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Dietary and Nutrition Recommendations Barbara Schneeman, Ph.D. I did want to say a little bit about my background which is human nutrition. I am on leave from the University of California at Davis, and I am working with the Agricultural Research Service of USDA. For those of you who are not familiar with ARS, it is the principal internal research arm of the USDA. Within ARS is the human nutrition program. Prior to working with USDA as a part of ARS, I have been involved with the dietary guidelines advisory committees. I served on the 1990 and the 1995 dietary guidelines committee and then was involved with USDA and HHS for the release of the 2000 dietary guidelines, and we will talk a little bit about the dietary guidelines. I say all of that so that you fully understand, I come to this issue as a nutritionist, not as a toxicologist. In fact, I have been reminded of what I often tell students when they confuse toxicology and nutrition, I point out that, as nutritionists, we get to work with what you want to have in your food while toxicologists consider what you do not want to have in your food. How did I come to be involved with the dioxin issue? The Office of Science Technology and Policy, the White House Office, created an interagency working group on dioxin, in anticipation of the release from EPA on the reassessment. I was asked to be a co-chair of this interagency working group that includes representatives from several federal agencies Our primary task was to pull together information that resides in the various agencies about dioxin and to provide that information in a coordinated manner to the government agencies and particularly to officials who might be asked to comment on the EPA reassessment. Once we were finished with that task we realized that we had, in fact, created a valuable document, and the questions and answers that were developed by the interagency working group is now available on the web. You can get it either through the EPA Web Site or the FDA Web Site. As we have been discussing, we know that one route by which Americans are exposed to dioxins is through the food supply. Certainly we can debate about the level of exposure and what that exposure means. I think it is pretty clear that, once it enters the food supply, where it is likely to be concentrated from a biological point of view, is in the fatty tissue of animal products. I want to then look at the issue in terms of what are the nutritional recommendations about consumption of animal products and specifically about animal fat. The first thing to look at is the food guide pyramid. I think it is important for you to understand how the food guide pyramid is developed. Some people actually think that someone just sat down and came up with nice little pictures and drew this pyramid. It is, in fact, a research-based education tool, designed to help Americans meet the RDA for nutrients. If we are making recommendations about the intake of vitamins, minerals, protein and energy, we want to make sure that a dietary pattern is developed that will provide those nutrients in adequate amounts to Americans. Another part of the food guide pyramid is to recognize the foods that are normally consumed. We want to make sure that, as we put together that dietary pattern, there is good likelihood that Americans will, in fact, consume those foods. So, it also involves looking at dietary patterns or foods that Americans choose. The food guide pyramid itself, the icon of the pyramid, doesn't specifically address the dietary guidelines, although these little dots that appear are a way of showing you the amount of fat or sugars in various food groups. There is a bulletin that goes with the food guide pyramid. In that brochure, there is a more complete discussion of how you use the food guide pyramid to meet the recommendations that are in the dietary guidelines that we will talk about in just a bit. Obviously, if we look at this food guide, you can quickly see where the animal products are. The meat, poultry, fish, or meat alternative group clearly has animal products and the potential to have animal fat, and the dairy group clearly has the potential to have dietary fat. The tip of the pyramid refers to the use of fats, oils, sugars, sweets, foods that provide primarily energy and they don't really provide any additional nutrients in the form of vitamins, minerals or proteins. I don't really count the tip as a food group. The general advice for the foods in the tip is to consume less, to decrease consumption. So, why are animal product groups in the pyramid? Most of your calories should come from the bottom of the pyramid, the grain products, the fruits and the vegetables. The dairy and the meat group is here because they do, in fact, provide key nutrients to meet these RDAs. Both dairy and meat are excellent sources of protein. It is a very high quality protein, and the quality of protein is assessed based on the amino acid profile and the digestibility of the protein, and dairy and meat are good quality on both counts. Obviously, dairy products are an excellent source of calcium. I think, if anything, everyone knows about the calcium but may not realize that dairy, in fact, is a good source of other nutrients. It is the primary source of riboflavin in the American diet. It is also an excellent source of vitamins A and D. Other nutrients include magnesium and phosphorus. When you look at the animal products, again, we tend to think of the protein. I think most people recognize meat as a source of iron. Iron is not only in animal products, but the availability of the iron from animal products is very high. So, it is a good source of that nutrient. In addition, there are a variety of B vitamins, and it varies somewhat among the different animal meat products, but generally you can think of them as a good source of B vitamins and a good source of zinc, a nutrient that is emerging in its importance, and emerging concern about marginal intakes in some sectors of the population. One of the B vitamins I should specifically highlight is vitamin B12. For the American public, animal products are really the only source of B12, other than taking a supplement or using fortified foods. So, they are important in that regard. Fish can provide many of those same nutrients. In addition, we are recommending fish consumption because of the n-3 unsaturated fatty acids, which we think are important for health as well. So, overall, these food groups provide nutrients. In some cases they provide nutrients because the concentration of that nutrient is high. In other cases, they are a good source because of the amount of that particular food group that we eat. They make a good contribution. The second set of recommendations are the dietary guidelines for Americans. These