Nutrition Counseling Program Research Articles

A Nutritional Counseling Program Prevents an Increase in Workers' Dietary Intake and Body Weight During the COVID-19 Pandemic.

The COVID-19 pandemic caused thousands of deaths and changed lives all over the world. Daily life has also altered people's eating habits, mainly among those who stayed working at home. However, changes in the eating habits of workers who remained working during the pandemic are still unknown. The aim of this study was to evaluate the impact of the COVID-19 pandemic on the dietary habits of day and shift workers from a condominium management company, as well as to measure adherence to a nutritional counseling program and its effect on workers' food intake and body weight. One hundred and fifty-one workers (77.5% of day workers and 22.5% of shift workers) were followed up in the pre-pandemic period and during the pandemic. Data on anthropometry, food consumption, and adherence to nutritional counseling were collected during nutritional meetings, which focused on qualitative modification of food intake and control of energy consumption. The rate of adherence to the program did not differ between shifts. The pandemic significantly increased the intake of calories, macronutrients, and several micronutrients in workers of both shifts. Adherence to the nutritional counseling program had an impact on the consumption of proteins and some micronutrients, and also promoted a reduction in body weight and body mass index of workers of both shifts. Evening/night shift workers overall ate their meals later than day workers and also presented an earlier afternoon snack during the pandemic when compared with the pre-pandemic period. In conclusion, the pandemic seems to contribute to the increase in food intake of workers, regardless of the work shift. Those who joined a nutritional counseling program managed their food intake and lost weight.

Impact of a diet diversification and health and nutrition counseling program in Madagascar

Background: Due to lack of resources, especially for mothers and children, Madagascar has high levels of malnutrition. Health promotion and education have shown to be effective in increasing health status in limited-resource areas. This study piloted a tailored, four-week health and nutrition counseling program to improve diet diversity and health promoting practices.
 Methods: Twenty child caregivers were recruited from Andasibe, Madagascar, using snowball sampling, and were provided weekly individualized health counseling with education materials by the research team. Diet, health knowledge, and health behaviors were assessed using a quasi-experimental one-group pre/post-test design. Body mass index, mid-upper arm circumference measurements, and Raman spectroscopy technology assessed nutritional status. Data were analyzed using descriptive statistics and paired sample t-tests to determine changes.
 Results: All caregivers were female. More caregivers were within normal limits for Body Mass Index (40%) than underweight or overweight, and most were within normal limits for mid-upper-arm circumference (75%). Significant increases (p≤0.01) were found in caregiver consumption of vitamin A-rich foods, and using treated water to wash fruits and vegetables, though significant increases were not found for children. The majority (80%) increased diet diversity. Participants increased their knowledge of nutrition and non-nutritious foods.
 Conclusions: Results suggest an individualized approach to health promotion in a limited-resource area can improve diet diversity, knowledge and health practices. Opportunities for further education and research include increasing knowledge of nutrient dense foods, expanding food choice beyond carbohydrate-rich foods, diet diversity importance, and sustaining education efforts beyond project implementation. Strategies highlighted in this research can inform others working in limited-resource areas.

A Pilot Study of Home-Based Exercise and Personalized Nutrition Counseling Intervention in Endometrial Cancer Survivors.

