Eating habits and eating behaviors by family dinner frequency in the lower-grade elementary school students

BACKGROUND/OBJECTIVES

Recently, there has been an increased interest in the importance of family meals on children''s health and nutrition. This study aims to examine if the eating habits and eating behaviors of children are different according to the frequency of family dinners.

SUBJECTS/METHODS

The subjects were third-grade students from 70 elementary schools in 17 cities nationwide. A two-stage stratified cluster sampling was employed. The survey questionnaire was composed of items that examined the general characteristics, family meals, eating habits, eating behaviors, and environmental influence on children''s eating. The subjects responded to a self-reported questionnaire. Excluding the incomplete responses, the data (n = 3,435) were analyzed using χ²-test or t-test.

RESULTS

The group that had more frequent family dinners (≥ 5 days/week, 63.4%), compared to those that had less (≤ 4 days/week, 36.6%), showed better eating habits, such as eating meals regularly, performing desirable behaviors during meals, having breakfast frequently, having breakfast with family members (P < 0.001), and not eating only what he or she likes (P < 0.05). Those who had more frequent family dinners also consumed healthy foods with more frequency, including protein foods, dairy products, grains, vegetables, seaweeds (P < 0.001), and fruits (P < 0.01). However, unhealthy eating behaviors (e.g., eating fatty foods, salty foods, sweets, etc.) were not significantly different by the frequency of family dinners.

CONCLUSIONS

Having dinner frequently with family members was associated with more desirable eating habits and with healthy eating behaviors in young children. Thus nutrition education might be planned to promote family dinners, by emphasizing the benefits of having family meals on children''s health and nutrition and making more opportunities for family meals.     

Evaluation of diet quality and its associated factors among adolescents in Kuala Lumpur,Malaysia

BACKGROUND/OBJECTIVES

This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia.

SUBJECTS/METHODS

This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively.

RESULTS

The majority of the respondents (80.7%) were at risk of poor diet quality. Males (mean = 34.2 ± 8.2%) had poorer diet quality than females (mean = 39.9 ± 9.0%) (t = -5.941, P < 0.05). Malay respondents (mean = 36.9 ± 8.7%) had poorer diet quality than Indian respondents (mean = 41.3 ± 10.0%) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents.

CONCLUSIONS

In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents.     

Peer Reviewed: Strategies of Asian,Hispanic, and Non-Hispanic White Parents to Influence Young Adolescents’ Intake of Calcium-Rich Foods, 2004 and 2005

Introduction

Optimal intake of dietary calcium is critical to prevent osteoporosis later in life, yet most young adolescents do not consume the recommended amount. We describe parental strategies that can influence young adolescents'' calcium intake in Asian, Hispanic, and non-Hispanic white households.

Methods

A qualitative research design employed semistructured individual interviews with a convenience sample of mostly female parents self-reported as Asian (n = 48), Hispanic (n = 44), or non-Hispanic white (n = 76) having a child aged 10 to 13 years at home. Interviews were conducted in homes or community centers in 12 states. Interview data were analyzed by using qualitative data analysis software and thematic content analysis procedures.

Results

Parents monitored calcium intake by making calcium-rich foods available, preparing calcium-rich foods, and setting expectations that children would consume calcium-rich foods. As mentors, parents encouraged intake of calcium-rich foods and advised children to moderate or increase intake of specific foods. Although parents perceived modeling of calcium intake as important, some were ambivalent about its effects. We noted minimal differences by racial/ethnic groups and sex of children in reported availability of selected calcium-rich foods at home, parental modeling of intake, and mentoring behaviors.

Conclusion

Our findings suggest that interventions to help parents increase children''s intake of calcium should focus on types of foods made available, giving age-appropriate encouragement and advice, and modeling proper intake.     

