Dining with Diabetes Program Development

IMPACT. 1: The class is taught in three sessions by Family and Consumer Sciences Extension Educators and community partners throughout the state. In 2012, DWD was taught in 19 counties with over 394 participants.OSU PARTNERS: College of Food, Agricultural, and Environmental Sciences; College of Education and Human Ecology; College of Public Health; OSU Extension; Department of Human NutritionCOMMUNITY PARTNERS: 19 County Extension AgentsPRIMARY CONTACT: Dan Remley ([email protected])Nearly 1 in 10 Ohioans has been diagnosed with diabetes which, if not managed properly, can increase the risk for serious health problems, from heart disease to eye and foot complications. Diabetes costs Ohio $5.9 billion annually in medical expenses, lost work, and early death. To address this critical problem, OSU Extension's Dining with Diabetes (DWD) teaches ways to manage diabetes through menu-planning, carbohydrate-counting, portion control, labelreading, food demonstration and healthy recipe taste-testing

A Conversation Tool for Assessing a Food Pantry\u27s Readiness to Address Diet-Related Chronic Diseases

Food insecurity is associated with diabetes and other chronic diseases. Individuals who experience food insecurity may use coping skills to avoid hunger, including eating unhealthful foods and binging when food is abundant, two practices that are often detrimental to prevention or management of chronic diseases. Food pantries, especially those using the Rainbow of Colors Choice Food Pantry System, are potential settings for providing nutrition education, healthful foods, and screenings to help individuals prevent or manage their chronic diseases. This article describes a conversation guide Extension professionals can use to assist food pantry personnel in identifying and implementing strategies for addressing chronic diseases

Maximizing the Nutritional Value of Produce Post-Harvest: Consumer Knowledge Gaps, Interests, and Opinions Regarding Nutrition Education Strategies

Although many consumers perceive locally produced, fresh fruits and vegetables to be healthier, they might not have the knowledge and skills to retain optimal nutritional quality following harvest or purchase. We surveyed Ohio farmers market consumers\u27 and managers\u27 knowledge and interests related to maximizing nutritional value of produce. Consumers and managers lacked knowledge but were interested in the topic. Respondents were concerned about chronic health conditions and how foods and nutrients might prevent them. The perspectives and knowledge gaps of the target audience will assist the development of educational materials and strategies

Educating Farmers\u27 Market Consumers on Best Practices for Retaining Maximum Nutrient and Phytonutrient Levels in Local Produce

Few farmers\u27 market consumers are aware of how to retain optimal nutritional quality of produce following purchase. Our objective was to develop and evaluate educational materials intended to inform market consumers about best practices for storing, preserving, and consuming local produce to maximize nutrients and phytonutrients. Printed educational materials were developed and then evaluated via a survey of and interviews with Ohio farmers\u27 market consumers. The materials were modified to reflect consumer comments, and finalized materials were distributed to farmers\u27 markets throughout Ohio. The approach we used can be applied by other Extension professionals when developing educational materials for different audiences

Unifying Multi-State Efforts through a Nationally Coordinated Extension Diabetes Program

The Cooperative Extension System translates research to practice and “brings the University to the people” throughout the U.S. However, the system suffers from program duplication and is challenged to scale-out effective programs. One program, Dining with Diabetes (DWD), stands out for its dissemination to multiple states. DWD is a community-based program aimed at improving diabetes management, nutrition, and physical activity behaviors. DWD was coordinated through a national working group and implemented by state Extension systems. A pragmatic, quasi-experimental study was conducted to determine the effectiveness of the national coordination model and the overall impact of DWD. Four states reported data representing 355 DWD participants. Significant differences were found in diabetes management behaviors and knowledge from pre to post-program. However, there were challenges with data analysis due to state differences in data management. We detail the transition from one state to a national workgroup, strengths and challenges of the national model, and implications for other Extension programs

