S.L. Anderson

A Descriptive Study of Breastfeeding Practices and Policies in Missouri Hospitals

All Missouri hospitals that offer maternity services were assessed to measure their compliance with WHO/UNICEF Baby Friendly Hospital Initiative (BFHI). Representatives from seventy six hospitals responded to a telephone survey relating to hospital breastfeeding practices and policies as defined by BFHIs Ten Steps to Successful Breastfeeding. No hospital fully supported the Ten Steps. Compliance with the WHO/UNICEF criteria varied greatly. The least support was for Step 1, only 28% of hospitals had a written breastfeeding policy that was communicated to all staff. The greatest support was for Step 3, 93% of hospitals had staff who informed all pregnant women of breastfeeding benefits. In order to increase breastfeeding rates and duration, administrators of hospitals that offer maternity services must increase their efforts to consistently implement the Ten Steps, to become more baby friendly, and to more fully establish a breastfeeding culture within their institutions.

The Effect of Folic Acid Fortification on Folate Intake in Rural Women

Abstract The objective of this study was to determine the effect of fortification on dietary folate intake in a sample of rural women. The 289 subjects were recruited at 2 community health screenings. Most were white (88%), college educated (51%), and middle income (60% with incomes

The Accuracy of Body Mass Index for Classifying Overweight using Self-Reported Measurements in Women

30K+). Average age was 47.7 years. Dietary assessment data were collected with a quantitative food frequency (Block) using the Nutrition DISCovery™ program. Fortification was simulated using the fortification standard, i.e., 140μg folic acid/100g flour. Mean dietary intake of folate increased significantly with fortification (320 vs 489μg, P P =.003). On the other hand, the upper quartile women consumed significantly more servings of fruits ( P P =.037) than women in the lowest quartile; food groups contributing to folate intake, but unaffected by fortification. The proportion of women consuming the dietary reference intake (DRI) of 400ug from food increased by 40% after fortification. From food alone, 35% of the women were still not meeting the DRI; this decreased to 20% when taking folic acid supplements into account. Concerns have been expressed that fortification may elevate folate intakes to unsafe levels (≥1000μg). Of the 10% of women meeting this criterion after fortification, their intakes ranged from 1009-1300 μg or levels that would preclude undue concern. Most of these women were taking a daily supplement of 400ug. The improvements in folate intake in this sample may not apply to groups with limited resources. Based on this sample of highly educated, adult women, the current level of fortification will improve the intakes of a large proportion of women especially when accompanied with folic acid supplements. However, some women still did not meet current recommendations.

Stages of Change for Dietary Calcium Intake Among Rural Adults

Abstract Many surveys and epidemiological studies largely rely on self-reported height and weight in data collection. Obesity and overweight are of public concern due to their relation to several chronic diseases. Since attitudes toward body weight change over time, it is important to continually assess the validity of using self-reported weights and heights. Relatively few studies have examined the accuracy of calculating BMI (kg/m 2 ) from self-reported data. Women attending a community health event volunteered to have their weights and heights measured on standardized equipment. Prior to the measurements, women provided their self-reported weights and heights. Measurements were completed on 176 females ranging from 17-89 years. Body size was defined with the NHLBI guidelines using measured BMI. Overall, measured weights were significantly higher than reported weights ( P P P

Which Weigh is the Right Way

Abstract Stages of change models provide one type of theoretical framework to explain health behaviors and predict which individuals are most likely to successfully make behavior changes. These models have been applied to fat, fruits and vegetables, and fiber intakes. Application to other dietary components has not been explored. The purpose of this study was to examine stage of change with regard to dietary calcium intake in rural adults. Data were collected from 66 males and 308 females, 18-89 years. Subjects were recruited from 2 community health screenings. Most were college educated (60%) and the average age was 48 y. A standard stage question for calcium intake was administered to classify individuals to precontemplation, contemplation, preparation, action, or maintenance. Dietary assessment was collected with a quantitative food frequency (Block) using the Nutrition DISCovery™ program. The distribution of males by stage status was significantly different from females. About a quarter (24%) of the males were in precontemplation compared to 8% of the females, whereas 58% of the males were in the action or maintenance stage compared to 60% of the females. The self-reported stage classification was significantly associated with total calcium ( P P P P =.014). Nutrition education programs addressing prevention of calcium-related diseases may benefit by incorporating stage based screening questions to their protocols. These results show promise for the stages model with dietary calcium intake.

Development of a Unit Incorporating Bioelectrical Impedance Analysis Into the Classroom

