Healthy Nutrition Practices Research Articles

Diyabetlilerde tatlandırıcı ve diyet/diyabetik ürün kullanım durumu

Amaç: Diyabetliler tıbbi beslenme tedavilerinin içerisinde çeşitlilik yaratmak adına tatlandırıcı ve diyet/diyabetik ürünler kullanabilirler. Bu çalışmanın amacı diyabetlilerin tatlandırıcı ve diyet/diyabetik ürün kullanım durumlarını, kullanma ve kullanmama nedenlerini saptamaktır. Yöntem: Bu araştırma Ekim-Aralık 2017 tarihleri arasında özel bir hastaneye başvuran 85’i (%63.4) kadın, 49’u (%36.6) erkek olmak üzere toplam 134 yetişkin diyabetli ile yapılmıştır. Yüz yüze görüşme yöntemi ile hastaların demografik verileri (yaş, cinsiyet, diyabet tipi, eğitim seviyesi vb.) ile tatlandırıcı ve diyet/diyabetik ürün kullanımına dair bilgiler alınıp kaydedilmiştir. Bulgular: Çalışmaya katılanların %79.1’inin herhangi bir tatlandırıcı kullanmadıkları belirlenmiştir. Tatlandırıcı veya tatlandırıcılı ürün tüketmeme sebeplerinin “sağlığa zararlı olduğu” (%41.5), “tadını beğenmediği” (%27.7), “fiyatını pahalı bulduğu” (%7.4) şeklinde olduğu belirlenmiştir. Tatlandırıcı ve tatlandırıcılı ürün tüketenlerin ise %40’ının şeker içermemesi ve %27.5’inin ise enerji içermemesi nedeniyle tercih ettikleri saptanmıştır. Diyabetlilerin diyet/diyabetik ürünleri tercih durumlarına bakıldığında; diyet ürünler içerisinde en çok diyet bisküvi/krakerler (%17.2), daha sonra diyet içecekler (%13.4) ve sırasıyla light meyveli yoğurt (%11.9), diyet sütlü tatlılar (%9), diyet dondurma (%8.2), diyabetik reçel/marmelat (%6), diyabetik çikolata (%5.2) ve diyet hamurlu tatlı (%3) tüketilmektedir. Sonuçlar: Bu çalışmanın sonucunda diyabetlilerin tatlandırıcılar konusunda yeterli ve doğru bilgiye sahip olmadıkları ve tatlandırıcı ile diyabetik ürün kullanımları düşük bulunmuştur. Diyabetlilerin sağlıklı beslenme uygulamaları çerçevesinde şeker yerine tatlandırıcılar ve diyet/diyabetik ürünleri kullanabilecekleri konusunda bilinçlendirilmeleri gerekir.

Integrating Nutrition Education into Clinical Practice.

The power of physicians to educate patients about nutrition and provide the tools and motivation needed for patients to adopt healthy eating habits is under-utilized. To unleash that power, practicing physicians need to synthesize the latest in nutrition science, integrate it with the established body of evidence on healthy nutrition, and translate and communicate this knowledge to patients in a practical and effective way. Physicians and patients face similar barriers in discussing and incorporating healthy nutrition practices. Tactics and tools that are simple, effective, affordable, and scalable, can be incorporated in clinical practice, thereby making nutrition counseling feasible with only incremental burden to physicians' time and energy. These tactics include: (1) assessing body mass index at every visit, (2) adding obesity or overweight on the problem list, (3) assessing diet, (4) acknowledging risk, (5) being mindful of language, and (6) writing a prescription. Understanding the psychological aspects of food choices and behavioral change, use of technology, and engaging teams are also important. Group visits to address nutrition-related topics are a novel approach to discuss and taste (literally) healthy eating. Finally, physicians' own health and nutrition are powerful predictors of nutrition education to patients and can be a target of intervention as well.

Promoting Healthy Environments In Afterschool Settings: The LiveWell Greenville Afterschool Initiative.

