Donut Day: A Time To Protest Nutrition Efforts?

Ready those cop-slash-confectionery punchlines: Today is National Donut Day. And yes, it's a real thing.

The holiday, which was established by the Salvation Army in 1938 to honor women who served doughnuts in World War I, is typically celebrated with deep-fried freebies.

But this year, one group is trying to make it political.

The Competitive Enterprise Institute, a non-profit group that says it stands for free markets and limited government, is calling for people to eat not one, but two doughnuts today. The idea? To protest what it described in a statement as the "government meddling in Americans' nutritional choices."

"Given the growing government attempts to regulate the childhood obesity problem, we thought this deserved some light-hearted attention," said Sam Kazman, general counsel for the group.

Ultimately, however, he said the issue was serious.

In a phone interview, Kazman called out government efforts to curb salt use. He described Michelle Obama's Let's Move initiative as "overreaching" and said it was based on shaky science, citing a recent Task Force on Childhood Obesity report that says the rapid increase in childhood obesity has slowed. But that same report showed that obesity has more than doubled among adults and tripled in children in the last 30 years.

"We're not saying there's not a problem here," Kazman said. "But for the government to be using childhood obesity as the basis for the wholesale reordering of American lifestyles is a constitutional stretch."

Dr. Marion Nestle, a professor in New York University's department of nutrition disagreed, saying that she believes an important function of the government is to advice the public on healthy eating.

"I wonder why people think it's funny to engage in risky health behavior just to show how independent they are," she said in an email. "Eating two donuts once in a while is not going to hurt anyone. But making a daily practice of eating lots of junk food might well lead to problems later on."

Source: www.huffingtonpost.com

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7:32 PM | 0 comments

The Baby Needs A Nutritious Breakfast Menu

id.custom.yahoo.com

Breakfast is very important for the fulfillment of your baby's nutritional needs. With breakfast, little ready spent his days full of activity. Here are some foods that are suitable for your baby.

1. Cereal and milk
This is the most easy and quick breakfast to serve. Even so, the nutrients in it are very complete. Cereals have protein and fiber are very good for children. Meanwhile, the milk has a complete nutritional needs of children every day.

2. Eggs
Besides containing protein, eggs have a variety of nutrients suitable for children's development, such as vitamins A, B, D, iron, calcium and many more. Eggs are also easy to prepare and mixed into the menu like a child. You can cook hard-boiled eggs, scrambled eggs scrambled, cheese egg omelets, egg sandwiches and much more.

3. Wheat bread
Bread wheat has a higher fiber than regular bread, so it can withstand hunger longer in children. In addition, wheat bread also makes the digestive system of the little more smoothly. You can create a variety of wheat bread sandwiches for breakfast child.

4. Fruit juice
Fruit juices can also be a healthy breakfast menu. Especially if you combine it with milk and honey are rich in nutrients. In addition to delicious, fruit juice also practical.

Source: id.custom.yahoo.com

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6:34 PM | 0 comments

Common sense needed in childhood nutrition guidelines

By Rep. Jean Schmidt (R-Ohio)

We can all agree that childhood obesity in America is a serious problem, and I commend the First Lady for addressing it directly in her “Let’s Move!” campaign to end childhood obesity within a generation. It is a worthwhile and attainable goal and one that I support.

However, lima beans, peas, corn and potatoes predate any kind of childhood obesity epidemic and needlessly attacking them gets us no closer to fixing the issue. What we need is a solution, not a scapegoat.

The United States Department of Agriculture’s “Dietary Guidelines for Americans” serve as the basis for school nutrition standards. The dietary guidelines list potassium, dietary fiber, calcium and vitamin D as “nutrients of concern in American diets,” because people aren’t eating enough of them.

Somebody, somewhere in the USDA, didn’t get the memo.

As a mother and grandmother, I want the best nutrition for my family. As a Member of Congress, I want to be responsible with taxpayer dollars. Fortunately, better nutrition and financial responsibility are not mutually exclusive, especially when it comes to the National School Lunch Program and the School Breakfast Program.

In proposed standards for the school breakfast and lunch programs also issued by USDA in January, a curious thing happened: nutritional recommendations were made that had no basis in science. Instead, recommendations were based on variety and cloaked as nutrition.

How else would you explain the arbitrary limitation of lima beans, peas, corn and potatoes to one cup per week per student in the school lunch program and the complete elimination of them in the breakfast program?

Lima beans are one of the best sources, if not the best source of dietary fiber. Potatoes are the best source of potassium, more than bananas. USDA’s recommendations went beyond those of the National Academy of Sciences’ Institute of Medicine.

One assumption frequently heard that cannot go unchallenged is that all potatoes in schools come in the form of French fries. The truth is they don’t.

Food service technology has made marked improvements over the last decade and most “fries” these days are baked. In fact, of all potatoes served in middle and high schools, only about 15 percent of them are in the form of French fries that are actually fried. In elementary schools, that number drops to about 11 percent. Most school kitchens don’t even have fryers anymore.

At less than $0.05 per serving, the result is an affordable, nutrient-dense food that kids love and that won’t end up in the trash can. Even more, because they are so affordable, serving them allows schools to have greater flexibility for other nutritious menu items.

The proposed changes to the breakfast and lunch programs would have a number of unintended, yet very real consequences. By USDA’s own estimation, the increased costs of the proposed menu changes would be $0.50 per school breakfast and $0.14 per school lunch. Nationwide, this translates to $6.8 billion of increased costs over five years, the bulk of which are associated with this vegetable limitation.

These are real costs that will be only partially offset by the Healthy and Hunger-Free Kids Act passed by the previous Congress that increased the reimbursement rate by $0.06 per meal. The resulting cost difference will be thrust upon the participating schools to make up at a time when they do not have extra funds. 

USDA expects that the difference in cost will be bridged by state funds and by raising the price for school meals for those children who do not qualify for free or reduced-price meals. At its core, USDA’s recommendations would amount to an unfunded mandate. Even worse and not acknowledged by USDA, the increased prices for those kids paying the full price of the school meal will result in fewer participants in the breakfast and lunch programs, undermining the original intent to deliver nutrition to those most in need of it.

There is concern that some schools may discontinue the programs — particularly the breakfasts — if the proposed changes are too cost prohibitive. 

To remove or limit vegetables from schools that our children and grandchildren actually like and will eat is simply misguided. But to make it more difficult for our schools to provide the best nutrition to those most in need of it is more than misguided, it is irresponsible. Fortunately, there is still time for USDA to do the right thing.

Source: thehill.com

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10:49 AM | 0 comments

Triathlon training: Nutrition tips for triathletes

D. Benjamin Satkowiak*

 

Triathlon competition is a physically demanding sport. The body, in effort to keep itself in optimal working condition, relinquishes its precious resources, sapping the life out of even the fittest competitor. Because of this, the nutrition plan of a triathlete must be adequate in conditioning the body, and its systems, for the physical turmoil.

A triathlete can expect to burn anywhere from 4,000-5,000 calories during a single event. During training, the amount is slightly lower, from 2,000 to 3,000 calories, per session. As such, nutritional needs need to be increased accordingly.

The following tips can help improve a triathlete's competition and training, by allowing for greater, more efficient use of energy.

1.) A.M. Nutrition, pt.1: Eat a pre-workout meal at least 2 hours before training, in order to allow for proper digestion.

2.) A.M. Nutrition, pt.2: Approximately 1 hour before your workout, ingest something small, containing carbs, such as an orange or apple, with a handful of nuts or granola.

3.) Hydration: During training or competition conditions, replenishing the body at frequent intervals is necessary. Attempt to drink 4-5 ounces of fluid approximately every 20 minutes, if at all possible.

4.) Avoid Deficits: Approximately every 30-35 minutes, ingest solid calories, such as a sports nutrition or protein bar. If you go too long without substantial amounts of nutrients, your body will become weak and sluggish.

5.) Avoid Painkillers: Many athletes feel the need to take pain relievers, such as Advil or Tylenol, before endeavors, in order to avoid fatigue symptoms. Doing so can cause undue stress on the kidneys.

6.) Stick With The Plan: Stay with what you know. Refuse food and drink you don't normally consume. Never try it on race day.

7.) Carb Loading: The night before an event, store up whole-grain, low-glycemic carbs, such as pasta, or rice. Look to consume several small portions, spread out evenly, every hour for the last 3-4 hours before bedtime.

8.) Fight Waste: Avoid high-fiber meals before events. The last thing you need stomach complications on event day.

9.) After Effects, pt.1: Have a carb-rich meal, within 30-45 minutes of finishing, replacing glycogen stores and replenishing your energy.

10.) After Effects, pt.2: Continue consumption of water and sports drinks. Your body will need several hours to recuperate.

Keep these tips in mind as you train. Never underestimate the importance of diet in triathlon competitions. Treat your body like a Porsche engine and fuel it with the highest-quality ingredients.

