Food and Nutrition
Section Newsletter
Winter 2008

Message from the Chair

Barbara Laraia

I’m happy to send you my first message as the new chair of the Food and Nutrition Section (FNS).  The Section had a very productive year in 2007 that will, hopefully, be followed by equally impressive accomplishments in 2008.  We will continue the work that started under the leadership of Patti Risica:

  • We had the largest volume of abstracts, over 300, and a wonderful program at the 2007 Annual Meeting Politics, Policy and Public Health held in Washington, D.C.  We had 20 oral sessions and five poster sessions, our largest program ever. Thank you, Sibylle Kranz!
  • We had a wonderful award banquet highlighting leaders in the public health nutrition field.  Thank you, Deirdra Chester and Sarah Samuels!
  • The Section focused a great deal on increasing communication with fellow colleagues, professional organizations and within the FNS.  Examples of these are:
    • Building collaborative scientific sessions at the Annual Meeting, creating joint sessions with the Environment, School Health Education & Services, Epidemiology and Maternal & Child Health Sections.
    • Formal liaison relationship with the American Dietetic Association, Society for Nutrition Education and National Association of Nutrition and Activity.  Thank you, Lissa Ong!
    • Launching a new Food & Nutrition Web site as part of the APHA Web site.  Thank you, Paul Cotton and Patti Risica!
    • The FNS volunteered to pilot the eCommunities function of the APHA Web site, so stay tuned.
  • FNS sponsored the new Physical Activity Special Interest Group (SPIG) that aims to form a section within the next three years.  The FNS worked with the Physical Activity SPIG and established three Scientific Sessions focused on physical activity.  Thank you, Susan Kayman!
  • The Child Overweight Committee outlined example “10 Steps” for schools and will be finalizing the approach this year.  Thank you, Gail Woodward-Lopez and Lynn Fredericks!
  • We have created a new Public Health Nutrition Workforce Committee lead by Susan Kayman at the University of California, Berkeley, who will identify needs of the PHN work force over the coming year.
  • Organized an exhibit booth for the APHA Annual Meeting to highlight the Section, Section activities, and food and nutrition materials.  Thank you, Janice Adams-King and Meredith Morrison!
  • Published three newsletters to keep membership informed of Section activities and food and nutrition related issues.  Thank you, Angela Odoms-Young and Sarah Forrestal!
  • We ushered in new APHA policies and continue to monitor issues pertaining to child overweight, agriculture and food programs and food safety and food security.  Thank you, Joan Trendell, Katrina Holt, Noel Chavez, Sue Foerster and Matthew Marson!

Our focus on child obesity will be strengthened as we develop concrete strategies to address this important issue.  Expanding the 10 Steps for schools, the Child Overweight Committee will also work on 10 Step approaches for other community venues.  We will continue to work with the Physical Activity SPIG to develop it as a Section.


The work of the Food Safety Committee is very vital and is bringing our Section into a new area of leadership.  This committee will continue to play a vigorous role in 2008 as we work to adopt a general resolution on food safety, continue to work with the Environment Section on policy issues and develop new scientific sessions.


Section membership remains a priority area for 2008.  We will encourage each member to bring others, especially students, into the Section.  Further, we plan to continue to highlight benefits of the Section and develop a formal mentoring program. This expansion of membership and a mentoring program should also help to diversify our membership in ways which will benefit the Section and our focus on food and nutrition policy.


We will build on existing efforts to establish strong Section linkages with the affiliates.  As you know, under the leadership of Patti Risica, in 2006 our section conducted a survey of affiliate needs in the area of supporting healthy weights.  She found that many affiliates had an interest in programs and activities related to healthy weights and wanted additional support from the Section including fact sheets and other resources.  Patti continues this effort in 2008 as the Communications Chair, and we will develop a comprehensive plan for fuller communication with affiliates, advising them on activities they can do and supporting their efforts, possibly through the eCommunities.


I look forward to working with you during this exciting year for our Section and for our field of food and nutrition.  Please continue your past efforts and work with us to increase our membership and our influence.  At this time I’d like to welcome our new 2008 secretary, Section Councilors, and Governing Council members: Lynn Fredericks, Susan Kayman, Noel Chavez, Gail Woodward-Lopez as well as the continuing members: Marcia Thomas, Sibylle Kranz, Katrina Holt, Joan Trendall, L. Beth Dixon, Janice Adams-King, Deirdra Chester, Sarah Samuels, Sara Fein, Paul Cotton, Angela Odoms-Young, Sarah Forrestal, Elaine Prewitt, Geraldine Perry-Allen, Sue Foerster, Matthew Marson, Ruth Palombo and Lissa Ong.