IntroductionLiveWell Greenville, a multi-organization community coalition, launched an initiative in 2011 to help afterschool programs promote environments that decrease the risk of obesity among children and adolescents. The objective of this study was to describe changes in nutrition and physical activity environments, policies, and practices among 37 afterschool programs after their participation in the LiveWell Greenville Afterschool Initiative.MethodsThe study used a nonexperimental, pre- and postsurvey design. The survey was based on the Nutrition and Physical Activity Self-Assessment for Child Care questionnaire and modified for afterschool settings. Items addressed sedentary time, physical activity time, availability of sugar-sweetened beverages, sweet and salty snack consumption, fruit consumption, staff behaviors, and policies that support nutrition and physical activity practices. The self-assessment survey was completed by an afterschool program supervisor at each site. The 9-month intervention consisted of program staff members’ completing the pre-assessment and goal-setting worksheet, receiving technical support and training from LiveWell Greenville staff, attending networking meetings about nutrition and physical activity promotion strategies, and completing a postassessment. ResultsWe found significant positive changes in afterschool environments in the type and frequency of snacks offered, duration of children’s sedentary time, staff behaviors that supported healthy nutrition and physical activity practices, and education provided to staff, children, and parents.ConclusionWe found the LiveWell Greenville Afterschool Initiative, which involved self-assessment, goal setting and technical support, to be a successful strategy to change nutrition and physical activity environments in afterschool settings.

Nutrition as aresource for networked community based health promotion for children-perspectives of parents and experts

The promotion of healthy nutrition and alimentary participation (the possibility of experiencing the social function of food) is an essential aspect of integrated overall approaches of community-based health promotion. Preschool and primary school settings are given particular importance in terms of the target group focused on by community-based approaches: children from socially disadvantaged families. How do parents and practice experts describe the status quo, potential, and obstacles in the implementation of healthy nutrition practices in the settings kindergarten and elementary school? What ist the importance of nutrition and alimentary participation within the framework of the integrated overall approach attributed by practice experts? In two urban centers, expert interviews were conducted with stakeholders of integrated overall approaches and administrators from preschools and primary schools. The perspectives held by parents in financially precarious situations or with immigrant backgrounds were explored in group discussions. Nutrition takes on an important role in the narratives of parents and experts. Preschools and primary schools draw upon daily interaction with food and shared meals in avariety of ways to foster the development of healthy eating habits and alimentary participation. It has become clear that preschools and primary schools must increasingly counteract delegation of parenting responsibilities and poor nutrition practices, for instance by providing socially compensatory breakfasts. Parents acknowledge these efforts but express criticism that food in schools is eaten under problematic spatial conditions and intense time pressure. Nutrition is used by experts as aresource but, in contrast to physical exercise or mental health, without reference to integrated community-based health promotion. Promotion of alimentary participation and healthy nutrition practice could have more impact if stakeholders saw themselves as essential components of integrated community-based health promotion.

Diabetes and Nutritional Screening in Post-Bariatric Patients.

With the rise of obesity there has been a concomitant increase in the incidence of type 2 diabetes (T2DM). As a result, the term "diabesity" has become a popular disease entity in the past several years. When lifestyle modification and pharmacotherapy fail to achieve successful weight loss and diabetes control, bariatric surgery is a recommended treatment option. Bariatric surgery has been shown to promote sustained T2DM remission in 30-63% of patients and improve other components of metabolic syndrome; thus a preferred term has been "metabolic surgery". As the practice of bariatric surgery for the treatment of T2DM increases, so will the number of patients with T2DM not achieving remission or with T2DM recurrence. There are currently no clear evidence-based guidelines delineating the proper management of T2DM in post-bariatric surgery patients. The focus of this review is to discuss current data on the efficacy of bariatric surgery in promoting T2DM remission, factors that predict T2DM remission and recurrence, and current treatment options for persistent hyperglycemia in post-bariatric surgery patients. To increase long-term T2DM remission and prevent or delay recurrence, post-bariatric surgery patients need close follow up to encourage adherence to healthy nutrition and lifestyle practices that will lead to sustained weight loss. In addition to this, patients need adequate nutritional supplementation and periodic screening for vitamin, mineral and protein deficiencies. Therefore, we will conclude with a brief review of current recommendations for nutritional deficiency screening and supplementation.

Assessment of nutrition and physical activity practices using self-report and observation in early care and education across multiple US states.

