Food and Nutrition
Section Newsletter
Fall 2003

Message from the Chair

It has been a busy year for our section. A critical role for APHA Sections is to produce relevant, up-to-date and science/evidence-based position papers and resolutions on emerging and current public health issues. APHA's policies serve as the organizaztion's official stance on health issues and guide the association in its public health advocacy efforts. In February, our FN Section submitted to APHA for review two Proposed Policy Statements for 2003: 1) Support for Child Nutrition Programs and 2) Food Marketing and Advertising Directed Children and Adolescents. The 'Support for Child Nutrition Programs' Policy Statement was submitted as a late-breaker resolution during the November 2002 Annual Meeting and was titled 'American Public Health Association Support for Reauthorization of USDA Child Nutrition and WIC Programs in 2003.' This was passed as interim policy, but is now required to undergo the complete policy development and approval process for 2003. The proposed policy statement was renamed 'American Public Health Association Support for Child Nutrition Programs.' The proposed policy statement is being co-sponsored by the Maternal and Child Health Section.

We also submitted for review a proposed policy statement on 'Food Marketing and Advertising Directed Children and Adolescents,' which is co-sponsored by the Food and Nutrition Section, the Maternal and Child Health Section, and the School Health Education and Services Section. We feel this is an important public health issue which needs national attention and that APHA should have a policy statement addressing this issue. Children and adolescents are currently being aggressively targeted and exposed to an increasing and unprecedented amount of food advertising and marketing of high-calorie, low-nutrition foods through a wide range of venues including television, the Internet and schools. This proposed policy statement is timely given the epidemic of childhood obesity. Both proposed policy statements we submitted must undergo the full APHA review process. The Association's Governing Council at the November 2003 Annual Meeting in San Francisco will do final voting for all policies. The 2003 proposed policies and the policy review schedule are available on the APHA Web site.

The Food and Nutrition Section Executive Board had its mid-year meeting March 5-6, 2003, and spent two highly productive days in Washington, DC, at APHA headquarters. Our meeting was devoted primarily to the Overweight in Childhood Action Plan and the Section Strategic Plan. The action plan continues the work laid out after the passage of the 2001 Overweight in Childhood resolution. The strategic plan is the Section's effort at mapping out our short-term and long-term (five year) goals and objectives. Sheryl Lee led the group discussion on the action plan and Annie Carr led the group in fine-tuning the Section strategic plan. The strategic plan and information on childhood overweight is available on our Section's Web site, <>. As part of the Overweight in Childhood Action Plan, we overhauled our Web pages on childhood overweight. Please look at our new Web pages on this topic as they offer many resources and links on the topic of child and adolescent nutrition. We need to thank Communication Committee Chair Paul Cotton, and Co-Chair Dena Goldberg for all their work on this project and our Web site in general. From October 2001 through June we had over 7,000 visits to our Web site, with visitors from around the world. In May alone, we had 821 hits on the obesity Web site.

The Web site was completed in time for this year's National Public Health week in April. Each April, APHA sponsors NPHW to draw national attention to a major public health issue. This year's theme for NPHW April 7-13 was overweight and obesity, which carried the tagline "Getting in Shape for the Future: Healthy Eating and Active Living." Our section was actively involved in working with APHA on NPHW. Patricia Risica, who is Secretary of our Section, served as our section's liaison to APHA and worked closely with Lakitia Mayo, APHA's Director of Grassroots Advocacy and Affiliate Affairs who coordinated the event this year. Our section helped develop the toolkit to help communities and public health personnel plan their NPHW activities. The kit features media advocacy tips, sample news releases, and talking points and tips on reaching legislators. It also features an overview on overweight and obesity and state-by-state data. We also sent letters to encourage APHA's sections and Affiliates to use NPHW as an opportunity to plan events around overweight and obesity and to educate their colleagues and communities. We thank Patricia and Lakitia for all their hard work on this event. Check out the APHA Web site on the activities and resources for the NPHW, <>.

In addition, at our meeting we discussed new awards criteria developed by Judy Wilson, chair of our awards committee. Barbara Polhamus reported on the plans for the APHA 2003 Annual Meeting in San Francisco and the abstract approval process. Charlene Sanders and Barbara are Chair and Co-chair of the Program Planning Committee. Under their guidance, we will have many exciting sessions and we hope you can join us in San Francisco Nov. 15-19.