Peer Reviewed: Assessing Calcium Intake in Postmenopausal Women

Introduction

Because foods fortified with calcium are increasingly available, the calcium content of calcium-fortified foods may not be adequately captured in traditional assessments of dietary intake, such as dietary records analyzed with commercially available software. The primary objective of our study was to design and test a calcium-focused food frequency questionnaire (CFFFQ) including foods naturally rich in calcium and calcium-fortified foods. Secondary objectives were to review calcium sources and adequacy of intake in black and in white postmenopausal women.

Methods

We studied a convenience sample of 46 black and 139 white postmenopausal women (mean [SD] age 69.4 [5.8] years). Subjects completed a multiple-pass interview for 24-hour recall of foods eaten and the 46-item CFFFQ.

Results

The correlation between measures for total daily calcium intake was moderately strong (r = 0.53, P < .001). The CFFFQ estimated greater total daily calcium intake than did the 24-hour recall (mean [SD], 1,021 [624] mg/d vs 800 [433] mg/d, P < .001). As daily calcium intake increased, the 24-hour recall increasingly underreported calcium (r = 0.41, P < .001) compared with the CFFFQ. Cross-tabulation and Χ² analyses found that the CFFFQ had greater specificity for lower calcium intakes. For calcium classified by food groups, there was moderate correlation for dairy (r = 0.56, P < .001) and fruits (r = 0.43, P < .001). The CFFFQ overestimated mean total calcium compared with the 24-hour recall by 221 mg/d (P < .001), including within racial groups (195 mg/d for black women, P = .04, and 229 mg/d for white women, P < .001). Dairy was the primary calcium source for both groups (55% of intake for black women and 57% of intake for white women).

Conclusion

The CFFFQ can be used to identify postmenopausal women with inadequate calcium intakes (<800 mg/d) and to identify key sources of dietary calcium. Older black women consume less daily calcium than do older white women.     

Comparison of sodium content of workplace and homemade meals through chemical analysis and salinity measurements

BACKGROUND/OBJECTIVES

Most Koreans consume nearly 70-80% of the total sodium through their dishes. The use of a salinometer to measure salinity is recommended to help individuals control their sodium intake. The purpose of this study was to compare sodium content through chemical analysis and salinity measurement in foods served by industry foodservice operations and homemade meals.

MATERIALS/METHODS

Workplace and homemade meals consumed by employees in 15 cafeterias located in 8 districts in Daegu were collected and the sodium content was measured through chemical analysis and salinity measurements and then compared. The foods were categorized into 9 types of menus with 103 workplace meals and 337 homemade meals.

RESULTS

Workplace meals did not differ significantly in terms of sodium content per 100 g of food but had higher sodium content via chemical analysis in roasted foods per portion. Homemade meals had higher broth salt content and higher salt content by chemical analysis per 100 g of roasted foods and hard-boiled foods. One-dish workplace meals had higher salinity (P < 0.05), while homemade broths and stews had higher sodium content (P < 0.05 and P < 0.01, respectively). The sodium content per 100 g of foods was higher in one-dish workplace meals (P < 0.05) and in homemade broths and stews (P < 0.01 and P < 0.05, respectively).

CONCLUSIONS

The use of a salinometer may be recommended to estimate the sodium content in foods and control one''s sodium intake within the daily intake target as a way to promote cooking bland foods at home. However, estimated and actual measured values may differ.     

Stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake and related psychosocial factors

BACKGROUND/OBJECTIVES

Understanding individual''s intention, action and maintenance to increase fruit and vegetable intake is an initial step in designing nutrition or health promotion programs. This study aimed to determine stages of change to increase fruit and vegetable intake and its relationships with fruit and vegetable intake, self-efficacy, perceived benefits and perceived barriers.

SUBJECTS/METHODS

This cross-sectional study was conducted among 348 public university staff in Universiti Putra Malaysia. A pre-tested self-administered questionnaire and two days 24-hour diet recall were used.

