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Full-Text Articles in Medicine and Health Sciences

Eliminating Routine Gastric Residual Volume Assessments In The Intensive Care Setting, John Marshall Smith May 2020

Eliminating Routine Gastric Residual Volume Assessments In The Intensive Care Setting, John Marshall Smith

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

This evidence-based project sought to evaluate the practice change of routine GRV elimination within a 14 bed adult intensive care unit (ICU) at a large teaching hospital in the southeastern United States. For decades, the gold standard to determine tolerance to enteral nutrition (EN) has been routine GRV assessments via aspiration. However, recent studies have concluded the practice ineffective. Critical Care guidelines published in 2016 now recommend cessation of routine GRV assessments (Ozen, et. al, 2018). In-servicing, education, and implementation of a validated protocol from the University of Virginia Medical Center was used to enact the practice change. A 30-day ...


Influences Of Coach Leadership Related To Nutrition On Collegiate Student Athletes Dietary Choices, Maria Fruechte May 2020

Influences Of Coach Leadership Related To Nutrition On Collegiate Student Athletes Dietary Choices, Maria Fruechte

Leadership Education Capstones

The purpose of this study is to better understand how coach leadership related to nutritional information influences collegiate student athletes’ acquisition and application of nutrition. This will be followed up to consider how the information and expectations of coaches influences athletes’ knowledge and dietary choices.


The Impact Of Stress On Diet, Sleep, And Exercise Amongst College Students, Jessica Rizzo May 2020

The Impact Of Stress On Diet, Sleep, And Exercise Amongst College Students, Jessica Rizzo

Senior Honors Projects

Stress is something that everyone faces in their lifetime and has an everlasting impact on their health. College students face high levels of stress throughout the semester, but how is that impacting their behavior? I conducted a survey alongside Dr. Melanson, a professor in the Department of Nutrition and Food Sciences, to see just how college students are reacting to stress. The survey was circulated to different departments and classes to achieve a widespread collection of data. The survey remained completely anonymous and posed questions about eating, exercise, and sleep habits, along with questions on demographics and stress levels. Our ...


The Effects Of A Nutritional Intervention On Healthy Eating Habits And Body Mass Index, Kelley Eshenaur May 2020

The Effects Of A Nutritional Intervention On Healthy Eating Habits And Body Mass Index, Kelley Eshenaur

Evidence-Based Practice Project Reports

In the US, overweight and obesity are growing concerns, as both can have life altering consequences if not prevented or treated. Since 2000, there has been nearly a 10% increase of adults who are obese, from 30.5% (85.8 million) to 39.8% (93.9 million) in 2016 (CDC, 2017). These conditions are preventable with early intervention and motivation. Obesity statistics are especially of interest during the transition to young adulthood. The purpose of this project was to improve student outcomes by identifying barriers, effective strategies, and healthy choices that would ultimately impact weight, increasing healthy food choices, and ...


Examination Of Perceptions Of Weight Loss And Weight Loss Methods, Andrew Seiber May 2020

Examination Of Perceptions Of Weight Loss And Weight Loss Methods, Andrew Seiber

Electronic Theses and Dissertations

The purpose of this study was to examine individuals’ perceptions of weight loss and weight loss methods. Respondents were employees and customers attending health/wellness events at local supermarkets in June, July, and August 2019. Participants completed a survey to assess their understanding and perceptions of weight loss and methods used to achieve weight loss. The majority of participants were white females, 60 years or older with a college degree and a Body Mass Index (BMI) classified as overweight or obese. Data revealed most participants had a variety of misconceptions relating to weight loss and weight loss methods that were ...


A Health/Media Literacy Intervention Improves Adults’ Interpretations Of Sugar-Sweetened Beverage Advertising, Yvonnes Chen, Kathleen J. Porter, Wen You, Paul Estabrooks, Jamie M. Zoellner Apr 2020

A Health/Media Literacy Intervention Improves Adults’ Interpretations Of Sugar-Sweetened Beverage Advertising, Yvonnes Chen, Kathleen J. Porter, Wen You, Paul Estabrooks, Jamie M. Zoellner

Journal of Media Literacy Education

Although excessive sugar-sweetened beverages (SSB) intake is linked to numerous adverse health consequences, media literacy interventions rarely address the influences of food and beverage marketing with a specific focus on adults. This randomized controlled trial study investigated (1) whether media literacy education modifies adults’ perceptions of SSB advertising and (2) whether changes are moderated by health literacy. Results from the multilevel mixed-effects regression analyses with the intention-to-treat last-observation-carried-forward method showed that compared to MoveMore (a matched-contact comparison condition), SIPsmartER (an intervention condition) participants significantly enhanced their skillsets across media literacy domains (i.e., authors/audiences, messages/meanings, representation ...


