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NURSES / NURSING

COWBROUGH, Kathy. Feeding the toddler: 12 months to 3 years - challenges and opportunities. Journal of Family Health Care Vol 20, No 2 - April 2010: 49-52
Abstract:
The toddler stage from one to three years continues to be a period of rapid growth although not as rapid as in the first year. Energy needs are high as toddlers become more active, but stomachs are still small relative to nutrient needs so food provided for this age group needs to be nutrient dense. Toddlers are beginning to exert their independence in food choices and parents may be faced with a fussy eater who refuses food that they normally like and enjoy. Parents need to be encouraged to establish a routine of three meals and two snacks a day and not to allow the toddler to set the rules for eating. Making time to enjoy eating together as a family should be a priority to help toddlers establish good eating habits for the future

GRUNERT, Klaus G and FERNANDEZ-CELEMIN, Laura and others. Use and understanding of nutrition information on food labels in six European countries. Journal of Public Health Volume 18, No 3 - June 2010: 261-277
Abstract:
Aim: The goal of the study was to investigate the use of nutrition information on food labels and understanding of guideline daily amount (GDA) front-of-pack nutrition labels in six European countries. Subjects and methods: In-store observations and in-store interviews were conducted in major retailers in the UK (n=2019), Sweden (n=1858), France (n=2337), Germany (n=1963), Poland (n=1800) and Hungary (n=1804), supplemented by questionnaires filled out at home and returned (overall response rate 50.3%). Use of labels was measured by combining in-store observations and in-store interviews on concrete purchases in six product categories. Understanding of GDA front-of-pack nutrition labels was measured by a variety of tasks dealing with conceptual understanding, substantial understanding and health inferences. Demographics, nutrition knowledge and interest in healthy eating were measured as potential determinants. Results: Across six product categories, 16.8% of shoppers were found to have looked for nutrition information on the label, with the nutrition grid (table or list), GDA labels and the ingredients list as the main sources consulted and calories, fat and sugar the information most often looked for. Understanding of GDA labels was high in the UK, Sweden and Germany, and more limited in the other countries. Regression analysis showed that, in addition to country-specific differences, use and understanding are also affected by differences in interest in healthy eating and in nutrition knowledge and by social grade. Conclusion: Understanding of nutrition information seems to be more widespread than use, suggesting that lack of use is a question of not only understanding, but also motivation. Considerable national differences exist in both understanding and use, some of which may be attributed to different histories of the role of nutrition in the public debate.

HOPPU, Ulla and LEHTISALO, Jenni and others. Dietary habits and nutrient intake of Finnish adolescents. Public Health Nutrition Vol 13, No 6(A) - June 2010: 965-972
Abstract:
Objective: To evaluate food and nutrient intake and especially eating during the school day among Finnish secondary-school pupils. Design: Cross-sectional study. Data were collected using a structured questionnaire mailed to home and by 48 h dietary recall interviews performed at schools in 2007. Setting: Twelve schools in three cities in Finland. Subjects: The seventh grade pupils (a total of 1469 at the mean age of 13.8 years). Questionnaire data were available from 726 pupils and dietary data from a subgroup of 40 % (n306). Results: According to the questionnaire data, 40 % of the girls and 28 % of the boys reported eating fresh vegetables daily and the respective figures for fruit were 32 % and 23 %. Altogether, 71 % of the adolescents reported having school lunch every day. The average intake of sucrose was higher and the average intakes of fibre, iron, folate and vitamin D were lower than recommended. School lunch provided around 20 % of daily energy intake, while the recommended daily energy intake level is one-third. However, the school lunch as consumed was nutritionally superior to the other daily meals. Snacks provided 41 % of the daily energy. The most common sources of sucrose were sugary drinks. Conclusions: Low consumption of fruit and vegetables and abundant consumption of sucrose-rich drinks and snacks are the main problems in the diet of Finnish adolescents. The nutritional quality of the school lunch is good, but the supply of healthy snacks must be improved in schools. Schools can promote healthy eating habits by making healthy choices easy during the school day.

JAGO, R and NESS, A R and others. Obesogenic diet and physical activity: independent or associated behaviours in adolescents? Public Health Nutrition Vol 13, No 5 - May 2010: 673-681
Abstract:
Objective: Associations between diet and physical activity may identify behaviours that could be changed together to prevent childhood obesity. The present study examines associations between physical activity and obesogenic dietary behaviours in a large UK adolescent cohort. Design: Cross-sectional analysis of a UK cohort. Adolescents aged 10-11 years completed three 1 d diet diaries. Average daily energy consumption, percentage energy from fat and carbohydrate, energy density and grams of fruit and vegetables were estimated. To assess physical activity participants wore an accelerometer for three or more days. Regression models were run by sex to examine the extent to which dietary variables predicted physical activity before and after controlling for pubertal status, maternal education and adiposity. Setting: The Avon Longitudinal Study of Parents and Children (ALSPAC), south-west England. Subjects: adolescents who provided diet data at age 10 years and physical activity data at age 11 years. Results: Among boys, percentage energy from fat was consistently negatively associated with accelerometer-determined indicators of physical activity (standardized beta ( [beta] ) = -0•055 to -0•101, P < 0•05) while total energy ( [beta] = 0•066 to 0•091, P < 0•05) and percentage energy from carbohydrate ( [beta] = 0•054 to 0•106, P < 0•05) were positively associated before and after adjustment for confounders. For girls fruit and vegetable intake was consistently positively associated with physical activity ( [beta] = 0•056 to 0•074, P < 0•005). However all associations were weak. Associations were broadly comparable when participants with non-plausible dietary reports were included or excluded from the analyses. Conclusions: Obesogenic diet and physical activity behaviours were weakly associated, suggesting that interventions should focus on implementing strategies that are independently successful at changing diet or physical activity behaviours either separately or in combination.

