JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

A PRECEPTOR FOCUS GROUP APPROACH TO EVALUATION OF A DIETETIC INTERNSHIP

KRUZICH LAURIE A; ANDERSON JEAN; LITCHFIELD RUTH E; WOHLSDORF-ARENDT SUSAN; OAKLAND MARY JANE

Geographical dispersion of preceptors within dietetic internship programs creates educational challenges. Iowa State University's dietetic internship utilizes preceptors from more than 90 facilities statewide. Three preceptor focus groups were conducted to identify strengths and areas needing improvement in the internship, including preceptor and intern needs and expectations. Of the more than 90 preceptors representing medical nutrition therapy, foodservice management, and community nutrition, 36 were contacted and 18 preceptors participated, resulting in 5 to 7 participants per focus group. Emerging themes included effective feedback; preceptor networking; and communication between internship program/faculty, interns, and preceptors. Geographic isolation and minimal use of Internetbased resources may contribute to these themes. Whereas the majority of preceptors had access to the Internet, only 7 (38%) had accessed the Internetbased resources provided by the program. Preceptor suggestions can provide new perspectives for enhancing the learning environment. Regional workshops and email list-serves can help facilitate communication and networking among preceptors. EDUCATIONAL EVALUATION, FOCUS GROUPS, INTERNSHIPS, NUTRITION EDUCATION

A WORLD WITHOUT BOUNDARIES-AND OUR PLACE IN IT

EDGE MARIANNE SMITH

Clearly, trends toward preventive care and people's interest in achieving and maintaining overall healthy lifestyles are two of the most dramatic developments affecting dietetics in the last two decades. Dietitians have made great strides in adapting themselves to these developments, increasing their professional value, and aiding patients and clients in all walks of life. And in a world without boundaries, they are poised-and able-to do much more. DIETITIANS, PROFESSIONS, PUBLIC HEALTH

CONSIDERING OPPORTUNITIES IN HIGH-LEVEL MANAGEMENT

BROWN DAMON

Being a dietetics professional gives one access to a whole world of career choices, perhaps more than the average dietitian realizes. Perhaps one of the most interesting positions available to dietitians is working in high-level management at a food company. CAREERS, DIETITIANS, MANAGEMENT

DEMENTIA HISTORY, TYPE CAUSES EXPLAINED

CHERNOFF RONNI

As the population ages, the prevalence of cognitive impairment, known as dementia, will become an increasing burden on the health care system. While it may seem that the incidence of dementia is increasing, the reality is that older adults now have an extended life expectancy. The likelihood becomes greater that elderly individuals will demonstrate loss of cognitive ability the longer they survive. COGNITION & REASONING, DEMENTIA, MEDICAL DIAGNOSIS, OLDER PEOPLE

DID FAT INTAKE IN THE UNITED STATES REALLY DECLINE BETWEEN 1989-1991 AND 1994-1996?

CHANMUGAM PRITHIVA; GUTHRIE JOANNE F; CECILIO SALVADORE; MORTON JOAN F; BASIOTIS P PETER; ANAND RAJEN

The objectives of this study were to determine changes in fat and energy intakes in the United States between 1989-1991 and 1994-1996, and to examine the implications of expressing fat intake in grams vs as a percent of total energy intake. The source of data was the Continuing Survey of Food Intake by Individuals. The results suggest that intake of energy rose between the 2 time periods, primarily due to higher carbohydrate intake. There was also a modest increase in fat intake. However fat intake, as a percent of total energy, declined. The higher energy intakes were primarily from beverages, especially soft drinks, food mixtures, grain snacks, and pastries. The primary sources of higher fat intakes were meat mixtures, vegetables, and some categories of the grain group. Similar trends in the Food Supply Series suggested that the changes observed were not entirely due to changes in survey methodology. Because the increase in fat intake was masked by the increase in energy intake, we conclude that assessing trends in fat intake as a percent of energy consumption can be misleading, unless information on total energy and fat intake, in grams, is also provided. These preliminary findings should be interpreted cautiously until they are confirmed by formal secular trend analyses. DIET, OILS & FATS, NUTRITION

