Diet Program Research Articles

Dry protein composite mixture enriched with calcium of dairy origin, in the dietary treatment of certain diseases of the digestive system accompanied by malabsorption syndrome

The aim of this study is to evaluate the effectiveness of diet therapy with the inclusion of a specialized food product of a dry protein composite mixture enriched with calcium of dairy origin in patients with enteral malabsorption syndrome. 66 patients with various diseases of the digestive system (chronic atrophic gastritis, condition after gastric resection, chronic pancreatitis, etc.), aged 47 to 79 years, were examined. All patients were divided into 2 groups: the study group (40 patients) and the control group (26 patients). All patients underwent comprehensive treatment according to the profile of their underlying disease, as well. Medical nutrition was prescribed according to the Order of the Ministry of Health of the Russian Federation #330 2003 with the inclusion of 27 g of a dry protein composite mixture according to the order of the Ministry of Health of the Russian Federation #395n 2013. For the patients of the study group, dry protein composite mixture was enriched with 1.85 g of calcium of dairy origin. The duration of treatment is 12 weeks. In patients of the study group, in comparison with the control group, all clinical signs of statistically significantly improved, the absorption function of enterocytes was proved to be activated, the dynamics of recovery of metabolic disorders was noted faster. Conclusion: it has been shown for the first time that the use of calcium-enriched dry protein composite mixture of dairy origin as part of the dietary program of complex therapy of patients with malabsorption syndrome significantly improves the functional state of the small intestine, provides rapid dynamics of regression of the malabsorption syndrome clinic and metabolic disorders of the patients’ body.

The Study of the Identification of Spleen-Stomach Damp-Heat Syndrome and Its Nourishment and Regimen

Through a review of the literature on spleen-stomach damp-heat syndrome and dietetic regimens, based on the doctrine of spleen and stomach, and the start point of the dialectics of spleen-stomach damp-heat, this study recommends beneficial eating times and methods, several medicinal diet programs, and an exercise training schedule for people suffering from damp-heat body compositions to achieve the effect of clearing away heat and promoting diuresis, thus achieving the goals of a healthy diet, disease prevention, and life extension.

Evidence-based information about intermittent fasting in diabetes patients: useful or harmful?

One of the most important components of treatment for diabetic patients is diet and healthy nutrition therapy. Calorie restriction is effective and without cost increases its appeal for both patients and physicians. Unfortunately, continuous calorie restriction is a difficult method. For this reason, alternative calorie restriction methods, such as intermittent fasting (IF), have been investigated by some researchers. IF refers to a wide range of diet programmes covering periods of eating and fasting, which vary according to the different regimens. In this article, first, some general information will enable us to understand the concept of IF, and then scientific evidence with respect to IF applications in diabetes will be discussed in detail. Thereafter our clinical experience will be summarised, finally, the author will try to answer the question "are the IF applications beneficial or harmful for diabetic patients?" Considering animal studies, epidemiological studies, pilot studies, clinical experiences and a small number of randomized controlled trials conducted so far, it seems possible to say that the beneficial effects of IF for diabetes patients are greater than potential harms. However, there are not yet enough studies with a high level of evidence to recommend IF as a routine part of the treatment in patients with diabetes. It is necessary to show which IF regimen is safe and effective, how often and for how long, for diabetic patients. This seems possible with well-designed randomized controlled trials focusing on long-term clinical outcomes and eliminating confounding factors. This will make the answer clearer.

NHS England tenders contract to roll out diabetes low-calorie diet programme nationally

NHS England has tendered for a contract worth £20m to commission up to five providers to offer a low-calorie diet programme to overweight patients with type 2 diabetes mellitus (T2DM) across England from June 2023. The contract, published on 22 November 2022, follows a pilot phase of the programme, in which patients adhered to a […]

Effect of aerobic exercise with diet on sex hormones and selected coagulation biomarkers in obese postmenopausal women: a randomized clinical trial.

