Magazine of the Gerald J. and Dorothy R. Friedman School of Science and Policy and the Jean Mayer USDA Human Nutrition Research Center on Aging Summer 2016 Vol. 17 No. 2

Nutrition

THEREADY, OLDER, SET, WISER GO! Simple ways to eat well after 65 Preparing baby boomers to eat well after 65 First Bite

WE DIDN’T GROW THE TOMATO. WE GREW THE FARMER. BATTLE-READY BELLIES

Traveler’s is an intestinal illness usually caused by a dietary fibers that beneficial gut bacteria consume, he hopes to bacterial . It’s a drag for vacationers, but far worse for encourage healthful microbes to thrive in the intestine. “We deployed soldiers. think we can create an environment that really deters the “They are not going to be out in the field fighting; they are growth and invasion of pathogenic bacteria or viruses.” Gerald J. and Dorothy R. going to be compromised,” says J. Philip Karl, N14, a research Karl, who has worked at the Army lab since 2004, has Friedman School of Nutrition dietitian at the U.S. Army Research Institute of Environmental always been interested in behaviors. But he became Science and Policy Medicine in Natick, Massachusetts. “It’s a huge problem.” fascinated by microbiology and bacteriology while finishing his Jean Mayer Human Nutrition A means of keeping the digestive peace may lie in the doctorate at Tufts, where he contributed to a whole- Research Center on Aging portable Meals Ready to Eat (MREs) that soldiers rely on in the study at the Jean Mayer USDA Human Nutrition Research New Entry Sustainable field. Karl is conducting a study of how these packaged rations Center on Aging. Farming Project affect the digestive system to figure out whether tweaking the Adding beneficial bacteria directly into the meals is unlikely ingredients could boost the gut health of military personnel. for now, as the MREs have to be shelf-stable for three years at “We know that bacteria that live in our intestinal tract have a 80 degrees. Karl says the military’s high-tech science big influence on human health,” he says. By changing the might get there one day. But a brownie with extra fiber? It prebiotic content of the meals, likely by adding combinations of could be a first line of peptic defense. —JULIE FLAHERTY

PHOTO: JOHNCREDIT: SOARES TK SUMMER 2016 Contents VOLUME 17, NO. 2

Features

12 UNNATURAL A quarter-million people died in the famine of 2011. It didn’t have to happen. BY JULIE FLAHERTY

14 TUFTS NUTRITION TOP 10 What you need to know to stay hydrated when the temperature soars. BY ELENA NAUMOVA AND EDWARD SALTZMAN

16 READY, SET, GO! COVER STORY Baby boomers will face many barriers to good nutrition as they age. It’s time to get prepared. BY JULIE FLAHERTY

22 TROUBLE BREWING change affects not only how much food we grow, but how it tastes. For crops like tea, small differences could have big economic consequences. BY CLARE LESCHIN-HOAR

26 LOW-ACID REDUX 26 Eating an alkaline diet—with fewer grains and more fruits and vegetables—may keep your bones strong. BY DAVID LEVIN In Every Issue

2 FOOD FOR THOUGHT 4 A LA CARTE Research in Brief 8 DIG IN The Wide World of Nutrition 29 FROM ALL CORNERS , School & Alumni News 36 ASK TUFTS NUTRITION Keep ’Til You Steep Cover photograph by Vito Aluia 8 Food for Thought

MAKE FOOD AN Nutrition

VOLUME 17, NO. 2 ELECTION ISSUE SUMMER 2016

Editor JULIE FLAHERTY AMID THE HOOPLA of the 2016 elections, many important topics Editor-in-Chief have been discussed: jobs, Syria, , immigration, health JOHN WOLFSON care, education, the courts, banking, our relations with other Editorial Director KAREN BAILEY nations, to name a few. While the candidates’ responses may Design Director not always have been satisfying, the issues have at least been MARGOT GRISAR raised and considered. Yet, astonishingly, the 2016 elections Contributing Writers so far have ignored the one topic that is among the biggest LAURA FERGUSON challenges and opportunities of our time: our food. CLARE LESCHIN-HOAR DAVID LEVIN Poor nutrition is the leading cause of poor health in this country JACQUELINE MITCHELL and around the world, causing more and disability than any other factor. ELENA NAUMOVA HELENE RAGOVIN Our food system is also the leading cause of environmental impact: 70 percent of EDWARD SALTZMAN use, 90 percent of tropical , immense challenges to the oceans Contributing Editor and as many greenhouse gas emissions as all the world’s transportation combined. BOB SPRAGUE How we eat is also a leading economic issue. The U.S. spends $3 trillion a year Editorial Advisers on health care—nearly one of every five dollars in the entire economy. From small Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy businesses to multinational companies, crushing health-care costs are a major DARIUSH MOZAFFARIAN, M.D., Dr.P.H., Dean obstacle to growth and success. Remember Congress’ great budget sequestration ELENA NAUMOVA, Ph.D., Academic Dean battle of 2013? That dispute was over $85 billion a year. Alone, diabetes and predi- for Faculty EDWARD SALTZMAN, M.D., Academic Dean abetes—mostly preventable through better lifestyle—cost $322 billion a year. Add for Education other diet-related illness, such as heart disease, cancers, cognitive decline and obe- CINDY BRIGGS TOBIN, Senior Director of sity, and we easily reach $1 trillion annually. Imagine how much less wrangling Development and Alumni Relations and partisanship there would be, and how much more achievement, by returning ANNIE DEVANE, Manager, Web and Communications all these dollars to the national coffers. Improving our food system, and how we Jean Mayer USDA Human Nutrition eat, should be a bipartisan priority. Research Center on Aging This is nutrition’s time. The public is deeply interested in healthy and sustain- SIMIN NIKBIN MEYDANI, D.V.M., Ph.D., Director able eating. Many across industry recognize that their success depends on being SARAH BOOTH, Ph.D., Associate Director part of the solution. Advances in nutrition science and policy have positioned us DEB DUTCHER, Communications Specialist to deliver major breakthroughs toward a healthier and more prosperous America. Tufts Nutrition is a publication of the During these elections, our food system should be front and center, receiving Gerald J. and Dorothy R. Friedman School abundant attention from candidates, the media, debate moderators and the public. of Nutrition Science and Policy and the Jean Mayer USDA Human Nutrition When we elect leaders who are nutrition-aware, we can bring together modern sci- Research Center on Aging at Tufts. It is ence and diverse stakeholders to achieve real change. Learning from past successes, distributed to alumni, students, faculty, staff and friends. we could accomplish in 10 years what required 50 years for tobacco reduction, 70 We welcome your letters. years for car safety, and 100-plus years for water and sanitation. As we enter the last Send correspondence to: lap of the 2016 elections, it’s time for food to be a major issue on the table. Julie Flaherty, Tufts Nutrition, Tufts University Office of Publications, 80 George St., Medford, MA 02155 Tel: 617.627.4273; Fax: 617.627.3549 E-mail: [email protected] Read us online at go.tufts.edu/nutrition

© 2016 TRUSTEES OF TUFTS UNIVERSITY DARIUSH MOZAFFARIAN, M.D., Dr.P.H., dean of the Gerald J. and Printed on 25% postconsumer waste recycled Dorothy R. Friedman School of Nutrition Science and Policy paper. Please recycle.

2 TUFTS NUTRITION | SUMMER 2016 PHOTOS: KELVIN MA LAURELS Four Friedman School professors WASHINGTON and researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at TAKES NOTE Tufts were recognized by the American Society for Nutrition at its Experimental Biology meeting this year. ALICE H. LICHTENSTEIN, THE CONNECTION BETWEEN nutrition and good health has been the Gershoff Professor and known since ancient Greek times, when Hippocrates director of the Cardiovascular declared, “Let food be thy medicine and thy medicine be Nutrition Laboratory, was given thy food.” Still, even after more than two millennia, we’re the David Kritchevsky Career continuing to promote nutrition as the path to preventing Achievement Award in Nutrition. many health risks that threaten vitality as we age. JEFFREY BLUMBERG, a scientist The movement to recognize nutritional well-being as a in the Antioxidants Research issue has been making progress with policymak- Laboratory, took home the Mary ers at the national level. In March, a multiagency committee, led by Swartz Rose Senior Award, given the U.S. departments of and Health and Human Services, released the to an investigator for outstanding National Nutrition Research Roadmap, a blueprint that will guide federal spending research on the safety and efficacy on human nutrition research for the next five years. The roadmap specifically cites of bioactive compounds for human the need to consider certain at-risk groups, including older adults. The scientists at health. SARAH BOOTH, director of the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at the K Laboratory, received Tufts read the report with great enthusiasm, as our research agenda is well repre- the Pfizer Consumer Healthcare sented in the 166-page document. Nutritional Sciences Award, given More recently, U.S. Sen. Ed Markey, D-Mass., reinforced the mission in recognition of recent investiga- of the HNRCA by adding this language to the fiscal year 2017 Agriculture tive contributions of significance Appropriations Bill: “Food and nutrition play a central role in U.S. health, envi- to the basic understanding of ronment and economic development. In fact, diet-related disease has become human nutrition. SUSAN ROBERTS, America’s largest single cause of premature and disability. More research director of the Energy is needed to address the needs of all Americans, with a particular focus on the Laboratory, was selected as the elderly, the fastest growing segment of the population. Therefore, the Agricultural W.O. Atwater Lecturer by the Research Service is encouraged to prioritize human nutrition research to explore USDA’s Agricultural Research the relationship between nutrition, physical activity and healthy and active aging.” Service. The Atwater Lecture, Similar language is being promoted in the House by U.S. Rep. Jim McGovern, cosponsored by the American D-Mass., who sponsored an educational event on Capitol Hill this spring for the Society for Nutrition, recognizes HNRCA to present the redesigned MyPlate for Older Adults to policymakers (see scientists who have made unique page 21). Following the event, Rep. McGovern gave a speech in Congress that contributions toward improving the focused on the problem of “hidden ” among older adults. diet and nutrition of people around While I’m pleased that policymakers are recognizing the importance of the world. nutrition, what matters most is what happens at the household level. Translating DARIUSH MOZAFFARIAN, dean of our research for individual use is important to all of us at the Friedman School the Friedman School, and JEFFREY and the HNRCA, and I’m hopeful that the information we share helps elevate the BLUMBERG, a scientist in the HNRCA importance of nutrition to the vitality of older adults. Antioxidants Research Laboratory, were named to Thomson Reuters’ 2015 list of the World’s Most Influential Scientific Minds. The list recognizes the top thinkers in 21 fields who between 2003 and 2014 SIMIN NIKBIN MEYDANI, D.V.M., Ph.D. published the most papers cited Director, Jean Mayer USDA Human Nutrition Research Center On Aging highly by other scientists.