The Role Of Diet In The Onset Of Depression: A Biochemical Connection Between Nutrition And Mental Health, Katlin Wildeman Apr 2020

The Role Of Diet In The Onset Of Depression: A Biochemical Connection Between Nutrition And Mental Health, Katlin Wildeman

Senior Honors Theses

Depression is a major clinical concern, having a complex onset and the presence of multiple, often unidentifiable causes. Depression affects millions of individuals worldwide, with a high prevalence in regions of the world with a Western-style diet as compared to regions with a Mediterranean diet. A Western-style diet consists of foods high in sugar, fat, and processed meats and grains, whereas the Mediterranean diet contains significantly more vegetables, fruits, lean meats, and whole grains. The link between diet and mental health disorders has implications for individuals of all ages who are hesitant to turn to medication. In addition to presenting ...


Community Cooking Course To Combat Nutritional Knowledge Deficit, Heather R. Bohman Apr 2020

Community Cooking Course To Combat Nutritional Knowledge Deficit, Heather R. Bohman

MSN Capstone Projects

More than two-thirds of American adults and almost one-third of American children are overweight or obese. Not only are the statistics alarming, the cost of obesity is staggering. Obesity robs an individual of their quality of life and costs the U.S. healthcare system an estimated $147 billion a year in obesity-related illness (Finkelstein, Trogdon, Cohen, & Dietz, 2009). The need to find solutions to improve the health of Americans is clear and communities are called to respond. The Centers for Disease Control and Prevention (CDC, 2018) recommends partnership with local agencies to promote obesity prevention initiatives and create a healthier food environment for all. Evidence suggests that interventions, such as cooking classes, can be made to improve the overall health of a community and reduce the obesity epidemic (Ickes, Mcmullen, Haider, & Sharma, 2014). The PICOT question asks, in low-income families (P), how does participating in a community cooking course (I) compared to not participating in a cooking course (C) affect nutritional knowledge (O) after completion of the cooking course (T)? In partnership with Hill Country Family Services (HCFS) of Kendall County, Texas, this capstone project set out to provide family centered cooking classes featuring accessible, low cost, and nutritious foods with the aim to improve nutritional knowledge and boost self-efficacy to a vulnerable population. Cooking classes were designed around the United States Department of Agriculture’s (USDA) Choose My Plate guidelines and the national Share Our Strength’s Cooking Matters for Families campaign (USDA, n.d.; Share Our Strength, 2019). Classes geared toward children accompanied by an adult were planned to feature fun activities and hands on cooking experiences. Unfortunately, the project was frozen mid-implementation due to a global pandemic. This paper will discuss the project thus far and outline ...


The Gut Brain Connection: Does Our Diet Affect Our Mood?, Rachel Miller Apr 2020

The Gut Brain Connection: Does Our Diet Affect Our Mood?, Rachel Miller

Georgia College Student Research Events

Recent research studies have revealed that there is validity to the claim that “you are what you eat”. In fact, emerging science suggests that there is evidence supporting that eating a nutrient dense healthy diet impacts one’s mental health. The goal of this research is to explore how the foods we consume affect our emotions. More specifically this poster focuses on the gut-brain connection and how individuals with depression are impacted by their food choices. To investigate the link between nutrition and depression, a literature review of three prominent research articles was completed. The articles examined include A modified ...


Pilot Study Of The Just Right Challenge Feeding Protocol For Treatment Of Food Selectivity In Children, Michelle A. Suarez, Elsie Bush Apr 2020

Pilot Study Of The Just Right Challenge Feeding Protocol For Treatment Of Food Selectivity In Children, Michelle A. Suarez, Elsie Bush

The Open Journal of Occupational Therapy

Background. This pilot study investigated the Just Right Challenge Feeding Protocol, a multicomponent treatment protocol for food selectivity that combines escape extinction, positive reinforcement, and systematic desensitization.

