Nutrition knowledge and food intake of seven-year-old children in an atherosclerosis prevention project with onset in infancy: the impact of child-targeted nutrition counselling given to the parents

OBJECTIVE: To compare nutrition knowledge and food intake in 7-y-old intervention and control children in an atherosclerosis risk factor intervention trial after 6.5 y of nutrition counselling given to the parents. DESIGN, SUBJECTS AND METHODS: Intervention families in the Special Turku Coronary Risk Factor Intervention Project received child-oriented nutritional counselling one to three times a year since child's age of 7 months, aimed at reduced saturated fat and cholesterol intake. Children's nutrition knowledge was analysed in a time-restricted cohort of 70 seven-y-old (34 boys) intervention children and 70 control children (40 boys) with a picture identification test. For comparison, children's food intake was evaluated using scores developed for the project that reflected quality and quantity of fat and quantity of salt in children's two or three 4-day food diaries recorded between 5.5 and 7 y of age. RESULTS: Child-targeted nutrition counselling of the intervention families only slightly increased intervention children's knowledge of heart-healthy foods (42.6% vs 34.9% correct answers by the intervention and control children, P = 0.057). Only < or = 20% of the children were able to adequately justify their answers in the test. The food diaries of the intervention children comprised more foods low in saturated fat and high in unsaturated fat than those of the control children (57.1% vs 41.7% of the maximum score for low fat foods, P = 0.0001; 48.9% vs 37.7% for high unsaturated fat foods, P = 0.0009, respectively), but the intervention and control children consumed similar amounts of low-salt foods (P = 0.23). Nutrition knowledge and food use scores correlated poorly (r = -0.20-0.35). CONCLUSIONS: Child-targeted nutrition counselling repeatedly given to the parents during and after child's infancy strongly influenced food choice scores of the 5.5-7-y-old children but failed to influence children's salt intake or scores in a nutrition knowledge picture test.     

Impact of nutrition counselling on nutrition knowledge and nutrient intake of 7- to 9-y-old children in an atherosclerosis prevention project

OBJECTIVE: To assess the impact of nutrition counselling given to 7.5- to 9-y-old children and their parents on children's nutrition knowledge and nutrient intakes. DESIGN AND SUBJECTS: The study children are participants in a prospective, randomised STRIP study (Special Turku Coronary Risk Factor Intervention Project for Children), whose aim was to decrease the intakes of saturated fat and cholesterol while increasing the intake of unsaturated fat in the intervention children from the age of 7 months onwards. Nutrition counselling was given only to the parents until the child's age of 7 y. Nutrition knowledge and nutrient intakes (total energy, total fat, saturated fat, unsaturated fat and sodium) were studied in a time-restricted cohort of 47, 7-y-old intervention and 51 control children. Thereafter, nutrition counselling was given both to the children and parents. Children's nutrition knowledge and nutrient intakes were measured again at the age of 9 y. RESULTS: Biannual nutrition counselling given to the intervention children and the parents maintained the differences in saturated fatty acid intake attained during the intervention given to the parents alone (11.5 vs 13.3 E% (percent of energy intake), at the age of 7 y, P<0.01; 11.1 vs 13.4 E% at the age of 9 y, respectively; P<0.01). The intervention children used more polyunsaturated fatty acids at the age of 9 y than the control children (5.7 vs 5.1 E%, P=0.05). At 7 y, the intervention and control children had similar nutrition knowledge scores (total knowledge score 12.9 vs 12.0, respectively, P=0.13). After 1.5 y of nutrition intervention, at 9 y, the intervention children's nutrition knowledge was higher than that of the controls (total nutrition score 16.5 vs 13.2, respectively, P<0.001) and the ability to explain the reasons for their picture choices in the nutrition knowledge test had increased. CONCLUSION: This study showed that only a relatively short period of counselling with low input is needed to increase in children's nutrition knowledge and ability to explain nutrition-related subjects if advice has first been given to the parents and if the parents have received reinforcement and concrete help with parent-child communication after their children have been involved in the counselling. The differences attained in nutrient intake could also be maintained.     

