General Nutrition Education Research Articles

A 6-month randomised controlled trial to compare the effectiveness of telenutrition v. telenutrition supported by telemonitoring and health coaching in a weight loss programme: a study protocol.

One of the main challenges in weight loss programmes is compliance with diet and achievement of sustainable changes in eating habits and lifestyles. Most clients desire to lose weight quickly, rather than looking at long-term changes. The literature suggests applying telenutrition, owing to its convenience and easy access in combination with both telemonitoring and health coaching, where confounding factors in the diet are tackled. A 6-month randomised controlled trial will be conducted to compare the effectiveness of telenutrition v. telenutrition supported by weekly telemonitoring and monthly health coaching in a weight loss programme. Participants are obese and overweight adults of both sex groups, aged 20-50 years who will be randomised to join a control or an intervention group. A total of three visits will be scheduled for all participants: at baseline, after three months and after six months. This study aims to answer the question of whether participants following a weight loss programme supported by telemonitoring and health coaching will increase their weight loss and compliance to the diet in comparison with the control group. This will be the first trial to assess the impact of integrating telemonitoring and health coaching in weight loss programmes, including the evaluation of associated confounding factors such as general nutrition education, eating behaviour, sensory modalities and hunger, and stress. This trial will support dietary weight loss programmes, contribute to the emerging field of telenutrition and provide advice for clinical dietitians and health coaches to work together to help individuals lose and maintain weight.

The Impact of Sustainability Courses: Are They Effective in Improving Diet Quality and Anthropometric Indices?

There are studies on the effect of general nutrition education on diet quality and anthropometric measurements, while studies showing the effectiveness of sustainable nutrition education, which also addresses the effect of food on the environment, are quite limited. This study aimed to investigate the effects of sustainable nutrition education on diet quality, anthropometric measurements, and the carbon footprint (CFP) and water footprint (WFP) of diet. A total of 160 university students received 1 h of sustainable nutrition education for 6 weeks. Before, at the end of, and 2 months after the courses, 24 h food consumption records were taken to assess diet quality and CFP and WFP values of diet, and Mediterranean diet (MedDiet) and Healthy Eating Index (HEI)-2020 scores were evaluated. The results of the study showed that sustainable nutrition education increased MedDiet score by 1.86 points and HEI-2020 score by 7.38 points. This education program also decreased body weight, body mass index (BMI), fat mass, and neck circumference. Sustainability education has a positive impact on calcium, potassium, and magnesium intakes, a negative impact on vitamin B12 and zinc intakes, and no effect on total protein intake. Education resulted in a 22% reduction in CFP and a 10% reduction in WFP.

Assessment and evaluation of nutrition education among physicians in a tertiary paediatric specialist hospital: The need for improved clinical nutrition teaching

Background Nutrition education is one the essential components of any paediatric residency training. However, many paediatricians world-wide have suboptimal knowledge in core clinical nutritional topics. The purpose of our study is to assess the perceived effectiveness of nutrition training among physicians, including paediatric residents, paediatric trainees and paediatricians; identify areas of need for additional education resources and the preferred method of teaching for nutritional topics for medical education. Material and Methods A survey-questionnaire was sent to our physicians in our centre to assess general nutrition education via self-assessment of current nutritional knowledge across 12 distinct topics; importance of teaching amongst these topics and the preferred method of teaching. Results A total of 64 physicians completed the survey with an overall response rate of 88%. Most responders reported having average or above-average knowledge base in all nutritional topics except for nutritional aspects of special diets. Poorest knowledge base (either below average or poor) was reported in special diet ( n = 38, 59.4%), inflammatory bowel disease ( n = 17, 26.6%) and gastrointestinal allergy ( n = 16, 25.0%). There was strong interest in additional teaching needs for the topics of failure to thrive ( n = 38, 59.4%), nutritional assessment ( n = 34, 53.1%) and infant feeding ( n = 31, 48.4%). Most popular teaching methods were clinical case review (31.7%) followed by didactic lectures (29.8%) for overall clinical nutritional education. Conclusions Physicians identified gaps in their nutrition knowledge base and multiple topics were identified for additional nutrition education. Preferred methods of teaching for nutritional education were clinical case reviews and didactic lectures.

Effects of a mobile health nutrition intervention on dietary intake in children who have autism spectrum disorder.

