Food and Nutrition
Section Newsletter
Winter 2009

Message from the Chair

Beth Dixon

 

It is my pleasure to update you on the activities of the Food and Nutrition Section. I hope many of you enjoyed the terrific Annual Meeting in San Diego last October. Many thanks to all who presented, and a big thank you to Janice Adams-King for organizing all of this – being program chair for the Annual Meeting is an incredible service to FNS. Congratulations too to the recipients of the awards (Marion Baer, Leslie Mikkelsen, Laurie True, and Matthew Lapierre) – it is always special to be recognized by one’s colleagues and inspires all of us. Thank you to Deirdre Chester and Sarah Samuels for organizing this wonderful annual event.

 

It is hard to believe, but we are already planning the sessions for the annual meeting in Philadelphia in November. The theme for the conference is Water and Public Health. In addition to sessions on water and nutrition, we will have sessions on familiar topics like nutrition and food policy, food security and hunger, child and adult overweight, and vitamin D and health, to name a few.  We are also working with the Physical Activity SPIG to co-sponsor a session on innovative technological approaches to assessment and intervention in physical activity and diet. FNS always needs reviewers for abstracts submitted to the Annual Meeting, so please e-mail Alyssa Ghirardelli if you would like to serve as a reviewer or if you would like to moderate a session. We are also making plans for our annual awards banquet and will co-sponsor the March of Dimes Agnes Higgins award presentation with the Maternal and Child Health Section. Last year’s recipient, Susan Carlson, gave a very interesting presentation on Improving Maternal and Fetal Nutrition: The DHA Story. This is a unique opportunity to learn about state-of-the-art science and enjoy a nice evening of food and wine with colleagues.

 

Each year, after the Annual Meeting, new members become leaders in our Section. Please welcome Sibylle Kranz as FNS chair-elect; Susan Kayman as secretary and chair of the Committee on the Public Health Nutrition Workforce; Lynn Fredericks, Katrina Holt, Susan Kayman, Sibylle Kranz, Angela Odoms-Young, and Joan Trendell as Section Councilors; Noel Chavez, Sarah Samuels, and Gail Woodward-Lopez as Governing Councilors; Marsha Spence and Katie Kavanagh as Awards and Social Committee chairs; Patti Risica as Communications Committee chair; Stephanie Jilcott as exhibit coordinator (for the booth at the Annual Meeting); Sara Fein and Janice Adams-King as Food Safety Committee chairs; Noel Chavez as Legislation Policy Committee chair; Sibylle Kranz and Katrina Holt as Membership Committee chairs; Sarah Forrestal as newsletter editor; Wendy Johnson-Askew, Alyssa Ghirardelli, and Rachel Fisher as Program Committee chairs; Barbara Laraia as Strategic Plan Committee chair; Carole Garner as representative to NANA and chair of the Committee on Childhood Overweight; Sue Foerster as Action Board representative; Geraldine Perry-Allen as Science Board representative; Lissa Ong as liason to the Maternal and Child Health Section; and Daniel Lau as our student representative. As you can see, there are many opportunities to become involved in the Section. Please e-mail me if you would like to join a committee or learn more about serving in the leadership positions.

 

In addition to our monthly conference calls, we will have our mid-year meeting at APHA in Washington, D.C. on March 13. This meeting provides an opportunity to meet with APHA staff and discuss activities of FNS. This year we plan to review existing APHA policies related to food and nutrition and discuss the status of the Child Nutrition Reauthorization Act. APHA posts all policies in a policy statement database that can be searched on the APHA Web site. At the Annual Meeting, our Governing Councilors attend sessions and vote on newly proposed policies. In the past, members of our Section have written policies on important topics like reducing sodium in the American diet, nutrition labeling in fast food restaurants, and supporting the WHO global strategy on diet, physical activity and health. Please do consider writing a policy statement in your area of expertise if you think APHA is the appropriate organization to sponsor. It is also possible for APHA to support other policies at the federal, state and local levels. For example, APHA wrote a letter on behalf of FNS to support the new WIC food packages. Such support is important for establishing best policies and practices in public health nutrition today.

 

This newsletter is also a great way to share updates about your research or practice activities. Deadlines for the next newsletters are June 1 and Sept. 14. Please e-mail Newsletter Editor Sarah Forrestal if you would like to contribute – definitely encourage your students to share their activities too, as Shoghig Balkian from Tufts University did in this edition.

