Nutrition Perspectives January

UNIVERSITY OF CALIFORNIA
COOPERATIVE EXTENSION

NUTRITION PERSPECTIVES

Volume 29, No. 1
January/February 2004

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

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

TABLE OF CONTENTS PAGE

Santa Cruz Chancellor Named Provost of UC System
Research Outcomes on Low-Carbohydrate Diets (Revised)
Consumer Alert: FDA Plans Regulation Prohibiting Sale of Ephedra-Containing Dietary Supplements and Advises Consumers to Stop Using These Products
To Take or Not to Take, the Nutritional Supplement Debate
FDA Warns Consumers about Star Anise Teas
Potential Drug Interactions with St. John’s Wort
USDA Buys Nuts and Fruits for Program
FDA Approves Health Claim for Walnuts
Food Guide Pyramid Gets a Facelift
FDA Announces to Grade Health Claims Using Report Cards
Report Sets Dietary Intake Levels for Water, Salt, and Potassium to Maintain Health and Reduce Chronic Disease Risk
Alcohol and Breast Cancer
Hormone-Free Claims to Be Removed from Labeling
Canada Starts Labeling for Certain Natural Products
Olestra Labeling Change
Long-Term Use of Multivitamins May Protect Against Colon Cancer
Study: Moderate Physical Activity Promotes Weight Loss as Well as Intense Exercise

Resources:

The Power of Choice
Need to Find an RD Who Is a Medicare Provider? Look No Further!
New Grant.Gov Web Site Offers One-Stop Shopping for Information on Applying for All Federal Grants

Subscription for NUTRITION PERSPECTIVES

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

SANTA CRUZ CHANCELLOR NAMED PROVOST OF UC SYSTEM

M.R.C. Greenwood was appointed provost and senior vice president of academic affairs, the second highest post in the UC system, during a special meeting of the Regents of the University of California February 24, 2004.

Greenwood, who is an internationally recognized expert in genetics and nutrition and a national leader in science and higher education policy, has served as chancellor of UC Santa Cruz since 1996. She will assume her new post on April 1.
“M.R.C. Greenwood possesses tremendous energy, academic accomplishment and administrative skill. She brings the perfect credentials to this position,” said UC President Robert C. Dynes, who submitted Greenwood's nomination to the Board of Regents. “UC Santa Cruz is a campus on the move, a campus making dramatic strides in countless areas, and M.R.C.'s leadership has had a great deal to do with that.”

Throughout the nation, public higher education is facing major challenges, the challenges of constrained state resources, increasing demand for services and increasing expectations as our society looks to universities for answers to our most pressing problems. The University of California needs to be a leader in confronting the challenges and pursuing the opportunities of this new era. Because M.R.C. Greenwood is exactly the right person to join me and the rest of the UC system in this exciting endeavor, I made every effort to convince her to accept this position.

“She leaves UC Santa Cruz with a strong leadership team that, I am confident, will continue the momentum she has created.”
Under Greenwood's leadership since 1996, UC Santa Cruz has increased the number of academic programs by 52 percent, from 63 to 96, including a 41 percent increase in graduate programs; created its first professional school, the Baskin School of Engineering; established two new residential colleges; more than doubled extramural research support; expanded total student enrollment by approximately 54 percent, with a nearly 50 percent increase in graduate enrollment; hired 250 new faculty members; constructed nearly one million assignable square feet in academic buildings and housing, including 2,800 spaces in new student housing; acquired 50 acres of oceanfront property to expand research opportunities at Long Marine Laboratory; and raised more private donations than the previous total for the campus's entire history.

In October, Greenwood unveiled an historic UC/NASA partnership to create a world-class educational R&D campus focusing on innovation and scientific discovery at the proposed NASA Research Park in the heart of Silicon Valley.

“I dearly love the Santa Cruz campus, and I had not planned on leaving it so soon,” said Greenwood. “But President Dynes is a very persuasive man, and he convinced me that I can better serve the university in this new role.”

“The University of California delivers tremendous value to its students, and through its research, to the public at large,” Greenwood added. “I am honored to be called on to help further work that is so critical for California.”

An announcement regarding an acting chancellor for UC Santa Cruz will be made soon. Dynes also will launch as quickly as possible a national search for a permanent replacement for Greenwood and expects to have a new chancellor at UC Santa Cruz by no later than the beginning of the next academic year.

Greenwood, 60, replaces C. Judson King as provost of the UC system. King is retiring after eight years in the position and returns to UC Berkeley to become director of the Center for Studies in Higher Education.

As provost, Greenwood will become the highest-ranking woman holding a system wide post at the University of California and the first woman appointed to the position.

She will oversee academic planning, research and academic policies for the 10-campus UC system. Other units under her supervision will include the Continuing Education of the Bar, Education Abroad Program, educational outreach, UC Press, UC Extension, the California Policy Research Center, and the Washington, D.C., Center.

After reviewing a group of about 60 exceptional candidates, a committee comprised of regents, chancellors and faculty advised Dynes in making his selection.

“On behalf of the faculty, I am delighted to welcome Chancellor Greenwood as the next provost. The faculty advisers to the search committee had an outstanding pool of initial nominees and when Dr. Greenwood was sought out, she emerged as the most stellar,” said Lawrence C. Pitts, chair of the Academic Council and an advisory committee member. “We're fortunate that she's willing to bring her energy and ideas to the Office of the President, where I know that she will help President Dynes and the faculty move UC forward in these turbulent times.”

Greenwood is a nationally recognized expert in a range of science and higher education policy issues, and she has testified at numerous legislative hearings in Sacramento and Washington, D.C., on issues ranging from faculty gender equity to national security. She will be paid $380,000 a year. The salary falls between the averages paid to provosts of comparable public and private institutions.

Greenwood received her A.B., summa cum laude, from Vassar College in 1968, and received her Ph.D. from Rockefeller University in 1973. She is a member of the Institute of Medicine of the National Academy of Sciences, and a fellow of the American Association for the Advancement of Science, where she served as president in 1998 and chair in 1999. She has delivered major policy addresses throughout California and in Washington, D.C., and internationally in London, New Delhi, Bangalore and Seoul. She serves as a board member of leading national professional organizations and has been appointed to a variety of high-level positions advising state and federal government in the areas of science and higher education policy.
Before taking the reins at UC Santa Cruz, Greenwood served as dean of graduate studies, vice provost for academic outreach and professor of biology and internal medicine at UC Davis. Prior to that, she taught at Vassar College, where she was chair of the department of biology and director of the Undergraduate Research Summer Institute. Previously, she was on the faculty of Columbia University's medical school.

