The food consumption patterns and perceptions of dietary advice of older people

Background Prevention policies do not have an upper age limit, and as the overwhelming majority of older people continue to reside in the community there is a growing role for community dietetics and primary care team members in the promotion of healthy eating.
Method The multi-method project ascertained the dietary beliefs and practices of older people residing in high-income, low-income and rural localities of Scotland. One hundred and fifty-two people aged 75 years and over were interviewed using a semistructured interview schedule and 24-h food recall questionnaire.
Results An analysis of the food recall questionnaire demonstrated that the diets of the elderly appear to differ little from the Scottish population as a whole. In all groups there was an under consumption of fruits and vegetables reported. Findings from the interviews demonstrated that dietary beliefs were found to be firmly rooted in childhood and lifetime experiences. Participants defined healthy eating as 'proper meals', 'proper foods', and a variety of foods eaten in moderation. These definitions were based upon the consumption of fresh foods which would be considered healthy. Changing and conflicting advice on health and nutrition was contrasted with personal experiences. Few knew of the role of the dietitian or community dietitian.
Conclusions This study demonstrates a contrast between stated beliefs and actual consumption patterns. Access to food, and the cost and quality of foods impacted upon food practices. The role of the community dietitian should be promoted. Advice on healthy eating must work with contemporary practices and beliefs building upon positive aspects of diet and eating and involving the food industry, retail sector and health services.     

Nutrition Knowledge and Dietary Intake of Adolescents in Cofimvaba,Eastern Cape,South Africa

The aim of the study was to assess the nutrition knowledge, nutrient intakes, and association between nutrition knowledge and dietary intakes of 98 adolescents attending five schools in rural Cofimvaba, South Africa. Measures included a socioeconomic questionnaire, two 24-hour-recall questionnaires, and food-frequency and nutrition knowledge questionnaires. The overall score for the multiple-choice section on general nutrition and the South African Food-Based Dietary Guidelines was 72.9%; 75.4% for correct identification of food groups; and 41.3% for correct identification of food portions/serving sizes. Median nutrient intakes, measured by 24-hour recall, failed to meet average requirements, with the exception of protein, carbohydrates, chromium, riboflavin, pantothenate, and vitamin K among girls. A similar trend was observed for boys. Lower total carbohydrate and fat and higher protein intakes were associated with a higher quartile score for nutrition knowledge. The study provided a valuable understanding of the association between nutrition knowledge and dietary intakes of adolescents.     

A study of clinical dietetic workforce recruitment and retention in Queensland

Aims: The aim of the present study was to investigate factors influencing the recruitment and retention of the clinical dietetics workforce in metropolitan practice, with a focus on Queensland Health. Methods: A qualitative study using semistructured telephone and face‐to‐face interviews among a purposively recruited sample of 28 Queensland clinical dietitians. The interviews explored factors affecting recruitment and retention, job satisfaction and possible strategies for the recruitment and retention of hospital‐based dietitians within Queensland Health was conducted. Interviews were audio‐recorded, transcribed verbatim and content analysed by two researchers (authors 1 & 2) before comparing, confirming, describing and interpreting themes identified. Results: All but two of the interviewees (26/28) were either existing (n = 16) or previous (n = 10) employees of Queensland Health. The demographic attributes of the sample reflected the broader Australian dietetic workforce. Factors effecting recruitment to current positions were the position itself, the closeness of the position to home and job security associated with Queensland Health positions. The most common factors assisting retention in Queensland Health were the team collegiality, opportunities, and the closeness to home of the workplace and professional development opportunities. The negatives of employment were high work demands or workload and bureaucratic frustrations within Queensland Health. Increasing remuneration rates, career pathways and increasing the flexibility of work hours were strategies considered as most important for Queensland Health to enhance clinician recruitment and retention. Conclusion: Factors effecting recruitment and retention of clinical dietitians are largely amenable to human resource and organisational management strategies that address these determinants of staff turnover.     

