FNCE report by Deborah David

by Deborah J David RD

Deborah David represented NHD Magazine at the ADA annual Food and Nutrition Conference, the largest nutrition and dietetic professional event in the world. The 2009 Conference, held in Denver in October carried the theme ‘Explore. Exchange. Engage’. It certainly met all Deborah’s expectations…

American Dietetic Association Food and Nutrition Conference and Expo, 2009

Imagine my surprise when, emerging bleary-eyed on the first morning after a nine-hour flight, I was greeted by the sight of a 40ft blue bear peering into the main entrance of the Colorado Convention Centre. The steel structure artwork is the creation of Professor Lawrence Argent and is called ‘I See What You Mean’. The inquisitive looking bear prompts a desire to get inside and find out what’s occurring, so I did.

The opening ceremony of the conference relayed the information that over 10,000 delegates had already passed through registration. After that, there must have been even more, as people seemed to be arriving non-stop for the chance to attend the sessions and to network with others from all over the US and elsewhere. I was informed that I was the only UK delegate (quite an honour), though whilst I didn’t meet any other UK delegates, it did seem hard to believe.

In preparation for the conference, I studied the packed programme. At any one time, there were up to 13 parallel sessions and with breakfast and evening meetings for specialist interest groups, culinary demonstrations, as well as the Expo Hall. Being selective about what to attend was essential. With my ‘press’ badge on display, I made sure I included some press briefings in my schedule - a first for me.

Latest trends and technologies

The EXPO was awesome! There were over 350 companies represented with stands and speciality pavilions where conference members were able to update on latest trends and technologies and fill up their conference bags and baskets with resources to take back home. After all the tasting sessions of new innovative products on healthy eating, I was glad of the 20-minute walk back to my accommodation at the end of each day. Many of the food product stands this year were promoting high fibre in line with recent US consumer research which indicates that Americans are falling short on fibre and are confused about wholegrain foods. Sound familiar? A food can be wholegrain and not high in fibre; therefore it is essential to recommend ‘high fibre and wholegrain’ to consumers.

The main programme kicked off with three interesting sessions on ‘Sustainability and Greening’. A hot topic on ‘Organic versus Conventional Food Production’ urged dietitians to become advocates for organic production, to encourage patients to increase intake of fruit and vegetables and to be active agents in the community. A second session explored food insecurity where individuals living in low-income neighbourhoods have limited access to affordable foods. As dietitians here in the UK know from experience, no matter how much information dietitians provide to their patients, it will have little effect if resources are unavailable in the community. Through descriptions of US projects in Baltimore, Maryland and Philadelphia, it was shown that by changing the ‘built environment’, we can transform the food environment and facilitate healthy eating in socially acceptable ways.

‘Do more with less’…

A third session entitled ‘Be Well, Live Well: Eating that Is Healthy for You and the Earth’ described how our food choices impact on the environment and our health. The audience was shocked to hear that the production of one cup of latte coffee needs more than 200 litres of water in terms of ingredients, packaging and distribution. Also, 60 percent of water used in the US for private consumption is wasted, as is 40 percent of the food purchased. It is clear that some drastic actions are needed in order to change individual habits and, with increasing demand from developing countries such as India and China, we need new sustainable ways to ‘do more with less’. In this ‘me’ orientated culture of today, there needs to be a balance between nutrition and the environment. Dietitians need to be part of the dialogue, as a nutrition resource, to think of new ways to educate the community. It was emphasised that dietitians need to expand their horizons and be comfortable with questions/discussions on a range of topics including agriculture.

A further interesting session relating to sustainability was on the topic of the ‘The Role of the Dietitian in the Green Movement’. Kathy Kress RD and Nancy Hudson RD from the University of California outlined how production of food in the US has become increasingly dependent on non-renewable energy and mineral resources which are not environmentally sustainable. As dietitians, we can stimulate interest and influence the community by ‘starting small – going big’. For example, we can build teams in the community, promote local organic produce and use local organisations to network with schools, colleges and farmers’ markets to expand sustainable practices. It was very encouraging and refreshing to hear enthusiastic speakers supporting each other in their approaches to address the challenges of sustainability.

