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OCR for page 9
1
Data Sources, Key Nutrients, and
Selection of Targets for Change
the current issues surrounding the ade-
quacy of the American diet no longer center
primarily on nutrient deficiency. Overcon-
sumption of calories, fat, saturated fatty
acids, cholesterol, and sodium has become
a serious problem for many consumers, and
animal products have been implicated as
major sources of these food components. At
the same time, it is recognized that meats,
fish, dairy products, and eggs are important
sources of many essential nutrients, includ-
ing protein, B vitamins, iron, zinc, and
calcium.
In this renort
the committee recom
mends various options for improving the
nutritional value of animal products. First,
however, it is important to understand clearly
the contemporary role of animal products
in the American diet. The following ques-
tions were essential to the committee's charge:
· What are the uses and limitations of
the data available to study consumption and
nutrient contribution of animal products?
· What have been the trends in con-
sumption of animal products in the United
States?
· What contribution do animal products
9
make to the nutrients available in the food
supply?
· What is the role of animal products in
the diets of different age and sex groups of
the population?
SOURCES OF DATA AND THEIR
LIMITATIONS
The U. S. Department of Agriculture
(USDA) provides data on food and nutrient
consumption at three levels: the U.S. food
supply, food use by households, and food
intake by individuals. In addition, data on
nutritional status from federal surveys are
used throughout the report.
Food Supply Data (1965-1985)
The food supply data (per capita disap-
pearance) measure the amount of food avail-
able for consumption in the United States,
based on annual estimates of production of
food products adjusted for imports, exports,
and stock exchanges. The data are collected
at the wholesale or retail level of distribu-
tion. The result is an estimate of the total
amount of food that is produced and mar
OCR for page 10
10
keted for national consumption. Dividing
this total by the U.S. population results in
an estimate of consumption per capita. This
series is often referred to as disappearance
data to indicate that it is based on the
disappearance of food through marketing
channels ant] is not a direct estimate of
consumption. In 1986, the USDA began
referring to this series as apparent con-
sumption" to distinguish it from more direct
estimates of consumption. A companion
series, the Nutrient Content of the Food
Supply, is derived by calculating the nutri-
tive value of the total amount of foods
available for national consumption (Marston
and Raper, 1987~. In using these data bases,
the committee found the term apparent
consumption confusing and elected to use
per capita disappearance or food supply data
instead throughout the report.
Federal Surveys
Nationwide Food Consumption Survey
¢1977-1978)
More direct estimates of food consump-
tion are provided by the USDA's Nation-
wide Food Consumption Survey (NFCS),
last conducted in 1977-1978. The NFCS,
which is conclucted every 10 years, is the
most comprehensive source of data available
on the food en c] nutrient intake of the U. S.
population. In total, 36,142 individuals were
surveyed over four consecutive seasons be-
ginning in the spring of 1977. A detailed
description of the survey methodology is
groveled in Peterkin (1981) and will not be
presented in this report. Even though the
NFCS is now 10 years old, it is still useful
for several reasons. For one, it is the most
recent information available on food and
nutrient intake for the household population
and is useful for comparing dietary intakes
among age and sex groups, especially when
analyzing the data at an aggregated level
such as food groups.
Furthermore, the survey measured die-
tary intake by individuals. In this phase of
DESIGNING FOODS
the survey, members of the participating
households provided information on foods
they ate on 3 consecutive days. Each was
asked by an interviewer to recall the foods
eaten the day before the interview and to
keep records offoocls eaten on the interview
day and the day following. Nutrient intakes
of the individuals were clerived from food
composition data for approximately 4,500
foods and food combinations in the USDA's
Nutrient Data Bank, a file of food compo-
sition maintainer] and updated by USDA s
Human Nutrition Information Service.
Continuing Survey of Food Intake by
Individuals (1985)
The most recent source of data available
on the dietary intake of individuals is the
USDA's Continuing Survey of Food Intake
by Individuals (CSFII). This survey was
designed to complement the decennial NFCS
by providing continuous data on dietary
status of selected subgroups, especially those
that may be at nutritional risk (Welsh, 1986).
It is the first nationwide dietary intake
survey designed to be conducted annually.
