Poster session: Medical nutrition therapy and wellness & public health

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MONDAY,OCTOBER21

POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: M E D I C A L NUTRITION THERAPY: O U T C O M E S F R O M A N U R B A N M E D I C A L C E N T E R A M B U L A T O R Y NlYrRITION CLINIC.

TITLE: THEEFFECTOFLOWCARBOHYDRAlX.HIGHPROTEINDIETSONWEIGHTLOSSANDBODY COMPOSITION

AUTHOR(S): D. C. Sowa, MBA, RD, LD, E. Pinmatel-Zablak Ph.D., K. Lorenz,

AUTHOR(S):A.M.Trappey,MS,RD,St. LmfisUniversityHospital,St. Louis,MO;M.K.Mattfcldt-

Rusli-Presbytcrian-St.Luke's Medical Center,Chicago,IL.

LEARNING OUTCOME: To identify a method to collect and analyze medical nutrition therapy outcome data for an urban medical cemer nutrition outpatient clinic.

Beman,PhD,RD,LD,SaintLmfisUniversity,SLLO~ MO; M.A.Sawicki,MS,RD,LD, SaintLOISUniversity,St. LOIS,MO; D.M.Rubio,Phi), SaintLois University,St. Lois, MO.

LEARN84GOUTCOME: ABSTRACT TEXT: With spiraling health care costs and payors interested in outcome*, it is essential to demonstrate the effcetiven~s of medical nutrition therapy. Rush-Presbyterian-St. Luke, Medical Center (RPSLMC) in Chicago developed an outcome collection sbeet to record intake, anthroporaelric, laboratory, and exercise data. The dietitian completed this sheet at the conclusion of each client visit. The clinic receptionist entered the data daily into an Access datnhase. The total number of clients (a~ 131) of which 56 were obese and 57 were diabetic were seen during Jenuary 1, 2001-December 31, 2001. Outcome data were analyzed in SPSS, version 10. The two Nuaition Clinicdietitianshad similarsuccesswith clients losing weight and returning for their follow-up visits. Both men and women visited the dietitian a ~-imilarnumber of time*, 3.3 + 1.9 and 3.8 + 2.1, respectively. There was no significant difference in weight loss between men and women. The obese clients, (242 + 72 lbs.) weighed more at the initial visit compared to the diabetic clients, (219 + 53 lbs.). Total weight loss for the obese clients, (6.3 + 7.6 lbs.) was significamly (p=0.006) greater, compared to diabetes clients, (2.3 + 7.5 lbs.). Weight loss between the initial visit and firm follow up visit was significantly (p=.008) greater, than subsequent visits. At the initial visit, clients with the higher BM/s exeroised the least, (r~-0.29, p=0.001), while clients coutinaed to exercise the same araoent over time (1=.692, p----0.000). Fifty nine pe~ent of clients indicated they exercised an average of 127 minute*/week. Reported percentage of clients exercising and the exercise time were consistent at visits 1, 2 and 4. Other laboratory data, i.e. glucose, I-Igb A1C, lipid levels were collected, but insufficient data were available for m e a n ~ analysis. Clients enrolled in ntarition counseling sessions successfully lost weight. Recording patient data systematically end continually can provide data for marketing outcomes to insurance companies, physicians and cliems.

TITLE: NUTRITION-RELATED PREDICTORS OF TOTAL HOURS OF MECHANICAL VENTILATOR SUPPORT IN CRITICALLY ILL PATIENTS AUTHOR(S): M.A. Lacasse ], M.L. Jenkins, RE)2, S.G. Affenito, PhD, RD ] Saint Joseph College, West Hartford, CT., 2 St. Francis Hospital and Health Center, Hartford, CT. LEARNING OUTCOME: To identify nutrition-related predictors of the duration of ventilation support in critically ill patients. A B S T R A C T TEXT: Malnutrition is commonly seen in patients who are ventilator dependent. Past research has shown that improved nutritional status is assooiated with improvement in pulmonary function aad ease in weaning from mechanical ventilation in critically ill patients. This was a non-experimental prospective study designed to identify nutrition-related predictors of the duration of ventilation support in critically ill patients in the acute care setting. The objectives of the current research were to provide descriptive information on the relationships that may exist between nutrition-related variables (macronntrient composition; prealbumin; time before nutrition support initiated; body weight) age; gender; and total hours ventilated in a twomonth period (vent time). Subjects were eligible if they met the following criteria: were intubated, tube fed, eventually weaned from the ventilator, aad had a minimum of 2 prealbumin measurements a week apart (n=10). Using SPSS, a significant positive correlation was found between the age end hours on ventilator and an inverse relationship between body weight aad vent time. Although regression analyses could not use nntrition-relnted variables to predict vent time, findings show that 80% of the variance for increase in prealbumin (timel) and 96% for prealbumin (time 2) was due to nutrition support provided (dayl) and patient's current weight. Given that increased prealbumin is associated with improvement in nutritional status, dietetics professionals should be cognizant of the need for immediate nutrition support in vent-dependentpatients, especially those who are older or at reduced body weight, as this may ultimately assist in decreased vent time.

To examinethe effectsof a low-carbohydrate,high-protein(LCHP)dietcomparedto a healthydiet (HD)in ovenveightadults lookingat weight loss and body compositionchanges, while controllingfor exercise habits.

ABSTRACTTEXT: This was a quasi-experimental12-weekstudy. Subjectswere classifiedas exer6sers or non-exercisers based on a physicalactivityrecallquestionoaire,randomizedto one of the dietprotocols,educatedon how to follow the diet protocol, and instructed to keep daily food records for dietary anolysis. Daily food records and anthropometricmeasurementswere collected. One hnodred lifty-llveapparentlyhealthy, overweightadults were screenedfor the study.Ofthe 21subjectswbo completedthe studyperiod, 9 were randomizedto the LCIlPand 12 were randomizedto the liD. Descriptivestatisticswere reported. A regression analysis was used to study the predictors of weight loss, and two tailed t-tests revealed differencesbetweenthe diet protocols. Therewas no significantdifferencein weightloss betweenthe diet groups for the 12-week study period. There were no significantchangesin pre/post lean body mass compositionor bodymass indexbetweene'dbergroup. Siguificoutlylowercaloricintakewas reportedby the LCHPsubjectsduringweeks 2, 5, and 8. Duringall weeksof the study,the LClfl'subjectsreported consumingsignificantlylowercarbohydrates. Thoughone wouldexpectsignificantlyhigherproteinintake amongthe LCHPsubjects,only weeks 1, 2, 4, and 10 were higher Finally,the reportedfat intake was significantlyhigherfor the LCHi'subjectsduringthe firstfiveweeksofthe study. Thegreatestweightloss reported duringthe studywas for a subjectfollowingthe lid protocol(22 pounds),followedcloselybya subjectlosing19 poundsfollowingthe LCHPprotocol. Neithera LCIlPdiet nor a HDis a better predictor of weightloss. Weightloss after 12 weeksoneitherofthetwo dietprotocolswas not influencedby diet type, exercisehabitor caloricdeficit. The resultsalso showedthat regardlessofdiet protocolfollowedand exercisehabitsoverthe 12-weekperiodchangesh bodycompositionwere similarbetweenthe groups.

TITLE: RATION SUPPLEMENT FOR HOSPITALIZED PATIENTS DURING MILITARY OPERATIONS AUTHOR(S): W.E. Wheeler, MS, RD, LD, MAJ; E.L. North, RD, LD, CPT. U.S. Army Medical Department Center end School, Fort Sam Houston, TX. LEARNING OUTCOME: To describe the process used to determine food end supplies needed to supplement the military rations to feed hospitalized patients. ABSTRACT TEXT: This study will determine the food and supply items necessary to prepare end serve modified diets to hospitalized patients during military operations. The food end supply items available in the current group rations for military operations are inadequate for preparing end serving modified diets in Army field hospitals. The study will be conducted during an annual Army course that trains military dietitians for deployments. The students will be given scenarios to prepare end serve simulated patients on modified diets in the field environment using military group rations end field equipment. The students will be inslxucted to use only food end supply items needed to supplement the current military group rations to prepare the diet orders based on the ADA Manual of Clinical Dietetics. The study will cover two days of feeding patients with diet orders typically seen during military operations. The food end supply items selected will be documented with follow up justification on why the additional items were needed to prepare end serve the patients. The food end supply items available for selection by the students will be items that were identified by Army dietitians in a classroom group exercise conducted earlier this year. The list of food and supply items identified during this study will be submitted to military ration developers and procurers to assist in creating the ration supplement for hospitalized patients during military operations.

J o u r n a l of THE AMERICAN DIETETIC ASSOCIATION / A-37

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH A COMPARISON OF OASIS, NSI LEVEL 1 AND AGENCY INITIATED SCREENING AND ASSESSMENT METHODS TO IDENTIFY CLIENTS AT NUTRITIONAL RISK AND THE PROVISION OF IN-HOME NUTRITION SERVICES

TITLE: TITLE: A SUCCESSFUL STRATEGY TO IMPROVE ONE-ON-ONE FOLLOW-UP RATES IN AN OUTPATIENT NUTRITION CLINIC AUTHORS:

A. Sproul, MS, RD, LD, CDE, Outpatient Nutrition Flight Commander, Lackland AFB, TX; S. McCann, MS, MEd, RD, FADA, Commander, Nutritional Medicine Squadron, Lacldand AFB, TX.

LEARNING OUTCOME: To provide a strategy to increase the rate and effectiveness of follow-up within an outpatient nutrition clinic seRing. ABSTRACT TEXT: Limited data exists in the literature regarding a standard, or typical rate of patient follow-up among outpatient nutrition clinics. Historically, no-show and cancellation rates for nutrition clinic appointments at our center ranged between 35 and 50 percent for one-on-one counseling. This was identified to be a poor utilization of clinic resources, which contributed to longer waiting times and reduced access to care. In order to determine what factors led a patient to cancel or "no-show" to a follow-up nutrition appointment, an informal telephone survey was conducted on 20 patients, aged 32 to 78 years. Reasons cited included: no transportation for that day, not feeling well, bad weather, feeling like appointment was not necessary, personal time conflict, and forgetting about the appointment. Based on this information a telephone-based follow-up system was employed, whereby patients were phoned at home (at a pre-determined, convenient time) to discuss their progress. Following implementation of the telephone-based service, the clinic combined no-show and cancellation rate was cut in half from a monthly average of 43% to a range of between 15% and 25%. Based on satisfaction surveys, the telephone-based follow-up service was exceptionally well received and appreciated by the patients. This data indicates that it is possible to improve follow-up in an outpatient nutrition setting. Since the collection of this data, we have implemented an e-mail follow-up system which has also proven to be successful.

TITLE:

USE OF REFEEDING PROTOCOL TO ENSURE APPROPRIATE NUTRITION DURING ACUTE GASTROENTERITIS

AUTHOR(S): C.A. Conkin MS, RD; J.A Campbell MS, RD; C.A. Smith CPHQ; M.D. Jearez RD, Texas Children's Hospital, Houston TX. LEARNING OUTCOME: To describe a collaborative approach to provide a nutritionally adequate diet for children during bouts of acuta gastroenteritis. ABSTRACT TEXT: The practice of providing only fluids and a limited diet during acute gastroenteritis (AGE) is known to exacerbate the symptoms of AGE, which negatively impacts the nutritional status of pediatric patients. Retrospective chart review concluded that 51% of patients admitted with AGE were discharged on an inadequate diet. Knowledge deficit of nutritional interventions during AGE was found to be a contributing factor. An interdisciplinary Refeeding Team project was initiated to promote use of a nutritionally adequate refeeding diet. A physician order protocol, with defined rehydration criteria, was developed that allowed diet progression by nursing. The dietitian monitored patients admitted with the study diagnosis and worked with physicians to initiate the protocol. Nursing assessed hydration status every 6 hours. Once hydration was achieved, feeding was initiated. Additional nutrition interventions included education of the resident staff as well as provision of food stock on the nursing units to promote timely meals. The pilot was implemented for a 6 month period on a medical unit. Physician compliance with the protocol increased from 76% to 100% at pilot end. Secondary to the training, dietitian involvement to correct the diet order decreased from 71% to 15%. Nursing diet order accuracy was monitored and found to be 100%. Appropriate diets by discharge consequently improved from 49% to 100%. Benefits were a decrease in wait time for physician to write new diet orders, increased patient satisfaction due to bypass of NPO status, as well as improved intake. Parent satisfaction followed, attributable to education on nutrition during their child's vomiting and diarrhea episode. Next steps include use of preprinted order sheets to facilitate earlier implementation of the protocol. A - ~ / S e p t e m b e r 2002 S u p p l e m e n t Volume 102 N u m b e r 9

AUTHOR(S):

LY Rosenzweig, MS, RD, DO Weddle, Phl), RD, National Policy and Resource Center on Nutrition and Aging, Florida International University, Miami, FL. LEARNING OUTCOME: The participant will be able to identify differences in nutrition risk screening and assessment instruments, and describe the use of MNT protocols and referral systems to improve in-home nutrition care provided to clients. ABSTRKCT TEXT: Medical nutrition therapy (MNT) is important in the treatment of chronic diseases and the maintenance of health. However, a serious concern is the availability of MNT in the home setting. The pttrpose of this study was to compare the nuttition-related screening and assessment indicators found on the Outcome and AssessmentInformation Set (OASIS) data set (which must be used for Medicare Beneficiaries) and home care agency instruments with those of the Nutrition Screening Initiative (NSI) Level I Screen; and to compare the MNT process, including screening, assessment and intervention, used by the home care agency with the process standards established by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). A convenience sample of three home care agencies in upstate New York was recruited. At each agency, interviews were held with staff (3 at each agency) to learn the MNT process in place and a random sample of 25 client care records at each agency were reviewed to document the MNT process and types of interventions provided. The OASIS data set contained 6 of the 21 nutrition risk indicators included on the NSI Level I Screen, while home care agency tools had 13 to 15 of these indicators. These agencies had a process to screen patients for nutrition risk, make referrals, and provide MNT. Therefore, they met the intent of the JCAHO standards. However, the screening process did not consistently trigger a referral to the consulting registered dietitian and as a result, she/he was not utilized as often as required based on patient nutrition risk scores. Only about two-thirds of the clients identified in the initial assessment to require MNT received this service. The registered dietitian must have greater involvement in developing the patient's care plan. Home care agencies must evaluate how effectively their screening process generates the t?.pe of refcrrals to address any nutrition risk.

