A Fortified Street Food to Prevent Nutritional Deficiencies in Homeless Men in France

Objective: To develop a food policy approach to prevent nutritional deficiencies and malnutrition in homeless men in France.

Study Population and Methods: A dietary survey was conducted among homeless men visiting an emergency shelter in Paris to assess their nutritional status and the quality of food aid provided. The use of a fortified food easy to eat in the street was identified as the best strategy to improve nutrient intake in this population. A fortified street food was therefore designed and its acceptability was tested in eight emergency centers.

Results: The dietary survey showed that there is a high frequency of malnutrition and inadequate intake of vitamins and minerals in homeless men in France although they are receiving food aid. A chocolate-flavored spread, naturally rich in potassium and n-3 fatty acids and fortified with nutritional doses of calcium, zinc, vitamins C, D, E, B₁₂, thiamin, niacin and folic acid was designed. It presents multiple advantages in the context of homeless nutrition: good resistance to bacterial contamination, a suitable viscosity for people with limited chewing capacity and high energy density. The acceptability study showed that approximately two thirds of the homeless men visiting emergency centers in Paris would consume the fortified food often, or daily, if available. Another advantage of this fortified street food is its high quality/price ratio, demonstrated by linear programming analysis in the present study.

Conclusions: Encouraging the use of fortified street foods in food aid programs is a practical and economic way to prevent nutritional deficiencies in homeless individuals.     

The eating patterns and problems of homeless women

While inadequate nutrition has been identified as a factor affecting the health of the homeless, there has been little research to identify the extent to which inadequate nutrition is a problem. The goal of this paper is to document the eating patterns and problems of single homeless women and to locate the determinants of nutritional adequacy in their diets. Our findings are based on a random sample of 84 single homeless women using hostels and drop-in centers. For 85.5% of the women food was provided primarily by hostels and supplemented by the drop-ins. When their daily food intake was compared to the Canada's Food Guide recommendations, the average number of servings in each of the four food groups was below the recommended. The women in our sample indicated that their problems with food consumption were rooted in their poverty and further analysis indicated that the provision of food by social agencies was an important factor in the nutritional adequacy of their diets. Hostels and drop-in centers not only provide shelter, they have also assumed most of the responsibility for feeding the homeless. It is their poverty which burdens these women and structures their eating patterns.     

Assessment of Dietary Intake and Food-related Behaviors of Gatekeepers in Homeless Families in Hawaii

We assessed diet quality and documented food-related behaviors of gatekeepers in homeless families with children in Hawaii. The dietary intake of gatekeepers residing in shelters (n = 44) was compared to that of gatekeepers living at beach parks (n = 13).The gatekeeper completed a 24-hour diet recall and answered questions about demographics and food-related behaviors. Diets were low in fiber, calcium, and vitamin A, did not vary significantly with shelter status, and were consistent with the diets of Expanded Food and Nutrition Education Program (EFNEP) participants in Hawaii. We concluded that both homeless groups would benefit from educational efforts similar to those used with EFNEP clients, with a greater focus on food safety, alternate food resources, and appropriate cooking methods.     

Nutritional status of institutionalized and free-living elderly in Alexandria

Because of an increase in the number of elderly and the problems of nutrition associated with them, it is of interest to study the nutritional status of elderly persons in Alexandria City. The purpose of this study was to assess the nutritional status of elderly population and to compare between the nutritional status of those institutionalized and those living free. The study was conducted on 240 elderly persons (120 institutionalized and 120 free living) selected randomly from institutions and from different sites. The basic data, weight, height, body mass index (BMI) of each were recorded. Dietary intake study was done by using 24 hours recall for 3 consecutive days and food frequency were used to obtain the best estimate of food intake. Energy and nutrient intakes were obtained and compared with the recommended dietary allowance (RDAs). The main findings of the study revealed that the mean age of the institutionalized elderly was greater than those living free. Percent of obesity among females was 71.7% among free living and 45% among institutionalized. Under-nutrition was present in 11.7% and 8.3% of institutionalized males and females respectively. Food habits showed that institutionalized subjects consume more amounts of many food items than free-living. Total daily energy intake was found to be below the recommendation for all subjects, with higher intake among institutionalized than free living. Nutrient intakes among institutionalized and free living elderly were inadequate except thiamin, riboflavin, vitamin C and iron. The nutrients least adequately supplied in the diets of elderly are vitamin A and calcium along with energy deficits. In conclusion both institutionalized and free living are at risk for developing nutrient deficiencies. Deficient energy, calcium and vitamin A are common problems among most subjects. The composition of the diet among free living subjects seem to be also poor in some micronutrients. We recommended a nutrition intervention program and nutrition education to improve nutritional status of elderly people.     

