Nutrition Perspectives May / June 2005

NUTRITION PERSPECTIVES

Volume 30, No. 3
May/June 2005

TABLE OF CONTENTS

Government Unveils New Food Pyramid: Critics Say Nutrition Tool Is Flawed
Managing Obesity: Clinical Practice Guideline from the American College of Physicians
Superintendent O’Connell Announces Formation of the Advisory Committee On Nutrition Implementation Strategies
Future Directions for Nutrition Professionals
Healthy School Food Policies: A Working Paper of the Center for Food and Justice, Urban and Environmental Policy Institute
Free MyPyramid Posters and Handouts
New Dietary Guidelines Pose Lofty Goals for Americans
Is There a Link Between Iron Deficiency Anemia and Postpartum Depression?
Organic Versus Conventional Produce: Is One “Healthier” Than the Other?

Sheri Zidenberg-Cherr, PhD, Editor Department of Nutrition University of California Davis, CA 95616

NUTRITION PERSPECTIVES is prepared by Sheri Zidenberg-Cherr, PhD, Nutrition Specialist, Cristy Hathaway, and staff. It is designed to provide research-based information on ongoing nutrition and food-related programs. It is published bimonthly (six times annually) as a service of the University of California Cooperative Extension and the United States Department of Agriculture. Subscription to NUTRITION PERSPECTIVES is available from UC Cooperative Extension, Department of Nutrition, University of California, Davis, California. Cost is ten dollars ($10.00) for a one-year subscription. Subscriptions and questions or comments on articles may be addressed to: NUTRITION PERSPECTIVES, Department of Nutrition, University of California, Davis, CA 95616-5270. Phone (916)752-3387; FAX, (916) 752-8905.

Government Unveils New Food Pyramid; Critics Say Nutrition Tool Is Flawed

The food pyramid has received a makeover. But even as the curious flocked to the Web site to view the latest version of the US government’s venerable device for nutrition education, critics were questioning whether it will translate into better dietary choices for consumers.

In rolling out the new pyramid on April 19, Mike Johanns, secretary of the US Department of Agriculture (USDA) said the icon, now called “MyPyramid,” is part of an overall food guidance system emphasizing a more individualized approach to improve health by making modest changes in diet and incorporating regular physical activity into daily living (http://www. MyPyramid.gov).

The new food pyramid is intended to emphasize an individualized approach to improve health through modest changes in the diet and daily physical activity.

The new icon features 6 colored panels to represent the need to include a wide variety of food groups (grains, vegetables, fruits, milk, oils, meats, and beans) in a daily diet. A cartoon figure running up a staircase on one side represents the need for exercise.

The MyPyramid Web site offers 12 individualized pyramids and a daily calorie consumption total based on sex, age, and a rough estimate of physical activity on most days (moderate or vigorous activity of <30 minutes, 30-60 minutes, or >60 minutes). But a limitation of the individualized pyramids is that they do not consider stature, a factor that can substantially affect estimates of appropriate caloric intake. A “customized” pyramid concedes that “This calorie level is only an estimate of your needs. Monitor your body weight to see if you need to adjust your calorie intake.”

Opportunity Missed?

Critics say that beyond such limitations in creating individualized plans for consumers, the USDA’s effort missed its chance to direct individuals toward a healthier diet.

“This is a huge lost opportunity to convey information about healthy food choices that could benefit Americans enormously,” complained Walter Willett, MD, professor of epidemiology and nutrition at the Harvard School of Public Health, Boston, who said he was “pretty disappointed” by the USDA’s $2.4-million effort. “The pyramid tells nothing of healthy food choices.”

Willett specifically criticized the pyramid’s overemphasis of dairy product consumption (3 cups daily, regardless of sex, age, or physical activity). He also cited the pyramid’s lack of detail about the risks and benefits of consuming various types of fat. “It’s a very important issue because replacing transfats and saturated fats (with unsaturated fats) is one of the most important things people can do to reduce heart disease,” said Willett. Information on salt and alcohol intake is also lacking, he noted.

Eric Hentges, PhD, executive director of the USDA’s Center for Nutrition Policy and Promotion, said the pyramid builds on data from the “Dietary Guidelines for Americans 2005” (http://www.healthierus.gov/ dietaryguidelines), released in January. “The pyramid reflects the federal nutrition policy and the latest science,” he said. “We’re looking at communicating and implementing the 2005 Dietary Guidelines.”

Physician Outreach

Another criticism of the food pyramid is that the details are conveyed through the MyPyramid Web site, a tool unavailable to the many citizens who lack access to the Internet. Government officials said they are getting around that problem by offering brochures and posters to schools, local governments, and health professionals.

