NUTRITION IN COMPLEMENTARY CAREintegrativerd.org/wp-content/uploads/2012/04/2003...Supplements...

SupplementsFood-Based Dietary Supplements . . .53

Functional FoodsThe Wonders of Whey Protein . . . . . . 53

SpotlightBastyr University’s Nutrition Department . . . . . . . . . . . 57

Resources Review . . . . . . 64

CPE ArticleTaking a CloserLook at Biotechnologyand Genetically Engineered Foods . . 65

Of InterestAwards and Accolades . . . . . . . . . . . . .59Sponsor Thank You’s . . . . . . . . . . . . . .58Announcements . . . . . . . . . . . . . . . . . . 59Editorial Staff . . . . . . . . . . . . . . . . . . . .71Key Contacts . . . . . . . . . . . . . . . . . . . . 72

Chair’s Corner . . . . . . . . . . 54

Chair’s Corner . . . . . . . . . . 55

Editor’s Notes . . . . . . . . . . . 54

• Fall 2003, Neuromuscular/Neurological Diseases; Editor’sDeadline, August 1, 2003.• Winter 2004, General; Editor’sDeadline, November 1, 2003.• Spring 2004, Women’s Health;Editor’s Deadline, February 1, 2004.• Summer 2004, General; Editor’sDeadline, August 1, 2003.For more information, contact SarahHarding Laidlaw,[email protected]

NCC Newsletter 2003 • Volume 5/6, Issue 4/1 A Dietetic Practice Group of the ADA b 53

A Dietetic Practice Group of the American Dietetic Association Summer 2003 • Volume 5/6, Issue 4/1

In This Issue . . .

Upcoming Issues . . .

NUTRITION IN COMPLEMENTARY CARENUTRITION IN COMPLEMENTARY CARENUTRITION IN COMPLEMENTARY CARENUTRITION IN COMPLEMENTARY CARE

NUTRITION IN COMPLEMENTARY CARE

Web site:www.ComplementaryNutrition.org

Member ElectronicMail List:

Contact Gretchen Forsellto get connected

([email protected])

Supplements…Food-Based DietarySupplementsMMaarryy MMuullrryy,, PPhh..DD..

FunctionalFoods...The Wonders of Whey ProteinDDaavviidd WW.. GGrroottttoo,, RRDD,, LLDD

Little Miss Muffet sat on a tuffet, Eating her curds and whey;

Along came a spider,who sat down beside her

And frightened Miss Muffet away.-A Mother Goose Poem-

HistoryAs the story goes, there was a little girl

by the name of Patience Muffet (MissMuffet) who was the daughter of then famous16th century entomologist, Dr. ThomasMuffet. One morning while eating breakfast,one of her father's spiders appeared to her.Alarmed, she rose suddenly, toppling hercurds and whey (cottage cheese) and ran outof the house. However, had she known of thenutritional value and potential health benefitsof the milky substance — whey, she mayhave been more careful not to have spilled theprecious liquid and told the spider to bug off!

Though more rigorous attention to thenutritional and health benefits of wheyprotein has only emerged in the last 15 to 20years, its health and healing qualities havebeen revered throughout history. Cleopatraused it as part of a milk bath prescribed tosooth dry, damaged or sensitive skin. Greeks

(continued on page 62)


Dietary supplement manufacturers oftenmake a marketing distinction between food-based dietary supplements, made fromnaturally occurring food components(sometimes blended with synthetic nutrients),and non-food-based supplements that areprimarily composed of only syntheticnutrients. Many supplement consumers saythey perceive differences as well and makepurchase decisions accordingly.1

Are food-based multivitamin/mineraldietary supplements, generally sold in naturalfoods supermarkets, better than non-food-based multivitamin/mineral supplements soldin supermarkets or drugstores? What shouldnutrition professionals know about theseproducts and what should they recommend totheir clients and patients? This articleexamines different kinds of food-basedsupplements and how they, as a group mightdiffer from non-food-based or syntheticmultivitamin supplements.

Many natural foods shoppers say theybelieve that food-based supplements are ofbetter quality because they are natural. Theseconsumers tell natural foods merchandisersthat they intuitively believe that plant-basedsupplements are better choices for theiroverall health. Some contend that those thatare food based improve digestion andutilization of nutrients.1

While the research support for theseperceived differences is somewhat limited,nutrition professionals should be able toanswer questions about how the various typesof supplements are made and how theyfunction. Any scan of supplements onsupermarket shelves reveals that food-basedsupplements may vary in price and often costmore than conventional non-food-basedsupplements and this variance alone may alsogenerate questions.

Three subcategories of food-basedsupplements:Food-Based

Food-based dietary supplements arecompounded synthetic multivitamin/mineralblends tableted in a base of green foods(sometimes referred to as superfoods). Thefood base for the synthetic nutrients typicallyconsists of types of algae, such as spirulina,chlorella and blue-green algae or grasses,such as wheat grass, barley grass, and alfalfa.The food base may also include whole foodextracts, such as broccoli and carrots, may

The views expressed in this newsletter arethose of the authors and do not necessarilyreflect the policies and/or official positions ofthe American Dietetic Association.

We invite you to submit articles, news andcomments. Contact us for author guidelines.

Send change-of-address notification to theAmerican Dietetic Association, 120 SouthRiverside Plaza, Ste. 2000, Chicago, IL 60606-6995.

Copyright © 2003 Nutrition in Comple-mentary Care, a Dietetic Practice Group of theAmerican Dietetic Association. All materialappearing in this newsletter is covered bycopyright law and may be photocopied orotherwise reproduced for noncommercialscientific or educational purposes only, providedthe source is acknowledged. For all otherpurposes, the written consent of the editor isrequired.

54 b Nutrition in Complementary Care NCC Newsletter 2003 • Volume 5/6, Issue 4/1

Editor’s Notes . . .

Annual Subscription Rates (in U.S. dollars, payable in U.S. funds)

Individuals who are ineligible for ADA membership . . . . . . . . . . . . . . . . . . . . . . . . . .$35/yearBack issues . . . . . . . . . . . . . . . . . . . . . . $10 each, 4 for $35

For international orders, add $5 shipping and handling perannual subscription and for each back issue order of 1–4issues. For orders of 5 or more back issues, shipping is $6.50and $1.50 for each additional issue.

Make checks payable to NCC DPG#18 and mail to theTreasurer. See back cover for address.

ISSN 1524-5209

Chair’s Corner . . .

Sarah Laidlaw, MS, RD, MPA

A new year for NCC and ADA is uponus. This issue of the newsletter marks ahopefully seamless change in the calendaryear for all DPG newsletters. This is the lastissue for the 2002-2003 year and the firstissue for 2003-2004. Each and every memberfrom 2002-2003 and those who signed upafter March 1, 2003 should be receiving acopy of this issue. As always, I, along withother members of the NCC ExecutiveCommittee hope that former members arecontinuing their membership and those nowjoining will remain members for years tocome, not just for the newsletter, but for thenumerous other benefits available tomembers.

I would like to take this opportunity tothank all of those who have contributed to thenewsletter as authors and reviewers. Withoutthese dedicated members we would not havethis quality publication. Many of our authorsthis year have been newcomers to the area ofwriting, some were just beginning practice inthe area of complementary nutrition andothers were students tackling issues incomplementary nutrition as an undergraduateor graduate project. I say this as anencouragement to those of you who havewanted to write but felt you were notqualified for various and sundry reasons.Everyone has to start somewhere and what

better way than to contribute to this premierDPG’s newsletter? Authors and ideas arealways welcome. Support is availablethroughout the process from currentPublications committee members andreviewers. If you have the desire to writeand/or an idea, please do not hesitate tocontact me [email protected] or970-241-5529. There are also opportunitiesfor members with the Web site, other specialprojects and at FNCE in San Antonio inOctober. If you are interested in otheropportunities, contact Susan Drake, MemberService Chair.

Speaking of FNCE, this year promises tooffer several premium sessions of interest toNCC members. In addition there will benumerous opportunities for networking withother members and the leadership of NCC. Apreliminary listing of FNCE sessions andmeetings are in this issue, with moreinformation coming in the Fall.

It is with great honor (and a bit of awe)that I accept the baton from our fearlessleader, Roz Kulik (2002-2003 NCC Chair). Istep into this role with enormous shoes to fill.My hope is to build upon the forwardmomentum that Roz has brought to bear,propeling NCC and its membership to theforefront within ADA and externally as arecognized force with expertise incomplementary care. Before I delve into myyear, it is fitting to highlight some of thesuccesses realized this year under Roz’sleadership. Under her purview, NCC saw asignificant growth in membership of morethan 150 members, as well as outstandingexternal presence as a leading force in ADA.NCC’s vision and strategic goals wereadvanced by leaps and bounds. NCCsponsored and lead a successful educationalsession at the 2002 ADA FNCE inPhiladelphia titled, “ImplementingIntegrative Care with Nutrition, Supplementsand Lifestyle Strategies: Potentials andPitfalls”; partnered with our DPG brethren,Dietitians in General Clinical Practice, to

develop easy-to-use CVD ready referencecards for common uses of dietarysupplements, botanicals and functional foods;finalized its organizational structure, andsuccessfully filled a majority of the leadershippositions with eager volunteers interested inhelping NCC and ADA forge ahead as aleader in complementary and alternative care.These are but a few accomplishmentsresulting from Roz’s tenure, and I for one amextremely grateful.

The impressive cache of NCCvolunteers recruited over the years is no smallfeat. Volunteering, while indeed rewarding,does translate to making a significantcommitment of time and energy on top ofextremely busy day job schedules. That wehave such an excellent cadre of individualsdevoting precious spare time speaks volumesabout the energy behind NCC. I do appreciateand recognize the investment that is beingdevoted by our voluntary leaders to advanceNCC, and ultimately ADA’s goals. With goodreason, complementary care and dietarysupplements is one of ADA’s five priorityareas in nutrition and dietetics in their 2004-2008 strategic plan. This is an emerging areaof nutrition and dietetics, and NCC —

through the hard work of its volunteers andmembers — is in position to foster anenvironment to elevate ADA as a leader inthis area. We are off to an amazing start forthe 2003-2004 program year, includingacceptance to two key sessions at the ADAFNCE in San Antonio (see page 59).

We are on the verge of one of the mostinteresting and critical times in food andnutrition. The Department of Health andHuman Services is due to revise the DietaryGuidelines for Americans. The USDA is inthe throes of re-evaluating the Food GuidePyramid. The Food and Drug Administrationis evaluating labeling implications of the DRIrecommendations from the NationalAcademy of Sciences. And, perhaps mostsignificant to NCC members, the Food andDrug Administration established a Task Forceon Consumer Health Information for BetterNutrition that will develop scientific guidancefor establishing standards for qualified healthclaims for foods. We are in a vital position tohelp our organization navigate through theseissues, lead the charge in new areas ofresearch, and become a force to promote theintegration of conventional nutrition practiceswith evidenced-based alternatives.

Susan Pitman, MA RDChair 2003-2004

Thank You!!Thank You!!

As I pass NCC’s virtual gavel to SuePitman, let me express my appreciation to allof you – especially those of you whovolunteered your time, shared your expertise,and helped further NCC’s mission. It’sthrough your efforts that NCC continues togrow stronger month by month, year by year.We value everyone’s help, regardless of itsmagnitude. To the 2,500+ members in 2002-2003, we hope that you gained more fromNCC than you contributed. And to all whoread this column, we encourage you to findways to support NCC in ways that makesense to you.

Nutrition in Complementary CareDietetic Practice Group Makes CompleteSense!

No-nonsense folks like us research the herbsand supplements.We utilize our senses in our work. That’scommon sense!

We heard the public’s changing attitudesabout their health, And hear the experts opine now at workshopsor by stealth.

We witnessed benefits of sharing knowledgegained with friends. Today, we filter what we’re reading through awider lens.

We mold nutrition’s destiny to varyingdegrees Through on-line networks made by pressingthose computer keys.

While pumping air a fresh into the dietitian’srole, We’ve smelled more chamomile and lemon— just to soothe the soul.

Although we savor growth in numbers, let usstrive for more. Encourage all to taste more veggies, grains,and nuts galore.

We dedicate our practice group to modesthat integrate alternative with standardmethods. Let us celebrate!


Chair’s Corner . . . Thank You

A sincere thank you to each and everyperson who has contributed to the success ofNCC. We apologize if someone is not listedbelow; we made every attempt to includeeveryone who has helped in any way. If yourname has been inadvertently left off and youwould like to be acknowledged, please do nothesitate to contact any one of the ExecutiveCommittee or the Newsletter Editor. Pleasenote that we did not have credentials for eachperson so in some cases credentials are notlisted.

Speaker’s Bureau: Joyce Bagyi;Cecelia Williams Nelson.

