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PubMed2005

Credit program outcomes: coping capacity and nutritional status in the food insecure context of Ethiopia.

This paper presents findings of a survey that was primarily intended as (1) an assessment of coping capacity in drought and food insecure conditions and (2) a microfinance program outcome study. A three group cross-sectional survey of 819 households was conducted in May 2003 in two predominantly rural sites in Ethiopia. Established clients of the WISDOM Microfinance Institution were compared with similar incoming clients and community controls. No overall pattern of enhanced prevalence of coping mechanisms was observed in any participant group, suggesting that participation in the lending program did not affect coping capacity at the household level. No significant differences in mean mid-upper arm circumference or prevalence of acute malnutrition were found in males or females when the total sample was assessed. In the primary survey site, Sodo, female clients and their children had significantly better nutritional status than other comparison groups: the odds of malnourishment in female community controls compared to established female clients was 3.2 (95% CI: 1.1-9.8) and the odds of acute malnutrition in children 6-59 months of age were 1.6 times greater in children of both male clients and community controls (95% CI: .78-3.32). Household food security among female client households in Sodo was significantly better than in other comparison groups according to a variety of indicators. As compared to female clients, male clients and community controls, respectively, were 1.94 (95% CI: 1.05-3.66) and 2.08 (95% CI: 1.10-4.00) times more likely to have received food aid during the past year. Findings of the present study suggest that microfinance programs may have an important impact on nutritional status and well-being of female clients and their families. That female clients were significantly less likely to be food aid recipients suggests that microfinance programs may be successful in reducing vulnerability to prolonged drought and food insecurity.

Adaptation, Psychological↗
PubMedDate not supplied

Sisters in health: experiential program emphasizing social interaction increases fruit and vegetable intake among low-income adults.

Sisters in Health, a nutrition education program aimed at increasing fruit and vegetable consumption among low-income women, includes active food experiences, positive social settings, a flexible meeting series, and small-group facilitation by paraprofessionals. The program's impact was evaluated in a nonrandom sample of 269 low-income adults in 32 intervention and 10 control groups in New York State using a quasi-experimental, pre-/postprogram evaluation design. Intervention groups reported increased fruit and vegetable consumption, measured by a brief screener, of 1.6 times a day (versus 0.8 times in the control groups) and were 0.44 times more likely to be eating fruits and vegetables 5 or more times a day (P < .05) than control groups. Group support, taste, and food skill experiences can be effective for increasing fruit and vegetable consumption.

Adult↗
PubMedDate not supplied

Preparing patients for home parenteral nutrition.

A comprehensive, interdisciplinary program for patients requiring home parenteral nutrition (HPN) is described. This program begins with an initial patient assessment, which includes medical prerequisites and evaluation of patient motivation and learning abilities, family supports, emotional status, and individual life-styles. The teaching phase involves instructing the patient in the tasks necessary to self-administer parenteral nutrition at home. Problems that can arise are presented, and patient self-monitoring for adverse reactions and problem solving is emphasized. Outpatient follow-up is provided by the interdisciplinary Nutrition Support Service in a clinic setting. Specific components of these visits in relation to physical and emotional adjustment to HPN are discussed. The Nutrition Support Service recognizes a long-term commitment to patients receiving HPN, and members of the team are available to assist patients when problems occur.

Home Nursing↗
PubMed1981

[Nutrition behavior, eating habits and mass index of 4 Swiss cities].

As part of the Swiss National Research Program for the Prevention of Cardiovascular Disease, body weight and length of the participants were recorded and eating habits were assessed by the 24-h-recall method and dietary history. The body mass index was found to increase with age, pointing to excessive energy intake. The lower the socioeconomic group, the higher the index. Men eat more meat and meat products but less fruit than women, and drink more alcohol. In the French-speaking part of Switzerland, significantly more cheese and more alcohol, but less meat, brown bread and milk are consumed than in the German-speaking part. The consumption of edible fats and fat-containing food differs as between the two parts of the country. In certain age groups, a low positive correlation is observed between total plasma cholesterol and fat ingestion, and a low inverse correlation between total cholesterol and milk consumption and frequency of meals.

Adolescent↗
PubMed1998

Wisconsin minimum weight program reduces weight-cutting practices of high school wrestlers.

