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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Frank Press is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Samuel O. Thier is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Frank Press and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council.

The study summarized in this publication was supported by funds from the National Research Council Fund, a pool of private, discretionary, nonfederal funds that is used to support a program of Academy-initiated studies of national issues in which science and technology figure significantly. The NRC Fund consists of contributions from a consortium of private foundations including Carnegie Corporation of New York, Charles E. Culpeper Foundation, William and Flora Hewlett Foundation, John D. and Catherine T. MacArthur Foundation, Andrew W. Mellon Foundation, Rockefeller Foundation, and Alfred P. Sloan Foundation; the Academy Industry Program, which seeks annual contributions from companies that are concerned with the health of U.S. science and technology and with public policy issues with technological content; and the National Academy of Sciences and National Academy of Engineering endowments. The study was also supported by W.K. Kellogg Foundation, The Henry J. Kaiser Family Foundation, Pew Charitable Trusts, Fannie E. Rippel Foundation, and Occidental Petroleum Corporation.

Library of Congress Cataloging-in-Publication Data

National Research Council (U.S.). Committee on Diet and Health.
Diet and health: implications for reducing chronic disease risk /          First Printing, July 1989
Committee on Diet and Health. Food and Nutrition Board, Commission      Second Printing, May 1990
on Life Sciences. National Research Council.                    Third Printing, May 1991
p. cm.                                                  Fourth Printing, July 1992
Includes bibliographies and index.                               Fifth Printing, March 1993
ISBN 0-309-03994-0
1. Chronic diseases—Nutritional aspects. I. Title.
[DNLM: 1. Chronic Disease. 2. Diet. 3. Health. 4. Risk Factors.
QU 145 N2761d]
RC108.N38 1989
613. 2—dc20
for Library of Congress                                             89.3261

Copyright © 1989 by the National Academy of Sciences

No part of this book may be reproduced by any mechanical, photographic, or electronic process, or in the form of a phonographic recording, nor may it be stored in a retrieval system, transmitted, or otherwise copied for public or private use, without written permission from the publisher, except for the purposes of official use by the U.S. government.

Printed in the United States of America

Cover photographs:
Paul Robert Perry/UNIPHOTO (black-eyed peas); Peter Beck/UNIPHOTO (fish); Hanley and Savage/UNIPHOTO (milk); Peter Beck/UNIPHOTO (fruits; vegetables); Gordon E. Smith/UNIPHOTO (bread); Renee Comet/UNIPHOTO (basket).

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