Elaine McDonnell

The role of fatty acid saturation on plasma lipids, lipoproteins, and apolipoproteins: I. Effects of whole food diets high in cocoa butter, olive oil, soybean oil, dairy butter, and milk chocolate on the plasma lipids of young men☆

The present studies were conducted to evaluate the cholesterolemic effects of whole-food diets high in stearic acid. In study no. 1, normocholesterolemic young men were fed diets high in stearic acid provided by cocoa butter (CB); oleic acid provided by olive oil (OO); linoleic acid provided by soybean oil (SO); and myristic acid (and lauric acid) provided by dairy butter (B). In study no. 2, different subjects with similar baseline characteristics were fed diets high in stearic acid provided by milk chocolate (C), CB, CB+B (4:1, MIX), and myristic (and lauric) acid provided by B. Both studies used a randomized, crossover, double-blind experimental design, and experimental subjects (n = 18 for study no. 1 and n = 15 for study no. 2) in each study consumed every diet for 26 days with a 1-month wash-out period between each experimental period. The diets provided 37% of calories from fat, of which 81% was provided by the test fat. Ten ounces (280 g) C was provided daily by the C diet. In study no. 1, the B diet was hypercholesterolemic, whereas the SO diet was hypocholesterolemic, compared with the other diets. The OO and SO diets were hypocholesterolemic compared with the CB diet. Low-density lipoprotein (LDL) cholesterol levels, in general, paralleled the changes in plasma total cholesterol levels. SO significantly decreased apolipoprotein (apo) B levels compared with the other diets. Plasma very-low density lipoprotein (VLDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and apo A-I levels were unaffected by the experimental diets.(ABSTRACT TRUNCATED AT 250 WORDS)

A Comprehensive Coding System to Measure the Quality of School Wellness Policies

In 2006, all local education agencies in the United States participating in the National School Lunch Program were required to establish school wellness policies that covered nutrition education, nutrition standards for school foods, and physical activity. The purpose of this psychometric study was to develop and evaluate the properties of a comprehensive and quantitative coding system to evaluate the quality of these policies. A 96-item coding tool was developed to evaluate seven goal areas: nutrition education, standards for US Department of Agriculture child nutrition programs and school meals, nutrition standards for competitive and other foods and beverages, physical education, physical activity, communication and promotion, and evaluation. Each goal area subscale and the total scale were scored on two dimensions: comprehensiveness and strength. Reliability was assessed by having pairs of researchers from four different states code a sample of 60 polices between July 2007 and July 2008. Goal area subscales were internally reliable (Cronbachs alpha=.60 to .93). Adequate interrater reliability scores were obtained at each level of scoring: total comprehensiveness and strength scores (intraclass correlation coefficient 0.82), subscale scores (intraclass correlation coefficient 0.70), and individual items (intraclass correlation coefficient 0.72). This coding system provided a reliable method for analyzing and comparing school district wellness policies in single or multistate studies.

School feeding programs in developing countries: impacts on children's health and educational outcomes.

School feeding programs (SFPs) are intended to alleviate short-term hunger, improve nutrition and cognition of children, and transfer income to families. The present review explores the impact of SFPs on nutritional, health, and educational outcomes of school-aged children in developing countries. Peer-reviewed journal articles and reviews published in the past 20 years were identified and screened for inclusion. Analysis of the articles revealed relatively consistent positive effects of school feeding in its different modalities on energy intake, micronutrient status, school enrollment, and attendance of the children participating in SFPs compared to non-participants. However, the positive impact of school feeding on growth, cognition, and academic achievement of school-aged children receiving SFPs compared to non-school-fed children was less conclusive. This review identifies research gaps and challenges that need to be addressed in the design and implementation of SFPs and calls for theory-based impact evaluations to strengthen the scientific evidence behind designing, funding, and implementing SFPs.

