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PubMed1996

The effectiveness of weekly iron supplementation regimen in improving the iron status of Chinese children and pregnant women.

It is evident that intermittent iron supplementation is better than daily supplementation in two aspects: iron absorption is more efficient and has insignificant side effects in contrast to the daily dose. The significantly higher daily iron loss observed in the daily iron supplemented groups rats also suggests alterations in total body iron metabolism. Based on serum ferritin distribution patterns, intermittent iron supplementation avoids temporary iron overload with daily iron supplemented. We conclude that weekly iron supplementation scheme is safer and easier to administer. This feasible strategy for the control of iron deficient anemia in pregnant women and children would be an effective iron-supplementation program (Baily et al., 1993).

Animals↗
PubMed1983

Dietary trends in Western Europe.

The documentation available on prevailing dietary trends and of relative nutritional status of the various populations in Western Europe, particularly in the European Economic Community (EEC) countries, is not homogenous, somewhat sparse, and often incomplete. It has been possible, however, to tentatively compare and evaluate the main trends of food consumption and to determine the areas and/or population groups potentially at risk for nutritional disorders. Although almost every country has drawn up national nutritional standards or allowances, there is no common agreement on criteria for the dietary typology adequate to maintain health and well-being, while respecting traditional food habits of the different areas. However, while it is evident that quantitative food consumption in Western Europe exceeds average need, marginal situations or qualitative imbalances are often observed. It would first be necessary, therefore, to promote nutritional surveillance programs in order to establish baseline values for the most vulnerable population groups and the relationships between food habits and epidemiology of nutrition related disorders, and subsequently to monitor their evolution over time and with economic changes.

Body Composition↗
PubMed1991

[Mortality in children under 5 years of age in families of marginal settlements in Guadalajara].

The purpose was, to determine the frequency of infant mortality in the marginal areas of Guadalajara and, find its association with sociodemographic and economical factors, which are known as determinant of the nutritional status of children. There were included 898 families in a cross sectional design among children who applied to the food supplementation program of ONI of Guadalajara. Through an interview and home visit, it was obtained information about sociodemographic and economical characteristics and food habits. The data was recorded and analyzed by the Dbase III Plus and Epi-Info program. It was also used Chi square test and Odds Ratio for the statistical analysis. Education of the mother and income per capita for feeding (as a percentage of the minimum salary) had a significantly and inverse association with infant mortality (P less than 0.0001 and P less than 0.001 respectively). There was also major mortality among children with no social security (P less than 0.05). The Odds Ratio for infant mortality was of 3.02 for education of the father, 8.42 for education of the mother and 6.8 for income per capita for feeding. Meanwhile the level of education and the economical situation of the studied population remain so low, it seems improbable to decrease the rate of infant mortality.

Child Welfare↗
PubMedDate not supplied

Food selection and eating patterns: themes found among people with type 2 diabetes mellitus.

OBJECTIVE: The objective of this study was to examine the beliefs and perspectives among people with type 2 diabetes mellitus about dietary requirements, food selection and eating patterns, and attitudes about self-management practices. DESIGN: Semistructured, in-depth interviews explored participants' experiences with diabetes prior to their diagnosis, participants' understanding of the guidelines for the nutritional management of diabetes, how participants applied their understanding of dietary guidelines to daily food selection and eating patterns, and the social and personal themes influencing participants' food selection and eating patterns. SUBJECTS: Interviews were conducted with members of a convenience sample of 45 men and women diagnosed with type 2 diabetes for at least 1 year. ANALYSES PERFORMED: Interviews were coded using a conceptual matrix derived from participants' statements. Common characteristics were grouped, and broad themes were identified. RESULTS: Eating patterns were influenced by participants' knowledge of diabetes management. Challenges that participants encountered when applying nutrition recommendations were linked to their prior eating practices. Dietary self-efficacy, social support, and time management were identified as mediating variables that can influence dietary behaviors. IMPLICATIONS: Diabetes nutrition education programs should increase awareness of eating history, spousal support, and time management practices. Future research should include the refinement and validation of a nutritional management model of diabetes.

Adult↗
PubMed1999

An iron treatment trial in an aboriginal community: improving non-adherence.

OBJECTIVE: To compare supervised vs unsupervised oral iron treatment in anaemic Aboriginal children living in a remote community with a 40% prevalence of iron deficiency anaemia. METHODOLOGY: A randomised unblinded clinical trial in children < 6 years presenting to a remote Health Centre with anaemia. Oral iron prescribed as a daily unsupervised dose (group A) was compared to twice weekly supervised administration (group B) over 12 weeks. Parenteral iron (group C) was reserved for failure of oral treatment. RESULTS: Only 3 of 25 children in group A responded to treatment compared to 23 of 26 children in group B (odds ratio = 7.7, 95% confidence interval 2.6-25.0). After six weeks of treatment, the mean haemoglobin rise was 0.96 g/L in group A compared to 10.9 g/L in group B and 12.4 g/L in group C. On entry to the study, 29.4% of subjects were underweight, 33.3% stunted and 35.3% microcephalic. The mean catch-up in weight/height on iron treatment over the study was only 0.28 (0.08, 0.48) Z-scores. CONCLUSIONS: Oral iron as directly observed twice weekly treatment is superior to unsupervised therapy. In view of the poor compliance with unsupervised treatment and the high prevalence of iron deficiency anaemia (along with stunting and microcephaly) in Aboriginal children in northern Australia, we propose to undertake in partnership with communities a nutritional intervention program with a high energy weaning food fortified with micronutrients (iron, vitamin A, zinc, folate) as the most effective strategy to address these nutritional problems in the weaning period.

Administration, Oral↗
PubMed2001

A collaborative model to guide program development and change: involving the users.

