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PubMed1979

Title VII--Nutrition Program for the Elderly. II. Relationship of socioeconomic factors to one day's nutrient intake.

Food records from 466 participants in the Title VII Nutrition Program for the Elderly were analyzed to determine the relationship of eating at the program site to improvement in dietary intake and to socioeconomic factors. The subjects were divided into three groups: (a) Participants who ate at the meal site on the day of the food record, (b) participants who did not eat there on the day of the food record, and (c) non-participants. Eating at the meal site erased significant differences in dietary intake of nutrients consumed at home related to sex, education, and occupation. Seven nutrients and energy were significantly associated with these factors for both groups of persons not eating at the meal site on the day of the record. However, only sex was related to intake of nutrients (energy, protein, and thiamin) for those eating at the meal site. Women and the socioeconomically disadvantaged benefited the most from the program.

Aged↗
PubMed2006

Factors influencing implementation of the Coordinated Approach to Child Health (CATCH) Eat Smart School Nutrition Program in Texas.

The purpose of this research was to evaluate factors influencing the implementation of the Coordinated Approach to Child Health (CATCH) Eat Smart School Nutrition Program in Texas using data from the CATCH dissemination study. A mail survey was sent to school foodservice personnel (N = 213) who attended a CATCH training from August 2000 through January 2002. A response rate of 40% (n = 85) was achieved. The mean score for the percentage of CATCH Eat Smart guidelines implemented was 80.44. Multivariate linear regression analysis revealed that, after adjusting for age and number of years employed in school foodservice, the following factors were significantly associated with the percentage of CATCH Eat Smart guidelines implemented: utility of CATCH and CATCH Eat Smart in meeting requirements for Coordinated School Health Programs (P = 0.006), school foodservice personnel's satisfaction with food made using the CATCH Eat Smart guidelines (P = 0.008), utility of CATCH in facilitating interschool communication about children's health (P = 0.019), and perceived student satisfaction with food made using the CATCH Eat Smart guidelines (P = 0.046). These results suggest that dissemination approaches for Coordinated School Health Programs should focus on ways to enhance program satisfaction, be consistent with legislated mandates, and increase interschool staff communication to increase program implementation by school foodservice personnel.

Adolescent↗
PubMed2001

Postpartum iron status in nonlactating participants and nonparticipants in the special supplemental nutrition program for women, infants, and children.

BACKGROUND: Iron deficiency, a pervasive problem among low-income women of childbearing age, threatens maternal health and pregnancy outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was designed to alleviate health problems and provides supplemental nutritious foods, nutrition education, and health care referrals. OBJECTIVES: The aim of this study was to examine the benefits associated with participation in WIC in terms of biochemical tests of postpartum iron status in nonlactating women. DESIGN: WIC participants (n = 57) and eligible nonparticipants (n = 53), matched by race and age, were followed bimonthly over 6 mo postpartum. Finger stick blood samples (500 microL) were collected for measurement of plasma ferritin, transferrin receptor (TfR), and hemoglobin (Hb). RESULTS: The mean (+/-SE) Hb concentration of participants exceeded that of nonparticipants from months 2 through 6. At 6 mo, the mean Hb concentration of participants was significantly higher than that of nonparticipants (8.01+/-0.12 and 7.63+/-0.12 mmol/L, respectively; P< 0.05) and the prevalence of anemia was significantly lower (17% and 51%, respectively; P<0.05). TfR and ferritin concentrations (consistently within the reference ranges) and dietary iron intakes did not differ significantly between participants and nonparticipants and were not correlated with Hb concentrations. CONCLUSIONS: Our results suggest that WIC participants were significantly less likely to become anemic if uninterrupted postpartum participation lasted for 6 mo. The lack of correlation among iron status indicators suggests that the lower mean Hb concentration in nonparticipants at 6 mo may not have been related to improved iron status in participants but to other nutrient deficiencies or differences in access to health care and health and nutrition education.

Adult↗
PubMed1985

Increasing malnutrition during hospitalization: documentation by a nutritional screening program.

Nutritional status can change during hospitalization. To evaluate the degree of change, a nutrition screening program (NSP) that included admission and 3-week reassessment was implemented. NSP parameters were weight for height, percentage of weight loss, arm muscle circumference, triceps skinfold, serum albumin, and total lymphocyte count. Nutritional risk factors (NRF) were also recorded: cancer, nothing by mouth (NPO) for 3 or more days, loss of appetite, difficulty chewing or swallowing, persistent fever, and cancer chemotherapy or radiation therapy. Of 15,876 patients admitted during the period of March 1982 through December 1982, 583 (3.67%) were found to be suffering from malnutrition or to have NRFs. Of the 583 patients, 182 received nutritional support and were excluded from the study. The remaining patients were reassessed after 3 weeks and had significant decreases in nutritional parameters; 622 patients with deficits in one parameter (visceral or somatic) on admission had a significant decrease in all parameters (p less than .001) on 3-week assessment. There was a deterioration in nutritional status in those patients entering the hospital with NRFs only or with one low parameter.

