JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

FINDINGS AND PERSPECTIVES FROM THE FIFTH INTERNATIONAL CHRONIC DISEASE SYMPOSIUM

MESSINA MARK

Messina reviews some of the findings from the Fifth International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. Two areas-bone health and cognitive function-are discussed in detail. SOY PRODUCTS, SOYBEANS, CHRONIC ILLNESSES, MEETINGS, NUTRITION, NUTRITION EDUCATION

WHAT DO 'NET CARB,' 'LOW CARB,' AND 'IMPACT CARB' REALLY MEAN ON FOOD LABELS?

MARCASON W

Marcason answers the question regarding on what do net carb, low carb, and impact carb really mean on food labels. He describes that these phrases are not defined by the FDA and they were created by companies to give their products more shelf appeal, as consumers are not likely to have time or interest in the calculations of crude protein, total fat, moisture, and ash. DESCRIPTIVE LABELING, FDA APPROVAL, NUTRITION, DIETARY SUPPLEMENTS, CONSUMER PROTECTION

POSITION OF THE AMERICAN DIETETIC ASSOCIATION: PROVIDING NUTRITION SERVICES FOR INFANTS, CHILDREN, AND ADULTS WITH DEVELOPMENTAL DISABILITIES AND SPECIAL HEALTH CARE NEEDS

It is the position of the American Dietetic Association that nutrition services are essential components of comprehensive care for infants, children and adults with developmental disabilities and special health care needs. The association claims that nutrition services should be provided throughout the life cycle in health care, educational, and vocational programs in a manner that is interdisciplinary, family centered, community based and culturally competent. HEALTH CARE, NUTRITION, NUTRITION EDUCATION, DEVELOPMENTAL DISABILITIES, BABIES, CHILDREN & YOUTH, ADULTS

USING A VISUAL PLATE WASTE STUDY TO MONITOR MENU PERFORMANCE

CONNORS PRISCILLA L; ROZELL SARAH B

Two visual plate waste studies were conducted in 1-week phases over a 1-year period in an acute care hospital. A total of 383 trays were evaluated in the first phase and 467 in the second. Food items were ranked for consumption from a low (1) to high (6) score, with a score of 4.0 set as the benchmark denoting a minimum level of acceptable consumption. In the first phase two entrees, four starches, all of the vegetables, sliced white bread, and skim milk scored below the benchmark. As a result six menu items were replaced and one was modified. In the second phase all entrees scored at or above 4.0, as did seven vegetables, and a dinner roll that replaced sliced white bread. Skim milk continued to score below the benchmark. A visual plate waste study assists in benchmarking performance, planning menu changes, and assessing effectiveness. [PUBLICATION ABSTRACT] FOOD, MEALS, CONSUMPTION, NUTRITIONISTS

EFFECTS OF PROMOTIONAL MATERIALS ON VENDING SALES OF LOW-FAT ITEMS IN TEACHERS' LOUNGES

FISKE AMY; CULLEN KAREN WEBER

This study examined the impact of an environmental intervention in the form of promotional materials and increased availability of low-fat items on vending machine sales. Ten vending machines were selected and randomly assigned to one of three conditions: control, or one of two experimental conditions. Vending machines in the two intervention conditions received three additional low-fat selections. Low-fat items were promoted at two levels: labels (intervention I), and labels plus signs (intervention II). The number of individual items sold and the total revenue generated was recorded weekly for each machine for 4 weeks. Use of promotional materials resulted in a small, but not significant, increase in the number of low-fat items sold, although machine sales were not significantly impacted by the change in product selection. Results of this study, although not statistically significant, suggest that environmental change may be a realistic means of positively influencing consumer behavior. [PUBLICATION ABSTRACT] PROMOTIONAL PRODUCTS, VENDING MACHINES, SALES, INTERVENTION