营养指导对妊娠期营养和妊娠结局的影响

目的评价妊娠期营养指导效果,探讨妊娠期营养对妊娠结局的影响。方法对73例经过营养门诊定期营养指导的孕妇和48例同期未经过营养指导的孕妇妊娠晚期膳食营养状况、外周血微量元素水平、妊娠结局进行比较。结果观察组孕妇膳食营养比较均衡,血液钙、镁、铜、铁水平高于对照组,新生儿平均出生体重高于对照组,胎膜早破、妊娠期高血压疾病、贫血的发生率低于对照组。结论妊娠期营养指导可以改善孕妇营养状况,促进胎儿生长发育,减少围生期并发症。     

Dietary patterns and nutrient intakes of 7-year-old children taking part in an atherosclerosis prevention project in Finland

OBJECTIVE: To evaluate the dietary patterns of 7-year-old children participating in an atherosclerosis prevention project and the relationship of those dietary patterns to nutrient intakes and serum cholesterol values. DESIGN: In the randomized, prospective Special Turku Coronary Risk Factor Intervention Project (STRIP) 1,062 children were randomly assigned to an intervention group (n=540; low-saturated fat, low-cholesterol diet) or to a control group (n=522; unrestricted diet) at 7 months of age. SUBJECTS/SETTINGS: The intervention families received, at 6-month intervals, individualized counseling that focused on the known environmental atherosclerosis risk factors and aimed at reducing children's saturated fat and cholesterol intake. Nutrition counseling was targeted at the child but, because of the young age of the children, was given to the parents. When children were 7 years old, food and nutrient intakes of 307 intervention and 323 control children were studied using 4-day food records. STATISTICAL ANALYSES PERFORMED: K-means cluster analysis was used to classify children into 4 groups on the basis of similarity of food intake. Differences in nutrient intakes and serum lipid concentrations between children in the 4 food intake clusters were evaluated using Tukey's multiple comparison test. RESULTS: Intervention children dominated the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster whereas the 1.5%-fat milk and butter cluster included mainly control children. Saturated fat intake was nearest to the recommendations, that is 11.7% and 11.9% of energy, in the bread, skim milk, and margarine cluster and the cereals, rice, and pasta cluster, respectively. Children in the bread, skim milk, and margarine cluster had 20% to 27% higher fiber intakes (P<.001) whereas children in the sugar and sweets cluster had markedly higher sugar intakes than children in other clusters (P<.001). Serum cholesterol concentrations were lower in those clusters with high dietary ratios of polyunsaturated to saturated fat. CONCLUSION: Detailed and repeated dietary counseling of parents, starting when children are aged 7 months, that aims at decreasing children's exposure to known nutrition risk factors for coronary heart disease modifies children's food patterns and nutrient intakes toward expected values.     

Nutrient intake of institutionalized developmentally disabled individuals: impact of the nutrition knowledge of paraprofessionals

The role of the caretaker in enhancing nutrient intake of developmentally disabled individuals living in an institutional setting was examined. Eighty developmentally disabled residents living at the Western Carolina Center, Morganton, NC, were assessed for anthropometric measurements and for dietary intake, with a 3-day plate waste study. Seventy paraprofessionals/feeders working at the same center were assessed for knowledge of nutrition and food practices and participated in a series of inservice programs on nutrition. Pretest and post-test scores for knowledge of nutrition and food practices were determined. For the paraprofessionals/feeders, inservice programs on nutrition resulted in increased knowledge of nutrition but did not increase the nutritional quality of their own diets. However, statistically significant differences were noted in residents' diets for calories (p less than .05), iron (p less than .05), and niacin (p less than .05) attributable to the inservice programs on nutrition.     

Long-term effects of dietary counselling on nutrient intake and weight loss in obese children

The effects of dietary counselling on food and nutrient intake and weight loss were studied over a two-year period in 32 obese children (relative weight greater than 120%) with intensive treatment (Group I) and in 16 obese children treated in a school health-care setting (Group II). The control group (Group III) comprised 29 normal-weight children (relative weight less than 120%). The children were 6-16 years old. The obese children were treated for one year and observed for another year. Food consumption data were collected by a four-day food record method. At baseline there were no differences in food consumption or nutrient intake between obese and normal-weight children. During treatment the children in Group I reduced their mean daily fat intake (P less than 0.001) and this reduction was maintained throughout the observation period. In Groups II and III no change was observed in mean daily fat intake. The relative body weight decreased by 16.2% in Group I (P less than 0.001) during the first year and the lower body weight was maintained during the observation year. No significant weight reduction was observed in Group II. The decrease in energy intake was significantly correlated with the reduction in body fat mass over the first year (rs = 0.50; P = 0.05, n = 16) in obese children passing through their pubertal growth spurt and to the reduction in relative weight over the first year (rs = 0.90; P less than 0.05, n = 5), as well as to the decrease in fat mass over the second year (rs = 0.70; P less than 0.05, n = 11) in adolescents beyond their growth spurt. In conclusion, intensive treatment resulted in decreased fat intake and also led to a reduction in relative weight, whereas a conventional approach appeared to be ineffective with regard to nutrient intake and weight loss.     

