Analysis of nutritional status among students benefitting from "nutrition improvement program" in Xi'an, 2017-2018 / 公共卫生与预防医学

Objective To analyze nutritional status among students participating in "nutrition improvement program" for the compulsory education students in Xi'an, and to provide a reference basis for student nutrition improvement. Methods Eleven districts and counties were selected. About 10% primary and junior high schools were selected from the nutrition improvement program. A total of 31,941 primary and junior high school students were selected. Height and weight were measured according to the standard methods. Results Malnutrition rate of 6~15 years old boys was 10.58% (stunting rate 2.40%, wasting rate 8.18%). Overweight and obesity rate was 14.23% and 11.22%, respectively. Malnutrition rate of 6~15 years old girls was 8.56% (stunting rate 2.17%, and wasting rate 6.40%). Overweight and obesity rate was 10.43% and 7.56%, respectively. The nutritional status of students in different gender, school period, feeding pattern and school location was analyzed. The malnutrition rate was higher in boys than in girls (10.58% vs 8.56%) (P<0.05). The combined obesity-overweight rate was higher in boys than girls (25.45% vs 17.99%) (P<0.05). The combined obesity-overweight rate was higher in 6~12 aged students than in 13-15 aged (22.82% vs 16.06%) (P<0.05). The combined obesity-overweight rate was higher (26.10%) (P<0.05) in the schools located in urban areas. The rate of malnutrition among students in the school-based cafeteria was higher (10.93%) (P<0.05), while the rate of overweight and obesity was higher in the students with meals supplied by the food suppling enterprise (25.18%) (P<0.05). Conclusions The malnutrition and overweight and obesity both existed in students who benefitted from the nutrition improvement program. Attention should be paid to the malnutrition of boys and county schools, the overweight and obesity of boys, 6-12 years old students, and urban students. It is suggested that while implementing the nutrition improvement plan, the nutrition health education in students should be strengthened to avoid an increase of overweight and obesity rate.

Strategies of Improve Elderly Nutrition through Nutrition Education : Evaluation of the Effectivenss of the Program / 대한지역사회영양학회지

The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enchance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk+education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk+education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk+education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk+education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk+education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk+education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model R2=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk+education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducting drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.

Strategies to Improve Elderly Nutrition : Comparisons of Dietary Behavior according to the Mean Nutrient Adequacy Ratio / 대한지역사회영양학회지

A deep understanding of the dietary patterns and nutrient intake is important for assessment of possilbe nutritional risk and for establishing nutrition improvement strategies. This study was conducted toexamine the dietary characteristics of a nutritionally poor elderly group compared to the middle-and highly-nourished group. Elderly participant was recruited from local elderly centers in Suwon city in 1998. Trained dietitians interviewed 119 elderly(35 males, 84 females) aged 60 years and over for collecting dietary data(24-hour recall) and related variables. Male and female subjects were grouped into high, middle, and low according to the mean nutrient adequancy ratio(MAR) tertiles. An analysisof the percentage of RDA(Recommended Daily Allowances of Korea) for each of the 10 nutrients showed that the male low-MAR group consumed below the RDA in all kinds of nutrients, and the female low-MAR group consumed nutrients below the RDA except vitamin C. An evaluation of nutrient density by Index of Nutritonal Quality(INQ) also showed a similar tendency. Thus, the INQ level of the male low-MAR group was significantly lower than the middle-or high-MAR group, especially in protein, vitamin A, thiamin, riboflavin, and phosphorus(p<0.05). Moreover, INQ level of female low-MAR group was significantly lower than that of the high group(p<0.05) in all nutrients. The female low-MAR group's daily food intake were also lower than those of the high-MARgroup in gains, fish, fruits, oil and beverages. The energy distribution from carbohydrates, fats and proteins showed that the male low-MAR group had significantly higher carbohydrate and lower fat proportions compared to each gender high-MAR group, respectively. The male and female low-MAR group had low scores about eating all side dishes. These findings indicate that a moderate increase of the meat/egg/fishes intake was needed by the male low-MAR group for improving nutrition adequacy, and an overall increase of the food quantity and quality was desired for the female low-MAR group. These data could be used for planning a community elderly nutrition program and establishing strategies for tailored guidelines for the individuals.

