Influential factors of caregiver behavior at mealtime: a study of 24 child-care programs.

OBJECTIVE: To measure the nutrition knowledge and attitudes of caregivers in child-care programs and to observe the behaviors of caregivers as they interact with children at mealtime. DESIGN: A nonexperimental research design. Nutrition knowledge and attitudes toward nutrition were measured using survey methodology designed for this study. Observers measured caregiver behavior by means of observation and quantified it using a behavior checklist. Interrater reliability was 98%. Instruments were piloted and content validity was established. Using Cronbach's alpha, reliability was .69 and .67, respectively. SUBJECTS/SETTING: Participants were 113 caregivers in 24 licensed child-care programs in three counties in Illinois. STATISTICAL ANALYSES PERFORMED: The independent variables (caregiver nutrition knowledge, caregiver nutrition attitudes, years of teaching, prior nutrition training, and education level) were correlated to the dependent variable (caregiver behavior), using the Pearson product moment correlation. The combination of variance from all independent variables was analyzed using the general linear regression model. RESULTS: Although caregivers held beliefs that should have a positive influence on children's eating behaviors, they demonstrated low knowledge of nutrition and displayed behaviors at mealtimes that were inconsistent with their beliefs and expert recommendations. Positive correlations were found between nutrition knowledge and behavior at mealtime, nutrition knowledge and attitudes, and attitudes and caregiver behavior. APPLICATIONS: These instruments can be used to assess and teach nutrition practices through self-assessment, training, and coursework. Results also begin to define the role of the caregiver in children's nutrition practices. Results demonstrate that caregiver behavior can be enhanced by addressing nutrition knowledge and attitudes.

Comparison of Eating Disorder Inventory (EDI-2) scores of male bodybuilders to the male college student subgroup.

The intensity and effort of bodybuilding training suggest an overinvestment in body shape and physical appearance, which has been suggested to be a risk factor for developing eating disorders. The purpose of this study was to investigate the prevalence of eating disorder tendencies among a sample of collegiate male bodybuilders (BB, n = 68) and controls (C, n = 50) (nonbodybuilders), using the Eating Disorders Inventory 2 (EDI-2). T tests were used to test the hypothesis that bodybuilders' scores would be higher than those of controls. The mean scores on the EDI-2 did not indicate the presence of eating disorder tendencies for either group. Controls scored significantly higher than bodybuilders on the Body Dissatisfaction scale. Results indicate that when the EDI-2 is used, college-age male bodybuilders are not shown to be more likely to have eating disorders than a group of college-age male controls.

Lack of significant changes in nutrition-related parameters with tumor necrosis factor treatment of cancer.

Cancer and its therapies frequently produce anorexia and cachexia. In this study, the acute (3 days) and chronic (4 wks) nutrition-related effects of cancer therapy with recombinant human tumor necrosis factor (rHuTNF) were investigated and described. Nutritional status, as measured by body weight and body composition (body fat and lean-to-fat ratio) with use of bioelectrical impedance, did not appear to deteriorate. None of the serum lipids changed significantly, but triglycerides did rise modestly over four weeks of therapy. Glucose and the peptide hormones (insulin, C-peptide, glucagon, and pancreatic polypeptide) thought to affect appetite did not change with rHuTNF therapy. Therefore, although TNF is thought to contribute to wasting in animal models, it had no negative effect on nutritional status in our small sample. The lack of adverse effect noted in this study is possibly due to the low dose level of rHuTNF or to adaptation.

Parenteral nutrition for marrow transplant recipients: evaluation of an increased nitrogen dose.

The use of total parenteral nutrition in bone marrow transplant (BMT) recipients is well recognized. These patients as a result of treatment with chemotherapy and immunosuppressive agents undergo catabolic stress. The metabolic effect of an increased nitrogen dose during total parenteral nutrition (TPN) was studied in 28 BMT patients. Patients were given TPN formulas providing a nitrogen intake of either 267 +/- 44 mg of N/kg/d or 330 +/- 60 mg of N/kg/d. Total calories, nonprotein and protein, were held constant at 40 kcal/kg/d for all patients. Data was collected for three periods posttransplant beginning at 3 days posttransplant through day 16. Both study TPN formulas improved patient weight and TIBC values over baseline. Nitrogen balance (NB) values were not significantly different at any study period. However, an overall group effect favored the H-N formula (p less than 0.01). BMT patients undergo catabolic stress which was reflected by average values of 24-hour urine urea nitrogen increasing from 8.1 +/- 4 g/d at baseline to 19.8 +/- 7.2 g/d at period 3 (p less than 0.01). The H-N formula did not differentially increase blood urea nitrogen or serum creatinine levels. Metabolic cart measures also showed no increase in metabolic rate, oxygen consumption, carbon dioxide production, or percent contribution of protein to total metabolic expenditure. Providing a caloric intake of 40 kcal/kg/d was excessive, where 30 to 35 kcal/kg/d would meet metabolic demands. Pertinent clinical outcomes including length of stay, relapse rate, and survival were monitored, but no conclusions could be drawn in this study. The H-N formula was more effective in reducing loss of lean body mass without causing detrimental metabolic effects in BMT patients.