OBJECTIVE: Winconsin high school wrestlers were surveyed 1 year before (90W) and 2 years after (93W) a new program was implemented to restrict weight loss for competition. The Wisconsin wrestling minimal weight program (WMWP) included a minimal weight limit determined from percent body fat and a nutrition education program. DESIGN: A retrospective survey of wrestlers was conducted, with schools stratified to reflect school size and quality of the wrestling program. PARTICIPANTS: Respondents surveyed in 1990 included 713 wrestlers from 45 schools; 368 wrestlers from 29 of the same schools responded to an identical survey in 1993. MAIN OUTCOME MEASURES: Measures of weight-cutting practices, weight-loss methods, bulimic behaviors, and nutritional knowledge. RESULTS: The most weight lost (MWL), the weight lost to certify (WLC), the weekly weight cycled (WWC), the longest fast (LF), and the frequency of cutting weight (FCW) all decreased significantly (chi 2, p < 0.05) among 93W wrestlers compared with 90W wrestlers. The results for the 90W group are as follows: MWL, 3.2 kg +/- 2.6; WLC, 2.8 kg +/- 2.8; WWC, 1.9 kg +/- 1.5; LF, 20.5 hours +/- 17.2; FCW, 6.2 +/- 6.4. The results for the 93W group are as follows: MWL, 2.6 kg +/- 2.6; WLC, 2.4 kg +/- 2.9; WWC, 1.6 kg +/- 1.4; LF, 16.5 hours +/- 15.6; FCW, 4.7 +/- 6.7. Weight-loss methods, including restricting food or fluids and use of rubber suits, declined significantly (chi 2, p < 0.05). Wrestlers exhibiting more than one of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R)-related bulimic behaviors decreased by 11% (chi 2, p < 0.05), but those exhibiting all five (1.6%) remained the same. CONCLUSIONS: The results suggest that the WMWP appeared to reduce unhealthy weight-loss behaviors among high school wrestlers. Other states should be encouraged to institute similar programs as recommended by the American Medical Association and the American College of Sports Medicine.

Adult↗
PubMedDate not supplied

[Nutritional status surveillance of children in a health district in southern Brazil].

OBJECTIVE: To investigate the nutritional status of children referred by a primary care center to the Nutritional Surveillance Program (Prá-Crescer), and to follow up children at risk in a health district of Porto Alegre. METHODS: A retrospective cohort study was conducted with 674 children, aged between 6 and 59 months, referred to the Prá-Crescer Program. Height-for-age, weight-for-height and weight-for-age indices were used to evaluate nutritional status. The cutoff points were the 3rd and 10th percentiles of the NCHS standards. The nutritional status of 391 children at nutritional risk was followed up for 12 months. The chi-square test was used to analyze associations between variables. RESULTS: Fifty-eight percent of the children had nutritional deficit. Of these, 38.1% were undernourished (< P3), and 61.9% were at nutritional risk (between P3 and P10). Height-for-age deficit was the most frequent, and the age group mostly affected was 12 to 24 months. Among those at nutritional risk, 50.1% completed the follow-up, 33.5% did not start follow-up, and 16.4% were lost to follow-up. 41.3 % recovered nutritional health, 10.2% showed some improvement, without correcting their anthropometric deficits. 39.8% did not show any improvement, and 8.7% had worsening of their deficits. Recovery of nutritional health occurred, on average, within 7.5 months. CONCLUSIONS: This study showed the importance of following up children at nutritional risk and indicates that some aspects should be improved in surveillance programs. Such improvements may reduce the number of children lost to follow-up.

Body Height↗
PubMed1991

Development of a nutritionally adequate and culturally appropriate weaning food in Kwara State, Nigeria: an interdisciplinary approach.

A nutrition education program was undertaken in Kwara State, Nigeria to improve infant feeding practices and nutritional status of weaning-aged children. A series of ethnographic, market survey, epidemiological, dietary, clinical, and communications research studies were implemented to develop a culturally acceptable, yet nutritionally adequate, weaning food. A premise of the project was that the development and introduction of any new weaning food should be based upon ingredients available in the community and to households, at a low cost and with minimum preparation time, and that would be culturally acceptable by mothers for feeding young children. Initially, research was conducted to define the problem in both nutritional and anthropological terms. Data was collected to describe: (1) present patterns of infant feeding and their determinants; and (2) dietary intake and nutritional status of infants in the intervention area. This paper focuses on the process of defining the problem and developing an intervention from an interdisciplinary perspective. The development of the new weaning food, Eko-Ilera, a fortified pap based on the traditional weaning food, is described.

Breast Feeding↗
PubMed1984

National Nutrition Monitoring System: a historical perspective.

The basic goal of nutrition strategy in the United States has been to ensure an adequate intake of all essential nutrients for the population. To achieve this goal, emphasis has been placed on human nutrition research, studies of the dietary and nutritional status of the population and its subgroups, and the expansion of federal programs to directly and indirectly enhance food consumption patterns, nutrient intake, and the health of the nation's citizens.

Diet Surveys↗
PubMed1978

Dietary status of lactating women. II. Relation of nutritional knowledge and attitudes to nutritional intake.