Statewide Assessment of Local Wellness Policies in Pennsylvania Public School Districts

With the passage of the Child Nutrition and Women, Infants, and Children Reauthorization Act of 2004, schools that sponsor school meals programs are required to establish local wellness policies to address childhood obesity. Little is known about how school districts will respond to this mandate, the nature of local wellness policies, and their compliance with this mandate. The objectives of this cross-sectional descriptive study, conducted in early 2007, were to assess local wellness policies established by Pennsylvania public school districts, compare these policies to local wellness policy mandate requirements, and provide information about local wellness policy development and implementation. Local wellness policies were collected from all Pennsylvania public school districts that sponsor school meals programs (N=499). School district representatives also completed and submitted a local wellness policy checklist, providing information about local wellness policy development and implementation. Policy goal data were abstracted and entered into a Microsoft Access database along with local wellness policy data. Frequencies were calculated. All required public school districts (N=499) submitted local wellness policies. Most school district local wellness policies (85.6%-100%) met each mandate requirement (eg, included goals for nutrition education, physical activity, etc.). The most common policy goals were general and may be difficult to measure, suggesting school staff may need assistance developing action plans and measuring policy implementation. Most respondents identified the superintendent (n=377; 75.6%) and school foodservice director (n=301; 60.3%) as responsible for ensuring local wellness policy implementation. Questions remain about feasibility of these district-level personnel to ensure policy implementation at the school level. The ability of local wellness policies to impact childhood obesity will depend on efforts at both the school and district levels to implement and enforce local wellness policies.

How to put the food guide pyramid into practice

The Food Guide Pyramid represents changes and challenges for nutrition educators. Nutrition educators will have to change the focus, content, and teaching expectations for lessons. Use of the Pyramid will also require changes in the way the concepts of good nutrition are related to different audiences. In contrast to previous food guides, which represented a foundation diet, the Food Guide Pyramid represents the total diet, addressing overnutrition as well as undernutrition. The Food Guide Pyramid is a graphic representation of the Dietary Guidelines for Americans, and illustrates the key concepts of variety, moderation, and proportionality. For practitioners, one challenge is to find ways to effectively use the Food Guide Pyramid to teach clients how to put the Dietary Guidelines into action. Another challenge involves designing materials that adapt the messages of the Food Guide Pyramid to a variety of audiences. Teaching materials and instructions should emphasize the key concepts of the Food Guide Pyramid and should be clear, consistent, motivational, and culturally sensitive. Few educational materials are available to help practitioners with these challenges. In this article we outline the key changes that the Food Guide Pyramid embodies, and provide ideas and suggestions for using the Pyramid in a practice setting.

Lessons From Pennsylvania’s Mixed Response To Federal School Wellness Law

Federal legislation aimed at tackling the nations soaring childhood obesity rate through changes to school meals and nutrition and wellness programs has met with mixed results. An examination of Pennsylvanias response to the Child Nutrition and Women, Infants, and Children (WIC) Reauthorization Act of 2004, one of the most comprehensive state responses, found improvements to the nutritional quality of foods offered à la carte in conjunction with school meal programs. However, multiple weaknesses remain. Consistent wellness policy implementation steps were not followed, and there was inadequate statewide enforcement. Despite this, Pennsylvania can offer lessons for other states in moving forward with programs to promote good nutrition and wellness.

Evaluation of Implementation of an Interdisciplinary Nutrition Curriculum in Middle Schools

Abstract This paper provides an evaluation of teachers’ implementation and perceptions of Mid-LINC, an interdisciplinary nutrition curriculum for middle school students. Evaluation methodology included both quantitative and qualitative procedures. Quantitative evaluation included distribution of a survey instrument to measure teacher attitudes toward the curriculum, their implementation of the curriculum, and factors related to attitude and implementation. Qualitative evaluation included classroom observation, depth interviews with teachers, and focus group interviews. On average, elementary and home economics teachers taught the highest number of lessons, and language arts teachers taught the fewest. The number of college nutrition courses taken by the teacher was the best predictor of implementation of the curriculum. Overall, the response to the curriculum was very favorable, with teachers rating it easy to use, flexible, and complete. The perceived importance of team teaching, the extent to which the teacher felt informed about nutrition, and the felt importance of nutrition in the middle school curriculum were significant predictors of comfort with the curriculum. Important facilitators to successful implementation are a project manager, teacher interest, and common planning times. Barriers to implementation include scheduling constraints, teacher resistance, personnel changes, and lack of administrative support.

