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The Special Supplemental Food Program for Women, Infants and Children (WIC) is a public health intervention targeted to reach a high risk pregnant population in order to promote beneficial effects on pregnancy outcome. The ultimate goal of this research was to examine the pregnancy outcomes, relative to selected biological, socio-demographic and nutritional risk variables, of pregnant women enrolled in the Virginia WIC Program. The study proposed that duration of WIC participation is associated with improved pregnancy outcomes, including higher infant birth weight, a decrease in low birth weight (LBW) and decreased incidences of prematurity, neonatal mortality and abnormal births. Nutritional and non-nutritional risk variables and birth outcomes were examined in 2,133 pregnant women enrolled in the Virginia WIC Program from December 1, 1984 to September 30, 1985. A WIC Pregnant Women Tracking Form was the designed instrument utilized by staff at health department clinic sites to record the data at time of program entry. Duration of participation in WIC was calculated by weeks and stratified into three groups by months (or trimesters) of participation. Results indicated that this subject population was demographically and nutritionally at higher risk for poor pregnancy outcomes. Stratification by demographic subpopulations showed the most vulnerable may be those prenatal subjects less than 18 years of age, and of black racial/ethnic status. Statistical analyses between the duration of indicated a positive correlation participation, especially when in the WIC Program and pregnancy birth weight, LBW, and birth stratified by trimester, outcome described by complications. It was concluded that for this high risk group of prenatal subjects, increased participation in the WIC Program is associated with enhanced pregnancy outcomes. While these findings suggest that birth weight and birth outcome differences are a function of WIC participation, other related factors may be basis for this causal effect. / M.S.

Our overall objective was to explore some individual and environmental determinants of eating habits with a main focus on nutrition labels and their usefulness for choosing foods for weight management. We first broadly examined these determinants using participants of the AFMNet Canadian Consumer Monitor (CCM), and found a number of attitudinal and perceived environmental barriers to healthy eating. In an experimental study with CCM respondents, we found that reduced fat claims may help consumers make better choices for weight management if calorie content on the Nutrition Facts Table is also considered. However, in our examination of foods with fat claims in the Canadian marketplace, we found that most products with fat claims are not significantly lower in calories than comparable foods without such claims. We conclude that fat claims could be useful in assisting consumers with food choices for weight management, if the foods were also reduced in calories.

Our overall objective was to explore some individual and environmental determinants of eating habits with a main focus on nutrition labels and their usefulness for choosing foods for weight management. We first broadly examined these determinants using participants of the AFMNet Canadian Consumer Monitor (CCM), and found a number of attitudinal and perceived environmental barriers to healthy eating. In an experimental study with CCM respondents, we found that reduced fat claims may help consumers make better choices for weight management if calorie content on the Nutrition Facts Table is also considered. However, in our examination of foods with fat claims in the Canadian marketplace, we found that most products with fat claims are not significantly lower in calories than comparable foods without such claims. We conclude that fat claims could be useful in assisting consumers with food choices for weight management, if the foods were also reduced in calories.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2658. Adviser: Deanna M. Hoelscher. Includes bibliographical references.

Thesis (M.Sc.) - University of KwaZulu-Natal, Pietermaritzburg, 2009. / Full text also available online. Scroll down for electronic link.

