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The Grapevine Teachers College, Columbia University Program in Nutrition Spring 2002, Issue III Nutrition and Public Health Nutrition and Education Applied Physiology and Nutrition Report on “Sustainable Agriculture in the Developing World: Innovative Examples” By Rebecca Sparks, R.D., Nutrition Education Program Nearly 30 percent of the world’s population opium. The MCC has introduced fruit trees, suffers from some form of malnutrition, like the Kaew mango and the indigenous Inside This Issue: according to the United Nations Food and perisimmon for consumption, processing, and Agriculture Organization (FAO). In the fight a source of revenue. Integrated farming against global hunger, some developing systems for small farmers have also been Quintessence 2 nations have found promise in sustainable introduced. Rather than planting monocrops agriculture. Sustainable agriculture is a (large fields of only one type of crop), School Vending 3 response to the dramatic changes that have different crops such as rice, garlic, soybean Machines occurred in agriculture since World War II. and onion are planted together in the same Although productivity has greatly increased, field. Prawn aquaculture has been re- Eat, Drink, and Be 4 there have been significant costs, including introduced in rice fields. Raising shellfish in Healthy topsoil depletion, groundwater rice fields had been a tradition in Asia for contamination, a decline in family farms, over 2000 years, but until recently it was The “Nutrition 4 neglect of living and working conditions of abandoned in favor of high-yield rice Transition” farm laborers, and disruption of economic varieties that required pesticides and and social conditions in rural communities. herbicides. The prawn aquaculture provides a Staying Informed 5 Sustainable agriculture aims to address these source or protein, increases rice yields, After Grad School costs by integrating environmental health, reduces insect pests (because the prawns eat economic profitability, and social and the insects), and stimulates revenue. States Fall Short On economic equity. 6 Physical Education “Successes of the Sustainable Agriculture On February 19th, a symposium at the 2002 Movement in Cuba” American Association for the Advancement Dr. Maria Caridad Cruz of the Antonio Dietetic Internship 7 of Science (AAAS) Annual meeting entitled Nunêz Jiménez Foundation for Nature and “Sustainable Agriculture in the Developing Man spoke on the shift from Cuba’s Defining Overweight World: Innovative Examples” was held at participation in the “Green Revolution” 9 in Children Tufts University. The symposium featured (which was characterized by large-scale speakers from developing countries in Africa, production, specialization of monocrops for Asia, and South America. The following is a export, and dependency on chemical Fresh Off the Vine 9 summary of the initiatives in sustainable fertilizers) to a new model in agricultural agriculture presented in the symposium: development—sustainable agriculture. “Agriculture Practices on Highlands of In rural areas there has now been a change Northern Thailand” from large intensive farms to smaller farms. Dr. Phrek Gypmantasiri of the Multiple Small work teams are directly responsible for Cropping Center (MCC) at Chiang Mai all aspects of production in a given piece of The Grapevine University spoke on developments in the land, allowing remuneration to be directly northern area of Thailand where 60 percent linked to productivity. Land is owned by the Teachers College, of households lack enough rice. The area is state but leased to the farmers at no cost. Columbia University plagued by erratic rainfall, an increase in Integrated pest management (IPM) is forest fires often due to slash and burn (a practiced where pests are controlled without 535 West 120th Street practice of clearing and burning a field to chemicals, organic and bio-fertilizers are New York, NY 10027 prepare it for planting), and opium drug used, animals are used for traction, and addiction. The MCC is working on multiple cropping systems are used where email@example.com improving rice yields, developing alternatives crops such as corn and sweet potatoes are to slash and burn, domesticating the interspersed in the same field. Crop rotation (212) 870-8765 Castanopsis tree (which provides edible is also practiced in which a field is planted nuts), and adding new cash crops to replace (Continued on page 8) Page 2 The Grapevine Restaurant Review: Quintessence By Mary Zotos, Applied Physiology and Nutrition Program Too tired to cook, but not in the mood to eat food that is cooked for you? Then you may want to check out Quintessence, a “raw” food restaurant which originated in the East Village and also recently opened on the Upper West Side. The “raw” food movement is based on the idea that food in its most natural state, Editor without any manipulation or additives, contains the highest concentration of Emily K. Bergeron nutrients. By consuming unadulterated food, the body is cleansed and mind and Nutrition and Public Health Program spirit are purified. All the foods served at Quintessence are uncooked, unprocessed, and vegan. Dr. Randi Wolf and doctoral student Lauren Weiss accompanied me for my first “raw” meal. Faculty Editor Try not too blink, or you’ll walk right by Quintessence (East Village location). Randi Wolf, Ph.D., M.P.H. The restaurant is charming, with only six tables, each with bamboo centerpieces. Research Assistant Professor The menu consists of “raw” appetizers, salads, soups and entrees and desserts. We started off with the chipotle hand roll, which consists of various vegetables mixed with a very spicy hot pepper sauce wrapped in nori sheets. We also had the Japanese “shrimp” balls made of brazil nuts, onion, garlic and ginger. They Faculty Advisor tasted more like falafel than shrimp, but were tasty nonetheless. Isobel Contento, Ph.D. Coordinator, Program in Nutrition For our entrées, we ordered the “burrito dinner” made of lettuce leaves filled with “refried beans” and “cheddar cheese”, served with guacamole tomatoes and onions along with a hot pepper sauce. We also ordered the “ravioli of the day”. Since “cooked pasta” is not an option, the ravioli were made of raw turnip slices Contributing Writers stuffed with spinach. The food is presented with creativity and flare. For drinks, Rachel Fassler we had celery and kale juice with a shot of ginger and lemon as well as coconut Applied Physiology and Nutrition Program water. Rounding out the menu were the “guiltless” desserts, all non-dairy and raw. We Lindi Chun shared the three-layer mudslide, which was made of carob mousse and mesquite Nutrition and Public Health Program cream in an almond walnut crust. Appetizers and salads cost about $7 to $8, entrees range from $9 to $15, drinks Rebecca Sparks, R.D. vary from $2.50 to $7, and all desserts are $7—certainly affordable for student Nutrition Education Program budgets. While there is a lack of scientific evidence to support some of the claims made Bridget Quinn for a “raw diet” — the experience is fun. So, would I recommend Quintessence Nutrition and Public Health Program for raw-foodists as well as non-followers? Without hesitation. ▪ Lauren Weiss, M.S. Quintessence is located on 263 east 10th street, between Nutrition Education Program Avenues A and 1st (646-654-1823) and 566 Amsterdam Avenue, between 87th and 88th streets Mary Zotos (212-501-9700). Applied Physiology and Nutrition Program Technical Coordinator We’re on the web! Katherine Roberts, M.P.H. Technology Fellow Go to www.tc.columbia.edu/~academic/nutri/Grapevine.htm Health Education Program to view the latest issue of The Grapevine. The Grapevine Page 3 Public Pressure and Legislation Needed in School Vending Machine Controversy By Emily K. Bergeron, Nutrition and Public Health Program In recent years, a growing number of schools have entered into In addition to funding, “the flaw in the state legislation process multi-million dollar “pouring rights” agreements with beverage is enforcement,” said Barry Sackin, Director of Government companies like Coca-Cola. In exchange for exclusively Affairs for the American School Food Service Association offering the company’s product, schools receive lucrative (ASFSA). Even if a state passes legislation that restricts the funding deals that help pay for items such as books, computers, sale of soft drinks and other competitive foods, there’s no and athletic equipment. While the agreements help some guarantee that schools will follow the policies. Sackin said a inadequately funded schools obtain the supplies they need, solution to the controversy is likely to be realized only, “when there is concern that “competitive foods” (foods sold in the public becomes outraged enough to say we are willing to competition with the school meal program) replace nutritionally come up with monetary alternatives—that’s when change will balanced school meals. Children’s soft drink consumption has happen.” been steadily on the rise. Results from the U.S. Department of Agriculture (USDA) Continuing Survey of Food Intakes by It appears that the public is beginning to recognize the adverse Individuals (CSFII) found that from 1989-91 to 1994-95, the consequences of these “pouring rights” agreements. According largest increase in beverage consumption among children to the Center for Commercial-Free Public Education, the list of occurred in soft drinks, while consumption of milk declined. communities where exclusive deals have been rejected is up to 67, including Philadelphia (PA), Pittsburgh (PA), Sacramento Current competitive foods policies differ from state-to-state and (CA), San Diego (CA), San Francisco (CA), Oakland (CA), even school-to-school. States are required to adhere to USDA Danbury (CT), Southfield (MI), Boulder (CO), Seminole (FL), regulations, but are free to impose stricter regulations. USDA Milwaukee (WI), and Madison (WI). And recently, the CDC regulations define competitive foods into two categories: has taken interest in the issue by requesting information from the public on policies and activities that are improving pouring 1) Foods of Minimal Nutritional Value (FMNV) - The sale of rights contracts and reducing access to competitive foods. The these foods (which have 5 percent or less of the RDI for eight ASFSA has been advocating over the past year to establish key nutrients—protein, vitamin A, vitamin C, niacin, riboflavin, authority of the Secretary of Agriculture to regulate the sale of thiamin, calcium, and iron) are prohibited during the school all foods sold throughout public schools during the school day. meal period in the food service area. Soft drinks fall under this The legislation has been introduced in both the House and the category. Senate, but Sackin said “the chance of moving the bill through on its own is marginal.” That’s why in addition to legislation, 2) All other foods offered - Regulations do not prohibit the sale pressure from health professionals, parents, teachers, and school of foods that are not considered a FMNV (which may include a board members to reject the contracts are so important. ▪ la carte sales, foods and beverages from vending machines, and second servings from reimbursable meals) at any time during the school day anywhere on school grounds. One Person Can Make A Difference Anastasia Schepers, M.S., R.D., has taken an active role in New legislation passed last fall in California will restrict the making a difference in one Long Island elementary school’s sale of soft drinks and increase reimbursement for meals served “competitive foods” purchases. “This is a subject near and to elementary and middle school children beginning in January dear to me, both as a nutritionist and a mother of three of 2004. The sale of all soft drinks will be prohibited in children between the ages of four and eleven,” says elementary schools. In middle schools, the sale of carbonated Anastasia. Through her son, Anastasia learned that less