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Using content analysis, this study evaluated the aging content and context in 11 nutrition sub-specialty textbooks: community nutrition (n = 3), diet therapy (n = 4), and nutrition and aging (n = 4). Pages with paragraphs on aging were identified in community nutrition and diet therapy textbooks, and 10% random samples of pages were evaluated in nutrition and aging textbooks. Paragraphs were assigned to one of four categories: gerontology, nutrition as primary, nutrition as secondary, or tertiary prevention. A total of 310 pages was qualitatively analyzed using NUD*IST 5 software and quantitatively with percentages. Only 7% of community nutrition and 2% of diet therapy pages were devoted to aging. There was little integration of aging beyond the chapters on aging. Community nutrition had the most gerontology (30%) and primary prevention (43%) content. Diet therapy and nutrition and aging had more secondary prevention (33% and 42%, respectively) and tertiary prevention (27% each) content. Some important databases and studies were absent. Of the 1,239 ageism words, 10% were positive, 53% neutral, and 36% negative. Photographs were generally positive. Women, but not minorities, reflected current older adult demographics. Future textbook editions should address aging more comprehensively and positively to better prepare dietitians for the job market. Recommendations for authors, course instructors, and publishers are given. (Contains 5 tables.)

We challenge the suggestion of Congress that the Older Americans Act (OAA) Nutrition Program should provide multivitamin-mineral supplements (MVMs) in addition to meals. MVMs are not a quick fix for poor diets. They do not contain calories, protein, essential fatty acids, or fiber, nor do they adequately address nutritional gaps of some vitamins and minerals. Older adults with chronic health conditions who take multiple medications are at greater risk than the general healthy population for nutrient-drug interactions and toxicity. The OAA Nutrition Program is not an appropriate venue to indiscriminately distribute MVMs, because there is insufficient evidence of their benefits and safety. The program's limited funds and efforts should instead be directed to nutrient-dense healthy meals, quality food service, and greater accessibility to individualized nutrition services.

Objectives. We assessed outcomes of an integrated nutrition and exercise program designed for Older Americans Act Nutrition Program participants as part of the Administration on Aging's You Can! campaign. Methods. A 10-site intervention study was conducted. Preintervention and postintervention assessments focused on nutrition and physical activity stages of change, self-reported health status, dietary intakes, physical activity, and program satisfaction. Results. Of 999 enrollees, the 620 who completed the program were aged 74.6 years on average; 82% were women, and 41% were members of racial/ethnic minority groups. Factors associated with program completion were site, health conditions, and nutrition risk. Seventy-three percent and 75% of participants, respectively, made a significant advance of 1 or more nutrition and physical activity stages of change; 24% reported improved health status. Daily intake of fruit increased 1 or more servings among 31% of participants; vegetables, 37%; and fiber, 33%. Daily steps increased 35%; blocks walked, 45%; and stairs climbed, 24%. Program satisfaction was 99%. Conclusions. This easy-to-implement program improves diets and activity levels. Local providers should offer more such programs with the goal of enabling older Americans to take simple steps toward successful aging. doi:10.2105/AJPH.2006.090522

This survey of 84 case managers (CMs) (88% response rate) in 11 south Florida hospitals, in one for-profit health care system, sought to identify their discharge planning concerns regarding the food and nutrition needs of older patients, how they addressed these concerns, and the degree to which registered dietitians (RDs) were involved. Most CMs were female (82 of 84, 98%), older than age 40 (59 of 84, 70%), and were registered nurses (51 of 84, 61%). Almost all (82 of 84, 98%) reported job barriers, including excessive patient loads and responsibilities and limited community services. Almost all said that nutrition-related diseases and factors (eg, chewing/swallowing problems, poor appetite, modified diets, poor dentition) strongly influenced discharge planning. Many perceived community nutrition resources (eg, congregate meals, food stamps, shopping assistance, outpatient dietitians) as not readily available. While physicians, nurses, social workers, and physical therapists were identified as very important in discharge planning, RDs were not; almost half of CMs consulted them infrequently, if at all. Strategies for the six nutrition-related case scenarios were inconsistent. Home-health agencies were chosen most often and outpatient RDs least often. Comprehensive discharge planning must include more attention to nutrition with greater input from clinical, outpatient, home health, and community RDs through, for example, attendance at hospital discharge planning rounds, inservices for CMs, and better marketing of RD services. More RDs can and should become CMs to help serve the number of older adults with nutrition-related chronic conditions. J Am Diet Assoc. 2005;105:603-607.

