Educational Materials in Review

E D U C AT I O N A L M AT E R I A L S I N R E V I E W

Edited by Leigh Ann Edwards, Editorial Assistant, GEMs and Reviews Books, curricula, audiovisuals, and other resources that nutrition professionals may use for reference, for continuing education, or in a formal or informal education setting are designated “professional.” Books, handouts, diet plans, and other resources specified by authors as being written for general audiences are categorized as “consumer.” Inclusion of any material in this section does not imply endorsement by the Society for Nutrition Education. Evaluative comments contained in the reviews reflect the views of the authors. Prices quoted are those provided by the publishers at the

TABLE OF CONTENTS Books Building Better Health: A Handbook of Behavioral Change . . . . . . .215 Cognitive-Behavioral Treatment of Obesity: A Clinician’s Guide . .216 Nutrition and Health Advertising: Evidence from Food Advertising 1977-1997 . . . . . . . . . . . . . .216 The New Becoming Vegetarian:The Essential Guide to a Healthy Vegetarian Diet . . . . . . . . . . . .217 Underage & Overweight: America’s Childhood Obesity Crisis—What Every Family Needs to Know . . .218 Nancy Clark’s Sports Nutrition Guidebook,Third Edition . . . . .219 Educational Curricula Let’s Get Moving with Exercise and Healthy Foods and Let’s Get Moving with Healthy Snacks and Play . . . . . . . . . . . . . . . . . . .219 Audiovisuals Nutrition Mission . . . . . . . . . . . .220 Kids a Cookin’ (Programs 001-012) . . . . . . . . . . . . . . .221 Web Sites The President’s Challenge . . . . . . .221 WIN the Rockies . . . . . . . . . . . .222 Report Linking Land Quality, Agricultural Productivity, and Food Security (No. 823) . . . . . . . . . . . . . . . . .222 Brochures Calcium:Are You Getting Enough? . .223 Choosing a Safe and Successful Weight-loss Program andYou Can Control Your Weight as You Quit Smoking . . . . . . . . . . . . . . .224

time materials were submitted. They may no longer be current when the review is published. ( J Nutr Educ Behav. 2004;36:215-224.)

BOOKS Professional Building Better Health: A Handbook of Behavioral Change. Jenkins CD, 2003. From Pan American Health Organization, 525 23rd St NW, Washington, DC 200372895, (202) 974-3000, softcover, 378 pp, $40.00, ISBN 92-75-11590-7. This book was written as part of the Pan American Health Organization’s (PAHO) health promotion effort. It aims to blend proven disease prevention practices and behavioral science principles into a comprehensive, hands-on manual. It spells out how to think about developing and carrying out effective health promotion/disease prevention programs for each stage of the life cycle, from infancy to the elder years. C. David Jenkins has written an ambitious and comprehensive handbook that covers a wide range of public health and health promotion topics, from epidemiology to health behavior change and practical approaches to designing and conducting health interventions.The book is written in 5 sections.The first section,“Part I. Laying the Foundation,” describes the basics of epidemiology and general principles of the multiple levels of prevention and community health. Parts II and III, “Improving Health Throughout the Life Cycle” and “Better Understanding the Leading Forms of Death and Disability,” make up the majority of the book. Part IV addresses intervening more effectively by discussing principles of behavioral change and key interventions to reverse major risk conditions and behaviors. The last part is the author’s epilogue, which includes a look to the future, addressing practical issues, and dilemmas for public health and prevention workers. This book takes on an enormous challenge to cover as much material as any graduate education program in public health for community health workers. Given its sponsorship by PAHO, however, it was written with public health practitioners in mind. These practitioners may not have the opportunity to engage in graduate or professional studies and might be exposed to the book as part of a short training program or as a stand-alone reference tool. From the point of view of a review for the 215

present journal audience, however, it is important to think of the book’s potential for benefiting various types of audiences, for example, nutrition educators working as part of a public health and prevention team; graduate students in public health, medicine, or psychology; and administrators who want a reference to update their knowledge base in prevention and behavior change. Because of its breadth, readers may find it most useful to refer to it when they need to get a better understanding of the types of health issues and concerns for a given community or audience and to guide them to more in-depth resources. As an example, Chapter 13 is entitled “Getting Specific: Actions to Reverse the Most Destructive Risk Forces.” In just over 40 pages, this chapter covers malnutrition (hunger); inadequate water supply and personal and domestic hygiene (including hand washing, food handling, and tobacco use); unsafe sex; alcohol use; hypertension; occupational health hazards; physical inactivity; primary health care services; and poverty. Clearly, it is not possible to go into much depth in a chapter that addresses so many diverse topics. However, this chapter might be a quick introduction that would enable a health worker to ask intelligent questions of an expert in one of the areas addressed and might stimulate further reading on one or more subjects. The reference lists at the back of the book are not long, but they give readers a good place to start. Another important consideration about this book is that it was intended primarily

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for those working in the field of international health and focuses on health improvement in developing countries. Students or professionals in the international health arena will be most likely to find it informative for their specific work. The book’s subtitle, “A Handbook of Behavioral Change,” should be taken with a grain of salt (but not too much salt; see Chapter 8 on diseases of the heart and blood vessels). Only one chapter in Part IV, entitled “Intervening More Effectively,” explicitly reviews principles, methods, and theories of behavior change; community mobilization; health communication; and diffusion of health behavior change.As with the other chapters and the book as a whole, the coverage is a mile wide and an inch deep. Readers would be best served to use this chapter as a starting point and not to think of it as a complete or comprehensive how-to guide for concepts and methods of behavior change. Those looking for an entire book on behavior change are apt to be disappointed. In conclusion, this book covers a broad range of topics and is quite readable. It is most likely to be useful as an introduction to a wide range of life cycle and health risk issues and as a launching pad to help students or practitioners identify directions that require more in-depth understanding. Karen Glanz, PhD, MPH, Professor of Behavioral Sciences and Health Education, Georgia Cancer Coalition Distinguished Cancer Scholar, Rollins School of Public Health,Emory University, Atlanta,GA 30322 Professional Cognitive-Behavioral Treatment of Obesity: A Clinician’s Guide. Cooper Z, Fairburn CG, Hawker DM, 2003. From Guilford Publications, 72 Spring St, New York, NY 10012, (800) 365-7006, [email protected], hardcover, 232 pp, $35.00, ISBN 1-57230-885. With the increasing secular trends in overweight and obesity in the United States,1 there is a pressing need to identify effective and practical weight loss programs.This book outlines a cognitive-behavioral weight loss and maintenance program for clinicians treating obese clients.The treatment is primarily intended for patients with a body mass index between 30 and 40 (obese), but it is also relevant to those with lesser degrees of overweight.The treatment program includes 9 modules that encompass both behavioral and cognitive methods used to help clients initially achieve weight loss and provide them with the strategies needed to maintain a lower body weight.

