KA 703. Nutrition Education and Behavior

Three major nutrition education and behavior efforts were conducted for the purpose of improving the health of Los Alamos County residents. Kitchen Creations, targets people living with diabetes and their families. It is a four-week series of education and hands-on food preparation. Through multiple community program offerings, the second effort, targets both people living with diabetes and heart disease. The third educational effort targets seniors participating in the meal program of the Los Alamos Senior and Retired Organization. Via lunch hour presentations, seniors are provided with education on ways to improve their nutritional health and well being.


Kitchen Creations is a four week series targeting people living with diabetes. Each class provides diabetes management education, hands-on food preparation, and a sit-down dinner prepared by the participants. Twenty four individuals [16(W) 8(H; 8(M) 16(F); 2(20’s) 1(30’s) 6(40’s) 7(50’s) 8(60’s] participated. The home economist and a local Diabetes Educator [1(W); 1(F)] co-taught the program. The following were the class sessions provided:
• April 7 – The Food Guide Pyramid and the 50/50 Plate (22 participated) [15(2) 8(H); 8(M) 15(F)
• April 14 – Desserts and Carbohydrates (17 participated) [13(W) 4(H); 4(M) 13(F)]
• April 21 – Vegetables, Grains and Beans (12 participated) [10(W) 2(H); 1(M) 11(F)]
• April 28 – Heart Healthy Cooking (11 participated) [8(W) 3(H); 11(F)]

Evaluation -- An open ended evaluation questionnaire was given at the end of each class session. If participants’ questionnaire comments indicated a need for further clarification or if there were additional questions, these were discussed at the next class. A final evaluation, conducted at the last class asked participants how participating in Kitchen Creations has helped them manage their diabetes. Of the ten responses, over 50% of participants eat at least 2 serving of whole grains per day, use the 50/50 method to control the amount of carbohydrates they eat at a meal, measure food portions, use more herbs and spices to flavor foods instead of salt and fat and read food labels to find the amount of carbohydrates in a serving.

Additional comments from participants included: “I like the education of balance – vegetable, protein and grains. I used to stay completely away from grains – now I can bring them back into my life.” “The 50/50 plan is very surprising and good.” “I learned carbohydrates vs. sugars and label reading.” “I was surprised how everything that I tasted was very good without added salt and very little fat.”

Funding for this program is provided by the New Mexico Department of Health Diabetes Prevention and Control Program.


Two heart healthy community educational programs, co-sponsored with the Los Alamos Heart Council were offered during the month of February. Heart Healthy: Take off 5 Pounds! A Little Goes a Long Way was held in Espanola and was presented by a certified diabetes educator/registered nurse. Fifty two individuals [15(W) 37(H); 8(M) 44(F)] attended. Participants learned how small weight and fitness changes can improve heart disease and prevent diabetes. This program was also co-sponsored with Presbyterian Healthcare Services -- Espanola Hospital and the Rio Arriba County Cooperative Extension Service. The second program, A Woman Cardiologist Talks About Women and Heart Disease, held in Los Alamos, was attended by one hundred thirty six individuals [124(W) 9(H) 3(A); 18(M) 118(F)]. The objective of the program was to learn about the challenges faced when trying to diagnose and treat women with heart disease. The programs were intended to create awareness of heart health during February -- National Heart Month.


As a follow-up to these community educational programs, Heart Healthy Cooking, Eating and Living School, a three hour long program ran once a week for four consecutive weeks. Twenty three individual, ages 27-76, [19(W) 4(H); 5(M) 18(F); 1(20’s) 3(30’s) 3(40’s) 8(50’s) 6(60’s) 2(70’s)] attend an hour presentation each week prior to the hands-on cooking portion of the class. Class goals are to teach participants to: plan heart-healthy meals; reduce fat and sodium without cutting taste; learn how to choose tasty and healthful carbohydrates; choose food supplements that can help to manage cholesterol, and learn to prepare healthy recipes. As an added bonus, participants have the opportunity to taste these heart-healthy recipes. The lecture sections offer information on: why cholesterol matters and helps participants understand their heart disease risk, discussion on the Therapeutic Lifestyle Changes (TLC) program which teaches participants how to make heart-healthy lifestyle changes including topics such as communicating better with their doctor and health care professional, reading food labels, making and sticking with lifestyle changes, planning heart-healthy menus for the whole family, and making heart-healthy choices when eating out. Weekly session topics include: The TLC Program and Risk Factors; More Flavor, Less Fat and Sodium; Whole grains and a Rainbow on Your Plate; and Phyto-Power: Cholesterol-Lowering Foods. Each participant received a pedometer with instructions and a log to track its use; two recipe books; a TLC Program booklet and weekly handouts with up-to-date information on nutrition and heart health. The home economist and a local registered dietician co-taught the series.