Older adults are living longer than ever before. By 2060, the U.S. population aged 65 or older is projected to reach 98 million. As adults age, the prevalence of chronic diseases and disabilities increases. The need for Meals on Wheels (MOW) services is growing alongside the aging population. Yet, little is known about the geographic variation of services. Little is documented about the organizational capacity of MOW organizations in terms of geography. The current policies supporting home-and community-based services, including MOW, may be insufficient to support all older adults in all types of communities. An analysis of the More Than a Meal® Comprehensive Network Study was conducted to determine geographic variation in services delivered through MOW programs and to document organizational capacity by geography. Chi-squared analyses were performed to identify relationships between twenty services offered through MOW organizations and categorial offerings within nutrition, in-home safety, socialization, and community connections categories. Spidergrams were created to document organizational capacity holistically and for three individual organizations for each of the geographic areas: Rural Only, Partial Rural, and Non-rural Service Areas. Using these findings, a policy analysis was conducted to determine policy recommendations to inclusively support rural older adults. Older adults living in rural areas access the full complement of services provided by MOW programs differently than do their non-rural counterparts. Specifically, a statistically significant relationship was found between the stratified component of in-home safety for rural, partial rural and non-rural service areas. When evaluated on the individual service offering level, statistically significant relationships between rurality and congregate meals, nutrition education, nutrition assessment, coordination of USDA food assistance programs, and telephone reassurance were seen. Spidergram documentation of capacity created visual representations of geographic similarities and differences. The policy analysis produced three potentially viable policy additions for the Older Americans Act around a provision for innovation programs, a report on in-home safety, and business acumen provisions. This work lays the foundation for further analysis of existing data with a lens of geographic specificity, as well as articulates the importance of looking at organizational capacity as a part of policy recommendations for understanding rural community-based organizations.

En hälsosam kosthållning minskar risken för kardiovaskulär sjukdom och bidrar till en minskad risk för akut koronart syndrom. De nordiska näringsrekommendationerna innehåller riktlinjer för att förebygga kardiovaskulär sjukdom, och dessa har vidare kvantifierats av Livsmedelsverket. Trots de stora hälsofördelar som en sådan kosthållning medför når få svenskar de uppsatta målen och kunskapen om hur kostvanorna ser ut hos gruppen av personer som genomgått akut koronar händelse är begränsad. Syftet var att undersöka hur kosthållningen hos patienter som vårdades för akut koronart syndrom stämmer överens med de nordiska näringsrekommendationerna. För att svara på syftet användes en kvantitativ metod i form av en enkätstudie. Fyrtiotvå personer som genomgått akut koronart syndrom rekryterades genom konsekutivt urval på tre hjärtmottagningar i södra Sverige. Svarsfrekvensen var 76 procent, vilket antyder att studien har god generaliserbarhet. Samband undersöktes genom Students t-test test och Fishers exakta test. Resultatet visade att enbart två procent av patienterna nådde kostrekommendationerna gällande frukt och grönsaker, och lika stor andel nådde det rekommenderade intaget av fullkornsprodukter. För konsumtion av rött kött och charkuteriprodukter åt 88 procent i enlighet med näringsrekommendationerna. Tjugosex procent åt den rekommenderade mängden nötter och frön medan 64 procent av studiedeltagarna nådde det uppsatta målet för intag av fisk. Enbart en liten andel av studiedeltagarna hade helt uteslutit feta mejeriprodukter och smörbaserade matfetter från sin kost i enlighet med rekommendationerna. Slutsatsen kunde dras att patienter som genomgått akut koronar händelse har en kosthållning som i liten grad överensstämmer med de Nordiska Näringsrekommendationerna. Med ökad kunskap om kostintagets betydelse finns det förbättringspotential för denna grupp patienters kostförändringar och hur personcentrerade kostinterventioner kan bidra till ökad kardiovaskulär hälsa. / Adhering to a healthy diet reduces the risk of cardiovascular disease and contributes to a lower risk of acute coronary syndrome. The Nordic Nutrition Recommendations includes a set of nutritional guidelines aimed at preventing cardiovascular disease and these have been further quantified by the Swedish National Food Agency. Despite the big health improvements that such a diet entails, few Swedes meet the recommended daily intakes. Little is known about how the dietary patterns of the specific subgroup of people who have experienced an acute coronary event compares to the Nordic Nutrition Recommendations. The aim was to investigate to what extent patients whom have been treated for acute coronary syndrome adhere to the latest nutritional guidelines given by the Nordic Nutrition Recommendations 2012. To answer the aim of the study a quantitative method was used through a survey study. Forty-two people were enrolled by consecutive sampling from three different heart polyclinics in southern Sweden. The study had a response rate of 76 percent, which suggests that the study had a high generalisability. Correlations between independent variables were controlled with Student’s t-test and Fisher’s exact test. The results showed that only two percent of the patients reached the guidelines dietary reference level when it comes to fruits and vegetables. The same result was shown when it comes to wholegrain dietary intake among this population, only two percent reached the recommended level. Looking at the dietary intake of red meat the result showed that 88 percent eat according to The Nordic Nutrition Recommendations. Looking at the intake of nuts and seeds, 26 percent of the patients ate as suggested in the guidelines. Sixty-four percent of this studies participants reached the recommended intake of fish per week. Only a low rate of the patients had completely excluded fat dairy products and butter-based products. The conclusion was made that patients who went through an acute coronary event have a dietary consumption that to a low extent correspond to The Nordic Nutrition Recommendations. There are room for improvement in this area. With the help of further studies in this subject would illuminate greater understanding about the dietary patterns among this patient group and how patient participatory dietary interventions could contribute to cardiovascular health.

