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Objective: To examine the impact of Nutrition for Life (NFL), a goal-setting nutrition education program, on the knowledge, self-efficacy and behaviour of adults eligible for Supplemental Nutrition Assistance Program-Education.Design: NFL was developed using a 4-week goal-setting behavioural strategy focused on nutrition, physical activity and meal planning techniques. A quantitative repeated-measures design using self-reported data was collected at pre- and post-interventions and at 1-week and 1-month follow-ups.Setting: Two Federally Qualified Health Centers in Philadelphia, PA, USA.Participants: A total of ninety-eight participants enrolled in the intervention; the majority were women (80·2 %), Black/Non-Hispanic (75·0 %) and 45-54 year old (39·6 %).Results: Participants showed significant improvement in knowledge, self-efficacy and behaviour. Specifically, mean daily intake for vegetables increased by 0·31 cup (P < 0·05) and for fruits by 0·39 cup (P < 0·01) at 1-week follow-up. Participants also showed healthier behaviour at 1-month follow-up. Planning at least seven meals per week increased from 14·8 to 50 % (P < 0·01), completing at least 30 min of physical activity every day in the last week increased from 16·7 to 36 % (P < 0·01) and consuming water with all meals increased from 39 to 70·6 % (P < 0·01).Conclusions: The implementation of a goal-oriented nutrition education program offers a promising approach at achieving positive behaviour change among SNAP-eligible adults. [ABSTRACT FROM AUTHOR]

Objective: Produce and evaluate About Eating (AE), an online program for low-income women aligned with the Satter eating competence model, congruent with best practices for nutrition education of low-income audiences. Methods: Responses from iterative cognitive interviews and online surveys with diverse samples of low-income women informed lesson revisions. The researchers conducted a randomized controlled trial of AE with low-income women to determine its impact on dietary behavior and food security. Results: In all, 284 women reviewed at least 1 AE lesson and endorsed it. After AE, women (n = 288) increased in use of food resource management skills (eg, using a budget [P = .008] and planning meals to include all food groups [P = .002]). About Eating participants who were food secure had more confidence in managing money for food (P = .002) and keeping track of food-related purchases (P = .02) than food-insecure persons. Conclusions and Implications: Mixed-methods research with life stage and geodiverse samples confirmed the usefulness of AE. Food security assessment may enhance interpretation of intervention effectiveness. [ABSTRACT FROM AUTHOR]

Abstract: Effective strategies are needed to increase vegetable intake in accordance with health recommendations. Previous research has shown that increasing the variety of foods leads to increased consumption, yet this strategy has not been investigated for promoting vegetable intake. This crossover study, conducted in 2008 and 2009, tested whether filling half the plate with a variety of vegetables influences vegetable consumption and meal energy intake. Once a week for 4 weeks, a meal of pasta and cooked vegetables was consumed ad libitum by 66 adults (34 women, 32 men). The meals were varied in the type of vegetables offered: at three meals 600 g of a single vegetable was served (broccoli, carrots, or snap peas) and at one meal 200 g of each of the three vegetables was served side by side. Data were analyzed using a mixed linear model with repeated measures. In this study, serving a variety of vegetables increased vegetable intake at the meal (P<0.0001). Subjects ate more vegetables when served the variety than when served any single type; the mean increase was 48±6 g, or more than one-half serving. This increase remained significant when intake of the variety of vegetables was compared with the preferred vegetable of each participant (mean 25±8 g; P=0.002). Vegetable intake was not significantly related to energy intake at the meal. The results of this study demonstrate that increasing the variety of low-energy-dense vegetables served at a meal can be used as a strategy to increase vegetable intake. [Copyright &y& Elsevier]

Background: Mississippi has one of the highest rates of childhood overweight and obesity in the US, and the latest pediatric research suggests that early childhood is the best time to intervene for prevention. In 1995, the University of Mississippi evaluated menus from Mississippi child care centers and found that while mean amounts of energy and several nutrients were lower than recommended levels, fat was higher. This study evaluated Mississippi child care center menus again to determine if new nutrition standards for centers who participate in the USDA Child and Adult Care Food Program (CACFP), have changed the nutritional content of menus. Methods: Survey questionnaires and requests for cycle menus were sent to 600 licensed child care centers in Mississippi that participate in the CACFP. There were 36 respondents for a response rate of six percent. Menu nutrient content was quantified using NutriKids menu analysis software. Results: The current means for energy (kalories) (497.8 ± 75.8), fiber (g) (5.72 ± 1.32), Vitamin A (IU) (414.05 ± 218.4), Vitamin C (mg) (29.07 ± 23.02), iron (mg) (3.22 ± 0.53), and calcium (459.92 ± 60.74) were significantly (p < 0.05) greater than the means measured in 1995. The means for saturated fat (g) (5.54 ± 1.39) and total fat (g) (15.05 ± 3.66) were significantly (p < 0.05) less. Conclusions: Menu analysis revealed that menus for Mississippi child care centers are lower in total fat and saturated fat than those collected in 1995, but while amounts of other nutrients increased. [ABSTRACT FROM AUTHOR]

