MINUTES OF THE NUTRITION COORDINATING COMMITTEE (NCC) …

         MINUTES OF THE NUTRITION COORDINATING COMMITTEE (NCC)
              MEETING, NATIONAL INSTITUTES OF HEALTH (NIH)
            Rockledge 2, Conference Room 9100-9004, Bethesda MD
                          May 5, 2005, 2:00-4:00 PM

WELCOME
Dr. Pamela Starke-Reed, Deputy Director, Division of Nutrition Research
Coordination (DNRC) convened the meeting at 2:00 PM and welcomed
participants. Dr. Van Hubbard, Director, DNRC, was on travel and joined the
meeting via phone. Also participating via phone were Dr. Sue Yanovski, National
Institute for Diabetes and Digestive and Kidney Diseases (NIDDK); Dr. Elizabeth
Maull, National Institute of Environmental Health Sciences (NIEHS); Dr. Deborah
Galuska, Centers for Disease Control and Prevention (CDC); Ms. Margaret
McDowell, National Center for Health Statistics (NCHS), CDC; Ms. Jennifer
Weber, Department of Health and Human Services (DHHS) Office of Disease
Prevention and Health Promotion (ODPHP); Dr. Karl Friedl, Department of
Defense (DoD); Dave Bullock, Department of Transportation (DoT); and Dr.
Peter Fischer, Dr. Mary L'Abbe, and Dr. Hasan Hutchinson from Health Canada.
Dr. Starke-Reed thanked the representatives from Health Canada for joining the
meeting and indicated that they would be most welcome at future NCC Meetings.
The agenda for the meeting is provided as Appendix A, and the list of attendees
is provided as Appendix B.

APPROVAL OF MINUTES FROM THE MARCH 3, 2005 NCC MEETING
Minutes from the March 3, 2005, NCC Meeting had previously been sent to NCC
members via email. Dr. Starke-Reed asked if there were any corrections to the
minutes. There were none. Dr. Becky Costello, Office of Dietary Supplements
(ODS), made a motion to approve the minutes, and Dr. Deb Olster, Office of
Behavioral and Social Sciences Research (BSSR), seconded the motion. The
minutes were thus approved and will be posted on the DNRC website,
http://www.dnrc.nih.gov along with the minutes from previous NCC Meetings.

USDA FOOD GUIDANCE: MYPYRAMID
Dr. Eric Hentges, US Department of Agriculture (USDA) Center for Nutrition
Policy and Promotion (CNPP), described the activities that have occurred since
the release of the new USDA food guidance system, MyPyramid. He offered his
thanks to those in DHHS who provided reviews of the USDA food guidance
interactive tool and other related materials. There were fewer than a dozen
corrections to the food guidance system since its release. The MyPyramid
website received 200 million hits in its first week and 100 million hits in the
second week. CNPP is convinced that the choice of delivery through the Internet
was a good one. Over 5,000 email comments have been received, most of
which requested additional information. CNPP plans to evaluate these
comments and respond as needed. They will also do evaluations with nutrition
educators and consumers and revamp the MyPyramid website as necessary.
Another evaluation will be done in a year's time. Because MyPyramid is driven
by food composition data, CNPP plans to work closely with the USDA Nutrient
Data Laboratory to find ways to efficiently update the USDA national food
composition database. Studies on food patterns are being planned to document
that the MyPyramid food guide meets DRI recommendations within caloric
needs.
     A print rider for hardcopies of the MyPyramid materials was sent to Ms.
Kathryn McMurry, ODPHP. She will send it to Dr. Hubbard who will then forward
it to NCC members. Other groups (ADA, commodity groups) are also printing the
materials. Many requests for materials have come in from schools, and the
USDA Food and Nutrition Service (FNS) will take care of these needs. An
advisory committee will do a formal evaluation of MyPyramid after three years to
determine its effectiveness. There was some discussion about negative press of
MyPyramid and about the accessibility of the MyPyramid materials for those
without access to the Internet.