than beverages and vending machine foods that don’t meet specified optimal foods were being sold in the Lynbrook elementary nutritional standards will be prohibited from one-half hour school store in Long Island. She took her concern to the before school starts to the end of the last lunch period. Schools teacher that oversees the ordering of the school store’s will receive an increase in reimbursement for free and reduced foods—after two phone calls and one visit, the pair identified price school meals in elementary and middle schools from 13 more healthful items that could be ordered from the vendor’s cents to 23 cents per meal. Schools may also choose to take part list. Within about a month, M&Ms were gone from the in a pilot program that implements nutrition standards for all school store’s shelves and were replaced with granola bars, foods sold outside the federal meal program. Schools Farley’s fruit chews, and three flavors of baked Lays potato participating in the pilot program will be eligible to receive chips. She has since been placed on a subcommittee with the grants that can be used to develop nutrition and physical school district’s Director of Health, Physical Education, and activity policies. While passage of the legislation is a step in Athletics to investigate what foods are being offered in the the right direction, there is a catch—the legislation is subject to district’s vending machines. “I thought I was going to approval of funding appropriations in California’s Budget Act encounter much more difficulty than I actually did,” says of 2003. Anastasia. Anastasia shows even small changes, and one person, help to make a difference. ▪ Page 4 The Grapevine Book Review: Eat, Drink, and Be Healthy: The Harvard Medical School Guide To Healthy Eating Walter C. Willet, M.D., Dr. P.H. — Co-Developed with the Harvard School of Public Health Review by Rachel Fassler, Applied Physiology and Nutrition Program Walter C. Willet, M.D., Dr. P.H., Chairman of the Department of Nutrition at the Harvard School of Public Health and a professor of medicine at the Harvard Medical School, is well known for investigating the connections between dietary factors and chronic diseases through epidemiologic research. In Eat, Drink, and Be Healthy, Dr. Willet summarizes over 20 years of diet research for the public in an easy to read text. Willet also introduces his version of a food pyramid called the Healthy Eating Pyramid. The Healthy Eating Pyramid differs from the USDA pyramid in that whole grains and plant oils are at the base; nuts and legumes, and fish, poultry, and eggs are separated from red meat (which is at the top, along with refined carbohydrates); and calcium supplements are included as an option for dairy. In the book, Willet argues that there is no “calcium emergency” like the country is led to believe by the dairy industry and that eliminating all of the fat in our diets is a common mistake people make. Willet further argues that the USDA pyramid is flawed because it may encourage consumption of refined carbohydrates, when it should emphasize whole grains. He questions the USDA pyramid for placing red meat in the same category as other sources of protein and finds that the USDA pyramid falls short by not addressing weight gain, exercise, alcohol and vitamins. He argues that a vital key to remaining healthy is maintaining a healthy weight, and that weight is directly linked to a variety of diseases. Because weight control is so critical to good health, he argues, its exclusion from the USDA pyramid is a serious omission. Although somewhat controversial, the book covers many current issues and debates in the field of nutrition. It is engaging and informative and is sure to stimulate discussion on many topics currently being analyzed. Eat, Drink, and Be Healthy is a thought provoking read for nutrition students and professionals that challenges many of today’s current dietary recommendations. ▪ To view the Healthy Eating Pyramid, go to www.hsph.harvard.edu/now/aug24/index.html. The “Nutrition Transition” By Lindi Chun, Nutrition and Public Health Program A recent United Nations (U.N.) Food the New York Obesity Research Center considered a problem of wealthy and Agriculture Organization (FAO) at St. Luke’s-Roosevelt Hospital Center, developed nations, but now obesity is Focus report states, “Obesity in the says that increasingly, developed also becoming a concern of developing developing world can be seen as a result nations are becoming urbanized. nations. However, an increase in the of a series of changes in the diet, Projections by the U.N. say that by the availability of foods doesn’t necessarily physical activity, health and nutrition, year 2005, populations in urban areas mean the poor are being better fed. collectively known as the ‘nutrition are expected to surpass rural areas and Obesity can often mask underlying transition.’ As poor countries become by 2020, 60 percent of the global vitamin and mineral deficiencies. And, prosperous, they acquire some of the population will live in urban areas. FAO notes, the priority remains to fight benefits along with some of the Urbanization contributes to a rise in hunger first then obesity in developing problems of industrialized nations. obesity because less physical exertion is nations. Dr. Prakash Shetty, Chief of These include obesity.” Take China for required of urban work, cities offer FAO’s Nutrition Planning, Assessment example—the FAO Focus report says greater ranges of food choices at a lower and Evaluation Service, says in the FAO that in China the number of overweight prices, and there is an increase in Focus report, “Obesity is not as big a people jumped from less than 10 percent i mp o r tatio n o f fo o d f r o m t he problem as hunger in developing to 15 percent in just three years. industrialized world. Traditional diets countries. First, we need to make sure based on grains and vegetables are being that people are eating enough food and A review on the causes and implications replaced with