 

In closing, please do consider becoming more involved in FNS. It doesn’t take a lot of time, and it is an opportunity to work with wonderful people all over the United States who are involved in many different areas of public health nutrition. The Section always benefits from new people and new ideas.

 

All the best for 2009,

Beth Dixon

Vitamin D Updates

The APHA Policy on Vitamin D

Susan J. Whiting, University of Saskatchewan

 

At the October 2008 APHA Annual Meeting, the Governing Council adopted a policy paper on vitamin D. The paper originated from the Community Health Planning and Policy Development Section, with input from FNS (Susan Whiting and Mona Calvo were co-authors).  When this policy statement was being written, through the fall of 2007 and early winter 2008, there was a sense of urgency among the writing team, as numerous studies were being written about the role vitamin D can play in health, as well as the need to improve Americans’ vitamin D status.  An excellent review of this was published just as we were finishing our report (1).  In our minds, few organizations were acting on this information.  In considering what could be done, we felt that education, research and policy change were ways to improve upon the issue of suboptimal vitamin D status.  The rationale behind the action statements and how these might impact FNS members are described below.

 

Action Statement 1. APHA urges the CDC to advocate and provide funding for a coordinated and integrated approach to educating health care providers/practitioners about the science and benefit of adequate levels of vitamin D.

 

Rationale: Vitamin D’s role in noncalcemic pathways is a relatively new area of study that may be unknown to current health practitioners.  Only recently has research indicated that vitamin D can reduce the risk of fracture and falls in older, especially institutionalized adults (2). African Americans are experiencing the lowest vitamin D status (3) yet the impact of low vitamin D status of African Americans, for whom osteoporosis is less of a health problem, might lead to a lack of concern about their higher risks for cancer and cardiovascular diseases that have been (but with less good evidence than osteoporosis), linked to poor vitamin D status.   

 

Action Statement 2. APHA urges the USDA and other federal agencies to promote the 2005 Dietary Guidelines for Americans as the scientific basis for increased public awareness using current nutrition guidance for healthy eating, notably for populations at highest risk for vitamin D deficiency/insufficiency.

 

Rationale: The 2005 Dietary Guidelines have a recommendation for vitamin D (4). They state that older adults (age over 50 years), people with dark skin, and people exposed to insufficient ultraviolet radiation (i.e. sunlight, but refers also to lack of UVB in winter and through clothing and sunscreen use) should consume extra vitamin D from fortified foods and/or supplements, and state a daily goal of 1,000 IU vitamin D intake for those at risk. Having this guideline coming from the government actually means that we should be using it in appropriate circumstances.

 

Action Statement 3. APHA recommends to the Department of Health and Human Services and USDA that the APHA have organizational representation on the panel of the 2010 Dietary Guidelines for Americans for strategies to improve vitamin D intake.

 

Rationale: Since the 2005 Guidelines indicated a need for supplemental vitamin D under certain circumstances, it seems appropriate for the 2010 Committee to be apprised of the need to better highlight the recommendation. However, prior to the presentation of the policy at the 2008 APHA Annual Meeting, the Committee was selected.  In general, APHA should attempt to influence important public health nutrition policies.

 

Action Statement 4. APHA requests that it become a participating organization in planning Healthy People 2020 to promote national awareness of the magnitude of the problem of poor vitamin D status; and the associated increased risk for chronic disease development by introducing specific objectives in planning Healthy People 2020 goals.

 

Rationale: As in the previous recommendations, it is important for APHA to involve itself in public health nutrition policy from the planning stages. Healthy People 2020 will set priority goals for action in public health, and we believe vitamin D status of Americans is a priority concern.

 

Action Statement 5. APHA urges Congress to appropriate funds to conduct research in diverse populations to determine population specific vitamin D intakes needed to produce and maintain optimal vitamin D status associated with reduced risk of chronic diseases.

 

Rationale: There is much to be studied regarding vitamin D.  It was somewhat neglected through the 1980s when calcium was the higher profile bone health nutrient.  Nutritionists believed vitamin D was adequate due to sun exposure, but at the same time, the American Cancer Society and others were waging public health campaigns against sun exposure.  Now evidence is needed in order to set recommendations for people living in different geographic locations, with different skin types, at different stages of the life cycle, and with different lifestyles.  

 

Action Statement 6. APHA recommends to the FDA to add vitamin D to the list of required nutrients appearing on the Nutrition Facts Panel that is required on all foods in the U.S. marketplace.