OBESITY AND THE METABOLIC SYNDROME: IMPLICATIONS FOR DIETETICS PRACTITIONERS

BRAY GEORGE A; CHAMPAGNE CATHERINE M

The Metabolic Syndrome encompasses a set of laboratory and physical findings, including central adiposity, insulin resistance, hypertension, high triglycerides, and low HDL-cholesterol and several abnormalities in clotting and inflammatory markers. Using the definition provided by the Adult Treatment Panel III of the National Cholesterol Education Program, 24% of adult Americans have the Metabolic Syndrome. Central location of fat and release of fatty acids and cytokines from enlarged fat cells located in the intra-abdominal fat tissue provide the major agents that incite this syndrome. From a practical point of view, identifying dietary and lifestyle factors, including low levels of physical activity, are important in designing a diet and exercise program that can help individuals with the Metabolic Syndrome to reduce the associated detrimental health consequences. [PUBLICATION ABSTRACT] OBESITY, METABOLISM, DISEASE, DIETITIANS

ADDITIONAL SELF-MONITORING TOOLS IN THE DIETARY MODIFICATION COMPONENT OF THE WOMEN'S HEALTH INITIATIVE

MOSSAVAR-RAHMANI Y.; HENRY H.; RODABOUGH R.; BRAGG C.; BREWER A.; VOSBURG S.; FREED T.; KINZEL L.; PEDERSEN M.; SOULE C.O.

ADDITIONAL SELF-MONITORING TOOLS IN THE DIETARY MODIFICATION COMPONENT OF THE WOMEN'S HEALTH INITIATIVE

MOSSAVAR-RAHMANI YASMIN; HENRY HOLLY; RODABOUGH REBECCA; BRAGG CHARLOTTE

Self-monitoring promotes behavior changes by promoting awareness of eating habits and creates self-efficacy. It is an important component of the Women's Health Initiative dietary intervention. During the first year of intervention, 74% of the total sample of 19,542 dietary intervention participants self-monitored. As the study progressed the self-monitoring rate declined to 59% by spring 2000. Participants were challenged by inability to accurately estimate fat content of restaurant foods and the inconvenience of carrying bulky self-monitoring tools. In 1996, a Self-Monitoring Working Group was organized p additional self-monitoring options that were responsive to participant needs. This article describes the original and additional self-monitoring tools and trends in tool use over time. Original tools were the Food Diary and Fat Scan. Additional tools include the Keeping Track of Goals, Quick Scan, Picture Tracker, and Eating Pattern Changes instruments. The additional tools were used by the majority of participants (5,353 of 10,260 or 52% of participants who were self-monitoring) by spring 2000. Developing self-monitoring tools that are responsive to participant needs increases the likelihood that self-monitoring can enhance dietary reporting adherence, especially in long-term clinical trials. [PUBLICATION ABSTRACT] DIET, INTERVENTION, MEDICAL EQUIPMENT, FOOD PROGRAMS, CLINICAL TRIALS

NUTRIENT INTAKES AND FOOD CHOICES OF INFANTS AND TODDLERS PARTICIPATING IN WIC

PONZA MICHAEL; DEVANEY BARBARA; ZIEGLER PAULA; REIDY KATHLEEN; SQUATRITO CATHIE

Ponza et al examine the nutrient intakes, foods consumed, and feeding patterns of infants and toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Using the Statistical Analysis Software, they found out that infants participating in WIC were less likely than nonparticipants to have ever been breastfed or to be currently breastfeeding, and were more likely to be consuming formula. DIET, BABIES, NUTRITION, VITAMINS, BABY FOODS, FOOD PROGRAMS, BREASTFEEDING & LACTATION

SUCCESSFUL RECRUITMENT AND RETENTION STRATEGIES FOR A RANDOMIZED WEIGHT MANAGEMENT TRIAL FOR PEOPLE WITH DIABETES LIVING IN RURAL, MEDICALLY UNDERSERVED COUNTIES OF SOUTH CAROLINA: THE POWER STUDY

