Dietary intake of homeless women residing at a transitional living center

Women who are homeless experience health problems due to many factors, including poor nutrition. This paper describes a nutritional assessment of women who are homeless living at a transitional living center in an urban setting. A rapid food screener was used to assess fat, fruit and vegetable, and fiber intake, and focus group analysis was used to assess nutritional attitudes and dietary behaviors. We found that the dietary intake of shelter residents does not meet the USDA recommendations in several key areas. We also found that shelter residents considered shelter cafeteria food to be inadequate in terms of taste, nutritional quality, and choices, and they believed the shelter diet contributed to chronic diseases and their symptoms. We conclude that addressing these barriers to good nutrition may help people who are homeless prevent and manage chronic illness.     

Why don’t elderly hospital inpatients eat adequately?

Background: Malnutrition is common among older hospital patients and contributes to poor clinical outcomes. Poor intake among this group of patients could be due to a variety of factors.Objective: To better understand the causes and consequences of inadequate food intake among hospitalised elderly patients, specifically: to determine (i) the prevalence of factors contributory to inadequate food intake, (ii) the relationship of these factors to nutritional status and course of hospital stay.Design: A longitudinal observational study of a convenience sample.Setting: Inpatients of an inner city elderly care unit in the UK.Methods: One hundred patients (mean 81.7 years (sd 7.2); 27 male, 73 female) were observed twice weekly, from admission to discharge/maximum of 4 weeks. Anthropometric assessments of nutritional status were made on admission and discharge. At each visit, adequacy of intake in the preceding 24-hour period, and reasons for inadequate intake, were determined using nurse observations, food-charts, case-notes, and interviews of patients/carers. With all available information, adequacy was estimated whether the subject had consumed at least three-quarters of their standard diet along with any prescribed food supplements. Inadequate nutritional intake was defined as completing less than this amount.Results: On admission, 21 patients were malnourished [below the 10th percentile for demiquet (weight/demispan2) for males or mindex (weight/demispan) for females. Three patients became malnourished during their stay. At 285/425 assessments (67%), patients were judged to be eating inadequately. Acute illness, anorexia, catering limitations and oral problems were the most prevalent reasons for inadequate intake during the earlier part of patients’ hospital stay. Confusion, low mood and dysphagia remained prevalent throughout. Compared to well-nourished patients (n=67), malnourished patients (n=24) had higher prevalence of oral problems (22%v6%;p<0.001), mood/anxiety disturbances (33%v19%;p=0.02), anorexia (38%v23%;p=0.02) and catering limitations (34%v12%;p<0.001), but lower prevalence of dysphagia (4%v13%,p=0.015). Of 51 patients in hospital for less than 10days, 36 were eating inadequately.Conclusion: Reasons for inadequate intake vary according to stage of hospital stay and nutritional status. Inadequate intake in the early stage after admission is mainly due to self-limiting temporary factors associated with acute illness.     

Under- and Over-Nutrition Among Refugees in San Diego County, California

Resettled refugees often arrive in their host country with little knowledge of nutrition or available food choices. We explored nutrition-related issues of recent refugee arrivals to San Diego County—the second largest California resettlement site. In-depth interviews (n = 40) were conducted with refugees, health care practitioners, and refugee service organizations. Content analysis identified nutrition-related themes. Unhealthy weight gain after arrival was the most common concern and was attributed to social pressures among adolescents, food choices and a more sedentary lifestyle. Conversely, undernutrition remained a concern due to poor diets. Factors influencing nutritional problems included continuation of past habits, acculturation, unfamiliarity with available foods and socio-economic influences. The nutritional concerns encountered by resettled refugees in San Diego are not unique to this group but are aggravated by their past experiences, and abrupt changes to food choices and behavior. Addressing contextual factors of poor food choices may prevent some of the long term health consequences of poor nutrition.     

Food provision and the meal situation in elderly care – outcomes in different social contexts

BACKGROUND: Nutritional problems concerning older people in care can be affected both by their illness and by the standard procedures surrounding food provision, for example rigid routines of food supply and ritualized mealtime situations. METHOD: The aim was to study how organizational structure and staff members' routines and actions influence activities related to food and meals in different caring context in Sweden. The qualitative methodology chosen for this study was participant observation. RESULT: Care recipients were given different opportunities concerning what, how, when and with whom to eat, depending on where their meals were served. In restaurants, older people could choose from several foods and they could also choose the time of and company for the meal. At care units with 'part-of-day' care or 'around-the-clock' care, food choices, time and company were limited, especially at the units with 'around-the-clock' care, where the most ailing older people lived. CONCLUSIONS: Food provision and the mealtime situation for the elderly are shaped by the individual's living arrangements, and the social organization surrounding it, not determined by the individual's needs and wishes, including social and cultural meanings of food and meals, which could, thereby, affect nutritional intake.     

