- 5

While not desiring to go into the details of execution at the local level, we do feel that some comment should be directed to the Program's educational aspect. Findings from nutritional studies

of the general population indicate that the elderly are relatively uninformed about good nutritional practice compared with other age groups. Two facts stand out: (1) The older person tends to follow the dietary patterns of the community in which he lives. (2) The older person tends to follow the dietary patterns of the years when his own life habits were formed. The development of nutrition education programs, then, becomes a very difficult matter, and it would seem that such programs should be put together on an individual (loca basis and centered around already accepted foods and established eating patterns. Indeed, it appears that with respect to older persons all methods of teaching nutrition facts, food purchasing, and prepar tion need to be designed in varied and special ways.

Turning now to the administrative provisions of S. 1163 we wish to express our satisfaction with the fact that Federal. administration of the program will be placed within the Administration on Aging rather than the Department of Agriculture.

Placing

the program within AoA is most appropriate in that S. 1163 envisions much more than the mere provision of a daily hot meal; rather, it approaches a comprehensive social program and, as such, its purpose can best be achieved through utilization of the resources of the Administration on Aging. Similarly, we feel that, at the state lev the administering agency should be that governmental unit having primary responsibility for responding to the needs of the state's older residents.

- 6 ·

In summary, Mr. Chairman, the nutrition problems of the aged

stem from multiple causes and experience would indicate that no single approach could be effective in overcoming all obstacles to adequate

food and nutrition.

As stated by Jeanette Pelcovits, Nutritionist

and Specialist in Aging with the Administration on Aging and Dr. Douglas Holmes, Director of the Center for Community Research in New York City:

"Certainly many of the aged cannot afford to buy
those foods which are essential to meeting nutri-
tional needs. At the same time, it has become
apparent that the mere provision of an income sub-
sidy would not produce solutions for all the social,
psychological and health-related factors that contri-
bute to malnutrition and undernutrition of the aged.
Raising the income level would not motivate the aged
person to cook for himself alone; it would not help
the invalid to shop; it would not alleviate the feel-
ings of loneliness, rejection, and apathy; it would
not help the aged person to understand the need for
a nutritionally adequate diet, or how to achieve it.
Nor would it produce solutions to such everyday prob-
lems as housing and transportation which are insepar-
able from the problem of nutrition.

Experience to date demonstrates that the most effective
program to combat the food and nutrition problems of
the aged needs to be comprehensive program designed.
to meet all these related needs. The provision
of meals in a group setting is a highly desirable
approach because it fosters social interaction,
facilitates the delivery of other services, and
meets emotional needs of the aged while improving
their nutrition."

Our Associations commend Senator Kennedy and the cosponsors of S. 1163 and we urge this Committee to take immediate and favorable action on it. We view the bill as a significant response to a serious need, and we appreciate your having given us the opportunity to express our thoughts.

Senator STEVENSON. The next witnesses are Mrs. Marjorie M. Donnelly, president, American Dietetic Association, North Carolina State University, Raleigh, N.C., and Mrs. Lois B. Earl, chief nutritionist, Department of Human Resources Community Health Services Administration.

STATEMENT OF MRS. MARJORIE M. DONNELLY, PRESIDENT, AMERICAN DIETETIC ASSOCIATION, NORTH CAROLINA STATE UNIVERSITY, RALEIGH, N.C.

Mrs. DONNELLY. Thank you, Mr. Chairman.

Mrs. Earl has not been able to attend due to illness in her family. Senator STEVENSON. I am sorry to hear that.

Do you have a statement you would like to read or would you care to summarize it?

Mrs. DONNELLY. I believe we can accomplish our purpose more quickly if I read the statement.

Mr. Chairman, I am Marjorie M. Donnelly and I serve as specialist in charge of foods and nutrition of the North Carolina Agricultural Extension Service at North Carolina University in Raleigh.

I am also the president of the American Dietetic Association and it is in that capacity that I am presenting testimony.

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 22,500 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.

The policy statement adopted by the association that is attached to my statement as attachment A states:

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 childbearing years, and the older age population.

With your permission I would submit for the record the entire text of this policy statement.

The aged are a nutritionally vulnerable group and it is for this reason that the American Dietetic Association fully supports S. 1163 and urges its enactment.

I would also like to submit for the record a position paper on nutrition and aging that has been adopted by the American Dietetic Association. It appears at the end of my statement as attachment B. (The information referred to follows:)

452

Journal of The American Dietetic Association

[VOLUME 55

Promoting Optimal
Nutritional Health of the
Population of the United States

A A AAA

Policy Statement of

The American Dietetic Association

TO FULFILL the objectives of 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 A

68-179 - 71-16

Reprinted from JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

Vol. 55, No. 5, November, 1969
The American Dietetic Association
Printed in U.S.A.

