Evaluation of a pilot volunteer feeding assistance program: Influences on the dietary intakes of elderly hospitalised patients and lessons learnt

Abstract Objectives Disparities in cancer among low-income Americans in the Supplemental Nutrition Assistance Program (SNAP) are well documented. While policies to alter food prices (taxes, subsidies) have demonstrated success at changing dietary intakes, the effectiveness of these policies on reducing cancer burdens and disparities has not been quantified. We aimed to evaluate the effectiveness of population strategies on reducing US cancer burdens and disparities through national or targeted food price policies. Methods A Comparative Risk Assessment (CRA) model was used to assess the effectiveness of 9 different potential policies for reducing cancer burden and disparity among US adults in 2015. These included (1) 5 policies with varying levels (10%, 30%) of subsidies on fruits, vegetables, and whole grains, with and without 10% taxes on sugar-sweetened beverages and processed meats for the general US population, (2) a targeted 30% subsidy in SNAP, and (3) combinations of the general policies and targeted SNAP policy. Data inputs included national demographic and dietary data on the US adult population and SNAP participants from the National Health and Nutrition Examination Survey 2009–2014, cancer incidence from the Surveillance, Epidemiology and End Results (SEER), and policy effects and diet-cancer effects from meta-analyses. Cancer disparities were quantified as the difference in cancer incidence between SNAP participants and higher-income individuals. Uncertainty in each parameter was jointly incorporated using probabilistic sensitivity analysis (PSA) with 1000 simulations. Results All policies reduced cancer burdens, with between ∼5 to 40 new cases per million adults prevented annually (Figure 1). The national 30% subsidy +10% tax produced largest overall benefits, averting an estimated 6875 new cancer cases (28 cases per million US adults) per year. The 10% national tax +30% SNAP-targeted food subsidies produced the largest reduction in cancer disparities (14 more cases averted per million among SNAP vs. higher-income individuals) (Figure 2). Conclusions All national food price policies meaningfully reduced cancer burdens, while SNAP-targeted food price policies, alone or in combination with national policies, reduced cancer disparities. Funding Sources This study was supported by NIH/NIMHD. Supporting Tables, Images and/or Graphs

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199: Correlates of Access to Prostate Cancer Care in a Statewide Public Assistance Program

The Journal of Urology ◽

10.1016/s0022-5347(18)30464-6 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 67-67

Author(s):

David C. Miller ◽

Laura Baybridge ◽

Lorna C. Kwan ◽

Ronald Andersen ◽

Lillian Gelberg ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Care ◽

Public Assistance ◽

Assistance Program

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Zinc Depletion Increases Readmission in Older Patients: An Example of Interactions Between Nutrition and Disease

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000275 ◽

2017 ◽

Vol 87 (1-2) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Salah Gariballa ◽

Awad Alessa

Keyword(s):

Nutritional Status ◽

Inductively Coupled Plasma ◽

Older Patients ◽

Controlled Trial ◽

Prognostic Indicators ◽

Hospitalised Patients ◽

Increased Risk ◽

Co Morbidity ◽

The Impact ◽

Poor Nutrition

Abstract. Background: ill health may lead to poor nutrition and poor nutrition to ill health, so identifying priorities for management still remains a challenge. The aim of this report is to present data on the impact of plasma zinc (Zn) depletion on important health outcomes after adjusting for other poor prognostic indicators in hospitalised patients. Methods: Hospitalised acutely ill older patients who were part of a large randomised controlled trial had their nutritional status assessed using anthropometric, hematological and biochemical data. Plasma Zn concentrations were measured at baseline, 6 weeks and at 6 months using inductively- coupled plasma spectroscopy method. Other clinical outcome measures of health were also measured. Results: A total of 345 patients assessed at baseline, 133 at 6 weeks and 163 at 6 months. At baseline 254 (74%) patients had a plasma Zn concentration below 10.71 μmol/L indicating biochemical depletion. The figures at 6 weeks and 6 months were 86 (65%) and 114 (70%) patients respectively. After adjusting for age, co-morbidity, nutritional status and tissue inflammation measured using CRP, only muscle mass and serum albumin showed significant and independent effects on plasma Zn concentrations. The risk of non-elective readmission in the 6-months follow up period was significantly lower in patients with normal Zn concentrations compared with those diagnosed with Zn depletion (adjusted hazard ratio 0.62 (95% CI: 0.38 to 0.99), p = 0.047. Conclusions: Zn depletion is common and associated with increased risk of readmission in acutely-ill older patients, however, the influence of underlying comorbidity on these results can not excluded.