The agency is preparing a “tool kit” to aid health professionals in disseminating information. “When the dietary guidelines came out, we knew the health professional would be a main player in getting the word out,” said Kimberly F. Stitzel, MS, RD, a nutrition advisor at the US Department of Health and Human Services’ Office of Disease Prevention and Health Promotion. The information contained in the tool kit is now available through the Internet at http://www.healthierus.gov/dietary guidelines; a printed version should be ready by July and can be ordered through http://bookstore.gpo.gov for about $10.

“The tool kit will incorporate the dietary guidelines into their practices,” Stitzel said Mary Frank, MD, president of the American Academy of Family Physicians, said her organization is already getting the word out about the food pyramid and tool kit to members. “I know some nutritionists have problems with the new pyramid, but we think it’s less complicated than the old one and will provide an opportunity to work with our patients,” said Frank. “We also think it’s extremely important that this new pyramid includes physical activity as a component of a healthy lifestyle.”

The tool kit will be modular and modified as the science changes. For example, one section conveys the science to clinical health professionals. Another allows for communication from clinicians back to researchers. A third section offers advice for health professionals for educating their patients.

Much of the food pyramid and dietary guidelines tool kit is based on information gathered by health researchers. But the government hopes to continuously update its data on diet and exercise and to communicate it to the public through clinicians and other health professionals, said Stitzel. As part of the update process, physicians are invited to e-mail suggestions to Stitzel at kstitzel@osophs.dhhs.gov.

Giving physicians the opportunity to have a say on updating the tool kit is a good idea, said Frank, who noted some of her members thought creating individual health plans on the MyPyramid Web site was too complicated and took too long.

Willett is not convinced the new effort will make a significant impact. “They’ve made some partway steps to conveying nutrition knowledge [such as emphasizing physical activity], but unfortunately, people will need to go elsewhere for better information,” he said.

Source: JAMA; 2005;293:2581-2582.

Managing Obesity: Clinical Practice Guideline from the American College of Physicians

In 2003, the US Preventive Services Task Force recommended that clinicians screen all adults for obesity (body-mass index, >30) and offer intensive behavioral counseling to obese adults (Journal Watch Dec 30 2003). The American College of Physicians has now published guidelines on the management of obesity (1, 2, 3). They recommend the following:

• Assess comorbid conditions (e.g., hypertension, diabetes).
• Determine patients’ goals and time frames for achieving them. Goals might be focused on weight loss or on intermediate outcomes, such as blood pressure and blood glucose control.
• Provide counseling on weight loss, diet, and physical activity.
• Discuss the use of medications (bupropion, diethylpropion, fluoxetine, orlistat, phenter-mine, sibutramine) with patients who are not meeting their goals through diet and exercise alone. Discuss the modest benefits typically achieved with such drugs (<5 kg loss at 1 year), known risks, lack of long-term safety data, and temporary nature of the weight loss.
• Consider surgery for patients with BMI’s >40 in whom adequate exercise and diet programs are failing and who have obesity-related comorbidities. Review with them the possible adverse effects of surgery (e.g., gall bladder disease, malabsorption, need for reoperation), as well as the lack of outcome data on these procedures: No randomized trials have been done to compare surgical versus nonsurgical treatment, surgery has no proven benefit in terms of mortality or cardiovascular morbidity, and no single procedure has been proven to be better than another.

Refer patients who choose surgery to experienced surgeons at high-volume centers.

These guidelines (and the underlying evidence reviews) bring attention to a major public health problem and offer a cautious approach to riskier treatments. Clearly, more work should be done to prevent obesity, so that these management guidelines are less necessary.

References:
Snow V, Barry P, Fitterman N, Qaseem A, and Weiss K. Pharmacologic and surgical management of obesity in primary care: A clinical practice guideline from the American College of Physicians. Ann Intern Med 2005 Apr 5; 142:525-31.
Li Z, Maglione M, Tu W, et al. Meta-analysis: Pharmacologic treatment of obesity. Ann Intern Med 2005 Apr 5; 142:532-46.
Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: Surgical treatment of obesity. Ann Intern Med 2005 Apr 5; 142:547-59.
Source: Richard Saitz, MD, MPH, FACP, FASAM; Journal Watch; April 26, 2005.

Superintendent O’Connell Announces Formation of the Advisory Committee On Nutrition Implementation Strategies

California State Superintendent of Public Instruction Jack O’Connell recently announced the establishment of the Advisory Committee on Nutrition Implementation Strategies and the appointment of its 23 members.

The Committee has been charged with recommending strategies that schools can implement to improve the quality of food and beverages sold or served on school campuses.