The current study determined the effect of aerobic training and diet program versus diet only on sex hormones and selected coagulation biomarkers in obese postmenopausal women. Further, the correlation between the measured variables after the intervention was identified. Eligible 40 women were distributed into two equal groups: the experimental group that received aerobic training three times per week for 12 weeks along with a balanced diet, and the control group that received a balanced diet only. Changes in weight, body mass index, sex hormones, and coagulation biomarkers were assessed pre-and post-intervention. The correlation between evaluated variables was assessed. Both groups demonstrated a significant difference in sex hormones (i.e., a substantial decrease in estradiol, total testosterone, free testosterone, and a substantial increase in sex hormone-binding globulin) and coagulation biomarkers (a considerable reduction in plasminogen activator inhibitor-1 activity, fibrinogen, and a significant increase in tissue plasminogen activator, prothrombin time, and cephalin-kaolin coagulation time). This discrepancy was highly significant in the experimental group (p < 0.01) relative to the control group (p < 0.05), and there was a strong link between sex hormones and coagulation biomarkers (p ≤ 0.05). Conversely, no correlation between variables was noticed in the control group (p > 0.05). Aerobic exercise along with a balanced diet modulates sex hormones level, improves homeostasis balance in postmenopausal women, and reduces the potential risk of cardiovascular disease.

The effect of omega-3 fatty acid supplementation on weight loss and cognitive function in overweight or obese individuals on weight-loss diet.

Objective: omega-3 polyunsaturated fatty acids (PUFAs) are important nutrients that play role in obesity, body lipids, inflammation, and neural function. There is controversy in studies on the effect of omega-3 PUFA supplementation on weight loss and cognitive function. The aim of this study was to investigate the effect of omega-3 PUFA supplementation on weight loss and cognitive function in obese or overweight adults on a weight loss diet. Methods: 40 adult volunteers aged 30-60 years, with body mass index (BMI) between 27.0 and 35.0 kg/m2, were randomly allocated into two groups. All subjects were involved in a weight loss diet program. The subjects in the omega-3 group (n = 20) also received daily supplementation with 1020 mg of omega-3 PUFAs (580 mg eicosapentaenoic acid (EPA), 390 mg docosahexaenoic acid (DHA), 50 mg other omega-3 PUFAs) for 12 weeks. Anthropometric measurements and body composition analysis were obtained at onset and at weeks 4, 8, and 12 of the study. The Montreal Cognitive Assessment (MoCA) test was used for evaluating cognitive functions at diet onset and at the end of week 12. Results: significant decreases were observed in weight, waist, and BMI in both groups. Abdominal fat mass and percentage decreased more in the omega-3 group than in the control group (p ≤ 0.05). MoCA scores increased in both groups within time, without statistical significance between groups. Conclusion: omega-3 PUFA supplementation augmented the reduction of abdominal fat mass and percentage in overweight or obese individuals on a weight loss diet. Further studies are required to identify the relationship and mechanisms of action of omega-3 PUFA supplementation on cognitive performance and weight loss.

Healthy Food Consumer Segmentation for Targeting and Positioning New Product Slimming Jelly

This study aims to determine market segments, market targets, and market positioning of slimming jelly using the segmentation analysis on healthy food consumer. The respondents used in this study were the consumers who regularly consume healthy food at least once per week within the last two months. The number of samples is 204 respondents. The consumer segmentation is done based on several variables including demographic aspects, motivation, consumption consistency, social tendencies, and attitudes towards new products. The segmentation analysis is carried out using the K-means non-hierarchical clustering method. The method splits the customers into three significantly different clusters at the 0.05 level, namely the adolescent age segment, which has attention to body shape, the adult segment which focus on body weight control, and the adults' segment which are not interested on body weight control. Based on the principle of selective specialization, the target market for slimming jelly is in clusters 1 and 2, with slimming jelly is positioned as a hunger delaying food that claimed to be high in fiber and low in calories so that it is suitable for health and can be used in diet programs.