From November 1993 to May 1995, while on leave from UC Davis, Greenwood served as associate director for science at the Office of Science and Technology Policy in the executive office of the president of the United States.

Greenwood's immediate family includes her son, Jim, a minister, who lives in Santa Rosa with his wife, Michelle, and their sons, Davis and Dillon. Her granddaughter Seanne attends college in Idaho.

Photographs of Greenwood and video clips from the press conference Feb. 23rd are available at: www.universityofcalifornia.edu/news/greenwood/photos.html. A brief biography of Greenwood is available at: www.ucsc.edu/administration/mrc/biography/index.html. Also, a message from Greenwood to the UC Santa Cruz community is available at: http://messages.ucsc.edu/03-04/02-23.chancellor.html.

Source: University of California Office of the President Press Release; February 23, 2004.

RESEARCH OUTCOMES ON LOW-CARBOHYDRATE DIETS (Revised)

Errata to original article published in Nutrition Perspectives in November/December of 2003. The original article contained an error under “What constitutes a low carbohydrate diet?” In the first paragraph the sentence stated, “To place this in context, 100g of cooked pasta (~3.4 oz., or less than 1/2 cup) has 75g of carbohydrates. Likewise, a fresh apple with the skin on contains 29.27g. Even during Atkin’s maintenance phase, which allows up to 60g of carbohydrate, an Atkin’s dieter could not eat a half a cup of pasta, but could eat half an apple, which would maximize their daily allotment.” This statement now more accurately reads “To place this in context, 160g of cooked pasta (1/2 cup) has 40g of carbohydrates. Likewise, a fresh apple with the skin on contains 29g. Even during Atkin’s maintenance phase, which allows up to 60g of carbohydrate, an Atkin’s dieter could only eat a half a cup of pasta and half an apple, which would maximize their daily allotment.” We apologize for any inconvenience this error may have caused. The article has been reprinted below.

The first known recorded low-carbohydrate diet to have enjoyed popular success was described by William Banting in the 1860s (1). Banting claimed that he lost 46 pounds in a year while never being hungry; thousands followed his diet regime. Today the low-carbohydrate crusader is Dr. Robert Atkins, who died earlier this year. His book, Dr. Atkin’s New Diet Revolution has been on the New York Times bestseller list for the last five years (2). Concurrently, professional organizations in the field of nutrition have cautioned against following a diet that restricts carbohydrate intake to 20 grams (g), as required in the first phase of the Atkins diet (3). There is a concern from these opponents that low-carbohydrate diets lead to abnormal metabolic function that may lead to serious medical complications, particularly those with cardiovascular disease. The Dietary Guidelines for Americans, published by the United States Department of Agriculture (USDA) recommends a diet based on the Food Guide Pyramid’s 6-11 servings of all carbohydrates, such as, bread, cereal, rice, and pasta. This amount equates to 90-165g of carbohydrates daily, clearly out of range for the Atkins diet (4). A person on a traditional diet consisting of 1200 calories could consume 48g of carbohydrates, almost 2.5 times that of the Atkins diet. Five intervention studies and one meta-analysis were published in 2003 that examined low-carbohydrate diets and their long-term effects. Below are some of their key findings.

What constitutes a low-carbohydrate diet?

The Atkins diet limits carbohydrate intake to 20g/day for the initial phase, which lasts a minimum of 14 days (2). To place this in context, 160g of cooked pasta (~1/2 cup) has 40g of carbohydrates. Likewise, a fresh apple with the skin on contains 29g. Even during Atkin’s maintenance phase, which allows up to 60g of carbohydrate, an Atkin’s dieter could only eat a half a cup of pasta and half an apple, which would maximize their daily allotment.

Why choose a low carbohydrate diet?

The metabolic theory that diets such as Atkins base their weight loss regimen on is that restricted carbohydrate and high fat/protein intake creates a “metabolic advantage” (2). Reduced glucose availability derived from decreased carbohydrate intake switches a person’s metabolism from burning sugar to burning stored fat, known as lipolysis. Furthermore the theory states, with a high fat diet the dieter is less hungry and more likely to eat less food creating a caloric deficit, furthering weight loss. Contradicting this theory are results from a recent clinical trial demonstrating that diet composition had no effect on weight loss (6).

Low carbohydrate diets and weight loss

Published recently in the New England Journal of Medicine (NEJM) are two clinical trials that addressed the current trend of eating high fat/protein, low carbohydrate diets. Results from both studies showed that weight loss occurs rapidly in the first few months of a high fat/protein, low carbohydrate diet, however, no significant difference in weight loss between diet compositions was seen at either the six month trial or the twelve month trial (5,7). Another clinical trial published in the American Journal of Clinical Nutrition found at the end of four months a significant difference in weight loss, but the decrease in weight was not affected by diet composition (6). Conversely, an Atkins funded, non-randomized, non-control intervention trial, published in The American Journal of Medicine found sustained weight loss, -9.0 ± 5.5 kg, in low carbohydrate dieters at six months (8).

Low carbohydrate diets and triglyceride levels

According to the American Heart Association (AHA), high triglycerides (TGs) are associated with Type 2 diabetes, coronary heart disease, and obesity (10). Reducing intakes of carbohydrates, saturated fat, and weight, if obese, will promote lower TGs levels. The AHA recommends TGs below 150mg/dl.

Foster and colleagues (5) found TGs levels decreased with the low-carbohydrate diet at the end of 12 months. Although part of this benefit may be due to the greater weight loss with the low-carbohydrate diet, the changes are greater than those expected from a moderate weight loss alone. However, comparison of subjects who lost the same total amount of weight demonstrated that this finding was limited to subjects who lost greater than five percent of their base-line weight.

Low carbohydrate diets and cholesterol levels

The Foster trial found that at the end of three months, low-density lipoprotein (LDL) cholesterol was 6 percent lower than base-line, in the traditional diet, but at twelve months there was no significant differences between groups (5). The Farnsworth and Samaha trials reported that LDL cholesterol concentration among subjects on the low-carbohydrate diet was similar to base-line values, and the changes in LDL cholesterol concentrations did not differ significantly between groups (6,7). However, high-density lipoprotein (HDL) levels varied among intervention trials, levels in some participants went up whereas others went down.

