EVIDENCE OF NUTRITION IMPACT

• Inadequate weight gain during pregnancy has been linked to growth stunting and brain development problems. Poor prenatal nutrition may play a role in the development of chronic diseases in adulthood.
• Food insecurity or hunger in school age children is associated with increased illness and school absence and poor academic performance independent of poverty and illness.
• A controlled study measuring the association of school breakfast consumption and academic performance also showed that those who ate the school breakfast scored higher on exams than those without. 
• National trends of poor food habits throughout childhood include increased soft drink consumption and an increase in caloric and fat consumption due to increases in snacking behavior. 
• Iron deficiency anemia persists among infants, young children, adolescent girls, and pregnant women and is associated with cognitive deficits, decreased resistance to infection, fatigue, and impaired growth and development.

The relationship between chronic disease and nutrition during childhood and adolescence is established, and the current epidemic of obesity in children from ages 2–18 requires immediate interventions. 

The challenge to nutrition training is to translate and disseminate this knowledge expansion clearly and regularly to maternal and child health professionals. 

NUTRITION TRAINING PROGRAMS

The first graduate training program in public health nutrition was initially developed and financed with Social Security Act Title V funds in 1943.  

By the early 1950s, five public health nutrition graduate training programs were funded around the country. Additional funding for public health nutrition graduate training became available in the 1950s through Social Security Act's Title VII. While the locations of nutrition training programs have varied across the United States over the past 60 years, the commitment to training nutrition and health professionals in the areas of public health and community nutrition, pediatric and adolescent nutrition, maternal nutrition, perinatal and infant nutrition, and nutrition for children with special health care needs has remained the core component of all nutrition training grants. Currently the awards emphasize Centers of Excellence to improve Maternal and Child Health Leadership for promoting the healthy nutrition of the mother, child, and family through good nutrition.  

Currently eight universities funded by the Maternal and Child Health Bureau (MCHB) offer nutrition training programs.  Of these, University of California–Los Angeles, University of Minnesota, University of New Mexico, University of North Carolina–Chapel Hill, The University of Tennessee–Knoxville offer graduate training in public health nutrition, which leads to a masters or doctoral degree. Indiana University, The University of Alabama at Birmingham, and the Baylor College of Medicine offer one week to six month fellowships in pediatric or neonatal nutrition, as well as short-term (1–5 day) continuing education programs for health professionals. All eight programs offer continuing education opportunities for health professionals at the local, regional and national levels. The programs offer a variety of areas of nutrition expertise including maternal, infant, child and adolescent nutrition issues, children with special health needs, and public health. 

From 1993 to 2000 the Maternal and Child Health Bureau supported masters level training programs that prepared 279 graduates. In addition, doctoral student enrollment increased from seven to 17 during this period and the programs mentored 102 doctoral students. Short term training programs provide important skill enhancement opportunities for practicing professionals. In the neonatal and pediatric training programs, 229 professionals completed a fellowship and, of those, 90% continued to work in MCH programs. Intensive courses on pediatric nutrition and maternal nutrition are offered annually and reached 1031 and 1097 professionals respectively. The University of Alabama at Birmingham offers an annual national videoconference which has reached 60,000 professionals growing from an audience of 3,000 to 10–12,000 per conference. Local continuing education activities offered by the graduate training programs reached over 10,880 professionals from every state in the U.S. Selected technical assistance and consultation activities of faculty are noted on the map inside.