Student consumption of a la carte foods during school lunch meals

The purpose of this study was to evaluate students' lunch consumption compared to NSLP guidelines, the contribution of competitive foods to calorie intake at lunch, and the differences in nutrient and food group intake between the a la carte food consumers and non- a la carte food consumers.^ In Fall 2011, 1170 elementary and 440 intermediate students were observed anonymously during school lunch. The foods eaten, their source, grade level, and gender were recorded. All a la carte offerings met the Texas School Nutrition Policy.^ Differences in nutrient and food group intake by grade level and between students who consumed a la carte and those who did not were assessed using ANCOVA. A chi-squared analysis was conducted to evaluate differences in a la carte food consumption by grade level, gender, and the school's low income status.^ Average lunch intakes for elementary students were 457 (SD 164) calories for elementary students and 541 calories (SD 188) for intermediate students (p<0.001). 760 students (47%) consumed 937 a la carte foods, with the most often consumed items being chips (32%), ice cream (22%) and snack items (18%). Mean a la carte food intakes were 60 and 98 calories for elementary and intermediate schools respectively (p<0.001). Significantly more (p<0.000) intermediate students (34.3%) consumed a la carte items compared to elementary students (27.5%).^ Students who consumed a la carte foods had significantly higher intakes of calories (p<0.000), fat (p<0.000), sodium (p<0.002), fiber (p<0.000), added sugar (p<0.000), total grains (p<0.000), dessert foods (p<0.000), and snack chips (p<0.000) and lower intakes of vitamin A (p<0.001), iron (p<0.000), fruit (p<0.022), vegetables (p<0.031), milk (p<0.000), and juice (p<0.000) compared to students who did not eat a la carte foods.^ Although previous studies have found that reducing availability of unhealthy items at school decreased student consumption of these items, the results of this study indicate that even the strict guidelines set forth by the state of Texas are not sufficient to prevent increased caloric intake and poor nutrient intake. Strategies to improve student selection and consumption at school lunch when a la carte foods are available are warranted.^

Evidence for a recommended dietary allowance for vitamin C from pharmacokinetics: A comment and analysis

The current recommended dietary allowance (RDA) for vitamin C, as proposed by the Food and Nutrition Board/National Research Council in 1980 and reconfirmed in 1989, is 60 mg daily for nonsmoking adult males. Levine et al. [Levine, M., Conry-Cantilena, C., Wang, Y., Welch, R. W., Washko, P. W., et al. (1996) Proc. Natl. Acad. Sci. USA 93, 3704–3709], based on a study of vitamin C pharmacokinetics in seven healthy men, have now proposed that the RDA should be increased to 200 mg daily. I have examined, in brief, the experimental and conceptual bases for this new recommendation and its implications for public health and nutrition policy and programs. Using, for illustrative purposes only, data extracted from each of two recent dietary surveys of noninstitutionalized adult males living in households in the Netherlands and the United States, it is predicted that the prevalence of intakes inadequate to meet the individual’s own requirement would be about 96% or 84%, respectively, if the criteria of adequacy used for derivation of the 200 mg RDA are accepted. Depending upon the particular average requirement value for ascorbic acid that might be derived from their data, the proposal by Levine et al. would mean a desirable increase in mean intakes in these two populations by as much about 2- to 3-fold. Hence, before an action of this kind is to be recommended, an answer must be sought to the question whether current experimental data including the criteria selected (saturation kinetics) are adequate to establish a new set of requirements for vitamin C, which then carry such profound policy implications. This will require critical assessment of all of the available evidence emerging from laboratory, clinical, and epidemiological studies to determine whether it provides a sufficient rationale for accepting criteria of vitamin C adequacy such as those proposed by Levine et al. and the requirement estimates so derived.