In an isocaloric intervention trial, published in the Journal of Nutrition, designed to only measure changes in total, LDL and HDL cholesterol in normal weight women consuming either a low carbohydrate or low fat diet, participants following a low carbohydrate diet had increased HDL’s and decreased TGs (9).

Low carbohydrate diets and blood pressure

With a decrease in weight loss, a decrease in blood pressure is expected. Surprisingly, in all three trials, blood pressure did not change significantly in any of the groups (5,6,7). However, many participants were on blood pressure lowering medications at baseline.

Low carbohydrate diets and ketones

High ketone levels are correlated with increased burning of fat stores. Only the Foster trial (5) tested for urinary ketones. During the first three months, the percentage of patients who tested positive for urinary ketones was significantly greater in the group on the low-carbohydrate diet, but there were no differences between the groups after three months. There was no significant relation between weight loss and ketosis at any time during the study (5).

Low carbohydrate diets and osteoporosis

Loss of calcium over time may lead to osteoporosis. Urinary calcium was unchanged regardless of the diet composition as measured in the Farnsworth trial (6). The concentrations of bone turnover markers (pyridinoline and deoxypyridinoline compared to creatinine) also did not differ between baseline and the end of the trial.

Attrition

Research has demonstrated that long-term, restrictive, dietary compliance leads to diet failure. Although many factors contribute to dietary compliance, adhering to a low carbohydrate diet may be more difficult than purported by Dr Atkins (2). Drop out rates were high for both the low carbohydrate and traditional carbohydrate groups (5,6,7).

The bottom line

For years the idea of promoting a low carbohydrate/high protein diet was fiercely dismissed by nutrition professionals. It is clear from recent studies that this is an area that obviously requires additional research. At this time the data can be summarized as follows:

· The first few months of a low-carbohydrate diet may initiate weight loss quickly, but at one year the difference in weight loss shows no relationship to macronutrient composition.
· Triglycerides levels decrease with a low-carbohydrate diet, though more studies are needed to determine if there is a positive correlation between macronutrient composition, or if the decrease is related to a decrease in total weight loss.
· Biomarkers for heart disease: LDL, HDL, and total cholesterol were not associated with diet composition at twelve months. HDLs initially increase on a low carbohydrate diet.
· The strongest correlation between weight loss and diet is a decrease in total calories.

References:
1. Banting W. Letter on Corpulence, Addressed to the Public. 2nd. London, England: Harrison and sons; 1863.
2. Atkins RC. Dr Atkins’ New Diet Revolution: New York, NY: Avon Books; 2002.
3. Bravata DM, Sanders L, Huang J, et al.Efficacy and Safety of low Carbohydrate Diets. JAMA; 2003; 289:1837-50.
4. Nutrition and Your Health: Dietary Guidelines for Americans. USDA 2000; Home and Garden Bulletin; No. 232, fifth edition.
5. Foster GD, Wyatt HR, Hill JO, et al. A Randomized Trial of a low-carbohydrate diet for obesity. N Engl J Med; 2003; 348:2082-90.
6. Farnsworth E, Luscombe ND, Noakes M, Wittert G, Argyiou E, Clifton PM. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women. Am J Clin Nutr; 2003; 78:31-39.
7. Samaha F, Iqbal N, Seshadri P, et al. A Low-Carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med; 2003; 348:2074-81.
8. Westman EC, Yancy WS, Edman JS, Tomlin KF, Perkins CE. Effect of a 6-month adherence to a very low carbohyrate diet program. Am J Med; 2002; 113:30-36.
9. Volek JS, Sharman MJ, Gomez AL, Scheett TP, Kraemer WJ. An isoenergetic very low carbohydrate diet improves serum HDL cholesterol and triacylglycerol concentrations, the total cholesterol to HDL cholesterol ratio and postprandial lipemic responses compared with a low fat diet in normal weight, normolipidemic women. J Nutr; 2003; 133:2756-61.
10. [Online source]: http://www.americanheart.org/presenter.jhtml?identifer=180. Accessed July 21,2003.
Source: Deanna Pucciarelli, Doctoral Student, Nutrition Department, University of California, Davis.

CONSUMER ALERT:
FDA PLANS REGULATION PROHIBITING SALE OF EPHEDRA-CONTAINING DIETARY SUPPLEMENTS AND ADVISES CONSUMERS TO STOP USING THESE PRODUCTS\

The Food and Drug Administration (FDA) is alerting the public to its forthcoming determination that dietary supplements containing ephedra present an unreasonable risk of illness or injury, and should not be consumed. The agency has notified firms manufacturing and marketing these products that it intends to issue a final rule prohibiting their sale, which will become effective 60 days after its publication.

The FDA has taken this step after conducting an exhaustive and highly resource-intensive process required under the Dietary Supplement Health and Education Act (DSHEA) of 1994 for banning a dietary supplement that presents a significant and unreasonable risk to human health.

To meet this challenging standard, the FDA gathered and thoroughly reviewed a prodigious amount of evidence about ephedra's pharmacology; clinical studies of ephedra's safety and effectiveness; newly available adverse events reports; the published literature; and a seminal report by the RAND Corporation, an independent scientific institute. The FDA also reviewed tens of thousands of public comments on the agency's request in February 2003 for information about ephedra-associated health risks.

The totality of the available data showed little evidence of ephedra's effectiveness except for short-term weight loss, while confirming that the substance raises blood pressure and otherwise stresses the circulatory system. These reactions have been conclusively linked to significant adverse health outcomes, including heart ailments and strokes.

By informing more than 60 dietary supplement firms about the upcoming final rule, FDA is sending a strong and unambiguous signal that dietary supplements containing ephedrine alkaloids present an unreasonable risk. Consumers are urged to stop buying and using these products immediately.

Ephedra, also called Ma Huang, is a naturally occurring substance derived from botanicals. Its principal active ingredient is ephedrine, which when chemically synthesized is regulated under the Federal Food, Drug and Cosmetic Act of 1938 as a drug. In contrast to the DSHEA-regulated dietary supplements that contain natural ephedra, the safety and effectiveness of the synthesized ephedrine has to be proven by the manufacturer, not the FDA. In recent years ephedra products have been extensively promoted for aiding weight control and boosting sports performance and energy.

This recent announcement is a continuation of a process that started in June 1997 when FDA first proposed to require a statement on dietary supplements with ephedra warning that they are hazardous and should not be used for more than 7 days. FDA modified this proposed rule in 2000, and in February 2003 it announced a series of measures that included strong enforcement actions against firms making unsubstantiated claims for their ephedra-containing products.

