DIET AND HEALTH -- Copyright -- Preface -- Contents -- PART I-INTRODUCTION, DEFINITIONS, AND METHODOLOGY -- 1-Executive Summary -- PURPOSE, APPROACH, AND SCOPE OF THE STUDY -- CRITERIA FOR ASSESSMENT -- Integration of the Overall Evidence -- CRITERIA AND PROCESS FOR FORMULATING DIETARY RECOMMENDATIONS -- Assessing Risks and Benefits -- Other Considerations -- Recommendations for Individuals as Opposed to Populations -- MAJOR CONCLUSIONS AND THEIR BASES -- General Conclusions -- Fats, Other Lipids, and High-Fat Diets -- General Conclusion -- Total Fats -- Saturated Fatty Acids -- Polyunsaturated Fatty Acids -- Monounsaturated Fatty Acids -- Dietary Cholesterol -- Trans Fatty Acids -- Carbohydrates, Vegetables, Fruits, Grains, Legumes, and Cereals and Their Constituents -- Protein and High-Protein Diets -- Energy -- Alcoholic Beverages -- Salt and Related Compounds -- Minerals and Trace Elements -- Dietary Supplements -- Coffee, Tea, and Other Nonnutritive Dietary Components -- THE COMMITTEE'S DIETARY RECOMMENDATIONS -- IMPLICATIONS OF RECOMMENDATIONS FOR FOOD CHOICES -- IMPACT ON PUBLIC HEALTH: BENEFITS AND RISKS OF DIETARY MODIFICATION -- IMPLEMENTATION OF DIETARY RECOMMENDATIONS -- RESEARCH DIRECTIONS -- 2-Methodological Considerations in Evaluating the Evidence -- ASSESSMENT OF DIETARY INTAKE OF HUMANS -- Methods for Assessing Dietary Intake -- Group Dietary Data -- Individual Dietary Data -- Accuracy -- Strengths and Weaknesses of Dietary Intake Assessment Methods -- Food Records -- The 24-Hour Recall -- Diet Histories -- Incompleteness of Food Composition Tables -- Biologic Markers -- EVALUATING SINGLE STUDIES FOR QUALITY AND RELEVANCE -- Problems Common to Observational Studies -- Assessment of Dietary Intakes -- Assessment of Disease Incidence and Prevalence -- Effects of Misclassification -- Temporal Relationships -- Confounding.

Discrepancies Between Ecological and Individual Correlations -- Case-Control Studies -- Longitudinal (Cohort) Studies -- Problems Common to Intervention Studies -- Experimental Design -- Duration of Exposure -- Clinical Trial Design -- Clinical Investigations -- Strengths and Weaknesses of Laboratory Experiments -- Studies in Animals -- Short-Term Tests -- EVALUATING THE EVIDENCE AS A WHOLE -- Categories of Research Subjects and Methods -- Underlying Assumptions -- Common Problems in the Weighting of Studies -- Studies in Humans -- Studies in Animals -- Studies in Humans Compared to Studies in Animals and Other Experimental Models -- Experimental Studies Compared to Observational Studies -- Inferring Causality in Associations Between Diet and Chronic Diseases -- Empirical Criteria for Inferring Causality -- Strength of Association -- Dose-Response Relationship -- Temporally Correct Association -- Consistency of Association -- Specificity of Association -- Biologic Plausibility -- SUMMARY -- References -- 3-Dietary Intake and Nutritional Status: Trends and Assessment -- NATIONAL SURVEYS OF DIETARY INTAKE AND NUTRITIONAL STATUS -- Surveys Conducted by the U.S. Department of Agriculture (USDA) -- The Food Supply: Historical Data -- The Nationwide Food Consumption Surveys (NFCS) -- Surveys Conducted by the U.S. Department of Health and Human Services (DHHS) -- Total Diet Study -- National Health and Nutrition Examination Survey (NHANES) -- Nutrition Monitoring in the United States -- National Nutrition Monitoring System (NNMS) -- Coordinated State Surveillance System (CSSS) -- Limitations of NFCS AND NHANES -- Populations Represented by NFCS and NHANES -- Comparability of NFCS and NHANES Data -- Methods of Estimating Dietary Intake -- Limitations of Food and Nutrient Intake Assessment Methods -- Limitations of Food Composition Data.

