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ADDRESSING FOODBORNE THREATS TO HEALTH: Policies, Practices, and Global Coordination

by Institute of Medicine of the National Academies

The National Academies Press (NAP)--publisher for the National Academies--publishes more than 200 books a year offering the most authoritative views, definitive information, and groundbreaking recommendations on a wide range of topics in science, engineering, and health. Our books are unique in that they are authored by the nation's leading experts in every scientific field.

FOOD INSECURITY and Hunger in the United States: AN ASSESSMENT OF THE MEASURE

by National Research Council of the National Academies

The National Academies Press (NAP)--publisher for the National Academies--publishes more than 200 books a year offering the most authoritative views, definitive information, and groundbreaking recommendations on a wide range of topics in science, engineering, and health. Our books are unique in that they are authored by the nation's leading experts in every scientific field.

Seafood Choices: Balancing Benefits And Risks

by Institute of Medicine of the National Academies

The fragmented information that consumers receive about the nutritional value and health risks associated with fish and shellfish can result in confusion or misperceptions about these food sources. Consumers are therefore confronted with a dilemma: they are told that seafood is good for them and should be consumed in large amounts, while at the same time the federal government and most states have issued advisories urging caution in the consumption of certain species or seafood from specific waters. Seafood Choices carefully explores the decision-making process for selecting seafood by assessing the evidence on availability of specific nutrients (compared to other food sources) to obtain the greatest nutritional benefits. The book prioritizes the potential for adverse health effects from both naturally occurring and introduced toxicants in seafood; assesses evidence on the availability of specific nutrients in seafood compared to other food sources; determines the impact of modifying food choices to reduce intake of toxicants on nutrient intake and nutritional status within the U.S. population; develops a decision path for U.S. consumers to weigh their seafood choices to obtain nutritional benefits balanced against exposure risks; and identifies data gaps and recommendations for future research. The information provided in this book will benefit food technologists, food manufacturers, nutritionists, and those involved in health professions making nutritional recommendations.

Dietary Reference Intakes Research Synthesis Workshop Summary

by Institute of Medicine of the National Academies

The National Academies Press (NAP)--publisher for the National Academies--publishes more than 200 books a year offering the most authoritative views, definitive information, and groundbreaking recommendations on a wide range of topics in science, engineering, and health. Our books are unique in that they are authored by the nation's leading experts in every scientific field.

NUTRITIONAL RISK ASSESSMENT: Perspectives, Methods, and Data Challenges

by Institute of Medicine of the National Academies

The National Academies Press (NAP)--publisher for the National Academies--publishes more than 200 books a year offering the most authoritative views, definitive information, and groundbreaking recommendations on a wide range of topics in science, engineering, and health. Our books are unique in that they are authored by the nation's leading experts in every scientific field.

Foodborne Disease and Public Health: SUMMARY OF AN IRANIAN-AMERICAN WORKSHOP

by Institute of Medicine National Research Council of the National Academies

The Institute of Medicine's Food and Nutrition Board and the National Research Council's Policy and Global Affairs Division convened a workshop in Washington, D.C., entitled Foodborne Disease and Public Health: An Iranian-American Workshop. The overall goals of this workshop were to facilitate the exchange of ideas about foodborne disease and public health and to promote further collaboration among Americans and Iranians on this topic of mutual interest. Experts invited to participate in this workshop addressed a variety of topics, ranging from the surveillance of outbreaks of foodborne illness to approaches to medical training in the Iranian and U.S. educational systems. The workshop was part of a series of cooperative efforts between the United States and Iran as the two countries have collaborated in the past on similar projects relating to foodborne disease.

Blessed

by Cynthia Leitich Smith

Even as teenaged Quincie Morris adjusts to her appetites as a neophyte vampire, she must clear her true love, the hybrid-werewolf Kieren, of murder charges; thwart the apocalyptic ambitions of Bradley Sanguini, the vampire-chef who "blessed" her; and keep her dead parents' restaurant up and running before she loses her own soul.

Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions

by Institute of Medicine of the National Academies

The National School Breakfast Program feeds 10 million children each day, and the National School Lunch Program feeds more than 30 million students. Yet the national nutrition standards and meal requirements for these meals were created more than a decade ago, making them out of step with recent guidance about children's diets. With so many children receiving as much as 50 percent of their daily caloric intake from school meals, it is vital for schools to provide nutritious food alongside the best possible education for the success of their students. At the request of U.S. Department of Agriculture (USDA), the Institute of Medicine assembled a committee to recommend updates and revisions to the school lunch and breakfast programs. The first part of the committee's work is reflected in the December 2008 IOM report Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Phase II of the report is expected in Fall 2009. This first report provides information about the committee's approach as it reviews the school lunch and breakfast programs. In the report's second part, the committee will share its findings and recommendations to bring these meals more in line with today's dietary guidelines. The committee welcomes public comments about its intended approach. An open forum will be held January 28, 2009 in Washington, DC to receive input from the public. Please go to http://www.iom.edu/fnb/schoolmeals for details or email FNBSchoolMeals@nas.edu with any input.

The Soy Zone

by Barry Sears

As America is finding out, soy is the most complete and versatile protein in existence. It has no cholesterol or saturated fat but plenty of vitamins and fiber and offers amazing health benefits for vegetarians and non-vegetarians alike. Based on the simple idea that food is your best medicine, The Soy Zone shows you how to maintain peak mental alertness, increase your energy, and reduce the likelihood of chronic disease -- all while losing excess body fat. Dr. Barry Sears brings all the life-enhancing benefits of the Zone to a mouthwatering collection of delicious soy-based Zone meals, featuring:Soy Zone-perfect breakfasts, lunches, appetizers, dinners, and snacksAppetizing new recipes from top chefs, such as Red Bean Chill, Hong Kong Burger, and Soy Zone-friendly Vegetarian Pad ThaiThe ultimate healthful food plan, with quick and easy fat-burning alternatives to dangerous high-carb dietsAn exercise and longevity plan for men and womenHelpful recommendations for Soy Zoning your kitchenA scientifically proven plan for achieving perfect hormonal balance while losing weight

Managing Food Safety Practices FROM FARM TO TABLE: Workshop Summary

by Institute of Medicine of the National Academies

Legal regulations and manufacturers' monitoring practices have not been enough to prevent contamination of the national food supply and protect consumers from serious harm. In addressing food safety risks, regulators could perhaps better ensure the quality and safety of food by monitoring food production not just at a single point in production but all along the way, from farm to table. Recognizing the troubled state of food safety, the Institute of Medicine's (IOM) Food Forum met in Washington, DC, on September 9, 2008, to explore the management of food safety practices from the beginning of the supply chain to the marketplace.

The Public Health Effects of Food Deserts: Workshop Summary

by Institute of Medicine National Research Council of the National Academies

This report from the January 2009 workshop examines neighborhoods and communities that have limited access to affordable and nutritious foods, and describes several approaches to measuring food deserts and their impact on public health. Researchers from the US and Britain evaluate different interventions to ameliorate food desert conditions and identify current research gaps and needs. No index is provided. Annotation ©2010 Book News, Inc. , Portland, OR (booknews. com)

Mitigating the Nutritional Impacts of the Global Food Price Crisis: Workshop Summary

by Institute of Medicine of the National Academies

In 2007 and 2008, the world witnessed a dramatic increase in food prices. The global financial crisis that began in 2008 compounded the burden of high food prices, exacerbating the problems of hunger and malnutrition in developing countries. The tandem food price and economic crises struck amidst the massive, chronic problem of hunger and undernutrition in developing countries. National governments and international actors have taken a variety of steps to mitigate the negative effects of increased food prices on particular groups. The recent abrupt increase in food prices, in tandem with the current global economic crisis, threatens progress already made in these areas, and could inhibit future efforts. The Institute of Medicine held a workshop, summarized in this volume, to describe the dynamic technological, agricultural, and economic issues contributing to the food price increases of 2007 and 2008 and their impacts on health and nutrition in resource-poor regions. The compounding effects of the current global economic downturn on nutrition motivated additional discussions on these dual crises, their impacts on the nutritional status of vulnerable populations, and opportunities to mitigate their negative nutritional effects.