Intended to be a guide for clinicians treating obese clients, this book outlines a 9-module cognitive-behavioral treatment program that includes 24 sessions extended over 44 weeks. During the first phase, which lasts 30 weeks, clients are encouraged to (1) address potential obstacles to accepting weight maintenance, as opposed to weight loss, as a goal in the next phase of the treatment program, and (2) understand and develop behavioral and cognitive strategies used to control weight.These strategies include a rigid dietary plan in which clients are instructed to keep their overall daily energy intake under 1500 kcal by counting calories, limiting portion size at meals, and self-monitoring food intake. In the second phase of the treatment program, clients focus on maintaining weight loss.The authors state that clients who follow this regimen should expect to lose 1 to 2 kg of body weight each week. The authors recommend that changes to the food environment be made as an agent of change. Having healthful choices available in the home and limiting the availability of more energy-dense foods will lead to more healthful patterns of intake and food choices. Although I agree that no foods should be completely banned from the diet (p. 46), it is better to remove energy-dense foods from the home entirely rather than have those foods in the home and restrict intake. It is likely that the “forbidden fruit” will become more attractive, and clients may experience feelings of guilt and failure if they give in to their desires. Clients are also given tips on how to follow the dietary component of the treatment regimen when they have little control over the food envi-

ronment (ie, restaurants, vacations, parties); this information was helpful because these special circumstances could prove to be a major barrier to change and maintenance. One of the major weaknesses in this program is an absence of discussions on the family. Family involvement in weight loss programs may add to the success of the program.1 Another major lack of discussion was the cultural appropriateness of this program. Cultural differences in acceptance of a larger body size and the motivation to lose weight have been established. Overall, certain components of this program are useful, and this book can provide a clear and easy to use guide for combining cognitive-behavioral strategies in treating overweight and obesity. However, this program does not appear to be designed for use in diverse populations.This is unfortunate because the prevalence of overweight and obesity is higher in black and Hispanic populations in the United States.2,3 Lori A. Francis, PhD, The Pennsylvania State University, S-110 Henderson Building, University Park, PA 16802

REFERENCES 1. McLean N, et al. Family involvement in weight control, weight maintenance and weight-loss interventions: a systematic review of randomised trials. Int J Obes. 2003;27:987-1005. 2. Flegal KM, et al. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288:1723-1727. 3. Ogden CL, et al. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA. 2002; 288:1728-1732. Professional/Consumer Nutrition and Health Advertising: Evidence from Food Advertising 19771997. Ippolito PM, Pappalardo JK, 2003. From Nova Science Publishers, Inc, 400 Oser Ave, Ste 1600, Hauppauge, NY 11788-3635, (631) 231-7269, softcover, 149 pp, $29.50, ISBN 1-59033-734-4. This study examines new data on the types of claims made in food advertising during the years 1977 to 1997.The study’s primary focus is the use of nutrition-related claims. Beside providing a wealth of data on the basic content of food advertising over time, there are two additional goals: first, to better understand the economic forces affecting the flow of nutrition information to consumers in marketing, and, second, to examine firms’ incentives to focus on nutrition

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in advertising under the various policies adopted during these years, including those adopted after the Nutrition Labeling and Education Act of 1990 (NLEA). Have you read a magazine lately? Did you notice the increased concentration of food advertising over the past several years? If you answered yes, then you are under the same impression as the authors of Nutrition and Health Advertising: Evidence from Food Advertising 1977-1997. Authors Pauline M. Ippolito and Janis K. Pappalardo designed a magazine content analysis study of food advertising that spans 2 decades. The book is arranged into 8 chapters beginning with the introduction, discussion of methodology, description of trends, explanation of nutrition and health claims, regulation of those claims, the economics of advertising, and, lastly, the conclusion. Ippolito and Pappalardo investigated magazine advertisements in popular women’s lifestyle and general readership magazines over a 20-year period. All advertisements that were included were required to have the following characteristics: (1) all foods except for baby foods and alcoholic beverage advertisements were included in the sample, (2) the advertisements were from years 1977 to 1997, and (3) the advertisements were from women’s lifestyle and general readership magazines. As for the sampling frequency, 3 months of every year during the 20-year period were used to eliminate the daunting task of analyzing the content from every month of every year. Broad trends in food advertising were the first category investigated. This section includes a quick overview of the cost of ad-