Reviewed an ADA Position Paper;FNCE abstract or a book for NCC:

Jackie Abbott, DrPH; Claudia Kelly,MPH,MS,RD,CNSD; Karen Kulakowski;Cheryl Craig, RD; Lillian L Reyes-Gates;Marjorie Geiser, RD, NSCA-CPT; DorothyHagan; Natalie Ledesma; Judith Lukaszuk,PhD,RD,LD; Angela Sheer; BarbaraMcFarland, RD, LDN; Laurie Mozian,MS,RD,CDN; Renae Norman RD/LD; GitaB Patel; MS,RD,LD; Diana Schell; KimSchenck, MS,RD; Lisa Schachter, MS,RD;Margie Ullmann-Weil, MS,RD; CherylCraig, RD; Rita Kashi Batheji; Monica RTredwell Thornton; Anita M. Boddie,RD,LD/N,PhD; Sandy Couvillon,MS,LDN,RD,CNM; Tamara Schryver,MS,RD; Joanne Shearer, MS,RD,CDE.

Volunteers that assisted Rita Bathejaat the NYSDA:

Chandra Balusa; Kashi Batheja; RitaBatheja; Heather Belding-Wilson; Judy Carr;Marcy Fiaco; Keri Gans; Naomi Garrell;Jinny Gerstle; Barbara Leatham; PatriciaLeistman; Linda Little; Susan Paradez; JaneSilver-Timm; Kimberly Woloszyn; EvelynGezo.

Volunteers on tellers committee:Linda Little; Lois Chait.

Web site: Karen Higgins

Executive Committee 2002 – 2003:Rosalyn Franta Kulik, MS,RD,FADA(Chair); Susan Pitman, MA,RD (Chair Elect);Susan Drake, MS,RD (Member ServicesChair); Deborah Ford, MS,RD,CCN(Secretary); Dennis Gordon, MEd,RD(Treasurer); Kathryn K. Hamilton,MA,RD,CDN (Nominating Chair); BarbaraAnn F. Hughes; PhD,RD, LDN,FADA(Content Chair); Tamara Schryver, MS,RD(Publications Chair); Gretchen K. Vannice,MS,RD (Liaison Chair).

NCC’s Administrative Assitant:Katherine L Bernard, MS, RD, CDN

ADA Staff Liaison: Amy Hobbs (past);Susan DuPraw, RD (interim); Diane Barrera(present)

Other Leaders: Kathleen Rourke,PhD,RD,RN,CHES (Professional IssuesDelegate); Amanda Archibald, RD(Marketing/Strategic Planning Advisor); RitaKashi Batheja, MS,RD,CDN(Reimbursement Chair/Member RecruitmentCoordinator); Bethany Braunstein, RD(Nominating Committee Member); DavidGrotto, RD (Nominating Committee Chair-elect); Ruth DeBusk, RD, PhD (TechnicalResource Advisor); Gretchen Forsell,MPH,RD,LD (Electronic Mail ListCoordinator); Cheryl Galligos, MA,RD(Administrative Advisor); Rick Hall, MS,RD(Web Master); Sarah Harding Laidlaw,MS,RD,MPA (Newsletter Editor); JocelynMathern, RD (Web Editor); Dena Fisher(Product Fulfillment); Kathy Swift(Resources); Volunteer Coordinator (BarbaraBarry); Christine DiMarco-Crook (PublicPolicy Chair); Kathleen Pompliano (AllianceRep); Wendy Reinhardt (Media/PublicRelations); Ruth DeBusk, RD,PhD & RickHall, MS,RD (Find a Complementary CareRD), Pam Brummitt (Newmenber Survey).

Newsletter Editorial Staff:Christian Calaguas, MPH RD; Susan

Drake, MS RD; Dennis Gordon, MEd RD;Sheryl Murphy, RD; Teri Mischler, RD.

Newsletter Article Authors:Anthony L. Almada, MSc; Felix M

Barker, OD; Hope Barkoukis, PhD RD LD;Shelley M Case, RD; Anne Chiavaci, MA MSRD LDN; Diana Dyer, MS RD; Deb Ford,MS RD CCN ACE; Carol M Meershaert, RDLDN; Ruth M DeBusk, PhD, RD; AmyFitzpatrick, MS RD; Kathryn K Hamilton,MA RD CDN; Stacy Kennedy, MPH RDLDN CNSD; Susan Pitman, MPH RD;Kirana Rao, RD; Karen Roberts, MS CNS;Carol Berg Sloan; Tracy R Smith, PhD RDLD; Kathie Swift, MS RD; Karen E Todd,RD; Stephanie Vangsness, RD LDN CNSD;Marian A Verbruggen, PhD

Ready References: Barbara J Goldman,MS, RD, CDE; Sandy Courillon, MS, RD,CDN; Christina Calaguro, MPH, RD; SharonHerr, RD; Joanne Shearer, MS, RD, CDE;Esther Trepae, MS, RD.

Thank you, Thank You,THANK YOU!RRoossaallyynn KKuulliikk MMSS,, RRDD,, FFAADDAA

Thank you to the following NCCmembers, volunteers & liaisonsduring 2002-2003

✱ ✱ ✱ ✱ ✱

Thank You!!

Lactoperoxidase and lysozyme aresmaller protein fractions that have also beenidentified in whey protein. Lactoperoxidasehas the ability to inhibit growth of irondependent bacteria and lysozyme containsimmune enhancing properties. In addition tothe benefits of the individual proteinfractions, whey protein also contains thehighest concentration of BCAA comparedwith egg, milk and soy protein, and rivals eggprotein for overall protein quality as indicatedin Table A.16

Health benefits of Whey:In addition to the potential health

benefits of the aforementioned whey proteincomponents, research has indicated otherpossible applications for whey protein.19 Byitself, whey protein is a popular proteinsource for those seeking improved athleticperformance. In combination with othernutrients, there may also be a synergisticeffect of enhancing athletic performance. ACanadian study found that 36 males who wererandomly assigned to supplementing withwhey protein in addition to their mixed dietwhile engaged in a six week resistancetraining program, demonstrated greaterimprovement in knee extension peak torqueand lean tissue mass than males engaged intraining alone. And the subjects whosupplemented with a combination of wheyprotein and creatine monohydrate had evengreater increases in lean tissue mass anddemonstrated greater improvement in the


and Romans stored whey in amphorae andHypocrites was known to consume aminimum of what would equal one to twoliters of whey daily. 1

What is Whey?Bovine milk protein consists of

approximately 80 % casein and 20% whey. Infact, whey proteins are not actually a singleprotein but rather a group of protein fractions.Whey occurs as a co-product of the cheesemaking process. When cheese is made, theliquid whey separates from the curd or casein.The whey proteins are then separated fromthe liquid and then purified to variousconcentrations. Many factors contribute tothe varied composition of whey proteinproducts including manufacturerspecifications, the method of production,source of the milk and finally, the type ofcheese being produced. Whey protein isutilized in food manufacturing in variousdifferent forms depending upon the specificapplication.2

The most common forms seen in dietarysupplementation are whey proteinconcentrate and isolate. The concentratesvary in protein content from 25-89% andwhey protein isolate must contain 90% ormore protein. Whey protein isolate alsocontains little to no fat or lactose. Both wheyprotein concentrate and isolate are availablein hydrolyzed forms that are generally welltolerated by most individuals as they are theleast allergenic. The following aredescriptions of the individual proteincomponents found in whey protein and theirpotential health benefits.3,4

Beta-lactoglobulin:This is the most abundant of the whey

proteins comprising up to 50-55% of totalwhey protein content. Some attributesinclude increased bioavailability of fat-soluble vitamins and an excellent source ofessential and branched chain amino acids(BCAAs).

Alpha-lactalbumin:Approximately 20-25% of whey protein

is made up of alpha-lactalbumin. It is theprimary protein found in human breast milkand is high in the amino acid L-tryptophan,which may aid cognitive function in stressedindividuals.5,6 It also is an excellent source ofboth essential and BCAAs. Other benefitsinclude enhancing the bioavailabilty ofcalcium and assisting individuals inovercoming ethanol toxicity.7,8

Immunoglobulins:Highest amongst the remaining smaller

percentage of protein fractions,immunoglobulins provide immunity-enhancing benefits to infants and others andis the predominant whey protein componentfound in colostrum.

Bovine Serum Albumin (BSA): BSA is a rich source of branch chain

amino acids. It has unique fat bindingproperties and like beta-lactoglobulin andalpha-lactalbumin, BSA possesses ACEinhibitory properties and may be beneficial incontrolling blood pressure.9-12

Glycomacropeptides (GMP): GMP provides a relatively good source

of BCAAs and is absent of aromatic aminoacids. It helps to limit dental plaque andcaries by inhibiting bacteria in the mouth. Itstimulates the body to producecholecystokinin (CCK), the hormone that isreleased after eating to give a sense ofsatiation. However, whey obtained throughacid separation from casein will not containany GMP.13

Lactoferrin: Lactoferrin inhibits the growth of

bacteria (including some pathogenic bacteria)and fungi due to its ability to bind iron. TheUSDA recently approved the use oflactoferrin in meat production to prevent thegrowth of pathogens such as E. coli andSalmonella. It also promotes the growth ofbeneficial bacteria such as Bifidus that helpsinfants establish good microbial flora. It mayalso help in reducing inflammation as it hasantioxidant properties. Currently, the use oflactoferrin in the area of cancer prevention isalso being studied.14,15

(continued from page 53)

Functional Foods... The Wonders of Whey Protein

Protein Type

Whey Protein

Whole Egg

Casein

Soy ProteinConcentrate

Beef Protein

Canned KidneyBeans

Wheat Glutten

ProteinDigestibility

CorrectedAmino Acid

Score(PDCAAS)17

1.00

1.00

1.00

1.00

0.92

0.68

0.25

Amino AcidScore

1.14

1.21

1.00

0.99

0.94

NA

0.47

ProteinEfficiency

Ratio

(PER)18

3.2

3.8

2.5

2.2

2.9

NA

NA

BiologicalValue

(BV)

100

88-100

80

74

80

49*

54

ProteinDigestibliity

99

98

99

95

98

NA

91

NA=Information Not Readily Available*value is for beans in general



Spotlight On…


Imagine a nutrition degree program thatincludes experimenting with ancient grainssuch as quinoa and amaranth; gainingmultidisciplinary clinical experiencealongside naturopathic physicians; and eatinglunch at a vegetarian cafeteria featuringgarden-fresh vegetables and herbs grown inthe campus compost gardens.

This is just a glimpse of what is offerednorth of Seattle, WA at Bastyr University inKenmore where students learn a natural,whole foods approach to nutrition, pairedwith a strong science curriculum that istypical of nutrition degrees. BastyrUniversity offers both undergraduate andgraduate degrees in nutrition, including anAmerican Dietetic Association (ADA)-approved didactic program in dietetics(DPD), as well as an ADA-accredited dieteticinternship. The nutrition department hasseven full-time faculty and approximately 15to 20 adjunct instructors, many of whomgrew up with a vegetarian or natural healthlifestyle.

As consumers take a more pro-active rolein their healthcare and explore alternative andcomplementary therapies, programs likeBastyr’s are becoming increasinglyattractive. Although the Commission onAccreditation for Dietetics Education(CADE) now requires all DPD programs toinclude some instruction on complementaryand alternative nutrition and herbal therapies,the way this is done varies. DPD programsfrequently integrate the topic into clinicalnutrition or diet and disease classes, and somecover it in a separate seminar class. A fewuniversities offer a graduate major or minorin complementary therapies, as well asspecial research opportunities (see sidebar onpage 58). Bastyr University integrates anatural health, whole foods philosophythroughout its nutrition programs and holdsinternational respect for its science-basednatural health curricula.

The PhilosophyAlthough some students come to Bastyr

expecting that the nutrition program willplace a lot of emphasis on supplements andherbs, that is only one component of thephilosophy. According to Beverly Kindblade,MS, RD, CD, Director of the DPD program,"We really believe in using food as medicinefirst and foremost, and sometimes thatsurprises students." Mark Kestin, PhD, MPH,Bastyr’s Nutrition Program Chair, believesthat "Compared to most schools, Bastyr is

very food based, rather than just talking aboutnutrients as nutrients. The least interferenceyou have with the food, the better the food isfor you."

This whole foods philosophy is especiallymanifest in the undergraduate and graduatewhole foods production classes, whichoriginated in the late 1970s and are nowtaught in a new state-of-the-art kitchen. Thestudents experience a combination of didacticand hands-on learning including preparing afull meal, often using fresh vegetables andherbs from the campus gardens. At the end ofeach class period, the entire group sits downto enjoy the meal together. Tiffany Andres,MS, a recent Bastyr graduate, found this classextremely valuable, expressing that, "Food issuch a central part of who we are, andsometimes in our culture we forget that.When we lose our connection with theprocess of cooking, serving and enjoying ourmeals, we lose connection with our food andwhat sustains us."

