Intensive Nutrition Education Research Articles

Protective effect of tartary buckwheat on renal function in type 2 diabetics: a randomized controlled trial.

Tartary buckwheat (TB) has been reported to be associated with a decreased risk of type 2 diabetes mellitus (T2DM), and T2DM has had a major impact on the development of diabetic kidney disease (DKD). Thus, the hypothesis that a daily intake of TB will improve DKD risk factors, including urinary albumin to creatinine ratio (UACR), urea nitrogen (UN), serum creatinine, and uric acid was tested. In a parallel, randomized, open-label controlled trial, 104 T2DM patients were randomly assigned to a diet control group (systematic diet plans and intensive nutritional education) or a TB intervention group (daily replacement of a portion of staple foods with TB foods). Blood samples and dietary information were collected at baseline and the end of the 4-week study. The primary outcomes were that TB significantly decreased the rela tive changes in UACR (2.43–2.35, logarithmic transformed mg/g creatinine) and UN (5.12–4.91 mmol/L) in the TB intervention group vs the diet control group at 4 weeks (P<0.05), without obvious effect on blood glucose during the 4-week study. In addition, subgroup analyses based on different DKD stages also showed a significant reduction in UACR and UN for the T2DM patients with normoalbuminuria and microalbuminuria (P<0.05). These results support the hypothesis that TB as a replacement of staple food probably alleviates renal dysfunction in T2DM patients.

The Effects of Intensive Nutrition Education on Late Middle-Aged Adults with Type 2 Diabetes.

Objective: Many patients with type 2 diabetes find it difficult to maintain good glycemic control. Undesirable glycemic control occurs greatly due to deficiencies of nutritional knowledge and difficulty in obtaining dietary prescriptions. The late middle-aged and elder individuals are the main populations that are affected by type 2 diabetes. The main purpose of this study was to investigate whether intensive nutrition education would make benefits for late middle-aged patients with type 2 diabetes. Method: 196 patients between 50 to 65 years old meeting type 2 diabetes criteria and eligible for the program were included in a single-blinded, 30-day centralized management of an education program in China. Participants in the program were randomly divided into a usual nutrition education group or an intensive nutrition education group. The usual nutrition education group was used as a control group and received only basic health advice and principles of diabetic diets at the beginning and the end of the study. Participants in the intensive nutrition education group were arranged to receive intensive nutritional lectures about diabetes for 30 days. The primary outcomes were the changes in weight, body mass index (BMI), fasting plasma glucose (FPG), 2-h postprandial plasma glucose (PG), glycosylated hemoglobin (HbA1c), total glycerin (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). Results: After 30 days of intervention, FPG, PG, and HbA1c in the treatment group decreased significantly than the control group (p < 0.05). HbA1c reduced significantly by 0.6% in the intervention group. No significant differences in the change of blood lipids were observed between groups. However, TG, TC, and HDL-c made improvements compared with the baseline in the experimental group. Both groups had a reduction in weight and BMI within groups, especially in intensive nutrition education group. However, there was no statistical significance between groups. Conclusions: Intensive nutrition education has significant effects on blood glucose control in late middle-aged adults with type 2 diabetes. Intensive education can cultivate good diet habits and increase physical activity, which are important for diabetes patients in the short and long terms. These findings may contribute to improving education methodology and nutrition therapy in patients with type 2 diabetes.

Health education: Effects on classroom climate and physical activity

Objective: The objective of this study was to investigate the relationship between classroom psychological climate and the physical and sedentary behaviour of primary school students after the implementation of an innovative education programme regarding nutrition and physical activity. Design: Randomised controlled trial. Setting: Study participants were 729 students, aged 8–10 years, in the third and fourth grade of 30 public primary schools in the Athens Metropolitan Area. Methods: Students were randomly assigned to three study groups: an Intensive Intervention Group (IIG) that underwent an intensive nutrition and physical activity education programme delivered by specialised personnel and teachers, an Intervention Group (IG) that underwent a less intensive programme delivered by their regular teacher and a Control Group (CG) that received no instruction. Classroom Psychological Climate (CPC) was measured in all groups, and the data regarding physical activity and sedentary lifestyle habits, such as the time spent viewing TV or video games (screen time), were recorded. Results: Friction declined and satisfaction increased significantly after the intervention in the IG compared with the CG. There was no significant difference in physical activity and screen time between the groups. Daily screen time was positively associated with increased friction, which is a measure of conflicts between students in the school environment. Conclusion: A school nutrition and physical activity education programme was shown to decrease friction by decreasing daily screen time and increasing outdoor activities. These findings also suggest that teachers alone may be more effective in delivering optional health education programmes than specialised personnel and instructors.