RESULTS

Half of the respondents (50%) were in preparation stage, followed by 43% in action/maintenance, 7% in pre-contemplation/contemplation stages. Respondents in action/maintenance stages had significantly higher self-efficacy (F = 9.17, P < 0.001) and perceived benefits (F = 5.07, P < 0.01) while respondents in pre-contemplation/contemplation and preparation stages had significantly higher perceived barriers (F = 4.83, P < 0.05). Perceived benefits tend to outweigh perceived barriers pre-ceding to taking action. Self-efficacy is important in motivating individuals to increase fruit and vegetable intake as self-efficacy and perceived barriers crossed over between preparation and action/maintenance. Respondents in action/maintenance stages had the highest adjusted mean serving of fruit and vegetable intake (F = 4.52, P < 0.05) but the intake did not meet recommendation.

CONCLUSION

Intervention strategies should emphasize on increasing perceived benefits and building self-efficacy by providing knowledge and skills to consume a diet high in fruits and vegetables in order to promote healthy changes in having high fruit and vegetable intake.     

Evaluation of dietary behaviors of preschool children in Seoul and Gyeonggi-do associated with the level of parents' health consciousness: using nutrition quotient for preschoolers (NQ-P)

BACKGROUND/OBJECTIVESThis study aimed to assess the dietary behaviors of preschool children using the nutrition quotient for preschoolers (NQ-P) and analyzed the difference in the scores of the children''s dietary behaviors in regards to the parents'' health consciousness.SUBJECTS/METHODSThe subjects were 257 children aged 3–5 years and their parents residing in Seoul and Gyeonggi-do, South Korea. The questionnaire is composed of demographic characteristics, the NQ-P questions, and health consciousness. All data were statistically analyzed by SPSS program (ver. 25.0) and the statistical differences in variables were evaluated by χ² test, Fisher''s exact test, t-test, 1-way analysis of variance and Tukey''s multiple comparison test.RESULTSThere was a significant difference on the intake frequency of processed meat by region and fast foods by age, region, and weight status (P < 0.05). There was also a significant difference in not moving around while eating by weight status and parents'' effort to have healthy eating habits by sex (P < 0.05). The mean score of NQ-P of the total subjects was 59.47, which was within the medium-low grade. The mean score of balance was 61.62, and the boys were significantly higher than girls (P < 0.05). As the age of children increased, the mean score of the moderation was significantly decreased (P < 0.05). The scores of NQ-P (P < 0.05), balance (P < 0.01), and environment (P < 0.05) were significantly higher in the high group of parents'' health consciousness than the low group.CONCLUSIONSAccording to the results of the evaluation by NQ-P, the dietary behaviors of preschoolers residing in Seoul and Gyeonggi-do need to be improved. For improving their eating behavior and nutritional health status, parents and children need customized nutrition education programs based on sex, age, region and weight status of preschool children as well as the degree of parents'' health consciousness.     

Psychosocial factors and eating behaviors according to the stages of change in nutrition management among elementary and middle school athletes

BACKGROUND/OBJECTIVESThis study examined the differences in psychosocial factors and eating behaviors by the stages of change (SOC) in nutrition management among elementary and middle school athletes.SUBJECTS/METHODSSubjects were young athletes recruited from the athletic clubs of 10 organizations. Subjects responded to a survey questionnaire, and data on 167 athletes were analyzed. Subjects were grouped into the pre-action or action stage in nutrition management. The χ² test, t-test, analysis of covariance, and correlation analysis were used in data analysis.RESULTSAthletes in the action stage (62.3%) compared to the pre-action stage, showed a higher self-efficacy (P < 0.01), and felt more confidence in performing specific eating behaviors (P < 0.05 to P < 0.01). Those in the action stage had more favorable beliefs regarding nutrition (P < 0.001) and agreed less strongly on the specific misconceptions/disadvantages of nutrition (P < 0.01) than those in the pre-action stage. Eating behaviors (P < 0.001) and subscales of the eating behaviors (P < 0.05 to P < 0.01) also differed significantly by the SOC group. Place of eating dinner (P < 0.05) and the person who prepares dinner (P < 0.05) showed significant differences by the SOC group. The relationship of self-efficacy, beliefs regarding nutrition, and eating behaviors to the SOC differed by sports type. Beliefs for football athletes, self-efficacy, and beliefs for baseball athletes were correlated significantly with the SOC, whereas all 3 variables were related to the SOC for handball and other athletes.CONCLUSIONSThis study showed differences in psychosocial factors and eating behaviors between the pre-action and action stages. Nutrition education should include strategies to help young athletes modify their beliefs, mainly misconceptions/disadvantages of nutrition, increase self-efficacy, and adopt specific and desirable eating behaviors. Nutrition education might employ different strategies considering the sports type that student-athletes participate.     

