About the Institute for Nutrition Interventions

Introduction

The University of Medicine and Dentistry of New Jersey is an academic health sciences center with five campuses in New Jersey including the School of Health Related Professions (SHRP), the New Jersey Dental School (NJDS), the School of Nursing (SN), the School of Public Health (SPH), three medical schools (New Jersey Medical School, NJMS, Robert Wood Johnson Medical School, RWJMS) and the School of Osteopathic Medicine, SOM) and the Graduate School of Biological Sciences (GSBS). Nutrition is a topic of increasing activity across UMDNJ in respect to teaching, research, practice and service across the University. This has created an opportunity for UMDNJ to create an Institute dedicated to nutrition education, practice, research and service for the UMDNJ community. The SHRP has taken a leadership role in the development of the Institute for Nutrition Interventions (INI) as it has the largest group of credentialed and doctorally prepared nutrition faculty in the University and houses the only dietetics education programs in the University (five programs).

Academically the dietetics faculty members of the Institute have a leadership role in nutrition with five programs addressing entry to advanced practice. In addition to the Dietetic Internship, MS in Clinical Nutrition program and PhD in Health Sciences Nutrition track, our coordinated program in dietetics for Dietetic Technicians Registered to advance to RDs and the Doctorate in Clinical Nutrition are unique and innovative approaches to entry and advanced practice respectively. These two programs are the only two of their kind in the U.S. and have received recognition for their innovative approaches to advancing dietetic practice. Continuing professional education programs for all disciplines continues to be a goal of INI.

As we prepare our students for the 21st century health care workforce, we must address the multidisciplinary nature of health care practice with a focus on comprehensive care. Strong research protocols, teaching programs and clinical initiatives concerning nutrition must be developed. While the science and practices of nutrition have been around for centuries, the global obesity epidemic (1, 2) combined with an increased recognition of the role of diet and nutrition in health promotion, disease prevention and management has resulted in growth in nutrition initiatives within and outside of UMDNJ. The Institute for Nutrition Interventions at UMDNJ is a viable and reliable source of information for both consumers and health professionals. There are many opportunities for an interdiscplinary Institute such as INI. Opportunities exist for scholarly activities, educational endeavors and community and image promotion activities. New Jersey is home to many pharmaceutical and food industries. Existing relationships with two of these industries provide opportunities that need time to be nurtured and developed.

The strength of the Institute is representative of the contributions and core strengths of its members. INI will strive to include an interdisciplinary team of members aimed at developing programs within and across disciplines. Internal collaboration of members will increase opportunities for stronger external competition in research. The mission and goals delineate the primary aims of the Institute. Nutrition is in many ways a nascent science; as genomics and other new realms move from the laboratory to the clinical area, INI is strategically positioned to house the related research, education and service projects to create the link between the basic and clinical sciences of nutrition and diet. INI seeks members dedicated to the pursuit of excellence in the education, practice and research of nutrition and dietetics.

Background

The role of nutrition in health promotion, disease prevention and disease management is an increasingly important public health issue. Overweight and morbid obesity is rampant in the U.S. and is now considered one of the leading causes of death of adults (1,2,3,4). One in two adults is overweight and one in five is obese (1). In children, 13% of those aged six to 11 years and 14% of adolescents aged 12 to 19 in the United States are overweight (5). The incidence of type 2 diabetes in children has grown significantly (6) much in part attributed to the rise in childhood overweight and obesity (6). In preventing chronic diseases such as diabetes, nutrition, diet and exercise are part of an essential regimen of wellness. There are increasingly new roles for diet and nutrition in the management of chronic diseases and therapies associated with some acute and chronic diseases such as diabetes mellitus, cardiovascular disease, and cancer (7-11). Once diagnosed, nutrition and diet are integral components of management for many acute and chronic diseases.

