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PubMed1989

Childhood nutrition education in health promotion and disease prevention.

In the last 10 to 15 years, nutrition has become a major component of health promotion and chronic disease prevention. Two widely recommended strategies for incorporating nutrition education directed toward children and youth into health promotion and disease prevention efforts are school-based nutrition education and the integration of nutritional care into health care. School-based nutrition education programs targeted toward very specific eating behaviors are showing very promising results in regard to behavior and attitude change of children and adolescents. Substantial changes in health care providers' attitudes and practices and in the funding and financing of health care will be needed if nutrition education delivered in the context of routine health care is to be a major force in health promotion and disease prevention for youth.

Adolescent↗
PubMed1995

Utilization of ICDS scheme in children one to six years of age in a rural block of central India.

The evaluation of nutritional and immunization services was undertaken in the rural ICDS block Sanwer (Madhya Pradesh) where the project is functioning from last 3 years. A door to door survey was conducted in 1993 in six Anganwadi areas in ICDS block and five randomly selected matched non ICDS rural area served as controls. There were a total of 709 children in ICDS and 500 in non ICDS block in 1-6 years age group. The difference was not statistically significant for nutritional status in the two blocks, but a remarkably better immunization status (p < 0.005) was observed in non ICDS block. The coverage for DPT (3 doses), and measles vaccination in ICDS block was 79.57% and 45.7%, respectively, while in non ICDS block it was 94.4% and 62.03%, respectively. It seems the ICDS scheme is under utilized by the community and requires immediate attention by the health authorities.

Child Nutritional Physiological Phenomena↗
PubMed1993

[Early severe malnutrition and psychomotor development. Effects of a rehabilitation program].

This study evaluates the psychomotor development of 228 undernourished infants submitted to an integral rehabilitation program in Nutritional Recovery Centers. At admission these children present a moderate retardation of their developmental quotient: mean 0.59 +/- 0.17, improving significantly to mean 0.79 +/- 0.4 (p < 0.001) after an average period of 178.2 +/- 63.9 days of intervention. As regards areas of development, rehabilitation only demonstrates a significant change in coordination and language, not so in the social and motor areas. Those children presenting the most severe developmental delays are also those who obtain the greater benefits from this integral rehabilitation program.

Developmental Disabilities↗
PubMed2000

[Value of a nutrition score in patients with advanced carcinomas in the area of the head and neck].

BACKGROUND AND OBJECTIVE: Patients with advanced head and neck cancer often suffer from malnutrition even before the start of therapy. Hence, the demand for nutritional support increases particularly before and during radiochemotherapy. Though nutritional therapy has been shown to substantially improve individual outcome, neither the criteria for patient candidacy nor the indications for therapeutic intervention have been established. We performed a retrospective analysis to determine the indications for nutritional support and < 0 evaluate the benefits of measures actually taken against malnutrition before and during radiochemotherapy as well as perioperatively. PATIENTS/METHODS: Data taken from a prospective study for the evaluation of oral mucositis during radiochemotherapy was analysed retrospectively. To calculate the indication for nutritional support, a nutritional scoring system (Hackl) was employed for the first time, which contained biochemical and anthropometric parameters as well as the period of starvation. The results were then compared to a nutritional support program implemented by the subjective examinations of the attending physician. RESULTS: Changes in body weight and body mass index (BMI) remained the most impressive parameters. Catabolic metabolism developed preoperatively and a significant loss of whole-body protein followed surgical therapy. Clinically, the results of the nutritional score correlated with the observation of malnutrition. Furthermore, our findings suggest that nutritional therapy was commonly delayed until late in the clinical course. CONCLUSION: The results indicate the necessity of objective and reproducible diagnosis and control of malnutrition. The scoring system used may provide a useful and yet simple tool for assessing individual indications for timely nutritional support.

Adult↗
PubMed2002

Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial.

BACKGROUND: The study objective was to determine the health and quality-of-life effects of moderate-intensity exercise among older women family caregivers. METHODS: This 12-month randomized controlled trial involved a volunteer sample of 100 women aged 49 to 82 years who were sedentary, free of cardiovascular disease, and caring for a relative with dementia. Participants were randomized to 12 months of home-based, telephone-supervised, moderate-intensity exercise training or to an attention-control (nutrition education) program. Exercise consisted of four 30- to 40-minute endurance exercise sessions (brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. Main outcomes were stress-induced cardiovascular reactivity levels, rated sleep quality, and reported psychological distress. RESULTS: Compared with nutrition participants (NU), exercise participants (EX) showed significant improvements in the following: total energy expenditure (baseline and post-test means [SD] for EX = 1.4 [1.9] and 2.2 [2.2] kcal/kg/day; for NU = 1.2 [1.7] and 1.2 [1.6] kcal/kg/day; p <.02); stress-induced blood pressure reactivity (baseline and post-test systolic blood pressure reactivity values for EX = 21.6 [12.3] and 12.4 [11.2] mm Hg; for NU = 17.9 [10.2] and 17.7 [13.8] mm Hg; p <.024); and sleep quality (p <.05). NU showed significant improvements in percentages of total calories from fats and saturated fats relative to EX (p values <.01). Both groups reported improvements in psychological distress. Conclusions. Family caregivers can benefit from initiating a regular moderate-intensity exercise program in terms of reductions in stress-induced cardiovascular reactivity and improvements in rated sleep quality.