*The author, D. Benjamin Satkowiak, is a successful business entrepreneur and personal trainer. All information herein is for educational and entertainment purposes only. Please consult a physician before starting any workout or nutritional program.

source: sports.yahoo.com

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12:46 AM | 0 comments

Pigeon Peas With Mango

This dish is based on a recipe from “660 Curries,” by Raghavan Iyer. I’ve given you the option of using cayenne and sesame seeds instead of Mr. Raghavan’s garam masala, but I encourage you to make the spice mix if you can. You can find pigeon peas and curry leaves in Indian markets. Pigeon peas resemble split yellow peas in color and flavor.

1 heaped cup skinned yellow pigeon peas (toovar or toor dal), preferably the un-oily variety, picked over for stones

1 medium ripe mango, peeled, seeded and chopped

1/2 teaspoon cayenne plus 1 teaspoon ground toasted sesame seeds, or 2 tablespoons Maharashtran sesame-flavored garam masala (see below)

Salt to taste

1/2 teaspoon ground turmeric

10 to 12 curry leaves

2 tablespoons ghee (clarified butter) or canola oil

2 teaspoons cumin seeds

1/4 cup finely chopped cilantro

1. Place the pigeon peas in a medium, heavy saucepan. Cover with 1 inch of water, and roll around the peas. The water will cloud. Drain through a strainer, and return to the pot. Repeat several times until the water is no longer very cloudy when you cover the peas. Drain and return to the pot, then add 3 cups water and bring to a boil over medium-high heat. Skim off and discard any foam. Stir the peas, reduce the heat to medium-low, cover and simmer, stirring from time to time, for 10 minutes. The peas will be partly tender.

2. Add the mango, the garam masala or the cayenne, salt, turmeric, curry leaves and 1 cup water. Bring back to a boil, then reduce the heat again to medium-low. Cover and simmer 20 minutes, stirring occasionally, or until the peas are tender and falling apart.

3. While the peas are simmering, heat the ghee or oil in a small, heavy skillet over medium-high heat. Add the cumin seeds. When they begin to sizzle, turn a reddish brown and smell nutty, remove from the heat. Add the cilantro, and stir until the sizzling stops.

4. When the pigeon peas and mango are very tender, remove the curry leaves and mash the mixture with the back of your spoon. Scrape in the seasoned ghee or oil, and stir together. Cover and simmer five minutes until the flavors are nicely blended. Taste, adjust salt and serve.

Note: For the garam masala, in a small, heavy skillet over medium-high heat combine 2 tablespoons skinned raw peanuts; 1 tablespoon white sesame seeds; 1 1/2 teaspoons coriander seeds; 1/2 teaspoon cumin seeds; 4 to 5 dried red Thai chilies, cayenne chilies or arbol chilies; 1/8 teaspoon freshly grated nutmeg or nutmeg shavings; and 1 blade of mace. Stir until the peanuts are lightly colored in spots and the sesame seeds are a honey-brown color. Immediately transfer to a plate or bowl to cool completely. Add the coconut to the pan, and stir just until almond brown, about 15 seconds. Transfer to the plate or bowl with the spices and nuts. Allow to cool completely. Blend in a spice mill, pulsing the mixture so that the sesame seeds and peanuts don’t heat and grind to butter. Transfer to a jar, and store in a cool, dry place.

Yield: Four servings.

Advance preparation: You can keep this in the refrigerator for two or three days. It will stiffen up. Thin out with water if desired.

Nutritional information per serving: 296 calories; 5 grams saturated fat; 1 gram polyunsaturated fat; 0 grams monounsaturated fat; 20 milligrams cholesterol; 44 grams carbohydrates; 9 grams dietary fiber; 12 milligrams sodium; 12 grams protein

Martha Rose Shulman is the author of "The Very Best of Recipes for Health."

Source: www.nytimes.com/

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9:25 AM | 0 comments

New menu-labeling rules for restaurants

Federal experts hope providing nutritional facts
on restaurant menus can decrease the obesity rate.
Keith Hale~Sun-Times

 A new federal law will soon make American diners far more aware of just what they are eating — but it might not change what they order.

The law will force chain restaurants to disclose the amount of calories, fat and sodium in diners’ favorite dishes. Many restaurants already are preparing for the changes, calculating calories in their meals, adjusting recipes and adding healthier choices.

At the same time, experts are divided over whether the new information will shock people into ordering protein-packed salmon instead of calorie- and fat-laden fettuccine Alfredo, or if it’s just more meddling by the federal government that takes the pleasure out of eating.

The move is driven by the nation’s growing weight problems. Thirty percent of Americans are classified as being obese, and that number is growing, according to the Centers for Disease Control and Prevention.

Government experts say including nutritional facts can help decrease those rates. Others say it won’t work because only those who already take responsibility for their diet will care.

Starting next year, restaurant chains with 20 or more locations will be required to print calorie counts on menus under the new federal menu-labeling regulation, part of the new health-care law.

The law also requires the chains to make other nutritional information available by request.

A statutory 60-day period for comments began April 1. The Food and Drug Administration expects to publish requirements by the end of this year. The law would take effect six to nine months after the requirements are published.

The federal law is backed by most major chains and the National Restaurant Association, which anticipated that a patchwork of local labeling laws would only get more complicated in the future. And while many restaurant and fast-food chains already post nutritional information on websites or on brochures available on counters, the FDA wants the calories in plain sight.

Americans spend 45 percent of their food budget dining out, according to the Restaurant Association. The CDC and other health experts have linked the nation’s obesity rates to eating out. And being overweight is a driver for chronic diseases and high health-care costs.

“Trying to find the healthy options when dining out can be more difficult than you think. Even a salad can be loaded with hidden fat and sodium,” said U.S. Sen. Tom Harkin (D-Iowa), who co-authored the menu-labeling provisions in the health-care law.

Source: www.suntimes.com

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7:37 PM | 0 comments

Pre-natal nutrition linked to adult health

An expectant mother’s diet during pregnancy can alter her baby’s DNA in the womb, increasing its risk of obesity, heart disease and diabetes in later life, an international study has found.

Researchers said the study provided the first scientific evidence linking pregnant women’s diet to childhood obesity, with major implications for public health.

“This a a major breakthrough because for the first time it gives us the potential to work out the optimal diet a mother should eat,” Peter Gluckman from Auckland University’s Liggins Institute told AFP.

“That’s likely to vary slightly from mother to mother, but it could be a major tool in addressing the obesity epidemic.”

The study, conducted by scientists in Britain, New Zealand and Singapore, showed that what a mother ate during pregnancy could change the function of her child’s DNA through a process calledepigenetic change.

Children with a high degree of epigenetic change were more likely to develop a metabolism that “lays down more fat” and become obese, researchers found.

Such children were around three kilograms (6.6 pounds) heavier than their peers by the time they were aged six to nine, Prof. Gluckman said.

“That’s a hell of a lot of extra weight at that age,” he said, adding that the extra fat was likely to be carried into adulthood, raising the chances of developing diabetes and heart disease.

The researchers used umbilical cord tissue to measure the rate of epigenetic change in 300 babies, then examined whether it was linked to the children’s weight when they were aged six to nine.

“The correlation was very strong, we didn’t believe it at first, so we replicated it again and again,” Prof. Gluckman said.

The study found the effect was not linked to either the mother or the baby’s weight at birth, meaning a slim woman could deliver a small baby which still went on to became obese because of changes triggered by diet in the womb.

Prof. Gluckman said the rate of epigenetic change was possibly linked to a low carbohydrate diet in the first three months of pregnancy but it was too early to draw a definitive conclusion and further studies were needed.

He said one theory was that an embryo fed a diet containing few carbohydrates – which provide the body with energy – assumed it would be born into a carbohydrate-poor environment and altered its metabolism accordingly.

This meant it stored more fat, which could be used as fuel when food was scarce.

Prof. Gluckman said the study, which will be published in the journal Diabetes this week, confirmed long-held suspicions that poor prenatal nutrition could have a major impact on adult health.

Source: www.timesofmalta.com

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7:37 AM | 0 comments

Balanced Nutrition for Every Age

At about 1950 on Indonesia's famous concept of nutritional guidelines called with 4 healthy 5 perfect. The concept was created by prof. Poerwo Soedarmo, also referred to as the father of Indonesian nutrition. But along with the development of science today, then realized that the nutritional needs can not be in the same averaged for every person at every age. In a sense nutrients needed by the children of course are different from adults, as well as nutritional needs for pregnant / lactating and the elderly.
Since 2000, MOH's actually started to introduce new guidelines on nutrition, which is called the "Guidelines for balanced nutrition" (PGS). But because of the lack of socialization, then there are still many people who still do not know about it. Therefore, on January 27, 2011 yesterday, held at Hotel Akmani, Jakarta, organized the event press conference on nutrition in balance and distribution of a book entitled "Healthy and Fit Thanks Balanced Nutrition."
The event is also conducted media education about balanced nutrition for every age group. Present as resource persons were: Prof. Soekirman, SKM, MPS-ID. PhD; Dr. Jus'at & Prof. Idrus. Ir. H. Hardinsyah, MS.PhD.

