NUTRITION AND.HEALTH PROMOTION

BY

       C. EVERETT KOOP, MD

  DEPUTY ASSISTANT SECRETARY FOR HEALTH

        AND SURGEON GENERAL

U,S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

PRESENTED TO A LUNCHEON MEETING OF THE

     WHEAT INDUSTRY COUNCIL

       WASHINGTON, DL

       SEPTEMBER 8, 1982


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(GREETINGS TO HOSTS, GUESTS)

  I'M DELIGHTED TO BE HERE TODAY TO LEND MY SUPPORT TO A VERY

IMPORTANT PUBLIC HEALTH EFFORT.  I WANT TO CONGRATULATE THE MEMBERS OF

THE WHEAT INDUSTRY COUNCIL FOR MOVING AHEAD WITH YOUR NUTRITION

EDUCATION PROGRAM.  IT DOESN'T COME A MOMENT TOO SOON. ALL OF US --

INDUSTRY, GOVERNMENT, AND THE VOLUNTARY SECTOR -- NEED TO GET THE WORD

OUT TO THE AMERICAN PEOPLE ABOUT THE RELATIONSHIP BETWEEN GOOD HEALTH

AND GOOD DIET,

  YOUR PLAN IS A GOOD ONE BECAUSE IT'S BASED ON A GOOD MESSAGE THAT

NEEDS A LOT OF PUBLIC EXPOSURE. WHEAT-BASED FOOD CAN BE AN INDIVI-

DUAL'S BEST ONE-STOP SOURCE OF CARBOHYDRATE, FIBER, PROTEIN, VITAMIN

B, AND IMPORTANT TRACE MINERALS, WHEAT FOODS ARE ABUNDANT AND

INEXPENSIVE, YET THEY ARE NOT FATTENING.  YOU CAN'T ASK FOR MUCH MORE

THAN THAT.

  THE FOOD MARKETPLACE -- AS YOU KNOW BETTER THAN I -- IS FULL OF

HIGHLY COMPETITIVE MESSAGES, AND THAT'S GOOD,,,COMPETITION IS WHAT


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THIS COUNTRY IS ALL ABOUT, BUT THE PUBLIC NEEDS HELP IN IDENTIFYING

THE MOST USEFUL MESSAGES, THE ONES THAT CAN REALLY CONTRIBUTE TO A

MORE HEALTHFUL DIET,

  THAT'S WHERE YOUR NUTRITION EDUCATION PROGRAM CAN BE SO VERY

IMPORTANT,  YOU AND I KNOW THAT WHEAT FOODS CAN STRENGTHEN THE DIET

WITHOUT WEAKENING THE POCKETBOOK. BUT EVERYONE ELSE SHOULD KNOW THAT,

TOO, SO I ENCOURAGE THE WHEAT FOOD INDUSTRY TO DO THE BEST JOB

POSSIBLE IN PUBLIC EDUCATION,

  I SAY THAT NOT ONLY FOR MYSELF BUT FOR THIS ADMINISTRATION AS

WELL,  FROM THE DAY PRESIDENT REAGAN TOOK OFFICE, HE HAS CONSISTENTLY

LOOKED TO THE PRIVATE SECTOR TO MAKE ITS UNIQUE CONTRIBUTIONS TO

PROGRESS IN AMERICAN LIFE. THE PRESIDENT'S ESTABLISHMENT LAST

DECEMBER OF THE "TASK FORCE ON PRIVATE SECTOR INITIATIVES" WAS AN

IMPORTANT STEP IN THAT DIRECTION. BUT THERE ARE OTHER METHODS FOR

PRIVATE SECTOR INVOLVEMENT, ALSO, ESPECIALLY WHEN THE ACTIVITY

REQUIRES SUBSTANCE AND DEPTH,  I THINK THE WHEAT INDUSTRY COUNCIL IS
PROVIDING JUST SUCH AN OBJECT LESSON FOR OTHERS IN THE PRIVATE SECTOR

TO FOLLOW,


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  GRANTED, THE COUNCIL IS HERE BECAUSE CONGRESS WANTED IT HERE. BUT
UNLESS I'M GREATLY MISTAKEN, THE PROVERBIAL "ACT OF CONGRESS" ISN'T A
PREREQUISITE FOR GETTING BUSINESS, INDUSTRY, AND CONSUMER GROUPS TO
RESPOND TO A NATIONAL NEED FOR HELP. FOR MEMBERS OF THIS COUNCIL,
PUBLIC LAW 95-113 HAS BEEN USEFUL -- BUT I THINK YOU WOULD HAVE

ARRIVED HERE ANYWAY WITHOUT IT.