The nutritional status and dietary adequacy of single homeless women and their children in shelters.

Data were collected on the nutrient intake and nutritional status of 96 single mothers and their 192 dependent children who had been displaced from their homes. The objective of the study was to provide information on the dietary adequacy of a newly identified subgroup of homeless persons, single women and their dependent children. Once situated in temporary housing, those participating in the study indicated that they believed that they were receiving sufficient food. However, a nutrient analysis found that the study subjects in all age groups were consuming less than 50 percent of the 1989 Recommended Dietary Allowances (RDA) for iron, magnesium, zinc, and folic acid. Adults were consuming less than 50 percent of the RDA for calcium. The type and amounts of fats consumed were in higher than desirable quantities for a significant number of subjects of all ages. The health risk factors of iron deficiency anemia, obesity, and hypercholesterolemia were prevalent. The findings indicate a need to examine and remedy nutrient intake deficiencies among single women who are heads of household and their dependent children in temporary housing situations. Diet-related conditions found included low nutrient intakes that may affect child growth and development, risk factors associated with chronic disease, and lack of appropriate foods and knowledge of food preparation methods in shelter situations.(ABSTRACT TRUNCATED AT 250 WORDS)     

温州市居民膳食结构及食物消费量调查分析

目的 掌握温州市居民膳食结构与食物消费量数据,为开展营养教育及营养改善工作提供科学数据。方法 采用多阶段分层随机抽样方法,对1 689户居民5 287人进行食物消费量调查。采用非连续3 d 24 h回顾法为基础,3 d称重法为补充收集居民食物消费量数据。结果 温州市居民平均每标准人日谷薯类摄入量394.8 g,蔬菜类273.4 g,水果类180.0 g,畜禽肉类71.7 g,水产品类78.4 g,蛋类35.5 g,大豆及坚果类29.8 g。城区除水果摄入量和城乡无统计学差异外,其余种类食物摄入量均大于城乡,且差异有统计学意义。水产品超过中国居民膳食指南推荐量要求,谷薯类、畜禽肉类、大豆及坚果类达到推荐量要求,蔬菜类、水果类、蛋类未达到推荐量要求。结论 温州市居民膳食结构及食物消费基本合理,但非主食类植物性食物摄入量未达到推荐量,应加强营养知识的健康教育,提倡合理膳食和健康的生活方式。     

吉林省农村居民食物摄入频率及摄人量调查

目的：调查吉林省农村居民食物摄人频率及摄入量,为今后在农村地区开展营养教育和营养改善工作提供科学依据。方法：采用多阶段分层随机抽样,在吉林省选取了674名农村居民作为调查对象,运用半定量食物频率法调查居民过去1年内各类食物摄入频率和摄人量。结果：吉林省农村居民膳食结构尚不合理,谷薯类、蔬菜类、水果类、蛋类摄入频率相对较高,畜禽肉类、鱼虾类、大豆类及奶制品摄人频率较低。谷薯类摄入量超过推荐标准,畜禽肉类、蛋类、大豆类摄入量基本达到标准,蔬菜类、水果类、鱼虾类、奶及奶制品摄人量均低于膳食宝塔推荐标准,且每类食物中各种食物摄人不均衡。结论：目前吉林省农村居民的膳食状况以谷薯类摄入过多、蔬菜水果类、鱼虾类、奶类摄入不足为主要问题,应针对性制定营养宣教方案,引导居民合理膳食。     

2000-2007年无锡市农村居民膳食营养状况

目的了解无锡市农村居民的膳食结构和营养状况，为开展营养教育和营养改善工作提供依据。方法利用无锡市统计局2000--2007年农村居民各种食物的消费量和人口资料，分析食物消费状况、各种营养素的摄人及营养素的食物来源情况。结果无锡市农村居民谷类、动物性食物摄人较合理，蔬菜、水果、奶类、豆类食物摄人偏低，视黄醇、硫胺素、核黄素、抗坏血酸、钙摄人量占推荐摄人量（RNIs）或适宜摄人量（AIs）百分比偏低。结论无锡市农村居民膳食不均衡，部分微量元素摄人不足。应加强营养干预和膳食指南的健康教育，促进农村居民形成健康的饮食习惯，提高健康水平和生活质量。     

Elderly men living alone: are they at high nutritional risk?