Method. This study used a single-subject, multiple-baseline-across-participants design to investigate whether treatment produced increases in the food inventories for seven children. All of the children in the study started with parent report of fewer than 15 foods in their dietary repertoire. A sensory profile for each child provided information for treatment planning and interpretation of the results of the study.

Results. Five out of the seven children accepted significantly more foods after a ...


Consciousness Level Determination Of Red Meat Consumption Of Pregnant Women, Giresun/Turkey Province, Duygu Balpetek Külcü, Özge Cağcağ Yolcu Apr 2020

Consciousness Level Determination Of Red Meat Consumption Of Pregnant Women, Giresun/Turkey Province, Duygu Balpetek Külcü, Özge Cağcağ Yolcu

Journal of Mind and Medical Sciences

In this study, meat consumption and the nutritional status of pregnant women living in Giresun province of Turkey were investigated. The study was carried out at Giresun University, the Maternity and Pediatrics Training and Research Hospital between February-March 2019. The study group consisted of 218 pregnant women aged 18 to 49 years, who benefited from polyclinic services and agreed to participate in the survey. A questionnaire consisting of 12 questions was used, and the findings were evaluated using SPSS to generate descriptive statistics and t-tests or ANOVAs. The majority of participants stated that red meat is beneficial during pregnancy (71 ...


Decreasing Rates Of Obesity In Onondaga County Among Older Adults, Julianna Duca Apr 2020

Decreasing Rates Of Obesity In Onondaga County Among Older Adults, Julianna Duca

Transformations: Research Papers

After an investigation of the health priorities in Onondaga County, research concludes that the mortality rates are generally higher when compared to New York State (New York State Department of Health, 2018). Currently, obesity and being overweight are the second leading causes of preventable deaths in the United States (New York State Department of Health, 2019e). Obesity is one chronic disease that shows higher rates in Onondaga County than New York State and the United States (Centers for Disease Control and Prevention, 2019; New York State Department of Health, 2016b). The rate of obesity in Onondaga County is 32%, the ...


Differences In Food Spending On Groceries And Eating Out Between Two Dietary Groups: The New Soul Study, Carly Fassler Apr 2020

Differences In Food Spending On Groceries And Eating Out Between Two Dietary Groups: The New Soul Study, Carly Fassler

Senior Theses

Background: Heart disease is now the leading cause of death for both men and women in the United States. Obesity, high blood pressure, and high cholesterol are all risk factors for heart disease. Research has shown that increasing consumption of plant-based foods may be effective in reducing risk factors for chronic disease, especially heart disease. A plant-based diet consists of nutrient-dense plant foods and minimizes the consumption of processed animal products. High costs of eating a healthier diet are a commonly cited barrier that prevents individuals from making dietary changes that could potentially decrease their chronic disease risk.

Objective: To ...


A Comparison Of Obesity And Nutrition In Chile And Peru Between The Years Of 2000-2016, Alaina Whitmore Apr 2020

A Comparison Of Obesity And Nutrition In Chile And Peru Between The Years Of 2000-2016, Alaina Whitmore

Honors Theses

Obesity is a disease characterized by the accumulation of excess energy storage within the body, and it is a risk factor for a number of non-communicable diseases that are increasing in prevalence worldwide. With the use of data collected between 2000 and 2016 by the Food and Agriculture Organization of the United Nations (FAO), it has been determined that adulthood obesity rates have been increasing for all of the South American countries that list Spanish as an official language (Argentina, Colombia, Peru, Chile, Venezuela, Uruguay, Ecuador, Bolivia, and Paraguay). Specifically, Peru and Chile were identified as the countries with the ...


