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Although their conclusions are not unanimous, they are all in the same direction as the dietary guidelines.
The Food and Nutrition Board has produced no new data in this. We think we have to rely on what is the consensus of scientific opinion.
Mr. GRASSLEY. What I would like to do is to submit for the record quotes from the American Council on Science and Health, a quote from Dr. Margaret Flynn, professor of family and community medicine at the University of Missouri-Columbia, a quote from a study between Oklahoma State University researchers and the Oklahoma Medical Research Foundation, a quote from a publication called the Lancett, one from Utah State University, and others.
Mr. RICHMOND. Without objection, they will be included in the record.
Mr. GRASSLEY. The American Council on Science and Health concluded:
Contrary to popular belief, there is no firm evidence to support the premise that reducing saturated fat and cholesterol in your diet will in itself lower your risk of heart disease.
Dr. Margaret Flynn, professor of family and community medicine at the University of Missouri-Columbia, has been doing cholesterol research with free-living individuals for the past 6 years. She finds diets high in eggs, beef, and pork have no significant impact on serum cholesterol. She says:
Most Americans-about 85 percent of us—have the genetic ability to handle cholesterol and can eat anything we want. What we need to do is watch our weight.
In a joint study between Oklahoma State University researchers and the Oklahoma Medical Research Foundation ground beef was fed to turkeys. The turkeys receiving the ground beef showed no significant differences in blood serum components than the control group.
Writing in the Lancet, a prestigious scientific publication, Dr. E. H. Ahrens of Rockefeller University in New York, says of the low fat, low cholesterol diet:
I feel it is irresponsible to make the dietary recommendations that are being so widely proposed to the general public at this time.
Utah State University, I understand, is doing some research which involves feeding very large amounts of eggs to pigs. Apparently the eggs are having no effect on the pigs' blood cholesterol levels.
A report released last fall by the American Cancer Society stated:
A preliminary study of dietary factors showed no higher rates of coronary heart disease and strokes in people who ate a high fat diet than in those who did not.
Prof. Ralph Blackett, a member of the Australian Heart Foundation's committee on diet and heart disease, says it is time to change our thinking away from cholesterol and fat to overweight and lack of exercise.
This is a followup question to my previous one, namely, that these statements and organization physicians seem to coincide quite closely with the position of the Food and Nutrition Board. You quoted from 16 different sources. I am saying that there are sources on the other side.
If it were just for one or two scientists who held the view of these from which I am quoting, that would be one thing, but there are more
than one or two. I am asking you this: Are they all lacking in scientific responsibility and credibility as well ?
Dr. HEGSTED. They vary in their scientific abilities and credibilities, but I am not quoting individuals. I am quoting deliberately developed expert groups, developed to evaluate the data, like the New Zealand Heart Foundation, the Royal College of Physicians of Great Britain, and the American Health Foundation. The American Medical Association has even recommended that all Americans should watch their fat intake as has the International Society of Cardiology.
There is a long list of groups composed of experts in the field. While one can always find individuals who disagree with the general opinion of the scientific body, we think the dietary guidelines represent a consensus at this time.
Mr. GRASSLEY. I guess I will not ask you to comment further than that. But do let me point out to you that in the quotations I have put in the record, the report from the American Council on Science and Health, for instance, is a review of the pros and cons of the issues and includes about 450 scientific references.
I would like to go on to ask you this. Do you feel that only studies conducted by the Federal Government, like the USDA and the FDA for example, are accurate and valid?
Dr. HEGSTED. No; certainly not.
Mr. GRASSLEY. I would like to have the same amount of time that Mr. Brown and Mrs. Heckler had.
Mr. RICHMOND. You had 5 minutes, Mr. Grassley. I will give you another
Mr. GRASSLEY. I would like to have as much time as the others had. I ask for unanimous consent to have 4 more minutes.
Mr. RICHMOND. Mr. Grassley, suppose we grant you unanimous consent this time, but if we do not stick to the 5-minute rule we will never finish these hearings.
Mr. GRASSLEY. That is exactly the point I am trying to make. All I want is the same amount of time that Mr. Brown and Mrs. Heckler had.