Intervention Program: Integral Diet And Physical Exercise In The Reduction Of Anthropometric Parameters In Salvador De Bahia-Brasil

Introduction: High rates in anthropometric parameters such as excess weight, body fat, visceral fat, hypertension generate serious problems that affect the health of the general population. Objective: To identify the effects produced by the intervention program "integral diet and physical exercise" on anthropometric parameters and blood pressure in a community in Salvador de Bahia. Methodology: Experimental intervention study lasting 40 days in which 31 adults participated, carried out in a neighborhood of the municipality of Salvador (Bahia), Brazil. The study consisted of administering a comprehensive diet based on whole grains, oilseeds, legumes, fruits, vegetables and total abstinence from foods of animal origin, refined, industrialized flours, sugar, following the "Healthy Plate" and Physical Exercise model. Results: The participants who followed the program of integral diet and physical exercise, obtained significant changes in the anthropometric values (weight, BMI, waist contour, percentage of body fat, abdominal fat, biological age, and systolic and diastolic blood pressure, (p &lt;0.01), body mass did not show significant changes (p &lt;0.57). Conclusion: The intervention program with a comprehensive plant-based diet and physical exercise can reduce the rates of obesity, abdominal fat, anthropometric perimeters and blood pressure and contribute to reducing potential problems of chronic non-communicable diseases.

The Effect of Planning a Family-based Sensory Diet on Children With Attention-Deficit/Hyperactivity Disorder

Background and Objectives: The present study was conducted to determine the effect of a family-based sensory diet program on children with attention-deficit/hyperactivity disorder (ADHD). In this program, parents were directed to use activities stimulating the vestibular, deep, tactile, visual, and auditory senses to maintain the children’s focus and organized consciousness. Methods: This research was a quasi-experimental study with a Pretest-Posttest design with an experimental group. Wechsler Intelligence Scale for Children (WISC-IV) and Conners’ parent rating scale were used to measure the study variables. The study’s statistical population included all children with ADHD aged 6-12 years referred to Hasti, Bahar, and Masir-e Sabz health clinics in 2020. Of them, 30 participants were selected through a convenience sampling method. Results: Based on the analysis of covariance (ANCOVA), the obtained F values of attention deficit and hyperactivity were significant at a level less than 0.05. So the test hypothesis is accepted, and family-based sensory diet sessions effectively reduce ADHD symptoms in these children. Conclusion: According to the findings and the degree of effectiveness, implementing the sensory diet program by the child’s family can effectively reduce ADHD symptoms.

Diet Quality Index for older adults (DQI-65): development and use in predicting adherence to dietary recommendations and health markers in the UK National Diet and Nutrition Survey.

Diet quality indexes (DQI) are useful tools for assessing diet quality in relation to health and guiding delivery of personalised nutritional advice; however, existing DQI are limited in their applicability to older adults (aged ≥ 65 years). Therefore, this research aimed to develop a novel evidence-based DQI specific to older adults (DQI-65). Three DQI-65 variations were developed to assess the impacts of different component quantitation methods and inclusion of physical activity. These were Nutrient and Food-based DQI-65 (NFDQI-65), NFDQI-65 with Physical Activity (NFDQI-65+PA) and Food-based DQI-65 with Physical Activity (FDQI-65+PA). To assess their individual efficacy, the NFDQI-65, NFDQI-65+PA and FDQI-65+PA were explored alongside the validated Healthy Eating Index-2015 (HEI-2015) and Alternative Healthy Eating Index-2010 (AHEI-2010) using data from the cross-sectional UK National Diet and Nutrition Survey (NDNS) rolling programme. Scores for DQI-65 variations, the HEI-2015 and AHEI-2010 were calculated for adults ≥ 65 years from years 2-6 of the NDNS (n 871). Associations with nutrient intake, nutrient status and health markers were analysed using linear and logistic regression. Higher DQI-65 and HEI-2015 scores were associated with increased odds of meeting almost all our previously proposed age-specific nutritional recommendations, and with important health markers of importance for older adults, including lower BMI, lower medication use and lower C-reactive protein (P < 0·01). Few associations were observed for the AHEI-2010. This analysis suggests value of all three DQI-65 as measures of dietary quality in UK older adults. However, methodological limitations mean further investigations are required to assess validity and reliability of the DQI-65.

