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PubMed1996

Recommendations of the Advisory Committee on Immunization Practices: programmatic strategies to increase vaccination coverage by age 2 years--linkage of vaccination and WIC services.

This statement by the Advisory Committee on Immunization Practices (ACIP), in collaboration with the U.S. Department of Agriculture's (USDA's) Food and Consumer Service (FCS), presents programmatic strategies to increase vaccination rates among preschool-aged children. This is the first statement to recommend assessment of vaccination status and referral for needed vaccinations of children receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Child, Preschool↗
PubMed1996

Diet-related cancer in Native Hawaiians.

BACKGROUND: Since contact with Westerners in 1778, the native people of the Hawaiian Islands have experienced multiple health and social problems. Among these are the debilitating effects of high rates of cancer incidence and mortality. METHODS: The method used in this article was a review and integration of the literature on cancer among Native Hawaiians. The empiric and conceptual literature related to cancer among Native Hawaiians has emerged primarily in the past two decades; therefore, it is limited and sometimes not fully complete. Despite the restricted nature of the literature, there is sufficient evidence to indicate the disproportionate rates of cancer among this native population. RESULTS: An important result of this review is the prescription regarding the incorporation of cultural practices and beliefs into health care services. In particular, incorporating the traditional Hawaiian diet into nutrition programs aimed at health education and promotion may have long-term consequences for cancer prevention. Preliminary data on dietary intervention for Native Hawaiians reveal success on several health indices. CONCLUSIONS: Intervention programs that use elements of a culture, such as the traditional Hawaiian diet, reflect the inherent strengths of that culture. A resolution to improve health status of Native Hawaiians in the 21st century will, in part, require a respect and systematic inclusion of such traditional elements into health care services.

Diet↗
PubMed1996

Impact of nutrition education and mega-dose vitamin A supplementation on the health of children in Nepal.

The impact on vitamin A deficiency (VAD), wasting malnutrition, and excessive childhood mortality of two alternative approaches-nutrition education and mega-dose capsule distribution (6-12-month-olds: 100,000 IU; 1-5-year-olds: 200,000 IU)-in communities in Nepal are compared. Approximately 40,000 children from 75 locations in seven districts in two ecological settings (lowland and hills) took part in the study and were randomly allocated to intervention cohorts or a control group. At 24 months after the implementation of the project the reduction of risk for xerophthalmia was greater among children whose mothers were able to identify vitamin-A-rich foods (relative risk (RR) = 0.25; 95% confidence interval (CI) = 0.10-0.62) than among the children who received mega-dose capsules (RR = 0.59; 95% CI = 0.41-0.84). The risk of mortality at 2 years was reduced for both the nutrition education (RR = 0.64; 95% Cl = 0.48-0.86) and capsule distribution (RR = 0.57; 95% CI = 0.42-0.77) cohorts. The nutrition education programme was, however, more expensive to deliver than the capsule distribution programme. High rates of participation for children in the supplementation programme were achieved quickly. The nutrition education messages also spread rapidly throughout the study population (regardless of intervention cohort assignment). Practices, however, were slower to change. In communities where maternal literacy was low and channels of communication were limited the capsule distribution programme appeared to be more economical. However, there are economies of scale for nationwide education programmes that do not exist for capsule distribution programmes. Although nutrition education provides economies of scale and the promise of long-term sustainability, a comprehensive national programme requires both dietary supplementation and nutrition education components.

Child↗
PubMed1997

Targeted screening for childhood lead exposure in a low prevalence area--Salt Lake County, Utah, 1995-1996.

During 1991-1994, an estimated 930,000 U.S. children aged < 6 years had blood lead levels (BLLs) > or = 10 micrograms/dL, and the risk for an elevated BLL was greatest among children who were non-Hispanic black or Mexican American, from low-income families, living in large metropolitan areas, or living in housing built before 1946. Because risk for lead exposure is associated with several different factors, it can vary greatly across relatively small areas. To establish the local prevalence and distribution of childhood lead exposure and develop local blood lead screening recommendations, the Salt Lake City-County Health Department (SLCCHD) offered free blood lead screening to all children aged 12-36 months enrolled at the seven Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics in Salt Lake County, Utah (1995 population: 812,000), during January-October 1995. This report presents findings of the screenings at WIC clinics, describes the design and promotion of local targeted screening recommendations, and describes the resulting increases in appropriate BLL screenings among children.

