Opportunities in the Nutrition and Food Sciences Research Challenges and the Next Generation of Investigators (1994) / Chapter Skim
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6 IMPROVING THE DIET AND HEALTH OF INDIVIDUALS AND POPULATIONS
6 IMPROVING THE DIET AND HEALTH OF INDIVIDUALS AND POPULATIONS
Pages 180-208
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From page 180... ...
Manipulating the food supply and using supplements alone cannot ensure adequate or "optimal" nutriture to prevent these diseases, which constitute the major causes of mortality in the United States. Inclividual responsibility for appropriate food selection must be an essential aspect of nutrition intervention programs.
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From page 181... ...
Since an uneven distribution of the food supply is thought to be the underlying cause of this problem, federal food assistance programs have been implemented over the past 20 years to improve access to food for the most vulnerable groups, such as infants, pregnant and lactating women, the poor, and the aged. While effective, a contemporary evaluation is needed of the impact of these programs in the context of today's social and economic problems.
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From page 182... ...
Actions based on a comprehensive understanding of the interaction between economic and health policies, societal values, and individual and household behaviors and food attitudes must be combined with efforts of the food industry to alter the food supply. Research bridging the gap between the biological science of nutrition and the behavioral and social sciences is required to accomplish the complicated task of influencing long-term choices in food habits.
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From page 183... ...
This chapter identifies selected research opportunities for this new breed of nutrition scientist in three general areas reducina the risk of diet-related diseases reducing the risk of food insecurity O , (, ~ ~ ~ , and hunger, and improving the methods and tools for nutritional assessment, monitoring, and evaluation. Several interesting and exciting needs and opportunities for research are identified for each area.
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From page 184... ...
We consider two general factors that influence food habits sociocultural and behavioral. Sociocultural Factors in Diet Selection While genetic and physiological determinants shape individual food preferences and aversions, the translation of these into behavior diet selection is mediated by sociocultural factors.
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From page 185... ...
The variables now seen as critical in differentiating Americans into food-consuming groups are more structural than cultural. For example, gender-based differences in control of household resources and control of decisions about food consumption have been implicated in the food habits and nutritional status of women and children.
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From page 186... ...
quantitative techniques. Behavioral Strategies for Lifestyle Change While improving the public's diet and health is the major goal of public health nutrition, motivating and assisting people to translate dietary guidelines into permanent dietary change remains a formidable challenge to health professionals.
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From page 187... ...
There are many barriers to healthy behavior change that range from lack of motivation and not perceiving immediate improvements in health to long-standing food preferences and socially influenced dietary patterns. The traditional strategy for dietary change has been nutrition education.
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From page 188... ...
Food habits at the community level are influenced by social nutrition. Studies on dietary change need to examine those cultural and environmental factors that promote or prevent the initial dietary change and its maintenance.
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From page 189... ...
Fourth, the link between diet, nutritional status, and chronic disease varies among individuals. Some are resistant to dietary interventions and show no improvement in cardiovascular-disease risks even after adhering to dietary guidelines.
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From page 190... ...
Food insecurity exists whenever the availability of nutritionally adequate, safe foods or the ability to acquire personally acceptable foods in socially acceptable ways is limited or uncertain. lIunger as a physical sensation caused by lack of food need not be present for persons or households to lack food security.
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From page 191... ...
It is sometimes possible to introduce randomization, even in a nonprobability sample. For example, if a survey of food insecurity among the homeless were conducted, it might be advisable to
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From page 192... ...
effective food assistance programs for those in need Federal food assistance programs are an important means of ensuring that access to an adequate, safe, nutritious, and reliable food supply is available to all at reasonable cost. The four major federal food assistance programs Pschool feeding programs, the Food Stamp Program the Snecial ~nnlemt?
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From page 193... ...
Cost-benefit and cost-effectiveness analyses can be used to quantify the value of federal food assistance programs for recipients, government, and taxpayers. Cost-effectiveness or economic analyses consider the outcomes of alternative actions or programs on consumers and society and the inputs required to deliver and manage the programs over time.
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From page 194... ...
Addressing these research questions and many others would provide data to assess the cost-benefit and cost-effectiveness of the federal food assistance programs. Knowledge about the food-related behaviors of low-income and cTisadvantaged people is limited.
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From page 195... ...
WIC is the most thoroughly evaluated of all federal food assistance programs. However, although the program is targeted for pregnant and lactating women, infants, and children, evaluations have focused on pregnant women and the outcome of pregnancy.
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From page 196... ...