These measures have prompted voluntary compliance with FDA rules, voluntary product recalls, FDA warning letters, seizures and injunctions, criminal actions, and joint enforcement actions with the Federal Trade Commission and the Department of Justice. More detail on these actions can be found at http://www.fda.gov/ola/2003/dietarysupplements 1028.html. As a result, ephedra-containing dietary supplements advertised for enhanced sport performance have been removed from the market, there has been a significant decline in the demand for ephedra products, and many firms have stopped their marketing. Additional information relating to this announcement is available online at www.cfsan.fda.gov/~dms/ds-ephed.html. Consumer Inquiries: 888-INFO-FDA.

Source: FDA Press Release; December 30, 2003.

TO TAKE OR NOT TO TAKE, THE NUTRITIONAL SUPPLEMENT DEBATE

Did you start your morning with your first serving of Five-A-day, or did you just pop your vitamins and hope for the best? Did you tell your harried patients to do the same? The most recent Clinical Guidelines from the US Preventive Services Task Force has called routine supplement use for health assurance into question, at least for the prevention of cancer and cardiovascular disease (CVD). Cynthia D. Morris, PhD, and Susan Carson, MPH, from the University of Oregon were commissioned to review studies of supplement use that looked at specific vitamins, antioxidants, and multivitamins (1). Their review did not find sufficient evidence in the literature published between 1966 and 2001 to conclude that supplements help prevent heart disease or CVD mortality. Drawing on other analyses, the Task Force extended this finding to cancer prevention as well (2).

Cardiovascular Disease Studies

The cardiovascular literature review was limited to randomized trials and prospective cohort studies of fair to good quality, i.e. those earning a “Jadad score” of 3 to 5. (Note: The Jadad scale is a 0-5 scale developed by Jadad and colleagues (3) to rate the quality of evidence reported in a study). Case control studies were not included due to retrospective data collection. The authors summarized selective studies in a table format and organized them according to the nutrients evaluated (vitamin A, vitamin C, vitamin E, antioxidant combinations and multivitamins, especially folate and B vitamins). They did not consider dietary nutrient intake. They assigned intervention trials for primary and secondary prevention (event prevention in the presence of disease) separately.

The vitamin score box looked something like the following:

· Vitamin A: A single supplementation study with no benefit.
· Vitamin C: No benefit in six of seven studies; one showed a large benefit in secondary prevention of restenosis. One small secondary prevention trial suggested a benefit.
· Vitamin E: Long-term cohort studies generally, but far from universally, suggested a benefit. However, intervention studies, mostly of shorter duration, were without benefit relative to placebo.
· Beta-carotene: Intervention studies did not reveal benefits, and in some studies, particularly in smokers, there was evidence of adverse outcomes related to total mortality, cancer, and ischemic heart disease.
· Antioxidant vitamin combinations: Some observational studies have indicated benefits, but even in large primary and secondary prevention interventional studies, benefits have not been seen; in one instance all-cause mortality was increased in women with heart disease who were give supplemental vitamins C and E.
· Multivitamins: The observational studies are a mixed bag, ranging from benefit to adverse outcomes. In a secondary prevention trial, a benefit on restenosis was seen, but no impact on myocardial infarction or cardiovascular mortality.

Cancer Review

In developing their summary statements about supplement use for cancer prevention, the Task Force relied heavily on a review published on their website available at www.ahrq.gov/clinic/3rduspstf/vitamins/viasum .htm.

Their findings are summarized as follows:

· Vitamin A: They cite no intervention trials, but note one observational study in women suggesting a protective effect for colon cancer.
· Vitamin C: Observational studies generally show no effect on cancer prevention.
· Vitamin E: One intervention study indicated a possible effect in reducing prostate cancer, but observational studies have not been corroborative. One observational study reported a benefit for colon cancer.
· Beta-carotene: No benefits, and possible adverse effects on lung cancer incidence in smokers.
· Antioxidant vitamin combinations: Mixed results; some of these are confounded by the use of beta-carotene.
· Multivitamins: Observational data from the Nurses’ Health Study show folate reduced colon cancer risk.

Overall, the Task Force concluded that “the evidence is insufficient to recommend for or against the use of supplements of vitamins A, C, E; multivitamins with folic acid; antioxidant combinations for the prevention of cancer or cardiovascular disease.” They leave open the possibility that by lowering plasma homocysteine, B vitamins (B6, B12 and folate) may prevent some CVD, but as yet we lack interventional studies with clinical endpoints.

They further cautioned about the use of beta-carotene in smokers, the use of potentially toxic does of vitamins A and D, and the possible lack of quality control for preparations lacking a US Pharmacopeia seal. The recommendations are also qualified in that they apply only to the disease conditions examined and not to other situations such as the use of folic acid to prevent neural tube defects or to prevent deficiency in patients taking methotrexate.

Advising Your Patients

So do we throw out those vitamin supplements or continue to take them in hopes they will keep us healthy? It’s a tough call for nutrition professionals, as we like to be data-driven, and the data just aren’t all in yet. But we are also aware that a relative lack of data is not the same thing as negative data. At this point there would appear to be a difference between taking or recommending beta-carotene or high doses of vitamin A vs. taking or recommending folate or vitamin E.

There are some hopeful signposts on the road, it appears that B vitamins and long-term use of vitamin E may help avoid CVD, and folate may help prevent colon cancer, but at this point supplement use for these purposes is still an act of faith (although, with certain caveats, one with a low probability of harm). Our understanding may improve as the evolving field of nutrigenomics begins to clarify specific nutritional risk and needs for subgroups of individuals rather than for the population in general.
When is diet of sufficiently poor quality to indicate that multivitamins and supplements are necessary? Does such use make us more likely to settle for poorer diet quality? The Task Force notes, “Although the health benefits of vitamin supplementation remain uncertain, there is more consistent evidence that a diet high in fruits, vegetables, and legumes has important benefits; other constituents besides vitamins may account for the benefits of such diets.” Other expert groups, including the American Academy of Family Physicians, the American Heart Association and the American Cancer Society, have made recommendations similar to those of the Task Force. According to both of the Task Force publications, multiple prospective studies are underway to give better advice in the future.

