• Title/Summary/Keyword: Family-related factors

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Anti-oxidative and Anti-inflammatory Activities of Fermented Turmeric (Curcuma longa L.) by Rhizopus oryzae (Rhizopus oryzae으로 발효한 울금의 항산화 및 항염효과)

  • Kim, Eun-Ju;Song, Bit-Na;Jeong, Da-Som;Kim, So-Young;Cho, Yong-Sik;Park, Shin-Young
    • Journal of Life Science
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    • v.27 no.11
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    • pp.1315-1323
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    • 2017
  • Turmeric is a rhizomatous herbaceous perennial plant (Curcuma longa (CL)) of the ginger family, Zingiberaceae. A yellow-pigmented fraction isolated from the rhizomes of CL contains curcuminoids belonging to the dicinnamoyl methane group. Curcumin is an important active ingredient responsible for the biological activity of CL. However, CL is not usually used as a food source due to its bitter taste. The present study was designed to determine the effect of the CL fermented by Rhizopus oryzae (FCL) on pro-inflammatory factors such as nuclear factor ${\kappa}B$ ($NF-{\kappa}B$), tumor necrosis factor alpha ($TNF-{\alpha}$), interleukin-6 (IL-6), nitric oxide (NO), prostaglandin $E_2$ ($PGE_2$), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in lipopolysaccharide (LPS)-induced RAW 264.7 cell line. The cell viability was determined by MTT assay. To evaluate the anti-inflammatory effect of FCL 80% EtOH extracts, IL-6 and $TNF-{\alpha}$ were measured by ELISA kit. Also, the amount of $NO/PGE_2/NF-{\kappa}B$ was measured using the $NO/PGE_2/NF-{\kappa}B$ detection kit and the iNOS/COX-2 expression was measured by Western blotting. The results showed that the FCL reduced NO, $PGE_2$, iNOS, COX-2, $NF-{\kappa}B$, IL-6 and $TNF-{\alpha}$ production without cytotoxicity. These results suggest that FCL extracts may be a developed the functional food related to anti-inflammation due to the significant effects on inflammatory factors.

THE EFFECT OF BMP REGULATED SMAD PROTEIN ON ALKALINE PHOSPHATASE GENE EXPRESSION (Smad에 의한 alkaline phosphatase 유전자의 발현 조절기전)

  • Kim, Nan-Jin;Ryoo, Hyun-Mo;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.238-246
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    • 2001
  • Bone morphogenetic proteins(BMPs), members of the transforming growth factor $\beta$(TGF-$\beta$) superfamily were first identified as the factors that induce ectopic bone formation in vivo, when implanted into muscular tissue. Especially BMP-2 inhibits terminal differentiation of C2C12 myoblasts and converts them into osteoblast lineage cells. In the molecular mechanism of the signal transduction of TGF-$\beta$ and related factors, intracellular signaling proteins were identified as Smad. In previous study, it has been reported that Smad 1 and Smad 5, which belong to the R-Smad family mediate BMP signaling, were involved in the induction of osteoblast differentiation in C2C12 cells. To understnad the role of Smads involved in osteogenic transdifferentiation in C2C12 cell, in present study, after we stably transfected C2C12 cells with each. Smad(Smad 1,Smad 5) expression vector, cultured for 3 days and stained for alkaline phophatase activity. ALP activity positive cells appeared in the Smad 1, Smad 5 stably transfected cell even in the abscence of BMP. After transiently co-transfected C2C12 cells with each Smad expression vector and ALP promoter, it was examined that Smad 1 and Smad 5 expression vector had increased about 2 fold ALP promoter activity in the abscence of BMP. These result suggested that both Smad 1 and Smad 5 were involved in the intracellular BMP signals which induce osteoblast differentiation in C2C12 cells. The effect of BMP on C2C12 cells with Smad 1, Smad 5 transfected were studied by using northern blot analysis. the treatment of BMP upregulated ALP mRNA level in three groups, especially upregulation of ALP was larger in Smad 1, Smad 5 transfected cell than control group. Pretreatment with cycloheximide($10{\mu}g/ml$), a protein synthesis inhibitor resulted in blocking the ALP gene expression even in BMP(100ng/ml) treated cell. These results suggested that Smad increased the level of ALP mRNA via the synthesis of a certain transcriptional regulatory protein.