Ki-ka : moderator; Prof. Soekirman, SKM, MPS-ID. PhD; Prof. Ir. H. Hardinsyah, MS.PhD & Dr. Idrus Jus’at

Prof. Soekirman in his foreword, said his lifestyle changes in society, where people become less frequent physical activity and eating patterns have changed (consume more sweet foods and high fat). So maybe even physically look normal, but if further testing will be visible lack one or more nutrients. In addition, more nutritional problems such as obesity and obesity at this time also began to appear. That is to say when this happens multiple problems in the community is that many cases of malnutrition occur and cases of overweight (overweight / obesity).
Guidelines for balanced nutrition (PGS) itself is a composition of daily food containing nutrients in the type & amount in accordance with the necessities of life, taking into account the 4 principles: (1) variety of food, (2) the importance of clean lifestyle, (3 ) the importance of active lifestyles and sports and (4) monitor ideal weight. In contrast to the concept of Healthy 4 5 Excellent that generalize the nutritional needs of all people, balanced nutrition guidelines principle that every age group, gender, health & physical activity requires a different PGS, in accordance with the conditions of each group.
In addition, PGS also emphasize different proportions for each group, adjusted or balanced by the needs of the body. Another difference is the PGS did not treat milk as a perfect food, but placed a group with other animal protein sources. To facilitate understanding of the PGS, every country in the world has a visualization tailored to each culture. In Indonesia, the principle of PGS visualized in the form of cone with a tray called "Tumpeng Balanced Nutrition" (TGS).

Bentuk Visual Pedoman Gizi Seimbang Indonesia

Tumpeng balanced nutrition (TGS) consists of several pieces of cone, namely: 1 large pieces, 2 pieces of medium, 2 small pieces and at the top there is the smallest piece. The extent of cuts TGS show the portion of consumption per person per day. TGS pieces covered by water, meaning water is the biggest part & nutrients essential for life, a day of white water requirements must be met minimum is 2 liters (8 cups).
On top is a cone shaped piece of large pieces which is a staple food group (carbohydrates). Carbohydrates consumed recommended 3-8 servings / day. Above this section there are groups of vegetables (recommended 3-5 servings / day) and fruit (recommended 2-3 servings / day) as a source of fiber, vitamins & minerals. Then again there are classes on top food sources of protein, which are divided into groups of vegetable and animal protein (consumed recommended 2-3 servings / day). At the top of the cone there are classes of oil, sugar and salt are recommended for consumption as needed.
One of the challenges that must also be considered is about the fulfillment of balanced nutrition in a certain period, which is also known as the window opportunity. That is a brief opportunity to do something beneficial and should be utilized. In the field of nutrition, occasion, ranging from before pregnancy until the child was about 2 years. To prevent the problem of the impact of malnutrition, it should be efforts to improve nutrition in population groups that are included in the window opportunity, namely adolescent girls, pregnant women, nursing mothers and infants to children aged 2 years.
Pregnant women often face multiple health problems, such as excessive nausea and vomiting, anemia and iron deficiency, constipation, hypertension, preeclampsia and eclampsia and gestational diabetes. While the adequacy of pregnant women have a lot of attention due to significantly affect the development of the child. The period of brain development of children's own gold begins in the womb until the child was 2 years old.

medicastore.com

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6:18 PM | 0 comments

Taburia, Supplement Overcome Malnutrition

This supplement contains 12 vitamins and four minerals are essential for child development.

For developing countries like Indonesia, malnutrition remains a serious problem. According to the World Bank reposition Nutrition as Central to Development in 2006, Indonesia including the country where people have problems of nutrition.

Not only is malnutrition due to lack of protein, vitamin A, iron, iodine, but also of excess nutrients that lead to obesity. Data for 2010 calls, there were still 17.9 percent of children suffer from the problem. Malnutrition as much as 4.9 percent and 13 percent severe malnutrition.

Tackle the problem, the government launched a nutritional supplement to improve the standard of nutrition Taburia community, especially in children. These supplements are easily processed. Even just sprinkled on food.

Taburia is in addition to a multivitamin and multimineral to meet the nutritional needs of infants aged 6-24 months. Giving Taburia intended to help children grow and develop optimally, increase endurance, increase appetite, prevent anemia and to prevent nutrient deficiencies.

That's because the first two years of age toddlers are periods in which they develop brain tissue so it is very influential in its growth during life.

Not only practical, Taburia also able to meet the 12 vitamins and minerals much needed four children, namely iodine, zinc, selenium and iron.

Although it can be blended at any kind of food, Taburia not be mixed with watery foods such as milk, tea, soup because it will be lumpy. And can not be mixed with hot foods because of fat that coats the iron will be damaged, and cause discomfort.

However, consumption Taburia can make constipation and black stools so that children are encouraged to drink more water.

Currently, Taburia can be obtained for free at the neighborhood health center-posyandu on 24 districts in North Sumatra, South Sumatra, NTB, NTT, West Kalimantan and South Sulawesi. Taburia giving any priority to children aged 6-24 months from a poor family.

Vivanews.com

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5:15 PM | 0 comments

Child nutrition program faces cuts

Governor Deval Patrick and state lawmakers are proposing to slash more than 20 percent of state money from a decades-old program that helps thousands of low-income mothers afford formula and other basic foods for their children.

The Women, Infants, and Children program, widely known as WIC, is regarded as a pillar of the social safety net, providing 130,000 low-income women in Massachusetts who are pregnant, breast-feeding, or raising young children with supplemental food, health care referrals, and nutrition education.

Despite concerns raised by advocates for the poor, state officials said they have no choice but to make the cuts because of the state’s budget crunch.

“Massachusetts, like all states, continues to feel the impact of the global economic crisis,’’ said Julia Hurley, a spokeswoman for the state Department of Public Health. “No agency wants to have to make these decisions, but sound fiscal management has required tough choices.’’

Hurley said the effects of the proposed cut in state funding for WIC, such as how many families might lose support, remain unclear. State spending would fall from $12.4 million this fiscal year to $9.8 million.

The state also receives federal aid for WIC, which is likely to decline next fiscal year, advocates said. State officials could not say how much the state receives from the federal government for WIC, which provides aid to children until age 5.

Advocates for low-income women, however, said they fear that the consequences of cutting WIC again — it sustained a 9 percent cut in the past three years — will prove devastating.

“This would just make it much harder for poor families,’’ said Valerie Bassett, executive director of the Massachusetts Public Health Association. “It would undermine our effort to make sure that low-income families have access to healthy food.’’

The monthly WIC benefits package can provide a child between the ages of 1 and 4 with a dozen eggs, 16 quarts of milk, and $6 in vouchers for fruits and vegetables, among other foods, according to the US Department of Agriculture.

Administration officials said they need to make such undesirable cuts as they try to close a projected $1.2 billion budget gap. The governor’s proposed $30.5 billion budget for fiscal 2012 called for cutting $570 million, the largest year-to-year cuts in 20 years.

Representative Brian Dempsey, a Haverhill Democrat who serves as chairman of the House Ways and Means Committee, said the WIC cuts represented one of many difficult choices his committee had to make in drafting its budget.

“There are a lot of very important and essential programs that we weren’t able to fund at the appropriate level, and this is one of them,’’ he said.

But Dempsey said he expects an effort to mitigate the WIC reduction. “This is a very difficult cut, and we would like to avoid making it, if we could,’’ he said.

Officials in Senate President Therese Murray’s office said the Senate has yet to decide whether to include the WIC program cuts in its budget, which will not be released until next month.

“We’re still working on our budget recommendations,’’ said David Falcone, a spokesman for Murray.

Organizations such as Horizons for Homeless Children in Boston said nearly all the families they provide services to rely on WIC.

Stacy Dimino, a spokeswoman for Horizons, said some of the children in her program already hoard the food they serve by putting it in their pockets. She said some of the children do not know when their next meal will be.

“If they have to go without WIC, it’s going to be much harder for these families,’’ she said. “These families are already struggling to pay rent, utility payments, and food, and without WIC, I worry they will not make the best nutritional choices. This program is critical.’’

Dr. Sean Palfrey, a professor of pediatrics and public health at Boston University School of Medicine, said about 90 percent of his patients are either eligible for WIC or enrolled in the program, which also provides counseling from nutritionists and referrals for services as diverse as dental care and fuel assistance.

“Without WIC, I wouldn’t know how to help them,’’ he said.

He predicted that many families will turn to food pantries. But he said pantries rarely have the formula and other food needed for pregnant women and newborns.

“WIC ensures that they get quality foods,’’ Palfrey said. “Food pantries aren’t focused on mothers and babies. A baby’s brain development depends on their nutrition. If families are being stretched because they don’t get this, it’s going to hurt.’’