Serum Vitamin B12, And Related Mtrr And Cubilin Genotypes, Predict Neural Outcomes Across The Ad Spectrum, K. E. Mcliman, A. D. Collazo Martinez, Jonathan P. Mochel, Karin D. Allenspach, Auriel A. Willette Mar 2020

Serum Vitamin B12, And Related Mtrr And Cubilin Genotypes, Predict Neural Outcomes Across The Ad Spectrum, K. E. Mcliman, A. D. Collazo Martinez, Jonathan P. Mochel, Karin D. Allenspach, Auriel A. Willette

Biomedical Sciences Publications

Epidemiological studies show mixed findings for serum vitamin B12 and both cognitive and regional volume outcomes. No studies to date have comprehensively examined, in non-supplemented individuals, serum B12 level associations with neurodegeneration, hypometabolism, and cognition across the Alzheimer's disease (AD) spectrum. Serum vitamin B12 was assayed from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and the Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL). Voxel-wise analyses regressed B12 levels against regional gray matter (GM) volume and glucose metabolism (p


A Coaching And/Or Education Intervention Targeting Physical Activity And Nutrition Behaviours In Parents With Overweight/Obesity And Their Children, Shazya Karmali Feb 2020

A Coaching And/Or Education Intervention Targeting Physical Activity And Nutrition Behaviours In Parents With Overweight/Obesity And Their Children, Shazya Karmali

Electronic Thesis and Dissertation Repository

The purpose of this dissertation is to provide a detailed overview of, findings from, and experiences participating in a 3-month randomized controlled trial (RCT) targeting obesity-related behaviours in parents with overweight/obesity (body mass index [BMI] ≥ 25 kg/m2) and their children (2.5-10 years old, any weight; N = 50 dyads). A concurrent mixed methods study comprised of an RCT and descriptive qualitative design was utilized. Parent-participants received Co-Active Life Coaching (CALC) and webinar-based health education (intervention) or education only (control). To address the dissertation’s purpose, Chapter II provides a detailed methodological account of the program, including rationale ...


Insights Into Novel Infant Milk Formula Bioactives, Jordan Skolnick, Claire Chou, John Miklavcic Feb 2020

Insights Into Novel Infant Milk Formula Bioactives, Jordan Skolnick, Claire Chou, John Miklavcic

Food Science Faculty Articles and Research

Human milk provides optimal infant nutrition for early life development. However, there are situations in which human milk feeding is not the most viable option for infant nutrition. Some factors include maternal illness, lactation insufficiency, storage complications, and time constraints. As a result, modern infant formula has become a substitute or alternative when breastfeeding is not possible or is inadequate for infants. In the optimal design of formula, many factors are considered in creating a product that is safe and provides a nutritional profile either equivalent to human milk or in optimal alignment with infant needs. Human milk composition serves ...


Replicating Intermittent Fasting In Human Skeletal Muscle Cells: A Pilot Study, Lael K. Ceriani, Felix Omoruyi, Jean Sparks, Daniel E. Newmire, Xavier F. Gonzales Feb 2020

Replicating Intermittent Fasting In Human Skeletal Muscle Cells: A Pilot Study, Lael K. Ceriani, Felix Omoruyi, Jean Sparks, Daniel E. Newmire, Xavier F. Gonzales

International Journal of Exercise Science: Conference Proceedings

Type 2 diabetes (T2D), the most common form of diabetes (90-95% of diagnoses), is marked by decreased insulin sensitivity (insulin resistance) or a defect in insulin secretion. T2D disrupts nutrient signaling where the body cannot maintain adequate blood glucose levels. Inability to receive glucose in skeletal muscle due to insulin resistance in T2D results in oxidative stress and increased muscle atrophy. Properly regulated glucose uptake is pivotal for healthy aging and maintenance of the skeletal muscle system. PURPOSE: The purpose of this study is to examine the effects of nutrient deprivation on human skeletal muscle metabolism, with an emphasis on ...


A Dietary Assessment Of Mid-Spectrum Chronic Kidney Disease, Kathleen E. Adair, Jeffrey S. Forsse, Matthew Peterson, Jeffery L. Heileson Feb 2020

A Dietary Assessment Of Mid-Spectrum Chronic Kidney Disease, Kathleen E. Adair, Jeffrey S. Forsse, Matthew Peterson, Jeffery L. Heileson

International Journal of Exercise Science: Conference Proceedings

Diets of adult individuals with mid-spectrum (stages III and IV) Chronic Kidney Disease (CKD) remain understudied. The 2015-2020 Dietary Guidelines for Americans food patterns based on the Recommended Dietary Allowances (RDA) in concert with the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) guidelines are advised to individuals with CKD. Estimated glomerular filtration rate (eGFR) remains the best method for tracking CKD progression, yet relationships between self-reported dietary intake and eGFR are understudied. PURPOSE: To assess the self-reported dietary pattern in patients with stage III or IV CKD in contrast to the RDA and NKF KDOQI dietary guidelines ...


