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Institution
Progress Report
Date
Healthy Diets at Grow Benzie Grow Benzie Project Title: Healthy Diets at Grow Benzie Institution: Grow Benzie Date: April 2017 Grow Ben...More ...
4/30/2017
Exercise in the overnight-fasted state: a practical nutritional strategy to augment intramyocellular triglyceride turnover in obesity? University of Birmingham, UK Background Obesity is a major public health issue and its association with insulin resistance gre...More ...
4/28/2017
Improving access to healthy, locally grown food by low-income families in Shiawassee County. DeVries Nature Conservancy Through the generous financial support of the Allen Foundation, DeVries Nature Conservancy launched ...More ...
11/22/2016
Healthy Diets at Grow Benzie Grow Benzie Project Title: Healthy Diets at Grow Benzie Institution: Grow Benzie Date: April 2016 Grow B...More ...
4/26/2016
Leptin and developmental delays in growth retarded preterm infants UC Davis Thanks to the gracious funding provided by the Allen Foundation, we have made substantial progress i...More ...
4/25/2016
Simply Delicious Workshop Oregon State University Foundation on behalf of the Healthy Youth Program, Linus Pauling Institute Funding Period: September 1, 2014, to August 31, 2015 Project Goals and Objectives: The goal o...More ...
8/19/2015
Meals on Wheels with Love Northwest Michigan Community Action Agency Dear Allen Foundation Board of Directors, We are very grateful for the $48,000 grant to the Meal...More ...
4/30/2015
Emergency Expansion Allied Churches of Alamance County, Inc. Overview The U.S. Census Bureau (2010) has published that per capita income in Burlington is $23,40...More ...
4/30/2015
MSUE Cooking Matters and Nutrition Program Incentives Michigan State University Extension Originally, the grant requested from the Allen Foundation was to fund participant take home grocerie...More ...
4/30/2015
Fighting with Your Fork Mary Bird Perkins Cancer Center Mary Bird Perkins Cancer Centers Fighting with Your Fork program provides nutrition education that e...More ...
4/29/2015
The Nutrition Center Progress Report The Nutrition Center Allen Foundation Progress Report Dear Members of the Board of the Allen F...More ...
4/29/2015
Aerobic exercise training in the overnight-fasted state: a practical nutritional strategy to augment intramyocellular triglyceride turnover in obesity? University of Birmingham, UK. Summary of Project Obesity is a major public health issue and its association with insulin resist...More ...
4/28/2015
Healthy Lifestyles Program for Individuals with Developmental Disabilities Maryland Community Connection Summary of Project Funding from the Allen Foundation for this project introduced healthy lifestyles...More ...
4/28/2015
Web Based Nutrition Education for Health Professions Students New York Institute of Technology Project Title: Web Based Nutrition Education for Health Professions Students Institution: New York ...More ...
4/28/2015
Cooking n' the Pantry Cornell Cooperative Extension of Niagara County Cooking n the Pantry has had a very successful first six months of the programming, from October 1, ...More ...
4/28/2015
Weekend Backpack Program McKenzie School District The McKenzie School District extends 42 miles along the McKenzie River at the eastern edge of Lane C...More ...
4/27/2015
Improving access to healthy, locally grown food by low-income families in Shiawassee County. DeVries Nature Conservancy Through the generous financial support of the Allen Foundation, DeVries Nature Conservancy has launc...More ...
4/24/2015
Healthy Diets at Grow Benzie Grow Benzie Project Title: Healthy Diets at Grow Benzie Institution: Grow Benzie Date: Mar. 7, 2015 Grow ...More ...
3/7/2015
Midland County Emergency Food Pantry network BackPack Buddies Program Midland County Emergency Food Pantry Network The BackPack Buddies program provides a weekend backpack of food to low income elementary students i...More ...
1/9/2015
Leptin and developmental delays in growth retarded preterm infants UC Davis Given below are the financial statement and scientific progress of the project, over the first 5 mon...More ...
12/30/2014
Nutrition and Wellness Promotion Among the Immigrant Population Spanish Catholic Center of Catholic Charities The Pasos Saludables Program is a self-management intervention program that promotes healthy eating ...More ...
5/2/2014
Role of Nucleotide-Binding and Oligomerization Domain Containing Protein (NOD) 1 in Diet-Induced Adipose Inflammation and Obesity University of Tennessee Knoxville Ling Zhao, PhD Proposal Number: 2011.393: Role of Nucleotide-Binding and Oligomerization Domain Con...More ...
4/30/2014
Longview Early Childhood Kitchen Project Midland County Educational Service Agency Progress Report on Longview Early Childhood Centers Kitchen: Longview Early Childhood Centers Kit...More ...
4/30/2014
Omega Tots: Polyunsaturated fatty acids to promote brain development in toddlers born prematurely The Research Institute at Nationwide Children's Hospital *************** INTRODUCTION *************** This report outlines activities of the project entit...More ...
4/22/2014
A Guatemalan Nutritioinal Expansion Program Due to the generosity of the Allen Foundation and others, Feed the Dream continues to make significa...More ...
4/17/2014
Feedign Program Children of Strength Children of Strength a US non-profit providing assistance to orphans in Kenya is in the second year ...More ...
4/10/2014
Healthy Habits Among the Elderly Western Michigan University Allen Foundation End of the Year Progress Report Dr. Amy Curtis Diana Hassan Western Michigan Uni...More ...
3/14/2014
The Effect of Vitamin D Supplementation on Pre-Diabetes in Obese Adolescents The University of Georgia Vitamin D supplementation trials with diabetes-related outcomes have been conducted exclusively in a...More ...
12/20/2013
Feeding Program Children of Strength Children of Strength a US non-profit providing assistance to orphans in Kenya, received a generous...More ...
5/10/2013
Nutrients regulate transcription via mTORC1 and Early Growth Response factors Boston University Medical School Konstantin Kandror, PhD Proposal Number: 2010.395: Nutrients regulate transcription via mTORC1 and ...More ...
5/3/2013
Circle Area Community Garden Caregiving Network, Inc. The Allen Foundation Grant (2011.047) Progress Report (April 30, 2013) The Circle Area Community ...More ...
5/1/2013
Healthy Habits Among the Elderly Western Michigan University Health Habits Program 6- month progress report Dr. Amy Curtis Diana Hassan Healthy Habits Pr...More ...
5/1/2013
Role for fatty acid consumption in the treatment of obesity Victoria University Allen Foundation: Progress report The Allen Foundation generously funded our project investigatin...More ...
4/30/2013
Growing Community Workshops Central Rivers Farmshed Central Rivers Farmshed’s Growing Community Grant Outcomes Since 2007, Central Rivers Farmshed ha...More ...
4/30/2013
Omega Tots: Polyunsaturated Fatty Acids to Promote Brain Development in Toddlers Born Prematurely The Research Institute at Nationwide Children's Hospital ************************ ******Introduction****** ************************ This report outlines Y...More ...
4/30/2013
YMCA Veggie Access Project YMCA of Greater Grand Rapids The following is a brief financial accounting of the expenditures of our Allen Foundation grant: ...More ...
4/30/2013
Healthy Families South Africa INMED Partnerships for Children With a generous grant from the Allen Foundation, INMED Partnerships for Children expanded its succes...More ...
4/29/2013
Role of Nucleotide-Binding and Oligomerization Domain Containing Protein (NOD) 1 in Diet-Induced Adipose Inflammation and Obesity University of Tennessee-Knoxville Progress report for the period: June 2012-May 2013 Obesity is one of the leading health problems ...More ...
4/29/2013
Feed the Dream--A Guatemalan Nutritional Expansion Program Due to the gracious generosity of the Allen Foundation and others, Feed the Dream continues to make ...More ...
4/26/2013
Food & Nutrition Support for HIV/Hep C Positive Individuals in Metropolitan Detroit Health Emergency Lifeline Programs Health Emergency Lifeline Programs received a generous grant of $16,500 from the Allen Foundation in...More ...
5/14/2012
Healthier Students Kingman Elementary School Kingman Elementary is a very small,rural,poor community school in Northern Maine. I iniated this gra...More ...
5/11/2012
Meeting the Nutritional Needs of College-Age Women in a Residential College Setting Cedar Crest College The following report details the progress of Cedar Crest College’s Allen Center for Nutrition’s “Mee...More ...
5/11/2012
Jefferson Ave Community Garden Caregiving Network, Inc. (EIN: 38-3202784) 05/11/2012 Progress Report: Caregiving Network and the Jefferson Ave Community Garden group remai...More ...
5/11/2012
2010.447 Michigan State University Extension Project Title: Project FRESH 2011 Institution: Michigan State University Extension Date 5-11-201...More ...
5/11/2012
Ypsilanti Health Initiative Ypsilanti Health Initiative / Ginsberg Center/University of Michigan Overview The Ypsilanti Health Initiative seeks to make healthy living more affordable and accessi...More ...
5/11/2012
A Double-Blind Placebo-Controlled Study of the Effect of Lutein/Zeaxanthin Supplementation on Macular Pigment Optical Density (MPOD) and Retinal Pigment Epithelium (RPE)/Photoreceptor Layer Architecture in Normals State University of New York, College of Optometry 40 students at SUNY College of Optometry were randomly chosen to participate in the project (there w...More ...
5/10/2012
Nutrients regulate transcription via mTORC1 and Early Growth Response factors Boston University School of Medicine Konstantin Kandror, PhD Proposal Number: 2010.395: Nutrients regulate transcription via mTORC1 and ...More ...
5/10/2012
Characterization of a Biomedical Model for Childhood Obesity University of Missouri The prevalence of childhood obesity has almost tripled over the last 20 years. The short- and long-t...More ...
5/9/2012
Project Agro: Feeding and Educating Communities Innovation: Africa Innovation: Africa received funding from the Allen Foundation to pilot a new initiative: providing...More ...
5/1/2012
Tu Corazon Tu Vida La Luz Center There is a dire need in the Sonoma Valley for comprehensive health and nutrition education directed ...More ...
5/1/2012
Passport to Healthy Living Program Episcopal Social Services of New York, Inc. Episcopal Social Services Year-End Report to the Allen Foundation Grant of $23,350 for the Passpor...More ...
5/1/2012
Innovative Nutrition Education for Medical Students Progress Report Boston Medical Center This project entailed three connected components that involve several activities and partners includ...More ...
5/1/2012
Growing Power Youth Corps Growing Power, Inc The Growing Power Youth Corps (GPYC) is a year-round, youth leadership program offering urban youth ...More ...
4/30/2012
Nutrition Education for Meal on Wheels and Congregate Nutrition Program Recipients Project Title: Nutrition Education for Meals on Wheels and Congregate Nutrition Program Participants...More ...
4/27/2012
A Native American Nutrition Education Program for Type 2 Diabetes Physicians Committee for Responsible Medicine With a grant of $20,000 from the Allen Foundation, Physicians Committee for Responsible Medicine (PC...More ...
4/26/2012
Nutrition Education Curriculum for the Parents as Teachers Program Weller Health Education Center Project Background The Weller Health Education Center received a $9600 grant from the Allen Foundat...More ...
4/19/2012
Folate, B-Vitamins and Reduced Risk of Autism Spectrum Disorders: Prospective Examination of an Association and Mechanisms University of California, Davis The Allen Foundation generously funded our project to prospectively collect data on B-vitamin intake...More ...
3/9/2012
Passport to Healthy Living Episcopal Social Services of New York, Inc. Episcopal Social Services Mid-Year Report to the Allen Foundation Grant of $23,350 for the Passpor...More ...
12/28/2011
Ypsilanti Health Initiative University of Michigan Receiving funding from the Allen Foundation has ensured the continued operation and expansion of the...More ...
12/20/2011
Folate, B-Vitamins and Reduced Risk of Autism Spectrum Disorders: Prospective Examination of an Association and Mechanisms University of California Davis The Allen Foundation generously funded our project to prospectively collect data on B-vitamin intake...More ...
10/2/2011
Foods For Health: Meat Patty with Added Legumes Louisana State University Agricultural Center Initial plan for the program was to feed children conventional foods where some of the meat was sub...More ...
8/21/2011
THE USE OF MILK IN FLOURS IN THE TREATMENT OF MODERATE MALNUTRITION Washington University 11-May-11 The trial was successfully conducted, with remarkable results! This is the first time ...More ...
5/11/2011
Expansion of Project Healthy Schools, Ypsilanti, MI, Middle Schools University of Michigan This school year marks the 7th year that Project Healthy Schools (PHS) has been encouraging healthy ...More ...
5/3/2011
Canned soup consumption and urinary bisphenol A Brigham and Women's Hospital Allen Foundation Progress Report 4/22/2011 CANNED SOUP CONSUMPTION AND URINARY BISPHENOL A Proj...More ...
4/29/2011
Berrien County Farmers Market Enhancement Berrien County Health Department Funding from the Allen Foundation has allowed the Berrien County Health Department to greatly enhanc...More ...
4/28/2011
Kids Cafe Nutrition Education Central Pennsylvania Food Bank The Central Pennsylvania Food Bank received a $10,000 grant from the Allen Foundation for its Kids C...More ...
4/27/2011
Nutrition 2.0: Nutrition Education for Parents, Caregivers and Practitioners of Children with Disabilities and Special Needs Easter Seals Florida, Inc. With the assistance of the Allen Foundation, Easter Seals Florida (ESF) created and implemented...More ...
4/15/2011
Growing Power Youth Corps Growing Power is pleased to report progress to the Allen Foundation regarding funds provided to supp...More ...
5/4/2010
Folate, B-Vitamins and Reduced Risk of Autism Spectrum Disorders: Prospective Examination of an Association and Mechanisms University of California - Davis Project Timeline: 02/01/2010 – 01/31/2012 The Allen Foundation generously funded our project to pr...More ...
5/1/2010
Nutrition Outreach and Resources Project for Elementary School Children Cedar Crest College The focus of the grant awarded to Cedar Crest College for 2009-2010 was to evaluate the community nu...More ...
4/30/2010
FEED THE DREAM--A Guatemalan Nutritional Expansion Program, Site #3 None Once again due to the gracious generosity of the Allen Foundation and others, Feed the Dream has ...More ...
4/1/2010
Development of Specialized Therapeutic Soy Foods for Treatment of Malnutrition Washington Univeristy The research description and findings are as follows Severe childhood malnutrition is defined as ...More ...
12/26/2009
A Proposal to Develop Scenarios for a Game Based Computer Simulation for Dietetics Education Central Michigan University FINAL REPORT: ALLEN FOUNDATION PROJECT TITLE: A PROPOSAL TO DEVELOP SCENARIOS FOR A GAME BASED C...More ...
10/29/2009
Developing and Promoting Interdisciplinary Competencies in Feeding and Pediatric Nutrition USC UCEDD Childrens Hospital Los Angeles. Developing and Promoting Interdisciplinary Competencies in Feeding and Pediatric Nutrition Princi...More ...
5/7/2009
Epidemiological evaluation of Anaemia amongst tribal women and children St. Johns Research Institute Summary of Work and Accomplishments: We have completed our field work and successfully recruited ou...More ...
5/4/2009
Independent Living Training Florence Crittenton Home and Services The nutrition component of Florence Crittenton Home’s Independent Living Training Program (ILT) flou...More ...
5/1/2009
Patroon Land Farm (a Project of the Regional Food Bank of Northeastern New York) Regional Food Bank of Northeastern New York The Regional Food Bank of Northeastern New York works to alleviate hunger and prevent food waste by ...More ...
5/1/2009
Healthy Choices Program La Maestra Family Clinic La Maestra Family Clinic, Inc 4185 Fairmount Ave San Diego CA 92105 Reporting Period: June 2...More ...
4/30/2009
The Benefits of a Nutritious Breakfast for School-Age Children Cedar Crest College In June 2006, 2007 and 2008 the Allen Foundation awarded Cedar Crest College one-year, $50,000 grant...More ...
4/29/2009
Determining role of vitamin A in obesity development Department of Nutrition, the University of Tennessee at Knoxville Progress Report (For grant #171) Guoxun Chen, PhD, Department of Nutrition, the University of Tenne...More ...
4/24/2009
FEED THE DREAM--A Guatemalan Nutritional Expansion Program, Site #3 None Project Title: A Guatemalan Nutritional Expansion Program, Site #3 Institution: Feed the Dream D...More ...
4/20/2009
New Kitchen for Parent Training Program Baptist Child & Family Services Baptist Child & Family Services (BCFS) was pleased to receive the awarded amount of $4,475 from the ...More ...
4/15/2009
Promoting Good Nutrition During Infusion Therapy MidMichigan Medical Center-Midland In 2008, MidMichigan Medical Center-Midland received an Allen Foundation grant of $3,060 toward equi...More ...
4/14/2009
Development of Specialized Therapeutic Soy Foods for the treatment of Malnutrition Washington University Allen Foundation Report $71,500 grant award, 2008 December, 2008 Development of Specialized ...More ...
12/31/2008
Vitamin D Deficiency and Rickets Among Healthy Infants and Toddlers Children's Hospital Boston Allen Foundation Annual Report - 2007 Project Title: Vitamin D Deficiency and Rickets among Healt...More ...
7/9/2008
Developmental outcomes of maternal micronutrient supplementation at three years of age Lancaster University Developmental Outcomes of Maternal Multiple Micronutrient Supplementation Goals The three goals ...More ...
6/11/2008
Della Terra educational We have been committed to expanding community awareness around the topic of early childhood nutritio...More ...
5/23/2008
Rescuing the Future Strategy Food Bank of Eastern Michigan The Food Bank of Eastern Michigan has completed the expansion process necessary to support its ...More ...
5/1/2008
The Allen foundation K-12 Nutrtion Initiative Cedar Crest College May 2008 Report to the Allen Foundation The Cedar Crest College project worked to accomplish the ...More ...
4/30/2008
FEED THE DREAM--"A Guatemalan Nutritional Expansion Program, Site #3 Project Title: A Guatemalan Nutritional Expansion Program, Site #3 Institution: Feed the Dream D...More ...
4/27/2008
Establishing an Iron-bioavailability Database University of Hawai'i at Manoa There is a growing concern over both iron deficiency, as well as iron overload. Reliable information...More ...
1/6/2008
West Midland Family Center- Making Hot Lunch a Reality West Midland Family Center The Allen Foundation provided West Midland Family Center with $10,550, which we used to purchase a c...More ...
12/18/2007
Improved Supplementary Feeding with Ready-to-Use Food Washington University This project has developed a new, low cost, energy dense, ready-to-use food for supplementary feedin...More ...
12/17/2007
Vitamin D Deficiency and Rickets among Healthy Infants and Toddlers Children's Hospital Boston Summary of Work and Accomplishments: We completed enrollment for our prevalence study on June 30, 2...More ...
12/12/2007
Improving the Health and Nutritional Status of Rural Guatemalan Women and Children Project Concern International Improving the Health and Nutritional Status of Rural Guatemalan Women and Children Through Expanded ...More ...
8/23/2007
Developmental outcomes of maternal multiple micronutrient supplementation Lancaster University This project is currently being undertaken with the support of the Allen Foundation is based on and ...More ...
5/3/2007
The Allen Foundation Elementary School Nutrition Education Initiative Cedar Crest College Cedar Crest College Report to the Allen Foundation During the past 10 months, The Allen Foundatio...More ...
4/26/2007
Healthy Living Montessori Children's House - Grand Traverse Healthy Living The Children’s House, an independent Montessori School Through generous suppo...More ...
4/10/2007
Food for Thought Geisinger Center for Health Research Since Dr. Larson assumed responsibility for this Allen Foundation funding opportunity, there has bee...More ...
2/22/2007
Dish Sanitizer for Camp Neyati Midland Camping Council The Midland Camping Council purchased and installed a new dish sanitizer in June for use by campers ...More ...
1/8/2007
Complementary feeding with ready-to-use food in young children in Malawi Dept of Pediatrics, Washington University School of Medicine Adequate complementary feeding is a significant problem in rural Malawi. We conducted a randomized ...More ...
1/7/2007
Child and Family Centered Nutrition & Health Enrichment Project West Midland Family Center Our initial concern was that many children in the western region of Midland County were being raised...More ...
1/5/2007
Establishing an Iron-bioavailability Database University of Hawai'i at Manoa The objectives of this project are to establish an in-vitro, cell-culture-based assay to compare the...More ...
12/21/2006
Utilization of bean based foods University of Botswana The nutritional aspect of HIV/AIDS has been a neglected dimension in the management and care of HIV/...More ...
6/18/2006
Midland, MI Civic Arena Fast Ice, Inc. The generous grant from the Allen Foundation to Fast Ice, Inc. has allowed significant improvements ...More ...
5/24/2006
Healthy Whole Grain Choices for Children and Parents: A School-Based Pilot Intervention University of Minnesota Final Report A 6-week multi-component school-based intervention including a 5-lesson classroom cu...More ...
3/28/2006
Complementary feeding with ready-to-use food in young children in Malawi Washington University Progress Report Complementary feeding with ready-to-use food in young children in Malawi. Grow...More ...
1/4/2006
Establishing an Iron Bioavailability Database University of Hawaii at Manoa Progress Report I. EXPENDITURES As of December 15, 2005, of the tota...More ...
12/28/2005
West Midland Family Center's Child and Family Centered Nutrition and Health Enrichment Project West Midland Family Center Our initial concern was that many children in the western region of Midland County were being raised...More ...
12/27/2005
Healthy Children, Healthy Futures - Improving Nutrition through School and Community Gardens International Medical Services for Health dba INMED Partnerships for Children Duque de Caxias, historically a sugar plantation, is situated north of the city of Rio de Janeiro, B...More ...
7/1/2005
Feeding Fish to Feed the People Marine Biological Laboratory The MBL project has gone according to the proposed timeline with a brief delay in progress due to th...More ...
1/13/2005
Healthy Children, Healthy Futures - Improving Nutrition through School and Community Gardens International Medical Services for Health dba INMED Partnerships for Children Duque de Caxias, historically a sugar plantation, is situated north of the city of Rio de Janeiro, B...More ...
12/31/2004
Communication Connections Saranac Community Schools Dear Mr. Baum, and The Allen Foundation Board of Trustees, In these difficult financial times for...More ...
12/27/2004
Immunotherapeutic Enhancement of the Repair of Host Defense of Nutritionally Deprived Mice. Michigan State University **Hard copies of publications and final budget were provided via mail.** Summary of Accomplishmen...More ...
6/24/2004
Kitchen at Camp Neyati United Way of Midland County The Midland Camping Council appreciates the grant for $6500 for purchasing a stove, refrigerator, an...More ...
5/27/2004
Project FRESH Michigan State University Extension Progress Report The goals for Project FRESH 2003 included reaching 1,320 families (10% increase o...More ...
5/4/2004
Community Service Scholarship for Graduate Students Enrolled in the CMU Dietetic Internship Central Michigan University Annual Report to the Allen Foundation, Inc. May 2003 to April 2004 This report covers the grant ...More ...
4/13/2004
Holy Rosary School, K - 8 Nutrition Education Grant Holy Rosary School; 4142 42nd Ave SW; Seattle, WA 98116 May 14th, 2002 Allen Foundation Inc. P.O. Box 1606 Midland, Michigan 48641-1606 Dear Exec...More ...
4/10/2003
The development of the mountainous region NGO Centre for the development of the mountainous region 12members,Staff-3members,,Exwcutive-5members,Health-care-3members,Culturaldevelopment-3members,Elder...More ...
11/30/2002
Effect of Varied Nutrient Substrate on Weight loss and Satiety University of Minnesota Analysis has been made of data for the first 27 subjects. An abstract has been submitted to ADA's Fo...More ...
9/6/2002
Home-based therapy for protien-energy malnutrition Washington University in St. Louis The field work has been completed. The children recieving the ready to use peanut butter food had a...More ...
9/6/2002
Refeeding Issues in Oncology Patients Receiving Parenteral Nutrition CMU/Mid Michigan Medical Center Data collection has been completed with a total of 41 patients enrolled. Preliminary statistics sho...More ...
9/6/2002
The Children's Kitchen classroom Montessori Children's House and Elementary School, Traverse City, MI New classroom kitchen due to open in June 2002....More ...
9/6/2002


Project Title: Healthy Diets at Grow Benzie
Institution: Grow Benzie
Date: 4/30/2017
Report:
Project Title: Healthy Diets at Grow Benzie
Institution: Grow Benzie
Date: April 2017

Grow Benzie’s Healthy Diets program provides experiential learning opportunities for youth and adults that teach them how to grow, harvest, prepare and cook healthful foods for themselves and their families. Grow Benzie’s educational programs include off-site visits to local schools and events, and on our 4-acre campus including 16,000 sqft of hoop houses, 1,500 sqft commercial kitchen, 5,000 sqft event center, a 2,700 sqft community garden, and a food truck.

The purpose of the project was for Grow Benzie to act as a catalyst in the community for better diets, better health, and regional economic activity. Our grant request of $20,000 per/yr (3 years total) was for helping us expand our existing programs, such as our farmers market and health/food classes, and expand our organization’s capacity by creating new programs including the addition of a youth hoop house and funding employee wages.

As detailed below, we have accomplished nearly 100% of our goals as listed in our initial proposal. We’re grateful to the Allen Foundation for providing Grow Benzie financial flexibility to grow from a working volunteer board and two (very) part time employees, to ultimately hiring a full time Executive Director, a part-time food truck manager, an after school coordinator, a part-time facilities manager, and a part-time greenhouse manager. The ripple effect from your award has resulted in other grant opportunities, including upgrades to our facilities and a consultation grant to complete our first Strategic Plan. The pursuit of our planning and funding strategies, including fundraising and revenue creation, by a dedicated employee would not be possible without the support of the Allen Foundation helping pay the wages of our part-time managers- for that we are grateful.

Staff:
Over the past three years, we have expanded our Kitchen Manager’s position into a broader role as Facilities Manager, and now supervises all scheduling and planning for programs in our community center and commercial kitchen. In 2016, her position grew to include book keeping and helping with social media and promotions. Creating revenue from the rentals and fee for service events is part of our funding strategy and is possible thanks to the Allen Foundation. We expanded our Greenhouse Manager’s responsibilities as a Garden Educator to include teaching workshops about gardening (prep, seed saving, compost) and food preserving (pickling, dehydrating, canning, etc). In the winter of 2016, Grow Benzie expanded its agriculture program to become an incubator farm for two apprentice farmers. One is a local protein farmer, and one is a recent MSU Organic Farming School graduate- both were looking to start their own produce growing operations. Grow Benzie is able to provide them the infrastructure, support network, and markets to sell their produce (including Grow Benzie’s farmers market, our food truck, and three local restaurant accounts). Both farmers will lead future educational workshops for Grow Benzie on growing, preparing, and preserving food. The Allen Foundation has helped us evolve into this capacity which will have exponential, sustainable economic impact in our community.

Farmers Market:
In large part to the support from the Allen Foundation, Grow Benzie has been gaining in popularity as an agritourism destination, particularly for our farmers market. 2016 vendor numbers increased by seven, but our attendance was lower due to the complete reconstruction of state highway M-115 on which we are located. However, our momentum in public awareness grew for the organization. We were recently awarded a grant that will help us distribute $12,500 in fruit/vegetable prescription vouchers at our farmers market to folks with obesity and chronic health issues, and provide clients with multiple nutrition and culinary demonstrations every week. We were also part of a winning collaborative grant to help create a brochure for distribution at food pantries and to help promote/explain how to utilize food assistance programs such as Double Up Food Bucks, WIC (Women-Infants-Children), and Senior Market Fresh at (our) farmers markets.

Youth Programs:
Our youth hoop house was used by a high school after school program called BCIA (Benzie Conserves, Inspires, Adapts) where they experimented with alternative growing methods including hugelkultur beds and mushroom production. They have since moved on to a new on-site project- planting a monarch way station. Over the past three years we’ve surpassed our goal of reaching 200-250 children by hosting field trips, summer camps, and after school programs. In 2016, elementary students learned about, and planted in the kids hoop house, squash seeds that had been passed down through the Miami-Ohio Native American tribes for over a thousand years. Our biggest shortcoming with this grant lies in the school year engagement with local elementaries. Due to the decline in transportation funding and availability of time to leave campus, we had less individual workshops than we were anticipating from our county schools. We hosted a dozen workshops instead of twenty that were hoping for in our initial application. Our work at one local elementary hoop house has sustained itself with support from the FoodCorps and teachers. We also surpassed our goal of hosting two series of “Cooking Matters” classes with MSU Extension. We recently completed our fifth class where youth and their parents learn how to identify, budget, and prepare a healthy meal. Participants also go home with a bag of groceries. We continue to expand our youth programs with relationships to the local sports teams. A half dozen teams have utilized our gardens as a space to volunteer over the past couple years, and all of them have taken advantage of our kitchen facilities to host their own team building activities related to nutrition and healthful food or host family/team night dinners.

Accessibility & Programs:
As previously reported, we expanded our community garden to include raised beds, built from recycled local barn wood and installed on a flat piece of our property, providing accessibility to our partners from multiple organizations and their clients in wheelchairs. We were recently awarded a grant to expand some of our ramps and trails throughout the property which will allow us to provide even more learning opportunities and hands-on engagement for different audiences. Our partnership with Northern Michigan Culinary Arts Community was so fruitful, that in the winter/spring of 2017, we offered dinners and potluck on a weekly basis from March-April, growing from six per season to eleven. Grow Benzie has gained consistent attention for these Tuesday night dinners, enough where attendance averages 40 people; our biggest night had 90 people attend. We have also created a great audience through our social media, e-newsletters, and through word of mouth. In just the past two years, our Facebook likes have increased from 552 to 1785, and we have over 43,000 video views to date. Focus on our outreach and online media presence would not have been possible without the support of the Allen Foundation.

Personnel participating in the grant implementation:

Josh Stoltz, Executive Director: josh@GrowBenzie.org, 231-882-9510

Grant expenditures:
$ 42,500 was spent on employment of our Greenhouse Manager and Facilities Manager
$ 7,500 was spent on promotion of all programs- flyers, print ads, posters, and email
$ 7,000 was spent on supplies and equipment for classes and meals
$ 3,000 was spent on stipends and costs for speakers and events

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Project Title: Exercise in the overnight-fasted state: a practical nutritional strategy to augment intramyocellular triglyceride turnover in obesity?
Institution: University of Birmingham, UK
Date: 4/28/2017
Report:
Background

Obesity is a major public health issue and its association with insulin resistance greatly increases cardiovascular disease and type 2 diabetes risks. Exercise training is recommended for obese populations but carefully controlled longitudinal studies indicate aerobic exercise training in obese individuals in the absence of weight loss has minimal impact on insulin resistance. However, these studies did not consider the impact of recent nutrition, which may reduce the stimulation of intramyocellular triglyceride turnover during exercise and muscle oxidative adaptation to exercise training. High intramyocellular triglyceride turnover during exercise and elevated muscle oxidative capacity are key features of the high levels of insulin sensitivity observed in endurance exercise-trained individuals. It remains to be tested if exercising in the fasted state could be used to optimise intramyocellular triglyceride turnover and metabolic adaptation to training in obese. We investigated the hypothesis that an acute bout of aerobic exercise performed in the overnight-fasted versus fed-state can stimulate greater intramyocellular triglyceride utilization during exercise in obese individuals.

Methods

8 normotensive men (age 29(10); peak oxygen uptake 29(6) ml/kg/min) who were obese or overweight and centrally obese as defined by ethnicity specific cut-offs (BMI 29(3) kg/m2; waist circumference 101(10) cm) completed the study. Each participant completed two main experimental trials preceded by a two-day standardised weight-maintaining diet. The trials consisted of 60 minutes of stationary cycle ergometry performed at 65% peak oxygen uptake, performed in the morning in the overnight-fasted or fed (~90 min post-meal; 25% estimated daily energy intake) state. Substrate oxidation was determined during the exercise bout using indirect calorimetry, and muscle glycogen concentration (acid hydrolysis and enzymatic determination) and fibre-specific intramuscular triglyceride (IMTG) content (immunofluorescence microscopy) were determined from skeletal muscle biopsy samples collected immediately before and after the exercise bout. Data are expressed as Mean+/-Standard Deviation unless otherwise stated, and statistical evaluation included paired-samples two-tailed t-tests or repeated measures ANOVA with post-hoc Bonferroni adjustments where appropriate.

Results

Substrate oxidation: Mean fat oxidation during exercise performed in the fed state was marginally lower than exercise performed in the overnight-fasted state (Mean+/-95% confidence interval: -19 (-6,-32)%; -0.07 (-0.02,-0.12) g/min), but no statistically reliable difference in fat oxidation was observed between conditions (Fed, 0.23(0.08) g/min; Fasted, 0.31(0.10) g/min; P=0.078. Accordingly, mean carbohydrate oxidation was marginally higher in the fed state but this also did not yield a statistically reliable difference from exercise performed in the overnight-fasted state (Fed, 1.65 (0.51) g/min; Fasted, 1.46 (0.51) g/min; P=0.067.

Muscle glycogen: Exercise reduced muscle glycogen concentration from 87(19) to 34(16), and 75(21) to 31(21) mmol/kg wet muscle when undertaken in the fasted or fed state, respectively. Repeated measures ANOVA revealed that the exercise induced reduction was statistically significant (main effect of time [pre-post exercise], P<0.001), but there were no statistically significant differences in muscle glycogen utilisation between the dietary conditions.

IMTG: Repeated measures ANOVA revealed a significant diet-time interaction for Type 1 fibres (P=0.024; expressed as % fibre area stained with Bodipy). In Type 1 fibres, IMTG content before exercise was higher in the fasted as compared to the fed condition (Mean+/-95% confidence interval of the difference: -4.0(-1.1,-6.9) %), but this was not statistically different after statistical adjustment for multiple comparisons (P=0.032). Type I fibre IMTG content significantly decreased from 13.8(4.0) to 10.3(3.4) % when exercise was performed in the fasted state (P=0.008), but no significant change was observed when exercise was performed in the fed state (9.8(4.8) to 11.2(4.9) %, for pre-post exercise, P=0.362). The change in type I fibre IMTG content from pre-post exercise was significantly greater in the fasted (Mean+/-95% confidence interval: -3.44(-1.6,-5.3) %) as compared to the fed trial (1.44(4.3,-1.5) %; P=0.024). No between trials differences existed for post-exercise Type 1 fibre IMTG content. Repeated measures ANOVA also revealed a significant diet-time interaction for Type 2 fibre IMTG content (P=0.038), but post-hoc analysis revealed that no specific comparisons were statistically different after adjustment for multiple comparisons.

Summary

In line with our primary hypothesis we demonstrate IMTG utilisation during exercise in obesity that is restricted to Type 1 skeletal muscle fibres and occurs only when exercise is performed in the overnight-fasted state. This is consistent with previous studies in lean individuals (e.g. de Bock, J Physiol, 564:649-60, 2005). An unexpected finding was that the pre-exercise Type 1 fibre IMTG levels were consistently higher, albeit non-significantly, in the fasted-state exercise trial. Accordingly, despite evidence of net reduction in Type 1 fibre IMTG as a function of fasted-state exercise, IMTG did not reduce to lower levels than those observed at the end of fed-state exercise. It is unclear why IMTG levels were higher pre-exercise in the fasted condition, but one plausible explanation may be continued IMTG synthesis due to high plasma fatty acid availability during the period before exercise, which may be negated in the fed-state condition with feeding induced suppression of lipolysis. Regardless, given that IMTG levels were similar at the end of exercise in both conditions, the use of fasted-state exercise to induce substantial increases in IMTG turnover (including substantial depletion /repletion cycles) and potentially augment the metabolic benefits of exercise training in obese individuals cannot be confirmed on the basis of the present observations. Our next step is to prepare the outcomes of the study for dissemination at an academic conference and publication, within which naturally we will acknowledge and express our gratitude to the Allen Foundation Inc. for supporting this work.

Personnel involved in grant implementation (Research team)

Gareth A Wallis, PhD (PI)
Helen Bradley, PhD (Co-investigator)
Scott Robinson, PhD (Co-investgiator)
Nurul Abdullah (Co-investigator, PhD candidate)
Konstantinos Manolopoulos, PhD (Co-investigator)

Final summary of expenditure

Total award, £27,317 (currency conversion from $46,698 awarded)
Staff costs (Gareth A Wallis, 5% effort), £2766
Consumables including facility use and laboratory analysis – £22,876.80
Overheads/Indirect costs, £4542.75 (20% of direct costs)
Total spend, £30,185.55
Budget remaining, -£2,868.55 (overspend covered from PI’s internal reserves).

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Project Title: Improving access to healthy, locally grown food by low-income families in Shiawassee County.
Institution: DeVries Nature Conservancy
Date: 11/22/2016
Report:
Through the generous financial support of the Allen Foundation, DeVries Nature Conservancy launched its Healthy & Local Food Initiative in 2014. The goal of this effort is to strengthen the critical foundations necessary to enhance the availability of nutritious, locally grown food to low income families through improvements in education and access. The following report summarizes the outcomes and experiences during the three-year period covered by this grant.

Community Garden

The community garden encompasses approximately 1.5 acres, and is the backbone of this project. Twenty-four 20’ by 20’ plots are made available for a nominal fee to people living where space for a garden isn’t available, and who wish to supplement their diet with fresh vegetables. The non-rented portion of the garden is used to grow the produce for the farmer’s market. The 18’ by 48’ hoophouse located in the DeVries’ community garden was completed in 2014, and has been used intensively to grow produce for the farmer’s market and sales to local restaurants.

The summer of 2016 was the fifth year of our partnership with the Shiawassee County Youth Center to provide meaningful work and life skill experiences to youth probationers. For eight weeks each summer, the Youth Center participants and their supervisors work in the community garden planting, weeding, and harvesting multiple garden plots, including two plots that they are solely responsible for maintaining. At summer’s end, DeVries hosts a picnic in recognition of their hard work, giving the students an opportunity to showcase the garden to the Shiawassee County Probate Judge and the Family Court staff.

Nutrition Education

In addition to allowing us to extend our growing season into the winter months, the hoophouse also serves as the perfect classroom for the educational component of the Initiative.

The nutrition education program is designed to offer children engaging, healthy food experiences and meaningful exposure to nutrition concepts, while concurrently educating parents in local food sourcing, preparation, and basic nutritional guidelines that promote lifelong healthy diets. Early childhood is the most influential time in promoting healthy eating habits.

Between twenty-six and thirty-one Head Start classrooms (around 450 preschool-aged children) and their parents spend several hours at DeVries each fall for a field trip experience that includes a trip to the hoophouse for lettuce tasting, nutrition-related activities, and a nature hike. A follow-up outreach session at each Head Start classroom serves as way to reemphasize the concepts introduced during the field trip to DeVries. Each classroom’s transportation costs for the field trips are provided by DeVries through the Allen Foundation grant.

Once the Head Start field trip sessions are complete in November, the students’ parents are invited to participate in a 4-week session at DeVries called Healthy Harvest. The program is taught by Michigan State University Extension staff, and focuses on fun and cost-effective ways to introduce healthy, locally grown foods into the family diet. Participating parents are encouraged to bring their children to each session. During the class, the children play games and explore the Nature Playscape under the supervision of DeVries’ staff. The evening concludes with a family meal featuring the suggestions and recipes introduced during the class.

Improving Access – The Fresh & Local Farm Market

On Wednesday, August 13, 2014 the DeVries’ Fresh & Local Farm Market was opened to the public. The market’s operating hours, Wednesday afternoons from 1:00 to 3:00, were chosen as an option to those interested in shopping locally for produce outside of the traditional weekend farmers market time period. The market also accepted food assistance programs such as SNAP, Double Up Food Bucks, WIC Project Fresh, and Senior Market FRESH. In the first two years of operation, the market generated $3,774 in produce sales, with 11.7 percent of sales coming from food assistance purchases.

Our principal measure of success, food assistance purchases, suggested that our stationary market was not adequately addressing the barriers that limit access among our target population. In 2016, we purchased a 19’ trailer and reconfigured the market to a mobile format. Seven sites were identified within Owosso: a mobile home community, senior and low-income apartment complexes, and social service agencies that serve people of need. The results of this format change were dramatic: total produce sales in 2016 were $6,195, with 30 percent of sales coming from the use of food assistance programs. The mobile market was very well received by residents, many of whom were previously unaware of the different food assistance programs available for use at farmer’s markets. An additional benefit of the market’s success is that local growers, who provided roughly half of the produce sold in 2016, received over $3,100 of income from mobile market sales - without the need to be physically present at the market.

Summary

The successes that we observed after the first three years of project implementation strongly suggest that the barriers to fresh and local produce facing underserved communities in Shiawassee County are not insurmountable. Our approach demonstrates that many of the tools necessary to address food insecurity, such as food assistance programs, are already in place. What is missing is the human connection that leverages the public investment in these programs through education and by introducing new pathways to access. We plan to continue this work by expanding the mobile market to additional sites within the county, and involving the local healthcare system to connect patient care with improved access to locally grown produce. We are so appreciative of the investment that the Allen Foundation has made in this effort.


Financial Summary

In addition to the funding received by the Allen Foundation, other financial contributors to the project include the Gerstacker Foundation, Saginaw Bay Watershed Initiative Network, the Shiawassee Community Foundations’s Youth Advisory Council, and a number of smaller gifts from community organizations and private individuals. The total project expenditures were $50,824 of which $21,310 was from the Allen Foundation grant. A breakdown of the Allen Foundation grant expenditures by category during the three year period is as follows:

Personnel (Garden manager & Education Coordinator): $ 14,663
Education Supplies: $ 1,801
Printing, Copying & Postage: $ 206
Transportation: $ 2,124
Portable toilets and POS expenses: $1,316
Mobile Market trailer: $ 465
Greenhouse completion: $ 735

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Project Title: Healthy Diets at Grow Benzie
Institution: Grow Benzie
Date: 4/26/2016
Report:
Project Title: Healthy Diets at Grow Benzie
Institution: Grow Benzie
Date: April 2016


Grow Benzie’s Healthy Diets program provides experiential learning opportunities for youth and adults that teach them how to grow, harvest, prepare and cook healthful foods for themselves and their families. Grow Benzie’s educational programs include off-site visits to local schools and events, and on our 4-acre campus including 16,000 sqft of hoop houses, 1,500 sqft commercial kitchen, 5,000 sqft meeting center, and 2,700 sqft community garden.

The purpose of the project is for Grow Benzie to act as a catalyst in the community for better diets, better health, and regional economic activity. Our grant request of $20,000 per/yr (3 years total) was for helping us expand our existing programs, such as our farmers market and health classes, and expand our organization’s capacity by creating new programs including the addition of a youth hoop house and funding employee wages.

To date, we have accomplished many of our goals as listed in our initial proposal, and the Allen Foundation’s support has provided Grow Benzie financial flexibility to hire a full time Executive Director in October of 2014. The ripple effect from this has resulted in other grant awards, including upgrades to our facilities and a consultation grant to complete our first Strategic Plan. The pursuit of our planning and funding strategies, including fundraising and revenue creation, by a dedicated employee would not be possible without the support of the Allen Foundation helping pay the wages of our part-time managers- for that we are grateful.

Staff:
In 2015, we expanded our Kitchen Manager’s position to a broader role as Facilities Manager, and now she supervises all scheduling and planning for programs in our community center and commercial kitchen. Creating revenue from these rentals and fee for service events is part of our funding strategy and is possible thanks to the Allen Foundation. We have also expanded our Greenhouse Manager’s responsibilities as a Garden Educator. From the time she plants seeds in our indoor germination station, to the time she is picking tomatoes from our 11ft plants in the hoop houses, she is teaching classes to show people how to grow their own nutrient rich foods. She is also responsible for food preserving workshops where attendees learn how to freeze, pickle and can healthful foods for winter storage. The fruits and vegetables we grow are sold at our Farmers Market and local restaurants and help sustain the wages of our Greenhouse Manager. Again, we are grateful to the Allen Foundation for the financial support to allow us to build this profit center within our organization.

Farmers Market:
We continue to enhance our weekly, summer farmers market with events and opportunities for shoppers from all socio-economic backgrounds. On average, we hosted twelve farm vendors who offered locally grown food and/or products. In 2015, we also partnered with local pantries, the Benzie Health Department, and Benzie Council on Aging to offer discounts and financial programs to families with low incomes. We hosted nutrition classes during and after the farmers market in our community center and have plans in 2016 to offer weekly food demonstrations and increase the number of vendors, including local fish, beef, pork and flours.

Youth Programs:
Our youth hoop house is now the growing space for a high school after school program called BCIA (Benzie Conserves, Inspires, Adapts) where they are experimenting with alternative growing methods including hugelkultur beds and mushroom production. Elementary students from Traverse City Area Public Schools and Benzie County Central Schools will also be planting in the hoop house this spring, and will be returning this fall to harvest the crops.

We are also working closely with the sports teams at area schools. In 2015, the Benzie Central football program volunteered every other week from April through August helping our Greenhouse Manager plant, grow and weed our gardens- including our heirloom tomatoes. Varsity players helped the younger kids, and our Greenhouse Manager helped all of them learn about growing food. In November, the team and their families (230 of them) celebrated their football season in our community center by preparing and dining their own marinara sauce with tomatoes they helped grow from seed. The Frankfort/Benzie ski team also used our facility for nutrition classes, and the Benzie Central Girls Soccer team made their own team meal from scratch in our kitchen in exchange for helping us with spring cleaning on the property. Their “taste tests” exposed them to multiple greens and lettuces, as well as oils and alternative salad dressings.

In April of 2016, our after school program, Hive Minded, hosted a “Grilled Cheese Challenge” with the girls softball team using only ingredients we’ll find at our farmers market this summer. The winner’s recipe will be included on the Grow Benzie food truck opening summer 2016. We also have a group of high schoolers making game boxes and bee boxes in the woodshop, learning how local ecology effects local economy. Students love the field trip to the honey making facility where they take home their own “squeeze bears” of tupelo honey.

Accessibility:
In 2015 we expanded our community garden to include raised beds. These were built from recycled local barn wood and installed on a flat piece of our property, providing accessibility to our partners from CentraWellness and their clients in wheelchairs. We offered free classes every week with our Greenhouse Manager called “Fridays with Britt”, allowing folks who couldn’t make it to our formal workshops to stop by and get advice in an informal setting. We hosted some of these days streaming online through the application “Periscope” and plan on offering our 2016 “Fridays with Britt” live via YouTube. In addition to her Friday open houses, Britt hosted 25 garden planning and food preservation classes and grew food for the local pantry and gleaning program with Beulah Sunrise Rotary. Grow Benzie also has created a new website and improved our social media outreach with media rich content to help educate and advertise Grow Benzie’s programs related to this Healthy Diets grant.

Total expenditures to date:
$ 21,750 was spent on employment of our Greenhouse Manager and Facilities Manager
$ 7,500 was spent on promotion of all programs- flyers, print ads, posters, and email
$ 6,000 was spent on supplies for classes and meals
$ 3,000 was spent on stipends and costs for speakers and events
$ 740 was spent on a new camera for pictures and video

To date, $21,010 of the $60,000 budget remains for Grow Benzie’s Healthy Diets grant. This allows us one more year of supplementing our Facilities Manager and Greenhouse Manager’s wages, and planning, promoting and paying teachers to lead educational classes pertaining to nutrition and healthful foods.

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Project Title: Leptin and developmental delays in growth retarded preterm infants
Institution: UC Davis
Date: 4/25/2016
Report:
Thanks to the gracious funding provided by the Allen Foundation, we have made substantial progress in understanding the effects of post-natal growth restriction, subsequent catch-up growth, and exogenous leptin administration on the long-term neurodevelopment, metabolic outcomes, and growth in our rodent model. These new understanding promise advances in the care of preterm infants who also suffer long-term neurodevelopment and metabolic risks that may be traced back to their early growth.

Below are summarized some of our main areas of progress.

EFFECT OF CATCH-UP GROWTH ON NEURODEVELOPMENT
In our preliminary studies we had shown that post-natal growth restriction lead to long-term deficits in neurodevelopment (e.g. in spontaneous alternation in the T-maze), however, it was unclear whether these deficits in growth restricted pups were reduced by subsequent catch-up growth.
We randomized rat pups to three groups on day 1-2 of life:
(i) Normal intake (litters of 10) from day 1 to day 21 (i.e. Normal growth)
(ii) Reduced intake (litters of 18) from day 1 to day 21 (i.e. reduced or restricted growth)
(iii) Normal intake (day 1-10) followed by catch-up growth (litters of 6, from day 11-21) (i.e. reduced or restricted growth, followed by catch-up growth)
Our current results show that subsequent catch partially ameliorates the neurodevelopmental effects of early growth restriction. Neurodevelopment was assessed at two time points.
On day 35 of life, rats with reduced intakes scored 5.8 (SE 0.19) out of 9 on the T-maze, those with normal intake scored significantly higher (7.1, SE 0.21, p < 0.05). Rats with early catch-up growth scored higher than those without catch-up growth (6.6 ±0.18 v 5.8 ±0.19, p<0.05) but scored lower than the normal rats, although the difference was not significantly different (p=0.10).
By day-70, the difference between the three groups were more apparent (Normal 7.6 ±0.28, Catch-up 6.7 ±0.22, Restricted 6.0 ±0.21; p < 0.0001), and all groups were significantly different from each other.
We conclude that post-natal growth restriction leads to long-term neurodevelopmental impairments that are partly reversed by subsequent catch-up growth.

EFFECT OF EXOGENOUS LEPTIN ON NEURODEVELOPMENT
By day-35, exogenous leptin administration had no significant effect on neurodevelopment in the normal intake rats (7.1 ±0.2 v 7.1 ±0.2, p = 0.78) or the rats with catch-up growth (T-maze, 6.8 ±0.19 v. 6.6 ±0.19, p = 0.48). However, exogenous leptin did significantly improve T-maze scores in the growth restricted rats I7.3 ±0.17 v. 5.8 ± 0.18, p < 0.0001). Results on day-70 were similar. Leptin administration had no effect on body weight or on the amount of catch-up growth.
We conclude that neurodevelopmental delays resulting from post-natal growth restriction can be partially reversed by exogenous leptin administration with-out any effect of growth.

EFFECT OF AN EXOGENOUS LEPTIN ANTAGONIST ON NEURODEVELOPMENT.
In the second experiment three litters of normally nourished rats (10 pups per dam) were randomized within litters to receive either 5 mcg/g of a long acting leptin antagonist (PESLAN-4, Protein Laboratories Rehovot Ltd, Rehovot, Israel) or an equal volume of vechile administered by s.c injection once daily between d 8 and 14, immediately prior to the start of the light cycle. Within each litter, 1/3 pups received the leptin antagonist and 2/3 received the vehicle.
Treatment with the long-acting leptin antagonist significantly reduced neurodevelopment on day-35 of life (T-maze, 6.3 ±0.21 v. 7.9 ±0.14, p<0.0001). The leptin antagonist did not affect growth.
We conclude that inhibition of leptin action reduces neurodevelopment to a similar degree as post-natal growth restriction, without having any effect of growth.

EFFECT OF LEPTIN ON CNS MYELINATION
The effects of exogenous leptin on CNS myelination were examined histologically. At d14, 12 growth restricted rats (6 treated with exogenous leptin since d8, and 6 treated with placebo) rats were sacrificed. They were deeply anesthetized with 50 mg/kg sodium pentobarbital (Western Medical Supply, Arcadia, CA) and infused with 60 ml ice-cold PBS followed by 120 ml 4% paraformaldehyde via transcardial perfusion. Total brains were removed and post-fixed in 4% paraformaldehyde overnight at 4˚C, and 10 series of 10 μm thick coronal sections were cut in a vibratome. One of the series was stained by the Nissl method for cell body staining, a second series with bone morphogenetic protein (BMP) as a marker for neuronal cell differentiation, and a third with Olig2 for oligodendrocyte detection. Corpus callosum volume was measured in Nissl-stained sections by stereology using the Cavalieri method. Sections were blocked, rinsed, and incubated for 24h at room temperature with primary antibodies against BMP (rabbit, 1:500, Abcam) or Olig2 (rabbit, 1:500, Abcam). Sections were then rinsed, incubated with the appropriate biotinylated secondary antibody, developed with DAB substrate, dehydrated, cleared, and mounted. The numbers of Olig2+ cells were quantified by stereological analysis using an optical fractionator method.
We did not find any difference in the volume of the body of the corpus callosum between the leptin group (5.0 ± 0.3 mm3), and the control group (4.9 ± 0.4; p = 0.8).
To quantified the number of oligodendrocytes within the corpus callosum we stained coronal sections with an antibody against Olig 2 and did not find any difference in number of oligodendrocytes between the experimental and control groups (314,710 ± 31,380 versus 298,270 ± 51,460; p=0.3)
Contrary to our expectations, we found no evidence that leptin administration affected the volume of the corpus callosum, the number of oligodendrocytes or oligodendrocyte precussors.

EFFECT OF POST-NATAL GROWTH RESTRICTION ON BRAIN STRUCTURE
These negative findings on CNS myelination were unexpected and bring in to question our hypothesis that leptin improves neurodevelopment by reversing deficits in myelination resulting from post-natal growth restriction.
To further understand the effects of post-natal growth restriction on brain development we have taken an imaging approach. Normal and growth restricted rats (age 21d) were anesthetized and brain specimens following transcardiac perfusion with PBS (with 2mM Gadolinium (Prohance) added) followed by 4% PFA (with 2mM Gadolinium (Prohance) added). Brains were dissected out and post-fixed in solution containing Gadolinium.
Brain tissues will be examined by high resolution MRI and volumetric reconstructions carried out to identify brain structure whose size, or degree of myelination, is affected by post-natal growth restriction. These studies are ongoing.

EFFECT OF POST-NATAL GROWTH RESTRICTION AND EXOGENOUS LEPTIN ON INSULIN SENSITIVITY
An intraperitoneal insulin stress test (ITT) was performed at 9 week in normal and growth restricted rats. Insulin (0.5 U/kg body weight) was intraperitoneally injected and blood glucose levels were measured from tail vein blood using at glucometer (Easy Plus, Home Aid Diagnostics, Deerfield Beach, FL) at 0, 15, 30, 45, 60, 90, and 120 min after insulin injection. The area under the blood glucose curve (AUC) was calculated using a rhomboid rule. The primary comparison between groups was the total AUC for the entire study (120 min). Growth restricted rats had improved insulin sensitivity (AUC, 11713 ± 194 vs. 13035 ± 266, p = 0.0001) but leptin treatment had no effect on insulin sensitivity.
At 6m of age, an insulin tolerance test was carried out in normally nourished, growth restricted, and catch-up rats. Insulin sensitivity was significantly better in growth restricted rats than in normally nourished rats (9600 ±290 v. 10700 ±280, p <0.05). However, catch-up growth, lead to a fall increase in insulin sensitivity compared to growth restricted rats, but was still better than the normally nourished rats (10030 ±240). Once again, exogenous leptin treatment had no effect on insulin sensitivity.
We conclude that (1) post-natal growth restriction is associated with improved later insulin sensitivity, (2) this effect is reduced by subsequent catch-up growth, and (3) that exogenous leptin administration between PN day 8 and 14 had no adverse effect on insulin sensitivity.

EFFECT OF POST-NATAL GROWTH RESTRICTION AND EXOGENOUS LEPTIN ON GLUCOSE TOLERANCE
At age 10w, a glucose tolerance tests (GTT) were performed after 4 h of food deprivation, in normal and growth restricted rats. Rats were intraperitoneally injected with 2 g/kg of glucose solution (Sigma, St. Louis, MO) and blood glucose was measured at 0, 15, 30, 45, 60, 90, 120, and 180 min after glucose injection. As before, the blood glucose concentrations were used to calculate the area under the blood glucose versus time curve (AUC) for the entire study (0 min to 180 min). Growth restricted rats had improved glucose tolerance (AUC, 30415 ± 306 vs. 32073 ± 403, p = 0.0015) when compared to normally nourished rats. However, leptin treatment had no effect on glucose tolerance.
At 6m of age, an second glucose tolerance test was carried out in normally nourished, and ingrowth restricted rats with and without catch-up growth. As before, glucose tolerance was better in the growth restricted rats than in the normally nourished rats (33170 ±1540 v 27850 ±1210, p = 0.02777). However, glucose tolerance in the growth restricted rats with later catch-up growth was intermediate between the other two groups (30700 ±1110).
In contrast to the earlier study, rats treated with exogenous leptin had worse glucose tolerance at 6m of age than those who had not been previously treated with leptin (32270 ±1070 v. 28890 ±1030, p = 0.0255). This effect was only seen in the growth restricted rats (Leptin 30850 ±1390, Placebo 25580 ±1400, p = 0.0156) and not in the rats with catch-up growth (Leptin 32190 ±1700, Placebo 29110 ±1820, p = 0.27) or the normally nourished rats (Leptin 33810 ±1920, Placebo 33310 ±1740, p = 0.96).
We conclude that that (1) post-natal growth restriction is associated with improved later glucose tolerance, (2) this effect is reduced by subsequent catch-up growth, and (3) exogenous leptin administration between PN day 8 and 14 reduced glucose tolerance in growth restricted rats, but has no effect on normally nourished rats, or rats with catch-up growth.

FINANCIAL STATEMENT
Salary: The grant has provided salary support for a laboratory technical who is primarily responsible for the conduct of the study ($20,148 in year two including benefits), and for the PI ($10,080 in year two including benefits).
Supplies: A total of $9,352 has been spent on supplies in the first 6m of year two, including a grip strength system.
Travel: No expenditure.


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Project Title: Simply Delicious Workshop
Institution: Oregon State University Foundation on behalf of the Healthy Youth Program, Linus Pauling Institute
Date: 8/19/2015
Report:
Funding Period:
September 1, 2014, to August 31, 2015

Project Goals and Objectives:
The goal of the Simply Delicious workshops is to teach parents how they can help their families adopt healthy eating habits. The objectives are to educate parents on (a) the importance of healthy dietary habits and regular balanced meals, (b) how to plan healthful and nutritious meals on a small budget, (c) how to shop for ingredients in the most economical way in a local grocery store, (d) how to include fresh or frozen produce into daily meals, and (e) how to follow a recipe and cook a meal for the family.

Project Evaluation:
To assess the impact of the workshops, we asked workshop participants to complete a survey after completion of the workshop. These are the results of the questions asked in the survey (in percentages):
1. Did you learn any new information about cooking a healthy meal?
Yes: 100%
2. Did you learn any new tips about cooking on a small budget?
Yes: 100%
3. What can you learn from reading nutrition labels?
How many calories are in the food item: 36%
How much salt, fat, and sugar is in the food item: 72%
4. Are frozen fruits and vegetables as healthy as fresh fruits and vegetables?
Yes: 100%
5. What are the health benefits of eating plenty of fruits and vegetables?
They contain many vitamins and minerals: 91%
They help me maintain a healthy weight: 64%
They help reduce my risk of developing a chronic disease: 27%
They contain a lot of fiber: 55%
They help reduce my risk of developing cancer: 18%
6. Why it is important to eat healthy fats?
It keeps my heart healthy: 100%
7. What is the difference between saturated and unsaturated fats?
Unsaturated fats are healthy fats that my body needs: 100%
8. Why should I limit processed food?
They contain a lot of calories and very few healthy nutrients: 91%
They contain a lot of sugar and salt: 64%
9. Why is it better to eat whole wheat pasta versus regular pasta?
Whole wheat pasta contains more fiber and nutrients: 100%
10.Why is it helpful to read and compare unit prices?
To stretch my food budget farther: 100%
11. Do you think you will use the recipes learned in this class?
Yes: 100%
12. How would you rate the delivery of this cooking class?
Average score: 9
13.How many times have you attended our Simply Delicious workshops?
Once: 27%
Twice: 22%
Three times or more: 51%

Number of Workshops and Participants:
We were able to host 36 workshops serving 292 participants.

Financial Accounting of the Expenditures:
In all the workshops we used seasonal recipes and, therefore, were able to use a lot of fresh produce from our own vegetable gardens. We spent the equivalent of $720.00 worth of produce from our own vegetable gardens, in addition to $1,979.65 for food purchased at the grocery store. The total amount spent on food was only $2,699.65 (instead of the budgeted $3,000.00). For miscellaneous items we had budgeted $500.00, but only spent $489.16. We spent $876.00 for advertising instead of the budgeted $500.00 and $219.00 for office supplies instead of the budgeted $150.00. Our total expense for the 36 workshops was $10,883.81, which is $133.81 more than estimated in the original budget.

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Project Title: Meals on Wheels with Love
Institution: Northwest Michigan Community Action Agency
Date: 4/30/2015
Report:
Dear Allen Foundation Board of Directors,

We are very grateful for the $48,000 grant to the Meals on Wheels program of Northwest Michigan Community Action Agency. This grant was pivotal to improving the health and quality of life of vulnerable homebound seniors in Grand Traverse, Leelanau, Manistee, Missaukee and Wexford counties by delivering vital nutrition, compassionate visits, and safety checks, enabling the seniors to live nourished lives with independence and dignity.

In the midst of federal and state funding cuts, the Allen Foundation grant enabled us to avoid harsh waiting lists for our clients, so that homebound seniors could receive the following crucial Meals on Wheels with Love when they needed it the most:
1)Vital nutrition: Because of the assistance from the Allen Foundation, homebound seniors received 13,714 life-sustaining, well-balanced meals enabling them to combat malnutrition and poor nutrition and sustain their health. We have expanded our partnership with Goodwill Inn, who prepares our meals, to incorporate their innovative Farm to Freezer program, utilizing local produce and meats from local farms in our meals. Almost all of our meals prepared are scratch-cooked.

2)Compassion, and security: In addition to the well-balanced meals, compassionate, caring drivers delivered smiles, friendship, and a feeling that people cared about seniors, combating depression, isolation and loneliness which many homebound seniors experience. Drivers took a few minutes of quality time with the seniors and the seniors looked so forward to the daily visits. In addition, the Meals on Wheels drivers conducted daily safety checks to ensure that clients were well and sought help when needed. Drivers opened their eyes to see little things that may hinder the safety of seniors as well as opened their hearts to them. Sometimes, we contacted family members to notify them of slight changes which we observed. Other times, we came upon urgent situations, where we called 911 to seek immediate help. A recent More than a Meal study demonstrated the significant improvement in quality of life of vulnerable homebound seniors as a result of daily home-delivered meals.

3)Independence: Many studies have demonstrated that Meals on Wheels is a proven and effective model for enabling homebound seniors to stay out of the hospital or nursing and remain healthy and independent in their own homes, where 85% of seniors prefer to be. The cost of one year of Meals on Wheels has been equated to one day in the hospital or six days in a nursing home.

Our clients reported the following health outcomes:
1)99% of clients reported that Meals on Wheels made it easier to live independently
2)100% of clients reported that Meals on Wheels made it easier to maintain a well-balanced diet.
3)88% of clients reported that they, their friends, or their families felt safer as a result of visits from our volunteers and staff
4)88% of clients reported that Meals on Wheels made it easier for them to maintain or gain weight

The grant was used to cover the cost to prepare meals. The remaining cost of delivery, client coordination, and program management was funded through other sources. Following is a breakdown of the expenditures incurred:
1)Food and disposables: $25,509
2)Kitchen staff labor: $14,400
3)Other costs to prepare meals (utilities, cleaning supplies, etc.): $8,901

The following stories illustrate the positive impact that the Allen Foundation has made on the lives of homebound seniors in our community:

After only a week
A new client just called. Shes been on the program about a week. She loves the meals and said she can tell that her health has improved so much in just a week. Her blood sugar is lower and she is getting stronger, not as tired. She looks forward to the visit from her driver and the delicious meal. She said there hasnt been one thing that she hasnt liked so far. She also said her days seem brighter. She sees her doctor next week and can't wait to see what he says about how much better she is. She just wanted to let us know how much it means and to tell us how much she loves each and every bite. Especially the vegetables AND Tom's spaghetti was the best. She said her mom was Italian and it reminded her of her moms homemade spaghetti.

Waiting for Daylight
I knocked once more, this time a little louder. There was still no answer. I walked around to the side door and knocked again. This door was unlocked. I opened it and called her name. The voice I heard was faint. I went in and found Sarah on the floor of the bedroom. She had fallen in the night and was unable to reach her phone. Sarah told me that she wasnt hurt, just unable to get up. I called for assistance and waited with her until they arrived. She told me that what kept her calm was watching and waiting for daylight. Once it was light, I knew it wouldnt be long before you got here.

We would like to express our immense gratitude to the Allen Foundation for enabling Meals on Wheels to be there for vulnerable homebound seniors in our community when they needed us the most. We look forward to further collaborations in the future.

