Introduction to Public Health Nutrition and Career Insights

Nutrition is essential for health throughout a person’s life. According to the CDC, consuming a healthy diet that includes proper portions of fruits, vegetables, whole grains, fat-free/low-fat dairy products, protein sources, and some oils allows for children to properly grow and develop¹. Adequate nutrition beginning in infancy and continuing through all stages of life also reduces the risk of chronic diseases, including heart disease, type 2 diabetes, and cancer, throughout the lifespan². These chronic illnesses are also all impacted by physical activity, a significant partner to nutrition in the realm of health science and, thus, in messaging surrounding health promotion. 

Nutrition even has implications in infectious diseases, as good nutrition helps bolster the immune system. In addition to providing the energy the immune system needs, healthy foods provide precursors necessary in the formation of some of the immune systems most powerful tools, such as antibodies and cytokines. Nutrients from food, such as vitamin D and zinc, can also provide anti-bacterial and/or anti-viral defenses of their own³. Without these immune system supports from good nutrition, people are at greater risk for disease and possible severe infection. 

Ingested foods impact the gut microbiome as well, an element of the human body that’s significance in overall health has gained understanding in recent years. In addition to functions such as improving nutrient absorption and limiting inflammation, the bacteria of the gut microbiome support neural pathways traveling between the gut and the brain. The gastrointestinal tract is also the producer of most serotonin, a neurotransmitter that helps regulate mood, sleep, appetite, and pain, in the body. Thus, for a multitude of reasons, it is also posited that nutrition plays a pivotal role in mental health⁴.

Poor nutrition and food insecurity, a phenomenon in which people lack access to an adequate amount of food, resulting in nutritional deficiencies, are considered major public health issues; public health practitioners understand that the resolution of these problems will result in better community nutrition and, thus, health outcomes for the population at large⁵. Such phenomena often occur in communities due to greater societal factors, such as socioeconomic status, that impact food systems, demonstrating that this issue is one that needs to employ a population health sciences perspective rather than an individualistic one⁶. Knowledge of the distribution of nutritional deficiencies and their associated disease risks falls under the study of nutritional epidemiology.

Several public health initiatives have been implemented to target food insecurity and poor nutrition in the United States. The National School Lunch Program (NSLP) was created with the goal of making healthy food accessible to children during the school day by providing nutritionally balanced meals at no- or low-cost⁷. Similarly, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious foods and dietary education to low-income pregnant or post-partum mothers, infants, and children five years old and younger⁸. Extending beyond mothers and children, the Supplemental Nutrition Assistance Program helps entire families afford nutritious groceries⁹.

While these are all domestic examples, international programs have also been implemented geared toward public health nutrition. Several United Nations agencies are engaged in efforts to combat food insecurity: 

• The World Food Programme (WFP) aims to prevent hunger in the future while also working to bring food assistance to over 80 million people spanning 80 countries in the present.

• The World Bank invests in new agricultural technologies and rural development around the world to promote food production and adequate nutrition.

• The Food and Agriculture Organization (FAO) strives to provide underserved populations globally with enough high-quality food for them to lead productive lives.

• The International Fund for Agricultural Development (IFAD) works to reduce rural poverty internationally¹⁰. 

Non-United Nations agencies engage in this work globally, too. Many of the initiatives above as well as those not listed here employ specific public health strategies to promote healthy nutrition and eliminate food insecurity. Some such strategies involve programs to eliminate food waste, utilize social media platforms, diversify accessible protein sources, consider occupational health hazards, increase awareness and education about food insecurity, direct funding toward programs that help make food accessible to vulnerable groups, and generally engage in activism to support at-risk populations¹¹.

In order to engage with and support a community, public health nutrition activists must first get to know the members and landscape of the targeted community. The U.S. Department of Agriculture (USDA) has created a Community Food Security Assessment Toolkit for this process¹². Next, it’s critical for public health professionals in this role to engage with stakeholders in the community to understand further the accessible resources. From these assessments, data can be collected that will inform decisions and help in the building of crucial partnerships as public health professionals work to promote healthy nutrition within the community¹³.  