Effects of multiple herb formula SEC-22 supplementation on dietary intake,picky eating behaviors,and growth indices in thin preschool children

BACKGROUND/OBJECTIVESThin children may have insufficient intake of energy and nutrients, resulting in reduced immune function and growth. This study aimed to identify the effects of multiple herb formula SEC-22 supplementation on growth, dietary changes, and picky eating behaviors in thin children.SUBJECTS/METHODSA double-blind, randomized clinical trial was conducted on 79 children aged 2-5 years with poor appetites, BMI percentile < 25, and without any illness. Subjects were given either SEC-22 (n = 35) or placebo (n = 44) for 2 months and followed for an additional 2 months. Three-day dietary records, questionnaires on picky eating behaviors, and anthropometric measures were collected.RESULTSEnergy, carbohydrate intake, and feeding difficulty improved in both groups during the intervention period. However, changes were maintained only in the SEC-22 group after 2 months of follow-up post-supplementation. ''Frequency of trying to feed'' was improved in the SEC-22 group compared to the placebo group after the first month of follow-up (P < 0.05). Intakes of potassium and thiamine were improved in the SEC-22 group compared to the placebo group after the first month of intervention (P < 0.05). ''Frequency of food reward'', eating amount, and intakes of carbohydrate, potassium, and vitamin C showed significant improvement compared to the placebo group after the second month of follow-up (P < 0.05).CONCLUSIONSThese results suggest that SEC-22 supplementation can improve parental feeding difficulty resulting from insufficient eating amount or picky eating as well as increase nutrient intake in thin children. Although these improvements were observable at least 2 months after supplementation, effects beyond this time frame need to be confirmed.     

Cholesterol-induced inflammation and macrophage accumulation in adipose tissue is reduced by a low carbohydrate diet in guinea pigs

BACKGROUND/OBJECTIVES

The main objective of this study was to evaluate the effects of a high cholesterol (HC) dietary challenge on cholesterol tissue accumulation, inflammation, adipocyte differentiation, and macrophage infiltration in guinea pigs. A second objective was to assess whether macronutrient manipulation would reverse these metabolic alterations.

MATERIALS/METHODS

Male Hartley guinea pigs (10/group) were assigned to either low cholesterol (LC) (0.04g/100g) or high cholesterol (HC) (0.25g/100g) diets for six weeks. For the second experiment, 20 guinea pigs were fed the HC diet for six weeks and then assigned to either a low carbohydrate (CHO) diet (L-CHO) (10% energy from CHO) or a high CHO diet (H-CHO) (54% CHO) for an additional six weeks.

RESULTS

Higher concentrations of total (P < 0.005) and free (P < 0.05) cholesterol were observed in both adipose tissue and aortas of guinea pigs fed the HC compared to those in the LC group. In addition, higher concentrations of pro-inflammatory cytokines in the adipose tissue (P < 0.005) and lower concentrations of anti-inflammatory interleukin (IL)-10 were observed in the HC group (P < 0.05) compared to the LC group. Of particular interest, adipocytes in the HC group were smaller in size (P < 0.05) and showed increased macrophage infiltration compared to the LC group. When compared to the H-CHO group, lower concentrations of cholesterol in both adipose and aortas as well as lower concentrations of inflammatory cytokines in adipose tissue were observed in the L-CHO group (P < 0.05). In addition, guinea pigs fed the L-CHO exhibited larger adipose cells and lower macrophage infiltration compared to the H-CHO group.