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Project Title: Emergency Expansion
Institution: Allied Churches of Alamance County, Inc.
Date: 4/30/2015
Report:
Overview
The U.S. Census Bureau (2010) has published that per capita income in Burlington is $23,405, a figure which is below both North Carolina and U.S. data ($25,285 and $28,051 respectively). Also, the percentage of Burlington residents who live in poverty is at 21.9%, while the NC rate is 16.8% and U.S. is 14.9%. Close to 21,000 residents receive food stamp benefits, and at least 11% of our population receives meals or groceries from local agencies. At Allied Churches of Alamance County, an increased number of no- and low-income families have come for both lunch and dinner meals steadily. Each weekday, over 100 men, women, and children on average come and eat for both lunch and dinner meals.
After the largest food pantry in Alamance County closed its doors in 2013, ACAC stepped in to fill the need in an extreme emergency. The community dinner meal was added, and has seen steady numbers since its beginning. ACAC's Community Kitchen serves not only to feed the hungry, but to build healthier lives for our struggling neighbors. We seek to meet the physical, emotional, and social needs of those living in poverty by offering healthy meals in a safe environment.
Impact
For many of those eating in the ACAC Community Kitchen that are not shelter residents, the free meals provided serve as a preventative of homelessness. Those at poverty level in Alamance County are forced to choose which expenses will be paid from month to month. Having ten meals a week at no expense enables these guests to pay heating, cooling, and electric bills, perhaps put gas in their cars, and ultimately stay in their homes while feeding themselves and their families healthily. Thus, barriers to permanent housing are lightened in our community and less people find themselves without a home.

The Allen Foundations generous gift of $15,000 has made a significant difference for thousands of hungry individuals and families in Alamance County, NC. The ACAC Food Pantry has provided emergency food to over 10,000 individuals in six months. The Community Kitchen has served 30,528 meals in that same time. Allied Churches has filled a void for thousands of struggling community members, and has kept pace with the continuous need for food.
Expenditures
Understandably, sourcing food is one of the biggest tasks involved in serving such a huge volume of people. An immediate expansion of ACACs services in 2013 required additional staff, travel, and overall capacity. Trips to Second Harvest Food Bank of Northwest NC, local farms, and grocery chains for food pickups total over 800 miles in travel monthly. The purchase of a 15- passenger van ($10,300 in total for vehicle, registration, and related costs) has made a huge impact on our ability to source food. Fuel costs per month have averaged $350. The $5,000 in funding allocated for fuel is still in use (as of April 2015).
We are extremely grateful to the Allen Foundation for the gift of travel! The ACAC passenger van has enabled us to take donations from farms, food cooperatives, local universities, and many local grocery and restaurant chains. Our mission to House the Homeless and Feed the Hungry is fulfilled each day because of compassion and generosity like yours.

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Project Title: MSUE Cooking Matters and Nutrition Program Incentives
Institution: Michigan State University Extension
Date: 4/30/2015
Report:
Originally, the grant requested from the Allen Foundation was to fund participant take home groceries for three Cooking Matters class series (reaching 45 adults) and to provide incentives (cutting boards, measuring cups, measuring spoons, food storage containers) for 5,000 nutrition education participants in Wayne County. The grant awarded $39,756 which was intended to be distributed as $2,430 for Cooking Matters participant groceries, $30,700 for incentives, and $6,626 for indirect cost.

In December 2014, after going through the bidding process for incentives, we received the good news that our incentives would cost $23,416.55 which was less than projected. We contacted the Allen Foundation and it was approved that we could use the additional amount earmarked for incentives of $7,283.45 for take home groceries for additional Cooking Matters series. Thus far, we have spent $2857.48 on seven Cooking Matters series. Not all money for the most recent class has yet been accounted for on the expenditures report, due to processing in the accounting office (this will account for about $200). Some reasons for the Cooking Matters expenditures being less than anticipated are as follows. The formulated budget was based on the following: $9 per week for 15 participants for 6 weeks for a total of $810 per Cooking Matters class series. Not all classes have a full class of 15 participants, as can be seen below in the list of classes which have been completed. Additionally, the recipes that are selected to be cooked by the class can sometimes cost less than $9 per person.

To date, seven Cooking Matters class series have been completed, one is in progress, and four are planned in Wayne County over the next couple of months, all of which have or intend to utilize funds from the Allen Foundation grant. Details of the completed class series are below. Out of the seven completed Cooking Matters class series, the Wayne County staff has reached 87 participants, and 59 of these participants graduated the class (meaning they completed at least four of the six classes and received a certificate of completion). Our current class (started on 4/21/15) has 11 additional participants enrolled. This results in a total of 98 enrolled participants that are actively engaged in, or finished with the class. This greatly exceeds our original goal of three classes with a total of 45 participants.

Cooking Matters Alumni shared what the class meant to them. Participants said they wished the classes could go beyond six weeks. At Bell Building, the participants said they wanted Michigan State University Extension to broaden their reach and presence at this site and continue programming there. Some of the favorite healthy recipes from all of the series were turkey tacos, baked flaked chicken, vegetable lasagna, turkey burgers, and black bean and vegetable quesadillas. Many said that they did not expect these healthy recipes could be so delicious, fun, and easy. A participant at Woodbridge Apartments shared that this class "Made me more aware of what I put into my body. With small adjustments in my sugar and salt intake I feel better and I have lost four pounds over this six week class by eating more fruits and vegetables and less processed foods. I read labels more and I am more conscious of my portions." Another participant at State Fair Apartments shared that their doctor recently put them on a low sodium and low cholesterol diet, and said this class has helped them significantly in learning how to cook for this specific diet. For example, participants learned to use healthier seasonings like herbs and spices instead of salt. Many also noted an increased confidence in their ability to cook healthy foods an attribute that will stay with them long after their six week class has come to a close.

The shipments of incentives including cutting boards, measuring cups, measuring spoons, and food storage containers arrived between January and March 2015. These items have been distributed to programming staff and are currently being used to incentivize participation in additional adult classes including Eat Smart Live Strong, Eat Healthy Be Active, and one time nutrition presentations. These items help enhance our current curricula and reinforce healthy cooking and nutrition messages with our limited resource clients. These items will continue reinforcing healthy messages after they have completed their classes with MSU Extension.

Total expenditures to date:
- $2857.48 for Cooking Matters programing series
- $23416.55 for incentives
- $5254.69 expended indirect cost
- $1371.31 anticipated indirect cost (this will be taken out as we continue using the grant)

To date, $6855.97 of the budget remains for Cooking Matters class series participant groceries. This allows for a minimum of 8 remaining series (with 15 participants in each class). We are requesting an extension to spend the remaining funds on additional Cooking Matters class series in Wayne County. We anticipate expending the account by June 2016.

COMPLETED CLASSES
Cass Community Social Services Group 1
# participants - 14
# graduates - 7

Cass Community Social Services Group 2
# participants - 12
# graduates - 6

State Fair Apartments
# participants - 10
# graduates - 8

Woodbridge Apartments
# participants - 16
# graduates - 12

Harriet Tubman Apartments
# participants 11
# graduates 10

Saint Johns Hospital Mothers Nurture Group
# participants - 11
# graduates - 7

Bell Building Neighborhood Services Organization
# participants - 13
# graduates - 9

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Project Title: Fighting with Your Fork
Institution: Mary Bird Perkins Cancer Center
Date: 4/29/2015
Report:
Mary Bird Perkins Cancer Centers Fighting with Your Fork program provides nutrition education that enhances cancer patient outcomes, improves quality of life, and helps patients and caregivers cope with treatment-induced side effects that can significantly affect outcomes. Fighting with Your Fork is a nutrition education program delivered through monthly cooking classes that target cancer patients dealing with treatment side effects such as malnutrition, fatigue, weight loss and nausea. The purpose of the project is to improve health and quality of life during treatment so patients are more likely to comply with their treatment plan and to prevent recurrences of the disease through lifestyle changes that reduce risks.

The program uses a disguised learning format that is social and fun for the participants but complementary to individual counseling sessions delivered by the oncology nutritionist to chemotherapy and radiation patients with dietary issues that are referred for dietary counseling. The program consists of 12 monthly cooking classes for up to 20 patients and caregivers each month. The program started in June 2014 after the award of $10,000 by the Allen Foundation. The classes were designed so participants would leave with new recipes that they have cooked and tasted, hints for grocery shopping and a cookbook of recipes written explicitly for cancer survivors and their related health issues. The classes also provided for increased emotional and psychological support from peer interaction.

Evaluation

The goals of the program were centered in enhancing recovery and healing; reducing recurrence of the disease; increasing knowledge of healthy but affordable food choices; and improved quality of life for patients under treatment. Secondary outcomes were focused on better food choices for healthy lifestyles among families of our patients and a reduction in the isolation and anxiety many patients and caregivers feel without the opportunity for support and interaction with other patients dealing with cancer. A minimum of 150 adults were targeted for the program, with up to 20 patients and caregivers anticipated attending the monthly classes.

The program was evaluated using participant feedback forms that were created during two trial sessions of the program prior to its start in June 2014. The evaluation included a rating scale from excellent to poor/not applicable. Items rated included: 1) The speakers were knowledgeable and informative, 2) sufficient time was allowed for topic presentations, 3) program content and format of the presentations, 4) likeliness of recreating the featured recipe(s) at home, 4) usefulness of written materials, 5) likeliness of applying obtained information to better your health and wellbeing, and 5) overall satisfaction with the program. A comprehensive summary of the program from June to March is included in the below table.

Comprehensive Summary (June 2014 March 2015)
The speakers were knowledgeable and informative
Excellent: 88 %
Very Good: 9.3%
Good: 2.3%

Sufficient time was allowed for topic presentations
Excellent:90.6%
Very good: 9.3%
Good: 1.20%

Program content and format of presentations
Excellent: 88%
Very good: 10.4 %
Good: 1.16 %

Likeliness of recreating the featured recipe(s) at home
Excellent: 81.14%
Very good: 11.76%
Good: 7.05%

Usefulness of written materials
Excellent: 89.4%
Very good: 9.41%
Good: 1.17 %


Likeness of applying obtained information to better your health and well-being
Excellent: 83.7%
Very Good: 12.8%
Good: 1.16%

Not applicable: 2.32%

Overall satisfaction with the program
Excellent: 89.5%
Very good: 10.5%

Participants stated that they liked the program because it raised awareness of healthy eating and cancer risks and they were able to discuss ways to alter recipes for patients whose taste buds have been affected by treatment.

More than 280 patients and caregivers have attended the nine classes that were held from June 2014 March 2015. A Fighting with Your Fork session was not held in February because the Project Director was on maternity leave, and rather than have the program suffer from lack of support, this session was postponed. On average, approximately 36 participants have attended each class, and 335 cookbooks that focus on cooking for cancer patients have been distributed.

Budget (June 2014 April 29, 2015)

Patient Support items (cookbooks, plates, utensils, napkins, recipe cards, food, etc.)
Budgeted: $10,000 Expended:$9,420.46 Balance: $579.54


The remainder of the funding will be spent during the two sessions that will be held in May and June. Mary Bird Perkins Cancer Center will provide a final report to the Allen Foundation reflecting the remaining months of the program.

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Project Title: The Nutrition Center Progress Report
Institution:
Date: 4/29/2015
Report:
The Nutrition Center
Allen Foundation Progress Report

Dear Members of the Board of the Allen Foundation,
The Nutrition Center (TNC) staff would like to thank you for your support of our Food Adventures program. The following is final report for the Food Adventures program that was delivered for the 2014-2015 school year. TNC delivered 72 Food Adventures classes to four 3rd grades, three 2nd grades, and four 1st grades with 12-18 students per class, reaching approximately 1,080 students. Each grade had a total of 4 exposures, two in the fall and two in the spring.
We have been successful in integrating local agriculture and farming practice topics into the Food Adventures curriculum. We did this by incorporating agricultural and farming discussions throughout the FA course including topics such as Where Food Comes From and What Food is in Season. For the first part of a geography lesson, the students were asked to think about food from a global perspective, and for the second part they were asked to think locally, about the Berkshires. The global perspective began with a review of the seven continents of the world, then locating regions in these continents that the class will focus on; specifically Japan, the Middle East and northern Africa, and South America. Once located, students were asked to speculate on specific things about each region including temperature, access to water, and proximity to larger regions. Based on these speculations, the students and instructors worked collaboratively to identify several cuisines specific to these regions. Students were then asked to apply these concepts to Berkshire County and discuss what type of food is seasonally available here.
For the Eating in Season lesson students were asked to identify foods that are in season during different times of the year. They began by brainstorming foods that are traditionally at a Thanksgiving dinner, a summer BBQ, or a traditional family holiday celebrated as described by any student in the class. These lists were then compared and contrasted and seasonal fruits and vegetables were identified. The students then engaged in a farm-to-table activity worksheet in which they arranged the steps involved to get food from seed to grocery store shelves including planting, growing, harvesting, shipping, distributing, and selling. With their new knowledge of seasonal foods, students worked collaboratively to prepare and cook Squapple Crisp (fall/winter) and Ribbon Salad (spring/summer). While the class was sampling their recipe, a Massachusetts Grown Produce Availability Calendar was distributed and discussed. For each class we deliberately chose recipes that could be matched with what was being seasonally grown at the time.
We are excited that this grant allowed us to develop a Food Adventures Cookbook. TNC collaborated with Massachusetts Farm to School and modified the cookbook to include agricultural, farming and local food fun facts based on Massachusetts Farm to School veggie and agricultural facts. Each student received a beautiful 27 page cookbook to bring healthy recipes home. Anticipating local farmers markets opening in a few weeks, we also distributed farmers market vouchers to encourage students and their families to attend and purchase/ consume local food. Combining the topic of local agriculture, nutrition and cooking skills, TNC has provided children with the tools needed to achieve and maintain a healthy lifestyle.
Evaluations were done using two methods. An independent consultant used the APT tool for meaningful engagement. For the second we conducted video interviews with students and teachers. And third, verbal assessments were led by class instructors and recorded on video before, during and after classes. Students tasted and used many new ingredients including leeks, purple cabbage, brown rice, mushrooms and golden beets. When a student was asked what s/he thought of Food Adventures they responded My favorite part was like trying new things. When a student was asked why it is important to eat healthy they responded So you can get stronger. When a student was asked if they would make these recipes at home they responded I hope we can make the veggies and fried rice for dinner tonight! We also used a teacher feedback form as well a student food intake questionnaire. The feedback from these tools has shown our classes encourage healthy eating while also supporting curriculum subjects such as geography, math, and reading.
Food Adventures is a well-received and valuable education outreach program. With the Allen Foundation grant we were able to expand our reach to a greater number of students in Berkshire County and provide fun, essential nutritional information through a hands-on effective program. Your grant also allowed us to collaborate with Massachusetts Farm to School on cookbook content and the development of curriculum, specific to agriculture and where food comes from. Your generosity has enabled Food Adventures to touch many with knowledge and skills that can be called upon from students so they may grow and mature to healthy adults.

Budget Allen Foundation:
TNC delivered 72 Food Adventures classes to four 3rd grades, three 2nd grades, and four 1st grades with 12-18 students per class, reaching approximately 1,080 students. Our requested budget was $16,064. We used the $2,600 for the Agriculture Curriculum Development and $13,464 in the delivery of the Food Adventures classes. The following is a further breakdown of expenses.

$187 per class x 72 classes =$13,464
Cost per child: $11 per student per class (approx.)

Educator ($40/hr) - 1 hour Class Time =$40
Educator ($40/hr)- 1 hour Preparation & Clean-up =$40
Assistant ($15/hr)- 2 hour =$30.00
Supplies (food,materials,equip.) =$60/class
Administrative expenses maximum 10% total cost per class

Curriculum development focusing on local agriculture.
60 hours of TNC staff at $20/hr =$1200
40 hours of Consultant in curriculum development at $35/hr = $1400
Total for curriculum development =$2,600

Bringing seven months of Food Adventures, twice a week, to four schools in Pittsfield: Total Request $16,064. 72 Classes delivered $13,464. Agriculture Curriculum Development $2,600

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Project Title: Aerobic exercise training in the overnight-fasted state: a practical nutritional strategy to augment intramyocellular triglyceride turnover in obesity?
Institution: University of Birmingham, UK.
Date: 4/28/2015
Report:
Summary of Project

Obesity is a major public health issue and its association with insulin resistance greatly increases cardiovascular disease and type 2 diabetes risks. Exercise training is recommended for obese populations but carefully controlled longitudinal studies indicate aerobic exercise training in obese individuals in the absence of weight loss has minimal impact on insulin resistance. However, these studies did not consider the impact of recent nutrition, which may reduce the stimulation of intramyocellular triglyceride turnover during exercise and muscle oxidative adaptation to exercise training. High intramyocellular triglyceride turnover during exercise and elevated muscle oxidative capacity are key features of the high levels of insulin sensitivity observed in endurance exercise-trained individuals. We are investigating the hypothesis that an acute bout of aerobic exercise performed in the overnight-fasted versus fed-state can stimulate greater intramyocellular triglyceride utilization during exercise and enhanced expression of genes related to muscle oxidative adaptation in obese individuals with reduced insulin sensitivity. The expected outcomes will help to determine if exercising in the fasted state could be used to optimise metabolic adaptation to training in obese, insulin-resistant individuals. The future impact of this research could be the recommendation of a simple nutritional strategy considering nutrient timing to enhance the effects of aerobic exercise training in obese individuals, with potential long-term benefits for reducing insulin resistance and cardio-metabolic disease risk.

Progress to Date

The funding was requested to be used during the period January to December 2015, to coincide, among other things, with commencement of graduate student support. Accordingly, the first part of this calendar year has been focussed on graduate student training, method development, clinical trial registration (ClinicalTrials.gov Identifier: NCT02397304) ethical approval and study-set up. Now this is all in place we are in a position to commence our experiments. Our anticipated timelines for the remainder of the calendar year are as follows:

May 2015: Participant recruitment and screening. We require 8 participants for this study, so do not anticipate a problem with recruitment.

June-September 2015: Conduct of exercise testing trials. Participants will perform two 1-h laboratory based cycle rides on two separate occasions separated by 1-2 weeks. One exercise bout will be performed in the overnight-fasted state, and the other in the fed-state. Indirect calorimetry (to measure whole body fat oxidation), blood (to measure blood metabolite and hormone responses) and muscle (to measure muscle triglyceride use and oxidative gene expression responses) sampling will be undertaken on each occasion to test our study hypothesis).

October December 2015: Analysis of biological samples and study conclusion.

Expenditure to Date

The total award was $46,698. The bulk of this expenditure is to come through the data collection and analysis phase. Nonetheless, some expenditure has been made in relation to initial study set-up/pilot work and method optimisation (last budget report April 5th 2015):

Initial study set-up/pilot work (e.g., phlebotomy/biopsy consumables, biological sample storage tubes - $848
Biological sample analysis method development - $2847
Total expenditure to date - $3695
Budget remaining - $43,003 (note, values are approximate based on exchange rate of 1.52 USD to 1.0 Pound Sterling).

Summary

In conclusion, we are extremely grateful for the funding provided by the Allen Foundation to allow us to embark on this novel research. We now have all the preparatory work completed to enable a clear focus on delivering the project during the remainder of the calendar year in line with our initially projected timings.

Gareth Wallis, PhD (PI)
School of Sport, Exercise and Rehabilitation Sciences
University of Birmingham, UK

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Project Title: Healthy Lifestyles Program for Individuals with Developmental Disabilities
Institution: Maryland Community Connection
Date: 4/28/2015
Report:
Summary of Project
Funding from the Allen Foundation for this project introduced healthy lifestyles and nutritional information to an extremely under-served population. The program objectives included engaging individuals with developmental disabilities in healthy nutritional practices and habits with cooking classes and demonstrations. The Allen Foundation funding was greatly appreciated as this provided opportunities for individuals to understand that healthy and positive nutritional choices are possible.

Progress and Results
Four different events were held for this project. At these events, individuals were provided with nutritional educational information. The four events included Family Fun and Fitness Day, a Farmers Market Visit, a Healthily Eating Habits presentation with a Healthy Lunch preparation, and Fruits and Vegetables Cooking Demonstration.
At Family Fun and Fitness Day, which was attended by over one hundred individuals, the day was focused on choosing to be active and making healthy choices when eating. The agency nurse conducted health screenings and make basic recommendations on how to make healthier and more nutritious choices. During the Farmers Market Visit, five individuals were taken to a farmers market and given the opportunity to discuss and make selection seasonal fresh nutritional items. At the Healthy Eating Habits presentation, a nutritionist presented a presentation on the importance of developing healthy eating habits and discussing the connection between the way you eat and the way you feel. The fifteen individuals that attended prepared their lunch for the next day, which consisted of a whole-wheat turkey wrap, grapes, carrots sticks, and a bottle of water. The individuals were pleased to have hands on demonstration and indicated they enjoyed their lunches the next day. At the Five Fruits and Vegetables Each Day presentation, the nutritionist gave a presentation on actual serving sizes to sixteen individuals so individuals had a better idea of what an actual serving size looked like. Since this event was being held in the evening during the dinner hour, the volunteer nutritionist gave a recipe of meatless zucchini lasagna to be prepared in advance. Many were reluctant to try but once they tasted the dish, they enjoyed the dish and some even asked for the recipe.


An agency nurse, licensed nutritionist, and staff provided knowledgeable encouragement and positive social/instrumental support. These events were customized to the individuals we serve to hel develop healthy habits. Individuals had the opportunity to participate in activities that encouraged positive nutritional choices, healthy eating and physical activity. Maryland community Connection collaborated with other organizations, such as Share Food, who provided space for two of the events. At each event, resources and supplies were provided to attendees to reinforce the information provided. Recognizing that small lifestyle changes can make dramatic difference in the lives of individuals with developmental disabilities made these events enjoyable and educational for all attendees. We believe that as a result of this project, individuals with developmental disabilities have improved their knowledge of the importance of healthful nutritional practices and habits, and made steps towards improving the quality of their lives.

Expenditures
Total Award: $1,500
Personnel- 464
Fringe -73
Supplies, Materials and Equipment - 506
Communications - 25
Postage - 50
Printing/Copy- 175
Transportation/Travel - 49
Total Direct Costs - 1,342
Indirect Costs - 160
Total Costs - 1,502

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Project Title: Web Based Nutrition Education for Health Professions Students
Institution: New York Institute of Technology
Date: 4/28/2015
Report:
Project Title: Web Based Nutrition Education for Health Professions Students
Institution: New York Institute of Technology
Date: April 28, 2015
Support from the Allen Foundation enabled faculty at the New York Institute of Technology to create a web based nutrition education program for health professions students. This was an interdisciplinary project involving faculty from the Department of Physician Assistant Studies, Department of Nutrition, Department of Physical Therapy and Department of Computer Science. While health professions programs recognize the importance of nutrition education, including this knowledge in their curricula has been problematic due to a variety of factors. The program created, Enhancing Nutrition Taught in Clinical Education (ENTICE), will fill the current void in the nutrition education of health professions students.
Meant to entice the reader, these 30 independent-learning modules hosted on a website cover all pertinent areas of nutritional concern for health professions students. Topics cover an introduction to nutrients, nutrition assessment, nutrition in the lifespan (pediatric, adult, geriatrics), nutrition and specific diseases/conditions, nutrition and disease prevention, herbal supplements, medication-nutrient interactions, enteral and parenteral nutrition and behavioral counseling. Each module contains objectives, didactic information related to the specific nutrition topic, pretest, checkpoint and post test quiz questions, interactive elements such as drag and drop features, matching games as well as additional resources. While not meant to be prescriptive in nature, they are designed to provide evidence-based content that allows the student to consider how nutrition impacts the overall health and wellbeing of their patients/clients.
A health professions program could use ENTICE as a dedicated nutrition course; however, as the majority of programs do not have time for such a course it was designed to be infused into the curriculum and completed by the student outside the classroom. An instructor handbook was developed to guide faculty on how to best infuse each module into their curriculum; conversely, due to its flexibility, specific implementation will be decided by each individual program itself. The instructor handbook includes a brief review regarding the need for nutrition education in all health professions programs curricula with relevant references, a description of each module and a suggestion as to where each module could be utilized.
New York Institute of Technology will be piloting the program in the School of Health Professions beginning in September, 2015. Our goal is for ENTICE to be offered to health professions programs across the United States. We would like to thank the Allen Foundation for supporting this program. It will have a continuous and lasting positive impact on future healthcare providers and the patients/clients they treat.

Final Expenditures Report:

Salary $41,323
Fringes $ 3,926
Supplies $ 4,500
Total Costs $49,749


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Project Title: Cooking n' the Pantry
Institution: Cornell Cooperative Extension of Niagara County
Date: 4/28/2015
Report:
Cooking n the Pantry has had a very successful first six months of the programming, from October 1, 2014 March 31, 2015. For the first component of the program, we delivered nutrition education and cooking preparation classes to participants at eight pantries, once a month. The Community Educator delivered forty eight classes throughout Niagara County reaching approximately 246 people from October to March. One problem that we encountered was that it was difficult around the Holidays for food pantry locations to give up space and time to accommodate other programs, because they were busy gearing up for the Holiday season events and meals. Throughout November and December, we were not able to deliver as many classes as we would have liked because of this, but we made up for these classes throughout January, February and March. In addition, some of the food pantries do not have a big enough kitchen for ten participants, so we have had to limit some classes to less than ten.

Prior to the nutrition education and cooking preparation class, participants are asked to complete a pre-survey. This survey asks the participants if they have ever used the main ingredient in their cooking before and do they consume the recommended number of servings of fruit or vegetables. When we have asked participants if they have ever used the main ingredient for the day, 72% reported that they had, while 28% reported that they had not. When we asked participants to report if they consume the recommended number of servings of fruits and vegetables, 88% reported that they do not consume the recommended number of servings of fruit and vegetables and 12% reported that they do consume the recommended number of servings.

After the lesson is complete, a post survey is provided to participants to obtain demographics and behavior change questions. Of the 246 participants, 55% were female and 45% were male. 83% were between the ages of 18- 59, 16% were over the age of 60 and 1% were below 18 years of age. When we asked participants whether they enjoyed the class or not, all participants reported that they enjoyed the class. We also asked participants if they would be willing to try the recipe made in class again at home. 94% reported that they would try the recipe at home, while 5% reported maybe and 1% reported no. In addition, we asked participants whether they were going to try to eat healthier by adding more fruits and vegetables into their diet. 96% reported that they would try to eat healthier and add more fruits and vegetables into their diet while 4% reported that they would maybe try to eat healthier. We also provided participants the opportunity to offer suggestions on how the classes could be improved or things we could have done differently. An interesting thing that we have learned from this question was that many participants, especially those that live in the city of Niagara Falls, do not have a stove and/or oven. Many of the participants asked us to include microwave recipes. As a result, if we make a recipe that requires a stove or oven, we also provide a modification for the recipe that can be cooked in the microwave. In addition, participants asked for vegetarian options, healthy baking recipes, curry chicken recipes and a class on how to cook fish and lasagna. We have used many of these comments to incorporate different recipes and ingredients into the cooking classes. Overall, we feel that the Cooking n the Pantry classes have been very successful thus far and we are excited for the next six months of the program.

The second component of the program includes fresh fruit and vegetable cooking preparation. In October and November, we used fresh produce that was gleaned from farmers fields through the Plentiful Partnership of Niagara program. Gleaning is simply the act of collecting excess or unwanted fresh produce from farms, farmers markets, gardens, or any other sources in order to provide it to those in need. Gleaning yields numerous benefits: 1) preventing the unnecessary wasting of quality food, 2) providing increased access to fresh, nutritious foods for low-income populations who are often unable to buy local foods because of cost or availability and 3) building collaborative relations between community members, local gardeners, and farmers. Cooking n the Pantry used beets, carrots and apples that were gleaned to make recipes for participants in the pantry. Participants were also able to take some of the produce home and cook it for their families. We have also purchased six Community Supported Agriculture (CSA) shares that will be used to provide participants with fresh fruits and vegetables from June through September. Our goal is to use as many fruits and vegetables as we can, while providing participants with the skills and knowledge to prepare them.

The third component of the program will include gardening education. Our horticulturist on staff has planted basil, parsley and pepper plants that will be used for the container gardens that participants will plant. In May and June, participants will be educated on simple and easy ways to grow their own food by creating their own container garden. We will also provide participants with recipes that incorporate the peppers, basil and parsley.

The pantries that CCE Niagara County have partnered with on the Cooking n the Pantry program are NIACAP- Lockport, NIACAP- North Tonawanda, NIACAP- Niagara Falls, St. John de LaSalle- Niagara Falls, Wilson Community Food Pantry, North Tonawanda Inter-Church Pantry, St. Johns Outreach Center/Sister Helen Food Pantry- Lockport, Faith United Methodist Church- Barker, and Heart, Love & Soul- Niagara Falls.

The following is a brief financial expenditure report based on October 1, 2014 to March 31, 2015.

Type Total Spent
Personnel (Salaries) $5,369.10
Contracted Services (CSA/Farm Shares) $3,150.00
Travel (Mileage) $404.36
Printing, Copying Binding $70.40
Small Equipment (Computer) $1,018.61
Teaching Supplies (Cooking Equipment, Supplies) $453.67
Nutritional Supplies (Food) $488.75
Total Expenditures $10,954.89

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Project Title: Weekend Backpack Program
Institution: McKenzie School District
Date: 4/27/2015
Report:
The McKenzie School District extends 42 miles along the McKenzie River at the eastern edge of Lane County. Three main communities, Vida, Blue River, McKenzie Bridge, as well as outlying areas are served, with a total population of approximately 2,700. The district is 67 miles from a metro area. Our district serves 220 students. Currently, 82% of our district students qualify for the Federal Free or Reduced Lunch Program, an indicator of poverty in our area; this number is continuing to rise. In grades K-12 there are 33 homeless youth this targeted group is 15% of our school population. On average over 75% of our students are first generation college students.
The McKenzie School District Family Resource Center used the Allen Foundation funds to support its Weekend Backpack Food Program. The program provides food to children who qualify for Free or Reduced Lunch. This year we sent home a letter asking people to self-identify if they were receiving free or reduced lunch. If they confirmed that they were they could put their name in for a lottery for the program. We had 60 families apply for the program. This year we are serving 25 families for a total of 48 kids in grades K-5th.
The Family Resource Center Coordinator uses the Allen funds in addition to other community donation to purchase food weekly for the Backpack Program. The food purchased includes but is not limited to: peanut butter, tuna, crackers, granola bars, string cheese, apples, noodles and sauce plus much more. The food is packed up every Thursday and sent home in the backpacks on Thursday because we operate on a 4 day week. We use reusable grocery bags and the students return them each week to be packed up again.
The cost of travel and time to pick up the groceries to pack in the backpacks is donated by the Family Resource Center Coordinator. On average it cost around $85.00 to feed 48 kids each week, some supplies are carried over from week to week in order to help offset the supplies. The Coordinator purchases the groceries with her own money and is then reimbursed by the district after turning in receipts.
The FRC has collaborated with Food for Lane County to provide fresh fruits and vegetables when available through their Produce Plus Program. Some examples include apples, celery, oranges, squash, potatoes and more. The produce can be picked up twice a month when available and is done so by the FRC Coordinator. The FRC has also received small donations from community organizations such as the Garden Club, Lions Club and Food Pantry. These donations help to offset the cost of the produce.
We hope to run this program again next year because of the wonderful impact we have had on these kids. With so many families in need this program is vital to our community.

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Project Title: Improving access to healthy, locally grown food by low-income families in Shiawassee County.
Institution: DeVries Nature Conservancy
Date: 4/24/2015
Report:
Through the generous financial support of the Allen Foundation, DeVries Nature Conservancy has launched its Healthy & Local Food Initiative. The goal of this effort is to strengthen the critical foundations necessary to enhance the availability of nutritious, locally grown food to low income families through improvements in education and access. The following report summarizes the outcomes and experiences from the first year of this initiative.

Despite the challenges of a delayed growing season, 2014 proved to be a successful inaugural year for the Initiative. In March, Heather Schwerin was hired as the projects garden manager and co-educator. With over 20 years of organic gardening experience and more than twelve years working as an educator of children, Heather brings a perfect balance to the Initiative.

The 18 foot by 48 foot hoophouse located in the DeVries community garden was completed in mid-summer. With the help of a Community Action Mini-Grant from the Saginaw Bay Watershed Initiative Network, a rainfall harvesting system was added to the hoophouse to capture and store over 600 gallons of water for irrigation use. A solar-charged pump will be installed in the spring of 2015 that will distribute the stored water throughout the hoophouse via a network of drip irrigation emitters.

2014 was the third year of partnership with the Shiawassee County Youth Center to provide meaningful work and life skill experiences to youth probationers. During the summer, the Youth Center participants worked in the community garden planting, weeding, and harvesting multiple garden plots, including two plots that they were solely responsible for maintaining. At summers end, DeVries hosted a picnic in recognition of their hard work, giving the students an opportunity to showcase the garden to the Shiawassee Family Court staff.

On Wednesday, August 13, 2014 the DeVries Fresh & Local Farm Market was opened to the public. The markets operating hours, Wednesday afternoons from 1:00 to 3:00, were chosen as an option to those interested in shopping locally for produce outside of the traditional weekend farmers market time period. Opening day was commemorated by a ribbon-cutting with the Shiawassee Regional Chamber of Commerce. In addition to produce grown at the DeVries community garden, the market also featured vegetables and honey from other local growers. To encourage the use of EBT cards and other alternative forms of payment, a phone line was installed at the barn to facilitate payment card processing on site. In addition to EBT payments, customers were also able to use Senior Market Fresh coupons.

In this first year, the market was open for nine weeks, resulting in total sales of $1,214.15. Of that total, $59.50 of produce was purchased with EBT cards, and $8.00 with Senior Market Fresh coupons. Clearly, the low usage of EBT and Senior Market Fresh coupons indicates that the market was not attracting the low-income consumers to the extent that we had hoped. Besides the newness of the market, location and limited access to transportation are the most likely factors that limited participation. To address these issues for the 2015 season, we are exploring the concept of offering a mobile farm market, which would travel to sites that are easily accessible to low-income housing facilities. This effort will be coordinated with other local agencies who serve the low-income community. In addition to EBT and Senior Market FRESH, WIC program benefits and Double-Up Food Bucks will be added to our payment options for 2015.

In 2015, the market will open earlier in the summer due to the extended growing season provided by the hoophouse. We will also be recruiting additional vendors, and will have the ability to expand our offering to items that require on-site refrigeration. Most of the food produced in the non-rented community garden plots was offered for sale at the Fresh & Local Market, and unsold perishable produce was donated to the Shiawassee Hunger Network. A small percentage of the produce was sold to local restaurants, with the proceeds reinvested back into the project.

In addition to allowing us to extend our growing season, the hoophouse also serves as the perfect indoor classroom for the educational component of the Initiative. The education program is designed to offer children engaging, healthy food experiences and meaningful nutrition awareness, while concurrently educating parents in local food sourcing, preparation, and basic nutrition concepts that promote lifelong healthy diets. Early childhood is the most influential time in promoting healthy eating habits.

Seven Head Start classrooms received outreach and field trip experiences in mid-November 2014, with four additional classes scheduled in the spring of 2015. Transportation is provided when needed, which is estimated to be $72 per classroom. In January, the parents were invited to accompany the Head Start preschoolers for a family trip to DeVries. The parents program is taught by Michigan State University Extension staff, and focuses on fun and cost-effective ways to introduce healthy, locally grown foods into the family diet. The session concludes with a meal featuring the suggestions and recipes introduced during the class. Due to low initial turnout, the parent program is being reconfigured to take place at the Head Start classroom immediately following the school day when children are being picked up, which will reduce the travel burden on those parents who wish to attend.

In addition to the funding received by the Allen Foundation, other financial contributors to the project include the Gerstacker Foundation, Saginaw Bay Watershed Initiative Network, and the Shiawassee Community Foundationss Youth Advisory Council. The total project expenditures to date are $23,699.77, of which $5,737.95 is from the Allen Foundation grant. A breakdown of the Allen Foundation grant expenditures is as follows:

Personnel (Garden manager & Curriculum development): $ 4,396.00
Education Supplies: $ 986.98
Printing, Copying & Postage: $ 21.17
Transportation: $ 333.80


The staff and the Board of Directors of DeVries Nature Conservancy are truly grateful to the Allen Foundation for their support of this project.

Submitted by: Kenneth Algozin, Executive Director

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Project Title: Healthy Diets at Grow Benzie
Institution: Grow Benzie
Date: 3/7/2015
Report:
Project Title: Healthy Diets at Grow Benzie
Institution: Grow Benzie
Date: Mar. 7, 2015

Grow Benzies programs were greatly strengthened through the support of the Allen Foundation this year. With additional time from both our greenhouse manager and kitchen manager we were able to expand our classes and outreach to schools, the community, and impact family well-being.

We partnered with the Northwestern Culinary Institute providing 6 community dinners and 2 special events, focusing on local, nutritional foods with speakers from various disciplines. These were all well received, and even with severe winter weather we averaged attendance of 45 people per dinner. We held two sets of 6 Cooking Matters classes in cooperation with Michigan State Extension and have a third set planned yet this spring. Our greenhouse manager led a series of 15 Preserve the Harvest Classes throughout the summer, both during the day and at night. The children s greenhouse was visited by several classes from the two school systems during the spring, while outreach classes continued at two elementary schools, taught by both our greenhouse manager and a volunteer. The summer program at Platte River Elementary supplied 7 families with the opportunity to work on garden plots that were initiated in the spring in the greenhouse, and reap the harvest. A junior master gardener series of classes was held for six weeks in July and August and we are exploring better ways to increase attendance for this coming summer.

A new program we have just begun since January, Hive Minded, is a partnership with Benzie Central Schools, and a local Business, St. Ambrose Winery, involving high school students making Bee Hive boxes in the schools former industrial arts facility while learning carpentry skills (St. Ambrose purchases the Bee Boxes). Along with that is a culinary group of students who are making snacks for the Bee Hive students. Their most recent snack was a pizza made in the school's former home economics room using fresh produce. We are finding that the way to draw students in is through mentorship with adults and having fun in the process. As word spreads, the students have become more excited about the classes and even text their volunteer teachers explaining why they cant come to a class but when they will be back. We intend to keep these classes going this way and then offer a wider range of culinary classes for teens this spring and summer at Grow Benzie.

Our budget:

$14,500 was spent on employment of our Greenhouse manager and Kitchen Manager
$ 2,500 was spent on promotion of all of the programs, utilizing flyers, small ads, posters, and email service.
$ 2,000 was spent on food, plus meal preparation/serving supplies.
$ 260 was spent on stipends for speakers.
$ 740 was used towards a purchase of a video camera. (Our greenhouse manager is an excellent teacher and we decided we want to video her classes in the future. We will be able to post them on our website for others to access.) We have already created a video tour to use in speaking engagements about our programs.

Of note since this grant was received is the decision Grow Benzie made to hire their first, full-time executive director, Joshua Stoltz. He worked previously with Seeds and is well known in the community and school systems. He works extremely well with students and has the football team scheduled to work and learn about gardening in the greenhouse. This fall the team will host their fundraising dinner prepared at Grow Benzie. Additionally, our new kitchen manager is also an entrepreneur, who produces her product in our kitchen, and she is very knowledgeable regarding food nutrition/preparation. She and Josh are working closely together to develop culinary classes going forward. We are utilizing social media more extensively too as a way to reach people in our rural area. This is a difficult problem for all organizations as there isnt consistent media that reaches those we are trying to reach.

We cannot thank the Allen Foundation enough for their support as we go forward expanding and defining our programs. As a nonprofit in a community where low incomes abound, having these funds makes the difference between having a program or not having it at all. The need is great and changing behaviors takes a long time, but our children and community are worth it. Thank you for helping us serve our families in this way.

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Project Title: Midland County Emergency Food Pantry network BackPack Buddies Program
Institution: Midland County Emergency Food Pantry Network
Date: 1/9/2015
Report:
The BackPack Buddies program provides a weekend backpack of food to low income elementary students in Midland County. For the 2014-2015 school year we have approximately 740 students enrolled in the BackPack Buddies program covering 12 elementary schools in Midland County. This represents a slightly larger enrollment than we have had in the last few years. To qualify for this BackPack program children have to be eligible to receive free or reduced price lunches.

The backpack contains approximately nine items, including products for breakfast, lunch, dinner and snacks. A typical back pack might contain several cans of soup, macaroni and cheese, instant oatmeal packets, canned fruit and several granola bars, although items vary from week to week. The food is received from the Food Bank of Eastern Michigan. The Food Bank is able to provide this food at a very reduced price. We have been looking at ways to supplement the food with fruits such as apples and oranges.

A backpack costs approximately $2.25/backpack/week. Since October we have received food for 12 weeks.

$2.25/backpack x 12 weeks x 740 children=$19,980

We are very grateful to the Allen Foundation for the $10,000 grant. This program is very valued by children and their families. Children often share the items with other members of the family. With support from organizations like the Allen Foundation and the Midland community we can continue to provide this program which helps in reducing childhood hunger.

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Project Title: Leptin and developmental delays in growth retarded preterm infants
Institution: UC Davis
Date: 12/30/2014
Report:
Given below are the financial statement and scientific progress of the project, over the first 5 months of this projected 24 months funded. Scientific progress has been extremely encouraging, and the project continues to be on budget.

We are deeply grateful for the funding provided by The Allen Foundation, and hope that this is work that the founder would be proud of.

FINANCIAL STATEMENT
Salary: The grant has provided salary support for a laboratory technical who is primarily responsible for the conduct of the study ($18,105 per year including benefits), and for the PI ($6,383 per year).
Supplies: In the first 5 months of the study at total of $6,468 has been spent on supplies (including the purchase of animals, recombinant rodent leptin and recombinant rodent leptin antagonist), and on animal housing.
Travel: No expenditure.

The costs of the study are within budget, and the objectives outlined in the original application will be delivered agreed two year budget as promised.

SCIENTIFIC PROGRESS
Scientific progress has been made on several of the study objectives:
OBJECTIVE #1. The first group of rats (n=84) in this experiment are now 7 weeks old, and data is available on neurodevelopmental testing (T-maze).We have confirmed our previous findings that early growth restriction leads to neurodevelopmental impairments, and that exogenous leptin administration reverses the impairments. In addition, we have demonstrated that early catch-up growth in the rat mitigates the neurodevelopmental impairments seen in growth retarded rats, and that leptin treatment further reduces these impairments. These findings are consistent with our hypotheses. The second group of rats in this experiment will commence the study within the next few weeks.
OBJECTIVE #2. In a preliminary dose finding study we have demonstrated the 3 mcg/kg/d of a long-acting recombinant leptin antagonist leads to significant neurodevelopmental delays in normally grown rats. This results is consistent with our hypothesis, and provides guidance of the dose to be used in further studies. We plan to begin long-term experiments on the effect of the leptin antagonist (as outlined in objective #2) in the next 6-9 months.
OBJECTIVE #3. Experiments on the effect of exogenous leptin on ob/ob and db/db mice will be carried out in the UC Davis Mouse Biology Program research facilities. The details of the experiment have been finalized, and will begin in the next 6 months depending on availability of space at the MBP.
OBJECTIVE #4. The current group of rats from objective #1 are now 7 weeks old. Additional groups of rats for objectives #1, #2 and #4 will begin the study at 6-8 week intervals to ensure that all animals reach 6 months of age, and have tissues analyzed, before the end of the 24 month study period.


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Project Title: Nutrition and Wellness Promotion Among the Immigrant Population
Institution: Spanish Catholic Center of Catholic Charities
Date: 5/2/2014
Report:
The Pasos Saludables Program is a self-management intervention program that promotes healthy eating behaviors and active lifestyles in the context of our patients built environment, in order to reduce the prevalence of overweight and obesity (as well as the conditions often associated with each, such as heart disease and diabetes) among Latinos. We designed the program to be patient-centered and culturally competent. The program is administered by bilingual immigrants.

Our primary care staff refer patients that are overweight or obese to the program, after which, each is encouraged to begin attending sessions with caregivers and family members. During the first and third sessions, we collect participants biomarker measurements (e.g., weight, blood pressure, abdominal circumference, etc.) in order to track participants progress throughout the year. We also give them a pre-test on their knowledge, attitudes and behaviors, followed by a post-test on their third visit. A satisfaction survey follows the end of each session.

Classes were held twice a month at two clinic sites, when most patients reported they were available. All classes were held in English and Spanish. We assisted patients with setting realistic self-management goals, showed them how to select healthy and affordable food at local grocery stores or farmers markets, showed them how to prepare it in a manner that tastes good and is culturally relevant, and helped them learn about their disease state and how to track the progress. We offered a series of wellness classes on various topics based on the recommendations of the USPSTF guidelines for obese patients and also used a curriculum established by the University of Maryland Extension Nutrition Program. These sessions were held in a peer group support setting. Our popular one-hour Zumba exercise activity followed the classes, which was then followed by food preparation demonstrations. Patients tasted the food prepared on-site and took the recipes home with them. During the grocery store/farmers market tours, patients were given an opportunity to demonstrate what they learned during the tour by bringing back samples of healthy meals and were then given $20 gift cards to purchase these items.

Between June 1, 2013 and April 30, 2014 we held 35 Pasos Saludables sessions. The total number of visits was 268, of which 80% were female. We had 86 unique patients, 50% were diagnosed with type 2 diabetes mellitus and about 68% of the participants attended at least three sessions. Of the 86 unique patients who attended the program their baseline measures were as follows: 35% were overweight and 65% were obese; 50% had pre-hypertensive blood pressure readings and 15% had hypertensive blood pressure readings (above 140/90).
The participants health outcomes from their first and third visits, included measuring BMI, abdominal circumference (AC) and LDL levels. A change in BMI of 1.0 point was considered significant. There was a reduction in the BMI of both men and women but the decrease was higher in women with an average of 2.0 points reduction. For AC, a change of more than one inch was considered significant. The reduction in the AC for both men and women was less than a point. This is a very difficult task to accomplish in such a short period of time. For LDL cholesterol, a change of 5 mg/dL was considered significant. Although there was a slight reduction in LDL for both men and women it was not considered significant.

Pre- and Post-Tests were administered to every Pasos participant during the first and third visits, respectively. The survey assessed and produced the following results:
1. Knowledge about nutrition and chronic diseases: Participants who accurately identified the daily number of recommended fruits and vegetables to consume increased from 35.15% to 55.56%. Accurate participant responses for What is considered exercise, increased from 55.56% to 65.85% and for Obesity increases risk of certain diseases, accurate responses slightly increased from 62.67% to 67.78%. Accurate participant responses for Obesity increases risk for diabetes, increased from 87.67% to 95.83%.
2. Attitudes related to nutrition and goal setting: Respondents were asked to report on their personal goals for participating in the program, as well as their level of confidence that they would achieve these goals. In comparing the pre- and post-tests, patients confidence levels increased from 68.42% to 80.12%. No one reported being not at all confident.
3. Healthy behavior activities: Patients reported an increase by 33.81% for consuming at least 2-4 servings of fruits and vegetables per day. Patients also increased their physical activity. Walking was identified as the most popular physical activity.

A Satisfaction Survey was also completed by all the participants at each session. All participants expressed gratitude that the sessions were held in Spanish and English, were free of charge and would like the program to continue. Many patients requested for the Zumba classes to be offered weekly. Patients thought the instructors were well prepared and presented on topics they would use in their daily life. All of the participants would recommend these classes to a friend or family member. All participants were either very satisfied (78%) or satisfied (22%) with the classes.

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Project Title: Role of Nucleotide-Binding and Oligomerization Domain Containing Protein (NOD) 1 in Diet-Induced Adipose Inflammation and Obesity
Institution: University of Tennessee Knoxville
Date: 4/30/2014
Report:
Ling Zhao, PhD
Proposal Number: 2011.393: Role of Nucleotide-Binding and Oligomerization Domain Containing Protein (NOD) 1 in Diet-Induced Adipose Inflammation and Obesity
Progress report for the period: June 2013-May 2014

Obesity is one of the leading health problems and causes of mortality in the United States. It has been recognized that obesity is associated with chronic inflammation in adipose tissue, characterized by increased proinflammatory chemokines/cytokines expression and immune cell infiltration. Obesity is thought to increase the risks of chronic diseases, such as insulin resistance, and type 2 diabetes, through the impact of adipose inflammation on metabolism of other tissues, such as muscle and liver, and itself. The objective of this proposal is to test the hypothesis that NOD1, one of the prominent members of the NOD-like innate immune receptor family, plays critical roles in mediating adipose inflammation in diet-induced obesity. Thanks to the generosity and support from Allen Foundation, we have made significant progress during the first year of the funding period (year 1), as reported in 2013 report. Here, we report the progress we have made during the second year of the funding period (year 2), which concludes the two-year award.

Aim 1: Define the role of NOD1 in diet-induced adipose inflammation and obesity
In year 1, we completed the studies of one cohort of mice on the high fat diet (HFD) (58% Fat kcal). We obtained results of mice body weight gain over time (week 4(after weaning) to week 20 (after 16 week on diet)), food intakes, insulin and glucose tolerance tests. Whole blood and various tissues, including various fat pads, were collected, frozen, and stored during year 1. Analysis of these samples, started in year 1, was extended into year 2. Evaluation of the results from this cohort of mice on HFD revealed that NOD1 deficiency (NOD1-/-) did not protect the mice from HFD-induced obesity and systemic insulin and glucose resistance. Surprisingly, analysis of the inflammatory gene expression in the gonadal (part of the abdominal fat) and subcutaneous (subQ) fat revealed that while some inflammatory gene expression were attenuated, but others were ENHANCED, in NOD1-/- mice, compared with WT mice. We went ahead and completed another cohort of mice studies on regular chow diet with low fat content (LFD) (10% Fat kcal). Even though there were still no significant differences in gross body weight between WT and NOD1-/- in both sexes at the termination, NOD1-/- mice showed significantly higher fasting glucose levels, and impaired glucose sensitivities and/or insulin sensitivities in both sexes on LFD. In the second cohort studies, we also completed the in vivo insulin signaling studies to examine insulin sensitivities in the fat, liver, and muscle tissues, and analyzed the immune cells infiltration into the gonadal and subQ fat pads in collaboration with Dr. Beiyan Zhou at Texas A&M University. Consistently with the impaired systemic glucose/insulin sensitivities, more proinflammatory macrophages (i.e., M1 macrophages), T cells, and B cells were found in the fat pads from NOD1-/- mice of both sexes, compared with WT mice. We are very intrigued by these new findings: contrary to the phenotypes reported for the mice with deficiency of Toll-like receptor (TLR) 4, or TLR2, members of another prominent innate immune receptor family, there was enhanced inflammation in NOD1-/- mice, which was associated with impaired systemic glucose and/or insulin tolerance on LFD. A more complex picture of roles of different innate immune receptors (NODs vs TLRs) played in the diet-induced obesity and insulin resistance has been suggested based on our new results: Is it possible that the role of NOD1-mediated inflammation is to antagonize TLR-mediated inflammation in the context of diet-induced obesity such that enhanced inflammation occurs when NOD1 is deficient while TLRs are intact (or vice versa). Clearly, more studies are needed. We plan to submit a R01 research proposal to National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) this year to further explore the complex roles of NOD and TLR. We are now finishing up analyzing the samples generated in year 2 and are in the process of preparing the manuscript.

Aim 2: Define the role of NOD1 in saturated fatty acid-induced inflammatory response in adipocytes and macrophages
In year 1, we demonstrated the roles of NOD1 in the crosstalks between adipocytes and macrophages, the two prominent cell types in the adipose tissue. Using adipocytes differentiated from stromal cells of adipose tissue and bone marrow derived macrophages (BMDM) from NOD1-/- mice, compared with that from WT controls, we have found that NOD1 activation by the synthetic ligand in adipocytes, but not in macrophages, induced chemotactic gene expression and monocyte chemotaxis, suggesting a role of NOD1 in initiation of adipose inflammation. Moreover, using BMDM, we have found that saturated fatty acid palmitate (C16:0) induced up-regulation of tumor necrosis factor alpha (TNF alpha) and interleukin 6 (IL-6) in WT BMDMs, but much attenuated expression in NOD1-/- BMDMs. These results will be incorporated in the manuscript to be submitted for publication.

The work funded by Allen Foundation is part of the dissertation research for the successful completion of the doctoral degree for student, Pan Hu. The manuscript generated will be submitted for publication this year.

Authors: Pan Hu1, Eddie W. Ying2, Beiyan Zhou2, and Ling Zhao1
Affiliations: 1Department of Nutrition, University of Tennessee Knoxville, TN; 2Department of Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University.

Acknowledgements: This research was supported by the UT faculty start-up funds and by Allen foundation grant 2011.393.

As the funds were made available at our institute starting July 1, 2012, therefore, the spending from 07/01/12 to 4/30/13 was shown in the year 1 report. The total spending as of 4/30/14 is shown below (note that the account will be officially closed on 6/30/14 at UT):

Direct costs: $41,445.95
$21,812.80Salary and benefits for the graduate student working on the project
$19,633.15Supplies and reagents, animal maintenance
Indirect costs: $6,216.90
Total: $47,662.85



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Project Title: Longview Early Childhood Kitchen Project
Institution: Midland County Educational Service Agency
Date: 4/30/2014
Report:
Progress Report on Longview Early Childhood Centers Kitchen:

Longview Early Childhood Centers Kitchen Project has come to fruition thanks to the generous grant of $66,260.00 from the Allen Foundation that was received in May of 2013. Every dollar of this grant was used to purchase 23 pieces of new kitchen and dishwashing equipment. See list of expenditures at the end of this report.

In September of 2013 Midland County Educational Service Agency opened a comprehensive early childhood center in the southeastern part of the City of Midland, in the former Longview Elementary building. Almost a year later, the ESA is proud to say the new kitchen is thriving and providing healthy, nutritious breakfasts, lunches and snacks to over 300 children a day or over 40,000 meals/snacks since Longview Early Childhood Center opened its doors in September. Hundreds of infants, toddlers and preschoolers, the majority coming from low-income families, have benefited from having a kitchen that prepares, serves and delivers them with delicious healthy meals and snacks everyday. In some cases these are the only nutritious meals and snacks they eat during their day.

Partnering agencies such as Head Start, Kinder Kare, Great Start Readiness Program and MCESA Early Childhood Special Education programs have shared in the benefits of having a state of the art kitchen at Longview. All the food service for these programs (and more) take place on site; gone are the days of hotboxes, transporting meals, classroom staff preparing meals, low quality of food and the use of costly outside food services, like Chartwells. Having our own food service program on site has allowed the flexibility to accommodate food allergies, special dietary needs and classroom requests easily, efficiently and economically. It has reduced overall food service costs, provided added conveniences and most importantly has increased the quality of the food being served to all children at Longview.

Jamie Agnew was hired by MCESA to over see the kitchen at Longview and has been doing a phenomenal job providing food services to everyone housed there. Jamies kitchen team creates monthly menus for the classrooms that meet all USDA and licensing guidelines, offering a variety of hot and cold homemade meals (and more). Here is an example of 3 breakfasts and lunches that were served during the month of April at Longview: Breakfasts-scrambled eggs, toast with jelly, tropical fruit and milk; pancakes, syrup, sausage links, cinnamon applesauce and milk; egg and cheese burrito, mandarin oranges and milk. Lunches-chicken drumstick, mashed potatoes w/gravy, breadstick, fresh fruit, milk and surprise treat (special Easter cupcakes); spaghetti w/meat sauce, baby carrots, fresh fruit and milk; chicken and cheese quesadilla, Mexican corn, peaches and milk. Its no wonder why staff and students rave about the wonderful variety and quality of food that comes out of the kitchen, not to mention the special surprises they receive every once in a while.

Over the past nine months, the kitchen at Longview has become more than just a food service program. Educational and catering opportunities in the kitchen have evolved and created additional win-win situations for the post secondary population, staff/trainers, and the community. The ESA has been able to use the kitchen as a work site for some of their post secondary students, creating job skill opportunities for students with special needs. Students, based on skill level, are able to learn how to operate some of the kitchen equipment; like the dishwasher. This situation has provided the post secondary population with a chance to learn an employable skill that they can use in the workforce once they exit the program. The ESA will continue to use the Longview kitchen as a work site to help build and foster employable skills and interests in their post secondary population.

Catering has become another feature that has evolved from the Longview kitchen. At first the kitchen staff catered to adult requests for salads, soups etc. This led to a monthly menu for adults in the building, featuring a daily soup, salad, sandwich and dessert. This in turn led to requests for providing refreshments for meetings and trainings held at Longview and other locations. Today, Jamie and her staff not only prepare and serve high quality meals to all children and adults at Longview, but have also developed a cliental they are able to serve in the greater Midland community.

The Longview kitchen has become a must see when tours of the building are given. The new state of the art stainless steel kitchen appliances and equipment have made all of the events mentioned above possible. Every dollar received from the Allen Foundation was used to purchase the appliances and equipment found in the kitchen at Longview Early Childhood Center. The impacts of the Allen Foundation dollars have far exceeded our expectations of the Longview Kitchen Project. Thank you.

Purchases made with Allen Foundation funds for
Longview Early Childhood Kitchen Project:
Convection gas over $3,561.32
Exhaust hood $22,608.00
Stainless steel work tables $1,887.50
Proofer holding cabinets $4,937.50
Reach in refrigerators $4,780.12
Reach in refrigerators $3,055.50
Reach in freezer $4,075.31
Two compartment sink $1,920.63
36 inch 6 burner gas range $2,310.20
Hand wash sinks $400.00
3 compartment sink $2,263.13
Wire shelving units $993.76
Disposal $2,995.64
Condensate hood $2,230.77
Dish table w/shelf (clean) $1,475.00
Dishwasher $5,271.31
Dish table (soiled) $1,495.00
Total $66,260.69

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Project Title: Omega Tots: Polyunsaturated fatty acids to promote brain development in toddlers born prematurely
Institution: The Research Institute at Nationwide Children's Hospital
Date: 4/22/2014
Report:
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INTRODUCTION
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This report outlines activities of the project entitled Omega Tots: Polyunsaturated fatty acids to promote brain development in toddlers born prematurely during the two year period of support from the Allen Foundation. The objective of this study is to evaluate, using a placebo-controlled randomized clinical trial, the effect of adding DHA to the diet of toddlers born preterm on developmental outcomes. During this two year period, over 1,200 children were screened for eligibility using the medical record and 101 participants were recruited and enrolled into the placebo-controlled randomized clinical trial. Recruitment and enrollment will be completed in June, 2014. Data collection for the 6 month pilot trial will be complete by the end of 2014. The PI is dedicating other resources to complete the project in the second half of 2014.

Upon completion of data collection, treatment effects of adding DHA to toddlers diets will be evaluated for the aims outlined in this project (e.g., cognition, language, motor development). Given the wealth of information collected for the Omega Tots cohort in toddlerhood, the study team is additionally well positioned to contribute to the literature by examining treatment effects related to additional outcomes, including, but not limited to sleep and growth and by examining long-term cognitive outcomes as children approach school age.

The results of the pilot trial need to be shared. If DHA supplementation is found to have positive effects for toddlers in the short or long term, parents and clinicians will have an inexpensive dietary supplement at their disposal to help promote typical development, growth, and healthy sleep patterns in children born preterm. Upon dissemination, results from the current pilot project will inform the training of professionals who advocate for good nutritional practices during childhood and may encourage the use of low-cost, effective early nutrition interventions for children born preterm; and will provide feasibility and proof of concept data to apply for funding to support a larger clinical trial.

In April, 2014 the PI was awarded a 3 year grant from the March of Dimes to add 202 more children to the Omega Tots study. The seed money provided by the Allen Foundation was crucial in the ability to demonstrate feasibility and secure this major grant.

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AIM 1
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Aim: Determine the feasibility of recruiting, enrolling, and following children from Nationwide Childrens Hospital (NCH) Clinics in a randomized, placebo-controlled trial of DHA and AA supplementation and development; and to evaluate acceptability and adherence.

Study Methods: A list of eligible children who were born at less than or equal to 34 completed weeks gestation, who are between 10 and 16 months of age (adjusted for prematurity), and were admitted to a Nationwide Childrens Hospital (NCH) NICU as well as children who have ever had a Neonatology Clinic follow up visit scheduled at NCH was obtained. The list contains approximately 1,000 potentially eligible children annually who are screened using the medical record based on study inclusion/exclusion criteria. Legal guardians of children who remain eligible are contacted via phone. The study is described to them and eligibility for participation is further assessed. Children who are eligible for participation after this phase of screening are invited to participate in a 6 month clinical trial involving three in-person study visits at baseline (T1), 2 months post baseline (T2) and 6 months post baseline (T3).

Results: Procedures to identify eligible children have been identified and implemented. The study aims to recruit 112 children and families. Eligibility and Recruitment: Approximately 83% of screened children are eligible based on inclusion/exclusion criteria.

Description of Enrolled Participants: There are 101 participants enrolled to date. Participants range in age from 10.5 to 17.0 months adjusted age at enrollment. On average, children enrolled in the trial at 15.3 (SD=1.7) months adjusted age. The gestational age of enrolled participants ranges from 24 to 34 completed weeks, with an average of 31.69 (SD=2.5) completed weeks. Sixty percent of enrolled participants are male; 61% are white, 24% are Black/African American, and 15% are multi-racial; 5% of participants are Hispanic. Follow up rates have been very good. Eighty-nine percent of participants enrolled for two or more months completed the T2 study visit as scheduled; of those enrolled for the duration of the six month study, 91% have completed the trial on schedule; 4% participants withdrew from the trial after the baseline visit.

Data regarding adherence to the prescribed protocol are collected in multiple ways: 1) parent report of supplement/placebo daily consumption; 2) assessment of the amount of supplement distributed and returned; and 3) analysis of DHA present in plasma. Parent report of compliance and assessment of supplement distributed and returned both demonstrate high compliance. On average, there is 87% compliance based on parent report and 75% compliance based on the amount of supplement/placebo distributed and returned. Information regarding compliance assessed through an analysis of DHA present in the plasma is discussed with Aim 2.

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AIM 2
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Aim: Evaluate change in DHA and AA as a percentage of total fatty acids in red blood cells (RBC) and plasma of participating children from baseline to 2 months post-randomization.

Study Methods: A 2mL blood sample is collected at each study visit. This has been collected at the T1 study visit for 99% of participants, at the T2 study visit for 96% of participants, and at the T3 study visit for 96% of participants. Collection of the biospecimen allows for an examination of a change in fatty acids throughout participation in the clinical trial. Additionally, extensive parent reported dietary intake data are collected at each data collection time point. Specifically, caregivers complete the Willett Food Frequency Questionnaire (FFQ), an additional fatty acid intake assessment designed for the purposes of this study, questions regarding breastfeeding history, and transition to solids that will facilitate achieving this study aim.

Results: Plasma sample pairs obtained at the T1 study visit and the T2 study visit have been collected and analyzed for 21 participants. As expected, preliminary data suggest baseline DHA levels (measured as a % of total fatty acids) were similar among the treatment and placebo arms (mtreatment=1.1, SDtreatment=0.3; mplacebo=1.3, SDplacebo=0.4), however, change in DHA levels from T1 to T2 differed significantly between treatment groups (mtreatment=1.5, SDtreatment=1.0; mplacebo=0.01, SDplacebo=0.5). This difference is statistically different (z=3.3; p=.001) and indicates participants are taking the supplement and responding biologically. Preliminary analyses show that treatment effects in the percent of total fatty acids that are AA did not reach significance. In addition, we have collected extensive dietary data across multiple time points for participants. A preliminary evaluation reveals that several measured dietary parameters are consistent with data from similar aged children reported in a national representative sample (i.e., NHANES).

The Omega Tots study represents a cutting edge analysis of baseline fatty acids in a high-risk population and collects a large amount of dietary and nutritional data on young children. It is expected that data generated from this study will contribute to multiple projects focused on the nutrition of young children, especially those born preterm.

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AIM 3
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Aim: Evaluate differences in cognitive, language, and motor development at 6 months post-randomization using the Bayley Scales of Infant and Toddler Development-3rd Edition.

Study Methods: A standardized developmental assessment, the Bayley Scales of Infant Development 3rd Edition, is administered at the T1 and T3 study visits. It is estimated that a total of 102 children (51/arm) are required to have adequate statistical power (81%) to detect an 8.5 point difference (SD=15) in mean Bayley scores between the treatment groups.

Significance: The evaluation of this aim will provide support for fatty acids as a low-cost, effective early nutritional intervention for children born preterm. If any developmental benefits are observed, they will provide an important contribution to our understanding of how nutrition influences development among very young children and how a dietary supplement like the one used in this study might be a good dietary add-on or alternative for some children, helping to reduce developmental inequalities associated with prematurity. This will be evaluated once all children complete the six month study.