A Segurança Alimentar e Nutricional (SAN) é a realização do direito de todos ao acesso regular e permanente a alimentos de qualidade, em quantidade suficiente, sem comprometer o acesso a outras necessidades essenciais, tendo como base práticas alimentares promotoras de saúde, que respeitem a diversidade cultural e que sejam social, econômica e ambientalmente sustentáveis. Nos últimos anos esta temática tem se destacado no cenário político nacional, principalmente após sua institucionalização por meio da Lei Orgânica de Segurança Alimentar e Nutricional (LOSAN 11.346/06) que cria o Sistema de Segurança Alimentar e Nutricional. Considerando os esforços para a implantação deste Sistema, nacionalmente, e a proximidade entre as proposições deste campo e o ideário da Promoção da Saúde, este estudo objetivou analisar um conjunto de programas de segurança alimentar e nutricional, desenvolvidos no município de São Paulo, sob a perspectiva da Promoção da Saúde, buscando verificar se ele compõe uma política de SAN promotora da saúde. A pesquisa, de caráter qualitativo, contou com análise de documentos referentes aos programas e entrevistas, por meio de questionários semi-estruturados, junto aos profissionais responsáveis por estas iniciativas. Verificou-se que os programas são distribuídos em todos os eixos de SAN (produção, abastecimento, consumo de alimentos e programas de suplementação alimentar e monitoramento da insegurança alimentar) com maior ênfase no eixo do consumo. Com relação à perspectiva da promoção da saúde, o conjunto dos programas não demonstrou ações intersetoriais, que atuassem sobre os determinantes da saúde e da má alimentação ou que promovessem a autonomia, participação e empoderamento dos indivíduos. A maior parte deles apresentou características próprias de políticas de um Estado neoliberal: assistencialistas, com ações limitadas ao oferecimento de alimentos ou renda; focalização, com atendimento apenas à população mais excluída da sociedade e alguns, de execução terceirizada, aumentando o distanciamento 2 entre Estado e população. Conclui-se que o conjunto dos programas analisados não compõe uma política municipal de SAN promotora da saúde. Descritores: Segurança Alimentar e Nutricional, Promoção da Saúde, Política de alimentação e nutrição, Nutrição e Saúde Pública / The Food and Nutrition Security is the realization of the right of everyone to the regular and permanent access to quality food, in enough quantity, without compromising the access to other essential necessities, based on health-promoting food practices that respect the cultural diversity and that are socially, economically and environmentally sustainable. In recent years this issue has been highlighted in the national political scene, especially after its institutionalization through the ´Organic Law on Food and Nutrition Security ´ (LOSAN 11.346/06) which creates the System of Food and Nutrition Security. Considering the efforts to implement this system, nationally, and the proximity between the propositions of this field and the idea of Health Promotion, this study aimed to analyze a set of programs for food and nutrition security, developed in the city of São Paulo, from the perspective of Health Promotion, to check if it makes up a policy of Food and Nutrition Security health-promoting. The qualitative research, included analysis of documents related to programs and interviews, through semi-structured questionnaires, with those professionals responsible for these initiatives. It was found that the programs are distributed on all axles of Food and Nutritional Security (production, supply, food consumption and nutritional supplement programs and monitoring of food insecurity) with greater emphasis on the axis of consumption. Regarding the perspective of health promotion, all the programs did not demonstrate intersectoral action, which acted on the determinants of health and bad nutrition or that promote autonomy, participation and empowerment of individuals. Most of them had characteristics of a neoliberal State policies: welfare, with actions limited to the offering of food or income; focus with service only to the population most excluded from society and some, outsourced execution, increasing the distance between the State and population. We conclude that all the programs analyzed did not make up a municipal policy of Food and Nutritional Security health-promoting