Maternal Diets in India: Gaps,Barriers, and Opportunities

Suboptimal dietary intake is a critical cause of poor maternal nutrition, with several adverse consequences both for mothers and for their children. This study aimed to (1) assess maternal dietary patterns in India; (2) examine enablers and barriers in adopting recommended diets; (3) review current policy and program strategies to improve dietary intakes. We used mixed methods, including empirical analysis, compiling data from available national and subnational surveys, and reviewing literature, policy, and program strategies. Diets among pregnant women are characterized by low energy, macronutrient imbalance, and inadequate micronutrient intake. Supply- and demand-side constraints to healthy diets include food unavailability, poor economic situation, low exposure to nutrition counselling, food restrictions and taboos, adverse family influence and gender norms, and gaps in knowledge. Intervention strategies with potential to improve maternal diets include food-based programs, behavior change communication, and nutrition-sensitive agriculture interventions. However, strategies face implementation bottlenecks and limited effectiveness in real-world at-scale impact evaluations. In conclusion, investments in systems approaches spanning health, nutrition, and agriculture sectors, with evaluation frameworks at subnational levels, are needed to promote healthy diets for women.     

Farmers’ Market Nutrition Program Educational Events Are Broadly Accepted and May Increase Knowledge,Self-Efficacy and Behavioral Intentions

The Farmers’ Market Nutrition Program (FMNP) in the U.S. provides coupons for the purchase of fruit and vegetables (FV) to pregnant women and children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and to income-eligible adults 60+ years of age. The New York State FMNP Education Event Guide was developed to support cooperative extension educators in providing information, food tastings, and cooking demonstrations at farmers’ markets (FM) to encourage consumption of FV. This paper describes implementation at seven FM in New York City, and shopping and eating behaviors in a cross-sectional survey of FM shoppers (n = 377). Three of nine lessons were implemented more than once, typically with food sampling (78.9%). FM shoppers were primarily women (81.5%), racially diverse (30.5% Black, 23.1% White), frequent shoppers (2.4 times/month), and had high FV consumption (2.24 cups fruit; 2.44 cups vegetables daily). Most FM shoppers participated in the FM education event (84%), and participants and non-participants had equivalent shopping and eating behaviors. More than 70% of FM education participants believed that the event positively impacted their knowledge, self-efficacy, and behavioral intentions. FMNP education events at FM were broadly accepted by FM shoppers of all characteristics, and may improve knowledge, self-efficacy, and behavioral intention.     

Interaction between risk factors for iron deficiency in young children

Aims: To describe interactions between risk factors for iron deficiency (ID). Methods: A random community sample of 316 children 6–23 months old of whom 13% had ID. Risk factors for ID were determined using logistic regression. Relative risks (RR) and 95% confidence intervals (95%CIs) were estimated. An additive relationship between risk factors was present if the RR of ID when both factors were present exceeded the sum of individual RRs of ID. Results: Independent risk factors for ID in a multivariate model were prematurity/low birthweight (RR 4.82, 95%CI 1.57–7.42), increased body mass index (5.57, 1.41–12.18), eating fruit only as a snack (3.48, 1.38–7.28), having no milk formula (4.40, 2.06–7.27), daily cow's milk (4.71, 1.99–8.56) and having only homemade first solids (2.91, 1.01–6.40). Eating fruit only as a snack had an additive relationship with three other dietary risk factors: no milk formula (RR 11.75, 95%CI 4.58–19.46), cow's milk daily (13.48, 1.20–42.37) and only homemade first solids (8.66, 3.43–14.76). Larger body mass had an additive relationship with four dietary factors: no milk formula (RR 14.69, 95%CI 1.95–24.00), fruit only as a snack (10.11, 4.59–16.36), cow's milk daily (12.28, 5.97–21.95) and only homemade first solids (7.05, 1.27–16.27). Prematurity/low birthweight had an additive relationship with two dietary risk factors: no milk formula (RR 9.16, 95%CI 2.42–12.11) and only homemade first solids (7.15, 1.47–9.73). Conclusions: Risk factors for ID interact to place young children at high risk of ID.     

