Poster session: Wellness & public health; research & grants; food & nutrition; foodservice systems

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TUESDAY,OCTOBER22

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POSTERSESSION:WELLNESS& PUBLICHEALTH;RESEARCH& GRANTS;FOOD& NUTRITION;FOODSERVICESYSTEMS

T I T L E : BREASTFEEDING CONFIDENCE OF MOTHERS WHO CHOOSE TO EXCLUSIVELY BREASTFEED AND COMBINATION FEED THEIR INFANTS AUTHOR(S): RL DeGraaf, RD; JC Chezem, PhD, RD, Ball State University; CA Friesen, Phi), RD, Ball State University LEARNING OUTCOME: To describe demographic characteristics and breastfeeding confidence of women planning to exclusively breastfeed and those planning to feed a combination of breast milk and human milk substitute. ABSTRACT TEXT: Subjects were recruited from physicians' offices and public clinics in a metropolitan area (n=71). Fifteen (21%) of the subjects were planning to combination feed while 56 (79%) were planning to exclusively breastfeed. Subjects completed the Maternal Confidence Survey (G'Campo et al, 1992) and provided demographic information. A higher proportion of women planning to exclusively breastfeed were married (p=0.003), Caucasian (p=0.005), and educated beyond the high school level (p=0.04). Subjects in the exclusively breastfeeding group were significantly older (mean age = 26.7) than those in the combination feeding group (mean age = 22.8) (p=0.009). Confidence scores were significantly higher (mean score = 4.7) among women planning to exclusively breastfeed compared to women planning to combination feed (mean score = 4.3) (p=0.04). Results of this study suggest women who intend to combination feed are distinctly different from those who intend to exclusively breastfeed. Women planning to combination feed may benefit from prenatal intervention to enhance breastfeeding confidence.

TITLE: BREASTFEEDING EDUCATION: A PROFILE OF PLANNED INFANT FEEDING METHODS AMONG MOTHERS AUTHOR: B Hiebert, MPH, RD, LD, CNSD; Johns Hopkins Bayview

Medical Center, Baltimore, MD.

TITLE: BREASTFEEDING WORKS! MEETING THE NEEDS OF BREASTFED BABIES IN CHILD CARE AUTHORS: C.T. Bayed, MS, RD, S.H. Shnman, I. Shui, and R. A. Berman MPH, RD. Bureau of Family and Community Health, Massachusetts Department of Public Health. Boston, MA. LEARNING OUTCOME: To encourage and improve the ability of child care providers to implement safe practices for the handling and storage of expressed breast milk, and to create a breastfeeding-friendly environment in the child care setting. ABSTRACT TEXT: Breastfeeding is widely acknowledged to be the preferred method of infant feeding. The health benefits of breastfeeding are remarkably striking for babies who continue to breastfeed beyond early infancy. Understanding and support from a child care provider helps the nursing mother who returns to work or school to succeed. Many resources are available for parents to learn about breastfeeding, but there is a potential gap in knowledge among child care providers. As we strive to meet the breastfeeding objectives of Healthy People 2010 and the Surgeon General's Call to Action to Prevent and Decrease Overweight, offering these providers' technical assistance on breastfeeding issues is imperative. This project was designed as part of a state health agency focus on providing health information to child care providers who provide center-based and family child care. As part of the project an extensive literature review was conducted. A survey of available, culturally sensitive and low literacy information on breastfeeding in day care settings was completed. A brochure was designed and evaluated by several groups of infant caregivers and lactation specialists. Several workshop/focus group(s) were designed, implemented and evaluated. Results of the focus groups, pilot tests, and evaluation as well as the final products will be shared.

TITLE: BREASTFEEDING ATTITUDES OF WOMEN PLANNING EXCLUSIVE AND PARTIAL BREASTFEEDING AUTHORS: JC Chezem, PhD, RD, CA Friesen, PhD, RD, Ball State

University

LEARNING OUTCOME: To identify patients least likely to choose breastfeeding in an effort to provide nutrition education.

LEARNING OUTCOME: To describe differences in breastfeeding attitudes among women planning to exclusively and partially breastfeed.

ABSTRACT TEXT: The benefits of breastfeeding are well documented in scientific literature. Breastfed infants are less likely to suffer from respiratory and gastrointestinal illnesses and ear infections. Breastfeeding has also been shown to have a prophylactic effect on atopic disease throughout childhood and adolescence. In 1990, 52% of women reported breastfeeding. By the year 2000, the rate had increased to 68%. The American Dietetic Association encourages broad-based efforts to break down barriers to breast feeding initiation and duration. Women who are least likely to choose breastfeeding as the preferred infant feeding method are those with less than 12 years of education and women of African-American heritage. Ninety-four pregnant women were surveyed at their first prenatal visit to an outpatient obstetrics clinic. They were asked to provide demographic information, preferred feeding method for their infants, and their desire to receive information about breastfeeding. Of these, 28% indicated that they planned to breastfeed their infants, 51% planned to bottle feed, 14% indicated they were undecided about feeding method, and 7% planned to use both modalities. The median age of patients planning to breast feed was 30.5 years, while that of the patients planning to bottle feed was 21.5 years. Teenage mothers made up 23% of the total population, with only 18% of those planning to breastfeed their infants. Thirty-nine percent of the patients who completed the form requested further information about breastfeeding. They were sent an information sheet prepared by Best Start, a government funded breastfeeding promotion program, along with a cover letter from a registered dietitian. The dietitian made follow-up calls to the patients to determine if the information was understood and/or if further information was needed. This study suggests that an educational intervention targeting the teenaged mothers may be the most effective way to increase breastfeeding among our patient population.

ABSTRACT TEXT: Pregnant women were recruited from private obstetrical practices and public clinics in a midwestern state. Eligibility criteria included no prior breastfeeding experience and the intention to breastfeed for at least six weeks. During the third trimester, participants completed a demographic survey and a maternal breastfeeding attitude test (Freed et al., 1993). Seventy-one women, 56 who planned to exclusively breastfeed (EB) and 15 who planned to breastfeed in combination with human milk substitute-feeding (CF), completed all study requirements. A higher proportion of women in the EB group were married (p=0.003), Caucasian (p=0.005), and educated beyond the high school level (p=0.04). All subjects strongly agreed with the statement, "breastfeeding is better for the baby." Compared to women in the CF group, those in the EB group indicated a higher level of agreement with the following statements, "I think highly of women who breastfeed (p=0.02), "my spouse/partner thinks highly of women who breastfeed (p=0.04), and "my spouse/partner thinks breasts were made for breastfeeding (p=0.009). Subjects in the EB group reported a lower level of agreement than those in the CF group the following statements, "breastfeeding is not natural" (p=0.02) and "breastfeeding is bad for breasts" (p=0.03). Women planning to partially breastfeed not only view breastfeeding less favorably than their exclusive breastfeeding counterparts, but also report more negative attitudes by their spouses/partners. Ideally breastfeeding promotion and education should target both the woman and her spouse/partner. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-69

TUESDAY, OCTOBER22

POSTERSESSION:WELLNESS& PUBLICHEALTH~RESEARCH& GRANTSi FOOD& NUTRITION~FOODSERVICESYSTEMS TITLE: AUTHOR(S):

NEW BMI-FOR-AGE PERCENTILES RELATE TO BLOOD PRESSURE, DIET, AND PHYSICAL ACTIVITY IN PRESCHOOLERS S. Frank, R.D.; C. Georgioa, Ph.D., L.D., Oregon State University, Corvallis, OR; K. Ellis, M.S., L.D., Tillamook County Health Department, Tillamook, OR.

LEARNING OUTCOME: To evaluate relationships mnong weight status, food intake, physical activity behavior, and clinical measures of health status in preschoolers participating in a countywide health screen. ABSTRACT TEXT: The new Centers for Disease Control growth charts use Body Mass Index (BMI)-for-age percentiles as reference values for US children. Height, weight, and blood pressure were measured and Food Guide Pyramid (FGP) servings eaten were calculated from a 24-hour Food Record for 98% of 3-5 year olds (n=286) particip~ng in a 2001 countywide preschool health screen. A Spanish version of the Food Record was used for 17% of the preschoolers. A mailed survey to parents of purticipants (response rate 63%) followed up with data on physical activity behavior. The pre-kindergarteners in this countyhad higher rates of BMl-for-age percentiles in the "at risk for overweight" and "overweight" ranges than children their age nationwide. The most dramatic disparity was in the overweight category. The preschool population studied who were at the > 95th BMl-for-age percentile was 21.9",6 for males and 19.3% for females. This contrasts to national rates of 6.2% for males and 8.2% for females. Systolic and diastolic blood pressure increased with increasing BlVlI-for-age percentiles. Children with BMl-for-age percentiles above the healthy range ate more FGP servings of concentrated fats/sweets than children whose BMI-for-age percentiles were in the healthy range. TV-viewing time alone positively related to BMI-for-age percentiles while the combination of more hours of physical activity with less TV viewing time was inversely related to BMI-for-age percentiles. Even at preschool ages, physical activity and diet are important to assess when increasing rates of overweight levels =nd associated increases in blood pressure are being investigated. TITLE:

TITLE: EVALUATING OUTCOMES OF A MULTIDISCIPLINARY FEEDING CLINIC FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AUTHOR(S):L. Jennlngs, MS,RD, Alabama Department of Rehabilitation Services, Montgomery,AL; H.H. Cloud, MS,RD FADA, Nutrition Consultant, Birmlngham,AL; T. Woosley, MPH 0TR, Children's Therapy Service, Montgomery,AL. ~ . LEARNINGOUTCOME:To identify a method of devezoplng outcome measures showing the effectiveness of a multidisciplinary feeding clinic for children with special health care needs. A B S T R A C T TEXT:Feedlng problems present a serious challenge for the nutritional status of children with special health care needs. One Title V agency in Alabama serving this population organized multidlsclpllnary feeding clinics across the state consisting of a nurse, social worker, occupational therapist and/or speech therapist and nutritlonlst. In December 1998 a feeding team was chosen as a pilot site to develop data collection tools to evaluate outcomes. The goal was to develop measures to determine effectiveness related to growth, nutritional and health status, feeding skills and family satisfaction. The pilot collection period ran from March 1999 to December 2000. Twenty-slx children ranging in age from birth to 6 years were seen for an initial and at least one follow-up visit. Results of the pilot study indicated an increase in parental satisfaction with feeding skills and a decrease in the number and length of hospitalizations. Dietary intake yas assessed on a 24 hour intake. Improvement was noted in follow-up visits in the cor~sumptlon of vegetables, milk and fruit. An Oral Motor Rating Scale was used to evaluate bottle drinking, cup drinking, spoon feeding and chewing skills. Each area showed a trend of overall improvement. Work from this project resulted in the refinement of the data collection forms, as well as development of a training manual and computer program for data entry. Data collection began state wide in June 2001.

"NIBBLES FOR HEALTH" PROVIDES AN EASY WAY TO EDUCATE PARENTS

AUTHORS:

E. C. McLaughlin, MS, RD Food and Nutrition Service, USDA, Alexandria, VA R.L. Duyff, MS, RD, CFCS Duyff Associates, St. Louis, MO

LEARNING O U T C O M E : To discover a new source of concise educational content that reflects federal guidance on nutrition, physical activity and health promotion to parents of young children. ABSTRACT TEXT:

Nibblesfor Health is a new leader's guide developed for use by childcare center staff to support parent education. This guide contains 40 single-page newsletter reproducible masters, and two sharingsession outlines based on visual messages contained in two posters. The guide is a ready-to-use communications tool designed to build skills and help learners' master complex concepts over time. The easyto-follow information is presented in a motivational way that offers personal benefits to parents. It is intended to be provided at the teachable moment when parents recognize the need for information to appropriately care for their young child. It supports a healthy lifestyle, total diet and wellness approach with actionable messages that link health, food choices and fitness. Messages were developed to enable parents to make decisions based on understanding key concepts about choices related to physical activity, the Pyramid, Nutrition Facts Food Label and the CACFP meal requirements. Content and approach were based on principles of health behavior theories and models. Findings from the formative evaluation process influenced content and approach. The materials were cleared through a 30-agency federal review mechanism. Process evaluation on implementation process is now in the planning stage, and will be implemented in the Fall of 2002. A-70 / September 2002 Supplement Volume 102 Number 9

TITLE: UPDATING AN IMPORTANT RESOURCE: FEEDING INFANTS: A GUIDE FOR USE IN THE CHILD NUTRITION PROGRAMS AUTHOR(S): D.M. Blum-Kemelor, MS, RD, LD, Food and Nutrition Service (FNS), U.S. Department of Agriculture (USDA), Alexandria, VA. LEARNING OUTCOME: To outline the process used by the U.S. Department of Agriculture's (USDA) Food and Nutrition Service (FNS) to revise and update an important public health nutrition educational resource to assist child care administrators, sponsors, and providers in providing nutrition services to infants. ABSTRACT TEXT: In 1988, the Food and Nutrition Service (FNS), U.S. Department of Agriculture published a guide for use by staff who care for and feed infants and who participate in the FNS Child Nutrition Programs. Since that time, new developments in infant nutrition have occurred. To incorporate new information relevant to feeding infants, FNS embarked on a process to revise this publication that involved extensive review of the draft revised publication by over 50 reviewers from Federal, Regional, State, and local levels. The revision of this publication also involved a decision-making process in order to determine the most appropriate information to include for maximum usefulness and relevance to State agencies, child care sponsors, and providers. As a result of this process, the guide was updated to include new sections on supporting breastfeeding mothers, preventing tooth decay, and sanitary food preparation and safe food handling. This paper describes how a federal publication with important public health nutrition applications was successfully revised to incorporate new information and meet the expressed needs of State agencies administering USDA's Child Nutrition Programs, child care sponsors, and child care providers who provide nutrition services to infants.

