THE GOOD WORD ABOUT GOOD NUTRITION

Most of us grew up thinking nutrition was a great bore. We learned the Basic Seven food groups (which became the Basic Four in the mid-1950s) and how many servings per day we were supposed to eat of each to pack in enough protein, vitamins, and minerals to grow on. Maybe a brightly illustrated chart accompanied the lesson, which advised eating two servings a day of meat or a meat equivalent, two to four servings of milk and dairy products, four or more servings of fruits and vegetables, and four or more servings of bread, grains, and cereals. But most of us went on eating precisely as we had before, and after passing the quiz, even forgot the groupings, not to mention the recommended number of servings.

Until recently, nutrition was a dead word. It didn't "sell." It was equated in the public mind with having to eat foods we disliked and giving up those we loved for the sake of some textbook formula for good health. Except for a small audience of "health nuts" who frequented "health food" stores scattered about the country's major metropolitan areas, nutrition simply turned people off. Even the late health-food guru Adelle Davis didn't use the word nutrition in her book titles!

Then in the 1970s, nutrition came out of the closet. The first wedge in the door was a negative one—tales of harmful food substances that might be poisoning us all. Farm produce was said to be riddled with pesticide residues, meat and poultry laced with potent hormones and antibiotics, fish polluted with toxic industrial chemicals, and processed foods filled with long strings of unpronounceable chemicals to make them resemble foods that they were not. What are these chemical concoctions you shake and bake and whip and chill, the instant breakfasts and hamburger helpers, the meals in a box and frozen dinners? And are they good for you?

The emerging crisis in confidence in the safety and healthfulness of the American food supply was nurtured by an increasingly aggressive health-food movement that promised safer and more nourishing alternatives free of chemical contaminants and fortified with "natural" goodness. Their ranks were swelled by hordes of faddists who latched onto one or another nutrient as the panacea for a host of modern ills, from backache to boredom.

Millions of Americans, whose sufferings resisted medical treatment or who no longer trusted the doctors who applied them, took matters into their own hands and turned to nutrition. Others bombarded doctors with questions about nutrients and diet plans—questions for which medical school had provided no ready answers. Coming from behind, the medical profession periodically defended itself against what it regarded as nutritional quackery—always useless and sometimes harmful, and most certainly threatening to the status of medicine.

But while scorned by doctors, scientists, and officials of government and industry, the health-food movement made nutrition a household word. Many Americans now pause to read labels as they scurry through the aisles of a supermarket, and stop to think before shoving coins into a vending machine. More and more of us are taking stock of how and what we eat and how it may affect our health.

National leaders were late getting into the act. After decades of governmental dillydallying and buckling under to industrial pressures, action finally came, not from the United States Department of Agriculture or the Department of Health, Education, and Welfare, but from Congress. As chairman of the Senate Select Committee on Nutrition and Human Needs, George McGovern took on the big guns—first the problem of obesity and the billion-dollar industry that caters to its cure, and then the entire structure of the American diet and its devastating effects on health and longevity. In 1977, the McGovern committee culminated its investigation with the publication of a new set of nutritional guidelines for Americans intended to quell many of the nation's major killers—heart disease, cancers of the colon and breast, stroke, high blood pressure, obesity, diabetes, arteriosclerosis, and cirrhosis of the liver, all of which have been linked to the current American diet.

The committee estimated that if its goals were reached by all Americans, there'd be an 80-percent drop in the number of obese Americans, a 25-percent decline in deaths from heart disease, a 50-percent drop in deaths from diabetes, and a 1-percent annual increase in longevity. To achieve only a part of this increase in life expectancy would be an incredible feat. Since 1920, the life expectancy for 50-year-old American men has increased by only nine months.

The Dietary Goals of the McGovern committee call for Americans to eat less fat, especially less artery-clogging saturated fat, less cholesterol, less refined and processed sugars, less salt, less alcohol, less calories, and more complex carbohydrates and roughage. The specific recommendations of the Dietary Goals are depicted in Chart 1. This chart shows the percentage of calories derived from various nutrients in the current American diet and in the dietary scheme recommended by the Senate Select Committee on Nutrition and Human Needs. Not shown are two other important Dietary Goals advised by the committee: a reduction in salt intake to a maximum of 5 grams a day and a reduction in cholesterol to 300 milligrams a day, about half the current amount. The chart does not include alcohol, which adds another 210 calories per day to the average diet of drinking-age Americans. No specific recommendation was made for increasing dietary fiber, but an increase in complex carbohydrates and natural sugars would lead automatically to more fiber in the diet.

To put these goals into effect, the McGovern committee recommended that people eat more fruits, vegetables, and whole grains; fewer foods rich in added sugars, refined flour, and fat; less egg yolks and other high-cholesterol foods, and less added salt and foods high in salt. The committee suggested choosing meats, poultry, fish, and dairy products that are lower in total fat, and specifically saturated fat, as well as lower in cholesterol. And it urged a cutback in calorically dense and nutritionally deficient "junk foods," especially sweet, fatty, and salty snacks and alcoholic beverages.

The concepts are hardly revolutionary. Many public-health experts have been saying as much for decades. But the meat, dairy, and egg industries took loud offense, and the American Medical Association (which has often opposed major public-health initiatives for the population as a whole, advising instead that you "see your doctor" for individualized advice) decried the goals as unproven, unnecessary, and premature.

Protest notwithstanding, the McGovern committee had started something. Within two years, the Departments of Agriculture and HEW had essentially adopted the Dietary Goals. The Department of Agriculture established a new Human Nutrition Center, with an internationally known biologist and former Harvard professor, Mark Hegsted, at the helm. Dr. Hegsted published in 1980 the first of a series of food guides to help people choose more healthfully from among the 12,000 products that may confront them in their neighborhood supermarket. And HEW released a Surgeon General's report on preventive medicine, "Healthy People," that advocates, among other things, a Dietary Goals diet. Even the recalcitrant National Institutes of Health, the leaders of the nation's medical research establishment, have come forward with dietary advice to help prevent heart disease and some cancers. Early in 1980, the USD A and HEW published "Nutrition and Your Health: Dietary Guidelines for Americans," a pamphlet based on the philosophy of the McGovern committee, and followed it with a menu plan developed by the Human Nutrition Center (see page 26). This new approach to nutrition is expected to be the foundation for forthcoming revisions in nutritional labels on food packages to enable Americans to choose more wisely when they shop for food.

So premature or not, the Dietary Goals are beginning to reshape the nutritional philosophy of America, if not yet the eating habits of most Americans. As Dr. Hegsted pointed out in a preface to the Dietary

Goals: "The diet of the American people has become increasingly rich —rich in meat, other sources of saturated fat and cholesterol, and in sugar. ... 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. The question to be asked, therefore, is not why should we change our diet but why not? . . . Heart disease, cancer, diabetes and hypertension are the diseases that kill us. They are epidemic in our population. We cannot afford to temporize."

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