An evaluation was completed and returned the last night of the class, aimed at determining the participants’ knowledge gained and understanding of their risk factors for heart disease. It further evaluated heart-healthy lifestyle changes participants plan to make or have made in their own lives such as exercising regularly and cooking and choosing a healthy diet. Results of this evaluation showed: 88% are reading labels to find the amount of saturated and trans fat in a serving, 71% have reduced the saturated fat, trans fat and high cholesterol foods in their diets, are eating at least 2-4 servings of fruit a day, and are choosing healthier carbohydrates that contain more soluble fiber and less sugar; 65% are measuring food portions, are eating at least 2-3 servings of whole grains per day, and are eating at least 3-5 servings of vegetables a day : 59% are involved in at least 30 minutes of moderate physical activity a day on most days of the week.

The Los Alamos Heart Council co-sponsored this program and helped fund program expenses. A modest fee was charged to participants for participation and scholarships were available to qualifying individuals. The registered dietician, co-teaching the class, volunteered her time and a former class participant assisted with set-up and clean-up. Estimated volunteer contribution was $2720.00.


Quarterly lunch-hour presentations were presented to seniors from the Los Alamos Retired and Senior Organization. Tiny Tastes Can Total Big Calories Over the Holidays program illustrated how eating small amounts of holiday foods high in fat and sugar can add up to a possible weight gain. The PowerPoint program was presented to fifty five (55) [45(W) 7(H) 3(A); 27(M) 28(F)] seniors and a handout Tips for Holiday Eating, was prepared by the home economist and provided to participants as well as to community members receiving home meal delivery. Immune Boosters was given to forty nine (49) [42(W) 7(H); 24(M) 25(F)] seniors. The program discussed the key nutrients beneficial for improving the immune system. The information was presented utilizing a Power-Point presentation. A handout was developed summarizing the key points of the presentation. In addition to the participants attending the program, homebound seniors participating in the meal delivery program were provided with the handout.
Fruits and Vegetables was presented to forty two (42) [38(W) 4(H); 22(M) 20(F)] seniors. The program discussed buying, preparing, serving and storing fruits and vegetables. In addition, the nutritional benefits were also discussed as well as how these foods may reduce the risk of several chronic diseases. Secrets to Healthier Groceries, Organic Foods and the Truth about Agave was presented to thirty nine (39) [33(W) 6(H); 19(M) 20(F)] seniors. The program discussed ideas for purchasing healthier foods, presented information on organic foods and their benefits as well as provided factual information on agave sweetener. All four programs utilized a PowerPoint presentation. In three of the four presentations, the home economist developed the PowerPoint presentation and prepared a handout for participants as well as for homebound seniors participating in the meal delivery program.


Keeping Your Diet Healthy – Giving Your Body The Energy It Needs was a program presented to the “Better Breathers,” an oxygen users support group. The majority of the twelve program participants [11W) 1(H); 2(M) 10(F)] have Chronic Obstructive Pulmonary Disease (COPD). The presentation discussed, through a PowerPoint presentation created by the home economist, how the body needs energy for breathing and digestion. Proper nutrition provides the energy needed for daily activities and helps strengthen the body’s immune system.


Los Alamos Health Fair -- the home economist prepared a table display providing information in three areas. One component of the display was MyPyramid food guide including life-size food models. A second component was a folding display titled “What You Should Know About Nutrition” which reviewed the different food categories and their effect on health. It also included information on MyPyramid, reading food labels, and vitamins and minerals. The final component offered handouts of upcoming Extension Home Economics programs. One hundred forty four (144) people [88(W) 47(H) 7(A) 2(NA); 45(M) 99 (F)] stopped to ask questions and/or pick-up educational materials. .


Prostate Cancer: Treatment Options was the topic of an educational seminar sponsored by the Los Alamos Council on Cancer. Prostate cancer is the most common cancer among US men. It's not always life threatening, but it forces many men to weigh the risks and benefits of its treatment. Three physicians [2(W) 1(A); 3(M)] spoke on: what is the prostate and how is prostate cancer diagnosed, who is a candidate for the “wait and watch” plan of care, surgical and radiation oncology treatment options and hormone ablation therapy and traditional chemotherapeutic agents used in the treatment of prostate cancer. The home economist assisted with program publicity, pre-registration and registration during the event. One hundred five (105) [91(W) 9(H) 4(A) 1(B); 51(M) 54(F)] attended the Prostate Cancer program which offered continuing nursing education units for nursing professionals. As vice president and a member of the Council on Cancer, the home economist will be assisting with upcoming educational programs scheduled bi-annually.