PARRA-MEDINA DEBORAH; D'ANTONIO ANGELA; SMITH SHARON M; LEVIN SARAH

We evaluated the feasibility of recruiting overweight adults with diabetes, living in rural, medically underserved communities, to a weight management intervention consisting of a 12-month clinical trial of two weight management programs and usual care. The sampling frame consisted of adults ages 45 years and older with clinically diagnosed diabetes from two community health centers. The recruitment process included medical record rescreening telephone call, two screening visits, and a randomization visit. Over 1,400 medical records were reviewed; 78.6% met eligibility criteria; 60.1% were contacted for telephone prescreening, and 35.5% remained eligible and were interested in participating. Of these, 187 completed visit 1, 164 completed visit 2, and 143 were randomized. Forty-six people were randomized who entered the study as walk-ins at screening visit 1, resulting in 189 subjects. The final yield was 21.5%. Subject mean age was 60.4 years, mean body mass index was 36.4 kg/m!sup 2!, 80% were African-American, and 46.6% had less than a high school education. Retention at 12 months was 81.5%. Successful strategies included partnering with community health centers, positive reinforcement and social supportiveness, monitoring progress, and free transportation. This work provides a useful example of an academic-community partnership designed to reach groups previously considered hard to reach. [PUBLICATION ABSTRACT] RECRUITMENT, RETENTION, WEIGHT CONTROL, DIABETES, CLINICAL TRIALS

A CALL FOR RESEARCH: WHAT WORKS WHEN TEACHING OLDER ADULTS TO IMPROVE THEIR NUTRITION PRACTICES?

HIGGINS MARY MECK

Benefits of nutrition education in controlling health care costs and safeguarding older adult's quality of life have received scant attention. Higgins claims that the study by Sahyoun et al makes a strong case that educational interventions can make a positive difference for older learners. Dietetics professionals would benefit if they collaborated in designing comprehensive studies, such as by working with those whose expertise is in evaluation. RESEARCH, TEACHING, ADULTS, DIETITIANS, NUTRITION EDUCATION

MEAL AND SNACK PATTERNS OF INFANTS AND TODDLERS

SKINNER JEAN D; ZIEGLER PAULA; PAC SUSAN; DEVANEY BARBARA

The prevalence of snaking and concerns about the quantity and nutritional quality of foods consumed by children and adolescents has increased in recent years. Skinner et al describe meal and snack patterns of infants and toddlers who participated in the Feeding Infants and Toddlers Study and identify transitions in these patterns before 2 years of age. They found out that in the average, infants and toddlers were fed seven times per day along with typical snack foods, including cookies, crackers, chips, and fruit drinks. DIET, BABIES, NUTRITION, BABY FOODS, SNACK FOODS, FOOD PROGRAMS

EVALUATION OF NUTRITION EDUCATION INTERVENTIONS FOR OLDER ADULTS: A PROPOSED FRAMEWORK

SAHYOUN NADINE R; PRATT CHARLOTTE A; ANDERSON AMY

This study was undertaken to identify nutrition interventions that could provide a basis for designing effective and measurable nutrition education programs for older adults. The authors conducted a literature search of articles published from 1990-2003 using Medline and Agricola. Key words were 'elderly,' 'older adults,' 'nutrition intervention,' and 'nutrition education.' Of 128 references identified, 25 studies included intervention and/or evaluation components and targeted adults over age 55 years. Although interventions tended to report limited success in behavior change, certain features had positive outcomes. These included limiting educational messages to one or two; reinforcing and personalizing messages; providing hands-on activities, incentives, cues, and access to health professionals; and using appropriate theories of behavior change. Based on these findings, a theoretical framework that includes these features but is set within a social and environmental context is proposed as a guideline for designing nutrition interventions for older adults. [PUBLICATION ABSTRACT] NUTRITION EDUCATION, ADULTS, INTERVENTION, WELLNESS PROGRAMS

