JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

A CAMERA'S VIEW OF CONSUMER FOOD-HANDLING BEHAVIORS

ANDERSON JANET B; SHUSTER THOMAS A; HANSEN KELEE E; LEVY ALAN S; VOLK ANTHONY

Nearly all of the 99 participants of this study cross-contaminated raw meat, poultry, seafood, eggs, and/or unwashed vegetables with ready-to-eat foods during preparation. Only one-third washed their hands with soap and/or thoroughly cleaned surfaces. Dietetics professionals are encouraged to familiarize themselves with the Fight BAC! consumer food recommendations, understand where food-handling errors are being made, and educate their clients and patients about foodborne illness. [PUBLICATION ABSTRACT] FOOD SAFETY, ILLNESSES, NUTRITION EDUCATION, FOOD PROGRAMS, CONSUMER BEHAVIOR

A MEDIA LITERACY NUTRITION EDUCATION CURRICULUM FOR HEAD START PARENTS ABOUT THE EFFECTS OF TELEVISION ADVERTISING ON THEIR CHILDREN'S FOOD REQUESTS

HINDIN TOBY J; CONTENTO ISOBEL R; GUSSOW JOAN DYE

Preschool children watch an average of 3 hours of food commercials per week. As a result of the curriculum, a sample of 35 participants from several boroughs of New York City learned how to critically analyze television commercials, better understand food labels, judge claims for food made by television advertisements, and increased their ability to appropriately respond to children's requests for food advertised on television. [PUBLICATION ABSTRACT] HEAD START PROJECT, PARENTS & PARENTING, MEDIA, NUTRITION EDUCATION, TELEVISION ADVERTISING, CHILDREN & YOUTH, BEHAVIOR, FOOD SAFETY, LITERACY

ATTITUDES, PRACTICES, AND CONCERNS ABOUT CHILD FEEDING AND CHILD WEIGHT STATUS AMONG SOCIOECONOMICALLY DIVERSE WHITE, HISPANIC, AND AFRICAN-AMERICAN MOTHERS

SHERRY BETTYLOU; MCDIVITT JUDITH; BIRCH LEANN LIPPS; COOK FRANCES HANKS

Parents play an important role in the development of their children's eating behaviors. We conducted 12 focus groups (three white, three African-American, and three Hispanic-American low-income groups; three white middle-income groups) of mothers (N=101) of 2- to less than 5-year-old children to explore maternal attitudes, concerns, and practices related to child feeding and perceptions about child weight. We identified the following major themes from responses to our standardized focus group guide: 12 groups wanted to provide good nutrition, and most wanted children to avoid eating too many sweets and processed foods; 12 groups prepared foods their children liked, accommodated specific requests, and used bribes and rewards to accomplish their feeding goals (sweets were commonly used as bribes, rewards, or pacifiers); and 11 of 12 groups believed their children were prevaricating when they said they were full and mothers encouraged them to eat more. The common use of strategies that may not promote healthful weight suggests work is needed to develop culturally and socioeconomically effective overweight prevention programs. Further study is needed to verify racial/ethnic or income differences in attitudes, practices, and concerns about child feeding and perceptions of child weight. [PUBLICATION ABSTRACT] ATTITUDES, CHILDREN & YOUTH, WEIGHT, CHILD CARE, MOTHERS, WHITES, HISPANICS, AFRICAN AMERICANS, PUBLIC HEALTH

DIETARY INTAKE IN THE LOWER MISSISSIPPI DELTA REGION: RESULTS FROM THE FOODS OF OUR DELTA STUDY

CHAMPAGNE CATHERINE M; BOGLE MARGARET L; MCGEE BERNESTINE B; YADRICK KATHY

The lower Mississippi Delta region is highlighted inadequate food and nutrition intakes compared to other national surveys. Results indicate an area of concern pertaining to intakes of African Americans compared to whites, adults compared to children, and in low-income households. Percentages of adults meeting Daily Recommended Intakes noted significant differences for 15 nutrients. [PUBLICATION ABSTRACT] DIET, COMPARATIVE STUDIES, CHRONIC ILLNESSES, NUTRITION, AFRICAN AMERICANS, WHITES, ADULTS, CHILDREN & YOUTH