more “Western diets,” the right foods.” ▪ of obesity in developing countries which are higher in saturated fat and published in Food, Nutrition, and sugar and lower in fiber. To learn more on the “Nutrition Agriculture, FAO’s on-line journal, by Transition” go to www.fao.org. Daniel J. Hoffman, Research Fellow at Overweight and obesity have long been The Grapevine Page 5 Staying Informed After Graduate School: Advice from Dr. Lora Sporny You’ve taken the required courses, read the texts, listened to Other professional organizations include the American Society lectures, written papers, and passed the exams—now the time for Clinical Nutrition, the American Society for Nutritional has come to graduate. Fully armed with new knowledge and Sciences, the American College of Nutrition, the American refined skills, you are ready to take on the world and begin Diabetes Association, the American College of Sports practicing as a professional. Have you thought about how you Medicine, the American Public Health Association and many will stay informed of the latest research, news, and current others. events in the field of nutrition once the supportive environment of a regular academic setting is no more? The Grapevine: How are you made aware of professional seminars, conferences or meetings? We asked Lora Sporny, Ed.D., M.Ed., M.A., R.D., Adjunct Dr. Sporny: High-quality seminars on a variety of nutrition Associate Professor of Nutrition and Education at Teachers topics are provided by MED2000 (817-354-3900) and College, for advice on staying up-to-date. In addition to having Biomed/INR (925-609-2820). Each noncommercial company a doctorate in nutrition and education and being a registered sponsors about three or four different seminars yearly and dietitian, Dr. Sporny has a Master of Arts in science these day-long seminars are given in cities throughout the journalism—so she really knows how to get the scoop on country. Telephone MED2000 and Biomed/INR to be placed what’s happening in the field. Here’s what she had to say: on their mailing list for seminar announcements. I'm made aware of other seminars and conferences through journal The Grapevine: Which print publications, for example announcements, organization websites and mailings. If you peer-reviewed journals and professional newsletters, do become an ADA member, announcements arrive in the mail you read? on a regular basis. Also, you can find out when nutrition- Dr. Sporny: I subscribe to and routinely read the following: related conferences and meetings are held by going to Consumer Reports on Health (800-234-1645), University of www.nutrition.gov. Under the “resources” section, click on California, Berkeley Wellness Letter (386-447-6328), Tufts “publications” and then “calendar of nutrition meetings, University Health and Nutrition Letter (800-274-7581), conferences, and activities”. The calendar lists upcoming Nutrition Action Health Letter (202-332-9110, ext 393), events up to the year 2008. Health News (877-717-8932), Environmental Nutrition (800- 829-5384), The Dietary Supplement (301-881-7008), The Grapevine: If you could give students one piece of Communicating Food for Health (800-462-2352), Today's advice on staying current in the field, what would it be? Dietitian (800-278-4400), Nutrition Today (800-638-6423), Dr. Sporny: My recommendation to all students is to read the Nutrition Reviews (800-627-0629), Journal of The American New York Times daily, especially the Science Times section on Dietetic Association (800-877-1600), and CA: A Cancer Tuesdays. In addition, a weekly news magazine such as Journal for Clinicians (404-929-6824). I read other journals, Newsweek is a must. To begin, subscribe to a couple of magazines and newsletters at the library. Additional newsletters (such as Nutrition Action Health Letter by the publications worth reading are: Journal of Nutrition Center for Science in the Public Interest and Consumer Education, American Journal of Clinical Nutrition, Journal of Reports on Health by Consumers Union). For in-depth Nutrition, Nutrition in Clinical Care, Journal of the American coverage, Nutrition Today, Nutrition Reviews and Today’s College of Nutrition, Journal of the American College of Dietitian are great magazines for review-style nutrition articles Sports Medicine, International Journal of Sports Nutrition, and commentary. My advice is to begin by subscribing to Journal of Sports Medicine and Physical Fitness, The Nutrition Today or Today’s Dietitian. If and when you choose Physician and Sportsmedicine, FDA Consumer, Nutrition a specialty area of practice, you should subscribe to the Insights, Harvard Health Letter, Nutrition and the M.D. and publications specific to that area. many others. You can use a search engine like www.google.com to look up these publications and get The Grapevine: That sounds like more than one piece of information on how to subscribe. advice, Dr. Sporny. Is that because it takes more than one way to stay informed? The Grapevine: Which professional organizations do you Dr. Sporny: To be an effective practitioner, you must stay recommend students become members? current on technical issues pertaining to your chosen area of Dr. Sporny: Membership in professional organizations is a specialization. In addition, you must stay abreast of nutrition personal choice. Since The American Dietetic Association is information that is made available to the public through the credentialing agency for the “R.D.” and represents the newspapers, magazines, newsletters and other media. We must largest number of clinical dietetics practitioners, I recommend remain several steps ahead of our clients. Much is expected of that all become members. The Society for Nutrition Education us. But when you enjoy what you do, staying current is a is a valuable organization for those who wish to apply their pleasure! ▪ expertise through quality education of individuals and groups. Page 6 The Grapevine States Fall Short in Meeting Physical Education Recommendations By Emily