Dietary recall data for 1 day by 1,503 women
19 to 50 years of age and by 548 children 1
to 5 years of age were collected by personal
interview from April through June 1985,
and for 5 days at 2-month intervals by
telephone interview (U.S. Department of
Agriculture, 1985). This core respondent
group was selected because previous sur-
veys had shown that women of childbearing
age and young children were more likely
than other age and sex groups to have diets
low in certain nutrients. The 1985 survey
was augmented by a 1-day intake record for
1,134 men (U.S. Department of Agricul-
ture, 1986~. Whenever possible, the com-
mittee compare(l data from the 1977-1978
NFCS and the 1985 CSFII.
National Health and Nutrition
Examination Survey
Another nationwide survey that includes
data on dietary intake is the National Health
OCR for page 11
DATA SOURCES, KAY NUTRIENTS, AND SELl:4JC'l'l().Y OF TARCx~'I
and Nutrition Examination Survey
(NHANES), performed by the U. S. l~e
partment of Health and Human Services
(DHHS). NHANES I took place between
1971 and 1974 and had ~ sample size of
28,043 individuals from its target population
of 1- to 7(year-olds. N HAN E S II was
conducted from 1976 to 1980 on a target
population of individuals ages 6 nlontlls to
74 years. The sample size was 277801, with
oversampling of children ages 6 months to
5 years, adults ages 60 to 74 years, ants Other Data LS`~`rce.s
those individuals flying in poverty areas.
NHANES is primarily a health survey de
J ~
signed to gather information on the total
prevalence of disease conditions and phys
ical status as well as clinical data Ott the
interrelationships of health and nutrition
variables. Individuals who participated in
the survey were interviewed for diet arid
health information and underwent clinical
examinations by health professionals.
The dietary component of N HAN E S con
sisted of a recall of dietary intake for the
previous day and an additional recall of
usual food consumption for the previous
month. NHANES is the only nationwide
survey available to measure the relationship
between food and nutrient intake and bio
chemical nutritional status (McDowell et
al., 1981~. It is used as an important source
of information on the health and nutritional
status of the U. S. population.
11
data On 1-eight, weight, and age are c~on-
verted to percentiles of height for a~,e and
weight for height using, the National Center
for Health Statistics reference population.
Durin, 1984, data were submitted for 610,439
children ages birth to 9 years (Centers fUr
Disease Control, 1985~. Although this source
floes not contain direct estimates of dietary
intake, it does provide valuable data on the
-tuitional status of c~hilclren.
Pediatric Nutrition Surveillance System
of the Centers for Disease Control
Since 1973, the Centers for Disease Con-
trol have coordinated the Pediatric Nutri-
tion Surveillance System (PNSS) to con-
tinuously monitor the nutritional status of
high-risk pediatric populations (Centers for
Disease Control, 1985~. The PNSS uses
nutrition-related data collected by local health
departments during delivery of routine child
health services. The data include demo-
graphic information, height, weight, birth
weight, and hemoglobin or hematocrit de-
terminations, or both. The anthropometric
The National Live Stocl; ~ Meat Boarcl
stu(ly (Breidenstein and Williams, 1987) and
the Stanton :1987) study for the American
Meat Institute both concentrate on the role
of reel Neat in the diet, particularly their
co~-~tributioll to the overall fat content of the
diet. The Household :tlefUse Analysis Proj-
cct, headed lo University of Arizona arche-
¢'k~gist William Hathje (1984), focuses on
trends in consumption of nougats and discard
patterns of separable flit through the analysis
of residential garbage. Each of these sources
has its limitations and advantages but is
valuable for its unique analytical approach.
Limitations of the Data Bases
The per capita disappearance data, NFCS,
CSFII, and private studies are important
sources of information, but none provide
exact measures of food or nutrient intakes.
In addition, each measures a different aspect
of food intake, and each has advantages and
limitations for assessing particular issues. It
is preferable, therefore, to use as many
suitable sources as possible to more closely
assess the consumption of animal products
and their contribution to the diet.