Children who have Autism Spectrum Disorder (ASD) show preferences for processed foods, such as salty and sugary snacks (SSS) and sugar-sweetened beverages (SSB), while healthier foods, such as fruits and vegetables (FV), are consumed less. Innovative tools are needed that can efficiently disseminate evidence-based interventions and engage autistic children to improve their diet. The aim of this 3-month randomized trial was to test the initial efficacy of a mobile health (mHealth) nutrition intervention on changing consumption of targeted healthy (FV) and less healthy foods/beverages (SSS, SSB) in children who have ASD, ages 6-10, who were picky eaters. Thirty-eight parent-child dyads were randomly assigned to either an intervention (technology) group or a wait list control (education) group. The intervention included behavioral skills training, a high level of personalization for dietary goals, and involved parents as "agents of change." Parents in the education group received general nutrition education and the dietary goals but did not receive skills training. Children's intake was assessed at baseline and at 3 months using 24-hour dietary recalls. While there were no significant group-by-time interactions (P > 0.25) for any of the primary outcomes, we found a significant main effect of time for FV intake (P = 0.04) indicating that both groups consumed more FV at 3 months (2.58 ± 0.30 servings/day) than at baseline (2.17 ± 0.28 servings/day; P = 0.03). Children in the intervention group who consumed few FV at baseline and showed high engagement with the technology increased their FV intake by 1.5 servings/day (P < 0.01). Children's taste/smell sensitivity significantly predicted their FV intake (P = 0.0446); for each unit of lower taste/smell sensitivity (indicating greater sensory processing abnormalities), FV intake increased by 0.13 ± 0.1 servings/day. This mHealth intervention did not yield significant between-group differences for changing consumption of targeted foods/beverages. Only children who consumed few FV at baseline and highly engaged with the technology increased their FV intake at 3 months. Future research should test additional strategies to expand the intervention's impact on a wider range of foods while also reaching a broader group of children who have ASD. This trial was registered at clinicaltrials.gov as NCT03424811.Clinical Trial Registration: This study was registered at clinicaltrials.gov as NCT03424811.

Application of food exchange portion method in home-based nutritional intervention for elderly patients with chronic heart failure

BackgroundThe home treatment of elderly patients with chronic heart failure (CHF) is often accompanied by malnutrition, which increases the risk of re-hospitalisation and affects the prognosis. Therefore, how to effectively improve the nutritional self-management of patients is a current focus of medical research. This study aims to test the effect of home-based nutritional intervention method on improving the nutritional status of elderly patients with CHF.MethodsA total of 90 hospitalised elderly patients with CHF were randomly divided into the experimental group (n = 45) and the control group (n = 45). The patients in both groups were given standardised drug therapy and their nutritional status was evaluated using a body composition analyser prior to discharge (protein, body fat percentage, visceral fat area, skeletal muscle, upper arm muscle circumference, left lower limb and right lower limb muscle mass), with the cardiopulmonary function evaluated using a six-minute walk test and the metabolic equivalents method. The control group was given general nutrition education and routine dietary guidance from cardiac rehabilitation nurses, while the experimental group was given an individualised nutrition prescription by dietitians based on the evaluation results, according to which one-to-one food exchange dietary intervention training was given until the patients mastered the process.ResultsThe nutritional indexes at the end of the study were significantly higher in the experimental group than in the control group and were higher than those before the intervention (P < 0.05). The muscle circumference of the upper arm, the muscle mass of the left lower limb and the right lower limb had no statistical significance following the intervention compared to the control group and before the intervention (P > 0.05). The cardiopulmonary function indexes were significantly better in the experimental group at the end of the study than before the intervention and were better than those in the control group, with statistically significant differences (P < 0.05), while no significant changes were observed in the control group before and after the intervention (P > 0.05).ConclusionThe home-based nutritional intervention method of food exchange portions can effectively improve the nutritional status of elderly patients with CHF, with the distribution of visceral fat more reasonable and the cardiopulmonary function and exercise endurance improved.