Maintaining and updating food composition datasets for multiple users and novel technologies: Current challenges from a UK perspective

The UK national food composition dataset, maintained at the Quadram Institute Bioscience, is a valuable national resource for a variety of users. The UK has a long history of compiling and utilising food composition data, which started for the specific purpose of understanding war‐time nutrition, and is now fundamental to multiple areas of research, policy, food manufacturing and consumer behaviour. The rise of mHealth technologies has brought food and nutrition data direct to the consumer and presents new challenges for food data compilers relating to coverage of foods and nutrients, and accessibility and transparency of data. In addition, emerging efforts in sustainable food production, changing diets and the ever‐increasing burden of non‐communicable diseases requires an integrated approach that will span the agri‐food, nutrition and health space. In order to achieve this, there needs to be continued efforts in food data standardisation, international collaboration and stronger emphasis in making food and nutrition data FAIR (findable, accessible, interoperable and reusable). The UK national food composition data and the emerging initiatives in food and nutrition it supports are playing an important role in the future development of healthy and sustainable UK diets.     

The Influence of Sport Nutrition Knowledge on Body Composition and Perceptions of Dietary Requirements in Collegiate Athletes

Sport nutrition knowledge has been shown to influence dietary habits of athletes. The purpose of the current study was to examine relationships between sport nutrition knowledge and body composition and examine potential predictors of body weight goals in collegiate athletes. Participants included National Collegiate Athletic Association Division III women (n = 42, height: 169.9 ± 6.9 cm; body mass: 67.1 ± 8.6 kg; fat-free mass: 51.3 ± 6.6 kg; body fat percent: 24.2 ± 5.3%) and men (n = 25, height: 180.8 ± 7.2 cm; body mass: 89.2 ± 20.5 kg; fat-free mass: 75.9 ± 12.2 kg; body fat percent: 13.5 ± 8.9%) athletes. Body composition was assessed via air displacement plethysmography. Athletes completed a validated questionnaire designed to assess sport nutrition knowledge and were asked questions about their perceived dietary energy and macronutrient requirements, as well as their body weight goal (i.e., lose, maintain, gain weight). Athletes answered 47.98 ± 11.29% of questions correctly on the nutrition questionnaire with no differences observed between sexes (men: 49.52 ± 11.76% vs. women: 47.03 ± 11.04%; p = 0.40). An inverse relationship between sport nutrition knowledge scores and body fat percentage (BF%) (r = −0.330; p = 0.008), and fat mass (r = −0.268; p = 0.032) was observed for all athletes. Fat mass (β = 0.224), BF% (β = 0.217), and body mass index (BMI) (β = 0.421) were all significant (p < 0.05) predictors of body weight goal in women. All athletes significantly (p < 0.001) underestimated daily energy (−1360 ± 610.2 kcal/day), carbohydrate (−301.6 ± 149.2 grams/day [g/day]), and fat (−41.4 ± 34.5 g/day) requirements. Division III collegiate athletes have a low level of sport nutrition knowledge, which was associated with a higher BF%. Women athletes with a higher body weight, BF% and BMI were more likely to select weight loss as a body weight goal. Athletes also significantly underestimated their energy and carbohydrate requirements based upon the demands of their sport, independent of sex.     

Post‐pyloric feeding tube placement in critically ill patients: Extending the scope of practice for Australian dietitians

Aim

To determine whether the placement of a post‐pyloric feeding tube (PPFT) can be taught safely and effectively to a critical care dietitian.