  I SAY THAT FOR SEVERAL REASONS, IN ADDITION TO MY FAITH IN THE

PRIVATE SECTOR,  FIRST, PEOPLE LIKE TO EAT AND THEY'VE ALWAYS WANTED TO
LEARN EVERYTHING THERE IS TO KNOW ABOUT FOOD, THE CAVE DRAWINGS BY
PREHISTORIC MAN, FOR EXAMPLE, WERE MORE THAN RANDOM PICTURES OF WILD

BEASTS: THEY WERE PORTRAITS OF DINNER, AND WE KNOW THAT AGRICULTURE

-- THE CULTIVATION OF GRAINS -- AND THE DOMESTICATION OF FOOD-PRODUCING

ANIMALS SIGNALLED THE DAWN OF WHAT WE CALL "CIVILIZATION,"

  FINALLY, A LITTLE CLOSER TO HOME, I THINK THE IDEA OF A "WHEAT
INDUSTRY COUNCIL" IS IMPORTA'NT TO ANYONE CONCERNED NOT ONLY ABOUT YOUR

PARTICULAR INDUSTRY BUT ABOUT NUTRITION IN AMERICA.


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  OUR SOCIETY HAS BEEN GRADUALLY CHANGING ITS PATTERNS OF FOOD

CONSUMPTION. THIS, IN TURN, HAS PRODUCED SEVERAL IMPORlX'lT CHANGES IN

THE NUTRITIONAL CONTENT OF THE AMERICAN DIET. ACCORDING TO THE U.S.

DEPARTMENT OF AGRICULTURE, AMERICANS HAVE,,,

  ,,,INCREASED THEIR CONSUMPTION OF FAT BY ABOUT 35 PERCENT BETWEEN

THE YEARS 1909 AND 1980,

  ouTHE CONSUMPTION OF SIMPLE SUGARS AND OTHER SWEETENERS HAS GONE

UP BY 50 PERCENT DURING THE SAME SEVEN DECADES,

  ,.,AND THERE'S ALSO BEEN A 44 PERCENT DROP IN THE PRESENCE OF

WHEAT FLOUR IN THE PER CAPITA FOOD SUPPLY,

  WHY IS THIS IMPORTANT? FOR ONE THING, FAT CONSUMPTION HAS BEEN

ASSOCIATED WITH DISEASES OF THE CARDIOVASCULAR SYSTEM. AND WE'RE

PARTICULARLY UNEASY ABOUT THE INCREASED CONSUMPTION OF PRODUCTS MADE

WITH STICKY SUGARS, WHICH HAVE BEEN IMPLICATED IN A VARIETY OF DISEASE

CONDITIONS, SUCH AS DENTAL CARIES, AND WE'RE UNCOMFORnBLE WITH THE

DIMINISHED PRESENCE OF WHOLE GRAINS AND FIBER, BECAUSE THEY


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HAVE BEEN A FAIRLY CHEAP SOURCE OF TROUBLE-FREE CARBOHYDRATE AND THEY

PERFORM OTHER FUNCTIONS IN THEIR PASSAGE THROUGH THE HUMAN GASTRO-

INTESTINAL SYSTEM.

  THESE AND OTHER CHANGES IN FOOD USE IN THE UNITED STATES HAVE HAD

AN IMPACT UPON THE HEALTH STATUS OF OUR CITIZENS, BUT FRANKLY, WE

DON'T KNOW JUST WHAT THE FULL IMPACT HAS BEEN.  IN ADDITION, WE HAVE

TO PAY SPECIAL ATTENTION TO A NUMBER OF IMPORTANT CHANGES THAT HAVE

BEEN OCCURRING IN THE AMERICAN DIET IN JUST THE PAST 10 YEARS,

  ON A PER CAPITA BASIS, FOR EXAMPLE, AMERICANS ARE NOW CONSUMING

MORE LOWFAT MILK, MORE CHICKEN AND LESS BEEF, MORE COMPLEX

CARBOHYDRATES, AND MORE VEGETABLE FATS, SUCH AS MARGARINE AND

SHORTENINGS, THESE DIETARY CHANGES HAVE TAKEN PLACE AT THE SAME TIME

THAT WE'RE SEEING A NUMBER OF IMPROVEMENTS IN THE HEALTH STATUS OF

AiiERICANS: GREATER LONGEVITY.. LOWER INFANT MORT4'LITY.o.AND A DECLINE

IN THE OVERALL DEATH RATE, INCLUDING A RATHER REMARKABLE DROP IN THE

DEATH RATE FOR HEART DISEASE,


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  WE CAN'T SAY FOR SURE HOW MUCH OF THIS CAN BE CREDITED TO DIET AND
HOW MUCH SHOULD BE CREDITED TO BETTER MEDICAL CARE AND IMPROVED
POPULATION SCREENING, SUCH AS THE EARLY DETECTION AND TREATMENT OF
POTENTIAL HEART DISEASE AND STROKE VICTIMS, THAT'S THE KIND OF
INFORMATION WE HOPE TO ACQUIRE THROUGH MORE RESEARCH AND IMPROVED