K. Bergeron, Nutrition and Public Health Program Health professionals have long known school students take physical education Working towards improvement the benefits of physical education for for just one year between 9th and 12th Some states, namely California, children: motor skill and bone grades. Kentucky, Maine, New York, South development, improved self-esteem, Carolina and Vermont, have begun to stress reduction, practice communicating develop state tests for physical education with peers, and of particular interest Adolescents in grades 9-12 and health. Making states accountable today, weight management and obesity participating in daily for student achievement on these tests prevention. The federal government is may help move physical education to now recognizing these benefits and has physical education fell higher priority ranks. In addition, issued several reports with specific from 42 percent in 1991 to Healthy People 2010 continues to recommendations for physical education 29 percent in 2000. specify the importance of physical for the nation. Donna E. Shalala, former education and includes three objectives: U.S. Secretary of Health and Human 1) Increase the proportion of the nation’s Services, stated in the 1996 Surgeon NASPE says in the report, “…most public and private schools that require General’s Report, Physical Activity and states, in the face of the growing crisis in daily physical education for all students, Health, “Schools and universities need to childhood obesity, Type II diabetes and 2) Increase the proportion of adolescents reintroduce daily, quality physical of increasing sedentary lifestyles, have who participate in daily school physical activity as a key component of a taken no action to provide education education, and 3) Increase the proportion comprehensive education.” Physical about the physical dimension of of adolescents who spend at least 50 education has been a part of the nation’s individuals.” In similar findings, Healthy percent of school physical education health objectives since 1990, included in People 2000 reports that adolescents in class time being physically active. both Healthy People 2000 and Healthy grades 9-12 participating in daily Approval of the Physical Education for People 2010. And, most recently, the physical education fell from 42 percent Progress Act (PEP) in 1999 for report The Surgeon General's Call To in 1991 to 29 percent in 2000. The target supplemental funding of physical Action To Prevent and Decrease goal for the year 2000 was to reach 50 education programs appears to be a start Overweight and Obesity, named physical percent. in obtaining federal funding for state education as one of 15 activities of mandated programs. Through PEP, in national priority, stating that the nation Why aren’t states requiring physical 2001, $5 million in grants was divided must take action to, “Ensure daily, education? among 18 school districts to supplement quality physical education in all school The 2001 Shape of the Nation report physical education programs and this grades. Such education can develop the identifies that there is no federal law that year, $50 million in grants will be knowledge, attitudes, skills, behaviors, requires physical education to be awarded. and confidence needed to be physically provided to students in the American active for life.” education system, nor are there any Dr. Judith Young, Executive Director of incentives for offering physical NASPE, said health professionals can Yet, despite recommendations by the education. States are responsible for help work towards improvement in federal government for states to require ma n d a t i n g p h ys i ca l ed uca t io n physical education requirements by physical education for all students in requirements for schools, and often “advocating for good health for children kindergarten through 12th grade, states times, while states may set some general and coordinating the school health have fallen short in meeting the requirements, this responsibility is effort.” Health professionals can also recommendations. That’s the conclusion handed off to local school districts. help by staying informed of the policies drawn by the 2001 Shape of the Nation When school districts are faced with in the states they practice. To learn more Report, a report conducted by the budget limitations, physical education is about state policies and how school National Association for Sport and often placed low in priority. And now, districts can apply for PEP grants, go to Physical Education (NASPE) to assess schools are being held accountable for the website for the American Alliance the status of physical education in the student performance on standardized for Health Physical Education U.S. The report found that since 1997, testing of subjects (particularly reading Recreation and Dance at Illinois has been the only state to require and math). Subjects like physical www.aahperd.org. ▪ daily physical education for all students education that do not require in kindergarten through 12th grade. The standardized testing are often put on the report also said that the majority of high back burner. The Grapevine Page 7 Dietetic Internship Update: A Student’s Perspective By Bridget Quinn, Nutrition and Public Health Program Although I am only just approaching with the patient, doctors, hospital staff With the incredible growth that has the halfway mark of my dietetic and extensive research on this case result accompanied the experiences in the first internship, I must admit I never thought in comprehensive knowledge of our half of the internship, I am excited about it possible to learn so much in such a patient’s condition, but it also served as a what lies ahead in the final modules. My short period of time. For all the rigorous “grand finale” to the clinical experience third community rotation will be the academic workloads that are needed to as we presented our case studies to our Community Health Resource at St. build a strong foundation in nutrition, I classmates and