A presente dissertação trata da Segurança Alimentar e Nutricional (SAN) entre os povos indí-genas sob a perspectiva do Direito Humano a Alimentação Adequada (DHAA) e da Soberania Alimentar (SA). Apresenta à experiência dos indígenas Asheninkas do Alto Rio Envira, nar-rada a partir deles mesmos, com o Programa de Aquisição de Alimentos (PAA) enquanto be-neficiários fornecedores, no Município de Feijó, Estado do Acre. O PAA invest igado é exe-cutado pelo governo do estado e a modalidade é a Compra com Doação Simultânea. Demons-tra-se, por meio do Estudo de Caso, que o PAA pode fortalecer a segurança alimentar e nutri-cional dessas sociedades diferenciadas com manutenção da sua autonomia cultural. Com isso, debate-se as questões sobre a prioridade legal conferida a estes segmentos e a valorização para a aquisição de produtos tradicionais, intrínsecos á cultura, alimentação e culinária indí-gena. A ressignificação e adequação do Programa localmente unida aos laços de reciprocidade e parentesco, típicos das comunidades indígenas, contribuem para o acesso e manutenção de famílias isoladas geograficamente no Programa. Argumenta-se ainda, que a participação indí-gena no PAA, uma vez seguido os princípios legislativos do Programa e o respeito à autode-terminação dos povos, fortalece o resgate e manutenção dos sistemas alimentares tradicionais dos povos indígenas em seus territórios e terras indígenas já conquistadas legalmente. Assim, o PAA constitui-se não apenas em uma politica geradora de renda, mas, reúne, principalmen-te, características opostas às politicas indigenistas praticadas no passado. / This dissertation discusses food security and nutrition between indigenous people under the consideration of The Human Right to Adequate Food and Food sovereignty perspectives. It presents the experience of the Asheninkas’ people from the high Envira River with the Food Acquisition Program (PAA) in Feijo municipality, from their narratives as suppliers-beneficiaries. The program studied is implemented by the state government in the modality of Buy with Simultaneous donation. It is demonstrated through this case study that the PAA can strengthen food security and nutrition of these diverse societies maintaining their cultural au-tonomy. By this means, questions about the legal priority given to these segments and the appreciation to the acquisition of traditional products, intrinsic to indigenous culture, food and cuisine, are raised and debated. The local reinterpretation and adaptation of the program com-bined with the reciprocity ties and parentage, typical of indigenous communities, contribute to the access and maintenance of geographically isolated families in the program. It is further argued that the indigenous participation on PAA, once its legislative principles and the respect for these people self-determination are observed, strengthens the recovery and maintenance of indigenous traditional food systems in indigenous territories and lands already occupied legal-ly. Therefore, the PAA is not just a income generation policy, but also, and specially, a policy with opposite characteristics from the old indigenous policies.