Reducing the intake of sodium is an important public health goal for Americans. Since the 1970s, an array of public health interventions and national dietary guidelines has sought to reduce sodium intake. However, the U.S. population still consumes more sodium than is recommended, placing individuals at risk for diseases related to elevated blood pressure. Strategies to Reduce Sodium Intake in the United States evaluates and makes recommendations about strategies that could be implemented to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans. The book reviews past and ongoing efforts to reduce the sodium content of the food supply and to motivate consumers to change behavior. Based on past lessons learned, the book makes recommendations for future initiatives. It is an excellent resource for federal and state public health officials, the processed food and food service industries, health care professionals, consumer advocacy groups, and academic researchers.
Micronutrient malnutrition affects approximately 2 billion people worldwide. The adverse effects of micronutrient deficiencies are profound and include premature death, poor health, blindness, growth stunting, mental retardation, learning disabilities, and low work capacity. Preventing Micronutrient Deficiencies provides a conceptual framework based on past experience that will allow funders to tailor programs to existing regional/country capabilities and to incorporate within these programs the capacity to address multiple strategies (i.e., supplementation/fortification/food-based approaches/public health measures) and multiple micronutrient deficiencies. The book does not offer recommendations on how to alleviate specific micronutrient deficienciesâ€"such recommendations are already available through the publications of diverse organizations, including the U.S. Agency for International Development, the Micronutrient Initiative, World Bank, United Nations Childrens' Fund, and the World Health Organization. Instead, this volume examines key elements in the design and implementation of micronutrient interventions, including such issues as: The importance of iron, vitamin A, and iodine to health. Populations at risk for micronutrient deficiency. Options for successful interventions and their cost. The feasibility of involving societal sectors in the planning and implementation of interventions. Characteristics of successful interventions. The book also contains three in-depth background papers that address the prevention of deficiencies of iron, vitamin A, and iodine.
This book reviews the research pertaining to nutrient requirements for working in cold or in high-altitude environments and states recommendations regarding the application of this information to military operational rations. It addresses whether, aside from increased energy demands, cold or high-altitude environments elicit an increased demand or requirement for specific nutrients, and whether performance in cold or high-altitude environments can be enhanced by the provision of increased amounts of specific nutrients.
Eating enough food to meet nutritional needs and maintain good health and good performance in all aspects of lifeâ€"both at home and on the jobâ€"is important for all of us throughout our lives. For military personnel, however, this presents a special challenge. Although soldiers typically have a number of options for eating when stationed on a base, in the field during missions their meals come in the form of operational rations. Unfortunately, military personnel in training and field operations often do not eat their rations in the amounts needed to ensure that they meet their energy and nutrient requirements and consequently lose weight and potentially risk loss of effectiveness both in physical and cognitive performance. This book contains 20 chapters by military and nonmilitary scientists from such fields as food science, food marketing and engineering, nutrition, physiology, psychology, and various medical specialties. Although described within a context of military tasks, the committee's conclusions and recommendations have wide-reaching implications for people who find that job-related stress changes their eating habits.
The model for risk assessment of nutrients used to develop tolerable upper intake levels (ULs) is one of the key elements of the developing framework for Dietary Reference Intakes (DRIs). DRIs are dietary reference values for the intake of nutrients and food components by Americans and Canadians. The U.S. National Academy of Sciences recently released two reports in the series (IOM, 1997, 1998). The overall project is a comprehensive effort undertaken by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (DRI Committee) of the Food and Nutrition Board (FNB), Institute of Medicine, National Academy of Sciences in the United States, with active involvement of Health Canada. The DRI project is the result of significant discussion from 1991 to 1996 by the FNB regarding how to approach the growing concern that one set of quantitative estimates of recommended intakes, the Recommended Dietary Allowances (RDAs), was scientifically inappropriate to be used as the basis for many of the uses to which it had come to be applied.
This volume is the newest release in the authoritative series of quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. Dietary Reference Intakes (DRIs) is the newest framework for an expanded approach developed by U.S. and Canadian scientists. This book discusses in detail the role of vitamin C, vitamin E, selenium, and the carotenoids in human physiology and health. For each nutrient the committee presents what is known about how it functions in the human body, which factors may affect how it works, and how the nutrient may be related to chronic disease. Dietary Reference Intakes provides reference intakes, such as Recommended Dietary Allowances (RDAs), for use in planning nutritionally adequate diets for different groups based on age and gender, along with a new reference intake, the Tolerable Upper Intake Level (UL), designed to assist an individual in knowing how much is "too much" of a nutrient.
