Effective Nutrition Education Research Articles

P64 Factors That Contribute to Effective Online Nutrition Education Interventions: A Systematic Review

Background The use of Internet and technology as a medium of delivering online nutrition education (ONE) has increased; however, evidence-based studies exploring factors that contribute to best practices in online interventions have not been standardized. Objective To identify factors that contributed to successful ONE interventions for research studies published between 2009 and 2018. Study Design, Settings, Participants Following the PRISMA guidelines, studies on nutrition education interventions delivered via Internet, computer, or text messages were identified through PubMed, Medline, Web of Science, Science Direct, and Educational Resources Information Center (ERIC) database. Twenty seven studies that met inclusion criteria were screened. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to determine the quality of each study included. Measurable Outcome/Analysis The primary analytic goal was to determine the overall effectiveness of ONE interventions according to their stated objective. Factors that were analyzed included: use of theory, recruitment and implementation methods, intervention duration, participant engagement, and study fidelity. Results Of the 27 studies, 21 studies delivered their interventions via websites, three through smartphone application, one via text messages, and one as an online course. Six factors associated with successful ONE interventions were identified: use of tailored messages/individualized feedback; participants engagement as measured by the level of interaction between investigators and participants; intervention duration ≥ three months; identification of specific targeted behaviors vs. general health; alignment of intervention activities with stated objectives; and use of theory-based interventions. The review identified several factors considered as poor design of ONE interventions, including comparison bias, lack of specific details on duration/dosage, lack of objective measurement, and lack of tracking system. Conclusion This review found that ONE interventions are more likely to be effective when they include tailored messages and/or individualized feedback, offer regular interaction between participants and investigators, and commit adequate duration for the intervention. Funding None.

P133 The Influence of Social Support on Self-Efficacy in Eating Habits Among High School Athletes

Background Previous studies have suggested that self-efficacy and social support are factors that influence dietary behavior in adults. However, the relationship between these two factors among high school athletes has not been adequately explored. Objective This study aims to determine which factor of social support (five-factors structure) is strongly associated with self-efficacy in eating habits among high school athletes. Study Design, Settings, Participants The acquired data in this cross-sectional study were analyzed. The subjects were 109 high school athletes. The data for this study were gathered through questionnaire (that included demographic characteristics, questions regarding nutrition education, self-efficacy and social support in eating habits of athletes). Validated self-efficacy scale and social support scale were used in this study. This social support scale includes the five-factors of “Informational Support of General Nutrition,” “Informational Support for Athletes,” “Tangible Support,” “Appraisal Support by Praise,” and “Appraisal Support by Advice.” Measurable Outcome/Analysis A multiple regression was utilized to determine which factor of social support is strongly associated with self-efficacy. Mann-Whitney U test was utilized to examine the relationship between social support and nutrition education. Results The results of the multiple regression analysis revealed that the most important predictive factors in the students' self-efficacy was “Informational Support of General Nutrition” (β = 0.378, P Conclusion The results of this study showed that “Informational Support of General Nutrition” is strongly associated with self-efficacy in eating habits. Further research is needed about longitudinal study of correlation between the social support and the self-efficacy. However, the finding can be used to develop effective nutrition education program to increase self-efficacy in eating habits among high school athletes. Funding None.

775-P: Significant Association of Food Group Intake with Obesity among Patients with Type 2 Diabetes Mellitus in Japan

Although obesity is closely associated with development and progression of type 2 diabetes mellitus (T2DM) and its complications, food group intake associated with obesity in diabetic patients has been very poorly investigated to date largely due to lack of large-scale databases with details on dietary intake. Thus, we aimed to determine intake of food groups by utilizing our nationwide database for people with diabetes with adjustment for confounders including energy intake. Analyzed were 1891 Japanese patients with T2DM (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. Obesity was defined by BMI>25. The associations between obesity and food groups were determined by multivariate quartile analysis. Among 15 food groups, both green and yellow and light-colored vegetables had significant negative associations with the presence of obesity among both men and women (Table). In addition, fruit and beans in men and fish in women were also negatively associated with obesity. Conversely, confectionery had positive associations with obesity in both men and women. Other food groups such as rice, meat or eggs did not show significant trends toward the presence of obesity. These results identified favorable dietary patterns for people with T2DM, which could be used for effective nutritional education to prevent obesity. Disclosure M. Hatta: None. K. Fujihara: None. Y. Takeda: None. R. Nedachi: None. D. Ishii: None. S.Y. Morikawa: None. C. Horikawa: None. M. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.