School Meals: Building Blocks for Healthy Children

by Institute of Medicine

Ensuring that the food provided to children in schools is consistent with current dietary recommendations is an important national focus. Various laws and regulations govern the operation of school meal programs. In 1995, Nutrition Standards and Meal Requirements were put in place to ensure that all meals offered would be high in nutritional quality. School Meals reviews and provides recommendations to update the nutrition standard and the meal requirements for the National School Breakfast and Lunch Programs. The recommendations reflect new developments in nutrition science, increase the availability of key food groups in the school meal programs, and allow these programs to better meet the nutritional needs of children, foster healthy eating habits, and safeguard children's health. School Meals sets standards for menu planning that focus on food groups, calories, saturated fat, and sodium and that incorporate Dietary Guidelines for Americans and the Dietary Reference Intakes. This book will be used as a guide for school food authorities, food producers, policy leaders, state/local governments, and parents.

Strategies to Reduce Sodium Intake in the United States

by Institute of Medicine of the National Academies

Reducing the intake of sodium is an important public health goal for Americans. Since the 1970s, an array of public health interventions and national dietary guidelines has sought to reduce sodium intake. However, the U.S. population still consumes more sodium than is recommended, placing individuals at risk for diseases related to elevated blood pressure.Strategies to Reduce Sodium Intake in the United States evaluates and makes recommendations about strategies that could be implemented to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans. The book reviews past and ongoing efforts to reduce the sodium content of the food supply and to motivate consumers to change behavior. Based on past lessons learned, the book makes recommendations for future initiatives. It is an excellent resource for federal and state public health officials, the processed food and food service industries, health care professionals, consumer advocacy groups, and academic researchers.

Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making

by Institute of Medicine of the National Academies

To battle the obesity epidemic in America, health care professionals and policymakers need relevant, useful data on the effectiveness of obesity prevention policies and programs. ridging the Evidence Gap in Obesity Prevention identifies a new approach to decision making and research on obesity prevention to use a systems perspective to gain a broader understanding of the context of obesity and the many factors that influence it.

Perspectives from United Kingdom and United States Policy Makers on Obesity Prevention: Workshop Summary

by Institute of Medicine of the National Academies

Both the United Kingdom and United States are grappling with nationwide epidemics of obesity. Obesity contributes to diabetes, cardiovascular disease, and some cancers, among other diseases. Although many people are aware of obesity's causes and consequences, few see it as a problem for their own families--despite clinical evidence to the contrary. Given this disconnect between perception and reality, policy makers in both countries struggle to find a way to reach people to encourage change. The IOM brought together policy makers from the U.K. and U.S. for a workshop on October 22, 2009, to discuss the challenges of and promising approaches to the struggle against obesity. Presenters spoke about current policies, programs, and partnerships that are addressing the obesity epidemic and evidence for effective strategies to change perception and behaviors. The workshop, summarized in this document, provided an opportunity for both countries to learn from each other's efforts and to consider how to apply new strategies at home.

Enhancing Food Safety: The Role of the Food and Drug Administration

by Institute of Medicine National Research Council of the National Academies

Recent outbreaks of illnesses traced to contaminated sprouts and lettuce illustrate the holes that exist in the system for monitoring problems and preventing foodborne diseases. Although it is not solely responsible for ensuring the safety of the nation's food supply, the U.S. Food and Drug Administration (FDA) oversees monitoring and intervention for 80 percent of the food supply. The U.S. Food and Drug Administration's abilities to discover potential threats to food safety and prevent outbreaks of foodborne illness are hampered by impediments to efficient use of its limited resources and a piecemeal approach to gathering and using information on risks. Enhancing Food Safety: The Role of the Food and Drug Administration, a new book from the Institute of Medicine and the National Research Council, responds to a congressional request for recommendations on how to close gaps in FDA's food safety systems. Enhancing Food Safety begins with a brief review of the Food Protection Plan (FPP), FDA's food safety philosophy developed in 2007. The lack of sufficient detail and specific strategies in the FPP renders it ineffectual. The book stresses the need for FPP to evolve and be supported by the type of strategic planning described in these pages. It also explores the development and implementation of a stronger, more effective food safety system built on a risk-based approach to food safety management. Conclusions and recommendations include adopting a risk-based decision-making approach to food safety; creating a data surveillance and research infrastructure; integrating federal, state, and local government food safety programs; enhancing efficiency of inspections; and more. Although food safety is the responsibility of everyone, from producers to consumers, the FDA and other regulatory agencies have an essential role. In many instances, the FDA must carry out this responsibility against a backdrop of multiple stakeholder interests, inadequate resources, and competing priorities. Of interest to the food production industry, consumer advocacy groups, health care professionals, and others, Enhancing Food Safety provides the FDA and Congress with a course of action that will enable the agency to become more efficient and effective in carrying out its food safety mission in a rapidly changing world.