One of his former patients, Sheryl Debarros-Carter, said she relied on WIC to raise her two children when she lived in Roxbury two decades ago. It allowed her to buy milk, juice, cereals, eggs, and other necessities.

“It was a blessing to me,’’ said Debarros-Carter, now 49 and living in Malden. “The foods they supplied I would have probably bypassed. I just couldn’t have afforded it all.’’

She said too many poor families rely on fast foods like pizza as a substitute for the fruits, vegetables, and other vitamin-rich nutrients their children need.

www.boston.com

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11:23 PM | 0 comments

Michael C. Latham, Expert on Nutrition in Developing World, Dies at 82

Michael C. Latham, an expert on international nutrition and tropical health who waged a long campaign against the use of infant formula and for the practice of breastfeeding in developing countries, died on April 1 in Boston. He was 82 and lived in Newfield, N.Y.

The cause was pneumonia, his son Mark said.

Dr. Latham, who directed the Program in International Nutrition at Cornell University for 25 years, first encountered the problems of nutrition in the developing world while practicing medicine as a young doctor for the British colonial service in Tanganyika (now Tanzania).

After the country had gained its independence, he stayed on and was appointed the director of the nutrition unit of the public health ministry. He became alarmed at efforts by Western companies to expand their marketing of infant formula to underdeveloped countries, where high birth rates promised a growing consumer base, and he became one of the first and most forceful public health scientists to sound a warning.

In many poor countries, he pointed out, mothers mixed powdered baby formula with contaminated water, leading to diarrheal diseases. To make the formula last longer, they often used too little of the powder, depriving their babies of vital nutrients.

Bottle feeding was “incredibly difficult and extremely bad,” Dr. Latham wrote in a 1976 report with Ted Greiner, but “the media onslaught is terrific, the messages are powerful and the profits are high.”

“High also is the resultant human suffering,” they wrote.

Dr. Latham’s cause, taken up by several health groups, led the World Health Organization in 1981 to develop a set of guidelines, the International Code of Marketing of Breast-milk Substitutes, which was intended to govern the behavior of private companies. He was a prominent figure in the boycott of Nestlé, a leading manufacturer of infant formula, which agreed in 1984 to abide by the marketing code.

The ideal food for infants, Dr. Latham argued, was breast milk. Its benefits, he wrote, were not limited to improved physical and mental development. It could also potentially curb population growth, he argued, since parents who were confident that their children would thrive would be more likely to have smaller families. In 1991, he helped found the World Alliance for Breastfeeding Action to explain and promote the benefits of breastfeeding around the world.

Michael Charles Latham was born on May 6, 1928, in Kilosa, Tanganyika, where his father was a doctor in the British colonial service. After earning a medical degree from Trinity College, Dublin, in 1952, he worked in hospitals in Britain and the United States before returning to Tanganyika to practice medicine in rural areas. During intermittent leaves, he earned a diploma in tropical public health from the London School of Hygiene and Tropical Medicine in 1958.

After leaving Tanzania in 1964, he taught nutrition at Harvard, where he received a degree in public health in 1965. In 1968 he was recruited by Cornell as a professor of international nutrition. He turned the university’s small Program in International Nutrition into one of the world’s largest training centers for nutritionists, many of whom went on to work in international agencies and public health departments around the world.

His research led to improved programs on infant nutrition, the control of parasitic diseases in humans, and the supply of micronutrients to poor populations.

Dr. Latham often did consulting work in Africa, Asia and South America for organizations like the World Health Organization, the United Nations Food and Agriculture Organization, Unicef and the World Bank.

In addition to his son Mark, of Somerville, Mass., he is survived by his second wife, Dr. Lani Stephenson, and another son, Miles, of Trumansburg, N.Y.

He was the author of two important books on international nutrition, “Human Nutrition in Tropical Africa” (1965) and “Human Nutrition in the Developing World” (1997), as well as a family memoir, “Kilimanjaro Tales: The Saga of a Medical Family in Africa” (1995), which drew on the journals kept by his mother, Gwynneth Latham.

www.nytimes.com

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11:15 PM | 0 comments

National Action Plan for Food and Nutrition 2011-2015

Nutritional state of society has shown a trend that is getting better, this is shown by the lower prevalence of malnutrition among children under five or infants with low weight. Cases of malnutrition among children under five as measured by the prevalence of underweight children under five, and malnutrition are used as an indicator of hunger, because it has strong links with the state of food insecurity in society. Another indicator of hunger is an average rate of energy consumption in the population under 70 percent of the nutritional adequacy. These conditions have a significant impact on the achievement of other goals, such as child mortality and access to education.

This action plan aims to become a guide in implementing food and nutrition development for government agencies, nongovernmental organizations, private institutions, society and actors at national, provincial and district / city. Minister of Planning / Head of Bappenas stated there are five pillars of food and nutrition development, including: (1) Improvement of public nutrition (2) the accessibility of food, (3) quality and food safety, (4) clean and healthy lifestyle behaviors (PHBS); and (5) institutional food and nutrition. Furthermore, the provincial government will develop regional action plan for food and nutrition (RAD-PG) with the district and the city this year as a follow-PG preparation of the NPA.

www.bappenas.go.id

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8:25 PM | 0 comments

Confused By Food Labels? Read the Fine Print!

 Even though nutrition info is slapped on all packaged foods and 

many restaurant items, people are heavier than ever. 

Use this advice to improve your label literacy.

By Amy Paturel, M.P.H., Women’s Health

Twenty years ago, no one scrutinized cereal boxes to compare calories in competing brands. They couldn’t–prior to the Nutrition Labeling and Education Act (NLEA) of 1990, that info wasn’t on most packages. And forget about finding calories on restaurant menus.

Yet the country’s obesity rate back then was about 14 percent lower than it is now. Labels, it seems, may be doing more harm than good. That’s why the Institute of Medicine (IOM), a nonprofit health advisory, is taking a fresh look at labeling policies in an effort to make the facts clearer and harder to ignore. Here’s how not to be duped.

Food Fakers

One of the biggest problems with labels is that while the NLEA specified what nutrition data should be shown, and even the typeface and size it had to be printed in, the legislation didn’t dictate where it should be placed. Consequently, most manufacturers will bury a product’s fact panel and ingredients list on the back or side of the package, while filling the front with such eye-catching words as sensible, smart, and healthy–claims that sound good and sell well but are often misleading.

“Many manufacturers and supermarkets seem to be creating their own proprietary ways of highlighting attributes on the front of packages,” says Nancy Childs, Ph.D., a professor of food marketing at St. Joseph’s University in Philadelphia. “With this proliferation of front-of-the-box babble, it’s very hard for a consumer to make sense of what’s in a particular food.”

Indeed, studies at Cornell University’s Food and Brand Lab show that consumers tend to lowball the number of calories in foods whose packaging features words such as low-fat. This miscalculation leads them to eat more of the product, even when the marketing buzzwords have nothing to do with calories. Cookies, for instance, were thought to have 40 percent fewer calories just because the word organic was printed somewhere on the label.

The assertions themselves may be true, but that doesn’t make them any less confusing.

“You’ll see no cholesterol labels on products that never had cholesterol in them,” says Marisa Moore, R.D., a national spokesperson for the American Dietetic Association. “The food might be filled with sugar or saturated fat, but a person who has high cholesterol might think, ‘Oh, I can eat this,’ without understanding that saturated fat increases cholesterol levels.”

Reform Package

Earlier this year, manufacturers of packaged foods took a step in the right direction by rolling out a voluntary front-of-package labeling system called Nutrition Keys. But critics say the system, like the Smart Choices program that came before it (which has been discontinued), is no less confusing to consumers.

“There’s still a need for awareness and education about how to interpret the information to answer important questions such as how many calories is enough? Or too many?” says Moore.

A preliminary report by the IOM addresses some of these issues and recommends that front-of-package nutrition information be standardized and emphasize the items of most concern: calories, salt, saturated fat, and trans fats.

The IOM is also rallying for more reasonable serving sizes. For example, a can of nuts may boast “150 calories!” on the front, but flipping it over reveals there are actually 150 calories per serving, and that the small package holds seven servings.

Nutrition information is likely to start showing up in more places too. As part of the new health reform bill, restaurant chains with 20 or more locations nationwide are required to post calorie information for all the food they sell, which is important legislation given how often American families eat out.

Of course, knowledge may be power, but it isn’t willpower. There will always be people who see that a food contains an astronomical amount of calories, shrug, and wolf it down anyway. Nothing you put on a label will change that. But experts are optimistic that the proposed mandates will make manufacturers and restaurants sit up and take notice.

“It’s clear that being required to display nutrition information prominently will sensitize food companies and restaurants to the calorie content of their foods,” says Michael Jacobson, Ph.D., cofounder of the Center for Science in the Public Interest, a Washington, D.C.-based public advocacy group. “This will hopefully put pressure on them to cut calories and reformulate their products.”

