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Children's School-Day Nutrient Intake in Ontario: A Cross-Sectional Observational Study Comparing Students' Packed Lunches from Two School Schedules. Nutrients 2022; 14:nu14091966. [PMID: 35565933 PMCID: PMC9104756 DOI: 10.3390/nu14091966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/20/2022] Open
Abstract
This study compared the caloric and nutrient values of packed lunch contents and consumption in the Balanced School Day (BSD) (two 20 min eating periods) versus the Traditional Schedule (TS) (one 20 min lunch). Foods consumed during school were assessed by direct food observation in 321 grade 3 and 4 students, aged 7−10 years, at 9 BSD and 10 TS elementary schools in Ontario. Packed lunch contents in the BSD were significantly higher than the TS in energy (3128.14 ± 1100.36 vs. 2658.98 ± 951.34 kJ, p < 0.001, respectively). Similarly, carbohydrates, total sugar, protein, fat, saturated fatty acids (SFA), calcium, iron, and sodium were significantly higher in the BSD versus TS packed lunches. Correspondingly, students in the BSD consumed significantly more energy, carbohydrates, total sugar, and SFA compared to the TS. Overall, lunches brought by students in the BSD schedule provided more energy across all macronutrients, with only a few micronutrients showing increased amounts, suggesting two 20 min eating opportunities could contribute to excess caloric intake during school, potentially contributing to the prevalence of childhood overweight and obesity in Canada. Furthermore, packed lunches in both schedules had excess amounts of nutrients of concern and much work is needed to ensure that children in Canada receive nutritious lunches at school.
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Gan K, Tithecott C, Neilson L, Seabrook JA, Dworatzek P. Picky Eating Is Associated with Lower Nutrient Intakes from Children's Home-Packed School Lunches. Nutrients 2021; 13:nu13061759. [PMID: 34064118 PMCID: PMC8224271 DOI: 10.3390/nu13061759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 11/23/2022] Open
Abstract
The objective was to assess the relationship between children’s picky eating (PE) status and nutrient intake from home-packed school lunches. The lunches of 321 students, aged 7–10 years, were quantified via cross-sectional direct observation. Children were classified as having PE (n = 155) or not (non-PE; n = 166) based on food neophobia scores and parental perceptions of PE. The PE group consumed significantly less protein, folate, magnesium, potassium, zinc, and vitamins B1, B2, B3, B6, D, and E than the non-PE group; however, both groups consumed amounts exceeding Dietary Reference Intakes (DRIs) for protein, carbohydrates, sugar, sodium, iron, and vitamins B1, B2, B3, B6, B12, and C. Conversely, both groups consumed amounts significantly lower than DRIs for calcium, fibre, folate, magnesium, potassium, zinc, and vitamins A, D, E, and K. The PE group ate significantly less meat and alternatives, vegetables and fruit, and fruit than the non-PE group, and did not meet any of Canada’s Food Guide (2007) recommendations. The non-PE group met recommendations for meat and alternatives only. PE impacts the dietary intake of children’s home-packed lunches; however, many packed lunches were of low nutritional quality. Focus should be placed on provision of nutritionally complete school lunches for all children.
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Affiliation(s)
- Kellseigh Gan
- School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Road, London, ON N6G 1H2, Canada; (K.G.); (C.T.); (L.N.); (J.A.S.)
| | - Carly Tithecott
- School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Road, London, ON N6G 1H2, Canada; (K.G.); (C.T.); (L.N.); (J.A.S.)
| | - Lisa Neilson
- School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Road, London, ON N6G 1H2, Canada; (K.G.); (C.T.); (L.N.); (J.A.S.)
| | - Jamie A. Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Road, London, ON N6G 1H2, Canada; (K.G.); (C.T.); (L.N.); (J.A.S.)
- Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON N6A 3K7, Canada
- Department of Epidemiology & Biostatistics, Western University, 1151 Richmond Street, London, ON N6A 3K7, Canada
- Human Environments Analysis Laboratory, Western University, 1151 Richmond Street, London, ON N6A 3K7, Canada
- Children′s Health Research Institute, 800 Commissioners Road East, London, ON N6C 2V5, Canada
- Lawson Health Research Institute, 750 Base Line Road East, Suite 300, London, ON N6C 2R5, Canada
| | - Paula Dworatzek
- School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Road, London, ON N6G 1H2, Canada; (K.G.); (C.T.); (L.N.); (J.A.S.)
- Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University, 1465 Richmond St., London, ON N6G 2M1, Canada
- Correspondence: ; Tel.: +1-519-432-8353
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Garcia JM, Chambers E, Yarrow K. Thickened liquids for dysphagia management: A call to action in the development of educational and instructional strategies. J Texture Stud 2021; 52:679-683. [PMID: 33890326 DOI: 10.1111/jtxs.12603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/08/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
This article is a "call to action" in the service delivery of thickened liquids. We discuss the importance of staff education and further development of educational resources in dysphagia management involving the use of thickened liquids, particularly as related to inadequacies in staff education and training. We discuss the use of contemporary instructional strategies to promote accuracy in preparation and knowledge about the thickening process.
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Affiliation(s)
- Jane Mertz Garcia
- Communication Sciences & Disorders, Department of Applied Human Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Edgar Chambers
- Department of Food, Nutrition, Dietetics & Health, Kansas State University, Manhattan, Kansas, USA
| | - Katie Yarrow
- Communication Sciences & Disorders, Department of Applied Human Sciences, Kansas State University, Manhattan, Kansas, USA
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Elliott S, McCloskey ML, Johnson SL, Mena NZ, Swindle T, Bellows LL. Food Photography as a Tool to Assess Type, Quantity, and Quality of Foods in Parent-Packed Lunches for Preschoolers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:164-173. [PMID: 33189584 DOI: 10.1016/j.jneb.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Explore using food photography to assess packed lunches in a university-based Early Childhood Center and contextualize these photographs through parent interviews. METHODS An explanatory sequential design was used. Packed lunches were photographed to assess the type and quantity of foods offered and consumed by Child and Adult Food Care Program components (fruit, vegetable, grain, and protein) and quality of foods offered using the Healthy Meal Index. Parent interviews aimed to understand motivations and behaviors related to packing lunch. RESULTS Data were collected on 401 lunches. Only 16.2% of lunches met all Child and Adult Food Care Program requirements. Most lunches included fruit (84%) and grains (82%), whereas fewer included vegetables (44%). Portion sizes were large, especially for grains (2.7 ± 1.5 servings). In interviews (n = 24), parents expressed tension between offering healthful items and foods they knew their child would eat, as well as concern about children going hungry. CONCLUSIONS AND IMPLICATIONS Food photography is a feasible methodology to capture parent-packed lunches for preschoolers and may have utility in nutrition education, particularly related to age-appropriate portion sizes.
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Affiliation(s)
- Savanah Elliott
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Morgan L McCloskey
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Noereem Z Mena
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Laura L Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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de Zwarte D, Kearney J, Corish CA, Glennon C, Maher L, Johnston Molloy C. Randomised study demonstrates sustained benefits of a pre-school intervention designed to improve nutrition and physical activity practices. J Public Health (Oxf) 2019; 41:798-806. [PMID: 30281073 DOI: 10.1093/pubmed/fdy173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/21/2018] [Accepted: 09/11/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Health-promoting programmes must demonstrate sustained efficacy in order to make a true impact on public health. This study aimed to determine the effect of the Healthy Incentive for Pre-schools project on health-promoting practices in full-day-care pre-schools 18 months after a training intervention. METHODS Thirty-seven pre-schools completed the initial study and were included in this follow-up study. The intervention consisted of one training session with either the pre-school 'manager-only' or 'manager and staff' using a specifically developed needs-based training resource pack comprised of written educational material and a validated health-promoting practice evaluation tool. Direct observation data of health-promoting practices were collected and allocated a score using the evaluation tool by a research dietitian at three time points; pre-intervention, between 6 and 9 months post-intervention and at 18-month follow-up. An award system was used to incentivise pre-schools to improve their scores. RESULTS Health-promoting practice scores improved significantly (P < 0.001) from the 6-9 month post-intervention to the 18-month follow-up evaluation. No significant differences were observed between 'manager-only' and 'manager and staff' trained pre-schools. CONCLUSIONS The introduction of a pre-school evaluation tool supported by a training resource was successfully used to incentivise pre-schools to sustain and improve health-promoting practices 18 months after intervention training.
