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Although low-income youth are likely to have low or less frequent fruit and vegetable intake, current understanding of the influences on intake in youth is limited. A systematic review of quantitative research on determinants of fruit and vegetable intake among low-income youth (i.e., persons aged <20 years) was conducted. The aims were to identify which determinants have been studied and which are consistently associated with intake. Fifty-eight papers published between 2003 and August 2013 were included. Across studies, 85 unique determinants were identified. Those best supported by evidence were race/ethnicity (with intake consistently higher among Hispanic as compared with African American and white youth), fruit and vegetable preferences, and maternal fruit and vegetable intake. For many potential determinants, the consistency of evidence could not be examined because of a lack of studies. Findings highlight racial/ethnic differences in fruit and vegetable intake and influences on intake that should be considered when designing dietary interventions for low-income youth. Further research on intake determinants in this at-risk population is needed to establish an evidence base to guide interventions., (© 2014 International Life Sciences Institute.)

The importance of creating healthier work environments by providing healthy foods and beverages in worksite cafeterias, in on-site vending machines, and at meetings and conferences is drawing increasing attention. Large employers, federal and state governments, and hospital systems are significant purchasers and providers of food and beverages. The American Heart Association, federal government, and other organizations have created procurement standards to guide healthy purchasing by these entities. There is a need to review how procurement standards are currently implemented, to identify important minimum criteria for evaluating health and purchasing outcomes, and to recognize significant barriers and challenges to implementation, along with success stories. The purpose of this policy paper is to describe the role of food-and-beverage environment and procurement policy standards in creating healthier worksite environments; to review recently created national model standards; to identify elements across the standards that are important to consider for incorporation into policies; and to delineate issues to address as standards are implemented across the country., (© 2014 International Life Sciences Institute.)

The most widely used method for estimating dietary zinc requirements is the factorial approach, in which it is assumed, in adults, that the physiological zinc requirement is the lowest intake that replaces endogenous zinc losses. Presented here are the results of two reviews: a narrative review of zinc losses from the human body and a systematic review of factors affecting zinc bioavailability in adult and elderly populations. The narrative review presents data on losses from integumental and excretory routes, obtained from 29 papers published up to April 2013. The systematic review includes a total of 87 publications describing dietary factors that impact zinc bioavailability, 30 of which examined phytate. A meta-analysis revealed an overall lowering of fractional zinc absorption by 0.14 (45% of control values) when the phytate : zinc molar ratio of the test meal or diet was greater than 15. These reviews provide a comprehensive resource for use in the setting of human dietary zinc requirements and emphasize the need for more high-quality data to improve estimates of zinc losses and gains., (© 2014 International Life Sciences Institute.)

Identification and management of sarcopenia are limited by lack of reliable simple approaches to assess muscle mass. The aim of this review is to identify and evaluate simple methods to quantify muscle mass/volume of adults. Using Cochrane Review methodology, Medline (1946-2012), Embase (1974-2012), Web of Science (1898-2012), PubMed, and the Cochrane Library (to 08/2012) were searched for publications that included prediction equations (from anthropometric measurements) to estimate muscle mass by magnetic resonance imaging (MRI) in adults. Of 257 papers identified from primary search terms, 12 studies met the inclusion criteria. Most studies (n = 10) assessed only regional/limb muscle mass/volume. Many studies (n = 9) assessed limb circumference adjusted for skinfold thickness, which limits their practical applications. Only two included validation in separate subject-samples, and two reported relationships between whole-body MRI-measured muscle mass and anthropometry beyond linear correlations. In conclusion, one simple prediction equation shows promise, but it has not been validated in a separate population with different investigators. Furthermore, it did not incorporate widely available trunk/limb girths, which have offered valuable prediction of body composition in other studies., (© 2014 International Life Sciences Institute.)

The purpose of this paper is to succinctly review the origin of US dietary surveys, the challenges and limitations of obtaining dietary intake data, the National Nutrition Monitoring and Related Research Act of 1990, the integrated US federal food survey, and the development of the US Department of Agriculture's (USDA) automated multiple-pass method. The USDA has monitored the food consumption patterns of Americans since the late 1890 s. In 2002, the US Department of Health and Human Services and the USDA integrated their data collection efforts, with data now collected on a continuous basis. Two 24-hour dietary recalls are obtained using USDA's automated multiple-pass method. By combining their respective areas of expertise, the USDA and the Department of Health and Human Services have increased research opportunities for scientists and provided data foundational for establishing programs and public policy., (© 2012 International Life Sciences Institute.)