SUMMER 2016 | TUFTS NUTRITION 3 A La Carte

Human Nutrition Research Center on Aging at Tufts. She says the urge to keep eating what’s in front of you is part of a natural Pavlovian response. “All we have to do is see and smell food, and our sympathetic nervous system revs up, insulin secretion drops blood glucose and our stomach relaxes—the goal of these physiolog- ical changes being to prepare us to eat all the food within reach,” said Roberts, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts. Study author William Masters, a professor at the Friedman School, points out that standard meals are sized for the hungriest customers, so people who need fewer calories are faced with a dilemma. The average adult woman doesn’t need more than 2,000 calories a day, while men average 2,500. “There is a gender dimension here that is really important,” Masters said. “Women, when dining out, typically Restaurant Pitfall have to be more vigilant.” Public health officials have pinned their hopes on new legislation that Today’s Special: A whopping number of calories requires restaurants with 20 or more locations to disclose nutrition infor- mation so their customers can make healthy choices. The authors of the T’S NOT JUST greasy fast-food meals from the big chains that are study write that menu labeling may caloric culprits. In a new study, almost all of the 364 restau- help, but aside from the fact that the rant meals researchers analyzed from across the country con- new law doesn’t apply to about half the tained more calories than one person needs in a single meal. restaurants out there, it won’t address And some of the meals even overshot the calories a person “the basic problem that human neuro- needs in a whole day. biology, rather than lack of willpower, IThe study examined meals served at 123 restaurants in Boston, is a primary drive of overeating” when San Francisco and Little Rock, Arkansas, between 2011 and 2014. it comes to restaurant meals. Even without extras like drinks, appetizers and desserts, the meals Masters said a good option would exceeded a typical woman’s energy needs (570 calories for lunch or be if customers could order partial dinner was the benchmark) 92 percent of the time. portions at partial prices, saying they The worst offenders by cuisine were American, Chinese and Italian would “be able to eat out more often restaurants, which had mean counts of 1,495 calories per meal. without weight gain.” But wait, you say. Can’t people just stop eating when they are The study appeared in the Journal full? It’s not so simple, says the study’s first author, Susan B. Roberts, of the American Academy of Nutrition director of the Energy Metabolism Lab at the Jean Mayer USDA and Dietetics.

4 TUFTS NUTRITION | SUMMER 2016 ILLUSTRATION: ERIN FARLEY RESEARCH IN BRIEF

Zinc and KIDS ARE As the body ages, it SITTING IT OUT becomes more susceptible to infections, thanks to the GUIDELINES RECOMMEND THAT children get an hour of exercise every day, including a half hour during school. Unfortunately, a new study finds natural weakening of the that few kids are meeting that goal, with girls particularly likely to fall immune system. Having too short during school time. A team led by Tufts researchers tracked the physical activity of 453 little zinc in your system can third, fourth and fifth graders at schools throughout Massachusetts for add to the problem. But a a week. They found that only 15 percent of children were getting the 60 minutes of daily moderate-to-vigorous physical activity (such as bike rid- recent study of 25 nursing ing, playing tag or jumping rope) that the Physical Activity Guidelines for home residents found that Americans recommend. Just 8 percent were getting 30 minutes during the school day, as recommended by the Institute of Medicine. supplements can help older The researchers expected the school day to be an equalizer, giving adults bring their zinc levels boys, girls and children of different weights similar exposure to physi- cal activity. “Instead, we found that up and increase the number girls and overweight children were and function of their less active for all measured segments, including during the school day,” T-cells—white blood cells said first author Kristie Hubbard, an that are integral to the adjunct instructor in the department of public health and community immune response. The medicine at Tufts University School researchers, part of the of Medicine. Girls were far less likely than Nutritional Immunology boys to meet the guidelines, as only Laboratory at the Jean 8 percent met the daily total and 2 percent met school-time recom- Mayer USDA Human mendations. Overweight and obese Nutrition Research Center children were also less active, both in and out of school. on Aging at Tufts, say the The researchers also measured findings suggest that getting the students’ light physical activity, such as walking around. Girls and boys did similar amounts of light activity outside of school, but girls enough zinc could help clocked significantly fewer minutes than boys during the school day. reduce the incidence and And all the children did less light physical activity as they got older. Jennifer Sacheck, N01, the study’s senior author and an associate severity of infections in professor at Tufts’ Friedman School, said schools need to give kids seniors, wherever they more opportunities for physical activity—from light to vigorous—and pay special attention to girls. “Clearly, schools need to be aware of this may reside. disparity and should focus on increasing all intensities of physical activity equally for all children across the school day,” she said.

SUMMER 2016 | TUFTS NUTRITION 5 A La Carte

FOLIC ACID CAVEAT

Here’s another case of too much of a good thing: Researchers equivalent of the Recommended Daily Allowance of folic acid, have found that excess folic acid can dampen the immune while another group got 20 times the RDA (very high even for system, at least in mice. a supplement, but it accounts for the mice’s ability to quickly In the study, scientists in the Vitamin Metabolism metabolize the vitamin). The mice who took the high dose of Laboratory at the Jean Mayer USDA Human Nutrition Research folic acid later showed less effective natural killer cells, types Center on Aging at Tufts gave a group of older mice the of immune cells that are important for defending against viral infections and cancer. The findings build on previous research by the same lab: In 2005, it found that 78 percent of healthy postmenopausal women had unmetabolized folic acid in their blood (a sign of excess intake) and that those women had significantly lower natural killer cell activity. Additional research could determine whether excess folic acid actually increases susceptibility to infections and provide guidance on the use of supplements among older adults. The A molecule of folic acid study appeared in the Journal of Nutritional Biochemistry.

There’s Something About Dairy Whole- choices may have a health benefit

CREAMY, RICH, DECADENT … and protective? A recent study by Friedman School researchers found that the dairy fat in milk, yogurt and cheese has a link to preventing diabetes. The research, published in the journal Circulation, followed 3,333 adults over two decades, not only noting what they reported eating, but measuring biomarkers of dairy fat in their blood. In the end, the people who had the most dairy fat in their diet had a 46-percent lower risk of diabetes, compared with people who ate the least. Satiety may explain why. While the study does not prove cause and effect, author Dariush Mozaffarian, dean of the Friedman School, says other studies have shown that when people consume more low-fat dairy, they eat more to compensate. Eating lots of refined, low-fiber carbohydrates that cause spikes in blood has also been linked to a higher risk of diabetes. It may be too early to call whole-fat dairy the healthiest choice, but Mozaffarian says there is enough research to reconsider policies that emphasize only low-fat options. The U.S. Dietary Guidelines, for example, recommend fat-free and low-fat dairy, reasoning that saturated fat—which is found in dairy, meat and other animal —has been shown in several studies to increase LDL cholesterol, a risk factor for heart disease. Mozaffarian would like to see a nice glass of 2 percent back on the table for some people. “Our research indicates that the national policy should be neutral about dairy fat until we learn more,” he told NPR.

6 TUFTS NUTRITION | SUMMER 2016 MOLECULAR MODEL: DR. TIM EVANS/SCIENCE SOURCE STAY ACTIVE FOR A HEALTHY HEART

PEOPLE IN THEIR 70s can likely lower their exercise reduces the risk of heart attack risk of stroke and heart attack with reg- and stroke. But few studies focused on ular moderate exercise, such as walk- whether those benefits held true for ing, according to a Tufts study, which older people, too. Mozaffarian and his provides some of the first evidence that research colleagues at the University continuing to exercise as we age really of Porto in Portugal, the New York does make a difference. Academy of Medicine and the “If you’re more active, you’re going University of Washington believe theirs to do better—especially with respect to is the first large, community-based link between more physical activity heart and brain health,” says Dariush study to include enough participants and lower instances of heart disease, Mozaffarian, dean of the Friedman over age 70 to provide statistically stroke and coronary heart disease, School, who led the study, which was strong evidence of the rewards of exer- even among the oldest people in the published in the journal Circulation.“It cise in older populations. study. The scientists paid particular reassures people that even after age 75, Mozaffarian and his colleagues attention to walking, noting that while being active can make a big difference.” used data collected on more than any walking at all appeared to lower What’s more, the types of exercise 4,200 men and women enrolled in the risk, intensity and duration of physical the researchers studied were activities Cardiovascular Health Study from 1989 activity still counted. many senior citizens enjoy: walking, to 1999. The researchers looked at peo- Study participants who were able to hiking, biking, swimming and mowing ple with an average age of 73 who had no walk faster than three miles per hour or raking the lawn. “You don’t need cardiovascular disease at the beginning experienced about half as many car- to be an ironman,” says Mozaffarian. of the study. By the end of the 10-year diovascular events as those who could “You can walk or garden and not only study, the group had experienced more manage just two miles per hour or less. have fun, but know you’re protecting than 1,100 cardiovascular events. Walkers who covered greater distances your heart and brain.” After controlling for participants or spent more time at it appeared to Researchers have known for some who reported known diseases or ill lower their risk of heart attack and time that for most adults, regular health, the researchers saw a clear stroke even more.

“Natural isn’t always better. It’s often better, but you still have to be smart about a knee-jerk reaction that everything natural is good and artificial is bad. That can get you to an unhealthy diet…I would much rather have people have a little than a large amount of sugar.”

— Professor Susan B. Roberts, director of the HNRCA’s Energy Metabolism Laboratory, in a Fortune.com article

ILLUSTRATION: ELISE GUILLEN SUMMER 2016 | TUFTS NUTRITION 7 Dig In

from other food-rescue Brittany Peats, N15, groups in Boston, including is director of operations at Food Link, a food Food for Free, which has rescue organization. been operating for 35 years. The Greater Boston Food Bank provides guidelines on how long certain foods can be considered fresh, which is often well past the “sell by” date. The goal, of course, is to cut down on waste. Up to 40 percent of food in the —20 pounds of food per person per month—is never eaten, according to the Natural Resources Defense Council. But Food Link is not about saddling the poor with old, damaged goods. “For a lot of people who haven’t been part of the organization, that is their first response: Why are we giving people seconds or expired food? But then WASTE NOT they see it’s all really good,” Peats says. “We tell our There’s a future for food beyond the ‘sell by’ date BY JULIE FLAHERTY volunteers, Don’t pass on any food that you wouldn’t DECIDING HOW TO divvy up to send them any bruised after-school programs, eat yourself.” the 1,000 pounds of extra fruit, which doesn’t fly with veterans groups, low-in- And there is a lot of it. edibles that the food-rescue picky young eaters. come housing facilities, A pickup from the nearby organization Food Link The folks at the senior food pantries and others. Whole Foods nets shop- collects each day is a bit of center, on the other It’s Peats’ job to orchestrate ping carts full of eggs, an art. Surveying a day’s hand, take the occasional the complicated logistics of yogurt, avocados, pickles, haul, Brittany Peats, N15, blemished peel in stride. getting food from where it’s plantains, oranges and the director of operations, “They’ll just make apple no longer wanted to where tomatoes, as well as soups, reasoned that the local sauce,” Peats says. it’s needed. sandwiches and pizzas. boys and girls club would Food Link, based in Since she joined the Back at the Arlington be happy to get the milk, Arlington, Massachusetts, 4-year-old nonprofit as its Food Pantry, which serves because the kids love to collects surpluses from first full-time employee last as Food Link’s base of eat cereal for snack time. restaurants and supermar- year, Peats has been con- operations, some of the And while the apples and kets—including Panera, centrating on streamlining organization’s 80 volun- oranges were also per- Whole Foods and Trader operations. She’s gotten tips teers sort through the fect for the after-school Joe’s—and distributes it to on logistics, reclaimed bounty. Meat programs, she knew not 30 nearby senior centers, and organizing volunteers goes into the food pantry

