Comm Nutr Exam 2

Front 1

National Nutrition Policy

Back 1

nationwide guidelines which specify meeting nutritional needs of people

Front 2

What does the National Nutrition Policy address?

Back 2

Hunger, Malnutrition, Food safety, Food labeling, Food fortification, Sustainable agricultural practices, Nutrition research

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What are the elements of Nutrition Policy?

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1. Food assistance programs
2. National nutrition and health objectives
3. Dietary guidance systems
4. Monitoring and surveillance programs
5. Food labeling legislation

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Does the U.S. have a national nutrition policy?

Back 4

Yes and No

Yes - responsibility is divided among congressional committees, federal agencies, and major department

No - no single federal agency has mandate to handle national nutrition policy as its sole function

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What is the purpose of the National Nutrition Monitoring System?

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Purpose: To obtain the information needed to ensure the populations adequate nutritional status
Operated by: USDA and HHS
Before 1940s... 1/3 of all Americans were poorly fed.

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What is the NNMRRP?

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National Nutrition Monitoring and Related Research Program

Established in 1990 by CONGRESS to coordinate more than 50 surveillance activities that monitor the health and nutrition status of the general public as well as high risk groups.

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What are the goals of NNMRRP?

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1. Information on health status of population and quality of food supply
2. Analyze data
3. Identify high risk groups
4. Establish national baseline data to improve standards and methods
5. Improve agricultural policies

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What are the 5 basic areas monitored by the NNMRRP?

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1. Nutritional status and nutrition-related health measurements
2. Food and nutrient consumption
3. Food composition and nutrient databases
4. Knowledge, attitudes and behavior assessments
5. Food supply determinations

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What is the Ten-State Nutrition Survey?

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It was the first comprehensive attempt to assess nutrition status of U.S (1968-1970).
- FIRST study to show hunger and malnutrition in the U.S.
- Iron def. found in all groups (esp. African Americans)
- Low vitamin A in teens, Hispanics
- Protein def. in low-income groups
-Higher incidence among low-income and lower educated
- AA and Hispanics had higher incidence of multiple deficiencies
- Children and parents had similiar trends
- Poor were FATTER
- Dental caries prevalent

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What is the NHANES?

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National Health and Nutrition Examination Survey

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How does NHANES measure nutritional status?

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The NHANES method is used to assess nutritional risk of Americans

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How does the NHANES measure?

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1. Anthropometric data
2. Biochemical data
3. Clinical data
4. Dietary data

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NHANES I

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1971-1974
-20,000 sample, 65 sites
-7 nutrients analyzed
-Results: def. in protein, Ca, Vit A, Iron
-AA had lower values than whites

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National Status and Nutrition-Related Health Measurements (NHANES) Series

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-Representative sample of civilian noninstitutionalized pop ages 2 mos and older
-Dietary intake (one 24-hr recall)
-Body composition
-Biochemical analysis of blood and urine
-Bone density
-Dietary and health behaviors
-Collects data at household, family, and individual level

Front 15

NHANES II

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-1976-1980
-20,000 samples
-Results: Def in protein, Vit A, Thiamin, Riboflavin, Fe
-Tend towards increases in body fatness

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HHANES (Hispanic)

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1982-1984
-Mexican Americans, Puerto Rican, Cuban
-Ages 6 mo - 74 mo

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NHANES III

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1988-1994
-34000 sample of age 2 mos and older
-50% energy from CHO, 15% energy from Protein, 34% energy from FAT, 2% energy from ETOH
-Ca intakes BELOW recommendations for teens, women and elderly
-9/10 non-smokers were exposed to smoke at home or work
-1/2 of women of childbearing age consumed enough FOLATE
-1 in 4 teens consumed RDA for IRON

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CURRENT NHANES (since 1999)

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-CONTINUOUS
-2000: combine NHANES and CSFII into ONE survey called... NATIONAL FOOD AND NUTRITION SURVEY (NFNS)
-ANNUAL sampling of home interview and health exam

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What is the Nationwide Food Consumption Survey?

