NUTRITION ACADEMIC AWARD

Release Date:  February 19, 1999

RFA:  HL-98-016

P.T.

National Heart, Lung, and Blood Institute
National Institute of Diabetes and Digestive and Kidney Diseases

Letter of Intent Receipt Date:  March 18, 1999
Application Receipt Date:  June 11, 1999

PURPOSE

The primary objective of this initiative is to encourage the development or
enhancement of medical school curricula to increase opportunities for
students, house staff, faculty, and practicing physicians to learn nutrition
principles and clinical practice skills with an emphasis on preventing
cardiovascular diseases (CVD), obesity, diabetes, and other chronic diseases. 
A second objective is to provide training modules for dissemination to other
medical schools as well as other health care professional schools.

HEALTHY PEOPLE 2000

The Public Health Service (PHS) is committed to achieving the health 
promotion and disease prevention objectives of "Healthy People 2000,"  a
PHS-led national activity for setting priority areas.  This RFA, Nutrition
Academic Award, is related to the priority areas of nutrition, heart disease
and stroke, obesity, physical activity, diabetes, chronic disabling
conditions, and clinical prevention services.  Potential  applicants may
obtain a copy of "Healthy People 2000" (Full Report:  Stock No.
017-001-00474-0 or Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government  Printing Office, Washington, DC
20402-9325 (telephone 202-512-1800).  It also may also be found at: 
http://www.crisny.org/health/us/health7.html.

ELIGIBILITY REQUIREMENTS

Institution

An application may be submitted by any domestic institution with a school of 
medicine.  Eligible institutions may submit only one application in each
competition and receive only one award.

Principal Investigator

A Principal Investigator for the Nutrition Academic Award must have the
following credentials:

o  doctoral degree

o  sufficient graduate or post graduate training and experience in nutrition
research, medical or nutrition clinical practice, and/or medical education to
develop and implement a high quality medical curriculum in clinical nutrition,
emphasizing cardiovascular disease prevention, obesity, and diabetes, and to
provide leadership for a multidisciplinary team;

o  knowledge and skills and a demonstrated commitment to medical education for
students, house staff, physicians and other health care professionals;

o  permanent appointment (not adjunct) at the rank of Associate or Full
Professor on the faculty of an accredited school of medicine in the United
States, its territories, or its possessions;

o  demonstrated support from the Dean and educational leadership of the
institution and;

o  be a citizen or non-citizen national of the United States or have been
lawfully admitted for permanent residence at the time of application.

Individuals who have or have had another NIH career development award (K
series) or a regular research grant (R01) are eligible for this award if the
individual meets the requirements of the Nutrition Academic Award program. 
Applications from women and individuals from diverse racial/ethnic backgrounds
are encouraged.

MECHANISM OF SUPPORT

This RFA is part of the Academic Award Program (K07) of the National Heart,
Lung, and Blood Institute.  Responsibility for the planning, direction, and
execution of the proposed project will be solely that of the applicant.  The
total project period may not exceed five years and is non-renewable.  Awards
will be limited to a maximum of $50,360 for the salary of the Principal
Investigator, plus applicable fringe benefits, and a maximum of $150,000 for
the total cost of the award for the first year (including indirect costs).  A
three percent escalation is allowed per year in subsequent years.  The salary
cap may not be exceeded in any year. Facilities and Administrative costs
(indirect costs) may not exceed 8 percent.

It is anticipated that support for this program will begin April 1, 2000.

Application instructions have been modified to reflect "just-in-time"
streamlining efforts at the NIH.  The just-in-time concept requires applicants
to submit certain materials only when there is the possibility of an award. 
It is anticipated that these changes will reduce the administrative burden for
the applicants, reviewers, and NHLBI staff.  If the possibility of an award
exists following the initial review, the Budget, Other Support, and Checklist
information will be requested by NHLBI staff.

