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Introduction The Food and Nutrition Board of the National Academy of Sciences under contract from the Food and Drug Administration (FDA) was charged to study the sources of data on food consumption and to suggest a system for integ- rating these data with data on nutrition and health status. The purposes of the study were to evaluate current means of determining food consumption patterns and nutritional status and to devise alternative methods for obtain- ing information on food consumption, food consumption patterns, and nu- tritional status. FDA'S interest in this subject is not unique. The White House Conference on Food, Nutrition and Health (1969) discussed the need for better surveil- lance data, and the General Accounting Office (1978) has detailed the need for improved food and nutrition information systems in the United States. Similarly, the Office of Science and Technology Policy (1977) and the Office of Technology Assessment (1978) have identified nutrition surveil- lance as an important priority. The Surgeon General's recent report, Pro- moting Health, Preventing Disease: Objectives for the Nation (Department of Health and Human Services, 1980), cites the need for a national nutrition surveillance system and for integration of various data sets to provide locally useful information for nutrition planning. While the need for appropriate systems of measuring food consumption and nutritional status is broadly recognized, such systems are relatively expensive and must be properly designed to provide appropriate information on a cost-effective basis. Reliable data concerning food consumption of individuals are needed for various reasons. They are important for adequate assessment of the nutri- tional value of the U.S. food supply, for assessment of the intake of inci- 1

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2 ASSESSING CHANGING FOOD CoNSUMPT~ON PATTERNS dental contaminants and of currently approved and possible new food addi- tives, and for development of food fortification policies and nutritional quality standards for food products. Regulators of the safety and nutritional efficacy of the food supply are concerned with linkages between food consumption patterns* and health. Changes in the world's economy and changes in food costs and availability, including the introduction of new products, may have a marked effect on food consumption patterns of individuals and population groups. An ability to forecast the possible influences of these changes upon nutrient intake and on the population's health and productivity would allow formulation of sound policies and programs with respect to food fortification, consumer education, nutrition and food intervention, and the like. In the final analysis, the requirements for appropriate food consumption data relate to health promotion and prevention of adverse health responses in the population. The primary uses for which FDA and other agencies may require data on food consumption patterns linked to nutrition and health are summarized in the following list. This summary, while not exhaustive, does illustrate those purposes the Committee considered while developing this report. Nutritional Considerations to identify foods that are the primary contributors of key nutrients in the diet for various groups to identify size and nature of populations whose health is at risk due to inadequate or excessive consumption of a nutrient to obtain more extensive and valid data on the potential relationships of food consumption patterns to nutritional and health status to identify foods most appropriate for use in supplying specific nutri- ents in fortification programs for populations at risk to measure the effectiveness of food fortification programs in reduc- ing the size of the populations at risk 2. Toxicological Considerations to identify the primary patterns of use of foods and food components in the diets of a population to identify extreme or unusual patterns of intake of foods or food ingredients including additives to identify size and nature of populations at risk from use of certain foods or food products to determine amount and/or number of food items in which a food additive may be permitted *"Food consumption patterns" as used in this document refer to combinations of foods that constitute an individual's usual dietary intake, which includes daily and longer cyclical varia- tions.

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Introduction 3 to determine the need to modify regulations in response to changes in food consumption to determine intake of incidental contaminants and food additives 3. Historical and/or Secular Trends to evaluate the past history of food consumption patterns of popula- tions, particularly as related to economic, technological, or other factors to predict changes in food consumption patterns as they may be influ- enced by economic, technological, or other developments