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Affiliation(s)
- Diewerke de Zwarte
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - John Kearney
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Corina Glennon
- Community Nutrition and Dietetic Service, Health Service Executive Dublin Mid-Leinster, Primary Care Unit, St. Loman's Hospital Campus, Co. Westmeath, Republic of Ireland
| | - Lorraine Maher
- Community Nutrition and Dietetic Service, Health Service Executive Dublin Mid-Leinster, Primary Care Unit, St. Loman's Hospital Campus, Co. Westmeath, Republic of Ireland
| | - Charlotte Johnston Molloy
- Community Nutrition and Dietetic Service, Health Service Executive Dublin Mid-Leinster, Primary Care Unit, St. Loman's Hospital Campus, Co. Westmeath, Republic of Ireland
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Lee RE, Lorenzo E, Szeszulski J, Arriola A, Bruening M, Estabrooks PA, Hill J, Marsiglia FF, O'Connor T, Pollins KS, Shaibi GQ, Soltero E, Todd M. Design and methodology of a cluster-randomized trial in early care and education centers to meet physical activity guidelines: Sustainability via Active Garden Education (SAGE). Contemp Clin Trials 2019; 77:8-18. [PMID: 30550775 PMCID: PMC6464371 DOI: 10.1016/j.cct.2018.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 10/27/2022]
Abstract
Strategies are needed to help early care and education centers (ECEC) comply with policies to meet daily physical activity and fruit and vegetable guidelines for young children. This manuscript describes the design and methodology of Sustainability via Active Garden Education (SAGE), a 12-session cluster-randomized controlled crossover design trial using community-based participatory research (CBPR) to test a garden-based ECEC physical activity and fruit and vegetables promotion intervention for young children aged 3-5 years in 20 sites. The SAGE curriculum uses the plant lifecycle as a metaphor for human development. Children learn how to plant, water, weed, harvest, and do simple food preparation involving washing, cleaning, and sampling fruit and vegetables along with active learning songs, games, science experiments, mindful eating exercises, and interactive discussions to reinforce various healthy lifestyle topics. Parents will receive newsletters and text messages linked to the curriculum, describing local resources and events, and to remind them about activities and assessments. Children will be measured on physical activity, height, and weight and observed during meal and snack times to document dietary habits. Parents will complete measures about dietary habits outside of the ECEC, parenting practices, home physical activity resources, and home fruit and vegetable availability. SAGE fills an important void in the policy literature by employing a participatory strategy to produce a carefully crafted and engaging curriculum with the goal of meeting health policy guidelines and educational accreditation standards. If successful, SAGE may inform and inspire widespread dissemination and implementation to reduce health disparities and improve health equity.
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Affiliation(s)
- Rebecca E Lee
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.
| | - Elizabeth Lorenzo
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Jacob Szeszulski
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Anel Arriola
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Meg Bruening
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Paul A Estabrooks
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Jennie Hill
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Flavio F Marsiglia
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, United States
| | - Teresia O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Kim Sellers Pollins
- Booker T. Washington Early Childhood Learning Center, Phoenix, AZ, United States
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Erica Soltero
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Michael Todd
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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Effect of implementing school meals compared with packed lunches on quality of dietary intake among children aged 7-13 years. J Nutr Sci 2019; 8:e3. [PMID: 30746124 PMCID: PMC6360196 DOI: 10.1017/jns.2018.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/26/2018] [Accepted: 12/06/2018] [Indexed: 11/21/2022] Open
Abstract
Strategies are needed to improve the dietary habits of children. The aim of the present study was to evaluate the effect of implementing a school food programme on the dietary quality of lunches consumed by school children aged 7–13 years compared with packed lunches brought from home. A secondary objective was to investigate if a possible effect would differ between the younger children and the older. A quasi-experimental study design with four intervention schools and four matched control schools was conducted. In total, 984 school children participated. Data on packed lunches were collected at baseline. At the 1st follow-up the children in the intervention schools were offered free school meals and at the 2nd follow-up children paid for their school meals. The control group had packed lunches at all measurements. A digital photographic method combined with a Meal Index of dietary Quality (Meal IQ) was used for dietary assessment. Multilevel modelling was employed for data analyses. The quality of dietary intake was improved when free school meals were offered (P = 0·004); if the school meals were paid for the use was limited and no difference in change in dietary quality was found (P = 0·343). The school food programme had no difference in effect according to age (P = 0·083). In conclusion, offering a free school meal had a positive effect on dietary quality of the lunches consumed by school children aged 7–13 years. No effect was measured when the school meals were not provided for free. The dietary effect did not depend on age.
