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PubMed1981

Nutrient intake, adiposity, plasma total cholesterol, and blood pressure of rural participants in the (Vermont) Nutrition Program for Older Americans (Title III).

The interrelationships of obesity, hypertension, elevated plasma cholesterol (risk factors), and intakes of selected nutrients were examined among elderly subjects attending a congregate meal program in Vermont. Mean nutrient intakes were significantly higher for 22 males compared to 69 females. Mean plasma cholesterol levels were higher in females. Age, systolic and diastolic blood pressure, and indices of adiposity showed no sex differences. Intakes of total fat and animal protein increased in males but plasma cholesterol decreased with age. Systolic blood pressure in females increased while body mass index decreased with age. A higher proportion of females had plasma cholesterol levels greater than or equal 260 mg/100 ml and a higher proportion of females than males greater than 73 yr of age had blood pressures at risk level. There was a greater proportion of females than males with both elevated plasma cholesterol levels and adiposity. Similarly the females had greater incidence of the combination of any two risks. No males, compared to 9% of females, were in the all three risk category.

Aged↗
PubMed1995

Response rates to six recruitment mailing formats and two messages about a nutrition program for women 50-79 years old.

Recruiting participants for large prevention trials is time consuming and costly. In order to test various recruitment techniques, we conducted two studies of response rates to recruitment mailings for the Women's Health Trial. The potential participants, 50- to 79-year-old women, were requested to return an enclosed postcard to learn more about the trial. In the first study, we sent at random either a short or a long message to a group of University of Miami personnel (N = 862) and a Dade County cohort (N = 2964). More university women responded to the short message than to the long message (22.4% vs 16.4%, p = 0.024). Similarly, more of the Dade County cohort replied to the short message than to the long one (12.1% vs 9.6%, p = 0.027). The long message listed details of the intervention (e.g., modifying recipes) that some women may have used to decide they were not interested in participating. In the second study, we examined response rates to two different ways of addressing the mailing, i.e., handwritten envelopes and machine-printed labels; we also evaluated three methods for delivering the short message: (1) formal invitation, (2) business letter with an inside name and address of the recipient, and (3) business letter without the recipient's name and address. Response rates were similar between the methods of addressing envelopes and among the three vehicles for the message, suggesting that the least costly method of mailing should be used.

Aged↗
PubMed1996

Assessment and related immunization issues in the Special Supplemental Nutrition Program for Women, Infants and Children: a status report.

This article reports the results of a survey undertaken to determine the current level of collaboration between Women, Infants and Children (WIC) programs and immunization services. While the results of this study are encouraging, WIC needs to continue to place emphasis on using written or computerized immunization records for client screening, utilize available computer hardware and software to assist assessments, and expand the use of food voucher incentives as a strategy to improve coverage.

Health Services Accessibility↗
PubMed1990

Evaluating community-based nutrition programs: assessing the reliability of a survey of grocery store product displays.

A pilot test of a survey of grocery store product displays was conducted to measure the amount of health-education information provided and the proportion of the display devoted to "healthier" products. Inter-rater reliability ranged between 0.73 and 0.78 for the healthiness indices and between 0.30 and 0.67 for the health education measures. Test-retest reliability ranged from 0.44 to 1.0.

Food Labeling↗
PubMed1991

Productivity in nutrition programs for the elderly that utilize an assembly-serve production system.

Observations of labor activities of workers performing foodservice functions were made in eight senior centers at 5-minute intervals for 3 consecutive days. On-site preparation was limited to rethermalization of frozen entrees and portioning of bulk-delivered items. Time spent was assigned or allocated to either congregate or home-delivered meal service on the basis of number of meals served. Time in each component of direct work, indirect work, and delay was divided by meals served to provide the productivity ratio, labor minutes per meal. Comparisons were also made on the basis of number of meals served. An average of 12.78 minutes per meal was used to serve congregate meals and 21.05 minutes per meal for home-delivered meals. Two of the eight centers differed significantly in time used for direct work and total work to serve congregate-meal participants. There was no difference between centers in time used to serve homebound clients. The number of meals served did not influence productivity for either meal service site. These findings establish baseline data for the amount of time needed in one production system to serve meals to center participants and homebound clients. Managers of senior centers can use information about this food production and delivery system to make decisions about the most cost-effective method to provide meals.

