Coronary Artery Disease / Dietary Goals of the United States

With me this morning are three of the country's leading thinkers in the area of nutritional health. They have very graciously assisted the staff of the Select Committee in the preparation of this report. They will explain in greater detail its purpose and goals.

First, Dr. Mark Hegsted, Professor of Nutrition from the Harvard School of Public Health. Dr. Hegsted has a long and distinguished career in science, bringing conscience as well as great expertise to his work. Dr. Hegsted has worked very closely and patiently with the Committee staff on this report, devoting many hours to review and counseling. He feels very strongly about the need for public education in nutrition and the need to alert the public to the consequences of our dietary trends. He will discuss these trends and their connection with our most killing diseases.

Following his presentation, Dr. Beverly Winikoff of the Rockefeller Foundation will discuss the changes necessary in food marketing and advertising practices if the consumer is to make more healthful food choices. Dr. Winikoff, who with Dr. Hegsted and Dr. Lee testified at our hearings in July, has also been extremely helpful in assisting the committee staff in preparing this report.

Dr. Philip Lee, the Director of the Health Policy Program at the University of California in San Francisco, and a former Assistant Secretary for Health, will conclude our presentation with a discussing of the costs of our current dietary trends. Dr. Lee has also consulted with the committee staff on this report and has offered much encouragement.

Before Dr. Hegsted begins, I would also like to note that the staff has also received valuable assistance from Dr. Sheldon Margen, a nutritionist with the University of California in Berkeley, who is traveling outside the country today.

I want to thank each of these people personally for their help and spirited concern for the public interest.

The Committee will continue its investigation into the connection between diet and health on February 1 and 2, when hearings will be held concentrating on problems of diet and heart disease and obesity.

After the presentation today we will be glad to answer questions.

STATEMENT OF DR. D. M. HEGSTED, PROFESSOR OF NUTRITION,
HARVARD SCHOOL OF PUBLIC HEALTH, BOSTON, MASSACHUSETTS

The diet of the American people has become increasingly rich-rich in meat, other sources of saturated fat and cholesterol, and in sugar. There will be people who will contest this statement. It has been pointed out repeatedly that total sugar use has remained relatively constant for a number of years. We would emphasize, however, that our total food consumption has fallen even though we still eat too much relative to our needs. Thus, the proportion of the total diet contributed by fatty and cholesterol-rich foods and by refined foods has risen. We might be better able to tolerate this diet if we were much more active physically, but we are a sedentary people.

It should be emphasized that this diet which affluent people generally consume is everywhere associated with a similar disease pattern-high rates of ischemic heart disease, certain forms of cancer, diabetes, and obesity. These are the major causes of death and disability in the United States. These so-called degenerative diseases obviously become more important now that infectious diseases are, relatively speaking, under good control. I wish to emphasize that these diseases undoubtedly have a complex etiology. It is not correct, strictly speaking, to say that they are caused by malnutrition but rather that an inappropriate diet contributes to their causation. Our genetic makeup contributes-not all people are equally susceptible. Yet those who are genetically susceptible, most of us, are those who would profit most from an appropriate diet. Diet is one of the things we can change if we want to.

There will undoubtedly be many people who will say we have not proven our point; we have not yet demonstrated that the dietary modifications we recommend will yield the dividends expected. We would point out to these people that the diet we eat today was not planned or developed for any particular purpose. It is a happenstance related to our affluence, the productivity of our farmers and the activities of our food industry. The risks associated with eating this diet are demonstrably large.