Taking the Pulse on Feeding Infants in a Child Care Setting (P11-067-19)

ObjectivesIdentify and understand contextual, cultural, and attitudinal variables related to breastfeeding and infant feeding that may inhibit or engender the utilization of USDA’s Team Nutrition resources and adoption of the communicated information. MethodsSeventeen focus groups were conducted with current breastfeeding mothers (n = 66) and expecting mothers (n = 20), and in-depth interviews (IDIs) were conducted with twelve child care providers with infants in their care. ResultsThe focus groups with current breastfeeding mothers and expecting mothers revealed that mothers were sensitive to information that was not consistent with their own experiences; preferred that technical information be conveyed using realistic photographs as opposed to illustrations or graphics; favored content that encouraged communication between child care providers and themselves; and accurately depicted breastfeeding.On the other hand, most child care providers did not feel comfortable actively encouraging breastfeeding at their child care site; the term “developmental readiness” for complementary feeding was not commonly understood; and felt that their biggest challenges with caring for infants included 1) effectively communicating with parents, 2) managing the time of on demand feedings with groups of children in their care, and 3) storing and handling breastmilk. ConclusionsAddressing the realities of breastfeeding and infant feeding, including common challenges for both mothers and child care providers, is essential in the development of effective nutrition education materials. Tools are needed to facilitate communication between child care providers and families. Funding SourcesUnited States Department of Agriculture.

Nutritional status of reproductive aged santal ethnic women

Measurement of nutritional status is always vital and thought to be primary step to formulate development strategy. Reproductive aged ethnic women are important group to study because of their distinct features. An observational cross-sectional study was carried out at northern part of Bangladesh to assess nutritional status of reproductive aged Santal women with a sample size 200. Face to face interview was carried out with the semi-structured questionnaire. Convenient sampling technique was used to collect data on the basis of inclusion and exclusion criteria and written consent was taken prior to interview. Nutritional status was determined according to BMI cut off value for Asian population. Descriptive as well as inferential statistics were used to present data. Mean±SD age of respondents was 34.27±8.60. More than half (67%) of the respondents were illiterate and housewife (84%). Mean±SD income of respondents was 5700.71±282.89 per month. Underweight, normal and overweight were 67%, 30% and 3% respectively. Most respondents took rice 2-3times/day. Vegetables and soyabean were taken randomly. Lentil was taken daily. Statistical significant association was found between nutritional status and age group (p<0.05), education (p<0.05), occupation (p<0.05) and monthly income (p≤0.05). Half of the respondents suffered from underweight and most of them income was very low. Income generating capacity should be increased as well effective nutrition education programme must be instituted.

Knowledge of Nutrition and Macronutrients Consumption as Factors Causing Wasting in School Children and Effective Nutrition Education to Improve It

Wasting is a nutritional problem suffered by many school children. The purpose of this study was to determine the factors that cause wasting in school children and effective nutrition education to improve it. This study is a Research and Development. Population of this research is all of children in 4 elementary schools at Sumbang district, amounts 743. The sample was taken by purposive with inclusion criteria are children who they are in the fourth graders study, amounts 101. Data Analysis by univariate and bivariate analysis by rank speraman and wilcoxon analysis. Lack of knowledge (p value=0.037) and low consumption of carbohydrates, protein, fat (p value=0,000;0.001;0.001) as factors that causes wasting. Wilcoxon analysis results showed that there were differences in sample knowledge given audiovisual media and picture book (p value=0,000). Audiovisual media was most effective for improving students' nutritional knowledge (37.22% vs 12.7% knowledge increase). The results of wilcoxon's analysis on changes in nutritional behavior did not show any differences in pictorial and audiovisual stories (p value=0.644), this means that both are equally effective in improving the nutritional behavior of school children. Suggested to carry out nutrition education regularly to reduce wasting in school children.

