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practice applicationsEDITOR’S OUTLOOK

“Eating for Two” Takes on New Meaningsett

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here was a time when pregnancysignaled concern for adequateenergy intake. Especially among

hinner women, the idea of gaining 30r more pounds over the course ofregnancy was associated with fewermall-for-gestational-age babies andower infant mortality rate (1). Small-or-gestational-age babies appear toave higher cortisol levels and higherercent body fat in adulthood (2-4).ubsequently, the Institute of Medi-ine in 1990 published guidelines forestational weight gain that ad-ressed these concerns by recom-ending lower weight gains among

bese women (1). More recent studieseport the absence of adverse affectsf lower maternal weight gain thatay have benefits long term regard-

ng maternal weight control withoutompromising birth outcome or theutritional status of the baby (5).In regard to further ways to en-

ance maternal weight control, espe-ially between pregnancies, growingiterature documents the benefits ofreastfeeding, with inverse associa-ions between length of time breast-eeding and not only postpartumeight loss, but reduced risk of over-eight in the offspring (6). While thexact mechanisms are unknown andre suggested to include behaviorals well as metabolic effects, the im-ortance of breastfeeding for reasonselevant to the health of both mothernd child, continues to mount.In this issue, Novotny and col-

eagues (p 1743) present additionalata from a study among children liv-ng in the Northern Mariana Islandsurther corroborating this finding. To-ether, improved maternal nutritionuality and weight gain along withubsequent breastfeeding practicesffer the potential for addressingeight-control strategies that could

nd should have major public health d

2007 by the American Dietetic Associat

ignificance as research in these ar-as continues to mount. Such preven-ion oriented efforts are key to effec-ive reduction of the obesity epidemic.

LSO THIS MONTHhat would happen if everyone com-

lied with recommendations to sub-titute monounsaturated canola oilor other oils commonly used in thisountry? This is the question studiedy Johnson and colleagues (p 1726).sing data from the National Healthnd Nutrition Examination Survey999-2002, the authors posed thisuestion and discovered that such anpproach would theoretically in-rease compliance with dietary rec-mmendations for saturated andonounsaturated fatty acid and

-linolenic acid but not linoleic acid.uch a public health shift could po-entially greatly enhance the overalluality of the national diet with sub-equent impact on cardiovascularisk factors.Also, as the public attempts to

ackle their weight-loss efforts, arehere particular programs or planshat are higher diet quality than oth-rs? Ma and colleagues (p 1786) ad-ressed this question and offer theirerspectives on this subject. Usinghe Alternate Healthy Eating In-ex, the authors compared populareight-loss diets to determine the rel-tive benefits of these programs. Theigh-complex carbohydrate, semi-egetarian Ornish-type diet was theverall winner, with the Atkins dietanking lowest among the dietsested. Since fruits, vegetables, andhole grains offer essential nutrients

hat are incorporated in the Healthyating Index, it is not surprising thatdiet low in these carbohydrate foodsould not measure up to the stan-

ards.

ion Journal

ISE IN IMPACTinally, the Journal’s Impact Factoras risen to an all-time high of 2.56,anking 13th among all nutrition-elated published journals. We arerateful to you the readers for ex-ressing support for high-quality, ev-dence-based nutrition research andt is a privilege to thank our authorsnd reviewers for their ongoing scien-ific integrity and academic rigor.lease feel free to share with us youromments, suggestions, and ideas toring the Journal to an even higherlace.Best regards.

inda Van Horn, PhD, RDditor-in-Chief

oi: 10.1016/j.jada.2007.08.018

eferences. Food and Nutrition Board, Institute of Medi-

cine. Nutrition during Pregnancy: Part I:Weight Gain. Part II: Nutrition Supplements.Washington, DC: National Academies Press;1990.

. Gillman M, Rich-Edwards J, Huh S, MajzoubJ, Oken E, Taveras E, Rifas-Shiman S. Ma-ternal corticotropin-releasing hormone levelsduring pregnancy and offspring adiposity.Obesity. 2006;14:1647-1653.

. Levitt NS, Lambert EV, Woods D, Hales CN,Andrew R, Seckl JR. Impaired glucose toler-ance and elevated blood pressure in low birthweight, nonobese, young South Africanadults: early programming of cortisol axis.J Clin Endocrinol Metab. 2000;85:4611-4618.

. Phillips DIW, Barker DJP, Fall CHD. Ele-vated plasma cortisol concentrations: A linkbetween low birth weight and the insulin re-sistance syndrome? J Clin Endocrinol Metab.1998;83:757-760.

. Harder T, Bergmann R, Kallischnigg G,Plagemann A. Duration of breastfeeding andrisk for overweight: A meta-analysis. Am JEpidemiol. 2005;162:397-403.

. Taveras E, Rifas-Shiman S, Scanlon K,Grummer-Strawn L, Sherry B, Gilman M. Towhat extent is the protective effect of breast-feeding on future overweight explained by de-

creased maternal feeding restriction? Pediat-rics. 2006;118:2341-2348.

of the AMERICAN DIETETIC ASSOCIATION 1701