A taste of nutrition--a nutrition resource for leaders working with mentally handicapped adults

The trend towards deinstitutionalization for mentally handicapped adults has precipitated a need to provide these individuals with nutrition education and food preparation skills. Food, nutrition, and eating are important components of training programs for life skills, which lead to greater independence for the mentally handicapped. The types of nutrition information and learning activities needed for the mentally handicapped were determined through a literature review and a series of interviews with those working with this target group. The nutritional concerns of mentally handicapped adults include food selection to meet their nutritional needs, menu planning, food preparation, weight control, and nutrient-drug interactions. A Nutrition Resource Kit for Leaders Working with Mentally Handicapped Adults has been developed in The Regional Municipality of York in response to local demand for nutrition education programs and resources for mentally handicapped adults. The kit provides those working with mentally handicapped adults with background nutrition information, learning activities, resource materials, and references to additional resources. The topic areas covered include basic nutrition, nutritional concerns of mentally handicapped adults, nutrient-drug interactions, menu planning, shopping strategies, and food preparation. Dietitian-nutritionists can assist leaders who work with mentally handicapped adults by providing them with up-to-date nutrition information and motivating the to use available nutrition education resources.     

Position of the American Dietetic Association: Food and Water Safety

It is the position of the American Dietetic Association that the public has the right to a safe food and water supply. The Association supports collaboration among food and nutrition professionals, academics, representatives of the agricultural and food industries, and appropriate government agencies to ensure the safety of the food and water supply by providing education to the public and industry, promoting technological innovation and applications, and supporting further research. New food and water safety issues evolve as the environment changes. Food and nutrition professionals should collaborate with food and agriculture industries and members of the medical community in a joint effort to address these issues. Recent food- and waterborne illnesses have occurred in new settings and/or unique foods not traditionally associated with foodborne illness outbreaks. New issues associated with food safety and security that have emerged support the need for continued education and research. Government programs have developed powerful tools such as FoodNet and PulseNet to detect food- and waterborne illness outbreaks in the United States. These government programs have provided the data to enhance public policy and educational programs such as FightBac! Mandatory and voluntary adoption of Hazard Analysis Critical Control Points in the foodservice and processing industries have contributed to a decrease in foodborne illness outbreaks from traditional foods and some microorganisms usually associated with foodborne illnesses. Food and nutrition professionals are positioned to provide food and water safety education in community, clinical settings, and foodservice operations and food industries. With an aging population and an increased number of people at risk due to medical conditions for food- and waterborne illness, food and nutrition professionals should be involved in collaborative food and water safety issues in educational, research, and policy agenda settings. As the food and nutrition experts, food and nutrition professionals must assume a major role in food and water safety education and research.     

Understanding Barriers to Implementing Quality Lunch and Nutrition Education

Food services and nutrition education are priorities for the Coordinated School Health Program in Massachusetts, which is a CDC funded partnership between the Massachusetts Departments of Education and Public Health. Despite funding and resources provided by governmental and non-governmental agencies, schools are facing barriers in effectively creating a healthy nutritional environment. A qualitative survey was conducted to understand barriers to implementing quality lunch and nutrition education programs perceived by superintendents, principals, food service directors, nurses, and health educators in Massachusetts. The results suggest that while funding can initially enable schools to provide quality lunch, but without changes in students' preference for unhealthy food and parental and community involvement in fostering students' healthy eating behavior, the lunch programs cannot achieve a sustainable success. Lack of opportunity for communication among food service staff, health educators, and teachers appears to hinder the coordination necessary to promote school lunch as well as school-wide nutrition education. Respondents acknowledged that the state's academic assessment system is the priority issue in their schools, but expressed that the interests and initiatives of superintendents and principals in the lunch and nutrition education programs can be enhanced. Overall, the results suggest that successful implementation of quality lunch and nutrition education programs require not only the collaborative efforts of school administration and staff but also the support of parents, community, and the mass media.     

