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There is a high prevalence of chronic diseases and conditions among older, low-income individuals in the United States. It is well recognized that diet plays an important role in the management and prevention of chronic diseases. Despite this, primary-care physicians often do not provide adequate dietary counseling or appropriate nutrition referrals to this patient population. Two surveys were conducted in Southwest and the western part of Central Virginia, one with 209 family practitioners and internists and the other with 57 low-income participants in the Food Stamp Nutrition Education Program (FSNEP). The FSNEP clients were aged 40 years or older, had been enrolled in FSNEP for four months or less, and had a diet-related chronic disease or condition. Eighty-one percent of physicians reported that they provide nutrition advice to their chronic disease patients on a regular basis. Most physicians further stated that they make a limited number of referrals to registered dietitians and very few referrals to community nutrition education programs. FSNEP clients were generally dissatisfied with their primary-care physician's provision of nutrition information and indicated a desire for more dietary guidance. Results indicate a need for primary-care physician referrals to free community nutrition education services that tailor their programs to the patient's socioeconomic situation. These referrals may improve the nutrition health of older, low-income patients and help manage their chronic diseases. Informational brochures need to be developed and distributed to primary-care physicians informing them of the positive attributes of free community nutrition education programs, such as FSNEP. / Master of Science

Cholesterol levels have been shown to be related to the development of coronary heart disease and can be lowered through dietary measures (National Institute of Health, 2003). Dietary counseling alone as well as in conjunction with pharmacotherapy has been demonstrated by research to lower blood cholesterol levels. A problem exists in that dietary counseling is underused for the treatment of hyperlipidemia. The purpose of this study is to identify the different types of dietary counseling and their benefits in the treatment of hyperlipidemia as demonstrated through research. Nursing and interdisciplinary research literature published between 1990 and 2003 regarding dietary intake and hyperlipidemia was reviewed and synthesized. The benefits of dietary counseling were synthesized in relation to the outcome measures of: reduced cholesterol levels according to different types of dietary counseling and diets, cost-effectiveness, synergistic effects with pharmacological and other non-pharmacological treatment, and reduced medication-related adverse affects. Different diets and dietary counseling that significantly reduced cholesterol are reported. Limitations in synthesizing these studies were related to different variables, designs, diets, and client types, as well as the fact most research on dietary counseling is not related specifically to nursing but is interdisciplinary. This study will be significant for nursing practice because nurses are often the health care professionals who counsel the patient prior to discharge, during a routine visit, or in any preventive setting, such as health fairs, clinics, consumer education via media, or other community sites. As benefits are clearly identified, nurses will gain a better appreciation for their role in dietary counseling with patients with hyperlipidemia. Recommendations for nursing education, practice, and research were included in this study based on findings synthesized.

Adult patient education is a major responsibility of registered dietitians. It is essential for registered dietitians to be effective adult educators as they teach adults in various employment settings. Review of the literature revealed that one important factor in being an effective adult educator is developing a teaching style which facilitates learning, known as learner-centered teaching style.The purpose of this descriptive study was to identify the teaching style preference and identify factors that have influenced registered dietitians' teaching style preference.The study sample of six hundred registered dietitians residing in the Midwest (Illinois, Indiana, Michigan, Ohio and Wisconsin) were sent two tools to complete, the "Principles of Adult Learning Scale (PALS)". Two hundred and fifty-two respondents completed the questionnaire and PALS, designed by Conti to determine teaching style preference.The overall PALS scores were computer generated. Frequency distributions and populations percentages were calculated for demographic and descriptive data. The mean, median, and standard deviation of PALS scores were calculated. Analysis of various factors and the PALS scores.The findings suggest that registered dietitians' teaching style preference is teacher-centered. The years of employment positively affected teaching style toward learnercentered until the dietitian had been employed more than 16 years, then the years of employment negatively affected teaching style preference. The number of formal educational sessions relating to adult education had the most positive effect on teaching style preference. The number of continuing education session related to adult education proved to be the factor that most affected teaching style preferences.The study has implications for registered dietitians regarding dietetic education and curriculum development, continuing professional education and adult educators utilizing the PALS instrument. Further study is recommended using PALS with only entry-level dietitians and comparing PALS scores with actual classroom teaching behavior. / Department of Educational Leadership

Tesis Previa a la Obtencion de la Licenciatura en Nutricion y Dietetica, Universidad Téchnica del Norte, Facultad de Ciencias de la Salud, Escuela de Nutricion y Dietetica, Escuela de Nutricion y Dietetica. / Abstract in Spanish and English.

Thesis (Ph. D.)--Virginia Polytechnic Institute and State University, 1993. / Vita. Abstract. Includes bibliographical references (leaves 114-122). Also available via the Internet.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2006. / Vita. Includes bibliographical references (leaves 93-99).

