Kathryn M. Kolasa

The potato and human nutrition

SummaryThe potato plays its role in human nutrition only to the extent that it is consumed. The basic product has excellent nutritional value for today and the future. However, there may be ways to enhance its contribution to human nutrition through education, marketing, breeding, field management, and finally preparation for consumption. “What I say is if a man really likes potatoes, he must be a pretty decent sort of fellow and well nourished.” ... Tom Curry

New Developments in Nutrition Education Using Computer Technology

Abstract In recent years, computer applications have emerged as viable means of gathering and disseminating nutrition information. Both stand-alone and on-line applications are being used to provide information on and training in nutrition education for the public, paraprofessionals, and professionals. While the use of on-line communication applications such as electronic mail (e-mail), electronic discussion groups, and list-servs are just emerging as important tools among nutrition educators, the exponential growth of the Internet and the World Wide Web are making these technologies more and more accessible. Nutrition educators are encouraged to explore the opportunities and challenges of these new technologies to enhance their work.

Food Literacy Partners Program: A Strategy To Increase Community Food Literacy

The Food Literacy Partners Program was developed to train health professionals and community volunteers and to provide culturally appropriate food, nutrition, and physical activity education to adults and children in rural areas who are eligible for food stamps. This strategy is designed to improve

Insulin Resistance Status: Predicting Weight Response in Overweight Children

OBJECTIVE To assess the relationship between insulin resistance and body mass index (BMI) z score associated with dietary modification that focuses on limiting sweetened beverage consumption in overweight children. DESIGN A retrospective cohort study conducted between July 1, 2004, and April 28, 2006. SETTING Community-based primary care practices treating children. PATIENTS Forty-five children (aged < or =18 years) at or above the 95th percentile of BMI for age and sex. Intervention Children and parents were instructed by a dietitian regarding caloric reduction and modification of sweetened beverage intake. MAIN OUTCOME MEASURES Insulin resistance at baseline was calculated from fasting insulin and glucose levels (ie, homeostatic model assessment [HOMA]) and change in BMI z score from baseline to 12-week follow-up. RESULTS Change in BMI z score in response to a decrease in sweetened beverages correlated (Pearson product moment correlation coefficient = 0.42; P < .01) with baseline insulin resistance. Those with a decrease in or an unchanged BMI z score had significantly greater insulin resistance than those whose BMI z score increased (mean [SD] HOMA, 6.2 [4.2] vs 2.6 [2.0], P < .01). Linear regression confirmed that HOMA was a significant predictor of change in BMI z score when controlling for age, race, and sex. CONCLUSIONS Among overweight children in primary care practices, a significant relationship was found between insulin resistance and the change in BMI z score associated with a dietitian-mediated intervention that includes a focus on decreasing sweetened beverage consumption. Estimating insulin resistance may inform dietary recommendations for overweight children.

Healthy Eating: Defining the Nutrient Quality of Foods.

Today, many initiatives to promote healthy eating and physical activity focus on changing policy and the environment to improve the health, not only of motivated or high-risk individuals but also the entire population. The escalating rates of overweight/obesity and incidence of diet-related diseases/health conditions will require many interventions to influence change. Those wishing to affect policy and environmental changes are often faced with defining foods and beverages that meet criteria defined as “healthy.”

Comparison of predictive equations and measured resting energy expenditure among obese youth attending a pediatric healthy weight clinic: one size does not fit all.

BACKGROUND The Academy of Nutrition and Dietetics recommends the use of indirect calorimetry for calculating caloric targets for weight loss in obese youth. Practitioners typically use predictive equations since indirect calorimetry is often not available. The objective of this study was to compare measured resting energy expenditure (MREE) with that estimated using published predictive equations in obese pediatric patients. MATERIAL AND METHODS Youth aged 7 to 18 years (n = 80) who were referred to a university-based healthy weight clinic and who were greater than the 95th percentile BMI for age and gender participated. MREE was measured via a portable indirect calorimeter. Predicted energy expenditure (pEE) was estimated using published equations including those commonly used in children. pEE was compared to the MREE for each subject. Absolute mean difference between MREE and pEE, mean percentage accuracy, and mean error were determined. RESULTS Mean percentage accuracy of pEE compared with MREE varied widely, with the Harris-Benedict, Lazzer, and Molnar equations providing the greatest accuracy (65%, 61%, and 60%, respectively). Mean differences between MREE and equation-estimated caloric targets varied from 197.9 kcal/day to 307.7 kcal/day. CONCLUSIONS The potential to either overestimate or underestimate calorie needs in the clinical setting is significant when comparing EE derived from predictive equations with that measured using portable indirect calorimetry. While our findings suggest that the Harris-Benedict equation has improved accuracy relative to other equations in severely obese youth, the potential for error remains sufficiently great to suggest that indirect calorimetry is preferred.