preceptors. Vincent’s Hospital and Medical Center, feel that nothing can quite compare to which will complete the community the personal and professional growth that My first community module rotation module of the internship. Foodservice occurs as a dietetic intern. I am not just was at Harlem Hospital’s Family Care will be the next module followed by referring to the immeasurable gains of Center, an outpatient clinic for people research and independent practice. With both knowledge and skills, although that infected and affected by HIV. I was the option to choose an independent too exceeded my expectations. Of equal responsible for the nutrition education practice site to match an area of personal importance, I’ve found the greatest component of their program. This interest, I hope to be completing this reward so far to involve acquiring new required me to develop lesson plans, module in an outpatient diabetes care perspectives and challenging old ones, materials, and hold the classes. The center, as my interest in this area of enhancing leadership skills, and settings for these education sessions nutrition has grown significantly through networking with nutrition professionals. varied, including both large and small my experiences in the internship. waiting room sessions, small group For my clinical module rotation I was classes, and an after school community If I could give future interns a few assigned to Columbia Presbyterian group. In addition, I provided nutrition words of advice on surviving the dietetic Medical Center. During the first two counseling and assisted with a study on internship, I would say the following: weeks I found myself completing lipodystrophy and antiretroviral therapy. roll up your sleeves, jump right in, and nutrition screenings and evaluations on Harlem Hospital was an incredible remember that attitude, your enthusiasm patients, by week three, assessments and setting as it offered a multitude of and desire to learn, ability to work well follow-ups, and by week eight I was on opportunities to perform nutrition with others, and your belief in the staff relief. It didn’t take me long to education with staff that supported my importance of nutrition, regardless of realize that even as an intern, each and work. setting, is just as important as your every day my efforts were influencing academic preparation. ▪ the quality of patient care and were truly At my current community module making a difference. During my rotation, the United Way of New York rotations I had many memorable City, I am working with the Hunger experiences—seeing jaundice for the Prevention Nutrition Assistance Program first time (aside from glossy textbook (HPNAP). So far my work has included For more information on the photos), calculating my first tube writing a newsletter for emergency food Teachers College Dietetic feeding, and working with transplant programs and working on a food quality Internship Program, go to the patients. For our final project, a case project (comparing the quality of food in pantries to nutrition benchmarks). Program in Nutrition’s study in which we were to follow a patient with a nutritionally complex case Through such projects I am being website at: from admission to discharge, I chose a exposed to the vast network of www.tc.columbia.edu/ patient who had undergone a bilateral emergency food programs in New York ~academic/nutri/DIP.htm. lung transplant from a rare disease of City and the surrounding boroughs. unknown origin. Not only did working Page 8 The Grapevine (Sustainable Agriculture, continued from page 1) 12,000 acres of no-till cropland and has been working with no- with different crops each season. till systems for the past 16 years. In conventional tillage, prior to planting, the field is plowed by cutting off weed shoots and Much of the food is now produced in cities on high intensity turning the soil over. Fertilizers and pesticides are often organic farms, intensive gardens, and personal pieces of land applied. According to Dr. Peiretti, this breaks down the soil with 200,000 people participating. It has helped to eliminate and releases carbon dioxide. The crop is then planted by urban waste and increase productive use of urban green space. tractor where a drill makes furrows in the field dropping seeds Though it doesn’t satisfy all the food needs of a city, it has led into the furrow and covering them up with a think layer of to a change in the way the people act and think. The new soil. Erosion occurs due to topsoil blowing away when nothing model has increased food security and improved the health of is growing to hold the soil. Contamination may occur from the ecosystem. But as Dr. Cruz concludes, “Only on the long- dust storms that can blow from continent to continent. No-till term basis will we be able to evaluate the permanence and farming helps to abate these problems. With no-till farming, impacts of current practices.” the farmer leaves the vegetative cover on the field and cuts a small slit in the field where the seeds are to be planted. IPM “Alternatives to Pesticides and Sustainable Agriculture in and other environmentally friendly practices are employed, Africa” though some herbicides are used. The advantages are Dr. Abou Thaim of the Africa Pesticide Action Network increased carbon in the soil, water retention, soil organic (PAN) discussed a process for training farmers to use matter, crop yields, and decreased water quality problems and Integrated Pest Management (IPM) for cotton production soil erosion. called the Farmer Field School (FFS). In the FFS, farmers participate in hands-on observation of IPM. Two fields of The solutions discussed by the symposium’s speakers have cotton are planted; one is treated in the conventional way begun to address the problems of local communities with using pesticides and the other using IPM. Farmers observe science and technology in an attempt to increase crop yields in each field at regular intervals looking at the life cycle of the a sustainable way and decrease