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PubMed1979

The consultant dietitian in nursing homes. II. Functions and change effectiveness.

Data are reported on functions and effectiveness of consultant dietitians in nursing homes. Key responsibilities of the consultants included: Planning and writing menus, in-service training, nutritional assessment, and discussing diets with physicians. Activities performed on each visit to the nursing home were resident visitation and dietary consultation, nutritional assessment, communication with other departments, and checking foodservice and sanitation procedures. Most important activities of the consultant, as perceived by the administrators, were in three functional areas: Menu planning, modified diets, and education and training. Administrators indicated that the most significant change brought about by consultants involved modified diets, menus, sanitation, and communication between the foodservice department and other departments and with the administration.

Consultants↗
PubMed2003

Position of the American Dietetic Association and Dietitians of Canada: vegetarian diets.

It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life-cycle including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fibre, magnesium, potassium, folate, antioxidants such as vitamins C and E, and phytochemicals. Vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. While a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes.

Adolescent↗
PubMed2003

Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets.

It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred, and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians, including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits, including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fiber, magnesium, potassium, folate, and antioxidants such as vitamins C and E and phytochemicals. Vegetarians have been reported to have lower body mass indices than nonvegetarians, as well as lower rates of death from ischemic heart disease; vegetarians also show lower blood cholesterol levels; lower blood pressure; and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. Although a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes.

Adolescent↗
PubMed1999

Methodology of a survey on meal patterns in private senior households.

The methodology of a study on meal patterns is discussed. For data collection, menu records on the current diet over two periods of 6 weeks each and an additional self-administered questionnaire on various food related aspects were selected as instruments. Information is required concerning e.g. time, kind and frequency of meals during the day, kind and frequency of dishes consumed and the combination of these. The aim of the study is to obtain information about the nutritional behaviour of the elderly especially on meal patterns. These data are intended as the basis for menu plans reflecting actual nutritional habits in a diet, according to individual requirements, and not for assessing the participants' nutritional status.

Aged↗
PubMed1998

Public health aspects of nutritional science in Estonia: status, research activities, and perspectives.

At the beginning of the 1990s Estonia was characterized by remarkable social and economic changes that also affected nutrition. An important step in the development of a Food and Nutrition policy was the adoption of a new 'Food Law' in February 1995. The publication of dietary recommendations followed recently. Scientific activities in Estonia are promoted by the 1993 established 'Estonian Society of Nutrition Researchers' (ESNS). The 'Ministry of Social Affairs' is of great importance for coordination of research into nutrition and it is making a great effort to connect Estonian nutrition research activities to European and international programs. An important field of scientific interest is concentrated on the nutrition of children and elderly people. With support of the 'Ministry of Social Affairs' a national health program for children and teenagers was established in which a school lunch project is integrated. Such a project has the aim to improve the quality of school lunches and to enable school teachers to conduct nutritional education. Within this national health program 1,900 schoolchildren were interviewed. This examination will also help to detect inequalities of the nutritional situation between social groups and to identify specific aims for a nutritional program in the different counties of Estonia. Health promoting units at schools will play an important role in realizing these aims. The nutritional supply and status of older persons will become an increasing problem. A survey of food supply with 429 subjects in social care facilities for older people was used to develop a new menu-planning system which meets the nutritional recommendations. Nutritional epidemiology is concentrated at the 'Department of Epidemiology and Biostatistics' of the 'Institute of Experimental and Clinical Medicine' in Tallinn. This department is also running the cancer registry of Estonia which has international reputation. Nutritional research of Estonia should aim to continue with the development of a new Food and Nutrition Policy. Important areas of activities will be concentrated on the training of young scientists, development of a food and nutrient data base, regular national nutrition and health surveys, and etiological-epidemiological studies on the basis of the Estonian Cancer Registry. The main targets of the 'Estonian Society of Nutrition Researchers' are directed to improve the scientific basis for research into nutrition and health.

Estonia↗
PubMed1994

An outcome evaluation of a food bank program.

