STATEMENT

  BY

C, EVEREI-T KOOP, M.D., Sc,D,

SURGEON GENERAL

     U,S, PUBLIC HEALTH SERVICE
U,S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

PRESS CONFERENCE TO RELEASE

THE SURGEON GENERAL'S REPORT ON NUTRITION AND HEALTH

NOT FOR RELEASE BEFORE
1l:oo kM.r JULY 27, 1988


I AM PLEASED TO RELEASE TODAY THE FIRST SURGEON GENERAL'S REPORT
ON NUTRITION AND HEALTH.  THIS REPORT IS A LANDMARK IN PUBLIC

HEALTH SERVICE EFFORTS TO IMPROVE THE HEALTH OF THE AMERICAN

PEOPLE:.  FOR THE FIRST TIME, WE ARE PRESENTING OUR CONSENSUS ON
THE STATE-KNOWLEDGE OF THE LINK BETWEEN DIET AND A BROAD RANGE

OF HEALTH ISSUES.  THIS REPORT PLACES PARTICULAR EMPHASIS ON THE

ROLE OF DIET IN PREVENTION OF THE CHRONIC DISEASES THAT ARE

LEADING CAUSES OF DEATH AND DISABILITY AMONG AMERICANS.  IT ALSO

DEFINES WAYS IN WHICH WE CAN CHANGE OUR DIETS TO REDUCE THE RISK

FOR THESE DISEASES.  THE REPORT REVEALS CLEARLY THAT THE HEALTH

OF AMERICANS COULD BE IMPROVED BY CHANGING THE DIET TO ONE THAT

CONTAINS LESS FAT.