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-performed every 10 years by USDA
-dietary interview component of NHANES
-Family food consumption for a wk
-Individual for 3 days
-times of eating occasions/sources of food observed
-1987 survey assessed fiber, sat fat, mono fat, poly fat, chol
-found dietary adequacy was related to INCOME

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What were the results of the Nationwide Food Consumption Survey??

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-Deficiencies found in low income pop
-Fat intake > 30% of cals
-Sugar 10-15% of cals
-Chol intake > 400mg
THERE WAS NO IMPROVEMENT IN 1987 SURVEY RESULTS FROM 1977.

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What is the Continuing Survey of Food Intakes by Individuals (CSFII)-USDA

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-conducted in between larger surveys
-1989-96 - ALL PEOPLE SURVEYEDD
-24 HOURS RECALL and food diary

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What is the Total Diet Study? (FDA)-HHS?

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-8 age groups, infant through elderly
-Assessed for nutrients and contaminants in foods.
-daily intake of 11 nutrients
-pesticides and contaminants surveyed
-234 foods from urban areas analyzed annually

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What is the 5-A-Day?

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-Adults older than the age of 18
-Assessed fruit and veg. intake, knowledge, attitudes, and behaviors
-found fruit and veg intake LOWER than recommendations

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What is dietary knowledge, attitudes and behavior assessments?

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-To gather data on wt loss practices
- General public's knowledge about relationship diet to health problems
-Awareness among general public, physicians, nurses, and dietitians about risk factors of HIGH BLOOD CHOL and CHD
-Knowledge and attitudes about cancer prevention

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What are the types of surveys?

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1. Behavioral Risk Factor Surveillance System
2. Weight Loss Practices Survey
3. Youth Risk Behavior Survey
4. Diet and Health Knowledge Survey

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What is the Behavioral Risk Factor Surveillance System (BRFSS)?

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- a telephone survey of adults 10 years and older

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What does the BRFSS measure?

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-Demographic info
-Ht, wt
-Smoking, alcohol use
-Wt control practices
-Diabetes
-Prevention
-Cholesterol
-Fat, fruit, veggies consumption

Front 28

What is the National Nutrient Data Bank?

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-established in 1892
-Nutrient content of foods
-Published tables of food composition
-Computerized databases

Front 29

What is the USDA Nutrient Data Base for Standard Reference?

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- It was initiated in 1980
- Produced from National Nutrient Data Bank
- Includes data on food ENERGY, 28 food components, and 18 AMINO ACIDS for ~5,200 items
-MAIN SOURCE of data for USDA Survey Nutrient Data Base

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What is the USDA Survey Nutrient Data Base?

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- It is updated continuously
- Used for analysis of nationwide dietary intake surveys
- Includes data on food ENERGY and 28 food components for >7,100 items

Front 31

What are NRC's Nutrition Recommendations?

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1. Reduce fat <30% of TOTAL cals
2. Reduce sat fat <10% of TOTAL cals
3. Reduce chol to <300mg/day
4. Increase starches and complex CHO
5. Protein @ mod levels
6. Maintain healthy weight
7. If you drink, <1 oz al/day (prego women avoid)
8. Limit salt <6g/day
9. Enough Ca
10. Avoid nutr sup in excess
11. Fluoride rec.

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DRIs (Dietary Reference Intakes)

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- A set of values for the dietary nutrient intakes of healthy people in the US and Canada. Used by planning and assessing diets.
- Are major shifts from prevention of nutr def to prevention of chronic disease
- Include change in role of dietary supple in achieving good health

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What values do the DRI's include?

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-EAR
-Al
-RDA
-UL

Front 34

What is an EAR?

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- Estimated Average Requirement: intake value that is estimated to meet the requirement defined by a specific indicator of adequacy in 50% of a group of a certain age and sex.

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What is an RDA?

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- Covers nutrient needs of 97-98% of healthy individuals in a pop group
- EAR + 2 SD EAR

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What is AI?

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-Adequate Intake: NOT a standard, but it can be used as guide for the nutrient intake of individuals and groups in situations where no RDA for a nutrient has been established.
-EXCEEDS EAR and RDA

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What is the UL?