The National Early Care and Education Learning Collaboratives (ECELC) Project aims to promote healthy physical activity and nutrition environments, policies and practices in early care and education (ECE) programmes across multiple states. The present pilot study sought to assess changes to the physical activity and nutrition practices in a sub-sample of ECE programmes participating in the ECELC using the Environment and Policy Assessment and Observation (EPAO). Additionally, it sought to compare results with the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC). Quasi-experimental pre-post pilot study where paired-sample t tests examined changes to physical activity and nutrition practices from pre-assessment to post-assessment (P<0·05). Pearson correlation coefficients examined change scores from EPAO compared with NAP SACC with statistical significance set at a two-sided α level of P<0·10 to account for sample size. The study occurred among ECE programmes. Pre-school classrooms in nineteen ECE programmes across four US states were observed. EPAO data demonstrated an increase in total score from pre-assessment to post-assessment (150 (sd 30) to 176 (sd 35)). NAP SACC change scores demonstrated little relationship with EPAO domain change scores, with exceptions in Nutrition Policy and Physical Activity Policy (r=-0·4 and -0·6, respectively). The overall improvements reported through the EPAO suggest participation in the ECELC resulted in changes in critical nutrition- and physical activity-related practices. However, considerable differences in data reported using the NAP SACC compared with the EPAO suggest subjective data should be interpreted with caution and objective measurement should be used when feasible.

HEALTH BEHAVIORS OF UNDERGRADUATE STUDENTS: A COMPARISON OF PHYSICAL EDUCATION AND TECHNICAL FACULTIES

INTRODUCTION:A healthy lifestyle is related to healthy practices, such as healthy diet, avoidance of psychoactive stimulants, appropriate level of physical activity, preventive behaviors, coping with stress, positive social relationships, and adjustments. University students do not usually engage in a healthy lifestyle. Moreover, excessive alcohol drinking among students is truly a health problem. OBJECTIVES: The primary objective of this study was to examine the association between alcohol drinking and healthy behaviors in undergraduate students from a large public technical university in the south of Poland (Europe). METHODS: A cross-sectional study was used with participants of 283 second year undergraduate students, aged 22 years (SD = 2.92), including 88 (31%) students of Physical Education and 195 (69%) students of the Technical Faculty. The study used self-administered questionnaires of the Alcohol Drinking Scale (ADS) and the Health Behavior Inventory (HBI), which includes the following subscales: healthy habits nutrition (HHN), preventive behavior (PB), positive adjustments (PA), and healthy practices (HP). RESULTS: Alcohol drinking was negatively correlated with the total HBI and also with two subscales: HHN and PPB. The female students drank significantly less alcohol than the male students and presented with a higher level of health behavior, both in the total HBI and in the individual HBI subscales, except for PA. Students of Physical Education drank more alcohol, and scored higher in preventive behaviors, than the students of Technical Faculties. CONCLUSION: It seems necessary to conduct general health education as part of prevention programs at the university, especially for male undergraduate students in the Physical Education faculty.

Assessment of the nutritional knowledge and nutrient Intake of lactating women and its impact on body mass index

The study was done to assess the nutritional knowledge and nutrients intake among lactating women. The total sample size was 151 lactating women selected randomly from those attending the Breastfeeding clinic at the center for social and preventive medicine (CSPM). The results revealed that obesity was the dominant feature in 47.7% of cases, while overweight and normal weight constituted 26.5% and 25.8% respectively. The majority of the women had very good nutrition knowledge (77.5%), while 22.5% had a good knowledge. 76.2% women were at risk of hunger and 23.8 were food secure. Poor maternal dietary quality may have implications for both mother and child, and socioeconomic position and nutritional knowledge are likely to be important. Effective interventions to support mothers to achieve healthy diets for themselves and their families are needed. Lactation period is an opportunity to increase awareness of the mother toward healthy nutritional practices. Achievement and maintenance of good dietary habits is expected to duplicate the benefit of health outcomes when mothers become models for their children and their families. Nutrition education for mothers should be provided in the all health and PHC centers that deal with breastfeeding mothers. It also important to increase awareness of lactating mother's and educate them about the quality of diet through mass media.