Some companies already have. Retail giant Walmart recently announced its plan to slash the salt, sugar, and fat in its own brand of packaged foods over the next five years, making it the largest manufacturer to do so. If this trend continues, your waistline will benefit–no matter which cereal you choose.

www.care2.com

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10:27 PM | 0 comments

US restaurants may soon have nutritional facts printed on menu

The US FDA (Food and Drug Administration) is keen to have manufacturers show the nutritional facts on restaurant menus.

In response to the growing concerns with respect to health issues, the US FDA has issued two proposed regulations regarding calorie-labelling on menus and menu boards in chain restaurants, retail food establishments, and vending machines.

"These proposals will ensure that consumers have more information when they make their own food choices," said department of health and human services secretary Kathleen Sebelius.

"Giving consumers clear nutritional information makes it easier for them to choose healthier options that can help fight obesity and make us all healthier," she added.

Specifically, consumers would see calories listed in restaurants and similar retail food establishments that are part of a chain with 20 or more locations doing business under the same name and offering for sale substantially the same menu items.

According to the proposal, these establishments will include fast food joints, bakeries, coffee shops and certain grocery and convenience stores. Movie theatres, airplanes, bowling alleys, and other establishments whose primary purpose is not to sell food will not be subject to this proposed regulation. Additionally, the proposal has invited the public to comment on whether more types of food establishments should or should not be covered by the new rule. A companion rule proposes calorie posting for food sold in vending machines. The FDA is accepting comments on both proposed rules.

"Americans now consume about one-third of their total calories on foods prepared outside their home," said Margaret A Hamburg, MD, FDA Commissioner, "While consumers can find calorie and other nutrition information on most packaged foods, it's not generally available in restaurants or similar retail establishments. This proposal is aimed at giving consumers consistent and easy-to-understand nutrition information."

The initiative, under the Affordable Care Act, requires the disclosure of calorie and other nutrition information in certain food establishments and for certain foods sold in vending machines.

Additionally, on menus and menu boards, statements would be posted concerning suggested daily calorie intake and indicating that additional nutrition information is available on request. Under the proposal, this information would be displayed clearly and prominently on menus and menu boards, including menu boards in drive-through locations; and for individual foods on display. Consistent with the law, the agency is proposing that the following statement on daily caloric intake be on menus and menu boards to help consumers understand the significance of the calorie information in the context of a total daily diet: "A 2,000 calorie diet is used as the basis for general nutrition advice; however, individual calorie needs may vary."

www.fnbnews.com

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10:02 PM | 0 comments

Egg Nutrition

Egg is a food that is very familiar with our daily lives. Eggs as a source of protein has many advantages, among others, the most complete amino acid content compared to other foodstuffs such as fish, meat, chicken, tofu, tempeh, etc.. Eggs have a delicious flavor, so favored by many people. Eggs are also functioning in a variety of food processing. In addition, egg protein include food sources are relatively inexpensive and easy to find. Almost all people need eggs.

Nutritional value of eggs
Actually, any content in an egg? Here is the nutritional value of table eggs in 100 grams of food. (100 salt, about 2 eggs free-range chicken).



However, be careful in consuming eggs. Because in addition to a fairly high fat bladder, eggs also contain sizable amounts of cholesterol than other foods. Cholesterol content in 100 grams of eggs is about 424 mg. Wow, pretty much yes. While we are encouraged to consume less than 300 mg of cholesterol per day. So, should consume enough eggs about 2 eggs per week. Hose-animal dishes interspersed with other food ingredients to enhance the variety of food. In accordance with a message of general guidelines for balanced nutrition (PUGS) that eat a varied diet, because no one food that has a complete nutritional content.

Tips on choosing eggs

1. Choose eggs with the skin intact, not cracked or broken, clean and no stains.

2. When viewed from the contents, the egg is fresh air cavity has a small yag, located in the middle yellow, egg-white solid. Eggs which had long been stored, will have a large air cavity so that it can float if the egg is inserted into the water.

3. Eggs are a good quality marked by the absence of sound (beat) the time the egg is shaken.

(No. 4 and 5 to determine the quality of eggs after the split and requires a rather complicated calculation.) I think if mothers spend, not gonna have time to calculate it first ... .. hehehehe

4. The quality of eggs can also be measured by Haugh unit, namely the measurement of height and thick egg white
egg weight. A fresh egg has a Haugh Unit: 100, good eggs: 72 eggs damaged and less than 50.

5. Index Index egg yolk and egg white can also determine the quality of eggs. Yolk index (IKT) is a high ratio of egg yolk with a diameter as measured after being separated from their eggs. IKT normal value is 0.33 to 0.50. The average egg have IKT 0.42. The longer eggs are stored, the smaller the value IKT due to migration of water.

While the egg white index (IPT) is a high ratio of eggs condensed with an average diameter of the long and short. IPT value of fresh eggs is 0.050 to 0.174. The average egg have IPT 0.090 to 0.120. The longer eggs are stored, the smaller the IPT ovomucin accelerated degradation due to the increase of pH.

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7:59 AM | 0 comments

IODINE AND GOITER: A CONSEQUENCES DURING PREGNANCY

By: Anie Kurniawan, MD, MSc 1), and Eman Sumarna, MSc 2)
1) Chief, Sub Directorate of Clinical Nutrition
2) Staff, Sub Directorate of Clinical Nutrition
Directorate of Community Nutrition MOH-RI

I. The Patho Physiology of Goiter

Goiter or as colloid nodular goiter is thyroid gland enlargement, which is usually caused by too little iodine in the body. Lack of iodine intake from the diet, is the primary cause of iodine deficiency, however goitrogens (substances in the diet which produce goiter due to action on the thyroid gland), such as thiocyanates can enhance the effect of iodine deficiency. Iodine is mineral essential for the normal metabolism of cells, which is a necessary nutrient for production of thyroxin hormones and normal thyroid function. The healthy human adult body contains 15–20 mg of iodine of which 70-80 percent is in the thyroid gland, which weight only 15-25 gr. Thyroid gland consisted of three lobes, which located in the neck two lobes were located behind the throat, with one lobe as conjunction between each lateral lobes.

Iodine exists in the thyroid gland as in organic iodine, that are 1) In the form of iodine containing amino acids; Monoiodotyrosine (MIT), Diodotyrosine (DIT), Thyroxin (T4) and Tri-iodothyronine (T3), 2) In the form of polypeptides containing thyroxin and 3) In the form of thyroglobulin. Thyroglobulin is the main constituent of the colloid, which fills the thyroid follicle, as the storage form of thyroid hormones, and make up 90 percent of the total iodine in the gland. Iodine exists in the blood as Thyroxin (T4) and Triodothyroxin (T3) and as in organics iodine. The level of inorganic iodine falls in iodine deficiency and rises with increase of iodine intake. The dissemination of free T4 is important to assess the thyroid status and to diagnose hypo or hyper thyroids. When iodine intake is deficient, the thyroid gland is unable to produce sufficient thyroid hormone, it may attempt to compensate by enlarging of thyroid gland, which is called colloid nodular goiter. In otherwise, when the thyroid is then reexported to iodine, the nodules may produce thyroid hormone, but occasionally, the nodules may produce too much thyroid hormone causing thyrotoxitosis, which usually accompanied by enlargement of thyroid gland, called a toxic nodular goiter. Colloid nodular goiter is also known as endemic goiters and are usually caused by inadequate iodine in the diet. Endemic goiter tends to be occurred in certain geographical areas with iodine-depleted soil away from the sea cost.

In Indonesia, endemic goiter occurred mainly in volcanic and mountain area affecting among population living in this area, such as pregnant women, newborn babies, under fives and school children. Mapping survey among elementary school children in 1998 showed that 334 sub districts categorized as severe endemic area (Total Goiter Rate/TGR > 30%), 278 from 4028 sub districts as moderate endemic area (TGR 20-24%) and 1167 sub districts as mild endemic area (TGR 5-19,9%). It revealed that around 45% of sub districts in Indonesia were risk to have goiter cases. The latest data showed that TGR among elementary school children, was little bit increased to 11.1% of national rate, but there was decreased TGR in the severe endemic areas significantly. The National IDD Evaluation Survey (2003) showed 50 districts had increased to the better status, while 68 districts had decreased to the worse status and 150 districts in stable condition.

II. The Causes of Goiter

Lack of iodine in the diet is the majority cause of endemic goiter, where the loss of iodine from the soil due to glaciating, erosion, high rain fall, snow and flooding leads to a low iodine content of all food grown in it. The husbandry and agriculture production was also lack of iodine content, which will be in appropriate resources when people in that area consumed it. Inadequate dietary iodine leads to reduce synthetics of thyroid hormones (T3 and T4). While the lower level of T4 in the blood stimulates the pituitary gland to secrete Thyrotrophin Stimulating Hormone (TSH) from the blood to fulfill the production of thyroid gland hormones. In other word, TSH increases the rate of pumping iodine by the thyroid from the blood, followed with hyperplasia of the thyroid gland, as resulted as goiter. Enlargement is regarded as significant in the human when the size of lateral lobes is greater than terminal phalanx of the thumb of the person examined.