Psychosocial Correlates of Low Fruit and Vegetable Intake Among Adolescent Boys and Girls in Tehran,Iran

This study examines the frequency of intake of fruits and vegetables among a sample of adolescents in the city of Tehran and the relationship of some behavioral, cognitive, personal, and environmental factors to low fruit and vegetable intake in this group. The study sample included 834 9th, 10th, and 11th grade student adolescents aged 14–19 years. The survey instrument was a structured self-administered questionnaire that consisted of several sections on demographic and social characteristics, perceived weight status, perceived health status, physical activity, food choices, and a 50-item qualitative food frequency questionnaire.

Less than daily consumption of vegetables and fruits was reported by 18% and 27% of adolescents, respectively. A significant association was found between gender and low vegetable but not fruit intake. Psychosocial and behavioral risk factors associated with inadequate fruit and vegetable intake included low self-efficacy, external locus of control, self-perception of health as fair or poor, and not having a regular exercise program.

     

Household food security status and its associated factors in Baft-Kerman,IRAN: a cross-sectional study

ABSTRACT

Food insecurity is prevalent in both developed and developing countries, which has considerable health impacts on the social, physical, and psychological status. This study aimed to examine the food security status and its related sociodemographic factors among the households living in Baft city of Iran. A sample of 702 households was selected by a simple random sampling method from January to March 2017. Using U.S. Department of Agriculture Food Security questionnaire, 34.3% of households showed some degree of food insecurity. Lower household size (OR = 0.84, CI: 0.73–0.97, P = .02), higher welfare facilities (OR = 1.55, CI: 1.32–1.81, P < .001), educational levels of the mothers and their spouse (being diploma as compared to under-diploma) (OR = 1.57, CI: 0.98–2.53, P = .04 and OR = 1.65, CI: 1.05–2.57, P = .02), governmental employment as compared to unemployment of the spouse (OR = 1.85, CI: 1.14–2.99, P = .01), and house ownership (rent compared to owner house; OR = 0.41, CI: 0.21–0.81, P = .01) were significantly associated with food security. The findings showed food insecurity was associated with some sociodemographic factors among households in Baft. These findings demonstrate that the government needs to continue its efforts to provide appropriate funding for population-based programs and policies, to enhance food security of the people living in this city.     

Nutritional status and functional ability of the elderly aged 60 to 90 years in the Mpigi district of central Uganda

OBJECTIVES: This study assessed the nutritional status of the elderly and their functional ability because poor nutritional status in the elderly is associated with poor functional ability. METHODS: Anthropometric measurements, demographic and socioeconomic data, dietary assessment by a food frequency list, and activities of daily life data were collected cross sectionally in 2002. Participants (n = 100) were randomly selected and the response rate was 95.2%. RESULTS: The overall prevalences of undernutrition were 33.3% based on body mass index (<18.5 kg/m(2)) and 52% based on mid-upper arm circumference (<24 cm). There was a large, significant difference between prevalences of malnutrition by sex: 68% of women were undernourished (body mass index < 18.5 kg/m(2)) compared with 32.4% of men. Dietary assessment showed that intake of fish, cereals, vegetables, tubers, and legumes was moderate (three to six times/wk). Evaluation of the ability of elderly people to perform basic activities of daily living showed that 33% of subjects were independent in all activities of daily living, except for mobility and feeding. The relation between body mass index and variables associated with functional ability were significant with regard to mobility, continence, and feeding (P < 0.05). CONCLUSION: This study found that a large percentage of older men and women are malnourished. This influenced their daily activities, especially mobility and feeding. The elderly need to be incorporated into health programs and policy.     