The independent older Australian: Implications for food and nutrition recommendations

The World Health Organisation has restructured their program for health and the elderly, renaming it Aging and Health, focussing on aging as a part of life rather than a static age group separated from the rest of the population. As the older population becomes more heterogeneous, nutrition and food service providers in the community are faced with new challenges. This paper presents nutrition recommendations relevant to community nutrition programs in Australia including the recently released Dietary Guidelines for Older Australians. The subsequent discussion focuses on issues associated with implementation of community based food and nutrition intervention programs. The following strategies for successful implementation of community based food and nutrition programs were identified: Meals on Wheels services. 1. should maintain a register of food service systems for each site to assist in the planning process. 2. Develop a procedure for the nutritional assessment of menus focussing on a standardised methodology and recipes as well as ensuring trained staff are available to apply the procedure. 3. Validate recommended serving sizes and recommend serving utensils for specific menu items. Provide advice on the purchasing, use and calibration of scales as well as containers. 4. Develop alternative, informal methods of assessing client satisfaction to ensure the clients' experience with the service, rather than their reaction to the experience, be assessed. 5. Develop a management training program which focuses on a "train-the-trainer' strategy to ensure continuous, on-site training. Meeting the nutritional needs of the heterogeneous group of older people implies a modified approach to nutritional support. All those involved in community nutrition organisations need to recognise the significance of the "caring" role as well as that of food provider and the impact of this on the nutritional status of the client. The development of consistent guidelines and tools will assist organisations in meeting the needs of their target groups. As professionals we need to understand and accept the constraints that these organisations deal with to ensure the services we provide are appropriate. These constraints include all of those issues detailed in this paper - production capability, training resources and the availability of volunteers.     

营养教育对幼儿家长营养知识·态度·行为的影响

目的了解营养教育对合肥市幼儿家长营养知识、态度与行为的影响,以便为制定幼儿营养干预措施的制定提供科学依据.方法采取随机、分层、整群抽样的方法在合肥市选取8所幼儿园,随机分为干预组和对照组.在干预组幼儿园定期举办家长营养知识培训班,并将编写的幼儿营养知识手册分发给家长学习.采用自拟调查问卷对干预前、干预中期和终期幼儿家长营养知识、态度与行为进行调查.结果组间比较显示,干预组家长的营养知识水平明显提高,每周吃1～2次及以上水果、牛奶、鱼类的人数增加.自身对照研究显示,通过营养教育,干预组家长每周吃1～2次及以上杂粮、牛奶、水产品、海带和紫菜的人数增加,而吃畜肉、街头小吃、西餐的人数减少.无论是干预组还是对照组,家长对接受营养知识均持积极的态度.结论营养教育对家长的营养知识、态度和行为有积极的影响,可通过书籍、报刊、杂志、电视节目、专家义务讲座等途径进行.     

Position of the American Dietetic Association: Child and Adolescent Nutrition Assistance Programs

It is the position of the American Dietetic Association that children and adolescents should have access to an adequate supply of healthful and safe foods that promote optimal physical, cognitive, and social growth and development. Nutrition assistance programs, such as food assistance and meal service programs and nutrition education initiatives, play a vital role in meeting this critical need. Nutrition assistance programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply. Federally funded nutrition assistance programs help ensure that children and adolescents receive meals that provide adequate energy and nutrients to meet their growth and development needs; children and adolescents have access to adequate food supplies; and women, infants, and children who have nutritional or medical risk factors, such as iron-deficiency anemia or overweight, receive supplemental nutritious foods as well as nutrition education. In addition, federally funded nutrition assistance programs serve as a means to combat hunger and food insecurity and as a vehicle for nutrition education and promotion of physical activity designed to prevent or reduce obesity and chronic disease. It is important that continued funding be provided for these programs that have been consistently shown to have a positive influence on child and adolescent well-being. Registered dietitians and dietetic technicians, registered, are uniquely qualified to design, implement, and evaluate nutrition assistance programs for children and adolescents. Registered dietitians and dietetic technicians, registered, are the only food and nutrition practitioners with adequate training in food science, nutrition, and food systems to implement research and surveillance programs to monitor, evaluate, and improve the nutritional status of children and adolescents.     