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Steap4 Stimulates Adipocyte Differentiation through Activation of Mitotic Clonal Expansion and Regulation of Early Adipogenic Factors (Steap4에 의한 지방세포분화 촉진 기전)

  • Sim, Hyun A;Shin, Jooyeon;Kim, Ji-Hyun;Jung, Myeong Ho
    • Journal of Life Science
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    • v.30 no.12
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    • pp.1092-1100
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    • 2020
  • The six-transmembrane epithelial antigen of prostate 4 (Steap4) is a metalloreductase that plays a role in intracellular iron and cupper homeostasis, inflammatory response, and glucose and lipid metabolism. Previously, Steap4 has been reported to stimulate adipocyte differentiation; however, the underlying mechanisms of this action remain unexplored. In the present study, we investigated the molecular mechanisms involved in Steap4-induced adipocyte differentiation using 3T3-L1 cells, immortalized brown adipocyte (iBA) cells, and mouse embryonic fibroblast C3H10T1/2 cells. The knockdown of Steap4 using adenovirus-containing shRNA attenuated mitotic clonal expansion (MCE), as evidenced by the impaired proliferation of 3T3-L1 cells, iBA cells, and C3H10T1/2 cells within 48 hr after adding the differentiation medium. Steap4 knockdown downregulated G1/S phase transition-related cell cycle regulators (including cyclin A and cyclin D) and upregulated cell cycle inhibitors (including p21 and p27). Furthermore, Steap4 knockdown inhibited the phosphorylation of p38 mitogen-activated protein kinase, extracellular signal-regulated kinase, and Akt. Moreover, Steap4 knockdown repressed the expression of early adipogenic activators, such as CCAAT-enhancer-binding protein β (C/EBPβ) and Kruppel-like factor family factor 4 (KLF4). On the other hand, Steap4 knockdown stimulated the expression of adipogenic inhibitors, including KLF2, KLF3, and GATA2. The overexpression of Steap4 using an adenovirus removed the repressive histone marks H3K9me2 and H3K9me3 on the promoter of C/EBPβ. These results indicate that Stepa4 stimulates adipocyte differentiation through the induction of MCE and the modulation of early adipogenic transcription factors, including C/EBPβ, during the early phase of adipocyte differentiation.

The Determinants of Consumption Characteristics and Patterns of Elderly Households (고령자 가구의 소비특성 및 소비패턴 결정요인)

  • Kim, Jinhun
    • 한국노년학
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    • v.36 no.3
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    • pp.905-926
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    • 2016
  • Although the concept of the elderly varies depending on scholars and laws, as consumption expenditure is deeply associated with income due to the nature of this study, 55 years old was set as the low limit standard for the elderly according to Prohibition of Discrimination on Age in Employment and Employment Promotion for the Aged Act and the elderly households were limited to single-elderly person household and an elderly couple family household for this study. It is considered consumption characteristics as a significant analysis subject in terms of social welfare because it could be understood as an expressed need which was a reflection of desire. Therefore, the present study aimed to investigate the consumption characteristics of the elderly households by stereotyping the consumption pattern of the elderly households, and find the determining factors for consumption patterns and thus contribute to the establishment of related policies through the expressed needs of the elderly households. K-means of cluster analysis was performed by putting the consumption expenditure of the elderly households to investigate inherent structural type of consumption pattern of the elderly households, which were the investigation subjects. As a result, four groups were stereotyped and named as below: 'health care-centered type', 'saving-centered type', 'livelihood-centered type', and 'food expenses-centered type' Binary Logistic Regression analysis was used to identify the factors that influence the decision of consumption pattern of the elderly households. The result of study showed that the elderly households faced all different needs and problems and thus there is a need for various approach plans to solve this situation. In particular, although the elderly have been viewed as economically poor people so far, the study showed that there were also kind of prepared households through saving. Overall, livelihoodcentered type accounted for the highest portion and, as a factor that influenced this, marital state and household income played an important role. Therefore, it is considered that more active efforts to increase the income of the elderly households are needed. In addition, age, owning of house and subjective health state were found to also have significant influence. Through these results of the study, the elderly's own improvement of awareness on health, presentation of overall standard for health state of the elderly, securement of the elderly's access to cultural life, and financial management coordination for improvement of quality of life, development and dissemination of jobs suitable for the elderly, and dissemination of communal life household, which is a cooperation residential type, were presented as institutional task in the conclusion.