PREVALENCE OF PICKY EATERS AMONG INFANTS AND TODDLERS AND THEIR CAREGIVERS' DECISIONS ABOUT OFFERING A NEW FOOD

CARRUTH BETTY RUTH; ZIEGLER PAULA J; GORDON ANNE; BARR SUSAN I

Dietary intake by infants begins with a liquid diet, a transition to complementary foods occurs in the latter six months, and, by 24 months, most children are consuming adult foods. Carruth et al determine the prevalence of infants and toddlers who were considered picky eater, the predictors of picky eater status and its association with energy and nutrient intakes, food group use, and the number of times that caregivers offered a new food before deciding their child disliked it. They found out that the percentage of children identified as picky eaters by their caregivers increased from 19% to 50% from 4 to 24 months. DIET, BABIES, NUTRITION, VITAMINS, BABY FOODS, VEGETABLES, FOOD PROGRAMS

DEVELOPMENTAL MILESTONES AND SELF-FEEDING BEHAVIORS IN INFANTS AND TODDLERS

CARRUTH BETTY RUTH; ZIEGLER PAULA J; GORDON ANNE; HENDRICKS KRISTY

Carruth et al identify ages at which gross motor developmental milestones and fine motor skills required for self-feeding were reported by primary caregivers and relate these self-feeding skills to energy and nutrient intakes. Self-feeding skills achieved in the first 2 years and details about age ranges at which developmental readiness to self-feed were evidenced are described. DIET, BABIES, NUTRITION, BABY FOODS, MOTOR ABILITY, FOOD PROGRAMS

HIGHER FAT INTAKE AND LOWER FRUIT AND VEGETABLES INTAKES ARE ASSOCIATED WITH GREATER ACCULTURATION AMONG MEXICANS LIVING IN WASHINGTON STATE

NEUHOUSER MARIAN L; THOMPSON BETI; CORONADO GLORIA D; SOLOMON CAM C

Neuhouser et al examine the associations of diet with acculturation among Hispanic immigrants from Mexico to Washington state and compare dietary patterns of Hispanic with non-Hispanic white residents. The results of the study showed that dietary patterns varied by ethnicity and acculturation status. Nutrition professionals should encourage their Hispanic clients to maintain their traditional dietary practices, such as high intake of fruits and vegetables and eating bread and potatoes without added fat. OILS & FATS, NUTRITION, DIET, HISPANICS, ALIENS, ACCULTURATION

TRANSITIONS IN INFANTS' AND TODDLERS' BEVERAGE PATTERNS

SKINNER JEAN D; ZIEGLER PAULA; PONZA MICHAEL

Beverage patterns of US youth are considerable concern to health professionals, owing to the increasing consumption of beverages that are high in calories and sugars and childhood obesity/overweight. Skinner et al describe transitions and patterns in infants' and toddlers' beverage intakes, with focus on nonmilk beverages. They found out that beverages provide 84% of total daily food energy for infants 4 to 6 months of age, decreasing to 36% at ages 19 to 24 months. DIET, BABIES, NUTRITION, BEVERAGES, BABY FOODS

FAMILY CAREGIVERS OF OLDER ADULTS ON HOME ENTERAL NUTRITION HAVE MULTIPLE UNMET TASK-RELATED TRAINING NEEDS AND LOW OVERALL PREPAREDNESS FOR CAREGIVING

SILVER HEIDI J; WELLMAN NANCY S; GALINDO-CIOCON DAISY; JOHNSON PAULETTE

Silver et al uses the stress process theory to be able to identify family caregiving variables that are salient to the experience of managing older adults' home enteral nutrition. The results of the study showed that caregivers of older adults on home enteral nutrition need training for multiple nutrition-related and caregiving tasks. CAREGIVERS, OCCUPATIONAL TRAINING, NUTRITION, OLDER PEOPLE, HOME HEALTH CARE