hunger. The solutions have insects and their natural predators as well as the development provided more food and income for local communities. Dr. of the plants. Results have consistently indicated a higher Richard Levins of the Harvard School of Public Health production at a lower cost on the IPM field. IPM makes summarized the symposium by stressing the importance of farmers less dependent on chemicals, ensures food security, integrating both large and small units of production, planting improves living conditions on small-scale farms and increases and “gentle” technology, and starting with the ecosystem then soil fertility with organics. This approach is a promising adapting technology to it. ▪ method of teaching farmers how to implement initiatives in sustainable agriculture. Two New Arrivals to the Nutrition Program! “A Multipurpose Rice Field: Experiences from Farmers in Cambodia Status” Dr. Yang Saing Koma of the Centre d'Etude et de Congratulations to Pamela Koch, Developpement spoke on the System of Intensification of Rice her husband Aaron and son Production (SRI) and Diversification and stressed the Benjamin. Garrison Lee was importance of the multi-purpose rice field. Certain aspects of born on October 23, 2001 and rice production change under SRI. Normally, irrigated, rainfed weighed 8 pounds, 4 ounces. rice fields are plowed when the rainy season begins. Seeds are then either spread or drilled into the soil or seedlings sewn in Pam has been back in the office nursery beds are transplanted in large clumps 21 days after part-time since mid-December sowing. With SIR, rice seedlings are transplanted singly after and at this point Garrison is still 1-2 weeks and widely spaced. This encourages stronger root her officemate. development. Instead of being flooded, rice fields are only kept moist during vegetative growth period. Organic mulch is placed around the plants, which improves aeration. Natural Congratulations to Christina pest control is achieved with frogs and ducks living in the Costa and her husband German. field. Though this type of cultivation requires more labor, the Sophia Elizabeth was born on type of labor is less intensive. These techniques have increased January 22, 2002 and weighed 7 rice yields by over 150 percent. pounds. Christina will be back “Economic and Environmental Benefits of No-Till Systems in the office on April 22. in Latin America” Dr. Roberto Peiretti of the Latin American Confederation of Farmers for Sustainable Agriculture Systems manages about The Grapevine Page 9 Defining Overweight and Obesity in Children By Lauren Weiss, M.S., Nutrition and Education Program Childhood overweight and obesity are increasing at an for use in children. In 1994, an expert committee organized by alarming rate. The latest findings from the Centers for Disease the CDC on the assessment and treatment of childhood obesity Control and Prevention's (CDC) 1999 National Health and recommended that BMI should be used routinely to screen for Nutrition Examination Survey (NHANES IV) show that 13 overweight adolescents. In 1997, a second committee percent of children ages 6-11 years are overweight and 14 concluded that BMI percentiles should be used to screen for percent of teenagers aged 12-19 years are overweight, both up overweight children in ages two and older. In 2000, this led to from 11 percent in the previous 1988-1994 NHANES III the introduction of two new CDC BMI-for-age charts for boys survey. and girls, 2 to 20 years of age. The new BMI-for-age charts consist of a series of BMI percentiles curves and incorporate But exactly how is overweight and obesity defined in the phenomenon of “adiposity rebound”. From these new children? In recent years, there has been controversy charts, it was determined that in children, a BMI-for-age >85th surrounding the exact definition and cutoff points that should percentile is considered at risk of overweight and a BMI-for- be used to determine prevalence and identify children at risk age >95th percentile is classified as overweight. There is no for becoming overweight or obese. Body Mass Index [BMI = established percentile associated with an obesity classification weight (kg)/height(m2)] and skinfold thickness are the most in children. These new BMI-for-age charts allow healthcare commonly used techniques. Concern has been raised with the professionals and parents to compare children to “normal” skinfold approach because the results have not been BMI ranges and identify children at risk for overweight. In reproducible with this measurement. Presently, BMI, a height addition, the new overweight definition has been applied to and weight based measurement, is the most widely accepted data from the earlier NHANES, thereby allowing for current criteria. However, caution must be exercised when using BMI comparisons to reflect true changes in overweight trends in to classify youth as overweight or obese because BMI changes children. dramatically with age during childhood and adolescence. During normal growth and maturation, changes in body Overweight and obesity are determined somewhat differently proportions, bone mass, muscle mass, and fat mass occur at in adults. While classification of overweight in children use different times and rates. A normal childhood developmental BMI percentiles, the classification in adults uses straight BMI process known as “adiposity rebound” usually occurs between values. BMI cutoff points for adults use one fixed number, four and eight years of age and is characterized by an upward regardless of age or sex. A healthy BMI for adults is between trend in BMI for the remainder of growing years after a low 18.5 and 24.9, while 25.0 to 29.9 is considered overweight and point is reached in earlier years. Current investigations show 30.0 is considered obese. BMI ranges are based on the effect that earlier “adiposity rebound” may be associated with an body weight has on disease and death. BMI is the most increased risk of childhood and adult overweight and obesity. commonly used approach