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FRONTIERS IN THE NUTRITION SCIENCES PROCEEDINGS OF A SYMPOSIUM Food and Nutrition Board Institute of Medicine NATIONAL ACADEMY PRESS Washington, D . C . 1989

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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative In identifying issues of medical care, research, and education. The work on which this publication.is based was supported by the National Research Council Fund -- a pool of private, discretionary, nonfederal funds that is used to support a program of Academy-initiated studies of national issues in which science and technology figure significantly. The Fund consists of contributions from a consortium of private foundations including the Carnegie Corporation of New York, the Charles E. Culpeper Foundation, the William and Flora Hewlett Foundation, the John D. and Catherine T. MacArthur Foundation, the Andrew W. Mellon Foundation, the Rockfeller Foundation, and the Alfred P. Sloan Foundation; the Academy Industry Program, which seeks annual contributions from companies that are concerned with the health of U.S. science and technology and with public policy issues with technological content; and the National Academy of Sciences and the National Academy of Engineering endowments. The views expressed in this book are solely those of the individual authors and are not necessarily the views of the Food and Nutrition Board. Library of Congress Catalog Card No. 89-63435 International Standard Book Number 0-309-04146-5 National Academy Press 2101 Constitution Avenue, NW Washington, DC 20418 Printed in the United States of America S060

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FOOD-AND NUTRITION BOARD RICHARD J. HAVEL (Chairman), Cardiovascular Research Institute, University of California School of Medicine, San Francisco, California : FAMISH N. MUNRO, (Vice Chairman), U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts EDWARD J. CALABRESE, Environmental Health Program, Division of Public Health, University of Massachusetts, Amherst, Massachusetts DORIS H. GALLOWAY, Department of Nutritional Sciences, University of California, Berkeley, California WILLIAM E. CONNOR, Department of Medicine, Oregon Health Sciences University, Portland, Oregon DEWITT S. GOODMAN, Institute of Human Nutrition, Columbia University, New York, New York M.R.C. GREENWOOD, Department of Biology, Vassar College, Poughkeepsie, New York JOAN D. GUSSOW, Department of Nutrition Education, Teachers College, Columbia University, New York, New York JOHN E. KINSELLA, Institute of Food Science, Cornell University, Ithaca, New York LAURENCE N. KOLONEL, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii BERNARD J. LISKA, Department of Food Science, Purdue University, West Lafayette, Indiana REYNALDO MARTORELL, Food Research Institute, Stanford University, Stanford, California ~

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DONALD B. McCORMICK, Department of Biochemistry, Emory University School of Medicine, Atlanta, Georgia J. MICHAEL McGINNIS, (Ex Officio), Office of Disease Prevention and Health Promotion, Department of Health and Human Services, Washington, D.C. WALTER HERTZ, Human Nutrition Research Center, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland ARNO G. MOTULSKY (Ex Officio), Center for Inherited Diseases, University of Washington, Seattle, Washington MALDEN C. NESHEIM, Office of the Provost, Cornell University, Ithaca, New York Food and Nutrition Board Staff SUSHMA PALMER, Director FRANCES M. PETER, Deputy Director UTE S. HAYMAN, Administrative Assistant KARLENE M. GOODE, Senior Secretary iv

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COMMISSION ON LIFE SCIENCES* BRUCE M. ALBERTS (Chairman), Department of Biochemistry and Biophysics, University of California, San Francisco, California PERRY L. ADKISSON, Office of the Chancellor, The Texas A&M University System, College Station, Texas FRANCTSCO J. AYALA, Department of Ecology and Evolutionary Biology, University of California, Irvine, California J. MICHAEL BISHOP, The G.W. Hooper Research Foundation, University of California, San Francisco, California FREEMAN J. DYSON, School of Natural Sciences, The Institute for Advanced Study, Princeton, New Jersey NINA V. FEDOROFF, Department of Embryology, Carnegie Institution of Washington, Baltimore, Maryland RALPH W.F. HARDY, Boyce Thompson Institute for Plant Research (Cornell), Ithaca, New York RICHARD J. HAVEL, Cardiovascular Research Institute, University of California, San Francisco, California LEROY E. HOOD, Division of Biology, California Institute of Technology, Pasadena, California DONALD F. HORNIG, Interdisciplinary Programs in Health, Harvard School of Public Health, Boston, Massachusetts ERNEST G. JAWORSKI, Division of Biological Sciences, Monsanto Company, St. Louis, Missouri SIMON A. LEVIN, Ecosystems Research Center, Cornell University, Ithaca, New York HAROLD A. MOONEY, Department of Biological Sciences, Stanford University, Stanford, California or