SYSTEMS OF COLLECTING DATA, ,

  ON THE RESEARCH SIDE, WE'VE BEEN GIVEN A GREAT OPPORTUNITY BY

SECRETARY RICHARD SCHWEIKER.  JUST ABOUT A YEAR AGO, ON SEPTEMBER 16,

TO BE EXACT, THE SECRETARY LAUNCHED HIS "RESEARCH INITIATIVE IN
NUTRITION" FOR OUR DEPARTMENT OF HEALTH AND HUMAN SERVICES, HE

STRONGLY BELIEVES -- AS I DO -- THAT WE NEED TO DO A BETTER JOB

POOLING OUR INFORMATION AND RESOURCES IN ORDER TO UNDERSTAND MORE
CLEARLY AND MORE EFFICIENTLY JUST WHAT THE RELATIONSHIP IS BETWEEN

HUMAN NUTRITION AND THE MAINTENANCE OF GOOD HEALTH.

  ON THE DATA SIDE, OUR DEPARTMENT AND THE DEPARTMENT OF AGRICULTURE

ARE NOW COOPERATING TO A MUCH GREATER EXTENT IN THE GATHERING OF

NUTRITIONAL AND DIEWRY INFORMATION FROM AMONG THE AMERICAN PEOPLE,

THIS COOPERATIVE EFFORT -- KNOWN AS THE "NATIONAL NUTRITIONAL

:


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MONITORING SYSTEM" -- WAS BEGUN UNDER PAST ADMINISTRATIONS, HAS BEEN

OF SPECIAL INTEREST TO THE CONGRESS, AND IS NOW IN FULL SWING UNDER

THE REAGAN ADMINISTRATION.

  IN THESE AND OTHER WAYS, I THINK OUR TWO DEPARTMENTS ARE BEGINNING

TO GET A BETTER HANDLE ON WHAT PEOPLE EAT AND WHY...WHAT THE

COMPOSITION OF THE FOOD SUPPLY IS,,. WHAT THE RESEARCH PRIORITIES OUGHT

TO BEamAND WHAT KIND OF INFORMATION IS NEEDED TO HELP BOTH THE PUBLIC

AND THE PRIVATE SECTORS DELIVER AN IMPROVED DIET TO THE AMERICAN

PEOPLE.

  BUT LET ME ADD THAT, AS IMPORl?i>T AS THESE GOVERNMENT EFFORTS ARE,

THEY WOULD NOT BE POSSIBLE WITHOUT THE STRONG COOPERATION OF THE

PRIVATE SECTOR,  THE DEPARTMENTS OF AGRICULTURE AND OF HEALTH AND

HUMAN SERVICES VALUE THE PARTICIPATION OF MEMBERS OF THE FOOD

INDUSTRY, WITHOUT YOUR INTEREST AND HELP -- AND WITHOUT THE

ASSISTANCE OF CONSUMER GROUPS, NUTRITIONISTS, DIETITIANS, THE ACADEMIC

COMMUNITY, AND MANY OTHERS WHO WORK WITH THE WHEAT INDUSTRY COUNCIL --

WE SIMPLY COULD NOT GET THE JOB DONE,


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  BUT ALL THESE ACTIVITIES IN NUTRITION RESEARCH AND DATA COLLECTION

REALLY MAKE SENSE, IN MY OPINION, WHEN THEY ARE EVALUATED IN THE LIGHT

OF THE HEALTH NEEDS OF THE AMERICAN PEOPLE,  YOU CAN'T STRESS THIS

POINT TOO OFTEN, AND IT'S PARTICULARLY TRUE IN THIS CURRENT PERIOD OF

SCARCE RESOURCES. EVERY INVESTMENT HAS TO COUNTmEACH DECISION HAS

TO KEEP US MOVING IN THE RIGHT DIRECTION,  AND I THINK WE MAY HAVE A

DOCUMENT -- A KIND OF ROADMAP IN PUBLIC HEALTH -- THAT SERVES THIS

VERY PURPOSE,

  NOT LONG AGO, THE PUBLIC HEALTH SERVICE PUBLISHED A DOCUMENT CALLED

HEALTHY PEOPLE: THE SURGEON GENERAL'S REPORT ON HEALTH PROMOTION AND

DISEASE PREVENTION,  THAT REPORT BROUGHT TOGETHER A WEALTH OF MATERIAL

CONTRIBUTED BY SOME 2,000 NON-GOVERNMENT EXPERTS REPRESENTING THE

MEDICAL, BEHAVIORAL, STATISTICAL, AND SOCIAL SCIENCES. FROM THAT

REPORT THE PUBLIC HEALTH SERVICE HAS BEEN ABLE TO DRAW UP A SET OF

NATIONAL HEALTH GOALS FOR THE YEAR 1990, AMONG THESE GOALS ARE

SEVERAL THAT CAN BEST BE ACHIEVED BY COMBINING IMPROVED NUTRITION WITH

NEW DEVELOPMENTS IN THE DELIVERY OF HEALTH AND MEDICAL CARE,


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  I'D LIKE TO SHARE WITH YOU A FEW OF THE MAIN HEALTH GOALS WE HOPE

TO ACHIEVE IN THIS DECADE, THEY ARE ORGANIZED ACCORDING TO POPULATION

AGE GROUPS.  I'LL PAY SPECIAL ATTENTION TO THOSE HEALTH GOALS WITH A

STRONG NUTRITION COMPONENT:

  * AT THE TIME HEALTHY PEOPLE WAS PUBLISHED, IN 1979, THE INFANT
MORTALITY RATE IN THE UNITED STATES WAS 13.2 DEATHS PER 1,000 LIVE
BIRTHS, WE WANT TO BRING THAT RATE DOWN TO FEWER THAN 9 DEATHS PER
1,000 LIVE BIRTHS BY 1990. OUR LATEST PROVISIONAL ESTIMATE, BY THE

WAY, PUTS THE INFANT MORTXLITY RATE AT 11.1 .

  LOW BIRTH WEIGHT IS THE GREATEST SINGLE HAZARD FOR THE NEWBORN,

TWO OF EVERY THREE INFANTS WHO DIE WITHIN THEIR FIRST 30 DAYS OF LIFE

WEIGH LESS THAN 5 AND l/2 POUNDS. BUT EVEN IF THEY SURVIVE BEYOND

THEIR FIRST 30 DAYS, THESE LOW BIRTH WEIGHT BABIES HAVE A 20 TIMES

GREATER CHANCE OF DYING BEFORE THEIR FIRST BIRTHDAY,

  WHAT CAN WE DO ABOUT THIS? FIRST, WE NEED TO DO EVERYTHING

POSSIBLE TO PROVIDE MOTHERS -- ESPECIALLY YOUNG, FIRST-TIME MOTHERS --

WITH GOOD PRENATAL CARE. AND DIET IS A CRITICAL FACTOR IN SUCH CARE,

SINCE PREGNANT WOMEN WHO LACK PROPER NUTRITION HAVE A GREATER CHANCE

OF BEARING A LOW BIRTH WEIGHT INFANT OR A STILLBORN BABY,


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  MATERNAL NUTRITION IS ONE OF THE SIX KEY POINTS IN THE NATIONAL

PROGRAM CALLED "HEALTHY MOTHERS, HEALTHY BABIES," THIS PROGRAM, BY

THE WAY, REPRESENTS A UNIQUE PARTERSHIP BETWEEN GOVERNMENT AND THE

PRIVATE SECTOR, THE PUBLIC HEALTH SERVICE IS JOINED BY MORE THAN 50

NATIONAL PROFESSIONAL AND VOLUNTARY ORGANIZATIONS AND PRIVATE FOR-

PROFIT CORPORATIONS IN THIS IMPORTANT COALITION DEDICATED TO IMPROVED

MATERNAL AND INFANT HEALTH,

  THIS COALITION h/ILL SOON BE DISTRIBUTING COLORFUL 5x7 TAKE-HOME

CARDS TO CLINICS AROUND THE COUNTRY, THESE CARDS WILL GET A VITAL

HEALTH MESSAGE ACROSS TO PREGNANT WOMEN, I THINK YOU'LL APPRECIATE

THE FIRST FEW SENTENCES OF ONE OF THESE CARDS,  IT SAYS:

"WHAT YOU EAT HAS NEVER BEEN SO IMPORTANT," THAT'S IN BOLD-FACE

TYPE, THEN IT GOES ON TO SAY, "THE FOOD YOU EAT NOURISHES YOU AND

YOUR UNBORN BABY, SO EAT A VARIETY OF GOOD FOODS EVERY DAY,

CHOOSE FOODS SUCH AS THESE, AND BE SURE TO SELECT SOME FROM EACH

GROUP:


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"WHOLE GRAIN AND ENRICHED BREADS, CEREALS, RICE, OATS, GRITS,
PASTA, TORTILLAS, AND CORNBREAD," AND THEN IT GOES ON TO COVER
OTHER FOODS AS WELL,

  IF WE COULD SOMEHOW GUARANTEE EVERY MOTHER A HEALTHY DIET, WE
WOULD SEE A SHARP DECLINE INSTHE NUMBERS OF LOW BIRTH WEIGHT BABIES --
AND, AS A RESULT, A PARALLEL DECLINE IN THE INFANT MORTALITY RATE.

