Origins of the Interdepartmental Committee on Nutrition for National Defense, and a Brief Note Concerning Its Demise

The Nutritional Condition of the Spanish Soldier: "Spain. Nutrition Survey of the Armed Forces, a Report by the Interdepartmental Committee on Nutrition for National Defence 1958"

The study of the nutritional transition in Spain must combine sources concerning the health conditions and the nutritional profile of the population. Such an approximation to the issue is, as a rule, not possible until the two final decades of the 20th century. However, the report on the nutritional status of the Spanish army, undertaken by the American Interdepartmental Committee on Nutrition for National Defence (ICNND) in 1958, combines both approaches. The report is based on the medical examination of 10727 army drafts. First, the article contextualised the report's sample geographically and demographically; second, it validated the variables used statistically; and third, it explored the relationship between the diseases diagnosed, the biomarkers yielded by blood and urine tests, and the diet. The main results were as follows: (a) the report confirmed that the military population under examination did not suffer from severe dietary shortcomings; (b) the sample presents a double bias, geographical (overrepresentation of southern provinces) and institutional (underrepresentation of the land forces).

Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority

BACKGROUND

The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain.

OBJECTIVES

Our aim was to provide an objective, informative summary of 1) the mounting diet-related health burdens facing our nation and corresponding economic, health equity, national security, and sustainability implications; 2) the current federal nutrition research landscape and existing mechanisms for its coordination; 3) the opportunities for and potential impact of new fundamental, clinical, public health, food and agricultural, and translational scientific discoveries; and 4) the various options for further strengthening and coordinating federal nutrition research, including corresponding advantages, disadvantages, and potential executive and legislative considerations.

METHODS

We reviewed government and other published documents on federal nutrition research; held various discussions with expert groups, advocacy organizations, and scientific societies; and held in-person or phone meetings with >50 federal staff in executive and legislative roles, as well as with a variety of other stakeholders in academic, industry, and nongovernment organizations.

RESULTS

Stark national nutrition challenges were identified. More Americans are sick than are healthy, largely from rising diet-related illnesses. These conditions create tremendous strains on productivity, health care costs, health disparities, government budgets, US economic competitiveness, and military readiness. The coronavirus disease 2019 (COVID-19) outbreak has further laid bare these strains, including food insecurity, major diet-related comorbidities for poor outcomes from COVID-19 such as diabetes, hypertension, and obesity, and insufficient surveillance on and coordination of our food system. More than 10 federal departments and agencies currently invest in critical nutrition research, yet with relatively flat investments over several decades. Coordination also remains suboptimal, documented by multiple governmental reports over 50 years. Greater harmonization and expansion of federal investment in nutrition science, not a silo-ing or rearrangement of existing investments, has tremendous potential to generate new discoveries to improve and sustain the health of all Americans. Two identified key strategies to achieve this were as follows: 1) a new authority for robust cross-governmental coordination of nutrition research and other nutrition-related policy and 2) strengthened authority, investment, and coordination for nutrition research within the NIH. These strategies were found to be complementary, together catalyzing important new science, partnerships, coordination, and returns on investment. Additional complementary actions to accelerate federal nutrition research were identified at the USDA.

CONCLUSIONS

The need and opportunities for strengthened federal nutrition research are clear, with specific identified options to help create the new leadership, strategic planning, coordination, and investment the nation requires to address the multiple nutrition-related challenges and grasp the opportunities before us.

The historical evolution of thought regarding multiple micronutrient nutrition

Multiple micronutrient nutrition is an idea that originated in the 1940s and exemplifies the iterative nutritional paradigm. In the first four decades of the 20th century, scientists sought to separate and characterize the vitamins that were responsible for xerophthalmia, rickets, pellagra, scurvy, and beriberi. The dietary requirements of the different micronutrients began to be established in the early 1940s. Surveys showed that multiple micronutrient deficiencies were widespread in industrialized countries, and the problem was addressed by use of cod-liver oil, iodized salt, fortified margarine, and flour fortification with multiple micronutrients, and, with rising living standards, the increased availability and consumption of animal source foods. After World War II, surveys showed that multiple micronutrient deficiencies were widespread in developing countries. Approaches to the elimination of multiple micronutrient deficiencies include periodic vitamin A supplementation, iodized salt, targeted iron/folate supplementation, fortified flour, other fortified foods, home fortification with micronutrient powders, and homestead food production. The prevention of multiple micronutrient malnutrition is a key factor in achieving the Millennium Development Goals, given the important effects of micronutrients on health and survival.

Interdepartmental Committee on Nutrition for National Defense Surveys in Asia and Africa

I suppose I should establish my bonafides for participation in this symposium. I did participate in 3 Interdepartmental Committee on Nutrition for National Defense (ICNND) surveys as far separated as one on the Blackfeet Indian Reservation (1) in Montana and 2 in Asia-Burma (2) and East Pakistan (3). In fact, the Blackfeet Reservation and Burma surveys were my training grounds for becoming the clinical chief for the East Pakistan survey and later the codirector. More importantly, in 1962, I followed Alan Forbes, who is much missed at this symposium, as the deputy to Arnie Schaefer at ICNND and NIH, and did have experience of an office in the Stone House on the NIH campus. There I participated in the transmutation of the ICNND to the Interdepartmental Committee on National Development and its alignment with the Office of International Research at the NIH and a repositioning within the Department of Health and Human Services. It was from this position that ICNND went on to organize some civilian surveys in the mid-1960s, including those in Central America and Panama (4), and it was from this position that the groundwork was laid for the application of ICNND techniques to the first U.S. domestic survey outside of an Indian reservation, culminating in the Ten State Nutrition Survey (5), which documented that there was hunger in America, as well as abroad.