Mr. RICHMOND. Mr. Grassley, Mr. Brown had 7 minutes and Mrs. Heckler, 5. Do you want the 4 more minutes ?
Mr. GRASSLEY. I ask for 2 more minutes.
Mr. GRASSLEY. Do you automatically rule out the validity of scientific research conducted by persons unless it is funded by the Federal Government?
Dr. HEGSTED. Do we rule out the research funded by the Federal Government ?
Mr. GRASSLEY. No; do you automatically rule out the validity of scientific research conducted by people unless it is funded by the Federal Government?
Dr. HEGSTED. Absolutely not.
Mr. GRASSLEY. This is my concluding question. It is admittedly a general one and it may imply an allegation. Are you not finding fault with the methodology because you disagree with the conclusion?
Dr. HEGSTED. I think what we have to believe is that the Academy did not follow their usual procedure in developing a well-balanced group to consider these issues.
Mr. GRASSLEY. I yield back my time, Mr. Chairman.
["Diet Modification: Can It Reduce the Risk of Heart Disease ?" publication of the American Council on Science and Health, is held in the subcommittee file.]
Mr. RICHMOND. Thank you, Mr. Grassley. Mr. Glickman?
I am sorry, Dr. Hegsted, that I was detained. I would like to ask you this. How were the USDA dietary guidelines deveolped, and who participated in that development ?
Dr. HEGSTED. We had a small committee that talked about this. While generally agreeing with the principles, we had difficulty deciding how much evidence should be put into the document itself—that is, how much of the basic evidence.
Mr. GLICKMAN. Who was in this group? Was it an internal USDA group?
Dr. HEGSTED. This was an USDA-HEW group that was appointed by a coordinating committee of USDA and HEW. Mr. GLICKMAN. Were there any outside scientists on this group? Dr. HEGSTED. There were none there at that time.
Mr. GLICKMAN. It was all employees of either USDA or the Department of Health and Human Services.
Dr. HEGSTED. However, then we got into the difficulty of preparing the report and deciding how much evidence would be there. Being aware that the American Society of clinical Nutrition had already appointed panels, we decided in advance of knowing what the conclusions would be, that we would use their recommendations as the basis for our guidelines. We feel that the scientific community certainly had an input into the development of them.
Mr. GLICKMAN. Since you are in the agency of Government that is primarily responsible for nutrition education and related things in America, can you advise the committee how many, to your knowledge, separate nutrition advisory panels there are in this Government of ours?
Dr. HEGSTED. I certainly cannot do that off the top of my head. I suppose I can find out.
Mr. GLICKMAN. Are there an abundance of them!
Dr. HEGSTED. I am sure there are-I really cannot answer that. I do not know enough about all of the agencies.
As you may know, the committees which advise the Office of Science and Technology now includes a subcommittee on nutrition that includes members of all—I think nine agencies.
Mr. GLICKMAN. My point is that part of the confusion that the American public has to contend with in nutrition relates to the bifurcation and the overabundant variety of both professional and nonprofessional committees appointed by various agencies that come up with conflicting conclusions. This does not lead to much stability.
I am not saying that we should have one, but I am saying that it is part of the problem. When I hear school districts tell me: 'Well, we do not know which way to go because we have 10 different reports to deal with," I think it is part of the problem.
Dr. HEGSTED. A lot of those, of course, do not originate from Government agencies. I think people have to realize that we are in somewhat of a transition period in terms of dietary advice. Over the last 20 years the primary advice has been to be sure you eat enough to get all the vitamins, minerals, and protein you need.
Now the evidence has accumulated that excess consumption is even more of a problem in the United States than underconsumption. Those two have to be blended together. That is a more difficult job and it is going to take some time before there is essential agreement on how to do that.
Mr. GLICKMAN. I would like to ask you two final questions. One is: How do
you think we can make nutrition a more exact science, and should we? No. 2 is: What kinds of additional scientific research are necessary to verify the data that came out of the Food and Nutrition report?