Objective: To gather information from survivors on the effects that the Holocaust had on their current attitudes toward food. Design: Qualitative study: one-on-one semistructured interviews with a script shaped by a pilot study. Setting: South Florida homes and community sites, including the Miami Beach Holocaust Memorial. Participants: Convenience sample of 25 Holocaust survivors: 14 men, 11 women; ages 71 to 85 years. Phenomenon of Interest: Current attitudes toward food in relation to Holocaust experiences. Analysis: Themes and illustrative quotations from transcriptions of audiotaped interviews. Results: Food attitudes were influenced by Holocaust experiences. Five themes emerged: (1) difficulty throwing food away, even when spoiled; (2) storing excess food; (3) craving certain food(s); (4) difficulty standing in line for food; and (5) experiencing anxiety when food is not readily available. Empathy for those currently suffering from hunger was also reported. Conclusions and Implications: Food-related issues from the Holocaust remain for survivors. Now in their 70s and 80s, many use health care and related services. Nutritionists, educators, and health professionals should be aware of such issues. Food and nutrition programs should minimize uncomfortable food-related situations for Holocaust survivors and others who experienced food deprivation. KEY WORDS: Holocaust survivors, food attitudes, food deprivation, starvation

This study examined the content on aging in dietetics curricula via the Internet and a follow-up questionnaire. Only 14% to 15% of programs were not online. The 203 undergraduate and 88 graduate program Web sites listed 44 (22%) undergraduate and 39 (44%) graduate courses in aging. However, more maternal and child courses were listed. The number of undergraduate aging courses was similar to the 20% reported in 1989, although methodologies differed among the studies. Life cycle and community nutrition courses had the most aging content. More than half of program directors were not satisfied with the aging curriculum content. Integrating aging material into existing courses was the most acceptable way of increasing aging content. The common barriers were "curriculum already full" and "lack of faculty expertise." As the nation's changing demographics are reshaping the dietetics marketplace, a greater emphasis on aging would enable students to be more effective in serving this booming population. J Am Diet Assoc. 2004;104:645-649.

Objectives We used stress process theory to identify family caregiving variables that are salient to the experience of managing older adults' home enteral nutrition. In this article, we describe the specific tasks family caregivers performed and their unique training needs in the context of caregiver preparedness, competence, effectiveness, and health care use. Design Hospital billing lists from two university-affiliated institutions in Miami, FL, were used to identify older adults who had enteral tubes placed over a 6-month period. Consent was obtained from those older adults discharged for the first time on home enteral nutrition and their family caregivers at the first scheduled outpatient visit. Subjects/Setting In-home interviews were conducted with a diverse sample of 30 family caregivers (14 white, 8 Hispanic, 7 African-American, 1 Asian) during their first 3 months (mean=1.83[+ or -]0.69 months) of home enteral nutrition caregiving. Statistical Analyses Performed Descriptive statistics were used to summarize data for all variables; [chi square] analysis was conducted to analyze differences in categorical variables. One-way analysis of variance was used to analyze mean differences among caregivers grouped by ethnicity for total number of hours and tasks performed. Post hoc comparisons were conducted using the Tukey HSD test. The Spearman rho correlations were calculated to assess bivariate associations between quantitative variables. Results Caregivers reported providing from 6 to 168 hours of care weekly (mean=61.87[+ or -]49.67 hours), in which they performed an average of 19.73[+ or -]8.09 caregiving tasks daily. Training needs identified were greatest for technical and nutrition-related tasks. Preparedness for caregiving scores were low (mean=1.72, maximum=4.0) and positively correlated with caregiver competence (P<.001) and self-rated caregiver effectiveness (P=.004). Preparedness negatively correlated with health care use (P=.03). Conclusions Caregivers of older adults on home enteral nutrition need training for multiple nutrition-related and caregiving tasks. Multidisciplinary interventions, involving dietitian expertise, are needed to better prepare caregivers to improve both caregiver effectiveness and enteral nutrition outcomes. J Am Diet Assoc. 2004;104:43-50.