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Hawthorne DL, Neilson LJ, Macaskill LA, Luk JMH, Horner EJ, Parks CA, Salvadori MI, Seabrook JA, Dworatzek PDN. Parental Reports of Lunch-Packing Behaviours Lack Accuracy: Reported Barriers and Facilitators to Packing School Lunches. CAN J DIET PRACT RES 2018; 79:99-105. [PMID: 29893145 DOI: 10.3148/cjdpr-2018-011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Parents influence the foods their children consume and often provide proxy reports of this intake. One way parents exert this influence is by providing home-packed lunches. This study compared parental reports of foods packed in children's lunches with what was actually packed and identified parental barriers and facilitators to packing lunches. METHODS Grade 3 and 4 student-parent dyads (n = 321) in 19 elementary schools in Ontario participated. Parental reports and actual packed lunch contents were collected via self-administered surveys and direct observation, respectively. Parental barriers and facilitators were obtained through open and closed survey questions. RESULTS Median portions packed were significantly higher for sugar-sweetened beverages and snacks and significantly lower for fruits, fruit juice, vegetables, milk/alternatives, and meat/alternatives than parents reported. Packing a healthy lunch was "important/very important/of the utmost importance" for 95.9% of respondents, and 97.5% perceived their nutrition knowledge as "adequate/good/very good". Barriers to packing a lunch included: child's food preferences, time, finances, allergy policies, and food safety. Nutrition resources, observing other children's lunches, child's input, and planning ahead were identified as facilitators. CONCLUSIONS Strategies to improve packed lunches should move beyond parental nutrition knowledge and importance of lunch packing to address parental barriers and facilitators.
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Affiliation(s)
- Dana L Hawthorne
- a Leeds, Grenville and Lanark District Health Unit, Brockville, ON
| | | | - Lesley A Macaskill
- c School of Food and Nutritional Sciences, Brescia University College, London, ON
| | | | | | | | - Marina I Salvadori
- g Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON
| | - Jamie A Seabrook
- c School of Food and Nutritional Sciences, Brescia University College, London, ON.,h Departments of Paediatrics, and Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON.,i Children's Health Research Institute, London, ON.,j Lawson Health Research Institute, London, ON.,k Human Environments Analysis Laboratory, London, ON
| | - Paula D N Dworatzek
- c School of Food and Nutritional Sciences, Brescia University College, London, ON.,l Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University, London, ON
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Mertz Garcia J, Chambers E, Cook K. Visualizing the Consistency of Thickened Liquids With Simple Tools: Implications for Clinical Practice. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:270-277. [PMID: 29255849 DOI: 10.1044/2017_ajslp-16-0160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Accurate texture modifications to thin liquids are a critical aspect of patients' nutritional health and well-being. This study explored the use of 3 tools (2 distance- and 1 time-measuring devices) to characterize texture-modified liquids. The objectives were to use the tools to measure modified liquids, to determine if measurements differentiated nectar and honey levels of modification, and to compare measurements with other published reports. METHOD We measured the flow distance of 33 prethickened water samples in centimeters (cm) using a line spread apparatus and a Bostwick Consistometer (Christison Particle Technologies). We selected a Zahn viscosity cup to measure the stream time of each prethickened liquid in seconds. RESULTS The 2 distance-measuring devices (line spread and Bostwick Consistometer) showed that thinner (nectar-thick) modifications spread or flowed a farther distance in comparison to thicker (honey-like) modifications. Testing with the line spread indicated that an average spread distance of 4.5 cm differentiated nectar-thick and honey-like consistencies. A flow distance of greater than 15 cm differentiated nectar from honey consistency measured with a Bostwick Consistometer. We were not successful in using the Zahn viscosity cup to determine the stream time of modified liquids. CONCLUSIONS Two of the tools provided objective information about levels of liquid modification, which has implications for day-to-day preparation. Measurement tools that are accurate and easy to use have the potential to provide quick and dependable feedback to verify a prescribed level of liquid modification. Further efforts are needed to standardize the application of simple measurement tools in the management of patients who consume thickened liquids.
