Dr. HANDLER. They are told what precautions they can follow, which will be about as successful as we know the diet will be. At this moment, there is only this vague linkage that links diet in the United States. to our vascular disease incidence; the evidence is not all that good. There are the risk factors that are responsible for this call it— epidemic of vascular disease and that are not all known. They are surely not primarily nutritional; there is something else that we do not really understand. There are many of them; we know about smoking; we know about insufficient exercise; we assume there is a nutritional component; we know there is a large genetic component. Then there are other things that I do not understand at all that are at least half of the problem. Mrs. HECKLER. I understand that my time has expired, but I would say that we are dealing with possibilities and probabilities in terms of prevention, not certainty. Dr. HANDLER. That is correct. Mrs. HECKLER. However, taking into account the level of morbidity due to this disease and the probabilities and the strong possibilities that other medical authorities have placed upon this, I question whether or not a fairly cavalier attitude toward cholesterol intake was an appropriate recommendation. However, I understand my time has expired. Dr. HANDLER. Well, you think it is cavalier, and we like to be scientists. Mr. PANETTA [acting chairman]. Mr. Glickman? Mr. GLICKMAN. I do not know if I am going to have my full 5 minutes, and if we have to break I hope I will be given a chance to come back. Mr. PANETTA. We will continue, but you may reserve your time. Mr. GLICKMAN. Yes. Mr. WAMPLER. Mr. Chairman, I would like to ask Dr. Handler some questions when my time arrives, and I do want to vote. I was just wondering if I could reserve the right to recall him in the event other witnesses are testifying. Mr. PANETTA. You certainly may, Mr. Wampler. We will continue. Mr. WAMPLER. I thank the gentleman. Mr. GLICKMAN. I have two questions now. In your report, you have a statement, Dr. Handler-or members of the panel-which I wonder if you have checked with the National Council of Drug Abuse or Alcohol Abuse. You talk about alcoholic beverages. On page 8, you state: Many Americans who drink do not do so moderately. Prudent individuals should consume no more than the equivalent of three mixed drinks a day. If I consumed three mixed drinks a day, I would be bombed and could not perform my duties, and maybe some people say I do not anyway. [Laughter.] I find that to be almost a positive endorsement of drinking three mixed drinks a day, and I know you did not intend it that way. I wonder why it was put in the report. Dr. HANDLER. Once again, Mr. Glickman, you will have to turn to my colleagues who wrote it and ask them what they had in mind; I had the same reaction to that statement; I worried about its being an endorsement of such behavior. I am sure they did not mean it to be that. I guess the question in this report, sir, is not whether or not you would be bombed or whether or not you could perform your duties but whether or not you would develop heart disease. All of the evidence about the relationship between alcohol and vascular disease is that one or two drinks a day are good for you. That evidence is there. We do not like to say it because we do not like to endorse such patterns of behavior, but the fact is that that is what the evidence says. Mr. GLICKMAN. I would say that if that is what the evidence says, it should have been contained in the report in some degree that you have done some epidemiological research of the use of alcohol in connection with relaxing people. But what concerns me about the way it reads in the report is it almost looks as if we are countenancing drinking up to three mixed drinks a day. And I do not think, as a matter of Government policy, we should be encouraging people to drink at all. Dr. HANDLER. I agree, sir. Mr. GLICKMAN. My second point is this. You responded to Mr. Panetta that the dietary guidelines basically, there is no problem with them. On page 17 of your testimony, however, you state, "What right has the Federal Government to propose that the American people conduct a vast nutritional experiment?" Dr. HANDLER. I offered that as two horns of a dilemma for the Congress to consider. I was not taking either position; I offered this as the dilemma. Mr. GLICKMAN. But do you, or do you not, have problems with the dietary guidelines of USDA ? Dr. HANDLER. First, I think they are very fuzzy. It is very hard to know what too much of something is if it is not stated what too much is; and, second, to the extent to which it was urging that you work at reducing your dietary cholesterol intake, we hold that there is no evidence to support such a