Body Weight↗
PubMed1987

Nutritional and biochemical effects of nutrition programs in the elderly.

The nutritional status of this population of elderly was generally quite good. However, these individuals were interested in the program and able to participate in the program. As age in years increases and the aging process continues, all the factors mentioned earlier may combine to contribute to less frequent or nonattendance and perhaps to deterioration of nutritional status. For example, an 80-year-old may be able to drive to a site, but a 90-year-old may not. Also, the older elderly may be more likely to live alone, with all the disincentives to eat well that living alone may be associated with at any age. Therefore, one cannot assume that all of the old elderly are as adequately nourished as this group. The less well nourished may be those not participating in programs for the elderly. Finally, the data presented here illustrate the need to learn more about the differences between middle-aged elderly and the old elderly, and to better differentiate pathologic from normal aging processes.

Aged↗
PubMed2006

Lower breastfeeding rates persist among the Special Supplemental Nutrition Program for Women, Infants, and Children participants, 1978-2003.

OBJECTIVE: We set out to compare rates of breastfeeding between women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with those of non-WIC mothers from 1978 to 2003. METHODS: The Ross Laboratories Mothers Survey is a national survey designed to determine patterns of milk feeding during infancy. Mothers were asked to recall the type of milk fed to their infant in the hospital and during each month of age. Rates of breastfeeding in the hospital and at 6 months of age were evaluated. Logistic regression analyses identified significant predictors of breastfeeding in 2003. RESULTS: From 1978 through 2003, rates for the initiation of breastfeeding among WIC participants lagged behind those of non-WIC mothers by an average of 23.6 +/- 4.4 percentage points. At 6 months of age, the gap between WIC participants and non-WIC mothers (mean: 16.3 +/- 3.1 percentage points) steadily increased from 1978 through 2003 and exceeded 20% by 1999. Demographic factors that were significant and positive predictors of breastfeeding initiation in 2003 included some college education, living in the western region of the United States, not participating in the WIC program, having an infant of normal birth weight, primipary, and not working outside the home. For mothers of infants 6 months of age, WIC status was the strongest determinant of breastfeeding: mothers who were not enrolled in the WIC program were more than twice as likely to breastfeed at 6 months of age than mothers who participated in the WIC program. CONCLUSIONS: Breastfeeding rates among WIC participants have lagged behind those of non-WIC mothers for the last 25 years. The Healthy People 2010 goals for breastfeeding will not be reached without intervention. Food package and programmatic changes are needed to make the incentives for breastfeeding greater for WIC participants.

Animals↗
PubMed1983

Pharmacy department costs and patient charges associated with a home parenteral nutrition program.

The pharmacy department costs of a home parenteral nutrition (HPN) program were identified, and the patient charges for HPN were compared with the charges for hospitalization for parenteral nutrition. Ten patients were randomly selected from 55 patients active in the HPN program at the University of Washington Hospital. Cost identification included quantification of supplies, personnel, equipment, freight, miscellaneous, and indirect costs. Patient charges were identified through billing documents. Charges included clinic visits and laboratory tests. Inpatient charges were identified in a similar manner and included a standard daily hospital charge. Average yearly costs to the pharmacy department were nearly +9000 per HPN patient. Patient charges for HPN were +48.19 per infusion day compared with +205.68 per infusion day for the hospitalized patient. The cost savings of HPN to the patient and the hospital were clearly demonstrated.

Costs and Cost Analysis↗
PubMed2005

Factors influencing the initiation and duration of breastfeeding among low-income women followed by the Canada prenatal nutrition program in 4 regions of quebec.

The factors that influence the actual initiation and duration of breastfeeding were studied among low-income women followed by the Canada Prenatal Nutrition Program (CPNP). A group of 196 pregnant women were selected at random from a sample of 6223 pregnant women who registered with the CPNP. Two 24-hour recalls and information regarding lifestyle habits, peer support, and infant-feeding practices were obtained between 26 and 34 weeks of gestation and 21 days and 6 months after birth. Women who received a university education (completed or not completed) versus women with < or = high school education (odds ratio [OR], 8.40; 95% confidence interval [CI], 1.02-69.50), women born outside Canada (OR,8.81; 95% CI, 3.34-23.19), and women of low birth weight infants (OR, 0.39; 95% CI, 0.16-0.96) were more likely to initiate breastfeeding. Late introduction of solid foods (P = .004), nonsmoking (P = .005), multiparity (P = .012), and a higher level of education (P = .049) were positively associated with the duration of breastfeeding among initiators. Understanding factors associated with initiation and duration of breastfeeding among low-income women is critical to better target breastfeeding promotion.