IntroductionTo assess the feasibility of a home-based aerobic exercise and nutrition counseling intervention and effect on cardiorespiratory fitness, cardiovascular disease risk profile, and immune response in obese endometrial cancer survivors.MethodsA longitudinal pilot study assessed a 12-week home-based aerobic exercise and nutrition counseling intervention in obese endometrial cancer survivors. The primary outcome was feasibility defined as 80% adherence to weekly walking sessions calculated among individuals that completed the intervention. Secondary outcomes comprised pre- and post-intervention differences in cardiorespiratory fitness, cardiovascular risk factors, and T-cell function. Descriptive statistics summarized data. Wilcoxon sign tests identified differences between and pre and post-intervention variables.ResultsNineteen women with stage 1 endometrial cancer consented; 9 withdrew and one was a screen failure. Median adherence to weekly walking sessions was 83.3%. Body composition was significantly altered with a reduction in median fat mass from 52.5 kg to 46.9 kg (p=0.04), and BMI from 37.5 kg/m2 to 36.2 kg/m2 (p = 0.004). There was no significant difference in cardiorespiratory fitness or cardiovascular parameters. The percentage of CD4+ and CD8+ T-cells producing IFNγ towards MAGE-A4 significantly increased from and 5.9% to 7.2% (p=0.043) and 13.9% to 14.8% (p=0.046), respectively. There were 3 related adverse events: hip pain, back sprain, and abdominal pain.DiscussionOur home-based exercise and nutrition counseling program was feasible based on 80% adherence to walking sessions and favored altered body composition. However, the discontinuation rate was high and further research is needed to overcome barriers to implementation. Improvement in cardiovascular parameters will most likely require longer and more intensive programs.

The impact of a nutrition counseling program on the use of hospital services for Meals on Wheels clients

Home-delivered meals have shown considerable promise in overcoming nutritional challenges among homebound older adults facing food insecurity and the risk of diabetes, while nutrition counseling provides knowledge and skills for diabetes management. The purpose of this study was to identify the impact of a program combining nutrition counseling with home-delivered meals by examining the use of hospital services 6 months before and after participating in the program. This study included 1009 clients who are at risk for diabetes and who received home-delivered meals and nutrition counseling via Meals on Wheels in Fort Worth, Texas. Hospital service data were extracted from a regional claims database. Generalized linear models were performed to examine changes in use of hospital services 6 months before and after program participation. The mean number of emergency department visits and hospitalizations decreased from 0.69 to 0.50 (p < .001) and from 0.35 to 0.22 (p < .001), respectively. The findings of this study indicate that combining structured nutritional counseling with home-delivered meals may contribute to reducing healthcare use among older adults facing the challenges of diabetes and food insecurity.

A study protocol of a randomized trial evaluating the effect of using defined menu plans within an intensive personal nutritional counseling program on cardiovascular risk factors: The MoKaRi (modulation of cardiovascular risk factors) trial

ImportanceChanges in dietary habits and lifestyle can reduce the risk of cardiovascular disease which is the leading cause of death worldwide. Objectives of the MoKaRi study The MoKaRi (modulation of cardiovascular risk factors) intervention study is designed to evaluate the effectiveness and potential of the developed MoKaRi concept. The MoKaRi concept comprises three components, each designed to improve dietary behavior. The first component entails using daily menu plans to implement a defined “cardioprotective diet”. This diet consists of seasonal menu plans which are characterized by:(i) a personalized energy supply depending on his or her age, gender, level of physical activity.(ii) an adequate intake of carbohydrates, protein, fat, vitamins, minerals, and trace elements according to the guidelines of the German Society of Nutrition (DGE).(iii) a recommended intake of saturated fatty acids (SFA; < 7% of caloric intake (En%)), monounsaturated fatty acids (MUFA; > 10 En%), polyunsaturated fatty acids.(PUFA; approx. 10 En%), and long-chain n-3 PUFA (≥500 mg per day).(iv) measures to encourage consumption of vegetables and fruits, and.(v) eating more than 40 g dietary fiber every day.Half of the participants will be scheduled to consume an additional 3 g of long-chain n- 3 PUFA every day in the form of fish oil.The second component consists of regular one-on-one nutritional counseling, while a variety of further incentives make up the third component of the MoKaRi concept.The MoKaRi study will provide essential insights into the relationship between defined nutrient intake, markers of food intake and health status. Our specific aim is to investigate the influence of dietary and lifestyle choices have on cardiovascular health.The information and practical tools suitable for daily use, such as the personalized menu plans, could help to transfer knowledge on nutritional facts to the general population. In this way, the validated MoKaRi concept may contribute to the prevention and therapy of cardiovascular diseases. MethodsIn line with our power calculation, we will enroll 60 participants and randomly assign them to one of two parallel arms. Each participant will receive personalized menu plans for each day of the study and will be provided with one-on-one nutritional counseling sessions every two weeks for a study period of 20 weeks (140 days). During this period, blood samples will be taken every 14 days (11 time points) and twice during a 20-weeks follow-up period. Incentives such as a supply of foods approved according t the standards of the study, a sports program, individual feedback on study parameters reflecting health status, and group activities round off the MoKaRi concept.Low-density cholesterol is the primary outcome measure of the MoKaRi study, and the secondary endpoints comprise markers of nutrient status (e.g. fatty acid distribution in plasma and erythrocyte lipids), a metabolomic profiling, diabetes risk markers, clotting markers, and further cardiovascular risk factors, such as blood lipids, homocysteine and high-sensitive c-reactive protein.The MoKaRi study was registered before launch at ClinicalTrials.gov (identifier NCT02637778; https://clinicaltrials.gov/ct2/show/NCT02637778).