Análisis de la política de nutrición en Colombia

Objetivo: Valorar la política de nutrición formulada en el Plan Nacional de Alimentación y Nutrición (PNAN) colombiano, 1996-2005, a partir de informantes clave (IC), planificadores y técnicos. Materiales y Métodos: Estudio descriptivo mediante encuesta transversal estructurada a 77 IC: 17 planificadores y 60 técnicos del PNAN. Variables: factores determinantes del problema alimentario, existencia de una política nutricional, valoración de políticas involucradas con seguridad alimentaria y, variables organizativas de la política. Se construyó un Índice de Posición (IP) que cuantificó las opiniones aportadas por los IC (0-0,33=valoración positiva; 0,34-0,67parcialmente/reajustarse; 0,68-1valoración negativa). Resultados: El 79 % de informantes clave coinciden en que existe una Política de Nutrición, pero debe reajustarse (IP=0,50 planificadores, IP=0,54 técnicos). Falta acuerdo entre IC sobre la coordinación institucional, mientras que los planificadores opinan que hay coordinación entre un grupo reducido de entidades incluyendo la suya (IP=0,33); los técnicos opinan que no hay coordinación entre todas las instituciones (IP=0,75), además opinan que la estrategia de investigación no ha tenido éxito (IP=0,73). Conclusiones: Diez años después de la Política de Nutrición en Colombia, los IC opinan que debe reajustarse. Estrategias como la coordinación e investigación pueden optimizarse para alcanzar sus objetivos.

Nutrición y salud pública: políticas de alimentación escolar en la España contemporánea (1931-1978)

El trabajo aborda los antecedentes históricos de las políticas de alimentación escolar en la España del siglo XX, a través del análisis del corpus normativo y de los textos y materiales que generaron organismos nacionales e internacionales que participaron en su implementación. La investigación muestra el impacto que tuvo el contexto internacional y en particular los acuerdos que se alcanzaron durante el primer franquismo con los Estados Unidos y con la FAO y UNICEF, en el desarrollo de dichas políticas. El carácter filantrópico de las primeras cantinas fue sustituido por una creciente implicación del ámbito público, al incorporar la alimentación de los escolares como objetivo de las políticas sanitarias y educativas de la Segunda República. La Ley de Educación Primaria de 1945 permitió la gradual institucionalización de la alimentación escolar. La creación en 1954 del Servicio Escolar de Alimentación y Nutrición y la necesidad de coordinar la ayuda norteamericana facilitaron la implementación de programas como el de Productos Lácteos pro Bienestar Infantil y Social o el de Educación en Alimentación y Nutrición, lo cual permitió implantar el complemento alimenticio en escolares y llevar a cabo un conjunto de actividades educativas coordinadas encaminadas a mejorar su alimentación.

School feeding programs in developing countries : an analysis of actual and potential impact /

"PN-AAL-060"--Cover.

Our food, will there be enough?

Sponsored by the University of Hawaii Cooperative Extension Service, College of Tropical Agriculture and Human Resources, and the American Association of University Women, Hawaii Division.

Obesity Prevention Initiative : a report to the Illinois General Assembly /

Understanding the health, economic and social costs of a growing obesity epidemic to Illinois and its citizens, the Illinois General Assembly passed the Obesity Prevention Initiative Act (PA 96-0155) in the spring of 2009. In accordance with the act, the Illinois Department of Public Health convened public hearings in Chicago, Springfield and Carbondale to: Illuminate the social and human costs of obesity and to highlight existing state and community level initiatives. Identify existing plans and opportunities for action and expansion of initiatives. Inform policymakers and the public about effective solutions to the problem. Identify and engage stakeholders to promote action to reduce obesity, to improve nutrition and to increase physical activity.

Tips for using the food guide pyramid for young children 2 to 6 years old.

"March 1999."