This review provides a classification of public policies to promote healthier eating as well as a structured mapping of existing measures in Europe. Complete coverage of alternative policy types was ensured by complementing the review with a selection of major interventions from outside Europe. Under the auspices of the Seventh Framework Programme's Eatwell Project, funded by the European Commission, researchers from five countries reviewed a representative selection of policy actions based on scientific papers, policy documents, grey literature, government websites, other policy reviews, and interviews with policy-makers. This work resulted in a list of 129 policy interventions, 121 of which were in Europe. For each type of policy, a critical review of its effectiveness was conducted, based on the evidence currently available. The results of this review indicate a need exists for a more systematic and accurate evaluation of government-level interventions as well as for a stronger focus on actual behavioral change rather than changes in attitude or intentions alone. The currently available evidence is very heterogeneous across policy types and is often incomplete., (© 2012 International Life Sciences Institute.)

This review considers the potential of certain dietary supplements, including garlic, Ginkgo biloba, ginger, ginseng, fish oil, and vitamin E, to interfere with hemostasis. Dietary supplements are common components of the diet in the United States, with about half the US adult population taking some type of dietary supplement regularly. It has been suggested that some supplements could adversely affect coagulation when taken alone or in combination with antiplatelet medications. Supplements could alter hemostasis by a variety of mechanisms, such as reducing platelet aggregation or inhibiting arachidonic acid, a cellular signaling messenger and inflammatory intermediate. To conduct this review, multiple databases were searched using a variety of search terms to ensure relevant papers were located. Moderate to severe adverse events, such as spinal epidural hematoma, spontaneous intracerebral hemorrhage, retrobulbar hemorrhage, subarachnoid hemorrhage, spontaneous hyphema, and postoperative bleeding, have occasionally been anecdotally associated with consumption of dietary supplements. However, the number of controlled studies in the literature is too limited to demonstrate consistent anticoagulant effects of dietary supplements alone or in combination with drug therapy., (© 2012 International Life Sciences Institute.)

The aim of the present review was to examine the existing literature on the effectiveness of economic incentives for producing sound nutritional behavior in schools. Studies published in the English-language literature that included baseline and/or outcome data regarding food and beverage intake of schoolchildren were eligible for inclusion. A systematic search of the literature was conducted to identify relevant primary studies and relevant systematic reviews of primary studies. Altogether, 3,472 research publications were identified in the systematic search, of which 50 papers were retrieved. Of these, 30 publications representing 28 studies fulfilled the criteria for inclusion. The studies addressing price incentives suggest that such incentives are effective for altering consumption in the school setting. Other types of economic incentives have been included in combined intervention schemes, but the inclusion of other intervention elements makes it difficult to draw conclusions about the effectiveness of the economic incentive instruments per se in these studies., (© 2011 International Life Sciences Institute.)

Preeclampsia (PE) accounts for about one-quarter of the cases of maternal mortality and ranks second among the causes of pregnancy-associated maternal deaths in Canada and worldwide. The identification of an effective strategy to prevent PE is a priority and a challenge for research in obstetrics. Progress has been hampered by inadequate understanding of the underlying etiology of the disease. The role of maternal diet in the etiology of PE has recently received increased attention. The objective of this paper is to provide an overview of the literature concerning 1) the current understanding of the pathogenesis of PE, 2) the biological plausibility and potential mechanisms underlying the associations between maternal dietary exposures, nutrition, and the risk of PE, and 3) the epidemiological findings of maternal nutrient intake in relation to the risk of PE.

