Food and Nutrition
Section Newsletter
Spring 2010

Message from the Chair

Sibylle Kranz, FNS ChairWelcome to the hot months of summer!


I would like to start this newsletter with a big, heartfelt congratulations to our own newsletter editor, brand new DOCTOR Sarah Forrestal – congratulations, Sarah!!  You have done an outstanding job as newsletter editor alongside writing and defending your dissertation.


The FNS Board held its mid-year meeting at APHA Headquarters in Washington, D.C., on May 15, 2010.  We had a very productive meeting with lively discussions and democratic principles at work.  I thank all of the participants who attended in person or via phone call.  Download the meeting minutes here.


This newsletter is filled with fascinating articles on the topics of the food environment and sustainability.  These timely issues have certainly raised a lot of interest in general public as well as the media; a noteworthy change.


We also share information from the Office of Women’s health on a social marketing campaign on bone health for girls – another timely issue in times when many children do not consume adequate amount of calcium and are lacking weight bearing physical activity.

Perspective: Nutrition, the Environment, and the Food Movement

Both improving public health and reducing health disparity through access to better nutrition certainly seem to be at the heart of what was recently referred to in the New York Review of Books by Michael Pollan as the food “movements.”  For example, urban agriculture and farmers’ markets increase access to healthier food, and many groups are working to have more of both. The social, environmental, cultural and economic problems often focused on in public health are to varying degrees rectifiable by reforming the ways in which food is produced and distributed. Such efforts can often be coordinated with those to protect the environment, since most farming in the United States pollutes our air, water and soil. At this crossroads, public health advocates can serve to foster more collaboration among environmentalists and food advocates and help make the case for public health on behalf of these common efforts to lawmakers. Some well known environmental issues related to food production are the distance traveled from the field to plate, chemicals used in food production, packaging, and perhaps the lesser known areas of composting, soil, air and water management.


The increase in garden spaces can help with both waste and water management. Many community gardens compost both the gardens’ organic matter as well as food scraps. According to the EPA’s 2008 data, 12.7 percent of municipal solid waste was food scraps and 13.2 percent was yard trimmings (of a total 250 million tons, prior to recycling).  If that waste was diverted to dispersed, small-scale composting facilities, much less fuel would be used to haul garbage, less space would be taken up in landfills, and less methane (a potent greenhouse gas) would be released by its anaerobic decomposition. The resulting compost humus can lead to healthier soils that are better capable of nourishing plants and with improved ability to drain excess water and to be drought resistant. The addition of new organic matter to soil reduces the concentration of toxic substances, an important function in cities where lead and other pollutants have often tainted the soil. Small-scale community gardens and those practicing ecological agriculture are already beginning to divert significant amounts of such matter by using it as a resource (check out Growing Power’s impressive composting information).


Soil can replace nonporous asphalt or concrete in urban environments, which aids in water management. Along with rain barrels, often used in backyard and community gardens, and the growing use of green roofs, these changes are diverting significant amounts of rainwater from wastewater management systems. The financial and energy costs of normal water management aside, this is no small matter when, as the New York Times noted last year, the systems can be overwhelmed during a storm, leading to the release of wastewater before it is treated.  The article states, “In the last three years alone, more than 9,400 of the nation’s 25,000 sewage systems — including those in major cities — have reported violating the law by dumping untreated or partly treated human waste, chemicals, and other hazardous materials into rivers and lakes and elsewhere.”  Gardeners and urban farmers could have a great impact on the number and volume of these overflows, which could protect both humans and wildlife alike from untreated wastewater.


