UNIVERSITY OF CALIFORNIA
COOPERATIVE EXTENSION
NUTRITION PERSPECTIVES
Volume 24, No. 2
Jul/Aug 1999
TABLE OF CONTENTS
California Nutrition Council Testimony Presented at Recent FDA Meeting
Is DHEA Replacement Beneficial?
Algae Safety Warning
The FDA Warns About a Potentially Deadly 'Party Drug'
Iron Supplements Recalled
FTC Attacks 'Vitamin O' Promotion
Calcium Update: Summary of the Research
Soy Protein Supplementation Benefits Perimenopausal Women
Soy Oligosaccharides and Flatulence
Broccolini: A Tasty New Vegetable
Diet and Blood Pressure
What is the DASH Diet?
Dietary Fiber Reduces Coronary Risk in Women
Dietary Fat and Risk of Breast Cancer
New Recommendation For Vitamin C
Vitamin C Reverses Acute Effects of Hyperhomocysteinemia
Dietary Supplement Labeling More Informative
Veggie Diets' Mushrooming Popularity Requires Watchfulness
Breast Cancer and Alcohol Consumption
Upcoming Conferences:
Partnerships for Health in the New Millennium
The American Dietetic Association's Annual Meeting: Spread the Word
The California Nutrition Council Annual Meeting
Resources:
New Pamphlets Highlight Calcium Benefits for English-Speaking, Minority
Groups
A New USDA Web Site Touts Health Benefits of Soy Foods
National Food Safety Education Month
Subscription for NUTRITION PERSPECTIVES
Sheri Zidenberg-Cherr, PhD, Editor
University of California
Department of Nutrition
One Shields Ave.
Davis, CA 95616
NUTRITION PERSPECTIVES is prepared by Sheri Zidenberg-Cherr, PhD, Nutrition Specialist,
Julie Schneider, and staff. It is designed to provide research-based information on
ongoing nutrition and food-related programs. It is published bimonthly (six times
annually) as a service of the University of California Cooperative Extension and the
United States Department of Agriculture. Subscription to NUTRITION PERSPECTIVES is
available from UC Cooperative Extension, Department of Nutrition, University of
California, Davis, California. Cost is ten dollars ($10.00) for a one-year subscription.
Subscriptions and questions or comments on articles may be addressed to: NUTRITION
PERSPECTIVES, University of California, Department of Nutrition, One Shields Ave., Davis, CA 95616-5270. Phone (530) 752-3387; Fax (530) 752-8905.
CALIFORNIA NUTRITION COUNCIL TESTIMONY PRESENTED AT RECENT FDA MEETING
Rita Mitchell, RD, current president of the California Nutrition Council (CNC), recently
presented the following testimony at the Dietary Supplement Stakeholder Meeting, Food and
Drug Administration (FDA), held on July 20, 1999.
My name is Rita Mitchell. I am the President of the California Nutrition Council, a
nonprofit organization of nutrition professionals and other individuals representing
government agencies, universities and colleges, professional associations, the food
industry, and consumer groups. This diverse membership allows the CNC to present a unique
viewpoint on dietary supplements because our members work directly with consumers; with
programs to educate consumers; and with peer-reviewed research evaluating nutritional
needs, safety issues and consumer understanding.
The CNC applauds the FDA for providing this opportunity to speak out publicly about the
inadequate system of assuring consumer safety with respect to dietary supplements. The
first question you raise asks for objectives that an overall dietary supplement strategy
should address, in addition to ensuring consumer access to safe dietary supplements that
are truthfully and not misleadingly labeled. We would be satisfied if consumers did have
access to safe dietary supplements that are truthfully and not misleadingly labeled. Under
the current laws, dietary supplements do not have to be proven safe or effective before
they are marketed. Ideally, the law would be changed to correct this situation and we
would support any legislative effort to do so. Consumers need assurances that products are
safe and that claims are substantiated by valid scientific research.
The CNC members in clinical practice have described experiences in which individuals have
delayed conventional treatment of serious illnesses in favor of taking dietary
supplements. Information on the package label led them to believe that these products
would help them. In fact, the supplements contributed to severe disability or even death.
Consumers must be protected and they should be informed that current law does not
guarantee that all dietary supplements offered for sale are safe and effective.
We strongly believe that ensuring public safety should be the FDA's top priority. We
recommend that the FDA mount a massive public education campaign, similar to the
anti-tobacco campaign, to encourage consumers to learn all they can about the dietary
supplements they take.
In preparing this testimony, I have spoken to many consumers and health professionals.
Most of them were not aware of the provisions of the Dietary Supplement Health and
Education Act (DSHEA). They were horrified to learn that products can be marketed before
they are proven safe and effective; that they are not required to meet the rigorous safety
and quality standards of food additives and drugs. They were also dismayed to learn that
manufacturers can sell products claiming to cure all kinds of illnesses or ailments, when
in fact, there is no proof that the products will cure illnesses and that they may even be
harmful or deadly. Consumers have a right to know of the potential risks associated with
intake of dietary supplements.
Since at this time, the FDA can't require manufacturers to prove safety and effectiveness
before a product is marketed, the CNC recommends that the FDA establish specific criteria
for a voluntary approval process, allowing products to bear a seal of the FDA approval for
safety and effectiveness. The CNC members would be willing to contribute expertise to the
development of such criteria.
We recommend strengthening the adverse event reporting system. This should be part of the
massive consumer education campaign - to let consumers know the importance of reporting
adverse events, and information about how to easily report them. The FDA must improve the
follow-up process when adverse events are reported. We urge you to enforce the existing
law to stop the rampant proliferation of dietary supplements with unfounded claims.
As part of the adverse event reporting system, we suggest that there be a requirement for
a mandatory report to the Centers for Disease Control and Prevention by physicians and
other health professionals who learn of cases of adverse events related to dietary
supplements.
The CNC recommends that the FDA require written information to be provided with dietary
supplements, including botanicals. This information should be standardized and should
include, but not be limited to:
¨ active ingredients;
¨ directions for use including maximum suggested level per designated period of time;
¨ interactions with prescription medications and over-the-counter drugs;
¨ toxicity levels;
¨ caution statements when appropriate for vulnerable groups such as pregnant and
lactating women, children, the elderly, and persons with compromised immune systems; and
¨ shelf-life and storage conditions.
There is much still to be learned in the area of dietary supplements. The CNC supports
scientific research on the safety and effectiveness of dietary supplements, especially
those for weight loss and other widely used products.