  * AN OLD CHINESE PROVERB GOES LIKE THIS: "PATRIOTISM IS THE LOVE
OF THE GOOD THINGS WE ATE IN OUR CHILDHOOD." I WOULDN'T CALL THAT
INSCRUTABLE, SO, FOR PATRIOTIC REASONS -- AND FOR EVERY OTHER GOOD

REASON, TOO -- WE WANT TO IMPROVE CHILD HEALTH AND FOSTER OPTIMAL

CHILD DEVELOPMENT.

  IF WE ARE SUCCESSFUL, THE DEATH RATE FOR CHILDREN 1 THROUGH 14
YEARS OF AGE SHOULD DROP BY AT LEAST 20 PERCENT BY 1990,  TO DO THIS,
WE NEED TO STAY ON TOP OF AN ALREADY SUCCESSFUL CHILD IMMUNIZATION
PROGRAM,,.WE NEED TO DEAL WITH CHILD ABUSE THROUGH A VARIETY OF SOCIAL
AND HEALTH AGENTS... AND WE NEED TO RAISE THE LEVEL OF PUBLIC

UNDERSTANDING OF THE ROLE OF NUTRITION IN CHILD HEALTH.


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  ALTHOUGH IRON DEFICIENCIES STILL EXIST AMONG POOR AND DISADVANT-

AGED CHILDREN, MOST AMERICAN CHILDREN ARE NOT UNDERNOURISHED. AS A

MATTER OF FACT, MOST NUTRITIONAL PROBLEMS AMONG OUR CHILDREN COME FROM

OVER-EATING AND EATING THE WRONG THINGS,

  WE HAVE VERY LITTLE INFORMATION ABOUT THE EXTENT OF OBESITY AMONG

CHILDREN -- EXCEPT THAT WE KNOW IT'S A PROBLEM. WE'VE LEARNED THAT

FROM OUR SURVEYS OF ADULTS WHO ARE OBESE: THAT IS, PEOPLE WHO ARE 20

PERCENT OR MORE OVER THE DESIRABLE WEIGHT FOR THEIR AGE, SEX, AND

HEIGHT,  FOR EXAMPLE, ABOUT A THIRD OF ALL ADULTS WHO ARE OBESE WERE

OBESE AS CHILDREN. OBESITY IS A KEY RISK FACTOR BEHIND HYPERTENSION,

DIABETES, AND HEART DISEASE, A SITUATION WHICH MAKES IT ESSENTIAL THAT

WE FOCUS ON WAYS TO CONTROL OBESITY AMONG CHILDREN.  AND WE NEED TO

BEGIN RIGHT NOW.

  * WE ALSO HOPE TO REDUCE THE MORTALITY RATE AMONG ADOLESCENTS AND

YOUNG ADULTS, AGES 15 TO 24. THE FIRST ORDER OF BUSINESS WOULD BE TO

SOMEHOW REDUCE THE NUMBERS OF DEATHS CAUSED BY MOTOR VEHICLES, WHICH

ARE THE LEADING CAUSE OF PREMATURE DEATH AMONG TEENAGERS AND YOUNG


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ADULTS. BUT ALCOHOL IS SUCH A KEY FACTOR HERE: HALF OF ALL HIGH

SCHOOL STUDENTS DRINK IN CARS, ALMOST 1 IN 4 DRINK AND THEN DRIVE.

ANYTHING WE CAN DO TO FIGHT ALCOHOL CONSUMPTION AMONG YOUNG PEOPLE I
THINK WE ARE DUTY-BOUND TO GO AHEAD AND DO,  YOUNG LIVES ARE AT STAKE.

  JUST LAST WEEK, SECRETARY SCHWEIKER ANNOUNCED A MAJOR ADMINISTRA-

TION INITIATIVE TO FIGHT TEENAGE ALCOHOLISM. HE REMINDED AMERICANS

THAT "8,000 TEENS AND YOUNG ADULTS DIE IN DRINKING-RELATED AUTO

ACCIDENTS EVERY YEAR, ANOTHER 40,000 SUFFER INJURIES," HE SAID --

AND I AGREE -- THAT "THE KILLING MUST STOP." UNDER THE SECRETARY'S

GUIDANCE, OUR DEPARTMENT WILL STRENGTHEN WORKING RELATIONS WITH

PARENTS AND HEALTH PROFESSIONALS IN THIS CRUCIAL STRUGGLE TO SAVE

YOUNG LIVES,

  STRICTLY SPEAKING, THIS IS NOT A NUTRITION ISSUE, ALTHOUGH THE

DEPAttTMENT OF AGRICULTURE DOES INCLUDE ALCOHOL IN "FOOD GROUP 5,"

ALONG WITH FATS AND OILS. BUT IT IS THE ISSUE RIGHT NOW, AS FAR AS

THE HEALTH STATUS OF TEENS AND YOUNG ADULTS ARE CONCERNED,  I THINK

EVERY AMERICAN NEEDS TO UNDERSTAND THIS AND SOMEHOW CONTRIBUTE TO

REVERSING THIS TRAGIC SITUATION.