Dietary practices of sixty-one nursing mothers who had been breast-feeding their infants an average of four months were examined in relation to their knowledge of nutrition and their attitudes about nutrition, taking vitamin supplements, meal preparation, and meal planning. The women were fairly knowledgeable about nutrition, and most exhibited an attitude that "nutrition is important". Nutritional knowledge, as measured by performance on a reliable test instrument, correlated well with the attitude that "nutrition is important" and with education. Nutritional knowledge also correlated well with four dietary factors used as dependent variables. Associations between nutrition-related attitudes and dietary factors were much less strong. Path analysis was used to test the knowledge-to-attitudes-to-behavior paradigm. Results, using multiple regression analysis, indicated that this model was not supported by the data. Rather, path analysis supported the model of attitudes-to-knowledge-to-behavior. This research suggests that nutrition education programs should adopt, as a primary goal, that of instilling positive attitudes about nutrition and demonstrating to learners that "nutrition is important". Once such attitudes have been formulated, ability to learn and comprehend nutritional facts and concepts will be facilitated, thus resulting in improved dietary intake of crucial nutrients.

Adult↗
PubMed2001

The independent older Australian: Implications for food and nutrition recommendations.

The World Health Organisation has restructured their program for health and the elderly, renaming it Aging and Health, focussing on aging as a part of life rather than a static age group separated from the rest of the population. As the older population becomes more heterogeneous, nutrition and food service providers in the community are faced with new challenges. This paper presents nutrition recommendations relevant to community nutrition programs in Australia including the recently released Dietary Guidelines for Older Australians. The subsequent discussion focuses on issues associated with implementation of community based food and nutrition intervention programs. The following strategies for successful implementation of community based food and nutrition programs were identified: Meals on Wheels services. 1. should maintain a register of food service systems for each site to assist in the planning process. 2. Develop a procedure for the nutritional assessment of menus focussing on a standardised methodology and recipes as well as ensuring trained staff are available to apply the procedure. 3. Validate recommended serving sizes and recommend serving utensils for specific menu items. Provide advice on the purchasing, use and calibration of scales as well as containers. 4. Develop alternative, informal methods of assessing client satisfaction to ensure the clients' experience with the service, rather than their reaction to the experience, be assessed. 5. Develop a management training program which focuses on a "train-the-trainer' strategy to ensure continuous, on-site training. Meeting the nutritional needs of the heterogeneous group of older people implies a modified approach to nutritional support. All those involved in community nutrition organisations need to recognise the significance of the "caring" role as well as that of food provider and the impact of this on the nutritional status of the client. The development of consistent guidelines and tools will assist organisations in meeting the needs of their target groups. As professionals we need to understand and accept the constraints that these organisations deal with to ensure the services we provide are appropriate. These constraints include all of those issues detailed in this paper - production capability, training resources and the availability of volunteers.

Aged↗
PubMed2001

The realization of a project aimed at reducing the plasmatic lipid level in a large Italian population improves the mean calcium daily intake: the Brisighella Study.

OBJECTIVES: Evaluation of the impact of a coronary heart disease prevention program on calcium, magnesium, phosphorus and vitamin D dietary intake in respect of recommended daily allowances in a large Italian rural population. DESIGN: Retrospective analysis of the Brisighella Study dietary data. The Brisighella Study started in 1972 as a longitudinal study on atherosclerosis risk factors. SETTING: Brisighella, a rural North Italian village. SUBJECTS: The Brisighella population's dietary habits were monitored from 1980 every 4 h through a dietary record sheet. 1,350 constantly tested subjects were subdivided according to NHI Consensus Conference on Calcium RDA. INTERVENTION: In 1986, the studied subjects were invited to reduce their consumption of animal fats and cholesterol through a Nutrition Educational Program (NEP). RESULTS: Before NEP, calcium intake was low in each sex and age category: 20-40% of the populatioin had a daily intake < 550 mg. In 1988, among the 1350 subjects who constantly completed the questionnaire (M = 651, F = 699), the mean calcium intake significantly rose in all age categories: M = 1,003 (25-65 y) and 877 ( > 65) mg/24h (P < 0.001 vs 1984); F = 923 (25-50), 860 (51-65) and 767 (> 65)mg/24h (P < 0.05). In 1992, 3y after the NEP conclusion, calcium intake dropped in each sex and age category. The NEP influenced vitamin D, phosphorus and magnesium intakes less. CONCLUSIONS: A collective NEP aimed at lowering saturated fats and cholesterol intakes, improves the calcium intake; in order to maintain their efficacy on nutritional habit changes, these programs must become an ongoing item.

Adolescent↗
PubMedDate not supplied

Anemia as an indicator of nutrition in children enrolled in a Head Start program.