FUNDS AVAILABLE

It is anticipated that in fiscal year 2000, support will be available for
total costs of approximately $1,050,000 and that approximately seven grants
will be awarded under this program.  The actual number of awards each year
will depend upon the merit and scope of the applications received and the
availability of funds.  Because the nature and scope of the research proposed
may vary, it is anticipated that the size of each award will also vary. 
Although the financial plans of the IC(s) provide support for this program,
awards pursuant to this RFA are contingent upon the availability of funds and
the receipt of a sufficient number of applications of outstanding scientific
and technical merit.

RESEARCH OBJECTIVES

Background

Diet has been associated with eight of the ten leading causes of death in the
United States (USDHHS, 1988).  A number of national committees, panels, and
agencies have made recommendations for the nation to modify and improve
dietary intake as a major step toward preventing premature morbidity and
mortality from cardiovascular diseases, obesity, diabetes, and other chronic
diseases (National Research Council, 1989; USDHHS, 1991; Expert Panel on
Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults,
1993; National High Blood Pressure Education Program, 1993; US Department of
Agriculture, 1995; Krauss et al, 1996; National Heart, Lung, and Blood
Institute, 1998).

Currently, health care providers and health care organizations are paying
increasing attention on risk factor management as a key part of optimal care
of patients to prevent CVD, and emphasis is being placed on strategies to
prevent nutrition-related diseases (Pearson et al, 1996).  More recognition is
being given to the importance of nutrition training for health care providers
from several disciplines, since they play a key role in meeting this need with
patients and the general public.  Over the years, physician and patient
surveys have shown repeatedly a need to increase physicians' skills and
efforts in nutrition.  For example, Schucker et al (1991) in a survey on
cholesterol awareness showed only 9% of the public reported that their
physicians gave them advice to follow cholesterol-lowering diets, although one
in four reported a diagnosis of elevated
cholesterol.

For over 30 years, inclusion of nutrition in medical school curricula has been
advocated by nutrition societies and expert committees (Zimmermann et al,
1993; USDHHS 1991; NHLBI, 1994; US Preventive Services, 1996).  The Committee
on Nutrition in Medical Education (1985) recommended that nutrition be a
required course in medical schools, a minimum of 25 hours be provided to teach
the basic material, nutrition questions be included in medical licensing
examinations, and a separate nutrition department be instituted in medical
schools.  At the time of the 1985 report, only 25% of medical schools had
required nutrition courses, only a few medical schools provided 25 hours or
more of nutrition content, fewer than 3% of questions on the National Boards
related to nutrition, and only one or two medical schools had a separate
nutrition department (Winick, 1993).  Nearly a decade later there was little,
if any, improvement in this situation (Winick, 1993).  In 1997, Hark et al
reported that medical licensing examinations contained 11% to 12% nutrition
content, as identified by nutrition professionals.  Many of the items were
related to vitamin deficiencies, and little coverage was given to
nutrition-related screening and preventive counseling (Hark et al, 1997).  A
national consensus on the essentials of nutrition education in medical schools
has recently been developed (American Medical Student Association, 1996). 
Thus, although numerous reports contain major recommendations for the
inclusion of nutrition in medical education and physician training,
implementation has been limited (USDHHS, 1991; Pearson et al, 1996; Tobin,
1997).

Prevention of CVD, obesity, diabetes, and other chronic diseases through
nutrition cuts across several medical and other health care specialties (e.g.,
cardiology, internal medicine, preventive medicine, family practice,
pediatrics, obstetrics and gynecology, geriatrics, nursing, dietetics,
physician assistants), and a multidisciplinary approach is required to
integrate nutrition training in these specialties.  In addition to training in
nutrition principles and counseling techniques, physicians need training on
how to set up an office practice system that is supportive of a team approach
to prevention.  Training mechanisms for faculty in medical schools with strong
backgrounds in nutrition science, research, and prevention to expand nutrition
training of physicians as well as other health professionals could help meet
some of these needs (Bruer et al, 1994; Hunt et al, 1995; Pearson et al, 1996;
Ockene et al, 1996; Morrison et al, 1996).