Tackling obesity

A final session on sustainability issues examined the political, environmental and economic factors contributing to the global food challenge and how we as dietitians can encourage uptake of a quality diet. Dr Eileen Kennedy of Tufts University and Dr William Masters of Purdue University described how these challenges are not just in the US but are global. In the 1950s, consumers got what they asked for: cheaper food, more leisure time and higher incomes. As in the UK, the trend in the US since the 1970s in obesity has been upward as a result of low cost, high energy dense foods, with a concurrent decrease in physical activity. In the developed world, the lowest income groups are more predisposed to

obesity and this is related to the intake of cheap foods containing increased levels of fats and sugars.

The question was posed ‘how can national governments and the international community address undernutrition, while at the same time tackle overweight and obesity?’ It seems that the challenges are to identify newer paradigms for promoting healthy lifestyles. Publicprivate partnerships involving food retailers in the past have been slow to help, but are now developing better food products. The chief factors important to consumers are taste, access to food (physical and affordability) and culture. The question remains what price point is acceptable to households in terms of meeting their nutritional needs? Retailers should work towards improving the nutritional quality of foods.

Discussing diabetes

There were several sessions on plant-based diets. Since my return to the UK, this subject has had a certain resonance, given the recent remarks by Lord Stern of Brentford on the benefits of vegetarian diets to the future of our planet. The session on ‘Can Plant Based Diet Approaches Be Safe and Adequate?’ discussed the resources needed to implement a balanced plant-based diet, highlighting major nutritional considerations of which dietitians should be aware. In another similar session, research on vegetarian dietary approaches to diabetes management in the Marshall Islands Diabetes Wellness Project was presented. (For those whose geography is not a strong point (like me), the Marshall Islands are located in the Pacific Ocean, north of the equator). Diabetes has spread so rapidly through these islands due to poor awareness about unhealthy western foods, that 30 percent of the population suffers from the disease. Such programmes alongside promotions for increased exercise have led to improvements in blood glucose control, plasma lipids, blood pressure and body weight. Vegan diets have shown similar benefits with additional improvements in patients with rheumatoid arthritis. The Wellness Programme has been designed to prevent and reverse the effects of diabetes; use of local resources for fitness and diet has been key to its success.

The Member Showcase this year entitled ‘Remarkable Communication, Remarkable Results’ was held in the Wells Fargo Theatre. The keynote speaker, Pamela Jett emphasised the importance of using words wisely when communicating with patients and colleagues in our personal and professional life. In her dynamic style, she illustrated useful techniques to facilitate healthy behavioural changes in patients’ lifestyles as well as boosting the confidence of

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health professionals as they take up the many challenges in their varied jobs.

As might be expected, there were several sessions on the problems of obesity, particularly in children. I attended a media briefing entitled ‘Fuel Up to Play 60’ which is the strapline for a programme created by a partnership between the US National Dairy Council and the Nutritional Football League. The programme has been designed and launched in 60,000 schools to empower youth to take action by making changes in nutrition and physical activity. ‘Wellness Activation Kits’ provide the tools for students to participate in the scheme, at the same time earning points for themselves and their school in a national competition. Research on modifying family and nutrition behaviours in the prediction of a child becoming obese was explored in a hot topic ‘The Family Focus: are we missing the boat?’ This research has formed the basis of a screening tool to be used to assess family environments which may predispose youth to overweight and obesity.

In between the main sessions, I hurried along to various culinary demonstrations, many of which focused on creative ways of increasing intake of grains and green vegetables. Throughout the conference period too, there were snatched opportunities to listen to sessions on food sensitivities, food allergies, labelling laws, vitamin supplements and clinical sessions on diet and asthma, autism, COPD, coeliac disease, inflammation and ageing. The only way to catch up with the content of these sessions is via the CDs of the conference presentations, which are available to purchase from the ADA website: www.eatright.org.

The gateway into sustainability

On the final day, I couldn’t resist attending a session which connected health with sustainability. Food and beverages are ‘the gateway into sustainability’ and it is incumbent on us as health professionals to help consumers in building diets which are good for them and the environment. It was a great wrap-up session encapsulating so many of the key messages that had been raised in the previous days.

As I boarded the plane for home, there was ample opportunity to reflect. The conference had been a great opportunity to meet people working in the field of dietetics and nutrition and to hear about the issues facing dietitians from the US perspective. I would like to thank NHD for helping me on my way to this thoroughly informative and educational experience. The next conference is in Boston, Autumn 2010. New England in the Fall…now there’s a thought!

NHD NETWORK HEALT H DIETITIA N S 25+ dietetic vacancies inside! See page 37 ISSN 1756-9567 (print) Oct ‘09 Issue 48

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