Child, Preschool↗
PubMed1997

[Zinc plasma levels in a low socioeconomic status population of children in Maracaibo, Venezuela].

The objective of the present work was to determine plasma zinc concentration in a children's population belonging to low income families in Maracaibo, Venezuela. One hundred fifty-nine children (M:75;F:84) aged 3 months to 8 years were studied by clinic, anthropometric and socio-economical parameters. Fasting peripheral venipuncture blood samples were obtained and analyzed for plasma zinc using atomic absorption spectrophotometry. Plasma zinc levels were low (< 75 micrograms/dl) in 38.36% of the children studied. In turn, 33.89% of the eutrophic group, and 41% of the malnourished group were zinc deficient. By analyzing separately the group of children in which plasma zinc levels ranged between 75-80 micrograms/dl (critical zone), it could be seen that 18.65% of eutrophic and 10% of malnourished children belonged to this group. Thus, over 50% of the total children's population studied had critical or deficient plasma zinc levels. Therefore, functional studies on nutritional status of zinc are recommended to the Venezuelan children population; in case of being evidently deficitary, it is necessary to establish immediate zinc supplementation nutritional programs; especially for children coming from low income families.

Child↗
PubMed1997

Predicting body weight from body measurements in Asian elephants (Elephas maximus).

Accurate estimates of body weight can be useful in the evaluations of feeding programs, nutritional status and general health, and in calculation of dose levels (such as for anesthesia)-thus providing a valuable tool for captive elephant management. We used body measurements of 75 Asian elephants (Elephas maximus) to predict body weight. Weight, heart girth, height at the withers, body length, and foot-pad circumference were measured. All possible linear regressions of weight on one, two, three, or four body measurements were calculated. The highest correlation with a single measurement was that between heart girth and weight (R2 = 0.90). The data were also divided into age groups (1-13, 18-28, 29-39, and 40-57 yr), and all possible linear regressions were calculated for each group (there were no elephants aged 14-17 yr). Adding body length or pad circumference to heart girth resulted in a slight increase in R2. We conclude that body weight in Asian elephants can be predicted from body measurements and that heart girth is the best predictor. A second body measurement might improve predictive accuracy for some age groups.

Age Factors↗
PubMed1998

Preparation of high-risk patients for major thoracic surgery.

For a least a decade, many patients have benefitted from new indications of major thoracic surgery owing to improvements in the surgical and anesthetic procedures of thoracic surgery. Identification of risk factors of perioperative morbidity and mortality becomes of paramount importance when trying to lesson the postoperative mortality rate to 1% or less. The careful assessment of the candidates for thoracic surgery with a multidisciplinary approach is the cornerstone of such an objective. The lower mortality rate should be achievable with a preoperative preparation of the patients of a rehabilitation and nutritional program and a pharmacologic treatment optimization.

Exercise Therapy↗
PubMed1998

Adolescent breakfast skipping: an Australian study.

Eating breakfast is important for the health and development of children and adolescents. This paper reports on the findings of an Australian survey of 699 thirteen-year-olds concerning the extent of skipping breakfast. Results indicated that approximately 12% of the sample skipped breakfast. Gender was the only statistically significant sociodemographic variable, with females skipping at over three times the rate of males. Skippers were more likely to be dissatisfied with their body shape and to have been on a diet to lose weight than were those who ate breakfast. However, in a follow-up telephone survey, the reasons given for skipping breakfast were almost exclusively lack of time and not being hungry in the morning. While North American school nutrition programs have considered poverty to be a key issue in breakfast skipping, these findings suggest that, for Australian adolescents, skipping breakfast is a matter of individual choice.

Adolescent↗
PubMed1993

Efficacy of interactive, automated programmed instruction in nutrition education for cancer prevention.

