The general nutrition practices of competitive powerlifters vary by competitive calibre and sex, weight, and age class.

PURPOSE: To characterise self-reported nutrition practices and beliefs of powerlifters. METHODS: Actively competing male (n = 240) and female (n = 65) powerlifters completed a cross-sectional online survey of self-reported nutrition practices across the competitive cycle, within specific competitive phases, and hard and easy training days. Data are presented as number (n) and percentage (%) of all powerlifters practicing a given strategy followed by a % of responses reporting various practices or beliefs within this strategy. Differences in categorical sub-groups (sex, age, and weight class; and competitive calibre) were analysed with a chi-square test and denoted where significant (p ≤ 0.05). RESULTS: Most powerlifters reported following a specific diet long-term (n = 203, 66.6%) of which If It Fits Your Macros (IIFYM)/flexible dieting was most common (n = 159, 78.3%). Over half reported introducing a special diet for a competitive phase (n = 162, 53.1%), of which IIFYM/flexible dieting was most followed for competition preparation (n = 80, 63%) and off-season (n = 48, 71.6%). Compared to normal dietary intake, most reported eating more on harder training days (n = 219, 71.8%) and refraining from eating less on easier training days (n = 186, 61%). CONCLUSIONS: IIFYM/flexible dieting is commonly followed by powerlifters to support performance and body composition goals. Females seemed to report more often restricting energy and dieting for body composition reasons than males. Powerlifters tailor their energy intake on harder training days to the higher training demands but refrain from reducing energy intake on rest/easier training days.

Nutrition Practices of Family Child Care Home Providers and Children's Diet Quality.

OBJECTIVE: To examine the relationship between the diet quality of children aged 2-5 years cared for in family child care homes (FCCHs) with provider adherence to nutrition best practices. DESIGN: Cross-sectional analysis. PARTICIPANTS: Family child care home providers (n = 120, 100% female, 67.5% Latinx) and children (n = 370, 51% female, 58% Latinx) enrolled in a cluster-randomized trial. MAIN OUTCOME MEASURES: Data were collected over 2 days at each FCCH. The Environment and Policy Assessment and Observation tool was used to document whether providers exhibited nutrition practices on the basis of the Nutrition and Physical Activity Self-Assessment for Child Care. Each practice was scored as either present or absent. Children's food intake was observed using Diet Observation at Child Care and analyzed with the Healthy Eating Index-2015. ANALYSIS: Multilevel linear regression models assessed the association between providers exhibiting best practices regarding nutrition and children's diet quality. The model accounted for clustering by FCCH and controlled for provider ethnicity, income level, and multiple comparisons. RESULTS: Children in FCCHs in which more of the best practices were implemented had higher diet quality (B = 1.05; 95% confidence interval [CI], 0.12-1.99; P = 0.03). Specifically, children whose providers promoted autonomous feeding (B = 27.52; 95% CI, 21.02-34.02; P < 0.001) and provided nutrition education (B = 7.76; 95% CI, 3.29-12.23; P = 0.001) had higher total Healthy Eating Index scores. CONCLUSIONS AND IMPLICATIONS: Future interventions and policies could support FCCH providers in implementing important practices such as autonomy feeding practices, talking informally to children about nutrition, and providing healthful foods and beverages.

Knowledge and nutrition-related practices among caregivers of adolescents with sickle cell disease in the Greater Accra region of Ghana.

BACKGROUND: Due to its severe adverse effect on child mortality, sickle cell disease (SCD) has been identified as a set of diseases of public health concern. The high mortality rate among children with SCD in Africa has been attributed to several factors including sub-optimal management and care. This study documented the nutrition-related knowledge and practices of caregivers of teenagers who suffer from sickle cell disease (SCD) to inform decisions on integrated management of the disease. METHODS: The study included caregivers (n = 225) of adolescents with SCD who attended clinic at selected hospitals in Accra, Ghana. Pre-tested semi-structured questionnaire was employed in the gathering of information related to general and nutrition-related knowledge about SCD, as well as data on their nutrition-related practices with regards to their children who suffer from SCD. Pearson's Chi-square test and binary logistic regression analyses were applied to explore the relationship between caregivers' nutrition-related knowledge and practice. RESULTS: Nutrition-related knowledge among the caregivers studied was low, with less than a third of them (29.3%) of the sample being classified as having good knowledge. Caregivers who considered nutrition care when the child experienced crises were few (21.8%), and those with low nutrition-related knowledge were less likely to do this compared with caregivers having high knowledge (OR = 0.37, 95% CI = 0.18, 0.78). The common nutrition actions reported were the provision of more fruits/fruit juices (36.5%) and warm fluids such as soups and teas (31.7%). More than a third of the caregivers (38.7%) admitted that they faced challenges in caring for their adolescents with SCD, particularly in the area of finance for the needed health care. CONCLUSION: Our study findings indicate that it is important to incorporate appropriate nutrition education messages for caregivers as part of a holistic management of SCD.