A retrospective chart review was conducted on the records of 467 children who were enrolled in the Head Start program in Alachua County, Florida, which is one of four counties in Florida cited among the 150 worst "hunger counties" in the United States by the Harvard University School of Public Health. The children were examined in the 1989-1990 school year by a team of nurse practitioners, and the data were analyzed to determine the incidence and distribution of anemia. Twenty-five percent of the sample was white, and 75% was black. One half of the white children and 20% of the black children attended schools in rural areas. The mean sample hematocrit value was 35.7%. Twenty-one percent of the sample had hematocrit values of less than 34.0%. More black children were anemic in both rural and urban groups. Black males had the highest rate of anemia at 27.3%; white females had the lowest rate of anemia at 9.8%. These data show that anemia is a serious problem among children from low-income families and suggest that government nutrition programs such as food stamps and WIC are not meeting the needs of these children.

Anemia, Hypochromic↗
PubMed1997

Nutritional screening for the elderly: a CNS role.

Detection and treatment of nutritional disorders has surfaced as a major health concern for older persons. This article explores how one clinical nurse specialist (CNS) used advanced practice knowledge and skills to develop a nutritional screening program for an elderly population served by a nursing clinic. A study was conducted to determine the prevalence of risk factors for poor nutritional status in these elderly clients according to the Nutritional Screening Initiative. Eighty-two percent of the clients in the study presented with two or more risk factors for poor nutritional status. Therefore, a proposal was developed for a standardized screening and treatment program.

Aged↗
PubMed1996

The national 5 A Day for Better Health Program: a large-scale nutrition intervention.

As cancer gains on heart disease as the leading cause of death, there is increased urgency to improve the current diet that contributes to 35 percent of cancer deaths. Lacking have been consensus about the strength of the science base, political will, resources, and conceptualization about what can be done in communities to change dietary behaviors. Over the past 10 years, the 5 A Day for Better Health Program has emerged as the major population-based initiative for nutrition and cancer prevention. The 5 A Day Program is a national theory-based program that approaches Americans with a simple, positive message: eat five or more servings of fruit and vegetables daily as part of a low-fat, high-fiber diet. This article describes the elements and theories woven into the national 5 A Day Program, provides a description of the important components of the program, and outlines the issues that will face dietary change initiatives in the future.

Community Participation↗
PubMed1992

Characteristics of the nutrition provider in corporate and hospital wellness programs.

This two-phase research project was conducted to examine the content of corporate- and hospital-sponsored wellness programs and to determine the characteristics of the nutrition provider. In the first phase of the study, a questionnaire was sent to 150 wellness program directors located throughout the United States to determine the nature of their total wellness program. In the second phase, questionnaires were sent to the nutrition provider to elicit specific information on the characteristics and requirements for that position. Results indicated that corporate- and hospital-sponsored wellness programs offered a variety of activities. Those incorporating a nutrition component offered a range of events from nutrition assessment to individual counseling and disease awareness programs. The position of nutrition provider was most often held by a 26- to 46-year old woman with a master's degree and experience and educational background in an allied health field other than dietetics or nutrition. Registered dietitians were more likely to be responsible for the nutrition component of a hospital program than of a corporate program. Our results suggest that opportunities exist for registered dietitians in the field of health promotion and wellness.

Adult↗
PubMed1992

Role of food and nutrition in the health perceptions of young children.

Sixty healthy children, 4 to 7 years of age, were interviewed to evaluate their health perceptions in general and to determine the degree to which they included food and eating behavior in their perceptions. Individual interviews with children incorporated both closed-ended and open-ended questions. Concept maps were used to analyze interview transcripts. The pretest/posttest experimental design randomly assigned children to experimental and control groups. Children in the experimental group completed a 4-week, home-based, nutrition education program to determine the feasibility of changing children's health perceptions with an educational intervention. Pretest and posttest health perception scores were compared by analysis of covariance. Results indicated that children perceived nutrition as a meaningful concept in relation to their health perceptions at pretest, but that after program participation, children significantly increased their perception that health and nutrition were related concepts. Our findings indicate that young children are cognitively ready to learn more about food, nutrition, and health than previously thought, but closed-ended questions may not be sensitive enough to evaluate their learning at this age.

Attitude to Health↗
PubMed1998

Clinical nutrition: opportunity in a changing health care environment.

This article summarizes presentations from a satellite symposium, "Clinical Nutrition: Opportunity in a Changing Health Care Environment," held July 26, 1997, at the 37th annual meeting of the American Society for Clinical Nutrition in Montreal. The symposium was cosponsored by the American Society for Clinical Nutrition and the American Society for Parenteral and Enteral Nutrition. The diverse topics served as a practical forum for sharing information on innovative responses, concerns, and impediments in the rapidly evolving practice environment.

Enteral Nutrition↗