Interest in the role of polyunsaturated fatty acids (PUFAs), particularly long-chain (LC) omega-3 (n-3) PUFAs, in mental health is increasing. This review investigates whether n-3 PUFA levels are abnormal in people with three prevalent mental health problems - attention deficit hyperactivity disorder, depression, and dementia. Data sources included PubMed, Web of Science, and bibliographies of papers published in English that describe PUFA levels in the circulation of individuals who have these mental health conditions. Although abnormal blood PUFA levels were reported in a number of studies, weighted comparisons of PUFA status showed no significant differences overall between people with mental health problems and controls. Whether those with low n-3 PUFA status are likely to be more responsive to n-3 PUFA supplementation is not yet resolved. Further studies assessing PUFA levels and mental status with greater uniformity are required in order to clarify the relationship between LC n-3 PUFA status and mental health.

Inflammatory bowel diseases (IBD) arise from multiple causes, including environmental factors, gut microflora, immunity, and genetic predispositions. In the course of IBD, immune homeostasis and intestinal mucosa barrier integrity are impaired. Among natural preventive treatments that have been identified to date, polyphenols appear as promising candidates. They have been shown to protect against several diseases, including cardiovascular diseases and cancers, and they have anti-inflammatory properties in non-intestinal models. This paper will review the literature that has described to date some effects of polyphenols on intestinal inflammation. Studies, conducted using in vivo and in vitro models, provide evidence that pure polyphenolic compounds and natural polyphenolic plant extracts can modulate intestinal inflammation.

Available information on dietary patterns (multiple dietary components operationalized as a single exposure) and cancer is still sparse. This review presents papers published to date that have identified dietary patterns according to all the existing approaches and have assessed their association with breast cancer. Nineteen articles published since 1995 were identified based on studies conducted in various populations across many countries. The majority of them identified a posteriori dietary patterns, mainly using principal component factor analysis. Six studies did not find associations between any of the identified dietary patterns and breast cancer. Nine studies identified one dietary pattern significantly associated with breast cancer, and the remaining four identified two to four dietary patterns related to breast cancer. Although the body of literature has recently increased, a meaningful assessment of the association between dietary patterns and breast cancer still calls for extra effort to refine the statistical techniques and to address the issue of reproducibility of dietary patterns.

This paper presents the results of a study that aimed to describe the prevalence and evolution of metabolic syndrome (MetS) in the Mediterranean population of Catalonia, Spain, between 1992-1993 and 2002-2003 by applying the National Cholesterol Education Program's Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) definitions. Data from two cross-sectional population-based surveys were used (ENCAT 1992-1993 [n = 820] and 2002-2003 [n = 1,384]). Applying IDF definitions, MetS tended to increase (P = 0.08), from 25% in 1992-1993 to 28.5% in 2002-2003. Applying ATPIII definitions, MetS prevalence was lower, and it increased significantly (P < 0.001) from 18.4% in 1992-1993 to 24.8% in 2002-2003. MetS prevalence is high and has increased significantly in the last decade in Catalonia.

This paper presents some of the most commonly utilized indicators to assess food and nutritional status. With respect to the indicators reflecting food access, those addressing poverty as well as food consumption are included. In addition, a variety of serum biochemical measures for the estimation of iron nutritional status and anemia are discussed; it is recommended that some of these be adjusted to account for sex, age, physiological status, and altitude above sea level.

Assessment of micronutrient status is a major concern in public health nutrition, yet there are serious limitations to the indicators currently available. This paper presents the merits of these indicators along with their drawbacks, which include cost, lack of congruence between cutoffs denoting deficiency and adverse functional consequences, and inconsistent methods of evaluating the confounding effects of infections on micronutrient status indicators. Methods for assessing the functional consequences of micronutrient deficiencies are even less well developed; their usefulness would be enhanced by a greater focus on outcomes known to be influenced by deficiencies. Although there have been notable breakthroughs, further improvements in methods to assess micronutrient status are urgently needed.

The purpose of this paper is to present a review of opportunities and challenges for future progress in building intercountry, regional, and global alliances for public health nutrition training. Drawing on experiences from developing, implementing, and evaluating public health nutrition training in Australasia, Europe, and the Middle East, suggestions are provided for building a network of global training activities. Opportunities are described in areas such as standardization of course competencies and registration schemes, resource sharing, student and trainer exchange programs, and professional development. Challenges are identified and options presented for building global alliances in public health nutrition training into the future.