Characterization of the Gut Microbiota in Individuals with Overweight or Obesity during a Real-World Weight Loss Dietary Program: A Focus on the Bacteroides 2 Enterotype.

Background: Dietary intervention is a cornerstone of weight loss therapies. In obesity, a dysbiotic gut microbiota (GM) is characterized by high levels of Bacteroides lineages and low diversity. We examined the GM composition changes, including the Bacteroides 2 enterotype (Bact2), in a real-world weight loss study in subjects following a high-protein hypocaloric diet with or without a live microorganisms (LMP) supplement. Method: 263 volunteers were part of this real-world weight loss program. The first phase was a high-protein low-carbohydrate calorie restriction diet with or without LMP supplements. Fecal samples were obtained at baseline and after 10% weight loss for 163 subjects. Metagenomic profiling was obtained by shotgun sequencing. Results: At baseline, the Bact2 enterotype was more prevalent in subjects with aggravated obesity and metabolic alterations. After weight loss, diversity increased and Bact2 prevalence decreased in subjects with lower GM diversity at baseline, notably in LMP consumers. Significant increases in Akkermansia muciniphila and Parabacteroides distasonis and significant decreases of Eubacterium rectale, Streptococcus thermophilus and Bifidobacterial lineages were observed after weight loss. Conclusions: Baseline microbiome composition is associated with differential changes in GM diversity and Bact2 enterotype prevalence after weight loss. Examining these signatures could drive future personalized nutrition efforts towards more favorable microbiome compositions.

Effects of a Very Low-Carbohydrate High-Fat Diet and High-Intensity Interval Training on Visceral Fat Deposition and Cardiorespiratory Fitness in Overfat Individuals: A Randomized Controlled Clinical Trial.

Purpose: This randomized controlled parallel-group study examined the effects of a very low-carbohydrate high-fat (VLCHF) diet and high-intensity interval training (HIIT) program over 12 weeks on visceral adipose tissue (VAT) and cardiorespiratory fitness (CRF) level in overfat individuals.Methods: Ninety-one participants were randomly allocated to the HIIT (N = 22), VLCHF (N = 25), VLCHF+HIIT (N = 25), or control (N = 19) groups for 12 weeks. Body composition and CRF were analyzed before the experimental period and after 4, 8, and 12 weeks. Dual-energy X-ray absorptiometry (DXA) and graded exercise test (GXT) to volitional exhaustion were used for the body composition and CRF assessments, respectively.Results: There were significant between-group differences in the VAT mass and body composition outcome changes. VAT mass decreased after 12 weeks only in the VLCHF and VLCHF+HIIT groups (p < 0.001, median [95% CI]: VLCHF: −142.0 [−187.0; −109.5] g; VLCHF+HIIT: −104.0 [−135.0; −71.0] g). Similarly, changes in body mass, total body fat, trunk fat mass, waist and hip circumferences were distinctly decreased in the VLCHF and VLCHF+HIIT groups, when compared to HIIT and Control groups. Total lean mass significantly decreased in the VLCHF and VLCHF+HIIT groups (−2.1 [−3.0; −1.6] kg and −2.5 [−3.6; −1.8] kg, respectively) after 12 weeks. While the HIIT program significantly increased total time to exhaustion in the GXT, peak oxygen uptake was unchanged.Conclusions: A VLCHF diet, either in isolation or in combination with HIIT, was shown to induce a significant reduction in VAT mass and body composition variables. HIIT alone did not cause such effects on body composition, but improved exercise capacity. Our findings indicate that the VLCHF diet and exercise training provoked different and isolated effects on body composition and CRF.Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03934476, identifier: NCT03934476.