In summary, the CNC members believe that the public has the right to dietary supplements
that are safe, effective, and appropriately labeled. They have the right to information
that allows them to make decisions based on sound scientific research. The CNC members
have expertise in nutritional science and consumer education. We stand ready to assist the
FDA in any way we can to achieve these goals and objectives.
Thank you for your attention and for allowing me to provide this testimony.
For membership information regarding the CNC, please contact Dr. Sheri Zidenberg-Cherr at
(530) 752-3387 or sazidenbergcherr@ucdavis.edu
IS DHEA REPLACEMENT BENEFICIAL?
Blood levels of the androgenic compound dehydroepiandrosterone (DHEA) and its sulfate
ester (DHEA-S) decline with age. Some people have claimed that DHEA supplementation might
improve health or well-being and slow down the aging process. Researchers enrolled 39
healthy men, aged 60 to 84, in a recent double-blind crossover study (1). Each subject
received three-month courses of DHEA (50 mg twice a day) and a placebo, given in random
order and followed by a three-month washout period.
Oral DHEA supplementation resulted in substantial increases in blood levels of DHEA and
DHEA-S. However, according to subjects' responses on standardized questionnaires, there
were no changes in attitudes, activity, lifestyle, or sex drive during DHEA therapy,
compared with placebo. In addition, there were no significant changes in body weight and
body fat, food intake, or urinary symptoms.
DHEA therapy, given at "replacement doses" according to the authors, had no
obvious clinical effects during relatively short-term administration. Whether longer
courses or higher doses of DHEA would confer demonstrable benefits or harms remains
unclear; for now, most authorities advise against DHEA supplemen-tation.
Reference:
1. Flynn MA, Weaver-Osterholtz D, Sharpe-Timms KL, Allen S, et al. Dehydroepiandrosterone
replacement in aging humans. J Clin Endocrinology and Metabolism, 84(5): 1527-33, May
1999.
Source: Brett AS. Journal Watch, 19(13), July 1, 1999.
ALGAE SAFETY WARNING
The Canadian Health Protection Branch has warned that blue-green alga products have been
found to contain microcystin levels that exceed those considered safe for daily
consumption. Microcystins, which some alga species naturally produce, accumulate in the
liver and can cause liver damage. The contamination potential appears greatest for
products made from the algae in natural lakes. Adverse symptoms from long-term use of
these products (weeks to months) may not be obvious, but could range from a feeling of
general malaise or gastrointestinal discomfort to jaundice. Children appear more sensitive
to these effects, which are more likely to manifest as nausea, vomiting, or diarrhea. The
agency also noted that it has not received any evidence that blue-green algae is effective
against attention deficit disorder in children and has not authorized the marketing of any
blue-green algae product for any therapeutic purpose.
Source: Nutrition Forum 16(4), July/August 1999.
THE FDA WARNS ABOUT A POTENTIALLY DEADLY 'PARTY DRUG'
Prompted by reports of at least three deaths and several severe adverse
reactions, the FDA in May warned the public about a new group of products sold on the
Internet, in health food stores, and through ads in muscle-building magazines. The agency
declared one of the new products - 1,4 butanediol (BD) - a Class I health hazard, meaning
its use could pose a potentially life-threatening risk.
The FDA considers BD products unapproved new drugs, and the products have been seized to
prevent their sale and further illnesses and deaths.
Marketed alternatively as sleep aids, "party drugs," and dietary supplements,
these BD-related products chemically resemble two other hazardous substances that the FDA
considers unapproved new drugs - gamma hydroxybutyric acid (GHB) and gamma butyrolactone
(GBL). The FDA has issued several warnings about GHB and GBL. Health officials believe
that manufacturers of these products are renaming them and substituting BD for GBL.
Considered as dangerous as GHB and GBL, BD can cause dangerously low respiratory
(breathing) rates, unconsciousness, vomiting, seizures, and death. Also, BD may increase
the effects of alcohol and is even more dangerous when consumed with other depressant
drugs.
Products that contain BD include Revitalize Plus, Serenity, Enliven, GHRE, SomatoPro,
NRG3, Thunder Nectar, and Weight Belt Cleaner. The labels of suspect products may list 1,4
butanediol, tetramethylene glycol, gamma butyrolactone, or 2(3H)-furanone di-hydro as
ingredients.
In issuing its warning on BD products, the FDA said it could not ensure the effectiveness
or safety of any sleep-aid product other than the FDA-approved drugs. "People who use
unapproved sleep inducement products, especially without proper medical supervision, may
be unnecessarily exposing themselves to serious harm," the agency said.
Source: FDA Consumer, 33(4), July/August 1999.
IRON SUPPLEMENTS RECALLED
The Sanapac Co. of Dallas, PA, in cooperation with the US Consumer Product
Safety Commission (CPSC), recalled 14,000 bottles of dietary supplements containing
elemental iron because they were not in child-resistant packaging. Children can be
seriously injured or die if they ingest the pills in toxic amounts.
The following products are included in the recall: Super Queens Inner Woman, Super Kings
Inner Man, Sanapac Inner Man Gold, Sanapac Rooster Brand Pills and Extra Strength Rooster
Kings. Each bottle features the Sanapac company name and logo; the products are packaged
in containers of 30, 35, 60, and 70 tablets, all with traditional, screw-on caps.
Pharmacies, health food, vitamin, and grocery stores nationwide sold the supplements from
January through December 1998 for $6 to $20.
Consumers should return the products to the store where purchased for a refund or a
child-resistant package. For more information call Sanapac Co. at (800) 220-8180 between 9
am and 5 pm EST Monday through Friday.
Products sold since December 1998 are in child-resistant packages and are not involved in
this recall.
Adapted from: AAP News 15(5), May 1999.
FTC ATTACKS 'VITAMIN O' PROMOTION
A federal court judge has ordered Rose Creek Health Products and The Staff of Life - both
owned by Donald L. Smyth - to stop making unsubstantiated claims about their "Vitamin
O." The defendants had advertised that (a) many people suffer disease and diminished
health as a result of oxygen deprivation caused by pollution, deforestation, stress, or
other causes; (b) "Vitamin O" contains "nearly 30,000 parts per million of
dissolved "stabilized oxygen"; (c) oral administration would cause oxygen to be
absorbed into the body through the gastrointestinal system and enrich the oxygen content
of the bloodstream; (d) this would provide the amount of oxygen needed for optimum health;
and (e) the product was effective against cancer, cardiovascular disease, lung disease,
and many other health problems. About a dozen other companies are making various false
claims for "stabilized oxygen" products.
Source: Nutrition Forum 16(4), July/August 1999.