Prevalence of iron deficiency anaemia and dietary iron intake among infants aged six to nine months in Keiyo south Sub County, Kenya

The increased prevalence of iron deficiency among infants can be attributed to the consumption of an iron deficient diet or a diet that interferes with iron absorption at the critical time of infancy, among other factors. The gradual shift from breast milk to other foods and liquids is a transition period which greatly contributes to iron deficiency anaemia (IDA). The purpose of this research was to assess iron deficiency anaemia among infants aged six to nine months in Keiyo South Sub County. The specific objectives of this study were: to establish the prevalence of infants with iron deficiency anaemia and dietary iron intake among infants aged 6 to 9 months. The cross sectional study design was adopted in this survey. This study was conducted in three health facilities in Keiyo South Sub County. The infants were selected by use of a two stage cluster sampling procedure. Systematic random sampling was then used to select a total of 244 mothers and their infants. Eighty two (82) infants were selected from Kamwosor sub-district hospital and eighty one (81) from both Nyaru and Chepkorio health facilities. Interview schedules, 24-hour dietary recall and food frequency questionnaires were used for collection of dietary iron intake. Biochemical tests were carried out by use of the Hemo-control photochrometer at the health facilities. Infants whose hemoglobin levels were less than 11g/dl were considered anaemic. Further, peripheral blood smears were conducted to ascertain the type of nutritional anaemia. Data was analyzed using the Statistical Package for Social Sciences (SPSS) computer software version 17, 2009. Dietary iron intake was analyzed using the NutriSurvey 2007 computer software. Results indicated that the mean hemoglobin values were 11.3± 0.84 g/dl. Twenty one percent (21.7%) of the infants had anaemia and further 100% of peripheral blood smears indicated iron deficiency anaemia. Dietary iron intake was a predictor of iron deficiency anaemia in this study (t=-3.138; p=0.01). Iron deficiency anaemia was evident among infants in Keiyo South Sub County. The Ministry of Health should formulate and implement policies on screening for anaemia and ensure intensive nutrition education on iron rich diets during child welfare clinics. Keywords: Iron, Deficiency, Anaemia, Dietary, Infants, Six, Nine, Screening

Effectiveness of Taste Lessons with and without additional experiential learning activities on children’s willingness to taste vegetables

This study assessed the effectiveness of the Dutch school programme Taste Lessons with and without additional experiential learning activities on children’s willingness to taste unfamiliar vegetables. Thirty-three primary schools (877 children in grades 6–7 with a mean age of 10.3 years) participated in Taste Lessons Vegetable Menu (TLVM, lessons and extra activities), Taste Lessons (TL, lessons), or a control group. A baseline and follow-up measurement was used to assess for each child: number of four familiar and four unfamiliar vegetables tasted, quantity tasted, choice of vegetable of which to eat more, and number of vegetables willing to taste again later. Furthermore, children filled out a questionnaire on daily vegetable intake and food neophobia. Multilevel and Cox regression analyses were conducted to compare changes in the outcome measures between the three study groups. No significant intervention effects were found on willingness to taste unfamiliar vegetables. Neither were effects found on familiar vegetables, except for number of familiar vegetables tasted (p < 0.05). Furthermore, no significant intervention effects were found on daily vegetable consumption and food neophobia. These results indicate that more intensive school-based nutrition education activities are needed to increase children’s willingness to taste unfamiliar vegetables and increase their vegetable intake.

Nutritional education for management of osteodystrophy: Impact on serum phosphorus, quality of life, and malnutrition.