Although the department emphasizes awhole foods approach, it does not sell aparticular philosophy such as vegetarianismor veganism. The faculty is open-minded,encouraging students to make their owndecisions about their dietary choices. Thecampus cafeteria typically serves vegan andnon-vegan, versions of entrees. Twoexamples are quiche and pizza. The veganversions are made with organic tofu, soycheese and soy milk for quiche, rather thandairy products. Many of the entrees theyserve are vegan without having to make twoversions--such as organic black beans andrice or a stir-fry. They use local dairyproducts with no antibiotics or BGH and free-range, antibiotic-free chickens. They alsoserve as much organic seasonal produce aspossible. All of their baked goods —including premade bread, scones, pastries anddesserts — are made from scratch and manyof the flours they use are organic. They alsoserve organic ice cream.

Denise Ward, a current undergraduateBastyr student, believes the cafeteria hashelped her improve her eating habits as itserves foods she does not have time to cookon a regular basis. Brown rice, kale, tofu andtempeh dishes are common fare in thecafeteria.

Academic ProgramsBastyr is a transfer school, so general

undergraduate classes are taken elsewhere,and students transfer to Bastyr their junioryear. Undergraduate students are initiallyadmitted into the general nutrition track andcan apply for the didactic program track,which is needed for eligibility for the dieteticinternship. The department has a large

percentage of non-traditional students andthose seeking second careers. The graduatenutrition program has approximately 80students (including incoming, second-yearand part-time students) and is the largest inWashington State. Eighty percent of thegraduate students come from other states.

The graduate program includes both aresearch track and a clinical/counseling track.The clinical/counseling track requires thatstudents consult/evaluate/assess/counsel/interview clients at the university teachingclinic, the Bastyr Center for Natural Health,under the supervision of graduate leveldietitians, two of who are also certifieddiabetes educators (CDEs).Clinical/counseling track students must passa competency-based exit exam. In therequired Research Methods in Nutrition classissues concerning research in complementarytherapies are extensively discussed. Researchis based on student interest, so some studentsdo gravitate towards complementary nutritionresearch topics. Research ranges from socialto lab research and may be anything fromwhole grain nutrition education interventionwith the elderly to measuring vitamin B12activity in wheat grass. Bastyr has many NIHgrants. They recently conducted a NIH-funded, joint research study with theUniversity of Washington to investigate theuse of Echinacea for cold prevention inchildren (double blind, placebo-controlled).This study is scheduled to be published soon;results are not available until publication.

All graduate students take a researchmethods class where they learn to readresearch critically and discuss issues inconducting complementary medicineresearch. Dr. Kestin teaches this class andsays it is important to realize that, "the wholeis greater than the sum of its parts." Heexplains that when you try to separate theeffects of individual nutrients you do notnecessarily get the same physiologicalresponse as that produced by the whole food.Kestin believes good research can bedesigned without necessarily pinpointing aspecific nutrient.

Some students come to Bastyr thinking itwill be less difficult due to its alternativefocus; however, they quickly learn that thescience requirements are rigorous. Accordingto Kindblade, "We have students graduatingfrom prestigious universities wanting tocomplete our master’s program, but they haveto take more science to meet our admissionsrequirements." Kindblade compares Bastyr toa traditional medical school, except ratherthan training medical doctors, they aretraining naturopathic doctors, acupuncturistsand dietitians who have both traditional and

Bastyr University’sNutrition DepartmentMMaarrsshhaa BBoonnnnee,, MMSS,, RRDD

Additional UniversityNutrit ion Programs With

Special CAM Opportunities

• Purdue University: The Food and Nu-

trition Department houses one of four NIH

funded Botanicals Research Centers in the

U.S. (in collaboration with the University of

Alabama-Birmingham). Students can work in

the botanicals research lab, develop graduate

theses around botanicals research and attend

weekly seminars on the topic. Visit

http://fn.cfs.purdue.edu/bot/

• University of Medicine and Dentistry

of New Jersey: The University’s Institute for

Complementary and Alternative Medicine

(ICAM), visit www.umdnj.edu/csacmweb,

and the graduate clinical nutrition program

offer a Web-based course on CAM annually

in the fall (available for either academic or

continuing education credit). Contact

[email protected]. Also will offer a

clinical nutrition practice doctorate

beginning fall of 2003, which will include an

option to focus academic and research work

on CAM. Contact [email protected] or visit

http://shrp.umdnj.edu/nutr/index.htm.

• University of Minnesota—Twin Cities:

Offers a graduate minor in Complementary

Therapies and Healing Practices. CAM

classes are open to juniors, seniors, graduate

students and the public. The University’s

Center for Spirituality and Healing also will

offer a new course beginning Spring of 2004

entitled "Functional Nutrition: An Expanded

View of Nutrition, Chronic Disease and

Optimal Health" (open to university students

and the public). Call Nancy @ 612-624-5166

or visit www.csh.umn.edu.

• West Chester University of Pennsyl-

vania: The University’s Department of

Health offers elective classes in

integrative/preventive medicine as well as a

master’s program in public health with an

integrative/preventive medicine focus.

Visit http://health-sciences.wcupa.edu

/health/mph-ipm.htm.



Spotlight … Bastyr University’s Nutrition Department

complementary, integrative knowledge. Although the students have no choice in

the scientific rigor, they do have a lot ofinfluence on elective courses. On a quarterlybasis, students complete surveys to indicatetheir interest in elective classes. They maychoose topics such as organic gardening,Ayurveda, or macrobiotics. Beyond classes inthe department, students can take electivecourses in other campus programs such asTraditional Chinese Medicine (TCM) andaromatherapy. Numerous brown-bag lunchseminars are also available daily on a rangeof topics across the campus.

One popular required undergraduate classis "Nutrition Supplements and Herbs," whichcovers botanical medicine and shows howsupplements should be used in the context ofoverall health. In Bastyr’s teaching clinic,students typically refer nutraceutical andsupplement questions, beyond multivitaminsand minerals, to naturopathic physicians.However, the nutrition faculty believessupplements and herbs are important classtopics, as many students will not have accessto naturopaths after graduation.

Dietetic InternshipBastyr offers an ADA-accredited dietetic

internship program that accepts six studentson the Washington campus and an additionalthree students in Hawaii (which requires aseparate application). Suzzanne Myer, MS,RD, CD directs the 9-month internship,which runs from September through June.According to Myer, the internship tends toattract students interested in naturalmedicine. Many have taken classes on thetopic and have worked in a natural foodsstore. The interns tend to be a mixture ofBastyr graduates and external graduates.

The internship meets CADE requirementsand offers a broad range of experiences.Interns rotate through hospitals, clinics,public health institutions, and sports clinics,as well as the Bastyr Center for NaturalHealth. The internship includes four weeks ofenrichment, in which students spend extratime in a specific area, such as working withan acupuncturist or TCM practitioner. Internsalso complete a year-long project in whichthey plan a full-day continuing educationconference for health professionals. Theconference is held each June on a topic of theinterns’ choosing and has a natural healthemphasis, such as women’s health orchildren’s nutrition from a natural healthperspective.

According to Myer, Bastyr’s

interns have had a 100% registration exampass rate for the past seven years, and Bastyr-trained registered dietitians (RDs) are verysought after by employers of both traditionaland complementary therapy clinics.Kindblade has found that many naturopathsnow prefer to hire registered dietitiansbecause they know RDs have completed anaccredited internship and have taken thenational registration exam. Plus, naturopathsare finding more clients wanting anintegrative approach to their care, in whichtreatment with their medical doctor iscomplemented by care with a naturopathicphysician and a registered dietitian. Thefuture is truly bright for dietitians who keepan open mind to alternative therapies. BastyrUniversity is one institution that provides anabundance of educational resources. Formore information, visit www.bastyr.edu andwww.bastyrcenter.org.

Marsha Bonne, MS, RD works inbusiness/industry and previously heldpositions in natural foods marketing andcollege teaching. Contact Marsha at 952-938-3639 or [email protected].

Gold LevelNature Made Nutritional Products

National Starch & Chemical Co.

Nutrilite A Division of

Access Business Group

Whey Protein Institute

Silver LevelIntegrative Therapeutics

BronzeAmerican Specialty Health Inc.

(Healthyroads.com)

Eggland’s Best

Enjoy Life Foods

International Tree Nut Council

Kashi Company

McNeil Nutritionals

Nature’s Path Foods Inc.

The Quaker Oats Company

Tropicana Products, Inc.Pharmaton Natural Health Products,

Consumer Health Care Divisionof Boehringer IngelheimPharmaceuticals, Inc.

Wild Oats Markets, Inc.Without you, the quality programs we haveto offer would not be possible.

Thank You to Our2002-2003 Sponsors

CONGRATULATIONS!!The following NCC members are ADA

Award Winners for 2003-04. The following awards will be presented duringthe 2003 Food and Nutrition Conference

in San Antonio in October. NCCcongratulates these individuals for their

contribution to the professionand to NCC.

Dietetic Education:

Riva Touger-Decker, PhD, RD, FADANew Jersey

Mary Abbott Hess Award forRecognition of an Innovative

Food/Culinary Effort:

Mildred Mattefeldt-Beman, PhD, RD, LDMissouri


Following are a list of sessions that NCC membersmay be interested in attending at this year’s FNCE.

ADA Foundation and NCC Yoga SessionsSunday, Oct. 26 6:00 a.m.-7:00 a.m.

5:30 p.m.-6:30 p.m.

Monday, Oct. 27 6:00 a.m.-7:00 a.m.

5:30 p.m.-6:30 p.m.

Tuesday, Oct. 28 6:00 a.m.-7:00 a.m.

Sunday, Oct. 26• Eye Health and Nutrition

• The Fountain of Youth:

Observations on living to 100

Monday, Oct. 27• Is There Science to Support

Claims Made on Dietary Supplements?

• Conflict of Interest, Ethical and Leagal

Issues of Selling Product

Tuesday, Oct. 28• What’s the Story with Dietary

Supplements?

•We’re Not Talking About Scurvy

Anymore: Multivitamin Supplementation

Takes on a New Role

FNCE Announcements.. .Mark Your Calendars! Two NCC SessionsApproved for ADA FNCE – San Antonio

Session one: Diversity, the Individual,and Proof of Efficacy: The Role ofComplementary and Alternative Medicine inSelf-care, Nutrition Management and PublicHealth is a basic session for dietitians withless familiarity of complementary care. Thegoals of this session are to help participantsunderstand the cultural, behavioral and ethicsof public health implications forcomplementary and alternative medicine andhelp participants understand and learn toidentify potential opportunities to considerself-care and CAM therapies into practice.The speaker, Dr. Tieraona Low Dog, from theUniversity of Arizona and a private medicalpractitioner, has studied self-care & herbalmedicine and its role in modern health care

for more than 20 years. A reknowned speakerin CAM, Dr. Low Dog was named by Timemagazine as 2001 Innovator inComplementary and Alternative Medicineand also named to the Clinton White HouseCommission of Complementary andAlternative Medicine.

Session two: Individualizing Nutrition:Putting Nutrigenomics and FunctionalNutrition Therapy Into Practice, features twodynamic speakers, Jeffrey Bland, PhD,Chairman, Institute for Functional Medicine,Inc and Ruth DeBusk, PhD, RD, a clinicalnutritionist and geneticist in private practice,and past NCC executive committee member.This session will define functional nutritiontherapy, what it is and how it enrichesconventional nutrition therapy and makes itmore effective.

Both sessions are scheduled as morningsessions on Sunday, October 26, 2003.

Don’t miss these opportunities fornetworking at FNCE:

• NCC/NE/DBC networking receptionSunday October 26, 2003. Last year’s eventwas a big success — just ask anyone whowent!

•NCC business breakfast/meetingMonday October 27, 2003.

Look for more information includingtimes and locations in the next issue of thenewsletter.