Organizations have different structures and cultures within which to conduct their business activities. Ranging from autocratic and rigid styles to more laissez-faire models, this report describes the program development and change model used by the Missouri Kidney Program (MoKP). Two examples illustrate how involvement of renal community professional staff and MoKP program staff in instituting and modifying program elements help to build in acceptance from the very beginning, avoiding start-up difficulties and miscues on implementation. Examples cited are the inception of the Nutritional Supplement Program and ongoing modification of the Centralized Drug Program's formulary. The Missouri Kidney Program uses a participatory approach to involve the users of service in program design and modification and historically has used this sort of approach with relative success over time.

Humans↗
PubMed1996

Economic advantage and the cognitive ability of rural children in Zaire.

Rural Zairian children (n = 32), 4 to 6 years old, were enrolled in a preschool educational and nutritional enrichment program throughout the school year. As part of the evaluative research for this program, cognitive and motor development of the children was assessed with the American Guidance Service (AGS) Early Childhood Screening Profiles (ECSP; Harrison et al., 1990) battery, adapted to the local Bantu dialect of Kituba. On the ECSP global indicator of cognitive ability, the children in the enrichment program performed significantly better than their counterparts in nearby villages, although the two groups did not differ significantly on motor development or anthropometric indicators of physical development. The results indicate that rural African children with reasonable nutritional status demonstrate significantly improved intellectual development in response to a comprehensive economic enhancement and educational enrichment program for them and their families.

Child↗
PubMed1995

The role and identity of physician nutrition specialists in medical school-affiliated hospitals. Committee on Clinical Practice Issues in Health and Disease.

This document was prepared by the Committee on Clinical Practice Issues in Health and Disease of The American Society for Clinical Nutrition (ASCN). The committee recommends that each major medical center has at least one physician nutrition specialist (PNS) who will be a regional resource for complex nutrition cases and will have a leadership role in the provision of coordinated nutrition services. The PNS will be responsible for nutrition education programs in associated schools of medicine and will be a role model for aspiring physicians. Typically, these individuals will have thorough training in human nutrition research. The PNS should be supported by a unique combination of resources including clinical earnings, teaching hospital and school of medicine salaries, state and federal funds, as well as private sector support. The ASCN should take a leadership role in developing the national identity of the PNS and in achieving recognition of board certification in nutrition.

Academic Medical Centers↗
PubMed1993

A meta-evaluation of nutrition education intervention research among pregnant women.

Inadequate nutrition during pregnancy retards human fetal growth and increases the risk of delivering a low birthweight (LBW) infant. Some studies place particular emphasis on reducing LBW through improved nutrition. Consensus documents have strongly recommended intense nutrition education programs for patients at risk. Despite this well-defined need few methodologically rigorous studies have been conducted to evaluate the behavioral impact of nutrition education for pregnant patients. Criteria are recommended in the following areas: (1) research design, (2) sample size and power, (3) specification of population characteristics, (4) measurement quality, and (5) replication. The methodological quality of completed evaluations are reviewed using these criteria. The authors advocate guidelines for future investigators for conducting rigorous trials in this critical public health area.

California↗
PubMed1976

Thirteenth Annual Lenna Frances Cooper Memorial Lecture: Nutrition education-what comes next?

Education for normal nutrition must include preventive measures against the principal health problems of the day, namely cardiovascular and gastrointestinal diseases. Preventive nutrition denotes a sufficiency of all nutrients for normal metabolic processes and the avoidance of excesses of calories, salurated fat, cholesterol, simple carbohydrates, and refined foods. The dietitian is uniquely qualified to interpret nutritional science and to apply it to daily food choices by people and must assume leadership in all program development for nutrition education, including nutrition education programs in the nation's schools. For effective, preventive nutrition education, new perspectives are needed to overcome the limitations of the simplistic, traditional approach.

Adolescent↗
PubMed1998

Medical nutrition therapy lowers serum cholesterol and saves medication costs in men with hypercholesterolemia.

This study was designed to evaluate whether medical nutrition therapy administered by registered dietitians could lead to a beneficial clinical and cost outcome in men with hypercholesterolemia. Ninety-five subjects participating in a cholesterol-lowering drug study took part in an 8-week nutrition intervention program before initiating treatment with a cholesterol-lowering medication, Patient records were reviewed via a retrospective chart review to determine plasma lipid levels at the beginning and end of the program and the number and length of sessions with a dietitian. Complete information was available for 74 subjects aged 60.8 n+/- 9.8 years (mean +/- SD). Medical nutrition therapy lowered total serum cholesterol levels 13% (P < .001), low-density lipoprotein cholesterol (LDL-C) 15% (P < .0001), triglyceride 11% (P < .05), and high-density lipoprotein-cholesterol (HDL-C) 4% (P < .05). Total dietitian intervention time was 144 +/- 21 minutes (range = 120 to 180 minutes) in 2.8 +/- 0.7 sessions (range = 2 to 4) during 6.81 +/- 0.7 weeks of medical nutrition therapy (range = 6 to 8 weeks). Analysis of covariance was conducted to examine whether mean change in LDL-C differed by number of dietitian visits. Results showed a marginal difference between the number of dietitian visits and change in LDL-C (f = 2.6, P < .084). However, the magnitude of LDL-C reduction was significantly higher with 4 dietitian visits (180 minutes) than with 2 visits (120 minutes) (21.9% vs 12.1%; P = .027). Lipid drug eligibility was obviated in 34 of 67 (51%) subjects per the National Cholesterol Treatment Program guidelines algorithm. The estimated annualized cost savings from the avoidance of lipid medications was $60,561.68. Therefore, we conclude that 3 or 4 individualized dietitian visits of 50 minutes each over 7 weeks are associated with a significant serum cholesterol reduction and a savings of health care dollars.

Adult↗