Food-based nutrition interventions at community level

Food education – let’s go back to the future

observational studies have shown that nutritional strategies to manage malnutrition may be cost-effective in aged care; but more robust economic data is needed to support and encourage translation to practice. Therefore, the aim of this systematic review is to compare the cost-effectiveness of implementing nutrition interventions targeting malnutrition in aged care homes versus usual care. residential aged care homes. systematic literature review of studies published between January 2000 and August 2017 across 10 electronic databases. Cochrane Risk of Bias tool and GRADE were used to evaluate the quality of the studies. eight included studies (3,098 studies initially screened) reported on 11 intervention groups, evaluating the effect of modifications to dining environment (n = 1), supplements (n = 5) and food-based interventions (n = 5). Interventions had a low cost of implementation (<£2.30/resident/day) and provided clinical improvement for a range of outcomes including weight, nutritional status and dietary intake. Supplements and food-based interventions further demonstrated a low cost per quality adjusted life year or unit of physical function improvement. GRADE assessment revealed the quality of the body of evidence that introducing malnutrition interventions, whether they be environmental, supplements or food-based, are cost-effective in aged care homes was low. this review suggests supplements and food-based nutrition interventions in the aged care setting are clinically effective, have a low cost of implementation and may be cost-effective at improving clinical outcomes associated with malnutrition. More studies using well-defined frameworks for economic analysis, stronger study designs with improved quality, along with validated malnutrition measures are needed to confirm and increase confidence with these findings.

Status of nutrition education in elementary schools: 1981 vs. 1975

Nutrition education: the way to reduce childhood obesity?

Food literacy is achieving attention worldwide and gaining traction in Arab countries. Strengthening food and nutrition literacy among Arab teenagers are important promising and empowering tools, which can protect them from malnutrition. This study aims to evaluate the nutrition literacy status of adolescents along with that of their parents in 10 Arab countries. This cross-sectional study involving a convenient sample of 5401 adolescent-parent dyads was launched between 29 April and 6 June 2022 in 10 Arab nations. The Adolescent Nutrition Literacy Scale (ANLS) and the Short Food Literacy Questionnaire (SFLQ) were used to meet the study aims. More than one-quarter (28%) of adolescents had poor nutrition literacy, with 60% of their parents being food illiterate. The top three countries with nutritionally less literate adolescents were Qatar (44%), Lebanon (37.4%), and Saudi Arabia (34.9%). Adolescents’ age, gender, education level, primary caregivers, employment status, and the inclusion of nutrition education in the schools’ curriculum predicted the nutrition literacy levels of Arab adolescents. Besides, parental weight status, health status, parent’s food literacy level, and the number of children per household were significant determinants too. Nutrition literacy inadequacy among Arab adolescents is a prioritized challenge to be tackled to achieve the sustainable developmental goals (SDGs) mainly SDG2 and SDG4.

OBJECTIVE: The purpose of this qualitative study was to reveal the expertise of educators and dieticians on food and nutrition education in the school environment. METHODS: This study used a qualitative approach developed jointly by the Department of Education of the state of Pernambuco, Brazil, and a school in that state. The participants were seven teaching technicians, eight teachers, and thirteen dieticians. The information was collected by interview and submitted to thematic content analysis. RESULTS: Six themes emerged from the participants' statements: food and nutrition education as a guideline for eating correctly; the purpose of food and nutrition education as an instrument for promoting healthy eating habits; the school as a promoter and empowering environment for food and nutrition education; food and nutrition education as a pedagogical practice focused on the reality of students' eating habits; school agents' assignments and partnerships for food and nutrition education; lack of knowledge in the practice of food and nutrition education. CONCLUSION: The participants' knowledge on food and nutrition education is dichotomous, at times permeated by biological aspects, at other times by the social context. Although there are gaps in the knowledge of the subject, educators and dieticians consider themselves partners for the provision of food and nutrition education in school.