Aged↗
PubMed1981

Assistance programs in nutrition management for dairy farms.

Successful veterinary nutrition programs have evolved over the years from little more than the use of a specific product to a ration formulation service to today's total nutritional management assistance program. A dedication to providing this total service, merged with technical help from outside consultants and sealed with experience, yields a package that is indeed valuable to the dairyman. A common thread among successful herd management assistance veterinarians is their willingness to spend time with their clients in discussing all of these areas as well as others not covered. Clients are quite willing to pay for this total service. They are not willing to pay for fragments of the total package. The dilemma of many practitioners is the fact that they do not seen to have enough time to devote to this type of program, even thought they realize they should be providing it. The poultry (and, to some extent, swine)industry faced this dilemma in past years. The unfortunate results were that very few veterinarians are now intimately involved. Dairymen are going to purchase a total service from someone in the future. No one is in a better position to offer this than the local practitioner.

Animal Feed↗
PubMed1990

Nutritional needs assessment of rural agricultural migrants of southern Brazil: designing, implementing and evaluating a nutrition education program.

A nutritional needs assessment was conducted among rural agricultural migrant women (target group) and children (less than 5 years). The study was conducted in Vila Diogo, a slum located on the periphery of Nuporanga, a village in Sao Paulo state, Brazil. A nutrition education program was designed on the basis of evidence obtained from demographic/socioeconomic information of the study population and a nutritional needs assessment of women (target group) and children less than 5 years of age. The nutritional needs assessment consisted of anthropometry, dietary assessment, and nutrition knowledge, attitudes, and beliefs questionnaires. Formative and summative evaluation of the nutrition education program, using appropriately selected criteria and comparisons of nutrition knowledge scores before and after the program, were used to determine program effectiveness. Major findings of the study were: Diets of Vila Diogo residents were generally simplistic, consisting primarily of rice, beans, and coffee with sugar. Vila Diogo women appeared to be at a relatively high risk for vitamin A, iron, calcium, ascorbic, and riboflavin deficiencies, based on comparisons of 24-hour dietary intake data with FAO recommendations. Children (2-5 years) appeared at high risk for vitamin A, iron, and ascorbic acid deficiencies, based on comparisons of 24-hour dietary intake data with FAO recommendations. All children less than 5 years of age had been breast-fed at birth, but more than one half of children had been weaned by the third month. Infant feeding practices during fever and diarrhea were nutritionally detrimental. Women generally recognized a relationship between dietary intake during pregnancy and fetal nourishment. Using weight-for-height index, a significant number of women were probably undernourished; a small percentage of women, however, were overweight or obese. Although children less than 5 years of age did not generally appear malnourished, a relatively large number were stunted in growth. Although Vila Diogo women reported many food taboos during various physiological states (menstruation, pregnancy, immediately post partum, lactation), relatively few food taboos had potentially negative nutritional consequences. For women who participated in the nutrition education program, nutrition knowledge scores after the program showed improvement which was statistically significant at alpha = 0.05, using Wilcoxon signed rank test.

Brazil↗
PubMed1997

Results of a community-based low-literacy nutrition education program.

A nutrition intervention focused on low-fat eating pattern changes was conducted among low-literacy participants in a Twin Cities Metropolitan area Expanded Food and Nutrition Education Program (EFNEP). A total of 134 EFNEP participants who participated in the intervention were compared to 70 comparison participants who received EFNEP nutrition education materials. Associations between changes in outcome variables specific to the intervention were evaluated using mixed-model regression analyses. The principal effects seen for this program were related to changes in eating pattern scales. More modest effects were seen in scales related to attitudes of low-fat eating, and although changes in dietary fat intake as measured by 24-hour dietary interviews suggested a positive intervention effect, this did not approach statistical significance.