References:
1. Morris CD and Carson S, Routine vitamin supplementation to prevent cardiovascular disease: A summary of the evidence for the US Preventive Service Task Force, Ann Intern med, 2003; 139:56. Review.
2. US Preventive Service Task Force, Routine vitamin supplementation to prevent cancer and cardiovascular disease: recommendations an rationale, Ann Intern med, 2003; 139:51.
3. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials; 1996 Feb; 17(1): 1-12.
Adapted from: Russell Merritt, MD, PhD, Nutrition & the M.D.; 29(12); December 2003; p. 1-3.

FDA WARNS CONSUMERS ABOUT STAR ANISE TEAS

People are being advised not to consume teas brewed from star anise after the FDA determined that such beverages have been associated with illnesses in adults, children, and infants. The illnesses range from serious neurological effects such as seizures, to vomiting, jitteriness and rapid eye movement.

Teas brewed from star anise are popular with some who believe that the brew helps to protect against colic infants. However, the FDA says that it is unaware of any scientific evidence to support those beliefs. According to the FDA, consumers should not drink star anise teas or give them to infants and children.

The initial reported illnesses were identified through a record review after a resident physician from Miami Children’s Hospital treating an infant with seizures associated with the ingestion of a star anise-containing tea reported his finding to the Florida Poison Information Center (FPIC). The FPIC then reported the findings to the FDA. All the infected individuals, including infants, recovered without complications. The FDA has since learned of similar reports from Florida, Illinois, New Jersey, Texas, and Washington as well as the Netherlands, France, and Spain.

Adapted from: FDA Consumer; 37(6); November-December 2003; p. 4.

POTENTIAL DRUG INTERACTIONS WITH ST. JOHN’S WORT

The risk for drug interactions is an important reason to ask patients about use of over-the-counter medications and dietary supplements. A recent open-label crossover study, US researchers assessed the effect of St. John’s wort (Hypericum perforaum) on the 2 most common drug metabolism enzymes, cytochrome P450 (CYP) enzyme subsystems #A4 and 2D6.
To establish baseline CYP activity, probe substrates for both enzyme systems (alprazolam for CYP 3A4 and dextromethorphan for CYP 2D6) were administered to 12 healthy volunteers (age range, 22-38). After a washout period, subjects received standardized, commercial preparations of St. John’s wort (300 mg 3 times daily) for 14 days, followed by another CYP activity assessment. St. John’s wort was associated with a significant mean 50 percent reduction in alprazolam plasma concentration and a corresponding 2-fold increase in alprazolam clearance; the half-life of alprazolam was shortened from a mean of 12.4 hours to 6.0 hours. Dextromethorphan metabolism did not change significantly.

These results suggest that St. John’s wort substantially induces the CYP 3A4 subsystem but not the CYP 2D6 system. According to the authors, the CYP 3A4 subsystem is involved in the metabolism of about half of marketed medications.

Reference:
1. Markowitz JS, Donovan JL, DeVane CL, et al. Effects of St. John’s wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA; 290; September 17, 2003; p. 1500-1504.
Source: Thomas L. Schwenk, Journal Watch; 23(22); November 15, 2003; p. 179.

USDA BUYS NUTS AND FRUITS FOR PROGRAM

Plums, dates, figs, raisins, and walnuts will be included in the federal school breakfast, lunch and summer food service programs in the fiscal year (FY) 2004. They will also be available for the Food Distribution Program on Indian Reservations, the Nutrition Program for the Elderly, the Commodity Supplemental Food Program, and the Emergency Food Assistance Program.

The US Department of Agriculture (USDA) bought $42 million of the fruits and nuts, which it announced the last day of FY 2003. This purchase accounts for almost half the total purchases of dried fruits and tree nuts in FY 2003, which began October 1, 2002. A total of $95.1 million worth of these products were purchased in FY 2002. This is the second largest total annual purchase of such products, behind the USDA’s FY 2001 purchases of $118 million worth of the commodities.

Source: Nutrition Week; 23(20); October 13, 2003; p. 7

FDA APPROVES HEALTH CLAIM FOR WALNUTS

Walnuts may now carry the label: “Supportive but not conclusive research shows that eating 1.5 ounces per day of walnuts as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.”

Source: Nutrition Today; 38(6); November/December; p. 200.

FOOD GUIDE PYRAMID GETS A FACELIFT

With the review of the dietary guidelines underway, the US Department of Agriculture (USDA) is revising the food guide pyramid for 2005. The original pyramid icon was introduced in 1992 to help people to easily and quickly grasp the basics of a healthy diet. As a first step in the update, the USDA’s Center for Nutrition Policy and Promotion (CNPP) has published some draft proposals for public comment. One possible alteration is to have individualized sex-, age-, weight-, height-, and physical activity-specific pyramids to personalize dietary recommendations. The American Dietetic Association will provide comments with its ideas for updating the Pyramid. Its working group includes Suzanne Murphy, PhD, RD, of Hawaii; Missy Cody, PhD, RD of Georgia; Constance Geiger, PhD, RD, of Utah; Judith Gilbride, PhD, RD, CDN, FADA, of New York; Rachael Johnson, PhD, MPH, RD, of Vermont; Eileen Kennedy, DS, RD, of Virginia; Melinda Manore, PhD, RD, of Oregon; and technical consultants.

Source: Nutrition Today; 38(6); November/December; p. 200.

FDA ANNOUNCES TO GRADE HEALTH CLAIMS USING REPORT CARDS

Since September 1st 2003, the US Food and Drug Administration (FDA) has been implementing a new law in which health claims on food labels, approved by the agency, come with a “Health Claims Report Card.” This system allows the FDA to grade the quality of scientific evidence presented in the health claims by the manufacturers on a “A-B-C-D” scale of an “A” representing “significant scientific agreement,” to a “D” representing “little scientific evidence supporting this claim.”

“This new initiative will better protect consumers from making uninformed or misinformed choices about their diet and nutrition, by giving consumers better information about the health consequences of those choices,” said FDA commissioner Mark B. McClellan, MD, PhD. In addition, he commented that the system is a reward for companies who produce healthier products, and that the FDA would “aggressively enforce the law against companies that appeal to consumers through false and misleading health claims.”

However, others disagree, such as the Center for Science in the Public Interest (CSPI), the American Council on Scientific Health, US Rep Henry Waxman (D. Calif), and the American Medical Association (AMA), arguing that the initiative avoids current law and misleads consumers. They believe that the labels confuse consumers rather than aid them in making “healthy” choices. In fact, some even argue that the new law allows the FDA to protect and give power to manufacturers. “All the good health claims will find their way onto food labels while the bad findings will be covered up by the food industry and be read only by medical professionals,” warned Bruce Silverglade, CSPI legal affairs director.