State agencies (SA) interpret federal regulations for Child and Adult Care Food Program (CACFP) institutions and facilities (I/F). 2016 brought major changes, the first since 1968, to CACFP meal requirements. Beginning October 1, 2019, menus must comply with these updated nutrition standards to qualify for reimbursement. To increase I/Fs menu compliance, North Carolina offered a voluntary, systematic menu assessment statewide. As the USDA recommended, the SA program provided technical assistance (without financial penalty) to l/F on their menus. The SA developed a Menu Assessment Tool (MAT) to assess compliance with meal requirements. l/F were invited to submit menus, review MAT scores, and revise and resubmit. From June 2018-January 2019, 42 institutions submitted revised child menus. A Sign test was used to analyze score differences between initial and revised menus on six metrics: (1) correct milk, (2) one whole grain-rich grain per day, (3) no grain-based desserts, (4) cereal identified, (5) cereal within sugar limits, and (6) 100% juice once per day or less. Revised menus demonstrated increased compliance on five of six metrics. Initial compliance rates were (1) 14.3%, (2) 38.1%, (3) 64.3%, (4) 66.7%, (5) 59.5%, and (6) 38.1%. Revised compliance rates were (1) 88.1% (p≤0.000), (2) 78.6% (p≤0.084), (3) 92.9% (p≤0.004), (4) 90.5% (p≤0.003), (5) 83.3% (p≤0.038), and (6) 90.5% (p≤0.000). Findings suggest I/F that utilized the menu assessment program increased meal requirement compliance and improved menu documentation. Continuing the program may increase the number of reimbursable meals served and enable l/F to avoid financial impacts of noncompliance [ABSTRACT FROM AUTHOR]

Most of the sodium Americans consume comes from processed and restaurant foods. An upstream global strategy to promote health is to work with local restaurants to reduce sodium content in their food offerings, while accounting for food taste and economic considerations. In urban communities, Chinese take-out restaurants serve meals with large amounts of sodium and are clustered in low-income, racial/ethnic minority communities with a high prevalence of hypertension. The objective of this study is to assess baseline knowledge, attitudes, and behaviors related to sodium use/consumption among Chinese take-out owners and chefs recruited to participate in the Philadelphia Healthy Chinese Take-Out Initiative. A cross-sectional study of 221 Chinese take-out restaurants was conducted from August 2012 to February 2013. Items measured knowledge, attitudes, and behaviors related to salt use, salt consumption, and health. Most owners/chefs knew that excess sodium consumption contributes to high blood pressure but were less aware of other health effects and of major sources of sodium in the U.S. diet. The majority were willing and able to reduce sodium content in meals if customer demand could be maintained, and they desired training in food preparation, procurement, and marketing. Findings show a need to provide education, strategies, and support to Chinese take-out owners/chefs in preparing low-salt dishes. The results of this and future studies to reduce sodium content in meals by working with restaurant owners and chefs have global health promotion implications., (© 2014 Society for Public Health Education.)

Problem: Medical nutrition therapy is an important component of glycaemic management in hospitalised patients with diabetes; however, there is a lack of information guiding the ordering of specific meal plans in this setting., Setting: University-affiliated academic medical centre., Methods: An administrative decision to gradually replace standard consistent-carbohydrate (CCMP) (standard group) with patient-controlled meal plans (patient-controlled group) presented the opportunity to compare menu selection, adherence to CCMP, glycaemic control and satisfaction as a quality-improvement initiative. Information was obtained from consecutive inpatients with diabetes admitted to units receiving standard (n=30) or patient-controlled meal plans (n=43). Patients received the meal plan according to unit location., Results: No group differences were observed in adherence to CCMP (70% vs 64%, p=0.1), mean capillary blood glucose (CBG) or hyperglycaemia frequency (CBG>180 mg/dl). Hypoglycaemia (CBG<70 mg/dl) occurred more frequently in the patient-controlled group (0.39 vs 3.23%, p=0.04). There were no episodes of severe hypoglycaemia (CBG<40 mg/dl) in either group. The patient-controlled group reported a greater satisfaction and had more opportunities for nutrition education, with a demonstrated improvement in adherence to CCMP following targeted education in six of nine patients with available menu data., Conclusions: The standard group experienced less hypoglycaemia and required less clinician oversight. The patient-controlled group allowed for identification of patients who would benefit from education, required more oversight by nutrition services and reported greater satisfaction with their meal plan. Both meal plans may be appropriate for inpatients with diabetes, provided that a sufficient review is available for patients who make inappropriate selections with the patient-controlled meal plan.