8 TUFTS NUTRITION | SUMMER 2016 PHOTO: ALONSO NICHOLS THE WIDE WORLD OF NUTRITION

freezer. Peak-ripe strawber- left businesses with four found the projects that up to three years after the ries go to the kids pro- options: Create less food continued to function had projects had concluded. grams. Unfamiliar exotic waste, give the extra to three things in common: Often, programs fruit is puzzled over. (“Are farm animals, compost it an ongoing source of bank on the notion that they supposed to be this or donate it. resources, trained people local people will con- squishy?”) Severely dented Donating it is becom- within the community to tinue to devote time and produce gets marked for ing popular. It’s just the run the activities, and a energy to a project once the chicken farm down the obvious thing to do, Peats way to keep the partici- the resources they provide street for feed and compost. said. “When you unload a pants motivated. are over—but that may be Boxes of seemingly van full of food and it’s just “One of the things we unrealistic. In many of the pristine cookies are well stacked up, you think, of were struck by was how programs studied, mothers within their “best by” date. course we’ll try to give this consistent that was,” says received food to improve They are a discontinued to someone who needs it.” Beatrice Rogers, a profes- their children’s diets, which item, one of the volunteers sor of economics and food served as an incentive to explains, pulled from the policy at Friedman. Rogers participate; when the free shelves to make room for and Jennifer Coates, J94, food ended, however, the new products. These and GRACEFUL N00, N06, an associate women needed to spend other sweet treats are put professor of food policy their time getting food in aside for community meet- EXITS and applied nutrition, other ways, and so they ings and conferences. conducted the study for stopped participating. “Our emphasis is on How do humanitarian the Food and Nutrition “Projects need to make distributing healthy foods,” projects succeed after the Technical Assistance sure that the people they Peats said. “We make sure organizers go home? Project, funded through serve have very clear expec- we’re not overloading kids’ BY HELENE RAGOVIN the U.S. Agency for tations and that the proj- programs and senior citi- International Development ects are transparent about zens with a bunch of sugar IT’S A USEFUL cliché: Give a (USAID). They examined what the plan is from the that they don’t really need.” man a fish and he eats for the exit strategies of 12 beginning,” says Coates. The laws on what foods a day; teach a man to fish USAID projects in four Rogers points to projects in can be donated vary by and he eats for a lifetime. countries—, Bolivia, Bolivia and , in state. Food-rescue groups Veterans of international Honduras and India—and which household members got a boost in 1996, when food-aid initiatives know the legacy of those projects receiving new residential an amendment to the that there is much truth national Good Samaritan there—a successful A successful Law said that people or nonemergency program project businesses that donate food should benefit the popula- in Honduras to nonprofits with best tion even after aid workers intentions are protected have left the scene. from liability. In the most compre- Closer to Tufts, an even hensive study of its kind, bigger incentive came two researchers from the from the Massachusetts Friedman School recently Department of took a close look at whether Environmental Protection, food-assisted development which, in October 2014, programs kept going well banned commercial food after the initial investment businesses from throw- ended, and what elements ing away more than a ton contributed to their of food per month. That long-term success. They

PHOTO: COURTESY OF BEATRICE ROGERS SUMMER 2016 | TUFTS NUTRITION 9 Dig In

water systems knew from ,” Wilde said at the would the start that they would DANGLING event. “It also is to promote expect, be paying user fees to a dietary quality. And these based on spend- community water-man- AN ACTUAL goals are not at all neces- ing data captured agement committee. The sarily in competition with at the checkout committees were trained CARROT each other.” counter. to manage maintenance In late 2011, the USDA Wilde says the funds and perform repairs. Financial incentive to Food and Nutrition Service difference could As a result, most systems promote healthy eating launched the Healthy be chalked up to were still functioning two appears to benefit those Incentives Pilot Program confusion over years later. on public assistance in Hampden County, exactly which fruits “The development program Massachusetts, where more and vegetables community has tra- BY CLARE LESCHIN-HOAR than 5,000 low-income qualified for the ditionally thought of households were given an financial incentive. as a kind of VERY FEW OF us eat enough extra 30 cents for every dol- White potatoes, fruit luxury,” Coates says. Aid fruits and vegetables, and lar of SNAP benefits that juice and any fruits organizations focus on for the more than 47 mil- they spent on a targeted or vegetables with immediate impact, “and lion Americans who partic- list of fruits and vegetables added salt or sugar if there is sustainability, ipate in the Supplemental offered by participating were excluded. that’s icing on the cake. But Nutrition Assistance retailers. For example, a we can envision situations Program (SNAP), formerly When the 12-month participant may have when shooting for large known as food stamps, that program ended, Wilde purchased canned short-term impacts can number is a bit smaller still. and researchers at Abt , but if those peas erode sustainability goals, But what if healthy Associates found the incen- contained added salt, and even sometimes bring fruits and vegetables, like tive had worked. It bumped they wouldn’t qualify harm.” She mentioned a leafy greens or crisp apples, consumption of healthy for the incentive. project in which farmers came with a financial fruits and vegetables by Researchers also did were encouraged to switch incentive for SNAP partic- almost a quarter cup a not have data on from subsistence farm- ipants? Would a tiny bit of day, a 26-percent increase fruits and vegetables ing to commercial crops. extra spending power, just over purchases by SNAP that participants When the project’s timeline a little over $6 a month, be participants not enrolled bought at nonpartic- expired, the farmers did enough to compel shoppers in the pilot. A quarter cup ipating retailers, which not yet have solid links to to move from the snack of extra veggies may not may account for some of markets—leaving them aisle to the produce bin? sound like much, but the the disparity. with no place to sell their The answer turns out to researchers say it’s “large Wilde, whose most crops and no subsistence be a modest yes, says Parke enough to be nutritionally recent paper on the pilot crops to fall back on. Wilde, an associate profes- relevant.” program was published Food for Peace has sor at the Friedman School. The study also found in December 2015 in the already incorporated many He spoke about recent that the overall calorie journal Applied Economics of the recommendations research on this and other intake of participants who Perspectives and Policy, says from the Tufts study in proposed changes to the ate more fruits and vege- the program may have per- its guidance to aid orga- SNAP program that aim to tables did not rise—good suaded SNAP participants nizations. “With the U.S. promote healthy diets while news for those concerned to eat more of all types government spending still helping people get with rates. of fruits and vegetables, approximately $2.5 billion enough to eat, at the White But there was an under- including those that didn’t annually on food-aid House Conversation on lying mystery associated qualify for the incentive. programming,” Coates Child Hunger in America with the pilot program. And, he adds, the pilot may says, “the issue of preserv- in January. The quarter-cup increase have played a positive role ing development gains “The goal of SNAP, in fruits and vegetables in influencing awareness from these investments is above all, is to protect food that participants reported among participants. paramount.” security and to prevent eating was more than one “It could be the whole

10 TUFTS NUTRITION | SUMMER 2016 pilot program had a mar- muscle strength, leg muscle an association between power reported less pain keting effect in addition to power and perceived knee more muscle strength and better quality of life, the explicit price incen- pain in people with osteo- and reduced pain—that overall, the participants tive,” he says. “Promotion arthritis of the knee. is, stronger people felt in the study were pretty of healthy diets, backed up Reid’s team gathered better—others saw just the frail. With an average age by a real financial incen- their data by measuring opposite. Measuring mus- of around 60, this group’s tive, increases fruit and the leg muscle strength cle power could eliminate muscle power was more in vegetable intake. It’s a sign and power of 190 men and the noise in the data. line with “mobility-limited that marketing plus price women, ages 41 to 90, with “The key difference older adults with a mean incentive is more effective knee osteoarthritis. They between training for build- age of about 80 years,” the than either alone.” assessed the strength and ing strength versus power researchers wrote. Whether power mainly of partic- is the speed at which the that’s a cause or an effect CLARE LESCHIN-HOAR is a freelance ipants’ quadriceps—the training is performed,” says of their knee pain, Reid writer in San Diego. big muscles on the front of Reid. “You can train on the can’t say without further the thigh—but also that of same machines to develop research. other leg muscle groups, strength and power, and But he says he wouldn’t including those in the but- with the same exercises— hesitate to prescribe them FAST tocks, hamstring and calf. leg curl, leg extension, exercise, especially based Participants were asked to bicep curl, etc.—but to on his previous experi- MUSCLES, perform a set of leg exer- develop muscle power ence as a scientist on the cises known as a double leg you have to perform the Lifestyle Interventions HAPPY press extension on an exer- exercise very fast or as fast and Independence for cise machine. Seated, the as you possibly can.” Elders study, led by Roger KNEES subject brings the knees Improving muscle Fielding, a senior scientist to the chest and presses a power instead of just and director of the HNRCA It’s power, not strength weighted plate away from focusing on strength Nutrition, Exercise that fights arthritis pain the body. The faster they training might prove to Physiology and Sarcopenia BY JACQUELINE MITCHELL can do the press, the better be a more useful clinical Laboratory. That study, their muscle power. goal, says Reid, who works which focused on sedentary SCIENTISTS AT TUFTS have The researchers found in the Nutrition, Exercise men and women ages 70 determined that a lack that people with greater Physiology and Sarcopenia to 89, “really showed for of leg muscle power— leg muscle power reported Lab at the HNRCA. the first time that we can the capability of the leg less knee pain and better “In previous studies, prevent or delay mobility muscles to rapidly exert quality of life. Muscle we’ve found that compared loss in at-risk older persons force—is a more accurate strength, however, was to muscle strength, muscle using a structured exercise predictor of knee osteo- linked to lower quality of power is a stronger predic- intervention,” says Reid. arthritis pain than simple life in some circumstances. tor of performance in tasks “We’re big advocates of leg strength, a finding that However, Reid doesn’t that are really important having older people exer- could lead to better diag- believe those data are to older people and their cise,” he notes, adding that nosis and treatment of the contradictory. physical independence, more research is needed to often debilitating disease. “We think power is a such as being able to get up determine the safest and Led by Kieran F. better way to evaluate the out of a chair or climb a most effective way to build Reid, an exercise physi- overall performance of flight of stairs,” he says. muscle power in older ologist at the Jean Mayer skeletal muscle compared Focusing on building people with knee osteoar- USDA Human Nutrition to strength,” he says. muscle power could prove thritis. “We know from the Research Center on Aging Their findings bring critical to staving off data that the older popu- (HNRCA) at Tufts, the some clarity to the scien- both osteoarthritis and lation tends to be the most study, which appeared in tific literature about the mobility problems in an sedentary, but they are also the journal Arthritis and role of musculature in aging population. While the most likely to benefit Rheumatology, examined knee osteoarthritis. While Reid’s team found that from exercise interven- the relationships among leg some studies have found people with greater muscle tions,” he says.

