Zn is regularly added to TPN solutions, however, requirements are poorly understood. This research investigated whether or not the route of Zn intake (oral vs parenteral) changes Zn concentration in rat tissues. Twenty-four male Fischer-344 rats were equally and randomly assigned to one of four groups (n=6): control (CON), baseline (BS), orally fed (OF), and intravenously fed (IV). After fifteen days of feeding, organs and sera were collected and analyzed for Zn by atomic absorption spectrophotometry. Of the nine tissues analyzed, the Zn concentrations in the liver, kidney, and lung of the IV rats were significantly higher (p<1.l) than those of the CON, BS, and OF rats. Results indicated that rats fed intravenously with Zn displayed increased Zn concentrations in liver, kidney and lung tissues, and that the concentration of Zn in the serum may not reflect tissue Zn levels. This suggests that the route of Zn intake affects tissue Zn concentration.

The relationship between the frequency of eating, physical activity and Body Mass Index (BMI) was investigated. Seventy five women, aged 24 to 55, were recruited from Florida International University. Via interview, subjects provided information regarding demographics and habitual eating frequency over 24-hours, and completed both the Baecke Questionnaire of Habitual Physical Activity and the Health Insurance Plan of New York Questionnaire on Physical Activity. Pearson correlations and partial correlation coefficients were used to assess the relationship between eating frequency, physical activity, age, and BMI. Results revealed significant positive correlations between eating frequency and total physical activity scores, and leisure time physical activity scores, but not between eating frequency and physical activity on the job. Partial correlations suggest that there may be an effect of eating frequency on BMI both through an effect on physical activity and through another mechanism. These results suggest that more frequent eaters tend to be more physically active, which may partially explain why lower body weights is associated with more frequent eating.

Purpose: The purpose of the study was to examine Jamaican adolescents in a school setting, for risk factors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). Methods: A descriptive epidemiological cross-sectional study of 276 Jamaican adolescents (112 males and 164 females) ages 14-19 years (15.6±1.2), randomly selected from grades 9-12 from ten high schools on the island. Thirteen risk factors were examined. Risk factors were compared with BMI levels and demographics. A sub-study validated finger prick testing of fasting blood glucose, total cholesterol, and HbAlc versus venous testing in 59 subjects. Results: Prevalence of overweight was 33.0% (n=91) with mean BMI of 23.74±7.74. Approximately 66.7% of subjects reported > 3 risk factors. The number of T2DM and CVDs risk factors increased for subjects with BMI above 25. One third of the overweight subjects were classified with the metabolic syndrome. High BMI was associated with high waist circumference (r =.767, p (r = .180, p.05). Percentage bias for the methods of blood testing met the reference standards for fasting blood glucose but not for total cholesterol and HbAlc. Bland Altman tests of agreement between the two methods indicated good agreement for all three tests. Conclusion: Jamaican adolescents are at high risk for T2DM and CVDs as seen in other study populations. Effective programs to prevent T2DM and CVDs are needed. Family history of diseases, anthropometric measures, and gender identified more subjects at risk than did the biochemical measures. Comparison between finger prick and venous blood methods suggested that finger prick is an adequate method to screen for risk factors in children and adolescents.

The purpose of this study was to describe and inform registered dietitians (RDs) in the State of Florida what insurance companies are providing in terms of medical nutrition therapy (MNT) coverage. A questionnaire was developed to encompass major MNT reimbursement stipulations such as policies, specific diseases coverage, specific Current Procedural Terminology (CPT) codes and descriptors, use of the medical necessity letter and nutrition cost benefits analysis (CBA). The questionnaire, encompassing 27 plans (HMO, PPO, Indemnity, Medicare, Medicaid), also served as a MNT promotional tool for 11 top administrators from insurance companies (10 private, 1 government) around the State of Florida. The results showed that 78% of all plans reimbursed for MNT caseby- case even without specific MNT policies. Sixty-seven percent of the plans would approve for MNT reimbursement with a medical necessity letter. Half of these top administrators showed an optimistic interest in using nutrition CBAs, case studies and practice protocols for creating MNT policies. The top ranked CPT codes were found to be 99204 (1), 99202 (2), 99201 (2), 99203 (3). The most recognized corresponding descriptors with the CPT were MNT, disease management skills and training and nutritional counseling. This questionnaire may be used to create additional MNT reimbursement audits or research. The results given in this study can aid RDs in proper documentation on insurance claim forms, usage of the medical necessity letter, nutrition CBAs, practice guidelines and case studies for successful MNT reimbursement.

This descriptive study examined whether discharge planning ensures that food and nutrition services are provided to older adults following hospital discharge. The questionnaire was distributed to discharge planning professionals in 11 South Florida hospitals. Of the 84 respondents (88% response rate), most were female nurse case managers. Almost all reported job barriers including excessive patient loads, too many responsibilities, and limited community services. While physicians, registered nurses, social workers, physical therapists, were deemed "very important" in discharge planning,registered dietitians were not, and almost half consulted them infrequently, if at all. Over 84% said nutrition-related medical conditions/factors, "strongly influenced" discharge planning. Many did not have adequate information about nutrition-related community resources, eg, home delivered meals, food stamps, outpatient registered dietitians. Therewere no universal approaches in meeting the nutrition needs in 6 case scenarios. More communication among community services and hospitals is needed.