CDC OBESITY MORTALITY STUDIES
Dr. Deborah Galuska, CDC, noted that in the past year, two papers published in
Journal of the American Medical Association (JAMA) by CDC reported different
numbers of deaths associated with excess weight. In the paper "Actual Causes
of Death in the United States, 2000," Mokdad and colleagues (2004) reported
that 365,000 deaths per year were attributable to poor diet and physical inactivity
(350,000 to overweight and obesity). In the paper, "Excess Deaths Associated
with Underweight, Overweight, and Obesity," (KM Flegal, BI Graubard, DF
Williamson, MH Gail. JAMA 293:1861-1867, 2005), the authors reported that
compared to a referent group of normal weight, obesity was associated with
111,909 excess deaths and overweight was associated 86,094 fewer deaths.
    There are two major factors that account for the differences between the 2004
and 2005 CDC studies. The most important factor is that the 2005 study
included two newer national data sets that more accurately reflect the current
health status of US adults, including the well-documented decline in heart
disease mortality. The second factor relates to a number of methodological
differences between the two studies. These differences include: a) the 2004
study used a formula for the population attributable fraction that did not fully
account for confounding factors; b) the 2005 study accounted for the modifying
effect of age on the relation between obesity and mortality; and c) the two studies
used somewhat different "normal weight" categories to define the body mass
index referent group.

US 2005 DIETARY GUIDELINES FOR AMERICANS
Ms. Kathryn McMurry, DHHS ODPHP, noted that since the release of the 2005
Dietary Guidelines for Americans (DGAs) in January 2005, eight sets of dietary
guidance materials have been reviewed by DHHS/USDA for consistency with
them. Any form of dietary guidance for the general public is required by law to be
consistent with the DGAs. If there are questions as to whether materials need to
be reviewed, the materials should be brought to the agency's representative to
the DHHS Committee on Dietary Guidance. Educational and informational



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materials such as the USDA MyPyramid and FDA Nutrition Facts panels are
derived from and are related to the DGAs, but it is the DGA document that serves
as the basis for consistency in nutrition advice among the Departments. ODPHP
is working on some guidance principles with the goal of assisting authors in
preparing materials that are consistent with the preponderance of scientific and
medical knowledge that is represented by the DGAs. ODPHP is working with
some members of the NCC Nutrition Education Subcommittee (NES) on the
initial draft, and plans to ask for further input from the broader DHHS Committee
on Dietary Guidance. These principles should serve as a reference point to
illustrate some overarching principles of the DGAs. ODPHP is tracking common
areas of disagreement among reviewers and will prepare them for discussion at
a future meeting of the DHHS Committee.
     ODPHP will soon begin planning for the 2010 edition of the DGAs. For that
edition, the responsibility for administrative management of the Advisory
Committee will rotate to USDA. All activities related to the DGA development are
accomplished jointly by DHHS and USDA. Healthy People 2010 is preparing for
its Midcourse Review, which is to be published in 2006. There will be a public
comment period this summer on the updated objectives. The dates have been
set for the Third Annual DHHS Prevention Summit; it will be held on October 24
and 25, 2005 in Washington DC.
     Ms. Kim Stitzel, ODPHP, discussed some of the DGA outreach activities. She
mentioned new and existing materials specifically for older Americans, African-
Americans, American Indians, children, and Latinos. The DGA health
professional's toolkit was developed with ADA and will go through review on May
15, 2005. Ms. Stitzel welcomed participation from NCC members in the
development of DGA-related materials.

DIETARY REFERENCE INTAKES (DRIs) RESEARCH RECOMMENDATIONS
Dr. Starke-Reed noted that each of the DRI Reports developed by the National
Academy of Sciences (NAS) Institute of Medicine (IOM) contained a section on
research recommendations. The collection of these research recommendations
(66 pages) will be sent to NCC members as an action item. NCC members will
be asked to respond to indicate how they use the DRIs. A subcommittee will
compile the results to determine what the Federal uses of the DRIs are and the
challenges of incorporating them into research. The results will be used to
formulate how to move ahead with future DRIs.

NIH OFFICE OF DIETARY SUPPLEMENTS (ODS)
Dr. Becky Costello, ODS, provided an update of the activities of that Office. Five
Dietary Supplement Research Centers focusing on studies of botanical products
have been jointly funded by the National Center for Complementary and
Alternative Medicine (NCCAM) and ODS. Research conducted by these centers
will advance the scientific base of knowledge about the safety, effectiveness, and
mechanisms of the actions of botanicals.
- At the Botanical Center for Age-Related Disease at Purdue University, principal
investigator Dr. Connie Weaver and researchers at partner institutions (West



