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APPENDIX
B
Summary of Committee's
Major Recommendations
PRINCIPAL IMPLEMENTATION STRATEGIES
1. Governments and health-care professionals must become more
active as policymakers, role models, and agenda setters in imple-
menting dietary recommendatior~s.
2. Improve the nutrition knowledge of the public and increase the
opportunities to practice good nutrition.
3. Increase the availability of health-promoting food.
RECOMMENDATIONS TO THE PUBLIC SECTOR
STRATEGY 1: Improve federal efforts to implement di-
etary recommendations.
ACTION 1: The executive branch should establish a coordinat-
ing mechanism that would promote the implementation of di-
etary recommendations.
ACTION 2: Encourage members of the U.S. Congress and state
legislative bodies to play active roles in the implementation of
dietary recommendations.
STRATEGY 2: Alter federal programs that directly influ-
ence what Americans eat so as to encourage rather than
impede the implementation of dietary recommendations.
This effort should affect food assistance, food safety, and
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APPENDIX B
nutrition programs, as well as farm subsidy) tariff, and
trade programs.
ACTION 1: Revise current U.S. Department of Agriculture
(USDA) regulations governing the child and family nutrition
programs to comply with dietary recommendations and train
federal, regional, state, and local personnel administering the
programs to implement the recommendations.
ACTION 2: Revise current regulations governing the Nutri-
tion Program for Older Americans (which provides congregate
meals and home-delivered mealsJ to conform to the principles of
dietary recommendations and train federal, regional, state, and
local personnel administering the programs accordingly.
ACTION 3: USDA and the U.S. Department of Health and
Human Services (DHHS) should ensure that food and health
programs serving all special populations conform to dietary rec-
ommendations.
ACTION 4: Ensure that the education and information compo-
nents of the foregoing federalfood assistance and nutrition pro-
grams are consistent with dietary recommendations.
ACTION 5: Incorporate dietary recommendations into current
rules and regulations governing commodity purchases.
STRATEGY 3: Change laws, regulations, and agency
practices that have an appreciable but indirect impact on
consumer dietary choices so that they make more foods
to support nutritionally desirable diets available. Examples
are food grading and labeling laws and standards of identity
for a number of food products.
ACTION 1: Improve food labeling and food description, pro-
duction, and processing regulations to permit consumers to make
better informed choices.
ACTION 2: Develop and adopt regulations governing food de-
scriptions, grading, and nomenclatural practices.
ACTION 3: Improve the nutritional attributes of animal products.
STRATEGY 4: Enable government feeding facilities to serve
as models to private food services and help people meet
dietary recommendations.
ACTION 1: The Office of the Secretary of the U.S. Department
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220
APPENDIX B
of Veterans Affairs should direct its health-care personnel to
follow dietary recommendations in all of its food and health care
systems.
ACTION 2: The surgeons general of the Army, Navy, and Air
Force within the Department of Defense (DODJ should develop
a plan for implementing dietary recommendations in all aspects
of the DOD food and health-care systems.
ACTION 3: The DOD's food and beverage services and prac-
tices should be revised to conform to dietary recommendations.
ACTION 4: Urge the director of the Federal Bureau of Prisons
to examine the feasibility of providing diets in line with dietary
recommendations, recognizing the complexity of the correctional
system and the special role offood in correctionalfacilities.
ACTION 5: The General Services Administration should en-
sure that food contracts and monitoring systems are made to
conform to the principles of dietary recommendations.
ACTION 6: Department secretaries should encourage govern-
ment employees to consume diets that meet dietary recommenda-
tions.
ACTION 7: The U.S. government personnel ultimately respon-
sible for funding official meal functions should offer meals that
are consistent with the principles of dietary recommendations.
STRATEGY 5: Develop a comprehensive research, moni-
toring, and evaluation plan to achieve a better understanding
of the factors that motivate people to modify their eating
habits and to monitor the progress toward implementa-
tion of dietary recommendations.
ACTION 1: The secretaries of USDA and DHHS should man-
date increased amounts of intramural research that relate to
implementation of dietary recommendations and give high prior-
ity to the funding of extramural research in this area.
ACTION 2: Improve the National Nutrition Monitoring Sys-
tem and provide it with adequate resources.
RECOMMENDATIONS TO THE PRIVATE SECTOR
STRATEGY 1: Promote dietary recommendations and
motivate consumers to use them in selecting and prepar-
ing foods and in developing healthful dietary patterns.
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APPENDIX B
ACTION 1: Make consumers aware of dietary recommendations
and their importance and how available products and services
can be used to meet them.