CONVINCING PATIENTS OF THE BENEFITS OF COMPLIANCE

THEDFORD KIMBERLY

According to Durose et al, knowledge of the recommended dietary restrictions and the medical consequences of non-compliance by patients on hemodialysis do not predict dietary compliance. This study adds to the current body of knowledge that verbal and written nutrition counseling do not necessarily achieve adherence among patients. DIET, RESTRICTIONS, PATIENT EDUCATION, HEMODIALYSIS

TODDLERS' TRANSITION TO TABLE FOODS: IMPACT ON NUTRIENT INTAKES AND FOOD PATTERNS

BRIEFEL RONETTE R; REIDY KATHLEEN; KARWE VATSALA; JANKOWSKI LINDA; HENDRICKS KRISTY

With the developmental changes from nine to 24 months of age, toddlers' dietary patterns change rapidly as the toddler transitions to the family diet. Briefel et al describe the differential changes in average intakes of nutrients and food groups among higher versus lower table food consumers during the transition from baby foods to table foods. They found out that the mean percentage of energy from table foods increased from 25% at 9 to 11 months to 63% at 19 to 24 months. DIET, BABIES, NUTRITION, BABY FOODS, VEGETABLES, FOOD PROGRAMS, BREASTFEEDING & LACTATION

KNOWLEDGE OF DIETARY RESTRICTIONS AND THE MEDICAL CONSEQUENCES OF NONCOMPLIANCE BY PATIENTS ON HEMODIALYSIS ARE NOT PREDICTIVE OF DIETARY COMPLIANCE

DUROSE CLAIRE LOUISE; HOLDSWORTH MICHELLE; WATSON VICKI; PRZYGRODZKA FRANCES

Durose et al investigates whether knowledge of the diet and medical consequences of noncompliance influences dietary compliance among patients on hemodialysis. Results of the study showed that more than one third of patients were noncompliant with at least one dietary restriction. Instead of the more traditional approach of information-giving, effective educational methods that focus on motivating patients to comply with dietary restrictions are needed to improve compliance. DIET, RESTRICTIONS, PATIENTS, HEMODIALYSIS

FEEDING INFANTS AND TODDLERS STUDY: IMPROVEMENTS NEEDED IN MEETING INFANT FEEDING RECOMMENDATIONS

BRIEFEL RONETTE R; REIDY KATHLEEN; KARWE VATSALA; DEVANEY BARBARA

Feeding patterns during infancy are important to growth and development and may affect preferences and eating habits later in childhood. Briefel et al aim to assess adherence to infant feeding recommendations among a sample of infants and toddlers four to 24 months of age in the United States. Using data from the Feeding Infants and Toddlers Study, they establish main outcome measures, including breastfeeding, timing of introduction of complementary foods, and adherence to infant recommendations. DIET, BABIES, NUTRITION, BABY FOODS, FOOD PROGRAMS, BREASTFEEDING & LACTATION

DEMOGRAPHIC AND HEALTH-RELATED CORRELATES OF HERBAL AND SPECIALTY SUPPLEMENT USE

GUNTHER SUSAN; PATTERSON RUTH E; KRISTAL ALAN R; STRATTON KAYLA L; WHITE EMILY

By broadening the definition of a dietary supplement, the 1994 Dietary Supplements Health and Education Act opened the market to many herbals, botanicals, and other food ingredients that would have otherwise needed safety testing before being sold. Information regarding patterns and correlates of herbal and specialty supplement use can help nutritionists understand which compounds are most commonly used, who are likely to use these supplements, and whether the choice of herbal supplements appears motivated by specific health concerns. DEMOGRAPHICS, DIETARY SUPPLEMENTS, FOLK MEDICINE, LEGISLATION

INTERNATIONAL DIETETICS

MOEN RONALD S; SHARP MARSHA

Moen and Sharp discuss this year's International Congress of Dietetics as an excellent opportunity to present the accomplishments and contributions of the profession in this region to the rest of the world, and for members of the American Dietetic Association (ADA) and Dietitians of Canada (DC) to learn from dietetics professionals from other countries. After this year's Congress, ADA and DC have plans to continue to focus on international issues through print materials, policy discussions, and continuing education events. DIETITIANS, CONFERENCES, NUTRITION

FEEDING INFANTS AND TODDLERS STUDY: WHAT FOODS ARE INFANTS AND TODDLERS EATING?