 

Rationale: The Nutrition Facts Panel requires labeling of some micronutrients but not vitamin D.  There are food sources of vitamin D, such as oily fish, yet without labeling information, these go unnoticed by consumers. Having vitamin D on the label may encourage manufacturers to add vitamin D.  There are many foods for which addition of vitamin D is currently permissible, but in practice, this is rarely done (5). 

 

References:

1.      Holick M (2007). Vitamin D deficiency.  NEJM 357(3):266-281.

2.     Cranney A, et al. (2007). Effectiveness and safety of vitamin D in relation to bone health. AHRQ Publication No. 07-E013.  Rockville, MD: Agency for Healthcare Research and Quality.

3.     Looker AC, et al. (2008). Serum 25-hydroxyvitamin D status of the US population: 1988–1994 compared with 2000–2004. Am J Clin Nutr 88:1519-1527.

4.      Dietary Guidelines for Americans, 2005.

5.     Calvo MS, Barton CN, Whiting SJ (2004). Vitamin D fortification in the US and Canada: Current status and data needs. Am J Clin Nutr 80:1710S-1716S.

 

 

Update on NIH Activities Related to Vitamin D

Rachel Fisher, MS, MPH, RD, Program Analyst, National Institutes of Health

 

The National Institutes of Health has implemented a multifaceted research initiative to respond to a growing body of evidence implicating vitamin D status in a number of adverse health conditions.  Since the initiative’s conception in 2003, NIH has supported many activities across a range of issues related to vitamin D and health.

 

One part of the vitamin D initiative was a systematic evidence-based review, “Effectiveness and Safety of Vitamin D in Relation to Bone Health,” requested and funded by the NIH Office of Dietary Supplements (ODS) through the Agency for Healthcare Research and Quality Evidence-based Practice Center program (1). The review, published in August 2007, confirmed that vitamin D from ultraviolet-B exposure, fortified foods, and dietary supplements are all effective in raising the level of circulating vitamin D.  However, the report identified a challenge in defining specific blood levels of markers for vitamin D status that indicate optimal levels for bone health. This is because the current method of quantifying vitamin D status (measuring serum 25-hydroxyvitamin D as the marker for vitamin D status) yields highly inconsistent results. As part of the broader NIH vitamin D initiative, ODS is working with laboratory testing facilities to standardize the quantification of vitamin D status.

 

In addition to the evidence-based review, NIH convened two conferences related to vitamin D in 2007.   The first, “Vitamin D and Cancer: Current Dilemmas and Future Needs,” was held in May and was sponsored by the National Cancer Institute and the NIH ODS (2). While the conference shed much light on the existing body of evidence, it was determined that many unanswered questions remain.  Specifically, many of the research gaps identified at the conference related to the need to develop predictive, validated and sensitive biomarkers.

 

The second conference, “Vitamin D and Health in the 21st Century: An Update” was held in September (3).  The objective of the conference was to evaluate available evidence on the efficacy and safety of vitamin D. In doing so, the conference aimed to identify knowledge gaps in order to inform NIH and other federal agencies of research needs concerning vitamin D and health as well as to inform the broader nutrition community. Following the conference, the NIH ODS held a roundtable discussion that included 16 scientists with expertise in areas relevant to the conference topics and the evidence-based review.  The goal of the roundtable was to gather additional input on research needs concerning vitamin D and health.   The roundtable participants identified several specific research needs such as the long-term safety of pharmaceutical doses of vitamin D, further understanding of the interrelation between calcium and vitamin D toxicity, and the determination of specific safety endpoints (4).

 

Several other activities have also been funded under the NIH vitamin D research initiative. Examples include the development of standard reference materials for 25-hydroxyvitamin D by the National Institute of Standards and Technology, national monitoring of vitamin D status via the National Health and Nutrition Examination Survey, and the development of analytic methods to measure vitamin D content in foods and dietary supplements by the U.S. Department of Agriculture (USDA) (3).

 

The growing body of evidence and attention to vitamin D status among the medical and research communities has clearly necessitated an evaluation of the current Dietary Reference Intakes for vitamin D, which were most recently updated in 1997.  The NIH, in addition to the Food and Drug Administration, the Department of Health and Human Services Office of Disease Prevention and Health Promotion, the USDA (Center for Nutrition Policy and Promotion, Agricultural Research Service), the U.S. Department of Defense (Telemedicine and Advanced Technology Research Center), and Health Canada, have provided support for this study. The Institute of Medicine’s Food and Nutrition Board at the National Academies will evaluate available evidence to determine if the Dietary Reference Intakes for vitamin D and calcium should be updated at this time.  The committee's report is expected to be publicly released by the summer of 2010 (5).

