Document Sample
					                                                      UNIVERSITY OF CALIFORNIA
                                                       COOPERATIVE EXTENSION

Volume 24, No. 6
Nov/Dec 1999


Vitamin B6 and Premenstrual Syndrome
Healthy Kids Snack Smart
Uterine Cancer Update: Can Weight Control and Diet Lower the Risk?
Why Breast Is Best
Health Benefits of Omega-3 Fatty Acids
A Pyramid for the 70+ Set
Two Studies Add to the Growing Evidence That Green Tea Is Beneficial for Health
FDA Asked to Acknowledge the Role of Vitamin E in Preventing Heart Disease
Exercise and Breast Cancer
Be Your Best at Every Stage of Life
Start Strength Training Now
This is Your Life!, A New Video Kit for Today's Teens

Sheri Zidenberg-Cherr, PhD, Editor
University of California
Department of Nutrition
One Shields Ave.
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, University of California, Department of Nutrition, One
Shields Ave., Davis, CA 95616-5270. Phone (530) 752-3387; Fax (530) 752-8905.

About 95 percent of menstruating women experience some physiological symptoms
during the luteal phase of their cycle, and about 5 percent have severe symptoms.
Recently a meta-analysis of nine randomized, placebo-controlled trials of one common
PMS treatment, vitamin B6 was conducted. A total of 940 patients were included.

After exclusion of one study, which introduced a significant amount of heterogeneity, the
analysis showed that vitamin B6 was more likely than placebo to lead to a favorable
result (odds ratio, 2.32). Four of the nine trials evaluated the efficacy of vitamin B6 in
treating depressive symptoms in 541 patients; again, favorable results were more likely
with vitamin B6 than with placebo (OR, 1.69). No dose-response relation was found.
Overall, the quality of the nine studies was low; only three met one threshold of adequate
quality, only one met another, and none met both.

While this analysis suggests that vitamin B6 may be of value in PMS, the poor study
quality and the lack of a dose-response relation make this conclusion somewhat suspect.
If vitamin B6 is used for this purpose, the authors suggest that doses of 50 to 100 mg/day
are most likely to be beneficial and caution against higher doses.

Reference: Systematic review. BMJ (Clinical Research Ed.), 318(7195): 1375-81. May
22, 1999.
Source: Marton KI, Journal Watch 19(14), July 15, 1999.

Snacks should provide the energy hungry kids need, as well as their meals. While
occasional sweet treats please young taste buds, offering snacks based on the USDA's
Food Guide Pyramid provides the biggest nutritional bang for your snack-time buck:
¨ Bread and grain group: Whole-grain breadsticks or crackers with cheese, fortified
ready-to-eat cereal with milk, toasted whole-wheat raisin bagels, pumpkin bread, bran
muffins, popcorn, fig bars, oatmeal-raisin cookies, graham crackers, whole-wheat toast,
or ginger snaps.
¨ Vegetable group: Baby carrots, celery with peanut butter, steamed broccoli or Chinese
pea pods with dip, grilled cheese and tomato sandwiches, or cheese and veggie
¨ Fruit group: Apple slices with peanut butter, pear slices with cheese, strawberries with
yogurt, orange segments, kiwi slices, cubed melon, mini bunches of grapes, raisins or
other dried fruit, or 100 percent fruit juice alone or mixed with mineral water.
¨ Dairy group: Go low-fat for kids over 5 years old. Flavored milk, yogurt, ice cream or
yogurt shakes, pudding, and slices of cheese or mozzarella "string" cheese. Make frozen
"juice pops" with calcium-fortified juices.
¨ Meat and meat substitutes group: Wedges of hard-cooked eggs, peanut butter on
crackers, bean dip on a tortilla, or humus with pita triangles.
NOTE: Avoid serving hard, round, or difficult to chew foods to children under 3 years of
Adapted from: Children's Nutrition Research Center. Nutrition and Your Child, Spring

According to the American Institute for Cancer Research expert report, Food, Nutrition
and the Prevention of Cancer: A Global Perspective, there is convincing evidence that
obesity, particularly that resulting from weight gained later in life, increases a woman's
risk of developing uterine cancer. A diet high in animal fat may also increase risk, while a
diet high in vegetables and fruits may offer protection against cancer.