SUMMER 2016 | TUFTS NUTRITION 11 Global View Dan Maxwell says the was just one factor in the famine. “When you start to think about accountability, it’s pretty clear nobody 250,000 people could have escapes unscathed.” been avoided, says Dan Maxwell, a professor of nutri- tion and humanitarian studies at the Feinstein International Center and the Friedman School of Nutrition Science and Policy at Tufts. In their new book, Famine in Somalia: Competing Imperatives, Collective Failures, 2011-12, Maxwell and coauthor Nisar Majid examine what went wrong with the response to the crisis. They say it was human decision-making that stymied efforts to prevent or mitigate the worst impacts of the drought, the food-price crisis and ongoing conflict in the region. Maxwell and Majid call for account- ability from the people who made certain decisions along the line, includ- ing leaders in governments, armed groups, donor organizations, human- itarian agencies and academia—and they make no bones that analysts and academics like themselves could and should have done more to sound the alarm. Only by talking about mistakes openly, they say, will the humanitar- ian system keep such tragedies from repeating. Maxwell talked with Tufts Unnatural Nutrition about the fallout. TUFTS NUTRITION: You say that despite the drought, this famine didn’t have to happen—that it was human factors that Disaster led to so many deaths. DAN MAXWELL: First of all, the governing A quarter-million people died in the Somalia famine of 2011. authority in south central Somalia, It didn’t have to happen. BY JULIE FLAHERTY Al-Shabaab, was opposed to human- itarian assistance, and food aid in particular. It expelled agencies or threatened them to the point that they HE SOMALIA FAMINE of 2011 was sparked by a confluence left. So several of the major agencies of . A major drought ruined crops, killed that could have responded to a cri- livestock and took away wage labor opportunities for sis of this magnitude, such as CARE people who relied on them. At the same time, global International and the [U.N.] World happened to rise sharply, a devastating Food Program, were not there. blow for Somalia, which relies on food imports even in Second, Al-Shabaab had been the best of times. labeled as an international terrorist T Yet even with those factors, the famine that killed organization several years earlier, so

12 TUFTS NUTRITION | SUMMER 2016 PHOTO: ALONSO NICHOLS there were increasingly dire warnings people in business, people in urban used overwhelming to buy food or pay that humanitarian agencies should areas such as Nairobi and Mogadishu, down debt—debt mostly incurred buy- not allow any assistance from Western people in the diaspora around the ing food before there was a response. donors to end up in Al-Shabaab hands. world. If you had a brother in the U.K. The other argument was about whether Agencies were so worried about the or a son in the Middle East who was injecting cash into the economy would legal and reputational risks of being sending you a regular remittance, simply drive high food prices even seen to be “assisting” terrorists that you survived. There was also a second higher. That also turned out not to be they were actually self-censoring, sort of network. Instead of one person the case. pulling themselves out even when they sending money to a family member, it Unfortunately, there has been a had some degree of access. Up until the famine was declared, there was a clear prioritization of a counterterror- ism imperative over a humanitarian “ Up until the famine was declared, imperative. Given that the epicenter of the affected area was well inside there was a clear prioritization of a Al Shabaab-controlled territory, the cumulative effect was that only limited counterterrorism imperative over a efforts at prevention, mitigation or response were mounted until after the humanitarian imperative.” famine was declared.

What else contributed to it? The international response to the crisis would be groups in the diaspora raising big effort to isolate these hawala from was far too little and far too late. By the money to send back to their commu- Western banks because of fears that time the famine was declared, mortal- nity in Somalia—to support people they might be channels for getting ity had already peaked. Even with the even beyond their immediate family. money to terrorist groups. What that drought and the food-price crisis, had does is strangle the means by which there been a widespread consensus that So how did aid agencies eventually millions of people survived in the hope prevention and mitigation was a pri- respond? that you might dry up a handful of ority, I doubt that it would have tipped A number of agencies wanted to provide terrorist cells. over into an actual famine. cash transfers and let people buy what The purpose of having an early they needed. The long history of people Why is accountability important? warning is that we get a good idea of migrating away from Somalia and Every time one of these events happens, what will happen, and we intervene remitting money back to their families we say this can never happen again. But early. And there is a lot of evidence that meant there was already an informal much of what we focus on are technical shows it is much more cost effective to money-transfer system in place. The fixes. We don’t look at who is respon- do so. But if you insist on seeing figures local agents of these transfer companies, sible for making the decisions that led for severe malnutrition and mortality known as hawala, more or less knew to this happening. Famines only rarely before you respond to something, then everyone in the community. There result from situations outside of human by definition you are already too late. was practically universal cell phone control. We shouldn’t have to learn this again. coverage, so you had a mechanism for When you start to think about informing people. And then you had accountability, it’s pretty clear nobody If Al-Shabaab was keeping food aid this network of food traders who were escapes unscathed. You can blame the out, and Western humanitarian agen- much better than humanitarians at donors for being late. You can blame cies were not able to engage, what did negotiating access, getting across battle the agencies for not having the courage people do? lines and getting into places. to respond. You can certainly blame What really determined whether There was a big argument at the Al-Shabaab. Part of the reason we people survived was the social network time that people would use the money wrote the book was to put this discus- that people could call on to help. Much to buy other things. We looked at that sion on the table, even though it can of this falls along clan or lineage lines. very carefully. It turned out that the be uncomfortable for people in the Some clans had more educated people, money from these cash transfers was humanitarian enterprise to address.

SUMMER 2016 | TUFTS NUTRITION 13 H O T

Tufts Nutrition TOP 10 How to stay hydrated when it’s hot

Here, in no particular order, are some thirst-quenching things to keep in mind when the mercury rises, according to Elena Naumova and Edward Saltzman, both professors and academic deans at the Friedman School. Saltzman, a physician, is also a scientist in the Energy Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging. Naumova, an adjunct professor at the School of Medicine, points out that dehydration is particularly dangerous for senior citizens, thousands of whom are hospitalized in the United States each year with heat-related illnesses, at a cost of about $27 million annually.

14 TUFTS NUTRITION | SUMMER 2016 TAKE IT EASY. HYDRATE IN ADVANCE. DRINK FRUIT JUICE When it’s hot, our bodies don’t respond If you anticipate being exposed to hot AND SUGAR-SWEETENED to physical activity as well. High temperatures, especially if you are BEVERAGES IN MODERATION. humidity further impairs your going to be physically active, These beverages help prevent dehy- body’s response. The best way prepare by drinking 1 to 1.5 dration, but they also contain calories, to avoid dehydration and quarts of fluid in the two which can add up quickly when you other types of heat-related to three hours beforehand. guzzle them. Very sweet drinks may injury to is kick back when Consider drinking even also make you feel thirstier, a physio- the temperature is higher more if the activity will be logical trick of absorbing all that sugar. than usual. If you have prolonged and strenuous— cardiovascular disease, diabe- up to 1.5 quarts for every 100 SPORTS DRINKS AREN’T tes, some types of lung disease or a pounds of body weight. NECESSARY FOR MOST PEOPLE. number of other conditions, you are at Unless you engage in strenuous activity especially high risk for dehydration and DRINK DURING HEAT EXPOSURE. in the heat, it is unlikely that drinks heat-related injury. The amount of fluid you need depends that contain and electro- on your body size, age, gender, the tem- lytes, such as sodium and potassium, DRINK WHEN YOU’RE THIRSTY. perature and humidity, and degree of will provide a clear benefit over other Forget the popular wisdom that physical activity. Aim for a minimum drinks. These drinks are more likely to everyone needs eight glasses of water of one quart every two to three hours. benefit athletes who train or compete per day—it’s not based on current If you get thirsty, drink more. in hot temperatures. science. Healthy people typically need to consume fluid just until they are FLUID TYPES FLUIDS IN FRUIT AND no longer thirsty, often referred to as AND TEMPERATURES VEGETABLES COUNT. “drink to thirst.” But on hot days, do DON’T MATTER. Nonstarchy vegetables and pay attention to the warning signs of All types of beverages will fruit—such as cucum- dehydration, including lightheaded- help you stay hydrated, includ- bers, lettuce and, of course, ness, weakness, decreased energy and ing water, carbonated beverages, watermelon—contain water, dark or infrequent urination. If you flavored beverages and even milk or hot which counts toward your fluid intake. experience these signs, you should chocolate. Make sure you have ready The same is true for foods that are drink more, cease physical activity, get access to drinks you like. prepared with water, such as soup. But someplace cooler and seek medical don’t rely on these foods to completely attention, especially if you have CAFFEINATED DRINKS ARE OK meet your total fluid needs—you still diabetes or heart disease. IN MODERATE AMOUNTS. need to drink. Contrary to prior belief, there is little evidence to suggest SPICY FOODS DON’T HELP. that caffeinated beverages Eating spicy foods can make you sweat, act as diuretics, at least in which helps dissipate body heat. But it’s the amounts that many people likely that being in hot temperatures consume. But larger amounts, such will have you sweating plenty without as more than 16 ounces of coffee or 32 the need to reach for the ghost peppers. ounces of black tea, may cause you to urinate more, contributing to fluid loss. Also, remember that caffeine may have extra stimulant effects if you drink Hmore than Oyou usually do.

ILLUSTRATION: PETER GRUNDY T SUMMER 2016 | TUFTS NUTRITION 15 READY,

GOOD FOOD has always been a prior- ity for Vyrl Robinson. As a child, she spent summers on her mother’s farm, where she learned to and “put up” fruits and vegetables. She learned to cook for a crowd as the youngest of 10 children. When she and her hus- band built their house in Burlington, Massachusetts, she planted a large SE T, garden and made her own preserves. Now 79 and widowed, Robinson still loves fresh produce, but she’s retired and lives on a fixed income, which makes it hard to justify the expense. So she was one of the best customers at the free weekly farmers that the Burlington Council on Aging orga- nized last year. She liked to try out new vegetables when the market provided interesting recipes—that’s how she discovered her taste for baked kale. “It’s just like eating potato chips,” she said. “They are crunchy like that.” GO! But Robinson doesn’t think she’ll make it back to the farmers market Baby boomers will face many barriers to good this year. She has back problems and emphysema and has had more than one nutrition as they age. It’s time to get prepared. heart attack. And with both her knees in need of replacement surgery, she has started using a walker (“I tried so hard BY JULIE FLAHERTY to get off it,” she said), which makes the PHOTOGRAPHS BY KATHLEEN DOOHER eight steps down to the street from her house a new barrier. So she relies a bit more on the Meals on Wheels delivered to her door. It’s a big help, although they do tend to cook the broccoli more than she likes. Robinson’s story highlights a widespread, though little recognized,

16 TUFTS NUTRITION | SUMMER 2016 SUMMER 2016 | TUFTS NUTRITION 17 problem in seniors: malnutrition. “The idea is that providing people in Getting older creates obstacles to eating their 60s with a concept of how to eat well at the very time that it’s most will prepare them when their lifestyles important to do so. When seniors don’t change in their 80s,” said Simin Nikbin eat enough, don’t eat the right foods Meydani, director of the Jean Mayer or lose the ability to absorb certain USDA Human Nutrition Research nutrients, it can cause physical decline Center on Aging (HNRCA) at Tufts. or exacerbate pre-existing conditions. 30s—and your metabolism will slow Now, nutrition researchers at Tufts are NEEDS CHANGE down, which means you’ll need fewer joining a nationwide effort to address Your body changes significantly as you calories than you once did. At the same the problem, including educating baby age, a process that calls for changes time, your nutrient needs will stay the boomers about the importance of in how you eat. For one thing, your same or even increase. Your body may diet long before they are living alone muscle mass starts to shrink—a begin to have trouble absorbing certain or dealing with physical limitations. decline that actually begins in your nutrients, such as B12 and magnesium,