Advocacy Is a Natural Part of Our Life and Work

This study explored the views of participants who completed a 5-week, online, interactive, family-based, salt reduction education program (Digital Education to LImit Salt in the Home). A secondary aim was to explore the views of school staff on the delivery of food and nutrition education in schools. Children aged 7-10 years, their parents and principals/teachers from participating schools located in Victoria, Australia, completed a semi-structured evaluation interview. Audio-recordings of interviews were transcribed verbatim and analysed using NVivo. Twenty-eight interviews (13 children; 11 parents; 4 school staff) were included. Thematic analysis revealed that the program was well received by all groups. Children reported that the interactivity of the education sessions helped them to learn. Parents thought the program was interesting and important, and reported learning skills to reduce salt in the family diet. School staff supported the delivery of nutrition education in schools but indicated difficulties in sourcing well-packed nutrition resources aligned with the curriculum. It appears that there is support from parents and teachers in the delivery of innovative, engaging, nutrition education in schools, however such programs need to be of high quality, aligned with the school curriculum and readily available for incorporation within the school's teaching program.

O13 Are Food-Based Dietary Guidelines an Nutrition Education Tool in Africa?

Materials were prepared for schoolteachers and healthcare workers to support permanent initiatives in food and nutrition education in schools, integrated into the curriculum. The article presents the matrix of food and nutrition topics that served as the basis for producing these materials (Matrix) and the convergence between the approach adopted in the activities in the Activity Manuals comprising the series of materials and food dimensions, the principles of the Framework for Food and Nutrition Education for Public Policies (Framework for Food and Nutrition Education), and the Brazilian National Curriculum Guidelines for basic education. The Matrix allowed designing educational activities that foster an expanded approach to food and nutrition which is simultaneously crosscutting and integrated into the curriculum. The activities allowed dialogue with various components of the curriculum and linkage between them. The activities' convergence with the Framework for Food and Nutrition Education was expressed in the contextualization of food practices in the schoolchildren's territories and realities; in the problematical approach, which encourages critical thinking and the promotion of autonomy, both for educators and schoolchildren; and inter-sector planning through topics and action strategies that encourage collaboration between healthcare professionals and teachers. The initiative presented in this article thus strengthens the actions by food and nutrition education in schools and can expand teachers' repertoire in food and nutrition and contribute to its crosscutting and routine inclusion in the curriculum.

Dietary guidelines based on 5 food groups was used as a main nutrition education tool until 1996 when food based dietary guidelines (FBDGs) were promoted after 2 years of formulation and development. These FBDGs for the general population were designed to promote desirable and culturally acceptable eating behavior. The nine qualitative guidelines of Thai FBDGs include: 1. eat a variety of foods from each of the five food groups and maintain proper weight, 2. eat adequate rice, or alternate carbohydrate, 3. eat plenty of vegetables and fruits regularly, 4. eat fish, lean meats, eggs, legumes and pulses regularly, 5. drink sufficient amount of milk every day, 6. take moderate amounts of fat, 7. avoid excessive intake of sweet and salty foods, 8. eat clean and uncontaminated foods, and 9. avoid or reduce consumption of alcoholic beverages. In 1998, the quantitative part of Thai FBDGs or food guide model was established as "Nutrition Flag" after rigorous test for understanding and acceptability among consumers. Promotion and dissemination of the Thai FBDGs have been carried out at national and community levels through basic health, agricultural and educational services and training activities, as well as periodic campaigning via multiple communication channels and media. Recently in 2009, the FBDGs for infant and preschool children were introduced to replace the previous infant and young child feeding guidelines. There has been no formal evaluation on the impact of promotion of the Thai FBDGs but some periodic testing of knowledge and practices have shown positive results.

Dietary diversity is one of the diet quality. Poor dietary diversity is associated with malnutrition, stunting, poor gut health, pregnancy complications, and cognitive impairment. Overcoming the underlying and basic causes of poor dietary diversity is imperative through policymaking. This current literature review discussed about intervention policies to improve dietary diversity at the individual and population levels. Literature search was carried out in some databases, i.e., Pubmed/Medline, Google Scholar, and Google with key word search such as dietary diversity, improvement, programs, interventions, and policies. The synthesized articles included observational studies, experimental studies, and grey literature on Dietary diversity programs and interventions. Articles on biodiversity and microbial diversity were not included. Dietary diversity can outgrow by knowing the policy on food-based interventions which are closely related to the food system and non-food-based interventions to improve socio-economic aspect and knowledge. Food-based interventions include food production, food prices, agricultural diversification, market development, and food-based dietary guidelines. Meanwhile, non-food-based interventions involve a country's development and economic growth, social behavior change, communication strategy, cash transfer, and mass media campaigns. Interventions to improve dietary diversity must be carried out in multi-sectors, for example, by improving family welfare, knowledge and behavior change, and stable food access.

Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrition education at the population level. Currently, more than 100 countries worldwide have developed FBDGs with majority of existing FBDGs in high-income countries. However, there are a few countries in Africa which have developed FBDGs. This review describes and compares the characteristics of existing FBDGs in Africa. Data were extracted from all existing FBDGs from African countries which have been archived in the Food and Agriculture Organization’s (FAO) online repository of FBDGs. In addition, supporting documentation from other sources linked to the identified FBDGs were also reviewed. Extracted data were coded and synthesized to describe the purpose of the FBDGs, the process for developing the FBDGs, and how healthy diets were expressed in the FBDGs. In addition, the FBDGs were examined for content on considerations for planetary health, and non-dietary recommendations. A checklist was used to extract the evidence in the identified documents. Of the 47 African countries in the WHO Africa region, only eight FBDGs were identified from seven countries. South Africa had two FBDGs (including a FBDG for young children). Multi-disciplinary technical working groups were convened in developing majority of the FBDGs. The working groups utilised scientific evidence on diet-related diseases and nutrient requirements as a basis for recommendations. All the FBDGs were intended as a tool for promoting healthy diets among the lay population. The FBDGs that were reviewed included between six and sixteen dietary messages. Diet diversification was promoted as the most common recommendation across African country FBDGs. The recommendations often promoted consumption of four to six food groups communicated using text as well as images (food guide). Local availability and cultural acceptability were important values promoted as part of an optimal diet in some of the countries. However, none of the recommendations addressed environmental sustainability. Apart from South Africa, none of the FBDGs had been evaluated or revised. Across Africa, there is a need for increased focus on developing new FBDGs or revising existing ones as a tool for meeting the dietary information needs of populations at risk of malnutrition in all its forms. Key words: Food-based, Dietary, Guidelines, diversity, Africa, Health, Non-communicable, Sustainability

Objectives This study was conducted to understand the nutrition education reality among nutrition teachers at elementary, middle, and high schools and examine the awareness and demand for non-face-to-face online nutrition education. Methods The subjects of this study were 158 nutrition teachers at elementary, middle, and high schools in Seoul and Gyeonggi Province. For the collected data, the Chi-squared test, Fisher's exact test, or independent sample t-test were performed according to the analysis items using SPSS Statistics version 26.0. Results The study showed that nutrition education was more prominent in elementary than middle and high schools. The lack of time due to overwork in nutrition teachers was suggested as the main reason for the failure to provide nutrition education. As the methods of implementing nutrition education, it was found that there were many direct education methods in the form of lectures during discretionary activity time in elementary schools, whereas indirect education methods using school newsletter were common in middle and high schools. As for the contents of nutrition education in schools for the past year, a balanced diet, good eating habits, and table manner were taught in the lower grades of elementary school, and food poisoning management was educated in the upper grades of elementary school. In addition, the proportions of contents on a balanced diet, obesity prevention and weight management, food poisoning management, food hygiene, eating blandly, and nutrition labeling were high in middle school. There was a high level of education in high school on healthy snack intake, obesity prevention and weight management, and nutrition labeling. Less than half of the study subjects experienced online nutrition education. The limitations of online nutrition education were the lack of a sense of presence with learners in online nutrition education and the restrictions on activity classes such as practice and experience. The highest percentage responded that various content levels are needed to be provided as a measure to improve online nutrition education. Conclusions Based on the results of this study, measures to activate online nutrition education are needed to be performed non-face-to-face in preparation for the occurrence and spread of infectious diseases such as COVID-19.

Undergraduate nutrition education of health professionals in Greek medical, dentistry, pharmacy, nursing and midwifery departments