Tray Service Generates More Food Waste in Dining Areas of a Continuing-Care Retirement Community

Objective To determine if the type of service system affects the amount of service food waste (SFW) generated in dining areas of a continuing-care retirement community.Research design A waste stream analysis was conducted for 7 days to determine quantity of SFW generated in three service systems: health care tray service, health care dining room with wait-staff service, and ambulatory dining room with family style service. Weight and volume were determined.Setting Health care tray service and wait-staff service were provided to 70 residents in a health care unit. Family-style service was provided as an optional service for 130 residents in independent-living units. An average of 229 meals were served per day.Statistical analysis performed Analysis of variance and a multiple comparison method were used to compare mean weight and volume of SFW on a per meal, per day, and per week basis.Results During the 7-day period, 482.8 lb, or 83 gal, of SFW was disposed of. Health care tray service generated more SFW by weight for all three meals than either family-style service or wait-staff service, and it generated the greatest total volume of service waste. Residents eating in the dining room with family-style service disposed of significantly less SFW by weight at lunch and dinner than those receiving the other two service styles.Applications Changing the style of service can affect not only quantity of solid waste generated and associated disposal costs but also food and supply costs, meal acceptability, and quantity of natural resources required. The systems approach should be used to assess the feasibility of changing service system so that all costs are considered. J Am Diet Assoc. 1997;97:879-882.     

Food Waste in a School Nutrition Program After Implementation of New Lunch Program Guidelines

ObjectiveTo assess the amount of food waste by meal components according to the new National School Lunch Program guidelines among pre-kindergarten and kindergarten students.MethodsFor 5 consecutive school days in 1 elementary school, the research team collected school lunch trays and separated meal components into bins relative to each food or beverage appearing on the school's daily menu. Bins were weighed in grams and converted to ounces and cups at the end of each lunch period.ResultsThe researchers examined 304 meals from 1 pre-kindergarten class and 5 kindergarten classes. Of 4,988 oz of food and beverages served, 2,261 oz (45.3%) were wasted during 1 full school week, totaling 141 lb. The greatest amount of food waste was generated from vegetables, the main entree, and milk, respectively.Conclusions and ImplicationsStrategies to reduce food waste in school lunch should be researched and implemented.     

Body composition changes during the first two years of university

Objective

Changes in body weight, composition, and shape were investigated in male and female college students between the freshman and sophomore years.

Methods

Changes in weight, body mass index (BMI), percent and absolute body fat and fat-free mass (via bioelectrical impedance), and waist circumference (via body scans) were assessed over the freshman and sophomore years (2007-2009) among 120 students attending a Southern public university.

Results

Weight (2.5 and 1.7 lbs) and BMI gains (0.3 and 0.3 kg/m²) did not significantly differ between the freshman and sophomore years, respectively. Significantly more percent body fat and fat mass were gained during the freshman (1.9% and 3.3 lbs, respectively) than the sophomore year (0.0% and 0.6 lbs, respectively). Females lost significantly more fat-free mass during the freshman (−0.8 lb) than during the sophomore year (1.0 lb). Changes in waist circumference and weight were significantly correlated. Increases in the percentages of females classified as overweight and with unhealthy body fat amounts and waist circumferences were observed.

Conclusion

While the sophomore year was characterized by slightly healthier body composition changes than the freshman year, the gains in weight, fat mass, and waist circumference measurements suggest increased health risks for many college females.     

Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost

Background

Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs.

Enzyme-specific activities and mineral concentrations of the exocrine pancreas from female SHR/N-corpulent (cp) rats.

The purpose of this study was to evaluate a simplified weight loss program in which subjects were provided a widely available meal replacement product and its package insert information (Ultra Slim-Fast).

Weekly follow-up visits were carried out by non-physician personnel for weight measurement, distribution of product, and completion of a subjective questionnaire. No dietary counseling was provided. A total of 273 of 301 subjects (91%) completed 12 weeks of study. Men lost 50% (from 119 to 108% of ideal body weight) and women lost 35% (from 122 to 111% of ideal body weight) of excess body weight. Thirty-five patients who lost < 9 lbs in 12 weeks were considered non-adherent and were excluded from the next phase of the study during which 238 subjects were followed biweekly.

Despite a $25/week payment for participation nearly 44% of subjects dropped out or were judged non-compliant prior to the end of the study. At 116 weeks, 133 (97 females, 36 males) of 238 subjects remained in the study (44% of the initial population), with average weight loss from baseline of 13.6 +/? 10.5 lb in females and 14.0 +/? 10.5 lb in males.