The per capita disappearance data are
primarily designed to measure gross trends
in food nutrient availability. They are val-
uable for determining the contribution of
specific animal products to total nutrients
in the food supply because they measure
distinct commodities. Because the data are
measured at the wholesale or retail level of
OCR for page 12
12
the food system, they measure nutrients
inherent in primary commodities before
processing, such as fresh meats, milk, and
cheese. In addition, the data have not been
adjusted for waste that may occur beyond
the retail level of distribution, such as plate
waste or trimming during meal preparation.
Moreover, no estimate of the discard of food
due to spoilage and other reasons that would
preclude human consumption is made.
In contrast, the NFCS data measure food
intake in the form consumed, such as
cheeseburgers and beef stew. Such dietary
survey data customarily group food mixtures
by the nutrient contribution of the mixture's
main ingredient. Such groups cannot cor-
rectly account for all nutrients derived from
animal products like milk and cheese, meat,
poultry, and fish. Nutrients from the cheese
and meat in pizza, for example, will be
credited to the grain products group because
grain is the main ingredient. On the other
hand, categories referred to as poultry or
meat may include nutrients from other cat-
egories, such as the fat used in frying chicken
or the vegetables used in beef stew. Thus,
assessing fat intake and the contribution of
various foods to total fat or any nutrient is
not a straightforward exercise and requires
numerous assumptions and interpretation
of the various sources of data.
The food supply data provide information
on the total amount of fat available. There
is specific information on the exact type of
fat ant] oil available (such as soybean oil and
lard, as well as fat occurring in foods), but
the data overstate the amount actually in-
gested because they are not adjusted for
waste, spoilage, trimming, or cooking losses.
In contrast, NFCS data attempt to include
only the fat ingested, but information re-
garding type of fat or the food from which
it is derived is imprecise, mainly because
considerable amounts of fat consumed are
in processed or mixed foods. However,
survey data more accurately reflect food and
nutrient intake than do per capita disap-
pearance data because they are based on
DESIGNING FOODS
individual records of foods eaten and there-
fore do not need to be adjusted for waste.
All sources of food consumption data are
imprecise. Food supply data are derivecl
from gross estimates. The accuracy of the
survey food intake data is limite(1 by the
extent to which individuals can recall and
describe the types and amounts of foods
they ate. It is likely that the NFCS data
generally underestimate foot] intake be-
cause it is so difficult for an individual to
recall accurately everything eaten (Weir,
1976~. In some cases, when precise descrip-
tions of foods eaten are not known or not
specifie(l by the individual surveyed, they
are entered by the USDA. This couIcl result
in errors in the quantities of nutrients con-
sumed. For example, if the respondent does
not know if the fat on his or her baked
potato is margarine or butter, the USDA
assumes it is margarine-the most often
used fat. If roast beef is reported, without
information about whether the fat was eaten,
USDA assumes that the lean and fat parts
are both eaten. In the 1985 CSFII, addi-
tional questions were asked to minimize this
problem.
Despite these limitations, each data source
is valuable because it offers a different
perspective on possible avenues for im-
provement in the (lies. The food supply data
estimate the nutrients inherent in the ani-
mal products before processing, which may
suggest changes achievable through genetic
manipulation, production, or processing
practices. The NFCS en c] CSFII survey data
point to population subgroups that may be
in need of modifying their dietary patterns
or the amount or proportion of individual
nutrients within the diet. The private stud-
ies, based largely on the federal dietary
surveys, evaluate trends in the dietary in-
take of animal fat and red meat.
IDENTIFICATION OF KEY FOOD
COMPONENTS
In July 1986, the Joint Nutrition Moni-
toring Evaluation Committee aNMEC), a
OCR for page 13
DATA SOURCES, KEY NUTRIENTS, AND SELECTION OF TARGETS
federal advisory committee jointly spon-
sored by USDA and DHHS, issued a prog-
ress report entitled Nutrition Monitoring in
the United States (U. S. Department of Ag-
riculture/U.S. Department of Health and
Human Services, 1986~. Because this report
represents the most current data on the
nutritional status of the U.S. population,
the committee chose to rely heavily on its
content. The INMEC concluded that the
principal nutrition-related health problems
in the United States arise from the over-
consumption of fat, saturated fatty acids,
cholesterol, and sodium, the same nutrients
emphasized by all the national health or-
ganizations issuing dietary recommenda-
tions. It stated that more than one-fourth
of the adults in the United States are over-
weight; for many of these individuals, obe-
sity probably resulted from consuming more
food energy than needed for their level of
physical activity. It also concluded that
certain subgroups of the U.S. population
have special nutrition-related health prob-
lems, specifically, low intakes of iron and
vitamin C among young children and fe-
males of childbearing age, especially if they
are black, poor, or both. The JNMEC also
expressed concern over the low intake of
calcium among women.
