more wealthy communities, and it was not always a question of them getting up late.

Lack of parental requirement that they eat a breakfast was also prevalent, but in the urban areas, we found that economic conditions was often the cause.

Mr. PUCINSKI. Of course, we could also argue very effectively that just because the mother doesn't feel a sense of responsibility, the child should not be punished for it and perhaps this program might be even more valuable to that youngster than one who normally would have environment where they would encourage to eat breakfast. You also say on page 3 that in your findings three-fourths of the children buying type A meals at school eat adequate lunch where nearly twothirds of the children eating lunch in any other way have an unsatisfactory meal. One of the problems I have with this whole concept is what constitutes an unsatisfactory meal. I have a 14-year-old son who I think someday is going to turn into a hamburger because he eats hamburger for breakfast, lunch, and dinner and no matter how much my wife tries to alter his eating habits and no matter how attractive she may try to make other meals, and no matter how much the cereal people spend on advertising and making their cereals attractive, my son, like most the other young people, is hung up on hamburgers.

Now, our family physician says, "Well, if he will eat them, don't stop him.” What really constitutes an unsatisfactory meal? I am disturbed about youngsters who go to the corner restaurant around the school where they get a coke and smoke in these modern days a lot more, I guess, but that does not necessarily mean that they are not getting a satisfactory meal when they buy a hotdog or hamburger and some potato chips. What criteria do we use to ascertain what these youngsters who are getting a meal on the fly are really getting an unsatisfactory meal?

Mr. STALKER. In this case the judgments were based on the type A pattern. We said that only 75 percent of the children having a type A lunch ate an adequate meal. You might ask why didn't all have a satisfactory lunch? In the reporting, they could not include foods left on the plate from the type A lunch, and that is why we found only 75 percent. Those that had unsatisfactory lunch were those that discarded some of the required foods and didn't have, for example, any fruits or vegetables in that meal.

Mr. PUCINSKI. When you make a survey like this, do we measure the food that goes at the counter or do we measure the food actually consumed on the table?

Mr. STALKER. This survey was on the basis of the food actually consumed and that is why you won't have a hundred percent. If you were measuring it from the food that goes on the counter according to type A lunch, every one that would take it would have a satisfactory meal.

Mr. PUCINSKI. I wonder if I may impose on your panel for another 6 or 7 minutes?

As you see those lights back there, I have delayed as long as I could but I have to run and answer the rollcall on the floor and I will be right back. And I will also try to bring back some of my members with me. If you will relax for a moment, I will be right back.

(A short recess was taken.)

Mr. PUCINSKI. When we were interrupted by the quorum call, Mr. Stalker, we were talking about the qualifications that you set up for ascertaining whether or not a meal is unsatisfactory. What are those qualifications? How is that done?

Mr. STALKER. This was a 24-hour recall. The children recorded what they ate, working backwards from lunch to breakfast and to the dinner meal. A more complete report is printed in the American School Service Journal, but the survey was based on actual consumption of food by the students in this 24-hour period and this is the result of it. It clearly indicated that those who had the type A lunch fared better than those who did not. But, of course, when you ask about inadequacy, it is those that did not have required exponents which would have included fruits and/or vegetables, milk, bread, and protein

content.

If they had one vegetable or fruit included, it was considered satisfactory.

Mr. PUCINSKI. When you say on page 3 of your statement that 24 percent or 257,000 children ate an inadequate meal and then by combining that with the number of youngsters who had no breakfast, you conclude that 400,000 boys and girls came to school "hungrily". I wonder if we don't do a disservice to our efforts to get this program through by using that kind of a description? These youngsters might have been inadequately fed but, to me, the word "hungrily" means only one thing, a person who is in need of food, and you know this is what gets us into trouble with this legislation. I hear some of the members of the other body saying that millions of American children are hungry. Well, I am not too sure that is true that they are actually hungry. They may be underfed or poorly fed or inadequately fed or their diets may be low in nutritional value, but do we really mean within the commonly accepted definition by Webster that these children were literally hungry?

Mr. STALKER. I think we only meant that in the study of 139,000 that came without a breakfast in the morning. We point out that they did have in the noon meal an unsatisfactory meal but those children that without breakfast would have been without any food for 14 to 16 hours and I think you would consider that group would have been hungry until lunch time.

Mr. PUCINSKI. I think that is a fair statement. I think you are absolutely right. If we talk about children who have no breakfast, I think you are probably correct in stating that 139,000 children came to school hungry, and mind you, I am for this legislation, but I want a record that is going to be able to help us convince the Congress of the needs of this legislation without relying on statistics that can be severely challenged and so I think we will have to correct.

We don't mean 400,000 boys and girls came to school hungry on the survey day. What we mean is 139,000 children came to school hungry

Mr. STALKER. Correct.