Effectiveness of nutrition education and counseling on metabolic control parameters of diabetes mellitus type 2 patients in primary health care centers

Background. Diet compliance is an essential part of the treatment and control of diabetes. The present study aimed to determine the effectiveness of education and face to face diet counseling on metabolic control parameters of patients with type 2 diabetes in primary health care centers. Methods. This quasi-experimental study was conducted on 90 T2DM patients who referred to Andimeshk community health centers in 2018. Patients were randomly divided into two intervention (n = 45) and control (n = 45) groups. Data were analyzed by independent t-test, paired t-test and Chi-square using SPSS-18 software. Results. Sixteen weeks after the implementation of the nutrition education and counseling program, there was a significant decrease in the clinical, anthropometric, and biochemical parameters of the intervention group (P 0.05). Conclusion. The research findings show that the implementation of group education program, along with individual nutrition counseling, is very effective and can lead to weight loss, improved blood pressure and better control of blood glucose and lipids in T2DM patients. Therefore, the combination of education and counseling as two complementary methods in the treatment and control of diseases such as diabetes seems essential and effective.

Pilot Cluster Randomized Controlled Trial of Integrative Nutritional Counseling Versus Standard Diabetes Self-Management Education for Chinese Americans with Type 2 Diabetes.

Purpose: Chinese Americans (CAs) with diabetes and limited English proficiency often struggle to adhere to standard diabetes diets focused on food measurement/restriction. Chinese medicine principles commonly inform food choices among CAs but are rarely acknowledged in nutritional interventions. We developed and tested feasibility of a theoretically informed integrative nutritional counseling (INC) program that combines Chinese medicine principles with biomedical nutrition standards.Methods: We randomized diabetes self-management education (DSME) classes to include either: (1) usual nutrition curriculum based on American Diabetes Association (ADA) recommendations delivered by a diabetes educator (control) or (2) INC curriculum based on a combination of ADA recommendations and Chinese medicine principles delivered by a diabetes educator and a licensed acupuncturist (intervention). All DSME enrollees were invited to participate in research entailing data collection at three time points: baseline, after the DSME nutrition class, and at 6-month follow-up. Using validated measures, we collected dietary self-efficacy, diabetes distress, diet satisfaction, and dietary adherence. We also measured weight and glycemic control.Results: Study participants were 18 Cantonese-speaking patients with diabetes who were predominantly female and older, with low levels of income and acculturation. Intervention and control groups were similar at baseline. INC performed similarly to usual DSME with 100% of participants reporting the INC booklet helped their learning. Dietary adherence significantly improved in participants who received the INC curriculum.Conclusion: INC is feasible to implement as part of DSME classes and shows promise as a complementary culturally sensitive addition to usual diabetes nutrition education for CA patients.

The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Syndrome in Hospitalized Schizophrenic Patients: A Randomized Controlled Trial.