FREE AND FRESH, FOR SENIORS ONLY

They say that it stretches their food budget farther because Center in Dorchester, Somerville/Cambridge Elder Services and their produce is covered for the week. And most report that councils on aging in Burlington, Peabody and Arlington. they are eating more vegetables. Devin Ingersoll, the food-access facilitator at New Entry, But just as important, the free weekly farmers market says that project organizers weigh the specific challenges that put on by the Council on Aging in Burlington, Massachusetts, seniors face in eating well. For instance, cooking can be difficult offers senior citizens a whole lot of social engagement. for this population, so project organizers include lots of foods “For some, it’s their only outing for the week,” said Marge that can be eaten raw, such as blueberries, apples, lettuce and McDonald, director of the council. cherry tomatoes. They’re also mindful of the dietary restrictions All the food at the market comes from the New Entry that can accompany old age, so kale, that nutritional power- Sustainable Farming Project, an initiative of the Friedman house, is offered only sporadically, as its high vitamin K content School and other partners that trains beginning farmers and can interfere with blood-thinning medication. helps them sell their crops through the World PEAS Food Hub. The success of the program reflects something the AARP In 2008, World PEAS began offering free or subsidized fresh Foundation discovered when it surveyed people ages 50 and produce to those in need, many of them older adults. Last year, over about what would help them eat more nutritious foods. the project supplied more than $90,000 worth of free produce The most popular response was “ways to find affordable fruits to 14 programs in Massachusetts, including the Kit Clark Senior and vegetables” where they live.

18 TUFTS NUTRITION | SUMMER 2016 To celebrate Older Americans Month in May, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts partnered with the Age-Friendly Boston project to give local senior citizens a tutorial on healthful grocery shopping. so every bite will need to provide that much more nourishment. “When you are younger, you don’t think it’s a big deal: You have a cup of tea, a bagel, that’s it,” said Shirley Chao, director of nutrition for the Massachusetts Executive Office of Elder Affairs, who received her Ph.D. from the Friedman School in 2008. But as you get older, the need for nutrient-rich foods becomes a big issue. And what if you don’t get enough? Malnourished seniors may lose weight, it is attacked to produce all kinds of the nutrition status of seniors and look get tired or become anemic. They are defensive mechanisms. And in order for ways to prevent malnutrition. That more likely to have diminished muscle to produce those defensive weapons, it may be smart public policy, because strength—a prime risk factor for falls— needs to have , essential amino it’s more than the seniors themselves and wounds that fail to heal properly. A acids, essential fatty acids, all kinds of who feel the effects of poor nutrition. 1995 study looked at a sample of patients .” Infections can also A recent study published in the Journal admitted to an intensive care unit and diminish your appetite and decrease of Parenteral and Enteral Nutrition esti- found that 43 percent of them were the body’s ability to metabolize nutri- mated that the national cost of treating malnourished; they were more likely to ents, further decreasing the immune illnesses related to malnutrition (any- have complications and longer hospital system’s arsenal. “It becomes a vicious thing from heart disease to depression) stays than other patients. cycle,” Meydani said. was $157 billion a year. With age, the immune system starts For decades, officials have recognized to malfunction, which means optimal malnutrition as a problem among older NEW CHALLENGES nutrition is particularly important for Americans. But with the eldest baby So what causes malnutrition in seniors? fighting off illness when we get older, boomers turning 70 this year, there To begin, there are financial constraints. said Meydani, who also heads the is a sense of urgency to find out just A recent AARP Foundation survey of HNRCA’s Nutritional Immunology how bad the problem is. Lawmakers in people ages 50 and older who live below Lab. “You have to think of the immune Massachusetts and Ohio, for example, 200 percent of the poverty line found system as a factory,” she said. “The are considering legislation that would that two in five had cut down on food factory needs to be ready as soon as create commissions to gather data on or nutritious meals in the prior year,

SUMMER 2016 | TUFTS NUTRITION 19 because they couldn’t afford them. But it is not just low-income Americans who are at risk, Chao said. “People are surprised when they see Meals on Wheels going to well-to-do communities,” Chao said. “What they don’t understand is that when you get old, you face the same problems regardless of income.” According to the U.S. Census Bureau, more than 38 percent of people ages 65 and over had at least one disability in 2010, with “That’s the hidden malnutrition.” conducted by the AARP Foundation, the most common involving walking, However widespread it may be in which sponsored and partnered with the climbing stairs and doing errands. That society, and however great its cost, mal- HNRCA on the MyPlate project, found makes chores like shopping and cooking nutrition still too often goes unnoticed. that while interest in eating nutritious impossible for many. “If you go to your physician, they will foods increases with age, understanding Then there’s the fact that eating weigh you and check your heart, but of what’s on a nutrition label declines. itself may no longer be as pleasurable they are not measuring your nutri- “There is a real need to fill that gap and for seniors. Medications can affect tional status,” Meydani said. ensure older adults have the knowledge the ability to smell and taste, as does and resources they need when they are aging itself. Meydani points to studies SMALL CHANGES choosing what to eat,” said Alex Lewin- showing a close correlation between Senior advocates are pushing for Zwerdling, a senior adviser for the loss of smell and illness and death in changes that could help address this AARP Foundation. older adults. And the act of eating can silent . Meydani would like As MyPlate makes clear, better become more difficult, thanks to lost to see doctors monitor their patients’ nutrition doesn’t have to involve a major teeth that make chewing arduous, or bloodwork for signs of malnutrition, diet overhaul. Even small changes, such arthritis that makes handling a knife and hospitals use a standardized as switching from salads made with ice- painful. Just as challenging for many system for keeping track of nutrition berg lettuce to ones with nutrient-rich seniors is that a meal may no longer be status. The Supplemental Nutrition spinach, could make a difference in a social experience. That’s because even Assistance Program (SNAP), formerly overall health. “Tea and toast can turn as more people are living independently known as food stamps, could make into a bowl of oatmeal with a banana,” for longer periods—Chao said that it easier for seniors to use the SNAP Chao said. “It’s just as easy to make.” there are more than 150 Massachusetts benefits that are available to them (only To spread the word, HNRCA centenarians still living in their com- two in five seniors who are eligible researchers recently helped the Harvard munities, an unprecedented num- currently enroll). Pilgrim Health Care Foundation create ber—many of them are doing so alone. To help seniors make good eating a booklet, “Healthy, Delicious Food Isolation, depression and just not caring choices, HNRCA scientists recently at Every Age,” which highlights how to cook for one person can lead to many released an updated version of MyPlate seniors can shop for, cook and even seniors simply not making nutrition a for Older Adults, an infographic that grow nutritious food; the publica- priority. “They have tea and toast in the provides a simple, pictorial guide to tion also describes some of the most morning; then for lunch and supper a healthy diet (see “A Healthy Meals common food and drug interactions. they just sort of get by,” Chao said. Cheat Sheet,” page 21). A recent survey Researchers in the HNRCA’s Nutrition,

20 TUFTS NUTRITION | SUMMER 2016 Participants walked together from of precut vegetables or the like, may be Chinatown to the Boston Public Market, on the horizon. “The private sector is where they met the vendors and hunted for items shown on the new MyPlate for becoming more and more interested in Older Adults. identifying solutions for older adults and healthy eating, in part because it is a huge market opportunity,” said Lewin- many nutrition programs, senior Zwerdling. That could mean foods that centers and councils on aging across are formulated with seniors’ nutritional Massachusetts have started offering needs in mind, and easy-to-open pack- classes on cooking for one or shopping aging with easy-to-read labels. with nutrition in mind. Meanwhile, public health officials Businesses also have a role to play. would like to see more seniors as Chao said that many seniors have trou- engaged as Vyrl Robinson. Shopping ble finding the quantities and prices and cooking may be harder than they they want at the supermarket: They used to be, but she still cares about Exercise Physiology and Sarcopenia might not have use of, say, a large bag what she eats. She recently made veg- Laboratory also worked with three of potatoes, but they still want to get etable soup from scratch and shared it Boston senior centers to create the the bulk discount. “Maybe it is time to with a neighbor. “You don’t want to live Fit-4-Life program, which combines have a senior lifestyle aisle,” she said, on sandwiches,” she said. nutrition education with instruction in the same way that stores have aisles on aerobic and mobility exercises. dedicated to organics and babies. JULIE FLAHERTY, the editor of this magazine, can be At the same time, Chao said that Such a section, with small packages reached at [email protected].

A HEALTHY MEALS CHEAT SHEET

Many seniors want to eat well; they just don’t know where of the goals of creating the new infographic was to let seniors to start. To help, scientists at the Jean Mayer USDA Human know that they have options. Getting to the store regularly for Nutrition Research Center on Aging (HNRCA) at Tufts have fresh produce may be difficult for those who no longer drive, just released the latest version of MyPlate for Older Adults, a or who “may be reluctant in the winter to go out,” Lichtenstein simple, easy-to-follow diagram for nutritious eating. It is based said. That’s why the modified graphic gives equal prominence on the 2015-2020 Dietary Guidelines for Americans, and its to frozen fruits and vegetables, as well as to low-sodium overarching advice could apply to adults of any age. But the canned versions, which have longer shelf-lives. graphic and accompanying website The graphic also acknowledges provide tips and reminders that are that seniors may no longer be cook- particularly suited to the needs and ing for a big family, or even a spouse. concerns of seniors. “With a bag of prepeeled carrots or As a person gets older, “one needs frozen broccoli, you can snip it open to be a little more careful about choos- and just take out a single serving,” ing food. The amount of nutrients she said. per calorie should be relatively high,” The MyPlate for Older Adults said Alice H. Lichtenstein, director of points out that cheese and yogurt the HNRCA Cardiovascular Nutrition have something in common with Laboratory and the Gershoff Professor fish, eggs, poultry and nut butter. at the Friedman School. “We moved them into the protein Lichtenstein, who served as vice quadrant because dairy is an excel- Learn more and download a copy of MyPlate for chair of the 2015 Dietary Guidelines lent source of high-quality protein,” Older Adults at hnrca.tufts.edu/myplate Advisory Committee, said that one Lichtenstein said.

SUMMER 2016 | TUFTS NUTRITION 21 1 2

3 Trouble Brewing BY CLARE LESCHIN-HOAR PHOTOGRAPHS BY COLIN ORIANS

Climate change affects not only how much food we grow, but how it tastes. For crops like tea, small differences could have big economic consequences.