Student Involvement in Wellness Policies: A Study of Pennsylvania Local Education Agencies

OBJECTIVE Explore student-involvement goals in local wellness policies (LWPs) of local education agencies (LEAs) in Pennsylvania (PA) and investigate associations with LEA characteristics. DESIGN An observational study that helped examine student-involvement goals. SETTING Public PA LEAs. PARTICIPANTS LWPs submitted by 539 PA public LEAs. MAIN OUTCOME MEASURES Six student-involvement goals analyzed as dependent variables. Correlations between demographic and policy characteristics of LEAs and student-involvement goals were measured. ANALYSIS Policies developed by LEAs were abstracted and analyzed. Logistic regression models were developed to analyze relationships between student-involvement goals and the demographic and policy characteristics of LEAs. RESULTS Majority of LEAs included policy goals that address student involvement in an array of activities related to wellness policy, food service, and role modeling. Regression models showed that LEAs with comprehensive and strong policies were most likely to include student-involvement goals regardless of LEA location, enrollment, or socioeconomic status of students. CONCLUSIONS AND IMPLICATIONS Student engagement in school nutrition policies has been shown to increase student acceptance in an array of health-related areas and is therefore promising in the area of obesity prevention. Comprehensiveness and rigor of LWPs were strongly correlated with the inclusion of student-involvement goals on LWPs. The upcoming reauthorization of the Child Nutrition programs in 2010 creates a good opportunity to address student involvement in LWPs.

Development and Delivery of a Nutrition Education Course with an Electronic Mail Component

Abstract This report describes the development and delivery of a distance education course in nutrition with an electronic mail component. The course is modeled after a traditional classroom course offered at our university. The distance version was piloted with nine students. It included a print study guide, written assignments, and an e-mail component. The e-mail component allowed for discussion among students without face-to-face meetings. Student achievement was high on the course assignments and exam. Students reported favorable reactions to the course content, the course delivery method, and the e-mail interaction. This report presents a model for nutrition educators to provide effective education to geographically dispersed audiences.

Menu Adjustments Made By School Food Service Directors To Address Usda Nutrient Standards and Dietary Guidelines

Abstract LEARNING OUTCOME: To delineate changes that School Food Service Directors (SFSDs) in Pennsylvania have made in response to the USDA Nutrient Standards and Dietary Guidelines. Based on Federal regulations, SFSDs need to document whether their menus meet nutrient standards. In order to assess the status of changes in menus based on the regulations, a survey was administered to a group of 48 school food service employees who attended a training session on nutrient analysis software. The survey included questions about participant demographics, perception of reaching USDA nutrient standards for school meals, self-reported menu changes, and documentation practices. The majority of the participants in the session were School Food Service Directors (83.33%). Respondents were split in terms of educational level. Twenty had high school diplomas and twenty had Bachelors degrees. Most of the SFSDs reported that they had begun to make menu changes associated with USDA nutrient standards. Twenty-five percent reported they felt they met the standards, forty percent had started the process, and only four percent (two respondents) stated that they had not yet begun making changes. Almost 40% of SFSDs felt that their meals were not less than 30% fat. Seventeen percent felt that their meals averaged less than 30% fat. The remaining 43% felt that their meals were sometimes low in fat. Eighty-five percent of the SFSDs reported increasing the amount of fruits and vegetables in their menus as a result of the new USDA regulations, and sixty-two percent felt that their menus were high in fruits and vegetables. Fifty-two percent had not analyzed the nutrient content of their menus; 48% had done so either by computer or manually. Most SFSDs (81%) are currently collecting nutrient information on the foods they are serving and most (73%) are requesting low fat foods from vendors. Most SFSDs in this sample are making changes to meet the USDA standards, and additional data about these changes will be presented along with conclusions.