What Is Uterine Cancer?
Uterine cancer is a disease of the uterus, the organ in the lower abdomen of a female
where a fetus develops until birth. The uterus consists of two layers: a thick muscular
outer layer and an inner lining referred to as the endometrium. By far, the most common
type of uterine cancer is cancer of the inner lining, endometrial cancer.

How Prevalent Is Endometrial Cancer?
Endometrial cancer, occurring mainly in women over age 50, is most common in
developed countries such as the United States, Canada, and countries in Western Europe.
It is uncommon in Asian and African countries. In 1999, there will be an estimated
37,400 new cases diagnosed in the US and 6,400 deaths caused by the disease.

What Are the Symptoms?
Any unusual vaginal bleeding or discharge that occurs at any time, but particularly after
menopause, is a warning sign. If the cancer has progressed to a more advanced stage,
there may be pain in the lower abdomen and weight loss.

Are There Screening Tests for Endometrial Cancer?
A very small percentage of endometrial cancers may be picked up by the Pap test used to
screen for cervical cancer. There is at this time no effective screening test for endometrial
cancer. The best way to detect the disease in its earliest stages is to see your doctor for
your annual pelvic exam and if you observe any of the symptoms.

Recent studies indicate that a major risk factor for developing endometrial cancer is an
elevated level of the female hormone, estrogen. Marc T. Goodman, PhD, and his
coworkers at the University of Hawaii Cancer Research Center in Honolulu, are studying
diet and endometrial cancer risk. According to Dr. Goodman, "Fat may have a direct
effect on circulating levels of estrogen." Many of the other risk factors for developing
uterine cancer may also be related to the life-long levels of estrogen in a woman's body.

Can Diet Reduce the Risk of Uterine Cancer?
Dr. Goodman says, "Data from our lab supports the notion that diets low in calories and
rich in vegetables, fruits, whole grain foods, and legumes especially soybeans, can reduce
the risk of endometrial cancer." Use these findings as you plan your menus:
¨ Include generous portions of a variety of vegetables, fruits, whole grains, and legumes
such as split peas, navy beans, kidney beans, chick peas, and soybeans.
¨ Minimize intake of foods high in animal fats such as whole milk, butter, cheese, meat,
sausage, and egg yolks.
¨ Finally, reach and maintain healthy body weight and stay physically active.
What Increases a Woman's Risk of Developing Uterine Cancer?
Dietary Risk Factors:
¨ Obesity (particularly weight gained later in life)
¨ Diet high in saturated fat
Other Risk Factors:
¨ Early onset of menstruation
¨ Late onset of menopause
¨ Infertility or never giving birth
¨ Estrogen replacement therapy (does not include progesterone plus estrogen hormone
replacement therapy)
¨ High blood pressure
¨ Diabetes
¨ Family history
Source: American Institute for Cancer Research Newsletter 65, Fall 1999.

Breastfeeding benefits both mother and infant, says Dr. Richard Schanler, a
neonatologist, Baylor University professor of pediatrics, and the president-elect of both
the Academy of Breastfeeding Medicine and the International Society for Research in
Human Milk and Lactation.