CONCLUSIONS

The results of this study strongly suggest that HC induces metabolic dysregulation associated with inflammation in adipose tissue and that L-CHO is more effective than H-CHO in attenuating these detrimental effects.     

Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents

BACKGROUND/OBJECTIVES

There is little information on the association between weight misperception and eating behavior in Korean adolescents. Therefore, we investigated the association of food intake habits and dieting method and disturbed eating behavior (DEB) in relation to weight misperception.

SUBJECTS/METHODS

Data was collected by using a nationwide online panel survey from 6,943 adolescents enrolled in middle/high school. DEB was measured with the Eating Attitudes Test (EAT-26) and those who scored ≥ 20 on the EAT-26 were considered to have eating disorder. Logistic regressions were conducted to examine the association between weight misperception based on self-reported weight status and dieting method and eating behaviors.

RESULTS

The proportion of weight underestimation was 23.5% and that of overestimation was 24.0%. Weight overestimating girls were more likely to engage in various unhealthy dieting practices (OR = 1.69 for fasting; OR = 1.88 for laxative or diuretic use; OR = 2.05 for self-induced vomiting after meals; P < 0.05). Moreover, there was a strong association between overestimation and undesirable eating behaviors, especially among girls, e.g.: having breakfast (OR = 0.85), high consumption of fast foods (OR = 1.28) and regular sodas (OR = 1.39), but not among boys. In both genders, weight overestimation appears to be a major risk factor for DEB (OR = 1.34 for boys and OR = 1.41 for girls; P < 0.05).

CONSLUSIONS

Weight overestimation is associated with unhealthy weight control practices and eating behaviors. We particularly found a significant association between weight overestimation and DEB among nationwide Korean adolescents.     

Interplay Between Self-Efficacy and Perceived Availability at Home and in the School Neighborhood on Adolescents’ Fruit and Vegetable Intake and Energy-Dense,Low-Nutrient Food and Sugary Drink Consumption

Objective

The current study aimed to examine the interplay between self-efficacy and perceived availabilities of fruits and vegetables (F&V) and energy-dense, low-nutrient foods and sugary drinks (EDLNF&SD) at home and in the school neighborhoods on adolescents’ eating behaviors.

Psychosocial Factors Influencing Calcium Intake and Bone Quality in Middle School Girls

Calcium intake has been associated with promoting bone health in children and adolescents, thus preventing osteoporosis later in life. Behavior change such as increased calcium intake, as well as physiological factors such as bone quality, may be facilitated by psychosocial and environmental factors. The purpose of this study was to identify pathways by which psychosocial factors influence calcium intake and bone quality in middle school girls. The study design was cross-sectional. Baseline data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study, collected in 2001-2003, were used. IMPACT was a 1.5-year nutrition and physical activity intervention study, designed to improve bone density in 717 middle school girls in Texas. Main outcome measures were calcium intake determined using mean milligrams of calcium consumed per day and number of glasses of milk consumed per day, and bone quality determined using a calcaneal stiffness index. Confirmatory factor analysis and path analysis were performed to identify the direct and indirect pathways used by various psychosocial factors such as knowledge, self-efficacy, outcome expectations, and milk availability at home, to influence calcium intake and bone quality. Results showed that knowledge of osteoporosis and calcium-rich foods had an indirect effect on calcium intake, with outcome expectations as the mediating variable (β=.035 and β=.03, respectively; P<0.05). Calcium self-efficacy had a significant indirect effect on calcium intake, with outcome expectations as the mediator (β=.085, P<0.05). None of the variables significantly influenced bone quality. Thus, several direct and indirect pathways used to influence calcium intake among adolescent girls were identified. These findings are critical for the development of effective interventions to promote calcium intake in this population.     