Quality of Life and Nutrition During Pregnancy

A communitys transition towards modernity and urbanization leads to lifestyle changes that influence an individuals health through modifications in physical activity and nutritional habits. Women of childbearing age, particularly during pregnancy require special attention with regards to nutrition because their health potentially affects the well being of the entire community beside herself and the fetus. The aim of this study was to explore the association between quality of life and the nutrition knowledge and dietary intake among a group of pregnant women in Malaysia. A cross sectional survey was carried out to explore the association of knowledge, attitudes and healthy nutritional practices with quality of life during the second and third trimester of pregnancy. In this study, nutritional habits during pregnancy were significantly associated with social functioning, vitality and physical functioning. A basic understanding of the influence a healthy lifestyle has on physical and emotional well being during pregnancy helps the mother and family members to have a positive attitude towards the need for healthy behaviors in regard to nutrition and physical activity. The findings of this study show the importance of nutritional intake and behavior with respect to their effects on dimensions of health quality.

Teachers’ Self-Efficacy and Knowledge of Healthy Nutrition and Physical Activity Practices for Preschoolers: Instrument Development and Validation

Childhood obesity remains a problem in the United States. Preschool teachers can help to attenuate it but need to have the confidence or self-efficacy to provide healthy practices. Therefore, the purpose of this study was to (a) develop and validate a preschool teacher self-efficacy tool to examine teachers’ confidence in addressing the nutrition and physical activity needs of children in their care and (b) examine relationships between teachers’ self-efficacy and knowledge of healthy nutrition and physical activity practices. Instrument design included examination of related literature and review by 12 subject matter experts. Two hundred seventy-three early childhood professionals submitted a 58-item questionnaire with 48 self-efficacy items in four domains of healthy practices for the preschool classroom; the remaining 10 items reflected knowledge of healthy practices. Two hundred fourteen professionals completed the questionnaire. A principle components factor analysis supported a five-factor self-efficacy scale (three of the original domains and one domain split into two factors) with 46 items. Knowledge of healthy practices and age of the professionals predicted overall self-efficacy. Results indicated evidence of validity for this new assessment tool to assess early childhood professionals’ self-efficacy toward healthy practices in preschool classrooms.

Knowledge of Infant Nutrition among Mothers in Enugu State, South Eastern, Nigeria: Implications for Social Work Practice

Malnutrition is widespread in Nigeria and has persisted at alarmingly high rate. Nutrition problems are at times due to lack of education and knowledge about healthy nutrition behaviours and practices. The purpose of this study was to examine the knowledge of infant nutrition in Enugu State, Nigeria. Ten focus-Group Discussions (FGDS) were conducted with seven (7) persons in each group comprising 5 young groups (18 – 35 years) and 5 old groups (36 years and above). The FGDS were analyzed using a thematic framework. The findings from the qualitative study showed that mothers had a very low perception on ways of improving children’s health. For instance many of them were against feeding their infants with meat or eggs because of their cultural beliefs and had negative perceptions on the exclusive breastfeeding and immunization services in their communities. In view of the above, the findings highlight the need to employ education to correct many of these archaic cultural practices mostly found in Nigerian rural communities and invest in programmes that will enhance the knowledge of infant nutrition among mothers in Nigeria.

A perspective on wellness: A physician′s prescription for enhanced patient care

With the beginning of the 21st century, medicine has seen the expansion of clinical interventions that could not have been predicted. Physicians trained in allopathic medicine embrace integrative medicine, prospective medicine, holistic medicine, and various permutations on comprehensive medicine. Recommendation for promoting wellness is often ignored. Wellness prescription complements every physician's practice irrespective of specialty. It requires physician to incorporate wellness strategy as a primary intervention. A prescription for wellness should include promotion of physical activity, healthy nutrition practices, management of stress, enhancements of individual relationships and recognizing awareness between mind, body, and spiritual components.