vertising, number of food advertisements, and food categories advertised. This background information prepares the reader for the content analysis of the various claims used in food advertising. The authors investigate general nutrition claims, health claims, and regulation and advertising claims in chapters 4 through 6. This is the core of the book, and each chapter is laden with graphs illustrating the content analysis findings for the 2 decades in each of the claim categories. The information is robust but not tedious. At the end of each chapter, Ippolito and Pappalardo do a thorough job of summarizing their findings of how often the claims are being used. Most of the conclusions appear to be on an upward trend in using claims, with some claims declining depending on the decade and the political and economic climate of the time. In the last chapter, “Economics of Advertising: Issues and Evidence,” the authors set out to confirm their theory on potential bias from the advertisers on selling their products.The final word on advertising bias is exactly what the author’s thought; when allowed, advertisers will attach a claim to reach their maximum consumer potential. Ippolito and Pappalardo conclude the book by pointing out that the research on this topic has only just begun.They believe that advertising has focused on how nutrition can affect health and that linking policy for consumer benefit is important in the marketing of foods. Some excellent points are made in this book, and it is a good foundation for future studies.The authors stress that more money is spent every year on food advertising.The study covers a 20-year period, including pre- and post-NLEA and nutrient claims regulations. Therefore, it is fascinating to watch food advertising unfold to fit the rules and consumer preferences. Ippolito and Pappalardo describe each chapter in great length on content analysis for every claim and summarize their findings. The chapters are laid out in a logical format, and their methodology is well explained. One thing to keep in mind is that this book is not intended as a commentary on the food advertising industry but more as a long study in a book format to be used as a reference. In closing, this is a helpful book for students as background information for a food studies or food marketing class and would be recommended as part of a course pack because the text has appendices that include screen shots of the content analysis coding,

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percentage of advertisements with various claims, and Federal Trade Commission food advertising cases. As for professional use, this is a background or a launching pad for forthcoming studies on how food advertising impacts society and the way we eat. Jeannie J. Houchins, MA, RD, Nutrition and Health Communications Writer and Consultant, Atlanta, GA 30341 Professional/Consumer The New Becoming Vegetarian: The Essential Guide to a Healthy Vegetarian Diet. Vesanto M, Davis B, 2003. From Healthy Living Publications, PO Box 99, Summertown, TN 38438, (888) 260-8458, softcover, 373 pp, $19.95, ISBN 1-57067144-3. “You may be wondering why a whole new version of The New Becoming Vegetarian was necessary.Whereas the first edition broke fresh ground, in the decade since, the amount of scientific research in this field has increased exponentially…. Vegetarian and especially vegan foods have become among the fastest-growing categories in the grocery store…. All of these advancements needed to be communicated in practical terms to consumers” (p. ix-x). In a cogent, respectful style, the authors have created a thorough, evidence-based discussion of vegetarian nutrition.This updated version incorporates both the new Dietary Reference Intakes and aspects of the 2003 American Dietetic Association and Dietitians of Canada joint position paper on vegetarian diets. Definitions of types of vegetarians and various motivations for adopting this lifestyle begin the discussion.While noting

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that “becoming vegetarian is no guarantee to a healthful diet,” the authors outline the limitations of research comparing vegetarians with nonvegetarians and review issues of health, longevity, and chronic disease risk reduction. Seven chapters clearly review scientific bases of vegetarian nutrition, with emphasis on energy, protein, iron, zinc, calcium, and vitamins D and B12. Of particular interest were potential interfering factors to ultraviolet production of vitamin D, vegan supplement sources, when supplements are necessary, and vitamin B12 sources, supplements, and analogs.Although these chapters deal with technical information, which may be less accessible to those with lower science literacy, each chapter ends with a summary of the major points provided in terms of practical food choices. As well, the authors introduce 4 2000 kcal menus (nonvegetarian, lacto-ovovegetarian, lacto-ovo plus legumes, vegan) for comparison of nutrient contribution. Detailed phytochemical coverage is new to this version and is located in the chapter on vegetables and fruit, whereas fibers are discussed thoroughly in the chapter on grains. Table 5.2 notes “ultra-high” fiber sources to be 2 to 20 g, although this is possibly a typesetting error. The authors provide a clear review of the complex topic of dietary lipids. The contributions of ω-3 and ω-6 fatty acids were particularly well covered. The review of nutrient needs, recommendations, and food sources leads to the presentation of a vegetarian food guide, which includes directional statements and serving size information in table format.To assist readers with self–dietary review, a food guide score sheet is also included.The food guide, presented in the pyramid format only, might have served Canadian readers better if the rainbow format1 had been incorporated as well. A large chapter examines vegetarian nutrition throughout life stages, from conception to aging. However, nutrition for vegetarian athletes is found in the earlier chapter on legumes, nuts, and seeds, likely owing to the discussions of protein and energy needs. Three chapters serve to enhance self-efficacy for individuals “becoming vegetarian in a non-vegetarian world.” The authors advocate a stepwise approach to lifestyle change. Readers are presented with techniques to deal with the reactions of family, friends, and coworkers through realistic, targeted scenarios. More practical coverage of food shopping and preparations include a basic shopping list,

ingredient substitution list, and 50 recipes, from the simple (eg, scrambled tofu) to the elegant (eg, German chocolate cake with coconut squash frosting). Tips for using nuts, seeds, agar, tofu, legumes and sprouting present vegetarian cooking without intimidation. For those interested, scientific references for each chapter are available online. Some chapters recommend topic-specific Web sites and books, and extensive cross-referencing was used throughout. Sidebar boxes provide short comments on numerous subjects such as amino acid basics, vitamin D needs of breast-fed infants, and organic produce. The first version of this book included a glossary, a feature that would have been useful in the revised version, especially for readers unfamiliar with the scientific jargon necessary to present detailed nutritional information. This comprehensive road map to vegetarian eating styles can be strongly recommended for nutrition counselors. It also would be a comprehensive guide for those considering a lifestyle change or wishing to fine-tune their vegetarian eating style. Laurie A. Wadsworth, PhD, PDt, FDC, Assistant Professor, Department of Human Nutrition, St. Francis Xavier University, Box 5000, Antigonish, NS B2G 2W5

REFERENCE 1. Can J Diet Pract Res. 2003;64:82-86.

