[Congressional Record Volume 142, Number 56 (Monday, April 29, 1996)]
[Senate]
[Pages S4365-S4366]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         SALUTE TO CARL GARNER

 Mr. PRYOR. Mr. President, on Friday, May 3d, Mr. Carl Garner 
of Tumbling Shoals, AR, will retire from Federal Service after 58 years 
as an employee of the U.S. Army Corps of Engineers. He is one of the 
longest consecutive serving Federal employees in the history of this 
Nation, and today I want to take a brief moment to reflect on his 
career and service to our country.
  Carl Garner began his career with the Army Corps of Engineers on June 
16, 1938, following his graduation from Arkansas College--now Lyon 
College. His early career placed him at Bull Shoals Lake in northern 
Arkansas. On March 15, 1959, he was assigned to the new project at 
Greers Ferry Lake as a supervisor for Construction Management 
Engineering.
  Greers Ferry Lake would become Carl Garner's life's work, and today 
you cannot mention one without mentioning the other. On October 14, 
1962, Carl was named Resident Engineer for Greers Ferry Lake, and has 
held that title for 34 years. On October 3, 1963, President John F. 
Kennedy dedicated the last public works project of his life and short 
Presidency on a hillside overlooking the dam at Greers Ferry Lake. Carl 
Garner stood on the podium with the President on that occasion.
  Carl Garner had a vision. He was an environmentalist long before the 
word became common in our vernacular. Carl's vision was that Greers 
Ferry Lake should be pollution free and should reflect the natural 
beauty and landscape of the region. Greers Ferry Lake should be a model 
for the Nation, and today, it is the pearl in our Nation's inventory of 
multiple purpose man-made lakes.
  The vision that Carl Garner has preached for the last 30 years 
involves responsibility. Today, because of the tenacity and foresight 
of this one man, we have a public law, Public Law 99-402, which 
requires all Federal agencies that manage land and water to conduct a 
Federal lands clean-up. Carl has taught us to be responsible with our 
environment through the Greers Ferry Lake clean-up, which occurs on the 
first Saturday following Labor Day each year. Over the years, literally 
hundreds of thousands of volunteers have learned how to be 
environmentally responsible because of Carl's legacy, and Greers Ferry 
Lake is the result.
  Mr. President, I am proud to say that Carl Garner is my friend. His 
impact on my world is profound. Today I salute him and wish him the 
very best in his future endeavors as he enjoys a well earned retirement 
from Federal service.
 Mr. HATFIELD. Mr. President, it gives me great pleasure to 
share with the Senate the accomplishments of an outstanding researcher 
from Oregon Health Sciences University [OHSU], Dr. David A. McCarron. 
His research was recently validated by a team of researchers from 
McMaster University in Hamilton, Ontario. The findings of the research 
was published in the prestigious Journal of the American Medical 
Association, on April 10, 1996, accompanied by an editorial from Dr. 
McCarron.
  The research done at McMaster University has bolstered the findings 
of Dr. McCarron and his team of researchers in dealing with the 
relationship between calcium deficiency in pregnant women, and the 
amount of maternal and fetal morbidity. What the team found was that if 
the amount of calcium taken by pregnant women is increased, the amount 
of maternal and fetal morbidity was significantly reduced. In fact, 
high blood pressure was reduced by 70 percent among women who consumed 
the equivalent of four servings of dairy products a day, or 1,500 
milligrams of calcium.
  What does this mean to all Americans? The 1992 direct health care 
costs related to hypertensive disorders of pregnancy have been 
estimated at $18 to $22 billion. But more importantly, the savings 
would be felt by millions of children who would have a healthier head 
start in life. This is another fine example of the cost savings results 
of biomedical research.
  Let me again point out for my colleagues that an important portion of 
the funding for this program came from the legislative language in an 
appropriations bill. The fiscal year 1992 Agriculture appropriations 
bill led to a grant to OHSU, and Dr. McCarron, to continue their 
research effort in the field of assessing calcium impacts on pregnancy, 
infant birth weight and a wide variety of other nutritional areas. The 
money bridged a gap for the program until further private funds could 
be obtained. The importance of this grant and the continuation of this 
program is now being felt throughout the medical community.
  This is the type of appropriations funding provision that has been 
the subject of heavy criticism in recent years. However, it is this 
type of modest investment, this type of gentle nudge to the 
administration, that leads to huge strides in medical research and 
better health for Americans. The simple fact is, without the funding 
that Dr. McCarron's research received, as a result of this provision, 
the program would likely have ended. The continued funding and granting 
of money to these programs is not only important, it is imperative. 
Billions of dollars will be saved and lives will be improved as a 
result of this work by Dr. McCarron.
  Dr. McCarron is a soldier in the cause of medical research. He not 
only fought for his program, but cleared a path for all medical 
research programs. His tireless devotion to the betterment of the 
community around him has made him an ally to all medical research. His 
research will help hundreds of thousands of mothers and children for 
decades to come.
  I ask to have printed in the Record the JAMA piece written by Dr. 
McCarron.
  The material follows:

      Dietary Calcium and Lower Blood Pressure--We Can All Benefit

       Dietary calcium intake fails to meet recommended levels in 
     virtually all categories of Americans. The health 
     implications of this trend were recently addressed by a 
     National Institutes of Health Consensus Conference, which 
     noted that several other common medical conditions besides 
     osteoporosis are associated with low dietary calcium intake. 
     The articles by Bucher et al in this issue and the April 3 
     issue of The Journal focus on one of these conditions: 
     increased arterial pressure. These meta-analyses of 
     randomized controlled trials of blood pressure and calcium 
     levels in 2412 adults and in 2459 pregnant women provide 
     compelling evidence that both normotensive and hypertensive 
     individuals may experience reductions in blood pressure when 
     calcium intake is increased.
       Do these reports represent this week's favorite nutrient-
     disease relationship, only to be cast aside when a subsequent 
     study fails to confirm these authors' conclusions? Several 
     factors argue against that possibility. Viewed in the context 
     of substantial prior observational and experimental evidence, 
     the biological plausibility that calcium exerts a favorable 
     effect on arterial pressure is strong. Furthermore, these 
     summary analysis provide insights concerning why nutrient-
     disease relationships appear at times inconsistent. A 
     threshold of calcium intake

[[Page S4366]]

     below which arterial pressure increases has been documented 
     in experimental models and in epidemiological reports linking 
     low calcium intake to higher arterial pressures. The 
     threshold range overlaps with the median intake of calcium 
     for adults. As observed by Bucher et al, such a threshold 
     effect predicts that trials composed of participants with 
     varying baseline calcium intake may result in a heterogeneous 
     response, with a negligible or small benefit. The benefits 
     for those individuals whose calcium intake is below the 
     threshold may be masked by the null effect in those whose 
     baseline calcium intake is sufficient.
       To better estimate the cardiovascular impact of achieving 
     the recommended levels of dietary calcium intake, researchers 
     should focus either on subjects who are below the threshold 
     or on those whose threshold has shifted upward because of 
     biological demands. Bucher et al did both. Numerous observers 
     have confirmed our index report that persons with 
     hypertension consume less calcium and thus are more likely to 
     be below the threshold. As that evidence would predict, 
     Bucher and colleagues identified a larger benefit of 
     increasing calcium intake in hypertensive than in 
     normotensive subjects.
       Calcium requirements vary across the life span. When 
     calcium needs are increased, the relationship between calcium 
     intake and biological responses may be amplified. By 
     analyzing separately the randomized controlled trials in 
     pregnant women, Bucher et al tested this relationship. 
     Gestation is a transient period of increased risk of elevated 
     arterial pressure. It is also a period in which the metabolic 
     demand for calcium increases dramatically. In this otherwise 
     healthy, young, normotensive population, Bucher et al 
     established an unequivocal benefit of increasing calcium 
     intake for both mean arterial pressure and the incidence of 
     pregnancy-induced hypertension, which was reduced by 70%. 
     Preeclampsia was reduced by more than 60%
       The observation of Bucher et al that cardiovascular 
     benefits of sufficient calcium intake increased with the 
     quality of the study strongly supports the validity of these 
     findings. The fact that pregnant women 20 years of age or 
     younger benefited more than older pregnant women is another 
     example of increased biological needs for calcium amplifying 
     the relationship between calcium level and blood pressure. 
     Younger pregnant women must provide calcium for the fetus as 
     well as their own continued skeletal growth, thus multiplying 
     their daily requirement. While the current calcium intake 
     recommendation for pregnant women and adolescent females is 
     1200 to 1500 mg/d, their reported median intake is 600 to 700 
     mg/d. As the analysis of Bucher et al revealed, the 
     cardiovascular benefits of consuming sufficient calcium are 
     greater in those whose intake is least adequate for 
     biological demands. As noted by these authors, what remains 
     to be confirmed are the trends for reduced maternal and fetal 
     morbidity. Similarly, the impact of adequate calcium 
     intake on infant and childhood blood pressure must be 
     defined, because calcium needs are increased at this time. 
     The anticipated release of data from the National 
     Institutes of Health trail of Calcium for Preeclampsia 
     Prevention (CPEP) should address these issues.
       For pregnant women the goal is clear, calcium intake must 
     meet metabolic needs. Current intakes in women of 
     childbearing age are not sufficient to assure optimal 
     gestational blood pressure regulation. Younger women can no 
     longer assume that the consequences of inadequate calcium 
     intake will emerge only decades later as osteoporosis. They 
     may occur within 9 months as serious complications for both 
     mother and child. Optimizing calcium intake will benefit not 
     only pregnant women but also society in general. The 1992 
     direct health care costs related to hypertensive disorders of 
     pregnancy and their sequelue have been estimated at $18 
     billion to $22 billion. Using the most conservative estimates 
     of Bucher et al, the savings from increasing calcium intake 
     during pregnancy might reach several billion dollars within 1 
     year.
       In virtually all age, sex, and ethnic categories of the US 
     population, median calcium intake is equal to or less than 
     the minimum recommendation, leaving more than 50% of 
     individuals consuming inadequate amounts of calcium. For 
     those groups at higher risk of hypertension (African 
     Americans, pregnant women, the obese, and the elderly), the 
     situation is worse. Furthermore, consuming adequate calcium 
     is no longer simply a ``women, issue.'' After age 40 years, 
     American men have a median calcium intake of less than 750 
     mg/d. For African-American men, whose risk of hypertension is 
     two to three time that of their white counterparts, the 
     median calcium intake is than than 600 mg/d. There are 
     therefore many reasons, including control of arterial 
     pressure, why every individual should be advised to consume 
     the current recommended level of calcium as a general health 
     measure.
     David A. McCarron, MD.
     Daniel Hatton, PhD.

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