TITLE: KIDPOWER: A LIFESTYLE CHANGE TRIAL FOR CHILDREN

AND TEENS SUSPECTED OF HYPERINSULINEMIA AUTHOR(S):

CS Sullivan, MPH, RD, LDN; JF Seste, MD; VH Hester, RD, LDN; KM Kolasa, PhD, RD, LDN; JM Olsson, MD LEARNING OUTCOME:

To increase knowledge regarding the prevalence of hypednsulinemia and associated complications in an overweight pediatric population ABSTRACT TEXT:

This project entitled KIDPOWER, was designed to determine the feasibility of conducting research on childhood obesity prevention and treatment in a rural southeastern community. The prevalence of hyperinsulinemia and other complications of obesity in this population and their willingness to participate in an apprepriate lifestyle intervention program were assessed. Children were recruited from family practice and pediatric clinics in the area. Children with BMI for age greater than the 85t, percentile were eligible for entry. The program was explained to caregivers and consent given. Preliminary results indicate a 30% prevalence of hypednsulinemia in the population of 110 children ages 4-18 recruited to date. The mean BMI = 36.7 for children considered to be hypednsulinemic. The non-hyperinsulinemic children BMI= 31.64 (p<. 05). Hypedninsulinemic children also had statistically significant (p<. 05) higher Total Cholesterol, LDL-C, Tdglyceddes, C-Peptide, Serum Glucose and Insulin to Glucose ratio over their counterparts. These children and teens have been recruited into a dietary intervention featuring a 40130130 dietary pattern, which will be displayed. Acceptability of the modified CHO pattern will be discussed. Funding was from Children's Miracle Network and Department of Family Medicine starter grants.

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MONDAY,OCTOBER21

POSTERSESSION:MEDICALNUTRITIONTHERAPYANDWELLNESS& PUBLICHEALTH

TITLE: THE EFFECT OF NUTRITION EDUCATION ON MEAL PLANNING AND SICK DAY MANAGEMENT SKILLS OF PEDIATRIC INPATIENTS WITH TYPE 1 DIABETES AUTHOR(S): R. Blaine-Niazi, MS, RD, LD, CDE, The Children's Hospital at the Cleveland Clinic, Cleveland, OH. LEARNING OUTCOME: To document the outcome of medical nutrition therapy as it relates to diabetes education provided by registered dietitians. ABSTRACT TEXT: Diagnosis and management of diabetes can be devastating and overwhelming to pediatric patients and their families. Many studies have demonstrated the importance of diabetes management and glycemic control to promote normal growth and development in pediatric patients. Sick day management and meal planning concepts have been established as two key components for diabetes control. A random sampling of subjects with Type 1 Diabetes (n=19) was selected from the inpatient population admitted for initial diagnosis or for complications/management of already existing diabetes. Patients and their families were given pre-tests regarding basic sick day management and meal planning concepts prior to individual education session(s) with the dietitian. The same tests were given post education. Paired t-Tests were performed to compare the pre and post test scores of each subject. Patients and their families demonstrated a significant improvement in mean scores for both sick day management (p=0.000) and meal planning (p=0.000). The subset of patients (n=8) admitted due to complications of already existing diabetes also showed significant improvement in mean scores for sick day management (p<.005) and meal planning (p=0.000). Results suggest that dietitian intervention and education is of benefit to patients and their families, including those patients with a history of diabetes admitted for complications.

TITLE: AN EXAMINATION OF THE EATING ATTITUDES AND BODY IMAGE AMONG UNIVERSITY NUTRITION AND NONNUTRITON MAJORS. AUTHOR(S): S. Homing, MS; A. M. Levine, PhD, RD; M.E. Borja, EdD, RD, FADA; L. Harrison, PhD, RD, FADA; Marywood University. Scranton, PA. LEARNING OUTCOME: To assess differences in eating attitudes and body image among collegiate nutrition and non-nutrition majors. ABSTRACT TEXT: The incidence of disordered eating patterns and body image disturbance in college females has increased over the past decade. However, limited research has been undertaken in relation to students' chosen area of study. This research examined the eating attitudes and body image in a convenience sample of non-nutrition majors (n=100) enrolled in 10 introductory physical education classes and all nutrition majors (n=62) at two colleges in northeastern PA. All participants completed the Eating Attitudes Test - 26 (EAT-26) and the Physical Appearance State and Trait Anxiety Scale (PASTAS). Although there were no significant differences in the mean EAT-26 scores (nutrition majors: 11.90 +/-10.22; non-majors: 9.42 +/-8.20) or PASTAS scores (nutrition majors: 20.63 +/-10.08; non-majors: 21.27 +/-8.91), nutrition majors had a higher than expected disordered eating attitude score (Eat-26 score > 20) than did non-majors (x2 = 5.456, p<.05). Additionally, there was a positive correlation between EAT-26 and PASTAS scores for both nutrition majors (r = .60, p_<.05 ) and nonmajors (r = .44, p_<.05). Individuals may in part enter the dietetics profession to better understand their own problems with food. Thus, dietetics educators and other RDs employed on college campuses should offer opportunities for nutrition majors and others to better understand the nature of any food-related problems, and provide an opportunity for students to work through individual issues.

TITLE: DEMENTIA UNIT DINING PROGRAM EFFECT ON NUTRITIONAL OUTCOMES

TITLE: OBESITY-RELATEDPATTERNS IN MULTIETHNIC FEMALES PARTICIPATINGIN CONGREGATE FEEDING PROGRAMS IN TARRANT COUNTY, TX

AUTHOR(S): Mary R. Chalich, M.S.,R.D. and Rosemary K. Sheehan, MEd.,R.D., Genesis Hospitality Services, Willow Ridge Center, Genesis Eldercare, Hatboro, Pennsylvania LEARNING OUTCOME: Dietitians in skilled nursing facilities will design dining and nutrition care resulting in improved nutrition and quality of life delaying decline in health among a dementia population.

AUTHORS: L. Dart, PhD,RD,LD, S. Hampton, MS,RD,LD, M.A. German, PhD,RD,LD, A.VanBeber, PhD,RD,LD, C. Ranelle, MS,RD,LD, Coordinated Program in Dietetics Students, Department of Nutritional Sciences, Texas Christian University, Ft. Worth, TX

ABSTRACT TEXT: In a 24-bed, secured dementia unit within a skilled nursing center, dining and nutrition care were given highest priority to support resident health maintenance and delay decline. Dining system changes promoted familystyle service with a trained, interdisciplinary team present to assure correct food to menu, positioning, appropriate diet order or indications for finger foods, provisions for dysphagia evaluation and/or adaptive equipment, proper table set-up promoting resident dignity, visual clarity and timely meal service. Point of service meal delivery was designed for hydration and main course consumption first and desserts last. Pre-meal preparations included essential staff on the unit, group activities, lighting and sound controls eliminating external distractions, placement of adult protective clothing devices and table mate compatibility assessments. Menus were posted with diet spreads on site while resident-specific diets were identified by a way ticket system. Nutrition therapy philosophy followed a liberalized diet approach. Consumption was documented as dining concluded with notice to the registered dietitian when trends of poor intake were observed. Dietitian tracking of individual residents upon admission and at 30-day intervals noted improved caloric intake, weight stability and gains in the first month, reduced or discontinued supplementation, and increased use of regular diet menus and snacks. Nutrition care plans include prospective tracking for continuously improved outcomes prolonging quality of life through a team approach to resident dining.

LEARNING OUTCOME: To identify obesity-related patterns of body fat distribution and anthropometrics in multiethnic females participating in Congregate Feeding Programs (CFPs). ABSTRACT TEXT: Although multiethnic differences in anthropometrics and body fat distribution patterns have been reported in adult female populations, they may not be appropriate among select elderly groups with similar age and lifestyle profiles. The relationship between total % body fat (%BF) by Bioolectrical Impedance Analysis (BIA) and five measures of anthropometrics and fat distribution (body weight [BW], body mass index [BMI], waist-to-hip ratio [WHR], and waist [WC] and hip [HC] circumferences) were examined in 134 independent and ethnically diverse (77/White, 41/Black, 16/I-Iispanic) females participating in CFPs in Tarrant County, TX. Demographic and lifestyle factors revealed subjects averaged 75-79 years of age, exhibited sedentary/mostly inactive physical activity patterns (87%), participated in CFPs >than 1 year (81%), and attended CFPs >3 days/week (77%). Regardless of ethnicity, females exhibited similar results for body fat distribution and anthropometrics. Data analysis revealed mean values (mean _+SD) for %BF (41_+9%), BW (76_+18 kg), BMI (29.6_+6.4 kg/m2),WC (39_+7in), HC (45_+6in), and WHR (0.87_+.08). Based on standard criteria, a high risk of obesity-related morbidity was noted among participants, with positive correlation (p<0.01) between %BF and BW (r~.80), BMI (r=0.88), WC (r=0.74), and HC (r=0.80). Results suggest that obesity-related patterns of body fat distribution and anthropometrics may be similar among ethnically diverse elderly females in select groups. Research is needed to examine the influence of lifestyle factors versus ethnicity as a determinant of obesity in aging females. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-39

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: THE EFFECT OF DIET INTAKE AND COMPETITIVE SWIMMING/GYMNASTICS ON BONE MINERAL DENSITY OF COLLEGIATE FEMALES AUTHOR(S): P.M. Howat, PhD, RD, T.C. Jones, MS, RD, L. LaMotte, PhD, Louisiana State University, and J. Ruiz, MD o f Woman's Health Research Institute, Woman's Hospital, Baton Rouge, LA. LEARNING OUTCOME: To define nutritional and specific activity effects upon hone mineral density. ABSTRACT TEXT: The purpose of this pilot study was to determine if was a relationship between dietary/supplemental intake aad competitive activity (swimming and gymnastics), on the bone mineral density of 18-21 year old females. Five svvluat~rs, 4 gymmsts, and 12 control subjects were recruited from the university student body. All subjects completed a 3-day diet/supplement record, 3-day activity record, past calcium intake form, and a medical history forn~ Bone mineral density (BMD) was measured for the whole body, LI-IA, the proximal femur and body composition by DEXA. Results indicated the control subjects reported a significantly greater percent o f the RDA for energy, protein, and ¢urhohydrate than the athletic groups. There were other dietary differences among groups for fiber, folato, kon, and zinc. There were no differences found for hone b u ~ nutrients among the three groups. No correlations could be made between dia/supplement intake and BMD. ~ s initiated training at an earlier age than swimmers, and were found to be shorter and experience delayed menarche than other groups. Gynmsts had significantly greater whole body BMD than the control subjects, but not significantly greater than the swimmers. Gynnmsts also had greater BMD at all sites measured, mad significantly greater than the control subjects at the spine L1-L4, and fmnoral neck. Gymnasts had st~mifieantly greater BMD at the femoral neck and total hip than the swimmers. Though not significant, the swimmers had greater BMD at whole body, and spine LIIA than the control subjects. The weight-beuring exercises o f gymnasts resulted in greater BMD in the gynmasts. Due to small sample size, conclusions concerning the benefit o f swimming on BMD can not he made from this study.