Fourteen Board members participated in the mid-year meeting -- Annie Carr, Noel Chavez, Paul Cotton, Ellen Harris, Jay Hirschman, Katrina Holt, Sheryl Lee, Geraldine Perry, Barbara Polhamus, Patricia Risica, Mary Story, Joan Trendell, Judy Wilson and Margo Wootan. This was the third mid-year meeting held by the Section. The attendance at the meeting and the hard work being carried out by the Committees highlights the commitment of the board to raise the visibility of the Section and make our presence known within APHA.

These are interesting and exciting times for the field of food and nutrition, and many things are happening in our Section.

Mary Story PhD, RD
Chair, Food and Nutrition Section

APHA Annual Meeting and Exposition

The 131st Annual Meeting and Exposition is Nov. 15-19, 2003, in San Francisco. The Annual Meeting consists of more than 900 scientific sessions, roundtables, poster sessions, Institutes and panel discussions at which over 4,000 scientific papers will be presented.

Check out the Food and Nutrition Section listings at <>.

Food and Nutrition Section Award Sessions

Come and join other Food and Nutrition Section members at the FNS Award Sessions.

Food and Nutrition Section Awards and Reception
Sunday, Nov. 16, 6:30-8:30
Marriott Hotel Room A2 - Golden Gate Hall

Agnes Higgins Lecture and Reception
Monday, Nov. 17, 6:30-8:30
Marriott Hotel Salon 7

Food and Nutrition Section News

Membership Report:

As of July 16, the APHA members Web site listed 648 Food and Nutrition Section primary section members. This is up from the official report of 623 on March 31, but still down from 653 in 2002, and 719 in 2001. APHA recently provided a list of our lapsed members over the past three years. Excluding 35 from 23 other countries, the list contains 675 lapsed members of the following types: Regular: 394; Student: 243; Special Health Worker: 30; Retired: 29; Consumer: 27; and, Contributing: 11. A sample of students and regular members were contacted by e-mail, however only a small percentage replied.

Those that did expressed regret that competing priorities for time and money influenced them to pare down memberships in professional organizations. The 2003 Membership Committee would appreciate hearing your ideas for retaining our current members and recruiting new or lapsed members. Committee member Pamela Darby distributed a recruitment message by e-mail to members of the Association of Graduate Programs in Public Health Nutrition, Inc. to pass along to students.

Co-Chair Elvira Jarka is busy putting together a section booth for the 131st Annual Meeting at the Moscone Convention Center in San Francisco to welcome members and attract new ones. The exhibition will be open on Sunday, Nov. 16 ,from 2 p.m. to 7:30 p.m., Monday, Nov. 17, from 8:30 a.m. to 7 p.m., Tuesday, Nov. 18, from 8:30 a.m. to 6 p.m., and Wednesday, Nov. 19, from 8:30 a.m. to 12:30 p.m. The section booth is #1748. Please contact Elvira Jarka to volunteer your ideas and time setting up or staffing the booth, <EJarka@HRSA.GOV>. Every member can help with recruitment by communicating with colleagues regarding the benefits of membership in APHA and the Food and Nutrition Section. Be sure to share our vision and mission via <>.

Section Web site:

If you have not already done so, please check out our section Web site at <>. The site provides useful and up-to-date information on issues that are relevant to our Section. The popularity of the Web site is rapidly increasing. Monthly hits have grown from 2,745 in January to 7,600 in June. Our busiest month was April with 37,282 hits. April included National Public Health Week with its focus on obesity prevention and the launching of our obesity Web site.

The Web site includes officer contact information and office descriptions, a link to APHA membership information, copies of the strategic plan, newsletter, and nutrition policy statements and resolutions and information on our section awards. The Web site also includes a student section with nutrition tips, a listing of Schools of Public Health, Nutrition and nutrition organizations, information on internships and a link to APHA public health links. Moreover, do not forget to check out the links to other APHA section Web sites, nutrition resources, information about the APHA Annual Meeting, nutrition meetings and other continuing education opportunities.

Additionally, there is a link to our obesity Web site with a plethora of information and resources on childhood obesity. This has been the most popular page with over 800 views in both April and May and close to 400 in June and July.

