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November 14, 1983

SUBJECT:

Questions Regarding Human Nutrition Positions

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Dr. Jack Iacona and Dr. Jerry Combs
The position held by Dr. Jack Iacona was eliminated through the
reorganization of SEA into S & E. Nevertheless, the duties of the
position now held by Dr. Combs are very similar to those once
performed by Dr. Iacona. The lack of qualified applicants caused
the delay in filling this position.

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Dr. Betsy Davis and Dr. Mary Heltsley
The situation is as described above. The positions are similar in
function yet different in title as defined by reorganization of SEA
to S & E.

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We are

Ritva Butrum
She left her position in June of this year for another job.
having difficulty finding a replacement for Ritva as this position
requires a person of level 14 qualifications.

Mr. BROWN. I want to express my thanks to all of you for your contribution. Your statements have been very helpful. We will continue to keep in close touch with you, as I am sure you know.

Ms. JARRATT. Thank you.
Dr. BENTLEY. Mr. Chairman, we thank you, too.

We realize there are a lot of questions that have come up. We hope we can continue the dialog. It is very important to us.

Mr. BROWN. Dr. Bentley, I have a whole sheet here that I didn't get around to.

[See followup questions and answers, appendix B, page 205.)

Our last panel this morning is a panel representing the academic, industrial and science communities. It includes Dr. Malden C. Nesheim, director of the Division of Nutritional Sciences at Cornell; Dr. Irwin Rosenberg, professor of medicine at the University of Chicago; Dr. Gilbert Leveille, director of Nutrition and Health Sciences at General Foods; and Dr. H. David Hurt, who is chairman of the National Nutrition Consortium.

We certainly appreciate your being so patient this morning, gentlemen. We hope we can finish up by 1, with a little discipline on the part of the members of the committee.

We invite you to proceed in the order that I called you. Dr. Nesheim.

STATEMENTS OF MALDEN C. NESHEIM, PH. D., DIRECTOR,
DIVISION OF NUTRITIONAL SCIENCES, CORNELL UNIVERSITY;
IRWIN H. ROSENBERG, M.D., PROFESSOR OF MEDICINE, UNI-
VERSITY OF CHICAGO MEDICAL CENTER; GILBERT A. LE-
VEILLE, Ph. D., DIRECTOR, NUTRITION AND HEALTH SCIENCES,
GENERAL FOODS CORP.; AND H. DAVID HURT, Ph. D., CHAIR-
MAN, NATIONAL NUTRITION CONSORTIUM, INC.
Dr. NESHEIM. Thank you very much, Mr. Chairman.

I have submitted written testimony to the committee and, thefore, I will try to just summarize what I have put before you.

Mr. BROWN. In each case, the full text will appear in the record. Dr. NESHEIM. Thank you.

I direct an academic unit in nutritional sciences. So, therefore, I am involved in the use of much of the Federal resources that are made available for research in human nutrition. So from that perspective, I bring a slightly different view to what the situation in the Federal support of nutrition might be compared to the panels earlier today.

We are extremely dependent upon Federal support for nutrition research to be able to carry out the research that our faculty are interested in doing, that we have a strong commitment in doing. In our own department, for example, about 88 percent of the research funds that we have available come from Federal sources, and only about 12 percent from industry and other sources.

Most of this—the vast majority of it-comes from NIH, reflecting the larger NIH budgets for nutrition. A smaller proportion comes from USDA. Because of our strong commitment in international areas, we also have research support from USAID.

I have outlined in my testimony some of the areas which I think are important in nutrition today, and I break these into basically three separate categories. Within that, there are several ways in which one has to approach questions of nutrition. That is one of the problems. This subject gets so fragmented within the Federal Government, it gets fragmented within universities, and it is a difficult to organize.

For example, we feel that much of the approaches that are important, particularly from the population of the United States, are those that deal with health and the dietary practices in relation to health, and all of the chronic diseases of aging, and so forth, that are involved. We have to undertake very basic biological approaches to understanding those things, but nutrition also needs to look at populations and where they are living, so we take epidemiological approaches. We need research also in areas that help us understand how to translate some of that information into programs and policies that will, in fact, have an effect upon public health of this country.

We also are concerned about the problems of the developing world. If you look outside of the United States, we find that protein-energy malnutrition, nutritional anemia, vitamin A deficiency, iodine deficiency causing endemic goiter--these are major public health problems in the world today. I think that the United States as a world power can't ignore the human cost of this malnutrition worldwide, and has both a moral and economic interest in participating in the alleviation of this world problem. The international issues involved in nutrition include these biological, as well as the social, economic, and even the political issues as to how these are to be taken care of.

Within the United States, I think we need a greater amount of research. We need to increase our efforts in program management and how to evaluate nutrition programs. I think that it is a real shame that we in the nutrition community and others working with it can't come before the Congress and give you some really good information as to how all of the money that the Congress has appropriated for many of these programs is, in fact, really impinging upon the nutritional status of our population. So I think this is an important area of research and we must continue it.