The Efficacy of Plant-Based Dietary Program in Patients with Diabetes: A Pilot Study

Dietary choices play a key role in insulin sensitivity among diabetes patients. An 8-week pilot study was conducted to evaluate whether a mostly plant-based dietary program will lead to improvement in biochemical markers in adults with diabetes. The dietary program included educational presentations, weekly cooking demonstrations and small group discussions. A sample of thirty-two adults with diabetes (types 1 and 2) were recruited and seventeen (53%) completed the study. Matched-pair tests and Fishers exact tests were used to compare the changes in means and proportion of the participants’ responses. There were changes in HbA1c, lipids, CRP (mg/L), cholesterol (mg/dL), HDL (mg/dL), triglycerides (mg/dL), LDL (mg/dL), non-HDL (mg/dL), Insulin (uIU/mL), AST (U/L), ALT (U/L), weight (lbs), systolic blood pressure (mmHg), diastolic (mmHg). The mean (std) age for the matched pair participant is 60.5 (11.35). Five type 1 and twelve type 2 diabetes patients showed a significant improvement in HbA1c (p = 0.001), weight (p = 0.002), intake of vegetables per day (p-value = 0.003), intake of plant-based protein (p-value &lt; 0.001) and self-reported reduction in fatigue and improvement in energy levels. Our 8-week dietary program showed an improvement in biochemical markers and positive attitudes toward the adoption of plant-based diets.

Development and Validation of a Questionnaire to Assess the Determinants of Dietary Adherence Among Patients After Bariatric Surgery.

PurposeThis study was aimed to develop a questionnaire to assess the determinants of dietary adherence among patients after bariatric surgery based on the attitude-social influence-efficacy (ASE) model and to evaluate its psychometric properties.Patients and MethodsAccording to semi-structured interview, Delphi expert consultation and pilot study, the initial questionnaire was formed and applied to investigate 319 patients after bariatric surgery in a tertiary hospital in Jiangsu Province, China. The reliability and validity of the scale were tested.ResultsThe 28-item of the attitude-social influence-efficacy questionnaire after bariatric surgery (ASEQBS) was formed. The results of exploratory factor analysis showed that four factors, including intention, attitude, social influence, and self-efficacy, could be extracted, and the cumulative variance contribution rate reached 59.98%. Confirmatory factor analysis showed the model fit well. The content validity index of each item was 0.800–1.000, and the content validity index of the ASEQBS was 0.857. The total Cronbach’s α of the ASEQBS was 0.920, the split-half reliability was 0.774, and the retest reliability was 0.922.ConclusionThe results suggest that ASEQBS is a valid and reliable measure of determinants of dietary adherence. It may be useful to evaluate the influence factors of dietary adherence and helpful to evaluate the efficacy of tailored dietary intervention programs.

Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of cancer patients

Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of cancer patients

Variation of psychological and anthropometrics measures before and after dieting and factors associated with body dissatisfaction and quality of life in a Lebanese clinical sample

