Do Japanese take more folate from traditional Japanese dish than is conventionally estimated?-Actual folate contents in hospital diets and marketed lunch boxes.
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Folic acid deficiency is very rare in Japan. However, recent concerns in relation to causal relationships between cancer and low folic acid levels necessitate information on actual folate intake by Japanese, which has hitherto not been well studied. We therefore evaluated folate contents of a hospital diet for 7 consecutive days and of 16 lunch boxes purchased at convenience stores. Dietary intake was assessed for weighed food items after cooking using our previously published data on folate contents of various foods and also by using Standard Tables of Food Composition in Japan (STFCJ). Mean daily folate intake from the hospital diet was 723.9 microg/day using our data but only 359.2 microg/day if calculated using the STFCJ. Twenty-nine % of the total daily folate intake was through rice. Mean folate intake through lunch boxes was 491.7 microg/day by our tabulation and 139.5 microg/day with the STFCJ. Folic acid intake of Japanese is far above the levels taken in other countries and over half of this amount is taken from rice. Levels of folic acid contents (especially in rice) listed in the STFCJ are too low and revision is strongly suggested. (+info)
Referrals of participants in an urban WIC program to health and welfare services.
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The Special Supplemental Food Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and referrals to available health and welfare services. Recipients are income-eligible pregnant and postpartum women, their infants, and their children who are younger than 5 years of age. Although studies have documented the nutritional benefits of the program, the extent to which WIC nutritionists help eligible women to obtain available health and welfare services, and the degree to which this referral activity promotes health, is largely unknown. The researchers examined the referral activity at one urban WIC clinic, but did not evaluate the outcomes. Of 1,850 persons seen, there were 762 referrals by WIC nutritionists for 597 persons at the Lawrence, MA, clinic during a 2-month period. Of the 597 persons, 494 (83 percent) were WIC participants and 103 (17 percent) were nonparticipants. The rate of referrals for WIC participants was 27 percent. Multiple referrals were common, with 127 people receiving more than one referral. WIC nutritionists at this site offered a variety of referrals to their clients. The majority of referrals (61.7 percent) were for supplemented food. Non nutrition-related referrals were to medical and dental services (20.5 percent), developmental and educational services (12.5 percent), and social services (5.4 percent). Non nutrition-related referrals for women included referrals for family planning, substance abuse, job training, teenaged parenting, and high school equivalency programs. Infants and children were referred for dental care, growth failure, the Head Start Program, kindergarten enrollment, early intervention, and protective services. WIC nutritionists are in an ideal position to evaluate a broad spectrum of health issues and to refer participants to health and welfare services because clients return regularly for vouchers and nutrition counselling. The authors conclude that WIC nutritionists should be given formal training in the evaluation of, and referral for, non nutrition related issues in order to maximize their health advocacy role. (+info)
A field trial of a survey method for estimating the coverage of selective feeding programmes.
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OBJECTIVE: To test a survey method for estimating the coverage of selective feeding programmes in humanitarian emergencies. METHODS: The trial survey used a stratified design with strata that were defined using the centric systematic area sample method. Thirty 100 km2 quadrats were sampled. The communities located closest to the centre of each quadrat were sampled using a case-finding approach. FINDINGS: The method proved simple and rapid to implement and allowed overall and per-quadrat coverage to be estimated. Overall coverage was 20.0% (95% confidence intervals, 13.8-26.3%). Per-quadrat coverage ranged from zero (in nine quadrats) to 50% (in one quadrat). Coverage was highest in the quadrats closest to therapeutic feeding centres and in quadrats containing major roads leading to the towns in which therapeutic feeding centres were located. CONCLUSION: The method should be used, in preference to WHO Expanded Programme on Immunization (EPI)-derived survey methods, for estimating the coverage of selective feeding programmes. Its use should also be considered when evaluating the coverage of other selective entry programmes or when coverage is likely to be spatially inhomogeneous. (+info)
The role of information in the planning, management and evaluation of community nutrition programmes.
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Protein-energy malnutrition has many diverse location-specific causes which make if difficult to solve through uniform interventions implemented through vertical programmes. This paper investigates the role of information in the planning, management and evaluation of several community nutrition programmes judged to be successful. The programmes come from Tanzania (Iringa), India (Tamil Nadu), Dominican Republic and Colombia. The review finds that the initial conceptualization and design of these programmes benefited from the results of earlier surveys and experience with similar programmes in the same or other countries. Strong capacity for operations research is important to assist with a myriad of small but important programme design details and larger mid-term re-orientations. The impact of this information depends upon the flexibility of the programme and receptivity of its management towards a learning-by-doing approach. Information for on-going programme management differs widely and conforms to the overall character of the individual programme. Thus, Iringa employs a simple system based on community growth monitoring, primarily to catalyze intervention planning and action at household and community levels. Tamil Nadu's system is far more complex and is primarily intended to assist in the delivery of centrally planned interventions. Programme evaluation benefited from information generated within the programme, but more rigorous impact evaluation requires stronger designs and more in-depth analysis than is usually provided. Overall, the review suggests that characteristics like community participation, empowerment and growth monitoring are less important in the short/medium term than strong management, a learning-by-doing approach, and the existence of some method for informing programme design and management about community needs and responses to the programme. The former characteristics may well be important for the longer-term sustainability of programmes. (+info)
Methodological challenges in performing targeting: assessing dietary risk for WIC participation and education.