The cost to developing countries, for current and future generations, of not eradicating hunger and poverty - in terms of recurrent conflicts and emergencies, widening inequalities, depleted resources, ill health, and premature death - is enormous. Although strategies are underway to address certain problems in Africa and the Middle East, much remains to be done. Breaking the poverty cycle in these regions demands both local and international attention. Nutrition transition is a key factor, since many countries in the region also suffer the consequences of the excessive and unbalanced diets that are typical of developed countries. This paper reviews the experiences with facing malnutrition in Sub-Saharan and North Africa and the Middle East.

This paper compares the efficacy of two widely used weight-loss diets differing in macronutrient composition - a low-carbohydrate diet versus a low-fat diet. Although "a calorie is a calorie" under the controlled conditions of a metabolic unit (i.e., only the level of calorie intake matters and not the source of calories), we conclude that these interrelationships are far more complex in the free-living situation. The different diet-related factors that condition energy balance, including total energy intake, satiety and hunger sensory triggers, and palatability, must be considered when assessing the efficacy of weight-reducing diets of different macronutrient composition.

Free radicals generated as byproducts of normal metabolism can damage biologically relevant molecules. When their generation is increased, damage can also be increased, resulting in the development of many pathological conditions. Antioxidant defenses protect the body from the detrimental effects of free radicals. Dietary fruits and vegetables provide a reasonable amount of compounds that act as physiological antioxidants. Although existing knowledge does not allow a final and conclusive assessment of the relevance of antioxidants for health, it does provide the basis for its rational consideration. This paper addresses the specific aspects of antioxidant supplementation in health and disease.

International organizations have raised awareness of the increasing prevalence of overweight and obesity worldwide and the impact on morbidity, mortality, quality of life, and cost of healthcare. The development and implementation of obesity prevention strategies requires the identification and understanding of determinant factors that can be influenced by effective large-scale action plans over time. Strategies aimed at the primary prevention of obesity in a population should be multifaceted and designed to actively involve stakeholders and other major parties concerned; in addition, multiple settings for implementation should be considered. In this paper, an overview is presented of the strategies currently in place for obesity prevention, particularly in Spain.

This paper presents three different hunger indicators and outlines how they can be used to assess the extent of food insecurity in population groups globally and within countries at community, regional, or other subnational levels. Hunger refers to the supply, access, consumption, and intake of food at levels that are insufficient to fulfill human requirements. If the requirements are not met through the adequate absorption and use of essential nutrients, food deprivation and undernutrition occur.

The purpose of this paper is to present an examination of the contrasting policies towards mandatory folic acid fortification in six countries from different regions of the world. Three questions are addressed: 1) What is the policy of the country? 2) Why was the policy adopted? 3) What lessons have been learned? Policy contrasts among countries were assessed as reflecting different interpretations of the potential risks and benefits associated with folic acid fortification. Although commonalities were identified, it was considered unlikely that there could be a standard policy response for all countries. Instead, a country-by-country policy response based on national circumstances is indicated.

There has been significant public debate about the susceptibility of research to biases of various kinds. The dialogue has extended to the peer-reviewed literature, scientific conferences, the mass media, government advisory bodies, and beyond. While biases can come from myriad sources, the overwhelming focus of the discussion, to date, has been on industry-funded science. Given the critical role that industry has played and will continue to play in the research process, the International Life Sciences Institute (ILSI) North America Working Group on Guiding Principles has, in this paper, set out proposed conflict-of-interest guidelines, regarding industry funding, for protecting the integrity and credibility of the scientific record, particularly with respect to health, nutrition, and food-safety science. Eight principles are enumerated, specifying ground rules for industry-sponsored research. The paper, which issues a challenge to the broader scientific community to address all bias issues, is only a first step; the document is intended to be dynamic, prompting ongoing discussion and refinement. The Guiding Principles are as follows. In the conduct of public/private research relationships, all relevant parties shall: 1) conduct or sponsor research that is factual, transparent, and designed objectively; according to accepted principles of scientific inquiry, the research design will generate an appropriately phrased hypothesis and the research will answer the appropriate questions, rather than favor a particular outcome; 2) require control of both study design and research itself to remain with scientific investigators; 3) not offer or accept remuneration geared to the outcome of a research project; 4) prior to the commencement of studies, ensure that there is a written agreement that the investigative team has the freedom and obligation to attempt to publish the findings within some specified time-frame; 5) require, in publications and conference presentations, full signed disclosure of all financial interests; 6) not participate in undisclosed paid authorship arrangements in industry-sponsored publications or presentations; 7) guarantee accessibility to all data and control of statistical analysis by investigators and appropriate auditors/reviewers; and 8) require that academic researchers, when they work in contract research organizations (CRO) or act as contract researchers, make clear statements of their affiliation; require that such researchers publish only under the auspices of the CRO.

