STATEMENT OF DR. BEVERLY WINIKOFF,
ROCKEFELLER FOUNDATION, NEW YORK, NEW YORK

What are the implications of these dietary goals?

Even "personal dietary preferences" are not immutable but interact with other forces in the environment and are influenced by them. People learn the patterns of their diet not only from the family and its sociocultural background, but from what is available in the marketplace and what is promoted both formally through advertising and informally through general availability in schools, restaurants, supermarkets, workplaces, airports and so forth.

It is generally recognized with regard to the overall economic climate that both what the Government does do and what it does not do shape the arena in which other forces interact. This is also true with regards to nutrition. In determining the parameters of the socioeconomic system, Government also determines the nature of the national buffet. Government policy, then, must be made with full awareness of this responsibility.

It is increasingly obvious that if new knowledge is to result in new behaviors then people must be able to act, without undue obstacles, in accordance with the information that they learn. The problem of education for health as it has been practiced is that it has been in isolation, not to say oblivion, of the real pressures, expectations, and norms of society, which mold and constrain individual behavior. There must be some coordination between what people are taught to do and what they can do. Part of the responsibility for this coordination rests with the Government's evaluation and coordination of its own activities. Effective
education must be accompanied by Government policies which make it easier, indeed likely, that an individual will change his or her lifestyle in accordance with the information offered.

This trend can be reversed by specific agricultural policies, pricing policies, and marketing policies, as well as the recommendations outlined in these "Dietary Goals for the United States."

In general, Americans have quite accurate perceptions of sound nutritional principles, as was demonstrated recently by a Harris poll conducted for the Mount Sinai Hospital in Chicago. However, people do lack understanding of the consequences of nutrition-related diseases. There is a widespread and unfounded confidence in the ability of medical to cure or mitigate the effects of such diseases once they occur. Appropriate public education must emphasize the unfortunate but clear limitations of current medical practice in curing the common killing diseases. Once hypertension, diabetes, arteriosclerosis or heart disease are manifest, there is, in reality, very little that medical science can do to return a patient to normal physiological function. As awareness of this limitation increases, the importance of prevention will become all the more obvious.

But prevention is not possible solely through medical interventions. It is the responsibility of government at all levels to take the initiative in creating for Americans an appropriate nutritional atmosphere-one conducive to improvement in the health and quality of life of the American people.