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Affiliation(s)
- Jane Mertz Garcia
- Communication Sciences & Disorders, School of Family Studies and Human Services, Kansas State University, Manhattan
| | - Edgar Chambers
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan
| | - Kelsey Cook
- Communication Sciences & Disorders, School of Family Studies and Human Services, Kansas State University, Manhattan
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10
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Díaz-Ramírez G, Jiménez-Cruz A, Bacardí-Gascón M. Nutritional Intervention to Improve the Quality of Lunchboxes Among Mexican School Children. J Community Health 2018; 41:1217-1222. [PMID: 27240816 DOI: 10.1007/s10900-016-0207-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In Mexico, the type of foods included in the lunchboxes of school children are unhealthy. The aim of this study was to evaluate the effects of an intervention program to improve the quality of the foods in the lunchboxes. Two schools were randomly selected as the intervention group (IG) and two more as the control group (CG). The evaluation was performed by comparing a food list from 3 days before and 6 months after the intervention. The components of the intervention included: exposure to posters inside and outside the classrooms and the distribution of pamphlets to parents, the pamphlets provided recipes and information about healthy foods. A lunchbox was considered adequate (AL) if it had less than 276 cal, fruits or vegetables, and an item prepared at home; a healthy lunchbox (HL) consisted of fruits or vegetables, water, and it did not have unhealthy foods. At the beginning of the study there were no significant differences in the compliance of AL and HL in both groups. By the end of the study, 19 % of the children in the IG and 10 % of the children in the CG met the criteria of a HL (p = 0.002). The results of this study demonstrate that a simple, 6 month intervention targeting parents improved the quality of the foods in the lunchboxes of second and sixth graders.
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Affiliation(s)
- Glenda Díaz-Ramírez
- Escuela de Ciencias de la Salud, Valle de las Palmas, Universidad Autónoma de Baja California, Campus Tijuana. Bulevar. Universitario Nº 1000 Valle de las Palmas, CP 22263, Tijuana, BC, Mexico
| | - Arturo Jiménez-Cruz
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Calzada Universidad # 14418, Mesa de Otay, CP 22390, Tijuana, BC, Mexico
| | - Montserrat Bacardí-Gascón
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Calzada Universidad # 14418, Mesa de Otay, CP 22390, Tijuana, BC, Mexico.
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Taylor JC, Sutter C, Ontai LL, Nishina A, Zidenberg-Cherr S. Feasibility and reliability of digital imaging for estimating food selection and consumption from students’ packed lunches. Appetite 2018; 120:196-204. [DOI: 10.1016/j.appet.2017.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/06/2017] [Accepted: 08/30/2017] [Indexed: 11/30/2022]
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Medin AC, Hansen BH, Astrup H, Ekelund U, Frost Andersen L. Validation of energy intake from a web-based food recall for children and adolescents. PLoS One 2017; 12:e0178921. [PMID: 28594899 PMCID: PMC5464590 DOI: 10.1371/journal.pone.0178921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/22/2017] [Indexed: 12/18/2022] Open
Abstract
The purpose of this study was to validate estimated energy intake from a web-based food recall, designed for children and adolescents. We directly compared energy intake to estimates of total energy expenditure, calculated from accelerometer outputs, combined with data on weight and sex or resting energy expenditure prediction equations. Children (8–9 years) and adolescents (12–14 years) were recruited through schools in Norway in 2013 (N = 253). Results showed that more than one third (36–37%) were identified as under-reporters of energy. In contrast, only 2–4% were defined as over-reporters of energy. The mean energy intake was under-reported with -1.83 MJ/day for the entire study sample. Increased underestimation was observed for overweight and obese participants, the oldest age group (12–14 years), boys, those with parents/legal guardians with low educational level and those living in non-traditional families. In conclusion, energy intake from the web-based food recall is significantly underestimated compared with total energy expenditure, and should be used with caution in young people.
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Affiliation(s)
- Anine Christine Medin
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
- * E-mail:
| | | | - Helene Astrup
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Masis N, McCaffrey J, Johnson SL, Chapman-Novakofski K. Design and Evaluation of a Training Protocol for a Photographic Method of Visual Estimation of Fruit and Vegetable Intake among Kindergarten Through Second-Grade Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:346-351.e1. [PMID: 28258818 DOI: 10.1016/j.jneb.2017.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 12/09/2016] [Accepted: 01/04/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To design a replicable training protocol for visual estimation of fruit and vegetable (FV) intake of kindergarten through second-grade students through digital photography of lunch trays that results in reliable data for FV served and consumed. METHODS Protocol development through literature and researcher input was followed by 3 laboratory-based trainings of 3 trainees. Lunchroom data collection sessions were done at 2 elementary schools for kindergarten through second-graders. Intraclass correlation coefficients (ICCs) were used. RESULTS By training 3, ICC was substantial for amount of FV served and consumed (0.86 and 0.95, respectively; P < .05). The ICC was moderate for percentage of fruits consumed (0.67; P = .06). In-school estimates for ICCs were all significant for amounts served at school 1 and percentage of FV consumed at both schools. CONCLUSIONS AND IMPLICATIONS The protocol resulted in reliable estimation of combined FV served and consumed using digital photography. The ability to estimate FV intake accurately will benefit intervention development and evaluation.
