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OCR for page 38
Conclusions and
Recommendations
The Food and Drug Administration has need of reliable data concerning
individual food consumption. These data are important for adequate assess-
ment of the safety and wholesomeness of the U.S. food supply, for assess-
ment of the effect of incidental contaminants and food additives, and for
development of food fortification policies and nutritional quality criteria for
food products. FDA must also be concerned with putative linkages between
food consumption patterns and health. An ability to forecast the effect of
changes in food consumption patterns on nutrient intake and on health and
productivity would aid the agency in formulation of sound policies and
programs with respect to food fortification, consumer education, nutrition
and food intervention, and the like. In the final analysis, the need for food
consumption data stems from concern for health promotion and prevention
of adverse health response in the population.
Systems currently in use in the United States do not meet the needs of
FDA. While the system proposed in this report is intended to meet the
specific needs of FDA, it may well prove useful to other government agen-
cies and institutions engaged in monitoring food consumption, nutritional
status, and health.
The proposed system is based on continuous determination of the usual
pattern of food intake of individuals and population groups. This informa-
tion plus information on variation in food intakes and food composition data
can be used to determine the usual pattern of nutrient intake and its varia-
tion. It is not possible from dietary data alone to assess nutritional status.
However, it is possible, with current knowledge of human requirements, to
assess the individual's risk of inadequate status based on intake of certain
38
OCR for page 39
Conclusions and Recommendations
39
nutrients and to predict for a normally distributed population the preva-
lence of individuals who have intakes below requirements. It is also possible
to estimate the risk of excessive intake of nutrients and of natural or added
food components, if there is knowledge of the association between level of
intake and risk of toxicity.
The health and nutritional status of individuals cannot be predicted from
dietary data alone. However, if dietary data can be linked to existing health
data, health status indicators believed to be associated with food or nutrient
intake can be identified. Data from appropriate studies of the food con-
sumption patterns of individuals in a group could then be used to predict the
prevalence of individuals with increased risk to health from a particular
pattern of food or nutrient intake.
Economic considerations and other factors may influence decisions as to
adoption of the proposed system. In addition, certain data bases are not
currently adequate. However, the Committee believes the method proposed
is sound and information gathered thereby would be significantly better than
that derived from methods that are currently in use.
The Committee recommends that an ongoing system be developed and
implemented by the federal agencies that have major interests in food con-
sumption and health. The system should encompass the following compo-
nents or subsystems:
· a continuous collection, processing, and review of food intake data
from a stratified probability sample of consumption data;
· the collection of health data from currently available sources and their
collation for population strata analogous to those from which dietary infor-
mation is derived; and
· ongoing examination of available aggregate data from commercial and
governmental sources on market food disappearance, from regional and
economic strata comparable to the above.
Ideally, a lead federal agency should take responsibility for collating,
analyzing, and reporting information from these three subsystems. This
agency must have adequate personnel and fiscal resources to undertake
special data analyses as needed.
Several areas require special consideration for implementation of an effi-
cient and reliable system. The Committee recommends that research be
initiated to determine the measurement frequency required for stipulated
levels of reliability of the estimate of usual food intakes of individuals in a
population and for estimation of the extremes of food consumption patterns.
A group experienced in design should be charged with the development of
an optimal sampling frame and stratification design to meet the needs of the
system.
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40 ASSESSING CHANGING FOOD CONSUMPTION PATTERNS
Several data bases require further development. It will be necessary to
assign responsibility to specific individuals or organizations to develop the
requisite data base from existing information. The Committee makes the
following specific recommendations for the establishment of the proposed
system:
1. This system be established as an ongoing operation, capable of rapid
data processing and of collating and analyzing data on a continuing ("mov-
ing average") basis.
2. AS the system is developed, a special advisory group be convened to
address the question of precision of food identification and coding in the
collection and storage of current and future food consumption data.
3. In order to increase the potential for identifying meaningful relation-
ships between food consumption and health status, available statistics be
examined to identify population segments whose health indicators appear to
be abnormal relative to the population average and to the average of other
subgroups.
4. A task force consider the existing sources of health status information
and devise an effective approach to the identification and transfer of data to
the proposed system.
5. The uses of aggregate data bases to supplement information needed for
a total overall monitoring system be identified.
6. Interagency discussions be undertaken with the objective of develop-
ing a coordinated system.
Representative terms from entire chapter:
consumption patterns
