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benefIcial public health program for preventing dental disease. In the July and August issues of Consumer Reports (1978), an in-depth investigation of the leaders of the antifluoridation movement revealed that this same organization "also opposed other proven public health measures-smallpox vaccinations, pasteurization of milk, and polio immunization." At the same time this same antifluoride group marketed numerous useless medical devices and earned itself a reputation with the U.S. Food and Drug Administration as "a front for promoters of unproved remedies, eccentric theories and quackery." Yet this same group is unfortunately still quite alive today, and, if they had their way, would deny the signifIcant dental health benefIts fluoridation provides to millions of children across the land. It is a sad commentary on the susceptibility of the American public to the fear propaganda of such anti fluoride selfinterest groups that only about 50% of the American public currently has fluoridation. Joel M. Boriskin, D.D.S., Chief, Dental Health, Alameda County Health Care Services Agency, Oakland, CA 94607.
More on Fluoride Benefits The article by Richmond (J. Nutr. Ed., 11 :62, 1979) was a timely contribution to a perenially important subject. Fluoride is perceived differently from other nutritionally essential trace elements by many members of the public. This results from distorted representations by cranks and by the "health food" industry. Strangely enough, the "organic farming" cult, which opposes fluoridation of drinking water, insists on the use of raw rock phosphate (2% fluorine) as a fertilizer instead of superphosphate, from which most of the fluorine has been removed by chemical processing. The fluoride content of seawater is about 1.4 ppm, but most sources of drinking water contain far less. This does not imply that we should drink seawater, but it serves to remind us that many of the mineral requirements of terrestrial animals are an echo of their evolutionary history. Iodine and selenium are other examples of trace minerals that are found in seawater and may be defIcient in dry-land environments. Without fluoridation, the "natural" fluoride content of drinking water is quite variable. For example, in Dade County, Florida, it varies from 0.03 to 0.3 ppm. In some other localities, it is well over 1 ppm. This brings out another point: the opponents of fluoridation seem to ignore the fact that the step to which they object represents adding an element that is already present. Glenn (1) reported results of a study with children whose mothers received 1.0 mg of fluoride in tablet form daily during pregnancy. Ninety-seven per cent of 36 children were caries-free during the ages 168
of 1 to 13 years as compared with 23070 in a control group of 699 children. No medical defects appeared in any of the children who received prenatal fluoride. These fmdings are most encouraging for the future prevention of tooth decay in children. Thomas H. Jukes, University of California, Berkeley, CA 94720. References
(4).
The cost for a family of four for the foods and quantities specifIed under the two days of the plan shown by the authors were investigated at a supermarket belonging to a major food chain. To view costs more realistically, costs were determined also in a small neighborhood food store. Both the neighborhood food store 1 Glenn, F. B., Immunity conveyed by sodi- and the chain supermarket are located in a um-fluoride supplement during pregnancy, section of Philadelphia where the majorpt. 2, J. Dent. Child., 46: I, 1979. ity of families have incomes below the federal poverty level. At the supermarket the cost of the fIrSt New Interdisciplinary day's menu was $6.61, or 8.5 cents for Society Is Organized every 100 kcal of energy. The cost of the I would like to call to the attention of second day's menu was $7.20, or 7.45 the readers of JNE the formation of the cents for every 100 kcal. For those items in Association for Chemoreception Sciences the 2 days of Thrifty Food Plan available (AChemS). It is organized as a profes- at both outlets, the cost for energy was sional, interdisciplinary society to foster 7.18 cents per 100 kcal at the supermarket communication among chemical, biologi- and 9.58 cents per 100 kcal at the neighcal, and behavioral scientists and clini- borhood store. These costs assume that the family purcians concerned with all aspects of taste and odor perception. Topics of papers chases the cheapest, largest quantities presented at the fust meeting included there and that the family prepares and clinical disorders of taste, selection of eats all food at home. Excluded are the food and regulation of intake, and other costs of spices and condiments, extra or chemical and anatomical aspects. Yearly more expensive beverages, the optional dues are $20 for professionals