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Affiliation(s)
- Natalie Masis
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL.
| | - Jennifer McCaffrey
- Office of Extension and Outreach, University of Illinois Extension, Urbana, IL
| | - Susan L Johnson
- Children's Eating Laboratory, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
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14
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Neilson LJ, Macaskill LA, Luk JM, Sharma N, Killip SM, Salvadori MI, Seabrook JA, Dworatzek PD. Students’ Food Intake from Home-Packed Lunches in the Traditional versus Balanced School Day. CAN J DIET PRACT RES 2017; 78:3-10. [DOI: 10.3148/cjdpr-2016-024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lisa J. Neilson
- Division of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
| | - Lesley A. Macaskill
- Division of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
| | - Jonathan M.H. Luk
- Division of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
| | - Navreeti Sharma
- Division of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
| | | | - Marina I. Salvadori
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON
| | - Jamie A. Seabrook
- Division of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON
- Children’s Health Research Institute, London, ON
- Lawson Health Research Institute, London, ON
| | - Paula D.N. Dworatzek
- Division of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
- Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, Western University, London, ON
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15
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Tugault-Lafleur CN, Black JL, Barr SI. A Systematic Review of Methods to Assess Children's Diets in the School Context. Adv Nutr 2017; 8:63-79. [PMID: 28096128 PMCID: PMC5227974 DOI: 10.3945/an.116.013144] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
To evaluate the impact of school-based nutrition interventions, accurate and reliable methods are needed to assess what children eat at school. The primary objective of this study was to systematically review methodological evidence on the relative accuracy and reliability of dietary assessment methods used in the school context. The secondary objective was to assess the frequency of methods and analytical approaches used in studies reporting in-school dietary outcomes. Three health databases were searched for full-text English-language studies. Twenty-two methodological studies were reviewed. For school meal recalls, the majority of studies (n = 8 of 12) reported poor accuracy when accuracy was measured by using frequencies of misreported foods. However, when energy report rates were used as a measure of accuracy, studies suggested that children were able to accurately report energy intake as a group. Results regarding the accuracy of food-frequency questionnaires (FFQs) and food records (FRs) were promising but limited to a single study each. Meal observations offered consistently good interrater reliability across all studies reviewed (n = 11). Studies reporting in-school dietary outcomes (n = 47) used a broad range of methods, but the most frequently used methods included weighed FRs (n = 12), school meal recalls (n = 10), meal observations by trained raters (n = 8), and estimated FRs (n = 7). The range of dietary components was greater among studies relying on school meal recalls and FRs than among studies using FFQs. Overall, few studies have measured the accuracy of dietary assessment methods in the school context. Understanding the methodological characteristics associated with dietary instruments is vital for improving the quality of the evidence used to inform and evaluate the impact of school-based nutrition policies and programs.