Made available in DSpace on 2015-01-26T13:21:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-06-24Bitstream added on 2015-01-26T13:30:39Z : No. of bitstreams: 1 000797769.pdf: 276956 bytes, checksum: 9c8a21a3c55f6160175e403ecda69fa0 (MD5) / Introdução: O Diabetes Mellitus tipo 2 (DMT2) é emergente problema de saúde pública tanto no Brasil, quanto no mundo e está associado a componentes comportamentais os quais incluem a ingestão dietética, inatividade física e obesidade. A mudança do estilo de vida (MEV) pela prática de exercícios físicos e aconselhamento dietético mostra-se como terapia mais efetiva para o tratamento e a prevenção da alteração glicêmica e do DMT2. Objetivo: Verificar a eficiência de 20 semanas de programa para a mudança do estilo de vida sobre a glicemia de jejum. Métodos: Foram avaliados 237 participantes ingressantes no programa para mudança do estilo de vida (dieta e atividade física) mexa-se pró-saúde, no qual 121 completaram as 20 semanas de intervenção. Os pacientes foram avaliados quanto ao perfil bioquímico, avaliação antropométrica e nutricional, avaliação da aptidão física. Resultados: Houve reclassificação glicêmica de 27,28% dos participantes com alteração glicêmica, sendo 15,15% destes normalizados. O componente dietético variedade foi relacionado ao risco de 8% (estimativa de 0,0768 IC (0,0009-0,1527)) no aumento na glicemia e apresentando odds ratio de 1,079826 IC (1,0009-1,164975) para alterações glicêmicas. Conclusão: A baixa qualidade da dieta, principalmente pela baixa ingestão de grupos alimentares considerados protetores, influenciou a variedade alimentar como componente de risco nessa população, principalmente pela baixa ingestão qualitativa e quantitativa de cereais, frutas, hortaliças e fibras / Introduction: Type 2 Diabetes Mellitus is an emerging public health problem in Brazil and worldwide and is associated with behavioral components including dietary intake, physical inactivity and obesity. The lifestyle change programs through the practice of physical exercises and dietary advice proves to be the most effective therapy for the treatment and prevention of T2DM and glucose amendment. Objective: Verify the efficacy of 20 weeks lifestyle change program on fasting glucose. Methods: We evaluated 237 free living people participating in the lifestyle change program (diet and physical activity) Mexa-se Pró-Saúde, in which 121 of the participants completed the 20 week intervention. Patients were evaluated for biochemical profiles, anthropometric and nutritional assessment, physical fitness assessment. Results: 27.28% of the participants some degree of glycemic change were reclassificated with 15,15% being normalized. The dietary component variety was related to a risk of 8 % ( CI estimate of 0.0768 ( 0.0009 to 0.1527 ) in the increase in blood glucose and presenting an odds ratio of IC 1.079826 ( 1.0009 to 1.164975 ) to glycemic alterations . Conclusion : The poor quality of the low diet mainly by low intake of food groups that are considered protective influence food variety as a risk component in this population mainly by low qualitative and quantitative intake of cereals , fruits, vegetables and fiber

M.S.

The general objective of this investigation was to implement and strengthen family orchards for the diversification of the diet and improvement of the consumption of vegetables and fruits available in the communities of the Rinconada and Cuambo. They collaborated in the implementation and strengthening of the family orchards and by means of focal group techniques determined the readiness, seasonal variance, and alimentary habits of the available vegetables and fruits. They made 10 nutritive preparations in each community in participating shops with the foods that were harvested in the orchards and with the help of consistent educational material as 2 three-page leaflets about the “Importanceâ of Iron in the Daily Dietâ and el Importance of Vitamin A in the Daily Diet, mothers were trained. Among the principle results they were able to determine that the women were very interested in having family orchards, since it allowed them to have fresh vegetables without the need of going to the market. The majority of families have gardens and orchards for both vegetables and fruits. In the community of the Rinconada they cultivate yellow carrot, chard, cabbage, and onion. In the community of Cuambo, tomato kidney, pepper, onion paitena, and pickle any time of the year are cultivated. Families from the Rinconada have more orchards with fruit than those of the Cuambo which produce tree tomato, taxo, and blackberries. In Cuambo they produce banana, papaya, watermelon, mango, lime, avocado, guava and custard apple. The vegetables and fruits most ready, determined through focal groups, are the same ones that are produced in the orchards and families from both communities donât have the habit of buying vegetables in the market. In Rinconada, the cultivations are seasonal and the surpluses of the harvests are wasted because they have not applied appropriate elaboration and conservation techniques. All the families in the communities investigated like all the vegetables and fruits that they harvest in their family gardens, the vegetables preferably added to soups and very little to salads. The majority of mothers in these communities know that these foods are important to eat every day if they want to grow strong and prevent illness. However, these mothers donât know how to prepare, for which reason they proceeded to prepare recipes that were adapted to the habits and tastes of the consumers, the same ones that were accepted in the communities, this action helped to increase the consumption of vegetables in the different times of eating, like in lunch and dinner in the two communities, where few families eat breakfast. The consumption of fruits is minimal in Rinconada, and in Cuambo the situation improves as long as they consume it during different times of eating.