to determine if adults are This time period in which “rebound” occurs is important for overweight or obese and now the BMI percentiles are the detection and prevention of the onset of overweight in recommended for children. This new approach will hopefully children. assist experts in more effectively identifying youth that could be at risk for overweight or obesity. ▪ In the last several years, BMI has received increased attention Fresh off the vine... The U.S. Food & Drug Administration (FDA) has developed a consumer information resource called, “Tips For The Savvy Supplement User: Making Informed Decisions and Evaluating Information.” The resource is intended to help consumers understand dietary supple- ment information and includes basic points to consider, tips on searching the web for supplement information, and evaluating medical and health-related research. It is available on the web at: www.cfsan.fda.gov/~dms/ds-savvy.html. What is really known about the popular weight loss diets that have permeated the market? Is the information scientifically sound? “Popular Diets: A Scientific Review” is a comprehensive review of the scientific literature on popular diets that fall into one of three cate- gories: 1) high-fat, low-carbohydrate, e.g. Dr. Atkins’ New Diet Revolution , 2) moderate-fat, e.g. Weight Watchers, and 3) low- and very-low fat, e.g. Dr. Dean Ornish’s Program for Reversing Heart Disease. The diets’ effect on weight loss, metabolic parameters, nutri- tional adequacy, and hunger and compliance are discussed. The reference for the review article is: Freedman M.R, King J., and Kennedy E. (2001) Popular Diets: A Scientific Review. Obesity Research. 9(1):1s-40s. On March 13th, 2002, New York Senator Charles E. Schumer issued a letter to the U.S Department of Agriculture (USDA) urging USDA to begin actively promoting milk vending machines in schools throughout New York and the country. Schumer cited the success of milk dispensing machines called “Vendi-Milk” that have been installed in four school districts in the Buffalo area. To read Senator Schumer’s letter, go to www..senate.gov/~schumer/. Click on “press room”, then “latest news” to obtain the press release and link to the letter. Page 10 The Grapevine The Search is On! The Grapevine is seeking a new editor for the 2002-2003 academic year. This is an excellent opportunity to gain experience in editing, writing, and publishing; working with students and faculty; and staying current on issues in nutrition, public health, and exercise physiology. The editor is involved in all aspects of newsletter publication from generating storylines to designing the layout. This is a part-time position requiring approximately 10-15 hours per week in exchange for 6 credits worth of reimbursement (3 credits per semester). For more information, contact Emily Bergeron at: firstname.lastname@example.org. The Grapevine Page 11 FREE e-seminars Available through Writers and Researchers Wanted Columbia Interactive The summer issue of The Grapevine will feature a Access FREE e-seminars on a variety of topics right from your computer. Columbia Interactive allows special alumni advocacy edition. Students are students, faculty, staff, and alumni to easily access e- needed to assist with composing alumni and faculty learning resources developed by Columbia University. The time length for e-seminars range from 1-5 hours briefs and researching and writing articles related and can be viewed in full at one time or in intervals to nutrition advocacy and policy. Interested stu- around your schedule. Browse the subject areas according to your interests and register for seminars as dents should contact email@example.com for directed by the website. Subject areas include: more information. ▪ architecture ▪ information technology ▪ arts ▪ journalism ▪ business and finance ▪ law ▪ culture and society ▪ literature Mentor Program is Here! ▪ engineering and applied ▪ political science and science social policy ▪ history ▪ philosophy and religion Remember what it was like being a new student at TC? Remember registration, trying to find the nutrition department, ▪ public health ▪ science trying to decide your class schedule for the next couple years, having a lot of questions but not knowing who to ask? If you remember (and I know you do) then you know why the nutrition Check out some of the currently available e-seminars: department has just developed a Mentor Program. The Mentor Program will pair new students this fall with students currently in the program to give new students access to our ▪ The Politics of Health Care – E-Seminar 1, The immeasurable advice and wisdom. We can help their introduction Roots of Health Care in the United States to TC be comfortable and seamless! ▪ Medical Ecology: Environmental Disturbance and To run the program successfully, we need volunteers! Any and all Disease – E-Seminar 2, The Normal Environment: students can volunteer whether you've been here for one year or The Way Things Are Now many. I promise being a mentor will be easy and immensely gratifying. All that is required of a mentor is: one e-mail or ▪ Biography of the AIDS Epidemic: Creating an telephone correspondence with your new mentee at the end of the Oral-History Project – E-Seminar 1, From Idea to summer your presence at a Student/Mentor lunch (catered!) Interview: Launching an Oral-History Project during the first week of fall semester and a follow-up phone call to your mentee a couple weeks into the semester ▪ America’s Battle for a Cure: The Culture and Politics of Breast Cancer Diagnosis and Treatment Become a mentor and put all you've learned from your experiences at TC to good use today! Please send an email to ▪ Environmental Sustainability: Perspectives on the Bridgette Burris at firstname.lastname@example.org if you are World interested. And thanks to all the mentors and mentees who participated in our pilot program this spring. The program is here To access Columbia Interactive, go to http:// because of you! ci.columbia.edu/ci/.