Other Sessions at FNCE...


bench press than the control group.20

Hydrolyzed whey protein is often apreferred substrate in infant formulas foroptimal digestibility and reduced potential forallergic reactions.21-24 Whey is the richestprotein source of leucine, which may play arole in weight management.25 Other benefitsinclude wound healing and reduction ofdental caries. Additionally, impressive dataexist demonstrating a positive role for wheyprotein in boosting immune function inhuman immunodeficiency virus (HIV) andcancer.26,27

Benefits in HIV:Depletion of body cell mass (BCM) in

HIV-infected patients is strongly associatedwith disease progression and death. Ideally,the goal of nutrition therapy should bedirected towards the maintenance of optimalnutrition status since adequate protein intakehas been associated with increased BCM inHIV-infected men, independent of musclebuilding activity.28 However, this may notalways be realistic considering the manynutrition-related difficulties in meetingnutrition needs for calories, protein and forpatients infected with HIV. In some cases amore appropriate goal is the prevention offurther depletion. This is preferablyaccomplished by a well-balanced diet butmay require the additional use of enteralformulas.29

A CD4 count fewer than 200 may be apredictor of poor survival along with reducedlevels of glutathione (GSH). Those with aCD4 count under 200, who also had very lowGSH, had an estimated three-year survivalrate as low as 20%, compared to 60-80% forthose with CD4 below 200 but with adequateglutathione levels.30 Cysteine is the rate-limiting amino acid for synthesis of GSH andbovine whey proteins are rich in cystine, thedisulfide form of the amino acid cysteine.31

Those who have less than optimal levels ofGSH may benefit from a diet rich in wheyproteins; several studies reviewing theeffects of whey protein in HIV patients havedemonstrated increased plasma GSH levels inpatients with advanced HIV-infection.32-35

Whey Protein in Cancer Therapy:GSH is involved in several important

biologic functions including the protection ofcells from free radicals, cell membranetransport and detoxification mechanisms. Italso is widely used by the red blood cells,which are vulnerable to oxidative damagecaused by peroxides.36 A characteristic ofmany tumor cells is that they haveparticularly high GSH values and may bemore resistant to chemotherapy and radiation.One approach has been to use GSH-depletingdrugs to reduce GSH values in cancer cells torender them more vulnerable to treatment. Ofconcern, this also reduces GSH in healthycells thus magnifying the side effects of

chemotherapy or radiotherapy.37

Oral and intravenous interventions thatraise GSH may also ameliorate the sideeffects of cancer treatments. In a study ofover 150 patients being treated for ovariancancer with the chemotherapeutic drugcisplatin, those who were also givenintravenous GSH showed statistically lessdepression, vomiting, hair loss, shortness ofbreath and neurotoxicity. Patients alsoimproved in areas of mental concentration,and kidney function and overall outcomestrended towards improvement.38 Asmentioned earlier, whey protein is anexcellent source for raising GSH and in ahuman prostate study, hydrolyzed wheyprotein isolate increased intracellular GSH inepithelial cell lines by 64% compared tocontrol cells.39 Baruchel et al and Kennedy etal demonstrated in both animal and humanstudies that whey protein paradoxically raisedGSH in lymphocytes while causing GSHdepletion in cancer cells thus inhibiting theirproliferation.40-42 Therefore, whey proteinmay cause cancer cells to be more vulnerableto chemotherapy or radiotherapy whilehelping protect normal tissues fromdamage.43,44

Limited research has evaluated thecombination of select nutrients such asvitamin C and specific foods includingbovine colostrum in combination with wheyprotein for effects on immunity. See et alfound significant increases in natural killer(NK) cells and tumor necrosis factor (TNF-alpha) while decreasing DNA damage. Inpatients with late-stage cancer, improvedclinical outcomes were achieved with severalof the subjects when whey was combinedwith the aforementioned nutritionalcomponents.45

Cancer patients undergoing radiation orchemotherapy often have difficulty inmeeting their nutritional requirements due tonausea and lack of appetite which mayultimately lead to wasting. Droge and Holmdiscovered that whey protein may assist inthe prevention of wasting attributed to GSHdepletion of healthy cells from thesetreatments since whey protein is a significantsource of cysteine and GSH, known tomitigate skeletal muscle wasting andfatigue.46 Whey proteins are also an excellentprotein source for cancer patients as they areeasy to digest and gentle to the system andcan be added to a wide variety of foods thatcan be flavored in many appealing ways.47

Take Home Message Numerous studies have shown that whey

proteins can help enhance the body's overallimmune system by raising GSH levels.48-51

GSH combats free radical oxidation of themitochondria and other components of thecell so it may be reasonable to assume it hasa role in protecting tissue from oxidativedamage attributed to aging.52 Therefore, wheyprotein may become an instrumental tool in a

dietitian’s arsenal for improving the overallhealth of their clients. A comprehensive list ofavailable whey protein products and wherethey can be purchased, information for itsuse, and helpful recipes can be found atwww.wheyoflife.org.

David Grotto, RD, LD is the Director ofnutrition education at the Block Center forIntegrative Cancer Care, a spokesperson forthe American Dietetic Association and thehost of, "Let’s Talk Health, CHICAGO!"radio program. In addtion, Dave hs beenhired as an idependent consultant for theWhey Protien Institute. You can contact himat [email protected] or by calling847-492-3040.

References

1. Whey Protein Institute The History ofWhey. Available athttp://www.wheyprotein.com/sec1.html.Accessed 2/06/03

2. Reference Manual For U.S. WheyProducts, U.S. Dairy Export Council, 2nd Ed,1999.

3. Miller G, Jarvis J, McBean L. Hand-book of Dairy Foods and Nutrition, SecondEd. 1991; National Dairy Council. New York:CRC Press, 1991.

4. Health-enhancing properties of dairyproducts: composition of whey. NationalDairy Council Digest. 2003. National DairyCouncil available athttp://www.nationaldairycouncil.org/lvl04/nutrilib/digest/dairydigest_722b.htm. Accessed02/06/03

5. Heine WE, Klein PD, Reeds PJ. Theimportance of alpha-lactoglobulin in infantnutrition. J Nutr1991;121:277-283.

6. Markus CR, Olivier B, de Haan EH.Whey protein rich in alpha-lactalbuminincreases the ratio of plasma tryptophan tothe sum of the other large neutral amino acidsand improves cognitive performance instress-vulnerable subjects. Am J Clin Nutr2002;75:1051-1056.

7. [Vegarud GE, Langsrud T, SvenningC.] Mineral-binding milk proteins andpeptides; occurrence, biochemical andtechnological characteristics. Br J Nutr.2000;84:S91-S98.

8. Matsumoto H, Shimokawa Y, UshidaY, et al. New biological function of bovinealpha-lactalbumin: protective effect againstethanol and stress-induced gastric mucosalinjury in rats. Biosci Biotechnol Biochem.2001;65:1101-1111.

9. Fitzgerald RJ, Meisel H. Lactokinins:whey protein-derived ACE inhibitorypeptides. Nahrung. 1999;43:165-167.

10. Mullally M, Meisel H, Fitzgerald R.Angiotensin-I-enzyme inhibitory activities ofgastric and pancreatic proteinase digests ofwhey proteins. Int Dairy J. 1997;7:299-303.

11. Groziak SM, Miller GD: Naturalbioactive substances in milk and colostrum:effects on the arterial blood pressure system.



(continued on page 61

Br J Nutr. 2000;84:S119-S125.12. Pins J, Keenan J. The antihy-

pertensive effects of a hydrolyzed wheyprotein isolate supplement (BioZate 1®).Cardiovascular Drugs and Therapy2002;16:S68.

13. Brody EP. Biological activities ofbovine glycomacropeptide. Br J Nutr2000;84:S39-S46.

14. Petschow BW, Talbott RD, BatemaRP. Ability of lactoferrin to promote thegrowth of Bifidobacteria receptor bindingcapacity and iron saturation level. J MedMicrob. 1999; 48:541-549.

15. Tsuda H, Sekine K, Ushida Y, et al.Milk and dairy products in cancer prevention:focus on bovine lactoferrin. MutationResearch. 2000; 462:227-233.

16. Whey Protein Institute. Sup-plements, Sources of Protein available atwww.wheyoflife.org. Accessed 02/05/03

17. Boutrif E. Protein Quality Eval-uation, Report of the Joint FAO/WHOconsultation 1991. Available ath t t p : / / w w w . f a o . o r g/docrep/U5900t/u5900t07.htm. Accessed02/02/03

18. Walzem R. Health enhaning pro-perties of whey protein and wehy fractions.Reference Manual for U.S. Whey Products,2nd Ed, U.S. Dairy Export council. 1999.Available at http://www.usdec.org/ P D F F i l e s / M a n u a l s / 7 H E A LT H . p d f .Accessed 01/30/03

19. Dangin M, Boirie Y, Guillet C,Beaufrere, B. Influence of the proteindigestion rate on protein turnover in youngand elderly subjects. J Nutr. 2002;132:3228S-3233S.

20. Burke DG, Chilibeck PD, DavidsonKS, et al.The effect of whey proteinsupplementation with and without creatinemonohydrate combined with resistancetraining on lean tissue mass and musclestrength. Int J Sport Nutr Ex Metab.2001;11:349-64.

21. Tolia V, Lin C, Kuhns L. Gastricemptying using three different formulas ininfants with gastroesophaegeal reflux. J PedGastroent Nutr. 1992;15:297-301.

22. Darling P, Dunn M, Sarwar G, et al.Threonine kinetics in pre-term infants fedtheir mothers milk or formula with variousratios of whey to casein. Am J Clin Nutr.1999;69:105-114.

23. Giampietro PG, Kjellman NI,Oldaeus G, et al. Hypoallergenicity of anextensively hydrolyzed whey formula.Pediatr Allergy Immunol. 2001; 12:83-86.

24. Merritt R, Carter M, Haight M,Einsenberg L. Whey protein hydrolysateformula for infants with gastrointestinalintolerance to cow milk and soy protein ininfant formulas. J Ped Gastroent Nutr.1990;11:78-82.

25. Layman D. The role of leucine inweight loss diets and glucose homeostasis. J

Nutr. 2003;133:252-256.26. Rayner TE, Cowin AJ, Robertson

JG, et al. Mitogenic whey extract stimulateswound repair activity in vitro and promoteshealing of rat incisional wounds. Am J PhysReg Integ Comp Phys. 2000;278:R1651-R1660.

27. Loimaranta V, Laine M, Soderling E,et al. Effects of bovine immune and non-immune whey preparations on thecomposition and pH response of humandental plaque. Eur J Oral Sci 1999;107(4):244-250.

28. Williams B, Bartsch G,Muurahainen N, et al. [Protein intake ispositively associated with body cell mass inweight-stable HIV-infected men.] Am SocNutrsci J Nutr. 2003; 133:1143-1146.

29. Rakower D, Galvin TA. Nourishingthe HIV-infected adult. Holist Nurs Pract.1989;3:26-37

30. Herzenberg LA, De Rosa SC, DubsJG, et al. Glutathione deficiency is associatedwith impaired survival in HIV disease. ProNatl Academy Sciences, 1997; 94: 1967-1972. Available ath t t p : / / h e r z e n b e r g . s t a n f o r d . e d u/Publications/Reprints/LAH426-Herzenberg-GSH.pdf. Accessed 02/15/03

31. Wang H, Ye X, NgTB. Firstdemonstration of an inhibitory activity ofmilk proteins against humanimmunodeficiency virus-1 reversetranscriptase and the effect of succinylation.Life Sci. 2000;67:2745-2752.

32. Micke P, Beeh KM, Buhl R. Effectsof long-term supplementation with wheyproteins on plasma glutathione levels of HIV-infected patients. Eur J Nutr. 2002;41:12-8.

33. Beeh M, Schlaak JF, Buhl R. Oralsupplementation with whey proteinsincreases plasma glutathione levels of HIVinfected patients. Eur J Clin Invest.2001;31:171-178.

34. Micke P, Beeh K, Schlaak JF, BuhlR. Oral supplementation with whey proteinsincreases plasma glutathione levels of HIV-infected patients. Eur J Clin Invest.2001;31:171-178.

35. Bounous, G. Immuno-enhancingproperties of undenatured milk serum proteinisolate in HIV patients. ConferenceProceedings of the 2nd International WheyConference, October 27-29, 1998 293-305.Available at http://www.pure-milk-calcium.com/Properties%20of%20Undenatured.htm. Accessed 02/03/03.

36. Bounous G. Whey proteinconcentrate (WPC) and glutathionemodulation in cancer treatment. AnticancerRes. 20:4785-92,2000

37. Sen CK. Nutritional biochemistry ofcellular glutathione. Nutr Biochem.1997;8:660–72.

38. Smyth JF, Bowman A, Perren T, etal. Glutathione reduces the toxicity andimproves quality of life of women diagnosed

with ovarian cancer treated with cisplatin:results of a double-blind, randomized trial.Ann Oncol. 1997; 8:569-73.

39. Kent KD, Harper WJ, Bomser JA.Effect of whey protein isolate on intracellularglutathione and oxidant-induced cell death inhuman prostate epithelial cells. ToxicolIn–Vitro. 2003;17(1):27-33

40. Baruchel S, Viau G. In vitroselective modulation of cellular glutathioneby a humanized native milk protein isolate innormal cells and rat mammary carcinomamodel. Anticancer Res. 1996;15:1095-1099.

