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WEDNESDAY,OCTOBER18 ORIGINALCONTRIBUTIONS:PUBLICHEALTHNUTRITION/POLICY TITLE: FREQUENT EGG CONSUMPTION IS NOT RELATED TO ELEVATED SERUM CHOLESTEROL IN THE U.S. POPULATION AUTHOR(S): ]J.M. Kerver, MS, RD, )L.J. Bianchi, PhD, :D.J. McNamara, PhD and ~W.O. Song, PhD, MPH, RD. ~Michigan State University, E Lansing, MI 48824. -'Egg Nutrition Center, Washington DC, 20036.

LEARNING OUTCOME: To estimate the association between: I) dietary cholesterol and serum cholesterol concentration: and 2) egg consumption and serum cholesterol concentration. ABSTRACT TEXT: The subjects of this study are individuals included in NHANES III, 1988-94 (o---15,633, excluded : <12 yrs old; unreliable dietary recall; pregnant/lactating women; taking drugs for hyperlipidemia or unspecified heart disease: reported diet change in past year due to high cholesterol; or consuming egg white products). SUDAAN software was used to account for the complex survey design. Dietary cholesterol was estimated by 24-hour recall and egg consumption was estimated by food frequency questionnaire and was categorized as < I/wk ; 2-3/wk; and >_4/wk (63%; 27%; and 10% of the population, respectively). We used total serum cholesterol concentration as an outcome variable after finding total serum cholesterol and non-HDL cholesterol to be highly correlated (r=0.94, p<.001). After adjusting for demographic variables (age, gender, ethnicity) and lifestyle variables (smoking and physical activity), dietary cholesterol had no linear relationship with serum cholesterol concentration. Persons who reported eating -2_4 eggs/wk had a significantly lower mean serum cholesterol concentration than those who reported eating < Iegg/wk (193 +_ 1.2 mg/dl vs. 197 _+0.7 mg/dl, p<.01 ). More frequent egg consumption was negatively related to serum cholesterol concentration (13 6.45, p<.01). It is feasible that individuals with known high serum cholesterol concentrations were more likely to consume fewer eggs, however, this study excluded individuals with concern for high cholesterol. Frequent egg consumption does not appear to adversely affect serum cholesterol concentrations. CONFLICT OF INTEREST (If applicable): Supported by the Egg Nutrition Center, Washington DC, 20036

TITLE: A REPORT TO CONGRESS ON NUTRITION EDUCATION APPROACHES FOR USDA NUTRITION ASSISTANCE PROGRAMS AUTHOR(S): C. Miller, MS, RD; J. Wilson, MPH, RD, and J. Hirschman. MPH, CNS, Office of Analysis, Nutrition and Evaluation. Food and Nutrition Service, USDA, Alexandria, VA LEARNING OUTCOME: To describe barriers, gaps and opportunities for promoting a comprehensive approach to nutrition education across USDA nutrition assistance programs. ABSTRACT TEXT: In fulfillment of a Congressional request for the Food and Nutrition Service (FNS) of USDA to report on a comprehensive, integrated approach to nutrition education for all nutrition assistance programs, a report was submitted to Congress in January, 2000. FNS consulted with a wide range of experts in the field of nutrition and nutrition education and asked for their input in the development of this report. The ~xperts agreed. While the nation's investment in nutrition assistance is a vitally-important and effective tool in fighting hunger and food insecurity, improving the quality of the American diet remains a major challenge. Poor nutrition and lack of physical activity account for 300,000 deaths per year, second only to tobacco as a cause of preventable mortality. Fortunately, nutrition education holds great potential to promote good health and prevent disease. Federal nutrition assistance programs offer a special opportunity to deliver nutrition and healthy lifestyle messages to those they serve, particularly children during formative years. However, critical changes are needed. First on the list is to secure a stable source of nutrition education funding for all programs. A second critical action is to set aside a small portion of Federal program resources for cross-program initiatives. The report also stresses that FNS should be authorized to direct its nutrition education efforts towards program-eligible groups, rather than program participants alone. The report includes a number of other key actions to improve nutrition education in these vital nutrition assistance programs.

