Future of the National Nutrition Intelligence System

The United States does not have a unified or coordinated nutrition intelligence system, but both the Department of Health, Education, and Welfare (HEW) and the Department of Agriculture (USDA) have programs which provide some of this information. With limitations, the existing programs provide: (1) periodic national population surveys to assess and monitor the dietary and nutritional status of the entire population and selected groups at nutritional risk; (2) surveillance at the community level for indicators of nutritional deficiency in selected high-risk groups; and (3) evaluations of the dietary and nutritional impacts of some food asssitance programs. While these activities generate useful information, there are weaknesses which limit their effectiveness as an overall system of nutrition intelligence.

Assessment and monitoring survey data are often untimely, insufficiently specific geographically, omit important population groups, and are inadequate for evaluating programs designed to improve nutritional health. The surveillance mechanism is weak in terms of population group and geographic coverage and reliability of data. A joint proposal by HEW and USDA for a comprehensive system of nutrition intelligence centers around four interrelated elements: (1) nutritional and dietary status; (2) nutritional quality of foods; (3) dietary practices and knowledge; and (4) impact of nutritional intervention. The system will function through recurring national surveys of the population, special surveys of nutritionally at-risk groups, expansion of existing surveillance programs, and studies to evaluate the nutrition intervention program. The system will operate through existing programs within each Department with a coordination mechanism at several levels. Areas of concern with the proposal involve: (1) lack of specificity and agreement between Departments; (2) lack of agreement on how a decennial survey would be conducted; (3) the role of the system in program evaluation; and (4) the adequacy of the coordination mechanism.