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LaFayette, Indiana; University of Alabama at Birmingham, Albama; Rutgers
University, New Brunswick, New Jersey) will investigate the health effects of
polyphenols (a diverse group of chemical components widely distributed in
plants) from sources such as soy and kudzu. They will study the ability of these
agents to prevent and treat common conditions associated with aging, including
osteoporosis, cognitive decline, and cataracts.
- At the Center for Botanical Dietary Supplements for Women's Health at
University of Illinois at Chicago IL (UIC), principal investigator Dr. Norman
Farnsworth and other UIC scientists are conducting a clinical trial to determine if
black cohosh and red clover provide relief of menopausal symptoms including
hot flashes. In addition to conducting basic and clinical research looking at
standardization, metabolism, and toxicity of botanicals, the Center will support
research training in pharmacognosy (the study of natural products).
- Principal investigator Dr. William Cefalu and researchers at partner Institutions
(Pennington Biomedical Research Center, Baton Rouge, Louisiana; Center of
Agriculture and the Environment of Rutgers University, New Brunswick, New
Jersey) will study extracts of Russian tarragon, Shilianhua (a Chinese herbal
product), and grape seed to determine how they may influence molecular and
cellular processes associated with the metabolic syndrome, which consists of
obesity, insulin resistance, development of type 2 diabetes, and accelerated
cardiovascular disease.
- At the Memorial Slone-Kettering Cancer Center (MSKCC) Research Center for
Botanical Immunomodulators in New York, New York, co-principal investigators
Dr. Barrie Cassileth and Dr. Philip Livingston along with researchers at partner
institutions (Weill Medical College of Cornell University, New York, New York;
The Rockefeller University, New York, New York; Institute of Chinese Medicine at
the Chinese University of Hong Kong, China) will investigate botanicals with
reported ability to modulate immune function (echinacea, astralgus, turmeric,
maitake, and a traditional Chinese formula) and their relevance for the treatment
of cancer and infectious disease.
- At the Wake Forest and Harvard Center for Botanical Lipids, principal
investigator Dr. Floyd Chilton with researchers at partner institutions (Wake
Forest University, Winston-Salem, North Carolina and Harvard University,
Cambridge, Massachusetts) will examine biological mechanisms and clinical
applications of polyunsaturated fatty acids derived from botanicals, such as
flaxseed, echium, and borage. The studies will focus on the anti-inflammatory
actions of botanical oils and their potential to prevent and treat inflammatory
diseases, such as atherosclerosis and asthma.
    ODS is holding a Public Meeting on May 20, 2005 at the Marriott Conference
Center in Bethesda MD. Information about the meeting was distributed and is on
the ODS Web site (http://www.scgcorp.com/odspublicmtg). IC and other Agency
representatives on the ODS Trans-NIH/Agency Working Group have been invited
to attend, and others are also welcome.
    On March 10, 2005, ODS issued a memo for support for dietary supplement
research: grants and conferences and workshops. To coordinate the ODS
review activities with those of the ICs, a June 2005 review session has been



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added. Those who would like to submit a grant or conference/workshop proposal
for ODS co-funding should contact Dr. Costello for details.
    A conference on Use and Misuse of Biomarkers as Indicators of Cancer Risk
Reduction Following Dietary Manipulation will be held at the NIH Lister Hill
Auditorium, NIH Campus, Bethesda, MD 20892 on July 12-13, 2005. Additional
information is available at http://www.scgcorp.com/biomarkers2005/.

UPDATE OF DNRC ACTIVITIES
Dr. Starke-Reed summarized some activities related to the DNRC's Workshop on
Vitamin E held in March 2005. She also noted that the NCC will be establishing
a subcommittee to evaluate nutrition reviews since the Center for Scientific
Review's (CSR) reorganization of study sections.

Nutrition Education Subcommittee (NES). Dr. Jean Pennington, DNRC, provided
an update of the activities of the NIH NCC NES. Since the beginning of 2005, 18
items have come in for review including five from NCI, one from the DNRC, one
from the National Institute of Child Health and Development (NICHD), two from
the National Heart, Lung, and Blood Institute (NHLBI), one from ODS, four from
DHHS, and four from the USDA CNPP. Materials reviewed since the last NCC
meeting include:
 - USDA Food Guidance System Sample Menus and Worksheet (CNPP,
    USDA)
 - BodyWorks Video Script (DHHS Office of Women's Health (OWH))
 - IHEI Children Education Messages (CNPP, USDA)
 - 5 A Day Messages (NCI)
 - We Can! Materials (NHLBI)
 - BodyWorks Toolkit (DHHS OWH)
 - Chromium Fact Sheet (ODS/Clinical Center)
 - Guide to a Healthy Heart (NHLBI)
The DNRC has developed some information on their website (under NCC)
pertaining to the review of nutrition education materials to assist authors who
develop these materials. It identifies the materials that need to be reviewed and
provides an overview of the NES and joint DHHS/USDA review process. A cover
page and checklist (available on request) have been developed for materials to
be submitted to NES.