All You Want to Know about Fruit Juice

The new regulations require some important changes in the labeling of juice and juice drink. Much confusion exists about fruit juices and juice drinks and their role in the American diet. This article identifies and examines nutrition and food science issues regarding juices and juice drinks, consumption patterns, manufacturing processes involved in their production, their macro- and micronutrient composition and their role in meeting the dietary needs of various population segments, labeling under the new NLEA regulations and other dietary issues related to juice product consumption.

Medical nutrition therapy for overweight youth in their medical home: The KIDPOWER experience

OBJECTIVE To determine the feasibility and impact of implementing a standardized medical nutrition therapy (MNT) protocol to treat overweight children in their medical home. Primary outcomes evaluated were changes in eating behaviors, television habits, and weight status. METHODS A MNT protocol with handouts (known as KIDPOWER) was delivered by a registered dietitian (RD) to overweight children (2-20 years) in 9 primary care practices in a rural community. A medical record review yielded height, weight and selected patient/parent reported eating and TV behaviors from each MNT visit. Mean values were compared by paired samples t-tests. Changes in behaviors and BMI z score were compared using repeated measures ANOVA. RESULTS For patients with at least three MNT visits (n=109) significant improvements in eating and TV viewing habits were seen by the third visit. Weight status, as determined by a significant decline in mean BMI z score, was improved. CONCLUSION The KIDPOWER protocol delivered by a RD in the pediatric medical home aided overweight youth in making behavior changes that positively impacted their weight status. PRACTICE IMPLICATIONS Reimbursement to RDs for treating childhood obesity is improving and KIDPOWER provides a model and tools for community practice.

Delivering a Behavior-Change Weight Management Program to Teachers and State Employees in North Carolina

Purpose. To ascertain the effectiveness of a behavior-change weight management program offered to teachers and state employees in North Carolina (NC). Design. Fifteen-week weight management program with premeasures and postmeasures. Setting. State agencies and public K-12 schools in five NC counties. Subjects. A total of 2574 NC state employees enrolled in 141 classes. Intervention. Eat Smart, Move More, Weigh Less (ESMMWL) is a 15-week weight management program delivered by trained instructors. Lessons inform, empower, and motivate participants to live mindfully as they make choices about eating and physical activity. Measures. Height, weight, body mass index (BMI), waist circumference, blood pressure, confidence in ability to eat healthy and be physically active, changes in eating, and physical activity behaviors. Analysis. Descriptive statistics, t-tests, χ2 tests, and analyses of variance. Results. Data are reported for 1341 participants in ESMMWL who completed the program, submitted an evaluation, and had not participated in the program in the past; 89% were female and mean age was 48.8 years. Average BMI and waist circumference decreased significantly. Confidence in eating healthfully and being physically active increased significantly. The percentage of participants with a BMI < 30 kg/m2 increased from 40% to 45% and those with a normal blood pressure increased from 23% to 32.5%. Participants reported being more mindful of what and how much they ate (92%), being more mindful of how much daily physical activity they got (88%), and eating fewer calories (87.3%). Conclusion. This project demonstrated the feasibility of implementing a behavior change–based weight management program at the worksite to achieve positive outcomes related to weight, blood pressure, healthy eating, and physical activity behaviors. Programs such as this have the potential to provide health care cost savings.

Using Synchronous Distance-Education Technology to Deliver a Weight Management Intervention

OBJECTIVE To compare the effectiveness of online delivery of a weight management program using synchronous (real-time), distance-education technology to in-person delivery. METHODS Synchronous, distance-education technology was used to conduct weekly sessions for participants with a live instructor. Program effectiveness was indicated by changes in weight, body mass index (BMI), waist circumference, and confidence in ability to eat healthy and be physically active. RESULTS Online class participants (n = 398) had significantly greater reductions in BMI, weight, and waist circumference than in-person class participants (n = 1,313). Physical activity confidence increased more for in-person than online class participants. There was no difference for healthy eating confidence. CONCLUSIONS AND IMPLICATIONS This project demonstrates the feasibility of using synchronous distance-education technology to deliver a weight management program. Synchronous online delivery could be employed with no loss to improvements in BMI, weight, and waist circumference.