The American Dietetic Association Position Paper on Nutrition and Aging

THE AMERICAN DIETETIC ASSOCIATION, in its commit-
ment to the improvement of the health and nutritional
status of aging people, particularly those over the age of
sixty-five years:
A. Recognizes that adequate nutrition for the older
citizen must be considered in connection with the
inter-related economic, social, physiologic, and
psychologic changes coincident with aging (1-3).
B. Recognizes that aging is a life-long process that
begins at conception and, therefore, that nutrition
services under the supervision of qualified person-
nel must be a component of all health and health-
related programs for all age groups, with priority
being given to the nutritionally vulnerable, in-
cluding those over sixty-five years of age (4,5).
C. Supports the existing Commodity Distribution pro-
gram and Food Stamp plan, but believes that:
1. These need to be better geared to the needs
of the elderly.

2. Distribution centers and availability must be
made more accessible.

3. Meal preparation centers designed for group
feeding, each with its own delivery systems
based on modern technology, need to be de-
veloped and put into operation in the near
future to provide nutritionally adequate, low-
cost meals for the aging in their homes or in
restaurants or schools.

4. The aging should be allowed to purchase pre-
pared meals with Food Stamps they buy at a
discount or free, depending on their economic
circumstances (6).

D. Actively supports and/or attempts to supply legis-
lative information and public policy related to
dietetics and nutrition which will:

1. Protect the nutritional health of the population
through the life cycle.

2. Identify and seek solutions to nutrition-related
health problems of the aging.

3. Include, expand, and strengthen the nutrition
component in such programs as preventive
medicine, medical care, rehabilitation, environ-
mental health, education, and welfare, and re-
search.

4. Provide continual periodic assessment of nu-
trition programs and food service operations
for the aging.

5. Fund research to advance knowledge about
the aging process and the relation of nutrition
and dietetics in it.

6. Increase recruitment and educational opportu-
nities for manpower, both professional and sub-
professional, in the field of dietetics so that
sufficient qualified personnel will be available
for the nutritional care of the aged.

7. Assure consumer protection in relation to the cost, quality, and packaging of foods (7, 8). E. Believes in helping the aging to resist being influenced by food faddism and food misinformation by:

1. Counseling and teaching both individuals and
groups of senior citizens, in their homes and in
institutions, in the importance and need for

Attachment B

eating good food and an adequate dict. 2. Interpreting modified diets prescribed by the physician for special conditions.

3. Cooperating with other associations in activities related to combating food misinformation and in the preparation of information for distribution through libraries, newspapers, magazines, radio, television, and other mass media.

4. Cooperating with the Library of Congress by suggesting books and references on foods and nutrition which should be made available to the aging blind in either braille or as talking books (9).

F. Believes that persons knowledgeable about all needs of the aging, particularly the advantages of particular food and dining arrangements, be involved in the planning of all facilities for housing for the aging (10).

G. Supports and participates in public health nutrition programs for the aging who suffer from chronic diseases, such as heart disease, stroke, diabetes, and arthritis (11).

H. Believes that the food service and feeding prac tices in nursing and retirement homes and in institutions and hospitals providing long-term care to the aging need to be continually surveyed and assessed as to their adequacy (11).

References

(1) Nutrition and Human Needs. Part 14-Nutrition and the Aged. Hearings before the Select Committee on Nutrition and Human Needs of the United States Senate, Ninetieth Congress, Second Session, and Ninety-First Congress, First Session, September 9, 10 and 11, 1969. Washington, D. C.: Govt. Prtg. Off. 1969, pp. 5287-5292.

(2) GERONTOLOGICAL SOC.: Working with Older People Vol. II. Biological, Psychological, and Sociological As pects of Aging, Washington, D. C.: Govt. Pitg. Off. 1970.

(3) Promoting optimal nutritional health of the popula tion in the United States. Policy statement of Th American Dietetic Association. J. Am. Dietet. A. 55 452, 1969.

(4) PELCOVITS, J.: Nutrition for older Americans. Am. Dietet. A., in press.

(5) Report of Panel II-4: Aging. In White House Cor ference on Food, Nutrition and Health. Final Repor Washington, D. C.: Govt. Prtg. Off., 1970.

(6) Recommendations Nos. 1, 3, and 4-Meal Deliver Food Stamp Program Revisions; and Education, R search and Development. In Report of Panel IIAging; White House Conference on Food, Nutrit.c and Health. Final Report. Washington, D. C.: Gor Prtg. Of., 1970.

(7) Statement on legislation and public policy. Chicag Amer. Dietet. Assn., 1968 (mimeo).

(8) Provisional Recommendations Nos. 1, 4, and 10.

Panel Recommendations to the White House Confe ence on Food, Nutrition and Health, Provisional Dra 1969.

(9) A.D.A. statement to Senate Subcommittee on Frau Affecting the Elderly. Chicago: Amer. Dietet As 1964 (mimeo).

(10) A.D.A. review and statements on Provisional Reco
mendations, Panel II-4: Aging. White House Cons
ence on Food, Nutrition and Health. Chicago: Am
Dietet. Assn., 1969 (mimeo).

(11) Recommendations to Workshop on Nutrition.
Natl. Health Council Forum, 1969 (mimeo).

Reprinted from Journal of The American Dietetic Association
Vol. 57, No. 5, November, 1970
The American Dietetic Association
Printed in U.S.A.

N.