ACTION 2: Contribute to efforts to improve the nutrition la-
beling offood so that it better assists consumers in making informed.
nutritionally desirable food choices.
O ,
ACTION 3: Provide consumers with information at points of
purchase so that they may assess quickly some of the nutrition
attributes of specific products and brands.
STRATEGY 2: Continue to increase the availability of a
wide variety of appealing foods that help consumers to
meet dietary recommendations.
ACTION 1: Develop more nutritionally desirable products that
appeal to consumers.
ACTION 2: Contribute to efforts to revise, or develop as appro-
priate, food-quality criteria (such as standards of identity and
grading), pricing structures, andfood product descriptors to promote
the production of more nutritionally desirable food products.
ACTION 3: Engage in practices leading to the greater avail-
ability of nutritionally desirable products that will assist con-
sumers in meeting dietary recommendations.
RECOMMENDATIONS TO HEALTH-CARE PROFESSIONALS
STRATEGY 1: Raise the level of knowledge among all
health-care professionals about food and nutrition and
the relationships between diet and health.
ACTION 1: Establish within the faculty of every health-care
professional school an identifiable program with overall respon-
sibility for planning and developing a research and education
agenda in human nutrition.
ACTION 2: Establish a program within the Public Health Ser-
vice to support the training offaculty in nutrition. The goal
should be at least one nutrition faculty member per health-care
professional schoolfor each of the licensed Graduate programs in
the health-care professions.
- O ~r -o
ACTION 3: Materials emphasizing dietary recommendations for
students in the health-care professions should be prepared by
curriculum committees, authors, publishers, and others with in
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APPENDIX B
terests in curriculum development. Such materials should in-
clude course syllabi at varying levels of complexity, batteries of
examination questions, relevant bibliographic listings, audiovisual
teaching instruments, and self-education computer programs.
ACTION 4: Expand nutrition education of health-care profes-
sionals at all levels. Certification and licensing bodies involved
in the education of health-care professionals should require a
demonstrated knowledge of nutrition.
STRATEGY 2: Contribute to efforts that will lead to health-
promoting dietary changes for health-care professionals,
their clients, and the general population.
ACTION 1: Encourage efforts to implement dietary recommen-
dations in a coordinated mannerfor maximum effectiveness and
to avoid unnecessary duplication.
ACTION 2: Encourage all health-care professionals to integrate
nutrition information into their multiple counseling, treatment,
skills training, and follow-up sessions with individual clients
and patients.
ACTION 3: Provide leadership, resources, and personnelfor the
~ dissemination of sound nutritional advice.
ACTION 4: Working as individuals or through professional so-
cieties, provide guidance to regulatory and legislative bodies concerned
with the establishment of dietary standards and with rules and
policies governing the production, harvesting, processing, pres-
ervation, distribution, and marketing offood products.
ACTION 5: Specialists in human nutrition and food science,
working through their professional organizations, should dis-
tribute practical information such as menus, recipes, and ideas
for health promotion initiatives to private and public providers
of meals.
ACTION 6: Serve as role models by following dietary recom-
mendations (and practicing other healthy behaviors) as often as
possible.
STRATEGY3: Intensify research on the relationships
between food, nutrition, and health and on the means to
use this knowledge to promote the consumption of healthful
diets.
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APPENDIX B
ACTION 1: Encourage sponsors of research to give high prior-
ity to research into diet and disease relationships and to deveZop-
ing innovative ways to use that knowledge in educating health-
care professionals and the public about nutrition.
RECOMMENDATIONS FOR EDUCATION OF THE PUBLIC
STRATEGY 1: Ensure that consistent educational messages
about dietary recommendations reach the public.
ACTION 1: Initiate meetings of leaders and representatives of
national groups (e.g., interest groups, professional associations,
and Cooperative Extension Service educators) to explore com-
mon interests in implementing dietary recommendations and to
develop a series of common educational initiatives related to the
attainment of that goal.
ACTION 2: Review materials on diet and health prepared for
the public by various professional groups and organizations to
achieve consistency and ensure compatibility with dietary rec-
ommendations.
ACTION 3: Convene an ad hoc committee composed of authors
and publishers of leading nutrition textbooks to develop a series
of broad guidelines that publishers could use to provide in their
publications consistent and authoritative information on dietary
recommendations and their scientific rationale.
ACTION 4: Constitute a panel to review and evaluate nutri-
tion education materials made available to schoolteachers from
various food industry sources.
STRATEGY 2: Incorporate principles, concepts, and skills
training that support dietary recommendations into all
levels of schooling kindergarten through college.