This time spent engrossing oneself within the locality and getting to know its constituents helps bolster community engagement in public health nutrition initiatives. Specifically, it’s important for public health professionals to behave as a partner, encourage discussion amongst community members, seek out leaders who can act as ambassadors, and participate in local events. These actions, paired with educational work and the creation of mutually beneficial opportunities, must be upheld consistently to maximize effectiveness¹⁴.
Advocacy can take on forms beyond direct community involvement as well. Many public health professionals work to support causes such as public health nutrition by trying to influence policy decisions.

The Center for Nutrition Policy and Promotion within the USDA helps to promote public health nutrition through this policy lens. In addition, they use their expertise toward the development of dietary guidelines for public access¹⁵. Thus, there are many ways to advocate and support nutritional improvements from a public health lens. Each of these methodologies involve challenges, such as community connection, access to technology, and political bureaucracy, that a strong public health educational background could help a budding public health nutritional professional navigate.

Public health nutritionists, professionals who specialize in population-level changes in nutrition, can work in a variety of healthcare settings, including hospitals, schools, and government. Amongst other activities, they engage in promotional work, the formulation of dietary guidelines, and the development of nutritional policy. At a minimum, practicing as a public health nutritionist requires a bachelor’s degree. Some colleges and universities have programs that have been approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) in nutritional sciences and, specifically, human nutrition.

This accreditation means that these programs prepare students well for the Registered Dietitian exam, a necessary step in nutritionist licensure in states that require it and for students that desire it for their career aspirations to become a registered dietitian¹⁶.

Many public health nutrition professionals will seek more advanced education through graduate school, as it is often necessary to move upward to higher ranking job positions. The degree options for this include Master of Science (M.S.), Master of Public Health (MPH), and Doctor of Philosophy (PhD) degrees. A number of public health schools offer specializations in public health nutrition studies to those seeking an MPH and/or a PhD. These schools include the New York University School of Global Public Health¹⁷, the Harvard T.H. Chan School of Public Health¹⁸, and the University of California, Berkeley, School of Public Health¹⁹. Degrees in public health can be valuable for people pursuing many professions²⁰, including those interested in nutrition who would like to engage in work at the population level.

One project operating to improve public health nutrition today targets the improvement of maternal, neonatal, and child health by reducing chronic malnutrition in Guatemala. This project, titled the USAID Health and Nutrition Project (PSN), aims to achieve the project goal by improving access to health and nutritional services as well as bolstering the strength of governance and human resources in health matters. As mentioned previously, collaboration amongst stakeholders proves paramount in this project as private sector, civil society, and the community work together²¹.

CARE’s Southern African Nutrition Initiative (SANI) also aims to reduce malnutrition amongst pregnant/nursing mothers and children. With financial support from the Government of Canada, they work to achieve this goal by providing nutritional counseling, training to local health care workers, pediatric therapeutic feeding, assistance for the building of community gardens and water systems, specific HIV/AIDS-related support, and expanded economic opportunities for women²². Thus, this project recognizes that supporting improved nutrition in a community requires involvement beyond solely dietary matters.

A third project taking action to eliminate chronic malnutrition was the South Asia Food and Nutrition Security Initiative (SAFANSI) from the World Bank. This initiative was determined to understand and remedy the trend seen in south Asian countries: entrenched issues with malnutrition despite economic growth in the region. This project encompassed two separate phases with the first aimed at altering the political agenda and the second geared toward stimulating awareness, behavioral changes, and overall capacity for adaptation. Like the others, this project was a concerted effort involving collaboration amongst many stakeholders²³.

Many public health nutrition projects operate domestically within the United States as well. One such operation is the Stellar Farmers Markets Program. Taking place at farmers’ markets across New York City, this program entails educational workshops about nutrition and cooking demonstrations utilizing locally sourced foods. This project takes place annually between July and November, and the lessons are given in multiple languages in consideration of community needs. The lessons themselves are free of charge, and adult participants will receive a coupon for attending. This program demonstrates the power of consistent community engagement and the difference it can make in the health of the populace²⁴.

In conclusion, public health nutrition represents a burgeoning and highly influential field. A career in this area would be one overflowing with fulfillment. Adequate nutrition is critical for good health outcomes, but one’s journey to improved nutrition is often riddled with barriers. Public health nutrition professionals seek to help alleviate these challenges, making proper nutrition, and, thus, good health, more accessible to all people. 

Get started on your career journey in public health nutrition today to help contribute to this impactful work.