Introduction Osteodystrophy management includes dietary phosphorus restriction, which may limit protein intake, exacerbate malnutrition-inflammation syndrome and mortality among hemodialysis patients. Methods A multicenter randomized controlled trial was conducted in Lebanon, to test the hypothesis that intensive nutrition education focused on phosphorus-to-protein balance will improve patient outcomes. Six hemodialysis units were randomly assigned to the trained hospital dietitian (THD) protocol (210 patients). Six others (184 patients) were divided equally according to the patients' dialysis shifts and assigned to Dedicated Dietitian (DD) and Control protocols. Patients in the THD group received nutrition education from hospital dietitians who were trained by the study team on renal dietetics, but had limited time for hemodialysis patients. Patients in the DD group received individualized nutritional education on dietary phosphorus and protein management for 6 months (2-hour/patient/month) from study renal dietitians. Patients in the control group continued receiving routine care from hospital dietitians who had limited time for these patients and were blinded to the study. Serum phosphorus (mmol/L), malnutrition-inflammation score (MIS), health-related quality of life (HRQOL) index and length of hospital stay (LOS) were assessed at T0 (baseline), T1 (postintervention) and T2 (post6 month follow up). Findings Only the DD protocol significantly improved serum phosphorus (T0:1.78 ± 0.5, T1:1.63 ± 0.46, T2:1.69 ± 0.53), 3 domains of the HRQOL and maintained MIS at T1, but this protective effect resolved at T2. The LOS significantly dropped for all groups. Discussion The presence of competent renal dietitians fully dedicated to hemodialysis units was superior over the other protocols in temporarily improving patient outcomes.

Effect of Intensive Salt-Restriction Education on Clinic, Home, and Ambulatory Blood Pressure Levels in Treated Hypertensive Patients During a 3-Month Education Period.

The authors tested the hypothesis that low-salt diet education by nutritionists would lower blood pressure (BP) levels in treated hypertensive patients. The amount of urinary salt excretion and clinic, home, and ambulatory BP values at baseline and at 3months were measured in 95 patients with hypertension. After randomization to a nutritional education group (E group, n=51) or a control group (C group, n=44), the C group received conventional salt-restriction education and the E group received intensive nutritional education aimed at salt restriction to 6g/d by nutritionists. From baseline to the end of the study, 24-hour urinary sodium excretion was significantly lowered in the E group compared with the C group (6.8±2.9g/24h vs 8.6±3.4g/24h, P<.01). Morning home systolic BP tended to be lowered in the E group (P=.051), and ambulatory 24-hour systolic BP was significantly lowered in the E group (-4.5±1.3mm Hg) compared with the C group (2.8±1.3mm Hg, P<.001). Intensive nutritional education by nutritionists was shown to be effective in lowering BP in treated hypertensive patients.

Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon

ObjectiveAssess the effect of intensive nutrition education by trained dedicated dietitians on osteodystrophy management among hemodialysis patients. MethodsRandomized controlled trial in 12 hospital-based hemodialysis units equally distributed over clusters 1 and 2. Cluster 1 patients were either assigned to usual care (n=96) or to individualized intensive staged-based nutrition education by a dedicated renal dietitian (n=88). Cluster 2 patients (n=210) received nutrition education from general hospital dietitians, educating their patients at their spare time from hospital duties. Main outcomes were: (1) dietary knowledge(%), (2) behavioral change, (3) serum phosphorus (mmol/L), each measured at T0 (baseline), T1 (post 6 month intervention) and T2 (post 6 month follow up). ResultsSignificant improvement was found only among patients receiving intensive education from a dedicated dietitian at T1; the change regressed at T2 without statistical significance: knowledge (T0: 40.3; T1: 64; T2: 63) and serum phosphorus (T0: 1.79; T1: 1.65; T2: 1.70); behavioral stages changed significantly throughout the study (T0: Preparation, T1: Action, T2: Preparation). ConclusionThe intensive protocol showed to be the most effective. Practice implicationsIntegrating dedicated dietitians and stage-based education in hemodialysis units may improve the nutritional management of patients in Lebanon and countries with similar health care systems.