DIETARY INTAKE OF CHILDREN AT HIGH RISK FOR CARDIOVASCULAR DISEASE

KELLEY COLLEEN; KRUMMEL DEBRA; GONZALES ELIZABETH N; NEAL WILLIAM A; FITCH CINDY W

Cardiovascular disease and obesity begin in childhood, and dietary interventions to prevent them should be initiated then. We hypothesized that children who were at high risk for cardiovascular disease based on family history would have diets that were different than those of children from low-risk families. Two hundred ninety-seven children were screened for family history of early cardiovascular disease; had height, weight, and fingerstick total cholesterol measured; and filled out food frequency questionnaires. Sixty-eight (23%) children were at risk for cardiovascular disease. Cholesterol was significantly higher compared with those not at risk (4.71(+-)0.93 mmol/L vs 4.35(+-)0.92 mmol/L, P=.005). Intakes of energy, fat, fiber, and cholesterol were similar between groups. Children at high risk for cardiovascular disease were no more likely to meet guidelines for heart-healthy diets than were children at low risk. Families need guidance to change dietary patterns to prevent future disease. [PUBLICATION ABSTRACT] DIET, CHILDREN & YOUTH, CARDIOVASCULAR DISEASE, PREVENTIVE MEDICINE

GET INVOLVED AND MAKE A DIFFERENCE

EDGE MARIANNE SMITH

With its commitment to bringing key food, nutrition, and health initiatives and priorities to reality, American Dietetic Association (ADA) has seen a number of notable successes in the past year in the policy and advocacy realm. Edge states that all these successes came about because individuals were willing to get involved by paying personal visits to congressmen, writing letters, contributing to ADA's political action committee, and getting involved at the local, state, and national levels to make their voice and that of their profession heard. SUCCESS, POLITICAL ACTION COMMITTEES-PAC, ASSOCIATIONS, INITIATIVES, BILLS, PROFESSIONAL PRACTICE, COMMUNITY RELATIONS

INSULIN RESISTANCE SYNDROME: A POTENT CULPRIT IN CARDIOVASCULAR DISEASE

COULSTON ANN M; PERAGALLO-DITTKO VIRGINIA

Despite widespread dissemination of information, health care professionals often give inadequate attention to the cardiovascular disease (CVD) risks associated with the syndrome of insulin resistance, which is recognized as an important cause of glucose intolerance, an underlying defect in type 2 diabetes mellitus (T2DM). Here, Coulston and Peragallo-Dittko address questions like what can dietetics and nursing professionals do to prevent further metabolic deterioration, development of frank CVD, and T2DM in patients, in order to provide basic knowledge and direction for clinical care. CARDIOVASCULAR DISEASE, DIABETES, DIETITIANS, INSULIN, DIET, OBESITY, GLUCOSE, METABOLISM

INTERCOLLEGIATE STUDENT ATHLETE USE OF NUTRITIONAL SUPPLEMENTS AND THE ROLE OF ATHLETIC TRAINERS AND DIETITIANS IN NUTRITION COUNSELING

BURNS ROBERT D; SCHILLER M ROSITA; MERRICK MARK A; WOLF KAY N

A survey of university student athletes was conducted to determine supplement use, perceived efficacy of supplements, availability and use of nutrition services, and perceived nutrition knowledge of athletic trainers. Results from 236 athletes showed that 88% used one or more nutritional supplements, yet perceived efficacy was moderate (2.9 or less; 5-point scale). Classes (69.4%), brochures (75%), and individual counseling (47%) were available and were used by 29.9%, 33.2%, and 17.9% of athletes, respectively. Primary sources of nutrition information were athletic trainers (39.8%), strength and conditioning coaches (23.7%), and dietitians (14.4%). Athletes perceived athletic trainers to have strong nutrition knowledge (mean = 3.8(+-)0.9; 5-point scale). Many (23.5%) did not know whether a dietitian was available. Dietitians must accelerate their marketing efforts to student athletes, work closely with athletic trainers to provide sound nutrition information, and provide services that meet the needs of a diverse population of student athletes. [PUBLICATION ABSTRACT] ATHLETES, COLLEGE STUDENTS, DIETARY SUPPLEMENTS, SPORTS TRAINING, DIETITIANS, NUTRITION EDUCATION