Professional/Consumer Underage & Overweight: America’s Childhood Obesity Crisis—What Every Family Needs to Know. Berg FM, 2004. From Hatherleigh Press, 5-22 46th Ave, Long Island City, NY 11101, (800) 528-2550, hardcover, 456 pp, $24.95, ISBN 1-57826-120-1. Underage & Overweight: America’s Childhood Obesity Crisis—What Every Family Needs to Know examines the scope of the current obesity problem, its root causes, the medical consequences, and the challenges facing overweight children and their parents. Obesity is a major challenge for Americans.That is not news! Yet Underage & Overweight: America’s Childhood Obesity Crisis— What Every Family Needs to Know helps put this whole critical issue of weight gain, especially among children and adolescents, into perspective. Health should be the focus, yet sometimes that is forgotten in the fight to reduce body weight.

The book is divided into 5 sections, with the first section covering the magnitude of the weight management problem within the United States. Although researchers fail to provide a clear link between weight, morbidity, and mortality, they point to inactivity and sedentary lifestyles as the main problem. However, this is only 1 of 5 root causes of obesity identified in the second section. The third section discusses why past solutions, such as drug therapy, calorie-restricted dieting, or surgery, have not worked. This is particularly true for children whose growth has been stunted, or, when dieting stopped, the weight rose quickly to perhaps 10 pounds more than it was when they started. The fourth section describes a new paradigm in which health, not weight, should be the focus of parents, school officials, and health care providers. In the last section, Berg proposes the nondiet approach to health: living actively, eating well, and feeling good about one’s self and others. By normalizing activity and eating, children become more attuned to their body, knowing when they are hungry and when to stop when they are satisfied. This will lead to better health but not necessarily a thinner child. After all, isn’t this all about health? The chapter on active living provides the nuts and bolts of starting lifestyle changes.The focus of a lifestyle change initially should be on consistency, not necessarily duration or intensity. Berg encourages a change to “active living,” not just exercising. Children (and their parents) are encouraged to write down short-term goals.

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As children become more fit, they are more likely to engage in more physically active behaviors. By making the change to active living, children are empowered to make other changes more easily. The chapter on the basics of good nutrition focuses on balance, variety, and moderation. Other topics include eating a healthful breakfast, what foods satisfy hunger, portion sizes, and fast food. Normal eating is necessary to prevent binging later. Consistency of dietary patterns is important too. Parents are reminded that they choose the foods that are made available at regular times, but children choose how much and what to eat. Underage & Overweight: America’s Childhood Obesity Crisis—What Every Family Needs to Know provides a common sense approach to the weight management problem facing the United States and other developed countries. It is a valuable resource for parents of children and adolescents who face challenges with weight management by providing practical tips that will lead to better health for their children. If parents practice the guidelines outlined for their children, their health may even improve too! Underage & Overweight is also a beneficial resource for health care professionals and schools who work with these children and their families. Berg suggests changes to current health promotion programs, including nutrition services that would improve the student’s health and quite possibly improve student education outcomes. The author includes 8 pages of resources, including books, videotapes, training programs for parents and care providers, and Web sites. The book is well referenced and indexed. Numerous case studies and other examples are given to assist adults in working with overweight children and adults. Ardith R. Brunt, PhD, RD, Assistant Professor, Department of Health, Nutrition and Exercise Sciences, North Dakota State University, Fargo, ND 58105 Consumer Nancy Clark’s Sports Nutrition Guidebook, Third Edition. Clark N, 2003. From Human Kinetics News, PO Box 5076, Champaign, IL 61825-5076, (800) 747-4457 ext. 2248, softcover, 416 pp, $18.95, ISBN 0-7360-4602-X. Nancy Clark’s Sports Nutrition Guidebook provides information on eating strategies for high energy and balancing weight

and activity. More than 65 recipes are also included for healthy ideas that are quick and easy. Exercising and eating well go hand in hand. Regardless of your reason to exercise and be active, it is known that you will feel better and perform better when you eat well. Like many others, you may wonder how you can lose weight and have energy to exercise. Often people lack the knowledge or are misinformed regarding the appropriate diet for an active lifestyle. Nancy Clark provides the nutritional knowledge that every active person should know and addresses many common misconceptions of dieting and exercise. Nancy Clark’s Sports Nutrition Guidebook is intended for the general public, presenting nutrition guidelines at a basic level. Clark covers nutrition guidelines, providing details for each food group and how each food group affects your energy and performance. She also goes into great detail regarding diet and its relation to specific diseases, emphasizing that “healthy choices make healthy bodies.” Clark presents her professional views and advice surrounding popular diets such as The Zone and Atkins, as well as the use of supplements and sports drinks. Following the section dedicated to eating strategies and energy, Clark moves her focus to balancing weight and activity. Here she provides information on body fat, building muscle, and losing weight healthfully. She also covers eating disorders and food obsessions because these problems are common among active people.The last section of Clark’s book consists of quick and

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easy recipes that provide maximal nutrition. Each recipe includes the calorie, fat, and protein content. Clark’s book is easily understandable, providing excellent explanations, so the reader comes away with great knowledge. Her graphics and additional tables presented throughout the book are also helpful. Gray shaded boxes detail related topics to the subject at hand, a useful and unique way of adding extra information. At times, they seemed to interrupt my reading flow, but I did find them effective and relevant. Her recipes are a nice addition and provide examples of the types of food she encourages. Clark does a fine job of presenting information at a level that can be easily understood by the general public. She simplifies complicated topics, making the book very easy to follow. Her organization also contributes to her effectiveness. Clark repeats a few points throughout the book, one being the importance of not skipping meals and denying yourself needed calories.At times, her emphasis on these key points seems repetitive, although her strategy does work in getting her point across and embedded in the reader’s mind. Because a large focus of the book is on nutrition for an active lifestyle, Clark does a fine job of addressing various levels of activity from “on-the-go” mothers to triathletes in training.This book is a great nutritional resource for nonactive people as well because it provides basic nutrition information and may motivate activity. Overall, Clark’s book provides useful and easily applied information from which we all can benefit to improve our health. Lindsay Young, BS, Dietetic Intern, Maricopa County Department of Public Health, 1414 W. Broadway,Tempe, AZ 85282 EDUCATIONAL CURRICULA Let’s Get Moving with Exercise and Healthy Foods and Let’s Get Moving with Healthy Snacks and Play. Division of Early Childhood, Youth and Women’s Health, Philadelphia Department of Public Health, 2002. From Division of Early Childhood, Youth and Women’s Health, Philadelphia Department of Public Health, 1101 Market St, 9th Fl, Philadelphia, PA 19107, (215) 685-5263, curriculum and videotape, 18 pp, $50.00 for the kit (includes the video, 3 Healthy Snacks and Play booklets, a pad of shopping lists, 2 posters, and 8 lesson plans).