Abstract Body composition is an important factor in determining the nutritional status of individuals and populations. Body mass index (BMI), a measure of weight independent of height, is commonly used to assess body composition in populations. Data from the Framingham cohort have shown that mean body mass index does not change across decades of age (Am J Public Health 1995; 85:726-8). Whereas, the proportion of body fat among women in the cohort increased between ages 30 and 60 and then declined. In contrast, waist-to-hip ratio (WHR) increased linearly with age. The purpose of this study was to examine these relationships in women over 19 years old from a rural population. Body composition measurements were offered as part of a total health-screening package. Trained volunteers measured the participants who wore light clothing and no shoes. Height was measured with a portable stature board. Weight was measured with an electronic floor scale. Waist and hip circumferences were measured. Bioelectrical impedance was measured by using a standard tetrapolar technique according to procedures provided by the manufacturers (BIA-101A, RJL Systems and BES 200 Z, Bioelectrical Sciences, Inc.). BMI was calculated as weight (kg)/height (m) 2 . Measurements were collected on 350 women. By decade, average BMI was 26.0 (20-29yrs), 27.0 (30-39yrs), 27.7 (40-49), 28.3 (50-59yrs), 27.7 (60-69yrs), 26.8 (70+yrs). For percent body fat, the average by decade was 32.6, 33.8, 32.5, 33.7, 33.0, and 30.8. The mean WHR increased from 0.77 among the 20-29 group to 0.82 among the 70+group. The effect of age on the various measurements was examined using linear regression. Only WHR was significantly associated with age ( p =.011). These data support the results from Framingham that fatness varies with age and more importantly the distribution of fat becomes unhealthy with age (i.e., closer to 1.0). These changes are not captured with the BMI.

College Students And The 1990 Nlea Food Labels: Room For Improvement

Abstract Bioelectrical impedance analysis (BIA) is an accepted, simple, non-invasive method for estimating body composition. Adolescents deal with concerns of body weight and body image on a daily basis. Addressing these concerns can provide educators with a teachable moment that may spark interest to enter the profession of dietetics. Data show that incorporating hands-on experiences into the classroom promotes scientific thinking and arouses and maintains the interest and curiosity of young people. The purpose of this project was to determine the effectiveness and acceptance of an instructional unit that incorporates BIA and its underlying electrical principles and the profession of dietetics into the classroom of 7 th , 8 th , and 9 th grade students. A module was developed intertwining the above mentioned topics. The module was field tested along with an evaluation component regarding acceptance of such a unit to young people. Evaluation of the cognitive information presented was completed verbally within the presentation. Twenty subjects participated in the field test. Subjects were participants attending a conference for middle school aged females at a Midwestern university. The evaluation tool was analyzed by computing frequencies and averages of Likert-type responses. Among the participants, 18 out of 19 (95%) responded that the workshop helped them understand what dietetics is about. In addition, 15 out of 19 (79%) answered that the workshop taught them some of the underlying electrical principles of BIA, and 15 out of 19 (79%) found the workshop to be interesting. Nine of the eleven (82%) written comments on the evaluation tool were positive. Based on the positive results from the field testing, the presentation was developed into a complete instructional unit. Overall, the field-testing and development of the instructional unit was found to be effective. Incorporating BIAs electrical principles into an instructional unit for middle school adolescents has a promising future.

Comparison Of Eating Disorder Inventory (edi2) Scores Of Male Bodybuilders To The Male College Student Subgroup.

Abstract LEARNING OUTCOME: To identify the knowledge, attitudes, and behaviors of college students related to the use of 1990 NLEA food labels. This study investigated the knowledge, attitudes, and behaviors of college students in relation to the 1990 NLEA food label. The purpose of the study was to: 1) determine if college students possess the knowledge and skills needed to use the 1990 NLEA food labels; 2) determine the attitudes of college students toward food labels; and 3) determine if college students are using the 1990 NLEA food labels as a tool in planning a healthy diet. The study surveyed 214 college students at Southeast Missouri State University who were enrolled in general education classes. The overall Cronbach alpha for the survey was .80. The response rate was 99.5%. Conclusions reached from analysis of the survey data were: 1) college students can obtain basic facts from the label, but are less successful at performing more complex tasks; 2) consumer confidence is low regarding the truthfulness of nutrition claims; 3) college students lack a clear understanding of which nutrients on the label are most important to their health; 4) the nutrition facts label plays a minor role in planning the daily diet of college students, although 95% felt that the label was useful; and 5) label reading educational programs increase student knowledge level. Further education of college students is needed to improve usage, understanding, and confidence in the 1990 NLEA label.

Comparison of Eating Disorder Inventory (EDI-2) Scores of Male Bodybuilders to the Male College Student Subgroup

Abstract Male bodybuilders report high-protein, low-fat hypocaloric diet patterns similar to those seen in college females with anorexia nervosa and bulimia. The intensity and effort that bodybuilders put into their training suggests obligatory-type behavior, not unlike compulsive eaters and/or compulsive alcohol drinkers, or those with eating disorders. This study surveyed volunteers who identified themselves as competitive or recreational bodybuilders regarding eating behaviors using the Eating Disorder Inventory 2 (EDI2), which has been assessed to be a reliable and valid instrument to screen for tendencies toward eating disorders. Male subjects (n=65) were recruited through announcements in two midwestern and one western university weight lifting clubs, announcements strategically placed on each campus, and phone and/or personal contact by the researchers. A control group (non-bodybuilders/non-weight lifters) (n=41) was recruited from students in non-athletic classes. Subjects were asked to complete a questionnaire composed of questions from the Eating Disorders Inventory 2 (EDI2) and an additional pool of questions. In addition to descriptive statistics, a t-test was used to examine relationships (p ≤ .05) between independent variables (control vs bodybuilder) and dependent variables (EDI2 scores), and between independent variables. EDI2 scores for bodybuilders were significantly different between the subjects and control groups on the Interpersonal Distrust scale. Since this comparison was based on average results for the groups, it does not rule out the possibility that some of the subjects exhibit characteristics typical of eating disorders. It is also possible that the EDI2 is not an appropriate scale to measure eating disorder tendencies in males, especially bodybuilders.