Hunger or Deportation: Implications of the Trump Administration's Proposed Public Charge Rule

Until recently, lawfully present noncitizens participating in the US Department of Agriculture Supplemental Nutrition Assistance Program (formerly Food Stamps) faced no immigration consequences. However, in September, 2018, the Trump Administration proposed a more expansive public charge rule in the Federal Register that would deny lawfully present noncitizens a path to citizenship if they had participated in certain federal safety net programs, including Supplemental Nutrition Assistance Program. This perspective discusses the proposed rule's implications, particularly for those with professional interests in promoting effective nutrition education and healthy behavior through research, policy, and practice among individuals who will potentially be affected.

Identifying perceived barriers and enablers of healthy eating in college students in Hawai\u2019i: a qualitative study using focus groups

BackgroundTo design effective nutrition education interventions for college students, research is needed to determine the factors influencing food choices. The purpose of this study was to identify perceived barriers and enablers of healthy eating in college students ages 18–24 at the University of Hawai’i at Mānoa.MethodsPrior to conducting focus groups, an interview guide was developed based on a literature review of relevant studies. The interview guide was successfully tested in the first focus group and used in the rest of the focus groups. Eleven focus groups with group sizes of two to six were conducted (n = 44). Focus groups were audio-recorded and transcribed. Transcripts were coded in NVIVO11 using content analysis, and additional codes were added to the codebook based on emergent ideas from the transcripts. After completion of the final codebook, transcripts were recoded with the new codebook. Final code counts were used to identify overarching ideas based on the socio-ecological model of health, consisting of four levels of influence: individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and macrosystem (societal).ResultsThe largest barriers according to level of influence in the socio-ecological model were nutrition knowledge deficit (individual), peer pressure (social environmental), unsupportive institutional environment (physical environmental), and cost (macrosystem). The largest enablers were nutrition knowledge (individual), parental influence (social environmental), an institutional environment with consistent healthy offerings (physical environmental), and social media (macrosystem). Some factors served as barriers for some participants and enablers for others, such as parental influence.ConclusionFactors such as individual knowledge and parental support were cited as having a positive influence in promoting healthy eating, while factors such as the cost of living and food availability at college serve as barriers even for motivated students. Results from this study identify potential areas of intervention, such as improving nutrition knowledge (individual), offering more healthy options (physical environmental), or reducing cost of food (macrosystem). However, more research is needed to identify which level of intervention may be most effective in changing food habits, and which barriers or enablers are deciding factors in determining this population’s food choices.

Examining the differences of food-related behavior in two different countries

PurposeStudy location may cause a different type of socio-demographic, body mass index (BMI), study intensity and food-related behavior. The increasing number of Indonesia students who study abroad to Taiwan is interesting to be examined those factors related. The purpose of this study is to examine the food-related behavior of Indonesian college students in different study location.Design/methodology/approachA descriptive cross-sectional study design was used to administer questionnaires assessing socio-demographic, BMI, study intensity, meal preparations, food access and eating behavior of Indonesian college students (n = 493). Study location took in two cities and different countries (Indonesia and Taiwan). Analysis statistics was using frequency descriptive, Chi-square test, Wilcoxon–Mann–Whitney U test, Kruskal–Wallis test and Logistic regression.FindingsThe trend showed students who lived in Malang tended to have healthier eating behavior. Students tended to have a higher prevalence of low study intensity, dependent meal preparation and difficult food access in Taipei. There was a significant relationship between study location and study intensity (p < 0.01), study location and BMI (p < 0.01), study location and meal preparation (p < 0.01), study location and food access (p = 0.02). On the other hand, eating behavior had no significant relationship with study location (p = 0.28). Marital status became the most dominant variable in influencing obesity (OR = 0.198). Findings indicate that there are significant differences between study location with marital status, BMI, study intensity, meal preparation and food access, but not eating behavior. Moreover, married status is most influencing to obesity risk.Research limitations/implicationsThe limitations of this research were data of height and weight was not be measured directly. Moreover, the reliability of the instrument was unexpected. In the future, research needs improvement more sample for fixing it. Moreover, to support initiatives to incorporate eating behavior into body weight management strategies may be needed. The implications are to create an effective nutrition education for Indonesian college students. Hopefully, it will be influencing public attitudes and affecting the quality of life.Practical implicationsFurther investigation should consider longitudinal studies to explore the different effects of eating behavior on overweight and obesity. Nutritional education programs should give to young adults not only in developed but also in developing countries.Originality/valueThis paper shows our findings about the difference study location that may cause a different type of eating behavior. The research subject was Indonesian college students who live and study in two cities, Malang-Indonesia and Taipei-Taiwan. The trend showed students who live in Malang tend to have healthier eating behavior. On the other hand, study intensity, meal preparation and food access were significantly different in both cities. Indonesian college students in Taipei tended to have the higher prevalence of low study intensity, dependent meal preparation and difficult food access. The authors believe that the findings would appeal to a broad audience, especially for improving meal preparation in college students who study abroad.

