Healthy People Consortium Meeting and Public Hearing
"Building the Next Generation of Healthy People"
November 12 and 13, 1998
Capital Hilton, Washington, D.C.

Nutrition

Discussion within the Nutrition Focus Area Breakout Group included significant emphasis on some generic issues which go beyond nutrition. Other comments on specific nutrition issues were well-voiced during the period of public comment and are not reproduced in this summary.

Nutrition is listed only under Promoting Healthy Behaviors, not in other sections. Should this bechanged?

Data Issues

• Some data that are not representative of national surveys still are worth considering.

• Present data sources do not get to the issues completely.

• Evaluate infrastructure and long-term ability to track what we want to track.

• We need more longitudinal components.

• The lack of a national data base may reflect a lack of emphasis on an objective.

• Data systems at the state level must measure the same things in the same way at periodic intervals in order to accurately monitor the direction in which states are moving.

There was discussion of the number of documents that will be published as part of this initiative and what each will cover. These will cover objectives, data sources, goals/rationales/targets. We need to enlist the partnership of all groups to move things forward. The Federal government cannot provide all the resources for HP2010. One argument was advanced to reduce the planned documents and publish short summaries, with the rationale that Congress won't read more than two pages. Another suggestion favored publication of a concise document of 40 pages, stating that the draft ojectives suffice to meet our WORKING objectives and our common purpose, although not our STRATEGIC objectives.

Concerns were raised about the cultural sensitivity of the objectives in relation to nutrition. It was suggested that culturally diverse approaches and strategies can be given consideration in the introduction, as opposed to integrating this throughout the document. Related to this was the issue of cultural food preparation.

Breakfast in Schools: This is an example of a strategy, not an objective. It promotes food security; uses a food quality index (Healthy Eating Index or H.E.I.); is related to S.E.S.; older children have different minority representation in schools. The old objective to have school meals consistent with the dietary guidelines was deleted. The focus is now all foods consumed at school. The new objective no longer provides the same leverage. Consider "offered" vs."consumed"; "put on the tray" vs. "left on the tray".

The H.E.I. does not address excess intake of food energy among children. This needs to be remedied, given the growing prevalence of obesity among children. There was discussion of the H.E.I. data and how these can be misinterpreted. The highest intake of fruits/vegetables actually occurs among the obese. The H.E.I. does not provide actual measures of calories or fat intake among children, which may be necessary in order to better address childhood obesity.

It was proposed that obesity be selected as a leading health indicator (L.H.I.) and further that a separate chapter be dedicated to obesity under section "Prevent and Reduce Diseases and Disorders".

There was discussion of establishing calcium status, fruit/vegetable intake, or anemia as a L.H.I. It was recognized, however, that obesity is a more far-reaching indicator in ternms of the diseases that it affects.

It was suggested that some measure of nutrition/health education could be considered as a L.H.I.

There is a need for integration of nutrition education topics with all subject matter, not just in a health course. This might be accomplished by having a health promotion specialist position in school districts. There is a need to coordinate with other organizations and disciplines and form partnerships so that we can address community needs in an innovative way. There is a need to teach nutrition and chronic disease in schools and to provide more description of all nutrition education topics listed in the draft document.