Use and Misuse of Standards of Dietary Adequacy -- Problems in Assessing Nutritional Status -- NHANES and Nutritional Assessment -- Problems in Using NHANES Data to Study Diet-Chronic Disease Relationships -- TRENDS IN THE FOOD SUPPLY AND DIETARY INTAKES -- Food Energy -- Sources of Food Energy -- Fats, Fatty Acids, and Cholesterol -- Fat Intake -- Dietary Food Sources of Fat -- Dietary Trans Fatty Acids -- Dietary Cholesterol -- Carbohydrates and Caloric Sweeteners -- Food Supply Data -- Carbohydrate Intake -- Caloric Sweetener Intake -- Dietary Sources of Carbohydrates -- Beverage Consumption -- Alcohol Consumption -- Drinking Water -- Dietary Fiber -- Protein -- Protein Intakes -- Vitamins -- Minerals -- Fortification and Enrichment of Foods -- CHANGES IN EATING PATTERNS -- Eating Occasions -- Eating Away from Home -- Snacking -- Dieting -- Alternative Diets -- DO FOOD CHOICES IN THE UNITED STATES REFLECT A CONCERN ABOUT HEALTH? -- PUBLIC OPINION SURVEYS ABOUT DIET AND HEALTH -- SUMMARY -- References -- 4-Genetics and Nutrition -- APPLICABILITY TO NUTRITION -- INBORN ERRORS OF METABOLISM AS A MODEL -- Possible Effects of Heterozygosity -- RESEARCH METHODS IN MEDICAL GENETICS -- GENE-ENVIRONMENT INTERACTION -- OTHER GENETIC FACTORS THAT AFFECT NUTRITION -- GENETIC FACTORS IN SOME CHRONIC DISEASES -- Coronary Heart Disease and Lipids -- Hypertension and Salt -- Diabetes Mellitus -- Obesity -- Epidemiologic Studies -- Animal Studies -- Cancer -- Lactose Malabsorption -- Hemochromatosis -- Alcoholism -- POLICY IMPLICATIONS OF GENETIC VARIATIONS -- SUMMARY -- DIRECTIONS FOR RESEARCH -- References -- 5-Extent and Distribution of Chronic Disease: An Overview -- ATHEROSCLEROTIC CARDIOVASCULAR DISEASES -- Coronary Heart Disease -- Population Differences In Frequency -- Among Countries -- Within the United States -- Time Trends in the United States.

Associations Between Risk Factors in Individuals and CHD -- Age -- Sex -- Ethnic, Racial, and Migrant Differences -- Socioeconomic, Occupational, and Psychosocial Factors - -- Familial and Genetic Factors -- Other Risk Factors -- Stroke -- Population Differences in Frequency -- Among Countries -- Within the United States -- Time Trends in Mortality and Morbidity -- Associations Between Risk Factors in Individuals and Stroke -- Age -- Sex -- Ethnic, Racial, and Migrant Differences -- Socioeconomic, Occupational, and Psychosocial Factors -- Familial and Genetic Factors -- Other Risk Factors -- Peripheral Arterial Disease (PAD) -- Associations Between Risk Factors in Individuals and PAD -- Age -- Sex -- Ethnic, Racial, and Migrant Differences -- Socioeconomic, Occupational, and Psychosocial Factors -- Familial and Genetic Factors -- Other Risk Factors -- HYPERTENSION AND HYPERTENSION-RELATED DISEASES -- Population Differences in Blood Pressure and Hypertension -- Among Countries -- Within Countries -- Time Trends in Frequency and Mortality -- Associations Between Risk Factors in Individuals and Hypertension -- Age -- Sex -- Ethnic, Racial, and Migrant Differences -- Socioeconomic, Occupational, and Psychosocial Factors -- Familial and Genetic Factors -- Associations of Blood Pressure with Relative Body Weight and Obesity -- Associations of Blood Pressure and Hypertension with Atherosclerotic Cardiovascular Diseases and Death -- OBESITY AND RELATED DISEASES -- Population Differences in Frequency -- Between Countries -- Within the United States -- In Migrants -- Time Trends in Frequency -- Associations Between Risk Factors in Individuals and Obesity -- Age -- Sex -- Racial and Ethnic Differences -- Socioeconomic, Occupational, and Psychosocial Factors -- Familial and Genetic Factors -- Obesity as a Risk Factor for Chronic Diseases -- CANCERS.

Esophageal Cancer (ICD 150) -- Stomach Cancer (ICD 151) -- Colorectal Cancer (ICD 153, 154) -- Liver Cancer (ICD 155.0) -- Pancreatic Cancer (ICD 157) -- Lung Cancer (ICD 162) -- Breast Cancer (ICD 174) -- Endometrial Cancer (ICD 182.0) -- Ovarian Cancer (ICD 183.0) -- Bladder Cancer (ICD 188) -- Prostate Cancer (ICD 185) -- OSTEOPOROSIS -- Population Differences in Frequency -- Among Countries -- Within the United States -- In Migrants -- Time Trends -- Associations Between Risk Factors in Individuals and Osteoporosis -- Age and Sex -- Racial and Ethnic Differences -- Socioeconomic, Occupational, and Psychosocial Factors -- Familial and Genetic Factors -- DIABETES MELLITUS -- Population Differences in Frequency -- Among Countries -- Within the United States -- In Migrants -- Time Trends -- Associations Between Risk Factors in Individuals and Diabetes Mellitus -- Age -- Sex -- Racial and Ethnic Differences -- Socioeconomic Factors -- Familial and Genetic Factors -- Other Risk Factors -- References -- PART II-Evidence on Dietary Components and Chronic Diseases -- 6-Calories: Total Macronutrient Intake, Energy Expenditure, and Net Energy Stores -- ENERGY INTAKE -- Historical Trends -- Recent Surveys of Energy Intake -- Factors Influencing Energy Intake -- ENERGY EXPENDITURE -- Measurement of Energy Expenditure -- Components of Energy Expenditure -- Historical Trends -- Factors Influencing Energy Expenditure -- ENERGY BALANCE -- Measurement of Body Fat -- The Association of Caloric Intake with Body Weight and Energy Stores -- Epidemiologic Data -- Clinical Data -- Animal Studies -- Association Between Energy Expenditure and Net Energy Stores -- Epidemiologic Data -- Clinical Data -- Animal Studies -- Energy Balance in Special Situations -- Periods of Rapid Growth -- Pregnancy -- Lactation -- The Elderly.

EVIDENCE ASSOCIATING TOTAL ENERGY INTAKE WITH CHRONIC DISEASES.