A comparative study on nutritional knowledge and dietary behavior between Korean and Chinese postpartum women.

BACKGROUND/OBJECTIVESProper nutrition intake during pregnancy and lactation is very important to both mothers and babies. Pregnant women should maintain proper nutritional status to restore decreased physical strength due to pregnancy and childbirth and produce breastmilk for the growth and development of the baby. Recently, the number of Chinese people living in Korea has increased as the exchange between Korea and China becomes active. It is important to provide proper nutrition education for pregnant women of both countries considering cultural differences.SUBJECTS/METHODSThe subjects of this study were postpartum women in Gyeonggi, South Korea and Jinhua, China. The subjects were 20–45 years old less than six months after childbirth. A survey, using self-administered questionnaires, was conducted from October 2018 to January 2019. For data analysis, 221 Korean postpartum women (KPW) and 221 Chinese postpartum women (CPW) questionnaires were used.RESULTSKPW had significantly higher nutritional knowledge score and dietary attitude score than CPW (P < 0.001). However, overall score for dietary habits was significantly higher in CPW compared to KPW (P < 0.001). In KPW, nutritional knowledge (P < 0.01) and dietary attitude (P < 0.001) had significantly positive correlations with dietary habits. The proportions of KPW and CPW who answered that they had experience of nutrition education were 28.5% and 80.1% (P < 0.001). The score for dietary habits was lower as the hours for watching TV and using mobile phone became longer in postpartum women of both countries, with significant differences in KPW (P < 0.001) and CPW (P < 0.05). In KPW, the score for dietary habits in postpartum women with exercise experience was significantly higher than that in postpartum women without exercise experience (P < 0.001).CONCLUSIONSMore pregnancy-related nutrition education should be provided and various and effective nutrition education programs, which not only transfer information but can be practiced in the actual life, should be developed.

Maternal Nutrition Education Provided by Midwives: A Qualitative Study in an Antenatal Clinic, Uganda.

Maternal nutrition during pregnancy affects the health of the mother and baby. The objective of this paper is to describe the maternal nutrition education offered by midwives to women attending an antenatal clinic. The study also examined the resources, support, and the needs of the midwives in offering the nutrition education. Six in-depth interviews with the midwives, six direct structured observations of the group education, and 12 one-on-one interactions of midwife and pregnant women observations were completed. The interviews and field observation notes were typed and analyzed using the latent content analysis. The emerging themes were the maternal nutrition education and the education needs of the midwives. The content and presentation of maternal nutrition were inadequate in scope and depth. The maternal nutrition education was offered to only pregnant women attending the first antenatal care visit. The routine antenatal education session lasted 45 minutes to 1 hour, covering a variety of topics, but the nutritional component was allotted minimal time (5–15 minutes). The organization, mode of delivery, guidelines, resources, and service environment were extremely deficient. The relevance of appropriate weight gain during pregnancy, guidelines for healthy habits, avoidance of substance abuse, and nutrition precautions in special circumstances was missing in the nutrition presentation. Information, maternal nutrition education resources, infrastructure, and health system gaps were identified. There was an inefficient nutrition education offered to the pregnant women attending the antenatal clinic. As means of promoting effective nutrition education, appropriate in-service training, mentorship, and support for the midwives are needed, as well as infrastructural and resource provision.