TITLE:WEIGHT GAIN AND HYPERLIPIDEMIA OBSERVED IN LONGTERM SURVIVORS OF TESTICULAR CANCER AUTHOR(S):K Claghom MS, RDI'2; L Jacobs Phl), CRNP1; D Vanghn, MDI'2; A Meadows, MD3. IUniversity of Pennsylvania Cancer Center; ~Abramson Family Cancer Research Institute at the University of Pennsylvania Cancer Center; 3The Children's Hospital of Philadelphia. LEARNING OUTCOME: To inform healthcare professionals caring for survivors of testieular cancer regarding the potential for treatment related weight gain and elevated lipids. ABSTRACT TEXT:There is little information on the long-term treatment related health issues of cancer therapies. As the number of cancer survivors grows, treatment-related secondary morbidities are being observed. A cancer survivorship program funded by a grant from the Lance Armstrong Foundation, was developed at a Comprehensive Cancer Center, to identify and address these medical issues with emphasis on potential prevention and/or reduction in morbidity. To date, 26 survivors of testicular cancer who have completed their cancer treatment and have been disease free for at least two years have been seen in the program. Eighteen patients were treated with cisplatin-based chemotherapy and 8 patients did not receive cisplatin-based chemotherapy. The median age of participants was 36 years (range 23-63 years). Weight gain was observed in 93% of participants treated with cisplatin-based chemotherapy for whom a baseline weight was recorded (n=lS), with 53% experiencing a weight gain greater than 20 lbs. In addition, elevated cholesterol levels (>200 mg/dL) and elevated triglycerides (>190 mg/dL) were observed in 24% (n=17) and 35%, respectively, following cisplatin-based chemotherapy. These data indicate that testicular cancer survivors who received cisplatin-based chemotherapy and who have many years of life ahead of them should be educated regarding the potential for weight gain and the development of hyperlipidemia. Future research is needed to examine the specific etiology of this apparent eisplatin-related toxicity, and to evaluate educational and medical interventions likely to reduce these late effects.

A-40 / September 2002 Supplement Volume 102 Number 9

TITLE: THE EFFECT OF DIETARY DIVERSITY ON MEASURES PRE-PUBERTAL CAUCASIAN GIRLS AUTHORtS): K HoUiday, BS; L Clemens, EdD, RD; C Mitchell Eady, Phl), RD, LDN, The University of Memphis, Memphis, TN; F Tylavsky, Dr. P.H., The University of Tennessee Memphis, Memphis, TN. LEARNING OUTCOME: To determine if diet diversity affects bone measures in pre-pubertal Caucasian girls. ABSTRACT TEXT: The association of diet diversity, milk intake, and fruit and vegetable intake with three different bone measures of the whole body and spine was evaluated in 57 Caucasian girls between the ages o f 8-13 years. All girls were in Tanner Stage two. Subject data was derived from a research study, Calcium, Health, and Metabolism in Preteens (CHAMPS), currently in progress in a large city in Tennessee. Scores for diet diversity, total milk intake, and total fruit and vegetable intake were obtained from 3 one-day food diaries. Bone area, bone mineral content, and bone mineral density of the whole body and spine were the six bone measurements used for the analysis. Using regression analysis, three different models were set up to determine the importance of different variables on six various bone measurements. All three, bone models were highly significant (p<0.001). In all models Age and BMI were significant independent variables. In the first model, diet diversity was significant for whole body bone area only and there was no effect of total milk on any bone measurement. In the second model, total milk was significant for whole body area only. In the third model, fruit and vegetable intake was significant for whole body area and whole body BMC. The results of the study indicate there is a relationship between different components of the diet and healthy bone measurements. The association of higher intake of fruits and vegetables resulting in higher bone area and bone mineral content suggests that fruit and vegetable intake is important in developing a healthy skeleton.

TITLE: CAN SUBJECTS COMPLY WITH DIETARY COUNSELING INSTRUCTIONS TO MODIFY FAT INTAKE? RESULTS FROM LOW FAT AND MEDITERRANEAN DIET CARDIOVASCULAR STUDIES. AUTHOR(S): C.M. Champagne, PhD, RD, K.C. Lastor, RD, M.M. Afton, H.R. Allen, PhD, D.W. Harsha, PhD and M.Lefevre, PhD, Pennington Biomedical Research Center, Louisiana StateUnivarsity, Baton Rouge, LA. LEARNING OUTCOME: To evaluate the ability of individuals to alter dietary energy intake and specific fat intakes in two counseling trials, one a comparison of a Mediterranean diet with a Step 1 diet and the other a low fat diet group (20% of energy from fat) with a non-intervention control group. ABSTRACT TEXT: The primary goal of this study was to evaluate the ability to comply with dietary counseling strategies to alter fat intake patterns. Either a lower fat diet supplying 20-30% of energy from fat or a diet higher in monounsaturated fat (MUFA) (<30% energy from total fat and about 20% from MUFA) may be recommended for cardiovascular disease. We conducted two separate studies of individuals instructed to adhere to these diets. MedStep, a six month trial, randomized 96 individuals to two diet arms, Step 1 diet or MUFA diet. The REACH (Reversal of Early Atherosclerotic Changes by Diet) project randomized 304 individuals to either control or low fat diets (20% energy from fat) for 24 months. Dietary records were collected to evaluate compliance at specific time points. REACH control subjects did not change their fat consumption. Those subjects on the low fat diet regimen decreased their consumption of total fat from 31.4±7.6% to 19.5±7.3% of kcal and saturated fat (SFA) from 10.4±3.3% to 5.74-2.5% at 6 months. At 12 months, these subjects were still consuming diets with 19.5±1.3% of energy from fat and 5.6±0.5% from SFA. In the MedStep trial subjects on the Step 1 diet actually reduced total fat to 25.5±6.4% of kcal and SFA to 7.2+2.1%. Subjects on the MUFA diet maintained total fat level at 35*5.8%ofkcal, but this was not reflected in the target MUFA% (16.6±3.6%) and they did not reduce their SFA consumption to 5% (8.5±2.4%). We conclude that it is possible after 6 months of intervention to successfully change dietary fat consumption patterns when subjects are taught a low fat diet and to maintain those changes for at least a year. While we did see a tendency toward Mediterranean diet targets during the 6-month trial, additional help with food selection is highly recommended to achieve this diet pattern.

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: AN EXAMINATION OF THE KNOWLEDGE ABOUT FOLIC ACID AMONGST AFRICAN AMERICAN WOMEN OF CHILDBEARING AGE, WHO USE VARYING LEVELS OF SUPPLEMENTAL FOLIC ACID AUTHOR(S): J. Thompson, MS, RD; A. M. Levine, PhD, RD; L. Harrison, PhD, RD, FADA; R. Quinton, MS, RD; Marywood University, Scranton, PA. LEARNING OUTCOME: To examine differences in knowledge about folic acid among African American women of childbearing age ABSTRACT TEXT: The link between supplemental folio acid during pregnancy and prevention of neural tube defects is well known among the medical community. However, women of childbearing age may not be aware of the benefits of supplemental folate. This research examined knowledge about folic acid using an adapted version of the March of Dimes 1995 survey. A convenience sample of 106 African American women of childbearing age was recruited from the Harrisburg, PA area. Overall knowledge about folic acid was low (mean = 3.89 +/2.25 out of a possible score of 11). Knowledge of folic acid was significantly higher (p<.05) in African-American women who use folio acid daily (mean = 4.87 +/-1.51) and occasionally (mean = 5.10 +/2.10) compared to those who did not use this supplement (3.31 +/2.23). There was a positive correlation between age of respondent and folic acid knowledge (r =.53, p<.001). Participants with at least a high school degree had significantly higher (p<.001) knowledge scores (mean = 4.65 +/-1.65 =) than those with less education (mean = 1.54 +/-1.53). Despite numerous campaigns and initiatives, AfricanAmerican women are still not aware of the benefits to folic acid supplementation prior to and during pregnancies. RDs must continue their efforts to target these vulnerable individuals in the design and implementation of health education programs about the importance of folic acid in both foods and nutritional supplements.

TITLE:

COMMUNITYNUTRITION THEORYAND APPLICATION: THE FOODDRIVE EXPERIENCE

AUTHOR(S): Rita M. Johnson, PhD, RD, FADA, Indiana

University of Pennsylvania, Indiana, PA LEAIININGOUTCOME: To describe a service learning project that applies community nutrition intervention theory. ABSTRACT TEXT:

For eight years, students enrolled in a community nutrition class have planned and evaluated a food drive that benefits the local community action program. Learning about food insecurity, program planning, intervention strategies, and evaluation is incorporated throughout the semester. A combination of peer and instructor-led discussions, guest speakers, peer managers, and role playing are used to teach community nutrition and public relations theory. These also develop enthusiasm for the project. Each year students develop the goals and objectives by applying the outcomes and recommendations from the previous year in their planning process. To complete the project, class members are required to complete a student-developed evaluation form. The pedagogical value of the food drive project is that students can apply community nutrition intervention theory and perform an actual intervention project within a 14- week semester. From a practical perspective, this growing service-learning project has become the third largest annual contributor to the county's food bank. The project adds personal value to the students and their careers and enhances the university's relationship with the

community.

TITLE: THE PERCEPTION, KNOWLEDGEAND BEHAVIOR OF SOUTH TEXAS MEXICAN AMERICANS RELATED TO THE ROLE OF FOLIC ACID IN PREVENTING BIRTH DEFECTS AUTHOR(8): S. F. Robinson, PhD, RD, Texas A&M University System, College Station, TX; J. Anding, PhD, RD, Texas A&M University System, College Station, "IX. LEARNING OUTCOME: To increase the awareness of the barriers to folic acid consumption by Mexican American women in South Texas.

TITLE: MIDDLE-SCHOOL STUDENT ACCEPTABILITYOF A POSTER CAMPAIGN TO PROMOTE FRUIT AND VEGETABLE CONSUMPTION

ABSTRACT TEXT:

ABSTRACT TEXT: Middle-school students do not eat fruits and

Many Mexican'American (MA) women consume diets inadequate in folic acid, a B vitamin that plays a role in neural tube development. MA women have been shown to be at an increased risk for giving birth to a child with a neural tube defect (NTD). This is of concern in south Texas, where clusters of NTDs have been reported. In order to develop educational materials that promote optimum folio acid intake before and during the first few weeks of gestation, the level of knowledge regarding folio acid and the potential barriers to adequate intake hadto be explored. Threepairs of focus groups (n=53) were conducted with MA in south Texas: women < 35 years of age without children; women 18-35 years of age with children, and men who had, or were planning to have, children. Only women with children who had been advised by their physician knew of the link between folio acid and NTDs. Participants had little krtowledge of food sources of folie acid. Rice, a food frequently consumed by the participants, which may be fortified with folio acid, was often rinsed prior to preparation. Few took vitamins of any kind citing that they were not needed if one was eating a healthy diet or unless instructed by a physician. Other reasons identified for not taking vitamins included nausea and fear of weight gain. Cost was not identified as a barrier to consuming vitamins containing folic acid. Based on these results, educational materials have been developed and are being evaluated for their effectiveness in promoting folio acid intake either through the consumption of fortified foods or the use of folio acid containing supplements.

AUTIIOR(S): VJ Thompson, MSt; KW Cullen, DrPH, RD, LDI; TV Marsh, MS, RD I IBaylor College of Medicine LEARNING OUTCOME: To determine middle-school student acceptability of a poster campaign designed to promote fruit and vegetable consumption at the snack bar vegetables (FV) from the snack bar. Formative assessment (i.e., interviews and surveys) with 6th - 8th grade students was used to develop FJV consumption-promoting posters within four (4) themes (i.e., Flavor/Texture/Freshness, Health, Social/Popularity, and Performance). Thirty posters were designed and placed in middle-school cafeterias during an environmental snack bar intervention. Students (n=1,539; 37% Hispanic, 31% White, 17% Black, 15% Asian/Other; 53% female) from five middle schools completed evaluations identifying poster preferences (1 : like a lot, 2 -- like a little, 3 = do not like). Mean preferences for themes were created by summing scores for each poster and compared across demographic categories using ANOVA. Overall mean preference for themes was 2.3 + 0.5 suggesting low overall preference. In general, 6th and 7th graders and girls liked posters from all themes more than 8 th graders (p<0.05) and boys (p<0.05). Blacks liked the posters from all themes more than Whites (p<0.01) and posters from three themes (Social/Popularity, Performance and Health) more than the Asian/Other group (p<0.05). Hispanics liked the health (p<0.01) and performance themed posters more than Whites (p<0.001). Although results of pretesting with middle-school students denoted overall poster acceptability, these results indicate middle-school student acceptability of posters varied across time and demographics. Funded by NCI. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-41

MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE:

DEVELOPING AN EFFECTIVE COMMUNITY NUTRITION EDUCATION PROGRAM IN ECUADOR

AUTHOR(S): L.M. Hubbard, 2LT, Dietetic Intern, US Army; J.L. Rodriguez, 2LT, Dietetic Intern, US Army; Brooke Army Medical Center, San Antonio, TX LEARNING OUTCOME:

TITLE:

WORKING WITH AFFILIATES OF THE NATIONAL URBAN LEAGUETO DELIVERHEALTH EDUCATION MESSAGES TO AFRICANAMERICAN COMMUNITIES

AUTHOR(S):

Cynthia L. Van Riper, MS, RD, CSP, CDE

LEARNING OUTCOME:

To develop a nutrition education program for elementary level students in small, isolated communities of Ecuador. ABSTRACT TEXT: The effectiveness of nntrition education can be increased when educators determine existing knowledge and develop learning activities that address the specific educational needs and cultural perspectives of the audience. The objective of this project was to improve the quality of life for Ecuadorian villagers through better nutrition and agricultural practices. Village children were observed to have inadequate protein and calorie consumption as evidenced by small stature and underweight status. The diet•ties student was assigned to teach basic nutrition principles, with emphasis placed on the benefits of consuming a variety of foods. The dietetics student observed that the villagers identified three common food groups: a vegetable/fruit group, a meat/protein group, and a carbohydrate/fat group. Based on these observations, the student organized the three groups into a "food guide basket" utilizing the principles of the Food Guide Pyramid; "Food guide baskets" were developed as a teaching tool and cultural frame of reference because villagers routinely use baskets to transport foods from the local market. The dietetics student also used handmade dolls to demonstrate the effects of proper nutrition on growth. One doll (Pepe) was small and emaciated whereas the other (Feruando) was tall and strong. The dietetics student told the story of"Pepe the small" and "Femando the strong," and how nutrition affects growth and stamina. The educator assessed learning with an activity in which the children planned a daily menu of healthy meals for Pepe. This ensured that the children could apply the newly acquired knowledge to their everyday lives. This program suggests that nutrition education initiatives can be effective if teaching strategies and tools are modified to address specific cultural differences. TITLE: THE RELATIONSHIP BETWEEN DIETARY INTAKE AND BLOOD LEAD LEVELS AMONG WIC INFANTS IN RURAL WEST VIRGINIA AUTHORS: N. Pefiuela, B.S. and C. Fitch, Ph.D., RD, West Virginia University, Morgantown WV. LEARNING OUTCOME: To understand the relationship between dietary intake and blood lead levels in children. ABSTRACT TEST: Although statistics show that blood lead in the United States population has decreased, lead poisoning continues to be the primary environmental threat to children in the United States. The purpose of this study was to quantify the relationship between blood lead levels and dietary intake in rural West Virginia infants. Thirty-seven infants, ages 6-24 months and without chronicdisease, were recruited from WlC clinics in counties where the prevalence of anemia is greater than 10%. The data collected included iron status, blood lead levels, and two 24-hour recalls. Nutrient intake was calculated using Food Processor, version 7. The relationship between blood lead levels~md calorie intake, and the dietary intake of fat, protein, calcium, phosphorus, iron, copper, selenium, zinc; and vitamins C, E, A, and thiamin was analyzed using stepwise regression procedure. The mean blood lead level for this group was 2.86 mcg/dL :t: 1.76, which is slightly higher than the national average. Although none of the infants had lead concentrations that were greater than 10 mcg/dL, these results indicate that rural infants are at risk for lead exposure. Blood lead levels were positively associated with protein and thiamin intake (t7< 0.002 and 0.05 respectively) and negatively associated with vitamin E and phosphorous intake (t7< 0.009 and 0.003 respectively). No other significant association was found. Although others have reported significant negative relationships between blood lead levels and iron or calcium intake, those relationships were not significant in this group. It is important to consider that the source of lead may have been the prenatal environment and not their current environment. This question requires further study. The relationships between blood lead level and dietary intake that were noted indicate that these nutrients are also important in the prevention of lead poisoning in children.

A-42 / September 2002 Supplement Volume 102 N u m b e r 9

To increase awareness of the opportunities for working with nontraditional organizations to deliver health education messages.

ABSTRACT TEXT:

In 1999, the Centers for Disease Control and Prevention (CDC) provided funding to establish diabetes education and awareness activities within 16 Affiliates of the National Urban League (NUL). This program was intended to support the National Diabetes Education Program (NDEP) by strengthening the capacity of National Minority Organizations (NMOs) to address the disproportionate burden of diabetes among high-risk populations. Founded in 1910, the NUL currently has over 100 Affiliates, serving urban African American communities, in 34 states. These Affiliates are entrenched in the social and economic life of their communities and are trusted and valued channels for information dissemination and education. Participating affiliates of the NUL networked with local health care providers and programs; developed multi-media resource libraries on diabetes; conducted focus groups with consumers and health care providers; and worked with print and other media to disseminate messages of the NDEP. NUL Affiliates are ideal partners in the public health approach to reducing the burden of diabetes and other chronic diseases in the African American community. TITLE: HEALTHY MESSAGES GO TO CAMP WITH KIDS AUTItORS: C. L. Hohobaum, MA, RD, LD, Healthy Kids Challenge, Wichita, KS.; V. L. James, RD, LD, Healthy Kids Challenge, Dightort, KS. LEARNING OUTCOME: To identify a model and practical application guidelines for creating healthy eating and physical activity messages for kids in a camping experience.

ABSTRACT TEXT: A recent Girl Scout Research Institute study shows weight is a particular concern for girls ages 8 to 12, and that girls as young as 8, talk about dieting and watching calories. The prevalence of eating disorders, as well as obesity and inactivity for girls in this age category is well documented. Althoughproblems are identified, solutions seem less apparent. Plan: A collaborative effort between Healthy Kids Challenge (HKC), a national nonprofit initiative to increase opportunities for healthy eating and physical activity, and Chalk Hills Girl Scout Camp, to implement healthy goals in a camp experience. The HKC mission "to provide an adaptable approach to educate, motivate, and link kids and adults (KidLinks) to make healthy living a habit" was the foundation of the model. Goals for campers: a) send a positive "healthy me" message with team and selfesteem building; b) increase free time fun and movement activities; e) increase healthy food choices at meals and snacks; d) develop healthy attitudes and perceptions; and e) motivate to take healthy practices home. Goals for camp staff: a) develop ownership of change b) take small, simple steps in implementing change; e) model healthy choices and attitudes; d) support and train food service staff; e) promote healthy choices to families. Intervention: Step 1--assessment of existing camp menu, snacks, activities, and classes (along with other factors it was determined the amount of time campers were engaged in physical activity and movement was less than recommended guidelines). Step 2--recommendations and suggestions for change. Step 3--camp staffparticipate in goal setting, action plans, personal wellness plans, and incentives to send healthy messages; Step 4--training for camp sta~ Step 5--implement plan and evaluate outcomes. Outcomes: *2-weeL kid friendly cycle menu featuring versions of CookingLight recipes *Water and milk replaced sugar-flavored drinks at meals; *Balanced food budget *Increase in movement and physical activity choices *Positive feedback from camper and staff surveys.

MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH T I T L E : KITCHEN CREATIONS: A COOKING SCHOOL FOR PEOPLE WITH DIABETES AND THEIR FAMILIES

AUTHORS: K. Halderson, MPH, RD, LD,CDE, New Mexico State University Cooperative Extension Service, Albuquerque, NM; M. Archuleta, PhD, RD, New Mexico State University Cooperative Extension Service, Las Cruces, NM; E. Douglass, MS, RD, CDE, New Mexico Department of Health Diabetes Program, Santa Fe, NM; H. Krapfl, MS, New Mexico Department of Health Diabetes Program, Santa Fe, NM; M. Frerichs, RN, MS, New Mexico Department of Health Diabetes Program, Santa Fe, NM.

LEARNING OUTCOME: To introduce nutrition professionals to the use of cooking schools as a part of diabetes education.

ABSTRACT TEXT: Kitchen Creations is a cooking school for people with diabetes and their families. It has four 3-hour sessions. Session 1 is "Meal Planning", session 2 is "Carbs Count", session 3 is "Vegetables, Beans, and Grains" and session 4 is "Heart Healthy Cooking". Participants learn about the Diabetes Food Guide Pyramid, the 50150 method for meal planning, how to use Nutrition Facts Labels, and portion control. Participants prepare recipes at sessions 2, 3, and 4. The curriculum has been translated into Spanish. Kitchen Creations is taught by an Extension Home Economist and an RD or RN. In 2000-2001, cooking schools were held in 12 New Mexico counties with 217 participants. Topics that ranked first in an increase of knowledge were "Eating heart healthy may help lower the risk of heart disease" (8 I%) and "Differences in carbohydrate and fiber contents of vegetables, beans, and grains" (81%). The leading three behavior changes that participants plan to make are "Measure portions of carbohydrate foods at meals" (82%), "Use of Diabetes Food Guide Pyramid when planning a day's meals" (80%), and "Control the amount of carbohydrate foods you eat at meals using the 50•50 method" (77%). In 2002, 38 cooking schools will be held in 22 New Mexico counties.

TITLE:

COMMUNITY-BASED INTERDISCIPLINARY PROGRAM FOR FAMILIES OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS

AUTHOR(S): JA Campbell, MS, RD; FT Green, EdD; CA Conkin, MS, RD; Texas Children's Hospital, Houston, TX LEARNING OUTCOME: To describe a successful method of providing nutrition education to children with special healthcare needs and their families. ABSTRACT TEXT: A community program was developed to provide Children with Special Healthcare Needs (CSHCN) an opportunity to participate in mainstream activities. The 4-week program, designed to meet on Saturdays, provided activities and learning opporttmities by dietitians, physical and occupational therapists, child life specialists, exercise specialists, and social wo,'kers. Each session provided activities by each discipline with the nutrition component focusing on healthy eating/balanced nutrition. During the first week, the parents and a dietitian discuss problems related to the nutritional intake ef children, and introduce concepts of modeling behavior, as well as the food guide pyramid. During week two, a dietitian leads the children, siblings, and parents in a discussion of portion sizes and the balanced eating. Using an interactive placemat, the children and parents work together to compare their dietary intake to the food guide pyramid. During week three, a dietitian meets with parents to discuss healthy cooking and kid-friendly snacks. During the final week, a dietitian meets with only the kids to play, "Who wants to be a dietitian?". Patterned after the popular game show, this activity enables the children to use the information learned over the last four weeks to win small prizes. Food habit surveys report 100% of parents made some positive change in their child's diet. Fifty percent of parents have introduced a new fruit or vegetable, 63% have increased whole grain intake, 88% of parents have decreased intake of sweets, and 88% have worked to increase their child's physical activity. This program has been helpful in giving parents and children an opportunity to spend time together, while learning useful information.

TITLE: SOYFOOD NUTRITION EDUCATION

AUTHOR(S): R.T. Wood, MEd, CFCS; L.M. Tice, BS; L.J. Hughes, MS, RD Rutgers ~ v e

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LEARNING OUTCOME: To increase consumer a ~ s soyfoods and their ~ a l

and aeeeptaa~ of

health benefits

ABSTRACT T E X T : Research is showing that soy consumption is protoctive against heart discas¢, some ~ , and ostooporosis. Due to research on its health benefits, soy has received extensive attmtion fi-om the press. More individuals are seeking out information on the advantages of soy aad how to incorporate it into their diets on a regular basis. Sinc~ 1998, Rutgws Cooperative Extension of Burlington County has been p r e s s i n g "Eating Healthy-The Benefits of Soyfoods" workshop. The goal is to provide researchbased information on the nutritional benefits of soyfoods and reconmmmdafions on bow to incorporate soyfoeds into tho diot on a regular basis. The soyfoods workshop features an in-depth lecture on the health benefits of soyfoods and a dcmoastration of the "what, whom, and how" to purchase aad prepare a variety of soyfoods-starfingwith green vegetable soybeans and progressing into secondgeneration soyfood products. Participants taste each soyfood as it is being discussed during the demoaslration. This includes food samples ofedamame (green ~ l e soyboam); soynuts; soynut butter; soy beverages; and miso. Also included were ~ t r ~ s , side dishes, and desserts prepared with tofu; temtmh; soy flour; textured soy protein; and other meat/cheese soy alternatives. To date, 412 consumers have participated in the workshops. Long-term surveys: (111 respended out of 220 surveys mailed to participants of the first 8 workshops, resulting in a 50% response.) 93% Purchase soyfoods 66% Prepare soyfood dishes at home 80% Include soyfoods in their diet daily or w¢¢ldy

TITLE: "FROM OUR FARMS": A NUTRITIONEDUCATIONPROGRAM WITH AN AGRICULTURAL"TwiST" AUTHOR(S): L.J. Hughes, MS, RD, Rutgers Cooperative Extension, New Brunswick, NJ LEARNING OUTCOME: To increase children's consumption and understanding of locally grown food products (fruit, vegetables, dairy foods). ABSTRACT TEXT: Pairin~ food and nutrition with the farm can be a savvy, appealing and marketable way to interest consumers in nutrition education programs for children. Helping people understand where their food comes from is one way to help them explore food options and incorporate more fresh foods into their diets. From Our Farms provides comung.rs with the necessary tools to introduce children to

food, the farm, and nutrition as a fun way of improving nutrition knowledge and adopting healthful eating behaviors. It is a learn-at-home and in-school program that offers parents, children, and teachers a series of fun, educational activides/pmgrams to promote goo~ numuon anu locat agncmmre. Data from telephone surveys of program participants revealed that participation in From Our Farms resulted in the following behavior changes: 88 % reported that their child tried a new fruit/vegetable 31% prepared/cooked locally grown foods with their children 79 % learned how fruits/vegetables grow 77 % learned which fruits/vegetables grow in New Jersey 98% visited a farm stand or farm market 99 % purchased ""Jersey Fresh" produce This poster presents a newly developed educatioanl program to increase children's consumption of fruits, vogetables, and dairy foods by learning about how food grows, why it's good for you, and which foods grow on local farms. Journal of TIlE AMERICAN DIETETIC ASSOCIATION / A-43

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: IMPLEMENTATION OF NEW BEVERAGE STANDARDS FOR MIDDLE SCHOOL AND HIGH SCHOOL VENDING AND A LA CARTE OPERATIONS AUTHOR(S):

J. McLaughlin, MS, RD, Nutrition Consultant

LEARNING OUTCOME: To identify opportunities and challenges in implementation of newly developed beverage standards as part of a Comprehensive School Nutrition Policy pilot project.