Association between family structure and food group intake in children

BACKGROUNDS/OBJECTOVES

Family has an impact on dietary intake of children as a proximal food environment and family structures are changing and becoming more diverse. This study was performed to identify the association between family structure and food group intake of children aged 3-18 years in Korea.

SUBJECTS/METHODS

A total of 3,217 children with complete data on variables for household information, dietary intake and sampling weights were obtained from 2010-2011 Korea National Health and Nutrition Examination Survey. Children''s family structure was classified into 3 groups (Living with both parents, Living with one parent and Living without parents). To evaluate children''s food group intake, scores of individual food groups (''Grains'', ''Meat, Fish, Eggs and Beans'', ''Vegetables'', ''Fruits'' and ''Milk and Dairy products'') was calculated from percent adherence to the recommended servings of the Korean Food Guidance System (KFGS). ''Food group mean score'' was obtained by calculating the average of five food group scores.

RESULTS

After adjusting for age, sex, number of family members, and household income, children living with both parents had higher scores in ''Fruits'' (P < 0.01), ''Milk and Dairy products'' (P < 0.05), and mean score of individual food group score (P < 0.001) compared to children living with one parent. Individual food group scores and mean scores of individual food group scores were associated with different socio-demographic factors in study children. Family structure was associated with ''Fruits,'' ''Milk and Dairy products'' score and mean scores of food group scores.

CONCLUSIONS

These results suggested that different approach might be required to solve nutrition problem in children depending on their family structure and other socio-demographic factors.     

The effects of the DASH diet education program with omega-3 fatty acid supplementation on metabolic syndrome parameters in elderly women with abdominal obesity

BACKGROUND/OBJECTIVES

The purpose of this study was to investigate the overall effects of a tailored Dietary Approaches to Stop Hypertension (DASH) nutritional intervention program which included omega-3 fatty acids supplementation, on dietary self-efficacy, dietary knowledge, and dietary behaviors in Korean elderly women with abdominal obesity. Furthermore, we investigated the effects of the program on metabolic syndrome parameters including the antioxidant capacities in these subjects.

SUBJECTS/METHODS

A randomized, controlled trial was conducted for 8 weeks. The experimental group (n = 21) received a weekly tailored nutritional program for 8 weeks and the control group (n = 18) received only one educational session. The clinical survey was conducted before and after the intervention period.

RESULTS

After the intervention, dietary self-efficacy (P = 0.023), frequency of fruit intake (P = 0.019), and dietary fiber intake (P = 0.044) were higher in the experimental group than in the control group. The oxidative stress (P < 0.001) was lower in the experimental group than in the control group. Moreover, low density lipoprotein (LDL) cholesterol (P = 0.023) had significantly decreased in the experimental group but not in the control group after the intervention.

CONCLUSIONS

The intervention program including omega-3 fatty acid supplementation had a positive effect on dietary self-efficacy, dietary behaviors, and oxidative stress among aged women with abdominal obesity.     

General Practitioners’ Empathy and Health Outcomes: A Prospective Observational Study of Consultations in Areas of High and Low Deprivation

PURPOSE

We set out to compare patients’ expectations, consultation characteristics, and outcomes in areas of high and low socioeconomic deprivation, and to examine whether the same factors predict better outcomes in both settings.

METHODS

Six hundred fifty-nine patients attending 47 general practitioners in high- and low-deprivation areas of Scotland participated. We assessed patients’ expectations of involvement in decision making immediately before the consultation and patients’ perceptions of their general practitioners’ empathy immediately after. Consultations were video recorded and analyzed for verbal and non-verbal physician behaviors. Symptom severity and related well-being were measured at baseline and 1 month post-consultation. Consultation factors predicting better outcomes at 1 month were identified using backward selection methods.