BARIATRIC DIET GUIDE: PLATE MODEL TEMPLATE FOR BARIATRIC SURGERY PATIENTS

ABSTRACT Background: The Bariatric Plate Model (BPM) may be an adequate form of nutritional guideline after obesity surgery. Aim: Create a food guide, based on the Plate Model for nutritional education of bariatric patients. Method: The Plate Model2 was revised from a model initially suggested for dyslipidemic and hypertensive patients to a new objective: adaptation to bariatric patient who needs effective long-term nutritional education. Results: The adaptation of the Plate Model considered protein needs with high biological value, as it is the priority in the BPM, followed by vitamins and minerals and lastly the carbohydrates, especially the whole ones. Conclusion: The BPM is a tool that can be effectively used in nutritional education of bariatric patients.

P93 - Contributing Factors for Effective Nutrition Education Interventions in Children: A Systematic Review

Background (Background, Rationale, Prior Research, and/or Theory): Nutrition education is a critical component in the development of healthy eating practices and behaviors as it enhances children's knowledge and skills that they need to perform desired behaviors which may track to adulthood. Objective: To identify factors associated with successful nutrition education interventions among children in promoting healthy behaviors. Study Design, Setting, Participants, Intervention: A systematic review of nutrition education interventions among children was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies published between 2009 and 2016 were identified through Pubmed, Medline, Web of Science, Science Direct, and Educational Resources Information Center (ERIC) database. Forty-eight studies met the inclusion criteria and were screened and determined the quality of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A total of 41 studies were included in the final analysis. Outcome Measures and Analysis: The data from 41 studies were extracted. The studies were grouped and reviewed according to their target age groups: preschoolers, elementary and secondary school children. The primary analytic goal was to determine the overall effectiveness of nutrition education interventions according to their stated objective. Results: Out of the 41 studies, 26 targeted elementary school children, eight targeted secondary school children, and seven studies targeted preschoolers. Seven overarching factors emerged as critical to successful nutrition education among children as follows: a multi-component (involving teachers and parents) and multi-level intervention (including the schools and home) approach; adequate duration and frequency of exposure; level of parental engagement; age-appropriate and hands-on experiences; fidelity as ensured by trained implementers and standardized protocol; environmental change for upstream and midstream outcome; and proper alignment between stated objectives, intervention, and desired outcome. Conclusions and Implications: The critical components for effectiveness of children education interventions included strategies that were age appropriate, involved parents and environmental change, ensured fidelity, and had adequate duration. Funding: None.

P92 - What Works: Identifying Effective Nutrition Education Curricula Delivered to Low-Income California Adults

P92 - What Works: Identifying Effective Nutrition Education Curricula Delivered to Low-Income California Adults

Prevalence and determinants of essential newborn care practices in the Lawra District of Ghana