Nutrition Advice and Perceived Confidence: A Cross Sectional Study of Practices among Female US Certified Fitness Professionals

ABSTRACT Nationally-recognized organizations offer fitness certifications which may include general nutrition education. While licensure laws and certification agencies restrict the scope of nutrition advice that certified fitness professionals (CFPs) can provide, research is limited regarding the form and frequency of nutrition advice CFPs provide clients. This quantitative and descriptive study examined frequency, form, and type of nutrition advice provided by CFPs, confidence level in providing advice, and frequency of consulting registered dietitian nutritionists (RDN) for nutrition knowledge. Data regarding frequency and means of providing various nutrition education to clients was collected electronically from 120 female CFPs nationwide using a cross-sectional convenience sample. CFPs rated their level of confidence in providing nutrition education and how often they consulted RDNs. In addition to frequency analysis, relationships between nutrition advice given and confidence were analyzed using Spearman-rho correlations. Over 70% of CFPs were asked about nutrition at least weekly and 90% provided nutrition advice within the past year. CFPs most often advised on general nutrition and health-related guidelines (97%), followed by various health conditions and dietary supplements. The percentage of CFPs providing nutrition advice correlated strongly with level of confidence on the provided topic (r = 0.92; p < .001). While most CFPs provided nutrition advice, 47.8% never consulted with RDNs. CFPs reported providing nutrition advice that may be beyond their scope of practice. Standardized education of CFPs regarding nutrition and scope of practice is suggested. It would also be valuable for certifying organizations to emphasize the importance of collaborations between CFPs and RDNs to maximize client health and fitness.

Explaining Excessive Weight Gain during Early Recovery from Addiction

Background: Many people receiving treatment for addiction gain an excessive amount of weight during early recovery. We outline two hypothesized mechanisms that might explain weight gain: The Addiction Transfer Hypothesis, which suggests that some individuals respond to cravings with non-nutritive eating behavior, and the Propensity for Behavioral Addiction Hypothesis, which suggests that some people are at higher risk for addiction, and that excess weight gain results from a rebound of appetitive processes that were temporarily suppressed during active addiction. Method: We evaluate the extent of support for these alternative hypotheses using repeated measures of cravings and eating behavior collected in real time using a combination of ecological momentary assessment methodology and interviewer-based 24-hour dietary recall. Participants included N = 111 individuals receiving treatment for substance use disorder who were currently abstaining from use, but who had used their primary treatment substance within the past 12 months. Results: Using linear mixed models to test the temporal effects of cravings on subsequent eating behaviors hypothesized by the Addiction Transfer Hypothesis and generalized linear models to evaluate the effect of a common propensity for behavioral addiction factor on eating behaviors (a test of the Propensity for Behavioral Addiction Hypothesis), we find no evidence to support the Addiction Transfer Hypothesis, but we find modest support for the Propensity for Behavioral Addiction Hypothesis. Findings do not account for appetitive effects of psychotropic medications. Conclusions: General nutrition education and encouragement of health eating behaviors may be useful for reducing excessive weight gain among people recovering from substance dependence.

Effect of Nutrition Education Based on Health Belief Model on Nutritional Knowledge and Dietary Practice of Pregnant Women in Dessie Town, Northeast Ethiopia: A Cluster Randomized Control Trial.

Background In Ethiopia, poor dietary practice among pregnant women ranges from 39.3 to 66.1%. Limited nutritional knowledge and wrong perception towards dietary behaviours were underlying factors. Hence, this study was aimed to determine the effect of nutrition education based on Health Belief Model on nutritional knowledge and dietary practice of pregnant women in Dissie town, northeast Ethiopia, 2017 GC. Methods Community-based cluster randomized control trial was employed. A total of 138 pregnant women participated. Nutrition education was given using Health Belief Model (HBM) theory and general nutrition education for intervention and control group, respectively. The baseline and endline nutrition knowledge and dietary practice was assessed using knowledge and dietary practice questions. HBM construct was assessed using five-point likert scale. Data were analyzed using SPSS version 20. Student's t-tests and chi-square tests were used. At 95% confidence level, P < 0.05 was considered statistically significant. Result The mean pre- and postintervention nutritional knowledge was 6.9 and 13.4, and good dietary practice was 56.5% and 84.1% in intervention group, respectively. The increase in mean nutritional knowledge was statistically significant (P < 0.001). In control group, the pre- and postintervention mean nutritional knowledge was 7.4 and 9.8, and good dietary practice was 60.9% and 72.5%, respectively. There was significant difference (P < 0.05) in mean nutritional knowledge and proportion of good dietary practices between two groups at endline, but the difference was not significant (P > 0.05) at baseline. There was significant (P < 0.001) improvement in the scores of HBM constructs in intervention group. Conclusion and Recommendations Providing nutrition education based on Health Belief Model improves nutritional knowledge and dietary practices of pregnant women. Hence, governmental, nongovernmental organization, health extension workers, and other health-care provider should include Health Belief Model construct into existing nutrition education programs. Moreover, government should incorporate HBM theory into national nutrition education guidelines.