TITLE: PARTNERING COMMUNITY SUPPORTED AGRICULTURE AND EMERGENCY FOOD PROGRAMS AUTHOR(S): Theresa Murphy, MS, RD, Rosario E. Valenzuela, MS, RD, and Ina Tsagarakis, Hunger Prevention and Nutrition Assistance Program, United Way of New York City, New York, NY. LEARNING OUTCOME: To increase awareness of partnerships designed to benefit local agriculture and improve the quality of distributed emergency food.

ABSTRACT TEXT: In an effort to reduce health risks associated with obesity, the Comprehensive School Nutrition Policy Task Force initiated a pilot project in four Philadelphia schools to evaluate the impact of nutrition policy on eating behaviors and activity levels of students. In many schools, vending and a la carte items compete with nutritious food choices where students otten have access to high calorie, sugar-sweetened beverages and high fat, high sugar snacks. The Task Force established Nutrition Standards for vending and a la carte beverages and snacks to: 1) reflect policy intent to increase healthy food offerings in schools 2) provide an easily understood framework for nutrition education efforts 3) guide the purchasing decisions of food service managers. Drinks sold in participating schools are expected to meet the following standards: 100% juice; low fat flavored milks; water or flavored waters with no added sugar or artificial sweetener; carbonated water containing fruit juice with no added sweeteners; sports drinks for atter school activities; limits on drink portion sizes; unlimited water. Operational challenges to implementation were evident, including: establishing a cooperative agreement with vendors to meet the standards; providing a consistent marketing message to students; limited product availability; vending machine placement; training needs for food service managers; school store compliance with standards; product pricing analysis timelines and; establishing tracking systems for a la carte and vending beverage sales. This initial process of project development identified critical issues associated with changing the school vending and a la carte offerings and will inform ongoing efforts of the Comprehensive School Nutrition Policy pilot project in Philadelphia public schools.

ABSTRACT TEXT: Emergency food programs (EFPs) cite lack of funding as the most significant barrier to purchasing farm fresh produce. Community Supported Agriculture (CSA) programs have difficulty existing in poor neighborhoods because produce Shares are expensive and require up-front payments. Many have failed because they are unable to sell enough Shares in the community to compensate the farmer. Since January 2000, a CSA Grants Program in partnership with a local non-profit working to develop urban CSAs has been administered. The CSA Grants Program is designed to provide farm fresh produce to EFPs, support CSAs in low-income neighborhoods, and contribute to local agriculture. The program works with impoverished communities by matching a CSA with two or three EFPs in the area who are awarded up to 10 Shares for the CSA season (June to November). By purchasing Shares for EFP awards, CSAs in lowincome neighborhoods are financially strengthened by ensuring Share purchases and adequate up-front payments to the farmer, reducing community Share price, and providing EFPs with farm fresh produce to distribute. Shares contain a variety of 7-10 vegetables and/or fruits, and 10 Shares equals 150-200 pounds of produce each week. EFPs pick up the farm fresh produce from the CSA once a week and distribute it to their communities. Because of the success of this mutually beneficial model, it is suggested that funders of EFPs consider partnerships that benefit local agriculture and improve the quality of distributed emergency food. Funding provided by the New York State Department of Health.

T I T L E : THE EFFECT OF ACCULTURATION ON DIET QUALITY OF U.S. MEXICAN-AMERICAN CHILDREN

TITLE:

AUTHOR(S): JR. Hey, BA, and LB. Dixon, PhD, MPH, Nutrition and Food Studies, New York University, New York City, NY.

AUTHOR(S): K. L. Marcoe, MBA, RD, and P. Britten, PhD, USDA Center for Nutrition Policy and Promotion, Alexandria, VA.

LI~ARNING O U T C O M E : To describe differences in the diet quality of U.S. Mexican-American children who differ by generational status.

LEARNING OUTCOME: To become aware of the extent of vegetable consumption as part of food mixtures, and the implications for meeting Food Guide Pyramid recommendations for vegetable consumption.

A B S T R A C T TEXT: Acculturation or immersion into the lifestyle and culture of the U.S. has been associated with unhealthful dietary changes in MexicanAmerican adults, increasing their risk of developing obesity, type 2 diabetes and other chronic diseases. The objective of this study was to examine the effect of acculturation, as measured by generational status, on the diet quality of Mexican-American children. Diet quality was measured by Healthy Eating Index scores and servings from Pyramid food groups determined from 24-hour dietary recall data for st nd rd 3,182 1 , 2 and 3 generation Mexican-American children, ages 2-16 years, who participated in NHANES lJI. Results showed that 1st generation Mexican-American children (least acculturated), ages 2-6 and 12-16, had significantly higher overall Healthy Eating Index scores than 2 "d and 3rd generation Mexican-American children (more acculturated) in the same age groups. 1st and 2 "d generation MexicanAmerican children also had diets that were more in accordance with U.S. dietary guidelines for key nutrients such as fat and saturated fat. These data suggest that differences exist in the diet quality among Mexican-American children by generational status. Practitioners should encourage retention of healthful aspects of the traditional Mexican diet in new immigrant families as one way to address the siRnificant health concerns of this population.

ABSTRACT TEXT: This study investigated amounts of vegetables that were consumed as part of food mixtures and implications for meeting Pyramid vegetable recommendations. Data on 2-day food intakes reported in the Continuing Survey of Food Intakes by Individuals 1994-96 for all individuals over the age of 2 were used. Food item groups were developed for all Pyramid vegetable sub-groups. Top-consumed items were separated by food code into 2 groups: those eaten plain and those eaten as part of a mixture. Food codes representing mixtures were further categorized into the type of product. Vegetables varied in the proportion eaten plain or as mixtures and in the type of mixtures most commonly eaten. Tomatoes were eaten as part of mixtures 74% of the time, and these mixtures made up 75% of total tomato consumption, while carrots were eaten as mixtures 58% of the time, and these mixtures made up 35% of total carrot consumption. Raw tomatoes and carrots were more likely to be eaten plain. Spinach was eaten as part of mixtures 57% of the time, but these mixtures made up only 19% of total spinach consumption. Broccoli was the vegetable most likely to be eaten plain rather than in mixtures. The most common mixtures containing tomatoes were pasta dishes and sauces, pizza, and condiment sauces. For carrots the most common were soups, meat dishes, and stews and for spinach the most common were pasta dishes and salads. Nutrition educators may find this information on "hidden" vegetables helpful in the design of realistic nutrition intervention programs and in counseling as a way to encourage healthful eating.

A-44 / September 2002 Supplement Volume 102 Number 9

"HIDDEN" VEGETABLES~2ONSUMPTION OF VEGETABLES AS PART OF FOOD MIXTURES

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: FOOD LABEL USE AND UNDERSTANDING IN OLDER AMERICANS AUTHOR(S): J.F. Wooden, MS, St. Luke's Hospital/Mayo Clinic Jacksonville, Jacksonville, FL; M.J. Oakland, PhD, RD, FADA, Iowa State University, Ames, IA; H.H. Jensen, PhD, Iowa State University, Ames, IA. LEARNING OUTCOME: To raise awareness that older Americans may need education on how to use food labels to make better food choices in the prevention or management of chronic disease. ABSTRACT TEXT: Food labels are the most frequently used source of nutrition information among all Americans; however, to be of benefit the consumer must be able to read and interpret the label correctly. Recent studies demonstrated that older adults have the lowest rates of food label use, primarily because the labels are considered to be too confusing and difficult to understand. Data from the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individual (CSFII) 1994-96 and the Diet and Health Knowledge Survey (DHKS) were used to obtain two, l-day diet recalls as well as information regarding nutrition knowledge and practices from 2,846 respondents aged 51 years and older. Variables from the CSFII and DHKS datasets were used to construct indices measuring respondents' awareness of fat in foods, dietary fat modifications, food label use and comprehension, and quality of health. Fat intake as percent of total calories was determined from the diet recalls. Response values within each index were summed to provide total scores; t-tests were used to compare differences and Pearson's correlations were calculated for all indices. Results showed that food label use was negatively correlated with percent energy from fat (p<0.01); likewise, correct interpretation of labels was associated with less use of added fat (p<0.01). Usage and understandability of food labels decreased with advancing age, while heart-related health problems increased (p<0.01). This suggests that older Americans would benefit from education on food label use and comprehension to decrease their dietary risk factors for nutrition-mediated chronic disease. CONFLICTS OF INTEREST: none Research partially supported by USDA/CSREES NRI Grant No. 97-352004235.

TITLE: THE USDA FOOD GUIDE PYRAMID: DO REGISTERED

DIETITIANS THINK IT'S OUTDATED? AUTHOR(S): P. J. Ward, BS, RD, CDN, Graduate School of Health Sciences,

New York Medical College. LEARNING OUTCOME: To explore and document the ideas and opinions of a small group of Registered Dietitians (RD) on the Food Guide Pyramid using individual phone interviews consisting of focus group type questions. ABSTRACT TEXT: Since the release of the USDA Food Guide Pyramid (FGP)

in 1992, there has been a wealth of new scientific findings about the benefits of a more plant-based diet. The USDA has begun exploratory work to reassess and possibly revise the FGP. For this project, 8 experienced RD's from a variety of practice settings were selected to participate. Advantages of using individual phone interviews consisting of open-ended, non-leading focus group questions over facilitating a focus group session included more convenient scheduling, the ability to ask more questions (23) and allowing each participant to speak as long as she wanted on any given topic without being influenced by other group members. This group was knowledgeable and articulate and this proved to be an effective way of collecting meaningful comments and opinions from a busy group of professionals. Analysis of the resulting qualitative data was completed using both the "cut and paste" and the content analysis methods. Although the results can't be generalized to all RD's, they were quite interesting. If the changes that this group thought were most important were made, the FGP graphic would look significantly different. Fruits and vegetables would be at the base, the number of fruit and vegetable servings would be nearly twice what they are now, and variety would be emphasized. The next level would consist of at least 6 servings of whole grains with refined grains placed up nearer to the eat sparingly group. Fish and healthier meats, including legumes and nuts, would be highlighted better. Healthier fats would be emphasized. Less healthy meats, less healthy fats, fried foods, sweets and sugary beverages would be pictured at the top to let people know what to eat less of. Graphics for activity and fluids would also be included. As work proceeds to assess and possibly revise the FGP, it is imperative that RD's be involved in the process and that the USDA seriously consider revisions to the graphic that will help Americans make changes in their diets that will make a real difference in health outcomes. TITLE: A PILOTFORAN INTERNET-BASEDLOWCARBOHYDRATEDIETREGISTRY AUTHORS: CJ Segal-Isaacson EdD RD, Albert Einstein College of Medicine

TITLE: NUTRITION FACTS LABELS: A COMPARISON OF GENDER

(AECOM); AE Segal-Isaacson BA; J Wylie-Rosett EdD RD, AECOM.