While the modern food movement appears to be hitting its stride on a number of levels, conventional agriculture is still the norm and is being exported to developing nations. Some contend it is the only way to feed the world. However, a recent study shows that ecological agriculture, including organic production, can in many cases increase yields while avoiding so many of the environmental problems caused by conventional agriculture. Raj Patel, in Stuffed and Starved, The Hidden Battle for the World Food System, counters that today, hunger is largely a problem of distribution, of people being denied the right to food, not one of production. Maria Rodale’s Organic Manifesto notes that compared to conventional, organic agriculture uses 30 percent less fossil fuel while creating 15 percent more jobs, which makes a strong economic case for switching to organic production. While organic food usually costs more, Rodale contends that it would be cheaper than conventional if it were not for the fact that “just 0.3 percent of the Farm Bill’s $284 billion budget” goes to organic research. Considering all of the external costs, opponents say that the real costs of conventional agriculture to both public health and the environment vastly outweigh any case that can be made for continuing on that path. What is the greatest case a public health advocate can make for reforming the way our food is produced? One of our largest public health threats is that which is posed by global climate change, and according to the Rodale Institute, “practical organic agriculture, if practiced on the planet’s 3.5 billion tillable acres, could sequester nearly 40 percent of current CO2 emissions.”


The growth of community gardens and farmers’ markets, along with a number of documentaries and books on the subject, is yielding a better-informed populace, more engaged with the food system.  Public health advocates are finding allies to improve nutrition through gardens and farmers’ markets among urban planners, environmentalists, human rights advocates, farmers, and increasingly, citizens, taking up shovels in gardens to partake once again in producing food. Highlighting improved nutrition as just one among many benefits of changing the manner and location in which our food is produced and distributed strengthens the case for such improvements as making available both farmers markets, community gardens, and changing the type of agriculture the Farm Bill supports.

Storing Empty Calories and Chronic Disease Risk – Snack Foods in Urban Corner Stores

Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child’s food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from.


Recognizing such holes in existing knowledge about urban corner stores, Dr. Sean C. Lucan, a family physician from Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, partnered with staff at The Food Trust, a Philadelphia-based non-profit organization dedicated to ensuring everyone has access to healthy, affordable food. The research team evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, low-income school neighborhoods. Team members recorded manufacturer, calories, fat, sugar, and sodium for all stocked snack items, then compared the nutritive content to established dietary recommendations and a school nutrition standard.


What the team found was a lot of unhealthy snacks – more than 450 kinds in fact! There were no fruit snacks (e.g. apples, raisins), no vegetable snacks (e.g. carrot sticks, hummus), and only 3.6 percent of all snacks (by liberal definition) were “whole grain.” The remainder (96.4 percent) were highly processed, prepackaged, calorie-dense snack products, laden with added fat and/or sugar.


While specific snacks varied considerably between neighborhoods, the distribution of snack types and nutritive content varied little by neighborhood or by store within neighborhood. Depending on serving size definition, 80.0-91.5 percent of snack foods were “unhealthy” by the school nutrition standard (including seven of 11 whole grain products). In fact, researchers found that a single snack item could supply 6-14 percent of a day’s recommended calories, fat, sugar, and sodium on average (or 56-169 percent at the extreme) for a “typical” child.


A finding of particular policy relevance from the study was that only three of the 65 identified manufacturers supplied most of the snack foods to stores in the three neighborhoods. All three manufacturers have already attempted to make healthier alternative snacks, and other snack-food manufacturers could be induced do the same - modifying their “regular” products to reduce the amounts of fat, sugar and sodium, for example, and increase the amount of whole grains or produce (e.g. dried fruit). The authors conclude that corner stores, non-profits and government can work together to encourage networks between store owners and local producers, bringing healthy food from local farms and bakeries into the corner store product mix to improve the healthfulness of corner store snack food inventories.

Sustainable Hospital Food Systems

An important emerging trend in the sustainable food systems movement is the development of healthier food systems in hospitals. This trend began around 2006, when the American Medical Student Association began a campaign to remove fast-food from hospital campuses. Other organizations, such as Health Care Without Harm, also joined the movement.