The weight loss observed (approximately 10% of body weight) is significant and has been associated with important health benefits particularly for patients with hypertension and non-insulin dependent diabetes. The potential advantages of using meal replacements for mild obesity include wide availability to aid compliance, low cost and minimal professional intervention.     

Blood pressure and body composition changes in women

To determine which of two measures of adiposity change (total weight or percentage fat determined by volume displacement) is more strongly associated with change in blood pressure, a longitudinal study was made of 68 women aged 15–59. The initial physical characteristics of the subjects were the following: mean age, 41.2 years; average weight, 127.1 lb; average percentage body fat, 24.4%; mean systolic blood pressure, 119.8 mm Hg; and mean diastolic blood pressure, 77.8 mm Hg. Changes over an average period of 25 months consisted of a mean weight loss of 2.0 lb, percentage body fat decrease of 1.3%, and systolic and diastolic blood pressure lowering of 1.5 and 1.4 mm Hg. For all women, the correlation coefficient for change in systolic blood pressure with change in percentage body fat by volume displacement was r = 0.28 (P < 0.05). This value, although slightly higher than that obtained using body weight in this study, is not significantly different from it. Results for diastolic blood pressure were similar. Partial correlation, adjusting for age, initial weight, and percentage body fat did not change the values. These findings suggest that the use of change in percentage body fat did not provide any improvement in the relationship between changes in blood pressure and in weight.     

Differences in weight gain in relation to race,gender, age and education in young adults: The CARDIA study

Objective. To assess ethnic differences in weight gain in young adults.

Design. Five‐year weight change was assessed in 4207 young adults initially aged 18–30 years at the CARDIA Study baseline examination (1985–1986).

Results. Weight gain was significantly (p < 0.0001) greater in black versus white men (13.2 versus 9.1 lb) and in black versus white women (13.2 versus 7.4 lb). Baseline weight and year‐five weight in all race and gender groups were strongly associated, suggesting a high degree of tracking of adiposity during young adulthood. Greater weight gain was noted in participants reporting baseline education of high school or less versus college graduates in black women (14.4 versus 10.0 Ib, p < 0.05), white women (10.2 versus 5.2 lb, p<0.0001) and white men (10.2 versus 7.8 Ib, p <0.001). Significantly greater weight gain was observed in younger (18—24 years) versus older (25–30 years) men, but no age‐related difference was seen in women. The racial differences in weight gain remained after adjustment for age and level of education. The above trends were confirmed for other measures of body size, i.e. body mass index and skinfold thickness.

Conclusion. These data indicate that young adults are at high risk of weight gain, and that weight gain was greatest among African Americans and among less educated participants. These high‐risk groups can be identified and targeted for primary prevention of adult obesity in addition to population wide efforts that will be required to counteract the secular trend of increased obesity observed in US adults.     

A decision tree for selecting the most cost-effective waste disposal strategy in foodservice operations

The purposes of this study were to determine costs of disposal strategies for wastes generated in foodservice operations and to develop a decision tree to determine the most cost-effective disposal strategy for foodservice operations. Four cases, including the central food processing center (CFPC) in a school district, a continuing-care retirement center (CCRC), a university dining center (UDC), and a commercial chain restaurant (CCR), were studied to determine the most cost-effective disposal strategy. Annual costs for the current and projected strategies were determined for each case. Results of waste characterization studies and stopwatch studies, interviews with foodservice directors, and water flow and electrical requirements from manufacturers' specifications were used to determine cost incurred. The annual percentage increases for labor, fees, and services were used to reflect an inflated economic condition for the ensuing 10 years of the study period. The Net Present Worth method was used to compare costs of strategies, and the multiparameter sensitivity analysis was conducted to examine the tolerance of the chosen strategy. The most cost-effective strategy differed among foodservice operations because of the composition of food and packaging wastes, the quantity of recyclable materials, the waste-hauling charges, labor costs, start-up costs, and inflation rate. For example, the use of a garbage disposal for food waste and landfills and recycling for packaging waste were the most cost-effective strategies for the CCRC. A decision tree was developed to illustrate the decision-making process that occurs when conducting cost analysis and subsequent decisions. Dietetics practitioners can use the decision tree when evaluating the results of the cost analysis.     