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TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTHi RESEARCH& GRANTS;FOOD& NUTRITION;FOODSERVICESYSTEMS TITLE: DIETARY FAT INTAKE AND BODY FAT IN 8 TO 11 YEAR OLD AFRICAN AMERICAN GIRLS

TITLE: DIETARY QUALITY AND BEVERAGE CONSUMPTION OF MOTHERS AND TODDLERS IN LOW INCOME FAMILIES

AUTHOR(S): J.L. Hatfield, MS, RD, P. Barbeau, PhD, M.S. Litaker, PhD, C.A. Howe, MS, I. Stallmaun-Jorgensen, MS, RD, B. Gutin, Phl), Medical College of Georgia, Georgia Prevention Institute, Augusta, GA.

AUTHORS: S. Lee, MS, S.L. Hoerr, PhD, RD, Dept. Food Science & Human Nutrition, R. Schiffman, PhD, RN, The College of Nursing, H.E. Fitzgerald, PhD, Dept. Psychology and Applied Developmental Science Graduate Programs, Michigan State University, East Lansing, MI.

LEARNING OUTCOME: To explore the relationships between reported dietary fat imake and visceral adipose tissue, subcutaneous abdominal adipose tissue and total percent body fat in young African American girls. ABSTRACT TEXT: Limited and conflicting data are available on the relationship of dietary fat intake and body fat mass in children. To explore this matter, 146 African American girls, 8-11 years old, were recruited from 5 dementary schools. Visceral and suheutaneous abdominal adipose tissues were measured using magnetic resonance imaging. Total percent body fat was measured using dual-energy x-ray absorptiometry. Record-assisted dietary recalls were conducted using the Minnesota Nutrition Data System for Research to obtain two consecutive days of nutrient imake. Spearman correlation ceefficients (r) were used as a measure of association between variables. Total percent dietary fat was positively correlated (p<0.0001) with percent saturated (r=0.69), monounsaturated (r--0.88) and polyunsaturated fatty acid intake (r=0.58). Mononnsaturated fatty acid intake was positively correlated (p<0.0001) with saturated (r=0.48) and polyunsaturated fatty acids(r=0.51). However, no significant correlation was seen between saturated and polyunsaturated fatty acid intake (r=-0.006; p=0.95). Visceral adipose tissue was significantly correlated with subeumneons abdominal adipose tissue (r=0.83; p<0.0001) and total percent body fat (r=0.82; p<0.0001). A positive correlation was also seen between subcutaneous abdommal adipose tissue and total percent body fat (r=0.96; p<0.0001). There were no significant correlations between any of the types of dietary fat intake that were considered and measures of adiposity. In conclusion, the various measures of fat deposition were highly inter-correlated. However, no evidence was provided that dietary fat intake was associated with fat deposition on the body. Funded by NIH grant #HL64972.

LEARNING OUTCOME: To evaluate the dietary quality and beverage consumption in limited income mother-child pairs. ABSTRACT TEXT: In a secondary data analysis we evaluated diet quality and assessed beverage consumption in 118 low income mother-toddler pairs (average age 25.5 + 5.2 yr and 25.9 _+ 2.0 too) eligible for EHS. Half the families were randomly assigned to the Early Head Start program, which provides weekly home-visit based health services. The dietary quality and beverage consumption were compared between groups. The percentage of mothers who consumed 1 svg of vegetables was 70% (including 20% fried potatoes); fruits, 39%; and dairy, 71%. Seventy percent of toddlers had 1 svg vegetables (including 21% fried potatoes); and 75%, fruits. Only 21% of mothers ate 1 svg of food from each of the five food groups in the Food Guide Pyramid, whereas 42% of their toddlers did so. There was no significant difference between groups for consumption of each group, nor in rate of eating breakfast or drinking beverages. The mothers' intake of soda (23.6 +25.1 fl oz) was four times that of milk (6.2 + 9.1 fl oz) and six times that of fruit juice (4.0 + 13.3 fl oz). About 30% of toddlers drank >12 fl oz of fruit juice/day. There was a positive weak relationship between mothers and their toddlers for the amounts of milk, juice and soda consumed (r = 0.25, p<0.05; r = 0.36, p<0.05; and r = 0.22, p<0.05). Nutritional education for Early Head Start parents should focus on the inclusion of whole fruits and vegetables and reduction of soda by mothers and limiting fruit juice intake to 4 - 6 fl oz/day for toddlers, (Funding source: 90YF0010 from ACYF, DHHS and the Michigan Agricultural Experiment Station)

COMPARISON OF FOOD INTAKES BETWEEN CHILDREN WHO TITLE: STAY AT HOME AND CHILDREN WHO ATTEND CHILI)CARE AUTHOR(S): AM Padget, ME Briley, PhD, RD, LD, The University of Texas at Austin, Austin, Texas; C Roberts-Gray Phi), The Resource Network, Galveston, Texas; MB Giilham, PhD, RD, LD, F Peterson, Jr., PhD, R Willis, PhD, The University of Texas at Austin, Austin, Texas. LEARNING OUTCOME:

TITLE: DIETARY VITAMIN D BUT NOT CALCIUM IS ASSOCIATED WITH MEASURES OF BODY FAT 1N YOUNG AFRICAN AMERICAN GIRLS AUTHOR(S): I Stallmann-Jorgeasen, MS, RD; P Barbeau, PhD; MS Litaker, Phi); CA Howe, MS; JL Hatfield, MS, RD; B Gutin, Phi). Georgia Prevention Institute, Medical College of Georgia~ Augusta, GA.

To recognize the importance of parental involvement in food choices for preschool children. ABSTRACT TEXT:

LEARNING OUTCOME: To examine relationships between dietary calcium and vitamin D intake, and body fat measures in 8-11 year old African American girls.

Three-day dietary records were obtained for 33 children ages 3-5 who attend childeare centers and 36 children who stay at home with a parent in Central Texas. Food intake during ehildcare was measured and recorded by a researcher. Food intake at home was measured by both groups of parents after they received training. Each child was weighed on a digital scale and measured using a Harpenden stadiometer. Dietary records were analyzed for nutrient content and food frequencies using FoodWorks version 2. Body mass index (BMI) was calculated for each child and plotted on the Centers for Disease Control (CDC) 2000 BMIfor-age growth charts. Thirty-one percent of ehildeare children and eleven percent of stay-at-home children were classified as overweight (BMI>85 thpercentile). Children in ehildeare consumed an average of 1598 kcal/day compared to 1351 keal/day by the stay-at-home children (p<.01). Almost 50% of calories eaten by children in childeare were consumed at home. Children in ehildeare consumed more fat, 58.7g, than stay-at-home children, 49.0g (p<.01). Children in childcare ate more servings of vegetables (p<.003) and meat (p<.035) each day. Problem nutrients for both groups ineladed iron, vitamin E, vitamin K, and folate. Children in ¢hildcare were more likely to consume 100% of the Dietary Reference Intake (DRI) for calcium than stay-at-home children (p<.03). This study suggests the importance of parents in making food choices for their children regardless of whether their children stay at home or attend ehildcare.

ABSTRACT TEXT: Dietary calcium (CAL) has been reported to be negatively associated with body fat mass. It is not known whether dietary vitamin D (VITD) is associated with body fat mass. The relationships of CAL, VITD, and two measures of body fat were investigated in a group (n=139) of 8-11 year old African American (AA) gifts. Diet data were obtained via recordassisted 24-hour recalls covering two consecutive days of imake, using the Minnesota Nutrition Data System for Research. Total body fat (TOTFAT) was measured using dual-energy x-ray absorpfiometry. Visceral adipose tissue (VAT) was measured using magnetic resonance imaging. Spearman correlation coefficients (r) were used as measures of association between all variables. CAL was not significantly associated with TOTFAT (r = -.16, p = .06), nor with VAT (r = -. 17, p = . 15). VITD was significantly negatively correlated with VAT (r = -.33, p<.01) and TOTFAT (r = -.22, p<.01). Removing the linear effect of age on the associations, only the correlation between VITD and VAT remained significant (r = -.29, p<.05). No evidence was provided that CAL was associated with adiposity, whereas VITD was associated with VAT in this group of young AA gifts. Funded by NIH Grant # HL64972.

Journal of THE AMERICAN DIETETIC ASSOCIATION / A-71

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TUESDAY,OCTOBER22 pOSTERSESSION:WELLNESS& PUBLICHEALTH;RESEARCH& GRANTS;FOOD& NUTRITION;FOODSERVICESYSTEMS TITLE: ARE KIDS' LUNCHES ALL THEY'RE PACKED UP TO BE?

TITLE: EFFECTIVE NUTRITION EDUCATION PROGRAMS FOR

AUTHOR(S): A. Tucker, C. Jones, & C.A. Houston, PHD, RD, LD,

AUTHOR(S): A. Stephan & C. A. Houston, PHD, RD, LD, Foutbonne

Fontbonne University, St. Louis, M e . LEARNING OUTCOME: To identify the types of food items contained in lunches brought from home by fourth grade students as a measure of dietary patterns in this population. ABSTRACT TEXT: While govemmem-sponsored school lunch programs are designed to provide nutritionally balanced meals, children ctmsuming lunches brought from home (LBH) r~..¢iveno assurance of nutritional adequacy. The purpose of this study was to determine the content of LBH among fourth graders as a measure of dietary patterns in this population. Observations were made of the ccraents of LBH (n=147) by fourth grade students from two randomly selected e l ~ r y schools. Trained observers collected data during the lunch period on three separate days at both schools. The most common items observed over the 3-day period included deli-meat based sandwiches on white bread (n=86), suack chips (n=105), most oiL*n potato chips, and sweets (n=108), most o f ~ cookies followed closely by candy and juice drinks cxraaining much less than 100% fruit juice or no fruit juice at all. Fruits (n=55) were more oftan observed than vegetables (n=2). Milk (n=15) was infrequently purchased at school to accompany the LBH and about half the time chocolate milk was chosen. Foods most commonly included in LBH were high in calories, total fat, saturated fat, simple sugar and sodium. The high number of cemmercially packaged foods observed indicates t l ~ parents may be more highly motivated to include foods based on convenience, and the children may be influenced by the media and taste and may request the purchase of these items by their parents for inclusion in LBH Furthermore, LBH may provide insight into the types of food choices available to these children at home to be eaten between or with other meals as well. This pattern, if perpetuated into adulthood, could result in negative health consequences for these children in the future. Dietitians must find ways to reach parents and educate them on creative ways to include food choices that are not only healthful, but also convenient and tasty. TITLE:

CORRELATIONSBETWEEN NUTRITION KNOWLEDGE, SELF-ESTEEM, BODY IMAGE, EATING ATTITUDES, AND BODY MASS INDEX AMONG 7TM GRADERS. AUTHOR(S): CL Kendle, B.S., MC Mitchell, Ph.D., ILD., AM Saddam, Ph.D., R.D., DL Habash Ph.D., ILD. The Ohio State University LEARNING OUTCOME: Explain relationships existing between nutrition knowledge, selfesteem, body image, eating attitudes, and body mass index for this adolescent population. ABSTRACT TEXT: Nutrition education programs attempting to modify behaviors with potentially long-term health outcomes, such as obesity, diabetes, and cardiovascular disease, play a significant role in health education. Additionally, Social Cognitive Theory suggests personal factors, such as body image and self-esteem, are equally important. This study explored relationships among self-esteem, body image, Eating Attitudes Test (EAT) scores, body mass index (BMI), and nulrition knowledge during adolescence. Methods: Seventh grade students from health classes in two separate public schools (N = 142, 58 males and 84 females) participated in a five-day nulrition education unit and completed nutrition knowledge, self-esteem, body image, and eating behavior questionnaires. BMI was calculated from serf-reported height and weight d,ta Results: This study revealed highly significant relationships among both male and female subjects with regard to self-esteem and body image (r = 0.546, p<0.01 and r = 0.564, p <0.01) as well as body image and B/vII(r = -0.451, p<0.01 end r = -0.540, p<0.01). Further, among female subjects, relationships existed between selfesteem and EAT scores (r = -0.405, p <0.01), self-esteem and BMI (r = -0.290, p <0.01), and body image and EAT scores (r = -0.388, ly<0.01). Nutrition knowledge positively correlated to self-esteem for female subjects (r = 0.286, p <0.01), however for male subjects nutrition knowledge was not related to other study factors. Conclusions: Although these results indicate self-esteem, body image, EAT scores, and BMI are interrelated, adolescents do not view healthy nutrition as an avenue of self-improvement. Future nutrition education programs should focus upon both personal and behavioral factors to further promote positive long-term health outcomes in the adolescent audience. A-72 / September 2002 Supplement Volume 102 Number 9

ADOLESCENTS: TEENS ARE TALKING BUT ARE WE LISTENING? University, St. Louis, MO

LEARNING OUTCOMES: To describe effective compenmts of nutrition education programs preferred by teenagers. ABSTRACT: School and community-based nutrition education programs for teenagers have been successful at increasing knowledge and awareness of good nutrin'on, but less success has been reported in terms of adolescents adopting healthier lifestyle behaviors. Understanding temagers' hrterests, omcems, motivations, and perceived barriers toward healthier eating is necessary in order to develop effective nutrition education programs that will affect desirable behavior change in this population. Using focus groups, this study investigated the factors that influence adolescmt eating behaviors, examined the studmts' expectations of nutrition education, and asked them to describe the educational strategies to which they would most favorably respond. Thirty-four students ages 13-17 participated in 5 focus groups. Findings revealed that teenagers are interested in learning about food, nutrition, and exercise and are willing to engage in healthier lifestyle behaviors. Participants described the ideal nutrition education program as one that meets once per week for 1 1/2 hours after school throughout the school-year; is held in a safe environment that they can easily get to, and has a fun atmosphere; involves a variety of leaming activities including haads-on food preparation, group discussions, guest speakers, and field trips. Participation should not require book work (reading or writing assignments, and homework) and information should not be given in the form of lectures. The program would be fun if it allows students to be with their friends, play games, and win prizes; is held both indoors and outdoors; includes fitness activities; and if refieshmmts are provided at every meeting. Multiple fun, young, energetic, and knowledgeable instructors, who are both male and female and who respect teens should lead such a program. The ideal student-to-teacher ratio would be 6:1 and the classes should be toed. Teens are interested in learning about the science of health, how good and bad diets play a role in determining long-term health outcomes, and useful skills that will help them lead better lives.