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PRELIMINARY BASELINE DATA
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Cognition
Although, on average, children perform within normal limits for their prematurity adjusted age on measures of cognition (m=101.21; SD=11.87), some children are doing poorly at the start of the study: 8% scored more than one standard deviation below the mean. This suggests many children stand to benefit from the fatty acid intervention.

Language
Although, on average, children perform within normal limits for their prematurity adjusted age on measures of language (m=93.87; SD =12.39), some children are doing poorly at the start of the study: 17% scored more than one standard deviation below the mean. This suggests many children stand to benefit from the fatty acid intervention.

Motor Development
Although, on average, children perform within normal limits for their prematurity adjusted age on measures of motor development (m=96.32; SD =10.32), some children are doing poorly at the start of the study: 12% score more than one standard deviation below the mean. This suggests many children stand to benefit from the fatty acid intervention.

Growth
Participants demonstrate a below average weight at the start of the study. When compared to the general population, children in this cohort are .75 of standard deviation below the mean (range: -3.50-1.28) and are, on average, in the 30th percentile for weight for age (range: <1-90th).

Sleep
Seventeen percent of parents reported their childs sleep is a problem at the start of the study. Data show that some children get as little as 5 hours of sleep per night and wake up to 4 times during the night. On average, it takes approximately 26 minutes to put children to sleep at night (range: 0-1.5 hours), children wake just under 1 time per night (range: 0-4 wakings), sleep an average 9.75 hours per night (range: 5-12.5 hours), and sleep approximately 2.6 hours during the day (range: 1-6 hours).

Preliminary Evaluation of Randomization Scheme
A preliminary test of the randomization scheme demonstrates effectiveness. At the start of the study, groups do not differ on gender (p=.97), child corrected age (p=.70), gestational age (p=.35), cognition (p=.54), language (p=.37), motor skills (p=.28), weight (p=.70), duration of sleep during the night (p=.18) or during the day (p=.48), number of night wakings (p=.37), wakefulness (p=.32), or perception of sleep problems for the infant (p=.08). This shows that our method of assigning children to each treatment group is working optimally. Therefore, the research team is well positioned to explore treatment effects on many important outcomes.


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BUDGET
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Year 1 Awarded: $69,366.00
Salaries and Benefits: $52,072.10
Operating Costs: $8,245.90
Indirect Costs: $9,048.00

Year 2 Awarded: $81,420.00
Salaries and Benefits: $66,810.00
Operating Costs: $3,990.00
Indirect Costs: $10,620.00






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Project Title: A Guatemalan Nutritioinal Expansion Program
Institution:
Date: 4/17/2014
Report:
Due to the generosity of the Allen Foundation and others, Feed the Dream continues to make significant progress in fulfilling its mission to improve the nutritional health of children under 6 years of age and young women of reproductive age (15-49) in an increasing number of remote Guatemalan Highland villages. The subject of this current project is Saquiya (Patzun), but the same projects were duplicated in Chuachun and Chuacay (Santa Apolonia), all in Chimaltenango department, and Xepatan.. **We are proud to report that in our 10 years we have had 11 villages graduate to self-sustainability!

The total population participating in our program here consists of 420 women and 286 children. Exponentially, since it involves and improves the quality of the entire family, the value of the program affects almost 5680! The format was as follows:

1. Nutritionally balanced snacks with vitamins were provided during 38 training sessions. The core of this program is a fortified nutritional drink called incaparina. A muffin or cookie enriched with chaya, amaranth or moringa accompanied the drink. At the same time a trained indigenous educator taught them the significance of nutrition and how to incorporate available local resources. While new recipes were learned, hygiene and proper food handling and preparation were taught.

2. Ricardo, our agricultural expert, held 28 different training sessions with the women to improve the production of basic grains while using soil conservation techniques and selection of better adapted native seeds to the new climate conditions. He instructed them on adding at least 5 new vegetables and herbs to their home gardens. More training sessions involved fruit tree selection and training on care of the 173 goats in our newest program with 20% of them already producing milk.


3. New and improved health practices also involved the opportunity to acquire a water-filter at a nominal cost and a crucial vented and enclosed stove. Children were weighed and measured every 3 months in order to monitor the results of nutrition. Guatemala is 4th in the world for the worst rate of nutrition with stunting the most obvious result. The status in Saquiya, which was representative of the other 3 villages, was as follows which represents only 8 months of our program there:

Baseline, July, 2013 March 1, 2014
Chronic malnutrition 52% 33%

Normal 48% 67%

4. Feed the Dream guaranteed accountability with on-site supervision with our local area partner Behrhorst Partners for Development (BPD). Their presence with the community indigenous health promoters added reinforcement to their education. With our program the indigenous gained improved physical health which in turn enriched them emotionally. The benefits of new self-esteem and socialization are beautiful to see, as well as aspects of improved living conditions and girls school attendance.


Financials: (through April 1, 2014)---Total Allen Foundation funds of $15,000 were greatly appreciated and were a significant part of our total project.


Nutritional Education
and Food $4800

Agricultural Supplies $2100

Salaries (partialfor
Indigenous educators $3600

Total $15, 000

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Project Title: Feedign Program
Institution: Children of Strength
Date: 4/10/2014
Report:
Children of Strength a US non-profit providing assistance to orphans in Kenya is in the second year of a generous grant of $20,000 from the Allen Foundation. Children of Strength is very grateful to the Allen Foundation for their support during this two year period. During this second year of this funding, the program remained a solid foundation in the social and educational development of over 5000 children at nine different schools in the Central District of Kenya. Funds from the Allen Foundation went directly to pay for food in our school feeding program. As discussed in our 2012 summary, Children of Strength provides a meal of beans and maize to elementary students for 9 months of the year. Children of Strength also provides the cooking staff to prepare these meals. In 2013, we also undertook a project to evaluate the efficacy of this program as it relates to the community development. We wanted to ask ourselves the question, how does this program impacts the lives of the children and adults in the participating communities. Staff conducted a study based on surveys and historical baselines to determine the extent and magnitude of the impact. The results of our study were both positive and encouraging.
Some of the more significant findings were as follows:
Children attending the schools supported by our feeding program typically stayed in school all day as opposed to leaving at the noon time break;
Primary school completion rates were higher in schools with feeding programs;
Overall dropout rates from school with feeding programs were lower;
Increase cognition and learning were observed in schools with feeding program as measure by standard testing;
The health and nutrition of children at schools with feeding programs was higher
Parents and guardians were able to work longer during a work day and because a lunch was provided. They were able to provide a better evening meal for their dependents;
In addition the Charm Effect was observed. This effect is when a child attends school primarily for food and ends up remaining because they are now excited by the learning experience;
The reverse flow effect refers to the pattern of support that those with completed educations extend back to their stem households and communities.

One negative impact of the feeding program was also observed. Increase class sizes have occurred as families move into the area for the sole purpose of having their children attend a school with a feeding program. This increased attendance does put additional strains on the teacher and school resources.

As a result of our survey and study we have also been able to identify some recommendation to enhance the effectiveness of this program. Some of these recommendations are:
Improve the nutrition value of the meal.
o Several schools have begun to collect 1 ksh per day from each student. These funds are then used to purchase fresh vegetables to be added to the bean and maize to help balance the mid-day meal. In addition, grinding of the maize to powder so that it can be made into ugali is being considered as ground maize has a much higher absorption rate than regular maize kernels.
Consider piloting a fortified porridge in the schools
o Many children were identified as having little if any meal prior to the morning class. The addition of a pilot breakfast is under consideration.
Convert all cooking to using an energy saving Jiko
Encouraging schools to plant trees
Involvement of the teachers in the feeding program


In the period under review, the total cost of food, transport and preparation of these meals was $59,326.47. The grant from the Allen Foundation was used to cover in part these costs. The purchase of food accounts for most of the expenditure and was 76% of the total cost, followed by 2% for transport and 22% for food preparation which includes the salaries of the cooks. No monies were spent for Children of Strength administrative costs. Children of Strength is a 100% volunteer organization.

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Project Title: Healthy Habits Among the Elderly
Institution: Western Michigan University
Date: 3/14/2014
Report:
Allen Foundation End of the Year Progress Report
Dr. Amy Curtis
Diana Hassan
Western Michigan University


Healthy Habits Program (HHP) is 5-week program that focuses on

Prevention of chronic illnesses related to obesity, specifically diabetes, among adults who are older than 45. The reason we selected this group is because the literature shows that this age group lacks appropriate interventions due to the misconception that older adults refuse to change. However, when looking at the results of the National Diabetes Prevention Program among different age groups, the older adults group was the most successful group in changing their behaviors and subsequently losing the most amount of weight and maintaining it.
The HHP curriculum was designed by the Michigan Department of Community Health (MDCH) based on the National Diabetes Prevention Program curriculum study which showed that participants who modified their eating habits and exercised 150 minutes a week were able to prevent or delay the onset of diabetes.
The educator delivering the program, Diana Hassan, was trained by MDCH in the curriculum.
Health screenings were offered to participants at the first and last session of the 5-week series program in addition to the follow-up sessions. Weight was measured as an outcome indicator. Additionally, blood pressure and glucose screenings were offered to increase participants awareness of their biometrics.

Measures:
Participants behaviors were measured pre/post the intervention utilizing a pre/post survey that was designed for the curriculum. The survey measured behavior frequency of eating fruits, vegetables, whole grains, and engagement in moderate and vigorous physical activity.
Participants knowledge about nutrition was also measured pre/post the intervention utilizing a validated and reliable pre/post survey to measure change in nutrition knowledge (Hawkes A., & Nowak, M, 1998. Nutrition Knowledge Questionnaire. Australian Family Physician; 27(11): 1057-1058).
To determine weight loss, weight was measured pre/post the program (HealthOMeter 349KLX digital media scale).

Inputs:
12 programs were delivered in 4 counties in southwest Michigan: Kalamazoo, Van Buren, St. Joseph, and Branch.

Kalamazoo (3 programs):

Friendship Village: FV is a senior living community. We faced some challenges with recruitment due to the high security and privacy of the facility. We did not have access to the addresses or email addresses of residents so recruitment efforts were limited to the efforts of the activity coordinator at that site. 2 participants graduated the program in July, 2012: 1 f and 1 m
Mt. Zion Baptist Church: one program was delivered at this site as part of their wellness initiative. 5 participants graduated the program in July 2012: 4 f and 1 m.
Dillon Hall: a senior living apartment complex. One program was delivered at this site with 7 f.

Van Buren County (5 workshops):

Van Buren County Employees: The program was offered to county employees during lunch as a worksite wellness in July 2012. 9 participants graduated the program: 8 f and 1 m.

A partnership with Senior Services of Van Buren County has been established to deliver the HHP at various sites in Van Buren County.

Decatur Senior Center: a total of 12 participants graduated the program in December 2012: 7 f and 5 m.
Mattawan Senior Center: a total of 7 participants graduated the program in March, 2012: 6 f and 1 m.
Paw Paw Senior Center: a total of 6 participants graduated the program in May 2013 (5 f, 1 m)
Gobles Senior Center: a total of 4 participants graduated the program in June 2013 (4 f)

St. Joseph County (3 programs):

Local MSU Extension office in Centerville: 2 programs have been offered in November, 2012 and February, 2013 with 2 f and 9 f who graduated respectively.
Sturgis Church of the Nazarene:
Centro V.I.D.A. in Sturgis (Hispanic Group): initially 20 participants started the program, however only 9 were able to graduate (8 f, 1 m). The Hispanic Council was able to provide an interpreter. The enrollment forms and the pre/post tests were translated to Spanish.

Branch County (1 program):
Local MSU Extension office in Coldwater: 1 program was offered with 11 participants who graduated.

Main results of the 5 week intervention:
Analysis of data revealed that participants lost a statistically significant amount of weight from an average of 194.8 lb to 191.6 lb within the 5-week program (p=0.00) for an average weight loss of 3.2 lb. Participants also showed a significant change in nutrition knowledge among participants. There was also a significant increase in frequency of eating vegetables (p=0.018) and frequency of engaging in vigorous physical activity (p=0.026).
Follow up sessions:
Currently, follow-up sessions are still being conducted to offer support for participants at 6 months after graduating the program. Weve also trained 8 lay-leaders in the program to disseminate the information and hold programs in different communities.

Budget expenditure:
Personnel (Project Investigator and Health Educator): $4,577
Translational Services: $360
Participant Support: $1,880
Travel: $2,039.65
Supplies: $3,377.52
Indirect costs: $1,658.67









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Project Title: The Effect of Vitamin D Supplementation on Pre-Diabetes in Obese Adolescents
Institution: The University of Georgia
Date: 12/20/2013
Report:
Vitamin D supplementation trials with diabetes-related outcomes have been conducted exclusively in adults and provide equivocal findings. If vitamin D supplementation improves glucose-insulin metabolism in children, an inexpensive public health prevention measure could be introduced to reduce healthcare costs associated with type-2 diabetes and to improve the quality of life for many children.

The objective of this study was to determine the dose-response of vitamin D supplementation on glycemia and insulin sensitivity in white and black children aged 9 to 13 years, who participated in the University of Georgia, Purdue University and Indiana University School of Medicine (GAPI) study: a 12-week randomized, triple masked, dose-response, placebo-controlled vitamin D trial (Lewis et al., JCEM, 2013).

Black and white children in the early stages of puberty (N=323, 50% male, 51% black) from Athens, GA (n=160) and West Lafayette, IN (n=160), were equally randomized to receive vitamin D3 (0, 400, 1,000, 2,000, or 4,000 IU/day) for 12 weeks. Vitamin D3 was supplied by Douglas Laboratories. In order to minimize effects of ultraviolet-B exposure on 25(OH)D, participants entered the study and completed testing during winter (October-March 2009 to October-April 2011). Serum 25-hydroxyvitamin D (25[OH]D), glucose and insulin were assessed at baseline and weeks 6 and 12. Homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were used as surrogate measures of insulin resistance and sensitivity, respectively. Statistical analyses were conducted as intent-to-treat using a mixed effects model.

Baseline serum 25(OH)D was inversely associated with insulin (r=-0.140, p=0.017) and insulin resistance (r=-0.146, p=0.012) and positively associated with insulin sensitivity (r=0.142, p=0.015) after adjusting for race, sex, age, pubertal maturation, fat mass, and body mass index. Fifteen subjects were determined to have serum glucose and insulin levels that met criteria for pre-diabetes. Glucose, insulin and insulin resistance increased (F>5.79, p<0.003) over the 12 weeks, and insulin sensitivity decreased (F=12.13, p<0.001) despite vitamin D dose-dependent increases in serum 25(OH)D. These changes were most likely related to physical maturation. The baseline relationships between serum 25(OH)D and measures of insulin resistance and sensitivity were non-causative in early pubertal children, since vitamin D supplementation over 12 weeks did not improve these measures of diabetic risk. In this population of healthy children with sufficient circulating 25(OH)D, supplementation did not alter glucose and insulin metabolism.

This work funded by the Allen Foundation resulted in the successful completion of the doctoral degree for student, A. Ferira. The manuscript has been prepared and will be submitted to the American Journal of Clinical Nutrition for peer review this year:

Title: Vitamin D Supplementation Effects on Insulin Sensitivity and Resistance in Early Pubertal White and Black Children

Authors: Ashley J Ferira, Emma M Laing, Dorothy B Hausman, Daniel B Hall, George P McCabe, Berdine R. Martin, Kathleen M Hill, Stuart J Warden, Connie M Weaver, Munro Peacock, Richard D Lewis

Affiliations: From the Department of Foods and Nutrition (AJF, EML, DBH [Hausman], and RDL), and the Department of Statistics (DBH [Hall]), The University of Georgia, Athens, GA. From the Department of Nutrition Science (CMW, BRM) and Department of Statistics (GPM), Purdue University, West Lafayette, IN. From the Department of Medicine (MP, KMH), Indiana University School of Medicine and Department of Physical Therapy (SJW), Indiana University School of Health and Rehabilitation Sciences, Indianapolis, IN.

Acknowledgements: This research was supported by the National Institute of Child Health and Human Development RO1HD057126 and by the Allen Foundation grant 2008.319.

The total amount awarded from the Allen Foundation was $54,561. A brief financial accounting of expenditures is below:
Salary (Doctoral Assistantship): $10,964
Operating (Supplies/Testing/Assays): $36,480
Indirect Cost Recovery: $7,117

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Project Title: Feeding Program
Institution: Children of Strength
Date: 5/10/2013
Report:

Children of Strength a US non-profit providing assistance to orphans in Kenya, received a generous grant of $20,000 over two years from the Allen Foundation in 2012. This support was utilized to provide basic food to a school feeding program in the Central District of Kenya. In a small rural community, Children of Strength in partnership with Watoto Wenye Nguvu provides food to elementary and high school children at nine different schools. To capitalize on the best prices and bulk purchasing, food is purchase at the start of each term. This food is stored on site at each school and we know that as each term begins, the children will have food for the entire quarter. The staple of the feeding program is maize and beans. When available we try to supplement the meal with vegetables and greens. The program supports cooks at each school. Our cooks arrive by 7:00 am and begin the process of preparing the meal for 400 – 900 children. By noon, the food is ready and the children line up by grade to receive their portion. They come with plates, cups, bowls and even lids as containers to hold this meal. Under this program, children attending school receive a meal of beans and corn five days a week.
Population Served: The feeding program reaches out to over 5500 Kenyan children whose ages range from 5 to 20 years old. These children attend 8 elementary and one high school in the area known as Kilimambogo. Many of these children have either lost a parent or have parents that work as day laborers earning minimum wage in Kenya. Most come from large families that are unable to provide daily food for their families for many of these children, this is the only meal that will get for that day
Impact: The impact of this program is widespread. The feeding program in Kilimambogo continues to be one of the most critical components of Watoto Wenye Nguvu outreach. To quote one of the Head-Teachers (our equivalent of Principal) “Because of this program, children come to school. Children then stay in school where they have to opportunity to receive an education, which is the primary source of hope for their future.” The ripple of effect of this program throughout the surrounding communities is also seen. Because the children are fed a nutritious and steady diet, medical visits to the local clinic are drastically down. They are healthier and able to fend off more and more illnesses. We have received a small stipend for 2013 to fund the collection of data on the feeding program impact. This work will be performed by our Kenyan staff and be available in our next year’s report.
Expenditures: Food is purchased three times a year and is bought at the beginning of each school term. Experience has taught us that by buying in bulk and storing the food on site at each school in locked rooms, a better price for food can be negotiated and transportation costs are kept to a minimum. During the period under review, the total cost of food, transport and preparation of these meals was $63,101.00. The grant from the Allen Foundation was used to cover in part these costs. The purchase of food accounts for most of the expenditure and was 76% of the total cost, followed by 2% for transport and 22% for food preparation which includes the salaries of the cooks. Children of Strength is a 100% volunteer organization and there were no costs for administrative support.

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Project Title: Nutrients regulate transcription via mTORC1 and Early Growth Response factors
Institution: Boston University Medical School
Date: 5/3/2013
Report:
Konstantin Kandror, PhD
Proposal Number: 2010.395: Nutrients regulate transcription via mTORC1 and Early Growth Response factors.
Progress report for the period: June 2012-May 2013

The central idea of this proposal is to test the hypothesis that nutrients control Egr transcription factors via mTORC1. The proposal had three Specific Aims, two of which (Aims 1 & 3) were accomplished during the first year of the award. Therefore, in the last year, we have focused on Specific Aim 2: “Does mTORC1 regulate activity of Egr1?”

In order to approach this problem, we have performed the reporter analysis of the Egr1-regulated ATGL promoter in the absence and in the presence of mTORC1 inhibitors rapamycin and PP242. In parallel, we have determined the effect of the specific mTORC1 activator, Rheb, on the activity of the ATGL promoter. We have found that the activity of the ATGL promoter is not affected by changes in mTORC1 signaling suggesting that mTORC1 does not regulate activity of Egr1. Thus, we have focused on the control of Egr1 expression by mTORC1. To this end, we have shown that (a) activity of the Egr1 promoter itself is highly sensitive to PP242 and rapamycin and (b) 4E-BP1/4E-BP2 double knock out mouse embryonic fibroblasts obtained from Dr. Sonenberg (Montreal) have increased levels of Egr1. These results strongly suggest that mTORC1 regulates expression of Egr1 both at the level of transcription and translation. We have submitted a new research proposal in order to explore regulation of Egr1 by mTORC1 in more detail.

Personnel. This project has been carried out by two post-doctoral fellows, Maneet Singh and Ju-Youn Kim with some help from research technician.

Materials and Supplies. Materials and supplies include FBS and plasticware for tissue culture, reagents for SDS electrophoresis, Western blotting, primers for qPCR, antibodies, animal costs, microarray costs, etc.

Publications. Results of this study have been submitted to MCB and reviewed favorably. We are currently finishing up several additional experiments suggested by reviewers, and we will re-submit the manuscript shortly.


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Project Title: Circle Area Community Garden
Institution: Caregiving Network, Inc.
Date: 5/1/2013
Report:
The Allen Foundation Grant (2011.047) Progress Report (April 30, 2013)

The Circle Area Community Garden (CACG) began in earnest in the fall of 2010. A group of interested parties gathered together and formed a project committee to create a mission statement. The group then met regularly into 2011 to begin planning a strategy for putting the garden into place.

Land on the corner of Ronan and Cambridge was donated by the Stuart Bergstein family to the City of Midland. The only condition of the donation was that the land be used as a community garden. The City agreed to receive the donation provided a 501(c)(3) nonprofit agency would adopt the garden project and provide continuing oversight of, and financial accountability for, the project.

With the CACG project consistent with its mission, Caregiving Network, Inc (CgN) agreed to adopt the project. Cgn's relationship with the CACG continues. All donations and expenses are tracked through a CACG Restricted Fund in CgN’s book-keeping system and the CACG project committee is accountable to the CgN’s Board of Directors.

The CACG committee produced a budget for the project and the fundraising campaign commenced. A local volunteer agreed to write the grant proposals - with assistance provided by CgN. Due to the timing of grants and issues related to the ground preparation, the commencement of gardening did not take place until the Spring of 2012. But already in the summer of 2011 as grants and donations were received, the CACG began to take shape.

Though all the construction components of the garden project were not yet completed, actual gardening began in the Spring of 2012. All 27 garden plots were gardened by family units (individuals, families, or nonprofit organizations). In accordance with the mission of the CACG, at least 11 of the plots are gardened by family units who live with income below the poverty level. The majority of the plots are granted to family units within relative close proximity to the garden neighborhood.

No discrimination takes place in the committee’s selection process for assigning plots to applicants. Most of the garden plots are assigned on a first-come-first-served basis. Prospective gardeners apply for a plot. The CACG Committee evaluates the applications and then assigns the plots to the approved family units. The family unit then signs a covenant of agreement to care for their plot and to volunteer for different tasks necessary to maintain a clean, viable, and attractive community garden.

Today, the CACG project is complete and the garden is in full operation. Construction components included installation of a water source, fencing, gazebo, shed, 27 raised 4’ x 12’ garden plots, signage, bench, and compost bins. Also completed were ground soil preparation, landscaping, and paving of the vehicle entrance to the garden. All Garden tools and equipment have been purchased.

With the assistance of several Midland Master Gardeners, other “green thumb” volunteers, the diligent work of the family units, and the cooperation of “Mother Nature,” the 2012 growing season was a success. The harvest was plentiful and was enjoyed by many in our community.

An official CACG dedication ceremony took place on September 6, 2012 with the Rev. Wallace H. Mayton officiating. Many of the donors contributing to the CACG project were named in the presentation. A memorial plaque was attached to the gazebo: it reads, “The Circle Area Community Garden property was formerly part of Community Drug Store’s Ashman Circle location. Community Drug Store’s four generations of owners, the Bergstein family, were always so grateful for the loyalty by Midland residents to the Community Drug Stores over the 70 years that they were in business and always felt strongly about ‘giving back’ to the community. With the gift of this land for use as a permanent community garden, the family continues that tradition.” – Rob Bergstein

Now, in 2013, all the garden plots have been assigned and preparation is already taking place for a successful growing season. The garden project remains alive and well and it is, truly, a community garden.

One of the CACG committee members recently sent me a note which included the following statement: “All the beds are ready for planting. The water was turned on by the City and half the beds were gridded by an eager crew on Saturday. On Monday, again we had a great crew which finished the job. There was lots of love, conversation, and laughter as the gardeners worked together.”

Donors to the CACG were many and varied in nature: some gave of their time and talents, others provided gifts of their financial resources, and several local Foundations contributed significant grant gifts. The Allen Foundation provided the largest grant gift ($16,900) of all contributors. Those of us with active interest in this project are very grateful for The Allen Foundation’s generosity and for its willingness to support this community project.

The Allen Foundation’s Grant funds were used across the spectrum of construction expenses of the CACG project. Some of the significant construction component expenses of the project were …

Fencing - $9,874 (Forkel Fence Co.),
Sod removal and top soil purchase - $2,192 (Pat’s Gradall),
Gazebo - $9,200 (KJP Sales, Inc.),
Shed - $3,987 (Scott Harris Builder),
Raised Garden Plot Materials and Construction - $6,820 (KJP Sales, Inc.).

Again, Circle Area Community Garden and Caregiving Network are grateful for The Allen Foundation’s support. Thank you!

Submitted by Thomas J. Vander Zouwen, Executive Director, Caregiving Network, Inc.


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Project Title: Healthy Habits Among the Elderly
Institution: Western Michigan University
Date: 5/1/2013
Report:

Health Habits Program
6- month progress report
Dr. Amy Curtis
Diana Hassan

Healthy Habits Program (HHP) is 5-week program that focuses on helping and empowering individuals older than 45 who are at risk for developing diabetes or have been diagnosed with prediabetes to lead healthier lifestyles in light of the continuous increases in chronic diseases such as obesity and diabetes. The curriculum used, a diabetes prevention curriculum, was created by the Michigan Department of Community Health (MDCH). The educator delivering the program, Diana Hassan, was trained by MDCH in the curriculum. The curriculum was designed based on the National Diabetes Prevention Program (NDPP) study which showed that participants who modified their eating habits and exercised 150 minutes a week were able to prevent or delay the onset of diabetes.
Health screenings are offered to participants at the first and last session of the 5-week series program. Screenings include weight. Additionally, blood pressure and glucose screenings are offered to increase participant’s awareness of their biometrics.
Participants are also surveyed about their habits related to nutrition and physical activity at the first and last session in addition to the follow-up sessions.

Nine programs have been implemented so far in three counties: Kalamazoo, Van Buren, and St. Joseph Counties with a total of 56 participants.

Kalamazoo County (2 programs):
Friendship Village: FV is a senior living community. We faced some challenges with recruitment due to the high security and privacy of the facility. We did not have access to the addresses or email addresses of residents so recruitment efforts were limited to the efforts of the activity coordinator at that site. 2 participants graduated the program in July, 2012: 1 f and 1 m
Mt. Zion Baptist Church: one program was delivered at this site as part of their wellness initiative. 5 participants graduated the program in July 2012: 4 f and 1 m.

Van Buren County (3 workshops):
Van Buren County Employees: The program was offered to county employees during lunch as a worksite wellness in July 2012. 9 participants graduated the program: 8 f and 1 m.
A partnership with Senior Services of Van Buren County has been established to deliver the HHP and to train their activities coordinators in the program. 2 seniors have been trained in the program: one is an activity coordinator in Van Buren County. The other one is an educator in St. Joseph County.
Decatur Senior Center: a total of 12 participants graduated the program in December 2012: 7 f and 5 m.
Mattawan Senior Center: a total of 7 participants graduated the program in March, 2012: 6 f and 1 m.


St. Joseph County (2 programs):
Local MSUE office: 2 programs have been offered in November, 2012 and February, 2013 with 2 f and 9 f who graduated respectively.


The average weight loss of those who attended the 5-session program is 0.8 pounds (n=27). On the other hand, the average weight loss among those who attended a 3-month follow up session is 3.2 pounds (n=14).
To improve weight loss, physical activity will be incorporated in each session in future programs. Many participants indicated that learning how to read food labels was the most useful tool they had learned from the program in addition to realizing that healthy food can taste good. Van Buren County administrator who attended the program said that “over the past few months, the Healthy Habits programs have had a positive impact upon many of our fellow employees. Diana’s lessons have empowered many including myself in making us healthier persons. Although the health insurance saving is a bonus, just feeling feel good is priceless”.

Additional workshops and follow-up sessions are being scheduled in all 3 counties at various sites to collect additional data on behavior change and nutrition knowledge gained from these workshops.

Three senior leaders have been trained in the curriculum. We are hoping to train an additional 3-5 more senior leaders as we offer more programs.

Expenditure:
Participant Support: $560.00
Travel mileage: $700.00
Cooking demonstrations: $430.00
Personnel, Health Educator $1350.00
Mileage $500.00
Screening supplies: $1500.00


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Project Title: Role for fatty acid consumption in the treatment of obesity
Institution: Victoria University
Date: 4/30/2013
Report:
Allen Foundation: Progress report

The Allen Foundation generously funded our project investigating the “Role for fatty acid consumption in the treatment of obesity”.
In addition to the Principle Investigators this project has involved a team of 3 PhD students and 1 postdoctoral fellow.
The project incorporated 3 Aims. Currently we have completed the following:

Aim 1 and Aim 2: We have established an experimental protocol, where animals were made obese for 9 weeks, then treated with our specific agonists and antagonist for the cannabinoid receptors for 6 weeks. Due to the nature of the experiments, as well as the numbers of animals involved (a total of 142), the generation of the animals was completed at the beginning of March, 2013.
At the completion of those studies, a number of tissues were harvested from the animals (e.g. heart, brain, kidney, liver, adipose, muscle) and have been stored at -80C. In addition we have harvested plasma and 24 hour urine from these animals, which is also stored.
At this time we have started to extract the mRNA and protein from key tissues, with characterisation of specific signalling proteins to commence shortly.
During the treatment period, the animals’ food consumption and total body weight were measured daily. In addition body fat percentage, glucose tolerance and insulin secretion were also determined.
Consistent with previous studies, we found that blocking cannabinoid receptor CB1 decreased food intake, decreased body fat percentage and systolic blood pressure. Data investigating the roles of other cannabinoid receptors on obesity and obesity associated abnormalities are currently being analysed.

Aim 3: At this time, ethical approval for the investigation of different fatty acids on cannabinoid signalling has been granted. Experiments are due to start before June 2013.

These studies will enhance our understanding of the abnormalities that are present in the skeletal muscle and kidney of obese animals which is essential to our development of treatments for these conditions. This research will therefore enable the provision of a more informed population health message regarding dietary advice for the consumption of specific fatty acids, based on their relationship with the endocannabinoid system.

Importantly, an abstract submitted by one of the PhD students involved in this project to the International Cannabinoid Research Society annual conference in Vancouver, in June 2013, has been selected as an oral presentation. The PhD student will present data on the effect of modulation of Cannabinoid receptor 2 in the kidney in the obese model.
In addition, we have published a review manuscript in the area with the Allen Foundations contribution cited.
http://www.ncbi.nlm.nih.gov/pubmed/22842535

Expenditure
Amount funded by the Allen Foundation in year one of the project (AUS $32,406.63 -please note that this is the Australian dollar equivalent for what was provided)

Supplies (Drugs, molecular biology and chemicals): $17,899.87
Other Expenses (Animal housing costs and purchase cost of animals): $7,698.88
Total: $25,598.75
Carry over of funds from Year one to Year two to assist with ongoing analysis of samples collected from aim one of the project: $6,807.88

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Project Title: Growing Community Workshops
Institution: Central Rivers Farmshed
Date: 4/30/2013
Report:
Central Rivers Farmshed’s Growing Community Grant Outcomes

Since 2007, Central Rivers Farmshed has been steadily implementing efforts to build support and educate our communities about their local food system. These efforts have been successful in garnering awareness around the health, environmental, and economic impacts our food system has on our people and productive lands. Created by hardcore volunteers dedicated to the relevance of food at face rather than processed value; who gave not only their time, resources, and ideas but their whole hearts to weekly conversations, bi-monthly meetings, and running several annual programs around food related issues. Now, things have culminated. The network so diligently built, has brought together more than local foodies; we've engaged a community voice who will assist us in creating a food economy supportive of its members.

In the midst of rehabilitating a 36,000 sq foot defunct garden center into a community food center in the heart of Stevens Point, WI, Farmshed now has the opportunity with a very modest staff and budget to further develop its programming and provide learning opportunities that cover a broad scope of activities and target audience. Our intention is not only to teach people new skills and help them navigate their local food landscape, but also to build a community that collaborates.

Community Potluck Series
When awarded the Allen Foundation in June of 2012, we wanted to pursue avenues with potential for the greatest outcome. That month, in addition to launching our farmer’s market work coordinating the EBT program, we implemented our first ever Community Potluck Series, hosting one, seasonally themed potluck per month for an average of 25 attendees. The new series enabled us to invite community members into our new and constantly changing facility; engage one another on food system topics; share healthy meals and recipes; and see progress on-site. Since June of last year, we have hosted a potluck every month reaching more than 200 people and a schedule that runs through 2013 and with plans to continue on into 2014.

EBT at the Farmers Market
The EBT at the Farmers Market program saw a 36% growth in sales from to $5766 in 2011 to $8941 in 2012. Participation in the program also increased 37% from 284 in ’11 to 448 participants in ’12. Throughout the market season, we held 8 chef demonstrations and staffed the EBT and farm to school tables weekly from June through October.

Growing Community Workshops
While establishing our Growing Community Workshops, we realized the interest in a variety of hands-on food system topics, not only concentrating on cooking and gardening, but also raising animals, fermentation, preserving and more. This led us to plan and implement a variety of courses open to all community members. Due to the lead time we needed for planning, we only hosted 3 workshops in 2012, but worked our way up to a schedule of 26 workshops in 2013. The largest course participation was 32 people with an average attendance of 9 people per course. Thus far, attendees of our workshops have been very pleased with the instructors and topics, providing extremely positive. Our instructor pool is a group of community educators who bring a dynamic and entertaining perspective to each theme. They also work with interested attendees to address any questions or needs after the course has been completed.

One quarter of the way through 2013, we are still working to get the word out. We have brochures out around the community and were able to publish 90% of our schedule in the Central Wisconsin Farm Fresh Atlas, our free annual publication representing local farms and their products in Central Wisconsin and the businesses, organizations, and restaurants that work to support them. The Atlas has an 30,000 household reach. We will also be promoting the workshops at the Natural and Organic Expo in Oshkosh, WI May 4th and as a major partner of the Midwest Renewable Energy Association’s Energy Fair in Custer, WI June 21st-23rd. We will also be plugging the workshops starting June 27th at two local farmers markets and at 3 major upcoming Farmshed events, Appetite for the Arts in Aug., HallowGreen Barn Bash in Oct. and the Farmer Tribute Dinner in Nov..

Growing Collective
The next best thing we were able to implement with this funding was the facilitation and implementation of the Growing Collective. In the winter and early spring, a Farmshed volunteer came together with staff to begin organizing a way to support the growing of vegetable starts for themselves and the community in our facility. The now 17-member collective, made up of home gardeners, small-scale farmers, and community groups (CWES and Giving Gardens) are growing more than 3,000 plants in hundreds of different varieties.

The Giving Gardens program, by our partner, the Portage County Hunger and Poverty Prevention Partnership, aims to promote and support efforts to maintain gardens in Portage County. The produce harvested from these gardens is donated to local food distribution centers in order to increase food security and provide healthy meal options for economically disadvantaged citizens.

While CWES is a partner in our farm to school efforts. Their 200-acre teaching and learning center located 17 miles east of Stevens Point on glacial Sunset Lake has been an integral part of the University of Wisconsin - Stevens Point College of Natural Resources program and is staffed with professional natural resource and environmental educators.

This season’s record-low temperatures and overcast skies, along with various, much-needed construction projects at the greenhouse, have put the Growing Collective members’ knowledge and spirits to the test. In spite of these challenges, the group’s seedlings are thriving. Collective members and community volunteers continue to gather weekly to complete planting tasks, keep up with transplanting, and planning for the plant sale. Proceeds from the plant sale go back to Farmshed to support the renovations of The Greenhouse Project and other needs of the organization, making this a truly collective growing effort with amazing results.

Thank you!
Our sincerest thanks to the Allen Foundation for giving us the footing to launch and sustain these amazing projects. We continue to be amazed by the diverse depth of knowledge and commitment in our community and the gaining interest to take our lives back to a slower time when community meant so much more. We also wanted to share a comment from the potlucks, farmers market, our workshop evaluations, and the growing collective members.

Potluck Attendee - "Dear Wilted Salad Maker, I love this so much. Please share the recipe. Your friend, Jennifer. (We began doling out recipe notecards the next week.)

EBT Participant - “This is the first time I have brought my teenagers to the farmers market, I feel like I have an opportunity to buy really great food at affordable prices while showing my sons a special place in our community.”

Workshop Participant - “I just wanted to let you know that the beekeeping course was pretty awesome, and it inspired me to look into getting my own hives going.”

Growing Collective Member - “We just made it happen...everyone pulled their weight, kept up with communication, and worked together to problem solve. The results...happy plants and happy members. We couldn’t have wished for more.”

Financials (to date)
Staff: $20,000 (remaining $9,725 to be spent on continuation of salary and fringe through 2013)
Supplies: $4,000 (remaining $3,000 to be spent on printing and distributing the updated marketing materials for the 2013 farmers market season)
Equipment: $1,200 (remaining $3455 to be spent on scheduled workshops)

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Project Title: Omega Tots: Polyunsaturated Fatty Acids to Promote Brain Development in Toddlers Born Prematurely
Institution: The Research Institute at Nationwide Children's Hospital
Date: 4/30/2013
Report:
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******Introduction******
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This report outlines Year 1 activities of the project entitled Omega Tots: Polyunsaturated fatty acids to promote brain development in toddlers born prematurely. The objective of this study is to evaluate, using a placebo-controlled randomized clinical trial, the effect of adding DHA to the diet of toddlers born preterm on developmental outcomes. Throughout Year 1 of study operations, progress to achieve the aims outlined in the original funding application has progressed. Specifically, the project has selected and obtained an investigational drug and placebo, gained necessary Institutional Review Board and Food and Drug Administration approvals, refined data collection instruments, identified and screened potentiality eligible children, recruited and enrolled participants into a placebo-controlled randomized clinical trial, and initiated data collection and preliminary analyses. Recruitment, enrollment, data collection, and analysis are expected to continue through 2014. Data collected from the current pilot project will inform the training of professionals who advocate for good nutritional practices during childhood and may encourage the dissemination of low-cost, effective early nutrition guidelines for children born preterm; and will provide feasibility and proof of concept data to apply for funding to support a larger clinical trial.

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**********Aim 1*********
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Aim: Determine the feasibility of recruiting, enrolling, and following children from Nationwide Children’s Hospital (NCH) Clinics in a randomized, placebo-controlled trial of DHA and AA supplementation and development; and to evaluate acceptability and adherence.

Modifications: No modifications have been made to this aim.

Study Methods: A list of eligible children who were born at less than or equal to 34 completed weeks’ gestation, who are currently between 10 and 16 months of age (adjusted for prematurity), and were admitted to a Nationwide Children’s Hospital (NCH) NICU as well as children who have ever had a Neonatology Clinic follow up visit scheduled at NCH was obtained. The list contains approximately 1,000 potentially eligible children who are screened using the medical record based on study inclusion/exclusion criteria. Legal guardians of children who remain eligible are contacted via phone. The study is described to them and eligibility for participation is further assessed. Children who are determined to be eligible for participation after this phase of screening and recruitment are invited to participate in a 6 month clinical trial involving three in-person study visits at baseline (T1), 2 months post baseline (T2) and 6 months post baseline (T3).

Results: Procedures to identify potentially eligible children have been identified and implemented in Year 1. The study aims to recruit 112 children and families. Recruitment began in April, 2012. Eligibility and Recruitment: Approximately 14% are children are determined to be ineligible during the medical record screening phase of recruitment. Approximately 15% of children determined to be ineligible during the phone screening phase of recruitment. Approximately 30% of families who are invited to participate enroll in the clinical trial. Description of Enrolled Participants: There are 36 participants enrolled to date. Participants ranged in age from 10.5 to 17.0 months of adjusted age at enrollment. On average, children enrolled in the trial at 15.3 (SD=1.7) months of adjusted age. The gestational age of enrolled participants ranges from 24 to 34 completed weeks, with an average of 31.4 (SD=3.1) completed weeks. Sixty-four percent (n=23) of enrolled participants are male; 70% (n¬=25) are white, 22% (n=8) are Black/African American, and 8% (n=3) of enrolled participants are bi-racial; 6% (n=2) participants are Hispanic. Seventy-two percent (n=26) of participants have completed the T2 study visit. Two T2 visits have not been completed as scheduled. These participants continued to be followed and a T3 study visit is scheduled. Fifty percent (n=18) of enrolled participants have completed the T3 study visit as scheduled. One participant has been lost to follow up at T3. Participants receive regular phone calls from trained study staff to assess adherence and barriers to acceptability of the protocol. Study staff is well-versed in addressing participant barriers and providing additional methods to facilitate acceptability and adherence. Data regarding adherence to the prescribed protocol are collected in multiple ways: 1) through parental report of supplement/placebo daily consumption; 2) through an assessment of the amount of supplement distributed and returned; and 3) through an analysis of DHA present in plasma.

Significance: The Nationwide Children’s Hospital NICUs contain approximately 200 beds. Additionally, the Neonatal Developmental Clinics at Nationwide Children’s Hospital provide care to 3,000 children annually. Therefore, the research team is well-positioned to screen, recruit, and enroll eligible participants. Acceptability of and adherence to the prescribed protocol are relevant to provide feasibility information to professionals who advocate for good nutritional practices during childhood to evaluate study aims.

Plans for Year 2: Recruitment and enrollment will continue until 112 participants are recruited. Recruitment rates and acceptability and adherence to the protocol will continue to be assessed and documented throughout study participation.

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*********Aim 2**********
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Aim: Evaluate change in DHA and AA as a percentage of total fatty acids in red blood cells (RBC) and plasma of participating children from baseline to 2 months post-randomization.

Modifications: No modifications have been made to this aim.

Study Methods: A 2mL blood sample is collected at each study visit. This has been collected at the T1 study visit for 100% of participants, at the T2 study visit for 92% of participants, and at the T3 study visit for 89% of participants. Collection of the biospecimen allows for an examination of a change in fatty acids throughout participation in the clinical trial. Additionally, extensive caregiver reported dietary intake data are collected at each data collection time point. Specifically, caregivers complete the Willett Food Frequency Questionnaire (FFQ), an additional fatty acid intake assessment designed for the purposes of this study, questions regarding breastfeeding history, and transition to solids that will facilitate achieving this study aim.

Results: Plasma sample pairs obtained at the T1 study visit and the T2 study visit have been collected and analyzed for 21 participants. Preliminary data suggest that baseline DHA levels (measured as a % of total fatty acids) were similar among the treatment and placebo arms (mtreatment=1.1, SDtreatment=0.3; mplacebo=1.3, SDplacebo=0.4), however, change in DHA levels from T1 to T2 differed significantly between treatment groups (mtreatment=1.5, SDtreatment=1.0; mplacebo=0.01, SDplacebo=0.5). This difference is statistically different (z=3.3; p=.001). Preliminary treatment group differences in the percent of total fatty acids that are AA did not reach significance. In addition, we have collected extensive dietary data across multiple time points for participants. A preliminary evaluation reveals that several measured dietary parameters are consistent with data from similar aged children reported in a national representative sample (i.e., NHANES).

Significance: This study represents a cutting edge analysis of baseline LCPUFAs in a high-risk population and collects a large amount of dietary and nutritional data on young children. It is expected that data generated from this study will contribute to multiple projects focused on the nutrition of young children, especially those born preterm.

Plans for Year 2: Biospecimen and caregiver report of dietary intake data will continue to be collected at each time point.

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*********Aim 3**********
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Aim: Evaluate differences in cognitive, language, and motor development at 6 months post-randomization using the Bayley Scales of Infant and Toddler Development-3rd Edition.

Study Methods: A standardized developmental assessment, the Bayley Scales of Infant Development – 3rd Edition, is administered at the T1 and T3 study visits. It is estimated that a total of 102 children (51/arm) are required to have adequate statistical power (81%) to detect an 8.5 point difference (SD=15) in mean Bayley scores between the treatment groups.

Results: It is too early in the data collection phase to evaluate this aim. Therefore, there are no results to report at this time.

Significance: The evaluation of this aim will provide support for LCPUFAs as a low-cost, effective early nutritional intervention for children born preterm. If any developmental benefits are observed, they will provide an important contribution to our understanding of how nutrition influences development among very young children and how a dietary supplement like the one used in this study might be a good dietary add-on or alternative for some children, helping to reduce developmental inequalities associated with prematurity. Additionally, evaluation of this aim will provide preliminary support for the protocol submitted for funding to examine the proposed intervention in a larger cohort.

Plans for Year 2: Standardized developmental assessment data will continue to be collected at T1 and T3 Differences in cognitive, language, and motor development will be examined when developmental data have been collected from 102 children.

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**Year 1 Expenditures***
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Salaries and Benefits: $52,063.36
Operating Costs: $5,555.20
Indirect Costs: $7,401.00
Projected Expenditures 5/1/13 to 5/31/13: $4,346.44

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Project Title: YMCA Veggie Access Project
Institution: YMCA of Greater Grand Rapids
Date: 4/30/2013
Report:
The following is a brief financial accounting of the expenditures of our Allen Foundation grant:

•$17,680.00—Allen Foundation funding helped support the full-time position of Veggie Van and Farmers Market Manager ($17/hour x 20hrs/week x 52 weeks). Allen Foundation funding allowed this part-time position to become full-time (for the purpose of working toward sustainability). Allen-funded responsibilities included establishing innovative relationships with local farmers and organizations to increase distribution sites and marketing to increase name recognition and customer base.
The following marketing efforts for our Veggie Van included:

•$6,800 for an outdoor Billboard near Farmers Market at a strategic location
•$1,650 for outdoor signage at Veggie Van distribution locations
•$500 for radio ads on local Latino Radio Station
•$145 targeted social media campaign
•$4,000 for Bus tail ads on urban Bus line, “the Rapid,” on 25 buses for 3 months, including the price of artwork development

These expenses, along with $4,725 in indirect administrative costs, were the total expenditures for our $35,000 grant. The total project cost was $119,728, with the YMCA providing $84,728 in in-kind support.

Project Objectives:

1.Increase awareness of the Urban Farmers Market and Veggie Van among our target population through innovative marketing.

The YMCA of Greater Grand Rapids used evaluation data from 2012 YMCA Farmers Market surveys to create a strategic marketing plan that promoted the use of food assistance benefits (SNAP, WIC, etc.) at the YMCA Farmers Market and Veggie Van. The spending patterns of Farmers Market consumers, the demographics of customers, and attendance and retention rates of customers were analyzed. This information provided clarity about the effectiveness of various marketing techniques and helped guide our strategic vision for a marketing plan. Through this analysis, the YMCA Marketing team determined that a speaker sound system for the Veggie Van to announce daily specials and a jingle for the Veggie Van were ineffective forms of marketing. Therefore, it was determined that billboards in strategic locations and signs throughout the Grand Rapids community were more effective marketing techniques when promoting the Farmers Market, Veggie Van, and Double Up Food Bucks program. Funding originally allocated for the speakers and jingle was used for small signs in English and Spanish throughout low-income neighborhoods and billboard advertisements.

2.Increase the number of Veggie Van distribution sites by developing relationships with senior centers, apartment complexes, corporations and corner store owners.

The Allen Foundation allowed our Veggie Van and Farmers Market Manager position to be full time, which provided the time needed to establish innovative relationships with local farmers and organizations to increase distribution sites. To date, we developed relationships with nineteen organizations, including senior centers, apartment complexes, and corporations. Most organizations are located in low-income areas (thereby increasing access to vulnerable populations). Our Farmers Market Manager has also initiated partnerships with corporations, such as GE Aviation, where we charge market prices for produce (rather than wholesale prices) to increase revenue and cover operation costs.

3.Achieve sustainability through increased sales

The number of Veggie Van distribution sites and knowledge about our Veggie Van has increased due to our targeted marketing efforts and the relationship building work of our Veggie Van and Farmers Market Manager. Because of this, Veggie Van sales have increased significantly. When comparing 4th quarter 2011 transactions and 4th quarter 2012 transactions, customer transactions increased by over 50 percent. Increased sales help cover operation costs (gas, mileage, staffing, etc.) and is helping the Veggie Van become a sustainable program.

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Project Title: Healthy Families South Africa
Institution: INMED Partnerships for Children
Date: 4/29/2013
Report:
With a generous grant from the Allen Foundation, INMED Partnerships for Children expanded its successful Healthy Futures South Africa school gardening and nutrition education program in Orange Farm, an impoverished township on the outskirts of Johannesburg, to incorporate an adaptive agriculture component featuring aquaponics—an intensive, organic method of food growing that uses at least 85% less water than traditional agriculture and produces up to 10 times the amount of crops in the same amount of space as traditional agriculture.

In Orange Farm, the incidence of poor nutrition is high and school attendance rates are low. Among the children who do attend school, many arrive hungry, and for most—especially those in child-headed households—their only meal of the day is the lunch they receive through the school feeding program. Children who are hungry cannot concentrate on their schoolwork, but more importantly, poor nutrition in childhood can compromise their ability to learn and succeed over their lifetimes.

The Healthy Futures South Africa expansion project has directly improved the nutritional status of 1,450 students at Pudumo Primary School and Steve Biko Primary School in Orange Farm and has also engaged their teachers and school food workers in increasing knowledge of nutrition, food safety, plant and animal biology, and climate change adaptation. Nearly 950 individuals participated in trainings on aquaponics and water conservation, and approximately 2,550 family and community members indirectly benefited through information-sharing and informal education about adaptive agriculture from the teachers and parents who participated in the program’s trainings and workshops.

Although the establishment of an aquaponic system was initially proposed for Steve Biko primary school, that school was unable to provide the necessary staff and volunteer support necessary to maintain the aquaponic system. Compared to Steve Biko, Pudumo has a similarly at-risk student population—the majority of its students are considered orphans or vulnerable children, many of them from HIV/AIDS-affected families—but Pudumo could offer consistent staff involvement as well as assistance from a cadre of 10 parent volunteers who are responsible for the daily maintenance and operation of the aquaponic system. Nevertheless, Steve Biko did receive a classroom-size aquaponic system for its students to learn about the concept and processes of aquaponics, and both Steve Biko and Pudumo received rainwater harvesting systems and took part in educational workshops.

Activities and Outcomes

• Implementation of a modular aquaponic system that produces vegetables and fish crops used to supplement and enhance the nutritional value of school meals.

In an aquaponic system, water from a fish tank, rendered nutrient-rich by the fish excreta, is circulated into a grow-bed area where the nutrients are absorbed by plants that are cultivated hydroponically. The grow bed acts as a biofilter, cleaning the water that is recirculated back to the fish tank. This process provides a method of food growing that greatly reduces the use of water resources, requires no soil or chemical fertilizers, and produces high yields of fresh, nutritious crops in the form of vegetables, fruits, herbs and fish. INMED’s system also utilizes inexpensive, locally available “off the shelf” modular components. Beyond the school context, this modular construction is particularly important for emerging farmers who adopt the practice, since the systems can be scaled up as their income allows, incrementally increasing revenue potential.

The aquaponic unit at Pudumo was completed—including a greenhouse cover and frost guard to protect against the winter cold—in July 2012. [Note that pictures of the system are available upon request.] Fish were added, the system was tested, and students, teachers and parents volunteers were trained in system maintenance. The first harvest of aquaponic lettuce was completed in September 2012, and has been followed by several successful harvests of spinach, which have been incorporated into the school meals. Tomatoes will be the next crop attempted. Fish have not yet been consumed, as they have not yet reached full size.

As noted above, INMED established a classroom-size aquaponic system at Steve Biko, which although not intended to generate sufficient produce to increase food security or nutritional status, does contribute herbs such as basil and sage to the school kitchen. Furthermore, the installation and operation of the rainwater catchment system at Steve Biko (see below) has created a secure water source for its traditional vegetable garden, resulting in greater production, thereby providing a consistent supply of fresh produce for school lunches for 600 students several times a week.

• Establishment of two rainwater catchment systems to provide a reliable source of water. A simple, low-cost gutter and pipe system, installed on the school rooftops, funnels rainwater into tanks equipped with filters and hand pumps. This harvested water is used to supply the aquaponic system as well as provide a reservoir for water for irrigation of the traditional vegetable gardens—and for handwashing and drinking in times of water shortage.

At Steve Biko, before the rainwater harvesting system, irrigation of the traditional vegetable garden built through the Healthy Futures South Africa program relied on municipal water supply, which was often unavailable—and even when it was, the tap had so little pressure that it could take up to 30 minutes to fill a 10-liter watering can. At both Steve Biko and Pudumo, rainwater catchment has enabled the schools to regularly irrigate their vegetable gardens—thus increasing crop yields and further enhancing the nutritional value of the school meals that incorporate the harvested produce—while also reducing dependence on the municipal water supply and preserving other scarce groundwater resources.

• Classroom education, school-based training and community workshops to introduce aquaponics and related topics to students, teachers, school food workers, parents and community members. Building on the existing Healthy Futures South Africa nutrition, food hygiene and gardening curriculum, we also incorporated training on fish and plant biology, climate change, natural resource conservation, sustainable agriculture and the income-generating potential of aquaponics for households and smallholder farmers. Training participants leveraged the impact of the education they received by acting as “multipliers” who share their new knowledge and skills with others, ensuring that change is driven and sustained by the community itself.

With the Allen Foundation’s support, the Healthy Families South Africa program has made a significant impact on the health and well-being of at-risk children in Orange Farm. The program’s school- and community-based activities continue to:
• Reduce hunger among young learners by increasing the availability of nutritious produce through aquaponic food production, school gardens and nutrition education.
• Improve children’s health and nutritional status by increasing their access to nutritious foods and educating them on good nutrition practices, preventive health and hygiene.
• Strengthen children’s educational outcomes by reducing hunger, maximizing cognitive potential through improved nutrition, and providing an enhanced school meal that serves as an incentive for regular attendance, including for students who might otherwise have been working inside or outside the home.
• Build the foundation for long-term improvements in the quality of life for families in the community by increasing household food security through adaptive agriculture and home vegetable gardening and providing a potential source of income generation through the sale of surplus produce. In particular, aquaponics is raising awareness and generating excitement in the community, as they come to understand the potential for greatly increased crop yields and a readily accessible source of animal protein (i.e., fish).

Grant Expenditures
Personnel $10,841
Supplies $2,607
Workshops & Training $3,297
Transportation $1,913
Core Operating Costs $3,711

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Project Title: Role of Nucleotide-Binding and Oligomerization Domain Containing Protein (NOD) 1 in Diet-Induced Adipose Inflammation and Obesity
Institution: University of Tennessee-Knoxville
Date: 4/29/2013
Report:
Progress report for the period: June 2012-May 2013

Obesity is one of the leading health problems and causes of mortality in the United States. It has been recognized that obesity is associated with chronic inflammation in adipose tissue, characterized by increased proinflammatory chemokines/cytokines expression and macrophage infiltration. Obesity is thought to increase the risks of chronic diseases, such as type 2 diabetes, through systemic impact of adipose inflammation. The objective of this proposal is to test the hypothesis that NOD1, one of the prominent members of the NOD-like innate immune receptors, plays critical roles in mediating adipose inflammation in diet-induced obesity. Thanks to the generosity and support from Allen Foundation, we have made significant progress in both of proposed aims in the past funding period:

Aim 1: Define the role of NOD1 in diet-induced adipose inflammation and obesity
We have bred and generated the experimental mice: male wild type (WT) n=7, NOD1-/- n=10; female WT n=7; NOD1-/- n=8. All four groups of mice were put on high fat diet (58% Fat kcal) for 16 weeks, body weights (BW) and food intake were monitored weekly, insulin and glucose tolerance tests were performed. As of now, all four groups of mice have been terminated. Whole blood and various tissues, including various fat pads, were weighed and snap frozen for later analysis. Initial evaluations of our collected data show that NOD1 deficiency did not protect the mice of both sexes from high fat diet-induced obesity and did not affect systemic insulin and glucose sensitivities. We are now in the process of evaluating the local adipose inflammation by inflammatory gene expression and macrophage infiltration in various fat pads in NOD1-/- mice, compared with their WT littermate controls. In the next funding period, we plan to complete the evaluation of the local adipose inflammation in NOD1-/- and WT control mice under high fat feeding. We also plan to study the systemic and local phenotypes in NOD1-/- and WT mice under low fat diet as proposed. It is anticipated that low fat feeding may yield information that is complementary to (or some time masked by) high fat feeding. Novel findings will be presented at the national professional meetings, such as annual experimental biology meetings, and prepared for manuscript submission to scientific journals.

Aim 2: Define the role of NOD1 in saturated fatty acid-induced inflammatory response in adipocytes and macrophages
We have made significant progress in demonstrating the roles of NOD1 in the crosstalks between adipocytes and macrophages, the two prominent cell types in the adipose tissue. Using adipocytes differentiated from stromal cells of adipose tissue and bone marrow derived macrophages (BMDM) from NOD1-/- mice, compared with that from WT littermate controls, we have found that NOD1 synthetic ligand C12-iEDAP induced up-regulation of the chemotactic factors monocyte chemoattractant protein 1 (MCP-1), 2, and 3, and adipocyte-derived serum amyloid A isoform 3 (SAA3) in WT primary adipocytes, but not from NOD1-/- primary adipocytes. Moreover, the conditioned media collected from C12-iEDAP-treated WT, but not NOD1-/-, primary adipocytes induced chemotaxis of human U937 monocytes. In contrast, no significant up-regulation of the chemotactic factors was detected in BMDM from both WT and NOD1-/- mice in response to C12-iEDAP. Therefore, these results have demonstrated that NOD1 activation in adipocytes, but not in macrophages, induced chemotactic gene expression and monocyte chemotaxis, suggesting a role of NOD1 in initiation of adipose inflammation. We are now in the process of preparing a manuscript to report these novel findings. In terms of the role of saturated fatty acids (SFA) in NOD1-mediated inflammation in vitro using BMDM from NOD1-/- mice compared with that from WT mice, we have found that saturated fatty acid palmitate (C16:0) induced up-regulation of tumor necrosis factor alpha (TNFĄ) and interleukin 6 (IL-6) in WT BMDMs, which were attenuated in NOD1-/- BMDMs. In the next funding period, we will extend our findings of the role of saturated fatty acids in NOD1-mediated inflammation in adipocytes and in the crosstalks between adipocytes and macrophages. Again, novel findings will be presented at the national professional meetings, such as annual experimental biology meetings, and prepared for manuscript submission to scientific journals.

As the funds were made available to us at our institute starting July 1, 2012, therefore, the spending from 07/01/12 to 4/30/13 is shown below:
Direct costs: $15,484.74
$8,592.64¡XSalary and benefits for the graduate student working on the project
$6,892.10¡XSupplies and reagents, animal maintenance
Indirect costs: $ 2,082.49
Total: $17,567.23

The remaining funds will continue to support the salary and benefits of the graduate student who is working on the project and to provide the support for supplies, reagents and animal maintenance to complete the proposed aims.

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Project Title: Feed the Dream--A Guatemalan Nutritional Expansion Program
Institution:
Date: 4/26/2013
Report:
Due to the gracious generosity of the Allen Foundation and others, Feed the Dream continues to make significant progress in fulfilling its purpose to improve the nutritional health of children under 6 years of age and young women of reproductive age (15-49) in an increasing number of remote Guatemalan Highland villages. Chichoy Alto, in the Patzun area, is the subject for this current project. It involves 140 families. Guatemala has the 4th worst rate of nutrition and stunting in the world, according to UNICEF.

Focusing on the goals of Feed the Dream, we can report:

1. Nutritionally balanced snacks with vitamins are provided to young children and women of reproductive age who are actively participating in our program. The core of this program is incaparina (a fortified nutritional drink.) Chaya is often added for additional benefits. Led by our nutritional specialist, Johanna, our educators work in partnership with women as they learn new recipes with their family garden produce, including vegetable leaves and local herbs which contain vitamin A. They are encouraged to use their own onions, garlic, celery, cilantro and red pepper for seasoning in place of artificial options. New products are encouraged, such as moringa, chaya and amaranth. The moringa turns their traditional tortillas a pale green, but after the initial shock, they have adjusted! The mothers learn and practice these new skills in a center and benefit from the social time spent together. At the same time we are encouraging reduction in use of carbonated drinks and sweets! This is an uphill battle!

2. Education on proper nutrition and potable drinking water takes place through the efforts of our local indigenous, Kaqchikel-speaking educators. Working with the mothers, Johanna teaches the significance of nutrition and how to take advantage of available local resources. There are weight and height evaluations. She emphasizes hygiene and proper food preparation while Gladys encourages early stimulation techniques to use with their young children.

3. Ricardo is our agricultural expert who gives hands-on training in crop diversity and plants that are nutritionally rich and easily grown in home gardens. Chaya has successfully been introduced, the leaves being used in soups and creams. The use of amaranth (a nutritious grain) and moringa tree leaves have also been encouraged. He has worked with 118 women in multiple sessions to implement their own small home gardens: using 5 different products, composting, soil conservation, making organic pesticides and fertilizers and encouraging vermiculture and other organic measures, emphasizing environmental care. Home visits take place for reinforcement and encouragement to sustain positive changes.


4. Feed the Dream provides the tools needed to carry out the above programs. We have a multi-purpose kitchen and activity center with the needed equipment, including the vented and enclosed stove. Following the instruction of hygiene and the food preparation done together, the mothers and children enjoy consuming the results. An added benefit is the socialization for both mothers and children, a rarity with their impoverished lifestyle. Since 98% of surface water is non-potable, families have the opportunity to acquire a water-filter at a nominal cost and a
crucial vented and enclosed stove. Prenatal vitamins with the essential folic acid and children’s vitamins are provided.

5. Our two newest programs ensure greater food security: introduction of goats for 35 families in July (and 14 newborn goats given to families in December) and improved corn storage for all.


In December and March weight/height for children under 5 were taken. As this program in Chichoy Alto has not yet been a full year, the improvement is small but already positive. We are encouraged that no child slipped to an inferior level. The statistics will be better telling
after the next weight session.


NUTRITIONAL STATUS Number Nov- Dec 2012 % Nov- Dec 2012 Number Feb- Mar 2013 % Feb- Mar 2013
Chronic malnutrition 40 43.5% 39 42.3%
Moderate acute malnutrition 1 1.1% 1 1.1%
Severe acute malnutrition 1 1.1% 0 0%
General malnutrition or underweight 11 12% 10 10.9%
Normal 36 39% 40 43.5%
Obesity 3 3.3 % 2 2.2%
Total children 92 100% 92 100%



Feed the Dream assures accountability through our local partner’s frequent visits to the site. In this area our local partner Behrhorst Partners for Development (BPD) has a staff team of agriculture and nutritional experts, all of whom are highly trained and who work with and teach respected community health promoters. With their daily presence the latter add credence and reinforcement to the teachings.


Feed the Dream’s goal is self-sustainability. The rural indigenous are uneducated (particularly the women), poor but hard workers. They had no
knowledge of the relationship between diet and health yet were avid proponents of a healthy future for their children. Their improved nutritional health guarantees them a chance to survive the many diseases that accompany poverty while at the same time reach their potential. The vital side-effects of our programs are new self-esteem and the benefits of socialization for both women and children with increased school attendance, especially notable with the girls, and a strong sense of community.
FINANCIALS: (through April 1, 2013)—Total Allen Foundation funds of $15,000 are greatly appreciated and have been a significant part of our total project.


Nutritional Education
And incaparina $4422

Early Childhood
Stimulation $2081

Seeds and pesticides $2613

Chaya and worms $1384

Salaries (partial of
Indigenous educators) $4500

Total $15,000




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Project Title: Food & Nutrition Support for HIV/Hep C Positive Individuals in Metropolitan Detroit
Institution: Health Emergency Lifeline Programs
Date: 5/14/2012
Report:
Health Emergency Lifeline Programs received a generous grant of $16,500 from the Allen Foundation in June of 2011 to support our Food and Nutrition Programs for low-income people living with HIV/AIDS and/or Hepatitis C in Southeast Michigan/Metropolitan Detroit. The following services are provided under this program:
1) Food vouchers directly support expanded food access for low-income recipients.
2) Nutritional counseling focuses on educating clients about nutrition, weight management and healthy eating as well as the impact of nutrition on their medical treatment and overall health.
3) Nutritional supplements help clients who are underweight or nutritionally compromised to take in adequate calories and nutrients.