Thyroid enlargement whether as form of a single small nodule or massive enlargement is typically symptoms of goiter, which occasionally accompanied with breathing and swallowing difficulties, cause of the compression of the trachea and esophagus. Neck vein distention and dizziness are occurred when the size of the thyroid gland rose above the head (large goiter). Chronic severe iodine deficiency is associated with thyroid hyperplasia. The prevalence of goiter increased, with the severity of the iodine deficiency and becomes almost universal in a population when the iodine intake less than 10 μg per day.

Iodine in the food stuff is widely available in seafood, such as “tenggiri” (cod) sejenis “ikan sungai” (sea bass), nama “ikan laut” (haddock) and ikan “air tawar berduri” (perch). Kelp or “lumut laut” is the most vegetable seafood that is a rich source of iodine. Dairy product and plants grown soil that is rich in iodine are also a good sources of iodine. The risk factors to become goiters are female, people older than forty, having an adequate dietary intakes, which living in an endemic area and having a family history of goiter.

III. Iodine Deficiency in Pregnancy

The term of “goiter” had been used in the past. Presently, the new term of “Iodine Deficiency Disorders (IDD)”, now been generally adopted as international health and nutrition environment. The effect of IDD is due to the impact of hypothyroidism with reduced of T4 levels, and often accompanied with normal T3 levels and raised TSH levels.

The spectrum of IDD affected among vulnerable groups that are fetus, neonates, infancy, childhood and adult. The most common effect of IDD in adults is goiters, while pregnant women who suffered from IDD will had an impact to their children. In iodine deficient areas, there is an increase rate of spontaneous abortions and stillbirths in humans, which can be reduced by correction of the deficiency. Thyroid treatment in pregnant women who are hypothyroid, also had similar benefits on reducing the abortus and stillbirths. (Mc. Michael et al, 1980). Study in Zaire and New Papua Guinea indicated that an increase of stillbirth and infant mortality could be reduced by controlled with iodine oil injection given during pregnancy. Recent evidence indicated that the effects of iodine deficiency on the occurrence of abortion, stillbirth, congenital anomalies, cretins, neonatal goiter and hypothyroidism, probably arise when mother suffered from iodine deficiency. Thus, it was indicated that the major impact of IDD among pregnant women is on child survival (Hetzel BS, 1991). The effect of pregnant women with IDD on their children, continued up to child and adolescent period, however the children had been supplied with sufficient iodine intake. This condition is due to the impairment of brain development of the children, which is depending on inadequate supply of thyroxin since earlier during conception. About one third of normal brain development occurred before birth and the rest is completed in the first two years of life. Normal brain development had to be maintained with normal level of thyroxin hormones that is important both during and after pregnancy, especially among the first two years of life. Thus prevention of goiter especially among pregnant women is important, in order to avoid the iodine deficient during pregnancy toward reducing the impact of IDD on pregnancy outcomes.

IV. Prevention of Goiter

Iodine supplementation is an effective approach to prevent and control goiter and IDD rapidly. However, commonly the thyroid gland cannot become smaller, particularly in person who had a big size of thyroid gland. In fact Iodine oil capsule supplementation targeted to women at reproductive age including pregnant women living in endemic area, are recommended to supply the iodine intake fulfill their requirement.

As known that people living in endemic area are risk to have IDD, more over in pregnant women, who are higher requirement of iodine rather than non-pregnant women. Two capsules, which contain 200 mg iodine for each capsule, should be taken once in year by non-pregnant mother, and adding with one capsule during pregnancy and one capsule during lactation. These supplements are sufficient to meet the minimum daily requirement of iodine, which only 100-150 μg per day.

Fortification of salt with iodine is widely used in the world to improve the iodine intake of the community. It was mandatory that instead of supplementation, the content of iodine in salt should be more than >30 ppm KJO3, and all salt producers have to follow that regulation. The advantage of iodine salt distribution and marketed throughout the country is, that iodine salt supplied can reach all level of social economic status in the community.

V. Conclusion

Pregnant women are risk to have goiters because the requirement of iodine is increased during pregnancy. Lack of iodine intake will cause iodine deficiency disorder (IDD), which result goiters when the deficiency are chronically. IDD in pregnant women will give a harmful effect among their children due to the congenital anomalies, neurological cretinism, myxoedematous, cretinism, which influence the quality of human resources in the future generation.

Therefore, iodine oil capsule distributed to women at reproductive age including pregnant women living in endemic area of goiter have to be implemented in order to eliminate their child growth impairment. Further more, the salt producers should distribute and market the iodized salt particularly in the community who living in endemic area goiter.

Last but not least, every pregnant woman have to visit the health services routinely for antenatal care, so the enlargement of thyroid gland can be detected earlier and then they will have an appropriate treatment.

References
1. Mc Michael, AxJx, Potter, JD and het ind Bys. Iodine Deficiency, thyroid function and reproductive failure. In endemic goiter and endemic cretinism. (eds JB Stanbury and BS Hetzel) pp 445-60 Willey, New York-1980)
2. Hetzel BS. The story of iodine deficiency. An international challenge in nutrition, pp 284-101, Oxford University Press. Oxford 1991
3. Health Encyclopedia: Iodine in diet Adam, p 1-2, 2004
4. Health Encyclopedia, Colloid nodular goiter, Adam p.1-3, 2004
5. American Map Corporation,1984.
6. Iodine Deficiency Disorders (IDD) control program in Indonesia, MOH RI, 2002

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6:33 AM | 1 comments

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www.nutritiondatacenter.blogspot.com/ has no access to or control over these cookies that are used by third-party advertisers.

You should consult the respective privacy policies of these third-party ad servers for more detailed information on their practices as well as for instructions about how to opt-out of certain practices. www.nutritiondatacenter.blogspot.com/'s privacy policy does not apply to, and we cannot control the activities of, such other advertisers or web sites.

If you wish to disable cookies, you may do so through your individual browser options. More detailed information about cookie management with specific web browsers can be found at the browsers' respective websites.

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6:03 AM | 0 comments

120 Malnutrition Found Post-Tsunami Mentawai

Dr. Louisa A. Langi, MSi is a humanity volunteer from NGO Mitra Indonesia when conducting surveys and data collection on ten points after the earthquake in Hamlet Rua Monga, Taikakok Muara Village, North Pagai find any cases of children with malnutrition and malnutrition.

Lecturer of Medicine at one university in Jakarta, the detailing, there were 40 cases of malnutrition and 80 cases of malnutrition.

One of the severely malnourished two-year-old died, after being in care at the Health Center of North Pagai, Mentawai Islands.

According to him, many found malnutrition in Mentawai aftermath of the tsunami, but the initial phase when humanitarian volunteers working in the medical field, seemed impressed by the local government cover-up.

The children must be helped and we need a clear statistical data. But the data is sometimes covered up the Mentawai government.

"We're here to run a humanitarian mission," said Louisa, accompanied by the local health center physician, Angela Puspita told reporters after handing over 80 units of BNPB Huntara to the local Regency in Hamlet Rua Monga.

So, it asks each shoulder to shoulder in handling cases of malnutrition and malnutrition, and no other purpose than volunteers to deliver the actual conditions to the public.

He explained that the cases are found in North Pagai, South Pagai, hamlet Silabu, Bitumonga, Bulok, Munte Recently, Malakopak and a number of other locations.

Efforts to monitor the condition of the local community, they visited hamlets and villages where the earthquake and tsunami victims temporary residency, even in extreme weather conditions though. 

Health workers are still needed today because the people who live together in Huntara still less, ranging from doctors, midwives, nurses and others.

While there were 10 points health posts in Sikakap, at each point that victims of the earthquake and tsunami are getting health care.

"Right from the data that we found, only one victim died of malnutrition," said Head of Disease Control & Environmental (P2PL), Mentawai District Andrew Budi, told reporters at the North Pagai 5.5 KM.

According to him, sometimes finding volunteers, there are also differences with the findings of the local health medical team, but the same goal.

Meanwhile, malnutrition indicators must be viewed from weight and height and age of the sufferer, unpredictable-guessed by naked eye and require intense communication from the victim's parents.

Precisely that, in conducting the data collection to victims of the tsunami through intense communication, because it is not easy and required caution.

Related, one would be wrong one way communication means, so use the services of the original officers Mentawai people, with so they can know the actual condition.

According to Budi, local health officials conducted a survey on 200 infants and toddlers, and their current condition began to improve, because it was given supplementary food.