Special Section: Breastfeeding

Thanks to Lissa Y. Ong, MPH, RD, Guest Editor and Regional WIC Nutritionist, USDA, Food and Nutrition Service, Western Region

Ban the Bags: A National Movement to Eliminate Take-Home Formula Sample Packs from the Hospital


   U.S. exclusive breastfeeding rates among newborns fall far short of national goals. Studies 1-5 show that distribution of formula company “diaper discharge bags” (infant formula sample packs) to new mothers at discharge undermines exclusive breastfeeding: the latest study, which found a negative effect of formula packs on exclusive breastfeeding at every week for 10 weeks postpartum, appears in the February 2008 issue of the American Journal of Public Health. 1

    The formula sample packs, which contain formula, coupons and other products, are given free of charge to the hospital, and distributed to new mothers. Such hospital-based distribution is widely criticized by medical and policy-making bodies, including the Government Accountability Office,6 the Centers for Disease Control and Prevention,7 the American Academy of Pediatrics,8 the American College of Obstetricians and Gynecologists,9 the U.S. Office on Women’s Health10 and the World Health Organization.11

    Ban the Bags as a national movement began in 2006, after the Massachusetts Breastfeeding Coalition, working with the Massachusetts Department of Public Health, attempted to remove formula sample packs from Massachusetts hospitals through statewide perinatal regulations. Then-Gov. Mitt Romney quashed the attempt,12,13 but the energy from the Massachusetts effort was directed towards national advocacy.

    Ban the Bags functions on many levels to publicize the cause and support advocates and clinicians who want to eliminate sample packs in their hospitals or regions. Information, resources, and progress reports are provided on the Web site. A broad survey, presented at the APHA Annual Meeting in 2007, documented that most U.S. hospitals distribute formula sample packs, but that in recent years, many have discontinued the practice. According to data collected between late 2006 and early 2007, Vermont, Massachusetts, Oregon, and New Mexico had the lowest numbers of hospitals distributing sample packs (58-68 percent). In many states, including Arizona, Arkansas, Mississippi, New Jersey, and the District of Columbia, 100 percent of hospitals distribute the sample packs.

    Some public health advocates have made outstanding progress towards elimination of the sample packs. The New York City Department of Health and Mental Hygiene launched a major breastfeeding initiative in 2006, which included efforts to reduce the influence of the formula industry, and led to the elimination of sample packs from all 11 public hospitals operated by the NYC Health and Hospitals Corporation.14 In 2007, work from the Breastfeeding Coalition of Oregon led to Portland, Oregon, becoming the first U.S. city where formula sample discharge packs were banned in every hospital.15

    For more information, visit

Anne Merewood, MPH, IBCLC; Director, The Breastfeeding Center, Boston Medical Center; Assistant Professor of Pediatrics, Boston University School of Medicine


1. Rosenberg KD, Eastham CA, Kasenhagen LJ, Sandoval AP. Infant formula marketing through hospitals:  Impact of commercial hospital discharge packs on breastfeeding. American Journal of Public Health  In press.

2. Bergevin Y, Dougherty C, Kramer MS. Do infant formula samples shorten the duration of breast-feeding? Lancet 1983;1(8334):1148-51.

3. Frank DA, Wirtz SJ, Sorenson JR, Heeren T. Commercial discharge packs and breast-feeding counseling: effects on infant-feeding practices in a randomized trial. Pediatrics 1987;80(6):845-54.

4. Dungy CI, Losch ME, Russell D, Romitti P, Dusdieker LB. Hospital infant formula discharge packages. Do they affect the duration of breast-feeding? Arch Pediatr Adolesc Med 1997;151(7):724-9.

5. Dungy CI, Christensen-Szalanski J, Losch M, Russell D. Effect of discharge samples on duration of breast-feeding. Pediatrics 1992;90(2 Pt 1):233-7.

