Dietary Changes for Women in Sobriety: A Cooking Demonstration Lesson Conducted by Melodie Anne Coffman
Alcoholics Anonymous • International non-profit organization • Focuses on 12 step program for sobriety • Designated sponsor helps keep you on track • Self-funded--does not receive government funds • Meetings occur at various locations several times per day • Attend meetings as often as you need
Sub-group • Sub-group of women in the surrounding Phoenix, Arizona area • Group consists of 15 women in sobriety • Meet Mondays at 6:00 for 1-hour meeting • Meetings typically have a specific topic or agenda focusing on the Alcoholics Anonymous book
Food & nutrition demo • Monday, December 5th 2011 @ 5:30 • 12 women in attendance • Each woman took a pretest upon arrival • 20 minute lecture on important nutrients for this population • Fiber • Calcium • Antioxidants • Macronutrients
…..continued • Food demonstration making baked stuffed chicken roulades • Plating tips and techniques • Food tasting • While women ate, I discussed specific amounts of nutrients in the dinner items from the demo • Post-demonstration survey
Baked Stuffed Chicken Roulade • Yield: 2 chicken roulades • Ingredients • 2 skinless chicken breasts • 2 tsp. dry ranch mix • 1/2 cup fresh baby spinach • 1/4 cup diced heirloom tomatoes • 2 tsp. feta cheese • 2 slices mozzarella cheese • 1 cup water • Non-stick pan spray
Mango Brown Rice • Yield: 2 1/2-cup servings • Ingredients • 1/2 cup brown rice • 1 cup water • 1 oz. olive oil • 1/4 cup diced mango • 1/2 tsp. powdered garlic • 1/2 tsp. Italian seasoning • Salt and pepper to taste
Garlic Sautéed Spinach with Heirloom Tomatoes • Yield: 2 1-cup servings • Ingredients • 1 oz. olive oil • 2 peeled garlic cloves, chopped • 2 cups baby spinach • 1/2 cup diced heirloom tomatoes • Salt and pepper to taste
Information retained • 8 women, both before and after, were able to identify soluble fiber as a type of dietary fiber • Prior to the demo, 5 women identified insoluble fiber, which doubled to 10 women after the demo • Only 2 women correctly identified the recommended 21-25 g of daily fiber for women before the demo • By the end, 9 women correctly identified the ideal fiber range • Most women were aware that meat was not a source of fiber
Bioavailability All women answered this question correctly in the post-test
Absorption Source of error in pretest: One woman selected two answers
Calcium summary • 10 women after the survey, as compared with 2 women beforehand, correctly identified amount of calcium in milk • All participants gained knowledge of calcium bioavailability • Most women (11 of 12) correctly identified vitamin D as an essential nutrient for calcium absorption during both the pretest and post-test • 50% more women correctly circled 1,000 mg as the proper intake during the post-test
Antioxidant summary • Prior to lecture, only half of the group was aware of vitamin C’s role in collagen formation • Knowledge of ideal vitamin C intake improved by 54% by the end of the lecture • Post-test results show that all women correctly identified functions of vitamin C and increased needs for smokers
Macronutrient summary • Women did not retain knowledge about types of macronutrients • By the end of the lecture and demo, the majority of the group were able to identify the correct calories per macronutrient and conduct basic calculations
Goal 1: Women attending Alcoholics Anonymous meetings will understand the connection between smoking, oxidation and dietary habits that can combat oxidative damage. • Objective 1: Following the cooking demonstration and discussion, 25% of participants will state that they plan to cut back or quit smoking. • Objective 2: Following the cooking demonstration and discussion, 50% of participants will be able to list at least three excellent dietary sources of vitamin C.
Results • Women did not commit to refraining from cigarette smoking • More than half of the group were able to list at least two functions of vitamin C
Goal 2: Women attending Alcoholics Anonymous meetings will gain understanding of the importance of calcium and vitamin D in the diet and the risk of osteoporosis in menopausal women. • Objective 1: After the demonstration and discussion, 75% of participants will state how much calcium they need in the diet. • Objective 2: Following the demonstration and discussion, 25% of women will be able to list at least two foods or drinks fortified with calcium and vitamin D.