According to Schanler, breastfeeding benefits babies because it decreases the incidence
and/or severity of:
¨ Diarrhea
¨ Lower respiratory infections
¨ Otitis media (ear infections)
¨ Bacterimia (bacteria in the bloodstream)
¨ Bacterial meningitis
¨ Urinary tract infections
¨ Necrotizing enterocolitis
Might protect babies against or modify the risk for:*
¨ Sudden infant death syndrome
¨ Juvenile-onset insulin-dependent diabetes
¨ Crohn's disease
¨ Ulcerative colitis
¨ Lymphoma
¨ Allergic diseases
¨ Other chronic digestive diseases
* Other benefits, including an apparent link between breastfeeding and reduced incidence
of childhood obesity, are under investigation.
Breatsfeeding may also:
¨ Shorten the course of infant botulism
¨ Enhance a baby's cognitive development
Breastfeeding benefits mothers because it:
¨ Reduces postpartum bleeding
¨ Helps the uterus get back in shape faster
¨ Promotes weight loss
¨ Aids in birth control
¨ May reduce the risk of osteoporosis, ovarian cancer, and pre-menopausal breast cancer
¨ Saves money
¨ Reduces parental time away from work due to child illness
Breastfeeding mothers often ask about the best ways to store their milk.
Recommendations are listed below:
The Basics:
¨ Use very clean containers. Glass is best, but plastic and baggy-type bottles can also be
¨ Express milk into 2- to 4-ounce "single serve" portions, plus a few extra 1-ounce
portions for when your baby wants more.
¨ Chill milk as soon as possible and definitely within four hours. When temperatures soar
above 100 degrees, chill immediately.
¨ Label and date bottles.
¨ If the milk will be used within 4 to 5 days, refrigerate. If not, freeze.
Tips for Fresh Milk:
¨ If stored in a cooler with frozen gel packs, use within 24 hours.
¨ If stored under standard refrigeration, use within 5 days.
¨ Warm by shaking gently under warm, running water.
¨ Avoid the microwave. Microwave warming can cause hot spots and damage protective
¨ Teach others who feed your infant how to prepare bottles for feeding.
Tips for Frozen Milk
¨ If stored at zero degrees in a self-defrosting freezer, use within 6 months.
¨ If stored at zero degrees in a standard freezer, use within 12 months.
¨ Defrost by shaking gently under warm, running water. Avoid microwave thawing,
which can cause hot spots.
¨ Shake gently to redistribute the fat of thawed milk that appears lumpy. It is perfectly
safe to use.
¨ Use as soon as possible once thawed. Freezing destroys some of the antibacterial
components of milk, making it more perishable than fresh.
Adapted from: Children's Nutrition Research Center. Nutrition & Your Child, Summer

Dieting and daily consumption of tuna, salmon, or other fish rich in omega-3 fatty acids
could help people lose weight. Researchers from the University of Western Australia
studied 69 overweight men and women for 4 months and found that those who took part
in a weight loss program and ate fish daily lost weight, lowered their cholesterol levels,
and reduced their risk of diabetes. Comparatively, participants who only participated in
the weight loss program, just consumed fish once a week, or continued with their normal
eating habits did not experience the benefits. The fish consumed by participants
contained 3.65 grams of omega-3 fatty acids. The researchers concluded that eating fish
once a day would likely reduce the risk of cardiovascular disease among obese people
and lower blood pressure and cholesterol levels.
Reference: American Journal of Clinical Nutrition; Vol. 70; 1999; pp. 817-25.
Source: Nutrition Week; Vol. XXIX No. 41; October 29, 1999; p. 7.

A new food guide pyramid is available for older Americans. Researchers at Tufts
University modeled the "70+" pyramid after the US Department of Agriculture's Food
Guide Pyramid.

Older Americans have some specific nutrient needs that the modified pyramid addresses.
Some notable differences in the "70+" pyramid include a narrowed base, signifying the
reduced energy intake common among this group. The modified pyramid outlines the
"nutrient dense" choices in each food category. It also emphasizes the need for adequate
hydration, a chronic problem for many older Americans, by placing water at the base of
the pyramid.

The importance of fiber intake is highlighted with icons throughout the grains , fruits, and
vegetables tiers of the graphic. Fiber intake is important for seniors but applicable to all
adults, since most Americans eat less than the recommended amounts. The flag perched
at the top of the "70+" pyramid is meant to "flag" possible nutrient deficiencies common
among seniors, and suggests that some might need supplements of calcium, and vitamins
D and B12.

"The pyramid is aimed at healthy, mobile seniors who have the resources to prepare
adequate meals," stated Alice Liechtenstein, D.Sc. with the Human Nutrition Research
Center on Aging at Tufts University. "It is especially designed to give them a little more
guidance on how to optimize their diet." The pyramid's main messages are that people
over age 70 have specific nutrient needs, and how well they meet those needs can affect
overall health status.
Adapted from: International Food Information Council Foundation Food Insight,
March/April 1999.