Which Physicians Are Best Prepared to Advise Seniors about Nutrition? A Pilot Survey in Israel

Physicians' knowledge and attitudes can profoundly impact the quality of nutritional care provided to older patients. We assessed physicians' knowledge and attitudes concerning nutritional care for older adults and its correlates. Questionnaires were mailed to 898 physicians in the second largest HMO in Israel: the response rate was 26.5%. Questionnaires assessed aspects of geriatric nutrition, such as food choices, functioning, and medical conditions. Results indicated highest knowledge of nutritional issues for family physicians and for those who were younger (<50 age) and female. Although 68% believed it is important for physicians to explain nutritional issues to older patients, this role was also deemed important for dietitians (83%) and nurses (59%). A variety of factors influencing geriatric nutrition, especially functional and medical conditions, were identified; likewise, nutrition was perceived as influencing various health conditions. Although the low response rate limits generalizability, it appears that physicians in this survey recognized the impact of proper nutrition health and take responsibility for explaining nutrition to their older patients.     

Position of the Academy of Nutrition and Dietetics: Child and Adolescent Federally Funded Nutrition Assistance Programs

It is the position of the Academy of Nutrition and Dietetics that children and adolescents should have access to safe and healthy foods that promote physical, cognitive, and social growth and development. Federally funded nutrition assistance programs, such as food assistance, meal service, and nutrition education, play a vital role in ensuring that children and adolescents have access to the foods they need and in improving the overall nutrition and health environments of communities. Federally funded nutrition assistance programs help to ensure that children and adolescents receive safe, healthy foods that provide adequate energy and nutrients to meet their growth and development needs. These programs provide access to adequate food supplies to combat hunger and food insecurity; provide healthy foods to children and adolescents who have nutritional or medical risk factors, such as iron deficiency anemia; and provide nutrition education. In addition, federally funded nutrition assistance programs serve as a means to prevent or reduce obesity and other chronic diseases. It is important that permanent and full federal funding be provided for these programs, which have been consistently shown to have a positive impact on child and adolescent nutrition and health outcomes. Registered dietitian nutritionists and nutrition and dietetic technicians, registered—trained in food science, nutrition, and food systems to implement programs to monitor, evaluate, and improve the nutritional status of children and adolescents—are preeminently qualified to implement and evaluate nutrition assistance programs for children and adolescents.     

Exploring global consumer attitudes toward nutrition information on food labels

In many parts of the world, food companies, consumers, and governments are re-examining the provision of nutrition information on food labels. It is important that the nutrition information provided be appropriate and understandable to the consumer and that it impact food-choice behaviors. Potentially, food labeling represents a valuable tool to help consumers make informed decisions about their diet and lifestyle. Food information organizations worldwide have been following consumer trends in the use of this information as well as consumer attitudes about food, nutrition, and health. This paper summarizes a workshop that examined consumer attitudes gathered regionally with the aim of establishing commonalities and differences.     

Position of the American Dietetic Association: child and adolescent food and nutrition programs

It is the position of the American Dietetic Association that all children and adolescents, regardless of age; gender; socioeconomic status; racial, ethnic, or linguistic diversity; or health status should have access to food and nutrition programs that ensure the availability of a safe and adequate food supply that promotes optimal physical, cognitive, and social growth and development. Appropriate food and nutrition programs include food assistance and meal programs, nutrition education initiatives, nutrition screening and assessment followed by appropriate nutrition intervention, and anticipatory guidance to promote optimal nutrition status. Malnutrition has been linked to delayed physical, psychosocial, and cognitive development and is now recognized as a major contributor to the growing problem of overweight and obesity in the child and adolescent population. Food and nutrition programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply and nutrition screening, assessment evaluation, and intervention. It is important that continued funding be provided for these programs, which have been consistently shown to have a positive impact on child and adolescent well-being. Food and nutrition programs will continue to serve not only as a means to combat hunger and food insecurity but also as a vehicle for nutrition education and promotion of physical activity designed to combat overweight and prevent chronic disease. It is the role of the credentialed dietetics professional to support permanent, adequate funding to food and nutrition programs, universal health-care reimbursement for nutrition services, and the use of research and surveillance programs to justify, evaluate, and improve these programs. In addition, the dietetics professional is responsible for serving as a nutrition resource to all groups and individuals working with children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits. J Am Diet Assoc. 2003;103:887-893.     