ObjectiveThe primary objective of this study was to assess a change in the psychological states (stress, self-esteem, anxiety and depression), anthropometric measurements and physical/mental quality of life before and after diet in a sample of Lebanese subjects visiting a diet clinic. The secondary objectives included the evaluation of factors associated with body dissatisfaction, mental and physical quality of life (QOL) before the intervention of the diet program and the change in quality of life after this intervention among those participants.MethodsThis cross-sectional study, conducted between May and August 2018, enrolled 62 participants recruited from three diet clinics. The QOL was measured using the 12-item Short Form Health Survey (SF-12) and the psychological states was measured using the following scales: The Rosenberg Self-esteem Scale, Perceived Stress Scale, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale.ResultsA significant reduction in body dissatisfaction, anxiety, waist, weight and body fat and a significant increase in the physical and mental quality of life was seen after diet compared to before it (p < 0.001 for all). No significant variation in perceived stress (p = 0.072), self-esteem (p = 0.885), and depression (p = 0.353) after diet were found. Higher BMI (β = 0.440) and higher anxiety (β = 0.132) were associated with higher body dissatisfaction scores, whereas higher self-esteem (β = − 0.818) was significantly associated with lower body dissatisfaction. Higher perceived stress (β = − 0.711), higher body dissatisfaction (β = − 0.480) and being a female (β = − 4.094) were associated with lower mental QOL. Higher Physical Activity Index was significantly associated with higher mental and physical QOL (β = 0.086 and β = 0.123 respectively).ConclusionThe results indicate the effectiveness of diet programs in enhancing the quality of life, psychological and anthropometric measures.

Nurses- Led Interventions: Effect of Alkaline-Based Diet on Blood Pressure, Lipid Profile and Weight among Patients with Hypertension

Nurses are qualified to provide effective nursing interventions in management of hypertensive patients and lower risk of cardiovascular disease; nurses-led interventions for hypertensive patients are measuring and monitoring blood pressure (BP); educate patients about importance of performing physical exercises, and select healthy diet as alkaline based diet. Eating more alkaline diet has many advantages as lowering blood pressure, lipid profile as cholesterol so improving cardiovascular health, moreover reducing body weight. The aim of the study: to examine the effect nurses- led interventions as intake alkaline-based diet on blood pressure, lipid profile and weight among patients with hypertension. Design: Quasi Experimental design. Setting: Medical outpatient clinic of Menoufia University Hospital, Egypt. Subject: Purposive samples of 100 hypertensive patients, they fulfill the inclusion criteria, 50 patients in each group (study and control). Tools: Three tools used to collect the current data; as follows: The tool (I): Interview questionnaire; Tool (II): Questionnaire for Alkaline – Based Diet. Tool (III): Physiological measurement. Results: the present results documented that; a highly significant difference was found between the two groups post intervention in relation to knowledge levels; blood pressure of the study group was lower than those of the control group after following the alkaline diet and water; also highly statistically significant differences were found between study and control groups at all measurements during post intervention in weight and all lipid profile variables except at the 3rd measurement. Conclusion: consumption of alkaline diet and water had a good effect in reducing arterial blood pressure, body weight and blood lipids. Recommendation: replicate the study on large sample and establishing periodical alkaline diet programs with planned meals for hypertension, overweight and high blood lipids patients with continuous follow up.

Comparing Video-Based, Telehealth-Delivered Exercise and Weight Loss Programs With Online Education on Outcomes of Knee Osteoarthritis : A Randomized Trial.