TITLE: INFLUENCING INFANT FEEDING PRACTICES OF AFRICAN AMERICAN ADOLESCENT MOTHERS

AUTHOR(S): E.G. Ford, MS, RD, Drexel University, D.L. Spatz, PhD, RN, and J.L. Lewis, CNM, MSN, University of Pennsylvania School of Nursing. LEARNING OUTCOME: To increase awareness of unhealthy infant feeding practices of African American adolescents and identify strategies for intervention. ABSTRACT TEXT: Limited data exists on African American adolescent mothers infant feeding choices and practices. This pilot study tested nutrition education/support via clinic, hospital, telephone and home visits to the mother/infant and her family by a registered dietitian mad advanced practice perinatal nurse (RD/APPN) to increase hreastfeeding duration and appropriate infant feeding. Subjects (n=14;aged 13-17) were recruited during the third trimester. Intervention group (n=7) received intensive RD/APPN nutrition education/support. Qualitative logs and infant feeding questionnaires completed by RD/APPN during phone or home visits every two weeks determined influences for feeding decisions, and specific feeding techniques: breast feeding quantification; formula selection, mixing and storage, mad all foods added to formula or fed to the infant. RD/APPN intervened to correct feeding practices. Infant feeding questionnaires were completed by phone on the control group. Four subjects in each group initiated breastfeeding. Duration of breastfeeding for intervention group ranged flom 7-230 days and 3-187 days for control group. Infant feeding practices that may negatively affect infant health identified in this study included: improper dilution of powdered formula, adding cereal to bottles, and unsafe formula preparation/storage. RD/APPN were effective in correcting these inappropriate practices for the intervention group. Both the RD/APPN and home visits were identified as effective strategies for influencing breasffeeding duration and infant feeding practices with this population.

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TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTH;RESEARCH& GRANTSIFOOD& NUTRITION;FOODSERVICESYSTEMS TITLE: CALCIUM INTAKE, LIFESTYLE HABITS, BONE FRACTURES, AND CONCERN ABOUT BONE HEALTH IN COLLEGE FEMALES AUTHOR(S): JL McArthur, JF Pope, Phi), LDN, RD, AE Hunt, PhD, LDN, RD, and EF Molaison, Phi), LDN, RD, School of Human Ecology, Louisiana Tech University, Ruston, LA LEARNING OBJECTIVE: To identify nutrition education needs of college females as related to maximizing bone density, decreasing fractures, and preventing ostcoporosis.

ABSTRACT TEXT: A convenience sample of 235 women enrolled at one southern university completed questionnaires designed to assess average daily calcium intake through diet and supplements; lifestyle factors such as exercise habits and use of tobacco, caffeine, and alcohol; history of bone fractures; and concern about current or future bone health. Chi squared, ttests, and ANOVA were used to assess relationships among variables. The average age oftbe participants was 21_+ 3.93 years; the majority were white and most were enrolled in human ecology/family and consumer science majors. While average calcium consumption exeeeded recommended intake levels (1330 + 564 mg/day), almost one-third did not meet their RDA. Over three-quarters (76%) reported consuming less than two cups of milk daily. Only 17% reported taking calcium supplements, although 71% used calcium fortified foods such as orange juice, cereals, and breakfast bars. Interestingly, use of supplements and fortified products was higher in women who had other healthy lifestyle habits (consumed milk, exercised regularly, and participated in collegiate sports). Conversely, women who engaged in one negative lifestyle practice (eg, smoking) were more likely to engage in others (large quantities o f carbonated beverages and caffeine; low intakes of calcium; no supplements; alcohol, and less likely to exercise). Approximately one-third o f the subjects had experienced bone fractures. Carbonated beverage consumption, caffeine, and smoking were shown to be related to a higher incidence of bone fractures. Over one-third indicated that they had no concerns about current or future bone health. These findings highlight the need for education messages that specifically target college students, as the ages between 18 and 30 are key for building bone mass.

TITLE: CALCIUM SUPPLEMENT USE IN HEALTHY OLDER MEN AND WOMEN.

AUTHOR (S): R. Abourizk, MA, MS, RD, E. Shemenski, A. Monette, K. Prestwood, MD, A. Kenny, MD, J. Kerstetter, Phi), RD, University of Connecticut, Storrs, CT and University of Connecticut Health Center, Farmington, CT. LEARNING OUTCOME: To characterize calcium intake from food and supplements in healthy older men and women. ABSTRACT TEXT: More than 30 million Americans are affected by osteoporosis or osteopenia. Adequate dietary calcium is important in maintaining bone heaRh to decrease fracture risk. Few studies document the use of calcium supplements in healthy older adults and whether these supplements are correcting inadequate calcium intake from food sources. We undertook a cross-sectional study involving 217 healthy older adults (76 men and 141 women) with an average age of 73+5 years and an average Body Mass Index (BMI) of 26+_4 kg/m2. Four-d~ food records (that included information on supplement usage) were analyzed by Food Processor II (ESHA Research, Salem, OR). Surprisingly, in this well-educated group of healthy older men and women, calcium intake from food sources only averaged 800£_39l mg per day, well below the Recommended Dietary Allowance (RDA) of 1200 rag. Eighty-six percent o f the population consumed a level of dietary calcium (from food sources) below the RDA. Only 29% used calcium supplements. There was no significant difference in supplement use between adults with adequate dietary calcium intake versus adults with inadequate dietary calcium intake. Sixty-three percent of the entire group were both inadequate in dietary calcium from food and did not take calcium supplements. In summary, in our group o f healthy older adults of middle to upper social-economic status, the data show: 1) calcium intake from food sources is very low, 2) calcium supplement use is also very low, 3) calcium supplementation is not necessarily used to correct an inadequate diet. Despite public health efforts, dietary calcium deficiency is not an uncommon problem in older adults, a population at the greatest risk of fracture.

TITLE: A LONGITUDINAL ANALYSIS OF WEIGHT AND SHAPE IDEALS AS DEFINED BY MISS AMERICA PAGEANT WINNERS AUTHORS: Carol Byrd-Bredbenner, Ph.D., R.D., F.A.D.A. and Jessica Murray, Rutgers University, 88 Lipman Drive, New Brunswick, NJ 08901. LEARNING OUTCOME: Describe the temporal changes in anthropometric measurements (i.e., bust, waist, and hip circumferences, weight, height, and curvaceousness) of Miss America Pageant Winners from 1921 to 2002. ABSTRACT TEXT: Evidence indicates that negative body images are prevalent among U.S. women. The media play an important role in defining the 'body beautiful', but what is the ideal body image defined by mass media, has it varied over time, and does it vary with the primary audience to whom a medium is targeted? This study compared the temporal changes in idealized female body image targeted families over the last 80 years. Anthropometric measurements were compiled for the winner of the Miss America Pageant for each year it was held (n=1921 to 1927; 1933; 1935 to 2002) (n=75). Weight data were unavailable for 2 years (i.e., 1996 & 1997). Bust, waist, and hip data from 1987 onwards were unavailable, thus these measurements were deduced from full length photos of the winners clad in form fitting clothing (e.g., swimwear). Mean height, weight, and BMI for all winners were 66.7"+2.1"SD, 121.6+-9.2SDlbs, 19.3+_1.1SDBMI, respectively. Simple linear regression revealed a significant time-dependent decrease in weight (p=0.0093) and BMI (p<0.0001). Mean BMI in the 20s was significantly higher (p_<0.0001) than all other decades; mean BMIs in the 70s and 80s were significantly lower (p<0.04) than all decades except the 90s. Only 23% of the winners had a normal BMI (i.e., 20-25); the remainder were underweight with 26% dipping below the WHO criterion for undernourished (BMI
TITLE: CALCIUM, IRON, AND ZINC INTAKES OF ELDERLY SUPPLEMENT AND NON-SUPPLEMENT USERS IN NHANES 111.

AUTHOR(S): B. Ervin, PhD, RD, National Center for Health Statistics, Hyattsville MD; J. Kennedy-Stephenson, M.Sc, National Center for Health Statistics, Hyattsville MD. LEARNING OUTCOME: Toknowthe prevalence of inadequate mineral intakes for elderly supplement and nonsupplement users in the third National Health and Nutrition Examination Survey (NHANES III). ABSTRACT TEXT: We examined usual dietary intakes (D) and diet plus supplements (D+S) for calcium, iron and zinc in elderly supplement (S) and nonsupplement users (NS) _>60yr in NHANES III. We adjusted intakes from 24-hr. dietary recalls to calculate usual dietary intakes and added average daily mineral intake from supplements and calcium from antacids to usual dietary intakes. Median intakes and prevalences of intakes below the Healthy People 2010 calcium objective and the Estimated Average Requirements (EAR) for iron and zinc were: Calcium in rag. NS [D only] S [D only] S [D + S] males (n=2432) 690 (75%) 716 (70%) 819 (60%) females (n=2570) 523 (87%) 590 (87%) 747 (66%) Iron in mg. males (n=2447) 13.9 (2%) 14.7 (1%) 21.7 (<1%) females (n=2587) 10.0 (4%) l 1.1 (2%) 15.5 (2%) Zinc in mg. males (n=2447) 10.2 (41%) 10.7 (35%) 14.7 (20%) females (n=2587) 7.2 (45%) 7.6 (36%) 10.6 (25%) Between 70 - 87% of males and females had dietary calcium intakes below the calcium objective; 35% - 45% of males and females had zinc intakes below the EAR, a value used to assess adequacy of intakes. Few individuals had iron intakes below the EAR. Supplement use improved intakes and reduced the prevalence of individuals falling below these EARs, hut most elderly supplement users still fell below the calcium objective. Although 49% of elderly adults took supplements, only about 41% - 44% of supplement users took supplements containing iron or zinc. Only 42% of male users, but 54% of female users took supplements containing calcium. A little less than one-third (31%) of antacid users took calcium-containing antacids. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-73

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TUESDAY,OCTOBER22 POSTERSESSION:Wl:llqESS & PUBLICHEALTH~RESEARCH& GRANTS~FOOD& NUTRITION~FOODSERVICESYSTEMS TITLE: ENHANCED FOODS AS AN ALTERNATIVE TO SUPPLEMENTS

TITLE: A PROGRAM FOR IMPLEMENTING EVIDENCE-BASED PRACTICE 1N THE CLINCAL SETTING

REDUCE LABOR HOURS IN LONG-TERM CARE AUTHOR: K.L. Hanulcik, MPA, RD, LD, HCR Manor Care, Toledo, OH

AUTHOR(S): C. Biesemeier, MS,RD,FADA, Vanderbilt University Medical Center, Nashville, TN

LEARNING OUTCOME: To identify resident acceptance of an enhanced foods program in a long-term care setting, and examine the impact of such a program on labor requirements for dietary and nursing staff.

LEARNING OUTCOME: To identify methods used to enhance dietitians' knowledge of research methods and evidence-based practice and their application of acquired knowledge and skills in day-to-day practice

ABSTRACT TEXT: Malnutrition, prevalent in long-term care centers nationwide, is associated with an increased risk of infections, development of pressure ulcers, suboptimal wound healing, weakness, and impaired cognitive ability. Some evidence suggests that staffing levels and staff-to-resident ratios may be a contributing factor to a multitude of nursing home problems, including malnutrition. The purpose of this study was to evaluate the acceptance of high calorie/high protein oral nutrition support in the form of enhanced (nutrient-dense) foods, and to compare the staffing requirements of offering an enhanced foods program as an alternative to traditional oral commercial supplements in a long-term care setting. Survey research tools were designed to evaluate enhanced food plate waste, enhanced food preparation time, nourishment preparation time, and nourishment distribution time. Eighteen nursing homes in 4 states participated in completing at least one set of the 4 survey tools, with the total number of observations returned after one month ranging from 93 to 207 for each tool. Mean enhanced food consumption was 58%. The mean amount of labor, in minutes, to prepare and distribute a single nourishment (i.e., supplemen0 was 4.1 minutes, compared to 9.6 minutes to prepare a batch of enhanced foods. Based on these findings, a long-term care center could theoretically save approximately 5 hours in labor daily by providing enhanced foods with meals, as opposed to the nutritionally equivalent amount of supplements (4 servings daily) between meals, if approximately 20 residents were in need of high calorie/high protein intervention. These findings could significantly impact a provider's approach to maximizing staffefficiency and resident outcomes, while minimizing costs in an industry challenged by limited health care resources.