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The purpose of the Let’s Get Moving curriculum is to educate 3rd- to 5th-grade schoolchildren on the importance of eating healthfully and being physically active. Eight copy-ready lesson plans accompany the Let’s Get Moving videotape, posters, and snack booklet. Get your students moving and eating nutritiously before you know it! Let’s Get Moving provides a variety of instructional materials to motivate grade-school children to choose healthful foods and be more physically active. This nutrition education

curriculum includes 8 short lesson plans, 2 healthful snack booklets, several copies of a healthy snack shopping list, an exercise and healthful food videotape, and a motivational poster. The lesson plans include objectives, materials to be used, a description of the activities, and take-home materials for the students. The fun-filled videotape is a 22minute teaching tool that includes making healthful food choices, an aerobics class, and tips to improve nutritional status. The program components have fun and eye-catching graphics that appeal to children. The curricular components of Let’s Get Moving are designed to assist the student in achieving the measurable objectives. Each detailed lesson plan includes planned activities with the necessary worksheets and handouts provided. The take-home activities reinforce the content and could facilitate parental involvement. The videotape could be used in one or more of the lessons, whereas the colorful poster could be used to stimulate discussion.Additional resources are provided at the end of each lesson. Overall, the versatility of the Let’s Get Moving curriculum is evident in its ability to be adapted to a variety of settings. If needed, nutrition educators could quickly adapt the “ready-made” lessons, or just use the videotape alone, and provide effective education as an after-school program in a community environment. The take-home materials, including the snacking booklet, allow students to practice the knowledge gained and facilitate family involvement after completing the program. Bridget Schade, BS, and Carrie O’Donnell, BS, Graduate Dietetic Interns, Melanie Tracy Burns, PhD, RD,Assistant Professor, Family and Consumer Sciences, Eastern Illinois University, Charleston, IL 61920

AUDIOVISUALS Nutrition Mission. Cason KL, 2003. From Interactive Design & Development, Inc and Penn State University-Publications Distribution Center, 112 Agricultural Administration Bldg, University Park, PA 16802, (877) 345-0691, CD-ROM, $30 plus $5 for shipping per order. Nutrition Mission is an extremely welldesigned CD-ROM containing a variety of interactive activities and games that will hold the attention of upper-level elementary schoolchildren.The theme of this CD-ROM is to communicate and enhance the understanding of the con-

cepts of balance, moderation, and variety as they apply to both the Food Guide Pyramid and the Activity Pyramid. Many children in the United States are not meeting current dietary or physical activity recommendations. They currently consume more energy-dense foods and snacks and watch more television than in the past 2 decades. Given the increasing numbers of overweight children, it is crucial that we educate children about healthful eating and physical activity practices to prevent immediate and long-term health problems. The Nutrition Mission is a secret agent headquarters where children can enter as recruiters with their own code. Then they receive “special agent” training, which can boost their knowledge to empower them to achieve a healthy lifestyle. There are four levels of training: Mission Briefing, Mission Training, R & D Lab, and Mess Hall. Mission Briefing focuses on the Food Guide Pyramid, the Nutrition Facts Label, and nutrient density. Mission Training highlights the physical activity pyramid and provides an activity log. The emphasis of the R&D Lab is on the roles and food sources of specific nutrients, namely, calcium, fats, iron, protein, sodium, sweeteners, and vitamin C. The R & D Lab also presents easy to conduct experiments that can be done at school or at home.The Mess Hall provides information about snacking and fast foods. Each level has been skillfully developed to focus on discreet content areas using a variety of educational techniques. Different games, videotapes, bar charts, multiplechoice questions, and minilectures are used to communicate information. Each level or content area takes a minimum of 20 minutes to complete; however, you can play the games as long as you like. It is easy to navigate both within and between levels.

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The final activity for each level is a Mission Readiness test.This comprehensive test is formatted as a board game in which you collect 3 pyramids. Your score is based on the total number of multiple-choice questions answered correctly. This activity requires the child to apply and evaluate the information presented. A useful feature is that users are given the opportunity to improve their score. In addition, there is no negative feedback associated with low scores. The information presented in this CDROM is accurate, with one minor exception. It correctly states that 1 serving is 2 to 3 oz of meat. However, when evaluating a menu, it states that 2 eggs are equivalent to 1 serving. With respect to activity, it states that 30 minutes of activity is recommended for adults. This, in fact, is the value presented in the Dietary Guidelines. However, newer guidelines recommend 60 minutes for both children and adults. A suggestion would be for the authors to provide supplementary written text that addresses the serving size equivalents for the meat group and current physical activity guidelines recommended by federal agencies. Nutrition Mission is not only a fun and informative way to teach children about nutrition and physical activity, it is also an excellent resource for educators and parents.The thoroughness and descriptive detail provided in each content area make this a valuable tool. Another unique feature of Nutrition Mission is that an educator can use only one level or combinations of the levels in their curriculum.This feature provides versatility to teachers who have different health objectives for various grade levels. Overall, Nutrition Mission provides quality information using colorful, realistic graphics with great sound effects. The user will enjoy the voices of the characters, which are clear, pleasant, and enthusiastic. The instructions are spoken with clarity and enough detail that a child can easily follow them. It even includes a rap song about B-V-M: balance, variety, and moderation. Teachers, parents, and children can benefit from the information presented. But, even more importantly, they can apply the knowledge gained to daily food choices and activity practices. In this sense, the Nutrition Mission’s usability expands the classroom setting. Marie Fanelli Kuczmarski, PhD, RD, LD, Professor, Health, Nutrition and Exercise Sciences, University of Delaware, 226 Alison Hall, Newark, DE 19716

