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Background: Analyses of global trends indicate that childhood undernutrition is more prevalent in rural areas, and also that maternal education and decision-making power are among the key factors significantly associated with child growth., Methods: The present study comprised a controlled longitudinal study aiming to assess the effectiveness of nutrition education with respect to improving growth patterns of young children of less-literate, low income caregivers in a rural subsistence farming community. Caregivers in the intervention group (n = 52) attended a structured nutrition education programme, whereas the control group (n = 45) participated in sewing classes. Weights and lengths/heights were measured for children in the intervention and control groups every month for 1 year to assess changes in growth patterns. Repeated measures analysis of covariance was used to access differences between the two groups over time and across age groups. Variability in growth patterns of individual children and clustering of caregiver effects were controlled for during the statistical analysis., Results: After 12 months, children in the intervention group had significant improvements in weight-for-age compared to the controls [mean (SD): 0.61 (0.15) versus -0.99 (0.16), P = 0.038]. Changes in height-for-age, weight-for-height and mid-upper arm circumference-for-age showed a positive trend for children in the intervention group. Changes in weight-for-height were statistically significant across age groups and negatively related to caregiver's age., Conclusions: Educating caregivers has the potential to improve young children's nutritional status and growth, especially among less literate populations where households subsist on what they produce., (© 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.)

Objectives: The purpose of this study was to assess the costs and impact of a nutrition education program following a cholesterol screening., Methods: Forty work-sites were randomly assigned to one of two educational interventions: a "usual" intervention of 5 minutes of counseling, or a "special" intervention of 2 hours of behaviorally based education on dietary changes to lower serum cholesterol. Costs were monitored, and cholesterol levels were retested 6 and 12 months later., Results: The total per-person cost for screening and the educational intervention was about $50. Cholesterol levels differed little between the two intervention groups 6 months after screening, but after 12 months those in the special intervention worksites showed a 6.5% drop in cholesterol, whereas those at the usual intervention worksites showed a drop of only 3.0%. Hence a 3.5% cholesterol reduction was attributable to the special intervention., Conclusions: A behaviorally based nutrition education program following cholesterol screening can have a meaningful impact on long-term cholesterol levels at a low cost. Nutrition education in work-sites may therefore be a useful way to lower the risk of heart disease in communities.

A random mailed survey (response N = 226; 75.3%) of participants in diet-related home-based learning evaluated exposure to recruitment channels and impact on salience, utility, level of participation, sharing the course with others, knowledge, and performing recommended behaviors. A post-only design, the study was conducted in a small Minnesota city (population = 20,000), part of the Cancer and Diet Intervention (CANDI) project. About 18.5% of residents (3,711) enrolled during an 8-week media campaign; women, college graduates, and those over 44 years old were overrepresented. Participants learned about the program through mass media (97%); small media (41.9%); and interpersonal sources (50%). Women were more likely to learn about the course through interpersonal sources. In analysis of variance (ANOVA) modeling, salience and utility predicted level of participation in course activities. Level of participation in turn predicted nutrition knowledge and with salience predicted performance of recommended behaviors. Although the course appealed to individuals who needed it less, there was evidence of diffusion to the unenrolled. About 57% of responding participants reported sharing it with spouses; about 67% reported sharing it with someone outside their households.

The National Cholesterol Education Program has underscored the need for health professionals to work together to promote dietary changes and reduce blood cholesterol levels across the population. This article reports the results of an evaluation of several low-intensity intervention programs designed for the general public that could be offered on a larger scale, either through traditional outlets for short courses or on an outpatient basis after physician referral. The interventions were designed as classes, required approximately 8 hr of contact time with the participants, cost approximately $20 per participant, and were taught by nutritionists and dietitians recruited from the community and trained for this program. Results indicated that similar net reductions in total cholesterol of about 4% were achieved at 1-yr follow-up either from a course which focused on changing eating patterns or from one which focused on weight loss and weight-loss management. These results support the hypothesis that cholesterol reduction is possible with inexpensive and simple methods in healthy, low-risk populations.

The purpose of this study was to determine the effectiveness of selected factors of performance of a telephone delivery system, Dial-A-Dietitian, which was established to provide nutrition information to the public. A model, developed for this use, entailed a systems approach with five phases, which included enabling factors (inputs), the interaction process, effort factors (outputs), performance (outcome), and feedback (reporting). The data analysis indicated that the Dial-A-Dietitian program was effective as measured by this model.

The National Cholesterol Education Program (NCEP) was initiated to contribute to the prevention of illness and death from coronary heart disease by reducing the prevalence of high blood cholesterol. The report of an expert panel of this program provides guidelines for the treatment of high blood cholesterol in adults 20 years of age and over. Dietary therapy is the primary treatment. The goal of the recommended dietary therapy is to lower the LDL-cholesterol concentration, although measurement of total blood cholesterol can be used to monitor the response to diet. Dietary modification involves a progressive decrease in intake of saturated fatty acids and cholesterol. The Step-One Diet calls for an intake of total fat less than 30% of calories, saturated fatty acids less than 10% of calories, and cholesterol less than 300 mg/day. If the desired decrease in LDL-cholesterol is not achieved with that dietary change, then the Step-Two Diet is begun. It requires a reduction in saturated fatty acids to less than 7% of calories and cholesterol to less than 200 mg/day. This article provides background information on the organization and objectives of the NCEP and focuses on the recommendations of the Adult Treatment Panel (ATP), e.g., classification of risk for developing coronary heart disease based on total and low-density-lipoprotein cholesterol levels and recommendations for treatment of patients with high blood cholesterol. The emphasis of the discussion is on dietary treatment. The implications of the recommendations for the dietetic practitioner are discussed. These include an expanded leadership role to meet the education needs of health professionals and patients.

Lean Meats Make the Grade is a collaborative nutrition intervention program involving the Minnesota Heart Health Program (MHHP), the Minnesota Beef Council, and the Pork Producers Council. The purposes of this program were to educate consumers about identification of leaner cuts of meat, low-fat preparation methods, and selection of appropriate meat portion size. Program components included training for meat managers, taste testing for consumers, recipes and customer information brochures, and labels on individual meat packages to assist in the identification of leaner cuts of meat. The program was implemented through grocery stores in two of the towns selected for MHHP intervention. Population-based telephone surveys indicated that respondents in the intervention towns were more aware of the lean meats program than those in the comparison communities. Knowledge of lean cuts of meat and low-fat preparation methods also increased as a result of the program. Independently collected sales data from five participating and two control stores provided some indications of a greater interest in lean cuts and 80% lean ground beef as a result of the intervention program. Programs such as this have potential for community-wide nutrition education.

A nutrition education curriculum was developed, based on a social learning model, that emphasized the importance of a low-salt, low-fat, and increased complex carbohydrate diet for cardiovascular health. The curriculum was pilot-tested in eight third and fourth grade classrooms. Students were exposed to cartoon character role models, were reinforced for dietary changes, and practiced relevant behavioral skills. Students in eight other third and fourth grade classrooms served as controls. At posttest, students participating in the nutrition education program reported a significant reduction in consumption of foods high in fat and salt and an increase in consumption of complex carbohydrates. These assessments were confirmed by food selection measures and by 24-hour food recalls. Students in the control classrooms did not report these eating pattern changes.