In many parts of the world, food companies, consumers, and governments are re-examining the provision of nutrition information on food labels. It is important that the nutrition information provided be appropriate and understandable to the consumer and that it impact food-choice behaviors. Potentially, food labeling represents a valuable tool to help consumers make informed decisions about their diet and lifestyle. Food information organizations worldwide have been following consumer trends in the use of this information as well as consumer attitudes about food, nutrition, and health. This paper summarizes a workshop that examined consumer attitudes gathered regionally with the aim of establishing commonalities and differences.

The proportion of the population that is > or = 60 years of age in sub-Saharan Africa (SSA) is increasing rapidly and is likely to constrain healthcare systems in the future. Nevertheless, the elderly are not a health policy priority for African countries. This paper reviews the nutritional and health status of older adults in SSA and their determinants. Literature was abstracted through the Medline, Google Scholar, and Dogpile databases using the following search terms: sub-Saharan Africa, older adults, nutrition, health. Findings showed that up to half (6-48%) of elderly Africans in SSA are underweight and almost a quarter (2.5-21%) are overweight, while 56% of older South Africans are obese. Low-quality diets contribute to poor nutritional status. Poverty, HIV/AIDS, and complex humanitarian emergencies are major determinants of undernutrition. Effective interventions need to consider socioeconomic, health, and demographic factors; social pensions may be the most cost-effective option for improving the health and nutritional status of the elderly in SSA.

Effects of nutrient intake timing and exercise on carbohydrate (e.g. insulin sensitivity), protein (muscle protein synthesis), and fat (circulating triacylglycerols) metabolism are reviewed in this paper. Altered nutrient intake timing relative to exercise can modulate the metabolic response, which is relevant for individuals seeking to use exercise to enhance health.

Although the overall population in the United States has experienced a dramatic increase in obesity in the past 25 years, ethnic/racial minorities, and socioeconomically disadvantaged populations have a greater prevalence of obesity, as compared to white, and/or economically advantaged populations. Disparities in obesity are unlikely to be predominantly due to individual psychosocial or biological differences, and they may reflect differences in the built or social environment. The retail food environment is a critical aspect of the built environment that can contribute to observed disparities. This paper reviews the literature on retail food environments in the United States and proposes interrelated hypotheses that geographic, racial, ethnic, and socioeconomic disparities in obesity within the United States are the result of disparities in the retail food environment. The findings of this literature review suggest that poor-quality retail food environments in disadvantaged areas, in conjunction with limited individual economic resources, contribute to increased risk of obesity within racial and ethnic minorities and socioeconomically disadvantaged populations.

An emerging goal of medical nutrition therapy is to tailor dietary advice to an individual's genetic profile. In the United States and elsewhere, "nutrigenetic" services are available over the Internet without the direct involvement of a health care professional. Among the genetic variants most commonly assessed by these companies are those found in genes that influence cardiovascular disease risk. However, the interpretation of DNA-based data is complex. The goal of this paper is to carefully examine nutritional genomics as a potential tool for targeted medical nutrition therapy. The approach is to use heart health susceptibility genes and their common genetic variants as the model.

The metabolic syndrome is a cluster of symptoms associated with insulin resistance and known to precede the onset of type 2 diabetes. Overweight and obesity contribute significantly to the development of the metabolic syndrome. In fact, weight loss has a huge impact in decreasing the symptoms associated with the metabolic syndrome. Several studies have demonstrated that just by losing 7% to 10% of initial body weight is sufficient to have improvement in waist circumference, dyslipidemias (elevated triglycerides and low high-density-lipoprotein cholesterol), trunk fat, and plasma glucose. This paper underlines the importance of weight loss and type of diet in reversing the symptoms of the metabolic syndrome.