The goal of this movement is to ensure that hospitals set a good example for healthy living and improve access to healthy foods by providing their staff and patients with healthier food choices. This includes not only improving the nutritional content of food available in the cafeteria, but also the food available in vending machines. While different organizations have varied criteria on what constitutes “healthy” food, there are general goals, including:

1.  Reducing or eliminating trans fats and high-fructose corn syrup.

2.  Reducing sodium content in foods.

3.  Reducing fat content in foods.

4.  Offering multiple vegetable and fruit servings.

5.  Providing nutritional information and pricing incentives to educate clients and encourage healthy choices.


However, a hospital can go beyond simply providing more nutritionally sound fare for its cafeteria and vending machine customers. Food purchasing choices can have a significant environmental impact. For instance, purchasing seasonal vegetables and fruits from local farmers’ markets not only brings money into the community but also results in a lower carbon footprint, since food does not have to be transported over long distances. Similarly, choosing organic produce, cage-free poultry meat and eggs, grass-fed meat not treated with antibiotics, and bovine growth hormone-free dairy products also carry significant ecological impact.


While it is too soon to tell whether providing customers with healthier options helps with behavioral and dietary change, the positive environmental impacts of more sustainable hospital food systems are difficult to ignore. Starting a “Healthy Hospital” movement in one’s own community is to a certain degree uncharted territory; however, many examples and resources exist to aid those who are interested.


If you are interested in making your local hospital healthier, check out these resources:



Center for Environmental Farming Systems: Promoting Healthy Food and Farming in North Carolina

The Center for Environmental Farming Systems (CEFS) CEFS logopromotes healthy food and farming systems through interdisciplinary research, teaching and Cooperative Extension programs. Recently, CEFS engaged more than 1,000 North Carolinians in a Farm to Fork initiative to gain their commitment in building the state’s local food economy. One of the outcomes of that process, From Farm to Fork: A Guide to Building North Carolina’s Sustainable Local Food Economy, highlights the policy and program initiatives needed on the state and local level. A number of working issues teams evolved, such as the Public Health and Food Access Disparities team. This working issues team includes representatives from public health, state universities, hunger relief agencies and not-for-profit organizations. Their goals focus on increasing funding for SNAP-Ed and increasing access of healthy food from North Carolina farmers to the table of people experiencing food insecurity (~13 percent of North Carolina households).


CEFS is also launching the 10% Campaign to encourage consumers to commit 10 percent of their existing food dollars to support local food producers and related businesses. Increasing access to and encouraging consumption of fresh, healthy foods is needed to 10% Campaign logocombat North Carolina’s high rate of diet-related diagnosed chronic diseases in adults, such as diabetes (9.1 percent - 2006 BRFSS data), hypertension (29.2 percent - 2006 BRFSS data) and obesity (26.6 percent - 2006 BRFSS data). According to the 2009 report from Trust for America’s Health, North Carolina has the 12th highest rate of adult obesity in the nation (28.3 percent) and the 14th highest of overweight and obese youths ages 10-17.  More than one in three youths are now considered overweight or obese.  Partners from across the state work together on many levels to address these health concerns.


The 10% Campaign includes a grass-roots initiative, and we’ve   leveraged the support of the NC Cooperative Extension, who have, as a result, designated Local Food Coordinators in every county.  They will connect farmers, processors, and distributors of local, fresh food with retail businesses, non-profits, and institutions to increase availability to all North Carolinians.

Second Largest U.S. Produce Market and the Chelsea Collaborative Form an Environmental Partnership to Reduce Diesel Emissions

RoseAnn Bongiovanni and Catherine Maas, Chelsea CollaborativeChelsea is an urban industrial city across the harbor from Boston.  It is home to 40,000 residents, and boasts the highest rate of respiratory illnesses, strokes, and cardiovascular disease in the state. It is in the highest category for expected lifetime cancer cases from diesel pollution, with a diesel exhaust level five times the U.S. average.


Chelsea hosts jet fuel storage facilities for Logan International Airport, 80 percent of the home heating oil used in the region, and all the road salt used in eastern Massachusetts. Chelsea also has heavy diesel trucking corridors that cut through and surround the city.


Chelsea's New England Produce Center is the second largest produce market in the country, and gets 37,000 refrigerated truck deliveries from across the country annually. With local produce distribution traffic, this adds up to about 2,000-3,000 delivery trucks in and out of the market daily. For extra cold storage space, many companies use stationary trucks that are no longer roadworthy. Using high sulfur diesel, they idle around the clock, producing thousands of tons of hazardous pollutants.