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STEVEN P. PAKES, Division of Comparative Medicine, Southwestern Medical School, University of Texas Dallas, Texas JOSEPH E. RALL, Intramural Research, National Institutes of Health, Bethesda, Maryland RICHARD D. REMINGTON, Office of Academic Affairs, University of Iowa, Iowa City, Iowa PAUL G. RISSER, Office of the Vice President, University of New Mexico, Albuquerque, New Mexico RICHARD B. SETLOW, Biology Department, Brookhaven National Laboratory, Upton, New York TORSTEN N. WIESEL, Laboratory of Neurobiology, Rockefeller University, New York, New York Commission on Life Sciences Staff JOHN E. BURRIS, Executive Director ., * The Food and Nutrition Board was in the Commission on Life Sciences at the time of the symposium on which these proceedings are based. vi

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PREFACE In 1987, the Food and Nutrition Board selected "Frontiers in the Nutrition Sciences" as the topic for its annual symposium. It symbolizes the Board's concern about declining attention to nutrition as a focal point in our universities and medical schools; but more importantly it expresses the Board's conviction that nutrition research has a bright and challenging future. Realization of this potential, however, requires cognizance of advances in molecular biology and related biological and physical sciences that form the basis of nutrition and ascertaining how this new knowledge in the basic sciences can be applied advantageously to uncover potential frontiers in nutrition research and training. The symposium program was a preliminary step to determining the nature and extent of scientific advances that relate to nutrition, barriers to progress in the nutrition sciences, and the opportunities that lie ahead. Therefore, the primary objective of the symposium was to examine the current status of nutrition research and training at medical schools, other institutions of higher education, government-sponsored programs such as those at the U.S. Department of Agriculture's Human Nutrition Research Centers and other relevant facilities, and to identify future directions for research and training in the nutrition sciences. Sessions I and II provided an overview of advances in certain basic and applied sciences that offer opportunities for developing programs and undertaking collaborative nutrition research both domestically and internationally. Session III offered insights into trends and directions in research and vii

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training in university nutrition departments, medical schools, and schools of public health. A panel discussion focused on factors that have constrained progress and those that might enhance opportunities for research and training in the nutrition sciences. The Food and Nutrition Board intends to use this symposium as a starting point for an in-depth study of opportunities in the nutrition sciences. Our ultimate objective is to draw attention to the field, point to barriers, highlight opportunities, and generate enthusiasm among young researchers and teachers for this indispensable component of biology. Richard Havel, Chairman Sushma Palmer, Director Food and Nutrition Board . . . I

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CONTENTS FRONTIERS IN THE NUTRITION SCIENCES Molecular Biology and Nutrition Research Richard Hanson. Maria Hatzaglou. Mary M. McGrane. Fritz M. Rottman. and Thomas Wagner............................ The Genome: Nutrition and Human Variation Arno Motulsky.................................. Biotechnological Developments: Potential for Improvements in Food Formulation, Nutrient Delivery, and Safety John E. Kinsella........................ From Ecologic Correlations to Metabolic Epidemiology: The Link with Nutrition Laurence N. Kolonel...................... II . 42 .95 FUTURE OF DIETARY INTERVENTION Introduction William E. Connor 113 Nutrition and Public Health -- New Dimensions J. Michael McGinnis 117 The National Cholesterol Education Program DeWitt S. Goodman e 143 The International Dimension: Nutrition's Role in World Food and Population Concerns Marian F. Zeitlin 149 1X

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ACADEMIA AND THE NUTRITION SCIENCES Recent Trends and Future Directions Maiden C. Nesheim e ee e Critical Issues in Nutrition Sciences at the University Level John A. Milnere ee e.ee eee Nutrition in Medicine: What Is Its Place? George A. Bray e eeeeeeeeeeeeee. Critical Issues in Nutrition Education and Training at the University Level Barbara Hansen e e eeee e The Role of Undergraduate Research Colleges- in the Education of Future Nutrition Scientists ~ M. R. C. Greenwood. and Patricia R. Johnson.. Commentary 171 183 ...191 205 ..209 Joan Gussow 221 AUTHORS AND COAUTHORS. ...229