TITLE: Demographic. Nutritional And Behavioral Predictors Of Low Birth Weight Mnong Infants Born To Low Income Adolescents In The State Of Georgia AUTHOR(S): I.V. Rolle, MS. RD, Princess Margaret Hospital, Nassau, Bahamas; G.S. Perry, DrPH, RD. Centers for Disease Control and Prevention (CDC), Atlanta, GA; B.W. Phillips, EdD, RD, Tuskegee Univesity, Tuskegee. AL LEARNING OUTCOME: To identify the risk factors tbr low birth weight Among infants born to low income African-American and White Adolescent mothers ABSTRACT TEXT: The 1996 Georgia Pregnancy Nutrition Surveillance System (PNSS) data were used to assess the risk factors for delivering a low birth weight infant among low income adolescents, aged 19 years or less, who were participants in the WIC Program. The database consisted of 1358 complete records with information on pregnancy outcome, demographics, nutritional and behavioral risk factors. A significant association was found between prepregnancy body mass index (BMI), maternal weight gain, gestational age at birth, race and low birth weight. An association was also found between anemia, prenatal care, education, marital status and low birth weight, but the relationship was not significant. The incidence of delivering a low birth weight infant was higher among adolescent mothers who entered their pregnancy underweight than those who were of normal prepregnancy weight. Adolescent mothers who gained less than the Institute of Medicine's (IOM) recommendations for weight gain during pregnancy were found to be at greater risk for delivering a low birth weight infant than adolescent mothers who gained at or above the recommendations. No significant difference was observed in the incidence of low birth weight when African-An~rican and White infants were born full-term. However, if preterm the risk of delivering a low birth weight infant was higher anaong African-American adolescent mothers than White adolescent mothers. The increased incidence of delivering a low birth weight infant among African-American adolescents can be addressed by aggressive methods to ensure early entry into medical care. and encouraging appropriate weight gain tbr prepregnancy body mass index (BMI). CONFLICT OF INTEREST (If applicable):

TITLE: AMENORRHEA IN ATHLETES: TRACKING THE OCCURRENCE AT THE COLLEGIATE LEVEL A UTHeR(S) : Sheila Fleischhacker, Student Researcher/Mulcahy Scholar Jeanne Kouba, MS, RD, School of Nursing, Loyola University Chicago

LEAR~NING OUTCOME: Participants will be capable of describing the prevalence of amenorrhea in collegzate athletes as well as identifying this disorder's cornucopia of possible contributing factors. ABSTRACT TEXT: The purpose of this study is to quantify the prevalence of amenorrhea in the female student-athlete populataon of a Division I school and attempt to determine some of the correlates. Currerrt research indicates amenorrhea, a female condition that is marked bythe absence of three consecutive menstrual cycles per year, has a prevalence of one to three percent in women in the United States. In athletes, however, the prevalence of amenorrhea runs as high as 66 percent. Whether an athlete's amenorrhea is caused by inadequate nutritional intake, percentage of body fat, weight, level of stress, or training, the risk of crippling effects is universal. Specifically, arnenorrhea may he related to stress fractures, bone loss, scoliosis and potentially osteoporosis. Nine student-athletes were compared to a control group of on-campus female students (n=15) in this cross-sectaonal study. Both groups were between the ages of 17-23, completed an informed consent form and were asked to provide data for five consecutwe months. The survey data included questions regarding menstrual cycle, dietary habits, and a validated eating disorders screening scale. In addition, study participants were asked to record a 24h food retake. Prevalence of amenorrhea in the female student-athlete populataon was 67% compared to 13% in the control group. The average BMI was 20.75 and 21.42, respecUvely. Prevalence of bone injury, defined as past history of any fracture, was 33% among student-athletes and 6% for controls. Weekly mileage reported for student athletes was 24.08 and 4.35 for controls. Data generated from this study demonstrates the need to monitor the occurrence of menstrual disorders among student-athletes.