A Kitchen Creations class series was offered in Columbus for Spanish speaking participants only. 14 attended classes 1&2. 5 of the participants were promatoras from Palomas,Mexico. 9 of the participants returned to classes 3&4. All participants said this was the only education they have received for diabetes nutrition. The promatoras from Palomas felt better educated to help their clients make healthier food choices. 80% of the participants said they now use the food guide pyramid to plan their daily meals, 80% use the 50/50 method for carbohydrate control and 90% said they read food labels to find amount of carbohydrates in a serving.

The ICAN participant numbers grew in Luna county. The Nutrition Educator chose to change to a 40 Hour work week.Her dedication to the program caused a jump in youth participation from 1100 total for the previous year to 1300 youth participants in just the first half of 2010. Cooking with Kids was taught in 3 of the elementary schools 4th grade classes. We partnered with the school district by using their grant money for fresh fruits and vegetables. Students were introduced to a variety of produce that would otherwise been unavailable to them. Students at one of the classes never heard asparagus before.Through this program the teacher reported that many of the kids came back saying they told their parents to buy asparagus. Youth are responding to the nutrition program.A mother recognized the nutrition educator at the store and said that her son told her not to buy the frozen french fries-she should buy the raw potato and bake it for dinner. A student knocked at the educator's door around 6:30 AM one morning. She decided to do her science project about what she had learned through her ICAN classes and wanted to make sure all of her information was correct.We are presently in the process of hiring a replacement and hope to continue to expand the program within the county.

At the request of the Mescalero Community Health Program Director, the Home Economist provided a presentation to 54 individuals at the Inn of the Mountain Gods in Mescalero on the USDA Food Guidance System, MyPyramid. The presentation was also provided to 10 individuals at The Counseling Center (an organization which provides mental health services to children, adults, and families in Alamogordo). Completed evaluations indicated that 98% of participants learned about the history of the MyPyramid; 97% of participants learned about the MyPyramid themes (variety, moderation, proportionality, personalization, activity, and gradual improvement); 100% of participants learned how to eat a variety of foods from the food groups each day for good health; 98% of participants learned how to choose moderate food portion sizes; and
100% of participants learned why physical activity is important for maintaining a healthy body. Other evaluation comments by participants included “I learned how to improve my food intake.”; “I took away a lot more information regarding “servings”, glad to hear about cups and ounces.”; and “(Presentation) Very interesting and informative…and encouraging to eat right and exercise, thanks!”

The Home Economist presented a foods and nutrition program, “Cooking with Pumpkins and Winter Squash”, to 26 members of the Mayhill Extension Association Club and 18 members of the Calico Extension Association Club. A PowerPoint presentation was developed on the health benefits of eating pumpkins/winter squash and demonstrations were conducted for preparing pumpkins/winter squash and recipes. Completed evaluations indicated that 100 % of participants learned about the health benefits of pumpkins/winter squash; about different varieties and flavors of pumpkin/winter squash; how to select pumpkins/winter squash; how to safely store pumpkins/winter squash in the kitchen; and basic preparation tips for cooking pumpkins/winter squash; 95% of participants learned how to prepare pumpkin puree for use as a cooking ingredient and how to prepare recipes with pumpkins/winter squash as an ingredient. Other evaluation comments by participants included “I have grown pumpkins and your program helped me on preparing and using them, thank you.”; and “Articulate speaker (Home Economist) made presentation interesting and easy to understand.”

In 2010, twenty-eight individuals participated in the Kitchen Creations Diabetes School classes offered at the Exhibit Building of the Fairgrounds and the classroom/kitchen of the Extension Office. Evaluation statistics for the Kitchen Creations indicate that the diabetes cooking classes helped participants to manage their diabetes for the reason that 68% of participants now read food labels to find the amount of carbohydrates in a serving; 61% of participants now measure food portions; 61% of participants use more herbs and spices to flavor foods instead of salt and fat; 43% of participants use the Diabetes Food Guide Pyramid to plan a day’s meal; and 43% of participants use the 50/50 method to control the amount of carbohydrates they eat at a meal. In addition, 79% of the participants were able to list knowledge gained as a result of participating in the Kitchen Creations Diabetes Cooking School which included how “food can taste good even though it is still a diabetic menu”. One participant commented on what they liked most about Kitchen Creations was “Great explanations. Very clear information. While so well organized, (instructors) could also step back and answer all questions. Very knowledgeable, with humor.”