The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and metabolic syndrome (MetS) in people with schizophrenia is unknown and remains to be investigated. Therefore, we have conducted a three-month parallel-group randomized controlled trial. Sixty-seven hospitalized schizophrenic patients with MetS [n = 33 in the intervention group (IG) and n = 34 in the control group (CG)] completed the intervention. The IG followed the DASH diet with the caloric restriction of approximately 1673.6 kJ/day (400 kcal/day) when compared to the standard hospital diet followed by the CG. Simultaneously, both groups participated in a nutrition counseling program. Anthropometric and biochemical parameters and blood pressure were measured at the baseline and after three months, while nutrient intakes during the intervention were assessed using three non-consecutive 24-hour dietary recalls. The analyses were carried out based on the per-protocol approach. At three months, the MetS prevalence significantly decreased in both the IG and the CG (75.8%, p = 0.002, and 67.7%, p = 0.0003, respectively; odds ratio = 0.9; 95% confidence interval = 0.43–1.87). No significant differences in the prevalence of MetS and its features were found between the groups.

Transnationalism and Caring for Migrant Families with Young Children

Abstract Background Migrant families’ transnational ties may contribute to their hardships and/or may be a source of resiliency. A care approach that acknowledges these transnational ties may foster a positive identity and give coherence to experiences. We conducted an integrative review to determine if there is evidence that health and social services supporting migrant families with young children consider transnational ties during care with these families. Methods We searched 15 databases to identify relevant literature including empirical research and discussion papers reporting on a health or social program, service, intervention or care experience of migrant families during early childhood (pregnancy to age five) in a Western country (i.e., Canada, US, Europe or Australia). Information regarding if and how the intervention/service/program/care addressed transnationalism, were extracted and synthesized. Results Over 34,000 records were screened; 296 articles met inclusion criteria. Most literature was from the US. Care, programs and interventions examined included prenatal classes, doula support, maternity care, postpartum home visits, breastfeeding support, nutrition and feeding counseling, and parenting and early childcare programs. There is evidence that care-providers empathize and offer information on family reunification processes for families dealing with separation from loved ones and are open to and accommodate cultural traditions (e.g., feeding and parenting practices) originating from the home country; otherwise there is little evidence that transnational ties are addressed during care. Conclusions Significant knowledge gaps remain regarding whether and how care-providers’ take into account transnational ties, including distance care-giving of children or elderly, use of health services abroad, and receipt of advice and support from family back home, which may affect their relationships with families and/or the effectiveness of their interventions. Key messages Significant knowledge gaps remain regarding whether and how care-providers’ take into account transnational ties in early chilldhood care. More research is needed on transnationalism and the health and social care of migrant families.

PEMBERDAYAAN KADER POSYANDU MELALUI PENERAPAN METODE KONSELING GIZI DAN KOMUNIKASI EFEKTIF PADA KADER POSYANDU KELURHAN PADEMANGAN BARAT JAKARTA UTARA

Kelurahan Pademangan Barat is one of the areas of malnutrition enclosed in the city of North Jakarta. Toddlers with malnutrition are recorded in the kelurahan. The level of education of the population as well as knowledge and public awareness in the field of health is relatively low suspected to be the main cause of the problem of malnutrition. One of the steps that can be done to help the nutritional problem is through nutrition counseling on posyandu cadres in the kelurahan. Nutrition counseling is a two-way communication process between counselor and client to help clients recognize and overcome nutritional problems. This program aims to increase knowledge of nutrition cadres of malnourished children under five. The outcomes of this program are the improvement of mother's nutritional knowledge and weight gain. Counseling was conducted several times, at each visit given by leaflet as a tool in delivering the material to the cadre. The visit time is approximately fifty hours. In addition, an informal mother and toddler approach is also used to identify parenting patterns, family characteristics, and children, as well as causes of malnutrition. As many as 88%,the cadre has increased the understanding and self confidence after following the nutrition counseling program.