A short survey is posted on the Web site. It is not too late to give us feedback on the Web site and suggestions for making the section more responsive to your needs by completing the survey. Or, you can e-mail your comments to Dena Goldberg at <>.

APHA Advocacy and Policy News

APHA appreciates the advocacy efforts of its members and the larger public health community on issues that ultimately affect the health of our entire nation. Members can obtain in-depth information on legislative updates on APHA's Web site. Information on the site is updated weekly.

Advocacy Web Sticker on FN Section web site
"Write Your Member of Congress" icon is now on the FN Section Web site. This allows section members to take action directly from our Web site.

Action Board Report
APHA's Government Relations staff works closely with the Action Board on advocacy efforts within Sections. The Action Board is made up of a representative from each Section, a member at large and three Affiliate members. This year the Action Board created working subgroups to addressed APHA's three priority areas: health disparities, access to health care and infrastructure. The health disparities workgroup contributed a lot of their expertise to staff from Senators Frist and Kennedy's offices. If you are interested in getting more involved in APHA advocacy efforts through Food &
Nutrition Section, please contact Sheryl Lee, Action Board Member.

APHA's E-Advocacy Tool: <>
In January, APHA purchased its first e-advocacy tool to help mobilize its members to send letters to their members of Congress electronically. APHA has organized several advocacy efforts through the system over the past six months. In June APHA used its e-advocacy tool to rally more than 1,500 public health professionals to send electronic letters to their members of Congress. APHA anticipates that these numbers will dramatically increase as we become more familiar with the system. APHA's new advocacy tool has many great features that all members and public health professionals can use when advocating on behalf of a public health issue. These resources include:

  • Mega Vote: Sign up to receive a weekly email on how your Senators and Representative voted during the week on important issues.

  • Elected Official Finder: Find biographical information on elected officials including the president, members of congress and agency heads.

  • Issues and Legislation: In this section you will find Capitol Hill Basics, pending public health legislation and key public health votes.

  • Media Guide: Send electronic letters to the editor on issues important to public health directly to your local media outlets with APHA's media advocacy tool.

  • Legislative Action Center: See the latest APHA Action Alerts. Send emails to your members of Congress on legislation important to APHA. This tool also allows members to customize APHA list.

Join APHA's Legislative Network
APHA staff works to ensure that public health is being fairly represented on Capitol Hill. APHA needs your help to ensure that our needs and accomplishments are being recognized on Capitol Hill. The most powerful message a member of Congress receives is from a constituent in his/her home district. That is why it is essential that APHA have a legislative advocacy network. Having a network of public health professionals willing to take action is essential to ensuring that the legislative priorities of APHA are addressed. While APHA will continue to request that its membership as a whole take action on issues effecting public health, the legislative network will serve as the "grass tops" of APHA's entire Advocacy network. Join Now!

Nutrition Policy Update-7/10/03

Child Nutrition:
This year, Congress is reauthorizing the federal Child Nutrition Programs, including the National School Lunch Program, School Breakfast Program, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Summer Food Service Program, which are reauthorized every four or five years. APHA is working in coalition with the National Alliance for Nutrition and Activity (NANA) to advocate for improvements to these programs. NANA's recommendations for reauthorization include:

  • Enhance and strengthen the Team Nutrition program by adding a state-level infrastructure and networking component called the "Team Nutrition Network." Fund by increasing the State Administrative Expense formula and dedicating the increase to nutrition education (to provide an additional $40 million annually).

  • Provide $10 million annually for grants to states or school districts for the "Healthy Foods for Healthy Kids Initiative" for creative ways to help schools provide and encourage children to consume more fruits and vegetables.

  • Give schools flexibility to decide what type(s) of milk to offer with school meals (i.e., remove the whole milk requirement).

  • Provide USDA's Food and Nutrition Service with $2 million per year to do field trainings and give grants to states to train localities on the School Meals Initiative to help schools improve the nutritional quality of meals.

  • Expand the pilot program providing free fruits and vegetables to school students as snacks.

  • Give the U.S Department of Agriculture authority to establish and enforce regulations for all foods sales anywhere on school campuses throughout the school day in schools that participate in the National School Lunch Program or School Breakfast Program to ensure that foods sold outside of the school meal programs make a positive contribution to children's diets and do not undermine the national investment in school meals.

