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Vital Signs

Improving nutrition in the real world

By James DiClerico

Lisa Sutherland hangs out in some unusual places for a medical school faculty member—places like supermarket aisles and middle-school classrooms. For several years, she headed a project to analyze food labels for one of New England's major grocery chains. Nowadays, she studies the influence TV and movies have on what kids eat. Nutrition science—Sutherland's field—has moved out of academe and into the real world. A research assistant professor at DMS, she came to academe by a circuitous route. After 10 years in marketing with the Gap, she finished her bachelor's at Simmons, went to work at theMassachusetts Department of Public Health, and thought about becoming a pediatrician. In the end, public health and nutrition won her over, and she earned her Ph.D. at the University of North Carolina (UNC).

Chain: While on the faculty at UNC, Sutherland sat in on a meeting with some officials from Hannaford supermarkets, a Maine-based chain with 160 stores in the Northeast. Hannaford customers had been asking for a simple way to identify healthy foods, and management was looking at how they might comply with the request.

During the meeting, it came out that Sutherland not only possessed the required nutritional expertise but also hailed from Maine. When the company decided to proceed and was considering staffing, Sutherland recalls that "Hannaford said, 'We'd like the girl from Maine.' I was in from day one."

Fat: She and a UNC colleague headed the advisory panel that Hannaford set up. The panel devised a system called Guiding Stars. It's based on an algorithm developed from eight dietary criteria, which Sutherland ticks off: "Transfat, fatfat, cholesterol, added sodium, added sugar, vitamins, minerals, fiber, plus a whole-grain bonus point." But all that customers see is a simple, shelf-edge label with one, two, or three bright gold stars—identifying good, better, and exceptional foods. Of the 32,000 food items inHannaford stores, only a quarter earned any stars.

A few months ago, the New York Times reported that Hannaford "declared success . . . for a year-old experiment in using a rating system to direct customers to healthier food items." For example,

Sutherland, who came to DMS in 2006, headed a national nutrition panel.

said the paper, "sales of whole milk, which received no stars, declined by 4%, while sales of fat-free milk (three stars) increased 1%." Sutherland, the Times said, was "thrilled." She called the effect "pretty much what I would have expected with an objective system that wasn't designed to promote or negate one food or another."

While the Hannaford project consumed much of Sutherland's time for two years, her current school-based projects better reflect her interests. "I really, really enjoy kids," she says. "So my work here in New Hampshire and Vermont is just schools." Her focus is on "tweens"—9-to-12-year-olds—who live in rural areas. She feels this group has been "understudied in the [nutrition] arena" and suspects "they are a little bit different from urban kids."

A project called TWEENS (Television Watching, Eating Exposure, and Nutrition Study) is Sutherland's current focus—an examination funded by the National Cancer Institute (NCI) of the impact of TV advertising on what middle-schoolers eat and drink. She just finished working with 200 students in area schools to develop a

"I really, really enjoy kids," says nutrition researcher Sutherland.

questionnaire soon to be distributed to 3,000 of their peers. "They're fabulous," she says of the kids who helped her. "They tell you exactly what they think . . . exactly what you're saying wrong."

Brands: A second NCI grant has Sutherland looking at the placement of food and beverage brands in popular movies released from 1996 to 2005.

Of the TWEENS project, Sutherland says, "There's been a lot of research that says the number of minutes a kid spends watching TV is highly correlated with their being obese or their diet being poor. However, the exact mechanism hasn't been teased apart, so we got funded to try to figure out is it that the kids are just sitting, is it that they have a different dietary pattern, is it really the advertising, is it not the advertising?"

If it is the advertising, she adds, the next step will be to develop interventions, such as media literacy for kids, and work them into school curriculums.

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