41. Kennedy RS, Konok GP, BounousGB, et al. The use of a whey proteinconcentrate in the treatment of patients withmetastatic carcinoma: a phase I-II clinicalstudy. Anticancer Res. 1995;15:2643-2650.

42. Lands LC, Grey VL, Smountas AA.Effect of supplementation with a cysteinedonor on muscular performance. J ApplPhysiol. 1999;87:1381-1385.

43. Tsai W, Chang W, Chen CH, Lu F.Enhancing effect of patented whey proteinisolate (Immunocal) on the cytotoxicity ofanti-cancer drug. Nutr Can. 2000;38:200-208.

44. Bounous G. Whey protein con-centrate (WPC) and glutathione modulationin cancer treatment. Anticancer Res.2000;20:4785-4792.

45. See D, Mason S, Roshan R.Increased tumor necrosis factor alpha (TNF-alpha) and natural killer cell (NK) functionusing an integrative approach in late stagecancers. Immunol Invest. 2002; 31:137-53.

46. Droge W, Holm E. Role of cysteineand glutathione in HIV infection and otherdiseases associated with muscle wasting andimmunological dysfunction. FASEB J. 1997;11,1077-1089.

47. Bounous G, Baptist G, Gold P. Wheyproteins in cancer prevention. Can Lett.1991;57:91.

48. Bounous G, Gold P. The biologicalactivity of undenatured dietary wheyproteins: role of glutathione. Clin Invest Med.1991;14:296-309.

49. Bounous G, Batist G, Gold P.Immunoenhancing property of dietary wheyprotein in mice: role of glutathione. ClinInvest Med. 1989; 12:154-161.

50. Bounous G, Molson J. Competitionfor glutathione precursors between theimmune system and the skeletal muscle:Pathogenesis of chronic fatigue syndrome.Med Hypoth. 1999;53:347-349.

51. Wong CW, Seow HF, Husband AJ, etal. Effects of purified bovine whey factors oncellular immune functions in ruminants.Veterinary Immunology andImmunopathology. 1997;56:85-96.

52. Bounous G, Gervais F, Amer V, et al.The influence of dietary protein on tissueglutathione and the diseases of aging. ClinInvest Med 1989;12:6:343.





also be included. Tablets made from thisprocess are usually more food-like in colorthan non-food-based supplements, ranging inshade from brown to orange to dark green.Since it is generally accepted that manyvitamins are better absorbed with specific co-factors or with a meal (see analysis below),these green foods are intended to provideadded value by delivering a substitute forfood for better absorption and bioavailabilityof nutrients. In addition, the green foodsprovide a source of vitamin B12, which is ofparticular concern to vegetarians who maynot be obtaining enough B12 in their diets.2

According to actual consumer anecdotesand claims in the literature of somemanufacturers, food-based supplements areless irritating to the stomach and easier forsensitive consumers to tolerate. Consumersalso perceive food-based supplements to beof higher value because they contain less ofthe fillers, binders, and excipients found inmany non-food-based multivitamin/mineralsupplements. Whole food ingredients areseen as replacing many of these lower-valueingredients.1

Food-GrownFood-grown dietary supplements are not

derived from whole foods such as broccoli,spinach, oranges, or carrots, as the namemight imply. Food-grown nutrients(sometimes called biocultured or food state)are made by introducing synthetic nutrientsinto cultures of yeast or other foods and thenspray drying the resultant product. Advocatesof this process say the yeast transforms thenutrients into a more bioavailable form.Only a few peer-reviewed studies showingincreased bioavailability of these types ofsupplements have been published. In one ofthese, a natural citrus extract containingbioflavonoids, protein and carbohydrates wasshown to be absorbed 35% better thansynthetic ascorbic acid alone.3 In anotherstudy by the same author, food-grownselenium yeast was shown to be superior toother synthetic forms of selenium.4 However,a similar study with a yeast-based food-grown calcium when compared to calciumcarbonate and calcium gluconate as sourceswas not able to demonstrate a significantdifference in calcium absorption by malesubjects.5

From FoodAnother class of supplements, in which

the nutrient is derived from the food itself,could be described as "from food.” Fish oil,which contains vitamins A and D and omega-3 fatty acids, is one example. Others areextracts of foods that contain highconcentrations of given nutrients, such asvitamin C from acerola cherry or beta-carotene from a carrot concentrate.

Many supplements consumers believe

these supplements to be of high quality and,since they are essentially taken in food form,presume that they have high nutrientbioavailability. There is some controversyover the use of the term natural when appliedto these extracts, since some concentratesmay be produced using synthetic solventssuch as hexane or methylene chloride.Natural solvents such as alcohol orsupercritical carbon dioxide are consideredpreferable to synthetic solvents. Thoughmanufacturers are often reluctant to sharetheir extraction processes, consumers believethat from food nutrients and supplements arederived using natural processes and solventsfrom food sources.1 Therefore, manyconsumers then perceive that the variouskinds of food-based supplements are better ina number of ways over their non-food-basedcounterparts.

Other Common BeliefsOther common beliefs among

supplements consumers are that naturalsupplements are better than synthetic and thatsupplements should be taken with food.1

Natural is Better Than SyntheticMany consumers believe that natural

supplements — those derived from naturalsources, such as vitamin C from acerolacherry or vitamin E derived from vegetableoils — are better than synthetic supplements.While synthetic supplements are made to bechemically identical to the natural form, thesesupplements are synthesized throughchemical processes by manufacturers. Mostof these supplements meet the strict

requirements set by the United StatePharmacopeia (USP) for purity and potency,yet consumers say they are wary of chemicalprocessing of their food and supplements.1

(Studies have demonstrated that some naturalsupplements are absorbed better and are morebioavailable than synthetic. Burton et al.demonstrated that natural vitamin E isapproximately twice as bioavailable assynthetic vitamin E.6 As a result of this data,many consumers seek out the d-alpha(natural) tocopherols at natural foods storesinstead of buying the widely available dl-alpha (synthetic) form. It should be noted thatthe natural form — (d-alpha) — is alsoavailable through many discount and vitaminsupplement stores.

Research on other nutrients is not asclear. A few studies of isolated nutrients innatural versus synthetic form thatdemonstrate that natural may be a betterchoice, while other data show that one is notclearly superior to the other. For example,food-based and non-food-based ascorbic acidhave been shown to have the samebioavailability in some studies.7, 8 A review ofdietary studies with the nutrient folatederived from foods and from supplementsdemonstrates that drawing comparisonsbetween natural and synthetic supplements isa complex exercise.9 With folate, there isconflicting information showing increasedbioavailability of folate from food sources,such as green leafy vegetables, beans andpeas, and fortified cereals and bread whencompared to folic acid from synthetic sourcesusing a rat bioassay.10 However, otherstudies show that the synthetic form offers


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greater benefits. Natural folates are found infoods as conjugated to polyglutamyl chains.These chains are removed by the enzymefolate conjugase, but this process isincomplete, resulting in a 25-50% reductionin the bioavailability when compared tosynthetics.11 In addition, food matrixes andfood sources seem to have complexinteractive effects on the bioavailability offolates.12 This further complicates thecalculation of folate intakes from diets andsynthetic sources for nutrition professionals.13

It is important to note that limited research,coupled with the complexity of these food-source issues, makes drawing conclusionsproblematic.

One Should Take a Supplement with FoodIt is widely believed that vitamins,

particularly fat-soluble vitamins, are betterabsorbed with a meal.14, 15 Higher fatconcentrations in the diet were correlatedwith higher levels of vitamin E or vitamin Ain the blood, but not consistently.16 However,there is evidence that other vitamins, such asvitamin B12 and folate, are better utilizedwhen taken while fasting between meals.17

Health care and nutrition professionalsand consumer groups frequently recommendthat vitamins should be taken with meals. Themandate may be based on the fact that amultivitamin/mineral supplement taken on anempty stomach can cause nausea and, insome cases, vomiting. Therefore, the generalwisdom on taking supplements is that thereare co-factors and co-enzymes that, whentaken with food, help increase the absorptionof supplements. This in turn supports theanalogy that food-based supplements providethe co-factors and co-enzymes that mimicthis phenomenon. These factors, in additionto the buffering effects of food on possiblegastrointestinal side effects, call for thecommon sense recommendation to consumesupplements with food.

Take Home MessageWhat message can nutrition

professionals take away from all this? Manyconsumers are purchasing food based andnatural dietary supplements based on thebelief that these products must be better.Food-based supplements contain co-factorsand other nutrients, which may optimizeabsorption and bioavailability.Unfortunately, the published scientificresearch does not support this view, exceptfor the examples of natural versus synthetic

vitamin E.6 Among natural foodssupermarkets shoppers, there is a perceptionthat supplements that contain more food orfood-like ingredients are a better value andare higher quality than those that containconventional fillers, binders, and excipientsbecause the total end product includes ahigher concentration of natural nutrients.1 Asdiscussed, existing research presentsconflicting or inconclusive information aboutthe real benefits of food-based dietarysupplements. Therefore, more research isneeded to better substantiate the perceivedopinion that nutrients from food or nature arebetter utilized by the body than syntheticnutrients. Manufacturers of food-basedsupplements clearly benefit by increasedsales to natural products consumers. Theyneed to substantiate the superior value thatthese products provide, since many consumergroups, such as Consumers Union andCenters for Science in the Public Interest(CSPI), recommend that consumers purchasethe least expensive dietary supplements,based on the assumption that all nutrients arethe same.

There is little or no evidence of potentialsafety issues or risk of harm to consumersinherent in these food-based dietarysupplements when compared to typicalsynthetic vitamin supplements. Therefore,there is no need for specific cautionary adviceto consumers who choose to use thesesupplements instead of synthetics.Consumers with questions should beencouraged to contact the manufacturersdirectly if they have questions about any ofthese supplements. Furthermore, consumersare not necessarily the only ones withquestions, and manufacturers should never bethe sole source of answers. Experiencedhealth care professionals, regulatory bodiesand other organizations may have potentialanswers as well.

Mary Mulry, Ph.D. is Senior Director ofProduct Development and Standards at WildOats Markets, Inc. She has worked in theconventional food as well as the naturalfoods and dietary supplement industry.Contact Dr. Mulry at 720-562-5018 or e-fax303-402-2008.

References

1. Author sourced anecdotal consumerdata, author’s notes, author’s observation offocus groups, personal correspondence,professional experience and conversationswith natural products industry professionalsand consumers.

2. Watanabe F, Takenaka S, Kittaka-Katsura H, et al. Characterization andbioavailability of vitamin from edible algaeB12 compounds. J Nutr Sci Vitaminol.(Toyko) 2002; 48:325-31.

3. Vinson JA, Bose P. Comparativebioavailability to humans of ascorbic acidalone and in a citrus extract. Am J Clin Nutr.1988;48:601-604.

4. Vinson JA, Stella JM, Flanagan TJ.Selenium yeast is an effective in vitro and invivo antioxidant and hypolipemic agent innormal hamsters. Nutr Res. 1999;18:735-742.

5. Vinson JA, Mazur, T, Bose P. Com-parison of different forms of calcium onblood pressure of normotensive young males.Nutr Rep Intl. 1997:36;497-501.

6. Burton GW, Traber MG, Acuff RV, etal. Human plasma and tissue å-tocopherolconcentrations in responses tosupplementation with deuterated natural andsynthetic vitamin E. Am J Clin Nutr.1998;67:669-684.

7. Nelson EW, Streiff RR, Cerda JJ.Comparative bioavailability of folate andvitamin C from a synthetic and a naturalsource. Am J Clin Nutr. 1975; 28:1014-19.

8. Mangels AR, Block G, Frey CM, et al.The bioavailability to humans of ascorbicacid from oranges, orange juice and cookedbroccoli is similar to that of syntheticascorbic acid. J Nutr. 1993;1193;123:1054-61.

9. Gregory JF. Case study: Folate bio-availability. J Nutr. 2001;131:1276S-82S.

10. Clifford AJ, et al. Bioavailability offood folates and evaluation of food matrixeffects with a rat bioassay. J Nutr.1991;121:445-453.

11. Gregory JF. Bio-availability offoates. Eur J Clin Nutr. 1997 51:554-559.

12. Tedstone A. Bioavailability of folicacid and natural folates: Studies using thefunctional plasma marker homocysteine.2003 Report N05013. Food StandardsAgency, United Kingdom.

13. Suitor C, Bailey LB. Dietary folateequivalents:interpretation and application. JAm Diet Assoc. 2000;100:88-94.

14. Dimitrov NV, Meyer C, Ullrey DE,et al. Bioavailability of beta-carotene inhumans. Am J Clin Nutr. 1988; 48:298-304.

15. Iuliano L, Micheletta F, MaranghiM, et al. Bioavailability of vitamin E as afunction of food intake in healthy subjects:Effects of plasma peroxide-scavengingactivity and cholesterol-oxidation products.Arterioscler Thromb Vasc Biol. 2001;21:E34-7.

