Exam 4- Nutrition Education and Nutrition Programs Flashcards
(62 cards)
1
Q
Food Choice Influences
A
•Biological factors Born liking sweet, fullness cues •Experiences with food Parenting practices –“clean your plate” •Personal factors Cultural norms; Motivations-e.g. health •Environmental factors Availability; Advertising
2
Q
Nutrition Education- What it is not…
A
- Medical nutrition therapy
- Expert knowledge transfer
- Telling people what to do
- Prescriptive or one-size-fits all
3
Q
Nutrition Education- What it is…
A
•Any combination of educational strategies
,•Accompanied by environmental supports,
•Designed to facilitate voluntary adoption of food choices,and other food and nutrition-related behaviors conducive to health & well-being,
•Delivered through multiple venues,
•And involves activities at the individual, community and policy levels.
•AND -Evidence-informed or evidence-based.
4
Q
Teaching Nutrition, vs. Nutrition Educators?
A
Skills & knowledge: •Food and nutrition content •Eating behavior •Health behavior, learning theories •Design/delivery of nutrition education •Research methods, program evaluation
5
Q
Organizations
A
Society for Nutrition education and behavior
Academy of Nutrition and Dietetics
6
Q
Settings for education
A
•Homes (one-on-one, or with family) •Workplaces & schools •Health care •Community & public health settings •WIC •Meals for low-income seniors (Administration on Aging) •Food pantries •Farmers markets• And more....
7
Q
Cooperative Extension Nutrition-Scope
A
•Nutrition (recently, physical activity), AND•Food Safety•Budgeting•Recipes/Cooking•Policy
8
Q
Cooperative Extension Nutrition- Audience
A
- Diversity•Culture•Family structure
- Socioeconomic Status
- Life Stage: Infant, Child, Adolescent, Adult, Pregnant, Elderly
9
Q
Health Behavior Theories Examples
A
- Stages of Change: precontemplation, preparation, action and maintenance
- Theory of Planned Behavior: Attitude, norm, control leads to intention and then behavior
- Socioecological model
10
Q
Teaching Methods-Adult learning & learner centered
A
- Mutual partnership of educator & learner(s)
- Participatory learning-learners involved in determining content, teaching, evaluation
- Learners identify what they know and practice, and what they want to learn
- Learner speaks 50% of the time (groups-to each other as well as educator)
- Learner’s experience valued-what knows, what wants to learn
- Learning put into learner’s context/situation
- Varied learning styles accommodated
- Interdisciplinary
11
Q
Eating Smart, Being Active Curriculum
A
- Welcome
- anchor - see what people know
- Add(information)
- Apply(put it in context)
- Being active
- Let’s taste it! (Also an apply!)
- Review
- Away(includes goal setting)- handout
12
Q
Program planning-Logic model
A
- Situation
- Inputs
- Outputs
- Outcomes or Impacts
- Assumptions
- External factors
- Evaluation
13
Q
Evaluation- Are the goals and objectives met?
A
Types •Formative-develop or improve existing education •Summative-assess education was effective (or not), and why/why not •Process-delivered as intended? For Whom •Educators •Sponsor/funder •Participants By Whom •Educator •Evaluator •Internal or third party
14
Q
USDA Food and Nutrition Service- Mission
A
To increase food security and reduce hunger in
partnership with cooperating organizations by
providing children and needy families better access to
food, a healthful diet, and nutrition education in a
manner that supports American agriculture and
inspires public confidence.
15
Q
Participation in nutrition programs
A
About 1 in every 4 Americans participates in at least 1 of the 15 domestic food and nutrition assistance programs of the U.S.
16
Q
SNAP Program Overview
A
Foundation of America’s national nutrition safety net and
first line of defense again hunger.
• Pilot started by JFK in 1961 @ $19 million
• Johnson made permanent program in 1964
• Entitlement program
• Provides electronic monthly benefits for eligible participants to purchase food items at authorized food stores.
• Eligibility based on income, assets, immigrant status (in U.S.
>5 years) and/or ability to work.
• Administration at state level
17
Q
SNAP Eligibility
A
Household gross ``income <130% FPL
• Household net income <100% FPL
• Most households can have up to $2,000 in countable
resources; $3,000 for disabled indiv. and >60 yrs
• Able bodied adults (16-60) must register for work, go to
employment/training programs, and accept/continue “suitable employment.”