Engaging Communities to Enhance Physical Activity among Urban Youth

As part of a USDA multi-year grant, this project has used community-based participatory strategies to help overcome barriers to eating more fruits and vegetables and increasing physical activity, and ultimately sparking youth to create healthy communities for a lifetime. The project supports teams of community and school partners in limited income neighborhoods. Obesity is a multifaceted, complex problem, but a sedentary lifestyle is a major contributor to this national health issue. Approximately one-third of children nationwide are overweight or obese; and minority children and those with a low socioeconomic status have the highest prevalence rates. Urban youth have been shown to be less physically active than rural youth. Supportive physical activity environments (understood as the geography, observations, and perceptions of features such as recreational facilities, sidewalks, bike lanes, traffic patterns, etc.) have been positively associated with adolescent physical activity behaviors within urban settings. As part of a socio-ecological intervention to improve physical activity behavior, the Physical Activity Resource Assessment (PARA), the Active Neighborhood Checklist (ANC), and focus groups to assess the physical activity influences within an urban middle school and surrounding community were completed. The assessments suggested that lack of parks, lack of walkability in the streets, perceptions of crime, lack of school programs, and parental and peer influences were all barriers to physical activity opportunities. The ANC, PARA and focus groups each added valuable information for program planning to improve adolescent physical activity behavior. From our initial experiences, environmental audits and focus groups are relatively easy to conduct by Extension professionals, working in partnership with a school and community team, and support a socio-ecological approach to improving physical activity with an urban setting.AUTHOR AFFILIATION: Susan Zies, Educator, The Ohio State University Extension, [email protected] (Corresponding Author); Tandalayo Kidd, Extension Specialist, Kansas State University Extension; Kendra Kattelmann, Professor, South Dakota State University; Dan Remley, Field Specialist, Food, Nutrition and Wellness, The Ohio State University Extension; Erika Lindshield, Extension Associate/Project Coordinator, Kansas State University; Nancy Muturi, Professor, Kansas State University; Koushik Adhikari, Assistant Professor, University of Georgia; Beth Stefura, Educator, The Ohio State University Extension; Marcia Jess, Program Coordinator, The Ohio State University Extension; Shannon Smith, Program Assistant, The Ohio State University Extension.A physical activity environmental assessment using the Physical Activity Resource Assessment and the Active Neighborhood Checklist instruments was completed as part of a United States Department of Agriculture grant targeting obesity in sixth- to eighth-grade students in an urban middle school. The assessments provided baseline data about the physical environments such as recreational facilities, sidewalk, bike lanes, and traffic patterns, in the neighborhood around the urban middle school identified in the project. Focus groups were conducted with adults and with youth to determine perceptions of physical activity in the neighborhood. The focus group data added valuable insight beyond the physical activity environmental assessment. Crime was a major concern among focus group participants as well as lack of non-competitive physical activity opportunities

Daily Dietary Intake Patterns Improve after Visiting a Food Pantry among Food-Insecure Rural Midwestern Adults.

Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, before-and-after design with a pantry visit as the intervention. Participants (n = 455) completed a demographic and food security assessment, and two 24-h dietary recalls. Adult food security was measured using the U.S. Household Food Security Survey Module. Dietary intake patterns were assessed using Automated Self-Administered 24-h Recall data and classified by Healthy Eating Index (HEI-2010) scores, dietary variety, number of eating occasions, and energy intake. Paired t-tests and Wilcoxon signed-rank tests compared outcomes before and after a pantry visit. Mean dietary variety increased after the pantry visit among both food-secure (p = 0.02) and food-insecure (p \u3c 0.0001) pantry clients. Mean energy intake (p = 0.0003), number of eating occasions (p = 0.004), and HEI-2010 component scores for total fruit (p \u3c 0.001) and whole fruit (p \u3c 0.0003) increased among food-insecure pantry clients only. A pantry visit may improve dietary intake patterns, especially among food-insecure pantry clients

Breakfast Consumption Is Positively Associated with Usual Nutrient Intakes among Food Pantry Clients Living in Rural Communities

Background: Breakfast consumption has declined over the past 40 y and is inversely associated with obesity-related diet and health outcomes. The breakfast pattern of food pantry clients and its association with diet is unknown. Objective: The objective is to investigate the association of breakfast consumption with diet quality and usual nutrient intakes among food pantry clients (n = 472) living in rural communities. Methods: This was an observational study using cross-sectional analyses. English-speaking participants ≥18 y (or ≥19 y in Nebraska) were recruited from 24 food pantries in rural high-poverty counties in Indiana, Michigan, Missouri, Nebraska, Ohio, and South Dakota. Participants were surveyed at the pantry regarding characteristics and diet using 24-h recall. A second recall was self-completed or completed via assisted phone call within 2 wk of the pantry visit. Participants were classified as breakfast skippers when neither recall reported breakfast ≥230 kcal consumed between 04:00 and 10:00; breakfast consumers were all other participants. The Healthy Eating Index-2010 was modeled with breakfast pattern using multiple linear regression. Mean usual intake of 16 nutrients was estimated using the National Cancer Institute Method and compared across breakfast pattern groups. Usual nutrient intake was compared with the Estimated Average Requirement (EAR) or Adequate Intake (AI) to estimate the proportion of population not meeting the EAR or exceeding the AI. Results: A total of 56% of participants consumed breakfast. Compared with breakfast skippers, breakfast consumers had 10–59% significantly higher usual mean intakes of all nutrients (P ≤ 0.05), and had 12–21% lower prevalence of at-risk nutrient intakes except for vitamin D, vitamin E, and magnesium. Conclusions: Adult food pantry clients living in rural communities experienced hardships in meeting dietary recommendations. Breakfast consumption was positively associated with usual nutrient intakes in this population. This trial was registered at clinicaltrials.gov as NCT03566095

Extension's Dining with Diabetes: Helping People Prevent and Manage Diabetes in Ohio and throughout the Nation

