American Heart Association Nutrition Committee History
The Nutrition Committee is nowadays considered by some AHA leaders to be activist, perhaps a “do-everything” in contrast to a “do-nothing” committee. But early on, at a time when some members held conservative and cautious views about dietary recommendations for the public, the committee was reticent to use its influence. For instance, one can almost feel the pangs as it moved tremblingly toward this painfully formulated and uncertain national statement on diet in the late 1970s:
“Unfortunately, whether the alteration of diet will actually reduce the risk of CHD has not yet been determined with certainty. One decision would be to make no recommendation about modification of diet because of lack of absolute proof. Another is to propose dietary alteration based on highly suggestive evidence.
“The latter has been the course chosen by AHA. The rationale is taken that some degree of hypercholesteremia is almost universal in the U.S. population. Thus, the whole population can be considered to be at risk compared to populations with much lower cholesterol levels. This premise can be accepted as a reasonable one on which to recommend universal dietary alteration. This might be called the public health approach.” (AHA Nutrition Statement 1979). Indeed.
In the late 1970s, the Nutrition Committee reviewed evidence about diet and heart disease from the Framingham Study, the Seven Countries Study, NiHonSan, and Seventh Day Adventist studies, as well as from geo-pathological studies and intervention trials. Finally, in 1979, it was able to summarize its views with the following advanced idea for its time:
“Indeed, it can be questioned whether a clinical trial is the most appropriate approach to the diet-heart hypothesis. Considering the complexity of the problem, the results from epidemiological comparisons with similar populations on different diets probably provide a better indication of the [long-term] role of diet in coronary disease” (AHA Nutrition Committee Report, 1979).
In addressing its recommendations on salt intake, which up to that point had been as vague and tentative as the recommendations on fat in the diet, the committee included the following tentative (it has not since become much more forthright on the issue of salt):
“It is well recognized that such a reduction (from 12 grams to 5 grams [salt] per day) can be achieved only with great difficulty because of the heavy salting of food by the food industry and the acquired taste for salt in our population. However, this may be a propitious time to begin a general reduction in salt intake.” (AHA Nutrition Committee Report 1979)
“It is well recognized that such a reduction (from 12 grams to 5 grams [salt] per day) can be achieved only with great difficulty because of the heavy salting of food by the food industry and the acquired taste for salt in our population. However, this may be a propitious time to begin a general reduction in salt intake (AHA Nutrition Committee Report 1979).
Only after NIH had invested large sums in preventive trials confined to individuals at highest risk, within an already high-risk entire society, and demonstrating risk lowering, did the AHA move from recommendations for the cardiac patient and the high-risk individual to those for the entire culture at excess risk. Most CVD epidemiological types have long felt that sort of public health policy to be a proper mission of the AHA. (Winston oral history 2005)(Henry Blackburn)
Historical Note:
The first documented meeting of the Nutrition Committee is September 10, 1954. The first Commission for Nutrition Committee states:
The Nutrition Committee of the Council on Community Service and Education of the AHA shall have the following functions:
- To serve in an Advisory and Consultant capacity in the field of nutrition to the committees and councils of the Association for the purpose of making the best possible use of nutritional information in all appropriate service and educational activities.
- To assist staff in the development and review of service and educational programs around the best opinions available covering the whole area of nutrition as it relates to the prevention, treatment and management of cardiovascular diseases.
- To recommend regarding research, in the field of nutrition, that would be significant to the Association’s three-fold program of research, community service and education.
Chairpersons of the Nutrition Committee since its origins:
| 1954-1960 | Herbert Pollack, M.D. |
| 1960-1962 | George V. Mann, M.D. |
| 1962-1964 | Willard A. Krehl, M.D. |
| 1964-1968 | Robert E. Hodges, Ph.D., M.D. |
| 1968-1971 | Rene Bine Jr., M.D. |
| 1971-1973 | John F. Mueller, M.D. |
| 1973-1976 | Robert E. Shank, M.D. |
| 1976-1979 | Edwin Bierman, M.D. |
| 1979-1983 | Scott M. Grundy, M.D. |
| 1982-1986 | W. Virgil Brown |
| 1986-1989 | John C. LaRosa, M.D. |
| 1989-1992 | Alan Chait, M.D. |
| 1992-1995 | Neil J Stone, M.D. |
| 1995-1998 | Ronald M. Krauss, M.D. |
| 1998-2001 | Robert Eckel, M.D. |
| 2001-2004 | Barbara V. Howard, Ph.D., FAHA |
| 2004-2006 | Alice H. Lichtenstein, D.Sc., FAHA |
| 2006-2008 | Lawrence J. Appel, M.D., FAHA |
| 2008-2010 | Linda Van Horn, Ph.D., RD, FAHA |
| 2010-2012 | Frank Sacks, M.D., FAHA |
Reference:
Susan Lucius, susan.lucius@heart.org