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PubMed1984

The National Evaluation of School Nutrition Programs: data analysis methods.

An overview of the analytic methods used in the National Evaluation of School Nutrition Programs is provided. A path model is described that shows the hypothesized relationships between outcome and predictor variables. The outcome variables are participation in the School Nutrition Programs and the effects of participation on family food expenditures and student dietary intake and anthropometric measurements. Individual student participation in the programs is seen as the last of a series of participation decisions that include the school's decision to offer the program and the prices charged for meals. Selection of specific statistical and structural models to present these relationships are discussed. The decision to use ordinary least square estimates of impact rather than a modified two-stage least squares approach is explained.

Anthropometry↗

PubMed1984

[A simple method for reviewing the curriculum of the Nutrition Program of the University of Costa Rica].

The article explains that, in drawing up and reviewing the Nutrition Program of the University of Costa Rica, it was viewed as important to determine the kind of professional to be produced. To find the answer, the methodology proposed in 1974 by Segall and associates for systematic course design was adopted. Based on the country's needs, two specific posts were described that should be filled with priority: Chief of a food service, and chief of the nutrition program in a health region. Professionals in each of those fields collaborated in defining the duties of each post and the skills, knowledge and attitudes required to enable a nutritionist to perform them well. The resulting list is distributed for each course and used as a basis for defining the aims of the Program and its courses.

Costa Rica↗

PubMed1979

The nutrition program for older Americans. Evaluation and recommendations.

A nutrition program for older Americans, funded under Title VII of the Older Americans Act of 1965, as amended, which served 547 persons over fifty-nine years of age, was evaluated. The results indicate the desirability of: (a) Employing dietitians to administer the program at regional, state, and area levels; (b) serving meals at least five days a week; and (c) including more than one-third of the Recommended Dietary Allowances in the meals served. Women, the socioeconomically disadvantaged, and the oldest senior citizens appeared to be helped the most by these programs. Analysis of blood samples indicated that emphasis on serving vitamin A- and ascorbic acid-rich fruits and vegetables and 3 oz. meat in each meal is warranted.

Aged↗

PubMed1991

Volunteer labor contribution in nutrition programs for the elderly.

Using the productivity ratio, labor min/meal, this study analyzed the contribution of volunteer as well as paid staff in the congregate and home delivered meal services of eight nutrition programs for the elderly. A simple monitoring instrument was used to record volunteer and paid staff work activities. The contribution by volunteers was substantial and varied significantly among the centers and by number of meals served. Volunteer time was greater than paid staff time for the service and cleaning components of congregate service and for the transportation component of home delivered service. Understanding the volunteer contribution in elderly nutrition programs is important to program administrators as they make decisions for the provision of nutrition services to an expanding clientele with limited federal funding.

Aged↗

PubMed1994

An examination of demographic, socio-cultural, and health differences between congregate and home diners in a senior nutrition program.

Building upon prior research, this study investigates characteristics of participants in a senior nutrition program in Hillsborough County, Florida. The Senior Citizens Nutrition and Activities Program serves approximately 2,600 meals per day to county residents 60 years of age and over. In this study, a sample of 1,071 participants are surveyed for background characteristics, interpersonal relationships and emotional closeness, health and economic condition, emotional condition, and participation in the program. Crosstabular analyses are performed on the collected data with age, sex, and race controlled. The results indicate that the program is reaching its goals of promoting good health among the older population of Hillsborough County by providing nutritious meals and reducing social isolation, which often accompanies aging.

Aged↗

PubMed2004

Research Designs for Assessing the USDA’s Food Assistance and Nutrition Programs Outcomes, Part 2: Impact Evaluation of Demonstrations.

This is the second part of a 2-part article that summarizes a review of research designs for assessing the impact of the USDA’s food assistance and nutrition programs on nutrition and health. The first part focused on the research designs for evaluating ongoing national programs. Here, the random experiment and 3 quasi-experimental designs that can be used to evaluate the impacts of demonstration projects are reviewed.