6. Government Accountability Office. Some strategies used to market infant formula may discourage breastfeeding; State contracts should better protect against misuse of WIC name, 2006.

7. Shealy KR, Li R, Benton-Davis S, Grummer-Strawn L. The CDC Guide to Breastfeeding Interventions. Atlanta: U.S. Department of Health and Human Services, 2005.

8. Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics 2005;115(2):496-506.

9. American College of Obstetricians and Gynecologists. ACOG Educational Bulletin,

Breastfeeding: maternal and infant aspects. Washington DC, 2000.

10. Office on Women's Health, US Department of Health and Human Services. Health and Human Services Blueprint for Action on Breastfeeding. Washington DC, 2000.

11. World Health Organization. International Code of Marketing of Breast-milk Substitutes. 1981, Geneva.

12. Smith S. Romney keeps tight rein on Health Dept. The Boston Globe 2006 Sept 10.

13. Associated Press. Romney overhauls panel that backed ban on baby formula giveaways. The Boston Globe 2006 May 20.

14. Zimmerman R. Wall Street Journal 2007.

15. Colburn D. Hospitals heed call to hold the formula. The Oregonian 2008 January 2.

Infant Feeding Practices Study II

Sara Fein, PhD; Consumer Studies Staff, Center for Food Safety and Applied Nutrition, Food and Drug Administration


    The Infant Feeding Practices Study II is a large-scale study of infant feeding and care practices conducted jointly by the Food and Drug Administration and Centers for Disease Control and Prevention.  About 4,000 pregnant women throughout the United States completed questionnaires when they were in their third trimester of pregnancy, and about 2,000 of these women were followed with nearly monthly questionnaires until their infants were 12 months old.  Data were collected in 2005-2007.  Topics include infant feeding, infant health, employment, child care, sleeping arrangements, food allergy and other related topics.  In addition, about 1,500 of the pregnant and 1,500 of the postpartum women, and a comparison group of about 1,500 women who were neither pregnant nor postpartum completed diet intake questionnaires.  

          First results were presented in the form of eight oral presentations at the APHA Annual Meeting in November 2007.  A journal supplement is under preparation and expected to be completed in early summer 2008.  The study data will be available as a public use database from CDC toward the end of 2008.  For more information about this study, see

Workplace Breastfeeding Resource Kit Announced

Isadora Hare, MSW, LCSW and Tiffany Pertillar, Social Work Intern, Office of Women's Health, Maternal and Child Health Bureau, Division of Healthy Start and Perinatal Services


    The U.S. Department of Health and Human Services (DHHS) Health Resources and Services Administration, Maternal and Child Health Bureau (MCHB) will soon be launching a Resource Kit focused on encouraging employers to establish, maintain and expand programs enabling their breastfeeding employees to continue breastfeeding their infants when they return to work.  The Resource Kit, The Business Case for Breastfeeding, is a comprehensive product, with separate sections geared to business managers, human resource managers, employees, breastfeeding advocates and others who are able to reach out to small, medium and even large businesses in their communities and states.  It also provides templates of letters, flyers and posters that can be used in this effort.  The National Business Group on Health, whose members are Fortune 500 companies, will also participate in the initiative.    


With the partnership and support of the Office of Women’s Health, DHHS, MCHB is offering training sessions on the implementation of the Resource Kit for state breastfeeding coalitions and Healthy Start sites over the course of the next three years.  The first of these trainings was held in Arlington, Va. from Jan. 25-26, 2008 in conjunction with the National Conference of State Breastfeeding Coalitions sponsored by the U.S. Breastfeeding Committee.  For more information, please contact Isadora Hare.

Updates on Breastfeeding Promotion Activities in WIC

Lissa Y. Ong, MPH, RD, Guest Editor and Regional WIC Nutritionist, USDA, Food and Nutrition Service, Western Region

  • The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) recently awarded the Center for Human Services a grant to develop a standardized breastfeeding curriculum for local agency staff entitled "Loving Support: Building Breastfeeding Competencies for Local WIC Staff."  This curriculum will outline competencies and skill sets appropriate for WIC local agency breastfeeding coordinators, WIC breastfeeding expert, competent professional authority (CPA) or other WIC health professionals who provide community-based breastfeeding leadership and education through the WIC program.