“This committee is one of the many steps needed to address the overall health and well-being of California students,” O’Connell said. “The kinds of food and beverages schools serve send a strong signal to young people about what they should be eating. We need to help them make wise choices and not tempt them with empty calories and fatty snacks and meals.”

It has been shown that healthy, active, and well-nourished children are more likely to attend school and are more prepared and motivated to learn. Yet an alarming number of students in California are overweight, unfit, or both. These children and youth are developing serious health problems now and face dire consequences in the future.

The 23 members represent students, school food service directors, school administrators, state agencies, teachers, parents, professional associations, and advocacy organizations that will all be working to improve the nutrition environment on school campuses.

The Committee will develop recommendations after considering factors within the following three broad areas: program, policy, and governance decisions; facilities and equipment availability; and fiscal implications. For more information, please visit the CDE Web site: http://www. cde.ca.gov/ls/nu/he/advisory.asp.

[Online Source]: http://www.cde.ca.gov/ls/nu/he/advisory.asp.

Future Directions for Nutrition Professionals

The Centers for Disease Control (CDC) estimates that approximately 30% of the adult population is obese, costing the United States between 5.5%-7.8% of all health care dollars annually. Research suggests that changes in lifestyle and the environment are responsible for this epidemic resulting in a gain of 1.8-2.0 pounds per year in American adults. Despite advances in knowledge about the etiology of obesity, little has proven effective at curbing the growth of obesity in the United States.

It is therefore imperative that nutrition professionals, partnered with physicians, health maintenance organiza-tions, insurance companies, government, and industry develop effective education strategies that stress sensible diets and increased levels of physical activity. Groups such as the Dietary Guidelines Advisory Committee and the American

Heart Association have developed health guidelines for Americans, but these messages need to be effectively communicated to the general population. Furthermore, more investigations looking at the regulation of food intake, the influence genetics has on obesity, and the effectiveness of weight-loss programs must be completed so that a greater understanding of obesity can be gained. Nutrition professionals who now have broad areas of expertise in fields such as nutrition education, clinical nutrition, and foodservice management are particularly well-suited to coordinate the activities of experts in a variety of health-related fields in developing novel obesity interventions. It is only through a large-scale collaborative effort that substantial gains will be made in fighting the obesity epidemic.

Adapted from: Pi-Sunyer, X., and Kris-Etherton, P.M., Improving Health Outcomes: Future Directions in the Field. JADA; 2005. 105 (5): p. S14-S16.
Karrie Heneman, PhD, Nutrition Department, University of California, Davis.

Healthy School Food Policies: A Working Paper of the Center for Food and Justice, Urban and Environmental Policy Institute

Throughout the country people are working to make schools healthier places to learn. They are getting fresh, tasty, locally-sourced food into school cafeterias and less-healthy food out. Health-oriented school food policies have been one way that educators, concerned parents, and community advocates have advanced these goals.

A recently developed working paper describes many of the innovative policies that have been adopted or proposed to improve school food. It provides a checklist of approximately 65 such policies. Legislative language and sources for all of the policies can be found in the endnotes.

When the Center for Food and Justice (CFJ) released the first version of this checklist in October 2002, most of the ideas were drawn from a small number of pioneering school districts. In the years since, driven by growing concerns over childhood obesity, more and more schools and states have debated and adopted healthy school food policies.

This updated version largely maintains the organization and intent of the original paper: to present a wide range of policy ideas and legislative language in a compact form. Over a dozen new policy ideas have been added to the list. The examples of policy language in the endnotes are now drawn from a much wider range of jurisdictions: states as diverse as Arkansas, California, Hawaii, Kentucky, Texas, and Washington, and the nation’s largest school districts as well as some smaller districts and even individual schools. Perhaps the most significant change is the addition of a new category on monitoring and enforcement, areas that bridge the policy process and the critical task of implementation.

A new federal mandate requires all school districts participating in federal meal programs to adopt school wellness policies by the beginning of the 2006-7 school year. It is hoped that the revised checklist can continue to serve as a source of ideas for those working to create or strengthen school food policies at the local and state levels. This paper is an evolving document. It only captures a slice of the exciting work being done to improve school food policies. Please send policies or proposals so they can be included in future versions of the checklist. Submit comments and proposals to mvalli@oxy.edu. Updates will be available online at our website: www.uepi.oxy.edu.

Adapted from: [Online Source]: Version 1.5: June 2005. www.uepi.oxy.eduUEPI.