DIFFERENCES IN USAGE RATES AND SKILLS AUTHORS: Carol Byrd-Bredbenner, Ph.D., R.D., F.A.D.A., Rutgers University, 88 Lipman Drive, New Brunswick, NJ 08901. LEARNING OUTCOME: Evaluate the nutrition label reading and manipulation skills of young adults and determine if gender differences exist. ABSTRACT TEXT: Although Nutrition Facts labels have appeared on virtually every food sold in the U.S. since the mid-1990s, few studies have examined the ability of consumers to read and manipulate food label information or determine if gender differences exist in label use skills. Thus, the purpose of this study was to evaluate young adults' (ages 17 to 33) ability to locate and manipulate data reported on labels and judge the nutrient content and health claim accuracy. The sample was comprised of 49 males with a mean age of 21.9+3.2SD and 195 females with a mean age of 21.1+3.1SD. On average, each week males visited a food store significantly (p=0.008) more often than females (2.2 trips +2.1SD vs. 1.4 trips + 1.3SD, respectively), however the average time both males and females spent food shopping each week did not differ significantly. Few differences existed between the genders in regard to frequency of label reading. About 15% reported that they always read nutrition labels, 76% read labels sometimes, and the remainder (9%) rarely read labels. Both women and men reported that labels had an important impact on their food purchasing decisions. A pencil/paper questionnaire revealed that both genders could locate and retrieve label information equally well, with an overall average accuracy rate of 92%. They also manipulated quantitative information on the label to make diet planning decisions equally well, with an overall mean accuracy rate of 81%. Males achieved a significantly (p=0.01) higher mean accuracy rate (88%) when asked to judge the truthfulness of nutrient content claims products than did females (81% mean accuracy). Males also were significantly (p=0.008) better able to accurately judge whether a health claim would be permitted on a product (77% of the time) than females (68% of the time). This investigation provides useful information for designing gender specific nutrition education programs designed to overcome barriers to nutrition label use. CONFLICT OF INTEREST: None

LEARNINGOUTCOME: To increase dietitians' awareness about low

carbohydrate dieting patterns and using the Internet to assess such patterns. ABSTRACTTEXT: Because little is known about the eating or weight loss

patterns of low carbohydrate dieters, an Internet-based pilot survey was developed in preparation for establishing an Internet-based low carbohydrate diet registry. Internet-based research is efficient, cost-effective and likely to be increasingly used as more Americans gain Internet access. All respondents completed online consents. A survey announcement was posted on two large low-carbohydrate diet websites and all identified Internet diet discussion groups with >75 members (n = 41). The survey was posted for two months in the Summer of 2001. Completed questionnaires were collected from 6,740 people of whom 6,088 reported using a low carbohydrate diet. Of these, 87.4% of the respondents were Americans, 75.4% were women, 90.5% were non-hispanic white and 48.9% had > a bachelor's degree. The three diets most frequently used by respondents were the Atkins Diet (85.0%), the Protein Power Diet (4.9%) and the Carbohydrate Addicts' Diet (3.0%). The three most common diet likes were not feeling hungry (87.5%) or deprived (85.6%) and losing weight easily (74.1%). The three most common diet dislikes were bad breath (30.9%), light headedness (15.0%) and nausea (8.3%). More than half of the respondents (55.9%) were currently dieting to lose weight and their BMI was higher than those who were not trying (31.2 + 7.8 compared to 29.8 5: 7.6; p < 0.001). Those who were not currently dieting to lose weight reported they had lost an average of 36.2 5:25.6 lbs but had wanted to lose 56.3 + 41.3 lbs. The amount of weight these respondents reported they kept off for at least one year was at least 11-20 lbs for 53.2% of the respondents and at least 21-30 lbs for 37.4% of the respondents. Most respondents modified the diet they chose (60.2%). The most common modifications were adding more vegetables (29.0%), fruit (12.4%) or occasionally going offthe diet (32.7%). In conclusion, although this sample may not be representative of all low carbohydrate dieters, this Intemet-based study provides insights about the characteristics of successful low carbohydrate dieters. Further, Internet-based nutrition research may be useful to initially describe eating habits among dieting subgroups. J o u r n a l of THE AMERICAN DIETETIC ASSOCIATION / A - 4 5

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: Breakfast, Cereal Consumption, and Body Mass Index in Adolescent Girls: The NHLBI Growth and Health Study.

TITLE: ARE FOOD GROUP CONSUMPTION PATTERNS CONSISTENT FROM CHILDHOOD TO YOUNG ADULTHOOD

AUTHOR(S): B.A. Barton (Maryland Medical Research Institute, Baltimore, MD), A.L. Eldridge, A.M. Albertson, R.C. Tobelmann, S.J. Crockett (Bell Institute, General Mills, Minneapolis, MN)

AUTHOR(S): DK Demory-Luce, PhD, RD, LDI; M Morales, BSL; TA Nicklas, DrPH, LN~; T Baranowski, PhD~; I Zakeri, PhDI; G Berenson, MDz IBaylor College of Medicine, 2Tulane Center for Cardiovascular Health

LEARNING OUTCOME: To document the frequency of breakfast and cereal consumption during the teenage years and the influence on body mass index

LEARNING OUTCOME: To determine whether food group consumption patterns of childhood persist into young adulthood in a longitudinal sample

ABSTRACT TEXT: The relationship between breakfast, cereal consumption and body mass index (BMI) was examined in a cohort of 2379 black and white girls who participated in the National Heart, Lung and Blood Institute Growth and Health Study (NGHS) from ages 9-19. General Mills supported these analyses. Three-day food records were collected annually from each girl. Variables were constructed to indicate the number of days (out of three) when a girl ate breakfast of any type, and the number of days she ate cereal (cold or cooked). Longitudinal regression models (GEE) were used to compare breakfast and cereal consumption and their influence on body mass index across ages, adjusting for caloric intake, physical activity, parental education, number of parents at home, and hours of TV watching per week. After adjustment for these factors, breakfast eating was significantly and negatively correlated with BMI (p<0.0003). For each day a girl ate breakfast, her BMI was 0.23 units lower. The number of days of eating cereal was also negatively associated with BMI over the entire age range (p<0.0001). For every day a girl ate cereal for breakfast, her BMI was 0.32 units lower. These effects were independent and additive, so that a girl who ate breakfast for three days had a BMI 0.70 units lower than a girl who did not and 1.65 units lower if she ate cereal in addition. Younger gifts (ages 9-10) ate breakfast on 80% of reporting days whereas older girls (ages 18-19) reported eating breakfast on only 44.5% of the days surveyed. Further analyses will investigate the associations of breakfast and cereal eating with other health-related outcomes, including fat intake, cholesterol intake, physical activity, blood pressure, and lipid levels.

ABSTRACT TEXT: Understanding whether eating habits of children begin early in life is important for planning effective intervention strategies. Twentyfour hour dietary recalls were collected on a longitudinal sample of 246 young adults (70% Euro-American (EA), 30% African-American (AA)) aged 19 to 28 years who also participated in a previous cross-sectional survey when they were 10-yr-olds. In childhood, consumption of fruits/fruit juice and mixed meats (p<_0.05), desserts, candy and milk (p~0.0001) were greater than in young adulthood. In contrast, young adulthood consumption was greater for sweetened beverages, poultry and seafood (p<_0.001), snacks (p_<0.05) and beef (p_<0.01) compared to childhood. Milk consumption decreased, but the decrease was greater among males (p_<0.0001). Sweetened beverage consumption increased, but the increase was greater for EA (p_<0.0001). Candy consumption decreased, but the decrease was greater for AA (p<_0.05). Consistency was defined as consumption at age 10 and at young adulthood (Y* Y) or not consumed at those two time periods (N-N). Positive consistency (YY) in food group consumption was highest for breads/grains (93%), vegetables (73%) and sweetened beverages (64%). Negative consistency (N-N) was highest for seafood (75%) and eggs (65%). Inconsistency (Y-N or N-Y) was highest for milk (52%), beef and fruits/fruit juice (51%) and desserts (50%), poultry, pork and mixed meats (45%) and snacks (44%). After combining food groups into larger categories, positive consistency for meats increased to 93%, dairy increased to 71%, sweets increased to 68%, fruits/fruit juices/vegetables to 83%. Our findings indicate that eating habits of children are consistent with those when they become young adults for certain food groups.

TITLE: BODY COMPOSITION AND SITE-SPECIFIC BONE MINERAL DENSITY IN YOUNG-ADULT MALE CYCLISTS, MALE NONCYCLISTS, AND FEMALE NON-CYCLISTS AUTHOR(S): M.K. 7__aek,MS, J.M. Beiseigel, MS, M.D. Coleman, MS, RD, S.M Nickols-Riehardson, Phl), RD. Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA. LEARNING OUTCOME: To identify differences in body composition and site-specific bone mineral density in young-adult male cyclists, male noncyclists, and female non-cyclists. ABSTRACT TEXT: Physical activity is important for bone strength. However, some non-weight beating activities, such as cycling, have been shown to provide inadequate stimulus to bone compared to weight beanng exercise. The purpose of this study was to investigate differences in body composition, including bone mineral density (BMD; g/cm2), in young-adult male cyclists (MC; n = 7), male non-cyclists (MNC; n = 7), and female non-cyclists (FNC; n = 9). Dual energy X-ray absorptiometry (Hologic QDR4500A, version 8.25a) was used to assess body composition and total body fiB), lumbar spine (LS), total proximal femur (TPF), and total forearm (TF) BMD. By analysis of variance, significant differences between groups were not observed in age (mean + SD = 22.7 _+1,9 y, N = 23). Mean height of MC was significantly greater (70.7 + 2.8 in; p < 0.0001) compared to FNC (64.0 + 2.6 in) but not MNC (71.9 _+2.4 in). However, mean body weight of MC (159.4 + 18.3 lbs) was not significantly different compared to MNC and FNC (188.3 + 47.9 and 135.0 _+14.0 lbs, respectively). Body mass index was not significantly different among groups (22.5 vs. 25.3 vs. 23.2 for MC, MNC, and FNC, respectively). MC and MNC possessed significantly greater lean body mass (LBM; p < 0.0001) and lesser fat mass (FM; p < 0.0001) compared to FNC (LBM = 60.8 + 6.8 vs. 70.3 + 15.7 vs. 43.3 + 4.2 kg, respectively; FM = 9.8 _+2.2 vs. 13.0 + 7.3 vs. 16.7 + 3.7 kg, respectively). For MC, BMD of the TB, LS, TPF, and TF did not differ from MNC or FNC; however, patterns were observed for lower LS (p = 0.08) and TF (p = 0.09) BMD in MC compared to MNC (but not to FNC). These data suggest that while participation in cycling among young-adult males may impart positive benefits to soft tissue composition (i.e., >LBM and
TITLE:DIETARY SUPPLEMENT USE BY ELITE FIGURE SKATERS AUTHOR(S):P.J. Ziegler, PhD, RD, Gerber Products Co., Parsippany, N J; S.S. Jonnalagadda, PhD, RD, Department of Nutrition, Georgia State Atlanta, GA; J.A. Nelson, MS, USOC, Colorado Springs, CO. LEARNING OUTCOME: To describe the use o f dietary supplements by elite figure skaters. ABSTRACT TEXT: Use of dietary supplements has gained widespread popularity among athletes. The present study examined the use o f dietary supplements by elite figure skaters and the nutrient intake of supplement users vs. non-users. Male (n=47, mean age 17y, BMI 21.5) and female (n=60, mean age 15y, BMI 18.6) figure skaters completed a supplement survey and 3-day food records. Sixty-five percent of male and 76% of female figure skaters reported use of supplements. Multivitamin-mineral supplements were the most popular dietary supplements consumed by these figure skaters. Significant gender differences were observed in the use o f multivitamin-mineral supplements (p<0.05). Echinacea and ginseng were popular herbal supplements used by these skaters. The 3 main reasons given for taking supplements by male figure skaters were: to provide more energy (41%), to prevent illness (34°,/0) and to enhance performance (21%). Among female figure skaters the 3 main reasons given were: to prevent illness (61%), to provide more energy (39%) and to make up for inadequate diet (28%). Significant differences (p<0.05) were observed in protein, total fat, saturated fat, and polyunsaturated fat intakes as well as % energy intake from carbohydrate o f male supplement users vs. non-users. Sodium was the only nutrient significantly different among female supplement users vs. non-users (p<0.05). Given the widespread use o f supplements and the reasons for their use, theres is a need to better understand the factors influencing athletes' use of dietary supplements, dosage of supplements used and their effectiveness in meeting the goals of the athletes. A better understanding o f these various factors will enable dietetic professional to better educate athletes about appropriate supplement use and optimum dietary intake.

MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: A MENU PLANNING MODEL FOR TRANSATLANTIC ROWERS

TITLE: PHYSICAL ACTIVITY AND OBESITY IN NATIVE AMERICAN YOUTH

AUTHORS: N. Clark, MS, RD, SportsMedicine Associates, Brookline MA, K. Figure, RD, Brigham & Women's Hospital, Boston MA, C Coleman III, NIDDK, Bethesda MD

AUTHOR(S):

LEARNING OUTCOME: Be able to easily create for ultradistance athletes an 8,000 calorie menu using a food exchange system based on supermarket foods.

LEARNING OUTCOME: To examine the association between physical activity patterns and obesity in Native American youth.

ABSTRACT TEXT: Transatlantic rowers and other ultradistance athletes (long distance hikers, mountaineers,) who do repeated days of endurance exercise need to eat adequately to delay fatigue and maintain good health. To do so requires consuming adequate calories, protein, vitamins, minerals and fluids. The athletes also need education regarding what, when and how much to eat. With ultra-athletes who have to carry and prepare their own food, the foods needs to be light-weight, compact, non-spoiling, taste good, quick to cook, nutrient dense, easily prepared--all of which creates menu planning challenges. We designed a model to easily create an 8,000 calorie/day meal plan based on supermarket foods for two men who were preparing to race in a transatlantic rowing competition (rowing 14 hours/day for 60 days ( 2,900 miles) in the tropical heat). The 8,000 kcal menu was divided into 1,500 kcal for breakfast (approximately 300 kcal protein-rich food, 600-700 kcal starch, 200-300 kcal fat, 300 kcal fluids); 1,500 kcal flavoring for water throughout the day; 3,500 kcal snacks to be eaten every 60-90 minutes at break time (4 food packets: 700 kcal chocolates/treats, 1,000 kcal nuts, 800 kcal dried fruit, 1,000 kcal energy bars); 1500 kcal for dinner (approximately 400 kcal protein-rich food, 700 kcal starch, 400 kcal fat). The ten day cycle menu approximated 55-60% carbohydrate, 10-15% protein and 30-35% fat. Each rower could pre-select his personalized menu because the food was to be prepacked into zip-lock bags, and then compiled into larger labeled bags. This identified how much each rower needed to consume for each meal and day. The rowers were taught to monitor each other's food and fluid intake, to be sure each consumed adequate rations. Using this model of food exhanges that meet a certain calorie level, the uitradistance rowers were able to systematically plan the menus and assemble food for the 60 day event. By choosing ten days of menus, tallying the amount of each food chosen for 10 days, and multiplying that by 6 (for the estimated 60 day journey), the rowers were able to purchase, pack and look forward to eating a supply of familiar supermarket foods that would meet their nutritional needs. These menus helped them finish the race, placing 1 lth of 35 boats.