Title III of the Older Americans Act is designed to provide meeting places where older adults can receive a nutritious meal and nutrition education and an opportunity for socializing and recreation. Congregate dining and home-delivered meals programs provide some food security and bring elderly persons into regular contact with others.
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From page 197... ...
The availability of surplus agricultural and price-supported commodities does not always improve the dietary patterns of recipients. We need to find ways to integrate nutritional goals with the aims of agricultural price supports in federal food assistance programs.
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From page 198... ...
IMPROVING METHODS AND TOOLS FOR NUTRITIONAL AS SE S SME NT, MONITORING, AND EVALUATION Nutritional assessment is typically defined as the interpretation of information obtained from dietary, biochemical, anthropometric, and clinical assays of nutritional status. This information is used to assess the health status of individuals or populations as influenced by their intake and utilization of nutrients.
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From page 199... ...
New applications of medical technology will permit rapid screening of large population samples in epidemiological studies and lead to better identification of subgroups at risk. Develop simple, specific anthropometric measures of nutritional status Anthropometric measures are widely used to assess body composition and growth.
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From page 200... ...
Field researchers still rely on anthropometric measures of height and weight, skinfoIcT thickness, and waist and hip circumferences to assess nutritional status. Anthropometric measures typically use cutoff points to classify individuals by nutritional status.
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From page 201... ...
Validating dietary assessment tools is always difficult. New biomarkers of nutrient intakes are needed to validate new methods for assessing intakes.
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From page 202... ...
Generally, FFQs and other techniques for assessing dietary intake are used to correlate nutrient intake with nutritional status and the risk of chronic disease. However, foods or nutrients should not be viewed in isolation, since absorption of nutrients from one food may be influenced by other foods in the diet.
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From page 203... ...
Measurements are made at different points along a "nutrition continuum" that ranges from food production to consumption and eventually to the health status of individuals and groups. Information derived from nutrition monitoring forms the basis for policy decisions such as those on food fortification, food safety, food labeling, nutrition education, public health interventions, and food assistance.
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From page 204... ...
Develop new, strategies for evaluating nutrition interventions The goal of many nutritional interventions is to improve health behaviors. While the basis for nutrition interventions may be clinical, laboratory, and epidemiological studies, successful implementation often falls within the purview of the social and behavioral sciences.
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From page 205... ...
Develop methods for assessing creative new interventions using computerassisted decision-making models Health and nutrition interventions are of three general types. There are those that deliver services and provide food, such as WIC, or provide food only, such as the various school-based and other child-feeding programs and the Food Stamp Program.
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From page 206... ...
Evaluation of this entire spectrum is, of course, beyond the means of a single investigator. However, mathematical modelin~, techniques, driven by advances in computer technology, allow information from large-scale surveys to be integrated with household or indi Research // Results // / / Data / / Needed / / for / / Decisionmaking NUTRITION POLICY-MAKIN~ Primary Federal Coordinating Bodies: Department Level- | · DHHS Nutrition Policy Board I · USDA Subcommittee on Human Nutrition I Components: · Public health and food assistance programs · Nutrition information and education programs Food production and marketing Food safety, labeling, and fortification regulation Dietary guidance Health objectives Military food service systems \\ Needs \\ for Date Data \ \ Decisions \N / NUTRITION RESEARCH Federal Coordinating Body: Interagency Committee on Human Nutrition Research Components: · Nutrition monitoring research · Nutrient requirements throughout the life cycle · Research on the role of nutrition in etiology, prevention, and treatment of chronic diseases and conditions · Nutrient content, bioavailability and interactions · Nutrition education research · Economic aspects of food consumption · Knowledge/attitudes' relationships to ': : ~ NUTRITION MONITORING \ Federal Coordinating Body: interagency Board for Nutrition Monitoring and Related Research Components: · Nutrition and related health · Food and nutrient consumption · Knowledge, attitudes, and behavior · Food composition · Food supply ~Research Results <~ Data for Research FIGURE 6.1 Relationships among nutrition policy-making, research, and Won taring.
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From page 207... ...
Challenges in public health nutrition for the future include developing successful interventions and policies to reduce the risk of diet-related diseases and the incidence of hunger and food insecurity anct monitoring the impact of those policies. New computer technologies are enabling scientists to estimate food and nutrient intakes of large groups, to store and interpret a vast array of survey data, anci to build decision-making model systems for testing potential interventions.
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From page 208... ...
Future interventions to deal with these complex problems will need to integrate findings from the basic behavioral sciences with agriculture, economics, political science, and the other social sciences. This process will provide many new, exciting research opportunities for nutrition and food scientists.
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