So, why is there such a big push towards regulating and providing health claims on food? The American Heart Association (AHA), along with the FDA, is concerned about the nutrition of Americans. Rose Mary Robertson, MD, chief science officer of the AHA has a positive outlook in that the labeling would help reduce the epidemics of obesity, childhood diabetes, and heart disease. “We hope this labeling will cause the food industry to compete on health grounds and not just on bigger portions,” she said.

In order to make the program effective, the FDA has been accepting petitions for qualified health claims to be a part of the new program. The agency will prioritize claims based on several key factors starting with how the claim may affect a life-threatening or serious illness, the efficacy of the claim based on scientific evidence, and, with the use of consumer research data, whether the claim is misleading.

Before any qualified health claim becomes accepted, the FDA will welcome public remarks on each petition. After the petition is filed, it becomes published in the Federal Register and also posted on the web site, accepting any comments from the public for 60 days. When the two-month open session is over, the FDA conducts a scientific review and performs further research.
For the FDA Task Force’s final report on the “Health Claims Report Card,” visit www.cfsan.fda.gov/~dms/ nuttftoc.html.

Reference:
1. Mike Mitka. Food fight over product label claims; Critics say proposed changes will confuse consumers. JAMA; August 20, 2003; 290(7): 871-5.
Source: Sayako Suzuki, Nutrition Student, University of California, Davis.

REPORT SETS DIETARY INTAKE LEVELS (DRI) FOR WATER, SALT, AND POTASSIUM TO MAINTAIN HEALTH AND REDUCE CHRONIC DISEASE RISK

The vast majority of healthy people adequately meet their daily hydration needs by letting thirst be their guide, says the newest report on nutrient recommendations from the Institute of Medicine of the National Academies. The report set general recommendations for water intake based on detailed national data, which showed that women who appear to be adequately hydrated consume an average of approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day, and men average approximately 3.7 liters (125 ounces) daily. These values represent adequate intake levels, the panel said; those who are very physically active or who live in hot climates may need to consume more water. About 80 percent of people's total water comes from drinking water and beverages, including caffeinated beverages, and the other 20 percent is derived from food.

“We don't offer any rule of thumb based on how many glasses of water people should drink each day because our hydration needs can be met through a variety of sources in addition to drinking water,” said Lawrence Appel, chair of the panel that wrote the report and professor of medicine, epidemiology, and international health, Johns Hopkins University, Baltimore. “While drinking water is a frequent choice for hydration, people also get water from juice, milk, coffee, tea, soda, fruits, vegetables, and other foods and beverages as well. Moreover, we concluded that on a daily basis, people get adequate amounts of water from normal drinking behavior, consumption of beverages at meals and in other social situations, and by letting their thirst guide them.”

Regarding salt, healthy 19- to 50-year-old adults should consume 1.5 grams of sodium and 2.3 grams of chloride each day, or 3.8 grams of salt, to replace the amount lost daily on average through perspiration and to achieve a diet that provides sufficient amounts of other essential nutrients. Elevated blood pressure, which may lead to stroke, coronary heart disease, and kidney disease, is associated with sodium intake. On average, blood pressure rises progressively as salt intake increases. A tolerable upper intake level (UL), a maximum amount that people should not exceed, is set at 5.8 grams of salt (2.3 grams of sodium) per day. Older individuals, African Americans, and people with chronic diseases including hypertension, diabetes, and kidney disease are especially sensitive to the blood pressure-raising effects of salt and should consume less than the UL. More than 95 percent of American men and 90 percent of Canadian men ages 31 to 50, and 75 percent of American women and 50 percent of Canadian women in this age range regularly consume salt in excess of the UL.

To lower blood pressure, blunt the effects of salt, and reduce the risk of kidney stones and bone loss, adults should consume 4.7 grams of potassium per day. However, most American women 31 to 50 years old consume no more than half of the recommended amount of potassium, and men's intake is only moderately higher. Canadians typically eat more potassium than their American counterparts. African Americans in the United States generally get less potassium than non-Hispanic whites, and because they have a higher prevalence of elevated blood pressure, increased potassium intake may have particularly significant benefits for them.

The typical Western diet is high in salt and low in potassium, the opposite of what evidence shows is optimal for good health and reducing the risks of chronic disease, the report says. “Research is needed to find ways to help people select better food choices to reduce their salt intake and boost their potassium consumption,” Appel said. In addition, because Americans and Canadians get the majority of their salt, 77 percent, according to one study, from prepared and processed foods, research should be done to help food processors develop alternative technologies that can reduce the amount of salt added during processing without impairing taste, shelf-life, or product qualities at an affordable cost.

Additional Findings on Water

This report refers to total water, which includes the water contained in beverages and the moisture in foods, to avoid confusion with drinking water only. Total water intake at the reference level of 3.7 liters for adult men and 2.7 liters for adult women per day covers the expected needs of healthy, sedentary people in temperate climates. Temporary under consumption of water can occur due to heat exposure, high levels of physical activity, or decreased food and fluid intake. However, on a daily basis, fluid intake driven by thirst and the habitual consumption of beverages at meals is sufficient for the average person to maintain adequate hydration.

Prolonged physical activity and heat exposure will increase water losses and therefore may raise daily fluid needs. Very active individuals who are continually exposed to hot weather often have daily total water needs of six liters or more, according to several studies.

While concerns have been raised that caffeine has a diuretic effect, available evidence indicates that this effect may be transient, and there is no convincing evidence that caffeine leads to cumulative total body water deficits. Therefore, the panel concluded that when it comes to meeting daily hydration needs, caffeinated beverages can contribute as much as non-caffeinated options.
Some athletes who engage in strenuous activity and some individuals with certain psychiatric disorders occasionally drink water in excessive amounts that can be life threatening. However, such occurrences are highly unusual. Therefore, the panel did not set an UL for water.

Additional Findings on Salt and Potassium

The recommended intake levels for salt provide enough sodium to balance losses from sweat by people who are exposed to temperatures higher than what they are used to or who are moderately physically active. Endurance athletes and other very active individuals may need more sodium because they lose more in sweat from intense and prolonged physical activity.
High salt intake has been directly linked to elevated blood pressure, also known as hypertension. About 25 percent of American adults and more than half of those age 60 and older have hypertension. American men's median intake of salt is between 7.8 and 11.8 grams per day, and women consume between 5.8 and 7.8 grams every day. Canadian men and women consume 7.1 to 9.7 grams and 5.1 to 6.4 grams per day respectively. Because these figures do not include the salt that people add at the table, they are probably underestimates.