16. Roodenburg AJ, Leenen R, van hetHof KH, et al. Amount of fat in the dietaffects bioavailability of lutein esters, but notof alpha-carotene, beta-carotene and vitaminE in humans. Am J Clin Nutr. 2000;71:1029-30.

17. Dawson EB, Evans DR, ConwayME, et al. Vitamin B12 and folatebioavailability from two prenatalmultivitamin/multimineral supplements. AmJ Perinatol. 2000;17:193-199.


Supplements... Food-Based Dietary Supplements


Resource Reveiw...unacceptable for accurate diagnosis or havequestionable validity. Their conclusions aresupported by references.

Section three is a compilation of therapieswith those that are most popular and morehighly researched given additional attention.Other therapies without sufficient evidence ofeffectiveness are listed in an easy-to-use tableformat.

Section four offers detailed informationabout herbal and non-herbal medicine. Themost common are reviewed in detail. Separatetables are presented for other medicinal herbswithout sufficient evidence of effectiveness;other non-herbal medicines without sufficientevidence of effectiveness; a terminology ofmedicinal plants table; medicinal plants notapproved; raw plant material causingintoxication; products requiring therapeuticmonitoring; interaction with a variety ofprescription medications; and useful web sites.

Section five is condition specific. Some 38common conditions frequently treated withCAM are reviewed. The condition is defined,and CAM therapy usage is reviewed withclinical evidence presented and overallrecommendations regarding the purportedcures provided. Each condition includesreferences and further readings for those whodesire additional information. Conditionsinclude: HIV/AIDS, Alzheimer’s disease,cancer, chronic fatigue syndrome,


Book Review...The Desktop Guide to Complementary andAlternative Medicine: An evidence basedapproach. Ernst E (ed), Pittler MH, StevinsonC, White A (assoc. Ed). New York, NY:Mosby, 2001 448 pp., Softcover; $36.95;ISBN:0-7234-3207-4.

Reviewed by Sarah Harding Laidlaw, MS,RD, MPA

This essential desk reference providesconcise evidence-based content and is areliable source of objective information fornutrition professionals. Sixty-four forms ofcomplementary and alternative medicine(CAM) and 38 common conditions frequentlytreated with CAM are reviewed. Vitamin andmineral use as complementary therapies is notdiscussed in detail in this book. This handyreference includes a CD-ROM that allows foreasy searching of the text.

Section one describes how to use the book.The authors provide the procedures theyfollowed to obtain the most accurate andconcise information including sources andreferencing, literature searches for andselection of clinical evidence and informationon safety of particular therapies.

Section two reviews the various diagnosticmethods that are used in CAM. Most of thediagnostic tests described are considered to be

hypercholesterolemia, premenstrual syndromeand upper respiratory infections.

The last section provides Canadian andEuropean perspectives of CAM and a reviewof CAM history in the United States. Whypatients chose to use CAM is explored and thesafety, legal and ethical issues surrounding useis discussed.

This is an excellent reference for anynutrition professional who wants a concise anduser friendly resource for CAM. The CD-ROM makes the publication even easier tonavigate and use with printable PDF tables.

Reviewed by Sarah Harding Laidlaw,MS, RD, MPA. Contact Sarah [email protected] or 970-241-5529


CPE Article. . .Taking a Closer Look atBiotechnology and GeneticallyEngineered Foods.CChhrriissttiinnaa MMccCCuulllluumm,, PPhh.. DD..

Biotechnology is not new; it has beenused for centuries in common foodprocessing techniques such as wine and beermaking.1 Under the 1992 United Nations(UN) Convention on Biological Diversity(CBD), biotechnology has been defined as,"any technological application that usesbiological systems, living organisms orderivatives thereof, to make or modifyproducts or processes for specific use."2

Interpreted in the broadest sense,biotechnology covers many of the tools thatare commonplace in agriculture and foodproduction. However, when used in a morenarrow sense, biotechnology considers onlynew DNA techniques, molecular biology andreproductive technological applications,which range from gene manipulation andgene transfer, DNA typing and cloning ofplants and animals.2 While there is littlecontroversy about many aspects of modernbiotechnology, development and use ofgenetically engineered (GE) crops and GEorganisms (GEOs) have resulted in intensedebate around the globe.

Genetic engineering has been definedas, "a biotechnological process in which traitsor characteristics of an organism are changedby transferring individual genes from onespecies to another or by modifying geneswithin species."3 Genes can be taken fromone species—such as an animal, plant,bacterium, or virus and inserted into anotherspecies, where the gene(s) are transferredusing either a gene gun or via a bacterial genecarrier or vector (e.g., Agrobacteriumtumefaciens). A gene promoter (e.g.,Cauliflower Mosaic Virus), which turns on adesired trait, is also used in the transferprocess as are selectable marker genes,usually genes resistant to antibiotics (e.g.,neomycin or kanamycin), to track themovement of the newly inserted gene(s) intothe DNA of the host plant. Scientists then testto see whether the gene has been successfullyinserted and whether it functions asexpected.3

The earliest applications of geneticengineering to food and agriculture havefocused primarily on the production of cropsengineered for disease and insect resistanceto prevent crop losses (e.g., insect-resistantcorn and cotton), and the production ofherbicide-resistant crops (e.g., glyphosate-resistant soybeans), which allow farmers tospray broad-spectrum herbicides overgrowing crops to make weed managementeasier. These were first planted commerciallyin 1995 and since then their use has rapidlyincreased.4 During the seven-year periodfrom 1996 to 2002, the global area of GEcrops has increased more than 35-fold with

the estimated global area covering 145million acres. In 2002, four countries grew99% of the global transgenic crop areaincluding the United States (66%), Argentina(23%), Canada (6%) and China (4%). Theprincipal GE crops grown in 2002 and theirpercentage of global area included soybeans(62%), corn (21%), cotton (12%) and canola(5%). The dominant GE crop/traitcombinations were herbicide-tolerantsoybeans and insect-resistant corn.5

Proponents promise that the nextgeneration of GE foods will bring directbenefits to consumers in both industrializedand developing countries. Examples includerice with increased pro-vitamin A and ferritinlevels, tomatoes with increased lycopenelevels, vegetable staples such as potato andcassava with increased protein content andfungus-resistant bananas.6,7 Transgenic(growth-enhanced) salmon and other fish arebeing developed as well as GE livestock withspecific agricultural and nutritional traits.6

GE crops and animals are also being targetedto produce a wide range of pharmaceuticaland industrial products. Examples include theproduction of transgenic corn hybridscontaining avidin, a protein that binds withbiotin to make useful products for themedical and biochemical diagnosticindustries, and transgenic goats whosemammary glands produce milk with proteinsderived from spider genes that can be used tocreate spider silk.6,8 Because the currentcontroversy and debate is mainly focused onthe use of modern biotechnology and geneticengineering in food and agriculture and notall applications of modern biotechnology(such as its use in medicine), the focus of thisarticle is: 1) to explore the currentinternational controversy surrounding GEfoods and crops; and 2) to provide nutritioneducators with a range of considerations oncurrent and future agricultural technologies,including biotechnology and geneticengineering, based on a food systemsperspective.

Precision of Genetic EngineeringOne of the first points of the debate

surrounding GE foods is whether geneticengineering is a more or less precise processcompared to conventional plant breeding.Many scientists believe that GE allowsbreeders to move specific traits using onlywell-characterized DNA while leaving otherunwanted traits behind, thus making it a moreprecise process and shortening the time todevelop a new variety. However, otherscientists believe that most significant traitsare likely to be affected by a complexinteraction among numerous genes aboutwhich there is limited knowledge. Thesescientists believe that conventional breedingis more likely to pass on all of the geneticmaterial needed for a trait to worksuccessfully in a plant or animal compared to

recombinant DNA techniques.6 It has alsobeen noted that there are uncertaintiessurrounding genetic alternations due to theinsertion site of the DNA, which is random,and metabolic changes due to the newproteins that are expressed—most of whichare difficult to predict.9 While it’s possiblethat these genetic alterations could result inincreased allergenicity in susceptible persons,there is no current evidence to support it, andthe position of the American Cancer Societyis that foods from bioengineered plantsneither increase or decrease the risk ofcancer.10

David Schubert, a Professor and CellBiologist at the Salk Institute, La Jolla, CA,has identified three areas of concern that hebelieves are receiving insufficient attention inthe current dialogue and debate surroundingGE foods:

"[F]irst, introduction of the same geneinto two different types of cells can producetwo very distinct protein molecules; second,the introduction of any gene, whether from adifferent or the same species, usuallysignificantly changes overall gene expressionand therefore the phenotype of the recipientcell; and third, enzymatic pathwaysintroduced to synthesize small molecules,such as vitamins, could interact withendogenous pathways to produce novelmolecules. The potential consequence of allof these permutations could be thebiosynthesis of molecules that are toxic,allergenic, or carcinogenic."11

The Global Debate:How to Regulate GE Foods and Crops

Much of the debate surrounding GEfoods and crops in the global regulatory arenais how these foods should be regulated. In theUS, three federal agencies regulate differentaspects of GE foods and crops:Environmental Protection Agency (EPA),Food and Drug Administration (FDA), andUnited States Department of Agriculture(USDA). These agencies operate underseparate statutes and under the oversight ofdifferent Congressional committees. Theycoordinate their efforts under the 1986 WhiteHouse Coordinated BiotechnologyFramework. Table 1 highlights the USagencies and selected international entitieswith legal authority in regulating GE plantsand GE organisms (GEOs).9 Risk assessmentrequires the designated agency to analyze andinterpret the scientific data and makeinformed predictions about the risks imposedby an activity. After assessing risk, riskmanagement requires that the agency makelegal and policy judgments about how toemploy regulatory options that are availableto the agency under its governing statute.12

The policy debate continues encompassing amultitude of issues including food safety and



CPE Article...Taking a Closer Look at Biotechnology and Genetically Engineered Foods.(continued from page 65)

environmental risks, scientific uncertainty,and consumer right to know issues.

Food SafetyIn 1992 FDA adopted a regulatory

policy that specified that foods producedthrough genetic engineering techniques orcontaining GE substances substantiallysimilar in "structure, function, andcomposition" to substances already in thefood supply (proteins, carbohydrates, fats,and oils) were to be considered "generallyrecognized as safe" (GRAS).13 Thisterminology was later changed to"substantially equivalent" (SE),14 a conceptfirst formulated by the Organization forEconomic Cooperation and Development(OCED)15 and later elaborated on by the Foodand Agriculture Organization (FAO) and theWorld Health Organization (WHO). Undercurrent FDA regulatory policy, if foodsproduced through GE techniques are deemedGRAS or SE, they are then not required toundergo mandatory pre-market approval orpre-market testing. The 1992 policy wasopposed by FDA’s own scientists as shown indocuments that were forced to be releasedduring a 1998 lawsuit against FDA thatcharged failure to fulfill its regulatoryduties.16 In January 2001, FDA proposedmodifications to its current regulatory policyon bioengineered foods calling for a 120-daypre-market notification for any GE food thatwould be brought to market.17 However, the

proposed changes would still fail to requirepre-market safety testing.