The Chelsea Collaborative, under the guidance of its association executive director RoseAnn Bongiovanni, was awarded $1.9 million in Recovery Act Funding to reduce diesel emissions. Forming a first time alliance with the Produce Center, the partners will upgrade the truck dock electrification system at the market and repower 79 stationary cold storage trailers with electric engines.


"The members of the New England Produce center are excited about enhancing the air quality by reducing harmful emissions caused by diesel engines. This project allows us to be a better neighbor and member of the community" said Brian Eddy, Sr., general manager of The New England Produce Center. "Our objectives from the start of this project were to obtain energy savings, environmental sustainability, and demonstrate community leadership. We take great pride in our participation and view the project as a major success. The Chelsea Collaborative and its representatives have played an integral part in bringing all of us a better community in which to live and work."


Catherine Maas, a member of the Chelsea Board of Health and the lead diesel activist for The Chelsea Collaborative, presented the Collaborative's unique community-market environmental partnership at the EPA's 2010 Environmental Justice Conference in New Orleans this past January.


Adapted with permission from a posting at "What Would Rachel Say?"


Additional Resources on Food Systems and Public Health

Angie Tagtow, MS, RD, LD, recommends several resources for readers interested in learning more about the links among food systems and environmental and public health.


Journal of Hunger & Environmental Nutrition, Volume 4

Special Issue: Food Systems and Public Health - Linkages to Achieve Healthier Diets and Healthier Communities


The Journal of Hunger & Environmental Nutrition proudly presents a special double issue titled “Food Systems and Public Health: Linkages to Achieve Healthier Diets and Healthier Communities.”  Co-edited by Mary Story, PhD, RD, of the University of Minnesota, Michael Hamm, PhD, of Michigan State University, and David Wallinga, MD, of the Institute for Agriculture and Trade Policy, this special double issue identifies research opportunities to develop successful interventions within agriculture, food and health systems as well as policies and actions for moving towards and achieving community environments that allow healthier diets and reducing obesity. This dynamic collection of articles was the outcome of a conference held in April 2009 that focused on the food system, food, agriculture and agriculture policy which was central to a discussion on healthy diets and obesity prevention. More than 80 leading thinkers nationwide from the health, nutrition, obesity and health policy domains together with those from the sustainable agriculture, economics and agriculture policy sectors participated in this robust dialog.

Journal of Hunger & Environmental Nutrition, Volume 3

Special Issue: Sustainable Food Systems - Perspectives from the United States, Canada and the European Union


This special issue of the Journal of Hunger & Environmental Nutrition showcases food system experts from the United States, Canada and the European Union.  The authors provide their analyses of the global food system infrastructure and offer alternatives for creating a food system  that is ecologically sound, socially just, economically viable, and ensures that all eaters have regular access to fresh and healthy food.  This collection of articles explores how food and agriculture decisions determine the quality, quantity and biodiversity of the food supply. This rich set of articles can further stimulate critical thinking, discussion, research and public policy development.  This issue can be used as a companion piece for undergraduate and graduate coursework, a compendium for academic audiences, and a reference for pubic policy advisors, organizations and sustainable food system advocates.

Healthy Land, Healthy Food, Healthy Eaters: Dietitians Cultivating Sustainable Food Systems


This educational piece was developed by Angie Tagtow, MS, RD, LD, and Alison Harmon, PhD, RD, CN, to support continuing education activities for dietitians. It is used with an online e-learning module with the American Dietetic Association, Continuing Professional Development.

A Vision for Good Food for Public Health: Linking Sustainable Food Systems to Healthy People & Healthy Communities


Angie Tagtow, MS, RD, LD, and Arnell Hinkle, MPH, RD, CHES, were Food and Society Policy Fellows with the Institute for Agriculture and Trade Policy and co-authored this educational piece for the 2008 APHA Annual Meeting.