This book summarizes information related to public health measures on the prevention, detection, and management of iron deficiency anemia. It presents draft guidelines and recommendations related to this area, as applicable in primary health care and public health clinic settings, and it formulates recommendations for research. This volume is intended both to provide a common frame of reference for health professionals in preventing and treating iron deficiency anemia and to enable the U.S. Centers for Disease Control and Prevention to prepare national guidelines and recommendations for the prevention and control of iron deficiency anemia.
Nearly one out of every three adults in America is obese and tens of millions of people in the United States are dieting at any one time. This has resulted in a weight-loss industry worth billions of dollars a year and growing. What are the long-term results of weight-loss programs? How can people sort through the many programs available and select one that is right for them? Weighing the Options strives to answer these questions. Despite widespread public concern about weight, few studies have examined the long-term results of weight-loss programs. One reason that evaluating obesity management is difficult is that no other treatment depends so much on an individual's own initiative and state of mind. Now, a distinguished group of experts assembled by the Institute of Medicine addresses this compelling issue. Weighing the Options presents criteria for evaluating treatment programs for obesity and explores what these criteria mean--to health care providers, program designers, researchers, and even overweight people seeking help. In presenting its criteria the authors offer a wealth of information about weight loss: how obesity is on the rise, what types of weight-loss programs are available, how to define obesity, how well we maintain weight loss, and what approaches and practices appear to be most successful. Information about weight-loss programs--their clients, staff qualifications, services, and success rates--necessary to make wise program choices is discussed in detail. The book examines how client demographics and characteristics--including health status, knowledge of weight-loss issues, and attitude toward weight and body image--affect which programs clients choose, how successful they are likely to be with their choices, and what this means for outcome measurement. Short- and long-term safety consequences of weight loss are discussed as well as clinical assessment of individual patients. The authors document the health risks of being overweight, summarizing data indicating that even a small weight loss reduces the risk of disease and depression and increases self-esteem. At the same time, weight loss has been associated with some poor outcomes, and the book discusses the implications for program evaluation. Prevention can be even more important than treatment. In Weighing the Options, programs for population groups, efforts targeted to specific groups at high risk for obesity, and prevention of further weight gain in obese individuals get special attention. This book provides detailed guidance on how the weight-loss industry can improve its programs to help people be more successful at long-term weight loss. And it provides consumers with tips on selecting a program that will improve their chances of permanently losing excess weight.
Food safety regulators face a daunting task: crafting food safety performance standards and systems that continue in the tradition of using the best available science to protect the health of the American public, while working within an increasingly antiquated and fragmented regulatory framework. Current food safety standards have been set over a period of years and under diverse circumstances, based on a host of scientific, legal, and practical constraints. Scientific Criteria to Ensure Safe Food lays the groundwork for creating new regulations that are consistent, reliable, and ensure the best protection for the health of American consumers. This book addresses the biggest concerns in food safetyâ€"including microbial disease surveillance plans, tools for establishing food safety criteria, and issues specific to meat, dairy, poultry, seafood, and produce. It provides a candid analysis of the problems with the current system, and outlines the major components of the task at hand: creating workable, streamlined food safety standards and practices.
This volume examines the current state of knowledge concerning the influence of a hot environment on nutrient requirements of military personnel. A parallel concern is ensuring that performance does not decline as a result of inadequate nutrition. The committee provides a thorough review of the literature in this area and interprets the diverse data in terms of military applications. In addition to a focus on specific nutrient needs in hot climates, the committee considers factors that might change food intake patterns and therefore overall calories. Although concern for adequate nutrition for U.S. soldiers in Saudi Arabia prompted the initiation of this project, its scope includes the nutrient needs of individuals who may be actively working in both hot-dry and hot-moist climates.
The incidence of stress fractures of the lower extremities during U.S. military basic training is significantly higher among female military recruits than among male recruits. The prevalence of this injury has a marked impact on the health of service personnel and imposes a significant financial burden on the military by delaying completion of the training of new recruits. In addition to lengthening training time, increasing program costs, and delaying military readiness, stress fractures may share their etiology with the longer-term risk of osteoporosis. As part of the Defense Women's Health Research Program, this book evaluates the impact of diet, genetic predisposition, and physical activity on bone mineral and calcium status in young servicewomen. It makes recommendations for reducing stress fractures and improving overall bone health through nutrition education and monitored physical training programs. The book also makes recommendations for future research to evaluate more fully the effects of fitness levels, physical activities, and other factors on stress fracture risk and bone health.