  • SUMA/Orchard Social Marketing (SOSM) recently received a Cooperative Agreement award to develop culturally tailored educational materials that address the barriers to breastfeeding for WIC Hispanic participants.  The project is now titled "Breastfeeding: A Magical Bond of Love."  A presentation of the final materials (video, brochure, and pamphlets) for the WIC Hispanic Breastfeeding Education and Promotion Project and findings from the field testing phase of this project which guided the creative process is forthcoming on a date to be determined.

Updates on these projects will be posted and current breastfeeding resources are available at the WIC Works Resource System.

CDC Begins Tracking Statewide Support for Breastfeeding

Katherine Shealy, MPH, IBCLC, RLC; Breastfeeding Specialist, Department of Nutrition and Physical Activity, Centers for Disease Control and Prevention


    The Breastfeeding Report Card – United States, 2007 is an important tool for improving breastfeeding nationwide.  It provides state and local community members with needed information on the current status of breastfeeding protection, promotion and support within a given state, while also allowing for direct comparisons across states.  Over time, data from the Breastfeeding Report Card will allow advocates to examine change and growth in their communities relative to progress across the nation and in peer states.


The Breastfeeding Report Card includes key breastfeeding data for each state.  These data identify successes and opportunities for more focused attention.  This is a national snapshot of major indicators of breastfeeding support.  As part of the Breastfeeding Report Card, each state has a State Profile, which provides specific information about each indicator from the Report Card for that state, as well as contact information for the state breastfeeding coordinator and state breastfeeding coalition.


The CDC breastfeeding Web site has two versions of the Breastfeeding Report Card so users can choose to either view it online or download it to print and share.  This handy reference can be a useful way to share abundant, state-specific data in a succinct and approachable format.

Adjustments to Healthy People 2010 Breastfeeding Objectives

Broad-based support for breastfeeding is an essential element of maternal-child health and nutrition, as reflected by the devotion of five Healthy People 2010 objectives to this critical public health issue.  At the inception of Healthy People 2010, the only available breastfeeding data source was the Ross Laboratories (Similac™) Mothers’ Survey.  It could not provide breastfeeding exclusivity data, and methodologic issues compromised data utility.  Since 1999, the Centers for Disease Control and Prevention's National Immunization Survey (NIS) continues to collect national and state level breastfeeding initiation, duration and exclusivity data.


The NIS is now the official breastfeeding data source for Healthy People 2010.  This allows for inclusion of two new breastfeeding objectives for exclusivity.  The original three breastfeeding objectives remain: to enable 75 percent of new mothers to initiate breastfeeding, 50 percent to continue breastfeeding for six months, and 25 percent to continue for 12 months.  The two new exclusivity goals are for 40 percent of mothers to exclusively breastfeed to 3 months, and 17 percent to exclusively breastfeed to 6 months.


These changes assist public health professionals in supporting families to meet established health goals to provide infants only breast milk until 6 months of age, with continued breastfeeding as complementary foods are introduced and beyond.

AHRQ Releases First Ever Systematic Review of Breastfeeding Health Outcomes in Developed Countries

Katherine Shealy, MPH, IBCLC, RLC, Breastfeeding Specialist, Department of Nutrition and Physical Activity, Centers For Disease Control and Prevention

    Breastfeeding substantially and significantly reduces maternal and infant health risk worldwide. A new systematic review of evidence from developed countries clarifies that breastfeeding offers infants dramatic protection from Sudden Infant Death Syndrome, chronic diseases including asthma, atopic dermatitis, childhood leukemia, obesity, type 1 and type 2 diabetes, and common childhood illnesses including otitis media, gastrointestinal infection, and lower respiratory tract diseases. Additionally, the risk of breast and ovarian cancer and type 2 diabetes for mothers who are supported to breastfeed is significantly reduced.

    Systematic reviews of breastfeeding health outcomes historically focused on the health and child survival risks in developing countries. The incomparable and necessary role of breastfeeding in these contexts is well-established. Some have speculated that the health impact of breastfeeding outside of developing countries is irrelevant. Although unique risks from formula use exacerbated by poor water quality, contamination in manufacturing processes, and unreliable product availability are undeniable, the biologic specificity of human lactation is fundamental and remains critical in developed countries.