TITLE: OUTCOMES OF DIETITIAN INVOLVEMENT WITH LEUKEMIA PATIENTS RECEIVING TOTAL PARENTERAL NUTRITION AUTHORS: C. Mattson, MS1; C. Seaborn, PhD, RDI; D. Ziemer, MS, RD, CNSD, Fairview Southdale Hospital, Edina, MN; P. Splett, PhD, RD, FADA, Splett and Associates, St. Paul, MN; L. Milanesi, PhDl; J. Coker, PhD 1, University of Wisconsin-Stout, Menomonie, WI I.

ABSTRACT TEXT: Data from the 1999 Membership Database of the ADA indicate that only a small number of dietetics professionals (7-10%) implement research studies designed by others. This is supported by information included in the 2002 Backgrounder to the House of Delegates on the Role of Researoh in the Profession. While methods for evaluating and implementing research for use by dietetic professionals have been identified, use of the methods may be limited by many factors, including lack of awareness and understanding of the methods. In February 2000, dietitians at Vandcrbilt University Medical Center completed a baseline assessment of their attitudes about the value of research and evidence-based practice, perceived confidence in evaluating research and conducting reviews of literature, and perceived support in using and applying research in practice. Baseline data indicated that, while the dietitians valued research and evidence-based practice, many (9/15) felt unsure of their knowledge and skills in this area. During the past two years, training on evidence-based practice concepts, evaluation of research articles, implementation of evidence-based practice guides, and The American Dietetic Association's on-line practice guides has been provided. Dietitians are applying their new knowledge and skills by completing reviews of literature on clinical questions derived from their practice settings, using a valid method to grade evidence, e.g. the Institute for Clinical Systems Improvement method. Four dietitians have completed reviews and presented their results to peers and dietetic interns. Six additional reviews are in progress. Performance indicators have been revised to include completion of reviews of literature and outcomes data collection. A re-assessment of attitudes and knowledge will be conducted at the end of three years (February, 2003).

TITLE: THE EFFECTIVENESS OF DIABETES SELF-MANAGEMENT ON GLYCEMIC CONTROL

AUTHOR(S): N.A. Banister, RD,LD, M.B. Gillham, PhD,RD,LD, R.A. Loop, PhD, V. Hebert, MS,RD,LD, The University of Texas at Austin, Austin, TX; S.T. Jastrow, RD,LD, People's Community Clinic, Austin, TX. LEARNING OUTCOME: To determine the clinical outcemes and total costs of a community clinic diabetes education program.

LEARNING OUTCOME: To identify potential outcomes of dietitian involvement in total parenteral nutrition support of leukemia patients. ABSTRACT TEXT:

ABSTRACT TEXT: There is an increasing need for justification of medical nutrition therapy provided by the dietitian. The purpose of this study was to identify and relate dietitian involvement to outcomes of care for leukemia patients on total parenteral nutrition (TPN). A retrospective study was conducted of 115 medical records of adult patients (18 years and older, 61 males and 54 females) with leukemia discharged from January 1997, through December 2000, from two large mid-western hospitals. Within the time frame of the study, 130 patients were admitted, but 15 were excluded from the study due to unavailability of medical records. Pearson correlations were used to determine the association of dietitian involvement with the outcomes of length of inpatient stay, length of TPN administration, weight change, visceral protein status measured by serum albumin, percent of energy requirements met by the TPN prescription, and transitional feeding. Dietitian involvement was defined as percentage of recommended follow-up documentations achieved (meeting the protocol of documentation every four days). Dietitian involvement was negatively correlated with number of days on TPN (r = -0.211, P = 0.026), and positively correlated with percentage of energy needs met (r = 0.238, P = 0.012). No significant associations were observed for the other outcome indicators. These results suggest that dietitians can improve patient outcomes by decreasing the number of days on TPN as well as meeting essential energy requirements. This study demonstrates that dietitian intervention produced better patient outcomes as well as potential cost savings to the institutions. A - 7 4 / September 2002 Supplement Volume 102 Number 9

Stringent glycemic control, indicated by glyeosylated hemoglobin level (HbAIc), improves quality of life and reduces health care costs for persons with diabetes. This study prospectively assessed the effectiveness of an intensive diabetes self-management education program at a clinic for the working poor. Basic education and glucometcrs were provided free of charge in a four-hour class. In addition, individual appointments with a dietitian and follow-up support meetings were provided. In 2001, 70 persons with type 2 diabetes provided consent and had at least two HbAlc values for comparison. Most participants were Hispanic (55%) or African American (23%) and had been diagnosed with diabetes for more than one year (61%). Body mass index (BMI), HbAle, medications, self-care behavior and number of follow-up visits were monitored. Mean age and BMI for the subjects were 49 + 10 years and 34 + 9 kg/m2, respectively. Following the initial class, 54 participants met individually with the dietitian. After three months the mean I-IbAlc decreased significantly from 9.8 ± 2.3% to 8.3 ± 1.9%, a change of-15% (n=62, p <.001). Thirty-eight subjects, for whom data are available at 12 months, have maintained the decrement in HbAlc. Only 19% of the participants required an increased dose of medication; 47% had no change. More than half of participants (55%) maintained their weight within five pounds. The total annual cost of the program to the clinic was -$225 per person. Although the total dollar savings in future health care costs attributable to the 15% decrease in I-IbAle levels is not known, it should be vastly greater than the cost of the program.

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POSTERSESSION:WELLNESS& PUBLICHEALTH~RESEARCH& GRANTS~FOOD& NUTRITION~FOODSERVICESYSTEMS TITLE: TELEPHONE VERSUS IN-PERSON INTERVIEWS AND THE ACCURACY OF FOURTH-GRADERS' DIETARY RECALLS AUTHOR(S): SD Baxter, Phl), RD, LD, FADA; WO Thompson, PhD; MS Litaker, PhD, CH Guinn, RD, LD; FHA Frye, RD, LD; ML Baglio, RD, LD; NM Shaffer, RD, LD; Medical College of Georgia, GPI, Augusta, GA. LEARNING OUTCOME: To compare accuracy of fourth-graders' recalls of school breakfast and school lunch obtained in-person compared to by telephone. ABSTRACT TEXT: Telephone dietary recalls are often used with children; however, accuracy may be compromised due to lack of eye contact between the interviewer and child. This study tested the hypothesis that accuracy of children's recalls of school breakfast and school lunch would be greater when obtained in-person compared to by telephone. Children (n=800) were recruited from all 42 fourth-grade classes at 10 schools in one district. Of the 451 (56%) who agreed to participate, 69 children were randomly selected. Each child was observed eating school breakfast and school lunch and interviewed with a multiple pass protocol either in-person (n=33; 10 Black [B] males [M], 8 White [W] M, 8 B females [F], 7 WF) or by telephone (n=36; 8 BM, 8 WM, 11 BF, 9 WF) that evening regarding intake that day. Items observed and/or reported eaten were weighted (combination entree=2, condiment--0.33, else=l) and categorized as matches (observed and reported), omissions (observed but not reported), or intrusions (reported but not observed). Omission rates (OR) and intrusion rates (IR) were calculated with 0% considered perfect. Amounts observed and/or reported were obtained and coded in servings. Total inaccuracy (TI) captured errors in reporting both items and amounts with 0 considered perfect. Results failed to indicate significant differences in OR (p>0.47, analysis of variance [ANOVA]) or TI (p>0.86, ANOVA) for in-person versus telephone recalls. The proportion of in-person and telephone recalls with passing (<30%) and failing (>30%) IR did not differ significantly (p>0.62, chi-square). Mean OR, IR, and TI were 34%, 19%, and 4.6 servings, respectively, for in-person recalls, and 32%, 16%, and 4.3 servings for telephone recalls. Accuracy from this study was better than previous studies with fourth-graders which indicated mean OR, IR, and TI of 51%, 39%, and 7.1 servings from morning recalls regarding intake the previous day. In conclusion, interviewing children by telephone compared to in-person does not appear to negatively impact recall accuracy. Furthermore, the accuracy of children's recalls is better for evening interviews regarding intake that day compared to morning interviews regarding intake the previous day. Funded by grant HL63189 from NHLBI of NIH.

TITLE: INTER-OBSERVER RELIABILITY DURING A SCHOOLBASED NUTRITION STUDY WITH FOURTH-GRADE CHILDREN AUTHOR(S): SD Baxter, Phl), RD, LD, FADA; ML Baglio, RD, LD; FHA Frye, RD, LD; NM Shaffer, RD, LD; CH Guinn, RD, LD; WO Thompson, Phi); Medical College of Georgia, Georgia Prevention Institute, Augusta, GA. LEARNING OUTCOME: To explain assessment of inter-observer reliability (IOR) for amounts consumed by fourth-grade children during school meals. ABSTRACT TEXT: Assessment oflOR is necessary when more than one data collector conducts observations for studies to determine that information is similar regardless of which data collector(s) conducted the observations. This abstract describes IOR assessed for a nutrition study regarding accuracy of the school breakfast and school lunch portions of dietary recalls obtained in the evening by telephone or in-person from 69 fourth-graders (34 males; 37 Blacks, 32 Whites) at 10 schools. Randomly selected children were observed consuming school breakfast and school lunch on the same day by 1 of 3 trained research dietitians (RD) who followed a written protocol. Each RD used a recording form while observing 1 to 3 children simultaneously. An RD stood by tables where groups or classes of children sat and appeared to be watching the entire group or class. Amounts eaten were recorded and coded in servings as none=0, taste=0.10, little bit=0.25, half--0.50, most=0.75, all=l.0, and >1 serving=actual number. To acquaint children with an observer's presence and, therefore, lessen reactivity during data collection, practice observations were conducted with each class prior to data collection. IOR was assessed between pairs of RDs weekly throughout data collection to ensure that all observations were conducted according to protocol. For each individual day of IOR, 2 RDs observed the same 1 or 2 children eating school breakfast and school lunch on the same day. After each day of IOR, each RD (whether in the pair or not) completed an IOR checklist to identify discrepancies; checklists were reviewed by the Principal Investigator and each RD. During the 6-week data collection period, each RD participated in IOR on 3 to 5 days, and IOR was conducted for 6 days at 6 schools on 10 children total (3 males; 5 Blacks, 4 Whites, 1 Mixed) which equals 14% of the 69 children in the nutrition study. Children observed for IOR were not interviewed that evening for the nutrition study. Results indicated 93% mean agreement (minimum=80%, maximum=100%, median= 92%) across pairs of RDs for food items in which amounts observed eaten were within 1/4 serving. This percent agreement is considered satisfactorily high according to the literature. Funded by grant HL63189 from NHLBI of NIH.

TITLE: QUALITY CONTROL METHOD FOR INTERVIEWS IN A STUDY REGARDING ACCURACY OF FOURTH-GRADERS' DIETARY RECALLS AUTHOR(S): SD Baxter, Phl), RD, LD, FADA; NM ShatTer, RD, LD; WO Thompson, PhD; CH Guiun, RD, LD; FHA Frye, RD, LD; ML Baglio, RD, LD; Medical College of Georgia, Georgia Prevention Institute, Augusta, GA. LEARNING OUTCOME: To report a quality control method regarding the extent to which interviewers followed protocol when obtaining dietary recalls. ABSTRACT TEXT: Establishing quality control (QC) is important when more than one interviewer obtains dietary recalls for studies. Typically, QC is established by asking 10% of subjects to provide duplicate, back-to-back recalls to two different interviewers and then comparing nutrient profiles of the two recalls. This abstract provides an overview of, and results from, a QC method used in a study regarding the accuracy of 69 fourth-grade children's dietary recalls. One of two research dietitians (RD) interviewed children on Monday through Thursday evenings regarding that day's intake. A multiple pass protocol was used to obtain the recalls. To ensure that the interview protocol was followed, the audio-recording ancI typed transcript from one recall obtained each evening during the previous week was randomly selected and reviewed by another RD who completed a QC checklist. The QC checklist had 56 items with response options of "adequate", "needs improvement", and "not applicable". Each completed QC checklist was reviewed by the Principal Investigator and the RD who obtained the recall. A total of 22 QC checklists were completed on 13 of 41 interviews (32%) by one RD (RD1) and 9 of 28 interviews (32%) by another RD (RD2). Across all 22 QC cheeklists, 96% of items (933 of 969) that were not rated "not applicable" were rated "adequate". Of the 36 items rated "needs improvement", 18 items were on the 13 QC checklists for interviews conducted by RD1 and 18 were on the 9 QC checklists for interviews conducted by RD2. Two or fewer items were rated "needs improvement" on 11 of 13 QC checklists for interviews conducted by RD1 and on 6 of 9 QC checklists for interviews conducted by RD2. These results indicated that RD1 and RD2 adequately followed the interview protocol. This QC method avoids placing extra burden on subjects asked to complete duplicate, back-to-back recalls; it also avoids problems created when subjects report different items or amounts to different interviewers during duplicate, back-to-back recalls. Furthermore, it encourages interviewers to follow the protocol because they know that one interview conducted each evening will be randomly selected and checked for QC purposes. Funded by grant HL63189 from NHLBI of NIH.