18
Q
SNAP Allotments
A
•Monthly allotment of SNAP benefits based
on the Thrifty Food Plan
•Average household size: 2.2
•Average monthly benefit/person ~$125
•Monthly benefits may fall short in covering avg. cost of low cost meal
• The average cost of a meal across the continental US and DC is $2.36, 27 percent higher than the maximum SNAP benefit per meal of $1.86.
19
Q
SNAP Benefits
A
• SNAP benefits can be used to purchase all foods intended to be eaten at home
•Not allowed: alcoholic beverages, cigarettes, foods hot
at point of sale, non-food items, vitamins or medicines
and pet foods
•What to call “food” is controversial
20
Q
Impact of SNAP on Food Insecurity
A
64% to 54% food insecure in 6 mo
21
Q
SNAP reduces poverty
A
greatest for children, severity of greatest
SNAP households acquire as many calories as nonSNAP
households while spending fewer dollars.
22
Q
SNAP & Diet Quality compared to others
A
less veges less whole grains and fruit eat less sodium eat more refined grains and empty calories less seafood and plant protein
23
Q
Foods Typically Purchased by SNAP
Households (USDA, 2016)
A
• 40 cents of every dollar spent on basic items (meat, FV, milk, eggs, bread) • 20 cents of every dollar spent on SSB, desserts, salty snacks, candy, sugar • Top 10 spending categories were same for SNAP and non-SNAP HH
24
Q
Nutritional Quality by Source of Food
A
- most for everyone is large grocery stores
- less restaurants for SNAP
- more for schools
25
SNAP Household Food Expenditures
SNAP eats less away from home
-48% at home from benefits, 25% away from home
Cyclic purchasing
-greatest spending on days 0-1
26
WIC
| Mission:
To safeguard the health of low-income women, infants,
and children through age 4 who are at nutritional risk.
•WIC provides nutritious foods to supplement diets,
nutrition education, and referrals to health care and
other social services
• Established in 1972
27
WIC Overview
•USDA’s third-largest food and nutrition
assistance program (based on expenditures)
•100% Federally Funded (no state match
required)
•Discretionary program – not an entitlement
program
28
WIC Participation
increased in 2008
| 2010-now: decreased due to decreasing birth rates and changes in program
29
WIC Participant Eligibility
```
Categorical
• Pregnant
• Non-bf woman up to 6mo
postpartum
• BF woman up to 1yr postpartum
• Infant up to 1st birthday
• Child up to 5th birthday
Residential
• Must reside in state where eligibility
is established
Income
• Household income <185% FPL
• May use current income or past 12
mo
• SNAP, Medicaid, TANF participants
are automatically deemed eligible
Nutritional Risk
• As determined by health professional
(MD, RD, RN, etc)
• Ht/wt/blood test for anemia
administered to all >9mo
```
30
5 Major types of nutritional risk
1. Abnormal nutritional conditions detectable by biological
or anthropometric measurements (anemia, underweight,
overweight)
2. Nutritionally related medical conditions (metabolic
disorders, nutrient deficiency dx)
3. Dietary deficiencies (inadequate dietary patterns)
4. Conditions that directly affect the nutritional health of a
person (alcoholism, drug abuse)
5. Conditions that predispose a person to inadequate
nutritional patterns or nutritionally related medical
conditions (migrancy, homelessness)
31
WIC Program Delivery
•Highest priority for pregnant & breastfeeding
women and infants at nutritional risk for nutritionrelated
medical conditions.
• Lower priority for older children (4-5) and nonbreastfeeding-postpartum
women
• Supplemental food packages (Approx. $41 per
month)
•Nutrition education
•Health care and social services referrals (Medicaid,
immunizations, SNAP, etc)
32
WIC Food Packages
• Allow appropriate substitutions for whole grain bread
• Whole grain tortillas
• Brown rice
• Other whole grains, as appropriate (whole grain oatmeal & grits)
• Allow substitutions for milk
• Soymilk
• Tofu if appropriate
• Lactose free milk or buttermilk
• Allow a variety of canned fish in addition to tuna for fully BF
woman (salmon, sardines, etc)
• Allow substitutions for beans:
• Canned beans as substitute for dry beans
• Variety of beans including kidney, pinto and lentils
33
WIC & Breastfeeding
•WIC mothers choosing to breastfeed get special
counseling, educational materials, and follow
-up
support through peer counselors.