IN FORMER YEARS, OUR MAIN CONCERN ABOUT NUTRITION FOCUSED ON THE

NEED TO OBTAIN ENOUGH CALORIES AND NUTRIENTS FROM THE DIET TO

MEET PHYSIOLOGICAL REQUIREMENTS, TODAY, AN ABUNDANT FOOD SUPPLY

HAS MADE IT POSSIBLE FOR MOST PEOPLE IN THIS COUNTRY TO AVOID

NUTRITIONAL DEFICIENCY DISEASES.  INSTEAD, NUTRITIONAL PROBLEMS

FOR MOST AMERICANS HAVE SHIFTED TO THOSE CREATED BY

OVERCONSUMPTION OF CERTAIN DIETARY COMPONENTS, OF GREATEST

CONCERN IS OUR EXCESSIVE INTAKE OF DIETARY FAT--AND ITS

RELATIONSHIP TO RISK FOR CHRONIC DISEASES SUCH AS CORONARY HEART

DISEASE, SOME TYPES OF CANCERS, DIABETES, HIGH BLOOD PRESSURE,

STROKES, AND OBESITY, ..*

THESE CONDITIONS HAVE MULTIPLE CAUSES. THEY ARE CREATED BY AN AS

YET INCOMPLETELY UNDERSTOOD COMBINATION OF BEHAVIORAL,


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ENVIRONMENTAL, AND GENETIC FACTORS, SOME OF WHICH ARE BEYOND OUR

-POWERS TO CONTROL.  MY CONCERN IS ABOUT THE FACTORS THAT CAN BE

CONTROLLED.  IF YOU, FOR EXAMPLE, ARE AMONG THE TWO OUT OF THREE

AMERICANS WHO DO NOT SMOKE OR DO NOT DRINK EXCESSIVELY, YOUR

CHOICE OF DIET CAN INFLUENCE YOUR LONG-TERM HEALTH PROSPECTS MORE

THAN ANY OTHER ACTION YOU MIGHT TAKE,

THIS MAY NOT SEEM SURPRISING,  BUT WHAT THIS PIONEERING REPORT

HAS, IN FACT, ACCOMPLISHED IS A RIGOROUS ANALYSIS OF THE EXISTING

EVIDENCE AND THE DEVELOPMENT OF CONCLUSIONS AND RECOMMENDATIONS

BASED ON THE BEST THAT SCIENCE CAN OFFER, ONE WAY TO APPRECIATE

THE ENORMITY OF THIS EFFORT IS TO PUT THIS ANALYSIS IN THE

CONTEXT OF WHAT WAS KNOWN ABOUT THE RELATIONSHIP OF CIGARETTE

SMOKI NG TO HEALTH IN 1964,  SURGEON GENERAL LUTHER TERRY RELEASED

THE FIRST REPORT ON SMOKING AND HEALTH 24 YEARS AGO ON THE

STRENGTH OF EPIDEMIOLOGICAL STUDIES--EXAMINATIONS OF RATES OF

SMOKING AND LUNG CANCER IN POPULATION GROUPS, SUBSEQUENT STUDIES

HAVE SUPPORTED THESE EARLY CONCLUSIONS,

THE PREPARATION OF THIS REPORT HAS BEEN JUST AS PAINSTAKING AND

HAS INVOLVED THOROUGH REVIEW OF AN EVEN BROADER SCIENTIFIC BASE,

OVER A FOUR-YEAR PERIOD OF PREPARATION, THE MORE THAN 50

NUTRITION SCIENTISTS WHO CONTRIBUTED TO THE WRITING OF THIS

REPORT, AND THE NEARLY 200 WHO CONTRIBUTED TO ITS REVIEW, HAD THE

FORMIDABLE TASK OF EXAMINING MORE THAN 2,500 SCIENTIFIC ARTICLES,

THESE ARTICLES PRESENTED THE RESULTS 0F EPIDEMIOLOGICAL


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INVESTIGATIONS, AS DID THE SMOKING REPORT, BUT IN THIS CASE,

ANIMAL AND BIOCHEMICAL STUDIES AND CLINICAL TRIALS WERE ALSO

EXAMINED IN ORDER TO ARRIVE AT ITS CONCLUSIONS AND

RECOMMENDATIONS.

THE FOUR PRINCIPAL CONCLUSIONS OF THIS REPORT ARE THESE:

FIRST: DIETARY CHANGES CAN IMPROVE THE HEALTH PROSPECTS OF
MANY AMERICANS.

SECOND: OVERCONSUMPTION AND IMBALANCES IN INTAKE OF CERTAIN

DIETARY COMPONENTS INCREASE THE RISK OF CHRONIC DISEASES

AMONG AMERICANS,

THIRD: OF PRIMARY IMPORTANCE IS THE NEED TO REDUCE

CONSUMPTION OF FAT, ESPECIALLY SATURATED FAT,

FOURTH: SIMILAR DIETARY CHANGES APPLY ~6 PREVENTION OF

MULTIPLE CHRONIC DISEASE CONDITIONS,

THESE CONCLUSIONS ARE BASED ON EVIDENCE THAT DIETS THAT CONTAIN A

LARGE PROPORTION OF CALORIES FROM FOODS HIGH IN FAT BUT LOW IN

COMPLEX CARBOHYDRATES AND FIBER ARE ASSOCIATED WITH AN INCREASED

RISK OF CORONARY HEART DISEASE, AND THAT SUCH DIETS ARE ALSO

ASSOCIATED WITH INCREASED RISK OF DIABETES, OBESITY, AND SOME

TYPES OF CANCER.  As 1 MENTIONED EARLIER, THESE ASSOCIATIONS ARE


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SUPPORTED BY EVIDENCE DERIVED FROM A RESEARCH BASE EVEN MORE
COMPREHENSIVE THAN THAT FOR THE 1964 REPORT ON SMOKING.

THIS REPORT * : PREPARED PRIMARILY FOR NUTRITION POLICY MAKERS,
                . -

ALTHOUGH THE EVENTUAL BENEFICIARIES WILL BE THE AMERICAN PEOPLE,
THE IMPORTANCE OF THE REPORT'S IMPLICATIONS FOR PUBLIC HEALTH

WILL BE SEEN IN THE MAGNITUDE OF THE PROBLEMS AT HAND, THE

OVERALL CONSISTENCY OF THE EVIDENCE, AND THE SIMILARITY OF

DIETARY PRINCIPLES FOR REDUCING THE RISK OF MULTIPLE DISEASE

CONDITIONS,  THE THREE MAJOR PoLfcy AREAS ARE: DIETARY GUIDANCE
AND EDUCATION, NUTRITION PROGRAMS AND SERVICES! AND NUTRITION