Nonprofit organizations such as the Food Bank of Delaware rely heavily on contributions as they strive to create a hunger-free society. To demonstrate to donors and the public at large the positive difference made by the Food Bank of Delaware, we developed an outcome evaluation method that would measure success in terms other than the amount of food distributed. A detailed list of foods available for 1 month was evaluated item by item in terms of the US Department of Agriculture's Food Guide Pyramid. From this list, we calculated the number of people who could potentially be provided with the minimum recommended number of servings per day for each food group. The highest amount of food distributed was from the Bread, Cereal, Rice, and Pasta Group; food items from this group could potentially meet recommended servings for more than 6,000 persons a day. The food bank distributed the least amount of food from the Milk, Yogurt, and Cheese Group. Food bank programs can use outcome evaluations to demonstrate to contributors and product providers the potential impact of the program and the qualitative and quantitative use of their donations. Results also identify areas for nutrition education and improved menu planning for the provider organizations who distribute these foods.

Delaware↗
PubMed1990

Child problem solving competence, behavioral adjustment and adherence to lipid-lowering diet.

Dietary problem solving competence, behavioral adjustment and low density lipoprotein cholesterol (LDLC) changes were evaluated in a cross-sectional study of 55 hyperlipidemic children and adolescents more than 12 months after they had been prescribed lipid-lowering diets. Adolescents who were able to generate multiple ways to cope with dietary temptations described in hypothetical vignettes evidenced better dietary adherence than adolescents who could produce fewer coping strategies. Observation of parent-child interaction during a standard menu planning task revealed that child satisfaction with the diet was positively associated with parental attempts to solicit and reinforce the child's involvement in meal planning. Findings raise the possibility that behavioral problem solving training might improve long term dietary adherence in adolescents and encourage further research on families' responses to nutritional counseling.

Adaptation, Psychological↗
PubMed2003

Vitamin K content of nuts and fruits in the US diet.

Assessment of vitamin K dietary intakes has been limited by incomplete vitamin K food composition data for the US food supply. The phylloquinone (vitamin K(1)) concentrations of nuts (n=76) and fruits (n=215) were determined by high-performance liquid chromatography. Each sample represented a composite of units obtained from 12 to 24 outlets, which provided geographic representation of the US food supply. With the exception of pine nuts and cashews, which contain 53.9 and 34.8 microg of phylloquinone per 100 g of nut, respectively, nuts are not important dietary sources of vitamin K. Similarly, most fruits are not important sources of vitamin K, with the exception of some berries, green fruits, and prunes. Menu planning for patients on warfarin can include a healthy diet including fruits and nuts without compromising the stability of their oral anticoagulation therapy.

Antifibrinolytic Agents↗
PubMed2006

Nutrient intakes and food patterns of toddlers' lunches and snacks: influence of location.

OBJECTIVE: To describe nutrient intake and food patterns of lunches and snacks eaten at various locations by US toddlers. DESIGN: A national, cross-sectional telephone survey in which mothers and primary caretakers reported toddlers' food and beverage intake for a 24-hour period. SUBJECTS: Toddlers (n=632), aged 15 to 24 months, a subset in the 2002 Feeding Infants and Toddlers Study. ANALYSES: Means+/-standard errors of the mean, percentages, t tests of mean differences, mean energy and nutrient intake, and nutrient density of toddlers' lunches and snacks. RESULTS: Overall, on any given day, 42.6% of toddlers consumed all meals and snacks at home, 8.1% consumed any meal or snack at day care (and others at home), and 49.3% consumed any meal or snack away from home (all other locations excluding day care). Mean energy intake at lunch ranged from 281 kcal at home to 308 kcal away from home to 332 kcal at day care. There were no significant differences in mean macronutrient intake or fiber intake across locations, but lunches eaten at day care were significantly higher in calcium, phosphorus, magnesium, vitamin D, potassium, and riboflavin compared with those eaten at home or away (P<.05). Mean trans fat intake was significantly (P<.01) lower for lunches consumed at home compared with away from home. For lunches consumed at away locations, the most frequently consumed item, by 35% of toddlers, was french fries. Carbonated beverages were consumed at away lunches by 16% of toddlers, compared with 3% at home and none at day care. Morning snacks provided 124 to 156 kcal and afternoon snacks provided from 139 to 170 kcal, depending on the location. Foods typically eaten at morning snacks for all locations were water, cow's milk, crackers, and 100% juice. Beverages frequently consumed at afternoon snacks were water, whole cow's milk, fruit-flavored drinks, and 100% apple juice. The most frequently consumed foods for an afternoon snack at home or day care were crackers or non-baby food cookies. CONCLUSIONS: Nutritious choices such as milk, fruits, vegetables, and whole grains need to be encouraged in a variety of forms to give toddlers an opportunity to build broader food preferences for life. The consumption of milk at home and other locations, such as restaurants and friends' homes, needs to be encouraged in place of fruit-flavored drinks or other sweetened beverages. For lunches at home, parents may be especially receptive to suggestions about appropriate and easy-to-serve foods, homemade or commercial, for a toddler's lunches and snacks. Day-care providers should be encouraged to use menu planning aids, such as those available from the US Department of Agriculture, even if they are not regulated by a government program.