BackgroundThere was less than satisfactory progress, especially in sub-Saharan Africa, towards child and maternal mortality targets of Millennium Development Goals (MDGs) 4 and 5. The main aim of this study was to describe the prevalence and determinants of essential new newborn care practices in the Lawra District of Ghana.MethodsA cross-sectional study was carried out in June 2014 on a sample of 422 lactating mothers and their children aged between 1 and 12 months. A systematic random sampling technique was used to select the study participants who attended post-natal clinic in the Lawra district hospital.ResultsOf the 418 newborns, only 36.8% (154) was judged to have had safe cord care, 34.9% (146) optimal thermal care, and 73.7% (308) were considered to have had adequate neonatal feeding. The overall prevalence of adequate new born care comprising good cord care, optimal thermal care and good neonatal feeding practices was only 15.8%.Mothers who attained at least Senior High Secondary School were 20.5 times more likely to provide optimal thermal care [AOR 22.54; 95% CI (2.60–162.12)], compared to women had no formal education at all. Women who received adequate ANC services were 4.0 times (AOR = 4.04 [CI: 1.53, 10.66]) and 1.9 times (AOR = 1.90 [CI: 1.01, 3.61]) more likely to provide safe cord care and good neonatal feeding as compared to their counterparts who did not get adequate ANC. However, adequate ANC services was unrelated to optimal thermal care.Compared to women who delivered at home, women who delivered their index baby in a health facility were 5.6 times more likely of having safe cord care for their babies (AOR = 5.60, Cl: 1.19–23.30), p = 0.03.ConclusionsThe coverage of essential newborn care practices was generally low. Essential newborn care practices were positively associated with high maternal educational attainment, adequate utilization of antenatal care services and high maternal knowledge of newborn danger signs. Therefore, greater improvement in essential newborn care practices could be attained through proven low-cost interventions such as effective ANC services, health and nutrition education that should span from community to health facility levels.

Factors that contribute to effective nutrition education interventions in children: a systematic review.

Establishing healthy dietary practices at an early age is crucial, as dietary behaviors in childhood track to adulthood. The purpose of this systematic review was to identify factors associated with successful nutrition education interventions conducted in children and published between 2009 and 2016. Using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, relevant studies were identified through the PubMed, Web of Science, ScienceDirect, and ERIC (Educational Resources Information Center) databases. Studies published in English between 2009 and 2016 that included a nutrition education intervention among children aged 2 to 19 years were included. Review articles, abstracts, qualitative or cross-sectional studies, and studies targeting children with special nutritional needs were excluded. Four authors screened and determined the quality of the studies using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system and extracted the data from the articles. Forty-one studies were included: 7 targeted preschool children, 26 targeted elementary school children, and 8 targeted secondary school children. A total of 46% met their primary objectives of nutrition education intervention, while the rest either partially achieved or did not achieve their stated objectives. Successful interventions targeting school children engaged parents by means of face-to-face sessions, identified specific behaviors to be modified, and assured fidelity by training teachers or recruiting trained experts to deliver the intervention. In addition, they allowed adequate dosage, with an intervention duration of at least 6 months, and used age-appropriate activities. Interventions with a multicomponent approach that were age appropriate and of adequate duration (≥ 6 months), that engaged parents, and that ensured fidelity and proper alignment between the stated objectives, the intervention, and the desired outcomes were more likely to succeed.

The impact of gender on control behavior when purchasing a new type of cheese

The impact of gender on control behavior when purchasing a new type of cheeseThe evidence for a sustainable perspective method is not a relatively small phenomenon in the EU and around the world; and eventually costumers are the last link of supply chains. But many consumers do not care about different values of food, they do not pay attention to information about food product. The aim of the paper is to investigate effect of gender on control behavior when purchasing a new kind of cheese. Data were collected in the Czech Republic using a paperbased questionnaire. Respondents were university students. Differences between genders in these variables were tested using ordered probit model. Stata was used for data analysis. Findings are that nutrient value of the products, name of the products, producer, the origin of the product, Internet information are significantly impacted by gender. Namely, female are more considerate of the nutrient value of the products they buy, of the name of the products, and producer; they search for desirable information on the labelings, than man. Contrary, man are more considerate of the origin of the product, and of Internet information on the product. The remaining variables were not significantly influenced by gender. Gender variable can be regarded as an indication to explain why some consumers have a positive attitude to solving food-related issue. These findings can help to understand the role of gender on consumer behavior, and may be relevant where there is an organic market at the beginning. The study also underlines the importance of effective nutrition education which should incorporate gender diff erences, it represents a key issue in human health and is compliant with the WHO as stated that “the increased knowledge and evidence of the impact of gender inequalities on specific health problems and health services and of successful responses, and developing tools to promote and expand health sector policies, interventions and programs that systematically address gender concerns”.