Effects of intensive nutrition education on nutritional status and quality of life among postgastrectomy patients

PurposeWe examined the effects of 3 months of intensive education (IE) after hospital discharge compared to conventional education (CE) on nutritional status and quality of diet and life among South Korean gastrectomy patients.MethodsThe study was conducted among 53 hospitalized gastrectomy in-patients (IE group, n = 28; CE group, n = 25) at Kyung Hee University Hospital at Gangdong. Baseline data were collected from electronic medical records and additional information was gathered via anthropometric measurements, assessment of nutritional status through a patient-generated, subjective global assessment (PG-SGA), diet assessment, and measures of self-efficacy and satisfaction with meals for 3 months following hospital discharge.ResultsTotal PG-SGA scores were significantly higher in the CE group than in the IE group at 3-week post-discharge (5.2 in the IE group vs. 10.4 in the CE group, P < 0.001), with higher scores indicating a greater severity of malnutrition. Energy intake over the 3 months increased in both the IE group (from 1,390 to 1,726 kcal/day) and the CE group (from 1,227 to 1,540 kcal/day). At 3-week post-discharge, the IE group had significantly higher daily protein and fat intake (P < 0.05). Self-efficacy improved in each category (P < 0.001), except for 'difficulty eating adequate food'. When assessing satisfaction with meals, there was a difference in the 'satisfaction with the current meal size' (P < 0.001) and 'satisfaction with the menu content' (P < 0.001).ConclusionNutritional status among gastrectomy patients in the IE group improved. Relative to the CE control, the IE group demonstrated improved self-efficacy and meal satisfaction 3-week post-discharge.

Body Mass Index in Children and Their Parents: A Cross-Sectional Study in a Study Population of Children from Southern Italy

The prevalence of overweight and obesity has increased over the last decades. Parental obesity plays an important role in determining childhood obesity. We aimed to evaluate the relationship between parental and offspring’ weight status in a population of children from South of Italy, as no data have ever been published from this area. We recruited 636 children (5.7 ± 1.5 years old) and their parents. Seventy-three (11.5%) and sixteen (2.5%) children were overweight and obese, respectively. Offspring weight status was significantly associated with parents’ weight status. The linear regression analysis showed that offspring BMI was more affected by paternal than by maternal BMI. Our data confirmed that parents’ weight status plays an important role on children’s BMI. Interestingly, in our study, parents’ height and weight were measured and not reported as in most of the previous papers, strengthening our conclusions. We suggest that intensive nutritional education and preventive programs should be performed in children with overweight / obese parents rather than in children with normal weight parent. Furthermore, nutritional education should be performed also for overweight parents to modify preventable risk factor for pediatric obesity.

Effect of Intensive Stage-Based Nutrition Education by A Dedicated Renal Dietitian on Phosphatemia Management Among Lebanese Hemodialysis Patients

Effect of Intensive Stage-Based Nutrition Education by A Dedicated Renal Dietitian on Phosphatemia Management Among Lebanese Hemodialysis Patients

The Women’s Health Initiative Randomized Controlled Dietary Modification Trial: An inconvenient finding and the diet-heart hypothesis

One goal of the US$700 million Women's Health Initiative Randomized Controlled Dietary Modification Trial was to determine whether post-menopausal women who adopted what was regarded as a 'heart healthy' low-fat diet, high in vegetables, fruits and grains, reduced their risk of developing cardiovascular disease. The trial substantially favoured the outcome in the intervention group, who also received an intensive nutritional and behaviour education programme not offered to the control group. These studies neatly disprove the diet-heart hypothesis since adoption of 'heart healthy' eating not only failed to influence future cardiac events in the healthy but it increased such events in the unhealthy and worsened diabetic control in those with type 2 diabetes mellitus.