This review article investigates the influence of living arrangements on the dietary intake and nutritional status of elderly men. Elderly men living alone have been identified as a group particularly at risk of poor dietary habits, however available evidence is inconsistent. Data from the United States suggests that low income elderly men living alone are at high risk of an inadequate dietary intake, and that a low energy intake is the most important predictor of a poor quality diet in this group. In Australia, older men living with a spouse have a better quality diet (higher nutrient density) than those living alone or with a person or persons other than a spouse, particularly regarding fruit and vegetable intake; differences in nutrient intake are not explained by lower energy intakes. In contrast, older men in European countries who live alone appear to have a more favourable dietary intake as compared to their counterparts in other living arrangements. Information on the association between living arrangements and household food security in the elderly in developing countries is sparse, however single living among older men is rare and the ethos of the extended family appears to remain intact. The inconsistencies in the apparent level of nutritional risk associated with living alone in elderly men in different countries necessitates the development and validation of screening programmes and nutrition services which are country-specific.     

运用中国膳食平衡指数评价邯郸市居民膳食质量

目的运用中国膳食平衡指数评价邯郸市民膳食质量,为本地区居民的膳食指导,营养干预工作提供科学依据. 方法选用2010年中国居民营养与健康状况监测的233名18~59岁居民完整的3天膳食调查及个人基本情况调查资料,采用DBI的评分及评价方法评价邯郸市居民膳食质量. 结果邯郸市居民膳食质量存在中度的摄入不足[LBS=(25.6±5.4)和低度的摄入过量[HBS=(9.8±4.7),以摄入不足为主要问题.与女性相比,男性摄入过量显著,膳食失衡状态显著(t=5.287,P=0.000和t=3.161,P=0.002).各个年龄段均存在摄入不足和摄入过量,且随着年龄增大,失衡状态显著增高.共存在5种膳食模式,分别为A,B,D,E和H模式,以B模式和E模式为主. 结论邯郸市居民膳食质量整体处于中度失衡状态,应广泛宣传中国居民膳食指南和膳食宝塔,以降低营养相关性非传染性疾病的患病率.     

Nutrient intake of institutionalized developmentally disabled individuals: impact of the nutrition knowledge of paraprofessionals

The role of the caretaker in enhancing nutrient intake of developmentally disabled individuals living in an institutional setting was examined. Eighty developmentally disabled residents living at the Western Carolina Center, Morganton, NC, were assessed for anthropometric measurements and for dietary intake, with a 3-day plate waste study. Seventy paraprofessionals/feeders working at the same center were assessed for knowledge of nutrition and food practices and participated in a series of inservice programs on nutrition. Pretest and post-test scores for knowledge of nutrition and food practices were determined. For the paraprofessionals/feeders, inservice programs on nutrition resulted in increased knowledge of nutrition but did not increase the nutritional quality of their own diets. However, statistically significant differences were noted in residents' diets for calories (p less than .05), iron (p less than .05), and niacin (p less than .05) attributable to the inservice programs on nutrition.     

Nutritional issues in long-term care

Because long-term care residents often have chronic illnesses and complex care regimens, nutritional issues are common in these populations. Furthermore, management is complicated because some residents are terminally ill and under palliative care treatment plans that allow for dehydration and low oral intake. As a result, the medical management of nutrition is complex and challenging for medical providers caring for residents of nursing homes, assisted living facilities, and other long-term care settings. Quality nutritional practice in long-term care involves careful assessment of barriers to adequate nutrition; reduction of risk factors; attention to specialized diets, food presentation, and supplements, when appropriate; awareness of the importance of psychosocial and environmental issues; and consideration of the role of medication both as a cause and a therapeutic adjunct. Optimal practice at a facility level would involve a systematic approach to applying the best evidence-based approaches, with a focus on individualizing each resident's nutritional management.     