Population Served: The program serves over 700 individuals each year across a six county region of Southeast Michigan. The majority of our clients reside in the city of Detroit and immediate surroundings which, with 64% of cases, constitute the epicenter of the state's HIV epidemic. The region also accounts for 45% of Michigan’s Hepatitis C cases. 81% of program participants have household incomes below federal poverty guidelines with the remaining 19% having incomes up to 150% of poverty guidelines. Over the last year, 85% of our clients identified as black/African American, a population disproportionately affected by HIV/AIDS.

Impact: Nutrition has a direct impact on an HIV/Hepatitis C positive individual's overall health and ability to adhere to medication regimens. Our program promotes access to food resources and simultaneously works to educate clients on healthy food choices that meet their individual needs to promote optimal health. A registered dietitian assesses clients' nutritional status and develops individual nutrition and weight management plans taking into consideration their health status, medical conditions, economic challenges and personal/cultural food preferences. More intensive counseling and monitoring is provided for individuals who are nutritionally compromised or experiencing significant weight loss and/or medication side effects such as chronic diarrhea or nausea/vomiting. Finally, liquid nutritional supplements are provided for individuals experiencing difficulties gaining weight, rapid weight loss, low protein, low albumin, low pre-albumin, problems with swallowing or dental conditions that impair food intake.
Through these services, HELP assists our clients in combating opportunistic infections and addressing health challenges that arise due to lack of adequate, nutritious food. By providing resources for a universal basic need, the program also serves as a key point of entry for people who are dealing with issues of poverty to gain access to health care services.
Outcome: Over the last year, 93% of program participants who had at least two dietitian assessments demonstrated improvement in their nutritional status and/or made progress towards their weight management goals.

Expenditures: Over 74% of total grant funds, or $12,262 was utilized to purchase food vouchers for clients to redeem at participating local grocery stores. Personnel costs for salaries and benefits accounted for 19% of grant funds at $3,168. The remaining 6.5% of grant funds totaling $1,070 supported administrative expenses.

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Project Title: Healthier Students
Institution: Kingman Elementary School
Date: 5/11/2012
Report:
Kingman Elementary is a very small,rural,poor community school in Northern Maine. I iniated this grant request to introduce some healthy foods ,eating habits and physical activity to this area.These students are extremely sheltered.90% of their parents are unemployed and about 92% never finished high school.Unfortunately their eating habits and buying procedures are poor.I was overwhelmed by the amount of these kids that did not know what carrots looked like ! Or what a pear was.Their diet consisted mostly of processed foods.I had high hopes to bring new foods into their menus here at school.Budget cuts and lay offs made that impossible.We were forced to provide the very basics and unfortunately ,the cheaper foods.
The main objective to this grant was to try an experiment through the year to bring healthy foods to these students.We first established an international lunch ,one per month.Students chose a country.So far we have done,Africa,Canada,France,China,Italy.....I then incorporate a learning lesson about this country,give it to the teachers and the kids study it a few minutes per day for that month.They learn culture,foods,games etc.At the end of the month we make a traditional meal from that country,using mostly fruits and vegetables.It is great to see the different cultures.These kids realize how much healthier most of the kids in other countries eat than we do.We also looked up games these kids play.Most are outside traditional games to entertain themselves.So we did purchase very basic 'toys' to get them moving.We bought frisbees,kites,balls etc...It has been an eyeopenning experience for these students.They have been so accepting of these traditions and foods.
The other thing we did was to ask the parents not to send snacks for afternoon break three days per week.We would provide them.The parents were very open to this.At first a few kids balked.They wanted chips,cookies and other packaged foods.Eventually though,all caught on. It has been SO accepted.The kids ask now,what is for snacks.They love some of the new fruits and vegetables they have tried.
We also did one field trip to a local Health Access Center.The students toured,got to 'play' with equipment and had question and answers from a doctor on good health practices.They STILL talk about that trip.
We do presently still have $1408.00 in the account.We are VERY thrifty.Money is important to us and we just have so little.I try to stretch it as far as we can.We will of course continue this practice of healthy eating and exercise next year until the money runs out.
I cannot thank you enough for your choice in giving us the grant.It has helped us in ways you will never know.The kids are so grateful. Hopefully the healthy lifestyles we teach them will follow them when they leave our school.Thank you again.
intial amount : $3000.00
food cost: $1242.00
field trip: $100.00
Phys ed props/toys: $ 250.00
total: $1592.00
Balance remaining : $1408.00

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Project Title: Meeting the Nutritional Needs of College-Age Women in a Residential College Setting
Institution: Cedar Crest College
Date: 5/11/2012
Report:
The following report details the progress of Cedar Crest College’s Allen Center for Nutrition’s “Meeting the Nutritional Needs of College-Age Women in a Residential College Setting.” The program responds to the issue of food-service personnel in schools and colleges having limited training regarding nutrition modifications for vegan and vegetarian diets and almost no training for disease states. This project responds to the cost of specialized food replacement, as such items can be excessive and may severely limit the food choices available. However, for students with documented health problems, appropriate choices to provide balanced nutrition are essential.

The Allen Center for Nutrition worked with food-service personnel to assess their baseline knowledge for the most commonly required modified food plans. Educational materials, menu substitutions for the most commonly requested modified diets, and cost of the substitutions were assessed and developed. Students and food-service personnel at the College evaluated the effectiveness of these materials for each group.

The principal investigator, Dr. Martine Scannavino, recruited project assistants for the Campus Nutrition Team using email notification to current students. Eleven students expressed interest in becoming members of the team, and following a consultation with Dr. Scannavino the students were accepted as project members. The team includes four dietetic interns and seven undergraduate students. The main purpose of this project was described to the team as follows:

• Assess the baseline nutrition knowledge and common dietary restrictions (e.g. vegetarian, vegan, food allergies, gluten free foods etc.) of the traditional students.
• Assess baseline knowledge of food service personnel for the most commonly required modified food plans.

Members were given the option of working on either the student portion or the food-service personnel aspect of the study. Groups were formed for each aspects, and two interns led the individual groups. The groups also consisted of undergraduate students who specified interest in either food-service personnel or students. Tasks completed to-date include:

• Researching the problem via peer-reviewed journals and summarizing and compiling the reviewed materials.
• Developing two separate questionnaires specific to the target populations based on the collected research.
• Preparing a submittal to the Institutional Review Board (IRB) that details the nature of the study; the qualifications of the team; the distribution and recruitment procedures for the study; the possible risks/benefits; and data handling procedures.
• Once approval was received from the IRB, the surveys were distributed to the appropriate populations via the delivery method specified in the approved document.

The following tasks are currently in progress with an expectation of completion by May 31, 2012.

• Compiling and analyzing the collected data.
• Preparing a report of findings that summarizes the explanation of the problem, the background research, the methodology, data analysis, and a discussion and conclusion of the results. Information gathered in the investigative portion of the survey will be used to develop educational materials for menu substitutions, and potentially modified diets for use on campus.

Financial accounting anticipates the full expenditure of the grant, $15,000. A total of $7,200 of funds have been released to pay project coordinator’s compensation and nutrition intern and group leaders annual stipends. The remaining $6,800 in stipend and project coordinators compensation will be released upon completion of development of educational materials. Materials, supplies, and production costs of all educational collateral is $1,000.


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Project Title: Jefferson Ave Community Garden
Institution: Caregiving Network, Inc. (EIN: 38-3202784)
Date: 5/11/2012
Report:
05/11/2012 Progress Report:

Caregiving Network and the Jefferson Ave Community Garden group remain grateful for the 2011 $500 grant provided by The Allen Foundation.

We are pleased to report that the national "America the Beautiful" Fund provided, free of charge, vegetable seeds for the garden.

The Community Church of the Nazarene, again this year, allowed our group the use of their land for the garden (approximately 40' x 120') and paid for our water usage throughout the growing months. The church also allowed us to use one of their sheds for storage of our gardening tools.

Neighborhood volunteers did all of the gardening work throughout the growing season and harvested some 1000 pounds of produce.

The produce from the garden was delivered to the Food Pantry of Caregiving Network. The produce was distributed, free of charge, to Caregiving Network's Food Pantry clients.

Of the $500 grant, only $130 was expensed during 2011. This amount was used for purchase of vegetable plants and some gardening tools. The remainder of the funds are in a restricted "Jefferson Ave Community Garden" account at Caregiving Network. These funds will be used for miscellaneous garden expenses for the 2012 garden.

Planting of the 2012 Jefferson Ave Community Garden at The Community Church of the Nazarene will begin in two weeks. Currently, the soil is being prepared for planting.

Once again, thank you for your concern for the Midland community and for your interest in assisting the Jefferson Ave Community Garden group as it provides quality fresh produce to our residents living in poverty.

Respectfully submitted by Thomas J. Vander Zouwen, Caregiving Network, Inc. Executive Director (on behalf of the Jefferson Ave Community Garden group and Rebecca Cummins-Lanter, Project Coordinator)

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Project Title: 2010.447
Institution: Michigan State University Extension
Date: 5/11/2012
Report:
Project Title: Project FRESH 2011
Institution: Michigan State University Extension
Date 5-11-2012

Project Title: Project FRESH 2011

The goals for 2011 for the 4 county Project FRESH grant recipients included reaching 1000 families in the Midland, Clare/Gladwin and Arenac county area, the actual number reached was 972. Dollars reinvested back into the 4 county totaled approximately $19,440.

In 2011, participants were able to spend their coupons at 25 vendor sites in the 4 county radius, and if they vacationed or traveled anywhere in Michigan they could use their coupons at other farmers markets.

Counties worked to secure additional local funding to help support the Project FRESH program. Midland County received additional support from local churches, the CROP Walk, and Emergency Food Pantry. Michigan State University Extension supported each county with a small stipend to purchase educational materials and demonstration supplies. (The stipend was based on the number of coupons a county received.)


In each county the participants attended a one-hour demonstration detailing instructions on proper use of coupons, a food demonstration and taste testing of a seasonal produce item. An educational enhancement was given to participants attending the class; they had their choice of a cutting board, vegetable scrub brush, or an insulated tote to take to the market.

In all four counties a total of 110 classes were taught to 972 participants. Arenac County received 288 coupon booklets they issued 287 of them (1 booklet was used for training demonstrations). Arenac County experienced 255 coupons redeemed allowing for a redemption rate of 88.72%. Clare County received 150 coupon booklets they issued 144 of them. Clare County experienced 102 coupons redeemed allowing for a redemption rate of 68.27%. Gladwin County received 189 coupon booklets they issued 175 of them. Gladwin County experienced 144 coupons redeemed allowing for a redemption rate of 75.93%. Midland County received 345 coupon booklets they issued 345 booklets to participants. Midland County experienced 274 coupons redeemed allowing for a redemption rate of 79.39%.

This past year, MSUE collaborated with the local WIC offices in each county, recruiting for Project FRESH participants. The MSUE staff conducted a pre/post survey of participants. This data is being used to measure impact of the program itself and determine the value of one-time presentations. More work is being done on this project.

At the end of 2011 conversations were held with the State Department of Community Health, it was determined that Midland, Clare, Gladwin and Arenac counties could be counted as part of the state’s Project FRESH program beginning the summer of 2012. This is a blessing in many ways. It gives the WIC office in each county the control of coupons and the MSU Extension office in each county the role of providing the education piece. With the many budget cuts the Extension offices have faced and the reduction in staff, the only true piece we can offer with Project FRESH at this time is the education piece. It is no longer feasible for our offices to play the role of Market Master, Coupon distributer etc. MSU Extension’s role will be just to provide education. The timing was perfect. Our partnership with the Allen Foundation has been historic; with your help we have touched many lives during a time when monies weren’t available. Changes are still coming some of our markets are going “live” with electronic benefits for our participants which will make the process of getting more fruits and vegetables that much easier using their WIC, Project FRESH or EBT benefits.




Expenditures:

Coupon Expense: $19,440
Educational Enhancements: $3000
Nutrition Education Materials and Promotional Materials: $7560
Total: $30,000


Shared Comments from Participants:

Dear Mrs. Allen
Thank you for what you are doing. My kids look forward to homemade strawberry jam every year made with the fresh strawberries that I get from Project FRESH. S S

Dear Mrs. Allen,
Thank you for supporting and funding Project FRESH. My daughter has type 2 diabetes. Project FRESH helps me with the cost of her fruits and veggies. Our family sends thanks to you! The P Family

Dear Mrs. Allen,
I soooo very much appreciate what you’ve done to help us. As a mother of 5 and a foster parent for over 15 years this has been a blessing for me and my family. Thank you for supporting us! CO

Thank you for being such an important part of Project FRESH. It’s people with kind hearts like you that make tough situations tons easier. Thank you from the bottom of our hearts! W VA.

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Project Title: Ypsilanti Health Initiative
Institution: Ypsilanti Health Initiative / Ginsberg Center/University of Michigan
Date: 5/11/2012
Report:
Overview

The Ypsilanti Health Initiative seeks to make healthy living more affordable and accessible to lower-income individuals living in Ypsilanti, Michigan. Our three-part approach includes health education, exercise, and supplemented grocery shopping as a means of offsetting the high costs of healthy groceries, improving health awareness, offering alternatives to fast and fatty foods, and increasing physical activity levels.

To this end, we held weekly workshops with residents of the Ypsilanti Towne Center during Fall 2011 and Winter 2012. Funds from the Allen Foundation supported 15 workshops (7 fall, 8 winter), bi-weekly grocery incentives for program participants ($10 gift card to Ypsilanti Food Co-op), and materials for programmatic improvement.

Impact

About 15 participants from the Towne Center (from a pool of 26 frequent participants) and 8 University of Michigan volunteers attended YHI workshops each week (attendance varied each week). The nine members the YHI Planning Team carefully designed the weekly workshops and recruited a volunteer base for the program. Each workshop included a health lesson, discussion, and a healthy meal. We focused on cardiovascular, skeletal, dental health, and many other dimensions of well-being; one workshop featured a physician from the University of Michigan with expertise in infectious disease prevention.

The impact of our workshops was felt by residents of the Towne Center and by University of Michigan volunteers alike. When Towne Center participant were asked what they valued about our program, they ranked the knowledge gained by participating in the program and interactions with student volunteers as their favorite. Many respondents also valued the meal provided at each session, and some indicated high regard for our exercises. We gleaned from these responses that opportunities to learn and to socialize are greatly valued by YHI participants, which is aligned with our mission to build knowledge and friendship at the Towne Center.
Student volunteers have also expressed great contentment in planning and participating in weekly workshops. For many students, organizing lesson materials offers the opportunity to learn new information about nutrition, exercise, and elder health. As the majority of YHI volunteers express interest in health-related careers (including medicine, kinesiology, and dietitian), this fuels an interest in public health. All volunteers enjoy the opportunity to spend time with Towne Center participants, evident in the many friendships, boisterous conversations, and laughs shared during each weekend session.

Changes

Two main changes were made to the 2011-2012 YHI program: (a) a revised grocery incentive program, and (b) a new initiative with the Ypsilanti Ozone House. Both are outlined below.
In 2010-2011, we noted that just 35% of program participants were utilizing the food incentive offered by our program (50% off up to $20 groceries at the Ypsilanti Food Co-op). In that most program participants report a weekly food budget of $41-60 or less, the coupon would require participants to designate about 25% of their weekly budget towards purchases at the co-op. For many, the cost was too great, thus the incentive was underutilized and our goal to offset the high cost of groceries remained largely unmet.
In 2011-2012, we changed our incentive. Instead of a coupon, we offered participants a $10 gift card (meaning that the per-person incentive amount remained the same). We then surveyed participants about their use of food supplements.
All participants received some form of assistance in purchasing groceries, and many respondents (60%) qualified for assistance provided by the Supplemental Nutrition Assistance Program of the Department of Human Services. The vast majority (87%) utilized the new food incentive ($10 gift card) offered by YHI, as compared to 35% the year prior. Our change in incentive thus resulted in a substantial increase in utilization of YHI assistance; in fact, supplements offered by YHI were the most-utilized form of grocery assistance.

We also worked with the Ozone House (an organization serving youth at-risk for homelessness in Washtenaw County) in Fall 2011 to pilot a new healthy eating initiative with adolescents from Ypsilanti. The initiative was entirely funded by the University of Michigan Student Assembly and consisted of three health workshops focused on healthy eating, alternatives to fast food, and cost-effective recipes. About 20 adolescents and all 9 members of Planning Team attended each workshop. Workshops included cooking a healthy meal with adolescent participants and an interactive health lesson.
We then evaluated the program with members of the Ozone House staff.

All stakeholders thought that the program was well received by the youth, making it a promising partnership for both organizations. After discussing program benefits and goals, we proposed a model for an expanded program for the 2012-2013 academic year in our application Allen Foundation funds. We hope to add the Ypsilanti Ozone House initiative to our efforts next year and reach adolescents whose nutritional needs may be unmet or at-risk.
In sum, changes made to the grocery incentive and the addition of the Ozone House program were both highly successful, and we hope to sustain these gains next academic year.

Results

To evaluate our program, we compared the results of our 2011-2012 annual survey with those from 2010-2011. Survey items included questions about physical activity, shopping patterns, nutrition, health, and perceptions of the YHI program. Using qualitative and quantitative methods, we assessed program gains and identified areas of need.

The results of the survey indicate improvements across all dimensions. For the first time ever, all respondents reported some form of weekly exercise, which may be attributed to recurrent efforts to identify appropriate means of physical activity for each program participant. Use of the YHI food supplement increased by over 50% in one year, corresponding with the new mechanism of disbursement (gift card as opposed to coupon). We also noted increases in protein consumption and multivitamin use, each attributable to targeted workshops held in Fall 2011.
Perception of program quality was extremely high. Most participants said that no improvement was necessary; those who did note the need for improvement unanimously suggested more information and workshops, not less. All respondents identified areas of the program that they greatly valued.

Challenges

The survey also served its function in identifying areas of need. Fruit and vegetable consumption remained sub-optimal, and many participants noted barriers to food access and physical activity. Transportation threatened participants’ ability to access grocery stores, while fear of falling and arthritis impeded physical activity. While we cannot reduce all barriers, it remains our goal to increase physical activity and healthy eating behaviors.

Moving Forward

Next year we will work to implement actions identified in our annual evaluation (identify more seated exercises, offer transportation to those lacking a personal vehicle on a bi-weekly basis, integrate simple and nutritious recipes into every lesson) and to sustain changes made to the program this year. We used funding from the Allen Foundation to purchase health education workbooks, DVDs with seated exercises for seniors, and a low-cost amplification system (to ensure that all participants can hear and participate). We expect that these investments will improve the quality of our workshops at the Towne Center and offer new ideas for our volunteers. Overall, we are proud of the gains we made during the 2011-2012 year, and we remain committed to improvement through targeted health intervention.

Budget as of April 2012

Healthy Lunches and Workshops: $2,070.00
Healthy Groceries: $2,000.00
Silverware for Workshop Lunches: $17.56
Copies/Duplicating: $84.37
Portable PA System: $81.57
Nutritional Materials (books, videos): $94.85

Indirect costs at 15%: $651.65

Total: $5,000.00










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Project Title: A Double-Blind Placebo-Controlled Study of the Effect of Lutein/Zeaxanthin Supplementation on Macular Pigment Optical Density (MPOD) and Retinal Pigment Epithelium (RPE)/Photoreceptor Layer Architecture in Normals
Institution: State University of New York, College of Optometry
Date: 5/10/2012
Report:
40 students at SUNY College of Optometry were randomly chosen to participate in the project (there were a total of 75 volunteers; 2 were eliminated because of existing ocular pathologies; one was eliminated because he did not meet the age requirement). 20 were randomly assigned to the lutein/zeaxanthin (L/Z) group and 20 were randomly assigned to the placebo group. The subjects did not know to which group they had been assigned.

All the participants were instructed to take their supplement (either L/Z or placebo) on a daily basis (at approximately the same time each day), were tweeted (or e-mailed) daily reminders and were instructed as to the procedure in case they forgot to do so on any particular day.

Each participant had his/her age recorded and height and weight measured at the outset of the project in order to calculate the body-mass index (BMI).

Participants had their macular pigment optical density (MPOD) measured using heterochromatic flicker photometry and their outer retinal thickness (ORT) measured using spectral domain optical coherence tomography (SD-OCT). Both instruments were available at the University Eye Center, the clinical component of SUNY Optometry.

Measurements were made immediately before ingestion of the supplement began and then again at the 6-week and 12-week points (at which time supplementation ended). The people measuring MPOD’s and ORT’s did not know which group any of the subjects were in.

Subject compliance with ingestion of the supplement was excellent. There were no reports of significant adverse events.

Data analysis is currently going on after which the 3 people who ran the study will discuss the results among themselves and with other appropriate individuals at the college and without. We expect this to be completed by around the end of June. After the results are analyzed and conclusions drawn, plans will be formulated for future work.

Expenses
L/Z $810
Placebo $151
Participant remuneration $6000
TOTAL (to date) $6961
Remaining $1539 to be used to fund travel to scientific meeting(s).

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Project Title: Nutrients regulate transcription via mTORC1 and Early Growth Response factors
Institution: Boston University School of Medicine
Date: 5/10/2012
Report:
Konstantin Kandror, PhD
Proposal Number: 2010.395: Nutrients regulate transcription via mTORC1 and Early Growth Response factors.
Progress report for the period: June 2011-May 2012

The central idea of this proposal is to test the hypothesis that nutrients control Egr transcription factors via mTORC1. In the previous funding period, we have focused on Specific Aims 1 & 3 of the Application.

Aim 1. Although preliminary experiments suggested that both Egr1 and Egr2 inhibited activity of the ATGL promoter, further studies demonstrated that Egr1 is much more potent in this regard. Therefore, we have focused our investigation on Egr1. Note, that the ATGL promoter that has a consensus Egr1 binding site located very close to the open reading frame.
The main goal of this Aim has been to determine if activation of mTORC1 is sufficient to induce expression of Egr1. With this aim in view, we have determined that expression of Egr1 is very low in wild type MEFs, but is significant in TSC2-/- MEFs that have hyper-active mTORC1 pathway. Also, rapamycin inhibits the expression of Egr1 TSC2-/- MEFs. Thus, activation of the mTORC1 pathway increases Egr1 expression.
In order to explore the effect of nutrients on expression of Egr1 in physiologically relevant cell type, we have shown that treatment of cultured 3T3-L1 adipocytes with leucine alone activates the mTORC1 pathway and stimulates Egr1 expression. On the contrary, in the absence of nutrients, insulin is not able to activate mTORC1 and expression of Egr1. We conclude that nutrients have a cell-autonomous mTORC1-mediated stimulatory effect on expression of Egr1.
We also planned to determine which “classical” mTORC1 substrates, S6K1 or 4E-BPs, are responsible for the induction of Egr1 by mTORC1. For that, we have compared expression of Egr1 in control and 4E-BP1/4E-BP2 double knock out MEFs that we have obtained from Dr. Sonenberg, and found no significant differences. This result leaves S6K1 as a likely mTORC1 substrate that is responsible for the effect of mTORC1 on the expression of Egr1. In order to confirm this idea, we will knock out S6K1 with the help of siRNA, and we will determine whether or not this has any effect on the expression of Egr1. By now, we have optimized the conditions of S6K1 knock out.
As is mentioned in the Application, Egr1 has a co-repressor, Nab2. We have performed several preliminary experiments with Nab2 and found that it potentiates (significantly, but not dramatically) Egr1-mediated inhibition of ATGL expression. Thus, we will keep Nab2 in mind, and we will get back to this protein after the Egr1 connection is firmly established in vivo.

Aim 3. In a collaboration with Susan Fried, we analyzed expression of Egr1 & Egr2 in insulin-resistant mice that received high fat diet for 14 weeks. As expected, activity of mTORC1 in fat tissue of these animals is increased. In agreement with our model, activation of mTORC1 suppresses ATGL. We have also determined, by qPCR, that high fat feeding increases expression of Egr1 and Egr2.
Our observation that high fat diet decreases ATGL expression, although supportive of the previous findings, may seem to contradict a well-known fact that plasma FFA are commonly increased in obesity. This, however, may reflect the overall increase in adipose tissue, whereas lipolysis normalized per kg of fat mass is actually decreased in obesity consistent with results shown.
In order to confirm and to follow up on this result, we have carried out a microarray study. Our Medical School has state-of-the-art gene array facility, so we took advantage of this equipment and competitive pricing in order to carry out a broad analysis of all genes regulated by high fat diet in vivo, and the role of the mTORC1 pathway and Egr1 in this regulation.
For this work, we used cost-effective GeneChip®Gene 1.0 ST Arrays where the probes are designed not against the 3’-terminal sequences of the gene, but rather are distributed across its whole length. This should provide more accurate results. We had 3 groups of age-matched male mice (3 animals in each group): low fat fed, high fat fed, and high fat fed mice injected with a 5mg of rapamycin/1kg of body weight. Controls were injected with 500 µL of sterile PBS and 5 µL of DMSO. At the end of experiment, epididymal fat was dissected, and RNA was isolated for the microarray analysis. We are expecting to obtain results of this study by mid-May, 2012.

Personnel. Partha Chakrabarty, MD,PhD who was listed as “key” personnel on the application obtained an independent position as Senior Scientist in the Cell Biology & Physiology Division at Indian Institute of Chemical Biology, Kolkata. Before he left, he had trained two graduate students who continued to work on the project in his absence. One of the students completed her degree in December, 2011, and another – in February 2012. For the second year of the application, we are planning to hire a recent MA graduate who has worked on the project for the last year.

Materials and Supplies. Materials and supplies include FBS and plasticware for tissue culture, reagents for SDS electrophoresis, Western blotting, primers for qPCR, antibodies, animal costs, microarray costs, etc.


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Project Title: Characterization of a Biomedical Model for Childhood Obesity
Institution: University of Missouri
Date: 5/9/2012
Report:
The prevalence of childhood obesity has almost tripled over the last 20 years. The short- and long-term implications of the early onset of the metabolic complications associated with childhood obesity are still being realized and require intensified research efforts. Currently, a suitable animal model for the study of childhood obesity does not exist. The goal of this project is to develop a biomedical model for the study of childhood obesity using the Ossabaw pig. The University of Missouri is at the forefront of biomedical research using pig models and has available the facilities and resources necessary to develop and characterize a new pig model. Due to the large costs associated with pig research, funds provided by the Allen Foundation will allow for a more complete characterization of this model. The data generated from this project will establish a solid foundation from which future studies of therapeutic and preventative approaches for childhood obesity can be studied.

Progress to date:
An initial group of 6 animals (3 lean and 3 obese) have completed the study and a second group of animals that will complete the data set is scheduled to be finished at the end of May. Preliminary data from the first group of animals provide a clear proof of concept for use of this model for the study of childhood obesity. Following weaning, female pigs were assigned to a low calorie/low fat diet group or a high calorie, high fat/high fructose diet. Over a period of four months, we were able to cause a doubling of body weight with lean animals weighing 60 lbs and obese 110 lbs. This time point is just prior to the onset of puberty in the pigs and is comparable to that of an adolescent child. As would be expected this difference in body weight was accompanied with an increase in body fat percent with the obese animals having a body fat content of 30%, which is similar to the body fat content reported for children who are classified as obese.

An important finding from this study is that physical activity is reduced very quickly after excess calories are consumed and precedes any significant difference in body weight. We were able to determine this through the use of accelerometers that were worn by the pigs for extended periods of time throughout the study. Accelerometers worn by the pigs clearly demonstrate that a reduction in physical activity occurs very quickly after the animals begin consuming excess calories. By the end of the study, obese animals were moving half as much as their lean counterparts. Therefore, both excess consumption of calories along with a reduction in physical activity are contributing to the obesity in our model and these are similar risk factors for obesity in today’s children. In addition, fasting insulin levels were elevated in the obese animals in order to maintain a regulated blood glucose level. This is an indicator of insulin resistance which is an early phenomenon in the progression towards type 2 diabetes. Glucose tolerance testing further verified the presence of insulin resistance in the obese animals.

Given the important nature of this research, a number of faculty members have aligned themselves with this project and each is studying their own tissue and helping to create a more complete characterization of the model. In addition to the overall changes in physiology that are being investigated, the more detailed areas that are currently under investigation include: liver metabolism and the development of fatty liver, adipose tissue metabolism and distribution, muscle metabolism, physiology of the heart and small vessels, changes in bone structure and development, reproductive physiology and follicular development, alterations of drug metabolizing enzymes in the intestine and liver, and the intestinal microbiota. A key aspect of this ongoing work is the RNA sequencing studies that are being performed on adipose tissue and liver. Recently this data has been generated from the first group of pigs and once the data from the second group is compiled, the process of analyzing these data will begin. These data will be the first of their kind for such a project and will provide important information that will help direct future studies with this model.
The impact of this model is already being realized as 3 abstracts were recently presented at the Experimental Biology meeting reporting findings from the limited data generated from the first group of animals. Once the data set is complete this summer, there will be several important manuscripts generated in addition to grant applications to the NIH and ADA that will allow this research to continue. Much of the progress that has been made and will continue to be made over the next year is due in great part to the generous grant provided by the Allen Foundation. Given the increasing prevalence of childhood obesity in the U.S. and worldwide, this novel biomedical model will provide a previously lacking tool to help us combat this serious issue.

Approximate spending to date:
$18,500 – technician support for the project
$25,000 for equipment including infusion pumps, a freezer and accelerometers
$5,000 supplies/diet
$15,000 RNA sequencing
$10,000 indirect costs
Remaining funds will be used towards additional RNA sequencing expenses and supplies for tissue collection and processing.

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Project Title: Project Agro: Feeding and Educating Communities
Institution: Innovation: Africa
Date: 5/1/2012
Report:

Innovation: Africa received funding from the Allen Foundation to pilot a new initiative: providing two schools in Tanzania with drip irrigation technology and a nutritional program. The goal was to teach students, teachers and local farmers how to grow more crops with less water, increasing their food supply in a region that is vulnerable to drought, hunger and malnutrition. To supplement the agricultural technologies installed, we planned to offer courses at the school in nutrition, educating both teachers and students about healthy eating while providing them with food to eat.

On March 1st of this year, Innovation: Africa was granted approval by the Trustees of the Allen Foundation to implement our agricultural and nutritional project in Malawi instead of Tanzania. Our reasons for making this request were namely that we were experiencing unexpected delays in our work in Tanzania due to elections and government regulations. We understand that the Allen Foundation granted this request to shift the location of our project hesitatingly, as we also hesitated to make the request. It is not something we have done before, nor do we hope to do it again. We are incredibly grateful, however, for the opportunity to implement the program in Malawi, where we are quickly moving forward with the pilot.

Since March 1st, our international staff has travelled to Malawi to meet with our partners there. This project will be completed through a three-way partnership between Innovation: Africa, ExAgris Africa and Goods4Good. In order to move forward more quickly and efficiently than we could have on our own, we are working with top experts in the field who have an established history of success in the agricultural and community organizing sector in Malawi. The breakdown of labor is as follows:

1. Goods4Good has a network of high performing schools and community based organizations (CBOs) in Malawi. They have helped us identify two communities that will be ideal for this pilot, as both have land available and both have a history of successful community-run programs. Goods4Goods' longstanding relationships with the two communities we have selected will make it easier for us to integrate the nutritional programs into their educational system, and to gain the trust of the people in the village.

2. ExAgris Africa has over 24 successful agricultural projects in Malawi alone, and is one of the only organizations that has worked with drip irrigation in the country. As mentioned in the proposal, it is their agronomists that will join our local managers in the field to sit down with the communities, select the crops they would like to grow and train them to use drip irrigation technology rather than the traditional flood methods. ExAgris will also buy surplus crops off the community to sell in their urban markets, providing a source of income to the community as well as funding the sustainability of the project.

3. Innovation: Africa convened these two partners, created the criteria for the sites selected and arranged for the local staff of these three organizations to travel together to the new project sites. Innovation: Africa worked with local chiefs to get land from local tribal leaders donated for the project as well. Because of this, we have avoided working Malawi's government (which has recently experienced a coup and is undergoing a great period of transition at the moment. While we maintain excellent relationships with both the local and national government, circumventing government bureaucracy at this turbulent time has proven key in moving the project forward). Innovation: Africa will manage the project, working with ExAgris' agricultural experts, Goods4Goods' local staff and the two communities themselves, ensuring that each plays their part in making this endeavor a success.

Thus far, things are progressing quite well. It's only been two months since we began working on this project in Malawi, and already we have the two communities, the necessary partners, we've conducted a joint site visit and have created a timeline for implementation. All are looking forward to moving quickly on this, though not--of course--without the proper level of community engagement and planning first. As we speak, each organizations' staff are working on their prospective roles: ExAgris on identifying the right crops to grow and Goods4Good on the

nutritional component and introducing the community that they already have a relationship with to this new initiative. Finally, Innovation: Africa is working on mobilizing the community, securing all land agreements with the local chiefs and checking the water source that will feed into the irrigation systems.

One important note is that the farms will not be located directly on the schools' property, but rather in plots nearby. The reason for this is twofold: First, this is where the land owned by the local chiefs is located. Second, because we will have not only students and teachers but also members of the community working on and learning from the farm, the school administration asked that we remove it from school property to avoid distracting the students. The plot is nearby enough, however, for students in the community to learn the new and improved farming methods. The nutritional programs will be run at the CBO--a community-run facility offering programs for the entire local population (e.g. infant care, homework help, HIV/AIDS education, etc.). This CBO culture is far more prevalent in Malawi than in Tanzania, and we are grateful to be able to make use of the pre-existing community infrastructure to increase the impact of our work. Now, not only will there be nutritional programming offered to students, but also to pregnant women, educating them on how best to nourish themselves and their babies. Starting nutrition at the prenatal level is crucial to improving children's health, and we will be proud to offer such services.

After re-budgeting for this new project, we are confident that we will still be able to complete the pilot in full with funding from the Allen Foundation. We will be happy to send over a final budget accounting for our spending after the pilot is complete.

Once again, we are grateful not only for the funding granted to us by the Allen Foundation, but also for the Trustees willingness to allow us to spend the funds granted in the area where we can do the most good. Because we hope to begin installing the drip irrigation technology in the coming months, and a full growing season can take up to a year depending on the crop, we will be happy to follow up with one or multiple reports on the progress of the project as we continue to move forward.

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Project Title: Tu Corazon Tu Vida
Institution: La Luz Center
Date: 5/1/2012
Report:
There is a dire need in the Sonoma Valley for comprehensive health and nutrition education directed at Spanish-speakers who experience dietary health problems. Sonoma Valley is populated mainly with low-income Latino immigrants, a population which experiences a disproportionately high rate of diabetes. In this area, very few people have health insurance or access to medical care and, untreated, prevalent diseases such as diabetes and obesity become even more severe. We believe that the best way to alleviate the problem of poor nutrition is through prevention, specifically through education.

La Luz addressed this issue by offering an eleven-week nutrition course, targeted towards our immigrant population, called Tu Corazón, Tu Vida (Your Heart, Your Life). In the initial course, we trained one staff member and twenty-one volunteers to become promotores, or advocates, in our community. After this training, the volunteers and staff became authorized to teach further nutrition courses, and to disseminate the information in less formal ways. These dedicated volunteers conducted two more sessions during the year, educating 49 residents of the Sonoma Valley. This succession of courses taught by dedicated volunteers trains more promotores and eventually will become a self-sustaining program dedicated to improving nutrition in the Sonoma Valley. The structure of this program is such that each subsequent course involves more members of the community, both educating them and empowering them to make a difference in their lives and in the lives of their neighbors.
Beyond teaching normal classes, our staff representative taught this nutrition education to a population that is largely neglected: vineyard workers. Many of these men live on the ranches they work on and have little down time, making it very difficult to get information and resources to them. Our staff representative has assembled a coalition of 7 workers representing the major vineyards and management companies, giving us access to this isolated community. By cultivating a relationship with these businesses, we were able to go to ranches and vineyards during the lunch hour, instead of asking the workers to come to us. This partnership is ideal, as it allows us to reach the workers while they are eating, a perfect time to talk about the importance of nutrition. Here, the curriculum was tailored to this specific population, emphasizing foods that provide energy and sustain the body’s physical strength.
Using curriculum developed by the National Heart, Lung, and Blood Institute, these classes combined theory with practice. Participants learned about different foods and how to combine them to make a balanced meal. Each week we addressed a different topic, such as cooking for diabetics or complete protein meals. Students also cooked sample dishes related to each topic of discussion, so they see and taste the merit of the healthy food they are encouraged to cook.
The first course was taught by St. Joseph Health System, a nearby organization that has conducted this training in the past. By using a small group of dedicated volunteers, the project was completed with minimum cost to our organization. These volunteers, like our employees, live in the area where they work and have used La Luz services in the past. This connection to the community gives them a strong personal incentive to improve nutrition and health in the Sonoma Valley, as these issues affect them directly.

With funding from the Allen Foundation, we paid for the educational materials, healthy food for recipes and for our staff representative’s time.

Expenses:
educational materials $453
food for recipes $480
staff salary $973
TOTAL $1906

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Project Title: Passport to Healthy Living Program
Institution: Episcopal Social Services of New York, Inc.
Date: 5/1/2012
Report:
Episcopal Social Services
Year-End Report to the Allen Foundation
Grant of $23,350 for the Passport to Healthy Living Program
May 1, 2012

The Allen Foundation's grant of $23,350, received June 2011, has enabled Episcopal Social Services (ESS) to provide 80 culturally diverse families and their young children served by ESS' Early Head Start (EHS) Program with comprehensive health education tools to combat obesity, and promote good nutrition and exercise as a way of life. With the help of this generous support, families are being educated in the causes and consequences of childhood obesity as well as strategies to reduce the risk of unhealthy nutrition choices.

In Spring 2012, ESS will resume partnership with New York City Department of Health's Health Bucks Program for complementary nutrition education. NYC DOH awarded ESS EHS with $500 worth of Health Bucks in June 2011 to be divided amongst the 80 families covered under the Passport to Healthy Living Program. Each health buck voucher equals $2 that can be redeemed for fresh and affordable fruits and vegetables at participating farmers' markets. Families are able to earn additional vouchers with every $5 spent in Electronic Benefit Transfer (EBT) as well as upon completion of a Stellar Farmers' Market workshop such as cooking demonstrations and recipe tastings.

Strategy Update
Staff
• In April 2012, the Passport to Healthy Living physical fitness consultant from Belin Sport and Fitness, Inc. (BS&F) created a fitness program for EHS parents that includes two 90-minute weekly workout sessions, a participant Health and Wellness questionnaire, and initial assessments of exercise tests, analyses, and measurements to monitor ongoing participant progress. Health benefits of the BS&F program include increased metabolism, decreased risk of diabetes and cancers, lowering high blood pressure and risk of cardiovascular disease, and more.

This exercise program is especially significant to EHS expecting mothers as it helps prepare the body for the stresses imposed by labor and delivery, including speedier recovery after delivery, reduced chances of having a Caesarean birth, boost in energy levels, and an increased sense of well being during and after pregnancy. Research also shows that group exercise programs, in particular, are beneficial for mothers with post partum depression due to the socialization and emotional support of other mothers in the group exercise program (Daley, 2007).

• The nutrition consultant is building nutritional literacy during monthly parent workshops and creating nutritional records for families to monitor their progress. EHS staff also attended Health and Wellness workshops aimed towards including a nutrition series in daily curriculum in both the center and home based programs.

• The mental health consultant cited that poverty and depression are two major factors contributing to obesity – poverty provides families with less opportunity to purchase healthy food options and parents suffering from depression are likely less motivated to make healthy choices often using food as comfort instead of nutrition.

Family Involvement
• Families attended approximately seven on-site cooking demonstrations and Health Bucks classes, received healthy recipes, nutrition handouts, and food safety tips.
• Families attended nineteen scheduled workshops and trainings thus far on Nutrition, Mental Health, and Exercise including: Introduction and Overview on What Is Obesity, Parent/Child Food Relationships, and Zumba fitness for parents.

Client Successes
• A retired community member living on a fixed income, who uses a cane to walk after being in an accident, says that positive thinking has made the biggest impression on her. She says that Passport to Healthy Living has introduced her to modified exercises that have helped improve her mobility and endurance which she would otherwise never have been able to afford.
• A mother of three says that most of the mothers really need the Passport to Healthy Living program since many can’t afford to pay for the tools they’ve learned in order to live a healthy lifestyle. She says that parents are learning to make healthier choices for themselves and for their children.

Given our ongoing success, ESS submitted a grant renewal of $40,293 in December 2011 for nutrition education and would be very grateful for the opportunity to partner with the Allen Foundation once again.


Financial Expenditures to Date

Personnel
•Nutrition Consultant - $3,600
•Mental Health Consultant - $1,350
•Education Consultant - $450
•Physical Fitness Consultant - $1,200
•Lactation Specialist - $0
•Medical Professional - $900
TOTAL: $7,500

OTPS
Estimated expenditures
•Health Food & Beverage - $3,300
•Healthy Snack Packs - $825
•Incentive Gifts - $750
•Transportation - $300
•Training Materials - $1,125
•Office Supplies - $900
•Advertisement - $375
•Postage - $225
•Kitchen/Cooking Supplies - $188
TOTAL: $7,988

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Project Title: Innovative Nutrition Education for Medical Students Progress Report
Institution: Boston Medical Center
Date: 5/1/2012
Report:
This project entailed three connected components that involve several activities and partners including the Nutrition Vertical Integration Group (VIG) at the Boston University School of Medicine (BUSM), the Student Nutrition Awareness and Action Council (SNAAC), the Nutrition and Fitness for Life (NFL) clinicians, and national professional societies and other medical schools. Because there is currently no available time to dedicate to new medical courses, we initiated the integration of nutrition medicine into the curriculum via several innovative mechanisms.

Goal 1: Increase medical students¡¦ clinical nutrition exposure
We paired medical students with the NFL staff. Students participated in the assessment and counseling of pediatric patients with one-on-one mentoring from the NFL clinicians. Additionally, advanced students had the opportunity to observe activities in the Intensive Care Unit, hospital wards, the Breastfeeding Center, and other pediatric specialty clinics. Advanced students also completed a nutrition-related project under the supervision of their mentor.

Goal 1 Accomplishments:
„« one new student from Introduction to Clinical Medicine I enrolled in the pediatric obesity rotation;
„« six SNAAC students participated in outpatient care activities in the NFL obesity clinic and three others are scheduled to join us before the end of the academic year; and
„« three fourth-year medical students have completed the Advanced Pediatric Nutrition elective: 1) One of these students will take an additional month to work with us in May on community and advocacy aspects of this project; 2) Another student completed a significant literature review on the nutrition status of homeless children and he presented this work ¡V which will be used by the Nutrition VIG for further nutrition education for medical students ¡V to his peers at a SNAAC event (see below); 3) Two of the students have been involved in creating the urban scavenger hunts (see below) and will present a poster at the John McCahan Education Day at BUSM on May 23rd, 2012; and 4) This elective has gained such popularity that we have a wait list for the upcoming academic year.

Goal 2: Fully Implement an Urban Nutrition Scavenger Hunt
The project was developed by an NFL registered dietician to assist medical students in understanding the socio-economic conditions that affect the ability of children and families to maintain a healthy diet and the role of cultural preferences therein. We sought to develop scavenger hunts in a variety of Boston neighborhoods with the goal for BUSM students to complete one scavenger hunt by the end of their BUSM career.

Goal 2 Accomplishments:
„« We have developed a partnership with Dr. Eric Hardt who organizes a Boston bus tour for all first year BUSM students during their orientation weeks; food environment education will become a part of this tour and students will be encouraged to register for the full tour on their own during their first two months of medical school;
„« As the bus tour covers four Boston neighborhoods, we are creating scavenger hunts to accompany each in the low-income neighborhoods of Field¡¦s Corner, Codman Square, Upham¡¦s Corner and South Boston; and
„« A Dietetic Practicum student has paired with two Advanced Pediatric Nutrition elective medical students to create scavenger hunts of Upham¡¦s Corner and South Boston, while BMC was able to adapt existing scavenger hunts of Fields Corner and Codman Square: 1) Scavenger hunt creation is intensive and involves exploring the neighborhood, meeting with community leaders and business owners, and conducting several interviews of professionals and residents and 2) We have identified opportunities within the clerkship and pre-clerkship curriculum to require the scavenger hunt.

Goal 2 Next Steps:
„« Dietetic interns and third and fourth year medical students will participate in bus tours to highlight the food environment to the first year students and encourage them to register for the scavenger hunts as an extracurricular activity;
„« The Nutrition VIG will reach out to targeted pre-clerkship and clerkship directors about adding the scavenger hunts as a mandatory part of their course and
„« Students involved in the development of the scavenger hunts will present a poster at John McCahan Education Day at Boston University on May 23, 2012.

Goal 3: Develop and Organize Nutrition-Related Events and Activities
Extracurricular nutrition-related events and activities were available to all BUSM medical students. SNAAC hosted nutrition lectures by speakers with expertise in diet and counseling techniques. Volunteer opportunities enabled medical students to participate in community nutrition events. Medical students had the opportunity in year 1 or 2 to work directly with an RD or dietetic intern to have their own dietary patterns assessed and be counseled on them.

Goal 3 Accomplishments:
„« We hosted quarterly nutrition lectures and events: 1) On September 1, 2011 Joan Salge Blake, MS, RD presented ¡§How to Win the Weight Loss Battle¡¨ to a lecture hall which was at capacity with medical students; 2) Fourth year medical student, Anthony Walls, and a panel of nutrition experts from Boston Medical Center¡¦s NFL Clinic, Grow Clinic and Medical Legal Partnership presented ¡§Nutrition Status of Homeless Children¡¨ on January 26, 2012; 3) SNAAC collaborated with two other nutrition groups at Boston medical schools to initiate a series of lectures across Boston, the first of which was held at Tufts, entitled ¡§Nutrition from a Global Health Perspective and Nutrition for Different Cultures¡¨ and presented by Frank Hu, MD, PhD, on January 11, 2012; 4) In collaboration new medical student groups from Tufts and Harvard, SNAAC coordinated and hosted ¡§Healthy Eating on a Budget¡¨ presented by K. Gorman and Laura Judd, MS, RD, LDN at BUSM on February 21, 2012; and 5) On April 12, 2012, BU Dietetic Practicum student Margaret Beste presented ¡§Why Did the USDA Change What I Put on My Plate¡¨ to BUSM medical students.
„« The Dietetic Intern/Medical Student match was successful in the fall of 2012 with seven pairs of students and an additional seven pairs are currently matched for the spring semester;
„« SNAAC students, trained by BMC¡¦s Chef Dietitian, are embarking on a new endeavor to offer healthy cooking classes to medical students beginning in June 2012; and
„« SNAAC students led nutrition education activities at BMC¡¦s bWell Center in the pediatric waiting area throughout the year and tat he American Medical Association Health Fair on April 28, 2012.

Recognition of the Allen Foundation: In addition to making progress toward all of our goals, described above, we acknowledged the Allen Foundation¡¦s support in the following which occurred locally and nationally:

1. Lenders CM, Gorman K, Lim-Miller A, Puklin S, Pratt, J. Practical Approaches to the Treatment of Severe Obesity. Pediatr Clin N Am, 2011.
2. Lenders CM, Gorman K, Feldman S, Peace K, Schoettler C. ¡§Nutrition Medicine: where we are and where we are going¡¨, New England Medical Schools Nutrition Summit, Boston, MA. September 28, 2011. (Oral Presentation)
3. Walls A, Sandel M, Lenders CM, Gorman K. ¡§Nutrition Status of Homeless Children.¡¨ BUSM SNAAC Nutrition Luncheon Event, Boston, MA. January 26, 2012. (Oral Presentation)
4. Judd L, Gorman K, Beste M. ¡§Healthy Eating on a Budget.¡¨ BUSM cross-town medical school education event, Boston, MA. February 21, 2012. (Oral Presentation)
5. Beste M. ¡§Why Did the USDA Change What I Put on My Plate?¡¨ BUSM SNAAC Nutrition Luncheon Event, Boston, MA. April 12, 2012. (Oral presentation)
6. Lenders CM, Gorman K, Peace K. ¡§A novel student-centered nutrition medicine education model.¡¨ Experimental Biology Meetings, San Diego, CA. April 23, 2012. (Oral Presentation)
7. Wang F, Lee S, Judd L, Feldman S, Salge-Blake J, Lenders CM, Gorman K. The DI/MS match pairing dietetic interns and medical students to promote interdisciplinary team development in nutrition-related patient care. Experimental Biology. Poster presentation, San Diego, CA, 2012.

In addition, other presentations and publications are planned for the coming months.

The grant from the Allen Foundation has greatly supported enhancing medical students¡¦ knowledge about and comfort with nutrition medicine, and built the foundation for a new generation of physicians whose proficiency in nutrition will empower them with nutrition counseling skills.

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Project Title: Growing Power Youth Corps
Institution: Growing Power, Inc
Date: 4/30/2012
Report:
The Growing Power Youth Corps (GPYC) is a year-round, youth leadership program offering urban youth (9-18 years old) academic and professional experience in Community Food System development and maintenance, with an eight week intensive summer session included. Through the GPYC program, youth work at the Growing Power Community Food Center and gain competencies in multiple aspects of the food systems, i.e. building/maintaining aquaponic systems (fish and plant symbiotic relationship systems), intensive sustainable food production, hoop-house construction, and local food distribution. In addition to the hard skills related to urban sustainable food production, processing, marketing, and distribution, youth learn living skills critical to effective planning, communication, good work ethic, time, and money management.

Their exposure to and increased knowledge of these urban sustainable food systems contributed to the development of healthy eating habits, an increase in knowledge of nutrition and heightened awareness of local environmental issues. To complement the hands-on agricultural work, the GPYC program incorporated academic and nutrition-based lessons that provided technical information related to sustainable farm-work activities. Growing Power staff supported a year-long youth program that engaged 20+ youth in regular programming that developed their leadership skills with respect to community food systems development and maintenance. Daily activities required youth to learn how to use specific farm tools, e.g., wheelbarrow, shovel, hand tools, which improved their physical capacity. Furthermore, youth increased physical activity through gardening, weeding, soil sifting, shoveling, tending to the farm animals, and lifting and carrying produce off the farm. This increased physical capacity is a key component of positive youth development. Coupled with increased physical activity was the requirement for youth to think critically about specific social issues, such as organic vs. commercial agriculture, food justice, and environmental sustainability. Youth were led in academic lessons that focused content on these critical issues which developed their intellectual capacity and academic abilities to review subjects in multiple ways, e.g., youth would physically sift soil used for seeding and then learn about the biological make-up of that soil and how healthy soil impacts sustainable agriculture vs. contaminated soil lacking the same biological components. More, Growing Power Youth Corps also met during the monthly “From the Ground Up” workshops held in January through May. During these workshops, youth were able to further increase their knowledge of nutrition with additional lessons and by helping to prepare locally grown and healthy meals for the participants.

During the intensive, eight-week summer session, youth met at the Center for three days from 8:00am to 3:00pm. A typical day included assisting staff in opening the Center; two hours of academic/nutrition education; a lunch break; two hours of “fieldwork” with the Facilities Instructor; and concluded with a half-hour for a healthy snack and a roundtable discussion.

Overall, our aim was to: increase youths’ knowledge about nutritional foods; increase youths’ access to healthy, affordable food; increase youths’ ability to grow pesticide-free, healthy vegetables; develop youths’ nutritional overall health and give healthy snack and lunch ideas to youth. Youth alongside onsite nutrition educator and chef, were able to create and prepare new healthy snacks and lunches that were inexpensive, accessible and kid-friendly. The youth helped to plant, grow and consume micro-greens and lettuce; and they were able to attend the agriculturally focused Wisconsin State Fair, a multi-day, hands on field trip as well as travel to a local family farm , both of which were generously funded by the Allen Foundation.

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Project Title: Nutrition Education for Meal on Wheels and Congregate Nutrition Program Recipients
Institution:
Date: 4/27/2012
Report:
Project Title: Nutrition Education for Meals on Wheels and Congregate Nutrition Program Participants
Institution: None
Date: 4/27/2012
Report: Peninsula Volunteers, Inc. Meals on Wheels
Year-End Report to the Allen Foundation
Grant of $10,000 Received June 1, 2011

The Allen Foundation's grant of $10,000 received June 2011, has enabled Peninsula Volunteers Inc. (PVI) Meals on Wheels program to provide nutrition education to approximately 2,000 culturally diverse individuals, which is more than double the original number (800) in the proposal. In the ten months since receiving the grant, the Director of Meals on Wheels has offered 12 nutrition education presentations at senior centers and wrote 10 nutrition education articles distributed to nearly 500 Meals on Wheels recipients and 1200 Little House Adult Activity Center newsletter recipients.

Program

Good nutrition is a very important part of staying healthy and increases one’s ability to recover from illness. Eating a well-planned, balanced diet can prevent disease and help to manage chronic conditions. Nutrition education is essential to help seniors understand the relationship between a balanced nutritious diet and their health. The goal of the nutrition education was to increase older adults’ knowledge and understanding of what good nutrition is and the benefits it provides.

Four nutrition topics, chosen with input from center directors and participants, were researched and presented at senior centers. The topics included: “Healthy Eating for Older Adults”; “Home Food Safety”; “Snack Attacks Are Okay”; and “Calcium and Osteoporosis”. Each education session included nutrition information, how it relates to chronic disease and health, practical tips, and hand-outs. In addition, attendees had the opportunity to ask specific health and nutrition questions at each session. Each session concluded with a topic review and oral “questionnaire”, to assess the impact of the education.

The education sessions were designed to be very interactive and utilized visuals, such as food models, to aid in reinforcing information. For example, food models demonstrated portion sizes to participants. Portion size is known to be a key contributor to being overweight and people who are overweight are at greater risk for high blood pressure, heart disease, diabetes, and some cancers. Another strategy utilized in the education sessions was reference to the meal served at the senior center. Each meal is comprised of the recommended dietary intake for adults 50 and over and reinforced the need to include protein, fruits and vegetables, grain, and dairy at each meal. In addition, the sessions focused on the importance of physical activity to aid in maintaining and improving health. Research has shown that being active for 30 minutes per day, most days of the week can lower your risk for disease.

The Allen Foundation grant enabled distribution of the nutrition education article to be expanded to include Peninsula Volunteers, Inc. Little House Adult Activity Center, in addition to the monthly distribution to Meals on Wheels recipients. The nutrition education article topics included: “Water and Hydration”; “Whole Grains”; “10 Reasons to Eat Fruits & Vegetables”; “Nutritional Facts About Pumpkins”; “Food Safety”; “Cranberries – Vitamin C”; “Good Nutrition”; “Heart Healthy Tips”; “Vitamin K and Greens”; “Calcium”; “Vitamin D”; and “Snacking Tips”. Each article provided nutrition information, including the Dietary Guidelines for Americans 2010 Dietary Reference Intakes (DRI) and food sources of the nutrient discussed.

Participant Feedback

The majority of education participants indicated the nutrition education was very useful and looked forward to the next session. Attendees at two centers are primarily Spanish speaking, presentations were translated and materials were offered in Spanish; they really appreciated the food examples being culturally sensitive. For instance, an example of a serving of whole grain is a six inch corn tortilla. Participants at every session reported the benefit of observing portion sizes; “the food models provided were very helpful”; “I didn’t understand serving size before.” A highlight of each session was the question and answer opportunity; attendees demonstrated their interest in the information and it provided a way to reinforce the nutrition message.

One story:

Mrs. AF is a 77 year old Tongan woman has several chronic conditions: Hypertension, high cholesterol, diabetes and osteoporosis. Mrs. AF’s recent follow-up visit was very encouraging; the doctor reported her blood pressure was normal and her blood sugar levels were within normal limits and reduced her medications. Mrs. AF attributes her success to the nutrition education she received each month. The three servings of fruit and vegetables daily, portion control, and whole grains and other high fiber foods are all supportive of heart health and controlling diabetes.

Expenditures

Research, planning, and implementing Nutrition Education Sessions & Articles - $7,200.00
Nutrition Education material costs - $2,800.00
TOTAL - $10,000.00

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Project Title: A Native American Nutrition Education Program for Type 2 Diabetes
Institution: Physicians Committee for Responsible Medicine
Date: 4/26/2012
Report:
With a grant of $20,000 from the Allen Foundation, Physicians Committee for Responsible Medicine (PCRM), provided education programs to health professionals and lay persons in Native American Communities in New Mexico and Arizona on how to prevent and control type 2 diabetes through the adoption of an ancestral, plant-based diet. In the course of this work, PCRM developed relationships with health care leaders within these communities that will help us take this program to the next level. We also developed a curriculum to support these programs and have made them available online at http://pcrm.org/health/diabetes-resources/.

PCRM conducted the following activities under this grant:

-Within the context of the Native Men’s and Women’s Wellness Conference, organized by the American Indian Institute (University of OK) in March 2011, PCRM conducted four meetings with eleven nutritionists and two service area supervisors from the Navajo Nation Special Diabetes Project office. The purpose of the meetings was to assess progress, build a common knowledge base, expand the repertoire of recipes, and establish working relationships. The conference was attended by more than 400 people, representing over 100 tribal communities. PCRM disseminated nutrition education materials, and hosted a screening of the movie Processed People for approximately 100 conference attendees. A highlight of PCRM’s involvement were two sponsored sessions featuring Native American chef Lois Ellen Frank, who demonstrated and served four traditional, meatless dishes for 200 people.

-Between June and August, 2011, six weekly classes were held at two sites: the Indian Pueblo Cultural Center in Albuquerque and the Institute for American Indian Arts in Santa Fe, New Mexico. Classes were taught by PCRM staff, local health care professionals, and Native American chefs. Attendance at each location ranged from 18-28 people for all classes. Attendees were provided with copies of the book, Dr. Neal Barnard’s Program for Reversing Diabetes, and a binder with recipes and handouts used in class. In addition, the revised curriculum was made available to the Navajo Nation Special Diabetes Program (NNSDP) staff, many of whom have gone on to implement it at chapter houses on the Navajo Reservation.

-On August 3, 2011, PCRM Director of Diabetes Education and Care, Caroline Trapp, MSN, APRN, BC-ADM, CDE, presented "Ancestral Diets for Modern Day Native Americans: Healing Diabetes, Reclaiming Health” with Lois Ellen Frank at the annual meeting of the American Association of Diabetes Educators.

-On August 16, 20II in Window Rock, Arizona, PCRM President, Dr. Neal Barnard, presented a community lecture on how a plant-based diet could prevent and heal diabetes, and distributed copies of his book, Dr. Neal Barnard’s Program for Reversing Diabetes. The program was organized in collaboration with the NNSDP.

PCRM had envisioned that by this date, we would have completed production of two DVDs – one for instructors; the other for the general public – on the benefits of a plant-based diet in diabetes control for Native Americans and guidance on how to transition to such a diet. Both DVDs are currently in production and we anticipate they will be ready for distribution by the fall of 2012. Monies designated for the production and distribution of these DVDs were used to develop a comprehensive curriculum (described in our proposal as a “booklet”), to support the education program. The task of creating the curriculum was more labor intensive than anticipated and by necessity, preceded the scripting of both videos since the curriculum determined their content. The curriculum can be viewed in its entirety at the website cited above. The goals of the class were to:

-Rediscover the foods of Native American Ancestors – who never had diabetes;
-Explore the latest research supporting plant-based nutrition for diabetes prevention and treatment;
-Taste healthy and delicious dishes and learn to prepare them at home; and
-Put new skills and knowledge into practice to prevent and heal diabetes.

Below, is the course outline (note that all classes include cooking demonstrations as well):

Food for Life: Healthy Native American Cooking and Eating to Beat Diabetes

Class 1: A Reason for Hope
-Research Explores A New Approach to Diet
-The Power Plate

Class 2: New Recipes with Commodities and the Three Sisters
-All About Fiber
-Major Effects of Eating Animal Fat and Protein
-Benefits of Beans

Class 3: Cooking Grains, the Staff of Life
-Complete Nutrition for Strong, Healthy Bodies

Class 4: Grocery Store Tour

Class 5: Stocking Up: Canning/Freezing/Drying and Sprouting
-Handling Tricky Situations
-Stocking the Kitchen

Class 6: Holidays and Feast Days, Healthy Families and Graduation
-Makeover Favorite Recipes
-Breaking Free from Problem Foods

Expenditures:

Two Native Ancestral cooking demos (200 people) $3,000
Dr. Neal Barnard’s Program for Reversing Diabetes (60 copies) $480
Postage $177
Catering costs and space rental for 12 classes $7,200
Class handouts $150
Room rental – Window Rock event $600
Handouts – Window Rock event $200
Advertising – Window Rock event $500
Personnel costs (Caroline Trapp, Director of Diabetes Education and Care) $7,693
TOTAL: $20,000

Support from the Allen Foundation has made it possible for PCRM to establish a solid foundation of experience as well as lasting relationships that will facilitate our future work in Indian country. We are deeply grateful for your generosity. It has opened minds and doors, and set hundreds of people on the path to better health.

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Project Title: Nutrition Education Curriculum for the Parents as Teachers Program
Institution: Weller Health Education Center
Date: 4/19/2012
Report:
Project Background
The Weller Health Education Center received a $9600 grant from the Allen Foundation for the creation of a nutrition education curriculum, train-the-trainer sessions, and educational presentations for the Parents as Teachers Program (PAT) at the Marvine Family Center, located in Bethlehem, PA. Unfortunately, due to unexpected funding cuts, the Marvine Family Center was closed and the Weller Health Education Center had decided to continue the project with another interested party, the Pottstown Family Center located in Pottstown, PA.

Given the change in venue, the creation of the curriculum and corresponding activities began in late July 2011. The Weller Health Education Center had worked closely with the Pottstown Parents as Teachers Program Directors to ensure that we were going to create a curriculum that met the needs of their program and of their clientele. At that time, two new employees to our organization who have public health / health education backgrounds had joined the Weller team and had been assigned the task of putting together the comprehensive curriculum for the Pottstown Family Center.

The Weller Health Education Center (WHEC) had decided upon a 12-unit curriculum that can be given to low-income parents over the course of several months during their regularly scheduled in-home visits by trained counselors. Each lesson would last only 15 minutes, and included instruction, activities, homework, and handouts. Examples of lesson plans include: General Nutrition, Food Allergies, Food Safety, Including Children in Meal Preparation, Picky Eaters and Food Battles, Eating Healthy on a Budget, and Meal Planning & Food Shopping. In addition to exposure to this comprehensive curriculum, a health educator from our organization provided a 30-minute program on “Picky Eaters” to the participating clients themselves at their scheduled parenting class on March 28, 2012. One additional presentation is scheduled for May 16th on the same subject to the new cohort of clientele.

Before the implementation of the curriculum itself in February 2012, the counselors were provided a 90-minute train-the-trainer workshop on how to implement the curriculum and facilitate all of the corresponding evaluation tools that would be used by Weller staff to evaluate knowledge gain and intent to change behaviors, in addition to several process evaluation questions regarding the curriculum overall. Each counselor was given an entire copy of the curriculum and 5 copies of each handout and evaluation assessment. An implementation agenda was also included for their reference, so that they knew which lessons to teach and what assessments needed to be completed. Because of the late start, WHEC had decided to “stagger” the start of the lessons, so that we could receive adequate data from the assessments in order to provide detailed results on this final progress report. The Pottstown Family Center is still in the process of implementing these lesson plans, and collecting data, so that we can continue to pilot-test our curriculum.

Evaluation Methods
The Weller Health Education Center performed a project evaluation on the curriculum component of Pottstown Family Center Nutrition Program in an effort to pilot-test this educational resource. The following narrative describes our evaluation methods in further detail.
Process Evaluation: There is some process evaluation data that was gathered from the counselors through paper surveys. Particularly, counselors were asked to “grade” the various procedures and tasks of each lesson plan, in addition to assessing how they perceive their clients were affected by the implementation of this project. Each counselor was to fill out an evaluation form for every three lessons taught. They were to complete the assessment one time, once all of their assigned clients had received each of these lessons.
Outcome Evaluation: The outcome evaluation for this project focused on the knowledge and attitude changes that have occurred due, in part, by the implementation of the nutrition curriculum. Each client was / will be asked to complete the following assessments: Pre-test, Lessons 1 – 3 Assessment, Lessons 4 – 6 Assessment, Lessons 7 – 9 Assessment, Lessons 10 – 12 Assessment, and Post-test. The purpose of assessing the client every three lessons was to two-pronged. It allowed us to collect more comprehensive data for the purposes of this evaluation, and it also enabled us to gather more qualitative data regarding individual lesson plans while it was still fresh in their mind. No matter where the counselor had begun within the 12-unit curriculum, each client was asked to complete a pre-test on their first visit (when the curriculum was being introduced to the client), and then they were asked to complete assessments every three lessons. The post-test is to be given the week after all lessons have been given to the individual clients.

