The impact of a community nutrition program on the nutritional status of an urban population group.
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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.
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.
From a meager beginning with the passage in 1946 of the initial National School Lunch Act, school nutrition programs have grown until today they are "big business," employing some 350,000 persons in more than 89,000 units, and representing more than $1 billion in volume. As programs have expanded, the need for more professionalism in the field has been felt, and a number of educational and certifying programs have emerged. A new aspect, just being implemented as a result of 1977 legislation, is the nutrition education facet implicit in serving school meals. A driving force in meeting nutritional goals of school foodservice programs is the American School Food Service Association, an organization of some 67,000 members.
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Massachusetts has the largest population of immigrant Portuguese in the United States, yet few elder service programs specifically designed to meet their needs exist. Therefore, a special nutrition program was developed in Somerville, Massachusetts to provide culturally appropriate lunches twice a week, followed by socialization activities. A survey of the participants showed that only 11% of respondents met recommended intake of dairy, protein, fruits and vegetables, as determined by the Basic Four Scoring System. The most frequently lacking food among the remaining participants were fruits and vegetables, followed by grains, as well as dairy products. The recommended protein intake was met by all but two respondents. The majority of respondents were able to identify a high sodium food, a food high in Vitamin C, a nutritionally balanced meal, and identified calcium as a necessary nutrient throughout the lifespan. Fewer respondents were able to identify foods high in protein, high in calories, and high in fiber, although their diets contained substantial amounts of these nutrients.
Food records kept by 466 individuals participating in the federally funded Nutrition Program for the Elderly show that those eating at the meal site on the day of the food record consumed more energy, protein, and calcium than non-participants and participants who did not eat there on the day of the record. Dietary ratings, which included eight nutrients and energy, indicated they also had better overall diets than non-participants. Non-participants consumed more iron than participants. The daily intake of all nutrients, except calcium, of those eating at the meal site reflected what was offered. Between 40 and 50 per cent of the total daily intake was consumed at the meal center. Women consumed a significantly greater proportion of their daily intake of most nutrients from the food provided by program than the men. The desirability of providing a high proportion of the recommended allowances for protein and other nutrients through the meal program menus is emphasized. The results of the study demonstrated the importance of nutritionists in administrative roles at the state and area levels in determining the effectiveness of a meal program, since food intake reflected menu planning.
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.
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