, state of São Paulo, Brazil. The sample consisted of 469 malnourished children enrolled in a feeding supplementation program sponsored by the State Health Secretariat. The children were divided into four groups according to how long they had been enrolled in the program: in group 1, the children had been enrolled for up to 12 months; in group 2, from 12 to 24 months; in group 3 from 24 to 36 months; and in group 4 the children had been enrolled for more than 35 months. Percentiles for weight/age, height/age and weight/height were calculated for each child. To assess the impact of the program, reference curves for the anthropometric profile were constructed based on expected variations in population percentiles. The changes observed in each group were analyzed statistically (McNemar). Groups 1 and 2 presented weight recovery and gains in the weight/height ratios for the most severely malnourished children; in group 3, the weight/height ratio was maintained and there was a discrete tendency towards weight recovery, which was reversed in group 4, in which the weight was again low in relation to height. The feeding supplementation program temporarily minimized severe nutritional deficiencies but was not sufficient to recover and maintain normal growth.

Age Factors↗
PubMed2001

Evaluation of a psycho-educational nutritional program in diabetic patients.

In this study, we have retrospectively (2 years) assessed the efficacy of the nutritional education (NE) program provided to 83 diabetic patients during an in-hospital training week. Two years after NE, type 1 diabetic patients have decreased significantly their total caloric intake, protein (P<0.05) and fat consumption. Type 2a diabetic patients disclosed a significant increase in CHO consumption while type 2b diabetic patients decreased their fat consumption, SFA consumption and total caloric intake. The percentage of patients following the European Association Study for Diabetes (EASD) nutritional recommendations regarding fat intake has increased significantly in all three diabetic groups and in type 2a diabetic patients regarding CHO consumption. In conclusion, a psycho-educational nutritional education program of 1 week allows a significant improvement of the alimentary behavior 2 years thereafter with 45% of the diabetic patients following the current EASD dietary recommendations.

Adult↗
PubMedDate not supplied

A cost-utility analysis of the home parenteral nutrition program at Toronto General Hospital: 1970-1982.

We performed an economic evaluation of a home parenteral nutrition (HPN) program by measuring the incremental costs and health outcomes for a cohort of 73 patients treated at our institution from November 1970 to July 1982. Over a 12-year time frame, we estimate that HPN resulted in a net savings in health care cost of $19,232 per patient and an increase in survival, adjusted for quality of life, of 3.3 years, compared with the alternative of treating these patients in hospital with intermittent nutritional support when needed. This result was sensitive to assumptions made about the cost of the alternative treatment strategy. When these assumptions were most unfavorable to the HPN program, we estimated that HPN resulted in incremental costs of $48,180 over 12 years, $14,600 per quality-adjusted life-year gained. We conclude that the cost-utility of HPN compares favorably with other health care programs, when HPN is used to treat patients with gut failure secondary to conditions such as Crohn's disease or acute volvulus. Since only one patient with active malignancy was enrolled in our HPN program, these results should not be extrapolated to patients with active malignancy.

Actuarial Analysis↗
PubMed1999

Special Supplemental Nutrition Program for Women, Infants and Children (WIC): non-discretionary funding provisions of the William F. Goodling Child Nutrition Reauthorization Act of 1998. Food and Nutrition Service, USDA. Final rule.

This final rule incorporates into the WIC program regulations numerous non-discretionary funding provisions mandated in the William F. Goodling Child Nutrition Reauthorization Act of 1998. This rule revises and expands backspend and spendforward authority, conversion of funds, multipurpose/infrastructure grants and the use of food funds for the purchase of breast pumps. The rule also revises nutrition services and administration expenditure standards and expands the timing for the use of vendor and participant collections. The provisions in this rule provide greater flexibility for State agencies in the operation of WIC program relating to funds management.

Breast Feeding↗