1993-2009年沈阳市成人膳食结构和营养状况变迁分析

目的通过监测和分析1993-2009年沈阳市成人居民在1993-2009年的食物消费、营养素摄入及健康状况等数据,了解沈阳市成人居民膳食结构与营养状况的变迁。方法采用多阶段分层整群随机抽样的方法,在沈阳市两个城市居委会和两个郊区进行膳食结构与营养状况调查。结果城市成人的植物性食物和动物性食物消费量均为下降趋势,而郊区均上升,城市脂肪供能比到2009年达到23.4%,郊区糖类摄入量到2009年达到70.1%,引起超重和肥胖人口所占比例提高,成人钙摄入不足的状况无显著改善,城市和郊区的维生素A、维生素B1和维生素B2摄入量明显不足,男性和女性其超重/肥胖率均呈现出波动增长的趋势,且男性超重/肥胖率增长幅度明显高于女性。结论沈阳市下一步的营养工作重点应放在调整营养不平衡上,提高豆类和奶类等富含钙质的健康食物的消费,降低富含脂肪的肉类和油类的消费;加大富含维生素A、维生素B1和维生素B2的食物的消费;扩大对成人超重/肥胖率的监测范围,做到及早进行合理饮食宣传和干预控制,防止慢性病范围进一步扩大。     

重庆市居民食物摄入频率现况及影响因素评价

[目的]了解重庆市居民食物摄入频率现状和膳食结构模式,为今后开展营养教育和营养改善工作提供科学依据.[方法]选用2002年中国居民营养与健康状况调查重庆地区的资料,运用食物摄入频率法调查了1 520名15岁及以上居民,对每个调查对象过去1年的各类食物摄入频率和摄入量进行询问.采用评分方法评价重庆市居民的膳食质量.采用多因素Logistic回归分析方法筛选食物摄入频率的相关影响因素.[结果]重庆市居民的膳食结构不太合理,城乡间人群的膳食结构存在着一定的差异.城市居民畜禽肉类和油脂类摄入过量,鱼虾类摄入不足;农村居民油脂类摄入过量,水果、鱼虾类、蛋类、奶及奶制品和豆类及豆制品摄入不足.[结论]目前重庆市居民的膳食状况以水果、豆类及豆制品和奶及奶制品摄入不足为主要问题,应加强宣传教育提高营养知识水平,合理调整膳食结构,纠正不良的膳食习惯.     

Institutionalized elderly women have lower food intake than do those living more independently (Dutch Nutrition Surveillance System).

The habitual intake of energy and nutrients (assessed through dietary history) among elderly women (aged 65 and over) living in a nursing home (n = 54), elderly women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and elderly women living independently (n = 52) was evaluated within the framework of the Dutch Nutrition Surveillance System. Intake of energy and nutrients was lowest among women in the nursing home and highest among those living independently. Almost all differences in absolute intake found were significant, both unadjusted and adjusted for age. In the nursing home the intake of energy and nutrients was lower at higher age. In qualitative terms the differences among the groups of women were less striking. Mean daily intakes of iron, vitamin A, thiamin, vitamin B6 and vitamin C were below the Dutch recommended dietary allowances (RDAs) among the nursing home women. Several interrelationships among nutrient intakes were found, low intake levels clustering somewhat among elderly subjects. Our data indicate that these nutritional risks are due to a lower food intake resulting in a lower intake of energy and nutrients, and owing to differences in food choice resulting in a lower nutrient density. We conclude that it is difficult to design a diet containing all essential nutrients at the RDA level in a nursing home with residents who have a relatively low intake of energy, especially among those at higher age.     

Institutionalized elderly women have lower food intake than do those living more independently (Dutch Nutrition Surveillance System).