TITLE: VALIDATION OF PHYSICAL ACTVITY RECORDING BY ADOLESCENT GIRLS AUTHOR(S): A. Camesano and S.S. Sullivan DSc, RD, Department of Food Science and Human Nutrition, University of Maine, Orono, Maine

LEARNING OUTCOME: To determine how well adolescent girls categorize physical activity. ABSTRACT TEXT: Physical activity is recorded in bone mineralization studies because physical activity increases bone mass and decreases the risk of osteoporosis. The purpose of this research was to validate a method of physical activity recording used in a longitudinal bone study of adolescent girls. The physical activity recording method was a combination of a diary and an interviewadministered recall. The method was validated against an objective measure of physical activity. Twenty-four adolescent girls between the ages of 9.8 and 14.1 wore Stayhealthy RT3 Research Trackers (tri-axial accelerometers) and recorded their activity for 24 hours on a diary form. The activity records were reviewed during a telephone interview the following day. The girls were asked to classify each period of activity into one of three categories: sitting (<1 MET), low intensity (1-3 METs) and high intensity (>3 METs). Motion detected by the aceelerometers was converted to METs and the average recorded METs were determined for each period of reported activity. The means of the recorded METs for the time periods when the subjects reported sitting, low intensity, and high intensity activities all fell within the predetermined ranges. When 99% confidence intervals were constructed, the confidence interval for the recorded high intensity METs did not fall within the pre-determined range of>3 METs. It is unclear whether these subjects over-reported their time in high intensity activity or whether the aceelerometers under-estimated energy expenditure. On average, adolescent girls were able to accurately classify their activities into one of the three intensity categories. This method of categorizing all daily activities by intensity is useful for comparing overall activity levels at different times of the year and between subjects. It is also potentially useful in documenting results of interventions to increase physical activity for weight control.

Journal of THE AMERICAN DIETETIC ASSOCIATION / A-75

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TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTH~RESEARCH& GRANTS~FOOD& NUTRITION~FOODSERVICESYSTEMS T I T L E : V A L I D A T I O N OF A N U T R I T I O N TEST F O R A S S E S S M E N T OF C U R R I C U L U M A D E Q U A C Y A N D PERFORMANCE BY MEDICAL STUDENTS AUTHORS:

T. Carithers, RD, M H S , LD. and T. Moore, PhD. The University o f Mississippi Medical Center, Jackson, MS.

TITLE:

DEVELOPMENT OF USDA'S FLAVONOID COMPOSITION DATABASE FOR FOODS S. Bhagwat, MS, D.B. Haytowitz, MS, S.E. Gebhardt, MS, AUTHOR(S):J.M. Holden, MS, G.R. Beecher, Phl), USDA-ARS-BeltsvilleHuman Research Center; J. Peters•n, MS, J. Dwyer, D.Sc, RD, Tufts University, Boston, MA; A.L. Eldridge, PhD, RD, General Mills, Minneapolis, MN. LEARNING OUTCOME:

LEARNING OUTCOME: To develop an understanding o f the critical design and interpretation criteria involved in validation o f nutrition testing instruments. ABSTRACT TEXT: Documentation of the health benefits and cost effectiveness o f nutrition interventions has led to a more receptive environment for teaching nutrition in medical schools. An evaluation o f a medical school's curriculum was conducted by surveying the faculty, querying the Association of American Medical College's curriculum management database for nutrition exposures and reviewing national literature to assess whether the medical school's curriculum was addressing national standards in nutrition science and whether the medical students' knowledge of nutrition was at an acceptable level. A criterionreferenced testing instrument was developed using a multiple-choice format with four distracters. National standards for question construction were utilized for item development. The acceptability of each item was analyzed using proportion correct, discrimination index, and item total test correlation criteria. The instrument was validated using two pilots and a faculty rating system for expected scores. The test was administered to medical students in their second, third or fourth year. Results indicate that students scored below the expected level o f performance. The areas o f weakness include principles of normal nutrition, life cycle nutrition, and selected areas o f therapeutic nutrition. Higher scores were noted on the micro/macro nutrients and questions on special nutrition topics.

To learn about the development of nutrient databases on the flavonoid content of foods. ABSTRACT TEXT: Recent interest in flavonoids and their possible role as contributors in the prevention of a number of diseases such as cancer and hypertension has led to the development of a database on the flay•hold content of selected foods. The objective of this project was to collect, evalute and compile a table of published flavonoid values for foods to identify gaps in data and analytical methods and to set priorities for new research. A search of the scientific literature identified 125 articles which contained quantitative data generated by valid and accurate methods. The data from these articles were evaluated according to USDA's data quality evaluation system and a quality score was assigned to each value and food. These values were aggregated by food and component to generate a database with approximately 240 foods. Selected compounds from five subclasses of flavonoids included in the database are: flavonols (quercetin, myricetin, kaempferol, isorhamnetin); flavones (apigenin, luteolin); flavanones (eriodictyol, hesperetin, naringenin); flavans (cat•chin, epicatechin, epicatechin gallate, epigallocatechin, epigallocatechin gallate, gallocatechin, theafiavin, thearubigins); and anthocyanidins (cyanidin, delpbinidin, malvidin, pelargonidin, peonidin, petunidin). The distribution of flavonoids varies from plant to plant. Not every flavonoid subclass is present in every plant food. Foods with significant amounts of specific flavonoids are citrus, red wine, berries, onions and teas. This new database on the flavonoid content of foods will enable researchers to assess dietary intakes of flay•holds and to identify relationships between flavonoid intakes and various risk factors. The database will be available on the Nutrient Data Laboratory Web site: http://www.nal.usda.gov/fnic/foodcomp.

TITLE: USDA'S NATIONALFOOD AND NUTRIENTANALYSIS

PROGRAM: STATUS REPORT AUTHOR(S): L.A. Amy, MS, RD; D.B. Haytowitz, MS;

P.R. Pehrsson, PhD; D. Trainer, MS; J. Exler, PhD; J.M. Holden, MS USDA Nutrient Data Laboratory, Beltsville, MD. LEARNING OUTCOME: To increase awareness of the USDA's National Food and Nutrient Analysis Program (NFNAP) among researchers, nutrition professionals and health care providers. ABSTRACT TEXT:

The National Food and Nutrient Analysis Program is designed to develop accurate estimates of the mean nutrient content of important foods in the food supply and significantly update and expand the quality of the food composition data in the USDA National Nutrient Databank (NNDB). Objectives ofthis study are to: (1)identify foods and nutrients for analysis using the Key Foods approach; (2) evaluate quality of existing data; (3) develop a nationally based sampling plan; (4) analyze sampled foods under USDA supervised laboratory contracts; and (5) incorporate new data into USDA databases on NDL's website: www.nal.usda.gov/fnic./foodcomp. The sampling plan was based on a detailed stratified random sampling design. Food pickups were completed at 12 to 24 retail outlets. Food brands and varieties picked up were based on market shares (amount consumed). Procurement and analysis of the sample units were completed using valid analytical methods and sophisticated quality control monitoring. To date, approximately 400 foods have been analyzed for over 80 nutrients. In addition to updating the USDA Nutrient Database for Standard Reference, the results of this study are being used to construct special interest databases including phytonutrients, flavonoids, vitamin K, choline, and fluoride. The NFNAP program is also facilitating the formation of ancillary databases that include ethnic foods, such as Native American foods. A-76 / September 2002 Supplement Volume 102 Number 9

TITLE: NUTRITIVE VALUE OF FOODS: A REVISED USDA CONSUMER PUBLICATION AUTHOR(S): R.G. Thomas, MS, RD; S.E. Gebhardt, MS, Nutrient Data Laboratory, USDA, Beltsville, MD LEARNING OUTCOME: To increase awareness of uses and benefits of a consumer publication on food composition ABSTRACT TEXT: USDA Home and Garden Bulletin 72, Nutritive Value of Foods (HG72), has been an important and popular source of food composition data for consumers since its first edition in 1960. The current revision includes many enhancements to the primary table, Nutritive Value of the Edible Part of Food. About 300 foods have been added, for a total of over 1200 items, New foods include more popular foods such as low-fat, fat-free, brand-name and fast-food items. Household measures focus on realistic, individual portions, though some measures were selected for ease of calculation. Dietary fiber values were added to the table, replacing phosphorus values. The nutrient data were derived from the USDA Nutrient Database for Standard Reference, Release 13. New tables added to HG72 include Tips for Estimating Amounts of Food; Daily Values; and Caffeine Values. Other tables were revised: Recommended Daily Dietary Intakes was updated to incorporate some of the newly revised Dietary Reference Intakes; Food Sources of Additional Nutrients was expanded to include vitamin K and phosphorus; Amount of Fat That Provides 30 Percent of Calories was modified to include the amount of saturated fat that provides 10 Percent of calories for diets at various total calorie levels. HG72 is a handy educational tool for dietitians and paraprofessionals. In addition, the primary table along with eight additional tables will assist consumers with their food selection and diet evaluation.

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TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTH~RESEARCH& GRANTS~FOOD& NUTRITION~FOODSERVICESYSTEMS TITLE: CALCIUM HOMEOSTASIS IN VEGAN PROTEIN DIETS

FOOD SOURCES AND INTAKES OF CAFFEINE IN THE DIETS OF AMERICANS

COMPARED TO OMNIVORE DIETS

TITLE:

AUTHOR (S): R.H. Raphael RD, J.E. Kerstetter PhD, RD, C.M. Svastisalee

AUTHOR(S):

MS, RD, University of Connecticut, Storrs, CT, K.O. O'Brien PhD, The Johns Hopkins Bioomberg School of Public Health, Baltimore, MD, D.E. Wall RN, M.E. Mitniek Phl), D.M.Caseria MS, RD, K.L Insogna MD, Yale University School of Medicine, New Haven, CT. LEARNING OUTCOME: To compare how 2 different sources of dietary protein (vegan versus omnivorous) impact calcium (Ca) homeostasis.

C.D. Frary, MS, RD; R.K. Johnson, PhD, RD Department of Nutrition and Food Sciences University o f Vermont, Burlington, VT

LEARNING OUTCOME: To identify intakes and food sources of caffeine in the U.S. diet. ABSTRACT TEXT:

ABSTRACT TEXT: In adults, 4 days of a low-protein omnivore diet decreases intestinal Ca absorption (as measured by dual stable Ca isotopes). The low-protein diet induces a compensatory secondary hyperparathyroidisr~ (2o HPT) (defined as an appropriate rise in circulating levels of parathyroid hormone, PTH). The impact of vegan proteins on Ca homeostasis is unknown. The purpose of this study was to directly compare vegan sources o f protein (primarily soy) with omnivorous protein on Ca homeostasis. Sixteen healthy women (8 premenopansal and 8 postmenopausal) participated in the study. The protocol consisted o f 2 weeks of a wellbalanced diet containing moderate Ca, Na, and protein followed by 4 days of an experimental diet. All subjects received all 4 experimental diets (highprotein vegan, low-protein vegan, high-protein omnivore, low-protein omnivore) randomly. The high-protein diets contained 2.1 g protein/kg and the low-protein contained 0.7 g protein/kg. In the low and high protein vegan diets, soy supplied 50% and 67% of the total daily protein, respectively. The vegan diets were very low in isoflavones and naturally contained more phytate than the omnivore. As expected, 20 HPT developed within 4 days o f the low-protein omnivore diet in all women (p<0.0001). The 20 HPT was more pronounced during the low-protein vegan compared tc the low-protein omnivore diet (serum PTH: 57+1 versus 46-a:1 nleq/ml, p< 0.0001)(normal range is <25 nieq/ml). These data clearly demonstrate that vegan proteins are changing Ca homeostasis differently than protein from omnivorous sources. The increased phytate in the soy foods may be contributing to the reduced Ca bioavailability ofvegan diets.

TITLE: BIOTECHNOLOGY WORKSHOP FOR FOOD AND NUTRITION PROFESSIONALS AUTHOR(S): N.M. Lewis, PhD, RD, FADA, J.A. Albrecht, PhD, RD, J.L. Flak, RD, S.B. Scheerger, BS, D.M. Namuth, Pb_D,S.M. Fritz, Phlg, S.M. Ward, PhD, University of Nebraska, Lincoln, NE and Colorado State University, Fort Collins, CO LEARNING OUTCOME: The participant will be able to describe the content of and results of an evaluation of a biotechnology workshop designed for food and nutrition professionals. ABSTRACT TEXT: In its strategic plan, the American Dietetic Association has identified biotechnology as a priority area for members. The purpose of this project was to design, conduct, and evaluate a two-day workshop for food and nutrition professionals. Workshop topics included benefits and potential risks of biotechnology, changes in the nutrient composition of foods produced using biotechnology, assessment of the potential allergenicity of bioengineered proteins in foods, extraction of the genetic material from a plant food, gene expression, and detection of a transgene. The workshop included didactic and laboratory experiences and small-group discussions. Attendees completed preand post-workshop questionnaires. The 15 attendees identified their areas of primary responsibility as dietitian (n=3, 20%), family and consumer science teacher (n=3, 20%), extension educator (n=7, 47%), and university food service (n=2, 13%). The majority of attendees, 11 (73%), had a graduate degree (MS or PhD) and 12 (80%) had been employed in the field of dietetics for more than 10 years. Before the workshop two attendees (13%) indicated they were aware of how biotechnology would affect their food, health and the environment. After the workshop, this increased to 14 (93%). Attendees were asked to rate their abilities in relation to biotechnology before and after the workshop using a score between 1 (high ability) and 4 (low ability). The largest change was in the ability to identify fundamental differences between genetically engineered crops and traditional crops (3.71 before, 2.07 after). Attendees also improved in their ability to respond to consumer concerns about the potential allergenicity of bioengineered proteins in food after the workshop (3.71 before, 2.13 after). Workshops such as this, provide bioteehnology information food and nutrition professionals need to respond to consumers questions.

