Impacts of a Vegetable Cooking Skills Program Among Low-Income Parents and Children

Objective

To evaluate the impact of a vegetable-focused cooking skills and nutrition program on parent and child psychosocial measures, vegetable liking, variety, and home availability.

Impact of a School-Based Gardening,Cooking, Nutrition Intervention on Diet Intake and Quality: The TX Sprouts Randomized Controlled Trial

School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students’ dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016–2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. −0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. −2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. −8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov ({"type":"clinical-trial","attrs":{"text":"NCT02668744","term_id":"NCT02668744"}}NCT02668744).     

The Impact of Nutrition Standards on Competitive Food Offerings and Purchasing Behaviors of High School Students

BACKGROUND: With adolescent obesity rates on the rise, the school food environment is receiving closer scrutiny. This study looks at the effects of nutrient standards as part of a wellness policy that was implemented in 3 public high schools in 1 county, by analyzing the nutritional value of competitive food offerings and purchases before and after the development of the standards.
METHODS: All food offerings and purchases were labeled based on their nutritional density using a stoplight approach of green, yellow, and red colors for the pre- and post- period. The stoplight approach to ranking foods is on a continuum of nutrient density, with green foods being the healthiest choices and red foods offering minimal nutrient density.
RESULTS: Results showed that after the implementation of the standards, red foods made up 30% of offerings, down from 48% of offerings prior to the existence of the guidelines. The proportion of red food purchases also decreased, from 83% to 47%. Additionally, yellow food offerings increased from 18% to 48% and purchases increased from 6% to 34%.
CONCLUSION: Results indicate that the nutrient standards as part of the wellness policy contributed to a positive shift in the nutritional value of competitive food purchases and offerings.     

Impact of an Expansion of a Clinical Nutrition Curriculum on Pre-Clerkship Medical Students’ Perception of Their Knowledge and Skills Related to Performing a Nutritional Assessment

Learning how to provide nutritional counseling to patients should start early in undergraduate medical education to improve the knowledge, comfort, and confidence of physicians. Two nutrition workshops were developed for first-year medical students. The first workshop, co-led by physicians and registered dieticians, focused on obtaining nutrition assessments. The second workshop focused on the appropriate dietary counseling of patients with chronic kidney disease and cardiovascular risk. We surveyed students before workshop 1, after workshop 1, and after workshop 2 to assess their perceptions of the value of physician nutrition knowledge and counseling skills as well as their own comfort in the area of nutritional knowledge, assessment, and counseling. We found a significant improvement in their self-assessed level of knowledge regarding counseling patients, in their comfort in completing a nutritional assessment, and in their confidence in advising a patient about nutrition by the end of the first workshop. By the time of the second workshop five months later, students continued to report a high level of knowledge, comfort, and confidence. The implementation of clinical nutrition workshops with a focus on assessment, management, and counseling was found to be effective in increasing student’s self-assessed level of knowledge as well as their confidence and comfort in advising patients on nutrition. Our findings further support the previous assertion that clinical nutrition education can be successfully integrated into the pre-clerkship medical school curriculum.     

Impact of a Pilot School-Based Nutrition Intervention on Fruit and Vegetable Waste at School Lunches

ObjectiveTo determine the preliminary impact of the Brighter Bites nutrition intervention on decreasing fruit and vegetable (F&V) waste at school lunches among fourth- and fifth-grade children.MethodThis was a nonrandomized pre–post-controlled study in Houston and Dallas, TX. Two schools received the Brighter Bites intervention (n = 76), and 1 comparison school (n = 39), during the 2017-2018 school year. Brighter Bites is a 16-week school-based nutrition intervention providing weekly distribution of fresh F&V plus nutrition education. Main outcome measures were direct observation and weights to measure the number of F&V dishes selected at school lunches, amount of F&V wasted (gm), and related nutrient waste (4 time points/child). Mixed-effects linear regression analysis was used to determine change in F&V selection and waste over time.ResultsThere was a significant decrease over time in proportion of F&V selected among those in the comparison school, but not the intervention schools (P < .001). Compared with children in the comparison group, those receiving Brighter Bites showed a significant decrease in the amount of F&V wasted at each meal (P < .001) and per item (P < .05) at the end of both 8 and 16 weeks of intervention. There were significant decreases in waste of energy (kcal); dietary fiber (gm); vitamins B₁, B₃, and B₆ (mg); total folate (µg); and B₁₂ (µg) among those receiving Brighter Bites (P < .05).Conclusions and ImplicationsAlthough absolute food or nutrient changes were small even when significant, programs such as Brighter Bites may contribute to a healthy intake. Future studies are warranted that include a larger sample size with a stringent, cluster-randomized control trial design and consideration for other covariates.     

