DOCOURN! RBSOUB 05606 - (B09058471 Federal Suman Nutrition Research Needs a Coordinated approach To advance Nutrition Knowledge (2 Volumes). PSAD-77-156; B-164031(3). iarch 26, 1978. 212 pp. + 9 appendices (43 pp.). Report to the Conqress; by Elmer 8. Staats, Comptroller General. issue Area: Science and Technology: management and Oversight of Programs (2004); Food (1700). Contact: Procurement and Systems Acquisition Div. Budget Function: Health: Health Research and Education (552). Organization Concerned: Office of management and Budget; National Institutes of Health; Department of Agriculture: Agricaltaral Research Center; Office of Sciesce and Technology Policy. Congressional Relevance: House Comaittee on Agriculture; Senate Commaittee on Agriculture and Forestry; Congress. Authority: Food and Agriculture Act of 1977. Each year the Federal Governseatt spends betwven S73 million and S117 million on husaa nutrition research. TJis represents about 3% of the S3 billion it spends annually on all research in agriculture and health. Several Federal departments and agencies support human nutrition research although no department or aceucy has human nutrition as its primary sissioc, Findings/Conclusions: major knowledge gaps and related research needs have been classified into four broad and interrelated areas that are important for sound nutrition planning whether a nutrition programer target is an entire populaticn, a population subgroup, or an individual. The areas include: human nutritional requirements; food composition and nutrient availability; diet, disease causation, and food safety; and food consumption and nutritional status. Research needs for responding to these knowledge gaps include: long-term studies of human subjects across the full range of both health and disease; comparative studies .-.n populations of different geoographic, cultural, and genetic backgrounds; basic investigation of the functions and interactions of dietary compoients; updated and expanded food composition data; and Improved techniques for assessing long-term toxicological risks. The following barriers to nutrition reaearch persist: lark of central focus and coordination, shortage of nutrition scientists, and uncertainty of Federal funds for extramural research. Secommendations: The Director, Office of science and Technology Policy, should work vith Federa: a-gacles to further define areas of human nutrition research and PAke recommendations to the Director, Cffice of Management and B-dget to: assign, wheore practicable, each area to a lead agency; eliminate unnecessary research that may exist among Federal agencies; and promote Governsent-uide human nutrition research plannaing, coordination, and reporting. (RRS) BY THE COMPTROLLER GENERAL Report To The Congress OF THE UNITED STATES Federal Human Nutrition Research Needs A Coordinated Approach To Advance Nutrition Knowledge The Federal Government spends from $73 to $117 million annually on human nutrition research--about 3 percent of the $3 billion it spends annually on all agriculture and health research. Several Federal departments and agencies support human nutrition research. However, comprehensive, consolidated information on Federal human nutrition research activities is limited, and some barriers to human nutrition research persist. GAO recommends steps for the executive branch to help overcome these barriers. Information needs to be developed concern- ing -- human nutrition requirements; --food composition and nutrient biologi- cal availability; --diet, disease causation, and food safety; and --food consumption and nutritional status. ....~~ ~ Volume I PSAD-77-156 ~~pcCUT~~ovUTS~~~` ~MARCH 28, 1978 COMrPTOLLER QINI'AL OF THE UNITED STATIE WAMSINOTON. O.L O B-164031¢3) To the President of the Senate and the Speaker of the House of Representatives This report identifies major human nutrition research gaps and describes Federal nutrition research activities. We are issuing a second volume with it containing statenments of experts that were used as pert of the review. We made our review pursuant to a March 11, 1976, Lequest by the Chairman of the Senate Select Committee on Nutrition and Human Needs. We are sending copies of this report Lo the Acting Direc- tor, Office of Management and Budgets the Director, Office of Science and Technology Policy; the Secretaries of Health, Edu- cation, and Welfare and Agriculture; and the heads of the other departments and agencies mentioned in the report. Comptroller General of the United States COMPTROLLER GENERAL'S FEDERAL HUMAN NUTRITION RESEARCH REPORT TO THE CONGRESS NEEDS A COORDINATED APPROACH TO ADVANCE NUTRITION KNOWLEDGE D I G E S T Information in this two-volume report should aid the Congress in evaluating the direction and emphasis