MIHAS, Constantinas and MARIOLIS, Anargiros and others. Evaluation of a nutrition intervention in adolescents of an urban area in Greece: short- and long-term effects of the VYRONAS study. Public Health Nutrition Vol 13, No 5 - May 2010: 712-719
Abstract:
Objective: To assess the short-term (15-d) and long-term (12-month) effects of a school-based health and nutrition education intervention on diet, nutrition intake and BMI. Design: The 12-week teacher-implemented intervention in combination with seminars organized for parents was aimed at improving children's diet and nutrition knowledge. The intervention took place between September 2007 and January 2008. The participants were randomized to two study groups, the intervention group (IG) and control group (CG), and were examined prior to the intervention on a variety of health knowledge, dietary, behavioural and anthropometric indices. The same measurements were collected 15 d and 1 year after the intervention. Setting: All high schools in Vyronas, a densely populated district of Athens, Greece. Subjects: The sample consisted of 191 students aged 12-13 years. Results: Twelve months after the intervention, the programme was effective in reducing various indices in the IG compared with baseline findings (BMI: 23•3 (sd 2•8) v . 24•0 (sd 3•1) kg/m 2 , P < 0•001; daily energy intake: 8112•4 (sd 1412•4) v . 8503•3 (sd 1419•3) kJ/d, P < 0•001; total fat intake: 31•3 (sd 4•4) v . 35•4 (sd 4•7) % of daily energy, P < 0•001). Except for BMI, decreases in the aforementioned indices were also observed 15 d after the intervention. In addition, students of the IG reduced their weekly consumption of red meat and non-home-made meals and increased their frequency of fruit and breakfast cereal consumption. Conclusions: The beneficial effects of this nutrition education intervention among adolescents may highlight the potential of such programmes in the prevention of obesity.

PIETINEN, Pirjo and MANNISTO, Satu and others. Nutrition policy in Finland. Public Health Nutrition Vol 13, No 6(A) - June 2010: 901-906
Abstract:
The present study describes the main actions in Finnish nutrition policy during the past decades. The main actor is the National Nutrition Council, which provides nutritional recommendations and action programmes, and sets up expert groups to solve nutritional problems in the population. The main fortification programmes have been the iodization of table salt, supplementation of selenium to fertilizers and the vitamin D fortification programme. As an example of national legislation, labelling the salt content of foods is described. Finnish nutrition policy is based on a good monitoring system of nutrition and risk factors of chronic diseases, as well as active epidemiological research. However, the authorities have not often taken proposed fiscal measures seriously but have instead considered agricultural and economic policies more important than health policy.

PIETINEN, Pirjo and PATURI, Merja and others. FINDIET 2007 Survey: energy and nutrient intakes. Public Health Nutrition Vol 13, No 6(A) - June 2010: 920-924
Abstract:
Objective: The National FINDIET surveys are carried out every 5 years to monitor dietary habits and nutrient intake of the adult Finnish population. The latest survey was carried out in 2007. Design: Cross-sectional population-based study. Dietary assessment was carried out using 48 h recall interviews. A picture book of food portions was used to estimate portion sizes and the national Food Composition Database Fineli to calculate nutrient intakes. Setting: A representative sample taken in five regions in Finland. Subjects: A total of 730 men and 846 women aged 24-64 years. Results: The percentage contribution of fat to the total energy intake was 33 % in men and 31 % in women. The respective percentages for SFA in men and women were 13 % and 12 %, respectively, and 0.4 % for transfatty acids in both genders. The average intakes of folate, vitamin D and fibre fell below the recommended levels, whereas the average salt intake was somewhat higher than the recommendations. Women's diet was higher in protein, dietary fibre and sucrose compared to that of men. Conclusions: According to the FINDIET 2007 Survey, the dietary habits of the adult Finnish population have headed in a positive direction overall. However, although the quality of the fats consumed has continued to improve, and the intake of salt has decreased, they still do not meet the recommended levels of intake. Similarly, the average intakes of folate and vitamin D continue to fall below the recommendations. There is also a need to increase fibre intake and to cut down the intake of sucrose.