Athletic Injuries↗
PubMed1979

Nutrition component in a comprehensive child development program. I. The home visitor's role in the prenatal intervention phase.

Nutritional services were integrated in a comprehensive child development program for sixty-eight disadvantaged urban families in an attempt to promote maximum cognitive and psychosocial functioning in their children. Child development trainers made weekly home visits beginning in pregnancy, which combined data gathering, direct nutritional counseling, and early sensory excercises for infants. This paper describes the prenatal home visit program, the training of the home visitors, how the 24-hr. food recall method was adapted for their use, the nature of the home visits, and the complex role of the home visitor. The group whose families participated in the prenatal home visits and were also followed for six months after the infants' birth scored higher on six-month Cattell Scales than did a control group who entered the program at six months of age. There were no stillbirths or neonatal deaths. The incidence of low-birth-weight infants was lower than the national averages. Participation in the program was high.

Child Development↗
PubMed2004

Discrepancies in body image perception among fourth-grade public school children from urban, suburban, and rural Maryland.

OBJECTIVE: The objective of this study was to determine whether there is an association between body image perception and weight status as measured by the body mass index among a group of fourth graders in Maryland. DESIGN: Cross-sectional data on height, weight, and body image were collected in the classroom. At risk for being overweight and being overweight designations were assigned to participants with body mass index (BMI) percentile values for age and sex of >/=85 to <95 and BMI >/=95, respectively. Students selected a figure (range 1 to 7) to represent their current and ideal images. SUBJECTS: The subjects of this study were 524 fourth-grade public school students (54% girls; 61% white; mean age, 9.2 years) from three geographically distinct regions in Maryland (38.6% urban, 30.7% suburban, 30.7% rural). Statistical analyses chi(2) tests were used to compare weight status with sex, race, geographic location, and body image discrepancy categories. One-way analysis of variance was used to compare BMI and body image scores with sex and race/ethnicity to geographic location. RESULTS: Thirteen percent of students were overweight, and 15% were at risk of overweight. There was no association between weight status and race, body image perception, or geographic location. African Americans chose larger figures than whites and other races to represent their current and ideal images and were most satisfied with their body size. CONCLUSIONS: Perceptions of body image are formed early in life. Dietitians can provide guidance on appropriate weight and body size to children, parents, and school professionals. Dietitians can also use their influence to secure funding for nutrition education programs.

Black or African American↗
PubMed1989

Continuous ambulatory peritoneal dialysis. Eight years of experience at a single center.

One hundred and thirty-four patients using continuous ambulatory peritoneal dialysis (CAPD) for a mean time of 23.1 +/- 18.3 months (range, 1-76.6) from a single center are reviewed with respect to biochemistry, hematology, parameters of dialysis efficiency, nutrition, and the nature and frequency of complications. Cumulative patient survival was 90%, 86% and 75% at 1, 2 and 3 years, and survival of patients using this technique was 75%, 62% and 40% at corresponding time intervals with no difference demonstrated in diabetic patients or in those older than 50 years. Biochemical and hematologic parameters were well maintained with peritoneal creatinine clearance increasing and peritoneal protein loss remaining stable with ongoing CAPD. Loss of ultrafiltration, however, accounted for 17.7% of permanent transfers to alternative therapy. Low serum albumin and elevated serum triglyceride concentrations correlated with mortality, whereas low serum albumin, low cholesterol, and high phosphate levels correlated with morbidity as assessed by frequency of hospital admissions. Dietary protein intake assessed by urea generation rate was significantly lower than that estimated from a 24-hour dietary recall (0.82 vs. 1.02 g/kg/day, p less than 0.01) and with the exception of body mass index and serum albumin, anthropometric and visceral protein measurements showed few correlations with nutritional adequacy. Bacterial peritonitis remained the major complication, although fungal infections made a significant contribution to morbidity and mortality. Overall, CAPD is confirmed to be a satisfactory form of dialysis for all forms of end-stage renal failure and an integral part of any renal replacement program. However, nutritional adequacy and lowering of complication rates require further investigation.