The aim of this academic award program is to stimulate the development and
enhancement of medical school education programs so that physicians may learn
nutrition principles and clinical practice skills for the prevention of CVD,
obesity, diabetes, and other chronic disease risks and improved nutritional
management of their patients.  A second aim is to provide training modules for
dissemination to other medical and other health professional schools.

Awardees should propose objectives and plans for incorporating nutrition into
medical school programs.  Preference will be given to applicants who also
include training opportunities for other health care providers.  The plans
should include mechanisms to:

o  Encourage the development of high quality curricula in schools of medicine
that will significantly increase the knowledge and skills of students, house
staff, and others, including faculty and practicing physicians, to apply
state-of-the-art nutrition principles, practice, and counseling with an
emphasis on prevention of chronic diseases.

o  Evaluate the impact of the proposed program.

o  Promote professional development of the awardee so he/she can serve as a
focal point for multidisciplinary interactions promoting effectiveness in
teaching, research, and clinical care in the field of nutrition, including
training of other health care professionals.

o  Develop or enhance an infrastructure at the Institution to continue
educational and training programs in nutrition and chronic disease prevention
when the award is concluded.

o  Promote communication among specialists in primary care and other
specialties to ensure coordinated nutritional prevention and treatment
strategies.

o  Develop coordinated clinical and educational approaches to address
nutritional needs of patients of various ages and ethnic groups, and
populations with special needs.

o  Engage in an interchange of teaching modules and strategies among other
awardees and their institutions.

o  Develop curricula and training modules in collaboration with other awardees
that can be adapted and used by other academic training units and
institutions.

o  Promote research studies in nutrition and CVD, obesity, and diabetes
prevention at the Institution, funded by other support.

SPECIAL REQUIREMENTS

Applicants should develop a comprehensive program that effectively addresses
their needs related to the objectives of this RFA.  The primary focus must be
on plans to improve the quality of nutrition medical school education for
students and physicians.  Plans and educational materials for curricular
improvements must be of a design that facilitates dissemination and adoption
at other institutions.  All applications must include plans to evaluate the
outcome of the educational initiatives.  The responsibilities of the Principal
Investigator and key personnel must be described in the budget justification
section.  The minority and gender composition of students to be trained should
be described.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups and
their subpopulations must be included in all NIH supported biomedical and
behavioral research projects involving human subjects, unless a clear and
compelling rationale and justification is provided that inclusion is
inappropriate with respect to the health of the subjects or the purpose of the
research.  This policy results from the NIH Revitalization Act of 1993
(Section 492B of Public Law 103-43).

All investigators proposing research involving human subjects should read the
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical
Research," which have been published in the Federal Register of March 28,
1994, (FR 59 14508-14513), and reprinted in the NIH GUIDE FOR GRANTS AND
CONTRACTS of March 18, 1994, Volume 23, Number 11.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (i.e., individuals under the age of 21)
must be included in all human subjects research, conducted or supported by the
NIH, unless there are scientific and ethical reasons not to include them. This
policy applies to all initial (Type 1) applications submitted for receipt
dates after October 1, 1998.

All investigators proposing research involving human subjects should read the
"NIH Policy and Guidelines" on the Inclusion of Children as Participants in
Research Involving Human Subjects that was published in the NIH Guide for
Grants and Contracts, March 6, 1998, and is available at the following URL
address:  http://grants.nih.gov/grants/guide/notice-files/not98-024.html

Although the Nutrition Academic Award is not primarily a mechanism to support
research, medical students and residents are likely to be involved. 
Therefore, protection of human subjects must be addressed, and the approximate
percent of women and each minority group that you expect in the total
population must be included.