Journal of THE AMERICAN DIETETIC ASSOCIATION / A-61

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WEDNESDAY,OCTOBER18 ORIGINALCONTRIBUTIONS:PUBLICHEALTHNUTRITION/POLICY TITLE: DIET AND LEAD POISONING. JUSTTHE FACTS. W[tO KNOWS rIIEM? AUTHOR(S): Helen J. Binns, MD, MPH. Northwestern University. Children's Memorial Hospital, Chicago, IL LEARNING OUTCOME: To understand the relationship between nutrition and lead absorption and to realize that health providers have limited knowledge about this. A B S T R A C T TEXT: There is no physiologic need for lead. Lead absorption in children is enhanced if diets are low in iron or calcium, or high in fat. Other dietary factors may also play a role. Studies have shown that many children at high risk for lead poisoning may have diets likely to promote lead absorption. Health providers (HP) need to know the relationship between diet and lead absorption to deliver parental education. Method: A 24-question test of "knowledge about lead poisoning, the Chicago Lead Knowledge Test (CLKT), previously administered to 2225 parents at primary care practices (Arch Pediatr Adolesc Med 1998:152; 1213-1218) was administered to 260 HP (physicians and nurses) at 38 urban inner-city practice sites. A l-hour lecture on lead poisoning was delivered by a lead expert at each site. 80 randomly selected HP repeated the CLKT 1-2 months after the intervention. Results: Among the 4 content areas of the CLKT (general intbrmation, exposure, prevention, nutrition), HP had the most limited knowledge when answering questions related to nutrition (see Table), but HP knew far more than was previously reported for parents (9%-27% correct). An educational intervention significantly improved HP responses tbr all nutrition questions (each, p<.05). Nutrition Questions % Correct: Baseline F-Up *The human body needs a small amount of lead for good nutrition... 64% 86% oA diet with a good amount of iron-containing foods will help decrease a child's chance of becoming lead poisoned ................... 66% 86% *A diet with enough calcium helps prevent lead poisoning ............ 44°/'0 75% *Less lead is taken up by the body ifa child eats a balanced diet. without too many fatty foods ................................................ 62% 84% Conclusion: Nutrition education needs to be a focus of lead poisoning education for HP.

TITLE: UNIQUE PARTNERSHIP: PROGRAM DIETITIANS AND RESTAURANT CHEFS CREATE A MENU MODEL FOR SENIOR NUTRITION PROGRAMS. AUTHOR(S): A.E. Rethmeycr, FAD, RD, CFSP, A. Esbelby, RD, B.Vidakovits, RD, CFSP, L.Yuille, RD, and M. Mansour, MS, RDE, Consulting Nutritional Services, Calabasas, CA., B. Hurd, AAA Nutritionist, City of Los Angeles Department of Aging. LEARNING OUTCOME: To identify a model of creative menu development for senior nutrition programs which focuses on functional foods and a unique partnership between dietitians and restaurant chefs. ABSTRACT TEXT: How can a more attractive, nutritions and high quality meal, that improves attendance, be prepared within the budget constraints of the Senior Nutrition Program administered by the City of Los Angeles? Our dietitians faced this challenge. We tapped a professional relationship with renowned Chefs of Levy Restaurants (award-winning restaurateurs and leader in sports and entertainment dining) to develop more tantalizing recipes and menus. The goal was to move beyond minimum nutritional meal requirements to create a new "Millennium Menu" with a focus on functional foods. Levy Restaurants' Chefs visited existing caterers and nutrition sites to assess the current meals and facilities. The Chefs were provided with the basic meal requirements, a list of functional foods, and then asked to structure the recipes for "one to one hundred" meals. The recipes and menus were analyzed for nutritional content and were formatted for HACCP programs. Participating caterers and central kitchen staff received hands-on training with the Levy Restaurants' Chefs to improve their knowledge and skills. Promotion of the new Millennium Menu at the existing meal sites included a new logo and color scheme. Two nutrition sites, now known as "California Dining Centers," were chosen for event tastings. These served as a "premiere" for the new menu concepts where Levy Restaurants' Chefs demonstrated the meal preparation. Following the initial tasting events, the menu was introduced one day a week over a six-week period. Seniors critiqued the meals for taste and food quality. The meals exceeded all expectations, resulting in a sustained increase in attendance. CONFLICT OF fiNTEREST (If applicable):