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Assessment of the Dietary Intakes of 6- and 12-Month-Old Infants in Saudi Arabia

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000250 ◽

2017 ◽

Vol 87 (1-2) ◽

pp. 37-48

Author(s):

Riyadh A. Alzaheb ◽

Norah Alatawi ◽

Khawla A. Daoud ◽

Naema Altawil

Keyword(s):

Vitamin D ◽

Saudi Arabia ◽

Age Groups ◽

Dietary Intakes ◽

Dietary Survey ◽

Daily Energy ◽

Omega 6 ◽

24 Hour Recall ◽

Adequate Nutrient ◽

Selection Of

Abstract.Background: Establishing understanding of infants’ dietary intakes can support interventions to improve their diets and overall health. Because information on the dietary intakes of infants aged ≤12 months in Saudi Arabia is scarce, this study examined the diets of infants aged 6 and 12 months in Saudi Arabia and determined their main dietary sources of total energy and macronutrients. Methods: A crosssectional dietary survey employing a single 24-hour recall was performed between May and December 2015 with a sample of mothers of 278 healthy 6-month-old and 259 12-month-old infants. An analysis of the dietary intake data determined the nutrient intake adequacy and the percentage contributions of foods to energy and macronutrient intakes. Results: The respective mean daily energy intakes of the 6-month-old and 12-month-old infants in the study were 703 kcal and 929 kcal. Both age groups recorded adequate nutrient intakes, with the exception that the 6-month-olds’ mean vitamin D intake fell below the recommended Adequate Intake (AI), and the 12-month-olds’ intakes of omega-6 fatty acids and vitamin D were also below the AI, along with their iron intake which fell short of the Recommended Dietary Allowance (RDA). Conclusion: The data generated here will assist health professionals in planning interventions which aim to improve infants’ diets and to offer guidance to parents on the appropriate selection of food for their infants.

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Minerals Intake Distributions in a Large Sample of Iranian at-Risk Population Using the National Cancer Institute Method: Do They Meet Their Requirements?

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000232 ◽

2015 ◽

Vol 85 (3-4) ◽

pp. 129-144 ◽

Cited By ~ 3

Author(s):

Zahra Heidari ◽

Awat Feizi ◽

Leila Azadbakht ◽

Nizal Sarrafzadegan

Keyword(s):

At Risk ◽

National Cancer Institute ◽

Population Based ◽

Cross Sectional Study ◽

Normal Function ◽

Dietary Intakes ◽

Middle Aged ◽

Cross Sectional ◽

Nutritional Interventions ◽

High Prevalence

Abstract. Background: Minerals are required for the body’s normal function. Aim: The current study assessed the intake distribution of minerals and estimated the prevalence of inadequacy and excess among a representative sample of healthy middle aged and elderly Iranian people. Methods: In this cross-sectional study, the second follow up to the Isfahan Cohort Study (ICS), 1922 generally healthy people aged 40 and older were investigated. Dietary intakes were collected using 24 hour recalls and two or more consecutive food records. Distribution of minerals intake was estimated using traditional (averaging dietary intake days) and National Cancer Institute (NCI) methods, and the results obtained from the two methods, were compared. The prevalence of minerals intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method, the probability approach and the tolerable upper intake levels (UL). Results: There were remarkable differences between values obtained using traditional and NCI methods, particularly in the lower and upper percentiles of the estimated intake distributions. A high prevalence of inadequacy of magnesium (50 - 100 %), calcium (21 - 93 %) and zinc (30 - 55 % for males > 50 years) was observed. Significant gender differences were found regarding inadequate intakes of calcium (21 - 76 % for males vs. 45 - 93 % for females), magnesium (92 % vs. 100 %), iron (0 vs. 15 % for age group 40 - 50 years) and zinc (29 - 55 % vs. 0 %) (all; p < 0.05). Conclusion: Severely imbalanced intakes of magnesium, calcium and zinc were observed among the middle-aged and elderly Iranian population. Nutritional interventions and population-based education to improve healthy diets among the studied population at risk are needed.