LETTER OF INTENT

Prospective applicants are asked to submit, by March 18, 1999, a letter of
intent, the name, address, and telephone number of the Principal Investigator,
the identities of other key personnel, participating institutions, and the
number and title of the RFA in response to which the application may be
submitted.  Although a letter of intent is not required, is not binding, and
does not enter into the review of subsequent applications, the information
that it contains allows NHLBI and NIDDK staff to estimate the potential review
workload and to avoid conflict of interest in the review.  The letter of
intent is to be faxed or sent to Dr. C. James Scheirer at the address listed
under INQUIRIES.

APPLICATION PROCEDURES

Applications are to be submitted on the grant application form PHS 398 (rev.
4/98).  These forms are available at most institutional offices of sponsored
research and from the Division of Extramural Outreach and Information
Resources,  National Institutes of Health, 6701 Rockledge Drive, MSC 7910,
Bethesda, MD 20892-7910, telephone (301) 435-0714, Email: GrantsInfo@nih.gov.

The RFA label available in the PHS 398 application form must be affixed to the
bottom of the face page of the application.  Failure to use this label could
result in delayed processing of the application such that it may not reach the
review committee in time for review.  In addition, to identify the application
as a response to this RFA, check "YES" in item 2 of application page 1 and
enter the title "Nutrition Academic Award  HL-98-016."  Sample budgets and
justification page will be provided upon request or following the submission
of a letter of intent.

The instructions described in the Career Award Section of the PHS 398 (rev.
4/98) must be followed when preparing an application in response to this RFA. 
Applications that do not conform to the instructions in the Career Award
section of the PHS 398 (rev 4/98) will be considered unresponsive to this RFA
and will be returned without further review.

The applicant should provide the name and phone number of the individual to
contact concerning fiscal and administrative issues if additional information
is necessary following the initial review.

Submit a signed, typewritten original of the application and three signed,
photocopies, in one package to:

CENTER FOR SCIENTIFIC REVIEW
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/courier service)

At the time of submission, two additional copies of the application must be
sent to Dr. James Scheirer, at the address listed under INQUIRIES.

Applications must be received by June 11, 1999.  If an application is received
after this date, it will be returned to the applicant without review.  CSR
will not accept any application in response to this RFA that is essentially
the same as one currently pending initial review, unless the applicant
withdraws the pending application.  The CSR will also not accept any
application that is essentially the same as one already reviewed.  This does
not preclude the submission of substantial revisions of applications already
reviewed, but such applications must include an introduction addressing the
previous critique.

If an application is determined to be unresponsive to the RFA, the principal
investigator will be notified and the application returned.

The following sections are specific cost guidelines that will apply to those
applications selected for award consideration.

1. Principal Investigator's Salary

The salary for the Principal Investigator (or any other investigator on the
team) must not exceed the actual institutional salary rates for the effort
being devoted to the Academic Award.  In addition, salary rates must not
exceed an annual salary level of $125,900 plus fringe benefits (a maximum of
$50,360 plus fringe benefits for 40 percent effort).  A candidate must devote
at least 20 percent effort and no greater than 40 percent effort to this
award.

The combined efforts of any individual, Principal Investigator or key
personnel, on the Nutrition Academic Award with any other non-NIH or
NIH-supported grant(s) or contract(s) must not exceed 100 percent.

2. Program Support

o the applicant should include some percentage of effort for a
multidisciplinary team with sufficient training and experience in medical
education and nutrition needed to develop, implement, and evaluate high
quality curricula.  The team might include health professionals such as
physicians, nutritionists, exercise scientists, behavioral scientists, or
nurses.  The mix of expertise will be determined by the applicant;

o  consumable supplies essential to the proposed program and education
materials are allowable.  Office equipment or furniture costs are not
allowable;

o  funds for the Principal Investigator to travel and meet with other
investigators,  NHLBI, and  NIDDK staff to exchange ideas and to develop
collaborative projects must be included.  Investigators may be requested to
meet as a group up to three times a year; $1,000 per trip should be budgeted
for this purpose.  One other member of the team also may be budgeted to attend
the meeting if needed;

o  funds for educational development to enable the awardee to develop relevant
skills can be included;

3.  Facilities and Administrative Costs

Awards will be provided for the reimbursement of actual Facilities and
Administrative costs at eight percent of the total direct costs of each award.