POSITION OF THE AMERICAN DIETETIC ASSOCIATION: USE OF NUTRITIVE AND NONNUTRITIVE SWEETENERS

Sweeteners elicit pleasurable sensations with (nutritive) or without (non-nutritive) energy. Nutritive sweeteners (eg, sucrose, fructose) are generally recognized as safe (GRAS) by the Food and Drug Administration (FDA), yet concern exists about increasing sweetener intakes relative to optimal nutrition and health. Dietary quality suffers at intakes above 25% of total energy (the Institutes of Medicine's suggested maximal intake level). In the United States, estimated intakes of nutritive sweeteners fall below this, although one in four children (ages 9 to 18 years) can surpass this level. Polyols (sugar alcohols), GRAS-affirmed or petitions filed for GRAS, add sweetness with reduced energy and functional properties to foods/ beverages and promote dental health. Five nonnutritive sweeteners with intense sweetening power have FDA approval (acesulfame-K, aspartame, neotame, saccharin, sucralose) and estimated intakes below the Acceptable Daily Intake (level that a person can safely consume everyday over a lifetime without risk). By increasing palatability of nutrient-dense foods/ beverages, sweeteners can promote diet healthfulness. Scientific evidence supports neither that intakes of nutritive sweeteners by themselves increase the risk of obesity nor that nutritive or nonnutritive sweeteners cause behavioral disorders. However, nutritive sweeteners increase risk of dental caries. High fructose intakes may cause hypertriglyceridemia and gastrointestinal symptoms in susceptible individuals. Thus, it is the position of The American Dietetic Association that consumers can safely enjoy a range of nutritive and nonnutritive sweeteners when consumed in a diet that is guided by current federal nutrition recommendations, such as the Dietary Guidelines for Americans and the Dietary References Intakes, as well as individual health goals. Dietetics professionals should provide consumers with science-based information about sweeteners and support research on the use of sweeteners to promote eating enjoyment, optimal nutrition, and health. [PUBLICATION ABSTRACT] ARTIFICIAL SWEETENERS, NUTRITION, OBESITY

READINESS TO IMPLEMENT HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS IN IOWA SCHOOLS

HENROID DANIEL JR; SNEED JEANNIE

Henroid and Sneed evaluate current food-handling practices, food safety prerequisite programs, and employee knowledge and food safety attitudes and provide baseline data for implementing Hazard Analysis and Critical Control Point (HACCP) systems in school foodservice. Emphasis on implementing prerequisite programs in preparation for HACCP is needed in school foodservice. Training programs, both basic food safety such as ServSafe and HACCP, will support improvement of food-handling practices and implementation of prerequisite programs and HACCP. HAZARD ANALYSIS FOR CRITICAL CONTROL POINTS, SCHOOLS, FOOD SAFETY, FOOD SERVICE, FOOD PROGRAMS