Evaluation Results
The following narrative highlights the results of our comprehensive evaluation methods:
• 89% of the curriculum components were given a score of “A” or “B” by the counselors who had implemented the lessons.
• 100% of the counselors felt as if the material was relevant to their client’s life and that they were able to “comprehend most things” presented to them.
• Demographics of the population served include:
o 66% of the clients were between the ages of 26 – 40;
o Nearly 44% of this population were either unable to work, or have been out of work for a period of time (more than and less than 1 year);
o 31% of the clientele had not graduated high school, whereas 25% of the clientele had some college or is a college graduate;
o 65% of the population is either married or a member of an unmarried couple. Only 10% described themselves as either separated or divorced;
o 84% of the clients have at least one child under the age of 5, 41% have at least one child between the ages of 5 – 12, and 6% have at least one teenager.
• The average score for the knowledge-based questions on the pre-test was 63%. The average score for the post-test have not been analyzed yet because we have not yet received them from the Pottstown Family Center. An increase in knowledge gain is apparent for 100% of the questions asked on the pre-test and again on the quarterly assessments at this point in time.
• On the pre-test, 41% of respondents assert that they are Unlikely or Very Unlikely to look at a Nutrition Facts Label when choosing foods to purchase or eat; 22% are Unlikely or Very Unlikely to purchase whole foods for their children; and a half of all respondents to date report that they are Unlikely or Very Unlikely to get the recommended amount of exercise. These indicators are asked again on the post-test to determine if any behavior change intent can be inferred. As stated above, this information will be analyzed once we receive the post-tests from the counselors in mid-May 2012.

Budget Summary
Total funding for the PAT nutrition education program was $9,600. Weller spent $9,649.02 to create the curriculum materials, implement and conduct the PAT training sessions and evaluate the project’s impact.

The following costs were incurred:
Salaries and Benefits: $7,673.86 for 325 hours of staff time to create course materials, attend training sessions and evaluate the process and outcomes
Travel: $180.70 for travel to meetings and PAT training sessions in Pottstown
Printing: $132.30 for copies of lesson plans and support materials
Supplies: $53.99 for laminating sheets for binders
Indirect Costs: $1,608.17 for administrative overhead

Conclusion
In conclusion, the Weller Health Education Center was very grateful to have the support of the Allen Foundation in providing the means to create and implement this curriculum. The staff at the Pottstown Family Center have be extremely enthusiastic about the project, and felt that it has made an impact in their clientele overall. We will be making some alterations to the lessons for the Pottstown Family Center so that the curriculum best matches their program and can be implemented for many years to come.

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Project Title: Folate, B-Vitamins and Reduced Risk of Autism Spectrum Disorders: Prospective Examination of an Association and Mechanisms
Institution: University of California, Davis
Date: 3/9/2012
Report:
The Allen Foundation generously funded our project to prospectively collect data on B-vitamin intake, genotypes, and metabolic profiles of a group of pregnant mothers at high risk for a second child with autism in the MARBLES Study. Presently, there are 215 women actively enrolled in the study, including 165 who have delivered, and over 100 children have completed their 24 or 36 month assessments, and 8 have been diagnosed with ASD. Another 135 children have completed their 12-month visit. Plasma stored in sodium citrate tubes and urine is available for these women at multiple time points and will be used for measurement of homocysteine and cysteine. We completed validation of measurement of homocysteine in urine samples. We selected 432 serum and 422 plasma samples and have measured serum folate, total B12, and vitamin B6 for 127 mothers and 19 children from multiple time-points, including before pregnancy, during each trimester of pregnancy, and for the children until 6 months of age. We also have quantified nutrient measures from 184 food frequency questionnaires. We have begun correlating these measures with intermediate developmental assessment scores and autism diagnosis; analyses are ongoing.
Progress made to date by each objective:

Progress to Date on Objective 1:

1. Characterize maternal periconceptional dietary and supplemental vitamin intake in families at high risk for delivering a child with AU/ASD. Determine whether maternal folate and B-vitamin intake is associated with altered metabolic profiles of the mother and child, and/or later developmental and behavioral outcomes, including those related to AU/ASD, in the index child.

We sent two batches of Block Food Frequency Questionnaire (FFQ) to NutritionQuest for nutrient analysis as planned and have received the nutrient data for 184 FFQs which have been cleaned and linked to other information, including blood metabolite measures and neurodevelopmental assessment scores. We have begun descriptive analyses and early examination of associations between measures. We found good correlation between folate supplement use during the second half of pregnancy, and serum folate levels during the 3rd trimester and at delivery (r sqr=.56, p=.002 and r sqr=.69, p=.003, respectively). Similarly, correlations between total B12, and PLP (vitamin B6) metabolites and FFQ amounts were correlated.
Very preliminary analysis of FFQ data showed that dietary folate equivalents were non-significantly lower in the children diagnosed with autism than others, but we are waiting for more children to reach diagnoses age to 36 months, since the 24 month diagnoses have been shown to be unreliable, often changing at the 36 month assessment.

Progress to Date on Objective 2:

2. Determine B vitamin metabolic profiles of mothers and index children and whether these metabolic profiles influence risk of AU/ASD in the index child

We are completed with serum folate, total vitamin B12, vitamin B6 (PLP) and homocysteine metabolite analysis. We postponed HoloTC measurement in anticipation of Dr. Miller’s laboratory developing a modified method that uses half the sample volume required for the current method, and we want to conserve sample if possible. Instead, we developed a collaboration with Marie Caudill at Cornell who measured choline and betaine metabolites. These measures have been linked to FFQ, genotype, and neurodevelopmental outcomes data and preliminary analyses were conducted; however, because appropriate samples were not obtained for the first year of the study, there are too few children with these measurements available that have reached either 24 or 36 month assessments. We will continue these analyses when a larger number of children have aged to 36 months.

Progress to Date on Objective 3:

3. Examine maternal and child gene-environment interaction effects between maternal folate and B-vitamin intake and genes in the transmethylation and transsulfuration pathways for altered metabolic profiles and/or AU/ASD diagnosis/symptoms.

We genotyped MTHFR, TCN2, MTRR, and COMT 472G>A. We will examine the association of these genotypes in relation to the metabolite levels, and with neurodevelopmental outcomes in the children as they age.

Budget Expenditures to Date:
Budget Expenses to Date Balance
Personnel Total Salaries,
Wages, Benefits $28,927.00 $30,032.68 $-1105.68
Other Direct Costs $38,290.00 $36,544.29 $1745.71
Total direct costs $67,217.00 $66,576.97 $640.03
Indirect Costs @ 15% $10,083.00 $ 9,986.54 $ 96.46
Total Costs $77,300.00 $76,563.51 $736.49


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Project Title: Passport to Healthy Living
Institution: Episcopal Social Services of New York, Inc.
Date: 12/28/2011
Report:
Episcopal Social Services
Mid-Year Report to the Allen Foundation
Grant of $23,350 for the Passport to Healthy Living Program
December 28, 2011

The Allen Foundation's grant of $23,350, received June 2011, has enabled Episcopal Social Services (ESS) to provide eighty culturally diverse families and their young children served by ESS' Early Head Start (EHS) Program with comprehensive health education tools to combat obesity, and promote good nutrition and exercise as a way of life. With the help of this generous support, families are being educated in the causes and consequences of childhood obesity as well as strategies to reduce the risk of unhealthy nutrition choices.

In June 2011, ESS also partnered with New York City Department of Health's Health Bucks Program for complementary nutrition education. NYC DOH awarded ESS EHS with $500 worth of Health Bucks to be divided amongst the 80 families covered under the Passport to Healthy Living Program. Each health buck voucher equals $2 that can be redeemed for fresh and affordable fruits and vegetables at participating farmers' markets. Families are able to earn additional vouchers with every $5 spent in EBT as well as upon completion of a Stellar Farmers' Market workshop such as cooking demonstrations and recipe tastings.

Strategy Update
Staff
• EHS staff attended the Nutrition Training on NYC Food Standards for Group Child Care Services; teachers gained knowledge on purchasing food, reading nutrition labels, and meal snack preparations to ensure that children are eating a healthy balanced diet.
• The nutrition consultant has drafted the pre-test, post-test, and survey program assessments to determine parents’ approach towards healthy living and to verify measurements of change throughout the program. These assessments will undergo continuous evaluation to improve the quality of each workshop series.
• EHS is awaiting approval for five Healthy Living consultants in the following areas: Mental Health, Education, Physical Fitness, Lactation, and Medical.

Family Involvement
• A total of five farmers' market visits took place every two weeks during the summer.
• Families attended three cooking demonstrations, received healthy recipes, nutrition handouts, and food safety tips.
• Families attended three scheduled workshops thus far on Nutrition, Mental Health, and Exercise including: Introduction and Overview on What Is Obesity, Parent/Child Food Relationships, and Zumba fitness for parents.

A few client successes:
• A young mother of four says that going to the Farmer’s Market opened her eyes to different opportunities to save money and eat healthier. Now, her children are keeping her on her toes when they ask if she bought the fruits and veggies from the Farmer’s Market.
• A mother of three with two of her children enrolled in the EHS program says that the tips offered at the Farmer’s Market have improved her family’s eating habits. According to her, the Passport to Healthy Living Program has given her family choices that they never had before.
• A single mother of a three-year old son, currently interning at ESS' EHS program, says that the Farmer’s Market cooking classes offered many recipes and valuable cooking tips in preparing food that she would not have thought of otherwise.
• A mother of two, including a newborn son, says that the Passport to Healthy Living program has enriched her family’s life by positively changing eating habits and learning to choose healthy and affordable meal options. She also mentioned that visiting the Farmer’s Market was a great experience that they'll never forget.

Given our ongoing success, ESS will continue to seek funds this fiscal year for nutrition education and would be very grateful for the opportunity to partner with the Allen Foundation once again.

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Project Title: Ypsilanti Health Initiative
Institution: University of Michigan
Date: 12/20/2011
Report:
Receiving funding from the Allen Foundation has ensured the continued operation and expansion of the Ypsilanti Health Initiative. The Ypsilanti Health Initiative (YHI) works to make healthy living more affordable and more accessible to lower-income families in Ypsilanti. Our three-part program includes
1. health education
2. exercise
3. incentivized grocery shopping.
Our goals are to offset the high costs of healthy groceries, improve health awareness, offer alternatives to fast and fatty foods, and increase physical activity levels.

Impact

The program has the largest impact on the seniors at the Ypsilanti Town Center, as the food coupons they get to the Ypsilanti Food co-op help them afford fresh, healthy food. Many have expressed that, without the vouchers, fresh produce would not be a daily option. Further, the co-op provides an excellent alternative to nearby convenience stores that lack fresh options.

Both seniors and students have gained a great deal of health-related knowledge from their participation in the program. We have covered cardiovascular health (a lesson that included a visit from a local cardiologist), mental health, and a variety of health eating topics. Each lesson includes a snack (some include a full meal), and each lesson includes the opportunity for seniors and students to work together to learn the material presented. Often lessons include time for students and seniors to prepare the snack together, allowing for casual conversation and friendship building. Both students and seniors express their delight in having someone to talk to for an hour each Saturday.

Both groups have changed as a result of the program; students and seniors have both expressed a commitment to live a healthier lifestyle in whatever ways they best see fit. For many, this means engaging in healthier eating. Many seniors have gained new exercise ideas from the weekly newsletters that we publish, and some report having lost weight over the course of the program.

Changes

The biggest change to our objectives over the course of the program was, at the recommendation of the program evaluation, to include more protein-rich recipes, as we noted that many seniors reported eating much less that the recommended daily serving of protein. We have also endeavored to include more exercises that feel safe to seniors with arthritis or low flexibility. To this extent we have included chair yoga poses, sitting stretches, and mental exercises in our program curriculum, all of which have been warmly received by program participants.

Both of these changes were made mid-year after conducting our annual evaluation. This speaks to the efficacy of our mid-year survey instrument in assessing the strengths and weaknesses of the program. We also found that 35% of all program participants purchased food from the Ypsilanti Food Co-op using the food vouchers that we provide. We have made it our goal to increase the utilization of the food supplements that we provide, and we are looking into different methods of disbursing food vouchers.

Results

We tend to see the results of our work after each nutrition session in the smiles of the senior participants at the Town Center. We offer 7 health sessions per semester, which are attended by between 10 and 20 senior participants. To assess the extent to which our participants view exercise and healthy eating as part of their identities, we administered a survey at the end of the 2010-2011 academic year.

Amongst the seniors sampled (n = 10), the majority found physical exercise important to their identities, with just one senior slightly disagreeing. The majority also found healthy eating important to their identities, with none expressing disagreement. Results for the other two questions were mixed, indicating that some felt more strongly about physical exercise and healthy eating than others. Regardless, the vast majority of survey respondents found healthy eating and physical exercise important to their identities.
To us, this indicates that our weekly seminars are well received. Our volunteers are also very pleased with the work that we do:
“This is my first year with the Ypsilanti Health Initiative, but I am very excited to be involved as a volunteer. I have always wanted to become a physician and have had an interest in medicine and health since I can remember, but my passion for public health disparities and inequalities has blossomed over the past year and a half. I am passionate about helping people and believe that it is important for more youth and people living within the community to get involved and make a change. I have learned so much from the residents of the Towne Center and will continue to come each week with an open mind and a mind to serve!”—Jasmine Calhoun, YHI volunteer

“Growing up, my family had a lot of health related issues that were very preventable through diet, exercise and proper health education; yet we never had adequate education to improve health. I saw myself heading down the same path as my family. That is why I am interested in YHI because it gives me a chance to interact one on one with amazing people that are so diverse. We get to share a learning experience and become close through the process. It puts a giant smile on my face to witness something such as YHI making a difference in people’s lives and that is why I love being a part of it!”—Jensen Allen, YHI volunteer

Challenges

One of our biggest challenges was maintaining consistent attendance amongst senior participants. After we had just 8 senior participants during one weekend session, we began to hand deliver invitations to our list of interested seniors. This dramatically improved attendance, especially when we advertised that a meal would be provided. We expect to continue delivering invitations to seniors, as many participants expressed their appreciation of receiving hand-delivered invitations.

Moving Forward

With grant funding from the Allen Foundation for the 2011-2012 academic year, we will continue our health sessions at the Ypsilanti Town Center. We have purchased cookware, which will allow us to expand our healthy cooking sessions, and we are working on re-tooling the food voucher system in order to reach more of our participants. We look forward to the year ahead.

Expenditures

Grocery reimbursements and healthy lunches, $3,000
Health workshops, material costs, $1,348
Indirect costs, $652
TOTAL, $5,000

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Project Title: Folate, B-Vitamins and Reduced Risk of Autism Spectrum Disorders: Prospective Examination of an Association and Mechanisms
Institution: University of California Davis
Date: 10/2/2011
Report:
The Allen Foundation generously funded our project to prospectively collect data on B-vitamin intake, genotypes, and metabolic profiles of a group of pregnant mothers at high risk for a second child with autism in the MARBLES Study. Presently, there are 215 women actively enrolled in the study, including 165 who have delivered, and over 100 children have completed their 24 or 36 month assessments, and 8 have been diagnosed with ASD. Another 135 children have completed their 12-month visit. Plasma stored in sodium citrate tubes and urine is available for these women at multiple time points and will be used for measurement of homocysteine and cysteine. We completed validation of measurement of homocysteine in urine samples. We selected 432 serum and 422 plasma samples and have measured serum folate, total B12, and vitamin B6 for 127 mothers and 19 children from multiple time-points, including before pregnancy, during each trimester of pregnancy, and for the children until 6 months of age. We also have quantified nutrient measures from 184 food frequency questionnaires. We will be correlating these measures with intermediate developmental assessment scores and autism diagnosis over the next few months.
Progress made to date by each objective:

Progress to Date on Objective 1:

1. Characterize maternal periconceptional dietary and supplemental vitamin intake in families at high risk for delivering a child with AU/ASD. Determine whether maternal folate and B-vitamin intake is associated with altered metabolic profiles of the mother and child, and/or later developmental and behavioral outcomes, including those related to AU/ASD, in the index child.

We have sent our second of two batches of Block Food Frequency Questionnaire (FFQ) to NutritionQuest for nutrient analysis as planned last month and have received the nutrient data for 184 FFQs which we are now cleaning and linking to other information. We have obtained the neurodevelopmental assessments and have begun initial descriptive analyses. Very preliminary analysis of FFQ data showed that dietary folate equivalents were non-significantly lower in the children diagnosed with autism than others.

Progress to Date on Objective 2:

2. Determine B vitamin metabolic profiles of mothers and index children and whether these metabolic profiles influence risk of AU/ASD in the index child

We are completed with serum folate, total vitamin B12, and vitamin B6 (PLP) metabolite analysis. We have been holding off on measuring HoloTC because Dr. Miller’s lab is working on a modification in methods that will allow us to use half the current sample volume needed, and we want to conserve sample if possible. Homocysteine should be measured by the end of this month.

Progress to Date on Objective 3:

3. Examine maternal and child gene-environment interaction effects between maternal folate and B-vitamin intake and genes in the transmethylation and transsulfuration pathways for altered metabolic profiles and/or AU/ASD diagnosis/symptoms.

We have genotyped MTHFR, TCN2, MTRR, MTR, and COMT 472G>A. Genotyping is ongoing and should be completed in the next couple of months.

Budget Expenditures to Date:
Budget Expenses to Date Balance
Personnel
Irva Hertz-Picciotto, PI
Rebecca Schmidt, Co-PI $10,920 $ 6,085.71 $ 4,834.29
Lab Tech $15,400 $ 9,754.65 $ 5,645.35
Programmer $ 2,607 $ 1,240.17 $ 1,366.83
Total Salaries, Wages, Benefits $28,927.00 $17,080.53 $11,846.47
Other Direct Costs
Metabolite analyses (supplies and analysis) $29,090.00 $ 8067.00 $21,023.00
NutritionQuest Block FFQ Analysis $ 4,200.00 $ 831.33 $ 3,368.67
Genotyping (assays, reagents, supplies) $ 5,000.00 $ 2,102.33 $ 2,097.67
Total direct costs $67,217.00 $28,081.19 $39,135.81
Indirect Costs @ 15% $10,083.00 $ 3,089.47 $ 6,993.53
Total Costs $77,300.00 $31,170.66 $46,129.34


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Project Title: Foods For Health: Meat Patty with Added Legumes
Institution: Louisana State University Agricultural Center
Date: 8/21/2011
Report:
Initial plan for the program was to feed children conventional foods where some of the meat was
substituted with beans. The plan was to provide chicken nuggets, hamburgers, lasagna, sloppy Joes etc.
The logistics of feeding children in the school environment became staggering. As a result we conducted
two rounds of "sensory" testing with children (elementary and middle school). In addition we designed
a study using adults with preliminary indicators of metabolic syndrome.

The middle school results with 50 children indicated a general acceptance of the hamburgers however
they indicated a lack of flavor. We therefore increased the flavor intensity. This summer we fed 75 third
and fourth graders hamburgers in for preference and difference testing. When asked for a preference
he students showed a slight preference for control product when asked which was better. However
when presented a triangle test to see if they could tell the difference between test and control they
could not tell the difference.

The study this summer resulted in 5 reports of adverse effects. Five students complained of stomach
aches a few hours after eating the hamburgers. The parents were contacted within 24 hours and the
students were all fine. It appeared that the discomfort was from gas. It is interesting to note that the
children with complaints had had No vegetables or fruit for the previous 24 hours. This clearly indicates
that addition of bean foods into the population must be done in small increments so that the microflora
in the subjects have time to adjust.

In the adult clinical previously described the in life phase has been initiated. The study is a double
blind placebo controlled crossover study with 100 subjects. Subjects will receive foods for 16 weeks on
each leg of the study. Final biomarkers are blood lipid profile, body fat/lean ratio, body weight, waist
circumference and a battery of tests for inflammation. Fecal samples ill be collected at the beginning
and end of each leg of the study and pH and short chain fatty acid profiles will be measured as indicators
of colonic fermentation.

Food preparation logistics for the study have involved some difficult logistics. The subjects will be
provide seven different entrées each week in addition to seven hand held snacks. The meals are all
designed for microwave reheating and include hamburger with bun, sloppy Joe with bun, Spaghetti,
lasagne, chicken nuggets and enchilada pie. The snacks include frozen yogurt, candy bar, bagel and
cream cheese, muffin, cookie, brownie and granola bar. All samples will deliver one portion of beans
per serving. We have prepared 1600 control and 1600 test of each food. The samples are divided
into boxes that contain a two week supply of food which will be collected on biweekly visits by the
subjects. Some foods such as yogurt and bagels will be prepared periodically during the study to assure
quality and freshness. We had to purchase a free standing 40 foot frozen storage container to hold the
products.

In each 16 week leg the subjects will be told to eat one half serving/day for the first week, one/day for
the second week, 1 and one half for the third week and 2/day for the remainder of the study. This will allow the time for the microflora to adjust.

Subject recruiting is ongoing. The first subjects will go on the diets the Week of August 22.

It should be noted that that this project was initially supported by the USDA through earmark funds. We
received an initial funding of $ 250,000 for the first year of the study. Changes in Congress have resulted
in our not receiving funding for the last two years of the study. As a result all testing for inflammation
markers and blood chemistry markers is on hold until we obtain additional funding. All samples will
be held at -80c until we find resources to fund the analysis. We have been=fortunate up to this time
because several companies have provided services and supplies at severely discounted rates. Cajun
Kettle in New Orleans has provided blending for frozen entrées and is currently providing additional
frozen storage for ingredient and products. French Market Foods provided preparation of the frozen
entrees at cost of labor and also provided shipping at a discounted rate.

Budget Planned vs Actual

Budget

Actual

Personnel
Graduate assistants (2)

Supplies
Food and Food Ingredients

$ 32,000

$33,000

Catering supplies for testing children

Overhead @ 15% Total Direct Costs

6,000

1,800

5,970

7,500

300

5,970

Total Project Costs

$45,770

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Project Title: THE USE OF MILK IN FLOURS IN THE TREATMENT OF MODERATE MALNUTRITION
Institution: Washington University
Date: 5/11/2011
Report:
11-May-11

The trial was successfully conducted, with remarkable results! This is the first time a blended-flour has achieved comparable recovery rates to a ready-to-use food. The addition of milk and micronutrients to a blended flour has improved its nutrient quality such that moderately malnourished children recover satisfactorily. A summary of the work follows. Thank you very, very, very much for your support.

Mark Manary


Objective: To test the effectiveness of three supplementary foods in the treatment of moderate acute malnutrition (MAM).

Design: Prospective, randomised, investigator-blinded, controlled clinical effectiveness trial.

Setting: 18 rural sites in southern Malawi.

Participants: Children 6-59 months old with MAM, defined as weight-for-height Z-score (WHZ) between -2 and -3 without bipedal oedema.

Intervention: Children received approximately 75 kcal/kg/d (314 kJ/kg/d) of one of three supplementary food products in two week rations for outpatient therapy of MAM. Supplements were a novel, locally produced, fortified blended flour (corn-soya blend ++, “CSB++”), a locally produced soya ready-to-use-supplemental food (soya RUSF), or an imported soya/whey RUSF (Supplementary Plumpy ®). In addition to corn and soya flour, CSB++ contains 3% soya oil, 8% dried skimmed milk, 9% sugar, and concentrated minerals and vitamins.

Main outcome measures: Primary outcome measures included recovery from MAM (achieving WHZ ≥ -2 by 12 weeks) or failure (death, development of severe acute malnutrition, transfer to hospital for inpatient care, failure to recover from MAM by 12 weeks, default). Secondary outcome measures included rates of weight, height, and mid-upper arm circumference (MUAC) gain, time to graduation, and adverse effects from the supplementary foods. Chi-square and ANOVA analyses were used to compare outcomes between different food groups.

Results: 2712 children participated in the study. There were no reports of adverse reactions to any of the foods. The proportion of children who recovered was similar for all three supplementary foods: CSB++, 763/888 (86%); soya RUSF, 795/906 (88%); and soya/whey RUSF, 807/918 (88%) (p > 0.3). Mean duration of treatment required to achieve recovery was 23 days but children who received CSB++ required on average two additional days to recover (p < 0.003). Children who received soya/whey RUSF had a greater rate of weight gain compared to CSB++ (3.6 g/kg/d v. 3.1 g/kg/d, p < 0.0006), and a greater rate of MUAC gain compared to both CSB++ and soya RUSF (0.21 mm/d v. 0.13 mm/d and 0.13 mm/d, p < 0.0001). The mean length gain was 0.13 mm/d.

Conclusion: A novel, locally produced, fortified blended flour (CSB++), a locally produced soya RUSF, and an imported soya/whey RUSF, were all similarly effective in helping rural Malawian children recover from MAM. The recovery rate for CSB++ was higher than for traditional fortified blended flours in previous studies.

Trial registration number: ClinicalTrials.gov NCT00998517



$72,985 was received, 15% was taken by the university as overhead, the remainder was used for purchase of corn-soy-milk-blended flour and ready-to-use soy-peanut supplementary food for the trial. I am unable to paste a screen shot of the official Washington University balance sheet, but will e-mail it.





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Project Title: Expansion of Project Healthy Schools, Ypsilanti, MI, Middle Schools
Institution: University of Michigan
Date: 5/3/2011
Report:
This school year marks the 7th year that Project Healthy Schools (PHS) has been encouraging healthy habits in youth through education, environmental change and measurement. Our program is currently in 16 schools throughout Southeast Michigan including the public school districts of Ann Arbor, Ypsilanti, Owosso, Corunna, Ovid-Elsie, Perry, Royal Oak and Charter schools in Detroit. What distinguishes PHS from other similar programs are its evaluation results, significant community partnerships, and strong team of experts. In addition, the hands-on learning activities and socio-ecological model, which engages the entire school community in this effort, make it a very effective, sustainable approach to impacting children’s health.
The Allen Foundation Award to PHS benefits many children and their families by helping them to increase their healthy eating behaviors. We appreciate the flexibility of the Foundation in allowing a change in grant implementation due to a fundamental change in the Ypsilanti School District where it was restructured from two traditional middle schools, 6-8 grades (as written in the original grant) to one school, Ypsilanti Middle School. Our second school implementation is the two Charter Schools in Detroit, University Prep Academy and University Prep Science and Math Academy where Project Healthy Schools is already currently offering programming, but has had a limited Farm to School program.
Through our Allen Foundation partnership we have been able to provide for the Ypsilanti schools:

• Local produce on the hot lunch line and in the cafeteria with posters promoting the event.
• Produce bowls for the classroom breakfast program, which prior to this served only juice.
• Local produce days and Fun Food Fridays (featured produce with an ethnic theme).
• A parent event, “Cool Summer Snacks for Kids” which emphasized fruits and veggies including locally grown produce that is available in the summer.
• Survey of students in fall related to fruit and veggie consumption that will be repeated before school is out
• Assistance in starting a Farm to School committee in Ypsilanti which is meeting monthly and has members from the county health department, Growing Hope (local gardening group that runs a downtown farmer’s market that facilitates its usage by lower income families), PE-Nut representative (elementary healthy eating and physical activity program), FSEP (Food Systems Economic Program) representative, the Ypsilanti Schools food service director and PHS Wellness Coordinator.
.
• A new salad bar for Ypsilanti Middle School purchased by School Food service director who was influenced by many discussions with PHS about getting more fruits and veggies in front of the kids. The new salad bar handles more fruit and veggie choices so the students really are the winners.
• Coordination with the health teacher to include more lessons that emphasize increasing fruit and vegetable intake and provided a food preparation class where veggie loaded sauce was made and served to the students over spaghetti squash.
Through our Allen Foundation partnership we have been able to provide for two Detroit Charter schools:
• Biweekly samples of local produce and promotion of these sample days through table tents, fliers and information tables in the cafeteria
• Biweekly PHS sample food which incorporates produce, other healthy ingredients (such as whole grains) and preferably local items into the cafeteria meals. PHS staff is present to offer samples, educate, administer surveys on food preference (for long term incorporation into the menu), posters, fliers, and table tents.
• Monthly Fun Food Fridays (FFF). FFF highlight regional food in the US or world and always incorporates a nutritious item
• Applied and received the Whole Foods grant for a produce cart at UPSM middle school. This chilled 5 compartment cart will provide weekly salads for all middle school students at UPSM.
• All initiatives were offered to grades 6-8 at UPA and UPSM middle school

Farm to School Obstacles and Limiting Factors:
• No planning period included in the grant timeline to create a plan and policy for securing locally grown produce every month. Chartwells is the foodservice operator and they have a multitude of policies around using local produce making it difficult to achieve without a lot of planning and preparation. Coastal was the only vendor that the school foodservice dealt with and they have very limited year-round access to locally grown foods.
• The food service director in Ypsilanti is new and she inherited a lot of problems that took most of the year to straighten out. Her issues took precedence over grant related issues so we got off to a slower start but have managed to get in several events.
• We found that partnerships with farmers from Ypsilanti Farmers’ Market to donate left-over produce to a low-income families was not a viable idea in Ypsilanti since the market is early in the week and the farmers go to other markets the next day.
• New principal at Ypsilanti middle school was new to middle school and had different priorities than the previous principal had. It has been much harder to get her support.
• We’ve discovered lunch time isn’t a good time to do food demos. The kids don’t want to listen they want to talk to their friends so you cannot talk about making a healthy snack. Many are willing to try samples but don’t want to get involved in a ‘classroom’ type situation.
• Unable to coordinate fall farmer visits when farmers have more time due to short time frame. With Farm to School committee will have more resources in the spring.

With the support of the Allen Foundation our Farm to School (F2S) component has been clearly and comprehensively integrated with existing PHS nutrition education programming: Evaluations have included school-wide surveys of students concerning their consumption of and preferences for the specific fruits and vegetables added to school breakfasts and lunches; family surveys concerning access to and purchase and use of fresh produce; satisfaction assessments of the program activities; and food-service records of produce purchases and consumption. Our partnership was able to cover the addition of a Farm-to-School (F2S) component to an existing childhood obesity prevention program. Funds requested from the Allen Foundation have covered personnel costs for organizing and conducting F2S activities and some supportive supplies while all other expenses for the F2S component were covered by the schools' food budgets, the existing Project Healthy Schools program, the Food System Economic Partnership, or in-kind donations.

Over the last year, with the support of the Allen Foundation, PHS has shown that a school based educational program that integrates farm to school education can consistently lower students’ health risk indicators and increase their healthy lifestyle choices. We appreciate the generous support we have received and look forward to the continued growth of PHS to make a positive impact on the health of our youth.

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Project Title: Canned soup consumption and urinary bisphenol A
Institution: Brigham and Women's Hospital
Date: 4/29/2011
Report:
Allen Foundation Progress Report
4/22/2011

CANNED SOUP CONSUMPTION AND URINARY BISPHENOL A
Project ID 2009.301

We conducted a randomized, single-blinded, crossover trial in a population of 75 Harvard School of Public Health student and staff volunteers in 2010. Participants were randomly assigned to one of two groups. For each day of the first five-day study period, one group was assigned to consume one serving (approximately 12 ounces) of soup prepared from fresh ingredients between the hours of 12:15-2 pm; the other group was assigned to consume one serving of canned soup (12 ounces from 18.5 oz cans) according to the same schedule. After a two-day washout period, the treatment assignments were reversed for a second five-day period. Participants were not restricted in their consumption of other foods, canned or fresh. For each treatment, five different varieties of vegetarian tomato and non-tomato based soups were used each week (one a day), and repeated in the same order the following week. Urine donation took place between 3 and 6 pm on the fourth and fifth day of each study period. When two samples were obtained per week (54/75 participants each week), equal volumes of each sample were combined in order to reduce within-person variation; otherwise, a single sample was used. Samples were adjusted for urine dilution using specific gravity (15).

Participants ranged in age from 22 to 56 years, with a median of 27 years (Table 1). Sixty-eight percent (N=51) of the study population was female. Average compliance (percentage of days that a participant collected soup) ranged from 60% to 100%, but was high overall, with a median of 100%. BPA was detected in 77% (N=58) of samples collected during the week of fresh soup consumption and 100% (N=75) of samples collected during the week of canned soup consumption.

The geometric mean concentration of specific gravity adjusted BPA was 1.1 g/L (0.9 g/L unadjusted) following a week of fresh soup consumption and 20.9 g/L (17.5 g/L unadjusted) after a week of canned soup consumption. Stratification by treatment sequence revealed similar values, with the group receiving canned soup first having slightly lower values both weeks (Figure). Difference values (BPAcanned-BPAfresh) were normally distributed; therefore, we used a two-sample t-test to compare the difference in treatment effect between the two groups (i.e., period effect). In the absence of a period effect (p=0.30), we used paired t-tests to examine the association between treatment assignment and specific gravity-adjusted urinary BPA concentrations (i.e., treatment effect) (Table 2). Following canned soup consumption, specific gravity adjusted urinary BPA concentrations were, on average, 24.4 g/L higher (95% confidence interval (CI): 19.7 to 29.0) than those measured after a week of fresh soup consumption (p<0.0001), representing a 1085% increase.

Financial Expenditures
Total Awarded $32,676
Actual Expenses (as of 03/31/10) $7,082.32*

*Note: A revised financial report will be submitted once all outstanding expenses have been processed through June 30, 2011. We anticipate using the full amount awarded in support of the project through the end of the budget period. There will be additional salary and fringe and other expenses, including an invoice from the CDC for $18,362.76 (received in April) for the sample analysis. Total charges through June 30, 2011 will not be reflected in our system until the General Ledger reports are available (typically 10 business days after month end).



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Project Title: Berrien County Farmers Market Enhancement
Institution: Berrien County Health Department
Date: 4/28/2011
Report:
Funding from the Allen Foundation has allowed the Berrien County Health Department to greatly enhance the capacity of the Benton Harbor Farmers Market (formerly the Project FRESH Market) using increased marketing and outreach and purchasing supplies.

Items specifically purchased using Allen Foundation funding included:

• Large banner and yard signs to advertise the market. ($500)
• Newspaper and radio advertising. ($2,200)
• Supplies including flip chart, click counter, and markers (for evaluation and tracking numbers) and some printing. ($337)
• Two tents for staff to sit under to take EBT benefits and provide nutrition education and give samples. ($625)
• Staff to oversee market operation and process Project FRESH and EBT benefits ($3,148).

The banner was hung at the entrance to the market to advertise that it accepts Project FRESH and EBT benefits and to draw attention during market operations. Tents are also set up at the market and provide a convenient shaded area for customers to redeem their benefits and for staff to provide free samples of produce available at the market. Other supplies such as a “clicker” counter and paper were used to count the number of attendees each market day for evaluation purposes. This will be done for all subsequent years of the market to determine trends in attendance.

Yard signs have been placed on streets surrounding the market to draw potential customers in. Many signs are placed on heavily traveled routes in residential and commercial areas. Newspaper advertising was chosen in a small local newspaper that is commonly read by residents in the City of Benton Harbor. After many advertising spaces were purchased in this paper, the editor also invited our staff to write a guest column focusing on the importance of eating fresh, local fruits and vegetables. This was an added benefit to the project that allowed for some mass education. Radio advertising was done on one of the most popular stations in the area. BCHD staff wrote the wording and it was read by a popular DJ in the morning on market days to promote attendance.

The market began as scheduled in July 2010 and ran through September. A new location was secured for the market at a park in downtown Benton Harbor that has parking as well as sidewalks to allow for pedestrian and bike traffic to easily access the market. Attendance at the market in the 2010 season included approximately 1,381 customers, with an average daily attendance of 85 “paying parties” (i.e. a family only counted as one). There were six regular vendors at the market all season, bringing in a total Project FRESH reimbursement of $1,500 and cash sales exceeding $4,300.

In preparation for the 2011 season, BCHD has also secured an EBT machine and “tokens” to be used as Market Money in exchange for SNAP benefits scanned on our machine. All procedures are in place to begin accepting EBT benefits next market season.

Allen Foundation funding to enhance market capacity has also played an important role in leveraging funding from other sources to sustain market activities in the future. Specifically, BCHD was awarded funding from the Michigan Farmers Market Food Assistance Partnership to purchase an EBT machine and tokens. Also, BCHD was awarded a grant from the USDA Farmers Market Promotion Program which will fund more advertising efforts in the 2011 season and increased staff to oversee operations and do community outreach.

The Berrien County Health Department would like to extend our gratitude again to the Allen Foundation for their generous support of the Benton Harbor Farmers Market, which has allowed us to provide a source of fresh, local produce sold by small farmers in an area comprised of many low-income residents who lack access to fresh food. The capacity built with the assistance of this funding has paved the way for years of future successful operation of the market.

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Project Title: Kids Cafe Nutrition Education
Institution: Central Pennsylvania Food Bank
Date: 4/27/2011
Report:
The Central Pennsylvania Food Bank received a $10,000 grant from the Allen Foundation for its Kids Cafe after-school study and meal program. Grant funds were used to contract with Carol H. Gilbert Consulting to provide nutrition education and wellness classes to 200 children, ages 6-17, at 11 Kids Cafe locations in Dauphin, Cumberland, Lebanon, and Lancaster Counties. Carol Gilbert, President, has a B.S. Foods and Nutrition; M. Ed. Training and Development, and 25 years experience in school food service, student education, and adult education.

Classes began in December 2010 following the curriculum we provided in our grant proposal. All instructors have food service and/or nutrition education backgrounds. Each seven-week class was scheduled to take place within a maximum of 10 weeks, however the winter weather did cause some sessions to be rescheduled resulting in longer training segments. Classes were provided by the same instructor during each training segment for continuity.

Learning objectives were established for each lesson. A combination of nutrition education, food tasting, and physical education were provided during each class. A pre-test was conducted during the first class where basic nutrition questions were posed to the students. Additional mini-quizzes and supplemental handouts were provided to participants during each class. A post-test was provided to students at the end of the seven-week course to ascertain the percentage of change in learning and retention of materials.

Based on answers to the pre- and post-tests, there was an increased level of knowledge across the board at most locations. The most noticeable improvements were in the examples of fruits and vegetables and knowledge of whole grains. Even though some of the sites already provide some basics of nutrition education, most of the students were excited about our classes and enjoyed participating in the group discussions. As is the case with most children and teens, the physical activities and snacks were preferred over the lessons.

Each participant was encouraged to take ‘two bites’ of each snack. One expects younger students to be wary of trying new foods but the biggest surprise was the unwillingness of the older children to sample new things. Overall, however, most were willing to participate.

One of the more interesting tasting activities included healthy brownies. To increase fiber and reduce fat, ground black beans were used in place of the oil, water and egg. Students were quite surprised by this modification and were generally pleased with the taste of the black bean brownies. The second most popular snack was the top your own fruit and yogurt parfait.

Internally, we have learned some lessons that will help us further refine nutrition education and wellness classes for low-income children:
• Teenagers benefit more from hands-on food prep integrated with nutrition education.
• Some children require additional assistance with activities involving writing.
• Older children are more interested in the physical activity component of the class.
• Lessons provided at sites where multiple age levels participate are more difficult.
• A more challenging curriculum will need to be developed for the site that benefits from other basic nutrition education efforts. Although modifications to the lessons and food demonstrations were made, future work with students at this facility should focus on advanced nutrition knowledge.
• We were able to utilize the kitchen at the Salvation Army which allowed additional training in preparation and/or cooking of healthy snacks. The lessons were also made more complex to build upon what the students were already learning on a regular basis.

Budget Summary:
Food $ 1,930
Supplies $ 2,110
Instructor Fees (76 classes) $ 5,460
Administration $ 500
Total $10,000

In summary, we were very grateful to have the support of the Allen Foundation to provide nutrition education and wellness programming for under-privileged children. The staff at each location were very appreciative of the added benefit the grant provided for their children. And the children were enthusiastic and showed weekly progress in nutrition education and enjoyed the exercise components. As a take-away, each child received a recipe book that included the healthy foods they had prepared and tasted to encourage preparation of some of the sample foods in their own home settings.

Thank you for your support!



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Project Title: Nutrition 2.0: Nutrition Education for Parents, Caregivers and Practitioners of Children with Disabilities and Special Needs
Institution: Easter Seals Florida, Inc.
Date: 4/15/2011
Report:
With the assistance of the Allen Foundation, Easter Seals Florida (ESF) created and implemented a nutrition program (Nutrition 2.0) that provides education to children, families and professionals relating to children with special needs and disabilities. The project launched in June 2010 and will continue to operate and provide resources and services past the grant cycle throughout the communities in which we serve across the State of Florida.
There were many components to the implementation and success of this program.
A nutritional consultant was hired in February 2011 and has been working in collaboration with ESF’s Vice President of Programs/Program Lead to develop and disseminate the nutritional curriculum. The curriculum contains lesson plans for weekly activities relating to nutrition, and have been implemented in and incorporated into coursework in classrooms at six Child Development Centers in Tampa and West Palm Beach, Florida serving children both typically developing and with special needs and disabilities ages 0-5. Curriculum incorporation and utilization is overseen by the Center Directors and/or Curriculum Specialists in all Centers. Lesson plans will impact the education of 150 children in these Centers. The curriculum will also be shared with partner organizations serving the 0-5 age group in other child development and early learning centers across all ESF served territories in our usual collaborative manner. The potential utilization is hundreds of children in counties across the State of Florida and will extend into years of increased nutritional education and positive outcomes.
Regarding staff training, three professional development workshops have been held to date, with a final session planned for May 2011. Within these four trainings, sixty-two (62) Child Development Center Staff, eleven (11) Therapists and Early Interventionists will have been trained (ranging from4-40 hours of training) on the nutritional curriculum and implementation, nutritional best practices for children with special needs, and working with families and caregivers.
Community education was a large part of this project. Parent training sessions are scheduled in West Palm Beach and Tampa in April and May, and through our Family Resources Project (serving the five counties of Southwest Florida) in the months of May and June, in which parents will receive education and resources regarding nutritional information for their special needs child. We also developed three education brochures addressing “Feeding Issues for Children with Disabilities”, “Healthy Eating and Weight Management for Young Children” and “Nutrition Needs and Eating Behaviors of Young Children” that have been developed with assistance from our Nutritional Consultant, and are currently pending publication from the printers. The printing will be competed before May 30th at which point they will be disseminated to families through our staff at our Child Development Centers, Resource and Referral services, Therapy and Early Steps programs in Palm Beach, Hillsborough, Lee, Collier, Charlotte, Indian River, St. Lucie, Okeechobee and Martin Counties. We will also be sharing the information with the Children’s Services Council of Palm Beach County and the Children’s Board in Hillsborough County to be able to provide resources for more families in each community. Brochures will also be distributed through our partner networks across the State, including the Early Learning Coalition, Children’s Medical Services, 4-C, and many others.
With all of the components completed, we anticipate that we will have reached approximately 8,000 children, professionals and families in both English and Spanish regarding nutrition information for special needs children across the State of Florida.
Regarding financial expenditures, to date $30,742 has been expended on salaries for program oversight, staff training and education. $3,000 was utilized for 75 hours of nutrition consultation services and $4,954 for administrative expenses. The remaining balance will be spent on printing and publication costs, parent workshops supplies and refreshments, postage for brochure dissemination, and reimbursements to staff for local travel expenses. By the conclusion of the project, the grant funds will be fully expended.
We are thrilled with the progress made and the milestones achieved. The investment in children’s healthy nutrition and the positive outcomes in their health will reap immeasurable benefits for decades to come. Healthy nutrition is important for all children to grow strong , clear minded and vibrant – ready for all life has to offer, but even more so for children who live in the poverty cycle, who have long-term disabilities and developmental delays because these children need very special nutritional attention and improvement, particularly in these formative years as we prepare them to enter school “ready to learn”. The grant from the Allen Foundation is going to make a world of difference in the lives of children and families and has enabled Easter Seals Florida to steward its investment to the best possible outcomes. On behalf of those we serve who will benefit from Nutrition 2.0, we sincerely thank the Allen Foundation for making all of this possible.

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Project Title: Growing Power Youth Corps
Institution:
Date: 5/4/2010
Report:
Growing Power is pleased to report progress to the Allen Foundation regarding funds provided to support Growing Power’s Youth Corps (GPYC) activities. GPYC is a year-round youth leadership program that provides urban youth with academic and professional experience in Community Food System development and maintenance. The goal of the program is to prepare at-risk youth to apply specific agriculture skills related to urban sustainable food production.

1. Outcome: Increase youths’ knowledge about urban sustainable food systems
•Indicator: Age-appropriate pre and post-tests on different components of a sustainable food system.
•Outputs: 15 Participating youth completed pre-tests and post tests to determine the extent of the impact of the Youth Corps educational component. Pre-tests were completed prior to starting the 8-week summer program and were prepared as part of curriculum developed by Education Specialist at Growing Power.

2. Outcome: Increase youths’ access to healthy, affordable food.
• Indicator: Records of healthy snacks/meals provided to youth during program.
• Outputs: Members participated in “From the Ground Up” monthly workshops from January – June, 2009 (6 total). At each workshop youth received three meals comprised of locally grown and supplied foods. In addition, youth were required to volunteer twice a month during the Fall, Winter, and Spring. During volunteer activities members have access to complimentary fruits and vegetables for snacking during breaks. In addition, during the 8 week summer program, youth were regularly served fresh fruits and vegetables, such as a Growing Power specialty micro-green salad.

3. Outcome: Develop GPYC members’ job and life skills needed for future endeavors.
• Indicator: Track Youth Corps members through the GPYC program and beyond by maintaining a relationship with each Youth Corps member.
• Outputs: 15 Youth participated in six “From the Ground Up” workshops. In addition, five of these Senior participants worked regularly at the Growing Power greenhouses on weekends throughout the school year. One Senior Youth Corps member, Dasia Harman, graduated from high school and has completed her first semester at Fort Valley State University (FVSU) this past fall in Atlanta, GA on a full scholarship arranged by Growing Power. Two other Senior Youth Corps members are preparing to graduate from high school this year and have made plans to pursue higher education in air pollution control and environmental law.

4. Outcome: Increase GPYC members’ nutritional health and knowledge through academic instruction and growing and eating health and nutritious food.
• Indicator: Age appropriate questionnaires on nutrition.
• Outputs: Growing Power staff and youth corps members prepared growing beds, seeded/planted vegetables, maintained growing systems, and harvested produce throughout the 8 week summer session. During seasonal harvest lessons the Growing Power Education Specialist emphasized nutritional value of vegetables, providing a multi-faceted approach to introducing some of these vegetables to the youth for the first time, i.e., while youth learned about harvesting they also learned about nutritional content and were taste tested new foods. This experience-based learning process has proven successful as youth are more likely to retain the information as it is absorbed in multiple ways.

5. Outcome: Develop GPYC members’ leadership, public speaking, teamwork, time management, and community outreach skills.
• Indicators: Document Youth Corps members’ participation in public events.
• Youth prepared responses for public speaking and worked as a team with Growing Power staff to promote events at the Growing Power Community Food Center. At the end of August, youth corps members attended an overnight fieldtrip to the Dick Cate’s Family Farm (grass-based beef) to offer one day of volunteering on the rural farm. Youth especially had to work as a team during this fieldtrip to complete tasks. Youth Corps members also participated in the implementation of a one-day Growing Power workshop preceding the annual Growing Food and Justice for All Initiative Annual Gathering hosted by Growing Power last fall.

6. Outcome: Develop critical thinking skills in Youth Corp’s members.
• Indicator: The development and completion of a summer-long project, i.e., Issue Spotlight newsletter.
• All participating youth worked to write articles for the Issue Spotlight newsletter that was completed and distributed after completion of an 8-week summer program.

The total Budget for the Growing Power Youth Corps in 2009 was $55,800. Funding from the Allen Foundation was matched with funds from the Greater Milwaukee Foundation to reach financial goals. Below is an accounting of expenditures:

Allen Foundation $20,800 Matching Funds: $35,000

Salaries and Wages:
Instructors $1,440 Matching: $1,440
Chief Executive 0 Matching: 720
Co-Director 3,400 Matching: 3,400
Education Specialist 3,800 Matching: 3,800
Chef Apprentice 0 Matching: 1,400
Facility Manager 5,000 Matching: 5,080
Administration 572 Matching: 3,850
Personnel Fringe Benefits 1,935 Matching: 3,150
Youth Stipends 600 Matching: 1,400
Travel 500 Matching: 1,038
Equipment & Supplies 2,535 Matching: 5,000
Printing 0 Matching: 475
Facilities 1,018 Matching: 4,247

Total budget spending $20,800.00 $35,000.00

The project staff at Growing Power is appreciative of the generous contribution from the Allen Foundation. With your support, we have been able to make a positive impact on the lives of urban youth who were eager to gain marketable skills and improve their accessibility to healthy foods.

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Project Title: Folate, B-Vitamins and Reduced Risk of Autism Spectrum Disorders: Prospective Examination of an Association and Mechanisms
Institution: University of California - Davis
Date: 5/1/2010
Report:
Project Timeline: 02/01/2010 – 01/31/2012
The Allen Foundation generously funded our project to prospectively collect data on B-vitamin intake, genotypes, and metabolic profiles of a group of pregnant mothers at high risk for a second child with autism in the MARBLES Study. Presently, there are 171 women actively enrolled in the study, including 32 pre-pregnant women and 139 who are pregnant or have delivered. Plasma stored in sodium citrate tubes is available for most of these women at multiple time points and will be used for measurement of homocysteine and cysteine. In February of 2009 we began collecting plasma in EDTA tubes, whole blood, and serum that will be more appropriate for measuring vitamin B6, red blood cell folate, and serum folate, total B12, and holotranscobalamin, respectively. As of April 2010, we had over 358 plasma and 413 serum samples collected at multiple time-points for 122 mothers and 73 children. We revised our project plan to include measurements of the B vitamins at multiple time-points, including before pregnancy, during each trimester of pregnancy, and for the children at 6 months, for each mother and child pair, as opposed to one sample for each mother and child. We feel the use of measurements made at multiple time-points during pregnancy will help pinpoint the critical periods for effects we might observe. It will also add to the scant literature on changes in these measurements over the course of pregnancy. In addition, because only a subset of the children born from these pregnancies will reach the age when autism diagnoses are typically made by the end of this project period, we will be correlating these measures with intermediate developmental assessments for the majority of children. The rest of the project is progressing as planned.

Revised objectives of the proposed study and progress made to date:

1. Characterize maternal periconceptional dietary and supplemental vitamin intake in families at high risk for delivering a child with AU/ASD. Determine whether maternal folate and B-vitamin intake is associated with altered metabolic profiles of the mother and child, and/or later developmental and behavioral outcomes, including those related to AU/ASD, in the index child.

Measures:
A. Block Food Frequency Questionnaire (FFQ) analyses on all mothers, 3 time-points each to determine food folate, supplementary folic acid, and dietary folate equivalents (DFEs), vitamin B6, vitamin B12, choline, betaine, and caloric intake
B. B vitamin metabolism profiles described below in 2.A
C. Behavioral outcomes
3 months: VABS-II, Parent Concerns Form
6 months: MSEL, CSBS-DP, ITC, Response to name, ITSC Parent Concerns Form
12 months: MSEL, CSBS-DP, ITC, ITSC, Response to name/AOSI, Parents Concerns Form
18 months: VABS-II, ITSC, MCHAT
24 months: ADOS, MCHAT, MSEL, Parent Concerns Form

Progress to Date on Objective 1:
We sent our first of two batches of Block Food Frequency Questionnaire (FFQ) to NutritionQuest for nutrient analysis. This batch included 122 FFQs for 75 different mothers. Descriptive analyses of these data are underway.

2. Determine B vitamin metabolic profiles of mothers and index children and whether these metabolic profiles influence risk of AU/ASD in the index child
Measures:
RBC folate, serum folate, serum total B12, holo-TC, and serum B6 (in whole blood, serum, and EDTA plasma collected since Feb 2009) and homocysteine and cysteine (in citrate plasma samples collected from the beginning of the study)

Progress to Date on Objective 2:
We have the methods ready for all metabolite analysis, and are waiting for whole blood, serum, and plasma samples to accumulate for the first batch of measurements in July 2010.

3. Examine maternal and child gene-environment interaction effects between maternal folate and B-vitamin intake and genes in the transmethylation and transsulfuration pathways for altered metabolic profiles and/or AU/ASD diagnosis/symptoms.

Measures:
Genotype all mothers and children for 10 Common functional SNPs in folate/B12-dependent pathways including:
MTHFR 677C>T & 1298A>C, TCN2 776C>G, MTR 2756A>G, MTRR 66A>G, CBS 919G>A, 833T>C, COMT 472G>A, BHMT 716G>A, SLC19A1 80A>G

Progress to Date on Objective 3:
Common functional variants to genotype have been identified and methods for all but the last SNP are established in the laboratory. We are in the midst of transferring DNA samples and funds for the laboratory technician to the Miller laboratory for the first batch of genotyping.
 BudgetExpenses to DateBalance
Personnel Salaries, Wages, Benefits$23,927.00$-$23,927.00
Metabolite analyses (supplies and analysis)$34,090.00$-$34,090.00
NutritionQuest Block FFQ Analysis $4,200.00 $831.33 $3,368.67
Genotyping (assays, reagents, supplies) $5,000.00 $- $ 5,000.00
Total direct costs$67,217.00$831.33$66,385.67
Indirect Costs @ 15%$10,083.00$124.70$9,958.30
Total Costs$77,300.00$956.03$76,343.97

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Project Title: Nutrition Outreach and Resources Project for Elementary School Children
Institution: Cedar Crest College
Date: 4/30/2010
Report:
The focus of the grant awarded to Cedar Crest College for 2009-2010 was to evaluate the community nutrition resources and the knowledge and needs of elementary educators within the Lehigh Valley. The development of a website dedicated to the development and dissemination of early childhood nutrition education materials was integral to the project.

A comprehensive review of nutrition education materials and resources in the surrounding community revealed a paucity of materials that were free of charge and commercial interest and that focused on general nutrition rather than nutrition related to specific nutrition needs an prevention of health problems in children ages 2 through 12. The need for nutrition education materials and resources among nonpublic schools and community organizations was also identified.

Cedar Crest collaborated with the director of the Allentown School Food Services, who also directs the Wellness Program for the Allentown School District, providing guidance for nutrition, physical fitness and health education through a district wide Wellness Committee, and the director of Lehigh Valley Child Care (LVCC). LVCC provides before- and after-school care at more than 20 locations throughout the Allentown region and has a high-risk family program.

The assessment of teacher knowledge and material requirements identified the following:
1. The State of Pennsylvania has published and made available curriculum for grades K-12. Lesson plans are aligned with the Pennsylvania Academic Standards, including activities that encourage physical activity, contain website links to additional resources, and provide ideas that assist schools with implementing the local wellness policy and involving parents, food service, and the community.
2. Major findings:
a. The physical education program and teachers are responsible for nutrition education programs. They have access to the State of Pennsylvania material, have formal education that includes the concepts of basic nutrition, and have the ability to present the material.
b. Within the 2009-2010 academic year there was a mandate for the physical education programs to increase the time spent on physical education components, thereby decreasing didactic nutrition education time.
i. Materials are available: they are well written and meet academic standards. What is lacking is classroom time.
c. The Wellness Committee of the Allentown School District provided further evaluation of health and nutrition classroom education time:
i. Time provided for nutrition and health education is highly variable dependent on the grade, the availability of trained educators and the interest of the teacher.
ii. There is no consistent nutrition plan for all schools.
iii. Kindergarten classes might receive health education including physical fitness activities only once every two weeks.
iv. Class room teachers are currently not assigned nutrition education as a part of their curriculum and therefore individual interest and knowledge are the primary determinant of what occurs in each classroom.

Next, an evaluation of the nutrition education needs of the educators at LVCC was conducted; the team developed, validated, and administered a tool to parents of children attending the child-care center to identify nutrition-related risk factors among children ages 8-11. This tool proved to be crucial to understanding the relationships of nutrition, environment, and family ability to provide sound nutrition to children. Future plans for the tool include conversion to a web-based format to expand its use, linking of survey results to suggested lessons and support materials for educators, and publication of the research findings.


Major findings:
1. Educators and child-care workers have no formal nutrition education knowledge.
2. Educators and child-care workers have access to age groups from infant through elementary school.
3. Educators and child-care workers need to have training and materials which help them identify significant problems with the nutritional care and knowledge of the parent and the child and provide guidance for change.
4. Lehigh Valley Child Care has the ability to include a curriculum plan focusing on nutrition education at all levels.
a. Flexibility for focused education is similar in other day care environments within the school district, and could be expected to be similar nationwide.
5. There are limited or no nutrition education materials available for use in the typical child-care setting, yet they have access to children and families at the earliest time frames when nutrition habits are formed and meaningful education is essential.
6. In Pennsylvania, and other states, children in high-risk families are provided free child care with the proviso that they attend parenting classes.
a. Nutrition education curriculum meeting the need of both child and parent is not available for this group education.
b. The Pennsylvania State Cooperative Extension Agent identified the lack of food preparation skills in young families as a major factor related to increased cost of meals and poor nutritional content. While there is evidence in the literature supporting family-based interventions and increasing self-efficacy through skills development such as food preparation, budgeting, and meal planning, opportunities and programming of this nature are lacking for the at-risk population within this community.
7. Educational materials need to be developed for the child-care educator, who may not be familiar with more formal curricula.
8. Free access materials must also address parental needs including: basic nutrition, simple recommendations for food selection and preparation and prevention of health problems.

As a result of these findings, the team re-evaluated which populations could benefit most from access to educational materials. A recognition that states were developing a curriculum driven by their legal requirements and that schools will use that curriculum over resources written by other groups helped the team refocus its goal of providing free access to educational materials. Based on these findings the entire website direction was re-evaluated, as well. The website will to go live during summer 2010, with both an education and a family focus.

The community evaluation process conducted this year was a highly valuable and rewarding learning experience. Meeting with stakeholders in nutrition education throughout the community enabled the Cedar Crest team to identify those groups who would most benefit from meaningful nutrition education, reaching those with the greatest needs.

Budget: Total: $59,200

Personnel:
1. Education and Research Coordinator (salary & benefits): $48,800
2. Stipends for student educators and outreach educators (4 per semester @ $1,000/stipend): $8,000
3. Administrative support: $2,400

Cedar Crest College matching funds for website design, educational materials and supplies, and additional administrative support: $23,000

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Project Title: FEED THE DREAM--A Guatemalan Nutritional Expansion Program, Site #3
Institution: None
Date: 4/1/2010
Report:

Once again due to the gracious generosity of the Allen Foundation and others, Feed the Dream has continued to make significant progress in fulfilling its purpose to improve the nutritional health of children under 6 years of age and young women of reproductive age (15-49) in an increasing number of Guatemalan Highland villages. The Allen Foundation funds were used for three villages in the Chimaltenango area. This is particularly promising as the Nov., 2009, UNICEF study ranked Guatemala as third in the world for
the worst rate of nutrition and stunting.

Focusing on the goals of Feed the Dream, we can report:

1. Nutritionally balanced meals with vitamins continue to be provided daily to young children and at least twice a week for women of reproductive age in the three Allen-funded villages. In our mountain hamlet area there are now 8 communities (caserios) participating in the Feed the Dream program. A total of 14 villages are involved in Feed the Dream which provides nutritional services to more than 1000 women and children daily.

2. In these same villages, education on good nutrition and safe drinking water takes place through the efforts of our local indigenous, Kaqchikel-speaking educators. Working with the mothers, Silvia, who has nutritional expertise, teaches the significance of nutrition and how to take advantage of available local resources. There are weight and height evaluations. She emphasizes hygiene, proper food preparation and potable water, while simultaneously encouraging early stimulation techniques to use with their young children. Adolfo is our agricultural expert who gives hands-on training in crop diversity and plants that are nutritionally rich and easily grown in home gardens. Chaya has successfully been introduced, the leaves being used in soups and creams. The use of amaranth (a nutritious grain), soy and moringa tree leaves have also been encouraged. Most families have gardens or tire-container gardens to take advantage of the few plots of land available. Home visits take place for reinforcement and encouragement to sustain positive changes.

3. In these same villages, indigenous women volunteers are participating in and carrying out the programs noted above. Our educators work in partnership with them as the women learn new recipes using their family garden produce, including vegetable leaves and local herbs which contain vitamin A. They are encouraged to use their own onions, garlic, celery, cilantro and red pepper for seasoning in place of artificial options. The educators introduce new products, such as moringa, chaya and amaranth, and teach the benefits of incaparina (fortified nutritional drink) and Protemas (soy meat). Our newest nutritional additive in the Maya Nut mixed with the incaparina. The mothers learn and practice these new skills in a center and benefit from the social time spent together. A most encouraging estimate is the 50% reduction in use of carbonated drinks and sweets!

4. Feed the Dream has provided the tools needed to carry out the above programs. We have built a multi-purpose kitchen and activity center with the needed equipment, including the vented Onil stove. Following the instruction of hygiene and the food preparation done together, the mothers and children enjoy consuming the results. An added benefit is the socialization for both mothers and children, a rarity with their impoverished lifestyle. Since 98% of surface water is non-potable, families have the opportunity to acquire a water-filter at a nominal cost.. Prenatal vitamins with the crucial folic acid and children’s vitamins are provided. In addition to Adolfo’s agricultural programs discarded used tires are provided, inverted, and filled with good soil for successful family container gardening which is done close to the home and uses very little water. Vermiculture is encouraged and other organic measures, emphasizing environmental care.

5. Feed the Dream assures accountability through the local partner’s frequent (at least weekly) visits to the sites. However, the nutritious snacks are daily. In this area our local partner Behrhorst Partners for Development (BPD) has a staff team of a doctor, nurse, agriculture and nutritional experts, all of whom are highly trained and who work with and teach respected community health promoters. With their daily presence the latter add credence and reinforcement to the teachings.

6. We are at the point of self-sustainability in several villages. Surrounding villages are anxious to be working with us as they witness the improved health of their neighbors. We are planning to include them as additional funds become available. Our achievements to date are heartening as seen by the reduction of malnutrition in our villages resulting in healthier babies and children (see tables below). The success of the crops grown and the village acceptance of new teachings are remarkable. We continue to face two major challenges: (1) finding qualified indigenous staff members, as their workload and travel on uncomfortable rural roads is demanding and time-consuming: and (2) having all the women attend meetings regularly (85% do), as they have many other daily obligations to fulfill such as childcare, household duties (often including many hours spent hauling water and firewood), taking lunch to their husbands in the field, school responsibilities or widows working in nearby villages. This is changing slowly as they hear the positive feedback from other women in the village.

We have seen the following outcomes of our efforts:

1. The three villages referred to in this report receive Allen Foundation funding. Their total population is 1614. In addition to the children there are 121 women of reproductive age receiving the benefits, as well as all the mothers of the involved children.

2. Health has measurably improved in the participating villages, in spite of being especially hard hit by rotovirus and are now in the process of regaining their health.. Please note that the following statistics do not reflect a full year in Xetzitzi.







CHILDREN AT RISK FOR LOW WEIGHT MALNUTRITION
PARTICIPATING MALNUTRITION LEVEL

CHOABAJITO ALTO
March 2009 25 2 2
March 2010 15 1 0
PACOXPON
March 2009 25 1 0
March 2010 21 1 0
XETZITZI*
Oct. 2009 78 31 0
March 2010 66 23 8


* Within a few months the improvement here is dramatic! We are especially encouraged that the low weight children held their own and did not slip down to the malnutrition area. The 8 listed there are due to the virus. The discrepancy in the numbers is due to the availability for attendance as previously mentioned in #6.

3. Feed the Dream’s goal is self-sustainability which we anticipate to be a 5-6 year process. Much will depend on the development of a strong community leader to encourage and maintain positive change. The rural indigenous are uneducated (particularly the women), poor but hard workers. They are growing new crops and learning the importance of crop diversity. As statistics indicate, the nutritional efforts have led to the reduction in malnutrition rates and significant gains in the normal weight category. We feel we are building a community which will lead to the emergence of leadership to continue these positive changes. Of course, we are thrilled with the babies being born bigger and healthier and the reduction of dysentery and diarrhea. Equally wonderful side-effects of our programs are new self-esteem and the benefits of socialization for both women and children with increased school attendance and a strong sense of community.

4. We are anticipating that once self-sustainability is attained, this pattern will continue into a healthy future. We already see other villages wanting to participate.