22 TUFTS NUTRITION | SUMMER 2016 5 6

1. Developing tea buds are often hand-picked to make green tea in the spring. 2. The tea team researchers explore insects known to increase tea . 3. Workers trim plants when temperatures are high. 4. Plucking leaves at a Longjing plantation 5. Drying leaves that will become Oriental Beauty tea 6. A tiny, beneficial leafhopper on a 4 leaf at the Shanfu garden in Fujian

hether it’s a farmer’s crops or “But you want just the right amount of preda- our own skin, bug bites are some- tion,” says Sean Cash, an associate professor at the thing few of us seek out or covet. Friedman School of Nutrition Science and Policy But the nibble of a green leafhop- at Tufts. per is the secret to the sweet flavor As any farmer can tell you, getting precisely and honeyed aroma of an oolong tea known as the right balance of beneficial insects can be Oriental Beauty. The bug’s bite sparks a chemi- tricky. Changes in pests (too many, too few, too cal response in the plant, enhancing that early, too late, the wrong ones) goes hand-in- delight tea drinkers. hand with , as Tufts Ph.D. student The leafhopper is considered a pest by many in biology Eric Scott is investigating in . It plantations, but certain farms in Taiwan and is just one of the areas being studied by a global China now encourage the insects because growers interdisciplinary team led by Tufts University have figured out that there’s a useful (and eco- researchers, who are in the midst of a four-year nomic) upside to letting them dine a little. project examining the impact climate change has

SUMMER 2016 | TUFTS NUTRITION 23 on Chinese tea production. feed the world’s population,” says Cash. close look at data and tea har- Unlike many agricultural studies out “This project is different because we’re vests using records dating back to 1980. there, this project isn’t a single experi- looking at the quality of the product— They found that the monsoon season ment, says Tim Griffin, director of the not just how much tea is being pro- was ending later and later and brought Agriculture, Food and Environment duced, but how good is it.” heavier rainfall—conditions that were Program at the Friedman School. And Nuances in quality may not matter associated with reduced tea yields, it’s one that includes a broad array of as much when you look at such crops as possibly because it was harder to harvest collaborators at Tufts as well as from , corn, soybeans or rice, but when and dry the leaves. Montana State University at Bozeman, it comes to tea, small differences matter The extended also Boston University, the University of a great deal. “For example, you can grow reduced tea quality. That’s because while Florida and the Tea Research Institute in wheat to have more protein, but most is monsoon rains bring a flurry of plant Hangzhou, China. grown for yields, and much less for the growth, they also change the chemistry While Americans may reach first quality,” says Colin Orians, a plant biol- of tea leaves. Selena Ahmed, an ethno- for coffee, tea holds the world title as ogist at Tufts. “Tea is one where quality botanist at Montana State University the most widely consumed beverage is really important to the final product. who did her postdoctoral research at after water. In 2012, 4.6 million tons of Grapes are also like that. You can’t make Tufts University, led a 2014 study that it was grown in 50 countries. Although a bad grape taste like a good wine.” analyzed a variety of Chinese tea sam- this calorie-free drink cannot directly All the tea we drink—green, oolong ples, including tea harvested from the prevent hunger, it’s a crop that’s eco- or black—is from the same species of same fields at different times of the year nomically important to the livelihoods plant, an evergreen perennial shrub and tea from varying elevations. The of more than 83 million rural people called Camellia sinensis. Many of the study, which included work by Cash, in China and India alone. And it’s also style differences come from how it’s Griffin, Orians and Albert Robbat Jr., one that’s vulnerable to climate change. processed after harvest. Says Cash: “It’s director of the Tufts University Sensory Teams of biologists, chemists, econo- the equivalent to ‘how dark do you and Science Center (TUSSC), showed mists and a host of other researchers roast your coffee?’ ” that rains prompted faster leaf growth, involved in the project are studying Processing, however, is not the but important catechin and methylxan- the breadth of those climate impacts— only factor to affect flavor, aroma and thine metabolites in the leaves dropped everything from tea quality to consumer nutrition, which make up a tea’s quality. by 50 percent. These metabolites are behavior to how farmers are adapt- conditions are keenly import- partly responsible for the flavor, aroma ing—and looking for methods to help ant, too. With climate change, Chinese and antioxidant content of the tea. mitigate risk to farmers’ livelihoods. farmers had noticed that the East Asian The precipitous drop in tea quality Many researchers are already monsoons were arriving earlier and happens surprisingly fast. Chinese looking at crop yields and how we can lasting longer. The researchers took a farmers have long known that leaves

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1. Buds on a recently trimmed plant 2. Workers pluck tea leaves at a Longjing tea plantation. 3. Drying leaves at a plantation in Fujian that specializes in Oriental Beauty tea

24 TUFTS NUTRITION | SUMMER 2016 and buds collected before the mon- anthropologic perspective, by talking reinforced their opinions. soon season begins bring a premium to Chinese farmers and tea-drinking “When consumers knew what they price. Monsoon teas sold for an average consumers. were drinking, they liked the premon- of half what they were getting for They assembled a trained panel of soon tea even more, and that differ- their premonsoon , with the 10 tea experts at Tufts. Their role wasn’t ence was statistically significant,” says dramatic price dip starting within 48 to say whether a tea tasted good or bad, Boehm. “But we also wanted to know hours of the rains. but to quantitatively measure aromas, their willingness to pay for the spring Interestingly, although the monsoon mouthfeel and aftertaste. vs. the monsoon tea, and we found that tea had lower concentrations of cate- “It’s a way to measure the big sensory they were willing to pay a significant chins and methylxanthines, Robbat’s differences in tea, going back to the premium for spring tea and tea with a group found that concentrations of same fields year after year,” says Cash. lower carbon footprint.” other healthful chemicals, such as anti- Next, Cash and Rebecca Boehm, In fact, consumers were willing cancer, antianxiety and antimicrobial a doctoral student in the Friedman to pay the most for tea that had a low compounds, increased after the rains. School’s Agriculture, Food and carbon footprint, followed by spring “It was originally thought that as Environment program, set up tasting teas, fair-trade teas, teas with organic the mass of the leaf grows faster, the sessions in specialty food stores and certification and antioxidant-rich teas. chemicals the plant produces would be grocery stores around Boston. Working The findings, says Boehm, are relevant lower, or diluted on a mass basis, but with Roy Desrochers, sensory practice to everyone in the tea supply chain. that’s not what happens,” says Robbat, leader at TUSSC, they developed a tast- And as growing conditions change even an associate professor of chemistry. “It ing protocol that included a controlled further, the researchers’ study methods turns out that a lot of the health bene- way to consistently brew hundreds of could be of use for other taste-sensitive ficial compounds are actually higher in identical tea samples. crops, such as grapes and cherries. monsoon tea.” Tufts students offered blind sam- For tea growers, the findings suggest Which means the less tasty mon- ples of pre- and postmonsoon tea to that they may need to plant more soon-season tea, the one rejected by tea consumers, asking them to rate the teas rain-tolerant tea varietals, change the growers and buyers, might be better on a simple 1-to-9 scale of likability. way they manage soil or shift traditional for us. But how much does tea’s nutri- They preferred the spring tea—much harvesting times. And as the research tion content matter to consumers? Is as researchers had expected. (Tasters continues, scientists may even find a it more important than taste? Would described it as floral, honey and bal- way to keep those leafhoppers nibbling they pay extra if they knew a farmer anced, while saying the monsoon tea at just the right rate. was making an effort to mitigate cli- had a metallic, grassy, haylike taste.) mate change impacts? To find out, the And when tasters were told that climate CLARE LESCHIN-HOAR is a freelance writer researchers looked at the data from an change affected the quality of the tea, it specializing in food policy topics.

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4. The Shaoxing Yuchacan Tea plantation 5. Roasting and drying the famous Longjing green tea that is highly sought after each spring 6. A germplasm garden at the Tea Research Institute in Hangzhou, one of many maintained in China for the study and preservation of tea varieties

SUMMER 2016 | TUFTS NUTRITION 25 LOW-ACID REDUX Fewer grains and more fruits and vegetables may keep your bones strong

stroll through your local grocery store, Human Nutrition Research on Aging at Tufts. and you’ll immediately notice America’s love affair She says that most humans reach their maximum with . Entire aisles are devoted to break- bone density by age 25—but after that, things fast cereals, bread, rolls, crackers and cookies. tend to go downhill, especially in middle age. According to the U.S. Department of Agriculture, Most men lose about 1 percent of their bone mass the amount of grain most annually after age 50, and Americans consume has BY DAVID LEVIN women lose even more. grown by nearly 40 percent ILLUSTRATION BY MICHAEL PARKIN “At menopause, women since the 1970s, adding up lose roughly 3 percent of to 500 extra calories to our diets each day. their bone mass annually for about five to eight That increase may have an insidious effect on years,” she says. That means more than 20 percent the body. According to Bess Dawson-Hughes, of the body’s total bone density can disappear in M75, it may be linked to bone loss late in life. less than a decade, leading to osteoporosis, pain- Dawson-Hughes is the director of the Bone ful fractures and a diminished quality of life. Metabolism Laboratory at the Jean Mayer USDA Losing a certain amount of bone density is a

26 TUFTS NUTRITION | SUMMER 2016 SUMMER 2016 | TUFTS NUTRITION 27 normal part of aging, Dawson-Hughes bone. Their study, published in the she says. “I wouldn’t be surprised if in notes, but the exact mechanism behind Journal of Bone and Research, the future we find that acid-base plays that bone loss is still unclear. She thinks involved 244 women and men over age a role in bone health, but I think it’s it may have something to do with the 50. Half were given daily supplements unlikely that it’s the only thing that has way the body metabolizes all those of potassium bicarbonate (a potent an effect.” cereals we’re eating. Because grains alkali), the rest a placebo. Over the Still, Weaver says, that doesn’t contain sulfur compounds, they break course of three months, the research- diminish the fact that a good diet is down into byproducts like sulfuric acid, ers took urine samples and measured essential for bone health, a sentiment which in turn leads to an increase in the overall amounts of calcium they that Dawson-Hughes wholeheartedly the body’s overall acidity. Although that contained. High levels of calcium, she supports. “Supplements are terrific for research purposes, because you can control the dose, but they’re not a real MORE THAN 20 PERCENT OF THE BODY’S solution,” Dawson-Hughes says. “Most people with a dietary imbalance will TOTAL BONE DENSITY CAN DISAPPEAR need six to eight bicarbonate pills a day to achieve a neutral pH range, so it’s IN LESS THAN A DECADE. hard to see how that would be sustain- “ able over the long term.” sounds awfully dramatic on paper, the says, showed that the body was actively Instead, she says, curbing the actual change in blood pH is thankfully breaking down bone in order to coun- amount of grains we eat and switching minute—on the order of a few tenths teract acid levels in the blood. to a diet higher in fruits and vegeta- of 1 percent—yet even this tiny change After” three months, the team found bles—which contain compounds that may trigger bone loss. that participants who had taken the metabolize to alkali in the body—may supplements showed significantly lower have a similar effect. Leafy greens, for CHEMICAL BREAKDOWN calcium levels in their urine, a sign of example, contain potassium and other Dawson-Hughes says that some of this less bone breakdown. In other words, compounds that metabolize to alkali loss is caused by a chemical breakdown Dawson-Hughes says, the study sug- in the body, effectively counteracting that happens when bone touches acidic gests that adding alkali like potassium acids in the bloodstream. blood. The rest, however, may be due to bicarbonate into the body can curb Like all things in nutrition, it’s not a specific defensive mechanism. bone loss by counteracting acids—at quite as simple as just eating a “bal- “As the pH goes down in the blood least, in theory. anced diet,” however. According to just a little bit, that activates a specific “That’s still controversial,” says Weaver, increasing consumption of receptor in bone, creating a chain of Connie Weaver, a nutrition researcher fruits and vegetables overall is a step events that results in bone resorption,” at Purdue University, and a for- in the right direction, but it might not she says. “It signals bone to break down, mer board member of the National pinpoint the exact foods that could which dumps alkali into the circulation, Osteoporosis Foundation. “I would say be most beneficial for bone health. neutralizing the acid. It’s a defensive the evidence is pretty convincing that Instead, prioritizing specific fruits and response—our bodies are basically diet patterns do influence bone health, vegetables over others might be needed defending against a dropping pH.” but not all scientists agree exactly how.” to get those health benefits. Ideally, this defense mechanism This sort of diet intervention is should keep our acid-base levels more SOME BONES ABOUT IT something Dawson-Hughes wants or less in balance. With high-grain Instead of being linked directly to to study next. “Once you define the diets continually adding more acid the pH of our blood, changes in bone parameters needed for bone health, the into our bodies, however, this system density could be related to other com- next step—and one we hope to take— may kick into overdrive to compensate, pounds in our food that have yet to be is to test a diet intervention designed leading to accelerated bone loss. studied. Likewise, changes in blood to bring the net acid in the body to The outlook for bone health isn’t pH, Weaver reasons, might also be a neutral. If you knew that, you’d be on all doom and gloom, fortunately. In side effect of high protein diets—which solid footing to make health-appropri- 2015, Dawson-Hughes and her team can metabolize to acid as well—or ate policy choices.” found that certain dietary supplements some other nutrition mechanism that’s may counteract the effects of acid on changing our bones. “Diet is complex,” DAVID LEVIN is a freelance science writer in Boston.