A participatory assessment of dietary patterns and food behavior in Pohnpei, Federated States of Micronesia

Non-communicable diseases are escalating rapidly within the Pacific region, including Pohnpei, Federated States of Micronesia. A shift in dietary patterns from indigenous, high fiber, healthy local food to energy-dense, imported food with low nutritional value, and increased sedentary lifestyles are expediting this process. Essential to counteract this trend is an understanding of how people make food decisions. This participatory assessment utilized a quantitative and qualitative approach to capture diet patterns and knowledge, attitudes, beliefs and practices of food consumption. A structured 7-day food frequency questionnaire (FFQ) was used to quantify the diets of 293 adult Pohnpeian women attending an island-wide education/disability screening program. An ethnographic approach, including in-depth interviews, informal focus groups and observations documented food behavior practices and contributed to the design of the FFQ. Of those responding to the FFQ, 96% reported eating rice frequently (3-7 days/week) whereas 75% reported eating locally grown carbohydrate foods frequently. Factors associated with culture change, including availability, affordability, convenience, and status of food items were found to determine food decisions. Food-based, culturally sensitive and innovative strategies that utilize existing resources are required to promote local food production and consumption. Prevention programs with an information, education and communication (IEC) approach are needed to provide accurate and available health and nutrition knowledge and to increase the demand for local foods. Behavior modification requires the continued collaboration of the national, state, and community organizations that partnered on this research to strategize programs in order to target individual food choices and to transform the environment to support these decisions.     

Government involvement in nutrition education: panacea or Pandora's box?

Key governmental policy shifts have affected nutrition educationactivities in recent decades. These activities included legislationof new programs, promulgation of program regulations, and theissuing of a number of authoritative scientific reviews documentingthe association between diet and health. Also during this period,the food industry and voluntary health associations steppedup their efforts to inform the American public. This paper reviewsrecent policy trends and identifies issues for the attentionof nutrition educators, including: (1) the appropriate rolefor government in nutrition education, (2) quantification ofdietary advice for consumers, (3) the effect of competing dietarymessages for consumers' attention and comprehension, and (4)how to tailor general dietary messages to best meet the consumers'individual biochemical and nutritional needs.     

Position of the American Dietetic Association,Society for Nutrition Education,and American School Food Service Association--Nutrition services: an essential component of comprehensive school health programs

It is the position of the American Dietetic Association (ADA), the Society for Nutrition Education (SNE), and the American School Food Service Association (ASFSA) that comprehensive nutrition services must be provided to all of the nation's preschool through grade twelve students. These nutrition services shall be integrated with a coordinated, comprehensive school health program and implemented through a school nutrition policy. The policy should link comprehensive, sequential nutrition education; access to and promotion of child nutrition programs providing nutritious meals and snacks in the school environment; and family, community, and health services' partnerships supporting positive health outcomes for all children. Childhood obesity has reached epidemic proportions and is directly attributed to physical inactivity and diet. Schools can play a key role in reversing this trend through coordinated nutrition services that promote policies linking comprehensive, sequential nutrition education programs, access to and marketing of child nutrition programs, a school environment that models healthy food choices, and community partnerships. This position paper provides information and resources for nutrition professionals to use in developing and supporting comprehensive school health programs. J Am Diet Assoc. 2003;103:505-514.     

营养教育对饮食行为的影响初探

目的营养教育是以改善营养状况目的的,通过传播相关营养信息,指导个人、家庭和社区人群选择健康食物,最终改变人群饮食行为的一系列有计划的活动。通过不同方式的营养教育,可以在人群中普及膳食营养知识,摒弃不健康的生活方式,指导公众建立良好的饮食行为。本文综述了营养教育对儿童、青年学生及中老年人群饮食行为的影响,以及实施营养教育中遇到的问题。为了取得更加满意的干预效果,在营养教育实践中,应注意大众传播和人际传播两种途径相结合,注意保持教育的长期性与有效性,并尽量涵盖不同年龄段和知识层次的人群。     

Nutrition education needs and services among American Indians participating in a federal food assistance program