  • Require that the WIC food packages, target nutrients and nutrient needs of participants be re-evaluated at least every 10 years and revised as needed to reflect current nutrition science.

The Senate Agriculture, Nutrition, and Forestry Committee was expected to mark up its child nutrition bill in late July, at the earliest. The House Committee on Education and the Workforce was expected to write its version of the Child Nutrition Bill during the August congressional recess, and introduce and mark it up in early fall. After the Senate and House bills are approved, then a conference committee will meet to work out the differences between the two bills.

Restaurant Labeling:
This year several states have taken steps to extend the Nutrition Labeling and Education Act (NLEA) to fast food and other chain restaurants (locally-owned, neighborhood restaurants are exempt). Legislators in Maine, New Hampshire, New York, Pennsylvania and the District of Columbia have introduced legislation to require labeling of calories on menu boards and of calories, saturated plus trans fat, sodium and, in some cases, carbohydrates on menus. These bills have faced tough opposition from the restaurant industry.

Litigation Against Food Companies:
In the U.S. House of Representatives, Representative Ric Keller,R-Fla., has introduced the Personal Responsibility in Food Consumption Act, which would prohibit lawsuits against restaurants and food manufacturers related to obesity and other diet-related diseases, such as diabetes. Senator Mitch McConnell,R-Ky., is expected to introduce similar legislation in the Senate. While no one is anxious to sue food companies, litigation has proven to be a powerful tool to achieve policy and environmental changes in other areas of public health, especially tobacco. Public interest lawyers, including lawyers that have worked on tobacco, have been discussing lawsuits that could help to provide nutrition information in restaurants, decrease the availability of low-nutrition foods in schools, and reduce the marketing of high-calorie, low-nutrition foods aimed at children.

Child Nutrition and WIC Reauthorization:
The authorizing legislation for WIC, the National School Lunch Program and other child nutrition programs expired on Sept. 30, 2003. APHA is active in the reauthorization as a steering committee member of the National Alliance for Nutrition and Activity (NANA).

USDA Under Secretary for Food, Nutrition and Consumer Services Eric Bost and Surgeon General Richard Carmona were the lead witnesses at the July 16, 2003, hearing on Child Nutrition and WIC Reauthorization before the House Committee on Education and the Workforce. The Senate Agriculture Committee hearing on reauthorization was held in April. The following links provide information on the hearing testimony and the policy positions of some major organizations:

Congressional Web Links:
51-page report from the Congressional Research Service (CRS) "Child Nutrition and WIC Programs: Background and Funding"

Senate Committee on Agriculture, Nutrition and Forestry

Senate Testimony from March 4, 2003 and April 3, 2003 Hearings (3/4 = ADA, ASFSA, CBPP and others; 4/3 = USDA, FRAC, AEI)

House Committee on Education & the Workforce:

House Issue Summary (about 1 page)

Nonprofit/Health Organizations Web Links:
ADA (7 page position paper from July 2003 JADA)

AEI - American Enterprise Institute (Besharov & Germanis book "Rethinking WIC"),filter./news_detail.asp

America's Second Harvest

ASFSA - American School Food Service Association (includes links to pending bills)

Bread for the World

CBPP - Center on Budget and Policy Priorities (analysis of NSLP overcertification estimates)

CFPA - California Food Policy Advocates

FRAC - Food Research and Action Center

NANA - National Alliance for Nutrition and Activity

NWA - National WIC Association

SNE - Society for Nutrition Education
Scroll down on left and click on "Positions and Resolutions", then click on "Platform/Policy Statement on Federal Child Nutrition Reauthorization of 2003"

Current Issues in Research and Practice

Public Health Nutrition
Public Health Nutrition is an international, peer-reviewed journal focusing on the promotion of good health through nutrition and the primary prevention of nutrition-related illness in the population.

This year PHN has increased its frequency to eight issues to properly reflect the increase in original research papers, topical review articles and other literature in the field. Topics covered include: nutritional epidemiology - studies relating nutrition to health or disease risk; nutrition-related health promotion; evaluation of effectiveness of intervention studies aimed at improving health; role of nutrition in high risk and vulnerable groups; development of research methods, validation of measures, calibration; and population-based research related to primary prevention of illness.