RAULIO, Susanna and ROOS, Eva and others. School and workplace meals promote healthy food habits. Public Health Nutrition Vol 13, No 6(A) - June 2010: 987-992
Abstract:
Objective: The present study is to describe, on the basis of recent Finnish population surveys, (i) the frequencies of school and worksite canteen use, (ii) the determinants of having a hot lunch during school or working hours and (iii) the associations of lunch eating patterns with food habits. Setting: The study summarises mainly basic reports and studies concerning catering services conducted in Finland based on nationally representative population surveys. Design and subjects: Cross-sectional study. The most important surveys cited in this paper are the School Health Promotion Study, the Work and the Working Conditions survey, the National FINDIET 2002 Study, and the Health Behavior and Health among Finnish Adult Population survey. Result: School lunch is eaten by on average 70-90 % of children aged 9-18 years. Of all employees, 30 % eat at a worksite canteen daily, whereas 30 % of men and 45 % of women eat packed lunches. Nationally representative cross-sectional population surveys show that the use of catering services is associated with more healthy food habits; schoolchildren eating school meals and employees eating lunch at a worksite canteen tend to make food choices closer to nutritional recommendations as compared to those not using catering services to the same degree. Conclusions: Some evidence exists that catering services in schools and worksites contribute to healthy eating habits in the population. In order to verify the positive role of catering services more scientific research with prospective and intervention design studies will be needed.

SOEDERBERG MILLER, Lisa M and GIBSON, Tanja N and others. Predictors of nutrition information comprehension in adulthood. Patient Education and Counseling Vol 80, No 1 - July 2010: 107 - 112
Abstract:
Objective: The goal of the present study was to examine relationships among several predictors of nutrition comprehension. We were particularly interested in exploring whether nutrition knowledge or motivation moderated the effects of attention on comprehension across a wide age range of adults. Methods: Ninety-three participants, ages 18-80, completed measures of nutrition knowledge and motivation and then read nutrition information (from which attention allocation was derived) and answered comprehension questions. Results: In general, predictor variables were highly intercorrelated. However, knowledge, but not motivation, had direct effects on comprehension accuracy. In contrast, motivation influenced attention, which in turn influenced accuracy. Results also showed that comprehension accuracy decreased-and knowledge increased-with age. When knowledge was statistically controlled, age declines in comprehension increased. Conclusion: Knowledge is an important predictor of nutrition information comprehension and its role increases in later life. Motivation is also important; however, its effects on comprehension differ from knowledge. Practice implications: Health educators and clinicians should consider cognitive skills such as knowledge as well as motivation and age of patients when deciding how to best convey health information. The increased role of knowledge among older adults suggests that lifelong educational efforts may have important payoffs in later life.

THOMPSON, Rachel. Preventing cancer: the role of food, nutrition and physical activity. Journal of Family Health Care Vol 20, No 3 - June 2010: 100-102
Abstract: The recommendations of a major report on dietary aspects of cancer prevention are summarised and discussed. The findings of The World Cancer Research Fund (WCRF/ American Institute for Cancer Research (AICR) Second Expert Report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective were published in 2007 and remain valid. The report reviewed the relationship between food, nutrition, physical activity, body fatness and 17 cancer sites. The goal of the report was to review all the relevant research, using precise and reproducible methodologies. An expert panel reviewed the evidence. Based upon evidence that was graded "convincing" or "probable", a series of 10 recommendations to reduce the risk of developing cancer was produced. One of the most important factors is maintaining a healthy weight throughout life, which can be achieved by regular physical activity and limiting consumption of energy-dense foods and sugary drinks. Other important dietary measures include consuming a diet high in plant-based foods, limiting intakes of red meat, and avoiding salty foods and processed meat. Alcohol should be consumed in modest amounts, if at all. Dietary supplements are not recommended for cancer prevention.

WATERLANDER, Wilma E and STEENHUIS, Ingrid H M and others. Expert views on most suitable monetary incentives on food to stimulate healthy eating. European Journal of Public Health Vol 20, No 3 - June 2010: 325-331
Abstract:
Background: Pricing strategies are an important component in the marketing mix and may also be useful in stimulating healthier food choices. However, due to competing interests and feasibility problems, the introduction of pricing strategies is complicated. For successfully introducing food pricing strategies, it is essential to explore incentives that are not only promising but also realizable and being approved by different sectors. Methods: We aimed to assemble a list of pricing strategies by exploring expert views using the Delphi method. Subjects included experts from academia, industry, retail, agriculture, policymakers, consumers and non-governmental organizations. Data were collected in three rounds. In round one, experts designed promising pricing strategies. Based on a time-budget model incorporating Sleep, Leisure, Occupation, Transportation and Home-based activities, these strategies were in the subsequent rounds judged on several criteria. Results were analysed using median and interquartile deviations scores. Results: We found fair consensus levels among experts and a varied list of promising pricing strategies. The panel agreed on the potential success of offering small presents, providing price-cuts on healthy foods and discounting healthier foods more frequently. Also, it was found that experts gave higher rates to pricing strategies for which the implementation responsibilities could be placed elsewhere. Conclusion: The resulted list of promising monetary incentives is an essential first step for the future design of pricing strategies. Following this study, it is important to determine how to make solid agreements on responsibility and implementation issues. Also, consumer perceptions regarding the proposed pricing strategies should be studied

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