Postoperative Atrial Fibrillation after Isolated Coronary Artery Bypass Graft Surgery (단독관상동맥우회로술 후 발생한 심방세동)

  • Suh, Jong-Hui;Park, Chan Beom;Moon, Mi-Hyoung;Kweon, Jong Bum;Kim, Young-Du;Jin, Ung;Moon, Seok-Whan;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.14-21
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    • 2009
  • Background: Postoperative atrial fibrillation (AF) is a common complication after coronary artery bypass graft (CABG) surgery. Although postoperative AF is regarded as benign, transient and self-limited, it has been associated with increased morbidity, thromboembolic events and an increased duration and cost of hospitalization. Material and Method: From January 1994 to December 2007, 190 patients that had isolated CABG surgery were divided into two groups. Group 1 (n=139) involved those who had postoperative atrial fibrillation, and group 2 (n=51) did not have any such events. We reviewed the medical records retrospectively including the incidence of postoperative AF, patient characteristics, surgery related factors and the outcome of the patients with postoperative AF. Result: The frequency of postoperative AF was 26.8%, the conversion rate to regular sinus rhythm before discharge was 82.4%; 82.4% of the AF developed within the first three postoperative days. Although the postoperative AF group was significantly older and had a prolonged postoperative Intensive care unit (ICU) stay, there was no difference in the aortic crossclamp time or duration of hospitalization. No spontaneous defibrillation at declamping, and longer duration of cardiopulmonary bypass were significantly related to the development of postoperative AF. However, postoperative treatment with a beta blocker was associated with a decreased incidence of postoperative AF. The multivariate analysis showed that age and ICU stay were significantly associated with the development of POAF. Spontaneous defibrillation and postoperative beta blocker treatment were significantly associated with a decreased frequency of POAF. Conclusion: AF after CABG surgery is a common complication associated with increased morbidity and a longer ICU stay. Therefore, various strategies aimed at reducing AF, and its complications, such as postoperative treatment with a beta blocker should be considered.

Effects of Nutrition Education Program Based on Social Cognitive Theory for Low Sodium Consumption among Housewives Living in Certain Regions of Seoul (서울시 일부 지역 주부의 나트륨 섭취 감소를 위한 사회인지이론 기반의 영양 교육 프로그램의 적용 및 평가)

  • Baek, Jae Yeon;Yi, Hae-Yeon;Hwang, Ji-Yun;Kim, Kirang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.10
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    • pp.1243-1252
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    • 2017
  • There are limited programs for low sodium intake based on the nutrition education model for housewives who cook family meals. The objective of this study was to evaluate the effects of model-based nutrition programs for low sodium intake among housewives residing in Seoul by incorporating social cognitive theory. A questionnaire survey before and after education was conducted on 140 housewives who participated in the 'Low Sodium Nutritional Education Program' delivered by a district public health center for 12 weeks from November 2015 to January 2016. The contents of the nutrition education program and program evaluation items were based on the action plans for 'Less Sodium Healthy Practice' suggested by the Ministry of Food and Drug Safety. The results show that program participants showed a lower preference for sodium, higher selection of low sodium dishes from restaurants or cafeteria if available, and increased awareness of the need of restaurants to serve low sodium dishes compared to before. In terms of behavioral changes, there were significant improvements in checking nutrition labeling and selection of foods with low sodium, use of low sodium food products, use of natural seasonings to reduce salt intake, and consumption of fast foods and processed foods. On the other hand, requesting less salty meals when ordering and introducing restaurants or cafeterias with healthy and low sodium menus turned out to be difficult to put into practice. In conclusion, the nutrition education program for sodium intake reduction for housewives was effective in increasing knowledge, environment recognition, and behaviors related to low sodium intake but not behaviors related to physical environmental factors. Therefore, further nutrition education programs and practices for sodium intake reduction should be comprehensively implemented with improvement of physical environments for low sodium intake.

Development of User Based Recommender System using Social Network for u-Healthcare (사회 네트워크를 이용한 사용자 기반 유헬스케어 서비스 추천 시스템 개발)