Results • 92% of women were able to state how much calcium they need in the diet by the end of the demo • More than half of the group were able to state at least two specific foods with calcium
Goal 3: Women attending Alcoholics Anonymous meetings will learn dietary sources of fiber and the roles of fiber in the diet. • Objective 1: By the end of the demonstration and discussion, 50% of women will be able to state how much fiber is needed in the diet. • Objective 2: After the demonstration and discussion, 25% of women will be able to state at least two functions or benefits of fiber.
Results • 75% of women correctly identified optimal fiber intake of 21-25 g • The majority of the group were able to list several functions and benefits of fiber in an open question-and-answer session
Goal 4: Women attending Alcoholics Anonymous meetings will be able to identify macronutrients and calculate macronutrient calories off of a food label. • Objective 1: Following the demonstration and discussion, 50% of women will be able to list all three macronutrients (carbohydrates, protein and fat). • Objective 2: By the end of the demonstration and discussion, 25% of women will be able to state the calories per gram in each macronutrient.
Results • More than two-thirds of the group were able to correctly calculate calories from carbs, protein and fat • There was very little difference in identifying macronutrients from a list in the post-test as compared with the pretest • I hypothesize that group members mixed up micronutrients with macronutrients, based on the results
Sources of error • Some women did not answer all questions • Two women showed up late and did not get all of the instructions for the pre-test • Education varied from high school level to medical doctor
References • Alcoholics Anonymous. "Alcoholics Anonymous : Frequently Asked Questions About A.A.'s History." Web. 22 Oct. 2011. <http://www.aa.org/lang/en/subpage.cfm?page=287>. • Alcoholics Anonymous. "This Is A.A.: An Introduction to the A.A. Recovery Program." Web. 21 Oct. 2011. <http://www.aa.org/pdf/products/p-1_thisisaa1.pdf>. • Anonymous, personal communication. Phoenix/Scottsdale Alcoholics Anonymous Chapter. November 7, 2011 • BecomeAnEx.org. National Alliance for Tobacco Cessation. "The Benefits and Rewards Of Quitting Smoking." Web. 21 Oct. 2011. <http://www.becomeanex.org/benefits-and-rewards.php>. • Boyle, M. A. & Holben, D. H. (2010). Community Nutrition in Action: An Entrepreneurial Approach (5th ed.). Wadsworth Cengage Learning: Belmont, CA • Higdon, Jane. “Vitamin D.” Linus Pauling Institute.March 2004. Web. 30 Oct. 2011. <http://lpi.oregonstate.edu/infocenter/vitamins/vitaminD/> • Mayo Clinic. "Dietary Fiber: Essential for a Healthy Diet.” Mayo Foundation for Medical Education and Research, 19 Nov. 2009. Web. 21 Oct. 2011. <http://www.mayoclinic.com/health/fiber/NU00033>. • McKinley Health Center.“Macronutrients: The Importance of Carbohydrate, Protein and Fat.”March 2008. Web. 7 Nov. 2011. <http://www.mckinley.illinois.edu/handouts/macronutrients.htm> • NIAAA Publications. "Alcohol and Nutrition - Alcohol Alert No. 22- 1993." National Institute on Alcohol Abuse and Alcoholism, Oct. 1993. Web. 22 Oct. 2011. <http://pubs.niaaa.nih.gov/publications/aa22.htm>. • Office of Dietary Supplements (ODS). "Dietary Supplement Fact Sheet: Calcium." National Institutes of Health. Web. 22 Oct. 2011. <http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional>. • Office of Dietary Supplements (ODS). "Vitamin C." National Institutes of Health. Web. 20 Oct. 2011. <http://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional>. • PubMed Health. "Osteoporosis - Thin Bones." U.S. National Library of Medicine, Nov. 2010. Web. 20 Oct. 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/>.