A recent legal analysis of currentregulatory policy on GE foods commissionedby Consumer Federation of America (CFA)12

concluded that the US system for regulatingGE foods includes loopholes that allowmanufacturers to market these products withlittle government oversight, which frees theFDA from blame if these foods are laterfound to be unsafe. Observed within thisanalysis was a heavy reliance on the legalprinciple that GE foods are substantiallyequivalent to non-GE foods, thus allowingmost GE foods to enter the market without aformal FDA safety determination. Morerecently, Center for Science in the PublicInterest (CSPI) issued a report that concludedFDA lacks both the authority and theinformation to adequately evaluate the safetyof GE foods.18 Through examination of 14submissions obtained under the Freedom ofInformation Act, CSPI found that biotechcompanies have occasionally refused FDA’srequest for more information. According tothe report, Monsanto, CIBA-Geigy (nowSyngenta) and Dow AgroSciences eachdeclined to provide requested scientific datato FDA about strains of GE insect-resistantcorn. The report by CSPI further revealedtechnical shortcomings in the data providedby the companies as well as obvious errorsFDA failed to detect. In one case, a developerused inadequate methodology to test for

allergens, and others failed to evaluatetoxicants and anti-nutrients. As a result, CSPIhas recommended that the voluntarynotification system be replaced with amandatory pre-market notification andapproval process and that companies berequired to submit more detailed testinginformation to FDA. It was alsorecommended that FDA form detailed safetytesting guidelines for developers.18

Kuiper et al have reaffirmed thatapplication of the concept of substantialequivalence is not a safety assessment per se;but rather, a concept that enables theidentification of potential differences that canthen be investigated further with respect totheir toxicological impact.19 These authorsconcluded that further consideration isneeded with respect to uniform selection ofcritical compounds and conditions underwhich GE crops should be grown. Thesescientists also have highlighted that theoutcome of a comparison between theagronomical and chemical properties of a GEfood and its traditional counterpart (based onthe concept of SE) may encounter practicaldifficulties due to: 1) the availability of near-isogenic parental lines to compare the GEfood with; 2) limited availability of methodsfor the detection of (un)intended effectsresulting from the genetic modification; and3) limited information on natural variations inlevels of relevant crop constituents.19

Agency Authority Specific Regulations Responsiblity

White House Executive 1986 Coordinated Framework Coordination of Federal Activities

US Department of Agriculture Plant Protection Act 7 CFR 340 New pests; environmental impact

US Environmental ProtectionAgency

Federal Food, Drug, andCosmetic Act (FFDCA); FederalInsecticide, Fungicide,Rodenticide Act (FIFRA)

FFDCA RulesFIFRA Rules

Plant Incorporated Protectants(Health and Environmental Risks)

US Federal Food and DrugAdministration

FFDCA 1992 Statement of Policy2001Proposed Policies

Whole Foods Risk to HumanHealth

European Union EC Treaty Directives 2001/18/EC Environmental Risks

European Union EC Treaty EC 258/97 EC 50/2000EC 1139/98EC 49/2000Directives 2001/18/EC

Food Risks and Labeling

United Nations (UN) Convention on BiologicalDiversity

Biosafety Protocol Interboundary Movement ofLiving Modified Organisms(LMOs)

Codex Alimentarius Commission(CAC)

Food and AgricultureOrganization (FAO)

In Process Labeling; Human Health

Table 1: US and Selected International Entities with Legal Authority in Regulating GE Plants and GEOs>

(Adapted from Reference 9)



To address such issues, scientists haverecommended use of an improvedmethodology called profiling methods for theidentification of non-targeted, unintendedeffects. These methods would allow for thescreening of potential changes in themodified host organism at differentintegration levels including at the genomelevel, during gene expression and proteintranslation and at the level of cellularmetabolism. However, these new profilingmethods have not yet reached status ofroutine methods. Standardization of samplepreparation, validation of measurements andtreatment and interpretation of large sets ofdata need to be addressed.19,20 Statisticalanalysis and interpretation of observeddifferences in the composition of GE foodsalso need to be developed and harmonized.19

Such issues are being addressed currentlywithin a EU funded project calledGMOCARE.19

Significant progress toward a globalconsensus on how to regulate GE foods wasmade when the UN Codex Alimentarius AdHoc Task Force on Foods Derived fromBiotechnology reached agreement on draftprinciples for the evaluation of GE foods,which stated that all GE foods should includea pre-market safety assessment on a case-by-case basis for both intended and unintendedeffects, and that all countries should includerisk management measures including asystem for post-market monitoring for the

purpose of facilitating withdrawal of productsfrom the market when a risk to human healthwas identified.21 The development of anagreement by this UN Task Force is a criticalconsideration because in the case ofinternational trade disputes, the World TradeOrganization (WTO) considers that, in termsof food safety, the standards of the CodexAlimentarius Commission (CAC) aredeemed the global science-based standard,and thus, immune to trade challenges.22

Finalized CAC standards are expected to beadopted in July 2003.21

Environmental Risks. A recent legal analysis by the Consumer

Federation of America has concluded that thecurrent US regulatory environment hasprevented comprehensive assessment of theadverse environmental effects of GE plantssince FDA has deferred such responsibilitiesto USDA.12 According to this analysis, USDAconsistently finds that its decisions to allowfull-scale commercialization of GE plantswill have no significant effects on theenvironment and, as a consequence, hasnever prepared an environmental impactstatement for such decision. It was furtherconcluded that while much attention has beengiven to a few particular impacts of many GEplants, very little comprehensive assessmenthas been carried out by the agency.12

In May 2001, the Ecological Society ofAmerica (ESA), an organization thatrepresents over 8,000 ecological scientists in

the US, issued a statement acknowledgingthat some GEOs may possess newcharacteristics that require greater scrutinythan organisms produced by conventionaltechniques of plant and animal breeding.23

The National Research Council (NRC) alsorecently cautioned that for some applicationsof transgenic animals, scientific uncertaintywill be a particular concern due to the noveltyof the health and environmental questionsposed and the lack of established scientificmethods for answering them.24 Otherscientists have expressed concern aboutpossible environmental risks of food cropsengineered to produce pharmaceuticalsand/or industrial chemicals, including thepossible negative effects on soilmicroorganisms and biodiversity, and thepossibility that the industrial compoundsproduced from these crops could leach fromthe soil into the water supply.25,26 These, andother questions, need to be resolved as moreGE crops and organisms are released into theenvironment.

At the international level, controversyhas stemmed from whether or not a legally-mandated Biosafety Protocol (The CartagenaProtocol on Biosafety),27commissioned byarticle 19 of the 1992 United NationsConvention on Biological Diversity (CBD),is needed to regulate Living ModifiedOrganisms (LMOs) introduced into theenvironment. The Cartagena Protocol onBiosafety, which is based on the

CPE Article...Taking a Closer Look at Biotechnology and Genetically Engineered Foods

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precautionary principle, gives countries theright to bar imports of GE seeds, microbes,animals and crops seen as a threat to theirenvironment. Exporters are required to obtainan importing country’s approval through aprocedure known as advanced informedagreement (AIA) for initial shipments ofLMOs. LMOs intended for food, feed, andprocessing are exempt from the AIArequirement. However, shipments must belabeled as "may contain LMOs" andcountries can decide whether or not to importthese commodities based on their ownscientific risk assessment. Negotiations areunderway to address liability for any damageresulting from the cross-boundary movementof LMOs. The Cartagena Protocol onBiosafety was approved by over 130countries on January 29, 2000, and wasrecently ratified by 50 countries in June 2003.It will become legally binding ninety daysfrom the date of the 50th ratification(September 2003).27

The Precautionary Principle As aBasis for Dealing with ScientificUncertainty.

The precautionary principle has itsorigins in the German word vorsorgeprinzip,or "foresightedness principle," which can betranslated into the obligation to "foresee andforestall" environmental harms. Theprecautionary principle was first establishedas a concept of environmental law in the1970s.28 Since this time, it has been invokedin numerous international environmentalagreements such as the 1992 Rio Declaration

on Environment and Development, TheBamako Convention on Hazardous Waste inAfrica, and The Convention on BiologicalDiversity. A 1998 consensus statementcharacterized the precautionary principle thisway, "when an activity raises threats of harmto human health or the environment,precautionary measures should be taken evenif some cause and effect relationships are notfully established."28 Its four centralcomponents include: 1) taking preventiveaction in the face of uncertainty; 2) shiftingthe burden of proof to the proponents of anactivity; 3) exploring a wide range ofalternatives to possibly harmful actions; and4) increasing public participation in decision-making.28 A realistic way to cope with suchinherent uncertainty in complex biologicalsystems is to implement an adaptivemanagement approach to biosafetygovernance. An approach for assessing theecological and human health effects for therelease of genetically engineered organismsinto the environment has been developed bythe Scientists’ Working Group on Biosafety,which is consistent with The Convention onBiological Diversity adherence to theprecautionary principle.27

Labeling, Consumer RiskPerceptions, and the ConsumerRight to Know

Labeling issues are not only scientificissues but rather policy judgments regardingwhether food producers and processorsshould provide consumers information. For

example, recently conducted consumer focusgroups, which were commissioned by theFDA, showed that the majority ofparticipants were "surprised and outraged" tolearn that GE foods were on the marketwithout their knowledge.29 However, FDAcurrently does not require labeling of foodsderived from bioengineering because itbelieves the GE process used in producing acrop or food is irrelevant as long as thenutritional content remains the same as itsnon-GE counterpart.13 In 2001, FDAproposed guidance to the food industry forvoluntary labeling of GE foods.30 Under thisproposed guidance, the approach towardslabeling GE foods shifts the burden ofresponsibility from growers andmanufacturers of GE foods to organicproducers and companies marketing GE freefoods. In the end, individuals who wish topurchase foods with non-GE ingredients mustpurchase the more expensive certifiedorganic alternative, which disallows the useof GE ingredients.

Representative Kucinich (D-OH), whofirst introduced national labeling legislationin 1999 and reintroduced similar legislationin 2002, believes that labeling GE foods iswarranted because of the widespread use ofGE foods with limited scientific knowledge.31

Confirming this belief are groups such as theBritish Medical Association, which have alsonoted that labels on GE foods could behelpful in tracing any potential healthproblems, should they occur.32 A leadingauthority in the study of risk communicationand consumer science has also argued that thepresence of labels would enable informedconsent, thereby reducing risk perceptionsassociated with GE foods. That is, thepresence of labels would transform theperception of risk from one that isinvoluntary to one that is voluntary.33 Recentresearch has demonstrated that theavailability of labels on foods that have beenderived from genetic engineering techniquesreduced risk perceptions toward GE foodirrespective of whether people act on theinformation.34 Another recent study has notedthat even when GE foods provide consumerswith a demonstrated benefit, consumers stillwanted GE foods to be labeled. 35

Many large multi-national foodcompanies have already establishedprocesses that keep GE products separatefrom non-GE products, particularly if theyship product into the European Union andJapan, as these countries require segregationfor labeling purposes. The ability to segregateGE and non-GE products is possible becauseof the use of identity preservation (IP)techniques that keep harvested GE cropsseparate from the point of planting to thepoint of food processing, and finally, to thepoint of export. While not infallible, IPproducts can be tested to ensure that cross-

CPE Article...Taking a Closer Look at Biotechnology and Genetically Engineered Foods.




contamination of products has not occurred atsome point in the supply chain. Because theUS food industry is already providing labeledfoods to these countries, any additional coststo providing labeled GE products to theAmerican consumer will most likely beminimal. Many countries, including membercountries of the European Union, Australia,Japan, New Zealand, and South Korea,already require GE products to be labeled.Other countries including China, CzechRepublic, Taiwan, and Saudi Arabia will beimplementing mandatory labelingrequirements for GE foods in the nearfuture.36

As the labeling debate continues acrossthe globe, consumer right-to-know Acts aresurfacing in the US.37 Attempting to respondto consumer demands without unnecessarilyburdening food producers and processors, theproposed right-to-know scheme wouldrequire simple disclosure. Basically, the actwould require registration of all GE foodproducts with a state agency that wouldmaintain a database accessible to consumers.Enforcement mechanisms, administrative andjudicial procedures, liabilities and availabledefense mechanisms would be included in theact. Advocates of this route believe thiscompromise meets the consumer’s need toknow, yet doesn’t jeopardize the cost or salesof GE products. Finally, it is argued a right-to-know Act should be formulated to survivelegal hurdles that have blocked state levellabeling legislation thus far.37

Are Transgenic Crops Being Used toAchieve Sustainability?

Certain applications of agricultural GEcrops (e.g., herbicide-tolerant crops used inconjunction with no-till conservation) mayreduce certain environmental impacts ofagriculture. However, as noted by Hubbelland Welsh, the risks of "developing invasiveweeds from herbicide-resistant transgeniccrops may prove to outweigh the potentialbenefits from compatibility with no-tillsystems and substitution of less toxic withmore toxic chemicals." 38 These authors havefurther cautioned that while some GE cropsmay produce limited short-termenvironmental benefits, they should not beconsidered sustainable interventions giventheir current application and use. The reasonwhy has been explained in a seminal articlethat was published in the Proceedings of theNational Academy of Sciences by Lewis et al.