and $10 for snacks allowed, and wasted food. Special students. Scientists working in the broad dietary needs due to age, activity, and fIeld of chemoreception are invited to join health are excluded. Furthermore, the by sending their name, area of interest, af- produce prices are lower in this summer fIliation, address, telephone number, and season, although produce was still missing a check for the 1980 dues (payable to from the neighborhood market shelves. We have determined that the Thrifty AChemS) to the address below. R. M. Pangborn, Food Science and Food Plan menus are costly. With the Technology, University of California, funds allotted by USDA, a family of four would have diffIculty purchasing the necDavis, CA 95616. essary energy to satisfy estimated needs. Deborah Patten, 3rd year student, Thrifty Food Plan Tufts University Medical College, and Robert J. Karp, M.D., Assistant ProWe reviewed the "Evaluation of the fessor Pediatrics, Director Nutrition Thrifty Food Plan" by Lane and Programs, Thomas Jefferson UniverVermeersch (J. Nutr. Ed., 11:96, 1979) sity, Philadelphia, PA 19107. and were concerned about the cost of the energy provided in the plan. Poor families References everywhere respond to rising food costs 1 Burnett, 1., English diet in the eighteenth by narrowing their selection of foods to and nineteenth centuries, Prog. Food Nutr. those providing the most calories at lowest Sci., 2:11-34, 1976. cost (1). If recommended micronutrient 2 Karp, R. J. et aI., Effects of rise in food costs on hemoglobin concentrations of needs are not met on the restricted diet, early school-age children, 1972-1975, Pub. there will be a rise in the prevalence of miHealth Rep., 93:456-459, 1978. cronutrient defIciency; in the United States the rise of food costs from 1972 to 3 U.S., Department of Agriculture, Science and Education Administration, Human 1975 was associated with increased occurNutrition Center, Consumer and Food rence of iron deficiency in a poor PhilaEconomics Institute, Cost of Food at delphia community (2). Home Estimated for Food Plans at Four Cost Levels, May 1979, U.S. Average, Coupon allotment in the USDA Food Hyattsville, MD, 1979. Stamp Program is based on the Thrifty Food Plan. The allotment is $5.66 per day 4 National Academy of Sciences, National Research Council, Food and Nutrition for a four-membered family with two preBoard, Recommended Dietary Allowances, school children and $6.81 per day for a 8th ed., National Academy of Sciences, four-membered family with two children Washington, DC, 1974. at early school age (3). Using recomAuthors Reply mended daily intakes, it is estimated that a In reply to the letter from Patten and family with a mother and father and two children consume 7,800 kcal if the chil- Karp, we must point our that their costing dren are infants or 8,400 kcal if the chil- the plan in a Philadelphia supermarket dren are of school age. Therefore, the and a small neighborhood food store is money allotted for energy is 7.3 and 8.1 not a suffIcient basis for their statement cents per 100 kcal consumed, respectively that "with the funds allotted by USDA, a
Journal of Nutrition Education Vol. 11 No.4 October-December 1979
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family of four would have diffIculty purchasing the necessary energy to satisfy esL timated needs." It is true that the food E stamp allotment, based on the Thrifty T T Food Plan, lags behind the cost of foods E specifIed in the menus because adjustR ments are only made every six months (1). S In the interim, with prices rising, the food specifIed in the plan would cost more than the food stamp allotment. But that does not mean that the family would have diffIculty purchasing the necessary energy to satisfy estimated needs. There are cheaper foods that can be purchased to meet energy needs, or for that matter, currently known nutrient requirements. Furthermore, the cost of the Thrifty Food Plan will vary in different places in the United States even at anyone time. The cost of food at home is higher in Philadelphia than in any other city in the coterminous United States excepting Houston and Washington, D.C. (2) The Thrifty Food Plan menus, if followed, will not, as indicated in our article (J. Nutr. Ed., 11:96, 1979), provide all of the nutrients currently known to be essential in suffIcient quantity for all types of persons, but it is possible to purchase the foods required for a nutritious diet with the food stamp allotment. The problem is poor families without the requisite knowledge and skills do not have adequate guides to enable them to do so.
Sylvia Lane, Professor, Department of Agricultural Economics, University of California, Davis; and Joyce Vermeersch, Nutrition Consultant to the State of California and formerly Assistant Professor, Department of Nutrition, University of California, Davis, CA 95616.