Mr. PUCINSKI. And the remainder came to school inadequately fed. Now, of course, you say that only 53 percent of the children surveyed ate a good or satisfactory lunch that day. Forty-one percent ate a poor meal and 6 percent had no lunch at all. In other words, almost half of the children in Massachusetts ate an inadequate noon meal on a survey

day. Have any studies been made, Mr. Stalker, to try to show what is the kind of stamina and attitude of a youngster for the remainder of the day?

I must confess to you that I eat a very light lunch because if I eat a heavy lunch, I become very sleepy in the afternoon when I can least afford it when there is a tremendous amount of work around here, and so I am wondering if there is any correlation between what you have put together to show whether or not the fact that a youngster does not eat an adequate lunch impedes his learning ability the rest of the day? Miss MARTIN. I would pass on school administration after title I service was provided for economically needy children. These superintendents county after county have indicated to us that children did produce at a higher level throughout the day and teachers have said that prior to the free school lunch program that the children just really went to sleep after lunch. Those that had had breakfast in the morning gave out after lunch. But now that they have title I program, the free school lunch program, that the children were able to produce. We do not have any studies on this but these are comments that have been made by school officials in the State.

Mr. PUCINSKI. Do you want to add to that, Mr. Stalker?

Mr. STALKER. That was what I was going to say. There are no specific studies you can get of that type except from observations of the educators. The only other way would be through blood tests and the like and those are not possible. But certainly it is indicated by the comments of teachers as to the performance of children.

Mr. PUCINSKI. Miss Fischer, I have your statement. We will let it go into the record in its entirety at this point. (Statement referred to follows:)

STATEMENT OF MISS FRANCES E. FISCHER, ASSISTANT PROFESSOR OF NUTRITION, CASE WESTERN RESERVE UNIVERSITY, CLEVELAND, OHIO

Mr. Chairman. I am Frances E. Fischer, and I am an assistant professor of nutrition at Case Western Reserve University in Cleveland, Ohio. I am also the immediate past-president of the American Dietetic Association and the current chairman of its Committee on Legislation and Public Policy. My testimony today is on behalf of the Association.

First of all, I want to express the appreciation of our association for this opportunity to present its views. The American Dietetic Association has a membership of approximately 23,000 dietitians and nutritionists who have as their objectives the improvement of nutrition of human beings and the advancement of the science of dietetics and nutrition, as well as education in these and allied

areas.

With your permission, I would like to submit for the record a policy statement adopted by our association entitled "Promoting Optimal Nutritional Health of the Population of the United States," attachment A, and pertinent recommendations of the White House Conference on Food, Nutrition, and Health on Nutrition Education as attachment B.

Three of the recommendations in this policy statement seem particularly pertinent to the legislation before this committee today:

I. Nutritionally adequate food should be available for all individuals and families.

II. Nutrition service under the supervision of qualified nutrition personnel should be a component of all health and health related programs and should be designed to reach the total population with priority to such nutritionally vulnerable groups as infants, children and youth in the growing years, women in the child-bearing years, and the older age population.

III. Nutrition education should be available to all individuals and families and, in schools, should be a basic curriculum requirement. School feeding programs in which there is continued application of current nutrition knowledge and coordination with nutrition education in the classroom should be available to all children.

In 1969, I was privileged to present testimony on the legislation that was enacted to guarantee a lunch to needy children at a free or reduced price. Our Association is convinced that at least one meal that supplies at least one-third of a child's daily nutritional requirements should be furnished every school child. Thus, we fully support this objective of H.R. 5291.

President Nixon stated in his message to Congress (May 6, 1969:

"Millions of Americans are simply too poor to fee 1 their families properly. For them, there must be first sufficient food income. But this alone would only begin to address the problem for what matters finally is what people buy with the money they have. People must be educated in the choosing of proper foods. All of us, poor and non-poor alike, must be reminded that a proper diet is a basic determinant of good health."

This association is in full agreement with this statement and with the emphasis on nutrition education in section 11(a) of H.R. 5291. We recommend, however, that it be specified that all nutrition education programs have a component which emphasizes applied nutrition related to the meals served at school. We believe that it is important that this meal be used as a tool to teach the development of desirable food habits by helping the child to recognize the contribution that this meal makes to the maintenance of his health. For example, this meal is planned to meet one-third of his daily nutritional requirement. It is important, therefore, that he learn about food values as they apply to this meal. It is important that every effort is made to help him and his family learn what their additional nutritional needs are. This meal and the pattern used in planning it can thus become the core for dynamic lessons in applied nutrition. As far back as 1932, Dr. Mary Swartz Rose said, "Every child has a right to nutrition knowledge which will enable him to conserve his own health and eventually that of his children."