4. Conditions of the Award

Institutions must provide documentation that the applicant would have the
necessary time and resources to implement the proposed plan.  In some cases,
it may be necessary for the applicant to be relieved of some responsibilities
for the five years of the grant award in order to implement the proposed plan.

An institution is expected to apply on behalf of a named individual meeting
the Principal Investigator criteria for this award.  Only one application may
be submitted from each eligible institution in each competition. Awards will
be limited to one from each eligible school over the life of the award.  After
the first year, grants will be renewed for a maximum of four years on a
noncompetitive basis depending upon progress in meeting the program's
objectives.  An annual report that summarizes curriculum development at the
institution and other elements of the program plan, and outlines future plans
will be required.  This report will serve as the basis for renewal of the
grant.

Awards may not be transferred from one institution to another.  If a Principal
Investigator moves to another institution, the award will continue at the
original institution only upon acceptance by the National Heart, Lung, and
Blood Institute or the National Institute of Diabetes and Digestive and Kidney
Diseases of a suitable replacement proposed by the grantee institution.  Such
a replacement will not lengthen the overall term of the award.

REVIEW CONSIDERATIONS

Upon receipt, applications will be reviewed for completeness by the CSR and
responsiveness to this RFA by NHLBI and NIDDK.  Incomplete and/or
non-responsive applications will be returned to the applicant without further
consideration.  Applications will be evaluated for scientific and technical
merit by an appropriate peer review group convened by the Division of
Extramural Affairs, NHLBI.

As part of the initial merit review, all applications will receive a written
critique and undergo a review in which only those applications deemed to have
the highest scientific merit of the applications under review (usually two to
three times the number of applications that the NHLBI and NIDDK anticipate
funding under the program) will be discussed, assigned a priority score, and
receive a second level review by the National Heart, Lung, and Blood Advisory
Council.

Review Criteria

Applications for this Nutrition Academic Award will be evaluated in terms of
the following criteria:

 o  qualifications and experience of the Principal Investigator candidate who
must hold an academic position in a medical school at the Associate or Full
Professor rank and key personnel, including pertinent experience in teaching,
curriculum development, program evaluation, clinical practice, administration,
and conducting research studies;

o  plans to develop, improve, and integrate an interdepartmental curriculum in
nutrition with existing institutional training programs for medical students,
graduates, and post-graduates at the institution and which also could be used
at other appropriate health professional schools;

o  plans to evaluate the proposed educational components and overall program;

o  plans for communication and interdepartmental collaboration between medical
specialists in appropriate disciplines to ensure the development,
implementation, and evaluation of optimal educational programs;

o  plans and ability to work cooperatively with other Awardees to develop
innovative and portable curricular materials and modules in nutrition for
adoption at other medical schools and other interested health professional
schools;

o  description of the need for this program including the potential impact of
the program on nutrition medical training at the institution and on medical
education in general with a focus on preventing cardiovascular diseases,
obesity, diabetes, and other chronic diseases;

o  the magnitude of current programs, curricula and nutrition related research
that exist at the applicant's Institution.  This award is designed to enhance
Institutions that have a base of research and training in nutrition as well as
develop such activities in Institutions that do not have existing nutrition
education programs.  Each applicant should provide a description or table of
what currently exists in curricular activities, nutrition research,
interdepartmental collaborative efforts, and mechanisms to provide training to
other health care professionals;

o  institutional commitment to implement the proposed curricular activities
and infrastructure to maintain a program in nutrition education after the
termination of the award.