Impact of dietary counselling on nutrient intake during pregnancy: a prospective cohort study

The aim of this study was to assess the impact of dietary counselling combined with the provision of food products on food and nutrient intake in pregnant women. We carried out a prospective cohort study of healthy and atopic pregnant women (n 209), who were randomized into dietary intervention and control groups. The intervention group received dietary counselling and food products to modify the fat composition of their diet to meet current recommendations. Three-day food records were collected during each trimester of pregnancy. Women in the intervention group consumed more vegetables, fruits, soft margarines and vegetable oils and less butter than those in the control group during the course of pregnancy (P<0.05). The main distinction between the groups in nutrient intake over the pregnancy was attributable to a higher energy intake (% energy) of PUFA by 0.5%energy (95% CI 0.1, 0.8) and to a lower intake of SFA by 0.8 % energy (95% CI -1.4, -0.4) in the intervention group. Dietary intake of vitamin E was 1.4 mg (95% CI 0.6, 2.2), folate 20.9 microg (95% CI 0.8, 41.0) and ascorbic acid 19.8 mg (95 % CI 3.5, 36.0) higher in the intervention group compared to the controls, while no differences in other nutrients were detected. Dietary counselling combined with the provision of food products during pregnancy is of importance in modifying food and nutrient intake, with potential health benefits.     

Adolescents living in boarding houses in Nsukka,Enugu State,Nigeria I: Meal patterns,nutrition knowledge and nutrient intake

The meal patterns, nutrition knowledge and nutrient intake of 287 secondary school adolescents aged 13–18 years, living in boarding houses were determined. The meal patterns and nutrition knowledge were determined by questionnaire. The dietary intake study was conducted on 50 adolescents over a 7‐day period and nurient intake calculated from the nutrient composition of foods consumed. Ninety‐two per cent (92%) of the adolescents depended on both school meals and snacks. About 87% skipped school meals at some time. Meal skipping depended on such factors as availability of money to purchase snacks, availability of food in adolescent's locker, school regulations regarding school meals, the quality of food served and the adolescents attitude towards certain foods. The most popular snacks were “Okpa”, a pudding made from bambara groundnut (Voandaeia subterranea) and soaked “garri” (fermented cassava product) with or without groundnuts. The energy and calcium intake (337–398 mg/d) for both sexes were below FAO/WHO standards. The energy intake of the male adolescents (35–37 kcal/kg) was higher than that of the female adolescents (28–30 kcal/kg). However, anthropometric indices showed that the female adolescents had better nutritional status compared to their male counterparts. Intakes of protein and iron were above FAO/WHO standards but were marginal for phosphorus. The adolescents had a fair nutrition knowledge with a percentage mean score of 56.1 ± 14.5. However, nutrition knowledge was not significantly related to nutrient intake.     

Impact of nutrition education on food and nutrient intake of pregnant women

Researchers compared data on 33 pregnant women attending nutrition education classes regularly over a 13-week period (nutrition education group) with data on 33 other pregnant women who did not receive such education (controls) to examine the impact of nutrition education on the pregnant women's food and nutrient intake. The 66 pregnant women were selected from two hospitals and two urban family welfare centers in Ludhiana city, India. All were from the low socioeconomic group (i.e., per capita income of Rs. 369/month). A dietary survey was conducted at 20 weeks gestation and again at 36 weeks gestation. At 20 weeks, the two groups were not statistically different. The intake of cereals, pulses, green leafy vegetables, fats and oils, and sugar and jagger were lower than the recommended daily intake (RDI). On the other hand, intake was more than RDI for milk and milk products, other vegetables, and roots and tubers. Except thiamine and ascorbic acid, intake of nutrients was inadequate. In both the nutrition education group and the control group, nutrient intake was higher at 36 weeks than at 20 weeks due to the increased food requirements of pregnancy. Women in the nutrition education group were more likely than the control group to consume more protein, vitamin A, thiamine, folic acid, and vitamin C. This likely reflects a higher consumption of pulses, milk and milk products, fruits, and vegetables as well as adopting favorable nutritional practices (e.g., use of sprouted grains). Nevertheless, intake was below RDIs for many nutrients, even for women in the nutrition education group. These findings suggest that nutrition education for pregnant women does improve nutrient intake but also that more needs to be done to bring intake levels up even higher.     