Comparison of Patient Food Intake,Satisfaction and Meal Quality Between Two Meal Service Styles in a Geriatric Inpatient Unit

Abstract

This pilot study evaluated the introduction of a bistro evening meal service in a geriatric inpatient unit by comparing patient intake, satisfaction and meal quality of this new service to the usual central preplated service. Ten meals were observed under each condition (n?=?30; mean age 79?years, 47% male). Data were collected on intake of each meal component (none, ¼, ½, ¾, all; converted to energy and protein using known food composition data), patient satisfaction with meals (meal flavor/taste, appearance, quality, staff demeanor; seven-point scale) and meal quality (sensory properties, temperature; five-point scale). Independent t-tests were used to compare energy and protein intakes between bistro and preplated services. There was no difference in mean energy or protein intake (energy: 2524?±?927?kJ vs. 2692?±?857?kJ, p?=?0.612; protein: 29?±?12?g vs. 27?±?11?g, p?=?0.699) patient satisfaction or meal quality between the bistro and preplated meal services. Patients were provided with fewer meal items during the bistro service, but ate a higher proportion of what was provided to them. Implementing a bistro service did not increase intake, satisfaction or meal quality in this study, suggesting that meal plating may be only one of many factors influencing intake and satisfaction of older inpatients.     

Urinary excretion half life of trichloroacetic acid as a biomarker of exposure to chlorinated drinking water disinfection by-products

Methods: A longitudinal pilot exposure/intervention study measured the elimination half life of TCAA in urine. Beverage consumption was limited to a public water supply and bottled water of known TCAA concentration, and ingestion volume was managed. The five participants limited fluid consumption to only the water provided. Consumption journals were kept by each participant and their daily first morning urine (FMU) samples were analysed for TCAA and creatinine. TCAA elimination half life curves were generated from a two week washout period using TCAA-free bottled water.

Results: Individual elimination half lives ranged from 2.1 to 6.3 days, for single compartment exponential decay, the model which fit the data.

Conclusion: Urinary TCAA is persistent enough to be viable as a biomarker of medium term (days) exposure to drinking water TCAA ingestion within a range of realistic concentrations.

     

Efficacy of a Meal-Replacement Program for Promoting Blood Lipid Changes and Weight and Body Fat Loss in US Army Soldiers

Excess weight is associated with negative health outcomes. Meal replacements are effective in promoting favorable body composition changes in civilian populations; however, their efficacy with military service members who have unique lifestyles is unknown. The objective of this randomized controlled trial was to determine the efficacy of the Army's education-based weight-management program, “Weigh to Stay,” with and without meal replacements for improving blood lipids, and to promote weight and body fat loss in overweight US Army soldiers. Soldiers (n=113; 76 males/37 females) attending Weigh to Stay at Fort Bragg, NC, in 2006/2007 were randomized to Weigh to Stay only or a commercially available meal-replacement program (two meal replacements per day) in conjunction with Weigh to Stay, and followed until Army body fat standards were met or for 6 months if standards were not met. Study completers (n=46) in both treatment groups lost weight (Weigh to Stay: −2.7±4.3 kg; meal replacers: −3.8±3.5 kg) and fat mass (Weigh to Stay, −2.7±3.2 kg; meal replacers: −2.9±2.5 kg), and improved high-density lipoprotein cholesterol concentrations (Weigh to Stay: 13±9 mg/dL [0.34±0.23 mmol/L]; meal replacers: 8±7 mg/dL [0.21±0.18 mmol/L]; P<0.05); however, no between-group differences were observed. Attrition was lower (P=0.009) and success in meeting body fat standards tended to be higher (P=0.06) for the meal replacers vs Weigh to Stay participants. Intent-to-treat analysis demonstrated that meal replacers lost more weight (1.2±0.5 kg), percent body fat (1.0%±0.4%), and fat mass (0.8±0.4 kg) compared to Weigh to Stay volunteers (P<0.05). Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay.     

