DietPal: a Web-based dietary menu-generating and management system.
BACKGROUND: Attempts in current health care practice to make health care more accessible, effective, and efficient through the use of information technology could include implementation of computer-based dietary menu generation. While several of such systems already exist, their focus is mainly to assist healthy individuals calculate their calorie intake and to help monitor the selection of menus based upon a prespecified calorie value. Although these prove to be helpful in some ways, they are not suitable for monitoring, planning, and managing patients' dietary needs and requirements. This paper presents a Web-based application that simulates the process of menu suggestions according to a standard practice employed by dietitians. OBJECTIVE: To model the workflow of dietitians and to develop, based on this workflow, a Web-based system for dietary menu generation and management. The system is aimed to be used by dietitians or by medical professionals of health centers in rural areas where there are no designated qualified dietitians. METHODS: First, a user-needs study was conducted among dietitians in Malaysia. The first survey of 93 dietitians (with 52 responding) was an assessment of information needed for dietary management and evaluation of compliance towards a dietary regime. The second study consisted of ethnographic observation and semi-structured interviews with 14 dietitians in order to identify the workflow of a menu-suggestion process. We subsequently designed and developed a Web-based dietary menu generation and management system called DietPal. DietPal has the capability of automatically calculating the nutrient and calorie intake of each patient based on the dietary recall as well as generating suitable diet and menu plans according to the calorie and nutrient requirement of the patient, calculated from anthropometric measurements. The system also allows reusing stored or predefined menus for other patients with similar health and nutrient requirements. RESULTS: We modeled the workflow of menu-suggestion activity currently adhered to by dietitians in Malaysia. Based on this workflow, a Web-based system was developed. Initial post evaluation among 10 dietitians indicates that they are comfortable with the organization of the modules and information. CONCLUSIONS: The system has the potential of enhancing the quality of services with the provision of standard and healthy menu plans and at the same time increasing outreach, particularly to rural areas. With its potential capability of optimizing the time spent by dietitians to plan suitable menus, more quality time could be spent delivering nutrition education to the patients. (+info)
An environmental intervention to promote lower-fat food choices in secondary schools: outcomes of the TACOS Study.
OBJECTIVES: We evaluated an environmental intervention intended to increase sales of lower-fat foods in secondary school cafeterias. METHODS: Twenty secondary schools were randomly assigned to either an environmental intervention or a control group for a 2-year period. The intervention increased the availability of lower-fat foods and implemented student-based promotions. RESULTS: A steeper rate of increase in sales of lower-fat foods in year 1 (10% intervention vs -2.8% control, P =.002) and a higher percentage of sales of lower-fat foods in year 2 (33.6% intervention vs 22.1% control, P =.04) were observed. There were no significant changes in student self-reported food choices. CONCLUSIONS: School-based environmental interventions to increase availability and promotion of lower-fat foods can increase purchase of these foods among adolescents. (+info)
Testing of the Individual Nutrition Rx assessment process among nursing home residents.
The purpose of this article is to describe the Individual Nutrition Rx (INRx) assessment process and to report preliminary findings on baseline nutritional status, common nutrition problems, and specific individualized interventions. The INRx utilizes a predictive model for participant identification, a systematic assessment process, and evidence-based interventions to improve the nutritional status of at-risk residents. Nineteen percent of participants had abnormal serum albumin levels, and 32.8% had abnormal serum prealbumin levels, indicating diminished protein stores and protein-calorie malnutrition. Frequent nutritional problems identified through the INRx assessment process are appetite change, poor positioning while eating, and oral status concerns. (+info)
Acceptability of lower glycemic index foods in the diabetes camp setting.
OBJECTIVE: To determine the acceptability of lower glycemic index (GI) foods served at diabetes camp. DESIGN: Crossover design of standard and lower GI menus. SETTING: Three consecutive 5-day diabetes camp sessions. PARTICIPANTS: 140 youth, age 7-16, with type 1 or 2 diabetes. INTERVENTION: A standard camp cycle menu was reformulated to include 2 1/2 days of standard foods and 2 1/2 days of lower GI foods. MAIN OUTCOME MEASURES: Youth provided satisfaction ratings after meals and snacks using measures designed for this study. Observations of food consumption were conducted on a random sample of youth for each meal. ANALYSIS: Descriptive analyses and t-tests were conducted to assess differences in satisfaction with and consumption of standard and lower GI foods. RESULTS: Lower GI foods served at dinner and for snacks received satisfaction ratings equal to standard foods (dinner: 3.68 lower GI versus 3.79 standard, P = .30; snacks: 3.74 lower GI versus 3.79 standard, P = .60). Lower GI foods served at breakfast and lunch received lower, though very acceptable, ratings (breakfast: 3.76 lower GI versus 4.04 standard, P < .01; lunch: 3.64 lower GI versus 3.88 standard, P = .01). Consumption of all meals was acceptable. No differences occurred in the frequency of high or low blood sugars between standard and lower GI days. CONCLUSIONS AND IMPLICATIONS: Higher quality carbohydrates may be provided to youth in institutional settings while maintaining sufficient levels of acceptability; specific findings are instructive for designing efforts to increase their consumption. (+info)
Examination of the food and nutrient content of school lunch menus of two school districts in Mississippi.
