Surgeon General C. Everett Koop, issuing his first report on nutrition and disease, said Wednesday that Americans are still eating too much dietary fat, thus increasing their risk of heart disease, some cancers, diabetes, high blood pressure, strokes and other chronic serious conditions.
"If you are among the two out of three Americans who do not smoke or do not drink excessively, your choice of diet can influence your long-term health prospects more than any other action you might take," Koop said at a press conference.
Recommends More Fiber
The 712-page report urged increased consumption of complex carbohydrates and fiber, including fresh fruits and vegetables, and whole grain products.
It warned that improper diet was associated with five of the 10 leading causes of death in this country, including heart disease, cancer, strokes, diabetes and atherosclerosis, a form of hardening of the arteries.
"These associations are supported by evidence derived from a research base even more comprehensive than that for the 1964 report on smoking," he said, referring to the surgeon general's landmark report that linked cigarette smoking to lung cancer.
Health and consumer groups generally applauded the report, although some complained that it did not go far enough.
The report said that, despite the recent sharp decrease in the death rate from heart disease, it is still the leading killer of Americans, resulting in more than 1.25 million heart attacks every year and more than 500,000 deaths. In 1985, illness and death from heart disease cost Americans an estimated $49 billion in direct health care costs and lost productivity, the report said, while the costs of cancer that same year were estimated at $72 billion. More than 475,000 Americans died of cancer in 1987, with more than 900,000 new cases during that same period, the report said.
Further, it said, more than 60 million Americans may have blood cholesterol levels that are too high and about 58 million Americans suffer from high blood pressure. Also, it said, approximately 34 million adults--one-quarter of the population--are significantly overweight.
The fat intake in the average American diet is 37%, the report said. The American Heart Assn., the National Cancer Institute and the American Cancer Society have all recommended that total fat intake be limited to 30%.
See Report Gaining Stature
While Koop's report is similar to others issued by the government in recent years, federal health officials said they believe that the stamp of the surgeon general will enhance the stature of the recommendations.
"Dr. Koop is well respected because of what he has already said on smoking and AIDS--and by coming out with a nutrition report under the surgeon general's name, it is hoped that people will listen more to his advice--after all, he's America's doctor," said Jim Brown, a spokesman for the Department of Health and Human Services.
In past years, Koop said, dietary concerns focused on "the need to obtain enough calories and nutrients" to avoid nutritional deficiencies. But today, he said, "nutritional problems for most Americans have shifted to those created by overconsumption of certain dietary components."
Urge Stable Body Weight
The report also recommended that Americans "achieve and maintain a desirable body weight" through sensible diet and increased exercise and reduce their intake of salt and alcohol, although it failed to propose specific numerical levels for these items.
"It's clear that what people need to do is choose leaner meats, eat chicken without the skin, use little or no fat when cooking and increase their consumption of vegetables and fruits and whole grain products," said Dr. J. Michael McGinnis, deputy assistant secretary for health.
"Most individuals in this country have not made these changes," he added. "We're addressing this report to the vast majority of Americans who have not made these changes. For most people in our population, there is a substantial measure for improvement. You should not consider yourself immune from the recommendations in this report."
Study Took Four Years
Koop said it took four years to prepare the report, which was written by more than 50 nutrition researchers and based on more than 2,500 scientific articles.
The guidelines were developed for those aged 5 and older and should not be applied to younger children, officials said.
Dr. Myron Weisfeldt, president-elect of the American Heart Assn., praised Koop's effort to persuade consumers to eat less fat, salt and calories, but he warned that it "will be a futile effort unless the foods they purchase are clearly labeled to show what they contain."
Michael F. Jacobson, executive director of the Center for Science in the Public Interest, agreed, saying that the Reagan Administration should initiate "vigorous actions," such as requiring nutrition and ingredient information on all processed and fresh foods, including fast foods, and "a crackdown on deceptive food advertising and labeling claims that promise everything from youthfulness to protection from heart disease and cancer."
DIET AND DISEASE
Boxes (+) indicate dietary changes that can reduce the risk of diseases or their complications
Reduce Control Increase Reduce fats calories starch*, fiber sodium Heart disease + + + Cancer + + + Stroke + + + Diabetes + + + Gastrointestinal diseases ** + + +
Control alcohol Heart disease Cancer + Stroke + Diabetes Gastrointestinal diseases ** +
* Complex carbohydrates provided by fruits, vegetables and whole grain products
* * Primarily gall bladder disease (fat and energy), diverticular disease (fiber), and cirrhosis (alcohol)
Source: The Surgeon General's Report on Nutrition and Health , 1988