Dr. HEGSTED. The only way to get new information is by research, obviously. I would say that some of the questions that people want answered are not really answerable, I think, with our current technology. However, I do not believe that that means we do not say anything. I think we have to make our best judgments based on the best evidence available.
Mr. GLICKMAN. Thank you, Mr. Chairman,
Dr. Hegsted, I want to thank you for being here this morning and I apologize for not being present to hear all of your presentation due to the activities on the House floor.
I gathered, in your responses to questions that were propounded by Mr. Brown, that you are somewhat critical of the report because if I understood you correctly—you said that the committee did not give adequate consideration to the epidemiologic literature in this field. Is that correct !
Dr. HEGSTED. That is one of our conclusions. Yes.
Mr. WAMPLER. As I read the references of the report it looks to me as if in fact the committee did rely very heavily on some of the literature in that area. Is that correct or not? Have you reviewed the references ?
Dr. HEGSTED. Yes; I reviewed them. I do not know or recall exactly what references they used, but it is clear from the report that the primary reason for not making recommendations is that clinical studies to modify diet have not—at least to the satisfaction of this groupshown much response in terms of reduction of heart attacks.
I have pointed out that we are dealing with atherosclerosis, which is a disease that develops over 20 to 30 years. Those kinds of clinical studies will always have limitations. We do not believe that atherosclerosis is really reversible in man.
Therefore, to rely solely, or almost solely, upon clinical trials, we think, is unfortunate.
Mr. WAMPLER. Dr. Hegsted, there are members of this committee who feel—and I guess I also put myself in this category—that the image of eggs, dairy products, and certain meats have been unfairly maligned in the eyes of the consumer and that the establishment of
the dietary goals by the Department of Agriculture and the Food and Drug Administration could have a very dramatic impact on the producers of these commodities and foodstuffs, in that, if your dietary guidelines are not accurate—and you must concede that there is a good deal of controversy over their validity.
The Department of Agriculture and other agencies of the Government can have a dramatic impact in prescribing what the dietary goals of the school lunch program are, as well as other programs. The point being that if your guidelines are not accurate and if there is scientific evidence to suggest that the consumption of eggs, dairy products, and meats is not harmful to one's health, then it is unfair to the agricultural producers of this country and ultimately to the consumers. Would you agree on that or not?
Dr. HEGSTED. Congressman, I think, as I said, that one has to look at this. The Board says in their own report that when you are uncertain of the benefits, you should be sure that your recommendations are not harmful. There is abundant scientific opinion that our consumption levels are too high and that they put us at risk.
We probably will never have the capacity to develop the kinds of evidence that we would really like to have. I cannot believe that under those circumstances we should simply say: "Americans, go ahead and eat whatever you are eating and we will wait another 20 or 30 years before we make any recommendations."
In other words, I think one has to evaluate our current diet just as critically as one would propose changes in diet.
Mr. WAMPLER. Let me quote from an article that appeared in the Richmond Times Dispatch, Wednesday, June 4, 1980. This article involved the controversial report on which we are holding the hearings.
The writer quoted Dr. David Richardson, who is chairman of the division of cardiovascular disease at the Medical College of Virginia in Richmond. Incidentally, he was a classmate of Dr. Olson's in the class of 1951 and he immediately recognized the name.
Although he was not familiar with the report, he was generally supportive of it. He suggested that it is almost unfair “to lead people to believe that by avoiding saturated fat in their diets that they will also avoid heart attacks." He says, "I think it is part of the way people are built to hope that there is something they can do to avoid catastrophe."
Dr. Richardson compares the situation to sacrifices of children to the gods in the hope that favor would be found. He said insurance did not come with sacrifices, however.
Here is what he is saying: “It is reasonable to put some effort into not getting fat and cutting down on the fat they eat in the hope that they will not get a heart attack.” He finally says, "It is not knownthat is, firm scientific evidence—that lowering cholesteral will be beneficial.”
I am simply quoting one person, recognizing that there are others that hold contrary points of view.
What bothers me, as one who acknowledges that he has a prejudice toward the producers of food and fiber in this country, that there is considerable evidence to suggest that your dietary guidelines are unrealistic. This is what I hope we can achieve; namely, some reasonable