Long-Distance Triathletes' Intentions to Manipulate Energy and Macronutrient Intake Over a Training Macrocycle.

This study explored the information sources long-distance triathletes used to inform their training and nutrition plans, and evaluated these plans over a training macrocycle. Seventy-four long-distance triathletes completed the online survey. Coaches were the most popular training information source (69%), whereas nonprofessional sources (internet 65%, other athletes 53%) were more popular than nutritionists (29%) for nutrition information. Attributes valued most in an information source were: source prior personal experience, individualized advice, breadth of knowledge, and credibility. Sixty-five percent of participants reported previously manipulating dietary intake to improve performance. Forty-three percent reported carbohydrate loading previously, but only 29% planned to carbohydrate load for their upcoming event. Thirty-six percent of participants planned to reduce carbohydrate intake at some point in training, predominantly early (28%) and toward the end (22%) of their macrocycles. Twenty percent of participants planned to maintain energy intake early, and increase (14%) or maintain energy intake (15%) mid-cycle. Triathletes' training plans showed intentions for concurrent increases in volume and intensity, rather than a classical periodized training progression. Limitations of this study include the lack of diet intake and training data, quantitative comparison with dietary guidelines and high/low carbohydrate classification, and an overrepresentation of women in the study cohort. This research showed the popularity of the internet and other athletes to inform triathletes' nutrition plans, and revealed intentions to reduce carbohydrate intakes alongside training load increases, contrary to professional guidelines. Understanding athletes' intentions and sources of nutrition information is crucial to developing effective nutrition education strategies.

Importance-Performance Analysis (IPA) of Foodservice Operation, Dietary Life Education, and Nutrition Counseling Tasks of Nutrition Teachers and Dietitians in Jeju, Korea.

The purpose of this study was to analyze foodservice operation, dietary life education, and nutrition counseling tasks of nutrition teachers and dietitians in elementary, middle, and high schools in Jeju, Korea, and to provide effective ways to implement dietary life education and nutrition counseling in schools. This study surveyed 94 nutrition teachers and 46 dietitians working at elementary, middle, and high schools in Jeju during 7–14 May 2015. The importance and performance of 16 tasks of nutrition teachers and dietitians were measured using questionnaires. The data was analyzed by using the SPSS software and Importance–Performance Analysis (IPA). Importance was ranked in the order of foodservice operation (4.72), dietary life education (4.37), and nutrition counseling (4.24); and performance was ranked in the order of foodservice operation (4.48), dietary life education (3.70), and nutrition counseling (3.22). The importance–performance matrix showed that in Quadrant 4, the “Concentrate Here” item was “nutrition and dietary life education for students”, while in Quadrant 2, the “Possible Overkill” item was “cost control and office management”. These findings suggest that it is important to reduce unnecessary administrative and office management tasks in order for nutrition teachers and dietitians to implement effective nutrition education, dietary life education, and nutrition counseling programs.

Nutritional status of adolescent girls in a rural area of Bangladesh: A cross sectional study

The improvement of adolescent nutritional status may help address the reduction of all forms of malnutrition in Bangladesh. This is because at this stage, they experience a growth spurt thus increasing the need for most nutrients, needed for growth and reproductive health. The objective of this research was to assess the nutritional status of adolescent girls in rural areas of Bangladesh and find out the associated factors that affects nutritional status. A cross sectional study was carried out among 106 adolescent girls of Nobabpur village in Comilla district. A questionnaire was developed to obtain demographic information, food intake pattern and anthropometric measures such as weight, height with measuring instruments. About 80% were found normal according to BMI where about 13% adolescent girls were malnourished, below the cut off value 18.5. Place of residence, education of adolescent girls, their family expenditure to food and improper knowledge on food and nutrition were identified as underlying causes. Nutritional profiles of adolescent girl can be improved by implementing effective nutrition education program, providing supplementary food, facilitating primary health care program and creating awareness about nutritional knowledge. Severely malnourished adolescent girl in the selected area should be identified as early as possible and brought under supplementary feeding program.Bangladesh J. Sci. Ind. Res. 52(3), 221-228, 2017