FIGHTING FAT IN LEAN TIMES

WATTS MARY LEE

Media coverage of obesity has grown exponentially in the last two years. Americans are experiencing a seemingly inexorable growth of girth-64% of adults and 15% of children are considered overweight or obese. Still, congressional attempts to address obesity remain thin. OBESITY, PUBLIC HEALTH

HEALTH LITERACY EDUCATION AND TRAINING: A STUDENT-PROFESSIONAL COLLABORATION

COTUGNA NANCY; VICKERY CONNIE E

A Healthy People 2010 objective is to improve the health literacy of persons with inadequate or marginal literacy skills. We designed a nutrition education module for dietetics students that allowed learning about health literacy while teaching this information to interested practitioners. Students designed a workshop for nutritionists by conducting a learning needs assessment and then developing learning objectives, content/ methods, and process/outcome objectives. Students presented interactive sessions on using literacy assessment tools and developing low-literacy education materials. Handout packets included a list of relevant literacy Web sites. Evaluations unanimously rated the workshop as excellent or good. By helping teach others, students' learning experience was enhanced. HEALTH EDUCATION, NUTRITION EDUCATION

HOW EFFECTIVE IS MEDICAL NUTRITION THERAPY IN DIABETES CARE?

PASTORS JOYCE GREEN; FRANZ MARION J; WARSHAW HOPE; DALY ANNE; ARNOLD MARILYNN S

Historically, there has been a lack of evidence-based outcomes research to document clinical effectiveness. Today, evidence is available for the effectiveness of medical nutrition therapy (MNT) in diabetes management. Evidence exists from randomized controlled trials, observational studies, and meta-analyses that MNT improves metabolic outcomes such as blood glucose and hemoglobin AIC in people with diabetes. CLINICAL OUTCOMES, DIABETES, DISEASE MANAGEMENT, NUTRITION

INTRODUCTION TO FOOD BIOTECHNOLOGY

Introduction to Food Biotechnology by Perry Johnson-Green is reviewed. Favorable book review. NONFICTION, FOOD SCIENCE, AGRICULTURAL BIOTECHNOLOGY

MACRONUTRIENT INTAKE OF BLACK AND WHITE ADOLESCENT GIRLS OVER 10 YEARS: THE NHLBI GROWTH AND HEALTH STUDY

KRONSBERG SHARI S; OBARZANEK EVA; AFFENITO SANDRA G; CRAWFORD PATRICIA B

This article examines overall levels and changes that occur in macronutrient (energy, carbohydrate, protein, and total, saturated, monounsaturated, and polyunsaturated fat) and cholesterol intake in girls over a 10-year period from childhood through adolescence; ethnic differences in these changes; adherence to NCEP recommendations; and sociodemographic associations with macronutrient intake. GIRLS, MINORITY & ETHNIC GROUPS, NUTRITION, TEENAGERS

NEW STUDIES: SOY APPEARS TO BENEFIT COGNITIVE FUNCTION

FILE SANDRA E

The first evidence that dietary soy might improve cognitive function came from a study in which ovariectomized female rats were fed a diet high in soy isoflavones for 10 months. A second study confirmed a positive effect of a life-long high soy diet in female rats, but found that the same diet impaired performance in male rats. An uncontrolled epidemiological study also provided some indication that a life-long dietary intake of soy might impair cognitive function in men. COGNITION & REASONING, DIET, NUTRITION, SOY PRODUCTS, STUDIES

NUTRIENT DATABASE FOR THE 2003 EXCHANGE LISTS FOR MEAL PLANNING

WHEELER MADELYN L

Since 1950, when the Exchange Lists for Meal Planning were first introduced, the lists of foods, serving sizes, and the average energy, carbohydrate, fat, and protein values for each list have been justified by nutrient databases. For the 2003 edition, the database was again updated and is presented here so that all nutrition professionals, other health professionals, and other interested persons have access. DATA BASES, DIET, NUTRITION