Journal Article↗

PubMed1983

Effect of a comprehensive nutritional program on the growth and ponderosity of infants.

One hundred eighty-two consecutive newborns from a university-based private practice were enrolled in a comprehensive nutritional program in an attempt to lower the incidence of ponderosity in the group. The program emphasized an individualized approach in which the feeding instructions given to parents varied with the growth pattern of their child. Whereas specific modalities of feeding, such as breast vs. bottle and early vs. late addition of baby foods, appeared not to modify growth, the group as a whole exhibited a trend to lower weight-for-length index (WLI) and less ponderosity than in previous published reports. We propose that the individualized nutritional program may have resulted in this improvement, and that such attention to detail will likely be more rewarding than an approach which emphasizes only general nutritional information to the group as a whole.

Adult↗

PubMed2002

Stable isotope aided evaluation of community nutrition program: effect of food supplementation schemes on maternal and infant nutritional status.

The supplementation program of the community nutrition project (PNC) launched by the Senegalese Government in order to protect the most vulnerable groups (children and women) was evaluated. Using a stable isotope (deuterium), we assessed the effect of the PNC on breastmilk output, mother's body composition, and baby's growth at three months of lactation. Breastmilk triglycerides, lactose, protein, and zinc were also determined. Mothers who were supplemented more than 60 days during pregnancy showed a significant increase in fat-free mass as compared to those who were supplemented for less than 30 days (p = .03). Breastmilk output was not influenced by the supplementation, but breastmilk lactose, total protein, and zinc contents increased significantly (p < .01) in the supplemented mothers. Growth of the babies of the supplemented mothers was better than that of those whose mothers were not supplemented. It was concluded that the food supplementation had beneficial effects on both mothers' and babies' nutritional status depending on the onset of the supplementation.

Adult↗

PubMed1988

A survey of parenteral nutrition programs.

A questionnaire on parenteral nutrition (PN) programs was sent to Canadian hospital pharmacy directors in a random sample of 100 hospitals. The intent was to obtain information about the existing status of PN committees, PN teams, PN pharmacists, and the environment in which they function. Sixty-seven of the 74 respondents had PN programs. PN protocols were approved in 85 percent of the hospitals; and PN committees existed in 60 percent of the hospitals. Ten hospitals had multidisciplinary PN teams, with pharmacists on each team. Most of the hospitals required routine standardized laboratory tests for PN patients; but only 34 percent of the hospitals had developed monitoring forms. Canadian pharmacists have made progress in the area of PN, however, there are still opportunities for pharmacist involvement in the clinical areas of PN therapy.

Canada↗

PubMed1989

Foodservice trends in the elderly nutrition program.

The foodservice delivery aspects of the federally-funded Elderly Nutrition Program (ENP) were examined via an original survey instrument sent to a random sample of nutrition projects nationally. In comparison to a similar survey conducted a decade ago, projects were more apt to rely on a combination of foodservice mechanisms including caterer contracts, on-site preparation, and use of central kitchens.

Aged↗

PubMed2003

Nutritional programming of blood pressure and renal morphology.

A range of epidemiological evidence from several diverse populations, supports the hypothesis that risk of essential hypertension, coronary heart disease and non-insulin dependent diabetes is, in part, programmed by intrauterine nutritional status. Animal models developed to investigate the mechanisms that are responsible for such programming are becoming more important as challenges to the epidemiological data become more robust. With strong evidence from animal studies it is now widely accepted that maternal nutritional status in pregnancy is a major programming influence upon the fetus. This paper considers the hypothesis that renal structure and function are determined by prenatal nutrition and that this is a key mechanism in the programming of hypertension. The feeding of low protein diets or other insults in pregnancy that have an impact upon the development of cardiovascular functions, also appears to impact upon nephron number. In the sheep nephron number is related to weight at birth following nutrient restriction, and in the rat low protein diets reduce nephron number by approximately 30%. However, it is possible that hypertension and reduced renal reserve merely coincide and are not causally associated. A study of rats fed low protein diets supplemented with additional nitrogen sources found that whilst only glycine could reverse the hypertensive effects of low protein diets, all supplements could normalise nephron number. The evidence thus suggests that prenatal undernutrition may programme renal structure in later life, but that renal programming is not one of the primary mechanisms leading to hypertension.