Child Day Care Centers↗
PubMed2000

Health advantages and disadvantages of weight-reducing diets: a computer analysis and critical review.

BACKGROUND: Some weight-loss diets are nutritionally sound and consistent with recommendations for healthy eating while others are "fad" diets encouraging irrational and, sometimes, unsafe practices. OBJECTIVE: The purpose of the study was to compare several weight loss diets and assess their potential long-term effects. DESIGN: Eight popular weight-loss diets were selected (Atkins, Protein Power, Sugar Busters, Zone, ADA Exchange, High-Fiber Fitness, Pritikin and Omish) to be non-clinically analyzed by means of a computer to predict their relative benefits/potential harm. A summary description, menu plan and recommended snacks were developed for each diet. The nutrient composition of each diet was determined using computer software, and a Food Pyramid Score was calculated to compare diets. The Mensink, Hegsted and other formulae were applied to estimate coronary heart disease risk factors. RESULTS: Higher fat diets are higher in saturated fats and cholesterol than current dietary guidelines and their long-term use would increase serum cholesterol levels and risk for CHD. Diets restricted in sugar intake would lower serum cholesterol levels and long-term risk for CHD; however, higher carbohydrate, higher fiber, lower fat diets would have the greatest effect in decreasing serum cholesterol concentrations and risk of CHD. CONCLUSIONS: While high fat diets may promote short-term weight loss, the potential hazards for worsening risk for progression of atherosclerosis override the short-term benefits. Individuals derive the greatest health benefits from diets low in saturated fat and high in carbohydrate and fiber: these increase sensitivity to insulin and lower risk for CHD.

Cholesterol↗
PubMed1981

Evaluation of food selection patterns and preferences.

Recently, studies related to food preferences and selection patterns are gaining more importance because of their multidimensional scope and application. Data from these studies are widely applicable in areas ranging from consumption, forecasting and menu planning in hospitals, restaurants, schools, etc. to nutrition evaluation. Also, they are immensely useful in studies related to various diseases and disorders, particularly cardiovascular diseases and obesity. Evidently, there is considerable lack of information available on this subject, especially on the applicable methodology. This article, is therefore, designed to present in a nutshell an up-to-date review on research, methodology and applications of food patterns and preferences, with emphasis on their nutritional impact.

Appetite↗
PubMed1995

Factors affecting the fat content of National School Lunch Program lunches.

An analysis of a week's menus from a nationally representative sample of 515 National School Lunch Program schools found that < 5% of schools offer lunches that provide a 5-d average close to the Dietary Guidelines recommendation for fat. This paper examines the factors associated with schools offering meals that, on average, provided different amounts of fat: low (< 32% of food energy from fat), moderate (32-35% fat), high (35-40% fat), and very high (> 40% fat). Schools in which NSLP lunches come close, on average, to meeting the Dietary Guidelines' goal for total fat follow several menu-planning, food-purchasing, and food-preparation practices to reduce the fat content of the school lunches.

Adolescent↗
PubMed1999

Food service in long day care centres--an opportunity for public health intervention.