Improvements of Nutrition Behavior Fitness and Body Fatness with a Short-Term after School Intervention Program

The prevalence of childhood obesity has been increasing worldwide and lifestyle changes are the most important strategies in managing this prevalence. This study aimed to describe the intervention effects of nutrition and physical activities offered as an after school short-term on outcomes of healthy nutrition practices, fitness and lowering fatness. This quasi-experimental study was conducted with a convenience sample of 59 caucasian children, aged 7.7 ± 1.4 years old (52.5% girls) registered on a private school of a middle-size town located in Sao Paulo State, Brazil. The school-based 12-week intervention consisted of 2 weekly 60 minutes section, during 3 months, including a nutritional education and a physical activity curriculum. Anthropometric data was measured for all children at baseline and after 12 weeks. All parents were contacted and requested to complete questionnaire about child’s eating behavior at baseline and after the 12-week program. After the intervention, children showed an increasing in the intake of fruits (64.3%), vegetables (61.9%), and water (52.0%). Overall, 83.3% of the children changed eating behavior according to the questionnaire responded by the parents. Waist circumference was significantly lower and abdominal strength improved after participating in the intervention program. Mean height and weight were significantly higher in boys and girls after a 12-week intervention. Although mean values of BMI remained the same after the intervention it was observed a decreasing in the prevalence of obesity among the children. Thus our study showed that a school-based intervention program focused on nutritional education and physical activity program promoted waist circumference reduction and decreased obesity without affecting the height growth along with improved fitness and healthy eating behavior. This intervention program would be feasible and replicable in others schools around the country.

Maternal–Child Nutrition Practices and Pediatric Overweight/Obesity in the United States and Chile: A Comparative Study

Childhood overweight/obesity is now epidemic in both developed countries and those undergoing economic transition. This study compared maternal and school-age child nutrition practices and body mass index in the United States and in Chile. Children (125 in the United States, 121 in Chile) and their mothers (116 in the United States, 101 in Chile) participated. Findings indicated that child nutrition practices were comparable, but mothers in the U.S. group demonstrated fewer healthy nutrition practices on behalf of their children. Significant associations were found between maternal and child nutrition practices. Substantially more children in the U.S. sample were overweight/obese. Implications for practice are presented.

Physical activity, sedentariness, and body fatness in a sample of 6-year-old Pacific children

Pacific children living in New Zealand exhibit considerably higher rates of overweight and obesity than their non-Pacific peers. The study aim was to identify physical activity and sedentary behaviors related to increased body size in Pacific children, to inform future intervention development for improved activity profiles and body size outcomes in this population. Three hundred and ninety-three 6-year-old Pacific children and their mothers living in Auckland, New Zealand were invited to participate. Activity was assessed over 8 days using accelerometry and mothers reported on their child's sedentary behaviours. Children's height, weight, and body fatness was assessed and body mass index (BMI) and body fat z-scores calculated. Maternal height, weight, and waist circumference were assessed and BMI calculated. Associations between children's body fat z-scores and potential related factors were determined using regression analyses. Of the 254 children who registered, 102 (27% overweight, 32% obese) were included in analyses. Almost all mothers were overweight or obese. On average, children's body fat z-scores were 1.75 standard deviations above the reference group (range -0.6, 3.14). After accounting for all other factors, watching television every day and having a mother with a high waist circumference were associated with increased body fat z-scores. Strategies for obesity reduction in Pacific children and their mothers living in New Zealand are urgently required. Multifaceted, family based interventions that include the promotion of healthy nutritional practices and television free days may be efficacious in improving activity profiles and body size outcomes for Pacific children.

Comparing Diverse Health Promotion Programs Using Overall Self-Rated Health as a Common Metric

Health promotion programs may target a variety of behaviors including weight loss, exercise, stress, nutrition, or other risk factors. Comparing the outcomes of diverse programs is hampered by the absence of a common metric. Overall self-rated health has been used as a health outcome measure in population studies and in some primary care studies, but its potential use to monitor the outcomes of health programs is unexplored. The purpose of this study was to compare the outcomes of 4 health promotion programs using change in overall self-rated health as a common metric. Program-specific metrics used were weight change, change in minutes of exercise, change in stress management activities, and change in healthy nutrition practices. We found that, although all of our lifestyle interventions positively affected the program-specific metrics, only the weight loss and exercise programs showed improvement in specific metrics correlated with improvements in overall self-rated health.