Free MyPyramid Posters and Handouts

Nutrition professionals, Cooperative Extension specialists, WIC clinics, Food Stamp offices, healthcare facilities, athletic facilities, etc. can receive an introductory packet of 1 full-size poster, 1 tear-pad of 50 MyPyramid mini-posters, and 1 Anatomy of MyPyramid handout. To receive this packet, send your name, mailing address, and request to publication@cnpp.usda.gov.

BULK COPIES of publications can be purchased through either the Government Printing Office (GPO) (bookstore.gpo.gov, 1-866-512-1800) or Purdue University Press (media.order@purdue.edu, 1-888-398-4636). MyPyramid: Steps To A Healthier You (Poster), Stock Number 001-000-04721-3: $ 6.50 each, or sold in packages of 10 for $29.00. Anatomy of MyPyramid (Paper Sheet), Stock Number 001-000-04722-1: $2.25 each, or sold in packages of 50 for $24.00 each. MyPyramid: Steps.

Source: Julie Engberg, RD, Past President, Bay Area Dietetic Association, WIC Nutrition Education Coordinator.

New Dietary Guidelines Pose Lofty Goals for Americans

With the release of the Dietary Guidelines for Americans (DGA) in January, the gap between common dietary and activity practices and recommendations may just have gotten a little wider.

For children over 2 years of age through adulthood, key messag-es include eating more fruits and vegetables, whole grains and milk products, and increasing physical activity. The report (www.health.gov/dietaryguidelines/dga2005/document) may generate questions from parents about the rationale for the guidelines and how closely the recommendations should be followed.

Following are highlights of the recommendations, talking points and strategies for implementation:

More fruits and vegetables

Rationale: These foods are excellent sources of nutrients and fiber, have low caloric density and contain many components protective against chronic illnesses, such as antioxidants.

Recommendation: For a 2,000-calorie diet, 4 cups per day (approximately nine servings) are recommended, with an emphasis on choosing a variety of types and colors.

Reality: National survey data indicate average daily intake of fruits and vegetables for children and adults to be about half of these recommended amounts, and servings of starchy vegetables (primarily fried potatoes) were more than three-fold greater than those of dark green/deep yellow vegetables. In practice, fruits and non-starchy vegetables often are absent in children’s diets.

Children can be encouraged to adopt healthy lifestyle choices, such as eating right, through repeated exposure to healthy foods.

Practical advice: Aim for at least one fruit and vegetable at every meal. Have fruits and vegetables available in the home and ready to eat. Serve them with healthy dips, such as yogurt or low-fat salad dressing.

More whole grains

Rationale: Compared to refined grains, whole grains have more micronutrients and fiber, are digested more slowly, and contain many protective factors.

Recommendation: At least half of the day’s servings should be from whole grains. For a 2,000-calorie diet, at least three “ounce-equivalents” (a typical slice of bread is 1 ounce) are recommended.

Reality: Average intakes for children and adolescents are less than one serving per day. Many people aren’t sure what constitutes a “whole grain” vs. such label terms as “stone ground” or “multigrain.”

Practical advice: Find products that list “whole wheat” as the first ingredient on the label. Other examples include oatmeal and brown rice. Start with a piece of “100% whole wheat” toast for breakfast. Try “quick cooking” brown rice for dinner.

Milk products

Rationale: Low-fat dairy products are excellent sources of calcium, high-quality protein and other nutrients.

Recommendation: Children 2 to 8 years of age should consume 2 cups per day of fat-free or low-fat milk or equivalent milk products, and children 9 years and older are to consume 3 cups a day.

Reality: Less than 50% of adolescent boys and 20% of adolescent girls meet these recommended milk intakes. Over the last 50 years, children’s milk intake has declined steadily, while intake of carbonated soft drinks has risen steadily.

Practical advice: Include a 4- to 8-ounce glass of milk with every meal.

Increase physical activity

Rationale: The report places a strong emphasis on the benefits of vigorous physical activity to promote fitness and reduce risk of excessive weight gain as well as many chronic illnesses.

Recommendation: Children and adolescents are encouraged to engage in 60 minutes of moderate to vigorous physical activity on most, and preferably all, days of the week.

Reality: Many children fall far short of these activity levels, especially as they enter adolescence.

Practical advice: The recommended activity time does not need to be in consecutive minutes. Children are more likely to be active in multiple bursts of activity throughout the day if they are given opportunities. Encourage outdoor playtime, which is a strong predictor of overall physical activity. Limit TV and screen time to two hours a day for children over age 2, and keep TVs out of children’s bedrooms.

Implementation

When encouraging health behavior change, a few principles should be kept in mind. First, small changes are less daunting than big ones. Help your families identify changes they can make rather than telling them what to do. The DGA recommendations are goals not absolutes; help your families set some new small goals.

