The purpose of this study was to evaluate the effectiveness of Centers for Child-care Foodservice Management (CCFSM)'s support on menu management in child-care centers and kindergartens by comparing two perspectives of pre-support vs. post-support and established vs. non-established. To evaluate dietary variety, we used methods that considered both Dietary Diversity Score (DDS) and Dietary Variety Score (DVS). For surveying pre-support and post-support state by CCFSM, we collected and analyzed menus of June and September, 2012, targeting 7 CCFSM supported institutions. Meanwhile, for surveying state in CCFSM established and non-established areas, we collected and analyzed menus of June, 2012, which were implemented in institutions in CCFSM established (181 places) and non-established (106 places) areas. The results of evaluation on the dietary support by CCFSM showed that post-supporting state by CCFSM (95.3%) was significantly higher than pre-supporting state (77.2%) (p < 0.001) and established areas (87.4%) were significantly higher than non-established ones (77.2%) (p < 0.05) on 'Meeting the DRI for infant'. Evaluation of dietary variety between pre- and post-support state by CCFSM showed that post-support state (total 77.3 point) was higher than pre-support state (total 76.4 point). Evaluation of dietary variety between established and non-established areas showed that established areas (total 81.1 point) were significantly higher than non-established ones (total 77.1 point) (p < 0.001). Therefore, it is considered that dietary support service conducted by CCFSM contributes to improve variety level of diet provided by child-care centers and kindergartens.
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A systematic review and meta-analysis of the literatures was conducted to evaluate the effectiveness of nutrition intervention by dietitian. The 31 studies that were all randomized controlled trials, were identified from computerized search of published researches on MEDLINE, Embase database until January, 2003 and review of reference lists. The main search terms were the combination "dietitian", "dietary intervention", "nutrition intervention" or "nutritional intervention" and "effectiveness". The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention (nutritional counseling and education/nutrition counseling and education + diet modification), method of intervention (individual/group/individual + group) and follow-up period. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The meta-analysis of 31 studies based on the random effect model showed that the medical nutrition therapy was significantly effective in treating the diseases (effect size 0.1715 ; 95% confidence interval 0.0938 - 0.2491). This study showed the clear evidence of the effectiveness of nutrition intervention through the meta-analysis. So the nutrition intervention by dietitian should be recommended and recognized as the effective therapy of treating the diseases. Also the nutrition intervention should be conducted regularly to maintain the effectiveness of the nutrition intervention. The nutrition intervention was significantly effective in treating the diseases on the random effect model (effect size :0.1715 ; 95% confidence interval 0.0938 - 0.2491).