are the guidelines that were just released in May of 2000. It is important to understand that the dietary guidelines are, in fact, federal policy. They are mandated to be reviewed every five years by public law. They form the basis of coordination between the Department of Health and Human Services and USDA on nutrition advice to the public. They are used in a variety of feeding programs. They seem simple at times and follow common sense, but they also form the base of public policy. In the year 2000 the format was changed. I know you can't read this and we are going to get into sections of the guidelines. They actually went from seven guidelines to 10. Most people can't remember 10 guidelines, so a simple format was developed which is, aim for fitness, build a healthy base and choose sensibly. The idea is, fitness deals with body weight, physical activity. Build a healthy base we will talk about a little bit more and choose sensibly we will talk about more. These are the two that refer to the recommendations about fat intake. If we look at the section on build a healthy base, the first one is to take people back to the pyramid, to use that to guide your food choices. Then, you can see that one of the strong messages within the dietary guidelines is to increase the consumption of grains, especially whole grains, and also to choose a variety of fruits and vegetables. Those groups are mentioned specifically because most Americans do not consume the recommended number of servings that are in the food guide pyramid. So, special emphasis is added for those. I should note that, for the first time, the dietary guidelines have a recommendation about food safety. Keep food safe to eat. Most of what is in that section focuses on microbial safety. Then the next section that deals specifically with what we are talking about, the choose sensibly, you can see that the first guideline is, choose a diet that is low in saturated fat, cholesterol and moderate in total fat. Now, obviously, if you are decreasing saturated fat intake, the primary way that you do that is to decrease fat from animal sources, plus decrease the use of hydrogenated plant oils. So, specific advice in that section encourages people to choose either fat free or low fat dairy products, to use lean meats, to trim fat from meats, remove the skin from poultry, remove the skin from fish. Also, use less fat and specifically less lard and butter in the preparation of foods. So, a strong recommendation to decrease the amount of saturated fat in the diet. The guidelines this time have emphasized saturated fat, getting people to look at ways they can decrease their saturated fat intake, but also keep a positive message about a moderate fat intake. A moderate fat intake is defined as about 30 percent of your energy from fat. Actually, five years ago we called that low fat. Now we are calling that moderate fat. Saturated fat should be less than 10 percent of energy. Obviously, if an individual is following the dietary guidelines and trying to decrease those sources of saturated fat in their diet, they should, in theory, decrease their risk of exposure to dioxin. I want to emphasize that that is not why the recommendations are made. The recommendations are made for decreasing risk for heart disease. If you want a copy of the guidelines, you just go to the USDA Web Site, www.usda.gov. Look for the section on nutrition or dietary recommendations and that will click you right through to where the dietary guidelines are. I want to conclude my comments by talking a little bit about what I am doing at USDA, some of the groups that I am working with, and the research responsibilities in the human nutrition program at ARS. One of the responsibilities of ARS is to determine the the food intake of America. This is the continuing survey of food intake of individuals, also called What We Eat in America. Traditionally, that survey, which is coordinated out of the Beltsville, Maryland Human Nutrition Lab, a part of ARS -- has been used to identify nutritional deficiencies and look at dietary patterns, food intake patterns that might be associated with nutrient deficiencies or associated with changing risk of chronic disease. That survey is finding new and different uses. The food industry uses it for developing petitions for food additives. EPA is using it to look at exposure to chemicals in the food supply. So, it is gaining in importance and it is being adapted for use in these different categories. In fact, several years ago we were given one-time money to expand the number of children that are included in the CSFII, so we would have accurate food intake data on children. I have to tell you -- this is me speaking as a faculty member -- one of the things that surprised me, when I began working with various constituent groups in Washington, is the degree to which this type of survey data is taken for granted. It is assumed that it will always be there. Yet, it is like any other research project. It requires a continual investment in the survey itself, new techniques, improving the sampling and improving the recall data that are available, also improvements in making the data available, so that it can be used, it is an accurate reflection of what Americans eat and it can be used for these various purposes. At a time when there is an increasing demand because of the Food Quality Protection Act, issues such as dioxin, USDA finds itself under pressure to actually decrease the sampling that is being done. We are looking at merging this sample with NHANES, which has some advantages, but could have some disadvantages. In my view, one of the most important strategies in being able to deal with this kind of issue is making sure that we do, in fact, have accurate, reliable, up-to-date information on food intake among the population. I think some of you who haven't really thought about these data and where they come from might want to consider the importance of it in looking at the assessment of chemicals in the food supply. MR. ESTREICHER: I think as Administrator Schneeman's remarks made clear, you have to know quite a bit about nutrition and the diet to make decisions with respect to food safety. As you may appreciate, EPA has a relatively narrow jurisdiction over food safety. They have jurisdiction over pesticide residues in food. Decisions historically on the safety of food and chemicals in food have been left to FDA and USDA. Now, when EPA had to get involved in dietary safety issues with respect to pesticide residues, it hadn't hammered out the methodology for that. The Novigen group has played a leading role in developing the key risk assessment models that EPA Office of Pesticides Programs now uses. One example is the D model, the dietary exposure assessment model that EPA uses to set pesticide residue tolerance. |