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The objective of the study was to determine the effectiveness of two nutrition education modules for use by food banks in a mobile kitchen for training of food service employees of feeding sites in remote areas. Demographic information and nutrition knowledge were assessed using two validated instruments. The modules included nutrition, use of the Food Guide Pyramid to select foods, and food safety. Mean post-test score differed significantly (p < 0.001) from mean pre-test scores. The retention test scores differed significantly from pre-test scores (p < 0.001), indicating that participants learned and retained knowledge over time. The study demonstrated a need for nutrition training for participants who use the food bank. Copyright © 2001 by Aspen Publishers, Inc. [ABSTRACT FROM AUTHOR]

Objectives: Comparisons of physical activity measured by accelerometers in overweight/obese adults and their normal-weight counterparts are limited. Compliance with the 2002 Institute of Medicine (IOM) exercise recommendations for 60 minutes of moderate-intensity exercise daily has not been reported. The purpose of this study was to compare physical activity, as measured by accelerometers, in overweight/obese adults vs. normal-weight controls and to assess compliance with recommendations for physical activity by the IOM in 2002 and by the Centers for Disease Control and Prevention and American College of Sports Medicine in 1995 for 30 minutes of moderate-intensity activity, preferably all days of the week., Research Methods and Procedures: Sixty-two overweight/obese subjects, BMI > or = 25, included 31 adults, 12 men and 19 women, 25 to 69 years old, and their normal-weight controls, BMI 18.5 to 24.9, matched for gender, age, and height. Body composition was assessed using DXA. Physical activity was measured with Actigraph accelerometers (MTI, Fort Walton Beach, FL) worn by each participant for 7 consecutive days., Results: Accelerometry data indicated that overweight/obese adults recorded approximately 60 counts per minute less per day and spent 21 minutes less engaged in moderate or greater intensity activity than their normal-weight counterparts. Although 71% to 94% of those studied met 1995 recommendations, only 13% of overweight/obese subjects and 26% of normal-weight participants met 2002 exercise recommendations., Discussion: These results suggest that daily minutes spent in moderate-intensity activity or greater are associated with weight status and that the 2002 IOM recommendations may be difficult to meet even for normal-weight individuals.

Objectives: To assess differences in dietary intake of overweight/obese subjects and sex-, age-, and height-matched controls and to identify dietary components associated with increased deposition of body fat., Design/subjects: A convenience sample of 52 overweight/obese and 52 normal-weight adults matched for sex, age (+/-1 year), and height (+/-1 inch) were recruited from the local area. Dietary intake was assessed with the Block 60-item food frequency questionnaire, physical activity was measured by the Yale Physical Activity Survey, and percent body fat was measured via dual-energy x-ray absorptiometry., Statistical Analyses Performed: Independent t tests compared between-group consumption of dietary components. The ability of dietary components to predict percent body fat before and after controlling for age-, sex-, and physical activity-related energy expenditure and other macronutrients was assessed with multiple regression analyses. Spearman correlation coefficients examined relationships among nutrients, Food Guide Pyramid servings, and percent body fat., Results: Overweight/obese subjects consumed more total fat, saturated fat, and cholesterol and less carbohydrate, complex carbohydrate, and dietary fiber than control subjects. Reported intake of dietary fiber was inversely related to percent body fat without (R(2)=0.052, P=0.02) and with (R(2)=0.045, P=0.013) control for potential confounding factors. Servings of fruit per day were negatively related to percent body fat (r=-0.40, P<0.01)., Conclusions: These findings suggest that the composition of a diet, especially low dietary fiber and fruit intake, plays a role in the etiology of obesity.

Stringent glycemic control reduces complications and health care costs for people with diabetes. This study assessed the effectiveness of a diabetes self-management training (DSMT) program at a community clinic. Education and a glucometer were provided to 70 people with type 2 diabetes in a 4-hour class, followed by individual dietitian consults and monthly support meetings. Most participants were Hispanic or African American with mean age of 49+/-10 years and mean body mass index of 34+/-9. Body weight, glycosylated hemoglobin (A1C), medications, and follow-up attendance were monitored. After 2 to 12 months of program participation, mean A1C improved from 9.7+/-2.4% to 8.2+/-2.0% (P<.001); 61% experienced positive medication outcomes. The cost of community clinic DSMT was approximately $280 per person per year, $185 for each point reduction in A1C. This study indicated that community clinic DSMT can improve glycemic control at modest cost.

Background: Provision of medical education that develops nutrition knowledge and self-efficacy is critical if physicians are to incorporate nutrition in preventive care. We studied the impact of a cardiovascular nutrition module on the knowledge, attitudes, and self-efficacy of fourth-year medical students and the relationship of these attributes to patient care practices., Methods: Based on national practice guidelines and learner needs, an educational intervention consisting of two web-based cases, pocket reference cards, and classroom discussion was developed and implemented. Knowledge, attitudes, and self-efficacy were measured at the beginning and end of the 4-week ambulatory care rotation for 40 control and 156 experimental students. Performance in patient care was approximated using a self-report; chart audits were performed for a subset of students., Conclusions: Knowledge scores of experimental students increased significantly from a mean of 10.3 to 14.4 (p<0.001), while the change for control students from 9.2 to 9.8 was not significant (p=0.20). The increase in self-efficacy scores from 26.2 to 35.7 in the experimental group (p<0.001) was twice that of the increase from 25.8 to 29.9 in the control group (p=0.001). Small but significant increases in attitude scores were similar for both groups. Limited data on student performance revealed that students with greater cardiovascular nutrition self-efficacy were more likely to address nutrition with cardiovascular patients., Conclusions: Incorporation of cardiovascular nutrition concepts in an ambulatory care rotation including use of computer-based cases improved student knowledge and self-efficacy, which may translate to increased frequency of future physicians addressing nutrition with patients.

The objective of this research project was to develop a useful, validated training manual to be used by supervisors in small foodservice operations and government-funded nutrition programs that do not have access to the services of a registered dietitian. The accuracy of the content was critiqued by an expert panel. The pilot phase was conducted at one congregate dining site to assess and revise problems involving evaluation design. The model phase evaluated the trainer's ability to use the manual and the worker's knowledge and performance as a result of training. Foodservice workers' scores after training were significantly higher than scores before training (p less than .01). Performance evaluations 4 weeks after training showed a significant positive change in work behavior (p less than .001) over evaluations before training. At 8 weeks a return to pretraining behavior was observed. The project showed that regular in-service training sessions conducted in short segments that are inexpensive and continuous would be valuable in any foodservice operation with limited access to dietitians. Benefits from such training include improved efficiency of food preparation and service, better quality of products produced, increased cost-effectiveness, and higher employee morale.