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Relationship Between Nutrient Intake and Vitamin D Status in Osteoporotic Women

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.77.6.376 ◽

2007 ◽

Vol 77 (6) ◽

pp. 376-381 ◽

Cited By ~ 12

Author(s):

de Souza Genaro ◽

de Paiva Pereira ◽

de Medeiros Pinheiro ◽

Szejnfeld ◽

Araújo Martini

Keyword(s):

Vitamin D ◽

Mineral Metabolism ◽

Sodium Intake ◽

Serum Vitamin ◽

Cross Sectional Study ◽

Dietary Intakes ◽

Mineral Density ◽

Cross Sectional ◽

Serum Vitamin D ◽

Dietary Records

Vitamin D is essential for maintaining calcium homeostasis and optimizing bone health. Its inadequacy is related to many factors including dietary intake. The aim of the present study was to evaluate serum 25(OH)D and its relationship with nutrient intakes in postmenopausal Brazilian women with osteoporosis. This cross-sectional study comprised 45 free-living and assisted elderly at São Paulo Hospital. Three-day dietary records were used to assess dietary intakes. Bone mineral density was measured with a dual-energy X-ray absorptiometer (DXA). Blood and urine sample were collected for analysis of biochemical markers of bone and mineral metabolism. Insufficiency of vitamin D was observed in 24.4% of the women and optimal levels (≥ 50 nmol/L) were observed in 75.6%. Parathyroid hormone was above the reference range in 51% of the participants. The mean calcium (724 mg/day) and vitamin D (4.2 μ g/day) intakes were lower than the value proposed by The Food and Nutrition Board and sodium intake was more than two-fold above the recommendation. Higher levels of serum 25(OH)D were inversely associated with sodium intake. Dietary strategies to improve serum vitamin D must focus on increasing vitamin D intake and should take a reduction of sodium intake into consideration.

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Higher Dietary Acidity is Associated with Lower Bone Mineral Density in Postmenopausal Iranian Women, Independent of Dietary Calcium Intake

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000207 ◽

2014 ◽

Vol 84 (3-4) ◽

pp. 0206-0217 ◽

Cited By ~ 8

Author(s):

Seyedeh-Elaheh Shariati-Bafghi ◽

Elaheh Nosrat-Mirshekarlou ◽

Mohsen Karamati ◽

Bahram Rashidkhani

Keyword(s):

Calcium Intake ◽

Dietary Calcium ◽

Dietary Calcium Intake ◽

Dietary Intakes ◽

Iranian Women ◽

Acid Base Balance ◽

Mineral Density ◽

Acid Base ◽

Base Balance ◽

Dietary Acid

Findings of studies on the link between dietary acid-base balance and bone mass are relatively mixed. We examined the association between dietary acid-base balance and bone mineral density (BMD) in a sample of Iranian women, hypothesizing that a higher dietary acidity would be inversely associated with BMD, even when dietary calcium intake is adequate. In this cross-sectional study, lumbar spine and femoral neck BMDs of 151 postmenopausal women aged 50 - 85 years were measured using dual-energy x-ray absorptiometry. Dietary intakes were assessed using a validated food frequency questionnaire. Renal net acid excretion (RNAE), an estimate of acid-base balance, was then calculated indirectly from the diet using the formulae of Remer (based on dietary intakes of protein, phosphorus, potassium, and magnesium; RNAERemer) and Frassetto (based on dietary intakes of protein and potassium; RNAEFrassetto), and was energy adjusted by the residual method. After adjusting for potential confounders, multivariable adjusted means of the lumbar spine BMD of women in the highest tertiles of RNAERemer and RNAEFrassetto were significantly lower than those in the lowest tertiles (for RNAERemer: mean difference -0.084 g/cm2; P=0.007 and for RNAEFrassetto: mean difference - 0.088 g/cm2; P=0.004). Similar results were observed in a subgroup analysis of subjects with dietary calcium intake of >800 mg/day. In conclusion, a higher RNAE (i. e. more dietary acidity), which is associated with greater intake of acid-generating foods and lower intake of alkali-generating foods, may be involved in deteriorating the bone health of postmenopausal Iranian women, even in the context of adequate dietary calcium intake.

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