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Quality control of food products purchased by the National School-Feeding Programme in Pernambuco, northeast Brazil, from 1985 to 1988.

The effectiveness of the Quality Control System (QCS) implemented by the Fundação de Assistência ao Escolar (FAE) for quality control of food products from different types and origins purchased by the National School-Feeding Programme (NSFP) in Pernambuco, Northeast Brazil, was evaluated. Physicochemical, microbiological, microscopical and organopetical analyses were performed in 4,860 food samples and the main causes of alterations were detected. Perishability was the characteristic used for distribution of food items into 3 main groups: A, B, and C. In accordance with 972 Quality Certificates between 1985 and 1988, 31.89 of the samples were rejected. The main reasons for rejection were innacuracies of net weight and drained weight and high moisture contents. Group B presented the smallest number of altered samples (27%); for Groups A and C these values were 33% and 44%, respectively. Our data lead to the conclusion that the QCS implemented by FAE is of paramount importance for an adequate quality control of foods provided to beneficiaries and for a good cost effectiveness of the school-feeding programme.

Brazil↗

Angeles Home Health Care: a model for nutrition services.

One in four older Americans is malnourished, and this figure is even higher for the homebound elderly. One home care agency built a successful nutrition services program into its existing pathways for care, decreasing the nutritional risk of its clients.

Aged↗

A practicum in clinical nutrition as the internship component of an integrated masters/internship program.

In September 1990, Chedoke McMaster Hospitals (CMH) admitted two students to the Practicum in Clinical Nutrition. This program was developed at CMH in affiliation with the graduate programs in nutrition offered at McMaster University and the University of Guelph. This is the first program in Canada to integrate a graduate nutrition degree at the Master's level with a clinical nutrition training program. The purpose of this paper is to describe the need, goals, educational philosophy, developmental process and anticipated benefits of this practicum.

Curriculum↗

Nutrition support of inborn errors of amino acid metabolism.

Programs for nutrition support of patients with phenylketonuria, maternal phenylketonuria, branched chain ketoaciduria and vitamin B-6 non-responsive homocystinuria were written in BASIC. These programs plan diets to fill diet prescriptions using natural foods, available amino acid-free or restricted elemental products, milk or infant proprietary formulae and protein-free fat and carbohydrate sources. Emphasis is placed on satisfying the amino acid and protein prescriptions simultaneously. The final semisynthetic formula is evaluated for vitamins, minerals, renal solute load and renal net acid excretion. Fluid requirement is estimated. The paper describes how the conventional protocols are enhanced by computerization and details the requisite calculations.

Amino Acid Metabolism, Inborn Errors↗

[The development of an informational logic support for aiding diagnosis and treatment. The Edecan-Med program. I. The assessment of nutritional status].

We present the elaboration of an informatic program (Informatic Logic Support [SLI]) as a clinical help in diagnosis and treatment, for use by compatible computers PC. In this first part dedicated to artificial nutrition, we explain the scientific support, the capture of anthropometric and biochemical data, the processing, the results and the conclusions delivered by the computer that inform us about all the calculated nutritional parameters the type of malnutrition, the surgical risk of morbimortality (nutritional prognostic), and the caloric needs.

Anthropometry↗

Comparison of family interaction patterns related to food and nutrition.

The study examined family interaction patterns related to food and nutrition and parents' attitudes toward the importance of nutrition and compared interaction patterns and attitudes of parents participating in a nutrition education program (self-selected) to a cross-sectional sample of parents. It also assessed differences according to educational level, income, and mother's employment status. Income and education levels were higher for the self-selected sample. Parents from the self-selected sample had higher attitude scores and interaction behavior scores than those in the cross-sectional sample. Ninety-five percent of mothers and 83% of fathers with young children in the cross-sectional sample ate the evening meal together. Parents who participated in a nutrition education program reported discussing topics related to food and nutrition with their families more frequently than did parents in the cross-sectional sample. For both fathers and mothers, attitude and interaction scores differed with education level. Mothers who were employed part-time showed the most positive attitudes toward nutrition and the highest family interaction scores. Possible explanations for and implications of these findings are discussed.

Adult↗

Targeting interventions for ethnic minority and low-income populations.

Although rates of childhood obesity among the general population are alarmingly high, they are higher still in ethnic minority and low-income communities. The disparities pose a major challenge for policymakers and practitioners planning strategies for obesity prevention. In this article Shiriki Kumanyika and Sonya Grier summarize differences in childhood obesity prevalence by race and ethnicity and by socioeconomic status. They show how various environmental factors can have larger effects on disadvantaged and minority children than on their advantaged white peers-and thus contribute to disparities in obesity rates. The authors show, for example, that low-income and minority children watch more television than white, non-poor children and are potentially exposed to more commercials advertising high-calorie, low-nutrient food during an average hour of TV programming. They note that neighborhoods where low-income and minority children live typically have more fast-food restaurants and fewer vendors of healthful foods than do wealthier or predominantly white neighborhoods. They cite such obstacles to physical activity as unsafe streets, dilapidated parks, and lack of facilities. In the schools that low-income and minority children attend, however, they see opportunities to lead the way to effective obesity prevention. Finally, the authors examine several aspects of the home environment-breast-feeding, television viewing, and parental behaviors-that may contribute to childhood obesity but be amenable to change through targeted intervention. Kumanyika and Grier point out that policymakers aiming to prevent obesity can use many existing policy levers to reach ethnic minority and low-income children and families: Medicaid, the State Child Health Insurance Program, and federal nutrition "safety net" programs. Ultimately, winning the fight against childhood obesity in minority and low-income communities will depend on the nation's will to change the social and physical environments in which these communities exist.