Position of the Academy of Nutrition and Dietetics: Nutrition Security in Developing Nations: Sustainable Food,Water, and Health

It is the position of the Academy of Nutrition and Dietetics that all people should have consistent access to an appropriately nutritious diet of food and water, coupled with a sanitary environment, adequate health services, and care that ensure a healthy and active life for all household members. The Academy supports policies, systems, programs, and practices that work with developing nations to achieve nutrition security and self-sufficiency while being environmentally and economically sustainable. For nations to achieve nutrition security, all people must have access to a variety of nutritious foods and potable drinking water; knowledge, resources, and skills for healthy living; prevention, treatment, and care for diseases affecting nutrition status; and safety-net systems during crisis situations, such as natural disasters or deleterious social and political systems. More than 2 billion people are micronutrient deficient; 1.5 billion people are overweight or obese; 870 million people have inadequate food energy intake; and 783 million people lack potable drinking water. Adequate nutrient intake is a concern, independent of weight status. Although this article focuses on nutritional deficiencies in developing nations, global solutions for excesses and deficiencies need to be addressed. In an effort to achieve nutrition security, lifestyles, policies, and systems (eg, food, water, health, energy, education/knowledge, and economic) contributing to sustainable resource use, environmental management, health promotion, economic stability, and positive social environments are required. Food and nutrition practitioners can get involved in promoting and implementing effective and sustainable policies, systems, programs, and practices that support individual, community, and national efforts.     

Comprehensive dietary evaluation of Italian primary school children: food consumption and intake of energy,nutrients and phenolic compounds

Abstract

Information on children’s diet including bioactive compounds is quite scarce. This observational study investigated the composition of the diet of children living in Parma (Italy; n?=?172, 8–10?years) using 3-day food records completed in winter and spring. Mean daily intakes of food groups, energy and nutrients were obtained using the national food database, while (poly)phenol contents were estimated from Phenol-Explorer or by specific literature searches. Food consumption, energy and nutrient intakes decreased in spring and were partially in line with national data. Adherence to the nutritional recommendations was not satisfied for the majority of nutrients. Main contributors to the phenolic intake were flavonoids (flavan-3-ols) and phenolic acids (hydroxycinnamic acids), while main dietary sources were fruit, chocolate-based products, vegetables, and tea & coffee (decaffeinated). This study provided the first comprehensive analysis of the nutritional composition of children’s diet. Future research should look at the health implications of dietary choices in children.     

Residence of College Students Affects Dietary Intake, Physical Activity, and Serum Lipid Levels

Objective Dietary intake, physical activity, and serum lipid levels of college students living on and off campus were compared.Design Subjects completed a questionnaire regarding lifestyle factors and a 3-day food record. Lipid levels were determined.Subjects College students enrolled in an introductory nutrition class.Main outcome measures Energy and nutrient intakes and serum lipid levels.Statistical analyses performed Analysis of variance and Student's t tests were used to determine differences in energy and nutrient intakes and serum lipid levels between men and women living on and off campus; χ² analysis was used to determine whether there were associations between residence and lifestyle factors; stepwise multiple regression analysis was used to investigate relationships among serum lipid levels, nutrient intakes, and exercise levels.Results Of the 104 participants, 81% were women and 19% were men; 51% lived on campus. In women, there was a statistically significant difference in age based on residence. Reported percentage of energy from protein was significantly higher in subjects living off campus. Serum triglyceride level and the ratio of total cholesterol to high-density lipoprotein were also significantly higher in students living off campus.Applications/conclusions Residence may affect serum lipid levels; living arrangements influence lifestyle factors such as food choices, nutrient content of the diet, and activity patterns. University foodservice directors are challenged to offer low-fat foods that students will choose to eat. Nutrition education is important for all students because their lifestyle may predispose them to development of chronic disease. J Am Diet Assoc. 1996; 96:35-38.     

Exploring the Experience and Determinants of the Food Choices and Eating Practices of Elderly Thai People: A Qualitative Study

Over the past decade, Thailand has experienced a rapid increase in its elderly population. Many unfavorable health outcomes among elderly people are associated with nutrition. Nutrition in elderly people is affected by physical, mental, and social factors. This study explored the food choices and dietary practices among community-dwelling elderly people in Thailand from the perspective of both caregivers and the elderly people themselves. Six focus group discussions and six semistructured interviews were conducted in the Samut Sakhon Province of Thailand. Deductive thematic analyses were conducted based on the “food choice process model framework.” The results show that physical and mental factors and societal factors are important determinants of food choices. Moreover, a changing food environment and economic factors were found to affect food choices. Issues of trust in food safety and food markets were highlighted as growing issues. Therefore, fostering healthy food choice interventions that consider both environmental and societal aspects is necessary.     