Family caregivers, although uncompensated, provide daily care for more than 75% of the older adults who are dependent on home care technologies such as home enteral nutrition. The high complication rates and poor outcomes seen in older adults suggest that being an effective caregiver requires specialized training in home care technologies, and dietitians need to be more actively involved in discharge planning and follow-up home care. The level of knowledge and skill mastery required for technology-dependent care, along with the chronic, intensive nature of family caregiving and the disruptions in caregivers' daily lives, lead to negative emotional and physical consequences that may interfere with caregivers' ability to do caregiving well. Recognizing that care recipients and caregivers are underserved populations, dietitians should develop their professional competencies and expand their roles in technology-dependent home care. Dietitians can thereby contribute to better outcomes for both family caregivers an d older home care recipients. J Am Diet Assoc. 2002;102:831-836., Family caregivers are increasingly relied upon to manage and monitor technology-based home therapies like home parenteral and enteral nutrition. Technological home care is the sector of the home health care [...]

The chronic, demanding nature of family caregiving for frail older adults creates a high degree of stress for caregivers, called caregiver burden. Caregiver burden compromises caregivers' emotional and physical health and health-prorooting behaviors. Deterioration in caregivers' health and nutritional status may put caregivers at risk for chronic disease, diminish the ability of caregivers to provide care, and impair the quality of life experienced by caregivers and care recipients. Nutrition education may help reduce caregiver stress and maintain caregivers' health and well-being. Mediating caregiver stress may allow family caregivers to meet their societal role, which has intensified because of health care cost containment. KEY WORDS: family caregiving, caregiver burden, older adults, aging, nutrition education (J Nutr Educ Behav. 2002;34:S53-S58.)

D. Kaempfer is a dietitian at West Boca Medical Center Delray Beach, Fla; at the time of this study she was a graduate student in the Department of Dietetics and Nutrition, Florida International University, Miami. N. S. Wellman is a professor and director of the National Policy and Resource Center on Nutrition and Aging and d S. P. Himburg is a professor, both with the Department of Dietetics and Nutrition, Florida International University, Miami., ********** ABSTRACT Objective This study examined students' knowledge and attitudes about aging and their interest in working with the older adult population in the United States. Design A 97-item questionnaire [...]

Nutrition Screening Initiative, started by the American Dietetic Association, American Academy of Family Physicians and the National Council on Aging, Inc. enables the implementation of better screening and providing nutrition care to old adults. The screening helps improve the quality of life and the health of the old adults through better nutritional care. The screening involves measurement of the blood pressure and pulse rate of individuals and an investigation of the food consumed by them.

The 1991 Consensus Conference of the Nutrition Screening Iniiative (NSI), Nutrition Screening I: Toward a Common View (1,2) has led to increased professional awareness of poor nutritional status and better [...]

The American public, health professionals, and policymakers generaly agree that nutrition directly affects health. Major efforts have been undertaken recently to alter dietary and life-atyle practices of the public on [...]

Enteral and parenteral feeding techniques are now used to maintain indefinitely patients who are unable to take food orally. Ethical, moral, and legal issues regarding the use and/or discontinuance of […]

I have asked Susan Calvert Finn and Judith L. Dodd to coauthor this President's Page with me. Susan Calvert Finn, PhD, RD, with the support of her company, Ross Laboratories, [...]

This month marks the 30th anniversary of the Older Americans Act Nutrition Program, the largest and most visible federally funded community-based nutrition program for older persons. It began in 1968 [...]

Challenges and opportunities for dietetics professionals During 1990 and 1991, the Nutrition Screening Initiative (NSI) developed and validated the "DETERMINE Your Nutritional Health Checklist," and created the Level I and […]

Presently nutrition labeling regulations focus on the avoidance of nutritional deficiencies, while consumers aim to avoid excess consumption of food components such as calories and sodium. Lack of uniformity, misleading [...]

Service trends in the luxury residential spa industry reflect client interest in fitness, wellness, health promotion, and disease prevention. Many spa programs now combine guidance in life-style change with luxury [...]