As we learn more about interactions between microbes and the developing gastrointestinal (GI) tract, it is becoming clear that the establishment of the intestinal "microbiome" shortly after birth plays a critical role in the early origins of health and disease. Nutrition, mode of delivery, the use of maternal or postnatal antibiotics, and pre- and probiotics are factors that may alter the microbial ecology and affect lifelong gene expression. Because the neonatal period is a critical period of development when microbes become established in the GI tract, the long-term effects of manipulations of the GI microbial ecology during this time are more amplified than the effects of later manipulations. In this paper, recent research findings are reviewed with the intent of providing information about the benefits of early manipulation of the GI microbiome, but also to give a warning about its indiscriminant manipulation during the perinatal and neonatal time periods.

The Dietary Guidelines for Japanese, released in 2000, provides the basics of a healthy diet for the people of Japan. In July 2005, the Ministry of Health, Labour and Welfare and the Ministry of Agriculture, Forestry and Fisheries of Japan jointly released a new pictorial guide, The Japanese Food Guide Spinning Top, to help people implement the Dietary Guidelines for Japanese. It guides people as to what kinds and how much food they should eat each day to promote health. This paper describes the nature of the diet and the theoretical framework applied in the development of the new guidelines.

Population food and nutrition monitoring plays a critical role in understanding suboptimal nutrition at the population level, yet current monitoring methods such as national surveys are not practical to undertake on a continuous basis. Supermarket sales data potentially address this gap by providing detailed, timely, and inexpensive monitoring data for informing policies and anticipating trends. This paper reviews 22 studies that used supermarket sales data to examine food purchasing patterns. Despite some methodological limitations, feasibility studies showed promising results. The potential and limitations of using supermarket sales data to supplement food and nutrition monitoring methods are discussed.

Like other diseases striking predominantly the affluent societies, idiopathic nephrolithiasis is increasing in rich countries and appears to be closely related to dietary habits. In this review we summarize the latest evidence about the efficacy of dietary treatment for idiopathic calcium and uric acid stones, dealing especially with its effect on the urinary stone risk factors, stone recurrences, and clinical limitations. After a short introduction on epidemiology and pathogenesis, we review the role of the most important foods and nutrients in stone formation and protection: water and other fluids, proteins, carbohydrates, fats, salt, milk and dairy products, fruits and vegetables, and vitamins. The final part of the paper will provide practical guidelines for pursuing an anti-lithogenic diet in idiopathic calcium and uric acid stones.

Content-based theories of motivation may best uti lize the meta-theory of work motivation. Process-based theories may benefit most from adopting Locke and Latham's goal-setting approaches and measures. Decision-making theories should utilize the measurement approach operationalized by Ilgen et al. Sustained effort theories should utilize similar approaches to those used in numerous studies of intrinsic motivation, but the measurement of which is typically observational or attitudinal. This paper explored the implications of the four approaches to studying motivation on the newly estab ished model of mental energy. The approach taken for examining motivation informs the measurement of mental energy. Specific recommendations for each approach were developed and provided. As a result of these efforts, it will now be possible to diagnose, measure, and experimentally test for changes in human motivation, which is one of the three major components of mental energy.

Many studies have attempted to identify specific positive health effects of probiotics. One of the challenges in generalizing health effects of probiotics is that different strains exert disparate effects on human health. As a result, the efficacy of one strain or species cannot necessarily be inferred from another. The objective of this review is to examine the current scientific literature that could be used as the basis for potential health claims. More specifically, this paper will review existing evidence of different probiotic strains to prevent and treat diarrhea, treat irritable bowel syndrome (IBS), treat inflammatory bowel disease, and prevent colon cancer. The strongest evidence is related to the use of Lactobacillus rhamnosus GG in the prevention and treatment of rotavirus-associated diarrhea. Further examination of the literature also shows promise in the treatment of some forms of IBS with probiotics. Future studies that use consistent supplementation regimes will allow more definitive conclusions to be drawn on the effects of probiotics on IBS, inflammatory bowel disease, and colon cancer.