Studies indicate that reduced consumption of salt coupled with increased potassium intake can blunt the age-related rise in blood pressure. American men consume just 2.8 to 3.3 grams of potassium daily on average, and women get an average of only 2.2 to 2.4 grams each day. Canadians consume slightly more, at 3.2 to 3.4 grams per day for men and 2.4 to 2.6 grams per day for women. Fruits and vegetables are both low in sodium and high in potassium. Among foods with the highest amounts of potassium per calorie are spinach, cantaloupes, almonds, brussel sprouts, mushrooms, bananas, oranges, grapefruits, and potatoes.

There was no evidence of chronic excess intakes in apparently healthy individuals to compel establishing a UL for potassium. However, people who have kidney dysfunctions that impair their ability to excrete potassium or who are on certain types of drug therapies, such as ACE inhibitors, should be under the supervision of a medical professional, who may recommend consuming less than the recommended 4.7 grams per day.

This study was sponsored by the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion and the National Institutes of Health; Health Canada; US Environmental Protection Agency; US Department of Agriculture; Institute of Medicine; the Dietary Reference Intakes Private Foundation Fund, including the Dannon Institute and the International Life Sciences Institute-North America; and the Dietary Reference Intakes Corporate Donors' Fund, contributors to which have included the Nabisco Food Group, Mead Johnson Nutritionals, and M&M Mars.

Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate is available on the Internet at http://www.nap.edu. Copies of the report will be available for purchase later this year from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242. This news release and report are available at http://national-academies.org.
Adapted from: The National Academies Press Release; February 11, 2004.

ALCOHOL AND BREAST CANCER

Alcohol consumption is linked to an increased incidence of hormonally sensitive breast cancer in older women, according to a recent report (1). The study, funded by the National Cancer Institute and conducted at the Fred Hutchinson Cancer Research Center in Seattle, consisted of interviews with nearly 2000 women aged 65 to 79 years, half with a history of breast cancer and half without. The researchers found that postmenopausal women who drank two or more alcoholic drinks per day had a significantly higher risk of breast cancer compared with nondrinkers. The data also showed that the alcohol-related risk varied by histological breast cancer type. Drinking two or more alcoholic drinks per day gave a 330 percent increased risk of lobular cancer, a 50 percent increased risk of ductal cancer and a 40 percent increased risk of estrogen-receptor and progesterone-receptor positive breast cancers. No link was found between alcohol consumption and hormonally insensitive breast cancers. The results suggest a hormonal basis for the association of alcohol and breast cancer incidence. “Alcohol is known to increase estrogen levels in the blood, and therefore it could stimulate hormonally sensitive tumors,” said lead author Christopher Li, MD, PhD, in a statement.

Reference:
1. Li CI, Malone KE, Porter PL, et al. The Relationship between Alcohol Use and Risk of Breast Cancer by Histology and Hormone Receptor Status among Women 65–79 Years of Age. Cancer Epidemiol. Biomarkers Prev; 2003 12: 1061-1066.
Source: JAMA; 290(24); December 24/31, 2003; p. 3186.

HORMONE-FREE CLAIMS TO BE REMOVED FROM LABELING

Four manufacturers of whole milk, reduced-fat milk, and ice cream received warning letters from the FDA in September 2003, informing them that their products are misbranded. The products’ labeling contains the false statements “No Hormones” or “Hormone Free.”

The warning letters explain that the statements make false claims because all milk contains naturally occurring hormones, and milk cannot be processed in a manner that renders it free of hormones.

The FDA also cautioned the firms that the agency could pursue further action such as seizure or injunction, or both, if they fail to take prompt action to correct the labels.

Source: FDA Consumer; 37(6); November-December 2003; p. 5.

CANADA STARTS LABELING FOR CERTAIN NATURAL PRODUCTS

Herbal remedies, homeopathic medicines, vitamins, minerals, traditional medicines, probiotics, amino acids, and essential fatty acids will all fall under the new Natural Products Regulations law. For a manufacturer to obtain a license to sell his or her products, he or she must submit to Health Canada the product’s medicinal ingredients, source, potency, non-medicinal ingredients, and recommended use. Once licensed, the product will be labeled with NPN or DIN-HN (homeopathic medicine) and a license number. The label will contain directions for use, any health claims, medicinal and non-medicinal ingredients and any contradictions or known adverse effects, Phase-in should take 2 to 6 years.

Source: Nutrition Today; 38(6); November/December; p. 241.

OLESTRA LABELING CHANGE

The labeling requirement advising consumers about the potential abdominal problems for foods containing the zero-calorie fat substitute olestra is no longer warranted, the Food and Drug Administration (FDA) says.

The FDA announced in the Aug. 5, 2003, Federal Register that manufacturers will no longer need to include the label statement, required since olestra’s approval in 1996. The statement informs consumers that olestra may cause abdominal cramping and loose stools in some people, that it inhibits the body’s absorption of vitamins A, D, E, and K and other nutrients, and that these vitamins have been added to compensate for olestra’s effects on these nutrients. Consumption studies of products containing olestra showed the fat substitute caused only infrequent, mild gastrointestinal effects in amounts that reflected typical dietary habits. However, the FDA will require manufacturers to continue adding vitamins A, D, E, and K to such products.

Olestra was approved in 1996 for use in potato chips, cheese puffs, and other savory snacks. While the label changes are effective immediately, consumers can expect that there may be a period of time before companies introduce the new product label.

Source: FDA Consumer; 37(6); November-December 2003; p. 6.

LONG-TERM USE OF MULTIVITAMINS MAY PROTECT AGAINST COLON CANCER

An article published in The American Journal of Epidemiology looked at the relationship between multivitamin use and the incidence of colon cancer (1). A total of 145, 260 men and women enrolled in the Cancer Prevention Study II Nutrition Cohort were asked about their multivitamin use. Looking at this data and data from the same participants enrolled in a study completed 10 years earlier, the authors concluded that regular multivitamin use (4 or more times per week) was not associated with a decreased risk of colorectal cancer (rate ratio = 1.04, 95 percent confidence interval). However, previous multivitamin use did reduce risk (rate ratio = .71, 95 percent confidence interval). Whether multivitamin use decreases the risk of colorectal cancer has not been studied in randomized studies.