Consumer perception of health properties and of other attributes of beef as determinants of consumption and purchase decisions

Consumers may feel confused by receiving conflicting information about health-related aspects of beef. Therefore, it is invariably important to assess how consumers perceive the health benefits of beef. The aim of the study was to assess the impact of consumer perception of beef values on consumer behavior towards this type of meat. The study consisted of a survey conducted among residents of Świętokrzyskie voivodeship in the period February 2013 – September 2014. The research was conducted among 1004 consumers. The questions included in the questionnaire concerned habits associated with consumption of beef, as well as issues related to the process of purchasing decisions, and in particular the place and frequency of purchase of beef. It was found that the frequency of buying beef was also significantly dependent on consumer belief in the health attributes of beef. Consumers consuming beef for this reason more often indicated that they consume beef once a week and 2-3 times a month. On the other hand, consumers who did not eat beef because of its impact on health in which they believed, more often pointed to its occasional/ sporadic consumption, that is once a month and less often. A significant percentage of consumers in the Świętokrzyskie voivodship misinterpret dietary recommendations and conclude that it is necessary to increase the consumption of beef due to medical reasons. Medical recommendations indicating the need to reduce meat consumption for a significant percentage of consumers from the Świętokrzyskie Voivodeship are of little importance and do not contribute to changing their eating behavior. Especially in the case of men, there is often a reluctance to change eating habits if it would involve the need to reduce the consumption of meat. There is a need to verify marketing messages and to carry out general nutrition education so that it is possible to actually reach consumers with information about the need to limit the consumption of meat products.

Lifestyle Interventions in Preschool Children: A Meta-analysis of Effectiveness.

With healthy behaviors becoming established in the preschool years, intervening with preschool children to assist them in establishing a healthy lifestyle and maintaining a long-term healthy weight is critical. To optimize future intervention designs, this meta-analysis aimed to estimate the effects of lifestyle interventions on BMI among preschool children and explore potential intervention moderators. In October 2015, a search of PubMed, CINAHL, EMBASE, PsycINFO, ERIC, and Cochrane library databases yielded 52 eligible articles with 42 randomized intervention-control comparisons (31 prevention and 11 treatment). In 2016, weighted standardized mean differences for BMI were calculated using random-effects models to estimate effect sizes. The effect sizes were -0.19 (95% CI=-0.28, -0.09) and -0.28 (95% CI=-0.48, -0.09) kg/m2 for prevention and treatment interventions, with sustained effect sizes of -0.21 (95% CI=-0.35, -0.08) and -0.23 (95% CI=-0.43, -0.04) kg/m2, respectively. Child mean age, percentage Hispanic, and parental intervention sessions were common significant moderators. School-based or prevention interventions with active parental involvement did not yield better outcomes. Interventions targeting parents with parenting skill training and behavioral change strategies, and children with general health and nutrition education, resulted in greater effects. Although publication bias limits the validity of the study findings, the meta-analysis results highlight the promising intervention approaches of parenting skill training and behavioral change strategies to target parents. However, for children, general health and nutrition education should be employed.

Medical students' perceived educational needs to prevent and treat childhood obesity.

Medical schools are challenged to incorporate more prevention-based education into curricula, offering an opportunity to revisit approaches to nutrition education. The objective of this study was to explore United States (US) medical students' understanding of childhood obesity, specifically barriers to childhood obesity prevention and treatment and students' perceived educational deficits. The research team conducted phone interviews with 78 3rd- and 4th-year medical students, representing 25 different medical schools across the US. Using a semi-structured interview guide, researchers asked students to describe the etiology of childhood obesity and reflect on where they acquired knowledge of the etiology and what additional resources they would need to treat obese children. Using a phenomenological approach to analysis, researchers identified five dominant emergent themes. Student-perceived barriers to childhood obesity prevention and treatment in clinical care included student-centered (e.g., lack of knowledge), patient-centered (e.g., lack of access), and healthcare system-centered barriers (e.g., limited time). Students requested more applicable nutrition information and counseling skills relevant to preventing and treating childhood obesity; however, they tended to identify others (e.g., parents, schools), rather than themselves, when asked to describe how childhood obesity should be prevented or treated. To provide students with an understanding of their role in preventing and treating childhood obesity, US medical schools need to provide students with childhood obesity-specific and general nutrition education. To build their self-efficacy in nutrition counseling, schools can use a combination of observation and practice led by skilled physicians and other healthcare providers. Increasing students' self-efficacy through training may help them overcome perceived barriers to childhood obesity prevention and treatment.