In addition to the role of diet and nutrition in weight management, there is growing attention by consumers on the importance of diet in maintenance of health and prevention of chronic diseases. The 2005 Dietary Guidelines focus on diet and nutrition as primary components of health promotion and disease prevention (12). They provide scientific evidence based guidelines for health promotion and risk reduction of chronic diseases through diet and physical activity. Furthermore, poor diet and physical inactivity, resulting in an energy imbalance (more calories consumed than expended), are the most important factors contributing to the increase in overweight and obesity in the U.S. The importance of nutrition is underscored by the role of nutrition in the prevention of the leading causes of death including cardiovascular disease, type 2 diabetes, hypertension, osteoporosis, and certain cancers (7-11,13). Four of the top six leading causes of death, diseases of the heart, cancer, cerebrovascular disease and diabetes can be influenced by diet and nutrition. Nutrition is the cornerstone of diabetes management and prevention and management of cardiovascular disease. Similarly, the DASH Diet for hypertension (11) has been shown to be extremely effective in lowering blood pressure in individuals with hypertension. The dietary guidelines for cancer prevention (9) and those for cancer survivors (8) of the American Cancer Society are supported by the National Cancer Institute (10) and demonstrate the role of diet and nutrition in cancer chemoprevention. Healthful eating as well as prevention and control of heart disease and hypertension are stroke prevention strategies, again underscoring the role of nutrition in disease prevention. Surgeon General Reports (SGP) (4,13,14) and ‘Calls to Action’ over the last decade have emphasized the role of nutrition in health promotion and disease prevention. On a federal level, several initiatives including the 2001 ‘Call to Action’ (4) to prevent overweight and obesity along with the 2003 ‘Call to Action’ to promote oral health (14) emphasize the role of nutrition and the importance of related research. The 2004 SGP on Osteoporosis (13) supports the role of nutrition, the RD and a team based approach to osteoporosis intervention and prevention services and research.

In addition to the aforementioned health promotion and disease prevention and intervention areas, there is an increasing need for nutrition research relative to dietetics and health care practice. Nutrition diagnostic coding is on the horizon for the profession of dietetics which will provide for new opportunities in dietetics outcomes research. Advanced level and specialty practice in dietetics is growing; there is a clear need for research exploring levels of practice in dietetics. Nutrition education of other health professionals as well as nutrition screening and education practices for these disciplines (medicine, dentistry, nursing and allied health) is increasingly important and discussed in the literature. The need exists for research aimed at both nutrition screening and educational practices areas.

References

1. Flegel KM, Carroll M, Ogden C, Johnson CL. (2002). Prevalence and trends in overweight among US adults, 1999-2000. J Amer Med Assoc, 288(14): 1723-1727, 2002.

2. Ogden CL, Flegel KM, Carroll MD, Johnson CL. (2002). Prevalence and Trends in Overweight Among US Children and Adolescents, 1999-2000. J Amer Med Assoc., 288 (14): 1728- 1732.

3. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. (2004). Actual causes of death in the United States, 2000. J Amer Med Assoc., 291(10): 1238-1245.

4. The Surgeon General’s Call To Action To Prevent and Decrease Overweight and Obesity http://surgeongeneral,gov/topics/obesity/default.htm. Accessed January 24, 2005.

5. Centers for Disease Control. Diabetes projects. http://www.cdc.gov/diabetes/projects/cda2.htm. Accessed January 24, 2005.

6. Rochford M, Kaminsky E. Fighting back against childhood obesity through the Cape May County Children’s Health Summit. Prev Chronic Dis [serial online] 2004 Oct [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2004/
oct/04_0067.htm. Accessed January 24, 2005.

7. American Diabetes Association. Nutrition Principles and Recommendations in Diabetes. Diab Care 27:S36-S46, 2004

8. Brown J, Byers T, Thompson K et al. Nutrition during and after cancer treatment. CA Cancer J Clin 2001;51:153-187.

9. Byers T, Nestle M, McTiernan et al. Guidelines on nutrition and physical activity for cancer prevention. CA Cancer J Clin 2002;52:92-119.

10. National Cancer Institute. National Institute of Health. Overview of Nutrition in Cancer Care. http://www.nci.nih.gov/cancertopics/pdq/supportivecare/nutrition. Accessed December 28, 2004.

11. NIH Publication No. 03-4082, Facts about the DASH Eating Plan, United States Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/. Accessed January 24, 2005.

12. U.S. D.H.H.S. Dietary Guidelines for Americans 2005. http://www.healthierus.gov/dietaryguidelines/. Accessed January 24, 2005.

13. Public Health Service, United States Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville MD: Office of the Surgeon General, October 2004.

14. Public Health Service, United States Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville MD: Office of the Surgeon General, May 2000.