The "Best Snacks Ever" Series, Catherine M. Westbom Jan 2020

The "Best Snacks Ever" Series, Catherine M. Westbom

Family Medicine Clerkship Student Projects

Vermont rates of obesity jump from 15.1% 10-17 year-old children to 27.5% in adults. In addition, studies show that keeping weight off is incredibly difficult with low success rates. Of the many factors that contribute to obesity, nutrition is among those that can be altered with great results. Taken in combination, this information speaks to the great change that can be made in targeting healthy eating habits in the youth population prior to the jump in obesity rates. This project aims to provide education to the child population in Montpelier, Vermont through the local Step 2 after-school program ...


Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson Jan 2020

Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson

Theses and Dissertations--Dietetics and Human Nutrition

Mexican Americans represent approximately 63 percent of the total Hispanic population in the US and are disproportionately affected by health disparities related to poor nutrition status. With this community among the fastest growing populations in the US, it is critical to address the health disparities and the relationship between culture and diet to provide evidence-based nutrition interventions that are culturally sensitive to specific communities. The purpose of this cross-sectional exploratory study is to examine the relationship between cultural values and dietary behaviors among a low-income, urban, clinical sample of Mexican Americans using the Mexican American Cultural Values Scale, dietary assessment ...


Grant Proposal For Thrive: Targeting Malnutrition In Children Under-Five In Bolivia’S Indigenous Population, Leah Mccaskey Jan 2020

Grant Proposal For Thrive: Targeting Malnutrition In Children Under-Five In Bolivia’S Indigenous Population, Leah Mccaskey

Capstone Showcase

Thrive: Targeting Malnutrition in Children Under-Five in Bolivia’s Indigenous Population

Leah McCaskey BSPH(c)

Faculty Advisor: Comfort Olorunsaiye, PhD

Malnutrition is a serious public health issue that has been linked to an increase in morbidity and mortality1. Poor nutrition can lead to severe health issues, including stunted growth, developmental disabilities, immune deficiency, chronic fatigue, and in the most severe cases, death1. Children under the age of five are the most vulnerable to malnutrition because of the immense nutrition requirements for physical and mental development. Bolivia has the highest prevalence of under-five malnutrition in South America, with 25 ...


Exercise And Physical Activity In Individuals With Type 1 Diabetes, Shelby Fisher Jan 2020

Exercise And Physical Activity In Individuals With Type 1 Diabetes, Shelby Fisher

Williams Honors College, Honors Research Projects

This paper will investigate, describe, and discuss the challenges that youth and adult athletes with Type 1 Diabetes face in order to successfully perform in sports while maintaining their health treatment goals. This paper will also describe how these challenges are overcome and this paper will share individual experiences from both adults and youth who have Type 1 Diabetes. This paper will describe meal management with sport, blood glucose monitoring with sport, medication management with sport, and interaction with the healthcare team and the athlete. This paper will also investigate the school personnel’s involvement in regard to assisting the ...


Investigations Of A Low Carbohydrate Ketogenic Diet As A Possible Treatment For Malignant Brain Tumors, Elizabeth Anaya Jan 2020

Investigations Of A Low Carbohydrate Ketogenic Diet As A Possible Treatment For Malignant Brain Tumors, Elizabeth Anaya

All Regis University Theses

Cancer is now the leading cause of premature death in the U.S. and second worldwide. However, all cancers on average have seen a 20% increase in 5-year survival in the last 30 years. This is not true for brain cancers which have only seen a 1% increase. Brain cancer is extremely hard to treat, costing the most money out of any other cancer. Nevertheless, Otto Warburg’s investigation of cancer as a metabolic disease has led to a variety of new promising treatments. One of these treatments involves starving cancer cells by cutting off their access to glucose, a ...