CABI Publishing on behalf of the UK Nutrition Society publishes PHN. More details on all the Nutrition Society journals can be found at <> with instructions for authors and sample copies available. If you would like to subscribe, please contact Richard Sullivan at <>.

Report by World Health Organization (WHO) confirms that fruit and vegetable intake lowers cancer risk

Yet another endorsement for eating fruits and vegetables is given by a recent report from WHO's cancer research agency. On March 24, 2003, the International Agency of Research on Cancer (IARC) released findings from an extensive review of current knowledge and research on the link between dietary intake of fruit and vegetables and cancer. The group of 22 scientists (from 10 countries) concluded that findings from both human studies and animal experimental studies indicate that a higher intake of fruits and vegetables is associated with a lower risk of various types of cancer, particularly cancers of the gastrointestinal tract. This confirms findings of a recent study by Japanese researchers.

In many studies, there is a consistent association of higher levels of fruits and vegetables intake with some reduction in cancer risk, said Professor Paul Kleihues, director of the IARC. This, plus the evidence of beneficial effects of fruits and vegetables on other major diseases such as heart disease, indicates that individuals and communities should increase their intake of these foods. He said the findings were important for governments, the food industry and consumers.

The clearest evidence of a cancer-protective effect from eating more fruits is for stomach, lung and esophageal cancers. Similarly, a higher intake of vegetables probably reduces the incidence of cancers of the esophagus and colon-rectum.

The working group estimated that approximately one in 10 cancers in Western populations are due to an insufficient intake of fruits and vegetables. Similar, although variable, fractions apply to other populations around the world, and may be higher in regions where the intake of fruits and vegetables is lower.

The group's chairman, Professor Tony McMichael from the Australian National University, stated that long-term follow-up studies involving large numbers from the general population would provide higher-quality information about evidence of diet-cancer relationship. His team met for a week in Lyon, France, to conduct their review.

Trans Fat Labels: Helping Americans Make Healthy Choices
July 9, 2003

We are empowering Americans to make healthier choices about the foods they eat. This new information will give consumers a more complete picture of foods' fat content, allowing them to choose foods low in trans fat, saturated and cholesterol, all of which are associated with an increased risk of heart disease.

Secretary Thompson announced that food labels will be required to list the amount of trans fatty acids, or trans fat, to give consumers better information for choosing a healthier diet. The new requirement will mean that manufacturers of most conventional foods and some dietary supplements will need to list in the Nutrition Facts panel the trans fat content of the product, in addition to the information about its overall fat content and saturated fat content.

The new label is part of FDA's broader efforts to inform consumers more effectively about the health consequences of their dietary choices. FDA hopes to further improve the nutrition label to provide clearer, up-to-date guidance on a healthy overall diet. FDA also is working to increase the focus on health in food product development and promotion and is encouraging research that would foster greater science-based competition among food producers to improve health.

Eat Smart. Play Hard. TM Web Site - Increasing Access to Nutrition Resources

On Feb. 25, 2003, U.S. Department of Agriculture (USDA) Secretary Ann Veneman announced the launch of the new USDA, Food and Nutrition Service "Eat Smart. Play Hard." The Web site provides nutrition educators with direct access to the Campaign's resources. The site contains a variety of tools that educators can use to promote healthy eating and activity to youth and their caregivers.

An order form for materials is located on the site at <>, but most materials can be downloaded. These resources include posters, activity sheets for kids, parent brochures, posters, stickers, guidance materials, and information about use of the Power Panther TM character and costume. The "Eat Smart. Play Hard." Web site received about 150,000 hits during 2002, and the new site is expected to attract many more consumers.

The Web site is a component of the USDA "Eat Smart. Play Hard." TM Campaign, a key administrative action of President Bush's Healthier United States Initiative. The Campaign is designed to promote positive changes in eating and physical activity behaviors of preschool and school-aged children and their caregivers.

Educational, Internship, and Training Opportunities

Eight Universities Offer Maternal and Child Nutrition Traineeships

Eight universities offer education and training opportunities in maternal and child nutrition to registered dietitians seeking training in public health nutrition. The programs vary in their emphasis and length of study, but all provide support in the form of tuition assistance, fees, and a monthly stipend. The U.S. Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services funds these traineeships. Application deadlines for the next academic year vary by program. Contact the individual university programs listed below for information, application deadlines and application materials.