The latest of a series of publications based on workshops sponsored by the Committee on Military Nutrition Research, this book's focus on emerging technologies for nutrition research arose from a concern among scientists at the U.S. Army Research Institute of Environmental Medicine that traditional nutrition research, using standard techniques, centered more on complex issues of the maintenance or enhancement of performance, and might not be sufficiently substantive either to measure changes in performance or to predict the effects on performance of stresses soldiers commonly experience in operational environments. The committee's task was to identify and evaluate new technologies to determine whether they could help resolve important issues in military nutrition research. The book contains the committee's summary and recommendations as well as individually authored chapters based on presentations at a 1995 workshop. Other chapters cover techniques of body composition assessment, tracer techniques for the study of metabolism, ambulatory techniques for the determination of energy expenditure, molecular and cellular approaches to nutrition, the assessment of immune function, and functional and behavioral measures of nutritional status.
It is a commonly held belief that athletes, particularly body builders, have greater requirements for dietary protein than sedentary individuals. However, the evidence in support of this contention is controversial. This book is the latest in a series of publications designed to inform both civilian and military scientists and personnel about issues related to nutrition and military service. Among the many other stressors they experience, soldiers face unique nutritional demands during combat. Of particular concern is the role that dietary protein might play in controlling muscle mass and strength, response to injury and infection, and cognitive performance. The first part of the book contains the committee's summary of the workshop, responses to the Army's questions, conclusions, and recommendations. The remainder of the book contains papers contributed by speakers at the workshop on such topics as, the effects of aging and hormones on regulation of muscle mass and function, alterations in protein metabolism due to the stress of injury or infection, the role of individual amino acids, the components of proteins, as neurotransmitters, hormones, and modulators of various physiological processes, and the efficacy and safety considerations associated with dietary supplements aimed at enhancing performance.
Obesity is a major public health challenge. More than one-third of the U.S. adult population is considered obese, a figure that has more than doubled since the mid-1970s. Among children, obesity rates have more than tripled over the same period. Not only is obesity associated with numerous medical complications, but it incurs significant economic cost. At its simplest, obesity is a result of an energy imbalance, with obese (and overweight) people consuming more energy (calories) than they are expending. During the last 10-20 years, behavioral scientists have made significant progress toward building an evidence base for understanding what drives energy imbalance in overweight and obese individuals. Meanwhile, food scientists have been tapping into this growing evidence base to improve existing technologies and create new technologies that can be applied to alter the food supply in ways that reduce the obesity burden on the American population. Leveraging Food Technology for Obesity Prevention and Reduction Effort examines the complexity of human eating behavior and explores ways in which the food industry can continue to leverage modern food processing technologies to influence energy intake. The report also examines the opportunities and challenges of altering the food supply-both at home and outside the home-and outlines lessons learned, best practices, and next steps.
In 2007 and 2008, the world witnessed a dramatic increase in food prices. The global financial crisis that began in 2008 compounded the burden of high food prices, exacerbating the problems of hunger and malnutrition in developing countries. The tandem food price and economic crises struck amidst the massive, chronic problem of hunger and undernutrition in developing countries. National governments and international actors have taken a variety of steps to mitigate the negative effects of increased food prices on particular groups. The recent abrupt increase in food prices, in tandem with the current global economic crisis, threatens progress already made in these areas, and could inhibit future efforts. The Institute of Medicine held a workshop, summarized in this volume, to describe the dynamic technological, agricultural, and economic issues contributing to the food price increases of 2007 and 2008 and their impacts on health and nutrition in resource-poor regions. The compounding effects of the current global economic downturn on nutrition motivated additional discussions on these dual crises, their impacts on the nutritional status of vulnerable populations, and opportunities to mitigate their negative nutritional effects.
Thanks to increased knowledge about nutrition, many threats to human health have been curbed. But there is much more to be learned. This new volume identifies the most promising opportunities for further progress in basic and clinical research in the biological sciences, food science and technology, and public health. The committee identifies cross-cutting themes as frameworks for investigation and offers a history of nutrition and food science research with nine case studies of accomplishments. The core of the volume identifies research opportunities in areas likely to provide the biggest payoffs in enhancing individual and public health. The volume highlights the importance of technology and instrumentation and covers the spectrum from the effects of neurotransmitters on food selection to the impact of federal food programs on public health. The book also explores the training of nutrition and food scientists. This comprehensive resource will be indispensable to investigators, administrators, and funding decisionmakers in government and industry as well as faculty, students, and interested individuals.