Adult↗
PubMed1982

[Nutrition programs and levels of health care].

Population health and nutrition situations present different degrees of complexity which must be met with different degrees of technological complexity. This can be accomplished by organizing, in a progressive way, the resources of the health service system to constitute different levels of attention. In this paper, the concept of levels of attention of the health service system is analyzed on the basis of the aforementioned ideas, and comments are made on the increasing administrative complexity required to keep pace with the increasing technological complexity. Mention is made of the criteria which must be taken into account in order to select nutrition activities to be performed in the health sector and the way in which these activities must conform to the different levels, according to their degree of specialization and complexity. Special reference is made of experiences where the basic or primary level activities involving community participation are particularly important. Finally, the incorporation of nutrition as a part of the attention routine at the various levels is discussed; here, the importance of the necessary mechanisms for coordination and support among the various levels is stressed.

Adult↗
PubMed1995

Evaluating community-based nutrition programs: comparing grocery store and individual-level survey measures of program impact.

BACKGROUND: This paper examines whether an "environmental indicator"--a survey of grocery store product displays--can provide a realistic alternative to individual-level telephone surveys for the evaluation of community-based nutrition programs. METHODS: Telephone and grocery store measures were used separately to evaluate three community-level dietary interventions that were part of the Kaiser Family Foundation Community Health Promotion Grants Program (CHPGP). Both surveys were conducted in the three intervention and seven control communities at three points in time: 1988, 1990, and 1992. The grocery store survey recorded the relative availability of low-fat and high-fiber products and the amount of store-provided health-education information. Self-reported dietary intake of residents was obtained in the same communities using a telephone survey. RESULTS: In the one community in which the intervention seemed to have contributed to reduced fat consumption, the grocery store and telephone surveys showed very similar relative changes for the only variable they had in common, low-fat milk consumption. In another community, both survey approaches indicated that there was no change or perhaps a slight worsening in the treatment relative to the controls. The third community produced the only contradictory results: the telephone survey suggested no change or perhaps a worsening, while the grocery store results were generally positive, though not statistically significant. CONCLUSION: These results, combined with the much lower cost of the grocery store survey, justify further pursuit of environmental indicators as an evaluation tool.

Diet↗
PubMed1990

Fatty acid pattern outcomes of a nutritional program for overweight and hyperlipidemic Australian men.

There is growing recognition of the value of changing tissue fatty acid patterns in their own right as coronary risk factors. To examine the effects of a conventional nutritional program on plasma triglyceride (TG), cholesterol ester, and phospholipid fatty acid patterns, a group of 20 hyperlipidemic men and a control group (n = 6) of normolipidemic men were followed for 6 months. As an index of change in energy balance in the hyperlipidemic men, body mass index decreased from 26.5 to 24.4 kg m-2 (an 8% decrease) at 6 months. Saturated fat intake fell from 46.7 to 25.3 g/day (a 46% decrease). Dietary polyunsaturated:saturated fat ratio (P:S) rose from 0.38 and to 0.70 (an 84% increase) at the 6-month review. Ethanol intake fell from 18 to 15 g/day (a 17% decrease). Changes in plasma fatty acid (FA) patterns were found in TG, cholesterol ester, and phospholipid fractions at the 6-week to 3-month period, and these changes were maintained at 6 months. Of the factors possibly contributory to plasma FA pattern change in these men, dietary FA intake underwent the greatest percentage shift and therefore probably makes an important contribution to the change. It was of interest that fatty acid patterns in plasma neutral lipids (triglyceride, cholesterol ester, and phospholipid) significantly predicted body mass index and serum total cholesterol, triglyceride, and high-density-lipoprotein cholesterol.

Adult↗
PubMedDate not supplied

Nutritional program for heart transplantation.

Methodist Hospital has completed 52 heart transplants during its 4 1/2-year history. Dietary restrictions for patients have been deemed necessary to offset the side effects from medication. The purpose of this article is to provide information regarding the nutritional program for heart transplant recipients. Evaluation of the dietary program, changes made, and problems encountered are discussed. The first 10 patients were instructed on a type IIA hyperlipoproteinemia (300 mg cholesterol), no concentrated sweets, and 2 to 4 gm sodium-restriction diet with no fresh fruit or vegetables for 6 weeks after the transplantation. These patients had limited follow-up dietary instruction. Of these patients, 50% (five of 10) gained 50 pounds or more above their pretransplant and/or desirable weight; two died within 1 year, and another two within 18 months with accelerated coronary atherosclerosis documented at autopsy. These results were considered unacceptable. The current diet after heart transplantation is 200 mg cholesterol, low saturated fat, low total fat, high fiber, 4 to 5 gm sodium, with limited concentrated sweets. The goals of this diet are discussed. Patients receive nutritional assessment before and after transplantation, care monitoring, and individualized dietary instruction, as well as outpatient follow-up done by the transplant team dietitian as needed. Of these patients, 20% (five of 25) gained 50 pounds or more, and one died with arteriosclerotic-related complications within the first year. The patient's nutritional status before transplant, previous eating habits, educational level, consistency in physician and team member reinforcement of diet are all major factors in long-term compliance.