  • Kim, Hyea-Kyeong;Choi, Il-Young;Ha, Ki-Mok;Kim, Jae-Kyeong
    • Journal of Intelligence and Information Systems
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    • v.16 no.3
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    • pp.181-199
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    • 2010
  • As rapid progress of population aging and strong interest in health, the demand for new healthcare service is increasing. Until now healthcare service has provided post treatment by face-to-face manner. But according to related researches, proactive treatment is resulted to be more effective for preventing diseases. Particularly, the existing healthcare services have limitations in preventing and managing metabolic syndrome such a lifestyle disease, because the cause of metabolic syndrome is related to life habit. As the advent of ubiquitous technology, patients with the metabolic syndrome can improve life habit such as poor eating habits and physical inactivity without the constraints of time and space through u-healthcare service. Therefore, lots of researches for u-healthcare service focus on providing the personalized healthcare service for preventing and managing metabolic syndrome. For example, Kim et al.(2010) have proposed a healthcare model for providing the customized calories and rates of nutrition factors by analyzing the user's preference in foods. Lee et al.(2010) have suggested the customized diet recommendation service considering the basic information, vital signs, family history of diseases and food preferences to prevent and manage coronary heart disease. And, Kim and Han(2004) have demonstrated that the web-based nutrition counseling has effects on food intake and lipids of patients with hyperlipidemia. However, the existing researches for u-healthcare service focus on providing the predefined one-way u-healthcare service. Thus, users have a tendency to easily lose interest in improving life habit. To solve such a problem of u-healthcare service, this research suggests a u-healthcare recommender system which is based on collaborative filtering principle and social network. This research follows the principle of collaborative filtering, but preserves local networks (consisting of small group of similar neighbors) for target users to recommend context aware healthcare services. Our research is consisted of the following five steps. In the first step, user profile is created using the usage history data for improvement in life habit. And then, a set of users known as neighbors is formed by the degree of similarity between the users, which is calculated by Pearson correlation coefficient. In the second step, the target user obtains service information from his/her neighbors. In the third step, recommendation list of top-N service is generated for the target user. Making the list, we use the multi-filtering based on user's psychological context information and body mass index (BMI) information for the detailed recommendation. In the fourth step, the personal information, which is the history of the usage service, is updated when the target user uses the recommended service. In the final step, a social network is reformed to continually provide qualified recommendation. For example, the neighbors may be excluded from the social network if the target user doesn't like the recommendation list received from them. That is, this step updates each user's neighbors locally, so maintains the updated local neighbors always to give context aware recommendation in real time. The characteristics of our research as follows. First, we develop the u-healthcare recommender system for improving life habit such as poor eating habits and physical inactivity. Second, the proposed recommender system uses autonomous collaboration, which enables users to prevent dropping and not to lose user's interest in improving life habit. Third, the reformation of the social network is automated to maintain the quality of recommendation. Finally, this research has implemented a mobile prototype system using JAVA and Microsoft Access2007 to recommend the prescribed foods and exercises for chronic disease prevention, which are provided by A university medical center. This research intends to prevent diseases such as chronic illnesses and to improve user's lifestyle through providing context aware and personalized food and exercise services with the help of similar users'experience and knowledge. We expect that the user of this system can improve their life habit with the help of handheld mobile smart phone, because it uses autonomous collaboration to arouse interest in healthcare.

Analysis of Bone Mineral Density and Related Factors after Pelvic Radiotherapy in Patients with Cervical Cancer (골반부 방사선 치료를 받은 자궁경부암 환자의 골밀도 변화와 관련 인자 분석)

  • Yi, Sun-Shin;Jeung, Tae-Sig
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.15-22
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    • 2009
  • Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

Mediating Roles of Attachment for Information Sharing in Social Media: Social Capital Theory Perspective (소셜 미디어에서 정보공유를 위한 애착의 매개역할: 사회적 자본이론 관점)