Diabetes is a common, serious and expensive disease in Ohio, the United States and around the world. The complications of untreated or undertreated diabetes are devastating and include heart, kidney, eye and nerve diseases. Studies have shown that when blood glucose is controlled, complications of diabetes are delayed or possibly prevented. Extension's Dining with Diabetes (DWD) program is designed for people with diabetes, their family members and those at risk; and it consists of education, cooking demonstrations, and taste testing. Participants are engaged on the topics of healthy cooking strategies, meal planning, portion control, label reading, physical activity, and goal setting. The program is delivered as a series of four face-to-face sessions with a three-month reunion led by Extension educators partnering with registered nurses, certified diabetes educators or registered dietatians. In addition to Extension offices, local community centers, faith-based organizations, libraries and hospitals are often used as locations in which to offer the program. State and local health departments, clinics, hospitals, pharmacies and community health coalitions are active in marketing the program. DWD has been implemented in Ohio for more than a decade, and is now a national program with more than 38 states participating. Dining with Diabetes has a successful history of being implemented in Ohio and adapted by other states. The national program and evaluation provides the opportunity to demonstrate national impact and how Ohio's efforts compare with other states in terms of improving diabetes outcomes. The national program evaluation includes assessment of knowledge, attitudes and skill gains related to diabetes management. Medium-term outcomes include reported behavior change in the areas of food selection, food preparation, label reading, and physical activity. Participants who reported at three months follow-up demonstrated the ability to maintain or improve dietary change after completing the program.AUTHOR AFFILIATION: Dan Remley, Field Specialist, Food, Nutrition and Wellness, The Ohio State University Extension, [email protected] (Corresponding Author); Shari Gallup, Educator, Family and Consumer Sciences, The Ohio State University Extension; Margaret Jenkins, Educator, Family and Consumer Sciences, The Ohio State University Extension; Tammy Jones, Educator, Family and Consumer Sciences, The Ohio State University Extension; Jenny Lobb, Educator, Family and Consumer Sciences, The Ohio State University Extension; Susan Zies, Educator, Family and Consumer Sciences, The Ohio State University Extension; Marie Economos, Educator, Family and Consumer Sciences, The Ohio State University Extension; Chris Kendle, Educator, Family and Consumer Sciences, The Ohio State University Extension; Chelsea Peckny, Assistant Professor, College of Pharmacy; Joyce Riley, Educator, Family and Consumer Sciences, The Ohio State University Extension; Amy Meehan, Healthy People Program Specialist; Brian Butler, Evaluation Specialist, The Ohio State University Extension; Ingrid Adams, Associate Professor; Lisa Barlage, Educator, Family and Consumer Sciences, The Ohio State University Extension; Candace Heer, Associate Professor; Amanda Bohlen, Educator, Family and Consumer Sciences, The Ohio State University Extension.Diabetes is a common, serious and expensive disease in Ohio, the United States and around the world. The complications of untreated or undertreated diabetes are devastating and include heart, kidney, eye and nerve diseases. Extension's Dining with Diabetes (DWD) program engages participants on the topics of healthy cooking strategies, meal planning, portion control, label reading, physical activity, and goal setting. The program is delivered as a series of four face-to-face sessions with a three-month reunion led by Extension educators partnering with registered nurses, certified diabetes educators or registered dietitians. DWD has a national curricula and evaluation, providing the opportunity to demonstrate national and state-level impact on knowledge, attitudes and skills related to diabetes management

Serving Up Change: A Food Ethics Workshop

Decisions about institutional food procurement take place in several public contexts, including public K-12 schools, public universities, public prisons, and hunger-relief agencies. Food sourcing decisions are often guided by institutional values such as animal welfare, cost, accessibility, convenience, cultural appropriateness, social acceptability, healthfulness, freshness, quality, workers’ rights, localness, and environmental sustainability. At times, these values might not align with the values of constituents of whom these institutions serve. Civic engagement can be used to identify value conflicts, reduce the extent of those conflicts, and find a path to their appropriate resolution. Principled civic engagement practices can also create equitable and inclusive environments in which dialogue can take place. The resulting decisions can benefit in terms of legitimacy, respectfulness, and epistemic soundness. The goal of this workshop is help public school food service directors learn about civic engagement skills so food procurement decisions can become more equitable and just.AUTHOR AFFILIATION: Dan Remley, associate professor and OSU Extension field specialist, [email protected] (Corresponding Author); Glennon Sweeney, senior research associate, Kirwan Institute for the Study of Race and Ethnicity at Ohio State; Karima Samadi, OSU Extension program coordinator; Tannya Forcone, graduate research assistant, Kirwan Institute for the Study of Race and Ethnicity at Ohio StateThis workshop will help nonprofit institutions develop inclusive dialogue with constituents around food values. Partnerships with Extension or public health can facilitate these engagements. At the end of the workshop, individuals will be charged and equipped with leading initiatives in their locale