Videotape/DVD Kids a Cookin’ (Programs 001-012). KState Research and Extension’s Family Nutrition Program, 2003. From K-State Research and Extension’s Family Nutrition Program, KSU 24 Umberger Hall, Manhattan, KS 66406-3402, (785) 532-5830, DVD/Web site (http://www.kidsacookin. ksu.edu/), free. Kids a Cookin’ is a weekly syndicated television feature series available on DVD designed to help parents and children of limited-resource families connect in the kitchen. It helps Kansas families develop lifelong cooking, nutrition, and food safety skills and gives children the opportunity to become independent while spending time with parents. Each of the 12 segments features a recipe promoting fun, inexpensive cooking, food safety, and proper nutrition. Materials are available in both English and Spanish. Children are exposed to nutrition education in school classrooms, cafeterias, and youth programs, but they often lack the opportunity to learn proper cooking skills, food safety practices, and the taste of good nutrition through participation.The Kids a Cookin’ program can do all 3, with the added bonus that the learning can take place in the family kitchen. The program is a series of 12 television segments on DVD targeting limited-income families with elementary-aged schoolchildren. For each, there is a short English version and a long version in English and Spanish.The segments run between 2 minutes to a little over 6 minutes in length and are packed with information. Together the host and a child show viewers how to prepare a basic recipe from start to finish, including reminders to wash hands at the beginning and as needed during the preparation, how to measure ingredients, how to efficiently and safely use kitchen equipment (with comments to parents regarding those procedures best done by an adult), and information on the nutritional contribution of the dish. Each segment ends

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with a review of main points and the host and child enjoying the fruits of their labor. The long versions of segments include greater detail on using equipment, nutrition, food safety, and development of basic skills. However, the short segments are very well edited and do not appear to be a cutand-pasted copy. Children and their families will be able to duplicate the recipe after viewing the shorter version. Children will be drawn to the program by the choice of recipes, fun graphics, bright colors. and slightly out-of-kilter set design, as well as the friendly host and her child assistant. Children from diverse racial backgrounds are featured.The host does an excellent job of bringing the children into the conversations and keeping them relaxed and enthusiastic. I would have liked to see the children do more of the preparation and less observing. One limitation to the program is that the Spanish version is done via voiceover rather than by a host and child who speak Spanish. Costs to produce the program in Spanish were probably prohibitive, and the program aired on Kansas Public Television, not a Hispanic network, but the potential for making an impact on the Hispanic community could have been greater if that option was possible. The DVD is tied closely to the Web site for the Kids a Cookin’ program.This allows users to print materials and get updates quickly. The host gives the Web address more than one time during each segment, and the address is posted for viewers to easily get the information and move directly to the Web. Kids a Cookin’ would be a valuable addition to youth programs, particularly those in which a parent and child can work together. It would also be a useful tool for use with parents to educate them on how to work with their children and guide them in their expectations of the skills the child should be able to demonstrate safely in the kitchen. Barbara Brown, PhD, RD, LD, Food Specialist, Oklahoma Cooperative Extension Service, Oklahoma State University, 309 Human Environmental Sciences, Stillwater, OK 74078

WEB SITES The President’s Challenge. President’s Council on Physical Fitness and Sports, 2003. From The President’s Council on Physical Fitness and Sports, Web site

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(www.presidentschallenge.org), accessed October 30, 2003, free. The President’s Challenge is a program that encourages all Americans to make being active part of their everyday lives. No matter what your activity and fitness level, The President’s Challenge can help motivate you to improve. For anyone who has ever attempted an exercise program, it does not take long before the motivation begins to dwindle, making it more and more difficult to continue the program. The President’s Challenge Web site confronts the motivational factor by offering rewards to people who meet their daily activity goal of 30 minutes per day for adults and 60 minutes per day for children younger than 18 for at least 5 days per week for a total of 6 weeks. The primary focus of The President’s Challenge Web site is to get people of all ages excited about physical activity. Goal setting and earning rewards for reaching those goals are promoted. Participants have 8 weeks to complete the program and are able to download or complete on-line activity logs to help them track their performance. A body mass index calculator and helpful ideas to assist people to become more active are included in an attempt to motivate and encourage participants. In general, the Web site is very enjoyable and easy to navigate through the placement of the index as a sidebar and at the bottom of each page.Very little scrolling is required, and there are no distracting blinking images that could lessen the educational purpose of the Web site.A consistent appearance is sustained throughout the site through the use of black and white professional graphics portraying physical activity as enjoyable and exciting. Although the benefits of physical activity and the negative consequences of inactivity are not noted, the overall effects of the graphics and motivational messages leave the viewer feeling as if the goal of engaging in physical activity 30 to 60 minutes a day is very obtainable. Although designed mostly for adolescent or adult use, the Web site includes sections for almost every age, from children through seniors. Each section begins with an appropriate captivating phrase for the target age group and a list of activities that pertain directly to that group. Educators are offered a page through which they can download a free tool, called Fitness File, which is designed to coordinate and track student’s records and fitness tests. The President’s Council on Physical Fitness and Sports program, which was once

available only to students in physical education courses, is now available to all ages through this Web site. Caregivers in daycare centers, fitness trainers, and health care providers can promote and use the site.The tracking program available can serve as a great motivator. In a time when obesity is on the rise, The President’s Challenge Web site offers an alternative to get Americans moving, thus helping to combat the increasing obesity rates. Erin Boester, MPH, and Lisa Cunningham, RD, Graduate Dietetic Interns, Melanie Tracy Burns, PhD, RD, Assistant Professor, Family and Consumer Sciences, Eastern Illinois University, Charleston, IL 61920