Feed the Dream is making a difference right now and for generations to come. The improved nutritional health of newborns and young children guarantees them a chance to be successful in school and survive the many diseases that accompany poverty, while at the same time enabling them to reach their potential IQ levels (which are stunted by as much as 15 IQ points if malnourished).

FINANCIALS (through April 1, 2010)—Total Allen Foundation funds of $10,000 are greatly appreciated and have been a significant part of our total project of 14 villages.

FOOD $ 4,700
oil, beans, incaparina, etc.
SEEDS, ORGANIC FERTILIZER 2,000
COMMUNITY CENTER 1,600
dining & kitchen center, Onil
stoves , water filters, etc.
SALARIES* 1,700
Partial indigenous educators
TOTAL $10,000

*portion paid through Allen Foundation funds



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Project Title: Development of Specialized Therapeutic Soy Foods for Treatment of Malnutrition
Institution: Washington Univeristy
Date: 12/26/2009
Report:
The research description and findings are as follows

Severe childhood malnutrition is defined as having a weight for height Z-score (WHZ) < -3 or bipedal pitting edema. Standard therapy for uncomplicated cases of severe acute malnutrition is home-based therapy with milk-peanut based RUTF. The cost of ingredients in RUTF limits its availability in resource-poor countries, with powdered milk constituting 67% of the cost. In this clinical effectiveness trial, severely malnourished children were given either a reduced milk formulation of RUTF (10% milk) in which milk was replaced with soy protein, or the standard formulation of RUTF (25% milk). Children received isoenergetic quantities of the foods (733 kJ/kg/d) for up to 8 weeks with biweekly follow up. The primary outcome was recovery, defined as having a WHZ of -2 and no edema. A total of 1874 children were enrolled in the study. Children receiving 10% milk had a lower rate of recovery compared to those receiving the standard therapy (84% in the 25% milk group and 81% in the 10% milk group). Nonlinear regression modeling showed type of food to be a statistically significant term in rate of recovery. Overall, children who received the 10% milk formulation had slower rates of weight gain and slower MUAC gain. Differences of gain in stature were not statistically significant. Treating severely malnourished children with a 10% milk RUTF results in a lower rate of recovery and slower growth rates when compared to the standard 25% milk RUTF.

Budget expenditures
Salary Heidi Sandige MD junior investigator new Wash U $27,500
Travel to Malawi x 2 for Dr. Sandige $ 5,000
Transport in Malawi (fuel, vehicle rental $600/month $14,200
Study Food $17,650
Indirect Cost $ 7,150

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Project Title: A Proposal to Develop Scenarios for a Game Based Computer Simulation for Dietetics Education
Institution: Central Michigan University
Date: 10/29/2009
Report:
FINAL REPORT: ALLEN FOUNDATION

PROJECT TITLE: A PROPOSAL TO DEVELOP SCENARIOS FOR A GAME BASED COMPUTER SIMULATION FOR DIETETICS EDUCATION

PROJECT INVESTIGATOR: R. Heuberger, Ph.D., R.D.

ORGANIZATION: Central Michigan University

PROJECT CATEGORY: Nutrition Education

Computer simulation, medical virtual reality and computerized patient simulators are the mainstay of medical education. Most other disciplines have incorporated this technology into their curricula, with the exception of dietetics. Today’s students are accustomed to learning in a computerized gaming environment and simulators have proven effective in increasing knowledge, critical thinking skills, computational prowess, navigation and communication abilities. Such a platform is scalable, flexible and can be used in conjunction with traditional classroom instruction, in distance education, or as a stand-alone “game”.

We have developed 15 scenarios of increasing levels of difficulty for dietetic students, interns or clinicians. The scenarios consist of commonly observed clinical situations with patients of various acute or chronic medical conditions. Decision trees allow the player to treat the patient based on the medical information provided. Based on the decisions made, the patient is rehabilitated or declines. The simulations can be re-run until patient rehabilitation is achieved. Learning takes place from errors made in a realistic environment without any real world patient harm. This enhances preparedness of future dietitians, increases the probability of better patient outcomes and increased familiarity with a broad range of health care attributes. Educators who choose to use the simulations have the benefit of real time assessment and evaluation of student learning, identification of problem areas and rapid compilation of data regarding an individual student or an entire class. All actions taken by the player are recorded and available to educators. Data may also be compiled if used in a classroom setting with multiple players.

Forty patient education materials were developed and their use incorporated into the scenarios for patient discharge when the player rehabilitates the patient in their scenario. Four complete scenarios have been programmed into a gaming environment complete with graphics, transitions and assessment output capabilities. The game is available on a dedicated website with a dedicated server that can handle multiple accesses for players and can house multiple assessment datasets. The remaining scenarios will be programmed for gaming at a future date. The patient materials are also housed on the dedicated website for retrieval by players or educators. The objectives of this project were met, including: 1. The creation of scenarios for use in the development of a computer simulation in a gaming environment to promote critical thinking skills with dietetics students; 2. The creation of a teaching tool that integrates textbook knowledge with experiential learning and provides ongoing evaluation and assessment of student skills in real time; 3. The establishment of a multifaceted, applied approach toward medical nutrition therapy education for a new generation of students accustomed to acquiring knowledge and skills in computer gaming environments; and 4.The modeling and adaptation of scenarios for patient education and continuing medical education of professionals in the field.

Central Michigan University sought Allen Foundation funding for the initial phase of the project. Phase I development included: Scenario Generation: specifying an initial patient state, possible student decisions, and new patient states that would realistically result from each of those player decisions; iteratively generate player decisions and resulting patient states until "win" and "lose" states are reached. Software development: Development of a software model of the game scenario, consisting of software objects (primarily the patient, the player, and possibly other characters such as the physician and nurse), properties of the objects (e.g. the specific medical conditions of the patient), and interactions between the objects (e.g., player reads lab results or prescribes a diet; patient's diagnostics change in response to player's prescription). The development was performed and housed at the following address: http://chpweb.cmich.edu/pdk.

All materials in hard copy will be sent via postal mail to the Allen foundation in binder form. A CD containing the game and “read me” instructions will be included. The binder will have screen shots of the game, the scenarios in their totality, the patient education materials, the diet editor spreadsheet, the flowchart, the original submission and this report. The investigator has a graduate student using the four programmed scenarios for thesis work. The thesis will entail pilot testing the game with dietetic interns, clinicians and patients. The thesis will also encompass focus groups with the target audiences to determine if there are acceptability issues, gaming issues, access issues or other concerns that need to be addressed to make the game most effective as an educational tool. Data from the pilot and focus groups will be collected, analyzed and utilized to debug the existing game and enhance the development of the remaining scenarios into game form. In addition, the assessment component of the game will be evaluated and refined, then programmed into the game, so that the assessment reports will be generated in a manner that is easily evaluated. A publication to a scientific journal on health professional education should be submitted in the Fall 2010. Work will continue on the game and scenarios.

BUDGET: Interim Accounting
Total Awarded $43,530
Actual Expenses (as of 10/28/09) $39,276.06*

(*Note: A revised financial report will be submitted once all outstanding expenses have been processed through 11/1/09). Permission was granted to submit an interim accounting report as charges through Nov. 1, 2009 will not be processed through accounting systems for several weeks. A final accounting report will be submitted on Dec. 30th, 2009.




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Project Title: Developing and Promoting Interdisciplinary Competencies in Feeding and Pediatric Nutrition
Institution: USC UCEDD Childrens Hospital Los Angeles.
Date: 5/7/2009
Report:

Developing and Promoting Interdisciplinary Competencies in Feeding and Pediatric Nutrition
Principal Investigator: Alice Kibele, PhD, OTR/L
Program Manager: L. Hope Wills, MA, RD, CSP

The Allen Foundation generously funded the Pediatric Nutrition and Feeding Workgroup. The main focus of the program is to promote competency in the area of feeding and nutrition for pediatric health care professionals. The journey so far has been richly illuminated by interdisciplinary collaboration. The following pages describe the objectives and goals that have been met, and those still in progress. Due to some early delays, there are remaining funds in the amount of $ 20,500 . We are requesting continued use of that funding to support work on the two main program goals listed below.

Program goal 1: Create 10 interdisciplinary competencies in feeding and nutrition for pediatric health care professionals for review by the hospital with the purpose of incorporating them into standard hospital practice.

The core members of the workgroup have developed 10 questions that demonstrate knowledge based competency for the following age groups: Toddler/Preschooler and Infants. Work has begun on the last two age groups, school age children and adolescents. Ultimately these questions will be included in age based competency trainings administered by the hospital to clinical staff.

Program goal 2: Conduct activities over the course of the year to identify potential funding to support the evaluation and dissemination of the training curriculum.

The members of the workgroup are seeking sustainable funding to support continued collaboration. Since the workgroup brings together members from other disciplines including trainees, we are seeking training grants to provide continued support

The following section describes the progress achieved on individual objectives of the workgroup.

Objective 1: Describe two roles or functions in feeding and nutrition for 3 disciplines apart from their own.

To meet this objective group participants attended an orientation in October and November. The group watched videos of children with feeding issues with the goal of developing a common lexicon of terms related to feeding and nutrition. In most of the video clips, the group participants concurred on what they observed. As the cases become increasingly more complex, observations shared across disciplines demonstrated subtle but significant differences on how each would approach the same issue and the tools they would use.

Objective 2: Identify three institutional and two external resources that provide intervention and support for children with feeding problems and their families.

This objective has been met through the case consultation and presentation format. The group member presenting the case is asked to provide information about the services that the client is receiving at the time of presentation. During the course of the consultation, group members provide information about services within the hospital and in the outside community.

Objective 3: Obtain interdisciplinary consultation on 3 children with feeding and nutrition concerns. (Performance)

A total of six children have been presented for consultation with diagnosis ranging from cerebral palsy to “neurological disorder of unknown etiology”. The consultations provided have included recommendations for formula changes, parenting strategies, outside resources and even referral for further medical work-ups. The participants in the workgroup bring a vast amount of clinical experience to the table. Although not all of them have worked in interdisciplinary settings in the past, the group provides members with an important forum to share information that impacts patient care.

Objective 4: Integrate information on nutrition and feeding, from other disciplines into a family centered care plan. (Performance)

This objective has been met with all of the cases presented for consultation. The presenting members have incorporated recommendations into family centered care plans that support needs of the child and their families.

We are grateful for the generosity provided by the Allen Foundation in support of our program, Developing and Promoting Interdisciplinary Competencies in Feeding and Pediatric Nutrition. The true beneficiaries of your generosity will be the children that we serve. How we nourish and nurture our children, in the home or in the hospital has an impact on the world. Thank you again.

Brief Summary of Financial Expenditures
Personnel and Fringe Benefits $54, 804
Principal Investigator Alice Kibele
Project Managaer Hope Wills
Pediatric Faculty Michelle Thompson
Pediatric Faculty Maryan Saifi
Nutrition Faculty Jenn Webb
Project Coordinator Kathy Soltani
Support Staff: Liz Dennon, Christine Anatone
Project materials $900.00
Binders, copying/printing , lunch for workgroup meetings



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Project Title: Epidemiological evaluation of Anaemia amongst tribal women and children
Institution: St. Johns Research Institute
Date: 5/4/2009
Report:
Summary of Work and Accomplishments:
We have completed our field work and successfully recruited our target sample size of 415 children and 372 of their mothers. These children and their mothers all live in villages of rural Karnataka, India; approximately two thirds are from the Chamarajnagar district, 200 kilometres south of Bangalore, and one third from Ramnagaram district, 100 kilometres north of Bangalore. These areas are adjacent but do not include the tribal areas of BR hills. Due to several constraints, this project was not performed in tribal women and children.

The field work was completed by a team of local health workers, who received training in research and the conduct of the questionnaire by the investigators. Between August and December 2008, field work was conducted. We are now preparing our analyses and are in the process of finalising the first results manuscript. We have also presented our preliminary data at two Indian national medical conferences: the Indian Pediatric Hematology Oncology Conference (PHOCON, November 2008) and the Indian Pediatric Conference (PEDICON, January 2009).

We anticipate a total of four results papers will be published from our data. We also anticipate presenting our research at several international conferences in the fields of haematology, pediatrics and nutrition. Among these papers, we will provide the first comprehensive evaluation of the aetiology of childhood anaemia in the rural Indian population – representative of several hundred million people.

Finally, we submitted a review article exploring the interactions between iron deficiency and malaria, and the implications for the Indian population and Indian public health policy. This review will cite our Allen Foundation funding as many ideas discussed within have been generated by this project. We anticipate this will be shortly accepted by the leading Indian journal, Indian Pediatrics.

Manuscripts Published
• Pasricha S-R, Vijaykumar V, Prashanth N, Sudarshan H, Biggs BA, Black J, et al. A community based field research project investigating anaemia amongst young children living in rural Karnataka, India: a cross sectional study. BMC Public Health. 2009 Feb 17;9(1):59 (Study Protocol)

• Pasricha S-R, Shet A, Sachdev HPS, Shet A; Risks of iron supplementation for young children in malaria endemic areas – implications for India (Accepted for publication, Indian Pediatrics).

Manuscripts in Preparation
• Pasricha S-R, Black JF, Shet AS et al; Understanding anaemia among young children living in rural Karnataka, India: a cross sectional study.

Conference presentations and abstracts
• Pasricha S-R, Black J, Shet A, Bhat V, Biggs B-A, Selvaraj S, et al. The etiology of anemia in young children aged 12-23 months. Proceedings of PHOCON 2008 Annual Conference of Pediatric Hematology Oncology Chapter Indian Academy of Pediatrics. New Delhi, India; 2008 (Oral Presentation)
• Pasricha S-R, Black Jm Shet A, Biggs B-A, Bhat, V, Muthayya S, Moodie, R, Sudharshan, S, Shet, AS. Etiology of childhood anemia in rural Karnataka, PEDICON 2009 Annual Conference of Pediatrics, Indian Academy of Pediatrics, Bangalore, 2009 (Poster Presentation)

Updates by specific aim

• Epidemiologic evaluation of anaemia amongst tribal women and children:
o We have completed a detailed evaluation of the aetiology of children and their mothers living in rural Karnataka, India.
o Samples have been processed for:
• Full blood examination (haemoglobin, mean cell volume) and peripheral blood film examination
• Serum ferritin
• Serum folate
• Serum C-reactive protein
• Serum B12
• Serum retinol binding protein
• Haemoglobin variant screen (HPLC)
• Malaria smear
• Stool hookworm evaluation
o Maternal samples have been processed for: haemoglobin
o Anthropometry:
Child: length, weight
Mother: height, weight
o Demographic survey
Covering: Socioeconomic, deographic details

• The NNACP at the Primary Health Care level
o We have evaluated coverage of the NNACP from the PHCs in which we worked.
o We have collected data from approximately 400 families concerning receipt of NNACP programme.
o We have compared the coverage of the NNACP to other established programmes such as vaccination, vitamin A supplementation.

Implementation and evaluation of iron, folate and B12 supplements
o We have provided a pilot anaemia control programme to the children whom were originally enrolled in the epidemiologic study.
o For each child, liquid iron/ folic acid/ b12 supplements were provided (as each of these three deficiencies were identified to be not infrequent).
o A follow up evaluation of maternal attitudes towards iron folic acid, perceived benefit from IFA supplementation, and their willingness to contribute financially towards a supplementation programme was conducted.

• Impact of climate change events on prevalence of nutritional anaemia
o We are preparing an evaluation of the interactions between food insecurity and wealth with nutritional intake, growth failure and micronutrient deficiency/ anaemia.
o Climate change and a new threat, the global financial crisis, may diminish wealth and increase food insecurity – our data will enable modelling to identify risks of deterioration in nutritional outcomes. We are assessing ways in which we can utilize our data to make such correlations.

Budget: Funds will be spent in entirety by the end of the funding period. We notified the Allen Foundation and obtained permission from the Foundation to utilize some funds to cover the cost of equipment for performing some of the laboratory tests. Therefore, some funding will be used to cover unanticipated equipment costs and performance of previousl budgeted laboratory tests. We anticipate complete utilization of the funds by Dec 2009. Detailed budget statement will be submitted later.

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Project Title: Independent Living Training
Institution: Florence Crittenton Home and Services
Date: 5/1/2009
Report:
The nutrition component of Florence Crittenton Home’s Independent Living Training Program (ILT) flourished this past year thanks to the financial assistance of the Allen Foundation Inc. With Allen Foundation’s support, our girls:
• learned meal planning and preparation for themselves and their babies.
• learned to develop grocery lists using nutritious meal plans and how to budget and shop.
• planned, planted, and harvested our therapeutic garden. Learned to cook with fresh vegetables and participated in a canning techniques class, designed to teach girls about eating healthy on a limited budget.
• learned to master breast-feeding, and transition their babies to appropriate solid foods.
• learned the importance of kitchen cleanliness, hygiene and safety measures.
• learned about “proportion distortion.”

As Montana’s only therapeutic residential maternity home, we serve pregnant and parenting girls ages 12 – 21. With an average age of 15, the girls stay between six and 24 months. Our ability to impart nutritional health skills is critical.
Allen Foundation’s support allowed us to provide much more than meal plans and rice and potatoes. You allowed us to focus on making meal planning fun, interesting and a way of life. You allowed us to recruit and bring in volunteers to teach such classes as Thai cooking. You allowed us to enhance Crittenton’s approach to meal planning and to make the basics of food and nutrition a solid and continually-refined component of the ILT. Thank you!

Highlights of our year include:
Once the meal plans were in place, the girls developed grocery lists and learned to budget and shop. Using the meal plans, USDA guidelines, recipes, and the number of girls and babies who will be eating, the girls wrote comprehensive grocery lists. Then they did the grocery shopping. Staff employed learning games at the grocery store to help the girls learn to read labels, select ripe produce, and choose healthy and appropriate substitutes for items that may be too expensive. Staff accompanied the girls to the local farmer’s market for fresh produce that wasn’t available in our garden. Vegetables, herbs, and fruit from the girls’ pesticide free garden at the Home were always included.
Coming up: We still need to work on the concept of budgeting around what is on sale and in season, not on what sounds tasty.

The girls helped in all aspects of the planning, planting, and harvesting of the summer garden in our back yard. Throughout the summer into late fall, the girls and babies spent a great deal of time in the garden. They learned how to properly plant seeds and starts, and to harvest the produce, cook with fresh ingredients, and can and freeze for later use. Fresh herbs were an unexpected hit.

The garden has also proven to be a great place for therapy to take place. Last year while pulling weeds with a case worker, a girl made a break through in her therapy. For her, working in dirt and talking about life became a safe place to reflect.
Coming up: We are planning this summer’s garden. A $950 grant from a local Optimist club will allow us to purchase tools that we can keep on site instead of borrowing.

Mastering breast-feeding, and later transitioning their babies to solid foods is a strong focus at Florence Crittenton Home. One year ago, none of the young mothers were initiating breast feeding with their newborns. Realizing the nutritional, health, and bonding benefits of breast feeding, our lactation specialist began a campaign to normalize breast feeding. This campaign has resulted in an almost 100% breast feeding initiation rate in the last year.
Coming up: Our new goal is that those mothers initiating breast feeding will continue to breast feed for a minimum of six months.

The importance of kitchen cleanliness and hygiene cannot be stressed enough in a home with 16 pregnant and parenting teens, little ones, and a staff ratio of one staff for every four girls at all times. The girls learn to always wash their hands upon entering the kitchen and while they cook. Separate areas for preparing meats, vegetables, and baked goods are in place. An outbreak of the norovirus last fall emphasized our continual teachings.
Coming up: Teaching and reminding (again and again!) to wash hands is a continual process. We also are seeking funds to install a hand washing sink beside the baby-changing station.

Periodic Proportion Distortion classes occurred throughout the year. Staff used menu planning, shopping, and cooking as opportunities for experiential lessons on proper proportions and serving sizes. How – and why – to read the food packaging labels became a part of daily living for the girls.

Expenditures:
Most of Allen Foundation’s grant of $28,105 was used for staff, as Nutrition is people-intensive work that requires planning, training and working with the girls on a one-to-one as well as group basis. Other expenses were used to purchase cookbooks and recipe cards and to cover travel for shopping. We are most grateful for this grant and look forward to future assistance you might provide as we continue changing the future . . . two lives at a time.

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Project Title: Patroon Land Farm (a Project of the Regional Food Bank of Northeastern New York)
Institution: Regional Food Bank of Northeastern New York
Date: 5/1/2009
Report:
The Regional Food Bank of Northeastern New York works to alleviate hunger and prevent food waste by collecting large donations of edible but unmarketable food from the food industry and distributing it to food pantries, soup kitchens and other charitable agencies feeding the hungry. Each year, the Regional Food Bank distributes nearly 20 million pounds of food to 1,000 agencies in 23 counties of northeastern New York.

To augment its supply of donated and purchased food, the Regional Food Bank began operating a Farm in 2006. The Farm supplies member agencies with a wide array of just-picked produce on a regular basis and ensures that families in need have access to the freshest, most nutritious food possible.

In its first year of operation, the Farm produced over 32,000 pounds of vegetables in spite of a very wet season and the lack of some essential infrastructure such as roads and drainage. In 2007, the Farm produced 96,000 pounds of food. Yet there remained several needs that, when met, would propel the Farm to the next level of production and efficiency.

The Regional Food Bank received $20,000 from the Allen Foundation to assist with the Farm’s expansion; namely, to drill a well and install fencing around the fields. Fencing was needed to keep deer, rabbits, and other wildlife from consuming crops. Water was also needed to irrigate the soil and allow plants to be washed after harvest. Allen Foundation support made both fencing and water possible.

Allen Foundation funding also made possible another important step in the Farm’s growth. After submitting its request to the Allen Foundation, the Food Bank learned that a second (though much smaller) request for fencing had been approved. That allowed the Food Bank to request a change in how some of the Allen Foundation grant would be used. The request was approved, and the Food Bank used $4,000 of the grant to buy a welder and a generator.

These two tools became the Farm Manager’s highest priority for day-to-day use. Until that equipment was purchased, farm repairs were time consuming and expensive. The Farm Manager had to take equipment off the field and truck it to a repair shop. Now, with this equipment in place, the Farm Manager can make repairs in the field—returning the equipment to use much faster and saving both money and time. These tools substantially increase the Farm’s self-sufficiency.

A significant portion of the Allen Foundation grant was used to dig a well and install a pump. Connecting power to the well has proved to be more expensive and time consuming than originally anticipated, but the power company should have the pole up and lines installed shortly, making the well fully operational. In the interim, the Farm Manager powers the pump with the generator when water is needed.

The balance of the Allen Foundation grant is being used to install fencing around the fields. Last year, the entire crop of peas was lost to rabbits, and portions of other crops were substantially damaged by wildlife. Installing the fence will result in more food being grown and harvested.

This process also took longer than expected to complete. Fencing companies are busiest during the summer, which is when the grant was received. It took the Farm Manager until the fall to secure three quotes. Then the winter came and installation was postponed due to the weather. Installation is beginning in earnest right now and should be completed by the end of May. When the fences are up, the fields will be protected and the crops will be free to grow without risk of wildlife destruction.

The Allen Foundation grant has transformed the Farm. No longer is the Farm ‘making do.’ The Farm is more productive, more efficient, and more secure than ever before, thanks to this generous funding. The end result is that larger quantities of fresh, nutritious food will be grown and distributed to those in need.

Financial Accounting for Allen Foundation Award

Amount Received
Allen Foundation $20,000.00

Amount Spent
Generator $3,375.00
Welder $ 605.00
Well Drilling $4,450.00
Well Pump $5,592.47
Fencing Deposit $5,610.25
Total Spent $19,632.72

Balance to Spend $ 367.28

Funds remaining will be put toward the balance of the fencing bill, which is $16,830.75. Installation of the fencing will be completed in May 2009.

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Project Title: Healthy Choices Program
Institution: La Maestra Family Clinic
Date: 4/30/2009
Report:


La Maestra Family Clinic, Inc
4185 Fairmount Ave
San Diego CA 92105
Reporting Period: June 2007- April 2009

OUTCOMES

La Maestra’s comprehensive Healthy Food Choices Program included outreach, health and nutrition classes, individual mentoring and support, and free nutritious food from our pantry.

Distribution of flyers (Goal: 5,000): 8,930 promotional program flyers were distributed in health fairs and other community events during the reporting period.

Families that received nutritious food and educational information through the food pantry (Goal: 3,500): La Maestra provided nutritious food and health education to 10,762 families. Participants received a variety of linguistically-appropriate educational materials in their pantry bag including: food preparation tips, healthy meal recipes, nutrition, physical activity, and disease prevention facts among many others. Different educational materials were distributed each week. In a pantry survey report done in January 2009, 47% of pantry participants reported that they had used the recipes given to them in the bag, implying that we are contributing to a positive impact in healthier cooking options.

Individual Education Sessions (Goal: 850 Participants)
1,947 participants completed at least one individual education session. These sessions took place in our health education unit, health fairs, schools, and other community events.

Four Session Classes (Goal: 200 Families)
163 Families were able to complete the four session classes. It was very challenging for participants to complete all sessions. Despite many calls and reminders, many patients did not attend all sessions. The major barriers found was lack of transportation and conflict with work schedules. As a result, classes started to be offered on Saturdays in January 2009 and have been successful in both recruiting and retaining more participants.

The curriculum developed for the five-week class is based on prevention of diabetes, cardiovascular disease, hypertension, obesity, and other weight-related health issues. Topics include:
Class 1: Program overview, introduction to food pyramid and recommended daily portions. Personal weight management plan established. Introduction to Food Portion Sizes.
Class 2: Food portions revisited and how to read food labels and calories
Class 3: Calculating BMI and physical activity
Class 4: Disease prevention, blood pressure, cholesterol, and other health education.





Each 60 minute session provides participants with tools to improve or better manage their weight, modify behavior, diet and lifestyle; and increase physical activity to prevent or delay the onset of a chronic disease.

From the class participants, only 20% reported that they knew what the food pyramid was at class 1 compared to 100% by class 4. . From first to fourth class, there was an increase from 45% to 75% of participants reporting that they were physically active for at least 30 minutes during the week. In addition, all participants reported an increase in physical activity, and increase intake of fresh fruits and vegetables when compared to when they began the classes.
There was a notable change in the percentage of people reading food labels by the end of the sessions, from 17% to 83%.
Thanks to your generosity, we have been successful in increasing awareness and promoting healthier lifestyle choices in our patient population.


FINANCIALS


Personnel
Health Educator (0.5 FTE @ $20/hr) $20,800 per year
Pantry Staff (0.5 FTE @ $10/hr) $10,400 per year

Total Personnel for 2 years ----------------- $62,400
Taxes and Benefits (2yrs) ------------------- $11,360
Total Personnel (2yrs)_________________ $73,760

Supplies
Pantry Food Supplies (52 wks @ $500/wk) $25,000 per year

Other Expenses
Consultant Dietician (250hrs @$40/hr) $10,000 per year

Total Non-Personnel (2 yrs)___________ $70,000

In-Direct (10% of Salaries)___________ $6,240

TOTAL____________________________ $150,000

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Project Title: The Benefits of a Nutritious Breakfast for School-Age Children
Institution: Cedar Crest College
Date: 4/29/2009
Report:
In June 2006, 2007 and 2008 the Allen Foundation awarded Cedar Crest College one-year, $50,000 grants for the initiation of elementary school nutrition education and challenged the College to match the funding, which was accomplished utilizing College and faculty resources. Through all three years, students in the Didactic Program in Dietetics at Cedar Crest College participated in development and presentation of nutrition education sessions at area schools, professional staff education and teacher education.

For the 2008-2009 academic year there were two focus areas:

Focus area I: Promote the importance of a nutritious breakfast for school children. The Bethlehem Area School District (BASD) and its food service operations welcomed the opportunity to expand their breakfast program. Less than 5 percent of eligible students ate school breakfast at three inner city elementary schools. These elementary schools with low participation were targeted for intensive programs. Other BASD schools participated through associated programs supported by Cedar Crest College staff and students. Twelve classes were provided to students in the three schools targeted for intensive education. A Breakfast Club provided nutrition education sessions, games, activities, and special recognition for participating students. The individual schools recognized the program with bulletin boards and posters. Cedar Crest College students provided breakfast education programs to a total of 1,200 students and nearly 100 educators within the targeted schools.

BASD food service personnel from all 24 schools in the district attended sessions including nutrition education and instruction on use of the Allen Foundation breakfast program. Materials to support the Breakfast Club programs at these schools were provided by the College. Working with the Food Service providers allowed expansion of the outreach to the entire district, maximizing the population served.

Focus Area II. Providing nutrition education materials and training to teachers. Nutrition students developed six nutrition topics and all support materials. The goal was to develop each topic so that an elementary school teacher had a ready-to-go nutrition unit for presentation in the classroom. With a national focus on developing healthy nutrition habits in elementary school, programs that support improved nutrition are truly essential. Focusing on development of quality nutrition education support materials for the elementary school classroom will continue the work of this grant far into the future. The topics selected for nutrition education program development were the macronutrients: Carbohydrates, Protein, and Fat in human nutrition and three micronutrients essential during growth and development: Vitamin C, Calcium, and Iron.

Area elementary school teachers from 16 school districts in Pennsylvania and New Jersey attended a workshop on April 25, 2009. The Weller Health Education Center participated in the conference as a partner. Teachers attended four education sessions: Macronutrients; Body Mass Index; Nutrition Resources; and a hands-on workshop. Students supported by the grant provided all of the education in session 4.

This teacher seminar fulfilled our educational goals for 2008-2009, to provide nutrition education that:

• Increases attendance and attentiveness in the classroom;
• Improves academic performance in subjects such as math and reading;
• Improves classroom behavior;
• Improves children’s diets;
• Works to reduce childhood obesity; and
• Supports relief of childhood hunger

While the nutrition outreach was a valuable learning experience for the elementary schools and students, the experience for the College’s future dietetics professionals was profound and truly invaluable. As a provider of didactic nutrition programming, The Allen Center for Nutrition validated that experiential learning through opportunities such as those supported by this grant are highly significant in preparation of students for professional practice. The cumulative work of the past three years is now being used to develop a website that will disseminate nutrition education materials to educators throughout the nation. The website will be operational by the end of the current calendar year. Working with partnerships developed as part of the grant, Cedar Crest will continue to support area elementary education and pursue opportunities for our students to participate in learning experiences.

During the past three years, students and teachers from over 30 school districts participated in nutrition programs and education. Through direct student education and professional outreach to teachers and food service personnel, nutrition lessons were made available to every student in both districts.

It is with great appreciation for the support of the Allen Foundation that Cedar Crest reports on this final segment of the three-year program. This support will continue to bring nutrition education to countless individuals in our community and the support the dissemination of nutrition education resources to the global community.

Budget

Part-time Coordinator*: $11,560
Student Stipends**: $31,000
Breakfast Club and related expenses: $3,500
Teachers’ Conference: $1,000
Website Development: $2,940
TOTAL: $50,000

*The increase reflects change in CCC wage rate for 2008-2009 and Social Security Costs.
**Since the funds required for supplies for the Breakfast Club program were less than anticipated, one additional student was entered into the grant for the spring semester at a stipend of $1,000.


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Project Title: Determining role of vitamin A in obesity development
Institution: Department of Nutrition, the University of Tennessee at Knoxville
Date: 4/24/2009
Report:
Progress Report (For grant #171)
Guoxun Chen, PhD, Department of Nutrition, the University of Tennessee at Knoxville

A. Introduction
In June of 2008, Allen Foundation Inc. decided to fund my research proposal entitled “Determining role of vitamin A metabolism in obesity development”. The project was intended to determine (1) the role of vitamin A in the development of obesity phenotype using Zucker lean and fatty rats as experimental model; and (2) the direct effects of retinoids on Srebp-1c and lipogenic gene expression in isolated primary hepatocytes from both lean and fatty rats. Here, I summarize what have been achieved in my lab since the beginning of the project and what remained to be done in the rest of the funding period. In addition, a report of expenditure is followed.

B. Experimental Results and Conclusion
B1. Since Sterol regulatory element-binding protein 1c (SREBP-1c) plays a critical role in mediating hepatic lipogenesis, its mRNA levels in primary lean rat hepatocytes treated with increasing dosages of retinol (ROL), retinal (RAL) and retinoic acid (RA) were analyzed by real time PCR. Figure 1 shows that ROL had no effect. However, RAL at 20 uM and RA at 2 uM synergized with insulin to induce Srebp-1c expression. RA alone at 2uM induced Srebp-1c mRNA level in the absence of insulin. These results demonstrated that retinoids can regulate the expression of a lipogenic gene.

B2. The effects of RA and insulin on mRNA levels of Srebp-1c and its down stream target, fatty acid synthase gene (Fas), were monitored over a 24 hour peroid of time. Figure 2A shows that RA synergized with insulin to induce Srebp-1c expression as early as 3 hours and lasted for 6 hours. The Fas mRNA levels (Figure 2 B) induced by RA + insulin were significantly higher than that by insulin alone at 6, 9, and 12 hours. The lag time between the increase of Srebp-1c mRNA (3 hours) and significant induction of Fas expression may reflect the time needed for the synthesis SREBP-1c protein and process of nuclear form of SREBP-1c. All these demonstrated the RA induces the expression of hepatic lipogenic genes.

B3. VA deficiency decreased body weight gain and improved plasma lipid profile in both Zucker lean and fatty rats. As obesity development is associated with increase of hepatic lipogenic gene expression. Zuker lean and fatty rats were fed with VA deficient (VAD, purified diet #5822, VA, 0 IU/g, TestDiet, Richmond, IN) or VA sufficient diet (VAS, #5755, VA, 22.1 IU/g, TestDiet) or regular chow diet (TEKLAD, rodent diet #8640). Figure 3 A shows that fatty rats on VAD diet gained significantly less body weight than those on VAS (starting from 2 weeks) or chow diet (starting from 3 weeks). While fatty rats on VAS or chow diet continuously gained body weight, VAD fatty rats stopped gaining body weight at around 5 to 6 weeks. These results demonstrated that the massive gain of body weight of Zucker fatty rats caused by the deficiency of leptin signaling can be curtailed by a lack of nutrient in the diet, vitamin A in this case.
VAD Zucker lean rats (Figure 3B) started to gain significantly less body weight at five weeks on the diet and the weight gain stopped at 6 weeks before it starts to drop at 7 weeks. In contrast, lean rats on VAS or chow diet continuously gained body weight. Comparing Fig. 3A and 3B, it seems that Zucker fatty rats are more sensitive to VA deficiency than lean rats.
B4. The reduction of body weight caused by VA deficiency is associated with the correction of hyperinsulinemia and hypertriglyceridenemia in Zucker fatty rays. Table 1 shows that VAD fatty rats have significantly lower, body, liver, and epididymal fat pad weights; and plasma glucose, TG, cholesterol, insulin and leptin levels, than VAS rats have. The ratios of liver to or epididymal fat to body weight are not significantly different, suggesting the overall reduction of the animal sizes. The reduced insulin and glucose levels suggest a dramatic improvement of insulin sensitivity in VAD fatty rats.

VAD Zucker lean rats (table 2) have reduced body, liver, and epididymal fat weights; fat/BW ratio; and vena cava plasma glucose, TG, insulin and leptin levels, than VAS rats have. There is no difference in liver to body weight ratio, and plasma total cholesterol level. It is interesting to note that VAD lean rats have no observable body fat.

B5. VA deficiency resulted in reduction of the expression of lipogenic, but nor cholesterol biosynthetic genes in liver of VAD fatty rats. The correction of hyperinsulinemia and hypertriglyceridenemia might be caused by the reduction of hepatic lipogenic gene expression in VAD fatty rats. Figure 4 shows that VA deficiency did not affect the hepatic expression of Ubc (ubiquitin) and Insr (insulin receptor) mRNA. Similar to that of Cyp26a1 mRNA, a RA responsive gene, the expression levels of lipogenic genes, such as Srebp-1c, Fas, Scd1, and Me, were significantly reduced in liver of VAD fatty rats. However, the expression of cholesterol biosynthetic genes, such as Hmgcs2 and Hmgcr, remained the same. In summary, our results demonstrated the critical role of VA in the development of obesity and insulin resistant phenotypes.

C. Ongoing experiments. Currently, the PI’s lab is actively performing the following experiments to investigate the roles of VA in the development of obesity. (1) We are analyzing the gene expression profile in livers of Zucker fatty and lean rats fed with VAD or VAS diet. The RNA samples have been sent to Affymetrix core facility in the Department of Nutrition at the University of Tennessee. (1) We will confirm the microarray data with real time PCR, Western blotting and activity assay if possible. (3) We and Dr. Qixin Zhong’s lab are trying to encapsulate ROL and RAL into nanoparticles for testing their absorption, retention and modification in GI tract. These additional experiments will provide us with detail information regarding alterations of metabolism caused by changes of VA status during the development of obesity.

D. Financial accounting of the expenditures of my grant
The total number of the funds was $50000. When it arrived at UTK, $6522 was considered indirect cost (15% allowed by Allen Foundation Inc) and $43478 was considered direct cost, which I have re-budgeted into the following categories: personnel ($12962), supplies ($28116), travel ($1000), maintenance & repairs ($400), and publication ($1000). Currently, the balances for the above mentioned categories are as follow: graduate student salary and fees ($8974), supplies ($5323), travel ($1000), maintenance & repairs ($400), and publication ($1000). The total unspent direct cost is $16697 as on March 31, 2009. I would like to ask a non-cost extension to carry over the unspent fund into the next fiscal year for the reasons that I stated in the letter addressed to Dr. Dale Baum, secretary of Allen Foundation Inc at D-Baum@TAMU.edu.

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Project Title: FEED THE DREAM--A Guatemalan Nutritional Expansion Program, Site #3
Institution: None
Date: 4/20/2009
Report:
Project Title: A Guatemalan Nutritional Expansion Program, Site #3
Institution: Feed the Dream
Date: April 20, 2009
Report:

Once again due to the gracious generosity of the Allen Foundation and others, Feed the Dream has continued to make significant progress in fulfilling its purpose to improve the nutritional health of children and young women of reproductive age in an increasing number of Guatemalan Highland villages. Allen Foundation funds were used for three villages in the Chimaltenango area.

Focusing on the goals of Feed the Dream, we can report:

1. Nutritionally balanced meals with vitamins continue to be provided daily to children 0 to 5 years of age and women of reproductive age in the three Allen-funded villages. In our mountain hamlet area there are now 8 communities (caserios) participating in the Feed the Dream program. A total of 14 villages are involved in Feed the Dream which provides nutritional services to more than 1000 women and children daily.

2. In these same villages, education on good nutrition and safe drinking water takes place through the efforts of our local indigenous, Kaqchikel-speaking educators. Working with the mothers, Silvia, who has nutritional expertise, teaches the significance of nutrition and how to take advantage of available local resources. There are weight and height evaluations. She emphasizes hygiene, proper food preparation and potable water, while simultaneously encouraging early stimulation techniques to use with their young children. Posters for reinforcement of her teachings are cheerfully displayed. Rigoberto is our agricultural expert who gives hands-on training in crop diversity and plants that are nutritionally rich and easily grown in home gardens. Chaya has successfully been introduced, the leaves being used in soups and creams. The use of amaranth (a nutritious grain) and moringa tree leaves have also been encouraged. Most families have gardens or tire-container gardens to take advantage of the few plots of land available. Home visits take place for reinforcement and encouragement to sustain positive changes.

3. In these same villages, indigenous women volunteers are participating in and carrying out the programs noted above. Our educators work in partnership with them as the women learn new recipes using their family garden produce, including vegetable leaves and local herbs which contain vitamin A. They are encouraged to use their own onions, garlic, celery, cilantro and red pepper for seasoning in place of artificial options. The educators introduce new products, such as moringa, chaya and amaranth, and teach the benefits of incaparina (fortified nutritional drink) and Protemas (soy meat). The mothers learn and practice these new skills in a center we have provided and benefit from the social time spent together.

4. Feed the Dream has provided the tools needed to carry out the above programs. We have built a multi-purpose kitchen and activity center with the needed equipment, including the vented Onil stove. Following the instruction of hygiene and the food preparation done together, the mothers and children enjoy consuming the results. An added benefit is the socialization for both mothers and children, a rarity with their impoverished lifestyle. Since 98% of surface water is non-potable, families have the opportunity to acquire a water-filter at a nominal cost.. Prenatal vitamins with the crucial folic acid and children’s vitamins are provided. In addition to Rigoberto’s agricultural programs discarded used tires are provided, inverted, and filled with good soil for successful family container gardening which is done close to the home and uses very little water. Vermiculture is encouraged and other organic measures, emphasizing environmental care.

5. Feed the Dream assures accountability through the local partner’s frequent (at least weekly) visits to the sites. However, the nutritious snacks are daily. In this area our local partner Behrhorst Partners for Development (BPD) has a staff team of a doctor, nurse, agriculture and nutritional experts, all of whom are highly trained and who work with and teach respected community health promoters. With their daily presence the latter add credence and reinforcement to the teachings.

6. We are approaching self-sustainability in several villages. Surrounding villages are anxious to be working with us as they witness the improved health of their neighbors. We are planning to include them as additional funds become available. Our achievements to date are heartening as seen by the reduction of malnutrition in our villages resulting in healthier babies and children (see tables below). The success of the crops grown and the village acceptance of new teachings are remarkable. We continue to face two major challenges: (1) finding qualified indigenous staff members, as their workload and travel on uncomfortable rural roads is demanding and time-consuming: and (2) having all the women attend meetings regularly (85% do), as they have many other daily obligations to fulfill such as childcare, household duties (often including many hours spent hauling water and firewood), taking lunch to their husbands in the field and school responsibilities. This is changing slowly as they hear the positive feedback from other women in the village.

We have seen the following outcomes of our efforts:

1. The three villages referred to in this report receive Allen Foundation funding. Their total population is 1476. In addition to the children there are 125 women of reproductive age receiving the benefits, as well as all the mothers of the involved children.

2. Health has measurably improved in the participating villages. Please note that the following statistics do not reflect a full year.










CHILDREN MALN MALN.RISK LOW WEIGHT NORMAL

CRUZ NUEVA
Feb, 2008 5 0 15 10
March 2009 0 1 1 18
CAMBALCOL ALTO
Feb. 2008 1 3 13 11
March 2009 0 0 2 23
CHOABAJITO ALTO*
Nov. 2008 5 4 15 12
March 2009 2 1 2 15


* Within a few months the improvement here is dramatic! We are especially encouraged that the low weight
children held their own and did not slip down to the malnutrition area. The discrepancy in the numbers is due
to the availability for attendance as previously mentioned in #6.

3. Feed the Dream’s goal is self-sustainability which we anticipate to be a 5-year process. Much will depend on the development of a strong community leader to encourage and maintain positive change. The rural indigenous are uneducated (particularly the women), poor but hard workers. They are growing new crops and learning the importance of crop diversity. As statistics indicate, the nutritional efforts have led to the reduction in malnutrition rates and significant gains in the normal weight category. We feel we are building a community which will lead to the emergence of leadership to continue these positive changes. Of course, we are thrilled with the babies being born bigger and healthier and the reduction of dysentery and diarrhea. Equally wonderful side-effects of our programs are new self-esteem and the benefits of socialization for both women and children with increased school attendance and a strong sense of community.

4. We are anticipating that once self-sustainability is attained, this pattern will continue into a healthy future. We already see other villages wanting to participate.

Feed the Dream is making a difference right now and for generations to come. The improved nutritional health of newborns and young children guarantees them a chance to be successful in school and survive the many diseases that accompany poverty, while at the same time enabling them to reach their potential IQ levels (which are stunted by as much as 15 IQ points if malnourished).

FINANCIALS (through April 1, 2009)—Total Allen Foundation funds of $10,000 are greatly appreciated and have been a significant part of our
total project of 14 villages.

FOOD $ 4,200
oil, beans, incaparina, etc.
SEEDS, ORGANIC FERTILIZER $ 2,500
COMMUNITY CENTER $ 1,800
dining & kitchen center, Onil
stoves , water filters, etc.
SALARIES* $ 1,500
Partial indigenous educators
TOTAL $10,000

*portion paid through Allen Foundation funds



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Project Title: New Kitchen for Parent Training Program
Institution: Baptist Child & Family Services
Date: 4/15/2009
Report:
Baptist Child & Family Services (BCFS) was pleased to receive the awarded amount of $4,475 from the Allen Foundation Inc. The funds were utilized for a kitchen renovation which was in desperate need of new appliances. The kitchen is used to prepare meals for parents and children enrolled in the Precious Minds, New Connections (PMNC) parent education program. The Kronkosky Charitable Foundation funds the BCFS managed PMNC program which offers parents across Bexar County. The eight week training program includes topics such as child development, preparing children for school through reading and play, and role modeling positive behaviors. While parents attend classes their children are provided childcare on-site. Just over 1,000 families were provided parent training, childcare and healthy meals during their attendance.

Parent education courses were held every 8 weeks at approximately 20 locations throughout Bexar County during the grant year. In meeting the needs of the community, courses are often held during breakfast and dinner times. Meals include turkey spaghetti, broccoli and cheese casserole, and bacon and egg quiche. For many parents and children, the meal offered by PMNC is one that otherwise might not be as nutritious or available to the family. Meals are prepared by PMNC staff in the “new” kitchen so that healthy options may be offered to parents and children. Families enjoy homemade healthy meals that are shared amongst the entire class. In addition, parents are able to access their own drink refills as the new refrigerator provides water and ice. The new kitchen is enjoyed by staff and families alike, as the varied days and times of classes allow daily access to the kitchen.

Other BCFS programs that have utilized the new kitchen include PAL (Preparation for Adult Living) which provides life skills training to youth aging-out of foster care. Building healthy meals on a budget is also discussed with the youth over lunch. Emergency Placement Services has hosts birthday parties and luncheons with delicious meal options for children in state custody. Additionally, the San Antonio Food Bank offered nutrition classes for PMNC parents, in which wholesome meals were prepared and shared by the group.
BCFS looks forward to serving many more parents and children with healthy meals and valuable parent education training. By facilitating parents groups, BCFS is able to provide a safe and comfortable environment in which families can support one another. By sharing a meal together, otherwise isolated parents are able to engage in positive social interactions; further role modeling healthy behaviors and choices for their children. Discussion of healthy habits and meals preparation occurs at this time as well, as parents and staff exchange ideas and suggestions. For many parents, preparing dinner on a limited budget is an outstanding issue and knowledge sharing amongst parent peers is extremely worthwhile. Overall, parents are trained on the importance of caring for their children’s physical and emotional health to better improve success in school and in life.

Appliances purchased, delivered and installed by Home Depot include: refrigerator, stove, microwave and dishwasher. In addition, a maintenance & repair warranty for each item was purchased. These expenses totaled $4,281.97. Kitchenware’s purchased at Wal-mart include: bake wares, utensils, cookware, toaster and blender cost $193.74. Total funds expended: $4,475.71.

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Project Title: Promoting Good Nutrition During Infusion Therapy
Institution: MidMichigan Medical Center-Midland
Date: 4/14/2009
Report:
In 2008, MidMichigan Medical Center-Midland received an Allen Foundation grant of $3,060 toward equipment, supplies and training to promote good nutrition among outpatients receiving infusion or intravenous therapies in the newly constructed Infusion Center. These patients often spend up to eight hours a day receiving infusions. Thanks to the grant, Infusion Center staff and volunteers were able to offer warm and nutritious food to patients. The food provided not only comfort, but an opportunity for MidMichigan's Infusion Center to promote good nutritional practices during cancer infusion therapies. For patients with cancer, both the illness and treatments can affect a patient's appetite and alter the body's ability to use nutrients. Good nutrition helps patients to maintain their strength and energy, weight and the body's store of nutrients, tolerate treatment-related side effects, decrease the risk of infection, and heal and recover more quickly. During the last year, the grant enabled the Infusion Center to provde nutrition to approximately 3,600 patients.

Specifically the grant allowed the purchase of a microwave, drink mixer and cups, coolers, an electric soup kettle, digital thermometers, soup ladles, coffee maker, cart, garbage disposal, and food and safety training to two individuals. Patients were offered hot soup, hot chocolate, coffee, cold shakes and smoothies, pudding and microwaveable meals. Food selections were made by Mary Jane Hoshaw, manager of Food and Nutrition Services at MidMichigan. Because volunteers were the primary food servers, a total of two volunteers received the food handling training thus far with an additional eight expected due to the natural volunteer turnover that occurs. This training is provided by the health department.

Joan Herbert, Pharm.D., director of Oncology Services at MidMichigan Medical Center-Midland, served as the principal investigator. Dr. Herbert is responsible for enhancing the quality and promoting the growth of oncology services for the Medical Center and other affiliates of MidMichigan Health.

For more information, please contact Dr. Herbert at (989) 839-6190 or by e-mail at joan.herbert@midmichigan.org.

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Project Title: Development of Specialized Therapeutic Soy Foods for the treatment of Malnutrition
Institution: Washington University
Date: 12/31/2008
Report:
Allen Foundation Report
$71,500 grant award, 2008

December, 2008

Development of Specialized Therapeutic Soy Foods for the treatment of Malnutrition

This project has developed a new, low cost, energy dense, ready-to-use food for therapeutic feeding (RUTF). It is currently being tested in a clinical trial to compare its effectiveness to the more standard expensive milk-based ready to use therapeutic food that is used to treat severly malnourished children.

The new formula, 10% milk RUTF, is a mixture of peanut butter, oil, sugar, milk and soy flour. RUTF will not support the growth of bacteria, nor will it spoil at tropical conditions. We prepared several formulations of RUTF and test marketed them with Malawian children to determine the most palatable recipe. Upon finding the most readily acceptable formula, we initiated a randomized, clinical effectiveness comparison trial of 10% milk RUTF with the standard 25% milk RUTF with 1800 children in rural Malawi. To date 1359 children have been enrolled in the study. Eligible children are severely malnourished and receive eight weeks of therapeutic food. Both diets are complete, supplying 175 kcal/kg/d. Children are monitored every two weeks. The outcomes of the trial are recovery rates and changes in anthropometry.

With the help of the Allen Foundation in 2001, we developed RUTF, a novel therapeutic peanut butter-based food that increased recovery rates of severely malnourished Malawian children from 25% to 95%. In four short years this breakthrough has been adopted in hundreds of settings throughout the developing world, and over 150,000 children were successfully treated last year. We expect this number to grow substantially in the next few years, as our factory increases capacity. We hope the Allen Foundation takes great pride in partnering with Project Peanut Butter in such a way as to create this level of impact, worldwide. Last year the World Health Organization made it official; RUTF is the appropriate treatment for severe childhood malnutrition. The product and treatment protocol has also been endorsed by the U.N. System Standing Committee on Nutrition, the World Food Programme and the U.N. Children’s Fund.

The project will be completed in 1 year and the total cost is still estimated at $71,500. There have been no substantial increases or decreases from the proposed budget, and, as expected, the World Food Programme made a significant donation of the required food ingredients.

Expenditures to Date

Salary Heidi Sandige MD junior investigator new Wash U $13,500 of $27,500
Travel to Malawi x 2 for Dr. Sandige $2500 of $ 5,000
Transport in Malawi for study team (fuel, vehicle rental $600/month) $7200 of $14,200
Study Food $2379 of $17,650
Indirect Cost $7150 of $ 7,150

Total $32,729 of $71,500

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Project Title: Vitamin D Deficiency and Rickets Among Healthy Infants and Toddlers
Institution: Children's Hospital Boston
Date: 7/9/2008
Report:
Allen Foundation Annual Report - 2007

Project Title: Vitamin D Deficiency and Rickets among Healthy Infants and Toddlers
PI: Gordon, Catherine M.
Four digit ID: 0409
Institution: Children¡¯s Hospital Boston
Funding from: 07/01/2006 ¨C 12/31/2007

Summary of Work and Accomplishments:
We completed enrollment for our prevalence study on June 30, 2007 and for the vitamin D treatment trial on August 15, 2007. We immediately began our final data analysis and began manuscript preparation. To date, 2 manuscripts have been accepted for publication, including a primary scientific article and case report. Two other primary articles are in preparation, including results from the treatment trial and a case control study of 13 infants identified to have a seemingly rare condition called transient, benign hyperphosphatasemia. Lastly, an invited review on vitamin D deficiency during childhood is being written by Dr. Gordon and Dr. Susanna Huh from our research group. This review will cite our Allen Foundation funding as many ideas discussed within have been generated by this project. An abstract highlighting data from our prevalence study of 380 infants was presented at the annual meeting of the Pediatric Academic Societies in Toronto in May 2007. In June 2007, the design of the study was included in an oral presentation that Dr. Gordon gave at the International Conference on Children's Bone Health in Montreal, entitled, ¡°What is the Optimal Vitamin D Level in Children?¡±

Publications and Abstract Resulting from Funding:
Articles
1. Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinman PK, Perez-Rosello J, Cox J. Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Ped Adol Med 2007 (in press).
2. LeBoff Williams A, Cox Joanne, Gordon CM. Rickets in an otherwise healthy 11-month-old. Clin Pediatr 2007 (in press).
3. Huh S, Gordon CM. Vitamin D deficiency in children and adolescents: prevalence, impact and treatment. Reviews in Endocrine and Metabolic Diseases. Springer 2008 (in press).

Abstract
1. Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinman PK, Perez-Rosello J, Cox J. Prevalence of vitamin D deficiency among healthy infants and toddlers. Pediatric Research 2007; Proceedings from annual meeting of Pediatric Academic Societies, May 2007.

Updates by Specific Aim:

1) To determine the prevalence of vitamin D deficiency among healthy infants.
We enrolled 380 infants and toddlers into a cross-sectional study to evaluate the prevalence of vitamin D deficiency among otherwise healthy young children. We reported a prevalence of vitamin D deficiency (25-hydroxyvitamin D or 25OHD) level < 20 ng/mL in 12.1% of participants. Forty percent were below an accepted optimal threshold of 30 ng/mL. The prevalence did not vary between infants and toddlers, nor did it vary by skin pigmentation. There was an inverse correlation between serum 25OHD and PTH: r = -0.27, p < 0.001 for infants and r = -0.20, p = 0.02 for toddlers. In multivariable models, breastfeeding without supplementation among infants and lower milk intake among toddlers were identified as significant predictors of vitamin D deficiency. Among the vitamin D deficient participants, 3 participants (7.5%) exhibited rachitic changes on knee and wrist radiographs, while 33% had evidence of demineralization. We conclude that suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D status were shown to vary in infants vs. toddlers, information important to consider as pediatric providers care for these young patients. One-third of vitamin D deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.

2) To evaluate the efficacy of three oral treatment regimens for treatment of vitamin D deficiency and rickets: 2000 IU of daily vitamin D2, 2000 IU of daily vitamin D3, or 50,000 IU of weekly vitamin D2.
Forty infants who were identified to have vitamin D deficiency were enrolled in a 6-week treatment trial. Participants were randomized to 1 of 3 treatment arms. Follow-up serum levels of 25OHD, PTH, calcium, magnesium, phosphorus, and alkaline phosphatase were obtained in follow-up. No adverse effects seen in any group. There was no difference in treatment as shown by biochemical assessments in Figure I. The conclusions are reassuring to pediatric clinicians as the medical literature contains contradictory information about the efficacy and safety of specific treatment regimens. Our data suggest that these 3 common vitamin D regimens we studied are effective and safe.

PLEASE SEE ORIGINAL REPORT (sent via email) FOR FIGURE 1

Figure 1: Change in serum 25OH-D and related markers in infants and toddlers diagnosed with rickets (25OHD ¡Ü 20 ng/dL), after 6 weeks of treatment with randomly assigned vitamin D regimens. Mean and 95% confidence interval from repeated-measures regression analysis of log-transformed concentration measures.

Budget: Funds will be spent in entirety by the end of the funding period, 12/31/2007. After notification of our Allen Foundation funding, our General Clinical Research Center at Children¡¯s Hospital Boston granted us partial funding to cover the expenses of some of the laboratory tests. Therefore, the funds allocated for these blood tests were then used to cover salary (e.g., to account for slight cost of living increases, etc).

PLEASE SEE ORIGINAL REPORT (sent via email) FOR FINANCIAL DATA

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Project Title: Developmental outcomes of maternal micronutrient supplementation at three years of age
Institution: Lancaster University
Date: 6/11/2008
Report:
Developmental Outcomes of Maternal Multiple Micronutrient Supplementation

Goals
The three goals of this project were (1) to assess the impact of multiple micronutrient supplementation during pregnancy on early child development, (2) to encourage good dietary habits and play-based stimulation in the homes of children at risk for undernourishment, and (3) to build local research capacity in nutrition and related fields through seminars and other types of training.

Research Site
Lombok is in the Nusa Tenggara Barat province of Indonesia, situated between Bali to the west and Sumbawa to the east. Pregnant women in Lombok are at risk for micronutrient deficiencies. According to Helen Keller International’s Nutritional Surveillance System, 33% of non-pregnant mothers surveyed in 2003 were anemic, suggesting high levels of iron deficiency. Vitamin A intake among non-pregnant mothers in Lombok was one fourth of the Indonesian Recommended Daily Intake and the use of adequately iodized salt was the lowest out of all the Indonesian provinces, reaching no more than 27%. (Helen Keller International, 2004). Children in Lombok are also at high risk for undernourishment. Among the 487 children assessed in our research project, 59% were in the bottom 5th percentile of height for their age, 38% were in the bottom 5th percentile of weight for their age, and 48% were anemic. These data suggest a strong need for supplementary nutrition and nutrition education programs in Lombok.

Maternal Multiple Micronutrient Supplementation and Child Development
Allen Foundation funds made possible a study following up on the the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT), which was carried out in Lombok by the University of Mataram, the Government of Nusa Tenggara Barat Province, the Ministry of Health of Indonesia, and Helen Keller International. The SUMMIT was a double-blind cluster-randomized trial conducted through the local health care system. It was designed to compare the effects of a pre-natal multiple micronutrient supplement containing 15 micronutrients (MMN) to the supplement currently provided nationally in Indonesia, which contains only iron and folic acid (IFA). From April to September 2007, 42-month old children of women who had participated in SUMMIT during pregnancy (244 who received MMN and 241 who received IFA) were assessed on tests of motor development, socio-emotional development, language development, and non-verbal cognitive development, including attention and executive function. Measures of anthropometry, stimulation children received from the environment, and dietary intake frequency were also gathered. Preliminary data analysis suggests that maternal MMN supplementation improved motor development, especially fine motor skills. This benefit of MMN was greater for children of women who were anemic when they enrolled in the supplementation program. Children of women who were undernourished when they enrolled in the program (based on mid-upper arm circumference less than 235 cm), showed a benefit of MMN over IFA on measures of non-verbal cognitive development, specifically attention (visual search) and visuo-spatial skill (block design). Overall, the amount of stimulation a child received from the environment, the child’s height for age (a measure of chronic undernutrition), and the child’s hemoglobin level were strong predictors of most developmental scores. These results suggest that while stimulation that children receive from the environment and nutrition after birth are very important to promote children’s development, maternal MMN supplementation can also improve some aspects of development, especially in undernourished women. All analyses are preliminary and are pending approval from the SUMMIT Data Oversight Committee.

Encouraging Good Dietary Habits and Play-Based Stimulation in the Home
All families who participated in the research were provided with an educational brochure that we produced for the purpose of promoting good dietary habits and play-based stimulation in the home. This brochure used a combination of locally drawn illustrations and written text in both Sasak (the local language) and Indonesian (the national language) in order to promote healthy nutrition and parent-child interaction. The first two pages provided information about good childhood nutrition from birth through early childhood. The second two pages provided advice about how parents can stimulate their children’s development by playing with them, teaching them, and encouraging independence and exploration. The next two pages presented ideas about how adults can use every-day locally available materials to make toys for their children to play with. During the testing visit, the testers, who were graduates from the nutrition program at the local Mataram University, explained the information in the brochures and gave a copy to the participants. Children found to be anemic (that is, whose hemoglobin level was less that 11 g/dl) were also provided with a box of fortified powdered milk. The testers gave the mothers of anemic children advice about what sorts of foods can improve the health status of their children.

Building Local Research Capacity
Allen Foundation funds allowed an office to be set up at the local Mataram University from which the research and educational activities were conducted. Our local collaborator was Dr. Husni Muadz, who is a professor and the head of a Research Center at the university. We were able to purchase several computers, a printer, and various other pieces of equipment, which we used for the duration of the field activities then donated to the local Research Center for use in future research projects in Lombok. A series of seminars were given by Dr. Katie Alcock and Ms. Beth Prado to students at Mataram University and local government research offices. The goal of these seminars was to expose students and established researchers to current ideas and methods and encourage them to develop their research skills. Dr. Muadz was also able to travel to Lancaster University in England to give a seminar and work on data analysis. The testers who worked on the project were given extensive training in child testing. They learned how to adapt standard child development tests to a different setting, culture, and language and how to measure the reliability and validity of the adapted tests. They also developed skills in designing a research project, applying rigorous methodology, interpreting data, and promoting nutrition education, all of which will enhance their capability to conduct research projects and educational programs in the future. Allen Foundation funds have also made possible a two-year scholarship for an Indonesian student to undertake a Master’s degree at Mataram University. This scholarship will be administered through the SUMMIT Institute for Development and the chosen student’s Master’s research will be conducted in the area of nutrition or nutrition education.

References:
Helen Keller International. (2004). Nutrition and health surveillance in rural Lombok: Key results for the period: Dec 1999 - Sep 2003. Indonesia Crisis Bulletin, 5(12).

Financial summary:
Expenditure to date (Conversion rate used is median of rates on August 1st 2006 and May 1st 2007). Note due to the change in exchange rates since the grant was applied for we have been left with a slight shortfall.

Category Expenditure in GPB Expenditure in US$
Salary contribution for PI 4,750.00 9,143.75
Travel 4,617.60 8,888.88
Consumables and office expenditure 4,224,03 8,136.98
Equipment 2,683.38 5,165.51
Salaries (Indonesia) 9,519.75 18,325.52
Overheads (Lancaster) 5,228.15 10,064.19
Total 31,025.88
59,724.82
Balance remaining on grant -3,503.82

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Project Title: Della Terra
Institution: educational
Date: 5/23/2008
Report:
We have been committed to expanding community awareness around the topic of early childhood nutrition education for lifelong health, and the Allen Foundation grant has allowed this work to continue for another year.
Our efforts culminated in March when the director of Della Terra, our gardening program, presented a workshop at the first Farm to School conference in the state which was held in Traverse City, Michigan.
More than 300 like-minded individuals from around the state attended the one-day event titled Farm to School: Healthy Kids, Thriving Farms designed to bring together schools, camps, parents, students and farms to help kids “eat healthy, learn well, and connect to their community with locally grown foods.”
Della Terra’s director presented two afternoon workshops on school gardens and inspired at least two other schools to start their own campus gardens.
Also, as part of the School’s healthy eating curriculum, the grant funded a Classroom Kitchen director/teacher ($15.5K annually) who not only headed up a classroom kitchen during the school year, but she also presented a workshop on cooking techniques at the farm to school conference.
The grant allowed Della Terra to engage in a number of other projects as well such as heating the greenhouse ($3.5K) where the children grew heirloom vegetables, flowers and herbs from seed. They sold their harvest at various plant sales at the school and at the local farm market. The children harvested, washed, packed, labeled and sold their produce to parents once a week for several weeks. In addition to the sales, school grown produce was used for hot lunch and prepared in the Kitchen Classroom.

With foundation support we were also able to purchase tools, potting soil, seeds and flats. ($15K) The vegetable plants were planted in the campus gardens and the harvest not only fed our students but the community as well. Lettuce was donated to the Fresh Food Partnership, an organization that supplies local food pantries with fresh produce as well as sold to a local restaurant. Other vegetables and herbs grown at the school like eggplant, tomatoes and basil were harvested by the children who learned how to preserve them for winter use in the classroom kitchen.
The 3-5-year-olds were introduced to a new vegetable each month such as edamambe and eggplant. They not only learned about its history and how it’s grown, but what part of the plant they are eating and the health benefits of each. They also had the opportunity to taste each vegetable.
As we continued our outreach efforts, Della Terra’s activities were posted weekly on the Internet and healthy living topics were featured in the school’s quarterly newsletter which is received by nearly 1,000 readers around the country. This increased effort on technology and outreach cost approximately $7.5K in technical support, development and implementation. As a result of these efforts, we were able to focus on our internet presence as a tool to other schools hoping to establish similar programs.
The second annual Fitness Festival was also held in February where children planted bean seeds, ate healthy snacks and focused on the importance of physical activity and healthy eating as a life-long habit.

