Community Nutrition : Chapters 1 and 2

NFS 3043

a group of people who are located in a particular space, have shared values, and interact within a social system

community

four components of community are

population, location, social interaction, shared values

Discipline that strives to improve public health and public eating habits.

community nutrition

three focal areas of community nutrition

people, policy, programs

an effort organized by society to protect, promote, and restore the people’s health through the application of science, practical skills, and collective actions

public health

aimed at preventing disease by controlling risk factors that are related to injury or disease

Primary prevention

focuses on detecting disease early through screening and other forms of risk appraisal.

Secondary prevention

aims to treat and rehabilitate people who have experienced an illness or injury

tertiary prevention

- focuses on the nature of people’s interactions with their surrounding physical and sociocultural environments.
− in this model, various levels of influence are arranged by relative proximity to the individual.

Social-Ecological Model (SEM)

community-based programs conducted by a government agency whose official mandate is the delivery of health services to individuals living in a particular areaL

Public health nutrition

the study of the distribution and determinants of
health-related states in specified populations, and the application of this study to control health problems

epidemiology

refers to the relationship between the health problem or disease and the population in which it exists

distribution

refers to the causes and factors that affect the risk of disease

determinants

a comparison of the risk of some health-related event,
such as disease or death, in two groups

relative risk

RR = 1

no association

RR > 1

exposed group is at greater risk of disease or death than the unexposed group

RR < 1

the exposed group has smaller risk than the unexposed group

single point in time, cross study, all cases counted in a
single survey or examination of a group, All individuals examined, including cases and non-cases

prevalence

cohort study, duration of the follow up period, New cases occurring during the follow-up period in a group initially free of the disease, all susceptible individuals present at the beginning of the follow-up period

incidence

− Compare frequency of events (or disease rates) with per capita consumption of specific food components
− Focuses on groups of people (rather than individuals) and examines the relationship between exposure and disease (or other outcomes of interest) with population-level data.
− Good for generating hypotheses or exploring initial hypotheses about the relationship between an exposure and a disease.
− Susceptible to the Ecological Fallacy

Ecological or correlational studies

“Snapshot” of a population – comparing dietary intake, disease, other variables in a population at a specific time
− Includes surveys, laboratory experiments, and studies to describe the prevalence of disease and/or exposure in a specified population at one point in time
− Can only evaluate prevalence, not incidence. Therefore, cannot estimate risk.

Cross-sectional or prevalence studies

Comparing a group with a disease with a group that does not have it
− A group of persons with the disease is compared with a group of persons without the disease to compare characteristics, such as previous exposure to a factor, between cases and controls.
− Useful when a rare disease (very low incidence) with long latency period is being studied

Case-control studies

− A group of people are followed over time to see who develops a particular disease or condition and to which risks they have been exposed
− Can be conducted prospectively or retrospectively
− Useful for observing nutrition-related practices and health outcomes over a long period of time (1949 Framingham Heart Study)
− Can calculate incidence and risk of disease (or outcome of interest)
− Requires many resources, including time, personnel, and money; and analyses becomes complicated by loss to follow-up over time

cohort studies

subjects are randomly assigned
to either an experimental/treatment group or control group
− Used to determine causality between an exposure factor and an outcome
− Can calculate incidence and risk of disease (or outcome of interest)
− Requires many resources, including time, personnel, and money

Randomized Controlled Trial (RCT)

Can provide detailed information, requires subjects to make
judgments about their usual food habits

diet history

Can assess groups of people,May not reflect an individual’s usual intake

24 hour recall

Strong assessment method, time consuming and individuals can make recording errors

food record

Good for large groups of people, provides less detailed information

food frequency questionaire

The leading causes of death in the US may be ranked in the following order:

Cancer, diabetes, CHD

A community nutrition intervention that is designed to promote heart health by educating the public on the importance of a low fat, high fiber diet is an intervention that occurs at which level?

Primary prevention

Advocating for McDonald's and other fast food restaurants to provide food label information on the menu is an example of what level of intervention/prevention?

Primary

________ strives to increase quality and years of life, to eliminate health disparities, to create social and physical environments that promote good health, and promote quality of life and healthy behaviors throughout the life cycle.

Healthy people 2020

Community Nutrition focuses on all the following EXCEPT

• People

• Policy

• Practices

• Programs

practices

Health may be defined as:

• Absence of disease and pain

• State of complete physical, mental, and social well being.

• The ability to deal with physical, biological and social stress.

All of the above

Figures pertaining to life events, such as births, deaths, and marriages are known as

vital statistics

Regardless of the community setting or target audience, community nutrition programs have one desired outcome, which is ________

to promote behavior change