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This paper summarizes recent evaluations of indicators of dietary risk used to determine eligibility and nutrition education and counseling within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The concept of dietary risk relates to an inadequate dietary pattern or a failure to adhere to the food guide pyramid and, within WIC, is typically assessed based on an individual's intake from a 24-h recall or FFQ. Available evidence suggests, however, that even with a high-quality technique, substantial error exists in these data at the level of the individual, making the likelihood of misclassification high. Such data, with appropriate statistical procedures, can provide valid information at the group or the population level, and this is a future area for indicator development and incorporation into the management of WIC and other nutrition education programs addressing dietary risk. (+info)
Meanings of targeting from program workers.
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Program workers have a critical role in targeting in nutrition programs, but little has been studied about the concept and the operation of targeting from their perspectives. This paper introduces and compares meanings of targeting from the perspectives of program workers in food assistance programs in the United States. There exist some variations in perceptions of targeting and actual operational procedures adopted by program workers at the local and federal levels. Regardless, program workers' perspectives on targeting suggest a new framework of targeting, which consists of key components (program access, service, and evaluation) and issues in need of careful attention in targeting nutrition programs. The success of targeting depends on how well these components and related issues can be translated into targeting policy, rules, and procedures. With increased devolution to the state and local levels in the United States, it is even more critical for federal policy makers and administrators to understand how frontline program workers perceive and implement targeting. The new framework based on the perspectives of program workers may contribute to developing a conceptual definition as well as practical guidance for targeting that can be used to formulate better ways of targeting in nutrition programs. (+info)
Competitive food initiatives in schools and overweight in children: a review of the evidence.
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BACKGROUND: Recent research has shown significant increases in the rates of obesity in US adults and children. Despite the widespread discussion about childhood overweight, relatively little discussion focuses on solutions. METHODS: We reviewed the literature on school programs and policies that address competitive foods-commonly called "junk" foods. These foods tend to be high in sugar or fat and provide minimal nutritive value. RESULTS: Sugar-sweetened beverages such as sodas contribute to weight gain and poor nutrition among students-the average student consumes 31 pounds of sugar in these drinks annually. The sale of competitive foods in schools often competes with the more nutritious school lunch programs. With minimal federal and state policies addressing the sale of competitive foods, individual school districts in Wisconsin and elsewhere have explored various alternatives to improve school nutrition. The evidence suggests that these policies can be effective and at the same time increase food sale revenue. CONCLUSION: Communities may be able to improve childhood nutrition through school-based nutrition programs and policies that address the sale of competitive foods. (+info)
Food offerings in Marshfield area businesses: a survey conducted in collaboration with the healthy lifestyles--Marshfield Area Coalition.
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PURPOSE: To survey Marshfield area businesses to determine the types of foods currently available to employees at the workplace and the potential need for nutrition information to facilitate the ordering of healthy food options at workplaces. METHODS: A 2-page self-administered questionnaire was mailed to all businesses registered with the Marshfield Area of Chamber of Commerce. Questionnaires were mailed a second time to non-responders to improve the response rate. The questionnaire included items about foods available to employees at the workplace, cooking and eating facilities available to employees, and reasons for food choices made. Data were entered into an Excel spreadsheet, verified against the hard copies and transferred to SPSS for analysis. RESULTS: Completed questionnaires were returned by 249 businesses (41.1% participation). The reported number of minutes that most employees take for their lunch ranged from 0 to 60 (median = 30). Eighty-one percent of businesses (n = 184) reported that most employees take 30 or more minutes for their lunch. Respondents were asked to list the most common menu items purchased for consumption on-site. One hundred fifteen respondents listed sandwiches (46.2%), 101 listed pizza (40.6%), 30 listed salad (12.0%), and 17 listed various sweets (6.8%). Employees were thought to be less likely than managers to select foods lower in calories if the foods are more expensive. DISCUSSION: There is great potential to improve the health of employees through the provision of nutrition information to businesses. The survey employed in the current study can be used again in the future to track changes after implementation of worksite initiatives through the Business and Industry Committee of the Healthy Lifestyles--Marshfield Area Coalition. (+info)