WIN the Rockies.Wellness IN the Rockies Team Members, 2003. From University of Wyoming. Wellness IN the Rockies is a collaborative effort with the University of Wyoming, University of Idaho, Montana State University, their Extension Services, their WWAMI Medical Education Programs, and Area Health Education Centers in Wyoming and Montana, along with other state organizations and community groups, Web site (http://www.uwyo.edu/winthe rockies), accessed January 8, 2004, free. Wellness in the Rockies is a food- and nutrition-related behavior-change consortium project. The mission is to assist communities in educating people to value health, respect bodysize differences, enjoy the benefits of self-acceptance, enjoy physically active living, and enjoy healthful, pleasurable eating. The “WIN the Rockies” project seeks to improve community standards of healthy lifestyles by providing information to parents, teachers, community educators, health professionals, and individuals looking to improve overall health and well-being in themselves, their children, students, community, or clients.The Web site provides accurate and easy to understand information to people of all ages and educational backgrounds and is geared toward providing information on how to increase physical activity, improve dieting through lifestyle changes, and enhance personal perceptions of all body types and individual and community levels. The Web site also provides free educational material, handouts, and posters, which emphasize fun activities that appeal to all ages.The graphics and illustrations are appealing to the eye, are appropriate for young children, and portray the activity or image being taught.

This Web site offers great ideas and activities that are useful to teachers, community educators, and the general public by introducing innovative ways to increase physical activity for those bored with their current routines. It also offers ideas on how to get started with an exercise routine for children and adults.These activities encourage the involvement of the entire family or community, which is a great message that promotes families and communities to become and stay healthy together. Another key point of the Web site is the promotion of a good body image and the emphasis that there is no such thing as a perfect body shape or size. Having a positive image of one’s body helps individuals accept others for what they are and not what they look like. Suggestions to improve this Web site might be to introduce more color and eliminate empty spaces by reorganizing objects and text. Colorful graphics will help to catch the reader’s eye and could also fill empty spaces.Another area of improvement would be adding descriptions of activities that are soon to appear on the Web site. For example, the WIN Kids Fun Days link has some activities that are being used in a pilot program, and only the titles of these activities are offered. Navigating through this Web site is easy, and links to other resources provide appropriate and accurate information.The organization of the Web site is clear, and the site map link was a great place to find answers to specific questions and topics. Downloading the conversation questions was the only link that I had difficulty with, but my computer had the necessary software needed. Overall, I find that this Web site offers accurate, appropriate, and useful ideas on improving one’s self–body image, nutrition, physical activity, and overall well-being.This material can be used in a variety of circumstances. It is useful in both group settings and for individuals. Erin Yde, Dietetic Intern, Maricopa County Department of Public Health, 1414 W. Broadway,Tempe, AZ 85282 REPORT Linking Land Quality, Agricultural Productivity, and Food Security (No. 823) Wiebe K, 2003. From US Department of Agriculture, Economic Research Service, 1800 M St, NW, Washington, DC 20036-5831, (800) 999-6779, report, 59 pp, $57.00.

Journal of Nutrition Education and Behavior Volume 36 Number 4

Keith Wiebe has provided a cogent analysis of the relationship between land quality, agricultural productivity, and food security.This research publication from the US Department of Agriculture’s Economic Research Service begins with a brief review of trends in food resources and then proceeds with sequential chapters outlining the analytic framework for evaluating land quality and agricultural productivity, land degradation and agricultural productivity, farmer responses to land degradation, and land degradation and food security. He concludes with some insights on challenges to research and policy. For nutrition educators interested in broadening their horizons to include the effects that production practices have on land quality and food security, this is a useful publication.Although the information is sometimes difficult for nonmodelers like myself to digest, to persevere is to gain an appreciation for the subtle and not so subtle ways in which our agricultural land management practices affect global food security. Wiebe uses newer data on soils and climate, while controlling for input variables (eg, fertilizer, pesticides), to investigate land quality’s contribution to agricultural productivity. Wiebe’s work provides evidence that the path to significantly reducing worldwide malnutrition is multifaceted but starts with maximizing our retention and stewardship of natural resources. Yet only about 3% of global land area has few constraints to agricultural production.The rest exhibits varying constraints owing to moisture, temperature, nutrient-holding capacity, and other considerations. Globally, it is estimated that 23% of our human-used land has been variably degraded since World War II. Wiebe analyzes the degree to which this degrada-

tion, modeled via soil erosion, affected land productivity and what it predicts about future productivity independently of further input increases. He conservatively estimates total production losses owing to water-induced erosion of about 0.3% or $439 million to $2 billion.Wiebe points out that the probability of a farmer adopting erosion control practices is very much influenced by a variety of socioeconomic issues, such as land tenure status. The primary issue in this research monograph for most nutrition educators is probably the relationship of these productivity losses to food security. Understanding the relationship between population growth, food needs, and regional production over the next 20 years is necessary. Wiebe reports estimates that baseline cereal demand and production will increase about 1.3% annually during this time, with a concomitant 21% decline in malnourished children globally but a 34% increase in subSaharan Africa. As some readers are aware, food security is measured and projected in 3 ways: the distribution gap, the status quo gap, and the nutritional gap. Neither of the latter 2 methods accounts for access variability by various economic strata within a country. As Wiebe reports, whereas the total number of hungry people is projected to decline between 2000 and 2010 (from 774 to 694 million), the food gaps, measured using any of these 3 methods, are projected to increase. In other words, there will be a growing global disparity in the ability of people to access sufficient food resources. Would a reduction in land degradation potentially mitigate the number of hungry people and/or the various food gaps? Wiebe has developed several useful scenarios to investigate this question. He estimates that eliminating the current losses of arable land (estimated at 5 to 6 million hectares annually through salinization, soil erosion, and other factors) would reduce the growth in food gaps (eg, a distribution gap increase worldwide of 1 million metric tons with no land lost to production vs 6 million metric tons at current loss rates), and the number of hungry people would decrease by an additional 68 million people.Wiebe also considers reduced-rate losses of land productivity over time and demonstrates a reduced food gap over the 10-year period, with the number of hungry people in 2010 reduced by 37 million relative to no action. In both cases, the greatest effect is also in that area with the greatest challenge: sub-Saharan Africa.