Globalization of the food supply has created conditions favorable for the emergence, reemergence, and spread of food-borne pathogens-compounding the challenge of anticipating, detecting, and effectively responding to food-borne threats to health. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year. This figure likely represents just the tip of the iceberg, because it fails to account for the broad array of food-borne illnesses or for their wide-ranging repercussions for consumers, government, and the food industry-both domestically and internationally. A One Health approach to food safety may hold the promise of harnessing and integrating the expertise and resources from across the spectrum of multiple health domains including the human and veterinary medical and plant pathology communities with those of the wildlife and aquatic health and ecology communities. The IOM's Forum on Microbial Threats hosted a public workshop on December 13 and 14, 2011 that examined issues critical to the protection of the nation's food supply. The workshop explored existing knowledge and unanswered questions on the nature and extent of food-borne threats to health. Participants discussed the globalization of the U.S. food supply and the burden of illness associated with foodborne threats to health; considered the spectrum of food-borne threats as well as illustrative case studies; reviewed existing research, policies, and practices to prevent and mitigate foodborne threats; and, identified opportunities to reduce future threats to the nation's food supply through the use of a "One Health" approach to food safety. Improving Food Safety Through a One Health Approach: Workshop Summary covers the events of the workshop and explains the recommendations for future related workshops.
Assists policymakers in evaluating the appropriate scientific methods for detecting unintended changes in food and assessing the potential for adverse health effects from genetically modified products. In this book, the committee recommended that greater scrutiny should be given to foods containing new compounds or unusual amounts of naturally occurring substances, regardless of the method used to create them. The book offers a framework to guide federal agencies in selecting the route of safety assessment. It identifies and recommends several pre- and post-market approaches to guide the assessment of unintended compositional changes that could result from genetically modified foods and research avenues to fill the knowledge gaps.
Dietary supplements are widely available through a rapidly expanding market of products commonly advertised as beneficial for health, performance enhancement, and disease prevention. Given the importance and frequent evaluation of physical performance and health as a criteria to join and remain in the military, the use of these products by military personnel has raised concern regarding over-all and long-term efficacy and safety. This evaluation is especially difficult, as many of these supplements contain multiple ingredients, have a changing composition over time, or are used intermittently at doses difficult to measure. This book analyzes the patterns of dietary supplement use among military personnel, examines published reviews of the scientific evidence, and identifies those dietary supplements that are beneficial and/or warrant concern due to risks to health or performance. The book also recommends a system to monitor adverse health effects and a framework to identify the need for active management of dietary supplements by military personnel. Military policy makers, personnel, and recruits will find this book useful, as will nutritionists, athletes, and others working in strenuous environments.
Covering recent developments in food safety and foodborne illnesses, this work organizes information to provide easy access to general and specific topics. It offers comprehensive summaries of advances in food science, compiled from over 620 sources worldwide. The main focus is on health and safety, with extensive reviews of microbiological and medical subjects.
Recognizing the importance of good nutrition for physical and mental status, the Department of Defense asked the Institute of Medicine to guide the design of the nutritional composition of a ration for soldiers on short-term, high-stress missions. Nutrient Composition of Rations for Short-Term, High-Intensity Combat Operations considers military performance, health concerns, food intake, energy expenditure, physical exercise, and food technology issues. The success of military operations depends to a large extent on the physical and mental status of the individuals involved. Appropriate nutrition during assault missions is a continuous challenge mainly due to diminished appetites of individuals under stress. Many less controllable and unpredictable factors, such as individual preferences and climate, come into play to reduce appetite. In fact, soldiers usually consume about half of the calories needed, leaving them in a state called "negative energy balance." The consequences of being in negative energy balance while under these circumstances range from weight loss to fatigue to mental impairments. An individual's physiological and nutritional status can markedly affect one's ability to maximize performance during missions and may compromise effectiveness. With the number of these missions increasing, the optimization of rations has become a high priority.
The present study was conducted by an ad hoc subcommittee of the Committee on Military Nutrition Research. The Subcommittee on Technical Specifications for a High-Energy Emergency Relief Ration was established by the Food and Nutrition Board of the Institute of Medicine in response to a request from USAID and DOD to develop technical specifications for a product for use in food relief after natural disasters or other emergency situations around the world. The specifications are to be used by both agencies in their calls for bids from U.S. food manufacturers to supply such a product.
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