CALCIUM UPDATE: SUMMARY OF THE RESEARCH
The information below is designed to provide a quick reference to the current calcium
research by highlighting the key elements of some recent studies.
Calcium and Osteoporosis
A comprehensive review of 31 published clinical trials examining the effects of calcium
supplementation on bone mass change in postmenopausal women was conducted by researchers
from the Helen Hayes Hospital in New York City (1). The purpose of the review was to
determine whether calcium supplementation improved the efficacy of the hormones estrogen
and calcitonin on bone mass change. Estrogen and calcitonin promote retention of calcium
in the bone. The results showed that calcium supplementation (1183 mg/day) enhanced the
positive impact of estrogen on bone mass at all skeletal sites. Calcium supplementation
also enhanced the beneficial impact of calcitonin on the bone mass of the spine.
Dairy Foods and Colon Cancer
Researchers from St. Luke's-Roosevelt Hospital Center in New York City conducted a study
investigating whether increased consumption of calcium from dairy products could reduce
the risk of colon cancer in people (n=70) at risk for the disease (2). The randomized,
controlled trial was conducted over periods of six and twelve months. The study tracked
whether increased consumption of calcium from dairy products could alter certain
biomarkers (indicators) of colon cancer, specifically abnormal, rapid cell growth. The
results showed that consumption of low-fat dairy products providing calcium in amounts of
approximately 1200 mg per day inhibited abnormal cell growth. Colon cancer is one of the
most widespread forms of cancer in the United States, afflicting approximately 55,000
people each year.
Numerous studies have indicated that calcium is a key factor in the protective role of
dairy products. Additional nutrients found in dairy foods are also believed to contribute
to the protective effect as well. Such components include vitamin D, butyrate,
sphingomyelin, and conjugated linoleic acid.
Calcium and PMS
A recent clinical study of healthy, premenopausal women (n=497) indicates that calcium
supplementation may be a highly effective treatment for premenstrual syndrome (3). The
team of researchers from St. Lukes-Roosevelt Hospital Center in New York City supplemented
half of the women with 1200 mg of elemental calcium and half were given a placebo. The
women were monitored throughout three menstrual cycles. Each provided daily documentation
of 17 core symptoms and 4 symptom factors including water retention, food cravings, and
pain. The results showed a 48 percent reduction in total symptom scores compared to a 30
percent reduction seen with the placebo. The researchers concluded that calcium is a
simple, effective treatment in premenstrual syndrome, resulting in a major reduction of
associated symptoms.
Calcium and Blood Pressure
Researchers from the University of Southern California School of Medicine studied
African-American teenagers (n=116) to assess the impact of calcium supplementation on the
teens' blood pressure levels (4). Participants were known to have low intakes of calcium
in their diet. The study results, showed that adding 1500 mg of calcium into the diet of
the teens significantly lowered their blood pressure.
The DASH (Dietary Approaches to Stop Hypertension) study (5) showed that a diet rich in
low-fat dairy products, fruits, and vegetables can have a substantial impact on the
lowering of blood pressure. This multi-center, randomized feeding study tested the effects
of dietary patterns versus individual nutrients in 459 adults. The participants were not
taking any blood pressure medication, and included a range of blood pressure from normal
to mildly hypertensive. The results indicate that a diet containing an abundance of
low-fat dairy products, fruits and vegetables, with reduced saturated and total fat
overall, could significantly lower blood pressure.
Low-fat dairy foods have been linked with the ability to reduce the risk of hypertension
in nearly 200 studies. For this reason, in August of 1998 the Milk Industry Foundation
submitted a health claim petition to the US Food and Drug Administration to allow
manufacturers to include information in food labeling on the link between diets rich in
dairy products and the lower risk of high blood pressure.
Calcium and Kidney Stones
Researchers from Washington State University conducted a study investigating whether
increasing calcium in the diet could potentially reduce the risk of kidney stones by
lowering levels of urinary oxalate (6). Oxalates, compounds present in certain foods, are
found in the make-up of kidney stones. The study participants had a history of at least
one calcium oxalate stone. The two study diets used differed only when milk was
substituted for apple juice. The diet itself was moderately high in oxalates. The
milk-drinking group - with higher calcium intakes - had lower levels of urinary oxalate,
which could potentially reduce the risk of kidney stones. The researchers believe that
milk binds with the oxalate in a meal, rendering it unavailable for kidney stone
formation.
References:
1. Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and
calcitonin on bone mass: review and analysis. Am J Clin Nutr 67(1): 18-24, 1998.
2. Holt PR, Atillasoy EO, Gilman J, Guss J, et al. Modulation of abnormal colonic
epithelial cell proliferation and differentiation by low-fat dairy foods: a randomized
controlled trial. JAMA 280(12): 1074-9, 1998.
3. Thys-Jacobs S, Starkey P, Bernstein D, Tian J. Calcium carbonate and the premenstrual
syndrome: effects on premenstrual and menstrual symptoms. Premenstrual Syndrome Study
Group. Am J Obstetrics and Gynecology 179(2): 444-52, 1998.
4. Dwyer JH, Dwyer KM, Scribner RA, Sun P, et al. Dietary calcium, calcium
supplementation, and blood pressure in African American adolescents. Am J Clin Nutr 68(3):
648-55, 1998.
5. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, et al. A clinical trial of the effects of
dietary patterns on blood pressure. DASH Collaborative Research Group. New England J Med
336(16): 1117-24, 1997.
6. Massey LK, Kynast-Gales SA. Substituting milk for apple juice does not increase kidney
stone risk in most normocalciuric adults who form calcium oxalate stones. J Am Dietetic
Assoc, 98(3): 303-8,1998.
Adapted from: California Milk Advisory Board News Release, January 1999.
SOY PROTEIN SUPPLEMENTATION BENEFITS PERIMENOPAUSAL WOMEN
There has been increasing interest in the effects of soy-containing products on women's'
health. It is believed that the phytoestrogens in these products may confer many of the
benefits of exogenous estrogen without all of the risks. A recent randomized,
double-blind, crossover trial investigated the effect of soy protein supplementation on
menopausal symptoms and risk factors for cardiovascular disease in 51 perimenopausal women
aged 45 to 55 years (1). All women received six weeks each of three dietary supplements:
20 g of soy protein containing 34 mg of phytoestrogens given in a single dose or split
into two doses or 20 g of complex carbohydrates (comparison diet).