SYSTEMATIC REVIEW OF LITERATURE ON THE COST-EFFECTIVENESS OF NUTRITION SERVICES

PAVLOVICH WENDY D; WATERS HUGH; WELLER WENDY; BASS ERIC B

Employers and health plan directors would like to know whether it is cost-effective to include outpatient nutrition services as a covered benefit. The purpose of this systematic review was to examine the strength of evidence on the cost-effectiveness of outpatient nutrition services from an economic perspective. All randomized controlled trials published between January 1966 and September 2001 that reported on costs and effectiveness of outpatient nutrition services for any indicated condition were identified and reviewed. Paired reviewers abstracted data from and assessed the quality of each eligible randomized controlled trial; 13 studies met the eligibility criteria. Relatively consistent evidence exists to support the cost-effectiveness of nutrition services in the reduction of serum cholesterol levels (eg, $20 to $1,268 per mmol/L decrease in serum low-density lipoprotein level), weight loss ($2.40 to $10 per pound lost), and blood glucose ($5 per mmol/L decrease), and for target populations with diabetes mellitus and hypercholesterolemia. However, the randomized controlled trials had important limitations and used different cost perspectives. Limited evidence of economic benefit exists to support coverage of outpatient nutrition services for selected indications. More randomized controlled trials of nutrition services should be conducted, taking into consideration all potential candidates for nutrition therapy and all potential costs to patients, providers, and payers. [PUBLICATION ABSTRACT] NUTRITION, OUTPATIENT CARE FACILITIES, BENEFIT COST ANALYSIS

MAINSTREAMING INTERNATIONAL OUTCOMES RESEARCH IN DIETETICS

TROSTLER NAOMI; MYERS ESTHER F

Dietetics counseling has similar clinical outcomes, health promotion, and quality of life objectives throughout the world. Trostler et al propose that the formation of professional alliances and research-based networks within and between the national and international dietetics profession and other health professionals will improve dietetics professionals' research activity, promote dialogue and exchange of knowledge and innovative ideas, and open professional boarders. DIETETIC COUNSELING, CLINICAL OUTCOMES, DIETITIANS, RESEARCH

AVOIDING MEDICAL ERRORS: JCAHO DOCUMENTATION REQUIREMENTS

PHILLIPS MICHAEL W JR

In today's hospitals and other health care settings, abbreviations, seen as useful shortcuts when writing prescriptions or documenting in the medical record, can lead to misunderstandings, that can result in misdiagnosis, improper medications dosage, or even death. As part of their ongoing efforts to improve patient safety, on Jul 18, 2003, the Board of Commissioners of the Joint Commissions on Accreditation of Healthcare Organizations approved their 2004 National Patient Safety Goals, which deal with such issues as identification of patients, medication safety, incorrect surgeries, and infection risks. MEDICAL ERRORS, ABBREVIATIONS, SAFETY, PATIENTS, HEALTH FACILITIES, PROFESSIONAL PRACTICE, DIETITIANS

NETWORKING: IT'S AN ART

STOKES D MILTON

Stokes states that networking is a reciprocal process that is mutually beneficial, where people share leads, ideas and information, and it enhances personal and professional lives and involves follow-up behaviors that create ongoing connections. Apart from studying the literature on networking, Stokes presents several suggested tips to get one started in networking. BUSINESS NETWORKING, PROFESSIONAL PRACTICE, DIETITIANS, PROFESSIONAL DEVELOPMENT

RECOGNIZING THE DIETETICS PROFESSION

WHITE JANE; IVENS BARBARA J

The American Dietetic Association (ADA) uses awards and certifications to recognize professional contributions and performance. Opportunities to serve the membership through elected or appointed office also provide recognition. However, unlike registration, certification or elected office, an award recognizes the individual's approach to the profession and is often not deliberately pursued. ADA aims to make ADA recognition more attractive and accessible to its members. DIETITIANS, AWARDS & HONORS, ASSOCIATION MANAGEMENT, PROFESSIONAL PRACTICE

NUTRIENT INTAKE OF KOREAN-AMERICAN, KOREAN, AND AMERICAN ADOLESCENTS

PARK SONG-YI; PAIK HEE-YOUNG; SKINNER JEAN D; SPINDLER AUDREY A; PARK HAE-RYUN

This study compared dietary intakes of Korean, KoreanAmerican, and American adolescents. Data were collected by 24-hour recall method from 471 Korean and 134 Korean-American adolescents. Data for American adolescents were obtained from NHANES III. Korean Americans had the lowest energy and cholesterol intakes but a higher percentage of energy from fat compared with Koreans. Korean and Korean Americans had lower intakes of calcium, iron, and zinc but higher sodium intake than Americans. Intakes of energy, folate, calcium, and iron in all three groups were below the recommended intakes for American adolescents. Korean Americans consumed cooked rice and Kimchi less often, but cookies, sweets, and soda were consumed more frequently than Koreans. These results indicate that Korean-American adolescents' dietary profiles are midway between those typical in Korea vs the United States. Nutrition education must focus on the benefits and weaknesses of Korean and western diets and how to blend the two cultures for optimal nutrition. [PUBLICATION ABSTRACT] TEENAGERS, NUTRITION EDUCATION, DIET, NUTRITION