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  + ANOTHER GOAL FOR OUR SOCIETY IN THIS DECADE IS TO REDUCE THE
MORTALITY RATE FOR PERSONS AGE 25 THROUGH 64 BY AT LEAST 25 PERCENT,

AND WE ARE MAKING GOOD PROGRESS:

0   DEATH RATES ARE DECLINING FOR NEARLY ALL MAJOR CAUSES OF DEATH
   IN THIS AGE GROUP, INCLUDING HEART DISEASE AND STROKE,

0   WHILE THE CANCER DEATH RATE HAS CREPT UP FOR PERSONS OVER AGE
  50, IT'S BEEN DECLINING FOR PERSONS UNDER THE AGE OF 50.

  THAT'S ALL VERY GOOD NEWS, BUT WE MAY NOT BE ABLE TO MAINTAIN OUR
RECORD OF PROGRESS UNLESS THIS AGE GROUP -- THE VITAL, PRODUCTIVE,
GOVERNING GROUP WITHIN AMERICAN SOCIETY -- GETS BETTER CONTROL OF ITS

DIET AND CERTAIN ASPECTS OF ITS LIFESTYLE,

  ELEVATED BLOOD CHOLESTEROL IS STRONGLY ASSOCIATED WITH PREMATURE
HEART DISEASE, OUR LEADING KILLER, AND, TO A LESSER EXTENT, WITH

STROKE, OTHER FACTORS ASSOCIATED WITH THESE DISEASES ARE HIGH BLOOD

PRESSURE, EXCESS WEIGHT, AND SODIUM CONSUMPTION, PARTICULARLY AMONG

SALT-SENSITIVE PEOPLE,  THESE FACTORS CAN ALL BE CONTROLLED THROUGH

NUTRITION AND DIET.


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  OF COURSE, THE LEADING FACTOR ASSOCIATED WITH HEART DISEASE IS NOT

A NUTRITIONAL ISSUE.  IT'S CIGARETTE SMOKING, AN ISSUE OF LIFESTYLE,
IN THIS CONNECTION, I HOPE YOU WILL READ THE NEXT SURGEON GENERAL'S
REPORT ON SMOKING AND HEALTH, DUE TO COME OUT EARLY IN 1983,  IT WILL
BE DEVOTED TO THE TOPIC OF "SMOKING AND CARDIOVASCULAR DISEASE." I
THINK YOU'LL FIND THAT THE EVIDENCE LINKING THESE TWO IS JUST AS
COMPELLING AS THE EVIDENCE THAT HAS LINKED SMOKING WITH CANCER.

  WE CAN'T TELL PEOPLE HOW TO LIVE THEIR LIVES, BUT WE HAVE THE
RESPONSIBILITY TO LAY BEFORE THEM AS MUCH SOLID INFORMATION AS WE HAVE
TO HELP THEM MAKE THEIR OWN BEST DECISIONS, THE SURGEON GENERAL'S
REPORTS ARE PART OF THAT INFORMATION AND PUBLIC EDUCATION PROCESS,
THE WHEAT INDUSTRY COUNCIL'S NUTRITION EDUCATION PROGRAM IS ANOTHER,

  ALSO PART OF THAT PROCESS WAS THE PUBLICATION IN 1980 OF THE
"DIETARY GUIDELINES FOR Al'iERICANS," JOINTLY RELEASED BY THE
DEPARTMENTS OF AGRICULTURE AND HEALTH AND HUMAN SERVICES. THE
GUIDELINES APPLY TO &=j= AMERICANS, OF COURSE, BUT HAVE SPECIAL
RELEVANCE TO PEOPLE WHO ARE BETWEEN THE AGES OF 25 AND 64.


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  THE GUIDELINES EMPHASIZE MODERATION, VARIETY, AND BALANCE. WE

CONTINUE TO STRONGLY ENDORSE THESE GUIDELINES, WHICH TAKE SPECIAL NOTE

OF THOSE PRODUCTS AND NUTRIENTS THAT ARE KEY CONTRIBUTORS TO ILLNESS

AND DEATH IN THIS COUNTRY: SODIUM, ALL FATS, CHOLESTEROL, ALCOHOL, AND

SUGAR. THEY ALSO URGE THE INCREASED CONSUMPTION OF WHEAT-BASED FOODS

AND GRAIN PRODUCTS, ALONG WITH FRUITS AND VEGETABLES.

  HERE AGAIN, I WANT TO COMMEND THE FOOD INDUSTRY FOR SUPPORTING

THOSE GUIDELINES AND FOR INCORPORATING SOME OF THAT INFORMATION INTO

THEIR ADVERTISING AND CONSUMER INFORMATION MATERIALS, I LOOK AT THE

NUTRITION EDUCATION PROGRAM OF THE WHEAT INDUSTRY COUNCIL AS ANOTHER

ASPECT OF INDUSTRY'S SUPPORT FOR THESE COMMON-SENSE AND COMMONLY

ACCEPTED "DIETARY GUIDELINES."