Use of Situational Vignettes Helps Assess the Competence of Frontline Workers (FLW) in Nutrition Counseling Programs (OR13-07-19)

ObjectivesBehavior change communication (BCC) effectiveness depends on the knowledge of frontline workers (FLWs) who counsel clients. Most studies assess content-based knowledge of FLWs but do not examine their ability to apply this content. We tested the use of situational vignettes to assess ‘application knowledge’ and examined gaps between content and application knowledge, and the association between both types of FLW knowledge and that of clients (mothers). MethodsData are from a survey of 100 FLWs and 409 mothers with children <2y in Madhya Pradesh, India. Content knowledge was assessed using questions on nutrition. Application knowledge to assess FLW knowledge of topics to cover in specific counselling contacts was measured using situation-based vignettes and follow-up questions. Gap was defined as FLW demonstrating content knowledge without application knowledge. Regression models were used to assess determinants of knowledge, gaps in types of knowledge and associations with mothers’ knowledge. ResultsMany FLWs had reasonable content knowledge of family planning (94%), iron-folic acid during pregnancy (68%) and exclusive breastfeeding (93%). However, vignette-based application knowledge was lower than content knowledge. FLW education was associated with higher content knowledge (β = 0.69; P < 0.05) and higher application knowledge (β = 1.08; P < 0.01) of FLWs. FLWs’ age and caste were associated with gaps between content and application knowledge (β = 0.03 and β = 0.51, P < 0.10). The magnitude of association of FLWs’ application knowledge with maternal knowledge (β = 0.07; P < 0.10) was nearly twice the association of FLWs’ content knowledge with maternal knowledge (β = 0.04; P < 0.10), adjusted for maternal characteristics. ConclusionsAssessing application-based knowledge using situational vignettes was feasible and helped understand FLW competence more than content-based knowledge tests only. Counseling programs must strengthen both content and application knowledge. Funding SourcesBill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.

Mother’s Role and Knowledge in Young Children Feeding Practices on the Nutritional Status of Infant and Toddler

Adequate nutrition, beginning in early stages of life, is crucial to ensure good physical and mental development as well as long-term health. Efforts in improving nutritional status in Indonesia are mostly focused to the vulnerable groups, mainly infant (baby under one year old) and toodler (baby under two years old). Childhood underweight and overweight are an important public health problem, as these conditions tend to have a chronic condition that cause a wide range of future morbidity. Overweight in young children is associated with future cardiovascular diseases, diabetes, and psychosocial problems and stunted children suffer from impaired growth with permanent consequences in their adult life that face a high risk of morbidity and mortality. In this case, parents (especially mothers as the role models) are mostly responsible on healthy eating behaviors of their young children. With refers to this empirical fact, the objective of this study was to assess the association of mother&amp;rsquo;s role and knowledge in feeding young children practices on the nutritional status of their infants and toddlers. Analytical cross-sectional study was used in this study. The sampling technique was purposive sampling and a total of samples were 136 mothers. Data were processed and analyzed by using a computer program with a chi-square test at a significance level of 95%. Overall, results of the statistical test showed that there were no significant associations between role and knowledge of the mothers and adequate nutritional status of their infants and toddlers at a p-value of 0.544&amp;gt; 0.05 and p-value of 0.749 &amp;gt; 0.05 respectively. Based on results of this study, more intensive nutrition intervention programs are necessary to prevent poor nutritional status of young children particularly for infant and toddler, conducting more active coordination in health cross-programs, and improving nutrition counseling programs and suitable health services for the concerned public.

Prognostic Value of Ultrasound Stratigraphy in Long-Term Weight Loss: Results from a Nutritional Counseling Program