Developing and Evaluating Methods for Using American Community Survey Data to Support the School Meals Programs: Interim Report

by National Research Council of the National Academies

The National School Lunch Program and the School Breakfast Program, administered by the Food and Nutrition Service of the U.S. Department of Agriculture (USDA), are key components of the nation's food security safety net, providing free or low-cost meals to millions of school-age children each day. Under the most commonly adopted provisions, USDA reimburses districts for meals served on the basis of data collected in a "base year

Child and Adult Care Food Program: Aligning Dietary Guidance for All

by Institute of Medicine of the National Academies

The Child and Adult Care Food Program (CACFP) is a federally-funded program designed to provide healthy meals and snacks to children and adults while receiving day care at participating family day care homes, traditional child care centers, afterschool facilities, adult care facilities, and emergency shelters. CACFP has the broadest scope of any of the U.S. Department of Agriculture (USDA) food program, serving more than 3 million children and 114,000 adults across the nation. To receive reimbursement for the foods served, participating programs must abide by requirements set by the USDA. Child and Adult Care Food Program assesses the nutritional needs of the CACFP population based on Dietary Guidelines for Americans and the Dietary Reference Intakes (DRIs) and makes recommendations for revisions to the CACFP meal requirements. The book outlines meal requirements that include food specifications that could be used for specific meals and across a full day, covering all age groups from infants to older adults and meal patterns designed for use in a variety of settings, including in-home care and in large centers. By implementing these meal requirements, consumption of fruits, vegetables, and whole-grain rich foods will increase while consumption of solid fats, added sugars, and sodium will decrease. Not only will this address the high prevalence of childhood obesity, it will also help to achieve consistency with the standards and regulations of other USDA nutrition assistance programs, particularly the Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the National School Lunch and School Breakfast programs. Child and Adult Care Food Program makes practical recommendations that would bring CACFP meals and snacks into alignment with current dietary guidance. The book will serve as a vital resource for federal and state public health officials, care providers working in child and adult day care facilities, WIC agencies, officials working with the National School Lunch and School Breakfast programs, and other organizations serving at-risk populations.

Providing Healthy and Safe Foods As We Age: Workshop Summary

by Institute of Medicine of the National Academies

Does a longer life mean a healthier life? The number of adults over 65 in the United States is growing, but many may not be aware that they are at greater risk from foodborne diseases and their nutritional needs change as they age. The IOM's Food Forum held a workshop October 29-30, 2009, to discuss food safety and nutrition concerns for older adults.

DRI Dietary Reference Intakes Calcium Vitamin D

by Institute of Medicine of the National Academies

Calcium and vitamin D are essential nutrients for the human body. Establishing the levels of these nutrients that are needed by the North American population is based on the understanding of the health outcomes that calcium and vitamin D affect. It is also important to establish how much of each nutrient may be "too much." Dietary Reference Intakes for Calcium and Vitamin D provides reference intake values for these two nutrients. The report updates the DRI values defined in Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride, the 1997 study from the Institute of Medicine. This 2011 book provides background information on the biological functions of each nutrient, reviews health outcomes that are associated with the intake of calcium and vitamin D, and specifies Estimated Average Requirements and Recommended Dietary Allowances for both. It also identifies Tolerable Upper Intake Levels, which are levels above wish the risk for harm may increase. The book includes an overview of current dietary intake in the U.S. and Canada, and discusses implications of the study. A final chapter provides research recommendations. The DRIs established in this book incorporate current scientific evidence about the roles of vitamin D and calcium in human health and will serve as a valuable guide for a range of stakeholders including dietitians and other health professionals, those who set national nutrition policy, researchers, the food industry, and private and public health organizations and partnerships.

