A new framework for the evaluation of participatory nutritional education is presented after a review of the concepts relating to participation and empowerment. There was a paradigm change from health education to health learning during the late 1980s in Japan, being similar to that from health education to health promotion in the Ottawa Charter of WHO in 1986. It is more important for people to participate in the planning and decision-making process than in its implementation. Community participation, involvement, organization, and empowerment are closely associated with this participatory approach. Japanese participatory health education, which is called health learning, closely resembles the idea of educational empowerment based on Freire's idea. In summary, participatory nutritional education needs the active involvement of participants in the decision-making process, dialogue among the participants, and identification of their problems and the social roots of these problems by critical thinking, besides empowerment for the action to overcome obstacles in achieving their goals. Few papers have been published in Japan on participatory nutritional education, and there is a need to discuss more about the methodology and to put most emphasis on the evaluation. In an ideal evaluation of participatory nutritional education, both an evaluation of the process and of the outcome are needed. The process evaluation should involve measurement on each level to identify individual, organizational, and community change. For the outcome evaluation, measurement should be made on each level to identify the knowledge, skill, attitude and behavior related to food and nutrition, food consumption, nutrient intake, nutritional and health status, and quality of life. The framework that I present in this article is intended to be useful for these evaluations.
The post-absorptive resting metabolic rate was reassessed by using published data for the Japanese basal metabolic rate (BMR). Concurrence between the observed value and that predicted by widely used equations for calculating BMR were also examined. All of the BMR data were measured under the post-absorptive condition early in the morning. The BMR value for each subject was also predicted from the sex, age and weight by using the equations presented by the Japanese Recommended Dietary Allowance (RDA-Jpn) (1999), Schofield (1985) and FAO/WHO/UNU (1985). A stepwise regression analysis of the original data indicated that weight alone explained more than 40% of the BMR variance, while other independent variables (sex, age, height, BMI, and indoor and outdoor temperature) together explained 77.9% of the BMR variance. The difference between the observed value and that predicted by the RDA-Jpn equation was higher for lean subjects over 18 years of age who had been classified according to the body mass index (BMI) (BMI≤18.4kg/m2), than those predicted by the other equations. In contrast, the difference was less for the normal-weight subjects (18.5kg/m2≤BMI≤24.9kg/m2). The degree of concurrence between the observed and predicted value thus differed by group based on a subject's BMI. This finding indicates that the body composition should be examined in a future study to provide a more appropriate database for BMR than that based on previous BMR measurements.
It is known that the fecal bulk and short-chain fatty acids produced by the anaerobic microbial fermentation of undigested carbohydrates increase the colonic motility. The fecal bulk and short-chain fatty acids respectively act as physical and chemical stimuli. An increase in fecal bulk and short-chain fatty acids can be respectively achieved by ingesting non-fermentable and fermentable dietary fiber. The present study investigates the effects on defecation by female college students suffering from functional constipation of a dietary fiber (DF) beverage containing 3g of commercial depolymerized sodium alginate as non-fermentable dietary fiber and 3g of commercial water-soluble corn bran fiber as fermentable material. The presence of functional constipation was determined in accordance with “Rome II” diagnostic criteria, and clinical testing was performed by using a single-blind crossover test. Ingestion for 2 weeks of the DF beverage significantly increased (p<0.05) the number of days on which the subjects defecated. The DF beverage also tended to increase the fecal volume and to improve the fecal properties without the subjects showing any sign of gas being present in the colon. The results demonstrate that the DF beverage was effective for inducing defecation by subjects with a tendency to functional constipation.