University of Alabama-Birmingham
Department of Adolescent Medicine
1600 7th Ave South
Birmingham, AL 35233
Attn: Bonnie Spear, PhD, RD

Baylor College of Medicine
Section on Neonatology
Department of Pediatrics
6621 Fannin St, A 340, 1-3460
Houston, TX 77
Attn: Diane Anderson, PhD, RD

University of California- Los Angeles
Children's Hospital (UCLA)
4650 Sunset Blvd., Mail stop #53
Los Angeles, CA 90027
Attn: Marion Taylor Baer, PhD, RD

Indiana University
Nutrition and Dietetics Program
702 Barnhill Drive, Room 3505
Indianapolis, IN 46202-5200
Attn: Karyl Rickard

University of Minnesota
Division of Epidemiology
School of Public Health
Suite 300, WBOB
1300 S. 2nd St
Minneapolis, MN 55454-1015
Attn: Jamie Stang, PhD, MPH, RD or Mary Story, PhD, RD
E-mail: or

University of New Mexico
Education Office Building, Room 215
Albuquerque, NM 87131-1231
Attn: Karen Heller, PhD

University of North Carolina
Department of Nutrition CB#7400
McGavran-Greenberg Hall
Chapel Hill, NC 27599-7400
Attn: Jan Dodds, EdD, RD

University of Tennessee
Department of Nutrition
1215 W. Cumberland Ave, 229JHB
Knoxville, TN 37996-1900
Attn: Betsy Haughton, EdD, RD


Association of University Centers on Disabilities -
Multicultural Council Resources: includes a survey evaluating progress toward organization cultural competence.

National Heart, Lung, and Blood Institute -
Includes an article discussing the changes in portion sizes over time and an interactive quiz.

Children's Defense Fund - Minnesota -
Includes information on Minnesota child and family well-being and the 2003 KIDS COUNT Data Book.

Identification, Evaluation, and Treatment of Overweight and Obesity in Adults-
The items in the kit let you easily and efficiently help your patients establish and achieve reasonable weight management goals. The kit includes:
  • A quick-reference card on "best practice" weight counseling techniques

  • Weight Education Kit <>

  • A pocket-sized, self-retracting tape for quick waist circumference measurement

  • Customizable take-away patient health and weight profile sheets complete with tips for weight loss success

  • A handy Practical Guide to effectively treat overweight and obese adults that includes a quick reference tool to ACT (assess, classify and treat patients) and reproducible patient handouts on weekly food intake and activities, sample reduced calorie menus, food preparation, dining out, and physical activity.

  • A copy of the Clinical Guidelines on the Identification, Evaluation, and treatment of Overweight and Obesity in Adults: The Evidence Report for your reference library --

Breastfeeding the Premature Infant -
The May 2003 issue of Pediatric Annuals focused on the topic "Breastfeeding the
Premature Infant." Articles of particular interest include "The Role of the
Pediatrician in Extended Breastfeeding of the Preterm Infant," "Maximizing the
Benefits of Human Milk Feeding for the Preterm Infant," "Breastfeeding the
Borderline (Near-Term) Preterm Infant," "Supporting Lactation in Mothers With
Very Low Birth Weight Infants," and "Medications in Breastfeeding Mothers of Preterm

Financial Toll of Obesity -
Did you know that treating the illnesses associated with obesity rivals the financial toll of smoking-related diseases and that obesity is a major risk factor for heart disease, hypertension, diabetes and other serious health problems? See the free online CME courses on obesity at <> for more information.

Rickets and Vitamin D-
A copy of the AAP position statement on Rickets and vitamin D deficiency is available online at <>.

Cross-cultural experience-
The BaFa simulation is a great simulation for a cross-cultural experience that allows groups of individuals to experience cultural differences through interactive activities. It is available from:
Simulation Training Systems
PO Box 910
Del Mar, CA 92014

ADA Position Papers

Briggs, M., Safaii, S., & Beall, D.L. (2003). Position of the American Dietetic Association, Society for Nutrition Education, and American School Food Services Association. Nutrition services: An essential component of comprehensive school health programs. Journal of American Dietetic Association, 103, 505-514.

Stang, J., & Taft-Bayerl, C. (2003). Position of American Dietetic Association. Child and adolescent food and nutrition programs. Journal of American Dietetic Association, 103, 887-893.