Animals↗

PubMed1980

Organization and operation of a home parenteral nutrition program with emphasis on the pharmacist's role.

A home parenteral nutrition program was organized at Mayo Clinic-Rochester Methodist Hospital in 1975. To date, 26 patients with chronic malnutrition usually due to either severe short bowel syndrome or extensive Crohn's disease have been trained in home parenteral nutrition for a total treatment period of 430 patient-months. Home parenteral nutrition is an attractive alternative for these patients in that it dramatically improves nutrition, promotes rehabilitation at home, and probably decreases long-term expenses. The numerous medical, psychosocial, and financial problems confronting patients on home parenteral nutrition are managed through a multispecialty team consisting of physicians, pharmacists, nurse, social worker, dietitian, physiatrist, psychiatrist, and business manager. The pharmacist is the person with whom the patient has the most contact during a 2-week training period. In addition to patient education, the pharmacist coordinates the transition to home care, offers in-service education on home parenteral nutrition to nurses and house officers, tests and evaluates the equipment, coauthors a training manual, and edits a quarterly newsletter to patients who are on home parenteral nutrition.

Crohn Disease↗

PubMed2007

The impact of food supplementation on infant weight gain in rural Bangladesh; an assessment of the Bangladesh Integrated Nutritional Program (BINP).

OBJECTIVES: To examine the efficiency of the Bangladesh Integrated Nutritional Program (BINP) in identifying which infants should be supplemented, whether full supplementation was given for the stipulated period of time, and whether the correct exit criteria from the supplementation programme were used. To test whether targeted food supplementation of infants between 6-12 months of age resulted in enhanced weight gain. SETTING: Mallickbari Union, Bhaluka, a rural area located about 100 km north of Dhaka, Bangladesh. PARTICIPANTS: Five hundred and twenty-six infants followed for 6 to 12 months. RESULTS: Of the 526 infants studied, 368 should have received supplementation based on BINP criteria but only 111 infants (30%) did so, while a further 13% were incorrectly given supplementation. So in total over half (52.8%) of the sample was incorrectly identified for supplementation. In addition, less than a quarter of the infants received the full 90 days of supplementation and close to half of the infants exited the programme without the requisite weight gain. Infants were assigned to one of four groups: correctly supplemented, correctly non-supplemented, incorrectly supplemented or incorrectly non-supplemented. This classification provided natural controls; the correctly supplemented infants versus the incorrectly non-supplemented infants, and the correctly non-supplemented infants versus the incorrectly supplemented infants. There were no significant differences in weight gain between the correctly supplemented group and the incorrectly non-supplemented group or between the correctly non-supplemented and the incorrectly supplemented groups, nor was there any evidence of growth faltering in the incorrectly non-supplemented group. CONCLUSIONS: This study found serious programmatic deficiencies - inability to identify growth faltering in infants, failure to supplement for the full time period and incorrect exit procedures. There was no evidence that food supplementation had any impact on improving infant weight gain.

Bangladesh↗

PubMed1978

Nutritional programming for the elderly.

It is impossible to talk about nutrition and the elderly without reviewing related factors such as program funding levels, income and purchasing power, education, medical implications, and resulting social costs.Although we have witnessed a tremendous increase in federal appropriations for Title VII programs, many senior citizens have not and will not benefit from nutrition programs. As the ratio of elderly citizens to total population increases, we may expect: (1) an increase in program budgets with a concomitant decrease in the proportion of senior citizens served; and (2) a regressed government attitude toward income-related support programs, causing decreased purchasing power, ineffective nutrition programs, and little relative improvement in the health of our elderly population.

Aged↗

PubMed2005

Factors associated with Oklahoma Older Americans Act Nutrition Program participants ability to shop, cook, and feed themselves.