"The their development are also monitored by officers in the ten point Huntara," she said, adding, other diseases Inspection acute respiratory infections (ARI), skin diseases and others that on average there were 10 to 15 patients.

The condition is, of course due to a number of factors among them, because of the weather, sanitation, latrines are less well during the evacuation and in Huntara.

Meanwhile, Angela Puspita a doctor on duty at the health center Mentawai added, malnutrition victim who died was aged 2 years.

The condition of the victims when handled very alarming, because the toddler she was only given water and food that is not feasible by his mother.

"We've tried to give the best for the baby in Taikakok, but his life was not saved. Because it is a very bad condition, "said Angela.

She explained that the severely malnourished in Taikako is one of 40 severely malnourished Mentawai earthquake and tsunami victims. But after getting a serious handling of health personnel who served in the Mentawai for two months, their condition began to improve.

"Right now their condition began to improve. Because the development of the children we always watched, "explained Angela and said, served in the Mentawai is not easy, because confronted by extreme weather. Moreover, one village or another village to go through the ocean.

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9:33 AM | 0 comments

WHAT CONSTITUTES HEALTHY FOODS?

A snap shot on perception and practice among visitors of selected canteens at UI Salemba campus

by

Dian, Dini, Erwin, Intan, Lina, Muharni, Nur Handayani, Rutlita, Tonny, and Ursula (in alphabetical order) Master Students batch 2008 and short course participants at FKUI Kekhususan Gizi Komunitas (SEAMEO-TROPMED Regional Center for Community Nutrition) University of Indonesia

The foods and nutrition play important roles in health and wellbeing of people. Foods related behavior are complex and influenced by many factors such as physiological, socio-demographic characteristics (income, education, ethnicity, etc), as well as behavioral and life style factors, also knowledge and attitude related to health and diet.

As part of the master training program, SEAMEO-TROPMED RCCN held a course on Introduction to Nutritional Anthropology on 5-19 January 2009. On the second week of the course, the course participants conducted a mini research with the following research questions:
1. How do people perceive “healthy food”?
2. How is the habit of tea drinking with meal?
Indepth interviews and observation were the main methods employed to gain information from the visitors of the canteens surrounding the campus compound. A total of 21 visitors agreed to be interviewed. They were mainly undergraduate and post graduate students of the University of Indonesia who come from health-related and non health-related educational background. They will be further regarded as “informants”.

The top-of-mind thinking articulated by the informants about “healthy food” were balanced nutrition (4 Sehat 5 Sempurna), fresh food like vegetables and fruits, not contained preservatives and food additives, contained less fat and cholesterol, hygienic, not overly consumed, and food that can not cause disease. Furthermore, traditional market (due to the freshness of groceries sold there) and homemade food (due to ensured hygiene) were considered to be the most prominent sources to obtain healthy foods. The informants also stated that restaurants/canteens may provide healthy menus. However, the visitor must have the skill to choose healthy food in order to obtain good dietary practices.

Interestingly, this health perception was mostly reflected in the food choice observed on their plates. However, time constraint, choices in the menu list, affordability, and promo advertisement from the canteen were some reasons why health perception was not always followed by the actual practice.

Surprisingly, little knowledge was observed among informants with medical background about the negative effect of tea drinking with meal on the iron absorption. Taste of tea was considered to be the reason of choosing tea with meal as quoted by one of the informant:
“Tea will ease nausea after meal….”
(Female, 30 years, postgraduate student with medical background)
These informants have developed tea drinking habit even since childhood. The usual frequency of tea drinking is at least once a day. Those consumed tea twice a day have it once in the morning and another one during lunch. These facts reflect tea drinking as family tradition.

In addition, the healthy food choice and practice were similar between those coming from health and non health background. However, female was more concerned with body image, thus more cautious in choosing food compared to male.

This mini research provide a snap shot on what is perceived as healthy food and how this perception can be implemented in the actual dietary practices. The study finally concludes that when it comes to practice the informants were mostly constrained with limited time and choices; no matter how good their knowledge on health and diet is.

Time limitation which is regarded as internal factor may be overcome by improving individual skill development. On the other hand, a limited healthy food choice as an external factor needs more collaborative efforts and resources to be defeated.

The final quest: Can we – consumers – influence the canteen managers to provide more healthy food choices? The answer lies upon our shoulders; because it is indeed the responsibilities of ALL OF US. So, let’s make a difference!

www.gizi.net

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7:14 AM | 0 comments

EVALUATION OF VITAMIN A SUPPLEMENTATION PROGRAM IN THREE PROVINCES IN INDONESIA

Vitamin A Deficiency (VAD) continues to be a major public health concern in Indonesia. In 1992, 50 percent of underfive children showed sub-clinical VAD as their serum retinol were less than 20 microgram/deciliter. The primary intervention for VAD control in Indonesia is biannual distribution of Vitamin A Capsules (VAC) to underfive children through the national network of integrated health post (Posyandu). Although the Vitamin A Supplementation (VAS) program has been conducted for three decades, the result, in term of coverage, is still low. Low coverage indicates that management of the VAS program may not properly function. Therefore, UNICEF and the Micronutrient Initiative collaborated with SEAMEO TROPMED RCCN University of Indonesia conducted a comprehensive survey in selected areas in three provinces to collect data on Vitamin A coverage and other critical information, particularly that related to VAS program’s management, which is required to identify barriers of program’s implementation. The information is then used to define critical actions to improve the program coverage.

The survey was designed as a cross sectional rapid survey, and was conducted from the forth week of February until mid of March 2007. It was conducted in West Kalimantan, Lampung, and Southeast Sulawesi, which were purposively selected based on the Ministry of Health’s latest VAS coverage data in August 2006. Two types of survey were done in order to collect data from community (i.e household survey to mothers of children aged 6-59 months) and program’s provider (i.e health system assessment to health staffs at provincial, district, and Puskesmas/ Posyandu level). The household survey was conducted in 5 districts in each province, which were purposively selected based on its coverage (2 districts had high coverage and 3 districts had low coverage). In each province, health system assessment was done in 3 out of 5 districts, i.e 1 district with high coverage and 2 districts with low coverage. By having 50 percent of Vitamin A coverage (in 2005), 10 percent difference from the true proportion in population, 95 percent of confidence level, and design effect of 2, as many as 200 children aged 6-59 months per district were included in the household survey. Thus, a total of 3000 children aged 6-59 months were needed from 3 provinces. Household survey was done through interview using structured questionnaire, while health system assessment was applied through in-depth interview, focus group discussion, secondary data review, and observation. A total of 3466 children were included in the survey. Overall, VAS coverage in February 2007 was 56.7, 80.9 and 63.1 percent in West Kalimantan, Lampung and Southeast Sulawesi, respectively. The coverage was lower than minimum services standard set by ministry of health in 2003 (SPM 2003), i.e 90 percent. Kota Pontianak and Bandar Lampung, as the capital city of West Kalimantan and Lampung Provinces, had the lowest coverage compared to other districts in respective province. Among those who received VAC, about 70.2 percent infants received incorrect dose (red capsule) and 13.9 percent children aged 12-59 months received incorrect dose (blue capsule).

Health system assessment results show that no special policy was made, both in Provincial and District level, to increase VAS coverage in February 2007, especially in the budget allocation and socialization. Budget was mostly allocated for VAC procurement and very limited for distribution activities. No specific budget was allocated for program socialization and sweeping activity, which are very crucial for the program, especially the program coverage. West Kalimantan, on the other hand, had started to allocate budget for VAC distribution to underfive children. They provided 200 rupiah per child to person who distributed VAC to underfive children. Sanggau District Health Office in West Kalimantan also allocated budget for Puskesmas staff who distributed VAC as much as 100 thousand rupiah per village per VAS period.

No specific activities were done to socialize VAS for February 2007. The information was mostly spread orally, by cadres, midwives or mothers. In most cases, schedule of VAC distribution was informed by cadres or midwives to mothers during Posyandu day in January 2007. The mothers were then requested to inform the schedule to other mothers of underfive children in their neighborhood. Cadres and midwives also re-informed underfive mothers as the distribution day became closer. Mostly, the cadres or midwives met the mothers by chance. Socialization materials such as banners, posters, or leaflets, were available in a very limited number at District until Posyandu levels. Such traditional message delivery in communities was found to be a very effective method in building awareness of the event (the distribution day), but ineffective in giving education about the importance of Vitamin A. The reason of conducting no specific activities to socialize VAS program may relate to the perception of almost all health workers interviewed (from District until Posyandu level) that VAS was a routine program which had been conducted for years, and mothers had been familiar with the program. Thus, no specific and intensive program socialization was needed. The result from household survey, however, shows that mothers who did not bring their children to receive VAC were mostly because they received no information regarding VAC distribution (32.8 percent). West Kalimantan, which had the lowest VAS coverage, had the highest proportion of mothers (41.9 percent) who received no information regarding the VAC distribution. When mothers were asked to mention the distribution period of VAS, only 20 percent mothers gave the correct answer (i.e February and August). West Kalimantan and Southeast Sulawesi had almost similar proportion of mothers who did not know the distribution period (46.7 and 48.7 percent, respectively). When the mothers were further asked about how frequent of underfive children should receive VAC per year, only 57.9 percent mothers could give the correct answer. Only 34.8 percent mothers were able to give correct answer about the age of a child when he/she should receive VAC for the first time. The figures reflect that mothers were not as familiar with VAS program as the health workers thought, meaning that VAS socialization is indeed still needed.