28 TUFTS NUTRITION | SUMMER 2016 From All Corners UNIVERSITY, SCHOOL & ALUMNI NEWS

NEVER SQUASH A DREAM

Martyn Botfield braves passing to harvest zucchini at the New Entry Sustainable Farming Project fields in Dracut, Massachusetts. The project, begun as a Friedman School initiative in 2008, trains begin- ning farmers, such as Botfield, who turned to farming two years ago after retiring from the pharmaceutical industry. This was his second harvest of the day: Zucchini grow quickly, and many that were undersized in the morning had reached the optimal 6- to 8-ounce weight by late afternoon.

PHOTO: ALONSO NICHOLS SUMMER 2016 | TUFTS NUTRITION 29 From All Corners

Work, Learn, Live

Online certificate programs bring new students, new perspectives BY JULIE FLAHERTY

S A PEDIATRICIAN in El Paso, Texas, Maria Lourdes Asiain has sets aside one day a week to meet with several patients—particularly teens—who are overweight, her adolescent patients who have nutri- obese or diabetic. She often wished she could do more to tional concerns, and has new expertise advise them on diet and exercise. “My medical school and to help them. residency didn’t stress nutrition much,” she said. Working professionals like Asiain After about a year of searching for the right way to have found a unique learning experi- Aincrease her knowledge, she found what she was looking for: the ence through the Friedman School’s Nutrition Science for Health Professionals online certificate program various Online Graduate Certificate offered by the Friedman School. Programs, says program director Diane She was concerned that it might be hard for her to be a student McKay, G89, N97, N00. again—it had been 10 years since she had done a research paper, after “It’s a very flexible way for them to all—but she was soon engaged by the coursework, which covers every- advance their knowledge, enhance their thing from clinical scenarios of patients who have chronic conditions skill set, improve their marketability, to the lowdown on fad diets that patients might ask about. and improve their ability to administer “I’m surprised that I enjoyed it so much,” she said. “It’s very prac- to their patients,” she said. tical, which is what I looked for, but it’s challenging. Manageable, but At the same time, she says the challenging.” As a mother of two who works in private practice and school has benefited from the virtual does rounds at a hospital, she knew an online course made logistical presence of its diverse online students, sense. “I can do it while I’m taking my son to basketball practice or who live around the world and bring a while I’m waiting for a C-section,” she said. range of ages and experiences to their The program has already made a difference in her practice. She now coursework. “The different perspectives

30 TUFTS NUTRITION | SUMMER 2016 ILLUSTRATION: ANGIE WANG they have on the same subject matter downloaded lectures on his laptop or make it particularly enriching for the phone and getting caught up on his ON THE students and for me, as an instructor,” reading assignments. said McKay, an assistant professor who Because he wasn’t sure how appli- MOVE teaches several of the certificate courses. cable it would be, Burrows didn’t Aside from the academic rigor, small mention the program to his super- Congratulations to the following class size and access to Tufts faculty, it’s visors until he was partway through faculty members, who have been the student interactions that set these his first semester. But when he did tell promoted to new positions at the programs apart from those at other uni- them about the kinds of things he was Friedman School effective this versities, says Patrick Connell, director learning, they were enthusiastic, and coming academic year. of online and blended learning at Tufts. even offered to reimburse his tuition. CHRISTINA ECONOMOS, N96, “We’re creating an environment Since then, he has helped his company cofounder and director of Child- where students and faculty can inter- think more comprehensively about its Obesity180 and the New Balance act and communicate both live and own social, economic and environ- Chair in Childhood Nutrition, is now asynchronously and spend a semester mental sustainability. a full professor. Her research has together experiencing pretty much the Vanessa Mathews-Hanna works for addressed the interaction among same thing that they would experience a nonprofit in Canada that provides nutrition, exercise, body composi- on campus,” he said. community development and disaster tion, bone health and the built envi- The school offers five certificate response in 35 countries. A colleague ronment, with the goal of preventing programs, each consisting of three pointed her to the Tufts program osteoporosis and obesity, starting courses that can be completed in one in Delivery Science in International in early childhood. year. Students may also take individual Nutrition, which lined up exactly with CHRISTIAN PETERS, a faculty courses or choose from the different her interests. member in the Agriculture, Food programs to meet their needs. “Child health has always been and Environment program, is now my passion and especially nutrition an associate professor with tenure. THE RIGHT BALANCE within that,” said Mathews-Hanna, His research focuses on the model- When Brandon Burrows wanted to whose duties have included managing ing of food systems to explore such continue his education, he gave careful a nutrition program for women and topics as the land requirements of thought to the kind of online program children in Bangladesh. Recently, she the human diet and the potential he wanted. Some years back, he had has been consulting on the creation of local and regional production earned his master’s in in of programs aimed at preventing systems to supply food needs. a rushed eight months, an experience childhood stunting. “I was greatly JENNIFER COATES, J94, N00, N06, that left him burned out. This time, he helped by the knowledge I gained with is now an associate professor. Her wanted to make sure he could balance the international nutrition certificate,” research focuses on the develop- school, working fulltime as a research she said. ment of methods for improving the and development manager at a food She appreciated that all her instruc- design, implementation and evalu- ingredient company and spending tors were seasoned professionals in the ation of international nutrition and time at home in Virginia with his wife field and that the readings were very programs. She is also and 1-year-old daughter. current. When she went to confer- a senior researcher at the Feinstein It was only after he enrolled in the ences, she was pleased to see that she International Center. Friedman School’s certificate program had read papers by some of the head- SARA FOLTA, N05, whose in Sustainable Agriculture and Food lining presenters. research focuses on communi- Systems that he learned his job would “Once I put my daughter to bed, ty-based strategies for improving soon require weekly travel and that his I just worked on the class,” said dietary intake, physical activity wife was pregnant with their second Mathews-Hanna, who has a 3-year-old and body composition, is now an child. Was he still glad he went back to daughter and was pregnant with her associate professor. She holds a school? son while taking the courses. Despite secondary appointment at the Tufts “Absolutely,” he said recently. “It the long days, she found the program Clinical and Translational Science was well worth it.” motivating. “I appreciated the intel- Institute and the Jonathan M. Tisch On business trips, he used the lectual break from work that studying College of Citizenship and Public airplane as his classroom, watching provides. It was just energizing.” Service.

SUMMER 2016 | TUFTS NUTRITION 31 From All Corners

School will help more people get it right. Last year, John Hancock introduced a new approach to life insurance that offers savings and rewards to encour- age people to pursue a healthy lifestyle, including walking, exercising and med- ical checkups. This year the insurance company expanded the program to include a HealthyFood benefit, allowing policyholders to save money when they purchase healthy foods at more than 16,000 grocery stores nationwide. Working with John Hancock and the new HealthyFood program, Friedman School researchers will help the insurer’s Vitality policyholders make smart dietary choices by provid- ing credible, science-based expertise in health and nutrition, including a free online subscription to the school’s flagship monthly newsletter, the Tufts Health & Nutrition Letter. “John Hancock is collaborating with us because of our focus on real-world impact, one of their main goals as well,” says Mozaffarian, a cardiologist. “Maintaining a healthy diet is one of the greatest opportunities, and challenges, facing society today, and it remains poorly addressed by traditional health care,” he says. “We’re excited to be part of this initiative to help people make better nutritional choices.” The Good Life “Over the past year, consumers have embraced the John Hancock Vitality John Hancock teams up with the Friedman School solution,” says Michael Doughty, to promote wellness president of John Hancock Insurance. “However, combining physical fit- ness with good nutrition is even more impactful on your health. That’s why A GOOD DIET is one of the most conse- you—and which are not. “An expanding we are delighted to be collaborating quential choices you can make to enjoy world of media pundits, book authors, with the Friedman School, one of a long, healthy life. But it can also be bloggers, social media, mobile apps, for- the country’s leading authorities on one of the toughest to get right—even profit wellness companies and food mar- nutrition. Now our policyholders will though the stakes are so high. Poor keters is creating an unfiltered firehose have access to expert information and diets are the leading cause of death in of often conflicting and contradictory guidance that will help them adopt the United States, killing more people messages,” says Dariush Mozaffarian, healthier eating habits and improve than all other risk factors, including dean of the Friedman School of their overall health.” , drinking and drug use. Nutrition Science and Policy at Tufts. The Friedman School also will reap Most of us find it difficult to Now, through a new collaboration additional benefits from the collabo- determine which foods are good for with John Hancock, the Friedman ration, which renews the company’s

32 TUFTS NUTRITION | SUMMER 2016 ILLUSTRATION: MIGUEL DAVILLA longstanding commitment to the Tufts Marathon Team has raised more than as school- and workplace-based Marathon Team, the largest known col- $5 million since its inception in 2003. initiatives. legiate marathon program in the United Starting with the 2017 Hopkinton- “I believe all , and in States. The Tufts runners raise funds to to-Boston run, John Hancock will particular Tufts and the Friedman support nutrition research and pro- increase the number of slots, or bibs, it School, should be centers for public grams at the university, including efforts contributes to the team. impact,” Mozaffarian says. “To achieve to stem the childhood obesity epidemic. The collaboration will also enable that goal, we need to be more innova- Thanks to the Boston Marathon the Friedman School to create new tive about translating our scholarship bibs that John Hancock, the marathon’s programs, activities and initia- and expertise into real-world change.” principal sponsor, provided, the Tufts tives with broad social impact, such —LAURA FERGUSON

