State of Science :: Commentaries
"Show Me the Soil to Health Science - Building Alliances with Dietitians"
Author(s): By Angie Tagtow, MS, RD, LD
Food & Society Policy Fellow, Owner of Environmental Nutrition Solutions, Managing Editor of the Journal of Hunger & Environmental Nutrition, firstname.lastname@example.org
Twenty years ago I was immersed in biochemistry, advanced human metabolism and nutritional assessment courses. Science was a passion and when blended with how food could improve health, I knew dietetics was my vocation. However, upon graduating I thought, "there must be more to dietetics than nutrition therapy to treat a disease."
After working in public health nutrition, I learned how food and nutrition programs prevented populations from succumbing to chronic disease. Again, I pondered, "there must be more to making eaters healthy than just teaching nutrition." This led me to study the connections between how food is grown, processed, sold, and consumed and the health of individuals, families, farms and communities.
Taking an ecological or systems approach to food and health has broadened my professional practice. I have worked with farmers, processors, cooperatives, businesses, organizations and academic institutions on the health, environmental and economic impacts of our food system.
As an active member of the American Dietetic Association (ADA), I am a proponent of a food system framework as a mechanism to optimize the nutritional health of eaters. Specifically, a food system that is resilient, conserves and renews natural resources, advances social justice and animal welfare, builds community wealth, and fulfills the food and nutrition needs of all eaters (1). Dietitians know how food choices impact health, but are less apt to question how food choices impact the health of the planet or how agriculture policies and practices influence the quality, quantity and biodiversity of food.
Touted as food and nutrition professionals, dietitians use research as the basis for practice, education and policy (2). However, the profession remains entrenched in patient-centered care (3) and has yet to transition to a systems approach to food. This narrow nutrient-based approach, an example of scientific reductionism,(4) has diverted the focus of dietetic professionals away from how food is grown and the impacts of farm production systems on nutrition, health and the ability to grow food in the future.
For example, in December 2008 the ADA released a paper on the relationship of high fructose corn syrup (HFCS) and weight status/obesity (5). In response to the paper, ADA was asked whether and how HFCS fit with a sustainable approach to food systems and why biodiversity, environmental degradation and production processes were not aspects of the paper. The response was "this was a short brief with a relatively narrow focus. Sustainability is not within the scope of this hot topic. Processing and production practices do not impact the relationship between HFCS and weight status."(6) An interesting caveat is this paper was co-authored by the Corn Refiners Association.
Author Michael Pollan would label this nutritionism (4), or the reduction of food to single nutrients or ingredients and their impact on disease. Why the narrow focus? First, it begins with training. Disease treatment and medical nutrition therapy remain as core competencies of dietetic education and the health impacts associated with growing and processing food are not incorporated. Therefore, soil to food quality to health connections are not routinely among the tools in the dietitian's toolbox.
Secondly, with so much emphasis on technology such as medicinal foods and pharmaceuticals to treat disease, it is assumed that all advances in technology are beneficial, without regard to their impact on the environment, local economics, energy consumption, working conditions, or waste generation. An example is the ADA position paper on agriculture and food biotechnology that urges dietitians to "encourage the availability of [biotech] products in the marketplace." (7)
Lastly, industry has influenced the dietetic profession. ADA corporate sponsors such as The Coca-Cola Company, Pepsico, Unilever, General Mills, and Mars Incorporated have many opportunities to "access key influencers, thought leaders and decision-makers in the food and nutrition marketplace." (8) This brand identity has bled into consumer-focused nutrition fact sheets (9), and in the examples above, hot topics and position papers. The disconnect between healthy nutrition messaging and the foods produced by the corporate sponsors has led to inherent biases and perceptions of dietitians and the ADA thereby diminishing professional integrity.
Dietitians must ask "Are we being effective? Are we optimizing the nation's health?" Based on the epidemic rates of overweight, obesity, diabetes and cardiovascular disease, that would be a resounding "no." Dietitians must take a food system approach in reducing diet-related chronic disease and embrace soil, plant and animal science and the connections to human nutrition. Dietitians must address the shrinking genetic biodiversity of our food supply and take a precautionary approach to food production.
The organic community can build stronger alliances with dietetic professionals beginning with evidence-based interactions. Science proves that healthy soil grows healthy food and healthy food nourishes healthy people. Dietitians thirst for the evidence that supports how organic farming increases the density of nutrients, specifically antioxidants, in foods. The following strategies will strengthen the relationship with dietitians while building visibility and credibility of organic food production within the nutrition and health communities:
• Publish research on the nutrition and health benefits of organic food production in the Journal of the American Dietetic Association or the Journal of Hunger & Environmental Nutrition.
• Collaborate with dietitians on organic research, education, product development and marketing.
• Form an organic community of practice or workgroup and include farmers, researchers, dietitians and health practitioners to develop white papers or consumer-based materials.