TITLE: CONSUMER ABILITY TO CLASSIFY BASIC FOOD INTO FIVE FOOD GROUPS

TITLE: ASSESSMENT OF THE FOOD STAMP NUTRITION EDUCATION PROGRAM IN THE USDA/FNS MOU,"NTAIN PLAINS REGION

AUTHOR(S): D.M. Gandy, RD, CNSD, CD: C. Kapica, PhD, RD, LD, Finch University of Health Sciences/The Chicago Medical School, North Chicago, IL

AUTHOR(S): W.M. Koszewski. PhD, RD University of Nebraska, Lincoln, NE; K. Hudson, MS, RD, P. Peters, PhD, Kansas State University, Manhattan, KS; L. Beckstrom, MS, RD, Colorado Nutrition Network Coordinator, Fort Collins, CO; J. Pbelan, Missouri Nutrition Network Coordinator. Columbia, MO LEARNING OUTCOME: The participants will be able to understand the impact and evaluation process of the ten-state food stamp nutrition education program for limited resource audiences.

LEARNING OUTCOME: To identify foods adults have difficulty classifying into one of five food groups. ABSTRACT TEXT: Objective: To determine if poverty level adults can classify 70 simple foods into the appropriate food group.

Design: A survey using food pictures. Subjects/setting: A convenience sample of 62 adults visiting the Graves County Health Department in Kentucky. Statistical analyse* performed: T test assessed differences in mean total scores and mean food group scores (p < .05). Analysis of variance tests assessed differences in mean total scores and mean food group scores among socioeconomic data. Mann Whitney U and Kruskal-Wallis H tests confirmed significant findings. The Games-Howell test made pairwise comparisons. The Pearson correlation coefficient described test scores and demographic relationships.

Results: Food was misclassified into food groups significantly more often than the 100% expected score. Education level significantly affected the ability to classify food for both the grain and meat groups. Females correctly classified food into the meat group significantly more often than males. Income did not affect ability to classify into food into groups. Sunflower seeds were the most inappropriately categorized food. Chicken, ham, carrots, and pineapple were among the 13 foods correctly classified by all subjects. Conch~ion: Adults have difficulty with simple food classification; food grouping reinforcement should be considered when using food guides as teaching tools. CONFLICI" OF INTEREST: None A-62 / S e p t e m b e r 2000 S u p p l e m e n t Volume 100 N u m b e r 9

ABSTRACT TEXT: The ten states (CO, IA, KS, MO, MT, ND, NE ,SD, UT, WY) in the USDA/FNS Mountain Plains region conduct nutrition education programming for people who are eligible to receive food stamps. This program is a partnership between the Cooperative Extension Service, state food stamp programs, state public health departments and other community agencies. In the 1998-1999 programming year, 301,155 people were reached through direct contacts (one-on-one counseling, group education, etc.) and 501,549 through indirect (PSA's, television programs, etc.) The program reached people in different life stages from infancy to older adulthood, with the majority being Caucasian (78%), followed by Hispanic (12%). Topics covered include general nutrition, food safety, food preparation, life-cycle nutrition, and food budgeting. Outcomes included improvements in food safety behaviors, diet quality, food budging, and food security. Improved food budgeting practices demonstrated that the recipients saved money during the month, extended their food stamps. used grocery lists, and practiced meal planning (n=21,310). Participants understood the food guide pyramid, improved in the number of servings, used the nutrition facts label, and tried to prepare healthier meals In=31,687). Food safety practices included washing hands, not leaving food out for more than 2 hours, separating raw meat and cooking meat thoroughly (n = 19,170). Improvements in food security were measured based on the usage of food pantries, soup kitchens and having enough to eat (n=5,797). FSNEP has made and continues to make a dynamic impact in the lives of its clientele. Funding for this project provided by the Food and Nutrition Service/USDA. CONFLICT OF INTEREST (If applicable):