•Breastfeeding mothers are eligible to participate in
WIC longer than non
-breastfeeding mothers.
•Mothers who exclusively breastfeed receive an
enhanced food package.
•Breastfeeding mothers can receive breast pumps,
breast shells or nursing supplementers to help
support the initiation and continuation of
breastfeeding.
34
Nutrition Education- WIC
•Available to all participants •At least 2 nutrition education sessions during each 6
month period is required
•Nutrition education designed to reach 2 broad
goals: • Emphasize relationship between nutrition, PA and health • Assist individuals at nutritional risk improve their health
status and achieve a positive change in dietary and
physical activity habits
•All pregnant participants are encouraged to BF,
unless contraindicated for health reasons
35
WIC and Dietary Quality
•WIC is positively associated with gestational age
and mean birth weight.
•Improved estimates of low and very low birth
weight (unadjusted for gestational age) with WIC
•WIC associated with improved diets, including
increased iron density, fewer added sugars, and
greater variety of foods.
• Lower breastfeeding rates among WIC
participants; negative to no association.
•Greater use of preventative care services
36
Impact of WIC Food Package
| Revision
Improvement in availability and variety of healthy foods in retail food
outlets
• Improvements in dietary behaviors
• Increased consumption of whole-grain food
• Decreased consumption of whole milk
• Increased consumption low-fat diary
• Increased consumption of fruits and vegetables
• Increased rates of BF initiation
• Delayed introduction of solid foods after 4 mo
• Reduction in 2-4 y/o obesity
37
Other benefits to WIC
* Premature births reduced
* Low birthweight reduced
* Long-term medical expenses reduced
38
WIC Farmers’ Market Nutrition
| Program
* Provides up to $10 - $30 in vouchers per family for fresh fruits, vegetables and herbs at authorized farmers’ markets and roadside stands.
* Two goals:
* provide fresh, nutritious, unprepared, locally grown fruits and vegetables
* expand consumers’ awareness, use of, and sales of farmers markets
* Available in 45 states
39
Child nutrition programs
Provide healthy meals to children
Fight hunger and obesity
Promote health and educational readiness
40
2010 Child Nutrition
| Reauthorization Act
Healthy Hunger-Free Kids Act (HHFKA)
Signed into law December 2, 2010
Expired September 30, 2015
Improves nutrition
Increases access
Improved program monitoring and integrity
Includes $4.5 billion in new funding over 10 years
41
National School Breakfast and Lunch Eligibility
Free meals for household income <130% FPL
Reduced price meals for household income
between 130% to 185% FPL
Students in households receiving SNAP, Medicaid, or foster parent households are automatically eligible for free meal participation (direct certification)
Community Eligibility Provision: FREE B&L to all students in high-poverty communities
42
NSLP and SBP Participation
NSLP
30 million children
67% free
SBP
14.7 million children
79% free
43
NSLP Meal Reimbursement
Reimbursement Rates FY18*
Free: $3.23
Reduced Price: $2.83
Paid: $0.31
HHFKA provided additional funding to schools meeting updated nutritional standards ($0.06/meal)
Schools certified as meeting the new nutrition standards receive an additional $.06 per lunch.
An additional $.02 per lunch is provided to schools in which 60 percent or more of the second preceding school year lunches were served free or reduced price.