TITLE: COMBINING HEALTHY CULTURALLY SI~qSITIVE RECIPES WITH I~V~RGENCY FOOD PROGRAM

AUTHOR(S): DM Hayes, MS, RD, CDN; T Rao, phl), RD, CDN; RS Schenk, MSEd, RD; ME Schriever, MS, RD, Buffalo State, State University of New York, Buffalo, NY LEARNING OUTCOME: To develop educational tools healthy culturally sensitive recipes and recipe demonstration video, that encourages the use of foods availabl~ at the Food Bank by Hispanic clients. A B S T R A C T TEXT:

The Food Bank of Western New York (FBWNY) was concerned if the foods provided to the food pantries were accepted and consumed by the Hispanic clients served. The objective of the project, funded by FBWNY, was to promote the utilization and acceptance of available foods from the Food Bank. A Puerto Rican food preference survey was developed based on a literature review, focus group sessions and results of a pilot study. It was then administered to 50 Hispanic food pantry clients. Food preference survey results were compared to the Food Bank foods that showed that the Food Bank was ordering and making available many of the culturally preferred foods. Puerto Rican traditional recipes, Tri-colored Pasta Casserole, Potato Pie, and Bread Pudding, were modified to incorporate preferred foods and available but underutilized Food Bank foods. The recipes demonstrated the use of underutilized foods such as dry beans, tri-colored pasta, non-fat dry milk powder, and instant potato flakes. These recipes were also adapted to meet the recommendations of the U.S. Dietary Guidelines. Healthy modifications included using complementary vegetable protein sources, substituting lower sodium foods, increasing fiber, lowering fat and sugar, and increasing vegetable intake. The results of the taste testing indicated high client acceptability of modified recipes. An instructional video, "Healthy Puerto Rican Recipes Using Food Bank Foods", that incorporated healthy eating and food safety tips was produced for use by Food Bank personnel to educate Food Pantry volunteers and Hispanic clients. Food Bank personnel who reviewed the video indicated that the video met the intended purpose. The video has multiple potential uses such as a promotional tool for the Food Bank and a nutrition education tool for the food pantry operators. It can also be used in the classroom to teach culturally diverse food habits and nutritional education tool development.

Stefanie Fila BS, RD, Chery Smith PhD, MPH, RD.

ABSTRACT TEXT: The surgeon general's goal is to increase physical activity in both children and adults in the United States. The Native American population has an alarming prevalence of obesity and little is unknown about the activity patterns of their youth. This study examined activity patterns in Native American youth and compared non-obese youth to obese youth. Native American youth (n=67), 7-12 years old, participating in an after school program at the Minneapolis American Indian Center were assessed for anthropometric measurements, self-esteem, physical activity knowledge, selfefficacy, body image, history of weight loss, lifestyle, and physical activity. Physical activity was measured using MTI Actigraph monitor. BMI (kg/m2) was calculated, 42.4o% were normal weight (5 th -85 th percentile), 15.2% were at risk for overweight (85~"-95th percentile), and 42.4% were overweight (>95 ~ percentile). Activity monitor data showed a mean expenditure of 342.72 Kcal from activity per day, a mean of 1361 minutes of light activity (< 2.99 METS) per day, a mean of 63.8 minutes of moderate activity (3.0-5.99 METS) per day, a mean of 4.19 minutes of hard activity (6.08.99 METS) per day, and a mean of 2.3 minutes of very hard activity (>9.0 METS) per day. Spearman's rho analysis showed a significant inverse correlation between BMI (kg/m2) and average minutes of hard activity (p=.025) and minutes of very hard activity per day (9=.007). Youth engaged in an average of 60 minutes of moderate activity daily, but less than 10 minutes of hard and very hard activity daily. Chi-Square test found no significant difference between activity levels in normal weight youth compared to activity levels in at risk and overweight youth. The similarity in activity levels of normal and overweight youth may indicate that other factors such as diet and or genetics may be contributing to a high prevalence of overweight in Native American youth. TITLE: NUTRITIONAL AND MONETARY IMPACT OF FAST FOOD ON L O W SOCIOECONOMIC STATUS W O M E N AUTHOR(S): S David; CE O'Neil, PhD, RD, J Smith, V Tiller, MS; PA Monroe; PhD. School of Human Ecology, Louisiana State University, Baton Rouge, LA 70803 LEARNING OUTCOME: To assess the effect that fast food meals have on the fat, sodium, and total and saturated fat intake and on food dollars spent by low socioeconomic status women receiving or not receiving food stamps or who are food secure or not at the beginning and end of the month. ABSTRACT TEXT: The effect of fast food on low socioeconomic status (SES) women has not been well characterized from either a nutritional or monetary standpoint. To assess this, 2 24-hour diet recalls-one at the beginning & t h e month (Day 1) and one at the end of the month (Day 2) were collected from 30 single low-income women living in rural LA; food items named were priced either at the store in which the women shopped, at 3 local grocery stores with a mean price taken, or from a fast food restaurant. 21 received food stamps (FS); 9 did not (noFS). The USDA short form was used to dichotomize women into food secure (FSec) (n=20) or insecure (noFSec) (n=10). Overall, 38% of FS recipients ate at least one fast food meal; 14% ate at least two fast food meals on Day 1 or Day 2. 67% of noFS participants ate at least one fast food meal, 33% ate least two. O f the FSec, 55% ate at least one fast food meal a day; 20% consumed at least two. 30% ofnoFSec ate at least one fast food meal a day; 10% consumed at least two. Mean dollars (_+ SD) spent on fast food were: $2.61+1.1, $ 3.71_+4.1 (FS Day 1 & 2, respectively); $2.56 _-+0.8, $2.86_+1.7 (noFS); $ 2.58+1.0, $3.61_+2.7 (Fsec), and $2.62_+1.0, $1.49_+0.2 (noFSec). The percentage & t h e food dollar for people consuming fast food was high for all groups: 53-55% on Day 1 and 37-47% on Day 2. Participants eating fast food consumed significantly higher amounts of sodium than those that did not eat them (p=0.0184). No significant differences were found for cholesterol, total fat, saturated fat and energy intake. Data suggest that low SES women spend a disproportionate amount of available food dollars on fast foods and that these foods significantly increase the amount of sodium consumed Journal of TIIE AMERICAN DIETETIC ASSOCIATION / #,-47

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: USING "FEEDING MINDS FIGHTING HUNGER" IN PENNSYLVANIA SCHOOLS AUTHOR(S): C. Probart, PhD, RD*, V. Menza, BS**, W. Clay, B**, E. McDonnell, MS, RD*, J. Muri. BS*. (*Penn State University, Nutrition Department; **Food and Agriculture Organization, United Nations) LEARNING OUTCOME: To describe the use of United Nations world hunger lessons in Pennsylvania classrooms ABSTRACT TEXT: "Feeding Minds, Fighting Hunger" is a set of lessons developed by the Food and Agriculture Organization of the United Nations providing three lessons for three grade levels including primary, intermediate, and secondary levels. The intent of the lessons is for students to understand that all countries and regions have hungry people and that the causes of hunger and malnutrition are complex, but the solutions can be found if we all work together. Lessons are available free of charge in print, CD-ROM, and web-based format ( w w w . f e e d i n g m _ ~ ) . These lessons were launched on World Food Day (October 16, 2001 ), and became the basis for three Pennsylvania classrooms to study hunger. Classrooms included one Kindergarten classroom and n two intermediate level classrooms in an urban school district in central Pennsylvania. The Kindergarten students used questions from the lessons as a basis to discuss the problem of hunger in their area. The story "Miguel's Tomatoes" was read to the students and used as the basis for a discussion about the food production system involving a nearby food manufacturing plant. The lessons ended with a visit to the school cafeteria. Posters they created were subsequently displayed in a local soup kitchen. The intermediate level teachers used the lessons as a basis for essays and discussions about geographic distribution of hunger, the food processing system, and problem-solving activities relating to hunger in their community. Students decided the world needed more heroes and the qualities of heroes included bravery, knowledge, mid courageousness. All three teachers rated the lessons as excellent stating student involvement and interaction were exceptional. Student interest was high and level of problem-solving and creativity were rated very high. As a result of these lessons several intermediate level students volunteered at a local soup kitchen.

TITLE:

BARRIERS AND MEDIATORS OF DIET QUALITY AND FOOD SUFFICIENCY FOR OLDER AMERICANS

AUTHOR(S):

J. Wooden, MS, M.J. Oakland, PhD, RD, FADA, H.H. Jensen, PhD, Iowa State University, Am~, IA

LEARNING OUTCOME: To identify and quantify the barriers and mediators of diet quality and food sufficiency for Americaus over age 50. ABSTRACT TEXT: The role of food assistance programs, access to food sources, health, and finances in helping older persons achieve Dietary and Food Guide Pyramid Guidelines and improving food sufficiency were examined using data from the USDA Continuing Survey of Food Intakes by Individuals (CSFII) 1994-96 (n=4,442). A model developed using qualitative methods (Wolfe et al. 1996) was adapted to include the following measures of diet quality: 1) intake of nul~'ientsfrequently inadequate in older adults' diets (mean ~- SD) and 2) Healthy Eating Index (HEI) total and ten HEI component scores (mean ± SD). Multiple regression models predicted HEI total score and logistic regression models predicted food insufficiency for men and women. Significant (negative) predictors of HEI for both men and women were age, poor self-reported health status, and income below 300% of poverty (p<0.10). Variables predicting food insufficiency for both men and women included using a supermarket as primary food store, infrequent food shopping, poor and fair self-reported health status, income below 130% of poverty, and Food Stamps use (p<0.10). Older recipients of Food Stamps are at risk for food insufficiency, as are men participating in Meals-On-Wheel or other corranuuity food programs. Men and women differ on other predicting factors; thus, older men and women need to be assessed separately for food insufficiency using a different set of food access, health, and financial factors. CONFLICTS OF INTEREST: none Research partially supported by USDA/CSREES NRI Grant No. 97-352004235. A-48 / September 2002 Supplement Volume 102 Number 9

Title: FOOD SECURITY A/vlONG SENIORS IN A SOUTHERN STATE Authors: BHD Luceia, PhD, RD, and ME Kunkel, PhD, RD, FADA, Department of Food Science and Human Nutrition, BH Lupo, Clemson University Cooperative Extension Service, Clemson University, Clemson, SC. Learning Outeome: To identify incidence o f food insecurity among elderly individuals participating in activities at Council on Aging sites in South Carolina. Abstract Text: Food security is access at all times to enough nutritionally adequate food for an active, healthy lifestyle. The objective o f this study was to assess food security o f seniors participating in Council on Aging (COA) activities. A home economist administered the USDA Food Security questionnaire to 80 seniors at 5 COA sites in a rural South Carolina county. The mean age o f respondents was 75 years, 72% were female and 77% identified themselves as white, non-Hispanic. Fifty-seven percent had enough as well as the types of food they wanted. O f the 14% who reported sometimes or often not having enough o f the food they wanted, 32% did not have enough money for food. Nearly one-third (30%) worried whether food would run out before there was money available to buy more and 22% reported that sometimes food did not last and there was no money to get more. One in five (19%) cut the size o f meals or skipped meals and 30% sometimes or often did not eat balanced meals because there wasn't enough money; 43% of these reported this behavior occurred at least once per month. Nearly one in ten (7%) experienced hunger in the last 12 months aad 4% did not eat for aa entire day at least once in the last 12 months. Food insecurity among rural seniors in South Carolina is significant and may impact health o f this population. Education for food insecure seniors on shopping for food and food resource management as well as encouragement to participate in food assistance programs could make a positive impact on their health.