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Affiliation(s)
- Claire N Tugault-Lafleur
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer L Black
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
| | - Susan I Barr
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Medin AC, Astrup H, Kåsin BM, Andersen LF. Evaluation of a Web-Based Food Record for Children Using Direct Unobtrusive Lunch Observations: A Validation Study. J Med Internet Res 2015; 17:e273. [PMID: 26680744 PMCID: PMC4704886 DOI: 10.2196/jmir.5031] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/15/2015] [Accepted: 10/02/2015] [Indexed: 11/13/2022] Open
Abstract
Background High-quality, Web-based dietary assessment tools for children are needed to reduce cost and improve user-friendliness when studying children’s dietary practices. Objective To evaluate the first Web-based dietary assessment tool for children in Norway, the Web-based Food Record (WebFR), by comparing children’s true school lunch intake with recordings in the WebFR, using direct unobtrusive observation as the reference method. Methods A total of 117 children, 8-9 years, from Bærum, Norway, were recruited from September to December 2013. Children completed 4 days of recordings in the WebFR, with parental assistance, and were observed during school lunch in the same period by 3 observers. Interobserver reliability assessments were satisfactory. Match, omission, and intrusion rates were calculated to assess the quality of the recordings in the WebFR for different food categories, and for all foods combined. Logistic regression analyses were used to investigate whether body mass index (BMI), parental educational level, parental ethnicity or family structure were associated with having a “low match rate” (≤70%). Results Bread and milk were recorded with less bias than spreads, fruits, and vegetables. Mean (SD) for match, omission, and intrusion rates for all foods combined were 73% (27%), 27% (27%), and 19% (26%), respectively. Match rates were statistically significantly associated with parental educational level (low education 52% [32%] versus high 77% [24%], P=.008) and parental ethnicity (non-Norwegian 57% [28%] versus others 75% [26%], P=.04). Only parental ethnicity remained statistically significant in the logistic regression model, showing an adjusted odds ratio of 6.9 and a 95% confidence interval between 1.3 and 36.4. Conclusions Compared with other similar studies, our results indicate that the WebFR is in line with, or better than most of other similar tools, yet enhancements could further improve the WebFR.
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Affiliation(s)
- Anine Christine Medin
- Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
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17
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Lee RM, Emmons KM, Okechukwu CA, Barrett JL, Kenney EL, Cradock AL, Giles CM, deBlois ME, Gortmaker SL. Validity of a practitioner-administered observational tool to measure physical activity, nutrition, and screen time in school-age programs. Int J Behav Nutr Phys Act 2014; 11:145. [PMID: 25429898 PMCID: PMC4264534 DOI: 10.1186/s12966-014-0145-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutrition and physical activity interventions have been effective in creating environmental changes in afterschool programs. However, accurate assessment can be time-consuming and expensive as initiatives are scaled up for optimal population impact. This study aims to determine the criterion validity of a simple, low-cost, practitioner-administered observational measure of afterschool physical activity, nutrition, and screen time practices and child behaviors. METHODS Directors from 35 programs in three cities completed the Out-of-School Nutrition and Physical Activity Observational Practice Assessment Tool (OSNAP-OPAT) on five days. Trained observers recorded snacks served and obtained accelerometer data each day during the same week. Observations of physical activity participation and snack consumption were conducted on two days. Correlations were calculated to validate weekly average estimates from OSNAP-OPAT compared to criterion measures. Weekly criterion averages are based on 175 meals served, snack consumption of 528 children, and physical activity levels of 356 children. RESULTS OSNAP-OPAT validly assessed serving water (r = 0.73), fruits and vegetables (r = 0.84), juice >4oz (r = 0.56), and grains (r = 0.60) at snack; sugary drinks (r = 0.70) and foods (r = 0.68) from outside the program; and children's water consumption (r = 0.56) (all p <0.05). Reports of physical activity time offered were correlated with accelerometer estimates (minutes of moderate and vigorous physical activity r = 0.59, p = 0.02; vigorous physical activity r = 0.63, p = 0.01). The reported proportion of children participating in moderate and vigorous physical activity was correlated with observations (r = 0.48, p = 0.03), as were reports of computer (r = 0.85) and TV/movie (r = 0.68) time compared to direct observations (both p < 0.01). CONCLUSIONS OSNAP-OPAT can assist researchers and practitioners in validly assessing nutrition and physical activity environments and behaviors in afterschool settings. TRIAL REGISTRATION Phase 1 of this measure validation was conducted during a study registered at clinicaltrials.gov NCT01396473.
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Affiliation(s)
- Rebekka M Lee
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Karen M Emmons
- Kaiser Foundation Research Institute, Oakland, California.
| | - Cassandra A Okechukwu
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Jessica L Barrett
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Erica L Kenney
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Angie L Cradock
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Catherine M Giles
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Madeleine E deBlois
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Steven L Gortmaker
- Harvard School of Public Health, Social and Behavioral Sciences, 677 Huntington Avenue, Boston, MA, 02115, USA.