Analysis of the Characteristics of an Attendee in an Elderly Nutrition Education Program -Using the Factors of Health Promotion Model / 대한지역사회영양학회지

Although many people initially enroll in health education programs, there are many instances of erratic participation and dropouts. Inconsistent participation in intervention programs minimizes their impact on health promotion. Therefore, a theoretical understanding of factors influencing participation in these programs can potentially enhance the effectiveness of its educational strategy. This study used the Pender's Health Promotion Model to examine specific factors influencing incentives to participate in an elderly nutrition education program. The Elderly Nutrition Counseling and Education Program was conducted with 147 volunteers (76 males, 71 females), aged 60 to 87, at 5 separate community elderly centers, by public health dietitians from February to April 1997. Some participants dropped out during the program. Overall, 61 people(18 males, 43 females) finished all 7 steps over 2 months. Pre-intervention data were collected by trained dietitians. This data included individual cognitive-perceptual factors(perceived benefits of nutrition improvement, importance of health, perceived control over health by multidimensional health locus of control, self esteem, perceived health status, concern about health, depression scale and social health scale), which were known to influence the likelihood of health behavior, and modifying factors(socioeconomic variables, biological characteristics, behavioral factors, such as smoking, alcohol drinking and exercise). Male finalists had a significantly lower chance for health locus of control, and better social health status with their children and grandchildren, compared to males who dropped out. Female finalists had a significantly higher locus of control regarding food behavior, higher self-esteem, better recognized nutritional status, worse self-recognized health status and lower concern about health than those who dropped out. There was no significant difference between the attendees and dropouts in age, BMI( kg/m2), Nutritional Risk Index, depression scale and daily nutrient intake. These results suggest that elderly nutrition intervention plans should focus on the individual cognitive and perceptual factors, with interpersonal influences, to increase participation in nutrition in nutrition improvement programs.

Strategies to Improve Nutrition in the Elderly : An Analysis of Health Related Factors and the Nutritional Risk Index of the Elderly / 대한지역사회영양학회지

The elderly are the most rapidly growing segment of the population in Korea and the largest consumers of expensive medical care. It is reasonable to believe that improving the nutritional status would be beneficial to reducing morbidity and to improving the quality of their lives. This study was conducted to assess the health status and the Nutritional Risk Index of the elderly, and to provide the basic data for the Elderly Nutrition Improvement Program at the Public Health Center. One hundred and forty seven(76 males. 71 females) aged 60 years and over living in Suwon, were assessed with anthropometric measurements, body fat analysis, blood pressure measurements, and a set of about health and other related variables. Over half of them had less than a junior middle school education and were considered low income. The percentage of overweight and obese subjects was 33% by the BMI(Body Mass Index), and the prevalence of hypertension was 28%(males) and 31%(females). They had a lot of self-recognized health problems, the male elderly complained about more than the female elderly. In the case of psychological health status, however, the female elderly showed a higher proportions of depression than the male elderly(p<0.05). In social health status, the elderly had good relationships with friends and collegues, whereas they had poor relationships with their families. They had many nutritional risk factors, and smoking was the most prevalent risk factor for the male elderly and anemia was for the female elderly. The results of this study suggest that Elderly Nutrition Improvement Programs should be planned that can be easily followed. It would be helpful to design a program focusing on individual phychological and social health status, this would increase the efficiency of the program.

Elderly Nutrition Improvement Program in the community health center : Nutritional evaluation of the elderly using the Index of Nutritional Quality and food group intake pattern

Physiological changes that affect nutrient absorption and utilization occur in older adults, and the collection of nutritional information is an important part of examining the nutrition and health issue. A nutritional survey using the 24-hour recall method was performed to identify nutritional quality and leading patterns of food group intake for protein, vitamin C, P and Fe were over 1, whereas those for vitamin A, B1, B2, niacin and Ca were below 1. The MAR(Mean Adequacy Ratio) was relatively low(0.75). The percentage of energy from carbohydrate, protein, and fat was 65.1, 15.6, and 19.5, respectively, thus the quantities of energy source were ideal. The Older subjects revealed poorer nutrition quality than the younger subjects did. The food group intake pattern of the elderly was not diverse, only 9% of them consumed all food groups in a day. These results suggest that nutritional guiflines for older Koreans should focus on the maintenance of adequate energy intake. In addition, selection of foods with high protein and calcium, such as dairy food, should be emphasized, particularly in the older elderly. Nutrition programs should target individuals at risk of not receiving enough nutrients, like the oldest elderly, and persons with lower education.

Evaluations of the Elderly Nutrition Improvement Program in the community health center: Effects of nutrition counseling and education program on elderly dietary behavior

Low energy intakes, poor nutritional quality, and low food diversity are among the factors affecting the nutritional status of elderly in Korea. Therefore, a nutrition counseling and education program was conducted to promote dietary change and to improve nutritional status of elderly. The 7 step program consisted of a individual nutrition counseling and weekly or biweekly group nutrition education programs. Pre- and post-test measurings of dietary behaviors, attitudes, nutrition knowledge, and 24-hour dietary recall data were collected. Positive changes in the attitude related to diet were noted, whereas nutritional knowledge scores were not improved. Significant increases were noted in the frequency of vegetable consumption in female and diversity of food consumption in male. The densities of vitamin C(male & female), B1, B2, and niacin, calculated using the INQ(Index of Nutritional Quality), were significantly improved by nutrition counseling and education programs. These results suggest the appropriateness of nutrition intervention programs for the improvement of elderly nutrition.