Mineral- and vitamin-enhanced micronutrient powder reduces stunting in full-term low-birth-weight infants receiving nutrition, health, and hygiene education: a 2 × 2 factorial, cluster-randomized trial in Bangladesh

The causes of stunting are complex but likely include prenatal effects, inadequate postnatal nutrient intake, and recurrent infections. Low-birth-weight (LBW) infants are at high risk of stunting. More than 25% of live births in low- and middle-income countries are at full term with low birth weight (FT-LBW). Evidence on the efficacy of specific interventions to enhance growth in this vulnerable group remains scant. We investigated the independent and combined effects of a directed use of a water-based hand sanitizer (HS) and a mineral- and vitamin-enhanced micronutrient powder (MNP) (22 minerals and vitamins) to prevent infections and improve nutrient intake to reduce stunting in FT-LBW infants. The study was a prospective 2 × 2 factorial, cluster-randomized trial in 467 FT-LBW infants during 2 periods: from 0 to 5 mo postpartum (0-180 d postpartum) and from 6 to 12 mo postpartum (181-360 d postpartum) with the use of 48 clusters. All groups received the same general nutrition, health, and hygiene education (NHHE) at enrollment and throughout the 12 mo. Group assignments initially included the following 2 groups: no HS (control) group or HS from 0 to 5 mo postpartum. These assignments were followed by further divisions into the following 4 groups from 6 to 12 mo postpartum: 1) no HS and no MNP (control), 2) HS only, 3) MNP only, and 4) HS and MNP. When delivered in combination with NHHE, the use of an HS showed no additional benefit in reducing indicators of infection in the first or second half of infancy or the likelihood of stunting at 12 mo postpartum. FT-LBW infants who received the MNP (with or without the HS) were significantly less likely to be stunted at 12 mo than were controls (OR: 0.35; 95% CI: 0.15, 0.84; P = 0.017). The use of a mineral- and vitamin-enhanced MNP significantly reduced stunting in FT-LBW infants in this high-risk setting. The use of a water-based HS did not have an additive effect. This trial was registered at clinicaltrials.gov as NCT01455636.

Need for Specific Sugar-Sweetened Beverage Lessons for Fourth- and Fifth-Graders

ObjectiveConsumption of sugar-sweetened beverages (SSB) is linked to obesity. The authors hypothesized that school-based nutrition education would decrease SSB consumption. DesignSelf-selected interventional cohort with random selection for pre and post measurements. SettingArizona Supplemental Nutrition Assistance Program–Education Program–eligible schools. ParticipantsRandomly selected (9%) fourth- and fifth-grade classroom students. InterventionThe University of Arizona Nutrition Network provided general nutrition education training and materials to teachers, to be delivered to their students. The University of Arizona Nutrition Network administered behavioral questionnaires to students in both fall and spring. Main Outcome Measure(s)Change in SSB consumption. AnalysesDescriptive statistics were computed for student demographics and beverage consumption on the day before testing. Paired t tests evaluated change in classroom averages. Linear regression assessed potential correlates of SSB consumption. ResultsFall mean SSB consumption was 1.1 (± 0.2) times; mean milk and water intake were 1.6 (± 0.2) and 5.2 (± 0.7) times, respectively. Beverage consumption increased (3.2%) in springtime, with increased SSBs (14.4%) accounting for the majority (P = .006). Change in SSB consumption was negatively associated with baseline SSB and water consumption but positively associated with baseline milk fat (P ≤ .05). Conclusions and ImplicationsThe results suggest the need for beverage-specific education to encourage children to consume more healthful beverages in warmer weather.