Effect of socio-demographic characteristics on the prevalence of anemia among school going adolescent girls in Lucknow district, India

Anemia is a serious public health concern in most developing countries and the prevalence of anemia is quite high among adolescent girls. A cross-sectional descriptive study was carried out among school going adolescent girls in urban as well as rural schools of the Lucknow district, Uttar Pradesh, India from October 2008 to September 2009 with the objectives of studying the prevalence of anemia and the various socio-demographic characteristics in relation to anemia. Multistage random sampling was used to select the requisite number of girls. A total of 847 school going adolescent girls between 10-19 years of age were interviewed. Information regarding their socio-demographic characteristics was collected and the girls were also examined for presence or absence of pallor for anemia. Statistical analyses were done using percentage, Chi-square test, and odds ratio. The prevalence of anemia was found to be 55.6% and 57.9% in urban and rural school going adolescent girls respectively and significant association of anemia was observed with religion, caste and socio-economic status (p value&lt;0.05). There is need to develop strategies for intensive adult education, nutrition education and dietary supplementation including anemia prophylaxis.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 8-12 DOI: http://dx.doi.org/10.3329/seajph.v2i1.15254

The impact of preschool feeding programmes on the growth of disadvantaged young children in developing countries: a systematic review of randomised trials

Background: Childhood malnutrition in developing countries contributes to developmental delays, as well as increased morbidity and mortality. The effectiveness of feeding programmes as a strategy to improve childhood malnutrition has been questioned.Objective: A systematic review was undertaken to examine the effectiveness of preschool feeding programmes in fostering the growth of children in developing countries.Design: A systematic literature search was undertaken to identify published studies that related to the objective. Studies had to be randomised intervention studies that reported on the growth outcomes of children from birth to six years of age in order to be included.Setting: An initial literature search yielded 59 studies, of which 44 were excluded based on initial screening. Five more were omitted based on detailed data extraction. Ten studies met the inclusion criteria. The results of these studies were compared and narratively described in the context of the objective.Results: The studies showed a great level of heterogeneity with regard to sample characteristics, intervention and reporting of results. In the context of recovery from malnutrition, most studies reported there to be a positive effect from feeding programmes. In studies that reported on weight gain, those that employed a supervised intake of food supplements resulted in higher rates of weight gain. Micronutrient fortification was described as having a positive influence on the rate of linear growth in studies that reported on linear growth. Intensive nutrition education aimed at mothers and caregivers is a sustainable way in which to change child feeding behaviour and may contribute to the effectiveness of nutrition intervention.Conclusion: The limitations of the study included the following: there was a low number (59) of identified studies in the initial search because of the use of limited search terms, assessment of risk of bias was carried out by only one reviewer using a self-designed grading system, there were high levels of heterogeneity, and less than half of the individual studies were rated to be of a high quality. In view of these limitations, no firm conclusion can be drawn. Additional research, aimed at determining the impact of supplementary feeding programmes in supporting the growth of disadvantaged children, is encouraged.

Improved Nutrition Knowledge and Practice through Intensive Nutrition Education: A Study among Caregivers of Mildly Wasted Children on Nias Island, Indonesia

Inappropriate nutrition knowledge and feeding practices of caregivers are among several important causes of persistent malnutrition problems in young children. Thus, it is essential to provide caregivers with the necessary knowledge to help them modify their feeding practices. To examine the effectiveness of two different nutrition education methods, weekly intensive nutrition education (INE) and monthly nonintensive nutrition education (NNE), designed for caregivers of mildly wasted children (weight-for-height z-score ≥ -1.5 to < -1) aged ≥ 6 to < 60 months on Nias Island, Indonesia. To assess the impact of the two different nutrition education approaches on nutrition knowledge and practice of caregivers with their children, respondents were assigned to receive either weekly INE (n=114) or monthly NNE (n=96). The knowledge and practice levels of the mothers in each group were assessed and compared using a pretested validated questionnaire at admission and after the intervention period. At admission, the knowledge and practice levels of caregivers in both groups were not statistically significantly different. After participating in the nutrition education program, the percentage of correct answers on nutrition knowledge and practice in the INE group was significantly higher than that in the NNE group. Significant improvement in knowledge and practice scores was observed in the INE group after the intervention (p < 0.001), whereas only a significant improvement in knowledge was found in the NNE group (p < .05). In comparison with NNE, the INE approach was significantly better in bringing about a positive change in knowledge and practice of caregivers of mildly wasted children in the study area.