Associations between caffeine consumption and adverse effects on the central nervous system, cardiovascular system, pregnancy outcomes, and bone mineral health have been found. Conversely, caffeine consumption has been shown to increase alertness and memory. Caffeine has also gained recognition as an ergogenic aid. The 1994-96 and 1998 USDA Continuing Survey of Food Intakes by Individuals (CSFII) provided the data to identify food sources and intakes of caffeine for people who provided two full days of dietary intake data (n=l 8,081). Mean intakes of caffeine by eight food and beverage categories and the percent contribution to total caffeine intake were examined. Mean intakes of caffeine (nag and mg/kg), were identified for the total sample (n=l 8,081) and for caffeine consumers (n=l 5,716) by age and gender groups. For the total sample, coffee and regular soft drinks contributed the largest amounts of caffeine (39% and 25 % respectively). Coffee was the major source of caffeine in the diets o f adults, while regular soft drinks were the major source for children aged 2-17. Mean caffeine intake was 176 mg and 1.14 mg/kg per day for the total sample. Males 35-54 years had the highest caffeine intakes (319 mg/day). Currently, there are no standard recommendations for caffeine intake. Furthermore, caffeine is not quantified on nutrition food labels. Knowledge of the major dietary sources and intakes of caffeine among all age and gender groups is valuable information for dietetic professionals. This study was funded by the Vermont Dairy Promotion Council and the New England Dairy Promotion

Board.

TITLE: OBJECTIVE AND SENSORY CHARACTERISTICS OF CARROT CHIP PRODUCTS WITH VARYING INITIAL MOISTURE CONCENTRATIONS AUTHOR.(S)S): Judy A. Driskell, Ph.D., R.D., and David W. Giraud, M.S., University of Nebraska, Lincoln, NE, and Ahmad Sulaeman, Ph.D., Institut Pertanian Bogor, Bogor, Indonesia LEARNING OUTCOME: To increase awareness of the influence that initial moisture concentration has on the objective and sensory characteristics of carotenoid-rich carrot chip products. ABSTRACT TEXT: A deep-fried carrot chip product previously developed in our laboratory can be used as a source ofcarotenoids, including those which are vitamin A precursors. The objectives of this research were to develop reduced-fat deep-fried carrot chips by altering their initial moisture content, and then to evaluate the objective and sensory characteristics of the products. Carrot slices, 2.5 mm thick, were steam-blanched, soaked in 0.2% sodium metabisulfite, drained, and partially dried until the moisture levels reached 93, 86, 70, and 45%. The slices were deep-fried in partially hydrogenated soybean oil, blotted, dehydrated, and packaged. Decreasing the moisture content and water activity of carrot slices had an significant effect (P<.05) on the yield; L, a, and Hue ° color values; crude fat; and fat-reduction. The product initially containing 45% moisture had significantly higher Hue° and fat-reduction values, and tended to have higher redness and lower yield values than carrot chips of other treatments. The yellowness, water activity, and moisture values of the carrot chips in all treatments were similar. Sensory evaluation of the products by a 16-member trained panel indicated that the product initially containing 45% moisture was significantly more (P<.05) crispy and had significantly higher (P<.05) overall acceptability than that of other products except the 70% moisture product. No significant differences by treatment were observed in panel's evaluation of the product's color, oiliness, odor, and sweetness. Lowering the moisture content, particularly to 45%, of the carrot slices resulted in a deep-fried carrot chip product that was lower in fat yet had higher Hue° values and a trained sensory panel judged it as being more crispy and of greater higher overall acceptability than the products with higher initial moisture concentrations. This reduced fat carrot chip product could be marketed as a carotenoid-rich snack product. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-77

TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTH;RESEARCH& GRANTS;FOOD& NUTRITION~FOODSERVICESYSTEMS TITLE: REPLACEMENT OF CORN OIL WITH COTTONSEED OIL IN BAKED FOOD PRODUCTS: EFFECT ON ACCEPTABILITY AND VITAMIN E CONTENT AUTltOR(S): L. Hernandex, MS, RD, M. Hernandez-Waida, MS, RD, A. Salgado, BS, J. Radcliffe, Pb.D, RD, FADA, FACN; Department of Nutrition and Food Sciences, Texas Woman's University, Houston, Texas LEARNING OUTCOME: To be aware o f the feasibility of using cottonseed oil in recipes for baked goods as a potential way to increase vitamin E intake. ABSTRACTS TEXT: Cottonseed oil (CSO), a polyunsaturated vegetable oil, is an excellent source of vitamin E, having higher levelsof thisvitamin than many other vegetable

oils(corn,soybean, olive,for example)..The new RDA for vitamin E for adults of 15 mg of ct-tocophcrol(ovT) per day is considerablyhigher than the previous RDA, which was 8 and I0 ct-tocopherolequivalents(equal to 6.4 and 8.6 nag of ct-T)per day for women and men, respectively. Because median intakesof a-T for adults(6 and 8 nag a-T per day for women and men, respectively) are well below the new RDA, there is a need to inerease intakes of a-T. This can be achieved by, for example, using oils like CSO to replace other oils, such as corn oil (CO) in recipes for baked products, as long as overall acceptability o f the products in not reduced. Accordingly, the effect of replacing CO with CSO on appearance, taste, texture, and overall acceptability was evaluated on four food products (carrot muffins, bread, cornbread, end pancakes) using 9-point hedonic scales (lffidislike extremely, 9=like extremely); 59 subjects (38 female, 21 male) participated in the study. Only one significant (p<0.05) between group difference was noted (a higher value for appearance pancakes made with CSO). On average, values for a-T content were 67% higher for pr~uets made with CSO than ones made with CO. Thus, replacement o f CO with CSO in baked products did not adversely affect overall acceptability, but did increase the products' vitamin E content.

TO LABEL OR NOT TO LABEL: THE PERSPECTIVES OF COLLEGE STUDENTS TOWARDS GENETICALLY ENGINEERED FOODS. AUTHOR(S): TITLE:

J.H. Schmidt, RD, LD, Graduate Student,University of IMlawar¢ C.M. Hamilton, PhD, RD, University of Delaware LEARNING OUTCOME: To examine college students' attitudes toward labeling of Genetically engineered foods. ABSTRACT TEXT: Utilizing WChCT, a course management system, students in an introduetery level nutrition class at a large Mid-Atlantic University were surveyed to determine their attitudes toward the labeling of genetically engineered foods. Thirty-nine students (43%) participated in the online survey. While 48.7% reported to be "not very familiar" with genetically engineered foods, the same percentage felt it was important for food products to be labeled if they contained genetically engineered food components. Use of language produced an interesting difference in perspective. When asked ifa loaf of bread labeled "contains genetically engineered wheat" was safer, just as safe, or not as safe, as compared to a loaf of bread without such a label, 51.2% of students reported it was just as safe. With the addition of"reducos pesticide use" to the same statement, the response rate increased to 64% of students feeling the product would be just as safe or safer. However, when the statement was reworded to "contains wheat developed with biotechnology", the acceptance rate dropped to 38.5% of students reporting the produot to be just as safe. As consumers, students were not willing to pay for price increases for additional labeling, with 87.2% reporting they were willing to pay less than $50.00 annually towards the total cost of their food budget for the additional information on the labels. These results show that while a certain segment of consumers consider the labeling of genetically engineered foods to be important, it is not valued enough by these consumers to justify an increase in the annual food budget. Because the issue of labeling of genetically engineered foods remains a contentious issue both domestically and internationally, policy makers need to consider the impact labeling would have both on industry and on consumers.

GLYCEMIC INDEX OF POPULAR NUTRITION AND ENERGY BARS

TITLE: EFFECT OF DIETARY FISH OIL SUPPLEMENT ON PERIODONTAL INFLAMMATION AND THERAPY

TITLE:

AUTHOR(S): J.L. Byme, MS, RD, The College of Saint Benedict, Saint Joseph, MN; K.F. Schrubbe, RDH, BS, M.ED, Marquette University School of Dentistry, Milwaukee, WI

AUTHOR(S):

LEARNING OUTCOME: To evaluate the role of fish oil supplements as and adjunetive therapy in the management of periodontal disease. R , q T ,R A ~huuouL~l~i~Txn;al infection characterized by gingival inflammation, destruction of periodontal tissue, loss of alveolar bone, and loss of teeth in severe cases. Etiologic factors include pathogenic bacteria and the immunologic host-mediated response to infection. Recent studies have suggested a link between hypertriglyeeridemla, impaired immune cell function, and tissue repair capacity in periedontitis. OmEga-3 fatty acids are known to lower serum triglycorides, and modulate inflammatory response in certain tissues, The objective of this pilot study was to determine if omega-3 fatty acids provided as a dietary fish oil supplement have potential benefits to periodontal health in addition to conventional non-surgical peridontal therapy (scaling and root planing). Fourteen adult patients with moderate to early advaneed periodontitis were randomly assigned to receive 3 grams of fish oil frO) or 3 grants of a soy lecithin placebo (SL) for 8 weeks. Patients were seen for 3 visits: baseline, 2 weeks and 8 weeks. A serum lipid panel was drawn at each visit and periodontal clinical mensurcments were obtained, which included probing depth (PD), bleeding on probing (BOP) and calculation of clinical attachment level (CAL). Patients receiving FO had an average reduction in serum triglycerides of 79.7 mg/dl vs an average rise of 6.9 mg/dl in the SL group. Patients receiving FO had greater reduetion in PD (1.314 mm+ 0.327 vs 0.929 mm +_0.216) and greater gain in CAL (0.986 nnn + 0.308 vs 0.529 ra~ _+ 0.264). BOP improved by 14.4% in the FO group vs 22.15% in the SL group. Due to small sample size, these results were not statistically significant. However, patients receiving FO for 8 weeks showed greater improvement in response to non-surgical therapy, especially with regard to reduction in serum triglycerides and CAL, suggesting improvement in tissue repair response.

A - 7 8 / September 2002 Supplement Volume 102 Number 9

T.M.S. Wolever, PhD, MD, and R. Radmard, MSc, Glycaemic Index Testing, Inc., Toronto, ON, Canada; M. Martini, Phl), RD, Kraft Foods, Glenview, IL.

LEARNING OUTCOME: To increase understanding that nutrition and energy bars have different glycemic index values not necessarily predicted by the information on the nutrition label. ABSTRACT TEXT: The glycemic index (GI) is a classification of the blood glucose raising potential of the available carbohydrate in foods. When used to supplement information on the nutrient composition of foods, GI may be useful in diet planning and food selection for some individuals. The GI of many popular nutrition bars is not known. Thus, we measured blood glucose in 10 overnight fasted normal subjects before, and 15, 30, 45, 60, 90 and 120 minutes after consuming 8 bars: Balance Yogurt Honey Peanut (BYHP), Balance Outdoor Crunchy Peanut (BOCP), Balance Gold (BG), Balance Oasis Strawberry Cheesecake (BOS), Met RX Fudge (MRX), Body Smarts Chocolate Peanut (BS), Power Bar Chocolate (PBC) and Clif Crunchy Peanut Butter (CCPB). Each subject also tested white bread (WB) on 3 occasions. All test meals contained 50g available carbohydrate, but, due to differences in protein and fat, varied in energy content from 245 to 500 Kcal. GI was calculated by expressing the incremental area under the glucose curve (AUC) as a percentage of the mean AUC aRer WB times 0.71 (to adjust so that the GI of glucose=100). Mean*SEM GI values were as follows (means with the same letter in the superscript do not differ significantlT): WB=71 a; CCPB = 68:~7ab; BS=64+6 abe; BOS=61±6 abe; PBC=59a:6~; MRX=55a:6c; BOCP=34±3a; BG=28+5d; BYHP=25±3 d. The 3 test bars which contained 40% energy as carbohydrate (BOCP, BG, BYHP) had significantly lower GI values than all other bars. However, variation in protein and fat in the other bars was unrelated to their GI values. The results suggest that nutrition bars with 40% energy as carbohydrate have low GI values possibly due to the protein and fat they contain. However, high carbohydrate nutrition and energy bars have GI values that are not readily predicted by the information on the nutrition label.

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PHYS1CAb AND SENSORY ATTRIBUTES OF A PASTATYPE PRODUCT FORTIFIED WITH CALCIUM

AUTHOR(S): DA Hardy, MJ Hinds, PhD; Oklahoma State University, Stillwater OK LEARNING OUTCOME: To compare physical and sensory characteristics o f a pasta-type product fortified with tri-calcium citrate, tri-calcium phosphate, or calcium carbonate. ABSTRACT TEXT: Adequate calcium intake is associated with the prevention of osteoporosis, and risk reduction for hypertension and some types o f cancer. Calcium-fortified foods provide an option for meeting calcium needs, however, calcium salts vary in bioavailability and solubility. Traditionally calcium is used to enhance the texture of processed foods. The objective of this study was to evaluate the effects of three calcium salts in a pasta-type product. The pasta, made with 41% defatted peanut flour (containing 1mg/g Ca) and fortified with tri-calcium citrate (TCC), tri-calcium phosphate (TCP) or calcium carbonate (CC) to achieve average calcium concentrations of 23 (control), 200, 400 and 600 mg/56 g serving of pasta, was prepared, immediately frozen (-15 C), and held for one week prior to evaluation. Physical and sensory properties of the pasta were determined. Color (Minolta chroma-meter) and hardness (TA.XT2i Texture Analyzer fitted with a TA42 knifeblade) were evaluated. Twenty-four untrained panelists assessed color, aroma, taste, texture and aftertaste using a 9-point Hedonic scale. No significant differences in objective color and hardness were identified between fortified pasta and the control. In addition, no significant differences were seen between the sensory acceptability ratings of the fortified pasta and the control, and all their sensory attributes were acceptable. Results indicate that tri-calcium citrate, tri-ca]cium phosphate, and calcium carbonate could all be used to increase calcium content in a pasta-type product made with defatted peanut flour. Selection of calcium would be based on bioavailability of the specific salt in the product.