Both total and low-density-lipoprotein cholesterol were significantly lower with either
soy diet (by roughly 5 to 7 percent) than with the comparison diet. Diastolic blood
pressure was significantly lower (by 5 mm Hg) with the twice-daily soy diet. This diet was
also associated with a significant improvement in the severity, but not the frequency, of
hot flashes and hypoestrogenic symptoms. These data provide further evidence of the
benefits of soy dietary supplements, at least in perimenopausal women. Further studies of
the effects of isoflavones and other phytoestrogens, with larger samples and for longer
periods, are needed.
Reference:
1. Washburn S, Burke GL, Morgan T, Anthony M. Effect of soy protein supplementation on
serum lipoproteins, blood pressure, and menopausal symptoms in perimenopausal women.
Menopause 6(1): 7-13, 1999.
Adapted from: Journal Watch 19(9), May 1, 1999.
SOY OLIGOSACCHARIDES AND FLATULENCE
Anyone counseling people about the use of soyfoods will occasionally
encounter the complaint that soybeans and soyfoods cause abdominal bloating and gas, also
known as flatulence. Soybeans and other legumes contain oligosaccharides: soluble
carbohydrates which are chemically larger than sugars but smaller than starch. Humans lack
the ability to make the enzyme (a-galactosidase) needed to digest oligosaccharides (1). As
a result, these large molecules move on to the lower intestine, where their digestion by
intestinal microorganisms causes the formation of gas. Individual differences in diet and
gut microflora determine how much, if any, flatulence occurs.
Two common oligosaccharides, stachyose and raffinose, are most frequently associated with
lower intestinal discomfort. Compared to other legumes, soybeans are fairly high in
oligosaccharides, with defatted soy meal containing about 60 mg/g. Mature soybeans contain
raffinose in the range of 0.1 to 0.9 percent and stachyose in the range of 1.4 to 4.1
percent.
Japanese food manufacturers have long included soy oligosaccharides in various foods, such
as soft drinks, cookies, cereals, and candies, with no apparent ill effects (2).
Unpublished data indicate similar results from a two-week regimen of 3.0 g/day of pure soy
oligosaccharides contained in carbonated soft drinks (3). Despite such findings, no
American food companies have developed functional foods using soy oligosaccharides.
People who have a difficult time digesting soyfoods may want to try the following options:
¨ Soy products which have most of the whey removed, such as tofu. The whey contains most
of the oligosaccharides.
¨ Fermented soy products, such as tempeh and miso. The fermentation process reduces most
of the flatus-inducing effects.
¨ Soy-isolate powders. All the carbohydrates have been removed.
¨ Soy products whose primary ingredient is soy concentrate. A portion of the
carbohydrates have been removed.
¨ Commercial products to reduce flatulence (eg, Beano) are helpful. If cooking raw
soybeans, draining and rinsing the beans after soaking them will remove most of the
soluble carbohydrates.
¨ Kombu, a dried seaweed found in Asian markets and natural food stores, can be added to
the cooking water when cooking soybeans.
¨ Finally, new 'value-added' soybeans have been developed which contain higher levels of
sucrose and lower levels of raffinose and stachyose than commodity soybeans. They can be
found in health food stores, natural food stores, and some supermarkets.
References:
1. Liu, K. Soybean Chemistry, Technology, and Utilization. New York: Chapman & Hall,
1997.
2. Tomomatsu, H. Health effects of oligosaccharides. Food Tech 48(10):61-65, 1994.
3. Quaker Oats Company. Internal Report D-93077. Barrington, IL, 1993.
Adapted from: The Soy Connection 7(3), Summer 1999.
BROCCOLINI: A TASTY NEW VEGETABLE
Broccolini, also called baby broccoli, is a cross between broccoli and
Chinese kale that resembles asparagus, tastes milder and sweeter than broccoli, but is
less fibrous. Developed by the Sakata Seed America of Morgan Hill, California, it is grown
in California and Arizona. An eight-stalk portion provides 35 calories, 1 gram dietary
fiber, 3 grams protein, 2 grams sugars, 2 grams other carbohydrates, 30 percent of the
Daily Value for vitamin A (as betacarotene), 130 percent of vitamin C, 6 percent of
calcium, and 4 percent of iron. The cost is similar to that of asparagus. Retailer
locations are available by e-mail from info@broccoli.com or by calling (800) 884-6266.
Source: Nutrition Forum 16(4), July/August 1999.
DIET AND BLOOD PRESSURE
If you are overweight and have high blood pressure, a first step is to lose weight,
usually through a combination of calorie reduction and increased physical activity. Eating
certain kinds of food and avoiding others also may help reduce blood pressure or keep it
from getting high in the first place.
Some dietary factors to consider in preventing and treating hypertension are:
Salt and Sodium
Many studies in diverse populations have shown that a high-sodium intake is associated
with higher blood pressure. The National Academy of Sciences, the American Heart
Association, and the federal government's "Dietary Guidelines for Americans"
recommend limiting sodium intake to 2,400 milligrams a day.
For cooking at home, low-salt and low-sodium cookbooks abound. Or simply spare the salt
and, if you like, substitute other spices and flavorings, such as pepper, garlic, ginger,
onion, or lemon juice. Watch out for some flavorings and ingredients, such as monosodium
glutamate (Accent, for example), soy sauce, and some spice mixtures that contain large
quantities of sodium.
Also, many processed foods are high in salt and other sodium-containing ingredients.
You can tell how much sodium is in packaged foods by reading the Nutrition Facts panel on
food labels. There, manufacturers must list the amount of sodium (in milligrams) in a
serving of the food and show (as a percentage) how that amount contributes to the daily
reference value for sodium, which is 2,400 milligrams.
To quickly identify foods with lower sodium contents, look for products with label claims
like "no salt added," "low sodium," or "two-thirds less
salt." These claims must meet government-enforced definitions, so that they mean the
same for any product on which they appear.
If you eat out a lot, you may want to ask restaurants to hold the salt in your orders.
Some may already offer lower sodium foods on their menus, so look for menu items with
claims like "low sodium." Nutrition claims on menus must mean the same as they
do on packaged food (1).
Before using salt substitutes, which contain potassium chloride, check with your doctor
just to make sure they're all right for you. In general, an increase in potassium can help
attain a normal blood pressure, but there may be other factors, such as medicines you are
taking and other health factors, that need to be considered.
Alcohol
Some studies show that low to moderate consumption of alcohol, especially wine, may help
reduce heart disease risks. But excessive amounts of alcohol are known to raise blood
pressure. Also, if you're trying to lose weight, you need to remember that alcoholic
beverages are calorie dense, providing about 100 to 145 calories a drink but little
nutritional benefit. Ask your doctor what is best for you when it comes to alcohol
consumption.