Background: Weight control through lifestyle interventions represents a suitable strategy to avoid the metabolic, endocrine, and reproductive comorbidities associated with overweight and obesity. Reduced testosterone (T) levels are a worsening factor in overweight males. However, prognostic parameters of long-term weight loss are not readily available. Here, we tested the prognostic value of early variations of anthropometric and hormonal parameters, with a focus on ultrasound stratigraphy (US) and the reduction in body mass index (BMI) associated with nutritional counseling/lifestyle interventions at 6-month follow-up. Methods: Ninety-five male subjects (BMI 25–34.9 kg/m²) who had undergone nutritional/lifestyle interventions, were retrospectively analyzed for: body weight and composition; US evaluation at the triceps (TRC), abdominal (ABD), and thigh (THI) areas; and circulating levels of T, luteinizing hormone, and follicle-stimulating hormone. Sixty patients (63.2%) completed the 6-month follow-up program. Results: At 6 months, a significant reduction in BMI (26.38 ± 1.55 vs. 31.5 ± 5.0 basal, p < 0.001) and increase in T levels (18 ± 5.4 vs. 9.5 ± 2.3 nmol/L basal, p = 0.04) were observed. Subjects in the highest quartile of the BMI reduction at 6 months (ΔBMI 6 mo), compared to the lowest, showed a significant difference at the 2-month follow-up variation of BMI (p = 0.025), and fat and muscle thickness at the TRC (both p < 0.001) and ABD (p < 0.001 and p = 0.002, respectively) areas. Variation of TRC muscle thickness at 2 months was the only independent predictor of ΔBMI 6 mo in the multiple stepwise regression analysis. Conclusions: BMI evaluation and US represent useful monitoring tools in the follow-up of nutritional/lifestyle interventions for overweight-to-mildly obese patients. The important effects on motivation and adherence to the intervention program are to be considered.

The Effect of Electrically Induced Cycling and Nutritional Counseling on Cardiometabolic Health in Upper and Lower Motor Neuron Chronic Spinal Cord Injury: Dual Case Report.

Introduction:Various therapies have been utilized to improve cardiometabolic health after spinal cord injury (SCI), including Functional Electrical Stimulation (FES) cycling. Typically, FES is used in SCI cases resulting from Upper Motor Neuron Injury (UMN-SCI). However, it has been reported that FES may improve muscle torque and functional mobility in individuals with Lower Motor Neuron Injuries (LMN-SCI) but potential effects on cardiometabolic health have not been studied before. Thus, this study examined the cardiometabolic health response to FES cycling combined with nutritional counseling in two individuals with chronic SCI; one person with LMN-SCI and one with UMN-SCI.Case Presentation:Body composition, vascular stiffness, and glucose deposition were assessed before and after participation in the FES cycling and nutritional counseling program. Despite the decrease in body mass in the case of LMN-SCI but not UMN-SCI, the fat mass-to-lean mass ratio in the lower limbs and trunk increased +4% and +8% respectively, in the former and decreased −10% and −8% respectively in the latter. Both subjects decreased markers of central vascular stiffness (AIx@75, reflection magnitude) as well as blood glucose and HbA1c levels, however, the changes were greater in the case of UMN-SCI.Discussion:This dual case study provides only a partial support for the use of FES cycling alone or in combination with nutritional counseling for improving cardio metabolic health in LMN-SCI, however modest decreases in glucose and vascular stiffness warrant further investigations.

청소년 빙상 선수들을 위한 영양교육 프로그램 적용 및 효과 평가

청소년 빙상 선수들을 위한 영양교육 프로그램 적용 및 효과 평가

Effects of a 6-week aerobic exercise programme on the cardiovascular parameters, body composition, and quality of life of people living with human immune virus.

This study evaluated the effects of aerobic exercise program on the cardiovascular parameters, body composition, and quality of life (QoL) of people living with human immune virus (HIV). Patients were recruited from the HIV clinic in a tertiary hospital in Nigeria. Fish bowl method was used to randomize the patients to either experimental or control group. Experimental group received nutritional counseling and aerobic exercise program on a treadmill, 3 times a week for a period of 6 weeks, while the control group received only nutritional counseling. Cardiovascular parameters, aerobic fitness, body composition parameters, and QoL were evaluated at baseline and 6 weeks. Descriptive statistics was used to explore demographic data while the hypothesis was tested using inferential statistics of t-test. Alpha level was set at P<0.05. The result showed that there was an improvement in cardiovascular parameters in both groups, attaining significance in the experimental group (P=0.000). Aerobic fitness increased significantly in experimental group (P=0.000). Body composition decreased significantly while there was a significant difference in the muscle mass (%) between groups (P<0.05). All domains of QoL had a significant improvement in both groups (P<0.005). A 6-week aerobic exercise program in addition to nutritional counseling was able to significantly improve cardiovascular fitness, body composition, and QoL in people living with HIV/acquired immune deficiency syndrome. Nutritional counseling alone can bring about an improvement only in QoL parameters.