recommendation. Mr. GLICKMAN. My only point is this. You indicate they are vague; you personally indicate that there is nothing seriously wrong with them if I may infer from what you are saying. Dr. HANDLER. I was talking about the package. Mr. GLICKMAN. I am just worried whether the reference to them as a vast nutritional experiment indicates that all of the recommendations of the Dr. HANDLER. No, sir; I was restricting myself only to the cholesterol component. Mr. GLICKMAN. Only to the cholesterol component? Dr. HANDLER. Oh, yes. Mr. GLICKMAN. Very well. My final question is-and I hope to be able to ask again-what sort of followup do we need now? There is great confusion, I think, that has developed. I went home this last weekend, and people asked me, "Are eggs bad for you or good for you? Is meat bad for you, or is it good for you?" What sort of followup do you recommend we do with this thing? Dr. HANDLER. Several pieces. One, of course, there is the never-ending demand for new understanding and evidence, and the chairman spoke to Dr. Levy about this, and Dr. Levy was delighted to respond because he knows that is just what his Institute is supposed to be doing. Second, and more specifically within this limited framework, at a meeting at the Academy on Monday morning at my suggestion, I confess we recognized that the primary difficulty with this report which is before you is that it is insufficient. It has not been the norm for reports from the Academy, as you know. We normallly provide these great big, thick, detailed, comprehensive studies in which we present all the evidence, weigh it in front of you and then tell you where we come out. In this instance, we had intended to do that, but while you were not here, Mr. Glickman, I explained how it had come about that we did not do that. Now we are resolved to go back and do it. Mr. GLICKMAN. Thank you, Mr. Chairman. Mr. PANETTA. Following up on that. Dr. Handler, it is the intention that the Academy do an indepth study? Dr. HANDLER. Yes, sir. Actually, in coming to this small report, members of the committee actually did that. What they did not do was to publish it. Now we are going to go back and do the whole task and publish it, so one can understand where those conclusions came from. Mr. PANETTA. Would your recommendation to the American public be that they withhold changing any particular pattern until that is completed? Dr. HANDLER. No; that is not my recommendation. We rest with the conclusions we have put before you. We do not expect them to change. We are going to summarize and publish the evidence that lies behind the report we gave you. We published an abstract of a report, as it were. We will now do a full report so that you can see it. Mr. PANETTA. I am a little concerned that as scientists you are prejudging what the full report will show. Dr. HANDLER. I repeat. We have done the study. We have examined the evidence. We simply have not published it. Mr. PANETTA. Mr. Chairman? Mr. RICHMOND. Thank you, Mr. Panetta. I am sorry that we have had this coming and going, but we have just had a vote on a conference report. Dr. Handler, I would be very grateful if you would stay because I know people would like to ask you questions. Meanwhile, I would like to call on the panel. Dr. HANDLER. I can stay until 1 o'clock, Mr. Chairman, if that is all right. Mr. RICHMOND. That is fine. I call now Dr. Alfred E. Harper, chairman, Food and Nutrition Board, University of Wisconsin, Madison, Wis.; Dr. Robert E. Olson, St. Louis University School of Medicine, St. Louis, Mo.; Dr. Edward H. Aherns, Jr., Rockefeller University, New York, N.Y.; and Dr. Gilbert A. Leveille, chairman, Department of Food Science & Human Nutrition, Michigan State University, East Lansing, Mich. Dr. Harper, you may proceed. STATEMENT OF ALFRED E. HARPER, CHAIRMAN, FOOD AND NUTRITION BOARD, NATIONAL ACADEMY OF SCIENCES/NATIONAL RESEARCH COUNCIL; CHAIRMAN, DEPARTMENT OF NUTRITIONAL SCIENCES, UNIVERSITY OF WISCONSIN-MADISON Mr. HARPER. Thank you, Mr. Chairman. I am pleased to have the opportunity to tell you about the background of the report "Toward Healthful Diets." I have submitted written testimony that I would like to have included in the record. Mr. RICHMOND. Without objection, it will be inserted in the record. [The prepared statement of Dr. Harper may be found on p. 204.] Mr. HARPER. Thank you. I have attached to that a statement from the Wisconsin Extension Specialists showing the similarities between the USDA guidelines and the publication of the Board, and also a short paper on science and the consumer. I should like to have the privilege of submitting for the record a copy of a letter that I wrote to the Secretaries of Health, Education, and Welfare at that time and the USDA concerning the publication of their dietary