ACTION 1: Design a model curriculumfor teachingfood skills,
nutrition, and health from kindergarten through grade 12.
ACTION 2: During the development of the curriculum proposed
in Action 1, identify teacher-tested lessons on health, nutri-
tion, and food selection and preparation skills- suitablefor use
in a variety of classroom settings at different grade levels.
ACTION 3: Professional nutrition, health promotion, and edu-
cation organizations in each state should organize their members
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APPENDIX B
(and through their members, local parents) to lobby state legisla-
tures and urge state boards of education to mandate the inclusion
of at least one food skills, nutrition, and health course in the
requirements for teacher preparation in each state.
ACTION 4: Revive, at the level of at least $0.50 per student,
the USDA-administered Nutrition Education and Training (NE TJ
Program that stimulated so much activity related to nutrition
O
education in the late 1970s.
ACTION 5: Offer a nutrition course or, at a minimum, a life
science course with a well-developed nutrition component at in-
stitutions of higher learning.
ACTION 6: Offer each student in grades 7 through college on a
periodic basis ¢e.g., every 3 years) a computer analysis of his or
her diet and a professional evaluation of how the student's food
habits conform to dietary recommendations.
STRATEGY 3: Ensure that children in child-care programs
(including out-of-home care programs and family-, group-,
or center-based programs) receive nutritious meals served
in an environment that takes account of the importance
of food in children's physical and emotional well-being.
ACTION 1: Establish an interdisciplinary task force to oversee
food-related matters involving children in child-care programs.
This task force would include experts in pediatrics, nutrition,
psychology, anthropology, and child development alone with child-
care providers and parents.
ACTION 2: Public policy committees in nutrition, medical, and
other health-related organizations should work to develop and
pass legislation to require thatfoods served to children help them
to meet dietary recommendations. The Child and Adult Care
Food Program standard of USDA should be used as a quality
. .
minimum.
STRATEGY 4: Enhance consumers' knowledge and the
skills they need to meet dietary recommendations through
appropriate food selection and preparation.
ACTION 1: Develop a consumer manual to present strategies that
can be used to influence local food providers (and others who play
important roles in the food system) to increase the availability of
foods that help people meet dietary recommendations.
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APPENDIX B
ACTION 2: Prepare an inexpensive, continually updatablefoods
data bank to inform consumers, food planners, and others about
the nutritional content, composition, and production/processing
history of the products available to them.
STRATEGY 5: Establish systems for designing, imple-
menting, and maintaining community-based interventions
to improve dietary patterns.
ACTION 1: Professional organizations concerned with food,
nutrition, and health should work to engage community leaders
in the development of community-based programs promoting di-
etary recommendations.
ACTION 2: Encourage schools of higher learning in various
regions of the country to develop programs for educating and
updating individuals in the skills needed to play key roles in
community-based nutrition education programs.
STRATEGY 6: Enlist the mass media to help decrease
consumer confusion and increase the knowledge and skills
that will motivate and equip consumers to make health-
promoting dietary choices.
ACTION 1: Develop a series of social marketing campaigns to
disseminate dietary recommendations.
ACTION 2: Appoint a committee of experts in nutrition educa-
tion, child development, social influence, and media to review
past attempts to regulate television food advertising to children.
ACTION 3: Appoint a standing committee to coordinate the
vast number of media activities necessary to increase consumer
knowledge about dietary recommendations and their application
and to decrease consumer confusion.
ACTION 4: Establish a taskforce of social scientists to examine
the utility of national entertainment television as a community-
organizing tool that can be used to enhance efforts of local health
agencies in encouraging appropriate dietary changes.
DIRECTIONS FOR RESEARCH
225
1. Improve methods to characterize what people actually eat, es-
pecially over long periods during which dietary patterns change.
2. Increase understanding of the existing and potential determi
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APPENDIX B
nants of dietary change and how this knowledge can be used to pro-
mote more healthful eating behaviors.
3. Continue research to develop new food products and modify
both the production and processing of existing products to help con-
sumers more easily meet dietary recommendations.
4. Review and improve government and private-sector policies that
directly and indirectly affect the availability of particular foods and
the promotion of healthful dietary patterns.
5. Determine how implementors of dietary recommendations at
all levels (e.g., supermarket managers, physicians, and high school
health teachers) can more effectively teach the basis of the recom-
mendations and motivate people to follow them.
6. Investigate the costs and benefits of implementing dietary rec-
ommendations as proposed by this committee and by others.
Representative terms from entire chapter:
recommendations action