Effect of ambience on food intake and food choice

Eating takes place in a context of environmental stimuli known as ambience. Various external factors such as social and physical surroundings, including the presence of other people and sound, temperature, smell, color, time, and distraction affect food intake and food choice. Food variables such as the temperature, smell, and color of the food also influence food intake and choice differently. However, the influence of ambience on nutritional health is not fully understood. This review summarizes the research on ambient influences on food intake and food choice. The literature suggests that there are major influences of ambience on eating behavior and that the magnitude of the effect of ambience may be underestimated. Changes in intake can be detected with different levels of the number of people present, food accessibility, eating locations, food color, ambient temperatures and lighting, and temperature of foods, smell of food, time of consumption, and ambient sounds. It is suggested that the manipulation of these ambient factors as a whole or individually may be used therapeutically to alter food intake and that more attention needs to be paid to ambience in nutrition-related research.     

Identification of Environmental Supports for Healthy Eating in Older Adults

Many environmental settings and influences can affect food choices and eating behaviors in the growing population of community-dwelling older adults. Using the Social Ecological model, an expert panel participated in online discussions and an Analytic Hierarchy Process survey to identify the most important and changeable environmental settings and enabling factors that promote healthy eating in older adults. Food stores were rated most important when considering accessibility and affordability. Congregate nutrition sites were important for social support along with supporting access and affordability of healthful foods and living accommodations. Senior housing, health care, and religious settings also contributed to the goal of promoting healthful eating in aging adults. Restaurants were rated of lower importance. Based on these results, it is recommended that community food policies include the nutritional needs of older adults by addressing food accessibility and affordability, social support, and living accommodations, with a focus on congregate nutrition sites, food stores, senior housing, health care, and religious organizations.     

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.     

Food insecurity in people living with obesity: Improving sustainable and healthier food choices in the retail food environment—the FIO Food project

At both UK and global level, dietary consumption patterns need to change to address environmental, health and inequality challenges. Despite considerable policy interventions, the prevalence of overweight and obesity in the United Kingdom has continued to rise with obesity now a leading cause of mortality and morbidity. Obesity prevalence is greater among those on lower incomes and the current UK food system, including government policy, does not effectively address this. Current behavioural approaches, without the support of structural changes in the system, may even widen the inequalities gap. Hence, using behavioural insights from those living with obesity and food insecurity, the project will explore potential avenues that can be applied in the food system to promote healthier choices in the food retail environment. The National Food Strategy report recommends that the UK food system should ensure “safe, healthy, affordable food; regardless of where people live or how much they earn”. However, the association between food insecurity and the development of obesity is not well understood in relation to purchasing behaviours in the UK retail food environment, nor is the potential effectiveness of interventions that seek to prevent and reduce the impact of diet-induced health harms. The FIO Food (Food insecurity in people living with obesity – improving sustainable and healthier food choices in the retail food environment) project provides a novel and multi-disciplinary collaborative approach with co-development at the heart to address these challenges. Using four interlinked work packages, the FIO Food project will combine our knowledge of large-scale population data with an understanding of lived experiences of food shopping for people living with obesity and food insecurity, to develop solutions to support more sustainable and healthier food choices in the UK retail food environment.     

Nutritional Status of Functionally Dependent and Nonfunctionally Dependent Elderly in Taiwan

Objective: The purpose of this study was to measure and compare nutritional status of the functionally dependent elderly with those nonfunctionally dependent elderly by assessing nutrient intake, anthropometric measurements, hematological and biochemical parameters, and the nutritional risk index (NRI).

Methods: Ninety-six volunteers (42 functionally dependent elderly, 54 nonfunctionally dependent elderly) participated in this study. The items of activity of daily living (ADL) were assessed to determine functional status. Demographic and health data were collected at the time of interview. Subjects completed 24-hour diet recall and food frequency questionnaires. Height, weight and skinfold thickness measurements were taken. Hematological and biochemical parameters were measured. The NRI was then calculated.

