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I Be ? PROCEEDINGS OF A SYMPOSIUM Food and Nutrition Board Commission on Life Sciences National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1986

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National Academy Press 2101 Constitution Avenue, NVV Washington, DC 20418 NOTICE: We project that is the subject of this mport was approved by the Goveming Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineenng, and the Institute of Medicine. This report has been approved 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 Research Counci! was established by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowl- edge and of advising the federal government. The Research Council operates in accordance with general policies determined by the Academy under the authority of its congressional charter of 1863, which establishes the Academy as a private, nonprofit, self-governing membership corpo- ration. The Research Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in the conduct of their services to the government, the public, and the scientific and engineering communities. It is administered jointly by both Academies and the Institute of Medicine. The National Academy of Engineering and the Institute of Medicine were established in 1964 and 1970, respectively, under the charter of the National Academy of Sciences. The work on which this publication is based was supported by the National Research Council Fund a pool of private, discretionary, nonfederal filnds that is used to support a program of Academy-initiated studies of national issues in which science and technology figure significantly. The Fund consists of contributions from a consortium of private foundations including the Carnegie Corporation of New York, the Charles E. Culpeper Foundation, the William and Flora Hewlett Foundation, the John D. and Catherine T. MacArthur Foundation, the Andrew W. Mellon Foun- dation, the Rockefeller Foundation, and the 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 the National Academy of Engineering endowments. LIBRARY OF CONGRESS CATALOG CARD NUMBER 85-62945 INTERNATIONAL STANDARD BOOK NUMBER 0-309-03635-6 Copyright ~ 1986 by the National Academy of Sciences No part of this book may be reproduced by a mechanical, photographic, or electronic process, or in the form of a phonographic recording, nor may it toe 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. First Printing, December 1985 Second Printing, August 1987 Gird Printing, January 1990 Printed in the United States of America

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Food arid Nutrition Board KURT J. ISSELBACHER (Chairman), Harvard Medical School and Department of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts RICHARD J. HAVEL (vice Chairman), Cardiovascular Research Institute, University of California School of Medicine, San Francisco, California HAMISH N. MUNRO (vice Chairman), Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts WILLIAM E. CONNOR, Department of Medicine, Oregon Heady Sciences University, Portland, Oregon PETER GREENWALD, Division of Cancer Prevention and Control, National Cancer Institute, Bethesda, Maryland M. R. C. GREENWOOD, Department of Biology, Vassar College, Poughkeepsie, New York JOAN D. GUSSOW, Department of Nutrition Education, Teachers College, Columbia University, New York, New York JAMES R. KIRK, Research and Development, Campbell Soup Company, Camden, New Jersey REYN.\LDO MARTORELL, Food Research Institute, Stanford University, Stanford, California WALTER MERTZ, Human Nutrition Research Center, Agricultural Research Service, U.S. Department of Agriculture, Beltsville, Maryland . . .

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1V FOOD AND NUTRITION BOARD J. MICHAEL McGINNIS, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Washington, D.C. MALDEN C. NESHEIM, Division of Nutritional Sciences, Cornell University, Ithaca, New York RONALD C. SHANK, Department of Community and Environmental Medicine and Department of Pharmacology, University of California, Irvine, California ROBERT H. WASSERMAN, Department/Section of Physiology, New York State College of Veterinary Medicine, Cornell University, Ithaca, New York MYRON WINICK, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, New York Staff SUSHMA PALMER, Executive Director, Food and Nutrition Board FRANCES PETER, Editor, Commission on Life Sciences