Accuracy of energy intake data estimated by a multiple-pass, 24-hour dietary recall technique

Objective This study examined the accuracy of a multiplepass, 24 hour dietary recall method for estimating energy intakes of men and women by comparing it with energy intake required for weight maintenance.Design Threeday, multiplepass, 24-hour recalls were obtained on randomly selected days during a selfselected diet period when subjects were preparing their own meals and during a controlled diet period when all meals were provided by the study. During the dietary intervention, weight was maintained; body weight and dietary intake were monitored closely, thereby allowing estimation of the energy intake required for weight maintenance.Subjects/setting Seventyeight men and women (22 to 67 years old) from the Dietary Effects on Lipoprotein and Thrombogenic Activity (DELTA) study participated in this study. All 24-hour recalls were collected using a computerassisted, interactive, multiplepass telephone interview technique. Energy requirements for each individual were determined by the energy content of the DELTA study foods provided to maintain weight.Statistical analysis Paired and independent t tests were conducted to examine differences among study variables. Agreement between recalled energy intake and weight maintenance energy intake was analyzed using the BlandAltman technique.Results Compared with weight maintenance energy intake, during the selfselected diet period men and women underestimated energy intake by 11% and 13%, respectively. During the controlled diet period, men underestimated energy intake by 13%, whereas women overestimated energy by 1.3%.Applications/conclusions Men had a tendency to underestimate energy intake irrespective of the recording period. The accuracy of the recalled energy intake of women may be influenced by recording circumstances. Researchers should examine the factors influencing underreporting and overreporting by individuals and their impact on macronutrient and micronutrient intakes. Also, strategies need to be developed to minimize underreporting and overreporting. J Am Diet Assoc. 2000; 100:303-308,311.     

Exposures to Ortho-Chlorobenzylidene Malononitrile

Obesity has definitely increased In 19 to 26year-old men in the past ten to 15 years. Hypertension is apparently also increasing. College men are more hypertensive but less obese than noncollege men. A questionnaire was given at random to 414 obese men disqualified for being “overweight” for military service. Answers indicate young men believe there is often more than one cause for their obesity. Many are not aware that vigorous exercise with dieting can assist in weight loss. Over half of these men think they can lose whenever they wish but over 60% lose less than 20 lb and half regain more than 20 lb. Many attribute weight gain to vague factors not personally controllable. Almost two out of five dieters in this group have an increased anxiety level during dieting. Almost half of the dieters think weight loss should proceed at an unreasonable 5 lb or more per week.     

Identification of risk factors for delayed onset of lactation

Objective To identify infant feeding, socioeconomic, demographic, and delivery-related factors that affect women's self-reported timing of the onset of lactation.Design Longitudinal survey of women from day 1 postpartum until self-reported onset of lactation. Subjects were interviewed in person on day 1 postpartum, then surveyed daily by telephone regarding infant feeding method, breast symptoms, and perception of whether the onset of lactation had occurred. Medical records were reviewed.Subjects/setting Data were collected from 192 women after they gave birth to a healthy, term singleton.Statistical analyses performed χ² Analyses were used to identify variables associated with delayed onset of lactation (onset of lactation ≥72 hours postpartum). Multivariate logistic regression was used to identify the independent association of each significant variable with delayed onset of lactation.Results Risk factors for delayed onset of lactation included white/Hispanic ethnicity, heavy/obese body build, delivery of offspring by unscheduled cesarean delivery, vaginal delivery with prolonged stage 2 labor, infant birth weight less than 8 lb, and exclusive formula-feeding before the onset of lactation.Applications/conclusions Women who are at risk for delayed onset of lactation need additional breast-feeding support during the first week postpartum. During their hospitalization, these women should be instructed about the normal lactation process and the possibility that onset of lactation may occur later than 72 hours postpartum. Frequent nursing should be recommended, as delayed onset of lactation was associated with the lack of infant suckling.JAm Diet Assoc. 1999;99:450-454.     

Impact of the Updated USDA School Meal Standards,Chef-Enhanced Meals,and the Removal of Flavored Milk on School Meal Selection and Consumption

