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9
Directions for Research
As INDICATED throughout this report, continued research is es-
sential to establish a better base of knowledge for designing
effective and efficient implementation strategies and for assessing
their costs and benefits. The committee identified six principal areas
of research in which more activity is required to achieve these goals.
They are not ranked in any order of priority. In the committee's
judgment, successful implementation requires that research in all six
areas be conducted simultaneously, as is currently the case. In fact,
there is considerable overlap between the research areas because each
is broad in scope and complex to investigate.
Research in each of the areas identified below tends to be con-
ducted by different types of experts in a wide variety of settings,
including nutrition scientists in laboratories; public health specialists
in communities; food policy analysts working for governments, voluntary
agencies, and consumer advocacy groups; and economists and other
social scientists in schools of higher education. Resources to increase
research in these areas will need to come from a wide variety of
sources, including governments, the private sector, foundations, vol-
untary agencies, and academia.
1. Improve methods to characterize what people actually eat, especially
over long periods during which dietary patterns change.
The difficulty in assessing dietary intakes is a major impediment
in studying the effects of diet on health and on assessing the effects
of initiatives to improve eating habits. There are weaknesses in all
current assessment methods (e.g., those based on food disappear
210
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DIRECTIONS FOR RESEARCH
211
ance, household food inventories, and individual diet histories) (see
review in the Diet and Health report [NRC, 1989, Chapter 2~. More
comprehensive data collection and timely reporting of results are
required to learn more about what people eat and how eating habits
vary in relation to such factors as geographical location, life-style,
ethnicity, and socioeconomic status. High priority should be given
to improving methods for collecting and assessing data on dietary
patterns, including the intakes of specific foods and the dietary con-
stituents of foods (e.g., macro- and microconstituents that affect the
risk of chronic diseases).
2. Increase understanding of the existing and potential determinants of
dietary change and how this knowledge can be used to promote more health-
ful eating behaviors.
As noted in Chapter 3, much more needs to be learned about the
behaviors and motivations of people who have improved their diets
compared with the behaviors and motivations of those who have not
and how dietary change is most effectively induced. Research in this
area would include basic and applied studies to lead to better under-
standing of the obstacles to, and opportunities for, dietary change.
In addition, very little is known about the influence of major life-
style factors (e.g., moving out of the parents' home, getting married,
having children, and working in a demanding job) on dietary changes.
Studies should also be conducted to learn more about taste prefer-
ences and how dietary change is influenced by the media (especially
television), growing older, and genetic and cultural factors. Further-
more, the extent to which environmental factors affect dietary change
require investigation. These factors include proximity of grocery stores
of various sizes to shoppers, transportation facilities, food costs, low-
income-neighborhood shopping strategies, and security of shopping
areas. Learning more about why, how, and when during the course of
a lifetime people began to adopt more healthful diets would provide a
better understanding of the factors that lead to long-term dietary change
(Achterberg and Trenkner, 1990; Sims, 1987; Sims and Light, 1980~.
Major efforts have been undertaken to educate and motivate people
to practice healthy behaviors such as quitting smoking or refraining
from taking up the habit, fastening seat belts in the car, and not
driving after drinking alcoholic beverages. Research should be con-
ducted to determine how the lessons learned from these initiatives
can be applied to the task of improving U.S. dietary patterns.
3. Continue research to develop new food products and modify both the
production and processing of existing products to help consumers more
easily meet dietary recommendations.
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212
IMPROVING AMERICA'S DIET AND HEALTH
By applying the results of research conducted at government, in-
dustry, and academic facilities, various segments of the food indus-
try have been able to develop nutritionally desirable foods that help
consumers to more easily meet dietary recommendations (see Chap-
ter 6~. This research should continue, especially in the areas of flavor,
texture, nutrient content and retention, preservation, and safety. Perhaps
the food industry could respond to trends (or anticipate them) even
more readily if more research were conducted to track consumer attitudes
and knowledge about food and nutrition issues and about their food
selection and preparation practices. Research should also be con-
ducted to identify alternative uses of foods or food constituents (e.g.,
butterfat) that should be limited in a healthful diet.
4. Review and improve government and private-sector policies that di-
rectly and indirectly affect the availability of particularfoods and the promotion
of healthful dietary patterns.
As noted throughout this report, government policies and private-
sector practices substantially influence consumer food demands and
dietary patterns often in complex and subtle ways. Systematic and
comprehensive studies should be conducted to determine precisely
how and at what critical points the policies and practices are so influential.
Studies should include comprehensive reviews of public laws and
regulations and private-sector activities pertaining to food and nutrition.
For example, there is a need to reconcile government activities in
these areas at the federal, state, and local levels. Results could be
used to improve policies and practices so that they encourage accep-
tance and practice of dietary recommendations.
5. Determine how implementors of dietary recommendations at all levels
(e.g., supermarket managers, physicians, and high school health teachers)
can more effectively teach the basis of the recommendations and motivate
people to follow them.
Success in implementing dietary recommendations can be achieved
only by teaching their basis and application to people with different
levels of interest in improving their diets, different capacities for un-
derstanding the recommendations themselves, and different tenden-
cies to become either informed, confused, or overwhelmed by the
proliferation of information and promotions encouraging consumption
of particular food products. Continued research is required to develop
educational strategies that motivate and empower people to select
and consume healthful diets that are nutritionally adequate and meet
dietary recommendations.
6. Investigate the costs and benefits of implementing dietary recommen-
dations as proposed by this committee and by others.
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DIRECTIONS FOR RESEARCH
213
As described in Chapter 2, scarce financial and human resources
should be used efficiently to accomplish the goals of implementation
at the lowest costs. The committee discovered that it could not pro-
vide estimates of the costs and benefits of its recommendations primari-
ly because of the lack of quantification of the effects of past initiatives
to improve dietary practices. In order to make cost-benefit calcula-
tions, the following types of systematic documentation are needed:
(1) the amount, length, and frequency of exposure to food and nutrition
messages; (2) descriptions of the channels through which the messages
are provided; and (3) the effects of the messages in terms of knowledge,
attitude, and behavioral changes of recipients. Continued research to
determine effective and efficient means to evaluate initiatives to imple-
ment dietary recommendations is important. In addition, all initia-
tives to Improve dietary pattems should include a comprehensive evaluation
component and sufficient resources to carry it out; the descriptions and
results of these evaluations should be made publicly available.
REFERENCES
Achterberg, C., and L.L. Trenkner. 1990. Developing a working philosophy of nutri-
tion education. J. Nutr. Educ. 22:189-193.
NRC (National Research Council). 1989. Diet and Health: Implications for Reducing
Chronic Disease Risk. Report of the Committee on Diet and Health, Food and
Nutrition Board, Commission on Life Sciences. National Academy Press, Washington,
D.C. 749 pp
Sims, L.S. 1987. Nutrition education research: reaching toward the leading edge. J.
Am. Diet. Assoc. 87:S10-S18.
Sims, L.S., and L. Light. 1980. Directions for Nutrition Education Research: The Penn
State Conferences: A Proceeding. Pennsylvania State University, University Park,
Pa. 108 pp.
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Representative terms from entire chapter:
dietary change