In addition, change takes place over time, not overnight. Children gradually learn healthy lifestyle choices. Repeated exposures are key to acceptance; encourage parents not to give up when children refuse all things green. Increasing from zero to one serving a day is a big accomplish-ment. Remind parents that they and other adults are critical role models. Their job is to provide an environment that encourages healthy choices.

The new DGA report represents a comprehensive review of the evidence base for diet and activity recommendations. These should form the basis for recommendations to individual patients and families. As always, pediatricians must monitor children’s growth to assure that individuals do not undertake extreme applications.

The guidelines also provide a basis on which to advocate for changes in food and vending programs in schools, activity and diet practices in schools and child care facilities, and food packages for federal programs. Although gaps in our knowledge remain, the funda-mental messages are sound and serve as an important guide for routine advice for diet and physical activity to promote health in the pediatric population.

Source: Nancy F. Krebs, M.D., FAAP. AAP News; April 2005; 26(4):15.

Is There A Link Between Iron Deficiency Anemia and Postpartum Depression?

The World Health Organization (WHO) estimates that between 66-80% of the world’s population is iron deficient, making this the most prevalent nutritional deficiency in the world. In its most severe form, iron deficiency leads to iron deficiency anemia, a condition in which the body is unable to produce adequate amounts of hemoglobin, needed to transport oxygen within the body. Symptoms of iron deficiency and iron deficiency anemia in adults include malaise, fatigue, and depression. Young children, menstruating women, and pregnant women are populations particularly vulnerable to iron deficiency due to their increased iron needs to support growth and blood synthesis.

Researchers from Pennsylvania State University recently hypothesized that mother’s suffering from iron deficiency anemia would exhibit depressive symptoms possibly leading to negative interactions with their infants. To investigate this hypothesis, they recruited 95 women who had recently given birth, residing in the peri-urban town of Khayelitsha, South Africa. Iron deficient anemic women were randomly assigned to receive 125 mg FeSO4 (25 mg elemental iron), 25 mg Vitamin C and 10 µg folic acid or 25 mg of Vitamin C and 10 µg folic acid daily for six months (n=64). Non-anemic women who did not receive treatment served as controls (n=31). The current DRI for iron is 18 mg per day.

Results from this study showed that anemic mothers receiving iron treatment had a 25% improvement in psychological evaluations, rating them as high as non-anemic mothers. Anemic mothers who did not receive iron supplementation showed no improvement in their scores. These findings suggest that iron therapy can improve depression in post-partum women; however, it was unable to provide answers regarding the effects of this depression on the interactions between mothers and their children. Future investigations looking at this relationship will be needed before causal relationships can be established.

Adapted from: Beard, J.L., Hendricks, M. K., Perez, E.M et al. Maternal Iron Deficiency Anemia Affects Postpartum Emotions and Cognition. J Nutrition; 2005. 135: p. 267-72.
Karrie Heneman, PhD, Nutrition Department, University of California, Davis.

Organic Versus Conventional Produce: Is One “Healthier” Than the Other?

The USDA defines organic food as “produced without using most conventional pesticides; fertilizers made with synthetic ingredients or sewer sludge; bioengineering; or ionizing radiation (1).” The goal of many organic farmers is to operate in a sustainable fashion, doing little or no harm to the environment. Previous research has found that organic practices can help maintain soil carbon and nitrogen (2) and reduce the amount of fertilizer and pesticide needed to produce a satisfactory crop yield (3). As of October 21, 2002, all foods bearing the USDA Organic symbol must contain at least 95% organic ingredients. Although this label allows consumers to make informed choices about what kind of farming practices they are supporting with their food dollars, many still wonder whether the extra cost of purchasing organic produce affords them nutritional benefits.

Research comparing the potential health benefits of organic and conventional produce can be divided into four categories: 1) analysis of grocery store produce, 2) analysis of fertilizer’s effect on produce, 3) chemical analysis of farm reaped produce, and 4) analysis of the effect of produce on animal or human health (4). Despite numerous investigations on this topic, few conclusions have been drawn due to the complexity of the issues. Confounding factors such as soil type, rainfall, average temperature, harvesting techniques, and storage conditions must all be considered when carrying out a well-planned research investigation, and current scientific techniques can not control for these factors (4). A critical review of the literature completed in 2002 revealed that many studies comparing the nutritional value of organic and conventional foods are not valid for comparison due to lack of control for one or multiple confounding factors. The authors of this review concluded that there was not currently research to support a difference in the nutritional content of organic versus conventional foods; however, they suggest that advances in scientific methods may provide a different answer to this question in the future (4).