Because we are aware of the need for preparation to teach nutrition in the schools, we are pleased under section 11 (a) that the training of school food service personnel and the training of teachers to conduct courses in child nutrition are included as part of "the basic elements of a nutrition education program." To be effective, the teacher must have some education in the subject of nutrition as well as in methods of teaching. We strongly urge that funds be earmarked to promote the incorporation of appropriate nutrition courses in the curricula for teachers preparing to teach grades K through 12 as well as to provide opportunities for continuing education in this subject.

With respect to section 17 and the local costs of supervision, we recommend that the supervision of local program operations (both the meal service itself and the related nutrition education programs) be under the guidance of a qualified dietitian employed by the administrative body.

In accordance with the report of Panel I-I of the White House Conference on Food, Nutrition, and Health, concerning a continuing monitoring system of dietary and nutritional evaluation in which it is recommended that "We should strive to evaluate and reevaluate nutritional status of samples of Americans to measure effectiveness of programs being applied to improve nutritional status," we recommend that there be a system established for the monitoring and evaluating, at regular intervals, the nutritional status of children participating in the "Universal Food Service and Nutrition Education Program." The findings of such a system should be the basis for recommending and implementing changes in both the food service and related nutrition education programs.

We also recommend that there be established in each state an advisory council on community nutrition programs with responsibilities parallel to those outlined for the National Advisory Council on Program Administration, such State council to report to the national council on an annual basis and to State administrative bodies as appropriate.

Finally, we recommend that there be established state and local advisory councils on child nutrition. A program of the magnitude of that which would be established with the passage of H.R. 5291 can succeed only with local involvement and cooperation. Local councils relating to a state council should help to relieve the

1 M. S. Rose. Teachers College Record 33, 391, 1932.

lack of uniformity in the administration of school food service from community to community. Local and State councils could also be of assistance in adapting programs to meet particular nutritional, economic, ethnic, and cultural needs.

Again, I wish to thank the committee for this opportunity to testify on this important legislation and would be happy to answer any questions at this time. ATTACHMENT A

[Reprinted from Journal of the American Dietetic Association, Vol. 55, No. 5,

November 1969]

PROMOTING OPTIMAL NUTRITIONAL HEALTH OF THE POPULATION OF THE UNITED STATES

POLICY STATEMENT OF THE AMERICAN DIETETIC ASSOCIATION

TO FULFILL the objectives of the The American Dietetic Association as stated in its Constitution, i.e., "To improve the nutrition of human beings; to advance the science of dietetics and nutrition; and to improve education in these and allied areas," The American Dietetic Association recommends that:

I. Nutritionally adequate food should be available for all individuals and families.

II. Nutrition service under the supervision of qualified nutrition personnel should be a component of all health and health related programs and should be designed to reach the total population with priority to such nutritionally vulnerable groups as infants, children and youth in the growing years, women in the child-bearing years, and the older age population.

III. Nutrition education should be available to all individuals and families and, in schools, should be a basic curriculum requirement. School feeding programs in which there is continued application of current nutrition knowledge and coordination with nutrition education in the classroom should be available to all children.

IV. Recruitment and training of professional and supportive nutrition personnel should be accelerated and expanded to fulfill the present and projected needs for manpower to provide the services needed to attain and maintain optimal nutritional health of the population.

V. To assist the states and their communities in improving the health of their residents through nutrition, the Federal government should:

(a) Develop and promulgate national nutrition policies;

(b) Recognize the importance of nutrition to health by establishing an organizational unit with responsibility for a comprehensive coordinated nutrition program in all federal agencies administering health services; (c) Establish at policy-making levels, authority which applies to all departments concerned with developing and implementing a coordinated nutrition program;

(d) Provide financial assistance for nutrition surveillance surveys, applied nutrition research and demonstrations, grants-in-aid to support public health nutrition programs, and consumer protection activities; and (e) Establish a uniform system for nation-wide reporting of morbidity and mortality of malnutrition which will provide statistics on the magnitude and location of primary, secondary, and tertiary malnutrition. VI. There be a White House Conference on Nutrition and that nutrition be represented in all White House Conferences with implications for nutritional health.

VII. Participation of the food industry should be solicited in promoting optimal nutritional health of the population.

ATTACHMENT B

RECOMMENDATIONS 45 AND 46 OF PANEL V-4 OF THE WHITE HOUSE CONFERENCE ON FOOD, NUTRITION AND HEALTH NUTRITION EDUCATION NEED

Frequently there is a delay or lack of application of nutrition knowledge to feeding practices. Since nutrition education and school feeding are directly related to health and education, school feeding should reflect the application of current nutrition knowledge to promote optimal health.

We recommend:

(45) Integrate nutrition subject matter into the school curriculum.