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18
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Carvalho M, Baranowski T, Foster E, Santos O, Cardoso B, Rito A, Pereira Miguel J. Validation of the Portuguese self-administered computerised 24-hour dietary recall among second-, third- and fourth-grade children. J Hum Nutr Diet 2014; 28:666-74. [DOI: 10.1111/jhn.12280] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M.A. Carvalho
- Institute of Preventive Medicine and Public Health; Faculty of Medicine; University of Lisbon; Lisboa Portugal
| | - T. Baranowski
- USDA/ARS Children's Nutrition Research Center; Baylor College of Medicine; Houston TX USA
| | - E. Foster
- Human Nutrition Research Centre; Institute of Health and Society; University of Newcastle; Newcastle upon Tyne UK
| | - O. Santos
- Institute of Preventive Medicine and Public Health; Faculty of Medicine; University of Lisbon; Lisboa Portugal
| | - B. Cardoso
- Center for Informatics and Information Technologies; Faculty of Sciences and Technology; New University of Lisbon; Lisboa Portugal
| | - A. Rito
- National Institute of Health Doutor Ricardo Jorge; Lisboa Portugal
| | - J. Pereira Miguel
- Institute of Preventive Medicine and Public Health; Faculty of Medicine; University of Lisbon; Lisboa Portugal
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19
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Farris AR, Misyak S, Duffey KJ, Davis GC, Hosig K, Atzaba-Poria N, McFerren MM, Serrano EL. Nutritional comparison of packed and school lunches in pre-kindergarten and kindergarten children following the implementation of the 2012-2013 National School Lunch Program standards. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:621-626. [PMID: 25457731 DOI: 10.1016/j.jneb.2014.07.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 07/13/2014] [Accepted: 07/30/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Approximately 40% of children bring a packed lunch to school. Little is known about the quality of these lunches. This study examined the nutritional quality of packed lunches compared with school lunches for pre-kindergarten and kindergarten children after the implementation of 2012-2013 National School Lunch Program standards. METHODS The researchers collected observational data for packed and school lunches from 3 schools in rural Virginia for 5 consecutive school days and analyzed them for macro and micro nutrients. RESULTS Of the 1,314 observations collected; 42.8% were packed lunches (n = 562) and 57.2% were school lunches (n = 752). Energy, fat, saturated fat, sugar, vitamin C, and iron were significantly higher whereas protein, sodium, fiber, vitamin A, and calcium were significantly lower for packed lunches than school lunches. CONCLUSIONS AND IMPLICATIONS Packed lunches were of less nutritional quality than school lunches. Additional research is needed to explore factors related to choosing packed over school lunches.
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Affiliation(s)
- Alisha R Farris
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.
| | - Sarah Misyak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Kiyah J Duffey
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - George C Davis
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA
| | - Kathy Hosig
- Department of Population Health Sciences, Center of Public Health Practice and Research, Virginia Tech, Blacksburg, VA
| | | | - Mary M McFerren
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Elena L Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
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Hanks AS, Wansink B, Just DR. Reliability and Accuracy of Real-Time Visualization Techniques for Measuring School Cafeteria Tray Waste: Validating the Quarter-Waste Method. J Acad Nutr Diet 2014; 114:470-474. [DOI: 10.1016/j.jand.2013.08.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
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21
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Lund AM, Garcia JM, Chambers E. Line spread as a visual clinical tool for thickened liquids. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 22:566-571. [PMID: 23813193 DOI: 10.1044/1058-0360(2013/12-0044)] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Preparing modified liquids to a target level of consistency is critical to patients' nutritional care. This study examined the relationship of line spread (i.e., the distance a liquid flows) to viscometer measurements for a variety of product/liquid combinations and determined if flow distance visually differentiated nectar-thick versus honey-like consistency. METHOD Combinations of 4 thickening products (3 starch-based and 1 gum-based thickener) prepared with 6 serving-temperature liquids that had various levels of fat, fiber, and added nutrients were tested. A total of 32 product/liquid combinations tested within the target range of 80-800 centipoise (cP). Measurements were recorded using line spread and a Brookfield RVDV-II+ viscometer. RESULTS Nectar-thick and honey-like consistencies significantly differed in their degree of line spread. Using our line spread apparatus, a value of 4.5 cm differentiated between nectar-thick and honey-like consistencies. There was an inverse correlation (-.75) between viscometer data and line spread results. That is, high viscosity values represented samples with less flow distance (line spread), and low viscosity values represented samples with more flow distance. CONCLUSION Line spread appears to be a quick, objective, and visual method that might be used to help patients and their caregivers achieve more accurate and consistent thickened liquid preparation.
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