Schedule

Letter of Intent Receipt Date:  March 18, 1999
Application Receipt Date:       June 11, 1999
Review by NHLBI Council:        February 10, 2000
Anticipated Award Date:         April 1, 2000

AWARD CRITERIA

The anticipated date of award is April 1, 2000.  Factors that will be taken
into consideration in making awards include the scientific merit of the
proposed program, as evidenced by the priority score, and the availability of
funds.  Subject to the availability of necessary funds and consistent with the
objectives of the Nutrition Academic Award, the NHLBI and NIDDK will provide
funds for a project period up to five years.

INQUIRIES

Inquiries concerning this RFA are encouraged.  The opportunity to clarify
issues or answer questions from potential applicants is welcomed.

Direct inquiries regarding programmatic issues to:

Elaine J. Stone, Ph.D., M.P.H.
Division of Epidemiology and Clinical Applications
National Heart, Lung, Blood Institute
6701 Rockledge Drive, Room 8134, MSC-7936
Bethesda, MD  20892-7936
Telephone:  (301) 435-0382
FAX:  (301) 480-1669
Email: Stonee@gwgate.nhlbi.nih.gov

Eva Obarzanek, Ph.D., M.P.H., R.D.
Division of Epidemiology and Clinical Applications
National Heart, Lung, Blood Institute
6701 Rockledge Drive, Room 8136, MSC-7936
Bethesda, MD  20892-7936
Telephone:  (301) 435-0383
FAX:  (301) 480-1669
Email: ObarzanE@gwgate.nhlbi.nih.gov

Judith M. Podskalny, Ph.D.
Division of Digestive Diseases and Nutrition
National Institute of Diabetes and Digestive and Kidney Diseases
45 Center Drive, Room 6AN-12E, MSC 6600
Bethesda, MD  20892-6600
Telephone:  (301) 594-8876
FAX:  (301) 480-8300
Email:  jp53s@nih.gov

Direct inquiries regarding review matters, address the letter of intent and
mail two copies of the completed application to:

C. James Scheirer, Ph.D.
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
6701 Rockledge Drive, Room 7220, MSC 7924
Bethesda, MD  20892-7924
Telephone:  (301) 435-0266
FAX:  (301) 480-3541
Email: js110@nih.gov

Direct inquiries regarding fiscal matters to:

Marie A. Willett
Grants Operation Branch
National Heart, Lung, and Blood Institute
6701 Rockledge Drive, Room 7156, MSC 7926
Bethesda, MD  20892-7926
Telephone:  (301) 435-0144
FAX:  (301) 480-3310
Email:  Marie_Willett@nih.gov

Nancy Dixon
Grants Management Branch
National Institute of Diabetes and Digestive and Kidney Diseases
45 Center Drive, MSC 6600
Bethesda, MD  20892-6600
Telephone:  (301) 594-8854
FAX:  (301) 480-3504
Email:  dixonn@extra.niddk.nih.gov

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No.
93.837.  Grants are made under the authorization of the Public Health Service
Act, Title III, Section 301 (Public Law 78-410, as amended by Public Law
99-158, 42 US 241 and 285) and administered under PHS grants policies and
Federal Regulations 42 CFR 52 and 45 CFR Part 74.  This program is not subject
to the intergovernmental review requirements of Executive Order 12372 or to a
review by a Health Systems Agency.

The PHS strongly encourages all grant recipients to provide a smoke-free
workplace and promote the non-use of all tobacco products.  In addition,
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain
facilities (or in some cases, any portion of a facility) in which regular or
routine education, library, day care, health care or early childhood
development services are provided to children.  This is consistent with the
PHS mission to protect and advance the physical and mental health of the
American people.

References

American Medical Student Association, Nutrition Curriculum Project. 
Essentials of nutrition education in medical schools: a national consensus. 
Acad Med 1996;71(9):969-971.

Bruer RA, Schmidt RE, David H.  Commentary: nutrition counseling--Should
physicians guide their patients?  Am J Prev Med 1994;10(5):308-311.