RESULTS

Patients in deprived areas had less desire for shared decision-making (P <.001). They had more problems to discuss (P = .01) within the same consultation time. Patients in deprived areas perceived their general practitioners (GPs) as less empathic (P = .02), and the physicians displayed verbal and nonverbal behaviors that were less patient centered. Outcomes were worse at 1 month in deprived than in affluent groups (70% response rate; P <.001). Perceived physician empathy predicted better outcomes in both groups.

CONCLUSIONS

Patients’ expectations, GPs’ behaviors within the consultation, and health outcomes differ substantially between high- and low-deprivation areas. In both settings, patients’ perceptions of the physicians’ empathy predict health outcomes. These findings are discussed in the context of inequalities and the “inverse care law.”     

Digital Education to Limit Salt in the Home (DELISH) Program Improves Knowledge,Self-Efficacy,and Behaviors Among Children

Objective

To determine the efficacy of a Web-based salt reduction program on children's salt-related knowledge, attitudes, and behaviors (KABs), self-efficacy, and intake of dietary salt.

School-based nutrition education improves breakfast-related personal influences and behavior of Indonesian adolescents: a cluster randomized controlled study

BACKGROUND/OBJECTIVESMany adolescents in developing countries skip breakfast. Innovative nutrition education (NE) strategies are needed to enhance knowledge and skills related to the breakfasts of adolescents in a low socioeconomic setting. The objective was to evaluate short- and long-term effects of a multi-strategy, school-based NE intervention on adolescents'' breakfast-related personal influences and behaviors.SUBJECTS/METHODSAn intervention study with a cluster randomized controlled trial design was conducted in 4 senior high schools in Makassar, Indonesia. The multi-strategy NE intervention was delivered for 3 months. Data were collected using a self-administered questionnaire and a 3-day breakfast recall (face-to-face interview). Wilcoxon, McNemar, and Mann-Whitney tests were used to determine intra- and intergroup differences.RESULTSUnlike knowledge, improvement was observed in attitude and self-efficacy scores in the intervention groups (IGs) (P < 0.01); however, no significant changes were observed in the control group (CG). More students showed improved motivation in the IG than in the CG (P > 0.05). Changes in breakfast frequency and macronutrient intake from breakfast were greater in the IG than in the CG (P < 0.05).CONCLUSIONSA multi-strategy NE intervention is effective in producing positive changes in breakfast-related attitude, self-efficacy, and motivation of adolescents from a low-middle socioeconomic setting. The intervention improved breakfast frequency and nutrient intake. This intervention has promise for sustaining the observed changes over the long-term.     

The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior,dietary behavior,nutrition risk level and nutrient intake

This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P < 0.001) and of depression (P < 0.001) improved significantly and that dietary behavior scores also improved significantly (P < 0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects'' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P < 0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.     

Effects of sensory education based on classroom activities for lower grade school children

This study is to verify the effects of sensory education based on classroom activities for 2^nd and 3^rd grade children. The hypothesis is that children who participated in sensory education would demonstrate positive changes in eating behaviors through sensory experiences. The sensory education program consists of 12 lessons. Twenty-six children were being recruited from one school in Changwon, Korea. Two control groups, one of which was the same age as the educated group and the other group of sixth graders, were selected by random sampling from the same school. Children answered a self-administered questionnaire. The parents (n = 20) of the children who participated in the program, took part in evaluating the program through self-administered questionnaires after the program ended. The questionnaire contained variables of general characteristics, education satisfaction, nutrition knowledge, eating attitude and behavior concerning unfamiliar foods. The score of nutrition knowledge was improved in educated children (P < 0.05). Food neophobia score towards unfamiliar foods (P < 0.05) was increased in educated children, but there are no changes in eating behaviors in all groups towards unfamiliar foods. In conclusion, sensory education is useful for having a positive eating attitude among children. Its consistent implementation could lead to healthier and well-balanced eating behaviors for children.