Introducing Best Bones Forever!, a Bone Health Campaign for Girls

Best Bones Forever! logoOsteoporosis is often called a “pediatric disease with geriatric consequences.” Childhood and adolescence are the key windows of opportunity for building strong bones and warding off the disease. In girls, close to 90 percent of bone mass is built by age 18. Girls, in particular, are at greatest risk for bone problems.  Osteoporosis is four times more common in women than men, and adolescent girls consume calcium and participate in physical activity at lower rates than boys. The new campaign empowers girls ages 9 to 14 to build the best bones forever!


Research shows that girls whose friends like milk are more likely to have higher calcium intake. Similarly, physical activity also gets a boost among girls whose friends have positive attitudes toward sports. That’s why the U.S. Department of Health and Human Services’ Office on Women’s Health (OWH) launched Best Bones Forever!, a national bone health campaign for girls ages 9 to 14.  Best Bones Forever! focuses on friendship and fun – and encourages girls to “grow strong together, stay strong forever.”


The new campaign empowers girls and their BFFs (best friend forever) to build strong bones by choosing snacks and foods with calcium and vitamin D, and getting an hour of physical activity a day. Campaign materials such as journals, posters, magnets, tattoos, book covers and a website get girls excited about growing healthy bones! Parents can get important bone health information from a brochure in both English and Spanish, and a website.


Help make an impact by encouraging girls and their parents to make bone health a priority. If you are interested in ordering free Best Bones Forever! materials, contact Talia Thompson.

Symposium on Breast Cancer Nutrition: Nutrition, Communication and Public Policy

This symposium brings together international experts in breast cancer prevention focusing on nutrition, communication and public policy.  Professionals in biology, epidemiology, medicine, nutrition, communication, education and public policy will engage in a global dialogue in breast cancer prevention. The symposium will be held at Purdue University in West Lafayette, Ind., on Oct. 18-19, 2010.  For more information, please see the attached flier or visit the symposium website.

Mark your Calendar for Food and Environment Working Group Events

Food & Environment Working Group logoMark your calendar for two events at the APHA Annual Meeting in Denver, CO in November!


Denver Food System Tour: Saturday, Nov. 6, 11 a.m. - 4:30 p.m.

From thriving urban gardens to innovative food-waste management entrepreneurs, Denver has a lot to share with those interested in a just, healthy and sustainable food system. Join us on a visit to some of the fascinating projects going on in Denver (final locations TBD).


Not only will you be inspired by what you see, but the tour is a great opportunity to network and get to know diverse colleagues interested in food systems and public health, as well as a chance for those new to APHA to come into the conference with some connections already made!


Please note the tour will be on Saturday, so make sure your travel plans get you to Denver by Saturday morning. The tour departs from and returns to the convention center, and lunch is included. The cost is $35. Please RSVP to, and include “Tour” in the subject line. Space is limited.


5th Annual Networking Reception: Tuesday, Nov. 9, 6:30 - 8 p.m.

Join like-minded colleagues for an evening of delicious, local, sustainable food and inspiring dialogue. The reception will be walking distance to the convention center, and will feature free hors d’oeuvres and a cash bar of local beer and wine. Please RSVP to, and include “Reception” in the subject line.


Questions? Please e-mail Becca Klein.

APHA Initiatives on Transportation and Public Health

As we all appreciate, our health is profoundly affected by our transportation decisions and options. Limited opportunities for physical activity, higher exposure to poor air quality, higher incidences of adult and childhood obesity and greater prevalence of asthma and cardiovascular disease are a few of the inequities brought by poor transportation policies.


As part of our effort to enhance crosscutting activity and knowledge among various APHA members and sections, APHA is developing advocacy materials and helpful information related to the links between transportation and public health. If anyone is interested in learning more about this initiative, sharing success stories or lessons learned, or establishing a new Forum on Transportation and Public Health, please reach out to us!


Interested members are asked to contact Eloisa Raynault.

Newsletter Submission Deadlines

Are you teaching an innovative public health nutrition course? Starting an exciting new project? Do you have a job opening or a conference you’d like to promote to the 600+ Section members? You are encouraged to submit content to the newsletter, which is published three times per year. Please e-mail news, research updates or announcements to the newsletter editor, Sarah Forrestal. The fall deadline is Sept. 17, 2010.