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Preface Each year, the Food and Nutrition Board (FNB) sponsors a symposium to stimulate discussion among scientists, practitioners, policymakers, and He public on a topic of particular interest to the nutrition community. A symposium entitled "What is America Eating?" was held December 10, 1984, at the National Academy of Sciences in Washington, D.C. Selecting a topic for the 1984 symposium was particularly difficult because many issues in nutrition both in the United States and abroad deserved special attention. For example, the widespread starvation and malnutrition in developing countries such as Ethiopia would have been a topic of timely and global significance. The implications of developments in genetic engineering for our food supply are also of widespread interest. Another topic, nutrition monitoring in the United States, has been in the forefront of nutrition discussions among scientists, the U.S. Congress, and federal agencies, especially He U.S. Depa~ent of Agriculture (USDA) and the U.S. Department of Health and Human Services (DHHS) agen- cies that have the primary responsibility for nutrition surveillance of the U.S. population. In Congress, discussions concerning the status and ad- equacy of federal nudition-monitor~ng efforts have led to proposed leg- islation. In addition, at He request of USDA and DHHS, an FOB committee prepared a report on the uses and implications of USDA's Nationwide Food Consumption Survey and the dietary intake portion of the National Health and Nutrition Examination Survey, which is conducted by the National Center for Health Statistics. From among all the critical nutrition-related topics deserving attention

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V1 PREFACE the FNB selected the dietary habits of Americans - their ~ends, deter- minants, and nutritional consequences as an outgrowth of its interest in nutrition surveillance. This challenging topic was greeted with enthusiasm by the speakers invited to participate in the symposium. As a result, their presentations were thoughtful, stimulating, and well received by all in attendance. The PNB is a unit of the National Research Councils Commission on Life Sciences. It was established more Han four decades ago, primacy to address issues of national importance that pertain to Be safety and adequacy of the nation's food supply, to establish principles and guidelines for adequate nutrition, and to render authoritative judgment on the rela- tionship between food intake, nutrition, and health. The FOB is a mul- d~disciplinary group of biomedical scientists win expemse in various aspects of nutrition, food science, epidemiology, food toxicology, and t-ood safety. These scientists deliberate on global issues concerning food and nutrition, initiate studies that are later assigned to standing or ad hoc FOB com- mittees, and oversee the work of these committees. The Food and Nutntion Board acknowledges Drs. Helen Guthrie, Jean- Pierre Habicht, Henry Kamin, and Stanley Johnson for Heir leadership in the planning of the symposium. The board is also grateful to Shirley Ash and Susan Barron for managing Be arrangements for the symposium. Thanks are also due to Frances Peter and audio Grumstrup-Scott for editing the proceedings. - Kurt Isselbacher, Chairman Food and Nutrition Board

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Contents [4TR O D U CTIO N I EA TIN G PAlErERU4S, N U TFUrrIO N. A N D H E A LT H IN 1lHE U NrrED ST AllES The Joint Nutrition Monitonng Evaluation Committee .... Susan Welsh Nutritional Status of the U.S. Population. Iron, Vitamin C, ~ d Zinc 21 Catherine Woteki, Clifford Johnson, and Robert Murphy 7 II WllA T PA CT O RS SHAPE E A TIN G PAlErERU4S? Introduction . Stanley R. Johnson Economics and Nutrition Benjamin Senauer The Acquisition of Likes and Dislikes for Foods ................ Paul Rozin and April Fallon Factors That Shape Eating Patterns: A Consumer Behavior Perspective ..................................................... Kenneth J. Roering, David M. Boush, and Shannon H. Shipp . V11 43 46 58 72

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. . . V111 III EATING TRENDS AND NUTRITIONAL CONSEQUENCES Introduction Helen A. Guthrie Snacking aund E ating A w ay fro m H o m e Karen J. Morgan and Basile Goungetas Variety in Foods ............................................ Helen Smiciklas-Wright, Susan M. Krebs-Smith, and James Krebs-Smith IV PERSPECTIVES ON NtTrRrrION PROGRAMS, POLICY, AND RESEARCH Introduction .................. Jean-Pierre Habicht CONTENTS 87 .......................... 91 ...... 126 lithe R ole of N u ~ tion Research in Policy and Program Planning ....................................................... Jean-Pierre Habicht The Food Industry aund N unction Gilbert A. Leveille Nutrition Education ............. Johanna T. Dwyer Assessment of Diet Quality and the U.S. Department of Agriculture's Nutrition Policy and Research .................. Betty B. Peterkin Legal Advocacy for the Hungry and Malnourished How Can Nutrition Scientists Help? ...... Lynn Parker PARTICIPANTS AND COAUTHORS INDEX ......... 144 148 150 158 162 165 167

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WHAT IS AMERICA EATING?

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