The Perception Of Men's Preferred Female Body Size And Weight Control Behaviors Of Afro-Caribbean Women In The United States Virgin Islands, Alice Victoria Henry Jan 2020

The Perception Of Men's Preferred Female Body Size And Weight Control Behaviors Of Afro-Caribbean Women In The United States Virgin Islands, Alice Victoria Henry

Walden Dissertations and Doctoral Studies

The prevalence of obesity among Afro-Caribbean women living in the United States Virgin Islands (USVI) is a health care issue that can have detrimental effects on society. To reverse the spread of this disease, factors contributing to its prevalence must be understood so that they can be addressed. The purpose of this cross-sectional study was to examine Afro-Caribbean women's perception of the female body size preferred by Afro-Caribbean men and the influence of that perception on the women's weight control behaviors of diet and physical activity. The reasoned action approach was the basis for the theoretical foundation. The ...


Exploring The Association Between Nutrition And Mental Health In Adolescence: A Systematic Literature Review, Asia Walker, Andrea Mcdonald, Angela Branch-Vital Jan 2020

Exploring The Association Between Nutrition And Mental Health In Adolescence: A Systematic Literature Review, Asia Walker, Andrea Mcdonald, Angela Branch-Vital

Pursue: Undergraduate Research Journal

Introduction: Throughout life, proper nutrition is important to the brain as it affects cognition and intellectual development. Studies have shown that a lack of certain nutrients can affect the body’s ability to perform mentally and physically. Annually, 14% of children in the United States receive mental health illness diagnoses. However, the link between nutrition and mental health is not clear. The purpose of this systematic literature review on mental health and nutrition in adolescence is to identify any gaps that require future research efforts. Methods: The Elton Bryson Stephens Company ( EBSCO), ProQuest, and Journal Storage (JSTOR) databases were used ...


Summary Of Nutrition Among Aboriginal And Torres Strait Islander People, Australian Indigenous Healthinfonet Jan 2020

Summary Of Nutrition Among Aboriginal And Torres Strait Islander People, Australian Indigenous Healthinfonet

ECU Publications Post 2013

No abstract provided.


The “Active Ingredients” Of Yin, Yang And Neutral Food And The Effect Of These Nutrients On Improving And Maintaining Health, Jingle Xu Dec 2019

The “Active Ingredients” Of Yin, Yang And Neutral Food And The Effect Of These Nutrients On Improving And Maintaining Health, Jingle Xu

Health and Kinesiology Theses

Chinese dietary therapy has been documented to date back at least 4000 years (Zhang, 2012). The aim of traditional Chinese dietary therapy was to maintain health by achieving the balance of Yin, cold or cool, and Yang, hot or warm, components in human bodies through having a Yin-Yang-balanced diet. Yin foods were to expel heat syndromes, such as constipation, caused by excessive Yang (heat), while Yang foods were to treat cold syndromes, such as fatigue, caused by excessive Yin (coldness). However, evidence of this food therapy phenomenon was not clear yet. The purpose of this study was to explore the ...


Comparing The Care Of Pregnant Women In Ghana And The United States, Olivia Zander Dec 2019

Comparing The Care Of Pregnant Women In Ghana And The United States, Olivia Zander

Honors Projects

During pregnancy, factors such as maternal nutrition, location of delivery, the number of antenatal care visits, maternal age, and more can all impact the health of both the mother and the developing fetus. All of these factors are subject to change based on where the mother lives and the resources that her country has to offer her. The objective of this paper was to compare and contrast the nutritional and non-nutritional care of pregnant women in Ghana and the United States and its impact on maternal/child mortality in the two countries. The information collected for this project was taken ...


The Impact Of Income On Nutrition. A Case Study Of Northern Mozambique, Hunter Swanigan Dec 2019

The Impact Of Income On Nutrition. A Case Study Of Northern Mozambique, Hunter Swanigan

Agricultural Economics and Agribusiness Undergraduate Honors Theses

In 2017, Mozambique ranked as one of the least-developed countries in the world by measures of health, education, and income, and had one of the lowest GDP per capita at $1,300. With a minimal income, purchasing adequate food to meet recommended levels of nutrients for a healthy diet is difficult, leaving almost half of the country’s population undernourished. This study researched what foods are available during the dry months (hungry season) of May through October in the Nampula province of Mozambique to analyze if it is possible to meet the National Institutes of Health’s recommended levels of ...