Effects of 12 weeks nutrition education on nutritional status in hemodialysis patients

Protein-energy malnutrition is present in a large proportion of patients with end stage renal disease and, is a strong risk factor for mortality in these patients. This study was aimed to evaluate the effectiveness of 12-weeks nutrition education during the hemodialysis session for the improvement of nutritional status. From the June 2011 to the September 2011, patients who were on regular hemodialysis in Pusan National University Hospital were enrolled in this study. In education group, intensive nutrition education was performed by the hemodialysis nurse, for fifty to sixty minutes during the hemodialysis session, once a week. Curriculum for renal nutrition includes regular taking of their medication, intake of moderate amount of protein and sufficient calories, reduction of water, salt, potassium and phosphate intake. Otherwise, any education program was not performed in patients of control group. Nutrition status was assessed by the subjective global assessment (SGA),body mass index (BMI), triceps skinfold thickness (TSF), arm muscle area(AMC) and laboratory markers such as serum albumin, serum blood urea nitrogen(BUN) and hemoglobin(Hb) level before and after the education. Effect of nutrition education was analyzed using ANCOVA test. A total of 49 patients were enrolled in this study and nutrition education was provided to 25 hemodialysis patients. Their mean age was 57.20±15.49 in education group and 55.13±14.42 in control groupand male was 56.0% in education group and 50.0% in control group and, other baseline characteristics were not significantly different between two groups. After the 12-week education, significant improvement was found in SGA, serum albumin, BUN and Hb level. SGA score was improved from 6.36±0.99 to 6.72±0.61 in education group, compared to control group(6.38±0.88 to 6.42±0.88, p=0.029 ). Improvement of serum albumin level, BUN and Hb was as follows: serum albumin(4.23±0.28 to 4.30±0.25 in education group, 4.28±0.39 to 4.13±0.34 in control group, p=0.040), serum Hb(10.45±1.49 to 11.13±1.74 in education group, 10.51±1.12 to 10.04±1.02 in control group, P=0.004), serum BUN(66.52±18.76 to 70.94±17.26 in education group, 59.50±13.61 to 58.68±13.88 in control group, p=0.032). 12 week nutrition education during the hemodialysis session by hemodialysis nurse was effective

Combined intensive nutrition education and micronutrient powder supplementation improved nutritional status of mildly wasted children on Nias Island, Indonesia.

To assess the impact of intensive nutrition education (INE) with or without the provision of micronutrient powder (MNP) on the nutritional status of mildly wasted children in Nias, Indonesia, two groups of mildly wasted (>=-1.5 to <-1.0 WHZ) children aged >=6 to <60 months in the Church World Service (CWS) project areas were assigned by village randomization to receive INE (n=64) or INE+MNP (n=51) in a weekly program. Another two groups of mildly wasted children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program (NNE) with or without MNP (n=50 both respectively). WHZ, weight, height, haemoglobin (Hb) level, and morbidity data were assessed at admission, during the study, and at individual discharge. Children's weight gain (g/kg body weight/day) was highest in INE+MNP group (2.2±2.1), followed by INE (1.1±0.9), NNE+MNP (0.3±0.5) and NNE (0.3±0.4) group. In both MNP intervention groups (INE+MNP, NNE+MNP), supplements significantly increased Hb value (g/L) of respective children (10.0±10.0; p<0.001 and 3.0±8.0; p<0.05 respectively). Proportion of children who reached discharge criterion was highest among the INE+MNP (70.6%; n=36), followed by INE (64.1%; n=41), NNE+MNP (26.0%; n=13), and NNE (20.0%; n=10) groups (p<0.001). Shortest length of stay until recovery was observed among children in the INE+MNP group (29.9 days), followed by INE (40.0 days), NNE+MNP (80.6 days), and NNE (86.2 days) respectively (p<0.001). Weekly intensive nutrition education supported by MNP supplementation produced the best results regarding weight gain and haemoglobin status of mildly wasted children.