The INMEC emphasized that inadequa-
cies or excesses of food components in the
diet and the effects on nutritional status
were indeed cause for concern. It singled
out the following 10 food components for
highest-priority monitoring on the basis of
the relationship of the component to nutri-
tional status:
High Dietary
Consumption
Food energy*
Total fat*
Saturated fatty acids*
Cholesterols
Sodium*
Alcohol
Low Dietar?]
Consumption
Vitamin C
Calcium*
Iron*
Fluoride
13
The seven food components marked with
an asterisk are of particular importance to
the committee because they are found in
animal products.
Other national organizations have also
recognized these nutrients as exerting the
greatest influence on health and have of-
fered a variety of specific recommendations
for altering their level in the diet. In 1984
a National Institutes of Health consensus
development panel on lowering blood cho-
lesterol to prevent heart disease suggested
that the food industry be encouraged to
intensify efforts to develop and market prod-
ucts that would facilitate adherence to the
dietary guidelines for fat and cholesterol.
The panel recommended that school food
services and restaurants serve meals con-
sistent with those recommendations (Na-
tional Institutes of Health, 1984~. The panel
also recommended that food labeling in-
clude the specific source or sources of fat;
the amounts of total fat, saturated and po-
lyunsaturated fatty acids, and cholesterol;
and other nutrition information. It further
recommended that the public be educated
on how to best use this information to
achieve dietary goals. In the most recent
American Heart Association dietary guide-
lines, food manufacturers were urged to
"gradually reduce the sodium and fat con-
tent of the food supply as well as to modify
the type of fat in food products" (American
Heart Association, 1986~.
TARGET LEVELS FOR CALORIC
INTAKE AND SELECTED NUTRIENTS
Dietary recommendations issued by the
major national health organizations in the
United States, as summarized in Table 1-
1, acknowledge the importance of eating a
varied diet; achieving and maintaining ideal
body weight; and limiting intake of total fat,
saturated fatty acids, polyunsaturated fatty
acids, and cholesterol as positive health
measures for optimal nutritional status. The
advice given is similar for all these organi
OCR for page 14
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OCR for page 15
DATA SOURCES, KAY NUTRIENTS AND 5~1
nations, although some groups are more
specific than others. In light of these rec-
ommendations and the charge to the com-
mittee to identify options to improve the
nutritional attributes of animal product),
the committee has chosen the following
specific target levels f`'r caloric intake and
nutrients in the diet:
· Caloric intake snatcher] to ~ncl'~id~l~ll
needs rind appropriate to (lC~iCLC (lnCI IlUlin-
tain desirc~l~le body wr~i-,ht (AInel-icall Call-
cer Society, 1984; American [leart Ass<'ci-
ation, 1986; National Institutes of Health,
1984; National Research Council, 198(), 1982;
OfTice of the Assistant Secretary for {lea]th
and the Surgeon General, 1979; U.~. De-
partment of Agriculture/U.~. Depart net
of Health and Human Services, 1985; U. S.
Senate Select Committee on Nutrition and
Human Needs, 19774. Data frown the 197
1980 NHANES indicate that approximately
34 million U.S. adults are obese, of which
12.4 million are severely obese. The inci-
dence of obesity varies widely according to
age and sex, with black adults having the
highest incidence (61.2 percent for females
and 41.4 percent for males). Childhood
obesity is more difficult to estimate, but
may range from 4 to 14 percent among k~w-
income populations.