References 1
2
170
Lane, S., Poverty Food Selection and Nutrition, USDA Agricultural-Food Policy Review, Proceedings of Five Food Policies Seminars, ESCS-AFPR2, September 1978, pp. 31-35. U.S., Department of Labor, Bureau of Labor Statistics CPI detailed report, September 1977 , Government Printing Office, Washington, DC, November 1977, pp. 20-21.
in children's eating patterns? In hearings scheduled for the spring of 1980, Congress will be looking for hard data as they debate continued funding for the NET Program. Did we decrease plate waste? Did we bring about changes in knowledge-in attitudes? Did we involve foodservice personnel? What program results can be attributed to their participation? Did participation in other child nutrition programs increase as a result of NET Program efforts? How do parents and the community view this program? What has been their involvement? These are just a few of the questions we need to be prepared to answer. The demands on NET Program Managers are great. We must develop, implement, promote, and evaluate. Some of us must do all of these things as a one-person staff. There are ways, however, to assure our success whether we are a staff of one or twenty-one. First of all, we can set realistic goals and closely monitor and reassess those goals as we follow through with implementation. We can involve the community and tap the valuable resources available to us; we can work to make our programs visible within our schools, communities, states, and nation; we can implement quality programs backed by comprehensive evaluation; we can share with each other and collaborate in a professional way to make our voices heard for the continuation of the NET Program. And, most important of all, we can be prepared with answers to the questions that will inevitably come in the spring of 1980. Support systems and a valuable network of people committed to nutrition education and its continuation in all food and health programs are as close as the telephone. This is the time to make nutrition education work and make it last. Don't let the clock strike midnight before we are prepared.
Amanda Dew Mellinger, M.S. Ed., Coordinator, Nutrition Education and Training Program, California State Department of Education, 721 Capitol Mall, Sacramento, CA 95814.
A Call for NET Program Communication
Call for Liaison With Nutritional Anthropologists
The clock is ticking away on the Nutrition Education and Training Program. The program was born running; there was no time to crawl or walk; its feet have rarely touched the ground since its birth. Because of the many intricacies involved in starting a new program within state systems, many of us have been operating our NET Program for only six to eight months-some even less. We have accomplished a lot, but there is much to be done. Within a few months we will be called on to account for our nutrition education dollars. The primary questions will be: How have we used the money and how effective were we in bringing about changes
While attending the Annual Meeting of the Society for Nutrition Education in San Francisco, I could not help thinking how useful it might be for nutrition educators to have benefit of the kinds of insights anthropologists bring to health problems that are social rather than, or more than, clinical in origin, and to the design of programs to aid in problem solution. There is a growing sub profession concerned with nutritional aspects of health that are amenable to study by anthropological and other social science technics. Topics examined by physical and biological anthropologists include growth and genetic factors; social anthropologists investigate
Journal of Nutrition Education Vol. 11 No.4 October-December 1979
behavioral and social concomitants of food choices and utilization. Nutritionists have termed the latter "food habits"-although much more than eating patterns is subsumed by the work of anthropologists who study diet and food in community settings. Medical anthropologists, geographers, agricultural economists, ethnobotanists, ecologists, paleodietitians, psychologists, and food historians are among the scientists who add to our knowledge about human interactions with food in both behavioral and biological contexts. Collectively, this multifaceted research approach has been named "nutritional anthropology." Increasing numbers of nutritional anthropologists are trained in both nutrition and anthropology, thus bringing sympathetic comprehension to nutritional problems and the biological as well as cultural limitations to their solutions. Earlier this year (1979), Helen A. Guthrie, former President of the Society for Nutrition Education, in a letter to the editor of the American Institute of Nutrition's newsletter, Nutrition Notes, called attention of nutrition scientists to the need to recognize the value and significance of the research of those whose work involves nutritional behavior and behavior change as quality applied nutrition research. As a nutritionist-anthropologist I laud and commend Dr. Guthrie for her concern and for expressing it to that audience. I would like to extend her plea by suggesting greater interaction and communication between anthropologists and those who work in nutrition, particularly on its applied aspects. Existence of both the Society for Nutrition Education and the Committee on Nutritional Anthropology provides a machinery through which this kind of interaction could be initiated, especially since the two groups have many members in common. The Committee on Nutritional Anthropology is a professional group affiliated with the Society for Medical Anthropology and the American Anthropological Association. Its members-some 200 in number-are eclectic in approach, geared through practical experience with client populations in the field to help toward the alleviation or prevention of nutrition problems, particularly those of communities. Interaction between these two professional groups seems both desirable and feasible, as do formal, enabling mechanisms. I should be glad to respond on behalf of the Committee on Nutritional Anthropology to reactions and suggestions from officers, committee and division chairpersons, and members of the Society for Nutrition Education who would be interested in developing such a liaison. Christine S. Wilson, Ph.D., President,
Committee on Nutritional Anthropology, c/o Department of Epidemiology and International Health, University of California, San Francisco, CA 94143.