Summary: The Departments of Agriculture (USDA) and Health, Education, and Welfare (HEW) developed and submitted to Congress a joint proposal for a comprehensive Nutritional Status Monitoring System (NSMS) which recognized that there was no adequate national nutrition surveillance system and proposed to institute one. An effective surveillance system should: promptly identify nutritional needs; pinpoint, within narrow geographic boundaries, specific target groups with nutritional needs; predict future areas of nutritional concern; and provide data which federal agencies can use to monitor the effectiveness of programs for various population groups. A number of weaknesses exist which preclude current programs from functioning as an effective surveillance system: (1) the systems are not always specific enough to identify problems by narrow geographic areas or do not always include important population groups; (2) the systems do not produce information in a timely manner; and (3) the systems do not provide information adequate for evaluating the effectiveness of programs designed to improve nutritional health. The proposed NSMS consists of four interrelated elements to determine nutritional and dietary status, nutritional quality of foods, dietary practices and knowledge, and the impact of nutrition intervention programs. There are four major areas of concern with the NSMS: (1) lack of specificity and agreement between USDA and HEW; (2) lack of agreement on the collaborative, dicennial survey; (3) the role of the system in program evaluation; and (4) the inadequacy of the coordination mechanism. Congress should designate either USDA or HEW as the lead agency for nutrition intelligence gathering, and an outside party should be selected to conduct an independent peer review of the program.
