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  • ISSN: 2333-6706
    Volume 8, Issue 1
    Review Article
    Ann Miller and Nanette Steinle*
    Background: Healthy eating promotes health and reduces the risk of chronic disease. Despite the fact that the federal government has set forth guidelines to achieve an adequate diet, Americans are not meeting the recommended nutritional intakes. National data show that those aged 65 years of age and older eat the most nutritious diets when compared to younger cohorts. However, this is the only age cohort whose nutrient intake did not improve from 1999 to 2016. To fully understand how to improve nutritional intake among older individuals, it is important to consider barriers to eating healthy unique to this population.
    Aim: In this review, we present an up to date overview of the literature pertaining to healthy eating among the elderly and barriers unique to this population.
    Results: While studies show the general population tends to find time, cost, and lack of motivation as barriers to healthy eating, the barriers unique to the age cohort of 65 years of age or older tend to be more social, habitual, or health related.
    Conclusion: It is important for health care providers to understand barriers toward optimal nutrition when planning care and interventions to maintain and improve nutritional status among older individuals.
    Short Report
    Jean Kristeller, Yann Cornil, France Bellisle, and Sophie Vinoy*
    Over the last decades, eating episodes in addition to the three daily main meals have been observed worldwide; the prevalence of these “snacking” episodes raises health questions that mindful eating may contribute to answering. The goal of the symposium entitled “Mindful eating applied to snacking: a promising behavioral approach supported by research” was to introduce, for the first time in a scientific congress, the emerging science related to mindful eating and to evaluate its application to snacking occasions. It was held at the 21st International Congress of Nutrition (IUNS), which took place in Buenos Aires from October 15-20, 2017. Three primary topics were presented: 1) the definition of snacking and its role in dietary quality in adults; 2) the value of eating mindfully as an emerging concept, in relation to snacking occasions; 3) a detailed approach to mindful eating from theoretical principles to applications. Promoting mindful eating is a relatively new ‘third-wave’ cognitive-behavioral approach that enhances individuals’ awareness of, and attention to, physiological hunger and satiety, eating enjoyment, portion size and nutritional health when eating or when making food choices. Encouraging results have been obtained in obese individuals. Applied to snacking, mindful eating may help individuals’ better control food intake, and help orient their choices without compromising pleasure while eating. This symposium was organized by Mondelez International R&D.
    Research Article
    Sophie Vinoy*, Roberte Aubert and Didier Chapelot
    Objectives: To compare the effects of two cereal products differing by their slowly digestible starch (SDS) content and by their glycaemic index (GI) on plasma glucose and insulin (Experiment I) and on subjective satiety scores (Experiment II) when eaten as part of a realistic breakfast.
    Design: A randomised double-blind within-subject design with subjects eating the breakfast with a high SDS (HSDS) or low SDS (LSDS) cereal product in counter-balanced order.
    Subjects: Twelve healthy young adults (6 males, 6 females) participated in both Experiments I and II and 12 adults (6 males, 6 females) were added to participate in Experiment II.
    Methods: In Experiment I, blood samples were drawn prior to and at various rates over a postprandial interval of 240 min for plasma glucose and insulin assays. In Experiment II, hunger and gastric fullness scales were rated prior to and every 30 min over the same postprandial interval as in Experiment I.
    Results: In Experiment I, plasma glucose and insulin incremental areas under the curves (iAUC) over 120 min were lower in the HSDS than in the LSDS condition (P = 0.03 and P = 0.004 respectively). Total AUC over the 240 min (tAUC) for plasma insulin but not glucose was lower in the HSDS than in the LSDS condition (P = 0.01). At 240 min, plasma glucose concentrations were higher in the HSDS than in the LSDS condition (P = 0.04). In Experiment II, hunger ratings were lower and gastric fullness ratings higher in the HSDS than in the LSDS but this difference occurred mainly between 90 and 160 min.