MEETING THE CHALLENGES OF DIETETICS PRACTICE WITH EVIDENCE-BASED DECISIONS

VAUGHAN LINDA A; MANNING CAROLYN K

The practice of dietetics is, and always has been, characterized by change. As new data becomes available and new scientific theories are put forth, nutrition scientists and dietetics practitioners are faced with conflicting interpretations and, hence, practice-related controversies. Vaughan and Manning discuss how the evidence-based decisions are used to meet the challenges of dietetics practice. NUTRITION, DIETITIANS, PROFESSIONAL DEVELOPMENT

FOOD SECURITY STATUS OF HOUSEHOLDS IN APPALACHIAN OHIO WITH CHILDREN IN HEAD START

HOLBEN DAVID H; MCCLINCY MEGAN C; HOLCOMB JOHN P; DEAN KELLY L; WALKER CAITLYN E

This study measured food security and hunger of households involved in Head Start in a rural Appalachian county and assessed factors that could affect food security and hunger. A convenience sample of households with children enrolled in the Head Start program in Athens County, Ohio, were sampled (n=710), with adults from 297 (42%) households responding. The survey instrument included the 18-question US Household Food Security Survey Module for measuring hunger and food insecurity. Of those responding, 152 households (51.2%) were food secure and 145 (48.8%) were food insecure. Ninety (30.3%) had experienced hunger in the previous 12 months, and 41 (13.8%) households were classified as food insecure with childhood hunger. Hunger was related to a variety of household characteristics and associated with several factors, including participation in food banks, dependence on family members and friends outside of the household for food, lacking reliable transportation, and not having a garden. [PUBLICATION ABSTRACT] HOUSEHOLDS, HEAD START PROJECT, CHILDREN & YOUTH, FOOD SUPPLY

OBITUARY: LOUISE W. HAMILTON

An obituary for Louise W. Hamilton who passed away on Jun 3, 2003 is presented. During her career, Hamilton helped start the Pennsylvania Expanded Foods and Nutrition Education Program. She also held leadership positions in the Pennsylvania Dietetic Association, serving on numerous committees and as a delegate and president. DEATHS, DIETITIANS

DIETARY PATTERNS, SMOKING, AND SUBCLINICAL HEART DISEASE IN WOMEN: OPPORTUNITIES FOR PRIMARY PREVENTION FROM THE FRAMINGHAM NUTRITION STUDIES

MILLEN BARBARA E; QUATROMONI PAULA A; NAM BYUNG-HO; O'HORO CATHERINE E

Millen et al present a study that investigates the relationship between a heart-healthy dietary pattern and subclinical heart disease in women, and to identify potential opportunities for primary prevention. Women who achieve a heart-healthy eating pattern, in combination with the avoidance of smoking, have lower odds of subclinical heart disease. A public health priority for women to promote the primary prevention of heart disease is the adoption of positive lifestyle behaviors, especially healthful eating and the avoidance of eating. DIET, SMOKING, CARDIOVASCULAR DISEASE, WOMEN, NUTRITION EDUCATION, HEALTH RISK ASSESSMENT

POSITION PAPER UPDATE FOR 2004

Updates on the American Dietetic Association's (ADA) positions for the year 2004 are presented. The HOD Leadership Team approved one new position of the ADA: Providing nutrition services for infants, children, and adults with developmental abilities and special health care needs. NUTRITION, DEVELOPMENTAL DISABILITIES, CHILDREN & YOUTH, FOOD PROGRAMS