    The US Agency for Healthcare Research and Quality (AHRQ) sponsors development of evidence reports through their Evidence-Based Practice Centers (EPCs) to improve the quality of health care in the United States. Reports generated from EPCs’ systematic reviews of relevant scientific literature provide organizations with comprehensive, science-based information on medical conditions and new health care technologies. The Office of Women’s Health, Department of Health and Human Services, requested and provided funding for the completion of an evidence report specific to developed countries.

    Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, Evidence Report/Technology Assessment number 153 is an invaluable resource for researchers, public health professionals and clinicians, all of whom play a critical role in supporting breastfeeding. It can be ordered free from AHRQ. All information from the report, including evidence tables and appendices can also be viewed and downloaded from the AHRQ Web site.

Application of Behavioral Theory to Breastfeeding -- An Opportunity to Optimize Counseling and Public Health Interventions

Patricia Markham Risica, DrPH, Assistant Professor (Research) of Community Health, Institute for Community Health Promotion, Brown University


    Lactation consultants, nutritionists, researchers and others continue to create new and innovative ways to increase breastfeeding among American women.  Breastfeeding interventions will likely be strengthened with incorporation of aspects of the behavioral theory based psychosocial characteristics of women and their lives.

    Behaviorists and psychologists have theorized some of the factors that predict behavior.  Many theories have been developed, many applied to negative health behaviors such as tobacco use and other additions.  Few have been applied to breastfeeding as a behavior.  Some of the theories that have been or could be applied to breastfeeding as a health behavior include Theory of Planned Behavior (TPB) and Theory of Reasoned Action (TRA), Social Learning Theory (SLT), the Transtheoretical Model (TTM) and Social Cognitive Theory.

    The TPB(1,2) and its predecessor TRA(3)  have both been used to describe breastfeeding predictors.(4-6)  Intention to breastfeed is posed as the antecedent to breastfeeding initiation and duration, and has been found to be tightly associated with both.(5) Bandura’s Social Learning Theory (SLT) has been invoked, specifically identifying self-efficacy (confidence) as a key predictor of breastfeeding.(7,8)

    The TTM was developed based on changing smoking behaviors and includes Stage of Change, Processes of Change, and Decisional Balance to explain how behaviors are considered and thoughts about those behaviors change during the behavior change.(9,10)  TTM assumes that people cycle between several stages when changing behavior (pre-contemplation, contemplation, preparation, action and maintenance).(11,12) Information needs differ at specific stages of behavioral change.(12) For example, individuals who are only contemplating behavior change need something completely different from those actively engaging in change.  Processes of change that focus on reinforcement management processes are predictive of breastfeeding intention.(4)  Intention was operationalized by Kloeblen as being the main construct in Stage of Change, or in the case of breastfeeding, Stage of Intention to Breastfeed.(4)

    Social support, a major concept from SLT, has also been studied as a predictor of breastfeeding, though the authors did not draw a direct link to the theory.(13,14)  Social support from a woman’s social network and from the father of the baby are strong predictors of breastfeeding intention, though support from medical professionals was not.(14)  The SCT, which stems from SLT, provides us with a construct that is geared toward individuals in later stages of readiness.  Self-efficacy, a major tenet of SCT, refers to a woman’s confidence that she can make a defined change to behavior even under conditions where that behavior change is particularly difficult (e.g., maintaining breastfeeding when it becomes painful or when she returns to work).  Self-efficacy scales have been developed for breastfeeding behavior and the construct has been shown to predict adherence to breastfeeding recommendations.(8)  Low self-efficacy can serve as a barrier to change in individuals who are ready to change, understand the pros of change, but do not feel that they are capable of making and maintaining a behavior change.  Enhancement of self-efficacy, therefore, is an integral part of adherence interventions for individuals in later stages of readiness.  This boosting of self-confidence ensures commitment to and maintenance of change, or in this case, adoption of breastfeeding.

    In assessment of this broad array of behavioral theories employed to better understand breastfeeding decisions, no one single theory seems to uniquely fit with the many predictors of this complicated behavior.  Many of the concepts described by these theories are already incorporated into counseling strategies and materials development, but a more thorough review of these concepts may broaden the clinical and public health approach to encouraging and improving breastfeeding intention, initiation and duration. 


1.         Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision. 1991;50:179-211.