Development and Pilot Testing of a Food Literacy Curriculum for High School-Aged Adolescents

Adolescent obesity and poor diet quality are increasingly prevalent and could be mitigated with attainment of food literacy. However, as these programs for adolescents are lacking, the purpose of this project was to develop a food literacy curriculum for high school-aged adolescents. The curriculum was designed in accordance with food literacy attributes and components utilizing Backward Design, Social Cognitive Theory, and Constructivism. After expert committee review, pilot testing was completed in two low-income communities by a trained facilitator and observer. Detailed observations were collected during pilot testing to assess achievement of learning objectives. Modifications were made to lesson procedures as required. The resulting curriculum, Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition, contains 12 modules of experiential lessons and application activities within three topics. Agriculture lessons concentrate on the food supply chain and food environments; nutrition lessons include food groups while focusing on nutrients of concern for underconsumption; and cooking lessons include food safety, budgeting, and preparation. Teens CAN provides a comprehensive and necessary approach to advancing food literacy in adolescents. Future directions include assessing dietary implications after participating in Teens CAN lessons and employment of an innovative two-tiered cross-age teaching model.     

某中学301名新入校学生艾滋病防治知识、态度、行为的干预效果分析

目的了解新入校中学生艾滋病防治知识知晓程度、态度、行为现状,探讨对中学生艾滋病知识宣传及行为干预的有效方式。方法在某中学随机抽取301名新入校学生参加讲座,讲座前后分别进行问卷调查,收集调查对象对艾滋病防治相关知识、态度和行为等相关信息。结果干预前后有效应答率为90.03%、86.71%。干预后学生对艾滋病相关知识知晓率有了明显提高（P〈0.01）,除对拒绝吸毒和婚前性行为态度无明显改变外（P〉0.05）,对待其他艾滋病相关态度和行为均有明显的转变（P〈0.01）;干预前初一与高一学生艾滋病防治知识知晓率、相关态度、行为差异有统计学意义（P〈0.05或P〈0.01）。结论在中学生中开展艾滋病防治教育效果明显。在初中阶段开展艾滋病防治教育,更具有积极和广泛的意义。艾滋病防治知识健康教育作为预防艾滋病有效可靠的疫苗,应该作为初中生健康必修课,并考虑将初中生掌握艾滋病防治知识纳入毕业考核。     

Impact of a cost constraint on nutritionally adequate food choices for French women: an analysis by linear programming

OBJECTIVE: To predict, for French women, the impact of a cost constraint on the food choices required to provide a nutritionally adequate diet. DESIGN: Isocaloric daily diets fulfilling both palatability and nutritional constraints were modeled in linear programming, using different cost constraint levels. For each modeled diet, total departure from an observed French population's average food group pattern ("mean observed diet") was minimized. RESULTS: To achieve the nutritional recommendations without a cost constraint, the modeled diet provided more energy from fish, fresh fruits and green vegetables and less energy from animal fats and cheese than the "mean observed diet." Introducing and strengthening a cost constraint decreased the energy provided by meat, fresh vegetables, fresh fruits, vegetable fat, and yogurts and increased the energy from processed meat, eggs, offal, and milk. For the lowest cost diet (ie, 3.18 euros/d), marked changes from the "mean observed diet" were required, including a marked reduction in the amount of energy from fresh fruits (-85%) and green vegetables (-70%), and an increase in the amount of energy from nuts, dried fruits, roots, legumes, and fruit juices. IMPLICATIONS: Nutrition education for low-income French women must emphasize these affordable food choices.     

预防艾滋病健康教育处方对大学生知识态度的影响

目的 探讨预防艾滋病健康教育处方对大学生预防艾滋病知识态度的影响，以便有针对性地对大学生制定和发放预防艾滋病健康教育处方。方法 2000年4～5月对北京2所普通高校273名在校大学生进行自填式、不记名问卷调查。结果 有38．8％的学生曾收到过预防艾滋病健康教育处方。收到过处方组的学生预防艾滋病基本知识和对艾滋病病毒感染／艾滋病患不歧视态度得分均明显高于未收到处方组；但对待婚前性交行为态度得分，收到处方组与没有收到处方组比较，差异无显性。结论 向大学生发放预防艾滋病健康教育处方是开展预防艾滋病健康教育的一种可行的、有效的方式，应该在大学和中学推广这一方法。     

Evaluation of the Impact of a Diabetes Education Curriculum for School Personnel on Disease Knowledge and Confidence in Caring for Students