The purpose of this study was to examine job satisfaction of dietitians in South Florida and to identify significant differences in job satisfaction between dietitians working in traditional versus non-traditional settings. A job satisfaction questionnaire was developed, validated, and mailed to dietitians in Palm Beach, Broward, Dade, and Monroe counties. Out of 600 questionnaires mailed, 203 surveys were returned and 187 were valid and analyzed statistically. Seventy three percent of subjects practiced in traditional and 17% in non-traditional settings. Eighteen percent of 187 subjects surveyed reported feeling dissatisfied with their jobs and 59% reported feeling satisfied. There was no significant difference in satisfaction due to practice settings (traditional versus non-traditional). The subjects reported satisfaction with co-workers and supervisors. The two major areas where dissatisfaction was reported were compensation and professional recognition. The results showed that the majority of dietitians in South Florida are, in general, satisfied with their jobs. Although dietitians' salaries have increased by approximately 80% since 1982, compensation was still viewed as inadequate by 48% of the subjects, given dietitians' education, skills and experience. Because legislation to approve reimbursement of medical nutrition therapy is pending, increase in dietitians' knowledge of reimbursement issues is recommended. Dietitians must also promote assertively their valuable contribution to wellness, health, and the treatment of disease.

In a cross-sectional study design, risk factors for coronary heart disease (CHD) were evaluated in three groups: 66 Afro Caribbeans (FBCA) living in the US for less than 10 years, 62 US-born Afro Caribbean (USBCA) and 61 African American (AA) adults (18-40 years), with equal numbers of males and females in each group. Socio-demographic, dietary, anthropometric and blood pressure data were collected. Fasting blood glucose, blood lipids and high-sensitivity C-reactive protein (hs-CRP) were determined. The USBCA and AA participants compared to the FBCA participants consumed significantly (p< 0.05) more mean total fat (g) (66.3 ± 41.7 and 73.0± 47.8 vs. 52.8± 32.3), saturated fat (g) (23.1± 14.9 and 24.9± 15.8 vs. 18.6 11.5), percent energy from fat (%) (33.1 ± 6.5 and 31.4 ± 6.4 vs. 29.3 ± 6.8), fat servings (1.8 ± 1.2 and 1.5 ± 1.0 vs. 1.2 ± 0.9), dietary cholesterol (mg) (220.4 ± 161.9 and 244.1 ± 155.0 vs. 168.8 ± 114.0) and sodium (mg) (2245.2 ± 1238.3 and 2402.6 ± 1359.3 vs.1838.0 ± 983.4) and less than 2 servings of fruits per day (%) (86.9 and 94.9 vs. 78.5). These differences were more pronounced in males compared to females and remained after correcting for age. Also, the percentages of USBCA and AA participants who were obese (17.1% and 23.0%, respectively) were significantly (p< 0.05) higher compared to FBCA (7.6%) participants. More USBCA and AA than FBCA individuals smoked cigarettes (4.8% and 6.6% vs. 0.0%) and consumed alcoholic beverages (29.0% and 50.8% vs. 24.2%). The mean hs- CRP level of the AA participants (2.2 ± 2.7 mg/L) was significantly (p< 0.01) higher compared to the FBCA (1.1 1.3 mg/L) and USBCA (1.3 ± 1.6 mg/L) participants. The FBCA participants had a better CHD risk profile than the USBCA and AA participants. Focus should be placed on the ethnic and cultural differences in a population to better understand the variations in health indicators among different ethnic groups of the same race. This focus can provide healthcare professionals and policy planners with the opportunity to develop culturally sensitive programs and strategies for the improvement of health outcomes.

The objective of this thesis was to determine how the availability of tropical fruit beverages, familiar to Hispanics, would affect fluid intake of Hispanic and non-Hispanic residents of a 120-bed nursing home. Beverage acceptance and intake were measured for three days with the following beverage offerings (including coffee): four fruit beverages usually served in the facility or two of the usual fruit beverages combined with two tropical fruit beverages. The presence of the tropical fruit beverages on the hydration cart significantly increased acceptance and intake in women but not men, regardless of ethnicity. Hispanic females chose and drank (ps < .01) more tropical fruit beverages than did their non-Hispanic counterparts. During the study residents consumed greater than six ounces of beverage 80% of the time and greater than ten ounces 57% of the time. Between-meal fluid intake in this population can be stimulated by offering generous servings (10-12 oz) of a variety of palatable beverages, including ethnic favorites.

The purpose of this study was to determine if food safety education influences food safety knowledge, attitude and behavior among inner city public school foodservice employees. Knowledge, attitude and behavior of an experimental group (n=22) was assessed before and after 3-hour food safety training and compared with a control group (n=10) that received no food safety training. We hypothesized that those who received food safety training would have improved knowledge, attitude and behavior towards food safety issues compared to those who did not receive training. Results showed that food safety training significantly increased (p<0.001) the knowledge of foodservice employees compared to those who didn’t receive the training. However, the 3-hour training did not significantly influence attitude or practice of safe food-handling techniques. Education and consistent re-training, coupled with Hazard Analysis and Critical Control Point (HACCP) system, food-handier sanitation certification and frequent supervision may help to increase food safety awareness among foodservice employees.

It is standard practice in acute-care settings to screen patients upon admission to determine whether they need a nutritional assessment; however, there is limited information on the ability of the screening tools to detect patients at nutritional risk. The purpose of this study was to determine (1) the sensitivity and specificity of the screening tool used at Jackson Memorial Hospital and (2) whether a new proposed tool would be more sensitive and specific. Dietitians screened patients upon admission using the existing and proposed tools (n=141). Sensitivity and specificity of these tools in identifying patients at nutritional risk was calculated. Mantel-Haenszel chi-square statistics were used to identify indicators correlated with nutritional risk. A revised tool was tested and found to have a higher sensitivity than the existing tool but lower specificity. Odds ratios indicated that the revised tool had a higher degree of association with nutritional risk than the existing one.