Calcium and Magnesium
Some studies have shown that people whose intakes of calcium are low are more likely to
have high blood pressure, but a link has not been proven. The same is true of magnesium.
Though the science is uncertain at this time, it can't hurt to eat a diet with sufficient
calcium and magnesium. Good sources of calcium are dairy products, such as milk, yogurt,
and cheese. Choose low-fat or nonfat versions of these foods. Other sources of calcium are
canned salmon, collard greens, broccoli, soy milk, tofu, and calcium-fortified orange
juice and grain products. Good sources of magnesium are whole grains, green leafy
vegetables, nuts, and legumes.
Check the Nutrition Facts panel on food labels to learn how much calcium is in a food. The
amount of calcium in a serving and how that amount contributes to the daily reference
value for calcium must be listed for all foods. Information about a food's magnesium
content may be offered voluntarily.
The DASH Diet
In 1997, the National Heart, Lung, and Blood Institute of the National Institutes of
Health released an eating plan that was found in clinical studies to lower systolic blood
pressure by 5.5 points and diastolic pressure by 3. According to researchers, blood
pressure reductions were seen within two weeks of starting the meal plan and maintained
for the rest of the eight weeks of study by men, women, whites, and minorities alike. This
meal plan, called Dietary Approaches to Stop Hypertension, or DASH for short, calls for
food intake similar to that recommended in the federal government's "Dietary
Guidelines for Americans."
More information on the DASH diet is available on the Internet:
¨ http://dash.bwh.harvard.edu/dashdietservings.html
¨ http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/folldash.htm
Reference:
1. Today's special: Nutrition information. FDA Consumer, May/June 1997.
Source: FDA Consumer 33(4), July/August 1999.
WHAT IS THE DASH DIET?
This meal plan is based on 2,000 calories a day. Depending on the calorie needs, your
number of daily servings may vary from those listed. Consult your doctor or a registered
dietitian to determine your calorie needs.
Food Group Daily Servings Serving Size
Grains and grain products 7 to 8 1 slice of bread
1 cup dry cereal*
1/2 cups cooked rice, pasta, or cereal
Vegetables 4 to 5 1 cup raw leafy vegetables
1/2 cup cooked vegetable
6 oz vegetable juice
Fruits 4 to 5 6 oz fruit juice
1 medium fruit
1/4 cup dried fruit
1/2 cup fresh, frozen, or canned fruit
Low-fat or nonfat dairy foods 2 to 3 8 oz milk
1 cup yogurt
1.5 oz cheese
Meats, poultry, fish 2 or fewer 3 oz cooked lean meat, poultry (skinless
white meat), or fish
3 oz tofu
Nuts, seeds and dry beans 4 to 5 per week 1/3 cup or 1.5 oz nuts
2 Tbsp or 1/2 oz seeds
1/2 cup legumes
Fats and oils 2 to 3 1 tsp soft margarine or butter
1 tsp regular mayonnaise or
1 Tbsp low-fat mayonnaise
1 Tbsp salad dressing or
2 Tbsp "light" salad dressing
1 tsp oil (olive, corn, canola, safflower, or other)
Sweets 5 per week 1 Tbsp maple syrup, sugar, or jelly
1/2 cup sherbet
3 pieces of hard candy
* Serving sizes vary between 1/2 to 1-1/4 cups. Check the product's nutrition label.
Source:
National Heart, Lung, and Blood Institute,
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/folldash.htm and
http://dash.bwh.harvard.edu/dashdietservings.html
DIETARY FIBER REDUCES CORONARY RISK IN WOMEN
High intake of dietary fiber decreases LDL cholesterol, but there are few data on the
impact of high-fiber diets on outcomes for women. A report from the Nurses' Health Study
examined the relation between fiber consumption, as self-reported by 68,782 women in 1984,
1986, and 1990, and coronary events from 1984 to 1994 (1). None of the women had prior
histories of cardiovascular disease, cancer, hypercholesterolemia, or diabetes at
baseline.
The women were grouped into quintiles according to the average amount of dietary fiber
they consumed. In age-adjusted analyses, women in the highest quintile had a 43 percent
lower risk for nonfatal myocardial infarction and a 59 percent lower risk for fatal
coronary disease than women in the lowest quintile. Multivariate analysis indicated that
each 10 gram increment in long-term total fiber intake correlated with a 19 percent
reduction in coronary heart disease risk. Analyses examining different sources of fiber
found significant protective effects from cereal fiber but not from vegetable or fruit
fiber.
This prospective study supports hypotheses that fiber, particularly cereal fiber, can help
reduce risk for coronary heart disease in women.
Reference:
1. Wolk A, Manson JE, Stampfer MJ, Colditz GA, et al. Long-term intake of dietary fiber
and decreased risk of coronary heart disease among women. JAMA, 281(21): 1998-2004, 1999.
Source: Lee TH. Journal Watch 19(13), July 1, 1999.
DIETARY FAT AND RISK OF BREAST CANCER
Studies have yielded mixed results on a possible association between high dietary fat
intake and risk for breast cancer. The investigation discussed below analyzed dietary fat
intake in 88,795 women free of cancer in 1980 who were then followed for 14 years as part
of the Nurses' Health Study. Fat intake was assessed by food frequency questionnaires (1).
The average total fat intake was 39 percent of energy intake in 1980, declining to 31
percent in 1990. There was no association between intake of total fat and risk for breast
cancer. Separate analyses examined the risk for breast cancer with higher intakes of
animal fat, vegetable fat, polyunsaturated fat, saturated fat, mono-unsaturated fat,
trans-unsaturated fat, omega-3 fat, and cholesterol. Analyses were performed separately
for premenopausal and postmenopausal women. No associations were detected, and in fact,
risk for breast cancer was lower with greater intake of vegetable, polyunsaturated,
monounsaturated, and trans-unsaturated fats.
These data indicate that women are unlikely to reduce their risk for breast cancer by
lowering fat intake in mid-life. Reducing the risk for heart disease is still the best
reason to reduce fat consumption.
Reference:
1. Holmes MD, Hunter DJ, Colditz GA, Stampfer MJ, et al. Association of dietary intake of
fat and fatty acids with risk of breast cancer. JAMA 281(10): 914-20, March 10, 1999.
Adapted from: Journal Watch 19(7), April 1, 1999.
