Suchergebnisse

Purpose:To examine changes in eating competence (EC) in 12-month weight loss intervention.Design:Randomized, parallel-arm with weight loss phase (baseline to month 4) and weight-maintenance phase (months 4-12).Setting:Face-to-face in University classrooms, supervised and self-directed fitness sessions at University fitness center, and home.Participants:Premenopausal, mostly college-educated Pennsylvania women, body mass index >25 (n = 101).Intervention:Twenty-eight, 1-hour classes tailored for extremes of the Dietary Guidelines' fat recommendations, based on social cognitive theory, problem-based learning delivery over 12 months. Exercise component included supervised and self-directed stretching, aerobics, and strength training.Measures:Anthropometrics, lipid profile, blood pressure, 24-hour dietary recalls, cognitive behavioral measures, Satter Eating Competence Inventory (ecSI).Analysis:General linear model repeated measures analysis of variance for outcome variables.Results:A total of 40% (n = 40) completed the ecSI. Overall, education and supervised exercise session attendance were 77% and 88%, respectively. Similar weight loss for lower and moderate fat groups (6.7 kg and 5.4 kg). The EC was unchanged baseline to month 4 but increased significantly from months 4 to 12, baseline to month 12 for both groups. The EC change baseline to month 12 was inversely associated with weight change from baseline to months 4 and 12.Conclusion:Weight management interventions, likely to introduce concerns with eating attitudes, behaviors, and foods, can reduce EC. Short-term measurement of EC change captures these consequent adjustments without opportunity to regain self-efficacy. Extending the measurement interval better reflects intervention impact on EC.

BACKGROUND: The increased use of high-oleic oils to replace trans fat has led to concern about declining intake of PUFA and the potential for essential fatty acid insufficiency or even deficiency. OBJECTIVES: The aim of this study was to examine circulating concentrations of essential and poorly biosynthesized fatty acids, as biomarkers of dietary intake, in the NHANES data sets prior to (2003–2004 cycle) and following (2011–2012 cycle) legislation to reduce trans fat in the food supply and also to explore the associations between these fatty acids and markers of cardiometabolic health. METHODS: Fasting circulating concentrations of fatty acids from adults (aged ≥20 y) in the 2003–2004 and 2011–2012 NHANES cycles were used for analysis. Dietary data from one day of both the 2003–2004 and 2011–2012 cycles were used to examine differences in dietary fatty acid intake between these cycles. Regression analyses were used to assess relations between circulating concentrations of fatty acids and cardiometabolic health. RESULTS: Between 2003–2004 and 2011–2012, circulating concentrations of linoleic acid (LA) increased (1.38%, P = 0.002); no difference in dietary intake was observed. α-Linolenic acid (ALA), measured by dietary intake (0.14 g, P < 0.001) and circulating concentrations (0.23%, P < 0.01), increased from 2003–2004 to 2011–2012. Circulating LA was inversely associated with BMI (in kg/m(2); regression coefficient per percentage point change in LA ± SE: –0.22 ± 0.04), waist circumference (–0.62 ± 0.09 cm), systolic blood pressure (–0.38 ± 0.09 mm Hg), triglycerides (–9.92 ± 0.63 mg/dL), glucose (–3.34 ± 0.13 mg/dL), insulin (–0.18 ± 0.05 µU/mL), and HOMA-IR (–0.29 ± 0.05). CONCLUSIONS: In a nationally representative sample of US adults, no declines in circulating concentrations of essential fatty acids, LA and ALA, were observed between 2003–2004 and 2011–2012, a time when high-oleic oils were increasingly used in the food supply. Higher amounts of circulating LA were correlated with lower risk of ...

Most health care professionals are not adequately trained to address diet and nutrition-related issues with their patients, thus missing important opportunities to ameliorate chronic diseases and improve outcomes in acute illness. In this symposium, the speakers reviewed the status of nutrition education for health care professionals in the United States, United Kingdom, and Australia. Nutrition education is not required for educating and training physicians in many countries. Nutrition education for the spectrum of health care professionals is uncoordinated, which runs contrary to the current theme of interprofessional education. The central role of competencies in guiding medical education was emphasized and the urgent need to establish competencies in nutrition-related patient care was presented. The importance of additional strategies to improve nutrition education of health care professionals was highlighted. Public health legislation such as the Patient Protection and Affordable Care Act recognizes the role of nutrition, however, to capitalize on this increasing momentum, health care professionals must be trained to deliver needed services. Thus, there is a pressing need to garner support from stakeholders to achieve this goal. Promoting a research agenda that provides outcome-based evidence on individual and public health levels is needed to improve and sustain effective interprofessional nutrition education.

In the United States, cardiovascular disease (CVD) is the leading cause of death and disability. Suboptimal diet quality is responsible for a greater percentage of CVD‐related morbidity and mortality than any other modifiable risk factor. Further troubling are the stark racial/ethnic and socioeconomic disparities in diet quality. This represents a major public health concern that urgently requires a coordinated effort to better characterize the barriers to healthy dietary practices in population groups disproportionally affected by CVD and poor diet quality to inform multifaceted approaches at the government (policy), community environment, sociocultural, and individual levels. This paper reviews the barriers, opportunities, and challenges involved in shifting population behaviors, especially in underserved populations, toward healthy dietary practices. It is imperative that public health policies address the social determinants of nutrition more intensively than previously in order to significantly decrease CVD on a population‐wide basis.