Adolescent↗

Declining rate of folate insufficiency among adults following increased folic acid food fortification in Canada.

OBJECTIVE: Canada introduced a mandatory folic acid food fortification program in November 1998. We investigated whether the rate of folate and vitamin B12 insufficiency among adults has changed since this mandatory fortification program was implemented. METHODS: We conducted a retrospective cross-sectional study using a large Ontario laboratory database. We included all individuals who underwent evaluation of their serum folate, red cell folate and serum vitamin B12 between April 1, 1997 to July 31, 1998 (Period A), August 1, 1998 to January 30, 1999 (Period B) and February 1, 1999 to March 31, 2000 (Period C). RESULTS: A total of 8,884 consecutive samples were analyzed during the period of study. Mean age was 57.4 years (SD 21.1), and 63.2% were female. The prevalence of serum folate insufficiency (below 3.4 nmol/L) fell from 0.52% in Period A to 0.22% in Period C [prevalence ratio (RR) 0.41, 95% confidence interval (CI) 0.18-0.93)]. The prevalence of red cell folate insufficiency (below 215 nmol/L) declined from 1.78% during Period A to 0.41% in Period C (RR 0.23, 95% CI 0.14-0.40). No significant difference was observed between periods in the prevalence of B12 insufficiency below 120 pmol/L (3.93% versus 3.11%, respectively; RR 0.79, 95% CI 0.62-1.01). CONCLUSIONS: There has been a significant decline in the prevalence of folate, but not vitamin B12 insufficiency, following Canadian folic acid food fortification. These changes may have important implications for the prevention and detection of folate and vitamin B12 insufficiency, including identifying the benefits of folic acid food fortification and the need to further consider fortification or supplementation with vitamin B12.

Adult↗

[Food consumption among rural schoolchildren from the metropolitan area of Chile. A comparative study. 1989].

A comparative study of dietary intake of a representative sample of 651 rural school children from Chile's Metropolitan Region was carried out between two periods: 1986-1987 and 1989. Standard procedures for 24 hr dietary recall individual interviews were used to collect data. The percentage of adequacy of energy and protein intake was calculated based on FAO/OMS/UNU (1985), and vitamins and minerals according to National Research Council Recommended Dietary Allowances. Socioeconomic status (SES) was measured through Graffar's Modified Method. Statistical procedures included chi-square test, analysis of variance and Student "t" test. Between 1986-1987 and 1989 not significant difference was found for dietary intake, despite the socioeconomic conditions had improved. Most part of the sample satisfied energy and protein requirements, but approximately 1/3 of the sample presented a low energy intake; the same was observed for protein intake. Protein contributed 12.0% of the dietary energy, fat 23.0% and carbohydrates 65.0%. Animal and vegetable protein intake was found in the proportion 4:6. Dietary intake significantly differed according to age and SES, and deficiencies in calcium, vitamin A, riboflavin and niacin intake were detected in both sexes. These results could be useful for food and nutrition planning related to school feeding programs and nutrition education.

Adolescent↗

National Nutrition Monitoring System: a congressional perspective.

A national nutrition monitoring system can serve as a basic epidemiological tool necessary to examine the linkages between food consumption patterns, nutritional status, and health status. The major component of the 1981 Joint Implementation Plan for a Comprehensive National Nutrition Monitoring System (NNMS) includes the interlocking of the study design and data analysis of the National Health and Nutrition Examination Survey and the Nationwide Food Consumption Survey to begin in 1987. Congress needs the information from the NNMS to formulate and evaluate the consequences of nutrition and health policies, regulations, and programs.

Diet Surveys↗

Nutrition education aimed at toddlers: a pilot program for rural, low-income families.

Childhood obesity is a major health problem. Effective strategies are necessary to promote healthy eating in toddlers. The Nutrition Education Aimed at Toddlers project examined rural, low-income caregivers' knowledge, attitudes, mealtime practices, and dietary intake before and after a nutrition program. A convenience sample of 38 families participated in the study; 19 attended classes, and 19 did not. Six months after the lessons, no significant differences were found between groups; however, the resultant dietary, feeding knowledge, attitudinal, and behavioral data provide a valuable description regarding a hard to reach, high-risk population. However, caregivers' perceptions about feeding their toddlers differed from their reported dietary intakes of dairy, fruits, and vegetables. It appears that knowledge is insufficient to change eating habits. Identification of the issues that prevent caregivers in providing proper feeding is needed for a lasting change of eating habits.

Adult↗