NUTRITIONAL ASSESSMENT OF ATHLETICS

Nutritional Assessment of Athletes edited by Judy A. Driskell and Ira Wolinsky is reviewed. Favorable book review. NONFICTION, NUTRITION, ATHLETES

POSITION OF THE AMERICAN DIETETIC ASSOCIATION: CHILD AND ADOLESCENT FOOD AND NUTRITION PROGRAMS

STANG JAMIE; BAYERL CYNTHIA TAFT

It is the position of the American Dietetic Association that all children and adolescents, regardless of age; gender; socioeconomic status; racial, ethnic, or linguistic diversity; or health status should have access to food and nutrition programs that ensure the availability of a safe and adequate food supply that promotes optimal physical, cognitive, and social growth and development. Appropriate food and nutrition programs include food assistance and meal programs, nutrition education initiatives, nutrition screening and assessment followed by appropriate nutrition intervention, and anticipatory guidance to promote optimal nutrition status. Malnutrition has been linked to delayed physical, psychosocial, and cognitive development and is now recognized as a major contributor to the growing problem of overweight and obesity in the child and adolescent population. Food and nutrition programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply and nutrition screening, assessment evaluation, and intervention. It is important that continued funding be provided for these programs, which have been consistently shown to have a positive impact on child and adolescent well-being. Food and nutrition programs will continue to serve not only as a means to combat hunger and food insecurity but also as a vehicle for nutrition education and promotion of physical activity designed to combat overweight and prevent chronic disease. It is the role of the credentialed dietetics professional to support permanent, adequate funding to food and nutrition programs, universal health-care reimbursement for nutrition services, and the use of research and surveillance programs to justify, evaluate, and improve these programs. In addition, the dietetics professional is responsible for serving as a nutrition resource to all groups and individuals working with children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits. CHILDREN & YOUTH, DIET, NUTRITION

RESEARCH AND THE DIETETICS PROFESSION: INITIATING UNDERGRADUATE STUDENTS INTO THE CULTURE OF RESEARCH

VAUGHAN LINDA

The following descriptions of student assignments offer examples of how undergraduates can be sequentially introduced to dietetics research. While these examples focus on nutrient metabolism and medical nutrition therapy, similar approaches can be used for courses in community nutrition, food production/service, and management. COLLEGE STUDENTS, DIETITIANS, HIGHER EDUCATION, RESEARCH

THREE MEASURES SHOW HIGH COMPLIANCE IN A SOY INTERVENTION AMONG PREMENOPAUSAL WOMEN

MASKARINEC GERTRAUD; BOBBINS CASEY; RIOLA BERNARD; KANE-SAMPLE LAUREN

The BEAN (Breast, Estrogen, and Nutrition) study is a 2-year nutritional intervention investigating the effects of soy on estrogens and mammographic density. Soy foods have been found to protect against breast cancer in some case-control studies, and a few short-term soy interventions have reported decreases in estrogen levels. Increased mammographic density, a predictor of breast cancer conferring a 4- to 6-fold risk of developing breast cancer, can be modified through dietary modification. Given the challenges of dietary change in a long-term intervention, we developed multiple strategies to increase adherence to the study regimen and implemented several measures of compliance. The objectives of this report are to describe the feasibility of incorporating soy in the diets of free-living women for an extended period of time and to compare three measures of compliance. DIET, NUTRITION, SOY PRODUCTS, WOMEN

USING FOCUS GROUPS TO DETERMINE WHAT CONSTITUTES QUALITY OF LIFE IN CLIENTS RECEIVING MEDICAL NUTRITION THERAPY: FIRST STEPS IN THE DEVELOPMENT OF A NUTRITION QUALITY-OF-LIFE SURVEY