Ninety-two undergraduates were assigned into groups to evaluate the effectiveness of interactive, computer-delivered programmed instruction for nutrition education on the topic of diet and cancer compared to traditional passive modes of instruction. Students were monitored for knowledge gains by means of a single 50-item test and an application task, using a 4-day diet record, administered 4 weeks prior to and 3 weeks after intervention. Results indicated that although subjects in the interactive group took nearly twice as long to complete the program, having the opportunity to respond to program blanks, this group produced significantly greater knowledge gains and lowered their fat intake by 41.8% compared to 26.1% reduction in fat intake in the noninteractive computer group and 18.6% in the passive prose text groups. Results suggest that interactive, computer-delivered, programmed instruction can be a very important adjunct to health care and cancer prevention programs at high schools and university settings.

Adult↗
PubMed2005

Conceptualizing and assessing nutrition needs: perspectives of local program providers.

This study aimed to understand how local Older American Acts Nutrition Program (OAANP) providers perceive and assess client need for the OAANP. Qualitative in-depth interviews were done with a sample of 36 local OAANP providers in upstate New York. Providers' perceptions of needs for the OAANP were determined by comprehensive understanding of the extent to which an elderly person has problems eating properly to maintain good nutritional and health status. Need was determined by various aging and environmental factors including food insecurity of the elderly, rather than by a single characteristic of problems of elders. Efforts to better understand and meet the needs of elders will enable nutrition programs to respond to heterogeneous needs in ever increasing older population.

Adult↗
PubMed1975

The diet, nutrition, and cancer program of the NCI National Cancer Program.

In November 1974, in response to a mandate in the revised National Cancer Act of 1974, a plan was introduced for the formation of a Diet, Nutrition, and Cancer Program. Dr. Frank J. Rauscher, Director of the National Cancer Institute, selected a group of scientists who defined the goals of the program and recommended the appointment of a program director and of an advisory committee. These recommendations were accepted, and an Advisory Committee, reflecting a cross-section of scientific expertise, has been selected. To recommend a well-balanced program, it will be necessary for the Advisory Committee to assess the current state of the art of nutrition in cancer etiology and therapy and to be apprised of current opportunities, needs, and resources. Toward this end, a literature survey project has been initiated and two specialized workshops have been held.

Diet↗
PubMed2026

Nutrition and Diet-Related Training and Curriculum in the US Predoctoral Dental Programs.

PURPOSE: Nutrition and diet are vital for oral and systemic health. It is unclear how well US predoctoral dental programs prepare students in nutrition screening and counseling. This study analyzed US dental school curricula on these topics. METHODS: A cross-sectional online survey was sent to the publicly available email addresses of 67 of 72 academic dental deans at US Commission on Dental Accreditation-accredited dental schools. Items assessed availability, modes and hours of instruction, curricular topics, clinical integration, and instructors. Descriptive statistics summarized responses. RESULTS: A total of 21 academic deans responded, for an overall response rate of 29%. Most (85%) of responding academic dental deans reported that nutrition and diet education was mandatory, with none treating it as optional. Of these schools, 83% offered both classroom and clinical training, while 17% provided only didactic teaching. Didactic hours varied; 42% reported 10 or fewer hours. Foundational nutrition topics were common, although dietary guidelines such as MyPlate were reported less often (66%). Oral health-related nutrition content was broadly covered, with all respondents reporting instruction related to caries, erosion, periodontal disease, and oral dysfunction. Counseling content was less consistent, particularly public health nutrition (67%) and the impact of oral dysfunction on diet and nutrition (72%). CONCLUSION(S): Most responding academic dental deans report including nutrition and diet education in their curricula. However, it remains uncertain whether these topics are incorporated at schools that did not participate in the survey. Variability in curricular time, counseling, and teaching highlights the need for clearer competencies and more clinical training. Improving this could better prepare future dentists for common dietary risks affecting oral and systemic health.

dental caries↗
PubMed2002

Nutrition before birth, programming and the perpetuation of social inequalities in health.

The need to explain social inequalities in health has led to the theory that chronic disease is due, in part, to a legacy of adverse experiences in early life. Epidemiological studies show consistently that individuals who are small at birth have an increased risk of cardiovascular disease in adulthood. There is growing consensus that this association reflects a causal relationship and is not simply the product of bias or confounding. The concept of programming is invoked as the biological mechanism; birth size is thus a proxy for fetal programming. Recent findings suggest that fetal programming interacts with the post-birth environment. The adverse exposures that are thought to underlie and potentiate programming cluster in socially patterned ways, thus creating substantial inequalities in health. Experiments in animals demonstrate that nutritional interventions before or during pregnancy can produce programming phenomena in the offspring, sometimes without an impact on birth size. However, the extent to which maternal nutrition contributes to programming in contemporary developed countries is uncertain.