Adolescent↗
PubMed1991

Nutrition education in supermarkets: the Lifestyle 2000 experience.

A 15-week supermarket-based nutrition education program was conducted as part of a larger multiple-strategy community-wide health promotion project. The program consisted of point-of-purchase materials displayed in the supermarkets and was supported by a mass media campaign and promotional activities such as competitions, taste testing and cooking demonstrations. The objective of the program was to promote the selection and purchase of low-fat foods, specifically low-fat dairy products, fresh fruit and vegetables, bread and cereal products. Awareness of the promotion was high, with some self-reported behaviour change. Supermarkets are potential sites for public health nutrition education and recommendations are made for improving the effectiveness of point-of-purchase promotions.

Australia↗
PubMed1984

Dietary compliance for pediatric burned patients.

Physician diet orders written for pediatric burned patients frequently differ from the diets patients actually receive. At Shriners Burns Institute in Boston, such deviations from the diet order were generally not recognized for at least two days. In order to increase compliance with physician diet orders, changes in the nutritional support program were implemented which included physician diet orders containing specific macronutrient requirements in addition to the caloric goal, which was changed in response to recent research demonstrating that the previously used formula provided excessive calories; introduction of modular diets for parenteral and enteral feedings; institution of daily nutrition flow sheets; and a change of the time at which daily caloric intake records were calculated. In order to assess the benefits of the new measures, the average deviation from the caloric goal was calculated for patients who did not receive the new assessment tools (control group, N = 51), compared with those who did (study group, N = 50). Least squares regression analysis indicated a trend toward improved compliance and less deviation from the calculated caloric goal following implementation of the four measures.

Adolescent↗
PubMed2006

Comparison of attitudes towards breakfast by Turkish fourth graders living in Turkey and Germany.

The purpose of this article is to identify and compare Turkish fourth graders attitudes towards breakfast living in Turkey and Germany. A sample group of 882 Turkish students enrolled in fourth grade in Hamburg (Germany, N=422) and Konya (Turkey, N=460) were surveyed. Independent t-tests, chi(2) test and Pearson product-moment correlations were used. More students living in Turkey had breakfast and had enough time before going to school (P<0.01). Students living in Turkey reported that eating breakfast affected them positively (P<0.01). Students living in Germany reported that eating breakfast made them feel tired (P<0.01). The consumption of breakfast cereal (P<0.05) and fruit juice (P<0.01) that had not been consumed widely in Turkey increased in Germany. Students who eat breakfast also eat lunch (r=0.296 and -0.236, P<0.01, students living in Turkey and Turkish students living in Germany, respectively). Nutrition education programs in primary schools may change Student's attitudes about breakfast and offering a breakfast programme in schools may greatly improve breakfast consumption rates.

Child↗
PubMed2005

A "contract for change" increases produce consumption in low-income women: a pilot study.

This study determined whether a "Contract for Change" goal-setting exercise enhanced the effectiveness of the Expanded Food and Nutrition Education/Food Stamp Nutrition Education programs to increase produce consumption in low-income (<130% of poverty) women after 4 weeks. Thirty-eight participants were randomized in this three-group parallel arm study: (a) control group participants received life-skills lessons, (b) the education group received the Expanded Food and Nutrition Education/Food Stamp Nutrition Education "Food Guide Pyramid" lessons, and (c) the contract group also received the "Food Guide Pyramid" series and completed a "Contract for Change." It was hypothesized that the contract group would have the greatest increases in advancement toward dietary change and produce consumption. Compared with controls, the contract group significantly moved toward acceptance of vegetable consumption (P < or = .05). Compared with the education group, the contract group significantly increased fruit consumption. Results suggest that nutrition professionals can effectively use goal-setting to assist low-income populations with dietary change.

Adult↗
PubMedDate not supplied

[Descriptive analysis of the nutritional support in a polyvalent intensive care unit. Complications of enteral nutrition].