Researchers have recently added polyphenol analysis to their experimental design investigating the potential health benefits of organic produce. Previous studies compared mainly the vitamin, mineral, fiber, and protein content of the two types of produce (4). Increased consumption of polyphenols has been associated with a reduced risk of cardiovascular disease and possibly cancer and stroke (5) and it was hypothesized that the absence of pesticides may positively alter the levels of polyphenols in organic produce. This hypothesis proved to be correct. A study completed in 2002 reported higher polyphenol levels in organic peaches and pears when compared to their conventional counterparts (6), and in 2003, researchers found higher polyphenol levels in organic marionberries, strawberries, and corn in comparison to conventional products (7).

Despite findings of higher phenolic content in the foods themselves, consumption of organic produce may not confer any added health benefits to its consumers. A study completed by French researchers in 2004 found that the higher vitamin C and polyphenol content of organic versus conventional tomatoes fed to study participants did not differentially affect plasma vitamin C or lycopene (the major polyphenol found in tomatoes) levels after consumption of organic or conventional produce (8).

As with previous investigations, the results of these recent studies have failed to provide conclusive evidence that consump-tion of organic produce has a positive affect on the nutritional status of an individual. Research in this field is far from being complete and advances in scientific methods may help to provide concrete answers regarding the nutritional content of organic versus conventional produce.

References:
1. Organic Food Standards and Labels: The Facts. 2002, The United States Department of Agriculture.
2. Drinkwater, L.E., P. Wagoner, and M. Sarrantonio, Legume-based cropping systems have reduced carbon and nitrogen losses. Nature, 1998. 396(19 November, 1998): p. 262-265.
3. Mader, P., et al., Soil fertility and biodiversity in organic farming. Science, 2002. 296(5573): p. 1694-7.
4. Bourn, D. and J. Prescott, A comparison of the nutritional value, sensory qualities, and food safety of organically and conventionally produced foods. Crit Rev Food Sci Nutr, 2002. 42(1): p. 1-34.
5. Arts, I.C. and P.C. Hollman, Polyphenols and disease risk in epidemiologic studies. Am J Clin Nutr, 2005. 81(1 Suppl): p. 317S-325S.
6. Carbonaro, M., et al., Modulation of antioxidant compounds in organic vs conventional fruit (peach, Prunus persica L., and pear, Pyrus communis L.). J Agric Food Chem, 2002. 50(19): p. 5458-62.
7. Asami, D.K., et al., Comparison of the total phenolic and ascorbic acid content of freeze-dried and air-dried marionberry, strawberry, and corn grown using conventional, organic, and sustainable agricultural practices. J Agric Food Chem, 2003. 51(5): p. 1237-41.
8. Caris-Veyrat, C., et al., Influence of organic versus conventional agricultural practice on the antioxidant microconstituent content of tomatoes and derived purees; consequences on antioxidant plasma status in humans. J Agric Food Chem, 2004. 52(21): p. 6503-9.
Karrie Heneman, PhD, Nutrition Department, University of California, Davis.

Job Opportunity: Dietetic Technician

Job Title: Dietetic Technician
Salary: $18.88 - $22.79 hourly
Job Type: Part-Time
Location: San Jose Metropolitan Area, California

Description:
Under direction of a Dietitian, assists in the planning and implementation of a nutritional program.

Distinguishing Characteristics:
This is the paraprofessional level in the Dietitian series. The next higher class of Dietitian I is the fully trained, professional level in the series. This class is distinguished from the next lower class of Dietetic Assistant in that the latter monitors the trayline assembly, assists patients and Dietitians, and performs specialized clerical work of the Diet Office. This class performs a combination of technical and educational functions requiring specialized education and experience in nutrition and diet.

Typical Tasks:
Screens individual patients for nutritional needs;
Obtains nutritionally relevant data (such as medical or diet history, socioeconomic, anthropometric or laboratory data) from the patient or medical record;
Calculates nutrient and energy intake values;
Implements and monitors routine nutrition care plans for selected patients, including the development of diet patterns and menus;
Provides nutrition education for selected patients, which includes individual and small group counseling, evaluation and follow-up;
Maintains education materials and assists in developing displays;
Assists in coordinating nutrition care with other team members;
Implements procedures for coordination of nutrition care with food service systems;
Maintains and participates in monitoring quality assurance procedures;
Guides and instructs support personnel;
Documents nutrition related data in the medical record;
Performs related work as required;

Employment Standards:
Sufficient training and experience to demonstrate possession of the following knowledges and abilities:
Note: A person would normally acquire the qualifications listed below by having possession of an Associate degree in a Dietetic Technician program which is approved by the American Dietetic Association (ADA), including the completion of supervised field experience.
Possession of a Dietetic Technician Registered certification issued by the Commission of Dietetic Registration (CDR) for the ADA.