We can also look at the problems when we look at international issues in nutrition. We tend to look at them that way. But I think also that we need to look at them as a division between problems of those who are rich and those who are poor.

We have just completed a study assessing the growth of children in the United States which is based upon data collected in the first and second HANES surveys, for example, and we can demonstrate that we can still show clearly demonstrable poverty-related growth deficits in our children in this country. There is something about our poverty environment that prevents the full expression of a child's biological potential, and nutrition certainly is a component of that.

The problem of support, then, for nutrition within the Federal Government and what agencies are involved has been discussed a great deal as to how these are coordinated and this sort of business. Let me just make a couple of comments about the various agencies that we look to for support.

NIH, or Health and Human Services primarily through NIH, conducts extramural programs that support nutrition research. We look for support for nutrition in the programs of practically all of the NIH institutes. I support that concept, that nutrition is a component of the programs of practically all of the NIH institutes, and we need to continue to look for support in that way.

The diffuse support for nutrition through NIH, however, has made it difficult to maintain support for some activities that strengthen the ability of the biomedical research community to carry out nutrition research. So, from that perspective, many in the nutrition community-and I would like to join in that pleathat some kind of center for nutrition be established within NIH, within one of the existing institutes. We are not asking for a new institute, but within one of the existing institutes-a greater focus for nutrition within NIH be established.

We are particularly concerned with the problems of NIH that were discussed with Dr. Wyngaarden about the difficulties of maintaining numbers of research grants and, at the same time, individual grants are being cut because the resources are not there to continue to cover the costs of this research in the way that we have expected that we needed to have it covered, and also the loss of centers and training moneys are of serious concern in terms of NIH's support.

I also think-and I make a strong plea in my testimony-that NIH could play a greater role in supportive research that deals with the problems of nutrition in the developing world. I think that we have begun to neglect—not only the United States, but in many other developed countries of the world-whole issues of tropical medicine, some of the issues dealing with health problems of developing countries. If we don't, I think, put a little bit more emphasis on that, our own capabilities here in the United States are going to suffer in the long run.

In terms of USDA, the role of USDA in human nutrition research has been expanded in recent years, and particularly with the development of the intramural research centers, such as the units administered by the Agricultural Research Service, I think these centers are a valuable national resource, and I strongly am in favor of their continued support.

I would like to make my comments primarily in relation to the extramural support for research from NIH because that affects me more directly in terms of our faculty and our departmental support.

I have attached to my testimony another report which is a subcommittee of the Experiment Station Committee, which I served on, which had analyzed the extramural support for human nutrition research by USDA over the last few years. Much of the extramural research in USDA is supported by formula funds that come to agricultural experiment stations. Over the last few years, only about 3.9 percent of the formula funds going to State agricultural experiment stations have gone into human nutrition research. Mr. MACKAY. Would you say that again, please?

Dr. NESHEIM. About 3.9 percent of the Hatch and Long-Evans or the 1890 formula funding that comes to agricultural experiment stations has actually gone into human nutrition research. This is a reflection of local priorities and local agricultural experiment stations as to how it is allocated to individual investigators wanting to do nutritional research. That is a relatively limited amount. But when we look at around 1982, there were around $2.8 million in competitive grant funds in human nutrition. That represented 46 percent of the extramural funding available to the nutrition community at large through the CSRS funding that came out of USDA. So it is only $2.8 million, but it was almost 50 percent of the available funding.

That message, to me, is clear that if the Congress is interested in increasing USDA's commitment extramurally to human nutrition research, the way to do that is to increase the competitive grants program because that is going to get into the hands of those who want to do human nutrition research.

Mr. BROWN. Did you speak to your local Congressman about that?

Dr. NESHEIM. I think that we will get support from our local Congressmen about that.

The other thing I called attention to relative to USDA was the fact that USDA does have a major commitment for extension education. It is one of the tenants of our land grant system that we put together research and extension to carry out this program of research and bring it to fruition by a program of extension education.

I think that the linkage there between human nutrition research funding and extension has fallen down. I don't think we are putting enough resources into the research that is going to enable the extension to be done properly, and particularly even in methodologies that are involved in this nutrition education, and so forth.

I also have a statement of support for the Food Consumption Surveys and the HANES surveys. I think those are very important. I was glad to see that the Department said that they were supportive of them. I would like to make sure that the funding, and so forth, of that in fact reflects that support, and that they in fact can go ahead.

Then I would like to call attention to my concern also, as someone outside the Federal departments, that I would like to see the human nutrition staffing of both the Health and Human Services and the U.S. Department of Agriculture really improved. The lack of a senior individual on the national program staff and the ARS has been felt by those of us outside. Dr. Kinney has been extremely supportive of nutrition research, and I don't want to imply any criticism of him in this regard. But I do think that we desparately need to have some expertise at that senior level in the Department in human nutrition.

The CSRS, which we interact with at experiment stations, has lost practically all of its human nutrition people, and I would like to see those restaffed-and Extension Service as well.

I appreciate the opportunity to bring some of these things to your attention today. Thank you very much.

[The prepared statement of Dr. Nesheim follows:]

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