OBJECTIVE: Description of the nutritional support in an intensive care unit. REFERENCE POPULATION: Patients hospitalized in our ICU over a period of 48 months (October 1994-September 1998). INTERVENTIONS: The study was carried out by means of a review of the two data bases generated, one by using the clinical history management program, and the other by using the artificial nutrition program. RESULTS: Nutritional support is used in 31% of the non-coronary patients, predominantly medical (61%), and followed by surgical (29%) and trauma (9%) cases. These patients presented an APACHE (17.7 +/- 15), a hospitalization (15.8 +/- 14.9) and a mortality (26%) that was greater than that in non-coronary patients who did not require the nutritional support. The delay in starting the nutritional support is 2.8 +/- 1.9 days. In decreasing order, the nutritional support is most used in medical (42%), trauma (37%) and surgical (18%) patients. The access route is similar, enteral in 55% of the cases, with a predominance of medical patients, and parenteral in 45% of the cases, with a predominance of surgical patients. In 100 patients with a nutritional support in excess of 10 days, it was found that 87% at some time were given this enterally. In this group we studied the gastrointestinal complications, finding these in 61% of these patients, with the most frequent complication being an increase in the gastric residue (44%). Diarrhea was found in 14% and broncho-aspiration in 3.4%. The enteral route as the initial access failed in 25% of these cases, thus requiring parenteral nutrition. CONCLUSIONS: In our unit we used nutritional support in 31% of the non coronary patients, and these presented a greater severity, longer hospitalization, and higher mortality than those patients who did not require this. The beginning of the nutritional support is relatively early. The gastrointestinal complications derived from enteral nutrition are very common, with a predominance of gastric retention. In 25% of the critical patients who begin enteral nutrition, this fails, and thus they require parenteral nutrition.

Coronary Disease↗
PubMed1980

The dietary survey and the assessment of food intake in the pre-school child. A review.

To obtain an accurate record of an individual's food intake in the assessment of his nutritional status is a difficult task. To obtain such a record for an infant is more difficult still, involving the close cooperation between the investigator and the infant's mother. Why there has been little progression in methodology from the earliest days of recording individual food intakes is discussed and areas of improvements are suggested. Accuracy could be improved if techniques were streamlined and objectives more clearly defined. Dietary surveys could provide data of value to other workers in the field by using conventions in data collection and in the reporting of results.

Child Nutritional Physiological Phenomena↗
PubMed1990

Breastfeeding and growth monitoring.

One of the main reasons women stop breastfeeding is they lack confidence in their ability to produce enough milk. Growth monitoring gives them the confidence by showing their baby's satisfactory growth. There are ten pitfalls to growth monitoring programs however: (1) the emphasis on a curative rather than a preventive approach; (2) monitoring starts too late; (3) programs emphasize nutritional status rather than growth status; (4) the chart is not used to prompt a dialogue with the mother on meaning; (5) health workers do not listen to find out why some babies are succeeding and others are not; (6) insufficient attention is paid to training and supervision, and programs should address the child's total environment; (7) growth monitoring is seen as isolated from other aspects of health care; (8) the community should become involved in addressing growth problems; (9) additional food is often seen as the only activity rather than separating the preventive strategy of growth monitoring from the curative activity; and (10) growth monitoring itself achieves little unless it leads to growth promotion.

Breast Feeding↗
PubMed1999

Dietary studies on two rural italian population groups of the Seven Countries Study. 3. Trend Of food and nutrient intake from 1960 to 1991.

OBJECTIVE: To examine the trend of food and nutrient intake from 1960 to 1991 of the subjects of two rural Italian cohorts of the Seven Countries Study. DESIGN: Longitudinal study of dietary patterns from 1960 to 1991. SETTING: Two rural Italian cohorts of Seven Countries Study: Crevalcore in the North near Bologna and Montegiorgio in the Centre near Ancona. SUBJECTS: Men aged 40-59 y in 1960 examined every 5 or 10 y until 1991. METHODS: Food intake was assessed by the dietary history method on all available subjects and by the weighed record method in a statistically selected subsample. RESULTS: A marked decrease of energy intake was observed, due not only to the aging process but also to a remarkable reduction of working activities and life habits. The trend of food group intake as percentage of energy shows an increase for milk, cheese, meat, vegetables, fruit, sweet beverages and cakes, pies and cookies and a decrease for bread and alcoholic beverages, which were more marked in Montegiorgio. The evaluation of the above changes by a Mediterranean Adequacy Index provided the following values: in Crevalcore in 1965 2.9 and in 1991 2.2; in Montegiorgio the corresponding values are 5.6 and 3.9. The Mediterranean Adequacy Index of diet of men from Nicotera (the third rural cohort examined only in 1960), considered the Reference Italian-Mediterranean Diet, is 7.5. Accordingly, in both cohorts dietary habits, different at baseline and rather far from the Reference Italian-Mediterranean type (especially in Crevalcore) became worse with time, particularly in Montegiorgio. CONCLUSIONS: The changes observed in 31 y in the diet of men from Crevalcore and Montegiorgio suggest the necessity in the longitudinal nutritional epidemiology studies particularly in rapidly changing societies to assess the trend of food intakes and the factors related to it. This is in view of the promotion of nutrition intervention programs.

Anthropometry↗