Green tea contains high concentrations of antioxidants that have known protective
effects. Green tea has received a lot of attention lately, as scientists begin to identify its
benefits in warding off heart disease, cancer, obesity, and other illnesses.
Two new studies published in December 1999 add to the growing evidence that green tea
is more than just a tasty beverage. The studies suggest that increasing consumption of
green tea, either through increased beverage intake or adding a dietary supplement to a
healthy diet, can trigger biochemical mechanisms that affect our health.
A study by Dulloo and colleagues, published in the American Journal of Clinical
Nutrition, found that green tea extract, which contains high concentrations of antioxidants
such as catechin-polyphenols and many other compounds including caffeine, can increase
the utilization of energy beyond the effects of caffeine alone. Consumption of green tea
produced thermogenesis and increased energy expenditure and fat oxidation in humans.
A study by Erba and colleagues, published in the Journal of Nutrition, evaluated the
effect of green tea compounds on oxidative damage caused by iron treatment in cultured
human leukemia cells. Results showed that green tea protects cells from injury.
Increasing intake of green tea may help reduce oxidative damage associated with various
disease processes.
Sheri Zidenberg-Cherr, PhD, a representative of the Public Information Committee of the
American Society for Nutritional Sciences and the American Society for Clinical
Nutrition notes, "This is exciting news for the health and nutrition community. As
scientists identify specific components in foods and beverages that affect human
physiology, we gain an understanding of the function of foods beyond meeting known
nutrient requirements and providing energy."
Today, scientists create "functional foods" by modifying the properties of existing foods
to promote specific physiological functions. The challenge for the future lies in
determining the beneficial functions of various natural foods like green tea, so we can
choose foods that meet our individual needs.
This media release provides current information on health and nutrition-related research.
This information should not be construed as medical advice. If you have a medical
concern, consult your doctor.

Source: Press Release; Public Information Committee (PIC) ASCN/ASNS, Nov. 30.

Louisiana State University professor William Pryor is petitioning the Food and Drug
Administration (FDA) to acknowledge that vitamin E offers major benefits regarding
heart disease.

Pryor, director of the LSU Biodynamics Institute and an expert on vitamin E, says the
vitamin can help prevent heart disease and even some types of cancer. Cardiovascular
disease is the leading cause of death in the US, with more than 730,000 deaths in 1996,
according to the Centers for Disease Control and Prevention.

Vitamin E, which Pryor says is nature's most potent antioxidant, prevents unwanted
oxidation, a process that triggers the development of artery-blocking plaque and the
mutation of certain chemicals into carcinogenic forms.

Pryor suggests taking about 40 IU of vitamin E per day, preferably from natural sources,
compared to the 10-15 IUs obtainable through diet alone. Although the exact amount of
vitamin E one should take is not yet known, Pryor notes that it is likely that the amount
necessary to protect against heart disease will be different from the amount that will
protect against cancer, cataracts, neurological disorders, and other diseases involving
oxidation. He believes more testing must be done to determine the proper dosage to
protect against disease.
Source: Nutrition and the M.D., 25 (11), November 1999.
Women who exercise for seven hours a week may help reduce their risk of contracting
breast cancer. Researchers from Brigham and Women's Hospital in Boston,
Massachusetts studied 120,000 women who participated in the Nurses' Health Study,
which began in 1997. Over a 14-year period, the women, who were 30 to 55 years old
when the study began, periodically reported how much exercise they got a week and were
routinely screened for breast cancer. About 3,100 participants developed breast cancer
over the course of the study. Researchers found that women who exercised an average of
seven hours a week, or one hour a day, for at least 10 years had a 20 percent less risk of
developing breast cancer than women who led more sedentary lives. There was no
difference in risk between women who exercised vigorously and women who exercised
moderately, researchers noted. Therefore, moderate exercise such as brisk walking,
jogging, or bike riding could reduce the risk of breast cancer just as effectively as
vigorous exercise. Women who exercised for an average of half an hour a day
experienced smaller reductions in risk of breast cancer, about 10 to 15 percent.
Resource: Archives of Internal Medicine; Vol. 159; October 1999; pp. 2290-96.
Source: Nutrition Week; Vol. XXIX No. 41; October 29, 1999; p. 7.