TITLE: IMPLEMENTATION OF AN A D V A N C E D MEAL DELIVERY SYSTEM IN A LONG TERM CARE SETTING

TITLE: RESIDENTS' EVALUATION OF FOODSERVICE AT A CONTINUING CARE RETIREMENT COMMUNITY AUTHORS: K. Lee, MS & C.W. Shanklin, PhD, RD, Kansas State University, Manhattan, KS. LEARNING OUTCOME: To identify strategies to improve residents' perceived quality and satisfaction related to the foodservice in a continuing care retirement community (CCRC) ABSTRACT TEXT: The purpose of the study was to assess CCRC residents' perceptions of quality, satisfaction, value, and behavioral intentions related to foodservice. A questionnaire was developed based on the review of literature, an expert panel review, and focus groups with CCRC residents. The questionnaire was administered to 159 independent living residents at a CCRC. Data were analyzed for 83 usable responses (52.2%). Descriptive statistics were calculated and t-test, correlation analysis, and regression analysis were conducted. The thirty-one performance statements were grouped into 6 dimensions: Tangibles, reliability, responsiveness, assurance, empathy, and food. The performance of tangibles was rated the highest, followed by assurance. The lowest performance ratings were found in the reliability and food dimensions. Performance statements related to employees' friendliness, respectfulness, and the cleanliness of the dining room were rated the highest. Menu choices, convenience of the service hours, and temperature of the foods were rated the lowest. The food, reliability, and empathy dimensions were the significant predictors of the overall quality perception. Overall quality of the foodservice was rated as 3.5 on 5.0. The residents' satisfaction with dining experience was neutral (3.6 on 5.0). Residents' age and length of residency at the CCRC were not significantly correlated to satisfaction with dining experience. The residents rated the overall value of the foodservice as 3.5 on 5.0. The respondents were most willing to give compliments to the foodservice staffwhen they were happy with the foodservice. The foodservice department should focus on the reliability and food dimensions to enhance the residents' quality perceptions and satisfaction. Employee training is critical to improving service and food quality.

TITLE: BRINGING FINE HOTEL SERVICE TO PATIENTS

AUTHOR: M. S. Howell, R.D., Masonic Homes o f The Grand Lodge o f Pennsylvania

AUTHOR(S): C.A. Frankmann, MS, RD, M. Tekrouri, C.A. Croissant, RD, R. Banamar, and F. Cherukara. The University of Texas M. D. Anderson Cancer Center, Houston, TX.

LEARNING OUTCOME: To identify the quality improvement steps that occurred in movingfrom a traditional cook-serve system into an advanced eook-ehill/rethermalization meal delivery system.

LEARNING OUTCOME: Participants will identify the impact of hotel style room service on patient satisfaction with service.

ABSTRACT TEXT: Due to our organization's increasing size and the desire to move toward a state-of-the-art food services facility, the decision was made to build a centrally located kitchen with cook/chill capabilities. Subsequently, a plated meal rethermalization and delivery system was brought on line for our healtheare residents. A broad group o f staffmet regularly to test foods for quality with the new cooking technique, and in light o f upcoming rethermalization. The course was set for using a decentralized rethermalization system with self-contained carts that are refrigerated on one side and then heated by convection on the other. A single tray with removable barrier holds all o f each resident's food. Multi-disciplinary task forces were established to evaluate and guide the process o f implementation. The five goals we established for use o f our system were improved quality, appearance, temperature, service, and nutritional benefit o f the food we served. Quality Improvement markers were tested prior to the start o f the system and after the system was in place to determine if goals were met. Overall results o f these markers were good. Temperature and service improved dramatically. Quality, appearance, and nutritional benefit had s o r e r measures o f improvement. In conclusion, we are very pleased with the improvements the cook/chill and rethermalization systems have brought.

ABSTRACT TEXT: Patient satisfaction surveys, external and internal, indicated that there were opportunities for improvement in food and service for patients. A pilot program was conducted on two inpatient nursing units to determine patient satisfaction with a Room Service style of food service. Patients were very satisfied with the personalized service, as well as the ability to order anytime between 6:30 AM-9:30 PM and the extensive menu of fresh, cooked-to-order foods. Patients on one nursing unit placed orders by phone; on the other unit, Wait staff visited patients to take their orders. Patients preferred placing their orders by phone. Following reconstruction of the kitchen, room service was implemented for all patients. Service standards were established for Walt Staff and Call Center staff. Based on fine hotel standards, the Walt staff and Call Center staff addxess patients by name, introduce themselves, review their orders, and offer personalized service. Walt staff visit patients who have missed meals to encourage them to eat and assist those who have difficulty placing their orders by phone. Call Center staff assist patients in selecting meals that comply with diet restrictions and suggest foods appropriate for patients who are experiencing side effects of anti-neoplastic therapy. Patient satisfaction with room service is reflected in patient surveys that show that the number of patients who rate "Service" as Excellent has increased from 14% to 85%.

Journal of THE AMERICAN DIETETIC ASSOCIATION / A-79

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TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTH;RESEARCH& GRANTS~FOOD& NUTRITION;FOODSERVICESYSTEMS TITLE: ACCEPTABILITY, ATTITUDE AND KNOWLEDGE OF FLAVORED COMMERCIAL SOYMILK-BASED YOGURT BY COLLEGE STUDENTS IN NORTHERN LOUISIANA AUTHOR (S): Y.-F. Wu, MS; E. Molaison, PhD, LDN, RD; J. Pope, PhD, LDN, RD; S. Reagan, PhD, Louisiana Tech University. LEARNING OUTCOME: To determine acceptability, attitude, and knowledge of college students toward commercially available soymilk-based flavored yogurt compared to traditional dairy yogurt.

TITLE: ACCEPTABILITY OF SPAGHETn SAUCE CONTAINING

VEGETABLE PUREE FOR VEGETABLE CONSUMPTION AUTHOR(S): K.N. Treybig, Dietetic Student, Louisiana Tech University; B.L. Gerald, PhD DTR, Louisiana Tech University LEARNING OUTCOME:

To determine the acceptability of spaghetti sauce containing vegetable puree. ABSTRACT TEXT:

Americans as a whole are not eating sufficient quantity or variety of vegetables ARSTRACT TEXT: Soybean-based foods traditionally have been considered to have poor sensory characteristics, including beany and other off-flavors and aroma. The flavorings available to mask off-flavors and the use of soy in fermented foods such as yogurt have significant potential to change consumer opinion of this functional ingredient. This project addressed consumer attitudes and knowledge toward soy food products and determined acceptability of commercial soymilk and dairy yogurts containing varying levels of fat. A convenience sample was used, consisting of 185 students from a university in northern Louisiana. Four yogurts (soymilk yogurt, full fat dairy yogurt, lowfat dairy and nonfat dairy yogurt) were evaluated. Lemon flavoring and honey were blended with yogurts. A 9-point hedonic scale was used to evaluate each yogurt for overall acceptance. Questionnaires were used to ascertain consumer knowledge and attitude toward soymilk yogurt compared to dairy yogurt containing varying levels of fat. Demographic information such as age, race, and gender also were collected. Consumer attitudes and beliefs regarding health benefits of soy correlated with overall acceptance of soymilk yogurt (p< 0.0001); only 38.9% of students recognized the role of soy in reducing heart disease. Acceptance scores for soymilk yogurt were significantly different (p<0.0001) from those for traditional dairy yogurt, but no significant difference (p>0.05) was noted for yogurts with varying levels of fat. Results indicate that college students in northern Louisiana are unaware of the health benefits of soy, and presently prefer soymilk yogurts less than traditional dairy yogurt.

TITLE: DESCRIPTIVE SENSORY ANALYSIS OF TWO REDUCED-IN-FAqF COOKIES PREPARED WITH HIGH INTENSITY SWEETENERS AUTHORS: EE Cardello, BS, and RB Swanson, Phl), Dept of Foods and Nutrition, University of Georgia, Athens, and BG Lyon, MS and EM Savage, BS, USDA-ARS Russell Research Center, Athens, GA L E A R N I N G OUTCOME: To evaluate the flavor and textural effects of reducing and replacing 50% of the sucrose in reduced-in-fat oatmeal and chocolate chip cookies with Ace-K, sucralose or a 1:3 Aee-K/Sucralose blend. ABSTRACT TEXT: Availability of reduced-in-fat and sugar foods may reduce excess fat and simple carbohydrate consumption associated with chronic diseases, while allowing retention of some favorite foods in the diet. Cookies are a popular high-fat, high-sugar food; acceptable reduced-in-fat cookies have been formulated using prune puree as the fat replacer. Sucralose and acesulfame-K (Ace-K), high intensity sweeteners (HIS), provide sweetness with less calories than sucrose. HIS sweetener synergistic effects may overcome reported functional limitations. Taste is the primary determinant of consumer consumption. Eight trained, descriptive sensory panelists employed the Spectrum®-approach to evaluate 3 replications of 4 cookies (control, Sucralose, Ace-K, l:3-Ace-K/Sucralose blend) of each cookie type (oatmeal and chocolate chip). Fat and sugar were reduced by 50%. Blends of Dextrose:Ace-K and Maltodextrin:Sucralose, marketed to consumers, were used. Panelists assessed 6 flavor and 4 textural attributes in oatmeal cookies, and 6 flavor and 6 textural attributes in chocolate chip cookies, on a 15-point intensity scale, where 1 was low and 15 was high, with Compusense® five software. Data were analyzed with ANOVA and SNK (p<0.05). No significant flavor effects were found during mastication of either cookie type. Oatmeal cookies were low in astringent, prune and brown sugar flavors (<3.4); cinnamon, grainy and sweetness levels were low to moderately intense (4.2-5.9). Chocolate chip cookies were low in salty, bitter and sour flavors (<2.7), and moderately low (3.6-4.8) in brown sugar, chocolate and sweet intensities. Oatmeal control zookies were more fracturable (5.0) and cohesive (6.7) than either sucralose or HIS blend cookies; Ace-K formulations did not differ significantly from any Dther treatment. Modified chocolate chip cookies were less cohesive, fracturable, rough, hard and chewy than the sucrose control (4.3-6.7), with no differences among HIS formulations. Consumer acceptability should be determined.

A-80 / 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

to meet dietary guidelines. The purpose of this research was to determine the acceptability of vegetable puree substitution in a menu item to increase vegetable consumption. Panelists recruited from a University evaluated sauces in three trials for acceptability of color, texture, flavor, and overall acceptability using a hedonic scale. Objective tests included line spread to evaluate flow properties and filter cone to measure separation of solids and liquids. A standard tomato spaghetti sauce was compared to variations containing 25%, 50%, and 75% vegetable puree (VP) replacing tomato sauce by weight. Vegetable puree consisted of sweet potato, carrot, and zucchini. Objective test scores with significant differences in flow properties and liquid separation from control were considered unacceptable. Control, 25% VP, and 50% VP mean hedonic scores were considered acceptable for categories color, texture, and flavor. Filter cone results showed significant difference (held more liquid) in all variations compared to control. Line spread results showed no significant difference of flow properties in 25% and 50% VP from the control. According to mean hedonic results and line spread tests, up to 50% replacement of tomato sauce with vegetable puree is acceptable in spaghetti sauce. TITLE: THE EFFECT OF SUBSTITUTING CANNELLINI BEANS FOR SHORTENING ON ACCEPTABILITY AND NUTRIENT CONTENT OF BROWNIES AUTHORS: JE Allen, ML Szafranski, MS, RC Bessinger, PhD, RD, CH Goodner, MS, RD; Department of Human Nutrition, Winthrop University, Rock Hill, SC LEARNING O U T C O M E : Determine the effect of substituting cannellini beans for shortening on overall acceptability and nutrient content of brownies. ABSTRACT TEXT: Few studies have investigated the use of legumes as fat substitutes. Studies have shown white beans to be an effective fat ingredient substitute in cookies. However, studies are needed to determine if legumes may be an effective replacement for fat in other types of products. The purpose of this study was to determine the overall acceptability and nutrient content of brownies made using cannellini beans as a substitute for shortening. Canned pureed cannellini beans were used to replace 25%, 50% and 75% of the shortening (by weight) in the USDA Quantity Recipes for School Foodservice brownie formula (control). Sensory characteristics including appearance, color, texture and flavor, as well as overall acceptability of the reduced fat brownies were compared to the control. One hundred and eighteen untrained panelists participated in rating the brownies on a seven point hedonic scale ranging from like extremely (assigned a value of 1) to dislike extremely (assigned a value of 7). Analysis of variance indicated a statistically significant effect for substituting beans for fat (p<.001). Post hoc testing (Scheffe's test) showed that neither the 25% nor the 50% bean brownies were significantly different from the control in overall acceptability, nor were they significantly different from each other. Also, the 50% bean brownies, compared to the control, had 2.5 grams less fat and 21 less kilocalories per serving. Only very modest changes were observed in the protein and fiber content. This study demonstrated that it is possible to use pureed cannellini beans to substitute as much as 50% of the fat (by weight) in brownies and still yield an acceptable product while improving the nutrient content.

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TUESDAY,OCTOBER22 POSTERSESSION:WELLNESS& PUBLICHEALTH~RESEARCH& GRANTS~FOOD& NUTRITION;FOODSERVICESYSTEMS TITLE: FEASIBILITY OF USING OKRA GUM AS A FAT REPLACER IN LOW FAT CHOCOLATE ICE CREAM

AUTHOR(S): J.E. Romanchik-Ceq~ovicz,Ph.D., RD, M.T. Setzer, and S.G. Tucker;

EFFECTS OF SUBSTITUTING SUCRALOSE ON THE TITLE: PHYSICAL AND SENSORY PROPERTIES OF TAPIOCA PUDDING. M. Dexter, E. Munroe, K. Navder, Ph.D., Nutrition and AUTHOR(S): Food Science in Urban Public Health Program, Hunter College, New York, NY.

