| Development of the Australian Guide to Healthy Eating 1: background and rationale
Alison M. Smith, Elizabeth Kellett, Yvonne Schmerlaib and Barbara Smith
Abstract The development of the new Australian food guide is part of the implementation plan of the national food and nutrition policy. One of the objectives of the policy is to improve the knowledge and skills necessary for Australians to choose a healthy diet. This project was the third in a series of three funded projects: the first developed the nutrition rationale for the guide; and the second described the knowledge, attitudes and needs of nutrition educators, communicators and consumers. The project team was contracted by the (then) Commonwealth Department of Health and Family Services to undertake the consultancy to develop the guide. This paper describes the background to the project and the development and rationale of the nutrition and communication framework of the food guide. In a separate paper, the research and evaluation undertaken to develop the finished educational materials are described. (Aust J Nutr Diet 1999;56:188-193.)
Development of the Australian Guide to Healthy Eating 2: materials development, evaluation and consultation
Alison M. Smith, Elizabeth Kellett, Yvonne Schmerlaib and Colin Sindall
Abstract In order to ensure the acceptability and relevance of the new Australian Guide to Healthy Eating to consumers, nutrition educators and users in many sectors, evaluation of, and consultation about, the guide were undertaken. Twenty-one focus groups, nine consultation workshops, four expert reference group workshops, a field testing trial involving 61 teachers, dietitians and other nutrition educators, and a survey of 750 consumers were carried out. There was broad general agreement with the main scientific rationale of the guide from nutrition and health educators and user groups from other sectors, probably due to the previous research and consultation on which the design was based. There was disagreement from some groups within the food industry and non-government sectors about some aspects of the scientific and communication rationales of the guide. This mainly related to the depiction of processed foods, and oils and fat spreads. The consumer focus groups were invaluable in refining the graphic design work to resolve these and other issues to ensure that the guide was interpreted appropriately by consumers. Many individuals and sectors were involved in the Australian Guide to Healthy Eating at all stages of the work undertaken, and the finished guide should be of use to many as a framework for the development of programs and policies for nutrition education, health promotion and general health. (Aust J Nutr Diet 1999;56:194-208.)
‘Filling the Gap’ – children aged two years or less: sources of nutrition information used by families and maternal and child health nurses
Veronica Graham, Kay Gibbons, Catherine Marraffa and Lindy Henry
Abstract The objective of this study was to identify the sources of nutrition information and services used by 115 parents of children aged less than two years, and by maternal and child health nurses. This is the first part of a larger study of children aged from birth to eight years old. Parents commonly accessed the maternal and child health nurses (85%), family (66%) and friends (48%) for nutrition information. Doctors (25%) were the second most accessed professional group by parents for nutrition information. Dietitians were most likely to be used by maternal and child health nurses, for information about specific nutrition problems as well as for referral. Maternal and child health nurses requested access to dietitians for both consultancy and referral, but preferred the latter. There were gaps in nutrition information available to both parents and professionals. Both groups expressed a need for information to be consistent, clear, concise, easy to use, and available in the required community languages. Doctors need to recognise the role they have in the provision of nutrition information to families with young children. Dietitians are well placed to provide specialist services for referral as well as resourcing the maternal and child health service, food industry, government departments and the media. (Aust J Nutr Diet 1999;56:209-214.)
Parental strategies and young children’s snacking behaviour: a pilot study
Heather Morton, Karen Campbell, Barbara Santich and Anthony Worsley
Abstract The environment in which a child learns food preferences is influenced by a range of factors, including parental attitudes to child feeding. The main aims of this qualitative pilot study in 27 women were to examine mothers’ attitudes to snack foods; to investigate the ways the women attempted to regulate or control the snacking habits of their two-year-olds; and to identify the type of parenting strategies and styles adopted for this purpose. Individual interviews and open-ended questions were used. There was common agreement about the types of snacks considered to be ‘healthy’ and ‘unhealthy’. The latter were restricted to varying degrees and most women adopted strategies that were indicative of an authoritative (democratic) parenting style. They aimed to balance good nutrition with a happy parenting relationship and were not over-anxious about any aspect of feeding their child. However, this paper raises concerns about some of the coercive practices used by mothers to control snacking as this may encourage food preferences that are not consistent with the parent’s desire to promote optimal nutrition. This paper provides new data regarding mothers’ attitudes towards, and control of, snack foods in the two-year-old age group. It provides insights that may inform health professionals in their development of nutrition education programs and policies for this age group. (Aust J Nutr Diet 1999;56:215-220.)
Insight
Case study: refeeding syndrome and thiamin deficiency after extended starvation
Christina Stubbs
Abstract This paper documents a case of refeeding syndrome in a previously healthy 22-year-old man who was snowbound without food for 43 days. Initial oral feeding commenced during rescue. Wernicke’s encephalopathy was diagnosed on admission to hospital about fourteen hours later and thiamin replacement was given. Feeding was gradually increased over twelve days to a normal diet. Supplements of phosphate, potassium, magnesium and vitamins were administered. Abnormal liver function tests were noted when voluntary daily oral intake was recorded to be 21 000 kJ. These improved when intake was reduced to 14 000 kJ per day. Mild neurological symptoms persisted after six years. The case highlights issues in nutritional management of malnourished patients, including the need to administer thiamin prior to refeeding, and to limit energy intake during refeeding. (Aust J Nutr Diet 1999;56:221-223.) |
Australian Journal of Nutrition and Dietetics, Volume 56, Number 4, December 1999