Human Nutrition

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food programs for children

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Head Start
Child and Adult Food Care Programs
School lunch and breakfast
WIC (Women, Infants & Children)

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food programs for older adults

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Congregate Meal sites
Home Delivered Meals (HDM)

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Food Security and Health Care

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food stamps
Medicare/Medicaid

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Adult & Youth Education by CES (Cooperative Extension Services)

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EFNEP (Expanded Food & Nutrition Education Program)
FNP (Family Nutrition Program)
Youth & Family Programs
4-H

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Nutritional Epidemiology

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study of relation of food, nutrients, and meal patterns to health, disease, and mortality

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Work in/with environment families and organization to enhance and maintain wellness via:

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food distribution system, media, schools, churches, worksites, health policies

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Normal values of HDL

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>45mg %

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Normal values of LDL

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<100mg %

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Normal values of triglycerides

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100-150mg %

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Normal values of blood pressure

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<120/180

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Normal values of BMI

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18.5-25

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Normal total cholesterol to HDL ratio

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<4

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Normal values of fasting blood glucose

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80-100mg %

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Tertiary Prevention

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Rx & Rehabilitation
(medical care; very expensive)

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Factors that increase the prevalence of diabetes

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obesity
inactivity
type of diet
genetics

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Leading causes of death in 2006

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1. Heart disease
2. Cancer
3. Cerebrovascular disease

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Lifestyle/Risk Factors of Cancer

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high fat intake
alcohol
severe obesity

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Lifestyle/Risk Factors of Hypertension

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obesity
inactivity
low fruit/vegetable/dairy intake
alcohol
high sodium

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Lifestyle/Risk Factors of Osteoporosis

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high sodium
alcohol
smoking
low calcium and Vitamin D
eating disorders
low body weight

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Lifestyle/Risk Factors of Type 2 Diabetes

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obesity
inactivity
irregular meal patterns

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community assessment

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examine the community as a whole for how quality of life relates to health of community; ecological approach to using the bio-psycho-social model

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Socioeconomic Data

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education of head of household
Hollingshead Index
Orshansky Index

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Health Statistics

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infant mortality rate
prevalence of chronic diseases

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perceived needs

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identified by community or individual

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prescriptive needs

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identified by health professionals

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Four basic components of community nutrition and NCP

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Assessment
Diagnosis
Intervention
Monitoring & Evaluation

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Nutrition assessment directed toward

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poor growth
over-nutrition
nutritional deficiencies

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Characteristics of a good food guide

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Flexible and easy to use
Ensures nutrient adequacy
Related foods with similar nutrients grouped together
Groupings are culturally relevant

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Downsides of some food guides

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Group names show cultural preferences
Group combinations can de-emphasize important nutrients or food components
Often foods high in sodium, sugar, fat, or fiber are not emphasized
Not designed for adequacy of all micronutrients and food components

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Four Components of MyPyramid

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Variety
Proportionality
Moderation
Physical activity

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MyPyramid definition

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Individualizes eating and physical activity
Gives specific guides on types & amount of food based on gender, age, and physical activity
ONLINE ASSESSMENT

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SoFAAS

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Solid Fats, Alcohol, Added Sugars

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MyPyramid 1 oz meat equivalents

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1 oz lean meat, poultry, fish
1/4 c cooked dry beans
1 egg
2 T peanut butter
1/2 oz nuts/seeds

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MyPyramid dairy equivalents

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1 c milk
1/2 oz hard cheese
2 oz processed cheese
2 c cottage cheese
1.5 c ice cream
1 c yogurt

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MyPyramid fruit equivalents

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1 med apple, 1 c applesauce
1 banana, orange, peach
1 c 100% fruit juice
1/2 c dried fruit

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MyPyramid 1 c vegetable equivalents

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1 c cooked spinach or broccoli
1 c carrots
1 c corn, peas, cucumbers
2 c iceberg lettuce

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MyPyramid 1 oz grain equivalents

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1 mini bagel
3 c popcorn
1/2 c cooked rice or pasta
~1 slice bread
~1 c cereal

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MyPyramid recommendations based on 2,000 kcal diet

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5.5 oz meat
3 cups dairy
2 cups fruit
2.5 cups vegetables
6 oz grains (1/2 whole grain)

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Mediterranean FGP compared to MyPyramid

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2/3 more vegetables
1/5 more legumes
olive oil preferred
1/2 meat
1/2 milk
2x cheese
2x seafood

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Disappearance Data

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food divided by number of people
easy and less costly
most accurate data on ALCOHOL
does not indicate individual intake

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DHHS

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Anthropometric
Biochemical
Clinical
Dietary
24 hour recall

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TSNS

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Ten State Nutrition Survey
malnutrition in U.S.
first national survey to collect health and diet data

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NHANES

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every 2-8 years in trailers
non-institutionalized U.S. population

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NFCS

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3 days intake (1 recall, 2 records)
self-reports of height/weight and activity

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CSFII

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administered by USDA
2 recalls (in person then by phone)

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Integrated National Survey

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sample 5,000/year
2 recalls (1 trailer, 1 phone)
data on high risk groups often missing

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BRFS

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random phone interviews
source of all data on state rates of obesity

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YRBS

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Youth Risk Behavior Survey
Michigan = 3rd in obesity
62% of adults overweight/obese

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sources of Vitamin B6

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greens
meat
beans
fortified cereal
bananas

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sources of zinc

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meat
fish
poultry
nuts
seeds
whole grains
beans

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fiber

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average intake 12-15 g/day
(only half of recommended)

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daily recommendation for sodium

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<2300 mg

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daily recommendation for cholesterol

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<300 mg

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dietary assessment

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simple and inexpensive
valid, reliable, objective

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food recall

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24 hours
can do in groups
memory limits
doesn't require literacy

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food/diet record

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list all food and drink as you consume it for 3 days
requires literacy

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Food Frequency Questionnaire

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checklist of 60-100 foods
only tool for past intake
requires literacy

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diet history

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cheapest
only method for bingeing, purging, drinking, smoking

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weighted intake

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all food consumed is weighed

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Thrifty Food Plan

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basis for Poverty Index
affects eligibility for social welfare programs

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Paternalism

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"You have a problem. I can fix it for you."

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Moral Model

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"You have a problem. It's your fault. Here is some information to fix it."

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Enlightenment Model

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"Your problem is not your fault. You need outside help."

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Compensatory Model

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"You have a problem. You're responsible for making choices that lead to a solution."

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Knowledge, Attitudes, Behavior (KAB)

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earliest model & simplest
"I give you information. You change your attitude."

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Behavior Modification

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use limited to those motivated to change
SMART objectives
keep food records and evaluate after a week

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Health Belief Model (HBM)

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health service use
threat-->outcome-->behavior

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Theory of Reasoned Action or Theory of Planned Behavior

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attitudes
subjective norm
self-efficacy
external variables

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Social Cognitive (Learning) Theory

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individual factors+behavior+environment
no single cause

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Stages of Change/Trans-Theoretical Model

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precontemplation
contemplation
decision/preparation
action
maintenance