  CANCER, THE SECOND LEADING CAUSE OF DEATH FOR ADULTS, SEEMS

RELATED TO DIET, ALSO. JUST THIS PAST JUNE, THE COMMITTEE ON DIET,

NUTRITION, AND CANCER OF THE NATIONAL RESEARCH COUNCIL RELEASED THE

RESULTS OF ITS REVIEW OF ALL TYPES OF EPIDEMIOLOGICAL AND LABORATORY

STUDIES ON DIET AND CANCER. THE COMMITTEE RELEASED ITS PROPOSED SIX

INTERIM GUIDELINES WITH THE FOLLOWING INTRODUCTORY NOTE:


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"IT IS NOT NOW POSSIBLE, AND MAY NEVER BE POSSIBLE, TO SPECIFY A

DIET THAT WOULD PROTECT EVERYONE AGAINST ALL FORMS OF CANCER,

NEVERTHELESS, THE COMMITTEE BELIEVES THAT IT IS POSSIBLE ON THE

BASIS OF CURRENT EVIDENCE TO FORMULATE INTERIM DIETARY GUIDELINES

THAT ARE BOTH CONSISTENT WITH GOOD NUTRITIONAL PRACTICES AND

LIKELY TO REDUCE THE RISK OF CANCER, THESE GUIDELINES ARE MEANT
TO BE APPLIED IN THEIR ENTIRETY TO OBTAIN MAXIMAL BENEFIT,"

  PLEASE NOTE THAT THESE ARE INTERIM GUIDELINES AND THAT MUCH OF THE

EVIDENCE COMES FROM ANIMAL MODELS AND THE CORRELATION OF CERTAIN HUMAN

CANCERS AND ETHNIC DIETS, THESE INTERIM GUIDELINES URGE REDUCING OUR

CONSUMPTION,, .

  , a ,OF FOODS HIGH IN SATURATED AND UNSATURATED FATS, WHICH ARE

LINKED TO BREAST AND COLONIC CANCERS

  ,,,OF SALT-CURED, SMOKED, AND PICKLED FOODS, WHICH SEEM TO

CONTRIBUTE TO STOMACH AND ESOPHAGEAL CANCERS

  ,,,OF ALCOHOLIC BEVERAGES, ESPECIALLY IN COMBINATION WITH SMOKING,

WHICH INCREASES THE RISK OF CANCERS OF THE UPPER GASTROINTESTINAL AND

RESPIRATORY TRACTS


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  ,m,OF CERTAIN NONNUTRITIVE CONSTITUENTS OF FOODS, NATURALLY OR
UNINTENTIONALLY INTRODUCED DURING PRODUCTION, PROCESSING, PACKAGING,

OR STORING

  ,,,AND OF CERTAIN ADDITIVES THAT ARE INTENTIONALLY INTRODUCED BUT

NOT YET FULLY EVALUATED FOR THEIR POTENTIALLY CARCINOGENIC PROPERTIES.

  THE COMMITTEE ALSO EMPHASIZED THE IMPORTANCE OF INCLUDING WHOLE

GRAIN CEREAL PRODUCTS IN OUR DAILY DIET, ALONG WITH FRUITS AND VEGE-
TABLES, THE REPORT IS QUITE CLEAR, "IN EPIDEMIOLOGICAL STUDIES," IT
SAYS, "FREQUENT CONSUMPTION OF THESE FOODS HAS BEEN INVERSELY COR-
RELATED WITH THE INCIDENCE OF VARIOUS CANCERS," IN OTHER WORDS, WHERE
THE CONSUMPTION OF WHOLE GRAIN CEREAL PRODUCTS, FRUITS, AND VEGETABLES
GOES UP, THE APPEARANCE OF CANCER TENDS TO GO DOWN, THIS IS ANOTHER

AREA WHERE ADDITIONAL RESEARCH IS NEEDED TO CLARIFY THIS RELATIONSHIP
BETWEEN CANCER AND THE CONSUMPTION OF CERTAIN FOODS.