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Both of these scenarios, although challenged owing to data limitations, indicate the significant role of maintaining the quality and quantity of arable land for enhanced food security. These data also provide an important lesson for the field of nutrition education; losses owing to poor or incomplete land management are far from unimportant but have been masked over the last 50 years by yield increases attributable primarily to genetic improvements and input increases.Wiebe does not address the issues of social inequity and unequal access to food resources, nor did he intend to. What he does provide is a useful body of research and analysis illustrating that solutions to food insecurity will probably not come from a single source but from many strategies, each contributing components to a solution. Michael W. Hamm, C.S. Mott Professor of Sustainable Agriculture, Departments of Community, Agriculture, Recreation and Resource Studies; Crop and Soil Science; and Food Science and Nutrition, Michigan State University, East Lansing, MI 48824-1222

BROCHURES Calcium: Are You Getting Enough? (Spanish/English). Oregon Dairy Council, 2003. From Oregon Dairy Council, 10505 SW Barbur Blvd, Portland, OR 97219, (503) 229-5033, brochure, 5 pp, $0.15. The Calcium: Are You Getting Enough? brochure, available in both English and Spanish, discusses the importance of obtaining calcium in the diet and how to calculate the amount of calcium consumed. Easy tips for consuming more calcium and information about other calcium-related issues are included.

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How much calcium does the average American consume each day? How much calcium is recommended? Unfortunately, most Americans are not getting enough of this essential mineral. The Calcium: Are You Getting Enough? brochure, which is designed for the general adult population, emphasizes the importance of dietary calcium and offers suggestions for increasing calcium intake, while helping consumers sort through the issues of lactose intolerance, weight management, and nutrition labeling. Although both versions contain essentially the same information, the Spanish version has been slightly modified to be more applicable to the Hispanic culture and diet differences. Based on the SMOG readability scale, the English version is written at a 9th-grade reading level and is easy to comprehend, with correct use of grammar and punctuation. To our knowledge, the grammar and punctuation used in the Spanish version are accurate, although it may not account for regional variations in dialect. Both versions contain appropriate paragraph headings to attract readers’ attention and include a manageable amount of information in each paragraph. Bullets are used for suggestion lists, thus emphasizing the key points in a format that is easier to read than paragraphs.A chart for calculating calcium intake is conveniently included, thus making the brochure more interactive and personal. Both versions of the brochure contain accurate and up-to-date information, reflecting the most recent Dietary Reference Intake levels for calcium and addressing current nutrition concerns, such as dietary supplements, fortified foods, vegetarian diets, and weight management. The chart of calcium-rich foods and the section on increasing calcium intake both reflect popular food selections, with the Spanish version modi-

fied to include calcium-rich food items common to the Hispanic culture. However, a closer look at the 2 calcium-rich foods charts reveals a minor discrepancy between the 2 versions (pancakes in the English version have 100 mg of calcium, whereas pancakes in the Spanish version have 50 mg). It is possible that the discrepancy is due to the way in which the items are commonly prepared in either culture. Overall, the Calcium: Are You Getting Enough? brochure provides information that is relevant to the majority of Americans. These brochures might be useful as part of a community nutrition program, with the Spanish version being especially useful in cities with larger Hispanic populations.The Calcium:Are You Getting Enough? brochure could be distributed in any public place, such as a library, grocery store, or health fair. These nutrition education brochures are designed to promote a positive lifestyle behavior for the healthy adult population, not to treat disease. Abigail Field, BS, and Christina Pruemer, BS, Graduate Dietetic Interns, Melanie Tracy Burns, PhD, RD,Assistant Professor, Family and Consumer Sciences, Eastern Illinois University, Charleston, IL 61920 Choosing a Safe and Successful Weight-loss Program and You Can Control Your Weight as You Quit Smoking. Weight-control Information Network, 2003. From Weight-control Information Network, 1 WIN Way, Bethesda, MD 20892-3665, (877) 946-4627, brochures and Web site, 5 pp, free. The Choosing a Safe and Successful Weight-Loss Program and You Can Control Your Weight as You Quit Smoking handouts and Web site are designed to assist people in managing their weight. The first handout provides potential questions to ask

when choosing a weight loss program, whereas the second handout addresses how to not gain weight once the smoker has stopped smoking. The educational handout Choosing a Safe and Successful Weight-Loss Program was informative, with an easy to follow format. Designed as a checklist of potential questions, the handout also included valuable tips on healthful eating, physical activity, and a healthful, average weekly weight loss. The accompanying Web site offered additional links on exercise and healthful eating. The second handout, You Can Control Your Weight as You Quit Smoking, addresses the health risks associated with weight gain versus the health risks of continued smoking and tips on preventing or minimizing weight gain owing to smoking cessation in a question-and-answer format. The corresponding Web site is easy to navigate and American Dietetics Assocation compliant and contains top of the page options. The overall content of the Choosing a Safe and Successful Weight-Loss Program and You Can Control Your Weight as You Quit Smoking handouts and accompanying Web site is basic, has a low literacy level, and includes simple design features, thus enhancing their versatility for use with many populations. The publications do include references and additional resources that can aid in the search for the right weight loss program and tips for smoking cessation in regard to weight gain. These publications can be found in health departments, in physician offices, or at health fairs, where the general public may show an interest in weight loss or smoking cessation. Lee Ann Price, MS, and Elizabeth Stanberry, BS, Graduate Dietetic Interns, Melanie Tracy Burns, PhD, RD, Assistant Professor, Family and Consumer Sciences, Eastern Illinois University, Charleston, IL 61920