Knowledge of:
Nutrient composition of foods;
Nutritional needs through the life cycle;
General influences of socioeconomic, cultural and psychological factors on food and nutrition behavior;
Modified diets and diet therapy;
Fundamentals of quality assurance;
Laws, regulations, and standards affecting dietetic operations;
Medical terminology;
Standard operating practices for food production and service.

Ability to:
Communicate effectively orally and in writing;
Interview and counsel patients;
Collect and interpret nutrition related data from patients or records;
Plan menus and meal patterns for regular and modified diets;
Document nutritional care in medical records;
Plan and evaluate nutritional care for defined patient groups based on specific criteria;
Instruct individuals and small groups;
Maintain positive relationships with those contacted in the course of work.
To Apply, go to www.sccgov.org and follow the instructions in the Employment opportunity link.

[Online source]: www.sccgov.org.

University of California
Division of Agriculture & Natural Resources
Central Valley Region
POSITION VACANCY ANNOUNCEMENT

Position: Cooperative Extension
Nutrition, Family, and Consumer Sciences Advisor
#ACV 05-02 Location: Fresno County, Fresno, CA

Closing Date: (open until filled)

BACKGROUND:
The County of Fresno’s mission statement is to “seek to enhance the quality of life in our diverse community by assuming that high quality, responsive, and focused services are delivered to our constituents in a cost effective and efficient manner in all areas of service.” The Nutrition, Family, and Consumer Sciences Program can efficiently and effectively serve the mission of the county with education and research. The population of Fresno County is over 800,000. Fresno County serves as the agricultural center of California and the urban base of the Central Valley. This county encompasses over 6,000 square miles. Forty-five percent of the residents live in poverty. Unemployment rates are at 14.1%. Over 32% of children (ages 0-17) live in poverty. Fresno County’s teen birth rate is 82% live births per 1,000; California’s average is 57%. Fresno County’s demographics include 54.3% White, 44% Latino, 5.3% African American, 8.2 % Asian/Pacific Islander, and .8% Native American.

This position will develop applied research focusing on obesity, human nutrition, food safety and accessibility, parenting education, and family resource management. This individual will administer programs, supervising staff and budgets in the Adult Expanded Food and Nutrition Education (EFNEP), Youth EFNEP, Adult Food Stamp Nutrition Education (FSNEP), and Youth FSNEP. This presently includes 8 career staff members and a growing yearly grant budget of $370,000. Opportunities developed through this program area will target all ethnic and socioeconomic groups; however, the intended focus of programs will be low-income, under-served populations.

Given the nutrition education grant programs identified and the opportunities to develop life skill education grant programs, this position requires expertise in community nutrition education from a broad community health perspective, and includes service learning opportunities, expertise in grant writing, budget development, family resource management, parenting education, and dietetics. The ability to identify current local and regional issues, focus on alternative delivery methods, and support a team approach is imperative.

NATURE AND PURPOSE:
The focus of the Nutrition, Family, and Consumer Sciences Advisor position is to administer the EFNEP and FSNEP programs, providing nutrition education to low-income families. It also includes conducting and coordinating a research and education program encompassing the needs of families in Fresno County. It is expected that the individual will identify timely and critical issues regarding the health of the community and families within. The position will interact as part of a diverse nutrition team, developing community strategies, collaborating with agencies, and building on a strong community network. Activities are directed towards community groups, low-income families, and health and family professionals.

MAJOR RESPONSIBILITIES:
Academic appointees in Cooperative Extension are responsible for performance in extending knowledge and information; applied research and creative activity; professional competence and activity; and University and public service.

The advisor is expected to:
Administer the Fresno County EFNEP and FSNEP (federally funded) programs;
Supervise eight nutrition program staff positions within UCCE Fresno;
Conduct a highly visible, broadly based Extension research and education program focusing on family needs in Fresno County;
Identify, prioritize, and develop comprehensive education and training programs based on clientele needs, especially of low-income families;
Facilitate collaboration with the Regional Nutrition Network and numerous agencies within the region;
Develop media and policy-maker relationships, locally, regionally, and statewide;
Demonstrated commitment to impact, outcome, evaluation, and dissemination of appropriate research;
Enlist the knowledge and skills of other NFCS advisors in the region and statewide.

RELATIONSHIPS:
This position is administratively responsible to the Cooperative Extension County Director in Fresno County and through the County Director to the Regional Director of the Central Valley Region of the Division of Agriculture and Natural Resources.