The habitual intake of energy and nutrients (assessed through dietary history) among elderly women (aged 65 and over) living in a nursing home (n = 54), elderly women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and elderly women living independently (n = 52) was evaluated within the framework of the Dutch Nutrition Surveillance System. Intake of energy and nutrients was lowest among women in the nursing home and highest among those living independently. Almost all differences in absolute intake found were significant, both unadjusted and adjusted for age. In the nursing home the intake of energy and nutrients was lower at higher age. In qualitative terms the differences among the groups of women were less striking. Mean daily intakes of iron, vitamin A, thiamin, vitamin B6 and vitamin C were below the Dutch recommended dietary allowances (RDAs) among the nursing home women. Several interrelationships among nutrient intakes were found, low intake levels clustering somewhat among elderly subjects. Our data indicate that these nutritional risks are due to a lower food intake resulting in a lower intake of energy and nutrients, and owing to differences in food choice resulting in a lower nutrient density. We conclude that it is difficult to design a diet containing all essential nutrients at the RDA level in a nursing home with residents who have a relatively low intake of energy, especially among those at higher age.     

农村社会营养评价与食物结构优化研究

目的 评价浙江省德清县三桥镇的社会营养状况。方法 采用实地膳食调查和一般性营养评价方法。结果 该镇居民的热能、维生素A、维生素B1以及维生素PP的平均摄入量已达到国家营养学会推荐的平均供给标准，而蛋白质、钙、铁、维生素C及维生素B2的平均摄入量则显不足。鉴于该镇存在的营养问题，采用单目标线性规划方法，以当地的主要食物种类为基础，以国家营养学会推荐的各营养素的平均供给标准为依据。优化并的提出了保证该镇居民营养安全的食物结构模式。结论 优化的食物结构模式符合国家提出的食物结构 的指导方针，经营养学验证，能提供满足当地人群所必需的主要营养素需求。该优化的食物结构模式为当地食物生产结构的调整提供了参考依据。     

城市社区签约居民营养知-信-行及指导需求调查研究

目的 了解目前社区签约居民的营养知识、态度、行为（KAP）现状及其营养指导需求，为社区营养干预提供科学依据。方法 随机抽取成都市某社区卫生服务中心签约居民134人作为调查对象进行访谈式问卷调查。结果 调查对象中70岁以上的老人占51．5％，超重／月巴胖者的比例为41．8％，高血压和糖尿病患者比例较高（共占70．1％）。调查对象的营养知识水平较差，主要表现在对中国居民膳食指南、重要营养素的食物来源及其与慢性病的关系等知识的缺乏；营养态度普遍较好；根据DBI（膳食平衡指数）评价调查对象的膳食营养质量，有65．1％的人存在不同程度的膳食摄入不足或／和膳食摄入过多问题。调查对象希望社区医院主要通过讲座、门诊和发放宣传资料等形式宣传营养知识和进行饮食指导；48．5％的人希望获得个体化的推荐食谱；但社区医生与签约居民见面并主动为其提供饮食建议的频率较低，所提供建议的满意率差。结论 加强社区医生的营养知识水平和饮食指导技能的培训，以满足社区签约居民日益增长的营养指导需求，以改善其营养健康水平。     

2009—2018年深圳居民膳食结构变化趋势

目的 通过比较2009年和2018年深圳市居民的膳食结构,了解深圳居民的膳食结构变化,为提出合理膳食建议提供参考依据。方法 分别于2009年和2018年,采用整群随机抽样法抽取8 487名和10 043名深圳常住居民进行相关营养与健康状况调查,比较深圳居民不同年度各类食物及营养素摄入量的差异。膳食调查采用食物频率调查法。结果 与2009年相比,2018年深圳居民平均每标准人日粮谷类、水果类、水产品、蛋类、烹调油的摄入量分别增加了39.35 g、33.66 g、14.51 g、8.82 g、7.54 g; 水果类、奶类及其制品的摄入低于推荐摄入量,而畜禽肉类、烹调油及盐的摄入依然高于推荐摄入量; 蛋白质、维生素B₁、维生素E、钙、镁摄入量呈上升趋势,其余营养素摄入量呈下降趋势; 膳食能量的47.50%来源于粮谷类,其次是纯热能食物(21.80%)和动物性食(19.60%); 与十年前相比,碳水化合物和蛋白质供能比有所上升,而脂肪供能比下降; 居民主要摄取动物性蛋白和动物脂肪。结论 2018年深圳居民的膳食结构较2009年有所改善,但仍存在膳食摄入不均衡,营养素摄入不足与摄入过量并存的现象,且膳食结构具有明显“西化”趋势。深圳市今后应根据人群的不同特征开展针对性、多方面的营养健康宣教工作,促进居民合理膳食习惯的形成,降低营养相关疾病发生率。