· Thirty percent or less of calories from
fat for adults (American Cancer Society,
1984; American Heart Association, 1986;
National Institutes of Health, 1984; National
Research Council, 1982~. Data from the
1977-1978 NFCS indicated that 6 percent
of the population overall had diets From
which 30 percent or less of the calories came
from fat; data from the 1985 CSFII showed
that about 15 percent of children and 12
percent of adult women had diets that met
the target.
· Ten percent or less of calories frolic
saturated fatty acids for adults (American
Heart Association, 1986; National Institutes
of Health, 1984~. Data from the 1985 CSFII
indicated that about 10 percent of women
ht'TiO.~ OF TARt':~ AXIS 15
ages 193 to 50 years and 4 percent off children
ages 1 to 5 years had diets that met the
target level fUr percentage of Bakeries from
saturated f;attv acids.
· Tell percent or le.s.s of calories from
'olqun.scituratecl fatty ricid.s for cidult.s
(AmeI it all Hear t A.~)Ciati()ll, 1986; National
Il~stitlltes `'f ~ lealtIl, 1984; National l:le-
search C`>uncil, 198()~. Lutz 1r()ln the 1985
CSt'II il~clicatecl that 86 pCl'C'Cllt `'f Walden
arcs 19 t() 50 VCdI'S aIld 98 pC'I'CC'Ilt `~fchildren
ages I t() 5 years had diets that met tile
t~I'gOt {Ol- p()lVIlIl.~]tIlr~tCCl tclttV cIC'iCiS.
· Fifteen ~ercc~nt or le.s.s of caloric.s (re-
''~aincle~r of calories fro- the fatty cicid.sJ
from mono~ln.scitilrcite~ciicitt'~ acid.sfor (ldult.s
:~ati`'na1 Institutes `~! Health, 1084~. Data
Freon the 198.5 C ~ HI iI~clic atecl that about
65 peIce~t off women awe 19 to 50 years
and 78 pert eat of chilclre~ age s 1 to 5 years
lead diets that met the target level for
mollou~lsaturate~1 kitty acids.
· Three hundred ''lill~gra~as or less of
chole.ster`'l tier day for adults (American
I I cart Association, 1986; National Institutes
of I-Icalth, 19844. Data from the 1985 CSFII
indicated that cholesterol levels averaged
254 mg/clay for children ages 1 to 5 years,
3()4 mg/day for women ages 19 to 50 years,
and 435 mg/day fair men ages 19 to 50 years.
Between 72 and 80 percent of children ages
1 to 5 years and 62 percent of women ages
19 to 50 years had diets that met the target
level for cholesterol; comparable data for
men were not available, but the trends are
thought to be similar.
· Calcium intake of the Recommender]
Dietary Allowances (RDAs) for age and sex
(National Research Council, 19804. Data
from the 1977-1978 NFCS indicated that
32 percent of individuals had diets that met
the target level for calcium (100 percent of
the RDA), including 48 percent of children
ages 1 to 8 years, 42 percent of males ages
9 to 18 years, arid 23 percent of females
ages 9 to 18 years. Data from the 1985
CSFII indicated that both total calcium
intake (mg/day) and mg/l, ()00 kcal have
OCR for page 16
16
increased in the diets of all population
groups since the 1977-1978 survey, but
women's mean intakes still fell short of
meeting the target level. About three-fourths
of the women did not meet 100 percent of
the RDA; of this group, half did not achieve
70 percent of the RDA.
· Iron intake of the RDA for age and sex
(National Research Council, 1980~. Data
from the 1977-1978 NFCS indicated that
44 percent of individuals had diets that met
the target level for iron (100 percent of the
RDA), including 38 percent of children ages
1 to 8 years, 36 percent of males ages 9 to
18 years, and 18 percent of females ages 9
to 18 years. Data from the 1985 CSFII
indicated that mean intakes (mg/day) in-
creased for women ant] children but not for
men, and that mg/l,OOO kcal increased for
children but not for women or men since
the 1977-1978 survey. About 95 percent of
the women did not meet 100 percent of the
RDA; of this group, three-fourths die] not
achieve 70 percent of the RDA.