To increase coverage, schedule of VAC distribution has to be informed to subjects at least one month prior to the distribution day, and become more frequent as it is closer to the day. Household survey resulted that in general, mothers received information more than one week before the distribution day (23 percent), within one week before the day (28.2 percent), on the day (26.8 percent). About 22.1 percent mothers had never been informed about the VAC distribution schedule, with the highest percentage in West Kalimantan (31.3 percent).

Some good points were found in relation with VAS socialization activities. In Southeast Sulawesi, two Puskesmas together with local youth organization (Karang Taruna) produced their own banners for VAS program. In some areas in Lampung, the schedule of VAC distribution was also announced through loudspeakers at the mosques on the day of distribution. In one sub-district in West Kalimantan, the Puskesmas sent a letter to the head of village to inform the chedule of VAC distribution, especially the village that was far from Posyandu.

Lack of coordination between Nutrition Unit of District Health Office and Pharmacy Warehouse was found in Lampung and Southeast Sulawesi. This condition resulted in many expired left over capsules from previous period. Poor coordination led to poor VAC distribution to lower level. Some Puskesmas/Posyandu had more number of capsules than needed, while other Puskesmas/Posyandu experienced lacking of stocks. Most VAC was not stored at Pharmacy Warehouse because VAS program implementer (Nutrition Unit) perceived that taking VAC from Pharmacy Warehouse took a long bureaucracy. Therefore, the capsules were stored at Nutrition Unit. There was no specific date set by the upper level as deadline for the lower level to submit the VAC request. However, none of the District Health Offices, Puskesmas, and Posyandus received the VAC late.

VAC was mostly distributed in Posyandu (87.1 percent) by cadres (42.7 percent) or midwives (41.9 percent), on Posyandu day (89.7 percent). Almost all mothers (96 percent) were satisfied with the distribution. Most mothers went to Posyandu on foot (86.2 percent), which took less than 10 minutes (70.3 percent). Some mothers (13.2 percent) in Muna District Southeast Sulawesi, had to take ojek (motorcycle taxi) to go to Posyandu that cost more than ten thousand rupiah. Ratio numbers of cadres to underfive children in most areas was considered sufficient. However, there was no consideration yet on ratio number of cadres to the size of Posyandu service area which affect the cadre’s ability to do socialization and conduct sweeping. In Sanggau District West Kalimantan, there were Posyandus which had no cadres. In some areas, cadres play a very significant role on VAS program to underfive children, since they did the socialization, distribution, recording and reporting, as well as sweeping activity. This significant role needs qualified and capable cadres who may be achieved by giving training and nutrition education to the cadres. In fact, however, there was a very limited number of cadres who ever received training for the past 2 years related to VAS program.Training was also highly needed to increase cadre’s knowledge and capability to give nutrition education to mothers. This issue was raised by most cadres as they felt they were not capable enough to deliver nutrition education, whereas nutrition education was considered the best way to increase mother’s awareness about the benefits of Vitamin A. Such awareness is needed to create demand for Vitamin A and lead to action to get the capsule, as it is shown by the result of household survey. Most mothers who received VAC for their children said that the reason to get the capsule was because vitamin A would increase their child’s health (50.6 percent), and it also would benefit for the child’s eye (32.5 percent). The reasons reflect that mothers are already aware of the benefit of Vitamin A. Lampung, which had the highest coverage of VAS, had the highest proportion of mothers (37.5 percent) who received health and nutrition education during distribution of VAC, compared to that in West Kalimantan (6.2 percent) and Southeast Sulawesi (12.5 percent). Cadres and midwives also noticed that Posyandu attendance was generally higher on Vitamin A months (February and August) compared to other months. Attendance of regular Posyandu during the last three months was 53.2 percent (routine) and 24.2 percent (not routine). Around 23 percent children never attended Posyandu for the last three months, with the highest percentage in West Kalimantan (39.9 percent).

In general, 9.2 percent children received VAC through sweeping approach, with the highest percentage in West Kalimantan (12.4 percent). In West Kalimantan and Lampung, sweeping approach was mostly done by cadres. While in Southeast Sulawesi, proportion of sweeping conducted by cadres and midwives were almost similar. In West Kalimantan, 20.3 percent of children received VAC at home from their family or neighbor. In West Kalimantan, some Puskesmas did sweeping for VAS program together with other programs, such as immunization and antenatal care. The decision of conducting integrated sweeping was based on program coverage, where the data may be available few weeks after the distribution day. In case of VAS program, the intensive and integrated sweeping was done when the coverage was less than 50 percent. Cadres admitted that no transportation support was the main constraint to do sweeping, especially in order to reach targets who lived in remote areas or lived as nomad.

Recording is very important for documenting facts. Among those who had Growth Monitoring Card (Kartu Menuju Sehat/KMS) and received VAC, only 55.4 percent had mark on their KMS that they received VAC, with the highest percentage in Lampung (83.3 percent). To reach underfive children who lived far from Posyandu, cadres or midwives sometimes entrusted the capsule to her/his neighbor. No supervision of this mechanism was done, which may lead to underreporting or over reporting of the number of children receiving VAC.

There was no standard format for reporting. There was inconsistency in defining the number of targeted children as well as the number of children who received VAC, from Posyandu until Provincial Health levels. Puskesmas mostly used the reports from Posyandu in defining the number of targeted children, which was the actual number. District and Provincial Health Office mostly used projection data derived from BPS data. Puskesmas preferred to use the actual number instead of the projected one, because the number of the targeted children based on projection data usually was higher than that from the actual data. Thus, using projection data as denominator in calculating coverage would result in lower coverage. Two districts in Lampung (i.e Tanggamus and Lampung Timur) distributed VAC every month instead of February and August. Close supervision and monitoring especially in recording are needed in this case to reduce the risk of giving the children incorrect spaced doses of VAC (which is high dose).

In some areas, especially in Southeast Sulawesi, sweeping data was not included in the report and coverage calculation. Reporting mechanism of VAC distributed by other channels besides Posyandu had not yet been established. Some areas had no deadline for report submission. No final data were available even until several months after VAC distribution day. Delay on report submission may also relate to poor data filling in each level.

By having all of the information regarding management of VAS program, some recommendations are proposed to increase performance of VAS program implementation. Socialization has to be given bigger attention regardless the fact that the VAS program is a routine program and perception that mothers are familiar with the program. Budget has to be allocated for socialization activities. Involving village and religious leaders to do socialization is considered an effective way since community very often listen more to its leader. Adequate supply of socialization materials should be supported by Provincial and District Health Office in coordination with other parties such as youth organizations.

Since Districts are expected to procure the needed VAC, coordination between Provincial and District Health Office is highly needed. VAC supply from Provincial Health Office without early information to District Health Office may ruin the District’s logistic plan. Each level has to give information on the number of VAC stocks in the request letter. This information will avoid the unnecessary purchase of VAC. Good recording in inventory log books at Provincial Health Office until Puskesmas levels is needed to provide information on the number and the distribution of VAC at different distribution points. First In First out (FIFO) system has to be practiced to prevent expired capsules. One example of good inventory log book is the one in Ketapang District in West Kalimantan.

Realizing that many children live in remote areas or even live as nomad (especially in Southeast Sulawesi), transportation support is highly needed by cadres to reach the children. Another way is by expanding the distribution channel through community or religious leader. To reduce operational cost, integrated sweeping like the one practiced in West Kalimantan, is one of the solutions to increase VAS coverage. Attention has to be put on when sweeping approach will be conducted and also its regularity. VAS coverage calculation must include the number of children who received VAC through sweeping and other channels besides Posyandu. Province until Puskesmas levels have to use the same source of data in defining the number of targeted children for VAS program. The decision has to be made by the Provincial Health Office and applied by all levels in the respective province. Cadres have to put children’s date of birth in their recording books. Children’s age calculation has to be based on the date of birth, to avoid giving incorrect dosing of VAC to the child.

Nutrition education as the key factor in increasing mother’s awareness has to be done continuously, both in formal or informal setting. Since cadres are the person who will deliver the nutrition education to mothers, cadres have to receive training on VAS program to make them become more capable and at the same time more confident to deliver the nutrition extension.

Survey conducted by MOH, UNICEF, and the Micronutrient Initiative collaborated with SEAMEO TROPMED RCCN University of Indonesia, 2007
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