FEED THE WORLD, BUT FEED IT WELL Groundbreaking agricultural scientist headlines 2016 commencement

Keeping agricultural production on pace with the growing global population is no longer the biggest food challenge we face, commencement speaker Pedro A. Sanchez told 115 graduates and their guests at the 35th graduation ceremony of the Gerald 1. 2. J. and Dorothy R. Friedman School of Nutrition Science and Policy, held on May 22 on Tufts’ Medford/Somerville campus. “The world will be able to feed itself by 2050. It ain’t going to be easy, it won’t happen everywhere, but I think the path is very clear,” said Sanchez, director of the Agriculture and Food Security Center at Columbia University’s Earth Institute who is widely recognized for changing the way technology is used to increase food production. “But whether the people in the world are going to be nutritionally secure and sound by 2050 is largely up to you.” Sanchez, the 2002 World Food Prize laureate and 2004 MacArthur Fellow, said this is a “fantastic time” to be a nutri- tion professional. “Get in there and do your thing,” he said. In his charge to the graduates, Dariush Mozaffarian, the dean of the school, said that small actions and choices, sewn together, drive the world: “Small choices about what to buy at the grocery store; small choices by industry that lead to healthier, more sustainable food systems; small choices by 3. governments that empower women and livelihoods; small actions that lead to breakfast for a low-income child, improv- 1. Ashish Pokharel received a master of science degree. 2. Katherine Docimo, N16, who gave the class address, said she ing their attention and learning on that day; small actions would cherish the supportive and collaborative culture she found that lead to the acceptance of differences, the celebration of among Friedman School students. 3. From left are Diane diversity and social justice.” Candiotto, Julianne Burkholder, Jensine Yang and David Grist.

PHOTOS: SHAMIT STHANKIYA SUMMER 2016 | TUFTS NUTRITION 33 From All Corners

YOUR ALUMNI ASSOCIATION A YEAR OF NEW HEIGHTS

AS PRESIDENT OF the of alumni and students partnering to Council, who, as part of their efforts Friedman School Alumni strengthen our profession. to revitalize and reorganize the Association, I am able, This dedication was also on display Alumni Association, worked this year once again, with tremen- in April, when we hosted our annual to develop revised mission and vision dous pride, to look back All-Alumni Reunion. We welcomed statements for the group that will help upon a year of amazing nearly 100 alumni, students and guests guide us forward. accomplishments, goals back to the Friedman School across Stay tuned in 2016–17 for initia- surpassed and new heights four different events, including the tives aimed at further supporting reached. For the three inaugural Friedman School Fun Run. career development, outreach and career panels we hosted this year, I would also like to highlight the engagement of alumni, including more we were able to engage 13 alumni as continued success of our Mentoring web-based events and programs and panelists or moderators. In addition, Program, which this past year matched opportunities for alumni around the our increasingly popular DC Alumni/ 12 students with alumni mentors, country to share their expertise with Student Networking trip saw 26 again exemplifying the collaborative their fellow alumni and students. alumni participants—including eight relationship among Friedman alumni, new ones—as well as 20 student par- students and faculty ANDREW SHAO, N00, President, Friedman School ticipants. This event is a great example Finally, my thanks to the Executive Alumni Association

REUNION 2016

Alumni, students and faculty gathered at the Boston Public Library on April 9 for the Alumni Association awards ceremony, which honors graduates of previous classes who have been humanitarians, innovators and leaders in their fields.

1. 2.

3. 4. 1. Simón Barquera, N96, N05, here with his daughter, received the Nutrition Impact Award. 2. Clockwise from left are Claire Mance, N16; Claire Whitney, N16; Townsend Benard, N17; Ibukun Owoputi, N16; Dianna Bartone, N17, MPH17; Alexandra Simas, N16; and Melissa Hudec, N16. 3. Professor Beatrice Rogers (left) with Anna Herforth, N05, who was presented with the Leadership and Expertise Award 4. The Leah Horowitz Humanitarian Award was presented to Ratna Megawangi, N88, N91, (right) shown with her daughter.

34 TUFTS NUTRITION | SUMMER 2016 PHOTOS: SCOTT TINGLEY Class Notes

N90 N98 N08 Obesity-Induced Colonic Inflamma- William Reid, senior vice president Claire MacEvilly will relocate over- CINDY IMAI has joined the academic tion and Tumorigenesis.” The Cohn of product management at SCI seas to take a new position as the affairs team at Tufts School of Award, created by JOAN COHN, J65, Solutions, has been appointed head of external affairs for Danone Dental Medicine as predoctoral and her husband, Peter Cohn, estab- interim regent of the American Ireland. She has been communica- clinical grading coordinator. She lished the award to provide funding College of Healthcare Executives tions manager for Food for Health received her B.S. in nutritional sci- to advance our understanding of (ACHE) for the State of Washing- Ireland and has more than 20 years ences from UC-Berkeley, an M.S. in aging, inflammation and chronic ton. He has been a member of of experience working in the private nutrition from the Friedman School disease, and the role nutrition can ACHE since 1993 and was recently and public sectors in the U.S., U.K. and a Ph.D. in nutrition from the play in keeping inflammation at bay. honored by the Washington chapter and Ireland. University of . Joan Cohn is a member of the board with the ACHE Service Award for his of advisors to the Friedman School. commitment to advancing excel- lence in health-care management. N07 N13 ELANOR S. STARMER, F07, has been ERIKA HVAL received the Legislative N16 named acting administrator of Advocacy Award from the New York EMILY FINNAN is the 2016 recipient N96 the USDA’s Agricultural Marketing State Dietetic Association for her of the Stanley N. Gershoff, Simon LISA FREEMAN, J86, V91, received a Service (AMS). She joined the efforts to improve awareness of J. and Arpi A. Simonian Prize for Distinguished Achievement Award, federal agency in 2011 and most how food, nutrition, government, Research Excellence in Nutrition the highest honor of the Tufts recently served as a senior adviser economy and medicine interact. Science and Policy at the Friedman University Alumni Association. This to Secretary Tom Vilsack. Starm- During her time at Tufts, Erika School. She entered the Friedman year’s awards ceremony, held on er’s focus has been the creation pursued a nutrition master’s degree School in the fall of 2014 and April 2, on the university’s Med- of new market opportunities for while taking part in the Combined pursued an M.S. in the Biochemical ford/Somerville campus, recog- farmers, ranchers and food busi- Dietetic Internship program at the and Molecular Nutrition program nized nine Tufts graduates for their nesses of all sizes. She says she Friedman School. with a specialization in Nutrition career achievements, contributions looks forward to continuing this ANNA PFALZER, a doctoral student Communication. She says she to the university and service work. work at AMS and to coordinating at the Friedman School, is the recip- plans to take all of the experiences, Freeman, an internationally recog- with the Office of the Secretary on ient of the inaugural Cohn Award for knowledge and skills gained at nized veterinary nutritionist, teach- the Know Your Farmer, Know Your her project “The Role of Salsalate Tufts into a full-time position as a es on all three Tufts campuses. As a Food initiative (KYF2). and Curcumin Supplementation in pediatric clinical dietitian. member of the faculty at Cummings School of Veterinary Medicine, she cares for animals that require spe- cialized nutrition and studies the role of nutrition in heart disease. She leads several initiatives, includ- ing Cummings School’s Residents Enhanced Veterinary Education and Nutrition GO.TUFTS.EDU/NUTRITION Academic Learning and Accelerated Clinical Excellence programs, the Tufts Clinical and Translational Now We’re Online, Too Science Institute, the One Health Program, and the Tufts Institute You’ll not only find all the stories that appear in the print publication, for Human-Animal Interaction. but a live news feed from the university news site Tufts Now. She also heads the Tufts Paws for People animal-assisted therapy IT’S A GREAT WAY TO STAY CONNECTED WITH TUFTS. program.

SUMMER 2016 | TUFTS NUTRITION 35 Ask Tufts Nutrition

Keep ’Til You Steep DIANE MCKAY, G89, N97, N00, a scientist in the Antioxidants Research Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts and an assistant professor at the Friedman School, serves as our expert.

How long can you store tea before it starts to lose its taste is somewhere in between. Measures of intactness vary from Q and nutritional benefits? leaf, to broken leaf, to fannings and dust. Fannings are small pieces of leaves, while dust is the tiny particles left at the bottom of the barrel. Black, oolong, green and white teas all come from the Tea bags most often contain fannings and dust because same plant, Camellia sinensis. They differ in how the they brew quickly. Some tea bags do contain whole leaves, but A leaves are processed after harvesting and before dry- they tend to be larger, to allow the leaves room to expand. ing. All will eventually lose their flavor, and the phytochemi- To keep your tea flavorful and flavonoid-rich for one to cals (primarily flavonoids) they contain will degrade. two years, transfer your tea bags or leaves to an airtight con- However, dried tea leaves that are kept dry will not spoil, tainer as soon as possible after purchase, and store it away and as long as they are stored away from heat, water, light from the stove and sink. and air, the flavor and phytochemical content can be main- tained for up to two years. The more fermented and intact Send your questions for future installments of “Ask Tufts Nutrition” to Julie the dried leaves are, the longer they will last. Black tea leaves Flaherty, Tufts University Office of Publications, 80 George Street, Medford, MA 02155 or email [email protected]. are more fermented than green or white, and oolong

36 TUFTS NUTRITION | SUMMER 2016 WE DIDN’T GROW THE TOMATO. WE GREW THE FARMER.

Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy Jean Mayer Human Nutrition Research Center on Aging New Entry Sustainable Farming Project

You can’t have sustainable, locally grown food without small, local farmers. But in New England and elsewhere, they’re a vanishing breed. So we’re helping new farmers acquire the land, farming know-how, money, and business skills they need to thrive. At the same time, we help low-income communities gain access to fresh, healthy food. It’s a great program, any way you slice it. Read more at nesfp.org. If you would like to donate in support of Tufts’ trusted nutrition science and sustainable farming program, visit nutrition.tufts.edu/givenow2. NONPROFIT ORG. U.S. POSTAGE PAID BOSTON, MA GERALD J. AND DOROTHY R. FRIEDMAN SCHOOL PERMIT NO. 1161 OF NUTRITION SCIENCE AND POLICY 150 Harrison Avenue Boston, MA 02111 nutrition.tufts.edu

Change of address? Questions? Email [email protected].

H O T 4 Just Too Much Food 12 Avoidable Famine 14 Proper Quenching

READING THE TEA LEAVES

Climate change affects not only what foods we can grow and where, but how they taste. For crops like tea, shifts in rainfall patterns can upset the delicate flavor, drastically altering the price that consumers are willing to pay and the money that farmers earn.

FOR MORE ON THE STORY, TURN TO PAGE 22.

THE OLDER, WISER DIET Simple ways to eat well after 65