Committee on Nutrition in Medical Education, National Research Council. 
Nutrition education in U.S. medical schools.  Washington, DC: National Academy
Press, 1985.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol
in Adults. Summary of the Second Report of the National Cholesterol Education
Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High
Blood Cholesterol in Adults (Adult Treatment Panel II).  JAMA 1993;269:
3015-3023.

Hark LA, Iwamoto C, Melnick DE, Young EA, Morgan SL, Kushner R, Hensrud DD. 
Nutrition coverage on medical licensing examinations in the United States.  Am
J Clin Nutr 1997;65:568-571.

Hunt JR, Kristal AR, White E, Lynch JC, Fries E.  Physician recommendations
for dietary change:  their prevalence and impact in a population-based sample. 
Am J Public Health 1995;85:722-726.

Krauss RM, Deckelbaum RJ, Ernst N, Fisher E, Howard BV, Knopp RH, Kotchen T,
Lichtenstein AH, McGill HC, Pearson TA, Prewitt TE, Stone NJ, Van Horn L,
Weinberg R. Dietary guidelines for healthy American adults.  A statement for
health professionals from the Nutrition Committee, American Heart Association. 
Circulation 1996;94:1795-1800.

Morrison G, Hark L.  Medical Nutrition and Disease.  Blackwell Science:
Philadelphia 1996.

National Heart, Lung, and Blood Institute.  Report of the Task Force on
Research in Epidemiology and Prevention of Cardiovascular Diseases. 
Washington, DC: USDHHS, NIH, NHLBI 1994.

National Heart, Lung, and Blood Institute.  Clinical guidelines on the
identification, evaluation, and treatment of overweight and obesity in adults
รพ the evidence report.  Obes Res 1998;6:51S-210S.

National High Blood Pressure Education Program.  Working Group Report on
Primary Prevention of Hypertension.  National Heart, Lung, and Blood
Institute, National Institutes of Health.  USDHHS, NIH Publication No.
93-2669, 1993.

National Research Council.  Diet and Health: Implications for Reducing Chronic
Disease Risk, National Academy Press: Washington, DC, 1989.

Ockene IS, Herbert JR, Ockene JK, Merriam PA, Hurley TG, Gordon MS.  Effect of
training and a structured office practice on physician-delivered nutrition
counseling: The Worcester-Area Trial for Counseling in Hyperlipidemia (WATCH). 
Am J Prev Med 1996;12(4):252-258.

Pearson TA, McBride PE, Miller NH, Smith SC.  Organization of preventive
cardiology services:  Task Force 8 Bethesda Conference Report.  JACC
1996;27(5):1039-1047.

Schucker B, Wittes JT, Santanello NC, Weber SJ, McGoldrick D, Donato K, Levy
A, Rifkind BM.  Change in cholesterol awareness and action.  Results from
national physician and public surveys.  Arch Intern Med 1991;151:666-673.

Tobin BW.  Nutrition in the basic medical sciences curriculum.  Nutrition
Today 1997;32(2):54-62.

US Department of Health and Human Services.  Surgeon General's Report on
Nutrition and Health.  USDHHS, Public Health Service, DHHS (PHS) Publication
No. 88-50210, Washington, DC, 1988, p. 4.

US Department of Agriculture and US Department of Health and Human Services. 
Nutrition and Your Health: Dietary Guidelines for Americans.  Home and Garden
Bulletin No. 232, 1995.

US Department of Health and Human Services.  Healthy People 2000: National
health promotion and disease prevention objectives.  Washington, DC: US GPO,
DHHS Pub. No. 93-1332, 1991.

US Preventive Services Task Force.  Guide to clinical preventive services, 2nd
ed.  Baltimore: Williams and Wilkins, 1996.

Winick M.  Nutrition education in medical schools.  Am J Clin Nutr 1993;58:
825-827.

Zimmermann M, Kretchmer N.  Isn't it time to teach nutrition to medical
students?  Am J Clin Nutr 1993;58:828-829.



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