Reference:
1. Jacobs EJ, Connell CJ, Chao A, et al. Multivitamin Use and Colorectal Cancer Incidence in a US Cohort: Does Timing Matter? Am J Epidemiology, 2003; 158:621-628.
Source: Nutrition Today; 38(6); November/December; p. 200.

STUDY: MODERATE PHYSICAL ACTIVITY PROMOTES WEIGHT LOSS AS WELL AS INTENSE EXERCISE

Women trying to loose weight can benefit as much from moderate physical activity as from an intense workout, according to researchers at the National Heart, Lung, and Blood Institute (NHLBI).

Prior studies have focused on short-term weight loss, and data on the optimal degree and amount of physical activity for long-term weight loss had been lacking, the researchers say (1).

The exercise dose and intensity trial involved 201 overweight, but otherwise healthy, women ages 21 to 45. All received reduced-calorie meals in addition to being randomly assigned to one of four physical activity regimes, which varied by intensity and duration. The regimes consisted of either a moderate- or vigorous-intensity physical activity performed for either a shorter (2.5 to 3.5 hours per week) or longer (3.5 to 5 hours per week) duration. The physical activity consisted primarily of brisk walking, and the regimens burned about 1,000 or 2,000 calories per week.

Women in all four groups lost a significant amount of weight, about 13 to 20 pounds, and maintained their weight loss for a year. They also improved their cardiorespiratory fitness. However, the weight lost or fitness improvement was not different among the four groups.

The same issue of JAMA includes an article on recreational physical activity and breast cancer risk. The study, based on data from the Women’s Health Initiative’s Observational Study, found that increased physical activity was associated with a reduced risk for breast cancer in postmenopausal women. Longer duration physical activity gave the most benefit, but the physical activity did not need to be strenuous to reduce breast cancer risk.

Reference:
1. Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. Effect of Exercise Dose and Intensity on Weight Loss in Overweight, Sedentary Women: A Randomized Trial. JAMA; Sept 10, 2003; 290:1323-1330.
Source: FDA Consumer; 37(6); November-December 2003; p. 8.

RESOURCES:

THE POWER OF CHOICE

The Department of Health and Human Service’s Food and Drug Administration and the US Food and Drug Administration’s Food and Nutrition Service developed the Power of Choice. It is intended for after-school program leaders working with young adolescents. Everything you need to know is in the Leader’s Guide, including most activity materials. It's full of quick, simple things to do with kids; many activities take little or no pre-planning. The publication contains 10 interactive sessions based on four posters. Included in the Leader's Guide are a recipe booklet, parent letter, and Nutrition Facts cards. The CD contains additional activities, tips for improved communication with adolescents, a training video for the adult leaders, and a song for pre-teens.
[Online source:] http://www.fns.usda.gov/tn/Resources/power_of_choice.html.

NEED TO FIND AN RD WHO IS A MEDICARE PROVIDER? LOOK NO FURTHER!

There are now several ways for consumers to identify a registered dietitian who is a Medicare provider. To find 1 of the 4,125 providers signed up to offer medical nutrition therapy through Medicare, consumers can go online with MEDPARD (Medicare Participating Physician/Supplier Directory) and can be found at: http://www.hgsa.com/bene/medpar.shtml. The MEDPARD now includes registered dietitians and nutrition professionals. Individual state carriers may also have state Medicare directories.
Finally, the American Dietitian Association (ADA) lists providers in its Nationwide Nutrition Network (NNN) online database at: http://www.eatright.org/Public/PublicDietitianDisclaimerAdvanced.htm. Entering a zip code can search the database for an RD in the nearest vicinity. Listings on the ADA site are free to ADA members; interested members should contact ADA’s member service center at 800-877-1600 Ext 5000.

Adapted from: Nutrition Today; 38(6); November/December; p. 200.

NEW GRANT.GOV WEB SITE OFFERS ONE-STOP SHOPPING FOR INFORMATION ON APPLYING FOR ALL FEDERAL GRANTS

The Department of Health and Human Services (HHS) Secretary Tommy G. Thompson recently unveiled a single, comprehensive Web site that will contain information about finding and applying for all federal grant programs.
The Web site, Grants.gov, makes it easier for organizations to learn about and apply for federal grants. Its launch marks an important milestone in President Bush's Electronic Government (E-Gov) Initiative.

“For the first time, there will be a single government-wide source for information about grants programs across the federal government,” Secretary Thompson said. “By putting relevant information in one place, we're helping to level the playing field for organizations less familiar with federal grant programs so that they too can identify and apply for appropriate grants.”
Grants.gov is a key element of President Bush's E-Gov initiative, which aims at harnessing Internet-based technology to make it easy for citizens and businesses to interact with the government, save taxpayer dollars, and streamline citizen-to-government communications.

The White House Office for Management and Budget (OMB) named the HHS as the lead agency for this Grants.gov initiative. The HHS awards more than half of all the competitive grants across the federal government.

“President Bush has made it a priority for his administration to provide government information and applications in ways that are more accessible and easier to understand,” OMB Director Joshua Bolten said. “Grants.gov is a strong step forward in that effort, as it makes the federal grant-making process simpler and more efficient for applicants. The launch of this important Web site is a milestone in progress on the President's Management Agenda.”

The HHS led the development of the cross-agency Web site, which now has information about more than 800 available grant programs involving all 26 federal grant-making agencies. These agencies together award more than $360 billion in grant funds. The site provides information in a standardized format across agencies and includes a “Find Grant Opportunities” feature to help applicants find potential funding opportunities.

The site also contains an “Apply for Grants” feature that greatly simplifies the application process by allowing applicants to download, complete and submit applications for specific grant opportunities from any federal grant-making agency.
To date, application packages have been posted to the Grants.gov Web site by five agencies, the US Departments of Commerce, Education, Energy, Justice and the HHS. This section will be expanded in the future as federal agencies continue to post application information about additional grant opportunities.

The site has been developed with extensive input from organizations that apply for and receive federal grants to maximize its potential to simplify the process and meet the needs of the grant community.

Grants.gov is a collaborative effort involving the HHS and the Departments of Agriculture, Commerce, Defense, Education, Homeland Security, Housing and Urban Development, Justice, Labor and Transportation, as well as the National Science Foundation.

More information about Grants.gov is available at http://www.grants.gov. More information about the President's E-Gov Initiative is available at http://www.whitehouse.gov/omb/egov.

Source: Tommy G. Thompson, DHHS Press Office. December 09, 2003.

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