RESEARCH AND SURVEILLANCE,

SOME OF THE REPORT'S IMPLICATIONS FOR DIETARY GUIDANCE AND

EDUCATION INCLUDE THE NEED FOR:

--









--









--

IMPROVED EDUCATION OF THE PUBLIC ABOUT DIETARY CHOICES

MOST CONDUCIVE TO GOOD HEALTH, ESPECIALLY AMONG GROUPS

AT GREATEST RISK--THE POOR, MOTHERS AND INFANTS, AND
OLDER AMERICANS,



IMPROVED USE OF NUTRITION LABELS TO HELP CONSUMERS
IDENTIFY FOODS THAT MEET ITS RECOMMENDATIONS,' AND

MORE AND BETTER EDUCATION IN NUTRITION FOR PHYSICIANS


AND OTHER HEALTH PROFESSIONALS WHO COUNSEL THE PUBLIC

ABOUT DIET AND HEALTH,

IN THE AREA OF NUTRITION PROGRAMS AND SERVICES, THE REPORT'S

FINDINGS EMPHASIZE THE IMPORTANCE OF:

w-









w-









I-









--

IDENTIFICATION AND REMOVAL OF THE BARRIERS TO OPTIMAL

HEALTH AND NUTRITIONAL STATUS AMONG THE GROUPS IN OUR

POPULATION WHO ARE MOST AT RISK OF CHRONIC DISEASE,

THE INCORPORATION OF NUTRITION SERVICES INTO HEALTH CARE
PROGRAMS FOR AMERICANS OF ALL AGES,

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THE NEED FOR INCREASED AVAILABILITY OF FOODS AND FOOD

PRODUCTS THAT ARE LOW IN FATI YET CONSISTENT WITH THE
OTHER DIETARY RECOMMENDATIONS OF THIS REPORT, AND

THE NEED FOR ADHERENCE OF ALL FOOD SERVICE PROGRAMS TO
THE REPORT'S RECOMMENDATIONS,

FINALLY, THE REPORT'S CONCLUSIONS POINT TO THE NEEDS FOR:

-- IMPROVED SURVEILLANCE OF NUTRITIONAL STATUS, ESPECIALLY

. AMONG HIGH-RISK GROUPS, AND


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-- EXPANDED RESEARCH INVESTIGATIONS INTO THE RELATIONSHIPS
  BETWEEN DIETARY FACTORS AND HEALTH,

THIS IS A LARGE ORDER,  IT NOT ONLY POSES A CHALLENGE TO THOSE OF

US IN THE GOVERNMENT, BUT DOES SO IN THE PRIVATE SECTOR AS WELL,

TO HEALTH PROFESSIONALS, TO EDUCATORS, AND TO POLICY MAKERS, IN
SCHOOLS, BUSINESSES, LABOR, AND COMMUNITY GROUPS. LASTLY, THE

CHALLENGE WILL BE AN INDIVIDUAL ONE.

I HAVE ASKED MY COLLEAGUES IN THE PUBLIC HEALTH SERVICE TO TAKE
THE LEADERSHIP IN A NATIONAL CAMPAIGN TO CHANGE THE AMERICAN DIET
TO ONE THAT IS BETTER FOR OUR HEALTH, THEY WILL TELL YOU HOW

THEY PLAN TO MEET THIS CHALLENGE, WILL PRESENT THE REPORT'S

SPECIFIC RECOMMENDATIONS, AND WILL ELABORATE ON ITS FINDINGS AND
IMPLICATIONS, THEY ARE ALSO PREPARED TO ANSWER YOUR QUESTIONS,

HERE IS DR. 3, MICHAEL MCGINNIS, ASSISTANT SURGEON GENERAL AND
CHAIRMAN OF THE DEPARTMENT'S NUTRITION POLICY BOARD, TO PRESENT
THE SPECIFIC RECOMMENDATIONS OF THIS IMPORTANT REPORT,

IINTRODUCTION OF DR, MCGINNISI