In addition to the above mentioned funding/budget items, the remaining $8.5K, was directed towards and offset the salary of the Della Terra program director which is $22K.

It is our hope that this information is satisfactory and fulfills the financial reporting requirements of your foundation. We are grateful for the support of the Allen Foundation and will continue to keep you updated on the development and outreach of our Della Terra program.

In addition to this report, I have submitted a complete packet with additional information by mail that you should have been in receipt of by the May 1st, 2008 deadline. I apologize for the confusion in getting this updated submitted online as well.

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Project Title: Rescuing the Future Strategy
Institution: Food Bank of Eastern Michigan
Date: 5/1/2008
Report:
The Food Bank of Eastern Michigan has completed the expansion process necessary to support its Rescuing the Future Strategy and is in the early stages of piloting the Rural Distribution and Food Rescue Programs. The Rural Distribution Program employs a four-pronged approach to meeting need in the Food Bank’s rural communities including encouraging successful Food Bank Partner Agencies to recruit and mentor qualifying organizations in their home communities, expanding the distribution system, increasing the volume and variety of food available, and assisting the Food Bank’s Partner Agencies to become financially sustainable, and nutritionally literate—and to share that information with those served. The Food Rescue portion increases the amount of nutritious food available and decrease the amount of food clogging landfills. Further, the expansion necessary to accommodate the availability of fresh produce and ability to process bulk foods has already added fresh fruit to all of Flint’s BackPack Programs, will be added to all Summer Food Service Sites, and is increasing in Mobile Food Pantry and Mass Feeding Programs. The Food Bank is now looking into the feasibility of adding “mini-carrots” and other child-friendly ready to eat vegetables to the 2008/ 2009 BackPacks and fruit to the 2008/2009 Kids Café Program.
The Allen Foundation’s generous grant of $75,000 has gone a long way toward Construction Costs in this project. The initial estimate placed the project at $1,597,012. With the addition of a 2,376 square foot vehicle maintenance building and a couple of unexpected drainage and run-off costs, the Food Bank and its funders have invested $1,824,002; that includes $226,990 in organizational funding. The construction is complete and installation of the new slide-back racking system in two weeks will bring the space to its full usability.
Data are still being gathered to complete the number of people served in 2007 and comprehensive demographic profile. Based on increased pounds of food distributed and the average pounds per person served ratio, it is projected that over 525,000 people received food from the Food Bank in 2007. (Agency distribution in 2006: 11,727,726 pounds /People served in 2006: 476,224 people. 11,727,726/ 476,224 =24.63  Average agency distributed pounds per person in 2006: 24.63 pounds. Agency distribution in 2007: 12,972,245 pounds  12,972,245/ 24.63 = 526, 684. Projected number served in 2007: 526, 684 people. The results of the completed demographics will be submitted immediately upon finalization.
The amount of Food distributed by the Food Bank in 2007 increased over 1.5 million pounds, over food distributed in 2006. In 2007, 17,824,654 pounds of food was distributed by the Food Bank. Of that, 12,979,245 pounds were distributed through our Partner Agencies. That increase is attributed to the efforts of the Rural Distribution Program. The Food Bank’s goal was to double the number and frequency in its outer service area; these were more than doubled from 17 deliveries per week in 2006 to 40 in 2008. An increase of 46,000 pounds of food distributed through Mass Feedings Program. The 34 Mobile Food Pantry sites in 2006 increased to 47 by 2008.
The Food Bank hoped to gain ten new Partner Agencies; through changes in the system of distribution, there was an increase of 40 new agencies. In the five county “red zone,” Crawford, Sanilac, Arenac, Alpena, and Otsego where less than 10% of need is met, five new mentored agencies have been established. Further, there has been a food distribution increase of 77.68% in 2007 over the previous year. Between 10% and 19% of need is met in the seven county “orange zone” which is made up of Gladwin, Bay, Alcona, Montmorency, Huron, Cheboygan, and Roscommon; nine new agencies have been established. Food distribution increased 16.09% in 2007 over the previous year. Between 20% and 22% of need is being met in the five county “yellow zone,” Lapeer, St. Clair, Presque Isle, Midland, and Saginaw; 22 new agencies have been established. There has been a food distribution increase of 16.09% in 2007 over the previous year. Finally, between 33% and 66% of need is met in the five county “green zone:” Ogemaw, Tuscola, Genesee, Iosco, and Oscoda; 10 new agencies have been established. Food distribution increased 11.20% in 2007 over the previous year.
The implementation of the Food Rescue Program has been exceptionally exciting. Typical food rescue operations pick up food that would be otherwise wasted and immediately deliver it to soup kitchens. Because the Food Bank has only a dozen Partner Agencies serving prepared food daily and more than 375 Partners serving considerably less, the Food Bank of Eastern Michigan has chosen to pilot a distribution model with the extra step of product stabilization. Warehouse-processing to stabilize rescued food is sometimes as simple as suspending the expiration date by freezing the product, sometimes bulk quantities are repackaged-- sometimes sorted, rinsed, and repackaged. The product, its quantity, and its condition determines the process necessary. By stabilizing rescued food, it is made available to all of the Food Bank’s agencies rather than the handful serving large quantities of ready-made food daily. Due to its unique service area including two counties with concentrated urban poverty, eighteen counties with sprawling rural poverty, and two counties with a largely suburban middle-class population with much lower prevalence of poverty--the Food Bank of Eastern Michigan is one of just a few food banks ideal to pilot this large-scale stabilization model. By implementing this food rescue model, the Food Bank of Eastern Michigan and food banks across the country will increase the available amount of rescued food and diversify the points of distribution.
The Food Bank has been slowly building the rescued food markets. Starting with one local Sam’s Club store in April of 2007, the Food Bank gleaned 5,000 pounds of donated bakery and saw a door open to three more Sam’s Clubs. This cautious increase has assured that none of our new donor-partners are disappointed in careless product pick-up errors, that minimal food is wasted through transport issues, and that the facility is ready to process the food donated.
• From January 1 to April 15, 2008, 24,554 pounds of food has been made available through the four Sam’s Club stores alone.
• From January 1 to April 15, 2008, almost 16,000 pounds of meat has been made available to our pantries at a shared maintenance fee of 18¢ per pound—steaks, hams, chops, bacon-- all available at 18¢ per pound. A package of hot dogs, 15¢. A ten pound ham, $1.80. Six pork chops, 68¢. A pound of bacon, 18¢.
• From January 1 to April 15, 2008, over 8,000 pounds of bakery items have been made available to our pantries with no shared maintenance fee. Tens of thousands of breads, cupcakes, cakes, pastries, rolls, and buns have been distributed to the hungry without even the minimal 18¢ shared maintenance fee.
• The Food Bank hoped to increase the number of food rescue program partners by five; we’ve increased by nine. (Sam’s Club and Target Stores)
o Another 23 are already committed and awaiting the finalization of details. (1 Meijer and 22 Kroger Stores)
o 18 Super Walmarts join our list of partners in 2009.
• In 2008 alone, an amazing 24,633 pounds of food has been donated through Sam’s Clubs. Of that, 15,869 pounds has been meat, 407 pounds in deli foods (fresh cut meats and cheese), 8,306 pounds in bakery goods, and only 51 pounds have been recycled.
• Thus far in 2008, six Target stores have collectively donated 11,377 pounds product; of that, 9,339 has been food product and 2,036 non-food products.
• Bed, Bath & Beyond has donated 575 pounds of product including bedding, towels, and shower curtains.
• As its name suggests, Organics sells organic foods; they’ve donated 2,497 pounds of food so far in 2008.
• Big Apple Bagels has donated 1,681 pounds of baked goods in 2008.
• Red Lobster restaurant has donated 184 pounds of pre-cooked seafood in 2008.
• Four Starbucks stores have donated a collective 711 pounds of coffee in 2008.
The Food Bank’s distribution goal for 2008 includes an increased 1,096,680 in perishable foods.
2007 2008
• 1,333,182 pounds of fresh produce--> 1,815,721 pounds of fresh produce
• 657,668 pounds of dairy products--> 898,936 pounds of dairy products
• 447,068 pounds of meats/ seafood--> 611,570 pounds of meats/ seafood
• 240,316 pounds of frozen foods--> 328,051 pounds of frozen foods
• 84,441 pounds of juice/ other non-shelf stable beverages--> 117,341 pounds of juice/ NSS bev.
• 41,816 in bakery and other non-shelf stable foods--> 129,550 pounds bakery and NSS
• 2,804,490 pounds of perishable foods--> 3,901,170 pounds of perishable foods

Four new staff members have been hired and trained to meet projected increases in services and programs. Jerry Crago was engaged by the Food Bank in June of 2007 as a youth leader through the Summer Youth Initiative and was hired at the end of season as a Programs Coordinator. Michael Williams was hired in August 0f 2007 as the Warehouse Operations Manager, streamlining the agency-order process and overseeing daily warehouse efficiency. Robert Newkirk joined the Food Bank team in January of 2008 as a Warehouse Associate, and also has a CDL enabling him to fill in as a truck driver and allows the Food Bank to groom him as an additional full-time truck driver as distribution continues increasing. Finally, in April of 2008, the Food Bank welcomed the return of Sarah (Waelde) Hierman as Director of Programs. Sarah’s organizational knowledge and skill in structuring new and fledgling programs will be immeasurable in this pilot process.
With the increased capacity, an increasing number of donor-partners are joining with the Food Bank to feed the hungry. As the number of donors increases, the number of agencies and pounds available are projected to increase proportionally. Although in the very early stages of pilot, this is proving to be one of the Food Bank’s strongest programs.

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Project Title: The Allen foundation K-12 Nutrtion Initiative
Institution: Cedar Crest College
Date: 4/30/2008
Report:
May 2008 Report to the Allen Foundation

The Cedar Crest College project worked to accomplish the following goals over the last 10 months:

Seven senior and two junior nutrition majors were selected as the core educators for the project. Five seniors were selected for full-time positions, with the remaining positions being part-time. Students were chosen based on their strong academic performances, interest in working with children and desire to pursue a career in Nutrition and Dietetics. The nine students working with project director Barbara Carlson, MA, RD, CDE, accomplished the work described in the following sections.

1. Five comprehensive, interactive nutrition sessions for use in Elementary Schools were developed. The materials were developed to be adapted for ages K-6. Five primary topic areas were chosen and developed. Those areas were:
• Reading Food Labels: How to choose Healthy Snacks; and
• Four lessons based on the Food Guide Pyramid:
i. Fruit for Good Health
ii. Vegetables Help us Grow
iii. Dairy Foods Build Strong Bones
iv. Whole Grains Provide Great Nutrition
2. Each learning session was developed using an interactive game or lesson format that involved the children in learning. The following games were developed, tested and used:
• Reading Labels: The 10-label challenge—choose the five healthy snacks.
• Fruit for Good Health: A board game in which fruits were matched to colored squares with vitamin and serving size information.
• Vegetables Help Us Grow: The game was “VINGO” played like the classic Bingo, but vegetables and recommended servings made up the squares.
• Dairy Foods Build Strong Bones used a “musical chairs” game which required exercise and identification of dairy products.
• Whole Grains Provide Great Nutrition: an interactive play with actions for each whole grain encouraged learning and movement.
Lessons were adapted based on the age of the audience. Reading Labels was limited to children in 3rd grad and above, but all other games were used for Kindergarten through sixth grades.
3. Learning packets with handouts for students, parents and teachers were provided with each lesson. Homework that required students to track their intake of fruit, vegetables and dairy foods was used to encourage students to practice what they learned.

As in the previous year, Cedar Crest was fortunate to partner with a variety of schools and education programs providing science-based education to elementary schools. The Da Vinci Science Center, The Allentown School District and The Bethlehem School District were all actively involved in nutrition education through the grant. To date, the program has presented in excess of 60 sessions that included more than 4,500 students and well over 50 educators within the schools. Programs were provided during physical education classes, after school as part of enrichment programs and in day-long sessions at several schools. As an example, in the Allentown School District, Ritter Elementary reviewed the program and requested that we come to their school for two days. Twenty classes were provided to grades one through five during the course of those two days. Grades four and five were instructed in Label Reading—How to Choose a Healthy Snack. Teachers in those classrooms were excited about the homework assignment, which required children to take their label-reading guide to the store and help their parents choose healthy snacks. Several teachers decided to use classroom computer resources to have their students access fast-food nutrition analysis and decide whether any foods from those venues fit the healthy snack criteria. In four schools, physical education teachers requested that all four sessions on the Food Guide Pyramid be presented to their classes. The requests for education this year were so numerous and so many that the grant-funded program was busy every week of the spring semester, often sending Cedar Crest students to as many as three schools a week.

The grant also enabled the College to partner with the Food Service Directors for Bethlehem and Allentown School Districts. The Allentown School District asked the students working in the grant to help them survey 100 students, 100 parents and 100 school staff regarding the food service provided, as well as regarding acceptance and use of both lunch and free breakfasts at the schools. This information will be used to plan better services that include more nutrition education and encourage improved intake among students.

The Bethlehem Area School District (BASD) invited Cedar Crest to work with their Aspire program. Aspire programs offers after-school education enrichment to students within the district, encouraging math and reading skills. The Aspire program and BASD recognized that nutrition education encompasses both of these skills, and the grant-funded program provided nine afterschool sessions at area schools.

Once again all students who participated in learning sessions were given a pencil with The Allen Center for Nutrition printed on the side. And this year, prizes, including key chains, fruit-shaped erasers, bookmarks and Food Guide Pyramid stickers were used during the lessons and games to reinforce learning. In addition, each class was provided with a healthy snack based on the lesson. Simple foods, like dried fruits, whole grain pretzels, 100-percent fruit juice, carrot sticks and string cheese were provided.

Materials were developed by the students for most classes. We continued to purchase and use the Food Guide Pyramid and Portion Distortion tear sheets which are available in both English and Spanish. Providing students handouts in their language was an essential part of helping them take the concepts learned into their homes.

Programs will continue to be offered through May and early June. In May the grant-funded program will have the opportunity to provide nutrition outreach education to Northeast Junior High School in Bethlehem. Cedar Crest students working in the grant will be spending two days at Northeast as part of interactive health days. Every student in the school will be attending this event, and they will be provided with information on choosing healthy snacks and the right portion.

One final event deserves note: For the past five years, Cedar Crest College has held a Healthy U Conference in the month of April, during which a wide variety of events encourage healthy habits, including nutrition and exercise. This year, the grant program displayed every game, activity, lesson plan and handout for the College community. Attendees were encouraged to play and learn just like the children in participating school districts. Additional schools and programs will expand the number of students who have had the opportunity to learn healthy nutrition lessons as a result of this grant. The benefits of nutrition education through the Nutrition Education in Elementary Schools has, indeed, had a wide-reaching impact on the Lehigh Valley community throughout 2007-2008.

Final Budget:

Personnel:

1. Program Director Salary $9,000.00 [$3,000.00/semester—summer, fall, spring]*

2. Student Stipends $31,950.00 [5 seniors, full-time, @ $4,500.00 ea., for total of $22,500.00; 1 senior for 1 semester @$2,250.00; 1 senior part-time for 2 semesters @$2,400.00; 2 juniors part-time @ $2,400.00 ea., for a total of $4,800.00]

Materials and Supplies

3. Cookbook contest: $800.00

4. Nutrition logo pencils: $1,200.00

5. Recipe books for children: $1,006.96 (2,000 @ $0.50 each

6. Educational materials, including posters and handouts: $2036.89

7. Food and food preparation supplies to support lesson and provide samples for students: $1,966.15

8. Publication of teacher and parent education materials: $2,040.00

TOTAL: $50,000

*$1,000.00 was moved from the originally budgeted program director’s salary and $950.00 from recipe book costs to partially support the addition of 2 part-time student positions. Other stipends were also adjusted to enable more students to participate. This expanded the program offerings and supported the grant purpose to provide nutrition education to the greatest number of elementary school students.

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Project Title: FEED THE DREAM--"A Guatemalan Nutritional Expansion Program, Site #3
Institution:
Date: 4/27/2008
Report:
Project Title: A Guatemalan Nutritional Expansion Program, Site #3
Institution: Feed the Dream
Date: April 28, 2008
Report:

Thanks to the generosity of the Allen Foundation and others, Feed the Dream has made significant progress in fulfilling its purpose to improve the nutritional health of children and young women of reproductive age in an increasing number of Guatemalan Highland villages. Allen Foundation funds were used for three villages in the area of San Martin Jilotepeque.

Focusing on the goals of Feed the Dream, we can report:
1. Nutritionally balanced meals with vitamins are now provided several times a week to children 0 to 5 years of age and pregnant women in the three Allen-funded villages. In our mountain hamlet area there are now 12 communities participating in the Feed the Dream program. A total of 15 villages are involved in Feed the Dream which provides nutritional services to 1000 indigenous daily.

2. In these same villages, education on good nutrition and potable water takes place through the efforts of our local indigenous, Caqchiquel-speaking educators. Working with the mothers, Evelyn, who has nutritional expertise, teaches the significance of nutrition and how to attain it locally. She emphasizes hygiene, proper food preparation with locally-available ingredients and potable water, while simultaneously encouraging early stimulation techniques to use with their young children. Rigoberto is our agricultural expert who gives hands-on training in crop diversity and plants that are nutritionally rich and easily grown in home gardens. Home visits also take place for reinforcement and encouragement to sustain positive changes.

3. In these same villages, indigenous women volunteers are participating in and carrying out the programs noted above. Our educators work in partnership with them as the women learn new recipes using their family garden produce, including vegetable leaves and local herbs which contain vitamin A. They are encouraged to use their own onions, garlic, celery, cilantro and red pepper for seasoning in place of artificial options. The educators introduce new products, such as moringa, chaya and amaranth, and teach the benefits of incaparina (fortified nutritional drink) and Protemas (soy meat). The mothers learn and practice these new skills in a center we have provided and benefit from the social time spent together.

4. Feed the Dream has provided the tools needed to carry out the above programs. We have built a multi-purpose kitchen and activity center with the needed equipment, including the vented Onil stove. Following the instruction of hygiene and the food preparation done together, the mothers and children enjoy consuming the results. An added benefit is the socialization for both mothers and children, a rarity with their impoverished lifestyle. Since 98% of surface water is non-potable, families have the opportunity to acquire a water-filter at a nominal cost. At other sites, all participating families have been able to purchase them. We expect the same results here within a short time. Prenatal vitamins with the crucial folic acid and children’s vitamins are provided. In addition to Rigoberto’s agricultural programs (see #2) discarded used tires are provided, inverted, and filled with good soil for successful family container gardening which is done close to the home and uses very little water. Vermi-culture is encouraged and other organic measures, emphasizing environmental care.

5. Feed the Dream assures accountability through the local partner’s frequent (at least weekly) visits to the sites. In this area our local partner Behrhorst Partners for Development (BPD) has a staff team of a doctor, nurse, agriculture and nutritional experts, all of whom are highly trained and who work with and teach respected community health promoters. The latter add credence and reinforcement to the teachings.

6. To prepare a definitive annual report as a blueprint for other villages to use is premature at this point. It will be more accurate and useful when we reach self-sustainability in another year or two and can include lessons learned. However, our achievements to date are heartening as seen by the reduction of malnutrition in our villages resulting in healthier babies and children (see tables below). The success of the crops grown and the village acceptance of new teachings are remarkable. We face two major challenges: (1) finding qualified indigenous staff members, as their workload and travel on uncomfortable rural roads is demanding and time-consuming: and (2) having all the women attend meetings regularly, as they have many other daily obligations to fulfill such as childcare, household duties (often including many hours spent hauling water and firewood) and taking lunch to their husbands in the field. This is changing slowly as they hear the positive feedback from other women in the village.
.
We have seen the following outcomes of our efforts:
1. By 2008 we hoped to have 5 to 7 Guatemalan villages which have participated or are participating in Feed the Dream. In this area we now have 12 villages total. The three referred to in this report receive Allen Foundation funding. They have a total population of 1564 with 150 children ages 0-5 years and 92 women of reproductive age.

2. Health has measurably improved in the participating villages. Please note that the following statistics do not reflect a
full year.


CHILDREN MALNUTRITION MALN.RISK LOW WEIGHT NORMAL

CHUSIAC-VARITUC
June, 2007 5 0 23 50
Feb., 2008 0 1 12 65
TUNAYES
June, 2007 4 5 14 18
Feb., 2008 2 2 7 30
CAMBACOL*
June, 2007 0 2 12 9
Feb., 2008 1 3 13 11


3. Feed the Dream’s goal is self-sustainability which we anticipate to be a 5-year process. Much will depend on the development of a strong community leader to encourage and maintain positive change. The rural indigenous are uneducated (particularly the women), poor but hard workers. They are growing new crops and learning the importance of crop diversity. As statistics indicate, the nutritional efforts have led to the reduction in malnutrition rates and significant gains in the normal weight category. We feel we are building a community which will lead to the emergence of leadership to continue these positive changes. Some wonderful side-effects of our programs are a new sense of self-esteem and the benefits of socialization for both women and children.

4. We are anticipating that once self-sustainability is attained, this pattern will continue into a healthy future and that other villages will want to emulate their success.

Feed the Dream is making a difference right now and for generations to come. The improved nutritional health of newborns and young children guarantees them a chance to be successful in school and survive the many diseases that accompany poverty, while at the same time enabling them to reach their potential IQ levels (which are stunted by as much as 15 IQ points if malnourished).

FINANCIALS (through April 1, 2008)—Total Allen Foundation funds of $10,000 are greatly appreciated, as
we are part of a larger project.

FOOD $ 3,700
oil, beans, incaparina, etc.
SEEDS, ORGANIC FERTILIZER $ 2,500
COMMUNITY CENTER $ 2,300
dining & kitchen center, Onil
stove and other equipment
SALARIES* $ 1,500
Partial indigenous educators
TOTAL $10,000

*portion paid through Allen Foundation funds



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Project Title: Establishing an Iron-bioavailability Database
Institution: University of Hawai'i at Manoa
Date: 1/6/2008
Report:
There is a growing concern over both iron deficiency, as well as iron overload. Reliable information on good food sources of iron is not being provided by health professionals or the internet because of the lack of knowledge about which foods provide sufficient bioavailable iron in a reasonable serving size. For this reason, the long-term goal of establishing an iron-bioavailability database is to generate reliable information that ranks foods as good iron sources based on their ability to provide absorbable iron rather than just the absolute amount of iron the foods contain.

The specific objective of this project was to establish, at the University of Hawaii, the in-vitro digestion/Caco2 cell-culture-based assay to measure food iron bioavailability that was created at USDA labs at Cornell. With the collaboration from Dr. Glahn’s USDA lab at Cornell, we were successful in setting up the system. Initial bioavailability assays on beef liver and molasses in our lab were found to be consistent with those found in the literature indicating that the assay is working reliably.

In addition to successfully mastering the laboratory techniques of the cell culture system, it has become evident that it is essential to analyze multiple iron-recommended foods for mineral composition due to changes in agriculture and food technology processing. This becomes particularly important as nutrients are being added to foods and may have added inhibitory effects (e.g. calcium added to iron fortified foods).

Although not directly a part of this study, a number of important iron content issues were identified during this study while determining the most useful way to present the iron bioavailability information.

1) Most foods are compared on an equal food weight basis (mg iron/ per 100 grams food). This system is not very practical in helping a person choose appropriate foods to meet their dietary iron requirement as it often results in unrealistic serving sizes. The bioavailability data will need to be incorporated into useful serving sizes. Most practical for the consumer will be by serving size. The most widely acepted serving size is that defined by the Nutrition Labeling and Education Act (1993) and found on food products labels.

2) Irregardless of the information source, most food iron data is presented in tables reflecting absolute iron content. More often than not, there is no differentiation between foods with known high iron bioavailability (beef) with known low iron bioavailability foods (bran).

3) Bioavailability on individual foods may or may not reflect the bioavailability of combined foods that contain different enhancers or inhibitors. Therefore combined foods should also be incorporated into iron bioavailability databases.

4) Enhancers and inhibitors are rarely mentioned.

To clarify, three points need to be considered:
1) When we compare beef liver (a well know iron source) with molasses (the most frequently recommended plant-based source), we find that raw liver contains about 4.9 grams iron per 100 gram edible portion of food and molasses contains about 4.7 grams iron per 100 gram edible portion of food.
2) The Caco2 cell results showed that the iron in both beef and molasses had similar efficiencies of absorption; therefore, a similar percent of the iron contained in each food was absorbable and thus had the same bioavailability.
3) When based on a realistic serving size for an individual food type, as defined by the Nutrition Labeling and Education Act 1993 (4 oz raw liver versus 1 tablespoon molasses, you would have to eat about 6 tablespoons of molasses (120 grams) to absorb the same amount of iron as you would from 4 ounces (114 grams) of beef liver. Since 6 tablespoons of molasses may be an unreasonable amount to consume for many individuals, this information should accompany any recommendations for choosing molasses as a source of iron over beef liver. It therefore becomes important to add this type of reality check to the formula for ranking foods to assure that the recommendation is reasonable.
4) It should also be mentioned that consuming molasses with other foods that may enhance or inhibit iron absorption may effect how it ranks with beef liver. With the cell culture methodology we’ve established we could also test combinations of foods, such as molasses and tea or molasses and vitamin C, to further understand the value of molasses as a source of iron.

In conclusion, we have completed the objectives of the first year of our proposed project: to establish at the University of Hawaii the methodology to compare the relative bioavailability of iron from different foods using the in-vitro digestion, Caco-2 cell-culture system. Our initial test results with beef and molasses demonstrate the usefulness of this method in comparing potential iron sources. It has also identified additional steps that will be needed for a bioavailability database to be practical. We are now ready to seek additional funds to begin building a database of multi-cultural food sources of iron to disseminate to consumers and public health professionals to assist them in making appropriate dietary and health decisions to prevent and treat iron deficiency.

We would like to thank the Allen Foundation for its support of this project. The final disposition of grant funds were: $58,876 in salaries, $10,555 on materials and supplies, and $10,412 on indirect costs for a total of $79,843.


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Project Title: West Midland Family Center- Making Hot Lunch a Reality
Institution: West Midland Family Center
Date: 12/18/2007
Report:
The Allen Foundation provided West Midland Family Center with $10,550, which we used to purchase a commercial grade, stacked-double convection oven. During the summer of 2007 we provided 7000 hot lunches and snacks for hungry children cooked in the oven provided by The Allen Foundation. The ¡Èhome-cooked¡É lunches consisted of (among other things) baked macaroni and cheese, meatloaf, Hungarian Goulash, spaghetti and meatballs and baked chicken. These were served with a combination of fresh salad, fresh vegetable, whole grain bread and fruit. These meals were highly received by the children and parents alike. We heard from many parents who were appreciative of the fact that their children were getting a hot lunch each day. This realization is in and of itself a testament to the fact that parents are learning the importance of proper nutrition. By supporting WMFC programs the Allen Foundation has been instrumental in helping parents learn how to provide healthful meals for their families.

The oven is used daily throughout the school year to provide 54 lunches for preschoolers in our daylong preschool classes. It is similarly used by the on-site KinderKare childcare. Additionally it gets used periodically to make a hot after school snack for approximately 80 kids, is used weekly to prepare the dinnertime meal for our parent support group typically attended by 50 families.

Because we believe that rights to good health and nutrition are universal and that all community members are entitled to have essential nutrition information and access to nutritious foods: we have incorporated a strong nutrition education component into our programs including skills building. Unfortunately the reality for many of our families is that they cannot afford the costs of nutritious foods. So in the summer of 2006 in collaboration with the MSU Cooperative Extension we began a gardening class for 10 families, which continues in consecutive summers. Families were provided a plot of land at the Center on which to garden. The goal was that parents would actually be able to provide low cost food items for their families and have the knowledge to put this food to good use. A real benefit was realized in the summer of 2007 as families learned how to prepare inexpensive casseroles and vegetable dishes using the commercial grade, stacked-double convection oven provided by The Allen Foundation. Parents were also taught how to made jam, pickles, and frozen green beans.

In every way, WMFC attempts to provide healthy, nutritious foods to participants in our programs and to provide up to date information regarding nutrition. We greatly appreciate the support we have received from The Allen Foundation, which has allowed us to address this vital issue in a variety of ways. The Allen Foundation¡Çs support of this effort has lead to a much greater awareness regarding the crucial value of proper nutrition among our patrons and staff members alike.

Financial Accounting

Funds received:
$10,550
Purchase Price of Commercial Grade, Stacked-double Convection Oven:
$10,550

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Project Title: Improved Supplementary Feeding with Ready-to-Use Food
Institution: Washington University
Date: 12/17/2007
Report:
This project has developed a new, low cost, energy dense, ready-to-use food for supplementary feeding (RUSF). It is currently being tested in a clinical trial to compare its effectiveness to corn/soy blend (80% corn/ 20% soy, extrusion cooked, blended four with added micronutrients) and the more expensive milk-based ready to use therapeutic food (RUTF) that is used to treat severely malnourished children. The new formula, RUSF, is a mixture of peanut butter, vegetable oil, sugar, powdered milk and soy flour. RUSF will not support the growth of bacteria, nor will it spoil at tropical conditions. We prepared several formulations of RUSF and test marketed them with Malawian children to determine the most palatable recipe, as follows:



RUSF Formula

27% peanut paste (roasted, ground peanuts)

26% soy flour

25% sugar

21% vegetable oil

1% Premix A + B12 (concentrated minerals and vitamins)



We initiated a randomized, clinical effectiveness comparison trial of RUSF, RUTF and corn/soy blend, with 950 children in rural Malawi. Eligible children are moderately malnourished and receive eight weeks of supplementary food. Each of the three diets provides 1300 kcal/d, about 100 kcal/kg/d, for each child. Children are monitored every two weeks. The outcomes of the trial are recovery rates and changes in anthropometry. The milk-based RUTF is included in this comparison because it has been shown to be superior to corn/soy blend and it is postulated by some nutritionists that milk protein promotes growth more than other foods.



With the help of the Allen Foundation in 2001, Dr. Manary developed RUTF, a novel therapeutic peanut butter-based food that increased recovery rates of severely malnourished Malawian children from 25% to 95%. In four short years this breakthrough has been adopted in hundreds of settings throughout the developing world, and over 150,000 children were successfully treated last year. We expect this number to grow substantially in the next few years, as our factory increases capacity and as commercial products become more available.

Last year the World Health Organization made it official; RUTF is the appropriate treatment for severe childhood malnutrition. The product and treatment protocol has also been endorsed by the U.N. System Standing Committee on Nutrition, the World Food Programme and UNICEF.



Current supplementary feeding programs miss the mark in bringing about recovery in moderately malnourished children, yet many aid agencies and governments continue to throw good money after bad in programs that provide these ineffective formulas. Over 50% of programs in sub-Saharan Africa demonstrated no significant weight gains in children treated, and comprehensive review by the World Health Organization did not identify any efficacy studies for these cereal/legume supplementary foods. These foods have a low energy density and poor protein quality; they are also similar to traditional foods, and are thus consumed by the entire family.



Since supplementary feeding is one of the first responses to international crises, more effective strategies are urgently needed. We know from our previous trials of RUTF in supplementary feeding that an energy dense food is substantially more effective than cereal/legume based food. The problem with RUTF is that it is expensive, largely due to the milk ingredient. RUSF is cheaper to produce, rendering the product more accessible.



If, through this Allen Foundation-funded research, recovery rates with RUSF are substantially higher, as presumed, this could transform supplementary feeding from an ineffective aid activity to one that prevents severe malnutrition. This would be similar to what we witnessed through the previous Washington University/Allen Foundation endeavor that resulted in RUTF. RUSF, by addressing moderate malnourishment, offers a preventive strategy for the severe/acute malnutrition that requires therapeutic feeding with RUTF, given in conjunction with a medical protocol. If malnutrition can be successfully addressed early in the cycle, it will alleviate the suffering of children, reduce the overall costs of addressing malnutrition and save thousands of children’s lives every year, across the globe.



The cost of the formula given to moderately malnourished children to prevent severe malnutrition and promote catch-up growth is an important consideration in supplementary feeding, since it is administered to thousands of vulnerable individuals. Cereal/legume combinations have the advantage of being a low-cost food, about $0.70/kg. RUTF, at $2.10/kg, is too expensive to be widely used, despite its superiority. Alternative formulations of a ready-to-use supplementary food that substitutes soy for milk could substantially lower the cost, while continuing to provide an energy dense food that is less likely to be shared among all family members. This is the focus of the study underway.



The trial is a randomized clinical effectiveness comparison of RUSF, RUTF and corn/ soy blend with 950 subjects. The study is in progress in rural, southern Malawi, where over 50% of children have chronic malnutrition, presenting at 12 health centers. Participating children have a weight-for-height between 70% and 85% of the international standard, the WHO definition of mild/moderate malnutrition, and no signs of edema, the hallmark of severe malnutrition. Subjects will receive eight weeks of supplementary feeding with one of three foods, RUSF, RUTF or micronutrient fortified corn/soy blend. The quantity of each food will provide 1300 kcal/d or 100 kcal/kg/d to the malnourished children, who are monitored every two weeks by measuring weight, length and arm circumference. The primary outcome will be recovery, defined as attaining weight-for-height > 85% of the international standard. Secondary outcomes will be rates of weight, height and arm circumference gain. This sample size will detect a difference in recovery rates of 12%, with 95% specificity and 80% power, assuming that 10% of the children are lost to follow up. The trial is approved by the Human Studies Committee of Washington University and College of Medicine Research and Ethics in Malawi.



Currently 599 children have been enrolled in the study, with new children enrolling every week, at every site. The children are tolerating the food very well, and logistically the study goals are being accomplished. The investigator is blinded to the food assignment groups to exclude bias from the study, so we cannot report on the children’s outcomes. Data are too preliminary to be conclusive at this juncture, but we will generate an additional report when the study is complete. Our expectation remains that this low cost, energy dense, ready-to-use food for supplementary feeding (RUSF) will be far superior to corn-soy blend, and slightly more expensive by weight; although much less of the high density, enriched RUSF is required, so the additional cost is rendered moot. We also expect RUSF to be less effective than RUTF, but within acceptable guidelines for health restoration within an acceptable time frame, at a cost 50% lower than that of RUTF.



The project will be completed in one year and the total cost is still estimated at $68,200. There have been no substantial increases or decreases from the proposed budget, and, as expected, the World Food Programme has come through with one half the required food ingredients. We anticipate bringing this study to a close on time and on budget.



Conclusion:

Current standard supplementary feeding schemes fail to help most children they serve. The importance of this project is that it will test a potentially powerful alternative to standard supplementary feeding schemes. If recovery rates with RUSF are substantially higher, this will transform supplementary feeding from an ineffective activity that is of little benefit to the recipient to a program the effectively prevents severe malnutrition in vulnerable children and promotes catch-up growth.



Dr. Manary and Washington University in St. Louis remain grateful for the support of the Allen Foundation for the support leading up to this study, and for our ability to conduct the trial. Our partnership has furthered our mutual goal of alleviating suffering through nutrition for some of the world’s most vulnerable citizens; children in the developing world. We hope this study has an impact equal to or greater than what we have achieved, together, through RUTF.



Expenditures to Date



Development of novel food $ 1,000 of $ 1,000

Foods $ 8,600 of $ 8,600*

Staff $ 3,150 of $ 6,300

Transportation $ 2,200 of $ 3,500

Consumable supplies $ 2,000 of $ 3,550

Small equipment $ 1,800 of $ 1,800

Local Research Fee, U. of Malawi $ 2,500 of $ 2,500

Salary support for PI $ 17,650 of $ 34,130

Indirect Cost (10%) $ 3,400 of $ 6,820



Total $ 42,300 of $68,200



* Actual cost of foods were estimated at $17,200 – World Food Program to cover one half, or $8,600

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Project Title: Vitamin D Deficiency and Rickets among Healthy Infants and Toddlers
Institution: Children's Hospital Boston
Date: 12/12/2007
Report:
Summary of Work and Accomplishments:
We completed enrollment for our prevalence study on June 30, 2007 and for the vitamin D treatment trial on August 15, 2007. We immediately began our final data analysis and manuscript preparation. To date, three manuscripts have been accepted for publication, including a primary scientific article, case report, and review article. Two other primary articles are in preparation, including results from the treatment trial and a case control study of 13 infants identified to have a seemingly rare condition called transient, benign hyperphosphatasemia. The review article, written by Dr. Gordon and Dr. Susanna Huh from our research group, discusses the prevalence of vitamin D deficiency during childhood and potential long-term complications that may stem from this problem. This review will cite our Allen Foundation funding as many ideas discussed within the article have been generated by this project. An abstract highlighting data from our prevalence study of 380 infants was presented at the annual meeting of the Pediatric Academic Societies in Toronto in May 2007. In June 2007, the design of the study was included in an oral presentation that Dr. Gordon gave at the International Conference on Children's Bone Health in Montreal entitled, “What is the Optimal Vitamin D Level in Children?”

Publications and Abstract Resulting from Allen Foundation Funding
Articles:
1. Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinman PK, Perez-Rosello J, Cox J. Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Ped Adol Med 2007 (in press).
2. LeBoff Williams A, Cox Joanne, Gordon CM. Rickets in an otherwise healthy 11-month-old. Clin Pediatr 2007 (in press).
3. Huh S, Gordon CM. Vitamin D deficiency in children and adolescents: prevalence, impact and treatment. Reviews in Endocrine and Metabolic Diseases. Springer 2007 (in press).

Abstract:
1. Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinman PK, Perez-Rosello J, Cox J. Prevalence of vitamin D deficiency among healthy infants and toddlers. Pediatric Research 2007; Proceedings from annual meeting of Pediatric Academic Societies, May 2007.

Updates by Specific Aim:

1) To determine the prevalence of vitamin D deficiency among healthy infants.

We enrolled 380 infants and toddlers into a cross-sectional study to evaluate the prevalence of vitamin D deficiency among otherwise healthy young children. We reported a prevalence of vitamin D deficiency (25-hydroxyvitamin D or 25OHD) level < 20 ng/mL in 12.1% of participants. Forty percent were below an accepted optimal threshold of 30 ng/mL. The prevalence did not vary between infants and toddlers, nor did it vary by skin pigmentation. There was an inverse correlation noted between serum 25OHD and PTH: r = -0.27, p < 0.001 for infants and r = -0.20, p = 0.02 for toddlers. In multivariable models, breastfeeding without supplementation among infants and lower milk intake among toddlers were identified as significant predictors of vitamin D deficiency. Among the vitamin D deficient participants, 3 participants (7.5%) exhibited rachitic changes on knee and wrist radiographs, while 33% had evidence of demineralization. We conclude that a suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D deficiency were shown to vary in infants vs. toddlers, information important to consider as pediatric providers care for these young patients. One-third of vitamin D deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.

2) To evaluate the efficacy of three oral treatment regimens for treatment of vitamin D deficiency and rickets: 2000 IU of daily vitamin D2, 2000 IU of daily vitamin D3, or 50,000 IU of weekly vitamin D2.

Forty infants, each identified to have vitamin D deficiency, were enrolled in a 6-week treatment trial. Participants were randomized to 1 of 3 treatment arms. Follow-up serum levels of 25OHD, PTH, calcium, magnesium, phosphorus, and alkaline phosphatase were obtained in follow-up. No adverse effects seen in any of the treatment groups. There was no difference in treatment as assessed by biochemical assessments (e.g., changes in 25OHD, parathyroid hormone, or alkaline phosphatase). The conclusions are reassuring for pediatric clinicians as the medical literature contains contradictory information about the efficacy and safety of specific treatment regimens. Our data suggest that these three common vitamin D regimens are equally effective and safe.

Budget: Funds have been spent in entirety. After notification of our Allen Foundation Award, our General Clinical Research Center at Children’s Hospital granted us partial funding to cover expenses associated with some of the laboratory tests. Therefore, some of the funds originally allocated for blood tests were used to cover salary (e.g., to account for slight cost of living increases) and travel expenses as Dr. Gordon presented at the annual meeting of the Pediatric Academic Societies in Toronto. We will submit a detailed finance report through the Children’s Hospital Research Finance Office in January 2008.

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Project Title: Improving the Health and Nutritional Status of Rural Guatemalan Women and Children
Institution: Project Concern International
Date: 8/23/2007
Report:
Improving the Health and Nutritional Status of Rural Guatemalan Women and Children Through Expanded Prenatal and Neonatal Education is a project which integrates nutrition education and training into Project Concern International’s (PCI) existing reproductive health and infant growth monitoring activities at its Casa Materna (Mother’s House) facility. The Casa Materna, established in 2000 in partnership with a local Association of Midwives in Todos Santos, Huehuetenango and the Guatemalan Ministry of Health (MoH), provides women with comprehensive evaluations, clinical services, medication, family planning services, access to contraceptives, high-risk pregnancy care, and other vital reproductive health services. It is supported by funding from multiple donors, including the Allen Foundation. Since its inception, Casa Materna has saved the lives of hundreds of mothers and their babies, evaluated over 36,000 patients, and cared for nearly 2,500 women with high-risk pregnancies. Its quality services are available and utilized by Mayan women and their families living in isolated rural communities of Huehuetenango, Guatemala.

Project Strategies and Activities:
The primary objective of this Allen Foundation-funded project is to promote the growth and development of healthy women and children in the target communities through community-based health, nutrition and hygiene education. Malnutrition is a significant risk factor during pregnancy, especially among the extremely poor and isolated Mayan communities of Guatemala. In addition, a combination of cultural practices, lack of information on neonatal nutrition, and the need for mothers to care for other children results in the early introduction of foods in infants’ diets not suitable to their digestive systems. Through the Casa Materna, education and training are provided to pregnant women, mothers and community health workers to improve prenatal and infant nutrition and hygiene. During the funded period of June 1, 2006 to April 30, 2007 PCI has successfully achieved the project’s four main objectives:

1. Provide refresher training to a minimum of 50 Traditional Birth Attendants (TBAs), 25 newly recruited TBAs and 25 MOH staff in prenatal and neonatal nutrition.
During the implementation period of the Allen Foundation grant, PCI provided refresher trainings to 165 TBAs – over 300% above the target of 50 TBAs – in prenatal and neonatal nutrition. PCI scaled up recruiting efforts and trained an additional 25 new TBAs in the identification of pregnancy risk factors, safe and hygienic delivery, and timely referral of pregnant women to the Casa Materna or the hospital in the case of an emergency. The training of TBAs is crucial for the promotion of safe birthing practices, especially in remote, isolated villages, as many women do not have access to healthcare services and depend entirely on TBAs for delivery. TBAs also serve a critical role in educating women in maternal and child health; the community trusts the leadership of TBAs because they are selected by the community members themselves. In addition to TBAs, PCI trained 35 MOH health technicians – 40% above the target of 25 MOH staff – in prenatal and neonatal nutrition to improve the quality of available community-based services. Training topics included: additional food and iron and folic acid supplements during pregnancy; appropriate diet for lactating mothers; exclusive breastfeeding for the first six months; appropriate nutrition for children 0-12 months; children’s stimulation; hygiene in food preparation; prevention of and proper treatment of diarrhea in young children; and appropriate diet for adolescents and women of reproductive age.

2. Provide training on nutrition and the Casa Materna’s range of services to a minimum of 250 community health workers
During the reporting period, PCI trained 352 community health workers – over 40% above the target of 250 – on nutrition and the services offered at Casa Materna, including family planning, reproductive health, and counseling. In addition to the trainings, PCI´s staff also conducted hands-on exercises with the trainees in the preparation of oral rehydration solution at the household level, food preparation, hand washing demonstrations and water treatment for human consumption. All of the community health workers are recruited from beneficiary communities and many are former patients or know someone who has benefited from the Casa Materna.

3. Conduct a minimum of three community activities to build awareness of the Casa Materna’s health and education services available in the target communities
During the reporting period, PCI held four health fairs in different villages to provide preventative medical care and health education and to build awareness of the availability of the Casa Materna’s health and education services in the target communities. During the community health fairs, copies of a new poster promoting the Casa Materna’s comprehensive services, designed in coordination with the MOH, were distributed to TBAs, health centers and community centers. PCI reached a total of 640 women and their children in the target communities through the four health fairs.

The health fairs resulted in myriad successful health outcomes for participants. During the health fairs, health workers educated women on the importance of early detection of cervical cancer and offered PAP tests to women who consent for this service. Through the health fairs, a total of 315 PAP tests were performed; the Casa Materna staff subsequently provided the health fair participants with their results and follow up services. In addition, medicines were available for sale to health fair participants at a very reasonable cost. In addition, multiple cases of severe malnutrition in young children were detected at the health fairs. The parents of malnourished children received individual counseling and their children were referred to the MOH hospital or village health centers for treatment. PCI´s staff provided incentives for children’s attendance at the health fairs by organizing games and other entertaining activities for them, such as the breaking of a piñata followed by the distribution of balloons and small prizes.

In addition to the health fairs, PCI organized six community meetings in collaboration with a Japanese nutritionist volunteer. A total of 196 women participated in these meetings, which included training on the causes of malnutrition in children, the food pyramid and the importance of appropriate nutrition for children.

4. Scale-up efforts to recruit more community health outreach workers and to create “self-help” groups within villages
The overall objective of self-help groups is to reduce maternal mortality by educating women in maternal and child health and encouraging them to advocate for their right to reproductive healthcare services. PCI currently works with 86 groups in which 3,145 women actively participate. During the reporting period, these self-help groups were trained by PCI on food and nutrition, signs of obstetric risk, self-esteem, newborn care, personal hygiene, and the early detection of cervical cancer. Once trained, self-help group members are then responsible for training other members of their communities and applying their knowledge in their households.

Many of the self-help groups are begun by former Casa Materna patients who are identified as leaders during their stay and are encouraged to start self-help groups upon return to their home villages. Generally, the former patient begins a self-help group by sharing her story with her peers, which may include a discussion of her health issues, how they were identified, her referral to the Casa Materna, and the positive resolution of her case. Each patient is counseled to share only as much as she is comfortable sharing about her personal medical history. Once the self-help group is formed, PCI implements a training plan comprised of seven modules in health, nutrition, hygiene and women’s rights. The implementation of self-help groups has proven to be of great benefit in municipalities where maternal mortality rate is high. PCI and the Casa Materna staff report seeing a noticeable decrease in maternal death after instituting self-help groups in areas where maternal death was considerable. Equally important, the self-help groups are a very effective forum to identify and recruit community health workers who obtain additional training and support from the Casa Materna to conduct outreach and education in their villages and neighboring areas. In the past year, these groups have contributed significantly to PCI’s ability to meet the expected outputs under Objective 2 above.

Financial Summary (through April 30, 2007)
Local Salaries $9,531.60 Country Director $423.50 Travel Costs $739.33 Medical Supplies $1,497.21 Education Materials $1,217.49 Indirect Expenses $2,011.37 Total Expenditures $15,420.50 Remaining Balance $4,578.50

Conclusion
PCI, through the generous support of the Allen Foundation and others, has made great progress in improving the health and nutritional status of rural Guatemalan women and children through expanded prenatal and neonatal education. During the life of this project, PCI has specifically identified self-help groups and community health fairs as two crucial methodologies to increase the impact of nutritional and health education in rural communities. The 86 current self-help groups provide a forum for women to share their education and experiences in implementing proper nutrition and hygiene practices. Furthermore, PCI has found that the self-help groups create a strong sense of community and promote collective problem-solving; these skills can be fostered and applied more broadly through continued self-help group education activities. The four community health fairs funded by this project also proved to be highly effective in reinforcing the health and nutrition education provided through the Casa Materna. The health fairs are a cost-effective way to provide health information and some preventative services to large groups of persons, most of whom could not afford these services elsewhere. In addition, the active inclusion of children in the health fairs resulted in the identification of multiple cases of severe malnutrition, which may not have been identified or treated otherwise.

Based on the success and popularity of these two methodologies in the community, PCI has received many requests from other communities to establish self-support groups and carry out health fairs. Through continued support from donors, PCI hopes to respond to these requests and expand health and nutrition education by increasing the number and scope of self-help groups and health fairs in Guatemala. On behalf of all of its beneficiaries, PCI sincerely thanks the Allen Foundation for their contribution to its efforts and extends a most cordial invitation to its representatives to visit the Casa Materna and the communities it serves in Huehuetenango.

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Project Title: Developmental outcomes of maternal multiple micronutrient supplementation
Institution: Lancaster University
Date: 5/3/2007
Report:
This project is currently being undertaken with the support of the Allen Foundation is based on and follows up on the Supplementation with Multiple Micronutrients Intervention Trial (SUMMIT) The SUMMIT was carried out on the Indonesian island of Lombok from 2001-2004 with an intervention designed to compare the effects of a pre-natal supplement containing 15 micronutrients to the pre-natal supplement currently provided in Indonesia, which contains only iron and folate. The goal of the current research project is to examine the long-term outcomes of the intervention on children’s development at age 42 months. Specifically, we are assessing four aspects of development: cognitive, language, motor, and socio-emotional. In parallel with the research, we are distributing educational brochures in the study area. The goal of these brochures is to enhance children’s development by encouraging good nutrition and play-based stimulation in the home.
Personnel
The PI, Dr Katie Alcock, has been acting as overall supervisor and has made a supervisory visit during the pilot testing phase, as well as delivering research seminars to medical and educational faculties in Indonesia, while the research student, Elizabeth Prado, has been supervising field operations. There have been up to six full-time staff employed in office and field positions in Indonesia.
Research Site
Lombok is in the Nusa Tenggara Barat province of Indonesia, situated between Bali to the west and Sumbawa to the east. Rice is the staple of the diet; although a rich variety of foods are available, a large proportion of the population are very poor, and often do not have enough money to buy these foods, especially meat. The principal language spoken in Lombok is Sasak. Most adult Lombok residents also speak Indonesian, which is the official national language of Indonesia. However, like many regional languages across the country, Sasak is the predominant language spoken in the homes and neighborhoods of Lombok. We therefore used Sasak as the medium of testing.
Research Materials
In developing the research materials, we began with tests that have been constructed and standardized in the West. The items and procedures in these standard tests are highly influenced by the language and culture in which they were developed. In order to obtain valid measures of Sasak children’s development to compare the relative effects of the two supplements, we have therefore spent a considerable amount of time adapting the tests to the language, culture, and testing conditions in Lombok villages. The tests are described below.
Tests
Motor Development Scale. In this test the child is asked to perform several motor activities, such as standing on one foot, jumping over a rope, threading beads, and copying shapes.
Picture Vocabulary Test. In this test the child is shown a series of pages, each of which depicts four pictures. The child is asked to point to the picture that matches the word spoken by the tester.
Sentence Complexity Scale. This is a test of language development based on the McArthur Communicative Development Inventory III, in which the parent is asked to describe the structure of his or her child’s speech. For example, the parent is given two sample sentences, one comparatively more complex than the other, and asked to choose which one is most like the way his or her child currently speaks.
Visual Search Test. This is a test of attention. The child is shown a page printed with multiple pictures of different objects. He or she is asked to point to every instance of a target picture, and speed and accuracy are measured.
Block Sorting Test. This is a test of executive function in which children are introduced to two buckets and asked to help the experimenter sort big blocks into the big bucket and little blocks into the little bucket. Then the experimenter suggests they play a “silly game” and reverse this categorization scheme
Snack Delay Test. This is a test of executive function in which the tester places a piece of candy where the child can see it and tells the child to wait until she tells them to before taking the treat. After a brief demonstration, there are four trials with delays of 5, 15, 30, and 45 seconds. The score is the number of trials on which the child was able to wait for the bell before taking the treat.
Windows Test. This is a test of executive function in which the experimenter places a treat inside one of two boxes, each of which has a clear window so that the child can see the treat. The child is instructed to point to the box without the treat in order to obtain the treat. In all three of these tests of executive function children must suppress their natural responses.
Block Design Test. This is a test of cognitive development, specifically visuo-spatial skill, in which the tester builds a shape with blocks and the child is asked to build an identical shape with his or her own blocks.
Socio-Emotional Development Scale. This test is based on the Brief Infant-Toddler Social and Emotional Assessment (Briggs-Gowan & Carter, 2002), in which the child’s parent or another caregiver is asked questions about the child’s behavior. A competence score is calculated as the sum of the competence items and a problem score is calculated as the sum of the problem items.
HOME Inventory. The Home Observation for the Measurement of the Environment (HOME) inventory (Caldwell & Bradley, 1984) measures the amount of stimulation a child receives in the home. Items probe parent-child communication and interactions, the types of toys available, specific events and other experiences that occur in the home, and the general quality of the physical home environment.
Pilot testing and Preparation : September, 2006 – March, 2007
Initially, testing materials were translated from English to Indonesian, with further adaptation into the Sasak dialects, and four staff were recruited at that time to be trained as research assistants. The pilot testing and preparation phase of the research consisted of three main activities: pre-pilot testing, pilot testing, and reliability testing.
Pre-pilot testing
Three tests, the HOME Inventory, the Socio-Emotional Scale, and the Sentence Complexity Scale, required specific information to be gathered in order to determine how to best adapt them to the culture and language in Lombok. Therefore, three pre-pilot testing activities were conducted: (1) focus group discussions concerning the items in the HOME Inventory, (2) item surveys regarding the items in the Socio-Emotional Scale, and (3) recording samples of spontaneous speech from Sasak children in order to gather information relevant to the Sentence Complexity Scale.
Pilot testing
We conducted pilot tests between Nov 2006 and Feb 2007. In total 167 children age 32-55 months in 14 villages participated in pilot testing. After each pilot test, data from each test were evaluated for (1) the presence of ceiling or floor effects and (2) the correlation between the test scores and age. In addition, the field staff and their supervisor (EP) discussed the feasibility of each test under the testing conditions at the homes of the participants. Based on these considerations, each test was either (1) eliminated from the test set, (2) confirmed for inclusion in the test set, or (3) revised and included in the subsequent pilot test. It was during this phase that KA visited the field testing site.
Reliability Testing
We conducted reliability testing in March, 2007. In each round of reliability testing, each tester administered the test battery to twelve children twice, with one week separating the two test sessions. All children were given the same tests by the same tester at both the first and second visit. The Block Sorting score yielded the lowest reliability out of the executive function tests, so this test was eliminated from the test set. The remaining tests were included in the set of tests to be administered to the children of women who participated in the SUMMIT.
Data Collection: April – September, 2007
We began data collection on April 12, 2007 and plan to continue through September, 2007. A subsample of SUMMIT participants provided blood samples at two time points during their enrollment in the program. We are specifically targeting children of women in this subsample in order to associate children’s development with maternal nutritional status as measured in the blood, as well as the type of supplement they received during pregnancy. Specifically, the target participants include the children of all SUMMIT participants with two completed blood draws born between September 23, 2003 and March 31, 2004 (555 children). We are testing children at the age of 42 months plus or minus three weeks.
In addition to the test scores, anthropometry measures (height, weight, head circumference and MUAC) and demographic information are being be gathered. Families who participate in the research are provided with a small gift to thank them for their time. Children whose haemoglobin level is less than 11 g/dl are also provided with a box of fortified powdered milk. The testers, who are all graduates from the nutrition program at Mataram University, also give the mothers of anaemic children advice about what sorts of foods can improve the health status of their children. All families are also provided with the educational brochure that has been produced.
Although, at the time of this report, data collection has just begun, we are confident that the preparatory activities we have undertaken in the past seven months will ensure the quality of the data and the validity of the results associating maternal micronutrient supplementation and nutritional status with children’s development levels. The project was due to begin in June 2006 and last for 12 months but due to our late start we have been granted an extension until the end of October 2007.

Financial summary:
Expenditure to date (Conversion rate used is median of rates on August 1st 2006 and May 1st 2007)

Category Expenditure in GPB Expenditure in US$
Salary contribution for PI 3,958.31 7,619.75
Travel 1,868.73 3,597.31
Consumables and office expenditure 2,549.67 4,908.11
Equipment 2,607.35 5,019.15
Salaries (Indonesia) 4,806.45 9,252.42
Overheads (Lancaster) 3,438.50 6,619.11
Total 19,229.01 37,015.84
Balance remaining on grant 19,205.16


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Project Title: The Allen Foundation Elementary School Nutrition Education Initiative
Institution: Cedar Crest College
Date: 4/26/2007
Report:
Cedar Crest College Report to the Allen Foundation

During the past 10 months, The Allen Foundation Elementary School Nutrition Education Initiative has accomplished the following goals:

Five Senior nutrition majors were selected as the core educators for the project. They were: Nusrat Fatima, Stephanie Gionta, Tara Harding, Michelle Martucci and Stephanie Gionta. Each of these individuals was chosen based on their strong academic performance, interest in working with children and desire to pursue a career in Nutrition and Dietetics. The five students, working with project director Barbara Carlson, MA, RD, CDE, accomplished the work described below

1. Five comprehensive, interactive nutrition sessions were developed for use in elementary schools were developed. The materials were developed to be adapted for grades K-6. Five primary topic areas were chosen and developed. Those areas were:
• Meal Planning – using the Food Guide Pyramid to make healthy choices
• Portion Distortion – how to choose a healthy portion of food
• Calcium – building healthy bones and teeth through good food choices
• Exercise and Nutrition – being physically active and eating well builds strong bodies
• Sugar – choosing foods with healthy sugar content
2. Each learning session was developed using an interactive game format that engaged the children in learning. Many of the lessons allowed multiple concepts to be taught and the games were adaptable to a variety of situations. The following games were developed, tested and used:
• A follow-the-path board to choosing healthy, low sugar foods.
• The “Wheel of Nutrition.” Children spun a wheel and answered questions based on the Learning Session. Questions could be changed to meet the lesson plan objectives
• A crossword puzzle for learning key calcium foods and knowledge
• An interactive Exercise and Meal Planning “race to build a healthy meal”
• Build the correct meal portions using a model Food Guide Pyramid.
3. Learning packets with handouts for students, parents and teachers were provided with each lesson. In addition, a brief post-test allowed the program and teachers to assess the learning experience.

The project was fortunate to partner with a variety of schools and education programs providing science-based education to elementary schools. The Da Vinci Science Center, the Weller Center, the Allentown School District, the Bethlehem School District, the Archdiocese of Allentown and the Lutheran School System of Allentown were all involved in program development and classes. To date the program has provided sessions that included 1,330 students, well over 50 educators and over 20 different schools in the districts noted above, as well as students from the Easton School District, Parkland School District and Whitehall School District. In addition, both the Bethlehem and Allentown School Districts requested that The Allen Center for Nutrition participate in more programs through out their school district in 2007-2008. Programs have been requested for use in physical education programs, health and wellness, cafeteria menu planning and meal selection.

The grant sponsored a Bookmark Contest for children from two schools in the 3rd and 4th grades. They developed bookmarks based on the meal-planning lesson. Eight bookmarks were chosen for their excellent representation of good meal planning. Students and teachers received a reward for their participation. The selected bookmarks will be printed and used in a variety of future programs.

The Allentown School District requested information that would help families prepare budget-conscious meals. Subsequently, students and staff of Cedar Crest College were invited to contribute a favorite healthy recipe for use in development of a cook book that promoted healthy family meals. Over 50 recipes were submitted and the cookbook is currently being developed.

All students who participated in learning sessions were given a pencil with “The Allen Center for Nutrition” printed on the side. Pencils are a precious item in many of the schools in the Allentown and Bethlehem School districts. We chose pencils as a reward for completing the post test. Our hope was that students would identify learning a nutrition lesson with an immediate reward, and the pencil they could use every day would remind them of long-term rewards.

Materials were developed by the students for most classe;, however, we also used a wide variety of materials that were available commercially. The Food Guide Pyramid and Portion Distortion tear sheets were available in both English and Spanish. Providing students whose primary language was Spanish a handout in their language was an essential part of helping them take the concepts learned into their homes.

Programs will continue to be offered through May and early June. Additional schools and programs will expand the number of students who have had the opportunity to learn healthy nutrition lessons as a result of this grant.

A summary of the budget for the program is provided below:

Program Director Salary--$2,700.00 per semester for 3 semesters:
Total $8,100.00

Student stipends--5 students@ $3,000.00/semester: Total $30,000.00

Educational Materials, Game production and supplies: Total $5,954.04

Food and Demonstration (supplies for food demonstrations and recipe testing: Total $4,278.96

Awards and Prizes: Total $1,275.00
Education

Conference for Students working in the Grant--Conference sponsored by Cornell University on Calcium in New York City: Total $392.50

Grand Total $50,000.00



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Project Title: Healthy Living
Institution: Montessori Children's House - Grand Traverse
Date: 4/10/2007
Report:
Healthy Living
The Children’s House, an independent Montessori School

Through generous support from the Allen Foundation, hundreds of young children in northern Michigan have become active participants in this independent school’s proactive Healthy Living curricular program. With a school-wide focus on choices for nutritional health, Healthy Living gives elementary age students pivotal community service roles as gardeners and co-producers of daily school-wide lunches and snacks. In campus gardens, the greenhouse, and in the Children’s Kitchen Classroom, young learners use a portion of each day to plant, tend, harvest, prepare, serve and report on healthy foods. In the gymnasium toddlers to twelve year olds develop lifelong habits of exercise. We have budgeted conservatively, using Allen Foundation funding to reach our first year goals.

Making a healthy choice the first choice is the primary commitment of the Healthy Living curriculum at the Children’s House.. The School has made great progress toward achieving this goal through hands-on daily experiences for all children with growing, preparing, sharing, and eating nutritious food and with vigorous exercise during the school day.

The School is equally committed to expanding community awareness around the topic of early childhood nutrition education for lifelong health. In January of 2007 the School hosted its first annual Family Fitness Festival for the greater community. More than 200 area children gained hands-on information as they planted bean seeds to take home. With snow on the ground and freezing temperatures outside of the hoop house, the gardening experience was even more impactful than it might have been in a more temperate climate. This memorable activity was one of many that took place at the Family Fitness Festival. Children 3 months to 12 years got their hands dirty in the greenhouse, created their own healthy snack, tried snowshoeing outdoors and learned to dance the salsa in the gymnasium. Their parents received helpful literature. Everyone had fun! Through these enjoyable, meaningful activities the message that Healthy Living means making good choices about nutrition and physical activity made a big impression and impact at the Family Fitness Festival. The local newspaper, The Record Eagle featured the event in a photo essay.

Della Terra at www.traversechildrenshouse.org is the School’s first step in communicating with and raising awareness within the global community. Hoping to inspire other schools and communities to develop similar programs, the School posts weekly updates on the Internet. The quarterly newsletter, The Montessori Sun, features in-depth Healthy Living topics. Future plans include development of an online student-produced publication to share with elementary schools worldwide.

Thanks to the Allen Foundation the Children’s House was able to heat our hoop house greenhouse throughout the 2006-2007 winter months, which enabled us to plant crops inside in a raised bed. The students filled this bed with compost in September, planted the seeds for Chinese kale, radishes and a variety of lettuces in November, watered, and then harvested the crops in January, February and March, washed, packaged and labeled their produce and sold them in the School lobby.

Allen Foundation funding allowed the School to employ three part-time instructors who brought professional expertise to The Children’s Kitchen Classrom, to Healthy Living - Della Terra and to Healthy Living - Health Clubs. We were able to implement school-wide composting that is now self-sustaining, and to bring a Michigan State University 4-H Extension Junior Master Gardener class to third and fourth grade students. In the Kitchen Classroom students are busy baking, slicing, dicing, and stirring five afternoons a week. The Della Terra director provided monthly garden and plant-related educational materials and activities to all Children’s House classrooms, reaching 185 enrolled children between the ages of 3 and 12 years and their families during the 2006-07 school year.

Student-sized supplies purchased with Allen Foundation support have included zinc greenhouse benches (they’ll last forever), soil test kits, watering cans, hoses, hand tools, and raised beds. Potting soil, seeds and flats for growing herbs, flowers and vegetable plants to sell were purchased in March for the small-business curriculum. To date the students have picked and sold more than 10 pounds of lettuce grown in the greenhouse.

Future plans are for Della Terra to grow heirloom vegetables and herbs in order to continue the legacy of delicious plants grown by our ancestors. We will donate a portion of our crops to the Fresh Food Partnership, a nonprofit organization that transports fresh food to area food pantries and to community meal programs. We also plan to expand our small business plan through participation in the area wide Farmer’s Market in July, 2007 where we will not only sell produce but provide information about our programs in order to raise awareness on a larger scale. The second Annual Family Fitness Festival is on the calendar for January 2008.

Allen Foundation support for the 2006-2007 school year has made all of this progress possible. The Children’s House Healthy Living curriculum is up and running. We look forward hopefully!