Scalable knee osteoarthritis programs are needed to deliver recommended education, exercise, and weight loss interventions. To evaluate two 6-month, telehealth-delivered exercise programs, 1 with and 1 without dietary intervention. 3-group, parallel randomized (5:5:2) trial. (Australian New Zealand Clinical Trials Registry: ACTRN12618000930280). Australian private health insurance members. 415 persons with symptomatic knee osteoarthritis and a body mass index between 28 and 40 kg/m2 who were aged 45 to 80 years. All groups received access to electronic osteoarthritis information (control). The exercise program comprised 6 physiotherapist consultations via videoconference for exercise, self-management advice, and behavioral counseling, plus exercise equipment and resources. The diet and exercise program included an additional 6 dietitian consultations for a ketogenic very-low-calorie diet (2 formulated meal replacements and a low-carbohydrate meal daily) followed by a transition to healthy eating, as well as nutrition and behavioral resources. Primary outcomes were changes in knee pain (numerical rating scale [NRS] of 0 to 10, higher indicating worse) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]; scale, 0 to 68, higher indicating worse) at 6 months (primary time point) and 12 months. Secondary outcomes were weight, physical activity, quality of life, mental health, global change, satisfaction, willingness to have surgery, orthopedic appointments, and knee surgery. A total of 379 participants (91%) provided 6-month primary outcomes, and 372 (90%) provided 12-month primary outcomes. At 6 months, both programs were superior to control for pain (between-group mean difference in change on NRS: diet and exercise, -1.5 [95% CI, -2.1 to -0.8]; exercise, -0.8 [CI, -1.5 to -0.2]) and function (between-group mean difference in change on WOMAC: diet and exercise, -9.8 [CI, -12.5 to -7.0]; exercise, -7.0 [CI, -9.7 to -4.2]). The diet and exercise program was superior to exercise (pain, -0.6 [CI, -1.1 to -0.2]; function, -2.8 [CI, -4.7 to -0.8]). Findings were similar at 12 months. Participants and clinicians were unblinded. Telehealth-delivered exercise and diet programs improved pain and function in people with knee osteoarthritis and overweight or obesity. A dietary intervention conferred modest additional pain and function benefits over exercise. Medibank, the Medibank Better Health Foundation Research Fund, and a National Health and Medical Research Council Centre of Research Excellence.

Fad diets past and present, including taurine for psoriasis, diet therapy for atopic dermatitis, and the role of elimination diets

The effect of diets and foods on cutaneous afflictions has never been a moot point. The number of inquiries from patients and the wider public about how certain foods have affected or, indeed, caused their skin eruption, is increasing. While this inquisition is at the forefront of people's and physicians’ minds in modern practice, this has long been a discussion in the scientific world. Élie Metchnikoff alluded to this at the turn of the 20th century. How foods and certain dietary programs affect diseases has been postulated, although there is still more to learn, despite the patient's advocacy for a particular dietary regimen. The study of the role of the microbiome is increasing. Gut dysbiosis, along with the interaction of the gastrointestinal tract, skin, and brain (gut-skin-brain axis) is discussed. The role and impact of neuroendocrine transmitters and the skin are explored.

A school-based nutrition education program involving children and their guardians in Japan: facilitation of guardian-child communication and reduction of nutrition knowledge disparity

BackgroundSince the risk of noncommunicable diseases is closely associated with dietary intake, it is important to establish healthy dietary habits in childhood. Although several dietary education programs for children have been attempted, their implementation at school was often difficult due to overcrowded study curricula. We developed a new program which included homework for children and guardians, and evaluated its effect. Determinants of the effect were also investigated.MethodsThe school-based nutrition education program including a 45-min lecture, a series of homework assignments involving children and guardians, and two handouts was implemented in 14 public primary schools in Japan. Seven schools each underwent the intervention in an alternating manner. Nutrition knowledge (percentage (%) of correct answers in the nutrition knowledge questionnaire) and attitude/behavior toward diet was evaluated three times (May (baseline), October, February) as outcomes. These factors and their changes following the intervention were assessed by linear mixed models to adjust for individual factors, with consideration to clustering of the participants and repeated measurements.ResultsIn total, 2227 children aged 10–12 years and their guardians participated. All schools completed the program. Children’s nutrition knowledge level was significantly increased (8.7%, 95% confidence interval [7.7–9.7]) following the intervention. Communication between children and their guardians, which was positively related with nutrition knowledge, was facilitated by the intervention. The increase in nutrition knowledge was greater among children with a lower knowledge level at baseline.ConclusionsThis school-based nutrition education program was effective and feasible. Appropriate teaching materials for homework can reduce the burden on schools and facilitate communication between children and guardians. Public schools can be crucial venues for decreasing disparities in nutrition knowledge.Trial registrationThis study was registered as an intervention study in the UMIN Clinical Trials Registry (trial ID: UMIN000029252) on Sep 22, 2017.