The Institute of Medicine (IOM) reports on Dietary Reference Intakes (DRIs) present a new paradigm for the description of nutrient requirements. Tradition and the DRI reports themselves have created an erroneous impression that the Recommended Dietary Allowance (RDA) is intended for use with individuals and the Estimated Average Requirement (EAR) is to be used with populations. Two recent IOM committee reports (one on nutrition labeling and one on Women, Infants and Children [WIC] food packages) challenge that interpretation, revealing the critical issues surrounding individuals versus groups or populations. The present paper examines the issues and concludes that the median requirement and Tolerable Upper Limit (UL) are the critical reference values for both individuals and populations. The RDA is both unneeded and lacking a sound scientific basis.

This paper addresses some of the ways that Nestlé is making a long-term commitment to the health and well-being of consumers. In particular, Nestlé, like other food companies, has a role to play in improving people's health and wellness by improving the nutritional profile of foods, by ensuring sound communication on nutrition and consumer education, and by collaborating with other stakeholders in order to improve consumer health.

Lack of effective implementation mechanisms is identified as a major obstacle in the prevention and control of iron-deficiency anemia. This paper discusses experiences gained from implementing iron-folic acid supplementation in the Philippines, Vietnam, and Cambodia. The understanding of contextual elements is proposed as a foundation for planning interventions. Moreover, it is suggested that a social marketing framework should provide a way of thinking about how to influence related behaviors. The application of a social marketing framework applied using a "5 P's" approach: public relations and collaboration, product, price, place, and promotion, is described, as well as enabling factors (possibilities) and inhibiting factors (challenges) of this approach. Although a program to improve iron nutrition among women of reproductive age may not be simple to implement, it is essential to enhancing health, human development, and economic advancement in developing countries.

This paper identifies trends in children's cookbooks for nutrition messages, cultural content, and food themes according to food guidance of the time. Except for those developed in government-sponsored nutrition programs since the 1970s, children's cookbooks seemingly have a preponderance of high-calorie dessert and party/fun recipes and limited vegetable recipes. In the past 150 years, the science of nutrition has grown from a focus on nitrogen to one on multiple nutrients and their interrelationships. Foods in the market have diversified in number and form, and a children's nutrition specialty has been introduced and expanded in many dimensions-including in the publishing of children's books. Because children's early food choices influence both their growth and health, factors impacting food choices need to receive more attention.

Preeclampsia has been suggested to result from a partial breakdown of tolerance to the developing fetus after maternal immune maladaptation. Several of the proposed immunomodulatory properties of the hormonal vitamin D system could potentially have beneficial effects for successful maintenance of pregnancy. Preeclampsia is characterized by marked changes in vitamin D metabolism. This paper reviews the evidence suggesting that the immunomodulatory properties of 1,25(OH)2D may play a key role in maintaining immunological tolerance in pregnancy, and proposes that ensuring adequate vitamin D status/intake may help in the prevention and management of preeclampsia.

The Food and Drug Administration's (FDA's) 1992 policy statement granted genetically engineered foods presumptive GRAS (generally recognized as safe) status. Since then, divergent views have been expressed concerning the scientific support for this policy. This paper examines four sources to better understand the basis for these claims: 1) internal FDA correspondence; 2) reports from the National Academy of Sciences; 3) research funded by US Department of Agriculture from 1981 to 2002; and 4) FDA's proposed rules issued in 2001. These sources reveal that little research has been conducted on unintended compositional changes from genetic engineering. Profiling techniques now make this feasible, but the new debate centers on the functional meaning of compositional changes.

Epidemiological studies have suggested an association between vitamin C (and other antioxidant vitamins) and cancer risk. However, the mechanisms accounting for prevention have not been extensively investigated. In skin, vitamin C (ascorbic acid) exerts different biological roles, including photoprotective effects and participation in collagen synthesis. This paper reports new findings about additional functions of the vitamin. Vitamin C counteracts oxidative stress via transcriptional and post-translational mechanisms; this modulation may interfere with the activity of redox-sensitive transcription factors, commitment to differentiation or cell cycle arrest, and apoptosis in response to DNA damage. All of these vitamin C-mediated responses might be important in different cell types, allowing for the maintenance of body homeostasis.