2.         Montano DE KD, Taplin SH. The theory of reasoned action and the theory of planned behavior. In: Glanz K LF, Rimer BK Eds., ed. Health Behavior and Health Education: Theory, Research and Practice, 2nd Edition. 2nd ed. San Francisco: Jossey-Bass; 1997:85-112.

3.         Ajzen I FM. Understanding Attitudes and Predicting Social Behavior. 1980.

4.         Kloeblen AS, Thompson NJ, Miner KR. Predicting breast-feeding intention among low-income pregnant women: a comparison of two theoretical models. Health Educ Behav. Oct 1999;26(5):675-688.

5.         DiGirolamo A, Thompson N, Martorell R, Fein S, Grummer-Strawn L. Intention or experience? Predictors of continued breastfeeding. Health Educ Behav. Apr 2005;32(2):208-226.

6.         Duckett L, Henly S, Avery M, et al. A theory of planned behavior-based structural model for breast-feeding. Nurs Res. Nov-Dec 1998;47(6):325-336.

7.         Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Res Nurs Health. Oct 1999;22(5):399-409.

8.         Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs. Nov-Dec 2003;32(6):734-744.

9.         DiClemente C.C. PJ, Fairhurst SK. The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal Consult Clin Psychol. 1991;59:295-304.

10.        Prochaska JO, DiClemente CC. Toward a comprehensive model of change. New York: Plenum; 1986.

11.        Strecher VJ, DeVellis BM, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Educ Q. Spring 1986;13(1):73-92.

12.        Stoto MA, McCormick MC, Almario DA, eds. Reducing the Odds: Preventing Perinatal Transmission of HIV. Washington, D.C.: National Academy Press; 1999.

13.        Raj VK, Plichta SB. The role of social support in breastfeeding promotion: a literature review. J Hum Lact. Mar 1998;14(1):41-45.

14.        Humphreys AS, Thompson NJ, Miner KR. Intention to breastfeed in low-income pregnant women: the role of social support and previous experience. Birth. Sep 1998;25(3):169-174.

Get Involved! Breastfeeding Promotion Act: HR 2236

The Breastfeeding Promotion Act:
• amends the Civil Rights Act of 1964 to protect breastfeeding women from being fired or discriminated against in the workplace.
• provides tax incentives for businesses that establish private lactation areas in the workplace.
• provides for a performance standard for breast pumps.
• allows breastfeeding equipment to be tax deductible for families.

Currently, 38 states and Puerto Rico have laws on their books protecting the rights of women to breastfeed.  The Breastfeeding Promotion Act would move beyond the patchwork of state laws and establish a national protection for breastfeeding mothers. 

The following Representatives are original co-sponsors of Congresswoman Meghan Maloney’s “Breastfeeding Promotion Act”: Keith Ellison (D-MN); Sheila Jackson-Lee (D-TX); Barbara Lee (D-CA); Carolyn McCarthy (D-NY); John Olver (D-MA); Bobby Rush (D-IL); Stephanie Tubbs-Jones (D-OH); Lynn Woolsey (D-CA), Lucille Roybal-Allard (D-CA).

It has been sent forward to the Ways and Means, Education and Labor and Energy and Commerce Committees.  Please write your  representatives that you’re in support of this legislation, especially if they are members of any of the mentioned committees.  For sample letters you may consider, who presented more information on this bill at the United States Breastfeeding Committee meeting of Coalitions in Arlington, Va. on Jan. 28, 2008.

APHA Adopts Comprehensive Breastfeeding Policy

During the 2007 APHA Annual Meeting, the Association adopted a new, comprehensive breastfeeding policy entitled, “A Call to Action on Breastfeeding: A Fundamental Public Health Issue.”  The policy was jointly submitted by the Maternal and Child Health, International Health, and Food and Nutrition Sections.  The breastfeeding policy supports early and exclusive breastfeeding for six months, and continued to up to 2 years of age or longer.  APHA joins all major health officials in recommending that infants receive no other food or drink besides breast milk for the first six months of life, with continued breastfeeding for at least one to two years thereafter, with rare exceptions.  APHA encourages policy-makers to provide adequate funding for breastfeeding support in the United States and foreign countries.  It also supports legislation that enables women in the United States to succeed in breastfeeding, including protection for breastfeeding in the public, paid maternity leave and worksite lactation protection.