Relationships between proximity to grocery stores and Oklahoma Early Care and Education classroom nutrition practices.

The study purpose was to determine associations between proximity to grocery stores and Early Care and Education programs' (i.e., ECEs) classroom nutrition practices and barriers, by ECE context (Head Start, community-based childcare [CBC], and family child care homes [FCCHs]). A statewide cross-sectional survey was implemented in Oklahoma ECEs. Directors reported classroom nutrition practices with the Nutrition and Physical Activity Self-Assessment tool, and barriers to implementation. Locations of 457 grocery stores statewide were determined by in-person audit. Geocoded ECEs were considered within a "low proximity" area if no grocery stores were available within a 0.25-mile radius for urban, or 10-mile radius for rural, ECEs. From November 2019 to February 2020, 54 Head Starts, 159 CBCs, and 160 FCCHs participated. 31.0 % were considered as low proximity. Head Starts demonstrated the highest classroom nutrition scores for mealtime practices, and nutrition education and policy. While proximity to grocery stores was not related to classroom nutrition practices for any ECE context (p > 0.05), FCCHs located within a low proximity area reported barriers to implementing those practices more often compared to FCCHs in an area within accessible proximity of grocery store. Thus, proximity to grocery stores was related to barriers in FCCHs only; those provider's experiences and perceptions may be most susceptible to influence of the community nutrition environment, compared to other ECE contexts. Contrary to studies in residential areas and schools, nutrition environments were not related to nutrition practices in ECEs. ECEs may serve as protective micro-environments supporting health for children residing in nearby low-access communities.

Integrating Nutrition Actions in Service Delivery: The Practices of Frontline Workers in Uganda.

BACKGROUND: Integrating nutrition actions into service delivery in different policy sectors is an increasing concern. Nutrition literature recognizes the discrepancies existing between policies as adopted and actual service delivery. This study applies a street-level bureaucracy (SLB) perspective to understand frontline workers' practices that enact or impede nutrition integration in services and the conditions galvanizing them. METHODS: This qualitative exploratory study assesses the contextual conditions and practices of 45 frontline workers employed by the agriculture, health and community development departments in two Ugandan districts. RESULTS: Frontline workers incur different demands and resources arising at societal, organizational, and individual level. Hence, they adopt nine co-existing practices that ultimately shape nutrition service delivery. Nutrition integration is accomplished through: (1) ritualizing task performance; (2) bundling with established services; (3) scheduling services on a specific day; and (4) piggybacking on services in other domains. Disintegration results from (5) non-involvement and (6) shifting blame to other entities. Other practices display both integrative and disintegrative effects: (7) creaming off citizens; (8) down prioritization by fixating on a few nutrition actions; and (9) following the bureaucratic 'jobs worth'. Integrative practices are driven mostly by donors. CONCLUSION: Understanding frontline workers' practices is crucial for identifying policy solutions to sustain nutrition improvements. Sustaining services beyond timebound projects necessitates institutionalizing demands and resources within government systems. Interventions to facilitate effective nutrition service delivery should strengthen the integrative capacities of actors across different government levels. This includes investing in integrative leadership, facilitating frontline workers across sectors to provide nutrition services, and adjusting the nutrition monitoring systems to capture cross-sector data and support policy learning.

Nutrition knowledge, attitudes and practices of primary school children in Tshwane Metropole, South Africa.