Oklahoma Older Americans Act Nutrition Program participants' (n = 859) ability to shop, cook, and feed themselves was evaluated using factor analysis and logistic regression. Congregate participants who reported they were not able to shop, cook, and feed themselves had significantly lower "mobility," "financial management," and "financial security" factor scores; home-delivered participants had significantly lower "mobility," "living arrangement" and "financial security," and higher "social interaction" factor scores. For congregate meal participants the factors "mobility" and "financial management" and for home-delivered meal participants, the factors "mobility" and "social interaction" were significantly associated with reported ability to shop, cook, and feed themselves.

Activities of Daily Living↗

PubMed2004

[Effect of a participation in a community-based nutrition program on children's outcomes].

BACKGROUND: This study aimed to assess the effectiveness of a protein-energetic malnutrition prevention and treatment community program on the nutritional status of 18 to 36-month-old children in the poor communities of the Mono Region in Benin. METHODS: Two cross sectional anthropometric surveys were conducted. The first survey took place in 1998, before the implementation of the program; the second survey was conducted three years later. At each survey, cluster samples proportional to the population size was done; the sizes of the samples were 617 in 1998 and 648 in 2001. The nutritional status of 18 to 36 month-old-children was assessed by z-score of the indexes height-for-age, weight-for-age and weight-for-height and the cut-off point of -2 standard deviation was used to identify children who had stunting, wasting or underweight; children with serious stunting, wasting or underweight were identified with the cut-off point of -3 standard deviation. RESULTS: From 1998 to 2001, there was a significant reduction in the prevalence of growth retardation (-13.1%) and underweight (-13.0%). The reductions observed for the three types of protein-energetic malnutrition were more pronounced in the 30 to 36 months age group than in the others age groups. CONCLUSION: Substantial improvement was observed during the three years activities. This improvement cannot be attributed to the program unconditionally, because there was no difference between the nutritional status of participant and non participant children.

Benin↗

PubMed2004

[A qualitative approach to nutritional programs for low-income populations].

This paper, based on a qualitative social research methodology, aims to analyze two nutritional programs through the users' perceptions. The study population consisted of frequent versus infrequent users of the program to identify similarities and differences and grasp various perspectives towards the phenomenon. Two main themes appeared in the discourse analysis: "routine functioning (of the program)" and "program user status". These themes gave rise to different categories demonstrating an association between the respective programs and poverty, as well as feelings related to this status, such as resignation, humiliation, and embarrassment. The study highlights the need to consider subjective aspects that influence social experiences and provide the basis for individual uniqueness, so that an effective dialogue between government planners and the population can be achieved.

Government Programs↗

PubMed2000

Geographic targeting of nutrition programs can substantially affect the severity of stunting in Honduras.

The effect of nutrition intervention programs in developing countries is likely to vary with the degree to which the program can be successfully targeted at the most vulnerable. In Honduras, the existence of a recent census of the height of first-grade children makes it possible to assess a priori the effect of different targeting strategies, holding constant other features of a hypothetical program. We simulate a nutrition intervention with 20% national coverage and uniform gains of 0.5 Z-scores for all beneficiaries, with a number of different approaches to targeting. The VIIth National Census of First-Graders' Heights provides the baseline scenario and permits identification of priority departments, municipalities, schools and individuals, for a total of six alternative targeting mechanisms. Effect is assessed on the basis of changes in the prevalence of stunting (less than -2 Z-scores) and in two different measures of the severity of stunting adapted from the economics literature (the malnutrition gap and the quadratic malnutrition gap). We find that the simulated program has the potential to substantially improve the severity, but not the prevalence of stunting in Honduras. Household targeting with an imperfect indicator of vulnerability could reduce the malnutrition gap by >20% and the quadratic malnutrition gap by >30%, but would be very expensive to implement. "Broad stroke" geographic targeting could reduce the same measures by 15 and 20%, respectively, and would be much less expensive to implement. We conclude that geographic targeting has the potential to substantially enhance the effect of nutrition programs on the severity of stunting in Honduras.

Body Height↗