Dietary patterns and nutrient intake of adult women in south-east China: a nutrition study in Zhejiang province

This study documents the dietary patterns and nutrient intake of 652 adult women living in south-east China. Compared with data from previous national surveys and other nutrition studies in China, the results show different dietary patterns. The major differences include a greater consumption of vegetables, fruits and animal foods, but a lower consumption of cereal and tuber foods. The mean daily nutrient intakes of the urban women met the Chinese recommended dietary allowances. However, the situation was different in rural areas, where women had lower mean intakes of vitamins and minerals. There were also significant differences in dietary pattern and food consumption between these two groups of women. Further improvements in dietary intake for those residing in the south-east rural areas of China are needed.     

Pre-admission education/counselling for patients undergoing coronary angioplasty: impact on knowledge and risk factors

This study aimed to evaluate whether a pre-procedural education/counselling program can improve knowledge and coronary risk factors in 130 patients (65 experimental; 65 comparison) approximately four months after having percutaneous transluminal coronary angioplasty (PTCA). Knowledge and physical activity levels (p=0.00) improved for both groups from pre-PTCA to the follow-up. Further, the experimental group showed favourable change in total cholesterol level (p=0.02) at follow-up. That participation in the intervention did not improve knowledge or risk factor prevalence may reflect the adequacy of standard ward care, the influence of factors not under the control of the study or the overall experience of PTCA. Limitations of educational programs without follow-up sessions are discussed and alternate rehabilitation approaches suggested.     

The nutrient intake of elderly men living alone and their attitudes towards nutrition education

Aims: A cross-sectional study was undertaken among elderly men living alone in Sunderland to (1) assess their dietary intake and food habits, (2) to identify factors which influence their food choice, and (3) to investigate perceived needs regarding nutrition education activities. Methods: A random sample of 66 men, aged 70 years and over was drawn from members of luncheon clubs ( n =33) and residents of sheltered housing accommodation ( n =33). Dietary intake was assessed using a validated semi-quantified food frequency questionnaire (FFQ). Results: Intake of all nutrients, with the exception of energy, vitamin D and fibre was adequate. Almost half of the subjects (47%) had energy intakes below the EAR, and the majority tended towards underweight, as indicated by the age-adjusted reference standards for BMI. Taste and enjoyment were the factors which most influenced food choice. The main identified source of nutrition information was the media, followed by relatives and friends. Only half of the subjects perceived that they would benefit from nutrition education and 58% reported a willingness to participate in such activities if they were available. Conclusion: The findings suggest that although most subjects were aware of the role of dietary factors in the maintenance of an optimal health status, this age group is not a receptive audience for nutrition education activities. The targeting of elderly men living alone presents a challenge to nutrition educators.     

Parental smoking and the nutrient intake and food choice of British teenagers aged 16-17 years.

STUDY OBJECTIVE: To examine the association between parental smoking habits and the nutrient intake and food choice of teenagers aged 16-17 years, allowing for differences in teenage smoking and the social class and regional distribution of the participants. DESIGN: Data were collected from the 1970 longitudinal birth cohort, cross-sectionally at 16-17 years. The smoking habits of teenagers were evaluated from a questionnaire completed by the subjects themselves, and the smoking habits of parents by interview. The nutrient and food intakes of teenagers were quantitatively assessed using a four day unweighed dietary diary. SETTING: The participants were distributed throughout Britain. PARTICIPANTS: A subsample of 1222 males and 1735 females was isolated from respondents to the 1970 birth cohort 16-17 year data collection sweep undertaken in 1986-87. MAIN RESULTS: Parental smoking habits were associated with different dietary patterns among teenagers regardless of whether the teenagers themselves smoked. Dietary differences noted were similar to those observed previously among smokers, with lower intakes of fibre, vitamin C, vitamin E, folates, and magnesium in particular reported among both males and females in households where parents were smokers. These lower intakes were associated with lower intakes of fruit juices, wholemeal bread, and some vegetables. CONCLUSION: Teenagers who lived with parents who smoked had different nutrient and food intakes to those with non-smoking parents, and teenagers exposed to parental smoking appeared to have similar dietary patterns to teenagers who themselves smoked.