An Examination of Medically Necessary Diets within the Framework of the Thrifty Food Plan.

The Thrifty Food Plan (TFP) determines the maximum allotment of nutrition assistance for over forty million Americans participating in the Supplemental Nutrition Assistance Program (SNAP). This research recalculates the official TFP allocations using a more straightforward model that minimizes cost subject to nutrient constraints to establish a baseline for adult females and males. We then examine three additional diet plans to evaluate their feasibility under the current SNAP benefit allotment: a diet for lactose intolerance, for persons with type 2 diabetes, and a diet for pregnant women. The first model calculates a diet plan that contains no fluid milk, taking into account that 1 in 4 Americans is lactose intolerant. The second model calculates a diet plan that is lower in carbohydrates (grains and fruits comprise less than 45% of calories), reflecting a recommended diet for a person with type 2 diabetes, approximately 10% of the U.S. population. The third model includes the Institute of Medicine's recommended diet for pregnancy. In each case, total daily cost per individual and allocation across food groups were compared. Our Lactose Intolerance, Type 2 Diabetes, and Pregnancy model for 20-50 year old females all return minimum food costs above the TFP budget allocation. This research demonstrates how the TFP provides an unrealistic assessment of need among 20-50 year old females with relatively common dietary needs. Results indicate that equalizing the TFP budget allocations between men and women would better accommodate the heterogeneous needs of America's poorest individuals.

[Lactose intolerance: past and present. Part II]. / A laktózintoleranciáról: Múlt és jelen - II. rész.

The author summarises the interrelations between lactose intolerance, calcium and vitamin D metabolism and osteoporosis. Lactose intolerance enhances the risk of forearm and hip fractures in some patients. Lactase gene genotype and fracture risk are related in some populations. Calcium and vitamin D supplementation increase bone mineral content and they are justified in children, during pregnancy and lactation, and in postmenopausal women. The intake of milk and milk products could increase the risk of ovarian carcinoma. CC genotype of the lactase gene increased the risk of colorectal carcinoma in Finns; no such effect was observed in British, Spanish and Italian patients. Even small quantities of lactose in drugs (10-750 mg) could elicit intolerance symptoms due to individual susceptibility. In spite of public knowledge and advertising, controlled studies did not prove the beneficial effect of either a lactose-free diet, enzyme supplementation or probiotics in an evidence-based manner. While accepted guidelines are lacking, a personalised therapy is mandatory. In spite of increasing public interest in lactose intolerance, many unknown factors must still be studied.

Attitudes, beliefs, and barriers related to milk consumption in older, low-income women.

OBJECTIVE: To determine attitudes, beliefs, and barriers related to adequate milk consumption in low-income women ages ≥ 60 years. METHODS: Nine focus groups were conducted with a convenience sample of 59 women at congregate meal sites in a metropolitan area. Grounded in Social Cognitive Theory, focus group questions were used to explore personal, behavioral, and environmental factors associated with milk consumption. RESULTS: Key response themes indicated a positive attitude for the taste of milk (except for low-fat), a primary belief that milk was important for bones and health, and a primary barrier of gastrointestinal side effects. CONCLUSIONS AND IMPLICATIONS: Knowledge regarding the benefits of milk and the dislike of its taste were not the primary reason for the lack of consumption. Instead, gastrointestinal side effects seemed to be the major barrier to adequate consumption. Future nutrition campaigns should test strategies for lactose intolerance management when communicating with low-income older women.