  * THE LAST AGE GROUP FOR WHICH WE HAVE 1990 HEALTH GOALS INCLUDES

MEN AND WOMEN AGE 65 AND OLDER.  AMERICANS ARE LIVING LONGER, BUT WE

AREN'T IMMORTAL, WE MAY PROLONG LIFE A BIT, BUT NOT FOREVER, SO OUR
GOALS FOR SENIOR CITIZENS ARE TO IMPROVE THEIR HEALTH AND THEIR


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QUALITY OF LIFE, REDUCE THE AVERAGE NUMBER OF DAYS OF RESTRICTED

ACTIVITY EACH YEAR BECAUSE OF ACUTE OR CHRONIC CONDITIONS, AND FOSTER

INDEPENDENT -- RATHER THAN DEPENDENT -- WAYS OF LIFE,

  JUST ABOUT EVERYTHING I'VE SAID SO FAR FOR EVERY AGE GROUP ALSO
APPLIES TO THE ELDERLY, BUT I WOULD ADD THIS ONE CAVEAT: THE ELDERLY

ARE MANY TIMES MORE VULNERABLE THAN THE REST OF US TO DISEASES AND

DEATH BROUGHT ON BY POOR NUTRITION.  THE ELDERLY ALSO TEND TO LIVE ON

LOW OR MARGINAL INCOMESuTHEY OFTEN TAKE A VARIETY OF MEDICATIONS

WHICH CAN AFFECT THEIR APPROACH TO FOOD,. .AND THEY EXPERIENCE MILD TO

SEVERE SENSORY DEPRIVATION. ALL THESE ARE FACTORS IN THEIR ABILITY TO

PROPERLY MANAGE THEIR DIET.

  THE DEPARTMENT OF HEALTH AND HUMAN SERVICES SPENT $160 MILLION FOR

NUTRITION RESEARCH IN FISCAL 1981. ABOUT 93 PERCENT OF THAT WAS N.1.H.

MONEY, AND AMONG THE AREAS BEING PURSUED IS THIS ONE CONCERNING NUTRI-

TION FOR THE ELDERLY. THERE IS SO MUCH WE STILL DON'T KNOW ABOUT THE

AGING PROCESS,  BUT CLEARLY WE NEED TO LEARN -- AND AS FAST AS POSSIBLE

-- SOME BASIC INFORMATION ABOUT THE NUTRITION NEEDS OF THIS VERY VUL-

NERABLE GROUP.


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  THESE, THEN, ARE THE GOALS FOR THE FIVE MAJOR AGE GROUPS IN OUR
SOCIETY, AS OUTLINED IN THE SURGEON GENERAL'S REPORT, HEALTHY PEOPLE,
AS YOU CAN SEE, THEY DEAL WITH THE MAJOR HEALTH ISSUES THAT CONFRONT
EACH POPULATION GROUP AND THEY ALL HAVE A STRONG, IMPORTANT NUTRITION

COMPONENT.

  GOOD NUTRITION IS AS MUCH A MATTER OF MAINTAINING ONE'S SOCIAL AND

EMOTIONAL HEALTH AS ONE'S PHYSICAL HEALTH, FOR EXAMPLE, BREASTFEEDING
IS THE BEST POSSIBLE WAY TO NOURISH THE NEWBORN NOT JUST BECAUSE OF
THE HIGH NUTRITION VALUE OF BREAST MILK BUT BECAUSE IT IS THE
BEGINNING OF THE CRUCIAL ELEMENT OF SOCIAL BONDING BETWEEN THE MOTHER

AND HER CHILD.  AT THE OTHER END OF THE AGE SCALE, ELDERLY PEOPLE

OFTEN PREFER TO EAT THEIR MEALS WITH OTHERS, WITH AGE PEERS,

NEIGHBORS, OR GRANDCHILDREN.

  G.K. CHESTERTON SAID HE THOUGHT "THERE IS MORE SIMPLICITY IN THE
MAN WHO EATS CAVIARE ON IMPULSE THAN IN THE MAN WHO EATS GRAPENUTS ON

PRINCIPLE,"  I AGREE. BUT I WOULD ADD THAT THERE IS MORE SOPHISTICA-

TION TO THE MAN WHO KNOWS WHEN TO EAT BOTH.  AND THAT'S THE KIND OF

DECISION THAT CAN COME ONLY WITH A WORKING KNOWLEDGE OF GOOD NUTRITION,


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  AFTER THUMBING THROUGH YOUR PLANNED NUTRITION EDUCATION PROGRAM, I
BELIEVE THAT'S WHAT THE WHEAT INDUSTRY COUNCIL IS AFTER -- GIVING THE

AMERICAN PEOPLE A WORKING KNOWLEDGE OF GOOD NUTRITION, WITH SPECIAL
EMPHASIS ON THE ROLE OF WHEAT-BASED FOODS.  I HOPE THE WHEAT FOOD
INDUSTRY WILL SUPPORT THE WORK OF THIS COUNCIL, SO THAT WE MAY SEE THE
AMERICAN DIET MAKE A STRONGER CONTRIBUTION TO THE IMPROVEMENT OF THE
HEALTH STATUS OF ALL AMERICANS OF ALL AGES,

  THANK YOU FOR INVITING ME HERE TODAY, AGAIN, BEST WISHES ON YOUR

NUTRITION EDUCATION PROGRAM,

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