Ageless Advice for Optimal Health
What was your favorite food as a child? It is probably not the same as your first choice
today. As your tastes change over the years, so do your nutritional needs. While it's true
that a primarily plant-based diet that is low in fat can meet the nutritional needs of nearly
all people, and help stave off cancer and other chronic diseases, children, teens, younger
adults and older people all have some special needs.
Growing Children
Children need energy, or calories, to help them grow, learn, and play. In addition to a
mostly plant-based diet, healthful snacks are important. Small children have small
stomachs that can hold only limited amounts of food at each meal; healthful snacks can
make up the missing calories and nutrients. Introducing children to healthful foods and
eating habits that they can continue to select and practice for a lifetime is important.
Independent Teens
For teenagers, who are growing rapidly and are often physically active, calories and
nutrients are in high demand. Two nutrients that typically fall short in a teen's diet are
calcium and iron. Calcium builds strong bones. Lowfat milk and dairy products, kale,
salmon with bones, calcium-fortified orange juice, or calcium-fortified foods such as
some brands of tofu and whole-grain breads (check labels) should be part of a teen's daily
diet. Iron helps carry oxygen through the blood to all parts of the body. Teenage boys
need iron to meet the needs of an increase in muscle mass and a greater blood supply;
girls require iron to replace menstrual losses. Lean meat and chicken, beans, green leafy
vegetables, fish, iron-fortified cereals, and enriched whole-grain breads are good sources
of iron.
Mid-life Adults
Eating a mostly plant-based diet may protect against many cancers, as well as heart
disease, cataracts, diabetes, stroke and high blood pressure. Choosing a naturally lowfat
diet centered around vegetables, fruits, whole grains, and beans, combined with regular
physical activity, may help prevent cancer, other chronic diseases, and mid-life weight
Women's nutritional needs change from the early to the later mid-life years. During
childbearing years, getting enough folic acid, found abundantly in beans, vegetables, and
fortified breads and cereals, is critical to reduce the risk of birth defects. Iron
requirements double during pregnancy and calcium intake continues to be important.
With menopause comes a decrease in estrogen and an increase in heart disease risk and
bone loss. It's wise to eat a lowfat, plant-based diet and get adequate calcium. Some
research has shown that soy foods, which are rich in phytoestrogens (plant estrogens),
may help reduce some symptoms of menopause.
Older Adults
Older adults often need fewer calories, but in some cases, more nutrients. That is why
choosing foods that are packed with good nutrition is so important. Experts at the Tufts
University Human Nutrition Research Center on Aging in Boston, Massachusetts,
recommend that adults over age 70 choose nutrient-rich, high-fiber foods like whole
grains, fortified cereals, and brightly colored vegetables. As the sense of thirst declines
with age, it is important for older adults to drink eight or more glasses of water a day.
Also, the risk of debilitation due to bone fractures and falls increases with age, so getting
at least three servings of foods offering calcium, or taking calcium and vitamin D
supplements, is important for maintaining bone strength. Finally, older adults don't
absorb vitamin B12 as well as younger people. Getting sufficient B12 from foods
including salmon, beef, yogurt, shrimp and milk, or a supplement, is recommended.
Check with your doctor regarding all dietary supplements.
Source: American Institute for Cancer Research Newsletter; Issue 66; Winter 2000; p. 4.

Don't Wait to Start Losing
The average 25-year-old woman is 25 percent fat. The average 65-year-old sedentary
woman is 43 percent fat. As we start to lose muscle over the years, our body fat increases.
The good news is, you don't have to be "average." You can build muscle and burn fat,
while gaining strength, balance, and confidence. Oh yes, and lose weight in the process.

A Dieter's Dream
Cutting calories can help you lose fat, but unless you exercise, you'll also lose muscle.
Strength training exercises, done two to three times per week, dramatically alters the ratio
of bulky body fat to fat-burning muscle tissue. The more muscle you have, the more
calories and fat you burn, even sitting still.
Strength training has several benefits for the body, but it produces different results than
aerobic exercise. Don't consider skipping your daily walk (a great cardiovascular
workout), or regular stretching, you need to combine these types of exercise for optimal
fitness and weight loss.