Breastfeeding policy co-authors

Breastfeeding Policy Co-authors from left to right (Lissa Ong, FN; Melissa Bartick, MCH; Miriam Labbok, IH)

APHA Actions Contradict Current Policy to Protect, Promote, and Support Optimal Infant and Young Child Feeding

Note from APHA: APHA Executive Director Georges Benjamin, MD, FACP, FACEP (E), addresses the Nestlé boycott and the importance of breastfeeding in the letters section of the March issue of The Nation’s Health. This article was written before that response was published.


APHA's Breastfeeding Policy, newly updated and reconfirmed, clearly supports the protection, promotion and support for optimal infant and young child feeding, and continues to support the standing policy: boycotting Nestle and not accepting funding from any formula manufacturer or distributor that violates the International Code of Marketing of Breast-milk Substitutes.  Despite this standing policy, APHA accepted a major exhibit by Nestle at the 2007 Annual Meeting.

When presented with this serious breach of trust, APHA Executive Director Dr. Georges Benjamin stated that this was entirely his error, and that he would make an effort to apologize to the membership and to right the situation through improved communication on this issue in an APHA publication.

To date, there has been neither a public statement of apology, nor coverage in The Nation's Health. The only mention of the Nestle Exhibit in The Nation's Health was a note that APHA had awarded it first prize for private industry exhibits. 

The continued sidestepping of this issue should be considered unacceptable by membership; the executives' role must be to maintain the duly endorsed policies, approved by the Governing Council and on record as member policy.

Other News

FNS Award Nominations

Please Consider Nominating Colleagues for FNS Awards



Catherine Cowell Award

This esteemed award honors district achievement in the areas of leadership, planning, administration, and mentoring in public health nutrition, with emphasis at the local level.  The recipient of this award has notably answered the unique needs of urban populations and young children.  The Food & Nutrition Section proudly sponsors this award.


Mary C. Egan Award

This honor goes to those public health nutritionists who pioneer fresh approaches to public health nutrition, nutrition education, and those groups with special dietary needs.  The Food & Nutrition Section proudly sponsors this award.


Excellence in Dietary Guidance Award

This distinction is sponsored by the Food & Nutrition Section and celebrates individuals who have made world-class contributions in dietary guidance formulation, research, education, implementation and/or policy change.


Awards Committee Process:

  • Awards committee chair sends out a call for nominations and for Award Committee members.
  • Food & Nutrition Section members send in nomination letters with the cv's for the person nominated and respond to the questions that are provided on the form.
  • Members that have been awarded an award from the Section in the past are not eligible for nomination again.
  • Those members who nominate can be part of the committee but cannot participate in the voting .
  • The Award Committee reviews the materials and makes their recommendations and decisions.
  • A running list of members that were nominated is kept for the following year to increase the pool of future nominations (It might be interesting during the awards dinner to have an activity for participants to get to know each other’s work; some of the committee members were new to the Section and wanted to get to know the members better).
  • The Award Committee chair notifies the awardees and solicits a photo and bio-sketch for the program and also notifies APHA by their deadline (General Timeline: Send out notice March 30, Gather nominations, deadline: April 30, Convene meeting to select Awardees some time before May 30 and let APHA know the names of the awardees by mid-June.
  • The Committee selects who will present the award during the reception.

Please contact 2008 Awards Committee Chair Deirdra Chester ( for more information.

Release of "Diet Quality of Americans in 1994-96 and 2001-02 as Measured by the Healthy Eating Index-2005"

Healthy Eating Index 2005 (HEI-2005) scores for Americans have been released by the USDA Center for Nutrition Policy and Promotion (CNPP) and are available at  The HEI-2005 measures the diet quality of Americans in terms of how food intakes compare with recommendations from the 2005 Dietary Guidelines for Americans.  This report presents baseline scores for the years 1994-96 and 2001-02.  The CSFII and NHANES national dietary intake surveys were used to calculate 12 component scores and a total score.  CNPP recommends using the component scores along with the total score for a better understanding of diet quality.  A documented version of the SAS code used to create the population scores will be released in the future.  The HEI-2005 utilizes a density approach to diet quality by measuring intake of dietary components on a per calorie basis.  More information on the components, the scoring system, and development and evaluation of the HEI-2005 can be found here.