guidelines. Mr. RICHMOND. The hearing record will remain open for 2 weeks. We welcome any additional information you would like to submit. Without objection, so ordered. Dr. HARPER. Thank you. The objective of the Food and Nutrition Board is to encourage sound nutrition practices by the U.S. population through providing reliable nutrition information based on critical evaluation and interpretation of scientific evidence. The major efforts of the Board have been the publication of the recommended dietary allowances, the food chemicals codex. The first of these is a standard for dietary intake of essential nutrients. The second is a set of standards for the chemicals that are used in the food industry. Both of these are used extensively by Government agencies, by industry, and by universities. Many of the publications of the Board are accepted as authoritative sources of food and nutrition information. In the report, "Toward Healthful Diets," is the outcome of a longstanding concern with the scientific basis for dietary guidelines. I know Dr. Handler took credit for initiating this project. I would like to suggest that he served as a stimulus for it, but the Board had discussed projects of this type over the years. In fact, in the 1970's, a proposal was entertained to prepare a publication on the healthful diet. The divergence of opinion at that time among Board members was such that the proposal was tabled. In 1974, when the recommended dietary allowances were being revised, there was further discussion of this. As a matter of fact, the guidelines of the American Heart Association were included in that publication. But they were not endorsed, either by the committee, or the Board. Four years ago, the Board proposed to review scientific evidence on what dietary guidelines for the U.S. population might have adequate scientific foundation. Dr. Handler described to you the problem about the proposal that was considered by the USDA and then withdrawn. So, I shall not go into that further. But also at this time, a request was received from the National Institutes of Health. They asked the Board to review research that was needed to establish dietary guidelines. This contract was accepted. The assignment was undertaken. It was submitted to the National Institutes of Health as a report entitled, "Research Needs for Establishing Dietary Guidelines for the U.S. Population." This was subsequently published as a Food and Nutrition Board report in 1979. The preamble to each list of researched needs indicated something of the present state of knowledge. In fact, that publication, in its preparation, required an evaluation of the literature bearing on dietary guidelines. The Board continued to examine the subject of the adequacy of scientific information for the development of these guidelines and proposed that it should eventually be a continuing project comparable to that of the recommended dietary allowances that would be published initially as a brief summary and then would be subject to revision and expansion at intervals thereafter. The Board decided, as had actually been done with the first edition of the recommended dietary allowances, that it should undertake the first report as a Board project. This is what it did, even though that may not conform entirely to the general procedures of the Academy at the present time. The procedure was that six members of the Board were asked to prepare sections for this report. Progress was slow in the first year. I asked Dr. Olson if he would coordinate the collation of the reports that were prepared. The sections were integrated into a draft. The sections were circulated to the entire Board of 15 people for comments. They were discussed each time we held a Board meeting. The report underwent 10 revisions, and the draft was approved by the Board in March 1980. The Board considers itself imminently qualified to prepare such a report. The education and professional experience of the Board in the fields of nutrition, biochemistry, medicine, food science, and related subjects, is in excess of 300 man-years. The Board considers itself qualified to evaluate the results of studies in epideminology. Perhaps it does not feel qualified to lecture on the subject or to conduct extensive studies on it, but certainly to evaluate the results of scientific papers. Dr. Olson received part of this early education in the School of Public Health-at least it seems early now. Dr. Slater and Dr. Owen, two other Board members, are in schools of public health at the present time, and three members of the Board are physicians. I would like to emphasize about the content of the report that it is not a report on diet and heart disease, although that subject is discussed in one section of the report. The essence of the report is a |