More Than Muscle
Besides building strength and aiding weight control, weight lifting also improves the ratio
of LDL (bad) cholesterol to HDL (good) cholesterol, relieves arthritic symptoms and
helps prevent diseases such as diabetes and hypertension. Studies show a direct link
between resistance training and increased bone density, important for preventing

Dumbbell Basics
Before getting started, consult your doctor and a strength training instructor. Strength
training exercises must be done properly to prevent injury, and effectively to build
muscle strength. Once you learn proper technique, exercises can be done on your own. If
you cannot meet with an expert, a good introductory video or guidebook can teach you
basic movements. Do exercises in front of a mirror at first, to be sure your form matches
that of the images you're learning from.
Begin a program of strengthening the largest muscles in the body: those in the legs, back
and chest. Lift a weight that's heavy enough to make you feel fatigued after 8 or 9 lifts. If
you can lift it more than 15 times, it's too light. Start with whatever weight you feel
comfortable lifting, and see how it goes. Starting out with weights that are too heavy can
cause injuries. A single set of 6 to 12 repetitions is a great place to start. In fact,
according to the American College of Sports Medicine, single sets are just as effective as
multiple sets for beginners.

Remember, a strong body not only builds confidence, improves health, and helps you
lose or maintain your weight, it promotes independence in life's later years.
Adapted from: American Institute for Cancer Research Newsletter; Issue 66; Winter
2000; p. 12.

Bring teens into the new millennium, healthy, happy, and wise! Finally, a video kit that
makes nutrition, fitness, body image, eating disorders, tobacco prevention, osteoporosis,
and media literacy come alive for today's teens. The best in live-action theater comes to
video in this thought-provoking, rib-tickling show that helps teens see through media
messages and peer group pressures in order to build positive body image and improve
their eating and exercise habits. Designed to reduce the alarming rates of eating disorders,
harmful dieting practices, and tobacco use among today's youth, this video kit helps kids
develop the critical decision-making skills needed to take charge of growing up healthy
and fit. Featuring a life-size Barbie Doll, outstanding actors who speak to teens in their
language, interactive game shows, and theater, this video kit helps kids discover that
every body is different and different is a good thing!

THIS IS YOUR LIFE! comes complete with a state-of-the-art Teacher's Activity
Guidebook which helps schools meet national standards for Comprehensive Health
Education. Featuring hundreds of hands-on activities, innovative lesson plans, self-
assessments, and resources for students, teachers, and parents, the kit helps educators
empower teens toward healthy lifestyle choices.

Created by nutritionist Barbara Storper, MS, RD, a leader in the field of children's
nutrition, and Emmy Award-winning actor/writer Paul Wagner, THIS IS YOUR LIFE!
has received rave reviews from students and educators throughout the country as well as
outstanding results from a two-year Centers for Disease Control Evaluation,
demonstrating outstanding success improving student knowledge, attitudes, and
behaviors regarding nutrition and health issues.
THIS IS YOUR LIFE! video kit features:
¨ Live action, full color video (3 parts, 50 minutes total running time)
¨ Plus comprehensive health education teachers' Follow-Up Activity Guidebook (150+
¨ Units on teen nutrition, body image, eating disorders, fitness, osteoporosis, tobacco use,
and media literacy
¨ Role plays, theater games, interactive lesson plans
¨ Discussion questions for large and small groups
¨ Health self-assessments
¨ Health and nutrition dictionary
¨ Frequently asked questions and answers
¨ Resource directory
¨ Ideal for grades 5 to 12
For more information on how to bring live health theatre shows and keynote
presentations to your school or conference, contact: (800) FOODPLAY.
¨ Address: FOODPLAY, 221 Pine Street, Northampton, MA 01062
¨ Orders: (800) FOODPLAY
¨ Office: (413) 585-8400
¨ Fax: (413) 585-8484
¨ Email:
¨ Website:


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University of California
Department of Nutrition
One Shields Ave.
Davis, CA 95616-5270