  • Chung, Namho;Han, Hee Jeong;Koo, Chulmo
    • Asia pacific journal of information systems
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    • v.22 no.4
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    • pp.101-123
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    • 2012
  • Currently, Social Media, it has widely a renown keyword and its related social trends and businesses have been fastly applied into various contexts. Social media has become an important research area for scholars interested in online technologies and cyber space and their social impacts. Social media is not only including web-based services but also mobile-based application services that allow people to share various style information and knowledge through online connection. Social media users have tendency to common identity- and bond-attachment through interactions such as 'thumbs up', 'reply note', 'forwarding', which may have driven from various factors and may result in delivering information, sharing knowledge, and specific experiences et al. Even further, almost of all social media sites provide and connect unknown strangers depending on shared interests, political views, or enjoyable activities, and other stuffs incorporating the creation of contents, which provides benefits to users. As fast developing digital devices including smartphone, tablet PC, internet based blogging, and photo and video clips, scholars desperately have began to study regarding diverse issues connecting human beings' motivations and the behavioral results which may be articulated by the format of antecedents as well as consequences related to contents that people create via social media. Social media such as Facebook, Twitter, or Cyworld users are more and more getting close each other and build up their relationships by a different style. In this sense, people use social media as tools for maintain pre-existing network, creating new people socially, and at the same time, explicitly find some business opportunities using personal and unlimited public networks. In terms of theory in explaining this phenomenon, social capital is a concept that describes the benefits one receives from one's relationship with others. Thereby, social media use is closely related to the form and connected of people, which is a bridge that can be able to achieve informational benefits of a heterogeneous network of people and common identity- and bonding-attachment which emphasizes emotional benefits from community members or friend group. Social capital would be resources accumulated through the relationships among people, which can be considered as an investment in social relations with expected returns and may achieve benefits from the greater access to and use of resources embedded in social networks. Social media using for their social capital has vastly been adopted in a cyber world, however, there has been little explaining the phenomenon theoretically how people may take advantages or opportunities through interaction among people, why people may interactively give willingness to help or their answers. The individual consciously express themselves in an online space, so called, common identity- or bonding-attachments. Common-identity attachment is the focus of the weak ties, which are loose connections between individuals who may provide useful information or new perspectives for one another but typically not emotional support, whereas common-bonding attachment is explained that between individuals in tightly-knit, emotionally close relationship such as family and close friends. The common identify- and bonding-attachment are mainly studying on-offline setting, which individual convey an impression to others that are expressed to own interest to others. Thus, individuals expect to meet other people and are trying to behave self-presentation engaging in opposite partners accordingly. As developing social media, individuals are motivated to disclose self-disclosures of open and honest using diverse cues such as verbal and nonverbal and pictorial and video files to their friends as well as passing strangers. Social media context, common identity- and bond-attachment for self-presentation seems different compared with face-to-face context. In the realm of social media, social users look for self-impression by posting text messages, pictures, video files. Under the digital environments, people interact to work, shop, learn, entertain, and be played. Social media provides increasingly the kinds of intention and behavior in online. Typically, identity and bond social capital through self-presentation is the intentional and tangible component of identity. At social media, people try to engage in others via a desired impression, which can maintain through performing coherent and complementary communications including displaying signs, symbols, brands made of digital stuffs(information, interest, pictures, etc,). In marketing area, consumers traditionally show common-identity as they select clothes, hairstyles, automobiles, logos, and so on, to impress others in any given context in a shopping mall or opera. To examine these social capital and attachment, we combined a social capital theory with an attachment theory into our research model. Our research model focuses on the common identity- and bond-attachment how they are formulated through social capitals: cognitive capital, structural capital, relational capital, and individual characteristics. Thus, we examined that individual online kindness, self-rated expertise, and social relation influence to build common identity- and bond-attachment, and the attachment effects make an impact on both the willingness to help, however, common bond seems not to show directly impact on information sharing. As a result, we discover that the social capital and attachment theories are mainly applicable to the context of social media and usage in the individual networks. We collected sample data of 256 who are using social media such as Facebook, Twitter, and Cyworld and analyzed the suggested hypotheses through the Structural Equation Model by AMOS. This study analyzes the direct and indirect relationship between the social network service usage and outcomes. Antecedents of kindness, confidence of knowledge, social relations are significantly affected to the mediators common identity-and bond attachments, however, interestingly, network externality does not impact, which we assumed that a size of network was a negative because group members would not significantly contribute if the members do not intend to actively interact with each other. The mediating variables had a positive effect on toward willingness to help. Further, common identity attachment has stronger significant on shared information.

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Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient (어린이 영양지수 (nutrition quotient)를 이용한 제주 지역 일부 초등학생의 식습관 및 영양 상태 평가)

  • Boo, Mi Na;Cho, Su Kyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.48 no.4
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    • pp.335-343
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    • 2015
  • Purpose: The aim of this study was to evaluate the food behavior and nutritional status of elementary school students in the Jeju area using Nutrition Quotient (NQ). Methods: The subjects were 440 students (235 boys and 205 girls) in the fifth and sixth grade at four elementary schools located in Jeju. Demographic, lifestyle, and environmental information was collected using a self-reported questionnaire. The food behavior checklist for children's Nutrition Quotient (NQ), consisting of 19 items, and nutrition education related information were also obtained. Results: The mean score of the children's NQ was poor, reaching 60.3 points. The percentage distribution of NQ grade was 19.8% (lowest), 18.6% (low), 45.0% (medium), 10.7% (high), and 5.9% (highest) and the factor scores for balance, diversity, abstinence, regularity, and practice were 56.6, 68.4, 71.3, 57.4, and 54.8 points, respectively. Compared with the NQ cut-off points for defining malnutrition (balance; 57, diversity; 87, abstinence; 66, regularity; 69, and practice; 67 point), average score of abstinence factor was only above the cut-off point and scores of the other factors were below the cut-off point. Subjects with higher NQ scores tended to have higher levels of exercise activity (p < 0.001), frequency of family meals (p < 0.01), and father's educational levels (p < 0.01) compared to those with lower NQ score. NQ score showed positive association with nutrition education experience and practice (p < 0.001). Conclusion: NQ score of elementary school students residing in Jeju was lower than the national average. More opportunities should be provided for participation in nutrition education, which incorporates a range of program strategies, as well as communication and education activities.