Adult↗
PubMed2002

Persistence and emergence of anemia in children during participation in the Special Supplemental Nutrition Program for Women, Infants, and Children.

CONTEXT: The prevalence of iron-deficiency anemia in children has decreased owing to the provision of iron-containing infant formula and cereal and food vouchers to children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). OBJECTIVE: To determine the prevalence of anemia and changes in anemia status in children receiving WIC supplementation. DESIGN: Retrospective cross-sectional and longitudinal analysis of information on WIC participants. Two definitions of anemia were considered separately: Anemia1 and Anemia2, the latter using a more stringent definition of anemia to avoid misclassification. PARTICIPANTS: Consecutive cohort of 7053 infants and children aged 6 to 59 months. MAIN OUTCOME MEASURES: Prevalence of anemia by age and race or ethnicity and relationship between anemia and sex, birth weight, and weight-for-height z score. RESULTS: Infants aged 6 to 8 months were 3.3 times more likely to be anemic than children aged 36 to 59 months. There was no association between anemia and race, birth weight, sex, or weight-for-height z score. Anemia rates were approximately halved in the more stringently defined Anemia2 group. Among children seen for at least 3 visits (n = 2926), 8.5% developed anemia and 19.1% of initially anemic children remained anemic; an additional 6.6% developed anemia at a third visit after having had 2 normal hemoglobin measurements. CONCLUSIONS: Anemia was common in WIC participants, with infants at highest risk. The diagnosis of anemia in black children depends on the cutoff value used. Despite ongoing receipt of WIC benefits, many children develop anemia or remain anemic. Implementation of mandatory follow-up of all anemic infants by WIC or health care providers may be warranted.

Adult↗
PubMed1996

Nutritional status of children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children--United States, 1988-1991.

Recent increases in the prevalence of overweight among school-aged children (1) and adults (2) in the United States have prompted concern about an increase in overweight among preschool-aged children and a possible association with the foods provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). To assess and compare weight status and nutrient intake among WIC participants and other low-income children, CDC analyzed data from phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1991. This report summarizes the results of this analysis, which indicate that foods provided by WIC are not associated with increased overweight among preschool-aged children.

Adult↗
PubMed2006

Diet, activity, and overweight among preschool-age children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

INTRODUCTION: Overweight is affecting children at younger ages and in increasing numbers, putting them at risk for a lifetime of chronic disease. Consumption of unhealthy foods and time spent watching television have increased concurrently. METHODS: Parents of 526 children aged 2 to 4 years old enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) answered questions about their children's food and beverage consumption, television-viewing and computer time, and physical activity. The children's height and weight measurements were collected from administrative records. Crude and adjusted odds ratios were calculated to test for associations between demographic, consumption, and activity variables and overweight or at risk of overweight (body mass index > or =85th percentile for age and sex). RESULTS: Of the participants, 38% of the children were overweight or at risk of overweight. Hispanic and white children were twice as likely as black children to be overweight or at risk of overweight. Fifty-eight percent of the children drank more than one and 30% drank more than two 8-oz servings of fruit juice per day. The children who drank more than one serving of nonjuice fruit drink per day (30%) had increased odds of being overweight or at risk of overweight. On average, the children spent more than twice as much time watching television and using computers as they did engaging in physical activity. In multivariate analyses, race and ethnicity as well as physical activity were associated with being overweight or at risk of overweight. CONCLUSION: Efforts to improve nutrition and prevent overweight in children should focus on the parents of infants and toddlers and provide them with anticipatory guidance on physical activity for young children and nutrition and food transitions.

Black or African American↗
PubMed1993

Developing nutrition programs for high producing dairy herds.

Herd average milk production continues to increase in the US. Average milk production in Holstein herds enrolled in DHI testing programs surpassed 9000 kg in some states in 1991. Individual dairy herds have produced > 14,000 kg per cow per lactation. The upper limit for milk production per cow continues to increase. A challenge exists in developing nutrition programs for these herds. The goal is to attain efficient and profitable levels of milk production while maintaining herd health and reproductive performance. Evaluation of rations currently fed to high producing herds indicate that these rations are consistent with current nutrient requirement guidelines. Many high producing herds have average DMI > 4% of BW. Ration formulation principles and nutrient requirements used in development of feeding programs for high producing herds are similar to methods already in use. Optimizing DMI, optimizing rumen fermentation, and providing supplemental nutrients are key factors in meeting tissue nutrient demands in this formulation process.

Animal Feed↗