BACKGROUND: The increasing prevalence of being overweight and obesity in South African school children requires interventions that are evidence based. Nutrition knowledge, attitudes and practices (KAP) studies are thus needed to provide evidence for the planning of interventions that address and prevent nutrition problems in school children. AIM: The aim of the study on which this article is based was to assess nutrition knowledge, attitudes and practices of grade 4-6 learners from three primary schools in a South African township. The article seeks to highlight the key results of this quantitative study. SETTING: The study took place in three primary schools in Mamelodi township, Pretoria, South Africa. METHODS: Data were collected from grade 4-6 learners using self-administered questionnaires. After coding and collating data using Epi infoTM, STATA was then used for analysis. A description of KAP results was carried out using simple descriptive statistics, while the associations were tested using a chi-square test. RESULTS: Learners displayed inadequate knowledge of a balanced diet (23%) as well as low knowledge of food groups. With regard to attitudes, the most liked food group was the drinks and snacks (72.9%), while the least liked food group was the fruits and vegetables (8.11%). With regard to practices, the most frequently consumed food group was the drinks and snacks (72.6%), while fruits and vegetables were the least consumed. However, 78.91% of the learners displayed very good nutrition-related practices, such as making their own breakfast and eating breakfast. CONCLUSION: The inadequate knowledge displayed by learners indicates a gap with nutrition education in the curriculum. There is a need to explore innovative and novel approaches to improve nutrition knowledge of school children. Parents also need to be targeted to ensure better outcomes.

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey.

BACKGROUND: This study aimed to assess the situational capacity for nutrition care delivery in the outpatient hemodialysis (HD) setting in Malaysia by evaluating dietitian accessibility, nutrition practices and patients' outcomes. METHODS: A 17-item questionnaire was developed to assess nutrition practices and administered to dialysis managers of 150 HD centers, identified through the National Renal Registry. Nutritional outcomes of 4362 patients enabled crosscutting comparisons as per dietitian accessibility and center sector. RESULTS: Dedicated dietitian (18%) and visiting/shared dietitian (14.7%) service availability was limited, with greatest accessibility at government centers (82.4%) > non-governmental organization (NGO) centers (26.7%) > private centers (15.1%). Nutritional monitoring varied across HD centers as per albumin (100%) > normalized protein catabolic rate (32.7%) > body mass index (BMI, 30.7%) > dietary intake (6.0%). Both sector and dietitian accessibility was not associated with achieving albumin ≥40 g/L. However, NGO centers were 36% more likely (p = 0.030) to achieve pre-dialysis serum creatinine ≥884 µmol/L compared to government centers, whilst centers with dedicated dietitian service were 29% less likely (p = 0.017) to achieve pre-dialysis serum creatinine ≥884 µmol/L. In terms of BMI, private centers were 32% more likely (p = 0.022) to achieve BMI ≥ 25.0 kg/m2 compared to government centers. Private centers were 62% less likely (p <  0.001) while NGO centers were 56% less likely (p <  0.001) to achieve serum phosphorus control compared to government centers. Patients from centers with a shared/visiting dietitian had 35% lower probability (p <  0.001) to achieve serum phosphorus levels below 1.78 mmol/L compared to centers without access to a dietitian. CONCLUSIONS: There were clear discrepancies in nutritional care in Malaysian HD centers. Changes in stakeholder policy are required to ensure that dietitian service is available in Malaysian HD centers.

[Nutrition as a resource for networked community based health promotion for children-perspectives of parents and experts]. / Ernährung als Ressource der vernetzten kommunalen Gesundheitsförderung für Kinder ­ Wahrnehmung durch Eltern und Experten.

BACKGROUND: The promotion of healthy nutrition and alimentary participation (the possibility of experiencing the social function of food) is an essential aspect of integrated overall approaches of community-based health promotion. Preschool and primary school settings are given particular importance in terms of the target group focused on by community-based approaches: children from socially disadvantaged families. OBJECTIVES: How do parents and practice experts describe the status quo, potential, and obstacles in the implementation of healthy nutrition practices in the settings kindergarten and elementary school? What ist the importance of nutrition and alimentary participation within the framework of the integrated overall approach attributed by practice experts? METHOD: In two urban centers, expert interviews were conducted with stakeholders of integrated overall approaches and administrators from preschools and primary schools. The perspectives held by parents in financially precarious situations or with immigrant backgrounds were explored in group discussions. RESULTS: Nutrition takes on an important role in the narratives of parents and experts. Preschools and primary schools draw upon daily interaction with food and shared meals in a variety of ways to foster the development of healthy eating habits and alimentary participation. It has become clear that preschools and primary schools must increasingly counteract delegation of parenting responsibilities and poor nutrition practices, for instance by providing socially compensatory breakfasts. Parents acknowledge these efforts but express criticism that food in schools is eaten under problematic spatial conditions and intense time pressure. DISCUSSION: Nutrition is used by experts as a resource but, in contrast to physical exercise or mental health, without reference to integrated community-based health promotion. Promotion of alimentary participation and healthy nutrition practice could have more impact if stakeholders saw themselves as essential components of integrated community-based health promotion.