of Federal human nutrition re- search. The Congress should determine whether the recent initiatives of the Office of Science and Tech- nology Policy and the Office of Management and Budget and the implementation of the Food and Agriculture Act of 1977 will result in the focus, direction, and coordination needed for this important work. The U.S. Government spends between $73 and $117 million annually on human nutrition re- search--about 3 percent of the $3 billion it spends annually on all agriculture and health research. Comprehensive, consolidated info. aa- tion on Federal human nutrition research ac- tivities is lackingi no department or agency has human nutrition as its primary mission. Hearings of the Senate Select Committee on Nutrition and Human Needs demonstrated tht importance of nutrition in public health and diet potential in health care and showed that substantial knowledge remains to be developed before the full benefits of human nutrition can be realized. (See p. 1.) Noting that advancement in nutritici. research is fundamental to improving human health, the Senate Select Committee on Nutrition and Human Needs asked GAO to examine and report on human nutrition research gaps and needs and on changes needed to facilitate progress. (See p. 121.) RESEARCH GAPS AND NEEDS On the basis of opinions and observations of 32 persons in the nutrition field (See vol. II), Federal officials and researchers, and studies on nutrition research and manpower needs, GAO found the following gaps in human nutrition research: J1 . !Upon removal, the report i PSAD-77-156 Cer e shoul~d be noted heren. -- Knowledge of dietary nutrients required to promote or maintain growth, development, or well-being under various stager, and condi- tions of life. (See pp. 7 to 17.) -- Information on the composition of the cur- rent U.S. food supply arid the extent that nutrients are bioloqicail. available. (See pp. 18 co 20.) -- Evaluation of long-term health Consequences of the modern diet. (See pp. 2. to 29.) -- Assessment of the Nation's current nutri- tional ;tatus in terms of dietary excesses, imbalances, as well as deficiencies. (See pp. 30 to 35.) Among the research needs GAO cites f)r respond- ing to the knowledge gap: are: -- Long-term .sudies of human subjects across the full range of both health and disease. (See pp. 14 to 15.) -- Comparative studies in populations of dif- ferent geographic, cultural, and genetic backgrounds. (See pp. 14 to 15.) -- Basic investigation of the functions and interactions o£ dietary components. (See pp. 15 to 17.) -- Updated and expanded food composition data (See pp. 18 to 20.) -- Improved techniques for assessing long- term toxicological risks. (See pp. 27 to 29.) ORGANIZAT .u AND COORDINATION OF HUMAN NUTRITON RESEARCH The two principal Federal agencies that sup- port human nutrition research are the Agricul- tural Research Service (Department of Agricul- ture) and the National Institutes of Health (Department of Health, Education, and Welfare). The Agricultural Research Service is concerned primarily with food and nutrient needs of normal, healthy people. The National Insti- ii tutes of Health focuses on nutritional needs of specific age groups and the prevention and treatment of disease through diet. Although these and other Federal agencies are supporting research addressing critical gaps in nutrition knowledge (see ch. 3), the follow- ing barriers to human nutrition research per- sist: -- Lack of central focus and coordination. -- Shortage of nutrition scie¢'ists. -- Uncertainty of Federal funds for extramural research. Several persons perceived firagmcntation of human nutrition research aniong Federal agen- cies as a likely reason why, some areas are not receiving adequate research. They called for greater coordination of human nutrition research programs to avoid overlapping and re- dundant work. (See p. 60.) For example, the separation of the national food consumption survey (Department f Airiculture) from the nutritional health Ptatus surveys (Department of Health, Education, 'nd Welfare) is seen to result in information that is inadequate for sound nutrition planning. (See p. 61.) The National Institutes of Health supports research on carbohydrates, lipids, vitamins, minerals, and protein, while the Agricultural Research Service has separate laboratories for research on the same nutrients. Other examples include studies of obesity, nutrient availability, food fortification, and dietary fiber. Many scientists and research administrators believe that there is a shortage of capable scientists working in the nutrition field. (See p. 63.) For instance, clinical nutrition research needs individuals trained in health- related areas of nutrition, and there is a shortage of nutritionists with the