Animals↗
PubMedDate not supplied

Nutritional evaluation and supplementation of elderly subjects participating in a "meals on wheels" program.

A nutritional assessment of 33 elderly subjects participating in a "meals on wheels" program revealed a high prevalence of nutritional deficiencies. Twelve of these subjects, who were considered to be at high risk for protein calorie malnutrition, received 240 ml of a polymeric dietary supplement three times daily for 16 wk. This resulted in a significant (50%) increase in total caloric and protein intake which was maintained for the entire 16 wk of study. In seven of the 12 subjects a weight gain of greater than 2 kg was found. Modest but significant elevations in serum albumin and highly significant elevations of the total iron binding capacity, serum and red cell folate, leukocyte ascorbate, and serum vitamin B12 provided strong evidence for improved nutritional status. In contrast no improvement in the hemoglobin, total lymphocyte count, T cell number, T suppressor cells, T helper, or B cells was noted. In no anergic subjects was skin test conversion found. In addition no increase in serum trace metals or vitamin B6 levels were noted. Thus this study demonstrates that nutritional supplementation results in significant improvement in selected nutritional parameters. The fact that the hematopoietic and immunological status of these patients was unchanged suggest that the abnormalities may be age rather than nutritionally related or that a critical nutritional deficiency was not corrected.

Aged↗
PubMed1993

[Sports and nutrition--an ambulatory care program for obese children (long-term experiences)].

Sports activity (three times per week), dietary changes and modification of behavior are the basic tenets of an outpatient program run for 9- to 12-year-old adipose children since 1987. The following goals are to be attained: increase in physical performance capacity and body awareness, long-lasting change in eating habits, weight loss to less than 20% overweight compared to the age-normal, and understanding of the permanence of body weight problems. Individual dietary consultation is offered in addition to the initial examination consisting of physical examination, skin fat-fold measurement, blood chemical parameters, spiroergometry and a detailed discussion with parents and children. The eating habits of the children are recorded in a dietary history (three-day dietary protocol, questionnaire) and discussed in individual consultations with the parents and children. Moreover, the nutritional program includes regular nutritional consultations and parents' meetings every month. Cooking instructions provide practical knowledge of food preparation to preserve nutrients in an energy-reduced, tasty diet, as well as theoretical basics of nutrition. The control examinations show improvement in body-weight related performance capacity and laboratory parameters (lipid metabolism) as well as individual weight loss or stability (reference weight). Aware and controlled nutritional habits were learned especially by the children of parents who, for their part, tried to tailor their diets to be better balanced, whole-some and more need-oriented. Overall the nutritional composition improved with less energy intake. The intake of complex carbohydrates increased especially through consumption of ballast-rich müsli, as well as whole wheat bread, vegetables and fruits.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMedDate not supplied

Home parenteral nutrition: a hospital-based program with commercial logistic support.

Since home parenteral nutrition was introduced in the 1970's, a number of medical centers have formed successful home parenteral nutrition programs which have reduced expenses to the patient and third party payers by 50 to 73% over in hospital costs. However, the cost of maintaining these programs for training and follow-up has largely been absorbed by the hospital as a nonreimbursable teaching expense. To offset the costs of our growing program in these times of budget "caps," we have established an agreement between our hospital and commercial home care company which provides for patient instruction and follow-up by the hospital parenteral and enteral nutrition team and logistic support by the home care company. We used the average cost of our first five patients to establish a fee schedule which the commercial company agreed to pay the hospital parenteral and enteral nutrition team for its services. This agreement reduces the number of nurses and pharmacists that the commercial company would otherwise have to hire for teaching and follow-up of home care patients, and supports the concept of regional care in medical centers where parenteral and enteral nutrition teams maintain quality control, continuity of care, and efficient teaching programs for patients requiring home parenteral nutrition.

Delivery of Health Care↗