The Effectiveness of School-Based Nutritional Education Program among Obese Adolescents: A Randomized Controlled Study

The purpose of the study was to determine the change in body weight and body mass index (BMI), as well as diet behaviors at 4 months after intervention between obese adolescent girls who participated in the school-based nutritional education program, addressed by pediatrician, compared to those who attended regular nutritional class. Methods. 49 obese girls were recruited from a secondary school. Those, were randomized into 2 groups of intervention and control. The intensive interactive nutritional program was provided to the intervention group. Weight and height, dietary record and % fat consumption, as well as self-administered questionnaires on healthy diet attitudes were collected at baseline and 4-month follow-up, and then compared between two groups. Results. There was a statistically significant change of BMI in the intervention group by 0.53 ± 1.16 kg/m2 (P = 0.016) compared to the control group (0.51 ± 1.57 kg/m2, P = 0.063) but no significant change in calorie and % fat consumption between groups. The attitudes on healthy eating behaviors in the intervention group were shown improving significantly (P < 0.001). Conclusions. Interactive and intensive nutritional education program as shown in the study was one of the most successful school-based interventions for obese adolescents.

Consumer acceptance of yellow, provitamin A-biofortified maize in KwaZulu-Natal

Objectives: To assess the acceptance of popular maize food products (phutu, thin porridge and samp), prepared with yellow, provitamin A-biofortified maize varieties, in 212 subjects between the ages of three and 55 years, from rural KwaZulu-Natal.Design: A cross-sectional study.Method: Preschool, primary school and secondary school subjects were randomly selected from two primary schools and one secondary school, respectively, while adult subjects constituted a convenience sample. Pre- and primary school children completed a paired preference test. Secondary school and adult subjects completed a five-point facial hedonic and a preference ranking test. Focus group discussions were conducted using adult subjects.Results: Preschool children preferred yellow maize to white maize food products: phutu (81% vs. 19%; p-value < 0.001), thin porridge (75% vs. 25%; p-value < 0.001) and samp (73% vs. 27%; p-value < 0.001). There was no statistically significant difference in preference for white and yellow maize by primary school children. Secondary school and adult subjects preferred white maize to yellow maize. Focus group discussions confirmed the preference for white maize by the adults.Conclusion: The study findings suggest that yellow, provitamin A-biofortified maize has the potential to succeed as a new strategy of dealing with the serious problem of vitamin A deficiency, especially among children of preschool age. However, in older groups, this strategy is unlikely to be successful, unless other strategies are implemented, including intensive nutrition education programmes on the nutritional benefits of the maize, targeting the market price at which yellow maize is sold, increasing its availability in local grocery stores, and improving its sensory properties through breeding.

Impact of Intensive School-Based Nutrition Education and Lifestyle Interventions on Insulin Resistance, β-Cell Function, Disposition Index, and Subclinical Inflammation Among Asian Indian Adolescents: A Controlled Intervention Study

The present study was designed to assess the impact of intensive and repetitive nutrition education and lifestyle interventions on insulin resistance, β-cell function, disposition index (DI), and subclinical inflammation in Asian Indian adolescents (15-17 years) residing in North India. In this prospective study, two matched schools were randomly allocated to the intervention (n = 56; 31 boys and 25 girls) or control group (n = 50; 30 boys and 20 girls). The intervention consisted of seven components: (1) Dissemination of health-related information through lectures and focused group discussions, (2) planning of activities such as quizzes, (3) individual counseling of students, (4) promotion of physical activity, (5) change in the canteen menu to healthier alternatives, (6) conducting health camps involving parents and teachers, and (7) training of student volunteers for sustainability of the program in school. Impact of intervention was studied on surrogate markers of insulin resistance, β-cell function, disposition index, and subclinical inflammation. At 6 months follow-up, significantly higher (P = 0.037) mean value of homeostasis model assessment denoting β-cell function (HOMA-βCF) was seen in the intervention group compared to the control group, whereas high sensitivity C-reactive protein (hs-CRP) was significantly lowered (P < 0.001). The increase (30.3 ± 73.4; P < 0.037) observed in the DI in adolescents in the intervention group was significantly higher compared to the control group. The Pearson's coefficient of correlation in the intervention group showed that the Δ-decrease in mean waist circumference was significantly correlated (r = 0.267, P < 0.05) with Δ-decrease in homeostasis model assessment of insulin resistance (HOMA-IR). The intervention model developed by us could be used for amelioration of insulin resistance with potential of preventing type 2 diabetes mellitus in Asian Indian adolescents.