FOX MARY KAY; PAC SUSAN; DEVANEY BARBARA; JANKOWSKI LINDA

An understanding of food consumption patterns of very young children can help tailor advice and recommendations to guide parents in fostering healthy eating habits in their children. Using the data from the Feeding Infants and Toddlers Study, Fox et al describe the food consumption patterns of US infants and toddlers 4 to 24 months of age and provide insights into this pivotal dietary transition period. DIET, BABIES, NUTRITION, VITAMINS, BABY FOODS, VEGETABLES, FOOD PROGRAMS

NUTRIENT INTAKES OF INFANTS AND TODDLERS

DEVANEY BARBARA; ZIEGLER PAULA; PAC SUSAN; KARWE VATSALA; BARR SUSAN I

Devaney et al assess the nutrient adequacy of the diets of US infants and toddlers 4 to 24 months of age. Using the personal computer version of the Software for Intake Distribution Estimation, they estimated the percentage of infants and toddlers with usual intakes below the estimated average requirement and compared the means of usual nutrient intake distributions with adequate intake levels. Determining whether parents overreport foods consumed by infants and toddlers and whether infants and toddlers are consuming more energy than required are suggested. DIET, BABIES, NUTRITION, VITAMINS, BABY FOODS, BREASTFEEDING & LACTATION

FEEDING INFANTS AND TODDLERS STUDY: OVERVIEW OF THE STUDY DESIGN

DEVANEY BARBARA; KALB LAURA; BRIEFEL RONETTE; ZAVITSKY-NOVAK TERESA

A child's physical, cognitive, and emotional growth and development depend largely on how much and what type of foods are eaten and the timing of the introduction of different food items. Devaney et al describe the design, data collection procedures, and sample characteristics of the Feeding Infants and Toddlers Study (FITS). The usefulness of FITS, including providing data on the food and nutrient intakes, background characteristics, growth and development milestones, and effective feeding patterns, is emphasized. DIET, BABIES, NUTRITION, BABY FOODS, DATA COLLECTION, FOOD PROGRAMS, BREASTFEEDING & LACTATION

FITS: NEW INSIGHTS AND LESSONS LEARNED

DWYER JOHANNA T; SUITOR CAROL W; HENDRICKS KRISTY

Dwyer et al provide valuable, detailed, and timely information on the dietary intakes of US infants and young children. Here, they discuss the usefulness of the Feeding Infants and Toddlers Study, including planning the dietary intakes of infants and young children, developing better nutrition education materials, and recommending healthier feeding practices. DIET, BABIES, NUTRITION, VITAMINS, CHILD CARE, BABY FOODS, FOOD PROGRAMS

TEN SPECIFIC FINDINGS ON SOY AND HUMAN HEALTH

MESSINA MARK

The ten specific findings on soy and human health during The Fifth International Symposium on the Role of Soy in Preventing and Treating Chronic Disease are presented. Among other things, daidzein and equol (a bacterially derived metabolite of daidzein) levels in the prostate cancer of men after consuming soyfood were found to be approximately 6 and 13 fold higher than serum levels whereas genistein levels were approximately 50% lower. SOYBEANS, SOY PRODUCTS, NUTRITION EDUCATION, NUTRITION, CANCER, CHRONIC ILLNESSES

CDS EXAMINES SOY, HUMAN HEALTH

The Fifth International Symposium on the Role of Soy on Preventing and Treating Chronic Disease was held last fall in Orlando FL. For a decade this symposium has been the seminal gathering place for investigators and health professionals to discuss the latest research on the health effects of soyfoods and soybean constituents. NUTRITION EDUCATION, NUTRITION, SOY PRODUCTS, SOYBEANS, MEETINGS, CHRONIC ILLNESSES