Prenatal education of overweight or obese pregnant women to prevent childhood overweight (the ETOIG study): an open-label, randomized controlled trial.

We aimed to evaluate whether pre and perinatal education of pregnant women would reduce childhood overweight. Four French centers included women at ≤21 gestational weeks (GWs) with body mass index (BMI) >25 kg/m2 before pregnancy. Patients were randomized to a control group (routine care including at least one dietary visit) or an intervention group (2 individuals (26 and 30 GW) and 4 group sessions (21, 28, 35 GW, 2 months postpartum)) aimed at educating the future mother regarding infant and maternal nutrition. The primary objective was to reduce post-natal excessive weight gain in the infant from birth to 2 years (NCT00804765). This project was funded by a grant from the National Programme for Hospital Research (PHRC-2007 French Ministry of Health). We included 275 women (BMI: 32.5 kg/m2). The rate of post-natal excessive weight gain was similar in the intervention (n = 132) and control (n = 136) groups by intention to treat (ITT: 59.1% vs 60.3% respectively, p = 0.84) in available data (AD, n = 206) and by per-protocol analysis (PP, n = 177). Two years after delivery, normalization of maternal BMI and number of infants with BMI < 19 kg/m2 were not significantly different in the interventional group in ITT and in the control group. Although not significantly different in ITT, normalization of maternal BMI was more frequent in AD (n = 149: 12.9% vs 3.8%, p = 0.04) and 2-year-old infant BMIs were less likely to be >19 kg/m2 in the intervention group in AD (n = 204: 0% vs 6.8%, p = 0.014) and PP (n = 176: 0% vs 6.4%, p = 0.03). An education and nutritional counseling program for overweight women, starting after 3 months of gestation, did not significantly change post-natal excessive weight gain of infants or prevent overweight in mothers and children 2 years after delivery.

Process Evaluation of the Integration of a 3-month Pilot Nutrition Education and Counseling Program at a Federally Qualified Health Center

Process Evaluation of the Integration of a 3-month Pilot Nutrition Education and Counseling Program at a Federally Qualified Health Center

Evaluation of Clinical Outcomes and Medical Provider Perceptions of a 3-month Pilot Nutrition Education and Counseling Program at a Federally Qualified Health Center

Evaluation of Clinical Outcomes and Medical Provider Perceptions of a 3-month Pilot Nutrition Education and Counseling Program at a Federally Qualified Health Center

Implementation of a nutrition assessment, counseling and support program and its association with body mass index among people living with HIV in Accra, Ghana

ABSTRACTIn spite of the important role nutrition plays in the management of HIV, access to nutrition services is inadequate, especially in resource limited settings. In addition, nutrition programs for people living with HIV (PLWH) have not been sufficiently evaluated for efficacy and this study was conducted to address this gap. This study aimed to evaluate the implementation of the nutrition assessment, counseling and support (NACS) program in Accra, Ghana, and to assess whether the level of implementation of NACS was associated with the body mass index (BMI) of PLWH. A cross-sectional study was conducted in six HIV clinics (3 NACS designated and 3 non-NACS). Study participants were 152 adult PLWH at least 6 months on antiretroviral therapy and not pregnant or breastfeeding. Using a NACS implementation scale developed for this study ranging from 0 to 8 (a higher score indicating better NACS implementation), median NACS implementation score was not different between NACS-designated, and non-NACS HIV clinics (5 vs 4, p = 0.14). Almost half (47%) of the respondents were overweight or obese. A higher score on the NACS implementation scale was not significantly associated with overweight or obesity (BMI >24.9 kg/m2) after adjusting for other covariates. It was concluded that, there was poor implementation of NACS in the NACS designated HIV clinics surveyed with no nutrition counseling offered nor food support available to those who might need it.