Hunger and Obesity: Understanding a Food Insecurity Paradigm - Workshop Summary

by Institute of Medicine of the National Academies

At some point during 2009, more than 17 million households in the United States had difficulty providing enough food for all their members because of a lack of resources. In more than one-third of these households, the food intake of some household members was reduced and normal eating patterns were disrupted due to limited resources. The Workshop on Understanding the Relationship Between Food Insecurity and Obesity was held to explore the biological, economic, psychosocial, and other factors that may influence the relationship between food insecurity, overweight, and obesity in the United States. Hunger and Obesity examines current concepts and research findings in the field. The report identifies information gaps, proposes alternative approaches to analyzing data, recommends new data that should be collected, and addresses the limitations of the available research.

Legal Strategies in Childhood Obesity Prevention

by The National Academy of Sciences

Since 1980, childhood obesity rates have more than tripled in the United States. Recent data show that almost one-third of children over 2 years of age are already overweight or obese. While the prevalence of childhood obesity appears to have plateaued in recent years, the magnitude of the problem remains unsustainably high and represents an enormous public health concern. All options for addressing the childhood obesity epidemic must therefore be explored. In the United States, legal approaches have successfully reduced other threats to public health, such as the lack of passive restraints in automobiles and the use of tobacco. The question then arises of whether laws, regulations, and litigation can likewise be used to change practices and policies that contribute to obesity. On October 21, 2010, the Institute of Medicine (IOM) held a workshop to bring together stakeholders to discuss the current and future legal strategies aimed at combating childhood obesity. Legal Strategies in Childhood Obesity Preventionsummarizes the proceedings of that workshop. The report examines the challenges involved in implementing public health initiatives by using legal strategies to elicit change. It also discusses circumstances in which legal strategies are needed and effective. This workshop was created only to explore the boundaries of potential legal approaches to address childhood obesity, and therefore, does not contain recommendations for the use of such approaches.

A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration

by National Research Council of the National Academies

With the responsibility to ensure the safety of food, drugs, and other products, the U.S. Food and Drug Administration (FDA) faces decisions that may have public-health consequences every day. Often the decisions must be made quickly and on the basis of incomplete information. FDA recognized that collecting and evaluating information on the risks posed by the regulated products in a systematic manner would aid in its decision-making process. Consequently, FDA and the Department of Health and Human Services (DHHS) asked the National Research Council (NRC) to develop a conceptual model that could evaluate products or product categories that FDA regulates and provide information on the potential health consequences associated with them. A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration describes the proposed risk-characterization framework that can be used to evaluate, compare, and communicate the public-health consequences of decisions concerning a wide variety of products. The framework presented in this report is intended to complement other risk-based approaches that are in use and under development at FDA, not replace them. It provides a common language for describing potential public-health consequences of decisions, is designed to have wide applicability among all FDA centers, and draws extensively on the well-vetted risk literature to define the relevant health dimensions for decision-making at the FDA. The report illustrates the use of that framework with several case studies, and provides conclusions and recommendations.

Food, Sacrifice, and Sagehood in Early China

by Roel Sterckx

In ancient China, the preparation of food and the offering up of food as a religious sacrifice were intimately connected with models of sagehood and ideas of self-cultivation and morality. Drawing on received and newly excavated written sources, Roel Sterckx's book explores how this vibrant culture influenced the ways in which the early Chinese explained the workings of the human senses, and the role of sensory experience in communicating with the spirit world. The book, which begins with a survey of dietary culture from the Zhou to the Han, offers intriguing insights into the ritual preparation of food - some butchers and cooks were highly regarded and would rise to positions of influence as a result of their culinary skills - and the sacrificial ceremony itself. As a major contribution to the study of early China and to the development of philosophical thought, the book will be essential reading for students of the period, and for anyone interested in ritual and religion in the ancient world.

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