    Conclusions: A cereal product with a high SDS content reduces the postprandial glucose and insulin responses and increases the satiety of a breakfast.
    Lucy Amanya Mutuli*, Peter Bukhala, Gordon Nguka
    Introduction: Sub-optimal dietary intake patterns have a major detrimental impact on the nutritional status of an alcoholic. These patterns exacerbate the status of alcoholism and the functioning of the alcoholic's body.
    Objective: This study aimed to examine alcoholic’s dietary intake patterns.
    Methods: A cross-sectional study was conducted on 204 alcoholics undergoing alcohol rehabilitation in selected rehabilitation centers. A 24 hour food recall and food frequency questionnaire was used to assess dietary intake of the respondents. Factor analysis of food items and groups, cluster analysis of dietary intake patterns, and multivariate regressions were carried out.
    Results: Three dietary intake patterns were identified among alcoholics namely a low calorie intake (described mainly by consumption of plant-based foods); a composite intake (distinguished by adequate consumption of both plant-based and animal-based foods) and a high calorie intake (characterized by high consumption of animal-based foods).
    Conclusion: Optimal dietary intake promotion programs are needed to address the dietary intakes of recuperating alcoholics under rehabilitation to help prevent malnutrition and other associated comorbidities.
    Lucy Amanya Mutuli* and Peter Bukhala
    Background: Structural equation modeling is a methodology for representing, estimating, and testing a network of relationships between measured variables and latent constructs. This statistical approach is used quite readily to test theoretical models and provide overall fit indices that determine whether the model tested actually fits the observed data.
    Objective: We aimed at providing recuperating alcoholics with the basics of structural equation modeling so they can assimilate evidence from studies that use this statistical tool to incorporate such findings into optimal dietary intake practice.
    Methods: This cross-sectional study was conducted from August to November 2018 amongst recuperating alcoholics receiving rehabilitation in Asumbi treatment center of Homabay County, Kenya. Structural equation modeling determined the evidence of practice of optimal dietary intake amongst recuperating alcoholics.
    Results: Structural model parameter estimation showed high values, especially for subjective norm (β=0.62, p<0.01, n=207) that significantly influenced practice of optimal dietary intake.
    Conclusion: Nutritionist or other health professionals who wish to use SEM to explore such relations should apply all the steps used in SEM and ensure they have a sample that is sufficient.
    Research Article
    Adewale M Adejugbagbe*, IkeOluwapo O Ajayi, Aderemi O Ayegbusi, and Olubunmi P Oki
    Background: Community Management of Acute Malnutrition (CMAM) is a proven approach for the reduction of under-five morbidity and mortality in Nigeria.
    Objective: To assess knowledge of and compliance with National Operational Guidelines (NOG) for Community Management of Acute Malnutrition (CMAM) among Community Health Workers (CHWs).
    Method: A descriptive cross-sectional study was conducted in Primary Health Care (PHC) facilities in Konduga Local Government Area of Borno State, Nigeria. All 48 CHWs providing CMAM services were included in the study, and assessed on knowledge and compliance with NOG for CMAM. A point was assigned to correct response to 6 knowledge and 5 compliance questions. Respondents with scores above 3 were categorized as those with good knowledge, while those with scores above 2 were categorized as good compliance. Data were analyzed using independent samples T-test and correlation analysis, with the level of significance set at 0.05.
    Results: Generally, 29 (69.0%) of the respondents had good knowledge of the CMAM guidelines, and 31 (73.9%) had good compliance with the guidelines. High level of compliance with the CMAM guidelines was significantly associated with having 5 or more years of working experience (t (30.6) = -2.27, P = 0.030) and increase in the level of knowledge of the guidelines (r = 0.37, P = 0.017).
    Conclusion: Our findings revealed that the level of compliance with the CMAM guidelines is high particularly among health workers with high years of working experience and high level of knowledge of the CMAM guidelines. Regular training of health workers on the guidelines, particularly among those with low years of experience is recommended.
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