Results: Osteoporosis and hypertension were the most frequently reported chronic diseases. A small proportion of the elderly with functional dependence (9.5%) and with nonfunctional dependence (13%) had a body mass index (BMI) (≤21 kg/m²), indicating they were underweight. There were no significant differences in nutrient intake between the two groups. However, a higher percentage of the functionally dependent elderly had a nutrient intake of less than 75% of the Taiwan Recommended Daily Nutrient Allowance (RDNA). The functionally dependent group had a higher prevalence of malnutrition than the nonfunctionally dependent group (44.7% vs. 25%) based on the NRI.

Conclusions: These functionally dependent elderly people exhibited a poorer nutritional status than the nonfunctionally dependent elderly. The elderly with functional dependence were at risk for inadequate iron intake and abnormal serum triglyceride concentrations; they were also at greater risk for chronic diseases and had a greater need for medications.     

Facteurs associés aux consommations alimentaires des bénéficiaires de l’aide alimentaire : étude abena

The majority of data available on the nutritional situation of low socioeconomic populations in industrialized countries describe a diet that is less favorable for health. The objective of this article is to describe the demographic and economic factors associated with low food intakes as defined by the National Nutrition and Health Program (Programme National Nutrition Santé, PNNS) dietary guidelines in a food aid dependent population.Subjects from the Abena (Food and nutritional status of food aid recipients) study were recruited in four urban zones (Marseille, Dijon, Paris, Seine-Saint-Denis). Questionnaires were principally about food intake frequencies, food supplies and food insecurity.Among the 1,164 included subjects, low consumption frequencies of fruits and vegetables (94.5% consuming <3.5/day), meat, fish and eggs group (42.6% <1/day), and dairy products (81.9% <3/day) were found. Men, young and aged people, and individuals with dependent children seem to be more often at risk for inadequate intakes with regard to the PNNS dietary guidelines. The food insecurity (49.2% declared not having enough to eat “sometimes” or “often”) was associated with an insufficient intake of fruits and vegetables, and meat, fish, and eggs.The described factors associated with lower food intakes observed in this precarious population confirms the notion that fruit and vegetable, and meat, fish and egg consumptions are markers of the socioeconomic status. This has been already observed in studies on more various socioeconomic statuses. The nutritional situation of food aid recipients described here underlines the need for food aid improvement, eventually focused on specific groups which have been identified.     

Dietary Intakes of Adolescents Living in Edirne,Turkey

Objective: To assess the dietary intakes of the adolescents in the area of Edirne, Turkey.

Design: Cross-sectional, prospective, epidemiological study.

Settings and Subjects: Our study group consists of 1944 adolescents aged between 12 to 17 years; 940 females and 1004 males.

Interventions: Three-day self-reported food records were collected from the subjects and evaluated by a nutrient database program. Reported nutrient intake data were analyzed for gender differences. Minitab statistical program was used to compare nutritional data of subjects.

Results: Energy, calcium, magnesium, folic acid, vitamins A, E, thiamine, and fiber intakes of whole adolescents, and also iron intakes of female adolescents were most likely to be inadequate compared with the recommendations. Iron, calcium, folic acid, thiamine, and fiber intakes were below two thirds of RDA/DRI in a large proportion of the adolescents. The intakes of protein, riboflavin, vitamin C, phosphorus and zinc were found to be adequate in a large percentage of the subjects. Forty eight percent of females and 60.1 % of males were below 2/3 of the RDA for energy.

Conclusion: Pediatricians and dietitians should train the adolescents living in our region and our country on practical strategies for making healthy food choices rich in nutrient content relative to energy value to ensure intakes that approach the recommendations.     

Disciplined appetites: Reimagining food and nutrition programs for people living with HIV and AIDS

Aims

Medical nutrition therapy is recommended for people living with HIV/AIDS to improve health and wellness; however, there is a lack of food and nutrition programs for people living with HIV/AIDS in Nova Scotia, Canada. The aim of this study was to explore the beliefs, values, and experiences of people living with HIV/AIDS in relation to food and nutrition programs.

Methods

A critical social theory lens with two disciplinary contexts: critical health geography and critical dietetics guided this research. Semi-structured interviews were conducted with 12 people living with HIV/AIDS and analysed for themes.

Results

The three main themes were identified: (1) intersections of social determinants of health, wellness, and food security; (2) discursive shaping of food and nutrition in relation to HIV; and (3) the dynamic nature of HIV care.

Conclusions

Participants offered recommendations on how food and nutrition programs might be reimagined to be more accessible, inclusive, and effective for people living with HIV/AIDS.