OBJECTIVE: To determine the characteristics of long day care centre operations, food service management practices, and nutrition resources use and needs. METHOD: In October 1996, all 330 long day care centres in Western Australia were surveyed by telephone to gather information to help develop strategies for food service improvement. RESULTS: The response rate was 85%. An accreditation committee directed operations in 76% of centres. Most centres employed a cook with limited or no cooking training. Coordinators identified training needs for cooks that are specific to the National Childcare Accreditation Council's Quality Improvement and Accreditation System (QIAS) guidelines: food hygiene; nutritional and food requirements of children; menu planning; and multicultural cooking. CONCLUSIONS: National standards for the quantification of foods to meet children's nutritional requirements in long day care would allow for consistency in educating child care workers, training cooks, and establishing and assessing government regulations and the QIAS guidelines. Nine recommendations for strategies to improve food service in long day care are presented. IMPLICATIONS: There are two main messages for public health practitioners working to improve the quality of food served to children in long day care: the strong influence of the QIAS guidelines, and the need for specific nutrition recommendations.

Child↗
PubMed1977

Feeding of school children in a London borough.

A survey of 12 schools in a London borough showed that the protein and energy content of the average school meal was below the standard set by the Department of Health and Social Security for all age groups. Failure to meet the standards resulted from inadequate food purchases, poor menu planning and portion control, and several management problems. A 24-hour recall questionnaire showed that 5% of the pupils were "poorly" fed. These pupils were, however, no worse off than their "adequately" fed peers with regard to absences from school or academic attainment measured by reading quotient, but there was some slight difference in height and weight. The percentage of children having no breakfast increased from 4% in the infant schools to 21% in the senior schools. Two per cent of the senior pupils regularly ate no lunch.

Adolescent↗
PubMed1993

A survey of food service managers of washington state boarding homes for the elderly.

Menus provided by food service managers of boarding homes for the elderly in Washington State were analyzed for nutrient content and frequency with which disease preventive foods were offered. Nutrition knowledge and flexibility of attitudes were measured among the food service managers. Forty-three homes responded. More than half of menus provided by homes exceeded Recommended Dietary Goals for saturated fat, sodium and cholesterol by 33%. Over 60% of menus were deficient (less than 67%) compared to the RDA for zinc, copper and magnesium. Nutrition knowledge and attitude scores of food service managers were not significantly correlated to the frequency with which disease preventive foods were served. Future opportunities for nutrition education should aim at increasing the ability of food service managers to transfer nutrition knowledge into menu planning skills.

Administrative Personnel↗
PubMed1989

Feeding the frail elderly.

1. Frail older adults need to be fed carefully and observed closely while eating to prevent choking and aspiration of food and fluids. They choke more easily on clear liquids than on soft foods with some texture. 2. The licensed nurse is responsible for evaluating the physical status of frail older adults before feeding them and for assuring that less qualified personnel are aware of the dangers and specific precautions in feeding these types of patients. 3. The use of nutritious finger foods allows frail older people some degree of independence by encouraging them to feed themselves whenever possible. Careful menu planning can result in a variety of nutritious foods for older people. 4. Soft-cooked vegetables and fruits are more appetizing and acceptable to frail edentulous older adults than pureed or ground foods. Making mealtime special may be one of their few pleasures. 5. Frail older adults should remain in a sitting or semi-Fowler's position for at least one to two hours after eating to prevent possible regurgitation and aspiration of food or fluids.

Aged↗
PubMed1990

Opportunities for better health in the elderly through various forms of mass catering.

Mass catering systems can be used to provide food for the elderly in their own homes, in luncheon clubs, in residential homes and similar establishments and in hospitals. Food and service should be not only nutritionally correct, but also pleasing and acceptable. Eating contributes to psychological and social as well as physical health. Because of limited budgets, strict control of suppliers must be maintained with clear specifications of all items. Staff responsible for menu planning and food service must be adequately trained. Meals should be enjoyable as well as healthy.

Aged↗
PubMed1990

1991 forecast: the year of restructuring.

How is the foodservice industry faring under the clouds of three big uncertainties--oil prices, recession and war? All things considered, its doing quite well. This annual status report of commercial and institutional business shows fast food, catering, nursing homes and employee feeding with growth percentages on the good, left side of the decimal point. Our forecast includes business trends to watch, food trends to guide menu planning and pricing, and interior- and kitchen-design trends that can be a blueprint for a successful new year.

Commerce↗