TITLE: FOOD SPENDING PATTERNS BY LOW INCOME WOMEN WHO RECEIVE OR DO NOT RECEIVE FOOD STAMPS OR WHO ARE FOOD SECURE OR INSECURE AUTHOR(S): CE O'Neil, PhD, RD; S David; J Smith; LSU Community Nutrition Class; V Tiller, MS, PA Monroe, PhD. School of Human Ecology, Louisiana State University, Baton Rouge, LA 70803 LEARNING OUTCOME: To compare dollars spent on food by low socioeconomic status women receiving or not receiving food stamps or who are food secure or not at the beginning and end of the month. ABSTRACT TEXT: Food spending patterns among low socioeconomic women have not been well characterized. To assess this, 2 24-hour diet recalls-one at the beginning of the month (Day 1) and one at the end of the month (Day 2) were collected from 30 single low-income women living in rural LA; food items named were priced either at the store in which the women shopped, at 3 local grocery stores with a mean price taken, or from a restaurant. 21 received food stamps (FS); 9 did not (noFS). The USDA short form was used to dichotomize women into food secure (FSec) (n=20) or insecure (ooFSec) (n=10). The rank of mean money (+ SD) spent was: $4.39-+ 2.73 (noFS Day 2), $ 3.78+ 2.85 (FSec Day 2), $3.73+ 2.33 (FSec Day 1), $3.54+ 2.17 (noFS Day 1), $3.50_+2.16 (FS Day 1), $3.08_+1.68 (noFSec Day 1), $2.60_+2.37 (FS Day 2), and $2.18+ 1.62 (noFSec Day 2). Food insecure participants spent significantly less money on Day 2 than Day 1 (p=0.039; one-tailed paired t test). There were no other significant differences seen. Data were evaluated further looking at mean cost (_+SD) for FS FSec (n=14) $3.80+2.34 (Day 1), $3.07+2.76 (Day 2); FSnoFSec (n=7) $2.92+1.75, $1.66_+0.80; noFSFSec (n=6) $3.58-+2.50, $4.88+2.89; and noFSnoFSec (n=3) $3.44-+1.82, $3.40_+2.61. Food stamp food insecure participants spent significantly less money on Day 2 than Day 1 (10=0.047; one-tailed paired t test). These data suggest low SES women receiving FS or who are food insecure spend less money at the end &the month than at the beginning. At the end of the month, noFSec women spend barely above the amount allotted for the thrifty food plan, suggesting that without good food choices, they may be or may become nutrient deficient.

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POSTERSESSION:MEDICALNUTRITIONTHERAPYANDWELLNESS& PUBLICHEALTH TITLE: TITLE: CHANGES IN FOOD SECURITY AMONG IOWA WIC PARTICIPANTS

AUTHOR(S): A. Tagtow, MS, RD, LD, Iowa Department of Public Health, Des Moines, IA; E. Roepsch, MPA, RD, LD, Iowa Department of Public Health, Des Moines, IA LEARNING OUTCOME: To determine change in household food security among Iowa WIC participants.

ABSTRACT TEXT: Introduction: An objective of the 2000 Iowa WIC Survey was to use the Radimer/Cornell hunger and food security indicators to determine whether the extent of household food security had changed among Iowa WIC participants since Congress implemented welfare reform measures in 1997. Methods: Data were collected using a selfadministered survey mailed to a 15% randomly selected sample (9194) of current WIC participants in Iowa. The survey was designed for English and Spanish-reading participants. Descriptive analyses were conducted using SPSS and quantitative reports were generated. Results: 2731 (146 Spanish) completed surveys were returned for a 30 percent response rate. Respondents experienced a greater degree of food insecurity in 2000 than in 1997 (p<.0001). Spanish-reading respondents had a greater degree of food insecurity than English-reading respondents (/9<.000 l) and single respondents had a greater degree of food insecurity than married respondents (p<.0001). Conclusions~Implications: Although the results suggest that welfare reform measures may have increased food security among WIC participants, additional studies are needed. Levels of food security should continue to be monitored and policies and programs to strengthen the nutrition assistance safety net need to be supported to boost the food purchasing power and nutritional status of low-resource families.

TITLE: DIFFERENCES 1N FOOD SAFETY KNOWLEDGE AND BEHAVIOR AMONG CONSUMERS WITH DIFFERENT DEMOGRAPHIC CHARACTERISTICS AUTHOR(S): j. Kwon, PhD, S. Tanner, A. Smith, Texas Woman's University, Denton, TX. LEARNING OUTCOME: safety education needs

To identify populations with increased food

ABSTRACT TEXT: In order to prevent foodbome illnesses, safe food handling at home must be ensured. Despite efforts to increase food safety knowledge of general populations, consumers are far from perfecting safe food handling at home. The objectives of this research were (1) to assess food safety knowledge and behavior of low-income consumers and (2) to compare results among consumers with different demographic characteristics. A questionnaire including demographics was developed, reviewed by an expert panel, and pilot tested before data collection. The sample included approx. 20 clients from each of the 200 local agencies of the Special Supplemental Food Program for Women, Infants, and Children (WIC). A total of 87 local WIC agencies (1,598 WIC clients) participated nationwide. Descriptive statistics, t-tests, and ANOVA were calculated with P<0.001 using SPSS for Windows. Seven questions related to lbod safety knowledge (KNOW) and 16 questions related to food handling behaviors (BEHAV) were computed to create overall indicators of KNOW and BEHAV. KNOW ranged 1-7 with possible max. of 7 (m=5.1), and BEHAV ranged 26-61 with possible max. of 64 (m=50.9). Results showed KNOW was increased as education levels increased. However, difference in BEHAV was found only between 'high school graduates or higher' and 'less than high school'. ANOVA showed that Hispanic population has the lowest level of KNOW, yet BEHAV was the lowest for black population indicating gaps existing between KNOW and BEHAV. Data also showed the younger (<_25 yrs) had poorer BEHAV than the older. Neither KNOW nor BEHAV showed any differences based on length of WIC participation. Despite 78.7% indicating they learned food safety from WIC, topics assessed by this research (food preparation and hand washing) may not be priority areas of WIC education. Public health and nutrition educators for low-income consumers may be encouraged to include critical topics of home food safety into education sessions already available.

POWER PANTHER TEAMS UP TO TAKE NUTRITION MESSAGES TO STUDENTS TM

AUTHOR(S):S. J. Safaii, MS, KID,H. Tubbs, MS, RD, Idaho State Department of Education, Boise, ID; L. F. Thomas, MEd, RD, and J. Zaske, MS, RD, Idaho Dairy Council, Boise, 1D. LEARNING OUTCOME: To describe how partnerships among agencies can enhance the delivery of nutrition messages to students. ABSTRACT TEXT: Power Panther the spokes character for USDA Food and Nutrition Service's EAT SMART. PLAY HARD. rM campaign joined forces with the State Department of Education (SDE) Child Nutrition Program, Dairy Council and state dietetic association to celebrate National Nutrition Month® (NNM) 2002. Within the framework of a healthy school nutrition environment, the consortium included the NNM theme "Start Today for a Healthy Tomorrow" and EAT SMART. PLAY HARD. rM messages into a successful statewide school and media campaign. Information/resource kits were developed and sent to 388 school food service managers and 508 registered dietitians, school nurses, and other nutrition educators in the state. In addition, school food service managers could request EAT SMART. PLAY HARD. rg campaign materials. During NNM, SDE and Dairy Council staff traveled with Power pantherrM throughout the state. With the help of local schools, Power Panther reached 7,863 students by holding school-wide assemblies that included a flavored milk break, visiting classrooms and making a snack, attending school meals, and playing hard with students at recess. At one school assembly, the state superintendent of schools was a special guest. For media outreach, the state dietetic association and local schools contacted the media about NNM and the Power pantherrM tour. Print and electronic media stories reached an additional audience of over 200,000. Interviews were secured in most of the major media markets in the state, including television, radio and print. This project demonstrates the synergy and importance of collaborating to teach students about nutrition. TM,

TM

TITLE: SENIORS FARMER'S MARKET PROGRAM EVALUATION: AN IOWA PERSPECTIVE AUTHOR(S): C Russell, MS RD LD FADA, Iowa Department of Public Health and Elder Affairs, Des Moines, Iowa LEARNING OUTCOME: To increase awareness of the Farmer's Market Program impact on nutritional intake of low-income seniors. ABSTRACT TEXT: There is ever-growing evidence of the health benefits derived from eating fruits and vegetables. Iowa's low-income senior citizens received the opportunity to obtain fresh fruits and vegetables from the first Seniors Farmer's Market Nutrition Program (SFMNP) in 2001. A pre and post survey was conducted to evaluate the program and participants' fruit and vegetable intake. Seventy six percent of the 13,682 SFMNP participants used all of their $28 allotment. Pre and post survey results revealed 40 percent of respondents had not previously bought produce directly from the farmer; they reported eating more fruits and vegetables and trying new fruits and vegetables because of the SFMNP. Seventy four percent continued shopping at the Farmers Market after they had used all of their checks. The results of the pre and post survey were very similar with 67 percent in both surveys consuming four or more servings of fruits and vegetables daily; 57 and 58 percent having vegetables for a snack; 87 and 91 percent having fruit for a snack. The pre-survey identified almost 44 percent of the SFMNP participants consumed five or more servings of fruits and vegetables daily. The Iowa SFMNP provided the opportunity for low-income seniors to obtain fresh fruits and vegetables and expand the variety of fruits and vegetables they eat. The data supports promoting fruit and vegetable for snacks in future programs with goal of increasing percentage of low-income seniors consuming five or more servings of fruits and vegetables daily. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-49

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MONDAY,OCTOBER21 POSTERSESSION:MEDICALNUTRITIONTHERAPYAND WELLNESS& PUBLICHEALTH TITLE: YOUNG ADULTS' BELIEFS ABOUT AND USE OF HERBAL SUPPLEMENTS IN RELATION TO THEIR DIETARY ATTITUDES AND BEHAVIORS

TITLE:

GEOPHAGIA PRACTICE AND BELIEFS IN LOW-INCOME PREGNANT WOMEN IN KAMPALA, UGANDA

AUTHOR(S): AUTHOR(S): TM Koomdyk, MS, VA San Diego Healtbeare System Dietetic Internship, San Diego, CA; C. Georgiou, PhD, RD, Oregon State University, Corvallis, OR. LEARNING OUTCOME: To increase awareness of the prevalence of herbal supplement use among young adults and the beliefs young adults hold about herbal supplements in relation to their dietary attitudes and behaviors. ABSTRACT TEXT: Several studies have documented the increasing prevalence of herbal supplement use among adults; however, there are very limited studies documenting young adults' prevalence of herbal supplement use and their attitudes and beliefs about using herbal supplements. A self-administered, four-part questionnaire was mailed to a geographically representative sample of 298 young adults (18 to 24 years) residing in Oregon; 205 (69%) questionnaires were usable. Respondents were equally divided between males and females and between students and nonstudents. The majority were Caucasian (93%), with a mean age of 21.5 years. Nearly 60% of the sample reported using herbal supplements. Thirty-seven percent were sometime users (less than weekly) and 22% were regular users (at least weekly). Herbal supplement users tended to have more healthful lifestyle characteristics than non-users. Regular use of herbal supplements was associated with less frequent fast food patronage; and a somewhat higher percentage of herbal supplement users tended to eat the recommended Food Guide Pyramid servings of fruit and vegetables than non-users. In general, young adults that use herbal supplements seemed to have more knowledge about herbs, and more positive attitudes toward the herbs they take, than non-users. Young adults who used herbal supplements more often believed they are useful for various health parameters, including insuring a well-balanced dict. With the increasing use of herbal supplements, and limited knowledge of their safety and efficacy, development of accurate educational materials about herbs, aimed at young adults, is warranted. Health professionals should find it helpful to identify young adults who are most likely to use herbal supplements.

A-,g0 / September 2002 Supplement Volume 102 N u m b e r 9

B. Wakou, MS; G. Gates, PhD, RD, LD, Oklahoma State University, Stillwater, OK. LEARNING OUTCOME: To identify practices and beliefs of clay and herbal consumption. ABSTRACT TEXT: In many African countries, it is common for pregnant women to consume clay but it is not clear why women engage in this practice. We conducted in-person interviews with 59 mothers delivering at a government hospital in Kampala in June 2001. Most mothers reported craving clay (53%) and consuming clay (51%) during pregnancy. Almost all mothers reported consuming a mixture of herbs and clay (90%) and most said they craved the mixture (51%). Maternal and infant health was the major reason for consuming herbal clay (76%) and craving was the major reason for clay consumption (41%). Mothers were asked to respond to belief statements about clay consumption. Most mothers agreed that clay consumption was a craving with no benefits (83%), herbal clay eased childbirth (80%), clay reduced saliva (73%), clay eased vomiting (59%), clay consumption was an irresistible urge (58%), clay caused worm infestation (56%), and clay provided a 'feeling' of well being (46%). Most mothers disagreed that only pregnant women ate clay (88%), clay was as good as food (88%), clay satisfied hunger (83%), clay eased childbirth (71%), clay provided health benefits (68%), craving clay was caused by nutrient (59%) or mineral deficiency (60 %), clay improved the taste of food (48%), and worms led women to crave clay (44%). Mothers reported pica practices that may affect maternal and infant health. Prenatal care should incorporate information about the potential harmful effects of geophagia such as impaired nutrient intake, displacement of nutrients, constipation, parasite infection, and intestinal obstruction.