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Project Title: Food for Thought
Institution: Geisinger Center for Health Research
Date: 2/22/2007
Report:
Since Dr. Larson assumed responsibility for this Allen Foundation funding opportunity, there has been significant activity on the development of protocols as well as structuring relationships with schools. During this time curriculum has been assessed, materials have been developed, staff members have been trained, and computers, software and other materials for use in the Food for Thought program have been ordered.
Community health education nurses have worked with Dr. Larson to develop curriculum for third and fourth grade students on subjects related to healthy food choices, physical activity, media awareness and health outcomes associated with overweight. Both attended a training session on the We! Can! Program offered by the National Heart Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH). Curriculum from this program is currently being adapted by our team for use in the classroom as well as for use in parent training and training of school cafeteria workers.
Community health nurses will assist teachers with delivery of health curriculum in third grade classrooms in the Danville Public School District and the Lewisburg Area School District beginning Mid-march 2007 and finishing by May 1, 2007. Curriculum materials including workbooks, power point lessons, curriculum assignments, pedometers, and websites related to children’s health will be available in the classroom for use by students participating in the program and teachers. Pre and post-testing has been developed and current work is in progress to procure the necessary IRB approval to collect data related to children’s school and health performance. Parents will receive training through school assignments they complete with their child, health fairs and parent education night, and opportunities to sign on to relevant websites. These activities are currently being finalized.
An important component of this proposal was the involvement of the school lunch room activities in the process of educating children and school workers about food choices, as well as in the ability to assess whether there are changes in these choices as teaching occurs. A curriculum including five modules has been developed to increase lunch room workers understanding about the food choices available to children, their role in educating children about food choices, as well as food preparation activities that improve the health quality of food available in the lunchroom. Cafeteria workers in the two school districts will take these courses and post tests in a computer format using computers provided with this funding opportunity. Additionally, educational materials will be made available to children at each station where food is selected in the cafeteria. Food choices will be labeled “slow” “go” and “whoa” to help children understand the proportion of their diet that should occur within each food choice. Children will report what they have eaten at the end of each lunch period, before during and after the training/teaching sessions have occurred. Further, monitors will be stationed in the lunchroom to assess the amount and type of food discarded by each child in the observation group. These opportunities to quantify what is being eaten by children will allow a further assessment of this curriculum to encourage healthy choices by children.
In an era of No Child Left Behind negotiating with school districts has been a challenging task. Teachers and administrators have little time to commit to health lessons that generally are not the subject of testing to demonstrate the school’s progress in meeting yearly targets. Teachers are able to provide 4 to 6 blocks of time (45 minutes to 1 hour in length) following the administration of annual performance tests that occur in late spring. However, with the implementation of the new Wellness Policies mandated for schools participating in the National School Lunch program, schools appear eager to accept outside assistance to implement wellness policy.

Expenditures to date include:

Salaries $3438.30
We! Can! Training and travel $296.39
Materials and Supplies $883.79
Benefits $735.80
Indirect Costs $803.15

Equipment and materials expenditures will increase significantly in the next 45 days, as will salary expenditures.


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Project Title: Dish Sanitizer for Camp Neyati
Institution: Midland Camping Council
Date: 1/8/2007
Report:
The Midland Camping Council purchased and installed a new dish sanitizer in June for use by campers at Camp Neyati. The new sanitizer worked flawlessly throughout the summer. The dish sanitizer is easier to use than the old one and the instructions are clearly marked on the machine. Our rental groups have multiple people using the equipment.

Our rental groups appreciated the new dish sanitizer. Last year, the old sanitizer was constantly breaking down causing much frustration among the rental groups. Having sanitary conditions in the kitchen are a priority that has been fulfilled with the purchase of the new dish sanitizer.

The installation was performed by volunteers and employees of the Midland Camping Council. Below is a financial report detailing expenditures.

$3425.32 - Stafford Smith, Inc. - Dish Sanitizer
$16.68 - Ackerman Plumbing - Plumbing materials for installation
$77.56 - Bob Draves - Electrical materials for installation
$225.00 - Cargill's Welding - Modification of the exit table for dish sanitizer
$255.44 - Stafford Smith, Inc. - Chemicals for the startup of the dish sanitizer

Total - $4000

The Midland Camping Council appreciates the donation from the Allen Foundation for a new dish sanitizer for Camp Neyati. The non-profits who rent our facility appreciate the foundation's assistance as well. Through your assistance, our camp has a state of the art kitchen that serves over 8000 nutritional meals each summer. Thank you for your support.

Should you need any further information, please contact me.

George Strom
Executive Director
Midland Camping Council
989-544-2480
midcamp@mindnet.org

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Project Title: Complementary feeding with ready-to-use food in young children in Malawi
Institution: Dept of Pediatrics, Washington University School of Medicine
Date: 1/7/2007
Report:
Adequate complementary feeding is a significant problem in rural Malawi. We conducted a randomized trial comparing two novel complementary feeding regimens using a peanut- and soy-based ready-to-use food (RUTF) and a concentrated maize porridge with powdered fish. Children from 8 rural Malawian villages were enrolled at the age of 6 months. Upon enrollment, demographic and anthropometric data were recorded, and blood was drawn to assess plasma Zn. Children were then randomized to one of the two diets: those receiving RUTF were instructed to feed their children 5 teaspoons twice a day, and those in the porridge group were instructed on to make a thick porridge with 5 teaspoons of powdered fish twice a day. Both diets provided approximately 200kcal/day, and at the age of 9 months, mothers were instructed to increase their feeds to give children approximately 300kcal/day. Children were then followed monthly for anthropometric measurements and fortnightly for signs of infection as evidenced by fever, cough, or diarrhea. At 6 months, blood was again drawn to follow plasma Zn. A student¡¯s T-test was used to compare average length and weight gain.

A total of 240 children were enrolled, with 125 children receiving RUTF and 115 children receiving fortified porridge. There were no significant differences in weight gain, length gain, weight-for-height z-score, or plasma Zn. In addition, there were no significant differences in the number of days of fever, cough, or diarrhea between the two groups (see Table). Four of the children receiving porridge developed edema (3%) compared to six in the RUTF group (5%). We plan to compare the results of this study with standard Malawian growth curves and a similar study involving milk-based RUTF.


Operationally, enrollment began in July 2005. Enrollment was complete in September 2005. The intervention period was 12 months, so the field work was completed in September 2006.
The Allen Foundation awarded Washington University $77,880 for the project. Final project expenditures were $108,245. The additional funds were obtained from a supplemental grant from Baylor College of Medicine. Of the total expenditures, expenses were broken down as follows, Allen Foundation contributing 72% of these.

Salaries (PI, nurses, field workers) $46,230
Supplies (data cards, scales, spoons, ect) $18,481
Food (fish, soy/ peanut paste, machinery) $22,385
Transportation (to and from field site) $10,991
Indirect Cost $10,158


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Project Title: Child and Family Centered Nutrition & Health Enrichment Project
Institution: West Midland Family Center
Date: 1/5/2007
Report:
Our initial concern was that many children in the western region of Midland County were being raised in homes that promote unhealthy lifestyles. Our perception was that generational ignorance regarding nutrition and health, compounded by the marked poverty in which these people live lead children into unhealthy lifestyle choices.

Through the Child and Family Centered Nutrition & Health Enrichment Project (NHE Project) the Allen Foundation partnership with West Midland Family Center has accomplished significant progress educating parents and their children regarding proper nutrition, achieving the following over the final six months of the project:
• Incorporated nutritionally based lessons within all parent and youth programs at the Center
• Provided hands-on nutrition focused activities for parents including, label reading, budgeting for nutritious purchases, etc.
• Provided “Nutrition Totes”, a hands-on activity for families to do together at home.
• Partnered with MSU Cooperative Extension for speakers on nutrition and health related topics to both youth and parents.
• Gave youth hands-on opportunities to prepare nutritious foods.
• Scheduled field trips for youth, label reading, comparison shopping etc.
• Provided 5,920 healthy afternoon snacks.
• Provided nutrition education at snack time.
In order to accomplish these objectives we implemented a nutrition focus into our Moment Making Monday’s Program. This is a parent education group that meets once a week. Its purpose is to help parents learn parenting skills, teach them to become better role models for their children and gain skills for better family management. We applied nutrition information into the existing family management component of this program. Michigan State University’s Cooperative Extension staff members spoke to the parents regarding physical fitness and healthy foods choices and budgeting for good nutrition.

We have used the After School (ASP) and Summer Programs (SP) to address the objective of educating children and teens to enhance their understanding of nutrition and their nutrition related food preparation skills. To assist in implementing an overall nutrition and fitness focus, we used the following nutrition and fitness curriculums obtained from the Michigan State University Cooperative Extension: “The Power of Choice”, “Pyramid Between the Pages”, and “Jump Into Food and Fitness. During Summer Program, a “Fitness Fun Time” was added as a 20-minute activity period that took place immediately after lunch. Throughout the school year ASP participants experimented with new foods including a variety of fruits for which each child indicated their preference on a wall chart. Children have prepared fresh healthy (child friendly) foods, and posted the ingredients and recipes on the youth activity room wall.

With Allen Foundation funds, we were able to reinstate mid-afternoon and after school snacks into the summer and after school programs. Since January of 2005 ~ 17,720 snacks have been served to children in these programs. This was a major accomplishment. Evidence continues to grow that many of the children with whom we work come from families with very poor eating habits. These nutrition habits are brought on by their poor economic status and limited budgeting skills, not due to a lack of parental caring. Our concern is meeting the needs of children that may well go to school without breakfast. We are pleased to have been able to provide fresh, healthy foods such as crackers and cheese, yogurt, fruits and vegetables to children that come to the center after school and attended summer program this summer.

Since our last report we have delivered nutrition education to an additional 48 families and 158 children. Nutrition education has been incorporated all the family service programs we offer at WMFC. The Allen Foundation inspired nutrition focus has not only lead to the incorporation of nutrition education into our programs but has inspired the inclusion of general health and fitness education as well.

The nutrition components have been well received within the context of our broader family and youth programs. Among the program participants some are quite able to learn at the Center and apply this knowledge at home. This is an outcome we had hoped for.

Together WMFC and the Allen Foundation have accomplished much. However, since the beginning of this project a disturbing fact has emerged. We underestimated the very deep-seated deficits among some of these families. Prior to receiving the Allen Foundation grant we recognized that families did not understand the complex nature of nutritional health needs and certainly were not inclined to seek this information of their own accord. Since the inception of this program we realize that the lack of understanding is so deeply ingrained in this culture that the work cannot be done simply within the context of general nutrition education. For every family we positively impact there appears another that has never considered the value of good nutrition and seems even more in need than the first. They lack the skills and the understanding of how food impacts lives. We continue to see children for whom WMFC (during the summer months/ the schools and WMFC during the school year) is the only source of healthful foods. Because they are so dependent on outside support for nutritious meals these children would be much better served if we could provide them with a hot lunch during the summer similar to the hot meal they receive during the school year at school.

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Project Title: Establishing an Iron-bioavailability Database
Institution: University of Hawai'i at Manoa
Date: 12/21/2006
Report:
The objectives of this project are to establish an in-vitro, cell-culture-based assay to compare the bioavailability of iron from different foods. Once established and validated, this system can be used to generate a data-base that ranks ¡°good¡± sources of food iron by there ability to provide absorbable iron rather than just on the amount of iron they contain. The first step to establish this iron bioavailability assay is to ensure that each part of the assay system is working reliably. This is what we have been working on over the past year. There are three major parts of the system: 1) the culturing of intestinal cells to use in the assay, 2) the digestion of foods to be tested in the system, and 3) the development of laboratory assays to measure iron absorption by the cultured cells.
Progress on #1: We have become proficient at culturing, freezing and storing the intestinal cells (caco-2 cells) and now have a large bank of frozen cells for future use. Progress on #2: we have become proficient at freeze drying foods, and digesting the dried powder to simulate gastric and intestinal digestion. Progress on #3: We have become proficient at conducting the laboratory assays used to monitor iron absorption by the cultured cells (i.e. ELISA for cell ferritin; assays for cell protein and iron content). Since we have mastered the three major components of the system, we are now ready to conduct our initial bioavailability tests on reference materials (ferrous sulfate) and foods. The results from these initial tests should match published bioavailability results from other labs using this same system and reference materials. These initial tests to validate the system relative to other labs will be done over the next six months. To date $51,734 has been spent on salaries, about $8,000 on materials and supplies, and $9,000 on indirect costs. This leaves a balance of about $11,000 to complete the establishment and validation of the system in the next six months.

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Project Title: Utilization of bean based foods
Institution: University of Botswana
Date: 6/18/2006
Report:
The nutritional aspect of HIV/AIDS has been a neglected dimension in the management and care of HIV/AIDS affected individuals. Yet, much of the data coming out of Africa suggests that persons living with HIV/AIDS, particularly children, often have marginal nutritional status or suffer from varying degrees of malnutrition prior to infection. This project compares the use of an increased protein cereal diet with a regularly consumed low protein cereal diet in reducing nutritional and developmental problems of 200 HIV seropositive children between 6-15 years on the national ARV programme over a 12 month feeding trial.
Ethical approvals were received from the Ministry of Health in Botswana as well as from the University Committee on Human Research at Michigan State University in January 2005. Development of the two products commenced soon after by a local food company and product safety was assessed using traditional microbiological approaches. Acceptability was tested on over 100 children and adults from a population that would not be enrolled in the study. In addition, a study to assess the protein quality of the protein-enhanced diet was compared with a similar soy-based diet. Eligible children presenting for care at a paediatric HIV/AIDS clinic in Botswana were enrolled into the study and were randomly assigned to receive one of the two products. Caregivers were instructed in how to prepare the product and the minimum daily intake that was necessary. Nutrition education was also provided to the caregivers on a quarterly basis and home visits to assess compliance with the protocol was conducted on a monthly basis.
The products contained no microorganisms of public health significance and were deemed safe for consumption. Both children and adults rated attributes such as colour, taste, texture as very acceptable and indicated that they would purchase the product if available for sale in a commercial setting. The protein quality of the protein-enhanced cereal was as high as that of a soy-based cereal.
As of March 2006, 136 subjects had enrolled in the study. One hundred and ten of the subjects enrolled had completed their second quarter evaluation, 66 had completed their third quarter evaluation and 4 completed their fourth quarter evaluation. Product will continue to be provided to all families who have completed fourth quarter evaluation and interested in receiving the product until the end of the study. The baseline data indicated higher levels of malnutrition (stunting and wasting) amongst the subjects in the study than national nutritional status figures for children of similar ages. In addition, there were relatively low levels of motor and cognitive development, physical activity and overall quality of life amongst the enrolled children. Preliminary evaluation of the effect of the nutritional intervention suggests an improvement in growth and development, particularly for the children consuming the protein-enhanced diet.
At the end of March 2006, over 50
persons had attended the nutrition education clinic in the two periods that it was offered. The participants were mothers, fathers or aunts and children enrolled at the clinic. The seminar included presentations on the role of good nutrition in the care of persons living with HIV/AIDS (PLWHA), strategies on child feeding, food safety, and food and nutrition safety net programs in Botswana. The educational programme was well received by most participants. Home visits were also conducted over the period, in particular to families most at risk. It was now easier to identify those participants that were not satisfactorily taking the product and provide individualised counselling to them on the importance of the project to the health of their child, including different ways of preparation. In almost all cases, the caregivers all agreed to continue with the product and this was observed during the next scheduled visit at the clinic.
The Allen Foundation approved funds of $81,765 and an initial amount of $40,883 has been provided. To date $19,663 has been spent and the balance of about $21,000 has been committed to various project activities.

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Project Title: Midland, MI Civic Arena
Institution: Fast Ice, Inc.
Date: 5/24/2006
Report:
The generous grant from the Allen Foundation to Fast Ice, Inc. has allowed significant improvements in the healthy and nutritional food selections offered through the concession stand in the Midland, MI Civic Arena. This means the athletes and visitors using the Civic Arena now have the readily available option of eating more nutritional food.

The financial contribution from the Allen Foundation over the last two years has amounted to $41,860. This money has been utilized in purchasing some new equipment for the concession stand, as well as hiring a nutritionist consultant to direct a program aimed at athletes eating a healthier diet.

The equipment purchased includes new and additional refrigeration resources allowing the concession stand to offer salads and homemade sandwiches, as well as some heating equipment to cook and maintain homemade soups.

The nutritionist developed and implemented a survey for athletes and adults on the kind of healthy foods they would like to see stocked and served in the concession stand. The respondents (a full 20% of those surveyed) indicated a list of 20-plus items they would purchase, if offered for sale. This is of particular importance given many of the skaters come to the rink immediately after school or participate in events over the dinner hour. It also resulted in the addition to the concession stand of soup, non-grilled sandwiches, a larger selection of fresh fruit, muffins and bagels, milk and additional fruit juices.

Our consultant also gathered materials, scientific studies, articles and books on healthy eating for athletes, all of which are now available on loan to coaches, athletes and parents.

Finally, this fall (2006) a healthy nutrition program, specific to speed skaters, figure skaters and hockey players, will be made available to coaches and teams. The powerpoint presentations will be available for use in team and/or parents meetings, and corresponding materials will be available for all athletes and their families. In addition, some novelty items will be available for skaters as a reminder of the importance of fueling their bodies in a healthy manner.

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Project Title: Healthy Whole Grain Choices for Children and Parents: A School-Based Pilot Intervention
Institution: University of Minnesota
Date: 3/28/2006
Report:
Final Report

A 6-week multi-component school-based intervention including a 5-lesson classroom curriculum, family newsletters and events, and school cafeteria menu changes were implemented to increase whole grain intake by fourth and fifth grade children. The intervention was conducted with 67 students in one school while 83 students in another school served as a control group. The curriculum lessons and evaluation instruments were pre-tested with parents and children in a third school prior to implementation.

Participants
The mean age of children was about 10 years. About half were in the fourth grade and half were girls. Parent respondents were mostly women with a mean age of 40 years. The majority had attended some college or were college graduates and worked part time or full time outside of the home. About two-thirds of the children and parents in the intervention school were White, while a greater percentage were White in the control school.

Changes in Whole Grain Intake
Refined grain products were substituted daily with whole or partial whole grain products in the school cafeteria of the intervention school. Foodservice worker training was conducted and menu analysis completed for 3 weeks before, during and after the intervention. A team of faculty and graduate research assistants were trained to conduct lunch meal observations with high inter-observer reliability. Lunch meal observations were conducted before and after the intervention with students in the intervention and control groups to estimate whole grain intake from the noon meal. Plate waste data were collected for selected refined and whole grain products before, during and after the intervention. From pre- to post-intervention, intake of whole grain foods increased by about 1 serving/day while intake of refined grain foods decreased by about 1 serving/day for children in the intervention school compared to children in the control school. The percentage of plate waste for whole grain dinner rolls, pizza crust, breadsticks, and pasta was similar to percentage plate waste for refined grain counterparts.

Changes in Children’s Knowledge and Parental Behaviors
Classroom lessons based on Social Cognitive Theory were developed and delivered for children in the intervention group. Learning objectives and activities were based on results from focus group interviews and aimed to improve instrumental knowledge to identify whole grain foods, increase availability in the home, self-efficacy, and intention to choose these foods. Classroom activities included label reading, menu planning, food preparation, food sampling, identification of grains, making flour, participating in a debate, and preparing promotional materials for the cafeteria and classroom. Parent newsletters including interactive activities for parents and children to complete together were sent home with students weekly. After the intervention, about two thirds of parents indicated that they had received and read most or all of the newsletters sent home with children, while about 40% reported completing newsletter activities with children. Three family events were conducted including a milling museum event, bakery and grocery store tour. After the grocery tour program, parents had higher knowledge scores compared to before the program regarding whole grain and refined grain terms and areas in a store where whole grain products could be found. Parents also improved their ability to identify whole grain foods and had greater intention to purchase whole grain foods their child requested. They also indicated a greater likelihood of being able to find whole grain foods their family liked. Children attending the program during a field trip improved knowledge regarding whole and refined grain terms and their ability to identify whole grain foods.

Children and parents in both the intervention and control groups completed questionnaires before and after the intervention to assess changes in behavioral outcomes. Children’s knowledge about whole grain foods increased in both groups with a trend toward a greater increase in the intervention group. Reported frequency of parental intake of refined grain foods decreased, while reported frequency of role modeling and enabling behaviors increased for parents in the intervention group compared to the control group.

Application
To our knowledge, this is the first multi-component school-based intervention designed to increase intake of whole grain foods by children. The results of this study indicate that modifying school cafeteria menus to include more whole grain foods can increase whole grain consumption by children to levels closer to current recommendations associated with reduction in risk for heart disease and type 2 diabetes. The successful outcome of this research has direct relevance to the National School Lunch Program and school meal policies regarding inclusion of additional whole grain foods served to children participating in the program. This research also demonstrates to the food industry that pilot testing of whole grain foods can be successfully implemented in a school foodservice program. This in turn may enhance research efforts by industry and academia regarding consumer and sensory issues related to whole grain foods.

Dissemination
The Power of 3: Get Healthy with Whole Grain Foods curriculum is available at:
http://www.extension.umn.edu/Nutrition/
Click on Educational Materials (Online for parents, teachers and coaches) on the right sidebar.
Then click on The Power of 3: Get Healthy with Whole Grain Foods

Results from the grocery store tour have been accepted as a GEM in the Journal of Nutrition Education and Behavior. Two other manuscripts are in preparation for submission to other journals. Email announcements regarding the availability of the curriculum have been disseminated through national health educator listservs.

Expenditures -Reporting Period: 09/01/04 to 02/28/06
Description Current Expenses
Salary 26,549.71
Fringe 14,846.22
Consulting Services 6,853.18
Supplies & Expenses 12,496.47
Travel 1,068.59
Indirect Costs 12,362.83
Total $ 74,177.00

Salaries and fringe benefits were paid for a graduate research assistant at 50% FTE, and for two principal investigators at 5% FTE. Funds were used for materials to develop, implement, copy and format the curriculum into pdf files for posting to the web site, for gift certificates and food samples to children and parents in return for participation, for travel by the graduate research assistant to the Society for Nutrition Education annual meeting to share results, and for a laptop computer and nutrient analysis software and training for collection and analysis of whole grain food intake data.

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Project Title: Complementary feeding with ready-to-use food in young children in Malawi
Institution: Washington University
Date: 1/4/2006
Report:
Progress Report

Complementary feeding with ready-to-use food in young children in Malawi.

Growth faltering in children in the developing world begins at about 6 months of age, and is temporally associated with the introduction of foods other than breast milk, the so called complementary foods. From 6-18 months many children in the developing world do not add stature, nor develop cognitively as they would if they had an adequate diet, and are more vulnerable to infections, disability and death. After this time, they grow at a rate similar to well-nourished children, but never catch-up for the growth and development that was lost due to poor nutrition during this critical developmental time.

This project compares the use of 2 novel complementary foods, a peanut/ soy-based ready-to-use food and a fish powder fortified dough, as complementary foods in a population of vulnerable Malawian children. The human studies applications were approved at the College of Medicine, University of Malawi and Washington University in May/ June 2005. In May/ June 2005 the recipe for the ready-to-use food was developed, and tested for acceptability in small groups of Malawian infants. Production of the food with a solar roaster and a hand powered grinder (total cost $250) was achieved in the villages where the study is being conducted. In fact all food production for the study has been done in the target villages.

All children in 8 rural villages in Machinga district were enrolled as they became 6 months of age in July/ August/ September 2005. The children were randomly assigned to receive one of two complementary foods. Mothers who received fish powder were instructed as to how to make the energy-dense soft dough and add powderized small fish. Mothers who received ready-to-use food were instructed how to feed their children the thick peanut/ soy paste. A total of 237 children were enrolled, more than the 200 children we anticipated.

The study plan calls for complementary feeding with these novel regimens for 1 year, until the children are 18 months of age, and assessing growth and development monthly during that year. So far 12 children have dropped out of the study. There have been no complications or adverse events. Everything seems to be proceeding well. We look forward to completion of a successful project in 2006. We will learn whether either of these complementary feeding regimens can improve child growth and development.

Additionally, we measured the quantity of breast milk intake in these children before and after initiation of complementary feeding, to assess how these foods affected breast feeding. This was measured with deuterated water, a stable isotope, given to mothers and the concentration of deuterium was measured in both mothers and infants. We were successful in completing this portion of the study. The samples have been analyzed at Baylor College of Medicine and the results from these analyses need to be calculated.

Upon receipt of the award we were asked by one of the Allen Foundation trustees, Dr. Patrick Oriel, why we were comparing 2 novel foods, rather than a novel and a control food. This is an interesting question, and we appreciate the opportunity to discuss it further. This project is operational research, designed to find a solution to the problem of poor complementary feeding. We have no doubt that the current standard complementary food, 10% watery corn porridge, is inadequate. The major deficiencies in corn porridge are a low energy-density and a poor micronutrient content. Fish powder is the most complete indigenous micronutrient rich additive that exists in Malawi. It is rich in iron, zinc, calcium and fat soluble vitamins. Adding fish powder is akin to adding vitamin/ mineral supplement to the food. Preparing the food as dough increases the energy density 2.5 fold. We believe this is the best that can be achieved using the Malawian staple food corn. The other food used is this project, the peanut/ soy ready-to-use food, uses other ingredients available in Malawi with added vitamins and minerals. These ingredients require processing in ways that Malawian mothers are not accustomed to, but processing in this manner is possible, as this project has shown, at the village level. The ready-to-use food has a more complete complement of micronutrients and an energy density 12 fold greater than corn porridge. So the trial compares Malawi’s best food versus a novel food that will require significant education and donation of a modest amount of resources to implement. Our project also uses the same design as another trial currently ongoing in Malawi conducted by a Finnish group under the leadership of Per Ashorn. They compared a milk-based ready-to-use food with traditional corn porridge, so we can readily compare our results to theirs, to see how both of the novel foods from our study compare to corn porridge.

The project received $77,880 from the Allen Foundation. Like all projects, several expenditures are made initially and lesser operational expenses are ongoing. To date we have spent $55,380. We anticipate completing the project on-time and on-budget. Next year we will be able to explain what we have learned from this study.

Mark Manary MD
Professor of Pediatrics
Washington University School of Medicine

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Project Title: Establishing an Iron Bioavailability Database
Institution: University of Hawaii at Manoa
Date: 12/28/2005
Report:
Progress Report

I. EXPENDITURES

As of December 15, 2005, of the total $79,828 awarded, we have spent $13,003.62, mostly on salaries leaving a total of $66,824.38 remaining in the budget. A breakdown of expenditures by categories is shown in the table below:


Budget Status Report as of 12/15/05:
Project 2004.432 ESTABLISHING AN IRON-BIOAVAILABILITY DATABASE
Principal Investigator: DUNN, MICHAEL
Award Type: GRANT Sponsor Name: ALLEN FOUNDATION, INC.
Indirect Costs Rate: 0.1500 Base: MODIFIED TOTAL DIR COSTS


DESCRIPTION AWARDED TOTAL EXPENDED AVAILABLE BAL

Salaries $39,000.00 $5,454.00 $33,546.00
Overload $0.00 $2,788.69 (-$2,788.69)
Fringe Benefit $14,820.00 $1,667.03 $13,152.97
Materials $12,096.00 $1,470.21 $10,625.79
Travel $3,500.00 $0.00 $3,500.00
Publications $0.00 $58.00 (- $58.00)

TOTALS:
DIRECT COSTS $69,416.00 $11,437.93 $57,978.07
INDIRECT COSTS $10,412.00 $1,565.69 $8,846.31

GRAND TOTAL $79,828.00 $13,003.62 $66,824.38
AWARDED TOTAL EXPENDED AVAILABLE BAL


II. PROGRESS

Summary.

To date, the progress made on establishing an iron-bioavailability database has been primarily administrative and initial laboratory set-up. Progress includes: setting up the grant award account in the University system, hiring and initial training of a research associate, obtaining authorization from the University’s Institutional Biosafety Committee to conduct the research, setting up a cell culture lab, obtaining frozen cells from Dr. Glahn’s lab at Cornell/USDA, and initial culturing of the cells for use in future bioavailability assays. The in vitro Caco-2 iron bioavailability system has many unique assaying steps, and in the coming year the remaining process will be set up and validated. Due to the delay in study research start-up, we estimate that the first results on validating food iron bioavailability from a standard sample will be after July 1, 2006 and as such, we request a six-month, no-cost extension until December 31, 2006 to complete funded project.


Report narrative.

Progress in the first six months of this one-year award has been challenging due to administrative hurdles at the institutional level of the University of Hawaii. The first hurdle was to implement a new grant in the middle of summer (July) when our business office is closed and doing inventory. The second hurdle was to get the Allen Foundation into the University of Hawaii’s accounting system, so we could begin to advertise to hire a research associate to conduct the work. This took two full months. On September 7, 2005, the job advertisement closed and we were able to identify a capable research associate with a MS degree from UC Davis. He joined our research team on October 1, 2005.
Over the last two and a half months, the main focus has been to set up a state-of-the-art cell culture lab. In large part, this process has entailed setting up and testing equipment already available in our department, but not being used.
Appropriate paperwork and training to receive authorization from the University’s Institutional Biosafety Office to use Caco-2 cells in our lab has been acquired. This was necessary because the cells are from a human cell line and a potential biohazard. A small number of frozen Caco-2 cells from Dr. Ray Glahn’s lab at USDA/Cornell have been obtained as a starter culture. These cells are presently being cultured to increase their numbers so sufficient quantities of cells are available for future bioavailability assays.
Because the CaCo-2 system is new to the University of Hawaii, time has also been devoted to making sure that all researchers and assistants involved are adequately trained for their part in the project.


III. PLAN OF WORK.

The most important part of establishing an iron bioavailability database is to ensure that each of the many parts of the assay system is both reliable and efficient. In the next three months, we plan to grow sufficient numbers of cells from our starter culture to have a large stock of cells in frozen storage. These cells will be used to set up and validate our initial bioavailability assays before we begin food assays. During the same time, we will begin to develop and validate the ELISA laboratory assay for cell ferritin content, a procedure needed in the bioavailability measurement assay. When we have sufficient cells and have validated the ferritin ELISA assay we will then set up and validate our food digestion procedures.
Once all these procedures are finalized and validated (estimated at six months from now), we will have all the needed assays to conduct a bioavailability test with standards of known bioavailability obtained from Dr. Glahn’s lab. In this way we can verify that our assay gives results similar to Dr Glahn’s system which has been validated (Glahn et al. 1998. J. Nutr. 128(9): 1555-61). To complete this set-up and validation phase of the project, we anticipate that we will need a six-month extension until December 31, 2006. There are sufficient funds in the budget to support this extension without requesting additional funds. During these times, we will also be seeking additional funding to ensure that the investment in this iron bioavailability database continues to grow.

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Project Title: West Midland Family Center's Child and Family Centered Nutrition and Health Enrichment Project
Institution: West Midland Family Center
Date: 12/27/2005
Report:
Our initial concern was that many children in the western region of Midland County were being raised in homes that promote unhealthy lifestyles. Our perception was that generational ignorance regarding nutrition and health, compounded by the marked poverty in which these people live lead children into unhealthy lifestyle choices.

Through the Child and Family Centered Nutrition & Health Enrichment Project (NHE Project) the Allen Foundation partnership with West Midland Family Center has accomplished significant progress educating parents and their children regarding proper nutrition, achieving the following over 1.5 years:
· Incorporated nutritionally based lessons within all parent and youth programs at the Center
· Provided hands-on nutrition focused activities for parents including, label reading, budgeting for nutritious purchases, etc.
· Provided “Nutrition Totes”, a hands-on activity for families to do together at home.
· Partnered with MSU Cooperative Extension for speakers on nutrition and health related topics to both youth and parents.
· Gave youth hands-on opportunities to prepare nutritious foods.
· Scheduled field trips for youth, label reading, comparison shopping etc.
· Provided 11,800 healthy afternoon snacks.
· Provided nutrition education at snack time.
In order to accomplish these objectives we implemented a nutrition focus into our Moment Making Monday’s Program. This is a parent education group that meets once a week. Its purpose is to help parents to learn parenting skills, teach them to become better role models for their children and gain skills for better family management. We applied nutrition information into the existing family management component of this program. Michigan State University’s Cooperative Extension staff members spoke to the parents regarding physical fitness and healthy foods choices and budgeting for good nutrition.

We have used the After School (ASP) and Summer Programs (SP) to address the objective of educating children and teens to enhance their understanding of nutrition and their nutrition related food preparation skills. To assist in implementing an overall nutrition and fitness focus, we used the following nutrition and fitness curriculums obtained from the Michigan State University Cooperative Extension: “The Power of Choice”, “Pyramid Between the Pages”, and “Jump Into Food and Fitness. During Summer Program, a “Fitness Fun Time” was added as a 20-minute activity period that took place immediately after lunch. Throughout the school year ASP participants experimented with new foods including a variety of fruits for which each child indicated their preference on a wall chart. Children have prepared fresh healthy (child friendly) foods, and posted the ingredients and recipes on the youth activity room wall.

With Allen Foundation funds, we were able to reinstate mid-afternoon and after school snacks into the summer and after school programs. Since January of 2005 ~ 11,800 snacks have been served to children in these programs. This was a major accomplishment. Evidence continues to grow that many of the children with whom we work come from families with very poor eating habits. These nutrition habits are brought on by their poor economic status and limited budgeting skills, not due to a lack of parental caring. Our concern is meeting the needs of children that may well go to school without breakfast. We are pleased to have been able to provide fresh, healthy foods such as crackers and cheese, yogurt, fruits and vegetables to children that come to the center after school and attended summer program this summer.

Since our last report we have delivered nutrition education to 100 adults and their 164 children. Nutrition education has been incorporated all the family service programs we offer at WMFC. The Allen Foundation inspired nutrition focus has not only lead to the incorporation of nutrition education into our programs but has inspired the inclusion of general health and fitness education as well.

The nutrition components have been well received within the context of our broader family and youth programs. Among the program participants some are quite able to learn at the Center and apply this knowledge at home. This is an outcome we had hoped for. However, since the beginning of this project a disturbing fact has emerged. We underestimated the very deep-seated deficits among some of these families. Prior to receiving the Allen Foundation grant we recognized that families did not understand the complex nature of nutritional health needs and certainly were not inclined to seek this information of their own accord. Since the inception of this program we realize that the lack of understanding is so deeply ingrained for some parents that the work cannot be done simply within the context of general nutrition education. These families and their children would be much better served if parents could attend small nutrition specific classes designed to meet needs unique to each family.

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Project Title: Healthy Children, Healthy Futures - Improving Nutrition through School and Community Gardens
Institution: International Medical Services for Health dba INMED Partnerships for Children
Date: 7/1/2005
Report:
Duque de Caxias, historically a sugar plantation, is situated north of the city of Rio de Janeiro, Brazil. It is considered one of the least developed regions of the country; many children come from disadvantaged families that live in substandard housing with little or no water and sanitation facilities. At the same time, poverty-level incomes make it difficult for families to provide adequate nutrition and medical care. In addition, drug trafficking in the city creates an atmosphere of fear and violence, and compromises efforts to strengthen community development.

Within Duque de Caxias, INMED’s Healthy Children, Healthy Futures (HCHF) program reaches the poorest and most disadvantaged schools with our program of:
• Treatment for intestinal parasitic infection and micronutrient deficiencies;
• Participatory education on preventive health, hygiene and sanitation, and basic nutrition; and
• Community action to create and support positive change.

A 2004 grant from the Allen Foundation helped support the development of a gardening and nutrition education module to supplement our core HCHF curriculum. During the 2004-2005 grant year, a total of 5,177 children in 18 schools participated in the enhanced HCHF project, which was incorporated into INMED’s new Horta Brasil (Garden Brazil) program, which is working to alleviate hunger and promote nutritional well-being and self-sufficiency for 100,000 disadvantaged youth in communities across Brazil, in support of the president’s Fome Zero (Zero Hunger) initiative.

For most of the children in Duque de Caxias, the lunch provided by their schools is their only meal of the day. Before INMED’s involvement, these lunches were generally not nutritionally adequate—and certainly not sufficient to sustain the children’s daily nutritional needs. Now, however, with the gardening and nutrition education activities now implemented among children, families, teachers and cafeteria workers, the nutritional quality of the school lunches has improved markedly.

Gardens were developed in each of the 18 schools, and each school has successfully cultivated crops of vegetables and fruits, and is using the produce in its daily school meals. The meals are prepared by the cafeteria workers who have been trained by INMED on topics including nutrition, food groups and balanced diets, food safety, and preparing produce in creative and appealing ways while preserving the maximum quantity of nutrients.

School meals, which had previously been heavy in processed carbohydrates, now typically include rice and beans with a vegetable, or pasta with a vegetable. Fruits and vegetables are also served in side dishes and juices. Cafeteria workers have also learned to cook with parts of produce that would previously have been discarded, including broccoli stems and banana peels (which are used in desserts).


Project Activities

1. Training
With the support of the Allen Foundation, INMED Brazil developed gardening and nutrition education training materials for the community of Duque de Caxias, including topics such as how to build and maintain school and home gardens using recycled materials, how to cultivate vegetables and fruits, and how to utilize the fresh produce for maximum nutritional benefit.

The first two-day training in Fall 2004 involved 28 participants, including teachers, school counselors, cafeteria workers and community health workers. The first day incorporated participatory education on nutrition, gardening and the HCHF project, and the second day encompassed hands-on practical training on building, cultivating and maintaining school and community gardens. The training was hosted by the Brasil-Itália school in Duque de Caxias, which already had an established garden.

The second training was conducted in Spring 2005, with a total of 79 community members: 24 teachers, 18 cafeteria workers and 37 community health agents. In addition to refresher education on nutrition topics, this training also encompassed topics such as basic sanitation infrastructure, filtering and treating drinking water, and the role of self-esteem in making positive lifestyle and behavior changes. A nutritionist from the state department of education also conducted a special session with the cafeteria workers to introduce new recipes.

2. Educational Activities
The schools participating in the HCHF program conduct daily educational activities for the children on health, hygiene, nutrition and gardening topics. Teachers employ participatory education techniques learned through our trainings with their students, encouraging their creativity and communication by developing lessons through posters, drawings, skits, songs, puppet shows, etc. as opposed to lectures or silent reading. The children enthusiastically share what they have learned with their families and communities, both directly and by example, thus stimulating positive changes in health, hygiene and nutrition habits within a broader population.

In the second half of the grant year, many of the educational activities were focused on gardening, as students continued to plant and harvest their crops. Among the most commonly cultivated crops are collard greens, spinach, carrots, beets, lettuce, tomatoes, cabbage, broccoli and herbs.

Other educational activities were highlighted in our previous report to the Allen Foundation. For example:

The Filinto Muller school developed the theme of “nutrition and balanced diets” through drawings. The children learned about the importance of eating fruits and vegetables, as well as the health consequences of a poor diet. At the Santo Izidro school, students researched and listed the fruit trees close to their homes and drew them, listing the nutritional properties of each fruit.

The Presidente Vargas school organized a field trip with the children to learn about gardening and environment. The Aila Saldanha school also organized what they called “ecological tours” and developed an environmental game that involved the whole community.

In the Sargento João Délio school, the teachers developed an activity through which their students researched the vegetables and fruits native to their region and identified regional recipes. In doing so, the students not only learned about the nutritional properties of various foods and how they can contribute to a balanced diet, but also learned more about their local geography and culture.

3. Treatment
Baseline biomedical tests conducted by INMED revealed that more than 60% of children in the project area were infected with intestinal parasites, so the deworming medication Pantelmin was administered on a mass scale according to World Health Organization guidelines. Semiannual deworming treatment was conducted in October 2004 and in April – May 2005.

In addition, because blood hemoglobin tests showed that nearly one-third of children in Duque de Caxias were anemic, and an additional 38% were borderline anemic, we also provided them with the polyvitamin supplement Rarical, a composition of iron sulfate, vitamin A and other key minerals and vitamins, during the grant year.

Follow-up biomedical testing is scheduled for the end of 2005. We will be happy to share the outcome of those tests with the Allen Foundation.

Future Activities

Although the grant year funded by the Allen Foundation has now ended, INMED will continue the following project activities in Duque de Caxias initiated in part with the Foundation’s support through the Horta Brasil program:
• Maintenance, monitoring and harvesting of school gardens;
• Incorporating garden produce in school meals;
• Ongoing and refresher training for teachers and cafeteria workers;
• Training for mothers in developing home vegetable gardens;
• Training for schools and community members in the solar water disinfection (SODIS) technique, which INMED is pioneering in Brazil;
• Developing community gardens;
• Ongoing treatment for intestinal parasitic infection and anemia;
• Follow-up biomedical examinations; and
• Ongoing educational activities with the children in the classroom and in the community.

Grant Expenditures

Labor 12,314.08
Benefits & Payroll Taxes 3,632.65
Travel 3,410.04
Consultants 939.07
Other 6,552.18
Subtotal 26,848.02
Indirect 4,026.97
Grand Total $30,875.00


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Project Title: Feeding Fish to Feed the People
Institution: Marine Biological Laboratory
Date: 1/13/2005
Report:
The MBL project has gone according to the proposed timeline with a brief delay in progress due to the Floirda hurricanes and the resulting difficulty in getting specific feed ingredients and fish fingerlings.
To date the following key goals have been accomplished:

Research was conducted and samples of four Haiti native plant materials were analyzed for nutritional composition inlcuding protein content, essential amino acids, fatty acids and digestability. Two recipes have been formulated by a fish nutirtionist to be used in preliminary feed trials. Nine fish rearing units have been designed and built. Feed manufaturers have been consulted in the pellet producing process and 12 different binding agent shave been identified that will prove to make the pellet water stable, bouyant and palatable to the fish. Beginning in October the fish were introduced to the systems and in mid-November the feed study began. Weight recordings ar emade every two weeks and the data calculated to determine efficacy of th efeed design and production and hence fish growth.

Of the $17,736 awarded by the Allen Foundation, the MBl has spent $5,522 for fish rearing, $5,085 for feed development, $2,247 for labor and administration and $1,119 for travel. The remaining $3,763 wil be used for travel to Haiti in January 2005.


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Project Title: Healthy Children, Healthy Futures - Improving Nutrition through School and Community Gardens
Institution: International Medical Services for Health dba INMED Partnerships for Children
Date: 12/31/2004
Report:
Duque de Caxias, historically a sugar plantation, is situated north of the city of Rio de Janeiro, Brazil. It is considered one of the least developed regions of the country; many children come from disadvantaged families that live in substandard housing with little or no water and sanitation facilities. At the same time, poverty-level incomes make it difficult for families to provide adequate nutrition and medical care. In addition, drug trafficking in the city creates an atmosphere of fear and violence, and compromises efforts to strengthen community development.

Within Duque de Caxias, INMED’s Healthy Children, Healthy Futures (HCHF) program reaches the poorest and most disadvantaged schools with our program of:
• Treatment for intestinal parasitic infection and micronutrient deficiencies;
• Participatory education on preventive health, hygiene and sanitation, and basic nutrition; and
• Community action to create and support positive change.

A 2004 grant from the Allen Foundation helped support the development of a gardening and nutrition education module to supplement our core HCHF curriculum. Currently, 5,177 children in 18 schools are participating in the enhanced HCHF project. For most of these children, the lunch provided by their schools is their only meal of the day. Before INMED’s involvement, these lunches were generally not nutritionally adequate—and certainly not sufficient to sustain the children’s daily nutritional needs.

Now, however, with the gardening and nutrition education activities now implemented among children, families, teachers and cafeteria workers, the nutritional quality of the school lunches has improved markedly. Gardens are being maintained in each of the 18 schools, and some have already been able to harvest their crops and use the produce in their school meals.

Project Activities to Date

1. Training
With the support of the Allen Foundation, INMED Brazil developed gardening and nutrition education training materials for the community of Duque de Caxias, including topics such as how to build and maintain school and home gardens using recycled materials, how to cultivate vegetables and fruits, and how to utilize the fresh produce for maximum nutritional benefit.

The first two-day training involved 28 participants, including teachers, school counselors, cafeteria workers and community health workers. The first day incorporated participatory education on nutrition, gardening and the HCHF project, and the second day encompassed hands-on practical training on building, cultivating and maintaining school and community gardens. The training was hosted by the Brasil-Itália school in Duque de Caxias, which already has an established garden.

2. Educational Activities
The schools participating in the HCHF program conduct daily educational activities for the children on health, hygiene, nutrition and gardening topics. Teachers employ participatory education techniques with their students, encouraging their creative and communicative side by developing lessons through posters, drawings, skits, songs, puppet shows, etc. as opposed to lectures or silent reading. Following are some examples of the activities developed in several of the participating schools:

The Filinto Muller school developed the theme of “nutrition and balanced diets” through drawings. The children learned about the importance of eating fruits and vegetables, as well as the health consequences of a poor diet. At the Santo Izidro school, students researched and listed the fruit trees close to their homes and drew them, listing the nutritional properties of each fruit.

The Presidente Vargas school organized a field trip with the children to learn about gardening and environment. The Aila Saldanha school also organized what they called “ecological tours” and developed an environmental game that involved the whole community.

In the Sargento João Délio school, the teachers developed an activity through which their students researched the vegetables and fruits native to their region and identified regional recipes. In doing so, the students not only learned about the nutritional properties of various foods and how they can contribute to a balanced diet, but also learned more about their local geography and culture.

3. Treatment
Recent biomedical tests conducted by INMED revealed that more than 60% of children in the project area were infected with intestinal parasites, so the deworming medication Pantelmin was administered on a mass scale according to World Health Organization guidelines. The most recent treatment was conducted in October 2004.

In addition, because blood hemoglobin tests showed that nearly one-third of children in Duque de Caxias were anemic, and an additional 38% were borderline anemic, we also provided them with the polyvitamin supplement Rarical, a composition of iron sulfate, vitamin A and other key minerals and vitamins.

Upcoming Activities

During the remainder of the grant year, we will carry out the following activities:
• Maintenance and monitoring of the school gardens;
• Additional training for teachers and cafeteria workers;
• Ongoing treatment for intestinal parasitic infection and anemia
• Educational activities with the children in the classroom and in the community, and
• Evaluation, including questionnaires and focus groups among project participants and stakeholders.

We will, of course, share the results of these activities with the Allen Foundation in our next report.




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Project Title: Communication Connections
Institution: Saranac Community Schools
Date: 12/27/2004
Report:
Dear Mr. Baum, and The Allen Foundation Board of Trustees,

In these difficult financial times for Michigan public schools, our partnerships with the community, businesses and foundations are more important to our district than ever. I am pleased to inform you of the progress made in Patti Patton's Special Education classroom, regarding the funds you granted us in June of 2004. The refrigerator has proven to be a great help to our Special Education self-contained classroom. Their efforts to serve the communities outside the classroom have been successful this school year due in part to your gracious contribution Refrigerator Budget.

Thank You Letter that was sent after the school received the grant money.

Mr. Dale Baum
Allen Foundation
PO Box 1606
Midland, MI 48641


Dear Mr. Baum, and The Allen Foundation Board of Trustees,

It is with heartfelt thanks that I send this letter. Your generosity in funding our grant request for funds to buy a refrigerator will allow us to continue with our “Communication Connections” project that teaches students about nutrition, life skills and service to their community and it’s senior citizens.

Please be advised that a project report will be prepared and mailed to you by December 31, 2004.

Thank you again,



Randy Masterson, Middle School Principal
Saranac Community Schools
234 S. Vosper Street
Saranac, MI 48881


Executive Summary:

Saranac Community Schools is requesting $624.00 to fund the purchase and delivery of a new refrigerator for our middle school special education self contained classroom. The teacher in this classroom has developed a curriculum that includes a service-learning project called “Communication Connections”. This project teaches the basics of good nutrition, food preparation, self-help skills, and community service. Every week the students in this classroom prepare a snack for local senior citizens that reside in a senior citizen facility near the school. They deliver the snack to the facility and serve it with smiles, providing a nutritious snack and companionship to their senior citizen friends. This service-learning project needs a refrigerator for proper food storage.

AMended Budget:

Kenmore, White, 18.2 cu. ft. ,Top Freezer

Vendor Model No. Serial Number Cost of unit Amt. of Tax Cost of Shipping Total

Lowes FRS26R2AWA LA42417166 $648.00 none $50.00 $708.00

Information source: Lowe's Sales Receipt 7/04/04
The difference between amount granted and amt. paid ($84.00) was paid by Saranac Community Schools.

Copy of text from Focal Point Article:

The Harker Middle School Community-Based Instruction Resource Room Classes are thrilled to be the benefactors of a brand new refrigerator. A grant from the Allen Foundation made it possible for the class to purchase the new, side-by-side, refrigerator /freezer.

Steven Kirby, a seventh grade CBI student said, "The refrigerator is really nice and cool. Now we can keep ice cream because we have a freezer."

The new refrigerator will be used as part of the kitchen in the middle school band room, where the CBI students apply their Math, Science, and Reading skills to real life food projects. They also run a small business, making and selling HUGE Rice Krispie Bars to their fellow students. Their profits fund field trips and class projects throughout the year.

Tiffany Ferris, another seventh grade CBI student, is looking forward to having cold water and ice cubes in the kitchen, and says "Thank You Allen Foundation!" The whole CBI class is looking forward to putting the new refrigerator to use!



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Project Title: Immunotherapeutic Enhancement of the Repair of Host Defense of Nutritionally Deprived Mice.
Institution: Michigan State University
Date: 6/24/2004
Report:
**Hard copies of publications and final budget were provided via mail.**

Summary of Accomplishments
The Allen support has enabled us to document the following new information:

1. Deficiencies in essential trace elements, like zinc or protein calorie deficiencies, cause neuroendocrine changes.

2. The neuroendocrine changes cause chronic elevation of a group of immunosuppressive steroids, glucocorticoids (Gc).

3. The Gc cause acceleration of apoptosis, cell death, among young developing precursor lymphocytes that leads to their death. This in turn appears to be the underlying cause of the reduced number of lymphocytes and atrophy of the thymus (needed for T-cell development), which are the hallmarks of zinc and/or protein calorie deficiencies. Thus our lab has identified a key mechanistic change that has helped us identify useful therapies.

4. Human bone marrow is also sensitive to these glucocorticoids so that human precursor lymphocytes also die rapidly when these steroids are present (directly supported by Allen Foundation – see publication by Dr. Lill).

5. Immunotherapeutic possibilities. Many of the inexpensive Gc antagonists, such as RU38486 and similar derivatives, provide almost complete protection of the precursor lymphocytes from Gc. They are fully protected against the death signals sent by Gc. Therefore, these drugs offer a real intervention that could be used short term in humans. Interleukin 7 (IL- 7) also provided really strong protection of young developing lymphocytes not only because it prevented apoptosis when Gc were present, but also allowed the cells to continue to proliferate and differentiate. This is a really reassuring finding with great potential. Interleukin III and Insulin Like Growth Factor also had some efficacy, but stem cell factor offered little protection.
Overall, we are really encouraged by the positive impact of Gc antagonists and IL-7 in protecting the immune system during malnutrition. Interleukin III and Insulin Like Growth Factor had enough protective effects to be somewhat effective. Thus we are hoping to:
a) Test a cocktail of these therapeutic mixtures for degree of protection against malnutrition using animal models.
b) Move to small trials using trauma patients at Sparrow Hospital in Lansing with Dr. John Kepros of Michigan State University surgery.

Publications
The final data for this project was collected several months ago. However, we wanted to wait until the final publication that is credited to the Allen Foundation was published (enclosed). You will note that data discussing the immunotherapeutic repair of the immune system is also published in the Annual Review of Nutrition – 2004. I am hopeful that the Allen Foundation Board will agree that the Annual Review series is fairly prestigious and reaches a wide audience in nutrition. We have resubmitted for your consideration the other publications provided in earlier reports citing the Allen Foundation for its support.

Budget
Enclosed in the packet is a February 2004 balance showing all Allen Funds have been utilized. These dollars also provided support for several graduate students who have successfully completed the Ph. D degree.

Summary
Dr. Fraker really appreciates the assistance of the Allen Foundation over the years. The foundation has allowed us to explore important research that will now lead to possible interventions to protect host defense systems of those who are malnutritioned. This research will impact low income Americans and children in underdeveloped countries that have poor diets. These interventions may also help stabilize patients with chronic diseases such as GI disorders, renal disease, AIDS, cancer, etc. where reduced intake of nutrients and weight loss lowers host defense capacity. Thus, these patients have higher rates of infection including sepsis and pneumonia that could be offset by nutritional and immunotherapeutic interventions. We are beginning some investigation of septic patients with Dr. John Kepros of MSU Surgery. All of us at Michigan State University greatly appreciate the support of the Allen Foundation.

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Project Title: Kitchen at Camp Neyati
Institution: United Way of Midland County
Date: 5/27/2004
Report:
The Midland Camping Council appreciates the grant for $6500 for purchasing a stove, refrigerator, and two stainless steel tables for the kitchen at Camp Neyati. The Midland Camping Council purchased a new stove with six burners, a grill section, and two ovens. The old stove was purchased in the 70’s. The cooks have expressed gratitude for the new stove. The Midland Camping Council purchased a commercial refrigerator to replace the used household refrigerator. The commercial refrigerator is used for storage of smaller items, commonly used ingredients, and leftovers. The commercial refrigerator minimized trips into the walk-in cooler where the majority of the food is stored. Therefore, no problems were experienced with the walk-in due to the new commercial refrigerator. The Midland Camping Council purchased two stainless steel tables for use in the kitchen. Two years ago, the health inspector commented on the condition of two of the tables in the kitchen. The tables were covered in Formica that was broken in several spots.

The new equipment allowed the cooks to provide nutritional meals to the thousands of campers using our facilities. The Midland Camping Council manages and maintains camping facilities for youth and families from the Midland area. The Midland Camping Council is an independent agency of the United Way of Midland County.

Financial Accounting
Refrigerator - $1958
Stove - $3965
Stainless Steel Tables - $415

Total - $6338

With the remainder, we purchased a small mixer as requested by the cooks - $248

Total - $6586

Our users have benefited from the improvements made to the kitchen. Thank you for your assistance in helping the Midland Camping Council fulfill our vision of having an excellent camp facility.

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Project Title: Project FRESH
Institution: Michigan State University Extension
Date: 5/4/2004
Report:
Progress Report

The goals for Project FRESH 2003 included reaching 1,320 families (10% increase over 2002) with $40 worth of coupons. The proposal included giving all families $40 to avoid a return trip to pick up additional coupons. To encourage the use of all the coupons, additional classes were offered focusing on long-term freezer storage. 30 families selected to attend extra sessions allowing them to carry their Project FRESH purchases well into the fall and winter months.

The total number of families reached was 1,341 families, slightly over the projected 1,320. The redemption rate was 85.5% in Midland, 82% in Clare/Gladwin and 73% in Arenac. All 3 efforts exceeded the statewide average of 70%!

A total of $52,800 was infused into the local 4 county agricultural economies. Participants were able to shop at 16 vendor sites and 6 different farm markets, 2 of which opened for the first time this summer.

The target audience included all WIC eligible families in Midland, Clare, Gladwin and Arenac counties. It also included food stamp recipient families that participate in the year-round Family Nutrition Program with children under the age of seventeen living in the home. In Arenac county summer migrant families were included.

Project FRESH families received one hour of instruction regarding the nutritional value, correct selection and storage, and food preparation/preservation information about fresh fruits and vegetables. Topics such as in-season, you-pick your own and what’s a good price were also included. Families were given $40 worth of coupons redeemable at local farm stands and markets throughout the counties. 107 classes were taught in small groups at local sites; in a single home visit or one-on-one where a mother may have been prescribed bed rest.


Submitted by
Elizabeth M Szymanski
Midland County Extension Director
989-832-6640

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Project Title: Community Service Scholarship for Graduate Students Enrolled in the CMU Dietetic Internship
Institution: Central Michigan University
Date: 4/13/2004
Report:
Annual Report to the Allen Foundation, Inc.
May 2003 to April 2004

This report covers the grant period from May 2003 to April 2004. We are appreciative of the Allen Foundations’ support for the community service scholarship to the Central Michigan University Dietetic Internship (CMUDI).

Background and Objectives

The mission of the CMUDI is to “promote the growth of a dynamic educational program committed to preparing competent registration-eligible dietitians to serve the nutrition needs of the community.” The CMUDI prepares entry-level registered dietitians who, as experts of food and nutrition, serve the nutritional needs of the community in the Tri-City area as well as throughout the State of Michigan. The CMUDI is accredited by the American Dietetic Association and meets its Standards of Education.

The purpose of the community service scholarship is to help offset the expenses each student incurs while participating in the community elective rotation. The scholarship provides each intern with a stipend of $1,500.

Activities, Outcomes and Accomplishments

Each student is required as their two-week community elective rotation to select a community based agency/program/organization that could benefit from a nutritional intervention. During the two-week period they research the agency, assess the nutritional needs of the population served and develop a plan to meet a specified nutrition need of the target population. They implement the plan, do appropriate follow-up, evaluate the results and make appropriate recommendations. The agencies/programs/organizations are usually unable to fund the services of a Registered Dietitian.

The following highlights some of the projects completed by the Dietetic Interns:

Agency Project Description
Heritage High School, Saginaw, MI Participated in Career Day, teach basic nutrition and sport nutrition to 9-12 grade health classes, varsity weight training class, and English class.
United Diary Industry of Michigan, Okemos, MI Planned and implemented presentation to the Farm Women’s Symposium workshop on the nutritional make up of various fad diets (Atkins etc).
Diabetes Center, Midland, MI Developed activities for the annual Youth Day Diabetes Event. Planned pre-dialysis low protein sample menus, and developed Type 1 diabetes bulletin board display for the Center.
Building a Healthier Community Coalition, Sault Ste. Marie, MI Surveyed the Chippewa County residents regarding educational needs. Developed educational handouts based on identified needs. Assisted with the coalition in developing mission and goals.
Central Michigan University, Mt. Pleasant, MI Assisted with data analysis for study done by Dr. Hildbrandt on administration of medium chain triglycerides and athletic performance.
Lansing Dietetic Association, Lansing, MI Assisted with the planning, marketing and implementation of the twenty-third annual Food and Fitness 5K race.
University of South Dakota Head Start Program Developed nutrition lesson plans for the head start program throughout South Dakota.
Gordon Food Service, Grand Rapids, MI Developed in-service kits to train foodservice personnel.
YMCA, Bay City, MI Provide nutrition information and education sessions to interested members.
Hundred Acre Woods, preschool, Freeland, MI Develop and present to caregivers, parents, and children various topics related to healthy snacks and good nutrition.
Saint Mary’s Health Connection, Saginaw, MI Develop and implement a presentation to the community on “Reversing the Fast Food Revolution”. Teamed up with the Saginaw Spirit hockey team to do a blood pressure screening for the public and promote the DASH diet.
Curves, Women’s Fitness Center, Portland, MI Provided individualized nutritional counseling to Curve members and staff.
MidMichigan Hospice, Midland, MI Survey RD’s across the country regarding current treatment protocols, complete a medical literature review pertaining to end of life nutrition and hydration concerns, develop a referral form for staff to use for an RD referral.
Area Agency on Aging of Northwest Michigan, North west Michigan Develop eight training modules to be used by employees and volunteers of the Senior Nutrition Programs for each of the 15 congregate meal sites.
District #2 Health Dept., Northeast Michigan Developed and implemented a breastfeeding promotion program for WIC clients in a four county area.
Midland County Council on Aging, Midland, MI Completed survey on seniors to increase attendance at the new Trailside Center, investigate and recommend packaging changes for Meals on Wheels.
District #10 Health Dept., Western Michigan Designed bulletin board template or kit for the WIC’s breastfeeding promotion program in August.
Mercy Hospital, Cadillac, MI Developed a nutrition presentation and delivered it to seniors at the Senior Center and hospital auxiliary members.
Nimkee memorial Wellness Center, Chippewa Tribe, Mt. Pleasant, MI Modify the nutrition education modules for the native American population.
Central Michigan Crisis Pregnancy Center Create nutrition education materials for pregnant women.

Financial Accounting of Expenditures for 2003-2004

Financial Aid $32,250
Indirect Costs $3,225.00
Total Expenses 35,475.00




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Project Title: Holy Rosary School, K - 8 Nutrition Education Grant
Institution: Holy Rosary School; 4142 42nd Ave SW; Seattle, WA 98116
Date: 4/10/2003
Report:
May 14th, 2002

Allen Foundation Inc.
P.O. Box 1606
Midland, Michigan 48641-1606

Dear Executors of the Allen Foundation:

With the Allen Foundation's generous donation of $4090.74, Holy Rosary School has made great progress in educating our students, (particularly those in the primary and intermediate grades), about the importance of good nutrition.

Teachers are extremely satisfied with the value and utility of the instructional materials they have received with grant monies. In addition, our junior high Health and Fitness elective students have designed and taught nutritional awareness lessons to grades K - 4 throughout the school year. This program has been implemented in the following three (3) phases this year:

Phase I: In early November, the Health and Fitness students visited primary and intermediate classrooms and taught their own, age appropriate lessons on what fruits and vegetables are, how "color" relates to variety, and approximate serving sizes. The primary and intermediate students then took home a food log and charted their consumption of fruits and vegetables over three (3) days. Parents signed and returned completed logs to the classroom teachers. The Health and Fitness students collected the logs and tabulated the data. The purpose of Phase I was to get a baseline for each child's intake of fruits and vegetables in grades K - 4.

Phase II: In March, the Health and Fitness students again went into the primary/intermediate classrooms to teach their personally designed lessons, this time, about the benefits of eating at least five (5) servings of fruits and vegetables a day. Many of these lessons included nutritious and tasty alternatives to junk foods, including: fruit smoothies, fruit salads, veggies with fat-free dip, and chocolate-covered strawberries. A second food log was sent home with the K - 4 students, and they (again) recorded their fruit and vegetable intake over three (3) days. The Health/Fitness elective students analyzed the data by comparing the November and March food logs. They noted a significant increase in the number of students who ate five (5) or more fruits and vegetables a day. The March food log results were posted in the school's main hallway with each participating class listed. A paper fruit or vegetable was posted in a line beside each classroom for each student in the class who ate at least five (5) frits or vegetables a day over three (3) days, (as recorded on his/her March food log).

Phase III: In mid-May, the Health/Fitness students surveyed the primary and elementary grades one final time. The classrooms with the most number of students eating five (5) fruits and vegetables a day received a fat-free, frozen fruit yogurt treat.

Throughout the year, K - 5 teachers have been using the instructional materials purchased with Allen Foundation grant money to teach nutrition to their students and to supplement their own health and science programs. The curriculum materials purchased for the junior high Health and Fitness elective have also proven invaluable in teaching such topics as: the Food Guide Pyramid, teenage body image, eating disorders, and student responsibility for healthy food choices.

Holy Rosary School is very grateful for your assistance. The curriculum materials, and the ideas generated from using them, will benefit all our students for many years to come.

Donna M. Popich

Health & Fitness Teacher
Holy Rosary School



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Project Title: The development of the mountainous region
Institution: NGO Centre for the development of the mountainous region
Date: 11/30/2002
Report:
12members,Staff-3members,,Exwcutive-5members,Health-care-3members,Culturaldevelopment-3members,Elderly concerns-3members,Employment-3members,Economy concerns,fund raising,Elections-3members,Publicity and communications-3members,Legal-3members.
The finances will be devided into the parts according to the received financial assistance.

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Project Title: Effect of Varied Nutrient Substrate on Weight loss and Satiety
Institution: University of Minnesota
Date: 9/6/2002
Report:
Analysis has been made of data for the first 27 subjects. An abstract has been submitted to ADA's Food & Nutrition Conference for October 2002. The analysis suggests that the hypothesis of the study is supported. A low-glycemic index diet may be preferable for imporving insulin sensitivity.

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Project Title: Home-based therapy for protien-energy malnutrition
Institution: Washington University in St. Louis
Date: 9/6/2002
Report:
The field work has been completed. The children recieving the ready to use peanut butter food had a better nutritional status than those who received corn/soy. The scientific resurlts will be presented at the Pediatric Academic Society meeting in May, 2002.

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Project Title: Refeeding Issues in Oncology Patients Receiving Parenteral Nutrition
Institution: CMU/Mid Michigan Medical Center
Date: 9/6/2002
Report:
Data collection has been completed with a total of 41 patients enrolled. Preliminary statistics show a significant phosphorous drop in our oncology patietns recieivng parenteral nutrition. The manuscript is near completion with a goal of submission to Nutrition in Clnical Practice fall 2002.

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Project Title: The Children's Kitchen classroom
Institution: Montessori Children's House and Elementary School, Traverse City, MI
Date: 9/6/2002
Report:
New classroom kitchen due to open in June 2002.

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