Subcommittee on International Nutrition Research (SCINR). Dr. Daniel Raiten,
NICHD, was unable to attend the NCC Meeting, but provided some notes
regarding the World Health Organization (WHO) Consultation on Nutrition and
HIV/AIDS in Africa, which took place on April 10-13, 2005 in Durban South
Africa. The Consultation was attended by over 200 participants including officials
from 20 countries of Southern and Eastern Africa, United Nations agencies
(UNAIDS, WHO, UNICEF, WFP, FAO), US Government agencies (NIH, CDC,
OGAC, USAID), 22 non-government organizations, regional networks, people
living with HIV/AIDS, researchers and members of civil society and produced a
"participants statement" that will be included in an official report to the Executive



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Board of the WHO meeting in May 2005. The results of this consultation
represent the first step in the development and promulgation of
recommendations and guidelines by WHO for the full integration of nutrition into
all aspects of prevention, care, and treatment of HIV/AIDS in resource-limited
settings such as sub-Saharan Africa. The delegation from NIH included Dr.
Yvonne Maddox, Deputy Director NICHD; Dr. Faye Calhoun, Deputy Director for
the National Institute on Alcohol Abuse and Alcoholism (NIAAA); and program
staff from NICHD, OAR, and the National Institute for Allergy and Infectious
Diseases (NIAID). The support for this meeting came from a consortium that
included CDC, USAID, OGAC, DHHS (Office of the Health Attache in South
Africa), and several departments within WHO. NIH support came from NICHD,
ODS, NIAID, OBSSR, and the Office of AIDS Research. Dr. Raiten, HSA,
OPRIP, Endocrinology, Nutrition and Growth Branch, NICHD, has played an
active role in these activities as a member of the WHO Advisory Group for
Nutrition and HIV/AIDS and as a member of the core consultation organizing
committee. Mr. Gray Handley, on detail from NICHD to the US Embassy in
Pretoria, South Africa, where he serves as Health Attache and DHHS Regional
Representative, played an active and integral role in the planning and conduct of
this event.

Human Nutrition Research and Information Management (HNRIM) System
Update. Mr. Jim Krebs-Smith, DNRC, provided a status report of the HNRIM
System. He thanked the Institutes and Centers (ICs) for their timely response
and efforts in providing Fiscal Year (FY) 2004 data for HNRIM. At present, only a
few final confirmations remain outstanding, and an email notice will go out to
these ICs tomorrow (Friday, May 6, 2005). The ODS review of dietary
supplement-related coding is also underway, and Mr. Krebs-Smith encouraged
ICs to respond as promptly as possible to ODS requests for code modifications.
He reminded NCC members that HNRIM codes 36 and 37 are used to identify
projects for the ODS CARDS database. In follow-up to a request from the
previous NCC meeting, guidance from the NIH Office of Budget on submitting
data for HNRIM has been posted to the home page of the HNRIM Update
website. (Contact Mr. Krebs-Smith if login information if needed.)

REPORTS FROM NCC MEMBERS AND LIAISIONS
Dr. Wendy Johnson-Taylor, DNRC, and Dr. Amy Yaroch, NCI, announced a Diet
and Communication Workshop which is to be held at the Lister Hill Auditorium on
NIH Campus (Building 38A), Bethesda, Maryland on July 14-15, 2005. This
Workshop is sponsored by the Behavioral Research Program of NCI and by the
DNRC. The Workshop will focus on media and policy issues, specific
populations, and strategic campaigns. The website address is
http://www.scgcorp.com/dietcomm2005/.