Patient’s Satisfaction Related to Nursing Care among Hospitalized Patients

Service to man Is service to God, This term usually discuss by the people when they works with in the health sector but here i would like to exclaim that A provision satisfactory service to man is good service because every employee is paid for his or her service they produce to the client. In regard to this subject the curent study based to as the patients satisfaction related to nursing care among hospitalised patients conducted in Dehradun. A qualitative non experimental method was approached & non-experimental descriptive survey design keeping in the view the objective of the study. The objective was To assess the patient's satisfaction level related to nursing care in selected units, and To assess the problem faced by patients during hospitalized patients. Purposive Sampling technique was used. Sixty hospitalized patients were involved in the study. The Demographic data is collected through tool Part A and Part B was used to collect the patients satisfactory level through 4point Likerts scale developed in Mostly satisfied, Partially satisfied, Mostly unsatisfied, Partially unsatisfied points in the areas like Communication, Personal Hygiene, General nursing care, Nutrition, Behavior, attitude, punctuality, Environmental Hygiene and Health education and discharge planning. The part C was developed open ended question for Determination of problem faced by patients with nursing Care. The data was analyzed through inferential statistics and it is found that the hospitalized patients were mostly satisfied in the area like nursing care and the behavior, attitude, punctuality as well as environment hygiene, whereas patients were mostly unsatisfied with areas like personal hygiene, General nursing care and Nutrition. The hospitalized patients expressed their opinion that during their hospitalization in particular area, like in personal hygiene they complained regarding insufficient staff and insufficient articles. In terms of food facility they are not satisfied with food serving, fewer alternatives in food items and poor quality of food. Other unsatisfied area is medicine delivery system and poor interdepartmental communication. Patients also provided some precious advices like public relation officer in each ward and good nurse patient ratio is one of the needs for each ward. The study was much helped at administrative level to modify their strategy towards patient care in the Himalayan Hospital trust, HIHT, SRHU. Dehradun.

Sugary Beverage Consumption, Not Water, Increases in Springtime among Low-Income Arizona 4th and 5th Graders

Objective: To measure change in sugary beverage consumption with nutrition education among low-income 4th and 5th graders. Theory, Prior Research, Rationale: Fifteen percent of US children aged 6 to 11 years are overweight, with an additional 30% at risk. Sugary beverage consumption is linked to obesity and US Dietary Guidelines recommend limiting intake. We hypothesized that nutrition education would result in decreased sugary beverage consumption. Study Design, Setting, Participants, and Intervention: The University of Arizona Nutrition Network (UANN) provides general nutrition education training and materials, aligned with USDA guidelines, to teachers at SNAP-Ed eligible schools. UANN administered self-report behavioral questionnaires to students in 8% of participating 4th and 5th grade classrooms in 5 Arizona counties in both Fall and Spring. Outcome, Measures and Analysis: Descriptive statistics were computed for student demographics and beverage consumption on the prior day. Paired t-tests were used to evaluate change in classroom averages between Fall and Spring. Results: Thirty-three classrooms participated (N1⁄4770 pre, 765 post, 90% complete surveys). Participant characteristics: 71% 4th graders, 50.5% female, 10.1 years of age. Fall sugary beverage consumption was 1.05 ( 0.23) times the previous day; milk and water were consumed 1.58 ( 0.24) and 5.20 ( 0.70) times, respectively. As expected, Arizona springtime beverage consumption increased overall (3.2%). Sugary beverage consumption increased 14.4% and accounted for the greatest portion of the total increase (p1⁄40.006). Small increases in milk (p1⁄40.03) and water (p1⁄40.86) were observed. Conclusions and Implications: This study suggests the need for beverage specific education to shift the children toward more healthful choices. Further research is needed to assess beverage consumption patterns longitudinally, controlling for season. Funding: Supplemental Nutrition Assistance Program Education.

Assessment of Nutrition Education Among Pediatric Gastroenterologists

Pediatric gastroenterology is the only pediatric subspecialty with nutrition as part of its official curriculum and objective; however, pediatric gastroenterology fellows believe that their baseline knowledge in nutrition is suboptimal. The purpose of the present study was to assess the perceived effectiveness of nutrition training among pediatric gastroenterologists, identify areas of need for additional education, and determine the perceived role of the gastroenterologist in obesity management. A survey was sent to members and fellows of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition to assess general nutrition education as well as obesity management and educational needs. A total of 272 responses were received, for an overall response rate of 15.2% (272/1784). Most responders reported having average or above-average knowledge base in all nutritional topics. There was strong interest in additional resources and a continuing medical education (CME) module on several nutrition topics including nutritional requirements in specific gastrointestinal (GI) disease, failure to thrive/growth failure, and parenteral nutrition support, with the format of CME dependent on the topic. There was also a strong interest in additional CME on the management of pediatric obesity (67%), as most responders believed that the management of obesity in children requires subspecialty care. The perceived role of the pediatric gastroenterologist was, however, one of support to treat the GI and hepatic comorbidities of obesity rather than serve as the main provider of comprehensive obesity care. Pediatric gastroenterologists identified gaps in their nutrition knowledge base that may be attributed to the present nutrition education training during fellowship. Multiple topics were identified for additional nutrition education, including obesity management. The nutrition management challenges of today necessitate improved baseline nutrition knowledge and this focus on nutrition should begin at the fellowship level.