NEW RECOMMENDATION FOR VITAMIN C
The recommended daily allowance for vitamin C should be doubled or even tripled, say
government researchers, because of increasing evidence over the last two decades of the
vitamin's cancer-fighting ability when consumed in fruits and vegetables. The National
Institutes of Health says the allowance should be 100 to 200 milligrams instead of the
current 60 milligrams established by the National Academy of Sciences in 1980. But
researchers are not sure if benefits come from the vitamin itself or from the vitamin plus
other components of the food containing the vitamin. And they add that there is such a
thing as too much vitamin C: 200 milligrams is the maximum the body can absorb, larger
amounts can increase the risk of kidney stones.
Source: FDA Consumer 33(4), July/August 1999.
VITAMIN C REVERSES ACUTE EFFECTS OF HYPERHOMOCYSTEINEMIA
A high serum homocysteine level has emerged as an intriguing new cardiac risk factor. Some
studies suggest that homocysteine damages the vascular endothelium, but the mechanism is
unknown. Some clues are provided by a recent British study of the effects, before and
after treatment with vitamin C, of infusions of homocysteine on the vascular endothelial
response of the brachial artery to vasodilatory stimuli in 17 healthy volunteers (1).
Oral ingestion of methionine (the metabolic precursor of homocysteine) was followed within
two hours by a significant decrease in the normal vasodilation of the brachial artery in
response to the stimuli. When vitamin C (1 g/day for one week) was given before the oral
methionine, however, the vascular dysfunction was prevented. Although this study does not
prove how homocysteine causes vascular damage, it suggests that oxidative stress is
involved and that the damage can be prevented by pretreatment with vitamin C.
Reference:
1. Chambers JC, McGregor A, Jean-Marie J, Obeid OA, et al. Demonstration of rapid onset
vascular endothelial dysfunction after hyperhomocysteinemia: An effect reversible with
vitamin C therapy. Circulation 9(99): 115-60, March 9, 1999.
Adapted from: Journal Watch 19(8), April 15, 1999.
DIETARY SUPPLEMENT LABELING MORE INFORMATIVE
A new information panel, "Supplement Facts," now required on the labels of
dietary supplements as part of the implementation of the Dietary Supplement Health and
Education Act of 1994, will provide consumers with more complete information. The labeling
is also required to provide a complete list of ingredients and a statement of identity
using the terms "dietary supplements" or a term identifying the contents of the
product, such as "vitamin C supplement" or "herbal supplement."
The "Supplement Facts" panel will provide information such as the quantity of
specific nutrients in vitamin and mineral products and the part of the plant used in
herbal products. It will be similar in format to the "Nutrition Facts" panel
that appears on most processed foods. Specifically, the panel will show (a) the
manufacturer's suggested serving size; (b) information on nutrients when they are
presented in significant levels, such as vitamins A and C, calcium, iron, and sodium, and
the percent daily value where a reference has been established - similar to nutrients
listed in the "Nutrition facts" panel on food labels; and (c) all other dietary
ingredients present in the product, including botanicals and amino acids, for which no
daily value has been established. These "other dietary ingredients" that do not
have recommendations for daily consumption are listed beneath a bar and are to be
identified as having no recommendations for consumption.
Herbal products will be identified by the common or usual name and the part of the plant
used to make the supplement, except that when such a name is not listed in Herbs of
Commerce, published by the American Herbal Products Association, the Latin binomial name
will be listed.
The new labeling regulations were published in final form on September 23, 1997, and
industry was given 18 months to comply. Products labeled prior to March 23, 1999, can be
sold until stocks are depleted.
Further information and an illustration of the new label are available on the Internet at
http://www.fda.gov/ bbs/topics/NEWS/NEW00678.html. Other FDA information on dietary
supplements, including agency warnings about some individual products, is available at
http://vm/cfsan.fda.gov/~dms/. This site also contains some agency information on the
following products about which consumers frequently have questions: ephedra (or
ephedrine), DHEA (dehydroepiandrosterone), melatonin, dieter's teas, L-tryptophan, and
folic acid.
Source: Nightingale SL. From the Food and Drug Administration. JAMA 281(17): 1580, May 5,
1999.
VEGGIE DIETS' MUSHROOMING POPULARITY REQUIRES WATCHFULNESS
Remember 20 years ago, when vegetarianism was regarded as a counter-cultural lifestyle,
and "veggies" were harmless eccentrics whose obsession with brown rice, yogurt,
and tofu struck most Americans as just a bit kooky?
Those days are long gone, according to the US Department of Agriculture's Continuing
Survey of Food Intakes, which recently reported the number of self-declared US vegetarians
has approximately doubled since 1977, from about 3.5 million to about 7 million.
Along with the continuing survey, several other recent US nutrition studies indicate
vegetarianism is going mainstream - especially in such youth-oriented venues as college,
high school, and even middle school cafeterias, where "vegetarian" offerings
frequently account for up to 25 percent of the daily fare.
"There's some reliable evidence out there that vegetarianism is a growing dietary
practice in the United States, and especially among female adolescents," said Jo Ann
Hattner, MPH, RD, a nutritionist at Stanford University Medical Center, California,
pointing to studies showing that up to 15 percent of teen-age girls in some areas have
given up red meat in recent years.
"If you talk to them, you'll find that many young girls today are concerned about
animal rights, and also about the impact of eating meat on the environment. They see these
horrific films at school about the meat industry, and many opt for vegetarianism. Others
are more concerned about health issues. But regardless of motivation, there's a definite
trend in the adolescent pediatric population toward a more vegetarian diet."
More vegetarian families
Many US pediatricians also report they're seeing more children whose parents have opted
for a vegetarian approach to eating. But a strict vegetarian regimen, while offering some
documented health benefits related to lowering cholesterol and fat intake, can put
children at significant risk for harmful nutritional deficiencies. These deficiencies can
lead to problems with growth, sexual maturation, and emotional stability, and can
exacerbate allergic sensitivities in some youngsters.
"I've been seeing a flurry of interest in vegetarianism during the past two
years," said Susan Baker, MD, PhD, FAAP, chair of the American Academy of Pediatrics
(AAP) Committee on Nutrition. "I think the risk of nutritional deficiency among this
population is pretty significant, especially for the teen-agers. If they're on a diet that
excludes dairy products, and they're teen-agers, I guarantee you that they're not getting
enough calcium. And calcium is a big worry, these days. There are some new studies showing
that teen-agers with low calcium in their diets are at risk for fractures."
According to Dr. Baker, a professor of pediatrics at the Medical University of South
Carolina, Charleston, the most important thing a pediatrician can do to prevent
nutritional deficiency in children from vegetarian families is "understand exactly
what a parent means when he or she uses the word 'vegetarian.'"