 

References

1.  Cranney A, et al. (2007). Effectiveness and safety of vitamin D in relation to bone health. AHRQ Publication No. 07-E013.  Rockville, MD: Agency for Healthcare Research and Quality.

2.  Davis, C. Vitamin D and cancer: current dilemmas and future research needs. Am J Clin Nutr 2008; 88(2): 565S-569S

3.  Brannon PM, Yetley EA, Bailey RL, Picciano MF. Overview of the conference “Vitamin D and Health in the 21st Century: An Update.” Am J Clin Nutr 2008; 88(suppl): 483S-490S.

4.  Brannon PM, Yetley EA, Bailey RL, Picciano MF. Summary of roundtable discussion on vitamin D research needs. Am J Clin Nutr 2008; 88(suppl): 587S-592S.

5.  Dietary Reference Intakes for Vitamin D and Calcium.

 

 

Institute of Medicine Announces Vitamin D DRI Project Committee Composition

The Institute of Medicine Food and Nutrition Board has announced the committee composition for the Dietary Reference Intakes for vitamin D and calcium project.  The committee will review the current literature to establish DRIs for these nutrients.  Information on the project and the committee members are available online.

Call for Nominations: Please Consider Nominating Colleagues for FNS Awards

Catherine Cowell Award

Established in 1993, the Catherine Cowell 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 esteemed award has notably answered the unique needs of urban populations and young children.  FNS proudly sponsors this award.

 

Mary C. Egan Award

Established in 1985, 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.  FNS proudly sponsors this award.

 

Excellence in Dietary Guidance Award

This distinction, established in 1992, is sponsored by FNS and celebrates individuals who have made world-class contributions in dietary guidance formulation, research, education, implementation and/or policy change.

 

Nomination/Awards Process:

·         Please send in nomination letters with the CV for the person nominated and respond to the questions that are provided on the form.

·         Deadline for nominations is April 30, 2009.

·         Members that have been awarded an award from the Section in the past are not eligible for nomination again.

·         Members can nominate themselves or other members for awards. 

·         Awardees will be notified May 30, 2009.

 

Please contact 2009 Awards Committee Chair Marsha Spence for more information.

Childhood Overweight Workgroup Update

In 2006, FNS organized a Childhood Overweight Workgroup to coordinate activities geared toward addressing the increasing prevalence of overweight.  Activities of this group included working with the Program Planning Committee to ensure that childhood overweight was prominently incorporated within the Annual Meeting agenda, working on the APHA position paper on Childhood Overweight, and advising the APHA leadership on childhood overweight topics. The workgroup had a very unique niche at its inception, but since then, there has been a proliferation of organizations solely focused on overweight. In order not to repeat the efforts of other groups, at the 2008 Annual Meeting, the Food and Nutrition Section leadership concluded that a more useful function of the workgroup was to keep the membership informed of current issues and opportunities for childhood overweight.

 

Below is a list of some activities that I would like to bring to your attention:

·         The Department of Health and Human Services, National Cancer Institute, is planning a Web-based seminar series on Obesity Policy Evaluation.  The aim of this series is to increase skills of researchers and practitioners in policy evaluation effectiveness.  The first of these seminars, Basics of Design to Evaluate Policy Interventions, is scheduled to be held Feb. 27, 2008.  If you are interested in finding out more information, please contact conferences@novaresearch.com.

·         Robert Wood Johnson has released two calls for proposals in their Childhood Obesity Program. They are seeing proposals in the following topic areas:

1. Food pricing and economic approaches;

2. Food and beverage marketing;

3. Improving access to healthy foods in low-income communities; and

4. Evaluations of promising food-related policy and environmental strategies in settings where children and their families make food choices.

Please visit the Web site for additional information: http://www.healthyeatingresearch.org/

·         Several Requests for Applications have been released in the NIH Guide.  Please follow this link for additional information:

http://grants1.nih.gov/grants/guide/WeeklyIndex.cfm/02-06-2009/

 

Submitted by Robin Hamre, MPH, RD on behalf of the group:

·         The Children's BMI Tool for Schools is an Excel spreadsheet that can be used to calculate BMI for groups of children:

http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/tool_for_schools.html

·         Submit your abstract for Weight of the Nation today at: www.WeightoftheNation.org.