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-Tolerable Upper Intake Level: the maximum level of a daily nutrient intake that is unlikely to pose any risk of adverse health effects to nearly all for the individuals in the age and sex-specific group

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Food Group Plans:

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1916-5 food groups
1943-basic seven
1956-basic four
1992-Food Guide Pyramid
-adequacy, balance, moderation, energy control, variety
2005-MyPyramid.gov

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What are the Dietary Guidelines for Americans 2005?

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1. Consume a variety of nutrient-dense foods in all food groups and limi sat and trans fats, chol, added sugars, salt and alcohol.
2. Meet energy needs using USDA MyPryamid or Dash diet
3. Maintain a healthy body weight
4.To reduce wt, do so gradually by dec. food and bev cals and inc. physical activity
5. Engage in regular physical activity
6. Consume fruits and veggies each day
7. Consume enriched or whole-grain products daily
8. Consume 3 cups or FF or low-fat milk or milk products daily
9. Consume less than 2300mg of sodium per day
10. Drink in moderation
11. Avoid foodborne illnesses

Front 40

What are the goals of HP 2010?

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- 60% of adults will have a healthy wt by 2010
- Currently, less than 30%

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What is Policy Making?

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-A process by which authorities decide what actions to take to address a problem or set of problems.
(what the gov't intends to happen through its laws, regulations and programs)

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What is the 1st step in the process of PM?

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1. Agenda setting - Issues become a part of the public agenda by being considered by a legislature or court.

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What is the 2nd step in the process of PM?

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2. Policy Formulation of alternatives - Interest groups, coalitions, networks of experts and grassroots individuals interested in the problem can help with designing alternatives to be presented to the policy makers.

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What is the 3rd step in the process of PM?

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3. Policy Adoption - Tools and instruments are selected to achieve the policy goal - such as regulations, funding, tax breaks, gov't-sponsored programs
- This can occur on a local, state, or national level.

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What is the 4th step in the process of PM?

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4. Policy Implementation - Putting the policy into action after necessary modifications have been made for the target clientele
-This may involve a large # of people and organizations to carry out the process.

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What is the 5th step of the process of PM?

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5. Policy Evaluation - the impact of the policy and the processes by which it is being implemented are evaluated.

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What is the 6th step of the process of PM?

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6. Policy termination - diminishing of policy when...
1. when the public need was met
2. loss of political support
3. private agencies relieved the need

Front 48

Who makes policy??

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- Elected officials
- Employees of muncipal, st or federal agencies
- Members of Congress and state legislators
- Street level bureaucrats
- An organization's or committee's executives, administrators, committees

Front 49

What is the mission of the DHHS?

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-To promote, protect and advance the nation's physical and mental health.
-Public Health Services (PHS)

Front 50

What is the mission of the USDA?

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-Primarily food safety and food distribution
-Food and Nutrition Services

Front 51

What is apart of the MANDATORY spending (entitlements) of the Federal Budget?

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- makes up 2/3 of budget
- social security
- medicare
- SNAP
- Agricultural Subsidies
- Veteran's Benefits

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What is apart of the DISCRETIONARY spending of the Federal Budget?

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- 1/3 of budget
- Areas of defense
- Energy assistance
- Education
- Nutrition Assistance

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What is budget authorization?

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- establishes programs
- sets a ceiling on spending
- does not provide money

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What is budget appropriation?

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- provides money for programs

Front 55

Medical MNT Act of 2005

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- A bill that would expand medicare coverage for MNT sevices as the science proves it to be cost effective to prevent before more expensive treatment.
-Diabetes and Renal already covered!
- RDs and nutrition profs will be paid for their services!!!

Front 56

What are the strategies for Influencing the Political Process?

Back 56

-Political Action Committees (PACs)
-Lobbying
-Building coalitions

Front 57

What is a political action committee?

Back 57

- the "political arm" of interest group
- raises money to support candidates whose views are favorabley aligned with the group's missions and goals

Front 58

What is lobbying?

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- providing technical info to policy makes to help pass legislation

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What is a coalition?

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- joining with smaller groups to influence the political system