Georgia Southern University, Stateeburo, GA LEARNING OUTCOME: To determine the feasibility of using okra gum as a fat replacer in low fat chocolate ice cream.

LEARNING OUTCOME:

ABSTRACT TEXT: Okra gum has been shown to be an acceptable fat replacer in baked products. This study evaluated the effects of 100% replacement of milk fat and egg yolk in chocolate ice cream with okra gum, extracted from commercially-packaged frozen okra by heating pods in non-fat milk to 82°C. Melting properties and sensory ac~.eptability of low-fat ice cream with okra gum (LFO) were compared to low-fat ice cream without okra gum (LF) and regular fat control ice cream (CTL). Upon exposure of 100 ml samples of ice cream to ambient air (25°C), melting initiation times were similar (33.7+/2.31 rain (LFO), 22.3+/-7.37 min (LF), and 33.3+/-2.08 min (CTL)(mean+/-SD, n=3). Consistent with fat properties, the melting rate of CTL (2.20+/0.14°/turin-1)was significantly faster than both LFO (1.98+/-0.087°/m~-in"l) and LF (1.55+/-0.085%min ~) (p<0.05, n=3). Sensory attributes of ice cream were measured using a hedenic scale (9=like extremely, l=-dislike extremely) by 65 semi-trained panelists. Scores were obtained for color (LFO=5.35+/-1.93, LF=6.00+/-I.81, CTL=5.79+/-1.76), smell (LFO=4.96+/-1.56, LF=5.59+/-1.50, CTL=5.88+/-1.63), flavor (LFO=3.85+/-2.05, LF=4.61+/-2.25, CTL=7.17+/1.60), creaminess (LFO=4.42+/-2.14, LF=4.76+/-2.22, CTL=5.70+/-2.38), aftertaste (LFO=3.61+/-1.96, LF--4.23+/-2.19, CTL=6.47+/-1.75), and overall acceptability (LFO=3.88+/-2.00, LF=4.74+/-2.14, CTL=6.86+/-1.59). Color scores were similar among products. While similar to LF, flavor, creaminess, and aRertaste acceptability scores for LFO were less than acceptable and significantly lower than CTL (p<0.01). In order to successfully use okra gum as a fat replacer in ice cream, future studies need to address these less than desirable characteristics. Future studies may include expanding flavor profiles to improve taste and physically manipulating the okra gum to improve its texture and the creaminess it can contribute to ice cream.

ABSTRACT TEXT:

TITLE:

ACCEPTABILITY OF REDUCED-FAT OATMEAL CHOCOLATE CHIP COOKIES PREPARED WITH NAVY BEANS

AUTHOR(S): P.D. Femando, PhD; S.T. Hawkins, PhD, RD, Indiana State University, Terre Hante, IN. LEARNING OUTCOME: To determine the effect of navy bean puree in oaUneal chocolate chip cookies on their acceptability. ABSTRACT TEXT: The purpose of the study was to determine the palatability and the overall acceptability of oatmeal chocolate chip cookies made using navy bean puree as a substitute for 15%, 30%, and 45% of the fat ingredient, and to compare bean cookies with those of cookies made with a traditional amount of fat (control). Three replications were completed for the control and for fat substituted bean cookies. Three trained judges evaluated the cookies for appearance, flavor, texture, and overall acceptability on a 9-point hedonic scale (preliminary evaluation). Cookies were also evaluated using objective tests. Results of the scorecard mean values showed that 30% bean cookies had the highest overall acceptability when compared with the control and other variations. According to cookie spread results there was no difference in the diameter between the control and bean cookies. In addition, substitution of fat with beans had no significant effect on cookie color. Based on the results from the preliminary evaluation, 30% bean cookies were chosen for further evaluation. Thirty-two untrained judges evaluated the 30% bean cookies on the same 9-point hedonic scale. Results from palatability ratings for 30% bean cookies were 7.90, 8.0, 7.67 and 7.97 for appearance, flavor, texture and overall acceptability, respectively. This suggests that it is possible to substitute navy bean puree for fat ingredient in cookies that results in an acceptable product. Dietetic professionals could use the substituted navy bean cookies that are lower in fat and sodium, and higher in dietary fiber, protein, folic acid and potassium as they provide dietary recommendations to clients.

To determine the degree of acceptability of sucralose as a substitute for sucrose in tapioca pudding.

This study investigated the partial and full substitution of sucrose with sucralose in tapioca pudding. Sucralose (sold under trademark Splenda) is a safe, intensely sweet, heat stable, non-caloric sucrose derivative shown to be noncariogenic and safe for diabetics. The control tapioca pudding was made using the basic tapioca pudding recipe provided on the pearl tapioca box and variations (33, 66 and 100% substitutions) were made following the same recipe except substituting equal volumes of sucralose for the sugar. Objective testing showed line spread and penetrometer readings to decrease as the percent of sucralose increased in the pudding. This indicated that the puddings became more viscous and less tender as sucrose substitution increased. Subjective tests were performed by 30 untrained student panelists using hedonic scorecards. Sensory results indicated no significant differences in tenderness, sweetness, flavor, aftertaste and overall acceptability. These results indicate that sucralose can be used as an acceptable sugar substitute in tapioca pudding. The tapioca pudding made with 100% sucralose is a healthy, acceptable, sugar-free alternative that provides 19% fewer calories compared to the control. TITLE. FEEDING LOW-INCOME CHILDREN WHEN SCHOOL IS OUT: FINDINGS FROM A STUDY OF MEALS SERVED THROUGH THE USDA SUMMER FOOD SERVICE PROGRAM AUTHOR(S): Jane Allshouse, BS?Anne Gordon, PhD; 2 Ronette Briefel,DrPH, RD; 2 Teresa Zavitsky, M.S.; 2 Elizabeth Frazao, PhD; 1 Joanne F. Guthrie, PhD, MPH, RD; r 1U.S. Dept. of Agriculture, Economic Research Service, Washington, DC; 2 Mathematica Policy Research, Inc., Princeton, N J; LEARNING OUTCOME: To describe the meal service component of the U.S. Department of Agriculture (USDA)'s Summer Food Service Program (SFSP) and the nutritional content of meals served. ABSI'KACT TEXT: The U.S. Department of Agriculture (USDA)'s Summer Food Service Program (SFSP) provides nutritious meals to lowincome children when school is not in session. USDA funds state SFSP programs that recruit local sponsors to operate the program at one or more sites. Sponsors include public and private nonprofit organizations; typical sites include schools, park and recreational centers, nonprofit residential summer camps, and other settings. SFSP meals must meet USDA's nutrition standards. Challenges of SFSP meal service include the short-term nature of the program (typically 7 weeks or less), and the varied settings in which meals are prepared and served. To obtain up-to-date information on SFSP operations, this study collected data in summer/fall 2001 fi'om all state agencies operating the SFSP, as well as a nationally representative sample of sponsoring organizations. A subsample of program sites were selected for an observational study of program meal service that assessed the quality, safety, and nutritional content of SFSP meals. Initial tabulations indicate that in 2001, almost all SFSP sites served lunch, about half served breakfast, approximately one in five served snacks, and a small percentage served supper. Approximately two-thirds of SFSP sponsors prepared meals on site, others made use of central kitchen facilities or contracted with a vendor. In the observational study, nearly three-fourths of breakfasts and two-thirds of lunches and suppers contained all the SFSP meal components in required amounts. On average, SFSP meals met generally-accepted dietary recommendations for energy, cholesterol, fiber and most key nutrients, but not for saturated fat. Lunches and suppers, but not breakfasts, also exceeded guidance levels for sodium and total fat. Almost half of sites provided a "share box" to encourage children to share unwanted food and to reduce food waste. Implications for SFSP meal service are discussed. Journal of THE AMERICAN DIETETIC ASSOCIATION / A-81

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POSTERS__.$$10N:WUCluNES$ & PILmIC HEALTH;RESEARCH& GRANTS~FOOD& NUTRITION~FOODSERVICESYSTEMS TITLE:

A Guide to the Guidelines

TITLE: HEALTHY SCHOOL NUTRITION ENVIRONMENT: MOST IMPORTANT COMPONENTS AND BARRIERS

AUTHOR(S): J.L. Dorsey, Phl), RD, LD/N,: B. Greenwood, Phi),: E.A. Anderson, MS, Florida State University, Tallahassee, FL

AUTHOR(S): D.M. Brown, PhD, RD, National Food Service Management Institute Applied Research Division, Hattiesburg, MS. A.J. Rainville, PhD, RD, Eastern Michigan University, Ypsilanti, MI.

LEARNING OUTCOME: To provide food service directors/managers with an easy-to-nse resource for training employees about the 2000 Dietary Guidelinesfor Americans.

LEARNING OUTCOME: To describe the most important components and barriers for a healthy school nutrition environment using results of a national pilot study for school personnel.

ABSTRACT TEXT:

ABSTRACT TEXT: The purpose of this pilot study was to have school personnel rank the most important components and barriers related to Healthy School Nutrition Environment (HSNE). The survey was sent to a random national sample of superintendents, principals, school foodservice directors, school foodservice managers, teachers, coaches, and school business officials. There were 50 from each group for a total of 350 surveys mailed. The response rate was 41.4% (n= 145). The respondents were employed in school districts for an average of 16.4 years and were employed in their current district for 11.7 years. Fifty-one percent of respondents were from districts with less than 2,500 students; 33% had 2,501-10,000 students; and 16% had more than 10,000 students. Ninety-one percent of respondents were from districts that participate in the National School Lunch Program. A HSNE was a high priority for 45% of respondents. Respondents identified the six most important components of a HSNE were school meals that meet USDA nutrition standards as well as provide choices; adequate funds provided by local, state, and federal sources; a la carte menu items that contribute to healthy eating patterns; behavior-focused nutrition education; adequate time for children to enjoy meals with friends; and involvement of students and parents in developing food and nutrition policy. The lowest ranked components were customer service, pleasant ambiance, and adequate dining space. The respondents ranked funding for school foodservice, competitive foods, television/media, and children's peer pressures as the most important barriers to a HSNE. Menus, cafeteria atmosphere, and funding for school activities were not ranked highly as barriers to HSNE. The results indicated that school meals that meet USDA nutrition standards, funding for school foodservice, and competitive foods are important components of HSNE.

The purpose of this project was to incorporate existing educational materials for school food service personnel pertaining to the 2000 Dietary Guidelinesfor Americans into stand alone, self-instructionaltraining modules. The modules were developed in an electronic format to provide ready dissemination using cun~nt school district inservice training programs within the state and also to serve as a nationwide demonstration project. The modules for the food service employees are included in an overall training package for the directors/managers. While the modules are intended to be selfinstructional, using either a computer or hard copy, directors are given suggestions for using the modules in a group setting. The director's package also contains a list of internat resources as supplementary materials. There are 10 employee modules, each corresponding to a separate Dietmy Guideline. Each module utilizes colorful graphics (including the cartoon "Guide" on each cover page) and easy-to-read bulleted information regarding benefits, facts, self-assessment and strategies for personal and nn-the-job application for that particular guideline. The last page of each employee module is a short evaluation of learner outcomes, both factual and behavioral. A key is provided in the director's materials for reviewing the evaluation page and a certificate of completion that the employee can submit for certification. In printed form, the employee modules are assembled into 5.5 x 8.5" booklets, which a focus group designated as more user friendly and less threatening than the conventional 8.5 x 11" page size. The modules were field tested with over 100 food service employees from four different Florida school districts, representing the diverse demographics within the state. The modules were well received by the field test participants. Modules have also been developed for school teachers and are currently undergoing field testing. This project was funded by the Florida Department of Education via a USDA team Nutrition Training Grant.

TITLE: MISSED OPPORTUNITIES-FIBER FOOD PREFERENCES OF CHILDREN NOT OFFERED IN A SCHOOL NUTRITION PROGRAM AUTHORS: LB Richardson, MS, RD, PG Wolman, FAD, RD, CH Goodner, MS, RD, SF Stallings, Phi), RD, Winthrop University, Department of Human Nutrition LEARNING O U T C O M E : To determine strategies for increasing dietary fiber intakes among school-aged children A B S T R A C T TEXT: Children's diets are high in fat, cholesterol, and sugar, but low in fiber. To determine what high fiber foods grade school children would prefer, 159 students, ages 4 to 14 years, enrolled in a South Carolina county school district completed a researcher-designed survey to identify preferences for high fiber foods from the fruit, vegetable, and brcads/grains/cercals groups. Preferred foods were then compared to the school district 20May menu cycle to determine if the preferred foods were offered. Out of the 30 high fiber foods that were surveyed only 14 were included on the 20-day school di._~ict menu cycle. High fiber foods offered most often included green beans (4 times), grits (3 times), blueberry muffins (3 times), peaches (2 times), corn (2 times), and baked beans (2 times). High fiber foods offered one time during the 20May menu cycle included apples, strawberries, bananas, pears, sweet potatoes, collard greens, broccoli, and whole grain breads. Foods chosen by at least 10% o f the students as preferences, but not included on the 20May menu cycle, were oranges, kiwi, butter beans, lima beans, cheerios, combread, oatmeal, brown rice, and bran cereal. Results indicate that students are willing to cat certain high fiber foods, but those foods were rarely or never offered on the school menu cycle in this South Carolina county. Intake o f fruits, vegetables and whole grains might increase if students were offered the high fiber foods they preferred.

A-82 / 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