Barriers to Healthy Nutrition and Food Preparation Practices of Rural Families

The increased incidence of obesity is a major concern and intervention efforts to thwart this trend in low income minority populations continue. Good nutritional habits and behavioral practices are important for healthy weight management and maintenance. This project was conducted to gain insight the personal and contextual factors, and barriers, impacting food preparation and consumption in rural families'. Focus groups were conducted with 100 low income parents from rural communities to collect cultural perspectives and to identify barriers to healthy eating and food preparation practices. Statements were extracted and categorized from the focus group transcripts. Analysis of the data resulted in themes including general food purchases, preparation practices, and barriers to good nutrition. Food preparation was based primarily on family history and tradition; example ‘fired fish Fridays’, and ‘family member preferences’. Advertising and children in charge were discussed by most of the participants as being significant barriers to healthy eating. Surprisingly, many of the families dining out decisions were determined by daily specials offered at local fast food restaurants with little thought given to the nutritional value of meals.Funding for this project was made possible by 1P20MD0002295 from the National Center on Minority Health and Health Disparities.

Development and validation of a new simple Healthy Meal Index for canteen meals

Nutrition evaluation tools should be developed both for scientific purposes and to encourage and facilitate healthy nutritional practices. The purpose of the present study was to develop and validate a simple food-based Healthy Meal Index (HMI) reflecting the nutritional profile of individual canteen meals. The development process included overall model selection, setting nutritional goals and defining scoring systems and thresholds. Three index components were included: (i) contents of fruit and vegetables, (ii) fat content and quality and (iii) contents of wholegrain products and potatoes. The development was built on the principles embodied by the Plate Model, but providing more specificity in some areas. The simple HMI was validated against weighed and chemically analysed food and nutrient content of a representative sample of canteen meals. The sample was split into four categories according to the total index score and compared across categories. A total of 180 meals from fifteen worksite canteens. Average energy density decreased significantly across categories (from 876 kJ/100 g to 537 kJ/100 g, P < 0.001). Also, the content of total and saturated fat, carbohydrate and fruit and vegetables varied across categories with higher score values being closer to dietary guidelines (P < 0.001). The simple HMI was successful in ranking canteen meals according to their nutritional quality. The index provides a valuable tool to both researchers and food and nutrition professionals, e.g. caterers and dietitians, who wish to evaluate nutritional quality of meals in line with the recommendations for healthier eating without the use of nutrition calculation programs.

“Smart Bodies” school wellness program increased children's knowledge of healthy nutrition practices and self-efficacy to consume fruit and vegetables

Diets rich in fruit and vegetables are important for long-term health yet children frequently do not like these foods. The “Smart Bodies” school wellness program sought to increase children's knowledge of healthy nutritional practices, improve psychosocial variables associated with eating fruit and vegetables, and develop preferences for these foods. A randomized controlled intervention trial was conducted in 14 low-income, urban, public elementary schools (seven pairs). Data from 278 fourth and 282 fifth graders (234 boys, 326 girls; 82% Black, 10% White, 1% Hispanic, 5% Asian, 2% Other) were examined using multi-level modeling. The 12-week intervention program included participation in an interactive wellness exhibit and a classroom curriculum that emphasized consumption of fruit and vegetables. After the intervention, children that participated in the “Smart Bodies” program had greater nutrition knowledge and expressed more confidence that they could eat fruit instead of a favorite dessert, drink fruit juice and consume the recommended number of fruits and vegetables servings each day. Preferences for fruit and vegetables did not change as a result of participating in the program. These findings demonstrate that the “Smart Bodies” school-based wellness intervention positively impacted children's nutrition knowledge and psychosocial variables associated with consuming fruit and vegetables.

An Evaluation of Elementary School Nutrition Practices and Policies in a Southern Illinois County

The purpose of this study is to assess elementary school nutrition programs in a rural county in southern Illinois. The researcher interviewed the food service managers of eight schools and completed the School Health Index (SHI) based on their responses. Eighty-seven percent of the schools did not have venues such as vending machines outside the cafeteria. Three food service managers stated that from 75% to 80% of the students in the district ate lunch in the cafeteria. The SHI corresponds to the eight components of a coordinated school health program; nutrition services are just one of the eight components. The SHI is a tool that can be used to identify strengths and weaknesses in the nutrition program. It covers items from healthy, low-fat choices to food preparation and cafeteria practices. School nurses can work with teachers and food service personnel to create nutrition programs and a curriculum related to healthy nutrition practices.