Celebrate National Public Health Week 2008 - "Climate Change: Our Health in the Balance"

TNPHW logohe health effects of climate change will take center stage during National Public Health Week, April 7-13, 2008. As part of the weeklong observance, themed "Climate Change: Our Health in the Balance," APHA will lead the charge in helping people, communities, and families recognize that adapting to climate change and mitigating its impact is critical not just for the health of our planet, but for the health of the people in our nation and around the world.


Changes in our climate are causing more severe weather events. Extreme weather conditions such as heat waves, high winds, snowstorms, floods and hurricanes have the potential to dramatically affect the health and safety of both individuals and our communities. Changing ecosystems allow for emerging or re-emerging infectious diseases such as dengue or malaria, which are changing the spectrum of disease risks affecting populations. In poorer parts of the world, drought and floods often force people to move away from lands no longer producing enough food, often resulting in hunger and malnutrition. Moreover, contaminated drinking water can result in outbreaks of diarrheal diseases, leading to dehydration or death.


Few Americans will ever see the melting Greenland ice cap up close, or interact with an arctic polar bear facing extinction as its habitat melts. But local public health professionals around the country increasingly will be dealing with the impacts of climate change on the ground, every day. Join APHA as we work to create a healthier planet. Visit the official National Public Health Week website to check out the climate change blog and brochure, sign up to be a National Public health Week partner, or add your week's event to the national calendar.  For more information about National Public Health Week, contact

Join the Newly Formed Genomics Forum

Members of the Food and Nutrition Section are invited to join the new Genomics Forum of APHA. This Forum will be one of the first to represent a new structure within APHA that was created to address cross-cutting issues and facilitate communication across Sections and Special Primary Interest Groups (SPIGs). By joining the Genomics Forum, APHA members retain their affiliation with their Sections.


Genomics – the study of genes and how they relate to each other and with the environment - is increasingly a public health issue. Expanding research and new applications of genomics in clinical and public health settings provides challenges and opportunities for public health professionals to promote equitable access to genetic services, and prevent misuse of genetic information and technology. For example, multiple government agencies are placing substantial funds into clinical applications such as pharmacogenomics (i.e., personalized medicine) without assessing this agenda from a public health perspective and its relative impact on individual rights and community health. To ensure that personalized medicine means public medicine, APHA must be at the forefront of conversations about how genomics will be used in relationship to population health in America and worldwide. This Forum will contribute to the realization of that goal.


Over 130 APHA members have currently enrolled in the Genomics Forum, representing a growing, interdisciplinary group of individuals including practitioners, researchers, students and community members from state and federal governmental agencies, advocacy groups, academia, and healthcare organizations. The Forum is committed to a diverse membership from APHA Sections, SPIGs, and Caucuses and hopes to work with the Food and Nutrition Section and its members on issues of mutual interest.


The Forum currently communicates via listserv, in regular conference calls, and through the development of a Web site, and has solicited abstracts for the 2008 Annual Meeting.  All are invited to participate in one of the general membership calls and to join any of the Forum’s committees.  


Please visit our Web site to see a schedule of upcoming activities and to sign up for the Forum:

APHA Seeking Nominations for Leadership Appointments

The leadership appointment process is an excellent opportunity for Food and Nutrition Section members to be more involved in APHA activities.  Sixteen APHA boards or committees, such as the Education Board, Equal Health Opportunity Committee, or an award committee, need members to serve.  The deadline for nominations is March 31, 2008.

Please visit to learn more or download the nomination form, or contact APHA Member Appointments Manager Natalie Raynor.

Employment, Conference and Grant Opportunities

Employment, Fellowships and Internships

Hispanic-Serving Health Professions Schools (HSPS) Training Program has announced several student fellowship and internship opportunities.  For more information, please visit their Web site.  The application deadline is March 3, 2008.


Oct. 25 – 29, 2008.  American Public Health Association 136th Annual Meeting: Public Health Without Borders.  San Diego.

If you would like to serve as an abstract reviewer or a moderator at the Annual Meeting for the Food and Nutrition Section, please contact the Program Planning Chair:

Janice Adams-King, RN, BSN, MS

OPEAO/Food Safety Education Staff

US Department of Agriculture, Food Safety and Inspection Service

5601 Sunnyside Avenue

Beltsville, MD 20705

phone: (301) 344-4745; fax: (301) 504-2092