• Meet with food service directors to determine opportunities for organic product procurement. Consider developing an institutional line of organic foods for hospitals, universities and schools.
• Appoint dietitians to serve on organic boards or committees.
• Host a seminar or lunch-and-learn at a hospital and provide samples of organic products.
• Seek opportunities to get involved with local, state or national dietetic groups. For example:
+ Submit articles about organic food production to newsletters.
+ Advertise organic products in newsletters and magazines.
+ Organize educational sessions that feature an organic farmer, researcher and dietitian.
+ Provide organic food for an event meal or refreshment break.
+ Sponsor a conference activity such as a farm tour or film festival.
+ Propose a Hot Topic, Nutrition Fact Sheet or Position Paper on the nutrition and health benefits of organic food.
+ Become a friend of the Hunger and Environmental Nutrition Dietetic Practice Group.
+ Interact with ADA Public Policy staff, affiliate legislative liaisons and public policy chairs on the National Organic Program policies and related farming legislation.
• Contact the dietetic education director at a university and provide a guest lecture on the nutrient benefits of grass-fed, pasture-raised organic livestock production in an advanced metabolism class.
• Host a guest speaker and provide samples of organic products at a student nutrition club meeting.
English agronomist Sir Albert Howard said, "Soil is the basis of the public health system." Although written more than 60 years ago, the science holds true today and hopefully will become a guiding principle for dietitians and other health professionals.
Resources of the American Dietetic Association, www.eatright.org
• ADA Affiliates, Dietetic Practice Groups and Member Interest Groups, http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_114_ENU_HTML.htm
• Healthy Land, Healthy People: Building a Better Understanding of Sustainable Food Systems for Food and Nutrition Professionals: A Primer on Sustainable Food Systems and Emerging Roles for Food and Nutrition Professionals. American Dietetic Association Sustainable Food System Task Force. 2007. Available at http://www.hendpg.com/index_1417.cfm
• Hunger and Environmental Nutrition Dietetic Practice Group, www.HENdpg.org;
• Organic Food Production Talking Points, http://www.hendpg.com/index_1417.cfm
• Journal of Hunger and Environmental Nutrition, http://JHEN.HaworthPress.com
• Journal of the American Dietetic Association, www.adajournal.org
• Position of the American Dietetic Association: Food and Nutrition Professionals Can Implement Practices to Conserve Natural Resources and Support Ecological Sustainability. J Am Diet Assoc. 2007; 107:1033-1043. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_adar2_1001_ENU_HTML.htm
• McCaffree J. Water and sustainable agriculture: What they mean to food and nutrition professionals. J Am Diet Assoc. 2008;108(2):215-216. Available at http://www.adajournal.org/article/S0002-8223(07)02219-5/fulltext
• Agriculture and Public Health Gateway, Johns Hopkins Center for a Livable Future, Bloomberg School of Public Health, http://aphg.jhsph.edu/
• American Public Health Association Policy Statement. Toward a Healthy, Sustainable Food System, www.apha.org/advocacy
• Health Care Without Harm, Healthy Food in Health Care, A Menu of Options, www.noharm.org/us/food/issue
• Leopold Center for Sustainable Agriculture, Scientific Findings About Organic Agriculture, http://www.leopold.iastate.edu/organic/
• Rodale Institute, http://www.rodaleinstitute.org/
• Today's Dietitian Magazine, www.todaysdietitian.com
• The Prevention Institute, Cultivating Common Ground - Linking Health and Sustainable Agriculture, www.preventioninstitute.org
1. Tagtow A, Harmon A. Healthy Land, Healthy Food & Healthy Eaters. Sustainable Food Systems: Opportunities for Dietitians. American Dietetic Association Food & Nutrition Conference and Expo. October 2008.
2. ADA's Research Philosophy. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/career_916_ENU_HTML.htm. Accessed December 30, 2008.
3. The Nutrition Care Process Model. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_14031_ENU_HTML.htm. Accessed December 30, 2008.
4. Pollan M. In Defense of Food. An Eater's Manifesto. New York:NY. The Penguin Press, 2008 (p 62).
5. ADA Hot Topic - High Fructose Corn Syrup. December 2008. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition_19399_ENU_HTML.htm. Accessed December 30, 2008.
6. Email correspondence from Helen Lane, PhD, RD, Chair of the Association Positions Committee to ADA Issues Management inquiry. Received December 30, 2008.
7. Bruehn C, Earl R. Position of the American Dietetic Association: Agriculture and Food Biotechnology. J Am Diet Assoc. 2006;106:285-293. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_abiotechnology_ENU_HTML.htm
8. ADA's Corporate Relations Sponsorship Program. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_7067_ENU_HTML.htm. Accessed on December 30, 2008.
9. Nutrition Fact Sheets. Available at http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition_350_ENU_HTML.htm. Accessed December 30, 2008.