Improving the nutrition and screen time environment through self-assessment in family childcare homes in Nebraska.

OBJECTIVE: To determine if family childcare homes (FCCH) in Nebraska meet best practices for nutrition and screen time, and if focusing on nutrition and screen time policies and practices improves the FCCH environment. DESIGN: A pre-post evaluation was conducted using the Go Nutrition and Physical Activity Self-Assessment for Childcare (Go NAP SACC). SETTING: FCCH in Nebraska, USA. SUBJECTS: FCCH enrolled in the Child and Adult Care Food Program (CACFP; n 208) participated in a pre-post evaluation using Go NAP SACC. RESULTS: At baseline, all FCCH met the minimum childcare standards for fifty-four of fifty-six practices in nutrition and screen time. After the intervention, FCCH demonstrated significant improvement in fourteen of the forty-four Child Nutrition items and eleven of the twelve Screen Time items. However, FCCH providers did not meet best practices at post-intervention. Lowest scores were found in serving meals family-style, promoting visible support for healthy eating, planned nutrition education and written policy on child nutrition. For screen time, lowest scores were reported on the availability of television, offering families education on screen time and having a written policy on screen time. CONCLUSIONS: FCCH in Nebraska were able to strengthen their policies and practices after utilizing Go NAP SACC. Continued professional development and participation in targeted interventions may assist programmes in sustaining improved practices and policies. Considering the varying standards and policies surrounding FCCH, future studies comparing the current findings with childcare centres and non-CACFP programmes are warranted.

Participation in the Child and Adult Care Food Program Is Associated with Healthier Nutrition Environments at Family Child Care Homes in Mississippi.

OBJECTIVE: Describe foods and beverages offered, nutrition practices, and nutrition policies of family child care homes in Mississippi and differences by participation in the Child and Adult Care Food Program (CACFP). DESIGN: Cross-sectional study conducted between fall, 2015 and spring, 2016. SETTING: Mississippi. PARTICIPANTS: Random, stratified sample of 134 family child care homes that enroll 3- to 5-year-olds. Providers completed a modified version of the Environment and Policy Assessment and Observation-self-report tool. VARIABLES MEASURED: Foods and beverages offered at lunch, provider practices regarding nutrition, and presence or absence of written nutrition policies. ANALYSIS: Descriptive statistics, likelihood ratio chi-square, and t tests. RESULTS: Most homes (>75%) provided components from the fruit, vegetable, grain/bread, meat/meat alternative, and milk food groups at lunch. At some homes, the food and beverage selections offered were high in fat, sugar, and refined grains. Providers at CACFP-participating homes (P < .05) reported healthier beverage selections, more healthful nutrition practices, and more written nutrition policies compared with providers at non-CACFP homes. CONCLUSION AND IMPLICATIONS: Interventions and regulatory standards are needed, particularly in non-CACFP homes, to ensure that food and beverage offerings, provider practices, and policies regarding nutrition support the development of healthful dietary behaviors in early childhood.

Cambios alimenticios en mujeres morelenses migrantes a Estados Unidos / Dietary changes in mexican women migrating to the U.S.

OBJETIVO: Describir la modificación de la alimentación y los procesos involucrados en la incorporación de nuevos alimentos, en mujeres mexicanas con experiencia migratoria hacia Estados Unidos de América. MATERIAL Y MÉTODOS: Estudio cualitativo basado en la teoría fundamentada, en el cual participaron mujeres con experiencia migratoria, residentes de zonas rurales de municipios del Estado de Morelos. Los datos fueron obtenidos a partir de 47 entrevistas en profundidad, realizadas entre febrero de 2005 y julio de 2006. RESULTADOS: La alimentación de las mujeres se modifica a partir de la experiencia migratoria, ya que se incrementa la cantidad de su consumo durante su estancia en Estados Unidos. Continúan cocinando comidas tradicionales mexicanas, pero incorporan alimentos del país de destino, lo cual se ve favorecido por el mayor poder de compra, aspectos laborales, y el acceso tanto a otro tipo de productos alimentarios, como a los diferentes espacios en los que se expende comida. CONCLUSIONES: Es necesario profundizar en la relación de alimentación-migración en el contexto de México-Estados Unidos-México y en su impacto sobre la salud de las mujeres, además de proponer políticas públicas dirigidas a fortalecer sus hábitos saludables.