The effects of tailored and threatening nutrition information on message attention. Evidence from an event-related potential study

Recent evidence indicates that attention is higher for individually tailored as compared to non-tailored health communications. The present study examined whether the predicted increased attention for the tailored as opposed to general nutrition education messages is moderated by presenting high vs. low threat information about the negative consequences of an unhealthy diet. In a mixed subject experimental design, undergraduate students (N=34) were reading tailored and non-tailored nutrition education messages with either high or low threat information about the negative consequences of an unhealthy diet. At the same time, they had to pay attention to specific odd auditory stimuli in a sequence of frequent auditory stimuli (oddball paradigm). The amount of attention allocation was measured by recording event-related potentials (ERPs; i.e., N100, MMN, P300) and reaction times. Result revealed main effects of tailoring and threat, indicating that more attention resources were allocated to tailored vs. non-tailored messages and to low threat vs. high threat messages. The findings confirm that tailoring is an effective means to draw attention to health messages, whereas threat information seems to result in a loss in message attention.

The effect of fortified breakfast cereal on plasma homocyst(e)ine concentrations in healthy older men already consuming a folate fortified diet

High plasma homocysteine (hcy) concentrations may be an independent risk factor for cardiovascular disease. Folic acid supplementation reduces plasma hcy, however no studies used fortified foods and nutrition education to promote a sustained diet change. The effects of nutrition education and fortified cereal consumption on plasma hcy were studied in 41 men ≥ 58 years old. Subjects randomized into the experimental group (n=21) received super-fortified ready-to-eat cereal (400 μg folic acid) for 8 weeks, and nutrition education based on the Social Cognitive Theory. Control group subjects (n=20) received general nutrition education only. Folate intake at baseline was similar to recommended levels (436±204 μg/day). Experimental subjects increased folic acid intake, and serum folate was significantly higher at follow up. Plasma hcy did not differ significantly over time between groups. Subjects with moderate hcy concentrations who are already eating fortified foods regularly may not benefit from consuming folate above recommended levels.

Web-based tailored nutrition education: results of a randomized controlled trial

There is ample evidence that printed, computer-tailored nutrition education is a more effective tool for motivating people to change to healthier diets than general nutrition education. New technology is now providing more advanced ways of delivering tailored messages, e.g. via the World Wide Web (WWW). Before disseminating a tailored intervention via the web, it is important to investigate the potential of web-based tailored nutrition education. The present study investigated the immediate impact of web-based computer-tailored nutrition education on personal awareness and intentions related to intake of fat, fruit and vegetables. A randomized controlled trial, with a pre-test-post-test control group design was conducted. Significant differences in awareness and intention to change were found between the intervention and control group at post-test. The tailored intervention was appreciated better, was rated as more personally relevant, and had more subjective impact on opinion and intentions to change than the general nutrition information. Computer literacy had no effect on these ratings. The results indicate that interactive, web-based computer-tailored nutrition education can lead to changes in determinants of behavior. Future research should be aimed at longer-term (behavioral) effects and the practicability of distributing tailored interventions via the WWW.

Pediatric Nutrition Assessment: Identifying Children at Risk

Nutrition services are important in the prevention of disabilities as well as in the treatment and/or habilitation of children with chronic illness. Level 1 nutrition care requires some basic knowledge of nutrition to screen for nutritional risk factors, knowledge of and access to referral systems for children identified to be at risk, and ability to use general nutrition education materials. Level 2 involves individualized nutrition assessment and intervention for problems such as anemia, chronic constipation, low- or high-calorie diets, feeding problems, and growth monitoring. Level 3 nutrition services are for children with identified disabilities such as cystic fibrosis, diabetes, and metabolic disorders that require specific complex nutrition interventions. The five major components of assessment of nutritional status in children are: anthropometric, clinical, biochemical, dietary, and feeding skill development. J Am Diet Assoc. 1997; 97(suppl 2):S107–S115.