This study examined the diet quality of the school meals in two Mississippi school districts and compared them to the national guidelines. We examined the lunch menus of the two school districts that participated in the National School Lunch Program and School Breakfast Program focusing on food quality and assessing both healthy and unhealthy foods and eating behaviors. This analysis was completed through a computerized review used to accurately determine the nutrient content. Both the standard and the alternative meals provided by the cafeterias in the two school districts exceeded the minimum requirement for calories for all grade levels. The meals from the urban schools cafeteria provide more calories than meals from the cafeteria in the rural school district. Although schools believe that they are making positive changes to children's diets, the programs are falling short of the nutrient recommendations. Poor nutrition and improper dietary practices are now regarded as important risk factors in the emerging problems of obesity, diabetes mellitus, hypertension and other chronic diseases, with excessive energy intake listed as a possible reason. Dieticians, school professionals and other health care practitioners need to accurately assess energy intake and adequately promote a dietary responsible lifestyle among children. (+info)
Advancing institutional dietetics and school nutrition program in Korea.
More than 21,000 practicing dietitians are working in the various fields of institutional foodservice settings in Korea. For the effective placement and practice of dietitians in their special areas, proper enactment and implementation of required legislations shall be imperative. Following legislations are few of those: regulations for dietitians enacted in 1963 in accordance with decree of the Ministry of Health and Social Affair; the School Meals Act in 1981; placement regulation for dietitians in childcare and nursery facilities with over 100 children under the enforcement of Infant Care Act of 1991; regulation for nutrition improvement program stated in the National Health Promotion Act of 1995; enforcement regulation for the placement of dietitians in public health centers under the Regional Public Health Act of 1997; amendment of School Meal Act and Primary and Secondary Education Act in 2003 stating that school shall have the nutrition education teacher who is dietitian qualified and passed national teacher qualifying examination; amendment of the Ministry of Health and Welfare Notification in 2003 enabled clinical dietitians at hospitals to bill a medical nutrition therapy service fee officially to patients with the following diseases: diabetes, hypertension, cardiac disease, and cancer; and amendment of the Justice Department and its Affiliates Notification in 2006 stating dietitians are placed at correction facilities. Newly introduced nutrition teachers who have tasks of nutrition education and meal service management were arranged at 4,134 schools of public or national primary and secondary as well as special schools for the handicapped in September, 2007. (+info)
Tawana project-school nutrition program in Pakistan--its success, bottlenecks and lessons learned.
Tawana Pakistan Project, a multifaceted pilot project (Sept. 2002 to June 2005) was funded by the Government of Pakistan to address poor nutritional status and school enrollment of primary school age girls. The core strategy was to create safe environment empowering village women to take collective decisions. Through reflective learning process women learnt to plan balanced menus, purchase food, prepare and serve a noon meal at school from locally available foods at nominal costs (USD 0.12/child). Aga Khan University partnered the government for the design, management, monitoring and evaluation of the project, 11 NGO's facilitated implementation in 4035 rural government girls' schools. Training was provided to 663 field workers, 4383 community organizers, 4336 school teachers and around 95 thousand rural women. Height and weight were recorded at baseline and every 6 months thereafter. Wasting, underweight and stunting decreased by 45%, 22% and 6% respectively. Enrollment increased by 40%. Women's' ability to plan balanced meals improved and >76% of all meals provided the basic three food groups by end of project. Government bureaucracy issues, especially at the district level proved to be the most challenging bottlenecks. Success can be attributed to synergies gained by dealing with nutrition, education and empowerment issues simultaneously. (+info)
Sharing Singapore's experience in dietetic practice and school nutrition programmes.
Dietetic practice in Singapore is mainly applied at the clinical settings, such as hospitals. The main scope of practice is in providing medical nutrition therapy to patients in a multidisciplinary team approach at both inpatient and outpatient clinics. This is delivered in the form of nutrition counseling and nutrition support. Dietitians are also involved in other areas such as conducting nutrition workshops and talks and provide consultation to the hospital's food service department. They set dietary guidelines for inpatient meal services and equip the food service personnel with the knowledge to plan and prepare healthier menus and therapeutic diets. In the schools, all the students are taught the basic principles of nutrition in the school curriculum. Healthy eating messages are reinforced through various interesting activities in schools. Nutrition guidelines on creating healthy and nutritious menus in the school tuckshops are available for schools to implement the Model School Tuckshop Programme. This programme is aimed at cultivating healthy eating habits among school children. For overweight students, they are referred to the students health centre for medical screening, assessment and for regular nutrition counseling at the Nutrition Clinic. (+info)