OBJECTIVE: To describe the dietary changes and processes involved in the incorporation of new foods, in Mexican women with a migratory experience to the U.S. MATERIAL AND METHODS: A qualitative study was conducted, based on grounded theory, of women who had had a migratory experience and were residing in rural zones of the state of Morelos, Mexico. The data were obtained from 47 in-depth interviews carried out from February, 2005 to July, 2006. RESULTS: The women's diet is modified by the migratory experience and the amount of consumption increases during their stay in the U.S. They continue cooking traditional Mexican meals but incorporate foods from their country of destination. These changes are favored by the greater purchasing power, work-related aspects and availability of products and spaces where food is sold. CONCLUSIONS: We need to go deeper into the relationship between food and migration in the context of Mexico - U.S. - Mexico migration and its impact on women's health. We also need to propose public policies geared towards strengthening healthy habits.

Atitutes e percepções em terapia nutricional entre médicos intensivistas: um inquérito via internet / Intensive care physicians' attitudes and perceptions on nutrition therapy: a web-based survey

OBJETIVO: Terapia nutricional é elemento importante no cuidado ao paciente grave. Mesmo reconhecida enquanto especialidade, a existência de equipes multidisciplinares ainda é escassa nas unidades terapia intensiva. Possivelmente a aplicação de cuidados em terapia nutricional seja variada entre intensivistas. O objetivo do estudo foi descrever percepções destes especialistas sobre atitudes e práticas em terapia nutricional enteral. MÉTODOS: Elaboramos questionário em plataforma on-line. Após fase de pré-validação, o instrumento foi distribuído via eletrônica. Após 30 dias as respostas foram computadas, considerando-se apenas os formulários completos. RESULTADOS: Cento e quatorze formulários foram devolvidos, 112 foram analisados. Os respondedores concentraram-se predominantemente na região sudeste do país. Sobre a instituição do suporte enteral, a maioria das respostas reflete percepções coadunadas às orientações de sociedades de especialistas. Os respondedores percebem frequentemente a aplicação de protocolos assistenciais relativos aos cuidados nutricionais. Após o início dos cuidados nutricionais, a percepção dos respondedores sobre a participação em modificações no plano terapêutico nutricional aparenta ser menor. O auto-conhecimento sobre o tema "terapia enteral" entre os respondedores foi quantificado em 6,0 (média aritmética), em escala de 1 a 10. CONCLUSÕES: Mais estudos para avaliação de práticas nutricionais entre médicos intensivistas são necessários. Alternativas à distribuição via plataforma on-line devem ser consideradas. Possivelmente intensivistas lidam melhor com as fases iniciais de instituição dos cuidados com nutrição enteral do que em relação à continuidade dos cuidados ou mudança na programação nutricional. Médicos intensivistas percebem em geral conhecimento sub-ótimo sobre o tema terapia nutricional enteral.

OBJECTIVE: Nutritional therapy is an important element in critical ill patient care. Although recognized as specialty, multidisciplinary teams in nutrition support are scarce in our country. Possibly, nutrition support therapy is applied by intensive care physicians and this may vary. The aim of the study is describe these specialists perceptions about theirs attitudes in enteral nutrition support. METHODS: A questionnaire was elaborated in an on-line platform. After pre-validation, it was sent by electronic mail to intensivists. In 30 days answers were collected, considering only the full-filled questionnaires. RESULTS: One hundred an fourteen forms were returned, 112 were analyzed. The responders were localized at majority in southeastern region. About beggining of nutritional support, the majority of answers reflect perceptions in accord to specialists societies recommendations. The responders' perception the frequent utilization of assistentials protocols in nutrition care. After support beginning, the responders perceptions about theirs participation in changes in therapeutic plan seems to be lower. The self-knowledge about the theme among the responders was 6.0 (arithmetic media) in a 1 to 10 scale. CONCLUSIONS: More studies are necessary to evaluate nutritional support practices among intensive care physicians. Alternatives to on-line platform should be considered. Possibly, intensive care physicians do better in the initial phases of enteral support than in continuity of care. Intensive care physicians knowledge about the issue is suboptimal.