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Maalouf J.,Centers for Disease Control and Prevention | Maalouf J.,Oak Ridge Institute for Science and Education | Cogswell M.E.,Centers for Disease Control and Prevention | Gunn J.P.,Centers for Disease Control and Prevention | And 6 more authors.
American Journal of Public Health | Year: 2013

We reviewed methods of studies assessing restaurant foods' sodium content and nutrition databases. We systematically searched the 1964-2012 literature and manually examined references in selected articles and studies. Twenty-six (5.2%) of the 499 articles we found met the inclusion criteria and were abstracted. Five were conducted nationally. Sodium content determination methods included laboratory analysis (n = 15), point-ofpurchase nutrition information or restaurants' Web sites (n = 8), and menu analysis with a nutrient database (n = 3). There is no comprehensive data system that provides all information needed to monitor changes in sodium or other nutrients among restaurant foods. Combining information from different sources and methods may help informa comprehensive system to monitor sodium content reduction efforts in the US food supply and to develop future strategies. Source


Elfassy T.,University of Miami | Yi S.,New York University | Eisenhower D.,Survey Unit | Lederer A.,Nutrition Strategy Program | Curtis C.J.,Bureau of Chronic Disease Prevention and Tobacco Control
Journal of the Academy of Nutrition and Dietetics | Year: 2015

The Nutrition Facts (NF) label was established to help individuals monitor their nutrient intake and select healthier foods. This tool is particularly useful for individuals for whom dietary improvements are recommended, such as those with hypertension. Study objectives were to examine the independent association between hypertension and frequency of use of the NF label for sodium information and determine whether frequent use in individuals with hypertension was associated with differences in mean sodium intake assessed through 24-hour urine samples. Data came from the New York City Community Health Survey Heart Follow-Up Study, a cross-sectional study conducted in 2010 in a representative sample of New York City adults (n=1,656). Participants were asked questions regarding frequency of checking the NF label and also had 24-hour urine samples collected to assess actual sodium intake. Results indicated that hypertension was associated with frequent use of the NF label for sodium information (adjusted odds ratio 1.71, 95% CI 1.07 to 2.73). In individuals with hypertension, sodium intake did not differ between frequent vs nonfrequent use of the NF label for sodium information (3,084 mg/day vs 3,059 mg/day; P=0.92). Although individuals with hypertension compared to those with no hypertension had 71% higher odds of frequently using the NF label for sodium information, suggesting they may be interested in decreasing sodium intake, sodium intake did not differ by frequency of NF label use among those with hypertension. Future research should explore strategies to ensure that when nutrition information is used, it is translated into meaningful results, especially in individuals with health concerns such as hypertension. © 2015 Academy of Nutrition and Dietetics. Source


Sealy Y.M.,Fordham University | Zarcadoolas C.,CUNY - Hunter College | Dresser M.,Bureau of Chronic Disease Prevention and Tobacco Control | Wedemeyer L.,Public Health Detailing Program | And 2 more authors.
Childhood Obesity | Year: 2012

Background: This paper describes the research and development of the Obesity in Children Action Kit, a paper-based chronic disease management tool of the Public Health Detailing Program (PHD) at the New York City (NYC) Department of Health and Mental Hygiene (DOHMH). It also describes PHD's process for developing the Obesity in Children detailing campaign (targeting healthcare providers working with children aged 2-18) and its results, during which the Action Kit materials were a focal point. The campaign goals were to impact healthcare provider clinical behaviors, improve the health literacy of parents and children, instigate patient-provider-parent dialogue, and change family practices to prevent obesity. Methods: Qualitative research methods consisted of healthcare provider in-depth interviews and parent focus groups to aid campaign development. Evaluation of the Obesity in Children campaign included self-reported data on uptake and usage of clinical tools and action steps of matched assessments from 237 healthcare provider initial and follow-up visits, material stock counts, and DOHMH representative qualitative visit excerpts. Results: Key themes identified in parent focus groups were concerns about childhood diabetes and high blood pressure, awareness of cultural pressure and our "supersize" culture, frustration with family communication around overweight and obesity, lack of knowledge about food quality and portion size, economic pressures, and the availability of healthy and nutritious foods. During the Obesity in Children campaign, six representatives reached 161 practices with 1,588 one-on-one interactions, and an additional 461 contacts were made through group presentations. After these interactions, there was a significant increase in the percentage of physicians self-reported use of key recommended practices: Use of BMI percentile-for-age to assess for overweight or obesity at every visit increased from 77% to 88% (p < 0.01); counseling all patients and their parents/caregivers about healthy eating and physical activity increased from 67% to 85% (p < 0.01); counseling all patients on reducing sugar-sweetened beverages increased from 63% to 78% (p < 0.01); and working with families to set realistic goals increased from 64% to 86% (p < 0.01). Clinical tools such as a soda bottle showing sugar content, pediatric plate planners, and goal setting posters were widely adopted (62%, 78%, and 41% respectively). Conclusions: The Obesity in Children campaign, as well as its predecessor, the Adult Obesity campaign and Action Kit, were amongst the best-received and most successful campaigns PHD has conducted since the inception of the program. They have elicited the most attention from healthcare providers and staff, with Obesity in Children Action Kit materials being requested throughout NYC, as well as nationally. © Mary Ann Liebert, Inc. Source


Lederer A.,Nutrition Strategy Program | Toner C.,Nutrition Strategy Program | Krepp E.M.,Nutrition Strategy Program | Curtis C.J.,Nutrition Strategy Program
Journal of Public Health Management and Practice | Year: 2014

OBJECTIVE:: To describe the characteristics, nutrition-related knowledge, practices, and attitudes of staff managing cafeterias in New York City (NYC) hospitals. METHODS:: An in-person survey was administered over 7 months to cafeteria managers from hospitals participating in the NYC Department of Health and Mental HygieneÊs Healthy Hospital Food Initiative. The survey assessed nutrition knowledge and attitudes; hospital cafeteria practices; and nutrition standards and policies. The majority of questions required a yes or no response, followed by an open-ended request for details related to the response. Other questions were multiple choice or used 5-point Likert scales to measure respondent perceptions. RESULTS:: Seventeen cafeteria managers completed the survey. Less than a third of respondents had training in nutrition, and less than a quarter of hospitals followed nutrition standards for food offered in the cafeteria. Most respondents thought cafeterias could play a role in reducing sodium consumption, yet less than half correctly identified the largest sources of sodium in the average diet. The most commonly cited limitation to making healthy changes in the cafeteria was perceived lack of demand for healthy foods/customer support. CONCLUSION:: Characteristics, nutrition knowledge, practices, and attitudes of hospital cafeteria managers vary. Communication with consumers and education of staff who lack training and experience in nutrition may be important focus areas for hospitals looking to improve their food environment. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

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