"There are many different kinds of vegetarianism, and the foods involved can vary
enormously," said Dr. Baker. "People are always coming into my office and
saying, 'I'm on a vegetarian diet.' And I always say: 'Oh, really? Well, tell me about it.
Let's talk about what you're actually eating, day in and day out.'
"Some vegetarian diets include dairy products and eggs, and those are usually
healthy. But then there are the really strict 'vegan' diets - no animal products of any
kind allowed - which can pose serious nutritional risks, especially for small children. So
it's important to find out what the child is actually eating. There's a lot of hot air
around this topic, and the cooler a pediatrician is about it, the better he or she is
going to do!"
Ronald E. Kleinman, MD, FAAP, a Harvard Medical School pediatrics professor, shares Dr.
Baker's concern. "I don't want to cast a vegetarian diet in a negative light,"
said Dr. Kleinman, editor of the AAP Pediatric Nutrition Handbook (4th Edition).
"Many people who practice vegetarianism do it well. And there are many studies that
show health outcomes are often better for vegetarians.
"But there are some people who adopt a vegetarian diet and don't understand how to
make sure they and their children get all of the nutrients they need. They need some good
advice from the pediatrician, or they'll be at risk for an unbalanced diet."
More restrictions, more worries
William H. Dietz, MD, PhD, FAAP, director of the Division of Nutrition and Physical
Activity at the US Centers for Disease Control (CDC), warned that "the more
restrictive a child's diet is, the more you have to worry about an associated
micro-nutrient deficiency."
"I think it's important to remember that there's no such thing as a vegetarian
diet. There are a variety of vegetarian diets - and what you have to worry about, in terms
of nutrients, depends on the type of diet being followed."
According to the AAP Guide to your child's nutrition, the basic categories of
vegetarianism are-
¨ partial vegetarianism, which allows dairy products, eggs, seafood and poultry but no
red meat;
¨ lacto-ovo-vegetarianism, which permits dairy products and eggs, but no other animal
products;
¨ ovo-vegetarianism, in which eggs are the only animal products permitted; and
¨ veganism, the strictest form, in which all animal products are excluded.
Marc S. Jacobson, MD, FAAP, a member of the AAP Committee on Nutrition, said it is
important for pediatricians to make a distinction between "kids whose parents come
from a culture in which vegetarianism is a way of life, and those who don't. People who
belong to the Indian culture from Asia, for example, have been living in a vegetarian way
for many generations.
"Grandma knows how to cook [vegetarian dishes], and Ma knows how to cook. And the
risks are much less. But if the vegetarianism isn't part of the culture, then I want to be
sure the parents are well-read and understand the need for dietary balance.
"Also, if I'm talking to a teen-age girl who says she's starting a new-found diet,
then I always want to ask myself: Could this be the start of an eating disorder? In that
case, I'll monitor weight more frequently and [schedule] more [patient] visits."
What symptoms may indicate that a vegetarian child is missing out on key nutrients?
According to Dr. Baker, most vegetarian diets will supply plenty of good nutrition. But
the more severe vegan regimen could trigger significant shortages of protein, B12,
riboflavin, Vitamin D, iron, calcium, and zinc. (For a detailed discussion of symptoms and
effects of these deficiencies, see the Pediatric Nutrition Handbook, Chapter 40) (1).
If a pediatrician isn't sure about nutrient intake in a vegetarian child - or simply
doesn't have the time to survey the child's eating habits - he or she should call in a
registered dietitian, said Dr. Baker: "The dietitian can take a recall history and
ask parents to keep a food diary for a couple of days, then give you a rundown." (To
contact the American Dietetic Association for a registered dietitian in your area call
(800) 366-1655 or visit their web site at http://www.eatright.org/find.html)
Although most parents are eager to work with pediatricians on nutrition issues, it's often
more difficult to convey nutrition messages to teen-agers and children, said Dr. Jacobson.
"I've found that it's good to talk to the kids about immediate effects,
rather than long-term effects.
"I tell 'em, 'If you want to make the baseball team - or stay out late with your
friends - you're gonna need lots of fuel, so you gotta eat the right stuff!'"
Reference:
1. American Academy of Pediatrics. Committee on Nutrition. Pediatric Nutrition. Ronald E.
Kleinman, editor. 4th ed. Elk Grove Village, IL. : American Academy of Pediatrics, 1998.
Adapted from: AAP News 15(6), June 1999.
BREAST CANCER AND ALCOHOL CONSUMPTION
A woman may be able to reduce the risk of breast cancer associated with
alcohol consumption if she increases her consumption of folate. Researchers examined over
3,480 women who participated in the Nurses' Health Study in 1980 and developed breast
cancer during the follow-up period. The risk of breast cancer was greatest among women who
consumed at least 15 grams of alcohol per day (1) (about 1 glass of wine/day) and had
folate levels lower than 300 µg a day. Women who took multivitamins, which are major
sources of folate, had the lowest risk of breast cancer among the alcohol consumption
group.
Reference:
1. Zhang S, Hunter DJ, Hankinson SE, Giovannucci EL, et al. A prospective study of folate
intake and the risk of breast cancer. JAMA, 281(17): 1632-7, 1999.
Source: Community Nutrition Institute. Nutrition Week 29(18), May 14, 1999.
UPCOMING CONFERENCES:
PARTNERSHIPS FOR HEALTH IN THE NEW MILLENNIUM
A joint conference hosted by the Healthy People Consortium and Partnerships
for Networked Consumer Health Information will be held January 24 through 28, 2000 at the
Omni-Shoreham in Washington, DC. Surgeon General Satcher will be launching the HHS
initiative, Healthy People 2010. "Partnerships for Health in the New Millennium"
will focus on:
¨ Partnering for Health Improvements
¨ Eliminating Health Disparities
¨ Increasing Quality and Years of Healthy Life
¨ Harnessing Technology for Health
The conference is expected to draw over 1,200 participants with diverse backgrounds from
public health, health care, academic and research institutions, employers, technology
companies, faith and advocacy organizations, government agencies, and health care
consumers.
For more information:
¨ Join the conference listserve
e-mail to listserv@list.nih.gov with the
following text: SUBSCRIBE partnerships-00 YOUR NAME
¨ Visit the conference website
www.health.gov/partnerships
¨ Send an e-mail
partnerships@health.org
THE AMERICAN DIETETIC ASSOCIATION'S ANNUAL MEETING: SPREAD THE
WORD
Looking for the latest information on food and nutrition science, consumer trends, food
safety, or lifestyle and disease management? Join the nation's leading experts October 18
to 21 in Atlanta at the American Dietetic Association's 82nd Annual Meeting and
Exhibition.