Consumption of at least two servings of fish per week is recommended by the American Heart Association (AHA) to achieve cardio-protective effects. However, some fish are contaminated with methylmercury, which may counteract the positive effect of the omega-3 fatty acids, and numerous governments have issued advisories for certain fish species. These mixed messages may be a source of confusion to the consumer and to the health professional. This paper reviews whether it is possible to follow the AHA recommendation for fish consumption while avoiding the risks associated with consuming mercury in amounts in excess of government thresholds.

Of the many carotenoids circulating in human sera, only lutein and zeaxanthin are accumulated throughout the tissues of the eye. Within the eye, they reach their highest concentration in the central retina, where they are clinically referred to as the macula lutea. Lutein and zeaxanthin, more commonly referred to as macular pigments, may serve a variety of roles in the specialized vision of higher primates. This paper reviews recent studies investigating the influence of macular pigments on human visual performance. Such studies have offered insight into why lutein and zeaxanthin are uniquely concentrated in ocular tissues.

The aims of this paper are to describe the rules of the cortical processing of taste and smell, how the pleasantness or affective value of taste and smell are represented in the brain, and to relate this to the brain mechanisms underlying emotion. Much of the fundamental evidence comes from studies in non-human primates, and this is being complemented by functional neuroimaging studies in humans.

Is dietary variety good or bad? The answer depends on how the variety is defined and the outcome of interest. The evidence for overall diet quality and food security still suggests that variety in consumption patterns is a net plus. However, variety in certain selected foods--energy-dense foods, for example--may contribute to overweight and obesity. The issue for overweight and obesity is clearly energy balance; results presented in this paper suggest that energy balance is harder to achieve with diets high in total fat and energy.

This paper examines the speed of change in diet, activity, and obesity in the developing world, and notes potential exacerbating biological relationships that contribute to differences in the rates of change. The focus is on lower- and middle-income countries of Asia, Africa, the Middle East, and Latin America. These dietary, physical activity, and body composition changes are occurring at great speed and at earlier stages of these countries' economic and social development. There are some unique issues that relate to body composition and potential genetic factors that are also explored, including potential differences in body mass index (BMI)--disease relationships and added risks posed by high levels of poor fetal and infant growth patterns. In addition there is an important dynamic occurring--the shift in the burden of poor diets, inactivity and obesity from the rich to the poor. The developing world needs to give far greater emphasis to addressing the prevention of the adverse health consequences of this shift to the nutrition transition stage of the degenerative diseases.

The agricultural and technological revolutions of the late 20th century have influenced both of the discretionary components of the energy balance equation, namely energy intake and physical activity. These changes act synergistically in the direction of encouraging weight gain and represent an unprecedented change in man's ecological niche. Obesity is the predictable biologic response to these external changes. This paper reviews the physiologic responses to modern diets and their effect on energy regulation. The energy density of foods is identified as a key element in influencing energy intake due to weak satiety signals that fail to compensate for very energy-dense foods. Evidence is also presented to show that interactions between energy-dense diets and low-levels of physical activity are key elements in encouraging weight gain due to an asymmetry between the hunger and satiety arms of human appetite control.

This paper presents a synopsis of the Institute of Medicine (IOM) Dietary Reference Intakes (DRIs) for folate and the recommended folic acid intake to reduce the risk of neural tube defects. Estimated intake of folic acid is presented and total folate intake is compared to the DRI. Vitamin B12 DRIs are highlighted in addition to the IOM recommendation for crystalline vitamin B12 intake specifically for individuals > or =51 years of age. Recently reported evidence of vitamin B12 inadequacy in the aging segment of the U.S. population will be addressed.

This paper reviews studies performed to date that have employed cluster or factor analysis to empirically derive eating patterns. Since 1980, at least 93 studies were published that used cluster or factor analysis to define dietary exposures, of which 65 were used to test hypotheses or examine associations between patterns and disease outcomes or biomarkers. Studies were conducted in diverse populations across many countries and continents and suggest that patterns are associated with many different biomarkers and disease outcomes, whether measured by cluster or factor analysis. Despite clear differences in approaches and interpretations, there is some evidence that underlying eating patterns are revealed by either method. Although the research considered herein has created a meaningful body of literature, refining both the factor and cluster analysis methods will help to further establish eating patterns as a sound dietary assessment method.