Supporting family meal frequency: Screening Phase results from the Simply Dinner Study.

We aimed to test main, additive, interactive effects, and feasibility of all possible combinations of six intervention components implemented for 8 weeks (Cooking/Serving Resources; Meal Delivery; Ingredient Delivery; Community Kitchen; Nutrition Education; Cooking Demonstrations). Primary outcomes were family meal frequency and preschoolers' dietary quality; secondary outcomes included family meal preparation type, meal preparation barriers, family functioning, and kitchen inventory adequacy. All possible intervention combinations were tested using a randomized factorial trial design in the first phase of a Multiphase Optimization Strategy (MOST). Feasibility was assessed via attendance, delivery logs, and satisfaction. Parent-reported data collection included: socio-demographics, frequency and type of family meals; preschooler dietary intake; perceived barriers to meal planning and preparation; assessment of family functioning; and a kitchen inventory of materials generally needed for meal preparation. Participants (n = 499) were recruited at two Head Start agencies in mid-Michigan with data collection and delivery of some intervention components in participants' homes. Promising intervention bundles were identified by evaluating pre-to post-intervention effect sizes. The combination of Cooking/Serving Resources and Meal Delivery increased family meal frequency (Cohen's d = 0.17), cooking dinner from scratch (d = 0.21), prioritization of family meals (d = 0.23), and kitchen inventory (d = 0.46) and decreased use/consumption of ready-made (d = -0.18) and fast foods (d = -0.23). Effects on diet quality were in the expected direction but effect sizes were negligible. Community Kitchen, Nutrition Education, and Cooking Demonstration showed poor feasibility due to low attendance while Ingredient Delivery was infeasible due to staffing challenges related to its labor intensity. Additionally, although not one of our pre-specified outcomes, Cooking/Serving Resources (RR = 0.74) and Meal Delivery (RR = 0.73) each decreased food insecurity. Cooking/Serving Resources combined with Meal Delivery showed promise as a strategy for increasing family meal frequency.

Effectiveness of differing levels of support for family meals on obesity prevention among head start preschoolers: the simply dinner study.

BACKGROUND: Despite slight decreases in obesity prevalence in children, nearly 25% of preschool-aged children are overweight or obese. Most interventions focused on promoting family meals as an obesity-prevention strategy target meal planning skills, knowledge and modeling of healthy eating without addressing the practical resources that enable implementation of family meals. There is a striking lack of evidence about what level of resources low-income parents need to implement family meals. This study will identify resources most effective in promoting family meals and, subsequently, test associations among the frequency of family meals, dietary quality and children's adiposity indices among children enrolled in Head Start. METHODS: The Multiphase Optimization Strategy, employed in this study, is a cutting-edge approach to maximizing resources in behavioral interventions by identifying the most effective intervention components. We are currently testing the main, additive and interactive effects of 6 intervention components, thought to support family meals, on family meal frequency and dietary quality (Primary Outcomes) as compared to Usual Head Start Exposure in a Screening Phase (N = 512 low-income families). Components yielding the most robust effects will be bundled and evaluated in a two-group randomized controlled trial (intervention and Usual Head Start Exposure) in the Confirming Phase (N = 250), testing the effects of the bundled intervention on children's adiposity indices (Primary Outcomes; body mass index and skinfolds). The current intervention components include: (1) home delivery of pre-made healthy family meals; (2) home delivery of healthy meal ingredients; (3) community kitchens in which parents make healthy meals to cook at home; (4) healthy eating classes; (5) cooking demonstrations; and (6) cookware/flatware delivery. Secondary outcomes include cooking self-efficacy and family mealtime barriers. Moderators of the intervention include family functioning and food security. Process evaluation data includes fidelity, attendance/use of supports, and satisfaction. DISCUSSION: Results will advance fundamental science and translational research by generating new knowledge of effective intervention components more rapidly and efficiently than the standard randomized controlled trial approach evaluating a bundled intervention alone. Study results will have implications for funding decisions within public programs to implement and disseminate effective interventions to prevent obesity in children. TRIAL REGISTRATION: Clincaltrials.gov Identifier NCT02487251 ; Registered June 26, 2015.

Terapia nutricional em pacientes grandes queimados – uma revisão bibliográfica / Nutritional therapy in big burn patients – a bibliographic review

As queimaduras são lesões parciais ou totais da pele, podem ser classificadasquanto à etiologia em térmicas, elétricas, químicas e por radiação, podendo resultar em graves alterações fisiológicas, metabólicas, hormonais e imunológicas. Com o objetivo de investigar qual a terapia nutricional mais indicada em relação à conduta nutricional em pacientes grandes queimados, realizou-se uma revisãobibliográfica, na qual se verificou quais os nutrientes que estão envolvidos naviabilização do processo de recuperação destes pacientes. O resultado da revisãosugere que o suporte nutricional adequado interfere positivamente na recuperação dos pacientes grandes queimados; a escolha da via de administração depende da situação do paciente, sendo fundamental o cálculo da quantidade de energia, proteínas, carboidratos, lipídios, vitaminas e minerais. Os nutrientes de maior destaque são as proteínas, glutamina, arginina, vitamina A, vitamina C, vitamina E, selênio e o zinco. Sobretudo, até o momento não há uma conclusão referente às doses específicas e propícias para o tratamento de pacientes grandes queimados, necessitando de mais estudos.

The burns are partial or total lesions of skin, can be classified as the etiology in thermal, electrics, chemicals and by radiation, may result in severe physiological, metabolics, hormonals and immunologics changes. With the objective to investigate which is the most indicated nutritional therapy in relation to conduct nutritional in big burn patients, we did a bibliographic review, where checked which nutrients that are involved in the viability of the recovery process of these patients. The result of the review suggest that the adequate nutritional support interfere positively in the recovery of the big burn patients, where the choice route of administration depends of the patient situation, being fundamental calculating of the quantity of energy, proteins, carbohydrates, lipids, vitamins and minerals. Nutrients most prominent are the proteins, glutamine, arginine, vitamin A, vitamin C, vitamin E, selenium and the zinc. Especially until the moment there isn’t a conclusion referring to specific doses and conducive for the treatment of big burn patients, requiring more studies.