44
School Nutrition Standards
HHFKA gave USDA authority to establish nutrition standards for all foods sold in school
Nutrition standards updated to match Federal Dietary Guidelines for Americans
45
Nutrition Standards for School Meals Programs
| select provisions
Offer fruits and vegetables as two separate meal components
Offer fruit daily at breakfast and lunch
Offer vegetables daily at lunch, including specific vegetable subgroups weekly (dark green, red orange, legume, other, and starchy)
Students required to take half-cup serving of fruits or vegetables with every breakfast and lunch
All grains must be whole grain-rich
Offer a daily meat/meat alternative at breakfast
Fat-free (unflavored and flavored) and low-fat milk (unflavored only)
Reduce sodium content over 10-year period
0 grams trans fat
<10% calories from saturated fat
Free drinking water must be available
46
New Meal Pattern Additions:
| Grade levels and Calorie Requirements
Grade Level:
PK-5 (ages 4-10)
Calorie Ranges:
Breakfast: 350-500
Lunch: 550-650
Grade Level:
6-8 (ages 11-13)
Calorie Ranges:
Breakfast: 400-550
Lunch: 600-700
Grade Level:
9-12 (ages 14-18)
Calorie Ranges:
Breakfast: 450-600
Lunch: 750-850
47
Additional Provisions (select
```
Smart Snacks
Nutrition Standards for competitive foods
Local Wellness Policies
Written wellness policy required
Farm to School
Improve access to local foods
```
48
Smarter Lunchrooms
```
Strategies
Focus on fruit
Vary the veggies
Highlight the salad
Move more white milk
Reimbursable meals
Lunchroom atmosphere
Student involvement
School involvement
```
49
Child and Adult Care Food Program (CACFP)
Subsidizes healthy meals and snacks in participating:
Child care Centers
Day care homes
Adult day care facilities
Emergency shelters
Afterschool care programs
Wellness, healthy growth and development of young children
Health and wellness of older adults and chronically impaired disabled persons
50
CACFP Eligibility
Centers:
Free meals for household income <130% FPL
Reduced price meals for household income
< 185% FPL
Day Care Homes:
Located in a geographic area that is shown to be low income by local school data or by census data
Categorical eligibility:
SNAP, FDPIR, TANF, Head Start, foster children, and adults who receive SNAP, FDPIR, SSI, or Medicaid
51
CACFP Participation
2 billion meals served
| Child care centers = 72% meals served
52
CACFP Meal Pattern
| select provisions
New meal pattern – required starting October 1, 2017 (first revision since 1968)
Increase variety of fruits and vegetables
More whole grains
More protein options
Less sugar and fat
Age appropriate meals
Improve access to healthy beverages
2 meals + 1 snack OR 2 snacks + 1 meal (per child each day)
= reimbursable
53
Afterschool Nutrition Programs
National School Lunch Program At-Risk Afterschool Snack Program
Child and Adult Care Food Program At-Risk Afterschool Meals
54
Summer Food Service Program
Nutritious meals when school is not in session
Eligibility:
Site in area where at least half of children come from families with incomes at or below 185% FPL
More than half the children attending the site meet income eligibility criteria
ALL children under 18 eat free meals at SFSP sites
Seamless Summer Option
55
Fresh Fruit and Vegetable Program
```
FREE fresh fruits and veggies to children during the school day
Introduce NEW fruits and veggies
Increase acceptance and consumption
of FRESH, unprocessed produce
Prioritizes schools with highest
percentage of students eligible for
free or reduced price meals
```
56
Special Milk Program
Provides milk to children who do not participate in other Federal meal service programs or to children who do not have access to the school meal programs.
57
Impact of HHFKA
```
Kids eating more fruits and vegetables
Nutritional quality of school meals improved
No affect on school lunch participation
School lunch revenue is up
Food waste decreased
```
58
Current Events
Interim Final Rule: Flexibilities for Milk, Whole Grains, and Sodium Requirements1
Flavored, low-fat (1 percent fat) milk
Include grains that are not whole grain-rich
Retaining Sodium Target 1
Progress of Child Nutrition Reauthorization Act
Senate Ag Committee
House Education & the Workforce Committee
Entitlement vs. Block Grants
59
Nutrition Education is
any combination of educational strategies,accompanied by environmental supports,designed to facilitate voluntary adoption of food choices and other food- and nutrition-related behaviors conducive to health and well-being. Nutrition education is delivered through multiple venues and involves activities at the individual, community, and policy levels
60
Growing Together WI:
collaboration between FoodWIse education staff and Master Gardener Volunteers to promote healthy food access and availability through garden spaces
61
Safe and Healthy Food Pantries
PSE effort to provide food pantries with guidance on how to improve the nutritional quality and safety of their food inventories.
62
Healthy Retail:
PSE effort to help food retailers market healthy foods in their stores.