BACKGROUND: School personnel may lack knowledge of diabetes and be unprepared to address the needs of students with type 1 diabetes. This project evaluated the effectiveness of a type 1 diabetes education program for school personnel on increasing knowledge of diabetes and confidence in caring for students with diabetes. METHODS: Two types of diabetes education programs were created for school personnel. The basic program provided a 60-minute overview of diabetes. The expanded program, intended for volunteer health aides, provided participants with a more in-depth overview of diabetes during a 180-minute session, including demonstrations of how to assist students with insulin injections. Instruments were created to assess changes in diabetes-related knowledge and confidence in caring for students. Separate knowledge instruments were created for the basic and expanded programs. Knowledge instruments were administered before and after delivery of the education programs to both groups. Confidence instruments were administered before and after for persons completing the expanded program. RESULTS: A total of 81 school personnel participated in the basic (N = 44) or expanded programs (N = 37). Overall knowledge regarding diabetes significantly increased in both the basic and expanded programs from baseline (p < .001). Confidence in caring for students with diabetes also increased from pretest to posttest, both for overall confidence and each individual item (p < .001). CONCLUSIONS: Educational programs offered for school personnel can lead to increased knowledge and increased confidence in caring for students with diabetes, which may assist school personnel in addressing the needs of students with diabetes.     

Effects of a nutrition education programme on the dietary habits of a population of students and staff at a centre for higher education

A programme of nutrition education and modification of catering practices was developed with the intention of influencing the eating habits of staff and students who attended a centre for higher education.
A questionnaire was used to assess the frequency of consumption of foods before and after the education programme. Seven-day weighed inventories were conducted to obtain information about portion sizes eaten by the study group. Caterers' purchasing figures were collected and assessed to determine any changes in catering practices. The results indicated that eating habits and catering practices did change within the duration of the project. Intake of wholemeal bread more than doubled while consumption of whole milk was at least halved. The nutrient intake of the student population appeared to be adequate when compared to Dietary Reference Values, apart from the energy, folate and iron intakes of female students which were rather low, Following the education programme, female students reported that the amount of energy obtained from fat had reduced by three percentage points, from 38% to 35%, while male students reported a reduction of five percentage points, from 42% to 37%.     

The Impact of Modifying Food Service Practices in Secondary Schools Providing a Routine Meal Service on Student’s Food Behaviours,Health and Dining Experience: A Systematic Review and Meta-Analysis

The education sector is recognised as an ideal platform to promote good nutrition and decision making around food and eating. Examining adolescents in this setting is important because of the unique features of adolescence compared to younger childhood. This systematic review and meta-analysis examine interventions in secondary schools that provide a routine meal service and the impact on adolescents’ food behaviours, health and dining experience in this setting. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist and Cochrane Handbook recommendations. Studies published in English searched in four databases and a hand search yielded 42 interventions in 35 studies. Risk of bias was assessed independently by two reviewers. Interventions were classified using the NOURISHING framework, and their impact analysed using meta-analysis, vote-counting synthesis or narrative summary. The meta-analysis showed an improvement in students selecting vegetables (odds ratio (OR): 1.39; 1.12 to 1.23; p = 0.002), fruit serves selected (mean difference (MD): 0.09; 0.09 to 0.09; p < 0.001) and consumed (MD: 0.10; 0.04 to 0.15; p < 0.001), and vegetable serves consumed (MD: 0.06; 0.01 to 0.10; p = 0.024). Vote-counting showed a positive impact for most interventions that measured selection (15 of 25; 41% to 77%; p = 0.002) and consumption (14 of 24; 39% to 76%; p = 0.013) of a meal component. Interventions that integrate improving menu quality, assess palatability, accessibility of healthier options, and student engagement can enhance success. These results should be interpreted with caution as most studies were not methodologically strong and at higher risk of bias. There is a need for higher quality pragmatic trials, strategies to build and measure sustained change, and evaluation of end-user attitudes and perceptions towards intervention components and implementation for greater insight into intervention success and future directions (PROSPERO registration: CRD42020167133).     

Recommendations on Complementary Feeding as a Tool for Prevention of Non-Communicable Diseases (NCDs)—Paper Co-Drafted by the SIPPS,FIMP, SIDOHaD,and SINUPE Joint Working Group

Adequate and balanced nutrition is essential to promote optimal child growth and a long and healthy life. After breastfeeding, the second step is the introduction of complementary feeding (CF), a process that typically covers the period from 6 to 24 months of age. This process is, however, still highly controversial, as it is heavily influenced by socio-cultural choices, as well as by the availability of specific local foods, by family traditions, and pediatrician beliefs. The Società Italiana di Pediatria Preventiva e Sociale (SIPPS) together with the Federazione Italiana Medici Pediatri (FIMP), the Società Italiana per lo Sviluppo e le Origine della Salute e delle Malattie (SIDOHaD), and the Società Italiana di Nutrizione Pediatrica (SINUPE) have developed evidence-based recommendations for CF, given the importance of nutrition in the first 1000 days of life in influencing even long-term health outcomes. This paper includes 38 recommendations, all of them strictly evidence-based and overall addressed to developed countries. The recommendations in question cover several topics such as the appropriate age for the introduction of CF, the most appropriate quantitative and qualitative modalities to be chosen, and the relationship between CF and the development of Non-Communicable Diseases (NCDs) later in life.