BARR JUDITH; SCHUMACHER GERALD

As the first part of a multiphase process to develop a Nutrition Quality of Life (NQOL) survey, our objective was to identify items that later will be psychometrically evaluated for inclusion into the NQOL survey, a survey that can be used in routine practice to monitor the impact of medical nutrition therapy (MNT). At this time, dietitians may use the 50 questions to probe the impact of MNT on their clients' NQOL. However, psychometric and clinical testing will be necessary to further refine these items before the NQOL survey can be scored and used to measure the NQOL of patients at baseline, to monitor the impact of MNT over time, and to manage future MNT interventions by using an NQOL survey in a quality improvement program. FOCUS GROUPS, NUTRITION, POLLS & SURVEYS, QUALITY OF LIFE

STUDY EXPLORES LINK BETWEEN OBESITY, TECHNOLOGY

BROWN DAMON

Last spring Darius Lakdawalla and Tomas Philipson produced a theory looking at the connection between obesity and technology. Entitled 'The Growth of Obesity and Technological Change: A Theoretical and Empirical Examination,' the writers use mathematical equations, information from studies like the National Health and Nutrition Examination Survey (NHANES), and other resources to prove that as society has become more advanced, exercise has become more expensive and less available. OBESITY, STUDIES, TECHNOLOGY

NEW DIABETES NUTRITION RESOURCES

DALY ANNE; FRANZ MARION; HOLZMEISTER LEA ANN; KULKARNI KARMEEN

Advances in diabetes management and the variety of nutrition care services available to individuals with diabetes make this an exciting time for dietetics professionals to be working in the field of diabetes. Evidence supporting the effectiveness of medical nutrition therapy (MNT) for diabetes management continues to grow. These outcomes are highly significant. CLINICAL OUTCOMES, DIABETES, DISEASE MANAGEMENT, NUTRITION

FOCUS ON ALUMINUM: QUESTIONS & ANSWERS

Alumina (aluminum oxide) is one of the most abundant natural resources in the earth's crust. It is the third most common element after oxygen and silicon. It is frequently found in cans, foil, and cookware. It is widespread in food and water supplies because of its presence in soil, water, and air. There is no known biological function for aluminum but the adverse health effects of aluminum have received attention in two areas related to soy intake. One is infant health and the other is Alzheimer's disease (AD). ALUMINUM, DIET, NUTRITION

HOW CAN HIGH-DENSITY LIPOPROTEIN CHOLESTEROL LEVELS BE ELEVATED?

CUNNINGHAM ELEESE

To address this issue, one should begin with the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, Adult Treatment Panel III (ATP III), released in May 2001. The science supporting the ATP III report was summarized in the October Journal following its release and offers an update on nutrition for cardiovascular health. CHOLESTEROL, DIET, NUTRITION

EVALUATION OF THE SOUTH CAROLINA SENIORS FARMERS' MARKET NUTRITION EDUCATION PROGRAM

KUNKEL MARY ELIZABETH; LUCCIA BARBARA; MOORE ARCHIE C

The Seniors Farmers' Market Nutrition Program (SFMNP) provides vouchers to low-income seniors for use at local farmers' markets. This study was conducted to determine if SFMNP participants increased fruit and vegetable consumption. A total of 15,000 people from 13 counties received vouchers. A random sample of 1,500 received a follow-up survey, of which 658 (44%) were returned. Of the 98% of respondents who used the vouchers, 531 respondents (83%) did not purchase foods that they had never tried before, but 89% reported the intention to eat more fruits and vegetables year round because of the program. Farmers reported benefits from the program, have a positive attitude about it, and are w/lilling to make certain accommodations to participate in it again. The SFMNP is an effective method for increasing consumption of agricultural commodities from farmers' markets by low-income seniors and is worthy of continued funding. FARMERS MARKETS, LOW INCOME GROUPS, NUTRITION EDUCATION, OLDER PEOPLE

SOY AND MINERAL BIOAVAILABILITY

MESSINA MARK

Mineral bioavailability is a consideration regarding the impact of soyfoods on overall nutriture. Soybeans are quite high in iron but due to the inhibitory effects of phytate, which is present in soybeans in high amounts, and to a lesser extent soy protein, soybeans are not considered a good source of iron. However, new research suggests this conclusion may not be justified. IRON, NUTRITION, SOY PRODUCTS