Adult↗
PubMed1978

Influence of a nutrition education program (EFNEP) on infant nutrition in East Harlem.

An assessment of the effectiveness of aides working in the Expanded Food and Nutrition Education Program (EFNEP) to improve the nutritional status of infants was conducted with a group of 118 infants attending a well-baby clinic in a low-income area of New York City. In addition to clinic care, the fifty-seven study infants received home visits from a nutrition aide whose role was to reinforce nutritional advice received at the clinic. The sixty-one control infants received only regular clinic care. The benefits of having an aide were suggested by three observations: Reduction in the practice of introducing whole cow's milk to young infants, familiarizing older infants with a variety of foods, and reducing the prevalence of iron-deficiency anemia. Few of the differences between study and control infants achieved statistical significance, although trends consistently indicated that the presence of aides was beneficial. The problems of assessing the effectiveness of nutrition education programs with healthy infants are discussed.

Black or African American↗
PubMed1998

Survey of clinical nutrition training programs for physicians.

Clinical nutrition training programs for physicians were surveyed to determine their number, demographic characteristics, primary teaching focuses, number of available trainee positions, funding bases, trainee numbers, backgrounds, and career positions taken. Twenty-two active programs were identified, compared with 38 programs in 1993. Thirteen of the programs were primarily focused on adult nutrition and 7 were focused on pediatric nutrition. Twelve programs appeared to have nutrition as their sole subspecialty focus, 8 were housed within gastroenterology fellowships, and 2 were within endocrinology fellowships. Most programs included training in research, which is conducted during a second or third year, or both. The decrease in numbers of programs appears to have resulted not only from relocation, retirement of key faculty members, and loss of training grants, but also because of the clearer definition of clinical nutrition training programs in this survey. The changes also reflect a national trend toward decreasing subspecialization. Within this climate, it is apparent that a new model for the training and career activities of physician nutrition specialists is needed that will attract more physicians into the discipline of nutrition. Intersociety efforts are underway to address this need and to develop a unified voice that can guide clinical nutrition training for physicians into the 21st century.

Curriculum↗
PubMedDate not supplied

A multidisciplinary QA program for enteral nutrition in high-risk patients.

An increase in elderly patients and severity of illness rates means greater use of nasogastric feeding tubes for both high-risk acutely ill and chronically ill patients. When the QA screening process at Booth Memorial Medical Center revealed a certain percentage of complications with small bore, weight-tipped feeding tubes inserted through the nares, a multidisciplinary peer review committee (MPRC) was formed to review the enteral nutrition program. After a literature review to determine possible complications, the MPRC identified lung perforations due to tube misplacement, tube feeding aspiration into the lungs leading to possible aspiration pneumonia, and an internal tip separation from the tube product failure. Unconscious incubated patients on ventilators were shown as at high risk for feeding tube misplacement in an initial MPRC patient study. A second study evaluated several different feeding tube products in the medical, respiratory and surgical ICU. The MPRC established a credentialing process for physician assistants, interns and residents in feeding tube placement. The MPRC proceedings were presented to the hospital-wide QA committee for review, endorsement and recommendations on all policy and procedure changes. The conclusions were that a more concerted effort must be made to improve medical management and encourage ongoing education in the administration of enteral feedings to high-risk patients.

Cost-Benefit Analysis↗
PubMed1990

Pawtucket Heart Health Program point-of-purchase nutrition education program in supermarkets.

Point-of-purchase nutrition education in supermarkets is one intervention strategy of the Pawtucket Heart Health Program, a community cardiovascular disease prevention program in Pawtucket, Rhode Island. Using consumer intercept interviews, awareness of shelf labels and their effect on purchase behavior have been continuously evaluated. Between 1984 and 1988, the percent of shoppers who could identify correct labels increased from 11 percent to 24 percent (95% confidence intervals of difference: 7.17). The percent who reported they were encouraged to purchase the identified foods increased from 36 percent to 54 percent (95% CI of difference: 5.41).

Adult↗