 

We would like to have an ongoing section of the newsletter dedicated to the dissemination of childhood obesity activities.  If you are aware of any, please forward them to Wendy Johnson-Askew.

A Student’s Perspective on Attending the Annual Meeting

As a first time APHA attendee, I was overwhelmed from the moment I looked at the schedule.  And stepping into the room that held 13,000 other attendees during the opening remarks slightly exacerbated that feeling!  Luckily, a friendly face behind me in line at the Starbucks, who turned out to be Patti Risica, the immediate past chairperson of FNS, who graciously took me under her wing and led the way to the first FNS business meeting of the conference.  Call it luck or call it divine, but that initial run-in with Patti paved the way for my experiences throughout the rest of the conference.

 

The FNS business meetings were full of opportunities to network and become acquainted with nutrition polices and practices in the public health nutrition world.  I was equally impressed by the Section sessions, which offered panels from issues on breastfeeding and school wellness programs, to obesity and “mindless eating.”  There were more sessions offered than I could attend, but all of the ones I went to were a good depiction of what public health practice is like outside the classroom.  As an MPH/Nutrition candidate, I look forward to being involved in future APHA Food and Nutrition opportunities because the professional and personal support I received from the group was both singular and encouraging.  I am extremely fortunate to have gone to the APHA Annual Meeting in San Diego and hope to build more professional and personal relationships through each opportunity.

A Message from the Physical Activity Special Interest Group (Status Pending)

We know that physical inactivity is an important contributor to the risk profiles for many chronic diseases and is an independent primary risk factor for cardiovascular disease, similar to smoking and hyperlipidemia in importance. Insufficient physical activity also contributes to the risk of obesity, type 2 diabetes, osteoporosis, breast and colon cancer, and other chronic conditions. With this in mind, the APHA Physical Activity Special Interest Group (PA SPIG) is being created to link researchers, practitioners, advocates and partners to facilitate programs, environments and policies to foster regular physical activity in the population and offset the multitude of adverse effects due to sedentary living. The PA SPIG will serve as a credible and visible “home” for those engaged in the science and practice of physical activity, embracing persons from diverse backgrounds in an effort to stimulate information exchange, new policies, multi-level interventions, research collaborations, and advocacy efforts to tackle this major public health concern.

 

The PA SPIG will again host a Reception/Social and Fun Run at the 2009 Annual Meeting in Philadelphia. We also plan to have an exciting array of high-quality presentations, symposia, and other activities. Five APHA sections had specific calls for physical activity-related abstracts at the 2009 meeting:

 

Food and Nutrition Section

  • Hydration and Physical Activity
  • Interventions to Increase Physical Activity
  • Mapping Food and Physical Activity Environments

Community Health Planning and Policy Development Section

  • Effective Planning and Policy Development for Nutrition, Physical Activity, and Public Health

Geroltological Health Section

  • Physical Activity and Successful Aging

Public Health Education and Health Promotion Section

  • Obesity Prevention
  • Physical Activity

School Health Education and Services Section

  • Fitness Issues and Programs for Schools and Colleges
  • Promotion of Physical Activity in School
  • Obesity Prevention
  • Safe Routes to School

We hope you can join us in Philadelphia!

If you are interested in joining the PA SPIG, or for more information, please contact Dr. Justin Moore or visit http://prevention.sph.sc.edu.

Announcements

Public Health and Social Justice Web site    

I have recently developed a Web site covering public health and social justice, found at http://www.phsj.org or http://www.publichealthandsocialjustice.org. The site contains articles, slide shows, syllabi, links and other documents relevant to topics in public health and social justice. References for most of the information contained in the slide shows can be found in the accompanying articles. Presentations will be updated a few times per year.

 

The site is aimed at students, educators and the general public. It grew out of my recognition that medical schools, and even schools of nursing and public health, tend to inadequately address the social, economic, environmental, human rights and cultural contributors to health and disease.

 

Feel free to use information from the articles and slide shows, indeed even the slides themselves, with appropriate citation. It is my hope that this information can be disseminated widely, influencing current and future generations of health professionals and others concerned about creating a more just and peaceful world.  I hope to add other syllabi and articles from the many talented individuals working in this area. Please e-mail me any articles and/or slide shows you would be willing to share, along with comments, corrections, and suggestions for the content.