Home enteral nutrition practices in Victoria

Jane E. Winter, Catherine L. Streeton and Allison Kenwood

Abstract  Anecdotal evidence suggests that home enteral nutrition (HEN) usage in Australia has increased significantly in recent years. This has yet to be systematically documented. We have undertaken research to describe the epidemiology of current HEN practices in Victorian public hospitals. To obtain a broad view of HEN usage in Victorian public hospitals, two research methods were used. The first involved analysis of data from the Victorian inpatient minimum database regarding surgical procedures used to insert an enteral feeding tube. The second was the collation of questionnaire responses from 19 public hospital providers of HEN. The two methods provided consistent data about the prevalence of HEN patients in Victoria. The results indicated that there has been a 685% increase in the rate of percutaneous endoscopic gastrostomy procedures between 1990/91 and 1995/96, and in March 1997 alone there were an estimated 400 HEN clients in Victoria being supported by public hospital providers. The survey results also indicated that current feeding practices are in line with the recommendations from the available literature. (Aust J Nutr Diet 1999;56:10-14)

An analysis of the introduction of folate-fortified food products into stores in Australia

Mark A. Lawrence, Ingrid H.E. Rutishauser and Janine L. Lewis

Abstract  This report presents an analysis of the availability, price and related information about the introduction of folate-fortified food products into Australia. The report is compiled from data collected by a sample of community nutritionists and health workers from 60 stores across Australia over a three-year period from late 1995 through to late 1998. Based on the data collected in this survey, 47 folate-fortified products were available in Australia in late 1998. The labels of most fortified products indicated a folate content of between 25 and 50% of the recommended dietary intake per serve. Among the stores surveyed: there was little difference in the number or price of folate-fortified products available in capital cities between areas with different socioeconomic status; more folate-fortified products were available in stores in capital and regional cities than in rural towns and remote areas; and the price of these products was higher in rural towns and remote areas. These data contribute to the NHMRC’s review of its folate fortification policy and provide baseline information for evaluating the impact of the 1998 decision to allow a health claim for folate-fortified foods. (Aust J Nutr Diet 1999;56:15-21)

An adaptation of the Australian core food groups to enable planning of vegan and lactovegetarian diets

Amanda J. Benham

Abstract  This work demonstrates how the Australian core food groups system can be modified to enable the planning of vegan and lactovegetarian diets as well as omnivorous diets. In the modified version the cereals, vegetables and fruits groups remain the same as in the core food groups system, while the meat group is replaced with legumes, soya products, nuts and seeds. The milk group becomes milk or fortified soya milk, to allow for both lactovegetarian and vegan diets. The core food groups standard of 70% of the recommended dietary intake was adopted as a target for determining recommendations on the minimum number of serves from each food group. As found in the development of the core food groups system, zinc was the most limiting nutrient. Vitamin B12 and calcium were other limiting nutrients in the vegan and lactovegetarian guides. The number of serves from each group required to meet 70% of the applicable recommended dietary intake has been calculated for children from four years old, adult men and women and pregnant and lactating women. It was found that the number of serves from each food group required in the vegan and lactovegetarian planning guides was in most cases similar to the number of serves of corresponding core food groups specified for a particular population group. This suggests that the vegan and lactovegetarian planning guides could be incorporated into a modified core food groups planning guide. Such a guide would cater for the general omnivorous population as well as for those seeking to avoid meat and/or dairy products. (Aust J Nutr Diet 1999;56:22-30)

Socio-demographic correlates of the consumption of specific foods in a non-metropolitan area of Tasmania

David R. Woodward, Kathleen N. Shaw, Mary C. Rathbone, Fiona J. Cumming, Peter J. Ball, Andrew Thomson and Peter T. Sexton

Abstract  Data on socio-demographic variations in Australian dietary patterns are scarce, particularly in regional and rural Australia. For this study, a systematic sample (n = 1088, response rate 82%) of people aged 20 to 70 years on electoral rolls for the north and north-west regions of Tasmania completed written questionnaires, indicating, among other things, which of 52 specific foods (covering all major food groups) had been consumed the previous day. Individual-based socio-demographic characteristics were associated significantly (P < 0.01, after adjustment for potentially confounding variables) with consumption of many of these foods: gender (11 foods), age (ten foods) and educational attainment (nine foods). Generally, healthier food choices were found among respondents who were female, older and more educated. Geographically-based socio-demographic characteristics, however, were rarely significantly associated with consumption of specific foods: there were no significant associations with region or the socioeconomic status of the postcode area, and only one food differed in consumption between urban and rural areas. We conclude that, at least in this area, geographically-based socio-demographic characteristics are much less important predictors of dietary patterns than individual-based socio-demographic characteristics. (Aust J Nutr Diet 1999;56:31-38)

Insight
Issues in menu design: what chefs say, nutritionists need to know

Jan Lewis, Flora Douglas, Christina Pollard, Cathy Thomas and Margaret Miller

Abstract  With increasing trends to eat food prepared away from home, caterers have a vital role in improving the quality of nutritional intake. A telephone survey of 300 senior chefs in Perth, Western Australia, was conducted to identify promoters of, and barriers to, providing healthy food choices. Self-selected senior chefs in catering establishments surveyed were experienced (52% had been working for more than 10 years) but over a third had no formal qualifications. Results showed that the four main issues considered when planning menus were aesthetics (46%), cost (35%), variety (29%), and customer demand (27%). Nutrition and health considerations (21%) were less important. Although chefs themselves were interested in providing healthy foods, they perceived that customers were less interested. It is essential that nutritionists consider the priorities of chefs when working collaboratively with them to improve the food supply. Encouragement to increase healthy options is best communicated in terms of business opportunities. (Aust J Nutr Diet 1999;56:39-41)

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