AFFIRMATIVE ACTION:
Implement outreach efforts to ensure nondiscrimination in program identification and delivery. Promote and encourage maximum participation of minorities, women and other under served groups. The Advisor will promote, in all ways consistent with other responsibilities of the position, the affirmative action goals established by the Division. This will include outreach objectives as a component in planning, implementation, and evaluating program efforts. Establish and update statistical data pertaining to female and minority populations to be served by programs. Record, document, and report plans, goals, activities, progress, and results; and submit required activity reports as scheduled.

EDUCATION AND EXPERIENCE:
A minimum of a Masters degree in one of the disciplines relevant to the duties and responsibilities of this position, including Public Health Nutrition, Community Nutrition, or Family and Consumer Sciences. Licensure as a Registered Dietitian is preferred.

In addition, the following experience and skills are required:

Demonstrated experience in management, administration, education and outreach, research, and facilitation skills;
Demonstrated supervisory experience in community health/nutrition;
Demonstrated experience working with low income and diverse populations;
Skills in public speaking, technical writing, statistical analysis and computer use;
Demonstrated ability to plan, implement, evaluate and publish research results;

SALARY:
Salary will be in the UC Cooperative Extension Assistant Advisor rank, commensurate with experience and professional qualifications. For information regarding Cooperative Extension Advisor salary scales, refer to the UC website at http://www.ucop.edu/acadada/acadpers/tab0405/table33.pdf. A background investigation will be required for the successful candidate, including fingerprinting and criminal history clearance by the Department of Justice and Federal Bureau of Investigations.

This position is an academic career track appointment, subject to administrative review of the need for the position and the incumbent’s performance, in three 2-year renewable terms. Upon successful completion of the three terms, the appointment will be converted to indefinite status. For information regarding merit and promotion procedures, see DANR Administrative Handbook, Series 300, Section 315 at http://danr.ucop.edu/admin-handbook/300.

If the successful candidate is currently a UCCE Advisor, the candidate will be offered the position as lateral transfer, retaining their current rank, step, salary, and definite or indefinite status.

BENEFITS:
The University of California offers comprehensive benefits including two days per month paid vacation, one day per month paid sick leave, and thirteen paid holidays per year. A variety of health and dental insurance plans are available, with employer contributions to the premiums. In addition, the University provides basic life and disability insurance, which may be supplemented at group rates. Workers’ Compensation Insurance is provided. The UC Retirement System is coordinated with Social Security and offers optional tax-deferred annuity plans. Automobile insurance is available. Sabbatical and study leaves are available. For more information, refer to the UC Benefits website at: http://atyourservice.ucop.edu.

INTERVIEWS:
A search committee will review all applications and associated materials, and recommend individuals most suitable for the position. Selected candidates will be asked to come to Fresno, CA, for an interview and seminar presentation. Travel expenses for interviews will be reimbursed according to University of California policy.

HOW TO APPLY:
To be considered, applicants must submit the following four components of the Application Packet:

Cover Letter
DANR Academic Application Form, including a list of potential references. Provide a minimum of four (4) and a maximum of six (6) references, including: Title/Name, current addresses, email address, and telephone numbers.
Resume
College Level Transcripts: Original transcripts preferred, however, photocopies of original transcripts will be accepted.

References will be contacted for applicants selected for interview.

Application and associated materials will not be returned to the applicant.

To download the UC DANR Academic Application form, visit our website at: http://cvr.uckac.edu click on: “Employment Opportunities”

B. To request a UC DANR Academic Application form, contact:
UC DANR Cooperative Extension
Central Valley Region - Cindy Inouye
9240 S. Riverbend Avenue
Parlier, CA 93648
Voice: (559) 646-6535; FAX: (559) 646-6513
E-mail Address: cinouye@uckac.edu Internet: http://cvr.uckac.edu/

PLEASE REFER TO POSITION NUMBER #ACV 05-02 IN ANY CORRESPONDENCE.

The University of California prohibits discrimination or harassment of any person on the basis of race, color, national origin, religion, sex, gender identity, pregnancy (including childbirth, and medical conditions related to pregnancy or childbirth), physical or mental disability, medical condition (cancer-related or genetic characteristics), ancestry, marital status, age, sexual orientation, citizenship, or status as a covered veteran (covered veterans are special disabled veterans, recently separated veterans, Vietnam era veterans, or any other veterans who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized) in any of its programs or activities. University policy is intended to be consistent with the provisions of applicable State and Federal laws. Inquiries regarding the University’s nondiscrimination policies may be directed to the Affirmative Action/Staff Personnel Services Director, University of California, Agriculture and Natural Resources, 300 Lakeside Drive, 6th Floor, Oakland, CA 94612-3550, (510) 987-0096. January 2004.

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