Dr. Darla Danford, NHLBI, noted that May is National High Blood Pressure
Education Month, and this year it coincides with the NHLBI release of Prevent
and Control High Blood Pressure: Mission Possible



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(http://hin.nhlbi.nih.gov/mission/). Mission Possible provides accurate, up-to-date
facts about the impact of high blood pressure on the Nation, and materials and
information that can be freely used by community organizations, corporate
wellness programs, health care providers, schools, other organizations, and
individuals to combat high blood pressure in the community and nationwide. No
further permission is required to use any of the content on this site, both during
National High Blood Pressure Education Month 2005 and the rest of the year.
The materials include the 2005 National High Blood Pressure Education Month
Community Kit, fact sheets on high blood pressure for specific target audiences,
healthy eating tips, physical activity tips, Spanish-language fact sheets, Spanish-
language radio spots, a hyperlink, a Call to Action publication to help reach out to
new partners, and ideas for new kinds of partnership activities.

NEXT NCC MEETING
The next NCC Meeting is scheduled for June 2, 2005.

ADJOURNMENT
Dr. Starke-Reed adjourned the meeting at 3:40 PM.

LIST OF APPENDICES
Appendix A - NIH NCC Meeting Agenda for May 3, 2005
Appendix B - NCC Meeting Attendees for May 3, 2005

5July2005draftjp




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      APPENDIX A. NIH NCC MEETING AGENDA FOR MAY 5, 2005
      2:00-4:00 PM, Rockledge 2, Conference Room 9112-9116, Bethesda MD

 1. Welcome..............................................................Pamela Starke-Reed
 2. Approval of Minutes of the March 3, 2005 Meeting....Pamela Starke-Reed
 3. USDA Food Guidance: MyPyramid.........................Eric Hentges, USDA
 4. CDC Obesity Mortality Studies.............................Deborah Galuska, CDC
 5. US Dietary Guidelines..........................Kathryn McMurry, DHHS ODPHP
 6. DRI Research Recommendations..........Federal DRI Steering Committee
 7. Office of Dietary Supplements Update............................Becky Costello
 7. DNRC Activities Update
      Nutrition Education Subcommittee................. ..............Jean Pennington
      Subcommittee on International Nutrition Research... ..........Daniel Raiten
      HNRIM ..................................................................Jim Krebs-Smith
 8. Reports from NCC Members and Liaisons.......................NCC Members
 9. Next Meeting: April 7, 2005....................................Pamela Starke-Reed
10. Adjournment.......................................................Pamela Starke-Reed




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APPENDIX B. NCC MEETING ATTENDEES FOR MAY 5, 2005
                    Members Present Members Absent         Alternates Present
Chairperson:          V Hubbard                            P Starke-Reed

NIH Members:
NCI                                    J Milner
NHLBI                  D Danford
NIDCR                                  R Nowjack-Rayner
NIDDK                  C Miles
NINDS                                  M Mitler
NIAID                  M Plaut
NIGMS                                  S Somers
NICHD                                  G Grave
NEI                                    N Kurinij
NIEHS                  E Maull
NIA                    J Finkelstein
NIAMS                                  J McGowan
NIDCD                                  B Wong
NIMH                                   P Muehrer
NIDA                                   G Lin
NIAAA                                  V Purohit             R Breslow
NINR                                   Y Bryan
NCCAM                  M Klein
NCRR                                   S Kayar
FIC                                    N Tomitch
NCHGR                                  K DeLeon

NIH Liaison Members:
CC                     N Sebring
CIT                                    J Mahaffey
CSR                    S Kim
NLM                                    S Phillips
OBSSR                  D Olster
OC                                     M Stern
ODS                                    P Coates             B Costello
OD/ODP                 B Portnoy
OLPA
ORWH
PRCC                                   M Vogel-Taylor

Agency Liaison Representatives:
CDC/NCCDPHP          D Galuska
CDC/NCHS                               V Burt
FDA                   K Ellwood
HRSA                                   M Lawler
IHS                                    T Brown
ODPHP                K McMurry
USDA                                   M Kretsch
DoD                   K Friedl

DNRC: W Johnson-Taylor, J Krebs-Smith, J Pennington, K Regan, L Somuah

Guests: T Agurs-Collins (NCI), R Breslow (NIAAA), D Bullock (DoT), C Davis (NCI), C Davis
(CNPP/USDA), A Ershow (NHLBI), P Fischer (Health Canada), E Hentges (CNPP/USDA), H
Hutchinson (Health Canada), S Krebs-Smith (NCI), M L'Abbe (Health Canada), J Lyon
(CNPP/USDA), M McDowell (NCHS/CDC), S Pope (NIDKK), J Reedy (NCI), K Stitzel (ODPHP),
R Troiano (NCI), J Weber (ODPHP), S Yanovski (NIDDK), A Yaroch (NCI)




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