Choose from nearly 150 continuing-professional-education sessions, including 40 at an
advanced level. Network with thousands of fellow professionals. Visit an exhibit area that
will feature more than 300 companies and organizations and the latest in food products,
computer programs, foodservice equipment, and much more. A live satellite broadcast on
childhood obesity is available for groups.
To register for the Annual Meeting and Exhibition or for information on the live satellite
broadcast, call (800) 877-1600, ext. 4868, or view the website at
http://www.eatright.org/ame.
THE CALIFORNIA NUTRITION COUNCIL ANNUAL MEETING
The 1999 California Nutrition Council Annual (CNC) Meeting is scheduled for September 17,
1999 at California Farm Bureau Federation Building, 2300 River Plaza Drive, Sacramento.
The meeting will feature key experts from cutting-edge nutrition education programs and
organizations who will share their secrets of success and marketing strategies. Top
leaders will also be on hand to highlight the importance of coordinated food and nutrition
policy for success in the 21st Century, and link community participation and empowerment
with positive health outcomes.
Space is limited. For registration information call Suzanna Nye, MS, RD, CTM, CNC Resource
Coordinator at (916) 928-8587 or e-mail her at sny@hw1.cahwnet.gov
.
RESOURCES:
NEW PAMPHLETS HIGHLIGHT CALCIUM BENEFITS FOR ENGLISH SPEAKING,
MINORITY GROUPS
Calcium, the mineral known for bone building, is the star of two new
nutrition pamphlets for consumers. Produced by the California Milk Advisory Board (CMAB),
the pamphlets highlight the array of health benefits dietary calcium provides including
calcium's ability to help prevent or mitigate colon cancer, hypertension, kidney stones,
and premenstrual syndrome.
The pamphlets are titled Calcium - the Superstar Nutrient for Better Health and Better
Health with Calcium.
Calcium - the Superstar Nutrient for Better Health, is an English-language pamphlet with
detailed information about calcium including dietary reference intakes, sources of
calcium, tips for including calcium in daily meals, and a few simple recipes.
Better Health with Calcium was produced for California's minority populations and includes
the dietary reference intakes and a chart of dietary sources for calcium. This pamphlet is
available in Chinese, Korean, Tagalog (for Filipinos), Vietnamese, and Spanish.
"Calcium is receiving a great deal of positive press lately, however, the public
is becoming more deficient in this essential nutrient," said Nancy Fletcher, director
of communications services for the CMAB. "According to the American Dietetic
Association, as many as 75 percent of all Americans are not meeting the minimum daily
calcium recommendations. California dairy products are an excellent way of getting daily
calcium and also other essential nutrients like vitamin D, phosphorous, riboflavin, and
protein."
"These new pamphlets show how easy and delicious it is to meet daily calcium
recommendations," she added.
For a sample of either pamphlet, consumers can send a self-addressed, stamped ($.55)
envelope to: Calcium Pamphlet, California Milk Advisory Board, c/o The Montgomery Group,
555 Montgomery Street, Suite 1415, San Francisco, CA 94111. All requests should specify
the pamphlet desired and, if applicable, which language preferred.
Established in 1969, the CMAB is headquartered in Modesto, California, and is the
largest marketing board in the Western United States, serving more than 2,300 dairy
families. Celebrating thirty years in 1999 of activities which promote California's
leading agricultural commodity, the CMAB executes generic advertising, retail and food
service promotions, and milk quality improvement and research programs on behalf of
California dairy products, including Real California Cheese.
Source: California Milk Advisory Board News Release, July 30, 1999.
A NEW USDA WEB SITE TOUTS HEALTH BENEFITS OF SOY FOODS
Seeking to increase public, and scientific, awareness of the benefits of healthful
nutrients found in soybeans and other foods, the US government has unveiled a web site
listing the amounts of estrogen-like compounds found in everything from beans to wieners
at http://www.intelihealth.com/enews?233720
.
NATIONAL FOOD SAFETY EDUCATION MONTH
"Cook It Safely" is the theme for September, National Food Safety Education
Month. Together the USDA and the FDA are joining with the restaurant and foodservice
industry to invite you to participate in celebrating this year's theme to educate the
public about safe food preparation.
The Planning Guide for Food Safety Educators is NOW available on
www.FoodSafety.gov/September. (It's No. 3) Check out the contents page for ideas to
promote National Food Safety Education Month. Included is a sample proclamation for local
use, sample press releases, sample logos and artwork, and many brochures such as Fight
BAC! in English, Spanish, and Chinese, Cook It Safely - Use a Food Thermometer, Playing It
Safe with Eggs, and puzzles, and games to help support your activity or local community
event! Start now!
Pass this information on to other educators and team up! Let us know your plans! And give
us your feedback!
Source: Holly McPeak, USDA/FSIS, Food Safety Education.
SUBSCRIPTION FOR NUTRITION PERSPECTIVES NEWSLETTER
NOTE: The top line of the mailing label shows the expiration date for your
subscription.
Please renew before that date to avoid a break in service.
o Renew my subscription o Start a new subscription
Enclosed is a payment of $10.00 for a one year subscription (6 issues). Checks should be payable to the Regents of the University of California.
PLEASE PRINT INFORMATION TO ENSURE ACCURACY
Name_______________________________________________________________________________________
Address_____________________________________________________________________________________
City____________________________State_____________Zip____________County_______________________
Professional Affiliation (optional)__________________________________________________________________
o The above is a change of address
Mail this form and payment to: NUTRITION PERSPECTIVES
Department of Nutrition, University of California
One Shields Ave.
Davis, California, 95616-8669.
The University of California, in compliance with the Civil Rights Act of 1964, Title IX
of the Education Amendments of 1972, and the Rehabilitation Act of 1973, does not
discriminate on the basis of race, creed, religion, color, national origin, sex, or mental
or physical handicap in any of its programs or activities, or with respect to any of its
employment policies, practices, or procedures. The University of California does not
discriminate on the basis of age, ancestry, sexual orientation, marital status,
citizenship, medical condition (as defined in section 12926 of the California Government
Code), nor because individuals are disabled or Vietnam era veterans. Inquiries regarding
this policy may be directed to the Director, Office of Affirmative Action, Division of
Agriculture and Natural Resources, 300 Lakeside Drive, Oakland, CA 94612-3550, (510)
987-0097.
NUTRITION PERSPECTIVES
University of California
Department of Nutrition
One Shields Ave.
Davis, CA 95616-5270