"Genetic engineering and other suchtechnologies are powerful tools of great valuein pest management. But, if their deploymentis to be sustainable, they must be used inconjunction with a solid appreciation ofmultitrophic interactions and in ways thatanticipate countermoves within systems.Otherwise, their effectiveness is prone to

neutralization by resistance in the samemanner as pesticides." 39

Lewis and co-authors argue that thecentral problem plaguing pest managementhas been the failure to recognize the need tomanage natural plant pest-beneficialinteractions, and that any toxin-basedintervention results in pest adaptation.39

Paradoxically, the best way to maximize thebenefits of many technologies, includingherbicide-tolerant and insect-resistant GEcrops, is to use them sparingly incombination with other technologies.Unfortunately this is not how either of thesetwo applications of genetic engineering hasbeen used to date, thereby limiting theirpotential usefulness in being sustainablesolutions to the problems each technologyhas sought to solve. Development of GEcrops with specific genetic traits that have ahigher potential for promoting sustainableagriculture have not been developed due to:1) lack of regulatory policies that explicitlypromote sustainable agriculture; 2) thestructure of the agricultural biotechnologyindustry, which is dominated by agriculturalchemical companies; and 3) patent law andindustry policies that prevent farmhouseholds from saving transgenic seed andtailoring transgenic crops to their localenvironmental conditions.38

Food Security and Genetic DiversityThe use of modern biotechnology and

genetic engineering in agriculture has beenreferred to some scientists as the "DoublyGreen" or "Gene Revolution" pointing to thepossible benefits of using such technologiesin meeting the world’s future food needs.40

However, the majority of current acreagedevoted to GE crops are cash crops such ascorn, soybeans and cotton as opposed to morenutrient dense crops found in the developingworld such as cassava, millet, pulses,bananas, beans and squash. Because of theway that GE crop technology has beenutilized to date, some scientists haveexpressed concern that the Gene Revolutionwill result in increased farmer dependence onchemically-based pest control methods andcause farmers to adopt modern crop varietiesin place of many local indigenous cropvarieties.41-43 Such uniformity, caused byincreasing areas sown to a smaller number ofcrop varieties, can also increase economicrisk to farmers since modern crop varietiesmay be more vulnerable to disease and pestattack than locally-adapted indigenousvarieties.41-44

One area that modern biotechnologytechniques may be helpful is theenhancement of genetic diversity in bananaproduction. The Food and AgricultureOrganization (FAO)45 has urged bananaproducers to promote greater geneticdiversity in commercial banana production

and has specifically called for: 1)development of more diversity in bananas; 2)promoting awareness of the inevitableconsequences of a narrow genetic base incrops and the need for a broader genetic basefor commercial bananas; and 3) strengtheningplant breeding programs in developingcountries for banana and other basic staplecrops. Because small-scale banana producersaround the world have maintained a broadgenetic pool this knowledge can still be usedfor future banana crop improvement.Furthermore, because more than 50% of thebanana germplasm are sterile, biotechnologyand mutation breeding are important toolsthat can improve banana varieties without thethreat of genetic drift.45 A recent project thathas utilized modern biotechnologytechniques as a way to benefit small-scalebanana producers in Kenya has resulted in anincreased yield in banana production and aprojected additional income for farmers whoparticipated in the project.46 However,according to the FAO, "genetically modifiedproducts are usually developed for large-scale commercial interests, and with a fewexceptions, small-scale farmers have so farnot benefited from the technology." 47

It is important to acknowledge thatadvances being made in agriculture usingmodern biotechnology and transgenictechnology (genetic engineering) are alsopossible by using conventional plant breedingtechniques, organic production methods andintegrated pest management techniques.48-53

For example, scientists at the InternationalRice Research Institute, Manila, Philippines,have bred a new type of rice that containstwice as much iron, along with vitamin A andzinc, using traditional breeding methods bytaking genetic samples from a traditionalIndian variety called Jalmagna. This shouldbe considered an important developmentsince 3.7 billion people worldwide arebelieved to suffer from iron deficiency, acondition that is most widespread in child andlactating mothers.53 Field research conductedin China has also produced encouragingresults through an approach to diseasemanagement called intra-specific cropdiversification. Rice fields in five townshipswere planted a mixture of rice cultivars thatwere susceptible and resistant to rice blastdisease, the region’s major pathogen. Yieldsrose 89% and blast severity fell 94% in thefields planted the seed mixtures compared tomonoculture with controls.48

Socioeconomic and Control IssuesCertain individuals and organizations

have noted that modern biotechnology(including transgenic technology) will be auseful tool in promoting a more abundant,nutritious and less expensive food supply.54-58

While technological developments may beuseful in achieving this goal, it is important to





understand that the problems of poverty,hunger and malnutrition are ultimatelyembedded within a broader set of social,economic and political determinants such asinternational trade policies, agriculturalsubsidizes, internal government policies andeconomics and inequalities in the productionand distribution of food.59-68 These areimportant considerations because it is thesocial, economic and political issuessurrounding developments in geneticengineering that are among the greatestconcerns to some scientists, small farmers,farm organizations and Indigenous People’sorganizations. For example, the NationalFamily Farm Coalition has recently issued anofficial statement on the use of geneticengineering in agriculture where it hasexpressed concerns related to the loss ofcritical markets, corporate control of the seedsupply and the threat of liability from damagecaused by genetic drift.69

International Trade and Intellectual Property Rights

A recent example where concernsrelated to international trade and the resultantsocioeconomic and control issuessurrounding developments in GE foods andcrops have been brought front and center iswith the development of GE wheat. InDecember 2002, USDA received a petitionfrom Monsanto to allow thecommercialization of herbicide tolerantwheat. By February 2003, individual wheatfarmers and several non-profit organizationsrepresenting the interests of wheat farmers inthe Northern Plains jointly filed a legalpetition with USDA requesting that theagency deny the Monsantocommercialization petition until the federalgovernment has fully analyzed the potentialeconomic and environmental impacts of GEwheat. The petition requests that USDAconsider socioeconomic factors in itsenvironmental impact analysis of GE wheat.The socioeconomic impacts outlined in thepetition include: 1) the potential loss of USwheat exports resulting from marketrejection; 2) the potential loss of US organicwheat production in the Northern Plainsbecause of contamination of the organicwheat supplies by GE traits; and 3) effects ofincreased seed prices to wheat farmers if theyare forced to pay royalties and signtechnology agreements in order to obtainaccess to GE seeds.70

In the international arena, theOrganization for African Unity (OAU), nowthe African Union, has developed a ModelLaw on Farmers’ Rights, Breeders’ Rightsand for the Regulation of Access to GeneticResources71 to address a range of socio-economic issues associated with the releaseof GEOs into the environment. The majorcomponents of the OAU Model Law include

provisions on: 1) access to biologicalresources, 2) community rights, 3) farmers’rights, and 4) plant breeders’ rights. Its mostcrucial features are a belief that breeders’rights are subordinate to farmers’ rights, thatpatent protection of any life form isprohibited, and provides for strong supportfor the role of women. Although the OAUModel Law is based in provisions ofinternational law (the United NationsConvention on Biological Diversity), it hasrecently been challenged by the WorldIntellectual Property Organization (WIPO), aGeneva-based organization that is part of theUnited Nations, whose mandate is to promoteand protect the intellectual property rights(i.e., to enforce patent rights), and theInternational Union for the Protection of NewPlant Varieties (UPOV).72 How suchdevelopments will play out in futureinternational trade negotiations andregulatory decisions is uncertain.

Are GE Crops a Threat to FoodSovereignty?

Peasant farmer and Indigenous Peoplesorganizations from around the world haveexpressed concern that developments inmodern biotechnology, including GE cropplants, along with the development of theUPOV, could threaten their food sovereignty,which they believe is a prerequisite toachieving food security.73 Food sovereignty isa term that has been coined by ViaCampesina, an international association ofsmall farmers and peasants from everycontinent, which has been defined as, "theright of countries and/or people to definetheir own agricultural and food policies,which they consider ecologically, socially,economically and culturally appropriate." 74 Akey focus of the food sovereignty movementis to strengthen people’s political power byworking with rural populations anddisadvantaged groups from around the globe,including women, to build their organization,negotiation and political advocacy skills.75

ConclusionIn the year 2002, four countries

accounted for 99% of the global area of GEcrops: US, Argentina, Canada and China. Themost commonly adopted GE crop/traitcombinations included herbicide-tolerantsoybeans and insect-resistant corn. Thesecrops primarily benefit multi-nationalcompanies and large farmers in theindustrialized world. The majority of thesetwo commodity crops are used to feedanimals and not to feed people.76 In thefuture, increased research and developmentefforts need to be conducted on nutrientdense crops in the developing world asopposed to the current focus, which isprimarily on export cash crops. To ensure thatfuture applications of modern agriculturalbiotechnology, including genetic engineering

technology, are in harmony with theinterrelated elements of sustainableagriculture, regulatory policy reforms areneeded. Without such reforms, theintroductions of these new technologies willmost likely exacerbate rather than alleviatepoverty in the developing world.

Rather than investing the majority ofavailable resources into one technology suchas GE crop production, a better solution toreducing global hunger and malnutritionwould be to use a combination ofconventional plant breeding, biotechnology(that does not necessarily involve the use ofgenetic engineering), food fortification, otherfood-based strategies and increasedinvestments in socioeconomic development.Increased research and development in agro-ecological farming (e.g., organic farming),techniques to conserve germplasm, micro-credit opportunities for small farmers,improved gender equity (including enhancedaccess to financial services), and land,livestock and water rights for women are alsoneeded to build food sovereignty.74

Future GE foods and crops that aredeveloped and brought to market need to beregulated using the precautionary principle,where the burden of proof for safety is shiftedfrom the public onto the companies that areproducing and marketing these foods.Mandatory pre-market approval and safetytesting is also needed for GE foods that arecurrently being brought to market. Suchmeasures would increase consumers’confidence in the government’s ability toregulate these foods. When used incombination with post-marketingsurveillance methods, labeling GE foodscould be a useful way to track any possibleadverse effects should they occur. It wouldalso provide consumers a choice in themarketplace as to whether or not they wish topurchase GE foods. Finally, Westerncountries need to respect and abide by theprinciples outlined in the OAU Model Law71

during international trade negotiations sinceits provisions are based in international law,(The United Nations Convention onBiological Diversity).

References:Please refer to the NCC web site forthis article’s references: www.ComplementaryNutrition.org.

Christine McCullum, PhD, RD, is aNational Cancer Institute (NCI) Post-doctoral Fellow at the Center for HealthPromotion and Prevention Research, at theUniversity of Texas Health Science Center,Houston, TX, where her current researchinterests include: community food security,food and nutrition policy, coordinated schoolhealth, and community-based planning andhealth promotion. Contact Christine [email protected] or713-500-9765




CPE Reporting FormSummer 2003Biotechnology and GeneticallyEngineered FoodsEXPIRATION DATE: September, 2005Please print or type

Name:

Address:

City/State/Zip:

Daytime phone:

Evening phone:

Email address:

ADA membership number:

NCC Member Yes No

This activity has been approved for two hours of CPEcredit. You will be notified if hours are not approved.

Cost: $12 NCC Members $20 non NCC Members

Make checks payable to NCC-DPG #18Mail to:Annie Griffin13611 Fernlace Ct.Pickerington, OH 43147


CPE QuestionsT/F 1. Biotechnology has been defined

as any technological application that usesbiological systems, living organisms, orderivatives to make or modify products orprocesses for specific use.

T/F 2. Genetic engineering is abiotechnological process in which traits orcharacteristics of an organism are changed bytransferring individual genes from onespecies to another or by modifying geneswithin species.

T/F 3. The use of the wordbiotechnology always means geneticengineering.

T/F 4. The development of geneticallyengineered crops has focused on improvingnutritional components of the crop.

T/F 5. The purpose of the CartagenaProtocol on Biosafety is to give countries theright to bar imports of GE seeds, microbes,animals and crops seen as a threat to theirenvironment.

6. The four central components of theprecautionary principle include all of thefollowing except: a) taking preventive actionin the face of uncertainty; b) shifting theburden of proof to the proponents of anactivity; c) exploring a wide range ofalternatives to possibly harmful actions; andd) decreasing public participation in decision-making.

T/F 7. Labeling of geneticallyengineered foods is currently mandated byFDA in the U.S.

T/F 8. Genetically engineered crops area solution to the world’s hunger crisis.

T/F 9. Currently, genetically engineeredcrops are used successfully in sustainableagricultural systems.

10. Which of the following is not acomponent of the OAU Model Law onBiosafety: 1) seed manufacturer’s rights, 2)community rights, 3) farmers’ rights, and 4)plant breeders’ right

PLEASE CIRCLE THECORRECT ANSWERS:



Answer Key:1. T2. T3. F4. F5. T6. D7. F8. F9. F10.1

1. T F

2. T F

3. T F

4. T F

5. T F

6. A B C D

7. T F

8. T F

9. T F

10. 1 2 3 4

Editorial Staff . . .EditorSarah Harding Laidlaw, MS RD

Publications ChairTamara Schryver, MS RD

EditorsChristian Calaguas, MPH RDSusan Drake, MS RDDennis Gordon, MEd RDTerri Mischler, RDSheryl Murphy, RDDanielle Torisky, PhD, RD

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NCC’s Leaders2003-2004 CONTACT INFORMATION

NCC’s Leaders2003-2004 CONTACT INFORMATION

Sarah Harding Laidlaw, MS, RD, MPAP.O. Box 23089Glade Park, CO 81523-0089

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Susan Pitman, MA RD Chair 2003-2004Porter Novelli1909 K St NW, 4th FloorWashington, DC 20006voice: 202-237-7886fax: [email protected]

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