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

New clinical practice guideline on enteral feeding in very low birth weight infants: first part

Introduction: The nutrition of very low birth weight (VLBW) infants is aimed at promoting a similar growth to that occurring in the uterus. However, in practice this is difficult to achieve and extrauterine growth restriction is frequent. The current tendency is to avoid this restriction by means of early parenteral and enteral nutrition. Nonetheless, uncertainty about many of the practices related with nutrition has resulted in a great variation in the way it is undertaken. In 2009 and 2011 in our hospital there was an unexpected increase in necrotizing enterocolitis. To check to see whether our nutrition policy was involved, we undertook a systematic review and drew up clinical practice guidelines (CPG) about enteral feeding in VLBW infants. New considerations about the duration of the fortification and the use of probiotics have led to an update of these CPG. Methods: A total of 21 clinical questions were designed dealing with the type of milk, starting age, mode of administration, rate and volume of the increments, fortification, use of probiotics and protocol. After conducting a systematic search of the available evidence, the information was contrasted and summarized in order to draw up the recommendations. The quality of the evidence and the strength of the recommendations were determined from the SIGN scale Comment: These CPG aim to help physicians in their decision making. The protocolized application of well-proven measurements reduces the variation in clinical practice and improves results.

New clinical practice guideline on enteral feeding in very low birth weight infants: second part

Introduction: The nutrition of very low birth weight (VLBW) infants is aimed at promoting a similar growth to that occurring in the uterus. However, in practice this is difficult to achieve and extrauterine growth restriction is frequent. The current tendency is to avoid this restriction by means of early parenteral and enteral nutrition. Nonetheless, uncertainty about many of the practices related with nutrition has resulted in a great variation in the way it is undertaken. In 2009 and 2011 in our hospital there was an unexpected increase in necrotizing enterocolitis. To check to see wether our nutrition policy was involved, we underlook a systematic review and drewup clinical practice guidelines (CPG) about enteral feeding in VLBW infants. New considerations about the duration of the fortification and the use of probiotics have led to an update of these CPG. Methods: A total of 21 clinical questions were designed dealing with the type of milk, starting age, mode of administration, rate and volume of the increments, fortification, use of probiotics and protocol. Afete conducting a systematic search of the available evidence, the information was contrasted and summarized in order to draw up the recommendations. The quality of the evidence and the strength of the recommendations were determined from the SIGN scale. Comment: These CPG aim to help physicians in their decision making. The protocolized application of well-proven measurements reduces the variation in clinical practice and improves results.

Controle social e políticas públicas: contribuições para aprimorar o controle social do programa nacional de alimentação escolar

The National School Feeding Programme (PNAE) is a public policy in Brazil for over 60 years and represents one of the most important programs of feeding and nutrition in the world. The role of family farming as a source of employment in rural areas, food provider and for ensuring much of the Brazil’s food security is constantly present at the government's and social movement’s agendas. Law 11.947 of 2009 marked its integration in the food supply for the National School Feeding Programme. Article 14 of aforementioned law highlights that a minimum of 30% (thirty percent) of the funds transferred by the National Development Fund Education (FNDE) to the Programme must be used for the purchase of food directly from family farmers or their organizations. The national school feeding policy under the responsibility of the FNDE and is subjected to agencies of internal control, such as the General Controllership of the Union (CGU), of external control, such as the Audit Courts of the Union and the of the states, and to the social control of the school feeding councils. Those funds are transferred to the implementing agencies, which are the education offices of the states, municipalities and of the Federal District. These entities must annually present their accountings to the School Feeding Councils, which analyze them and then issue a conclusive report to the FNDE, approving with or without reservations, or rejecting them. In this sense, this research aims to propose parameters that should contribute to the improvement of the social control over purchases from family farming for the National School Feeding Programme. The study was conducted by non parametric sampling alongside the managers of the implementing entities, school feeding councils and Family Farming Organizations all across Brazil, from the databases provided by FNDE and by the National Union of Cooperatives of Family Agriculture and Solidarity Economy (Unicafes). The study points out that the legal framework of PNAE seeks to ensure the participation of family farming in the food supply for the Programme, despite allowing the executing agencies to justify the non-compliance of the minimum required in a number of ways. The survey also signalizes that the school feeding councils follow the implementation of the Programme very shyly, and points out that there is room to expand and enhance the participation of these councils and organizations of family farming in the execution of PNAE. Its effectiveness requires a constant and effective process of training of the agents involved in the Programme.