This study presents data on the nutrition education needs and services among a nationally representative sample of American Indians participating in the Food Distribution Program on Indian Reservations (FDPIR) during September 1989. A multi-stage, stratified sample design was utilized, and 757 FDPIR households completed interviews. Three focus groups, composed of FDPIR household members responsible for food selection and preparation, also were conducted.Over half of all households participating in the program had at least one adult with one or more nutrition-related health problems, and more than one out of four households had at least one member who was supposed to be on a special diet. FDPIR Program Directors and focus group participants independently identified these same health problems as issues of importance to their reservations. However, focus group participants demonstrated misconceptions about diet and health, a lack of information related to improving dietary habits, frustration in changing dietary practices, and a need for more health and nutrition education.The 30 local FDPIR programs included in this study allocated an average of 5% of their administrative funds to nutrition education. Over 25% of the programs reported no nutrition education budget. Nineteen programs reported nutrition education personnel expenditures. With few exceptions, these staff had little or no formal training in either health or nutrition. The focus of nutrition education activities usually was limited to distributing commodity recipes and cookbooks, and demonstrating how to prepare foods.The nutrition education needs identified in this article go beyond the scope of FDPIR nutrition education services being provided or required by Federal regulations. Federal and tribal program changes are necessary to ensure that adequate nutrition education services are available through FDPIR.     

Position of the American Dietetic Association: child and adolescent food and nutrition programs

It is the position of the American Dietetic Association that all children and adolescents, regardless of age, sex, socioeconomic status, racial diversity, ethnic diversity, linguistic diversity, or health status, should have access to food and nutrition programs that ensure the availability of a safe and adequate food supply that promotes optimal physical, cognitive, social, and emotional growth and development. Appropriate food and nutrition programs include food assistance and meal programs, nutrition education initiatives, and nutrition screening and assessment followed by appropriate nutrition intervention and anticipatory guidance to promote optimal nutrition status. Food and nutrition programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply and nutrition screening, assessment, and intervention. It is important that continued funding be provided for these programs, which consistently have been shown to have a positive impact on child and adolescent health and well-being. Food and nutrition programs serve as a means to prevent or reduce hunger and food insecurity, but also as a vehicle for nutrition education and promotion of physical activity designed to prevent or reduce overweight and prevent chronic disease. It is the role of the registered dietitian to support adequate and sustained funding for food and nutrition programs, universal health care reimbursement for nutrition services, and the use of research and surveillance programs to evaluate and improve these programs. In addition, the registered dietitian and dietetic technician, registered, are responsible for serving as a nutrition resource to all groups and individuals providing services to children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits.     

The European view of hospital undernutrition.

Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support.     

Effects of home-visit nutrition education on nutritional status improvement of an urban community-dwelling elderly women in Korea

PURPOSE: This study was conducted to evaluate the effects on home-visit nutrition education by a dietitian on nutritional status improvement of an urban community-dwelling elderly women in Korea. METHODS: In the baseline survey, information on general characteristics, health-related characteristics, anthropometric measurements, biochemical measurements, nutritional knowledge. nutritional attitude, dietary habits, and food and nutrient intakes of 183 elderly people were obtained. The intervention group received weekly home-visit nutrition education over 4 months. RESULTS: After home-visiting nutrition education, nutritional knowledge, nutritional attitude and dietary habit were increased significantly by 1.8, 2.1 and 6.9 in the intervention group (P<0.01), respectively, who also appeared to consume more cereals and their products, legumes and their products, vegetables, seasonings, milk and dairy products than the control group. It was found that the nutrient intake increased significantly regarding energy, protein, calcium, iron, phosphorus, thiamin and riboflavin (P<0.05). The MAR (mean nutrient adequacy ratio) increased by 0.22 during the period of the study in the intervention group, and 0.09 in the control group, the difference being statistically significant (P<0.01). Differences between in mean change of anthropometric and biochemical indices between the intervention and control groups were not significant. CONCLUSIONS: These findings suggest that home-visit nutrition education by a dietitian is effective for improvement of the nutritional status of elderly women in an urban community. In conclusion, home-visit nutrition education should be recommended for nutritional status improvement and health promotion in the community elderly.