These targeted levels are chosen by the
committee as constituting the consensus of
dietary and nutrition recommendations made
by the various government and nongovern-
ment agencies cited. It is not the intention
of the committee to establish new dietary
guidelines for the American public. The
Food and Nutrition Board of the National
Research Council is currently conducting a
major study of diet and health issues, and
a new National Research Council report
may eventually be issued dealing with spe-
cific recommendations for these guidelines.
For the purpose of assessing target levels
of various food components in the diet, the
committee has followed the basic recom-
mendations that have been made by other
organizations.
The target levels do not include all im-
portant characteristics of diets thought to
promote health and prevent disease. For
example, protein is not targetec! because it
is plentiful in the fliers of most people in
DESIGNING FOODS
the United States. Of the many essential
vitamins and minerals, only calcium and
iron are targeted] because their levels in
many diets are below that recommended
and animal products are rich sources of
them.
REFERENCES
American Cancer Society. 1984. Nutrition and cancer,
cause and prevention. An American Cancer Society
special report. Ca A Cancer Journal for Clinicians
34(29:121-126.
American Heart Association. 1986. Dietary guidelines
for healthy adult Americans. Circulation 74:1465A.
Breidenstein, B. C., and J. C. Williams. 1987. Con-
tribution of Red Meat to the U.S. Diet. Chicago,
Ill.: National Live Stock & Meat Board.
Centers for Disease Control. 1985. Nutrition Surveil-
lance 1983. U. S. Department of Health and Human
Services, Public Health Service, DHHS Publication
No. (CDC) 8~8295. Atlanta, Gal: Centers for Dis-
ease Control.
Marston, R., and N. Raper. 1987. Nutrient content of
the U.S. food supply. Pp. 18-23 in National Food
Review, NFR-36, Economic Research Service.
Washington, D. C.: U. S. Department of Agriculture.
McDowell, A., A. Engel, J. T. Massey, and K. Maurer.
1981. Plan and Operation of the Second National
Health and Nutrition Examination Survey, 197~80.
Series 1, No. 15. DHHS Publication No. (PHS) 81-
1317. Vital and Health Statistics. Washington, D.C.:
U.S. Public Health Service.
National Institutes of Health. 1984. NIH Consensus
Development Statement on Lowering Blood Cho-
lesterol to Prevent Heart Disease. Vol. 5, No. 7.
Washington, D.C.: National Institutes of Health.
National Research Council. 1980. Recommended Di-
etary Allowances, 9th ed. Washington, D.C.: Na-
tional Academy Press.
National Research Council. 1982. Diet, Nutrition, and
Cancer. Washington, D.C.: National Academy Press.
Office of the Assistant Secretary for Health and the
Surgeon General. 1979. Healthy People, the Sur-
geon General's Report on Health Promotion and
Disease Prevention. DHEW (PHS) Publication No.
7~55071. Washington, D.C.: U.S. Public Health
Service.
Peterkin, B. B. 1981. Nationwide Food Consumption
Survey, 1977-1978. Pp. 59~9 in Nutrition in the
1980s: Constraints on Our Knowledge. New York:
Alan R. Liss.
Rathje, W. L. 1984. Where's the beef? Red meat and
reactivity. Am. Behav. Sci. 28:71-91.
Stanton, J. L. 1987. An Investigation of Fat Intake.
Paper presented to the American Meat Institute,
Washington, D.C., January 1987.
OCR for page 17
DATA SOURCES, KEY NUTRIENTS, AND SELECTION OF TARGETS
U. S. Department of Agriculture. 1985. P. 48 in Women
19-50 Years and Their Children 1-5 Years, 1 Day,
1985. Nationwide Food Consumption Survey, Con-
tinuing Survey of Food Intakes by Individuals,
Report 85-1, Human Nutrition Information Service.
Hyattsville, Md.: U. S. Department of Agriculture.
U.S. Department of Agriculture. 1986. P. 46 in Men
19-50 Years, 1 Day, 1985. Nationwide Food Con-
sumption Survey, Continuing Survey of Food In-
takes by Individuals, Report 85-3, Human Nutrition
Information Service. Hyattsville, Md.: U. S. De-
partment of Agriculture.
U.S. Department of Agriculture/U.S. Department of
Health and Human Services. 1985. Nutrition and
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Representative terms from entire chapter:
food supply