BackgroundIn Fall 2012, updated US Department of Agriculture school meal standards went into effect and did not result in increased food waste overall. However, consumption of school foods, especially fruits and vegetables, remains low. Therefore, strategies to improve school meal consumption are necessary.ObjectiveThis study evaluated the combined impact of the updated school meal standards and chef-enhanced, healthier meals, and the removal of flavored milk on students’ school food selection and consumption compared with students in control schools.DesignThe Project MEALS (Modifying Eating and Lifestyles at School) study was a cafeteria-based quasi-experimental intervention conducted during the 2012 to 2013 school year.Participants/settingParticipants were students (n=1,309) in grades 3 through 8 attending four intervention and four control schools in two low-income, urban school districts.InterventionChef-enhanced school meals and the removal of flavored milk combined with the updated US Department of Agriculture school meal standards.Main outcome measuresChanges in school meal selection and consumption were examined using plate waste methodology.Statistical analyses performedLogistic regression and mixed-model analysis of variance adjusting for student demographics and schools/students as a random effect (students nested within schools) were used to examine differences in selection and consumption before (Fall 2012) and after (Spring 2013) a chef-based intervention with the updated school meal standards.ResultsAfter the chef-based intervention was implemented, there were no significant differences in entrée, vegetable, or fruit selection. Significantly fewer students selected milk compared with students in control schools (56.8% vs 94.0%; P<0.0001) and milk consumption was significantly lower (54.8% vs 63.7%; P=0.004). However, consumption was significantly greater for vegetables (62.2% vs 38.2%; P=0.005) and fruits (75.2 vs 59.2%; P=0.04) in the intervention schools compared with control schools. There were no significant differences in entrée consumption.ConclusionsSchools collaborating with chefs can be an effective method to improve the consumption of fruits and vegetables with the updated US Department of Agriculture school meal standards. Further research should examine the longer-term impact of the removal of flavored milk from schools to determine whether the lower selection and consumption rates persist.     

Insulation workers in Belfast. 1. Comparison of a random sample with a control population

Wallace, W. F. M., and Langlands, J. H. M. (1971).Brit. J. industr. Med.,28, 211-216. Insulation workers in Belfast. 1. Comparison of a random sample with a control population. A sample of 50 men was chosen at random from the population of asbestos insulators in Belfast and matched with a control series of men of similar occupational group with respect to age, height, and smoking habit.

Significantly more of the insulators complained of cough and sputum and had basal rales on examination. Clubbing was assessed by means of measurements of the hyponychial angle of both index fingers. These angles were significantly greater in the group of insulators.

Twenty-one insulators had -rays which showed pleural calcification with or without pulmonary fibrosis; one control -ray showed pulmonary fibrosis.

The insulators had no evidence of airways obstruction but static lung volume was reduced and their arterial oxygen tension was lower than that of the controls and their alveolar-arterial oxygen gradient was greater.

     

Socioeconomic Differences in Weight Retention, Weight-related Attitudes and Practices in Postpartum Women

Objective To determine if there is a socioeconomic status (SES) gradient in postpartum weight retention in women living in the UK, and examine SES differences in weight-related attitudes and practices in the postpartum period. Methods Women (n = 2745) who had full-term live births between July and December 1999 in four London hospitals were eligible to participate in this self-report postal questionnaire study. The questionnaire included items on socio-demographic characteristics, pre-pregnancy weight, postpartum height and weight, pregnancy weight gain and duration, and postpartum weight-related attitudes (body image and weight beliefs) and practices (weight control and weight monitoring). Education was used as the indicator of SES. Results Questionnaires were returned by 954 women (35%) on average eight months postpartum. Median postpartum weight retention was 2.7 kg and was significantly higher in the medium and lower SES women (3.2 kg) than higher SES women (1.8 kg) despite no difference in pregnancy weight gain. A greater proportion of higher SES women believed they would return to their pre-pregnant weight, and they engaged in more frequent weight monitoring. There were no SES differences in body dissatisfaction or the proportion of women trying to lose weight postpartum. Conclusion In the postpartum period, women of higher SES retained less weight than women of lower SES. There were also differences in weight-related attitudes and frequency of weight monitoring across SES groups.

Geospatial Reach of the Maryland COVID-19 School Meals Response: Spring 2020

ObjectiveExamine characteristics of pandemic meal site (n = 602) location and meals served per site in Maryland, Spring 2020, following federal/state waivers for local meal site placement decision-making.MethodsUsing geographic information systems, we connected meal sites to census tract-level data and generated service areas from sites and distances from population-weighted census tract centroids to the closest pandemic meal site. Regression analysis determined associations of census tract pandemic meal site count and meals served per site with socioeconomic and demographic variables.ResultsCensus tracts with more meal sites were urban (P < 0.001), food deserts (P < 0.001), and had higher percentages of children in poverty (P < 0.001). Sites serving fewer meals were in food deserts (P < 0.001) and areas with more children in poverty (P < 0.001).Conclusions and ImplicationsWaivers allowing local meal site placement decision-making supported meal sites in high-need areas. Geospatial approaches could optimize site locations to ensure maximum reach to populations in need. Additional supports may be needed to ensure children in poverty areas receive meals distributed at these sites.