Methods

This is a prospective observational study conducted in an adult intensive care unit (ICU). The intervention consisted of 19 attempts at post‐pyloric intubation by the dietitian. The 10 ‘learning’ attempts were performed by the dietitian under the direction of an experienced (having completed in excess of 50 successful tube placements) user. A subsequent nine ‘consolidation’ attempts were performed under the responsibility of the intensive care consultant on duty. The primary outcome measures were success (i.e. tip of the PPFT being visible in or distal to the duodenum on X‐ray) and time (minutes) to PPFT placement. Patients were observed for adverse events per standard clinical practice.

Results

A total of 19 post‐pyloric tube placements were attempted in 18 patients (52 (23–70) years, ICU admission diagnoses: trauma n = 4; respiratory failure n = 3; and burns, pancreatitis and renal failure n = 2 each). No adverse events occurred. Most (75%) patients were sedated, and mechanically ventilated. Prokinetics were used to assist tube placement in 11% (2/19) of attempts, both of which were successful. Placement of PPFT was successful in 58% (11/19) of attempts. Whilst training, the success rate was 40% (4/10) compared with 78% (7/9) once training was consolidated (P = 0.17). In the successful attempts, the mean time to placement was 11.0 minutes (3.9–27.1 minutes).

Conclusions

A dietitian can be trained to safely and successfully place PPFT in critically ill patients.     

广东省城市居民食物和营养素摄入现状及变化趋势

目的 描述广东省城市居民食物消费及营养素摄入现状及变化趋势。方法 在广东省5个城市调查点选取3 154户7 421 人进行调查,膳食调查采用连续3 d 24 h回顾法,调味品消费量采用称重法。结果 广东省城市居民平均每标准人日粮谷类食物摄入量为240.1 g,蔬菜为302.1 g,水果为58.4 g,畜禽肉类为157.3 g,水产品类为50.4 g,蛋类及其制品为25.0 g,奶类及其制品为44.3 g,豆类及其制品为7.9 g,食用油摄入量为30.2 g,食盐为 7.6 g,酱及酱油为10.2 g;城市居民每标准人日能量平均摄入量为7 173.7 kJ,蛋白质为69.4 g,脂肪为74.4 g,碳水化合物为196.0 g,视黄醇当量为176.7 μg,核黄素为0.9 mg,硫胺素为0.9 mg,钙为415.5 mg;与1992年比较,能量、脂肪、蛋白质、碳水化合物摄入呈下降趋势。结论 广东省处于经济转型升级时期,城市居民食物消费及营养素摄入发生变化,需加强合理营养、平衡膳食的宣传教育。     

Foods, nutrients and portions consumed by a sample of Australian children aged 16–24 months

Aim:  To describe the diet of a sample of Australian children aged 16–24 months with regard to the amounts of foods and nutrients consumed.
Methods:  Cross-sectional data collected from participants in a five-year randomised trial of the primary prevention of asthma. Pregnant women with a family history of atopy were recruited from six hospital antenatal clinics in western Sydney. At the 18-month assessment, carers of 429 of children completed three-day weighed food records. Three-day average intakes of foods and nutrients and average portions per eating occasion for commonly consumed foods. T -tests for comparing gender differences.
Results:  Diets were characterised by large amounts of milk and non-milk drinks with smaller amounts of cereals, fruits, vegetables and meats. Total energy intake was significantly higher for boys than girls and exceeded estimated energy requirements in both boys and girls. Food groups contributing most to energy included milk and milk products (35%), cereals (15%), cereal-based products (9%) and non-milk drinks (8%). Micronutrient intakes were below the Estimated Average Requirement in more than 5% of the children for vitamin A, calcium, vitamin C and iron. Sodium intakes exceeded the upper level of 1000 mg for 62% of children, while dietary fibre intake was only half the Adequate Intake of 14 g. Relatively few foods were widely consumed and median portion sizes were typically small in relation to commonly used reference portion sizes.
Conclusion:  These data may be useful as a preliminary basis for developing age-specific dietary surveillance tools and dietary guidance for children aged one to two years.